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    20 October 2012, Volume 7 Issue 10
    Living Together
    WANG Yong-Jun
    2012, 7(10):  753-754. 
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    述评
    Actions of BDNF Val66Met Polymorphism in Depression Disorders
    LUO Ben-Yan
    2012, 7(10):  755-759. 
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    Study on the Relationship between White Matter Lesions and Cognitive Impairment
    PAN Jie;LUO Ben-Yan
    2012, 7(10):  762-768. 
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    Objective To assess the correlation of the white matter lesions and the cognitive function of the patients with small vessel disease. Methods The patients with small vessel disease were chosen from all the outpatients of the Department of Neurology in First Affiliated Hospital of the Medical College of Zhejiang University from October 2009 to December 2009, by the assessments of cognitive function, such as the informant questionnaire on cognitive decline in the elderly(IQCODE), the Mini-Mental State Examination(MMSE), the Clinical Dementia Rating(CDR) and so on, the cerebral magnatic resonance imaging(MRI) and the clinical data. The effect of the different extents and locations of the white matter lesions to the cognitive function was assessed by statistical analysis. Results A total of 147 patients were included in this study, with 33 small vessel disease. Comparing with the normal group, significant differences(P =0.00) were found in the patients with small vessel disease in the remembrance(z =-3.36), the orientation(z =-3.14), the judgement(z =-3.38) and the social activity(z =-3.22). We found significant correlations between the scores of MMSE(r =0.82),the remembrance scores of CDR(r =0.82), the total scores of CDR(r =0.62)and the extent of the periventricular lesions(P =0.00), but the correlations between the deep white matter lesions and the cognitive impairment were middling correlated, as the scores of MMSE(r =0.51, P =0.01), the remembrance scores of CDR(r =0.49, P =0.02). Conclusions The scores of MMSE and the CDR may be predictors to the progress of the white matter lesion, especially the periventricular lesions.

    Memory Tests Predict the Change of Hippocampus Topography in Mild Cognitive Impairment Patients
    LI De-Qiang;LIANG Hui;PENG Guo-Ping;QI Dong-Sheng;GUOZhong-Wei;LUO Ben-Yan.
    2012, 7(10):  769-774. 
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    Objective To determine which type of memory test can better predict hippocampus topography change underlying amnestic form of mild cognitive impairment(aMCI) conversion to Alzheimer's disease(AD) over a year period. Methods Three subtypes of patients with aMCI: 30 patients with predominant verbal memory impairment(verbal-aMCI), 28 with predominant visual memory impairment(visual-aMCI) and 44 with both verbal and visual memory-predominant impairment(both-aMCI), were enrolled. The level of hippocampal atrophy at baseline and a year later using visual 4-grade scale on magnetic resonance images(MRI) were analyzed. Patients were treated with either donepezil, rivastigmine or galantamine at a low dose. Results Data at baseline indicated that more patients(80%) with verbal-aMCI showed marked cortical thinning in the left hippocampus compared with visual-aMCI(43%). The cortical thinning areas of both-aMCI group overlapped those of verbal-aMCI but were more extensive and the proportion of patients with atrophic hippocampus got to 91 percent. After one year observation, the conversion rates of clinical dementia in the former subgroups(verbal-aMCI, visual-aMCI and both-aMCI) were 20.0%, 10.7% and 31.8%, respectively. More patients' initially diagnosed verbal-aMCI(50%) and both-aMCI(68.2%) were characterized by bilateral hippocampal atrophy or thinning aggravation, but only a small proportion(28.6%) of visual-aMCI patients indicated a mild bilateral hippocampal shrinking. Conclusion The verbal-aMCI and both-aMCI are more likely to be a precursor of AD than aMCI,and verbal memory test combined with hippocampal atrophy is more sensitive in predicting the aMCI conversion over a year period.

