Metabolic abnormality in type 2 diabetes mellitus(T2DM)can cause damage to the central nervous system,leading to cognitive decline.Neurofilament light chain protein(NFL),as a blood marker of neuroaxonal injuries,is significantly associated with the onset of cognitive impairment and affected by the renal function.It can participate in the development of cognitive impairment in T2DM through inflammation,blood-brain barrier breakdown,interaction between microglia and neurons,and Tau protein phosphorylation.We re-viewed the mechanism of the occurrence and development of NFL-involved cognitive impairment and the correla-tion between NFL and renal function in T2DM,hoping to provide a basis for early diagnosis and treatment of cog-nitive impairment in T2DM patients.

Background: Cardiopulmonary resuscitation (CPR) strategies in COVID-19 patients differ from those in patients suffering from cardiogenic cardiac arrest. During CPR, both healthcare and non-healthcare workers who provide resuscitation are at risk of infection. The Working Group for Expert Consensus on Prevention and Cardiopulmonary Resuscitation for Cardiac Arrest in COVID-19 has developed this Chinese Expert Consensus to guide clinical practice of CPR in COVID-19 patients. Main recommendations: 1) A medical team should be assigned to evaluate severe and critical COVID-19 for early monitoring of cardiac-arrest warning signs. 2) Psychological counseling and treatment are highly recommended, since sympathetic and vagal abnormalities induced by psychological stress from the COVID-19 pandemic can induce cardiac arrest. 3) Healthcare workers should wear personal protective equipment (PPE). 4) Mouth-to-mouth ventilation should be avoided on patients suspected of having or diagnosed with COVID-19. 5) Hands-only chest compression and mechanical chest compression are recommended. 6) Tracheal-intubation procedures should be optimized and tracheal-intubation strategies should be implemented early. 7) CPR should be provided for 20-30 min. 8) Various factors should be taken into consideration such as the interests of patients and family members, ethics, transmission risks, and laws and regulations governing infectious disease control. Changes in management: The following changes or modifications to CPR strategy in COVID-19 patients are proposed: 1) Healthcare workers should wear PPE. 2) Hands-only chest compression and mechanical chest compression can be implemented to reduce or avoid the spread of viruses by aerosols. 3) Both the benefits to patients and the risk of infection should be considered. 4) Hhealthcare workers should be fully aware of and trained in CPR strategies and procedures specifically for patients with COVID-19.

Objective To analyze the expression levels of IL-11 and connective tissue growth factor (CTGF) in patients with breast cancer and their correlation with bone metastasis .Methods The 108 cases of breast cancer(breast cancer group) ,30 cases of breast benign tumor (breast benign tumor group) and 30 cases of healthy controls (control group) were performed by ELISA to de-tect the expression of serum IL-11 ,CTGF ,and their relationship with bone metastases was analyzed .All the patients were followed up for 2 years ,survival rates between different expression levels of IL-11 ,CTGF were compared .Results Compared with those in control group and breast benign tumor group ,the expressions of IL-11 ,CTGF in breast cancer group were increased (P<0 .05) , while there was no significant difference between control group and breast benign tumor group (P<0 .05) .The levels of serum IL-11 ,CTGF in different stages of breast cancer with bone metastases were significantly higher than those in breast cancer without bone metastases(P<0 .05) ,and the levels of IL-11 ,CTGF in bone metastases stage of Ⅲ - Ⅳ were higher than those in bone me-tastases stage ofⅠ - Ⅱ(P<0 .05) .Serum IL-11 and CTGF was positively correlated in breast cancer patients with or without bone metastases(r=0 .514 ,0 .477 ,P<0 .05) .At 2 year after surgery ,the survival rate in patients with high expression of IL-11 and CT-GF was significantly lower than that with low expression (χ2 =4 .50 ,5 .18 ,P<0 .05) .Conclusion The levels of serum IL-11 ,CT-GF in breast cancer patients are overexpressed ,which could be used as an effective serological tumor markers for diagnosis of bone metastases and assessment of prognosis .

