Objective To explore the correlation of protein and mRNA levels of monocyte chemotactic protein-1 (MCP-1) and serum amyloid A protein (SAA) with cognitive function in chronic obstructive pulmonary disease (COPD) patients with or without hypoxemia, in order to identify the serum indexes of early cognitive impairment in patients with COPD, and investigate the effect of hypoxemia on cognitive impairment. Methods Sixty-two COPD patients admitted in the respiratory department of Affiliated Hospital of North China University of Science and Technology from January 2013 to January 2017 were included in the study. The COPD patients were divided into a hypoxemia group (25 cases) and a non-hypoxemia group (37 cases) according to blood gas analysis. Meanwhile 30 healthy subjects were recruited as control. ELISA was used to measure the concentration of serum MCP-1 and SAA in all subjects, and RT-PCR was used to detect the mRNA expression of MCP-1 and SAA in peripheral blood mononuclear cells. Montreal cognitive assessment scale (MoCA scale) was used to determine cognitive function. The expression levels of MCP-1 and SAA were compared between three groups, and the correlations with cognitive dysfunction were analyzed. Results The expression levels of serum MCP-1 and SAA had the same trend as those of MCP-1 mRNA and SAA mRNA in peripheral blood in the COPD patients. The protein and mRNA levels of MCP-1 and SAA were higher than those in the healthy control group (all P<0.05). The COPD hypoxemia group and the COPD non-hypoxemia group were lower than the control group in MoCA score, and the MoCA score of the COPD hypoxemia group decreased more obviously (allP<0.05). The protein and mRNA levels of SAA and MCP-1 were negatively correlated with MoCA score (allP<0.05). Conclusion The protein and mRNA levels of MCP-1 and SAA in peripheral blood increase in COPD patients, and hypoxemia may be involved in cognitive dysfunction in COPD patients.
ObjectiveTo analyze the related factors of cognitive impairment in patients with post-traumatic epilepsy. MethodsFrom January 2016 to January 2019, 45 patients with post-traumatic epilepsy (epilepsy group) and 48 patients with physical examination (control group) at the Department of Neurosurgery, the 904th Hospital of PLA were analyzed retrospectively. Cognitive assessment were evaluated by the following scales: Montreal cognitive assessment (MoCA), Mini-mental state examination (MMSE), Audio verbal memory test (AVMT), Rey-osterrieth complex figure test (CFT) and Trail making test (TMT). Then we analyzed the influences of gender, age, course of disease, cause, type, degree and location of injury, seizure frequency and Anti-seizure medications (ASMs) on cognitive impairment. ResultsThe results showed that there were significant differences between the epilepsy group and the control group in all scales (P<0.01). Analysis of influencing factors in epilepsy group showed: MoCA and MMSE scores: there were statistical significance in the comparison of seizure frequency and injury degree (P<0.05); AVMT, CFT and TMT scores: there were statistical significance in the comparison of seizure frequency, injury degree and location, ASMs within the group (P<0.05). ConclusionPost-traumatic epilepsy can cause cognitive impairment. The more frequent epileptic seizures and the more severe the degree of trauma, the more serious the cognitive impairment. Different injury sites affect the scope of cognitive impairment, temporal lobe injury is easy to cause memory function decline, frontal lobe injury is easy to cause spatial structure and executive ability decline, at the same time, the combined use of ASMs has an impact on cognitive function.
Based on literatures on Meta-analysis and randomized controlled trial, drug use and some geriatrics syndromes such as cognitive impairment and depression, in elderly diabetic patients were reviewed. Insulin plus oral hypoglycemic drugs was more rational therapy for insulin resistance and islet dysfunction in type 2 diabetes mellitus. We should pay more attention to cognitive impairment and depression in elderly type 2 diabetic patients.
ObjectivesTo systematically review the efficacy of telephone-delivered cognitive behavioral therapy (CBT) for insomnia. MethodsDatabases including PubMed, EMbase, PsycINFO, The Cochrane Library (Issue 7, 2015), CBM and CNKI were searched from inception to July 2015, to collect randomized controlled trials (RCT) about telephone-delivered CBT for insomnia. Two reviewers independently screened literature, extracted data and assessed the risk of bias of included studies. Then, RevMan 5.2 software was used to performing meta-analysis. ResultsFive RCTs involving 322 patients were included. The results of meta-analysis showed that:Compared with the waiting group, the sleep onset latency was shorter (MD=-30.31, 95% CI -40.41 to -20.22, P<0.00001), the waking after sleep onset was shorter (MD=-15.59, 95% CI -24.09 to -7.09, P=0.0003) and the sleep efficiency was higher (MD=11.02, 95% CI 7.87 to 14.18, P<0.00001) in the telephone-delivered CBT group, but there was no significant difference between the two groups in total sleep time (MD=13.45, 95% CI -37.01 to 63.92, P=0.60). ConclusionCurrent evidence shows, telephone-delivered CBT is effective for insomnia. Due to limited quantity and quality of the included studies, the above conclusion needs to be verified by more large-scale, high quality RCTs.
White matter lesion (WML) of presumed vascular origin is one of the common imaging manifestations of cerebral small vessel diseases, which is the main reason of cognitive impairment and even vascular dementia in the elderly. However, there is a lack of early and effective diagnostic methods currently. In recent years, studies of diffusion tensor imaging (DTI) and resting-state functional magnetic resonance imaging (rs-fMRI) have shown that cognitive impairment in patients with WMLs is associated with disrupted white matter microstructural and brain network connectivity. Therefore, it’s speculated that DTI and rs-fMRI can be effective in early imaging diagnosis of WMLs-related cognitive impairment. This article reviews the role and significance of DTI and rs-fMRI in WMLs-related cognitive impairment.
