Post-stroke cognitive impairment (PSCI) seriously affects neurological recovery and quality of life of patients. Its mechanism, clinical evaluation, intervention have become research hotspot at home and abroad. Many studies have confirmed that secondary neurodegeneration in remote cognitive-related brain not affected by ischemia after stroke is one of the mechanisms of PSCI. It has been found in rodents that β-amyloid deposition and neuron loss in distant cognitive-related brain regions are involved in the occurrence of cognitive dysfunction and reducing these secondary damages can improve cognitive function. Experiments involving non-human primates have found neuronal loss but no β-amyloid deposition in distant brain regions after stroke. Clinical studies have found associations between secondary neurodegeneration in remote regions and cognitive function by using neuroimaging techniques, but the relationship between PSCI and β-amyloid deposition is not clear now. Due to its late occurrence time and wider therapeutic time window, its intervention treatment is expected to alleviate cognitive impairment, which has great clinical significance.

ObjectiveTo observe the effect of mometasone furoate on serous eotaxin in children with allergic rhinitis.MethodsThe observation group included 30 cases who got allergic rhinitis and treated by mometasone furoate.The level of eotaxin before and after treatment was detected by ELISA,and was compared with normal children in control group.ResultsBefore treatment,the signs scores of observation group was (9.4 ± 2.3 ),and after treatment was(3.1 ± 1.8),the difference was statistically significant(t =2.148,P ＜0.05).The treatment effect contained 19 cases(63.3％ ) 9 cases(30.0％ ) effective and 2 cases(6.7％ ) ineffective.Before treatment,the level of eotaxin in observation group was remarkably higher than control group [ (221.41 ± 137.96 ) ng/L vs ( 128.71 ± 60.73 ) ng/L,t =- 2.721,P ＜ 0.05 ],after treatment,symptom and sign was mitigated and eotaxin level was remarkably lower than before treatment[ ( 115.50 ± 52.71 ) ng/L vs (221.41 ± 137.96 ) ng/L,t =- 3.661,P ＜ 0.05 ].There was no serious adverse reaction in observation group.ConclusionTreated allergic rhinitis by corticosteroids could inhibit the allergic inflammation and down-regulate the eotaxin level.

Objective To study ultrasound features of breast cancer before and after neoadjuvant chemotherapy,and its correlation with histopathology. Methods One hundred and nine patients with breast cancer underwent paclitaxel plus carboplatin neoadjuvant chemotherapy, the change of the primary lesions and axillary lymph nodes were studied by ultrasound,and compared with histopathology. Results Seventeen patients achieved complete remission under ultrasound, the rest measurable lesions became significantly shortened in maximum diameter [ ( 22.46 ± 11.50) mm vs (34. 71 ± 13.67) mm, P ＜ 0. 001 ], and showed decrease both in longitudinal-transverse ratio (0. 80 ± 0. 23 vs 0. 86 ± 0. 22, P ＞0. 05) and grades of blood flow (0. 51 ± 0.80 vs 1.23± 1.05, P ＜0. 001 ). 44. 83% (44/92) of metastatic axillary lymph nodes disapeared after treatment. Comparing with histopathology, the sensitivity and specificity of ultrasound assessing complete remission were 57. 89 % ( 11 / 19) and 93.33 % (84/90), respectively. The moderate concord between ultrasound with histopathology might be attributed to the pathologic change of breast tissue and stroma after treatment, nevertheless grades of blood flow might be more meaningful. Conclusions Ultrasound assessment of neoadjuvant chemotherapeutic response might be of reference value,and studying corresponding ultrasonic manifestation of different kinds of pathological changes would help with better evaluation.

Objective To investigate the diagnostic value of color doppler transvaginal scan for patients with ectopic pregnancy. Methods Transvaginal scan and transabdominal scan were used to inspect 109 cases that were clinically doubted as early ectopic pregnancy. 126 cases only received transabdominal scan were as control group. Results Through transvaginal scan,35 cases were found as early unruptured ectopic pregnancy after they stop men-stru-ation about 35 to 42 days. The inspected time of the other 74 cases and control cases was post-poned obviously. All cases were compared with laparoscopy or skive belly operation and got the consilient rate of 97%. And the inspected time was earlier for 11. 3 days than the contrel group. This was a notable discrepancy (P < 0.01). Conclusion Transvaginal scan could improve the inspected rate for the early ectopic pregnancy greatly. It had more value than other methods,so it was worth being utilized widely.

Objective To retrospectively study the value of ultrasonography in diagnosing breast lymphoma and compare with mammography and MRI. Methods Imaging characteristics of 26 patients who were pathologically comfirmed as breast lymphoma were reviewed, including ultrasonography,mammography and MRI, and compare the diagnostic accuracy among the three. Results Twenty-four patients underwent ultrasonography and 32 lesions were found, with longest diameters averaged 30 mm.Tumors were mostly hypoechoic or very hypoechoic (81.3％), some were lobular (25.0％) or oval (21.9 ％ ) in shape, the margins were most frequently circumcribed (62. 5 ％ ), and a few tumors showed an echogenic boundary (18.8 ％ ). Color Doppler imaging showed hypervascularity in most tumors (59.4 ％ ).Ninteen patients undewent mammography, 15 solitary lesions were identified in 12 patients, asymmetric density in five,punctate calcification in one,and no abnormality in one. Eleven lesions were identified in MRI of 10 patients, 10 lesions showed hypointensity on T1-weighted images and hyperintensity on T2-weighted images, and heterogeneous enhancement after contrast. The diagnostic accuracy of ultrasonography,mammography and MRI was 83％, 52％ and 100％, respectively. Conclusions The sonograms of breast lymphoma have some distinct features, the combination of ultrasonography and MRI might benefit the diagnosis of breast lymphoma.

