Objective To explore the clinical features of spongiform encephalopathies occurred in the elderly and causes of misdiagnosis. Methods Clinicopathological diagnosis of a 79 year old man with acute spongiform encephalopathy was reported. Clinical, EEG and MRI characteristics of eight old patients with spongiform encephalopathy in China confirmed by neuropathology were reviewed. Results Elder patients with spongiform encephalopathies had an acute onset and a rapid developing course, and all patients presented with progressive dementia accompanied by various clinical manisfestations of extrapyramidal diseases. EEG recordings with typical periodic sharp wave complexes (PSP) was shown in six cases, and abnormal T2 signal in both basal ganglia by MRI in one case. Three cases were misdiagnosed as cerebral vascular disease and one cse as encephalitis herpes cimplex. Conclusions Spongiform encephalopathy in the elderly should be paid more attention to since their early clinical symptoms are similar to that of the acute cerebral vascular diseases. It is suggested that early diagnosis of spongiform encephalopathy could be made basing on the combination of the typical clinical characteristics and dynamic EEG findings, and brain biopsy if necessary, to avoid nosocomial spreading.

To study the features of sporadic Creutzfeldt Jakob Disease(CJD) in China. Three cases of CJD diagnosed by clinical, electroencephalography (EEG), MRI,14 3 3 brain protein in cerebrospinal fluid (CSF),pathology and immunocytochemistry prion protein (PrP) were analysed. The average age of the onset of CJD was sixty four years.The onset was acute in all three cases. Visual and cerebellar signs appeared comparatively early besides mental and myoclonic symptoms,but signs of pyramidal damage were not obvious relatively. In all the three cases EEG showed periodic sharp wave complexes. Calcification of pallidumes was showed by CT in one case. Brain atrophy was not so obvious in three cases on MRI. One case showed increased signal surrounding both lateral ventricles of the brain on T2 weighted images. Biopsy,narked changes in the frontal lobe in one case,and in the occiptal lobe in another case were observed,with disappearance of nerve cells and extensive astroglial proliferation and spongiform state. Anti PrP immunocytochemistry had detected PrP deposits in the one biopsy,but the 14 3 3 brain protein was negative in CSF. The diagnosis of CJD was made clinically, but the 14 3 3 brain protein was suspicious one time and negative in another test. It suggested that CJD in Chinese patients may consist of the following features: 1. The onset was comparatively early in age. 2. The onset was acute. 3. Visual and cerebellar signs appeared comparatively early besides mental and myoclonic changes,but signs of pyramidal damage were not obvious relatively. 4. Brain atrophy was not remarkable. 5. Farther study with MRI should be carried out. 6. Negative 14 3 3 brain protein test could not rule out CJD.

Objective:To investigate the relation of cerebral blood flow(CBF) and memory in patients with cerebral infarction. Methods:The cerebral blood flow of 30 patients with cerebral infarction and 20 healthy controls was measured. The WMS was used for memory function assessment. Results: CBF and memory performance in patients group were lower than those of controls. There was a statistically significant correlation between CBF and memory performances. Conclusion: The decreasing of CBF was an important causal factor to the memory dysfunction in cerebral infarction patients.

Three cases of Pick's disease diagnosed by clinical observation, MRI, SPECT, PET and pathology were analysed. Compared with Alzheimer′s disease, Pick's disease consisted of the following features: ①The changes in personality, judgement, affection and emotion, Kl?ver Bucy syndrome, progressive non fluent aphasia,and the defect of semantic memory were prominent in the early stage, but the disturbance of cognition and visuospatial ability were relatively late. ②Marked cerebral atrophy in the temporal pole was showed in MRI. ③Hypoperfusion and hypometabolism could be found in the frontal and / or temporal cortexes on SPECT or PET scans. It is important to understand the salient features for early diagnosis of Pick's disease in clinic.

ObjectiveTo study the change of cerebral blood flow and hemorheology in patients with brain post-traumatic syndrome (PTS) and heavy cerebral trauma.Methods122 cases(A group) of PTS and 113 cases(B group) of heavy cerebral trauma were explored the anterior cerebral artery (ACA),middle cerebral artery (MCA),posterior cerebral artery (PCA),vertebral artery (VA) and basilar artery (BA) with transcranial Doppler (TCD). Their blood viscosity, plasm viscosity, red blood cell (RBC) deformed exponent were also measured.ResultsThe blood stream in most of patients with PTS manifested slowing especially in MCA,ACA,VA and BA at left. However,most of patients with heavy cerebral trauma manifested vasospasm. The blood and plasm viscosity of both groups obviously increased, but RBC deformed exponent decreased.ConclusionPatients with PTS suffered organic brain damage, mainly in levo-hemisphere.The patients with PTS or with heavy cerebral trauma present disorder in hemorheology.

