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Objective:To investigate the relationship between cognitive function and brain event-related potential in patients with lacunar cerebral infarction.Methods:A total of 464 patients with lacunar cerebral infarction admitted to the Department of Neurology, Kailuan General Hospital from 2014 to 2019 were prospectively selected as observation subjects (case group). According to mini-mental state examination (MMSE) score, the patients in the case group were divided into 352 cases of lacunar cerebral infarction with normal cognition and 112 cases of mild cognitive impairment. At the same time, 100 healthy volunteers were selected as the control group. All subjects were assessed by simple intelligent mental state, Zung self-rating anxiety scale, Zung self-rating depression scale and brain event-related potential P3a and P3b. The measurement data of normal distribution adopts one-way ANOVA, the measurement data of non normal distribution adopts Kruskal Wallis H test, and the counting data adopts χ2. Multivariate statistical analysis was performed by unconditional Logistics (stepwise method). Results:The proportions of smokers in control group, lacunar cerebral infarction cognitive normal group and lacunar cerebral infarction mild cognitive impairment group were 20.00% (20/100), 38.07% (134/352) and 46.42% (52/112), respectively. The proportions of drinkers were 18.00% (18/100), 33.24% (117/352), 33.93% (38/112), respectively. The proportions of hypertension were 38.00% (38/100), 58.24% (205/352), 59.82% (67/112), respectively. The proportions of hyperhomocysteinemia were 19.00% (19/100), 34.00% (120/352) and 68.75% (77/112), respectively, and the differences among the three groups were statistically significant ( χ2 values were 15.66, 7.91, 11.86 and 54.57, respectively; P<0.001, 0.019, 0.003, <0.001). The peak latency CZ leads of visual P3b wave group N2 were (271.48±40.65), (285.67±44.08) and (290.57±68.41) ms, respectively. PZ leads were (276.70±50.92), (287.86±43.28) and (312.16±62.75) ms. P3b peak latency FZ leads were (392.67±42.50), (405.82±52.43) and (410.34±64.27) ms. CZ leads were (395.04±42.44), (412.51±55.86) and (433.28±66.32) ms. PZ leads were (398.24±40.93), (411.17±49.48) and (435.78±67.69) ms. N2 amplitude CZ leads were (-3.99±2.81), (-3.60±3.00) and (-2.70±2.37) μV, PZ leads were (-3.18±2.69), (-2.91±2.62) and (-1.87±2.89) μV, respectively. Leads P3b amplitude of FZ were 5.27 (3.27, 7.40), 4.21 (2.31, 6.49) and 3.12 (1.61, 5.08) μV. CZ leads were 4.81 (2.78, 6.71), 4.15 (2.76, 6.16) and 3.51 (1.75, 5.15) μV. PZ leads were 5.17 (3.03, 6.97), 4.40 (2.89, 6.12) and 3.43 (1.52, 5.34) μV. There were statistically significant differences among the 3 groups ( F=3.29, 14.49, 3.95, 11.73, 14.06, 5.66 and 3.57, H=18.23, 10.33,18.25; P=0.027, <0.001, 0.025, <0.001, <0.001, 0.004, 0.042, <0.001, 0.006, <0.001). The peak latency FZ leads of visual P3a wave group N2 were 265.00 (256.00, 286.00), 277.00(260.00,300.00), 282.00(270.00,304.00) ms, respectively. CZ leads weres 274.00(255.00,305.00), 285.00(262.00,329.00), 293.50(270.00,346.00) ms. P3a peak latency FZ leads were (413.83±49.58), (429.83±55.38) and (449.04±54.79) ms, CZ leads were (441.53±61.78), (457.12±69.29) and (460.23±72.24) ms. PZ leads were (430.14±54.53), (462.31±69.2) and (470.02±74.92) ms. N2 amplitude FZ leads were (-6.34±3.13), (-5.72±2.96) and (-4.92±2.05) μV, respectively. Leads P3a amplitude of FZ were 4.00 (2.28, 5.55), 3.15 (2.14, 4.91) and 2.80 (2.19, 4.19) μV. CZ lead were 3.37 (1.98, 4.66), 2.73 (1.70, 3.97) and 2.41 (1.64, 3.45) μV. There were statistically significant differences among the three groups ( H=13.92, 8.65, 9.17, 10.02, F=8.18, 6.33, 10.73, 4.62, P =0.001,0.013,0.010,0.007, <0.001,0.002, <0.001,0.010). Logistic