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.

Objective To explore the effect of Jinmaitong (JMT) on expression of Bax, Bcl-2 and Caspase-3 in hippocampal neurons culturedwith high glucose. Methods Hippocampal neurons were primarily cultured and purified from the hippocampus of new-born SpragueDawley rats. Neuron-specific enolase immunocytochemical method was adopted for the identification of the neurons. They were divided intonormal control group, high glucose group, high-dose JMT (JH) group, middle-dose JMT (JM) group, low-dose JMT (JL) group and a positivecontrol group. 72 hours later, Western blotting was adopted to detect the expression of Bax, Bcl-2 and Caspase-3. Results Comparedwith the normal control group, the expression of Bax and Caspase-3 in the high glucose group significantly increased (P<0.01), and the expressionof Bcl-2 significantly decreased (P<0.05). Compared with the high glucose group, the expression of Caspase-3 and Bax in the positivecontrol group and JH, JM, and JL groups significantly decreased (P<0.01), and the expression of Bcl-2 significantly increased (P<0.05).Compared with the positive control group, the expression of Caspase-3 and Bax significantly decreased in JH, JM, and JL groups (P<0.05),and the expression of Bcl-2 significantly increased in JH and JM groups (P<0.05). Conclusion JMT may reduce apoptosis by inhibiting theexpression of Bax and Caspase-3 and promoting the expression of Bcl-2.

Objective To discuss the influence about three kinds of nasal feeding methods on ICU critical patients with gastrointestinal complications, thus providing guidance for ICU patients to choose reasonable way of nasal feeding pump injection. Methods 120 ICU patients were randomly assigned into three groups, which is the continuous 6-hour and intermittent 2-hour every three time pump group and continuous 24-hours pump group and intermittent 24-hour(continuous 2-hour and intermittent 1-hour every eight time units)pump group ,each group has 40 cases. To observe the the influence about three different way of nasogastric on ICU critical patients with gastrointestinal complications. Results The incidence of diarrhea and constipation among the three groups was not statistically significant (P>0.05) . The gastric retention rate of the continuous 24-hour pump group was significantly higher than that of the continuous 6-hour and intermittent 2-hour pump group and the intermittent 24-hour pump group, the differences were statistically significant (P < 0.05). There was no statistically significant difference between the continuous 6-hour and intermittent 2-hour pump group and the intermittent 24-hour pump group, (P > 0.05). Conclusions The continuous 24-hour pump group in gastric retention was slightly worse than the other two pump way. Compared with ICU class three a week and feeding times , the continuous 6-hour and intermittent 2-hour pump method is more suitable for ICU patients.

Objective To investigate personality characteristics and its correlation with academic performance of vocational nursing students.Methods 153 nursing students were asked to filled out the questionnaire of Chinese College Student Personality Scale(CCSPS).The results were analyzed by 13.0 SPSS.Results Nursing students concentrated in the middle-up level in all the seven dimensions of the T-norm.The mean of directness,sensation and amiability were higer than the T-norm; The mean of tenaciousness and altruian were lower than the T-norm; There were different levels of correlation between academic performance and the four dimensions including directness,tenaciousness,rigorousness and amiability(P＜0.05).Finally only the dimension of rigorousness entered into the regression equation of academic performance.Conclusion Vocational nursing students tend to have ordinary personalities.The dimension of rigorousness is the major factor influencing vocational nursing students' academic performance.So it should be targeted to promote vocational nursing students' personality perfection.

Objective To study the clinical value of magnetically controlled capsule endoscopy in diseases screening. Method We retrospectively analyzed 61 cases which were evaluated by magnetically controlled capsule endoscopy from March 2015 to December 2016. The items include operating time, the divergence rate score and cleanliness score of stomach. The consistency was compared between magnetically controlled capsule endoscopy and gastric duodenal endoscopy. Results 61 upper gastrointestinal tract studies were included. The mean age was (49.4 ± 11.6) years. No capsule retention, perforation or bleeding occurred. There was 98.4% patients, which cleanliness of stomach was good. There was 68.9% patients, which filling degree of stomach was good. The concordance rate of the two tests of gastrduodenoscopy and magnetically controlled capsule endoscopy was 89.9% (80/89). The concordance rate of the two tests was 78.9% (15/19) in esophageal and cardia, 92.9% (52/56) in stomach, 92.9% (13/14) in duodenum. Conclusion Our experience shows that magnetically controlled capsule endoscopy is a safe and useful tool for the diagnosis of upper gastrointestinal tract disease. The detection rate is similar to gastrduodenoscopy.

