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.

Based on the literatures in MEDLINE database and EMBASE databases this article has carried out a bibliometrics study on foreign clinical researching institutions of acupuncture and moxibustion to screen those institutions who had more published articles as our major cooperation and exchange objects in the future,hoping for providing information basis of TCM international scientific research.

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.

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.

Objective To explore the dead reasons and related factors of acute leakemia(AL)in children.Methods The clinical data of 42 dead cases of children with AL,who were admitted to Guangzhou Children's Hospital between Jan.1999 and Mar.2007 were reviewed.Nineteen cases were boys,23 cases were girls;the aging from 4 months to 12 years old and 5 months.Of 42 children,21 cases were acute lymphoblastic leukemia(ALL),18 cases were acute myeloid leukemia(AML),3 cases were unclassified AL.Results Ten out of 12 early-dead cases died of bleeding.Among 30 cases who received chemotherapy,4 cases died of bleeding,others of myelosuppression combined with infection,14 of whom died from sepsis,3 cases with fungal infection,1 case with virus infection,4 cases with unknown pathogens.Sixteen children relapsed among those who got remission,half of them relapsed within 1 year since diagnosed.Treatment-related mortality(TRM)was 90%(27 out of 30 cases).The main causes of TRM were infection and hemorrhage.Hyperleukocytosis and bleeding were 2 risk factors related to early death in new-diagnosed children.Conclusions More emphasizes should be put on bleeding tendency during early treatment in children with AL and treatment of infection complications during induction chemotherapy to reduce TRM.

Objective To explore the spatial distribution of Keshan disease(KD) in the 15 surveillance provinces(municipalities,autonomous regions ) and to provide the basis for the development of prevention and control strategies.MethodsBased on the KD surveillance data of the 15 provinces in 2007,five indicators were selected.Moreover,a comprehensive indicator score to assess KD of different areas was made through the method of principle components analysis,which was applied for regionalization of the KD areas by the subsection method of standard deviation in whole China.The KD areas were divided into mild,moderate and severe endemic areas.The spatial distribution feature of the comprehensive indicator score was displayed by using geographic information system (GIS).ResultsThe three principal components contained 88.123％ information of all the selected indicators,the first principal component had a close relationship with total KD detection rate,chronic KD detection rate and latent KD detection rate; the second principal component had a close relationship with the threatened number in KD areas,and the third principal component had a close relationship with new KD detection rate; the comprehensive indicator indicates that Gansu,Jilin,Heilongjiang,Hebei,and Liaoning provinces were serious prevalent KD areas; Inner Mongolia,Shandong,Hubei,Sichuang provinces (autonomous region) were moderate prevalent KD areas,and Shanxi,Shaanxi,Yunnan,Henan,Guizhou,Chongqing provinces(municipality)were mild prevalent KD areas.Conclusions The introduction of the GIS to Keshan disease monitoring,provides a convenient and direct method to observe the spatial distribution of the disease,and the results point out the key areas for further KD surveillance according to local conditions.

Objective:To investigate relationship between parents'marital relationship and intergenerational transmission of value orientation of marriage and love among college students.Methods:Totally 712 families inclu-ding a college student and his/her parents from 9 universities were surveyed.The Marital Health Test (MHT)was used to assess parents'marital relationship and transmission of value orientation of marriage and love from father and mother.The structural equation modeling and stepwise multiple regression were used to analysis the relationship between parents'marital relationship and intergenerational transmission of value orientation of marriage and love a-mong college students.Results:Moderate correlations (r =0.24 -0.58,Ps <0.01 )were found between parents'marital relationship and transmission of value orientation of marriage and love from father and mother.Path analysis suggested that paths from parents'marital relationship to paternal transmission and maternal transmission were statis-tically significant (path coefficient was 0.59 and 0.75).Grouping regression analysis showed that the influences of parents 'marital relationship of same-sex transmission (R2 =0.49,0.35 ) were greater than opposite-sex transmission.Conclusions:The findings indicate that parents'marital relationship could facilitate the intergeneration-al transmission of value orientation of marriage and love.Moreover,the influences of parents'marital relationship of same-gender transmission may be greater than opposite-sex transmission.