The concept of white matter dementia was first introduced by Filley in 1988.It was found following behavioral neurologica researches that patients with this type of dementia manifested the dysfunctions of sustained attention,memory retrievial,frontal lobe and visualspatial function.They also had psychiatric manifestations but language and extrapyramidal function remained normal.10 diseases of white matter disorders are listed for understanding the clinical characteristics of this type of dementia.

Objective: To analysis the clinical characteristic and pathogenic bacterium of infective endocarditis (IE),and to compare the pathogenic microorganism and vegetation localization between the prosthetic valve endocarditis (PVE) and the native valve endocarditis (NVE).Methods: The data was collected from 266 in-patients who fulfilled Duke Criteria for IE from May 2003 to May 2008 in our hospital.The demographics and clinical data were analyzed retrospectively.Results: There were 243/266 of IE patients suffered from basic heart disease,among them,101 patients with congenital heart disease,77 patients with non-rheumatic valvular heart disease,62 with rheumatic heart disease and 3 with other heart disease.There were 218 (82%) patients with identified vegetation,and the most common vegetation localized at aortic valve,mitral valve,and aortic plus mitral valve in turn.Bacterial cultures were positive in 49.5% of patients.The proportion of Gram-Negative bacillus and Fungi infection had risen in IE.Detection rate of vegetation was lower in PVE patients than that in NVE patients (P<0.01).However,the positive bacterial culture rate was higher in PVE than in NVE (P<0.01).Streptococcus,coagulase negative staphylococcus,gram-negative bacteria showed significant difference between the two groups (P<0.05).The spectrum of microorganism was different between the early and the late PVE patients.The in-hospital mortality rate of PVE was higher than NVE.Conclusion: The spectrum and pathogenic bacterium of IE had changed obviously during the past years.Early diagnosis,bacterial culture with correct antibacterial treatment,transesophageal echocardiography,and active prevention of nosocomial infection should be essential for the disease control.

Objective To observe the neuroprotective effect of Copolymer 1 ( Cop 1) in rats with elevated intraocular pressure (IOP), and explore the clinical application of Cop 1 in the prevention of optic nerve atrophy induced by glaucoma. Methods Thirty adult Wistar rats were rendered for elevation of IOP in both eyes by Shareef-Sharma method. At the third week of IOP elevation, a mixture (1:1) of Cop 1 (100 μg) emulsified in complete Freund's adjuvant (CFA) was injected intracutaneously at two hind footpads in 15 rats (Cop 1 model group), and the other 15 rats were given the same dose of PBS emulsified in CFA (model control group) . Retinal ganglial cell (RGC) retrograde labeling was performed with Fluorogold 6 d later, and retina was taken after 24 h to compared the density of RGC between two groups. Another normal rats were served as blank controls. Results It was found that lymphocytes were accumulated on the histological slices of retina and optic nerve in Cop 1 model group. The rates of RGC loss of Cop 1 model group and model control group were 10. 24% ± 3.75% and 29.00% ±6.92%, respectively. The RGC density in Cop 1 model group was significantly lower than that in model control group (P <0. 05), while there was no significant difference in that between Cop 1 model group and blank control group (P >0.05). Conclusion Intracutaneous injection of Cop 1 can reduce the damage of RGC induced by elevated IOP.

Objective To explore the pathological and imaging features of adenosquamous carcinoma (ASC) of pancreas.Methods Both clinical data and imaging findings in seven cases with pathologically proved ASC of pancreas were analyzed retrospectively.Imaging features were compared with pathological results.Results 1 )The disease mainly occurred in people around 55 years, among the 7 cases ,5 located in the pancreatic head, 2 in the body and tail, with abdominal pain and jaundice as the chief complaint.2)Pathologically, the solid part of the tumor was made up of ductal adenocarcinoma and squamous carcinoma components, with a different rate, while the cystic part was made up of necrosis, liquefaction.3) the imaging of 5 cases with ASC of pancreas in which squamous carcinoma components predominate shows solid and cystic tumors of pancreas, furthermore the ratio of central cystic diameter and the whole tumor diameter increase with the the volum of the tumor.4) There is no partitioning in the cystic part of the tumor, with a few irregular microcyst around it.5 ) The tumor shows a pattern of infiltrative growth, associated dilatation of the common bileduct or pancreatic duct in all cases, pancreatic atrophy in part.6) Squamous carcinoma components of the tumor was the pathologic basis for the formation of the solid and cystic structure in imaging.Conclusions ASC of pancreas is a rare aggressive subtype of pancreatic adenocarcinoma with a worse prognosis than the usual type of ductal adenocarcinoma, although symptoms similar to pancreatic ductal carcinoma.Cases of ASC of pancreas in which squamous carcinoma components predominate have certain characteristic imaging and pathologic features,which is important to early diagnosis.

