Objective To explore the correlation between gait disorders and alterations in diffusion tensor imaging(DTI)parameters in different regions of interest(ROI)and associated white matter tracts in older patients with leukoaraiosis(LA).Methods A total of 108 elderly LA patients admitted in our department from July 2023 to May 2024 were enrolled,and based on the Fazekas scale,they were divided into normal(n=28),moderate(n=48),and severe groups(n=32).Tinetti Gait Scale(TGS)was used to evaluate the morbility and balance function,and Short Physical Performance Battery(SPPB)was employed to assess motor function.All participants underwent brain MRI and DTI scanning.Fractional anisotropy(FA)values were quantitatively measured in predefined ROIs and specific white matter tracts.Results The moderate and severe groups had significantly advanced age and higher homocysteine level,and lower total TGS score,Tinetti gait score,total SPPB score,and walking speed score than the normal group(P＜0.05).The severe group exhibited obviously lower education level,and decreased Tinetti balance score and standing score than the normal and moderate groups(P＜0.05).The FA values at the left pa-rietal lobe,the anterior horn of bilateral lateral ventricles,and the splenium of the left corpus cal-losum were notably lower,so were the FA values at the corpus callosum(left-right),left cortico-spinal tract(inferior segment),left anterior thalamic radiation(inferior segment),left inferior fronto-occipital fasciculus(inferior segment),and left superior longitudinal fasciculus(inferior segment)in the moderate group and the severe group than the normal group(P＜0.05).The se-vere group demonstrated lower FA values at the left and right parietal lobes than the other two groups(P＜0.05).Multivariate logistic regression analysis revealed that the anterior horn of the left lateral ventricle(β=-0.683,P=0.001)and the left inferior corticospinal tract(β=-0.742,P=0.001)were influencing factors for gait disorder in elderly LA patients.Conclusion In elderly LA patients,gait disorders are correlated with decreased FA values in specific ROI and white mat-ter tracts,with the decreased FA values in the anterior horn of the left lateral ventricle and the left inferior corticospinal tract demonstrating the most significant impact.

Objective To explore the correlation between gait disorders and alterations in diffusion tensor imaging(DTI)parameters in different regions of interest(ROI)and associated white matter tracts in older patients with leukoaraiosis(LA).Methods A total of 108 elderly LA patients admitted in our department from July 2023 to May 2024 were enrolled,and based on the Fazekas scale,they were divided into normal(n=28),moderate(n=48),and severe groups(n=32).Tinetti Gait Scale(TGS)was used to evaluate the morbility and balance function,and Short Physical Performance Battery(SPPB)was employed to assess motor function.All participants underwent brain MRI and DTI scanning.Fractional anisotropy(FA)values were quantitatively measured in predefined ROIs and specific white matter tracts.Results The moderate and severe groups had significantly advanced age and higher homocysteine level,and lower total TGS score,Tinetti gait score,total SPPB score,and walking speed score than the normal group(P＜0.05).The severe group exhibited obviously lower education level,and decreased Tinetti balance score and standing score than the normal and moderate groups(P＜0.05).The FA values at the left pa-rietal lobe,the anterior horn of bilateral lateral ventricles,and the splenium of the left corpus cal-losum were notably lower,so were the FA values at the corpus callosum(left-right),left cortico-spinal tract(inferior segment),left anterior thalamic radiation(inferior segment),left inferior fronto-occipital fasciculus(inferior segment),and left superior longitudinal fasciculus(inferior segment)in the moderate group and the severe group than the normal group(P＜0.05).The se-vere group demonstrated lower FA values at the left and right parietal lobes than the other two groups(P＜0.05).Multivariate logistic regression analysis revealed that the anterior horn of the left lateral ventricle(β=-0.683,P=0.001)and the left inferior corticospinal tract(β=-0.742,P=0.001)were influencing factors for gait disorder in elderly LA patients.Conclusion In elderly LA patients,gait disorders are correlated with decreased FA values in specific ROI and white mat-ter tracts,with the decreased FA values in the anterior horn of the left lateral ventricle and the left inferior corticospinal tract demonstrating the most significant impact.

