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.

CD4 + CD25 + regulatory T cells are produced in the thymus and have anergic and immunosuppressive properties.Researchers measured the antibody level related with CD4+ CD25+ T cells,CD4+ CD25hi T cells,CD4+ CD25+ Foxp3 and CD4+ CD127 in regenerative anemia,leukemia,ITP,NHL,MDS.Then they got the conclusions that regulatory T cells decreased in the autoimmune blood diseases and increased in the neoplastic diseases.The regulatory T cells have great prospect in the treatment of autoimmune diseases,allergic diseases,transplant rejection,tumors and specific vaccination.

Objective To investigate the reason of fracture internal fixation of locking plates and conventional plate in the treatment of femoral fractures.Methods A total of 198 patients with femoral fracture taken plate fixation were selected as our subjects.Of which,the locking plate were used in 87 cases served as control group and 111 cases had traditional plate fixation served as study group.Fracture fixation rate in patients were follow-up and the reasons for broken were analyzed.Results Fracture fixation occurred 5 cases (4.5％,5/111) in the locking plate,and 3 cases (3.4％,3/87) in traditional plate,and the difference was not significant (x2 =0.053,P =0.987).Fracture reason included plate fracture (4 cases),fracture of screws (2 cases) and plate fracture complicated with breakage of screw (2 cases).Iatrogenic factors lead fracture fixation was 30.0％ (3/10),significantly higher in patients with rehabilitation exercises errors (6.9％,2/29; x2 =3.851 ; P =0.046).Both iatrogenic factors and rehabilitation exercises errors caused fracture fixation rate was 100％.Conclusion Iatrogenic factors combined rehabilitation exercises error was the main reasons in fracture fixation.We should properly choose fixation methods and correctly guide the postoperative functional exercise for patients.

Objective To explore the role of LGR5 positive intestinal stem cells in repairing damage of intestinal mucosa resulting from endotoxemia and to determine whether the damaged intestinal mucosa can be repaired by regulating the proliferation and differentiation of intestinal stem cells.Methods Wistar rats were randomly divided into control group,lipopolysaccharide(LPS) group,and glucagon-like peptides 2(GLP-2) group.LPS was injected interaperitoneally into rats of the LPS group and GLP-2 group at a dose of 5 mg/kg(1 ml/kg) ; saline(1 ml/kg) was injected into the rats of control group.GLP-2 250 μg/kg(1 ml/kg) was rnjected into the rats of GLP-2 group 1 hour after the LPS injection.The terminal ilea were collected from 8 rats in each group at 6 h,24 h,and 72 h post-LPS injection.Structrral changes in the intestinal epthelium of every group were observed under the light microscope and electron microscope.The expression of LGR5 in intestinal stem cell was detected by immunohistochemical method and RT-PCR.Results In general,intestinal edema and hyperemia was observed in both LPS and GLP-2 groups at 6 h.Fracture and lodging of villi,infiltration of inflammatory cells,and visible exudate within the cavity were observed under light microscopy.The inflammatory injury was less severe in the GLP-2 group than in the LPS group at 6 h.The injury of intestina mucosa gradually repaired between 24 h and 72 h after injection of LPS in both LPS group and GLP-2 group.Importantly,samples taken from GLP-2 group and LPS group at the same time point indicated that the GLP-2 group recovered significantly better than the LPS group.And expressions of LGR5 mRNA in GLP-2 group at 6h,24h,72 h(0.13 ±0.05,0.16±0.05,0.16±0.04) were significantly higher than those in LPS group respectively (0.52 ±0.09,0.73 ±0.14,0.48 ±0.24),as shown by RT-PCR,and than that in control group(0.12 ±0.03) (P ＜ 0.05).Conclusion Exogenous GLP-2 may facilitate intestinal stem cell proliferation,thereby promoting the recovery of intestinal mucosa damaged by endotoxemia.GLP-2 appears to promote stem cell proliferation,differentiation,and gradual migration of stem cells from the intestinal crypts to the damaged mucosa.

Objective To investigate the influence of intra-articular injection of hyaluronic acid at early stage on articular cartilage cells apoptosis in elderly patients with articular injury.Methods A total of 89 elderly patients with articular injury from Jan.2013 to Oct.2014 were randomly divided into observation group and control group.In control group,40 cases were treated with conventional surgery and anti-inflammatory therapy.In observation group,49 cases were treated intraarticular injection of hyaluronic acid added to conventional therapy.The apoptosis rate of articular cartilage cells,cell cycle and proliferation index were compared between the two groups.Results The apoptosis rate of articular cartilage cells was lower in observation group than in control group [(4.08±0.74)％ vs.(6.41±0.54)％,t=16.403,P＜0.001].The ratio of G0/Giin articular cartilage cells was lower in observation group than in control group[(83.5 ± 3.5)％ vs.(91.7± 4.3)％,t10.275,P＜0.001].The ratios of S and G2/M and the proliferation index in articular cartilage cells were lower in control group than in observation group[(3.5 ± 0.3)％ vs.(8.2± 2.4)％,(4.7±0.6)％ vs.(8.5±1.8)％ and (9.1±1.1)％ vs.(16.7±1.9)％,t=12.293,12.731 and 22.198,respectively,all P＜0.001].Conclusions Intra articular injection of hyaluronic acid at early stage decreases the apoptosis rate of articular cartilage cells,helps articular cartilage cells turnover and improves the recovery of articular injury in elderly patients.

