Vascular dementia (VaD) is one of the most common dementia types in the elderly population. Its incidence is only second to Alzheimer's disease. At present, the diagnosis of VaD mainly based on the clinical manifestations, neuroimaging and neuropsychological scales of the patients. It still lacks higher sensitive and specific metabolism indexes. Magnetic resonance spectroscopy is a noninvasive technique for detecting the energy of living tissues and the changes of metabolism. In recent years, it has been more and more used to patients with VaD and has achieved initial results in the diagnosis, differential diagnosis and cognition-related studies of

Objective To investigate the relationship between cognitive impairment and the other clinical features of subcortical damage in patients with magnetic resonance imaging(MRI)-defined subcortical ischemic vascular disease(SIVD).Methods The cohort for this study included 110 SIVD patients who were divided into 3 groups according to cognitive status:patients with noncognition impairment(SIVD-NCI group,n=34),patients with mild cognitive impairment(SIVD-MCI group,n =47) and patients with vascular dementia (SIVD-VaD group,n =29).The cognitive functions were evaluated by the mini-mental state examination (MMSE) and Montreal cognitive assessment(MoCA),the Cambridge cognitive examination-Chinese version(CAMCOG-C),activity of daily living scale(ADL) and clock drawing task(CDT),etc.Depression symptoms were assessed by the geriatric depression scale (GDS),while the other clinical features of subcortical damage were assessed by the timedGet-Up and Go test,etc.Results There were statistically significant differences in the MMSE,MoCA,CAMCOG-C,CDT and ADL scores among the three groups(H=85.36,F=50.32,55.03,H=27.39,40.87,respectively,all P＜0.05).Gait disturbance,urinary disorder,pseudobulbar palsy,depression and falls were statistically significantly different among the threegroups(x2=21.69,21.41,25.51,6.91,21.87,all P＜0.05).In addition,gait disturbance was increasingly aggravated with the severity of cognitive impairment.In SIVD-MCI group,urinary disorder,pseudobulbar palsy and falls were significantly increased as compared with SIVD-NCI group (x2 =15.57,16.31,8.92,both P＜0.017).Depression was statistically significant different between SIVD-NCIandSIVD-VaD group(x2 =6.90,P＜0.017).Among the three groups,there was no significant difference in the feature of emotional incontinence.Conclusions With the decline in cognitive function,the patients with SIVD can present with different clinical features of subcortical damage.Gait disturbance is gradually aggravated with the decline in cognitive function.Urinary disorder,pseudobulbar palsy,and falls can reflect the cognitive impairment from normal to mild on the other hand.Depression can be used as one of the signs that show cognitive impairment reached to dementia.

The isolated vessel elements from the xylem in Chinese Sarcandra species were observed by scanning electron microscope and optical microscope. The vessel elements with simple pits or (and) bor dered pits or (and) scalariform pits or (and) circular-scalariform pits in their secondary walls are 1200-1900 in length and all have scalariform multiperforation plates in which the numbers of bars are between 60 to 160.

Objective To investigate the neuropsychological features of different mild cognitive impairment (MCI) subtypes.Methods A neuropsychology battery was applied in this study.Seventy MCI participants were enrolled in the test and classified as:28 amnestic MCI ( aMCI),21 vascular MCI ( V-MCI),and 21 Parkinson' s disease MCI (PD-MCI).Forty six normal old people were also evaluated as control.Results First,there were significant differences in the CAMCOG-C and CAMCOG-C subscales of each MCI subtype compared with the normal control. aMCI patients showed significantly impaired orientation,language expression,recent memory,attention,calculation,abstraction and perception (t =4.580,5.150,3.053,4.070,5.918,2.121,2.952,3.175 ; all P ＜ 0.05).However,the ability of language comprehension,remote memory and execution were relatively reserved.V-MCI patients scored lower in the cognitive function of orientation,language expression,attention and execution compared with the normal control(t =2.974,3.165,4.216,3.197; all P ＜ 0.05),with no significant difference in memory,calculation,abstraction and perception.A boarder cognitive impairment was observed in PD-MCI patients who showed significantly impaired language expression,recent memory,remote memory,learning memory,attention and execution(t =4.433,3.065,3.821,3.447,5.344,0.348 ; all P ＜ 0.05).Second,aMCI (3.07 ± 0.81,11.07 ± 2.28 ) and PD-MCI (3.00 ± 0.89,11.33 ± 1.91 ) patients scored significantly lower in CAMCOG scores and CAMCOG subscales including recent memory and learning memory compared with V-MCI(3.52 ±0.87,12.48 ± 1.83;aMCI vs V-MCI:t =1.868,2.381,PD-MCI vs V-MCI:t =1.921,1.980 ; all P ＜ 0.05 ).The remote memory and execution function in PD-MCI were significantly impaired compared to the other two subtypes(PD-MCI vs aMCI:t =2.498,4.257; PD-MCI vs V-MCI:t =1.684,1.492 ;all P ＜ 0.05 ).Third,the GDS scores were different among the four groups. aMCI grouphad significant higher GDS score compared to the normal control group( t =2.850,P ＜ 0.05 ),while there were no similar changes in V-MCI and PD-MCI groups.Comparing different MCI subtypes with each other,aMCI and V-MCI groups had higher GDS scores than PD-MCI group.Conclusions The features of cognitive impairment in the 3 subtypes are all multiple domains.The characteristic impairment domains are memory in aMCI,executive function in V-MCI,and both memory and executive functions in PD-MCI.aMCI may show greater depression tendency compared to the other two subtypes.The different features in the subtypes of MCI may represent different pathophysiololgical changes in each MCI subtype.

