Differential acetylcholine and choline concentrations in the cerebrospinal fluid of patients with Alzheimer’s disease and vascular dementia

Background An important aspect of Alzheimer’s disease (AD) is loss or impairment of cholinergic neurons. It is controversial whether there is a similar cholinergic impairment and cerebral deficit of acetylcholine (ACh) in the case of vascular dementia (VD). The purpose of this study was to explore the levels of ACh and choline (Ch) in the cerebrospinal fluid (CSF) of patients with AD and VD, and their possible relationship with cognitive impairment.Methods Twenty-two AD patients, twenty-two VD patients, and twenty normal controls were recruited and scored with a Mini-Mental State Examination (MMSE). CSF concentrations of ACh and Ch were measured using high-performance liquid chromatography with an electrochemical detector (HPLC-ECD) and the results were then compared to cognitive status.Results ACh concentrations in CSF of AD patients ［(10.7±5.1） nmol/L］ and VD patients ［(16.8±7.4） nmol/L］ were both significantly lower than in controls ［(34.5±9.0） nmol/L, t=10.67, P<0.001; t=6.91, P<0.001］. Both results correlated positively with MMSE scores (rs=0.88 and rs=0.85, respectively, P<0.01). The CSF concentration of Ch was significantly higher in VD patients ［(887.4±187.4） nmol/L］ compared to AD patients ［(627.6±145.1） nmol/L, t=6.4, P<0.001］ and controls ［(716.0±159.4） nmol/L, t=4.2, P=0.002］. CSF Ch concentration showed no difference between AD patients and normal controls, nor did it correlate with MMSE score in any of the three groups. Conclusions The positive correlation between ACh deficit and cognitive impairment suggests that ACh is an important neurotransmitter for memory. The similar decrease in ACh concentration in AD and VD patients may imply a similar pathogenesis for the process of cognitive impairment involved in these two disorders. The elevated CSF levels of Ch in VD patients compared to AD patients may be useful diagnostically. Cholinesterase inhibitors may be helpful not only for AD patients, but also for VD patients.     

Herbal Medicine in the Treatment of Alzheimer’s Disease

Associated with the aging of our world population is a sharp increase in the incidence of Alzheimer’s disease,which not only poses a significant health issue but also presents a serious social problem.Although pharmacological treatments were developed based on existing hypotheses,the disease pathogenesis remains to be fully elucidated.Given the complexity of Alzheimer’s disease,Chinese herbal medicine appears to have therapeutic potential for Alzheimer’s disease through multi-target and multi-pathway approach at cellular and molecular levels and holistic adjustment of the body at organ system levels.Recently,a significant breakthrough has been made in the research of Chinese medicine for Alzheimer’s disease.In this article,we review the experimental research progress in understanding how Chinese medicine could be used for the treatment of Alzheimer’s disease.     

Apolipoprotein E genotype in patients with Alzheimer’s disease

Objective To explore the frequency and significance of ApoE gene polymorphisms in patients with sporadic Alzheimer’s disease (AD).Methods Single nucleotide polymorphisms of the ApoE gene were analyzed in 32 cases of AD and 26 controls, using PCR and gene sequencing.Results The single nucleotide polymorphism of ApoE gene 462C/G was significantly associated with AD (P<0.05).Conclusions The 462C/G polymorphism might be a specific genotype in Chinese patients with sporadic AD.     

Validation of the China’s maternal and child mortality surveillance in the diagnosis of infant deaths in two counties in Guizhou Province

The infant mortality rate in China declined from 50.2‰ to 13.8‰ between 1991 and 2009.1 Although China has made good progress,there were still about 190 thousand infants who died in 2009.Reliable birth and death registration and the causes of death in populations are essential for public health planning.The National Maternal and Child Mortality Surveillance System （MCMS） is the major system to register maternal and infant deaths.It samples 126 districts and 210 counties,totally 336 sites,covering 12% of counties and 9% of the population.Causes of deaths are determined by the attending clinician.For those who die out hospital or clinic,a community health provider will be asked to visit that family and make a decision as to the cause of death.     

