[Objective] To sum up researches on components, pharmacological actions and toxicity of Polygonum multiflorum Thunb(Heshouwu). [Method] The research reference about Heshouwu in CNKI, VIP and PUBMAD database is col ected and calssified to three aspects on components, pharmacological actions and toxicity.[Result]①On components:Heshouwu contains stilbene, lecithin, anthraquinone, flavonoids, tannin and trace elements. The stilbene and anthraquinone are the mainly active components. Producing area, growth years, harvest time and processing methods are factors affecting the content of the components such as TSG in Heshouwu; Macroporous adsorption resin is the main separation method for preconcentration of TSG and anthraquinone constituents; ② On pharmacological actions and toxicity: Heshouwu has effects of hypolipidemic and liver protection, antioxidative, anti-osteoporosi, hpyerglycemic, antidepressive and antibiosis, the hypolipidemic and liver protection are the main effects which have been studied more. A reversible liver injury which displays as abnormal liver function parameter and bile metabolic disorder would be induced if the Heshouwu is administrated with a large dosage for long term. The possible components which would induce the toxicity in Heshouwu are tannin and anthraquinone, and the anthraquinone is the component with double effects of toxicity and therapy which should be considered in clinical application. [Conclusion]Reducing lipid and protecting liver is the main pharmaceutical function of the herb. As a commonly used Chinese herb for liver protection, the studies on alcoholic hepatic injury protection of Heshouwu may be a point for the researchers to focus on. The comparison studies on hypolipidemic and liver protection between Hesouwu and its processing products, and the correlations between components and pharmacological actions are worth study further.

BACKGROUND:Some studies indicate that PI3K/Akt signaling pathway is associated with the expression of glucose transporter 4 (GLUT4) and the function of cAMP response element binding protein (CREB) in skeletal muscle. However, it is stil unclear whether PI3K/Akt signaling pathway has the effects on CREB and GLUT4 in skeletal muscle of the rats with high-fat diet and treadmil exercise. OBJECTIVE:To investigate whether PI3K/Akt signaling pathway has the effects on CREB and GLUT4 in gastrocnemius muscle of the rats with high-fat diet and treadmil exercise. METHODS:A total of 70 rats were fed with normal diet for 2 weeks, and randomly divided into common feed group (n=20) and high-fat feed group (n=50). Rats in both groups were respectively fed with common feed and high-fat feed for 8 weeks. The rats in the common feed group were equaly assigned to common feed quiet group and common feed exercise group. 20 rats from the high-fat feed group whose body weight was 1.4 times of common rats were randomly and equaly assigned to obese quiet group and obese exercise group. Rats in the quiet groups did not do exercises. Rats in the exercise groups received adaptive sports for 1 week and medium-intensity treadmil exercise for 8 weeks. RESULTS AND CONCLUSION:(1) Impairments of PI3K/Akt signaling pathway appeared in obese rats, however, the quantity of GLUT4 expression did not change obviously in gastrocnemius muscles of obese rats. The reasons for the decrease of the nuclear protein CREB level of gastrocnemius muscles of obese rats might be related to the decrease of pAkt-Ser473 level. (2) The increase of the quantity of GLUT4 expression was accompanied by significantly up-regulated pAkt-Ser473 level by exercise intervention in gastrocnemius muscles of obese rats. Exercise intervention significantly increased the expression of nuclear protein CREB in gastrocnemius muscles of chow-fed rats and obese rats, which was consistent with the changes of pAkt-Ser473. These findings suggest that pAkt-Ser473 can play an important role in the effects of high-fat diet and exercise intervention on GLUT4 and CREB protein expression in gastrocnemius muscles of obese rats.

Objective To investigate the effect of caffeine citrate in the treatment of neonatal apnea and the corresponding intervention measures. Methods A total of 88 children with apnea were enrolled in this study from December 2015 to February 2017, and were randomly divided into control group and study group, 44 cases in each group.The study group on the basis of conventional therapy plus caffeine citrate, the control group on the basis of conventional therapy plus aminophylline group, two newborns with apnea were duration of treatment should be 7 for 7 days, record the treatment effect and the incidence of adverse reactions. Results The total effective rate was 88.64％ in the study group and 72.73％ in the control group (P<0.05). The incidence of adverse reactions was 11.36％ in the study group and 40.91％ in the control group (P<0.05). Conclusion The application of caffeine citrate treatment of apnea with clinical efficacy and safety of the ideal of the newborn, in the course of treatment given targeted clinical nursing intervention is conducive to the protection of newborns with apnea of quality of life and life safety.

