Background: Disorders of the blood-brain barrier (BBB) arising from diabetes mellitus are closely related to diabetic encephalopathy. Previous research has suggested that neuron-glia antigen 2 (NG2)-glia plays a key role in maintaining the integrity of the BBB. However, the mechanism by which NG2-glia regulates the diabetic BBB remains unclear. Methods: Type 2 diabetes mellitus (T2DM) db/db mice and db/m mice were used. Evans-Blue BBB permeability tests and transmission electron microscopy techniques were applied. Tight junction proteins were assessed by immunofluorescence and transmission electron microscopy. NG2-glia number and signaling pathways were evaluated by immunofluorescence. Detection of matrix metalloproteinase-9 (MMP-9) in serum was performed using enzyme-linked immunosorbent assay (ELISA). Results: In T2DM db/db mice, BBB permeability in the hippocampus significantly increased from 16 weeks of age, and the structure of tight junction proteins changed. The number of NG2-glia in the hippocampus of db/db mice increased around microvessels from 12 weeks of age. Concurrently, the expression of MMP-9 increased in the hippocampus with no change in serum. Sixteen- week-old db/db mice showed activation of the Wnt/β-catenin signaling in hippocampal NG2-glia. Treatment with XAV-939 improved structural and functional changes in the hippocampal BBB and reduced MMP-9 secretion by hippocampal NG2-glia in db/db mice. It was also found that the upregulation of β-catenin protein in NG2-glia in the hippocampus of 16-week-old db/db mice was significantly alleviated by treatment with XAV-939. Conclusion The results indicate that NG2-glia can lead to structural and functional disruption of the diabetic BBB by activating Wnt/β-catenin signaling, upregulating MMP-9, and degrading tight junction proteins.

To further standardize the ethical review of life science and medical research involving humans,the National Health Commission,the Ministry of Education,the Ministry of Science and Technology,and the State Administration of Traditional Chinese Medicine jointly issued the Measures of the Ethical Review of Life Science and Medical Research Involving Humans in 2023.The provisions concerning research related to health information data within it include:emphasizing the protection of personal information and privacy rights,personal information can only be collected,stored,and used under the premise that research participants know and permit,and must not be disclosed to third-party without the authorization of research participants;the ethical committee should focus on reviewing the adequacy of confidentiality measures of personal information;for research that provides information and data or cooperation with external organizations,it is necessary to fully understand the research,conduct a full ethical review,and clarify the use,processing,and disposal after completion of information data through an agreement.The research institutions should improve the information data governance and supervision system in conjunction with the key points of information data management in the new regulations.The initial ethical review should focus on the risk-benefit ratio of the research,the reasonableness of the informed consent procedure,the feasibility of the opt-out procedure,the protection measures for the privacy of the research participants,and the data management capability of the research team.The knowledge training of researchers should be strengthened,policy advisory services should be provided for them,and even a unified information data management platform should be built for them from the overall level of research institutions.The ethical follow-up review emphasizes whether the researchers continue to protect the participant's right to independent information or personal information,and privacy.It is believed that through a series of governance measures,the health information data of research participants in China will be better protected,thus safeguarding their legitimate rights and interests.

As a structural barrier, the blood-brain barrier (BBB) is located at the interface between the brain parenchyma and blood, and modulates communication between the brain and blood microenvironment to maintain homeostasis. The BBB is composed of endothelial cells, basement membrane, pericytes, and astrocytic end feet. BBB impairment is a distinguishing and pathogenic factor in diabetic encephalopathy. Diabetes causes leakage of the BBB through downregulation of tight junction proteins, resulting in impaired functioning of endothelial cells, pericytes, astrocytes, microglia, nerve/glial antigen 2-glia, and oligodendrocytes. However, the temporal regulation, mechanisms of molecular and signaling pathways, and consequences of BBB impairment in diabetes are not well understood. Consequently, the efficacy of therapies diabetes targeting BBB leakage still lags behind the requirements. This review summarizes the recent research on the effects of diabetes on BBB composition and the potential roles of glial and vascular cells as therapeutic targets for BBB disruption in diabetic encephalopathy.

