RESUMO
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.
RESUMO
Objective To investigate nutritional knowledge,attitude,and practice (K-A-P) of medical staff in the nerve-related departments in Hebei province,with the aim of determining a basis for the effective education of nutrition.Methods A multicenter,observational study was utilized to conduct a questionnaire survey.642 medical staff in nerve-related departments from 15 hospitals in 11 prefecture level cities was surveyed from September 2016 to March 2017 in Hebei Province.Results were statistically analyzed.Results The overall scores of nutrition knowledge,attitude,and practice were 34.88±22.90,69.14± 16.75 and 42.86± 18.22,respectively.There were positive correlations between nutrition knowledge and attitude (r=0.150,P＜ 0.001),knowledge and practice (r=0.152,P＜0.001),and attitude and practice (r =0.432,P＜0.001).The nutrition knowledge score of male medical staff was higher than that of female (t =3.546,P＜0.01) however,there was no significant difference between males and females in nutrition attitude and practice scores (t =0.685,P=0.494;t=1.649,P=0.091).In addition,the nutrition knowledge scores of physicians and medical technicians were significantly higher than that of nurses (F=46.89,P＜0.01) while the nutrition practice scores of physicians were significantly higher than both medical technicians and nurses (F=7.85,P＜0.01).It was also found that nutrition attitude scores of senior and secondary medical staff were higher than junior medical staff (F=5.116,P=0.002) and nutrition practice scores of senior and secondary senior medical staff were higher than that of junior medical staff (F=4.074,P=0.007).Furthermore,it was found that nutrition knoledge scores of undergraduate,master and doctoral degree staff were higher than that of junior college staff (F=15.617,P＜0.001) and nutrition attitude score of undergraduate and master degree staff were significantly higher than that of junior college staff (F =4.11,P =0.003).It was also found that the nutrition knowledge scores of medical staff with less than 5 years of work experience were significantly higher than those with more than 5 years of work experience (F=3.312,P =0.02).However,the scores of nutrition attitude of medical staff with more than 15 years of work experience were significantly higher than those with less than 15 years of work experience (F=6.356,P＜0.001) and the scores of nutrition practice of medical staff with 10-15 years of work experience were higher than that of less than 5 years and 5-10 years of work experience (F=2.959,P=0.032).It was also identified that the top three ways to obtain nutrition knowledge were learning at work (68.85％),learning at university (68.69％) and reading books and journals (57.79％).Conclusion The medical staff of nerve-related departments in Hebei province has positive attitudes towards nutrition treatments.However,their mastery of nutritional knowledge and practice could and should be improved further.Therefore,it is necessary to strengthen the nutrition education for medical staff of the nerve profession.
RESUMO
Objective To investigate the pattern of the cerebral white matter lesions in patients with mild and moderate Alzheimer's disease(AD)and healthy controls using proton magnetic resonance spectroscopy(~1H-MRS)and diffusion tensor imaging(DTI).Methods Twenty AD patients and Twenty healthy controls were recrnited.All subjects underwent clinical examination,neuropsychological assessment.The quantitative analysis of N-acetylaspartate(NAA),myoinositol(mI),Chotine(Cho)and Creatine(Cr)resonance signals in region of interests(ROIs)located in the paraventricular white matter region bilaterally were measured.Ratios of NAA/Cr,mI/Cr and Cho/Cr were calculated in two groups.In addition,conventional MRI and DTI scanning were received,fractional anisotropy(FA)and mean diffusivity(MD)values of white matter in the same regions were measured respectively.Results No significant difference between two groups were observed in NAA/Cr ratio(P＞0.05).A significantly increased mI/Cr and Cho/Cr were found in AD patients than in controls(P＜0.05).FA and MD values in AD patients were 0.470±0.082 and 0.771±0.099,and in controls were 0.539±0.068 and 0.691±0.064,respectively.FA value decreased significantly in AD patients(P＜0.05),M D value increased significantly in AD patients(P＜0.05).After controlling for age-related,partial correlation analysis revealed a negtive correlation between mI/Cr and FA value in the patients with AD(P＜0.05).No correlation between mI/Cr and MD was found(P＞0.05).Conclusion The results suggest that not only the gray matter is injured,but also the white matter is abnormal in AD patients.Combining ~1H-MRS with DTI alterations could provide the valuable informations about white matter lesions in AD patients.
RESUMO
Objective To investigate the relationship of lacunar infarction (LI) and white matter lesion with cognitive impairment in patients with subcortical ischemic vascular disease (SIVD) Methods Fifty-three patients were diagnosed as SIVD according to the criteria of Erkinjuntti. The symptoms and signs were recorded by an interview and examination, and neuropsychological assessment and magnetic resonance imaging (MRI) were performed. A semi-automated MRI quantitative method was used to measure the volume of white matter hyperintensity (WMH) and the number of LI was counted. Correlation and the partial correlation analysis were performed to examine the relationship of general cognitive function with the volume of WMH and the number of LI. Results The pseudobulbar paralysis symptom and the upper motoneuron injury sign were the most common in these patients (18.9% and 37.7%). Correlation analysis showed that there was positive correlation between the volume of WMH and age (r = 0. 518, P < 0. 05), and there was negative correlcction between mini-metal state examination (MMSE) scures and the volume of WMH (r=-0.514, P<0. 05), After controlling confounding factors, only age was positively correlated with the volume of WMH (r=0. 400, P=0. 004). There were negative correlation between the number of LI, the volume of WMH and MMSE scores(r=-0. 456,-0. 514,-0. 385,-0. 382;all P<0. 05), and the years of education was positively correlated with MMSE scores (r= 0. 518, P< 0. 001). Conclusions Age may not be the main risk factor for cognitive impairment in patients with SIVD. The volume of WMH and the number of LI are independent risk factors for cognitive impairment in patients with SIVD. Patients with severer SIVD or more LI show poorer performance on cognitive function.