The traditional ideas consider that aphasia is caused by the damage of cortical language center. However, with the development of imaging techniques, especially the appearance of diffusion tensor imaging and tractography, it is found that subcortical white matter also participates in the language course and plays an important part in aphasia.

Objective Under the requirements of dose distribution in target and normal tissue ,five radiotherapy fields are de‐voted to making Intensity‐modulated radiation therapy (IMRT) plan ,thus the IMRT radiotherapy of Nasopharyngeal Carcinoma (NPC) could be underway with the radiotherapy field as few as possible .Methods Through the comparison of the NPC patients′IMRT plans in our hospital ,the angle of fields have been make out with 0° ,75° ,125° ,225°and 285° .At the same time ,this field scheme is compared with projects of front five fields ,behind five fields and share five fields .The result was statistically analyzed . Results In these four field schemes ,the maximum and minimum dose in the target area showed no statistically difference (P>0 . 05) ,while in the average dose ,D95 and normal tissue dose have statistical difference (P<0 .05) .Conclusion Comprehensive com‐parison of the dose distribution in the target and normal tissue in these four field schemes showed that the field scheme with the an‐gles of 0° ,75° ,125° ,225°and 285°could obtain better results ,so this field scheme should be more suitable for local area NPC patient′s IM RT .

Objective To discuss the feasibility of endoscopic thyroidectomy via breast approach for papillary thyroid carcinoma.Methods From April 2009 to December 2013,clinical data of 90 papillary thyroid carcinoma cases undergoing endoscopic thyroidectomy was analyzed retrospectively.Results There was no conversion to open surgery,the mean operation time was 97 min,the mean intraoperative blood loss was 10 ml,the mean postoperative drainage volume was 65 ml,the mean hospital stay was 4.5 d,the mean lymph node number dissection of central compartment was 5.3.No obviously chest pain and numbness occurred.No skin flap ecchymosis,necrosis,effusion,and hematoma occurred.No hypocalcemia convulsions occurred.Transient hoarseness occurred in 3 cases which recovered within 1 to 2 months.Follow-up time ranged from 1 to 5 years,the median follow-up time was 41 months,with no tumor recurrence and lymph node enlargement.All patients were satisfied with the cosmetic results.Conclusions Endoscopic thyroidectomy via breast approach is a safe and feasible procedure in treating papillary thyroid carcinoma (cN0).

Objective To compare the clinical curative effect of proximal femoral anatomic locking plate and DHS plate in treatment of femoral proximal fracture.Methods 86 cases of fracture of the proximal femur were randomly divided into the control group of 40 cases,46 cases in the observation group.The control group used DHS plate for treatment,observation group were treated with anatomical proximal femoral locking plate in the treatment of operation,operation time and the clinical efficacy of two groups were compared,the amount of bleeding; follow-up of 6 months,compared with two groups the quality of life of the patients.Results In the observation group,the excellent and good rate was 86.9%,which was better than 75% in the control group (x2 =4.307,P ＜ 0.05).The observation group operation time,operation bleeding volume were (106.3 ± 29.6) min,(171.6 ± 34.1) ml,were significantly better than the control group(149.7 ± 32.7) min,(329.7 ± 47.2) mL(t =6.459,7.569,all P ＜ 0.01).Two groups of patients with postoperative quality of life than the preoperative improve,observation group than in the control group was more obviously improved(t =4.417,P ＜ 0.05).Conclusion The anatomical proximal femoral locking plate is applied to treat proximal femoral fractures,which not only improves the effect of operation,but also improves quality of life.

Objective To observe the effects of posterior screw and rod fixation on nerve function and vertebral indicators in patients with lumbar vertebral fracture.Methods The clinical data of 32 cases with lumbar vertebral fracture were analyzed retrospectively.According to Frankle grading:grade A 1 case ;grade B 7 cases;grade C 12 cases ;grade D 12 cases.All the patients were treated by posterior screw and rod fixation.The nerve function and vertebral indicators were compared.Results Followed-up for 22.3 months,according to Frankle grading:grade A 1 case;grade B 3 cases;grade C 9 cases;grade D 15 cases;grade E 4 cases.The nerve functions were improved after operation.There was a significant difference between before and after treatment (all P ＜ 0.05).The the height of the front edge of the fractured vertebral and cobb angle were improved after operation (all P ＜ 0.01).Conclusion Posterior screw and rod fixation can significantly improve nerve function and vertebral indicators in patients with lumbar vertebral fracture.

