Objective To investigate the predictive value of serum lipoprotein-associated phospholipase A2(Lp-PLA2)and homocysteine(Hcy)combined with white matter hyperintensities(WMH)for cognitive impairment in patients with cerebral small vessel disease(CSVD).Methods A total of 240 patients with CSVD were selected.According to the Montreal Cognitive Assessment(MoCA)scale,all subjects were divided into the non-cognitive impairment group(MoCA≥26 points,120 cases)and the cognitive impairment group(MoCA＜26 points,120 cases).Paraventricular white matter high signal(PWMHs)and deep white matter high signal(DWMHs)were scored by Fazekas scale.The sum of the two parts was the total score,and the severity of DWMHs was graded by the score.The basic information,serum Lp-PLA2,Hcy level and severity of WMH were compared between the two groups.Logistic regression was applied to analyze influencing factors of cognitive impairment in CSVD patients.The predictive value of serum level of Lp-PLA2 and Hcy and WMH for cognitive impairment in CSVD patients was analyzed by receiver operating characteristic(ROC)curve.Results Compared with the non-cognitive impairment group,patients of the cognitive impairment group were older,had higher serum levels of Lp-PLA2 and Hcy,and had more severe of WMH(P＜0.05).Results of Logistic regression analysis showed that serum Lp-PLA2,Hcy levels and severity of WMH were influencing factors for cognitive impairment of patients with CSVD(P＜0.05).The results of ROC curve analysis showed that the area under the curve of serum Lp-PLA2,Hcy level combined with severity of WMH predicting cognitive impairment in patents with CSVD was 0.812,the sensitivity was 81.7%and the specificity was 71.7%(P＜0.05).Conclusion Patients with cognitive impairment caused by CSVD have higher serum levels of Lp-PLA2 and Hcy,and more severe WMH.The combination of the three has a relatively high predictive value for cognitive impairment in patents with CSVD.

Objective To investigate the predictive value of serum lipoprotein-associated phospholipase A2(Lp-PLA2)and homocysteine(Hcy)combined with white matter hyperintensities(WMH)for cognitive impairment in patients with cerebral small vessel disease(CSVD).Methods A total of 240 patients with CSVD were selected.According to the Montreal Cognitive Assessment(MoCA)scale,all subjects were divided into the non-cognitive impairment group(MoCA≥26 points,120 cases)and the cognitive impairment group(MoCA＜26 points,120 cases).Paraventricular white matter high signal(PWMHs)and deep white matter high signal(DWMHs)were scored by Fazekas scale.The sum of the two parts was the total score,and the severity of DWMHs was graded by the score.The basic information,serum Lp-PLA2,Hcy level and severity of WMH were compared between the two groups.Logistic regression was applied to analyze influencing factors of cognitive impairment in CSVD patients.The predictive value of serum level of Lp-PLA2 and Hcy and WMH for cognitive impairment in CSVD patients was analyzed by receiver operating characteristic(ROC)curve.Results Compared with the non-cognitive impairment group,patients of the cognitive impairment group were older,had higher serum levels of Lp-PLA2 and Hcy,and had more severe of WMH(P＜0.05).Results of Logistic regression analysis showed that serum Lp-PLA2,Hcy levels and severity of WMH were influencing factors for cognitive impairment of patients with CSVD(P＜0.05).The results of ROC curve analysis showed that the area under the curve of serum Lp-PLA2,Hcy level combined with severity of WMH predicting cognitive impairment in patents with CSVD was 0.812,the sensitivity was 81.7%and the specificity was 71.7%(P＜0.05).Conclusion Patients with cognitive impairment caused by CSVD have higher serum levels of Lp-PLA2 and Hcy,and more severe WMH.The combination of the three has a relatively high predictive value for cognitive impairment in patents with CSVD.

