Diabetic cognitive dysfunction is one of the important complications of diabetes mellitus .Insulin plays an important protective role in cognitive function through MAPK and PI 3-K/Akt signaling pathway .Insulin resistance may give rise to excessive tau protein phosphorylation , formation of neurofibrillary tangles inhibits insulin degrading enzyme , reduces the degradation of amyloid β;enhances oxidative stress , further damages the integrity of the neu-ronal structure and function and eventually leads to cognitive dysfunction .

Objective To improve recognition of posterior reversible encephalopathy syndrome (PRES) in children. Methods Two children with PRES admitted to children's hospital were included. Clinical data were retrospectively studied and related literatures were reviewed. Results The primary diseases of the two patients are systemic lupus erythematosus and nephritic syndrome, respectively. They all developed an acute onset of headache, visual changes, consciousness disturbance, hypertension and seizures. Cranial MRI showed bilateral parietal, temporal and occipital cortical or subcortical lesions with hypointensity on Tl-weighted imaging and hyperintensity on T2-weighted imaging. Clinical symptoms resolved soon and radiographic recovery occurred within 14 to 21 days with prompt anti-hypertension treatment and supportive care. Among the mechanisms which might contribute to the development of PRES, acute elevated blood pressure seems to be the most important factors in these two cases. Prompt anti-hypertension treatment usually can reverse the PRES lesion. Conclusions It is important to improve cognition of PRES in children. Delayed treatment can cause permanent neurological impairment. Doctors should be alert to this syndrome. Early diagnosis and prompt treatment are very important. (J Clin Pediatr,2010,28(2):168-170)

Objective To study the effects and mechanisms of resveratrol (Resv) on the expression of adiponectin receptors ( AdipoR1 and AdipoR2 ) in rat mesangial cells (MCs) cultured in intermittent high glucose medium.Methods The MCs cultured in normal glucose ( 5.6 mmol/L) medium were transfected by the plasmid vector of the FoxO1 short hairpin RNAs ( FoxO1 shRNA ),and then cultured in intermittent high glucose medium (5.6mmol/L or 30 mmol/L,alternately every 8 hours ) and resveratrol ( Resv 20 μmol/L).The MCs cultured in normal glucose (5.6 mmol/L) medium served as normal glucose control group (NG),and the MCs exposed to iutermittent high glucose medium were divided into five groups:intermittent high glucose group (IHG),IHG+Resv group,IHG+FoxO1 shRNA group,IHG+ Resv + FoxO1 shRNA group,IHG + Negative control group ( shNC ),each group was cultured for 72 h.The level of reactive oxygen species (ROS) was assessed by Fluorescence microplate reader.The mRNA levels of Sirt1,Foxo1,AdipoR1,and AdipoR2 were assessed by RT-RCR.The protein levels of FoxO1,phosphorylation FoxO1 ( p-FoxO1 ),AdipoR1,and AdipoR2 were assessed by Western blotting.Results ( 1 )Compared with NG,intermittent high glucose significantly decreased the mRNA expression of Sirt1,but markedly increased the level of p-FoxO1.Furthermore,the mRNA and protein expression levels of AdipoR1 were obviously decreased while the level of ROS was enhanced in IHG ( all P＜0.05 ).(2) Compared with IHG,the mRNA and protein expression levels of FoxO1 and AdipoR1 were inhibited,but the level of ROS was enhanced in group IHG+FoxO1 shRNA ( all P＜0.05 ).( 3 ) Compared with IHG,after treating with Resv,the mRNA expression level of Sirtl was increased,whereas the level of p-FoxO1 was decreased.Moreover,the mRNA and protein levels of AdipoR1 was increased while the level of ROS was lowered in group IHG+Resv (all P＜0.05 ).(4) Compared with group IHG+Resv,the mRNA and protein levels of FoxO1 and AdipoR1 were inhibited,but the level of ROS was increased in group IHG+Resv+FoxO1 shRNA (all P＜O.05).(5) In addition,the mRNA and protein expression level of AdipoR2 showed no significant difference among these groups ( P＞0.05 ).Conclusion ( 1 ) Resveratrol significantly increases the expression of AdipoR1 in MCs induced by intermittent high glucose.( 2 ) FoxO1 plays an important role in regulating the expression of AdipoR1 by resveratrol.

