Objective To analyze the relationship between type 2 diabetes mellitus(T2DM)and cognitive disorder in middle-aged and elderly patients with Parkinson's disease(PD),and to identify risk factors for cognitive disorder in PD patients.Methods The clinical data of patients aged≥50 years and hospitalized for PD in Xijing Hospital of Air Force Medical University from Jan.2010 to Dec.2021 were collected,including demographic characteristics,general clinical features,laboratory indicators,etc.The cognitive status was evaluated by mini-mental state examination(MMSE).A total of 281 PD patients were assigned to T2DM group or non-T2DM group,and MMSE original score,standardized score,and cognitive status were compared between the 2 groups.The 281 patients were reassigned to normal cognition group or abnormal cognition group,then multivariate logistic regression was used to analyze the risk factors of cognitive disorder in middle-aged and elderly patients with PD.Results The MMSE original score and standardized score in the T2DM group were significantly lower than those in the non-T2DM group(23[18,25]vs 24[21,27],P=0.011;-1[-3,2]vs 1[-1,3],P=0.004),and the detection rate of cognitive disorder was significantly higher than that of the non-T2DM group(53.57%[45/84]vs 33.50%[66/197],P=0.002).Multivariate logistic regression analysis showed that T2DM(odds ratio[OR]=2.452,95%confidence interval[95%CI]1.397-4.306,P=0.002),place of residence(OR=2.208,95%CI 1.261-3.868,P=0.006),and age(OR=1.054,95%CI 1.006-1.104,P=0.028)were risk factors for cognitive disorder in middle-aged and elderly patients with PD,while serum uric acid(OR=0.274,95%CI 0.098-0.768,P=0.014)was protective factor for cognitive disorder in middle-aged and elderly patients with PD.Conclusion T2DM,rural area,advanced age,and hypouricemia are independent risk factors for cognitive disorder in middle-aged and elderly patients with PD.For middle-aged and elderly PD patients with T2DM,screening for cognitive disorder should be strengthened for early prevention and intervention.

Objective To evaluate the safety and efficacy of flow diverter stent(FDS)implantation in treating blood blister-like aneurysms(BBA).Methods The clinical data and imaging findings(including baseline data,aneurysm data,surgical pattern,surgery-related complications and follow-up results)of 14 patients with BBA,who were admitted to West China hospital of Sichuan University from January 2022 to June 2023,were retrospectively analyzed.Results Of the 14 patients with BBA,pipeline embolization device-assisted(PED-assisted)coil embolization was performed in 5,only PED in 3,Tubridge close-mesh stent(TB)-assisted coil embolization in 5,only TB in one.In the 4 patients receiving only FDS,the immediate postoperative angiography showed that retention of contrast agent was seen in the aneurysm,and no aneurysm visualization was seen in the remaining patients.One patient,who received TB-assisted coil embolization,developed postoperative delayed massive cerebral infarction and died.One patient,who received only PED,developed right limb hemiplegia with an mRS score of 2 points at follow-up visit.In the remaining 12 patients,the mRS score was 0 point at the time of discharge as well as at the time of follow-up visit.In 13 patients,follow-up angiography demonstrated that the aneurysm was completely occluded.Conclusion For the treatment of BBA,FDS-assisted coil embolization or single FDS is clinically safe and effective,although there is potential risk of perioperative aneurysm rebleeding and cerebral infarction.

