The Relationship between Trait Impulsivity and Everyday Executive Functions among Patients with Type 2 Diabetes Mellitus: The Mediating Effect of Negative Emotions.

Background: In recent years, the incidence of type 2 diabetes mellitus (T2DM) has dramatically increased, imposing a heavy financial burden on society and individuals. The most cost-effective way to control diabetes is diabetes self-management, which depends on patients' executive functions (EFs). However, the level of EFs among patients with T2DM varies greatly. In addition to diabetes-related factors contributing to a decline in EFs, trait impulsivity as a relatively stable personality trait may explicate individual differences in EFs. The objective of this study was to verify the mediating effect of negative emotions on the relationship between trait impulsivity and EFs among patients with T2DM in China. Methods: A total of 305 patients with T2DM were enrolled consecutively from the endocrinology departments of three tertiary hospitals in China using convenience sampling. The participants completed the Sociodemographic Questionnaire, Mini-Mental State Examination (MMSE), Barratt Impulsiveness Scale-Brief (BIS-Brief), Depression Anxiety and Stress Scales with 21 items (DASS-21), and Behavior Rating Inventory of Executive Function-Adult (BRIEF-A) version. A structural equation modeling was used to verify the mediating effect of negative emotions on the relationship between trait impulsivity and EFs. Results: A total of 32.46% of the participants experienced at least one aspect of daily EF decline. The mediating effect of trait impulsivity on the Behavioral Regulation Index (BRI) of EFs through negative emotions was significant, accounting for 29.57% of the total effect. The mediating effect of trait impulsivity on the Metacognitive Index (MI) of EFs through negative emotions was significant, accounting for 31.67% of the total effect. Conclusions: Trait impulsivity can positively predict EF decline, which can be alleviated by improving the negative emotions of patients with T2DM. Future research exploring interventions to improve the EFs of patients with T2DM should therefore consider their trait impulsivity and negative emotions.

[Change of blood parameters in liver failure patients with severe hepatitis after combined therapy].

OBJECTIVE: To determine the feasibility, security and clinical effects of the combination of plasma exchange(PE) and high-flow hemodiafiltration (HDF) in the treatment of liver failure caused by severe hepatitis. METHODS: Fifty-eight treatments with combined therapy were taken in 26 patients with severe hepatitis. The changes of clinical symptom, liver function, plasma thrombinogen activity and ammonia were observed to determine the clinical effects. The feasibility and security were determined by therapy related adverse reactions and tolerance of the patients. RESULTS: After the treatment, the clinical symptoms such as conscious disturbance, jaundice, inertia, abdominal distention were taken better turn. The serum bilirubin decreased [(190.8+/-93.6) micromol/L] and PTA increased [(19.7+/-8.9)%]. The major adverse reaction was hypersensitive to plasma, no severe hemorrhage, shock and superinfection happened. All patients tolerated the combined therapy. CONCLUSION: The combined therapy is a safe treatment and can significantly improve the symptoms, blood parameters and recently mortality in hepatic failure patients with severe hepatitis. The therapy is worth to spread.