Objective:To explore the correlation between risk factors of microvascular dysfunction and cognitive impairment in Late-life depression (LLD).Methods:From May 2014 to May 2019, a total of 89 healthy elderly people (normal control group) and 113 patients with LLD (LLD group) were recruited. Patients with LLD were divided into normal cognition group ( n=33) and mild cognitive impairment (MCI) group ( n=80). The related medical history of microvascular dysfunction (e.g. hypertension, type 2 diabetes, coronary heart disease and hyperlipidemia), plasma concentration of homocysteine and C-reactive protein, and MRI features of cerebral small vessel disease (e.g. white matter hyperintensities, enlarged perivascular space and lacunar infarction) were collected or detected. All participants completed the comprehensive neuropsychological assessment on global cognition and other cognitive domains. The differences of microvascular function and cognition among the groups were compared. The correlation between microvascular dysfunction related biomarkers and the cognitive scores was further analyzed. Finally, Logistic regression analysis was used to explore the risk factors affecting cognitive impairment in patients with LLD. Results:The proportion of hypertension and the concentration of homocysteine in LLD with MCI group were significantly higher than those in normal control group and LLD with normal cognition group (χ 2=15.67, P<0.01; F=7.05, P=0.001). Enlarged perivascular space in centrum semiovale in LLD with MCI group was more severe than that in normal control group (χ 2=10.64, P=0.005). Both homocysteine ( r=-0.25, P=0.024) and white matter hyperintensities ( r=-0.33, P=0.017) were negatively correlated with executive function in LLD with MCI group. Hypertension (β=2.34, P=0.005), high levels of homocysteine (β=1.74, P=0.039) and increased EPVS in the semi-oval area (β=1.31, P=0.028) were the independent risk factors for cognitive impairment in patients with LLD. Conclusion:The cognitive impairment of LLD patients may be related to microvascular dysfunction.

Objective:To explore the correlation between risk factors of microvascular dysfunction and cognitive impairment in Late-life depression (LLD).Methods:From May 2014 to May 2019, a total of 89 healthy elderly people (normal control group) and 113 patients with LLD (LLD group) were recruited. Patients with LLD were divided into normal cognition group ( n=33) and mild cognitive impairment (MCI) group ( n=80). The related medical history of microvascular dysfunction (e.g. hypertension, type 2 diabetes, coronary heart disease and hyperlipidemia), plasma concentration of homocysteine and C-reactive protein, and MRI features of cerebral small vessel disease (e.g. white matter hyperintensities, enlarged perivascular space and lacunar infarction) were collected or detected. All participants completed the comprehensive neuropsychological assessment on global cognition and other cognitive domains. The differences of microvascular function and cognition among the groups were compared. The correlation between microvascular dysfunction related biomarkers and the cognitive scores was further analyzed. Finally, Logistic regression analysis was used to explore the risk factors affecting cognitive impairment in patients with LLD. Results:The proportion of hypertension and the concentration of homocysteine in LLD with MCI group were significantly higher than those in normal control group and LLD with normal cognition group (χ 2=15.67, P<0.01; F=7.05, P=0.001). Enlarged perivascular space in centrum semiovale in LLD with MCI group was more severe than that in normal control group (χ 2=10.64, P=0.005). Both homocysteine ( r=-0.25, P=0.024) and white matter hyperintensities ( r=-0.33, P=0.017) were negatively correlated with executive function in LLD with MCI group. Hypertension (β=2.34, P=0.005), high levels of homocysteine (β=1.74, P=0.039) and increased EPVS in the semi-oval area (β=1.31, P=0.028) were the independent risk factors for cognitive impairment in patients with LLD. Conclusion:The cognitive impairment of LLD patients may be related to microvascular dysfunction.

