OBJECTIVE: To observe the clinical efficacy of long-time needle retaining at Baihui (GV 20) on post-stroke cognitive disorder of deficiency and blood stasis. METHODS: A total of 70 patients (3 cases dropping) with post-stroke cognitive disorder of deficiency and blood stasis were randomized into an observation group (34 cases) and a control group (33 cases). Neurological routine treatment and western medicine rehabilitation therapy were given in the control group as the basic treatment, on the basis of the treatment as the control group, long-time needle retaining at Baihui (GV 20) was applied in the observation group. The treatment was given once every other day, 3 times a week for a total of 4 weeks. The National Institute of Health stroke scale (NIHSS), mini-mental state examination (MMSE), Montreal cognitive assessment (MoCA) and deficiency blood stasis syndrome scale score were observed before and after treatment, and the clinical efficacy was compared between the two groups. RESULTS: After 4 weeks of treatment, the NIHSS scores of the two groups were lower than those before treatment (both <0.01), and the MMSE and MoCA scores were higher than those before treatment (<0.05, <0.01), and the scores in the observation group were better than those in the control group (all <0.01). After treatment, the scores of deficiency and blood stasis syndrome were lower than those before treatment (all <0.01). The scores of the shortness of breath, facial color, tongue pulse and dizziness in the observation group were better than those in the control group (all <0.05), there was no significant difference in the degree of spontaneous sweating between the two groups (>0.05). The total effective rate was 94.1% (32/34) in the observation group, which was higher than 75.8% (25/33) in the control group (<0.05). CONCLUSION Long-time needle retaining at Baihui (GV 20) is safe and effective in treating with post-stroke cognitive disorder of deficiency and blood stasis.
Cognition ; Cognition Disorders ; etiology ; therapy ; Humans ; Qi ; Stroke ; complications ; Treatment Outcome

Metabolic syndrome (MetS) is a cluster of cardiovascular risk factors that includes obesity, diabetes, and dyslipidemia. Accumulating evidence implies that MetS contributes to the development and progression of Alzheimer's disease (AD); however, the factors connecting this association have not been determined. Insulin resistance (IR) is at the core of MetS and likely represent the key link between MetS and AD. In the central nervous system, insulin plays key roles in learning and memory, and AD patients exhibit impaired insulin signaling that is similar to that observed in MetS. As we face an alarming increase in obesity and T2D in all age groups, understanding the relationship between MetS and AD is vital for the identification of potential therapeutic targets. Recently, several diabetes therapies that enhance insulin signaling are being tested for a potential therapeutic benefit in AD and dementia. In this review, we will discuss MetS as a risk factor for AD, focusing on IR and the recent progress and future directions of insulin-based therapies.
Alzheimer Disease/etiology/metabolism ; Amyloid beta-Peptides/metabolism ; Animals ; Brain/metabolism ; Cognition Disorders/*etiology/*metabolism ; Humans ; Insulin/metabolism ; *Insulin Resistance ; Metabolic Syndrome X/complications/drug therapy/*metabolism ; Molecular Targeted Therapy ; Signal Transduction/drug effects ; tau Proteins/metabolism

