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| 1 | 中国血管性认知障碍诊疗指导规范(2016年)显示文摘随着人口老龄化进程的日益加速,脑血管病及其危险因素导致的血管性认知障碍(vascular cognitive impairment,VCI)的发病率、患病率、致残率及死亡率日益升高。VCI严重损害患者的日常生活能力和社会功能,明显降低患者的生活质量,给家庭和社会带来沉重的照护和经济负担,已经成为全世界重大的公共卫生问题之一。 | 无 王拥军 | 2016 | 全科医学临床与教育2016，14，5： | 61 |
| 2 | Update on the treatment of type 2 diabetes mellitus显示文摘To achieve good metabolic control in diabetes and keep long term, a combination of changes in lifestyle and pharmacological treatment is necessary. Achieving near-normal glycated hemoglobin significantly, decreases risk of macrovascular and microvascular complications. At present there are different treatments, both oral and injectable, available for the treatment of type 2 diabetes mellitus(T2DM). Treatment algorithms designed to reduce the development or progression of the complications of diabetes emphasizes the need for good glycaemic control. The aim of this review is to perform an update on the benefits and limitations of different drugs, both current and future, for the treatment of T2 DM. Initial intervention should focus on lifestyle changes. Moreover, changes in lifestyle have proven to be beneficial, but for many patients is a complication keep long term. Physicians should be familiar with the different types of existing drugs for the treatment of diabetes and select the most effective, safe and better tolerated by patients. Metformin remains the first choice of treatment for most patients. Other alternative or second-line treatment options should be individualized depending on the characteristics of each patient. This article reviews the treatments available for patients with T2 DM, with an emphasis on agents introduced within the last decade. | Juan Jose Marin-Penalver Iciar Martin-Timon Cristina Sevillano-Collantes Francisco Javier del Canizo-Gomez | 2016 | World Journal of Diabetes2016，7，17： | 37 |
| 3 | Incidence and Risk Factors of Cognitive Impairment 3 Months after First-ever Stroke: A Cross-sectional Study of 5 Geographic Areas of China显示文摘This study examined the incidence, neuropsychological characteristics and risk factors of cognitive impairment 3 months after stroke in China. Five regions that differed in geography and economy in China were selected. Patients from the hospitals located in the five regions were prescreened at admission, and the demographic data, vascular risk factors and clinical characteristics of stroke were obtained. A battery of cognitive-specific domain tests was performed in the patients who failed to pass cognitive screening 3 months post stroke. Patients were diagnosed as having post-stroke cognitive impairment (PSCI) or no cognitive impairment (NCI) based on the results of the neuropsy-chological tests. Univariate analysis was performed for suspect risk factors, and significant variables were entered in multivariable logistic regression analysis. Our results showed that a total of 633 patients were recruited 3 months after stroke; complete cognitive tests were performed in 577 of the stroke pa-tients. The incidence of PSCI in these Chinese patients was 30.7%. There were 129 (22.4%) patients with visuospatial impairment, 67 (11.6%) with executive impairment, 60 (10.4%) with memory impairment and 18 (3.1%) with attention impairment. The risk factors associated with PSCI were older age (odds ratio [OR] 1.76, 95% confidence interval [CI] 1.20-2.58), low education level (OR 2.45, 95% CI 1.65-3.64), depressive symptom (OR 1.69, 95% CI 1.09-2.61), obesity (OR 2.57, 95% CI 1.41-4.71), stroke severity 3 months post stroke (OR 1.62, 95%CI 1.10-2.37) and cortex lesion (OR 1.55, 95% CI 1.04-2.31). It was concluded that PSCI occurs commonly 3 months after first-ever stroke in Chinese patients. Visuospatial ability may be the most frequently impaired cognitive domain for the patients with stroke. The critical risk factors of PSCI are older age, low education level, depressive symptom, obesity, stroke severity 3 months post stroke and cortex lesion. | 张勇 张振馨 杨百渔 李延峰 张蕲 屈秋民 王延平 张世红 岳卫东 谭毓绘 张宝荣 徐涛 | 2012 | Journal of Huazhong University of Science and Technology(Medical Sciences)2012，32，6： | 29 |