Objective To investigate the correlation between clinicopathological features and lymph node metastasis (LNM) in early gastric cancer (EGC).Methods From January 2006 to June 2009,the clinical data of 473 patients with EGC were collected.The data of patients including gender,age,tumor size,tumor number,general classification,differentiation degree,invasion depth,ulcer in tumor,nerve invasion,and lymphatic tumor cell embolus were analyzed.Chi-square test was performed to analyze the correlation between clinicopathological features and LNM in EGC.Logistic regression analysis was used to analyze the independent risk factor of LNM in EGC.Results Among 473 patients with EGC,77 patients had LNM and the metastasis rate was 16.3％.The metastasis rate of the female patients (24.6％,41/167) was higher than that of the male (11.8 ％,36/306).The metastasis rate of the tumors with maximum diameter over 2 cm (22.0％,39/177) was higher than that of the tumors less than 2 cm (12.8％,38/296).The metastasis rate of the elevated lesions (26.1％,6/23) was higher than that of flat and concave lesions (9.0 ％,15/167;19.8％,56/283).The metastasis rate of poorly differentiated tumors was higher than moderate differentiated and high differentiated tumors (12.7 ％,23/181; 7.1％,3/42).The metastasis rate of tumors invading into submucosa (22.9％,41/179) was higher than that of tumors invading into mucosa (12.2％,36/294).The metastasis rate of tumors with lymphatic embolus (40.7％,11/27) was higher than that of tumors without lymphatic embolus (14.8％,66/446) and the differences were statistically significant (x2 =12.960,6.873,10.704,7.382,9.277 and 12.572,all P＜0.05).The results of multifactor analyzed by Logistic regression analysis revealed that female,maximum diameter over 2 cm,poorly differentiated type and invasion to submucosa were the independent risk factors of LNM in EGC (relative risk (RR)=2.53,2.14,1.63 and 2.39,all P＜0.01).Conclusion Female,maximum diameter over 2 cm,poorly differentiated type and invasion to submucosa are the independent risk factors of LNM in EGC.

Objective To explore the role of glucose-regulated protein 78 (GRP78),p38 mitogen-activated protein kinase(p38MAPK) signal pathway in seizure-reduced brain injures and the regulatory effect of Nimodipine on it.Methods Sprague-Dawley(SD) rats were randomly divided into status convulsion group (SC group),Nimodipine group(NM group),and a normal control group(NC group).The expressions of GRP78/Bip and p38MAPK mRNA and protein were detected by reverse transcription(RT)-PCR and immunohistochemistry.The expression of apoptosis cells was observed by TdT-mediated dUTP nick end labeling (TUNEL).Results (1) Immunohistochemistry:at 4 h after induction of status convulsion,the expression of GRP78 protein in the hippocampus CA1 domain began increasing slightly,and reached a maximum at 24 h,and then began decreasing slowly ; at 4 h after induction of status convulsion,the expression of p38MAPK protein in the hippocampus CA1 domain began increasing,and reached a maximum at 24 h,and decreased remarkably at 48 h.(2) RT-PCR:at 4 h after induction of status convulsion,the expression of GRP78 protein in the hippocampus CA1 domain began increasing slightly,and reached a maximum at 24 h,and then began decreasing slowly.The NM group was much higher than the SC group and the NC group(all P ＜ 0.05) ; at 4 h after induction of status convulsion,the expression of p38MAPK protein in the hippocampus CA1 domain began increasing,and reached a maximum at 24 h,and decreased remarkably at 48 h;the NM group was much lower than the SC group,and higher than the NC group (all P ＜ 0.05).(3) TUNEL:at 4 h after induction of status convulsion,the expression of the TUNEL positive cells in the hippocampus CA1 domain began increasing slightly,and reached a maximum at 48 h,and then began decreasing,and there was no difference between SC group and NC group;the NM group was much lower than the SC group(all P ＜ 0.05).Conclusions The correlation of the increased expression of p38MAPK and neuronal apoptosis indicates that GRP78 signal pathway may be mediated to cell apoptosis through p38MAPK.Nimodipine can affect the expression of GRP78/Bip and p38MAPK,and relieve endoplasmic reticulum stress,and lessen the pathologic damage to the hippocampus.