Objective Esophageal spindle cell carcinoma is a rare type of esophageal squamous cell carcinoma , which was usually named esophageal carcinosarcoma .This article was to discuss the clinical characteristics , treatment and prognostic factors of e-sophageal spindle cell carcinoma . Methods The clinical and pathological data of 28 cases of esophageal spindle cell carcinoma were retrospectively analyzed .The prognostic factors was analyzed for various factors including gender , age, smoking history , tumor loca-tion, tumor size, lymph node metastasis, histological type, pathological staging and adjuvant treatment regimen .Kaplan-Meier method was applied to calculate the survival rate , log rank method for single prognostic factor analysis and Cox proportional hazard regression model for multivariate analysis of prognosis . Results One-year, three-year, and five-year survival rates were 89.3%(25/28), 67.1%(19/28), 38.5%(10/28)respectively.Single factor analysis showed that the pathological type , N stage, T stage, pTNM stage were the factors influencing the prognosis(P﹤0.05), while gender, age, smoking and drinking history, tumor location, tumor size, operation incision selection , adjuvant treatment regimen were not .Multivariate analysis showed pTNM stage were the independent fac-tors affecting the prognosis of esophageal spindle cell carcinoma (χ2 =13.104, P=0.000). Conclusion Esophageal spindle cell carcinoma is a rare kind of esophageal squamous cell carcinoma with less invasiveness , low rate of lymph node metastasis and good progno-sis.Radical operation is the preferred treatment .

Objective To investigate the mechanism of mastoparan-1 (MP-1) antagonizing lipopolysaecharide (LPS) in vitro. Methods The affinity of MP-1 for lipid A was assayed by biosensor, and the neutralization of MP-1 on LPS (2 μg/L) was detected by kinetic turbidimetric limulus test. After exposing fluorescin isothiecyanate (FITC) labeled LPS (FITC-LPS) to MP-1 at different concentrations (5, 10, 20, 40 μmol/L), the binding of FITC-LPS to murine RAW264.7 cells was analyzed by laser scanning confocal microscopy. The influence of MP-1 on TLR4 expression in RAW264.7 cells stimulated by LPS (100 μg/L) was detected by immunoeytochemieal staining. The expressions of TLR4, TNF-α and IL-6 at the gene and protein level were detected by RT-PCR and ELISA after exposing LPS (100 μg/ L) stimulated RAW264.7 cells to MP-1 at different concentrations. The effect of MP-1 on the viability of RAW264.7 cells was detected by MTT assay. Results MP-1 had high affinity to lipid A and could neutralize LPS. MP-1 at 10 μmol/L significantly inhibited not only binding of FITC-LPS to RAW264.7 (P < 0.05), but also protein and gene expressions of TLR4, TNF-α and IL-6 in LPS stimulated RAW264.7 cells in a dose-dependent manner (P < 0.05). No toxic effect of MP-1 on the viability of RAW264.7 cells was found (P > 0.05). Conclusions MP-1 inhibits cell viability mediated by LPS, which may be related to its neutralization of LPS and inhibition of binding of LPS to RAW264.7 cell membrane receptors.

In order to study the role of prostaglandin E2(PGE_2)on the pathogenesis of candidal vaginitis,the effect of Candida albicans and histamine on the production of PGE_2 by peripheral blood mononuclear cells from patients with candidal vaginitis and normal controls,the effect of PGE2 on germ tube formation of Candida albicans,and the effect of PGE2 on Candida albicans adhering to vaginal ep- ithelial cells were observed.The results showed that:Candida albicans and histamine induced PGE2 synergistically,and the production of PGE2 increased markedly.PGE2 enhanced germ tube formation in Candida albicans,increased the number of Candida albicans adhering to the vaginal epithelial cells, and the pathogenicity of C.albicans.The above results indicate that PGE_2 plays a role in the pathogene- sis of candidal vaginitis.