Using dementia rating scales in the diagnosis of Alzheimer’s disease

INTRODUCTION Alzheimer′sdisease(AD)isaninsidious,primarycerebraldegenerativediseasewiththeimpairment ofcognitionfunctionasthemainclinicalmanifestation.Inclinic,thelanguage,memory,visuospatialfunction,feelings,orpersonality,andcognition(generalization,calculationandjudgment)areimpaired.Atpresentthere isnospecificdiagnosticmethod,butneuropsychological testresultsdogoodtodiagnosisanddifferentialdiagnosis ofAD[17].Aboveall,neuropsychologicaltestsare,perhaps,abletobeusedtodiagnosepre clinica…     

Gene polymorphism in apolipoprotein E and presenilin-1 in patients with late -onset Alzheimer’s disease

Objective To evaluate the association of apolipoprotein E (apoE) and presenilin-1 (PS-1) gene polymorphism with late-onset Alzheimer’s disease (AD). Methods A case-control study was undertaken to detect the polymorphism of apoE and PS-1 by polymerase chain reaction and digestion with the endonucleases of BspL Ⅰ, Hha Ⅰ and BamH Ⅰ. Results The frequencies of apoE ε3/4 genotype and ε4 allele in late-onset AD (n=42) were significantly higher than those of age-matched controls (P<0.05). The frequencies of the apoE intron 1 enhancer (IE1) G/G genotype and G allele in late-onset AD were also significantly higher than those in controls (P<0.05). The frequencies of the PS-1 1/1 genotype but not the 1 allele in AD were significantly higher than those in controls (P<0.05).The apoE ε4 allele was associated with a tripling of risk for late-onset AD compared with that with no ε4 allele (odds ratio: 2.932). Homozygosity of the G allele in IE1 and 1/1 genotype in PS-1 was associated with a doubling of risk for late-onset AD, and odds ratios were 2.223 and 2.066, respectively.When the apoE ε4 was controlled, the association between the IE1 G/G genotype AD was no longer statistically significant (P>0.05). We sequenced the exon 4 of apoE in patients with late-onset AD, and found no other genetic polymorphism or mutation except for apoE ε4 and IE1 G alleles associated with AD. Conclusion apoE ε4 gene appears to be the strongest gene risk factor for late-onset AD and its apparent association between the IE1 G/G genotype and late-onset AD is a consequence of the association between the ε4 and IE1 G/G genotype.The PS-1/1 genotype is weakly associated with late-onset AD.     

Advances in the study of Alzheimer＇s disease

Alzheimer＇ s disease （AD） is the most common cause of dementia, and the only treatment currently available for the disease is acetylcholinesterase inhibitors. Recent progress in understanding the molecular and cellular pathophysiology of Alzheimer＇s disease has suggested possible pharmacological interventions, including acetylcholineseterase inhibitors; secretase inhibitors; cholesterol lowering drugs; metal chelators and amyloid immunization. The objective of this paper is to review the main drugs possibly used for AD and their future therapeutic effects.     

