Carotid stenosis is one of the important risk factors for cerebrovascular disease.Many studies have shown that carotid stenosis may cause cognitive impairment,but the specific mechanisms remain unclear.Carotid endarterectomy and stenting can relieve carotid stenosis,improve cerebral perfusion,and may improve the cognitive function of patients,but the complications and long-term efficacy after intervention remain to be further studied.

Objective To assess the relationship between ambulatory pulse pressure (PP),pulse pressure indices (PPI) and the severity of cognitive function.Methods Sixty patients with severe,moderate,mild vascular cognitive impairment(VCI) as the research object,and forty healthy people as control group.All of the patients of ambulatory blood pressure were monitored.Results Severe VCI group of PP and PPI was significantly higher than moderate,mild VCI group and the control group (PP (mmHg):(59.10 ± 11.82,54.94 ± 10.86,50.28 ±8.33,45.54±9.22,P＜0.05),PPI:(0.61±0.08,0.53±0.06,0.44±0.05,0.37±0.03,P＜0.05),and the MMSE score was significantly lower than moderate,mild,and the control group(15.56±2.64,19.32±3.32,22.62±3.11,26.45±2.94,P＜0.05).Moderate VCI group of PP and PPI was significantly higher than the control group(P＜0.05).MMSE score was significantly lower than mild VCI and the control group(P＜0.05).Linear correlation analysis showed that PP and PPI was significantly negative related to MMSE score.Conclusion The increase of dynamic pulse pressure,pulse pressure index is associated with the damage of cognitive function.

Objective To study the relationships between retinal microvascular disease and acute coronary event (ACE) among aged people. Methods A controlled study for senile people in communities was conducted. Xinglong Zhuang Coal Mine Community in Jining city, Shandong province was chosen to carry out the study, and the residents in that area aged≥60 years were asked to take questionnaire survey, physical and laboratory examinations. There were 139 cases met the diagnostic criteria of ACE being in the observation group, and 1 509 cases without ACE were assigned in the control group. The gender, age, smoking, alcohol intake, hypertension, diabetes mellitus, education, physical exercise, retinal microvascular disease, fasting blood-glucose, high density lipoprotein cholesterin (HDL-C), low density lipoprotein cholesterin (LDL-C), triacylglycerol (TG), systolic pressure, diastolic pressure, body mass index (BMI) were collected in the two groups to perform univariate analysis. Multivariate non-conditional logistic regression analysis was used for the factors with statistical significance to screen out the independent risk factors that could affect the occurrence of ACE. Results The univariate analysis showed:the risk factors that might cause the occurrence of ACE included age, gender, smoking, hypertension, diabetes mellitus, LDL-C, systolic pressure, diastolic pressure, BMI, and retinal microvascular disease (P<0.05 or P<0.01). In the ACE patients of observation group, the rates of presence of arteriovenous crossing sign [44.6%(62/139) vs. 27.8%(419/1 509)], hard exudates [9.4%(13/139) vs. 4.9%(74/1 509)] and cotton-wool patches [19.4%(27/139) vs. 7.3%(110/1 509)] in retinal microvascular disease were significantly higher than those in control group (P<0.05 or P<0.01). The logistic regression analysis showed:age [P=0.002, odds ratio (OR)=1.06, 95%confidence interval (95%CI)=1.04-1.09], smoking (P=0.032, OR=2.17, 95%CI=2.04-2.30), retinal microvascular disease (P = 0.010, OR = 2.33, 95%CI = 0.97 - 1.27), hypertension (P < 0.001, OR = 5.21, 95%CI=4.11-6.36), diabetes mellitus (P=0.021, OR=1.03, 95%CI=1.01-1.05) and LDL-C (P=0.020, OR=2.80, 95%CI = 2.65 - 2.99) were the independent risk factors for the occurrence of ACE. Conclusions Retinal microvascular disease is the independent risk factor for the occurrence of ACE. The retinal angiography can be a useful examination to forecast ACE.

