Objective To improve the diagnosis of cerebral lobe hemorrhage (CLH) associated with cerebral amyloid angiopathy (CAA) according to its clinical characteristics and GRE/SWI.Methods Thirty-four CAA-related CLH patients admitted to Inner Mongolia People's Hospital for GRE/SWI from 2013-04-15 to 2015-07-19 were included in this study.Their demographic data,clinical data (age,gender,past history of hypertension,diabetes mellitus,use of antiplatelet drugs) and clinical manifestations were recorded.Results Of the 34 patients,5 were diagnosed with progressive dementia and hypomnesis,4 were diagnosed with epilepsy,7 were diagnosed with past cerebral hemorrhage,18 were diagnosed with hypertension.SWI showed that the CLH was round and oval in shape and was located in parietal lobe,occipital lobe,frontal lobe and temporal lobe respectively with single lobe hemorrhage occurred in 7 patients and multiple lobe hemorrhage occurred in 27 patients.Conclusion The clinical characteristics of CAA-related CLH are highly heterogeneous.SWI plays an important role in diagnosis of CLH and is thus worthy of popularizing its clinical application.

Objective To study the association between Essen stroke risk score (ESRS) and coronary heart disease (CHD).Methods One hundred and forty-six patients who underwent coronary angiography in our hospital from July 1,2015 to December 31,2016 were divided into CHD group (n=105) with their stenosis ≥50％ and non-CHD group (n=41) with their stenosis ＜50％.Their clinical,laboratory and coronary angiography data were recorded and analyzed by univariate logistic regression analysis and multivariate logistic regression analysis respectively.ROC curve of ESRS was plotted for diagnosing CHD.Results The age was significantly older,the incidence of hypertension,diabetes mellitus and myocardial infarction,the ESRS and fasting blood glucose level were significantly higher in CHD group than in non-CHD group (P＜0.05,P＜0.01).The age,history of smoking and alcohol drinking,and the incidence of abnormal blood lipid,AF,other heart diseases,peripheral artery disease,ischemic stroke or the serum levels of TIA,TC,TG,LDL-C,HDL-C and uric acid were significantly different between CHD group and non-CHD group (P＞0.05).Multivariate logistic regression analysis showed that ESRS was an independent risk factor for CHD (OR=2.070,95％CI:1.473-2.908,P＜0.01).The area under the ROC curve of ESRS for diagnosing CHD was 0.743 (95％CI:0.651-0.834,P＜0.01).The Youden's index was the highest when the ESRS was 2 with a sensitivity of 80.95％ and a specificity of 58.54％.Conclusion ESRS is related with CHD and can thus predict the occurrence of CHD.It is necessary to make an overall assessment of CHD when the ESRS is ≥2.

Objective To analyze the clinical factors associated with CT image in diagnosis of elderly brain atrophy patients with mental disorder.Methods Forty elderly brain atrophy patients with mental disorder served as group A,40 elderly brain atrophy patients without mental disorder served as group B,and 40 healthy people served as group C in this study.The chacteristics of their CT image were retrospectively analyzed.Their CT imaging indicators (including the width of ventricle,brain pool,brain ditch and the CT value of white matter) were recorded and analyzed.Results The width of ventricle,brain pool,brain ditch and the CT value of white matter were significantly different in 3 groups (P＜0.01).The width of ventricle,brain pool,brain ditch was significantly longer while the CT value of white matter was significantly lower in groups A and B than in group C (17.2±4.9 mm and 15.7±3.9 mm vs 12.2±3.0 mm,8.7±2.8 mm and 6.9±2.5 mm vs 3.9±1.0 mm,24.3±5.1 mm and 20.8±4.5 mm vs 14.3±3.2 mm,28.2±4.3 HU and 33.9±5.0 HU vs 38.1±6.3 HU,P=0.000).The width of brain ditch was significantly longer while the CT value of white matter was significantly lower in group A than in group B (P＜0.05).The incidence of ischemic stroke and white matter demyelination was significantly higher in group A than in group B (40.0％ vs 17.5％,P =0.26;47.5％ vs 25.0％,P=0.36).Conclusion Brain atrophy patients with mental disorder demonstrate worse CT findings and those with white matter demyelination and ischemic stroke are more prone to occur mental disorder.