Clinical features and management of Crohn’s disease in Chinese patients

Background An increasing incidence of Crohn‘s disease has been found in China in recent years.Our study has been focused on evaluating the diversity of the clinical manifestations of Crohn‘ s disease in order to improve early diagnostic accuracy and therapeutic efficacy.Methods Thirty patients with active Crohn‘s disease were enrolled and their clinical data, including diagnostic and therapeutic results, were analyzed. Endoscopy combined with histological examination of biopsy specimens provided characteristic features of the disease. Transabdominal bowel sonography (TABS) was used for detecting intestinal complications. Nutritional supportive therapy was given to 20 subjects with active cases of the disease.Results Most patients were young adults with a higher proportion of females to males ( ratio: 1.14:1 ). The disease affects any segment or a combination of segments along with the alimentary tract(from the mouth to the anus). In this study, the colon and small bowel were the major sites involved.Recurrent episodes of abdominal pain in the right lower quadrant and watery diarrhea were the most common symptoms. Granulomas were identifiable in nearly one-third (30. 8%) of all biopsy specimens. In moderate cases of the disease, remission was achieved more quickly through the use of oral prednisone therapy than with SASP or 5-ASA. Beneficial effects on the host‘ s nutritional status were observed. Immunosuppressives were used on an individual basis and showed variable therapeutic effects. Sixteen patients had surgery due to intestinal obstruction or failure to respond to drug therapies. Rapid improvement after surgery was reported.Conclusion Endoscopy (with biopsy) and TABS were both crucial procedures for diagnosis. SASP (or 5-ASA) and prednisone were effective as inductive therapies. Azathioprine has demonstrable benefits after induction therapy with prednisone. Surgery, as an alternative treatment, provided another effective choice in selected patients.     

Clinical study on treatment of Alzheimer’s disease from the viewpoint of Xin and Shen

Clinical Study on Treatment of Alzheimer’s Disease from the Vie wpoint of Xin and Shen@林水淼$Institute of Geriatrics, Shanghai TCM University!Shanghai @王健$Institute of Geriatrics, Shanghai TCM University!Shanghai @周如倩$Institute of Geriatrics, Shanghai TCM University!Shanghai @郁志华$Institute of Geriatrics, Shanghai TCM University!Shanghai…     

Pericardial devascularization combined with Latarjet’s innervation in the treatment of patients with

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Systematic examination of DNA variants in the parkin gene in patients with Parkinson’s disease

Increasing evidence suggests that genetic factors play an important role in the pathogenesis of Parkinson‘s disease(PD). Three genes, namely α-synuclein, parkin, and UCH-L1, have been implicated in familial PD. An exon deletion in the parkin gene is the mutation most frequentlymentioned in published data. The parkin gene was first identified by Japanese researchers, and, since fragment deletions in coding exons of this gene have been proven     

Serum albumin in Down Syndrome with and without Alzheimer’s Disease

Aims  

We investigated whether or not serum albumin concentrations in Down Syndrome were lower than those of a cohort of similarly moderately-to-severely-disabled institutionalised patients without Down Syndrome and, if so, whether or not this could be ascribed to the presence of liver disease. We also sought to determine the influence of Down Syndrome, age, liver disease, and Alzheimer’s Disease on the serum albumin concentration.     

Pathway and mechanism of oxidative stress in Alzheimer＇s disease

Current hypotheses of pathogenesis of neuronal degeneration in Alzheimer＇s disease （AD） have been proposed, including formation of free radicals, oxidative stress, mitochondrial dysfunction, inflammatory processes, genetic factors, environmental impact factors, apoptosis, and so on. Especially, oxidative stress plays an essential role in AD pathogenesis by the function of linking agent. Oxidative stress in AD mainly includes lipid peroxidation, protein oxidation and DNA oxidation. Lipid peroxidation plays a key role in the development and progression of AD. Protein oxidation is an important mechanism in AD. Oxidative damage to DNA may plays an important role in aging and AD.     

In-home monitoring of older adults with vision impairment: exploring patients’, caregivers’ and professionals’ views

Objective

To develop a conceptual framework for the design of an in-home monitoring system (IMS) based on the requirements of older adults with vision impairment (VI), informal caregivers and eye-care rehabilitation professionals.

Materials and Methods

Concept mapping, a mixed-methods statistical research tool, was used in the construction of the framework. Overall, 40 participants brainstormed or sorted and rated 83 statements concerning an IMS for older adults with VI. Multidimensional scaling and hierarchical cluster analysis were employed to construct the framework. A questionnaire yielded further insights into the views of a wider sample of older adults with VI (n=78) and caregivers (n=25) regarding IMS.

