AIM To explore the agreement between the mini-mental state examination(MMSE) and montreal cognitive assessment(Mo CA) within community dwelling older patients attending an old age psychiatry service and to derive and ...AIM To explore the agreement between the mini-mental state examination(MMSE) and montreal cognitive assessment(Mo CA) within community dwelling older patients attending an old age psychiatry service and to derive and test a conversion formula between the two scales.METHODS Prospective study of consecutive patients attending outpatient services.Both tests were administered by the same researcher on the same day in random order.RESULTS The total sample(n = 135) was randomly divided into two groups.One to derive a conversion rule(n = 70),and a second(n = 65) in which this rule was tested.The agreement(Pearson's r) of MMSE and Mo CA was 0.86(P < 0.001),and Lin's concordance correlation coefficient(CCC) was 0.57(95%CI:0.45-0.66).In the second sample Mo CA scores were converted to MMSE scores according to a conversion rule from the first sample which achieved agreement with the original MMSE scoresof 0.89(Pearson's r,P < 0.001) and CCC of 0.88(95%CI:0.82-0.92).CONCLUSION Although the two scales overlap considerably,the agreement is modest.The conversion rule derived herein demonstrated promising accuracy and warrants further testing in other populations.展开更多
目的探讨氧化低密度脂蛋白(oxidized Low density lipoprotein,ox-LDL)与阿尔茨海默病(Alzheimer’s dis-ease,AD)患者认知功能损害的关系。方法运用简易精神状态检查量表(mini mental state examination,MMSE)检测入组患者认知功能,将...目的探讨氧化低密度脂蛋白(oxidized Low density lipoprotein,ox-LDL)与阿尔茨海默病(Alzheimer’s dis-ease,AD)患者认知功能损害的关系。方法运用简易精神状态检查量表(mini mental state examination,MMSE)检测入组患者认知功能,将其分为3组,即正常组(NC组,37例)、血管性痴呆组(VD组,41例)、阿尔茨海默病组(AD组,48例),分别用酶联免疫吸附试验(enzyme-linked immunosorbnent assay,ELSIA)测定3组患者血浆ox-LDL的浓度。结果 NC组、VD组、AD组患者血浆ox-LDL浓度分别为(47.46±10.04)μg/L、(60.95±11.78)μg/L、(112.25±17.81)μg/L,AD组患者血浆ox-LDL浓度显著高于VD组,差异有统计学意义(P<0.01);相关分析显示,AD患者血浆ox-LDL浓度与MMSE得分呈负相关(r=-0.574,P<0.01);对AD患者各个认知领域的分值与血浆ox-LDL水平进行多元线性回归分析显示,血浆ox-LDL水平与AD患者记忆力、定向力、注意力和计算能力呈负相关。结论血浆ox-LDL浓度测定有可能作为判断AD患者认知功能损害的生化指标,亦可作为AD与VD鉴别诊断的生物学指标。展开更多
Stroke is the leading cause of death and long-term disability worldwide,and cognitive impairment and dementia are major complications of ischemic stroke.Cystatin C (CysC) has been found to be a neuroprotective factor ...Stroke is the leading cause of death and long-term disability worldwide,and cognitive impairment and dementia are major complications of ischemic stroke.Cystatin C (CysC) has been found to be a neuroprotective factor in animal studies.However,the relationship between CysC levels and cognitive dysfunction in previous studies has revealed different results.This prospective observational study investigated the correlation between serum CysC levels and post-stroke cognitive dysfunction at 3 months.Data from 638 patients were obtained from the China Antihypertensive Trial in Acute Ischemic Stroke (CATIS).Cognitive dysfunction was assessed using the Mini-Mental State Examination (MMSE) at 3 months after stroke.According to the MMSE score,308 patients (52.9%) had post-stroke cognitive dysfunction.After adjusting for potential confounding factors,the odds ratio (95% CI) of post-stroke cognitive dysfunction for the highest quartile of serum CysC levels was 0.54 (0.30–0.98),compared with the lowest quartile.The correlation between serum CysC and cognitive dysfunction was modified by renal function status.We observed a negative linear dose-response correlation between CysC and cognitive dysfunction in patients with normal renal function (Plinearity = 0.044),but not in those with abnormal renal function.Elevated serum CysC levels were correlated with a low risk of 3-month cognitive dysfunction in patients with acute ischemic stroke,especially in those with normal renal function.The current results suggest that CysC is a protective factor for post-stroke cognitive dysfunction,and could be used to treat post-stroke cognitive dysfunction.The CATIS study was approved by the Institutional Review Boards at Soochow University from China (approval No.2012-02) on December 30,2012,and was registered at ClinicalTrials.gov (identifier No.NCT01840072) on April 25,2013.展开更多
