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Alzheimer's disease (AD) is the most common form of dementia in the elderly, and there is no specific treatment to stop or reverse its progression. Mild cognitive impairment (MCI) is an important entry point for early diagnosis and prevention of AD. More and more studies have explored the risk factors and biomarkers for conversion from MCI to AD, and a series of risk prediction models have been established. This article analyzes and summarizes the different predictors and risk prediction models so as to provide basis for early identifying the high-risk group of AD, managing the controllable risk factors, and providing references for the selection and improvement of these models.
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Objective:To explore the structure of maternal verbal scaffolding features and develop a questionnaire on Mother's language scaffolding characteristics, so as to provide a quantitative, convenient and economical self-assessment tool for describing maternal verbal scaffolding features.Methods:On the basis of qualitative research and literature research, a questionnaire survey was conducted among 704 mothers of preschool children. After item analysis and exploratory factor analysis, a formal questionnaire was formed. Two weeks later, 106 mothers were retested to collect test-retest reliability data. Preschool children's expressive vocabulary checklist was used as external criterion.Data were analyzed by SPSS 18.0 and Amos 21.0.Results:(1)The formal questionnaire includes 28 items with two factors-detailed support factor and control rejection factor, the internal consistency coefficients of the two factors were 0.849 and 0.811, the project load was from 0 .482 to 0 .701, and the variance contribution rate was 40.36%.(2) AMOS 21.0 was used for confirmatory factor analysis, indicating that the two-factor structure met the requirements of psychometrics.( χ 2/ df=1.96, RMSEA=0.05, NFI=0.86, CFI=0.90, IFI=0.89). (3)The results of two-factor text-retest reliability were 0.840 and 0.871 as well as the results of split-half reliability was 0.801.The internal consistency reliability was 0.740.The external validity analysis showed that the mother's education level was positively correlated with factor Ⅰ( r=0.288, P=0.000), but not with factor Ⅱ( r=-0.091, P=0.052). There was significant difference in factorⅠbetween mothers with expressive vocabulary development delay children (52.22±10.56) and non delayed children (57.71±7.51) ( t=-5.07, P=0.000). There also was a significant difference in factor Ⅱ between mothers with expressive vocabulary development delay children (37.12±10.09) and non delayed children (31.53±8.59) ( t=4.61, P=0.000). (4)There was no significant difference in the characteristics of language scaffolding between boys(factorⅠ(58.08±8.14), factorⅡ(32.86±9.51)) and girls' mothers(factorⅠ(56.93±8.20), factorⅡ(31.42±8.48)). Analysis of the sample groups showed that age did not affect the verbal scaffolding features of preschool children's mothers( F1=1.633, P1=0.181; F2=0.758, P2=0.518). Conclusion:There are two factors in the questionnaire of the verbal scaffolding features questionnaire, which meet the criteria of psychometrics.The questionnaire of the verbal scaffolding features questionnaire is suitable for evaluating the characteristics of language scaffolding of mothers of preschool children aged 3-6.
