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Association between NT-proBNP and elevated nocturnal blood pressure in male elderly primary hypertension patients

Chinese Journal of Geriatric Heart Brain and Vessel Diseases.2017;19(8):833-836. doi:10.3969/j.issn.1009-0126.2017.08.013

Objective To study the association between NT-proBNP and elevated nocturnal blood pressure in male elderly primary hypertension patients.Methods Five hundred and ninety male elderly primary hypertension patients,admitted to our hospital from January 2009 to December 2012,were divided into non dipper hypertensivon group (n=418) and anti-dipper hypertension group (n =172).Their clinical data,laboratory test parameters and ambulatory ECG findings were recorded.Results The age was older,the serum levels of creatinine,HbAlc and NT-proBNP were higher in anti-dipper hypertension group than in non-dipper hypertensivon group (81.47± 9.25 years vs 77.81±11.10 years,P=0.000;113.18±99.70 μmol/L vs 93.35±84.49 μmol/L,P=0.017;7.34％±8.35％ vs 6.37％±1.05％,P=0.001;551.16±991.72 ng/L vs 355.12±934.89 ng/L,P=0.009).Multivariate regression analysis showed that average day systolic blood pressure was independently associated with NT-proBNP (P=0.004).Conclusion The loss of rhythmia is more noticeable and the target organ damage is more serious in anti-dipper hypertension patients than in non-dipper hypertensivon patients.The serum NT-proBNP level plays a certain role in regulating blood pressure.

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Relationship of MR diffusion tensor imaging for corpus callosum and cingulate bundles with cognitive impairment in SIVD patients

Shuhu ZHOU ; Baojun QIAO ; Qinxia KONG

Chinese Journal of Geriatric Heart Brain and Vessel Diseases.2017;19(5):517-520. doi:10.3969/j.issn.1009-0126.2017.05.016

Objective To study the relationship of MR diffusion tensor imaging for corpus callosum and cingulate bundles with cognitive impairment in subcortical ischemic vascular dementia (SIVD) patients.Methods Sixty elderly SIVD patients admitted to our hospital from July 2015 to June 2016 served as a SIVD group and 40 age-matched persons undergoing physical examination served as a control group in this study.The mean ADC and FA were calculated according to the MR diffusion tensor imaging parameters in region of interest.Relationship between fiber tract integraty and MMSE Scale score was compared between the two groups.Results The ADC was significantly higher while the FA was significantly lower for the genu of corpus callosum in SIVD group than in control group.However,no significant difference was found in ADC for the spenium of corpus callosum between the two groups (P＞0.05).The ADC was significantly higher while the FA was significantly lower for bilateral cingulate bundles (P＜0.05,P＜0.01).The FA for the genu of corpus callosum and bilateral cingulate bundles was positively related with the MMSE Scale score (r=0.511,r=0.469,r=0.457,P＜0.05).However,the FA for the splenium of corpus callosum was not related with the MMSE Scale score(r=0.364,P＞0.05).Conclusion Changes of MR diffusion tensor imaging parameters in corpus callosum and cingulate bundles contribute to the early prevention and treatment of cognitive impairment in SIVD patients.

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Relationship between serum uric acid level and cerebrovascular stenosis in acute ischemic stroke patients

Huifeng CHEN ; Dandan YANG ; Yuanrong YAO

Chinese Journal of Geriatric Heart Brain and Vessel Diseases.2017;19(5):503-506. doi:10.3969/j.issn.1009-0126.2017.05.013

