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Primary liver cancer is one of the common tumors in China， which seriously endangers human health. With the advancement in medical science and technology， some achievements have been made in the clinical treatment of liver cancer， but there is an urgent need to find a safe and effective solution for patients with advanced liver cancer. As a unique therapy in China， traditional Chinese medicine （TCM） has the characteristics of multiple targets and multiple pathways and plays a certain role in the treatment of malignancies. The present study aimed to clarify the mechanism of action of "dispelling pathogens" in the treatment of liver cancer through literature research. In TCM etiology and pathogenesis， deficient healthy Qi and exuberance of pathogenic Qi， such as phlegm， blood stasis， and toxins， lead to the development of liver cancer. The treatment should follow the principles of reinforcing healthy Qi and eliminating pathogens. It has been generally believed that tumor cell is the "pathogenic factor" and the immune function serves as the "healthy Qi". In the treatment of malignancies and the regulation of the immune function of patients， it is often advocated to reinforce healthy Qi to eliminate the accumulation. With the continuous updating of knowledge on tumors and tumor microenvironment， it is also recognized that there are "healthy Qi" and "pathogenic Qi" in the immune microenvironment of tumors. For example， the immune cells and immune factors that inhibit tumor growth can be classified as "healthy Qi" with TCM attributes， while those promoting tumor growth can be classified as "pathogenic Qi". Additionally， as proved by clinical data and experimental research， the elimination methods represented by "activating blood， resolving phlegm， and removing toxins" in the treatment of liver cancer can combat tumor cells and also regulate the "healthy Qi" and "pathogenic Qi" in the immune microenvironment of liver cancer to achieve the balance of Yin and Yang. Based on this， the present study reviewed from the TCM theory and the mechanisms of western medicine to provide theoretical support for the TCM treatment of malignancies by elimination methods and some ideas for TCM in tumor resistance.
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Background@#Subclinical hypothyroidism (SCH) is the most common thyroid dysfunction, and its relationship with blood pressure (BP) has been controversial. The aim of the study was to analyze the association between SCH and newly-diagnosed hypertension. @*Methods@#Based on data from the Thyroid disease, Iodine nutrition and Diabetes Epidemiology (TIDE) study, 49,433 euthyroid individuals and 7,719 SCH patients aged ≥18 years were enrolled. Patients with a history of hypertension or thyroid disease were excluded. SCH was determined by manufacturer reference range. Overall hypertension and stage 1 and 2 hypertension were diagnosed according to the guidelines issued by the American College of Cardiology/American Heart Association in 2017. @*Results@#The prevalence of overall hypertension (48.7%), including stage 1 (28.9%) and 2 (19.8%) hypertension, increased significantly in SCH patients compared with euthyroid subjects. With elevated serum thyroid stimulating hormone (TSH) level, the hypertension prevalence also increased significantly from the euthyroid to different SCH subgroups, which was more profound in females or subjects aged <65 years. The age- and sex-specific regression analysis further demonstrated the same trends in the general population and in the 1:1 propensity matched population. Similarly, several BP components (i.e., systolic, diastolic, and mean arterial BP) were positively associated with TSH elevation, and regression analysis also confirmed that all BP components were closely related with SCH in female subjects aged <65 years. @*Conclusion@#The prevalence of hypertension increases for patients with SCH. SCH tends to be associated with hypertension and BP components in females younger than 65 years.
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ObjectiveTo systematically evaluate the difference in recurrence-free survival rate, hepatocellular carcinoma (HCC) recurrence rate, all-cause mortality rate, and liver-related mortality rate between hepatitis C-related HCC patients receiving oral direct-acting antiviral (DAA) and those receiving non-DAA (NDAA) treatment regimen. MethodsCNKI, Wanfang Data, VIP, CBM, PubMed, Embase, and Cochrane Library were searched for Cohort studies of DAA in the treatment of hepatitis C-related HCC patients published before December 2020, and quality assessment and meta-analysis were performed. ResultsA total of 10 cohort studies were included in this study, with 3108 patients in total. The meta-analysis showed that compared with NDAA regimen, DAA treatment significantly increased recurrence-free survival rate (risk ratio ［RR］=1.38, 95% confidence interval ［CI］: 1.10-1.72, P=0.005) and significantly reduced HCC recurrence rate (RR=0.52, 95%CI: 0.42-0.63, P＜0.000 01), all-cause mortality rate (RR=0.42, 95%CI: 0.32-0.55, P＜0.000 01), and liver-related mortality rate (RR=0.37, 95%CI: 0.18-0.76, P=0.007) in hepatitis C-related HCC patients. ConclusionDAA treatment is beneficial and safe for hepatitis C-related HCC patients.
