The care needs of the elderly in China's elderly care institutions: a narrative synthesis.

China's population is ageing, affecting trends in social development and basic national conditions. More attention must be paid to the lack of care needs assessments for the elderly in China's pension institutions. This paper discusses a systematic evaluation of the care needs of the elderly in China's elderly care institutions. Literature was collected and synthesized after a search of the Web of Science, PubMed, and other databases for works published up to August 2021. Relevant content is proposed, including the name of the first author, publication date, study area, and sample size. Exactly 18 articles were included in the literature, documents that reported on a total of 7277 elderly people. The results showed a combined demand rate of primary care needs ≥50%. The top five needs included mental/psychological (76%), tranquillity/care (73%), living/environmental (71%), medical treatment (64%), and preventive healthcare (64%). The combined demand rate of secondary care needs was ≥50%. The top five needs included 79% for room/laundry/cleaning, 77% for psychological comfort and nursing, 73% for end-of-life care, 70% for disease diagnosis and treatment, and 69% for physical examination. The health needs of older people are diverse and focus mainly on mental/psychological, tranquility/care, living/environmental (71%), pharmacotherapy, and preventive healthcare.

Outdoor light at night and depressive symptoms in male veterans: a multicenter cross-sectional study in China.

Previous studies have indicated depression was associated with environmental exposures, but evidence is limited for the association between outdoor light at night (LAN) and depression. This study aims to examine the association between long-term outdoor LAN exposure and depressive symptoms using data from the Chinese Veteran Clinical Research platform. A total of 6445 male veterans were selected from 277 veteran communities in 18 cities of China during 2009‒2011. Depressive symptoms were evaluated using the Chinese version of the Center for Epidemiological Studies Depression scale. Outdoor LAN was estimated using the Global Radiance Calibrated Nighttime Lights data. The odds ratio and 95% confidence intervals of depressive symptoms at the high level of outdoor LAN exposure against the low level during the 1 years before the investigation was 1.49 (1.15, 1.92) with p-value for trend < 0.01, and those associated with per interquartile range increase in LAN exposure was 1.22 (1.06, 1.40).

Robust estimation of dementia prevalence from two-phase surveys with non-responders via propensity score stratification.

BACKGROUND: Missing diagnoses are common in cross-sectional studies of dementia, and this missingness is usually related to whether the respondent has dementia or not. Failure to properly address this issue can lead to underestimation of prevalence. To obtain accurate prevalence estimates, we propose different estimation methods within the framework of propensity score stratification (PSS), which can significantly reduce the negative impact of non-response on prevalence estimates. METHODS: To obtain accurate estimates of dementia prevalence, we calculated the propensity score (PS) of each participant to be a non-responder using logistic regression with demographic information, cognitive tests and physical function variables as covariates. We then divided all participants into five equal-sized strata based on their PS. The stratum-specific prevalence of dementia was estimated using simple estimation (SE), regression estimation (RE), and regression estimation with multiple imputation (REMI). These stratum-specific estimates were integrated to obtain an overall estimate of dementia prevalence. RESULTS: The estimated prevalence of dementia using SE, RE, and REMI with PSS was 12.24%, 12.28%, and 12.20%, respectively. These estimates showed higher consistency than the estimates obtained without PSS, which were 11.64%, 12.33%, and 11.98%, respectively. Furthermore, considering only the observed diagnoses, the prevalence in the same group was found to be 9.95%, which is significantly lower than the prevalence estimated by our proposed method. This suggested that prevalence estimates obtained without properly accounting for missing data might underestimate the true prevalence. CONCLUSION: Estimating the prevalence of dementia using the PSS provides a more robust and less biased estimate.

[The contributing risk factors, prevention and treatment of functional dependence among the oldest-old and elderly subjects].