Objective To explore the abnormalities in the posterior cingulated cortex structure by voxel based morphometry(VBM)and changes of functional connectivity by resting-state functional magnetic resonance imaging(fMRI)in long-term heroin addictions.Methods High-resolution volumetric T1-weighted images and resting state fMRI examination were performed on 13 long-term heroin addicts and 14 matched healthy volunteers.The T1-weighted images were processed using optimized voxel-based morphometry to investigate abnormalities in the gray matter,at the sarne time,the posterior cingulated cortex was setted as the region-of-interest(ROI)seed,with which a whole-brain voxel temporal correlation in low frequency fMRI fluctuations was calculated,to find changes of the posterior cingulated cortex functional connectivity.Results Compared with the control group,gray matter concentration significantly decreased in the posterior cingnlated cortex,at the same time,the functional connectivity between the left posterior cingulated cortex and the right temporal lobe was increased,but the functional connectivity between the left posterior eingulated cortex and the left thalamus,the left parietal lobe,the left cerebrum were all decreased in heroin addicts.At the same time,the functional connectivity between the fight posterior cingulated cortex and the left thalamus,the left parietal lobe,the left frontal lobe were decreased in heroin addicts(t testing,P<0.01).Conclusion The structure and the functional connectivity in posterior cingulated cortex in long-term heroin addicts are changed,which may affect the dysfunction of the addictive brain and the function of reward mechanism.

Objective To investigate the characteristic of P30o event-related potentials(ERP) of impulsive behavior in heroin addicts.Methods The Iowa gambling task (IGT) were performed by using the paradigm for psychological experiment both in heroin addiction group (HA group) and health control group (HC group),the inspection of electroencephalography were underwent in all the subjects concurrently.Following the collection of data of ERP,amplitude and latency of P300 were compared between the two groups,and then the relationship betweenamplitude or latency of P300 and the results of Barratt impulsiveness scale were analyzed separately.Results Compared to HC group,BIS score as well as the numbers of high frequency loss cards were significantly higher in HA group ( HA:75.12 ± 12.49,91.14 ± 21.35 ; HC:66.54 ± 8.61,73.71 ± 18.91 ; P ＜ 0.05 ),while the both two groups had visible waveforms of P30o,and the amplitude and latency were markedly lower ( HA:4.92 ± 1.14,293.43 ± 36.21 ; HC:7.65 ± 1.59,332.68 ± 40.15 ; P ＜ 0.05 ) and were negatively associated with BIS score in HA group( r =-0.76,-0.52,P＜ 0.05).Logistic regression results showed that the scores of BIS-11 were related to amplitude of P30o merely( P ＜ 0.05 ).Conclusion Impulsive behavior can be observed from the abnormal characteristic of the P300 event-related potential of impulsive behavior in heroin addicts,which may partly contribute to both addiction and relapse of heroin addict.

OBJECTIVE: To evaluate the safety and efficacy of Yiqi Pingchuan Granule in treating acute attack of asthma due to qi deficiency and cold syndrome. METHODS: A randomized controlled trial was conducted. A total of 80 patients with an acute attack of asthma were included. They were allocated into two groups randomly in a ratio of three to one. Sixty patients in the treatment group received Yiqi Pingchuan Granule and 20 patients in the control group received Ruyi Dingchuan Pill. Patients in both groups were treated for 7 days. RESULTS: There were no significant differences in traditional Chinese medicine syndrome, clinical symptoms and lung function between the two groups (P>0.05). After treatment, the forced expiratory volume in 1 second was increased in the treatment group (P<0.05), and the peak expiratory flow was accelerated in the control group (P<0.05). No significant side effects were noted in both groups. CONCLUSION: Yiqi Pingchuan Granule is safe and effective in treating acute attack of asthma due to qi deficiency and cold syndrome.

Objective To investigate the relationship between impulsive behaviors and the errorrelated negativity (ERN) component of event-related potentials of error processing in heroin addicts.Methods Using the paradigms for psychological experiment,the Iowa gambling task (IGT) was performed both in heroin addiction group (HA group,20 cases) and healthy control group (HC group,20 cases),and the inspection of electroencephalography was underwent in all subjects concurrently.Following the collection of data,the amplitude and latency of ERN were compared between the two groups,and then the relationship between the amplitude of ERN and the scores of Barratt Impulsiveness Scale (BIS-11) was analyzed separately.Results Decision-making course had no effect on the net score remarkably in HA group (F =1.21,P ＞0.05).Compared with HC group(64.3 ±8.4,73.8 ± 16.4),BIS score as well as the numbers of high frequency loss cards were significantly higher in HA group(75.2 ±7.6,105.5 ±22.2; t =-5.39,-9.24 ; P ＜ 0.05),while both the two groups had visible waveforms of ERN,and the amplitude was markedly lower in HA group(HA:(4.23 ±0.87) μV,HC:(6.11 ± 1.09) μV; t =5.96,P ＜0.05),but no statistical difference was found in latency of these two groups(HC:(102.1 ±28.2) ms,HA:(107.8 ±24.2) ms;t =-0.62,P =0.54),and the amplitude of the two groups was negatively associated with BIS score respectively in both two groups (HC:r =-0.66,HA:r =-0.78 ; both P ＜ 0.05).Conclusion The reduced capability of error processing maybe partly contribute to both addiction and relapse to heroin addict,and the ERN event-related potential could be regarded as an indicator of impulsive behaviors and the capability error processing.