BACKGROUND: Memory impairment is the main manifestation of Alzheimer disease (AD) and mild cognitive impairment (MCI) conspicuous in the early stage. However, such patients very often develop attentional dysfunction, which may affect their normal work and daily life.OBJECTIVE: To investigate the attentional function, including continuous attention, selective attention and divided attention, of patients with mild AD and of those with MCI.DESIGN: A case-control study.SETTING: Department of neurology of a university hospital and department of psychology in a university.PARTICIPANTS: The research was completed in the Laboratory of Neuropsychology, the First Hospital of Peking University from November 2003 to January 2004. Totally 18 patients with mild AD and 19 with MCI were enrolled in this study, with 20 normal elderly subjects also included to serve as the normal control group.INTERVENTIONS: Several tests were designed to assess the attentional functions of all the subjects, including continuous performance task (CPT) test for assessing continuous attention, simplified Stroop test for selective attention, and dual task test for divided attention.MAIN OUTCOME MEASURES: The reaction time (RT) and the percentage of false response were recorded in CPT test and Stroop test, and performance decrement in dual task test was observed.RESULTS: In CPT test, the RT of mild AD patients was much longer, and the rates of missing and false responses were higher than those of normal control group [(539.29±103.86) vs (458.47±40.87) ms, 4.08% (3. 13, 13.64) vs0.91% (0.60, 1.90), and 1.51% (0.64, 2.54) vs 0.43% (0.37, 0. 84), respectively, P ＜ 0. 05]. The difference between MCI group and normal control group failed to reach statistical significance. The rate of missing response of all the three groups grow higher with the prolongation of time, with the highest occurring in the third 5 minutes of the test.More AD patients showed sustained attention deficiency after 10 minutes of test (33.33% within 10 minutes and 77.8% within 20 minutes). In Stroop test, all the three groups tended to make more false responses under incongruous condition[11.25% (7.50, 22.50), 2.50% ( -2.50, 5.00), 2.50% (0.00, 4. 38) ], exhibiting significant interference effect, which was the most obvious in mild AD group ( P ＜ 0.05). Patients with mild AD responded more slowly than MCI patients and normal control subjects [ (579. 19 ± 89.93) ms,(524.28 ± 68. 96) ms, (486. 75 ± 51.58) ms, respectively, P ＜ 0.05 ]. MCI group made more false responses than normal control group during the whole course of the test as well as under coincident and neutral conditions[5.83% (4. 17, 8.33) vs2.92% (1.67,3.96); 5.00% (2.50, 7.50) vs0.00% (0.00, 2.50); 5.00% (2.50, 10. 00) vs 2.50% (0.00, 5.00), P ＜ 0. 05]. In dual-task test, a significant decrement in mild AD patients was noted without statistical difference between MCI and normal control group[ 1.03 (0.49,3.75),0.46 (0.08, 1.02),0. 10 ( -0.25, 0. 64), P ＜0.05]. Within mild AD group, more patients showed deficiency in Stroop test and CPT test than in dual-task test (81.25%, 77.8%, and 29.41%, respectively).CONCLUSION: Patients with mild AD suffer impairment in continuous,selective and divided attentions, especially obvious in the former two attentional functions. MCI also impairs selective attention as compared with normal aged subjects, with the continuous and divided attention remaining normal. Mild AD patients, MCI patients and normal elderly subjects all show decreased continuous attention, and longer time (than 10 ninutes) of CPT may more sensitively identify continuous attention deficit.

Objective To determine whether the sustained,selective and diverted attention functions are affected in patients with mild Alzheimer's disease(AD).Methods Several tasks designed to test the attention functions on the computer were performed in patients with mild AD as well as elderly controls: Continuous Performance Task(CPT) for assessing sustained attention function,simplified Stroop task for selective attention function,dual task for diverted attention function.Results In CPT test,mild AD patients responded more slowly((539.29?103.86)ms vs(458.47?40.87)ms,P

Vascular cognitive impairment(VCI)is a continuum including early cognitive impairment to dementia caused by cerebral vascular disease.VCI was introduced to identify cognitive decline in early stage for valid treatment.There is inconsistence about the cognitive impairment profile in VCI.This paper reviewed the neuropsychological features of VCI.The problems existed in researches were also discussed.

Objective To investigate the induced-factors levels of venous thrombosis associated with the placement of peripherally inserted central catheters (PICC) in patients with malignant tumor,and establish intervention model accordingly. Methods 40 patients complicated with venous thrombosis after PICC were set as the thrombosis group, 40 patients without venous thrombosis were selected as the no-thrombosis group, 30 healthy cases were selected as the control group. All cases' serum samples were ob-tained to measure the levels of molecular biomarkers of the coagulation system, platelet parameters and molecular biomarkers of the fibrinolysis system. The results of the three groups were assessed. Results Patients in the thrombosis group were reported significantly higher levels of vWF, GMP140,TAT than those in both two other groups, but lower levels of ATⅢ. Higher levels of MPV and PCT were found in the throm-bosis group than those in both two other groups.Tthe data also showed higher PLG and PAI levels and lower levels of PLM in the thrombosis group. Conclusions From this study it shows that patients with malig-nant tumors during the placement of PICC have evident hypercoagnlahility, high- activated platelet and se-vere pre- thrombosis state caused by PICC. In treatment of malignant tumor patients with PICC, the level of coag-ulation system molecular markers, platelet parameters,fibrinolysis molecular markers shoud be used as a clinical routine and as the index of early intervention and evaluation of the PICC.

