Objective To investigate the influencing factors of cognitive impairment in patients with lacunar infarction (LI) and to analyze the features of cognitive impairment at different parts in patients with LI.Methods Patients with LI and normal controls were enrolled in the study.Mini-Mental Status Examination (MMSE) was used to evaluate cognitive impairment.California Verbal Learning Test (CVLT),Verbal Fluency Test (VFT),Benton Judgment of Line Orientation Test (BJLOT),Digit Symbol-Coding subtest (DSCT),Paced Auditory Serial Addition Test (PASAT),and Wisconsin Card Sorting Test (WCST)were used to evaluate attention,information processing speed,memory,verbal fluency,and executive function.Results A total of 98 patients with LI and 20 normal controls were enrolled.Of the 98 patients with LI,31 had cognitive impairment and 67 were cognitively normal.The proportions of hypertension,diabetes,multiple LI,and severe white matter lesions,as well as the level of low-density lipoprotein cholesterol in the CI group were significantly higher than those in the normal controls (all P ＜ 0.05).Multivariate logistic regression analysis showed that hypertension (odds ratio [OR] 5.391,95％ confidence interval [CI] 1.515-19.182; P=0.009),diabetes (OR 4.679,95％ CI 1.428-15.339; P=0.011),multiple LI (OR 6.458,95％ CI 1.797-23.213; P =0.004),and severe white matter lesions (OR 6.724,95％ CI 1.440-27.331; P=0.014) were the independent risk factors for the occurrence of cognitive impairment in patients with LI.Among the 98 patients with LI,56 were pure LI (no white matter lesions),but 5 of them were excluded because they could not complete neuropsychological tests.Finally,51 patients were enrolled and were compared and analyzed with the normal control group.Compared to the normal control group,the number of correct answers of WCST-64 in the corona radiata/semi-oval center group (n =15) reduced significantly,and the number of sustained errors increased significantly (P ＜ 0.05).The scores of verbal fluency,DSCT,PASAT,as well as the number of correct answers and the number of completed categories of WCST-64 decreased significantly in the basal ganglia group (n =20) (all P ＜0.05).The scores of short-term memory and delayed recall,as well as the scores of DSCT and PASAT decreased significantly in the thalamus group (n =16) (all P ＜0.05).Conelusiuns Hypertension,diabetes,multiple LI,and severe white matter lesions are the independent risk factors for occurring cognitive impairment in patients with LI.The corona radiata/semi-oval center infarction is easy to complicate with impaired executive function.Basal ganglia infarction is associated with verbal fluency,information processing speed,attention,and executive function impairment.The cognitive impairment of thalamic infarction is mainly manifested in the memory,attention,and information processing speed.

Trace dements molybdenum was discovered in 1778.As a rare refractory metals,it is one of the essential trace elements for human body.Molybdenum is mainly distributed in the skeleton,absorbed in the digestive tract,and excreted by the kidney,bile,sweat,and hair.Molybdenum is involved in metabolism mainly through two ways:inorganic salts,and molybdenum-containing enzyme cofactor.An appropriate mount of molybdenum is important for life activities of the human body,whereas molybdenum deficiency and molybdenum accumulation may cause the multiple system dysfunction.Molybdenum imbalance can be prevented and treated by diet or supportive therapy.

Objective To investigate the clinical efficacy of warm needling moxibustion in treating irritable bowel syndrome of liver depression and spleen deficiency type and explore the mechanism of its action.Methods Ninety-two patients with irritable bowel syndrome of liver depression and spleen deficiency type were randomly allocated to treatment and control groups, 46 cases each. The same acupoints were selected in the two groups. The treatment group received warm needling moxibustion and the control group, conventional acupuncture. The abdominal overall symptom grading score was observed before and after treatment. The clinical therapeutic effects were compared between the two groups.Results The total efficacy rate was 95.6% in the treatment group and 77.8% in the control group; there was a statistically significant difference between the two groups (P<0.05). In the two groups, there was a statistically significant difference in the abdominal overall symptom grading score at the end of treatment and two months of follow-up compared with before treatment (P<0.05). There was a statistically significant difference in the Hamilton Depression Scale score at the end of treatment and two months of follow-up between the treatment and control groups (P<0.05). In the control group, there was a statistically significant difference in the abdominal overall symptom grading score at two months of follow-up compared with the end of treatment (P<0.05).Conclusion Warm needling moxibustion is an effective way to treat irritable bowel syndrome of liver depression and spleen deficiency type.

