Objective Vascular mild cognitive impairment(VaMCI) refers to mild cognitive impairment caused by or associated with vascular causes.This study aims to investigate the characteristics of the cognitive impairment in patients with vascular mild cognitive impairment (VaMCI).Methods Seventy-five patients with VaMCI(VaMCI group) and 38 healthy old subjects whose age, sex and education level match the VaMCI group patients(control group) were recruited from the department of Neurology, Beijing Chaoyang Hospital, Capital Medical University between Jan 2016 and June 2016.The neuropsychological examinations were used to evaluate the severity of cognitive impairment, specifically including the Minimum Mental State Examination(MMSE), Montreal cognitive assessment scale(MoCA), Clinical Dementia Rating(CDR), Activity of Daily Living Scale(ADL), Hachinski ischemic score table, Hamilton Depression Scale(HAMD) and Auditory Verbal Learning Test(AVLT).The Fazekas scale was used to assess the severity of white matter lesions, and the medial temporal lobe atrophy rating scale(MTA) was used to evaluate the atrophic severity of medial temporal lobe.Results The overall cognitive function score in VaMCI group was significantly lower than the control group [MMSE [25.7±2.3 vs 28.4±2.0] MoCA [22.8±3.9 vs 26.3±3.7]], the differences was statistically significant(P<0.05);as well as the AVLT-I [5.1±1.0 vs 8.9±1.9], AVLT-D [3.7±1.0 vs 9.8±1.5] and AVLT-R [7.6±1.9 vs 12±1.5] scores in VaMCI group was significantly lower than the control group, the differences was statistically significant(P<0.05), which suggested patients with VaMCI have overall cognitive impairment, especially memory impairment.But Fazekas and MTA scores in VaMCI groups were higher than the control group, the differences was statistically significant(P<0.05).Correlation analysis showed that the scale of medial temporal lobe atrophy had a negative relationship with the performance of MoCA (r=-0.434,P=0.002).Conclusion Our findings demonstrate patients with VaMCI have significant cognitive impairment, especially memory impairment, which may be correlated to the severity of the white matter lesions and the medial temporal lobe atrophy.

Reversible cerebral vasoconstriction syndrome (RCVS) is characterized by thunderclap headache and reversible cerebral vasoconstriction, with other neurologic signs and symptoms. To the best of our knowledge, there were only a few cases of RCVS presenting both as both convexity subarachnoid hemorrhage (cSAH) and posterior reversible encephalopathy syndrome (PRES). Herein, we report a case of a 32-year-old woman with RCVS who presented with recurrent thunderclap headaches that occurred 50 days after delivery, with cSAH and PRES on magnetic resonance imaging (MRI). She had significant clinical and radiological recovery on 3 months’ follow-up. The clinical coexistence of cSAH and PRES in our case with RCVS is quite rare. This case illustrates the importance of awareness of the diagnosis of RCVS among clinicians even when initial brain and vascular imaging are normal. Early diagnosis and treatment are crucial for better prognosis.

AIM:To study the effects of methylene blue (MB) on myocardial ischemia/reperfusion (I/R)-induced mitochondrial injury in isolated rat hearts.METHODS:Spragure-Dawley (SD) rats were divided into 3 groups randomly (n=6): control group, I/R model group and MB treatment group (IR+MB group).The isolated rat hearts were prepared and set up to Langendorff perfusion.The rats in I/R+MB group received MB (2 mg/kg) by intraperitoneal injection 2 h before operation.The hearts in control group were perfused with K-H solution for 110 min consecutively.The hearts in I/R group and I/R+MB group were in equilibrium for 20 min, following by 45 min of global ischemia, and then reperfused for 60 min.The heart rate (HR), left ventricular developed pressure (LVDP), left ventricular pressure maximum change rate (±dp/dtmax) and left ventricular end-diastolic pressure (LVEDP) were recorded.The perfusate was collected to determine the activity of creatine kinase-MB (CK-MB) and lactate dehydrogenase (LDH).The contents of reactive oxygen species (ROS), malondialdehyde (MDA) and adenosine triphosphate (ATP), and the activity of superoxide dismutase (SOD) in the myocardial tissues were all determined.Histopathological examination of left ventricle was performed.The mitochondria from the heart tissues was isolated and the mitochondrial swelling and mitochondrial membrane potential (MMP) were analyzed.RESULTS:Compared with control group, the hearts in I/R group showed poorer function, higher CK-MB and LDH levels in the perfusate, increased ROS and MDA contents, higher SOD activity and less ATP content in the heart tissues (P<0.05).Furthermore, the mitochondrial swelling level increased and MMP reduced in I/R group (P<0.05).Compared to I/R group, MB improved heart function and reduced the release of CK-MB and LDH (P<0.05).MB also decreased ROS and MDA contents, and increased the activity of SOD and the content of ATP (P<0.05).In addition, MB alleviated mitochondrial swelling and restored the reduced MMP (P<0.05).CONCLUSION: MB protects the isolated rat hearts from I/R-induced injury by attenuating the damage of mitochondria.

