Whole mount of adult ear skin as a model to study vascular malformations

Background:Genetic analysis in human patients has linked mutations in PIK3CA,the catalytic subunit of PI-3′Kinase,to sporadic incidences of vascular malformations.Methods:We have developed a mouse model with inducible and endothelial-specific expression of PIK3CA H1047R,resulting in the development of vascular malformations.Systemic induction of this mutation in adult mice results in rapid lethality,limiting our ability to track and study these lesions;therefore,we developed a topical and local induction protocol using the active metabolite of tamoxifen,4OH-T,on the ear skin of adults.Results:This approach allows us to successfully model the human disease in a mature and established vascular bed and track the development of vascular malformations.To validate the utility of this model,we applied a topical rapamycin ointment,as rapamycin is therapeutically beneficial to patients in clinical trials.We found that the induced ear lesions showed significant attenuation after treatment,which was easily quantified.Conclusions:These data collectively provide evidence of a new model to study vascular malformations in adult tissues,which should be particularly useful in environments lacking specialized small-animal imaging facilities.

A promising approach for quantifying focal stroke modeling and assessing stroke progression:optical resolution photoacoustic microscopy photothrombosis

To investigate the mechanisms underlying the onset and progression of ischemic stroke,some methods have been proposed that can simultaneously monitor and create embolisms in the animal cerebral cortex.However,these methods often require complex systems and the effect of age on cerebral embolism has not been adequately studied,although ischemic stroke is strongly age-related.In this study,we propose an optical-resolution photoacoustic microscopy-based visualized photothrombosis methodology to create and monitor ischemic stroke in mice simultaneously using a 532 nm pulsed laser.We observed the molding process in mice of different ages and presented age-dependent vascular embolism differentiation.Moreover,we integrated optical coherence tomography angiography to investigate age-associated trends in cerebrovascular variability following a stroke.Our imaging data and quantitative analyses underscore the differential cerebrovascular responses to stroke in mice of different ages,thereby highlighting the technique's potential for evaluating cerebrovascular health and unraveling age-related mechanisms involved in ischemic strokes.

Animal models of pulmonary hypertension due to left heart disease

Pulmonary hypertension due to left heart disease(PH-LHD) is regarded as the most prevalent form of pulmonary hypertension(PH). Indeed, PH is an independent risk factor and predicts adverse prognosis for patients with left heart disease(LHD). Clinically, there are no drugs or treatments that directly address PH-LHD, and treatment of LHD alone will not also ameliorate PH. To target the underlying physiopathological alterations of PH-LHD and to develop novel therapeutic approaches for this population, animal models that simulate the pathophysiology of PH-LHD are required. There are several available models for PH-LHD that have been successfully employed in rodents or large animals by artificially provoking an elevated pressure load on the left heart, which by transduction elicits an escalated pressure in pulmonary artery. In addition, metabolic derangement combined with aortic banding or vascular endothelial growth factor receptor antagonist is also currently applied to reproduce the phenotype of PH-LHD. As of today, none of the animal models exactly recapitulates the condition of patients with PH-LHD. Nevertheless, the selection of an appropriate animal model is essential in basic and translational studies of PH-LHD. Therefore, this review will summarize the characteristics of each PH-LHD animal model and discuss the advantages and limitations of the different models.

Can mouse models mimic sporadic Alzheimer’s disease?

Alzheimer’s disease(AD)is a progressive neurodegenerative disorder and the most common form of dementia worldwide.As age is the main risk factor,>97%of all AD cases are of sporadic origin,potentiated by various risk factors associated with life style and starting at an age>60 years.Only<3%of AD cases are of genetic origin caused by mutations in the amyloid precursor protein or Presenilins 1 or 2,and symptoms already start at an age<30 years.In order to study progression of AD,as well as therapeutic strategies,mouse models are state-of-the-art.So far many transgenic mouse models have been developed and used,with mutations in the APP or presenilin or combinations(3×Tg,5×Tg).However,such transgenic mouse models more likely mimic the genetic form of AD and no information can be given how sporadic forms develop.Several risk genes,such as Apolipoprotein E4 and TREM-2 enhance the risk of sporadic AD,but also many risk factors associated with life style(e.g.,diabetes,hypercholesterolemia,stress)may play a role.In this review we discuss the current situation regarding AD mouse models,and the problems to develop a sporadic mouse model of AD.

