Altered neurovascular coupling in arteriosclerotic cerebral small vessel disease and the correlation with cognitive function / 中华神经科杂志

Objective:To investigate the global and local changes of neurovascular coupling in arteriosclerotic cerebral small vessel disease (aCSVD) and the correlation with cognitive function.Methods:Forty-three patients with confirmed aCSVD from the outpatient department or ward of the Department of Neurology, the First Affiliated Hospital of Anhui Medical University between June 2020 and June 2021 were enrolled in this study. Meanwhile, 48 healthy subjects were selected as controls. Cognitive evaluation, resting-state functional magnetic resonance imaging and 3D pseudo-continuous arterial spin labeling magnetic resonance imaging scanning were performed in all subjects. The global cerebral blood flow-regional homogeneity (ReHo) correlation coefficient and the cerebral blood flow/ReHo ratio were used to evaluate global and local neurovascular coupling. Meanwhile, correlations between the cerebral blood flow/ReHo ratio and neuropsychological assessments were explored in aCSVD patients.Results:Global cerebral blood flow-ReHo coupling was decreased in aCSVD patients compared to healthy controls [aCSVD patients: 0.942(0.933, 0.950), healthy controls: 0.947(0.939, 0.954), Z=-2.11, P=0.035]. aCSVD patients showed decreased cerebral blood flow/ReHo ratio in the right lingual gyrus ( t=-4.45, P<0.05) and increased cerebral blood flow/ReHo ratio in the left ( t=4.91, P<0.05) and right ( t=4.72, P<0.05) inferior parietal lobule. Cerebral blood flow/ReHo ratio of the right inferior parietal lobule was negatively correlated with total score ( r=-0.33, P=0.031) and praxis score ( r=-0.43, P=0.004) in Cambridge Cognitive Examination-Chinese Version subitems and positively correlated with scores of Stroop Color Word Test (SCWT)-color ( r=0.33, P=0.032), SCWT-word ( r=0.34, P=0.025) and Trail Making Test-B ( r=0.31, P=0.043) in aCSVD patients. While the cerebral blood flow/ReHo ratio of the right lingual gyrus was negatively correlated with Visual Replicate-Immediate Recall score ( r=-0.36, P=0.017). Conclusion:aCSVD patients showed abnormal global and local neurovascular coupling, which was associated with attention, executive function, and visual space function.

The grey matter volume and fractional amplitude of low-frequency fluctuation alterations in cerebral small vessel disease patients with subcortical ischemic depression and their relationship with brain derived neurotrophic factor gene polymorphism / 中华神经科杂志

Objective:To investigate the relationship between brain derived neurotrophic factor (BDNF) gene polymorphism and the change of grey matter volume (GMV) and fractional amplitude of low-frequency fluctuation (fALFF) in cerebral small vessel disease (CSVD) patients with subcortical ischemic depression (SID).Methods:Eighty-seven CSVD patients in the First Affiliated Hospital of Anhui Medical University were enrolled from July 2017 to November 2020 and divided into CSVD-SID group [Geriatric Depression Scale (GDS) score>10] and CSVD-non - depression group (CSVD-ND group, GDS score≤10) according to GDS. Both GMV and fALFF were calculated based on structural and functional magnetic resonance imaging data, and the interactions between SID diagnosis and BDNF gene on brain function and structure alteration were explored.Results:GMV was significantly increased in the posterior default network (pDMN; such as posterior cingulate gyrus/precuneus and middle temporal gyrus) in the CSVD-SID group compared with the CSVD-ND group. On GMV property, significant interactions between BDNF gene and SID were found in the cuneus ( F=25.50, P<0.001), precuneus lobe ( F=13.61, P<0.001) and cerebellum ( F=17.23, P<0.001). In the aspect of fALFF, the brain functional activity in the superior frontal gyrus was significantly increased in the CSVD-SID group compared with that in the CSVD-ND group (0.363±0.648 vs -0.427±0.514,cluster size=48 voxels, t=5.63, P<0.001). But there was no significant interaction between diagnosis and BDNF genotype on brain function. Conclusions:Both the GMV and fALFF were increased in CSVD-SID, mainly located in the pDMN and frontal lobe. Significant interaction was found between CSVD-SID and BDNF genotype on GMV.

The correlation among altering gray matter volume, cognition and gait disorder in patients with amnestic mild cognitive impairment / 中华神经科杂志