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Objective:To investigate the correlation between vascular wall characteristics and ischemic stroke and its mechanism in patients with atherosclerotic middle cerebral artery (MCA) stenosis.Methods:Patients with atherosclerotic MCA stenosis received high-resolution vessel wall imaging (HR-VWI) in Shenzhen Bao'an District People's Hospital from November 2017 to November 2018 were enrolled retrospectively. The imaging characteristics, such as the lumen and vessel diameter and vessel wall area at the narrowest level of MCA plaque, plaque load, remodeling index, and plaque enhancement rate were measured. A multivariate logistic regression model was used to identify the independent risk factors for stroke in patients with atherosclerotic MCA stenosis. Results:A total of 53 patients with atherosclerotic MCA stenosis were enrolled, aged (53.5±9.7) years, 28 were male (52.8 %). There were 28 in the stroke group and 25 in the non-stroke group. Thirteen patients were artery-artery embolization, 15 were non-artery-artery embolization; 39 were mild stenosis, and 14 were moderate to severe stenosis. Compared with the non-stroke group, the moderate to severe stenosis was more common in the stroke group ( P=0.010), the plaque load was greater ( P=0.006), and the remodeling index was lower ( P=0.010). Multivariate logistic regression analysis showed that the remodeling index was an independent risk factor for stroke in patients with atherosclerotic MCA stenosis (odds ratio 0.002, 95% confidence interval 0.000-0.952; P=0.048). Compared with the non-artery-artery embolization group, the mean thickness of MCA was larger in the artery-artery embolization group ( P=0.037). Compared with the mild stenosis group, the plaque load was greater ( P=0.001), the plaque enhancement rate was higher ( P=0.004), and remodeling index was lower ( P<0.001) in the moderate to severe MCA stenosis group. Conclusions:In the atherosclerotic MCA stroke group, patients with moderate to severe stenosis are more common, with greater plaque load and lower remodeling index. Remodeling index is an independent risk factor for ischemic stroke. Patients with moderate to severe MCA stenosis have a higher plaque enhancement rate and a lower remodeling index, suggesting that the vessel wall inflammatory response is more significant and had decompensation. HR-VWI is expected to be used to assess the pathogenesis of ischemic stroke events.
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Objective To explore the clinical significance of ischemia modified albumin for the degree of myocardial damage and prognosis of neonates with pneumonia combined with heart failure.Methods Select 60 samples of neonates with pneumonia,neonates with pneumonia combined with heart failure,and normal neonates respectively,then detect and compare the level of ischemia modified protein (IMA),cTnI and CK-MB from the three groups neonates' serum.Calculate the left ventricular Tei index of three groups neonates by ultrasonic testing and compare.Compare the positive rates of IMA,cTnI,and CK-MB in neonates with pneumonia combined with heart failure group.Analyze the correlation between IMA and cTnI,CK-MB,and left ventricular Tei index in neonates with pneumonia combined with heart failure group.The incidence of death and cardiac events were recorded by follow-up visiting neonates with pneumonia combined with heart failure,and the relationship between IMA level and prognosis was analyzed.Results The differences in three indexes of IMA,cTnI and CK-MB were statistically significant in the three groups,all of which were significantly higher in neonates with pneumonia combined with heart failure group than those in other two groups (P < 0.05).The positive rate of IMA in neonates with pneumonia combined with heart failure group was the highest 88.33% (P < 0.05).The left ventricular Tei index of the pneumonia combined with heart failure neonates group was 0.42 ± 0.11,which was significantly higher than the other two groups (P < 0.05).The IMA and cTnI,CK-MB and left ventricular Tei index in pneumonia combined with heart failure neonates were all positively correlated (r =0.81,r =0.73,r =0.69,P < 0.05).Both the mortality and cardiac events in the high IMA group were significantly higher than that in the mid-level IMA group and the low-level IMA group (P < 0.05).Conclusion The ischemic modified albumin can be used as an effective indicator for the degree of myocardial damage and prognosis of neonates with pneumonia combined with heart failure.
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Objective To evaluate the application value of different MR sequences in cerebral developmental venous anomalies (DAVs),and to explore the relationship between DVAs and its associated lesions.Methods MRI findings in 38 patients of DAVs were analyzed retrospectively.Imaging performance and characteristics of DAVs and its associated lesions in different MR sequences were analyzed.Results In all of the 38 cases,3 cases were multiple DVAs without associated lesions,1 case was combined right lateral ventricle hemorhage,1 case was combined with multiple cavernous hemangioma,8 cases were single DVAs with solitary cavernous hemangioma,5 cases were combined with astrocytoma,1 case was combined with intracranial hematoma,and 19 cases were single DVAs with no comorbidity.DVAs in 16 cases showed strip or small patchy hypo-intensity lesions and 15 cases were not visible on T1WI;16 cases showed strip or small patchy hypo-intensity,5 cases showed strip or flocculent hypo-intensity and 10 cases could not seen on T2WI;19 cases showed patchy or strip hypo-intensity and 8 cases showed iso intensive signal on DWI;8 of the 10 cases who performed susceptibility weighted imaging (SWI) examination showed dendritic low signal,showing a typical caput medusae sign,2 cases showed no lesions on SWI;30 cases underwent 3D-T1WI enhanced scan showed clearly all lesions of DAVs,19 cases of them showed typical caput medusae sign and large draining veins.Conclusion Routine MR sequence can demonstrate part of the DVAs and associated peripheral lesions,DWI showed lesions of DAVs is superior to routine MR sequence,SWI and enhanced 3D-T1WI can accurately diagnose DVAs and show the venous drainage.
