Objective To evaluate the effects of N-acetycysteine on the expression of caveolin-3 (Cav-3) during myocardial ischemia-reperfusion (I/R) in diabetic rats.Methods Twenty-four pathogenfree healthy adult male Sprague-Dawley rats,weighing 230-270 g,were divided into 3 groups (n =8 each) using a random number table:myocardial I/R group (group I/R),diabetes mellitus plus myocardial I/R group (group D) and N-acetycysteine group (group NAC).Diabetes mellitus was induced by injection of streptozotocin 60 mg/kg via the tail vein and confirmed by blood glucose ≥ 16.7 mmol/L 3 days later.At 1 week after successful establishment of the model,N-acetycysteine 1.5 g · kg-1 · d-1 was injected through a gastric tube into stomach for 4 consecutive weeks in group NAC,and the equal volume of normal saline was given for 4 consecutive weeks in I/R and D groups.Myocardial I/R was then induced by 30 min ligation of the left anterior descending branch of the coronary artery followed by 2 h of reperfusion.At the end of reperfusion,the myocardial infarct size was determined by triphenyl tetrazolium chloride staining,the levels of serum creatine kinase-MB (CK-MB) and 15-F2t-Isoprostane were measured by enzyme-linked immunosorbent assay,and the expression of myocardial Cav-3,Akt,phosphor-Akt (p-Akt),endothelial nitric oxide synthase (eNOS) and phosphor-eNOS (p-eNOS) was detected by Western blot.Results Compared with group I/R,the myocardial infarct size and levels of serum CK-MB and 15-F2t-Isoprostane were significantly increased,and the myocardial Cav-3,p-Akt and p-eNOS expression and NO level were decreased in group D (P＜0.05).Compared with group D,the myocardial infarct size and levels of serum CK-MB and 15-F2t-Isoprostane were significantly decreased,and the myocardial Car-3,p-Akt and p-eNOS expression and NO level were increased in group NAC (P＜0.05).Conclusion N-acetycystein can activate Akt/eNOS/NO signaling pathway through up-regulating myocardial Cav-3 expression,thus reducing myocardial I/R injury in diabetic rats.

Objective:To investigate the metabolic disorder of gut microbiota and short-chain fatty acids (SCFAs) in patients with hypertensive intracerebral hemorrhage and their correlations with the poor outcomes.Methods:Thirty-eight patients with hypertensive intracerebral hemorrhage within 7 d of onset and 32 healthy controls were enrolled prospectively. Fecal samples were collected for 16S rRNA sequencing and SCFAs levels detection. The outcome was evaluated by the modified Rankin Scale at 90 d after the onset, and >2 points were defined as a poor outcome. Multivariate logistic regression model was used to determine the correlations between the gut microbiota and the fecal SCFAs levels and outcomes. Results:The gut microbiota of patients with hypertensive intracerebral hemorrhage was significantly different from that of healthy control group. It is manifested as a decrease in α diversity, a difference in β diversity, an increase in the abundance of potential undesirable bacteria, a decrease in the abundance of common SCFA-producing bacteria and a decrease in the fecal SCFAs levels. In patients with hypertensive intracerebral hemorrhage, compared with the good outcome group, the α diversity of the gut microbiota, the abundance of SCFA-producing bacteria such as Lacetospirillum and Bacteroides, and the total SCFAs, acetic acid and propionic acid levels decreased in the poor outcome group. Multivariate logistic regression analysis showed that after adjusting for potential confounding factors, the decrease of fecal SCFAs levels after log2 conversion was significantly and independently correlated with the poor outcomes. Conclusion:Patients with hypertensive intracerebral hemorrhage have gut microbiota and SCFAs metabolic disorder, the latter is significantly correlated with the poor outcomes. Gut microbiota and SCFAs may become an outcome marker and treatment target for patients with hypertensive intracerebral hemorrhage

ObjectiveTo investigate the status and influencing factors of medication adherence in patients with severe mental disorders in Zhengzhou， so as to provide references for the formulation of prevention and treatment measures for severe mental disorders. MethodsFrom March to June 2021， a stratified multistage cluster sampling method was applied to select 342 patients from the National Information System for Severe Mental Disorders in Zhengzhou. The general demographic data of patients were collected via self-designed questionnaire， and the medication status was investigated， then the influential factors were summarized. The differences in influential factors of medication adherence were compared between the medication adherence group and the medication non-adherence group. Thereafter， Logistic regression analysis was applied to explore the factors influencing medication adherence. ResultsA total of 320 patients were included in the final analysis， altogether 76.56% of patients （n=245） complied with medication. The differences between patients in the medication adherence group and those in the medication non-adherence group were statistically significant in terms of residence， occupation， and outpatient chronic disease reimbursement （χ²=14.015， 7.502， 13.106， P<0.05 or 0.01）. In the questionnaire of influential factors on medication adherence， there were statistically significant differences in the scores of lack of insight， stigma and drug-related factors between the two groups （Z=7.588， 2.379， 2.893， P<0.05 or 0.01）. Outpatient chronic disease reimbursement was a protective factor for medication adherence （OR=2.727， 95% CI： 1.320~5.634， P<0.01）， while rural residence （OR=0.465， 95% CI： 0.221~0.977， P<0.05） and lack of insight （OR=0.398， 95% CI： 0.286~0.553， P<0.01） were risk factors for medication adherence. ConclusionPatients with severe mental disorders in Zhengzhou have a high rate of medication adherence， moreover， the outpatient chronic disease reimbursement， lack of insight and residence may be influencing factors for medication adherence in patients with severe mental disorders.