Objective:To explore the e ect of QingreJiedu herbs in combination with Jiegeng decoction on expression of NF-?B p65 in ALI induced by LPS.Methods:Male Sprague-Dawley rats were randomly divided into normal group,model control group,QingreJiedu group,and the group of QingreJiedu herbs in combination with Jiegeng decoction.The model of ALI was made by injected with a single dose of LPS through vena femorali,the pathologic morphology,MPO activity and the expression of NF-?B p65 was observed.Result:Compared with normal group,infiltration.of PMNs,capillary congestion and swelling were found in model control group,and the content of MPO and expression of NF-?B p65 in the nuclear were significantly increased(P

Objective To investigate the relationship of T peak-T end (Tp-Te) interval and Tp-Te interval disper-sion (Tp-Ted) in different periods of myocardial ischemia in patients with acute myocardial infarction (AMI), and to assess the clinical significance of Tp-Te and Tp-Ted for prediction of the ventricular arrhythmia (VA). Methods A total of 80 pa-tients with AMI were enrolled in the study. The sizes and changes of Tp-Te and Tp-Ted were observed during the acute phase and recovery phase in patients. The differences of Tp-Te and Tp-Ted were compared between ventricular tachycardia group (A group), ventricular premature beats group (B group) and non- ventricular arrhythmia group (C group). Results The values of Tp-Te and Tp-Ted were obviously longer in acute period [(125.22±17.70) ms and (54.76±13.26) ms] than those in recovery period[ (113.84±17.37) ms and (42.06±13.95)ms] (P<0.01). The values of Tp-Te and Tp-Ted were signifi-cantly longer in A group[ (134.82±19.56) ms and (62.00±15.19) ms] than those in B [(122.94±15.09) ms and (54.09±10.56) ms ]and C group [(110.09±15.21) ms and (45.27±9.85) ms]. The values were higher in B group than those of C group. Con-clusion The Tp-Te interval and Tp-Ted prolongated in acute phase than those of recovery phase in patients with AMI. Tp-Te interval and Tp-Ted can be used as an important index to predict VA in patients with AMI.

Objective To investigate the effects of different doses of rosuvastatin on expression of liver X receptor(LXR) and caveolin-1 in cultured human monocyte-macrophage cells which induced by oxidized low density lipoprotein (ox-LDL).Methods The human monocyte-macrophage cells were divided into six groups:control group,ox-LDL group,different doses of rosuvastatin group (0.01 μmol/L,0.1 μmol/L,1 μmol/L,5 μmol/L).The expression of LXR mRNA and caveolin-1 mRNA were assayed by RT-PCR.Results LXR mRNA expression induced by ox-LDL in the control group and ox-LDL group were 1.00 ± 0.02,0.26 ± 0.02,and the difference was significant (t =56.39,P ＜ 0.001).Meanwhile,caveolin-1 mRNA expression in ox-LDL is (0.27 ± 0.01) fold than that in control (t =31.27,P ＜ 0.001).Meanwhile,There were significant differences among ox-LDL group and the different doses of rosuvastatin group in terms of LXR mRNA and caveolin-1 mRNA expressions (F =72.154,66.007,P ＜ 0.001).Along with the increase the doses of rosuvastatin,there was an increased trends of LXR mRNA and caveolin-1 mRNA expressions (P ＜ 0.05).Conclusion Rosuvastatin and upregulated the LXR mRNA and caveolin-1 mRNA expressions in a dose dependent manner.

Objective To study the clinical and genetic features of Lowe syndrome. Methods The clinical data and test results of OCRL gene from two children with Lowe syndrome were analyzed. The related literatures were reviewed. Re-sults Two male patients all presented with low molecular proteinuria, hypercalciuria, rickets and nephrolithiasis. Patient 2 had renal tubular acidosis, glycosuria and cryptochism. Patient 1 was found to have abnormal vision and congenital cataract soon after birth and treated surgically. Patient 1 also had psychomotor retardation and the cranial magnetic resonance ima-ging (MRI) showed agenesis of the corpus callosum. Patient 2 did not have obviously extra-renal symptoms, but was found to have mild cataract by a meticulous ophthalmological examination. MRI showed cerebral hypoplasia and myelination delay and mental retardation was gradually appeared during follow-up. Two OCRL gene mutations were detected. A splice site mutation NG_008638.1:g.46846-46848delTAA/insC was found in patient 1 and a frame shift mutation NM_000276.3:c.321delC in exon 5 was found in patient 2. Both mutations were not reported previously. Conclusions The diagnosis of Lowe syndrome is mainly by clinical manifestations and test of OCRL gene. Lowe syndrome needs to be included in the differential diagnosis of a patient with congenital cataract and renal tubulopathy. Two novel mutations in the OCRL gene were identiifed.

