Objective:To investigate the cognitive characteristics and related influencing factors in Parkinson′s disease (PD) patients with or without olfactory anosognosia (OA).Methods:A total of 113 PD patients who were treated at the Affiliated Hospital of Yangzhou University between March 2023 and April 2024 were selected. The PD Olfactory Dysfunction Auxiliary Diagnostic Card was used to assess olfactory function. Based on the olfactory identification scores and subjective awareness of olfactory dysfunction, patients were divided into the normosmic group, olfactory dysfunction group, and the later was further divided into olfactory dysfunction without OA (OA-) group, and olfactory dysfunction with OA (OA+) group. The results of the Unified Parkinson′s Disease Rating Scale-Ⅲ (UPDRS-Ⅲ) and Hoehn-Yahr (H-Y) staging assessments of the patients were collected. Non-motor symptoms such as cognitive function, anxiety, depression, sleep disturbances, and constipation were evaluated using relevant scales. Logistic regression analysis was used to explore the related factors affecting OA in PD patients with olfactory decline.Results:The Montreal Cognitive Assessment (MoCA) scores of the olfactory dysfunction group were lower than those of the normosmic group (20.30±4.47 vs 22.64±2.50, t=2.907, P=0.007). The Self-Rating Anxiety Scale scores (39.00±8.60 vs 43.86±10.63, t=2.444, P=0.016), visuospatial and executive function scores (2.35±1.32 vs 2.98±1.42, t=2.263, P=0.026), and orientation scores (4.88±1.14 vs 5.34±1.07, t=2.046, P=0.043) of the OA+ group were lower than those of the OA- group. Logistic regression analysis revealed that lower MoCA scores were an independent risk factor for PD combined with OA ( OR=0.853, 95% CI 0.743-0.980, P=0.024). Conclusions:PD patients with olfactory dysfunction exhibit more severe cognitive impairment. Among them, patients with OA show more significant impairments in visuospatial, executive function and orientation. Cognitive impairment may be an independent risk factor for PD combined with OA.

Objective:To investigate the cognitive characteristics and related influencing factors in Parkinson′s disease (PD) patients with or without olfactory anosognosia (OA).Methods:A total of 113 PD patients who were treated at the Affiliated Hospital of Yangzhou University between March 2023 and April 2024 were selected. The PD Olfactory Dysfunction Auxiliary Diagnostic Card was used to assess olfactory function. Based on the olfactory identification scores and subjective awareness of olfactory dysfunction, patients were divided into the normosmic group, olfactory dysfunction group, and the later was further divided into olfactory dysfunction without OA (OA-) group, and olfactory dysfunction with OA (OA+) group. The results of the Unified Parkinson′s Disease Rating Scale-Ⅲ (UPDRS-Ⅲ) and Hoehn-Yahr (H-Y) staging assessments of the patients were collected. Non-motor symptoms such as cognitive function, anxiety, depression, sleep disturbances, and constipation were evaluated using relevant scales. Logistic regression analysis was used to explore the related factors affecting OA in PD patients with olfactory decline.Results:The Montreal Cognitive Assessment (MoCA) scores of the olfactory dysfunction group were lower than those of the normosmic group (20.30±4.47 vs 22.64±2.50, t=2.907, P=0.007). The Self-Rating Anxiety Scale scores (39.00±8.60 vs 43.86±10.63, t=2.444, P=0.016), visuospatial and executive function scores (2.35±1.32 vs 2.98±1.42, t=2.263, P=0.026), and orientation scores (4.88±1.14 vs 5.34±1.07, t=2.046, P=0.043) of the OA+ group were lower than those of the OA- group. Logistic regression analysis revealed that lower MoCA scores were an independent risk factor for PD combined with OA ( OR=0.853, 95% CI 0.743-0.980, P=0.024). Conclusions:PD patients with olfactory dysfunction exhibit more severe cognitive impairment. Among them, patients with OA show more significant impairments in visuospatial, executive function and orientation. Cognitive impairment may be an independent risk factor for PD combined with OA.

Atractylodis rhizoma is a perennial herb of the Asteraceae family,which mainly divided into A.chinensis(DC)Koidz and Atractyiodes lancea(Thunb)DC,with the effects of strengthening the spleen,drying dampness,brightening the eyes,etc.Atractylodis rhizoma is mainly used in the clinical treatment of spleen deficiency and dampness,night blindness,eye fatigue and other symptoms.According to the clinical effect,and modern pharmacological researches have confirmed,the Chinese herbal medicine Atractylodis rhizoma contains a variety of active ingredients,such as volatile oils,alkynes,glycosides,etc.In recent years,pharmacological studies on Atractylodis rhizoma have found that atractylodin in polyalkynes has good activity in anti-inflammation,treatment of bacterial resistance,and inhibition of cholangiocarcinoma cell migration,and its high biological activity may be related to the conjugated enyne structure.Therefore,this article summarizes the studies on chemical components and pharmacological effects of polyalkynes in Atractylodis rhizoma that have been published in recent years,and comprehensively expounds the research progress of polyalkynes in Atractylodis rhizoma,so as to provide reference for scientific researchers and promote the in-depth development and utilization of the medicinal value of Atractylodis rhizoma.

