Objective To explore the clinical efficacy of Toutongning capsule combined with nimodipine in the treatment of 76 patients with primary vascular headache.Methods 76 patients with primary vascular headache were selected as the research subjects.According to the different surgery,the patients were randomly divided into control group (n =38) and observation group (n =38).The control group was given compound Danshen injection,while the observation group was given Toutongning capsule combined with nimodipine.The efficacy,the peak systolic velocity(Vs) and pulsatility index(PI) of each vessel,the time of stopping pain,recurrence rate and adverse reaction were compared between the two groups.Results The total effective rate of the observation group was 94.74％,which was higher than 84.21％ of the control group,the difference was statistically significant (x2 =4.785,P ＜ 0.05).The MCA,ACA,BA,VA value of Vs and PI,the time of stopping pain and recurrence rate in the observation group were better than those in the control group (t =5.385,6.834,7.407,6.651,4.032,5.716,6.203,5.016,4.785,x2 =5.473,all P ＜ 0.05).There were no significant differences between the two groups in PCA value of Vs and PI and adverse reaction(t =0.283,0.037,x2 =0.314,all P ＜ 0.05).Conclusion Toutongning capsule combined with nimodipine in the treatment of primary vascular headache has high application value and significant effect,and it can promote cerebral circulation,blood flow,time of stopping pain and recurrence rate,so it is worthy of clinical popularization and application.

Objective To explore the effect of Xingnaojing injection on cognitive function recovery in patients with acute cerebral infarction. Methods 100 patients with cerebral infarction who were hospitalized from November 2015 to October 2016 were selected and randomly divided into experimental group and control group, with 50 cases in each group.The patients in the control group were treated with routine treatment of cerebral infarction, including treatment of blood circulation, intravenous drip of mannitol to reduce intracranial pressure, subcutaneous injection of low molecular weight heparin sodium anticoagulant, control of blood pressure and blood glucose to appropriate level, and prevention of venous thrombosis.On the basis of the control group, the experimental group received Xingnaojing injection treatment , according to moderate moderation dose and drip rate.We adjusted the dosage and the drop rate according to the illness.The cognitive function was assessed by using Montreal Cognitive Assessment Scale ( MoCA) and minimum mental state examination (MMSE) at admission and after one month of treatment.Results At one month after treatment, the MoCA score of the experimental group and the control group was (27.44 ±2.97), (25.08 ±0.54) respectively, which was higher than that before treatment, but the experimental group was significantly higher than the control group, the difference was statistically significant ( P<0.05 ) .The MMSE scores of the experimental group and the control group were (21.06 ±1.43), (20.29 ±1.16) respectively, the score did not changed compared with before treatment, and the difference was not statistically significant.Conclusion Xingnaojing injection can improve cognitive impairment in patients with acute cerebral infarction, MoCA is better than MMSE in assessmenting the cerebral infarction patients cognitive situation.

