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 observe the effect of penehyclidine hydrochloride (PHCD) combined with mechanical ventilation on inflammatory response in rats with acute respiratory distress syndrome(ARDS)induced by hydrochloric acid(HCl)inhalation. Methods 32 adult healthy male Sprague-Dawley(SD)rats were randomly divided into four groups:sham operation group,ARDS model group,PHCD group(intraperitoneal injection of 0.5 mg/kg PHCD at 30 minutes before HCl instillation)and mechanical ventilation group〔mechanical ventilation was given after PHCD treatment,ventilator settings were as follows:tidal volume(VT)=4 mL/kg,respiratory rate(RR)= 70 beats/min,the time ratio of inspiration to expiration(I:E)=1:2,fraction of inspired oxygen concentration(FiO2)=0.21〕,8 rats in each group. The rat ARDS model was created by HCl(0.1 mol/L,1.2 mL/kg) intratracheal instillation. After mechanical ventilation for 4 hours,the experiment was stopped. Arterial partial pressure of oxygen(PaO2)was measured,and the oxygenation index as well as lung wet/dry weight ratio(W/D)were calculated respectively. The pathological changes in lung tissues were observed under light microscope,and the pathological score was evaluated. The levels of myeloperoxidase(MPO),interlukin-8(IL-8)and nuclear factor-κB (NF-κB)in homogenate of lung tissues were all measured respectively by enzyme linked immunosorbent assay (ELISA). Results In rats of ARDS model group, there were significant infiltration of inflammatory cells, collapse of extensive pulmonary alveoli and hyaline membrane formation in lung tissues,but the edema in pulmonary mesenchymal tissue and congestion of micro vessels were not obvious. Compared with sham operation group,the lung tissue pathological score(9.88±2.03 vs. 1.38±0.92),lung W/D ratio(7.67±0.96 vs. 4.08±0.65)were significantly increased(both P<0.01),while oxygenation index〔mmHg(1 mmHg=0.133 kPa):213±29 vs. 428±28〕was markedly decreased in model group(P<0.01);and the concentrations of MPO(μg/L:34.18±3.99 vs. 20.92±1.40), IL-8(ng/L:864±53 vs. 583±91)and NF-κB(ng/L:1 229±133 vs. 803±130)in homogenate of lung tissues were significantly higher in model group(all P<0.01). The pathological changes in lung tissues including inflammatory cell infiltration,collapse of alveoli and pulmonary edema,etc. were obviously improved when treated by PHCD or mechanical ventilation and the lung pathological score and W/D ratio were significantly decreased compared with those of model group,oxygenation index in these two groups were both significantly increased,meanwhile, the concentrations of MPO,IL-8 and NF-κB were sharply decreased when compared with those of model group (all P<0.05). The degree of improvement in all above indexes were greater in mechanical ventilation group than those in PHCD group(lung injury score:5.63±1.85 vs. 7.63±1.67,lung W/D ratio:5.35±1.05 vs. 6.46±1.17, oxygenation index:325±57 vs. 272±44,MPO:25.80±3.36 vs. 29.88±3.93,IL-8:736±53 vs. 802±53, NF-κB:984±75 vs. 1 109±118,all P<0.05),however they did not reach the levels of the sham operation group (P<0.05 or P<0.01). Conclusion PHCD can inhibit the inflammatory response in ARDS rats induced by HCl inhalation,thus it may protect the lung tissue from injury induced by HCl,and the protective role of PHCD plus menchanical ventilation is superior to that of PHCD only.