Objective To study the effect of inducible nitric oxide synthase(iNOS)on the occurrence of ischemic cerebral stroke in passive smoking female.Methods 100 passive smoking female patients with ischemic cerebral stroke(passive smoking group) according to the passive smoking index were divided into sub-groups index 900;25 cases in each group.The level of serum iNOS and the situation of carotid atherosclerosis were detected.The resules were compared with healthy female who without smoking and passive smoking(normal control group).Results Compared with the normal control group,the levels of serum iNOS,the intimal media thickness(IMT)s of carotid artery and the positive rates of carotid atherosclerosis plaque in each passive smoking index sub-group were significantly increased(all P

As the number and proportion of aging population increase,dementia has posed tremendous challenges to the sustainable social and economic development of many countries in the world.Thus,dementia has been identified as a global public health priority.Clinically,there is currently no cure for dementia.However,in the past decades epidemiological research has suggested that cardiovascular risk factors and psychosocial factors over the life-course could significantly affect the risk of dementia occurrence later in life.Of these factors,smoking,diabetes,and midlife hypertension,obesity,and high cholesterol might contribute to the clinical onset of late-life dementia by causing cerebral macro-and microvascular damage and neurodegeneration,whereas high educational attainments in early life and social engagement,physical and mentally-stimulating activities during adulthoods might help maintain late-life cognitive function by increasing cognitive reserve.Thus,theoretically clinical onset of dementia is likely to be postponed by implementing interventions targeting these factors over the lifespan.In recent years,evidence from research in Europe and North America has emerged that multimodal interventions that consist of intensive control of cardiovascular risk factors,balanced diets,physical activity,and cognitive training may help maintain cognitive function among individuals at risk for dementia.We call that population intervention research against dementia should be strengthened in China.Identifying the intervention programmes against dementia that are effective specifically among Chinese population is of high relevance for developing the national dementia action plan,and thus effectively dealing with the huge challenges by dementia.

Objective To investigate the correhtion between cognitive impairment and cerebral atherosclerosis in patients with acute ischemic stroke.Methods Acute ischemic stroke patients without cognitive impairment were recruited before symptom onset.The Montreal cognitive assessment (MoCA) was used to evaluate the cognitive function.Magnetic resonance imaging (MRI) was used to identify the infarct locations and sides.Magnetic resonance angiography,CT angiography and digital subtraction angiography were used to identify atherosclerotic arteries.Resul~ A total of 101 patients with acute ischemic stroke were enrolled,including 75 (74.3％) with cognitive impairment.The proportions of age (54.54 ± 12.59 years vs.64.43 ± 10.37 years;t =-3.960,P ＜0.001),years of education ≤6 years (50.7％ vs.11.5％;x2 =12.257,P ＜ 0.001),and cerebral atherosclerosis (89.3％ vs.50.0％;x2 =18.137,P ＜0.001) of the cognitive impairment group were significantly higher than those of the normal cognitive function group.Multivariate logistic regression analysis showed that cerebral atherosclerosis was an independent risk factor for cognitive impairment in patients with acute ischemic stroke (odds ratio 1.720,95％ confidence interval 1.005-2.942;P=0.048).MoCA score was negatively correlated with the offending vessels (r=-0.365,P＜ 0.001) and the most severe vessels of atherosclerotic degree (r=-0.243,P =0.014).Conclusions Most patients with acute ischemic stroke had cognitive impairment in the early stage after onset,and the MoCA scores was negatively correlated with the degree of cerebral atherosclerosis.Cerebral atherosclerosis was an independent risk factor for cognitive impairment in patientswith acute ischemic stroke.

Objective To investigate the effect of the 5-hydroxytryptamine (5-HT) on the occurrence,development of post-stroke depression (PSD).Methods The literatures on the relationship between 5-HT and PSD were selected from databases such as Wanfang Data,CNKI and PubMed before in 2010-2014.According to absorption and exclusion criteria of the literature,collect literatures,and summary,induce and analyze on them.Results Search 258 literatures and accept 44 literatures accorded with the criteria,including the relationship between 5-HT and PSD,the relationship between 5-hydroxytryptamine receptor (5-HTR) gene polymorphism and PSD,the relationship between 5-hydroxytryptamine transporter linked promoter region (5-HTTLPR) and PSD,and the treatment of selective serotonin reuptake inhibitors (SSRIs) in PSD.Conclusion Reduced levels of 5-HT lead to the occurrence of PSD,and they had a negative correlation;5-HTR 1 A,5-HTR2A are related genes of PSD;S allele and S/S genotype is susceptible factors of PSD,while the L allele is the protective factors of PSD;SSRIs can increase the level of 5-HT in the synaptic gap so as to improve the depressive symptoms of PSD.In the future,it is necessary to increase the sample size to confirm the relationship between 5-HT and PSD,and combine with other factors to explore the relationship between them.

