[Effects of left heart function changes on cerebral small vessel diseases and its cognitive impairment].

Objective: To explore the correlation of left heart function changes with cognitive impairment in patients with cerebral small vessel diseases (CSVD). Methods: From February 2012 to June 2018, 199 CSVD patients admitted to the Department of Neurology of the First Affiliated Hospital of Anhui Medical University were enrolled as CSVD group. A total of 103 healthy elderly persons without cognition disorders were included as normal control group (NC group). According to the diagnostic criteria, CSVD patients were divided into 112 CSVD patients with vascular cognitive impairment (CSVD-VCI group) and 87 CSVD patients without cognitive impairment (CSVD-NCI group). Neuroimaging markers of CSVD (including lacunar infarction and white matter hyperintensity) were assessed through brain MRI. Cognitive function was evaluated by The Mini-Mental State Examination (MMSE), the Cambridge Cognitive Examination-Chinese Version (CAMCOG-C), etc. Routine echocardiography was performed to evaluate left ventricular ejection fraction (LVEF), left atrial diameter (LAD) and other parameters. Results: Compared with NC group, the LVEF level was significantly decreased in CSVD group [(65±5)% and (63±6)%, respectively] (P=0.007), while LAD level was significantly increased in CSVD group (P=0.024). The LVEF level of CSVD-VCI group [(62±6)%] was significantly lower than that of CSVD-NCI group [(64±5)%] (P=0.02). Correlation analysis revealed MMSE and CAMCOG-C scores in CSVD group were positively correlated with LVEF level (r=0.210, P=0.003; r=0.238, P=0.001). Logistic regression analysis revealed that declined LVEF was an independent risk factor associated with CSVD (OR=0.937, 95%CI 0.890-0.986) and CSVD-VCI (OR=0.900, 95%CI 0.829-0.977). Conclusions: Left heart function changes play important roles in the occurrence of CSVD and severity of its cognitive impairment. The declined LVEF may represent an independent risk factor for CSVD and its cognitive impairment.

[Efficiency of integrin αvß3 inhibitor Cilengitide in acute cerebral ischemia in rats].

OBJECTIVE: To explore the effect of the integrin αvß3 inhibitor Cilengitide on the blood brain barrier (BBB) permeability, brain edema, neuronal cell apoptosis and the relation with the vascular endothelial growth factor (VEGF)expression in acute cerebral ischemia rats. METHODS: A rat focal cerebral ischemia/reperfusion model was established by middle cerebral artery occlusion. Rats with middle cerebral artery occlusion, in accordance with the random number table, were divided into four groups: (1) the rats in Cilengitide group A (n=30) were treated with Cilengitide at a dose of 100 µg/kg; (2) the rats in Cilengitide group B (n=28) were treated with Cilengitide at a dose of 200 µg/kg; (3) the rats in sham group (n=31), without inserting thread into middle cerebral artery, were treated with normal saline; (4) the rats in control group (n=27) were treated with normal saline.All rats were treated with Cilengitide or saline 1 hour after infarction, given reperfusion 2 hours after infarction and were sacrificed 22 hours after reperfusion.The brain-water content was measured by dry/wet weight method. The permeability of BBB was measured by quantifying Evans Blue. The infarction volume was measured by 2, 3, 5-tripheyl tetrazolium Chloride (TTC) staining. Expression level of VEGF, P-Flk, Cleaved-Caspase-3 was measured by immunohistochemistry and Western blot, respectively.The neuronal cell apoptosis was evaluated by terminal deoxynucleotidyl transferased UTP nick end labeling (TUNEL). RESULTS: Compared with Control group, treatment groups with cilengitide at the dose of 100 µg/kg and 200 µg/kg reduced brain-water content [(80.8±1.1)% vs (84.8±1.4)%, (81.0±1.4)% vs (84.8±1.4)%, P<0.05], reduced exudation of Evans blue[(9.2±1.1) µg/g vs (12.2±0.8) µg/g, (8.6±0.6) µg/g vs (12.2±0.8) g/g, P<0.05], reduced infarction volume[(31.9±4.9) mm(3) vs(43.0±2.2) mm(3), (29.2±3.5) mm(3) vs(43.0±2.2) mm(3), P<0.05] , reduced neuronal cell apoptosis [(36±4)vs(69±6)、(35±3)vs (69±6), P<0.05]. Compared with sham group, Cilengitide group A and Cilengitide group B had lower brain-water content, permeability of BBB, infarction volume, expression level of VEGF, P-Flk, Cleaved-Caspase-3 and neuronal cell apoptosis (P<0.05). When Cilengitide group A was compared with Cilengitide group B, there were no significant differences in brain-water content, permeability of BBB, infarction volume, expression level of VEGF, P-Flk, Cleaved-Caspase-3 and neuronal cell apoptosis (P>0.05). CONCLUSION: The integrin αvß3 inhibitor Cilengitide improves outcomes in the MCAO model by preserving the blood-brain barrier, attenuating brain edema and inhibiting neuronal cell apoptosis, which may occur in a VEGF-and VEGF-receptor-dependent manner, with the same efficacy between Cilengitide 100 µg/kg and 200 µg/kg after 23 hours treatment.

