BACKGROUND Chemotherapy for malignant tumors can cause brain changes and cognitive impairment,leading to chemotherapy-induced cognitive impairment(CICI).Current research on CICI has focused on breast cancer and Hodgki...BACKGROUND Chemotherapy for malignant tumors can cause brain changes and cognitive impairment,leading to chemotherapy-induced cognitive impairment(CICI).Current research on CICI has focused on breast cancer and Hodgkin’s lymphoma.Whether patients with non-Hodgkin’s lymphoma(NHL)undergoing chemo-therapy have cognitive impairment has not been fully investigated.therapy have cognitive impairment has not been fully investigated.AIM To investigate whether NHL patients undergoing chemotherapy had cognitive impairments.METHODS The study included 100 NHL patients who were required to complete a compre-hensive psychological scale including the Brief Psychiatric Examination Scale(MMSE)at two time points:before chemotherapy and within 2 wk of two chemo-therapy courses.A language proficiency test(VFT),Symbol Number Pattern Test(SDMT),Clock Drawing Test(CDT),Abbreviated Daily Cognition Scale(ECog-12),Prospective and Retrospective Memory Questionnaire,and Karnofsky Perfor-mance Status were used to assess cognitive changes before and after chemo-therapy.RESULTS The VFT scores for before treatment(BT)and after treatment(AT)groups were 45.20±15.62,and 42.30±17.53,respectively(t-2.16,P<0.05).The CDT scores were 8(3.5-9.25)for BT and 7(2.5-9)for AT groups(Z-2.1,P<0.05).Retrospective memory scores were 13.5(9-17)for BT and 15(13-18)for AT(Z-3.7,P<0.01).The prospective memory scores were 12.63±3.61 for BT and 14.43±4.32 for AT groups(t-4.97,P<0.01).The ECog-12 scores were 1.71(1.25-2.08)for BT and 1.79(1.42-2.08)for AT groups(Z-2.84,P<0.01).The SDMT and MMSE values did not show a significant difference between BT and AT groups.CONCLUSION Compared to the AT group,the BT group showed impaired language,memory,and subjective cognition,but objec-tive cognition and execution were not significantly affected.展开更多
Objective:This study aimed to explore the efficacy and safety of Qingxin Fupi Jieyu formula(the herbal formula has the function of clear away the heart fire,tonify spleen,and relieve depression,QXFPJYF)in treating dig...Objective:This study aimed to explore the efficacy and safety of Qingxin Fupi Jieyu formula(the herbal formula has the function of clear away the heart fire,tonify spleen,and relieve depression,QXFPJYF)in treating digestive tract cancer-related cognitive impairment(CRCI).Methods:28 subjects with digestive tract CRCI were treated with QXFPJYF for 6 weeks.The scores of Montreal Cognitive Assessment and Mini-Mental State Examination were observed at four-time points(baseline,week 2,week 4,week 6).Besides,anxiety and depression scores and tumor markers were measured.Results:The scores of Montreal Cognitive Assessment and various fields were elevated steadily after treatment,such as visuospatial/executive,attention,language,delayed recall,and orientation.The differences were statistically significant(P<0.05)besides language score.The scores of Mini-Mental State Examination and various factors were elevated gradually at week 2,week 4 and week 6,including language and praxis,attention and calculation,recall and orientation,and the differences were statistically significant(P<0.05)except for recall score.The results also showed the change of tumor markers were not obvious,but anxious and depressed emotions were improved.More importantly,no subjects developed with obvious adverse reactions during the study.Conclusion:The finding indicated that QXFPJYF treated digestive tract CRCI with great efficacy and safety,which improved cognitive function from several fields.Nevertheless,the current study was limited by sample and medical ethics,and which was a self-control trial,some limitations needed to be acknowledged,further high-quality research is required to explore and verify it.展开更多