Objective To evaluate graft isometry after anatomic single bundle reconstruction of anterior cruciate ligament (ACL) using dynamic computed tomography (CT).Methods A retrospective study was conducted of the 14 patients who had undergone single bundle ACL reconstruction from June to August 2015.They were all men,with an average age of 28.6 years (range,from 18 to 39 years).At 6 months after operation,they received dynamic CT scanning during a cycle of knee extension to flexion.3D bone models representing the knee at different flexion positions (0°,30°,60°,90°,and 120°) in each patient were reconstructed from the CT images.The grid method was used to locate the positions of the central footprints of the tibial and femoral tunnels.The lengths between the entries of the femoral and tibial tunnels were measured from each tunnel entry to reflect the graft length change.Furthermore,we measured the isometry at the over-the-top position of the femur and at the anatomic tibial position.Results All the tunnel entries were located at the central area of the ACL anatomic attachment.The reconstructed ACL was the longest when the knee was in full extension.The length was gradually shortened between the femoral and tibial tunnels during flexion of the knee from 0° to 90°.The anatomic position showed an average of 4.82 mm shortening and the over-the-top position an average of 3.28 mm shortening.The length excursion increased in early flexion from 0° to 30° (2.91 ±0.91 mm on average) and reduced in later flexion from 90° to 120° (2.98 ± 1.41 mm on average).Conclusions None of the reconstructed ACL was isometric.A graft length may be the longest when the knee is in full extension and decrease gradually during the flexion from 0° to 90° and increase gradually during the flexion of 90° to 120°.The graft should be fixed when the knee is in the flexion of 30°.

Objective To investigate the dietary structure,nutrition and health status of elderly military cadres.Methods Questionnaire,dietary investigation and physical examination were performed in elderly cadres in Hangzhou Sanitarium in 1992,2002 and 2008(520,720 and 643 cases,respectively).The dietary structure,nutrition and health status were analyzed systematically.Results The intake of cereals dropped,and also the dried legumes.The intake of meats and aquatic products was significantly increased,and the intake of all the vegetables,fruits,dairy products,nuts and vegetable oils was rapidly increased too.The intake of pickles was decreased.The intake of salt and soy sauce showed a insignificant tendency of change.The intake of food supplying energy and protein had exceeded the recommended nutrient intake(RNI).The intake of niacin,vitamin E and Fe was increased gradually and reached the standard of RNI.Vitamin B1 intake also reached that of RNI.Vitamin C intake was increased rapidly,and reached 176.0?23.5mg/d in 2008.Zinc intake was not enough in 1992,while reached the standard of RNI in 2002 and 2008.Selenium intake reached RNI in 2008.With the increasing of milk consumption,calcium intake had greatly improved.There was also an increase in the proportion of energy from fat,which reached 37% in 2008.The health status of military old cadres had greatly improved.The prevalence of digestive diseases and hyperosteogeny decreased significantly by years,while the cardiovascular and cerebrovascular diseases increased.Conclusions The nutrition status and the quality of average diet in military elderly cadres have improved obviously,while the intake of fat,cholesterol and sodium is excessive.As a result,overweight,obesity and hypertension are prevalent.Propagation of nutrition knowledge and nutrition intervention should be emphasized.

In combination with the experience in teaching practice,we discuss medical lit-erary teaching reform,method and the significance and sparkplug exhibiting the knowledge forming process,cultivate managing the information ability,inspire creative interest,and form the style of study as "to study the phenomena of nature in order to acquire knowledge"and"reasonable doubt".

Objective To investigate the clinical significance and indications of non operative management for liver trauma(LT). Methods The clinical date of 66 cases of LT treated by non operation from November 1987 to November 2000 were retrospectively analyzed. Results There were 38 cases (57.6%) in class I of LT, 18(27.3%) in class II, 10(15.2%) in class III in this series. 64 cases were cured (97.0%), including 2 cases combined with active bleeding were converted to operation and curred; 2 cases (3.0%) died of combining with severe brain damag. 4 cases(6.1%) complicated with liver abscess were cured by non operative treatment. Conclusions The non operative management is suitable for all cases of class I, II and partial cases of class III of LT. The observation of blood dynamics is most important, and B-type ultrasonography is also imporant, The operation would be done if the case is combined with massive active bleeding.

Objective To explore the quality of life(QOL) of stroke patients and the influence factors.Methods The QOL of stroke patients was measured with Shot Form 36 Health Survey Questionnaire(SF-36) and questionnaire survey before discharge and six months after discharge;the patients' state of life was analyzed with the ordinal Logistic regression method to find out influence factors.Results The QOL of the stroke patients decreased obviously with an average sphere score between 38.18～67.57.Sphere scores increased during the six months of post-discharge,but only those of physical functioning(PF),role limitations due to physical health(RP),bodily pain(BP),general health perceptions(GH) and vitality(VT) rose significantly.Some common factors that would affect physical and mental health of the patients included: marriage state,economic conditions,medical care assurance,health care,psychological obstacles,rehabilitation and viability.Besides,age,the features of pathological changes and the complication had significant effect on the physical health of the patients,while children and aphasia affected mental health.Conclusion Early and canonical rehabilitation physical care,language and psychological training and so on,as well as family caring and nursing all are contributive to improve the QOL of the stroke patients.