Characteristics of apolipoprotein E genotype and cognitive impairment in patients with cerebral microbleeds and positive β amyloid / 中华老年医学杂志

Objective:To analyze the characteristics of the apolipoprotein E(Apo E)genotype and cognitive impairment in patients with cerebral microbleeds(CMBs)and positive β-amyloid(Aβ)by using [18F]-AV45 positron emission tomography(PET).Methods:From September 2015 to May 2018, 152 patients with cognitive impairment and CMBs on the susceptibility-weighted imaging(SWI)sequence of head MRI at the neurology department of our hospital, assessed by mini-mental status examination(MMSE)score ≤26 and Montreal cognitive assessment(MoCA)≤25, were consecutively recruited in this retrospective study.After assessment with the inclusion and exclusion criteria, 69 patients aged 68.8±9.3 years were considered eligible for further analysis.Patients were divided into the Aβ-positive group(Aβ + Group, n=37)and the Aβ-negative group(Aβ -Group, n=32)after cognitive assessment, ApoE genotyping and [18F]-AV45 PET examination.Twenty-one healthy elderly controls(HC Group)who took health examination during the same period were enrolled.The results of cognitive assessment and Apo E genotyping were compared between the three groups. Results:The positive rate of the ApoE ε4 allele was 35.6%(32/90), 56.8%(21/37), 18.8%(6/32), and 23.9%(5/21)in the Aβ + , Aβ -and HC groups, respectively, with statistical significant differences between the groups( χ2=12.467, P<0.01). There were significant differences in the positive rate of the ApoE ε4 allele between the Aβ + and HC groups and between the Aβ + and Aβ -groups( χ2=5.880 and 10.407, P<0.05 and P<0.01). The percentage of patients with deep cerebral microbleeds was higher(56.3% or 18/32 vs.8.1% or 3/37, χ2=18.784, P<0.01)and of patients with lobar hemorrhage was lower(12.5% or 4/32 vs.45.9% or 17/37, χ2=9.066, P<0.01)in the Aβ -group than in the Aβ + group, while there was no significant difference in the percentage of patients with mixed cerebral microbleeds between the Aβ -and Aβ + groups( χ2=1.556, P>0.05). There were significant differences in cognitive function between the Aβ + and HC groups, in memory, executive function, visuospatial ability and language between the Aβ + and Aβ -groups, and in executive function, visuospatial ability and attention between the Aβ -and HC groups. Conclusions:Cognitive impairment is more extensive and severe in CMBs patients with Aβ deposition and is associated with positive ApoE ε4.

Demand for health care service and associated factors in rural children under 7 years old of Ningxia / 中国学校卫生

Objective@#This paper aims to understand demands for health care service demand and associated factors among children under 7 years old in rural areas of Ningxia,and to provide the statistical support for changing the hygiene resources mode and public hygiene admistration.@*Methods@#Data of 12 887 children selected from Rural Residents Family Health Survey in five counties of Ningxia (Haiyuan, Yanchi, Tongxin, Pengyang and Xiji) in 2009, 2011, 2012 and 2015 were collected. Demand for health care service and associated factors of children under 7 years old were analyzed through univariate analysis and multivariate Logistic regression in SPSS 23.0.@*Results@#Demand for health care services among children under 7 years old in rural areas of Ningxia was relatively high. Univariate analysis showed that children with different distances from medical institutions, family size and family income status showed significantly different rates of two-week sickness visits(χ2=6.56,6.81,29.52,P<0.05). Multivariate Logistic regression analysis showed that children with older age, large family population, low level of family income and long-term parental employment outside the home may be the risk factors for children under 7 years of age to see a doctor(P<0.05).@*Conclusion@#Physical accessibility,family income and parental employment outside the home for a long period are the main factors affecting demand for health care services for children in this area,the government should continue to improve the conditions of primary health facilities, adjust macro health policies, and promote the good and rapid development of child health in this area.

Diagnostic value of 18F-AV45 positron emission tomography for cerebral microbleeds of different regions / 中华老年医学杂志

Objective To analyze the relationship of cerebral microbleeds (CMBs)of different regions,especially mixed-CMBs,with cerebral amyloid angiopathy (CAA)detected using 18F-AV45 positron emission tomography(PET).Methods A total of 52 consecutive patients (68.17 ± 9.89 years old)with memory decline and CMBs found in susceptibility-weighted images(SWI)according to the inclusive and exclusive criteria were recruited.Patients were divided into three groups based on different regions of CMBs,the strictly lobar CMBs (SL-CMBs) group,the deep-CMBs (D-CMBs) group and the mixed-CMBs (M-CMBs)group.Patients in the three groups underwent 18F-AV45 PET detection and then were analyzed based on the results of 18F-AV45 PET.Results The positive rates of cerebral amyloid angiopathy in the SL-CMBs,M-CMBs and D-CMBs groups were 68.4 ％ (13/19),82.4 ％ (14/17) and 25.0 ％ (4/16),respectively,with statistical significance (P =0.002).There were significant differences in positive rates of cerebral amyloid angiopathy between the D-CMBs group and the M-CMBs group and between the D-CMBs group and the SL-CMBs group(P =0.001 and 0.010,respectively),while there was no difference between the M-CMBs and SL-CMBs groups in positive rates of cerebral amyloid angiopathy(P =0.335).Using the D-CMBs group as the reference group,multivariate logistic regression analysis showed that the odds ratios of positive CCA detected by PET in SL-CMBs and M-CMBs were 30.585(95％CI:2.492-375.360)and 8.107(95％CI:1.072-61.295),respectively.Conclusions Compared with D-CMBs,M-CMBs and SL-CMBs are more likely to be related to cerebral amyloid angiopathy.The presence of M-CMBs also indicates that patients have a high probability of CAA.