| 4 | Type 2 diabetes mellitus and Alzheimer's disease显示文摘Epidemiological and biological evidences support a link between type 2 diabetes mellitus(DM2) and Alzheimer's disease(AD). Persons with diabetes have a higher incidence of cognitive decline and an increased risk of developing all types of dementia. Cognitive deficits in persons with diabetes mainly affect the areas of psychomotor efficiency, attention, learning and memory, mental flexibility and speed, and executive function. The strong epidemiological association has suggested the existence of a physiopathological link. The determinants of the accelerated cognitive decline in DM2, however, are less clear. Increased cortical and subcortical atrophy have been evidenced after controlling for diabetic vascular disease and inadequate cerebral circulation. Most recent studies have focused on the role of insulin and insulin resistance as possible links between diabetes and AD. Disturbances in brain insulin signaling mechanisms may contribute to the molecular, biochemical, and histopathological lesions in AD. Hyperglycemia itself is a risk factor for cognitive dysfunction and dementia. Hypoglycemia may also have deleterious effects on cognitive function. Recurrent symptomatic and asymptomatic hypoglycemic episodes have been suggested to cause sub-clinical brain damage, and permanent cognitive impairment. Futuretrials are required to clarify the mechanistic link, to address the question whether cognitive decline may be prevented by an adequate metabolic control, and to elucidate the role of drugs that may cause hypoglycemic episodes. | Mario Barbagallo Ligia J Dominguez | 2014 | World Journal of Diabetes2014，5，6： | 22 |
| 5 | 轻度认知障碍危险因素及干预的研究现状显示文摘随着阿尔茨海默病(Alzheimer's disease,AD)研究的深入,其预防性干预得到更多重视。在《2011年美国AD最新诊断标准》中,轻度认知障碍(mild cognitive impairment,MCI)被认为是AD连续谱中的痴呆前期症状状态[1],称为"AD所致MCI",是介于衰老所致认知功能衰退、增龄相关记忆障碍与某些临床初期痴呆、AD、某些血管性痴呆(vascular dementia,VD)之间的过渡性或痴呆前期的病理状态。 | 吴含 朱奕 王彤 | 2016 | 中国康复医学杂志2016，31，5： | 21 |
| 6 | Contribution of diffusion,perfusion and functional MRI to the disconnection hypothesis in subcortical vascular cognitive impairment显示文摘Vascular cognitive impairment(VCI)describes all forms of cognitive impairment caused by any type of cerebrovascular disease.Early identification of VCI is quite difficult due to the lack of both sensitive and specific biomarkers.Extensive damage to the white matter tracts,which connect the cortical and subcortical regions,has been shown in subcortical VCI(SVCI),the most common subtype of VCI that is caused by small vessel disease.Two specific MRI sequences,including diffusion tensor imaging(DTI)and functional MRI(fMRI),have emerged as useful tools for identifying subtle white matter changes and the intrinsic connectivity between distinct cortical regions.This review describes the advantages of these two modalities in SVCI research and the current DTI and fMRI findings on SVCI.Using DTI technique,a variety of studies found that white matter microstructural damages in the anterior and superior areas are more specific to SVCI.Similarly,functional brain abnormalities detected by fMRI have also been mainly shown in anterior brain areas in SVCI.The characteristic distribution of brain abnormalities in SVCI interrupts the prefrontal-subcortical loop that results in cognitive impairments in particular domains,which further confirms the‘disconnection syndrome’hypothesis.In addition,another MRI technique,arterial spin labelling(ASL),has been used to describe the disconnection patterns in a variety of conditions by measuring cerebral blood flow.The role of the ASL technique in SVCI research is also assessed.Finally,the review proposes the application of multimodality fusion in the investigation of SVCI pathogenesis. | Qing Ye Feng Bai | 2018 | Stroke & Vascular Neurology2018，3，3： | 20 |
