1.Analysis of potential biomarkers for behavioral and psychological symptoms in patients with Alzheimer′s disease continuum
Jiwei JIANG ; Qiwei REN ; Shirui JIANG ; Tianlin JIANG ; Shiyi YANG ; Jun XU
Chinese Journal of Health Management 2023;17(7):502-507
Objectives:To analyze the potential biomarkers of behavioral and psychological symptoms of dementia (BPSD) in patients with Alzheimer′s disease (AD) continuum.Methods:A prospective cohort study was consecutively conducted on 179 patients with AD continuum (135 presented with BPSD, 44 patients without BPSD as control) from Capital Medical University, Beijing Tiantan Hospital, the Chinese imaging biomarkers and lifestyle cohort between January 1, 2021 and December 31, 2022. Gender, age, body max index, education level, diagnosis, the apolipoprotein E epsilon4 allele (APOE ε4) carrier status, the scores of the Mini-Mental State Examination (MMSE) and Montreal Cognitive Assessment (MoCA), cerebrospinal fluid (CSF) AD-related pathological biomarkers (Aβ 42, Aβ 40, Aβ 42/40, tTau, pTau181), and blood biomarkers (white blood cell count, red blood cell count, hemoglobin, platelet, total bilirubin, albumin, total cholesterol, triglyceride, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, fasting glucose, erythrocyte sedimentation rate, homocysteine, vitamin B 12, folate) were compared between the two groups by using hypothesis testing and univariate logistic regression analysis. Multivariate logistic regression analysis was used to analyze the potential biomarkers associated with BPSD in patients with AD. Results:Among the 179 patients with AD continuum in the final analysis, 77 patients were men, 102 cases were women; 35 patients were identified with mild cognitive impairment (MCI) due to AD and 144 patients with AD dementia stage, the mean age was (66.54±9.75) years. Compared with those in control group, patients with BPSD had lower cerebrospinal fluid (CSF) Aβ 40 and blood hemoglobin levels [7.08 (4.42, 15.42) vs 9.62 (6.45, 12.12) pg/L, (132.70±13.37) vs (138.80±14.38) g/L] ( U=-1.856, t=2.579, P<0.05). The levels of CSF Aβ 40 ( OR=0.030, 95% CI: 0.001-0.760) and blood hemoglobin ( OR=0.051, 95% CI: 0.004-0.670) were independently negatively associated with BPSD in patients with AD continuum (both P<0.05). Conclusion:The decreased levels of CSF Aβ 40 and blood hemoglobin could be considered as potential biomarkers in detecting BPSD in patients with AD continuum.
2.Impact factors of behavioral and psychological symptoms of dementia in patients with Alzheimer′s disease
Jiwei JIANG ; Wenyi LI ; Yanli WANG ; Linlin WANG ; Shirui JIANG ; Yuan ZHANG ; Jun XU
Chinese Journal of Health Management 2022;16(8):535-540
Objective:To explore the impact factors of behavioral and psychological symptoms of dementia (BPSD) in patients with Alzheimer′s disease (AD).Methods:The clinical data of 116 patients with AD admitted to the Outpatient Department of Cognitive Neurology of Beijing Tiantan Hospital, Capital Medical University from June 1, 2021 to March 1, 2022 were collected continuously. The patients were divided into BPSD group ( n=85) and control group ( n=31) according to the presence or absence of BPSD. The sociodemographic data (gender, age, body mass index, years of education), the medical history of hypertension, diabetes mellitus, hyperlipidemia, and the scores of the Mini-Mental State Examination (MMSE), the Activity of Daily Living (ADL), Mini-Nutritional Assessment scale (MNA) and Caregiver Burden Inventory (CBI) were compared between the two groups with hypothesis test and univariate logistic regression analysis. The statistically significant factors in hypothesis test and univariate logistic regression analysis were enrolled in multivariate logistic regression analysis to further identify the factors associated with BPSD in patients with AD. Results:There was no significant statistics differences in the gender, age, body max index, years of education and the medical history of hypertension, diabetes mellitus, hyperlipidemia between the two groups (all P>0.05). Compared with control group, patients with BPSD had lower scores of MMSE and MNA scales [(16.24±7.52) vs (20.81±5.09) points, (21.62±3.75) vs (24.87±2.89) points] (both P<0.001) and higher scores of ADL and CBI scales [29.00 (22.00, 38.50) vs 22.00 (20.00, 25.00) points, 25.00 (12.50, 41.00) vs 3.00 (0.00, 11.00) points](both P<0.001). The multiple logistic regression analysis demonstrated that the decreased MNA scores ( OR=0.762, 95% CI: 0.631-0.922; P=0.005) and elevated CBI scores ( OR=1.077, 95% CI: 1.029-1.128; P=0.002) were associated with BPSD in patients with AD. Conclusion:The malnutrition or the risk of malnutrition and greater caregiver burden can independently contribute to the onset of BPSD in patients with AD.
3.Advantages of Traditional Chinese Medicine in Treating Dominant Disease: Allergic Rhinitis
Lili LIU ; Daxin LIU ; Jinfeng LIU ; Shuzhen GUO ; Zhonghai XIN ; Renzhong WANG ; Li TIAN ; Kuiji WANG ; Mingxia ZHANG ; Shirui YANG ; Shufan GUO ; Yonggang LIU ; Wei ZHANG ; Lingyan JIANG ; Hui CHEN ; Xing LIAO ; Geng LI ; Chenyu CHI ; Xiaoxiao ZHANG ; Zhanfeng YAN
Chinese Journal of Experimental Traditional Medical Formulae 2023;29(2):203-211
In response to the Opinions of the CPC Central Committee and the State Council on Promoting the Inheritance, Innovation, and Development of traditional Chinese medicine(TCM) and the spirit of the National Conference on TCM, Chinese Association of Chinese Medicine organized experts in Otorhinolaryngology Head and Neck Surgery of traditional Chinese and western medicine to discuss the clinical advantages of TCM and integrated traditional Chinese and western medicine in the treatment of allergic rhinitis (AR) and they reached a basic consensus. In recent years, the prevalence of AR has been on the rise, threatening the quality of life of patients and giving rise to a heavy burden to both the patients and the society. AR is resulted from immune imbalance rather than reduced immunity or hyperimmunity, and the imbalance is similar to the Yin-yang disharmony in TCM. In the treatment of this disease, western medicine features rapid onset. However, it is cost-intensive and causes severe surgical trauma, and the recurrence is common. TCM boasts diverse methods for AR, which can be used in all stages of this disease. It has advantages in controlling symptoms such as nasal congestion, runny nose, or dysosmia in the attack stage, preventing recurrence in the remission stage, and treating refractory AR or steroid-resistant AR. In particular, acupuncture enjoys a reputation in treatment of AR, which has been supported by evidence-based medicine and recommended by guidelines. While treating local symptoms of AR, TCM regulates the psychosomatic conditions, which facilitates chronic disease management and long-term follow-up. We should integrate the advantages of TCM and western medicine, give full play to the unique nonnegligible and irreplaceable advantages of TCM, formulate a comprehensive diagnosis and treatment scheme for learning and promotion, and summarize the research outcomes to promote the theoretical innovation of TCM on AR from the perspective of integrated traditional Chinese and western medicine.