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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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Etiology of 96 syncope patients

Chunyan LIU ; Yan XING

Chinese Journal of Geriatric Heart Brain and Vessel Diseases.2017;19(9):971-973. doi:10.3969/j.issn.1009-0126.2017.09.019

Objective To study the diagnosis and treatment of syncope by analyzing its etiology.Methods Ninety-six syncope patients admitted to our hospital from 2014-01-01 to 2016-12-21were included in this study.The etiology of syncope was analyzed.Results Of the 96 syncope patients included in this study,50 (52.1 ％) were diagnosed with nerve-mediated reflex syncope,31(32.3％) with orthostatic hypotensive syncope,10 (10.4％) with cardiogenic syncope due to arrhythmia,coronary atherosclerotic cardiopathy or pulmonary embolism,5 (5.2％) with other diseases.Conclusion Nerve-mediated reflex,orthostatic hypotension and cardiogenic factors are the causes of syncope.Attention should thus be paid to syncope caused by nervous system diseases.Clarification of the risk factors for syncope helps to reduce its potential risk.

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Effect of hyperthermia-induced MMP-9 on expression of claudin-1 in in vitro blood brain barrier model

Limin WANG ; Conghua JI ; Qiang MENG

Chinese Journal of Geriatric Heart Brain and Vessel Diseases.2017;19(9):979-983. doi:10.3969/j.issn.1009-0126.2017.09.021

Objective To study the effect of hyperthermia-induced MMP-9 on expression of claudin-1 in in vitro BBB model.Methods BMEC and astrocytes were cultured.An in vitro BBB model was established with its permeability assayed by LY test.The BBB model was randomly divided into 37℃ group,39℃ group,37℃+MMP-9 group and 39℃+MMP-9 group.The permeability of BBB model was recorded at 30,60 and 90 min respectively.Expression of claudin-1 in BMEC was detected by Western blot with immunocytochemical staining.Results The permeability of BBB model was higher in 39℃ group than in 37℃ group (P＜0.05) and was significantly higher in 39℃ +MMP-9 group than in 37℃ group (P＜0.05).The number of claudin-1 positive BMEC was smaller in 39℃ +MMP-9 group than in 37℃ group at the same time points (P＜0.05) and in 39℃ +MMP-9 group than in 39℃ group at 90 min (75.0±12.8/HP vs 97.0±6.1/HP,P＜0.05).The expression level of claudin-1 was lower in 39℃ group than in 37℃ group (P＜0.05) and was significantly higher in 39℃ +MMP-9 group than in 37℃ group (P＜0.05),which further increased with the increasing time.Conclusion Hyperthermia can downregulate the expression of claudin-1 in in vitro BBB model and upregulate the permeability of in vitro BBB model.Adding MMP-9 can further aggrevate the damage of in vitro BBB model,indicating that hyperthermia can aggrevate the damage of in vitro BBB model through MMP-9.

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Clinical characteristics of elderly HFmrEF patients

Xiaomei YUAN ; Hong KONG ; Wenyan WANG

Chinese Journal of Geriatric Heart Brain and Vessel Diseases.2017;19(9):957-960. doi:10.3969/j.issn.1009-0126.2017.09.016

Objective To study the cause,clinical characteristics and treatment of HFmrEF,HFrEF and HFpEF patients.Methods Three hundred and eighty-five heart failure (HF) patients aged ≥60 years admitted to our hospital from January 2016 to March 2017 were divided into HFrEF group (n=96),HFmrEF group (n=34) and HFpEF group (n=255) according to their ejection fraction.Their demographic data,HF cause,clinical characteristics,cardiac ultrasonographic data,laboratory testing data and therapies were recorded.Their clinical characteristics were compared.Results The number of males was greater and the cardiac function grade Ⅳ was higher in HFmrEF group than in HFrEF and HFpEF groups.The incidence of hypertension was the highest followed by that of valvular disease.The number of HFmrEF patients who used intravenous nitrates,spironolactone and milrinone was greater than that of HFpEF and HFrEF patients who used intravenous nitrates,spironolactone and milrinone.The serum creatinine level was higher in HFmrEF patients than in HFpEF and HFrEF patients at the time when they were discharged.Conclusion Hypertension and valvular disease are the mian risk factors for HFmrEF.The number of males is greater and the cardiac function grade Ⅳ is higher in HFmrEF patients than in HFrEF and HFpEF patients.The serum creatinine level is higher and the outcome is better in HFmrEF patients than in HFrEF and HFpEF patients at the time when they are discharged.

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Association between early functional outcome and serum thyroid hormone level in elderly acute ischemic stroke patients

Jinjing WANG ; Fengli LI ; Ruibing GUO

Chinese Journal of Geriatric Heart Brain and Vessel Diseases.2017;19(9):930-933. doi:10.3969/j.issn.1009-0126.2017.09.009

Objective To study the association between early functional outcome and serum thyroid hormone level in elderly acute ischemic stroke (AIS) patients.Methods Two hundred and twenty-four AIS patients admitted to our hospital from May to December 2016 were divided into good functional outcome group (n=166) and poor functional outcome group (n=58) according to their mRS score.The serum levels of FT3,FT4,TSH were measured.The patients were further divided into FT3≤4.05 pmol/L,FT3 4.06-4.46 pmol/L,and FT3＞4.46 pmol/L.The association between early functional outcome and serum levels of FT3,FT4,TSH in elderly AIS patients were analyzed by univariate and multivariate logistic analysis.Results The AIS was severer,the BMI and incidence of AF were higher,the number of WBC was greater,the serum FT3 and CRP levels were higher in poor functional outcome group than in good functional outcome group (P＜0.05,P＜0.01).The rate of poor functional outcome was significantly higher in FT3≤4.05 pmol/L than in FT3 4.06-4.46 pmol/L and FT3 ＞4.46 pmol/L (39.5％ vs 22.2％,39.5％ vs 15.8％,P=0.003).Univariate logistic regression analysis and multivariate logistic regression analysis showed that FT3 was an independent risk factor for early poor functional outcome in AIS patients.Concision The lower the serum FT3 level on admission is,the poorer the early functional outcome is in AIS patients.

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