Objective To investigate the effects,mechanisms,and the optimum doses of Rosuvastatin and Losartan on expression of caveolin-1 in cultured human monocyte-macrophage cells which were induced by oxidized low density lipoprotein(ox-LDL).Methods Human-monocyte cells were separated and changed into the human monocyte-macrophage cells.The model of amerosclerosis was set up.These cells were incubated in different doses of Rosuvastatin(0.1,1.0,5.0 μmol/L) and Losartan (10,50,100 μmol/L),and then cultured in combination of two drags (5.0 μmol/L + 100 μmol/L).Expression of caveolin-1 mRNA was determined with real-time fluorescent quantitative polymerase chain reaction (RT-PCR).Results In ox-LDL group,caveolin-1 mRNA was decreased sharply relative to control group [(0.2533 ±0.00973) vs (0.9410 ±0.03677)] in a concentration-dependent manner (P ＜0.01).Compared to ox-LDL group,expressions of Caveolin-1 mRNA were increased gradually in different doses of Rosuvastatin alone and Losartan alone group [(0.5198 ± 0.04840),(0.6183 ± 0.06740),(0.7257 ± 0.03052) vs (0.2533 ± 0.00973) ; (0.3350 ± 0.04177),(0.4428 ± 0.03804),(0.6049 ± 0.02627) vs (0.2533 ± 0.00973)] in a concentration-dependent manner (P ＜ 0.01) ; the summit expressions of caveolin-1 mRNA were emerged in using Rosuvastatin and Losartan together (F =59.119,P ＜ 0.01).Conclusions Rosuvastatin and Losartan may be responsible for the expression of caveolin-1 in human monocyte-macrophage cells that were induced by ox-LDL.The expressions were up-regulated with dose dependent manner of these drugs,and got the crest stage when using optimum doses of Rosuvastatin and Losartan together.

Objective To assess the clinical efficacy and adverse effect of pemetrexed-based chemotherapy as first-line treatment in elderly patients with advanced non-squamous non-small-cell lung cancer (NSCLC).Methods A total of 40 elderly patients with advanced non-squamous NSCLC confirmed by pathology were retrospective analyzed in the study,who received pemetrexed plus cisplatin (group A,n =18) or pemetrexed plus carboplatin (group B,n =22) as the first-line treatment.RECIST was used to assess the efficacy of the treatment and NCI-CTC AE version was used to describe adverse events.Results In the 40 patients,no one received complete response (CR),17 patients showed partial response (PR),16 had stable disease (SD),7 had progress disease (PD),the objective response rate (ORR) was 42.5 ％ (17/40) and the disease control rate (DCR) was 82.5 ％ (33/40).The median progression-free survival (PFS) time was 5.3 months.1 year suvival rate was 63.2 ％ (24/38).In further subgroup analyses,the ORR,DCR,PFS and 1 year suvival rate in group A were higher than those in group B,but they had no statistically significant difference (P ＞ 0.05).The drug-related adverse events were myelosuppression,gastrointestinal response,most of which were grade 1 to 2.Conclusion Pemetrexed combined with cisplatin or carboplatin may be recommended as first-line chemotherapy for elderly patients with advanced non-squamous NSCLC because of its safety and efficacy.

Objective:To observe the influence of methylprednisolone in the respiratory mechanical parameters in the elderly patients undergoing major surgeries with general anesthesia intubation after mechanical ventilation,and to investigate whether methylprednisolone can improve the respiratory system degenerative diseases and benefit the mechanical ventilation. Methods:Sixty patients undergoing elective line laparotomy were divided into experimental group and conrol group (n=30) according to their wishes.The patients in experimental group receieved intravenous injection of methylprednisolone 1 mL (40 mg) after endotracheal intubation,and the patients in control group receieved 1 mL intravenous saline water injection.The airway peak pressure (Ppeak), airway platform (Pplat), lung compliance (Compl), and airway resistance (Raw) of the patients in two groups were recorded at the time of immediately before administration and 10,20,30,40 min after administration.The arterial blood oxygen partial pressure(PaO2),arterial blood CO2 partial pressure(PaCO2),CO2 partial pressure at the end of breathe out(PetCO2) of the patients were detected at the time of immediately before administration and 20 min after administration.Results:Compared with before administration, the respiratory mechanics parameters of the patients in control group 10,20,30,40 min after administration had no statistically significant differences (P>0.05);the Comple of the patients in experimental group was singnificantly increased (P<0.05), and the Ppeak, Pplat,and Raw were significantly decreased (P<0.05).Compared with control group, the Compl of the patients in experiment group 10,20,30,and 40 min after administration were significantly increased (P<0.05),and the Ppeak, Pplat, and Raw were decreased (P<0.05).Compared with before administration,the PaO2,PaCO2,and PetCO2 of the patients in control group 20 min after administration had no significant differences(P>0.05);the PaCO2 and PetCO2 of the patients in experimental group 20 min after administration were decreased(P<0.05),and the PaO2 was increased(P<0.05).Compared with control group,the PaCO2 and PetCO2 of the patients in experimental group 20 min after administration were decreased(P<0.05),and the PaO2 was increased(P<0.05).Conclusion:Methylprednisolone can obviously reduce PaCO2,Peak, and Pplat and increase PaO2 and Compl;methylprednisolone has possibility in improving the adverse effects of degenerative disease of respiratory system on general anesthesia in the elderly patients.