Objective To observe the effects of computer assisted training combined with the actual environment training on vascular cognitive impairment with no dementia (VCIND) after stoke.Methods Sixty elderly patients with VCIND after stroke were randomly divided into a research group and a control group,each of 30.All patients were given routine medication and rehabilitation training,while the research group was additionally provided with computer assisted training and the actual environment training lasting two months.All patients' cognitive function and activities of daily life (ADL) in both groups were assessed using the Montreal cognitive assessment scale(MoCA) and modified Barthel index(MBI) before and after treatment.Results After two months of treatment,the total score of MoCA (22.80 ± 4.63) and the scores of seven subprojects including visual space (4.00 ± 0.93),naming (2.67±0.62),attention(4.13 ±0.74),language(2.33 ±0.62),abstract thinking(1.60± 0.83),delayed memory(2.93 ±0.70) and orientation(5.13 ± 1.19) in the research group were significantly higher than those before treatment and those of the control group.However,in the control group,only the total score and the scores of naming,language and delayed memory in the control group significantly were higher than those before treatment.After treatment,the scores of MBI in both group were significantly promoted,reaching (61.53 ± 7.13) and (52.20 ± 4.93) for the research and control group respectively,with the former improving more significantly than the latter.Conclusion The computer assisted training combined with the actual environment training helps to improve cognitive function and ADL for patients with VCIND after stoke.Such combined therapy is worth of promoting in clinical practice.

Objective Studies have shown that estrogen plays profound roles on nerve system,but the mechanism is now poorly understood.In order to address this question,the distribution of the newly cloned estrogen receptor ?(ER\|?) immunoreactivity(ER\|?\|ir) was examined in the brain of adult female rats. Methods Using nickel ammonium sulfate intensified immunohistochemistry technique. Results 1.ER\|?\|ir was mainly localized in the nuclei of neurons,it was also found in the perikaryon and neuritis;while in very few neurons,positive signals were only detected in the perikaryon and neuritis;2.High level of ER\|?\|ir positive signals were detected in the anterior olfactory nucleus,cerebral cortex,Purkinje cells,vertical limb of the diagonal band,superior vestibular nucleus,endopiriform nucleus,lateral amygdaloid nucleus,red nucleus and loci ceruleus;moderate level of ER\|?\|ir was detected in the medial septal nucleus,posterior cortical nucleus of the amygdaloid,CA3 and CA4 of the hippocampus,dentate gyrus,bed nucleus of the stria terminalis,supraoptic nucleus;weak signals were detected in the nuclei of hypothalamus,oculomotor nucleus,claustrum and some nuclei of the amygdaloid complex.Conclusion\ ER\|? immunoreactive neurons are extensively distributed in the brain of the adult female rats;this receptor may be involved in different brain function in different brain nuclei. \;[

In the recent few years,apart from the development of interventional technology,the development of new kinds material for packing intracranial aneurysms has hastened the promotion of endovascular interventional treatment greatly. Microvention company introduces lately Hydrocoil,a kind of hydro-agglutinated microspring coil which adopts a special hydrolink detachment technology,enriching the methods of endovascular treatment for cerebral aneurysms. Hydrocoil is a traditional platinum coil coated with expandable,unabsorble hydrogel material,which can improve the filling volume proportion of the aneurysm. At present it has been initially applied in clinic. This article summarizes the characteristics,the preclinical study,and the clinical application of Hydrocoil.(J Intervent Radiol,2007,16: 710-713)

Objective To evaluate the clinical effect of potassium permanganate solution in treating the infected prepuce wound. Method From July 2000 to July 2007,97 patients with infected prepuce wound from Beijing Chaoyang hospital and other hospitals, aged 3 ～ 69 years, averaging 22.6 years, were all washed with 0. 1% potassium permanganate solution for 5～10 minutes 1～3 times a day. The 8 cases with abscess were sutured when exudate disappeared and fresh granulation tissue appeared. Results For the 89 infected patients, the wound surface became clear, dry and less exudate appeared after 3～5 days and then formed scabs. They all healed in 1 to 2 weeks. The 8 cases with abscess were all healed within 1 to 2 weeks after saturation. Conclusion Potassium permanganate solution is a convenient, economic and effective method in treating the infected prepuce wound.

