BACKGROUND: Primary progressive aphasia(PPA) is a degenerative disease of nervous system, which is very rare in clinics. Only 3 cases have been reported in our country. There is very little clinical information regarding the characteristics of PPA in linguistics and imageology.OBJECTIVE: To report the language disorder and the characteristics of imageology of one PPA patient for the clarification of the clinical features of PPA.DESIGN: A case analysis.SETTING: Department of Neurology, Beijing Tiantan Hospital; Faculty of Psychology, Beijing Normal University.PATICIPANT: Male, 56 years old, senior high school graduate, businessman before the onset of the disease. The case visited the department of Neurology,Tiantan Hospital, Beijing due to the complaint of three years of progressive decreasing in language skills, which was then diagnosed with PPA.METH ODS: Spoken language fluency evaluation in Chinese Aphasia Examination Set of the First Affiliated Hospital of Beijing Medical University was used to evaluate this patient, the type of Aphasia was judged by Western Aphasia Examination Set, and the severity gradation was classified by the Boston Diagnostic Aphasia Examination(BDAE) . Memory, intelligence screening and imageology examination were performed as well.MAIN OUTCOME MEASURES: The fluency of spoken language, the type of aphasia, and the severity of aphasia of the patient were judged, and whether the patient suffered from memory and intelligence disorder were observed as well as the features of imageology.RESULTS: The patient had fluent spoken language, which was evaluated as sensory aphasia(SA) with the aphasia severity of level 4, and had no memory or intelligence disorder. MRI showed atrophy in left frontal lobe and temporal lobe, which was more significant in left side. MRI also showed that left temporal and frontal lobes had low metabolism and low perfusion.CONCLUSION: PPA is a disease with language disorder as its dominant clinical manifestation, which no other cognitive disorder at its initial stage,and with its main pathological changes in left temporal and frontal lobes.

Objective To evaluate the imaging feature of microcarcinoma of thyroid with CT.Methods CT findings of 50 lesions in 47 patients with microcarcinoma of thyroid ( dimeter,0.5 to 1.0 cm) were retrospectively analyzed.All of the patients had pathological diagnosis.Results Of the 50 lesions,38 lesions showed homogeneous low density on non-enhanced CT and various degree of enhancement on postcontrast CT. Thirty-three lesions showed discontinuous edge of the thyroids on non-enhanced CT. The boundary of 30 lesions became unclear on post-contrast CT relative to non-enhanced CT and the extension of low density of lesions decreased. Theshape of 31 lesions were irregular. Fifteen lesions showed calcifications,with granular calcifications in 13 lesions.Ten lesions were complicated with thyroiditis.Conclusions Irregular shape,discontinuous edge of the thyroids,the shrinkage of low density of lesions on post-contrast CT relative to non-enhanced CT,granular calcifications and multiple small lymph node around lesions indicate the diagnosis of microcarcinoma of the thyroid.It should be noted that thyroiditis can cover up microcarcinoma of thyroid.

AIM: To investigate the pathological changes of motoneuron's function and morphology after root avulsion in order to study the neurobiology mechanism of motoneuron death. METHODS: Twenty female adult Sprague-Dawley rats, 200-300 g were used. The C 5-C 8, T 1 roots of the right brachial plexus were avulsed. All rats were killed 3 d, 5 d or 1 week after avulsion. One group of the C 5-C 8 spinal cords freeze sections (40 ?m thick) were collected for the NADPH-d histochemistry with neural red counterstained. Another group of the C 5-C 8 spinal cords freeze sections (40 ?m thick) were collected for the c-Jun immunocytochemistry stain. The paraffin sections (5 ?m thick) were collected for HE stain. The amount of NOS-positive and survival motoneurons was counted. The percentage of NOS expression and motoneuron survive were quantitatively analyzed considering the amount of contra lateral motoneurons as one hundred percent. RESULTS: The NOS expression rate was 0.74%?0.59% (3 d), 24.84%?6.73%(5 d), or 51.16%?8.67% (1 week), respectively. The survive rate was 93.00%?4.32% (3 d), 93.67%?5.27% (5 d), or 89.83%?2.65% (1 week), respectively. The motoneuron expressed c-Jun as early as 3 days after avulsion. The expression declined afterward until one week after avulsion. There was no significant change on the size of motoneuron. The nuclear membrane was still clear but some nuclei were not located in the middle of the cell body. There were some nucleoli with the chromatin condensation. CONCLUSION: The motoneuron NOS expression and cell death were increased within one week after spinal root avulsion. meanwhile, the c-jun expression was decreased. The NO/NOS may induce the motoneuron death by inhibiting the regenerating reactions of motoneuron after root avulsion injury.