Objective To study the effect of letrozole plus metformin on infertility of polycystic ovary syndrome(PCOS).Methods According to the digital table,90 patients with infertility of PCOS were randomly divided into the control group(n =45 cases) and the treatment group(n =45 cases).The patients of the control group were treated though clomiphene,while the patients of the treatment group were treated though letrozole plus metformin.The ovulation rate,pregnancy rate,sex hormones and insulin resistance were detected.Results The homeostasis model assessment of insulin resistance index (HOMA-IR) was (5.72 ± 2.37) before treatment and (3.16 ± 1.39) after treatment in the treatment group.HOMA-IR was (5.69 ± 2.40) before treatment and (4.81 ± 2.06) after treatment in the control group.There was a significantly decrease in the treatment group (t =3.7246,P ＜ 0.05).The ovulation rate was 80％ in the treatment group,while 60％ in the control group,the difference between the two groups was significant(x2 =4.06,P ＜0.05).The pregnancy rate was 48.9％ in the treatment group,while 28.9％ in the control group,the difference between the two groups was significant (x2 =5.77,P ＜ 0.05).Conclusion Letrozole plus metformin could promote the ovulation and decrease insulin resistance.

Objective To analyze the effect of health education and caring experience on the patients of non neonatal acquired deficiency of vitamin K dependent coagulation factor deficiency (VKDCF) due to rodenticide poisoning.Methods A total of 55 patients diagnosed with acquired deficiency of VKDCF through determining anticoagulant rodenticide concentration in blood were provided with health education and rational medication for 6 months.The patients with unclear poisoning reasons and definite diagnosis were analyzed and given corresponding nursing measures.Results All patients received treatment and corresponding nursing measures.Hemorrhage improved quickly in 2 days and was under control in 1 week.No recurrence happened in half year follow-up visit.Conclusions Systematic treatment and standardized health education are clinically effective on the patients of non neonatal acquired deficiency of VKDCF,and can gain active cooperation and favorable comment of the patients.

Objective To explore and analyze the pathogenic bacteria distribution and its prognostic factors of pneumonia patients after chronic intracerebral hemorrhage. Methods 375 pneumonia patients after chronic intracerebral hemorrhage who were treated in the rehabilitation department of Qingdao Workers' Sanatorium of Shandong Provincial Federation of Trade Unions from July 2011 to July 2013 were chosen as the research objects. The clinical data of all the subjects were collected, and the pathogenic bacteria distribution and its prognostic factors were analyzed by SPSS 17.0 statistical package. Results Good prognosis rate of the pneumonia patients after chronic intracerebral hemorrhage was 85.60%, the bacterium was the main pathogenic bacteria, accounted for 42.51%. Multiariable logistic regression analysis showed that swallowing reflex disorder (OR=12.922,P<0.01) and the combination of respiratory system disease (OR=3.327,P<0.01) were risk factors for the prognosis of pneumonia patients after chronic intracerebral hemorrhage, and chest breathing training (OR=0.695,P<0.01) was the protection factor. Conclusion The prognosis of pneumonia patients after chronic intracerebral hemorrhage is tolerable. The gram-negative bacterium is the main pathogenic bacteria. The prognostic factors of pneumonia patients after chronic intracerebral hemorrhage is concerned with swallowing reflex obstacles, other combination of respiratory system diseases and chest breathing training.In the process of clinical medical, we should strengthen the chest breathing training guidance and improve the prognosis of patients, especially in high-risk groups.

At present,stroke has become one of the diseases seriously harming the human life and the quality of life with its high morbidity,disability,and mortality.Therefore,clinicians need to find more effective indicators to identify the clinical conditions and outcomes,and guide the treatment.Studies in recent years have suggested that the biological markers have important clinical value for guiding the treatment of stroke.

Objective:To explore the relationship between the expression of EGFR and STAT3 in human la-ryngeal papilloma and its biological behavior. Method: Reverse transcription polymerasechain reaction(RT-PCR), immunohistochemical staining and Western blot were used to evaluate the mRNA and protein expression of EGFR and STAT3(p-STAT3) in 42 laryngeal papilloma tissues and 15 samples of normal laryngeal tissue, and the rela-tionship between the protein expression of them and clinicpathological parameters was also analysized. Result: The mRNA expression levels of EGFR and STAT3 in laryngeal papilloma tissue were significantly higher than that in normal laryngeal tissue(P<0.05,P<0.01). Protein positive expression of EGFR and p-STAT3 were also detected in a significantly greater proportion of laryngeal papilloma than normal laryngeal tissue by immunohistochemistry and western blot(P<0.01,P<0.05). There was relationship between EGFR and p-STAT3 overexpression in la-ryngeal papilloma(P<0.05). The expression p-STAT3 was correlated with the recurrence and canceration of la-ryngeal papilloma(P<0.05). Conclusion: The EGFR-STAT3 signal transduction pathway may be involved in the pathogenesis of laryngeal papilloma,, and the persistent activation of STAT3 gene plays an important role in the recurrence and canceration of laryngeal papilloma.