Objective:To investigate the staging criteria of renal tuberculosis，and to analyze the diagnostic and therapeutic characteristics as well as prognostic outcomes at different stages.Methods:A retrospective analysis was conducted on the clinical data of 134 patients with renal tuberculosis who were admitted to the Second Hospital of Lanzhou University between January 2019 and December 2023.The study cohort included 62 males and 72 females，with a mean age of（46.63 ± 13.52）years and a mean body mass index（BMI）of（22.85 ± 3.73）kg/m 2. A total of 107 patients resided in rural areas. Sixty patients had a history of pulmonary tuberculosis. Tuberculous lesions were located in the left kidney in 72 cases and in the right kidney in 62 cases. The main presenting complaints included irritative lower urinary tract symptoms in 85 patients and systemic symptoms in 92 patients. Ureteral involvement was observed in 97 patients，bladder involvement in 32 patients，and genital involvement in 9 patients. Based on computed tomography（CT）findings，the number，extent，and degree of renal destruction caused by tuberculous lesions were comprehensively evaluated in axial，coronal，and sagittal planes. The primary staging criteria included lesion diameter（2 cm）and the proportion of renal volume involved by the lesion（one-third，one-half，and two-thirds）. Renal tuberculosis was classified into three stages and six subtypes：Stage Ⅰa，a solitary lesion with a diameter ≤ 2 cm；Stage Ⅰb，a solitary lesion >2 cm or multiple lesions confined within one-third of the renal volume；Stage Ⅱa，lesions involving more than one-third but confined within one-half of the renal volume；Stage Ⅱb，lesions involving more than one-half but confined within two-thirds of the renal volume；Stage Ⅲa，lesions involving more than two-thirds of the renal volume with a glomerular filtration rate（GFR）of the affected kidney <10 ml/min；and Stage Ⅲb，complete renal calcification，presenting as an “autonephrectomy”. Among the 134 patients included in this study，7 were classified as Stage Ⅰa，17 as Stage Ⅰb，20 as Stage Ⅱa，19 as Stage Ⅱb，62 as Stage Ⅲa，and 9 as Stage Ⅲb. The severity of hydronephrosis was graded as follows：mild，renal pelvic separation <2 cm；moderate，2-3 cm；and severe，>3 cm. Prior to treatment，the mean renal pelvic separation was（1.76 ± 0.92）cm in Stage Ⅰa，（1.69 ± 0.81）cm in Stage Ⅰb，and（1.10 ± 0.82）cm in Stage Ⅱa，corresponding to mild to moderate hydronephrosis. All 7 patients in Stage Ⅰa underwent ureteroscopic examination and double-J stent placement，combined with a 6-month short-course anti-tuberculosis regimen consisting of isoniazid，rifampicin，pyrazinamide，and ethambutol for 2 months（intensive phase），followed by isoniazid and rifampicin for 4 months（continuation phase）. Among the 17 patients in Stage Ⅰb，13 presented with hydronephrosis and underwent ureteroscopic examination and double-J stent placement in combination with 6 months of anti-tuberculosis therapy，while 4 patients with isolated renal tuberculosis received anti-tuberculosis therapy alone for 6 months.Of the 20 patients in Stage Ⅱa，4 with hydronephrosis underwent ureteroscopic examination and double-J stent placement plus 6 months of anti-tuberculosis therapy，whereas 16 underwent nephroureterectomy. All 19 patients in Stage Ⅱb underwent nephroureterectomy. Among the 62 patients in Stage Ⅲa，60 underwent nephroureterectomy，while 2 refused surgery and were treated with the 6-month short-course anti-tuberculosis regimen. Of the 9 patients in Stage Ⅲb，8 underwent nephroureterectomy；in 1 patient，surgery was not performed due to severe adhesions in the operative field，and the patient received the 6-month short-course anti-tuberculosis regimen instead. Follow-up assessments included clinical symptoms，erythrocyte sedimentation rate（ESR），serum creatinine，degree of renal pelvic separation，and