In recent years, more and more attention has been paid into impairment of central nervous system after diabetes mellitus, including cognitive dysfunction. This paper would review the etiological factor and pathogenesis of cognitive dysfunction in type 2 diabetes mellitus patients.

As an important way to maintain the internal environment of the human body, the renin-angiotensin system (RAS) plays an important role in the diabetic cognitive dysfunction, which may associate with insulin resistance, inflammatory reaction, oxidative stress and other mechanisms. Traditional Chinese Medicine can improve cognitive function of diabetes, in which RAS may play a role.

Learning and memory dysfunction caused by diabetes is gaining an increased attention. Diabetes can significantly increasethe risk of dementia, including vascular dementia and Alzheimer's disease; and diabetes itself can lead to mild or moderate cognition decline.Many clinical and experimental datas indicated that deficiency of insulin or insulin resistance can significantly reduce the threshold of cognitivedysfunction and accelerate the progress of cognitive decline. This paper reviewed the effect of insulin and insulin resistance on cognitivefunction in diabetes.

OBJECTIVEThis study explores the effects of different fibrin glue combination modes on the survival, proliferation, and apoptosis of dental follicle cells (DFCs), as well as to evaluate the feasibility and effectiveness of fibrin glue as transplantation material.

METHODSThe membranes of surviving DFCs were marked using 3,3'-dioctadecyloxa carbocyanine perchlorate (DIO), and the cell number was counted by using ImageJ2x software. The apoptotic cells were marked with prodium iodide (PI).

RESULTSCompared with that of the 3D-2 and 2D-1 groups, the degradation speed of the 3D-1 group was the slowest. DFCs could survive and grow well in fibrinogen with a concentration of 15 mg · mL⁻¹ supplemented with thrombin with a concentration of 2 U · mL⁻¹. In particular, the 3D-1 combination mode was significantly conducive to cell proliferation and stretching.

CONCLUSIONFibrin glue can be used as an effective cell transplantation material. The different combination modes have certain effects on cell proliferation. The 3D-1 combination mode is more conducive to the survival and proliferation of DFCs than other modes.

Apoptosis ; Cell Proliferation ; Cell Survival ; Dental Sac ; cytology ; Fibrin Tissue Adhesive ; pharmacology ; Fibrinogen ; Humans ; Thrombin

Objective To investigate the proliferation and analyze the protein expression of the Hela cells by the regulation of glyceryl trinitrate (GTN) that acts as the donor of nitric oxide.Methods Cell morphology and MTT assay were used to analyze cell proliferation.Two-dimensional polyacrylamide gel electrophoresis (2-DE) and computer-assisted image analysis find the spots of interests. Difference of protein expression between GTN-treating group and control group was detected.Results Hela cells treated with 40?g/ml GTN in culture medium underwent inhibition of the growth activity, which were not clustered and shriveled. Some atypia cells were observed.Density of the cells was obviously decreased(0.0825, P

ObjectiveTo evaluate regional and global systolic function of left ventricle (LV) after mitral valve replacement(MVR) of different methods by 2-dimensional strain (2DS).MethodsAccording to the operational method whether preserve the posterior leaflet and its subvalvular apparatus,48 patients who underwent MVR were divided into two groups,the preservation group (group A) and the resection group (group B).Echocardiography was examinated before and after MVR and the apical four-chamber view,two-chamber view and long-axis view of LV were acquired.Regional peak strain (Sp) and global strain (GS) of LV longitudinal movement were analysed by 2DS software.Results①Compared to preoperation,the Sp in basal segment of posterior septum and inferior wall and middle segment of lateral wall in group A increased significantly ( P ＜0.01 or P ＜0.05).The Sp of group B were improved in both basal and middle segments of posterior septum ( P ＜0.05),while declined in middle segment of lateral wall and anterior wall,basal segment of lateral wall and apical segment of anterior wall significantly (P ＜0.01 or P ＜0.05).②Compared with group A,subtractions between preoperative and postoperative Sp of group B decreased in middle segment and apical segment of anterior wall,middle segment of lateral wall and middle segment of inferior wall significantly ( P ＜0.01 or P ＜0.05).③The GS of group A increased significantly ( P ＜0.05),while that in group B tended to reduce with no statistical significance ( P ＞0.05).Compared with group A,subtractions between preoperative and postoperative GS of group B droped significantly (P ＜ 0.05).ConclusionsAppropriate preservation of the posterior leaflet and its subvalvular apparatus has morebeneficial effect in improving the early regional and global function of LV after surgery,which would be recommended in MVR.Early regional and global systolic function of LV after MVR could be accurately evaluated by 2DS relatively,which has the application value of guiding clinical treatment and estimating prognosis.

Objective To evaluate the diagnostic value of shoulder MR arthrography for superior labral anterior-posterior (SLAP) lesions.Methods A retrospective study was conducted in 137 cases of shoulder MR arthrography confirmed by subsequent shoulder arthroscopy.Two radiologists analyzed all MR examinations independently and the results were compared with those of arthrescopy.The superior labrum was described as normal or torn.In addition, each iabral tear was classified as type Ⅰ-Ⅳ.Type Ⅰ lesions were defined as marked fraying of the articulating surface of the superior labrum; type Ⅱ, avulsion of the labral-bicipital complex from the ghnoid; type Ⅲ, displaced bucket handle tear of the superior labrum; and type Ⅳ, bucket handle tear of the superior labrum with extension into the fibers of the biceps tendon.Sensitivity, specificity, and accuracy were calculated.Kappa values were calculated to quantify the level, of inter-observer agreement.Results SLAP lesions were arthroscopically diagnosed in 59 of the 137 patients.Six of the 59 lesions ( 10.2% ) were classified as type Ⅰ , 50 (84.7% ) as type Ⅱ, and 3 (5.1% ) as type Ⅲ.The overall sensitivity, specificity, and accuracy of MR arthrographic detection of SLAP lesions were 86.4% (51/59), 78.2% (61/78), and 81.8% ( 112/137), respectively, for observer A, and 88.1% (52/59), 84.6% (66/78), and 86.1% (118/137), respectively, for observer B.At inter-observer comparison, agreement was very good (Kappa values = 0.796 ).The MR arthrographic classification showed correlation with the arthroscopic classification of SLAP lesions were 83.1% (49/59)and 79.7% (47/59) for two observers, respectively.Conclusion Shoulder MR arthrography is a reliable method for evaluating SLAP lesions.

