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.

In recent years , the increasing number of private medical institutions in China has not led to the re-sponding increase in medical services , capital asset scales .The competitive situation between public and private medical institutions has not yet been formed .This paper discusses the difficulties that Chinese private medical institu-tions have encountered in overseas capital inflow , in order to foster local private medical Institutions , as well as the development of private non-profit hospitals .Based on a systematic analysis of the key points in policy , suggestions were proposed in regarding with enhancement of top-level design of the policies , encouragement of the development of off-shore or on-shore small-scale private medical institutions , as well as facilitation of the productive factors flow in medical institutions'operation.The suggestions on the policies are to be referenced in decision making for a healthy development of Chinese private medical institutions .

The relationship between retinal vasculopathy and cerebrovascular disease is receiving increasing attention.Most studies have shown that retinal vasculopathy may reflect cerebrovascular disease,and thus help us to understand cerebrovascular disease more directly.Retinal vasculopathy is closely associated with the onset risk of cerebrovascular disease,outcome and cognitive impairment.

Objective To investigate the cognitive function and emotional disorder and their interrelationships in patients with essential tremor(ET).Methods The cognitive function was evaluated by using scales such as mini-mental state examination (MMSE), aphasia buttery of Chinese for oral-test and read-test, Rey-Osterreith complex figure (ROF), digit span (DS), similarties tests, symbols-digital test, Wisconsin card sorting test, trail making test A, verbal fluency test and clock drawing test in fourty cases and fourty healthy controls matched on age, education level and handedness.The Hamilton depression scale was applied to assess the emotional state of the patients with ET.Results Compared with healthy controls, patients had significantly lower scores in Rey-Osterreith complex figure (t=6.66,P<0.001),digit span (positive)(t=3.32,P<0.001),symbols-digital test (t=4.18,P<0.001),Wisconsin card sorting test (P<0.05),trail making test A (t=3.59,P<0.001),verbal fluency test (t=-3.98,P<0.001) and clock drawing test (t=-4.18,P<0.001), but similar scores in aphasia buttery of Chinese for oral-test and read-test and similarties tests(P>0.05).The cognitive function scores were not significantly associated with the intensity and duration of tremor in patients with ET(P>0.05).Depression, mostly mild depression, was observed in 52.5 percent of patients with ET.Depression was significantly associated with the age (X~2=27.03, P<0.001) and was observed more frequently in the patients under the age of 50.There was no significant association between the cognitive impairment and depression in patients with ET (P>0.05).Conclusions The patients with ET have a multiple-domain cognitive deficit, in which executive function, attention and memory are impaired more severely.The patients with ET have a high incidence of depressive symptoms.

There are still some flaws in the private non-profit hospital supervision system since those hospitals recently began to grow in China. The paper aims to analyze the access and changing processes from the non-profit to profit hospitals and the non-profit character supervision of the private non-profit hospitals based on the literature and survey data in Hubei, Guangdong and Jiangsu Provinces. It also puts forward some suggestions on the private non-profit hospitals development including how to optimize the access process, increase taxes or liquidation in the chan-ging process, and establish the coordination supervision mechanism for the non-profit Character in China.

Objective Discuss elderly hypertension of chronic heart failure among the edema of lower limbs and the N end of b-type natriuretic peptide(NT-proBNP) formerly relationship and its value in differential diagnosis.Methods Hospitalized for high blood pressure and breathing difficulties in 301 cases of elderly patients,with 220ng/L for the NT-proBNP exception standard defines value,and comparing the edema of lower limbs and the NT-proBNP levels and heart failure.Results In the elderly hypertension of chronic heart failure population of double lower limbs swelling predict heart failure with NT-proBNP similar value.Conclusion Elevated levels of double lower limbs swelling in the NT-proBNP positive predictive value was 90.3％,negative predictive value was 42.1％,sensitivity 74.4％,specificity 80.0％ ;On heart failure of sensitivity 86.4％,specificity 78％.The edema of lower limbs were significantly associated with NT-proBNP and heart failure.

Objective To investigate the therapeutic efficacy and side effect of regional blockade using diprospan combined with oxycodone and acetaminophen taking orally which called balanced analgesia on severe tension-type headache. Methods 32 patients diagnosed as severe tension-type headache were treated with regional blockade using diprospan mixed with 0.4% lidocaine, combined with oxycodone and acetaminophen. The severity of pain (using numeric rating scales, NRS) and the duration of headache were observed and the side effects were recorded. Results There was a significant decrease in the severity of pain and the duration of headache after treatment compared with those before (P<0.01). No serious side effects were observed. Conclusion The balanced analgesia therapy mainly including regional blockade and oxycodone and acetaminophen can be significantly effective on the severe tension-type headache.

