The incidence of vascular cognitive impairment is increasing year by year.Its medical burden is getting worse, therefore, there is an urgent need to delay and prevent its occurrence and development.Active symptomatic treatment and targeted intervention of vascular risk factors may alleviate the progress of disease to a certain extent.This article reviews the advances in the treatment and prevention of vascular cognitive impairment.

Objective To explore the risk factors for acute kidney injury (AKI)in patients with acute myocardial infarction (AMI).Method The medical data of hospitalized patients with AMI admitted from October 2013 to May 2014 were reviewed.All patients were divided into AKI group and non-AKI group.The univariate comparison analysis were performed to obtain the AKI risk factors.Results A total of 565 patients were enrolled.The incidence of AKI (n =91 )was 16.1% and there were 474 non-AKI patients.The mortality of AKI group was 19.8% and mortality of non-AKI group was 0.4% (P <0.01). Univariate analysis demonstrated that the risk factors of AKI were age,hypertension,previous myocardial infarction,heart failure history,chronic kidney disease,cerebral infarction history,peripheral vascular disease;ventricular fibrillation,heart rate,Killip grade ≥3 stage,left ventricular ejection fraction,serum creatinine,eGFR,hemoglobin,blood urea nitrogen,troponin I,B-type natriuretic peptide and C-reactive protein,fasting glucose,albumin,maximum daily dose of furosemide,non-use of ACEI /ARB and statins, the use of intra-aortic balloon pump, temporary pacemaker and pulmonary mechanical ventilation, implementation of PCI and coronary artery bypass graft surgery.Conclusions These risk factors for AKI after AMI were found to identify high-risk patients,helping the clinicians to make decision for preventive intervention.

OBJECTIVE To study the metallo-?-lactamases of 5 carbapenem resistant Pseudomonas aeruginosa isolates,which were recovered at 2006 in the Third People's Hospital of Yueqing. METHODS K-B method was used to determine the antimicrobial agents susceptibility in 5 isolates. The minimal inhibitive concentrations (MICs) of antimicrobial agents to these strains were determined by agar dilution method. Double disk synergy test was used to detect the metallo-?-lactamase. Molecular screening for blaIMP,blaVIM,and blaSPM was carried out using PCR method. The PCR product was sequenced. RESULTS One out of the 5 carbapenem resistant P. aeruginosa was positive for MBL double disk synergy test,and confirmed to contain blaVIM-2 gene. CONCLUSIONS A blaVIM-2-producing isolate of P. aeruginosa is identified. This carbapenem-resistant isolate is all multi-drug resistant.

To observe the transcriptional regulation of the two isoflavones genistein and daidzein on target genes.

Background Most anti-inflammation eyedrops are limited in clinical application owing to multiple adverse effects.A novel peptide GC31 derived from human thrombomodulin has a natural anti-inflammatory activity.Compared with conventional anti-inflammatory eyedrops,GC31 possesses more advantages and potential clinical transforming value.However,relevant study is still lack.Objective The purpose of this study was to evaluate the anti-inflammatory effect of GC31 and the possible mechanisms.Methods Sixty SPF male Wistar rats aged 8-10 weeks were randomized into 6 groups using randomized number table.Non-specific keratitis models were established in 40 rats by intrastromal injection of 10 μl of lipopolysaccharide (LPS) dissolved in PBS.Different doses of GC31 (125 μg or 250 μg) or dexamethason soluble in PBS were sunconjunctically injected in the experimental eyes respectively in the low dose GC31 group,high dose of GC31 group and the dexamethason group,and 10 μl of PBS was used in the same way in the PBS control group.No drug was injected in the model group,and the normal rats were employed as the blank control group.The corneas were examined by slit lamp microscope and were scored based on the criteria of Anand 24 hours after injection.Then the corneas were collected for histopathological examination.Expression of nuclear factor-κB (NF-κB) p65 in the corneas was detected using immunochemistry.Expressions of interleukin-6 (IL-6) and tumor necrosis factor-α (TNF-α) proteins were assayed using ELISA.Real-time PCR was used to detect the expressions of IL-6 mRNA and TNF-α mRNA.The use and care of the experimental animals followed Regulation for the Administration of Affair Concerning Experiment animals by State Science and Techonology Commission.Results A significant difference was seen in the ocular inflammatory scores among the six groups (F =301.238,P =0.000).The inflammatory scores were significantly lower in the high dose of GC31 group than those in the model group (1.85 ± 0.36 versus 2.90± 0.43) (t' =-5.144,P =0.000) ; and the scores in the dexamethason group was lower than those in the high dose of GC31 group(t' =-3.931,P=0.000).Infiltration of inflammatory cells in corneal tissue was milder in the high dose of GC31 and the dexamethason group compared with the model group.The positive response for NF-κB p65 was obviously weaker in the rat corneas in the low and high dose of GC31 groups and the dexamethason group in comparison with the model group.The contents of IL-6 and TNF-α proteins in the corneas were significantly reduced in the low and high dose of GC31 group and the dexamethason group compared with the model group (low dose group:t=-2.626,P=0.009;t'=-2.310,P=0.017.high dose group:t =-3.361,P=0.001 ;t'=-3.151,P=0.002),and the contents of IL-6 and TNF-α proteins in the dexamethason group were lower than those in the high dose of GC31 group (t=-3.361,P=0.001;t'=-3.360,P=0.000).In addition,the expression trend and compared results of IL-6 mRNA and TNF-α mRNA among the groups were similar to those of the IL-6 and TNF-α proteins (all at P＜0.01).Conclusions GC31 suppresses LPS-induced corneal inflammation response by downregulating the expression of inflammatory eytokines.The effect is more dominant in the doses of 250 μg than that in the doses of 125 μg.

