Diabetic peripheral neuropathy (DPN) is a common complication of diabetic mellitus. The treatment is so difficult that doctors have not found reliable methods to cure this disease. The research progress both in TCM and western medicine of this disease were reviewed in terms of aspects of etiology, pathogenesis and differential treatments.

To investigate the protective effects of Tangxinping Capsule, a compound traditional Chinese herbal medicine, on diabetic cardiomyopathy in rats.

Objective To examine the sensitivity,specificity and accuracy of dobutamine stress quantitative tissue doppler imaging(DSE+TDI） for detecting CAD in the elderly patients.Methods Totally 98 patients underwent DSE+ TDI,and completed coronary angiography (CAG) in two weeks.Peak tissue velocity (Vpeak),peak tissue tracking (Dpeak),peak strain rating (SRpeak),peak strain (Speak)in different dobutamine stress stations were measured and analyzed during systolic period in mid-segments of left ventricle walls.Results In comparison of CAG,the sensitivity,specificity and accuracy of DSE+ TDI for detection CAD in the elderly patients showed that Vpeaks were 82.3％,61.7％,72.4％,Dpeak 82.4％,59.5％,77.4％,SRpeak 71.7％,82.2％,78％ and Speak 78.6％,72.3％,74.7％,respectively.All the adverse effects during tests were mild and transient.Conclusions Quantitative dobutamine stress tissue doppler imaging is a safe,effective and non-invasive technique and has higher sensitivity and specificity for detecting CAD in the elderly patients.

Objective:To compare the accuracy and timeliness of 3-lead electrocardiography (ECG) and pulse oximetry (POX) in neonatal heart rate (HR) monitoring after birth.Methods:This prospective study recruited 42 high-risk newborns with gestational age ≥37 weeks and birth weight >1 500 g who were born through cesarean section without resuscitation requirement in Xi'an People's Hospital (Xi'an Fourth Hospital) from October 2019 to August 2020. 3-lead ECG electrodes and POX sensors were attached to the neonates immediately after drying to continuously monitor the HR within 10 min after birth. All procedure was recorded by video camera, and data were independently analyzed by a clinician after the procedure was completed. Differences in time required to connect the devices, time to obtain a reliable HR and the interval between them, the time needed for obtaining a reliable HR after birth, the proportion of neonates with reliable HR obtained within 5 min after birth and the consistency in the reliable HR readings between the two devices were compared using Wilcoxon signed-rank test, McNemar test, Spearman's correlation coefficient, intraclass correlation coefficient or Bland-Altman bias analysis.Results:The median time required to connect POX and 3-lead ECG and to acquire a reliable HR were 13.0 s (10.0-17.0 s) vs 23.0 s (18.0-28.3 s) ( Z=-5.050, P<0.001), and 79.5 s (56.2-128.0 s) vs 11.0 s (10.0-13.3 s) ( Z=-5.646, P<0.001), respectively. The total time from the beginning of connecting the devices and birth to acquiring a reliable HR were both longer for POX than those for 3-lead ECG [92.0 s (71.3-139.0 s) vs 35.0 s (30.0-39.5 s), Z=-5.579, P<0.001; 110.5 s (85.8-153.5 s) vs 52.0 s (45.0-66.3 s), Z=-5.579, P<0.001]. Reliable HRs were obtained in 69.1% (29/42) and 2.4% (1/42) of the infants by 3-lead ECG and POX within 1 min after birth, respectively. The percentage of infants for obtaining a reliable HR detected by 3-lead ECG within 5 min after birth were more than those by POX, but with statistically significant differences only at the first 60 s, 90 s, 120 s and 150 s (all P<0.001). The median HRs obtained by 3-lead ECG and POX within 10 min after birth were 161 beats/min (147-175 beats/min) and 160 beats/min (146-176 beats/min), respectively ( r=0.966, P<0.001). The mean difference of HR detected by the two devices was 0.56 beats/min (95% CI:-4.3 to 5.4 beats/min). The intraclass correlation coefficient was 0.961, showing good internal consistency. Conclusions:Neonatal HR can be assessed accurately by 3-lead ECG within 1 min after birth, which is far earlier than that by POX. Therefore, 3-lead ECG can be an option for continuously HR monitor in neonatal resuscitation.

0.05).Conclusion The local relapse rate and the survival rate within 3 years has no significant difference between patients with lower rectal cancer of Duck stage A after sphincter-preserving surgery and Miles surgery.

