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 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.