AIM: To investigate the effects of caveolin-1 (Cav-1) scaffolding domain peptide, cavtratin, on lipopolysaccharide (LPS)-induced mouse acute lung injury and heme oxygenase-1 (HO-1) activity.METHODS: Adult male BALB/c mice were randomly divided into 6 groups (n=8 to 10): control, Antennapedia internalization sequence (AP), LPS, LPS+hemin, LPS+ hemin+cavtratin and LPS+hemin+cavtratin+zinc protoporphyrin IX (ZnPP) groups.After LPS administration for 24 h, the lung pathological changes, the wet/dry weight (W/D) ratio of lung tissues, total cell number in bronchoalveolar lavage fluid and serum lactate dehydrogenase activity were measured.The co-localization of HO-1 and Cav-1 was displayed by immunofluorescence, and the HO-1 activity were detected.The mRNA expression of pro-inflammatory cytokines IL-1β, IL-6, TNF-α, MCP-1 and iNOS was detected by real-time PCR.RESULTS: The mice in LPS+hemin+cavtratin group had the decreased interaction between HO-1 and Cav-1, and the increased HO-1 activity compare with LPS group (P<0.05).Compared with LPS group, the pulmonary damage was attenuated in LPS+hemin+cavtratin group, and the injury indexes, including W/D ratio, total cell number in bronchoalveolar lavage fluid and lactate dehydrogenase activity in the serum, and the mRNA expression of inflammatory cytokines all decreased (P<0.05).HO-1 activity inhibitor ZnPP abolished the above protective effect of cavtratin on the lung tissues with LPS-induced acute lung injury.CONCLUSION: Cavtratin has beneficial effects on the lung with LPS-induced acute injury by restoring the HO-1 activity.

Objective To investigate the neural circuit of inhibitory control in late-onset depressed patients(LOD) by functional magnetic resonance imaging(fMRI). Methods Fourteen late-onset depressed patients (LOD group) and thirteen elderly healthy subjects( control group) were recruited. The two groups were age, gender, and education matched. All the subjects performed a visual Go/Nogo task during the fMRI scan. Erect or inverted isosceles triangular figures were used for stimuli. The two groups were instructed to press a button as quickly and correctly as possible when the erect triangular figures(Go) were presented, but not to response when the inverted triangular figures(Nogo) were presented. The differences of brain activation between the two groups were compared. Results ( 1 ) During Go trials, there were no significant differences in reaction time and hit rate between the two groups (P ＞ 0.05 ). During Nogo trials, however, the late-onset depressed patients showed much higher false alarm rate(0.09 ±0.06) compared with control group(0.04 ±0.02) (P＜0.05＝. (2) During Go trials , LOD group showed significantly greater activity in left postcentral gyrus, left inferior parietal lobule, right precentral gyrus, left paracentral lobule, right inferior parietal lobule, right anterior cingulate cortex, left middle frontal gyrus, right middle frontal gyrus, right superior frontal gyrus compared with the control group. Whereas during Nogo trials, LOD group exhibited greater activity in left inferior parietal lobule and left middle frontal gyrus compared with the control group. Conclusion This study suggests that inhibitory control dysfunction in late-onset depressed patients may be closely related to frontostriatal circuit impairment. Over activation in left middle frontal gyrus, right middle frontal gyrus and right anterior cingulate cortex may contribute to the pathogenesis of late-onset depression.