Objective To investigate the relationship between serum three triacylglycerol lipase (ATGL) and inflammatory factors in patients with coronary atherosclerotic heart disease (CHD).Methods 135 cases of CHD patients,and 50 healthy people were enrolled in the study.CHD patients were divided into stable angina pectoris (SAP) group (53 cases),unstable angina pectoris (UAP) group(46 cases) and acute myocardial infarction (AMI) group (36 cases) according to relevant diagnostic criteria.The serum levels of ATGL,tumor necrosis factor (TNF-α),interleukin-6(IL-6), interleukin-10(IL-10),1,25 dihydroxy vitamin D3[1,25(OH)2D3] were measured by ELISA, and statistical treatment was performed.Results The levels of ATGL,1,25(OH)2D3 in CHD group were lower than that in control group,and the levels of TNF-α,IL-6 and IL-10 were higher than those of control group(P<0.05).Comparison among different clinical types of CHD patients showed that ATGL,1,25 (OH)2D3 levels of AMI group were significantly lower than those of SAP group and UAP group,while TNF-α,IL-6 and IL-10 were higher than those of SAP group and UAP group(P<0.05);the levels of ATGL,1,25(OH)2D3 in UAP group were lower than those in SAP group,and TNF-α and IL-10 were higher than those in SAP group(P<0.05).Spearman correlation analysis showed that in the CHD group the serum levels of ATGL negatively correlated with TG,LDL-C,LP (a),TNF-α,IL-6,IL-10(r=-0.289,-0.227,-0.359,-0.243,-0.205,-0.337,P<0.05),while positively correlated with age,HDL-C,1,25(OH)2D3(r=0.267,0.356,0.229,P<0.05).Conclusion The ATGL levels in patients with CHD decreases with the increase of inflammatory factors,and plays a certain anti-inflammatory role in the progression of CHD.It can be used as a monitoring indicator to reflex the progress of CHD.

Objective:To evaluate the clinical outcomes of endoscopic submucosal dissection ( ESD ) for early gastric cancer ( EGC) in a single center in China. Methods:We performed a retrospective ana-lysis of the patients with single EGC lesion who received ESD in Peking University Cancer Hospital from January 2011 to December 2013. Their clinicopathologic data, resectability, curability, complications and follow-up data were assessed. Results:A total of 116 patients were enrolled in the study. The patients in-cluded 88 men and 28 women, with a median age of 63 years ( range:25-80 years) . The post-operative histology of the lesions included 28 (24. 1%) high grade intraepithelial neoplasia, 35 (30. 2%) well differentiated adenocarcinoma, 35 (30. 2%) moderated differentiated adenocarcinoma and 18 (15. 5%) poorly differentiated adenocarcinoma. Of all the lesions, 75. 0% (87/116) were confined into mucosa, 15. 5% (18/116) invaded SM1 ( <500 μm from the muscularis mucosae) and 9. 5% (11/116) inva-ded SM2 (≥500 μm from the muscularis mucosae). The mean tumor size was (1. 49 ± 0. 96) cm, and the rate of ulceration was 14. 7% (17/116). The en bloc resection rates were 96. 7% (111/116), com-plete resection rates were 93. 1% (108/116) and curative resection rates were 77. 6% (90/116). Ac-cording to the curability, 62 (53. 4%) cases were classified into the standard curative resection ( sCR) group, 28 (24. 2%) into the expanded curative resection ( eCR) group and 26 (22. 4%) into thenon-curative resection ( nCR) group. The mean tumor size of the sCR group was smaller than that of the eCR and nCR group (t= -4. 121, P<0. 001 and t= -3. 420, P=0. 001). In the nCR group, the portion of type 0-Ⅲlesion and ulceration were significantly higher (χ2 =10 . 287 , P=0 . 006 andχ2 =17 . 737 , P<0. 001). In multivariate analysis, EGC with ulceration and submucosal invasion were the risk factors for non-curative resection ( OR=6 . 634 , P=0 . 006 and OR=12 . 735 , P<0 . 001 ) . The ESD-related complications included 4 ( 3. 4%) post-operative bleeding, 3 ( 2. 6%) intra-operative perforation, 2 (1. 7%) cardiac stenosis and 1 (0. 9%) heart failure. In the study, 106 of the 116 patients received periodic follow-up, during a median follow-up of 22 months(12 -47 months), Local tumor recurrence developed in 1 patient of the eCR group 8 months post the ESD. Conclusion:ESD is a safe and feasible option for EGC in China, ulceration and submucosal invasion are associated with non-curative resection, and post-operative bleeding and intra-operative perforation should be concerned as the main complica-tions.

