Analysis of the relationship between blood pressure variability and subtle cognitive decline in older adults.

BACKGROUND: Blood pressure variability (BPV) has been shown to be related to mild cognitive impairment and Alzheimer's disease in a number of studies. However, the relationship between BPV and subtle cognitive decline (SCD) has received minimal attention in this field of research to date and has rarely been reported. AIM: To examine whether SCD is independently associated with changes in BPV in older adults. METHODS: Participants were selected based on having participated in cognitive function evaluation and ambulatory blood pressure measurement at the Shanghai Sixth People's Hospital Affiliated with Shanghai Jiao Tong University School of Medicine between June 2020 and August 2022. The participants included 182 individuals with SCD as the experimental group and 237 with normal cognitive function as the control group. The basic data, laboratory examinations, scale tests, and ambulatory blood pressure test results of the two groups were analyzed retrospectively, and the relationship between SCD and BPV was subsequently evaluated. RESULTS: Significant differences were observed between the two groups of participants (P < 0.05) in terms of age, education level, prevalence rate of diabetes, fasting blood glucose level, 24-h systolic blood pressure standard deviation and coefficient of variation, 24-h diastolic blood pressure standard deviation and coefficient of variation. The scale monitoring results showed significant differences in the scores for memory, attention, and visual space between the experimental and control groups. Logistic regression analysis indicated that age, education level, blood sugar level, and BPV were factors influencing cognitive decline. Linear regression analysis showed that there was an independent correlation between blood pressure variation and SCD, even after adjusting for related factors. Each of the above differences was still significant. CONCLUSION: This study suggests that increased BPV is associated with SCD.

Correlation between ankle-brachial index and subtle cognitive decline.

BACKGROUND: Subtle cognitive decline (SCD) is considered the early stage of Alzheimer's disease (AD) and is of great clinical significance for the prevention and treatment of AD. The ankle-brachial index (ABI) has been reported to be associated with cognitive impairment; however, there are few studies on the relationship between ABI and SCD. METHODS: From August 2019 to April 2021, subjects were recruited to participate in a cognitive function test at the Shanghai Sixth People's Hospital. Based on the test results, 217 patients with SCD were selected as the experimental group and 259 patients with normal cognitive function were selected as the control group. The data of the two groups were compared, and the correlation between the ABI and cognitive decline was analyzed. RESULTS: There were significant differences in age, sex, smoking status, hypertension, diabetes, triglycerides, serum creatinine, and ABI (p < .05)between the two groups. Logistic regression analysis showed that age, hypertension, diabetes, and ABI influenced cognitive decline(p < .05). After correcting for other factors, ABI was independently related to cognitive decline. Pearson's correlation analysis showed that a low ABI (<0.9) had a significant effect on memory and visual space of the cognitive domain (p < . 05). CONCLUSIONS: ABI is significantly associated with SCD and may be a critical tool to predict early cognitive decline.

[Association between uroguanylin G-247A polymorphism and blood pressure/fluid and electrolytes homeostasis].

OBJECTIVE: To observe the association between uroguanylin G-247A polymorphism and blood pressure/fluid and electrolytes homeostasis. METHODS: Uroguanylin genotype was determined by restrictive fragment length polymorphism (RFLP) and blood pressure as well as fluid and electrolytes homeostasis were measured in 442 volunteers from Jing Ning County, ZheJiang Province. Data were analyzed by ANOVA, Generalized Estimating Equations (GEE), and Quantitative Transmission Disequilibrium Test (QTDT). RESULTS: Ten uroguanylin gene polymorphisms were detected in 40 subjects by direct sequencing, all were reported in the NCBI SNP database. We selected the G-247A polymorphism for genotyping. Compared with G allele carriers, AA homozygotes had a higher urinary volume (P = 0.08), higher excretions of sodium (P = 0.07) and potassium (P < 0.001), but similar systolic and diastolic blood pressure (P > 0.32) both before and after adjustment for sex, age, body-mass index, current smoking, alcohol intake, and antihypertensive treatment. CONCLUSIONS: The uroguanylin G-247A polymorphism was associated with urinary volume and sodium and potassium excretions.