imaging findings from urinary tract CT. Efficacy was evaluated according to the following criteria：Cure was defined as clinical stability with all of the following conditions：① improvement of systemic symptoms，including absence of flank pain，fever，and lower urinary tract irritative symptoms，with normalization of erythrocyte sedimentation rate（ESR）；② negative urine culture for Mycobacterium tuberculosis；and ③ complete calcification of renal lesions and/or no evidence of tuberculous lesions at other sites. Stable disease was defined as no change in the size or extent of renal tuberculosis lesions. Progressive disease was defined as enlargement or increase in the number of tuberculous lesions or involvement of additional sites. Results:Among the 7 patients in Stage Ⅰa，follow-up imaging after treatment showed a mean renal pelvic separation of（0.44 ± 0.56）cm，which was significantly reduced compared with baseline（ t = 3.909， P = 0.008）. Five patients achieved cure，1 remained stable，and 1 showed disease progression and subsequently underwent nephroureterectomy，resulting in postoperative cure. In Stage Ⅰb，among 13 patients with hydronephrosis，post-treatment imaging showed a mean renal pelvic separation of（0.8 ± 0.75）cm，a statistically significant improvement from baseline（ t = 5.633， P < 0.01）. Six patients were cured，4 remained stable，and 3 experienced disease progression and underwent nephroureterectomy. Of the 4 patients with isolated renal tuberculosis，2 were controlled，and 2 progressed and underwent nephroureterectomy. In Stage Ⅱa，among 4 patients with tuberculous hydronephrosis，post-treatment renal pelvic separation was（1.20±0.98）cm，with no significant difference from baseline（ t = -1.675， P = 0.193）；these patients underwent nephroureterectomy 1-2 years later. The remaining 16 patients without hydronephrosis underwent nephroureterectomy and were cured. All 19 patients in Stage Ⅱb underwent nephroureterectomy；17 were cured，and 2 developed ipsilateral perirenal fluid collections 3 months postoperatively，which resolved spontaneously with the standard 6-month anti-tuberculosis regimen. Among 62 patients in Stage Ⅲa，60 underwent nephroureterectomy. Of these，54 were cured；1 developed a urinary tract infection within 2 weeks postoperatively；3 showed contralateral renal disease progression at 3 months；and 1 developed ipsilateral perirenal fluid at 3 months，which resolved spontaneously with standard anti-tuberculosis therapy. One patient developed solitary kidney failure 7 months postoperatively and underwent ureteral stent placement，with disease remaining stable thereafter. Two patients refused surgery and received only anti-tuberculosis therapy；during follow-up，1 patient experienced disease progression and died of disseminated tuberculosis after 1 year，while the other developed contralateral renal involvement at 3 months and received standard 6-month therapy，with disease remaining stable. Among 9 patients in Stage Ⅲb，8 underwent nephroureterectomy and were cured. One patient，with severe adhesions precluding surgery，received anti-tuberculosis therapy alone，and disease remained stable over a 2-year follow-up. Conclusions:The CT-based staging system for renal tuberculosis proposed in this study（three stages and six subtypes）effectively reflects the severity of renal lesions and clearly delineates the clinical characteristics and prognostic outcomes at each stage. Stage Ⅰ patients treated with anti-tuberculosis drugs combined with double-J stent placement demonstrated favorable outcomes and high renal preservation rates. In contrast，Stages Ⅱ and Ⅲ patients showed poor responses to anti-tuberculosis therapy combined with drainage，with a higher risk of disease progression and relatively worse prognosis，highlighting the recommendation for early nephroureterectomy of the affected kidney.

