The combined presence of hypertension and vitamin D deficiency increased the probability of the occurrence of small vessel disease in China.

BACKGROUND: The exact relationship between 25-hydroxyvitamin D [25(OH) D] levels and small vessel disease (SVD) are not clear in China. The aim of this study was to determine such the association between 25(OH) D and SVD in China. METHODS: We retrospectively enrolled 106 patients with SVD and 115 controls between Jan 2017 and Dec 2017. All the subjects were categorized into three subgroups according to the level of 25 (OH) D: vitamin D deficiency (< 12 ng/ml), insufficiency (12-20 ng/ml) and sufficiency (> 20 ng/ml). RESULTS: Among 106 SVD patients, 80 (75.5%) were men and the mean age was 61.6 ± 13.2 years. The deficiency of 25(OH) D was observed in 76 (71.7%) of SVD patients and 47 (40.9%) of controls (P = 0.001). Compared with controls, patients with SVD were more likely to be male, a stroke history, smokers, with hyperlipidemia, higher systolic and diastolic blood pressure and low-density lipoprotein, and lower of 25(OH)D level (P < 0.05). Logistic regression analysis revealed the level of 25 (OH) D as an independent predictor of SVD (OR 0.772, 95% CI 0.691-0.862, P = 0.001). Compared with the sufficient 25 (OH) D group, the ORs of SVD in deficient and insufficient 25(OH)D group were 5.609 (95% CI 2.006-15.683) and 1.077 (95% CI: 0.338-3.428) after adjusting for potential confounders, respectively. In hypertensives with vitamin D deficient and insufficient group compared with sufficient group, the ORs of SVD increased to 9.738 (95% CI 2.398-39.540) and 1.108 (95% CI 0.232-5.280), respectively (Pinteraction = 0.001). CONCLUSION: We found significant associations between SVD and 25(OH)D deficiency. The combined presence of hypertension and vitamin D deficiency increased the probability of developing SVD. Our findings will warrant further prospective studies in the future.

Changes in Levels of Homocysteine and C-Reactive Protein in Patients with Alzheimer's Disease and Their Correlation with Cognitive and UPDRS Functions.

Objective: To investigate the changes in the levels of homocysteine (Hcy) and C-reactive protein (CRP) in patients with Alzheimer's disease (AD) and analyze their correlation with cognitive and UPDRS functions. Methods: A total of 50 patients with AD admitted to our hospital from January 2020 to March 2022 were selected into the research group, and 50 healthy subjects were selected as the control group. The levels of Hcy and CRP of the two groups were analyzed, and the patients' cognitive functions were evaluated with the Mini-Mental State Examination (MMSE) score and UPDRS function scoring. The correlation between the changes in levels of Hcy and CRP, and cognitive and UPDRS functions in the two groups was compared and analyzed. Results: The levels of Hcy and CRP of the research group were higher than those of the control group, with statistical significance (P < 0.05). The following were evaluated for the scoring of patients' cognitive functions in the research group: orientation, attentional computation, short-term memory, language ability, visuospatial ability, instant memory, and MMSE total score, all of which were lower than those in the control group, with statistical significance (P < 0.05). UPDRS I, UPDRS, UPDRS, and total UPDRS score in the research group were higher than those in the control group, with statistical significance (P < 0.05). In the research group, the higher the Hcy level, the lower the MMSE score, with a negative correlation (P < 0.05), and the higher the Hcy level, the higher the UPDRS score, with a positive correlation (P < 0.05). And, the higher the CRP level, the lower the MMSE score, with a negative correlation (P < 0.05); the higher the CRP level, the higher the UPDRS score, with a positive correlation (P < 0.05). Conclusion: Compared with the health subject group, the levels of Hcy and CRP were higher in patients with AD, and their changes had a negative correlation with cognitive functions in patients with AD, and a positive correlation with UPDRS in patients with AD, with high clinical values in evaluating cognitive and UPDRS functions.

Effect of programmed nursing combined with cognitive behavioral intervention on clinical nursing effect and neurological function of patients with intracerebral hemorrhage.