OBJECTIVE： To investigate the efficacy and safety of Chinese herbal medicines in the treatment of patients with vascular dementia. DATA RETRIEVAL： We retrieved publications from Cochrane Library （2004 to July 2011...OBJECTIVE： To investigate the efficacy and safety of Chinese herbal medicines in the treatment of patients with vascular dementia. DATA RETRIEVAL： We retrieved publications from Cochrane Library （2004 to July 2011）, PubMed （1966 to July 2011）, the Chinese Science and Technique Journals Database （1977 to July 2011）, the China National Knowledge Infrastructure （1979 to July 2011）, Google Scholar （July 2011）, and the Chinese Biomedical Database （1977 to July 2011） using the key words ＂Chinese medicine OR Chinese herbal medicine＂ and ＂vascular dementia OR mild cognition impair OR multi-infarct dementia OR small-vessel dementia OR strategic infarct dementia OR hypoperfusion dementia OR hemorrhagic dementia OR hereditary vascular dementia＂. SELECTION CRITERIA： Randomized controlled trials comparing Chinese herbal medicines with placebo/western medicine in the treatment of patients with vascular dementia were included. Diagnostic standards included Diagnostic and Statistical Manual of Mental Disorders-IV, and National Institute of Neurological Disorders and Stroke and Association Internationale pour la Recherche et I＇Enseignement en Neurosciences. Two participants independently conducted literature screening, quality evaluation and data extraction. The quality of each trial was assessed according to the Cochrane Reviewers＇ Handbook 5.0. MAIN OUTCOME MEASURES： Effective rate, Mini-Mental State Examination scores, Hasegawa Dementia Scale scores, and incidence of adverse reactions. RESULTS： We identified 1 143 articles discussing the effects of Chinese medicine on vascular dementia. Thirty-one of these were included in the analysis. These studies involved a total of 2 868 participants （1 605 patients took Chinese medicine decoctions （treatment group）; 1 263 patients took western medicine or placebo）. The results of our meta-analysis revealed that Chinese herbal remedies in the treatment group were more efficacious than the control intervention （relative risk （RR） = 1.27; 95% confidence interval （C/）： 1.18-1.38, P 〈 0.01）. Mini-Mental State Examination scores were higher in patients taking Chinese herbal medicines than in those in the control group （weighted mean difference （WMD） = 2.83; 95%CI： 2.55-3.12, P 〈 0.01）. Patients in the treatment group showed better disease amelioration than those in the control group （Hasegawa Dementia Scale scores; WMD = 2.41, 95%CI： 1.48-3.34, P 〈 0.01）. There were also considerably fewer adverse reactions among those in the treatment group compared with those in the control group （RR = 0.20, 95%CI： 0.08-0.47, P 〈 0.01）. CONCLUSION： Chinese herbal medicine appears to be safer and more effective than control measures in the treatment of vascular dementia. However, the included trials were generally low in quality. More well-designed, high-quality trials are needed to provide better evidence for the assessment of the efficacy and safety of Chinese medicines for vascular dementia.展开更多