OBJECTIVE:To explore the effect of prophylactic use of vitamin B6 with chlorpheniramine on the adverse reactions in fundus fluorescein angiography (FFA). METHODS:326 patients with FFA were randomly divided into observation group and control group. Observation group was orally given Vitamin B6 tablet 10 mg 30 min before angiography+Chlorpheniramine maleate tablet 4 mg;control group was orally given Metoclopramide tablet 10 mg+Chlorpheniramine maleate tablet 4 mg. The occurrence time and incidence of adverse reactions in 2 groups were observed and correlation analysis was conducted. RESULTS:There was no significant difference in the occurrence time of adverse reactions between 2 groups(P>0.05);the incidence of adverse reactions in observation group was significantly lower than control group,the difference was statistically significant(P<0.05). The correlation analysis of adverse reactions in control group showed the occurrence of adverse reactions had no correlation with age and gender of patients(P>0.05). CONCLUSIONS:Prophylactic use of vitamin B6 with chlorphenir arnine can reduce the occurrence of adverse reactions in FFA.

Subjective memory complaints (SMC) is increasingly recognized as the earliest prodromal stage of Alzheimer's disease.Individuals with SMC whose memory without measurable cognitive deficits,however,demonstrated some neurodegenerative brain changes.It would be more appropriate to prevent or postpone the AD process by interventing in this earlier stage of SMC,while relatively little is known about the brain plasticity in elderly with SMC.Therefore,further research is necessary in understanding the brain plasticity in SMC on the basis of further elucidating the pathophysiological mechanisms in this group of individuals.

Objective To observe the effects and study the underlying mechanism of siRNA targeting PARP1 on the proliferation of androgen independent prostate cancer PC3 cell line.Methods Three specific siRNA sequences targeting PARP1 were designed and synthesized.And two sequences which had better interfering effect on the expression of PARP1 were evaluated and selected through lipofectamine transfection,RT-PCR and Western Blot.The effect of PARP1 silencing on the proliferation of PC3 cells was observed with MTS assay and the levels of the phosphorylation of Akt and GSK3β were detected by Western Blot.Results Compared to the blank control group,the transfected group with the negative control sequence had no significant impact on the expression of PARP1,however the transfected group with siRNA-1706,-2003 or-2907 could significantly suppress the mRNA and protein expression of PARP1.The mRNA inhibition rate reached to(52.07 ± 4.65)％,(44.38 ± 9.15)％ and(22.05 ± 6.65)％,respectively;and the protein inhibition rate reached to(86.86 ± 4.94)％,(83.30 ± 7.18)％ and(63.05 ± 10.19)％,respectively.The siRNA-1706 and-2003 could significantly inhibit the proliferation of PC3 cells;the inhibition rate was(38.93 ± 3.87)％ and(34.93 ± 1.21)％.And they also could down-regulate the intracellular levels of phosphorylated Akt and GSK3β in PC3 cells.Conclusion PARP1-targeted siRNA can significantly suppress the expression of endogenous PARP1 and inhibit the proliferation of PC3 cells,which is related to the inhibition of Akt activity and the activation of GSK3 β.

