BACKGROUND: Patients with Alzheimer disease (AD) usually have visuospatial dysfunction at an early stage and most patients with AD were evolved from mild cognitive impairment (MCI).OBJECTIVE: To detect whether a patient with MCI has a visuospatial dysfunction similar to AD. To compare the cerebral activation with ferromagnetic resonance between the healthy people and the patients with mild cognitive disorder.DESIGN: A case controlled observationSETTING: The Department of Neurology of the First Hospital of Peking University.PARTICIPANTS: Nine inpatients with mild cognitive disorder hospitalized at the Department of Neurology of the First Hospital of Peking University from April 2000 to March 2003 were involved and other 9 healthy people matching in age, gender and the educational level were also involved.METHODS: The subjects had the task of discriminating the different finger positions on the clockface. They could see the mission clearly showed on the cloth through refractor, and they were supposed to give the corresponding reaction to different cognitive tasks with left and right hands pressing the keys according to visual sign generated by the computer.Block design was adopted in the cognitive task. Stimulus block and baseline block appeared in turn. Baseline block displayed "+" mapped in the center of the image and was kept for 21s. Stimulus block displayed 10 pictures successively. The finger position of the two clockfaces among three clockfaces was the same in one picture. The absolute value of the rotated angles of the different clockfaces in each image on the same stimulus block was the same. The angles formed by six stimulus block fingers arranged randomly were 300, 450, 1800. The two clockfaces had the same finger positions, and the subjects were requested to discriminate the finger position of these two clockfaces. It was carried out on a 1.5 T GEMRTWIN magnetic resonance scanning apparatus. Then t test was performed to work out the right reaction time and proper rate with Excel software between the patients with mild Alzheimer's disease and the healthy persons. Pretreatment and statistical analyses were performed with analysis of functional neuroimages software used internationally.MAIN OUTCOME MEASURES: Comparison of the reaction time and proper rate between the two groups.parison of the reaction time between the two groups: The reaction time for distinguishing the change of 300, 450, 1800 was longer than that in the control group, and there was significant difference in distinguishing the change of 300, 450, 1800 for the patients [(1 776.7±570.2), (1 646.3±432.7)ms;of the proper rate between the two groups: The proper rate for distinguishing the change of 300, 450, 1800 was significantly lower than that in the control group (62.8±21.4)%, (82.8±15.8)% ;(76.7±17.0)%, (95.0±8.7)%; (69.4vation: the activation density at the bilateral parietal lobe, bilateral temporooccipital borderline and bilateral lateral striate cortex in patients was weaker than that in the control group (P ＜ 0.05).CONCLUSION: Neural network activation related with visual space in patients with MCI was weaker than that in the healthy people indicating that visuospatial impairment exists in the patients with mild cognitive impairment.

Objective To study changes and effects of transforming growth factor-?1(TGF- ?1) and its receptorIII (TGF-?1 R III) in children with idiopathic thrombocytopenic purpura (ITP). Methods Bone marrow were respectively collected from 28 children with acute idiopathic thrombocytopenic pupura(AITP),16 children with chronic idiopathic thrombocytopenic purpura(CITP) and 20 comparably normal children; Percoll density gradient and immunomagnetic beads methods were used to purify megakaryocytes from bone marrow; ABC- ELISA was used to detect TGF - ?1 in bone marrow; in situ hybridization was used to detect TGF-?1 RIIImR-NA expression on megakaryocytes.Results In AITP and CITP group, the levels of TGF-?1 and TGF-?1 RIIImRNA were significant higher than those in control group(P

The clinical study on acupuncture-moxibustion of traditional Chinese medicine has been attracting more and more global attention. With the development of medical pattern, we hold that, to prove the therapeutic efficacy, not only modern clinical research methods should be adopted, but a scientific and standard evaluation method in accord with the features of acupuncture-moxibustion also needs to be developed. We also believe that, in the clinic of acupuncture-moxibustion, disease differentiation treatment and syndrome differentiation treatment share an equal role, as they are relatively independent but mutually unified, together boosting the completion of treatment for a type a disease in a dynamic variation process.

ObjectiveTo explore the early diagnosis of Alzheimer's disease (AD),the arithmetic calculation ability in the patients with mild cognitive impairment (MCI) was detected under the functional magnetic resonance imaging (fMRI),combined with the neuropsychological test.Methods8 patients with MCI and 9 controls matched for the age, gender, level of education and handedness performed the subtraction of two digits presented visually while the MR machine was scanning. The raw data of the fMRI were processed with the software AFNI. The reaction time and correct ratio were analyzed with the statistical software Excel.ResultsCompared with the controls, the patients manifested longer reaction time and lower correct ratio. The patients' brain activation showed significant decrease in the inferior frontal lobe,temporal neocortex and inferior parietal area mainly in the left hemisphere. On the contrary, the activation intensity and extension in the right inferior frontal lobe were increased as compensation.ConclusionsThe patients with MCI have the deficit in calculation ability. The examination of the calculation by means of the cognitive neuropsychology and fMRI test can offer a powerful reference for the early diagnosis of AD.