Objective To investigate the effects of Chinese herb formula Tangtongfang by bathing the affected feet of patients with diabetic peripheral neuropathy (DPN) in the pattern of Qi deficiency and blood stasis. Methods A parallel, randomized, controlled clinical research was performed. 70 diabetics in the inpatient and outpatient divisions of the Department of Endocrinology, Guanganmen Hospital, from January 2005 to October 2007 were investigated. They were divided randomly into two groups, treatment group and control group, 35 cases in each group. Before study, there were no statistic differences between the two groups, including gender, age, course of diabetes mellitus(DM), course of DPN, blood glucose (including fasting blood glucose and postprandial blood glucose), traditional Chinese medicine(TCM) symptom scores and nerve conduction velocity (NCV). The treatment group were treated with Tangtongfang bathing and the control group were treated with warm water bathing. Each group was also administered Vitamin B1 20 mg, t.i.d and Vitamin B6 20 mg, t.i.d respectively. All patients were keeping their routine treatment and diabetic care to control their blood glucose, such as diets, practices and drugs. Clinical symptoms and electrophysiological tests in diabetic peripheral neuropathy syndrome were investigated. The period of treatment was 8 weeks.Results After study, 9 cases retreated from this clinical trial totally, 4 cases in the treatment group whereas 5 in the control group. Among 4 common single symptoms, coolness feeling of the feet of diabetic patients was significantly improved (P<0.05) after bathed with Tangtongfang. The change of TCM symptom scores and tibialis NCV was significantly improved (P＜0.001, P<0.05) in the treatment group. The improvement ratio was 45.2% and 61.3% in the treatment group, while was 10% and 3.3% in the control group. In each group there was no statistical difference between pre-and post-study with blood test, urine test, blood ALT, blood BUN and Cr, ECG examination (P>0.05). No adverse event was observed in each group.Conclusion Tangtongfang bathing improved several symptoms of patients suffering from DPN, especially the symptom of coolness feeling of the patients' feet. No adverse event was observed. This result showed that Tangtongfang bathing was worthy of using as a safe agent in treatment of DPN.

In order to reveal feasibility of different concentrations of Ca2+ and SA on Platycodon grandiflorum under high temperature stress, the effects of Ca2+ on physiological index and related photosynthetic parameters were studied. Pot cultured P. grandiflorum leaves under the same outdoor conditions were sprayed with CaCl2 and SA separately, and then placed in the high incubator [35 degrees C/25 degrees C (day/night), light intensity 3 600 lx], and sprayed with distilled water at 25 degrees C and under high temperature stress were set as the control. The related photosynthesis, relative conductivity, contents of proline, malondialdehyde, soluble protein, activities of SOD and CAT, ASA and GSH content were measured. The results show that the 6 mmol x L(-1) CaCl2 and 1.5 mmol x L(-1) SA enhanced the activities of SOD and CAT, the contents of proline and soluble protein, and effectively reduced the damage of heat stress on cell membrance. At the same time, the exogenous Ca2+ and SA increased the contents of chlorophyll and carotenoid, the efficiency of leaf photosynthesis and ASA and GSH content, and thus effectively resisted the oxidative stress caused by high temperatures, but with the increasing concentration of spraying, P. grandiflorum decreased the ability to resist high temperature stress. In conclusion, the foliage spraying CaCl2 and SA could reduce the damage of high temperature stress on P. grandiflorum leaves.
Calcium ; metabolism ; Hot Temperature ; Malondialdehyde ; metabolism ; Oxidative Stress ; Photosynthesis ; Plant Leaves ; metabolism ; Platycodon ; metabolism ; Salicylic Acid ; metabolism ; Stress, Physiological

AIM:Heart failure is characterized by immune activation leading to production and release of proinflammatory cytokines .Inter-leukin 17A (IL-17A) is a proinflammatory cytokine and multiple lines of evidence from animal and human studies suggest crucial roles of IL-17A in heart failure.Therefore, we investigated whether common polymorphisms of genes IL17A and IL17RA (coding interleukin 17 receptor A) gene contribute to genetic predisposition to heart failure and adverse clinical outcomes associated with it .METHODS AND RESULTS:A total of 1713 adults patients with congestive heart failure and 1713 age-and sex-matched controls were genotyped for promoter SNPs, rs2275913 and rs8193037 in IL17A and rs4819554 in IL17RA, to assess the relationship between individual SNPs and the risk of congestive heart failure .Results showed that rs8193037 in IL17A was associated with the risk of congestive heart failure (P<0.01) after adjustment for multiple cardiovascular risk factors including age , sex, smoking status, diabetes, hypertension and dyslipidemia.This association was evident in both ischemic and non-ischemic heart failure (P<0.05).Furthermore, prospective fol-low-up of 12.7 months for the occurrence of adverse clinical outcomes showed that rs 4819554 in IL17RA was significantly associated with cardiovascular mortality (P<0.05) after adjustments for multiple cardiovascular risk factors and New York Heart Association functional class.CONCLUSION:This study demonstrated associations of rs8193037 in the promoter of IL17A with the risk of conges-tive heart failure, and of rs4819554 in the promoter of IL17RA with the risk of cardiovascular mortality in patients with congestive heart failure.These data lend further support to the notion that immune activation and genetic polymorphisms contribute to heart failure path -ogenesis and progression .