Altered microRNA expression in animal models of Huntington’s disease and potential therapeutic strategies

A review of recent animal models of Huntington’s disease showed many microRNAs had altered expression levels in the striatum and cerebral cortex,and which were mostly downregulated.Among the altered microRNAs were miR-9/9*,miR-29b,miR-124a,miR-132,miR-128,miR-139,miR-122,miR-138,miR-23b,miR-135b,miR-181(all downregulated)and miR-448(upregulated),and similar changes had been previously found in Huntington’s disease patients.In the animal cell studies,the altered microRNAs included miR-9,miR-9*,miR-135b,miR-222(all downregulated)and miR-214(upregulated).In the animal models,overexpression of miR-155 and miR-196a caused a decrease in mutant huntingtin mRNA and protein level,lowered the mutant huntingtin aggregates in striatum and cortex,and improved performance in behavioral tests.Improved performance in behavioral tests also occurred with overexpression of miR-132 and miR-124.In the animal cell models,overexpression of miR-22 increased the viability of rat primary cortical and striatal neurons infected with mutant huntingtin and decreased huntingtin-enriched foci of≥2μm.Also,overexpression of miR-22 enhanced the survival of rat primary striatal neurons treated with 3-nitropropionic acid.Exogenous expression of miR-214,miR-146a,miR-150,and miR-125b decreased endogenous expression of huntingtin mRNA and protein in HdhQ111/HdhQ111 cells.Further studies with animal models of Huntington’s disease are warranted to validate these findings and identify specific microRNAs whose overexpression inhibits the production of mutant huntingtin protein and other harmful processes and may provide a more effective means of treating Huntington’s disease in patients and slowing its progression.

Hidden Markov Models to Estimate the Lagged Effects of Weather on Stroke and Ischemic Heart Disease

The links between low temperature and the incidence of disease have been studied by many researchers. What remains still unclear is the exact nature of the relation, especially the mechanism by which the change of weather effects on the onset of diseases. The existence of lag period between exposure to temperature and its effect on mortality may reflect the nature of the onset of diseases. Therefore, to assess lagged effects becomes potentially important. The most of studies on lags used the method by Lag-distributed Poisson Regression, and neglected extreme case as random noise to get correlations. In order to assess the lagged effect, we proposed a new approach, i.e., Hidden Markov Model by Self Organized Map (HMM by SOM) apart from well-known regression models. HMM by SOM includes the randomness in its nature and encompasses the extreme cases which were neglected by auto-regression models. The daily data of the number of patients transported by ambulance in Nagoya, Japan, were used. SOM was carried out to classify the meteorological elements into six classes. These classes were used as “states” of HMM. HMM was used to describe a background process which might produce the time series of the incidence of diseases. The background process was considered to change randomly weather states, classified by SOM. We estimated the lagged effects of weather change on the onset of both cerebral infarction and ischemic heart disease. This fact is potentially important in that if one could trace a path in the chain of events leading from temperature change to death, one might be able to prevent it and avert the fatal outcome.

Computational fluid dynamics modeling in intracranial atherosclerotic disease

Intracranial atherosclerotic disease(ICAD)is an important cause for ischemic stroke and transient ischemic stroke(TIA)throughout the world,especially in Asians,which is not fully appreciated,partly due to its inaccessibility and limitations of current neuroimaging methods.The computational fluid dynamics(CFD)modeling technique provides a novel approach to reveal the hemodynamic characteristics in ICAD,e.g.,the distributions of pressure,wall shear stress and flow velocity.In this review article,we aim to provide an overview of the general methodology of CFD modeling in arterial stenotic diseases,the established application of this technique in coronary artery disease,and more importantly,perspectives and challenges of this technique in the investigation of ICAD.Promising findings of preliminary studies using a CFD model for hemodynamic analysis in ICAD warrant verifications.Further studies in this area will help rectify loopholes in the current secondary prevention strategy,and inform individualized treatment for ICAD patients in the near future.

