Role of Ferroptosis in Bone Homeostasis and Traditional Chinese Medicine Intervention： A Review / 中国实验方剂学杂志

Osteoporosis （OP） is a systemic metabolic bone disease characterized by bone microstructure degeneration and bone mass loss， which has a high prevalence and disability rate. Effective prevention and treatment of OP is a major difficulty in the medical community. The nature of OP is that multiple pathological factors lead to the imbalance of human bone homeostasis maintained by osteoblasts and osteoclasts. Ferroptosis is a non-apoptotic cell death pathway， and its fundamental cause is cell damage caused by iron accumulation and lipid peroxidation. Studies have shown that ferroptosis is involved in and affects the occurrence and development of OP， which leads to OP by mediating the imbalance of bone homeostasis. Ferroptosis is an adjustable form of programmed cell death. The intervention of ferroptosis can regulate the damage degree and death process of osteoblasts and osteoclasts， which is beneficial to maintain bone homeostasis， slow down the development process of OP， improve the clinical symptoms of patients， reduce the risk of disability， and improve their quality of life. However， there are few studies on ferroptosis in OP. Traditional Chinese medicine （TCM） is a medical treasure with unique characteristics and great application value in China. It has been widely used in China and has a long history. It has the multi-target and multi-pathway advantages in the treatment of OP， with high safety， few toxic and side effects， and low treatment cost， and has a significant effect in clinical application. The intervention of TCM in ferroptosis to regulate bone homeostasis may be a new direction for the prevention and treatment of OP in the future. This article summarized the regulatory mechanisms related to ferroptosis， discussed the role of ferroptosis in bone homeostasis， and reviewed the current status and progress of active ingredients in TCM compounds and monomers in the regulation of OP through ferroptosis， so as to provide a theoretical basis for the participation of TCM in the prevention and treatment of OP in the future.

A case of recurrent Miller-Fisher syndrome with multiple anti-ganglioside antibodies / 中国综合临床

Guillain-Barré syndrome (GBS) defines a kind of Immune-mediated acute inflammatory peripheral neuropathy. Miller-Fisher Syndrome (MFS) is a special variant of GBS, with mostly one-way course and rare clinical recurrence. Only a few recurrent cases have been reported in China. Here we report a case of a young male patient with double vision and progressive aggravation of limb numbness, acute onset, with symptoms of upper respiratory tract infection before onset, accompanied by pupil abnormalities and autonomic nervous dysfunction, who was was admitted to our hospital for similar symptoms 3 years ago and was improved by immunotherapy. The patient had a triad of “ataxia, areflexia and ophthalmoplegia”. Cerebrospinal fluid showed protein-cell separation. Serum anti-Sulfatides antibody IgM, anti-GT1a antibody IgG, anti-GQ1b antibody IgG and anti-GM3 IgM were positive. Recurrent MFS was diagnosed and the symptoms improved after immunotherapy. This case suggests that MFS is clinically heterogeneous, a few patients can present with relapse and generally have a better prognosis with immunotherapy. Pre-existing infection and anti-GQ1b antibody production may be predisposing factors for MFS recurrence.

Reproducible Abnormalities and Diagnostic Generalizability of White Matter in Alzheimer's Disease / 神经科学通报·英文版

Alzheimer's disease (AD) is associated with the impairment of white matter (WM) tracts. The current study aimed to verify the utility of WM as the neuroimaging marker of AD with multisite diffusion tensor imaging datasets [321 patients with AD, 265 patients with mild cognitive impairment (MCI), 279 normal controls (NC)], a unified pipeline, and independent site cross-validation. Automated fiber quantification was used to extract diffusion profiles along tracts. Random-effects meta-analyses showed a reproducible degeneration pattern in which fractional anisotropy significantly decreased in the AD and MCI groups compared with NC. Machine learning models using tract-based features showed good generalizability among independent site cross-validation. The diffusion metrics of the altered regions and the AD probability predicted by the models were highly correlated with cognitive ability in the AD and MCI groups. We highlighted the reproducibility and generalizability of the degeneration pattern of WM tracts in AD.