OBJECTIVETo observe the clinical efficacy and safety on moderate and severe persistent allergic rhinitis treated with acupuncture.

METHODSSixty-six patients of moderate and severe persistent allergic rhinitis were randomized into an acupuncture group (34 cases) and a western medication group (32 cases). In the acupuncture, group, acupuncture was applied to Dazhui (GV 14), Feishu (BL 13), Pishu (BL 20), Ganshu (BL 18) and Shenshu (BL 23) in the prone, retained for 20 min; then in the supine, at Baihui (GV 20), Yintang (GV 29), yingxiang (LI20) Taichong (LR 3) and Hegu (LI 4), retained for 20 min. Acupuncture was given once every two days, three times a week, continuously for 8 weeks. In the western medication group, cetirizine hydrochloride was taken orally, 10 mg each time, once every day, continuously for 8 weeks. Separately, before treatment, after the treatment of 1 and 2 months and in 1 month after treatment, the total nasal symptom score (TNSS), the scores in the emotion rating scale for Ganzangxiang of TCM (ERSG) and the rhinoconjunctivitis quality of life questionnaire (RQLQ) were observed in the patients of the two groups. The clinical efficacy was compared between the two groups.

RESULTS(1) For TNSS, the results after 1 and 2 months treatment and in 1 month after treatment were all, reduced as compare with that before treatment separately in the two groups (P < 0.05, P < 0.01) The result after 2 months treatment was lower than that after 1 month treatment in the acupuncture group (P < 0.05). In 1 month after treatment, the result in the acupuncture group was lower than that in the western medication group (P < 0.05). (2) For ERSG, the score after 2 months treatment was lower than that before treatment in the two groups (both P < 0.05). The score after 2 months treatment in the acupuncture group was lower than that in the western medication group (P < 0.05). (3) For RQLQ, the score after 1 month treatment was lower than that before treatment and the score after 2 months treatment was lower than that after 1 month treatment in the two groups (all P < 0.05). The score after 1 and 2 months treatment and in 1 month after treatment in the acupuncture group was lower than that in the western medication group separately (all P < 0.05). (4) The total effective rate was 91.2% (31/34) in the acupuncture group and was 90.6% (29/32) in the western medication group, without significant difference between the two groups (P > 0.05).

CONCLUSIONAcupuncture is the safe and effective intervention on moderate and severe persistent allergic rhinitis. Compared with the western medicine group, the efficacy in the acupuncture group presents much more advantageous at its durability.

Acupuncture Points ; Acupuncture Therapy ; Adult ; Female ; Humans ; Male ; Middle Aged ; Quality of Life ; Rhinitis, Allergic ; diagnosis ; therapy ; Young Adult

BACKGROUND:Intensity-time (I/T) curve examination is a monitoring technology used for diagnosis of nerve damage,muscle disease and prognostic evaluation using current stimulation and qualitative or quantitative analysis.It also has significance to the diagnosis of lumbar disc herniation (LDH).Whether it can be used in LDH prognostic evaluation is poorly understood.OBJECTIVE:To explore the effectiveness of I/T curve in diagnosis and prognostic evaluation of LDH.METHODS:I/T curves of 113 LDH patients were measured by CX-3 electrodiagnostic equipment,and the results were compared with their unaffected sides and analyzed after physiotherapy.A total of 253 curves were measured,including 107 biceps femoris,101 gastrocnemius and 45 tibialis anterior muscle curves.All patients were sequential treated by traction,medium frequency,ultrashort wave,electric acupuncture as well as infrared radiation following I/T diagnosis,once a day,10 days for a course,with 10 days interval in 3 courses,I/T curves were performed after 3 courses.The therapeutic effect was evaluated by using I/T results combined with clinical symptom and physical signs.RESULTS AND CONCLUSION:The first estimated percentage by I/T curved line were 36.36% (controlled by normal nerve),62.85% (controlled by part of the denervated),0.79% (controlled by the completely denervated) and 63.64% (controlled by total abnormal nerve).After the physiotherapy,the effectiveness of the complete recovery was 92.86% by the normal nerve as well as 58.82% by the abnormal nerve.Above all,the practical value could be concluded from the diagnosis,evaluation and effectiveness of LDH used by I/T curve line.The therapeutic effectiveness controlled by the normal nerve is much better than that controlled by the abnormal.