Objective:To investigate the staging criteria of renal tuberculosis，and to analyze the diagnostic and therapeutic characteristics as well as prognostic outcomes at different stages.Methods:A retrospective analysis was conducted on the clinical data of 134 patients with renal tuberculosis who were admitted to the Second Hospital of Lanzhou University between January 2019 and December 2023.The study cohort included 62 males and 72 females，with a mean age of（46.63 ± 13.52）years and a mean body mass index（BMI）of（22.85 ± 3.73）kg/m 2. A total of 107 patients resided in rural areas. Sixty patients had a history of pulmonary tuberculosis. Tuberculous lesions were located in the left kidney in 72 cases and in the right kidney in 62 cases. The main presenting complaints included irritative lower urinary tract symptoms in 85 patients and systemic symptoms in 92 patients. Ureteral involvement was observed in 97 patients，bladder involvement in 32 patients，and genital involvement in 9 patients. Based on computed tomography（CT）findings，the number，extent，and degree of renal destruction caused by tuberculous lesions were comprehensively evaluated in axial，coronal，and sagittal planes. The primary staging criteria included lesion diameter（2 cm）and the proportion of renal volume involved by the lesion（one-third，one-half，and two-thirds）. Renal tuberculosis was classified into three stages and six subtypes：Stage Ⅰa，a solitary lesion with a diameter ≤ 2 cm；Stage Ⅰb，a solitary lesion >2 cm or multiple lesions confined within one-third of the renal volume；Stage Ⅱa，lesions involving more than one-third but confined within one-half of the renal volume；Stage Ⅱb，lesions involving more than one-half but confined within two-thirds of the renal volume；Stage Ⅲa，lesions involving more than two-thirds of the renal volume with a glomerular filtration rate（GFR）of the affected kidney <10 ml/min；and Stage Ⅲb，complete renal calcification，presenting as an “autonephrectomy”. Among the 134 patients included in this study，7 were classified as Stage Ⅰa，17 as Stage Ⅰb，20 as Stage Ⅱa，19 as Stage Ⅱb，62 as Stage Ⅲa，and 9 as Stage Ⅲb. The severity of hydronephrosis was graded as follows：mild，renal pelvic separation <2 cm；moderate，2-3 cm；and severe，>3 cm. Prior to treatment，the mean renal pelvic separation was（1.76 ± 0.92）cm in Stage Ⅰa，（1.69 ± 0.81）cm in Stage Ⅰb，and（1.10 ± 0.82）cm in Stage Ⅱa，corresponding to mild to moderate hydronephrosis. All 7 patients in Stage Ⅰa underwent ureteroscopic examination and double-J stent placement，combined with a 6-month short-course anti-tuberculosis regimen consisting of isoniazid，rifampicin，pyrazinamide，and ethambutol for 2 months（intensive phase），followed by isoniazid and rifampicin for 4 months（continuation phase）. Among the 17 patients in Stage Ⅰb，13 presented with hydronephrosis and underwent ureteroscopic examination and double-J stent placement in combination with 6 months of anti-tuberculosis therapy，while 4 patients with isolated renal tuberculosis received anti-tuberculosis therapy alone for 6 months.Of the 20 patients in Stage Ⅱa，4 with hydronephrosis underwent ureteroscopic examination and double-J stent placement plus 6 months of anti-tuberculosis therapy，whereas 16 underwent nephroureterectomy. All 19 patients in Stage Ⅱb underwent nephroureterectomy. Among the 62 patients in Stage Ⅲa，60 underwent nephroureterectomy，while 2 refused surgery and were treated with the 6-month short-course anti-tuberculosis regimen. Of the 9 patients in Stage Ⅲb，8 underwent nephroureterectomy；in 1 patient，surgery was not performed due to severe adhesions in the operative field，and the patient received the 6-month short-course anti-tuberculosis regimen instead. Follow-up assessments included clinical symptoms，erythrocyte sedimentation rate（ESR），serum creatinine，degree of renal pelvic separation，and imaging findings from urinary tract CT. Efficacy was evaluated according to the following criteria：Cure was defined as clinical stability with all of the following conditions：① improvement of systemic symptoms，including absence of flank pain，fever，and lower urinary tract irritative symptoms，with normalization of erythrocyte sedimentation rate（ESR）；② negative urine culture for Mycobacterium tuberculosis；and ③ complete calcification of renal lesions and/or no evidence of tuberculous lesions at other sites. Stable disease was defined as no change in the size or extent of renal tuberculosis lesions. Progressive disease was defined as enlargement or increase in the number of tuberculous lesions or involvement of