Objective To investigate the correlation of postoperative cognitive dysfunction (POCD)and the preoperative he-moglobin (HbA1c)in elderly patients with type 2 diabetes mellitus (T2DM).Methods 82 patients with T2DM who were underwent non-cardiac surgery were included in this study,group A had 37 patients with POCD after surgery,group B had 45 patients with non POCD,the patients in two groups used the same anesthesia method,compared the general data and pre-operative HbA1c,fasting blood glucose levels of two groups,compared the incidence of POCD in patients with HbA1c in dif-ferent levels.Results There was no significant difference in gender composition,age,body mass index,preoperative MMSE score,hypertension rate,operation time and bleeding volume in operation,and there was no significant difference in fasting blood glucose of patients in two groups.Fasting blood-glucose (FBG)of two groups were 7.1±2.6 and 6.7±1.8 mmol/L (t=0.821,P=0.424),it was no significant difference;HbA1c of two groups were (7.2±1.3)% and (6.3±1.0)%,the group A was higher than the group B (t=3.543,P=0.001),there was significant difference.The incidence rate of POCD of the group AH was 58.1%(25/43),while the group AL was 30.8% (12/39),the group AH was higher the group AL(χ2=5.131,P=0.024),there was significant difference.Conclusion Preoperative determination of HbA1c in elderly patients with T2DM after surgery has forecast values for the occurrence of POCD,to control HbA1c in the low level can reduce the occurrence of POCD in elderly patients with T2DM.

Objective To investigate the correlation between prognosis of patients with severe acute pancreatitis and changes of plasma albumin. Methods A total of 235 patients with severe pancreatitis who were admitted into hospital from September 2008 to October 2013 were selected as research object. According to the prognosis, they were divided into the survival group (143 cases who were recovered and still alive) and the death group (92 cases who died of the deterioration of diseases). Retrospectively analyzed the basic situation of the pa-tients and the changes of serum albumin levels in the two groups. And the correlation between prognosis of patients with severe acute pancrea-titis and changes of plasma albumin were evaluated by the logistic regression analysis. Results Compared with the death group,there were significant differences (P<0. 05) in terms of age,APCHEⅡ score,Ranson score,SOFA score,length of hospital stay,duration of mechani-cal ventilation,continuous renal replacement therapy,average serum albumin level,decrease of serum albumin within 24 hours,and variation of serum albumin. And ROC curves suggested the best cutoff value of decrease of serum albumin within 24 hours to predict death in patients within 24 hours was 4. 24 g/L,and the best cutoff value of variation of serum albumin to predict death was 13. 6%. Logistic regression analy-sis showed that the major risk factors of death in severe acute pancreatitis were decrease of serum albumin within 24 hours,variation of serum albumin within 24 hours,average serum albumin level,and the APCHEⅡscore. Conclusion Changes in plasma albumin can reflect the se-verity of severe acute pancreatitis,and the sharp decrease of serum albumin within 24 hours can be used as a risk factor for death.

Aim This study was to examine the effect of ethyl acetate extract of shiitake mushroom on a human breast cancer line-MCF-7 cell in vitro. Method Cell cytotoxicity was examined using MTT method, Cell apoptosis was examined by AnnexinV-FITC/PI staining,Cell cycle analysis was determined by flow cytometry. Western blot analysis was used to determine Cyclin D_1、Cdk4、Bax and p21WAE1/CIP1 protein expression. Results Concentration-dependent cytotoxic effects of the extract were observed in MCF-7 human breast cancer cell lines. Pro-apoptotic proteins (Bax, p21WAE1/CIP1)were up-regulated while proteins involved in cell cycle(Cyclin D_1 and Cdk4)were down-regulated. Conclusion This study suggests that the anti-breast cancer activities might result from increased apoptosis and growth arrest

