Application of Periventricular White Matter Hyperintensities Combined with Homocysteine into Predicting Mild Cognitive Impairment in Parkinson's Disease.

Purpose: To verify the associations between white matter hyperintensities (WMHs), plasma homocysteine (Hcy) levels, and mild cognitive impairment (MCI) in Parkinson's disease (PD) patients and evaluate the predictive value of combination of WMHs and plasma Hcy levels for MCI. Patients and methods: In this study, 387 patients with PD were divided into MCI group and non-MCI group. Their cognition was evaluated with a comprehensive neuropsychological evaluation including 10 tests. Five cognitive domains, including the memory, attention/working memory, visuospatial, executive and language domains, were evaluated using two tests for each domain. MCI was determined when at least two tests demonstrated abnormal results, either one impaired test in two different cognitive domains or two impaired tests in a single cognitive domain. Multivariate analysis was performed to determine risk factors for MCI in PD patients. The receiver operating characteristic (ROC) curve was employed to assess the predictive values, and the Z test was employed to compare the area under curve (AUC). Results: MCI was identified in 195 PD patients with an incidence of 50.4%. Multivariate analysis results showed that PWMHs (OR: 5.162, 95% CI: 2.318~9.527), Hcy levels (OR: 1.189, 95% CI: 1.071~1.405) and MDS-UPDRS part III score (OR: 1.173, 95% CI: 1.062~1.394) were independently correlated with MCI in PD patients after adjusting for confounders. ROC curves showed that the AUCs of PWMHs, Hcy levels and their combination were 0.701 (SE: 0.026, 95% CI: 0.647~0.752), 0.688 (SE: 0.027, 95% CI: 0.635~0.742) and 0.879 (SE: 0.018, 95% CI: 0.844~0.915), respectively. Z test showed that the AUC of combination prediction was significantly higher than those of individual predictions (0.879 vs 0.701, Z=5.629, P<0.001; 0.879 vs 0.688, Z=5.886, P<0.001). Conclusion: The combination of WMHs and plasma Hcy levels could be applied in the prediction of MCI in PD patients.

Stroke incidence and cognitive outcomes of intracranial atherosclerotic stenosis: study protocol for a multicenter, prospective, observational cohort study.

Background: Intracranial atherosclerotic stenosis (ICAS) is one of the leading causes of stroke worldwide. Current diagnostic evaluations and treatments remain insufficient to assess the vulnerability of intracranial plaques and reduce the recurrence of stroke in symptomatic ICAS. On the other hand, asymptomatic ICAS is associated with an increased risk of cognitive impairment. The pathogenesis of ICAS related cognitive decline is largely unknown. The aim of SICO-ICAS study (stroke incidence and cognitive outcomes of ICAS) is to elucidate the pathophysiology of stroke and cognitive impairment in ICAS population, comprehensively evaluating the complex interactions among life-course exposure, genomic variation, vascular risk factors, cerebrovascular burden and coexisting neurodegeneration. Methods: SICO-ICAS is a multicenter, prospective, observational cohort study. We aim to recruit 3,000 patients with symptomatic or asymptomatic ICAS (>50% or occlusion) who will be followed up for ≥12 months. All participants will undergo pre-designed magnetic resonance imaging packages, blood biomarkers testing, as well as detailed cognitive domains assessment. All participants will undergo clinical visits every 6 months and telephone interviews every 3 months. The primary outcome measurement is ischemic stroke or cognitive impairment within 12 months after enrollment. Discussion: This study will establish a large prospective ICAS cohort, hopefully discover new biomarkers associated with vulnerable intracranial plaques, identify subjects at high risk for incident ischemic stroke or cognitive impairment, and eventually propose a precise diagnostic and treatment strategy for ICAS population. Trial Registration: Chinese Clinical Trials Register ChiCTR2200061938.

Value of Combination of the A2DS2 Score and IL-6 in Predicting Stroke-Associated Pneumonia.

