Predicting conversion to Alzheimer's disease among individual high-risk patients using the Characterizing AD Risk Events index model.

AIMS: Both amnestic mild cognitive impairment (aMCI) and remitted late-onset depression (rLOD) confer a high risk of developing Alzheimer's disease (AD). This study aims to determine whether the Characterizing AD Risk Events (CARE) index model can effectively predict conversion in individuals at high risk for AD development either in an independent aMCI population or in an rLOD population. METHODS: The CARE index model was constructed based on the event-based probabilistic framework fusion of AD biomarkers to differentiate individuals progressing to AD from cognitively stable individuals in the aMCI population (27 stable subjects, 6 progressive subjects) and rLOD population (29 stable subjects, 10 progressive subjects) during the follow-up period. RESULTS: AD diagnoses were predicted in the aMCI population with a balanced accuracy of 80.6%, a sensitivity of 83.3%, and a specificity of 77.8%. They were also predicted in the rLOD population with a balanced accuracy of 74.5%, a sensitivity of 80.0%, and a specificity of 69.0%. In addition, the CARE index scores were observed to be negatively correlated with the composite Z scores for episodic memory (R2  = .17, P < .001) at baseline in the combined high-risk population (N = 72). CONCLUSIONS: The CARE index model can be used for the prediction of conversion to AD in both aMCI and rLOD populations effectively. Additionally, it can be used to monitor the disease severity of patients.

Survey and analysis of the nutritional status in hospitalized patients with malignant gastric tumors and its influence on the quality of life.

BACKGROUND/OBJECTIVES: The assessment of nutritional status and the quality of life in patients with gastric cancer has become one of the important goals of current clinical treatment. The purpose of this study was to assess the nutritional status in hospitalized gastric cancer patients by using patient-generated subjective global assessment (PG-SGA) and to analyze the influence of nutritional status on the patients' quality of life (QOL). METHODS: We reviewed the pathological diagnosis of gastric cancer for 2322 hospitalized patients using PG-SGA to assess their nutritional status and collected data on clinical symptoms, the anthropometric parameters (height, weight, body mass index (BMI), mid-arm circumference (MAC), triceps skin-fold thickness (TSF), and hand-grip strength (HGS). We also collected laboratory data (prealbumin, albumin, hemoglobin) within 48 h after the patient was admitted to the hospital. The 30-item European Organization for Research and Treatment of Cancer Core Quality of Life Questionnaire (EORTC QLQ-C30) was used for QOL assessment in all patients. RESULTS: By using PG-SGA, we found 80.4% of the patients were malnourished (score ≥ 4) and 45.1% of the patients required urgent nutritional support (score ≥ 9). In univariate analysis, old age (> 65 years, p < 0.001), female (p = 0.007), residence in a village (p = 0.004), a lower level of education (p < 0.001), and self-paying (p < 0.001) were indicated as risk factors of patients with gastric cancer to be suffering from severe malnutrition. There was a negative correlation between PG-SGA and various nutritional parameters (p < 0.05). The quality of life was significantly different in gastric cancer patients with different nutritional status (p < 0.01). CONCLUSION: Malnutrition of hospitalized patients with gastric cancer in China is common and seriously affects the patients' quality of life. The nutritional status should be evaluated in a timely manner and reasonable nutritional intervention should be provided as soon as possible. The PG-SGA was fit for using as a clinical nutrition assessment method, being worthy of clinical application.

[Corrigendum] Naotaifang extract treatment results in increased ferroportin expression in the hippocampus of rats subjected to cerebral ischemia.