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Objective:To analyze the incidence, biochemical and molecular characteristics, and gene mutation spectrum of neonatal methylmalonic acidemia (MMA) in Shaanxi province.Methods:This study involved 146 152 newborns undergoing neonatal screening for methylmalonic acidemia by tandem mass spectrometry in Northwest Women's and Children's Hospital from January 2014 and December 2019. Clinical manifestations and follow-up data of newborns diagnosed with MMA and their acylcarnitine profiles and gene mutations were analyzed. According to whether they had elevated homocysteine or not, these patients were divided into two groups, the complicated group and the isolated MMA group. The control neonates were those excluded from having methylmalonic acid by re-examination. Kruskal-Wallis and Mann-Whitney U test was conducted for statistical analysis. Results:(1) Twenty-one cases of MMA were confirmed with an incidence of 1/6 960, including 11 cases (52.4%) of isolated MMA (isolated MMA group) and 10 (47.6%) complicated by elevated homocysteine (complicated group). Eight patients in the isolated group had symptoms within one month after birth, mainly feeding difficulties, vomiting, drowsiness, poor response and infection, and five died. Patients in the complicated group were all diagnosed before developing typical clinical symptoms, and no developmental abnormalities were reported during follow-up. (2) Blood propionyl carnitine and its ratios to acetylcarnitine and free carnitine in the isolated MMA and complicated groups were higher than those in the control group [ M (min-max), 9.26 (3.70-37.78) μmol/L and 7.27 μmol/L (3.58-13.62 μmol/L) vs 4.51 μmol/L (1.48-8.69 μmol/L), H=23.239; 1.12 (0.32-2.43) and 0.74 (0.36-1.90) vs 0.25 (0.09-0.45), H=47.061; 0.94 (0.12-1.92) and 0.56 (0.18-1.03) vs 0.17 (0.06-0.38), H=36.868; all P<0.001]. The blood methionine level in the complicated group was significantly lower than that in the isolated MMA group [7.64 μmol/L (3.40-19.25 μmol/L) vs 24.22 μmol/L (10.73-56.55 μmol/L), U=3.000, P<0.001]. (3) All 21 patients carried complex heterozygous mutations or homozygous mutations in pathogenic genes, including 15 distinct MMUT mutations and 13 distinct MMACHC mutations. In the isolated MMA group, the most common mutation was c.323G>A (p.Arg108His) in the MMUT gene with a positive rate of 13.6%, and an unreported mutation, c.1676+11A>G, with unidentified clinical significance, was also found. The most common mutations in the complicated group were c.609G>A (p.Trp203Ter) and c.567dupT (p.Ile190fs) in the MMACHC gene, and the positive rates were both 20.0%. Moreover, two unreported variants, c.430-2A>C and c.648_650delAGA (p.216_217delSEinsS), were detected and suspected to be pathogenic. Conclusions:MMA is not uncommon in Shaanxi province. Children with isolated MMA tend to be more severe clinically. The identification of hotspot mutations, including c.609G>A (p.Trp203Ter) and c.567dupT (p.Ile190fs) in MMACHC gene and c.323G>A (p.Arg108His) in MMUT gene, provides a foundation for further genetic screening, counseling, and prenatal diagnosis, and is conducive to reduce the mortality and disability rate of neonatal MMA.