| 7 | Mesenchymal stem cell-derived exosomes promote neurogenesis and cognitive function recovery in a mouse model of Alzheimer’s disease显示文摘Studies have shown that mesenchymal stem cell-derived exosomes can enhance neural plasticity and improve cognitive impairment.The purpose of this study was to investigate the effects of mesenchymal stem cell-derived exosomes on neurogenesis and cognitive capacity in a mouse model of Alzheimer’s disease.Alzheimer’s disease mouse models were established by injection of beta amyloid 1?42 aggregates into dentate gyrus bilaterally.Morris water maze and novel object recognition tests were performed to evaluate mouse cognitive deficits at 14 and 28 days after administration.Afterwards,neurogenesis in the subventricular zone was determined by immunofluorescence using doublecortin and PSA-NCAM antibodies.Results showed that mesenchymal stem cells-derived exosomes stimulated neurogenesis in the subventricular zone and alleviated beta amyloid 1?42-induced cognitive impairment,and these effects are similar to those shown in the mesenchymal stem cells.These findings provide evidence to validate the possibility of developing cell-free therapeutic strategies for Alzheimer’s disease.All procedures and experiments were approved by Institutional Animal Care and Use Committee(CICUAL)(approval No.CICUAL 2016-011)on April 25,2016. | Edwin E. Reza-Zaldivar Mercedes A. Hernández-Sapiéns Yanet K. Gutiérrez-Mercado Sergio Sandoval-ávila Ulises Gomez-Pinedo Ana L. Márquez-Aguirre Estefanía Vázquez-Méndez Eduardo Padilla-Camberos Alejandro A. Canales-Aguirre | 2019 | Neural Regeneration Research2019，14，9： | 19 |
| 8 | MicroRNAs as diagnostic and therapeutic tools for Alzheimer's disease: advances and limitations显示文摘Alzheimer's disease(AD) is the most common age-related, progressive neurodegenerative disease. It is characterized by memory loss and cognitive decline and responsible for most cases of dementia in the elderly. Late-onset or sporadic AD accounts for > 95% of cases, with age at onset > 65 years. Currently there are no drugs or other therapeutic agents available to prevent or delay the progression of AD. The cellular and molecular changes occurring in the brains of individuals with AD include accumulation of β-amyloid peptide and hyperphosphorylated tau protein, decrease of acetylcholine neurotransmitter, inflammation, and oxidative stress. Aggregation of β-amyloid peptide in extracellular plaques and the hyperphosphorylated tau protein in intracellular neurofibrillary tangles are characteristic of AD. A major challenge is identifying molecular biomarkers of the early-stage AD in patients as most studies have been performed with blood or brain tissue samples(postmortem) at late-stage AD. Subjects with mild cognitive impairment almost always have the neuropathologic features of AD with about 50% of mild cognitive impairment patients progressing to AD. They could provide important information about AD pathomechanism and potentially also highlight minimally or noninvasive, easy-to-access biomarkers. MicroRNAs are dysregulated in AD, and may facilitate the early detection of the disease and potentially the continual monitoring of disease progression and allow therapeutic interventions to be evaluated. Four recent reviews have been published of microRNAs in AD, each of which identified areas of weakness or limitations in the reported studies. Importantly, studies in the last three years have shown considerable progress in overcoming some of these limitations and identifying specific microRNAs as biomarkers for AD and mild cognitive impairment. Further large-scale human studies are warranted with less disparity in the study populations, and using an appropriate method to validate the findings. | Bridget Martinez Philip V.Peplow | 2019 | Neural Regeneration Research2019，14，2： | 18 |