Objective:To investigate the impact of altering brain gray matter volume (GMV) on cognition and gait disorder in patients with amnestic mild cognitive impairment (aMCI).Methods:Thirty-six patients with aMCI, who admitted to the First Affiliated Hospital of Anhui Medical University from July 2018 to August 2020, were collected, and 33 normal controls (NC) matched with age, sex and education level were included in the same period. The neuropsychological assessment was done in all the subjects using Mini-Mental State Examination (MMSE), Montreal Cognitive Assessment scale (MoCA), Cambridge Cognitive Examination-Chinese version (CAMCOG-C), Geriatric Depression Scale (GDS) and Activities of Daily Living scale (ADL). The timed up and go test (TUG), dual task of timed up and go test (D-TUG) and Berg Balance Scale (BBS) were used in the subjects for assessment. The parameters such as stride length, gait speed, gait frequency were collected by intelligent device for energy expenditure and activity. All the subjects received 3.0 T magnetic resonance imaging scan to obtain high-resolution T 1 structural images. Voxel-based morphometry (VBM) was used to compare the difference of GMV between aMCI patients and NC. Partial correlation analysis was performed among altering GMV in the regions of interest (ROI), cognitive score and gait parameters, respectively. Linear regression analysis was used between whole brain GMV and gait parameters. Results:The scores of MMSE, MoCA, CAMCOG-C and the subitems of CAMCOG-C in aMCI group were significantly lower than those in NC group ( P<0.05). In aMCI patients, both the test time of TUG and D-TUG increased, gait speed slowed down, stride length shortened, and stride frequency and BBS score decreased ( P<0.05).VBM analysis showed that the whole brain GMV in aMCI patients was obviously lower than that of NC. In the aMCI group, GMV in ROI1 (right hippocampus, right parahippocampal gyrus, right amygdala and right fusiform gyrus), ROI2 (right middle temporal gyrus), ROI3 (right angular gyrus), ROI4 (right occipital lobe), ROI5 (bilateral orbital frontal lobe), ROI6 (left middle frontal gyrus and rectus gyrus), ROI7 (left fusiform gyrus and left parahippocampal gyrus) was significantly decreased compared with the NC group [Gaussian random field (GRF) correction, two-tailed test, voxel level P<0.001, cluster level P<0.05). In the aMCI group, GMV in ROI1 was positively correlated with orientation ( r=0.437, P=0.012), memory ( r=0.360, P=0.043), execution ( r=0.414, P=0.019), and negatively correlated with ADL score ( r=-0.529, P=0.002). GMV in ROI2 was negatively correlated with ADL score ( r=-0.400, P=0.023). GMV in ROI4 and in ROI5 was positively correlated with the calculation ( r=0.370, P=0.037) and execution ( r=0.360, P=0.043), respectively. GMV in ROI6 was positively correlated with MMSE score ( r=0.357, P=0.045), CAMCOG-C total score ( r=0.503, P=0.003) and calculation ( r=0.395, P=0.025), and negatively correlated with ADL score ( r=-0.387, P=0.028). GMV in ROI5 was positively correlated with gait speed ( r=0.391, P=0.027). In the aMCI group, CAMCOG-C total score was negatively correlated with D-TUG results ( r=-0.387, P=0.035), executive function was negatively correlated with TUG results ( r=-0.450, P=0.013) and D-TUG results ( r=-0.553, P=0.002), and positively correlated with gait speed ( r=0.379, P=0.039). Attention was positively correlated with gait speed ( r=0.590, P=0.001), and computing was positively correlated with gait speed ( r=0.371, P=0.044). The linear regression of whole brain GMV and gait parameters showed negative correlation between the GMV of left occipital lobe and TUG results in the aMCI group. The GMV of bilateral prefrontal cortex, right occipital lobe and surrounding cortex was positively correlated with gait speed (GRF correction, two-tailed test, voxel level P<0.001, cluster level P<0.05). Conclusions:Patients with aMCI presented with gray matter atrophy, cognition impairment, and gait disorders. The cognition impairment was closely related to the atrophy of medial temporal lobe. Gait disorders were not only associated with cognition impairment but also with gray matter volume in the prefrontal lobe, occipital lobe and its surrounding cortex, and anterior central gyrus.

Changes in gray matter volume and their correlation with cognitive impairment in patients with subcortical vascular cognitive impairment / 中华神经科杂志