Objective To analyze a possible association of -A930G and C242T polymorphism with cognitive dysfunction in obstructive sleep apnea (OSA) patients, and assess potential interactions of CYBA alleles in OSA patients with cognitive dysfunction. Methods A total of 157 OSA patients with cognitive dysfunction were recruited as an experimental group, and 526 matched OSA patients without cognitive dysfunction as an control group. The neurocognitive assessment, polysomnography, genetic analyses, NADHP oxidase (NOX) activity, determination of urinary 8-OH-dG were completed in all subjects. Results Frequencies of the -930G allele carriers were not significantly different between two groups (P>0.05). Frequencies of the TT/CT genotypes were significantly higher in the OSA patients without cognitive dysfunction (P<0.05). NOX activity was assessed and found to be increased in the OSA patients with cognitive dysfunction (P<0.01). NOX activity was significantly higher in whom the allelic T variant was absent (P<0.05). The level of urinary 8-OH-dG was higher in the OSA patients with cognitive dysfunction (P<0.05). The level of urinary 8-OH-dG was significantly higher in whom the allelic T variant was absent (P<0.05). Conclusion The p22phox C242T polymorphism may be involved in the development of oxidative stress reaction in OSA patients with cognitive dysfunction.
Lung cancer ranks first in the incidence of malignant tumors in China, which is seriously harmful to people’s life and health. Chemotherapy is an effective treatment for lung cancer, and it is also an important cause of cognitive dysfunction. Cognitive impairment is usually evaluated by subjective assessment, neuropsychological testing and neuroimaging research. The mechanism of cognitive impairment in patients with lung cancer caused by chemotherapy may include the accumulation of a large amount of endogenous tau protein in hippocampus, the induction of hippocampal neuroinflammation, and the direct killing effect of drugs on nerve cells. There is no effective treatment for chemotherapy-related cognitive impairment (CRCI), but current studies have found that cognitive education in the form of mind map, diet regulation, physical exercise and caring therapy may contribute to the improvement of cognitive function of lung cancer patients after chemotherapy. Based on the current research results, this article provides new ideas for the research and treatment of lung cancer patients with CRCI in terms of clinical characteristics, evaluation methods, influencing factors, mechanism and prevention strategies.
Objective To assess the effectiveness of psychological intervention on post-stoke depression. Methods Such databases as the JBI Database of Systematic Review (1980 to June, 2010), The Cochrane Library (1980 to June, 2010), PubMed (1966 to 2010), CINAHL(1982 to May, 2000), CBM (1978 to 2010), and CNKI (1979 to 2010) were searched to collect randomized controlled trials (RCTs). In accordance with the predefined inclusion and exclusion criteria, the quality of included studies was evaluated, and then meta-analyses were performed by using RevMan 5.0 software. Results A total of 33 RCTs were included. The results of meta-analyses showed: (1) Compared with the control group, the short-term effect of psychological intervention was more effective in decreasing depression score. The subgroup analysis showed that the intervention effects at the time of four weeks, six weeks, eight weeks, and 12 weeks were better than those of the control group. (2) The long-term effect of psychological intervention was more effective in decreasing depression score. The subgroup analyses showed that the intervention effects at the interval of eight weeks, 24 weeks, and 48 weeks were better than those of the control group. (3) The combined or single application of either cognitive-behavioral psychotherapy or supportive psychotherapy was more effective in decreasing depression score than the control group. However, there was no significant difference between the general psychological treatment group and the control group. (4) The subgroup analyses showed that the different qualities of the included studies were more effective than those of the control group. Conclusion Various psychological intervention is effective in decreasing the patient’s depression score, and cognitive-behavioral therapy and supportive psychotherapy, especially, can significantly improve the depression state and promote recovery.
Patients with autoimmune encephalitis are mainly characterized by behavioral, mental and motor abnormalities, neurological dysfunction, memory deficits and seizures. Different antibody types of autoimmune encephalitis its pathogenesis, clinical characteristics are different, in recent years found immune related epilepsy is closely related to autoimmune encephalitis, based on autoimmune encephalitis type is more, we choose more common autoimmune encephalitis, expounds its characteristics, to help clinical diagnosis.
Objective To compare the effects of cognitive-behavior therapy (CBT) and domestic paroxetine in the treatment of minor depression. Methods A therapeutic technique model for the treatment of minor depression was established. Sixty-four patients with minor depression meeting DSM-IV criteria were divided into CBT and paroxetine groups with 32 patients respectively, and were treated for six weeks. The Hamilton Depression Scale (HAMD) was used to evaluate the clinical efficacy and relapse/recrudescence rate of the two groups. Side effects of paroxetine were also recorded. Results At the end of 2 weeks, no significant difference was noted in the reduction of the HAMD score between the two groups. At the end of 6 weeks, there was little difference in thHAMD score reduction between the two groups (F=8.3,P= 0). No significant difference was found in the curative effects between the two groups (u=316.5,P=0.06).In the paroxetine group, cure rate was 20.7%, significant improvement rate was 48.3%; In the CBT group, cure rate was 10.0%, significant improvement rate was 36.7%.The relapse/recrudescence rate after six in the paroxetine group was higher than in cognitive-behavior therapy group at 6 months’ follow-up (u=106.5,P=0.04).Conclusion The clinical efficacy of cognitive-behavior therapy for minor depression seems to be similar to that of paroxetine. The established model of CBT can be used in clinical practice.