| 9 | 不同延伸护理方式对轻度认知功能障碍患者的干预效果显示文摘轻度认知功能障碍(mild cognitive impairment,MCI)是介于正常衰老和痴呆之间的一种认知缺损状态,患者表现为与年龄不符的记忆力减退和其他认知功能障碍,不影响日常活动能力,未达到目前老年痴呆的诊断标准。但是,确诊为MCI的患者发生痴呆的危险性极高,阿尔茨海默症(Alzheimer′s disease,AD)转化率为每年8%-25%,比健康对照组发病率高10倍。 | 李佳 梁晓红 王凤霞 刘继红 秦燕 廖春莲 | 2015 | 重庆医学2015，44，34： | 18 |
| 10 | An Integrated Analysis of Risk Factors of Cognitive Impairment in Patients with Severe Carotid Artery Stenosis显示文摘Objective To investigate cognitive dysfunction in patients with carotid artery stenosis(CAS) and potential risk factors related to cognitive-especially memory-dysfunction. Methods Forty-seven patients with carotid artery stenosis were recruited into our study cohort. The Mini-Mental State Examination(MMSE) and the Montreal Cognitive Assessment(MoCA) were adopted to assess cognitive function, the Wechsler Memory Scale(WMS) to assess memory function, high-resolution MRI and enhanced ultrasound to evaluate carotid plaques, and computed tomography perfusion(CTP) imaging to evaluate intracranial blood perfusion. Single-factor analysis and multiple-factor regression analysis were used to analyze potential risk factors of cognitive impairment. Results Mini-Mental State Examination test results showed that 22 patients had cognitive impairment, and MoCA test results showed that 10 patients had cognitive impairment. Analysis of various risk factors indicated that the average memory quotient of female patients was higher than that of males(P = 0.024). The cognitive and memory performance of those with an educational background above high school were significantly better than those of participants with high school or lower(P = 0.045). Patients with abnormal intracranial perfusion performed worse on the MMSE test(P = 0.024), and their WMS scores were significantly lower(P = 0.007). The MMSE scores and the memory quotients were significantly lower in patients with a history of cerebral infarction(MMSE, P = 0.047, memory quotient score, P = 0.018). Conclusion A history of cerebral infarction and abnormal cerebral perfusion are associated with decline in overall cognitive function and memory in patients with carotid stenosis. Being female and having an educational background above high school may be protective factors in the development of cognitive dysfunction. | LUO Ru Tao WANG Pei Jiong DENG Xiao Feng ZHOU Shu Jie ZHAO Meng QIAN Jing ZHANG Dong WANG Rong ZHANG Yan | 2018 | Biomedical and Environmental Sciences2018，31，11： | 17 |
| 11 | Formaldehyde stress显示文摘Formaldehyde,one of the most toxic organic compounds,is produced and processed in human cells.The level of human endogenous formaldehyde is maintained at a low concentration(0.01-0.08 mmol L-1 in blood) under physiological conditions,but the concentration increases during ageing(over 65 years old).Clinical trials have shown that urine formaldehyde concentrations are significantly different between elderly Alzheimer's patients(n=91) and normal elderly volunteers(n=38)(P<0.001).Abnormally high levels of intrinsic formaldehyde lead to dysfunction in cognition such as learning decline and memory loss.Excess extracellular and intracellular formaldehyde could induce metabolic response and abnormal modifications of cellular proteins such as hydroxymethylation and hyperphosphorylation,protein misfolding,nuclear translocation and even cell death.This cellular response called formaldehyde stress is dependent upon the concentration of formaldehyde.Chronic impairments of the brain resulted from formaldehyde stress could be one of the mechanisms involved in the process of senile dementia during ageing. | HE RongQiao1*,LU Jing1,2 & MIAO JunYe1,2 1State Key Laboratory of Brain and Cognitive Sciences,Institute of Biophysics,Chinese Academy of Sciences,Beijing 100101,China 2Graduate University of Chinese Academy of Sciences,Beijing 100049,China | 2010 | Science China(Life Sciences)2010，53，12： | 16 |
