Subcortical ischemic vascular disease (SIVD) is a group of ischemic cerebrovascular diseases caused by small-vessel disease,and the major pathological damage is multiple subcortical lacunar infarction and white matter lesions.SIVD is the most major cause of resulting in vascular cognitive impairment.It can also have gait disorders,such as Parkinsonlike gait,frontal gait,ataxia,or frequent fall without obvious inducement,etc.Several studies have shown that the gait abnormalities in the elderly may be the early signs of vascular dementia.This article reviews SIVD caused pathomechanisms,clinical features,clinical significance,analysis and evaluation and treatment of gait disorders.

Objective: The nutritional composition of the muscle of six kinds of cold-water fishes was analyzed . Methods: All fishes were collected and analysed from Bohai Experimental Farm, a base of Heilongjiang River Fisheres Research Institute by conventional biochemical methods. Results: The content of crude protein, lipid and ashes in muscle of six fishes was 75.49%-91.51%, 1.21%-16.80%, 4.93%-6.61% respectively. The total content of amino acids was 69.89 %-88.58%, of 8 essential amino acids 29.61%-38.23%, of 4 delicious amino acids 27.20%-34.92%. All data demonstrated that there is relatively high protein content, comprehensive amino acids and high content of essential and delicious amino acids. Conclusion: The six cold-water fishes belong to super cultured ones involved in high nutritional and economic value and worth to explore for food study and stipulation of germplasmic standard.

Vascular dementia (VaD) is one of the most common dementia types in the elderly population. Its incidence is only second to Alzheimer's disease. At present, the diagnosis of VaD mainly based on the clinical manifestations, neuroimaging and neuropsychological scales of the patients. It still lacks higher sensitive and specific metabolism indexes. Magnetic resonance spectroscopy is a noninvasive technique for detecting the energy of living tissues and the changes of metabolism. In recent years, it has been more and more used to patients with VaD and has achieved initial results in the diagnosis, differential diagnosis and cognition-related studies of

Objective To examine changes infibrinogen (FIB),D-dimer and homocysteine (HCY) levels and their significance in patients with cerebral small vessel disease (CSVD).Methods This was a prospective study consecutively recruiting 116 patients with CSVD from January 2015 to August 2016 at the Second Affiliated Hospital of Bengbu Medical University,including 50 patients with lacunar infarction and 66 patients with leukoaraiosis.As a control group,89 age-matched healthy elderly individuals were enrolled in the study.FIB,D-dimer and HCY levels in the groups were measured and compared.Results Serum FIB,D-dimer and HCY levels in CSVD patients,including the lacunar infarction group and the leukoaraiosis group,were all significantly higher than in the control group[(3.3±0.9)g/L vs.(3.3±1.0)g/L vs.(3.3±0.8)g/L vs.(2.6±0.5)g/L,(631.1± 487.1)μg/L vs.(479.2 ± 277.6)μg/L vs.(750.2 ± 577.4)μg/L vs.(202.8±81.7)μg/L,(20.6 ± 12.8)μmol/L vs.(14.4 ± 4.8) μmol/L vs.(25.4 ± 15.0)μxmol/L vs.(12.8 ± 4.6) μmol/L,all P ＜ 0.05)].Multiple Logistic regression analysis showed that FIB,D-dimer and HCY were independent risk factors for CSVD (P＜0.01).Additionally,multiple regression analysis of lacunar infarction and leukoaraiosis showed that HCY had no significant correlation with lacunar infarction (P ＞ 0.05).Conclusions FIB,D-dimer,HCY may be risk factors for cerebral small vessel disease,which may not carry the same weight for lacunar infarction and leukoaraiosis.

Objective To investigate the leukoaraiosis(LA)influencing factors of sleep disorder patients. Meth-ods 90 cases of LA patients which were conformed MRI diagnostic criteria were chosen as LA group,90 cases of normal old people which the gender and age were matched with LA group were chosen as NC group;by asking the medical history to inquirying blood vessel hazards;pittsburgh sleep quality index(PSQI)was adopted to evaluate the condition of sleep disorders,according to the performance MRI of skull to part LA group as four grades. Results In LA group,hypertension and diabetes incidence were significantly higher than that in group NC(P < 0. 05);LA group,PSQI score was significantly higher than that of NC group(P < 0. 01). LA group with the LA increasing grade,PSQI score increased(P < 0. 05). Regression analysis showed that age,hypertension,diabetes and MoCA were associated with LA in patients with sleep disorders. Conclusion Patients with LA have a sleep disorder, which is closely related with the degree of cognitive impairment,LA lesions,age,hypertension,diabetes etc.

Objective To investigate the relation between CAG expansion length and clinical symptoms in hunting-ton′s disease ( HD) ,and to evaluate the value of CAG age product ( CAP score) in the clinical practice. Methods Two Han Chinese HD family members’ clinical data, including clinical symptoms and signs, the Cambridge cog-nitive examination-Chinese version ( CAMCOG-C) and Hamilton depression rating scale were collected, and these two families pedigree trees were drawn. Volunteers peripheral venous blood was extracted to pursue IT15 genetic test. CAP scores among members whose CAG repeat number was more than 35 were calculated. Results The pedi-gree trees indicated that HD was autosomal dominant inheritance. Among 6 participants who had pursued genetic test,1 was normal and 5 were carring expanded allele; according to fomal clinical diagnosis criteria,2 participants were in manifest period and 3 were in pre-manifest period. Individuals in manifest period had clinical triad,and in-divudals in premanifest period,though hadn’ t been clinically diagnoseded, were characterized by subtle motor,cog-nitive,behavioural or personality changes. Conclusion HD prior to clinical diagnosis may have mild clinical symptoms;the more CAG repeats indicate earlier onset, the heavier the symptoms. CAP score as a parameter, combined with the CAG repeat number and the age, is of great significance for predicting the onset age, clinical tri-al subjects grouping, and give a better understanding of the natural history of HD.

