Vascular eognitive impairment (VCI) is a large class of syndromes from mild cognitive impairment to dementia, which are caused by the cerebrovascular risk factors (eg, hypertension, diabetes and hyperlipemia), obvious (eg, cerebral infarction and intracerebral hemorrhage) or unobvious cerebrovascular diseases (leukoaraiosis and chronic cerebral ischemia). Accurate early diagnosis provides the best treatment opportunity and slows down the progress of the disease. In recent years, the research on VCI has made a great progress. This article reviews VCI from the aspects of the etiology, clinical manifestation, neuropsychology, imaging, neuroelectrophysiology, biomarkers, and diagnostic criteria.

Acupuncture Therapy ; Aged ; Aged, 80 and over ; Female ; Humans ; Male ; Pulmonary Disease, Chronic Obstructive ; physiopathology ; therapy

Objective:To explore the efficacy of nimodipine in treating cognitive impairment of cerebral small vessel disease (CSVD) and the value of magnetic resonance diffusion tensor imaging (DTI) in CSVD.Methods:A total of 80 patients with CVSD and cognitive dysfunction who admitted to Suzhou Municipal Hospital from February 2018 to February 2019 were selected, and the patients were divided into control group (40 patiengts) and observation group (40 patients) by random number table method. The control group received basic treatment and donepezil, and the observation group added nimodipine on the basis of control group. All patients were followed up for 12 months. Before treatment, 6 months after treatment and 12 months after treatment, the patients’Montreal cognitive assessment scale (MoCA) score, daily living ability scale (ADL) score, and Tinetti balance and gait analysis(TGA) were recorded. The levels of total cholesterol (TC), triacylglycerol (TG), low-density lipoprotein cholesterol (LDL-C) and high-density lipoprotein cholesterol (HDL-C), homocysteine (Hcy) and high-sensitivity C-reactive protein (hs-CRP) before and after treatment were recorded. The changes of DTI data before and after 12 months′ treatment in the two groups were recorded.Results:The MoCA score, ADL score, and TGA score of the two groups were higher than those before treatment and at 6 months and 12 months after treatment, and those 12 months after treatment were higher than those at 6 months after treatment. There were significant differences ( P<0.05). The MoCA and ADL scores of the observation group were higher than those of the control group at 6 and 12 months after treatment at 6 months: (24.61 ± 2.54) scores vs. (22.21 ± 2.83) scores, (71.53 ± 6.25) scores vs. ( 69.51 ± 6.81) scores; 12 months: (26.39 ± 2.16) scores vs. (23.76 ± 2.64) scores, (78.39 ± 5.76) scores vs. (72.39 ± 6.12) scores, P<0.05. At 6 months and 12 months after treatment, the visual space and execution ability, delayed memory, and orientation scores were higher than those before treatment, and in the observation group 12 months after treatment was higher than those 6 months after treatment: (5.97 ± 1.37) scores vs. (5.36 ± 1.29) scores, P<0.05. The observation group′s visual space and executive ability, abstract thinking, delayed memory, and orientation score were higher than those in the control group at the same period ( P<0.05). The levels of TC, TG, LDL-C, Hcy and hs-CRP of the two groups after treatment for 6 and 12 months were lower than those before treatment, and the levels of these index at 12 months after treatment were lower than those at 6 months after treatment ( P<0.05). The levels of Hcy and hs-CRP in the observation group were lower than those in the control group at 12 months after treatment, and Hcy was lower than that in the control group at 6 months after treatment ( P<0.05). After treatment, the fractional anisotropy (FA) values of the center, frontal lobe, and parietal lobe of both sides of the two groups were higher than those before treatment, and the difference in the observation group before and after treatment was higher than that of the control group ( P<0.05). After treatment, the mean diffusivity (MD) values of both frontal lobe and parietal lobe of the two groups were lower than those before treatment, and the difference between the observation group before and after treatment was higher than that of the control group ( P<0.05). Conclusions:Nimodipine has a good effect on the treatment of CVSD, which can effectively improve the patients′ cognitive impairment and other symptoms. DTI can sensitively sense the white matter integrity and cerebral blood flow perfusion of patients, which has a positive significance for the prevention and treatment of CVSD.

Objective Inquire into the relationship between diabetic peripheral neuropathy(DPN)pathogenic factor and Antigangliosides antibody(Anti-GS-Ab)in type 2 diabetes mellitus. Methods It was examined by enzyme-linked immunosorbent assays(ELISA)to the levels of serum Anti-gangliosides(Anti-GS)in 2 DM and DPN as well as healthy.Results The positive rate of Anti-GS-IgM,IgG in DPN group were 46.7% and 20.0%.repectivily it was obviously higher than normal group and 2 DM group.Conclusion The relationship between the DPN and Anti-GS-Ab is a close.It show that Anti-GS-Ab play an important role in DPN pathological process.

72 cases of treatments on insomnia were recorded in the medical books of Ming and Qing dynasties(A.D.1368～1911 years).The compatibility regularity of treating insomnia in these 72 cases were statistically analyzed with frequency and the R type cluster analysis methods. Combining the data and modern recognition, compatibility and medication regularity of treating insomnia was further analyzed.