| 12 | MoCA量表在帕金森病轻度认知障碍筛查中的应用价值显示文摘帕金森病(Parkinson’s disease,PD)合并轻度认知功能障碍(mild cognitive impairment,MCI)常见,MCI在PD患者中发生率为20%-50%。PD-MCI是介于认知功能正常与痴呆的过渡阶段,PD晚期并发帕金森病痴呆(Parkinson’s disease dementia,PDD)高达80%。原先易被忽视的PDMCI在近来的临床与科研工作中得到越来越多的关注,并成为该领域的研究重点和难点问题。对PD患者的认知功能进行早期评估,并给予早期干预,对预防和延缓帕金森病痴呆具有重大意义。 | 陈文鑫 邓远飞 吴学良 张丹霓 李鑫 黄妙珊 | 2017 | 卒中与神经疾病2017，24，2： | 14 |
| 13 | Differentiating between Alzheimer’s disease, amnestic mild cognitive impairment, and normal aging via diffusion kurtosis imaging显示文摘Diffusion kurtosis imaging can be used to assess pathophysiological changes in tissue structure and to diagnose central nervous system diseases. However, its sensitivity in assessing hippocampal differences between patients with Alzheimer’s disease and those with amnestic mild cognitive impairment has not been characterized. Here, we examined 20 individuals with Alzheimer’s disease (11 men and 9 women, mean 73.2 ± 4.49 years), 20 with amnestic mild cognitive impairment (10 men and 10 women, mean 71.55 ± 4.77 years), and 20 normal controls (11 men and 9 women, mean 70.45 ± 5.04 years). We conducted diffusion kurtosis imaging, using a 3.0 T magnetic resonance scanner, to compare hippocampal differences among the three groups. The results demonstrated that the right hippocampal volume and bilateral mean kurtosis were remarkably smaller in individuals with Alzheimer’s disease compared with those with amnestic mild cognitive impairment and normal controls. Further, the mean kurtosis was lower in the amnestic mild cognitive impairment group compared with the normal control group. The mean diffusion in the left hippocampus was lower in the Alzheimer’s disease group than in the amnestic mild cognitive impairment and normal control groups, while the mean diffusion in the right hippocampus was lower in the Alzheimer’s disease group than in the normal control group. Fractional anisotropy was similar among the three groups. These results verify that bilateral mean kurtosis and mean diffusion are sensitive to the diagnosis of Alzheimer’s disease and amnestic mild cognitive impairment. This study was approved by the Ethics Review Board of Affiliated Sixth People’s Hospital of Shanghai Jiao Tong University, China on May 4, 2010 (approval No. 2010(C)-6). | Guo-Ping Song Ting-Ting Yao Dan Wang Yue-Hua Li | 2019 | Neural Regeneration Research2019，14，12： | 11 |
| 14 | GJB2 mutation spectrum in deaf population in a typical southeastern area of China显示文摘Mutations in GJB2 gene are the most frequently found mutations in patients with nonsyndromic hearing impairment. However, the spectrum and prevalence of mutations in this gene vary among different ethnic groups. In China, 30,000 infants are born with congenital hearing impairment annually. In order to provide appropriate genetic testing and counseling to the families, we investigated the molecular etiology of nonsyndromic deafness in 103 unrelated school children attending Nantong School for the Deaf and Mute in Jiangsu Province, China. The coding exon of the GJB2 gene was PCR amplified and sequenced. Sixty two GJB2 mutant alleles were identified in 35.9% (37/103) of the patients. Twenty five patients carried two pathogenic mutations and 12 patients carried one mutant allele. The 235delC was the most common mutation accounting for 69.4% (43/62) of GJB2 mutant alleles. The GJB2 mutant alleles accounted for 30.1% (62/206) of all chromosomes responsible for nonsyndromic hearing impairment. Testing of the 3 most prevalent deleterious frame shift mutations in this cohort detected 100% of all GJB2 mutant alleles. These results demonstrate that an effective genetic testing of GJB2 gene for patients and families with nonsyndromic hearing impairment is possible. | DAI Pu1*, YOU Yi-wen2*, CUI Jing-hong2*, YU Fei1, HAN Bing 1, KANG Dong-yang1, YUAN Hui-jun1, HAN Dong-yi1, 1. Department of Otolaryngology, PLA General Hospital, Beijing, People’s Republic China, 100853 2. Department of Otolaryngology, Nantong University Affiliated Hospital, Nantong, Jiangsu Province, People’s Republic China, 226001 *Pu Dai, Yiwen You, Jinghong Cui contribute equally to this paper | 2006 | Journal of Otology2006，1，2： | 10 |