Clinical value of precise rehabilitation nursing in management of cerebral infarction

BACKGROUND Cerebral infarction,previously referred to as cerebral infarction or ischemic stroke,refers to the localized brain tissue experiencing ischemic necrosis or softening due to disorders in brain blood supply,ischemia,and hypoxia.The precision rehabilitation nursing model for chronic disease management is a continuous,fixed,orderly,and efficient nursing model aimed at standardizing the clinical nursing process,reducing the wastage of medical resources,and improving the quality of medical services.AIM To analyze the value of a precise rehabilitation nursing model for chronic disease management in patients with cerebral infarction.METHODS Patients(n=124)admitted to our hospital with cerebral infarction between November 2019 and November 2021 were enrolled as the study subjects.The random number table method was used to divide them into a conventional nursing intervention group(n=61)and a model nursing intervention group(n=63).Changes in the nursing index for the two groups were compared after conventional nursing intervention and precise rehabilitation intervention nursing for chronic disease management.RESULTS Compared with the conventional intervention group,the model intervention group had a shorter time to clinical symptom relief(P<0.05),lower Hamilton Anxiety Scale and Hamilton Depression Scale scores,a lower incidence of total complications(P<0.05),a higher disease knowledge mastery rate,higher safety and quality,and a higher overall nursing satisfaction rate(P<0.05).CONCLUSION The precision rehabilitation nursing model for chronic disease management improves the clinical symptoms of patients with cerebral infarction,reducing the incidence of total complications and improving the clinical outcome of patients,and is worthy of application in clinical practice.

Multi-target mechanism of triphala in cardio-cerebral vascular diseases based on network pharmacology

OBJECTIVE Numerous references made clear that triphala is revered as a multiuse therapeutic and perhaps even panacea historically.Nevertheless,the protective mechanism of triphala on cardio-cerebral vascular diseases(CCVDs)remains not comprehensive understanding.Hence,a network pharmacology-based method was suggested in this study to address this problem.METHODS This study was based on network pharmacology and bioinformatics analysis.Information on compounds in herbal medicines of triphala formula was acquired from public databases.Oral bioavailability as well as drug-likeness were screened by using absorption,distribution,metabolism,and excretion(ADME)criteria.Then,components of triphala,candidate targets of each component and known therapeutic targets of CCVDs were collected.Compound-target gene and compounds-CCVDs target networks were created through network pharmacology data sources.In addition,key targets and pathway enrichment were analyzed by STRING database and DAVID database.Moreover,we verified three of the key targets(PTGS2,MMP9 and IL-6)predicted by using Western blotting analysis.RESULTS Network analysis determined 132 compounds in three herbal medicines that were subjected to ADME screening,and 23 compounds as well as 65 genes formed the principal pathways linked to CCVDs.And 10 compounds,which actually linked to more than three genes,are determined as crucial chemicals.Core genes in this network were IL-6,TNF,VEGFA,PTGS2,CXCL8,TP53,CCL2,IL-10,MMP9 and SERPINE1.And pathways in cancer,TNF signaling path⁃way,neuroactive ligand-receptor interaction,etc.related to CCVDs were identified.In vitro experiments,the results indi⁃cated that compared with the control group(no treatment),PTGS2,MMP9 and IL-6 were up-regulated by treatment of 10μg·L^-1 TNF-α,while pretreatment with 20-80 mg·L^-1 triphala could significantly inhibit the expression of PTGS2,MMP9 and IL-6.With increasing Triphala concentration,the expression of PTGS2,MMP9 and IL-6 decreased.CON⁃CLUSION Complex components and pharmacological mechanism of triphala,and obtained some potential therapeutic targets of CCVDs,which could provide theoretical basis for the research and development of new drugs for treating CCVDs.

Response of the sensorimotor cortex of cerebral palsy rats receiving transplantation of vascular endothelial growth factor 165-transfected neural stem cells

Neural stem cells are characterized by the ability to differentiate and stably express exogenous ge- nes. Vascular endothelial growth factor plays a role in protecting local blood vessels and neurons of newborn rats with hypoxic-ischemic encephalopathy. Transplantation of vascular endothelial growth factor-transfected neural stem cells may be neuroprotective in rats with cerebral palsy. In this study, 7-day-old Sprague-Dawley rats were divided into five groups： （1） sham operation （control）, （2） cerebral palsy model alone or with （3） phosphate-buffered saline, （4） vascular en- dothelial growth factor 165 ＋ neural stem cells, or （5） neural stem cells alone. The cerebral palsy model was established by ligating the left common carotid artery followed by exposure to hypox- ia. Phosphate-buffered saline, vascular endothelial growth factor ＋ neural stem cells, and neural stem cells alone were administered into the sensorimotor cortex using the stereotaxic instrument and microsyringe. After transplantation, the radial-arm water maze test and holding test were performed. Immunohistochemistry for vascular endothelial growth factor and histology using hematoxylin-eosin were performed on cerebral cortex. Results revealed that the number of vas- cular endothelial growth factor-positive cells in cerebral palsy rats transplanted with vascular endothelial growth factor-transfected neural stem cells was increased, the time for finding water and the finding repetitions were reduced, the holding time was prolonged, and the degree of cell degeneration or necrosis was reduced. These findings indicate that the transplantation of vascu- lar endothelial growth factor-transfected neural stem cells alleviates brain damage and cognitive deficits, and is neuroprotective in neonatal rats with hypoxia ischemic-mediated cerebral palsy.