Objective:To investigate the value of serum gastrin-17 (G-17), pepsinogen (PG) I and II, and narrow-band imaging endoscopy in combination for identifying early gastric cancer.Methods:A total of 86 patients with suspected gastric cancer admitted to Zhoushan Hospital from January to September 2021 were included in this study. These patients underwent serum G-17, PG I, and PG II examination and narrow-band imaging endoscopy. PG I/PG II ratio (PGR) was calculated. Taking pathological results as a gold standard, the sensitivity, specificity, and accuracy of serum G-17, PG I, PG II, and narrow-band imaging endoscopy in combination for identifying early gastric cancer were calculated.Results:Serum G-17 level and PGR in the gastric cancer group were (20.14 ± 4.59) pmol/L and (20.21 ± 4.50) μg/L, respectively, which were significantly higher than (17.06 ± 4.05) pmol/L and (17.15 ± 4.08) μg/L in the atrophic gastritis group ( q = 4.12, 3.77, both P < 0.05) and (12.35 ± 3.31) pmol/L and (10.82 ± 5.26) μg/L in the non-atrophic gastritis group ( q = 9.34, 10.39, both P < 0.05). PG I and PGR in the gastric cancer group were (63.90 ± 14.41) μg/L and (3.17 ± 2.08), respectively, which were significantly lower than (79.34 ± 16.25) μg/L and (5.04 ± 3.61) in the atrophic gastritis group ( q = 5.33, 3.44, both P < 0.05) and (106.42 ± 20.18) μg/L and (9.22 ± 4.06) in the non-atrophic gastritis group ( q = 13.16, 9.97, both P < 0.05). Among the 86 patients included, gastric cancer was determined by biopsy in 43 patients. Pathological results showed that 37 patients had early gastric cancer and 6 patients had gastric cancer involving the muscle layer or serous layer. Narrow-band imaging endoscopy results showed that 83.78% (31/37) of patients had early gastric cancer. Serum G-17, PG, and narrow-band imaging endoscopy in combination showed that 91.89% (34/37) of patients had early gastric cancer. Taking pathological results as a gold standard, the sensitivity, specificity, positive predictive value, and negative predictive value of serum G-17 combined with PG for screening early gastric cancer were 72.97% (27/37), 77.55% (38/49), 71.05% (27/38), and 79.17% (38/48), respectively. The sensitivity, specificity, positive predictive value, and negative predictive value of narrow-band imaging endoscopy for screening early gastric cancer were 83.78% (31/37), 85.71% (42/49), 83.10% (31/38), and 87.50% (42/48). The sensitivity and specificity of serum G-17, PG, and narrow-band imaging endoscopy in combination for screening early gastric cancer were 91.89% (34/37) and 91.84% (45/49), respectively. Conclusion:Serum G-17, pepsinogen, and narrow-band imaging endoscopy in combination can improve the diagnostic accuracy of early gastric cancer and is an effective method for screening early gastric cancer.