| 15 | 轻度认知功能障碍显示文摘轻度认知功能障碍(mild cognitive impairment,MCI)是一种介于正常衰老与痴呆之间的认知功能障碍。MCI患者易高风险地转化为痴呆,严重影响了老年人的健康。研究和识别MCI,有助于发现最佳干预时机的个体,从而在最佳时间窗进行防治。 | 张晓梅 岳卫东 | 2016 | 脑与神经疾病杂志2016，24，3： | 10 |
| 16 | Icariin Improves Cognitive Impairment after Traumatic Brain Injury by Enhancing Hippocampal Acetylation显示文摘Objective: To examine the effect of icariin(ICA) on the cognitive impairment induced by traumatic brain injury(TBI) in mice and the underlying mechanisms related to changes in hippocampal acetylation level. Methods: The modified free-fall method was used to establish the TBI mouse model. Mice with post-TBI cognitive impairment were randomly divided into 3 groups using the randomised block method(n=7): TBI(vehicle-treated), low-dose(75 mg/kg) and high-dose(150 mg/kg) of ICA groups. An additional sham-operated group(vehicle-treated) was employed. The vehicle or ICA was administrated by gavage for 28 consecutive days. The Morris water maze(MWM) test was conducted. Acetylcholine(ACh) content, m RNA and protein levels of choline acetyltransferase(Ch AT), and protein levels of acetylated H3(Ac-H3) and Ac-H4 were detected in the hippocampus. Results: Compared with the sham-operated group, the MWM performance, hippocampal ACh content, m RNA and protein levels of Ch AT, and protein levels of Ac-H3 and Ac-H4 were significantly decreased in the TBI group(P<0.05). High-dose of ICA significantly ameliorated the TBI-induced weak MWM performance, increased hippocampal ACh content, and m RNA and protein levels of Ch AT, as well as Ac-H3 protein level compared with the TBI group(P<0.05). Conclusion: ICA improved post-TBI cognitive impairment in mice by enhancing hippocampal acetylation, which improved hippocampal cholinergic function and ultimately improved cognition. | ZHANG Zi-gang WANG Xin ZAI Jin-hai SUN Cai-hua YAN Bing-chun | 2018 | Chinese Journal of Integrative Medicine2018，24，5： | 9 |
| 17 | Diabetic retinopathy: a matter of retinal ganglion cell homeostasis显示文摘Diabetic retinopathy(DR)is the most common complication of diabetes and the leading cause of visual impairment in the working-age population in the Western world(http://www.diabetesatlas.org/).One of the earliest events observed in DR is the impairment of retinal perfusion,caused by the constriction of retinal blood vessels,inducing biochemical and metabolic alterations,perycites/endothelial degeneration,and retina ischemia(Wong et al.,2016).Severe stages of DR include proliferative DR,caused by the abnormal growth of new vessels,and diabetic macular oedema in the central part of the retina.DR is strongly associated with a prolonged duration of diabetes,hypertension,and hyperglycaemia but it can persist even after replacement of normal glycaemic status(Wong et al.,2016). | Elisabetta Catalani Davide Cervia | 2020 | Neural Regeneration Research2020，15，7： | 9 |
| 18 | Effect of Western medicine therapy assisted by Ginkgo biloba tablet on vascular cognitive impairment of none dementia显示文摘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. | Shi-Jin Zhang Zhan-You Xue | 2012 | Asian Pacific Journal of Tropical Medicine2012，5，8： | 9 |
