Vascular eognitive impairment (VCI) is a large class of syndromes from mild cognitive impairment to dementia, which are caused by the cerebrovascular risk factors (eg, hypertension, diabetes and hyperlipemia), obvious (eg, cerebral infarction and intracerebral hemorrhage) or unobvious cerebrovascular diseases (leukoaraiosis and chronic cerebral ischemia). Accurate early diagnosis provides the best treatment opportunity and slows down the progress of the disease. In recent years, the research on VCI has made a great progress. This article reviews VCI from the aspects of the etiology, clinical manifestation, neuropsychology, imaging, neuroelectrophysiology, biomarkers, and diagnostic criteria.

?AIM: To investigate the compliance in patients with topical glaucoma therapy, and identify the most frequent barriers to adherence.?METHODS: One-on-one interview and questionnaire were taken to investigate the compliance with hypotensive eye drops in 366 patients who had been diagnosed as glaucoma and received the therapy for at least 6mo in Wuhan and suburban district from July 2014 to June 2015 in Wuhan Aier Eye Hospital.?RESULTS: The proportion of compliance was 44. 3%( 162/366 ) . Factors significantly influencing compliance included severity of the better eye, the severity of symptom when attacked, duration of medication and whether to administrate on the same time daily ( OR=5. 700,0. 554,0. 336,0. 558,P<0. 05). Age, gender, marital status, education level, economic status, domicile, knowledge of the disease, suffering from other diseases with medication, type of glaucoma, type of eye drop, frequency were not associated with a higher rate of non-compliance.? CONCLUSION: Compliance in patients with topical glaucoma therapy in Wuhan is poor. Regularly carrying out relevant health education and interventions is very important.

Abstract?AIM: To assess the efficacy and adverse reactions of two concentrations of diluted botulism toxin A ( BTX-A) for blepharospasm.?METHODS:Totally 220 patients (440 eyes) confirmedas blepharospasm in our department ( from January 2013 to January 2015 ) , were divided randomly into two groups:110 in high concentration group and 110 in low concentration group.The two groups were given local injections with 25 U/mL or 40 U/mL concentration of botulism toxin type A to the upper and lower eyelids orbicular muscle, corrugator, reducing eyebrow muscle and procerus respectively.We observed dosage of two groups, the treatment effect, the duration of the effect and the incidence of adverse reactions.?RESULTS: The high concentration group was given the BTX-A with 48.33 ±4.02U, the low concentration group was given the BTX-A with 28.51 ±3.42U,the differences were statistically significant( P<0.05).The differences of post-operative evaluation of curative effect, onset time and duration of the effect between the groups were not statistically significant ( P >0.05 ). Sixteen cases had ptosis in different levels in the high concentration group, and 2 in the low concentration group, the differences were statistically significant ( P<0.01).There were no serious complications such as intoxication, drug allergy in both groups.Ptosis relieved after using naphcon-A and disappeared in 2-3 wk.?CONCLUSION: The efficacy of local injection with two concentrations of diluted botulinum toxin A for blepharospasm was positive. Considering the high incidence of ptosis in high concentration group, we recommended the 25U/mL botulism toxin A for blepharospasm.

Impaired glucose tolerance is the prediabetic state of diabetes mellitus,and its main manifestation is postprandial hyperglycemia.Studies in recent years have suggested that the large vascular disease of the impaired glucose tolerance state is similar to diabetes mellitus.The relationship between impaired glucose tolerance and atherosclerotic disease is increasingly receiving attention.This article reviews the relationship between both of them.

Currently, the commonly used diagnostic markers have the shortcomings of lower sensitivity or specificity in the early diagnosis of cardio-cerebrovascular diseases. Therefore, it needs to use the novel specific biochemical markers for the early diagnosis arid treatment, so as to decrease the high mortality and disability caused by cardio-cerebrovascular events. Fatty acid-binding proteins (FABPs) are a family of low-molecular-weight intracellular lipid-binding proteins. They are divided into 9 different subtypes, including the liver-, intestinal-, heart-, brain-, adipocyte-, skin-, ileal-, myelin-, and testis-subtype. Their primary function is to transport long-chain fatty acids into the cells, and thus regulate intracellular lipid metabolism. The structures of all FABP subtypes are similar, inclusive of two α2 helices arid one β2 fold structure. Among them, the sensitivities and specificities of the heart- and brain-subtype FABPs are higher in the early diagnosis of cardio-cerebrovascular diseases. It is promising to become the novel markers in the early diagnosis of cardio-cerebrovascular diseases.