Objective To investigate the value of phase-contrast magnetic resonance imaging (PC-MRI)in evaluating pulmonary artery blood flow and right ventricular(RV)function in elderly patients with chronic obstructive pulmonary disease (COPD).Methods Twenty-four elderly patients with COPD admitted to Beijing Anzhen Hospital between February 2016 and June 2017 were enrolled in this retrospective study.Based on pulmonary artery pressure evaluated by right heart catheterization,COPD patients were divided into a pulmonary hypertension group (PH group,n =12)and a non-PH group(n=12).Pulmonary artery blood flow velocity and volume,pulmonary arterial compliance and right heart function parameters including ejection fraction,end diastolic volume,endsystolic volume and cardiac output,and 6-min walking distance evaluated by PC-MRI were compared between the two groups.Results There were significant differences in peak flow velocity[(88.1 ±16.0)cm/s vs.(59.8± 13.8) cm/s,P =0.005],flow volume [(80.7± 22.0) ml/s vs.(53.2± 26.7)ml/s,P=0.012],main pulmonary artery compliance[(42.3± 14.6)vs.(22.7± 10.8),P =0.001],right ventricular ejection fraction [(48.4 ± 13.4) ％ vs.(37.6 ± 11.1) ％,P =0.000],end-diastolic volume[(64.6±22.5)ml vs.(72.5±22.8)ml,P =0.030]and end-systolic volume[(50.6±33.1)ml vs.(41.7±33.1)ml,P =0.040]between the non-PH and PH groups,while there was no significant difference in cardiac output between the non-PH and PH groups[(34.2±10.8)ml vs.(34.4±8.3)ml,P =0.080].Pearson's correlation analysis showed that 6-minute walking distance had good correlations with right ventricular ejection fraction(r =0.49),forced expiratory volume in 1 s(FEV1)(r=0.60)and main pulmonary artery diameter(r=0.61).Conclusions PC-MRI is a noninvasive imaging method for quantitative analysis of pulmonary artery dynamics and right heart function for the elderly with COPD,and it can provide information for evaluating therapeutic effects and prognosis.

Objective To observe the value of optimized temporal parallel acquisition technique (TPAT) sequence in evaluating cardiac structure and function in arrhythmia patients.Methods Totally 33 arrhythmia patients (arrhythmia group) and 48 normal rhythm subjects (normal group) underwent cardiac MRI with conventional cine (balanced steadystate free-precession [bSSFP]) sequence and optimized TPAT sequence.Myocardial thickness,cardiac function,myocardial strain parameters of left ventricle and image quality of 2 sequences were compared in the two groups,respectively.Results In arrhythmia group,there was statistical difference of myocardial thickness in 12 myocardial segments between the 2 sequences (all P ＜ 0.05),as well as peak and average values of myocardial radial and circumferential strain (all P＜0.05).In normal group,there was no statistical difference of myocardial thickness and stain parameters between the 2 sequences (all P＞0.05).Additionally,no statistical difference of cardiac function was found between the 2 sequences in two groups (all P＞0.05).In arrhythmia group,the image quality of optimized TPAT sequence was better than that of bSSFP sequence (P＜0.05).Conclusion For arrhythmia patients,optimized TPAT cine sequence could improve image quality of cardiac MRI.