Objective To investigate regional spontaneous brain activity in mild cognition impairment (MCI) patients with amnesic (aMCI) and non-amnesic (naMCI).Methods Twenty-five aMCI patients,21 naMCI patients and 15 normal controls (NC) underwent resting-state functional magnetic resonance imaging.The regional homogeneity (ReHo) map of the whole brain was obtained by calculating the similarity of each voxel with its nearest 26 voxel time series.The differences of ReHo map across the whole brain among three groups were compared.Results In aMCI group,ReHo values were lower in right frontal lobe and higher in left middle temporal gyrus and left cerebellum compared with NC (P＜0.05,Alphasim correction).In naMCI group,ReHo values were higher in anterior cingulate cortex and right middle frontal gyrus and lower in right parahippocampa gyrus,right middle temporal gyrus as well as right precuneus compared with NC (P＜0.05,Alphasim correction).Compared with naMCI,the ReHo values were significantly higher in left prefrontal gyrus,left middle temporal gyrus and lower in right cerebellum (P＜0.05,Alphasim correction).Conclusion There are differences in spontaneous brain activity of left prefrontal gyrus,left middle temporal gyrus and right cerebellum between aMCI and naMCI,which may be used to differentiate brain function between aMCI and naMCI patients.

Objective To explore the effects of hyperbaric oxygen treatment on chronic stress and glucocorticoid receptor (GR) expression in the hippocampus.Methods A total of 60 male Wistar rats were randomly divided into a restraint group,an HBO (hyperbaric oxygen) group,an HBO-restraint group and a control group using a random number table,each group with 15 animals.All the rats in the restraint and HBO groups were constrained by immobilizing their fore-and hind-limbs on a self-made frame for 3h daily for 21 days,and those in the HBO group received HBO treatment once daily for the same 21 days.The HBO-restraint group was immobilized in the morning and treated with HBO in the afternoon.The control group was reared without any special intervention.On the 1st,11th and 21st day of treatment,rats from the different groups were assessed using the open field test.On the 21st day,all the animals were sacrificed and their brains were harvested to detect GR expression.Results In the open field test on the 11 th day,the restraint group scored (131.0 ± 20.6) in terms of motor level and (26.5 ± 4.6) for exploratory behavior,both significantly higher than before restraint and significantly higher than those in the HBO-restraint group at the same time point.Immunofluorescence assay showed that GR expression in the hippocampus of the restraint group was significantly decreased compared with the control group.There was no significant difference,however,between the HBO-restraint group and the control group.Conclusion Chronic restraint stress induces changes in behavior and GR expression in rats which can be alleviated by hypbaric oxygen treatment.

Objective To explore the effect of hyperbaric oxygen (HBO) on iatrogenic spinal cord injury (ISCI) associated with spinal corrective surgery in child congenital scoliosis (CS).Methods The subjects of our study were 8 cases of ISCI associated with corrective surgery for CS admitted into our hospital for treatment from November 2010 to September 2014.Age,gender,the starting time of HBO therapy after surgery,sessions of HBO therapy,micturition and defecation,muscle strength of lower extremities and ASIA scores (grade) before/after HBO therapy,and long-term prognosis were analyzed retrospectively.Results The spinal cord function of 8 congenital scoliosis child patients displayed normal before surgery,and they received corrective surgical treatment at proper time.Serious symptoms of SCI were displayed after surgery:partial or complete disorder of micturition and defecation (only one case was normal);muscle strength of the lower extremities was 0-3;ASIA scores were of B-C grades.After surgery,the patients respectively received HBO therapy for 3 to 7 days,averaging 5 days,with total treatment sessions of 7 to 50,averaging 25 sessions.Upon completion of HBO therapy,all the child patients had normal micturition and defecation (except 1 case),muscle strength of lower extremities recovered to 3-5 grades,and ASIA evaluation was of C-E grades,increasing by 3 grades on the average.The mean follow-up time was 17.6 months,with the longest follow-up time being 37 months.Neurologic functions of spinal cord in seven patients all recovered,they either went to school or kindergarten.One case failed to have medical follow-up.Conclusions Surgery coupled with early HBO therapy might be an effective treatment method for ISCI associated with spinal corrective surgery for CS.