OBJECTIVE: To compare the risk factors on the functional dependence between the oldest-old and elderly veterans. METHODS: A cross-sectional survey was conducted among veterans ( ≥ 60 years of age) lived in 44 veterans' communities in Beijing. The socio-demographic information and history of non-communicable chronic diseases were collected via face-to-face interviews, and the functional status was assessed by the 20-item version of the Activities of Daily Living Scale. RESULTS: The risk factors associated with increased hazard of the functional dependence in the oldest-old ( ≥ 80 years old) were cognitive impairment, extrapyramidal diseases, cerebral infarction, transient ischemic attack, sleep disorders, hypnotics, osteoarthrosis, hypertension and fall with the odds ratio (OR) of 1.241-2.962 (all P < 0.05). Stroke, depression, cognitive impairment, extrapyramidal diseases, sleep disorders, hypnotics, fall, cardiovascular diseases, osteoarthrosis and hearing loss were the risk factors for that in the elderly subjects (aged 60-79 years). The OR was 1.232-5.790 (all P < 0.05). However, avocational activities such as social activity, physical exercise, photography, reading and games, decreased the risk of functional dependence in both the oldest-old and elderly people. CONCLUSIONS: Neuropsychiatric disorders are the leading causes contributed to the functional dependence among oldest-old and elderly population. Neurodegenerative diseases in the oldest-old, stroke and depression in elderly people should be the priorities in ameliorating disability. Healthy lifestyle and avocational activities could improve the functional status of the oldest-old and elderly population.

[The etiology of neurological disorders in 1 188 elder patients with neuroimaging at geriatric outpatient clinic].

OBJECTIVE: To investigate the etiology of neurological disorders in elderly at outpatient clinic. METHODS: Elderly patients aged 60 years old or more who visited the geriatric neurological outpatient clinic of PLA General Hospital from July 1, 2009 to June 30, 2012 and underwent the brain MRI or CT imaging were retrospectively analyzed. The constituent ratio of common neurological disorders in all patients and patients from different age groups were statistically analyzed based on the information from PRIDE data management system. RESULTS: A total of 1 188 patients were enrolled in this study with well documented record of complaint examination of the nerve system and brain MRI or CT imaging. Common neurological disorders in those patients were cerebrovascular disease(22.39%), mild cognitive impairment and dementia (15.99%), movement disorders including Parkinson disease, Parkinsonism and essential tremor(9.09%), sleep disorders (6.73%) and psychological diseases(6.65%). Spinal degenerative diseases accompanied by neurological symptoms also accounted for 10.52%. Less common causes in those patients were benign paroxysmal positioning vertigo(3.96%), headache and neck pain (3.28%), cranial nerve diseases (2.78%) and intracranial tumors (2.61%). Constituent ratios of mild cognitive impairment and dementia in different age groups were associated with aging, and the same was observed with Parkinson disease. CONCLUSION: The common neurological disorders in the geriatric outpatients are cerebrovascular disease and neurodegenerative diseases including different type of dementia and Parkinson disease. Those disorders should be focused for the prevention and treatment of the nervous system diseases in the elderly.

Positive relief of stroke patients with dysphagia under cluster nursing strategy.

For exploring the positive relief effect and application value of cluster nursing strategies on stroke patients with dysphagia in rehabilitation medicine. A retrospective analysis was conducted on 70 patients with stroke dysphagia admitted to the Rehabilitation Medicine Department of our hospital from June 2021 to November 2022; by comparison, patients were separated into intervention group (IG) and control group (CG) according to different degrees of swallowing difficulty, and nutritional nursing interventions were conducted on the selected research subjects. It was given routine care in the CG and a cluster nursing strategy in the IG, with a total intervention time of 5 months. Before intervention, general information of all patients was compared. Before and after intervention, the incidence of aspiration, nutritional biochemical indicators (hemoglobin, total serum protein, albumin, prealbumin, total cholesterol), grip strength, Swallowing Quality of Life score, etc were collected from the 2 groups of patients. Finally, the specific benefits were analyzed through statistical results to evaluate the intervention effect. After intervention, the explicit aspiration rate of the participants in this experiment significantly decreased, and the difference among the participants in this experiment was statistically significant (P < .05); the implicit aspiration rate was not statistically significant (P > .05). In the comparison of nursing expenses, the CG spent 5403.57 ± 815.51 yuan, while the IG spent 5237.10 ± 758.35 yuan. There was a statistically marked disparity among the participants in this experiment (t = 52.41, P < .001). In the comparison of hospitalization expenses, the cost of the CG was 9236.05 ± 3236.08 yuan; The cost of the IG was 9538.59 ± 4985.21 yuan, and there was a marked disparity among the participants in this experiment (P < .001). The significant statistical significance exists (P < .05) in the 5 indicators of hemoglobin, total protein, prealbumin, albumin, and total cholesterol, quality of life scores, and patient physical efficacy in both groups. The intervention study of cluster nursing strategy for stroke patients with dysphagia in rehabilitation medicine can effectively reduce the incidence of overt aspiration and ultimately improve their quality of life. It has high clinical application value.