Objective To investigate the ability of targeting in vitro breast carcinoma and photoacoustic-mediate apoptosis of breast carcinoma of the nanoparticle probe loaded with Fe3O4 and observe its consequence of photoacoustic imaging in vitro.Methods The polymeric multifunctional nanoparticles probe that was loaded with Fe3O4 and connected with Herceptin targeting breast carcinoma was prepared in the use of double emulsion method and carbodiimide method.General physical property,the condition of Herceptin connected with nanoparticles and the ability of targeting of the probe were tested.The different concentration of nanoparticles was imaged by photoacoustic.The inhibiting effect of targeting nanoparticles on breast carcinoma cells was evaluated in vitro.Results The targeting polymeric multifunctional nanoparticles probes loaded with Fe3O,were prepared successfully with average particle diameter of (235.4± 53.75)nm and Zeta potential (-13.4 ± 4.7)mV.Fe3O4 particles dispersed on the shell of the probes.Antibody Hereeptin was successfully connected with the surface of the nanoprobes.There were massive targeting nanoprobes surround the breast carcinoma cell strains SKBR3 in the targeting group in vitro.The photoascoustic signal of the nanoprobes enhanced with the increase of Fe3O4 concentration in photoacoustic experiment in vitro.The apoptotic rate of breast carcinoma increased after the laser irradiation in the cell inhibition experiment in vitro.That proved the obvious inhibition of breast carcinoma cells was caused by photothermal effect of the prepared nanoprobes.Conclusions The prepared polymeric multifunctional nanoparticles probe that was loaded with Fe3O4 and connected with Herceptin targeting breast carcinoma can be used as a photoacoustic contrast agent,which can inhibit the proliferation of breast carcinoma by targeting photoacoustic therapy.

Objective Both right and left ventricular function should be taken into account in the assessment of anthracycline (ATC)-induced cardiotoxicity.The aim of this study was to assess the subclinical dysfunction of right cardiac system in patients with newly diagnosed lymphoma who received ATC treatment by echocardiography.Methods A total of 74 patients with lymphoma who received ATC treatment were enrolled.Each patient underwent transthoracic echocardiographic examination before chemotherapy as well as after two,four and six cycles of ATC remedy.Right atrial (RA) and right ventricular (RV) end-diastolic area (EDA) and end-systolic area (ESA) were calculated.RV end-diastolic volume (EDV) and end-systolic volume (ESV),as well as RV ejection fraction (EF) were measured simultaneously.Tissue Doppler imaging (TDI) measurements of systolic and early or late diastolic myocardial velocities of RV free wall at tricuspid annuals were also analyzed.Two-dimensional speckle tracking echocardiography (2DSTE) was conducted to evaluate RV free wall strain along with strain rate.Results None of the echocardiographic parameters showed significant alteration after two and four cycles of chemotherapy compared with those at baseline (P＞0.05).At the end of the therapy (i.e.after six cycles of ATC treatment),there was still no statistical difference on TDI data aswell as 2DSTE measurements (P＞0.05).An unexpected finding was that the RAEDA((6.6±1.9) cm2 vs (7.7±2.4) cm2) and RAESA ((8.8±2.5) cm2 vs (10.8±2.8) cm2) revealed obvious dilatation after six cures of the regimen compared with those at baseline (P＜0.01).Similar morphologic characteristics displayed on the RVEDA ((14.1 ±3.4) cm2 vs (16.2±3.7) cm2) and RVESA ((7.9±1.9) cm2 vs (9.0±2.2) cm2) (P＜0.01)simultaneously.Furthermore,RVEDV ((29.8±10.5) ml vs (37.0±12.7) ml) and RVESV ((12.7±4.4) ml vs (15.0±5.2) ml),as well as RVEF ((59.4±5.8)％ vs (56.4±5.8)％),in patients with lymphoma presented statistically significant difference between basic state and the level after six cycles of chemotherapy (P＜0.01).Meanwhile,no marked change was detected on left ventricular ejection fraction(LVEF) throughout the follow-up period (P＞0.05).Conclusions Echocardiography can be used easily and noninvasively to assess right cardiac system subclinical dysfunction.ATC-induced cardiotoxicity of right cardiac system is firstly manifested as morphological changes than the measurements with novel echocardiographic techniques.In addition,RVEF expresses as a valuable parameter for assessing subtle RV impaired performance in patients with lymphoma received ATC therapy.