Objective: To investigate the value of four-dimensional echocardiography combined with speckle tracking technique on the assessment of right heart function and prognosis in patients with pulmonary arterial hypertension (PAH). Methods: In this prospective study, 51 patients with PAH diagnosed by right heart catheterization in east hospital and south hospital of Renji hospital affiliated to school of medicine of Shanghai Jiaotong University from September 2015 to July 2017 were enrolled as PAH group from July to November 2017. Meanwhile, 26 healthy volunteers with age and sex matched with pulmonary hypertension patients were recruited as control group. The patients were aged (45.8±15.5) years old in PAH group, and there were 6 males and 45 females. The healthy volunteers were aged (45.4±14.6) years old in control group, and there were 4 males and 22 females. Two-dimensional and four-dimensional echocardiographic images were obtained to measure the structure and function of the right heart. The myocardial strain of each ventricle and atrium was measured by sparkle tracking. The patients in PAH group were followed up from July 2017 to August 2018 to observe the endpoint events including all-cause death, re-hospitalization, and clinical deterioration. Results: There were significant differences in two-dimensional echocardiographic parameters(including tricuspid annular plane systolic excursion (TAPSE), right ventricular area change fraction (FAC), and right ventricular systolic pressure (RVSP)), speckle tracking parameters (including global longitudinal systolic peak strain of left ventricle (LVGLS), global longitudinal systolic peak strain of right ventricle (RVGLS),left atrial reservoir function(LASr), left atrial conduit function (LASc), left atrial pump function (LASp), right atrial reservoir function (RASr), right atrial conduit function (RASc), and right atrial pump function (RASp)), and four-dimensional echocardiographic parameters(including right ventricular end diastolic volume (RVEDV) , right ventricular end systolic volume(RVESV), right ventricular stroke volume(RVSV), right ventricular freewall longitudinal strain(RVLSf), interventricular septum longitudinal strain(IVSLS), right ventricular ejection fraction(RVEF)) between control group and PAH group (all P<0.01 or 0.05).Spearman correlation analysis showed that RVEF was correlated with 6-minute walking distance (r=0.540, P<0.001), B-type natriuretic peptide (r=-0.545,P<0.001), New York Heart Association (NYHA) cardiac function classification(r=-0.583, P<0.001), TAPSE(r=0.595, P<0.001), LVGLS (r=-0.461, P=0.001) ,LASc (r=0.453, P=0.002) ,RASc (r=0.532, P<0.001) ,RVESV (r=-0.418, P=0.004) , RVSV (r=0.351, P=0.017) , and IVSLS (r=-0.450, P=0.002) . Pearson correlation analysis also showed that RVEF was correlated with FAC(r=0.579, P<0.001),RVSP (r=-0.442, P=0.002) ,RVGLS (r=-0.521, P<0.001) , LASr (r=0.483, P=0.001) , RASr (r=0.617, P<0.001) , RASp (r=0.513, P<0.001) , and RVLSf (r=-0.592, P<0.001) .After a follow-up of (10.4±2.7) months, there were 4 all-cause deaths, 5 re-hospitalizations and 5 clinical deterioration. Multivariate Cox regression analysis showed that increased RVEF was independent protective factor for end-point events in PAH patients (HR=0.702, P=0.043), and increased RVSP was independent risk factor for end-point events in PAH patients (HR=1.083, P=0.017). The receiver operating characteristic (ROC) curve showed that RVEF and RVSP could be used to predict the end-point events in PAH patients. The area under the curve (AUC) was 0.835(P=0.001) and 0.820(P=0.001), respectively. Conclusions RVEF measured by four-dimensional echocardiography is correlated with right ventricular function parameters measured by two-dimensional echocardiography and can be used to estimate the prognosis of PAH patients. The right atrial and left atrial function assessed by speckle tracking can also reflect the right ventricular function to a certain extent.

Objective:To investigate the prevalence of hearing loss among community-dwelling older people aged 60 and over, and also to compare the discrepancies between self-reported hearing loss and hearing loss diagnosed via audiometry.Methods:Subjects were from the Prevention and Intervention on Neurodegenerative Disease for the Elderly in China(PINDEC)project.By using the stratified multi-stage cluster random sampling method, a total of 10 347 residents aged 60 years and over were selected from 12 counties and districts in Liaoning, Henan and Guangdong Provinces and hearing function assessment was performed in 2020 through otoscopy, pure-tone audiometry and questionnaires.Hearing loss(HL)was defined by the World Health Organization criteria.Self-reported hearing loss was assessed by asking participants whether they had difficulty in hearing.The χ2 and Cochran-Armitage trend tests were used to analyze the differences in HL between different groups.The multivariate Logistic regression model was applied to assess factors influencing HL. Results:In 2020, the prevalence of HL among the elderly aged 60 and older in Liaoning, Henan and Guangdong Provinces was 69.8%(95% CI: 68.9%-70.7%). The prevalence of HL in men was higher than that in women, and increased gradually with age.The prevalence of mild HL was 47.2%, and the prevalence of moderate, severe and profound HL were 18.0%, 3.6% and 0.9%, respectively.Multivariate Logistic regression analysis showed that factors positively correlated with HL were aging, male sex, living in rural areas and working in manual labor.Education level was negatively correlated with HL.Of the 7223 participants who were found to have HL, 5106(70.7%)self-reported having good hearing.Those of a younger age, with a higher educational achievement, having a spouse, or with mild HL were more likely to report having good hearing(all P<0.05). Conclusions:Hearing loss is quite prevalent among community-dwelling older people, and there is a large discrepancy in prevalence between self-reported HL and HL diagnosed via audiometry.Screening and comprehensive intervention for hearing loss for the elderly should be strengthened.