Effect of traditional Chinese medicine external therapy for functional constipation: a meta-analysis.

OBJECTIVE: To systematically review the effectiveness and safety of external treatment with traditional Chinese medicine in patients with functional constipation. METHODS: In this meta-analysis study, we searched for randomized controlled trials (RCTs) on traditional Chinese medicine (TCM) external therapy for treating functional constipation from various databases. Search time was from database establishment to May 2022. The included studies were evaluated for meta-analysis using RevMan 5.3 software. RESULTS: A total of 18 randomized controlled studies were included, including 1404 patients. Results showed the total effective rate [OR = 3.83, 95% CI (2.71, 5.43), P < 0.01] and quality of life [OR = -9.78, 95% CI (-12.32, -7.23), P < 0.01] effectively improved after TCM external therapy; constipation symptoms [OR = -1.64, 95% CI (-2.31, -0.96), P < 0.01] reduced; defecation time [OR = -0.68, 95% CI (-0.99, -0.37), P < 0.01] shortened and spontaneous complete bowel movements (SCBM) [OR = 0.48, 95% CI (0.01, 0.95), P < 0.05] increased; and recurrence rate [OR = 0.25, 95% CI (0.17, 0.38), P < 0.01] reduced. The results of a subgroup analysis of the types of TCM treatment showed acupoint catgut embedding [OR = 3.04, 95% CI (1.10, 8.41), P < 0.05], acupoint application [OR = 3.46, 95% CI (1.74, 6.89), P < 0.01], manipulation [OR = 4.26, 95% CI (0.81, 22.53), P > 0.05], the combination of two external treatment methods [OR = 7.73, 95% CI (3.00, 19.91), P < 0.01], acupuncture [OR = 3.09, 95% CI (1.21, 7.85), P < 0.05], and other external therapies [OR = 3.58, 95% CI (1.89, 6.80), P < 0.01] had certain value in treating functional constipation. CONCLUSIONS: TCM external therapy has good clinical efficacy in treating functional constipation (FC) patients, which can improve main treatment efficacy and life quality, reduce constipation symptoms, shorten defecation time and SCBM, and reduce the recurrence rate. This therapy has no adverse reaction and can be widely applied in clinical practice.

The association between long-term exposure to outdoor artificial light at night and poor sleep quality among Chinese veterans: A multi-city study.

BACKGROUND: A handful of previous studies have reported the association between exposure to outdoor artificial light at night (ALAN) and sleep problems. However, evidence for such association is limited in low- and middle-income countries. This study aimed to examine the association between outdoor ALAN exposure and sleep quality in veterans across different regions of China. METHODS: Within the network of the Chinese Veteran Clinical Research Platform, we selected 7258 participants from 277 veteran communities in 18 cities across China during December 2009 and December 2011, using a multi-stage stratified cluster sampling strategy. Face-to-face interviews with the participants were conducted by trained investigators. We used the Pittsburgh Sleep Quality Index (PSQI) to assess participants' sleep quality. We defined poor sleep quality as a PSQI global score >7. The 3-year average exposure to outdoor ALAN prior to the baseline interview was calculated using satellite imagery data, according to participants' geolocation information. The association of ALAN exposure with sleep quality was examined using the mixed-effects logistic regression models with natural cubic splines. RESULTS: The exposure-response curve for sleep quality associated with ALAN exposure was nonlinear, with a threshold value of 49.20 nW/cm2/sr for the 3-year average exposure to outdoor ALAN prior to the baseline interview. Higher ALAN exposure above the threshold was associated with increased risk of poor sleep quality. After adjusting for potential confounders, the odds ratios (and 95%CI, 95% confidence intervals) were 1.15 (0.97, 1.36) and 1.45 (1.17, 1.78) at the 75th and 95th percentiles of ALAN against the threshold. The association of ALAN exposure with poor sleep quality was more pronounced in veterans with depression than those without. Higher OR of poor sleep quality at the 75th percentile of ALAN against the threshold was observed in veterans with depression than those without [2.09 (1.16, 3.76) vs. 1.09 (0.92, 1.30)]. CONCLUSIONS: Long-term exposure to outdoor ALAN was associated with higher risk of poor sleep quality in Chinese veterans. Effective outdoor ALAN management may help to reduce the burden of sleep disorders in Chinese veterans.

