Diabetes could damage the peripheral and central nervous system,and was the risk factor of cognitive impairment in the elderly.The pathogenesis of cognitive dysfunction caused by diabetes was complex.At present,hyperinsulinemia and/or insulin deficiency,glycemic control,glycation end-products,inflammatorv mediators,hypothalamic-pituitary-adrenal axis dysfunction,blood-brain barrier dysfunction and other factors were considered to be the major causes of cognitive impairment in elderly patients with diabetes.Good metabolic control may help prevent its occurrence and/or progression.

Objective To introduce a method and the clinical effects of treating the blocks of nasal-lachrymal ducts by the memory alloy stands without TV monitoring.Methods 15 blocks of nasal-lachrymal ducts of 12 cases were taken radiography of nasal-lachrymal ducts;to fix the position,to put into the conducting threads from the tear spots and introduce the dilators inversely along the threads.And then China-made titanium-nickel memory alloy stands were planted into the nasallachrymal ducts.Results To visit the patients for 1 to 12 months after operation,the radiography showed that the nasal-lachrymal ducts were clear.The symptoms of overflowing tears and pus disappear completely,11 blocks of 9 cases fully recovered,4 blocks of 3 cases were on the mend.Conclusion Interventional treatment of blocks of nasal-lachrymal ducts is easy,safe and effective.

At present, there are many methods for genotype of hepatitis C virus , but not a gold standard. In order to establish the rationale for genotypic determination of optimal region sequence, fifteen complete genome sequences of hepatitis C which had been given the annotation about every region and derived from different country were downloaded from GenBank. Phylogenetic trees on 5' UTR, core, E1, E2 and NS5B region were established. The results demonstrated that genotyping group was not all correct on 5' UTR region while genotyping groups were wholly correct on core, E1, E2 and NS5B region. Comparing phylogenetic distances on core, E1, E2 and NS5B region with that on complete genome sequence demonstrated that the NS5B area was the best genotyping region instead of the complete genome sequence. In addition, analysis of the molecular evolution on each core region could supply some clues for creating novel genotyping method based on PCR-RFLP.

Objective To discuss hemorheologic changes and hepatic function in patients with chronic hepatitis B(CHB)and its correlation with HBV genotype.Methods Relative index of hemorheologic changes,ALT,HBV-DNA and HBV genotype were examined in 96 CHB patients and 24 healthy control people.The results underwent correlation analysis.Results Low-shear blood viscosity and RBC aggregation index were significantly higher in CHB patients than those in the healthy control people(P＜0.05).Low-shear blood viscosity and RBC aggregation index were significantly higher in CHB patients with abnormal ALT than those CHB patients with normal ALT and the healthy control people(P＜0.05).No statistical difference was seen when CHB patients with normal ALT were compared with the healthy control people and patients with positive HBV-DNA were compared with patients with nesative HBV-DNA(P＞0.05).No statistical difference was seen in hemorheologic changes in CHB patients with different genotype(P＞0.05).Conclusions Microcirculation disorder of CHB patients is correlated with damage degree of hepatic function.Hemorheologic changes are not correlated with HBV-DNA and HBV genotype,so it can be a relatively independent index for clinical evaluation of disease.

ObjectiveTo investigate the preventive effects of rosiglitazone on nonalcoholic steatohepatitis (NASH) rats and to explore the potential mechanisms in modulating peroxisome proliferator-activated receptor gamma (PPARγ),nuclear factor kappa B (NF-κB),and cyclooxygenase-2 (COX-2) expression.Methods Thirty male SD rats were assigned into the normal group ( n =10),the model group ( n =10),rosiglitazone prevention group [ n =10,simultaneously 4mg/( kg · d) gavage daily at beginning].Liver appearance,liver index,and histological changes were assessed.Serum tumor necrosis factor-o (TNF-c) and prostaglandin E2 (PGE2) were determined using enzyme-linked immunosorbent assay.The expressions of PPARγ,NF-κB,and COX-2 in liver were determined using immunohistochemical methods.The mRNA and protein expressions of COX-2 were disclosed by real-time polymerase chain reaction and Western blot analysis.ResultsCompared with the normal group,the liver index significantly increased in model group (3.92 ±0.72 vs.5.71 ± 1.05,P =0.004).HE and Masson staining showed significantly increased steatosis,inflammation,and fibrosis.The serum levels of TNF-α,PGE2 in high-fat-diet-fed rats were significantly increased ( 11.72 ± 2.47 vs.29.39 ± 5.32,P =0.002 ; 236.60 ± 24.90vs.288.24 ± 17.17,P =0.004).Immunohistochemistry showed NF-κB and COX-2 in livers were significantly elevated,but PPARγ wasdecreased in nonalcoholic steatohepatitis rats.Real-time polymerase chain reaction and Western blot found mRNA and protein expressions of COX-2 were increased in the model group (0.57 ± 0.08 vs.2.83 ± 0.24,P =0.0007 ; 0.38 ± 0.03 vs.1.00 ± 0.03,P =0.004).Compared with the model group,the expressions of PPARγsignificantly increased and the expressions of NF-κB and COX-2 significantly decreased ( mRNA:2.83 ± 0.24 vs.0.46 ± 0.11,P =0.002 ; protein: 1.00 ± 0.03 vs.0.62 ± 0.02,P =0.006 ) in the rosiglitazone prevention group.ConclusionBy inhibiting NF-κB and COX-2 expressions,rosiglitazone can reduce insulin resistance and then prevent the occurrence and deve lopment of nonalcoholic steatohepatitis.