BACKGROUND:Using Twin-block appliance to treat mandibular retrusion,the mandible position changes greatly.The influence of this change on temporomadibular joint and the effect of Twin-block appliance on condylar growth remain unclear.OBJECTIVE:To observe the effect of Twin-block appliance on condylar process location during mandible forward positioning.PARTICIPANTS:A total of 20 patients with mandible retraction (Angel Ⅱ) malocclusion were selected from Department of Stomatology,First Sanatorium of Qingdao,Jinan Military Area Command of Chinese PLA,comprising 13 males and 7 females,aged 10.8 years (range 9-13 years).All patients were treated with Twin-block appliance.Four median joint pantomograms were taken before treatment,1 week after treatment,1 week and 1 year after treatment finish to measure the condylar process location.RESULTS AND CONCLUSION:In all cases,neutroclusion were obtained.No clicking,pain or other temporomadibular joint symptoms were observed.The condylar process position altered significantly.The anterior space distance was decreased,the superior space distance was increased,and posterior space was enlarged (P<0.05-0.01),i.e.condylar process moved downward and forward.The condylar process position was consistent with preoperative,and joint superior,anterior and posterior space distributed balancedly.Twin-block appliance could restore normal and harmonious process-fossa relationship through growth remodeling,but maintenance is necessary till the remodeling accomplish.

OBJECTIVE To observe and compare the cytotoxicity induced by andrographolide (AD)and its water soluble derivatives:andrographolide sodium bisulfite(ASB),active pharmaceutical ingredients of Chuanhuning and Yanhuning on human renal tubular epithelial cells (HK-2),and to explore the ASB-induced endoplasmic reticulum stress(ERS)mechanism. METHODS HK-2 cells were treated with the above four drugs respectively. The survival rate was examined by methyl thiazolyltetrazolium (MTT) assay and 50% inhibitory concentration (IC50) was calculated. In ASB treated group, Hoechst33342 staining and flow cytometry analysis were used to determine cell apoptosis, intracellular superoxide dismutase(SOD)activity and malondialdehyde(MDA)content were examined, and the protein expressions of binding immunoglobulin protein (Bip),C/EBP-homologous protein (CHOP)and cysteine-containing aspartate-specific protease 4(caspase 4)were detected by Western blotting. RESULTS The four drugs inhibited HK-2 cell growth in a time-dependent and concentration-dependent manner. At 24 h,the IC50 of AD (30.6 μmol · L- 1) was lower than that of others. Active pharmaceutical ingredients of Chuanhuning and Yanhuning (16.2 and 15.6 mmol · L- 1) were very close,ASB was 29.4 mmol · L-1. ASB(0,15,30 and 60 mmol · L-1)increased the apoptotic rate and caused the decrease in SOD activity and the increase in MDA content in a dose-dependent manner. Compared with control group,the protein expression of CHOP increased (P<0.01) at 8 h with ASB (30 and 60 mmol · L-1)treatment,Bip and caspase 4 had no significant change. In addition,at 24 h, ASB(60 mmol·L-1) decreased the expression of Bip(P<0.05),ASB(30 and 60 mmol·L-1)promoted the expression of CHOP(P<0.01),and the protein expression of activated caspase 4 increased in a concentration-dependent manner(P<0.01). CONCLUSION AD and its water soluble derivatives have a toxic effect on HK-2 cells. CHOP and caspase 4 pathway related to ERS is involved in ASB-induced apoptosis.

OBJECTIVE:To explore the characteristics of pathogens distribution of pediatric vulvovaginitis and drug resis-tance,and to provide reference for clinical drug use. METHODS:409 strains of positive routine bacteria and fungus culture were collected from 380 children with vulvovaginitis in 2014. The pathogens culture and drug sensitivity were recorded. RESULTS:The top 5 bacteria were Escherichia coli [36.67%(150/409)],Haemophilus influenzae [20.29%(83/409)],Streptococcus hemolyticus group A [13.20%(54/409)],Klebsiella pneumonia [8.80%(36/409)] and Staphylococcus aureus [5.37%(22/409)]. CONCLU-SIONS:The main pathogenic bacteria of pediatric vulvovaginitis is Gram negative bacilli,so that drug resistance should be paid at-tention to improve therapeutic efficacy when antibiotics are used in the clinic. The result of sensitivity test should be taken as basis for rational application of antibiotics in the treatment.