Objective:To analyze the changes of total gray matter volume in patients with subcortical vascular cognitive impairment (SVCI) and their correlation with cognitive impairment.Methods:Data of fifty patients with subcortical ischemic vascular disease (SIVD) who admitted to the outpatient department or ward of the Department of Neurology, the First Affiliated Hospital of Anhui Medical University from November 2017 to March 2019, were collected for the study, including 23 patients with SVCI and 27 patients with subcortical ischemic vascular disease without cognitive impairment (SIVD-NCI). All subjects were assessed using the Minimal Mental State Examination (MMSE), the Montreal Cognitive Assessment scale (MoCA), the Cambridge Cognitive Assessment scale for the elderly-Chinese version (CAMCOG-C), the Stroop test, the Geriatric Depression Scale, and the Activity of Daily Living scale (ADL). All subjects underwent 3.0 T magnetic resonance imaging scans to obtain T 1WI, T 2WI, fluid attenuated inversion recovery (FLAIR) images and 3D-T 1 structural image data. Voxel-based morphometry (VBM) was used to analyze and compare the differences in gray matter volume between SVCI group and SIVD-NCI group. Results:Compared with the SIVD-NCI group, the MMSE score (22.00 (20.00, 24.00) vs 28.00 (27.00, 29.00), Z=-6.073, P<0.001), MoCA score (15.00 (13.00,19.00) vs 24.00 (23.00, 26.00), Z=-5.233, P<0.001), total score of CAMCOG-C (67.65±13.35 vs 88.41±10.98, t=-6.032, P<0.001) and the directional (8.00 (5.00, 9.00) vs 10.00 (9.00, 10.00), Z=-4.133, P<0.001), language (24.00 (21.00, 26.00) vs 27.00 (24.00, 28.00), Z=-3.171, P=0.002), memory (11.00 (9.00, 15.00) vs 19.00 (17.00, 21.00), Z=-4.648, P<0.001), attention (4.00 (2.00, 6.00) vs 7.00 (6.00, 7.00), Z=-3.929, P<0.001), executive (8.00 (6.00, 10.00) vs 11.00 (9.00, 12.00), Z=-3.696, P<0.001), calculation (2.00 (2.00, 2.00) vs 2.00 (2.00, 2.00), Z=-2.528, P=0.011), thinking (6.00 (3.00, 6.00) vs 6.00 (6.00, 8.00), Z=-4.029, P<0.001), perception (6.00 (6.00, 7.00) vs 8.00 (7.00, 9.00), Z=-4.221, P<0.001) in the SVCI group were obviously decreased. ADL score (21.00 (20.00, 26.00) vs 20.00 (20.00, 20.00), Z=-2.634, P=0.008) and Stroop test score (28.61±4.53 vs 20.04±6.07, t=5.704, P<0.001) were significantly higher in the SVCI group than in the SIVD-NCI group. The total gray matter volume ((556.86±49.19) mm 3vs (618.13±51.73) mm 3, t=-3.572, P=0.001) and white matter volume ((479.35±48.17) mm 3vs (507.22±43.84) mm 3, t=-2.141, P=0.037) in the SVCI group were smaller than that in the SIVD-NCI group. VBM analysis showed that the SVCI group had significantly smaller gray matter volume in the left inferior temporal gyrus ( t=5.17, P<0.001, family wise error (FWE) correction), right middle temporal gyrus ( t=4.99, P<0.001, FWE correction), right orbital superior frontal gyrus ( t=5.02, P<0.001, FWE correction), left middle occipital gyrus ( t=5.67, P<0.001, FWE correction), right middle occipital gyrus ( t=5.77, P<0.001, FWE correction). MoCA score was positively correlated with the volume of gray matter in the left inferior temporal gyrus of patients with SIVD ( r=0.292, P<0.05), language function score was positively correlated with the volume of gray matter in the left inferior temporal gyrus ( r=0.322, P<0.05), and Stroop test score was negatively correlated with gray matter volume in the left inferior temporal gyrus ( r=-0.329, P<0.05). Conclusion:Gray matter atrophy exists in multiple brain regions in patients with SVCI, and these atrophic brain regions are associated with cognitive impairment of SIVD.

Correlation between metabolic syndrome and cerebral artery stenosis in patients with subcortical ischemic vascular disease / 国际脑血管病杂志

Objective@#To investigate the effects of metabolic syndrome (MetS) and each component on cerebral artery stenosis in patients with subcortical ischemic vascular disease (SIVD).@*Methods@#From June 2017 to May 2019, patients with SIVD admitted to the Departments of Neurology, the First and Forth Affiliated Hospitals of Anhui Medical University were enrolled retrospectively. MetS was diagnosied using NCEP-ATP III criteria. The North American Symptomatic Carotid Endarterectomy Trial criteria were used to evaluate the degree of cerebral artery stenosis. Multivariate logistic regression analysis was used to determine the independent correlation between MetS and cerebral artery stenosis.@*Results@#A total of 460 patients with SIVD were enrolled, including 289 males (62.8%), 171 females (37.2%), and age 72.7±4.787 years; 278 (60.4%) in the MetS group, 182 (39.6%) in the non-MetS group; and 279 (60.7%) in the cerebral artery stenosis group, 181 (39.3%) in the non-stenotic group. The proportion of patients with cerebral artery stenosis in the MetS group was significantly higher than that in the non-MetS group (84.2% vs. 24.7%; χ2=162.876, P<0.001). Among them, the proportions of patients with middle cerebral artery, internal carotid artery, vertebral artery, basal artery, and multiple cerebral artery stenosis in the MetS group were significantly higher than those in the non-MetS group (all P<0.05), and the proportion of patients with moderate and severe cerebral arterial stenosis was also significantly higher than that in the non-MetS group (all P<0.05). Multivariate logistic regression analysis showed that after adjusting for confounding factors such as previous stroke or transient ischemic attack history, alcohol consumption, and low-density lipoprotein cholesterol levels, there was still a significant independent correlation between the number of MetS components and cerebral arterial stenosis; with the number of MetS components increaseing, especially 3 or more, the risk of cerebral artery stenosis increased (2 components: odds ratio [OR] 4.573, 95% confidence interval [CI] 1.388-15.068; 3 components: OR 452.450, 95% CI 115.505-1 772.310; 4 components: OR 452.503, 95% CI 117.664-1 740.191; 5 components: OR 411.356, 95% CI 96.975-1 744.911).@*Conclusions@#MetS is an independent risk factor for cerebral artery stenosis in patients with SIVD, and the correlation between them increases with the increase of MetS components.