Guillain-Barré syndrome with GM3 antibody positive: a case report / 中华神经科杂志

Guillain-Barré syndrome is an autoimmune disease, and its pathogenesis is believed to be closely related to the appearance of ganglioside antibodies, while GM3 ganglioside antibodies have been reported rarely. This article reports a case of Guillain-Barré syndrome associated with GM3 antibody positive. The patient was a 58-year-old female. The chief complaint was "weakness of both lower limbs for 10 days, incomplete closure of the right eyelid for eight days, and incomplete closure of the left eyelid with dizziness for one day". The serum anti-GM3 antibody was positive, and her symptoms improved after treatment with gamma globulin.

Clinical analysis of neuropsychological and behavioral symptoms in a patient of frontal variant Alzheimer disease / 中国综合临床

Although the neuropathologic changes and diagnostic criteria for the neurodegenerative disorder Alzheimer′s diseasehave been established, the clinical symptoms are very different largely.The clinical symptoms of its special type frontal lobe variant and behavioral variant frontotemporal dementia are very similar, which brings great challenges to the differential diagnosis.Therefore, we report a patient with progressive cognitive impairment, early significant executive dysfunction and abnormal behavior, and magnetic resonance imaging showed significant frontotemporal atrophy.It is easy to be misdiagnosed as behavioral variant frontotemporal dementia.However, multimodal functional neuroimaging results show that neuropathological changes are more likely to be frontal variant Alzheimer′s disease.This study shows that the use of detailed neuropsychological tests, biological markers and multimodal neuroimaging to identify these atypical syndromes will help to improve the accuracy of diagnosis and patient management.

Clinical analysis of the effect of metabolic syndrome on cognitive function after acute ischemic stroke / 中华老年医学杂志

Objective@#To explore the effect of metabolic syndrome(MetS) and its individual components on cognitive impairment and neurological dysfunction in patients after acute ischemic stroke.@*Methods@#A total of 733 patients with acute ischemic stroke aged 60 to 83 years admitted in Tianjin Huanhu hospital from January 2010 to May 2018 were enrolled in this cross-sectional study.The patients were divided into the non-metabolic syndrome(non-MetS) group and the metabolic syndrome(MetS) group according to the diagnostic criteria of metabolic syndrome.Cognitive functions were evaluated by using the Montreal Cognitive Assessment(MoCA) and Mini-Mental State Examination(MMSE). Neuropsychiatric behavior was assessed by using the Neuropsychiatric Inventory(NPI) questionnaire.Emotional state was examined according to the 21-item Hamilton Depression Rating Scale(HAMD-21). The degree of neurological impairment after stroke was evaluated by using the National Institutes of Health Stroke Scale(NIHSS). The activity of daily living was evaluated by Barthel index and the Activity of Daily Living(ADL) scale.The overnight fasting blood samples were obtained in order to determine biochemical indicators.@*Results@#The average age of first-onset of ischemic stroke was earlier, and the body mass index(BMI) was higher in the MetS group than in the non-MetS group(P<0.05). The levels of high sensitivity C-reactive protein(hs-CRP), total cholesterol(TC), triglyceride(TG), low-density lipoprotein cholesterol(LDL-C), homocysteine(Hcy), fasting plasma glucose(FPG) and haemoglobin A1c(HbA1c) were higher, and the level of high-density lipoprotein cholesterol(HDL-C) was lower in the MetS group than in the non-MetS group(P<0.05). In addition, the proportions of patients with hypertension, type 2 diabetes and smokers were higher in the MetS group than in the non-MetS group(P<0.05). The scores of MMSE, MoCA and BI were lower and the scores of NIHSS, NPI-Q and HADM-21 were higher in the MetS group than in the non-MetS group.MetS could increase the risk of cognitive impairment in patients after acute ischemic stroke(OR=3.169, 95% CI: 1.110-9.048). After adjusting for socio-demographic and clinical covariates, the estimated OR value for increasing the risk of cognitive impairment was further increased in MetS(OR=4.741, 95% CI: 2.027-7.427). Furthermore, the increased numbers of MetS components were significantly associated with the cognitive impairment in patients after stroke.With the increasing number of MetS components, the scores of MoCA and BI were decreased, and the scores of ADL, NIHSS, NPI-Q, HADM-21 and Hachinski ischemic scale(HIS) were increased.With the increasing number of MetS components, the degree of neurological impairment and the risk of injury were increased.@*Conclusions@#MetS is associated with the decline of cognitive function, neuromotor dysfunction and the increased risk for neuropsychological disorders in patients after acute ischemic stroke.

