Objective To investigate the relative factors of vascular parkinsonism(VP),in order to provide a clinical basis for early diagnosis of VP. Methods The method of prospective cohort study was used. The first cerebral infarction was taken as the initiating event. All the cases were followed up for 4 years. When they suffered from VP or died of VP, the follow-up was termina-ted. Logistic regression model was used to analyze the risk factors for VP. Results Fifty-four pa-tients developed VP in 404 patients with first cerebral infarction,the incidence rate was 13.4%.According to the typing standard of OCSP,in the 404 patients, the incidence of VP was highest in lacunar infarction group(42 cases, 20.4%). The main risk factors for VP included age (P=0.043, OR = 1. 135,95% CI: 1. 010-1. 275),hypertension history (P=0.032, OR=2.019,95% CI: 1.247-4.746), blood viscosity (P=0.041, OR=1.724,95% CI: 1.036-3.058) and fibrinogen (P=0.001, OR=2.241,95% CI: 1.272-5.473). Conclusion During follow-up for 4 years,the incidence rate of VP in patients with first cerebral infarction is 13.4%. Lacunar in-farction is apt to cause occurrence of VP. Age, hypertension history, blood viscosity and fibrinogen are risk factors for VP. VP may be caused by multiple factors and multiple mechanisms.

Objective To analyze the characteristics of pulse pressure index(PPI) and its value in predicting the risk for cerebral and cardiac vascular events in old males with hypertension. Meth-ods The 24-hours ambulatory blood pressure monitoring was performed in a total of 265 elderly men with essential hypertension(EH). The patients were classified into 3 groups based on the lev-el of PPI.PPI≤0.400(103) ,0. 401-0. 500(124) ,and≥0.501(38). Results There was significant difference in PP between day-time and night-time in hypertensive patients. The change of PPI was less than that of PP. With the increase in PPI, SBP(24 h, day-time, night-time), PP(24 h, day-time, night-time), the load of SBP(night-time), systolic blood pressure variation(BPV, 24 h, day-time) were raised significantly (P<0.01); while DBP(24 h, day-time, night-time), nocturnal de-cline in BP and the load of DBP(day-time) declined with the decrease in PPI (P<0.01). High PPI would increase the incidence of cardiac-cerebral vascular events (P < 0.01). Conclusion PPI is a useful parameter in clinical evaluation of arteriosclerosis. It may also have prognostic value for cardiac-cerebral vascular events in elderly men with EH.

Objective To study the effect of epigallocatechin-3 gallate (EGCG) on cholesterol efflux in foam cells and its mechanism.Methods THP-1 cells were induced to differentiate into macrophages which were then transformed to foam cells.Foam cells were divided into 0 μmol/L EGCG group,10 μmol/L EGCG group,30 μmol/L EGCG group,and 100 μmol/L EGCG group (1.5 × 106 in each group).Their cholesterol content was measured with a cholesterol test kit,apoA-I-mediated cholesterol efflux was assayed with a liquid scintillation counter,expression of ATP-binding cassette A1 (ABCA1) was detected by RT-PCR and Western blot respectively.Results The ABCA1 mRNA and protein expression levels and cholesterol efflux were significantly higher while the cholesterol content was significantly lower in 10 μmol/L EGCG group,30 μmol/L EGCG group,and 100 μmol/L EGCG group than in 0 μmol/L EGCG group (7.04％ ±0.21％,7.75％±0.17％ and 8.53％±0.18％ vs 3.37％±0.16％,P＜0.01;419.33±19.75 mg/g,352.58± 14.23 mg/g and 312.62±17.45 mg/g vs 520.51 ±20.62 mg/g,P＜0.01),and in 30 μmol/L EGCG group,100μmol/L EGCG group than in 10μmol/L EGCG group (P＜0.05).Conclusion EGCG increases cholesterol efflux and decreases cholesterol content in foam cells by upregulating the transcription and expression of ABCA1.