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Objective:To compare the therapeutic effect of drum room injection and intramuscular injection of rat nerve growth factor on occupational noise-induced deafness (ONID).Methods:Sixty-six patients with ONID treatment from January 2018 to December 2019 in the People′s Hospital of Liaoning Province were divided into control group and study group by random number table, with 33 patients in each group. On the basis of conventional treatment, all patients in the study group were injected with 20 μg rat nerve growth factor in the drum room, and each ear was injected once every other day. The control group was given intramuscular injection of rat nerve growth factor 20 μg per day, and the patients in two groups were treatment for 28 d. The hearing threshold of left and right whisper frequency of the two groups were compared. The improvement of tinnitus, dizziness, headache, insomnia, other symptoms and the scores of Hamilton Depression Scale (HAMD) was compared between the two groups.Results:Before treatment, the hearing thresholds of left whisper frequency and right whisper frequency in two groups had no significant differences ( P>0.05). After treatment, the hearing thresholds of left whisper frequency and right whisper frequency in the study group were significantly lower than those in the control group: (23.8 ± 4.2) dB/HL vs. (34.5 ± 3.9) dB/HL, (23.2 ± 4.4) dB/HL vs. (35.9 ± 5.1) dB/HL, and there were statistical differences ( P<0.05). After treatment, tinnitus and dizziness symptom improvement rate in the study group were higher than those in the control group: 93.3% (28/30) vs. 72.4% (21/29), 15/17 vs. 8/16, and there were statistically significant differences ( χ2 = 4.584 and 5.705, P<0.05). There was no statistically significant difference in the improvement rate of headache and insomnia symptoms between 2 groups ( P>0.05). The total effective rate in the treatment group was significantly higher than that in the control group: 90.9% (30/33) vs. 69.7% (23/33), and there was statistical difference ( χ2 = 4.694, P<0.05). After treatment, the scores of HAMD of 2 groups were significantly decreased, and the scores of HAMD in the study group was lower than that in control group: (8.46 ± 3.13) scores vs. (10.55 ± 3.83) scores, and there was statistical difference ( P<0.05). The incidence of total adverse reactions between 2 groups had no significant difference ( P>0.05). Conclusions:The injection of mouse nerve growth factor into drum room to treat ONID can effectively improve the hearing level of patients, alleviate tinnitus and dizziness symptoms and improve adverse mood without obvious adverse reactions.
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Background@#Subclinical hypothyroidism (SCH) is the most common thyroid dysfunction, and its relationship with blood pressure (BP) has been controversial. The aim of the study was to analyze the association between SCH and newly-diagnosed hypertension. @*Methods@#Based on data from the Thyroid disease, Iodine nutrition and Diabetes Epidemiology (TIDE) study, 49,433 euthyroid individuals and 7,719 SCH patients aged ≥18 years were enrolled. Patients with a history of hypertension or thyroid disease were excluded. SCH was determined by manufacturer reference range. Overall hypertension and stage 1 and 2 hypertension were diagnosed according to the guidelines issued by the American College of Cardiology/American Heart Association in 2017. @*Results@#The prevalence of overall hypertension (48.7%), including stage 1 (28.9%) and 2 (19.8%) hypertension, increased significantly in SCH patients compared with euthyroid subjects. With elevated serum thyroid stimulating hormone (TSH) level, the hypertension prevalence also increased significantly from the euthyroid to different SCH subgroups, which was more profound in females or subjects aged <65 years. The age- and sex-specific regression analysis further demonstrated the same trends in the general population and in the 1:1 propensity matched population. Similarly, several BP components (i.e., systolic, diastolic, and mean arterial BP) were positively associated with TSH elevation, and regression analysis also confirmed that all BP components were closely related with SCH in female subjects aged <65 years. @*Conclusion@#The prevalence of hypertension increases for patients with SCH. SCH tends to be associated with hypertension and BP components in females younger than 65 years.
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Objective To investigate the distribution of urinary iodine level and its relationship with thyroid function in Tibetan adults in Lhasa. Methods Tibetan residents living in Lhasa and its surrounding countryside were recruited by the method of multistage randomized cluster sampling. Their salt iodine, drinking water iodine, urinary iodine, and thyroid function levels were detected. According to the urinary iodine level, these subjects were divided into the iodine deficiency group ( urinary iodine<100μg/L) , the iodine enough group ( urine iodine 100-199μg/L) , the iodine adequate group ( urine iodine 200-299 μg/L ) and the iodine excessive group ( urine iodine≥300μg/L) . The differences in thyroid function among various groups were compared. Results A total of 2235 subjects were included in the study. The overall level of urinary iodine was in skewed distribution, with a median ( upper and lower quartiles) of 154 (99, 229) μg/L. The proportion of subjects with insufficient iodine intake was 25.7％, while those of the enough, adequate, and excessive groups were 41. 5％, 21. 3％, and 11. 5％, respectively. There was no significant difference in urine iodine level between males and females [152(95,219)μg/L vs 155(100,232)μg/L P>0.05]. The urinary iodine levels in residents of urban were higher than those in rural residents [157(101,232)μg/L vs 140(92,200)μg/L, P<0.05]. The urinary iodine levels in the young, middle-aged, and elderly groups were 175 ( 116,256) , 136 ( 91, 200) , and 116 ( 68, 164)μg/L respectively, showing a gradual decrease in urine iodine level with aging (P<0.05). The average salt iodine content of Tibetan adults in Lhasa was 23.16 mg/kg, and that in drinking water was 4.33μg/L. There were no significant differences in TSH levels among various iodine intake groups ( P>0.05) . The levels of thyroid peroxidase antibody ( TPOAb) and thyroglobulin antibody ( TGAb) were gradually decreased with the increase of urinary iodine level (P<0.05). Conclusion More than 50％ of Tibetans are at the status of low iodine and high iodine intakes in Lhasa. Although the salt iodine content meets national standards, the drinking water iodine content is lower than that standard.
