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Objective To investigate the effect of hypertriglyceridemic waist(HTWC)phenotype on cognitive function in patients with type 2 diabetes.Methods According to the standard of plasma triglycerides concentration≥1.7 mmoL/L,waist circumference(WC)≥ 90 cm in men or ≥80 cm in women,304 patients with type 2 diabetes were divided into four groups:normal triglycerides and waist circumference group(group A,n =65),normal waist circumference and hypertriglyceridemia group (group B,n=53),abdominal obesity and normal triglycerides group(group C,n=114),and HTWC group(group D,n =72)for prospective studies.Patients in four groups were surveyed with Mini-mental state examination (MMSE)and Montreal cognitive assessment (MOCA).And changes of cognitive function among the four groups were compared.Results Total score for the MMSE was significantly lower in group D than in group A(27.1±1.9 vs.29.0±1.3,F=2.869,P=0.019).The subscales of attention and calculation(4.0± 1.4 vs.4.6±0.9,F=1.605,P=0.047)and recall(2.2± 0.9 vs.2.6±0.6,F=1.959,P=0.043) were significantly lower in group D than in group A.Total score for the MOCA was significantly lower in group D than in group A(23.4±3.9 vs.25.9±3.6,F =1.975,P=0.031).The subscales of visuospatial and executive(3.5 ± 1.4 vs.4.1 ± 0.9,F=1.537,P =0.048),attention(5.1±1.4 vs.5.7±0.9,F=1.660,P=0.048)and orientation(5.6±1.0 vs.6.0± 0.0,F=2.362,P=0.030)were significantly lower in group D than in group A.Conclusions There is a statistically more significant decline in cognitive function in patients with HTWC phenotype and the effective intervention and treatment are needed.

Objective To investigate the association between gene polymorphism of sortilinrelated receptor 1 (SORL1) and Alzheimer' s disease by detecting a series of single nucleotide polymorphisms (SNPs).Methods The Snapshot method was used to genotypc 6 SNPs (SNP10,19,23,24,25,27) in SORL1 and the distributions of allele and genotype of the 6 SNPs were compared between AD patients and healthy control individuals.Results There were significant differences in the genotype distributions of SNP19,23,24 and 25 between AD patients and control group (all P＜0.01).Subjects with TT genotype in SNP19 had significantly lower risk for AD and was protective for AD (OR=0.089,95％CI:0.011-0.718,P＜0.01).The AT genotype in SNP23 (OR＝3.826,95％CI:1.388～10.544,P＜0.01),CT genotype in SNP24(OR=5.935,95％CI:1.774-19.853,P＜0.01)and CT genotype in SNP25(OR=5.754,95％CI:2.007-16.496,P＜0.01)had higher risks for AD.Conclusions SORL1 gene variants of SNP19,23,24 and 25 might be the important risk factors for late-onset AD.

Dementia is a clinical syndrome characterized by cognitive impairment and decreased daily activity.In recent years, more and more studies have shown that there are neuropsychiatric syndromes in people with normal cognitive function , thus increasing the risk of dementia.This population has been defined as mild behavioral impairment (MBI).MBI is now considered to be one of the prodromal symptoms of dementia, and there have been some researches and consensus on the definition , diagnosis and screening scale of MBI, but there are still a lot of controversies.For this reason, we systematically reviewed the research progress of MBI , to clarify the evidence on the definition , diagnostic criteria and screening methods of MBI, and to summarize the consensus and controversy of the research on the correlation between MBI and dementia, aiming to draw attention to the applicability and necessity of MBI diagnostic criteria in clinical practice.

Objective To investigate the structural changes of gut microbiota in patients with Parkinson's disease ( PD).Methods Twenty-four PD patients and 14 healthy controls from Beijing Hospital in 2015 were recruited in this cross-sectional study.The general clinical information was collected and all subjects were assessed with Parkinson's disease related scales.The gut microbiota status between two groups was analyzed after extracting feces'DNA and carrying out high-throughput sequencing of bacterial 16S rRNA.Results At the phylum level, actinobacteria (0.76%(0.13%, 1.85%) vs 0.14%(0.07%, 0.30%), Z＝2.784, P＜0.01) were significantly increased and bacteroidetes (57.28%(48.75%, 64.95%) vs 63.78%(56.72%, 68.21%), Z＝-4.963, P＜0.01) were significantly decreased in PD patients compared to healthy controls.At the class level, bacilli (0.52%(0.11%, 2.10%) vs 0.13%(0.05%, 0.16%), Z＝2.693, P＜0.01), negativicutes (5.04%(2.93%, 14.02%) vs 2.87%(1.46%, 4.43%), Z＝2.360, P＝0.018), actinobacteria (0.60%(0.10%, 1.59%) vs 0.12%(0.04%, 0.20%), Z＝2.512, P＝0.011 ), gammaproteobacteria ( 1.72%( 0.58%, 5.46%) vs 0.43%(0.24%, 2.19%), Z＝2.179, P＝0.029) were significantly increased in PD patients compared to healthy controls.At the family level, veillonellaceae (3.78%(0.53%, 13.82%) vs 0.49%(0.08%, 3.14%), Z＝2.754, P＜0.01), streptococcaceae (0.33%(0.09%, 0.69%) vs 0.19%(0.14%, 0.24%), Z＝1.770, P＝0.004), enterobacteriaceae (1.04%(0.40%, 4.95%) vs 0.20%(0.10%, 0.45%), Z＝2.784, P＜0.01 ), lactobacillaceae ( 0.079%( 0.014%, 0.575%) vs 0.003%(0.002%, 0.028%), Z＝3.119, P＜0.01), bifidobacteriaceae (0.60%(0.09%, 1.57%) vs 0.11%(0.03%, 0.19%), Z＝2.481, P＝0.012) were significantly increased and pasteurellaceae (0.009%(0.002%, 0.047%) vs 0.110%(0.022%, 0.898%), Z＝-2.545, P＝0.010) were significantly decreased in PD patients compared to healthy controls.Conclusions The structures of gut microbiota in PD patients and healthy controls were significantly different at the levels of phylum , class, and family.All these changes are potentially associated with the development of PD pathology.

