Objective To understand the health status of elderly people with dementia and explore the risk factors and impact of dementia. Methods The health statuses of 104 elderly patients with dementia and 99 normal controls were analyzed with Mini-Mental State Examination. Medical history,laboratory tests,and physical examinations of all patients were collected and compared.Results The incident of dementia was significantly higher in patients with dementia,and the risk factors included female,older age,low education,history of stroke,history of surgical operation,tumors,pneumonia,severe osteoarthropathy,low calcemia,and hypercholesterolemia (P<0.05).Other indicators were not significantly different between the patients and controls(P>0.05).Conclusions Multiple risk factors contribute to dementia in elderly people.In return,dementia deteriorates the health of these patients.

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The risk factors for ischemic stroke in the very old (≥ 80 years) are not exactly the same as other populations (＜ 80 years). Compared to other age groups, the incidence of ischemic stroke in the very old female population is higher, and the traditional risk factors such as atrial fibrillation and hypertension are more common, whereas diabetes, hyperlipidemia, smoking and drinking are less common. It is uncertain that whether heart failure, ischemic heart disease and high creatinine level increase the risk of ischemic stroke. Overall, the effect of traditional risk factors on ischemic stroke in the very old remains to be further studied.

A total of 94 patients aged 80 years or over diagnosed as acute ischemic stroke based on their clinical features and CT or MRI and 64 elderly people without stroke as controls were enrolled in this study. They were admitted in Beijing Hospital from September 2003 to July 2008. Blood pressure measurement, electrocardiogram (ECG) and color doppler ultrasonography in carotid arteries were performed for all of them, as well as blood glucose, lipid and fibrinogen were measured and history of hypertension,diabetes, coronary heart disease, hyperlipidemia, smoking and alcohol drinking were recorded. Univariate analysis showed that more hypertension, hyperfibrinogenemia, atrial fibrillation and carotid atherosclerosis were found in the elderly patients with ischemic stroke than in those without it ( P ＜ 0. 05 ). And, multivariate logistic regression analysis showed that hyperfibrinogenemia ( OR = 16. 23, P = 0. 009 ), atrial fibrillation ( OR = 3.47, P = 0. 080) and isolated systolic hypertension ( OR = 1.05, P ＜ 0. 01 ) all were independent risk factors for ischemic stroke in the elderly.

The prevalence of Alzheimer's disease(AD)increases along with the increase of human lifespan.AD has become one of the leading death causes.However,the exact etiology of AD remains unclear.More evidences have demonstrated that dietary factors play key roles in the pathogenesis of AD.Nutritional status evaluation and nutrition support are important in the early prevention and treatment of AD.

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Objective To explore the distribution characteristics of intra/extracranial large-artery disturbance in patients with ischemic stroke (IS)/transient ischemic attack (TIA).Methods The medical history information of 169 IS/TIA patients was recorded.The results of laboratory examination,electrocardiogram,echocardiography,abdominal ultrasound and chest radiography were analyzed.At the same time,the intra/extra-cranial large arteries were examined to analyze the degree,distribution and pattern of their disturbance.Results Among them,there were intra/extra-cranial large-arterial stenosis (n =112,66.3％) and small-arterial disturbance (n =57,33.7％).Multiple vascular disturbance pattern was more common in patients with intra/extra-cranial large-arterial stenosis (n =71,63.4％).The incidence of intracranial large-arterial stenosis was significantly higher than that of extracranial large-arterial stenosis (53.8％ vs.35.5％,P ＜ 0.05).And middle cerebral artery was the most commonly affected artery,36 of those were culprit vessels accounting for 73.5％ (36/49).Conclusions The IS/TIA patients have a high incidence of intra/extra-cranial large-arterial stenosis.Multiple vascular disturbance is a more common pattern.The incidence of intracranial large-arterial stenosis is greater than that of extracranial and middle cerebral artery is the most common affected artery.

Objective　 In order to observe the long-term follow-up of 72 patients with transient ischemic attack（TIA），including the recurrence of TIA after the first attack, occurrence of complete stroke and myocardial infarction, fatality rate, causes of death, and the survival rate in each year and its 95% confidence interval, and to evaluate the clinical significance of neurovascular surgical indication.　Methods　 Seventy-two patients with TIA collected from 1959 to 1977 were followed up by means of face-to-face communication with the patients themselves or their families till 1998. And those aspects mentioned above were analyzed with the methods of cohort study, life table and other medical epidemiological statistics. 　Results　 The recurrent rate of TIA in 72 patients was 27.9%, and the occurrence rate of complete stroke 65.7%, and that of the myocardial infarction and the fatality 8.4% and 72.7%, respectively. There were 2(3.8%) patients died of myocardial infarction. It was showed from the study that the main cause of death was complete stroke, accounting for 59.6% of all dead patients, with the first cause in non-elderly patients was cerebral hemorrhage and that in the elderly patients was cerebral infarction. The 20-year survival rate was 39.9% and its 95% confidence interval was (28.4%，51.4%). Nineteen cases had the indication of neurovascular surgical operation, accounting for 26.6% of all 72 patients. 　Conclusions　 In the long-term follow-up study, the prognosis of patients with TIA was better than that of those with cerebral infarction. About one third of patients had the recurrence of TIA. The occurrence rate of the complete stroke was obviously higher than that of the myocardial infarction. It was considered that neurovascular surgical operation for preventing the happening of complete stroke in patients with TIA was limited.

Objective To discuss the mechanism,procedures and effect of implantable intrathecal infusion system for intractable pain therapy. Methods Among the 4 patients with intractable pain,2 had cancer pain,2 had failed back syndrome.Before operation,Visual Analogy Scale(VAS) were 8～10.Three had bolus intrathecal injection screening trial,1 had bolus epidural injection screening trial.In the clinical trail,VAS all decreased to 75%～90%.(Results) They all had intrathecal infusion system implantation.After operation,Morphine was prescribed(intrathecally.) The dose was 1～(8 mg).They all had satisfied pain relief without serious drug adverse effects.Conclusion The effect of implantable intrathecal system for intractable pain was satisfied.The drug adverse effects were obviously alleviated.