Clinical analysis of the effect of metabolic syndrome on cognitive function after acute ischemic stroke / 中华老年医学杂志

Objective To explore the effect of metabolic syndrome(MetS) and its individual components on cognitive impairment and neurological dysfunction in patients after acute ischemic stroke.Methods A total of 733 patients with acute ischemic stroke aged 60 to 83 years admitted in Tianjin Huanhu hospital from January 2010 to May 2018 were enrolled in this cross-sectional study.The patients were divided into the non-metabolic syndrome(non-MetS) group and the metabolic syndrome(MetS) group according to the diagnostic criteria of metabolic syndrome.Cognitive functions were evaluated by using the Montreal Cognitive Assessment (MoCA) and Mini-Mental State Examination (MMSE).Neuropsychiatric behavior was assessed by using the Neuropsychiatric Inventory(NPI) questionnaire.Emotional state was examined according to the 21-item Hamilton Depression Rating Scale (HAMD-21).The degree of neurological impairment after stroke was evaluated by using the National Institutes of Health Stroke Scale(NIHSS).The activity of daily living was evaluated by Barthel index and the Activity of Daily Living(ADL) scale.The overnight fasting blood samples were obtained in order to determine biochemical indicators.Results The average age of first-onset of ischemic stroke was earlier,and the body mass index(BMI) was higher in the MetS group than in the non-MetS group (P ＜ 0.05).The levels of high sensitivity C-reactive protein (hsCRP),total cholesterol (TC),triglyceride (TG),low-density lipoprotein cholesterol (LDL-C),homocysteine(Hcy),fasting plasma glucose (FPG) and haemoglobin A1c (HbA1c) were higher,and the level of high-density lipoprotein cholesterol(HDL-C) was lower in the MetS group than in the non-MetS group(P ＜0.05).In addition,the proportions of patients with hypertension,type 2 diabetes and smokers were higher in the MetS group than in the non-MetS group(P＜0.05).The scores of MMSE,MoCA and BI were lower and the scores of NIHSS,NPI-Q and HADM-21 were higher in the MetS group than in the non-MetS group.MetS could increase the risk of cognitive impairment in patients after acute ischemic stroke(OR =3.169,95 ％ CI:1.110-9.048).After adjusting for socio-demographic and clinical covariates,the estimated OR value for increasing the risk of cognitive impairment was further increased in MetS(OR =4.741,95 ％ C1:2.027-7.427).Furthermore,the increased numbers of MetS components were significantly associated with the cognitive impairment in patients after stroke.With the increasing number of MetS components,the scores of MoCA and BI were decreased,and the scores of ADL,NIHSS,NPI-Q,HADM-21 and Hachinski ischemic scale (HIS) were increased.With the increasing number of MetS components,the degree of neurological impairment and the risk of injury were increased.Conclusions MetS is associated with the decline of cognitive function,neuromotor dysfunction and the increased risk for neuropsychological disorders in patients after acute ischemic stroke.

Olfactory and Imaging Features in Atypical Alzheimer's Disease.

OBJECTIVES: Cognition and speech disorders are the most common symptoms of dementia in neurodegenerative disease. Here, we present a detailed clinical evaluation of a case of logopenic variant of primary progressive aphasia (lv-PPA), an atypical form of Alzheimer disease (AD), including cognitive testing over time, brain imaging, electrophysiology, and tests of olfactory function. CASE REPORT: We present the case of a 58-year-old man suffering from progressive language difficulties who was finally diagnosed with lv-PPA. Clinical data included neuropsychological examinations, electrophysiology tests, neuroimaging, biomarkers, olfactory tests, and olfactory functional magnetic resonance imaging (fMRI). RESULTS AND DISCUSSION: The patient suffered from language disorders, including stumbling speech and forgetting appropriate words and how to pronounce some words. This had started 2 years earlier, and he had begun to deteriorate in recent months. In addition to his speech disorder, scores on the Mini Mental State Examination and Montreal cognitive assessment indicated that his cognition was affected. Structural imaging revealed no obvious hippocampal atrophy (score of 1), and molecular imaging showed hypometabolism and amyloid deposits in the temporal parietal region. The patient also presented with olfactory impairment. Although his odour detection threshold was normal, his cognitive threshold for scent recognition was significantly increased. Olfactory fMRI showed that activation of the whole brain and primary olfactory cortex was rare. CONCLUSION: This case provides evidence suggesting that lv-PPA is an atypical form of AD, with symptoms including speech disorders and impaired cognition. This patient with lv-PPA presented with olfactory impairment.