PURPOSE: To evaluate the value of the combination of the age, atrial fibrillation, dysphagia, male sex, and National Institutes of Health Stroke Scale (A2DS2) score and serum interleukin 6 (IL-6) concentration in predicting stroke-associated pneumonia (SAP). PATIENTS AND METHODS: A total of 398 patients with acute ischemic stroke (AIS) from the medical ward was included in this retrospective study. They were divided into the SAP group and non-SAP group according to the diagnostic criteria of SAP. Multivariate analysis was performed to analyze the association between the A2DS2 score, serum IL-6 concentration, and SAP using a backward stepwise logistic regression model. The receiver operating characteristic (ROC) curve was used to evaluate the value of the A2DS2 score, serum IL-6 concentration and combination of A2DS2 score and IL-6 in predicting SAP. RESULTS: SAP was diagnosed in 70 patients (17.6%). Multivariate analysis showed that the A2DS2 score (odds ratio [OR]: 2.25, 95% confidence interval [CI]: 1.17-4.99, P=0.017) and serum IL-6 concentration (OR: 1.76, 95% CI: 1.44-1.95, P<0.001) was independently associated with SAP after adjusting for age, smoking, hypertension, hyperlipidemia, and atrial fibrillation. When the A2DS2 score, serum IL-6 concentration and combination of A2DS2 score and IL-6 were employed to predict SAP, the AUC was 0.824 (SE: 0.026, 95% CI: 0.773-0.875), 0.715 (SE: 0.034, 95% CI: 0.641-0.788) and 0.917 (SE: 0.015, 95% CI: 0.887-0.946), respectively. The AUC of combinative prediction was significantly higher than independent prediction (0.917 vs. 0.824, Z=3.098, P<0.001; 0.917 vs. 0.715, Z=5.436, P<0.001). CONCLUSION: The addition of serum IL-6 to the A2DS2 score could significantly enhance the AUC of predicting SAP in AIS patients from the medical ward.

[Inhibitory effects of saikosaponin a on rat hippocampal astrocyte activation in vitro].

OBJECTIVE: To investigate the effects of saikosaponin a (SSa) on Glu-activated hippocampal astrocytes of rats. METHODS: Neonatal rat (1-3 days) hippocampal astrocytes were obtained and divided into control group, L-Glu activation group and SSa groups with SSa treatment at 5, 2.5, and 1.25 mg/L. The cell proliferation, cell cycle changes, and expression of glial fibrillary acidic protein (GFAP) after the treatments were assessed with MTT assay, flow cytometry and Western blotting, respectively. RESULTS: In comparison with Glu-activation group, SSa treatment resulted in significant inhibition of the cell proliferation, cell division and GFAP expression in the Glu-activated astrocytes (P < 0.05). SSa at 2.5 mg/L showed the strongest inhibitory effects against astrocyte activation and maintained nearly normal level of astrocyte activation in comparison with the control group (P > 0.05). CONCLUSIONS: Glu-induced activation of rat hippocampal astrocytes can be inhibited by SSa, whose antiepileptic effects is probably mediated by inhibition of hippocampal astrocyte activation.

[An analysis of general programs in preventive medicine submitted and funded in NFSC from 2004 to 2006].