Objective To explore the association of interleukin (IL)-1 genotypes with Alzheimer′s disease (AD). Methods Using polymerase chain reaction and restriction fragment length polymorphism, the IL-1A (-889) and IL-1B (+3953) genotypes in 84 cases of AD and 139 controls were detected and analyzed. Results The frequencies of IL-1A(- 889) C/C, C/T and T/T genotypes were 72.6% and 84.2%, 23.8% and 14.4%, 3.6% and 1.4% in AD cases and controls respectively. The genotypes frequencies of IL-1A (-889) C/C, C/T and T/T in AD cases were similar to that of controls (χ2=4.53, P＞0.05), but the frequencies of IL-1A (-889) T allele were significantly higher in AD cases than in controls (15.5% vs. 8.6%, χ2=4.93, P＜0.05). The frequencies of IL-1B (+3953) C/T genotypes and T allele were also significantly higher in AD cases than in controls (16.7% vs. 6.5%, 8.3% vs. 3.2%, χ2=5.88,5.56, both P＜0.05). Conclusions IL-1 genotypes are associated with AD. IL-1 genotypes may play an important role in the development of AD.

Objective To investigate the predictive value of quick sequential organ failure assessment (qSOFA) score on the prognosis of adult patients with infection in intensive care unit (ICU). Methods A retrospective analysis was conducted on the clinical data of the infected patients in the ICU of the 401st Hospital of the People's Liberation Army from August 1st, 2000 to December 31st, 2017. The clinical data included patients' gender, age, basic diseases, etc.; the worst values of vital signs and laboratory test results within 24 hours of admission were recorded, the scores of the qSOFA, sequential organ failure assessment (SOFA), acute physiology and chronic health evaluationⅡ(APACHEⅡ) were calculated separately; the outcome of ICU was recorded. The predictive values of three scoring systems were evaluated by receiver operating characteristic curve (ROC). Results Excluding patients with incomplete clinical data, cancer and immunosuppressive patients, a total number of 1 059 patients were enrolled in this study, with 679 males and 380 females, the average age was 72.57±16.06, the ICU mortality was 35.32% (374/1 059). The ROC curve analysis showed that the areas under ROC curve (AUC) of APACHE Ⅱ, SOFA, qSOFA scores to predict the prognosis of infected patients were 0.713, 0.744 and 0.662, respectively. Although the AUC of qSOFA in predicting prognosis was significantly lower than that of other two scoring systems (both P < 0.05), but it still had some predictive ability. According to the Youden index, the best cut-off point for qSOFA was 2 to evaluate the prognosis of the infection, and the sensitivity was 71.65%, the specificity was 53.87%, the positive likelihood ratio was 1.55, the negative likelihood ratio was 0.53, the positive predictive value was 0.426, the negative predictive value was 0.799, and the accuracy was 59.62%. The mortality of the infected patients was increased with qSOFA score, and the mortality difference among patients with different qSOFA scores was statistically significant (χ2= 84.605, P = 0.000). The patients were divided into two groups according to the cut-off value of qSOFA, and the mortality in qSOFA score ≥2 group was higher than that in qSOFA score < 2 group [odds ratio (OR) = 2.767, 95% confidence interval (95%CI) = 2.116-3.617, P = 0.000]. Conclusions qSOFA, SOFA and APACHE Ⅱscores have the capability of predicting the outcome for the infected patients. qSOFA score is expected to be a quick and simple tool to judge the prognosis of ICU infection patients because of its advantages of quick acquisition.

OBJECTIVE: To study the influence of maternal sex chromosomal abnormalities on the prediction of fetal sex chromosome abnormalities (SCAs) by non-invasive prenatal testing (NIPT). METHODS: Thirty-six pregnant women with a prediction for fetal SCAs by NIPT were verified as false positive after prenatal diagnosis using amniotic fluid samples. With informed consent, these women were subjected to chromosomal karyotyping or copy number variations (CNVs) analysis through high-throughput sequencing. RESULTS: Sex chromosomal abnormalities were found in 8 women, which yielded an abnormal rate of 22.22% (8/36). Among these, 3 had sex chromosome aneuploidies (47, XXX), 4 had sex chromosome mosaicisms, and 1 carried structural chromosomal abnormalities. Reanalysis of the results of NIPT were consistent with the maternal CNVs by large. With the ratio of cffDNA (ChrX)/cffDNA was more than 2, 6 of the eight women were found to harbor sex chromosome abnormalities, and the fetal karyotype was normal. However, with a ratio of less than 2, only 2 of the 38 pregnant women had sex chromosome abnormalities, and 10 of the fetuses were confirmed as positive. CONCLUSION The presence of maternal sex chromosomal abnormalities can greatly influence the result of NIPT, which may also be an important reason for false prediction for fetal SCAs by NIPT. When NIPT indicates abnormal SCAs, it is necessary to analyze maternal sex chromosomes. The ratio of cffDNA(ChrX)/cffDNA may help to determine the source of abnormal signals.