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 evaluate the clinical value of epicardial echocardiographic examination in cardiac valve surgery.Methods Epicardial echocardiography were performed in 46 patients undergoing valvular plasty or valvular replacement surgery to estimate the function of valve and left ventricle and residual shunt during cardiac surgery.Results Twelve cases of 46(26.1％)showed abnormality during cardiac surgery.Two cases of 15 patients performed valvuloplasty were changed to valvular replacement because of remarkable regurgitation of native valves.There was 1 case of periprosthetic leakage,3 cases of left atrial appendage thrombus,1 case of patent foramen ovale and 5 cases of low ejection of left ventricle in all 31 cases of valvular replacement.Conclusions Epicardial echocardiograpyc examination is an effective examination in cardiac valve surgery with clearly image,simplicity operation and promptness.

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 analyze the clinical effect of different surgical methods on giant-cell tumor of bone (GCTB). Methods:Between January 2007 and June 2012, 37 patients receiving treatment for GCTB were enrolled in this study. These patients included 20 males and 17 females whose ages ranged from 20 to 56 (average=31.6). The prosthesis replacement and nonprosthetic replacement op-eration on the postoperative recurrence, limb function, comprehensive evaluation of the curative effect, as well as morbidity and recur-rence rate among different nations and in the upper and lower limbs of GCTB patients were analyzed. Results:The predilection age of the cases ranged from 20 to 50 years old. The incidence was higher in the Uighur population of Xinjiang, China. However, the recur-rence rate in ethnic difference was not statistically significant (P>0.05). Conclusion:The predilection age of GCTB cases was 20~50 years old, with higher morbidity in Uighur than in Han and other ethnic groups. The morbidity and recurrence rate were higher in the lower limbs than in the upper limbs of patients. The scraping bone graft and bone cement filling, the internal fixation of the scraping bone graft, and the artificial joint replacement of tumor resection were all reliable modes of treatment.

Medication error in anesthesia is a serious problem,which may endanger to patients′ life. The aim of this article is to review the study on medication errors in anaesthesia,so as to provide references for building the prevention strategies against medication errors in anaesthesia,and ensure the safety of patients.

Objective:To explore the mediating effect of psychological capital between occupational fatigue and occupational burnout in nurses of the Operating Room, so as to provide a reference for alleviating nurses' occupational burnout.Methods:From October to December 2020, convenience sampling was used to select 230 nurses of Operating Room from 5 ClassⅢ hospitals in Changchun City as the research object. The General Information Questionnaire, Occupational Fatigue Scale, Psychological Capital Scale, and Occupational Burnout Scale were used to evaluate nurses in the Operating Room. The influence of psychological capital and occupational fatigue on occupational burnout was analyzed. Taking occupational fatigue as the independent variable, psychological capital as the mediating variable, and occupational burnout as the dependent variable, the structural equation model was used to test the mediating effect of psychological capital.Results:A total of 230 questionnaires were distributed, and 212 questionnaires were effectively returned. Among 212 nurses in the Operating Room, the scores of occupational fatigue, psychological capital and occupational burnout were (18.27±4.16) , (80.16±14.48) and (68.48±12.82) respectively. Occupational fatigue and occupational burnout of nurses in the Operating Room were positively correlated ( r=0.648, P<0.01) , psychological capital was negatively correlated with occupational burnout ( r=-0.589, P<0.01) , and occupational fatigue was negatively correlated with psychological capital ( r=-0.584, P<0.01) . The hierarchical linear regression results showed that occupational fatigue had a positive predictive effect on occupational burnout ( P<0.01) , while psychological capital had a negative predictive effect ( P<0.01) . The mediating effect of psychological capital between occupational fatigue and occupational burnout of nurses in the Operating Room was 0.18, accounting for 34.61% of the total effect. Conclusions:The psychological capital of nurses in the Operating Room plays a part of the intermediary role between occupational fatigue and occupational burnout. Improving the psychological capital of nurses in the Operating Room can help reduce their level of occupational burnout.

OBJECTIVEOsseointegration of orthodontic microscrew implant is influenced by tooth extraction. This study aims to evaluate the safety margin of the osseointegration of orthodontic implants by investigating the healing process of the implant-bone interface through histopathological studies and quantitative determination.

METHODSTwelve male beagles were selected and randomly divided into four groups. An orthodontic microscrew was implanted beside the tooth extraction area. Animals were killed in 1, 3, 8, and, 12 weeks to investigate tissue response. Histomorphological observation and bone implant contact ratio (BIC) tests were performed at different healing time after implantation.

RESULTSA new bone was formed on the implant-bone interface of the control group. Bone resorptions were also detected in the experimental group 3 weeks after implantation. The BIC level of the control groups increased during the first 8 weeks; no change was observed anymore after the 8th week. On the other hand, the BIC value in the experimental group decreased in the first 3 weeks. It then increased rapidly and reached its peak of 80.08% in the 8th week. No significant difference wa s found between the experimental and control groups in the first 3 weeks. After the 3rd week, the BIC value of the experimental group (44.35%) was lower than that of the control group (55.46%) (P < 0.01).

CONCLUSIONThe healing process after implantation was influenced by tooth extraction. Bone resorption was detected at an early stage. However, vigorous bone remodeling was observed subsequently.