Objective To assess the diagnostic value of MRI for the long head of the biceps brachii tendon tear,and to compare the diagnostic efficiency between routing MRI and MR arthrography. Methods A retrospective study was conducted in 215 cases with shoulder MR examination (107 with MR arthrography, and 108 with routing MRI) and subsequent shoulder arthrescopy and surgery. Two radiologists analyzed all MR examinations independently, and the results were compared with those of arthroscopy and surgery. Sensitivity, specificity, and accuracy were calculated. Kappa values were used to quantify the interobserver agreement. Results Based on the results of arthroacopy and surgery, 215 patients comprised 7 cases of complete tear of the long head of the biceps brachii tendon, 29 cases of partial tear, and 179 cases without tear. The overall sensitivity, specificity, and accuracy for the diagnosis of tears (complete and partial tear) of the long head of the biceps brachii tendon were 72.2% (26/36), 91.6% (164/179), and 88.4% (190/215) respectively for observer 1, 80.6% (29/36), 93.8% (168/179), and 91.6% (197/215) respectively for observer 2. The interobserver agreement was good (Kappa value=0.681). For the complete tear of the biceps brachii tendon, the sensitivity, specificity, and accuracy were all 100% (7/7), 100% (208/208), and 100% (215/215) for both observers. For the tear of the long head of the biceps brachii tendon, the accuracy of MR arthrography were 93.4% (100/107) for observer 1 and 96.3% (103/107) for observer 2. They were higher than the Accuracy of routing MRI, which were 83.3% (90/108)and 87.0% (94/108) respectively for two observers (P<0.05). Conclusion Shoulder MRI is a moderate reliable method for evaluating the tear of the long head of the biceps brachii tendon, and the accuracy of MR arthrography is found to be superior to that of routine MRI.

Objective To investigate the global and regional dyssynchrony of left ventricle in patients with coronary artery disease before and after revascularization by tissue synchronization imaging(TSI).Methods Subjects with the left anterior descending coronary artery(LAD)stenosis＞75% who underwent revascularization(n=26)and normal controls(n=30)were studied with TSI.Echocardiography was performed one day before revascularization,then repeated one month and three month after the operation,respectively.The sample volumes were located at the mid-myocardium of base and middle segments in apical four-,two- and three-chamber view of left ventricle.The time-to-peak velocity(Tp)of all myocardial segments were examined to access the regional dyssynchrony,and the standard deviations of Tp of 12 segments(TSD)were calculated to evaluate the global dyssynchrony.Results Before revascularization,Tp of segments in the anterior wall and the interventricutar septum in patients were more delayed than those of control group(P＜0.01),and the color coding of ischemic segments were red and yellow.After operation,Tp of delayed segments were significant improved,and the color coding turn to yellow or even green,but there was still significant difference of Tp between disease group and control group(P＜0.01 or P＜0.05).TSD decreased gradually on the preoperatative,early postoperative,and later postoperative echocardiogram,and it on each time point of the disease group were all longer than that of control group.An improvement of TSD was observed after revascularization,especially for the three month examination(P＜0.01),but the difference between early and later postoperation was not significant(P＞0.05).Conclusions The asynchronous motion of LV is very obvious in CAD patients.After revascularization,both global and regional dyssynchrony were improved gradually.Moreover,TSI is a convenient and non-invasive way to quantitate left ventricular asynchrony with the parameters.

Objective To evaluate the clinical value of tissue Doppler imaging(TDI)in assessing left ventricular(LV)function after mitral valve replacement(MVR).Methods Forty-five patients having their implantations for more than three months were examined by echocardiography and divided into atrial fibrillation group(AF group,n=21)and sinus rhythm group(SR group,n=24).Thirty normal volunteers served as control group.Left atrium and ventricle indexs of cardiac function and mitral inflow velocity(E)were measured by two dimensional and Doppler echocardiography,and TDI-derived systolic mitral annular velocity(Sm),diastolic mitral annular velocity(Em)and isovolumic relaxation time(IVRT)were measured at the septal and lateral corners of mitral annulus from the apical four-chamber view.Then E/Em ratio was calculated.Results ①Compared with control group,Sm and Em in MVR group were significantly lower and IVRT was higher(P＜0.001),however there were no significant differences between AF group and SR group.② The E/Em ratio in MVR group was significantly higher than that in control group(P＜0.001)and positively correlated with IVRT.The best cutoff value for E/Em ratio was increased of 15 which yielded the sensitivity and specificity in predicting LV diastolic dysfunction were 91.11% and 90.32%,respectively.The area under the ROC curve was 0.9548±0.0402.Conclusions TDI-defived indexes(Sm,Em)can assess LV function accurately and the E/Em ratio,an estimate of myocardial relaxation and LV filling pressures,can be used to evaluate left ventricular diastolic function after MVR.