Objective To investigate the value of echocardiographic Tei index combined with serum high-sensitivity cardiac troponin T(hs-cTnT) on monitoring cardiac toxicity associated with anthracycline chemotherapy drug in patients with diffuse large B-cell lymphoma(DLBCL).Methods PW-Tei index,TDI-Tei index of left/right ventricles and radionuclide cardiac measurement were acquired from 56 patients with DLBCL before,after the completion of 2-4 cycle(100-200 mg/m2) and 6-8 cycle(300-400 mg/m2) of the regimen,part of them received serum hs-cTnT detection at the same time.Cardiac toxicity event was defined as a relative reduction of radionuclide left ventricular ejection fraction(LVEF) of ≥10％ during the regime or an absolute radionuclide LVEF≤50％ after the complete chemotherapy.Results Compared with baseline,left ventricular PW-Tei index significantly increased after whole cures [(0.36-± 0.12) vs (0.44 ±0.13) vs (0.40 ± 0.13),P =0.002].After complete regimen,serum hs-cTnT level elevated significantly [(0.006 ± 0.006)tg/L vs (0.012 ± 0.007) μg/L vs (0.020±0.013)tμg/L,P =0.001].The sensitivity,specificity and area under ROC curve of early diagnosis of anthracycline-induced cardiotoxicity with elevated serum hs-cTnT in 2-4 cycle and increased left ventricular PW-Tei index in 6-8cycle detected together were 75％,85％,0.736 and 92％,50％,0.675,respectively(all P ＜0.05).Conclusions Echocardiographic PW-Tei index combined with serum hs-cTnT is a simple method and can be easily obtained in outpatient settings to monitor early cardiac toxicity induced by anthracycline therapy.

Objective To evaluate the subclinical dysfunction of left ventricle (LV) induced by anthracycline(ATC) in patients with newly diagnosed diffuse large B-cell lymphoma (DLBCL) by two-dimensional speckle tracking echocardiography (2DSTE) as well as real-time three-dimensional echocardiography (RT3DE).Methods Traditional echocardiography images and RT3DE images were acquired from 59 patients with DLBCL before,after the completion of two cures(100 mg∕m 2)and four cures of the regimen(200 mg∕m 2).LV global longitudinal strain(GLS),global circumferential strain(GCS),LV apical rotation and basal rotation,LV end-diastolic volume (EDV),end-systolic volume (ESV),stroke volume(SV) and ejection fraction(EF)were calculated simultaneously.Results Compared with baseline, LV apical rotation and basal rotation reduced significantly after two cures and four cures of therapy [LV apical rotation:(5.34±1 .80)°vs (3.80±1 .45)°vs (2.96±1 .1 8)°;LV basal rotation:(-3.32±1 .14)°vs (-2.65±1 .12)°vs (-2.56±1 .19)°;both P <0.01].LV GLS and GCS decreased significantly till four cures of treatment compared with those at baseline[GLS:(-21 .62±2.5 1)% vs(-20.1 7±2.74)%;GCS:(-26.34±4.76)% vs (-23.27 ±4.73)%;both P <0.01].The alternation on EDV,ESV,SV and EF manifested no visible degradation during the whole procedure (P > 0.05 for all). Conclusions Cardiotoxicity during the early phase of anthracycline treatment can be detected via 2DSTE prior to the traditional echocardiographic expression of ventricular systolic function.The left ventricular rotation index seems to be more sensitive than strain parameters for the estimation of early cardiac injury in patients with ATC chemotherapy.There is no safe dose for anthracycline in all patients with DLBCL treated with anthracycline even at lower doses.

Traumatic brain injury (TBI)has been classified as mild,moderate,or severe,on the basis of the Glasgow coma scale (GCS)score.Mild TBI is estimated to account for 90% of all cases of TBI, and it has become a serious public health problem,with morbidity increasing year by year.At present,there is a lack of accepted uniform definition of mild TBI.Clinically,mild TBI and concussion are interchangeable terms.In recent years,advances in brain imaging,biomarkers determination,and neuropathology have encouraged people to revise and update their knowledge about mild TBI.In view of the high prevalence of mild TBI in the emergency and community,and the absence of the data concerning the long-term effects of mild TBI, further research is needed about how to reduce morbidity and costs, alleviate delayed consequences,and develop evidence-based interventions to improve outcomes.