Animals ; Bone Remodeling ; Bone and Bones ; Dental Implantation, Endosseous ; Dental Implants ; Dogs ; Male ; Mandible ; Osseointegration ; Prostheses and Implants ; Tooth Extraction ; Wound Healing

Objective:To evaluate the efficacy and safety of adalimumab (ADA) in the treatment of Crohn′s disease (CD), and to analyze the predictive factors of ADA efficacy.Methods:From January 2020 to December 2020, 49 CD patients treated with ADA at the Department of Gastroenterology, Tenth People′s Hospital of Tongji University of Shanghai were enrolled. The clinical data before treatment were collected. During 12 weeks of ADA treatment, the patients were followed up every 2 weeks, the laboratory examinations were conducted every 4 weeks, and colonoscopy examination was rechecked at the 12th week. The improvement of the main symptoms of patients was assessed at 2nd, 4th, and 6th week during ADA treatment. At the 12th week after ADA treatment, the clinical response (Crohn′s disease activity index (CDAI) score decreased ≥70 points from baseline), clinical remission (CDAI score < 150 points), endoscopic response (simple endoscopic score for Crohn′s disease (SES-CD) decreased >50% from baseline) and endoscopic remission (SES-CD ≤2 points or Rutgeerts score ≤1 point), closure of anal fistula of CD patients complicated with anal fistula and occurrence of adverse reactions during treatment were recorded. The predictive factors of clinical remission of CD patients after ADA treatment for 12 weeks were analyzed. The Mann-Whitney U test and binary logistic regression analysis were used for statistical analysis. Results:The main symptom improved rates of 49 CD patients received ADA treatment at 2nd, 4th and 6th week were 75.5% (37/49), 95.9% (47/49) and 98.0% (48/49), respectively, and the main symptom improved time was 14.0 d (7.0 d, 17.0 d). After ADA treatment for 12 weeks, the clinical remission rate was 55.1% (27/49), the clinical response rate was 73.5% (36/49), the endoscopic remission rate was 43.3% (13/30), the endoscopic response rate was 55.6% (15/27), the anal fistula closure rate was 7/18, and the overall incidence of adverse reactions was 24.5% (12/49). The baseline of fecal calprotectin (FC) level of patients in the clinical remission group (27 cases) was lower than that of the patients in the active disease group (22 cases) (111.0 μg/g, 26.3 μg/g to 125.6 μg/g vs. 540.5 μg/g, 420.2 μg/g to 866.9 μg/g), and the difference was statistically significant ( Z=-4.44, P<0.001). The results of binary logistic regression analysis showed that baseline FC level was an independent predictive factor of clinical remission in CD patients treated with ADA for 12 weeks ( OR=1.08, 95%confidence interval 1.02 to 1.14, P=0.013). When the baseline FC cut-off value was 172.39 g/g, the sensitivity and specificity of it in predicting clinical remission in CD patients treated with ADA for 12 weeks were 81.48% and 90.91%, and the area under the receiver operator characteristic curve was 0.87 ( P<0.001). Conclusions:ADA is safe and effective in the treatment of CD. The baseline FC level is an independent predictive factor of clinical remission in CD patients treated with ADA for 12 weeks.

ObjectiveTo investigate the Character of Symptom Checklist 90 (SCL-90) in detoxification addicts in reeducation center.Methods100 detoxification addicts in reeducation center were evaluated.ResultsThe results showed that the mean scores of all factors in detoxification addicts were higher than those of normal population, and there was difference between different drug dependence addicts.ConclusionThe detoxification addicts shows serious psychological disorders.

Purpose To investigate the diagnostic value of multimodal imaging in cardiac lipoma.Materials and Methods The clinical symptoms,echocardiography,CT and cardiac magnetic resonance images of 14 patients with cardiac lipoma diagnosed in Xijing Hospital of Air Force Military Medical University from July 2016 to November 2022 were retrospectively analyzed.Results Five patients with lipoma had symptoms of chest tightness and shortness of breath.A total of 18 lesions were found in 14 cases with cardiac lipoma.The locations of cardiac lipomas were widely distributed in the heart,of which 9 were located under the inner lining of the ventricular lumen(6 in the left ventricle,3 in the right ventricle),5 in the myocardium(4 in the left ventricle wall,1 in the right ventricle wall),3 in the pericardium,and 1 in the right ventricle.Echocardiography of 12 cases showed strong echoic mass image,and CT of 7 cases showed uniform low-density mass image.All patients cardiac magnetic resonance showed high signal of T1WI,and the tumor signal of lipid-pressure sequence decreased significantly.T2WI showed high signal and low signal ring around the tumor,indicating a chemical shift artifact.In the film sequence of heart,the mass could be seen to wobble gently and change in the shape of spontaneous motion cycle.The first perfusion scan did not show perfusion elevation.No enhancement was observed on the delayed enhanced scan.Native T1 mapping showed that the T1 value of mass was significantly lower than that of normal myocarda[(255.9±48.4)ms vs.(994.2±66.4)ms],and the difference was statistically significant(t=-32.5,P<0.001).Conclusion Multimodal imaging can provide objective evidence for clinical diagnosis of cardiac lipoma.Lipomas with extremely low T1 values were found,which is helpful to assist in the diagnosis of cardiac lipoma,clearer observation of the lesions,accurate localization,and strong ability to detect small lesions.Therefore,when cardiac lipoma is suspected,T1 mapping can be used as a routine examination method for the diagnosis and differential diagnosis of cardiac masses.