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1.
Article in Chinese | WPRIM | ID: wpr-929881

ABSTRACT

Atrial fibrillation is one of the most common arrhythmia types. With the increase of age, atrial fibrillation will increase the incidence of silent cerebral infarction (SCI), and the correlation between them will lead to the aggravation of cognitive impairment. Atrial fibrillation can be regarded as an independent risk factor for accelerating cognitive impairment in patients with SCI, but the possible mechanism is not completely clear. Therefore, patients with atrial fibrillation should undergo MRI examination, find SCI in time and develop corresponding intervention measures in order to reduce or delay a series of subsequent negative effects. This article reviews the related cognitive impairment of SCI patients with atrial fibrillation.

2.
Article in Chinese | WPRIM | ID: wpr-909524

ABSTRACT

Objective:To investigate the correlation between total MRI burden and serum uric acid level in patients with cerebral small vessel disease(CSVD) and its gender differences.Methods:A total of 217 patients with CSVD were retrospectively included as the research objects, and the clinical data such as serum uric acid value were collected.The imaging findings of patients with CSVD were evaluated by MRI, and the total MRI burden score of CSVD was calculated.According to the total MRI burden score of CSVD, patients with CSVD were divided into mild-to-moderate burden group ( n=133) and severe burden group ( n=84). SPSS 20.0 software was used for data analysis and processing.Logistic regression was used to analyze the relationship between uric acid and the total MRI burden score of CSVD. Results:The serum uric acid of severe burden group was higher than that of mild-to-moderate burden group((326.94±70.95)μmol/L, (293.42±80.52)μmol/L, P=0.002). The multivariate logistic regression analysis showed that the elevated level of serum uric acid was an independent risk factors for total MRI burden of CSVD ( β=0.005, OR=1.005, 95% CI=1.001-1.009, P=0.019). The patients with CSVD were equally divided into four group based on the serum uric acid concentration.After controlling the confounding factors, with the increase of uric acid level, the risk of aggravating total MRI burden score of CSVD increased, and the difference was statistically significant( P=0.001). Serum uric acid(for each quartile increase)was an independent risk factor for total MRI burden in male patients with CSVD( β=0.482, OR=1.619, 95% CI=1.125-2.330, P=0.010), while there was no significant difference in female patients( P=0.070). Conclusion:Serum uric acid level is a risk factor for increasing the total MRI burden in male patients with CSVD, but this effect is not found in female patients with CSVD.

3.
Article in Chinese | WPRIM | ID: wpr-909508

ABSTRACT

Objective:To explore the correlation between enlarged perivascular spaces and other imaging markers of cerebrovascular disease in patients with ischemic stroke.Methods:Totally 287 patients with ischemic stroke hospitalized in neurology department from January 2018 to January 2019 were selected. According to the severity of EPVS in different parts of the brain, the correlations between the severity of EPVS in different parts of the brain and cerebral microbleeds (CMBs), white matter hyperintensity (WMH), lacunar infarcts (LIs) were analyzed. SPSS 22.0 software was used for analysis. Chi-square test, independent sample t-test, rank-sum test and non parametric Mann-Whitney U test were used for group comparison, and Logistic regression analysis was used for multivariate analysis. Results:EPVS was common and severe in patients with ischemic stroke. Periventricular white matter hyperintensity(PWMH)( β=1.604, P<0.001, OR=4.971, 95% CI=2.015-12.263), CMBs ( β=1.224, P=0.018, OR=3.339, 95% CI=1.232-9.383) and LIs ( β=0.626, P=0.047, OR=1.871, 95% CI=1.009-3.470) were independent risk factors for BG-EPVS. PWMH ( r=0.614), DWMH ( r=0.622), LIs ( r=0.532) were positively correlated with the severity of BG-EPVS (all P<0.01). Conclusion:The imaging makers of CSVD are related to BG-EPVS, which can affect the severity of brain BG-EPVS in patients with ischemic stroke.

4.
Article in Chinese | WPRIM | ID: wpr-929858

ABSTRACT

Vascular cognitive impairment is the only cognitive impairment disease that can be intervened at present. In recent years, the research on its genetic factors has attracted much attention. Among them, apolipoprotein E (ApoE) and its genotypes are closely associated with lipid metabolism, β-amyloid aggregation and deposition, the changes of brain structure and function, and are closely correlated with the pathogenesis of dementia. This article discusses some possible mechanisms of ApoE and its genotypes affecting cognitive function, in order to provide reference for the management of cognitive function in patients with vascular cognitive impairment.