PURPOSE: Insulin resistance plays a role in the development of dementia and hypertension. We investigated a possible relationship between cognitive impairment and insulin resistance in elderly Chinese patients with primary hypertension. MATERIALS AND METHODS: One hundred and thirty-two hypertensive elderly patients (>60 years) were enrolled in this study, and assigned into either the cognitive impairment group (n=61) or the normal cognitive group (n=71). Gender, age, education, body mass index (BMI), waist hip ratio (WHR), total cholesterol (TC), triglyceride (TG), C-reactive protein (CRP), high density lipoprotein cholesterol (HDL-C), low density lipoprotein cholesterol (LDL-C), creatinine (Cr), fasting plasma glucose (FPG), fasting insulin (FINS), homeostasis model of assessment for insulin resistance index (HOMA-IR), systolic blood pressure, diastolic blood pressure, smoking history, atherosclerosis and the proportion of uncontrolled hypertension were compared between the two groups. Multi-factorial logistic regression analysis was performed. RESULTS: No significant differences were found in gender, age, TC, CRP, HDL-C, LDL-C, Cr, BP, smoking history, atherosclerosis and the proportion of uncontrolled hypertension between the two groups. The cognitive impairment group had lower education levels, and higher BMI, WHR, TG, FPG, FINS, and HOMA-IR levels than the control group. Logistic regression analysis revealed the levels of education, BMI, WHR, and HOMA-IR as independent factors that predict cognitive impairment in patients. CONCLUSION: Our study demonstrates that poor education and increased BMI, WHR, and HOMA-IR are independent risk factors for cognitive impairment in elderly patients with hypertension. Insulin resistance plays an important role in the development of cognitive impairment in primary elderly hypertensive patients.
Aged ; Case-Control Studies ; Cognition Disorders/*etiology ; Female ; Humans ; Hypertension/*complications ; *Insulin Resistance ; Logistic Models ; Male ; Risk Factors

Blast injury has become the major life- and function-threatening injuries in recent warfares. There is increased research interest in the mental disorders caused by blast-induced traumatic brain injury (bTBI), which has been proved as one of the "signature wounds" in modern battlefield. We reviewed the recent progresses in bTBI-related researches and concluded that the new era of blast injury research has shifted from the traditional physical impairments to cognitive dysfunctional/mental disorders that are proved to be more related to the outcome of combat casualty care.
Animals ; Blast Injuries ; complications ; etiology ; Brain Injuries, Traumatic ; complications ; etiology ; Cognition Disorders ; etiology ; Humans ; Mental Disorders ; etiology ; Research

This study prospectively examined the relationships among cognitive factors and severity of Posttraumatic stress disorder (PTSD) symptoms in female victims of sexual violence. Thirty-eight victims of sexual violence recruited from Center for Women Victims of Sexual and Domestic Violence at Ajou University Hospital. Cognitive factors and PTSD symptom were assessed within 4 months of sexual violence and 25 victims were followed-up 1 month after initial assessment. Repeated-measured ANOVA revealed that PTSD incidence and severity decreased over the month (F [1, 21]=6.61). Particularly, avoidant symptoms might decrease earlier than other PTSD symptoms (F [1, 21]=5.92). This study also showed the significant relationship between early negative trauma-related thoughts and subsequent PTSD severity. Shame and guilt proneness had significant cross-sectional correlations with PTSD severity, but did not show associations when depression severity is controlled. Our results suggest that avoidant symptoms might decrease earlier than other PTSD symptoms during the acute phase and that cognitive appraisals concerning the dangerousness of the world seem to play an important role in the maintenance of PTSD (r=0.499, P<0.05).
Adolescent ; Adult ; *Cognition ; Cross-Sectional Studies ; Depression/diagnosis/etiology ; Female ; Follow-Up Studies ; Humans ; Pilot Projects ; Prospective Studies ; Psychiatric Status Rating Scales ; Questionnaires ; Severity of Illness Index ; *Sex Offenses ; Stress Disorders, Post-Traumatic/*diagnosis/etiology ; Women ; Young Adult

BACKGROUNDHypertension (HTN) is a very prevalent public health problem and as the population ages, cognitive impairment (CI) is also going to be a public health burden. However, the relationship between hypertension duration and cognitive function declination worldwide is still unknown. The aim of the study was to investigate the effects of HTN duration on CI in Chinese population.

METHODSAt baseline, 1 386 HTN patients and 293 normotensive (NT) people were enrolled. The HTN patients were further divided into four subgroups (duration of HTN <6 years, 6-10 years, 11-20 years, and >20 years) according to the HTN duration and were screened for cognitive function with neuropsychological tests including mini-mental-state-examination (MMSE) and clock-drawing-test (CDT) in comparison with the NT group.

RESULTSMore HTN patients had CI (45.3%) than NT subjects (30.4%), and increased with HTN duration (P < 0.000 1). Compared with the scores of MMSE and CDT in the NT group, the declines were higher in the HTN patients (P < 0.000 1), and in the four HTN subgroups, both MMSE and CDT scores fall when the HTN duration increased (P < 0.05). Furthermore, in the HTN population without CI, the trend in alteration of CI was relatively mild but still existed (P < 0.05).