| 19 | Comparative efficacy and safety of cognitive enhancers for treating vascular cognitive impairment: systematic review and Bayesian network meta-analysis显示文摘Objective: To assess and compare the clinical efficacy and safety of cognitive enhancers(donepezil, galantamine, rivastigmine, and memantine) on cognition, behavior, function, and global status in patients with vascular cognitive impairment.Data sources: The initial literature search was performed with PubMed, EMBASE, the Cochrane Methodology Register, the Cochrane Central Register of Controlled Trials, and Cumulative Index to Nursing & Allied Health(CINAHL) from inception to January 2018 for studies regarding donepezil, galantamine, rivastigmine, and memantine for treatment of vascular cognitive impairment.Data selection: Randomized controlled trials on donepezil, galantamine, rivastigmine, and memantine as monotherapy in the treatment of vascular cognitive impairment were included. A Bayesian network meta-analysis was conducted. Outcome measures: Efficacy was assessed by changes in scores of the Alzheimer's Disease Assessment Scale, cognitive subscale, Mini-Mental State Examination, Neuropsychiatric Inventory scores and Clinician's Interview-Based Impression of Change Scale Plus Caregiver's Input, Activities of Daily Living, the Clinical Dementia Rating scale. Safety was evaluated by mortality, total adverse events(TAEs), serious adverse events(SAEs), nausea, vomiting. diarrhea, or cerebrovascular accidents(CVAs). Results: After screening 1717 citations, 12 randomized controlled trials were included. Donepezil and rivastigmine(mean difference(e) = –0.77, 95% confidence interval(CI): 0.25–1.32; MD = 1.05, 95% CI: 0.18–1.79) were significantly more effective than placebo in reducing Mini-Mental State Examination scores. Donepezil, galantamine, and memantine(MD = –1.30, 95% CI: –2.27 to –0.42; MD = –1.67, 95% CI: –3.36 to –0.06; MD = –2.27, 95% CI: –3.91 to –0.53) showed superior benefits on the Alzheimer's Disease Assessment Scale–cognitive scores compared with placebo. Memantine(MD = 2.71, 95% CI: 1.05–7.29) improved global status(Clinician's Interview-Based Impression of Change Scale Plus Caregiver's Input) more than the placebo. Safety results revealed that donepezil 10 mg(odds ratio(OR) = 3.04, 95% CI: 1.86–5.41) contributed to higer risk of adverse events than placebo. Galantamine(OR = 5.64, 95% CI: 1.31–26.71) increased the risk of nausea. Rivastigmine(OR = 16.80, 95% CI: 1.78–319.26) increased the risk of vomiting. No agents displayed a significant risk of serious adverse events, mortality, cerebrovascular accidents, or diarrhea.Conclusion: We found significant efficacy of donepezil, galantamine, and memantine on cognition. Memantine can provide significant efficacy in global status. They are all safe and well tolerated. | Bo-Ru Jin Hua-Yan Liu | 2019 | Neural Regeneration Research2019，14，5： | 9 |
| 20 | Effects of glucagon-like peptide-1 receptor agonists on renal function显示文摘Glucagon-like peptide-1(GLP-1)receptor agonists result in greater improvements in glycemic control than placebo and promote weight loss with minimal hypoglycemia in patients with type 2 diabetes mellitus.A number of case reports show an association of GLP-1receptor agonists,mainly exenatide,with the development of acute kidney injury.The present review aims to present the available data regarding the effects of GLP-1 receptor agonists on renal function,their use in subjects with chronic renal failure and their possible association with acute kidney injury.Based on the current evidence,exenatide is eliminated by renal mechanisms and should not be given in patients with severe renal impairment or end stage renal disease.Liraglutide is not eliminated by renal or hepatic mechanisms,but it should be used with caution since there are only limited data in patients with renal or hepatic impairment.There is evidence from animal studies that GLP-1 receptor agonists exert protective role in diabetic nephropathy with mechanisms that seem to be independent of their glucose-lowering effect.Additionally,there is evidence that GLP-1 receptor agonists influence water and electrolyte balance.These effects may represent new ways to improve or even prevent diabetic nephropathy. | Theodosios D Filippatos Moses S Elisaf | 2013 | World Journal of Diabetes2013，4，5： | 9 |
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