Objective:The aims of this study was to explore the clinical characteristics of patients with digestive tract cancer-related cognitive impairment(CRCI),and provide reference for the comprehensive clinical understandin...Objective:The aims of this study was to explore the clinical characteristics of patients with digestive tract cancer-related cognitive impairment(CRCI),and provide reference for the comprehensive clinical understanding,early prevention and treatment.Methods:164 patients with digestive tract cancer were divided into CRCI group and non-CRCI impairment group based on the Montreal Cognitive Assessment Scale(MOCA)and the Minimal Mental State Scale(MMSE).Baseline features,blood biochemical indexes,anxiety and depression were compared.Statistical analysis were carried out by SPSS software(version 20.0).Results:Among all the patients with CRCI,males were more common.Also,there were statistically differences in marital status,liver metastasis,hypertension,ferritin(FER),high density lipoprotein-cholesterol(HDL-C),low density lipoprotein-cholesterol(LDL-C),NK cells,anxiety and depression(P<0.05).Conclusion:Part of patients with digestive tract cancer have varied degrees of cognitive dysfunction.Marital status,hypertension,immune function,liver metastasis and serum lipid metabolism were the risk factors for patients with digestive tract CRCI.Early identification of CRCI is of great significance to ensure the integrity of treatment,improve the quality of life and prognosis for patients with digestive tract CRCI.展开更多
Objective:To discuss the clinical effects of Western medicine therapy assisted by Ginkgo biloba tablet(GBT) on patients with vascular cognitive impairment of none dementia(VCIND).Methods: A total of 80 patients with V...Objective:To discuss the clinical effects of Western medicine therapy assisted by Ginkgo biloba tablet(GBT) on patients with vascular cognitive impairment of none dementia(VCIND).Methods: A total of 80 patients with VCIND were divided into two groups randomly:Conventional treatment group(control group) and combined treatment group.Conventional treatment group was given conventional treatment with anti-platelet aggregation.In this group,75 mg aspirin was given three times a day for 3 months.While in combined treatment group,19.2 mg CRT was given three times a day for 3 months together with conventional treatment(anti-platelet aggregation drugs). Montreal cognitive assessment(MoCA) and transcranial Doppler(TCD) were used to observe changes of cognitive ability and cerebral blood flow in VCIND patients before and after treatment in both groups.Then the clinical data were analyzed so as to compare the efficacy in two groups. Results:After 3 month-treatment in combined treatment group,the scores of executive ability, attention,abstract,delayed memory,orientation in the MoCA were significantly increased compared with those before treatment and those in control group after treatment.Besides,blood flow velocity of anterior cerebral artery increased significandy than that before treatment and that in control group after treatment.Conclusions:CBT tablet can improve the therapeutic efficacy as well improve cognitive ability and cerebral blood flow supply of patients with VCIND.展开更多
Individuals with amnestic mild cognitive impairment(aMCI)have a high risk of developing Alzheimer’s disease.Although repetitive transcranial magnetic stimulation(rTMS)is considered a potentially effective treatment f...Individuals with amnestic mild cognitive impairment(aMCI)have a high risk of developing Alzheimer’s disease.Although repetitive transcranial magnetic stimulation(rTMS)is considered a potentially effective treatment for cognitive impairment in patients with aMCI,the neuroimaging mechanisms are poorly understood.Therefore,we performed a double-blind randomized sham-controlled trial in which rTMS was applied to the left dorsolateral prefrontal cortex of aMCI patients recruited from a community near the