Type 2 diabetes mellitus(T2DM) is a prevalent metabolic and endocrine disorder. Long-term hyperglycemia can lead to severe chronic complications, imposing substantial economic burdens on both society and patients. Despite the availability of various hypoglycemic agents for clinical use, these agents often fail to meet the therapeutic needs of T2DM and its complications. Consequently, there is an urgent need for novel therapeutic strategies and drugs. Lithocarpus litseifolius(L. litseifolius), commonly referred to as "cordyceps on trees", has a long history of use in traditional medicine and can be applied in tea, sugar, and medicine. Research indicates that L. litseifolius extracts are rich in dihydrochalcones, including trilobatin, phloridzin, and phloretin, which exhibit a range of pharmacological activities, such as anti-inflammatory, antioxidant, hypoglycemic, hypolipidemic, hepatoprotective, and cardioprotective effects. These properties suggest potential applications in the treatment of T2DM and its complications. This review systematically compiled and organized the relevant literature from the past decade on dihydrochalcones(trilobatin, phloridzin, and phloretin) from L. litseifolius extracts. It highlighted recent research progress regarding their role in treating T2DM and its complications through mechanisms such as reducing insulin resistance, regulating glucose transport, improving glucose and lipid metabolism, modulating enzyme activity, regulating gut microbiota, and alleviating inflammation and oxidative damage. The purpose of this review is to provide a reference and basis for future research on the prevention and treatment of T2DM and its complications using dihydrochalcones(trilobatin, phloridzin, and phloretin) from L. litseifolius extracts.
Chalcones/chemistry* ; Diabetes Mellitus, Type 2/metabolism* ; Humans ; Animals ; Elaeocarpaceae/chemistry* ; Drugs, Chinese Herbal/therapeutic use* ; Hypoglycemic Agents/chemistry* ; Plant Extracts/chemistry*

Patients with severe trauma require an extremely timely treatment and transfusion plays an irreplaceable role in the emergency treatment of such patients. An increasing number of evidence-based medicinal evidences and clinical practices suggest that patients with severe traumatic bleeding benefit from early transfusion of low-titer group O whole blood or hemostatic resuscitation with red blood cells, plasma and platelet of a balanced ratio. However, the current domestic mode of blood supply cannot fully meet the requirements of timely and effective blood transfusion for emergency treatment of patients with severe trauma in clinical practice. In order to solve the key problems in blood supply and blood transfusion strategies for emergency treatment of severe trauma, Branch of Clinical Transfusion Medicine of Chinese Medical Association, Group for Trauma Emergency Care and Multiple Injuries of Trauma Branch of Chinese Medical Association, Young Scholar Group of Disaster Medicine Branch of Chinese Medical Association organized domestic experts of blood transfusion medicine and trauma treatment to jointly formulate Chinese expert consensus on blood support mode and blood transfusion strategies for emergency treatment of severe trauma patients ( version 2024). Based on the evidence-based medical evidence and Delphi method of expert consultation and voting, 10 recommendations were put forward from two aspects of blood support mode and transfusion strategies, aiming to provide a reference for transfusion resuscitation in the emergency treatment of severe trauma and further improve the success rate of treatment of patients with severe trauma.

OBJECTIVES: To explore the optimal maintenance dose of caffeine citrate for preterm infants requiring assisted ventilation and caffeine citrate treatment. METHODS: A retrospective analysis was performed on the medical data of 566 preterm infants (gestational age ≤34 weeks) who were treated and required assisted ventilation and caffeine citrate treatment in the neonatal intensive care unit of 30 tertiary hospitals in Jiangsu Province of China between January 1 and December 31, 2019. The 405 preterm infants receiving high-dose (10 mg/kg per day) caffeine citrate after a loading dose of 20 mg/kg within 24 hours after birth were enrolled as the high-dose group. The 161 preterm infants receiving low-dose (5 mg/kg per day) caffeine citrate were enrolled as the low-dose group. RESULTS: Compared with the low-dose group, the high-dose group had significant reductions in the need for high-concentration oxygen during assisted ventilation (P=0.044), the duration of oxygen inhalation after weaning from noninvasive ventilation (P<0.01), total oxygen inhalation time during hospitalization (P<0.01), the proportion of preterm infants requiring noninvasive ventilation again (P<0.01), the rate of use of pulmonary surfactant and budesonide (P<0.05), and the incidence rates of apnea and bronchopulmonary dysplasia (P<0.01), but the high-dose group had a significantly increased incidence rate of feeding intolerance (P=0.032). There were no significant differences between the two groups in the body weight change, the incidence rates of retinopathy of prematurity, intraventricular hemorrhage or necrotizing enterocolitis, the mortality rate, and the duration of caffeine use (P>0.05). CONCLUSIONS This pilot multicenter study shows that the high maintenance dose (10 mg/kg per day) is generally beneficial to preterm infants in China and does not increase the incidence rate of common adverse reactions. For the risk of feeding intolerance, further research is needed to eliminate the interference of confounding factors as far as possible.
Caffeine/therapeutic use* ; Citrates ; Humans ; Infant ; Infant, Newborn ; Infant, Premature ; Respiration, Artificial ; Retrospective Studies