Objective:To investigate the prevalence and associated risk factors of pre-hypertension and hypertension in young and middle-aged population in Nanjing.Methods:Subjects of the study were those who underwent physical examination in the physical examination center of Nanjing Drum Tower Hospital from 2009 to 2016. The prevalence and risk factors of pre-hypertension and hypertension in young (aged 18-44 years old) and middle-aged people (aged 45-59 years old) were analyzed.Results:A total of 142 857 participants aged 18-59 years old were analyzed. Among them, 64 220 cases in the pre-hypertension group and 13 912 cases in the hypertension group. The prevalence of hypertension was 9.74% (12.51% in males and 5.82% in females). The prevalence of pre-hypertension was 44.95% (53.31% in males and 33.15% in females). In the middle-aged group, the prevalence of pre-hypertension and hypertension were 51.68% and 15.13%, respectively, which was higher than that in the young group (37.95% and 4.13%, respectively). The prevalence of pre-hypertension and hypertension in 2013-2016 was 45.37% and 10.65%, respectively, which was higher than that in 2009-2012(44.52% and 8.78%). In addition, the prevalence of abnormal blood glucose metabolism, abnormal blood lipid metabolism and abnormal glucose and lipid metabolism in the pre-hypertension group was higher than that in the normal blood pressure group, but lower than that in the hypertension group ( P<0.001). A logistic regression analysis indicated that age, overweight or obesity, hyperglycemia, hypertriglyceridemia and hypercholesterolemia were risk factors of pre-hypertension in male. Age, overweight or obesity, hyperglycemia, hypertriglyceridemia, hypercholesterolemia and hyper-low density cholesterolemia were associated with hypertension in male and with pre-hypertension and hypertension in female. Conclusions:Middle age, overweight/obesity, elevated fasting plasma glucose, elevated triglyceride and elevated total cholesterol were risk factors of pre-hypertension and hypertension in both men and women. Intervention on the related risk factors should be conducted as early as possible.

Objective To evaluate the long-term prognosis and safety of ABO-incompatible (ABO-I) liver transplantation on type-O patients with acute severe liver disease,analyze and compare the effects and main complications between different donor blood types,and investigate corresponding treatment measures.Methods The clinical data of 65 cases of emergency orthotopic liver transplantation (OLT) for type-O patients with acute severe liver disease from January 2014 to January 2017,including 41 cases of ABO-compatible (ABO-C) OLT and 24 cases of ABO-incompatible OLT (7 with type-A donor,9 with type-B donor,and 8 with type-AB donor) were retrospective analyzed.Results The model for end-stage liver disease (MELD) score in the ABO-incompatible group was 32.5±5.5,significantly higher in the ABO-compatible group (23.3±8.9) (P=0.001).The data of the other perioperative factors showed no statistically significant difference between two groups.The cumulative survival rate in the ABO-compatible group was 87.8 % (36/41),not significantly different from that in the ABO-incompatible group [87.5% (21/24),P=0.924].The 57 cases who had survived after perioperative period were followed up for 4-37 months (mean 18 months).Significantly higher incidence of hepatic artery and biliary complications was found in ABO-incompatible group (P=0.005,and P<0.001,respectively).The incidence of hepatic artery complication and biliary complication in ABO-incompatible group was 29.2% (7/24) and 37.5% (9/24),and that in ABO-compatible group was 4.9% (2/41) and 0 (0/41),respectively.The rate of acute rejection in the ABO-incompatible group and ABO-compatible group was 9.8% (4/41) and 4.2% (1/24) (P=0.463).The infection rate in the ABO-compatible group and ABO-incompatible group was 24.3% (10/41) and 29.2%(7/24),respectively (P=0.598).Conclusion The different donor blood types including ABO-compatible and ABO-incompatible liver transplantation program on type-O patients with acute severe liver disease have a favorable outcome.The long-term cumulative survival rate between two groups shows no significant difference.With the help of effective immunosuppression and intensive perioperative management,ABO-incompatible liver transplantation is an acceptable option to cure type-O patients with acute liver failure in emergency.The incidence of hepatic artery and biliary complications was lower in ABO-compatible group than in ABO-incompatible group.For the type-O patients with ABO-incompatible liver transplantation,the use of rituximab and plasma exchange to decrease the antibody titers of recipients is essential to prevent and cure the hepatic artery and biliary complications.