Objective To evaluate the effectiveness of transitional care model on life quality of patients with Alzheimer's disease in China.Methods The literatures of randomized controlled trials (RCT) of transitional care of patients with Alzheimer's disease in mainland China published in Chinese or English were enrolled in this review.RevMan5.1 software was used to analyze the data.Results Twelve articles met the inclusion criteria.The scores of mini-mental state examination (MMSE),health state survey questionnaire (SF-36) of the intervention group was higher than the control group,which had a significant difference.While no significant difference was found in the scores of activities of daily living (ADL) between the intervention group and the control group.Conclusions Transitional care can improve cognitive function and quality of life of patients with Alzheimer's disease in China.

MicroRNAs ( miRNAs) are small noncoding RNAs that post transcriptionally regulate the gene expression , involving in the process of growth , development , aging and death of organisms .It has been demonstrated that miRNAs were associated with the structure and function of blood vessels and heart , involving in the aging process of blood vessels and cardiomyocytes .For example , miR-29, miR-34a, miR-217, miR-146a may participate in the regulation of aging blood vessels;miR-21, miR-22, miR-18, miR-19 may emerge as the regulators of aging cardiomyocytes .These miRNAs may function as the novel biomarkers for the cardiovascular ag-ing.This article reviews the current studies on miRNA and cardiovascular aging .

Objective To investigate the optimal combination and the value of functional magnetic resonance imaging in the diagnosis of breast tumors. Methods One hundred and forty patients who had been clinically and pathologically diagnosed as breast tumors in our hospital during the period of 2009 to 2013 were collected. 63 of whom had breast cancer and 77 had benign tumor. All the patients received 1H-MRS, DWI and dynamic enhanced MRI at the same time. The obtained images were analyzed and then compared with the pathological findings. The accuracy, sensitivity, and specificity of MRS combined with DWI or dynamic enhanced MRI, or DwI combined with enhanced MRI in the diagnosis of breast cancer were obtained. Results All the diagnosis were pathologically confirmed. The accuracy, sensitivity, and specificity were 89.8%, 90.1%, and 90.0% for DWI combined with dynamic contrast-enhanced MRI; 77.9%, 77.3% and 79.3% for MRS in combination with enhanced MRI; and 76.3%, 77.8% and 77.1% for DWI combined with MRS. There were significant differences among the three kinds of combination detection in diagnosis of breast cancer , χ2= 9.057, P = 0.011. Conclusions The sensitivity, specificity and accuracy is the highest in DWI combined with dynamic enhanced MRI in the diagnosis of breast tumor , which can be used as the best combination imaging for breast tumor.

Objective To explore the diagnosis and Fogarty catheter embolectomy operation management of acute arterial embolism in the extremities.Methods The clinical data of 87 cases of acute arterial embolism in the extremities treated by Fogarty catheter was ana- lyzed retrospectively,Results All cases were diagnosed through asking patient history and symptom,physical examination and the check of color Doppler while the results were proved by operation.No one case received vasography.After operation,78 cases blood stream of limb had been resumed and cure rate of 87.6% was achieved while 4 cases improved(4.5%),and no occurrence of ischemic necrosis and amputated ex- tremity.5 cases(5.6%)received amputation at the relative level and there were 2 cases(2.3%)of perioperative death.Those cases who re- ceived operations within 48 hours from the time of morbidity achieved cure rate of 100%,while those cases more than 48 hours achieved cure rate of 47.6%,improvement rate of 19.0%,amputation rate of 23.8% and mortality of 9.6%.Conclusion First,Ultrasound Doppler exami- nation should be taken for avoidance of misdiagnosis when acute extremity arterial embolism is suspected.Second,The key Intraarterial embo- lectomy using Fogarty catheter is an effective method for the treatment of acute arterial embolism in the extremities,is significant in application,Third,as soon as the diagnosis is established,embolectomy with Forgarty catheter must be carried out to avoid clot extension and necrosis of the extremity.Satisfactory therapeutic efficacy can be got,if the patient receive operation within 48 hours from onset.