A systematic review and meta-analysis of pulmonary surfactant combined with budesonide in the treatment of neonatal respiratory distress syndrome.

Background: Neonatal respiratory distress syndrome (NRDS), if caused by a lack of pulmonary surfactant (PS), leads to progressive alveolar collapse. Glucocorticoids have anti-inflammatory and anti-allergic effects and can reduce bronchial and pulmonary edema. This research hopes to systematically evaluate the efficacy and safety of animal-derived PS combined with the glucocorticoid drug budesonide in the treatment of NRDS. Methods: Electronic databases (i.e., Wanfang, Weipu, CNKI, PubMed, Embase, Cochrane Library) were searched from inception until May 30th, 2021. Studies relevant to the treatment of pulmonary surfactant combined with budesonide in the treatment of neonatal respiratory distress syndrome were identified. Consequently, all the studies that met the inclusion criteria were considered qualified for screening. For the meta-analysis, all data were analyzed using RevMan 5.3 software. Furthermore, subgroup analysis was performed to evaluate the administration method of budesonide (nebulized inhalation, intratracheal instillation) combined with intratracheal instillation of pulmonary surfactant. Results: A total of 10 articles were included in this study, involving 527 children. This meta-analysis suggests that the treatment of intratracheal infusion of pulmonary surfactant combined with budesonide therapy can effectively (I) reduce the time of mechanical ventilation (OR =-1.72,95% CI: -2.44 to -1.01, P<0.00001); (II) reduce the length of stay (OR =-5.17, 95% CI: -9.35 to -0.99, P=0.02); (III) reduce the incidence of bronchopulmonary dysplasia (BPD) (OR =0.52, 95% CI: 0.39-0.68, P<0.00001); and (IV) reduce the incidence of BPD (RR =0.73, 95% CI: 0.40-1.35, P=0.32). There was no significant difference in the incidence of retinopathy of prematurity (ROP), necrotizing enterocolitis (NEC), patent ductus arteriosus (PDA), or sepsis between the experimental group and the control group. Discussion: The treatment of animal-derived pulmonary surfactant combined with budesonide can effectively shorten the hospital stay and reduce the time of invasive mechanical ventilation and the incidence of BPD. Meanwhile, it does not increase the risk of related complications or death. This approach can be applied clinically.

Long-term exposure to outdoor light at night and mild cognitive impairment: A nationwide study in Chinese veterans.

BACKGROUND: Evidence is limited for the association between outdoor light at night (LAN) and mild cognitive impairment (MCI), a transitional stage between normal aging and dementia and Alzheimer's disease in the elderly. In this study, the association between outdoor LAN and MCI was examined based on a multi-city study among veterans in China. METHODS: A total of 5496 participants from 18 cities across China were investigated during 2009-2011, selected using a multi-stage random sampling method. Participants' cognitive function was firstly assessed using the Mini Mental State Examination and the Montreal Cognitive Assessment in the Chinese version, and then was further confirmed by clinical examination. Participants' exposure to outdoor LAN was estimated using the Global Radiance Calibrated Nighttime Lights Product at a spatial resolution of around 1 km. The mixed-effects logistic regression model was used to examine the association between outdoor LAN and MCI. RESULTS: After controlling for covariates, odds ratio (OR) and 95 % confidence intervals (95%CI) of MCI was 1.44 (95%CI: 1.36, 1.52) associated with per interquartile range (IQR = 21.17 nW/cm2/sr) increase in exposure to outdoor LAN during the 3 years before the investigation, and for categorical variable of LAN, the highest OR was observed for the highest against the lowest quartile of LAN with a monotonically increasing trend (p values for trend <0.001). Furthermore, higher ORs were observed for females, veterans who had less educational attainment, and had no regular social activities. CONCLUSIONS: Our study revealed that exposure to excessive outdoor LAN was associated with higher risk of MCI. Effective measures should be taken to reduce LAN exposure, which may help to prevent MCI.

Accuracy of the Short-Form Montreal Cognitive Assessment Chinese Versions.