Aim To investigate the hypoglycemic pathway of terpenes from Cornus officinalis(TCF) from three aspects of insulin dependence, α-glucosidase inhibition, insulin sensitizing.Methods Insulin-deficient diabetes mellitus(DM) model was induced by tail vein injection of streptozotocin(STZ) into SD rats at the dose of 50mg·kg-1 body weight.Rats were randomly divided into seven groups: control group(CON), model group(Model), metformin group(Met) 0.1g·kg-1, shenqi jiangtang granules(Shenqi) group 1.0 g·kg-1, three dose groups of TCF: 0.10, 0.05, 0.025 g·kg-1.Body weight and blood glucose were measured every week.After four weeks, glycosylated hemoglobin (HbA1c), glycosylated serum protein (GSP) were determined.Normal ICR mice were divided into seven groups: CON, Model, Met group 0.2g·kg-1, acarbose group(Acar) 0.1 g·kg-1, Shenqi group 1.5g·kg-1, three dose groups of TCF: 0.20g·kg-1;0.10g·kg-1;0.05 g·kg-1.After 10 days of administration, intraperitoneal injections of glucose and gavage starch tolerance tests were employed.Normal SD rats were divided into six groups: CON, rosiglitazone group 0.02 g·kg-1, glipizide group 0.02 g·kg-1, three dose groups of TCF: 0.10, 0.05, 0.025 g·kg-1.After seven days of administration, intraperitoneal glucose tolerance test(IPGTT) was employed and levels of insulin was determined.Results (1)High dose of TCF significantly reduced the level of HbA1c(P<0.05), GSP(P<0.05) on STZ model rats;(2)TCF significantly improved the glucose tolerance and gavage starch tolerance in ICR mice(P<0.05);(3) High dose of TCF significantly reduced the blood glucose and serum insulin level.Conclusions TCF has obvious effects on inhibiting glucose absorb and promoting the use of glucose.It is able to exert hypoglycemic effect through non-insulin dependent pathway, whereas, whether it has the effects of α-glucosidase inhibition and insulin sensitization should be further validated.

Objective To explore the intervention effect of low-dose vitamin D on glucose metabolism of patients with impaired glucose regulation. Methods A total of196 subjects receiving oral glucose tolerance test were enrolled in this study, including individuals with normal glucose tolerance ( NGT group, n=67) and indi-viduals with impaired glucose regulation (IGR group, n=129). The IGR group was divided into intervention group ( n=64) and non-intervention group ( n=65) according to vitamin D intervention ( for 1 year) performed or not. Clinical data and biochemical parameters were collected. Results The level of serum 25(OH)D3 was significantly lower in the IGR group than that of normal control group ( P<0. 05) . After 1 year of low-dose vita-min D intervention, insulin sensitivity increased and insulin resistance decreased in the intervention group as compared with non-intervention group. Diabetes developed less frequently in the intervention group ( 25 of 64 [ 39. 1％] ) compared with non-intervention group ( 30 of 65 [ 46. 2％] ) . But there was no significant differ-ent in diabetes prevalence between the two groups. Conclusions Vitamin D intervention can improve insulin sensitivity and reduce insulin resistance in patients with impaired glucose regulation. Low dose vitamin D can improve the abnormal glucose metabolism outcome in patients with impaired glucose regulation.

To investigate the hypoglycemic effects of terpenes from Fructus Corni(TFC)on type 2 diabetes mellitus, the db/db diabetic mice were intragastrically administered with 25, 50, 100 mg/kg of TFC for 10 weeks. The fasting blood glucose, insulin(Ins), glycosylated serum protein(GSP), total cholesterol(TC)and triglyceride(TG)levels were determined. At weeks 8 and 10, intraperitoneal injections of glucose and gavage starch tolerance tests were performed, respectively. The db/db mice showed obvious obesity. Each dose of TFC could significantly reduce the body weight of db/db mice(P< 0. 05). After 4 weeks of administration, all doses of TFC significantly reduced the fasting blood glucose of db/db mice(P< 0. 05). The serum TC, TG levels were also significantly decreased in the TFC middle- and high-dose groups(P< 0. 05). In addition, middle- and high-dose of TFC could significantly reduce the level of GSP. Middle- and high-dose of TFC also significantly improve the glucose tolerance and gavage starch tolerance in db/db mice(P< 0. 05). These results suggest that TFC could improve diabetes-related symptoms via regulating glucose and lipids metabolism.

Salvianolic acid injection play an important role in cardiovascular diseases by promoting angiogenesis, improving hemorheology, anti-platelet aggregation, anti-inflammatory, anti-oxidative stress, improving endothelial cell function, and inhibiting atherosclerosis. However, mechanismstudies focusing on molecular level are quite few. Although there are many adverse reactions and many factors causing adverse reactions, the incidence rate of adverse reactions is low with safety.