Subcortical ischemic vascular disease (SIVD) is one of the most common subtypes in vascular cognitive impairment.This article reviews the research progress in the aspects of its pathogenesis,neuropsychological performance,imaging changes,and biological markers of SIVD.

Objective To explore the clinical efficacy and safety of mifepristone combined with misoprostol in the treatment of missed abortion.Methods According to the digital table,184 patients with missed abortion were randomly divided into study group and control group,92 cases in each group.The control group was given oral diethyl-stilbestrol underwent curettage,while the study group was given mifepristone combined with misoprostol therapy under-went curettage.The clinical therapeutic effect and adverse reaction were compared between the two groups.Results The effective rate of the study group after treatment was 95.65%,which was significantly higher than 86.96% of the control group,the difference was statistically significant(χ2 =4.38,P <0.05).Compared with the control group,in the study group,the operative time[(7.22 ±1.11)minute]observed significant relationship,intraoperative hemorrhage volume[(35.68 ±5.62)milliliter]decreased significantly,pregnancy natural rate of discharge(81.52%)was obvi-ously improved,artificial abortion syndrome incidence rate(3.26%)and again the rate of curettage(5.43%)was obviously decreased,and the differences were statistically significant(t =16.10,12.52,χ2 =7.84,8.87,15.93,all P <0.05).The clinical adverse reaction rate in the study group was 16.30%,which was significantly lower than 29.35% in the control group,the difference was statistically significant(χ2 =4.44,P <0.05).Conclusion Mife-pristone combined with misoprostol plays a complementary role,can improve the treatment of missed abortion and has good operation condition.It also can reduce the adverse reactions,complications and pain of patients.It is worth of clinical promotion.

A lot of evidence shows that autophagy is involved in the occurrence and development of cerebral ischemia - reperfusion. Autophagy and its related signal transduction pathways may be an effective therapeutic target for ischemic brain injury. This article reviews related signal transduction pathways of autophagy regulation after cerebral ischemia.

By studying the physician-related factors in physicianpatient relationship,authors put forwards that excellent medical skill,good medical ethics,favorable communication ability,and adequate knowledge on relevant legal regulations are four key points to handle the physician-patient relationship harmoniously.This article will supply reference from the above aspects for the all-around quality-based education for medical students.

OBJECTIVE: To explore the factors,general pattern and characteristics of adverse drug reactions(ADR) in children.METHODS: A total of 188 pediatric ADR reports collected in our city from Jan.2002 to Sept.2007 were statistically analyzed in respect of children's age and sex,route of administration,ADR severity,category of drugs involved,organs or systems involved and clinical manifestations etc.RESULTS: Of the 188 pediatric ADR cases,95(50.5%) were induced by intravenous route.A total of 112 kinds of drugs were involved in the ADR,with anti-infective agents showing the highest proportion.Digestive system,neural system,urinary system and skin etc were involved in the ADR.CONCLUSION: Clinic should attach great importance to the monitoring and reporting of pediatric ADR to reduce or avoid the occurrence of ADR.

Objective Observe the fine distribution and morphologic feature of the intramural lymphatics in rats' rectum and to provide the morphological evidence for studying the mechanism of lymphous metastasis of rectum carcinoma.Methods The intramural lymphatics of rectum in rats were studied by light and electron microscopy to obtain some data regarding their fine distribution.Results The intramural capillary lymphatics of rats' rectum were observed in deep lamina propria of tunica membrane and the dermal papilla layer of anal pectin. The intramural capillary lymphatics and lymphatics were both observed in tela submucosa, reticular layer, hypodermis and intermuscular and serosa. The capillary lymphatics in rectums' wall have the similar ultrastructure feature to normal ones. Three kinds of endothelial cells junctions are overlapping-junctions, embedding-junctions and end-to-end-type junctions. About 21% of cell-junctions are opening types. There are normal organelles and many vesicals in the endothelial of capillary lymphatics. Conclusion The distribution of lymphatics in every layer of dentate line upwards are similar to other digestive tubes'. The distribution of lymphatics in anal pecten of rats' rectum are similar to cutis. The results show that big molecule substance and tissue hydrolysate are transporting mainly by opening-junction of endothelial cells and the vesicle system.

Objective To explore the value of E-flow technique in ultrasound examination of fetal pulmonary vein.Methods The pulmonary veins of 332 fetus were examined using lungs as acoustic window by two-dimensional echocardiography(2DE), color Doppler flow imaging (CDFI) and E-flow.Visualization ratios of the three methods were compared.Results The fetal pulmonary veins were displayed as following:7 cases were showed by 2DE,49 cases by CDFI and 73 cases by E-flow among 118 cases during 12 - 22 gestational weeks.The visualization ratio of E-flow was higher than that of the other two methods (P ＜0.001).Fourty-one cases were showed by 2DE, 171 cases by CDFI and 177 cases by E-flow among 214 cases during 23 - 40 gestational weeks.The visualization ratios of E-flow and CDFI were higher than that of 2DE (P ＜ 0.001).The visualization ratio of E-flow and CDFI has no distinct differrence (P ＞ 0.0167).Conclusions E-flow was sensitive to pulmonary vein blood flow and better than 2DE and CDFI in early stage of the second trimester.