5.
Article in Chinese | WPRIM | ID: wpr-882393

ABSTRACT

Post-stroke cognitive impairment (PSCI) directly affects the outcome of patients with stroke. Enlarged perivascular spaces (EPVS) suggest the impairment of brain clearance mechanism and may affect cognitive function. More and more studies have confirmed that the presence of EPVS will aggravate PSCI. This article reviews the relationship between EPVS and PSCI.

6.
Article in Chinese | WPRIM | ID: wpr-882381

ABSTRACT

A large number of studies have shown that the elevated lipoprotein (a) is a risk factor for ischemic stroke, but the specific mechanism is still unclear. Therefore, this article reviews the role of elevated lipoprotein (a) in ischemic stroke, its mechanism, and intervention measures.

7.
Article in Chinese | WPRIM | ID: wpr-882367

ABSTRACT

The perivascular space is formed by the pia mater around the blood vessels and participates in the fluid exchange and waste clearance in the brain. The enlarged perivascular space (EPVS) indicates the disorder of brain clearance mechanism, which is closely related to the occurrence and development of a variety of clinical diseases. In recent years, there are a lot of studies on the pathogenesis and influencing factors of EPVS. This article reviews its anatomy, neuroimaging, pathogenesis, and risk factors.

8.
Article in Chinese | WPRIM | ID: wpr-867056

ABSTRACT

Objective:To investigate the effects of butylphthalide(NBP) on cognitive function and Nrf2 / SIRT3 signal pathway in vascular dementia (VD) mice.Methods:Wild-type mice (Nrf2 + /+ ) were divided into sham group, model group (VD group), butylphthalide treatment group (Nrf2 + /+ NBP group), and Nrf2 gene knockout mice (Nrf2 -/-) were divided into Nrf2 -/-model group (Nrf2 -/-VD group) and Nrf2 -/-treatment group (Nrf2 -/-NBP group). Both the model group and the treatment group were repeated.The bilateral common carotid arteries were ligated three times to establish a mouse model of cognitive dysfunction caused by cerebral ischemia-reperfusion.The sham group only isolated the bilateral common carotid arteries and threaded the wires, but did not block blood flow.Morris water maze experiment was used to analyze the cognitive function of mice.HE staining was used to observe the changes of neuron morphology and structure in CA1 region of hippocampus, and immunohistochemical analysis was used to analyze the positive expression of caspase 3 and caspase 9 in mouse CA1 region of hippocampus.Western blot was used to detect mouse hippocampus Nrf2, p62, LC3, SIRT3 protein expression. Results:(1) In Morris water maze experiment: compared with VD group, the escape latency of Sham group and Nrf2 + /+ NBP group was significantly shorter on the 5th day ((20.69±8.91) s, (7.58±9.47)s, (8.41±12.20)s; q=3.58, 5.07, both P<0.05), and the percentage of stay time in target quadrant was significantly increased ((16.80±3.27)%, (25.25±5.51)% and (24.18±6.46)%; q=3.36, 4.43, both P<0.05). Compared with VD group, the escape latency of Nrf2 -/- VD group was significantly prolonged on the 5th day ((33.71±9.05) s), and the percentage of stay time in target quadrant was significantly reduced ((10.84±3.26)%)( q=3.56, 3.58; both P<0.05). Compared with Nrf2 -/- VD group, the escape latency and the percentage of stay time in target quadrant in Nrf2 -/- NBP group had no significant difference ( P>0.05). (2) Pathological results showed that, compared with VD group, the damage of pyramidal neurons in CA1 area of hippocampus in Sham group and Nrf2 + /+ NBP group was lighter, and that in Nrf2 -/- VD group was more serious, and the improvement of neuron morphology was not obvious after NBP treatment.(3) The expression of apoptosis: compared with VD group, the expression of caspase-3 and caspase-9 in the CA1 area of hippocampus in Sham group and Nrf2 + /+ NBP group were significantly lower, and those in Nrf2 -/-VD group were significantly higher ( t=3.48, 2.95, 3.46, 2.93, -2.99, -3.77, all P<0.01). Compared with Nrf2 -/-VD group, the expression of caspase- 3 and caspase-9 in the CA1 area of hippocampus in Nrf2 -/-NBP group were not significantly changed (both P>0.05). (4) Expression of related proteins: compared with VD group, Nrf2, SIRT3, p62 protein expression increased, LC3II/I ratio decreased in Nrf2 + /+ NBP group( t=-3.24, -4.04, -4.03, 3.62, all P<0.01); Nrf2, LC3II/ I ratio decreased, SIRT3, p62 protein expression increased in Sham group( t=3.44, 4.72, -3.52, -4.19, all P<0.01); Nrf2, SIRT3, p62 protein expression decreased and LC3II/I ratio increased in Nrf2 -/-VD group( t=9.14, 4.20, 4.30, -3.78, all P<0.01); Compared with Nrf2 -/- NBP, the expression of Nrf2, SIRT3, p62 decreased, and LC3II/I ratio increased in Nrf2 -/-VD group( t=2.40, 3.24, 1.21, -1.16, all P<0.01). The expression of Nrf2, SIRT3, p62 protein in Nrf2 + /+ NBP group increased, and the ratio of LC3II/ I decreased ( t=-3.29, -5.00, 6.24, all P<0.01). Conclusion:Butylphthalide can reduce the apoptotic damage in hippocampus of VD mice and improve cognitive dysfunction caused by repeated ischemia-reperfusion injury.Regulating Nrf2 / SIRT3 pathway to inhibit hippocampal neuronal apoptosis and autophagy may be its role mechanism.

