BackgroundCarotid atherosclerosis (CA) is a reflector of generalized atherosclerosis that is associated with systemic vascular disease. Data are limited on the epidemiology of carotid lesions in a large, nationally representative population sample. We aimed to evaluate the prevalence of CA detected by carotid ultrasonography and related risk factors based on a national survey in China. Methods and ResultsA total of 107 095 residents aged ≥40 years from the China National Stroke Prevention Project underwent carotid ultrasound examination. Participants with carotid endarterectomy or carotid stenting and those with stroke or coronary heart disease were excluded. Data from 84 880 participants were included in the analysis. CA was defined as increased intima–media thickness (IMT) ≥1 mm or presence of plaques. Of the 84 880 participants, 46.4% were men, and the mean age was 60.7±10.3 years. The standardized prevalence of CA was 36.2% overall, increased with age, and was higher in men than in women. Prevalence of CA was higher among participants living in rural areas than in urban areas. Approximately 26.5% of participants had increased IMT, and 13.9% presented plaques. There was an age‐related increase in participants with increased IMT, plaque presence, and stenosis. In multiple logistic regression analysis, older age, male sex, residence in rural areas, smoking, alcohol consumption, physical inactivity, obesity, hypertension, diabetes mellitus, and dyslipidemia were associated with CA. ConclusionsCA was highly prevalent in a middle‐aged and older Chinese population. This result shows the potential clinical importance of focusing on primary prevention of atherosclerosis progression.

PURPOSE:This study aimed to detect the association between angiotensin I converting enzyme (ACE) gene polymorphisms (rs4343 and rs1800764) and Alzheimer's disease (AD) in Han population in Hebei Peninsular.METHODS:We recruited 113 AD patients and 142 healthy individuals in this case-control study. Differences of genotypes, alleles and haplotypes in two groups were analyzed by chi-square test. Besides, odds ratios (ORs) and 95% confidence intervals (CIs) were used to represent the relative risk of AD. At last, the analyses of linkage disequilibrium and haplotypes were done with HaploView software.RESULTS:In the analyses of genotypes and alleles of ACE polymorphisms (rs4343 and rs1800764) in AD, no obvious association was found between genotypes and alleles of rs4343 with the susceptibility of AD. In rs1800764 polymorphism, only C allele had significant association with AD susceptibility (P=0.035, OR=1.473, 95% CI=1.027-2.111), which suggested that rs1800764 C allele is the susceptible allele of AD. Linkage disequilibrium analysis between rs4343 and rs1800764 polymorphisms indicated there existed 3 haplotypes (A-T, A-C and G-C). A-C haplotype might associate with the susceptibility of AD (P=0.023, OR=2.591, 95% CI=1.111-6.043).CONCLUSION:Rs4343 polymorphism of ACE gene had no relationship with AD risk. C allele of rs1800764 could increase the susceptibility of AD. A-C haplotype of rs4343 and rs1800764 polymorphisms might increase the risk of AD, and the ORs was 2.591.

A male, 62-year-old patient was admitted to hospital due to dizziness and gait disturbance for 10 days. The patient had fallen a few times due to the gait instability, which was associated with stiffness and memory loss. The patient had undergone cardiac carcinoma surgery three years previously and had no drinking history. Physical examination revealed that the patient was lucid when conscious but exhibited slurred speech, apathy and cognitive impairment. The finger-to-nose and rapid alternating movement tests showed the patient to be slightly clumsy. Magnetic resonance imaging revealed symmetric abnormal signals in the splenium of the corpus callosum, and the diagnosis was Marchiafava-Bignami disease (MBD). The patient recovered following the administration of vitamin B and other treatments. The patient had long-term appetite loss. A brain myelin metabolism disorder caused by long-term malnutrition and leading to demyelinating changes in the brain may have been the cause of the MBD of this patient. Clinicians should increase awareness of this disease and should not ignore the diagnosis of it, even when the patient lacks a drinking history. Early diagnosis and treatment can improve the prognosis of the patient.