Correlation between methylenetetrahydrofolate reductase gene C677T polymorphism and plasma homocysteine levels and white matte hyperintensities: a meta-analysis / 国际脑血管病杂志

Objective To investigate the correlation between methylenetetrahydrofolate reductase (MTHFR) gene C677T polymorphism and plasma homocysteine (Hcy) levels and white matte hyperintensities (WMHs). Methods PubMed, EMbase, Cochrane Library, China National Knowledge Infrastructure (CNKI), Weipu and Wanfang databases were retrieved to search studies on correlation between MTHFR gene C677T polymorphism and plasma Hcy levels and WMHs. The search deadline was October 31, 2018. Stata 14.0 software was used for statistical analysis. Results Six eligible literatures on the correlation between MTHFR gene and WMHs were included. The results of meta-analysis showed that there was no significant correlation between MTHFR C677T gene polymorphism and WMHs in 5 genetic models (T allele vs. C allele, TC vs. CC genotype, TT vs. CC genotype, TT+TC vs. CC genotype, and TT vs. TC+CC genotype). A total of 22 eligible literatures on the correlation between plasma Hcy level and WMHs were included. The results of meta-analysis showed that the plasma Hcy levels in patients with WMHs were significantly higher than those in the control group (weighted mean difference 3.48, 95% confidence interval 2.36-4.60; Z=6.03, P<0.01). Conclusions There was no significant correlation between MTHFR gene C677T polymorphism and WMHs, and the elevated plasma Hcy levels may be a risk factor for WMHs.

Clinical and genetic characteristics of frontotemporal dementia with amyotrophic lateral sclerosis:one case report and literature review / 中华神经科杂志

Objective To report a case of frontotemporal dementia with amyotrophic lateral sclerosis (FTD-ALS),review the relevant literature and then summarize the clinical and genetic characteristics of FTD-ALS patients.Methods A FTD-ALS patient admitted to the First Affiliated Hospital,Anhui Medical University in May 2017.After diagnosis,genetic analyses were performed on DNA extracted from peripheral blood of the patient and his first-degree relatives.Chinese FTD-ALS patients reported in detail were reviewed and the clinical and genetic characteristics of the disease were summarized.Results The patient,a 49-year-old man,responded slowly with impaired confrontation naming and impaired single-word comprehension.Magnetic resonance imaging showed temporal lobe atrophy.Besides,the patient gradually developed atrophy in limbs and bulbar muscles as well as spasticity of arms and legs,with positive pathological and primitive reflexes.Electromyography suggested a wide range of neurogenic changes,which were consistent with the FTD-ALS diagnostic criteria.A new heterozygous mutation (c.1335G＞A chr12:64879792 p.W445X) was found in the TBK1 gene.The reference to the American College of Medical Genetics and Genomics guidelines suggested that this mutation type is likely pathogenic,which has not been reported by the Human Gene Mutation Database.There were a total of 21 Chinese FTD-ALS patients (including this case) reported in detail,including 13 males and eight females.The age of onset was (59.01±8.58) (44-73) years.Most of them had typical manifestations of FTD as the first symptom,followed by ALS.Among these patients,seven had genetic data analyses,five of which had positive results.The mutations occurred in TBK1 (two cases),C9onf72 (one case),DCTN1 (one case) and TARDBP (one case)genes,respectively.Most FTD-ALS cases were sporadic (including this case),and only two cases were familial.Conclusions FTD-ALS is a relatively rare disease,mostly sporadic,with a younger onset age,in which behavioral variant FTD is the main manifestation of dementia in the context of ALS,and cognitive impairment is occurred earlier than ALS.In addition to C9orf72 gene,TBK1 gene is an important pathogenic gene of FTD-ALS.Genetic analysis is of great value in the early diagnosis of FTD-ALS.

Correlation between apolipoprotein E gene polymorphism and the urine level of Alzheimer-associated neuronal thread protein in patients with Alzheimer's disease and mild cognitive impairment / 中华神经科杂志

Objective To explore the correlation between apolipoprotein E (ApoE) gene polymorphism and urine Alzheimer-associated neuronal thread protein (AD7c-NTP) level in patients with Alzheimer's disease (AD) and mild cognitive impairment (MCI).Methods The cognitive function of 30 AD patients (AD group),30 MCI patients (MCI group) and 30 normal controls (NC group) was evaluated by neuropsychological batteries like MMSE,the Cambridge Cognitive Examination-Chinese Version (CAMCOG-C),etc.ELISA was used to test the urine level of AD7c-NTP.The genotypes of ApoE were analyzed by the high-resolution melting assay in blood samples.Results Compared with the NC group (0.59 (0.40,0.66) ng/ml),the urine level of AD7c-NTP in the AD group (1.03(0.80,1.41) ng/ml) and the MCI group (0.69(0.53,0.91) ng/ml) was increased (Z =33.727,P ＜0.01).The urine level of AD7c-NTP in the AD group was higher than that in the MCI group (Z =8.232,P ＜ 0.05).The level of AD7c-NTP in urine was negatively correlated with MMSE and CAMCOG-C scores (rMMSE =-0.604,P ＜ 0.01;rCAMCOG-C =-0.486,P ＜ 0.01).According to receiver operating characteristic curve,the optimal cutoff point of AD7c-NTP in urine for diagnosis of patients including AD and MCI was 0.70 ng/ml,with sensitivity of 71.7％ and specificity of 83.3％,and area under the curve of 0.82 (95％ CI 0.73-0.90,P ＜0.05).There were four genotypes comprising ε2/3,ε3/3,ε3/4 and ε4/4 for ApoE gene.The frequencies of ε4 carriers were 46.7％ (14/30),23.3％ (7/30) and 23.3％ (7/30) in the AD,MCI and NC groups,respectively.There was a notable increase in urine AD7c-NTP and a significant decrease in CAMCOG-C scores in MCI patients who harbored the ApoE ε4 allele (ZAD7c-NTP =4.857,P ＜ 0.05;ZCAMCOG-C =4.284,P ＜0.05).Conclusions The urine level of AD7c-NTP was significantly increased in AD and MCI patients,the higher the level of AD7c-NTP,the more serious the cognitive impairment.The ε4 carriers exhibited higher urine level of AD7c-NTP,but worse cognitive function compared to ε4 non-carriers in the MCI group.

