Objective To investigate the change of the cerebral glucose metabolism in Parkinson's disease(PD) with cognitive impairment.Methods Fifty patients with PD and twenty normal controls were enrolled in this study.Based on MMSE score,the PD patients were divided into PD-NC(n=25) and the PDD(n=25) group.Twenty age-and sex-matched physical health examinationer were colleted as control group.Using the SPM to analyze the characteristics of the metabolism in different cognitive level io PD patients.Results (1) Compared with control group,P D-NC group showed significant hypermetabolism in occipital (-24,-92,10),parietal (-48,12,-16) and temporal lobe(52,8,-32).(2)Compared with control group,the glucose metabolism of PDD group decreased in most cerebral cortex and subcortex.(3)Compared with PD-NC group,the metabolism of parietal lobe (-42,-48,40),occipital lobe (-22,-96,-6) and tetnporal lobe (-42,-58,16) reduced in PDD group.Conclusion Cortical brain metabolism decreases in PD-NC group.The degree and scope of glucose metabolism of PDD group will increase with the progress of cognitive dysfunction.These features could help with the diagnosis and differential diagnosis of cognitive dysfunction in Parkinson's disease.

Objective To investigate the correlation between insulin resistance with female overactive bladder (OAB) .Meth‐ods 96 female patients with OAB were selected as the observation group and contemporaneous 92 women with healthy physical ex‐amination were taken as the control group .The fasting plasma glucose (FPG) ,triglycerides (TG) ,total cholesterol (TC) ,high‐den‐sity lipoprotein (HDL‐C) ,low‐density lipoprotein (LDL‐C) ,fasting insulin (FINS) ,and C reaction protein (CRP) levels were measured in the two groups .The insulin resistance index was calculated by the homeostasis model assessment of insulin resistance (HOMA‐IR) .Results The waist circumference ,body mass ,body mass index (BMI) ,hypertension cases and proportion of meno‐pause cases in the observation group were higher than those in the control group .FPG ,TG ,FINS ,CRP levels and HOMA‐IR in the observation group were significantly higher than those in the control group ,while the HDL‐C level was lower than that in the con‐trol group .In addition ,the differences in TC and LDL‐C levels between the two groups were not statistically significant (P>0 .05) . Conclusion Insulin resistance has no correlation with female OAB .

Objective To investigate the influence of indomethacin to the unite treatment effect on chronic phase myeloid leukemia (CML-CP) with interferon alpha-2b (IFNα-2b) and low dose cytarabine (LD-Ara-C).Methods 22 CML-CP patients were randomly divided into two groups.Control groups (10 cases) injected with IFNα-2b (3 million units),injection frequency was q.o.d,the duration of treatment was about 3-18 months,cytarabine (Ara-C) by slowly intravenous driped (30 mg/d).In this treatment schedule,every course of treatment sustained 10 days,and with a 2 weeks interval.During this process,patients in treatment group were treated with hydroxyl urea only when their WBC in peripheral blood exceed 20×109/L,otherwise,discontinue it.Treatment group (12 cases),on the first day of treatment with IFNα-2b and Ara-C,added indomethacin (25 mg) through oral administration,the frequency was t.i.d.During treatment in the two group,the end point of observation was completely hematology ease,at the same time,these indicators in the two groups needed to be compared,the time when WBC begin to fall,the time when WBC fall to normal range,the time when immature cells returned to normal,the time which complete hematological remission and the highest temperature of patients after IFNα-2b was subcutaneous injected.Results The time when WBC begin to fall in treatment group was (4.2±2.7) d,and the time was (5.0±2.5) d in control group (t =0.714,P ＞ 0.05).In treatment group,the time when WBC fall to normal range was(10.0±4.5) d,and the time was (12.0±4.5) d in control group (t =1.036,P ＞ 0.05).The time when immature cells returned to normal in treatment group was (14.2±4.8) d,and the time was (19.0±3.6) d in control group (t =2.609,P ＜ 0.02).The time which complete hematological remission was achieved in control group was (45.8±5.6) d,but it was (53.9±10.5) d in control group (t =2.314,· P ＜ 0.05).Meanwhile,the fever degree after IFNα-2b was subcutaneous injected obviously achieved improvement in treatment group (x2 =12.041,P ＜ 0.005).Conclusion The advantage of indomethacin to the unite treatment with IFNα-2b and LD-Ara-C on CML mainly lays in which cound alleviated the adverse reaction such as flu-like of IFN,and more,there are synergy effect in antagonist CML.