BACKGROUND: Bag-1 is a multifunctional and anti-apoptotic gene. Its anti-apoptotic ability is enhanced when binding to bcl-2 to form a complex.Now it is considered as a predictive biomarker for the early diagnosis of breast cancer. However, whether it is useful in the assessment of the prognosis of breast cancer is still elusive.OBJECTIVE: To explore the expression of bag-1 in breast cancer and its role for prognosis.DESIGN: A controlled study with breast cancer, benign breast tumor and normal breast tissues as subjects.SETTING: The Vascular and Endocrine Surgery Department of Xijing Hospital of the Fourth Military Medical University of Chinese PLA.MATERIALS:Totally 100 breast cancer specimens were obtained form May 1995 to May 2000. Ten benign breast tumor and 10 normal breast tissues were used as control. All the specimens were paraffin-embedded and came from the Pathological Department of Xijing Hospital Affiliated to Fourth Military Medical University of Chinese PLA.METHODS: Immunohostochemical strept avidin-biotin complex(SABC) method was adopted to detect bag-1 expression in these specimens.pression levels of bag-1.RESULTS: The positive expression rate of bag-1 in breast cancer (85%) was significantly different form those of benign breast tumor (10%) and normal breast (10%) (χ2= 29.98, P = 0.00). While the positive expression rates in breast cancer of different stages (stage Ⅰ, stage Ⅱ and stage Ⅲ ) were 88%, 82% and 88%, respectively, which has no significant difference (χ2 = 0. 61, P = 0.75) . In duct carcinoma, lobular carcinoma and special carcinoma, bag-1 positive expression rate was 86%, 85% and 80%,which was also no significantly different (χ2 =0.16, P =0.95). In the 94followed patients, the 5-year survival rate of positive bag-1 expression was 79% and that of negative bag-1 expression was just 9%. The difference was significant (χ2 = 0. 07, P = 0.04).CONCLUSION: High bag-1 expression exists in breast cancer and its level is not associated with the clinical stages or pathological types of the cancer.Therefore, bag-1 may be used as a predictive marker for the prognosis of breast cancer.

Objective To evaluate the incidence and imaging features of tibial plateau fracture combined with dislocation.Methods A total of 298 patients with intact imaging data treated for tibial plateau fracture from December 2012 to June 2014 were analyzed retrospcctively.Tilt angle of medial fragment fracture line,ratio of width of medial fragment to total plateau,surface area percentage,fragment height,and major displacement were measured on CT images using picture archiving and communication system (PACS).Results Eighteen patients (6.0％) had tibial plateau fractures combined with dislocation,with tilt angle of medial or posteromedial fragment fracture line of (62.1 ± 14.1)°.Eleven patients (61％) had split of the medial tibial plateau with surface area percentage of (46.3 ± 2.5) ％,fragment height of (43.9 ± 6.2) mm,and major displacement of (5.3 ± 2.1) mm.Seven patients (39％) had posteromedial fragment fracture with surface area percentage of (25.1 ± 5.7) ％,fragment height of (40.0 ± 10.1) mm,and major displacement of (4.8 ± 6.45) mm.Conclusions Fracture line of fracture-dislocation tibial plateau fracture is much often through the eminence or located at the lateral eminence with large medial or posteromedial fragments.Surgical approaches and directions of nailing should be considered properly according to the morphological characteristics.

BACKGROUND:Due to special physiological and anatomical location, stability of the spine is very complicated during thoracolumbar fractures. It is difficult to identify the stability of the spine. It should be based on their individual circumstances, to explore more effective internal fixation repair method.
OBJECTIVE:To explore the Cobb’s angle and vertebral height of patients with thoracolumbar fracture and spinal cord compression treated with posterior laminectomy and screw fixation, and compared with anterior laminectomy.
METHODS:One hundred patients with thoracolumbar fracture and spinal cord compression, who were treated in the Panyu District Central Hospital from January 2013 to November 2014, were enroled in this study. The patients were equaly and randomly divided into posterior laminectomy fixation group and anterior laminectomy fixation group. Tactile and sports of American Spinal Injury Association scores, Cobb’s angle and vertebral height were assessed before treatment and 1 month after treatment, and fixation effects were compared between the twogroups.
RESULTS AND CONCLUSION:(1) No significant difference in each index was detected between the two groups preoperatively (P> 0.05). (2) Tactile and sports of American Spinal Injury Association scores, Cobb’s angle and vertebral height were better in the posterior laminectomy fixation group than in the anterior laminectomy fixation group at 1 month postoperatively (P< 0.05). (3) These findings indicated that compared with the anterior laminectomy fixation, posterior laminectomy fixation for thoracolumbar fracture combined with spinal cord compression obtained better outcomes, and could obviously relieve spinal cord compression. Posterior laminectomy fixation isasafe and effective treatment method for thoracolumbar fracture and spinal cord compression.