Objective To investigate the clinical features of kidney transplantation of small pediatric donors to pediatric recipients.Method A retrospective analysis of 48 kidney transplants from small pediatric donors into pediatric recipients was performed.Result Based on the transplantation types,the patients were divided into two groups:the single kidney transplantation (SKT) group and the en bloc kidney transplantation (EBKT) group.SKT was performed on 36 patients and EBKT on 12 patients.In the SKT group,postoperative complications included vascular thrombosis in 1 case (2.8％),primary disease recurrence in 1 case (2.8％),ureteral stenosis in 1 case (2.8％),delayed graft function in 17 cases (47.3 ％) and acute rejection in 4 cases (11.1 ％).In the EBKT group,postoperative complications included vascular thrombosis in 4 cases (33.3％),urine leak in 2 cases (16.7％),delayed graft function in 2 cases (16.7％) and acute rejection in 2 cases (16.7％).At last follow-up,patient survivals were 100％ in both groups,whereas graft survival was 94.4％ (34/36) in the SKT group and 75％ (9/12) in the EBKT group.The mean serum creatinine in the SKT and EBKT group was (68.4 ± 22.1) and (55.8 ± 16.7) μmol/L,respectively.Conclusion Favorable outcomes can be obtained from transplantation from small pediatric donors.The use of this donor population for pediatric recipients should be encouraged.

Objective To investigate whether the pretreatment of SS31 could alleviate hypoxia/reoxygenation (H/R)-induced injury by inhibiting p66Shc.Method The cultured rat renal proximal tubular cell line NRK52E cells were exposed to 24-h hypoxia (5％ CO2,1％ O2,and 94％ N2) followed by 6-h reoxygenation (5％ CO2,21％ O2,and 74％ N2).SS31 was added to the culture medium 4 h prior to the treatment.Then the cell viability,apoptosis,ROS and MTP were determined.In addition,Western blotting was used to detect the expression of p66Shc and p-p66Shc.Result H/R induced apoptotic cell death,accompanied with activation of total and p-p66Shc in NRK52E cells.Total p66Shc and p-p66Shc were detected at low levels in control NRK52E cells,and their levels were dramatically increased in cells after H/R treatment.Pretreatment with 100 μmol/L SS31 significantly prevented cell death and attenuated total p66Shc and p-p66Shc levels after H/R.Conclusion This study revealed that SS31 pretreatment serves a protective role against H/R-induced apoptosis of human renal tubular epithelial cells by suppressing p66Shc.

Objective To investigate the therapeutic principle of en-bloc kidney and single kidney transplantation from pediatric donors to pediatric recipients.Method A retrospective analysis of 11 pediatric kidney transplants into pediatric recipients was performed.The age of donors and recipients was 33 days to 48 months,and (9.1 ± 3.4) years (4.6 14.3 years) respectively.Result During the follow-up period of 1 to 22 months,the patient survival rate was 100％.Complications included delayed graft function in 1 case (managed by peritoneal dialysis),urine leak in 2 cases (treated by reoperation),hydronephrosis in 2 cases (treated by extracting ureteral catheter) and vascular thrombosis in 1 case.Due to thrombosis,one graft was lost.Of the remaining 10 recipients,all had excellent long-term function.At the last follow-up,their serum creatinine levels were 65.5 ±13.6 μmol/L (49-83μmol/L),and transplanted renal ultrasound examination showed no abnormality.Conclusion Kidney grafts from pediatric donors can be successfully transplanted to pediatric recipients,but the therapeutic principle is different from that in adult kidney transplantation.

Objective To observe the effect of home nursing based upon protocol nursing theory on liq-uid intake compliance improvement of patients undergoing hemedialysis. Methods Forty-eight HD patients of hquid intake un-compliance were randomized into the observation group and the control group with 24 cases in each group. The control group received routine nursing, the observation group was given home care instruc-tion based upon protocol nursing theory for 1 month. The two groups both received follow-up for 3 months and their liquid intake comphance were evaluated before and after intervention. The relationship between family sup-port and relative increase of body weight during hemodialysis was also evaluated. Results The IDGW relative magnitude was lower, the compliance of liquid intake was higher, the level of family support was higher in the observation group than those of the control group. There was negative correlation between the family support and the IDGW relative magnitude the IDGW relative magnitude, family support, comphance of liquid intake. Conclusions Home care nursing based upon nursing theory facilitate patients to get effect family support, increase the compliance of hquid intake and make IDGW within desirable range.