Pathogenesis of diabetic cerebral vascular disease complication

Diabetes mellitus is one of the most potent independent risk factors for the development of diabetic cerebral vascular disease(CVD). Many evidences suggested that hyperglycemia caused excess free fatty acids, the loss of endothelium-derived nitric oxide, insulin resistance, the prothrombotic state, endothelial dysfunction, the abnormal release of endothelial vasoactivators,vascular smooth muscle dysfunction, oxidative stress, and the downregulation of mi Rs participated in vessel generation and recovery as well as the balance of endotheliocytes. In turn, these abnormalities, mainly via phosphatidylinositol 3 kinase, mitogen-activated protein kinase, polyol, hexosamine, protein kinase C activation, and increased generation of advanced glycosylation end products pathway, play an important role in inducing diabetic CVD complication. A deeper comprehension of pathogenesis producing diabetic CVD could offer base for developing new therapeutic ways preventing diabetic CVD complications, therefore, in the paper we mainly reviewed present information about the possible pathogenesis of diabetic CVD complication.

The Relationships between Respiratory Disease, Cardio-cerebral Vascular Disease and Temperature Change

Respiratory disease and cardio-cerebral vascular disease frequently occur in Anyang City. In this paper, by comparing incidence num- bers of respiratory disease and cardio-cerebral vascular disease in Anyang People＇s Hospital during 2010 -2012 with seasonal change of local tem- perature,it is found that they have obvious relationship, which has very important significance for preventing respiratory disease and cardio-cerebral vascular disease in the future.

A Study on the Correlation Between Cerebral Small Vascular Disease and Constitution Types of Traditional Chinese Medicine

Objective:To study the correlation between cerebral small vascular disease and constitution types of Traditional Chinese Medicine(TCM).Methods:The severity of lacunar infarction and leukoaraiosis were graded in 230 patients with cerebral small vascular disease,and they were divided into TCM constitution types.The survey of TCM constitution types was carried out by using standardized TCM constitution scale,and order multivariate Logistic regression was used to analyze the correlation between TCM constitution types with severity of lacunar infarction and leukoaraiosis.Results:Yang-deficiency(阳虚)constitution,blood-stasis constitution and phlegm-dampness constitution were the most common TCM constitution types in patients with lacunar infarction,accounting for 33.7%,12.5%,11.5%respectively.Yang-deficiency constitution,blood-stasis constitution and Yin-deficiency(阴虚)constitution were the most common TCM constitution types in patients with leukoaraiosis,accounting for 28.8%,18.5%,13.7%respectively.There were significant differences in lacunar infarction of Yang-deficiency constitution and blood stasis constitution(P<0.05),and there were significant differences in leukoaraiosis of phlegmdampness constitution and blood-stasis constitution(P<0.05).Single factor analysis showed that the main risk factors of lacunar infarction were age,smoking,alcohol consumption,Yang-deficiency constitution and blood-stasis constitution,and the main risk factors of leukoaraiosis were age,smoking,hypertensive disease,phlegm-dampness constitution and blood-stasis constitution.The ordered multivariate Logistic regression analysis found that the severity of lacunar infarction was closely related to age,and the severity of leukoplosis was closely related to age,smoking and hypertension disease.Conclusion:TCM constitution types of lacunar infarction in patients with small cerebral vascular disease is mainly Yang-deficiency constitution and blood-stasis constitution,and the risk factors include age,smoking,alcohol consumption,Yang-deficiency constitution and blood-stasis constitution.Age is closely related with lacunar infarction.TCM constitution types with leukoaraiosis are mainly phlegm-dampness constitution and blood-stasis constitution,and the risk factors are age,smoking,hypertension disease,phlegm-dampness constitution and blood-stasis constitution.Age,smoking and hypertension disease are closely related with leukoaraiosis.