Ambulatory arterial stiffness index derived from 24-hour ambulatory blood pressure monitoring.

We hypothesized that 1 minus the slope of diastolic on systolic pressure during 24-hour ambulatory monitoring (ambulatory arterial stiffness index [AASI]) might reflect arterial stiffness. We compared AASI with established measures of arterial stiffness and studied its distribution in Chinese and European populations. We used 90207 SpaceLabs monitors and the SphygmoCor device to measure AASI, central and peripheral pulse pressures, the central (CAIx) and peripheral (PAIx) systolic augmentation indexes, and aortic pulse wave velocity. In 166 volunteers, the correlation coefficient between AASI and pulse wave velocity was 0.51 (P<0.0001). In 348 randomly recruited Chinese subjects, AASI correlated (P<0.0001) with CAIx (r=0.48), PAIx (r=0.50), and central pulse pressure (r=0.50). AASI increased with age and mean arterial pressure but decreased with body height. Both before and after adjustment for arterial wave reflections by considering height and heart rate as covariates, AASI correlated more (P<0.0001) closely with CAIx and PAIx than 24-hour pulse pressure. Among normotensive subjects, the 95th percentile of AASI was 0.55 in Chinese and 0.57 in 1617 Europeans enrolled in the International Database on Ambulatory Blood Pressure Monitoring. The upper boundary of the 95% prediction interval of AASI in relation to age ranged from 0.53 at 20 years to 0.72 at 80 years. In conclusion, AASI is a new index of arterial stiffness that can be easily measured under ambulatory conditions. Pending additional validation in outcome studies, normal values of AASI are probably <0.50 and 0.70 in young and older subjects, respectively.

[The relationship between quantitative ultrasound and osteoporosis self-assessment tool for Asians (OSTA) score and non-vertebral fracture in postmenopausal Chinese women].

OBJECTIVE: To assess a simple and non-invasive scoring system, osteoporosis self-assessment tool for Asians (OSTA) and quantitative ultrasound (QUS) measurement to identify Chinese postmenopausal women with non-vertebral fracture. METHODS: Data came from 513 healthy women. Speed of sound (SOS) of the radius, phalanx and tibia was assessed using the instrument of Omniscience (Sunlight Ltd. Israel). Body height and weight were measured. Body mass index and OSTA were calculated. Self-reported fractures were identified using a structured questionnaire. RESULTS: SOS of radius was significantly lower in women with non-vertebral fracture than those without. SOS of phalanx was significantly lower in women with a history of postmenopausal non-vertebral fracture than those without. Using cut-offs of OSTA -4 and -1 to categorize osteoporosis risk, SOS of radius, phalanx and tibia decreased with increasing risk, while the prevalence of non-vertebral fracture increased. OSTA values of

[Association of peripheral and central blood pressure with the alpha-adducin Gly460Trp polymorphism in a Chinese population].

OBJECTIVE: To investigate the association of peripheral and central blood pressure with the alpha-adducin Gly460Trp polymorphism in Chinese. METHODS: We randomly selected 6 villages from JingNing County, ZheJiang Province. We invited nuclear families to take part in our study. We measured each participant's blood pressure at the non-dominant arm by means of a standard mercury sphygmomanometer at subjects' homes. Five consecutive readings were averaged for analysis. Central blood pressures were obtained by use of SphigmoCor pulse wave analysis system. The observers administered a standardized questionnaire to collect information on smoking habits, alcohol consumption and use of antihypertensive drugs. Venous blood was sampled and the adducin genotype was determined by restrictive fragment length polymorphism (RFLP). RESULTS: Four hundred and forty-two subjects included 230 (52.0%) women, and 116 (26.2%) hypertensive patients, of whom 49 (11.1%) took antihypertensive drugs. The frequencies of alpha -adducin GlyGly, GlyTrp and TrpTrp genotypes were 21.3%, 54.5% and 24.2%, respectively. There was no association between the alpha-adducin Gly460Trp polymorphism and peripheral systolic and diastolic blood pressure and pulse pressure. However, both before and after adjustment for sex, age, age(2), body-mass index, current smoking, alcohol intake, and antihypertensive treatment, the alpha-adducin polymorphism was significantly (P < 0.02) associated with central systolic blood pressure and central pulse pressure. After adjustment, central systolic blood pressure (+/- SE) averaged 122.5 +/- 3.5, 114.1 +/- 1.5 and 109.1 +/- 1.8 mm Hg (P = 0.01) in the GlyGly, GlyTrp and TrpTrp subjects, respectively. The corresponding values for central pulse pressure were 39.4 +/- 1.3, 36.4 +/- 1.0 and 32.9 +/- 0.9 mm Hg (P = 0.002), respectively. CONCLUSIONS: In the JingNing population, the adducin 460Trp allele was associated with lower levels of central systolic pressure and pulse pressure.