Background: There is a strong need for short and effective methods to screen for cognitive impairment. Recent studies have created short forms of the Montreal Cognitive Assessment (s-MoCA) in English-speaking populations. It is also important to develop a validated Chinese short version to detect cognitive impairment. Methods: Item response theory and computerized adaptive testing analytics were used to construct abbreviated MoCAs across a large neurological sample comprising 6,981 community-dwelling Chinese veterans. Results: Six MoCA items with high discrimination and appropriate difficulty were included in the s-MoCA. The Chinese short versions (sensitivity 0.89/0.90, specificity 0.72/0.77) are similar in performance to the full MoCA in identifying cognitive impairment (sensitivity 0.91, specificity 0.82). Conclusions: These short variants of the MoCA may serve as quick and effective instruments when the original MoCA cannot be feasibly administered in clinical services with a high patient burden and limited cognitive testing resources.

Associations of particulate matter with dementia and mild cognitive impairment in China: A multicenter cross-sectional study.

Ambient air pollution has been shown to be associated with the pathogenesis of dementia and mild cognitive impairment (MCI). However, few studies have examined these associations in well-characterized populations with low residential mobility, similar living habits, and a standardized assessment of both air pollution exposure and clinical outcome. This study examined the associations of long-term exposure to particulate matter (PM) air pollution with dementia and MCI, using data from the Chinese Veteran Clinical Research Platform. The cognitive function of elderly veterans from 277 communities in 18 Chinese cities was examined. Participants' daily exposures to aerodynamic diameters ≤2.5 µm (PM2.5) and ≤10 µm (PM10) during the 3 years prior to the survey were estimated using a satellite-based prediction. The adjusted odds ratios (ORs) and 95% confidence intervals of MCI associated with each 10 µg/m3 increase in PM2.5 and PM10 were 1.52 (1.39, 1.67) and 1.04 (1.00, 1.08), and those of dementia associated with PM2.5 and PM10 were 1.27 (1.11, 1.46) and 1.13 (1.05, 1.21), respectively. This demonstrates that long-term exposure to PM2.5 and PM10 can increase the prevalence of dementia/MCI among veterans in China. Higher ORs were observed for those with ≤9 years of educational attainment, those who actively attended physical activities, those who never smoked, former drinkers, and those who did not suffer from cerebral infarction. Improvement of ambient air quality, especially decreasing levels of PM2.5, may help to decrease the risk of dementia/MCI. Given the statistically significant association between PM and cognitive impairment demonstrated here, future studies should focus on examining the causal effect of PM pollution on dementia and MCI.

Daclizumab for relapsing remitting multiple sclerosis.

BACKGROUND: The anti-CD25 treatment of daclizumab appears to be effective in patients with relapsing remitting multiple sclerosis (RRMS) as regards clinical and MRI outcomes. Moreover, there are no severe safety concerns arising from clinical testing so far. OBJECTIVES: To assess the efficacy and safety of daclizumab for patients with relapsing remitting multiple sclerosis. SEARCH STRATEGY: We searched the Cochrane Multiple Sclerosis Group trials register (September 2009), MEDLINE (January 1966 to September 2009), EMBASE (January 1985 to September 2009). At the same time, we handsearched the references quoted in the identified trials, reports (September 2009) from the most important neurological associations and MS Societies in Europe and America, contacted researchers who were participating in trials on daclizumab. SELECTION CRITERIA: All randomized controlled clinical trials (RCTs) evaluating daclizumab, alone or combined with other treatments versus placebo, or any other treatment for patients with RRMS. Both parallel group and cross-over designs were included. DATA COLLECTION AND ANALYSIS: Two reviewers independently assessed references retrieved for possible inclusion. All disagreements were resolved by an independent party. Study authors were contacted for additional information. Adverse effects information was collected from the trials. MAIN RESULTS: We found no study meeting our inclusion criteria. AUTHORS' CONCLUSIONS: Although studies examining daclizumab for relapsing remitting multiple sclerosis were located, methodologic limitations resulted in the exclusion of all studies. Some of the studies were labelled as crossover trials, however they only compared the effect of different interventions for the same individual. The true randomized crossover trial should compare the effect of different groups, which receive the same intervention, only with the difference in sequence. In other words, the crossover comparison should be between the different groups, rather than on the individual between pretreatment and post treatment. At the same time, all the individuals should be randomly allocated to different groups. There was also a rigorous randomized controlled trial, but the follow-up was shorter than one year (only 44 weeks). In general, daclizumab is safe and well tolerated in combination of interferon treated multiple sclerosis population. Improvements in methodology in future studies are required for meaningful synthesis of data.

Cognitive stimulation therapy in the treatment of neuropsychiatric symptoms in Alzheimer's disease: a randomized controlled trial.