Objective: To assess the differences between ultrasound cardiac output monitor (USCOM) and thermodilution (TD) systematically in cardiac function monitoring of critically ill patients. Methods: The Chinese and English literatures about the clinical trials which using USCOM and TD to monitor cardiac function published in CNKI, Wanfang database, China biomedical literature database, VIP database, China Clinical Trial Registration Center, PubMed, Embase and Cochrane Library were searched by computer from the establishment to December 2018. Some indicators, like cardiac output (CO), cardiac index (CI), stroke volume (SV) and other parameters were used to evaluate cardiac function. Literature search, quality evaluation and data extraction were conducted independently by two authors. The tailored Quality Assessment of Diagnostic Accuracy Studies (QUADAS-2) was used for literature quality evaluation. EndNote X6 was used for literature screening and management. RevMan 5.3 was used for Meta-analysis. Funnel chart analysis was used for publication bias. Results: A total of 26 studies involving 772 patients were included. Among them, there were 5 literatures found that the agreements of cardiac function between the USCOM and TD methods were poor. Meta-analysis showed that there was no significant difference between the two methods in CO and CI monitoring [CO: mean difference (MD) = -0.06, 95% confidence interval (95%CI) was -0.17 to 0.05, P = 0.31; CI: MD = -0.04, 95%CI was -0.13 to 0.05, P = 0.38]. Subgroup analysis of different TD methods [pulmonary artery catheter (PAC), pulse indicator continuous cardiac output (PiCCO)] and different windows of USCOM ultrasonic probe [aorta (AA), pulmonary artery (PA)] in CO monitoring was not shown significant difference yet (PAC: MD = -0.07, 95%CI was -0.18 to 0.04, P = 0.23; PiCCO: MD = 0.09, 95%CI was -0.31 to 0.50, P = 0.65; AA windows: MD = -0.14, 95%CI was -0.31 to 0.02, P = 0.09; PA windows: MD = -0.00, 95%CI was -0.15 to 0.14, P = 0.95; AA/PA windows: MD = 0.23, 95%CI was -0.40 to 0.86, P = 0.47). However, the difference in SV was statistically significant between the USCOM and TD method (MD = 1.48, 95%CI was 0.04 to 2.92, P = 0.04). Funnel chart showed that the literature distribution of CO and CI monitoring were basically symmetrical, indicating that the bias of literature publication is small. Conclusion USCOM has good consistency with TD method in monitoring the cardiac function parameters of CO and CI, and different windows of ultrasonic probe of USCOM have no significant influence on the monitoring results, but there is significant difference in the consistency of the two methods in SV monitoring.

OBJECTIVE: To assess the differences between ultrasound cardiac output monitor (USCOM) and thermodilution (TD) systematically in cardiac function monitoring of critically ill patients. METHODS: The Chinese and English literatures about the clinical trials which using USCOM and TD to monitor cardiac function published in CNKI, Wanfang database, China biomedical literature database, VIP database, China Clinical Trial Registration Center, PubMed, Embase and Cochrane Library were searched by computer from the establishment to December 2018. Some indicators, like cardiac output (CO), cardiac index (CI), stroke volume (SV) and other parameters were used to evaluate cardiac function. Literature search, quality evaluation and data extraction were conducted independently by two authors. The tailored Quality Assessment of Diagnostic Accuracy Studies (QUADAS-2) was used for literature quality evaluation. EndNote X6 was used for literature screening and management. RevMan 5.3 was used for Meta-analysis. Funnel chart analysis was used for publication bias. RESULTS: A total of 26 studies involving 772 patients were included. Among them, there were 5 literatures found that the agreements of cardiac function between the USCOM and TD methods were poor. Meta-analysis showed that there was no significant difference between the two methods in CO and CI monitoring [CO: mean difference (MD) = -0.06, 95% confidence interval (95%CI) was -0.17 to 0.05, P = 0.31; CI: MD = -0.04, 95%CI was -0.13 to 0.05, P = 0.38]. Subgroup analysis of different TD methods [pulmonary artery catheter (PAC), pulse indicator continuous cardiac output (PiCCO)] and different windows of USCOM ultrasonic probe [aorta (AA), pulmonary artery (PA)] in CO monitoring was not shown significant difference yet (PAC: MD = -0.07, 95%CI was -0.18 to 0.04, P = 0.23; PiCCO: MD = 0.09, 95%CI was -0.31 to 0.50, P = 0.65; AA windows: MD = -0.14, 95%CI was -0.31 to 0.02, P = 0.09; PA windows: MD = -0.00, 95%CI was -0.15 to 0.14, P = 0.95; AA/PA windows: MD = 0.23, 95%CI was -0.40 to 0.86, P = 0.47). However, the difference in SV was statistically significant between the USCOM and TD method (MD = 1.48, 95%CI was 0.04 to 2.92, P = 0.04). Funnel chart showed that the literature distribution of CO and CI monitoring were basically symmetrical, indicating that the bias of literature publication is small. CONCLUSIONS USCOM has good consistency with TD method in monitoring the cardiac function parameters of CO and CI, and different windows of ultrasonic probe of USCOM have no significant influence on the monitoring results, but there is significant difference in the consistency of the two methods in SV monitoring.
Cardiac Output ; China ; Humans ; Monitoring, Physiologic ; Thermodilution ; Ultrasonography

