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.

Objective To investigate the expression of vascular endothelial growth factor (VEGF)、matrix metalloproteinase-2(MMP-2) and matrix metalloproteinase-9 (MMP-9) in tongue squamous cell carcinoma and the clinical significance.Methods The expression of MMP-2,MMP-9 and VEGF in 60 cases of tongues quamous cell carcinoma tissues and in 20 cases of normal tongues tissues were examined by immunochemistry.Results The expression of MMP-2,MMP-9 and VEGF was higher in tongues quamous cell carcinoma than that in normal pancreatic parenchyma.In cases with lymph nodes metastasis and TNM stage Ⅲ + Ⅳ,the expression of two markers were significantly higher than those without lymph nodes metastasis and TNM stage Ⅰ + Ⅱ (P ＜ 0.05).A positive correlation was found between the expression of VEGF and MMP-2,MMP-9 in tongues quamous cell carcinoma ( P ＜ 0.05 ).Conclusion The expression of MMP-2,MMP-9 and VEGF was closely correlated with lymph nodes metastasis and TNM stage of tongues quamous cell carcinoma(P ＜ 0.05 ).VEGF and MMP-2,MMP-9 play an important role in the development of tongues quamous cell carcinoma,may cooperate with each other.

Objective To discuss the surgery for the patients with bruise of bilateral frontal lobes complicated with central encephalocele.Methods 48 patients diagnosed as bruise of bilateral frontal lobes complicated with central encephalocele were analyzed retrospectively.According to the results of CT and clinical symptoms,timing of surgery was selected.All patients were given unilateral decompressive craniectomy or bilateral decompressive craniectomy.Results All patients were followed up for 1 year.42 cases survived,while 6 cases died.All cases were estimated with GCS:18 cases ( 37.5％ ) were cured excellently,16 cases ( 33.3％ ) were mild morbidity,5 cases ( 10.4％ ) were severe morbidity,3 cases ( 6.3％ ) were in persistent vegetative state and 6 cases ( 12.5％ ) were dead.Conclusion The progression of patients with bruise of bilateral frontal lobes comphcated with central encephalocele were rapid.Diagnosis and treatment at the early stage could improve patients' prognosis.

Positron emission tomography (PET)/CT plays an important role in the diagnosis of bone metastasis from lung cancer,and can reflect the pathophysiological and morphological changes in lesion of bone metastasis.The sensitivity,specificity and the overall accuracy of PET-CT for the diagnosis of bone metastasis in patients with lung cancer are higher than those of routine methods such as X-ray,CT scan,MRI and SPECT/CT.

The diagnosis and treatment of age-related macular degeneration (AMD) is an international hotspot of eye research.Successful clinical applications of anti-VEGF drugs promoted both basic research and clinical practice of AMD.A number of countries and professional societies have established clinical guidelines for AMD management,including the epidemiology,risk factors,diagnosis,classification,and treatment process.These AMD guidelines are mostly based on recently published results of clinical trials,provided good model of evidence based medicine.It is urgent and necessary to have our own guideline which is suitable for Chinese patients.Reviewing and learning existed guidelines will help us to improve the clinical practice of AMD in China.

Objective: To analysis the clinical characteristic and pathogenic bacterium of infective endocarditis (IE),and to compare the pathogenic microorganism and vegetation localization between the prosthetic valve endocarditis (PVE) and the native valve endocarditis (NVE).Methods: The data was collected from 266 in-patients who fulfilled Duke Criteria for IE from May 2003 to May 2008 in our hospital.The demographics and clinical data were analyzed retrospectively.Results: There were 243/266 of IE patients suffered from basic heart disease,among them,101 patients with congenital heart disease,77 patients with non-rheumatic valvular heart disease,62 with rheumatic heart disease and 3 with other heart disease.There were 218 (82%) patients with identified vegetation,and the most common vegetation localized at aortic valve,mitral valve,and aortic plus mitral valve in turn.Bacterial cultures were positive in 49.5% of patients.The proportion of Gram-Negative bacillus and Fungi infection had risen in IE.Detection rate of vegetation was lower in PVE patients than that in NVE patients (P<0.01).However,the positive bacterial culture rate was higher in PVE than in NVE (P<0.01).Streptococcus,coagulase negative staphylococcus,gram-negative bacteria showed significant difference between the two groups (P<0.05).The spectrum of microorganism was different between the early and the late PVE patients.The in-hospital mortality rate of PVE was higher than NVE.Conclusion: The spectrum and pathogenic bacterium of IE had changed obviously during the past years.Early diagnosis,bacterial culture with correct antibacterial treatment,transesophageal echocardiography,and active prevention of nosocomial infection should be essential for the disease control.

