[Acupuncture and moxibustion for vascular dementia and its effect on serum VEGF and AChE].

OBJECTIVE: To observe the efficacy of Huayu Tongluo moxibustion combined with acupuncture at Jing-well points on the differentiated meridians and routine acupuncture for vascular dementia (VD) and its effect on serum levels of vascular endothelial growth factor (VEGF) and acetylcholinesterase (AChE). METHODS: A total of 60 patients with VD were randomized into an observation group (30 cases, 1 case dropped off) and a control group (30 cases, 2 cases dropped off). In the observation group, Huayu Tongluo moxibustion combined with acupuncture at Jing-well points on the differentiated meridians and routine acupuncture were adopted, Huayu Tongluo moxibustion was applied at Baihui (GV 20), Dazhui (GV 14) and Shenting (GV 24); acupuncture at Jing-well points on the differentiated meridians was applied at corresponding Jing-well points according to pattern of syndrome; routine acupuncture was applied at Baihui (GV 20), Sishencong (EX-HN 1), etc. Acupuncture and moxibustion were given once a day, 6 times a week for 4 weeks. In the control group, donepezil was prescribed for oral administration, 5 mg each time, once a day for 4 weeks. Before and after treatment, the scores of mini mental state examination (MMSE) and activities of daily living (ADL) were observed, and the serum levels of AChE and VEGF were detected in the two groups. RESULTS: Compared before treatment, the MMSE and ADL scores and serum level of VEGF were increased (P<0.05), the serum level of AChE was decreased (P<0.05) after treatment in the two groups. The MMSE and ADL scores after treatment in the observation group were higher than the control group (P<0.05). CONCLUSION: Huayu Tongluo moxibustion combined with acupuncture at Jing-well points on the differentiated meridians and routine acupuncture could improve cognitive function and activities of daily living, which may be related to the regulation of serum levels of VEGF and AChE.

Cognitive decline is related to high blood glucose levels in older Chinese adults with the ApoE ε3/ε3 genotype.

BACKGROUND: Few studies have investigated the effects of blood glucose (BG) on cognitive function in community-dwelling elderly individuals carrying the apolipoprotein E (APOE) ε3 allele. OBJECTIVE: To explore the effect of high BG levels on cognitive function in APOE ε3-carrying, non-demented, community-dwelling older adults, as compared to their counterparts carrying the APOE ε4 or APOE ε2 alleles. METHODS: Within the China Longitudinal Ageing Study, we recruited 282 elderly adults without dementia. Data collected included demographic information; psychological measures; laboratory test results, including BG and plasma lipid levels; and APOE genotypes. We divided the participants into APOE ε2(ε2/ε2, ε2/ε3), ε3(ε3/ε3), and ε4(ε3/ε4, ε4/ε4) groups. Partial correlation analyses and multivariate linear regression analyses were utilized to compare the cognitive function and laboratory data between the APOE groups. White matter hyperintensity (WMH) was measured on magnetic resonance images in 77 participants. RESULTS: With adjustment for age, sex, education, and diabetes, higher BG in non-demented community-dwelling older adults was associated with cognitive decline in immediate memory and executive function. In the APOE ε3 group, elevated BG was associated with cognitive decline in immediate memory, executive function, and perceptual reasoning. In the APOE ε4 group, higher BG was also correlated with a decline in abstract reasoning. There was a trend for association between higher BG and more severe WMHs. CONCLUSION: Worse cognitive function was correlated withApoEε3/ε3 genotype carriers with higher BG in community-dwelling older adults.

Clinicians' prescription preferences for treating patients with Alzheimer's disease in Shanghai.

BACKGROUND: China has more cases of Alzheimer's disease (AD) than any other country in the world. As training to recognize and manage dementia is in its early stage, it is important to study clinicians' current prescription preferences for treating patients with AD. METHODS: This study surveyed neurologists, psychiatrists, and general physicians (GPs) in Shanghai who had outpatients with AD, using a questionnaire asking about their prescription preferences for these patients. RESULTS: Among the 148 clinicians in the study, 26.4 % were psychiatrists, 44.6 % were neurologists, and 29.1 % were GPs. The groups did not differ significantly in age, gender, or their monthly cases of new patients with mild or moderate AD (P > 0.05). Most clinicians prescribed Cholinesterase inhibitors (ChEIs), including Huperzine A, but there were significant group-differences in prescribing specific ChEIs (P < 0.05). The daily dosages of ChEI and Memantine prescribed by all three groups were small (P > 0.05), and all three groups prescribed piracetam, ergot, and ginkgo biloba drugs. All three groups also tended to treat AD patients with a combination of antidepressants and anxiolytics, although psychiatrists were significantly more likely than neurologists to combine antipsychotics with other drugs (P < 0.05). CONCLUSION: Clinicians in Shanghai prescribed low doses of ChEIs and Memantine for patients with AD. A relatively high proportion also prescribed cognitive enhancers, which lack evidence-based support of their use, and antipsychotics. There is a need for more training about treating patients with AD and for clinicians to standardize their clinical practice.

