The practice guidelines on Alzheimer's disease and other types of dementia have been developed and revised by European federation of neurological societies(EFNS),American academy of neurology(AAN) and American psychiatric association(APA) recent years.The aim of these international guidelines was to present evidence-based statement for the care of patients with dementia.These guidelines on dementia cover major aspects of diagnosis,with particular emphasis on assessment of cognitive functions and psychological symptoms,the blood tests,neuroimaging,electroencephalography(EEG),cerebrospinal fluid(CSF) analysis,genetic testing and tissue biopsy.

BACKGROUND:Internal fixation is the main treatment of humeral shaft fractures, especial y for cases accompanied several injuries. According to the fracture reduction method and fixation methods, the commonly used repair methods include intramedul ary nail and minimal y invasive plate. How to choose a safe and effective method of internal fixation is a hot issue in the repair of humeral shaft fractures. OBJECTIVE:To explore the clinical effect of different fixations of intramedul ary nail and plate in the treatment of adult humeral shaft fracture. METHODS:A total of 252 patients with humeral shaft fracture recruited from Heze Municipal Hospital from May 2010 to May 2013 were randomly divided into two groups, with 126 cases in each group. Patients in the two groups were treated with intramedul ary nail fixation and plate fixation, respectively. The average operation time, intraoperative blood loss, hospital stays, and healing time of fracture in the two groups were recorded. Al patients were fol owed up for 1 year postoperatively, the incidence of radial nerve injury, infection and non-union was compared. The recovery of shoulder joint and elbow joint of patients was assessed with Neer method and Mayo method, respectively. RESULTS AND CONCLUSION:After treatment, the rate of primary success of internal fixation showed no significant differences between the two groups (χ2=0.399 7, P>0.05). The average operation time, intraoperative blood loss, the healing time of fracture and hospital stays in the intramedul ary nail group were significantly shorter than that in the plate group B, the difference of the results were extremely significant in two groups (t=15.442 5, 21.713 4, 8.217 6, 1.214 8, P<0.01). After 1-year fol ow-up, the incidence of radial nerve injury showed extremely significant differences between the two groups (χ2=8.262 3, P<0.01);the incidence of nonunion in the intramedul ary nail group was significantly lower than that in the plate group, with extremely significant differences (χ2=3.947 2, P<0.05). The overal incidence of complications in intramedul ary nail group was significantly lower than that in the plate group, with extremely significant difference (χ2=11.977 9, P<0.01). Besides, the Neer scores of shoulder joint and the Mayo scores of elbow joint between the two groups had no statistical y significant difference (χ2=0.235 4, 0.273 0, P>0.05). Both intramedul ary nail and plate fixations show good clinical effect in treatment of adult humeral shaft fracture, and each technique has their advantages and disadvantages, we should choose the proper technique according to the patient’s condition.

Objective:To develop a Wnt-dependent ?-catenin-mediated functional assay system.Methods:To construct a vector,pCMV-bcGFP,which can express the ?-catenin and green fluorescent protein(GFP) fusion protein;transfect HEK293 with the vector,select the cells with G418 and LiCl and establish the stable cell line,293-bc-GFP by cloning.Results:293-bc-GFP stable cell line was developed;the background expression of ?-catenin-GFP fusion protein was detectable at a very low level in the cell line under fluorescent microscope and via Western blotting analysis;however,the fusion protein was showed to significantly increase in the presence of Wnt1 and lithium.Conclusion:Our results showed that the system is regulated by ?-catenin in a Wnt-responsive fasion.Thus,it can be used as a functional reporter to identify potential upstream factors during tumorigenesis,as well as to screen for the potential anti-cancer agents that specifically inhibit ?-catenin signaling in human tumors.

OBJECTIVE: To evaluate characteristics and security of artificial synthetic material for repairing incisional hernia of abdominal wall. METHODS: Articles about randomized controlled studies which were focus on repairing incisional hernia of abdominal wall were collected from CNKI from 2001 to 2009 with the retrieval words of "repairing materials for hernia,polypropylene patch, and incisional hernia ofabdominal wall". And then, those articles were summed up and analyzed. RESULTS: Among 24 tests, a total of 1 393 patients who had incisional hernia of abdominal wall, abdominal-wall defect, andinguinal hernia were included in the final analysis. Polypropylene patch and polytetrafluoroethylene patch could reconstruct integrity of abdominal wall during repairing large and huge incisional hernia, characterizing by less trauma, simple operation, rapid recovery, and low relapse rate. However, import patches were expensive. Home-made dacron materials for repairing hernia has been compared with import polypropylene patch, and the results indicated that dacron materials had light foreign body sensation and good complaisance after implantation; additionally, there was no significant difference in security and adverse reaction between dacron materials and import patches. CONCLUSION: Artificial synthetic materials characterize by great biocompatibility, strong anti-tensile strength, excellent tolerance to inflexion, optional cutting, beneficial for abdominal-wall defect at differential sizes, no comfortlessness, rapid recovery, low relapse rate, and less complication. Thus, artificial synthetic materials are extensive prospect.