Progress on the relationship between preeclampsia and long-term cardiovascular disease among women / 中国综合临床

Preeclampsia(PE) is a unique disease to pregnancy women,and women who had a history of preeclampsia significantly increased the risk of cardiovascular disease.Preeclampsia etiology and pathogenesis is not clear yet,it may have common pathophysiology with cardiovascular disease(CVD),such as oxidative stress,endothelial injury,insulin resistance,lipid metabolic disorder and so on.The article reviewed the relationship between preeclampsia and long-term cardiovascular disease among women,especially discussed the disease such as coronary heart disease,hypertension and stroke,to find the association and to explore the potential risk management options for these high-risk women.To block,intervene,and prevent cardiovascular disease starting with preeclampsia,it is of significance to the cardiovascular health of over 300 million women worldwide.

Status quo of medical application software for chronic diseases management and its prospect / 中华医学图书情报杂志

Objective To analyze and assess the major functions of medical APP by investigating its application in self management of chronic diseases. Methods The 3 major functions of APP were analyzed, including data record and condition assessment, medical consultation, and life therapy. Results The medical APP possesses its basic functions for chronic diseases management. However, it lacks of practicality and convenience and its homogenization is severe. Conclusion The APP +hardware +cloud medical management model should be promoted by making use of the Internet + medical technology, the supervision of mobile medical APP should be strengthened, the mobile information management mechanisms of chronic diseases should be perfected, and the self management efficiency of patients with chronic diseases should be improved.

Pathological changes of vascular tissue after rabbit limb replantation with different methods of cryopreservation / 中国组织工程研究

BACKGROUND:The cryopreservation of single tissue has achieved great advancement and is gradual y applied in clinics. However, the cryopreservation of complex tissue is rarely reported. OBJECTIVE:To investigate the morphological change in rabbit limb tissue after replantation through different rewarming methods, find the best rewarming methods of compound textured blood vessels, and provide theoretical basis for the feasibility of limb replantation after long-term cryopreservation. METHODS:Thirty New Zealand white rabbits were randomly divided into control group, slow freezing-slow thawing group, and slow freezing-rapid thawing group. The right posterior limbs of al the rabbits were cut off 1 cm above the knee joint. Except control group, the latter two groups were given limb replantation after thawing, and then the right posterior limb was again cut off after the replanted limbs were survived for 6 hours. For al groups, the histological changes and gross observation in aorta tissue were observed by light microscopy and transmission electron microscope, and the results were analyzed with statistical methods. RESULTS AND CONCLUSION:In the slow freezing-slow thawing, slow freezing-rapid thawing groups, the pathological changes (gross specimen, light microscope, electron microscope) of rabbit limbs 6 hours after replantation were worse than those in control group. Compared with slow freezing-rapid thawing group, better integrity of endothelial cells and less damage of the organel es were found in slow freezing-slow thawing group. Through deep cryogenic freezing-thawing process, rabbit limb blood vessels can maintain the structural integrity after replantation and survived at 6 hours. Slow freezing-slow thawing is better than slow freezing-rapid thawing for the preservation of severed limbs, providing evidences for the long-term survival fol owing a deep cry ogenic treatment after the severed limb replantation.

Correlation between stenosis or occlusion of vertebral-basilar artery and the location of infarctions in pontine / 中华神经科杂志

Objective To investigate the correlation between stenosis or occlusion of vertebralbasilar artery and the location of infarctions in pontine. Methods All 139 patients with acute pontine infarction who were admitted to the Department of Neurology,Xuanwu Hospital,Beijing,during February,2005 and September,2007 were studied. All patients received the examinations of head MRI and digital subtraction angiography (DSA). Patients with possible cardiac embolism were excluded from the study. All the cases were then divided into four groups: A( paracentral artery group); B (short rotary artery group); C (long rotary artery group) and D (combined group). Results In all 139 cases,78 cases (56. 1% ) were in A group,3 (2. 2% ) in B group,7 (5.0%) in C group and 51 (36.7%) in D group. Fifty-six cases (40. 3% ) have occlusion in vertebral artery,60 cases (43.2%) have stenosis of vertebral artery. Cases having stenosis or occlusion in basilar artery are 14 cases (10. 1% ) each. Sixteen cases (11.5%) have unimpaired vertebral-basilar artery. A group is related to occlusion of vertebral artery and basilar artery and unimpaired artery ( x2 =3. 945,6. 824,4. 485 ,P = 0. 043,0. 021,0. 041 respectively). D group is related to occlusion of basilar artery ( x2 = 10. 952,P = 0. 006). Logistic binary analysis found that A group is more related with occlusion of vertebral artery ( OR = 2. 261 ),while D group is more related to occlusion of basilar artery ( OR = 15. 750). Conclusions There is a significant correlation between stenosis or occlusion of vertebral-basilar artery and the locations of infarctions in pontine. The physicians are suggested to perform the examinations on cerebral vessels such as brain MRI or DSA in patients with infarctions in pontine.