Since the biological characteristics of esophageal gastric junction (EGJ) cancer are different from those of gastric cancer and esophageal cancer, the choice of initial treatment is particularly important. This article introduces a case of locally advanced EGJ can-cer with single metastasis factor treated with preoperative radiochemotherapy in the Beijing Cancer Hospital. Through the multidisci-plinary team, we aim to achieve a better prognosis for this patient and propose new treatment practices for EGJ cancer.

Objective To explore properties of emotion memory circuits in late-life depression,and differences in functional connectivity of emotional memory network between late-life depression and healthy controls who were investigated by resting-state fMRI.Methods Eighteen late life depression patients and twenty four healthy controls were involved in our study.Resting-state functional MRI data were acquired via 3.0T MRI scanner.Functional MRI data were analyzed.Behavioral data were acquired during retrieval.The independent samples t-test of functional MRI data and ANOVA of behavioral performance were performed with AFNI and SPSS 13.0 statistical software,respectively.Results Decreased connectivities had been shown in depression,including amygdala-thalamus,amygdala-left inferior frontal gyrus,supramarginal gyrus-dorsomedial prefrontal cortex/anterior cingulate cortex (ACC),middle temporal gyrus-middle frontal gyrus and thalamus-inferior frontal gyros/left frontal eye fields (FEF) connectivity;while increased connectivities included hippocampus-middle temporal gyrus,hippocampusventromedial prefrontal cortex/middle temporal gyrus/ACC/FEF,middle temporal gyrus-fusiform gyrus/FEF,insula-middle temporal gyrus/FEF and thalamus-caudate connectivity (P＜0.05).For depression,global hubs included left amygdale,right hippocampus,right middle frontal gyrus,and right insula.For healthy group,global hubs included bilateral amygdale and middle frontal gyrus,right anterior inferior parietal lobe and right insula.Conclusion There are common and different characters in functional connectivity of emotional memory network between depression and healthy control.Global hub function decreases in the right amygdale and left inferior frontal gyrus,while right hippocampus shows compensatory increase.

Background and purpose:BCRP was recently discoveried as a membrane transport protein affiliated with multiple drug resistance(MDR).The aim of present study was to investigate the expression of breast cancer resistance protein(BCRP) in primary breast carcinoma and its potential significance of guiding breast carcinoma chemotherapy and to determine whether such expression can be used as a predict factor for chemosensitivity.Methods:Expression of BCRP in 31 primary breast carcinoma tissues was determined by flow cytometry.The relationship between the expression of BCRP with the clinicpathological characteristics and the prognosis of breast carcinoma patients was also analyzed.Results:The expression level of BCRP was higher in breast carcinoma tissue(0.282581?0.183686) than control group(0.03125?1.000905).There was no statistical difference befween BCRP and state of ER,PR,C-erbB_2 and EGFR in breast carcinoma tissues.In addition,it was the same situation no matter whether axillary lymph node was metastatasied or not.Conclusions:The results suggest that BCRP is expressed in primary breast carcinoma and is a cell membrane protein independent on ER,PR,c-erb-B-2,EGFR.Based chemotherapy is more effective for the patients with the overexpression of BCRP in primary breast carcinoma tissue.

Objective To detect the serum levels of 25‐hydroxy vitamin D[25‐(OH)D] ,homocysteine(HCY) andβ2‐microglob‐ulin(β2‐MG) in the patients with type 2 diabetes mellitus (T2DM ) and to investigate the relationship between serum HCY and β2‐MG with 25‐(OH)D and its clinical significance .Methods A total of 139 cases of T2DM were selected anddivided into 3 groups , the normal albuminuria group for [urinary albumin to creatinine ratio (UACR)< 30 mg/gCr ,45 cases] ,microalbuminuria group (UACR ≥ 30 mg/gCr and < 300 mg/gCr ,48 cases) and massive proteinuria group (UACR ≥ 300 mg/gCr ,46 cases) according to the urinary albumin to creatinine ratio (UACR) .Other 45 individuals undergoing the physical examination were selected as the con‐trol group .The serum 25‐(OH)D level was measured by electrochemiluminescence .Serum HCY level was determined by the enzy‐matic method .Serum β2‐MG level was measured by the latex enhanced immune turbidity method .At the same time ,the biochemical indicators of FBG ,HbA1C ,serum calcium and phosphorus were measured .Results The serum 25‐(OH)D level was decreased with the increase of urinary albumin in the DM patients .And the serum 25‐(OH)D level in the microalbuminuria group and the massive proteinuria group was significantly decreased compared with the normal albuminuria group and the control group ,the difference was statistically significant(P<0 .01) .The serum HCY and β2‐MG levels in the microalbuminuria group and the massive proteinuria group were significantly increased compared with the healthy control group ,the difference was statistically significant (P<0 .05) . Conclusion The serum 25‐(OH)D level is decreased with the increase of urinary albumin in the diabetic patients .The serum HCY andβ2‐MG levels are increased with the increase of urinary albumin and serum 25‐(OH)D level is negatively correlated with the HCY andβ2‐MG levels .