Objective To study the relationship between serum uric acid (UA) level and cerebrovascular stenosis in acute ischemic stroke (AIS) patients.Methods Five hundred and thirteen patients with AIS or old IS admitted to our hospital from April 2014 to April 2016 were divided into primary IS group (n=236),recurrent IS group (n=136),and old IS group (n=141).Venous blood samples were taken on admission for biochemical testing.The patients were further divided into serum UA≤255 μmol/L group (n=128),serum UA=256-312μmol/L group (n=129),serum UA=313-371 μmol/L group (n=129),and serum UA＞371 μmol/L group (n=127).Their cerebrovascular stenosis was assessed by CT angiography or magnetic resonance angiography after admission.Results The severity of cerebrovascular stenosis,hypertension,diabetes and hyperlipidemia was significantly different in primary IS group,recurrent IS group and old IS group (27.5％ vs 33.8％ vs 12.8％、24.2％ vs 28.7％ vs 46.8％、61.9％ vs 49.3％ vs 40.4％、71.6％ vs 61.8％ vs 46.8％,P=0.000).Logistic regression analysis showed that serum UA≤ 255 μmol/L was an independent risk factor for cerebrovascular stenosis (OR =2.787,95 ％CI:2.209-3.365,P=0.001).The risk of cerebrovascular stenosis decreased gradually with the elevated serum UA level.Conclusion Serum UA level is not directly related with recurrent IS.Low serum UA level is a risk factor for cerebrovascular stenosis in AIS.

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Relationship between ambulatory blood pressure and cognitive function in elderly hypertensive patients with leukoaraiosis

Ming YE ; Shuguo LI

Chinese Journal of Geriatric Heart Brain and Vessel Diseases.2017;19(5):492-495. doi:10.3969/j.issn.1009-0126.2017.05.011

Objective To analyze the relationship between ambulatory blood pressure (ABP) and cognitive function in elderly hypertensive patients with leukoaraiosis (LA).Methods Eighty elderly hypertensive patients with LA underwent 24 h ABP monitoring to record their 24 h SBPV,DBPV,AASI,and APPI.The patients were scored according to the MMSE Scale.Results The 24 h SBPV,DBPV,AASI,and APPI were significantly higher in degrees 1,2,3 of LA than in degree 0 of LA (P＜0.05),in degrees 2,3 of LA than in degree 1 of LA (P＜0.05),and in degree 3 of LA than in degree 2 of LA (P＜0.05).The MMSE Scale score of memory,attention,counting,recall,language and the total score were significantly lower in degrees 2,3 of LA than in degrees 1,2 of LA (P＜0.05).The 24 h SBPV,DBPV,AASI,and APPI were negatively related with the MMSE Scale score (r=-0.8697,P=0.000;r=-0.6709,P=0.002;r=-0.8373,P=0.000;r=-0.5991,P=0.007).Conclusion The severer the LA is,the higher the 24 h SBPV,AASI and APPI are.The 24 h SBPV and AASI can thus be used as the indicators of LA and cognitive function impairement.

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Relationship between renal function impairement and obesity in patients with primary hypertension

Yu WEN ; Yi WU

Chinese Journal of Geriatric Heart Brain and Vessel Diseases.2017;19(5):472-474. doi:10.3969/j.issn.1009-0126.2017.05.006

Objective To analyze the relationship between renal function impairement and obesity in patients with primary hypertension.Methods One hundred and twenty-eight primary hypertension patients with renal function impairement admitted to our hospital from January 2012 to December 2015 were divided into obesity group (n=68) and control group (n=60) according to the Asian obesity diagnosis criteria established by the International Diabetes Federation.Relationship of serum urea nitrogen (BUN),creatinine,cystatin C (Cys-C),urinary N-acetyl beta-D glucosaminidase (NAG),urinary micro albumin levels and BMI with renal function impairment in primary hypertension patients was analyzed by multivariate linear stepwise regression analysis.Results The BMI,serum levels of urinary NAG,Cys-C,BUN,and creatinine were significantly higher in obesity group than in control group (31.70±1.80 kg/m2 vs 23.95±2.00 kg/m2,19.34±1.40 U/L vs 14.92±1.31 U/L,0.69±0.06 mg/L vs 0.47±0.05 mg/L,11.50±2.90 mmol/L vs 8.60±1.90 mmol/L,159.50±10.40 μmol/L vs 148.90±10.70 μmol/L,P＜0.05).The incidence of urinary micro albumin was significantly higher in obesity group than in control group (79.4％ vs 46.7 ％,P＜ 0.01).Blood pressure,pulse pressure difference,BMI,fasting blood glucose,serum levels of ereatinine,urinary NAG,Cys-C,BUN and urinary micro albumin were the risk factors for renal function impairement in primary hypertension patients (P＜0.05,P＜0.01).Conclusion Renal function impairement is related with obesity in primary hypertension patients.