Objective: To retrospectively analyze the potential correlation between cardiac magnetic resonance (CMR) imaging and clinical features and idiopathic arrhythmia in patients with straight back syndrome (SBS). Methods: Patients receiving CMR imaging examination from April 2015 to March 2016 at our department (n=1 432) were screened, 76 patients met the diagnosis criteria of flat chest (anteroposterior diameter/transthoracic diameter (APD/TTD) ratio<0.37 at the T8 vertebra). After excluding 33 patients with structural heart disease, 43 SBS patients were divided into two groups: SBS without obvious morphological change in the heart (group A, n=19) and SBS with morphological change of the heart (group B, n=24). CMR images were analyzed, focusing the heart morphological changes induced by SBS. The clinical data were collected to comprehensively analyze the medical history, electrocardiogram and electrophysiological examination in order to observe the relationship between SBS induced heart morphological change and the arrhythmia type and origin. Results: There were 21 male patients in this cohort, mean age was (28.5±11.5) years (13-58 years). APD/TTD ratio was similar between the two groups (0.30±0.03 vs. 0.29±0.04, P>0.05). LVEF tended to be lower in group B than in group A ((47.48±12.77)%vs. (59.31±9.04)%, P>0.05) . In group B, there were 15 patients with left ventricular enlargement, 2 with left ventricular wall thickening, 5 with uncoordinated ventricular wall motion, 5 with tricuspid regurgitation, 3 with mitral regurgitation, 2 with myocardial fibrosis, 5 with increased trabecular and 16 with decreased left ventricular function. Direct compression sign of right ventricle (disappeared precordial fat tissue space, secondary right atria enlargement and tricuspid regurgitation) and left atria (with or without secondary left ventricular enlargement and mitral regurgitation) were evidenced in patients of group B. CMR revealed that the arrhythmia origin corresponded the compression site of the heart in 8 cases (42.1%) in group A and 13 cases (54.2%) in group B, not corresponded to the compression site in 6 patients (31.6%) in group A and in 7 patients (29.2%) in group B, not attributable in 5 patients (26.3%) in group A and 4 patients (16.7%) in group B. The percent of arrhythmia origin corresponded the compression site of the heart tended to be higher in group B as compared to group A (P>0.05). Conclusion SBS can induce changes of cardiac morphology and cardiac function. SBS induced cardiac compression is linked with the development of arrhythmias and might be one of the reasons of arrhythmias in these patients.

Objective To explore the clinical application value of left atrial function with feature tracking cardiac magnetic resonance imaging (FT-CMR) by evaluating preliminarily left atrial strain and strain rate in patients with atrial fibrillation. Methods Thirty patients with paroxysmal atrial fibrillation, thirty patients with persistent atrial fibrillation and twenty-two healthy subjects were enrolled. All the subjects underwent cardiac magnetic resonance imaging with the real steady-state free precession(SSFP) sequence. FT-CMR parameters included left atrial strain and strain rate parameters, left atrial volume and function parameters were detected by using offline cardiovascular analysis software, respectively. Left atrial strain and strain rate parameters included left atrial total strain(Εs), passive strain(Εe), active strain(Εa), peak positive strain rate(SRs), peak early negative strain rate(SRe)and peak late negative strain rate(SRa). Volume and function parameters included maximum of left atrial volume(LAVmax), minimum of left atrial volume(LAVmin), total left atrial emptying fraction(LATEF), passive left atrial emptying fraction(LAPEF)and active left atrial emptying fraction(LAAEF). The differences in the general data among the paroxysmal atrial fibrillation group, the persistent atrial fibrillation group and the control group were compared by usingχ2 test or ANOVA analysis. The differences in all parameters between the atrial fibrillation group and the control group, the paroxysmal atrial fibrillation group and the persistent atrial fibrillation group were compared by using independent t test. Left atrial strain and strain rate parameters on an intra-observer and inter-observer were determined by intraclass correlation coefficient(ICC)analyses. Results Compared to control group, LAVmax and LAVmin in atrial fibrillation group were significantly increased(t=9.737,7.889,P<0.001);The LATEF and LAPEF had no significant difference, the LAAEF in two groups had statistically significant difference(t=-4.762,P<0.001).The absolute value of Es, Ee, Ea, SRs, SRe, SRa in atrial fibrillation group were significantly reduced than in control group(t=-7.732,-6.610,-6.493,-7.546, 6.864, 5.917,P<0.001). Compared with paroxysmal atrial fibrillation group, LAVmax and LAVmin in persistent atrial fibrillation group were increased obviously, LATEF and LAPEF were significantly decreased, and the differences were statistically significant(t=-4.575,-5.524, 4.002, 4.028,P<0.001).The LAAEF in two groups had no statistically significant difference. Compared with strain and strain rate in two groups, absolute value of Es, Ee, Ea, SRs, SRe, SRa in persistent atrial fibrillation group significantly decreased than in paroxysmal atrial fibrillation(t=4.310, 3.128, 4.465, 5.496,-3.290,-3.863,P<0.001). The intra-group and inter-group had well correlation coefficients between the observers in the left atrial strain and strain rate parameters of the subjects(ICC=0.85—0.94,0.81—0.90). Conclusions FT-CMR technique can be used to assess the left atrial strain and strain rate in patients with atrial fibrillation;Left atrial reservoir, conduit and booster-pump functions in patients with atrial fibrillation were impaired. Patients with persistent atrial fibrillation had worse left atrial function throughout the entire cardiac cycle compared with those with paroxysmal atrial fibrillation.