Third Hospital Affiliated to Sun Yat-sen University,China.Twenty-four patients with aMCI were randomly assigned to receive true rTMS(treatment group,n=12,6 men and 6 women;age 65.08±4.89 years)or sham stimulation(sham group,n=12,5 men and 7 women;age 64.67±4.77 years).rTMS parameters included a stimulation frequency of 10 Hz,stimulation duration of 2 seconds,stimulation interval of 8 seconds,20 repetitions at 80%of the motor threshold,and 400 pulses per session.rTMS/sham stimulation was performed five times per week over a period of 4 consecutive weeks.Our results showed that compared with baseline,Montreal Cognitive Assessment scores were significantly increased and the value of the amplitude of low-frequency fluctuation(ALFF)was significantly increased at the end of treatment and 1 month after treatment.Compared with the sham group,the ALFF values in the right inferior frontal gyrus,triangular part of the inferior frontal gyrus,right precuneus,left angular gyrus,and right supramarginal gyrus were significantly increased,and the ALFF values in the right superior frontal gyrus were significantly decreased in the treatment group.These findings suggest that high-frequency rTMS can effectively improve cognitive function in aMCI patients and alter spontaneous brain activity in cognitive-related brain areas.This study was approved by the Ethics Committee of Shenzhen Baoan Hospital of Southern Medical University,China(approval No.BYL20190901)on September 3,2019 and registered in the Chinese Clinical Trials Registry(registration No.ChiCTR1900028180)on December 14,2019.展开更多
Objective We investigated the feasibility and efficacy of cognitive training for older adults in rura settings and with low education levels, who have mild cognitive impairment （MCl）. Methods Forty-five older adults...Objective We investigated the feasibility and efficacy of cognitive training for older adults in rura settings and with low education levels, who have mild cognitive impairment （MCl）. Methods Forty-five older adults （ages 〉65 years） with MCI were assigned to treatment or control groups, at a 2：1 ratio. Cognitive training occurred in the treatment group for 2 months. The cognitive abilities of the participants were assessed at pre-training, metaphase, and post-training time points, using the Mini-Mental State Examination （MMSE）, Montreal Cognitive Assessment （MoCA）, Loewenstein Occupational Therapy Cognitive Assessment （LOTCA）, and Hamilton Depression Scale （HAM-D）. Results Following training, cognitive abilities improved in the treatment group, based on the total scores of all 4 measures, as well as specifically on the MoCA and LOTCA. There were differences in the main effects of group and time point on some subscales, but these differences had little, if any, effect on the overall analyses. Conclusion The present study demonstrated that cognitive training has beneficial effects on attention, language, orientation, visual perception, organization of visual movement, and logical questioning in patients with MCI. Furthermore, the observed effects are long-term changes.展开更多
We report a case of a 21-year-old man who had severe traumatic brain injury as a result of an accident at the age of 16 years. Two years and 4 months after the trauma, at the age of 19 years, he still had severe right...We report a case of a 21-year-old man who had severe traumatic brain injury as a result of an accident at the age of 16 years. Two years and 4 months after the trauma, at the age of 19 years, he still had severe right hemiplegia and cognitive dysfunction including aphasia and attention and memory disturbance. Conventional rehabilitation programs cou（d not resolve all of the neuropsychological problems. He started receiving Goshinjo therapy over a period of 22 months. Following the therapy, significant improvements in verbal intelligence quotient （assessed by the Wechsler Adult Intelligence Scale-Third Edition） and attention and concentration function （using the Wechsler Memory Scale-Revised）, and remission of traumatic epilepsy were observed. Goshinjo therapy is suspected to be effective in the treatment of cognitive dysfunction in the chronic stage after severe traumatic brain injury.展开更多