目的:探讨中文版约翰霍普金斯改编认知检查量表(the John Hopkins adapted cognitive exam,ACE)在呼吸危重症患者中应用的有效性,为其在国内临床应用提供客观依据。方法:选择2022年10月—2023年10月100例呼吸重症监护病房(respiratory i...目的:探讨中文版约翰霍普金斯改编认知检查量表(the John Hopkins adapted cognitive exam,ACE)在呼吸危重症患者中应用的有效性,为其在国内临床应用提供客观依据。方法:选择2022年10月—2023年10月100例呼吸重症监护病房(respiratory intensive care unit,RICU)患者作为RICU组和40例同期体检的健康人作为对照组,分别用简易精神状态量表(mini-mental state examination,MMSE)和中文版ACE评估其认知功能。结果:(1)RICU组ACE总分和MMSE总分呈显著相关(r=0.709,P<0.001);两者相同子项目相关系数在0.444—0.804,低度至高度相关;中文版ACE各子项目与ACE总分低度至高度显著相关,相关系数在0.438—0.769(P<0.001)。(2)RICU组和对照组间,在中文版ACE中定向力、模仿能力、记忆能力及总分均有显著性差异(P<0.05),在MMSE中定向力、注意力与计算力、回忆能力、语言能力和总分均有显著性差异(P<0.05)。(3)中文版ACE总分90.5时约登指数最大(0.49),MMSE总分26.5时约登指数最大(0.525)。受试者操作曲线曲线下面积ACE为(0.813±0.035),MMSE为(0.841±0.032),两者无显著差异(Z=1.00,P=0.317)。结论:中文版ACE可以作为RICU患者认知障碍筛查的工具,且较MMSE更适宜在气管插管、气管切开及使用机械通气患者中使用。展开更多
文摘AIM To explore the agreement between the mini-mental state examination(MMSE) and montreal cognitive assessment(Mo CA) within community dwelling older patients attending an old age psychiatry service and to derive and test a conversion formula between the two scales.METHODS Prospective study of consecutive patients attending outpatient services.Both tests were administered by the same researcher on the same day in random order.RESULTS The total sample(n = 135) was randomly divided into two groups.One to derive a conversion rule(n = 70),and a second(n = 65) in which this rule was tested.The agreement(Pearson's r) of MMSE and Mo CA was 0.86(P < 0.001),and Lin's concordance correlation coefficient(CCC) was 0.57(95%CI:0.45-0.66).In the second sample Mo CA scores were converted to MMSE scores according to a conversion rule from the first sample which achieved agreement with the original MMSE scoresof 0.89(Pearson's r,P < 0.001) and CCC of 0.88(95%CI:0.82-0.92).CONCLUSION Although the two scales overlap considerably,the agreement is modest.The conversion rule derived herein demonstrated promising accuracy and warrants further testing in other populations.
基金supported by the National Natural Science Foundation of China,No.81673263(to YHZ)Ministry of Science and Technology of China,No.2016YFC1307300(to YHZ)a Project of the Priority Academic Program Development of Jiangsu Higher Education Institutions,China(to YHZ)
文摘Stroke is the leading cause of death and long-term disability worldwide,and cognitive impairment and dementia are major complications of ischemic stroke.Cystatin C (CysC) has been found to be a neuroprotective factor in animal studies.However,the relationship between CysC levels and cognitive dysfunction in previous studies has revealed different results.This prospective observational study investigated the correlation between serum CysC levels and post-stroke cognitive dysfunction at 3 months.Data from 638 patients were obtained from the China Antihypertensive Trial in Acute Ischemic Stroke (CATIS).Cognitive dysfunction was assessed using the Mini-Mental State Examination (MMSE) at 3 months after stroke.According to the MMSE score,308 patients (52.9%) had post-stroke cognitive dysfunction.After adjusting for potential confounding factors,the odds ratio (95% CI) of post-stroke cognitive dysfunction for the highest quartile of serum CysC levels was 0.54 (0.30–0.98),compared with the lowest quartile.The correlation between serum CysC and cognitive dysfunction was modified by renal function status.We observed a negative linear dose-response correlation between CysC and cognitive dysfunction in patients with normal renal function (Plinearity = 0.044),but not in those with abnormal renal function.Elevated serum CysC levels were correlated with a low risk of 3-month cognitive dysfunction in patients with acute ischemic stroke,especially in those with normal renal function.The current results suggest that CysC is a protective factor for post-stroke cognitive dysfunction,and could be used to treat post-stroke cognitive dysfunction.The CATIS study was approved by the Institutional Review Boards at Soochow University from China (approval No.2012-02) on December 30,2012,and was registered at ClinicalTrials.gov (identifier No.NCT01840072) on April 25,2013.