Enhanced Diabetes Susceptibility in Community Dwelling Han Elders Carrying the Apolipoprotein E 3/3 Genotype.

Despite Apolipoprotein E (ApoE) being one of the main apolipoproteins in the blood, the association between its genotype and the high cholesterol or blood glucose levels commonly seen in clinical practice is inconclusive. Such research is also lacking in the Han population. The aim of this study was to investigate the association between APOE genotype, diabetes, and plasma glucose and lipid levels. We included 243 community-dwelling elderly residents in this study. Participant APOE genotypes were assessed and were simultaneously tested for weight, height, blood glucose, triglycerides, cholesterol, and high- and low-density lipoprotein. In addition, gender, age, years of education, cognitive function, and medical history was recorded. Subjects were divided into 3 groups based on APOE genotype: APOE ε2 group (ε2/ε2 and ε2/ε3), APOE ε3 group (ε3/ε3), and APOE ε4 group (ε2/ε4, ε3/ε4 and ε4/ε4). Comparisons between groups were conducted for the incidence of diabetes, high blood pressure, and dementia, as well as for differences in body-mass index, fasting plasma glucose, and blood lipids. The APOE ε3/ε3 genotype exhibited the highest frequency (70.4%) among the subjects. Participants in the APOE ε3 group demonstrated significantly higher levels of fasting plasma glucose than those in the APOE ε2 and APOE ε4 groups (P<0.05). The APOE ε3 group had slightly higher abnormal fasting plasma glucose values than did the APOE ε2 group (P = 0.065). Furthermore, the APOE3 genotype was significantly correlated with both fasting plasma glucose level and glucose abnormality (P< 0.05) and trended toward statistically significant correlation with diabetes (P = 0.082). The correlation between APOE2 and low low-density lipoprotein levels also approached statistical significance (P = 0.052). Thus, elderly community dwelling residents of Han ethnicity carrying the APOE ε3/ε3 genotype might have higher plasma glucose levels and a higher occurrence of diabetes.

Diversity and taxonomy of endophytes from Leymus chinensis in the Inner Mongolia steppe of China.

Epichloë species and their anamorphic relatives in genus Neotyphodium are fungal symbionts of grasses ubiquitously existing in temperate regions all over the world. To date, 13 Epichloë species and 22 Neotyphodium species have been formally described, based on morphological characters and phylogenetic analyses. Leymus chinensis (Poaceae) is a dominant grass native to the Inner Mongolia steppe of China. Previously, it was reported to harbor endophytes, but little was known about these endophytes. To investigate their diversity and taxonomy, 96 fungal isolates were obtained from three field populations of L. chinensis. The isolates were classified into three morphotypes based on morphological characters and phylogenetic analyses of sequences of genes for ß-tubulin (tubB), translation elongation factor 1-α (tefA), and actin (actG). The dominant morphotype, morphotype I, was identified as a choke disease endophyte, Epichloë bromicola. This broadened the host range and phylogenetic definition of E. bromicola.

[Brain volume changes of patients with Alzheimer's disease in two years: a case control study].

OBJECTIVE: To study the brain volume changes of patients with Alzheimer's disease (AD). METHODS: 23 patients with (AD and 23 sex, age, and educational background-matched normal controls (NC group) underwent three-dimensional MRI to measure the hippocampus, amygdala, entorhinal cortex (EC), perirhinal cortex (PC), cornu temporale, and uncus distance in the baseline survey. Two years later 10 AD patients and 11 normal controls underwent 3-D MRI once again in the follow-up survey. RESULTS: The baseline survey showed that the levels of uncus distance and total temporal horn volume of the ADS patients were 11 +/- 4 and 1.21 +/- 1.00 respectively, both significantly higher than those of the NC group (7 +/- 3 and 0.59 +/- 0.54 respectively, P < 0.01, P < 0.05), and the levels of total entorhinal cortex volume, total perirhinal cortex volume, and total hippocampus volume were 2.52 +/- 0.86, 2.19 +/- 0.62, and 3.23 +/- 0.75 respectively, all significantly lower than those of the BC group (3.67 +/- 0.54, 3.39 +/- 0.51, and 3.98 0.38, all P < 0.01). The levels of uncus distance and total temporal horn volume of the AD patients during the follow-up survey were 11 +/- 4 and 1.21 +/- 1.00 respectively, both significantly higher than those of the NC group (7 +/- 3 and 0.59 +/- 0.54 respectively, both P < 0.05); and the total entorhinal cortex volume, total perirhinal cortex volume, and total hippocampus volume of the AD patients during the followup survey were. 1.79 +/- 0.56, 1.77 +/- 0.59, and 2.80 +/- 0.80 respectively, all significantly lower than those of the NC group (2.76 +/- 0.50, 2.76 +/- 0.41, and 3.59 +/- 0.38 respectively, all P < 0.01). CONCLUSION: The AD patients have more remarkable atrophy of entorhinal cortex, perirhinal cortex, and have obvious extension of cornu temporale and uncus distance in comparison with the normal controls. The shrinkage rate of hippocampus can be used as a marker for the diagnosis and progress of AD.