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Objective To detect the expressions of hTERT and MMP-7 mRNA in the peripheral blood of patients with colorectal cancer and their correlation,and discuss the clinical significance of peripheral blood micro-metastasis.Methods Total RNA was extracted from blood samples by TRIzol and was reverse transcribed into cDNA.The mRNA expressions of MMP-7 and hTERT were detected by real-time PCR.Results Positive mRNA expression of hTERT was found in 63 of 181 patients with colorectal cancer,while positive mRNA expression of MMP-7 was seen in 61 cases.The positive rates of hTERT and MMP-7 mRNA had no significant differences in the patients' sex and age (P > 0.05).The positive rate of MMP-7 mRNA in the patients with poorly differentiated adenocarcinoma (43.9 %) was higher than that in the patients with moderately and well differentiated adenocarcinoma (27.8 %) (x2 =4.873,P < 0.05).The positive rate of HTERT mRNA in the patients with stage Ⅲ-Ⅳ (42.5 %) was higher than that in the patients with stage Ⅰ-Ⅱ (24.0 %) (x2 =6.591,P < 0.05).The positive rate of MMP-7 mRNA in the patients with stage Ⅲ-Ⅳ (39.6 %) was higher than that in the patients with stage Ⅰ-1Ⅱ (25.3 %) (x2 =4.014,P < 0.05).The positive rate of hTERT mRNA in the patients with distant metastasis (53.3 %) was higher than that in the patients without distant metastasis (28.7 %) (x2 =9.059,P < 0.05).The positive rate of MMP-7 mRNA in the patients with distant metastasis(46.7 %) was higher than that in the patients without distant metastasis (29.4 %) (x2 =4.506,P < 0.05).The positive rate of hTERT mRNA in the patients with positive CEA expression (52.6 %) was significantly higher than that in the patients with negative CEA expression (30.1%) (x2 =6.735,P < 0.05).The positive rate of MMP-7mRNA in the patients with positive CEA expression (60.5 %) was significantly higher than those in the patients with negative CEA expression (26.6 %) (x2 =15.490,P < 0.05).In the patients without distant metastasis,any of hTERT and MMP-7 mRNA expression was thought to be blood micro-metastasis.The recurrence and metastasis rates after 6 months in the patients with blood micrometastasis (36.58 %) were higher than those in the patients without blood micro-metastasis (7.14 %)(x2 =13.027,P < 0.05).The recurrence and metastasis rates after 12-month follow-up in the patients with blood micro-metastasis (68.29 %) were higher than those in the patients without blood micro-metastasis (12.5 %) (x2 =31.948,P < 0.01).The sensitivity of combined detection was 80.00 %,and the specificity was 79.03 % after 12-month follow-up.Spearman correlation analysis revealed that significant positive correlation existed between hTERT and MMP-7mRNA expression (r =0.341,P =0.000).Conclusion Detection of hTERT and MMP-7 mRNA expression can be used as reliable markers to predict peripheral blood micrometastasis in colorectal cancer patients.