The comparison of urine AD7c-NTP levels and olfactory function among three types of dementia patients / 中华老年医学杂志

Objective To explore the diagnostic value of Alzheimer-associated neuronal thread protein(AD7C-NTP)and olfactory function in the differentiation of three types of dementia,and to evaluate their clinical application value.Methods Mini-Mental State Examination (MMSE)and Montreal Cognitive Assessment(MoCA)were applied to evaluate cognitive function of all subjects with Alzheimer disease(AD),frontotemporal dementia (FTLD),or mixed dementia (MD).Enzyme-linked immunosorbent assay(ELISA)was used to detect the expression levels of AD7c-NTP in urine.T&T test method was applied to detect the olfactory function.Spearman rank correlation was used to evaluate the correlation of urine AD7c NTP with MMSE and MoCA scores.Results There was no significant difference in the demographic profile (except age)among three types of dementia of AD,FTLD and MD(F =4.05,P =0.02).Among the three dementia groups,the mean age of the MD group was highest.The statistically significant difference in MMSE scores was found among the three groups(F 3.79,P=0.03),while there was no significant difference inMoCAand NPI scores among the three dementia groups.The levels of the urine AD7c-NTP were different among the three dementia groups,but without statistical significance(H 1.25,P =0.53).Additionally,the FTLD group had the highest urine AD7c NTP level.Spearman rank correlation analysis showed no correlation of AD7c-NTP with MMSE and MoCA(r =0.18,P =0.25;r =0.14,P =0.39,respectively).No differences in olfactory function of the recognition domain(H =3.40,P=0.18)and in the detection domain(H =2.07,P=0.36)were found among three dementia groups of AD,FTLD and MD.Conclusions The level of urine AD7c-NTP is not of clinical significance in differentiating three types of dementia,and it is not correlated with the MMSE and MoCA scores.This study fails to find the clinical value of olfactory function test for distinguishing three types of dementia.

Olfactory functional magnetic resonance imaging in patients with mild cognitive impairment / 中华耳鼻咽喉头颈外科杂志

Objective@#To analyze the activation of brain regions associated with olfactory in patients with mild cognitive impairment (MCI) by olfactory functional magnetic resonance imaging (fMRI). @*Methods@#Twenty six patients with MCI were compared with twenty six controls in the dementia center of Tianjin HuanHu hospital in terms of olfactory function T&T testing, the differences between the activation of the whole brain and region of interest associated with olfactory (bilateral primary olfactory cortex(POC), bilateral hippocampus, bilateral orbital frontal gyrus) by olfactory stimulator using event correlation design for olfactory fMRI scanning. To analyze the correlation between the number of activator in POC and the threshold of olfactory discriminate as well as the severity of cognitive impairment.SPSS 19.0 software was used for the statistical analysis. @*Results@#T&T olfactory testing revealed that MCI patients had higher scores than controls (3.57±1.29 (±s) vs 1.02±0.35, t=4.372, P<0.05). The activation range of whole brain in MCI patients was less than controls (pleasant odor (po) 147.36±21.45 vs 323.11±39.76, unpleasant odor (upo) 201.86±24.93 vs 447.73±57.22, tpo=4.241, tupo=5.365, both P<0.05). The activation range of whole brain in inhaling unpleasant odor was more than pleasant odor in controls (447.73±57.22 vs 323.11±39.76, t=3.936, P<0.05). The number of activator in ROIawo in MCI patients was less than controls (pleasant odor (po) 51.0[8.0, 109.0](M[P25, P75]) vs 135.0[21.0, 321.5], unpleasant odor (upo) 65.0[6.0, 158.0]vs 205.0[36.5, 491.0], Zpo=-2.199, Zupo=-2.216, both P<0.05). The number of activator in POC in MCI patients was less than controls (pleasant odor (po) 19.0[4.0, 35.5]vs 46.0[9.0, 118.5], unpleasant odor (upo) 26.0[2.0, 51.0]vs 79.0[17.5, 189.0], Zpo=-1.898, Zupo=-2.167, both P<0.05). The number of activator in POC was negatively correlated with olfactory discriminate threshold in MCI patients (rpo=-0.415, rupo=-0.409, both P<0.05). The number of activator in POC was positively correlated with MoCA in MCI patients (rpo=0.289, rupo=0.296, both P<0.05). @*Conclusion@#Olfactory fMRI can objectively assess the olfactory function in MCI, it is a imaging indicator with neuropsychological tests for detection in MCI, the number of activator in POC can reflect the severity of MCI.