OBJECTIVE: To investigate the effect of programmed nursing combined with cognitive behavioral intervention on clinical efficacy and neurological function of patients with intracerebral hemorrhage (ICH). METHODS: In this retrospective study, 96 patients with ICH admitted to our hospital were enrolled and divided into a programmed group and a joint group, with 48 cases in each group. Patients in the programmed group were treated with programmed nursing while those in the joint group were given cognitive behavior intervention based on programmed nursing, for 28 days. The Fugl-Meyer (FM) Assessment Scale was used to evaluate the motor function of patients, the Barthel index to analyze the activities of daily living (ADL), and the National Institutes of Health Stroke Scale (NIHSS) and Glasgow Outcome Scale (GOS) to assess the neurological function. The quality of life of patients was evaluated by the World Health Organization quality of life Brief Version (WHOQOL-BREF), and the nursing satisfaction of patients or their families was investigated by the self-made satisfaction scale. The incidence of adverse reactions during treatment was recorded and compared. RESULTS: FM Assessment Scale and Barthel index did not differ significantly between the two groups before nursing (tFugl-Meyer =0.059, tBarthel =0.033, both P>0.05); after nursing, the two scores increased in both groups, with higher scores in the joint group (tFugl-Meyer =3.331, tBarthel =2.735, both P<0.05). Before nursing, there was no difference in NIHSS and GOS scores between the two groups (tNIHSS =0.257, tGOS =0.553, both P>0.05); after nursing, however, the NIHSS score decreased and the GOS score increased in both groups, with statistically significant differences between the two groups (tNIHSS =5.158, tGOS =5.303, both P<0.05). The total effective rate in the joint group was significantly higher than that in the programmed group (91.67% vs. 77.08%; χ2=4.511, P=0.034). No significant difference was observed in the World Health Organization Quality of Life Scale Brief Version (WHOQOL BREF) score between the two groups (t=0.049, P=0.960) before nursing; after nursing, the score increased significantly in both groups, with a significant difference between the two groups (t=15.970, P<0.001). The satisfaction was 95.83% in the joint group, which was higher than that of 83.33% in the programmed group (χ2=3.913, P=0.048). The joint group also had fewer adverse reactions than the programmed group (χ2=7.401, P=0.007). CONCLUSION: Programmed nursing combined with cognitive behavioral intervention can improve the clinical efficacy of patients with ICH, improve limb motor ability, and reduce neurological deficits, with high safety.

Treatment and recurrence of traumatic versus idiopathic benign paroxysmal positional vertigo: a meta-analysis.

Background: So far, there has been a controversy surrounding repositioning difficulty and recurrence rate between traumatic benign paroxysmal positional vertigo (t-BPPV) and idiopathic BPPV (i-BPPV). Objectives: This meta-analysis was aimed to explore whether or not the differences between t-BPPV and i-BPPV in the repositioning difficulty and recurrence rate existed. Material and methods: A literature search was performed in the databases including Pubmed, Embase, CENTRAL, which completed in 21 January 2019, with no restriction of publication language. Relative risk (RR) of number of repositioning maneuvers and the recurrence rate was calculated with its 95% confidence interval. Sensitive analysis was performed simultaneously. Results: Six retrospective cohort studies were included in our meta-analysis, including 865 t-BPPV patients and 3027 i-BPPV patients. All studies were high quality according to Newcastle-Ottawa Scale (NOS) assessment. Patients with t-BPPV required more repositioning maneuvers for resolution than those with i-BPPV (RR = 3.27, 95% CI = 1.88-5.69, p < .0001), and the recurrence rate of t-BPPV was higher than that of i-BPPV (RR = 2.91, 95% CI = 2.04-4.14, p < .00001). Conclusions and significance: Compared with i-BPPV, patients with t-BPPV require more repositioning maneuvers to resolve, and the recurrence of t-BPPV was more frequent.

Thioredoxin is a novel diagnostic and prognostic marker in patients with ischemic stroke.

Serum thioredoxin (TRX), a redox-regulating protein with antioxidant activity, was recognized as an oxidative-stress marker. The purpose of this study was to investigate the potential diagnostic and prognostic role of TRX in Chinese patients with acute ischemic stroke (AIS). From January 1, 2012, to December 31, 2013, all patients with first-ever acute ischemic stroke were recruited to participate in the study. Serum levels of TRX were assayed with solid-phase sandwich ELISA, and severity of stroke was evaluated with the National Institutes of Health Stroke Scale (NIHSS) score on admission. Short-term functional outcome was measured by a modified Rankin scale (mRS) 3 months after admission. Multivariate analyses were performed using logistic regression models. We found the serum TRX reflected the disease severity of AIS. There was a significant positive association between serum TRX levels and NIHSS scores (r= 0.476, P<0.0001). Based on the ROC curve, the optimal cutoff value of serum TRX levels as an indicator for auxiliary diagnosis of AIS was projected to be 11.0 ng/ml, which yielded a sensitivity of 80.3% and a specificity of 73.7%, with the area under the curve at 0.807 (95% CI, 0.766-0.847). Elevated TRX (≥ 20.0 ng/ml) was an independent prognostic marker of short-term functional outcome [odds ratio (OR) 9.482 (95% CI, 3.11-8.15) P<0.0001; adjusted for NIHSS, other predictors and vascular risk factors] in patients with AIS. TRX improved the area under the receiver operating characteristic curve of the NHISS score for functional outcome from 0.722 (95% CI, 0.662-0.782) to 0.905 (95% CI, 0.828-0.962; P<0.0001). Our study demonstrated that elevated serum TRX level at admission was a novel diagnostic and prognostic marker in patients with acute ischemic stroke.