Abstract BACKGROUND: Calcium dobesilate (calcium dihydroxy-2, 5-benzenesulfonate) has been widely used to treat chronic venous insufficiency and diabetic retinopathy, especialy many clinical studies showed that calcium dobesilate as vasoprotective compound ameliorates renal lesions in diabetic nephropathy. However, there are few literatures reported calcium dobesilate in the treatment of chronic renal alograft dysfunction after renal transplantation. OBJECTIVE:To observe the efficacy and safety of calcium dobesilate on chronic renal dysfunction after renal transplantation. METHODS:A total of 152 patients with chronic renal alograft dysfunction after renal transplantation were enroled from the Military Institute of Organ Transplantation, Changzheng Hospital, Second Military Medical University of Chinese PLA. They were randomly divided into the treatment group (n=78) and the control group (n=74). Patients in the treatment group received 500 mg of calcium dobesilate three times daily for eight weeks. Al patients were treated with calcineurin inhibitor-based triple immunosuppressive protocols and comprehensive therapies. RESULTS AND CONCLUSION: For patients receiving calcium dobesilate, serum creatinine, blood urea nitrogen and uric acid decreased significantly at two weeks after treatment and maintained a stable level (P < 0.05). However, serum creatinine and blood urea nitrogen returned to the original level soon after drug withdrawal. No significant difference was observed in blood cel count, liver function, blood lipids, electrolytes, blood pressure and 24-hour urine output between the two groups before and after therapy (P > 0.05). Administration of calcium dobesilate did not change the general condition of patients with renal insufficiency, nor did it affect blood concentrations of the immunosuppressive agents. Calcium dobesilate may help to delay the progress of graft injury in patients with chronic renal graft dysfunction by conjugating with creatinine, ameliorating the impaired microcirculation and its antioxidant property. The decline in serum creatinine aleviates patients’ anxiety and concern arising from the elevation of creatinine. However, the negative interference with serum creatinine caused by calcium dobesilate should be cautious in order to avoid misjudgment of patients’ condition.

Objective: To investigate the clinical efficacies of fire acupuncture in treat various types of acne. Methods: An open test was designed. One thousand and eighty-six patients who visited for clinical service were collected as a sample. Results: The cure and marked effective rate was 78.5% for lung heat type, 80.8% for heat toxin type, 77.4% for disharmony of the Thoroughfare and Conception Vessels type and 80.1% for blood stasis and phlegm accumulation type. Statistical analysis showed no significant differences in therapeutic effect between different types (P>0.05). Conclusion: Fire acupuncture has an exact therapeutic effect on various types of acne without toxic side effects.

