December 2013, Volume 16, No.36 Abstracts
Progress of the Treatment of Vascular Dementia
ZHANG Nan.Department of Neurology，Tianjin Medical University General Hospital，Tianjin 300052，China
【Abstract】 Vascular dementia(VaD) is a syndrome characterized with acquired mental retardations due to brain damages of cerebrovascular origin，causing 20% to 30% of all the elderly dementia cases.The pathogenesis of VaD involves a series of molecular and structural changes subsequent to cerebrovascular lesions，which includes inflammatory reactions，oxidative stress，apoptosis，excitotoxicity and synaptic transmission impairments.Although clinical trials have been conducted on a number of drugs including cholinesterase inhibitors，memantine，nimodipine and cerebrolysin，there is not a FDA approved drug for treating VaD so far，since the drugs are either with limited effect on ability of daily living，or with uncertain security.The treatment of VaD should be multiple targeted and further clinical trials precisely designed are needed for the effective treatment of VaD.This paper summarizes the pathogenesis and treatment of VaD.
【Key words】 Dementia，vascular；Alzheimer disease；Therapy
Research Progress of Correlation between High-density Lipoprotein and Atherosclerosis
ZHAI Zhen-li，MA Wei-hong，SHEN Wei.The Affiliated Hospital of Guilin Medical College，Guilin 541001，China
【Abstract】 High-density lipoprotein(HDL) and atherosclerosis(AS) are closely related.HDL has anti-AS function by reversing cholesterol transport(RCT)，anti-oxidation，anti-inflammatory，endothelial cell maintenance functions and anti-thrombosis.However，HDL can become dysfunction or even promote AS.Low level of HDL-C cannot fully reflect the function of HDL，and it is more meaningful to detect the function of HDL.The paper reviews the functional HDL and dysfunctional HDL.
【Key words】 Atherosclerosis；Lipoproteins，HDL；Cholesterol，HDL
Relationship between Vascular Dementia and Helicobacter Pylori and Homocysteine
LUAN Li-qin.Department of Neurology,People′s Hospital of Jiangbei，Nanjing 210048,China
【Abstract】 Objective To study the positive rate of Helicobacter pylori(Hp) and the concentration of palsma homocystein(HCY) in patients with vascular dementia(VD),and to discuss factors related to VD development and degree.Methods A total of 60 patients with VD who admitted to our hospital from October 2009 to June 2012 were selected as VD group,60 patients with lacunar infarction (LI) were selected as LI group,40 healthy subjects who were proved by outpatient medical examination were selected as control group.Patients with VD were divided into three groups (mild,moderate and sereve group) by mini-mental state examination (MMSE).The 14C urea breath test was applied to detect the Hp,fluorescence polarization immunoassay was applied to determine plasma HCY level.The positive rate of Hp and the plasma HCY level were compared among 3 groups,correlation between MMSE score and plasma HCY level in patients with VD was analysed.Results The positive rate of Hp and the level of palsma HCY in VD group were significantly higher than those in LI group and control group,the positive rate of Hp and the level of palsma HCY in LI group were significantly higher than those in control group (P＜0.05).The positive rate of Hp and the level of palsma HCY in sereve VD group were significantly higher than those in moderate VD group and mild VD group,the positive rate of Hp and the level of palsma HCY in moderate VD group were higher than those in mild VD group (P＜0.05).MMSE score showed a negative correlation with palsma HCY level in patients with VD (r=-0.437,P＜0.05).Conclusion The detections of the positive rate of Hp and the level of palsma HCY are useful for forecasting the development of VD and evaluating the degree of dementia.
【Key words】 Dementia，vascular；Helicobacter pylori；Cysteine
Correlation between Heart Rate Parameters and Urinary Minim Albumin in Patients with Essential Hypertension
ZHU Jie，XU Xin-juan.Department of Hypertension，the First Affiliated Hospital of Xinjiang Medical University，Urumqi 830000，China
【Abstract】 Objective To study the influence of heart rate parameters on urinary minim albumin(MAU) in patients with essential hypertension(EH).Methods 206 EH patients admitted to our hospital from November 2011 to July 2013 were selected and their hypertension level was between level 1 and level 2.The 24 h average heart rate(AHR)，daily heart rate(DHR)，night heart rate(NHR)，resting heart rate(RHR)，night heart rate drop rate(NHD) and urinary MAU level were detected.The patients were divided into three levels according to the levels of AHR，DHR，NHR and RHR：level A(heart rate＜70/min)，level B(70/min≤heart rate＜80/min) and level C(heart rate≥80/min).The patients were also divided into two types according to NHD：Dipper Group(NHD≥10%) and non-Dipper Group(NHD＜10%).Urinary MAU level of patients with different levels and different types were compared，and the relationship between heart rate parameters and urinary MAU was studied.Results (1)The urinary MAU between different levels of AHR，DHR，NHR and RHR showed statistically significant difference(P＜0.05)，and with the increase of AHR，DHR，NHR and RHR，the urinary MAU level also increased（P＜0.05）.Non-Dipper patients had higher urinary MAU level than Dipper patients〔(50.6±24.5)mg/24 h vs.(37.4±22.6)mg/24 h，t=26.24，P=0.000〕.(2)Pearson correlation analysis showed that AHR，DHR，NHR and RHR were all positively correlated with urinary MAU(r=0.754，0.729，0.795 and 0.786，P＜0.05).NHD was negatively correlated with urinary MAU(r=-0.398，P＜0.05).Conclusion Heart rate parameters has certain influence on urinary MAU in EH patients.Heart rate should be controlled together with the regulation of blood pressure can reduce the urinary MAU level in EH patients.NHR，RHR and AHR are closely related with urinary MAU in EH patients.