ObjectiveTo study the clinical effect of sodium aescinate on the edema of limb tibial plate fracture.Methods69 patients with edema of limb of tibial plate fracture were randomly divided into two groups,treatment group(46 cases)and control group(23 cases).Both of them were transfused with 20％ mannitol(250ml,Bid ×7days).In addition,these patients in the treatment group were treated with sodium aescinate(30mg Qd × 7days).ResultsThe repercussive effect of the edema grade in the treatment group were obviously better than those in the control group(P ＜0.05 ).ConclusionSodium aescinate had a remarkable repercussive effect on the limb edema of tibial plate fracture.

AIM: To investigate the efficacy and safety of liduofen in the treatment of patients with osteoarthritis of the knee joint. METHODS: A randomized, double-blind, parallel-controlled, multi-centre study was adapted to compare the efficacy and safety between liduofen and Olfen-75 in 136 patients. Patients were randomly assigned into two groups: liduofen group which was received 75 mg (diclofenac) Liduofen injection (n=69) once a day for seven days and Olfen group which was received 75 mg (diclofenac) Olfen-75 injection (n=67) once a day for seven days. RESULTS: After the treatment, similar improvements for rest pain, pain on exercise, swelling of joint, pressing pain of joint, knee joint bend extend function measured using a 10 cm visual analogue scale was performed in two groups. In Olfen-75 group, the rate of efficacy was 62.69% in the 3rd day, 95.76% in the 5th day and 97.88% in the 7th day. While in liduofen group, the rate of efficacy was 57.97% in the 3rd day, 93.87% in the 5th day and 96.94% in the 7th day. In liduofen and Olfen-75 groups, the progressive rates were 56.72% and 55.07%, respectively. The total improvement rates were 89.85% and 92.54% respectively (P＞0.05), and the rates of side effects were 0% and 1.49%, respectively (P＞0.05). CONCLUSION: Liduofen is an effective and safty drug inthe treatment of patients with osteoarthritis of the knee joint. There is no significant difference on efficacy and safety between the two groups using liduofen and Olfen-75.

Objective To investigate the expression of vascular endothelial growth factor (VEGF)、matrix metalloproteinase-2(MMP-2) and matrix metalloproteinase-9 (MMP-9) in tongue squamous cell carcinoma and the clinical significance.Methods The expression of MMP-2,MMP-9 and VEGF in 60 cases of tongues quamous cell carcinoma tissues and in 20 cases of normal tongues tissues were examined by immunochemistry.Results The expression of MMP-2,MMP-9 and VEGF was higher in tongues quamous cell carcinoma than that in normal pancreatic parenchyma.In cases with lymph nodes metastasis and TNM stage Ⅲ + Ⅳ,the expression of two markers were significantly higher than those without lymph nodes metastasis and TNM stage Ⅰ + Ⅱ (P ＜ 0.05).A positive correlation was found between the expression of VEGF and MMP-2,MMP-9 in tongues quamous cell carcinoma ( P ＜ 0.05 ).Conclusion The expression of MMP-2,MMP-9 and VEGF was closely correlated with lymph nodes metastasis and TNM stage of tongues quamous cell carcinoma(P ＜ 0.05 ).VEGF and MMP-2,MMP-9 play an important role in the development of tongues quamous cell carcinoma,may cooperate with each other.

Objective To discuss the surgery for the patients with bruise of bilateral frontal lobes complicated with central encephalocele.Methods 48 patients diagnosed as bruise of bilateral frontal lobes complicated with central encephalocele were analyzed retrospectively.According to the results of CT and clinical symptoms,timing of surgery was selected.All patients were given unilateral decompressive craniectomy or bilateral decompressive craniectomy.Results All patients were followed up for 1 year.42 cases survived,while 6 cases died.All cases were estimated with GCS:18 cases ( 37.5％ ) were cured excellently,16 cases ( 33.3％ ) were mild morbidity,5 cases ( 10.4％ ) were severe morbidity,3 cases ( 6.3％ ) were in persistent vegetative state and 6 cases ( 12.5％ ) were dead.Conclusion The progression of patients with bruise of bilateral frontal lobes comphcated with central encephalocele were rapid.Diagnosis and treatment at the early stage could improve patients' prognosis.

Positron emission tomography (PET)/CT plays an important role in the diagnosis of bone metastasis from lung cancer,and can reflect the pathophysiological and morphological changes in lesion of bone metastasis.The sensitivity,specificity and the overall accuracy of PET-CT for the diagnosis of bone metastasis in patients with lung cancer are higher than those of routine methods such as X-ray,CT scan,MRI and SPECT/CT.

Objective To discuss the responsibility and quality requirement of head nurses in nursing quality improvement in obstetrical and gynecological department.Methods The responsibility of head nurses in nursing quality improvement in obstetrical and gynecological department were investigated by carrying out surveys in patients of obstetrical and gynecological department.Results The quality of head nurses needed improvement and their responsibility required definitude,thus the satisfaction degree of patients and nursing quality can be improved.Conclusions Through this research,we find that the head nurses not only need good quality,but also should be given definite responsibility and certain service,supervising and management power,if so,they can fully exert their role in nursing work.