Ecological executive function characteristics in patients with white matter lesions and its influencing factors / 安徽医科大学学报

Objective To investigate the characteristics of the ecological execution function in patients with white matter lesions ( WML) and its influencing factors. Methods 43 cases of magnetic resonance imaging( MRI) find-ings in patients with WML were selected. In the same period, 27 patients who were matched in age and educational level, and brain MRI examination showed normal were selected as the control group. The experimental group and the control group were evaluated by the behavior rating inventory of executive function-adult version ( BRIEF-A) . Results Including the each factor score, global executive composite(GEC), behavioral regulation index(BRI) and metacogniton index( MI) score of WML patients were significantly higher than the control group, the differ-ences were statistically significant (P＜0. 05). In the severe group, the BRI, MI and total score were higher than those in the moderate group and mild group. Compared with the mild group, the BRI, MI and total score in patients with moderate group were notable higher (P＜0. 05). Similarly, the scores of all factors in the severe group were all higher than those in the mild group, and the scores of inhibition, plan and organization were higher than those in the moderate group. There was a significant difference in shift, emotional control, self monitoring, initiation, work-ing memory and organization between the moderate group and the mild group ( P ＜0. 05 ) . There was statistical difference on the scores of each factor, BRI, MI and total score between group deep white matter lesions ( DWML) and group periventricular lesions(PVL) (P＜0. 05). Multiple linear regression analysis showed that the inhibition, emotional control, self-monitoring, MI, initiation, working memory, planning, organization and total score were positively correlated with lesion severity. There was a significant positive correlation between BRI and the level of education and the severity of the disease. At the same time, the BRI was negatively correlated with lesion site. Conclusion The each factor score, BRI, MI and total score of BRIEF-A scale are elevated in WML patients, which is related to the severity of the disease and the site of the lesion.

A Study of Resection of Pterygopalatine Fossa Tumor by Transnasal Recessed Approach under Nasal Endoscope / 医学研究杂志

Objective To analyze and discuss the surgical outcome and complications of resection of pterygopalatine fossa tumor along the lateral wall of maxillary sinus.Methods Nine patients with pterygopalatine fossa tumors received from March 2012 to June 2015 were treated by transnasal endoscopic approach to resect the pterygopalatine fossa tumors by transnasal recess-maxillary sinus approach.Surgery used general anesthesia,while controlling intraoperative hypotension in patients.The CT and MRI examinations of the sinuses were performed before operation,and the patients were followed up regularly.Results All of the patients underwent successful operation.The pterygopalatine fossa tumors were cleared once,and were discharged after 6-12 days.Although there were 2 patients with mild facial paralysis of the maxillary nerve in 3-24 months of follow-up,there was no serious complication or recurrence.Conclusion The removal of pterygopalatine fossa tumors by transnasal endoscopic approach can safely and effectively remove the tumor tissue and preserve the integrity of the lateral wall of the nasal cavity,minimize facial trauma and nasal cavity function.It is a complication less,low recurrence rate,rapid recovery of the new minimally invasive approach,it is worth to promote the use of clinical.

Changes in fibrinogen, D-dimer and homocysteine levels in elderly patients with cerebral small vessel disease / 中华老年医学杂志

Objective To examine changes infibrinogen (FIB),D-dimer and homocysteine (HCY) levels and their significance in patients with cerebral small vessel disease (CSVD).Methods This was a prospective study consecutively recruiting 116 patients with CSVD from January 2015 to August 2016 at the Second Affiliated Hospital of Bengbu Medical University,including 50 patients with lacunar infarction and 66 patients with leukoaraiosis.As a control group,89 age-matched healthy elderly individuals were enrolled in the study.FIB,D-dimer and HCY levels in the groups were measured and compared.Results Serum FIB,D-dimer and HCY levels in CSVD patients,including the lacunar infarction group and the leukoaraiosis group,were all significantly higher than in the control group[(3.3±0.9)g/L vs.(3.3±1.0)g/L vs.(3.3±0.8)g/L vs.(2.6±0.5)g/L,(631.1± 487.1)μg/L vs.(479.2 ± 277.6)μg/L vs.(750.2 ± 577.4)μg/L vs.(202.8±81.7)μg/L,(20.6 ± 12.8)μmol/L vs.(14.4 ± 4.8) μmol/L vs.(25.4 ± 15.0)μxmol/L vs.(12.8 ± 4.6) μmol/L,all P ＜ 0.05)].Multiple Logistic regression analysis showed that FIB,D-dimer and HCY were independent risk factors for CSVD (P＜0.01).Additionally,multiple regression analysis of lacunar infarction and leukoaraiosis showed that HCY had no significant correlation with lacunar infarction (P ＞ 0.05).Conclusions FIB,D-dimer,HCY may be risk factors for cerebral small vessel disease,which may not carry the same weight for lacunar infarction and leukoaraiosis.

