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The neurological complications following cardiovascular surgery can significantly affect the prognosis of patients. As a convenient and non⁃invasive intraoperative neurological monitoring method, transcranial Doppler ultrasonography (TCD) can provide real⁃time assessment of cerebral hemodynamics and microemboli signals, guide the development of neuroprotective strategies, and reduce the brain injury events. This review systematically summarizes the basic methods and technical performance of TCD monitoring, its clinical application in cardiovascular surgery, as well as the main limitations and future trends of this technology, in order to improve perioperative safety.

Brain and heart comorbidity is one of the major public health problems in China, which seriously threatens national health. After many years of exploration, the concept of "synchronous treatment for brain and heart" has become more and more accepted. This article summarizes the pathophysiological mechanism of brain ⁃ heart interaction, the clinical and research practice of the theory of "synchronous treatment for brain and heart", and its future development direction, and jointly help the diagnosis and treatment of brain and heart comorbidity.

Objective To explore a potential relationship of Timed Up and Go (TUG) test to cognitive functions among elders. Methods The participants were from Rugao Longevity and Ageing Study conducted in Jiangsu province, China. TUG test was completed, recording gaits stability, test time and the overall scale. Cognitive function was evaluated using Chinese version of revised Hasegawa's Dementia Scale (HDS-R). Results A total of 1 655 participants (aged 75-84 years old) completed the TUG test and cognitive evaluation were included in this study. Among them, 872(52.7%) in cognitive impairment group and 783(47.3%) in non-cognitive impairment group, the gait stability, time and scale of TUG test were inverse associated with HDS-R and its subcomponents, respectively(P＜0.001). Logistic regression analysis showed that unsteady gait(OR=1.11, 95% CI:1.08-1.14, P＜0.001), longer time (OR=2.50, 95% CI:1.76-3.55, P＜0.001) and deteriorated scale (OR=1.62, 95% CI:1.39-1.89, P＜0.001) in TUG test were independently associated with increased risk of cognitive impairment. Conclusions Worse motor function performance on TUG test is significantly associated with cognitive impairment. The application of TUG test is potential method in early risk screening of cognitive impairment in community and has certain feasibility.

Objective To investigate whether depression is a potential risk factor for falls in the elderly in China. Methods Data were collected from the Subcohort of Rugao Longevity and Aging Study. Depression in the elderly was assessed by the GDS-15(Geriatric Depression Scale), and the occurrence of falls in the subjects at baseline in 2014 and the second follow-up in 2017 were collected and recorded. According to the depression status, subjects were divided into depression group and normal group, and the general information and occurrence of falls were compared between the two groups. Logistic regression was used to analyze whether depression increased the risk of falls in older adults. Results In the cross-sectional study of 1 548 subjects, the incidence of falls was 8.3%. The proportion of subjects in the “fall” group was higher in older age, lower education level and cognitive impairment. Compared with the normal group, the depressed group had a higher proportion of women, farmers, less education, unmarried, non-smokers, non-drinkers and cognitively disabled people. After adjusting for confounders, depression was associated with an increased risk of falls at baseline and 3 years later in older adults (P＜ 0.05). Conclusions Depression is a potential risk factor for falls among the elderly in the Chinese community.

