In recent years, more and more attention has been paid into impairment of central nervous system after diabetes mellitus, including cognitive dysfunction. This paper would review the etiological factor and pathogenesis of cognitive dysfunction in type 2 diabetes mellitus patients.

As an important way to maintain the internal environment of the human body, the renin-angiotensin system (RAS) plays an important role in the diabetic cognitive dysfunction, which may associate with insulin resistance, inflammatory reaction, oxidative stress and other mechanisms. Traditional Chinese Medicine can improve cognitive function of diabetes, in which RAS may play a role.

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 assess left ventricular systolic strain in patients with mitral valve replacement (MVR) by speckle tracking echocardiography. Methods Two-dimensional images were acquired from the apical four-chamber view, two-chamber view and long-axis of the left ventricular view in 30 MVR patients (MVR group) and 30 healthy subjects matched by age and gender(control group), and then were analysed off line to evaluate left ventricular systolic strain. The maximum systolic longitudinal strain(LS) of myocardial segments and global longitudinal strain(GLS) were measured in apical views. Left ventricular ejection fraction(LVEF) was calculated using Simpson's method. The correlation between GLS and LVEF was analyzed using Pearson's method. Results Compared with the control group, LS of corresponding segment and GLS in MVR group decreased significantly (P < 0.01), but there were no statistical differences within MVR group(P>0.05). There was a good linear positive correlation between GLS and LVEF in patients (r = 0.710, P <0.01). Conclusions Speckle tracking eehoeardiography is available for measuring left ventricular systolic strain and estimating global systolic function in patients with MVR. Bull's-eye strain map, created by speckle tracking imaging, can achieve an accurate real-time segmental wall motion analysis.

ObjectiveTo evaluate regional and global systolic function of left ventricle (LV) after mitral valve replacement(MVR) of different methods by 2-dimensional strain (2DS).MethodsAccording to the operational method whether preserve the posterior leaflet and its subvalvular apparatus,48 patients who underwent MVR were divided into two groups,the preservation group (group A) and the resection group (group B).Echocardiography was examinated before and after MVR and the apical four-chamber view,two-chamber view and long-axis view of LV were acquired.Regional peak strain (Sp) and global strain (GS) of LV longitudinal movement were analysed by 2DS software.Results①Compared to preoperation,the Sp in basal segment of posterior septum and inferior wall and middle segment of lateral wall in group A increased significantly ( P ＜0.01 or P ＜0.05).The Sp of group B were improved in both basal and middle segments of posterior septum ( P ＜0.05),while declined in middle segment of lateral wall and anterior wall,basal segment of lateral wall and apical segment of anterior wall significantly (P ＜0.01 or P ＜0.05).②Compared with group A,subtractions between preoperative and postoperative Sp of group B decreased in middle segment and apical segment of anterior wall,middle segment of lateral wall and middle segment of inferior wall significantly ( P ＜0.01 or P ＜0.05).③The GS of group A increased significantly ( P ＜0.05),while that in group B tended to reduce with no statistical significance ( P ＞0.05).Compared with group A,subtractions between preoperative and postoperative GS of group B droped significantly (P ＜ 0.05).ConclusionsAppropriate preservation of the posterior leaflet and its subvalvular apparatus has morebeneficial effect in improving the early regional and global function of LV after surgery,which would be recommended in MVR.Early regional and global systolic function of LV after MVR could be accurately evaluated by 2DS relatively,which has the application value of guiding clinical treatment and estimating prognosis.

Objective To investigate the value of contrast-enhanced ultrasound (CEUS) in evaluation of the protective effect of edaravone injection in rabbit skeletal muscle ischemia-reperfusion injury.Methods Thirty healthy New Zealand white rabbits were established a model of skeletal muscle ischemia-reperfusion injury in left hind limb and randomly divided into the experimental group and control group.Edaravone was injected with the dose of 1.5 mg/kg at the time of 30 minutes before reperfusion in the experimental group,the control group were given an equal volume of physiological saline.Blood samples were collected respectively at the times of pre-ischemia,post-ischemia and 24 hours after reperfusion for detecting creatine kinase(CK),lactic dehydrogenase(LDH),and CEUS parameters such as peak intensity(PI),time to peak (TTP) and area under the curve(AUC) were measured at the same time.Pathological examination was carried out after the rabbits were sacrificed.Results ①Serological tests:compared to before the blocking of blood supply,the content of CK and LDH after the blocking were significantly increased (P ＜ 0.01);compared to before or after the blocking,the content of CK and LDH at the time of 24 hours after reperfusion in the two groups were increased,and was lower in the experimental group than the control group.(②CEUS:compared to before the blocking,PI,TTP and AUC in each group were significantly increased after the blocking and at the time of 24 hours after reperfusion(P ＜0.01);compared to those in the control group,PI and AUC in the experimental group were decreased at the time of 24 hours after reperfusion,but there was no significant difference in TTP(P ＞0.05).③Correlation analysis:there was a good correlation between PI,AUC and CK,LDH (r =0.87,0.81,0.86,and 0.80,respectively).④Pathological analysis:muscle fibers were swelling with no stripes,partial fractures and interstitial edema and a large amount of inflammatory cells were infiltrated in the control group,while muscle fibers were almost normal with a small amount of inflammatory cells infiltrated in the experimental group.Conclusions Edaravone injection before reperfusion can obviously improve rabbit skeletal muscle ischemia-reperfusion injury,and CEUS can be used to observe these changes directly and effectively.

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 assess the efficacy and safety of solifenacin in patients with neurogenic detrusor overactivity (NDO). Methods 50 patients with NDO received solifenacin 5 mg/d. During the treatment period, the voiding diary, Patient Perception of Bladder Condition-Scale (PPBC-S) and side effects were recorded. Results 2 weeks and 12 weeks later, the volume of the catheterization every time increased from (224.2±15.7) ml at baseline to (302.6±23.3) ml and (301.3±21.1) ml (P<0.05); the volume of leakage every day decreased from (753.9±121.7) ml to (444.1±87.1) ml and (449.1±89.2) ml (P<0.05); PPBC-S score decreased from (5.12±0.072) to (4.36±0.073) and (4.36±0.068) (P<0.05). There were 3 cases (6%) with dry mouth, and no patients complained dry eyes and blurred vision. Conclusion Solifenacin is safe and effective, and can significantly improve the quality of life in patients with NDO.