Objective To study the relationship between basal ganglia ischemic stroke (BGIS) and paroxysmal atrial fibrillation (PAF) due to abnormal vagus nerve tension.Methods A total of 1483 elderly ischemic stroke patients who underwent head CT or MRI in our hospital from January 2013 to December 2014 were divided into BGIS group (n=1045) and non-BGIS group (n=438).Their heart rate variability and frequency parameters (SDNN,RMSSD,PNNS0) were recorded.The LF/HF ratio was analyzed.Results The incidence of PAF was significantly lower in ＜69 years old patients of BGIS group than in those of non-BGIS group (P＜0.05) and was significantly higher in ≥70 years old patients of BGIS group than in those of non-BGIS group (P＜0.05).The incidence of ischemic stroke with PAF was significantly higher in BGIS group than in nonBGIS group (56.8％ vs 41.0％,P=0.031).The incidence of PAF was significantly higher in ＞79 years old patients of BGIS group than in those of non-BGIS group (P＜0.05).The incidence of AF increased with the increasing age of ischemic patients between the two groups.The SDNN,RMSSD,PNN50 were significantly higher while the LF/HF ratio was significantly lower in nonPAF patients of BGIS group than in those of non-BGIS group (P＜0.05).Conclusion The incidence of BGIS shows a tendency to increase.PAF is prone to occur in BGIS patients.The vagus nerve tension is increased in BGIS patients with PAF.

Objective To analyze the incidence of atrial fibrillation (AF) and asymptomatic AF in sick sinus syndrome (SSS) and atrioventricular block (AVB) patients after dual-chamber pacemaker implantation.Methods Five hundred and fifteen SSS and AVB patients who underwent dual-chamber pacemaker implantation were divided into SSS group (n =221),AF group (n =106),non-AF group (n=115)and into AVB group (n=294),AF group (n=103),non-AF group (n=191).The clinical data,incidence of AF and asymptomatic AF,their influence factors in different groups were compared.Results The incidence of AF was 40.6％ in the 515 patients.The percentage of ventricular pacing (VP％) was significantly higher and the left ventricular end diastolic diameter was significantly longer in AVB group than in SSS group (P＜0.01).The age was significantly older,the incidence of CHD and the percentage of atrial pacing (AP％) were significantly higher,the left atrial diameter was significantly longer in AF group than in non-AF group (P＜0.05,P＜0.01).The age was significantly older,the incidence of CHD and the VP％ were significantly higher in asymptomatic AF group than in symptomatic AF group (P＜0.05,P＜0.01).Multivariate logistic regression analysis showed that age,AP％ and amiodarone amnistration history were the risk factors for AF while age and VP％ were the risk factors for asymptomatic AF (OR=0.957,95％CI:0.925-0.990,P=0.011;OR=0.982,95％CI:0.972-0.992,P=0.000).Conclusion Pacemaker can effectively monitor AF,especially asymptomatic AF.

Objective To study the β3-adrenoceptor (β3-AR) in heart and lungs of elderly heart failure (HF) rats.Methods Forty-eight elderly HF Wistar rats were included in this study.A HF model of rats was established by ligating the aorta.The rats were divided into sham operation group (n=24) and HF group (n=24).The rats in each group were further divided into 4 subgroups at weeks 5,7,9 and 11 after operation (6 in each group).The hemodynamics,pathology and expression of β3-AR mRNA and protein in heart and lungs were detected at weeks 5,7,9 and 11 respectively after operation.Results The heart rate,LVESP,and dp/dtmax were significantly lower in HF group than in sham operation group at weeks 9 and 11 after operation while the LVEDP was significantly higher in HF group than in sham operation group at weeks 5,7,9 and 11 after operation (P＜0.01).Pulmonary edema occurred at week 7 after operation and myocardial necrosis was detected at week 9 after operation.The expression level of β3-AR mRNA in lungs was significantly lower in HF group at weeks 5,7,9 and 11 than at week 2 after operation (P＜0.05).The expression level of β3-AR mRNA in heart was significantly higher in HF group than in sham operation group at weeks 9 and 11 after operation (1.21±0.26 vs 0.98±0.22,1.26±0.23 vs 1.05±0.24,P＜0.01).Conclusion The β3-AR mRNA expression is downregulated in the lungs and upregulated in the heart.