Objective To explore the effect of hyperbaric oxygen (HBO) on iatrogenic spinal cord injury (ISCI) associated with spinal corrective surgery in child congenital scoliosis (CS).Methods The subjects of our study were 8 cases of ISCI associated with corrective surgery for CS admitted into our hospital for treatment from November 2010 to September 2014.Age,gender,the starting time of HBO therapy after surgery,sessions of HBO therapy,micturition and defecation,muscle strength of lower extremities and ASIA scores (grade) before/after HBO therapy,and long-term prognosis were analyzed retrospectively.Results The spinal cord function of 8 congenital scoliosis child patients displayed normal before surgery,and they received corrective surgical treatment at proper time.Serious symptoms of SCI were displayed after surgery:partial or complete disorder of micturition and defecation (only one case was normal);muscle strength of the lower extremities was 0-3;ASIA scores were of B-C grades.After surgery,the patients respectively received HBO therapy for 3 to 7 days,averaging 5 days,with total treatment sessions of 7 to 50,averaging 25 sessions.Upon completion of HBO therapy,all the child patients had normal micturition and defecation (except 1 case),muscle strength of lower extremities recovered to 3-5 grades,and ASIA evaluation was of C-E grades,increasing by 3 grades on the average.The mean follow-up time was 17.6 months,with the longest follow-up time being 37 months.Neurologic functions of spinal cord in seven patients all recovered,they either went to school or kindergarten.One case failed to have medical follow-up.Conclusions Surgery coupled with early HBO therapy might be an effective treatment method for ISCI associated with spinal corrective surgery for CS.

Objective To compare and observe the clinical effects of different oxygen-breathing methods coupled with drugs in the treatment of sudden hearing loss (SHL),so as to explore new approaches for the treatment of the illness.Methods In accordance with the set criteria,101 cases of sudden hearing loss admitted into the center from Feb.2011 to Aug.2013 were selected for our study.All the patients received injections of dexamethasone sodium phosphate,ginkgo leave extract injection and other drug treatment.Then,the patients were randomly allocated to groups A,B and C in accordance with different methods of oxygenbreathing.Group A (37 cases) received drug treatment coupled with 0.20 MPa hyperbaric oxygen (HBO) therapy; Group B (also 37 cases) received the same drug treatment coupled with 0.16 MPa HBO therapy; and Group C (27 cases) received the same drug treatment coupled with 0.10 MPa (normal pressure) oxygen maskbreathing.During HBO therapy,the feeling of ear stuffiness in 3 patients from group A and 6 patients from group B was worsened and "C curve" of tympanic acoustic impedance was shown,and these 9 cases changed to receive low pressure oxygen breathing at 0.07 MPa,and were assigned as group D.The remaining 34 patients in group A and 31 patients in group B were then respectively assigned as group A1 and group B1.Pure tone audiometry and tympanic acoustic impedance detection were performed in all the patients both before treatment and at d 14 after treatment.Results Total effective rates for groups A1,B1,C and D were 82.4％,83.9％,59.3％ and 77.8％ respectively.Pure tone average (PTA) were respectively increased by (43.7 ± 17.4) dB,(46.3±21.2)dB,(28.1 ± 12.3)dB and (41.9 ± 19.8)dB.When compared with the control group,statistical difference could be seen in total effective rates for groups A1 and B1 (x2 =6.218,P ＜ 0.05).PTA values of groups A1 and B1 were higher than that of group C (P ＜ 0.05),and the feeling of ear stuffiness in patients of group D was obviously lighter following treatment.Conclusions HBO therapy combined with dexamethasone sodium phosphate and ginkgo leave extract injection was an effective method for the treatment of SHL.HBO therapy at 0.16 MPa could achieve quite satisfactory results,and was economical as well.For patients with an obvious feeling of ear stuffiness could receive oxygen breathing at a pressure of 0.07 MPa.

