Objective To study the cell metabolism changes of hippocampal region in patients with vascular dementia (VD) after stroke by 1 H-magnetic resonance spectroscopy (1 H-MRS),and to observe the relationship between cell metabolism changes and clinical symptoms after donepezil hydrochloride treatment.Methods Enrolled 18 patients with VD after stroke,16 males and 2 females,with a mean age of (76.9±2.7) years,13 patients without VD after stroke,11 males and 2 females,with a mean age of (76.2±3.6) years and 14 health volunteers as control group,12 males and 2 females,with a mean age of (75.1+2.4) years.The mini-mental state examination (MMSE),activities of daily living (ADL) and Hamilton depression scale (HAMD) were used to assess the effects on cognitive function,ability of daily living and behavior symptoms.1 H-MRS examination of bilateral hippocampus was conducted in all subjects.Metabolisms of N-acetylaspartate (NAA),choline (Cho) and creatine (Cr) were examined and the ratios of NAA/Cr and Cho/Cr were calculated.The patients with VD were prescribed donepezil and given 1 H-MRS assessment half a year later.Results The patients with VD had a significantly lower NAA/Cr ratio in bilateral temporal hippocampus area than did health controls and the patients without VD (F=4.23,4.98,both P＜0.05),and a higher Cho/Cr ratio than did health controls and the patients without VD in left hippocampus (P＜0.05).The NAA/Cr and Cho/Cr ratios in patients without VD had no significant changes compared to health controls.There was a positive relationship between MMSE score and NAA/Cr ratio,and negative relationship between MMSE score and Cho/Cr ratio in the bilateral hippocampus area in patients with VD.After 6 months of treatment of donepezil hydrochloride,the MMSE and ADL scales significantly increased (both P＜0.05),and NAA/Cr ratio had no significant change in hippocampal region (t=-2.02,-2.04,both P＞0.05),whereas Cho/Cr had significant decrease (t=2.86,2.23,both P＜0.05).Conclusions The data suggest that the lower NAA/Cr ratio and higher Cho/Cr ratio in hippocampus area might be helpful in distinguishing VD and no-VD in patients with stroke.Donepezil improves general cognition function in patients with VD,which may be associated with regulating the cholinergic pathogenesis of VD in vivo and in vitro.

Objective To examine the role of synthetic cyclic citrullinated peptide (CCP) in T cell autoreactivity in rheumatoid arthritis (RA) by detecting T cell proliferation. Methods Twenty-nine RA, 8 primary Sjo gren syndrome (pSS) and 16 osteoarthritis (OA) patients were included in this study. Proliferation of T cells was measured by methyltetiazolium incorporation following incubation with CCP. Results T cell response to CCP was more common in RA patients than in controls. The response rate to CCP was higher in late RA than in early RA. However, the response wasn′t associated with disease activity. A strong association between T cell proliferation and RF, anti-CCP antibody was observed. Conclusions T cell proliferation in response to CCP was found in the majority of RA patients, even in early RA, suggesting that the citrullinated peptide play an important role in the pathogenesis of RA.

Objective To evaluate the prognostic value of combining postprocedural fibrinogen with high-sensitivity C-reactive protein (hs-CRP) in first time ST elevated myocardial infarction (STEMI) patients who had underwent successful primary percutaneous coronary intervention (PCI).Methods A total of 183 consecutive patients who had their first acute STEMI attack and underwent successful primary PCI were enrolled. Fibrinogen and hs-CRP levels were measured within 12 hours after PCI. All patients were followed up for 2 years. The primary end point was death of any cause. The secondary end point was a combined end point of death, non-fatal MI, heart failure (NYHA Ⅲ~Ⅳ),myocardial ischemia confirmed by stress test and revascularization. Results Postprocedural fibrinogen level correlated with hs-CRP level linearly (r=0.452, P

Based on Sun Yat-Sen University Cancer Hospital’s practice of applying big data for prevention of registration traffickers,the paper analyzes the behavioral characteristics of technology-based registration traffickers'malicious occupation from the aspects of abnormal registration,abnormal withdrawal,abnormal grab and abnormal user binding,makes the corresponding technical plans and countermeasures,so as to limit the malicious registration of registration traffickers using the reservation system and guarantee the medical resources can be distributed to patients fairly and impartially.