【Key words】 Hypertension；Heart rate；Albuminuria
Relationship between Glycated Hemoglobin and Left Ventricular Function in Elderly Patients with Type 2 Diabetes Mellitus and Hypertension
SONG Jing，ZHU Min.The Second People′s Hospital of Hangzhou City，Hangzhou 310015，China
【Abstract】 Objective To study the relationship between glycated hemoglobin（HbA1c） and left ventricular cardiac function in elderly patients with type 2 diabetes mellitus(T2DM) and hypertension.Methods 153 patients with T2DM and hypertension admitted to our hospital from January 2008 to July 2013 were divided into group Ⅰ(HbA1c＜7.0%，71 cases) and group Ⅱ(HbA1c≥7.0%，82 cases).Echocardiography heart structure parameters，including left ventricular end diameter diastolic(LVIDd)，left ventricular end-systolic diameter(LVIDs)，interventricular septum thickness at end-diastole(IVSD)，left ventricular posterior walldepth(LVPWD)，left ventricular ejection fraction(LVEF) were observed.The serum level of NT-proBNP was detected by ELISA.The above parameters were compared between the two groups，and the levels of HbA1c in patients with different NYHA classification were analyzed.Results The NT-proBNP level of group Ⅱ was significantly higher than group Ⅰ〔（747±223)ng/L vs.(116±60)ng/L；P＜0.05〕.Color Doppler echocardiogram showed that the LVIDd，LVIDs，IVSD and LVPWD were significantly increased in group Ⅱ compared with group Ⅰ(P＜0.05).But LVEF in group Ⅱ was lower than group Ⅱ〔(65.3±7.8)% vs.(68.9±4.8)%；P＜0.05〕.Pearson correlation analysis showed that HbA1c was positively correlated with NT-proBNP(r=0.244，P=0.024).NYHA grade Ⅱ，grade Ⅲ，and grade Ⅳ patients had increased HbA1c level in that same order〔(7.3±1.1)%，(8.5±1.2)%，(12.0±2.5)%；P＜0.01〕.Conclusion More significant cardiac structural change is observed in higher HbA1c level patients with T2DM and hypertension.Positive correlation exists between HbA1c and serum NT-proBNP.
【Key words】 Hypertension；Diabetes mellitus，type 2；Hemoglobin A，glycosylated；Ventricular function，left；Natriuretic peptide，brain
Relationship between Differentiated Thyroid Cancer and Serum Thyroid Stimulating Hormone,Thyroid Autoantibodies
HUANG Ting,LI Wei-xing,ZHANG Li.Department of Endocrinology,the Second Affiliated Hospital of Xinjiang Medical University,Urumqi 830063,China
【Abstract】 Objective To investigate the feasibility and clinical value of thyroid stimulating hormone(TSH),thyroid peroxidase antibody(TPOAb) and thyroglobulin antibody(TgAb) in predicting differentiated thyroid cancer(DTC).Methods From January 2009 to December 2011,400 patients with thyroid nodule underwent their first thyroidectomy，200 cases were diagnosed with DTC,and the other 200 cases were diagnosed with benign nodule by postoperative pathology.The levels of preoperative serum TSH,TgAb and TPOAb in patient of both groups were tested,the patients were divided into negative group and positive group by the reference range of TgAb；at the same time the patients were divided into three groups(low,normal,high) according to reference range of TSH.The data were analyzed separately using method of statistics.Results Preoperative serum TSH level in DTC group and benign group was 2.95(2.22)mU/ml and 1.92（1.68）mU/ml,separately,TSH level in DTC group was significantly higher than that in benign group,the difference was statistically significant(Z=-6.52,P＜0.01).Among DTC group,the TSH level in 40 cases was high,the TSH level in 155 cases was normal,and the TSH level in 5 cases was low;Among benign group,the TSH level in 17 cases was high,the TSH level in 170 cases was normal,the TSH level in 13 cases was low.There was significant difference in TSH level distribution between DTC group and benign group（u=-3.673,P＜0.001）.Preoperative serum TgAb level in DTC group and benign group was 154（48）mU/L and 35(14)mU/L,separately,TgAb level in DTC group was significantly higher than that in benign group（Z=-2.35,P=0.019）.Among DTC group,TgAb in 34 cases was positive（17.0%）,TgAb in 166 cases was negative（73.0%）;Among benign group,TgAb in 9 cases was positive（4.5%）,TgAb in 191 cases was negative（95.5%）.There was significant difference