additional sites. Results:Among the 7 patients in Stage Ⅰa，follow-up imaging after treatment showed a mean renal pelvic separation of（0.44 ± 0.56）cm，which was significantly reduced compared with baseline（ t = 3.909， P = 0.008）. Five patients achieved cure，1 remained stable，and 1 showed disease progression and subsequently underwent nephroureterectomy，resulting in postoperative cure. In Stage Ⅰb，among 13 patients with hydronephrosis，post-treatment imaging showed a mean renal pelvic separation of（0.8 ± 0.75）cm，a statistically significant improvement from baseline（ t = 5.633， P < 0.01）. Six patients were cured，4 remained stable，and 3 experienced disease progression and underwent nephroureterectomy. Of the 4 patients with isolated renal tuberculosis，2 were controlled，and 2 progressed and underwent nephroureterectomy. In Stage Ⅱa，among 4 patients with tuberculous hydronephrosis，post-treatment renal pelvic separation was（1.20±0.98）cm，with no significant difference from baseline（ t = -1.675， P = 0.193）；these patients underwent nephroureterectomy 1-2 years later. The remaining 16 patients without hydronephrosis underwent nephroureterectomy and were cured. All 19 patients in Stage Ⅱb underwent nephroureterectomy；17 were cured，and 2 developed ipsilateral perirenal fluid collections 3 months postoperatively，which resolved spontaneously with the standard 6-month anti-tuberculosis regimen. Among 62 patients in Stage Ⅲa，60 underwent nephroureterectomy. Of these，54 were cured；1 developed a urinary tract infection within 2 weeks postoperatively；3 showed contralateral renal disease progression at 3 months；and 1 developed ipsilateral perirenal fluid at 3 months，which resolved spontaneously with standard anti-tuberculosis therapy. One patient developed solitary kidney failure 7 months postoperatively and underwent ureteral stent placement，with disease remaining stable thereafter. Two patients refused surgery and received only anti-tuberculosis therapy；during follow-up，1 patient experienced disease progression and died of disseminated tuberculosis after 1 year，while the other developed contralateral renal involvement at 3 months and received standard 6-month therapy，with disease remaining stable. Among 9 patients in Stage Ⅲb，8 underwent nephroureterectomy and were cured. One patient，with severe adhesions precluding surgery，received anti-tuberculosis therapy alone，and disease remained stable over a 2-year follow-up. Conclusions:The CT-based staging system for renal tuberculosis proposed in this study（three stages and six subtypes）effectively reflects the severity of renal lesions and clearly delineates the clinical characteristics and prognostic outcomes at each stage. Stage Ⅰ patients treated with anti-tuberculosis drugs combined with double-J stent placement demonstrated favorable outcomes and high renal preservation rates. In contrast，Stages Ⅱ and Ⅲ patients showed poor responses to anti-tuberculosis therapy combined with drainage，with a higher risk of disease progression and relatively worse prognosis，highlighting the recommendation for early nephroureterectomy of the affected kidney.

OBJECTIVE: Foreign studies have reported that coronary artery disease (CAD) patients with high baseline low-density lipoprotein cholesterol (LDL-C) may have a good prognosis, which is called the "cholesterol paradox". This study aimed to examine whether the "cholesterol paradox" also exists in the Chinese population. METHODS: A total of 2,056 patients who underwent the first percutaneous coronary intervention (PCI) between 2014 and 2016 were enrolled in this retrospective cohort study and classified into two groups based on baseline LDL-C = 2.6 mmol/L (100 mg/dL). The outcomes of interest included major adverse cardiovascular events (MACE), all-cause mortality, recurrent nonfatal myocardial infarction, unexpected coronary revascularization, or any nonfatal stroke. RESULTS: All-cause mortality occurred in 8 patients (0.7%) from the low-LDL-C group and 12 patients (2.4%) in the high-LDL-C group, with a significant difference between the two groups (adjusted hazard ratio: 4.030, 95% confidence interval: 1.088-14.934; P = 0.037). However, no significant differences existed for the risk of MACE or other secondary endpoints, such as unexpected revascularization, nor any nonfatal stroke in the two groups. CONCLUSION In this study, a high baseline LDL-C was not associated with a low risk of clinical outcomes in CAD patients undergoing first PCI, which suggested that the "cholesterol paradox" may be inapplicable to Chinese populations.