Correlation between the visiting rate of patients with allergic rhinitis and airborne pollen concentrations in Beijing in recent 3 years / 中华耳鼻咽喉头颈外科杂志

Objective@#To evaluate the daily airborne pollen concentrations and visiting rate of patients with allergic rhinitis (AR) and their correlation during 2012-2014 in Beijing.@*Methods@#Daily airborne pollen concentrations (55 998 numbers in total and 549 numbers in average) and its constitution from April to September each year (2012 to 2014) were compared. The number of patients with AR (44 203 in total) who visited the outpatient department of Otorhinolaryngology Head and Neck Surgery, Peking University Third Hospital between January 2012 and December 2014 was analyzed by month. Using SPSS 22.0 software, Kruskal-Wallis test was done for the comparison of visiting rate of patients with AR and airborne pollen concentrations. Correlation analysis between them was made as well.@*Results@#χ2 value of airborne pollen concentrations between different months in 2012 to 2014 was 110.7, 108.4 and 121.4, respectively; all P<0.01. The airborne pollen concentrations had two peaks per year, respectively: April to May, August to September. χ2 value of visiting rate of patients with AR between different months in 2012 to 2014 was 175.0, 185.1 and 134.5, respectively; all P<0.01. Visiting rate of patients with AR showed two scattering peaks each year, respectively: April to May, August to September. The highest pollen concentration of spring (April to May) was in early and middle April. Tree pollen was the major portion in spring, which were poplar pollen, pine tree pollen, ash tree pollen, cypress tree pollen and birch trees pollen. The highest pollen concentration of autumn (August to September) was in late August and early September. Weed pollen was the major portion in summer and autumn, which were artemisia pollen, chenopodiaceae pollen and humulus japonicas pollen. The visiting rate of patients with AR showed significant correlation with airborne pollen concentrations (r value was 0.537, 0.484 and 0.566, respectively; all P<0.01).@*Conclusion@#The visiting rate of patients with AR showed positive correlation with airborne pollen concentrations in recent three years.

The change of serum alkaline phosphatase in patients with acute cerebral infarction and its clinical significance / 中华老年医学杂志

Objective To investigate the change of serum alkaline phosphatase (ALP) level in patients with acute cerebral infarction (ACI) and its clinical significance.Methods A total of 400 patients with ACI (ACI group) and 240 gender-and age-matched healthy controls during the same period were enrolled in this study.Serum ALP,total protein,alanine aminotransferase (ALT) and aspartate aminotransferase (AST) and other indicators of liver function,serum creatinine (Cr),blood urea nitrogen (BUN) and other indexes of renal function were determined.ACI patients were divided into three subgroups according to the largest diameter of infarction slice on the diffusion weighted imaging (DWI):small area group (＜1.5cm),middle area group (1.5-4.0cm) and large area group (＞4.0cm).The degree of neurologic impairment at admission and the degree of nerve function recovery at discharge were assessed by National Institute of Health stroke scale (NHISS) and modified-Rankin Scale (mRS) in all patients.The relationship of serum ALP level with infarction area,NHISS score and mRS was analyzed.Results Serum ALP level was higher in ACI group than in control group [(80.1±24.4)U/L vs.(75.5±21.5)U/L,t=-2.471,P=0.014].Serum ALP level was elevated along with the increase of infarction areas in ACI group [(78.0 ± 23.3)U/L,(79.4±24.9) U/L vs.(87.7±26.0) U/L,F=4.374,P=0.013].The correlation analysis showed that serum ALP level was positively correlated with infarction area (r=0.118,P=0.019) and NHISS score (r=0.114,P=0.023),but no significant relationship was found with mRS (r=0.071,P=0.08).Multivariate regression analysis revealed that patients with high serum ALP level (＞86 U/L) had 1.691-fold higher risk for cerebral infarction than did those with low serum ALP level(＜67 U/L) (OR=1.691,95％CI:1.103～2.594) after adjusting for confounding variables including age,gender,hypertension,diabetic mellitus,heart disease (coronary heart disease and atrial fibrillation),et al.Receiver operating curves (ROC) analysis revealed that the area under the curve of serum ALP level for predicting ACI was 0.557 (95％CI:0.512～0.602,P=0.016),and its sensitivity and specificity were 43.1％ and 67.6 ％ respectively when serum ALP level was 81.5 U/L.Conclusions Serum ALP level is increased in ACI patients,which has positive correlations with cerebral infarction areas and NHISS scores.In the future,maybe,we could assess ACI by monitoring serum ALP levels or improve the prognosis of ACI patients by decreasing serum ALP levels in the future.