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Effect of dimethyl fumarate on Aβ-induced oxidative stress in rat astrocytes

Beibei CAO ; Yan CHENG ; Nan ZHANG

Chinese Journal of Geriatric Heart Brain and Vessel Diseases.2017;19(5):532-535. doi:10.3969/j.issn.1009-0126.2017.05.020

Objective To study the effect of dimethyl fumarate (DMF) on Aβ-induced oxidative stress by regulating NF-E2-related factor 2 (Nrf2) expression and its mechanism.Methods Rat astrocytes were divided into Aβ group,DMF group,Nrf2 group and Nrf2 +DMF group.Expressions of Nrf2,Nqo1,Ho-1,Keap1 mRNA and HDAC were detected by RT-PCR and Western blot respectively.Results The expression levels of Nrf2,Nqo1 and HO-1 mRNA were significantly lower in Nrf2 group and Nrf2+DMF group than in Aβ group and DMF group (P＜0.05) and were significantly higher in DMF group than in Aβ group (P＜0.05) while the expression level of Keap1 mRNA was significantly lower in DMF group and Nrf2+DMF group than in Aβ group and Nrf2 group (P＜0.05).The expression level of HDAC was significantly lower in DMF group and Nrf2+DMF group than in Aβ group and Nrf2 group (6.41±0.43 vs 9.01±1.54,P＜0.05;6.72±0.30 vs 8.76± 0.74,P＜0.05).Conclusion DMF increases the Nrf2 expression by inhibiting the HDAC expression,thus reducing Aβ-induced oxidative stress in rat astrocytes.

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Association between platelet parameters and renal dysfunction in elderly patients with early heart failure

Dongyang ZHANG ; Xiaojuan BAI ; Lulu HAN

Chinese Journal of Geriatric Heart Brain and Vessel Diseases.2017;19(7):725-730. doi:10.3969/j.issn.1009-0126.2017.07.013

Objective To study the association between renal dysfunction and platelet parameters in elderly patients with early heart failure (HF).Methods 637 patients (350 old-aged and 287 middle-aged) with hypertension,CHD,T2DM admitted to our hospital from January 2013 to December 2014 served as a disease group and 464 subjects (229 old-aged and 235 middle-aged) selected from the 973 Aging Project in September 2007-June 2008 served as a healthy group.Their eGFR and platelets (PLT) were calculated,their plateletcrit (PCT) and mean platelet volume (MPV) were measured.Association between platelet parameters and renal dysfunction was analyzed by binary logistic regression analysis.Results The MPV and PCT were significantly lower in the old-aged disease group than in the old aged healthy group (9.78± 1.45 vs 10.66±0.78,P＜0.01;19.79 ± 6.21 vs 21.82 ± 6.04,P＜0.01).The PLT and PCT were closely associated with the eGFR in two groups (P＜0.05,P＜0.01).Binary logistic regression analysis indicated that the median and high PLT in disease group and the median PLT in healthy group were independently associated with renal dysfunction (OR=0.560,95％CI:0.315-0.996;OR=0.480,95％CI:0.262-0.879;OR=0.483,95％CI:0.249-0.936,P＜0.05).Conclusion Attention should be paid to the effect of PLT and their functional activity on renal function in treatment of early HF patients because aging-induced change of PLT and their functional activity are associated with renal dysfunction.

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Effect of Radix Angelica Sinensis on Alzheimer's disease-like lesions and cognitive function in rats with chronic cerebral hypoperfusion

Haomin YAN ; Xuebei DU ; Junjian ZHANG

Chinese Journal of Geriatric Heart Brain and Vessel Diseases.2017;19(7):699-703. doi:10.3969/j.issn.1009-0126.2017.07.007