    论著
    Analysis of Myeloproliferative Disorders Patients with Thrombosis
    ZOU Xu;CHANGBing-Qing;HUANG Xin-Chun;GONG Xi-Ping.
    2012, 7(10):  775-780. 
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    Objective To retrospectively analyse the thrombotic risk factors of myeloproliferative disorders.Methods We collected data from 107 cases of patients with essential thrombocytosis(ET) and polycythemia vera(PV), including 65 patients with thrombosis from Beijing Aerospace General Hospital and Beijing Tiantan Hospital affiliated to Capital Medical University since August 2007 to February 2012. Clinical characteristics and laboratory data(history, age, leukocyte count,JAK2V617F mutation and bone marrow assay) were reviewed and analyzed by multivariate logistic regression analysis.Results The population consisted of 43 women and 64 men with ages ranging from 28 to 84 years.Sixty five patients had thrombosis concomitantly, including 34 ischemic cerebrovascular incidents.The leukocytes was over 11.0×109/L for 41 patients(63.1%) and mutation JAK2V617F was found for 39 patients(60.0%) in those thrombotic events. These two rates were higher than those ofpatients group with non-thrombosis. The number of patients with age over 60 also increased in thrombotic patients. Multivariate logistic regression analysis showed leukocytosis([odds ratio,OR]3.393, P<0.05), mutation JAK2V617F (OR 3.104, P<0.05) and over 60 years(OR 2.523, P<0.05) were the risk factors of thrombosis.Conclusion Leukocytosis, mutation JAK2V617F and over 60 years are the independent risk factors of myeloproliferative disorders with thrombosis, especially in ischemic stroke.
    Efficacy on Cognitive Function of Nimodipine in Patients with Cerebral Vascular Disease
    HE Jian-Hua;YI Jin;ZHANG Na;LI Cong-Jia;FAN Dong-Ning
    2012, 7(10):  781-785. 
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    Objective To observe the efficacy of Nimodipine on vascular cognitive impairment in a shortperiod treatment.Methods It was a prospective opened own control study. Sixty-four patients with cerebrovascular disease were recruited from outpatient of neurology department. On the basis of secondary prevention drugs, patients were given to oral Nimodipine 60-90 mg/d. The patients' cognitive functions have been assessed using the mini mental state examination(MMSE) and Montrealcognitive assessment(MoCA) before and after 12-24 weeks treatment.Results After treatment of Nimodipine, the performance record were significantly better than before, total scores of MMSE were 26.3±2.7 vs 25.6±2.9(P =0.039), MoCA were 20.5±4.6 vs 19.0±4.1(P =0.000), and the memory test of MoCA were significant better than before(1.8±1.7 vs 1.1±1.2, P =0.000).Conclusion Nimodipine may have some benefits for cognitive function in patients with cerebralvascular disease
    专题论坛
    Pay Attention to the Early Identification and Treatment of Post-stroke Depression
    ZHANG Shu;LUO Ben-Yan
    2012, 7(10):  793-797. 
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    论著
    Effect on Different Pathways of Transplantation of Human Umbilical Cord Blood Stem lls on Neural Function in Rats with Cerebral Hemorrhage
    YAO Xing-Yu;YANG LI-in;ZHANG Guo-Hua.
    2012, 7(10):  796-791. 
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    【Abstract】Objective To observe the changes in behavior in rats with cerebral hemorrhage which were transplanted human umbilical cord blood stem cells by different ways in two weeks and to discuss the best pathway of stem cell transplanted.Methods An animal model of intracerebral hemorrhage(ICH) was established by autologous blood injection/withdraws two times. The success of cerebral hemorrhage model confirmed by computed tomography(CT) examination. And then fresh human umbilical cord blood mononuclear cells(HUCBMC) which were isolated from human umbilical cord blood were transplanted into experimental animal in vivo respectively by Wister rats, caudal vein, left ventricular and theposition of cerebral hemorrhage. The control group was fed well without treatment after modeling successfully and observed the process of natural recovery. The behavior of each model was assessed by Longa 5 grading method on 1, 3, 7 and 14 days.

    Results Statistical data suggested that it was a significant difference in the changes of rats,neurological function at different time points which were transplanted HUCBMC through the tail vein, left ventricular and cerebral hemorrhage local pathways(F =131.87, P <0.001). The factors which time and group interaction effect showed that different treatment tend to the same trends of time(F =35.54, P >0.05). Influence of different transplantation methods on changes of neural function in rats was different(F =6.434, P =0.001). The rats, neurological function scores(2.35±0.67) which were transplanted HUCBMC by cerebral hemorrhage local pathways were obviously higher than the other groups on the 1st day. And the scores(0.40±0.60, 0.25±0.37, 0.03±0.22) were lower than the other groups on the 3th, 7th and 14th days. There was no significant differences between the neurological function scores of the four groups when HUCBMC were transplanted for 1 day(F =2.14, P =0.10). There were significant differences between the group transplanted by the local cerebral group and the other groups on the 3th, 7th and 14th days(F =5.59, 22.94 and 11.07, All of P <0.01).There were no significant differences between the group transplanted by caudal vein and left ventricular(P =0.85, 0.08, 0.70, 0.68).

    Conclusion Human umbilical cord blood stem cell transplantation can improve the neural function in rats with cerebral hemorrhage through the tail vein, left ventricular and cerebral hemorrhage local pathway. The best way of transplantation was local cerebral transplantation.

    Cerebral Small Vessel Disease and Vascular Cognitive Impairment
    LIU Ping;LUO Ben-Yan
    2012, 7(10):  798-803. 
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    病例讨论
    One Case of Follow-up Study on Reading Functions in Chinese Aphasia
    CHEN Zhong-Qin;XU Ming-Wei;SHAO Han-Yu;et al
    2012, 7(10):  804-806. 
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    指南与规范
    American Association of Clinical Endocrinologists’ Guidelines for Management of Dyslipidemiaand Prevention of Atherosclerosis(Excerpt Part 2)
    SHEN Dong-Chao;WU Shuo-Lin;WU Jia;et al
    2012, 7(10):  807-812. 
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    综述
    Screening of Post-stroke Depression
    SHI Yu-Zhi;ZHANG Li-Li;YUAN Huai-Wu;BAIYing;ZHANG Ning;WANG Chun-Xue.
    2012, 7(10):  813-816. 
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    Depression is a common and serious complication after stroke. Although it may affect the process of rehabilitation, increase mortality and with low diagnosis and treatment rates, such conditions were often ignored in clinical practice. We reviewed data about post stroke depression(PSD) screening, included population need to screening, screening tools and time point,in order to provide some reference for the clinical practice of PSD screening.
    Research Progress of Micro Ribonucleic Acid in Cerebral Ischemia
    GU Ya-Li;CHU Ke-Tan;LUO Ben-Yan.
    2012, 7(10):  817-821. 
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    教学园地
    Application of Medical Students as Standard Patients in Clinical Neurological Teaching
    SHAO Xiao-Qiu;ZHANG Xing-Hu;ZHANG Ning;et al
    2012, 7(10):  823-824. 
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    Discussion of Establishment on Training in Vascular Neurological Doctors and Qualification System in Beijing Area
    WANG Yi-Long;WANG Chun-Xue;LIU Li-Ping;et al
    2012, 7(10):  825-827. 
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    Discussion of Teaching Approach on 'Cases as the Basic and Reference as the Guide' to Neurological Graduate Students
    LIU Li-Ping
    2012, 7(10):  828-829. 
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