Comparative study on neuropsychological tests for typical Alzheimer's disease, frontal variant of Alzheimer's disease and behavioral variant of frontotemporal dementia / 中华老年医学杂志

Objective To compare the neuropsychological features and other clinical and imaging characteristics among patients with typical Alzheimer's disease (TAD),frontal variant Alzheimer's disease (fvAD) and behavioral variant frontotemporal dementia (bvFTD).Methods Neuropsychological scales were used to evaluate the cognitive function and neuropsychiatric symptoms of nine patients with fvAD,30 patients with bvFTD and 32 patients with typical AD (TAD).The apolipoprotein E (ApoE) ε4 allele and brain imaging techniques,including the magnetic resonance imaging (MRI),11 C-Pittsburgh compound B positron emission tomography (PIB-PET),and 18F-deoxyglucose positron emission tomography (FDG-PET),were used for the differential diagnosis of fvAD and bvFTD.Results There were no significant differences in general cognitive function or daily activity in patients among the three groups.However,the cognitive subscale scores of Montreal Cognitive Assessment (MoCA) scale,including visual acuity and executive function,delayed recall,and orientation,were significantly different among the groups (Z =7.891,P =0.035;Z =7.412,P =0.031;Z=6.437,P=0.043,respectively).The clock drawing test (CDT) score of TAD group was higher than that in the bvFTD and fvAD groups (Z=8.673,P=0.020),while the neuropsychological questionnaire (NPI) scores of the bvFTD and fvAD groups were higher than those of the TAD group (Z=7.577,P =0.023).Meanwhile,the incidences of agitation,disinhibition and abnormal behavior of NPI in the bvFTD and fvAD groups were higher than those in the TAD group (x2 =11.139,P =0.004;x2 =6.481,P =0.039;x2 =6.812,P =0.033,respectively).The frequencies of the ApoE ε4 allele were 44.4％ in the fvAD group and 33.3％ in the bvFTD group,which were not significant different from that in the TAD group (40.6％).Furthermore,patients in the fvAD group were associated with decreased regional cerebral glucose metabolism and amyloid deposition in the temporalparietal cortex evaluated by FDG-PET and PIP-PET.Conclusions Neuropsychological evaluation is valuable for the differential diagnosis of TAD,fvAD and bvFTD.The frequencies of the ApoEε4 allele are similar among the three groups.FDG-PET and PIB-PET imaging plays an important role in the diagnosis of variant types of Alzheimer's disease.

A transcranial magnetic stimulation study on Alzheimer's disease and behavioral variant frontotemporal dementia / 中华神经科杂志

Objective To investigate the changes in cortical excitability and inhibitory circuits of patients with Alzheimer's disease (AD) or behavioral variant frontotemporal dementia (bvFTD) using transcranial magnetic stimulation (TMS).Methods Forty-four patients with AD,30 patients with bvFTD and 44 healthy controls were enrolled in the study.The epidemiological data of all subjects were collected.Each participant received a neurological evaluation and neuropsychologic tests which included Mini-Mental State Examination (MMSE),Activities of Daily Living (ADL) and Hamilton Rating Scale for Depression (HAMD).Neurophysiological evaluations including resting motor threshold (rMT),active motor threshold (aMT) and cortical silent period (CSP) were conducted by means of TMS.Neurophysiological parameters were compared among groups.Results There were significant differences in MMSE,ADL and HAMD assessments among 3 groups,but no significant differences between AD and bvFTD groups.There were significant changes in left rMT(46.52％ ± 8.77％,52.00％ ± 7.30％ and 52.14％ ± 8.27％,F =6.295,P=0.003),left aMT(29.68％ ±7.01％,35.13％ ±8.46％ and 35.39％ ±7.24％,F=7.735,P=0.001) and right rMT(47.82％ ±7.94％,52.07％ ±8.77％ and 53.12％ ±8.61％,F=4.772,P=0.010) among 3 groups.AD patients showed significantly reduced left rMT and aMT comparing to bvFTD patients (P =0.017 and 0.008 respectively) and controls (P =0.005 and 0.002 respectively).In addition,AD patients had a significant decrease in right rMT comparing to controls (P =0.011).There were no statistically significant differences in TMS parameters between bvFTD patients and controls.Conclusions AD is associated with hyperexcitability of the motor cortex,whereas the lack of changes in motor cortical excitability is found in bvFTD.TMS technique may be helpful in differential diagnosis between AD and bvFTD.