ObjectiveTo investigate the effect of thalidomide on the proliferation and apoptosis in human pancreatic cancer cell SW1990 in vitro.MethodsSW1990 cell line was treated with thalidomide at different concentrations (3.125,6.25,12.5,25,50,100,200 and 400 μg/ml) for 24,48,72 h,and then cell proliferation were evaluated by MTT.Cell cycle was determined by flow cytometry,apoptosis was determined by annexin V/PI fluos staining,Bcl-2,Bax protein expression and Bcl-2/Bax ratios were measured by Western Blot in vitro.ResultsThalidomide inhibited the proliferation of SW1990 cells in a time and dosedependant manner.The proportion of G0/G1 phase of SW1990 cells with 200 μg/ml thalidomide treatment increased from (41.15 ± 2.23 ) ％ to (58.83 ± 2.33 ) ％,apoptosis rate increased from 2.6％ to 28.0％,the expression of Bax protein up-regulated from 0.17 ± 0.03 to 0.33 ± 0.04,the expression of Bcl-2 protein downregulated from 0.35 ± 0.02 to 0.17± 0.01,the ration of Bcl-2/Bax decreased from 2.17 ± 0.44 to 0.52 ±0.07.ConclusionsThalidomide can inhibit the proliferation of pancreatic cancer SW1990 cells by upregulating Bax,down-regulating Bcl-2,inducing cell apoptosis and cell Go/G1 phase arrest.

Objective To investigate the efficacy of externally applied diclofenac diethylamine emulgel on the prevention of PICC-induced mechanic phlebitis. Methods One hundred cancer patients with PICC were divided into two groups. diclofenac diethylamine emulgel and mucopolysaccharide polysulfate cream were applied three times a day for 7 days after catheterization in the two groups,respectively. Results There was no significant difference on the incidence of mechanic phlebitis between the two groups (4% vs. 8%,P>0.05). Conclusion The efficacy of externally applied diclofenac diethylamine emulgel on the prevention of PICC-induced mechanic phlebitis is the same as mucopolysaccharide polysulfate cream. Except their common virtue of convenient and simple operation,the price of diclofenac diethylamine emulgel is lower than mucopolysaccharide polysulfate cream and worthy to be spread in clinical practice.

AIM: To study the preparation and physiological compatibility of pulmonary administration with Saponius of Panax Notoginseng (PNS) liposomes. METHODS: PNS liposomes was prepared by thin film dispersion method. The prefered formulation was determined by factorial design. Ciliary movement in situtoad palate model and the changes of pulmonary edema index and pathology of lungs in rats were investigated to evaluate the physiological compatibility of PNS liposomes. RESULTS: PNS liposomes were proved to be large unilamellar vesicle (LUV) liposomes with spherical shape .The liposomes composed of PC and Ch has a high PNS capture efficiency of 78.5% ?2.15% . The mean vesicle size of liposomes were 1546.5nm ?321.4nm which were quite homogeneous in size distribution. The lasting time of ciliary movement after the rinsing of PNS liposomes was the 92.14% of the effect of PBS buffer. The pulmonary edema index and pathological changes of lung tissue in PNS liposomes group were significantly different from those in PNS solution group and close to those in PBS buffer group. CONCLUSION: PNS liposomes has good physiological compatibility with promising market development and application.

Objective To evaluate the effect of early surgical treatment for primary lower limb varicose veins complicated by thrombophlebitis.Methods The clinical date of 42 patients with primary lower extremity varicose veins complicated by thrombophlebitis treated in 4 years were analyzed retrospectively.The CEAP classification was adopted to establish the diagnoses of the all patieats.In the early stage,high ligation and stripping of the varicase veins were performed.After removal of varicose veins and thrombi,both anti-inflammation therapy and anticoagulant therapy were applied.Results All patients made a good recovery.After surgery,3 patients had skin callous and swelling,and 3 patients had foot nerve paresthesia.But,no serious complications,such as deep venous thrombosis or pulmonary embolism,were observed.The was no recurrence during 2 months to 4 years follow-up.Conclusions Early surgical treatment for primary lower limb varicose veins complicated by superficial thrombophlebitis not only has good results but also helps control of deep venous thrombosis and pulmonary embolism,and other serious complications that can result from superficial venous thrombosis.