Objective To study the association between chronic kidney disease (CKD) and dilated Virchow-Robin space (dVRS) in acute lacunar ischemic stroke patients.Methods A total of 1078 acute lacunar ischemic stroke patients admitted to our hospital were divided into mild dVRS group 1 (n=737) and moderate-severe dVRS group 1 (n=341) according to the severity of their dVRS in basal ganglia (BG),and into mild dVRS group 2 (n=789) and moderate-severe dVRS group 2 (n =289) according to the severity of their dVRS in centrum semiovale (CSO).Their kidney function was assessed according to the estimated glomerular filtration rate (eGFR).CKD was classified into stage 1,stage 2,stage 3a and stage 3b.The association between renal function and dVRS was analyzed by multivariate logistic regression analysis.Results The age was older,the number of females was greater,the incidence of hypertension and CKD was higher,the proportion of smoking was lower in moderate-severe dVRS group 1 than in mild dVRS group 1 (P＜0.05).The incidence of hypertension was higher in moderate-severe dVRS group 2 than mild dVRS group 2 (P＜0.05).Multivariate logistic regression analysis showed that age,hypertension,stage 2 CKD,stage 3a CKD and stage 3b CKD were the independent risk factors for severe dVRS in BG (P＜0.05,P＜0.01).Hypertension was an independent risk factor for severe dVRS in CSO (P=0.04).Conclusion CKD is an important risk factor for dVRS in BG.However,it is not associated with dVRS in CSO.This result highlights the different pathological mechanisms and risk factors for dVRS in BG and CSO.

Objective To study the characteristics of brain function in different cognitive states.Methods Fifty mild cognitive impairment (MCI) patients admitted to our hospital from August 2012 to August 2014 served as a MCI group and 45 elderly people undergoing physical examination served as a control group in this study.The electroencephalography (EEG) signals of patients were recorded for 5 minutes in cognitive load state with their eyes closed.The Lemple-Zie complexity (LZC) was assayed and analyzed.Results The LZC in different brain regions was significantly higher in control group than in MCI group (P＜0.05).The decreasing amplitude of LZC on leads T3,FP1,FP2,F3,F4,P3,P4 was significantly greater (＞20％) in MCI group than in control group (P＜0.01).No significant difference in LZC was found in rest state and cognitive load state between the two groups (P＞0.05).The LZC was significantly lower and the decreasing amplitude of LZC on leads F7,F8,T3,T4,FP1,FP2,F3,F4,P3 was significantly greater in cognitive load state than in rest state in MCI group (P＞0.05).Conclusion The changing LZC can show the brain function and can thus be used an objective EEG nonlinear detection method of cognitive function.

Objective To study the association of Hp infection and insulin resistance (IR) with vascular dementia (VaD).Methods Eighty-six elderly VaD patients admitted to our hospital from April 2015 to April 2016 served as a VaD group and 52 healthy subjects undergoing physical examination served as a control group in this study.The patients in VaD group were further divided into Hp-positive group (n =50) and Hp-negative group (n =36).Their fasting blood glucose (FBG) and fasting insulin (FINS) levels were measured with positive C13 urea breath test as the diagnostic index of Hp infection.HOMA-IR=FINS× FBG/22.5 was calculated according to the self balance model analysis.Results The positive Hp rate,serum FBG and FINS levels,and HOMA-IR were significantly higher in VaD group than in control group (58.14％ vs 28.58％,x2=10.273,P=0.002;5.53±0.60 mmol/L vs 5.19±0.38 mmol/L,P=0.0004;10.29±4.95 μIU/L vs 8.77±4.02 μIU/L,P=0.0317;2.57±1.34 vs 2.06±0.96,P=0.0179).The serum FBG and FINS levels and HOMA-IR were significantly higher in Hp-positive group than in Hp-negative group (P＜0.05,P＜0.01).Conclusion Hp infection and IR are closely associated with VaD,and can thus lead to the occurrence or progression of VaD by inducing or aggravating IR.

Objective To analyze the classification of etiology in 48 patients with acute isolated pontine infarction (IPI),a special subtype of ischemic stroke,according to the characteristics of Chinese ischemic stroke subclassification (CISS) and Kumral ischemic stroke subclassification.Methods The basic characteristics,risk factors,clinical manifestations of 48 acute IPI patients were analyzed according to the CISS and Kumral ischemic stroke subclassification.Results Hypertension (70.83 ％),smoking (64.58 ％),hyperlipidemia (50.00 ％),and abnormal glucose metabolism (37.50％) were the major risk factors for acute IPI.Of the 48 acute IPI patients,38 (79.17％) manifestated as hemiplegia and 15 (31.25％) manifestated as dizziness,33 (68.75％) were diagnosed as paramedian pontine infarction,a most common location of IPI,16 (33.33％) were diagnosed as large artery occlusion,a major subtype of IPI,according to the Kumral ischemic stroke subclassification,17 (35.42％) were diagnosed as intracranial and extracranial large artery atherosclerosis according to the CISS (P=0.830).Conclusion IPI is mainly manifested as paramedian pontine infarction.Large artery occlusion according to the Kumral ischemic stroke subclassification and intracranial and extracranial large artery atherosclerosis according to the CISS are the major subtypes of IPI.IPI is diagnosed when a large part of brainstem is involved.