Writing behavior is affected by many factors and depends on the functional integrity of the nervous system. Its neuropsychological mechanism remains unknown. The agraphic features involving different parts of brain damage are dissimilar. The neuroanatomic location of agraphia and its possible brain mechanism are reviewed.

Objective To explore the clinical indication and operative methods for different upper eyelid aging through perieyebrow incision.Methods We collected totally one hundred fifty-two cases in this study,including six males and 146 females,and aged from 26 to 80 years (average 47).There were 29 cases with only ptosis of upper eyelid,and the rest 123 cases were ptosis of upper eyelid with ptosis of eyebrow,sunken upper eyelid,bloated upper eyelid,or over-wide between eyebrow and eye region (compensatory eyebrow elevation).Through the incision of upper or lower margin of eyebrow,we treated these five types of upper eyelid aging by excision of redundant skin,orbicularis oculi muscle,frontal muscle,ROOF,or orbital fat,or ROOF elevation for upper eyelid rejuvenation.Results Patients were followed up for 3 to 120 months,with average 14.4 months.All ptosis of upper eyelid and over-wide between eyebrow and eye region patients were improved obviously.In 36 ptosis of upper eyelid with ptosis of eyebrow,seven of them treated with upper eyebrow margin incision got the best results;and the rest 29 patients treated with lower eyebrow margin incision,fifteen patients were lifted slightly,and the rest fourteen patients got no improvement.All scars of inferior eyebrow margin incision were invisible.Faded and applanate one millimeter wide scars were seen on two patients with superior eyebrow margin incision.In all patients with ptosis of upper eyelid,80％ patients with sunken upper eyelid were improved obviously,and 85 ％ with bloated upper eyelid were improved significantly.Conclusions Upper eyelid aging is divided into five categories.Upper eyelid aging could be corrected by perieyebrow approach.Our methods are simple,safe,fewer complications,and with short convalescence,which is the minimally invasive procedure recommended for Chinese patients with upper eyelid aging.

ObjectiveTo avoid the complications such as scar,alopecie,scalp numbness,hematoma etc,resulted from the conventional coronal incision rhytidectomy,and to explore and solve the issues about endoscopic frontal and temporal rhytidectomy.MethodsThrough 3-5 short incisions in hairline,we dissected under frontal periosteum or gales aponeurotica and in superficial layer of deep temporal fascia.The frontal and temporal cavitites were feedthrough at temporal crest.The corrugator supercilii muscle,superciliary depressor muscle,frontal muscle and orbicularis oculi were treated.Sufficient dissection was done under the periosteum of os orbitale.ResultsThis method had been applied in 186 patients with forehead lift.After operation,transient paralysis of facial nerve frontal branch were found in 3 patients.The depression of glabellum and lateral canthus were found in 5 patients.The depressions were corrected by autologous fat injection. Other 178 patients' results were satisfactory.ConclusionsEndoscopic frontal and temporal rhytidectomy has some advantages,such as minute invasion,less hemorrhage,few complications,and stable operation result,etc.Compared to the conventional coronal incision rhytidectomy,this method will be used more widely.

Objective:To investigate the affects of NOD2 on rapamycin (Rap)induced autophagy and on the proliferation and mi-gration of tongue squamous carcinoma SCC-1 5 cells.Methods:① Synthesized NOD2 over-expression plasmid and NOD2-shRNA were transfected into SCC-1 5 cells respectively.②Normal control SCC-1 5 cells,NOD2 over-expression cells and NOD2-shRNA cells were treated with Rap to induce autophagy.Then,the expression of LC3 and Beclin-1 was examined by Western blot.Cell pro-liferation was tested by MTT assay.Cell migration was assessed by wound healing assay.Results:①After Rap treatment,the expres-sion of protein LC3-Ⅱand Beclin-1 in NOD2 over-expression cells increased(P <0.05)and in NOD2-shRNA cells were suppressed (P <0.05).② Compared with control group,the proliferation and migration ability were decreased in NOD2 over-expression cells (P <0.05),but in NOD2-shRNA cells the proliferation and migration ability were increased(P <0.05).Conclusion:NOD2 can up-regulate the autophagy and suppress the proliferation and migration of tongue squamous SCC-1 5 cells.

Objective To investigate the correlation between diabetic distress and coping styles among patients with type 2 diabetes. Method One hundred inpatients with type 2 diabetes were engaged in the investigation of their diabetes distress and coping styles by the diabetes distress scale (DDS) and medical coping modes questionnaire (MCMQ) and the correlation between them. Results The average score of diabetic distress was (2.17 ± 0.71), which was at mild level. 57%of them were at the higher level of diabetic distress. Confrontation and avoidance dimensions were lower than the norm in coping styles, and the acceptance dimension was higher than the norm (all P<0.01). The average scores of diabetic distress, regimen-related distress and physician-related distress subscales were negatively correlated with confrontation (all P<0.05). The average score on diabetic distress and the subscales were positively correlated with avoidance and acceptance dimension (all P<0.01). Conclusions Diabetic distress is prevalent in type 2 diabetic patients and the degree of positive coping is still not insufficient. The diabetic distress is negatively correlated to the confrontation, and positively correlated to the avoidance and the acceptance dimension. The medical staff should instruct the patients to adopt positive coping styles, and avoid negative coping styles to reduce diabetic distress. It will be conductive to the physical and mental rehabilitation of the patients as well.