Human pluripotent stem cell-derived kidney organoids:Current progress and challenges

Human pluripotent stem cell(hPSC)-derived kidney organoids share similarities with the fetal kidney.However,the current hPSC-derived kidney organoids have some limitations,including the inability to perform nephrogenesis and lack of a corticomedullary definition,uniform vascular system,and coordinated exit path-way for urinary filtrate.Therefore,further studies are required to produce hPSC-derived kidney organoids that accurately mimic human kidneys to facilitate research on kidney development,regeneration,disease modeling,and drug screening.In this review,we discussed recent advances in the generation of hPSC-derived kidney organoids,how these organoids contribute to the understanding of human kidney development and research in disease modeling.Additionally,the limitations,future research focus,and applications of hPSC-derived kidney organoids were highlighted.

同型半胱氨酸、胱抑素C、高密度脂蛋白胆固醇与脑小血管病患者认知障碍的关系

目的 探讨同型半胱氨酸(Hcy)、胱抑素C(Cys C)、高密度脂蛋白胆固醇(HDL-C)与脑小血管病(CSVD)患者认知障碍的关系。方法 回顾性选取2021年8月至2023年6月浙江中医药大学附属温州市中医院收治的119例CSVD患者为研究对象,根据蒙特利尔认知评估量表(Mo CA)评分分为认知障碍组62例,认知正常组57例;比较两组患者临床资料。采用多因素logistic回归分析CSVD患者发生认知障碍的影响因素,采用ROC曲线分析HDL-C、Hcy、Cys C对CSVD患者发生认知障碍的预测效能,采用Pearson相关分析这些实验室指标与CSVD认知障碍患者Mo CA评分的相关性。结果 认知障碍组高血压、糖尿病比例以及Hcy、Cys C水平均高于认知正常组,HDL-C、白蛋白水平均低于认知正常组,差异均有统计学意义(均P<0.05)。高血压(OR=4.221)、糖尿病(OR=3.059)、HDL-C(OR=0.070)、Hcy(OR=1.176)、Cys C(OR=1.178)均是CSVD患者发生认知障碍的独立影响因素(均P<0.05)。HDL-C、Hcy、Cys C预测CSVD患者发生认知障碍的AUC分别为0.723、0.807、0.799。HDL-C与CSVD认知障碍患者Mo CA评分呈正相关(r=0.362,P=0.004),而Hcy、Cys C与Mo CA评分均呈负相关(r=-0.410、-0.394,均P<0.01)。结论 HDL-C、Hcy、Cys C与CSVD患者认知障碍的发生关系密切,可为认知障碍的诊断与防治提供参考。

糖尿病前期对皮质下缺血性血管性认知障碍的影响

目的探讨糖尿病前期对皮质下缺血性血管性认知障碍(SIVCI)的影响。方法回顾性分析2017年4月至2022年7月于作者医院就诊的皮质下缺血性脑血管病(SIVD)患者242例。依据认知功能分为血管性痴呆组(VaD),轻度认知障碍组(vMCI)以及无认知障碍组(NoCI),记录并应用单因素分析比较各组一般临床资料以及空腹血糖、糖化血红蛋白等生化指标,以及颅内脑白质病变(WMLs)的Fazekas评分、腔隙性脑梗死评级等影像学指标的差异,并将组间差异有统计学意义(P<0.05)的指标纳入有序Logistic回归方程,分析SIVD发生SIVCI的危险因素。结果VaD组及vMCI组的受教育程度低于NoCI组,高血压、糖代谢异常的患者比例高于NoCI组,而VaD组糖尿病患者比例高于vMCI组(均P<0.05),VaD组与vMCI组的受教育程度、高血压、糖尿病前期患者比例差异无统计学意义(P>0.05);VaD组的MMSE评分低于vMCI组及NoCI组,重度WMLs患者比例高于vMCI组及NoCI组,vMCI组MMSE评分低于NoCI组(均P<0.05),vMCI组与NoCI组的重度WMLs比例差异无统计学意义(P>0.05)。有序Logistic回归分析提示糖尿病〔OR(95%CI)=2.921(1.636~5.215),P=0.001〕及糖尿病前期〔OR(95%CI)=2.743(1.461~5.150),P=0.002〕均是SIVD患者发生SIVCI的危险因素。受教育程度低〔OR(95%CI)=0.861(0.811~0.914),P=0.001〕、有高血压史〔OR(95%CI)=1.867(1.089~3.201),P=0.023〕、重度WMLs〔OR(95%CI)=2.227(1.344~3.690),P=0.002〕也是发生SIVCI的危险因素。结论除了受教育程度低、高血压史以及重度WMLs以外,糖尿病前期及糖尿病也是SIVD患者发生认知障碍的危险因素。对SIVD患者早期进行糖代谢筛查,在糖尿病前期进行血糖干预有助于预防SIVCI发生。

