Objective To explore the relationship between the serum anticardiolipin antibody (ACA),vascular endothelial grow factor (VEGF) concentration and cognitive impairment in patients with ischemic stroke.Methods Totally 128 cases with acute ischemic stroke were admmitted in stroke unit ward of our hospital during June 2014 to December 2014.According to the score of Montreal cognitive assessnent (MoCA),128 patients with ischemic stroke were divided into groups A (53 cases with cognitive impairment) and group B (75 cases without cognitive impairment).The concentrations of serum ACA,VEGF were quantitatively determinated by ELISA.The differences of serum ACA,VEGF concentrations were compared between the two groups.Results Compared with normal cognitive function group,the cognitive impairment patients had significantly higher ACA concentration ((0.86±0.16) mg/L vs (0.52±0.08) mg/L,P＜0.01),and lower VEGF concentration ((197.60±7.48) pg/ml vs (205.80±8.52) pg/ml,P＜0.05).Logistic regression revealed that ACA and VEGF were independent effect factors for cognitive impairment (ACA:B =2.841,OR =0.33,95 ％ CI =0.118-0.926,P=0.025.V EGF:B =-1.674,OR =4.99,95％ CI =1.688-4.741,P=0.034).Conclusion ACA and VEGF may play an important role in cognitive impairment after ischemic stroke.

Objective To explore the influence of the cognitive function and related dangerous factors in patients lacunar infarction(LI) after carotid artery stenting (CAS).Methods Neuropsychological tests (MoCA and MMSE)were conducted in 43 patients with LI before CAS,1 month,6 months,1 year and 2 years after CAS and the scores were compared with those of 41 healthy cases.Results Compared with control group,in therapy group,MMSE scores before CAS,1 month and 6 months after CAS,MoCA scores before CAS(19.39 ±2.17) and 1 month after CAS(19.51 ± 1.99) and the scores of Cube Copying before CAS,Alternating Trail Making Test,attention and delayed recall before CAS,1 month after CAS and Clock Drawing before CAS,1 month and 6 months after CAS all lowered obviously.There were statistical differences(P＜ 0.05 or P ＜ 0.01).Compared with before CAS,in therapy group,MMSE scores and MoCA scores 6 months,1 year and 2 years after CAS,the scores of Alternating Trail Making Test 2 years after CAS,Cube Copying and Clock Drawing 1 year and 2 years after CAS and attention and delayed recall 6 months,1 year and 2 years after CAS all increased obviously.There were statistical differences (P ＜ 0.05 or P ＜ 0.01).In the follow-up of 2 years,the result of Logistic Regression Analysis showed that MoCA scores has correlation with age(OR =50.751,95％ CI 1.407 ～ 19.464; P =0.006),high blood pressure(0R=8.012,95％ CI1.212 ～27.550; P=0.042)and low levels of education(OR=11.586,95％ CI1.164～ 16.903 ; P =0.029) and no correlation with diabetes and CAS.Conclusion Cognitive impairment in patients with LI is improved 2 years after CAS,and visuospatial function,attention and delayed recall are significantly improved.But CAS is not independent protective factors for cognitive functions,and old age,low education levels and high blood pressure are independent risk factors for cognitive impairment in patients with LI.

Objective To observe the effect of dual-task interference on postural sway and hand flexibility of patients with early Parkinson's disease (PD).Methods Twenty-tree patients with early PD and twcnty-three healthy,sex-and age-matched control subjects were examined.Postural sway was measured with an accelerometer at the centre of mass at the lower spine.Two parameters of postural sway were computed from the acceleration signals including root mean square acceleration (RMS) and jerkiness of sway (JERK).Purdue pegboard test,single-task tests and dual-task test were performed respectively to record the numbers of nails inserted with left hand,right hand and both hands within 30 seconds.Results In the usual conditions,no significant differences of postural sway parameters were found between the control group and PD group in eye open and eye closed condition.In dualtask condition,PD patients showed an increase of RMS values (eye open conditions:PD group (0.156±0.112) m/s2,control group (0.086±0.026) m/s2;eye closed conditions:PD group (0.204±0.162)m/s2,control group (0.095±0.023)m/s2) of sway acceleration,compared with control subjects (P＜0.01).These differences reached significance during cognitive task performance in eye open and eye closed with dual task.PD patients showed larger JERK values with increasing difficulty of the sway task which also reached significance during cognitive task performance(P＜0.05).The number of pegs inserted within 30 s in patients with PD (17.33±4.87)was significantly lower than that in controls (20.77±4.13) (P＜0.05).Conclusion The hand flexibility of patients with early PD obviously decrease.The balance of patients with early PD may deteriorate when their attention is diverted or reduced because of attempting to perform cognitive tasks.

Objective:To investigate the value of diffusion kurtosis imaging (DKI) combined with quantitative dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) in predicting axillary lymph node metastasis in breast cancer.Methods:A total of 150 cases of breast cancer confirmed by pathology in the Affiliated Hospital of Jining Medical University were retrospectively analyzed. 68 cases had axillary lymph node (ALN) metastasis and 82 cases had no ALN metastasis. All breast lesions were examined by DKI and DCE-MRI before operation. We analyzed clinical case data, routine MRI features, DKI, and DCE-MRI parameters between two groups, including diffusion kurtosis (MK), mean diffusion rate (MD), volume transfer constant (K trans), extravascular volume fraction (Ve), and rate constant (Kep); The receiver operating characteristic (ROC) curve was used to analyze the diagnostic efficacy of quantitative parameters for ALN metastasis of breast cancer. Results:The proportion of lesions with blurred edges in the metastatic group was higher than that in the non ALN metastatic group ( P=0.032); The proportion of uneven and circular enhancement within the ALN metastasis group was relatively high ( P=0.018). The MD value of the ALN transfer group was lower than that of the group without ALN transfer ( P=0.021); The MK value, K trans value, and Kep value were higher than those in the group without ALN metastasis (all P<0.01). The K trans value of DCE-MRI model was the most effective in diagnosing ALN metastasis of breast cancer, and the area under the ROC curve (AUC) was 0.831; The AUC of DCE-MRI model was 0.833, which was higher than that of DKI model (AUC=0.733), and the difference was statistically significant ( Z=2.208; P=0.027). The AUC of DCE-MRI and DKI models were higher than that of conventional MRI models ( Z=3.184, P=0.002; Z=1.917, P=0.046). The sensitivity and accuracy of combined DKI and DCE-MRI models in the diagnosis of ALN metastasis in breast cancer were higher than those of single model. Conclusions:DKI and DCE-MRI models can be used to predict axillary lymph node metastasis in breast cancer. Among them, the K trans value of DCE-MRI model is the most effective in diagnosing axillary lymph node metastasis in breast cancer.