Objective To explore a venipuncture method that can reduce the pain, improve the suc-cess rate of puncture as well as reduce vascular injury. Methods Self-controlled method was applied in 200 patients, needle tips with 20～25°,31～40°,41～50°, 51～60°, > 60° angles on the top of the blood ves-sels,the inclined plane of the needle parallel to the longitudinal axis of the blood vessel (that was,the in-clined plane to the left or right) or traditional method with upward of needle tips were adopted, the observa-tion group and the control group were divided according to different methods, pain and success rate of puncture were compared. Results There were differences between the two groups,results of the observa-tion group were better than those of the control group (except when > 60°, success rate showed no differ-ence). Conclusions Venipuncture with needle tip parallel to the longitudinal axis of the blood vessels can significantly reduce pain in patients, improve the success rate of puncture and reduce the vascular in-jury, which were superior to the traditional venipuncture method. Whatever method is chosen, 51～60° is the best angie into the vessel.

Objective To investigate the techniques and signifcations of endoscopic forehead lift when it was done alone or in combination with conventional facelifting.Methods For the patients with forehead transverse wrinkle,vertical frown line and eyebrow ptosis,resection of partial frontalis muscle,procerus muscle and eorrugator muscle was performed.If the patients had obvious excessive and drooping skin in middle face and lower face together with the wrinkles that were mentioned above,endoscopic forehead lift in combination with conventional facelifting was done at the mean time.The excessive skin was tailored and removed,SMAS was complicated or resected and sutured.Results 104 patients were subjected to the endoscopic forehead lift,in which 20 cases underwent it alone,and another 84 cases were treated in combination with the conventional facelifting.Of all cases,104 patients presented satisfactory results of forehead.They showed the eliminating of transverse wrinkle of forehead,glabellas vertical fold and lifting of eyebrow ptosis.Complications were less and minimal,including minimal local depression,retrodisplacement of hairline of forehead,recurrence of wrinkle and numb of forehead.No injuring of temporal branch of facial nerve occurred in this group.The cases that underwent endoscopic forehead lift in combination with conventional faeelift showed the coordinate and consistence of rejuvenation from forehead to middle face and lower face.Conclusions Endoscopic forehead lift is a minimally invasive technique,and it presents more satisfactory results with less severe complications.Its operative principle is reasonable,procedure is safe and reliable,and therefore it represents the tendency of developing of plastic surgery and cosmetic surgery.If patients have obvious excessive and drooping skin in middle face and lower face,endoscopic forehead lift is suggested in combination with the conventional facelift,and this resolution shows more balanced and coordinate cosmetic correction of whole face.

Objective:To investigate the functional status of dendritic cells(DCs)in oral leukoplakia(OLK)tissues.Methods:The expression of DC-specific markers CD1 a,CD209,CD1 23 and CD83 in 20 cases of OLK with abnormal dysplasia,1 0 with simple dys-plasia and 1 0 of normal oral mucosa tissues was examined by immunohistochemistry.Results:CD1 a and CD209 positive DCs were found in all cases.More CD1 a positive Langehans cells(LCs)in lamina propria were found in OLK with abnormal dysplasia than in normal o-ral mucosa and OLK with simple dysplasia(P <0.01 ).A great mount of CD209 positive stromal DCs were recruited in OLK.There was no CD83 positive and CD1 23 positive cell in normal oral mucosa,however,CD83 positive mature DCs and CD1 23 positive plasmacytoid DCs(PDCs)were observed in OLK(P <0.01 ).Conclusion:OLK is characterized by the recruitment of different subsets of DCs,the different DC subsets may play an important role in the development of OLK.

AIM: Construction of an eukaryote- E. coli shuttle expressing recombinant plasmid which expresses OmpL1 envelope protein of pathogenic Leptospira, serovar Lai strain 017. METHODS: The OmpL 1 gene was amplified by PCR from the leptospiral genome. Then it was cut with restriction enzymes and ligated to the plasmid pBK-CMV. The correct recombinant plasmid was screened out with analysis of restriction enzymes and PCR. After inducing the E. coli baring recombinant plasmid with IPTG,the complete protein of the bacteria was extracted for SDS-PAGE. At the same time, OD600 of the host bacteria was examined at different time after inducing or uninducing with IPTG. RESULTS: Five strains E. coli containing proper recombinant plasmids were screened out. Four strains E. coli expressed a new protein with a weight of 37 kD among them. With the expression of the heterogenous protein,the OD600 of the host bacteria decreased. CONCLUSION: The shuttle expressing plasmid of the OmpL 1 gene of strong virulent Leptospira strain 017 was successfully constructed. Furthermore,the recombinant plasmid expressed the expected OmpL 1 fusion protein in E. coli and the expression of the heterogenous protein had toxic effect on the host bacteria. This work was important for the future research of OmpL1 protein which relates to the diagnosis,new vaccine preparing and the pathogenic mechanism of leptospirosis.

Objective To study the effects of light at different intensities and an enriched environment (EE) on rats' level of voluntary exercise,and to explore the resulting benefits.Methods Thirty male SpragueDawley rats were tested successively under 4 different experimental conditions:EE + strong light,EE + dim light,open-field environment (OFE)+ strong light and OFE + dim light.Each rat's path in the different conditions was recorded using an automated tracking system.Distance moved (m),velocity (m/s),mobile duration (s),mobile frequency,moving duration (s) and moving frequency were recorded over a one-hour period. ResultsThe EE rats were significantly more active than the OFE rats in both strong and dim light.All rats were more mobile under dim light than under strong light.Conclusion Environment and light intensity are independent factors affecting rats' voluntary exercise levels,and they can exert their influence in synergy.