9.
Article in Chinese | WPRIM | ID: wpr-863118

ABSTRACT

At present, the main treatment strategy for acute ischemic stroke is to recanalize the occluded blood vessels through drug or endovascular interventional therapy, and to save the ischemic penumbra is the key of the treatment, but due to the factors such as time window and indications, some patients cannot benefit from them. NeuroFlo technology can redistribute blood flow in body, increase intracranial blood supply, promote the establishment of collateral circulation around infarctions, effectively save ischemic penumbra, and ultimately improve the long-term prognosis of patients.

10.
Article in Chinese | WPRIM | ID: wpr-742980

ABSTRACT

The incidence of vascular cognitive impairment (VCI) is increasing year by year,and early intervention and treatment for VCI can effectively reduce the occurrence of vascular dementia.The application of repetitive transcranial magnetic stimulation (rTMS) opens a new window for the treatment of VCI.This article reviews the efficacy,biological mechanism and safety of rTMS in the treatment of VCI.

11.
Article in Chinese | WPRIM | ID: wpr-742979

ABSTRACT

Perivascular spaces (PVS) are an important part of the glymphatic system of the brain.Enlarged PVS (EPVS) may be an early manifestation of brain microvascular diseases and brain clearance mechanism disorders.There is growing evidence that EPVS plays an important role in the development and progression of cognitive impairment and may be its early warning sign.This article reviews the relationship between EPVS and cognitive impairment.

12.
Article in Chinese | WPRIM | ID: wpr-742911

ABSTRACT

Objective To investigate the effects of carcinoembryonic antigen (CEA), carbohy-drate antigen (CA19-9), carbohy-drate antigen (CA125), human epididymis protein 4 (HE4) And the combined detection of ovarian cancer risk prediction model (ROMA) in the diagnosis and significance of endometrial cancer.Methods From May 2014 to May 2010, 80 patients with endometrial cancer were treated.According to its clinical pathology is divided into observation 1 group and observation 2 group.Serum samples were collected and serum CEA, CA19-9, CA125 and HE4 levels were analyzed statistically and the ROMA values were calculated according to menopausal status.Results Compared with the control group, the levels of CEA, CA19-9, CA125 and HE4 in the serum of observation group patients with endometrial carcinoma were significantly higher than those in the control group, the ROMA value of the menopausal state was significantly higher, the difference was statistically significant (P<0.05).And with the progression of endometrial cancer staging, compared with the observation 1 group, the levels of CA19-9, CA125 and HE4 in the serum of the observation 2 group were significantly higher, the ROMA values of the menopausal states were significantly increased, the difference was statistically significant (P<0.05).The combined detection rate of CEA, CA19-9, CA125, HE4 and ROMA in serum of patients with endometrial carcinoma was significantly higher than that of each index (P<0.05).Conclusion The abnormally elevated levels of CEA, CA19-9, CA125, HE4, and ROMA in the serum of patients have important significance and role in the clinical diagnosis of endometrial cancer and its clinical staging.