Objective: To evaluate the post-operative mortality of left ventricular end-diastolic pressure (LVEDP) during primary percutaneous coronary intervention (PCI) in patients with acute ST-segment elevation myocardial infarction (STEMI). Methods: We retrospectively analyzed 255 patients with new onset of STEMI who received primary PCI in our hospital and all patients received LVEDP measurement before coronary artery opening. According to LVEDP value, the patients were divided into 2 groups: LVEDP≤14 mmHg group,n=155 and LVEDP>14 mmHg group,n=100. The post-operative mortality up to 6 months was observed, and the effect of LVEDP on death rate was studied by Cox regression analysis. Results: Compared with LVEDP≤14 mmHg group, the patients in LVEDP>14 mmHg group had the 6 months mortality at HR=4.26, 95% CI (1.13-16.08),P=0.03. Relevant study presented that LVEDP was slightly related to LVEF (r=-0.267, P=0.001) and BNP (r=-0.154,P=0.041). Multi-regression analysis indicated that with adjusted LVEF and BNP, LVEDP was the independent predictor for post-operative mortality up to 6 months in acute STEMI patients after PCI. Conclusion: The LVEDP value measured during PCI procedure is the independent predictor for mortality after PCI in patients with new onset of STEMI.

Objective To study the expression of PIWIL1, PIWIL3 and PIWIL4 in human colon cancer and its clinical significance. Methods We collected cancerous tissues and its adjacent tissues of 106 patients with colon cancer, two tissue microarrays were constructed, with 62 and 150 points respectively. We studied the expression of PIWIL1, PIWIL3 and PIWIL4 through immunohistochemistry. Results The expression of PIWIL1, PIWIL3 and PIWIL4 were significantly higher in cancerous tissues than those in adjacent tissues (P＜0. 01). In cancerous tissues and its adjacent tissues, postive correlation were seen among PIWIL1, PIWIL3 and PIWIL4 expression (P＜0. 01). PIWIL1 expression was significant higher in low differentiation group than that in high differentiation group (t =- 2. 840, P＜0.01 ). PIWIL3 expression was higher in high clinical stage than that in low clinical stage (F= 3. 112, P＜0.05). The expression of PIWIL3 and PIWIL4 were significantly higher in patients with colon cancer with distant metastasis than those without distant metastasis (t= -3. 349, P＜0.01 ; t = - 2. 168, P＜0. 05). PIWIL3 and PIWIL4 expression were correlated with occurring of colon cancer (P＜0. 01). Conclusions The expressions of PIWIL1,PIWIL3 and PIWIL4 in colon cancer were correlated with the differentiation, clinical stage and distant metastasis of colon cancer. PIWIL3 and PIWIL4 expression were two independent related factors of occurring of colon cancer, which would be furtherly investigated to be served as novel markers for early diagnosis and promising molecular targets for colon cancer therapy.