Objective To explore the correlation between executive function and white matter lesions (WML) and the diagnostic value by clock drawing test(CDT) in patients with vascular dementia (VaD). Methods Twenty-seven VaD patients and twenty-five normal control subjects were evaluated with CDT to assess the executive function. CDT was scored according the four point method. Age-related white matter change rating scale (ARWMCrs) was used qualitatively to measure and locate the WML by cranial MRI scanning. Results 1. The scores of CDT in normal cognition health and VaD were ( 3.88 ± 0. 33 ) and ( 1.74 ± 0. 98 ). The difference between two groups was statistically significant (P＜0. 01 ). The humerous part and the point part were the earliest to decline in the VaD Patients. The scores of WML were (5.12 ± 4. 19) and ( 11.19± 3.09), respectively. There was significant difference between two groups(P ＜ 0. 01 ). The scores of CDT had significant positive correlation with MMSE scores and negative correlation with WML scores (P ＜ 0. 01 ). Conclusion The executive functional impairment in patients with VaD could be associated with the degree of WML.

Objective To investigate the prevention and management of anastomotic leakage in patients with middle and lower rectal cancer after neoadjuvant therapy.Methods In this study,50 cases of middle or lower rectal carcinoma underwent anus preserving radical resection and anastomosis after a 4 cycles of chemotherapy with FOLFOX and 46 Gy(2 Gy×23)radiotherapy.Anastomotic leakage,the prevention and management of this complication were analyzed retrospectively.Results All these 50 patients received low anterior resection after chemoradiotherapy,among the 19 cases receiving prophylactic ileac stoma simultaneously,there was no anastomotic leakage,whereas anastomotic leakage developed in 4 out of the 31 patients who did not receive prophylactic ileac stoma,including concomitant rectovaginal fistula in 2 cases.All these fistulae were cured conservatively.Conclusion Concomitant treatment of FOLFOX regimen and RT in neoadjuvant setting of rectal cancer could increase the rate of anal interior sphincter reservation,prophylactic ileac stoma helps to reduce the rate of anastomotic leakage after a anus-preserving low anterior resection of the cancer.

OBJECTIVE:To investigate the protective effect of the compatibilities of ginsenosides Rg1 and aconitine on myocar-dial cell of in vitro cultured heart failure model. METHODS:The myocardial cells of neonate rat were grouped into normal control group,model group,positive control group(Deslanoside injection,1×10-7 mol/L),ginsenosides Rg1 group(1×10-8 mol/L),acon-itine group (1 × 10-9 mol/L) or their compatibilities groups (1∶1,2∶1,1∶2,V/V). Except for normal control group,other groups were given 0.8%pentobarbital sodium to induce heart failure model of myocardial cells. After modeling,each group was given rele-vant medicine for 1 h,and then the activities of T-ATPase,Ca2+-Mg2+-ATPase,Na+-K+-ATPase in cells were all detected. The activi-ties of acyl carrier protein(ACP)and lactate dehydrogenase(LDH),and the contents of brain natriuretic party(BNP),TNF-α and total glycogen were measured in cell culture fluid. RESULTS:Compared with normal control group, T-ATPase and Ca2+-Mg2+-ATPase activities were decreased significantly in model group;meanwhile,Na+-K+-ATPase activity was increased signifi-cantly,and ACP,LDH activities and BNP content in cell culture fluid were increased significantly(P<0.05). Compared with mod-el group,the activities of T-ATPase in treatment groups were increased significantly,while the activity of LDH in cell culture fluid was decreased significantly;when the volume ratio of ginsenoside Rg1 to aconitine was 2∶1,protective effect was the strongest;the activities of Na+-K+-ATPase in aconitine group and compatibility groups were all decreased significantly,with statistical signifi-cance(P<0.05). The activities of ACP and BNP in cell culture fluid were all decreased in treatment groups,but the content of to-tal glycogen in cells and the TNF-α content of in cell culture fluid had no change (P>0.05). CONCLUSIONS:Compatibility of ginsenosides Rg1 and aconitine can improve ATPase activities and membranous permeability,regulate BNP secretion and protect myocardial cell of heart failure model,especially the compatibility of ginsenosides Rg1 to aconitine of 2∶1 ratio.