Mol Med Rep 11: [Related article:] 4047­4052, 2015; DOI: 10.3892/mmr.2015.3309 Following the publication of this article, an interested reader drew to our attention anomalies associated with the presentation of Figs. 1 and 4. The image selected for Fig. 1A, the data pertaining to '2 h', was inadvertently selected for Fig. 4A, the image labeled 'Sham'. Additionally, in Fig. 4, the same source image had inadvertently been used to provide the images for the 'Low dose group' and 'Model' panels (although the view presented differed in these panels). On re-examining our data, we realized that these errors had occurred during the compilation of Fig. 4, and that the images were correctly selected for Fig. 1. An amended version of Fig. 4 is presented below, featuring images which correctly show the data for the 'Low dose', 'Sham' and 'Model' groups. The immunohistochemical results suggested that, following treatment with 27 g/kg naotaifang extract, the expression of Fpn increased significantly compared with the other treatment doses (P<0.05), whereas significant changes were not observed among the other groups (P>0.05). The errors made in the selection of certain images for Fig. 4A did not affect the overall conclusions reported in the present study. We sincerely apologize for this mistake, and thank the reader of our article who drew this matter to our attention. Furthermore, we regret any inconvenience this mistake has caused.

Combining diffusion tensor imaging and gray matter volumetry to investigate motor functioning in chronic stroke.

Motor impairment after stroke is related to the integrity of the corticospinal tract (CST). However, considerable variability in motor impairment remains unexplained. To increase the accuracy in evaluating long-term motor function after ischemic stroke, we tested the hypothesis that combining diffusion tensor imaging (DTI) and gray matter (GM) volumetry can better characterize long-term motor deficit than either method alone in patients with chronic stroke. We recruited 31 patients whose Medical Research Council strength grade was ≤ 3/5 in the extensor muscles of the affected upper extremity in the acute phase. We used the Upper Extremity Fugl-Meyer (UE-FM) assessment to evaluate motor impairment, and as the primary outcome variable. We computed the fractional anisotropy ratio of the entire CST (CSTratio) and the volume of interest ratio (VOIratio), between ipsilesional and contralesional hemispheres, to explain long-term motor impairment. The results showed that CSTratio, VOIratio of motor-related brain regions, and VOIratio in the temporal lobe were correlated with UE-FM. A multiple regression model including CSTratio and VOIratio of the caudate nucleus explained 40.7% of the variability in UE-FM. The adjusted R2 of the regression model with CSTratio as an independent variable was 29.4%, and that of using VOIratio of the caudate nucleus as an independent variable was 23.1%. These results suggest that combining DTI and GM volumetry may achieve better explanation of long-term motor deficit in stroke patients, than using either measure individually. This finding may provide guidance in determining optimal neurorehabilitative interventions.

Naotaifang extract treatment results in increased ferroportin expression in the hippocampus of rats subjected to cerebral ischemia.

The expression of Ferroportin (Fpn) was examined at different time points in rats following focal cerebral ischemia treated with or without the traditional Chinese medicine Naotaifang. Initially, rats were randomly divided into 2, 6, 12, 24 and 72 h groups following middle cerebral artery occlusion (MCAO) and the mRNA and protein level of Fpn was detected by immunohistochemistry and reverse transcription polymerase chain reaction (RT­PCR) at the above time points. Secondly, the rats were randomly divided into five groups as follows: Sham surgery group, model group, low­dose group (3 g/kg NTE), medium dose group (9 g/kg NTE) and the high­dose group (27 g/kg NTE). After 3 days of corresponding therapy by intragastric administration once a day, the regional cerebral ischemia model was reproduced by the MCAO suture method. On the third day, the neurological behavior of the rats was analyzed by neurobehavioral assessment. Fpn in the hippocampal CA2 region was measured by immunohistochemistry and the mRNA level of Fpn was detected by RT­PCR. Expression of Fpn in the hippocampal CA2 region reached a peak 12 h after surgery (P<0.05, compared with the model group). The high­dose group (27 g/kg NTE) exhibited a lower neurological behavior score (P<0.05) and a higher level of expression of Fpn at the mRNA and protein level compared with the sham surgery group and model group (P<0.05). Dysregulation of intracellular iron balance is possibly a new mechanism underlying cerebral ischemia. NTE can protect the neuronal population in the hippocampal CA2 region by adjusting the expression of Fpn to balance iron levels following cerebral ischemia.