13.
Article in Chinese | WPRIM | ID: wpr-754163

ABSTRACT

Haze pollution is a mixture of many substances,the main components of which are sulfur dioxide,nitrogen oxides and particulate matter (PM). The study found that PM2. 5 not only affects the respir-atory and cardiovascular system,but also affects cognitive function,resulting in cognitive impairment such as memory loss and executive function decline. With the increase of PM2. 5 concentration,cognitive function gradually declines. Haze can cause organic changes in brain tissue. Studies have shown that haze can cause inflammation,oxidative stress response,neurodegeneration and other central nervous system damage,and lead to cognitive impairment by interfering with gene expression and regulation process. Haze increases the risk of cardiovascular and cerebrovascular diseases,mediates emotional and behavioral changes,thus indirectly af-fecting cognitive function. Therefore,in areas with severe haze,it is necessary to take more active measures to reduce the degree of haze and minimize haze damage.

14.
Article in Chinese | WPRIM | ID: wpr-789085

ABSTRACT

Cerebral microinfarct is a pathological manifestation of cerebral small vessel disease, which is common in the elderly, and is closely related to cognitive impairment and dementia. Therefore, it has received increasing attention in recent years. This article reviews the risk factors, neuroimaging, and clinical significance of cerebral microinfarct.

15.
Article in Chinese | WPRIM | ID: wpr-801603

ABSTRACT

Ischemic stroke has a higher disability and mortality rate. Good collateral circulation is beneficial to improve the success rate of ischemic stroke reperfusion, and is associated with good outcome. Collateral blood flow can prolong the survival time of brain tissue after occlusion of the intracranial artery, so improving collateral blood flow may become a potential therapeutic target for ischemic stroke.

16.
Article in Chinese | WPRIM | ID: wpr-704139

ABSTRACT

Vascular cognitive impairment(VCI) is a group of syndroms from mild cognitive impairment to dementia caused by cerebrovascluar disease.The preventable and therapeutic characteristics of VCI bring an opportunity for its effective treatment.Non-pharmaceutical interventions play a vital role on its treatment,which gradually becomes a research hotspots.A variety of interventions to improve VCI have been confirmed,and the pathophysiological mechanism is unique but also complementary to each other.And their synergistic action cannot be ignored.This review focuses on the research progress in the effects of non-pharmaceutical interventions:physical activity,cognitive training,transcranial stimulation and acupuncture on VCI,and the possible mechanisms,in order to open new doors for the early detection,prevention and treatment of VCI.

17.
Article in Chinese | WPRIM | ID: wpr-704106

ABSTRACT

Objective To explore the improvement of cognitive impairment in patients with mild and moderate vascular cognitive impairment( VCI) treated with cerebralcare granule ( CG) and basic treat-ment.Methods From October in 2014 to December in 2016 year,143 cases of VCI patients were admitted from six hospitals in some areas of Hebei Province as the research objects,and divided into CG treatment group (experimental group,n=98) and conventional treatment group (control group,n=66).Three months and six months after treatment,the score of mental state examination ( MMSE) ,the Montreal cognitive assess-ment scale ( MoCA) and the daily living capacity scale( ADL) of the two groups were compared after 3 and 6 moths of treatment.Results ①The total score of MMSE in the experimental group was higher than that of the control group for six months after treatment, and the difference was statistically significant ( ( 23. 76 ± 4.02) vs (21.52±5.13),P<0.05).②Six months after treatment,the total score of MoCA ((21.06±4.66) vs (18.32±5.20)) and visual spatial/executive function((3.05±1.37) vs (2.42±1.66)),calculation force ((2.24±0.84) vs (1.83±1.05)) and orientation ability((5.20±1.12) vs (4.06±1.35)) scores in the ex-perimental group were significantly higher than those in the control group (P<0.05) .③Six months after treat-ment,the ADL score in the experimental group was lower than that before treatment,and the difference was statistically significant((24.96±8.74) vs (29.20±11.55),P<0.05);while there was no significant difference in the ADL score between the experimental group and the control group after 6 months (P>0.05).Conclusion CG can improve cognitive function in mild to moderate VCI patients,mainly in visual space/execution func-tion,calculation ability and orientation ability,and with the extension of treatment time,the curative effect is more obvious.