Impact of serum alkaline phosphatase on the cognitive impairment in patients with subcortical ischemic vascular disease / 中华神经科杂志

Objective To explore the levels of serum alkaline phosphatase ( ALP) as well as its impact on the cognitive impairment in patients with subcortical ischemic vascular disease ( SIVD).Methods One hundred and fifty-eight SIVD patients were divided into two subgroups which included 86 patients with mild cognitive impairment ( SVMCI ) and 72 patients with vascular dementia ( SVaD ) according to the severity of cognitive impairment.Sixty-seven old people with normal cognitive function were selected as control qruop.Multiple lacunar infarction ( LI) or leukoaraiosis ( LA) was detected according to their MRI scan appearances and graded LA according to the severity.Serum ALP was measured by an enzymatic method as well as the Mini-Mental State Examination ( MMSE) and the Cambridge Cognitive Examination-Chinese Version (CAMCOG-C) were used in assessments.Serum ALP was divided into 3 groups and the occurrence rate of LI , LA and cognitive impairment were compared with each other.The levels of ALP were compared in different cognitive impairment and Logistic regression was used to explore the relation between ALP and cognitive impairment.Results Both SVaD and SVMCI groups (17.00 (13.00, 20.00), 59.50 (49.00, 68.75);25.00 (25.00, 26.00), 82.50 (76.75, 89.00)) showed significantly lower scores in MMSE and CAMCOG-C than control group (28.00 (28.00, 29.00), 93.00 (89.00, 96.00); Z=187.337, P=0.000; Z=150.480, P=0.000).A positive relationship between the elevated ALP level and the severity of cognitive impairment was found after adjusting for sex , age and other confunding factors ((68.60 ±15.52), (78.76 ±13.39), (86.75 ±18.85) U/L, F=22.587, P=0.000).The occurrence rate of LI, LA and SVaD among the three groups were significantly different (χ2 =8.008, P=0.018;χ2 =17.998, P=0.000;χ2 =12.255, P=0.002).The ALP level was negatively correlated with MMSE and CAMCOG-C scores ( r=-0.350, P=0.000; r=-0.286, P=0.000 ).Logistic regression analysis revealed the relation between ALP and cognitive impairment was positive when we controlled all the vascular risk factors.However , the relation had gone when futher adjusting for the grade of LA.Conclusions The level of ALP is significantly higher in SIVD patients and positively relates with cognitive impairment especially in those whose grade of LA is severe.

Correlation between vertebral artery tortuosity and posterior circulation ischemia / 国际脑血管病杂志

Objective To investigate the correlation between vertebral artery tortuosity and posterior circulation ischemia (PCI). Methods The patients with PCI aged ≥50 years old and the controls without PCI at the same time were enrolled. CT angiography was performed in all patients. The cervical vertebral artery tortuosity was observed and rated, and the related risk factors for influencing PCI were analyzed. Results A total of 112 patients with PCI and 90 controls were enrolled. Univariate analysis showed that the proportions of patients with hypertension (80. 36% vs. 54. 44% ; χ2 = 15. 613, P < 0. 001), smoking (35. 71% vs. 18. 89% ; χ2 = 6. 974, P = 0. 008), alcohol consumption (25. 89% vs. 10. 00% ; χ2 = 8. 253, P = 0. 004), posterior circulation vascular stenosis (54. 46% vs. 24. 44% ; χ2 = 18. 578, P < 0. 001), and vertebral artery tortuosity (71. 43% vs. 48. 89% ; χ2 = 10. 695, P = 0. 001), as well as the levels of the total cholesterol (4. 96 ± 1. 26 mmol/L vs. 4. 61 ± 1. 04 mmol/L; t = - 2. 110, P = 0. 036 ), low-density lipoprotein cholesterol (3. 02 ± 0. 90 mmol/L vs. 2. 69 ± 0. 78 mmol/L; t = - 2. 671, P = 0. 008 ), and fibrinogen (3. 67 ± 1. 69 mg/L vs. 3. 25 ± 0. 97 mg/L; t = - 2. 002, P = 0. 047) in the PCI group were significantly higher than those in the control group. The proportion of bilateral vertebral artery tortuosity in the PCI group was significantly higher that in the control group (30. 36% vs. 12. 22% ; χ2 = 9. 478, P =0. 002). The proportion of grade 3 vertebral artery tortuosity in the PCI group was significantly higher than that in the control group (43. 75% vs. 26. 67% ; χ2 = 6. 310, P = 0. 012). Multivariate logistic regression analysis showed that smoking (odds ratio [OR] 2. 339, 95% confidence interval [CI] 1. 037-5. 278; P =0. 041), low-density lipoprotein cholesterol (OR 1. 580,95% CI 1. 050-2. 377; P = 0. 028), hypertension (OR 2. 631, 95% CI 1. 237-5. 596; P = 0. 012), posterior circulation vascular stenosis (OR 3. 419, 95% CI 1. 638-7. 134; P = 0. 001), and vertebral artery tortuosity (OR 2. 413, 95% CI 1. 212-4. 803; P = 0. 012) were the independent risk factors for PCI. Conclusion The vertebral artery tortuosity is an independent risk factor for PCI in the middle-aged and elderly people.

Effect of Hyperbaric Oxygen Combined with Acupuncture and Moxibustion on Traumatic Peripheral Facial Nerve Injury:A Electromyography Study / 中国康复理论与实践

Objective To explore the effect of hyperbaric oxygen combined with acupuncture and moxibustion on traumatic peripheral facial nerve injury, and the results of electromyography. Methods From January, 2007 to January, 2013, a total of 160 patients with traumat-ic peripheral facial nerve injury were divided into treatment group (n=80) and control group (n=80). Both groups received routine drug treat-ment. Hyperbaric oxygen combined with acupuncture and moxibustion was applied to treatment group in addition. The clinical efficacy and the results of electromyography were analyzed before and 36 days after treatment. Results After treatment, the cure rate and total efficiency was significantly higher (χ2>7.657, P2.214, P3.116, P5.45, P<0.001) in the treatment group than in the control group. Conclusion Hyperbaric oxy-gen combined with acupuncture and moxibustion is more effective on traumatic peripheral facial nerve injury than routine.

