From the beginning of the 20th century, Alois Alzheimer, a German doctor, discovered Alzheimer′s disease, so far, the isease-related research has been the focus of researchers all over the world. From Alzheimer's disease to mild cognitive impairment, then to subjective cognitive impairment, the attention phase of the disease is also being advanced. Subjective cognitive impairment, as a stage earlier than mild cognitive impairment, has important implications for the early diagnosis and intervention of Alzheimer′s disease.This article will summarize the research progress of conception and screening instruments for subjective cognitive impairment at home and abroad.

ObjectiveTo study the clinicopathologic features of post-transplant lymphoproliferative disorders (PTLD).Methods Three cases of PTLD in renal transplant recipients were studied.The clinical data,diagnosis and differential diagnosis,and relevant literatures were also reviewed.Results All the 3 cases studied had received cyclosporine A or Tac after transplantation.The duration between organ transplantation and diagnosis of PTLD was 10 years,4 years and 2 months respectively.Two cases were suffered from monomorphic PTLD and 1 from plasmacytic hyperplasialike PTLD in morphology.Two cases of monomorphic PTLD died within one year after diagnosis.Conclusion PTLD is a lymphoproliferative disease with distinctive morphologic and clinical characteristics.The main treatments included the dosage reduction of immunosuppressive agents,radiotherapy and chemotherapy.The prognosis of monomorphic PTLD was poor.

Objective:To improve the radiologic diagnostic and treatable rate of mannmmary ductal diseases.Methods:We retrospectively analyzed the galactographic materials of 369 cases.Results:The mammary ducts were classified into 4 types according to their morpholgy,including general fruticoses,multiple fruticoses,less fruticoses and single fruticoses.In this group,the multiple and less fruticoses were the most common,the general and single fruticoses were the less.Conclusion:Understanding radiologic anatomy of mammary duct is very valuable in the diagnosis and treatment of mammary ductal diseases. [

Objective To observe the effects of 860 MHz microwave radiation on an established dual task model of trace and delay eyeblink conditioning in guinea pigs.Methods Twenty-four guinea pigs with an established dual task model of trace and delay eyeblink conditioning were assigned randomly into four groups : a microwave-exposed 1 h group, a microwave-exposed 20 min group, a sham-exposed group and a normal control group.The guinea pigs in the 1 h and 20 min groups were irradiated on the head daily for 3 days using 860 MHz electromagnetic radiation at a power density of 1 mW/cm2 for 1 h and for 20 min, respectively. After radiation the guinea pigs were trained with classical dual task eyeblink conditioning.Results Compared with the normal control group, the behavioral parameters (acquisition rate and peak amplitude of trace and delay eyeblink) of guinea pigs in the microwave-exposed 1 h group had decreased significantly with no obvious change in latency. The behavioral parameters of guinea pigs in the microwave-exposed 20 min group, the sham-exposed group and the normal control group showed no obvious change.Conclusions Microwave radiation at 860 MHz and 1.0 mW/cm2 for 1 h can cause changes in dual trace and delay eyeblink conditioning in guinea pigs and decrease learning and memory capacity.

BACKGROUND:Previous studies have found that the susceptibility genes of adiponectin gene and calpain 10 gene of type 2 diabetes are closely related with the incidence of diabetes in Chinese renal transplantation patients. So, are other susceptibility genes of type 2 diabetes also associated with posttransplantation diabetes mel itus? OBJECTIVE:To investigate the association between the zinc transporter solute carrier family 30 member 8 (SLC30A8) gene polymorphism and the posttransplantation diabetes mel itus. METHODS:A total of 97 patients with posttransplantation diabetes mel itus and 301 patents without posttransplantation diabetes mel itus (control group) were selected, and then the SLC30A8 gene rs13266634 genotype was detected with real-time PCR method. The association between gene polymorphism and posttransplantation diabetes mel itus was analyzed with Logistic regression test. RESULTS AND CONCLUSION:There were significant differences in al ele frequencies and genotype distributions of rs13266634 between the patients with and without posttransplantation diabetes mel itus (P<0.05). After adjustments of age, sex, body weight and body mass index, the incidence of posttransplantation diabetes mel itus of the CC genotype patients was 2.108 times to that of the TT genotype patients (odds ratio=2.108, 95%confidence interval:1.075-4.131, P=0.044);and the incidence of posttransplantation diabetes mel itus of the CC+CT genotype patients was 1.862 times to that of the TT genotype patients (odds ratio=1.862, 95%confidence interval:1.049-3.306, P=0.034). The results suggest that the C-al ele in rs13266634 of SLC30A8 gene is the independent risk factor of posttransplantation diabetes mel itus.