18.
China Pharmacy ; (12): 472-475, 2017.
Article in Chinese | WPRIM | ID: wpr-507951

ABSTRACT

OBJECTIVE:To investigate the protective effect of the compatibilities of ginsenosides Rg1 and aconitine on myocar-dial cell of in vitro cultured heart failure model. METHODS:The myocardial cells of neonate rat were grouped into normal control group,model group,positive control group(Deslanoside injection,1×10-7 mol/L),ginsenosides Rg1 group(1×10-8 mol/L),acon-itine group (1 × 10-9 mol/L) or their compatibilities groups (1∶1,2∶1,1∶2,V/V). Except for normal control group,other groups were given 0.8%pentobarbital sodium to induce heart failure model of myocardial cells. After modeling,each group was given rele-vant medicine for 1 h,and then the activities of T-ATPase,Ca2+-Mg2+-ATPase,Na+-K+-ATPase in cells were all detected. The activi-ties of acyl carrier protein(ACP)and lactate dehydrogenase(LDH),and the contents of brain natriuretic party(BNP),TNF-α and total glycogen were measured in cell culture fluid. RESULTS:Compared with normal control group, T-ATPase and Ca2+-Mg2+-ATPase activities were decreased significantly in model group;meanwhile,Na+-K+-ATPase activity was increased signifi-cantly,and ACP,LDH activities and BNP content in cell culture fluid were increased significantly(P0.05). CONCLUSIONS:Compatibility of ginsenosides Rg1 and aconitine can improve ATPase activities and membranous permeability,regulate BNP secretion and protect myocardial cell of heart failure model,especially the compatibility of ginsenosides Rg1 to aconitine of 2∶1 ratio.

19.
Article in Chinese | WPRIM | ID: wpr-664938

ABSTRACT

Objective To explore distribution characteristics and risk factors of cerebral microbleeds (CMBs),and the correlation between CMBs and white matter lesions (WML) in patients with ischemic cerebrovascular disease(ICVD).Methods 180 patients with ICVD in neurology department of Hebei General Hospital from February 2015 to January 2017 were recruited.Those patients were underwent brain magnetic resonance imaging (MRI),and magnetic susceptibility weighted imaging (SWI).Recorded the baseline data and risk factors of high blood pressure,diabetes,hyperlipidemia,and high homocysteine were recorded.Patients with CMBs were counted and graded to understand the characteristics of CMBs distribution.Logisitic regression analysis was used to analyze the influencing factors.ICVD patients were divided into CMBs group and non CMBs group.CMBs group was further divided into 4 groups according to the severity,which was divided into level 1-3.The correlation between CMBs influencing factors and classification was further studied.Then patients with ICVD were divided into WML group and non WML group.WML group scored each region with age-related white matter changes rating scale (ARWMCrs).The correlation between WML and CMBs classification was further studied.Results (1) The overall prevalence of CMBs in patients with ICVD was 61.7% (111/180).The most common location of CMBs in patients with ICVD was the cortical and subcortical regions (80/111,72.1%),followed by the basal ganglia and thalamus regions (61/111,55.0%),and the infratentorial regions(38/111,34.2%).The difference between them were significant (x2 =32.061,P=0.000).In cortical and subcortical regions of CMBs,temporal lobe was the most common (61.3%).(2) Age(B=0.046,Or=1.047,95%CI =1.017~ 1.077,P=0.002) and the high homocysteine (B =1.458,Or=4.299,95% CI =2.114 ~ 8.744,P<0.001) were the risk factors for CMBs.(3) Four classification of CMBs was positively correlated with and WML total score (r=0.393,P=0.393).Conclusion The temporal lobe was the most common region for CMBs in patients with ICVD.Age and high homocysteine were risk factors for CMBs.With the increase of WML total score,severity of CMBs was also increased.

20.
Article in Chinese | WPRIM | ID: wpr-494955

ABSTRACT

Subcortical ischemic vascular disease (SIVD) is considered to be the most important and common cause of vascular cognitive impairment (VCI). If patients with subcortical ischemic vascular cognitive impairment (SIVCI) and subcortical vascular cognitive impairment (sVCI) can be found early, it is possible that vascular dementia (VaD) can be identified before occurrence and even reverse the process. Recent studies have shown that resting-state functional magnetic resonance imaging (rsfMRI) may provide the objective basis for the diagnosis of SIVCI. This article reviews the application of rsfMRI in the diagnosis of SIVCI.

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