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Cognitive impairment and dementia are increasingly considered to be a continuum of overlapping neurological syndrome in the elderly with cerebrovascular disease and neurodegenerative disease.The association between cerebral microbleeds and cognitive impairment have attracted more and more attention.This article reviews the relationship between spatial distribution of cerebal microbleeds and cognitive impairment.
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<p><b>OBJECTIVE</b>To observe early intervention effects of Modified Shuyu Pill (MSP) on vascular cognitive impairment no dementia (VCIND).</p><p><b>METHODS</b>Totally 100 patients VCIND were randomly assigned to the treatment group (43 cases) and the control group (33 cases). On the basis of the treatment targeting risk factors of blood vessels, patients in the treatment group were treated by MSP, while those in the control group were treated by donepezil hydrochloride. The therapeutic course was 16 weeks. The neuropsychological scales [mini-mental state examination (MMSE) and Montreal cognitive assessment (MOCA) score] and Chinese medicine dementia syndromes scales were observed before and after treatment.</p><p><b>RESULTS</b>The MMSE and MOCA score of the two groups increased when compared with the same group before treatment (P < 0.01). But there was no statistical difference in MMSE or MOCA score after treatment between the two groups (P > 0.05). The Chinese medicine dementia syndromes scales significantly decreased in the treatment group when compared with before treatment (P < 0.01). But there was no statistical difference in Chinese medicine dementia syndromes scales in the control group between before and after treatment (P > 0.05). There was statistical difference in Chinese medicine dementia syndromes scales after treatment between the two groups (P < 0.01).</p><p><b>CONCLUSION</b>MSP could effectively intervene the progress of VCIND.</p>
الموضوعات
Aged , Female , Humans , Male , Middle Aged , Cognition Disorders , Drugs, Chinese Herbal , Therapeutic Uses , Early Medical Intervention , Indans , Therapeutic Uses , Piperidines , Therapeutic Usesالملخص
Background Congenital fibrosis of extraocular muscles (CFEOM) affects patient' s appearance and quality of life,and no effective treatment for this disease is available.Imaging study is helpful for exploring the pathogenesis of CFEOM.Objective This study was to describe the characteristics of CFEOM associated with limb movement disorder using magnetic resonance imaging (MRI).Methods A family with CFEOM associated with limb movement disorder was investigated in Renmin Hospital of Wuhan University.Disease history was collected and the pedigree was investigated.Ophthalmologic examinations,including corrected visual acuity,refractive error,slitlamp examination,ophthalmoscopic examination,force of levator palpebrae superioris,ocular movement,eye position,forced duction test,and bell phenomenon examination,were performed.Ocular orbital and cranial MRI was performed in 4 CFEOM patients and 10 normal subjects to compare the structures of the extraocular muscles,motor nerve and cranium.Oral informed consent was obtained from each patient prior to any medical examination.Results A total of 1 1 members from 3 generations were investigated in this study,presenting with 4 cases of disease.The mode of inheritance of this family complied with the Mendelian autosomal dominant inheritance law.Clinical signs included disturbance of eye movement,deviation of eye position,ptosis,lack of Bell sign and positive reaction of passive pull test.In addition,unstable gait,improper body limb alignment,dysphasia and mental retardation were ohserved in 1 patient,which coincided with the diagnostic criteria of type 3 CFEOM.MRI results demonstrated that the levator palpebrae superioris,superior rectus and superior oblique muscle were clearly thinner,and the medial rectus,lateral rectus,inferior rectus muscle were thinning in the patients,showing significant differences in comparison with the normal controls(P＜O.05).The oculomotor and abducens nerves became thinner and even absent in the patients.Cranial MRI showed that Ⅲ-3 in the pedigree with callosum was shorter than that of the normal controls,suggesting that patient suffered from corpus callosum hypoplasia.Meanwhile,cranial MRI indicated the presence of cerebellar hypoplasia and the expansion of the fourth ventricle.Conclusions MRI demonstrates consistent abnormalities of the oculomotor nerves and abducens nerves in the affected individuals in this CFEOM 3 family,and some affected members exhibit two types of central nervous system abnormalities-corpus callosum and cerebellar hypoplasia.These findings suggest that CFEOM 3 is primarily a neuronal disease.
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Objective To investigate the expression of Toll like receptor 4(TLR4)in the injured brain tissue atter traumatic brain injury(TBI) and explore the potential role of TLR4/NF-κB in the secondary brain injury.Methods Thirty-six SD rats were randomly divided into control group(n=1 2),TBI inducement for 1 d group(n=6),TBI inducement for 3 d group(n=12)and TBI inducement for 7 d group(n=6).TBI models of the later 3 groups were induced by Feendy's free-falling,and rats of the control group are only performed exposure ofdura of the right parietal lobe.TLR4 mRNA expression in the injured brain tissue was studied by RT-PCR,NF-κB binding activity was detected by electrophoretic mobility shift assay (EMSA),and the TNF-α and IL-6 levels were detected by enzyme linked immunosorbent assay(ELISA).Immunohistochemistry was employed to determine the protein expression of TLR4 in the brain tissues of control group and TBI inducement for 3 d group.Results The TLR4 mRNA expression,NF-κB binding activity,and the levels of TNF-t and IL-6 in rats of the TBI inducement for 1,3 and 7 d groups were significantly increased as compared with those in the control group(P＜0.05).The protein expression level of TLR4 in the brain tissue of control group was rare,and a large number of TLR4-positive immunostained cells,including cortical glial cells and neurons,were noted in the brain tissue of TBI inducement for 3 d group.TLR4 mRNA level was positively correlated to the NF-κB activity(r=0.786,P=0.000),and positive relations were also noted between TLR4 mRNAlevel and both TNF-α and IL-6 levels(r=0.517,P=0.010; r=0.503,P-0.012).Conclusion TBI could induce concomitant and persistent up-regulation of TLR4 expression and NF-κB binding activity in the injured brain tissue.TLR4/NF-κB might play a central role in the secondary injury after TBl.
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Objective To study the effect of ultrashortwave irradiation and chest-wall vibration therapy on serum eosinophil cationic protein(ECP)and percentage of eosinophil(EOS%)in the sputum of children with mild to moderate asthma. Methods A total of 68 children with asthma were divided into a control group and a treatment group.The control group WaS treated with conventional treatment only,while the treatment group was given ultrashortwave irradiation and chest-wall vibration therapy in addition to the conventional treatment.The serum ECP,EOS% in induced sputum,FEV1.0%,and PEF% were measured before and after treatment.The relationships among ECP,EOS%,FEV1.0% and PEF% were analyzed.Results FEV1.0% and PEF% were negatively correlated with serum ECP and EOS% in children with asthma.Compared with the control group,ECP and EOS% were significantly reduced after treatment,while FEV1.0% and PEF% were significantly elevated. Conclusion Uhrashortwave irradiation and chest-wall vibration therapy can improve ventilation by ameliorating airway inflammation and obstruction.