目的明确脑小血管病(cerebral small vessel disease,CSVD)患者认知障碍(cognitive impairment,CI)的独立危险因素并构建列线图临床预测模型。方法回顾性纳入2017年1月1日~2022年12月31日于西安交通大学第一附属医院住院诊断为脑小血管...目的明确脑小血管病(cerebral small vessel disease,CSVD)患者认知障碍(cognitive impairment,CI)的独立危险因素并构建列线图临床预测模型。方法回顾性纳入2017年1月1日~2022年12月31日于西安交通大学第一附属医院住院诊断为脑小血管病的患者共247例,依据简易认知状态量表(mini-mental state examination,MMSE)分为伴有认知障碍组(CSVD-CI组,n=83)及无认知障碍组(CSVD-NCI组,n=164),通过Logistic回归筛选其发生认知障碍的影响因素,基于筛选的影响因素建立列线图临床预测模型并检验该模型效能。结果与CSVD-NCI组相比,CSVD-CI组患者中性粒细胞/淋巴细胞比值(neutrophil/lymphocyte ratio,NLR)(3.03±2.56 vs 2.33±1.34)和清蛋白/球蛋白比值(1.58±0.27 vs 1.49±0.28)显著增高、估测肾小球滤过率(estimated glomerular filtration rate,eGFR)[88.59±16.59 ml/(min·1.73m^(2))vs 94.02±12.45 ml/(min·1.73m^(2))]显著减低,差异具有统计学意义(t=2.282,2.426,2.689,均P<0.05)。与CSVD-NCI组比较,CSVD-CI组患者男性比例更低(43.4%vs 67.7%),且受教育程度更低(2.13±1.50 vs 2.86±1.12),差异具有统计学意义(χ^(2)=13.516,t=4.283,均P<0.001)。NLR(OR:1.20,95%CI:1.01~1.43),性别(OR:0.43,95%CI:0.24~0.79),eGFR(OR:0.97,95%CI:0.95~0.99)及受教育程度(OR:0.72,95%CI:0.57~0.91)为CSVD患者发生认知障碍的影响因素。基于此四项影响因素建立列线图预测模型具有良好的认知障碍预测效能(AUC=0.704,95%C:0.633~0.766)。结论构建的列线图在预测CSVD患者认知功能障碍的发生方面具有较高的准确度和临床实用性。展开更多
Background:The incidence of cognitive impairment(CI)is gradually increasing,which has attracted more attention from medical researchers worldwide.Definitive mechanisms of pathogenesis remain elusive,and there are few ...Background:The incidence of cognitive impairment(CI)is gradually increasing,which has attracted more attention from medical researchers worldwide.Definitive mechanisms of pathogenesis remain elusive,and there are few medications that have been proven effective for CI.The utilization of Chinese herbal medicine has shown positive therapeutic effects for a broad spectrum of diseases,including CI.Objective:The purpose of this study is to evaluate the safety and efficacy of Guilingji Capsules(GLJC,龟龄集胶囊)in treating mild-to-moderate CI with Shen(Kidney)and marrow deficiency syndrome.Methods:This is a randomized,double-blind,positive-controlled,multicenter clinical trial with a noninferiority design that included 348 participants randomly divided into an experimental arm and an active comparator arm.Individuals in the experimental arm(174 cases)took 0.6 g of GLJC once a day and 19.2 mg of Gingko biloba extract mimetic 3 times a day.Individuals in the active comparator arm(174 cases)took 0.6 g of GLJC mimetic once a day and 19.2 mg of Gingko biloba extract in tablet form 3 times a day.The intervention period included two sessions over 24 weeks.The primary outcome be the effectiveness of GLJC on cognitive improvement after 24 weeks of treatment,which was defined as an increase in the Mini Mental State Examination(MMSE)and Montreal Cognitive Assessment(MoCA)Scale.The secondary outcomes were improvement in independence,daily living ability,and Chinese medicine(CM)syndrome,which were measured with the Alzheimer’s disease Rating Scale-Cognitive Project(ADAS-Cog),Clinical Dementia Rating(CDR)Total Score,Activities of Daily Living(ADL)Total Score and the Chinese Medicine Symptom Scale(CM-SS),respectively.Serum acetylcholine,acetylcholinesterase,bax and bcl-2 were monitored to explore the mechanism of GLJC on CI.In addition,safety measures,including vital signs,electrocardiography,laboratory indicators(full blood count,kidney and liver function tests,routine urine test and routine stool test)and adverse events,were also recorded.Discussion:The purpose of this trial is to evaluate the efficacy and safety of GLJC in patients with mild-to-moderate CI with kidney and marrow deficiency syndrome.If successful,the results would provide a viable treatment for patients with mild-to-moderate CI.展开更多