Objective To investigate the correlation of the vascular endothelial growth factor (VEGF) gene variations in the promoter region with the sporadic Alzheimer' s disease (SAD) in Chinese Han population for better understanding the mechanism of SAD. MethodsThe polymorphisms of 279 SAD Chinese Han patients from Northern China were analyzed by comparing with those from 317 healthy individuals using the method of polymeraee chain reaction-restriction fragment length polymorphism ( PCR-RFLP) or direct sequencing.The commercial statistics package SPSS 11.5 was used to compare the distribution of the allele and the genotype, and to analyze their correlations with SAD. ResultsThree polymorphism sites were found for the VEGF promoters in the Chinese Han sample group including -2578C/A,- 2549I/D and- 1154G/A.- 2549I/D and- 2578C/A exhibiting strong linkage disequilibrium. Individuals with the A allele at position -2578 had an insertion of 18 nucleotides at -2459I/D, whereas CC homozygotes did not contain th es were found between the SAD patients and the controls in the 3 VEGF polymorphisms. After adjusting the data for gender, age and the ApoE ε4 allele using Logistic regression, the - 1154G/G genotype of the VEGF promoter might increase the risk of SAD in Chinese Han population.Among the subgroup without the ApoE ε4 allele, -2549D/-1154G haplotype might increase the risk for SAD (OR = 1.325, 95％ CI 1.023--1.716, P=0.033). ConclusionsThree polymorphism sites ( -2578C/A, -254911D, and -1154G/A) are found in the VEGF promoter regions in Chinese Han population. The-1154G/G genotype of the VEGF promote appears to increase the risk of SAD in Chinese Han population.In the absence of ApoE ε4, the -2549D/-1154G haplotype of the VEGF promoter appears to affect the risk for SAD.

Objective To determine the cognitive profile of mild cognitive impairment due to subcortieal small vessel disease(MCI-SSVD)and mild cognitive impairment caused by Alzheimer's disease(MCI-AD)and to establish the best way of differentiating.Methods Extensive neuropsychological tests covenng 5 cognitive domains were performed on 45 MCI-SSVD patients,30 MCI-AD patients,and 61healthy controls.The impaired domains in patient groups were determined.Tests valuable in discriminating MCI-SSVD and MCI-AD were established using logistie regression analysis.Results Both patient groups showed impairments in multiple cognitive domains.The auditory verbal learning test immediate recall(control group 55.48±5.33;MCI-SSVD group 38.55±8.04;MCI-AD group 34.93±8.79;F=113.407,P=0.000),short time delayed recall(control group 13.34±1.38;MCI-SSVD group 8.47±2.18;MCI-AD group 4.06±2.87;F=216.284,P=0.000),and long time delayed recall(control group13.18±1.19;MCI-SSVD group 8.58±2.02;MCI-AD group 3.93±2.84;F=239.394,P=0.000)impaired most.Compared with MCI-SSVD,MCI-AD patients did worse in memory assessments(P=0.000),but better in mental processing and visuoconstruction(P=0.000-0.023).Two tests tapping memory and processing speed in combination could identify 93.3%MCI-SSVD patients and 93.3% MCI-AD patients correctly.Conclusions Current study indicates that both MCI-SSVD and MCI-AD,varying significantly in memory and mental processing speed,have a multiple-domain cognitive deficit,with memory impaired most seriously.Tests involving these 2 domains might be useful in differentiating MCI-SSVD from MCI-AD.

Objective To determine the risk factors and clinical features of mild vascular cognitive impairment due to subcortical small vessel disease (mVCI-SSVD).Methods Detailed demographic data,vascular risk factors, past and present history were collected and carefully neurological examination, National Institutes of Health Stroke Scale (NIHSS), as well as Hachinski ischemic score (HIS) were performed on 56 mVCI-SSVD patients.Further, the demographic data and vascular risk factors of mVCI-SSVD patients were compared with those of 80 normal control subjects.Results Proportions of smoking (39.3% (22/56)), hypertension (67.9% (38/56)), and diabetes (25.0% (14/56)) were higher in the patient group than in the normal control group (21.3% (17/80) , 47.5% (39/80), 11.3% (9/80)).Odds ratio (2.32(95% CI 1.05-5.13),2.15 (95% CI 1.02-4.54),2.26(95% CI 0.86-5.92)) between the two groups was statistically significant (P value: 0.039, 0.045, 0.047).There was no difference in terms of hyperlipidemia and cardiac disease between groups.Fifty percent (28/56) mVCI-SSVD patients had a clear stroke history.Twenty-six point eight percent (15/56) patients developed the cognitive impairment with an acute onset.Neurological focal signs presented in 20 patients (35.7%).Twenty four (42.9%) patients with HIS ≤ 4 points.Thirty eight cases (67.9%) scored 0 on NIHSS.Conclusions Current study suggested that smoking, hypertension, and diabetes may be risk factors for mVCI-SSVD.While hyperlipidemia and cardiac disease do not increase the risk of mVCI-SSVD.Unlike mVCI caused by large vessel disease, about half mVCI-SSVD patients lack of stroke history.Most patients show a relatively insidious onset and free of significant neurological focal signs.

