Subcortical ischemic vascular disease (SIVD) is a group of ischemic cerebrovascular diseases caused by small-vessel disease,and the major pathological damage is multiple subcortical lacunar infarction and white matter lesions.SIVD is the most major cause of resulting in vascular cognitive impairment.It can also have gait disorders,such as Parkinsonlike gait,frontal gait,ataxia,or frequent fall without obvious inducement,etc.Several studies have shown that the gait abnormalities in the elderly may be the early signs of vascular dementia.This article reviews SIVD caused pathomechanisms,clinical features,clinical significance,analysis and evaluation and treatment of gait disorders.

Objective To develop an instrument for measuring family relocation stress scale during patient transferred from ICU. And to provide evidence for ICU health care personnel to assess and deal with the family member′s relocation stress. Methods A draft scale was developed based on the result of related scale abroad, literature review and semi-structured interviews. Delphi method and Classical test theory were used in item selection. Results The degree of experts′ authority in two rounds′consultation were 0.83. The Kendall′s coordination coefficients of importance were 0.36, 0.36 (P<0.05) in dimension and 0.35, 0.37 (P<0.05) in item. Five items were deleted by the statistical analysis with pilot investigation. 6 dimensions (transfer anxiety, environmental changes, disease severity, nursing model changes, the safety of transfer, self-efficacy of care ability) and 20 items consisted the scale. The Cronbach α coefficient was 0.882. Exploratory factor analysis extracted 6 items, accumulated variance contribution rate was 72.226%. Confirmative factor analysis showed χ2/df=1.677, comparative fit index=0.936, Tucker-Lewis index=0.921, root mean square error of approximation=0.061. Conclusions The scale is based on abundant theoretical evidence and reasonable design, with satisfactory reliability and validity. It can be used as the evaluation tool for family relocation stress during patient transferred from ICU.

Objective To investigate age-related changes of serum prolactin(PRL) and testosterone (T) in aging males and to study the correlation between PRL and prostatic hyperplasia. Methods 84 aged males were divided into four groups, the fifties, the sixties, the seventies and the eigh- ties . Serum PRL and T were measured using radioimmunoassay. The volume of prostate was evaluated by ultrasound in 38 and it's correlation with PRL studied. Results Serum T level of the 4 age groups from fifties to eighties was (25.92?2.54),(21.00?1.92),(18.37?2.49) and (14.75? 2.38 ) nmol/L respectively and PRL concentration (1.11?0.16), (0.96?0.20), (0.99?0.18) and (0.91?0.29) nmol/L. Analysis of variance showed that serum T concentration significantly decreased with age ( F =3.44, P 0.05). No association between PRL and volume of prostate has been observed. Conclusions PRL play a physiological role in the development and growth of prostate via androgen. But such effect of androgeno-dependence on prostate is greatly diminished because of the decrease of androgen hormone with age especially in the aged.

OBJECTIVE:To provide reference for imipenem-resistant Pseudomonas aeruginosa infection control. METHODS:114 patients infected with imipenem-resistant P. aeruginosa were selected from 3 tertiary hospitals in Zhoushan during Feb. 2013 to Feb. 2014. 114 strains of P. aeruginosa were isolated from clinical specimens,and drug resistance characteristics and carbapene-mase-producing gene diversity were analyzed. 101 inpatients with imipenem-resistant P. aeruginosa infection were included in con-trol group;univariate and multivariate Logistic regression analysis were adopted to explore the risk factors of imipenem-resistant P. aeruginosa infection. RESULTS:114 strains were sensitive to polymyxin B,and had different levels of resistance to other 9 kinds of antibiotics. Carbapenemase-producing gene were mainly IMP and VIM type gene. Long-term hospitalization,mechanical ventila-tion,used imipenem and early combined use of antibiotics were risk factors of imipenem-resistant P. aeruginosa infection. CON-CLUSIONS:In Zhoushan area,imipenem-resistant P. aeruginosa shows serious drug resistance. To avoid long-term hospitalization and early combined use of antibiotics can reduce imipenem-resistant P. aeruginosa infection.

Objective To investigate the curative effect and adverse reaction of caffeic acid (CFA) for leukopenia and thrombocytopenia caused by imatinib in chronic myeloid leukemia (CML) patients.Methods The effect and adverse reactions of CFA for leukopenia or thrombocytopenia induced by imatinib in 42 CML patients were observed.The CFA was admitted by 0.2 g/time,3 times/d,oral.Results 21 cases of 42 CML patients with thrombocytopenia achieved remarkable curative effect after CFA treatment,13 achieved good effect and 8 had no effect.The total effective rate was 81.0 ％ (34/42).While 15 of 28 leukopenia CML patients achieved remarkable curative effect,8 achieved good effect and 5 had no effect.The total effective rate was 82.1％ (23/28).After CFA therapy for 2 weeks,both platelet and white blood cells count were elevated compared with before treatment,the differences were statistically significant (t =2.015,P =0.023,t =1.913,P =0.035).The average onset time of CFA for leukopenia and thrombocytopenia was 2 weeks and no treatment-related adverse reaction was found.Conclusion CFA is an effective and safe auxiliary drug for treatment of imatinib-induce leukopenia and thrombocytopenia in patients with CML.