OBJECTIVE: to determine the efficacy of cognitive stimulation therapy (CST) in the treatment of neuropsychiatric symptoms in patients with Alzheimer's disease. DESIGN: a randomized, controlled, rater-blind clinical trial. SETTING: the military sanatorium. SUBJECTS: thirty-two patients with mild to moderate Alzheimer's disease exhibiting marked neuropsychiatric symptoms were included in the study. INTERVENTION: all 32 patients were randomly assigned to a cognitive stimulation therapy group (n = 16) or a control group (n = 16) for 10 weeks. MAIN MEASURE: the efficacy measures included the Mini Mental State Examination and the Neuropsychiatric Inventory. RESULTS: patients receiving cognitive stimulation therapy showed a greater improvement in the Neuropsychiatric Inventory total score (mean change - 2.06 points versus 0.00 points, t = -4.766, P<0.001) and in the Mini Mental State Examination total score (mean change 0.81 points versus -0.19 points, t =3.106, P =0.004) compared to control at week 10. Analysis of the individual Neuropsychiatric Inventory domains revealed a statistically significant benefit for cognitive stimulation therapy-treated patients in the areas of apathy (mean change -1.06 points versus -0.31 points, P =0.017) and depression/dysphoria (mean change -0.50 points versus 0.06 points, P =0.047). There were no statistically significant benefits for cognitive stimulation therapy-treated patients in the other individual Neuropsychiatric Inventory domains or in the caregiver distress score. CONCLUSIONS: cognitive stimulation therapy has significant efficacy in lowering apathy and depression symptomatology and in the Mini Mental State Examination in patients with mild to moderate Alzheimer's disease.

[A cross-sectional study of neurological disease in the veterans of military communities in Beijing].

OBJECTIVE: To investigate the prevalence of cognitive and motor disorders as well as emotional and sleep abnormality in the veterans from military communities in Beijing. METHODS: The participants underwent a comprehensive in-person evaluation including detailed neuropsychological testing, Hospital Anxiety and Depression Scale and special questionnaires for movement and sleep disorders. RESULTS: The overall prevalence of cognitive impairment, extrapyramidal diseases was 32.7%, 8.8%. The prevalence of mild cognitive impairment, dementia, Parkinson disease, essential tremor, anxiety and depression was 26.2%, 6.5%, 2.0%, 6.1%, 1.4% and 4.1% respectively. Prevalence of all kinds of sleep disorders ranged from 10.3% to 53.9%. The prevalence of cognitive impairment had no significant difference of sex, but were correlated to age and education, the correlation coefficient was 0.326 and -0.221 (P<0.01). CONCLUSION: Veterans from military communities had higher prevalence of cognitive impairment, extrapyramidal diseases and sleep disorders and lower that of anxiety and depression relatively.

Anti-SOX1 Antibodies in Paraneoplastic Neurological Syndrome.

Anti-Sry-like high mobility group box (SOX) 1 antibodies (abs) are partly characterized onconeural autoantibodies (autoabs) due to their correlation with neoplastic diseases. Anti-SOX1 abs are associated with various clinical manifestations, including Lambert-Eaton myasthenic syndrome (LEMS) and paraneoplastic cerebellar degeneration (PCD). However, the clinical characteristics of patients with anti-SOX1 abs have not been described in detail. This review systematically explores the reported patients with anti-SOX1 abs and analyzes these cases for demographic characteristics, clinical features, coexisting neuronal autoabs, neuroimaging findings, treatment, and clinical outcomes. In addition, considering that PCD is the most common paraneoplastic neurological syndrome and that the association between PCD and anti-SOX1 abs remains unclear, we focus on the presence of autoabs in relation to PCD and associated tumors. PCD-associated autoabs include various intracellular autoabs (e.g., anti-Hu, anti-Yo, anti-Ri, and anti-SOX1) and cell-surface autoabs (anti-P/Q-type voltage-gated calcium channel). Commonly involved tumors in PCD are small-cell lung cancer (SCLC), gynecological, and breast tumors. LEMS is the most common clinical symptom in patients with anti-SOX1 abs, followed by PCD, and multiple neuronal autoabs coexist in 47.1% of these patients. SCLC is still the predominant tumor in patients with anti-SOX1 abs, while non-SCLC is uncommon. No consistent imaging feature is found in patients with anti-SOX1 abs, and there is no consensus on either the therapy choice or therapeutic efficacy. In conclusion, the presence of anti-SOX1 abs alone is a potential predictor of an uncommon paraneoplastic neurological disorder, usually occurring in the setting of LEMS, PCD, and SCLC. The detection of anti-SOX1 abs contributes to an early diagnosis of underlying tumors, given the diversity of clinical symptoms and the absence of characteristic neuroimaging features.