随着社会老龄化的加重,血管性认知障碍和痴呆(vascular cognitive impairment and dementia,VCID)的发病率日益升高,挖掘与研究可以阻止疾病进展的有效干预方剂具有重要的社会意义。中医“瘀血理论”对健忘、精神异常等认知减退症状有...随着社会老龄化的加重,血管性认知障碍和痴呆(vascular cognitive impairment and dementia,VCID)的发病率日益升高,挖掘与研究可以阻止疾病进展的有效干预方剂具有重要的社会意义。中医“瘀血理论”对健忘、精神异常等认知减退症状有丰富、明确的论述。通窍活血汤出自清代王清任《医林改错》,具有活血化瘀、通窍活络之功效,其原书所载治疗症目十三条,主要治疗头目、官窍等因血瘀引起的病证。通窍活血汤因其临床疗效确切、组方精妙,在当代临床中应用十分广泛。临床及基础研究表明,通窍活血汤可以通过调节炎症、自噬、凋亡、氧化应激等途径改善β淀粉样蛋白的沉积和Tau蛋白过度磷酸化引起的神经退行性改变发挥治疗血管性认知障碍和痴呆。通过查阅文献,综述近年来通窍活血汤及其加减化裁方治疗血管性认知障碍和痴呆上的临床应用及基础研究进展,为其更广泛地研究提供支持。展开更多
文摘BACKGROUND Chemotherapy for malignant tumors can cause brain changes and cognitive impairment,leading to chemotherapy-induced cognitive impairment(CICI).Current research on CICI has focused on breast cancer and Hodgkin’s lymphoma.Whether patients with non-Hodgkin’s lymphoma(NHL)undergoing chemo-therapy have cognitive impairment has not been fully investigated.therapy have cognitive impairment has not been fully investigated.AIM To investigate whether NHL patients undergoing chemotherapy had cognitive impairments.METHODS The study included 100 NHL patients who were required to complete a compre-hensive psychological scale including the Brief Psychiatric Examination Scale(MMSE)at two time points:before chemotherapy and within 2 wk of two chemo-therapy courses.A language proficiency test(VFT),Symbol Number Pattern Test(SDMT),Clock Drawing Test(CDT),Abbreviated Daily Cognition Scale(ECog-12),Prospective and Retrospective Memory Questionnaire,and Karnofsky Perfor-mance Status were used to assess cognitive changes before and after chemo-therapy.RESULTS The VFT scores for before treatment(BT)and after treatment(AT)groups were 45.20±15.62,and 42.30±17.53,respectively(t-2.16,P<0.05).The CDT scores were 8(3.5-9.25)for BT and 7(2.5-9)for AT groups(Z-2.1,P<0.05).Retrospective memory scores were 13.5(9-17)for BT and 15(13-18)for AT(Z-3.7,P<0.01).The prospective memory scores were 12.63±3.61 for BT and 14.43±4.32 for AT groups(t-4.97,P<0.01).The ECog-12 scores were 1.71(1.25-2.08)for BT and 1.79(1.42-2.08)for AT groups(Z-2.84,P<0.01).The SDMT and MMSE values did not show a significant difference between BT and AT groups.CONCLUSION Compared to the AT group,the BT group showed impaired language,memory,and subjective cognition,but objec-tive cognition and execution were not significantly affected.
文摘Objective:This study aimed to explore the efficacy and safety of Qingxin Fupi Jieyu formula(the herbal formula has the function of clear away the heart fire,tonify spleen,and relieve depression,QXFPJYF)in treating digestive tract cancer-related cognitive impairment(CRCI).Methods:28 subjects with digestive tract CRCI were treated with QXFPJYF for 6 weeks.The scores of Montreal Cognitive Assessment and Mini-Mental State Examination were observed at four-time points(baseline,week 2,week 4,week 6).Besides,anxiety and depression scores and tumor markers were measured.Results:The scores of Montreal Cognitive Assessment and various fields were elevated steadily after treatment,such as visuospatial/executive,attention,language,delayed recall,and orientation.The differences were statistically significant(P<0.05)besides language score.The scores of Mini-Mental State Examination and various factors were elevated gradually at week 2,week 4 and week 6,including language and praxis,attention and calculation,recall and orientation,and the differences were statistically significant(P<0.05)except for recall score.The results also showed the change of tumor markers were not obvious,but anxious and depressed emotions were improved.More importantly,no subjects developed with obvious adverse reactions during the study.Conclusion:The finding indicated that QXFPJYF treated digestive tract CRCI with great efficacy and safety,which improved cognitive function from several fields.Nevertheless,the current study was limited by sample and medical ethics,and which was a self-control trial,some limitations needed to be acknowledged,further high-quality research is required to explore and verify it.