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Objective To register the inpatients with stroke in Lasa plateau region,understand the clinical characteristics,risk factors and prognosis of patients with stroke in plateau region,and provide reference for prevention and treatment of stroke in plateau region.Methods Hospital-based stroke registration database was established,follow-up visits were paid to registered patients with stroke;the general sociological characteristics,clinical features,diagnosis and treatment situations of patients were collected and analyzed.Results Continuous registration in 464 patients with stroke in Tibet Autonomous Region People' s Hospital was made from July 1,2007 to March 30,2013,including 332 Tibetan patients and 132 Han patients,whose average age was (57.45 ± 16.14) years;326 male patients,138 female patients.Sixty-eight patients' age of onset was smaller than 40 years (14.22％).Among stroke subtypes,cerebral infarction was the most frequent syndrome (322 patients (69.40％)),followed by brain hemorrhage (129 patients (27.80％)),subarachnoid hemorrhage (13 patients (2.80％)).The difference between the male to female ratio of Tibetan patients (213:119) and Han patients(113:19) was statistically significant (x2 =20.795,P ＜0.001).The 4.5 h clinic visit rate of patients with stroke was 18.53％ (86/464),the 4.5 h clinic visit rate of patients with cerebral infarction was 13.35％ (43/322),including 1 patient who took intravenous thrombolytic therapy,accounting for 0.31％ of patients with cerebral infarction.The analysis indicated that the major risk factors of this group of patients with stroke were high blood pressure (249 patients (53.66％)),heart disease (102 patients (21.98％)),diabetes (67 patients (14.43％)) and chronic high altitude polycythemia (65 patients (14.00％)).Conclusions The patients with stroke in plateau regions tend to be younger,the clinic visit rate within 4.5 h is low,and the application of intravenous thrombolysis in patients with cerebral infarction is low.Chronic high altitude polycythemia becomes the special risk factor in plateau region.
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Objective To provide the effective references for reasonable arrangement of nursing post by comparison on the core competence level and characteristics between the upgraded and the fulltime bachelor nurses.Methods Questionnaire survey based on the basic demographic data and the Competency Inventory for Chinese Registered Nurse for 391 clinical nurses from 13 three level of firstclass hospitals.Results The core competence score of the upgraded and the full-time bachelor nurses showed a moderate degree of satisfaction; the full-time bachelor nurses' total scores were higher than those of the upgraded nurses,and there were statistically significant differences among 6 dimensions included critical thinking and scientific research ability; there was no significant difference in clinical nursing dimension.Conclusions The full-time bachelor nurses' core competence is higher than that of the upgraded nurses in general,but no significant difference exists in clinical nursing dimension.
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Objective To analyze perioperative management and risk factors for the prognosis of hip fracture surgery in elderly patients.Methods The present study included 112 elderly patients (aged ≥65 years) who received hip fracture surgery from January 2009 to January 2013 in our department,and their clinical data were retrospectively analyzed.Results The percentage of cases with concomitant diseases before operation was 91.0 ％,and the postoperative complications rates were 35.7％.One-year mortality after operation was 21.4％.The percentage of survival cases with daily living activities fully restored to pre injury status was 47.6％.Logistic regression analysis revealed that independent risk factors for the one-year mortality included general health before injury (OR=13.36,P =0.047),pulmonary disease (OR =18.33,P =0.007),number of postoperative complications (OR=15.14,P=0.025),and renal failure (OR=11.26,P=0.034).Conclusions Elderly hip fracture patients have many different concomitant diseases.By applying the qualified levels of perioperative management,anesthetic and operative methods,and postoperative rehabilitation measures according to the conditions of the patient,the incidence of perioperative complications and one year mortality can be decreased,and qualified surgical outcomes can be obtained.The independent risk factors for the one-year mortality include general health before injury,pulmonary disease,number of postoperative complications and renal failure.