TCD监测颅内血流动力学变化与脑小血管病患者病情严重程度及神经功能恶化的相关性

目的探讨经颅多普勒超声(TCD)监测颅内血流动力学变化与脑小血管病(CSVD)患者病情严重程度及神经功能恶化的相关性,为早期制定治疗方案、改善CSVD预后提供参考依据。方法回顾性分析2022-01—2023-12在郑州大学第二附属医院住院的98例CSVD患者的临床资料,采用磁共振成像(MRI)评估CSVD患者的MRI总负荷,采用经颅多普勒(TCD)监测大脑中动脉(MCA)和大脑前动脉(ACA)双侧血流动力学参数血流速度(Vm)、搏动指数(PI),比较轻中度负荷组和重度负荷组MCA和ACA的Vm、PI值,分析MCA和ACA的Vm、PI值与CSVD患者MRI负荷严重程度的相关性。根据CSVD患者入院1周内是否发生神经功能恶化分为恶化组和未恶化组,比较2组患者MCA和ACA的Vm、PI值,分析MCA和ACA的Vm、PI值与CSVD患者发生神经功能恶化的相关性。结果重度负荷组患者入院时MCA和ACA的Vm(41.35±5.47、35.44±3.37)均低于轻中度负荷组(48.32±6.43、44.61±4.86),而重度负荷组MCA和ACA的PI(1.17±0.26、0.98±0.23)均高于轻中度负荷组(0.92±0.21、0.78±0.19),组间比较差异均有统计学意义(P<0.05);MCA和ACA的Vm与MRI负荷严重程度呈负相关,而PI与MRI负荷严重程度呈正相关(均P<0.05);恶化组入院时MCA和ACA的Vm(39.38±4.37、34.11±2.34)均低于未恶化组(48.34±6.07、44.11±4.82),而恶化组MCA和ACA的PI(1.25±0.22、1.06±0.16)均高于未恶化组(0.91±0.19、0.76±0.19),组间比较差异有统计学意义(P<0.05);MCA和ACA的Vm与CSVD患者神经功能恶化的发生呈负相关,而PI与CSVD患者神经功能恶化的发生呈正相关(均P<0.05)。结论颅内血流动力学参数异常与CSVD患者病情严重程度和神经功能恶的发生均具有相关性,通过TCD监测CSVD患者的颅内血流动力学参数,可早期评估CSVD患者的严重程度,早期发现神经功能恶化的风险。

脑小血管病患者对氧磷酶1、载脂蛋白A1、脂蛋白相关磷脂酶A2水平与脑白质高信号及认知功能的关系探讨

目的:探讨脑小血管病(CVSD)患者对氧磷酶1(PON1)、载脂蛋白A1(ApoA1)、脂蛋白相关磷脂酶A2(LP-PLA2)水平与脑白质高信号(WMH)及认知功能的关系。方法:选取2022-01-2024-01我院收治的165例CVSD患者为研究对象,依据蒙特利尔认知评估量表(MoCA)将其分为无血管性认知损害组(N-VCI,94例)和血管性认知损伤组(VCI,71例)。同期选取165例近1个月体检健康人群作为对照组。比较三组的MoCA评分以及血清PON1、ApoA1、Lp-PLA2水平。采用Fazekas量表评估患者的WMH严重程度。运用相关法分析PON1、ApoA1、Lp-PLA2水平与MoCA、WMH程度的相关性。通过受试者工作特征(ROC)曲线分析PON1、ApoA1、Lp-PLA2单独或联合检测对VCI的临床诊断价值。结果:相较于对照组,N-VCI组和VCI组MoCA评分、PON1、ApoA1水平更低,而Lp-PLA2水平更高(P<0.05);相较于N-VCI组,VCI组PON1、ApoA1水平更低,而Lp-PLA2水平、WMH严重程度、侧脑室旁高信号评分、深部白质高信号评分更高(P<0.05);相关分析显示,PON1、ApoA1水平与MoCA评分呈正相关,与WMH严重程度、PVWMH评分、DWMH评分呈负相关,而Lp-PLA2水平与MoCA评分呈负相关,与WMH严重程度、PVWMH评分、DWMH评分呈正相关(P<0.05)。ROC曲线分析显示,PON1、ApoA1、Lp-PLA2单独诊断患者VCI的曲线下面积(AUC)>0.8,三者联合检测诊断VCI的AUC>0.9。结论:PON1、ApoA1、Lp-PLA2水平与CVSD患者的WMH和认知功能密切相关。三者单独或联合检测对诊断VCI有一定临床价值。