Objective To study the significance and expression relationship among STAT1,STAT2 and hMLH1 ,hMSH2 proteins in hepatocellur carcinoma(HCC). Methods SABC immunohistochemistry method was used to detect the expression of STAT1,STAT2,hMLH1 and hMSH2 proteins in cancer tissues and paracancer tissue from 37 patients of HCC. Results The positive rates and expressive levels of STAT1,STAT2,and hMLH1, hMSH2 in HCC was significantly lower than those in paracancer liver tissues(P

0.05), and the 1- and 3-year survival rate of group A was significantly higher than that of group B (P

Background and purpose:Checkpiont targeted immunotherapy in the field of solid tumor therapy has huge potential, triggering a boom in the study of immune targeted drugs. A study has provided a basis for the follow-up study of ipilimumab combined with chemotherapy in the treatment of non-small cell lung cancer(NSCLC) patients. This study counted the adverse event statistics that ipilimumab or placebo combined with paclitaxel and carboplatin as first-line therapy for the treatment of stage Ⅳ or recurrent squamous cell carcinoma to evaluate the safety of ipilimumab combined with chemotherapy in the treatment of advanced squamous cell carcinoma.Methods:This study selected 13 patients with ECOG scores≤1 and stage ⅣA or ⅣB squamous cell carcinoma in the Shanghai Chest Hospital, Shanghai Jiao Tong Uni-versity. Randomized controlled double blind trial was used in this study. The patients of experimental group were treated with ipilimumab combined with paclitaxel and carboplatin, while the patients of control group were treated with the placebo combined with paclitaxel and carboplatin. Adverse events (AEs) were counted in the process of treatment.Results:The most common AEs were the 1/2 grade AEs. Immune-related AEs (irAEs) reported in the ipilimumab group included level Ⅰ of diarrhea and pruritus, level Ⅱ of rash and pruritus and level Ⅲ of hypophysitis.Conclusion:The side effects of ipilimumab were mild, tolerable and manageable.

Background and purpose:Cytokine-induced killer (CIK) has both the advantages of T lympho-cytes’ powerful anti-tumor activity and NK cells’ tumor killing capacity without MHC restriction. It could directly kill tumor cells, regulate and enhance immune function, without damaging the structure and functions of the immune sys-tem. Its effects on the treatment of malignant solid tumors has been widely recognized. This study aimed to evaluate the anti-proliferation effects of CIK cells obtained and cultivated from lung cancer patients’ lymph nodes. Meanwhile, the safety of clinical transfusion was observed.Methods:The peripheral blood and lymph nodes of 6 surgery patients with lung cancer from Shanghai Chest Hospital were used to cultivate CIK cells for 14 days. The phenotypes of CIK cells were detected by lfow cytometry. The anti-proliferation activities of CIK cells on A549 lung cancer cells were detected by CCK8 assay. The morphological changes of CIK cells were observed by invert microscope. The expression of CEA level and adverse events were evaluated after CIK transfusion.Results:The proportion of CD3+CD56+T lymphocyte in two groups were both more than 30%. The CCK8 assay showed that the suppression rate of lymph nodes group was higher than that of peripheral blood group at each effect/target ratio(P<0.05). The adverse effect of CIK transfusion was mild and tolerable. The expression of CEA level decreased in patients.Conclusion:Lymph nodes of surgery patients with lung cancer can be used for cultivation of CIK cells. The anti-tumor activity of CIK isolated from lymph nodes is better than that of CIK cells cultivated from peripheral blood. Preclinical experiments showed high safety.

Objective To observe the changes of arm equilibrium pressure (Parm) in different occlusion time,the reference range of Parm in hemodynamic stable patients,and to explore the relationship between Parm and systemic hemodynamic parameters.Methods Mechanically ventilated postoperative abdominal surgery patients who admitted to ICU with stable hemodynamic status were enrolled.After hemodynamic data were recorded,arm stop-flow maneuvers were performed to measure Parm.At 10,20,30,40,50,60 seconds after occlusion,arterial pressure were measured twice within 5 minutes and recorded as the average value.Results Thirty patients were included.The Parm decreased gradually with the prolongation of the occlusion time.The value was not stable within 60 s,but the reducing extent was not obvious after 40s.The 95％ reference range of Parm 30 S was 23-44 mmHg(1 mmHg =0.133 kPa) and Parm 60 S was 19--35 mmHg.Parm at 30 s and 60 s were positively correlated with systolic arterial pressure,diastolic arterial pressure,mean arterial pressure,central venous pressure (all P ＜ 0.001),but not heart rate and pulse pressure.Linear regression analysis showed that Parm at 10 s,20 s,30 s only had linear correlation with diastolic arterial pressure (10 s,β =0.504,P =0.001;20 s,β =0.297,P =0.005;30 s,β =0.231,P =0.015),and Parm at 40 s,50 s,60 s were linear correlation with diastolic arterial pressure (40 s,β =0.220,P =0.004;50 s,β =0.210,P =0.004;60 s,β =0.213,P =0.004) and central venous pressure (40 s,β =0.516,P =0.018;50 s,β =0.513,P =0.01;60 s,β =0.472,P =0.023).Conclusion In mechanically ventilated postoperative abdominal surgery patients with stable hemodynamic status,Parm decreases when occlusion time is prolonged,which is not stable within 60 s occlusion.Arterial blood pressure and central venous pressure are positively correlated with Parm.