Objective To evaluate the efficacy of lower pole incision pyelocalycolithotomy for the removal of complex stag-horn renal calculi. Methods The clinical data of 13 patients with complex stag-horn renal calculi underwent lower pole incision pyelocalycolithotomy were retrospectively analyzed. Results The renal pedicel blood flow did not be interrupted during operation. The mean operative time was 140 minutes, and the mean amount of blood loss during operation was 220ml. The size of the biggest removed stone was 7 2cm?4 1cm?3 5cm, and in one case the number of the removed stones amounted to 35 pieces. KUB plus IVP examination did not reveal the residual renal stone in all cases one month after operation. Conclusion The lower pole incision pyelocalycodithotomy have the advantages of simplicity, less bleeding,complete removal of calculus and preservation of renal function. It is one of effective operative procedures to treat big stag-horn renal calculi.

The purpose of this study was to found a three dimensional anatomical model of normal knees in Chinese and to carry out measurements of the relating parameters with this model. Three dimensional CT scan of 18 normal Chinese (36 knees) were acquired. All the cases were divided into three groups according to the height of each individual (156～165cm, 166～175cm, 176～185cm), with each group consisting of 6 individuals (12 knees). Data of the 6 ipsilateral knees were integrated to create a typical three dimensional anatomical model. Altogether 15 parameters including the linear and the angular indices were measured through this model. The results showed: (1) Most anatomical characteristics of the knee of typical Chinese population could be covered by the 3 D model we established; (2) There were stable positive relationships between different linear parameters and between the linear parameters and the body height; (3) The angular parameters were comparatively independent. This well developed 3 D model could provide a reliable method on the measurements of the knee geometry in Chinese people.

Objective To evaluate wedge resection of the back labium renalis and intrasinusal pyelolithotomy for staghorn calculi of kidney in patients with intrarenal pelvis and renal malrotation. Methods From August 1998 to February 2001, 18 cases of staghorn stones of kidney were removed via the wedge resection of the back labium of hilum renalis and incision of the intrarenal sinus. Results The mean operative time was 110 min and the mean blood loss 300 ml.The biggest stone was 6.5 cm?5.0 cm?3.0 cm and in one case the number of stones amounted to 1 400. Postoperative KUB showed no residual stones and postoperative IVU indicated normal renal function.All patients have been followed up for 1～3 years and have been free of stone. Conclusions The procedure has the advantages of no need of pedicle renalis occlusion,less bleeding,a clear operation field,easy staghorn calculi removal and the avoidance of renal hilum outlet obstruction.

ObjectiveTo evaluate wedge resection of th e back labium renalis in the repairation of iatrogenic pelvis tear. MethodsFrom October 1999 to February 2002,7 cases of iatrogenic pel vis tear were repaired with wedge resection of the back labium of renal hilum.Th ere were 5 male patients and 2 female with an average age of 45.The tear occurre d during lithotomy for pelvis stone in 6 and transureteroscopic lithotripsy in 1.ResultsThe mean operative time was 130 min and the m ean blood loss 300 ml,postoperative IVU showed no obstruction of the renal pelvi s,and the renal function has been normal.All patients have been followed up for 3 months to 3 years.Neither hydronephrosis nor renal pelvis obstruction has been noted.ConclusionsThe procedure has the advantages of no need of predicle occlusion,less bleeding,a clear operation field,easy repaira tion,and the avoidance of pelvis obstruction.

Objective To evaluate suprapubic transvesical prostatectomy without partition of the prostatic cavity. Methods From Nov.1999 to Mar.2000,20 cases of BPH were treated by suprapubic transvesical prostatectomy without partition of the prostatic cavity and the therapeutic result was evaluated. Results The blood loss has been less.The patients have been followed up for 1～5 months.Neither incontinence nor bladder outlet obstruction has been noted.IPSS decreased from 29.4?2.0 to 8.8?2.0,Qmax increased from 6.8?1.3 ml/s to 16.8?2.0 ml/s,AFR increased from 3.5?0.9 ml/s to 10.0? 2.0 ml/s and QOL decreased from 5.5?0.5 to 1.7?0.5.All these differences were statistically significant ( P