Analysis of brain of sleep disorders in patients with leukoaraiosis and its influencing factors / 安徽医科大学学报

Objective To investigate the leukoaraiosis(LA)influencing factors of sleep disorder patients. Meth-ods 90 cases of LA patients which were conformed MRI diagnostic criteria were chosen as LA group,90 cases of normal old people which the gender and age were matched with LA group were chosen as NC group;by asking the medical history to inquirying blood vessel hazards;pittsburgh sleep quality index(PSQI)was adopted to evaluate the condition of sleep disorders,according to the performance MRI of skull to part LA group as four grades. Results In LA group,hypertension and diabetes incidence were significantly higher than that in group NC(P < 0. 05);LA group,PSQI score was significantly higher than that of NC group(P < 0. 01). LA group with the LA increasing grade,PSQI score increased(P < 0. 05). Regression analysis showed that age,hypertension,diabetes and MoCA were associated with LA in patients with sleep disorders. Conclusion Patients with LA have a sleep disorder, which is closely related with the degree of cognitive impairment,LA lesions,age,hypertension,diabetes etc.

Appliation of Stroop color-word test on Chinese elderly patients with subjective cognitive impairment / 安徽医科大学学报

Objective To investigate the applicability of Stroop color-word test in Chinese eldly patients with sub-jective cognitive impairment. Methods 36 patients with subjective cognitive impairment and 35 normal elders,all accepted general information questionaire( including age,gender,education,ect) ,Chinese version Stroop color-word test,background neuropsychological tests(MMSE,ADL,GDS,ect). Analysis of indicators included: the number of errors,average response,Stroop interference effects ( SIE)-Time difference of the Color inconsistencies and consist-ent with the meaning of words. At last we analyse relationship between CWT results and age,education,et al. Re-sults There were no significant differences in neuropsychological tests. Compared with normal subjects,subjective cognitive impairment subjects spent more time and made more errors in doing this task. They made statistical signifi-cance. The linear regression analysis between reaction time, the number of errors and overall cognitive function ( MMSE) , age, memory ( digit span, delayed recall) showed:the numbers of errors and the average response time had significant positive correlation with age. SIE of SCI was significantly longer than the normal control, the differ-ence was significant (P<0. 05). And it had no significant correlation with age, overall cognitive function and mem-ory and other related inspection. Conclusion Stroop color-word test has a certain sensitivity in recognition of sub-jective cognitive impairment elders.

Effect of metabolic syndrome on the imagings of brain damage in patients with subcortical ischemic vascular disease / 中华老年医学杂志

Objective To investigate the effect of metabolic syndrome and its components on imaging of brain impairment in subcortical ischemic vascular disease.Methods 120 patients with subcortical ischemic vascular disease (SIVD) including 25 cases without metabolic syndrome,25 cases with the risk of metabolic syndrome,70 cases with metabolic syndrome.The diagnostic criteria of metabolic syndrome was the National Cholesterol Education Program Adult Treatment Panel Ⅲ (NCEP-ATP Ⅲ).Brain MRI was assessed by the Scheltens scale,and divided into 3 regions:periventricular hyper intensities (PVH),leukoaraiosis (LA),basal ganglia hyper-intensities (BG).Results The assessment scores of PVH,LA,BG and Scheltens scores were higher in patients with the risk of metabolic syndrome and patient with metabolic syndrome than in patient without metabolic syndrome [(3.75±1.60),(4.21±1.09) us.(2.76±1.62),(10.67±5.26),(13.79±5.25) us.(6.36±3.93),(3.21±2.62),(6.90±4.25) us.(1.52±1.50),(17.62±8.32),(24.90±9.25)vs.(10.58± 5.89),respectively,all P＜0.05].Waist circumference had positive correlations with LA and Scheltens scores (r=0.185,P=0.046; r=0.488,P＜0.001).Positive correlation was found between triglyceride (TG) and LA,BG scores (r=0.188,P=0.042; r=0.311,P =0.001).The positive correlations of impaired glucose tolerance (IGT) with LA,BG and Scheltens scores were found (r=0.235,P=0.011; r=0.229,P=0.013; r=0.206,P=0.027).High density lipoproteincholesterol (HDL-C) was correlated negatively with LA,BG and Scheltens scores (r=-0.238,P=0.010;r=-0.189,P=0.042; r=-0.335,P＜0.001).The further multivariate linear regression analysis showed that IGT,HDL-C had significant correlations with LA assessment score (both P＜0.05),TG had significant correlation with BG assessment score (P＜0.05),and waist circumfernce,IGT,HDL-C had significant correlations with Scheltens scores (all P＜ 0.05).Conclusions Metabolic syndrome and its components correlate with the imagings of cerebral damage in SIVD.Abdominal obesity,TG,IGT,HDL-C are the important risk factors for SIVD.

Resting-state functional MRI study on properties of emotional memory networks in late-life depression / 中华行为医学与脑科学杂志

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.