[Effect of brain atrophy on the cognition in patients with subcortical ischemic vascular disease].

OBJECTIVE: To explore the effect of brain atrophy on the cognition in patients with subcortical ischemic vascular disease (SIVD). METHODS: A total of 116 SIVD patients were enrolled from the Department of Neurology, First Affiliated Hospital, Anhui Medical University between September 2013 and December 2014. Lobar atrophy, leukoaraiosis (LA), lacunar infarcts (LI) and vascular risk factors were analyzed in the 116 SIVD patients who were divided into three groups according to the diagnostic criteria: non-cognitive impairment group (SIVD-NCI) , mild cognitive impairment group (SIVD-MCI) and dement group (SIVD-VaD). All patients underwent magnetic resonance imaging (MRI) with a 3.0-T system. The cognitive functions were evaluated by mini-metal state examination (MMSE), the Cambridge cognitive examination-Chinese version (CAMCOG-C), etc. A widely used visual atrophy rating method (0 to 3) was adopted to rate the severity of frontal, parietal and temporal lobe atrophy. The degree of LA and the numbers of LI in 4 brain regions (frontal, parieto-occipital, temporal, and basal ganglia) were evaluated meanwhile. RESULTS: Firstly, both the SIVD-MCI and SIVD-VaD groups showed significantly higher total scores of atrophy, higher frontal lobe atrophy scores, higher LA scores and larger LI numbers than SIVD-NCI (H=6.138, P=0.013; H=45.845, P=0.000; H=36.818, P=0.000; H=37.46, P=0.000). There were no significant differences in temporal lobe atrophy scores between SIVD-NCI group and SIVD-MCI group. Parietal lobe atrophy scores also showed no differences among the three groups. Secondly, as well as total numbers of LI, total scores of atrophy and LA were negatively correlated with SIVD cognition, especially frontal lobe atrophy scores, parieto-occipital LA scores and basal ganglia LI numbers had a remarkable negative correlation with MMSE scores, CAMCOG-C scores and partial subitems in CAMCOG-C scores (P<0.005). However temporal LI numbers was absence of correlation with MMSE scores, CAMCOG-C scores and subitems in CAMCOG-C scores (P>0.005). Thirdly, education (OR= 0.787, P=0.009), total scores of LA (OR= 1.201, P=0.036) and total numbers of LI (OR= 1.221, P=0.011) remained to be associated with cognition after controlling for sex, age, education, hypertension, diabetes, smoking. While, after adjusting atrophy scores, total scores of LA had no significant association with cognition. Atrophy scores, total numbers of LI and education still showed significant association with cognition, particularly frontal lobe atrophy scores (OR= 16.082, P=0.000), but not temporal and parietal lobe atrophy scores. CONCLUSIONS: Brain atrophy may be a new and independent predictive index of cognitive impairment in SIVD. Further, the effect of brain atrophy, the numbers of LI and degree of LA on cognitive decline is independent and decreases in turn.

Evaluation of organic contamination in urban groundwater surrounding a municipal landfill, Zhoukou, China.

This paper investigates the organic pollution status of shallow aquifer sediments and groundwater around Zhoukou landfill. Chlorinated aliphatic hydrocarbons, monocylic aromatic hydrocarbons, halogenated aromatic hydrocarbons, organochlorine pesticides and other pesticides, and polycyclic aromatic hydrocarbons (PAHs) have been detected in some water samples. Among the detected eleven PAHs, phenanthrene, fluorine, and fluoranthene are the three dominant in most of the groundwater samples. Analysis of groundwater samples around the landfill revealed concentrations of PAHs ranging from not detected to 2.19 µg/L. The results show that sediments below the waste dump were low in pollution, and the shallow aquifer, at a depth of 18-30 m, was heavily contaminated, particularly during the wet season. An oval-shaped pollution halo has formed, spanning 3 km from west to east and 2 km from south to north, and mainly occurs in groundwater depths of 2-4 m. For PAH source identification, both diagnostic ratios of selected PAHs and principal component analysis were studied, suggesting mixed sources of pyro- and petrogenic derived PAHs in the Zhoukou landfill. Groundwater table fluctuations play an important role in the distribution of organic pollutants within the shallow aquifer. A conceptual model of leachate migration in the Quaternary aquifers surrounding the Zhoukou landfill has been developed to describe the contamination processes based on the major contaminant (PAHs). The groundwater zone contaminated by leachate has been identified surrounding the landfill.

[Effects of replenishing kidney herbs on estrogen and 1,25-dihydroxyvitamin D3 of dexamethasone-induced rats model with osteoporosis].

Estrogen and 1,25-(OH)2-D3 change in rats with osteoporosis induced by dexamethasone (DXM) was observed. The calcium and replenishing Kidney Herbs (RKH) was used in treating osteoporosis. The results shown: The level of estrogen and 1,25-(OH)2-D3 in rats with osteoporosis was lower than that of the normal. Calcium and RKH were effective in treating osteoporosis and they could recover the level of estrogen and 1,25-(OH)2-D3 to normal state, the effect of RKH was better than that of calcium. There was positive correlation between the level of estrogen and 1,25-(OH)2-D3. The treatment of RKH might be an optimal method for osteoporotic treatment.