Objective To determine the relationship between characteristic damages in white matter and its executive dysfunction by magnetic resonance diffusion tensor imaging (DTI) in the patients with leukoaraiosis (LA). Methods A total of 23 patients with LA and 19 age,sex and education-matched healthy people as control were enrolled.Montreal cognitive assessment (MoCA),Stroop test,trail making test (TMT),digit-symbol test(DST),verbal fluence (VF) were applied to assess cognitive and executive functions.Fractional anisotropy (FA),apparent diffusion coefficient (ADC) and mean diffusivity (MD) in white matter lesion (WML) and normal appearing white matter (NAWM) were measured in LA group,the bilateral centrum semiovale,anterior and posterior periventricular white matter in control group were measured by DTI. The white matter DTI parameters were compared between the groups, the relationship between DTI parameters and executive function was investigated in LA group. Results In LA patients,distinct executive dysfunction were found.The scores of Stroop B [(69.4± 13.4) vs.(43.3 ± 5.0),t =8.03,P＜0.05)],Stroop C [(141.4±42.1) vs.(65.4±10.3),t=7.66,P＜0.05)]and Stroop C B[ (72.0±41.4) vs.(22.1±9.6),t=5.13,P＜0.05)],TMT-A[(73.2±15.3)vs.(31.2±7.2),t 10.97,P＜0.05) ],TMTB[(125.6±18.0) vs.(81.6±5.9),t=10.22,P＜0.05) ] andDST[ (24.8±5.6 )vs.(36.8±5.1),t=7.19,P＜0.05) ] were inferior in LA group to control group.The values of FA in centrum semiovale [(0.2±0.1) vs.(0.4±0.1) and (0.4±0.1),F =45.08,P＜0.05)],anterior periventricular white matter [(0.2±0.0) vs.(0.4±0.1) and (0.4±0.1),F =70.11,P＜0.05)] and posterior perivcntricular white matter[ (0.3±0.1) vs.(0.4±0.1) and (0.4±0.1),F=8.54,P＜0.05) ]of WML were reduced as compared with those of NAWM and control group.The values of ADC(×10- 3mm2/s) in the above three regions of WML [(1.2±0.2) vs.(0.8±0.1) and (0.8±0.1),F=46.77,P＜0.05)],[(1.2±0.3) vs.(0.8±0.0) and (0.8±0.1),F=68.22,P＜0.05)]and [(1.4±0.3) vs.(0.8±0.0) and (0.9±0.1),F=17.08,P＜0.05) ] were elevated,as compared with those of NAWM and control group,and the values of MD ( × 10-5 mm2/s) in the three regions of WML[ (127.8±14.5) vs. (95.3±26.4) and (100.8±9.4),F 19.72,P＜0.05) ],[(127.4±16.0) vs.(101.8±13.9) and (93.4±5.6),F=39.26,P＜0.05) ] and [(134.4±21.2)vs.(114.8=14.5) and (114.4±11.7),F=10.66,P＜0.05) ]were also increased,as compared with those of NAWM and control group.There was negative correlation of FA with Stroop C-B (r=-0.46,P＜0.05),TMT-A (r=-0.48,P＜0.05) and TMT-B (r=0.46,P＜0.05),while FA was positively related with DST test (r=0.42,P＜0.05) in anterior periventricular white matter.Conclusions DTI can detect the characteristic damages of white matter,which is strongly related with executive function impairments possibly induced by the damage of prefrontal-subcortical loop in the patients with LA.

Cerebral microbleeds (CMBs),as an important imaging marker of cerebral small vessel disease (CSVD),is a subclinical damage caused by small hemosiderin deposits indicative of prior cerebral microscopic hemorrhage.In recent years,CMBs have become an important research issue in the field of neuroimaging with the development of newer magnetic resonance imaging (MRI) methods for the higher detection rate of the CMBs.It must to be mentioned that CMBs plays a crucial role in the formatting process of vascular cognitive impairment (VCI),which caused researcher's attention.This review focuses on the research progress in epidemiological status,pathological mechanisms,risk factors,imaging manifestations,clinical features and treatment therapies of CMBs,in order to provide theoretical references for the early detection,prevention and treatment of CSVD and VCI.

Cerebral small vessel disease (CSVD) gives rise to one in five strokes worldwide,which affect the small arteries,arterioles,capillaries and small veins of the brain.CSVD is associated with recent small subcortical infarct,lacuna of presumed vascular origin,white matter hyperintensity of presumed vascular origin,perivascular space,cerebral microbleeds,and brain atrophy.CSVD constitutes a major source of cognitive decline,affective disorder,urinary disorders,gait disturbances,impaired activities of daily living particularly in the elderly.The review will focus on recent progress on the clinical features of cognition,the neuroimaging,treatment and the prospective in the future study.

Cerebral small-vessel disease(CSVD)is a major cause of cognitive decline, dementia, affective disorders, urinary dysfunction and functional disability in the elderly.This review will focus and elaborates on the pathogenic classification, pathogenesis, clinical features and treatment and propose the prospect in the future study, in order to raise the importance of CSVD and provide a certain theoretical basis for clinical diagnosis and treatment.

Since epileptic seizure is unpredictable and paroxysmal, an automatic system for seizure detecting could be of great significance and assistance to patients and medical staff. In this paper, a novel method is proposed for multichannel patient-specific seizure detection applying the earth mover's distance (EMD) in scalp EEG. Firstly, the wavelet decomposition is executed to the original EEGs with five scales, the scale 3, 4 and 5 are selected and transformed into histograms and afterwards the distances between histograms in pairs are computed applying the earth mover's distance as effective features. Then, the EMD features are sent to the classifier based on the Bayesian linear discriminant analysis (BLDA) for classification, and an efficient postprocessing procedure is applied to improve the detection system precision, finally. To evaluate the performance of the proposed method, the CHB-MIT scalp EEG database with 958 h EEG recordings from 23 epileptic patients is used and a relatively satisfactory detection rate is achieved with the average sensitivity of 95.65% and false detection rate of 0.68/h. The good performance of this algorithm indicates the potential application for seizure monitoring in clinical practice.
Classification ; Discriminant Analysis* ; Electroencephalography* ; Epilepsy* ; Humans ; Medical Staff ; Methods ; Scalp* ; Seizures ; Weights and Measures