The treatment and nursing experience of a patient with acute coronary syndrome with ketoacidosis and chronic gastric volvulus were summarized.The nursing points are as follows:dynamic assessment of chest pain,timely warning of disease changes,helping early identification of chest pain etiology;accurately monitoring hemodynamics,ensuring rapid fluid resuscitation,preventing heart failure;closely observation of bleeding and bleeding tendency,doing gastrointestinal bleeding care;phased posture therapy and cardiac rehabilitation to improve chronic gastric volvulus;applying positive dual intervention strategy and implementing psychological nursing.After active diagnosis and treatment and careful care,the patient was discharged smoothly after 20 d of hospitalization and followed up for 1 year in good condition.

Dexmedetomidine displays multiple mechanisms of neuroprotection in ameliorating ischemic brain injury. In this study, we explored the beneficial effects of dexmedetomidine on blood-brain barrier (BBB) integrity and neuroinflammation in cerebral ischemia/reperfusion injury. Sprague-Dawley rats were subjected to middle cerebral artery occlusion (MCAO) for 1.5 h and reperfusion for 24 h to establish a rat model of cerebral ischemia/reperfusion injury. Dexmedetomidine (9 µg/kg) was administered to rats 30 min after MCAO through intravenous injection, and SB203580 (a p38 MAPK inhibitor, 200 µg/kg) was injected intraperitoneally 30 min before MCAO. Brain damages were evaluated by 2,3,5-triphenyltetrazolium chloride staining, hematoxylin-eosin staining, Nissl staining, and brain water content assessment. BBB permeability was examined by Evans blue staining. Expression levels of claudin-5, zonula occludens-1, occludin, and matrix metalloproteinase-9 (MMP-9) as well as M1/M2 phenotypes-associated markers were assessed using immunofluorescence, RT-qPCR, Western blotting, and gelatin zymography. Enzyme-linked immunosorbent assay was used to examine inflammatory cytokine levels. We found that dexmedetomidine or SB203580 attenuated infarct volume, brain edema, BBB permeability, and neuroinflammation, and promoted M2 microglial polarization after cerebral ischemia/reperfusion injury. Increased MMP-9 activity by ischemia/reperfusion injury was inhibited by dexmedetomidine or SB203580. Dexmedetomidine inhibited the activation of the ERK, JNK, and p38 MAPK pathways. Moreover, activation of JNK or p38 MAPK reversed the protective effects of dexmedetomidine against ischemic brain injury. Overall, dexmedetomidine ameliorated brain injury by alleviating BBB permeability and promoting M2 polarization in experimental cerebral ischemia/reperfusion injury model by inhibiting the activation of JNK and p38 MAPK pathways.

The treatment and nursing experience of a patient with acute coronary syndrome with ketoacidosis and chronic gastric volvulus were summarized.The nursing points are as follows:dynamic assessment of chest pain,timely warning of disease changes,helping early identification of chest pain etiology;accurately monitoring hemodynamics,ensuring rapid fluid resuscitation,preventing heart failure;closely observation of bleeding and bleeding tendency,doing gastrointestinal bleeding care;phased posture therapy and cardiac rehabilitation to improve chronic gastric volvulus;applying positive dual intervention strategy and implementing psychological nursing.After active diagnosis and treatment and careful care,the patient was discharged smoothly after 20 d of hospitalization and followed up for 1 year in good condition.

Objective:To analyze the differences of effectiveness of stenting for vertebral artery ostium severe stenosis via transradial access and transfemoral access. Methods:Sixty-three patients with vertebral artery ostium severe stenosis confirmed by cerebral angiography in our hospital from December 2017 to March 2022 were enrolled. Stent implantation via transradial access was performed in 30 patients (radial artery group) and stent implantation via transfemoral access was performed in 33 patients (femoral artery group). The radial artery group was divided into left and right subgroups according to the lesions of vertebral arteries; and according to the anatomical classification of vertebral arteries, radial artery group was divided into two subgroups: anatomical type I and anatomical type II. The baseline data and surgery-related data (success rate of stent implantation, time from sheath insertion to stent implantation, surgical time, exposure time, and incidence of surgical complications) of patients in the radial artery group and femoral artery group were compared and analyzed. The surgical data of patients in the subgroups of radial artery group were compared and analyzed. Results:There was no significant difference in the success rate of stent implantation or incidence of primary endpoint events 3 d after surgery between the radial artery group and femoral artery group ( P>0.05). The time from sheath insertion to stent implantation, surgical time, and exposure time in the radial artery group were statistically shorter than those in the femoral artery group ( P<0.05). The radial artery group had significantly lower incidence of complications (9.01% vs. 30.0%) and incidence of hematoma (3.03% vs. 20.05) at the puncture sites than the femoral artery group ( P<0.05). Time from sheath insertion to stent implantation, surgical time, and exposure time in the anatomical type I patients of radial artery group were significantly longer than those in the anatomical type II patients ( P<0.05); those in patients with left lesions of radial artery group were significantly shorter than those in patients with right lesions ( P<0.05). Conclusion:As compared with that via transfemoral access, the stenting via transradial access has almost the same success rate, without significant difference in incidence of perioperative serious complications, and stenting via transradial access has shorter surgical time, lower surgical difficulty, and lower incidence of complications; patients with anatomical type II or left lesions have better efficacy than those with anatomical type I or right lesions.

