Objective To examine the impact of chronic diseases and blood biomarkers on daily living activities of hospitalized nonagenarians.Methods We used data from 161 nonagenarians who had been admitted to the Department of Internal Medicine from January to December 2014.Patients were divided into three groups:the mild dependence group,the moderate dependence group and the severe dependence group,based on the Barthel Index.Data were collected from patients' medical records.Differences in chronic disease characteristics and biomarkers between the three groups were compared and multiple regression and correlation analysis was also carried out.Results Compared with the mild independence group,patients in the severe dependence group were older(92.6 ± 2.6 vs.91.2 ±1.7 years,P＜ 0.05)and had lower levels of sodium(138.0 ± 5.0 vs.140.9 ± 3.7 mmol/L),albumin(35.4 ± 4.2 vs.39.2 ± 4.3 g/L),prealbumin,total cholesterol,low density lipoprotein cholesterol,and total iron binding (34.8 ± 7.9 vs.43.2 ± 7.4 mmol/L) respectively,P＜ 0.01 or 0.05),and higher levels of high-sensitivity C-reactive protein [22.0 (31.6) vs.2.6 (6.6) g/L,P＜ 0.01].Multivariate linear regression showed that albumin (β=0.23,P =0.011),sodium (β=0.21,P=0.003),total iron biding capacity(β=0.26,P=0.003),and age (β=-0.15,P =0.036) were significantly associated with daily living activities.Conclusions Higher proportions of hospitalized nonagenarians suffer multiple diseases.Activities of daily living are significantly associated with albumin,total iron biding capacity,and sodium.While the number of diseases has no influence on activities of daily living,good nutritional status and electrolyte balance are very important to nonagenarians.

Objective To investigate the ultrasonic appearance of peripheral neurilemmoma.Methods Ultrasonic appearances of 43 patients with 46 neurilemmomas confirmed by surgery and pathology were analyzed retrospectively and compared with their MRI and pathological features.Results Forty-five neurilemmomas were with regular shape and clear boundary,except one at the root of nerve C4 that was irregular in shape and unclear in boundary,like adumbbell.Sonography showed that there were 30 neurilemmomas displaying as solid tumors,15 as cystic and solid,and 1 as entirely cystic.Posterior echoenhancement,target sign,rat tail sign and vessels accompanying sign were found in 39,21,23 and 17 neurilemmomas,respectively.There were 4 neurilemmomas with ultrasound blood flow grade 0,9 with grade Ⅰ,22 with gradeⅡ,and 11 with grade Ⅲ.The target signs were found in 21 cases (21/46,45.6％) and 26 cases (26/46,56.5 ％) by ultrasound and MRI,respectively.The capability of ultrasound finding the target sign in neurilemmoma was comparable to MRI(Kappa =0.527,P ＜0.001).The diagnostic accuracy rate of neurilemmoma by ultrasonography was 73.9％(34/46).Conclusions The ultrasound has a relatively high detection of the target sign in neurilemmoma,which may provide a new basis for the ultrasonic diagnosis of neurilemmoma.

ObjectiveTo observe the variation in content of vascular endothelial growth factor （VEGF） in patients with Alzheimer's disease （AD） and to investigate efficacy of Yangxue Qingnao granule on AD and the effect on VEGF. MethodA total of 60 patients with cognitive impairment ［30 of AD and 30 of amnestic mild cognitive impairment （aMCI）］ were selected， and another 30 healthy people with Montreal Cognitive Assessment （MoCA）≥26 and age， gender， and complications insignificantly different from the patients were included as healthy control. The venous blood of aMCI group， AD group， and the healthy control group was collected at the enrollment to measure the level of serum VEGF. Then， the aMCI and AD patients were randomized into the observation group and the control group， with 30 patients in each group. The control group was given Donepezil Hydrochloride （5 mg·d^-1）， while the observation group received Donepezil Hydrochloride （5 mg·d^-1） and Yangxue Qingnao granule. MoCA was used to evaluate the severity of cognitive impairment. After the treatment for 6 months， the clinical efficacy and adverse reactions of the two groups were compared， and the serum VEGF levels were detected again by enzyme-linked immunosorbent assay （ELISA）. ResultThe serum content of VEGF in AD patients was significantly lower than that in aMCI patients and healthy people （P<0.05）. Serum VEGF levels in aMCI patients were significantly decreased compared with those in healthy people （P<0.05）. After treatment for 6 months， the serum VEGF level in the observation group was significantly higher than that before treatment， and was higher than that in the control group （P<0.05）. MoCA scores in the observation group were higher than those in control group （P<0.05）. The incidence of adverse reactions was insignificantly different between both groups. ConclusionThe serum levels of VEGF significantly decreased in aMCI and AD patients， suggesting that angiogenesis might be involved in the pathophysiological process of AD and correlated with the early stage of AD. Yangxue Qingnao granule， as a safe adjuvant therapy， showed ideal effect on aMCI and AD， as manifested by the improvement of cognitive function. The mechanism is the likelihood that it can elevate the expression of angiogenic factors such as VEGF， promote angiogenesis， and then improve the microcirculation of cortex.