Objective To evaluate the effect of midwives′antenatal clinic service on management of gestational weight and birth outcomes .Methods Totally 420 primiparas who had made registration and regular antenatal examination in a hospital ,were randomly divided into two groups .The women in the control group(n=208) received routine antenatal clinicservice .In addition ,the women in the experimental group(n=212) participated in an individual midwives′antenatal clinic .The primiparas′gestational weight gain and birth outcomes were measured and compared between the two groups .Results The rate of natural birth in the experimen‐tal group was higher than that of the control group .The rate of fetal macrosomia ,episiotomy and labor analgesia were lower than that of the control group(P<0 .01) .The rate of naturalbirth ,fetal macrosomia ,episiotomy ,labor analgesia were significantly lower than that of the control group(P<0 .01) .The neonatal weight[(3 250 .58 ± 270 .03)g vs .(3 405 .42 ± 403 .28)g] and volume of bleeding[(199 .13 ± 64 .37)mL vs .(249 .53 ± 93 .56)mL] 2 hours postpartum in the experimental group were significantly lower than that of the control group(t=28 .610 ,P<0 .01 ;t=20 .581 ,P<0 .01) .There were no significant differences in the rate of gesta‐tional diabetes mellitus ,pregnancy‐induced hypertension and fetal distress in uterusbetween the two groups (P>0 .05) .Conclusion The midwives′antenatal clinic service has good effects on management ofgestational weight gain ,improves birth outcomes and pro‐vides primiparas positive experience of childbirth .

Objective To study the diagnostic value of difusion weighted imaging in brain ischemic stroke and to summarize the MR appearances and characteristics of the false negative and false positive cases.Methods 225 cases which were highly suspected of brain ischemic stroke were studied prospectively.The final diagnosis of the cases were verified by following up examination or pathology.The diagnostic value were calculated.Results The sensitivity and specificity for the diagnosis of ischemic stroke were 93.55% and 100% at superacute stage(

【Objective】To compare different approaches and their effectiveness on the treatment of the femoral neck fracture in children,in order to provide a reliable and effective way for the treatment of the disease.【Methods】Clinical data of 21 cases with femoral neck fracture from 1983 to 1993 were analyzed retrospectively.【Results】21 cases were divided into three groups:① group Ⅰ:14 cases underwent closed reduction and internal fixation with multiple Kirscher′s pins or cannulate compression screws under C-arm X-ray monitor.Of the 14 cases,11 cases were healed,3 cases developed ischemic necrosis of femoral head;② group Ⅱ:4 cases was treated with skin traction and hip spica cast plaster fixation,3 cases was healed,1 case developed ischemic necrosis of femoral head;③ group Ⅲ:3 cases underwent opened reduction and internal fixation with multiple pins or cannulate compression screws,1 case was healed,2 cases developed ischemic necrosis of femoral head.【Conclusion】Closed reduction and multiple pins internal fixation under C-arm X-ray monitor may be the best choice of treatment of femoral neck fracture in children.

Objective To investigate the characteristics of cerebral glucose metabolism (CGM) in PD patients with cognitive impairment (PD-CI) using 18F-FDG PET/CT,and to analyze the correlation between the progress of PD-CI and CGM changes.Methods A total of 31 idiopathic PD patients (14 males,17 females,aged 37-77 years) from May 2013 to February 2014 were divided into 3 groups based on Montreal cognitive assessment (MOCA):none CI in PD (PD-NC) group (MOCA＞26 scores),mild CI in PD (PD-MCI) group (MOCA 21-26 scores),PD with dementia (PDD) group (MOCA＜21 scores).The normal controls (NC) group included 12 age-and gender-matched healthy adults (7 males,5 females,aged 40-76 years).All subjects underwent PET/CT imaging after intravenous injection of 18F-FDG(5.55 MBq/kg).MIMneuro software was used to analyze the data.The correlation between the CGM and cognitive function was analyzed using Pearson or Spearman correlation analysis.Results (1) Compared with NC group,PDD group presented a widespread cortical metabolism decrease in frontal,parietal,temporal,occipital 19bes and the limbic lobe;PD-MCI group showed hypometabolic areas in the parietal and occipital lobes,and with less extent in the frontal and temporal lobes;PD-NC group showed no significant cerebral hypometabolism.(2) Compared with PD-NC group,PDD group showed widespread cortical metabolism decrease in occipital lobe,temporal lobe,partial parietal cortex and the posterior cingulated cortex.Compared with PD-MCI group,PDD group had lower metabolism,mainly in posterior brain areas (parietal,occipital and temporal lobes).Compared with PD-NC group,PD-MCI group showed hypometabolism in right supramarginal gyrus and the left parahippocampal gyrus.(3) There were positive correlations between visuospatiaL/executive function and visual cortex metabolism,angular gyrus metabolism or superior parietal lobule metabolism (r =0.535,0.443,0.395;all P＜0.05).A positive correlation was also found between delayed memory and heschl's gyrus metabolism (r=0.337,P＜0.05).Conclusions The cerebral glucose metabolism detected with 18F-FDG PET/CT is well correlated with MOCA assessments.Thus it may be helpful in evaluation of the progress of cognitive impairments in PD.

