BACKGROUND: In clinic, primary progressive aphasia is a dementia syndrome with the only or prominent characteristic of progressive decline in language function. In advanced stage, deficit of cognitive capability and loss of daily living ability would turn up while memory ability would be relatively preserved. The risk factors of primary progressive aphasia might include poor language ability in childhood and speech center involved by brain trauma.OBJECTIVE: To report the intracerebral image features of 1 case of primary progressive aphasia so as to disclose the general lesion area of the disease , the changes of intracerebral blood volume and metabolism , and connecting fibers among the language domains.DESIGN: Case-report.SETTING: Department of Intervention, Hongqi Hospital, Mudanjiang Medical College, Hei Longjiang Province.PARTICIPANTS: 1 case of patient with primary progressive aphasia,male, 56 years old and with senior high school culture, was in business before the onset of disease. He had "progressive decline in language ability for 3 years" as the main complaint and was diagnosed in Department of Neurology of Beijing Tiantan Hospital on March 20th, 2004. 3 years before that time, the patient could not tell the name of daily living appliances while his comprehensive ability was generally normal. 2 years before, he could still be in business. 1 year before, his language disorder was aggravated, auditory and comprehensive abilities gradually decreased and the changes of character turned up while he could take care of himself and had no obvious degeneration in memory ability. Neural systemic examination: systolic pressure was 130 mmHg and diastolic pressure was 80 mmHg, with clear consciousness, poor language expression ability, and nomenclatural disability while no abnormity was inspected in other neural systematic examinations. He was assessed as sensory aphasia with normal memory and intelligence according to aphasia assessment measuring scale made by the First Hospital of Beijing Medical University.METHODS: First, general magnetic resonance examination was taken to fix the lesion area of the patient. Then, functional magnetic resonance was carried out, which mainly included using magnetic resonance spectroscopy analysis to determine the metabolic rates of N-acetyl-aspartic acid, choline and creatine in the lesion area and then compare them with those in the contralateral corresponding area; Magnetic resonance perfusion imaging was carried out to detect regional cerebral blood volume, regional cerebral blood flow, average pass time and peak time of the contrast medium; Fibertracking method was used to track corticospinal tract and the amount of connecting fibers between left Broca and Wernicke areas and then compare them with those in the contralateral corresponding area.MAIN OUTCOME MEASURES: Detection of the metabolic rates of Nacetyl-aspartic acid, choline and creatine in lesion area and the contralateral area; Detection of regional cerebral blood volume, regional cerebral blood flow, average pass time and peak time of the contrast medium in lesion area and the contralateral area; Comparison of the amount of connecting fibers between left cortioospinal tract and left Broca and Wernicke areas.RESULTS: ①The results of general magnetic resonance: there was atrophy in left temporal and frontal lobes, especially significant in temporal pole, which was manifested as widening of cerebral sulcuses and fissures,thinness of cortex, and enlargement of frontal and temporal angles. ② The results of functional magnetic resonance: N-acetyl-aspartic acid, choline and creatine in left temporal lobe and anterior part of frontal lobe decreased more obviously and regional cerebral blood volume and regional cerebral blood flow in these areas decreased,while average pass time and peak time of the contrast medium in these areas slightly increased as compared with those in the conitralateral areas; fraction of anisotropy values and the tracked fasciculus in left corticospinal tract decreased, and the connecting fibers between Broca and Wernicke areas also decreased as compared with those in the contralateral area.CONCLUSION: The lesion area of primary progressive aphasia is mainly located in left temporal and frontal lobes where low perfusion, low metabolic state and decrease of connecting fibers between Broca and Wernicke areas were shown as compared with those in the contralateral area, which might be the pathogenesis of this case of primary progressive aphasia.

Psychosomatic medicine studies on interaction between body and mind,etiology,pathology,diagnosis,and prevention of psychosomatic diseases.TCM has no concept of psychosomatic medicine,but studies result from research progress of psychosomatic medicine suggested that TCM had obvious advantages in treating these kinds of diseases.

