Vascular cognitive impairment (VCI) is a main type of syndrome from mild cognitive impairment to dementia,which is caused by cerebrovascular risk factors (eg,hypertension, diabetes,hyperlipemia),obvious (cerebral infarction and hemorrhage) or unobvious cerebrovascular disease (leukoaraiosis and chronic cerebral ischemia).Its incidence is increasing,however,its pathogenesis remains uncertain,and effective therapeutic tools are lacking.Therefore,an increasing attention is being paid to all aspects of studies.This article mainly reviews the recent development in research of neuropsychology,imaging,electrophysiology,biology,and gene.

Objective To investigate the feasibility and outcome of resection and reconstruction of hepatic artery in hilar cholangiocacinoma (HCC).Methods The data of 29 patients with HCC with hepatic artery reconstruction carried out from March 2009 to August 2013 in our center were retrospectively analyzed.23 right hepatic arteries and 6 common hepatic arteries were involved.In-situ anastomosis was carried out in 20 patients and a double anastomosis using gastrodoudenal artery grafts was carried out in 9 patients.Results There were no arterial thrombosis or other related complications on prolonged follow-up.Conclusion Hepatic artery resection and reconstruction should be carried out if the artery was invaded by a hilar cholangiocarcinoma to produce a high resection rate and a better outcome.

Objective To explore the possible function and significance of pancreatic polypeptide during the healing process of experimental gastric ulcer in rat. Methods The immunohistochemical PAP method,morphometry and image analysis were applied to study the changes of the morphology,numerical density on area(N_A) and mean grey degree of islet PP cells during the healing process of experimental gastric ulcer in rats. Results Compared with normal control group(NCG) and saline control group(SCG),the N_A of PP cells markedly decreased,and the mean grey degree markedly increased(P

Objective To summarize the clinical experience of hepatic artery bypass reconstruction using gastroduodenal artery in radical resection of hilar cholangiocarcinoma,and to provide assistance for surgeons applying artery reconstruction technique correctly in radical operation of hilar cholangiocarcinoma.Methods 9 cases of hilar cholangiocarcinoma with hepatic artery invasion wcrc subjected to radical resection combined with tumor invaded hepatic artery resection and reconstruction.Hepatic artery bypass reconstruction was performed by end-to end anastomosis,using the gastroduodenal artery interposition graft.The clinical data of these patients were reviewed retrospectively.Results All tumors of these cases with hilar cholangiocarcinoma were involved right hepatic artery,and the in volvement length was not less than 2 cm.The artery reconstruction was one-time successfully per formed in all cases.The median time required for anastomosis was (23.0±3.1) min.No postoperative complications,the dysfunction of gastrointestinal peristalsis or abnormal gastric drainage volume for example,related to the gastro-duodenal artery resection was observed.None of the patients devel oped any complications related to the arterial bypass reconstruction in the follow-up period,which was confirmed by abdominal CT scan.Conclusion Hepatic bypass reconstruction using gastro duodenal artery graft decreases the morbidity related to artery reconstruction and has little effect on gastrointes tinal function,which is the optimal choice for arterial reconstruction in radical operation for hilar cholangiocarcinoma.

Objective To-identify the factors associated with radiation-induced liver disease (RILD) and to describe the probability of RILD using the Lyman normal tissue complication(NTCP) model for primary liver carcinoma(PLC) treated with hypofractionated conformal therapy (CRT).Methods A total of 109 PLC patients treated with hypofractionated CRT were prospectively followed according to the Child-Pugh classification for liver cirrhosis,93 patients in class A and 16 in class B.The mean dose of radi- ation to the isocenter was (53.5?5.5) Gy,fractions of (4.8?0.5) Gy,with interfraction interval of 48 hours and irradiation 3 times per week.Maximal likelihood analysis yielded the best estimates of parameters of the Lyman NTCP model for all patients;Child-Pugh A and Child-Pugh B patients,respectively.Results Of all the patients,17 developed RILD (17/109),8 in Child-Pugh A(8/93 ) and 9 in Child-Pugh B(9/ 16).By multivariate analysis,only the Child-Pugh Grade of liver cirrhosis was the independent factor (P= 0.000) associated with the developing of RILD.The best estimates of the NTCP parameters for all 109 pa- tients were n=1.1,m=0.35 and TD_(50) (1)=38.5 Gy.The n,m,TD_(50) (1) estimated from patients with Child-Pugh A was 1.1,0.28,40.5 Gy,respectively,compared with 0.7,0.43,23 Gy respectively,for patients with Child-Pugh B.Conclusions Primary liver cancer patients who possess Child-Pugh B cirrho- sis would present a significantly greater susceptibility to RILD after hypofractionated CRT than patients with Child-Pugh A cirrhosis.The predominant risk factor for developing RILD is the severity of hepatic cirrhosis in the liver of PLC patients.