Objective:To evaluate the value of Facial Emotion Recognition Test (FERT) in the early diagnosis of behavioral variant frontotemporal dementia (bvFTD).Methods:A total of 27 patients with mild bvFTD, 27 patients with mild Alzheimer′s disease (AD) and 54 normal controls were successively collected in the Memory Clinic of Department of Neurology,Xuanwu Hospital, Capital Medical University from January 2018 to July 2019. The subjects were assessed by the FERT and a battery of neuropsychological background tests including Mini-Mental State Examination, Frontal Assessment Battery (FAB), and Auditory Verbal Learning Test (AVLT), etc. The discriminatory power of the FERT was evaluated using the receiver operating characteristic curve (ROC).Results:The average FERT scores of bvFTD, AD and control groups were 18.00 (14.00, 21.00), 25.00 (21.00, 28.00) and 28.00 (26.00, 30.00) respectively. The FERT scores of bvFTD group were significantly lower than those of control groups ( H=-55.278, P<0.001) and AD groups ( H=-28.407, P=0.002). ROC results showed that the FERT had a high discriminatory power for differentiating bvFTD from the controls, with an area under the curve (AUC) value of 0.969 (95% CI 0.931-1.000, P<0.001). Both the sensitivity and specificity were 92.6% with a cut-off value at 24. For differentiating bvFTD group from AD group, the AUC value for the FERT was 0.850 (95% CI 0.749-0.951, P<0.001), with sensitivity of 81.5% and specificity of 71.4% with a cut-off value of 22. Compared with the AUC values for the FAB and AVLT-Delayed Recall (0.776 and 0.714), the AUC value for the FERT was slightly higher, though the differences among them were not statistically significant. Conclusions:Disturbance of emotion processing is presented in the early stage of bvFTD. FERT is one of the sensitive and specific neuropsychological indicators for the early diagnosis of bvFTD.

Objective To investigate the mechanisms of decreasing insulin degrading enzyme (IDE) level by mutation V97L in the gene presenilin 1 (PS-1).Methods Transcription factor GATA binding protein 3 (GATA-3) activity was assessed by protein/DNA array and verified by Western blot in SH-SY5Y cells transfected by PS-1 mutation V97L.Results Protein/DNA array and Western blot revealed that there was increased transcript factor activity (5.5 times high) and protein level of GATA-3 in V97L-PS-1 transfected SH-SY5Y cells.Transcription factor GATA-3 can bind to the IDE promoter and negatively control the IDE transcription level.Conclusion PS-1 mutation V97L may regulate the transcription of IDE via GATA-3, and subsequently involve in deposition of Aβ42 and development of Alzheimer's disease.

Objective To explore preliminarily the effects of preoperative depression condition in patients with breast cancer on the efficacy of intravenous analgesia with dezocine and the serum level of 5 hydroxytryptamine.Methods Sixty patients with breast cancer were assessed with Hamilton depression scale (HAMD).The total patients were divided into three groups according to HAMD scores,including normal group (26 cases),suspicious group (22 cases),and depression group (12 cases).The postoperative analgesia was facilitated with patients intravenous control analgesia with dezocine and the postoperative pain was assessed by visual analogue scale (VAS) at 2 hours,12 hours,and 24 hours.Yhe serum concentration of 5 hydroxytryptamine was measured by enzyme-linked immunosorbent assays before anesthesia,2 hours after surgery beginning,and 24 hours after surgery.Results The postoperative VAS at 12 hours and 24 hours in suspicious group and in depression group were higher than those in normal group (P ＜ 0.05).There was no statistical difference between depression and suspicious groups (P ＞ 0.05).The serum concentrations of 5 hydroxytryptamine in three groups increased obviously at 2 hours after surgery beginning (P＜0.05),and then decreased at 24 hours postoperation.The serum concentrations of 5 hydroxytryptamine in suspicious group and depression group at three measurement point were significantly lower than those in normal group (P ＜0.05).The serum concentrations of 5 hydroxytryptamine in depression group at three measurement point were significantly lower than those in suspicious group (P ＜ 0.05).Conclusions Under this preliminary study condition,the preoperative severity of the depression in patients with breast cancer may affect the analgesia effect of patients intravenous control analgesia with dezocine and maybe have some relationships with serum levels of 5 hydroxytryptamine.