Objective To investigate the applicability of Stroop color-word test in Chinese eldly patients with sub-jective cognitive impairment. Methods 36 patients with subjective cognitive impairment and 35 normal elders,all accepted general information questionaire( including age,gender,education,ect) ,Chinese version Stroop color-word test,background neuropsychological tests(MMSE,ADL,GDS,ect). Analysis of indicators included: the number of errors,average response,Stroop interference effects ( SIE)-Time difference of the Color inconsistencies and consist-ent with the meaning of words. At last we analyse relationship between CWT results and age,education,et al. Re-sults There were no significant differences in neuropsychological tests. Compared with normal subjects,subjective cognitive impairment subjects spent more time and made more errors in doing this task. They made statistical signifi-cance. The linear regression analysis between reaction time, the number of errors and overall cognitive function ( MMSE) , age, memory ( digit span, delayed recall) showed:the numbers of errors and the average response time had significant positive correlation with age. SIE of SCI was significantly longer than the normal control, the differ-ence was significant (P<0. 05). And it had no significant correlation with age, overall cognitive function and mem-ory and other related inspection. Conclusion Stroop color-word test has a certain sensitivity in recognition of sub-jective cognitive impairment elders.

Objective To explore the polymorphisms of serotonin transporter gene-linked promoter region (5-HTTLPR) and cognitive function in patients with subcortical ischemic depression (SID). Methods A battery of neuropsychological tests including Hamilton Depression Scale (HAMD), Mini Mental State Examination (MMSE) and Montreal Cognitive Assessment (MoCA) were used to evaluate depression and cognitive function for all enrolled subjects. And the distribution frequency of 5-HTTLPR-promoter region polymorphism was detected by polymerase chain reaction-restriction fragment length polymorphism in 60 SID patients and 60 health controls. Results There were significant differences in 5-HTTLPR genotypes and alleles between SID group and control group (χ2=7.833, χ2=6.290, both P＜0.05).The SID group showed higher genotype SS than did the control group (58.3% vs. 23.3%) and higher allele S (68.3% vs. 52.5%) but lower genotype LL (16.7% vs. 23.3%) and allele L (31.7% vs. 47.5%). SID group had lower MoCA score than did the control group [(23.63±1.59) scores vs. (27.25±1.59) scores, t=12.44, P＜0.01]. Conclusions The polymorphism of 5-HTTLPR gene may play an important role as a nosogenesis of SID. The frequency of SS genotype may be associated with SID especially in females, having more cognitive impairment. The genotype LL and allele L may be a protective factor for depression symptoms of SID.

Objective To investigate the cognitive impairment characteristics in Parkinson's disease (PD) with mild cognitive impairment(PD-MCI)as well as their related risk factors.Methods In all of the participants, a battery of neuropsychological tests were selected to identify the cognitive deficits; the 2 cognitive screening tests utilized in this study were the MMSE and the CAMCOG-C; the severity of disease was measured using the Hoehn-Yahr;the motor portion of the UPDRS and Webster scale were used to evaluate motor function and PD-MCI were classified according to modified Petersen's criteria.Results Of the 89 PD cases, 56 (63%) were cognitively normal (PDCOGNL), 20 (22%) had MCI and 13 (15%) met criteria for PD dementia (PDD). The cognitive domain abnormal in PD-MCI was orientation, language, memory, attention, praxis, thinking and perception. The PDCOGNL group had no significant differences in age and PD onset versus the PD-MCI group, but had significant difference in the years of education (PD-MCI:4.4±4.3,PDCOGNL:7.1±4.9;q=3.270, P<0.05); PD-MCI also had no significant differences for all of them versus the PDD, but the PDD group had significant differences for them (q=-4.913, -4.997, 4.740,all P<0.01) compared with the PDCOGNL group; there were no significant differences among 3 groups in years of PD duration. Hoehn-Yahr and Webster scale, UPDRS-motor score had negative correlation with PD cognitive function. Conclusions A stage of clinical cognitive impairment in PD can be defined between PDCOGNL and PDD that characterized as PD-MCI. There are multiple domains impaired in PD-MCI. The risk factors of PD cognitive impairment include the elder, later onset and lower education level. There are negative correlation between the severity of disease, motor function and PD cognitive function.

This paper introduced the feasibility of flexible management from medical scientific re-search institutions, embarks on the aspects of construction contents such as value identity system, fuzzy eval-uation system, sharing mechanism of scientific management aims and information involving in implementing management. And the paper combined with the experience of the innovation projects in Chinese Academy of Sciences and our institution, and preliminarily expounds the construction connotations and keys of the "flexi-ble management system" in medical scientific research units to provide ideas for enriching the management thoughts of medical scientific research.