Objective:To establish a recombinant adenovirus vector carrying HBX gene for investigation of the functions of HBX gene on the hepatocellular carcinoma.Methods:HBX gene was amplified from genomic DNA of HBV by polymerase chain reaction(PCR) technique, and subcloned to plasmid pHAHA to construct recombinant plasmid pHAHA-HBX.subcloned HAHA-HBX into a shuttle vector pAdTrack-CMV.After being identified by endonuclease,and subsequently cotransformed into E.coli.293 cells with an adenoviral backbone plasmid,e.g.pAdEasy-1.Results:HBX gene was cloned from HBV genome by PCR successfully,and proved by sequence determination.A vector producing cell line 293/HBX was established.An HBX gene integration was detected by PCR in the recombinant adenovirus vectors.Conclusion:A recombinant adenovirus vector containing HBX gene was successfully constructed.

Objective To investigate the effect of rehabilitation education of movement disorders of Parkinson's disease in general hospital. Methods The postgraduates and visited physicians in department of neurology received curriculum of rehabilitation for movement disorders. They were investigated with the questionnaire after curriculum. Results All the postgraduates and visited physicians accepted the role of rehabilitation for movement disorders after the curriculum (P<0.001), and learnt some knowledge about the rehabilitation. Most postgraduates (37/62) preferred teaching based on clinical cases, while the visited physicians (49/60) preferred demonstration. For the content, most the postgraduates (35/62) preferred academic progress, and the visited physician (50/60) preferred operation and practice. Conclusion It is necessary and feasible to teach rehabilitation for movement disorders in neurology of general hospital.

Objective To investigate the therapeutic effect of two-stage delayed open reduction and internal fixation on Pilon fractures.Methods The clinical data of 36 patients(26 males and 10 females;aged 18-57 years with a mean of 38.5 years;9 patients suffered from open fractures and 27 with closed fractures;25 combined with fibular fractures) with monolateral Pilon fracture hospitalized in succession from Jan.2001 to Oct.2006 were analyzed retrospectively.According to the Ruedi-Allgower classification,there were 6 cases with type Ⅰ,21 with type Ⅱ and 9 with type Ⅲ fracture.All patients underwent temporary fixation with calcaneal traction or plaster slab for 7 to 14 days(mean 9.8d),and then they were treated with delayed surgery when the soft tissue injuries subsided.Ankle functions were evaluated to assess the clinical outcomes,and complications were documented for further analysis.Results Follow-up was performed for 19 to 34 months(in mean of 28 months).Based on the Mazur classification,the ankle function in 13 cases was excellent,17 as good,4 as fair and 2 as poor,with a satisfactory rate of 83.3%.Postoperative complications included 2 cases of superficial incision infections,2 of skin slough and 19 of articular degeneration.Conclusion Two-stage delayed open reduction and internal fixation is a reasonable and effective procedure in treating Pilon fractures with advantages of few complications and satisfactory ankle function.

Objective: To assess the influence of different doses of CKLF1 plasmid on the dynamics and magnitude of the mobilization of the mobilization bone of marrow stem cells in a rat AMI model.Methods: Different doses of plasmid DNA encoding CKLF1 gene,empty plasmid or saline were injected into male SD rats intramuscularly with in vivo electroporation.Rats were subjected to left coronary artery ligation 6 days after gene transfer.Peripheral blood samples were drawn and CD34~+ cells were assayed by FACS calibur flow-cytometer.The changes in absolute number of CD34~+ cells were evaluated.Results: Expressions of CKLF1 mRNA and protein were detected in the injection site 7 days after gene transfer.Five days after gene transfer,the CD34~+ cells numbers in CKLF1 groups were significantly higher than those in empty plasmid group,especially in CKLF1 100?g group(16.63?10~6/L vs 4.98?10~6/L,P

The important difference between post-graduate and undergraduate education is to train their reseach ability,which is very important especially to the post-graduate students of basic medicine who will be researchers.The problem in training research ability of post-graduate was studied in this paper and solution plan was put forward.

Objective To investigate the features of magnetic resonance imaging(MRI)in the brain of patients with multiple system atrophy(MSA)and compare with that in Parkinson Disease(PD).Methods Thirteen patients with MSA-C,12 patients with MSA-P,and 30 patients with Pakinson disease(PD)were retrospectively studied in terms of MRI data.Results The area of the pons in the patients with MSA-C(386.4±74.2)mm2 was significantly smaller than in those with PD(528.5±40.8)mm2,as well as the average of the pons transverse diameter([17.9±1.8]mm in the patients with MSA-C and[20.2±1.4 lnun in PD patients)(t=6.5 and 4.7,Ps<0.01).The area of the pons in MSA-P patients(474.1±88.0)mm2 and the average of the pons tranverse diameter(19.3±2.4)mm were similar to those of PD patients(Ps>0.05).The average width of middle cerebellar pedncles(MCP)in MSA-C(6.1±1.6)mm and MSA-P(6.5±1.2)mm were smaller than those in PD patients(9.1±1.0)mm(t=6.2 and 7.1,Ps<0.01),whereas there was no significant difference between MSA-C and MSA-P group(P>0.05).In the MRI findings,cerebellar atrophy was the highest sensitive,and cruciform hyperintensity and hyperintensity of MCP followed.The MBI profiles were more specific for hyperintensity of cruciform and MCP than for cerebellar atrophy in MSA-C population.For MSA-P population,MRI was relatively sensitive for hyperintensity of rim of the putamen and putamen,but less specific.Conclusion The assessment of MRI may be useful to diagnose and distinguish MSA from PD.