Objective To study the distribution of pathogenic spectrum in children with severe community-acquired pneumonia(CAP) and bacteria antibiotic resistance.Methods One hundred and ninety-three children with severe CAP were enrolled from Mar 2011 to Feb 2012.Sputum specimens were collected for bacterial culture and drug sensitive test.Meanwhile mycoplasma pneumonia and chlamydia trachomatis were detected by fluorescent quantitative polymerase enzyme technology.Antigen of virus were detected by immunofluorescence assay.Results A total of 96 cases (49.7％) were bacteria positive in 193 children with severe CAP.The top four bacteria strains were klebsiella pneumoniae,staphylococcus aureus,escherichia coli and streptococcus pneumoniae.Most of gram-negative bacteria were resistant to ampicillin,cefazolin,ceftriaxone,ceftazidime,and compound sulfamethoxazole,but were sensitive to piperacillin/tazobactam,imipenem,ciprofloxacin,levofloxacin,amikacin.Gram-positive bacteria were resistant to penicillin and erythromycin,but sensitive to vancomycin.Fifty-three cases (27.5 ％,53/193) were virus Positive,81.1％ of which were less than 1 year old.Respiratory syncytial virus accounted for the most prevalent pathogen,followed by adenovirus,influenza virus A.Mycoplasma pneumoniae were positive in 4 patients (2.1％,4/193),chlamydia trachomatis were positive in 3 patients (1.6％,3/193).Mixed infection was found in 23 cases (11.9％,23/193).There were 14 cases (7.2％,14/193) with undetected pathogens.Conclusion Bacterium is the major pathogen in children with severe CAP and the virus is the second.The initial antibiotics administration of piperacillin/tazobactam or carbapenem and vancomycin should be chosen for severe bacteria pneumonia.

With the further development of education informatization,the popularity of computer simulation technology and multimedia network technology were increasing.The teaching center of school of stomatology in the fourth military medical university combined stomatology teaching with information technology and gradually applied diversified teaching mode in the dental clinical experiment teaching,which not only saved the input of faculty and consumables items,but also improved the stomatology experimental teaching quality and achieve the teaching modernization.

Objective To compare the effect of two different treatment approaches on femoral shaft fractures in polytrauma patients.Methods One hundred and forty-eight polytrauma patients were selected as our subjects,who were hospitalized from Jan.2000 to Dec.2009.They were randomly divided into cast group and external fixation group.Patients in cast group were fixed with cast within the first 24 h after the injury and patients in external fixation group were stabilized with a unilateral external fix stent within the first 24 h after the injury.Results In cast group,71 of 75 patients were followed up and follow up periods was 26.4 months.Follow up data showed that 18 patients developed multiple organ failure (MOF) and 26 patients developed ARDS.The average healed periods was 5.9 month.Three patients developed nonunion and 4 cases developed wound infection.The average of the knee motion angle was 107 degrees (60 to 110 degrees).In external fixation group,68 patients were followed up and the follow-up period was 27.5 months.Of which,13 patients developed MOF and 12 patients developed ARDS.The average healed periods was 5.6 months.2 patients developed nonunion and 3 cases developed for.wound infection.The average of the knee motion angle was 120 degrees (60 to 140 degrees).Conclusion The damage control orthopedics surgery was proved as a safe and effective treatment approach for fractures of the shaft of the femur in selected multiply injured patients compared with cast methods.