Protective effect of ulinastatin on acute lung injury induced by orthotopic liver transplantation / 中华器官移植杂志

Objective To evaluate the effects of ulinastatin on acute lung injury during ortho- topic liver transplantation(OLT).Methods Twenty ASAⅢ-Ⅳpatients with end-stage liver disea- ses.undergoing OLT were randomly divided into two groups.Ulinastatin group received intravenous infusion of ulinastatin(3?10~4 IU in 100 normal saline)after skin incision and every 4 h thereafter(n =10).Control group received same amount of normal saline instead of ulinastatin(n=10).Blood sam- pies were taken before skin incision,120 min after skin incision,30 min after liver was removed,5 min and 60 min after reperfusion of the graft and at the end of operation for determination of plasma IL-6, IL-8,TNF-?,MDA concentrations and SOD activity.Respiratory index(RI)[P_(A-a)DO_2/PaO_2]was cal- culated before skin incision,30 min after liver was removed,5 min and 60 min after reperfusion of the graft and at the end of operation.After anesthesia was induced,cardiac output,mixed venous oxygen saturation and central venous temperature were continuously monitored during operation.ECG,CVP, SpO_2,P_(ET)CO_2,radial artery and MPAP were also continuously monitored during operation.P_(ET)CO_2 was maintained at 35-40 mm Hg during operation.Blood temperature was maintained above 35.5℃during operation.Results In group C plasma IL-6 and IL-8 concentrations were significantly increased from 120 min after skin incision to the end of operation as compared with the baseline values(P0.05).RI was significantly lower at 60 min after reperfusion of the graft and at the end of operation in group U than in group C(P

Effect of ulinastatin on the expression of neutrophil CD_(11b)/CD_(18) in patients during orthotopic liver transplantation / 中华麻醉学杂志

Objective To investigate the effects of ulinastatin on the expression of neutrophil CD_(11b) and CD_(18) during orthotopic liver transplantation(OLT).Methods Forty patients with liver diseases,ASAⅢorⅣ, undergoing OLT were randomly divided into two groups.Ulinastatin group(n=20)received intravenous infusion of ulinastatin 3?10~5 IU in 100 ml normal saline after skin incision and repeated every 4 hours thereafter.Control group received same amount of normal saline instead(n=20).Blood samples were taken immediately before skin incision,120 min after skin incision,30 min of anhepatic phase,60 min of neohepatic phase and at the end of operation for measurement of CD_(11b) and CD_(18) expression of neutrophil by flow cytometry.Results CD_(11b)/CD_(18) expression was increased significantly in control group 60 min of neohepatic phase and at the end of operation compared to the level before skin incision,but in ulinastatin group there was no significant change in CD_(11b)/CD_(18) expression during the whole procedures(P＞0.05).CD_(11b)/CD_(18)expression was significantly lower 60 min of neohepatic phase and at the end of operation in ulinastatin group than in control group(P＜0.01).Conclusion Ulinastatin can inhibit the increase in CD_(11b)/CD_(18)expression during OLT,and be helpful for reducing the inflammatory response.