Objective:To analyze the differences of effectiveness of stenting for vertebral artery ostium severe stenosis via transradial access and transfemoral access. Methods:Sixty-three patients with vertebral artery ostium severe stenosis confirmed by cerebral angiography in our hospital from December 2017 to March 2022 were enrolled. Stent implantation via transradial access was performed in 30 patients (radial artery group) and stent implantation via transfemoral access was performed in 33 patients (femoral artery group). The radial artery group was divided into left and right subgroups according to the lesions of vertebral arteries; and according to the anatomical classification of vertebral arteries, radial artery group was divided into two subgroups: anatomical type I and anatomical type II. The baseline data and surgery-related data (success rate of stent implantation, time from sheath insertion to stent implantation, surgical time, exposure time, and incidence of surgical complications) of patients in the radial artery group and femoral artery group were compared and analyzed. The surgical data of patients in the subgroups of radial artery group were compared and analyzed. Results:There was no significant difference in the success rate of stent implantation or incidence of primary endpoint events 3 d after surgery between the radial artery group and femoral artery group ( P>0.05). The time from sheath insertion to stent implantation, surgical time, and exposure time in the radial artery group were statistically shorter than those in the femoral artery group ( P<0.05). The radial artery group had significantly lower incidence of complications (9.01% vs. 30.0%) and incidence of hematoma (3.03% vs. 20.05) at the puncture sites than the femoral artery group ( P<0.05). Time from sheath insertion to stent implantation, surgical time, and exposure time in the anatomical type I patients of radial artery group were significantly longer than those in the anatomical type II patients ( P<0.05); those in patients with left lesions of radial artery group were significantly shorter than those in patients with right lesions ( P<0.05). Conclusion:As compared with that via transfemoral access, the stenting via transradial access has almost the same success rate, without significant difference in incidence of perioperative serious complications, and stenting via transradial access has shorter surgical time, lower surgical difficulty, and lower incidence of complications; patients with anatomical type II or left lesions have better efficacy than those with anatomical type I or right lesions.

Objective To investigate the association of prevalence of periodontitis with metabolic syndrome (MS). Methods Data were analyzed from 1 650 Uygur rural residents in Moyu County. The subjects, aged over 18 years, were sampled randomly from 15 villages out of total 364 villages. Questionnaire, oral examination, and blood biochemical indicators were collected. The subjects were divided into groups with and without periodontitis based on chronic periodontitis diagnostic criteria, and the group with periodontitis was further divided into subgroups, each with mild, moderate, and severe periodontitis respectively. The diagnosis of MS was madeaccording to the definition of the International Diabetes Federation in 2005. Results Among 1 415 subjects whosedata were complete, there were 275 ( 19.4% ) subjects with MS and 934 (66.0%) subjects with periodontitis. The prevalence of MS was higher in the group with periodontitis than that without perionontitis (23.1% vs 12.3%, x2=23.9, P<0. 001 ). The prevalence of MS was increased with the grade of periodontitis, being 19.8%, 20.8%,27.6% in the mild, moderate, and severe periodontitis groups, respectively(x2= 31.9, P<0. 001 ). Multiple logistic regression analysis showed that the risk of MS increased with the grade of periodontitis, with OR 1. 6, 1.7,1.9, respectively, in the groups with mild, moderate, and severe periodontitis compared with that without perionontitis ( P<0.05 or P<0.01 ). Conclusions The prevalence of MS was related to periodontitis in the Uygur nationality and increased with the grade of periodontitis.