CONCLUSIONPeople with HTN are more likely to have CI and the possibility and aggravation increases the prolongation of HTN duration, both in amnesic and nonamnesic function.

Adult ; Aged ; Aged, 80 and over ; Asian Continental Ancestry Group ; Cognition ; physiology ; Cognition Disorders ; etiology ; Cross-Sectional Studies ; Female ; Humans ; Hypertension ; complications ; Male ; Middle Aged

OBJECTIVETo explore the diagnostic value of magnetic resonance (MR) diffusion tensor imaging (DTI) in detecting brain white matter (WM) damage of patients with delayed encephalopathy after acute carbon monoxide poisoning (DEACMP) and evaluating their cognitive dysfunction.

METHODSThirteen patients with DEACMP and thirteen age- and sex-matched volunteers underwent DTI using 1.5T MR scanner. FA and ADC values of 16 WM regions of interests (ROIs) were measured on DTI by two experienced radiologists independently with double blind methods, cognitive functions were evaluated by another experienced neurologist blinded to patient's medical history using the Montreal cognitive assessment (MoCA). ADC and FA values in DEACMP patients, and their correlations with cognitive dysfunction were analyzed.

RESULTSADC values of DEACMP patients increased significantly in all ROIs (P < 0.05) in comparison with the corresponding ROIs of healthy controls, whereas FA values were significantly decreased in all ROIs (P < 0.05) in comparison with that in controls except the bilateral optic radiations, anterior and posterior internal capsules. MoCA scores were positively correlated with FA values of bilateral lower frontal (r(L) = 0.736, P = 0.011; r(R) = 0.762, P = 0.003) lobe, temporal lobe (r(L) = 0.605, P = 0.016; r(R) = 0.559, P = 0.021) and total average WM (r(A) = 0.688, P = 0.001), however it inversely correlated with ADC values of bilateral lower frontal WM (r(L) = -0.674, P = 0.007; r(R) = -0.681, P = 0.019).

CONCLUSIONDTI can quantitatively reveal WM microstructure damage of DEACMP patients, indicate the severity of cognitive dysfunctions, and provide important information for pathogenesis and pathological study for DEACMP.

Brain ; pathology ; Brain Diseases ; diagnosis ; etiology ; Carbon Monoxide Poisoning ; complications ; Cognition ; Cognition Disorders ; Diffusion Magnetic Resonance Imaging ; Diffusion Tensor Imaging ; Double-Blind Method ; Humans ; White Matter ; pathology

Child ; Child Behavior Disorders ; etiology ; Cognition Disorders ; physiopathology ; Humans ; Sleep Apnea Syndromes ; psychology

OBJECTIVETo explore the effect of acupuncture-anesthetic composite anesthesia (AACA) on the incidence of postoperative cognitive dysfunction (POCD) and changes of TNF-alpha, IL-1beta, and IL-6 in elderly patients.

METHODSTotally 83 patients undergoing surgical resection of gastrointestinal tumor were randomly assigned to the simple anesthesia group (A group, 41 cases) and the AACA group (B group, 42 cases). Patients in Group A received endotracheal general anesthesia. Those in Group B were induced by acupuncture anesthesia for 30 min by needling at Baihui (DU20), Neiguan (PC6), Zusanli (ST36). The electro-acupuncture (EA) apparatus was connected after arrival of qi, with the wave pattern of density 2/100 Hz. The stimulus intensity was set by patients' tolerance, with the peak current of 5 mA. Then the endotracheal general anesthesia was performed and the EA lasted till the end of the surgery. The cognitive function of all patients was assessed before operation and at day 3 after operation using mini-mental state examination (MMSE). POCD was confirmed if with one or more decreased stand- ard. The peripheral venous blood was collected before anesthesia induction (TO), immediately at the end of surgery (T1), 24 h after operation (T2), and 48 h after operation (T3), and serum concentrations of IL-1beta, IL-6, and TNF-alpha were correspondingly measured using ELISA.

