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 assess left ventricular systolic strain in patients with mitral valve replacement (MVR) by speckle tracking echocardiography. Methods Two-dimensional images were acquired from the apical four-chamber view, two-chamber view and long-axis of the left ventricular view in 30 MVR patients (MVR group) and 30 healthy subjects matched by age and gender(control group), and then were analysed off line to evaluate left ventricular systolic strain. The maximum systolic longitudinal strain(LS) of myocardial segments and global longitudinal strain(GLS) were measured in apical views. Left ventricular ejection fraction(LVEF) was calculated using Simpson's method. The correlation between GLS and LVEF was analyzed using Pearson's method. Results Compared with the control group, LS of corresponding segment and GLS in MVR group decreased significantly (P < 0.01), but there were no statistical differences within MVR group(P>0.05). There was a good linear positive correlation between GLS and LVEF in patients (r = 0.710, P <0.01). Conclusions Speckle tracking eehoeardiography is available for measuring left ventricular systolic strain and estimating global systolic function in patients with MVR. Bull's-eye strain map, created by speckle tracking imaging, can achieve an accurate real-time segmental wall motion analysis.

Objective To evaluate the clinical value of color M-mode Doppler echocardiography (CMM) in assessing left ventricular(LV) diastolic function after mitral valve replacement(MVR). Methods Fifty-two patients who had received the implantation for more than three months were examined by echoeardiography (MVR group). Thirty age and sex-adjusted normal volunteers served as control group. Dimensions of left atrium and ventricle,ejection fraction(EF) and mitral inflow velocity(E) were measured by two-dimensional and Doppler eehocardiography. Color M-mode Doppler flow propagation velocity(Vp) and TDl-derived diastolic mitral annular velocity(Em) were measured from the apical four-chamber and two-chamber views. Then two new indexes based on the ratio of E to Vp(E/Vp) and E to Era' (E/Em') were while E/Vp and E/Era' increased, there were significant differences(P <0.01). The correlation coefficient and atrial fibrillation(P <20.01) ,however E/Vp was lower affected hy EF or atrial fibrillation(P >0.05). dysfunction were 2.00. Conclusions CMM is an effective technique to assess LV diastolic function after MVR. E/Vp has good consistency with E/Era and may be a potential useful parameter for assessing LV diastolic function.

Objective To evaluate a new computer-aided technique applicable for myocardial contrast echocardiography(MCE) to quantitate automatically calibrated myocardial contrast intensity(CD and to test the feasibility of calibrated CI in assessing myocardial perfusion. To analyze the relationship on myocardial perfusion,regional contractile function and cell apoptosis in stunned myocardium. Methods According to coronary occlusion and reperfusion at different times, rabbits were divided into three groups: 15 min occlusion/30min reperfusion (group Ⅰ ),30 min occlusion / 60min reperfusion (group Ⅱ ) and 120 min occlusion / 60min reperfusion (group Ⅲ ). MCE was performed on all rabbits at baseline,occlusion and after reperfusion,and its images were analyzed by a new computer-aided technique. Myocardial calibrated CI of each segment was measured automatically by software. Percentage wall thickening (WT) of each risk segment at each stage were also measured by echocardiography. The apoptotic index(AI) in regional left myocardial dysfunction was calculated by terminal deoxynucleotidyl transferease-mediated biotinylated deoxyuridine triphosphate nick end labeling(TUNEL ). Results (1) During occlusion, WT in the areas at risk decreased to zero or negative and the calibrated CI values were significantly lower than those at baseline ( P ＜0.01 ). After reperfusion, WT in all risk segment remained depressed, but calibrated CI significantly improved in group Ⅰ and Ⅱ while those remained unchanged in group Ⅲ. (2)AI in risk myocytes were (13. 70 ± 5.48 ) %, (36.25 ± 5.55 ) % and ( 62.06 ± 6. 70 ) %, respectively, both statistically significant difference between the two groups ( P ＜0.05 or P ＜ 0.01 ). AI were negatively correlated to WT and calibrated CI ( r = - 0. 87 and r = - 0. 77, P ＜0.05). Conclusions MCE with computer-aided technique can assess quantitatively myocardial perfusion and regional contractile function. Short-term ischemiareperfusion does not cause myocardial necrosis, but it will lead to myocardial cell apoptosis and the phenomenon of myocardial stunning. Prolonged ischemia, even if given sufficient reperfusion, can lead to apoptosis and necrosis simultaneously.

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.