Objective: To study the influence of screening dementia with mini-mental state examination (MMSE) combining with delay memory test . Methods: MMSE and delay memory test are used in screening 301 residents. The diagnosis of dementia is according to the DSM-Ⅲ-R criterion. The validity and reliability were studied when the MMSE and delay memory test were used to screen dementia alone or combined. Results: When MMSE was used to screen dementia alone, the specificity, sensitivity, false positive proportion and false negative proportion were 85.40%, 52.43%, 47.56% and 14.60% respectively. When delay memory test was used to screen dementia alone, the specificity, sensitivity, false positive proportion and false negative proportion were 74.45%, 92.07%, 7.93% and 25.55% respectively. If parallel connection of MMSE and delay memory test were used to screen dementia, the specificity, sensitivity, false positive proportion and false negative proportion were 95.62%, 49.39%, 50.61% and 4.38% respectively. If MMSE was in series with delay memory test, the specificity, sensitivity, false positive proportion and false negative proportion of screening dementia were 64.23%, 95.73%, 4.27% and 35.77% respectively. Conclusion: The parallel connection of MMSE and delay memory test can elevate sensitivity of screening dementia and decrease false negative proportion, so it is important in epidemiologic investigation. MMSE in series with delay memory test will raise specificity of screening dementia and decrease false positive proportion, so it is useful for diagnosing early dementia.

Objective To investigate the cause of low rate for dementia diagnosiss in out-patient clinic.Methods All outpatients between September 15,2009 and December 25,2009 were screened by IQCODE,MMSE and neuropsychological examination.Diagnosis of dementia and its subtype were confirmed according to DSM-IV-TR,NINCDS-ADRDA,and NINDS-AIREN criteria.The caregivers of dementia patients were interviewed with questionnaire.Results There were 8,042 outpatients in the period and 1716 patients completed IQCODE,317 completed MMSE,72 completed a set of neuropsychological test.41 patients were diagnosed as dementia which composed of 23 cases of AD (56.1％),12 cases of vascular dementia(29.3％),2 cases of mixed dementia(4.9％),4 cases of other types of dementia(9.7％),and the prevalence of dementia at age of over 55 years was 1.8％ in out-patient clinics.Among the patients,18 cases were mild dementia (43.9％),19 moderate dementia (46.3 ％ ) and 4 severe dementia (9.8 ％).Four patients(9.8 ％ ) were diagnosed as dementia by case history,15 patients(36.5％) were diagnosed as dementia by clinic doctors,while 22 patients (53.7％) were diagnosed as dementia in the survey.35 caregivers finished questionaire,and 10 caregivers(28.6％) had no knowledge about dementia,22(62.8％) caregivers had a few knowledge and 3(8.6％) caregivers had lots of knowledge.19 (46.3％) dementia patients went to see a doctor with cognitive impairment and 22 (53.7 ％) with other symptoms.The reasons for delay in seeing a doctor included that caregivers considered the impairment of cognition as a result of normal aging (54.3％),patients rejected to see a doctor(14.3％),caregivers considered no treatment for dementia (5.7 ％),and there was economic reason ( 2.9％),inconvenient (8.5 ％) and others ( 14.3 ％).Conclusions The visiting rate of dementia patients in china is very low and many demented patients do not receive early diagnosis and treatment.Patients' delay may contribute to the lack of knowledge of caregivers,and to doctor's ignore of the cognitive impairment.