Objective:To summarize the patient profiles and therapeutic efficacies of ABO-incompatible living-related kidney transplantations at 19 domestic transplant centers and provide rationales for clinical application of ABOi-KT.Methods:Clinical cases of ABO-incompatible/compatible kidney transplantation (ABOi-KT/ABOc-KT) from December 2006 to December 2009 were collected. Then, statistical analyses were conducted from the aspects of tissue matching, perioperative managements, complications and survival rates of renal allograft or recipients.Results:Clinical data of 342 ABOi-KT and 779 ABOc-KT indicated that (1) no inter-group differences existed in age, body mass index (BMI), donor-recipient relationship or waiting time of pre-operative dialysis; (2) ABO blood type: blood type O recipients had the longest waiting list and transplantations from blood type A to blood type O accounted for the largest proportion; (3) HLA matching: no statistical significance existed in mismatch rate or positive rate of PRA I/II between two types of surgery; (4) CD20 should be properly used on the basis of different phrases; (5) hemorrhage was a common complication during an early postoperative period and microthrombosis appeared later; (6) no difference existed in postoperative incidence of complications or survival rate of renal allograft and recipients at 1/3/5/10 years between ABOi-KT and ABOc-KT. The acute rejection rate and serum creatinine levels of ABOi-KT recipients were comparable to those of ABOc-KT recipients within 1 year.Conclusions:ABOi-KT is both safe and effective so that it may be applied at all transplant centers as needed.

Objective To observe the clinical efficacy and safety of levocarnitine injection combined with Shengxuening tablets in the treatment of diabetic nephropathy peritoneal dialysis patients with renal anemia.Methods A total of 30 diabetic nephropathy peritoneal dialysis patients with renal anemia were randomly divided into control group and treatment group with 15 cases per group.Control group was given recombinant human erythropoietin injection 100-150 U · kg-1 per time,3 times a week,subcutaneous injection.Treatment group was given levocarnitine 1.0 g per time,3 times a week,intravenous injection + Shengxuening tablets 0.5 g per time,tid,orally,on the basis of control group.Two groups were treated for 3 months.The clinical efficacy,the levels of serum ferritin (SF),transferrin saturation (TSAT),malondialdehyde (MDA),superoxide dismutase (SOD),glutathione peroxidase (GSH-Px),hematokrit (HCT) and hemoglobin (Hb),and adverse drug reactions were compared between two groups.Results After treatment,the total effective rates in treatment and control groups were 93.33％ (14 cases/15 cases) and 60.00％ (9 cases/15 cases) with significant difference (P ＜ 0.05).After treatment,the main indexes in treatment and control groups were compared:SF were (471.26 ± 43.46),(352.45 ± 33.27) ng · mL-1;TSAT were (34.75 ±3.86)％,(27.12 ±2.89)％;MDA were (9.47 ± 1.02),(12.37 ± 1.04) nmol · L-1;SOD were (73.05 ± 5.37),(62.12 ± 6.45) μg · mL-1;GSH-Px were (60.85 ± 5.48),(54.34 ± 5.39) U · L-1;HCT were (32.87 ± 2.74) ％,(25.63 ± 2.46) ％;Hb were (110.42 ± 11.23),(92.14 ± 10.04) g · L-1,all with significant difference(all P ＜ 0.05).The adverse drug reactions in treatment group were abdominal pain,fever,nausea and vomiting,which in control group were fever,nausea and vomiting.The incidences of adverse drug reactions in treatment and control groups were 20.00％ and 13.33％ without significant difference (P ＞ 0.05).Conclusion Levocamitine injection combined with Shengxuening tablets has a definitive clinical efficacy in the treatment of diabetic nephropathy peritoneal dialysis patients with renal anemia,which can significantly improve the levels of serum SF and TSAT and the antioxidant capacity,and reduce oxidative stress,without increasing the incidence of adverse drug reactions.