Objective To study the role of gastric mitochondrial DNA cytochrome C oxidases (COX) subunit Ⅱ gene and its expression in diabetic gastric motility dysfunction. Methods Seventy Wister rats were randomly divided into 2 groups: diabetic group (STZ 60mg/Kg intraperitonealy) and control group. The changes in expressions of COX protein were assayed by Westernblot. Mitochondrial DNA COX mRNA was assayed with reverse-transcriptional polymerase chain reaction(RT-PCR). Cytochrome C oxidase activity was determined by ultraviolet spectrophotometer. Results Gastricelectric dysrythmia was more frequently delected in diabetic rats, and the COX activity in diabetic rats was 0.41?0.21/min, which was significantly lower than that in normal rats (0.78?0.37/min). The expression of gastrointestinal COX protein and COX gene in diabetic gastroparesis rats were markedly decreased compared with normal rats. Conclusion Cytochrome C oxidases activity was greatly reduced in diabetic rats. Diabetic gastroparesis was associated with down-regulation of the expression of gastrointestinal mtDNA encoding COX gene and protein. These changes might play a key role in pathogenesis of diabetic gastroparesis

Objective To investigate the relationship between mitochondrial membrane potential change and apoptosis of smooth muscle cells of the small intestine in diabetic rats. Methods Seventy Wistar rats were randomly divided into two groups: diabetic group(STZ60mg/kg intraperitonealy) and control group.The gastric empty time and intestinal transit were determined in diabetic rats 2 months after the reproduction of diabetes. Mitochondrial membrane potential in small intestinal smooth muscle cells was determined by the change in the intensity of labeling rhodamine 123 with lasor scanning confocal micrographs, and apoptosis index was assessed with the technique of terminal deoxynucleotidyl transferase mediated d-UTP nick end labeling(TUNEL) test and flow cytometry.The changes in expression of cytochrome C were determined by Western blotting. Results The mitochondrial membrane potential of small intestine smooth musele cells was significantly lowered in diabetic rats compared with normal rats. Apoptosis index in diabetic rats was significantly higher than that of normal as shown by TUNEL technic. Apoptosis rate in diabetic rats was 15%, and it was significantly higher than that of normal rat (P

Objective To study the change in cytosolic Ca 2+ in smooth muscle cells in gastric antrum of diabetic rat. Methods Rats were randomly divided into diabetic group and control group. Gastric empty time was determined 3 months after diabetes was reproduced in rats, the apoptosis rate of smooth muscle cells in the gastric antrum was assessed by flow cytometry, and the content of cytosolic Ca 2+ in smooth muscle cells was measured by laser scanning confocal microscopy. Results In diabetic rats, gastric emptying was significantly delayed. Compared the normal rats, the content of cytosolic Ca 2+ in smooth muscle cells from the antrum of diabetic rats was increased. The apoptosis rate of smooth muscle cells in the antrum of diabetic rats was 15%, and it was higher than that in normal rats. Conclusion With the increase in the content of cytosolic Ca 2+ in smooth muscle cells, smooth muscles were damaged and therefore their contraction was also impaired.

Objective To study the role of nitriergic nerves in the myenteric plexus of the gastric antrum in diabetic rats with motor disorder. Methods Rats were randomly divided into diabetic group and control group. Electrogastrogram was recorded, and the number of cholinergic nerves in the myenteric plexus of the gastric antrum was counted 3 months after reproducing diabetes in the model group. Results In the rats of diabetic group, gastro-electric dysrhythmia was observed more frequently, and the number of nitriergic cells in the myenteric nerves was significantly decreased compared with control group. Conclusion The changes in nitriergic nerves in the myenteric plexus of the gastric antrum might be one of the mechanisms of gastro-electric dysrhythmia and gastric motility disorders in diabetic rats.