RESULTSThe postoperative anesthesia awakening time was shorter in Group B than in Group A [(20.37 +/- 6.09) min vs (29.24 +/- 7.48) min, P < 0.05]. The remifentanil dose used during the operation was less in Group B than in Group A (P < 0.05). The incidence of POCD at day 3 was lower in Group B than in Group A [10/41 (23.8%) vs 15/42 (36.5%), P < 0.05]. The concentrations of IL-1beta, IL-6, and TNF-alpha at T1-T3 were higher than those at TO in the two groups (P < 0.05). The increment of TNF-alpha and IL-1beta was less in Group B than in Group A (P < 0.05). CONCLUSION AACA could reduce the incidence of POCD and inhibit postoperative release of TNF-alpha, IL-1beta, and IL-6 in elderly patients undergoing colorectal cancer resection.

Acupuncture Analgesia ; Aged ; Cognition Disorders ; etiology ; prevention & control ; Gastrointestinal Neoplasms ; surgery ; Humans ; Interleukin-1beta ; blood ; Interleukin-6 ; blood ; Postoperative Complications ; prevention & control ; Tumor Necrosis Factor-alpha ; blood

OBJECTIVE: Understand the changes before and after treatment in patients with severe OSAHS serum S100β protein, NSE levels and cognitive function. To investigate the molecular mechanisms of cognitive dysfunction in patients with severe OSAHS. Serum S100β protein, NSE levels and cognitive function were examined before and after the therapy. METHOD: Select one hundred patients diagnosed as severe OSAHS were included, by polysomnography (PSG) diagnosis of severe OSAHS patients. Determination of serum S100β protein, and NSE levels and theat the same time be MoCA score were checked at after the day after admission, CPAP treatment for the 7th days after CPAP treatment and the 90th day after, comprehensive treatment in these patients for 3 months. Assessment of severe OSAHS patients with serum S100β protein, NSE basic level and MoCA score situation. Comparison of three groups serum S100β protein, NSE levels and MoCA score changes. Serum S100β protein, NSE detection assay (ELISA) method using enzyme-linked immunosorbent. RESULT: (1) Severe OSAHS patients with serum S100β protein, and NSE levels in severe OSAHS patients were positively correlated with AHI, but negatively correlated with lowest oxygen saturation (LSaO2); (2) MoCA score in patients with severe OSAHS was significantly negatively correlated with AHI, but positively correlated with LSaO2; (3) S100β protein, NSE levels were negatively correlated with MoCA score; (4) Compared with admission, serum S100β protein, and NSE levels in these patients have declined after 7 days CPAP therapy, compared with admission the difference was statistically significant (P < 0.05). After 3 months of comprehensive treatment, patients' serum S100β protein and, NSE levels were significantly decreased, compared with the admission and the 7th days after CPAP treatment. The difference was statistically significant (P < 0.05). (5) After CPAP treatment for 7 days, the MoCA scores were slightly higher, but have there was no statistically significant difference compared with the admission (P > 0.05). After 3 months of comprehensive treatment, MoCA score improved significantly, compared with the admission and 7 days after CPAP treatment the difference was statistically significant (P < 0.05). CONCLUSION Comprehensive treatment can reduce serum S100β protein, and NSE levels, and improve MoCA score. Disease severity in patients with OSAHS have a correlation some relative.with the serum S100β protein, NSE levels and MoCA score. Long-term hypoxemia and the structure of sleep disorders may be the cause of elevated serum S100β protein, NSE levels elevated and causes of cognitive dysfunction. Comprehensive treatment can improve patient hypoxemia, correct disorders of sleep structure ,and can improve cognitive function and to improve the quality of life of patients.
Cognition Disorders ; blood ; etiology ; Continuous Positive Airway Pressure ; Humans ; Polysomnography ; Quality of Life ; S100 Calcium Binding Protein beta Subunit ; blood ; S100 Proteins ; blood ; Sleep Apnea, Obstructive ; blood ; therapy