Objective To investigate effects of changes in body composition and pancreas islet β-cell function on bone mineral density(BMD)in obese women with normal glucose metabolism at child-bearing age.Methods Ninety-five obese women with normal blood glucose at child-bearing age were recruited for the study,20 in non-obese group with body mass index(BMI)less than 23,20 in overweightgroup with BMI equal to or more than 23 and less than 25.28 in obesity Ⅰ group with BMI equal to or more than 25 and less than 30.and 27 in obesity Ⅱ group with BMI equal to or more than 30.Their BMD,body fat and lean mass were measured with by dual energy X-ray absorptiometer(DEXA),and intravenous -glucose tolerance test(IVGTT)was performed.Area under the Curve of insulin(AUCins)and acute jnsulin response(AIR)phase were calculated to assess their early insulin secretion.Homeostasis model assessment β-cell function index(HOMA2-%B)and homeostasis model insulin resistance index(HOMA2-IR)were used to assess their β-cell function and insulin resistance.Results Fat and lean mass in the upper and lower extremities.trunk and whole body and BMD in those women increased with increasing of their BMI(P＜0.05),particularly in fat mass.as well as their otller parameters including plasma insulin level at zerominute of IVGTT(IVGTTins0),AUCins.HOMA2-%B and HOMA2.IR(all P＜0.01).BMD in the upper and lower extremities,trunk and whole body showed a positive correlation with BMI,FPG,lean mass and/or fat mass.respectively(P＜0.05).BMD of the trunk and whole body also had a positive correlation with TVGTTins0,AIR,AUCins and HOMA2-IR.respectively(P＜0.05).Results of multivariate linear regression analysis showed that HOMA2-%B and HOMA2-IR correlated with BMD in a linear pattern.As the vailable body composition was added to the regression model.HOMA2 parameters would be removed from the model.Results of partial correlation analysis showed that islet β-cell function did not correlate with BMD after controlling body composition factors.Conclusions Insulin resistance or islet β-cell function compensation accompanied in obese women with main increase in fat mass have little benefit for their BMD,which may reflect indirectly their change in body compositions.Body composition,especially lean nlass,is the most important determinants of BMD in obese women.

Objective To explore the relationship between body composition and β-cell function in obese females with normal glucose metabolism. Methods Seventy-five obese women with normal blood glucose and without family history of diabetes were investigated. They were assigned to 4 groups based on body mass index (BMI). Body fat content was measured by dual-energy X-ray absorptiometry (DEXA), and intravenous glucose tolerance test (IVGTT) was performed. The acute insulin response (AIR), the area under the curve (AUC) of insulin (AUCins) and homeostasis model assessment (HOMA) for β-cell function (HOMA2-% B) were calculated. Insulin resistance index(HOMA2-IR) and the ratio of AUCins to AUC of glucose (AUCins/AUCglu) were calculated to assess insulin resistance. Results Women with higher BMI appeared to have more total body fat content and trunk fat content. The similar distribution was also found in other parameters, including the plasma glucose levels at 0 and 10 min, AUCins, AIR, AUCins/AUCglu and the difference of insulin level between 0 and 10 min [INS (10-0)] during IVGTF. AUCins, AIR, AUCins/AUCglu and [INS (10-0)] were positively correlated with the age, BMI,total body fat content and trunk fat content. After adjustment of age, the trunk fat content was independently associated with the AIR in a good linear manner. Conclusion The obese females show change in body composition with more trunk fat content. They show significant insulin resistance with compensated elevation of insulin secretion. Body composition assessment is a valid and more accurate method than BMI and waist circumference in predicting early damaged β-cell function in obese patients.

AIM: To study the time-dependent effects of diabetes mellitus (DM) on the development of cardiac remodeling in untreated streptozotocin (STZ)-induced rats with acute myocardial infarction (MI). METHODS: The left anterior descending coronary arteries were ligated 10 weeks after DM induction without any therapy. Transmission electron microscopy, echocardiography, heart weight to tibial length ratios, histological examination, microarray analysis, and real time-PCR were utilized to monitor the changes up to 56 d. RESULTS: After MI, the diabetic rats experienced lower survival rate compared to non-diabetic animals. The pathophysiologic changes indicated that DM accelerated the cardiac remodeling post-infarction. In primary examination, 164 genes related to cardiac remodeling were found to be candidates for hierarchical analysis, such as leucine-rich PPR-motif containing (interleukin-6 signaling pathway), procollagen type I and III, fibronectin-1, RT1, and TIMP-1, etc. The gene expression profile at 14 d in diabetic rats were comparably similar to both 14 d and 28 d in non-diabetic rats, while such changes at 28 d and 56 d in diabetic rats was also similar to the ones at 56 d in non-diabetic rats. CONCLUSION: The accelerated cardiac remodeling of post-infarction in STZ-induced untreated diabetic rats seems be associated with the different profile of gene expressions.