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OBJECTIVE@#To explore the expression and significance of survivin and proliferating cell nuclear antigen (PCNA) on the occurrence, proliferation, recurrence and carcinogenesis of the sinonasal inverted papilloma (SNIP).@*METHOD@#Immunohistochemical method was used to detect the expression of survivin and PCNA in 10 cases of nasal cavity mucosal (NM), 45 cases of SNIP and 9 cases of canceration SNIP.@*RESULT@#The positive expression of survivin and PCNA increased gradually in NM,SNIP and canceration PCNA group, and there were significant difference between the three groups. But there was no correlation between survivin and PCNA in the tissue of SNIP (r = 0.135, P > 0.05).@*CONCLUSION@#Survivin and PCNA are involved in the growth and carcinogenesis of SNIP.
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Humans , Inhibitor of Apoptosis Proteins , Metabolism , Nose Neoplasms , Metabolism , Pathology , Papilloma, Inverted , Metabolism , Pathology , Paranasal Sinus Neoplasms , Metabolism , Pathology , Proliferating Cell Nuclear Antigen , Metabolism , Repressor Proteins , Metabolism , SurvivinABSTRACT
OBJECTIVE@#To explore the expression of Smac(second mitochondria-derived activator of caspase)and survivin on the growth, development, recurrence and carcinogenesis of the sinonasal inverted papilloma(NIP).@*METHOD@#Immunohistochemical method was used to detective the expression of Smac and survivin in 10 cases of (nasal cavity mucosae, NM), 45 cases of NIP. The NIP group including 25 cases of NIP without dysplasia, 11 cases of NIP with dysplasia, and 9 cases of NIP with malignant transformation to squamous cell carcinoma(SCC).@*RESULT@#The intensity of the positive expression of Smac in NIP was lower than NM, the intensity of the positive expression decreased with the decreasing degree of histological differentiation. There was significantly difference between NIP without dysplasia and SCC. The expression of survivin was negative in the control group, the expression intensity of NIP was enhanced. The degree of histological differentiation was lower, the intensity of the positive expression was higher. The expression between NIP without dysplasia and SCC had significantly differences. Smac negatively correlated with survivin(rs = -0.403, P<0.01).@*CONCLUSION@#Smac and survivin were associated with the growth and carcinogenesis of NIP.
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Adult , Aged , Female , Humans , Male , Middle Aged , Inhibitor of Apoptosis Proteins , Metabolism , Intracellular Signaling Peptides and Proteins , Metabolism , Mitochondrial Proteins , Metabolism , Nasal Mucosa , Metabolism , Pathology , Nose Neoplasms , Metabolism , Pathology , Papilloma, Inverted , Metabolism , Pathology , SurvivinABSTRACT
OBJECTIVE@#To investigate the diagnosis of frontal, ethmoid sinus cyst with eye symptoms as initial amount,and the curative effect of nasal endoscopic operation.@*METHOD@#To retrospectively analyze clinical data of sixteen patients with frontal, ethmoid sinus cyst from February 2006 to March 2008.@*RESULT@#Diagnostic accordance rate of paranasal sinus MRI and CT examination In 16 patients is 100%. Fourteen patients' ocular symptoms disappeared after nasal endoscope operation treatment, two of them improved. None of them recurrened after the fol low-up 3-6 years up to now, all the patients had satisfactory curative effect.@*CONCLUSION@#Paranasal sinuses and or bital cavity have close relationship , patients with sinus lesions always firstly visit Ophthalmology doctor. The results of MRI and CT examination are of great value for diagnosis. Patients with frontal, ethmoid sinus cyst with eye symptoms as initial amount should be early diagnosed. The treatment of nasal endoscope operation is safe, effective and is worth of firstly chosen.
