The concept of white matter dementia was first introduced by Filley in 1988.It was found following behavioral neurologica researches that patients with this type of dementia manifested the dysfunctions of sustained attention,memory retrievial,frontal lobe and visualspatial function.They also had psychiatric manifestations but language and extrapyramidal function remained normal.10 diseases of white matter disorders are listed for understanding the clinical characteristics of this type of dementia.

BACKGROUND: There are many reports on the entrance point of adult inferior thoracic spinal latero-anterior screw.Because of the differences in race,districts and the shape of vertebral body are various,and the choice of screw placement position is also varied.OBJECTIVE:To provide an anatomical reference for the implantation of clinical screws for inferior thoracic spinal latero-anterior fixation with the concave rib set as a reference.METHODS:Spinal specimens from 20 adult cadavers were observed,and anatomical data were colected from the concave ribs.One vernier caliper was used for the measurements.RESULTS AND CONCLUSION:The thoracic transverse diameters and the distance between the upper and the inferior edge of the concave rib and upper endplate increased gradualy as the vertebral number increased,whereas the distances between the upper and the inferior edge of the concave rib and inferior endplate and between the anterior edge of the concave rib and anterior edge of the vertebral canal decreased gradualy.Above findings suggested that the anatomical positions of the inferior thoracic concave ribs folowed a set of rules.The concave rib could be used as a simple,constant,and reliable reference point for inferior thoracic spinal latero-anterior fixation screw placement.

Lymph node metastasis is the main prognostic factor of endometrial cancer patients.As the metastasis of early endometrial cancer patients is very low,it remains a controversy whether these patients are necessary to undergo conventional lymphadenectomy and a challenge to confirm the scope of lymph node dissection.We intend to demonstrate the application of lymphadenectomy in patients with early endometrial cancer via the impact of lymphadenectomy on the prognosis of these patients.The risk factors for lymph node metastasis of endometrial cancers were analyzed to explore its value in the surgical option.Furthermore,the guidance of sentinel lymph node in surgical staging and prognostic prediction of early endometrial cancer was explored to clarify the applied condition and scope of lymphadenectomy in these patients.

Objective To evaluate the clinical efficacy of intensive needling stimulation at external Laogong (EX-UE 8) in treating post-stroke hand hypermyotonia.Method Sixty patients with post-stroke hand hypermyotonia were randomized into a treatment group and a control group, 30 cases in each group. The treatment group was intervened by ordinary acupuncture plus strong stimulation at external Laogong (EX-UE 8), while the control group was by ordinary acupuncture. After 8-week treatment, the modified Ashworth Scale (MAS) was used to assess the muscular tension of the affected limbs, Fugl-Meyer Assessment (FMA) was for assessing motor function of the affected hand, and Activities of Daily Living (ADL) was used to evaluate the activities of daily living before and after the intervention.Result The MAS, FMA, and ADL scores were significantly changed after the intervention in both groups (P<0.05). The MAS, FMA, and ADL scores of the treatment group were significantly different from that of the control group (P<0.05).Conclusion Acupuncture at external Laogong (EX-UE 8) with intensive stimulation is an effective approach in treating post-stroke hand hypermyotonia.

CD4 + CD25 + regulatory T cells are produced in the thymus and have anergic and immunosuppressive properties.Researchers measured the antibody level related with CD4+ CD25+ T cells,CD4+ CD25hi T cells,CD4+ CD25+ Foxp3 and CD4+ CD127 in regenerative anemia,leukemia,ITP,NHL,MDS.Then they got the conclusions that regulatory T cells decreased in the autoimmune blood diseases and increased in the neoplastic diseases.The regulatory T cells have great prospect in the treatment of autoimmune diseases,allergic diseases,transplant rejection,tumors and specific vaccination.

Objective To investigate the reason of fracture internal fixation of locking plates and conventional plate in the treatment of femoral fractures.Methods A total of 198 patients with femoral fracture taken plate fixation were selected as our subjects.Of which,the locking plate were used in 87 cases served as control group and 111 cases had traditional plate fixation served as study group.Fracture fixation rate in patients were follow-up and the reasons for broken were analyzed.Results Fracture fixation occurred 5 cases (4.5％,5/111) in the locking plate,and 3 cases (3.4％,3/87) in traditional plate,and the difference was not significant (x2 =0.053,P =0.987).Fracture reason included plate fracture (4 cases),fracture of screws (2 cases) and plate fracture complicated with breakage of screw (2 cases).Iatrogenic factors lead fracture fixation was 30.0％ (3/10),significantly higher in patients with rehabilitation exercises errors (6.9％,2/29; x2 =3.851 ; P =0.046).Both iatrogenic factors and rehabilitation exercises errors caused fracture fixation rate was 100％.Conclusion Iatrogenic factors combined rehabilitation exercises error was the main reasons in fracture fixation.We should properly choose fixation methods and correctly guide the postoperative functional exercise for patients.