regression analysis showed that alcohol consumption, P3b peak latency and wave amplitude PZ lead, N1 wave amplitude of visual P3a group FZ lead were the influencing factors of MMSE ( OR=0.04, 1.01, 0.76, 1.51, 95% Cl were 0.00-0.30, 1.00-1.03, 0.59-0.97, 1.08-2.10, P=0.002,0.007,0.029,0.016). Conclusion:The peak latency and amplitude of endogenous psychological cognitive potentials N2, P3b and P3a of event-related potentials P3b and P3a in patients with lacunar cerebral infarction were prolonged and decreased. At the same time, with the occurrence of clinical cognitive impairment, the peak latency and amplitude of these cognitive potentials were further prolonged and decreased more significantly. Alcohol consumption, P3b peak latency and PZ lead of visual P3b wave group, and FZ lead of N1 wave of visual P3a wave group were the influencing factors of simple intelligent mental state.
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Objective:To analyze the changes of cerebral perfusion level and its relationship with cognitive impairment in patients with first anterior circulation acute ischemic post-stroke cognitive impairment.Methods:From March 2018 to March 2020, 70 patients with acute ischemic stroke in the first anterior circulation who were treated in the Department of Neurology of Kailuan General Hospital affiliated to North China University of Technology and met the inclusion and exclusion criteria were retrospectively analyzed.The mini-mental state examination was used to divide 36 cases of post-stroke cognitive impairment group and 34 cases of post-stroke cognitive impairment group.All the selected patients were examined by computed tomography(CT) and diffusion-weighted MR imaging(MRI-DWI) to determine the diagnosis and distribution of lesions; detection of cerebral artery stenosis by MRA; apply 3D pseudo-continuous arterial spin labeling(3D-pCASL) perfusion imaging, set the post label delay 1.5 s and 2.5 s to detect cerebral perfusion level.Results:(1)There was no statistical significance between the two groups in the comparison of basic clinical data.(all P>0.05). (2) The proportion of patients with middle cerebral artery, anterior cerebral artery and internal carotid artery ≥1 or ≥2 moderate and severe stenosis / occlusion on the focal side in the post-stroke cognitive impairment group (91.67%(33/36), 33.33%(12/36)) was higher than that in the post-stroke non-cognitive impairment group (23.53%(8/34), 8.82%(3/34)); the proportion of patients with moderate and severe stenosis / occlusion of MCA and ICA on the focal side in the post-stroke cognitive impairment group (69.44%(25/36), 44.44%(16/36)) was higher than that in the post-stroke cognitive impairment group (14.71%(5/34), 11.76%(4/34)), and the difference was statistically significant(χ 2 values were 33.455, 6.239, 21.394, 9.150, all P<0.05). (3) The proportion of patients with ≥ 2 cerebral infarction lesions in the post-stroke cognitive impairment group (61.1%(22/36))was higher than that in the post-stroke cognitive impairment group (38.03%(27/71))than that in the non-stroke group (20.6%(7/34), 19.05%(8/42)), and the difference was statistically significant(χ 2=11.833, 4.447, all P<0.05). PLD 2.5 s, the CBF value of frontal lobe infarction in post-stroke cognitive impairment group((31.516±8.333) mL/(100 g·min)) was lower than that in post-stroke non-cognitive impairment group((45.442±8.281) mL/(100 g·min)), the difference was statistically significant( t=3.835, P<0.05). Correlation analysis showed that the CBF value of PLD 2.5 s frontal infarction lesion was positively correlated with MMSE score( r=0.738, P<0.05). (4) The proportion of patients with ≥ 1 or ≥ 2 hypoperfusion areas (frontal lobe, temporal lobe, parietal lobe) on the focal side of PLD 1.5 s and 2.5 s