Objective To investigate whether serum cystatin C (Cys C) is a potential risk factor for motoric cognitive risk syndrome (MCR) in Chinese elderly. Methods A total of 1592 elderly people were included in the subcohort from Rugao Longevity and Aging Study (RuLAS) at the third follow⁃up in 2019. The presence of subjective memory complaints was assessed by Geriatric Depression Scale (GDS⁃15) and the presence of slow walking speed was assessed by the 5⁃Meter Walking Speed Test. The presence of both symptoms was determined as MCR (n = 132). According to the serum Cys C level, the patients with serum Cys C level < 1.06 mg/L were classified as low level group (n = 794), and the patients with serum Cys C level ≥ 1.06 mg/L were classified as middle and high level group (n = 798). Univariate and multivariate stepwise Logistic regression were used to analyze whether elevated serum Cys C levels increased the risk of MCR. Results Compared with non⁃MCR group, MCR group had higher age (P = 0.041), female proportion (P = 0.027), farmer occupation (P = 0.044), married status (P = 0.034), cerebral vascular disease (P = 0.015), higher Cys C level (P = 0.023). Compared with the Cys C low level group, the Cys C middle and high level group had higher age (P = 0.000), male (P = 0.000), hypertension (P = 0.006), MCR (P = 0.049), and lower farmer proportion (P = 0.001); there was significant difference in smoking status (P = 0.041). Logistic regression analysis showed that increased Cys C level was a risk factor for the occurrence of MCR (OR = 1.419, 95%CI: 1.027-1.962; P = 0.034). Conclusions The incidence of MCR is higher in older people, female, farmers and the elderly with the history of cerebral vascular disease, and increased Cys C level is a potential risk factor for MCR.

Objective To explore whether cognitive frailty increases the risk of falls 5 years later in elderly Chinese population. Methods The data were collected from the Rugao Aging Cohort. Fried frailty phenotype was used to evaluate frailty. Those who met ≥3 of the five criteria were defined as frailty, those who met 1-2 criteria were defined as pre-frailty, and those who did not meet any criteria were considered to be robust. The revised Hasegawa Dementia Scale(HDS-R) was used to evaluate cognitive function. Excluding severe cognitive impairment (HDS-R≤10), the lowest quartile of scores was cognitive impairment. Those with both frailty and cognitive impairment were defined as cognitive frailty. Binary logistic regression was used to analyze frailty and falls risk at 5-year follow-up, and explore the effect of cognitive frailty (frailty plus cognitive function assessment) on falls risk. Results This study included 962 subjects with a mean age of 74.7±3.7 years at baseline, including 526 females. After 5 years of follow-up, 134 people experienced falls in the last year of following up . The incidence of falls was higher in female, illiterate and unmarried subgroups. Logistic regression analysis showed that the frail subjects at baseline were more likely to fall(OR=4.360,95% CI=1.955-9.722), and those with cognitive frailty had a higher risk of fall than those robust without cognitive impairment (OR=6.000,95% CI=1.935-18.603). After adjusting for covariates, the higher five-year falls risk for cognitive frailty remained statistically significant (OR=6.736,95% CI=1.897-23.922, P＜0.05). Conclusions Cognitive frailty is significantly correlated with a higher risk of falls after 5 years. The assessment of cognitive frailty is important for assessing the risk of falls in older adults.

Objective To explore the epidemiological characteristics of motoric cognitive risk syndrome (MCR) in Chinese elderly and its relationship with hospitalization. Methods Data were collected from a subcohort of the rugao longevity and aging study. Subjective memory complaints were assessed by the geriatric depression scale (GDS-15), and slow gait was assessed by the time up and go test (TUGT). MCR was determined by the presence of both. The incidence of hospitalization was recorded from the baseline survey in 2014 to the second 3-year follow-up in 2017, and the incidence of MCR in the hospitalized and non-hospitalized groups was compared to analyze the association between MCR and hospitalization. Results In this study, 1 076 subjects were enrolled, with an average age of 75.0±3.8 years old; The prevalence of MCR was 3.3%. During the 3-year follow-up period, 61.1% of the MCR group had records of hospitalization, while only 41.9% of the non-MCR group had the record of hospitalization (P＜0.05). The hospitalized group had a higher average age, and a higher proportion of men, non-illiterates, and those with hypertension, diabetes, and cerebrovascular disease. Hospital combination and the proportion of MCR is 4.8%, the hospital group was 2.3% (P＜0.05). After adjusting for age, sex, occupation, level of education, marital status, smoking status, BMI, blood pressure, diabetes and coronary heart disease, cerebrovascular disease, and other confounding factors, MCR is associated with increased risk of hospitalization in the elderly (P＜0.05). Conclusions The incidence of hospitalization was higher in the population of male especiall those with hypertension, diabetes and cerebrovascular history, MCR is significantly associated with hospitalization.