Objective To evaluate the differences, including clinical symptoms, endoscopic and histopathologic findings, status of Helicobacter pylori (Hp) infection and cytokeratin (CK) expressions, be-tween Barrett esophagus (BE) and heterotopic gastric mucosa (HGM) in upper esophagus. Methods Clinical data of 152 patients with BE and 52 patients with HGM in upper esophagus diagnosed from February 2004 to September 2005 were retrospectively studied. The parameters being compared include-ed clinical manifestations, conventional and magnifying endoscopic findings, histopathological findings, Hp infection determined by rapid urease test and Warthin-Starry staining and expression of CK phenotypes detec-ted by immunohistochemistry. Results Gastro-esophngeal reflux was observed in 64. 5% of patients with BE (98/152), higher than that in patients with HGM ( 13.5%, 7/52, χ2 = 40. 36, P < 0. 01 ). Endoscopic faveolus of BE mucosa included 46 cases of spot pattern, 65 striations and 41 villiform patterns, while those of HGM were all striation patterns. The histologic classification in BE included 56 cases of fundic type, 39 junction type and 57 specialized intestinal metaplasia, while in HGM mucesa, 31 cases of fundic type, 16 junction type and 5 antrum type were diagnosed, and no goblet cells were found. Moderate and severe infil-tration of inflammatory cells in BE mucosa was 63.2% (96/152), which was significantly higher than that in HGM mucosa (15/52, 28. 8%, P<0. 01). However, no difference was found in gastric antrum inflam-mation between the two groups (44.7%, 68/152, vs. 51.9%, 27/52, P>0.05). No difference was ob-served in prevalence of Hp infection between BE and HGM groups (P >0. 05 ), either in involved mucosa or in antrum. CK7 was not expressed in HGM or normal squamons mucosa, but was expressed in BE. CK20 and CK19 were expressed in both HGM and BE, and CK13 expression was found in some BE nmcosa including gas-tric metaplesia (55/95) and intestinal metaplasia (29/57) but not in HGM mucosa. Conclusion There are differences between HGM and BE, in regarding of reflux symptoms, magnifying endoscopic findings, histo-logical types and CKs expressions, which may be indicators to make differential diagnosis.

Objective To study the effect of carbachol(CCH) on membrane potential of smooth muscle cells of gastric antrum of diabetic rats to verify the mechanism of gastric motility disturbance.Methods Fifty healthy Wistar rats of 2-month old,weighing 100-160 g,were divided into the control group(n=20) and diabetes mellitus group(n=30).Three months after the establishment of the rat model of diabetes by intraperitoneal injection of 60 mg/kg streptozotocin,gastric emptying time and gastric electrical activity were measured,and the resting membrane potentials of smooth muscle cells in antrum were measured by confocal laser scanning microscopy,then treated with carbachol of 10~(-9) mmol/L,10~(-8) mmol/L,10~(-7) mmol/L,the membrane potentials were measured.Results As compared with the normal rats,gastric emptying time in diabetic rats was significantly longer and abnormal gastric electric rhythm was significantly increased,the abnormal rhythm index(ARI) and the coefficient of variation(CV) of slow wave frequency in diabetic rats were significantly higher,but the resting membrane potentials remained unchanged and the sensitivity of CCH-induced membrane depolarization was increased.Conclusion The increase of sensitivity of CCH-induced membrane depolarization may be involved in the diabetes-induced gastric motor disorders.

Objective To clarify the changes of ultrastructure of interstitial cells of Cajal in the small intestine of diabetic rats. Methods Rats were randomly divided into diabetic group and control group. The rate of the small intestinal transit was measured and the tissues of the small intestine were observed by transmission electron microscopy at 3 months after the establishment of rat model of diabetics. Results In the diabetic rats, the rate of small intestinal transit was delayed as compared with that in the control group. The number of the gap junction of interstitial cells of Cajal in the small intestine of diabetic rats decreased significantly, and the rest structures were damaged. Damaged organelles and formation of vacuoles were also found. Conclusion The changes of ultrastructure of interstitial cells of Cajal in the small intestine may be one of the mechanisms resulting in slow rate of the small intestinal transit in diabetic rats.