Objective To study the role of nicorandil in protecting myocardium of very old patients with non-ST segment elevation myocardial infarction.Methods Ninety-six very old patients with non-ST segment elevation myocardial infarction admitted to our hospital from March 2012 to July 2016 were randomly divided into experimental group (n=48) and control group (n=48).After 4 weeks of comprehensive treatment,the patients in experimental group were given oral nicorandil (5 mg,3 times a day).The serum cTnI level was measured in 2 groups before treatment and on days 1,3,7 and 10 after treatment.The ECG of 2 groups was observed before and after treatment.Results The serum cTnI level was significantly lower in experimental group than in control group on days 3,7 and 10 after treatment (3.24±4.31 μg/L vs 10.47±t4.72 μg/L,P＜0.05;0.53±0.31 μg/L vs 2.50±1.45 μg/L,P＜0.01;0.09±0.07 μg/L vs O.41±0.26 μg/L,P＜0.01).The ECG was significantly better in experimental group than in control group after treatment (P＜0.05).Conclution Oral nicorandil can protect the myocardium of very old patients with non-ST segment elevation myocardial infarction.

Objective To study the diagnostic value of serum N-terminal probrain natriutetic peptide (NT-proBNP) level and its influencing factors in very old male heart failure (HF) patients with preserved ejection fraction.Methods Two hundred and thirty-six very old male HF patients with preserved ejection fraction admitted to our hospital from February 2008 to July 2016 were divided into HF group (n=92) and HF-free grup (n=144).Their biochemical parameters were tested and analyzed by correlation analysis.Results The serum NT-proBNP level and logNT-proBNP were significantly higher in HF group than in HF-free group (2205.4±2128.4 ng/L vs 457.3± 312.2 ng/L,P=0.000;3.3±0.3 vs 2.5±0.3,P=0.004).Univariate correlation analysis showed that serum NT-proBNP level was positively related with AF,diuretics,LVEF,left atrium diameter,eGFR,creatinine and logcTnI (P＜0.05,P＜0.01).Multivariate linear regression analysis revealed that AF,LVEF,left atrium diameter,eGFR,and logcTnI were the independent risk factors for NT-proBNP and that NT-proBNP was negatively related with LVEF and eGFR.Conclusion The serum NT-proBNP level in very old male HF patients with preserved ejection fraction can be influenced by a variety of factors.Increasing LVEF and eGFR can reduce their serum NT-proBNP level and improve their outcome.

Objective To study the association between NT-proBNP and elevated nocturnal blood pressure in male elderly primary hypertension patients.Methods Five hundred and ninety male elderly primary hypertension patients,admitted to our hospital from January 2009 to December 2012,were divided into non dipper hypertensivon group (n=418) and anti-dipper hypertension group (n =172).Their clinical data,laboratory test parameters and ambulatory ECG findings were recorded.Results The age was older,the serum levels of creatinine,HbAlc and NT-proBNP were higher in anti-dipper hypertension group than in non-dipper hypertensivon group (81.47± 9.25 years vs 77.81±11.10 years,P=0.000;113.18±99.70 μmol/L vs 93.35±84.49 μmol/L,P=0.017;7.34％±8.35％ vs 6.37％±1.05％,P=0.001;551.16±991.72 ng/L vs 355.12±934.89 ng/L,P=0.009).Multivariate regression analysis showed that average day systolic blood pressure was independently associated with NT-proBNP (P=0.004).Conclusion The loss of rhythmia is more noticeable and the target organ damage is more serious in anti-dipper hypertension patients than in non-dipper hypertensivon patients.The serum NT-proBNP level plays a certain role in regulating blood pressure.

Objective To study the relationship of MR diffusion tensor imaging for corpus callosum and cingulate bundles with cognitive impairment in subcortical ischemic vascular dementia (SIVD) patients.Methods Sixty elderly SIVD patients admitted to our hospital from July 2015 to June 2016 served as a SIVD group and 40 age-matched persons undergoing physical examination served as a control group in this study.The mean ADC and FA were calculated according to the MR diffusion tensor imaging parameters in region of interest.Relationship between fiber tract integraty and MMSE Scale score was compared between the two groups.Results The ADC was significantly higher while the FA was significantly lower for the genu of corpus callosum in SIVD group than in control group.However,no significant difference was found in ADC for the spenium of corpus callosum between the two groups (P＞0.05).The ADC was significantly higher while the FA was significantly lower for bilateral cingulate bundles (P＜0.05,P＜0.01).The FA for the genu of corpus callosum and bilateral cingulate bundles was positively related with the MMSE Scale score (r=0.511,r=0.469,r=0.457,P＜0.05).However,the FA for the splenium of corpus callosum was not related with the MMSE Scale score(r=0.364,P＞0.05).Conclusion Changes of MR diffusion tensor imaging parameters in corpus callosum and cingulate bundles contribute to the early prevention and treatment of cognitive impairment in SIVD patients.