Objective To study effect of Radix Angelica Sinensis (RAS) on Alzhemier's Disease (AD)-like lesions in rats with chronic cerebral hypoperfusion (CCH).Methods rats were randomly divided into sham group,bilateral vascular occlusion (model group),low RAS dose treatment group and high RAS dose treatment group.Cognitive function was assessed by Morris Water Maze and Object Recognition Test.Aβ was detected by ELISA while brain-derived neurotrophic factor (BDNF)、β secretory enzyme 1 (BACE1)、phosphorylated Tau and phosphorylation of Akt/ GSK3β was detected by Western blot.Results There were shorter target quadrant exploration time (TQET),lower priority index (PI) 、phosphorylated Akt/GSK3β expression、BDNF and high-er Aβ1 40 、Aβ1-42 、p-Tau and BACE1 in model group than insham group (P＜0.05,P＜0.01).Low and high RAS dose treatment lengthened TQET,improved PI、phosphorylated Akt/GSK3β expression and BDNF while decreased Aβ1-40 、Aβ1-42 、p-Tau and BACE1 compared with model group.BDNF was higher after high dose RAS treatment than model group (P＜0.01).Conclusion RAS inhibits AD-like lesions in rats with CCH by downregulating the Akt/GSK3β pathway and BACE1 activity,thus improving the cognitive impairment.

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Establishment of ischemic stroke recurrence model and its prospective application

Yachen AN ; Yuxun WANG ; Yan CHENG

Chinese Journal of Geriatric Heart Brain and Vessel Diseases.2017;19(7):685-688. doi:10.3969/j.issn.1009-0126.2017.07.004

Objective To establish Cox proportional hazards regression model and individual prognosis index (PI) equation for the 3-year recurrence of ischemic stroke and to verify their external reality according to their propective application.Methods A total of 1058 first-ever ischemic stroke patients admitted to our hospital were followed up from 2013-01-01 to 2013-12-31,during which the recurrence of ischemic stroke was recorded.Cox proportional hazards regression model and PI equation for the 3-year recurrence of ischemic stroke were established.Six hundred and sixteen first-ever ischemic stroke patients admitted to our hospital were followed up from 2016-01-01 to 2016-12-31.The external reality of Cox proportional hazards regression model for the 3-year recurrence of ischemic stroke was verified according to the established PI equation.Results Of the patients who were followed up in 2013,ischemic stroke reoccurred in 184.Cox proportional hazards regression model analysis showed that age,heart disease,hypertension,diabetes mellitus and TC were the independent risk factors for the recurrence of ischemic stroke.Of the patients who were followed up in 2016,ischemic stroke reoccurred in 114.The sensitivity,specificity and accuracy of PI equation in predicting the recurrence of ischemic stroke were 71.9％,76.9％ and 80.0％ respectively.Conclusion Establishment of PI equation for the 3-year recurrence of ischemic stroke can predict the recurrence of ischemic stroke.

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Risk factors for cognitive impairment in obstructive sleep apnea-hypopnea syndrome patients with ischemic stroke

Xin ZHANG ; Yaning ZHAO

Chinese Journal of Geriatric Heart Brain and Vessel Diseases.2017;19(2):167-170. doi:10.3969/j.issn.1009-0126.2017.02.015

Objective To study the risk factors for cognitive impaurment in obstructive sleep apnea-hypopnea syndrome (OSAHS) patients with ischemic stroke.Methods Three hundred and twenty-eight OSAHS patients with ischemic stroke were divided into cognitive impairment group (n=158) and cognitive impairment-free group (n=170) according to their MMSE score.The risk factors for their cognitive impairment were analyzed by multivariate logistic regression analysis and stratification analysis respectively.Results The blood glucose and lipid,AHI,LSaO2,infarction size and site,HIF-1 and Ngb level were significantly different between the two groups (P＜0.01).Multivariate logistic regression analysis showed that blood glucose and lipid,AHI,infarction site and Ngb level were the independent risk factors for cognitive impairment (OR=3.527,95％CI:1.559-7.983,P=0.002;OR=6.413,95 ％CI:2.766-14.865,P=0.000;OR=4.099,95％CI:1.694-9.918,P=0.002;OR=4.484,95％CI:1.950-10.310,P=0.000;OR=3.891,95 ％CI:1.759-8.606,P=0.001).Stratification analysis showed that high HIF-1 and Ngb levels were positively related with cognitive impairment in patients with AHI＞20 times/h,frontotemporal infarction,hyperglycosemia or hypoglycosemia,and dyslipidemia.Conclusion High HIF-1 and Ngb levels are independently related with cognitive impairment in OSAHS patients with ischemic stroke.

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