Objective To explore the role of LGR5 positive intestinal stem cells in repairing damage of intestinal mucosa resulting from endotoxemia and to determine whether the damaged intestinal mucosa can be repaired by regulating the proliferation and differentiation of intestinal stem cells.Methods Wistar rats were randomly divided into control group,lipopolysaccharide(LPS) group,and glucagon-like peptides 2(GLP-2) group.LPS was injected interaperitoneally into rats of the LPS group and GLP-2 group at a dose of 5 mg/kg(1 ml/kg) ; saline(1 ml/kg) was injected into the rats of control group.GLP-2 250 μg/kg(1 ml/kg) was rnjected into the rats of GLP-2 group 1 hour after the LPS injection.The terminal ilea were collected from 8 rats in each group at 6 h,24 h,and 72 h post-LPS injection.Structrral changes in the intestinal epthelium of every group were observed under the light microscope and electron microscope.The expression of LGR5 in intestinal stem cell was detected by immunohistochemical method and RT-PCR.Results In general,intestinal edema and hyperemia was observed in both LPS and GLP-2 groups at 6 h.Fracture and lodging of villi,infiltration of inflammatory cells,and visible exudate within the cavity were observed under light microscopy.The inflammatory injury was less severe in the GLP-2 group than in the LPS group at 6 h.The injury of intestina mucosa gradually repaired between 24 h and 72 h after injection of LPS in both LPS group and GLP-2 group.Importantly,samples taken from GLP-2 group and LPS group at the same time point indicated that the GLP-2 group recovered significantly better than the LPS group.And expressions of LGR5 mRNA in GLP-2 group at 6h,24h,72 h(0.13 ±0.05,0.16±0.05,0.16±0.04) were significantly higher than those in LPS group respectively (0.52 ±0.09,0.73 ±0.14,0.48 ±0.24),as shown by RT-PCR,and than that in control group(0.12 ±0.03) (P ＜ 0.05).Conclusion Exogenous GLP-2 may facilitate intestinal stem cell proliferation,thereby promoting the recovery of intestinal mucosa damaged by endotoxemia.GLP-2 appears to promote stem cell proliferation,differentiation,and gradual migration of stem cells from the intestinal crypts to the damaged mucosa.

Objective To investigate the influence of intra-articular injection of hyaluronic acid at early stage on articular cartilage cells apoptosis in elderly patients with articular injury.Methods A total of 89 elderly patients with articular injury from Jan.2013 to Oct.2014 were randomly divided into observation group and control group.In control group,40 cases were treated with conventional surgery and anti-inflammatory therapy.In observation group,49 cases were treated intraarticular injection of hyaluronic acid added to conventional therapy.The apoptosis rate of articular cartilage cells,cell cycle and proliferation index were compared between the two groups.Results The apoptosis rate of articular cartilage cells was lower in observation group than in control group [(4.08±0.74)％ vs.(6.41±0.54)％,t=16.403,P＜0.001].The ratio of G0/Giin articular cartilage cells was lower in observation group than in control group[(83.5 ± 3.5)％ vs.(91.7± 4.3)％,t10.275,P＜0.001].The ratios of S and G2/M and the proliferation index in articular cartilage cells were lower in control group than in observation group[(3.5 ± 0.3)％ vs.(8.2± 2.4)％,(4.7±0.6)％ vs.(8.5±1.8)％ and (9.1±1.1)％ vs.(16.7±1.9)％,t=12.293,12.731 and 22.198,respectively,all P＜0.001].Conclusions Intra articular injection of hyaluronic acid at early stage decreases the apoptosis rate of articular cartilage cells,helps articular cartilage cells turnover and improves the recovery of articular injury in elderly patients.

Ligustrazine which has extensive pharmacological effects has been clinically used in the treatment of cardiovascular and cerebrovascular diseases,respiratory diseases,urinary diseases,cirrhosis,cancer,etc.Research of protective effects of Ligustrazine on spinal cord injury has recently increased year by year.Numerous clinical trials and animal experiments suggest that Ligustrazine can play a role on ischemic cerebrovascular disease, degenerative brain disease,epilepsy,spinal cord injury and so on,whose main mechanisms include inhibiting of apoptosis and inflammation,enhancing the body’s antioxidant level,improving hemorheology,increasing expression of neurofilament protein and neurotrophic factors,and regulating balance of the ion intracellular and extracellular.Through consulting the relevant literature since 2003,this article reviews the protective roles and mechanisms of Ligustrazine on cerebra and spinal cord injury for the past 10 years.

Objective To investigate the role of interleukin-22 (IL-22) in the pathogenesis of pityriasis rosea (PR).Methods Peripheral venous blood samples were obtained from 48 patients with PR in acute stage and recovery stage and from 20 healthy human controls.Real-time fluorescence-based quantitative PCR was performed to measure the mRNA expression of IL-22 in peripheral blood mononuclear cells (PBMCs),and enzyme-linked immunosorbent assay (ELISA) to determine the level of IL-22 in sera.Results The relative expression level of IL-22 mRNA in the patients with PR in recovery stage was significantly higher than that in the healthy controls (2.89 ±0.91 vs.1.91 ± 0.60,t =3.84,P ＜ 0.05),but lower than that in the patients in acute stage (2.89 ± 0.91 vs.4.15 ±1.36,t =3.61,P ＜ 0.05).Similarly,the level of serum IL-22 was significantly increased in the patients with PR in recovery stage compared with the healthy controls ((21.44 ± 7.33) vs.(13.22 ± 4.26) ng/L,t =4.49,P ＜ 0.05),and increased in the patients with PR in acute stage compared with those in recovery stage ((36.87 ± 10.63) vs.(21.44 ± 7.33) ng/L,t =5.01,P ＜ 0.05).The level of serum IL-22 was positively correlated with the stage of PR (r =0.883,P ＜ 0.05).Conclusions IL-22 is overexpressed in PBMCs and sera of patients with PR,implying that IL-22 is involved in the pathogenesis of PR.