in TgAb positive rate between DTC group and benign group（χ2=18.56，P＜0.01）.Preoperative serum TPOAb level in DTC group and benign group was 51（17）mU/L and 33(13)mU/L in benign group,separately,there was no significant difference in TPOAb level between DTC group and benign group（Z=-0.916,P＞0.05）.Single factor analysis showed that both positive of TgAb〔β=1.49,OR=4.46,P＜0.01，95%CI（2.15，9.23）〕 and elevation of TSH〔β=0.95,OR=2.58，P＜0.01，95%CI（1.41，4.74）〕 were correlated to DTC.In the multivariate Logistic regression analysis,positive of TgAb〔β=1.92,OR=6.82,P＜0.01，95%CI（2.96，15.73）〕 and elevation of TSH 〔β=0.88,OR=2.42,P＜0.01，95%CI（1.24，4.72）〕 entered the regression model.Level of serum TSH in DTC patients with neck lymph node metastasis and DTC patients without neck lymph node metastasis was 2.95（2.22）mU/L and 2.66(1.98)mU/L,separately,TSH level in DTC with metastasis group was significantly higher than that in simple DTC group（Z=-6.11,P＜0.01）.Conclusion Preoperative elevated serum TSH and TgAb levels may be the risk factors for DTC,large sample prospective studies are needed to confirm whether they can be used as predictors in DTC screening.The elevated serum TSH level is correlated to DTC with neck lymph node metastasis.
【Key words】 Thyroid neoplasms；Thyroid nodule；Thyrotropin；Thyroglobulin antibody；Thyroid peroxidase antibody
Risk Factors for Stroke in High-risk Community Residents in Beijing
GAO Yu，LEI Xiao-chun，BU Fan.Xicheng District Tianqiao Community Health Service Center，Beijing 100050，China
【Abstract】 Objective To analyze the risk factors for stroke in high-risk community residents in Beijing，and put forward some preventions and control measures in order to reduce the incidence of stroke in community.Methods Residents aged over 50 years in Tianqiao community of Beijing were recruited in our study from July to October 2012，who were given questionnaire survey and physical examinations.Carotid artery color Doppler ultrasound（Mylab 20） was applied to examine the thickness of intima，plaque，and stenosis of bilateral common carotid arteries.Logistic regression analyses were performed to determine the risk factors of stroke.Results A total of 662 high-risk participants were investigated，there were 261 cases(39.43%) with thickened carotid artery intima，220 cases(33.23%) with carotid artery plaques，and 19 cases(2.87%) with carotid artery stenosis.There were significant differences in the thickness of carotid artery intima，the incidence of carotid plaque and the incidence of carotid artery stenosis among different age groups(P＜0.05).The incidence of carotid plaques was significantly higher in the participants with hypertension〔41.37%（151/365）〕 than in those without hypertension〔23.23%（69/297），P＜0.05〕.The thickness of carotid artery intima and the incidence of carotid plaques were significantly higher in participants with diabetes〔48.99%（73/149），44.97%（67/149）〕 than those in participants without diabetes〔36.65%（188/513），29.82%(153/513)；P＜0.05〕.There was no significant difference in the study variables between the participants with hyperlipoidemia and those without hyperlipoidemia(P＞0.05).The incidences of carotid plaques in participants with one，two and three chronic diseases were 34.27%（73/213），37.56%（80/213），44.87%（35/78），respectively；Which were all significantly higher than that in participants without any chronic disease〔20.25%（32/158），P＜0.008〕.Logistic analyses showed that age，diet，hypertension and carotid plaques were all significantly correlated with the incidence of stroke(P＜0.05).Conclusion Oder age，fatty foods，hypertension and carotid plaques are the risk factors for stroke in community residents.Therefore，we should provide health guidance and intervention to community residents through extending health knowledge，enhancing hypertension management and helping them to form good diet habits and behavioral habits.
【Key words】 Community health services；Stroke；Carotid artery diseases；Ultrasonography；Risk factors
The Staus of Physical Growth and Malnutrition of Preterm Infants
ZHANG Xiao-ning,TAN Ying-chun,WANG Jun.School of Nursing,Xuzhou Medica