after stroke (88.89%(32/36), 88.89%(32/36), 77.78%(28/36), 66.67%(24/36)) were higher than those without cognitive impairment after stroke (67.65%(23/34), 8.82%(3/34), 29.41%(10/34), 0), the difference was statistically significant(χ 2 values were 4.686, 44.837, 16.483, 34.493, all P<0.05). At PLD 1.5 s, CBF values of frontal lobe and parietal lobe in cerebral hypoperfusion area ((20.260±5.266) mL/(100 g·min), (17.664±3.947) mL/(100 g·min)) in patients with cognitive impairment after stroke were lower than those in patients without cognitive impairment ((33.442±10.563) mL/(100 g·min), (28.071±6.913) mL/(100 g·min)), the difference was statistically significant( t values were 3.392, 6.225, all P<0.05), at PLD 2.5 s, the CBF value after compensatory perfusion of frontal lobe, parietal lobe and temporal lobe in the post-stroke cognitive impairment group ((37.732±8.355) mL/(100 g·min), (32.942±6.459) mL/(100 g·min), (39.282±7.443) mL/(100 g·min)) was lower than that in the non cognitive impairment Group ((57.189±9.965) mL/(100 g·min), (52.415±7.017) mL/(100 g·min), (49.258±8.912) mL/(100 g·min)), the difference was statistically significant( t values were 5.443, 10.227, 2.950, all P<0.05). Correlation analysis found that the CBF value of the frontal lobe and parietal lobe of the PLD 1.5 s lesion area and the CBF value of the PLD 2.5 s hypoperfusion brain area after the perfusion of the frontal lobe, parietal lobe, and temporal lobe were positively correlated with the MMSE score( r values were 0.693, 0.675, 0.823, 0.799, 0.545, all P<0.05). Conclusion:Patients with first anterior circulation acute ischemic post-stroke cognitive impairment often have extensive hypoperfusion in the peripheral cerebral region, the occurrence of cognitive impairment after the first anterior circulation acute ischemic post-stroke cognitive impairment is related to the decrease of the perfusion level of the infarct lesion and the brain area around the lesion.
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Objective To investigate the imaging features of hippocampus and entorhinal cortex in the normal,mild cognitive impairment(MCI) and Alzheimer's disease (AD),and explore the value of diagnosing MCI and AD by using the method of MRI measuring the volume of hippocampus and entorhinal cortex.Method One hundred and twenty-two people including 42 cases of MCI,38 cases of AD,and 42 cases of noroal cognition(NC) were selected as our subjects from health examination persons both in hospital and outpatient service.All were performed general examination and neuropsychological scale evaluation.The volume of hippocampus and entorhinal cortex were measured by using MRI.The correlation between the volumetric changes of hippocampus and entorhinal cortex with scores of mini-mental state examination (MMSE) and Montreal Cognitive Assessment(MoCA) was analyzed.Results The volume of hippocampus and entorhinal cortex in the MCI group,AD group and NC group were (6.29 ± 1.13)cm3 and (2.71 ± 0.51) cm3,(6.27 ± 1.11) cm3 and (2.09 ±0.68) cm3,(7.01 ±0.92) cm3 and (3.12 ±0.34) cm3 respectively.The volume of MCI group was obviously smaller than that of NC group (P ＜ 0.05).The volume of AD group was smaller than that of NC group(P ＜0.01).The volume of AD group was obviously smaller than that of MCI group(P ＜0.01).There was positive correlation between hippocampus volume,the volume of entorhinal cortex and MMSE scores (r =0.770,0.811 ; P ＜ 0.01).Meanwhile,hippocampal volume,volume of entorhinal cortex were positive correlated with MoCA (r =0.810,0.842; P ＜ 0.01).Conclusion The atrophy of entorhinal cortex and hippocampus is closely related to cognitive disorder.The MRI measuring of the volume of entorhinal cortex and hippocampus has a potential value in diagnosing and distinguishing of MCI and NC.