Objective To observe the efficacy and safety of recombinant human growth hormone ( rhGH) replacement therapy in GHD childhood with craniopharyngioma after surgery. Methods This study retrospectively reviewed the records of 18 inpatients with secondary GHD diagnosed by insulin tolerance test ( ITT ) after craniopharyngioma surgery at the Department of Endocrinology, Beijing Tiantan Hospital, from January 2012 to December 2015. The clinical benefits and risks of 18 patients were evaluated systematically, and then were divided into rhGH treatment group(n=9) and control group(n=9). The parameters of height, growth velocity(GV), height standard deviation score (HtSDS), insulin-like growth factors-1 (IGF-Ⅰ), insulin-like growth factor binding protein 3 (IGFBP3) and adverse events rate were recorded after treatment for six months. MRI was followed up every 3 to 6 months to observe the difference of the tumor recurrence and second malignant neoplasm between two groups. Results All 18 patients with craniopharyngioma presented with multiple pituitary-target glands hormone deficiency after surgery. Among these patients, 17 cases (95% ) presented with hypothyroidism or adrenal insufficiency, 7 cases (39% ) with delayed puberty, and 12 cases(67% ) with central diabetes insipidus. Based on pituitary-target gland axis function deficiency, these patients were given appropriate L-thyroxine, prednisone, and desmopressin(DDAVP) replacement therapy, respectively. The median time of 9 patients starting rhGH replacement was 48(36,72)months after surgery. The levels of height, GV, IGF-Ⅰ, HtSDS, and IGFBP3 were significant increased after rhGH treatment for 6 months as compared with pre-treatment and control group (all P<0. 05). In addition, changes of height, GV, HtSDS, and IGF-Ⅰ levels before and after treatment in rhGH treatment group were significantly higher than those in control group (all P< 0. 05). During the period of treatment, there were no serious adverse events to be observed in rhGH treatment group, except 1 case of mild headache in the control group. The differences of biochemical and endocrine parameters such as thyroid function, liver and renal function, blood glucose, etc. were without statistical significance compared with pre-treatment after rhGH treatment ( P > 0. 05 ). The tumor recurrence and second malignant neoplasm were not detected by MRI scanning in rhGH treatment group,but there were 3 cases in the control group. Conclusion Multiple pituitary-target glands axis deficiencies were observed in childhood patients with craniopharyngioma after neurosurgery, and the evident deficiency of GH-IGF-Ⅰ axis was observed. rhGH replacement therapy in short-term would significantly improve the parameters of growth and development of patients with GHD after craniopharyngioma neurosurgery. No recurrence tumor in situ and second malignant neoplasms were detected during the period of rhGH replacement therapy.

Objective:To observe the clinical efficacy of Shenfu Injection for the most gastric resection.Methods: ASA II-III patients undergoing elective surgery for 60 patients with subtotal gastrectomy, were divided into experimental group, control group randomly. The experimental group was divided into Shenfu group (A), the control group treated with dopamine (B). In the A group before induction of anesthesia with intravenous injection of 0.8ml/kg of Shenfu injection,and group B received balanced salt to maintain anesthesia, the disposal of the same. Patients were given dopamine, atropine and other vasoactive drugs, there were recorded before anesthesia(T0), immediately after tracheal intubation (T1), 30min after intubation (T2), 1h after intubation(T3) hemodynamics.Results: Compared with the control group, the experimental group canachieve hemodynamic stability time earlier, smaller influence on the fluctuation of blood pressure.Conclusion: Shenfu Injection on patients with coronary heart disease underwentsubtotal gastrectomy to improve the stability of circulation system.

arotid artery atherosclerosis is closely associated with ischemic stroke.Carotid artery intimamedia thickness is an important indicator of carotid artery atherosclerosis.Magnesium is involved in the in vivo metabolism of a wide variety of processes.Studies have shown that magnesium can decrease carotid intimamedia thickness.This article reviews the relationship between magnesium levels and carotid artery atherosclerosis in different populations.

Objective: To investigate the inhibitory effect of grape proanthocyanidins (GPC) on P38 mitogen-activated protein kinase(P38MAPK)pathway in mice with breast cancer . Methods: BALB/C mice inoculated with EMT-6 breast cancer cells were given 10, 100 and 200 mg/kg bw GPC po daily for 2 w. The expression levels of phosphorylated P38MAPK and matrix metalloproteinase-2(MMP-2)protein were detected by Western blot. Results: The levels of phosphorylation P38MAPK in tumor control group and 200 mg/kg GPC group were 1.16?0.18 和 0.58?0.12 respectively,and the levels of MMP-2 protein were 0.98 ?0.04 和 0.69?0.04 respectively. The differences between the two groups were significant (P

OBJECTIVE: To optimize the therapeutic regimen for acute cerebral infarction for clinical reference. METHODS: Medical records of patients in who acute cerebral infarction occurred for the first time in a hospital during 2003～2006 were analyzed statistically in respect of drug use. RESULTS: In terms of DDDs, dehydrants, diuretics, platelet aggregation inhibitors, promoting cerebral circulation agents and supportive drugs took the lead in this hospital. The DDDs of drugs used for complications in descending order were antiinfectives, hypotensors, and drugs for heart diseases. CONCLUSION: The drugs used for inpatients with acute cerebral infarction varied in kinds; therefore, clinical choice of drugs and the rationality of drug use remain to be further studied.