An analysis and literature review of two cases of autoimmune encephalitis with GABAB receptor antibodies / 中华内科杂志

Autoimmune encephalitis with GABAB receptor antibodies has been rarely reported.Two cases of GABAB receptor antibodies encephalitis were presented here.Epilepsy was the onset symptom,followed by declined consciousness and frequent seizures.Fever was presented in the whole course of the disease.Myorhythmia of the two hands and pilomotor seizures were shown in the later course of the disease.No specificity was demonstrated in electroencephalograms and magnetic resonance imaging.Sensitive response was shown to the first-line immunotherapy.

Olfactory function in patients with mild cognitive impairment / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>To analyze the correlation between olfactory bulb (OB) volume, depth of olfactory sulcus (OS) and olfactory function in patients with mild cognitive impairment (MCI).</p><p><b>METHODS</b>Fifty patients with MCI were compared with fifty controls in terms of olfactory function T&T testing, OB volume and depth of OS assessed with magnetic resonance imaging (MRI). SPSS 13.0 software was used to analyze the data.</p><p><b>RESULTS</b>T&T olfactory testing revealed that MCI patients had higher scores than controls (t = 3.142, P < 0.05). Both men and women with MCI were affected by the same extent of olfactory loss(t = 0.973, P > 0.05). Both men and women as controls were affected by the same extent of olfactory loss (t = 1.092, P > 0.05).OB volume of left side in MCI patients was (36.35 ± 4.09) mm(3), right side was (36.57 ± 4.13) mm(3), average OB volume was (36.47 ± 4.12) mm3; OB volume of left side in controls was (46.65 ± 6.23) mm(3), right side was (46.83 ± 6.27) mm(3), average OB volume was (46.71 ± 6.25)mm(3); OB volumes were lower in MCI patients as compared with controls (t value was 3.113, 3.145 and 3.132, all P < 0.01).OS depth study revealed no statistical different between MCI patients and controls (t value was 0.876,0.952 and 0.904, all P > 0.05). Olfactory discriminate threshold was negatively correlated with OB volume in MCI patients and controls (r value was -0.643, -0.541, both P < 0.05); was no correlated with depth of OS (r value was -0.167 and -0.183, both P > 0.05). Olfactory discriminate threshold was negatively correlated with cognitive impairment degree in MCI patients (r value was -0.427, -0.418 and -0.399, all P < 0.05), average OB volume was positively correlated with cognitive impairment degree in MCI patients (r value was 0.364, 0.383 and 0.379, all P < 0.05).</p><p><b>CONCLUSIONS</b>The OB volumes are lower in MCI patients as compared with controls, the depth of OS show no significant changes in MCI patients. The OB volume is correlated with olfactory function, the depth of OS is not correlated with olfactory function. Cognitive impairment degree in MCI patients is accordance with olfactory function lower degree. The olfactory loss may be a earlier period and objective diagnosis indicator for MCI patients.</p>

Comparative analysis of cognitive function and neuropsychiatric behavior between Alzheimer's disease and frontotemporal dementia patients / 中华神经科杂志