Objective To study the feasibility and curative effect of transumbilical single-incision (TSIL) vs multiple-incision (MIL) laparoscopic splenectomy.Methods Ten cases (2 cases of idiopathic thrombocytopenia purpura,1 case of hereditary spherocytosis,3 cases of splenic hemangioma and 4 cases of cirrhotic splenomegaly) underwent TSIL from Jan 2010 to Ju12011,and 12 cases (3 cases of ITP,2 cases of hereditary spherocytosis,3 cases of splenic hemangioma and 4 cases of splenomegaly) underwent MIL.Clinical data were compared with each other.Results No severe complications occurred in either group.The mean operation time of single-incision group and multiple-incision group was ( 182 ± 23 ) min and ( 169 ± 19) min,and blood loss was( 160 ± 13 ) ml and ( 155 ± 16) ml ( P ＞ 0.05 ).The post-operative pain score in TSIL and in MIL group was respectively [ ( 1.60 ± 0.20) vs (3.60 ± 0.90) on day 1,P ＜ 0.05 ; (0.50 ±0.10) vs (2.00 ±0.45) on day 2,P ＜0.05].There was no significant difference between the two groups in the recovery of the gastrointestinal function,the length of hospital stay and the cost of hospitalization, all P ＞ 0.05.The umbilical incision in TSIL cases is more cosmetic.Conclusions Transumbilical single-incision laparoscopic splenectomy is feasible and safe in experienced hands.

Hierarchical medical system is a high priority in China ’s health reform,bearing significant impacts on remolding of its healthcare system,in which tertiary public hospitals must redefine its role.Five strategies have been proposed as follows:the first is internal management;The second is high-tech;Third is paring assistance;Fourth is telemedicine;Fifth is better medical conditions.

Purpose To investigate the imaging features of lumbar spinal epidural angiolipoma, and to improve the imaging diagnostic capability of the disease. Materials and Methods Four patients with lumbar spinal epidural angiolipoma confirmed by pathology were recruited in the study. CT and MRI images were reviewed and the imaging characteristics including the shape, size, location, density, and signal intensity were analyzed. Results The lesions located at the right front of the spinal canal in two cases, at the left front in one case, and the residual one case located directly behind the spinal canal. The longitudinal axis of the lesions paralleled to the longitudinal axis of the spine. The dura mater spinalis was compressed and inward shifted. All of the four cases showed homogeneous iso- or hypo-density on CT without calcification or necrosis in the lesions. The maximum diameter was 3 to 5 cm. The boundary was clear and smooth. Three lesions showed dumbbell-shaped and crossed foramen, but the adjacent bone were not absorbed or destructed. One lesion showed scallop-like. On MRI, four cases displayed slightly hypointense on T1WI and hyperintense on T2WI. On STIR images, the lesions showed hyperintense with patchy low signal intensity in it. The boundary of the lesions was clear. After administration of contrast media, two lesions presented remarkably homogeneous enhancement, one lesion showed dual tail sign, and one lesion displayed pen-tip-like at the both ends. Conclusion MRI plays an important role in locating the lesion and distinguishing internal tissue components of spinal angiolipoma, which is the gold standard for the diagnosis of the tumor. CT provides excellent supplement. The Combination of CT and MRI will improve the diagnostic accuracy of the spinal angiolipoma.