Objective To observe the neuroprotective effect of Copolymer 1 ( Cop 1) in rats with elevated intraocular pressure (IOP), and explore the clinical application of Cop 1 in the prevention of optic nerve atrophy induced by glaucoma. Methods Thirty adult Wistar rats were rendered for elevation of IOP in both eyes by Shareef-Sharma method. At the third week of IOP elevation, a mixture (1:1) of Cop 1 (100 μg) emulsified in complete Freund's adjuvant (CFA) was injected intracutaneously at two hind footpads in 15 rats (Cop 1 model group), and the other 15 rats were given the same dose of PBS emulsified in CFA (model control group) . Retinal ganglial cell (RGC) retrograde labeling was performed with Fluorogold 6 d later, and retina was taken after 24 h to compared the density of RGC between two groups. Another normal rats were served as blank controls. Results It was found that lymphocytes were accumulated on the histological slices of retina and optic nerve in Cop 1 model group. The rates of RGC loss of Cop 1 model group and model control group were 10. 24% ± 3.75% and 29.00% ±6.92%, respectively. The RGC density in Cop 1 model group was significantly lower than that in model control group (P <0. 05), while there was no significant difference in that between Cop 1 model group and blank control group (P >0.05). Conclusion Intracutaneous injection of Cop 1 can reduce the damage of RGC induced by elevated IOP.

Objective:To explore the relationship between the expression of EGFR and STAT3 in human la-ryngeal papilloma and its biological behavior. Method: Reverse transcription polymerasechain reaction(RT-PCR), immunohistochemical staining and Western blot were used to evaluate the mRNA and protein expression of EGFR and STAT3(p-STAT3) in 42 laryngeal papilloma tissues and 15 samples of normal laryngeal tissue, and the rela-tionship between the protein expression of them and clinicpathological parameters was also analysized. Result: The mRNA expression levels of EGFR and STAT3 in laryngeal papilloma tissue were significantly higher than that in normal laryngeal tissue(P<0.05,P<0.01). Protein positive expression of EGFR and p-STAT3 were also detected in a significantly greater proportion of laryngeal papilloma than normal laryngeal tissue by immunohistochemistry and western blot(P<0.01,P<0.05). There was relationship between EGFR and p-STAT3 overexpression in la-ryngeal papilloma(P<0.05). The expression p-STAT3 was correlated with the recurrence and canceration of la-ryngeal papilloma(P<0.05). Conclusion: The EGFR-STAT3 signal transduction pathway may be involved in the pathogenesis of laryngeal papilloma,, and the persistent activation of STAT3 gene plays an important role in the recurrence and canceration of laryngeal papilloma.

Objective To observe the clinical value of doppler ultrasound in evaluation of the treatment outcome of alcoholic liver disease.Methods 212 patients with alcoholic liver disease were selected.Ultrasound and liver function tests were applied before and after treatment,and temperance and medicines were applied for treating.The effects were used to observe the senlitivity of ultrasound applied in evaluation the treatment outcome of alcoholic liver disease.Results Of 212 cases,95 cases were diagnosed as alcoholic fatty liver disease by ultrasound before treatment,and the detection rate before treatment was 96.70％.51 cases were diagnosed as alcoholic hepatitis and 59 cases were alcoholic cirrhosis.After treatment,there were 37 cases had abnormal ultrasound images in 43 patients with alcoholic liver disease,and the detection rate was 86.04％.And 9 cases were diagnosed as alcoholic fatty liver disease by ultrasound,12 cases were diagnosed as alcoholic hepatitis and 16 cases were alcoholic cirrhosis.Conclusion It was noninvasive,cheap,convenient and repeated by using doppler ultrasound,and it was conducive to grasp the change of the condition of the patients for doctors.Ultrasound could be chosen as the preferred method for diagnosis of alcoholic liver disease.

ObjectiveTo study the clinical effect of sodium aescinate on the edema of limb tibial plate fracture.Methods69 patients with edema of limb of tibial plate fracture were randomly divided into two groups,treatment group(46 cases)and control group(23 cases).Both of them were transfused with 20％ mannitol(250ml,Bid ×7days).In addition,these patients in the treatment group were treated with sodium aescinate(30mg Qd × 7days).ResultsThe repercussive effect of the edema grade in the treatment group were obviously better than those in the control group(P ＜0.05 ).ConclusionSodium aescinate had a remarkable repercussive effect on the limb edema of tibial plate fracture.