Panax ginseng is the king of herbs and plays important roles in the traditional Chinese medicine industry. In this paper, we summarized the development of ginseng cultivation in China and other main countries, analyzed the effects of ecological factors of soil and climate on ginseng distribution, and investigated the characteristic of main cultivation patterns (conversion of forest to cultivate ginseng soils, cultivated ginseng in the farmland and wild nursery). Aimed at the serious issues in the cultivation, research strategies have been provided to guarantee the sustainable development of the ginseng industry. The patterns of cultivated ginseng in the farmland should be strive to develop; pollution-free cultivation and studies of continuous cropping obstacles should be carried out; ginseng varieties suited to ecological environment of farmland should be bred using modern biotechnology.
Agriculture ; methods ; China ; Climate ; Ecosystem ; Panax ; chemistry ; growth & development ; Soil ; chemistry

OBJECTIVE To study characteristics of changing T lymphocytes in epidemic hemorrhagic fever(EHF) patients during acute phase and find out the pathogenesis,in order to elevate the level of early diagnosis.METHODS The anticoagulant blood from 30 cases of EHF patients and 50 normal healthy blood donors was collected.T lymphocyte subsets were detected by flow cytometry.RESULTS Compared with those of normal persons,CD4+ T cell counts of EHF patients decreased,CD8+T cell and double CD4+CD8+ cell(double positive cells,DP cell) counts of EHF patients increased obviously,and 25 cases of EHF in recovery stage returned to normal.And in comparison with HIV,CMV and EBV patients,DP cell counts of EHF patients increased obviously.CONCLUSIONS T lymphocytes of EHF decrease obviously but could be resumed,detection of amounts of lymphocyte subsets and CD4+CD8+ cells can provide an early diagnosis method to EHF.

Objective To investigate the clinicopathological significance of expression of insulin like growth factor 1 receptor (IGF1R) protein in primary gastrointestinal stromal tumors (GIST) and their impacts on prognosis.Methods Between January,2005 and January,2011,84 primary GIST patients underwent surgery.Immunohistochemical analysis was performed based on tissue microarray to estimate expression pattern of IGF1R in tumor cells and nomal controls.Association of IGF1R expression with clinicopathological features and relapse-free survival (RFS) were also analyzed.Results The negative,weakly positive,positive,and strong positive expression rates of IGF1 R protein in GIST group were 20％,14％,48％ and 18％,respectively;while in the control group were 32％,40％,20％ and 8％,respectively (x2 =30.663,P ＜ 0.001).The 5-year overall survival (OS) rate was 93％.1-year,3-year and 5-year RFS rate were 99％,76％ and 60％,respectively.As shown by univariate analysis the following factors were poor prognostic indicators for RFS,non-gastric tumor location (P =0.017),large tumor size (P =0.022),high mitotic index (P ＜ 0.001),high cellularity (P =0.012),tumor rupture (P =0.013),absent or low expression of IGF1R (P =0.022).Tumor size (HR5.1-10 ≤5 cm =1.86,95％ CI:0.67-5.15;HR＞10 ≤5cm =6.71,95％ CI:0.67-5.15,overall P =0.023),and mitotic index (HR5.1-10/50HPFsvs.≤5/50HPFs =5.72,95％ CI:2.09-15.64;HR＞10/50HPF ≤5/50HPFs =3.44,95％ CI:1.13-10.45,overall P =0.002) were negative independent risk predictors by multivariate analysis.Conclusions High expression of IGF1R may be involved in the occurrence,development and poor prognostic of primary GIST.Expression of IGF1 R is correlated with high risk potential and may predict early recurrence.

Objective To investigate the value of partial hepatectomy and vascular resection in the treatment of hilar cholangiocarcinoma. Methods Seventy four patients with hilar cholangiocarcinoma who underwent hepatectomy of Chinese People' s Liberation Army from January 2008 through December 2011 were analyzed retrospectively.Results Of the 74 patients,33 underwent radical resection and 19 palliative resection,22 received internal or external drainage.In the radical resection group,the median survival time was 27 months,and the overall survival rate at 1,2 and 3 years were 79％,64％ and 49％.In the palliative resection group,the median survival time was 14 months and the overall survival rate at 1,2 and 3 years were 56％,25％,and 19％.In the drainage group,the median survival time was 9 months and the overall survival rate at 1,2 and 3 years were 23％,15％,0.Conclusions Hepatectomy combined with hilar vascular resection helps increase survival rate of patients in radical excision of hilar cholangiocarcinoma and Surgical resection is the most elective method for treatment of hepatic hilar cholangiocarcinoma,and the radical resection might improve the prognosis of the patients with hilar cholangiocarcinoma.

Objective To observe clinical curative effect of modified total cystectomy and Mainz Ⅱ neobladder. Methods Seventeen patients with bladder neoplasms were treated with modified total cystectomy and Mainz Ⅱ neobladder for urinary diversion. The paries posterior allantois with intestinum rectum and colon sigmoideum were taken 10 cm respectively, split the mesenterium edges, conduplicated and bilayer sutured from the junction of intestinum rectum and colon sigmoideum, bilateral ureters antireflux anastomosed respectively with colon sigmoideum and rectal papilla, then bilayer sutured paries anterior became Mainz allantois. Results There was no surgical mortality. The operative time was 340 ～ 420 mins (mean, 350 mins).Blood transfusion was 400 ～ 800 ml ( mean 600 ml). The follow-up was 4 ～ 18 months, urine and dejecta were shunt, uresis continence was fine and the operation had fewer severe complications. Conclusion Modified total cystectomy and Mainz Ⅱ neobladder to be an effective method for urinary diversion because of its simple operation, fewer severe complications, good uresis continence and high quality of life.