Objective:To detect the effects of porcelain-fused-to-metal(PFM)crown on the periodontal tissue of the restored teeth,and the relationship between the levels of intedeukin(IL)-1β,aspartate transaminase(AST)and alkaline phosphatase(ALP)in gingival crevicular fluid(GCF)and the health condition of periodontal tissue.Methods:Among 28 patients,34 maxillary incisors with PFM crowns were selected for the study.There were 19 Ni-Cr PFM crowns and 15 Au-Pt PFM crowns.The contralateral homonymy natural teeth were healthy and treated as control teeth.The patients were followed up 6 to 8 months after restoring crowns.The values of IL-1β,AST and ALP in GCF were analysed.Results:The concentrations of IL1β and ALP were significantly higher in GCF of Ni-Cr PFM compared with those of control,whereas no significant difference in Au-Pt PFM group compared with that of control.The level of GCF-AST was higher in Ni-Cr PFM and Au-Pt PFM group than that of healthy control.Conclusion:Ni-Cr PFM crowns have negative influence on periodontal tissue,but Au-Pt PFM have little influence on periodontal tissue of the restored teeth.The activity of IL-1β,AST and ALP of GCF are sensitive to reflect the effect of PFM crowns of different materials on periodontal tissue.

Objective To investigate the application of middle segment pancreatectomy (MSP) in treating benign pancreatic tumors and the effect on exocrine function.Methods From Jan.2010 to Feb.2013,19 cases with benign pancreatic tumor undergoing MSP were enrolled in our study.Pre-and postoperative pancreatic exocrine function were studied.Results No perioperative death happened.The tumor diameter was 4.2 to 7.0cm,operative time was 80 to 320 mins,and intraoperative blood loss was 200 to 1000 ml.The retained pancreas was＞l.5 cm at pancreatic head side,and＞5 cm at pancreatic caudal side.Three days after surgery,the peritoneal drainage and amylase was 2.5-12.5 ml and 568.4-1013 IU/L,respectively.Seven days after surgery,the peritoneal drainage and amylase was 1.0-19.8 ml and 45.4-76.3 IU/L,respectively.The postoperative hospitalization stay were 10 to 25 days.Three cases (all single anastomosis) had pancreatic fistula after surgery and healed after 3 months without undergoing surgery again.Patients were followed up for 2 months to 3 years.All patients have a good life quality,without new-onset diabetes and cancer recurrence.MSP had no side effects on pancreatic exocrine function.Conclusion MSP is safe and feasible in treatment of benign pancreatic tumors.

Objective To observe the change of vascular endothelial cells and structure of the auricular posterior vein caused by freezing or pingyangmycin injection alone and freezing in combination with pingyangmycin injection,to investigate the effect of these treatments on the vein. Methods Eighteen rabbits were divided into 3 groups of 6 each, and another rabbit was used as a control. (Pingyangmycin) was injected into the auricular posterior vein in the first group, spray freezing within 20 seconds on the auricular posterior vein was performed in the second group,and freezing in combination with pingyangmycin injection was performed in the third group. Light microscope and transmission electron microscope were used to observe the change of auricular posterior vein in the rabbits.Results Proliferation of endothelial cells,and thickening of vessel wall were induced by pingyangmycin. Thrombus formation, tissue oedema and inflammatory infiltration induced by spray freezing within 20 seconds were reversible. Thrombus formation, proliferation of endothelial cells and thickening of the vessel wall was induced by freezing in combination with pingyangmycin injection.Conclusion Freezing and pingyangmycin injection have the synergistic effect, resulting in the proliferation of endothelial cells, thrombus formation, thickening of vessel wall, and even occlusion of vessels.

ObjectiveTo evaluate the effect and safety of dezocine and sufentanil in intravenous analgesia for postoperative pain. Methods60 patients with ASA Ⅰ～Ⅲ,underwent general anaesthesia operation were divided into two groups randomly,with 30 cases for each group:dezocine 0.6mg/kg and sufentanil 0.6mg/kg was applied to PCIA in group A and B.PCIA was administered with subsequent bolus of 1 ml with lockout time 15 minutes and background infusion of 2ml/h.The analgesic effect was evaluated by VAS,BCS and Ramsay at 1、2、4、12、24、48 hours after operation.The changes of vital sign were also assessed. ResultsThere was no significant difference between two groups in analgesia effect(all P＞0.05)and adverse reaction incidence rate(P＞0.05). ConclusionThe effect of dezocine in intravenous analgesia for postoperative pain could be as satisfaction as that of sufentainyl.