Objective To investigate the role of hypoxia inducible factor(HIF)-prolyl hydroxylase 1 (HPHl)and factor inhibiting HIF-1(FIH-1)in placentas in the pathogenesis and development of severe pre-eclampsia.Methods RT-PCR and western blot analyses were used to detect the HPH1 and FIH-1expression levels in placentas of 34 patients with severe pre-eclampsia and 24 cases of term pregnancy (normal pregnancy group)and their correlations with symptoms were analyzed.Results (1)The HPHI mRNA and protein expression levels in placentas of severe pre-eclampsia group were 0.40±0.04 and 59.5±3.4 separately,significantly lower than those of normal pregnancy group,0.84±0.12 and 71.6±1.7(P<0.01).The FIH-1 mRNA and protein expression levels in placentas of severe pre-eclampsia group wereQ 31 ±0.05 and 45.6±2.4 separately,significantly lower than those of normal pregnancy group,0.43±0.04 and 54.9±2.1(P<0.01).(2)The mRNA and protein expression levels of HPH1 and FIH-1 in severe pre-eclampsia group were all negatively correlated with mean arterial pressure(MAP)[the Spearman correlation coefficient was-0.854(P<0.01)],urinary protein per 24 hours[the Spearman correlation coefficient was-0.936(P<0.01)1 and the occurrence of fundus oculi artery spasm[the Spearman correlation coefficient was-0.854(P<0.01)].(3)rrhe expression of HPHl mRNA in placentas of all the 58 cases WBB 0.58±0.27.higher than the expression of FIH-1 mRNA,which was 0.39±0.10.There was a positive correlation between them.The pearson correlation coefficient was 0.686(P<0.01).The expression of HPH1 protein in placentas of all the 58 cases was 64.5±6.7,higher than the expression of FIH-1,which was 49.4±5.2.There was a positive correlation between them.The Pearson correlation coefficient was 0.947(P<0.01).Conclusion The expression imbalance of HPH1 and FIH-1in palcenta may play an important role in the pathogenesis and development of severe pre-eclampsia through inhibiting HIF-1a.

BACKGROUND: Oxfordshire Community Stroke Project(OCSP) is a new type of clinical classification for subdividing cerebral infarction(CI) conducted on the basis of a large-scale of investigation of stroke in the population of Oxfordshire Community, England in 1991. This kind of classification completely bases on the clinical manifestations without the help of diagnostic instruments, which can predict site and size of the lesion and the involved vessels.OBJECTIVE: To acknowledge the clinical classification of CI patients with Bamford's OCSP and its significance in predicting their long-term functional prognosis.DESIGN: Clinical observation, comparison and verified study based on patients.SETTING: Neurological department in a university hospital.PARTICIPANTS: Between January 1st and December 31st 2001, totally 126 patients with cerebrovascular disease were hospitalized in the Neurological Department of First Affiliated Hospital of Xi' an Jiaotong University,including 82 males and 44 females.METHODS: Totally 126 in-patients with CI were subdivided with Bamford's OCSP classification, and their disablity was assessed with Barthel index (BI)and modified Rankin Scale(mRS) when they were discharged and 3 months and 6 months later.MAIN OUTCOME MEASURES: Classification of patients with CI and their scores of BI and mRS when they were discharged and 3 months and 6months later.RESULTS: Of the 126 patients, 8(6. 3% ) patients were confirmed of total anterior circulation infarction (TACI), 29 (23. 0% ) of part anterior circulation infarction(PACI), 78(61.9% ) of lacunar infarction(LACI), 11(8.7%) of posterior circulation infarction(POCI) . They were followed-up for 6 months, and meanwhile 12 patients died. Of the other 114 cases the prognosis of TACI was the worst, while the prognosis of POCI and LACI was relatively better than that of PACI.CONCLUSION: CI is predominated by LACI. OCSP is effective for predicting long-term functional prognosis of patients with CI. But it is necessary to make multi-center prospective study on a much larger scale of samples of disease.

Aim To study the effects of ganoderma lu-cidum polysaccharides and metformin on myocardial fi-brosis of type 2 diabetic rats and its mechanism. Methods SD rats were fed with high fat diet for 4 weeks, and then were injected with streptozotocin (30mg·kg-1 ) to replicate type 2 diabetic model. The diabetic rats were randomized into normal control group,diabetes group, ganoderma lucidum polysaccha-rides group ( 600 mg · kg-1 ) , metformin group ( 600 mg·kg-1 ) , and combination group( ganoderma lucid-um polysaccharides 300 mg·kg-1 +metformin 300 mg ·kg-1 ) . After 12 weeks’ treatment,the levels of fast-ing serum glucose were determined and the extent of myocardial fibrosis was observed by Picro-sirius red staining. The contents of AGEs in serum were deter-mined by fluorescence spectrophotometer. The activities of CAT and GSH-Px in myocardium were detected. Im-munohistochemical method and Western blot were used to detect myocardial tissue AGEs and CTGF protein ex-pression. Results Combination group could repress patho-proceeding of myocardial fibrosis efficiently, im-prove the activity of CAT and GSH-Px in myocardium and lower the concentration of AGEs in serum, as well as reduce the expression of AGEs and CTGF in myo-cardium. Conclusions Ganoderma lucidum polysac-charides and metformin could prevent myocardial fibro-sis. The possible mechanism may be related to repress-ing oxidative stress of myocardium, lowering serum AGEs and down regulating AGEs and CTGF of myocar-dium.