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Objective To investigate the clinical application of renal vessel angiography with 256-slice spiral CT in laparoscopic surgery for renals.Methods One hundred and fifty-five cases underwent computed tomograph angiography(CTA) who were all confirmed by operations.According to preoperative renal artery CTA case shown,the initial plan intraoperative renal artery was compared with the situation with the actual surgery.AIl axial images were reconstructed using technique.Results All patients underwent preoperative renal artery CTA operative findings correspond with the actual rate of 100％.CTA stereoscopic images were good at reflecting renal vascular anatomy and ectopic blood vessels line.Conclusion CTA can accurately evaluate out of shape and variation of the renal arteriesvariation.It has important significance of processing of renal arteries intraoperative rapid,dealing with the renal artery accurately and reducing blood loss or damage and other complications.
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Objective To study the clinical significance of urinary hTERT in diagnosis and follow up of transitional cell carcinoma of urinary bladder.Methods Semi-quantitative RT-PCR was used to detected the expression of hTERT mRNA expression in 42 cases with bladder transitional carcinoma and 40 patients without carcinoma of bladder.Regular urine cytology results were compared with the expression of hTERT.Following-up observision of the changes of hTERT mRNA expression and its relation with recurrency in 36 cases of transitional cell carcinoma of urinary bladder was conducted.Results 30 0f 42 cases with bladder transcriptional carcinoma were found positive expression of hTERT.but only 3 in the control group of 40 cases presented the positive expression of hTERT.The overall sensitivity and specificity for hTERT were 71.43%and 92.50%.The sensitivities for hTERT were 50.00%,73.68%and 90.91%respectively in G1-G3 tumor.The urine hTERT expression level significantly increased with the tumor grade and clinical staging.The sensitivity and the specificity of urinary cytology were 19.05%and 100%.Compared with hTERT.the cytology had lower sensitivity and no difference in specificity.The recurrence of the tumor was found in 6 patients.8-16 weeks after positive expression of hTERT,cystoscope confirmed recurrence of bladder carcinoma.Conclusions hTERT is a tumor marker of transcriptional carcinoma of bladder.because of its relatively high sensitivity and specificity.Detection of hTERT in urine sediment is superior to traditional cytology.The urine hTERT rate significantly increases with the tumor grade and the clinical stage.hTERT can indicate recurrence of bladder carcinoma.so it is valuable to the monitoring of recurrence of transcriptional cell carcinoma of bladder.
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OBJECTIVE:To discuss the preparation methods of polyaspartate derivatives as drug delivery systems. DATA SOURCES:An online search of Elselvier,ACS publications and Springerlink between January 1990 and January 2006 was undertaken by using the keywords of "polyaspart*,hydrogels,micelles,complexes" to identify the relevant articles published in English.Meanwhile,Chinese journals full-text database were scanned with computer to search relevant articles published from January 1995 to October 2005,and the keywords were"asparmide,complexes,hydrogels,release" with language limited to Chinese.STUDY SELECTION:All the related data were analyzed to select those were aimed directly at the criteria.As for the arti cles in the same field,those published recently or published in the authority journals were preferred. DATA EXTRACTION:A total of 56 articles about the preparation methods of polyaspartate derivatives as drug delivery systems were collected, and 29 of them were in accordance with the inclusion criteria. DATA SYNTHESIS:Polyaspartate derivatives are new biodegradable and biocompatible materials.Covalent complexes, hydrogels and micelles,three main drug delivery systems of polyaspartate derivatives,exhibit good biocompatibility and conspicuous effect of control-release.CONCLUSION:With the help of the short synthesis route,simple manipulation,high production rate, the excellent biocompatibility as well as the better hydrophile,the polyaspartate derivatives are prone to reacting with other compounds for the modification.It is noted that the controllability of the control-release systems will be well improved through the researches of the influence factors of the degrading velocity and the new modifying method,additionally,the polyaspartate derivatives will be applied in the drug delivery field widely.