Objective: To lay a foundation for elucidating the mechanism of microbial regulation of γ-amino butyric acid (GABA) formation in the processing of Sojae Semen Praeparatum. Methods: The ability of glutamic acid decarboxylase and protease (neutral protease, alkaline protease and acid protease) production of Bacillus subtilis, Enterococcus avium, Enterococcus faecium, Bacillus amyloliquefaciens, Aspergillus niger, Aspergillus flavus, Aspergillus tamarii, Penicillium citrinum, Cladosporium tenuissimum, Phanerochaete sordida, Rhizopus oryzae, Sporidiobolus salmonicolor in different pH and temperature conditions were determined by Berthelot colorimetry and Folin phenol method. Results: The GAD and protease activities of the twelve strains were stronger at pH 5-7 and temperature 28-37 ℃. The highest GAD enzyme activity from A. flavus was 41.97 U/h, the optimum pH was 7 and the temperature was 28 ℃, followed by S. salmonicolor, A. niger, R. oryzae, and B. subtilis, respectively. The enzyme activities were 29.04, 25.78, 22.42 and 19.43 U/h. The highest neutral protease activity of B. subtilis was 24.80 U/mL, the optimum pH was 7 and the temperature was 37 ℃, followed by B. amyloliquefaciens, R. oryzae and E. avium. The enzyme activities were 16.86, 12.51 and 9.18 U/mL. The highest alkaline protease activity of B. amyloliquefaciens was 13.29 U/mL, the optimum pH was 7 and the temperature was 34 ℃, followed by B. subtilis and R. oryzae. The enzyme activities were 8.86 and 6.20 U/mL, respectively. The ability of 12 kinds of microorganisms to produce acid protease was generally poor. Conclusion: The optimal pH and temperature of the 12 kinds of microorganisms selected for this experiment are basically consistent with the natural processing of Sojae Semen Praeparatum. Among them, fungi have stronger GAD production capacity and bacteria have stronger neutral protease production capacity. The high GABA concentration of Sojae Semen Praeparatum is caused by the joint action of multiple strains.

Objectives To investigate the effect of magnetron sputtered niobium nitride (NbN) on the bonding strength of commercially pure cast titanium (Ti) and low-fusing porcelain (Ti/ Vita titankeramik system).Methods Sixty Ti specimens were randomly divided into four groups, group Tl, T2, T3 and T4.All specimens of group Tl and T2 were first treated with 120 μm blasted Al2O3 particles, and then only specimens of group T2 were treated with magnetron sputtered NbN film.All specimens of group T3 and T4 were first treated with magnetron sputtered NbN film and then only specimens of group T4 were treated with 120 μm blasted Al2O3 particles.The composition of the deposits were analyzed by X-ray diffraction (XRD).A universal testing machine was used to perform the three-point bending test to evaluate the bonding strength of Ti and porcelain.The microstructure of NbN, the interface of Ti-porcelain and the fractured Ti surface were observed with scanning electron microscopy (SEM) and energy depressive spectrum (EDS) , and the results were compared.Results The XRD results showed that the NbN deposits were cubic crystalline phases.The bonding strength of Ti and porcelain in Tl to T4 group were (27.2±0.8) , (43.1±0.6) , (31.4±1.0) and (44.9±0.6) MPa.These results were analyzed by one-way analysis of variance and differences between groups were compared using least significant difference test Significant inter-group differences were found among all groups (P<0.05).The results of SEM showed that with treatment of Al2O3 or NbN, alone, pre-cracks were found in the interface of Ti-porcelain, while samples treated with both Al2O3 and NbN had better bond.EDS of Ti-porcelain interface showed oxidation occurred in T1, T2 and T3, but was well controlled in T4.Conclusions Magnetron sputtered NbN can prevent Ti from being oxidized, and can improve the bonding strength of Ti/Vita titankeramik system.Al2O3 blast can also improve the bonding strength of Ti/Vita titankeramik system.