基金supported by a Special Funding Project for the Chinese National Outstanding Ph.D.Thesis Author,No.201082the First Grade of China Postdoctoral Science Foundation,No.20110490080the National Natural Science Foundation of China,No.81202653
文摘OBJECTIVE： To investigate the efficacy and safety of Chinese herbal medicines in the treatment of patients with vascular dementia. DATA RETRIEVAL： We retrieved publications from Cochrane Library （2004 to July 2011）, PubMed （1966 to July 2011）, the Chinese Science and Technique Journals Database （1977 to July 2011）, the China National Knowledge Infrastructure （1979 to July 2011）, Google Scholar （July 2011）, and the Chinese Biomedical Database （1977 to July 2011） using the key words ＂Chinese medicine OR Chinese herbal medicine＂ and ＂vascular dementia OR mild cognition impair OR multi-infarct dementia OR small-vessel dementia OR strategic infarct dementia OR hypoperfusion dementia OR hemorrhagic dementia OR hereditary vascular dementia＂. SELECTION CRITERIA： Randomized controlled trials comparing Chinese herbal medicines with placebo/western medicine in the treatment of patients with vascular dementia were included. Diagnostic standards included Diagnostic and Statistical Manual of Mental Disorders-IV, and National Institute of Neurological Disorders and Stroke and Association Internationale pour la Recherche et I＇Enseignement en Neurosciences. Two participants independently conducted literature screening, quality evaluation and data extraction. The quality of each trial was assessed according to the Cochrane Reviewers＇ Handbook 5.0. MAIN OUTCOME MEASURES： Effective rate, Mini-Mental State Examination scores, Hasegawa Dementia Scale scores, and incidence of adverse reactions. RESULTS： We identified 1 143 articles discussing the effects of Chinese medicine on vascular dementia. Thirty-one of these were included in the analysis. These studies involved a total of 2 868 participants （1 605 patients took Chinese medicine decoctions （treatment group）; 1 263 patients took western medicine or placebo）. The results of our meta-analysis revealed that Chinese herbal remedies in the treatment group were more efficacious than the control intervention （relative risk （RR） = 1.27; 95% confidence interval （C/）： 1.18-1.38, P 〈 0.01）. Mini-Mental State Examination scores were higher in patients taking Chinese herbal medicines than in those in the control group （weighted mean difference （WMD） = 2.83; 95%CI： 2.55-3.12, P 〈 0.01）. Patients in the treatment group showed better disease amelioration than those in the control group （Hasegawa Dementia Scale scores; WMD = 2.41, 95%CI： 1.48-3.34, P 〈 0.01）. There were also considerably fewer adverse reactions among those in the treatment group compared with those in the control group （RR = 0.20, 95%CI： 0.08-0.47, P 〈 0.01）. CONCLUSION： Chinese herbal medicine appears to be safer and more effective than control measures in the treatment of vascular dementia. However, the included trials were generally low in quality. More well-designed, high-quality trials are needed to provide better evidence for the assessment of the efficacy and safety of Chinese medicines for vascular dementia.
文摘目的:探讨中文版约翰霍普金斯改编认知检查量表(the John Hopkins adapted cognitive exam,ACE)在呼吸危重症患者中应用的有效性,为其在国内临床应用提供客观依据。方法:选择2022年10月—2023年10月100例呼吸重症监护病房(respiratory intensive care unit,RICU)患者作为RICU组和40例同期体检的健康人作为对照组,分别用简易精神状态量表(mini-mental state examination,MMSE)和中文版ACE评估其认知功能。结果:(1)RICU组ACE总分和MMSE总分呈显著相关(r=0.709,P<0.001);两者相同子项目相关系数在0.444—0.804,低度至高度相关;中文版ACE各子项目与ACE总分低度至高度显著相关,相关系数在0.438—0.769(P<0.001)。(2)RICU组和对照组间,在中文版ACE中定向力、模仿能力、记忆能力及总分均有显著性差异(P<0.05),在MMSE中定向力、注意力与计算力、回忆能力、语言能力和总分均有显著性差异(P<0.05)。(3)中文版ACE总分90.5时约登指数最大(0.49),MMSE总分26.5时约登指数最大(0.525)。受试者操作曲线曲线下面积ACE为(0.813±0.035),MMSE为(0.841±0.032),两者无显著差异(Z=1.00,P=0.317)。结论:中文版ACE可以作为RICU患者认知障碍筛查的工具,且较MMSE更适宜在气管插管、气管切开及使用机械通气患者中使用。