Objective To examine the feasibility of using the serous-lined tunnel technique for orthotopic neobladder, continent cutaneous diversion and ureteral replacement by the intestinal segment. Methods In 31 patients of orthotopic ileal neobladder, the serous-lined tunnel techniques were used for antirefluxing ureteral implantation: In 13 patients of continent ileal pouch, the techniques were adopted for continent-valve construction and for uretersl implantation: In 3 patients (with lower ureteric cancer), the same techniques were applied for constructing the ileal ureters with a proximal antirefluxing mechanism. Results With a mean follow-up of 27 mon( 12-132 mon), 88 ureters implanted into ileal neobladders or continent pouches functioned well with neither obstruction nor reflux: 12 in 13 continent valves functioned well with no incontinence. 3 patients with ileal ureters showed no ileo-ureteric reflux and had reduced hydronephrosis comparing to that of before surgery.Conclusions Ureteral reimplantation and continent valve formation achieved by adopting the serouslined tunnel technique provide satisfactory results. The versatility of the technique is obvious in the present experience and the creative application of the serous-lined tunnel technique should be possible in urinary reconstruction.

The objectives of this study are to prepare resveratrol loaded mixed micelles composed of poloxamer 403 and poloxamer 407, and optimize the formulation in order to achieve higher drug solubility and sustained drug release. Firstly, a thin-film hydration method was utilized to prepare the micelles. By using drug-loading, encapsulation yield and particle size of the micelles as criteria, influence of three variables, namely poloxamer 407 mass fraction, amount of water and feeding of resveratrol, on the quality of the micelles was optimized with a central composite design method. Steady fluorescence measurement was carried out to evaluate the critical micelle concentration of the carriers. Micelle stability upon dilution with simulated gastric fluid and simulated intestinal fluid was investigated. The in vitro release of resveratrol from the mixed micelles was monitored by dialysis method. It was observed that the particle size of the optimized micelle formulation was 24 nm, with drug-loading 11.78%, and encapsulation yield 82.51%. The mixed micelles increased the solubility of resveratrol for about 197 times. Moreover, the mixed micelles had a low critical micelle concentration of 0.05 mg · mL(-1) in water and no apparent changes in particle size and drug content were observed upon micelles dilution, indicating improved kinetic stability. Resveratrol was released from the micelles in a controlled manner for over 20 h, and the release process can be well described by Higuchi equation. Therefore, resveratrol-loaded poloxamer 403/407 mixed micelles could improve the solubility of resveratrol significantly and sustained drug release behavior can be achieved.
Drug Carriers ; chemistry ; Fluorescence ; Kinetics ; Micelles ; Particle Size ; Poloxamer ; chemistry ; Solubility ; Stilbenes ; chemistry ; Water

Objective To investigate the evolution of cognitive function and its influence factors,so as to provide evidence for guiding treatment of cognitive impairment after stroke.Methods A total of 98 cases of patients with stroke admitted in the First and Second Affiliated Hospital of Medical College of Xi'an Jiaotong University and Shaanxi Provincial People's Hospital between April and September 2009 were enrolled and recruited.Mini-mental state examination(MMSE) and Montreal cognitive function rating scale (MoCA) were adopted to assess the evolution of cognition at acute phase( within 2 weeks),6 weeks,and 12 weeks after stroke among patients within 2 weeks after onset,questionnaire score≤56,without aphasia and consiousness disturbance and at least one side of upper extremities muscle force ≥ grade 3.Results When using MMSE scale as criteria,the incidence of cognitive impairment was 24.5% at acute phase,12.1% at 6 weeks and 9.9% at 12 weeks after stroke,while the incidence was 86.8%,68.2%,and 38.0% respectively when using MoCA scale as criteria.The scales of MMSE and MoCA were increased and the incidence of cognitive impairment was decreased within 12 weeks after stroke.Logistic regression analysis indicated that,advanced age( β = -0.124 ),hypertension ( β = -3.705 ),low education level ( β = 0.560 )and depression after stroke ( β =4.613 ) were related with cognitive impairment after stroke ( all P values ＜0.05 ); low education level ( β = 0.710 ),coronary heart disease ( β = -3.649 ),elevated total cholesterol (TC) ( β = -3.361 ) and low density lipid cholesterol (LDL-C) ( β = - 5.833 ),and depression ( β =-3.612) delayed recovery of cognition after stroke.Conclusions The cognitive function improves and the incidence of cognitive impairment lowers as the time goes on within 12 weeks after stroke.The factors that may affect the improvement of cognitive function include low educational level,coronary heart disease,elevated TC and LDL-C,and post-stroke depression.