Objective To investigate the efficacy and safety of conversion therapy to mizoribine (MZR) for renal transplant patients who suffered MMF or Aza adverse reaction. Methods In 56 patients with adverse reactions at different time points after renal transplantation, there were 23 cases of pulmonary infection, 14 cases of bone marrow depression, 6 cases of hepatic functional lesion and 13 cases of diarrhea. The immunosuppressive protocols of these patients were changed to CNI + MZR + Pre when the adverse reaction occurred. During the follow-up period (11 to 53 months), the effect and adverse events of conversion treatment were observed. Results After conversion treatment, 1 of 23 patients with pulmonary infection was re-infected after 26 months and finally died of heart and lung function failure. In 14 patients with bone marrow depression, blood test returned to normal in 13cases. Six patients with hepatic functional lesion were administered hepatoprotection treatment and their liver function was restored without recurrence of impaired liver function. All 13 patients with diarrhea were relieved without recurrence. The serum creatinine was 123 ± 21.3 μmol/L and 119±18. 2 μmol/L before and after the conversion therapy respectively (P＞0. 05). During the follow-up period, all patients' graft function was good. The incidence of rejection was 1.7 % (1 case). Nine patients (16. 1 %) had a higher level of uric acid after conversion. One patient had finger and toe joint pain. The symptoms were relieved after symptomatic treatment. Conclusion There were high security and good effect of conversion therapy to MZR due to MMF or Aza adverse reaction. Besides, MZR conversion therapy for renal transplantation patients provided a new option for individual immunosuppression.

Objective To summary the clinical data of pediatric renal transplantation from multiple renal transplant centers in China,and analyze the factors influencing the therapeutic outcomes of pediatric renal transplantation.Methods From March 1986 to May 2010,the clinical data of 138 children who underwent renal transplantation in eight centers of renal transplantation in China were retrospectively analyzed.Results The one-year patient and graft survival rate was 99.3％ and 95.7％respectively.Acute rejection episodes occurred in 38 cases (27.5％),15 cases suffered delayed graft function (DGF),and graft functions were returned to normal in all recipients within one month.Moreover,other complications included transplant renal artery stenosis in 8 cases (5.8％),ureteral necrosis in 2 cases (1.4％),urinary fistula in 5 cases (3.6％),hypertension in 57 cases (41.3 ％),hyperlipidemia in 38 cases (27.5％),hirsutism in 32 cases (23.2％),drug-induced liver damage in 26 cases (18.8％),urinary tract infection in 25 cases (18.1％ ),gingival hyperplasia in 22 cases (15.9％),pulmonary infection in 21 cases (15.2％),bone marrow suppression in 12 patients (8.7％),herpes simplex in 10 cases (7.2％),and diabetes in 8 cases (5.8％).The body weight was increased by 4 to 13 kg and the body height was increased by 2 to 7 cm during the first year posttransplantation. Conclusion The careful perioperative management, rational use of immunosuppressive agents,strengthening the follow-up management of children and social support,and improving compliance were the key points to obtain good outcomes in pediatric renal transplantation.

Objective To compare the difference of clinical and laboratory characteristics between the patients undergoing uninephrectomy for urologic diseases and healthy living kidney donors.Methods The change of blood pressure,renal function,blood routine examination,urine protein,plasma electrolytes and blood fat in two groups preoperatively and at one week,one month,6 months and one year postoperatively were retrospectively assessed.Of the 65 living kidney donors,12 were male and 53 were female.Among 354 cases of uninephrectomy for urologic diseases,there were 291 cases of hpper urinary tract tumor,56 cases of hydronephrosis and 7 cases of severe kidney injury.Results Compared to the preoperative status,there was significant difference of hemoglobin,creatinine,urea nitrogen and urine protein in two groups.Clinical and laboratory characteristics of two groups became stable at one months postoperatively,and could reach the preoperative level at 6 months or one year postoperatively.But the creatinine was 25.71%higher than the preoperative level in healthy donors and 25.49%in patients undergoing uninephrectomy for urologic diseases.There was no significant difference between the two groups at one year postoperatively.Conclusions Two groups are safety after nephrectomy.There is no significant difference of clinical and laboratory characteristics between the 2 groups.Strict donor selection,appropriate pretransplantation evaluation,careful operation and postoperative health consulting play important roles in donors;safety and health.