Cognitive frailty, which increases the risk of dementia, is a geriatric syndrome characterized by both physical frailty and cognitive impairment. It is associated with adverse health events such as functional disability, hospitalization, falls, all-cause mortality and the incidence of dementia, vascular dementia, neurocognitive disorders, with potential reversibility. A clear and unified operational definition of cognitive frailty in the future is of great significance for early recognition and intervention of cognitive frailty and secondary prevention of early or asymptomatic dementia.

Frailty is a geriatric syndrome caused by a decrease in multi ⁃ system physiological reserve and function, which reduces the elderly's ability to stress the internal and external environment and maintain homeostasis, and increases the risk of adverse health events. The incidence of frailty and pre ⁃ frailty in stroke patients is the highest and significantly higher than that in non ⁃ stroke patients, while the prevalence of cerebrovascular disease in frailty patients is also significantly increased and the prognosis is worse. This paper intends to review the potential association between frailty and cerebrovascular disease.

The female infant in this case study was admitted to the hospital 4 hours after birth due to preterm birth and respiratory distress. On the third day after birth, peripherally inserted central venous catheter (PICC) catheterization was performed. On day 42, thrombus was found at the entrance of the right atrium from the inferior vena cava during a cardiac ultrasound, and it was considered to be related to PICC placement. Low-molecular-weight heparin and urokinase were given. After two weeks of treatment, ultrasonic monitoring showed thrombus shrinkage. No bleeding or pulmonary embolism occurred during the treatment. The patient discharged after improvement. This article mainly introduces a multidisciplinary team approach to diagnosis and treatment of PICC-related thrombosis in neonates. [ABSTRACT FROM AUTHOR]

The Guanzhong Plain of Shaanxi Province is a severely afflicted hemorrhagic fever with renal syndrome (HFRS) epidemic area, while HFRS prevalence has decreased in most epidemic areas in China. Little information is available regarding the leading fine-scale influencing factors in this highly HFRS-concentrated area and the roles of natural environmental and socioeconomic factors. To investigate this, two regions in the Guanzhong Plain, that is, the Chang'an District and Hu County, with similar geographical environments, different levels of economic development, and high epidemic prevalence, were chosen as representative areas of the HFRS epidemic. Maximum entropy models were constructed based on HFRS cases and fine-scale influencing factors, including meteorological, natural environmental, and socioeconomic factors, from 2014 to 2016. More than 95% of the HFRS cases in the study area were located in the northern plains, which has an altitude of less than 800 m, with topography contributed 84.1% of the impact on the spatial differentiation of the HFRS epidemic. In the northern plains, precipitation and population density jointly affected the spatial differentiation of the HFRS epidemic, with contribution rates of 60.7% and 28.0%, respectively. By comparing the influencing factors of the northern plains of Chang'an District and Hu County, we found that precipitation and the normalized difference vegetation index (NDVI) dominated the HFRS epidemic in the relatively developed Chang'an District, while land-use type, temperature, precipitation and population density dominated the HFRS epidemic in the relatively undeveloped Hu County. Topography was the primary key factor for HFRS prevalence in the Chang'an District and Hu County, and the spatial differentiation of HFRS was dominated by precipitation and population density in the northern plains. Compared with the influencing factors of the relatively developed Chang'an District, the developing Hu County was more affected by socioeconomic factors. When formulating targeted HFRS epidemic prevention and control strategies in the targeted areas, it is crucial to consider the local economic development state and combine natural environmental factors, including the meteorological environment and vegetation coverage. [ABSTRACT FROM AUTHOR]