Animals ; Corticosterone ; pharmacology ; Hippocampus ; drug effects ; physiology ; In Vitro Techniques ; Long-Term Potentiation ; drug effects ; physiology ; Male ; Rats ; Rats, Wistar

Objective To explore and establish the effective model of assessment for residen-cy training. Methods Totally 181 residents completed general specialist stage of resident training of Liaoning province in 2010. Assessment process was designed and implemented for general specialist training stage, including theory exam (basic knowledge, professional knowledge and public knowledge) and objective structured clinical examination (OSCE) (standardized patient(SP), computer-based case simulations(CCS) and clinical skills operation). T test and variance analysis were used and P≤0.05 stands for statistically significant difference. Results The total results consisted of two parts, theory examination results (40.00%) and OSCE results (60.00%) and two students failed the examination. The mean score of OSCE was up to standard (66.58±5.50). The mean score of SP and CCS was close to standard. The mean score of clinical skills operation reached a good level. In terms of the OSCE, SP examination and CCS examination, the performance of residents from the two universities had sig-nificant difference (t=3.818, P=0.000; t=5.581, P=0.000; t=5.419, P=0.013) and the performance of residents from the five hospitals also had significant differences. Conclusions The assessment of standardized resident training is improving gradually. Through the widespread application of OSCE in the assessment;it could be helpful to the clinical training of residents.

To analyze six cases concerning clinical features, the treatment process and curative effect of Rhinolith. The six patients had unilateral nasal obstruction, three of them were accompanied with purulent nasal discharge, two had blood with them, one patient had repeated hemorrhage of nasal cavity and two patients had developed headache. By using endoscopic, four irregular stones which are yellow, gray and brown were found in the middle and back end. Because of the severe nasal septum deviation and inferior turbinate polypoid, the stone could not be seen clearly but could be touched by aspirator. In sinus CT examination of 6 cases, it showed incomplete irregular shapes and had high density unilateral nasal cavity in the posterior segment. 4 patients had nasal deviation, 3 patients had ipsilateral sinusitis. 4 patients removed their stone by using endoscopy, 2 patients took the stone away after correction of nasal septum. Pathologic diagnosis: rhinolith. Two patients also had exogenous foreign matters which were considered as pseudo nasal stones.
Back ; Calculi ; Endoscopy ; Headache ; Humans ; Nasal Cavity ; Nasal Obstruction ; Nasal Septum ; Nose Diseases ; pathology ; surgery ; Paranasal Sinuses ; Sinusitis ; Turbinates

Objective To investigate the clinical value of ultrasonography in diagnosis and the significance in the pelvic lymph node metastasis in endometrial carcinoma.Methods Endometrial carcinoma admitted for initial treatment of patients with a total of 60 cases,take color Doppler imaging (GE730),the uterine,vaginal examination, accessories and tumor size,internal echo,and the relationship with the surrounding tissue boundaries of tumor four weeks and internal flow characteristics were observed.Results 60 cases of endometrial carcinoma,50 cases of patients with ultrasound findings with operation pathologic examination results,which were positive in 45 cases (75%),8 cases of false negative (13.33%),false positive in 2 cases (3.33%),5 cases were negative (8.33%). The detection sensitivity was 84.91% (45 /53);the rate of missed diagnosis was 15.09% (8 /53);the rate of misdi-agnosis was 28.57% (2 /7);the specificity was 71.43% (5 /7);Youden index 0.5634.Resistance index,CDFI value of carcinoma of endometrium and pelvic lymph node metastasis,there were significant differences (P <0.05). Conclusion Node metastasis in endometrial carcinoma by ultrasonography in diagnosis of pelvic lymph,ultrasonic diagnosis accuracy rate reaches 83.33%,so by ultrasonographic features can be found audio -visual abnormalities in patients,and timely diagnosis of pelvic lymph node metastases in endometrial carcinoma,to lower the risk of blind treatment to the female brought.