Humans ; Cholesterol, LDL ; Retrospective Studies ; Percutaneous Coronary Intervention/adverse effects* ; Coronary Artery Disease/surgery* ; Cholesterol ; Cholesterol, HDL ; Stroke/etiology* ; Treatment Outcome ; Risk Factors

Objective: To evaluate heterogeneity and clonal evolution in pediatric ETV6-RUNX1⁺ acute lymphoblastic leukemia (ALL) in China. Methods: Totally 48 children (<14 years) with newly diagnosed ETV6-RUNX1⁺ ALL in Institute of Hematology and Blood Disease Hospital, CAMS and PUMC, from February 2006 to June 2011 were included. The copy number variations were analyzed by quantitative multigene fluorescence in situ hybridization (QM-FISH) in 48 patients. Non-normal distribution of measurement data were shown with Median (range) , count data were shown with percent (%) . Overall survival and event-free survival were estimated by the Kaplan-Meier method and compared with the log-rank test. Results: Forty-eight patients were tested by QM-FISH. Of 48 patients, 70.8% harbored one clone, 18.8% two subclones, and 10.4% three or more subclones. The clone heterogeneity was detected by two different models: the linear succession model and the branching evolution model. ETV6-RUNX1⁺ ALL relapse evolved from an ancestral clone or a new clone. The patients relapsed from a new clone got the worse outcome. Conclusion The clone evolution was detected in pediatric ETV6-RUNX1⁺ ALL in China. QM-FISH might be helpful to evaluate the outcome of relapsed patients. A new clone was associated with a poorer outcome.

Objective To investigate the implementing effect of team-based learning combined with situational simulation in clinical teaching of psychiatry.Methods A compendium was selected from "Psychiatric nursing",which was about the prevention and nursing of psychiatric crisis. We designed curriculums and wrote the scripts,and organized professional scenario walkthroughs. Eventually,we made them into videos and audio data. Firstly,60 nursing students were given team-based learning combined with situational simulation based on traditional teaching for 4 weeks. After teaching,the results of the theory and emergency skills examination and teaching satisfaction were compared.Results After 4 weeks,the professional theoretical examination of nursing students was (88.93±8.20) pints,and it was significantly higher than (83.27±5.31) points before teaching;meanwhile the emergency skills examination was (93.48±5.99) points,which was significantly higher than (85.87±7.34) points before training (t=-7.91,-9.12;P<0.01). The score of satisfaction of nursing students with teaching was (97.21±1.75),which was higher than (83.82±8.23) before training (t=10.78,P<0.01).Conclusions The team-based learning combined with situational simulation teaching not only cultivates nursing students' autonomous learning interest,which could improve independent study ability and effectiveness,but also improves their teamwork skills,which could improve clinical teaching quality and satisfaction.

Objective To discuss the implementation effects of the team-based learning combined with situational simulation in the standardized training in psychiatric.Methods A total of 70 psychiatric nurses in the standard training period from June to August 2015 were randomly divided into control group and experimental group, 35 respectively. Nurses in the control group received traditional teaching mode, while nurses in the experimental group used the teaching mode of the team-based learning combined with situational simulation. After the training, the theoretical knowledge, the comprehensive ability of emergency response, and the ability of team work of nurse in two groups were evaluated.Results After 6 months of standardized training, the scores of theoretical knowledge (87.13±7.50) and comprehensive ability of emergency response (95.57±4.19) of nurses in the experimental group were significantly higher than those in the control group (t=8.52, 7.81;P<0.01). The scores of different dimensions of team work ability were (6.58±2.11) of gregariousness, (5.16±2.65) of antorhythmicity, (4.73±2.18) of belongingness and (5.84±1.87) of valuable, which were significantly better than those in the control group (t=-3.36, -6.55, -5.89, -4.51;P<0.05).Conclusions The team-based learning combined with situational simulation model not only increases the knowledge level and comprehensive ability of emergency of nurses, but also improves the team work ability, which can enrich the forms and contents in psychiatric standardized training.