Results

Concept mapping revealed a nine-cluster model of IMS-related aspects including affordability, awareness of system capabilities, simplicity of installation, operation and maintenance, system integrity and reliability, fall detection and safe movement, user customization, user preferences regarding information delivery, and safety alerts for patients and caregivers. From the questionnaire, independence, safety and fall detection were the most commonly reported reasons for older adults and caregivers to accept an IMS. Concerns included cost, privacy, security of the information obtained through monitoring, system accuracy, and ease of use.

Discussion

Older adults with VI, caregivers and professionals are receptive to in-home monitoring, mainly for fall detection and safety monitoring, but have concerns that must be addressed when developing an IMS.

Conclusion

Our study provides a novel conceptual framework for the design of an IMS that will be maximally acceptable and beneficial to our ageing and vision-impaired population.     

Management of the occlusion and stenosis of the aortic arch branches in the course of Takayasu’s arteritis

Takayasu＇s arteritis （TA） is a chronic inflammatory disease of the aorta and its thoracic and abdominalparts, most commonly involving the aortic arch and the arteries that arise from it. TA is an autoimmune disease, although certain HLA-linked genetic predispositions have been observed. TA affects females 2 to 8 times more fi＇equently than males. The onset age is between 10 to 40 years old.1 TA is extremely uncommon in Poland. Corticosteroids are the choice of treatment for TA,     

Analysis of the association of serum uric acid levels with the progression of Parkinson’s disease in Chinese patients

Background/Aims: Uric acid (UA) is suspected to play a neuro-protective role in Parkinson’s disease (PD). This study aims to evaluate whether the serum UA level is associated with the disease progression of PD in a relatively large population of Chinese patients. Methods: Serum UA levels were measured from 399 Chinese PD patients and 387 age-matched controls; following the uric acid colorimetric method, the serum creatinine (Scr) levels were also measured to reduce the bias caused by possible differences in renal excretion function. The disease severity was scored by Hoehn and Yahr (H&Y) Scales and disease durations of PD; and the associations between serum UA level and disease progression were analyzed. Results and conclusion: PD patients were found to have significantly lower levels of serum UA than controls (249.31±79.48vs283.78±103.30, umol/). Stratified analysis showed a similar PD progression rate in both men and women. There was a significant inverse correlation of UA levels with H&Y Scales (Rs=-0.421, p<0.01) and disease duration (Rs=-0.239, p<0.01) of PD patients of both females and males. No difference of the Scr levels between PD patients and controls was found (72.09±15.64vs69.93±19.59, umol/L). Our data suggest that lower serum UA levels may possess higher risk of PD, which may be a useful biomarker to indicate the progression of PD.     

Late onset Alzheimer’s disease and apolipoprotein association in the Irish population: Relative risk and attributable fraction

Background Familial and sporadic late onset Alzheimer’s disease (LOAD) shows a consistent genetic association with APOE ε4. Aims To examine the role of APOE in the AD Irish population. Methods One hundred and ten Irish LOAD patients and 217 ethnically-matched controls were genotyped for APOE marker as described by Crook et al.¹ Chi square test was used to compare allelic and genotypic frequencies between patients and controls samples. Attributable fractions were calculated as described by Levin.² Results A highly significant association between AD and APOE ε4 was observed (X²=37.9, p=0.0000000, RR=2.18). Further, the influence of APOEε4 seems to follow a dose-dependent manner whereby individuals with the genotype APOEε4/4 have a higher relative risk than those heterozygous for the ε4 allele (RR=4.03 and 1.76 respectively). The relative risk and the attributable fraction calculated for APOE ε4 are consistent with those reported for other €pean populations. This places the influence of this locus on AD development in the Irish population between those of the Spanish and New York white populations. Conclusion These findings provide further evidence for the importance of APOE in the development of AD.