【Objective】To observe the jaundice-relieving effect of therapy of clearing heat and draining dampness combined with cooling blood and normalizing gallbladder function for severe icterohepatitis with damp-heat in liver and gallbladder.【Methods】Seventy-one severe icterohepatitis patients with damp-heat in liver and gallbladder were randomized into groups A(n=38) and B(n=33).The two groups received routine basic treatment and symptomatic treatment,group A was treated with heat-clearing,dampness-draining,blood-cooling and bile-draining herbs,and group B with intravenous drip of small-dose 654-2 additionally.Serum levels of total bilirubin(TBil),direct bilirubin(DBil),glutamic pyruvic transaminase(ALT),prothrombin activation(PTA) and jaundice duration were observed for the evaluation of jaundice-relieving effect.Meanwhile,the changes of gallbladder ultrasonograms were observed.【Results】After treatment,serum levels of TBil and ALT were decreased in both groups(P0.05)but the markedly effective rate in group A was higher than that in group B(P

Aim To investigate the effects of gene expression through activating endothelial target for acetylcholine (ETA).Methods Comparative studies were carried out to explore the distinct gene expression of carbachol and pilocarpine.Results Human coronary aortic endothelial cells were incubated with carbachol which activates ETA and muscarinic receptors and with pilocarpine which activates muscarinic receptors distinctly for 10 hours at the concentration of 100 ?mol?L -1.The endothelial gene expression was detected by BiostarH-14112S cDNA expression profiling microarrays containing 14 000 human unigenes. There were 801 differential genes totally (491 differentially expressed both by carbachol and by pilocarpine, 310 differentially expressed by carbachol exclusively). We found a significant increase in expression of 119 and a significant decrease in expression of 191 genes after treatment by carbachol preferentially. And these genes were not affected by pilocarpine. Further globally functional catagorization indicates that there are seven types of distinct expressed genes induced by carbachol selectively including membrane receptors and G proteins, ion channels, G protein coupled receptors, transcriptional factors, apoptosis-related genes, cell adhesive factors, thrombosis and atherosclerosis-related genes.Conclusion The differentially expressed genes evoked by carbachol exclusively are closely associated with ETA and its effectors.

Aim To study the subtypes distribution of G-proteins and modulation by carbachol and pilocarpine on gene expression in endothelial cells.Methods The rat aorta endothelial cells were cultivated and incubated with carbachol and pilocarpine at the dose of 10~(-4) mol?L~(-1)for 6 h.Then the total RNA was extracted.The mRNA levels of G-protein ? subunits was measured by RT-PCR.Results Gq/11,Gs and Gi mRNA was detected in rat aorta endothelial cells,while G12/13 mRNA was not detected.Carbachol and pilocarpine treatment induced no changes in Gs,Gi and G11 mRNA.Gq mRNA was 72.7% up-regulated by carbachol and unchanged by pilocarpine.Conclusion In all G-protein ? subunits,only Gq mRNA was changed after activation of non-neuronal muscarinic receptor by carbachol.We can conclude that Gq-protein may play an important role in signal transduction of nonneuronal muscarinic receptor.

To examine the role and effect of nitric oxide synthase type II (NOS II) in cirrhotic rats, expression of NOS II mRNA was detected by real time RT-PCR. The enzymatic activity of nitric oxide synthase and the circulating levels of NO, systemic and portal hemodynamics and quantification of cirrhosis were measured. Chinese traditional medicine was used to treat cirrhotic rats and the effect of NO was evaluated. Double-blind method was used in experiment. Our results showed the concentration of NO and the enzymatic activity of NOS increased markedly at all stages of cirrhosis and iNOSmRNA was strongly expressed. Meanwhile, the portal-venous-pressure (PVP) and portal-venous-flow (PVF) were significantly increased. NO, NOS and iNOSmRNA were positively correlated to the degree of hepatic fibrosis. Tetrandrine significantly inhibited NO production and the expression of iNOSmRNA. Our results suggested that increased hepatic expression of NOS II is one of the important factors causing cirrhosis and portal hypertension. Tetrandrine can significantly ameliorate cirrhosis and portal hypertension.

Optic neuritis is a common optic neuropathy,which typically presents with sudden loss of vision.Visual deficit of optic neuritis varies in severity and generally can be improved spontaneously over several-month duration.The most convincing eight evidences from level Ⅰ and Ⅱ evidence of evidence-based medicine( EBM ) about the treatment of all the optic neuritis were collected by searching theCochrane Controlled TrialsRegister (CENTRAL),MEDLINE,EMBASE and reference lists of identified trial reports since the last decade.At present,the latest findings showed that there is no conclusive evidence of benefit in terms of recovery to normal visual acuity,visual field or contrast sensitivity with either intravenous or oral corticosteroids at the doses evaluated in trials included in this review.Either no treatment or intravenous corticosteroid therapy followed by oral corticosteroids is appropriate,and intravenous corticosteroid may benefit the patient in terms of faster recovery to normal vision.There may be of different treatment of optic neuritis in China compared to Western countries due to geographical,racial and genetic background that may cause different etiology and clinical features of optic neuritis.Therefore,in China,it is imperative to carry out a large randomized control trial(RCT) of optic neuritis as soon as possible to get the best evidence for the management of optic neuritis patients.