Objective To construct the risk model for healthcare-associated infection (HAI)with multidrug-re-sistant organisms(MDROs)in intensive care unit (ICU).Methods 836 patients who were admitted to ICU for more than 48 hours between October 2012 and September 2015 were analyzed retrospectively,logistic regression model of HAI was constructed,the model was conducted goodness of fit tests and the area under ROC curve analysis. Results Among 836 patients,incidence of HAI with MDROs was 14.23%(n=119).15 variables that were statis-tically significant in univariate analysis were included in logistic multivariate analysis,the results showed that the following variables entered into logistic regression equation:length of ICU stay (OR,2.493 [95%CI ,1 .816 -3.494]),underlying diseases (OR,1 .536 [95%CI ,1 .243 - 1 .898 ]),hypoproteinemia (OR,87.211 [95%CI , 36.165-210.304]),ventilator days (OR,1 .723 [95%CI ,1 .399-2.121 ]),fever(OR,20.639 [95%CI ,3.462 -123.043]),and primary pulmonary infection (OR,0.295 [95%CI ,0.133 -0.664]).Evaluation of model effect:sensitivity 95%,specificity 87.9%,the area under ROC curve 0.973.Conclusion Logistic regression model has a high goodness of fit in predicting HAI among ICU patients.

Objective To investigate the proliferation,apoptosis and cell cycle and possible mechanisms of different breast cell lines by difluoromethylorithine (DMFO).Methods The growth of breast cancer MDA-435 (ODC GG) cell lines and SK-br3 (ODC AA) cell lines treated with DFMO were observed.The apoptosis and cell cycle were detected by flow cytometry.PCR was applied to detect the changes of A and G alleles of ODC G316A in MCF-7 cells treated with DFMO.Results The growth inhibition rates of MDA-435 and SK-br3 cells treated with 10 mmol/L and 20 mmol/L DFMO after 48 h were 24.1％ and 33.6 ％,46.3 ％ and 53.5 ％,respectively,and there was statistical significance (t =2.134,P =0.021,t =2.213,P =0.019).The growth inhibition rates of MDA-435 and SK-br3 treated with 10 mmol/L and 20 mmol/L DFMO after 72 h were 28.9 ％ and 35.7 ％,54.3 ％ and 65.4 ％,respectively,and there was statistical significance (t =2.434,P =0.015,t =2.489,P =0.013).The apoptosis rates of MDA-435 (ODC GG) and SK-br3 (ODC AA) cells both dealt with 20 mmol/L of DFMO after 24 h,48 h and 72 h were (7.58± 2.06) ％ and (13.88±3.45) ％ (t =2.047,P =0.041),(43.28±14.28) ％ and (59.96±16.42) ％ (t =3.680,P =0.000),(77.87±30.25) ％ and (93.08±32.15) ％ (t =3.293,P =0.000 1),respectively.The proportions of S stage cells MDA-435 (ODC GG) and SK-br3 (ODC AA) cells under the same condition after 24 h,48 h and 72 h were (13.25±2.38) ％ and (12.89±2.21) ％ (P ＞ 0.05),(21.43±3.12) ％ and (12.24±3.55) ％ (t =2.638,P =0.012),(16.32±3.23) ％ and (15.24±3.01) ％ (P ＞ 0.05),respectively.After the treatment by DFMO,the expression of ODC G316A allele A in breast cancer cell line MCF-7 (ODC AG) was reduced (t =3.708,P =0.000),and the expression of G had no significant changes.Conclusion The proliferation inhibition and apoptosis in breast cancer cells treated by DFMO is different in breast cancer cells with different genetic type of ODC G316A.DFMO can inhibit the activity of ODC,and the mechanism may be that DFMO could selectively bind to ODC G316A allele A.

Objective To explore the influence of repeatedly PICC catheterized on catheter tip position. Methods We analyzed the catheter tip position of patients who located PICC in one level three class-A hospital in Beijing from May to October in 2014. A total of 381 effective medical records were collected and divided into having the history of catheterization group and having no history of catheterization group depending on patients whether catheterized before. The patients having the history catheterization were divided into ipsilateral catheter group(B1 group)and no ipsilateral catheter group(B0 group),the catheter tip position was compared. Results The best catheter tip position for patients having the history of catheterization was 30. 79% , which was lower than patients having no history group of 52. 66%(χ2 = 17. 565,P < 0. 01),and the patients of having catheterization history group had the incidence rate of shallow catheterization(47. 74% )higher than 35. 40% in the no catheterization history group(χ2 = 5. 817,P < 0. 05). The patients of having catheterization history group happened the incidence of catheter tip position acquired dystopia of venae subclavia higher than patients having no catheterization history group(P < 0. 05). The best catheter tip position had lower rate in the B1 group comparing with B0 group,but the patients acquired dystopia of venae subclavia in the B1 group was lower than the patients in the B0 group(P < 0. 05). Conclusions Multiple PICC catheterization reduces the accuracy of catheter tip position,and impacts the safety and reservation of PICC. We should minimize the non-planned extubation incidences. If patients require re-catheterizaiton,we should select the opposite limbs to catheterize without catheterizaiton contraindication to ensure the safe of PICC catheterization.