文摘Objective:The aims of this study was to explore the clinical characteristics of patients with digestive tract cancer-related cognitive impairment(CRCI),and provide reference for the comprehensive clinical understanding,early prevention and treatment.Methods:164 patients with digestive tract cancer were divided into CRCI group and non-CRCI impairment group based on the Montreal Cognitive Assessment Scale(MOCA)and the Minimal Mental State Scale(MMSE).Baseline features,blood biochemical indexes,anxiety and depression were compared.Statistical analysis were carried out by SPSS software(version 20.0).Results:Among all the patients with CRCI,males were more common.Also,there were statistically differences in marital status,liver metastasis,hypertension,ferritin(FER),high density lipoprotein-cholesterol(HDL-C),low density lipoprotein-cholesterol(LDL-C),NK cells,anxiety and depression(P<0.05).Conclusion:Part of patients with digestive tract cancer have varied degrees of cognitive dysfunction.Marital status,hypertension,immune function,liver metastasis and serum lipid metabolism were the risk factors for patients with digestive tract CRCI.Early identification of CRCI is of great significance to ensure the integrity of treatment,improve the quality of life and prognosis for patients with digestive tract CRCI.
基金supported by National 'Eleventh Five-year Plan' Science and Technology Support Project(2006BAI06A15-3)
文摘Objective:To discuss the clinical effects of Western medicine therapy assisted by Ginkgo biloba tablet(GBT) on patients with vascular cognitive impairment of none dementia(VCIND).Methods: A total of 80 patients with VCIND were divided into two groups randomly:Conventional treatment group(control group) and combined treatment group.Conventional treatment group was given conventional treatment with anti-platelet aggregation.In this group,75 mg aspirin was given three times a day for 3 months.While in combined treatment group,19.2 mg CRT was given three times a day for 3 months together with conventional treatment(anti-platelet aggregation drugs). Montreal cognitive assessment(MoCA) and transcranial Doppler(TCD) were used to observe changes of cognitive ability and cerebral blood flow in VCIND patients before and after treatment in both groups.Then the clinical data were analyzed so as to compare the efficacy in two groups. Results:After 3 month-treatment in combined treatment group,the scores of executive ability, attention,abstract,delayed memory,orientation in the MoCA were significantly increased compared with those before treatment and those in control group after treatment.Besides,blood flow velocity of anterior cerebral artery increased significandy than that before treatment and that in control group after treatment.Conclusions:CBT tablet can improve the therapeutic efficacy as well improve cognitive ability and cerebral blood flow supply of patients with VCIND.
基金This work was supported by the National Natural Science Foundation of China,No.81874032(to GZH)the Science and Technology Planning Project of Shenzhen of China,No.JCYJ20160427191726109(to FZ)+1 种基金the Science and Technology Planning Project of Guangdong Province of China,No.2016A020215202(to SHC)Shenzhen Health and Family Planning System Research Project of China,No.SZXJ2017069(to SHC).
文摘Individuals with amnestic mild cognitive impairment(aMCI)have a high risk of developing Alzheimer’s disease.Although repetitive transcranial magnetic stimulation(rTMS)is considered a potentially effective treatment for cognitive impairment in patients with aMCI,the neuroimaging mechanisms are poorly understood.Therefore,we performed a double-blind randomized sham-controlled trial in which rTMS was applied to the left dorsolateral prefrontal cortex of aMCI patients recruited from a community near the Third Hospital Affiliated to Sun Yat-sen University,China.Twenty-four patients with aMCI were randomly assigned to receive true rTMS(treatment group,n=12,6 men and 6 women;age 65.08±4.89 years)or sham stimulation(sham group,n=12,5 men and 7 women;age 64.67±4.77 years).rTMS parameters included a stimulation frequency of 10 Hz,stimulation duration of 2 seconds,stimulation interval of 8 seconds,20 repetitions at 80%of the motor threshold,and 400 pulses per session.rTMS/sham stimulation was performed five times per week over a period of 4 consecutive weeks.Our results showed that compared with baseline,Montreal Cognitive Assessment scores were significantly increased and the value of the amplitude of low-frequency fluctuation(ALFF)was significantly increased at the end of treatment and 1 month after treatment.Compared with the sham group,the ALFF values in the right inferior frontal gyrus,triangular part of the inferior frontal gyrus,right precuneus,left angular gyrus,and right supramarginal gyrus were significantly increased,and the ALFF values in the right superior frontal gyrus were significantly decreased in the treatment group.These findings suggest that high-frequency rTMS can effectively improve cognitive function in aMCI patients and alter spontaneous brain activity in cognitive-related brain areas.This study was approved by the Ethics Committee of Shenzhen Baoan Hospital of Southern Medical University,China(approval No.BYL20190901)on September 3,2019 and registered in the Chinese Clinical Trials Registry(registration No.ChiCTR1900028180)on December 14,2019.
