The relationship between cognitive function and having diabetes in patients treated with hemodialysis

Purpose:Patients undergoing maintenance hemodialysis(MHD)have a higher prevalence of cognitive impairment and inferior cognitive performance than the general population,and those with cognitive impairment are at higher risk of death than those without cognitive impairment.Having diabetes has been associated with an increased risk of cognitive decline in end-stage kidney disease patients treated with peritoneal dialysis or kidney transplant.However,these findings may not extend to the hemodialysis population.Thus,we aim to investigate the relationship between having diabetes and cognitive function in MHD patients.Methods:This was a cross-sectional study.A total of 203 patients treated with MHD from two blood purification centers were enrolled as subjects.The Chinese version of the Montreal Cognitive Assessment(MoCA)was utilized to assess cognitive function.Results:MHD patients with diabetes had a significantly higher prevalence of global cognitive impairment and inferior performance in global cognition,visuospatial/executive function,naming,language,abstraction and orientation tasks compared with those without diabetes.According to the multiple linear analyses,having diabetes was significantly associated with lower global cognitive function,naming,and language scores,withβcoefficients and 95%CIs of-1.30[-2.59,-0.01],-0.25[-0.47,-0.02],and-0.32[-0.58,-0.07],respectively(all P<0.05).Having diabetes could not independently predict an increased risk of global cognitive impairment.Conclusions:In MHD patients,having diabetes is significantly associated with lower cognitive function scores.Medical staff should evaluate early and focus on the decline of cognitive function in MHD patients with diabetes,in order to achieve early diagnosis and earlv intervention.

Multidisciplinary management of recurrent and metastatic hepatocellular carcinoma after resection: an international expert consensus

Hepatocellular carcinoma (HCC) is the sixth-most common cancer and the third leading cause of cancer-related death in the world. However, 40–70% patients eventually suffer from postoperative recurrence within 5 years. HCC recurrence after surgery severely affects prognosis of the patients. Nevertheless, there is an opportunity to improve patients' prognosis if doctors and researchers can recognize the importance of a standardized perioperative management and study it in clinical and pre-clinical settings. Hence, based on our own experience and published studies from other researchers, we develop this consensus regarding multidisciplinary management of locally recurrent and metastatic hepatocellular carcinoma after resection. This consensus consists of the entire course of recurrent hepatocellular carcinoma (RHCC) management, including prediction of recurrence, prevention, diagnosis, treatment and surveillance of RHCC. Consensus recommendations are presented with grades of evidences (Ia, Ib, IIa, IIb, III and IV), and strength ofrecommendations (A, B, C, D and E). We also develop a decision-making path for RHCC treatment, which can intuitively demonstrate the management for RHCC. It is hoped that we may make some effort to standardize the management of RHCC and ultimately understand how to improve outcomes.

Transcriptome analysis of wheat grain using RNA-Seq

With the increase in consumer demand,wheat grain quality improvement has become a focus in China and worldwide.Transcriptome analysis is a powerful approach to research grain traits and elucidate their genetic regulation.In this study,two cDNA libraries from the developing grain and leaf-stem components of bread wheat cultivar,Nongda211,were sequenced using Roche/454 technology.There were 1061274 and 1516564 clean reads generated from grain and leaf-stem,respectively.A total of 61393 high-quality unigenes were obtained with an average length of 1456 bp after de novo assembly.The analysis of the 61393 unigenes involved in the biological processes of the grain showed that there were 7355 differentially expressed genes upregulated in the grain library.Gene ontology enrichment and the Kyoto Encyclopedia of Genes and Genomes pathway enrichment analysis showed that many transcription products and transcription factors associated with carbohydrate and protein metabolism were abundantly expressed in the grain.These results contribute to excavate genes associated with wheat quality and further study how they interact.