Objective:To evaluate the predictive value of gait kinematic combined with total MRI burden for the risk of falls in patients with gait disorder in cerebral small vessel disease(CSVD)using logistic regression analysis and ROC curve. Method:Forty-three patients diagnosed with CSVD and presenting primarily with gait disorder at Rehabilitation Department of Gansu Province Hospital from March 1,2019 to March 30,2020 were selected.The statistical clinical data were collected,and according to the TUG test time,all patients were divided into a group with high risk of fall(high risk of falling,HRF,TUG≥15s)and a group of low risk of falls(low risk of falling,LRF,TUG＜15s).Logistic regression analysis and ROC curve were used to assess the predictive value of gait kinematic characteristic combined with total MRI burden for the risk of falls in CSVD patients. Result:A total of 43 patients were included with average age(71.07±8.17)years.Among them,there were 26 female(60.4％)and 30 hypertension patients(69.8％),After adjusting for age and TUG,the logistic regres-sion analysis showed that the step length(OR 0.821,95％CI 0.702-0.959,P=0.013)was an independent protec-tive factor against the risk of falls in CSVD patients,while the total MRI burden(OR 4.217,95％CI 1.444-12.317,P=0.009)was an independent risk factor for the falls in CSVD.The ROC curve analysis showed that the combination of step length and total MRI burden had a high predictive value for the risk of fall in CSVD patients with gait disorder(AUC=0.904),with a sensitivity of 82.6％and a specificity of 90％. Conclusion:Step length combined with total MRI burden has a high predictive value for the risk of falls in CSVD patients with gait disorder.

Objective To investigate the predictive value of National Institutes of Health Stroke Scale(NIHSS)score,serum brain-derived neurotrophic factor(BDNF)and interleukin-6(IL-6)in post-stroke depression(PSD).Methods A total of 180 patients with stroke were selected and divided into the PSD group(n=80,HAMD≥8 points)and the non-PSD(NPSD)group(n=100,HAMD＜8 points),according to HAMD score at 3 months after stroke.The basic information,NIHSS score,serum BDNF and IL-6 were compared between the two groups.The influencing factors of PSD were analyzed by Logistic regression method.Receiver operating characteristic(ROC)curves were plotted to evaluate the predictive value of NIHSS score,serum BDNF and IL-6 for PSD.Results Compared with the NPSD grope,low density lipoprotein cholesterol(LDL-C)and serum BDNF level were significantly lower,NIHSS score and serum IL-6 level were significantly increased in the PSD group(P＜0.05).Results of Logistic regression analysis showed that increased NIHSS score and serum IL-6 were risk factors for PSD,and increased serum BDNF was the protective factor in patents with PSD(P＜0.05).The area under curve(AUC)of NIHSS score,serum BDNF and IL-6 and their combination prediction of PSD were 0.762,0.746,0.796 and 0.839,respectively.The sensitivity of the combined prediction was 86.0%and a specificity was 95.0%.Conclusion Compared with NPSD patients,the NIHSS score and serum IL-6 level are increased,and the serum BDNF level is decreased in patients with PSD.The combination of all three has a high predictive value for patients of PSD.

AIM: To establish the method for determining tetrahydropalmatine、rhynchophylline and isorhynchophylline in AnshenYangxue Oral Liquid(Ramulus uncariae cum uncis, stephania kwangsiansis,Radix polygoni multiflori praeparata cum succo glycinus sotae,Caulis Polygoni multiflori and Pine needle). METHODS: Tetrahydropalmatine、rhynchophylline and isorhynchophylline were determined by HPLC.Chromatographic condition was composed of Kromasil C_18 column,a mixture of methanol and water(55∶45) as mobile phase with 0.01 mol/L triehthylamine,adjusted with acetic acid to pH of 7.5,UV detection wavelength of rhynchophylline and isorhynchophylline was set at 254 nm,UV detection wavelength of tetrahydropalmatine was set at 281 nm. RESULTS: The averagere recoveries of tetrahydropalmatine、rhynchophylline and isorhynchophylline were 98.47%、99.04%and 98.75% respectively;RSD were 0.95%、2.6%and 1.6%,respectively. CONCLUSION: This method is simple,sensitive,accurate,and can be used for determining tetrahydropalmatine、rhynchophylline and isorhynchophylline in Anshen Yangxue Oral Liquid.