[Objective]To summarize Pro.YangJiguo’s experience in using PingchuanⅠ for treating three periods of asthma in children .[Method] Accord-ing to the analysis of three clinical features and diagnosis and treatment of pediatric asthma, namely attack period(not the control period), duration peri-od(part of the control period) and remission period(control period), it concluded Professor Yang Jiguo's how to use PingchuanⅠto treat pediatric asthma. [Result] For pediatric asthma episodes in smooth wheezing, we join the medicine of freeing lung to relieve exterior syndrome on the basis of Pingchuan I;in duration, join yupinfeng for nourishing Qi and supporting essence; in remission, join the dragon negundo ginseng and astragalus mixture to improve children's physique, and improve the body's immune function. [Conclusion] Pingchuan I for treating three periods of asthma in children has a significant effect, unique advantages and is worth promotion.

Objective To investigate the application value of the Mini-Nutritional Assessment (MNA) in assessing the nutritional status in middle-aged women with diabetes.Methods Using the normal range of traditional nutritional index as the reference standard,two hundred and forty middle-aged women with diabetes were recruited and their nutritional status were assessed by MNA and laboratory test (including PAB,Fib,TLC,CHOL),respectively.Finally,the results were analyzed and compared.Results The correlation coefficient of MNA value and BMI、PAB,Hb,TLC,CHOL were 0.571,0.614,0.781,0.568,0.218.MNA had good correlations with several traditional laboratory indicators regarding with nutritional status,with signifi-cant difference.In this study,the results of investigation by MNA showed that:the rates of malnutrition,potential malnutrition,and normal nutritional were 30％(72 cases),65％(156 cases),and 5％(12 cases),respectively.The sensitivity and specificity of MNA were 96.1％ and 98.2％ respectively.Laboratory testing resuits:malnutrition and normal nutrition were 31％ (74 cases) and 4％ (10 cases).Kappa test(Kappa=0.922):the results of MNA and laboratory testing had strong consistency.Conclusions MNA is feasible in assessing nutritional status in the domestic middle-aged women with diabetes.

Objective To evaluate the diagnostic value of blue laser imaging( BLI) combined with magnifying endoscopy for precancerous lesions and early gastric cancers. Methods From September 2015 to May 2016, a total of 249 gastric lesions detected with conventional white light endoscopy ( WLE) on the basis of the assessment of mucosal shape and color were enrolled in this study. The pathological results were used as golden standard,and diagnostic accuracy rates of precancerous lesions or early cancers by white light magnification alone,BLI?contrast magnification and BLI?bright magnifier were determined according to the VS criteria. The concordance between endoscopic diagnosis and pathological diagnosis was evaluated through the agreement ( Kappa ) test, and diagnostic value was compared with McNemar paired Chi?square test. Results Pathological examination showed chronic gastritis in 149 lesions, intestinal metaplasia in 67, low grade intra?epithelial neoplasia in 8, and high grade intra?epithelial neoplasia or early cancer in 25. The concordance rates of lesions were 76?7% for white light magnification alone, 85?1% for BLI?contrast magnification, and 86?7% for BLI?bright magnification. Kappa values were 0?571, 0?730, and 0?760 respectively. For the screening of high grade intra?epithelial neoplasia or early cancer, the diagnostic sensitivities were 72?0%, 92?0%, and 92?0%, respectively, the specificities were 95?5%, 98?2%, and 99?1%,the consistencies were 93?2%,97?6%,98?4%,and the Kappa values were 0?642,0?871,and 0?911. In contrast to white light magnification alone,the concordance between endoscopic diagnosis and pathological diagnosis of BLI?contrast magnification and BLI?bright magnification was significantly higher(P<0?05).And in the diagnosis of high?grade intraepithelial neoplasia or early gastric cancer,the concordance between endoscopic diagnosis and pathological diagnosis of BLI?contrast magnification and BLI?bright magnification was higher than that of white light magnification alone( P<0?05) . Conclusion BLI combined with magnifying endoscopy may improve the diagnostic accuracy of early gastric cancer and precancerous lesions.