BACKGROUND: Cognitive function of simple leukoaraeosis (LA) and subcortical arterioselerotic encephalopathy (SAE) is a part of research in cerebrovascular neuropsychology, however, there is no contrast study on cognitive function between the two diseases. OBJECTIVE: To investigate the different features in cognitive function among patients with simple leukoaraeosis, subcortical arterioselerotic encephalopathy and simple leukoaraeosis combined with cerebral infarction. DESIGN: Randomized controlled observation SETTING: Department of Neurological Medicine, Qilu Hospital, ShandongUniversity. PARTICIPANTS: A total of 91 cases of patients with cerebrovasculardisease diagnosed in Department of Neurological Medicine of Qilu Hospital of Shandong University from March 1997 to May 2000 were selected. All the patients participated in the observation voluntarily. They were divided into 3 groups according to the type of disease, with 27 cases in simple leukoaraeosis group, 33 cases in subcortical arterioselerotic encephalopathygroup and 31 cases in simple leukoaraeosis + cerebral infarction group.Additionally, 30 healthy cases were selected as control group. All the subjects in the above groups participated in the observation voluntarily. METHODS: Assessment on cognitive function and memory ability was conducted on the subjects in each group, and contrast analysis was performed. Mini-mental state examination was used for detecting cognitive function. Patients whose score was less than 17, 20, 22, 23 respectively according to different educational degree (illiteracy, primary school, middle school, university), would be diagnosed as dementia. Clinical me mory scale A edited by Psychology Institute of Chinese Academy of Medical Sciences was used for detecting memory ability including associative learning, directive memory, recognition of nonsense figure, image free recall and portrait characteristics associative recall. Conversed the above 5 items of detecting results to scores of scales and calculated out the memory quotients. MAIN OUTCOME MEASURES: State of cognitive disorder and scoresof mini-mental state examination and clinical memory scale of subjects in each group. RESULTS: All the 91 cases of patients with cerebrovascular disease and 30 healthy control cases entered results analysis without any drop out. ① Comparison of the state of cognitive disorder among subjects in each group: There were 21 cases of mild cognitive disorder (77.8%) in simpleleukoaraeosis group, 8 cases of moderate cognitive disorder (24.2%) and 25 cases of dementia (75.8%) in subcortical arterioselerotic encephalopathy group, 6 cases of moderate cognitive disorder (19.4%) and 24 cases of dementia (77.4%) in simple leukoaraeosis + cerebral infarction group. ② Comparison of the scores of mini-mental state examination among and clinical memory scale: Scores of the two scales in simple leukoaraeosis group, subcortical arterioselerotic encephalopathy group and simple leukoaraeosis + cerebral infarction group were significantly lower than those in healthy control group (t=2.14-3.81, P ＜ 0.05-0.01). The scores in subcortical arterioselerotic encephalopathy group and simple leukoaraeosis+ cerebral infarction group were significantly lower than those in simple leukoaraeosis group (t=2.13-3.37, P ＜ 0.05-0.01).CONCLUSION: ① The cognitive impairment in simple leukoaraeosis is mainly mild cognitive disorder. ② The cognitive impairments in subcortical arterioselerotic encephalopathy and simple leukoaraeosis + cerebral infarction are mainly moderate cognitive disorder and dementia which are obviously severer than mild cognitive disorder. Cognitive function can be used as reference indicator for assessing simple leukoaraeosis and subcortical arterioselerotic encephalopathy.Liang LP, He Y, Guo HZ.A contrast between the cognitive function of patients with simple leukoaraeosis and subcortical arterioselerotic encephalopathy.