OBJECTIVE: To analyze the projects of the general program in preventive medicine submitted to and funded by National Natural Science Foundation of China (NSFC) from 2004 to 2006, and to discuss the disadvantages of these projects and foundation trends. METHODS: 4124 projects submitted and 656 projects supported in 16 fields of preventive medicine between 2004 to 2006 were analyzed statistically. RESULTS: 1082, 1378 and 1664 projects were submitted to NSFC and 199, 210 and 247 projects were financially supported in last three years, respectively, with selecting rate 18.4%, 15.2% and 14.8%, respectively. The number and the selection rate of projects supported in the different study fields from 2004 to 2006 were 15 (7.5%), 24 (11.4%) and 18 (7.3%) in environmental health, 8 (4.0%), 12 (5.7%) and 15 (6.1%) in occupational health, 30 (15.1%), 24 (11.4%) and 31 (12.6%) in nutrition and food hygiene, 3 (1.5%), 4 (1.9%) and 4 (1.6%) in child and adolescent health, 14 (7.0%), 20 (9.5%) and 20 (8.1%) in toxicology, 7 (3.5%), 7 (3.3%) and 2 (0.8%) in social medicine, 17 (8.5%), 22 (10.5%) and 31 (12.6%) in epidemiology, 7 (3.5%), 7 (3.3%) and 10 (4.0%) in endemiology, 2 (1.0%), 5 (2.4%) and 5 (2.0%) in biostatistics, 0 (0%), 2 (1.0%) and 1 (0.4%) in health laboratory technology, 7 (3.5%), 2 (1.0%) and 7 (2.8%) in vector biology, 15 (7.5%), 9 (4.3%) and 16 (6.5%) in parasitology, 0 (0%), 2 (1.0%) and 0 (0%) in disinfection, 58 (29.1%), 51 (24.3%) and 58 (23.5%) in infectious disease, 3 (1.5%), 1 (0.5%) and 5 (2.0%) in sexually transmitted disease, 13 (6.5%), 18 (8.6%) and 24 (9.7%) in dermatology, respectively. The contents of these research subjects reflected that more importance has been attached to the fields of preventive medicine. However, it is necessary that original and innovatory research should be further strengthened, and the field and prospective study should be emphasized in the future. CONCLUSION: Rapid advancement have been made in the fields of toxicology, epidemiology, environmental health, nutrition and food hygiene, and infectious disease, while other areas such as social medicine, health laboratory technology, disinfection and sexually transmitted disease need a rapid advancement. In general, the levels of the projects received and funded have been elevating yearly.

Effects of life away from home and physical exercise on nutrient intake and blood/serum parameters among girl students in Japan.

This study was initiated to examine if the life away from home and participation in sport activities affect nutritional health among girl university students. For this purpose, anthropometric data, peripheral blood and spot urine samples, 24-hour food duplicate samples, and answers to questionnaires were collected from 71 girl students at 19 to 23 years of ages who provided informed consent to participate in the study. Of the 71 participants, 29 and 42 participants lived in their homes or outside, respectively, and 23 subjects participated in sport activities whereas 48 subjects did not. Hematology, serum biochemistry and nutrient intakes were evaluated in comparison with the life conditions (home vs. dormitory, boarding house, etc.) and participation in sport activities. The population studied had insufficient intake of energy, protein, and minerals such as Ca and Fe. Those who lived in home or participated in sport activities took more energy and protein (although not the two minerals) than others. Skipping of breakfast was more common among those who lived away from home and had no sport activity. Thus, two social factors of life in home and participation in sport clubs contribute favorably for better food habits, but not necessarily improved intakes of Ca and Fe.

Number of dishes as an indicator of nutrient intake in China.

The objectives of this analysis are to investigate if counting the number of dishes consumed per day is a rapid procedure for estimating daily nutrient intake in China, and to explore if urban-rural differences exist in the daily number of dishes. A nutritional survey (including dish number counting) was conducted on 499 adult women in six urban and four rural communities in China. The number of dishes was an influential variable in estimating intake of protein, animal protein, fat, animal fat, and some vitamins (e.g., vitamin B2) and minerals (e.g., zinc), but not of energy and carbohydrate. Intake of some nutrients (e.g., protein) was sufficient when people consume more than 10 dishes per day. Thus, the number of dishes is a useful indicator of sufficient intake of animal protein and fat as well as some micro-nutrients. The application of the dish number counting method showed that there was a significant difference between urban (11.9 dishes per day) and rural populations (7.9 dishes).