Background Pupil atresia increases the difficulty of cataract surgery.The improper enlarging pupil will lead to many complications.The appropriate method of pupil dilation is very important to improve the postoperative effect.Objective This study was to evaluate the pupillary function after manually enlarged pupil to different sizes for pupil atresia complicated cataract.Methods A retrospective case-controlled study was designed.Thirty-eight eyes of 30 cases suffered from pupil atresia complicated cataract induced by chronic uveitis were enrolled in Shandong Eye Institute from May 2006 to May 2012.The eyes underwent pupil forming and phacoemulsification and assigned to the pupil enlarged to ≥6.0 mm group (15 eyes) and 4.5-5.5 mm group (23 eyes).The fibrosis membrane at pupil zone was removed,and the fibrosis strip at pupil collar was cut evenly by 23G intraocular microscissors as zigzag shape.Then the pupil was enlarged in multipoint by a pair of left and right iris hook from the main and lateral incisions.The pupils of 15 eyes in the pupil enlarged to ≥6.0 mm group were dilated above 6.0 mm and 23 pupils in the 4.5-5.5 mm group were dilated to 4.5-5.5 mm and followed by routine phacoemulsification and foldable intraocular lens implantation.Topical and systemic corticosteroids and nonsteroidal anti-inflammatory drugs combined topical mydriatic were applied before and after operation.The pupil diameter,light reflex and photophobia symptom in postoperation were compared between the two groups.The visual acuity before and after operation and intra-and post-operative complications were recorded.This study was approved by Ethic Committee of Shandong Eye Hospital,and written informed consent was obtined from each patient before operation.Results The pupil diameter in the pupil enlarged to ≥6.0 mm group was dilated to (6.9±0.4) mm and that of the 4.5-5.5 mm was dilated to (5.1 ±0.3) mm intraoperatively,with a statistical significance between them (t =16.100,P =0.000).Three months later,the pupil diameter in the pupil enlarged to ≥ 6.0 mm group was (4.9 ±0.4)mm,with different degrees of lacerated pupillary margins,and that in the pupil enlarged to 4.5-5.5 mm group was (3.5 ±0.5) mm,with rare lacerated pupillary margins,showing a statistically significant difference (t =9.820,P =0.000).The unresponsive or obtuse light reflex in the pupil enlarged to ≥6.0 mm group was significantly higher than in the pupil enlarged to 4.5-5.5 mm group(11 eyes vs.6 eyes) (x2 =8.200,P =0.005).The subjective photophobia symptom of 2-3 grades in the pupil enlarged to ≥6.0 mm group was in 12 eyes,which was higher than that in the pupil enlarged to 4.5-5.5 mm group (2 eyes) (H=19.840,P=0.000).The iris haemorrhage were seen in 3 eyes in the pupil enlarged to 4.5-5.5 mm group and 7 eyes in the pupil enlarged to ≥6.0 mm group (x2 =5.290,P=0.030).The visual acuities of the operated eyes in the two groups improved at different degrees.Conclusions Approximate physiological pupil and good visual quality can been obtained by manual releasing and enlarging pupil to less than 5.5 mm evenly during the surgery for pupil atresia complicated cataract induced by chronic uveitis.

Background Eyes with filamentary keratitis present with serious clinical symptoms.This disease is easy to relapse and the treatment is tricky.At present,its pathogenesis is still unclear,and few works were done on filamentous composition.Objective This study was to analyze the composition of corneal filament by imageological and histopathological method,and discuss the formation mechanism of filamentary keratitis.Methods Eighty-eight eyes of 82 cases who suffered from filamentary keratitis were collected in Shandong Eye Hospital between January 2008 and January 2011.The etiologies of the patients were classified and the clinical data were recorded.Firstly,the corneal filiform strip was detected by laser scanning confocal microscopy (LSCM),and the corneal structure was examined by high-definition optical coherence tomography (HD-OCT).Then the composition of filamentary strip was analyzed by Giemsa and Masson trichrome staining of stretched preparation of filiform strip.Results Etiological study showed that filamentary keratitis occurred after penetrating keratoplasty in 40 eyes,after cataract surgery and photorefractive keratectomy (PRK) in 18 eyes,dry eye and neural dystrophic corneal disease in 14 eyes,acute conjunctivitis in 10 eyes.HD-OCT revealed that filament lesion developed to Bowman layer.Filament was composed of epithelial cells,inflammatory cells,mucus and the high reflective strip core with spiral arrangement under the LSCM,and epithelial cells,inflammatory cells and fibrous tissue were seen in the strip core.Giemsa staining exhibited that filament contained corneal epithelial cells,inflammatory cells,mucus and dark blued strip core with helical arrangement.Masson trichrome discovered that the strip core was red fibrous tissue surrounding by blue mucus.Conclusions Epithelial cells,inflammatory cells,mucus and the high reflective strip core with spiral arrangement are the main elements of filament in filamentary keratitis.The lesion can reach Bowman layer.The results contribute to reveal the formation mechanism of corneal filament and assist treatment.

Professor TANG Wei-yong's treatment for children acute tonsillitisis from the three aspects oftreating symptoms, treating muscle and reconciliation, namely three-solution method. In addition, he modified three ancient prescriptions to create three-solution prescription. He applied the prescription into clinical practice and obtained a lot of good efficacy.