Diabetic patients are prone to developing Alzheimer’s disease (AD), in which microglia play a critical role. However, the direct effect of high glucose (HG) on microglia and the role of extracellular-signal-regulated kinase 5 (ERK5) signaling in this interaction have not been examined before. Here, these questions were addressed in microglia cultured in HG versus normal glucose (NG) conditions. Initially, HG induced microglial differentiation into the M2a phenotype with concomitant ERK5 activation. However, longer exposure to HG further induced differentiation of microglia into the M2b-like phenotype, followed by the M1-like subtype, concomitant with a gradual loss of ERK5 activation. BIX021895, a specific inhibitor of ERK5 activation, prevented M2a- differentiation of microglia, but induced earlier M2b-like polarization followed by M1-like polarization. Transfection of microglia with a sustained activated form of MEK5 (MEK5DD) prolonged the duration of the M2a phenotype, and prevented later differentiation into the M2b/M1 subtype. Conditioned media from the M2a-polarized microglia reduced neuronal cell apoptosis in hypoxic condition, while media from M2b-like or M1-like microglia enhanced apoptosis. Together, our data suggest that chronic hyperglycemia may induce a gradual alteration of microglia polarization into an increasingly proinflammatory subtype, which could be suppressed by sustained activation of ERK5 signaling.

Aim: Foreign body (FB) injuries represent a severe public health problem during childhood. The aim of this study was to report our experience with patients with injuries due to FB ingestion and insertion who were treated surgically at our institution. Methods: A total of 78 paediatric patients who were hospitalised for FB injuries were retrospectively reviewed. Results: The series was composed of 27 males and 51 females, with a median age of 3.6 years. The cases included 35 cases of FB ingestion and 43 cases of FB insertion, including 40 cases with a vaginal insertion, 2 cases with a rectal insertion and 1 case with a urethra insertion. Intestinal perforation (n = 26) was a more common complication than intestinal obstruction (n = 9) in patients who had ingested a FB. The main clinical symptom was persistent vaginal discharge, followed by vaginal bleeding for patients with a vaginal FB insertion. Exploratory laparotomy was performed on 36 patients, while a laparoscopic approach was employed in 1 patient. Forty patients underwent hysteroscopy and one patient underwent cystotomy to remove the FB. All FBs were successfully removed. Of the 78 FBs recovered, 26 were food objects, while non-food objects were found in 52 patients. All patients recovered well, except one patient with an intestinal obstruction from adhesions that occurred approximately 1 month after discharge. Conclusions: Early recognition of FB injuries and appropriate management can significantly reduce complications. Surgical removal of a FB can be safe and effective, and relatively better outcomes can be achieved.What is already known on this topic 1 Foreign body (FB) injuries represent a severe public health problem during childhood. 2 Some FB injuries have an unclear history and non-specific clinical presentation, resulting in a delay in diagnosis.

Necrotizing enterocolitis (NEC) is one of the most common devastating gastrointestinal emergencies and affect premature intestine infants. However, there is still a lack of indications for timely surgery, which cause complications and miss the optimal surgical timing. We collected plasma fibrinogen from 168 postoperative NEC patients using the pt-der method and the patients were divided into four groups, including 68 Infant patients with intestinal perforation and necrosis (IPN), 61 Infant patients of intestinal necrosis without perforation (INWP), 15 Infant patients of intestinal perforation without necrosis (IPWN), and 24 infants without necrosis and perforation (WNP). Compared to no intestinal necrosis patients, there was a significant increase of the fibrinogen level in NEC children with intestinal necrosis. This study may provide important information for early diagnosis of infant patients with intestinal necrosis for immediate decision of surgery.