The Epoch Effect on Cognitive Function Requires Regular Updating of Cognitive Screening Tests.

BACKGROUND: Over time, improved cognitive abilities in elderly individuals lead to an overall increase in performance on widely used cognitive screening tests (e.g., Mini-Mental State Examination, MMSE) and impact screening efficacy. OBJECTIVE: We aimed to examine the epoch effect on cognitive function measured using MMSE, in addition to the influence of demographic characteristics on MMSE. We also evaluated the ability of the MMSE in detecting dementia and examined the discrimination ability and measurement precision of the MMSE. METHODS: In a cross-sectional survey, Chinese veterans aged ≥60 years were interviewed. Multiple linear regression analysis was applied to explore the factors affecting the MMSE. The expected MMSE score was calculated to examine the epoch effect. The diagnostic accuracy of the MMSE was determined via receiver operating characteristic curve analyses. Item response theory methods were implemented using Stata 16.0. RESULTS: The MMSE score increased with higher education and decreased with advancing age. The observed MMSE score in this study (26.9) was higher than the expected MMSE score (24.9). It demonstrated 78.3% /84.1% /89.9% sensitivity and 85.8% /79.5% /66.8% specificity in detecting dementia using the cut-off score 25/26/27. The MMSE showed reduced discrimination and provided little information for ability level of -1 and above. CONCLUSION: Improved cognitive ability over time may increase the performance on cognitive screening tests (e.g., MMSE). This impact of epoch in cognitive function emphasizes the importance of regularly updating cognitive screening tests.

A comparative study of the typical toxic metals in serum by patients of schizophrenia and healthy controls in China.

Toxic metals are ubiquitous environmental pollutants, and their potential risks associated with the development of schizophrenia remain a subject of debate. In this study, we investigated the associations between six typical toxic metals (mercury, lead, chromium, silver, antimony, and uranium) in serum with the risk of schizophrenia using a case-control study design. In total, 109 patients with schizophrenia (cases) and 106 normal subjects (controls) from Shandong Province, China were recruited. Fasting blood samples were collected from all participants, as well as serum samples from the cases before and after medical treatment. The six metals were analyzed by inductively coupled plasma mass spectrometry. Only three metals (antimony, silver and uranium) had acceptable detection rates of >80%. The concentrations of antimony and uranium were significantly higher in the cases than in the controls, while no significant difference for silver. Moreover, the serum concentrations of antimony and uranium were significantly lower after medical treatment. Clear dose-response relationships between serum metal concentrations and the risk of schizophrenia were observed, even after adjusting for potential covariates. This suggests that higher levels of antimony and uranium may be one of the factors associated with an elevated risk of schizophrenia.

The etiological effect of a new low-frequency ESR1 variant on Mild Cognitive Impairment and Alzheimer's Disease: a population-based study.

Latent genetic variations of cholesterol metabolism-related genes in late-onset Alzheimer's disease, especially, as well as in mild cognitive impairment pathogenesis are still to be studied extensively. Thus, we performed the targeted-sequencing of 12 nuclear receptor genes plus APOE which were involved in cholesterol content modulation to screen susceptible genetic variants and focused on a new risk variant ESR1 rs9340803 at 6q25.1 for both late-onset Alzheimer's disease (OR=3.30[1.84~4.22], p<0.001) and mild cognitive impairment (OR=3.08[1.75~3.89], p<0.001). This low-frequency variant was validated in three independent cohorts totaling 854 late-onset Alzheimer's disease cases, 1059 mild cognitive impairment cases and 1254 controls from nine provinces of China mainland. Preliminary functional study on it revealed decreased ESR1 expression in vitro. Besides, we detected higher serum Aß1-40 concentration in participants carrying this variant (p=0.038) and lower plasma total cholesterol level in this variant carriers with late-onset Alzheimer's disease (p=0.009). In summary, we identified a susceptible variant which might contribute to developing mild cognitive impairment at earlier stage and Alzheimer's Disease later. Our study would provide new insight into the disease causation of late-onset Alzheimer's disease and could be exploited therapeutically.