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Objective To explore the value of color Doppler ultrasound detection renal interlobar arterial hemodynamic parameters for early diagnosis in patients with chronic kidney disease(CKD).MethodsSeventy-eight patients with CKD were undergone interlobar arterial hemodynamic parameters detection and 65 normal persons served as the control.The peak systolic velocity (PSV),end-diastolic velocity (EDV),pulsatility index(PI),resistive index (RI) of interlobar arterial and serum cystatin C (SCysC) were measured.The variation of RI and the correlation of renal interlobar arterial RI and pathological findings in early CKD was analyzed.Results In 40 CKD cases with normal SCysC(group A),the PSV,EDV,PI,RI of renal interlobar arterial were not statistically significant (P>0.05).In 38 CKD cases with increased SCysC(group B),the RI of renal interlobar arterial were higher than those of group A and control group (P<0.05),and the PSV and EDV were lower than those of group A and control group (P<0.05).In cases of CKD with normal RI,the disease limited to the glomeruli;while the RI increased,the disease locate in the tubulointerstitial compartment.Conclusions Interlobar arterial RI united SCysC is a sensitive indicator in assessing early injury of chronic kidney disease.
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Objective To discuss the diagnostic value of high frequency ultrasound on lesions of knee traumas.Methods Ninty-eight cases with post-traumatic knee injuries were examined by high frequency ultrasound,and the characteristics of changing ultrasonogram were observed and comparing with surgical results and MR.Results Of the 98 cases with post-traumatic knee injuries,there were 57 cases with effusion and hematocele in knee joint,among which there were 41 cases with collateral ligaments and meniscus injuries,the diagnostic coincidence rate was 93.3% in tendon tear and complete tendon fracture(compared with MR),91.7% in partial and complete muscle tear(compared with MR),67.7% and 71.4% in collateral ligaments and meniscus injuries(compared with surgical results).Conclusions High frequency ultrasound can be used as a conventional imaging examination method for post-traumatic knee injuries.
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Objective To investigate the cultivation, biochemical features and drug susceptibilities of Vibrio vulnificus. Methods Three strains of Vibrio vulnificus were isolated from fatal patients in the Second Hospital of Jiaxing, Zhejiang province. Cultivation, identification and antibacterial susceptibility test were performed. Results Vibrio vulnificus grew on blood agar as dull-gray, opaque colonies with β-hemolysis. The organism presented positive in lactose, cellobiose fermentation and O/129 (10 μg) tests, but lack of inositol and rhamnus. The antibacterial susceptibility tests showed that Vibrio vulnificus strains were sensitive to ciprofloxacin, levofloxacin, imipenem, cefepime, ceftazidime, ceftriaxone, compound sulfamethoxazole and nitrofurantoin, however, resistant to gentamicin, tobramycin, aztreonam and cefazolin. Conclusions Vibrio vulnificus can be isolated from blood, bubbles fluid, and stool. Rapid identification, early diagnosis, and prompt empirical antibacterial therapy are important for reducing the mortality.
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Objective To evaluate the effects of femoral artery wall thickness, stillness and ankle brachium index(ABI) on clinical manifestation of peripheral vascular disease(PVD) in type 2 diabetes mellitus. Methods According to the presence of lower limb and reduced ABI (ABI<0.9), 151 patients with type 2 diabetes were divided into group of patients with and without PVD symptoms, and group of patients with and without reduced ABI. Intima-media thickness of femoral artery (FA-IMT) and stiffness of femoral artery (FA-β) were measured by ultrasound. FA-IMA and FA-β of femoral arteries were compared between group of patients with and without PVD symptoms as well as between group of patients with and without reduced ABI. Correlation between FA-IMT and FA-β was analyzed. Factors affecting symptoms of lower limb and ABI were evaluated by multiple logistic regression analysis. Results FA-IMT and FA-β in group of PVD symptoms were higher than those in group without PVD symptoms. Similarly, patients with reduced ABI had greater FA-IMT and FA-β than those without. However,there was no correlation between FA-IMT and FA-β in group of PVD symptoms. Multiple logistic regression analysis indicated that the presence of PVD symptoms was associated closely with increased FA-β, whereas reduced ABI was associated closely with FA-IMT. Conclusions The stiffening of arterial wall has a significant impact on PVD manifestations,particularly on the leg symptoms in patients with type 2 diabetes.