Objective To investigate the relationship between the mutation of the exon 4 of leptin receptor gene(4Lys 109 Arg)and left ventricular function and renal hemodynamics in patients with hypertension.Methods From December 2005 to December 2006,digoxin marked primer enzyme coloration technique was used to detect the 4Lys 109 Arg polymorphism.The color Doppler echocardiography was used to detect the left ventricular function and the renal hemodynamics.The study covered 90 patients with hypertension (hypertension group)and 52 controls (control group).Results The frequencies of 4Lys109Arg in hypertension group and control group had no significant difference.The hypertension with GG genotype was significant difference in left ventrieular ejection fraction(LVEF),E/A,left ventrieular fractional shortening(LVFS),resistance index(BI),pulsatility index(PI)(P<0.05).The hypertension with GA genotype had significant difference in LVEF,E/A,LVFS(P<0.05).In hypertension group,LVEF,E/A,LVFS.RI and PI had significant difference between GG and AA genotype(P<0.05).In control goup,RI had significant difference between GG and AA genotype(0.65 ±0.02 vs 0.63±0.02,P<0.05).Conclusion The renal hemodynamics and the left ventricular function are associated with 4Lys109Arg polymorphism.

Objective To observe the effects of target-controlled infusion ofpropofol on hemodynamics during anesthesia induction in intracranial aneurysms interventional treatment.Methods Ninety patients in intracranial aneurysms interventional treatment were divided into three groups by random digits table method with 30 cases each:control group (group C),plasma drug concentration in target controlled infusion group (group P) and effect of chamber drug concentration in target controlled infusion group (group E).The induction of anesthesia:patients in group C were single intravenous injected with propofol of 2 mg/kg; patients in group P were set target plasma concentration of propofol with 4 μ g/ml.Patients in group E were set the effect target concentration of propofol with 4 μ g/ml.Three groups were set the concentration of remifentanil 4 ng/ml with plasma controlled infusion,and cisatracurium was injected with 0.2 mg/kg.Electrocardiogram,mean arterial pressure (MAP),heart rate (HR),end-tidal pressure of carbon dioxide,bispectral index,pulse oxygen saturation were continuously monitored.Before the time of induction (T0),immediately before intubation (T1),after intubation 1 min (T2),3 min (T3),5 min (T4),10 min (T5),arterial pressure and HR were recorded and the number of using vasoactive drugs were recorded.Results The level of MAP and HR among three groups at T0 had no significant difference (P ＞ 0.05).The level ofMAP and HR in three groups at T1 was significantly lower than that at T0.(P ＜ 0.05).The level of MAP and HR in group P was lower than that in group E and group C,and there was significant difference (P ＜ 0.05).The incidence of using vasoactive agen in group P was significantly lower than that in group C [6.7％(2/30) vs.40.0％ (12/30)],and there was significant difference (P ＜0.01).Conclusion Hemodynamics is relatively stable during anesthesia induction using plasma target controlled infusion with propofol in patients undergoing interventional therapy for intracranial aneurysm.

Radiotherapy is the primary treatment modality for nasopharyngeal carcinoma(NPC) which can effectively control the disease.Oral cavity,anatomically near nasopharyngeal region is the main area for the occurrence of complication of radiotherapy.Second primary malignancy (SPM) in oral cavity is an important factor interferencing NPC patients survival rate.The etiology of oral SPM is unclear and,the prognosis is poor.The research of it is still in exploration.

Purpose To assess the initial and follow-up CT findings of proven pulmonary invasive fungal disease (IFD) in patients after hematopoietic stem cell transplantation (HSCT), and to look for the signs for the prognosis. Materials and Methods A retrospective investigation of the CT features and the evolution process was carried out in 13 patients with proven pulmonary IFD diagnosed by histological examination. Results The first abnormal CT finding showed single nodule or mass in 5 cases, two nodules or masses in 2 cases, multiple nodules or masses in 2 cases, patchy consolidation in 1 case, patchy ground glass opacity (GGO) in 1 case, multiple stripes and GGOs in 1 case, and multiple consolidations in peribronchial distribution in 1 case; the presence of reversed halo sign (RHS) was found in 7 cases, not including 4 cases with aspergillosis. The median initial diameter was 32.0 mm, and the median maximum diameter was 51.5 mm. 9 of them reached partial remission after drug treatment, and 9 accepted operation resection. In the end, there were 5 cases cured, 1 keeping stable, 2 suspected recurrent on imaging, and 5 dead. In summary, it showed less than 2 nodules or masses in 7 patients (group 1) and other imaging patterns in 6 patients (group 2), the former group had smaller max diameter (t=4.397, P<0.01), the effective rate within 12 weeks, operation resection rate and final cure rate of group 1 were 85.7%, 100.0% and 71.4%, and those of group 2 were 16.7%, 33.3% and 0, respectively, with group 1 all higher than group 2 (P<0.05). Conclusion Nodule or mass is the most common CT finding of pulmonary IFD in HSCT recipients, with high incidence of reversed halo sign, less than 2 nodules or masses on the first CT imaging may be associated with better prognosis.