基金supported by the Department of Health,Heilongjiang Province,China
文摘Objective We investigated the feasibility and efficacy of cognitive training for older adults in rura settings and with low education levels, who have mild cognitive impairment （MCl）. Methods Forty-five older adults （ages 〉65 years） with MCI were assigned to treatment or control groups, at a 2：1 ratio. Cognitive training occurred in the treatment group for 2 months. The cognitive abilities of the participants were assessed at pre-training, metaphase, and post-training time points, using the Mini-Mental State Examination （MMSE）, Montreal Cognitive Assessment （MoCA）, Loewenstein Occupational Therapy Cognitive Assessment （LOTCA）, and Hamilton Depression Scale （HAM-D）. Results Following training, cognitive abilities improved in the treatment group, based on the total scores of all 4 measures, as well as specifically on the MoCA and LOTCA. There were differences in the main effects of group and time point on some subscales, but these differences had little, if any, effect on the overall analyses. Conclusion The present study demonstrated that cognitive training has beneficial effects on attention, language, orientation, visual perception, organization of visual movement, and logical questioning in patients with MCI. Furthermore, the observed effects are long-term changes.
文摘We report a case of a 21-year-old man who had severe traumatic brain injury as a result of an accident at the age of 16 years. Two years and 4 months after the trauma, at the age of 19 years, he still had severe right hemiplegia and cognitive dysfunction including aphasia and attention and memory disturbance. Conventional rehabilitation programs cou（d not resolve all of the neuropsychological problems. He started receiving Goshinjo therapy over a period of 22 months. Following the therapy, significant improvements in verbal intelligence quotient （assessed by the Wechsler Adult Intelligence Scale-Third Edition） and attention and concentration function （using the Wechsler Memory Scale-Revised）, and remission of traumatic epilepsy were observed. Goshinjo therapy is suspected to be effective in the treatment of cognitive dysfunction in the chronic stage after severe traumatic brain injury.
文摘目的明确脑小血管病(cerebral small vessel disease,CSVD)患者认知障碍(cognitive impairment,CI)的独立危险因素并构建列线图临床预测模型。方法回顾性纳入2017年1月1日~2022年12月31日于西安交通大学第一附属医院住院诊断为脑小血管病的患者共247例,依据简易认知状态量表(mini-mental state examination,MMSE)分为伴有认知障碍组(CSVD-CI组,n=83)及无认知障碍组(CSVD-NCI组,n=164),通过Logistic回归筛选其发生认知障碍的影响因素,基于筛选的影响因素建立列线图临床预测模型并检验该模型效能。结果与CSVD-NCI组相比,CSVD-CI组患者中性粒细胞/淋巴细胞比值(neutrophil/lymphocyte ratio,NLR)(3.03±2.56 vs 2.33±1.34)和清蛋白/球蛋白比值(1.58±0.27 vs 1.49±0.28)显著增高、估测肾小球滤过率(estimated glomerular filtration rate,eGFR)[88.59±16.59 ml/(min·1.73m^(2))vs 94.02±12.45 ml/(min·1.73m^(2))]显著减低,差异具有统计学意义(t=2.282,2.426,2.689,均P<0.05)。与CSVD-NCI组比较,CSVD-CI组患者男性比例更低(43.4%vs 67.7%),且受教育程度更低(2.13±1.50 vs 2.86±1.12),差异具有统计学意义(χ^(2)=13.516,t=4.283,均P<0.001)。NLR(OR:1.20,95%CI:1.01~1.43),性别(OR:0.43,95%CI:0.24~0.79),eGFR(OR:0.97,95%CI:0.95~0.99)及受教育程度(OR:0.72,95%CI:0.57~0.91)为CSVD患者发生认知障碍的影响因素。基于此四项影响因素建立列线图预测模型具有良好的认知障碍预测效能(AUC=0.704,95%C:0.633~0.766)。结论构建的列线图在预测CSVD患者认知功能障碍的发生方面具有较高的准确度和临床实用性。