Fully automated detection of corticospinal tract damage in chronic stroke patients.

Structural integrity of the corticospinal tract (CST) after stroke is closely linked to the degree of motor impairment. However, current methods for measurement of fractional atrophy (FA) of CST based on region of interest (ROI) are time-consuming and open to bias. Here, we used tract-based spatial statistics (TBSS) together with a CST template with healthy volunteers to quantify structural integrity of CST automatically. Two groups of patients after ischemic stroke were enrolled, group 1 (10 patients, 7 men, and Fugl-Meyer assessment (FMA) scores ⩽ 50) and group 2 (12 patients, 12 men, and FMA scores = 100). CST of FA(ipsi), FA(contra), and FA(ratio) was compared between the two groups. Relative to group 2, FA was decreased in group 1 in the ipsilesional CST (P < 0.01), as well as the FA(ratio) (P < 0.01). There was no significant difference between the two subgroups in the contralesional CST (P = 0.23). Compared with contralesional CST, FA of ipsilesional CST decreased in group 1 (P < 0.01). These results suggest that the automated method used in our study could detect a surrogate biomarker to quantify the CST after stroke, which would facilitate implementation of clinical practice.

[Cognitive function, serum BDNF levels and BDNF gene Val66Met polymorphism in amnestic mild cognitive impairment].

OBJECTIVE: To investigate the relationship between serum brain-derived neurotrophic factor, concentrations and BDNF gene Val66Met polymorphism and amnestic mild cognitive impairment (aMCI), and neuropsychological characteristics. METHODS: Ninety-nine aMCI patients and 99 matched normal controls were recruited for the study. Multi-dimension neuropsychologic tests were used to extensively assess the cognitive function, an enzyme-linked immunosorbent assay was applied to measure serum BDNF concentrations, and polymerase chain reaction-restriction fragment length polymorphism was used to analyse BDNF gene Val66Met polymorphism in the subjects. RESULTS: The scores of neuropsychologic tests in aMCI patients were significantly lower than those in the normal controls (all P<0.001), with the largest impairment on delayed recall of the auditory verbal memory test (AVMT) which reflect verbal episodic memory. The serum concentrations of BDNF in aMCI patients (median: 4.37 microg/L) were significantly lower than those of the normal controls (median: 4.98 microg/L) (z=-2.449, P=0.014). There was positive correlation between the serum concentrations of BDNF and the scores on delayed recall of AVMT (r=0.264, P=0.008). No significant differences were found for the genotype and allele distribution of BDNF Val66Met polymorphism between aMCI patients and the normal controls. BDNF Val66Met polymorphism was not associated with serum BDNF concentrations and cognitive assessment scores in aMCI patients (P>0.05). CONCLUSION: aMCI is characterized by episodic memory impairment. Decreased BDNF concentrations may play a role in the pathophysiology of aMCI, and BDNF gene Val66Met polymorphism may not be an important genetic factor in susceptibility to aMCI.

[Clinical research of effect of Yishen Yangnao capsule on vascular dementia].

OBJECTIVE: To find a good way to diagnose VD, value the effect of Yishen Yangnao capsule on VD and try to find some rules of changes in Chinese medicine syndromes. METHOD: Patients were randomly divided into treating group and western medicine comparison group. It's the phase III clinical research of Rishen Yangnao capsule curing VD, judging the validity and security of it, using dukexi slice as comparison drug. Some of the patients did the examination of P300. RESULT: The total validity of Yishen Yangnao capsule is 56.3% (contract team is 60.0%). The improve rate of ADL is 0.1069% (contract team is 0.1134%). The scores of Chinese medicine syndrome descend. CONCLUSION: Yishen Yangnao capsule has the same effect as dukexi slice in curing VD at the side of intelligence situation and life ability.