Objective To investigate the relationship between duration of hypertension and cognitive function in adult hypertension patients.Methods A total of 224 subjects with normal blood pressure were enrolled in group A,and 1 296 patients with poorly controlled hypertension were further divided by the duration of hypertension into group B (≤5 years),group C (6-10 years),group D (11-20years) and group E (＞ 20 years).Face-to-face surveys were conducted in all the subjects by trained physicians using Mini-Mental-State-Examination (MMSE) and Clock-Drawing-Test (CDT).The incidences of cognitive impairment were compared among the five groups and the relationship between duration of hypertension and cognitive function were analyzed by SPSS 18.0 software.Results (1) Compared with the normotensive group,the hypertensive group performed worse in the scores of MMSE,CDTs,the memory type cognitive function and the non-memory type cognitive function (MMSE:Z =-2.585,P =0.010;C DTs:Z =-3.689,P ＜ 0.001 ; memory type cognitive function:Z =-2.718,P =0.007 ; non-memory type cognitive function:Z =-1.994,P =0.046).(2) The incidences of cognitive impairment in the five groups were 3.6％ (8/224),6.6％ (26/393),16.6％ (72/433),19.7％ (55/279) and 33.5％(64/191),respectively.(3) Compared with the group A,the cognitive function was significantly worse in the group E (MMSE:Z =61.314,P ＜ 0.001 ; CDTs:Z =44.642,P ＜ 0.001 ; memory type cognitive function:Z =35.703,P ＜ 0.001 ; non-memory type cognitive function:Z =54.440,P ＜ 0.001).Conclusions Hypertension is a risk factor for the cognitive dysfunction.The incidence of cognitive dysfunction and the severity are positively associated with the duration of hypertension.In those with hypertension over 20 years,the cognitive dysfunction occurs much more obviously.

Objective To investigate the technique and application of nasolacrimal duct imaging using MR hydrography.Methods Eight healthy volunteers(16 lacrimal ducts)and 17 patients affected by primary epiphora(32 lacrimal ducts)underwent MRl with three.dimensional fast recovery fast spin echo (3D-FRFSE)MR dacryocystography(MRD)sequence after sterile saline solution had been instilled into the conjunctival sac.For all patients affected by primary epiphora,FRFSE T2-weighted oblique coronal and axial images were obtained after MRD.All patients(32 lacrimal ducts)underwem lacrimal endoscopy.which served as a standard of reference for confirming MR findings.Results Eight cases of 16 normal lacrimal passages were showed by MR hydrography with administering topical sterile saline solution,which demonstrated the lacrimal sac well and whole course of the nasolacrimal duct.Endoscopic findings confirmed nasolacrimal duct obstruction secondary to chronic non-specific inflammation:the color of the mucosa of the nasolaerimal ducts was grey-red,and the obstructive sinuses were filled with nonelastic grey-white membrane.The accuracy of 3D-FRFSE MRD sequence in diagnosing obstructive level was 78%(25/32). The lacrimal ducts above the obstructive level showed watery hypo-intensity on 3D-FRFSE MRD.and the lacrimal ducts below the obstructive level could not be showed.Abnormal findings were presented in all cases of obstructive nasolacrimal ducts with Axi-FRFSET2 WI and Cor-FRFSET,WI sequences:long T2 fluid signals were seen in the lumens of tlle lacrimal sac and(or)nasolacrimal duct above the obstructive level. equal or slightly long T2 soft-tissue signals were seen in the lumens of the nasolaerimal duct below the obstructive level.and the mucosa of the ducts thickened Conclusion MR imaging performed after the topical administration of sterile saline solution can reveal normal nasolacrimal duct and is feasible in evaluating obstructive nasolacrimal ducts.

BACKGROUND:Pauwels Ⅲ femoral neck fracture is a typical unstable fracture characterized by high vertical shear force and high incidence of postoperative complications.At present,there are many fixation methods for Pauwels Ⅲ fracture,and there is no clear conclusion as to which internal fixation is the best fixation method for Pauwels Ⅲ femoral neck fracture in young adults. OBJECTIVE:To compare the clinical effect of three inverted triangle cannulated screws assisted transverse lag screws and femoral neck system in fixing Pauwels Ⅲ femoral neck fractures of young adults. METHODS:From May 2021 to December 2022,21 young and middle-aged patients with Pauwels Ⅲ femoral neck fracture were treated with three inverted triangle cannulated screws assisted by transverse lag screws and femoral neck system in Affiliated Hospital of Southwest Medical University.Of them,9 patients were treated with three inverted triangle cannulated screws and one transverse lag screws perpendicular to the fracture line as the 3+1 cannulated screw group and 12 patients were treated with femoral neck system as the femoral neck system group.The two fixation methods were compared in terms of operation time,intraoperative blood loss,total incision length,intraoperative fluoroscopy times,fracture healing time,and limb function. RESULTS AND CONCLUSION:(1)All patients were followed up.Patients in the 3+1 cannulated screw group were followed up for 10-25 months,with a mean of(17.44±4.30)months.The patients in the femoral neck system group were followed up for 8-24 months,with a mean of(15.58±4.68)months.(2)The intraoperative fluoroscopy times and Harris score at 3 months postoperatively in the femoral neck system group were better than those in the 3+1 cannulated screw group,and the difference was statistically significant(P<0.05).The intraoperative blood loss,total incision length,and femoral neck shortening distance in the 3+1 cannulated screw group were better than those in the femoral neck system group,and the differences were statistically significant(P<0.05).There was no significant difference in operation time,fracture healing time,and Harris score at the last follow-up between the two groups(P>0.05).(3)It is indicated that three inverted triangle cannulated screws assisted transverse lag screw and femoral neck system can achieve good clinical effects in the treatment of young and middle-aged Pauwels Ⅲ femoral neck fracture.The femoral neck system has fewer intraoperative fluoroscopy times and better early overall stability,while the 3+1 cannulated screw is more minimally invasive,easier to operate.Both fixation methods are worthy of clinical application and promotion,and can be selected according to the actual clinical situation.

BACKGROUNDHypertension (HTN) is a very prevalent public health problem and as the population ages, cognitive impairment (CI) is also going to be a public health burden. However, the relationship between hypertension duration and cognitive function declination worldwide is still unknown. The aim of the study was to investigate the effects of HTN duration on CI in Chinese population.

METHODSAt baseline, 1 386 HTN patients and 293 normotensive (NT) people were enrolled. The HTN patients were further divided into four subgroups (duration of HTN <6 years, 6-10 years, 11-20 years, and >20 years) according to the HTN duration and were screened for cognitive function with neuropsychological tests including mini-mental-state-examination (MMSE) and clock-drawing-test (CDT) in comparison with the NT group.

RESULTSMore HTN patients had CI (45.3%) than NT subjects (30.4%), and increased with HTN duration (P < 0.000 1). Compared with the scores of MMSE and CDT in the NT group, the declines were higher in the HTN patients (P < 0.000 1), and in the four HTN subgroups, both MMSE and CDT scores fall when the HTN duration increased (P < 0.05). Furthermore, in the HTN population without CI, the trend in alteration of CI was relatively mild but still existed (P < 0.05).

CONCLUSIONPeople with HTN are more likely to have CI and the possibility and aggravation increases the prolongation of HTN duration, both in amnesic and nonamnesic function.

Adult ; Aged ; Aged, 80 and over ; Asian Continental Ancestry Group ; Cognition ; physiology ; Cognition Disorders ; etiology ; Cross-Sectional Studies ; Female ; Humans ; Hypertension ; complications ; Male ; Middle Aged