Objective To investigate the characteristics of traditional Chinese medicine(TCM) constitution of patients with metabolic syndrome(MS), so as to provide individualized therapy for the treatment and rehabilitation of MS. Methods The data of a total of 328 MS patients were collected, covering body height, body mass,body mass index(BMI),waist circumference,blood pressure,blood glucose,blood lipids such as triglyceride(TG),total cholesterol(TC),low-density lipoprotein cholesterol(LDL-C),high-density lipoprotein cholesterol(HDL-C), etc.. TCM constitution types of the MS patients were classified according to Self-rating Scale for Traditional Chinese Medicine Constitution Classification and Discrimination. Results (1)In the 328 cases,the patients with increased TG or having treated with lipid-lowering therapy,the patients complicated with increased blood pressure or having treated with antihypertensive therapy,and the patients with the previous diagnosis of hypertension were dominant,accounted for 41 cases(12.50%).(2)Bias constitution was predominant, showing in 308 cases and accounting for 93.90%. Phlegm-damp constitution was mostly commonly seen in the bias constitution, accounted for 78 cases(23.78%). And then the damp-heat constitution, Qi stagnation constitution, complicated constitution, Qi deficiency constitution, yang deficiency constitution, blood-stasis constitution, yin deficiency constitution and specific constitution came next orderly. Twenty patients had the harmony constitution, accounting for 6.10%. (3)MS patients with phlegm-damp constitution had higher body mass and BMI than the patients with harmony constitution, the difference being significant (P < 0.05). The differences of TG were significant between the phlegm-damp constitution and the specific constitution(P <0.05). Conclusion The included MS patients have typical clinical manifestations, and their TCM constitution types are commonly seen as phlegm-damp constitution,damp-heat constitution,and Qi stagnation constitution. The results of constitution discrimination will supply evidence for the individualized therapy for the treatment and rehabilitation of MS patients.

Abstract?AIM:To investigate the effective treatment methods of corneal injury caused by chestnut thorns and the factors affecting the disease progression.?METHODS: From Jul.2014 to Oct.2015, the clinical data of 15 patients(15 eyes) with corneal injury caused by chestnut thorns in Ophthalmology Inpatient Department of Wuhan Tongji Hospital was retrospective analyzed. The patients without fungal keratitis were treated with the surgery of removing chestnut thorn from cornea and antifungal drugs. For the patients complicated with fungal keratitis, besides surgery of removing chestnut thorn and antifungal drugs, anterior chamber irrigation and corneal stroma injection with fluconazole solution were given to treat the disease.If necessary, amniotic membrane transplantation or keratoplasty was also given to the patients complicated with fungal keratitis. After that, the effectiveness of those methods and the factors affecting progression were analyzed.?RESULTS:For 11 patients without fungal keratitis, the average time between corneal injury and receiving treatment at Tongji Hospital was 1-7 (2.42±2.15) d and for 4 patients complicated with fungal keratitis, the average time was 3-30 (18.25±4.35)d.Among 15 cases, statistics suggested that the average number of chestnut thorn in patients complicated with fungal keratitis was 4.5, and all the chestnut thorn penetrated the cornea into the anterior chamber.The average number of chestnut thorn in patients without fungal keratitis was 3.5, and the proportion of chestnut thorn penetrated the cornea into the anterior chamber was 28.5%.After treatment, all patients had no new fungal keratitis or other complications.Those results indicated that the different treatments for the patients with or without fungal keratitis were all effective.?CONCLUSION:The factors affecting the progression of cornea foreign body injury caused by chestnut thorn are the number of chestnut thorn, whether chestnut thorn penetrate the cornea into the anterior chamber, time since injury, active anti -fungal therapy. If patients complicated with fungal keratitis could be treated with antifungal agents and anterior chamber irrigation or corneal stroma injection using fluconazole solution without delay, the progress of fungal keratitis could be effectively controlled, and favorable conditions for further therapy such as amniotic membrane transplantation or keratoplasty could be provided.