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Female , Humans , Male , Cysts , Diagnosis , General Surgery , Endoscopy , Methods , Ethmoid Bone , Ethmoid Sinus , Frontal Sinus , Magnetic Resonance Imaging , Nasal Surgical Procedures , Paranasal Sinus Diseases , Diagnosis , General Surgery , Retrospective StudiesABSTRACT
OBJECTIVE@#To explore the expression and significance of second mitochondria derived activator of caspase (Smac), X-linked inhibitor of apoptosis protein (XIAP)and cysteine containing aspartate specific protease 3 (caspase-3) in the growth, development and carcinogenesis of the nonnasal inverted papilloma (NIP).@*METHOD@#Immunohistochemical method was used to detect the expression of Smac, XIAP, caspase-3 in 10 cases of nasal cavity mucosae (NM) and 45 cases of NIP, the group of NIP including 25 cases of NIP without dysplasia, 11 cases of NIP with dysplasia, and 9 cases of NIP with malignant transformation to squamous cell carcinoma (SCC).@*RESULT@#The intensity of the positive expression of Smac, Caspase-3 in NIP were lower than NM, the intensity of the positive expression decreased with the decreasing degree of histological differentiation. There was a significant difference between NIP without dysplasia and SCC. It was presented with a progressive tendency for the expression of XIAP in the group of NM and NIP. The lower degree of histological differentiation, the higher intensity of the positive expression. The expression between NIP without dysplasia and SCC had a significant difference. Smac negatively correlated with XIAP (r(s) = -0.323, P < 0.05), XIAP negatively correlated with caspase-3 (r(s) = -0.408, P < 0.01), Smac positively correlated with caspase 3 (r(s) = 0.424, P < 0.01).@*CONCLUSION@#Smac, XIAP, caspase 3 might be associated with the growth and carcinogenesis of NIP.
Subject(s)
Adult , Aged , Female , Humans , Male , Middle Aged , Caspase 3 , Metabolism , Intracellular Signaling Peptides and Proteins , Metabolism , Mitochondrial Proteins , Metabolism , Nose Neoplasms , Metabolism , Pathology , Papilloma, Inverted , Metabolism , Pathology , X-Linked Inhibitor of Apoptosis Protein , MetabolismABSTRACT
Objective To explore the operative cooperation and nursing points of holmium laser lithotripsy under percutaneous nephroscope. Methods A retrospective study was carried out to investi-gate the operative cooperation and nursing of 38 patients receiving holmium laser lithotripsy under percuta-neous nephroscope in our hospital from March 2006 to August 2007. Results Stones were completely cleared in 31 patients at first holmium laser lithotripsy,in 5 patients at second holmium laser lithotripsy,in 2 patients at third holmium laser lithotripsy. One patient complicated with water intoxication and septicemia. Operation time ranged from 50 to 190 minutes,blood loss volume reached 50 to 200 ml with a average of 100 ml.No blood transfusion was needed during the operations and no secondary hemorrhage was seen postoperation. Double J catheter was inserted and indwelled for 30 to 60 days with a average of 38 days. Postoperative follow-up was satisfying. Conclusions Holmium laser lithotripsy under pereutaneous nephroscope possesses the advantages of little trauma,hemorrhage and complication and quick recovery.It is the best choice for treatment of calculus in urinary system.
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OBJECTIVE To explore the predisposing factors of pharyngo-cutaneous fistulas after surgical treatment of laryngeal cancer. METHODS A retrospective study of 757 patients who underwent laryngectomy during a 10-year period was carried out. RESULTS The occurrence rate of post-laryngectomy pharyngo-cutaneous fistula was 4.2 %. Single-factor analysis showed that parameters related to the occurrence rate of post-laryngectomy pharyngo-cutaneous fistula included clinical stage of tumor, appearance of post-operative infection, undergoing of pre-operative radiotherapy, and pre-operative nutrition states. CONCLUSION Pharyngo-cutaneous fistulas appears more frequently in patients with T3 and T4 tumor and who underwent pre-operative radiotherapy. Skillful operative technique and effective prevention of post-operative infection may contribute toward reducing the incidence of pharyngo-cutaneous fistulas after surgical treatment of laryngeal cancer.
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Objective To investigate the distribution of the mini mental status examination in the elderly Methods Totally 3 776 residents aged 55 years or over serving as samples in the urban and rural areas of Lhasa city, from August to December in 2001 were studied A residential area and a door to door general sampling procedures were used in this study, respectively Mini mental status examination (MMSE) and a activity of daily living scale (ADL) were used as screening methods for dementia Results The distribution of lower scores in such examination in middle elderly people, in Lhasa city was 7 2%, in which, males were 9 3% and femals, 6 3% Conclusion The results of lower scores in the mini mental status examination were similar to those reporting from inland cities, but there appear some what differences in distributions of ages, educational levels and sexes from Tibetan, which may be due to their special location and living habits