Objective To introduce the technique and experience in reconstruction of posterior crueiate ligament-posterolateral comer(PCL-PLC)injuries with only one allograft of Achilles tendon. Methods The instable knees in 12 cases with PCL injury combined with three degree chronic PLC injury were treated with PCL reconstruction under arthroscope and PLC reconstruction through posterolateral arc incision.Single bundle grafts of PCL reconstructions in tibial and femoral tunnels were fixed by resorption screws.Fibular collateral ligament(FCL)and popliteofibular ligament(PFL)were reconstructed with reforming Larson(?)method.All reconstruction grafts only needed one Achilles tendon as donator.Total op- eration time was 130 minutes including 90 minutes of PCL reconstruction and 40 minutes of PLC recon- struction.Gradual weight loading was allowed after six weeks of bracing.Results Follow-up for mean 12 months(5-24 months)indicated that tibial“step off”reduction was 83%(10/12)and posterior drawer test of 0-1~+ 75%(9/12).Dial sign evaluated that normal external rotation angle was 75%(8/12).Nor- real varus stress test at 30?knee flexion accounted for 83%(10/12).Scores of Lysholm,Tegner and HSS were 90.5,5.1 and 84.5,respectively(P＜0.01=.Conclusion Synchronized reconstruction of PCL and PLC injuries with only one Achilles tendon can obtain satisfactory clinical result,with less expense and shorter operation time.

0.05).Conclusion MRI is a highly accurate diagnostic tool for detecting tears of the medial and lateral menisci.At present,there is no evidence to ascertain that higher magnetic field strength improves discriminatory power for meniscal tears.

ObjectiveTo investigate the distribution of Kashin-Beck disease(KBD) in Tibet, and assess the disease status. Methods Between 2007 and 2008, a survey was done on KBDepidemiology which was carried out in four prefectures of 26 counties according to the east, south, west, north and center in Nakchu,Lhoca, Nyingtri and Shigatse districts of Tibet, with towns and villages as baseline survey points. According to the KBD e survey scheme, KBD clinical examination for adults was also carried out and at the same time clinical and right hand anteroposterior X-ray examinations were given to children aged 4 - 13. The partition of endemic area was based on the criteria of national standards for Kashin-Beck disease diagnoses《GB 16395-1996》. Slight KBD area:clinical prevalence of Kashin-Beck disease grade Ⅰ and above was less than 10％ or X-ray detection rate ＜ 10％ of children; the moderate prevalent KBD area: clinical prevalence of Kashin-Beck disease grade Ⅰ and above was between 10％ and 20％ or X-ray detection rate was between 10％ and 30％ of children; severe KBD area: clinical prevalence of KBD grade Ⅰ and above was more than 20％ or X-ray detection rate was higher than 30％ of children.ResultsA total of 108 townships of 26 counties were surveyed, 14 686 adults were clinically examined, cases detection of grade Ⅰ and above were 637 people, the prevalence was 4.34％, and no case of grade Ⅲ was detected.Of 5769 children's right anteroposterior X-ray film, 102 were detected positive; the prevalence rate was 1.77％.Metaphysis was affected in most of the child cases, which accounting for 89.2％ (91/102). Amongst all the counties, there were 10 counties, clinical detection rate of adult KBD was 0, and children's X-ray detection rate of KBD was also 0. In 1 county the clinical prevalence rate for adults KBD was 0 and X-ray detection rate for children was 3.66(7/191 ). In 12 counties the clinical prevalence rate for adults KBD was between 1.03％ and 7.54％, X-ray detection rate for children was between 0 and 7.76％, amongst all these counties surveyed there were 5 counties,the detection rate for children was 0. In 3 counties the clinical prevalence rate for adult KBD was between 10.69％and 13.88％, the X-ray detection rate for children was between 5.31％ and 7.76％. Conclusions According to the criteria for diagnoses of KBD, within the 26 counties surveyed, 10 counties are non-endemic areas, 13 counties are slight endemic areas, 3 counties are medium endemic areas. So far, KBD is prevalent in 52 counties of 7 prefectures (cities) in Tibet, the disease is widely distributed, the situation is still severe, and there is a need to continue to strengthen KBD surveillance.

OBJECTIVETo investigate the short-term clinical outcome of unicompartmental knee arthroplasty for the treatment of spontaneous osteonecrosis of the knee.

METHODSFrom September 2013 to April 2014,5 patients with spontaneous osteonecrosis of the knee underwent unicompartmental knee arthroplasty, included 3 males and 2 females, aged from 65 to 80 years old with an average of 74 years. The courses of disease was from 1 to 6 years with the mean of 3 years. According to the radiographic staging criteria of Koshino, 1 case was stage II, 2 cases were stage III, 2 cases were stage IV. Clinical effects were assessed by VAS score, HSS score, and knee range of motion, tibiofemoral angle before and after operation.

RESULTSAll the patients were followed up from 6 to 7 months with an average of 6.4 months. All incisions obtained primary healing, and there were no complications such as infection, thrombosis, fracture of lower limbs. All 5 patients' pain relieved and their knee function improved significantly after operation, but knee range of motion had no obviously improved. Postoperative HSS scores, VAS scores, tibiofemoral angle were significantly improved than that of preoperative.

CONCLUSIONThe short-term effect of unicompartmental knee arthroplasty in treating spontaneous osteonecrosis of the knee is satisfactory.

Aged ; Aged, 80 and over ; Arthroplasty, Replacement, Knee ; methods ; Female ; Humans ; Joint Diseases ; physiopathology ; surgery ; Knee Joint ; Male ; Osteonecrosis ; physiopathology ; surgery ; Range of Motion, Articular