Objective To investigate if isoflurane pretreatment can protect brain from bilateral hemispheric ischemia-reperfusion injury. Methods Seventy-eight male Wistar rats weighing 250-300 g were randomly divided into 4 groups : (A) sham operation group ( n = 15 ); (B) ischemia-reperfusion group (I/R, n = 21); (C) ischemia-preconditioning group (IP, n = 21) and (D) isoflurane pretreatment group (ISO, n = 21) Group B, C and D were further divided into 3 subgroups according to the duration of reperfusion 6 h, 24 h, 72 h. Global cerebral ischemia was produced by 4-artery occlusion technique. In sham operation group (A) bilateral vertebral and common carotid arteries were exposed but not occluded. In ischemia-reperfusion group (I/R) bilateral vertebral arteries were occluded by cauterization and bilateral common carotid arteries were exposed and clamped for 20 min, then undamped for reperfusion of different duration (6 h, 24 h and 72 h) . In ischemia-preconditioning group (C) ischemia-reperfusion was preceded by 3 min global ischemia. In isoflurane-pretreatment group (D) the animals inhaled 1,5% isoflurane for 2 h before I/R. The animals were sacrificed right after reperfusion and brain was removed immediately for microscopic examination of hippocampal CA1. The number of living neurons (HE staining) and apoptotic neurons (TUNEL) was counted. Results (1) In group B (I/R) the number of living neurons in CA1 was decreasing with duration of reperfusion from 90.2 ? 2.4 (after 6 h reperfusion) to 45.8 ??4.9 (72 h of reperfusion) ( P

Objective:To investigate the surgical outcome of one-stage combined anterior and posterior ap-proach for severe thoracolumbar and lumbar spine fracture.Method:A total of 62 cases suffered from severe thoracolumbar and lumbar spine fracture undergoing surgery from Jan 2003 to Jan 2008 were reviewed retro-spectively.Of these,there were T11 involved in 2 cases,T12 in 13 cases,L1 in 28 cases,L2 in 10 cases,L3 in 6 cases and L4 in 3 cases.There were 58 fresh fractures and 4 old fractures.Based on Dennis classifica-tion,12 were compression fracture,33 were burst fracture and 17 fracture dislocation.All cases had spine load score≥7 and TLICS score≥5.Of 19 cases with neurological deficit according to Frankel grade,there were 7 A,5 B and 7 C.Combined anterior and posterior approach was performed in all cases,anterior bony graft plus posterior pedicle instrumentation were performed either,of these,52 cases had additional anterior decompres-sion.Result:All operations were performed successfully,with the mean surgical time of 170min (range, 150-210min) ,the average blood loss was 819ml(range,400-2900ml).No iatrogenic neuroinjury,skin infection, dural matter tearing and graft displacement were noted.The preoperative Cobb's angle was 8°-40°(mean, 23.9°), while the postoperative counterpart returning to normal with 5 cases having 2°-10° kyphosis.The preoperative compression rate was 20%-95%(mean,54.5%),while the postoperative counterpart returning to normal in 47 cases,with 15 cases having 2%-30%.The preoperative canal stenosis rate was 5%-90%(mean,51.1%) while the postoperative counterpart was 0-30%(mean,4.7%),which showed significant difference with regarding to these 3 parameters (P<0.05).All cases were followed up for an average of 31 months (range,12-72 months). Bony fusion was evidenced in cases undergoing anterior bony graft.At 10-12 months, the Cobb's angle was 0°-15°(mean,0.62°) ,the vertebral compression rate was 0-30%(mean,4.6%),no significant difference were noted between them and their postoperative counterparts(P>0.05).At final foUow-up,15 of 19 cases with neu-rological deficit had neurofunction improved,while 4 remained unchanged.According to our hospital criteria,of 43 cases with no neurological deficit,there were 30 excellent,9 good,3 fair and 1 bad with the total excel-lent to good rate of 90.6%.Cage subsidence and pedicle screw breaking was noted in 1 case,who developed severe kyphosis presenting with irreducible back pain.Conclusion:One-stage combined anterior and posterior approach for severe thoracolumbar and lumbar spine fracture can ensure three column stability as well as complete decompression,which has good early outcome.