Objective To explore the Influence of different health education approaches to standard anticoagulation of non-valvular atrial fibrillation. Methods 400 patients with NVAF were randomly divided into the research group (n=200) and the control group (n=200). Baseline clinical information was recorded. Both groups were given regular education and treatment. The control group was randomly divided into two subgroups. One subgroup (patients or/and family members) was given knowledge lectures of atrial fibrillation, atrial fibrillation anticoagulant, and application of warfarin. The other was given the knowledge through booklets. Standard anticoagulation fulfillment rate, ischemic stroke, other events of artery embolism, major bleeding, minor bleeding and death in the two groups were observed after 1 year. The cost for different education approaches was also compared between the 2 subgroups. Results (1)In the research group, standard anticoagulation fullfillment rate (40.53%) was higher than that of the control group(15.96%) (P<0.01). The rate of ischemic stroke (2.63%) was also lower than the control group (4.49%) (χ2=4.49, P<0.05). The death rate was lower in the research group than those in the control group, but minor bleeding rate was higher, without statistically significance (P>0.05).Other artery embolism rate , major bleeding, minor bleeding, death rate had no statistical difference. (2)Knowledge lecture group (10.8±1.0 min) spend more time than the booklet group (1.0±0.5 min) (P<0.01). The booklet group (5.1±1.1 yuan) costed more in terms of money than the knowledge lecture group (1.8±0.5 yuan) (P<0.01). (3)The knowledge lecture group showed higher standard anticoagulation fulfillment rate (47.96%) than that of booklet group (32.60%) (χ2=7.33, P<0.01). There was no statistical difference in ischemic stroke rate, other artery embolism rate, major bleeding rate, minor bleeding rate and the death rate. Conclusions Detailed, correct anticoagulant education and guidance can improve NVAF patients with standard anticoagulation, and reduce the risk of ischemic stroke. Knowledge lecture consumes more time but can improve the standard anticoagulation fulfillment rate.

Objective To observe the improvement of postoperative pulmonary function and oxygen partial pressure during general anesthesia for open abdominal surgery with lung protective ventilation strategies and alveolar recruitment maneuvers. Methods Seventy patients who underwent selective open abdominal surgery were selected, and they were divided into standard ventilation group (tidal volume 8 ml/kg) and protective ventilation group (tidal volume 6 ml/kg, 5 cmH2O positive end-expiratory pressure, and alveolar recruitment maneuvers, 1 cmH2O=0.098 kPa) according to the random digits table method with 35 cases each. The airway pressure, blood pressure, pulse oxygen saturation (SpO2), end-tidal partial pressure of carbon dioxide (PETCO2) and adverse reactions were observed. The SpO2, partial pressure of O2 (PaO2) and pulmonary function before surgery and 1, 3, 5 d after surgery were measured. Results The respiratory rate, airway pressure and PETCO2 levels in protective ventilation group were significantly higher than those in standard ventilation group: (12.3 ± 2.1) times/min vs. (10.2 ± 1.0) times/min, (15.1 ± 2.8) cmH2O vs. (13.5 ± 2.3) cmH2O, (34.6 ± 2.1) mmHg (1 mmHg=0.133 kPa) vs. (32.1 ± 1.4) mmHg, and there were statistical differences (P<0.05). The SpO2 in 2 groups was maintained at 0.99. There was no statistical difference in the incidence of postoperative complications between 2 groups (P>0.05). The SpO2 and PaO2 levels at 1, 3 d after surgery in protective ventilation group were significantly higher than those in standard ventilation group:0.951 ± 0.018 vs. 0.936 ± 0.016 and 0.964 ± 0.018 vs. 0.949 ± 0.018, (74.8 ± 6.8) mmHg vs. (65.0 ± 6.2) mmHg and (79.6 ± 6.0) mmHg vs. (70.6 ± 5.3) mmHg, and there were statistical differences (P<0.05). The forced expiratory volume in 1 s (FEV1), percentage of the estimated value of FEV1, forced vital capacity (FVC) and percentage of the estimated value of FVC at 1, 3 and 5 d after surgery in protective ventilation group were significantly higher than those in standard ventilation group, the FEV1/FVC at 1 d after surgery was significantly higher than that in standard ventilation group, and there were statistical differences (P<0.05). Conclusions The lung protective ventilation strategy and alveolar recruitment maneuvers can improve the postoperative pulmonary function and oxygen partial pressure during general anesthesia for abdominal surgery. Low vital volume, appropriate positive end-expiratory pressure and recruitment maneuvers can protect the lung in general anesthesia patients.