ObjectiveTo evaluate the value of CT in diagnosis and discrimination of acute focal bacterial nephritis(AFBN). Methods 6 cases of AFBN were reported which were all performed with ultrasound and CT scan.4 of 6 cases were observed by delay contrast enhanced CT examination. ResultsCT scan showed wedge-shaped masses with thickened Gerota fascia.The delayed contrast enhanced CT revealed more clear shapes and verges of the lesions than immediate contrast enhanced CT. ConclusionCT scan is of significant value in diagnosis and discrimination of AFBN with overall review of documents and statistic analysis.

OBJECTIVE: To observe the clinical efficacy of the combination of traditional Chinese medicine and western medicine in treating irritable bowel syndrome (IBS) and the result of intestinal flora regulation. Methods: Sixty IBS patients, 36 males and 24 females, were divided into two groups, with 30 patients in each group. Herbal formula of TongxieYaofang and clostridium butyricum (Cb) were used in the first group for four weeks, while only Cb was used for four weeks in the second group. We observed the changes of coliform group, enterococcus, lactobacillus, bifidobacterium after treatment. RESULTS: The effective rate of the Tongxie Yaofang and Cb treated group was significantly higher than that of the Cb treated group (P < 0.05). The numbers of bifidobacterium and lactobacillus increased, while the numbers of coliform group and enterococcus decreased after the treatment, and the changes of intestinal flora in the integrative medicine treated group were significantly greater than those in the Cb treated group. CONCLUSION: After treatment with the combination of traditional Chinese medicine and western medicine, the intestinal flora can be regulated to equilibrium state.

OBJECTIVE:To comparison the clinical efficacy and safety of sitagliptin and Repaglinide in the treatment of new-ly diagnosed patients with type 2 diabetes mellitus. METHODS:214 newly diagnosed patients with type 2 diabetes mellitus were randomly divided into study group and control group with 107 cases in each group according to random number table method. Both group received routine diabetes diet,health education and suitable exercise. Control group was treated with Repaglinide tablet 1.0 mg,tid;while study group was treat with Sitagliptin tablet 100 mg,qd. Lab indexes,FBG,PBG,HbA1c and BMI were observed in 2 groups before and after treatment. ADR were compared between 2 groups. RESULTS:There was no statistical significance in lab indexes between 2 groups before and after treatment (P>0.05). After treatment,FBG,PBG,HbA1c were significantly de-creased significantly in 2 groups,with statistical significance (P<0.05),there was no statistical significance between 2 groups (P>0.05). BMI of 2 groups were increased significantly,and the study group was higher than the contrd group,with statistical sighificance (P<0.05). Patients in the study group had no hypoglycemia,while 3 patients in the control group suffered from it, there was statistical significance (P>0.05). CONCLUSIONS:Sitagliptin is similar with repaglinide in therapeutic efficacy;both can effectively reduce blood glucose of elderly patients with newly diagnosed type 2 diabetes mellitus,and the incidence of hypo-glycemia was low,the saterty was good,but sitagliptin has a better control of BMI in patients.

Objective To evaluate the improvement of diagnosis and treatment of hypercatecholaminism. Methods A total of 95 cases of hypercatecholaminism were reviewed.Of them 74 cases were of pheochromocytoma and 21 cases were of adrenal medullary hyperplasia (AMH).In pheochromocytoma group,67 cases (90.5%) had symptom of hypertension.Increase in 24 h urinary VMA occurred in 62 cases (83.8%) and elevated urinary catecholamine level in 67(90.5%).All thses had positive findings of ultrasound,CT scan and MRI.In AMH group,all the patients were hypertensive and their 24 h urinary VMA was increased.Most of them (15/16) had higher urinary catecholamine level than normal;14 out of the 21 cases had positive findings of B-ultrasound examination. Results Surgical operations were performed in the 74 patients with pheochromocytoma including 9 cases of extra-drenal pheochromocytoma.Of them 5 cases were confirmed as malignant pheochromocytoma.In the 21 cases of AMH,18 undewent surgical operation.Of them 12 received unilateral resection and 6 received bilateral resection of adrenal gland.The pathological examination confirmed the diagnosis of AMH. Conclusions The diagnosis of pheochromocytoma should be focused on endocrinological examination,ie,qualitative examination,whereas it is diffucult to localize the lesion in AMH compared with pheochromocytoma.The establishment of notion of AMH as an isolated clinicopathological entity broadens and perfects the theory of hypercatecholaminism.

Crohn disease (CD) is a relatively infrequent disease in China. CD and intestinal tuberculosis (IT) are lack of specific clinical manifestations and are generally identified by endoscopic and histological examination. However, it is sometimes difficulty to distinguish them by endoscopy and histology. Their characteristics were investigated to offer more evidences and data for their differential diagnosis. The records of inpatients were reviewed from 1980～2001 in our hospital, all enrolled subjects were verified by endoscopy(or operation) and histology. The characteristics and key points of differential diagnosis of 28 CD cases and 14 IT cases were comparatively analyzed. The results showed that abdominal pain, mass, and hematochezia occurred more significantly in CD than in IT ﹙ P