Objective To evaluate the diffuse myocardial fibrosis of the left ventricle (LV) in patients with atrial fibrillation (AF) by cardiac MR (CMR) T1 mapping methods.Methods Totally 60 subjects (30 paroxysmal AF patients and 30 persistent AF patients) and 59 normal control underwent MR cardiac cine,late gadolinium enhancement,and LV T1 mapping.For T1 mapping,modified Look-Locker inversion recovery sequence was used.Compared with control,pre-contrast ventricular T1 times were quantified and extracellular volume (ECV) was calculated.Results All subjects completed the CMR exam,no myocardial delay enhanced lesion was found.Pre-contrast ventricular T1 time in healthy controls was lower than that in patients with persistent and paroxysmal AF,and the pre-comrast ventricular T1 time in persistent AF patients was higher than that of paroxysmal AF patients (all P＜0.05).The mean LV myocardial ECV had no statistical difference between healthy controls and paroxysmal AF patients (P＞ 0.05),while lower than persistent AF patients (P ＜ 0.05).The mean LV myocardial ECV in patients with persistent AF was larger than that in patients with paroxysmal AF (P＜0.05).LV functional indexes were positive correlated with pre-contrast ventricular T1 time and ECV in patients with AF (all P＜0.05).Conclusion There is LV myocardial fibrosis in patients with AF,and the degree in patients with persistent AF is more severe than that in patients with paroxysmal AF.

Objective To investigate the value of contrast enhancement T1 mapping in detection of diffuse myocardial fibrosis in cardiomyopathy, and the relationship between myocardial fibrosis and cardiac function. Methods From September 2013 to September 2014, 76 cases of cardiomyopathy patients (including myocarditis) and 33 cases of healthy controls were enrolled in our study. All the subjects underwent cardiac MR (CMR) examination. Scan sequences included cine MR, pre-contrast and post-contrast T1 mapping and late gadolinium enhancement (LGE) imaging. The pre-/post-contrast left ventricle average T1 value and cardiac function of patients and controls were measured and compared by using independent-samples t test. According to the LGE imaging, all the subjects were subsequently divided into LGE positive group, LGE negative group and control group. The myocardial average T1 value and cardiac function among the three sub-groups were compared by using one-way ANOVA, and the relationship among them were analyzed by using Pearson correlation. Results Among the 76 cases of non-ischemia cardiomyopathy patients, 51 cases (67.1%) had LGE. Compared with controls, cardiomyopathy patients presented with higher pre-contrast T1 value [(1 306.4 ± 84.6)ms vs. (1 266.6 ± 57.3)ms, t=2.10, P<0.05] and lower post-contrast T1 value [(483.6 ± 112.0)ms vs. (534.1 ± 92.7)ms,t=-0.27, P<0.05]. Pre-contrast and post-contrast average T1 value of LGE positive patients were (1 322.2 ± 85.8) and (459.7 ± 132.2)ms respectively;pre-contrast and post-contrast average T1 value of LGE negative patients were (1 267.0 ± 68.5) ms and (521.0±95.2)ms, there were statistical significant differences of T1 value between LGE positive and LGE negative patients (P<0.01), however, there were no statistical significant differences of T1 value between LGE negative patients and controls (P>0.05). There were correlation between pre-/post-contrast left ventricle T1 value and ejection fraction (EF) in cardiomyopathy patients (r=-0.252,-0.217, P<0.01), however no statistical correlation with other cardiac function parameters (P>0.05). Conclusions The average pre-/post-contrast T1 value in left ventricle myocardium are helpful for detection of diffuse fibrosis in cardiomyopathy patients. The LGE positive is a sign that can greatly change the T1 value of the myocardial tissue, meanwhile, myocardial fibrosis is negative correlated with ejection fraction in cardiomyopathy patients.

PurposeTo determine the feasibility and accuracy of dual source CT (DSCT) in assessing myocardial delayed-enhancement and left ventricular wall thickness of hypertrophic cardiomyopathy (HCM) in comparison with cardiac magnetic resonance (CMR).Materials and MethodsEighty patients with HCM confirmed by clinical diagnosis were enrolled in the study. DSCT images and CMR images were acquired at the arterial and lag phases. According to 17-segment model provided by American Heart Association, the left ventricular wall thickness and location of delayed-enhancement were verified, and the correlation of these two methods were analyzed in terms of the diagnosis of myocardial delayed enhancement (MDE).Results1360 myocardial segments for 80 patients were assessed. The left ventricular wall thickness determined by DSCT was significantly correlated with MR results (r=0.88,P<0.01). DSCT and MDE showed substantial agreement on per-patient (n=74,Kappa=0.751,P<0.05) and per-segment (n=1238, Kappa=0.746,P<0.01) levels. For dense myocardial delayed enhancement, CT findings were significantly correlated with those of CMR (r=0.89, P<0.01), but CT scan slightly underestimated the lesion scope of fibrosis. Bland-Altman analysis showed that CT and MRI were different in measuring the lesion volume of myocardial delayed enhancement (mean standard deviation was 2.71%).ConclusionThe cardiac CT examination provides comprehensive information in coronary artery and myocardial assessment, and MDE-DSCT is also effective in the diagnosis of myocardial fibrosis in HCM since it can be used in assessing myocardial fibrosis.