基金Supported by Beijing Municipal Science and Technology Project(Capital Characteristic Clinic Project,No.Z171100001017106)Beijing Municipal Science and Technology Project"Ten Disease and Ten Medicine"(No.Z171100001717016)。
文摘Background:The incidence of cognitive impairment(CI)is gradually increasing,which has attracted more attention from medical researchers worldwide.Definitive mechanisms of pathogenesis remain elusive,and there are few medications that have been proven effective for CI.The utilization of Chinese herbal medicine has shown positive therapeutic effects for a broad spectrum of diseases,including CI.Objective:The purpose of this study is to evaluate the safety and efficacy of Guilingji Capsules(GLJC,龟龄集胶囊)in treating mild-to-moderate CI with Shen(Kidney)and marrow deficiency syndrome.Methods:This is a randomized,double-blind,positive-controlled,multicenter clinical trial with a noninferiority design that included 348 participants randomly divided into an experimental arm and an active comparator arm.Individuals in the experimental arm(174 cases)took 0.6 g of GLJC once a day and 19.2 mg of Gingko biloba extract mimetic 3 times a day.Individuals in the active comparator arm(174 cases)took 0.6 g of GLJC mimetic once a day and 19.2 mg of Gingko biloba extract in tablet form 3 times a day.The intervention period included two sessions over 24 weeks.The primary outcome be the effectiveness of GLJC on cognitive improvement after 24 weeks of treatment,which was defined as an increase in the Mini Mental State Examination(MMSE)and Montreal Cognitive Assessment(MoCA)Scale.The secondary outcomes were improvement in independence,daily living ability,and Chinese medicine(CM)syndrome,which were measured with the Alzheimer’s disease Rating Scale-Cognitive Project(ADAS-Cog),Clinical Dementia Rating(CDR)Total Score,Activities of Daily Living(ADL)Total Score and the Chinese Medicine Symptom Scale(CM-SS),respectively.Serum acetylcholine,acetylcholinesterase,bax and bcl-2 were monitored to explore the mechanism of GLJC on CI.In addition,safety measures,including vital signs,electrocardiography,laboratory indicators(full blood count,kidney and liver function tests,routine urine test and routine stool test)and adverse events,were also recorded.Discussion:The purpose of this trial is to evaluate the efficacy and safety of GLJC in patients with mild-to-moderate CI with kidney and marrow deficiency syndrome.If successful,the results would provide a viable treatment for patients with mild-to-moderate CI.
文摘随着社会老龄化的加重,血管性认知障碍和痴呆(vascular cognitive impairment and dementia,VCID)的发病率日益升高,挖掘与研究可以阻止疾病进展的有效干预方剂具有重要的社会意义。中医“瘀血理论”对健忘、精神异常等认知减退症状有丰富、明确的论述。通窍活血汤出自清代王清任《医林改错》,具有活血化瘀、通窍活络之功效,其原书所载治疗症目十三条,主要治疗头目、官窍等因血瘀引起的病证。通窍活血汤因其临床疗效确切、组方精妙,在当代临床中应用十分广泛。临床及基础研究表明,通窍活血汤可以通过调节炎症、自噬、凋亡、氧化应激等途径改善β淀粉样蛋白的沉积和Tau蛋白过度磷酸化引起的神经退行性改变发挥治疗血管性认知障碍和痴呆。通过查阅文献,综述近年来通窍活血汤及其加减化裁方治疗血管性认知障碍和痴呆上的临床应用及基础研究进展,为其更广泛地研究提供支持。