Objective To study the relationship between serum uric acid (UA) level and cerebrovascular stenosis in acute ischemic stroke (AIS) patients.Methods Five hundred and thirteen patients with AIS or old IS admitted to our hospital from April 2014 to April 2016 were divided into primary IS group (n=236),recurrent IS group (n=136),and old IS group (n=141).Venous blood samples were taken on admission for biochemical testing.The patients were further divided into serum UA≤255 μmol/L group (n=128),serum UA=256-312μmol/L group (n=129),serum UA=313-371 μmol/L group (n=129),and serum UA＞371 μmol/L group (n=127).Their cerebrovascular stenosis was assessed by CT angiography or magnetic resonance angiography after admission.Results The severity of cerebrovascular stenosis,hypertension,diabetes and hyperlipidemia was significantly different in primary IS group,recurrent IS group and old IS group (27.5％ vs 33.8％ vs 12.8％、24.2％ vs 28.7％ vs 46.8％、61.9％ vs 49.3％ vs 40.4％、71.6％ vs 61.8％ vs 46.8％,P=0.000).Logistic regression analysis showed that serum UA≤ 255 μmol/L was an independent risk factor for cerebrovascular stenosis (OR =2.787,95 ％CI:2.209-3.365,P=0.001).The risk of cerebrovascular stenosis decreased gradually with the elevated serum UA level.Conclusion Serum UA level is not directly related with recurrent IS.Low serum UA level is a risk factor for cerebrovascular stenosis in AIS.

Objective To analyze the relationship between ambulatory blood pressure (ABP) and cognitive function in elderly hypertensive patients with leukoaraiosis (LA).Methods Eighty elderly hypertensive patients with LA underwent 24 h ABP monitoring to record their 24 h SBPV,DBPV,AASI,and APPI.The patients were scored according to the MMSE Scale.Results The 24 h SBPV,DBPV,AASI,and APPI were significantly higher in degrees 1,2,3 of LA than in degree 0 of LA (P＜0.05),in degrees 2,3 of LA than in degree 1 of LA (P＜0.05),and in degree 3 of LA than in degree 2 of LA (P＜0.05).The MMSE Scale score of memory,attention,counting,recall,language and the total score were significantly lower in degrees 2,3 of LA than in degrees 1,2 of LA (P＜0.05).The 24 h SBPV,DBPV,AASI,and APPI were negatively related with the MMSE Scale score (r=-0.8697,P=0.000;r=-0.6709,P=0.002;r=-0.8373,P=0.000;r=-0.5991,P=0.007).Conclusion The severer the LA is,the higher the 24 h SBPV,AASI and APPI are.The 24 h SBPV and AASI can thus be used as the indicators of LA and cognitive function impairement.

Objective To analyze the relationship between renal function impairement and obesity in patients with primary hypertension.Methods One hundred and twenty-eight primary hypertension patients with renal function impairement admitted to our hospital from January 2012 to December 2015 were divided into obesity group (n=68) and control group (n=60) according to the Asian obesity diagnosis criteria established by the International Diabetes Federation.Relationship of serum urea nitrogen (BUN),creatinine,cystatin C (Cys-C),urinary N-acetyl beta-D glucosaminidase (NAG),urinary micro albumin levels and BMI with renal function impairment in primary hypertension patients was analyzed by multivariate linear stepwise regression analysis.Results The BMI,serum levels of urinary NAG,Cys-C,BUN,and creatinine were significantly higher in obesity group than in control group (31.70±1.80 kg/m2 vs 23.95±2.00 kg/m2,19.34±1.40 U/L vs 14.92±1.31 U/L,0.69±0.06 mg/L vs 0.47±0.05 mg/L,11.50±2.90 mmol/L vs 8.60±1.90 mmol/L,159.50±10.40 μmol/L vs 148.90±10.70 μmol/L,P＜0.05).The incidence of urinary micro albumin was significantly higher in obesity group than in control group (79.4％ vs 46.7 ％,P＜ 0.01).Blood pressure,pulse pressure difference,BMI,fasting blood glucose,serum levels of ereatinine,urinary NAG,Cys-C,BUN and urinary micro albumin were the risk factors for renal function impairement in primary hypertension patients (P＜0.05,P＜0.01).Conclusion Renal function impairement is related with obesity in primary hypertension patients.