Objective To study the indications,feasibility and efficacy of rigid choledochoscopy via biliary fistula tracts to remove bile duct stones.Methods A retrospective analysis was performed on the clinical data of 86 patients with bile duct stones treated with rigid choledochoscopy via biliary fistula tracts at our hospital between November 2011 and July 2016.Patients with bile duct stones were divided into the percutaneous transhepatic cholangio drainage (PTCD) group and the T tube tract group.There were 40 patients who underwent lithotomy using rigid choledochoscopy via the PTCD tract and 46 patients who underwent choledocholithotomy using rigid choledochoscopy via the T-tube tract.A comparison was conducted to compare the duration of the procedures,the amount of perioperative bleeding,the postoperative complication rates and residual stone rates between the two groups.Results In the PTCD group,the average operation time was (77.0 ± 36.5) min,the amount of perioperative bleeding was (26.5 ± 54.1) ml,and the postoperative complication rate was 37.5 ％ (15/40).Complete lithotomy in one-stage was successful in 33 patients,and in two-stages in 1 patient.The residual stone rate was 15.0％ (6/40).In the T tube tract group,the average operation time was (82.5 ± 44.1) min,the amount of perioperative bleeding was (14.8 ± 21.0) ml,and the postoperative complication rate was 32.6％ (15/46).Complete lithotomy in one-stage was successful in 34 patients,and two-stages in 2 patients.The residual stone rate was 21.7％ (10/46).There were no significant differences in the residual stone rates,complication rates and operation time between the two groups (P ＞ 0.05).The amount of operative bleeding was significantly better in the T tube tract group than the PTCD group,(P ＜ 0.05).Conclusions There was no significant differences in the clinical efficacy in the treatment of bile duct stones using choledochoscopy either via the PTCD tract or the T tube tract group.Both approaches can be used for bile duct stones.

Objective: To observe the effect of cilostazol on the ion channel of right ventricular cells in experimental rats, and to explore the ion channel mechanism of ciolstazol for preventing the ventricular arrhythmia in Brugada syndrome.
Methods: Our research was composed of 2 groups: ①Perfusion group, the cells were treated in 4 sub-groups by cilostazole at 1, 2, 5, 50μmol/L respectively, and there were 9, 5, 3, 7 cells were recorded at each sub-group to observe the differences of current density Ito at before and after treatment. ②Oral group, which included 4 sub-groups:Control 1 with 7 rats, Experiment 1 with 5 rats, and Control 2 with 8 rats, Experiment 2 with 6 rats respectively. The differences of current density Ito and ICa,L were studied between each Control and Experiment sub-groups.
Results: In Perfusion group,①with cilostazole 1, 2, 5, 50μmol/L treatment, the current density Ito decreased in all sub-groups, when the self-command voltage at+60mV, the Ito was signiifcantly different in each sub-group at before and after treatment, all P<0.05.②When each command voltage decreasing, the reduction rates of Ito were similar among 4 sub-groups, all P>0.05. In Oral group,①When the self-command voltage from-50mV reached the maximum of+60mV, the Ito was similar between Control 1 and Experiment 1 sub-groups, P>0.05.②When the self-command voltage at+10mV, the current density of ICa,L was slightly higher in Control 2 sub-group than that in Experiment 2 sub-group, P>0.05.
Conclusion: Direct perfusion of cilostazole in right ventricular cells may inhibit Ito in experimental rats, such effect was similar with cilostazole treatment at (1-50)μmol/L. Cilostazole might prevent the ventricular arrhythmia in Brugada syndrome in experimental rats.

Wide- angle viewing system as an important auxiliary device can clearly observe the whole fundus field of vision in vitreous surgery, which enable vitreoretinal surgery more efficient, safer and more effective. So it has very high application value in ophthalmologic operation. In this paper, we studied the development and application of wide - angle viewing system in vitreoretinal surgery in recent years, from which we summed up the advantage of non - contact wide - angle viewing system in clinical field, and pointed out the shortcomings. The ultimate goal is to make the non -contact wide - angle viewing system better applied in vitreous surgery.