Objective To evaluate the necessity of indwelling gastrointestinal decompression after gastrectomy. Methods Eight publications on the necessity of gastrointestinal decompression after gastrecomy were colleted, data on recovery time of gastrointestinal function and hospital stay, complications,and motality were Meta-analyzed using fixed effect model and random effect model. Results Eight randomized trails including 975 patients were qualified and included in this study. The differences in time to oral intake ( WMD =0. 61, 95% CI: 0. 17 - 1.05, P ＜ 0. 05 ) and hospital stay ( WMD = 1.20, 95% CI:0. 05 -2. 36, P ＜ 0. 05 ) between the decompression group and non-decompression group were statistically significant, but the difference in time to flatus (WMD = 0. 31,95% CI: -0. 07- 0. 69, P ＞ 0. 05 ) was not significant. There were no significant differences in complications such as nausea and vomiting ( OR = 1.43,95% CI: 0. 61 - 3.31, P ＞ 0. 05 ), pulmonary infection and atelectasis ( OR = 1.43, 95 % CI: 0. 82 - 2. 49,P＞0.05), anastomotic leakage (OR = 1.17, 95%CI: 0.54-2.49, P ＞0.05), abdominal abscess ( OR = 1.08, 95% CI: 0. 50 - 2. 34, P ＞ 0. 05 ), wound dehiscence ( OR = 1.47, 95% CI: 0. 43 - 4. 95,P ＞ 0. 05 ) between the two groups, except for fever ( OR = 1.76, 95% CI: 1.11 - 2. 78, P ＜ 0. 05 ), which was found more frequent in decompression group than in non-decompression group. Conclusions Routine gastrointestinal decompression after gastrectomy was not conductive to the recovery of gastrointestinal function, and could not reduce the incidence of postoperative complications. Postoperative GI decompression increased fever incidence rate and prolonged hospital stay.

Objective To develop a model of type 2 diabetes with early renal injury on spontaneously hypertensive rats (SHR). Methods The 6-week old SHR were fed with the diets enriched with sucrose (20%, W/W), lard (10%, W/W), cholesterol (2.5%, W/W) and chleolate (1%, W/W) to induce insulin resistance. Hyperglycemia was developed by intraperitoneal injection of streptozotocin (STZ, 35 mg/kg). Wistar-Kyoto rats (WKY) were used as normal controls. Rats with plasma glucose (PGL) ≥ 16.7 mmol/L were diagnosed as diabetes. Eight weeks after the induction of diabetes, plasma triglyceride (TG), cholesterol (CHO), glucose, systolic pressure(SP), 24-h urine protein excretion (Upro) were examined in all the rats, and the homeostasis model assessment of insulin resistance (HOMA-IR) was analyzed. Renal pathological changes were studied by immunohistochemical staining and electron microscope. Results After 2 weeks on the high sucrose and fat diets, the model rats exhibited significant increase in basal PGL, TG and CHO levels as compared to control rats (P<0.05, respectively). The insulin resistance was developed in model rats demonstrated by the higher HOMA-IR (5.03±0.38 vs 2.61±0.34, P<0.05). At the end of the experiment, model rats were associated with hypertension. Upro level was significantly increased in model rats compared with that in controls [(57.58±16.54) mg/24 h vs (5.35±1.90) mg/24 h, P<0.01]. The kidney hypertrophy index (KWI) was significantly increased in the model rats compared to controls (P <0.05). Moreover, the diabetic model rats showed glomerular hypertrophy, foot process effacement, micro villous transformation, glomerular basement membrane (GBM) thickening. Conclusion A rat model is successfully established, which presents typical features of human type 2 diabetes and can be served as an ideal model to study the diabetic nephropathy.