Aim To investigate the effects and mecha of ganoderma lucidum polysaccharides and metformin on pathological changes of thoracic aorta in diabetic ratsandthemechanisms.Methods SDratswerefed with high fat diet for 4 weeks and injected with strepto-zotocin ( 30 mg · kg-1 ) to replicate type 2 diabetic model. The diabetic rats were randomly into diabetes group, ganoderma lucidum polysaccharides group ( 600 mg·kg-1 ) ,metformin group(600 mg·kg-1 ) ,combi-nation group ( ganoderma lucidum polysaccharides 300 mg· kg-1 + metformin 300 mg · kg-1 ) and normal control group. After 12 weeksˊ treatment, the levels of fasting serum glucose, the activity of catalase(CAT), glutathione peroxidase ( GSH-Px ) , total cholesterol (TC)and triglyceride(TG) in serum were detected. Pathological changes of thoracic aorta were observed by HE staining. Immunohistochemy and Western blot were used to detect thoracic aorta VEGF protein expression. Results Combination group could lower fasting serum glucose and blood fat significantly, meanwhile the ac-tivity of CAT and GSH-Px in serum was improved. The expression of VEGF in thoracic aorta was repressed. The result of HE staining suggested that the lipid de-posits in aortic endothelium in combination group were lessthanthoseinthemodelgroup.Conclusions Ga-noderma lucidum polysaccharides combined with met-formin has an obvious prevention on pathological chan-ges of thoracic aorta in diabetic rats. The possible mechanism may be related to repressing oxidative stress of thoracic aorta, regulating the dyslipidemia, and the down regulation of the expression of VEGF in thoracic aorta.

AIM: To investigate the time - effect relationship between the expression of rhodopsin and recoverin and photoreceptor damage induced by N - nethl - N -nitrosourea ( MNU) .
METHODS: Thirty-six 7-week old Sprague-Dawley ( SD ) rats were intraperitoneally injected with MNU ( 60mg/kg ) and were put to death by dislocation of cervical vertebra 6, 12, 24h; 3, 7d after injection ( 6 per group) , respectively. As a control, six rats were injected with phosphate buffer saline (PBS) 5mL/kg and sacrificed on d3 after injection. The degree of photoreceptor apoptosis was detected by HE staining, terminal deoxynucleotidyl transferase-mediated dUTP nick end-labeling ( TUNEL ) and transmission electron microscope ( TEM ) in the right eyes. The mRNA expressions of rhodopsin and recoverin were detected different time after injection by Western blot and immunohistochemical method in the left eyes.
RESULTS:The dissolution of photoreceptor nucleus and apoptosis body were first perceived at 12h by TEM; most of cells at outer nuclear layer were presented positive reaction. The apoptotic index reached peak ( 29. 7% ±2.3%) at 24h which was coincided with the observation of TEM. The results of immunohistochemistry displayed that rhodopsin and recoverin were on a declining curve with time extension. Furthermore, the results of Western blot indicated that rhodopsin had dramatic decline at 6h after injection (P<0. 05), and extremely significant difference comparing to control group after 12h ( P<0. 01 ); while recoverin dramatic declined at 12h, and extremely significant difference after 24h (P<0. 01).
CONCLUSION:60mg/kg MNU intraperitoneally injection one - time may specifically induce photoreceptor apoptosis, The mechanism of down - regulation of rhodopsin and recoverin may be related to the selected apoptosis of photoreceptors.