阿托伐他汀联合胞磷胆碱治疗脑小血管病轻度认知障碍疗效观察

目的 分析阿托伐他汀联合胞磷胆碱治疗脑小血管病(CSVD)轻度认知障碍(MCI)的疗效及对患者血-脑屏障功能和炎症因子的影响。方法 选取2021-03—2023-03自贡市第四人民医院收治的102例CSVD合并MCI患者为研究对象,分为观察组与对照组各51例。对照组口服胞磷胆碱钠片,观察组在对照组基础上加用阿托伐他汀钙片口服,2组均持续治疗3个月。治疗结束后比较2组患者临床疗效,以及治疗前、治疗3个月后蒙特利尔评定量表(MoCA)评分、血-脑屏障功能、炎症因子水平[血清C反应蛋白(CRP)、白细胞介素-6(IL-6)]和血脂水平[总胆固醇(TC)、甘油三酯(TG)和低密度脂蛋白(LDL-C)],记录治疗期间不良反应。结果 治疗后观察组总有效率优于对照组(94.12%比78.43%,P<0.05)。2组患者MoCA评分较治疗前均显著升高,观察组为(27.07±1.05)分,高于对照组的(25.89±1.54)分(P<0.05)。2组患者治疗后伊文思蓝水平、血清CRP、IL-6水平、血清TC、TG和LDL-C水平较治疗前均降低,观察组分别为(10.29±1.17)μg/g、(4.67±1.03)mg/L、(101.76±10.54)ng/L、(2.06±0.46)mmol/L、(1.65±0.32)mmol/L、(1.84±0.30)mmol/L,均低于对照组的(13.87±1.56)μg/g、(6.93±1.78)mg/L、(109.34±11.12)ng/L、(3.24±0.49)mmol/L、(2.24±0.48)mmol/L、(2.39±0.46)mmol/L(P<0.05)。2组患者治疗期间相关不良反应发生率无统计学差异(7.84%比5.88%,P>0.05)。结论 阿托伐他汀联合胞磷胆碱治疗CSVD合并MCI疗效确切,有利于改善患者认知功能、血-脑屏障功能,并降低炎症因子和脂质代谢水平。

水蛭治疗脑小血管病所致认知功能障碍的疗效分析

目的探究水蛭饮片治疗脑小血管病(Cerebral Small Vessel Disease,CSVD)所致认知障碍患者的临床疗效。方法方便选取2020年10月—2023年6月广西壮族自治区民族医院神经内科收治的120例CSVD所致认知障碍患者为研究对象,以随机数表法分为对照组和观察组,各60例。对照组实施内科常规西药基础治疗,观察组在对照组治疗基础上增加中药水蛭口服治疗。观察并对比两组的治疗结果。结果治疗后与对照组相比,观察组最小量认知评估量表(Mini Mental State Examination,MMSE)评分、蒙特利尔认知评估量表(Montreal Cognitive Assessment,MoCA)评分更高,差异有统计学意义(P均<0.05)。观察组临床治疗有效率(86.67%)显著高于对照组(71.67%),差异有统计学意义(χ^(2)=4.093,P<0.05)。治疗后与对照组相比,观察组的白细胞介素-6(Interleukin-6,IL-6)和超敏-C反应蛋白(High Sensitive C-reactive Protein,hs-CRP)水平更低,差异有统计学意义(P均<0.05)。结论水蛭能有效减轻CSVD所致认知障碍患者的临床症状,改善患者的认知功能障碍。