Objective Due to the accelerated growth of Chinese children, the secular trend of accelerated skeletal development was observed in this study in order to provide the evidence for using the standards of skeletal maturity in reason.Methods The subjects were the children from two skeletal development surveys in 1980s and 2000s. The appearance age and fusion age of ossification centers in hand and wrist were calculated using the probit regression analysis, and the skeletal ages of children from the survey in 2000s were estimated by CHN method. The CHN skeletal ages were compared with calendar ages. Results Compared with the children in 1960s, the appearance ages and fusion ages of the ossification centers were all advanced in children in 1980s. Compared with the children in 1980s, the metacarpals and phalanges of children in 2000s were advanced by 0.5-1.0 year at age of appearance of ossification centers and 1.0 year in boys and 1.0-1.5 years in girls at the ages of fusion ossification centers. The ages of complete ossification of radius and ulna in children in 2000s were advanced by 0.4 year in boys and 0.3 year in girls. The differences between CHN skeletal age and chronological age of all age groups in 2000s were 0.3-1.1 year in boys and 0.2-1.0 year in girls. Conclusions In the last 40 years, the secular trend of accelerated skeletal development was presented in Chinese children. It should be cautious to estimate the contemporary Chinese children when using the skeletal norms of 1960s or 1980s.

6 cm AVMs(57.1%)were much higher than that with 0.05).Seizure was found in forty-three patients.After embolization the seizure in 20 patients disappeared,11 patients had been improved greatly.The total effective power was 72.1%.Conclusions The size and location of AVM is significantly associated with the onset of seizure.The number of feeding artery has no relation with the seizure.Endovascular embolization for the AVMs has got better cure effect.

Objective To explore the role of glycididazole(CMNa) in enhancing radiosensitivity to three-dimensional conformal radiotherapy(3D-CRT) and its safety in elderly patients with lung cancer.Methods Twenty-seven elderly patients with lung cancer,which had been confirmed by pathological examination,were treated with radiosensitizer glycididazole(CMNa) and 3D-CRT.Diluted with 100ml saline solution,800mg/m2 glycididazole(CMNa) was intravenously injected within 30 minutes,and 3D-CRT was performed within 3 hours.3D-CRT was composed of 6MeV liner accelerator at a dose of 5.0-6.0 Gy/fraction for 3 fractions/week with a total dosage of 40-42Gy/3-4weeks.Treatment plan was evaluated by dose volume histogram(DVH) to ensure peripheral normal tissue and sensitive tissue to receive the dose within a permitted extent.Results Seventeen cases(63%) showed complete responses(CR),and 10 cases(37%) showed partial responses(PR),theretore the total response rate was 100%(27/27).No patients suffered from obvious adverse effects.Conclusions With significant ability to enhance radiosensitivity,glycididazole combined with 3D-CRT afford an effective treatment for elderly patients with lung cancer.

Objective To evaluate the correlations of emphysema and airway wall thickness to chronic obstructive pulmonary disease(COPD) of airflow limitation by quantitative CT.Methods 40 COPD patients and other 40 normal controls underwent pulmonary function tests and following MSCT exams with inspiration.The square root of wall area of an airway with an internal area of 8 mm2 (Ai8) and the percentage of low attenuation volume(LAV%) of the whole lung and each lobes at the threshold of-950 HU were measured by a software of Thoracic VCAR.The Ai8 between the observation group and the control one was compared using SPSS2.2.The contributions of LAV% and Ai8 to predictions of FEV1/FVC and FEV1% were also evaluated.Results There was a significantly statistical difference in the Ai8 between the observation group and the control one.There were correlations between airflow limitation markers and all of LAV% as well as Ai8 (P<0.05 for all standardized coefficients).Only the Ai8 of right inferior lobar made a significant contribution to airflow limitation in the whole lung bronchus, and the LAV% of each lobes made a stronger contribution to airflow limitation than the Ai8 of right inferior lobe.Conclusion There is a significantly statistical difference in the Ai8 between the observation group and the control one.The LAV% may make a greater contribution to airflow limitation than Ai8 in COPD group.The influential factors of airflow limitation in order were LAV%, Ai8 of right inferior lobe and Ai8 of the other lobes.