Objective To implement a systematic anatomy learning system based on android platform and evaluate the application effects of the learning system in clinical medical undergraduate students.Methods The systematic anatomy learning system was based on android development package and correlation functions were implemented using java technique.108 undergraduate students in clinical major of 2014 in Kunming Medical University were selected and randomly divided into experimental group and control group.Students of the experimental group were given the traditional teaching method and this learning system for autonomous learning,while students of the control group were given the traditional teaching method.These two teaching methods were subjectively and objectively evaluated by questionnaire survey and final examination respectively.Results The questionnaire showed that the 87.5％ of students thought that it was necessary to use the learning system.The 90.74％ of students in experimental group thought their learning effect were improved and the 98.15％ of them thought themselves learning ability were improved.The average score of the experimental group and the control group was 83.56 ± 5.61 and 75.33 ± 4.62 respectively.The difference between the two groups was statistically significant (P＜0.05).Conclusion The systematic anatomy learning system can help students to understand and grasp the knowledge points of the systematic anatomy,and it can improve the teaching effect too.It will provide research foundation for the next step of applying for patent.

Objective To compare the clinical effect of drug-eluting stents implantation or pure balloon expansion for the treatment of patients with knee artery lesions. Methods Sixty-eight patients with knee artery lesions were randomly and voluntarily divided into the control group( n=34 )and observation group( n=34 ) . The patients in the control group were given balloon expansion treatment,while in observation group were implanted drug-eluting stents besides balloon expansion. Pathological changes of skin temperature,percutaneous oxygen partial pressure( TcPO2 ),ankle brachial index( ABI),and the recurrence rate of patients before and after treatment for 6 months and 12 months were recorded and compared. Results After 6 months treatment,TcPO2 and ABI in observation group were(35. 4 ± 4. 5)mmHg and 0. 85 ± 0. 04,significantly higher than that in control group(( 28. 2 ± 3. 5 ) mmHg and 0. 62 ± 0. 03 ),and the differences were statistically significant( t=2. 535,2. 185;P﹤0. 05). At 12 months after treatment,skin temperature,TcPO2,ABI in observation group were(32. 4 ± 4. 3)℃,(34. 3 ± 4. 2)mmHg and 0. 80 ± 0. 04,significantly higher than that of the control group ((28. 6 ± 3. 7)℃,(26. 4 ± 3. 6)mmHg,0. 53 ± 0. 02;t =2. 354,2. 648,2. 064;P ﹤0. 05). Meanwhile,the recurrence rate was 5. 9% in observation group,significantly lower than that of the control group( 32. 4%;χ2=8. 463,P﹤0. 05). Conclusion The clinical effect of drug-eluting stents implantation in treatment of patients with knee artery lesions is superior to that of balloon expansion.

Objective To study the curative effect of breast-conserving therapy in patients with breast cancer.Methods 100 cases with breast cancer were divided into breast-conserving therapy 50 cases and radical therapy 50 Cases.The primary manner was wide excision of tumor and dissection of axillary lymph node.Adjuvant radiotherapy,chemotherapy and incretion treatment were given postoperatively.Results In 100 cases of breast cancer,the surviral of 83 cases(83.0%),17 patients(17.0%)died,30 cases(30.0%)of metastasis,local recurrence in 13 cases (13.0%);ER,PR-positive are 62 cases(62.0%),both wholly negative in 18 cases(18.0%),ER-positive only 12cases(12.0%),only 8 cases(8.0%)of PR positive;comparing two groups,survival and recurrent rate had no significant difference(X2=3.503,X2=4.284,P＞0.05),metastasis rate was significant different(X2=6.789,P＜0.05);satisfaction degree was 99.0% more than 12 months,and got ideal appearance was over 90%.Conclusion Breastconserving therapy can get long-term effect like Auchineol's.Breast-conserving therapy can gain good cosmetic resuits.