The current situation of the standardization of acupuncture and moxibustion in the Taiwan region is introduced in this paper from the three aspects, named the development state of standard of acupuncture and moxibustion in Taiwan, the implementation of Taiwan district standard and the standardization of acupuncture and moxibustion in Taiwan. At present, the relevant standards of acupuncture and moxibustion in Taiwan just include the standard operation procedure of acupuncture and moxibustion, the reference guideline of the safe operation in the medical service centers of traditional Chinese medicine, and the faculty standard of Chinese medicine hospital, etc. It is concluded that the current situation of the standardization of acupuncture and moxibusiton presented the weak awareness of the standardization of acupuncture and moxibustion in the industry, insufficient enterprise standard, less-quantity of the implemented standards and narrow coverage.
Acupuncture ; legislation & jurisprudence ; manpower ; standards ; Acupuncture Therapy ; standards ; Humans ; Moxibustion ; standards ; Reference Standards ; Taiwan

Objective To explore the application effect of systematic health education in patients with nasopharyngeal carcinoma undergone radiotherapy.Methods Eighty-three patients with nasopharyngeal carcinoma from the Department of Oncology,Affiliated Hospital of Guangdong Medical College from January 2009 to January 2011 were randomly divided into two groups:the control group (41 patients) and the observational group (42 patients).The control group received routine health education,while the observational group received systematic health education with a health education guidebook throughout the treatment period.Questionnaire on the radiotherapy knowledge was used on the 10th day during radiation treatment to evaluate patients' mastering of the knowledge and their satisfaction with medical personnel.Results 98％ patients in the observational group knew the aetiological agent of nasopharyngeal carcinoma,95％ of them knew the importance of radiotherapy,95％ patients knew the secondary reaction of radiotherapy and matters need attention,98％knew the dietary instruction and 98％ knew the discharge guidance,all of which were higher than those in control group (76％,78％,80％,78％,78％,respectively).The differences were statistically significant (x2 =8.742,5.332,4.260,7.499,7.499,respectively; P ＜ 0.05).In observational group,the incidence rate of mucous membrane of mouth reaction was 35.7％,radiodermatitis accounted for 35％,mucous membrane of nasopharynx accounted for 30.9％,jaw joint functional disorder accounted for 38％,all of which were lower than those in the control group (73.1％,70.7％,65.8％,75.6％,respectively).The differences were statistically significant (Hc =10.266,10.173,8.772,10.414,respectively; P ＜ 0.05).The satisfaction with medical personnel in observational group was 95％,was higher than that in the control group (80％),and the difference were statistically significant (x2 =4.26,P ＜ 0.05).Conclusions Systematic health education can increase the nasopharyngeal carcinoma patients' knowledge about radiotherapy,reduce the incidence rates of adverse reactions,improve their satisfaction with the nursing,and promote good communication between patients and nurses.

BACKGROUNDThe mammalian target of rapamycin (mTOR) pathway, a key cellular signaling pathway associated with various cellular functions, has distinct roles in the inflammatory process. In this study, the mTOR inhibitor rapamycin (Rapa) was used to test whether inhibition of mTOR activation attenuates lipopolysaccharide (LPS)-induced acute lung injury (ALI) in a murine model.

METHODSMice pretreated with Rapa or vehicle were given LPS intratracheally. Local cell numbers and inflammatory cytokines present in the bronchoalveolar lavage fluid (BAL), wet-to-dry weight ratio, histopathology of the lungs, and survival were evaluated.

RESULTSThe phosphorylation of S6, a major downstream target of mTOR, had a 3-fold increase in lung tissue after LPS stimulation, but the increase was blocked by Rapa. Rapa reduced the levels of TNF-α (LPS vs. LPS + Rapa, (1672.74 ± 193.73) vs. (539.17 ± 140.48) pg/ml, respectively; P < 0.01) and IL-6 (LPS vs. LPS + Rapa: (7790.88 ± 1170.54) vs. (1968.57 ± 474.62) pg/ml, respectively; P < 0.01) in the BAL fluid. However, Rapa had limited effects on the overall severity of ALI, as determined by the wet-to-dry weight ratio of the lungs, number of neutrophils in the BAL fluid, and changes in histopathology. In addition, Rapa failed to reduce mortality in the LPS-induced ALI model.

CONCLUSIONSWe confirmed that mTOR was activated during LPS-induced ALI and strongly inhibited by Rapa. Although Rapa reduced the levels of the mediators of inflammation, the overall severity and survival of the ALI murine model were unchanged.

Acute Lung Injury ; chemically induced ; drug therapy ; Animals ; Lipopolysaccharides ; Mice ; Mice, Inbred C57BL ; Phosphorylation ; Sirolimus ; pharmacology ; therapeutic use ; TOR Serine-Threonine Kinases ; drug effects