Objective The purpose of this study was to investigate the differences of cognitive impairment and neuropsychiatric behavior disturbances between Alzheimer's disease (AD) and frontotemporal dementia (FTD) patients,as well as their relationships with dementia severity.Methods A total of 38 FTD patients and 46 AD patients were recruited in this study.The Montreal Cognitive Assessment (MoCA) and Mini-Mental State Examination (MMSE) were used to evaluate the degree of cognitive impairments.The Neuropsychiatric Inventory Brief Questionnaire Form (NPI) and Frontal Behavioral Inventory (FBI) were used to measure behavioral disturbances.The 21-items Hamilton Depression Rating Scale (HAMD-21) was used to evaluate the mental or emotional state of patients.Clinical dementia rating scale (CDR) was used to divide the dementia severity.Results FTD patients were younger ((70.13 ± 8.36) years vs (66.46 ± 7.04) years,t =2.124,P =0.037),earlier at age of onset ((68.58 ± 8.51) years vs (64.43 ± 6.82) years,t =2.396,P =0.019),with lower MoCA scores (12.50 (8.00,16.25) vs 17.00(10.75,21.00),Z=-2.428,P=0.015),higher NPI (15.00(7.00,25.50)vs 9.50(4.00,17.75),Z=-2.251,P=0.024),FBI (21.00(13.00,27.00)vs 16.00(10.75,23.00),Z=-2.159,P=0.031),FBI-A (13.00 (8.00,16.00)vs 9.00(6.00,12.00) Z=-2.159,P=0.041),FBI-B (9.00(7.00,14.00) vs 7.00(3.00,11.00),Z=-2.051,P=0.040) and HAMD-21 scores (7.00(2.75,14.00) vs 5.00 (3.00,8.00),Z =-2.061,P =0.039).A detail analysis of different cognitive domains showed the executive functions (Z =-2.140,P =0.032),language (Z =-3.357,P =0.001),abstraction (Z =-2.498,P =0.012) and delayed recall (Z =-4.317,P =0.000) of the MoCA scale were lower in FTD patients than that in AD patients,while AD patients had lower scores in memory (Z =-1.999,P =0.046) and orientation (Z =-2.941,P =0.003) of the MMSE scale.Within the subscale scores of the NPI,the agitation (Z =-3.255,P =0.001),disinhibition (Z =-3.093,P =0.002) and irritability (Z =-2.214,P =0.027) scores were higher in FTD patients than in AD patients.The total scores of NPI (r=0.279,P=0.010),FBI (r =0.353,P=0.001),FBI-A (r=0.386,P=0.000) and FBI-B (r =0.273,P =0.012) were positively correlated with the CDR scores,whereas MoCA scores were negatively correlated with the CDR scores (r =-0.760,P =0.000).The subscale scores on MoCA and NPI areas changed corresponding with dementia severity in both groups.Conclusions The cognitive function,behavioral and psychological symptoms between FTD and AD patients are different.FTD patients have poorer executive function,language,abstraction and delayed recall ability,whereas AD patients perform worse in memory and orientation.With the progression of the disease,FTD patients gradually emerged disorientation,while the cognitive impairment in AD patients almost affected all the areas.FTD patients are more likely to have agitation,disinhibition and irritability behavior,and AD patients are more likely to have depression in the late stage.Dynamic evaluation of the cognitive function,behavioral and psychological symptoms in clinical practice can help to distinguish FTD and AD.

Analysis on Risk Factors of Type 2 Diabetes Mellitus with Mild Cognitive Dysfunction / 天津医药

Objective To investigate the risk factors of mild cognitive impairment (MCI) in patients with type 2 dia-betes (T2DM), and the clinical evidence for the early diagnosis and treatment thereof. Methods A total of 217 T2DM pa-tients were divided into T2DM with MCI group (n=92) and T2DM with normal cognitive function(NMCI) group (n=125). Mon-treal cognitive assessment scale (MoCA) and activities of daily living scale (ADL) were used to assess the functional status in two groups of patients. The general clinical data and biochemical indicators were obtained and compared in two groups. Re-sults There were statistical differences in age, smoking history, education status, high sensitive C reactive protein (hs-CRP), coronary heart disease, hypertension, glycated hemoglobin A1c (HbA1c) and T2DM history between two groups. Re-sults of univariate logistic regression analysis showed that old age, longer course of T2DM, smoking history, higher hs-CRP and HbA1c, complicated with coronary heart disease and hypertension were risk factors for T2DM with MCI, while the higher education status was a protective factor. Multiple logistic regression analysis showed that old age and longer T 2DM history were risk factors, and the higher education was a beneficial factor for T2DM with MCI. Conclusion Many risk factors may play a part in T2DM with MCI. Early detection and prompting medical attention may help prevent and decrease the preva-lence of MCI in patients with T2DM.