Breast cancer (BC) is the most common cancer of women worldwide. Over the past 20 years, the incidence and mortality rates of BC have increased and have ranked the first place of the female cancer in our country. In the theory of traditional Chinese medicine (TCM), etiology and pathogenesis of BC have long been recognized. Base on these basic theories, TCM physicians have developed their typical opinions on BC treatment. Liver depression has been considered as the key point and the main syndrome type in BC syndrome differentiation. It showed the impor-tance of liver depression syndrome in breast cancer and provided ideas for clinical treatment. With the development of modern science, several experimental and clinical studies have found that liver depression syndrome is closely related to BC. Further study on liver depression syndrome in BC procession may not only helpful to screen high-risk BC groups and improve the early diagnosis rate but also helpful to find new drug targets.

Objective To observe the effect of memantine on NR1 ,NR2A ,NR2B of N‐methyl‐das‐partate receptor and learning or memory ability in vascular dementia (VaD) rats .Methods Thirty adult male SD rats were randomly divided into sham operation group ,VaD model group and me‐mantine treatment group (10 in each group) .A rat VaD model was established by permanent liga‐tion of bilateral common carotid arteries .Rats in memantine treatment group received gastric me‐mantine 10 mg/(kg · d) 1 week after operation while those in model group received normal sa‐line .Five weeks after operation ,their learning or memory ability was tested by Morris water maze test ,expressions of NR1 ,NR2A and NR2B were detected by Western blot .Results The escape latency was significantly longer whereas the percentage of target quadrant and expression levels of NR1 ,NR2A and NR2B were significantly lower in model group than in sham operation group (P=0 .001 ,P=0 .002 ,P<0 .05) .The learning or memory ability and the expression levels of NR1 ,NR2A and NR2B were significantly higher in memantine treatment group than in model group but still lower in memantine treatment group than in sham operation group ( P< 0 .05) . Conclusion Memantine can improve the learning or memory ability of VaD rats by upregulating the expression of NR1 ,NR2A and NR2B in their hippocampus .

Objective To observe the effect of rosuvastatin and memantine on EPC and learning or memory ability in VaD rats .Methods Forty adult male SD rats were randomly divided into sham operation group ,VaD model group ,memantine treatment group ,rosuvastatin treatment group , and memantine+rosuvastatin treatment group (combined treatment group) (8 in each group) .A VaD model was established by permanent ligation of bilateral common carotid arteries .The ani‐mals in rosuvastatin treatment group ,memantine treatment group and combined treatment group received gastric rosuvastatin 10 mg/(kg · d) ,memantine 10 mg/(kg · d) and memantine 10 mg/(kg · d)+rosuvastatin 10 mg/(kg · d) for 4 weeks while those in model group received gastric normal saline .Five weeks after operation ,the learning or memory ability was tested by Morris water maze test ,the escape latency and percentage of target quadrant were calculated ,the circulat‐ing EPC were detected by flow cytometry ,and the MVD in hippocampaus was assyed with vWF immunostaining .Results Five weeks after operation ,the learning or memory ability was signifi‐cantly lower in model group than in sham operation group (P< 0 .01) whereas the learning or memory ability ,the percentage of circulating EPC and the MVD in hippocampus were significantly higher in 3 treatment groups than in model group (P<0 .05) .Conclusion Rosuvastatin and me‐mantine can effectively improve the learning or memory ability of VaD rats by mobilizing their cir‐culating EPC and increasing the MVD in their hippocampus .However ,the effect of memantine or rosuvastatin does not differ greatly w hen they are used alone .