Objective To investigate the relationship between hyperbaric oxygen (HBO) and stress through observation on rats behavior and stress-related indicators.Methods Twenty Wistar rats were randomly divided into the HBO group and the control group.The HBO group was exposed to HBO at a pressure of 0.20 MPa once a day,for a succession of 21 days,and the control group was left there without HBO treatment.After one week of adaptive training,elevated plus maze test was conducted at days 1,7,14 and 21 to observe openarm (OA) time.The contents of corticotropin-releasing hormone (CRH),adrenocorticotropic hormone (ATCH),glucocorticoids (GCS),nitric oxide synthase (NOS),nitric oxide (NO) and tumor necrosis factorα (TNF-α) in serum of the animals in each group were detected by ELISA (enzyme-linked immunosorbent assay).Results HBO treatment could significantly increase the level of GCS in peripheral blood (P ＞ 0.05),but with no obvious effect on open-arm time (anxiety degree) and the expression levels of nitric oxide and TNF-α.Conclusions HBO treatment was in conformity with the general characteristics of chronic stress,but would not bring about damage to the body,suggesting that one of the mechanisms of HBO might lie in the increased tolerance of the involved tissues to stressors.

Objective To compare and observe the clinical effects of different oxygen-breathing methods coupled with drugs in the treatment of sudden hearing loss (SHL),so as to explore new approaches for the treatment of the illness.Methods In accordance with the set criteria,101 cases of sudden hearing loss admitted into the center from Feb.2011 to Aug.2013 were selected for our study.All the patients received injections of dexamethasone sodium phosphate,ginkgo leave extract injection and other drug treatment.Then,the patients were randomly allocated to groups A,B and C in accordance with different methods of oxygenbreathing.Group A (37 cases) received drug treatment coupled with 0.20 MPa hyperbaric oxygen (HBO) therapy; Group B (also 37 cases) received the same drug treatment coupled with 0.16 MPa HBO therapy; and Group C (27 cases) received the same drug treatment coupled with 0.10 MPa (normal pressure) oxygen maskbreathing.During HBO therapy,the feeling of ear stuffiness in 3 patients from group A and 6 patients from group B was worsened and "C curve" of tympanic acoustic impedance was shown,and these 9 cases changed to receive low pressure oxygen breathing at 0.07 MPa,and were assigned as group D.The remaining 34 patients in group A and 31 patients in group B were then respectively assigned as group A1 and group B1.Pure tone audiometry and tympanic acoustic impedance detection were performed in all the patients both before treatment and at d 14 after treatment.Results Total effective rates for groups A1,B1,C and D were 82.4％,83.9％,59.3％ and 77.8％ respectively.Pure tone average (PTA) were respectively increased by (43.7 ± 17.4) dB,(46.3±21.2)dB,(28.1 ± 12.3)dB and (41.9 ± 19.8)dB.When compared with the control group,statistical difference could be seen in total effective rates for groups A1 and B1 (x2 =6.218,P ＜ 0.05).PTA values of groups A1 and B1 were higher than that of group C (P ＜ 0.05),and the feeling of ear stuffiness in patients of group D was obviously lighter following treatment.Conclusions HBO therapy combined with dexamethasone sodium phosphate and ginkgo leave extract injection was an effective method for the treatment of SHL.HBO therapy at 0.16 MPa could achieve quite satisfactory results,and was economical as well.For patients with an obvious feeling of ear stuffiness could receive oxygen breathing at a pressure of 0.07 MPa.

Objective To investigate the relationship between hyperbaric oxygen (HBO) and stress through observation on rats behavior and stress-related indicators.Methods Twenty Wistar rats were randomly divided into the HBO group and the control group.The HBO group was exposed to HBO at a pressure of 0.20 MPa once a day,for a succession of 21 days,and the control group was left there without HBO treatment.After one week of adaptive training,elevated plus maze test was conducted at days 1,7,14 and 21 to observe openarm (OA) time.The contents of corticotropin-releasing hormone (CRH),adrenocorticotropic hormone (ATCH),glucocorticoids (GCS),nitric oxide synthase (NOS),nitric oxide (NO) and tumor necrosis factorα (TNF-α) in serum of the animals in each group were detected by ELISA (enzyme-linked immunosorbent assay).Results HBO treatment could significantly increase the level of GCS in peripheral blood (P ＞ 0.05),but with no obvious effect on open-arm time (anxiety degree) and the expression levels of nitric oxide and TNF-α.Conclusions HBO treatment was in conformity with the general characteristics of chronic stress,but would not bring about damage to the body,suggesting that one of the mechanisms of HBO might lie in the increased tolerance of the involved tissues to stressors.