Role of Family-Community-Hospital Rehabilitation Management on Community Schizophrenics / 中国康复理论与实践

@#Objective To investigate the rehabilitation role of family-community-hospital rehabilitation management for communityschizophrenics. Methods 110 schizophrenic patients were divided into the control group (n=60) and the training group (n=50). The controlgroup were followed up once a month, while the training group participated in the family-community-hospital rehabilitation care. They wereassessed with Social Disability Screening Schedule (SDSS), General Well-Being Schedule (GWB), Self-Esteem Scale (SES) before and afterthe treatment, as well as the compliance and management of medcine questionnaire. Results No significant difference was found betweenthese groups with SDSS, happiness, self-esteem, compliance and management of medcine before the training(P>0.05), but were significantlyhigher in the training group(P<0.01). Conclusion Family-community-hospital rehabilitation management can significantly improvethe social function, the happiness, the self-esteem, the medication compliance and self-management of schizophrenia patients.

Effect of self-recognition-based health management on community diabetics / 中华健康管理学杂志

Objectives To learn the effect of self-recognition-based healthy management on community diabetics. Methods A total of 40 community diabetics were evaluated and trained for 3 months.SPSS11.5 software was used for data analysis. Results At 3 months, some risk factors of diabetes,including body weight, body mass index (BMI), waist circumstance (WC), systolic blood pressure (SBP), diastolic blood pressure (DBP) and 2 h postprandial blood sugar (PBS), were improved (P ＜0. 05). Male patients showed statistically significant reduction in body weight, BMI and WC ( P ＜ 0. 05 ).However, female subjects were found to have significant decline in body weight, BMI, WC, SBP and DBP (P＜0. 05). Those ＞60 year-old had significantly decreased body weight, BMI, WC, SBP, DBP and 2 h PBS ( P ＜ 0. 05). Lower levels of WC, SBP and triglyceride were seen in individuals ＜ 60 year-old ( P ＜0. 05 ). Conclusion Self-recognition-based healthy management could effectively reduce diabetic risk factors and prevent the development of diabetic complications.

Effects of uvulopalatopharyngoplasty on hemorheology in patients with obstructive sleep apnea hypopnea syndrome / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To observe the effect of UPPP on hemorheology in patients with obstructive sleep apnea-hypopnea syndrome (OSAHS).@*METHOD@#Thirty patients of moderate or severe OSAHS were randomly selected from February 2004 to February 2006 in our hospital. Among them, 11 cases are moderate OSAHS (AHI40). They were received uvulopalatopharyngoplasty. Whole blood specific viscosity, erythrocytic and erythrocyte aggregation index were detected before and after operation.@*RESULT@#The values of testing in post operation were significantly lower than that in pre-operation (P<0.01).@*CONCLUSION@#Uvulopalatopharyngoplasty has can improve abnormity of hemorheology of OSAHS and decrease the danger of cerebrovascular disorder.

A clinical analysis of nasal endoscopic management for refractory epistaxis / 中国微创外科杂志

Objective To summarize the clinical experience of nasal endoscopic treatment for refractory epistaxis. Methods .A retrospective analysis was made on 258 patients with refractory epistaxis treated with intranasal endoscopic exploration and hemostatic treatment from January 1998 to December 2004 in this hospital. Results .Hemorrhage was found on the nasal septum and the lateral nasal wall in 118 and 47 patients, respectively. Nose bleeding resulted from intranasal tumor in 8 patients. The site of bleeding was not clearly identified in 85 patients. Of the 258 patients, 257 responded to the treatment (99.6%) and 1 died ( 0.4%).Recurrent bleeding occurred in 43 patients. The incidence of recurrent bleeding was significantly higher in patients with unknown bleeding sites than in clearly diagnosed patients (?2=17.689,P=0.000). Conclusions .The emphasis of nasal endoscopic treatment for refractory epistaxis should be laid on the initial management, during which the bleeding site should be carefully identified. For patients with repeated nose bleeding, a combination treatment, including endoscopic filling-up of the anterior nasal cavity, endoscopic embolization of anterior and posterior nose, or embolization of the internal maxillary artery, is necessary.