Objective To investigate the awareness rate of health knowledge,health behavior formation rate and psychological state before and after retirement intervention,analyse comprehensive psychological intervention and general psychological intervention to health behavior formation and improve the negative emotion in retired population.Methods By using cohort study method,206 retired people were randomly divided into comprehensive psychological intervention group (experimental group) and only given general psychological intervention group (control group),and each group included 103 cases.Comprehensive psychological intervention group were given health behavior and cognitive intervention,psychological intervention,psychological intervention in general family and social family care intervention,and the control group was given healthy behavior and cognitive intervention,psychological intervention.The staff were treated within 1 weeks of first assessment,2 weeks after the second assessment,4 weeks after the final.Health behavior was surveyed by Ministry of finance,the Ministry of health on public health subsidies special funds notice in city community health education pilot project in the questionnaire.Health status and quality of life were assessed with the family APGAR index (APGAR).Mental state evaluation and assessment of the treatment effect by using Hamilton Depression Scale (HAMD),MBI index method was assessed with activities of daily living.The effect of the two groups were compared before and after the intervention of health knowledge rate and formation rate of different intervention methods and psychological state of health behavior.Results The results showed that there were no significant differences between experimental group and control group in age,sex,level of education and other social,and there was no significant difference in HAMD,MBI and APGAR scores at baseline.Through the implementation of the comprehensive of psychological intervention,subjects have varying degrees of improving the awareness rate of health knowledge,and the intervention group was significantly higher than the control group (P ＜ 0.05).The two group of healthy behavior of subjects in the chopping board monitoring,physical fitness,blood pressure to separate raw and cooked on such projects had different degrees of improvement,at the same time,although no intervention,in the monitoring of blood pressure.The control group increased compared with the baseline significantly (P＜ 0.05).Intervention group had significant difference in APGAR score increased (P＜ 0.05).HAMD score and MBI score decreased and the differences were statistically significant (P＜ 0.01),while the control group had no significant difference before and after intervention.Conclusion Comprehensive psychological intervention can significantly improve the rate of formation from the awareness rate of health knowledge and health behavior of retirees,and improve the state of negative emotions from retiree.

Objective To evaluate the safety and efficacy of early carotid artery stenting in treating cerebral watershed infarction patients with carotid artery stenosis. Methods A total of 33 patients with acute cerebral watershed infarction complicated by carotid artery stenosis received carotid artery stenting within one week after the onset of the disease. The clinical safety and efficacy were evaluated. Results The carotid artery stenting was successfully accomplished in all 33 patients with a success rate of 100%. After the procedure, different degree of bradycardia and hypotension was seen in 23 patients, which restored to normal after prompt medication with atropine, dopamine, etc. During the procedure, one patients developed cerebral embolism due to dislodgment of emboli, resulting in contralateral hemiparalysis, and the contralateral limb muscle strength returned to preoperative status after proper treatment. After the treatment, no ipsilateral hemisphere excessive perfusion or cerebral hemorrhage occurred. Thirty days after the treatment, NHISS scores of the patients were obviously improved, which were significantly different from those determined before the treatment (P<0.05). Conclusion For the treatment of acute cerebral watershed infarction, early carotid artery stenting to relieve carotid artery stenosis is quite safe and it may improve the prognosis as well.

Post-stroke aphasia is an acquired language disorder caused by stroke.It impaired the quality of life of patients and brought a heavy burden to family and the society.Unfortunately,the highly variable predictive factors make the prognosis of aphasia recovery difficult.Much of the researches indicated that the post-stroke aphasia recovery is associated with the patient-related and stroke-related factors.We searched the recent advances on the influence of patient-related factors and stroke-related factors on aphasia recovery.It showed that patient-related factors have no obvious effect on predicting aphasia recovery while the lesion (stroke)-related factors appeared close correlation with post-stroke aphasia recovery.The clinicians should pay more attention on lesion (stroke)-related factors when evaluate the outcome and give the intervention measures.