BACKGROUND:Chinese medicineTangbikang can improve nerve conduction velocity in diabetic rats, and has anti-inflammatory and antioxidant effects. Insulin like growth factor-I is a key target in the treatment of diabetic peripheral neuropathy. OBJECTIVE:To observe the effect ofTangbikangon the expression of insulin-like growth factor-I and its receptor protein and mRNA in the sciatic nerve of diabetic rat model. METHODS:The experimental diabetes melitus rat models were induced by feeding high fat forage and injection with streptozotocin. After model establishment, rats were givenTangbikang 4.18, 8.35, 16.7 mg/kg per day. This study set positive control methycobal, model and normal control groups. Intragastric administration was performed for 16 weeks. RESULTS AND CONCLUSION: Compared with the model group, blood glucose levels were similar in the methycobal group, but decreased in the high-doseTangbikang group (P < 0.01). Immunohistochemical staining and real-time fluorescence quantitative PCR detection revealed that body mass, motor nerve conduction velocity, insulin like growth factor-I and its receptor protein and mRNA expressions were increased in the methycobal and high-dose Tangbikang groups (P< 0.05 orP < 0.01). Results indicated that Tangbikang can prevent and treat diabetic peripheral neuropathy by promoting insulin like growth factor-I and its receptor. Cite this article:Mu XH, Sun W, Qin LL, Wu LL, Li WL, Guo X, Zhang L, Liu TH.Effects of Tangbikang on insulin like growth factor-I and its receptor expression in sciatic nerves of diabetic rats. Zhongguo Zuzhi

Diabetic cognitive dysfunction,a glucose metabolic disorder,is caused by metabolic,neurochemistrical,morphological,electrical physiological and behavioral changes featuring the disability of reasoning and learning,memory loss,inattention and hypophrenia.In recent years,more attention has been attached to the field of medicine.In this review,a progress of cognitive disorder was systematically explored over the pathogenesis and treatment of both TCM and western medicine,and investigated multi-targets and multiple methods of Chinese herbal researches at multiple stages for expanding the range of clinical application of TCM,enriching and developing the theory of TCM compatibility,and promoting the advantages of TCM syndrome differentiation.

Objective To understand the current situation of pediatric nurses' perceived stress,coping style and professional burnout,analyze the influence of pediatric nurses' perceived stress and coping styles on professional burnout,and to provide references for reducing pediatric nurses' professional burnout.Methods A questionnaire survey was conducted on 415 pediatric nurses from 9 tertiary level A hospitals in Tianjin using general information questionnaires,Chinese Perceived Stress Scale(CPSS),Simplified Coping Style Questionnaire (SCSQ),and Maslach Burnout Inventory(MBI).Results Pediatric nurses'MBI scores were divided into emotional exhaustion score (25.19 ± 9.98) points,depersonalization total score (10.70 ± 4.65) points,personal achievement sense (29.72 ± 9.62) points,and higher degree of burnout.Correlation analysis showed that the perceived stress was positively correlated with emotional exhaustion and depersonalization dimensions,and negatively correlated with the dimension of personal accomplishment (r =0.398,0.236,-0.388,P ＜0.01);positive coping dimensions were negatively correlated with emotional exhaustion and depersonalization dimensions,and positively correlated with the dimension of personal accomplishment(r =-0.544,-0.205,0.608,P＜0.01);negative coping dimensions and emotional depletion and depersonalization dimensions were positively correlated,and negatively correlated with individual achievement dimension (r =0.559,0.298,-0.652,P ＜0.01).Multiple stepwise regression analysis showed that perceived stress and negative coping style had influence on emotional exhaustion,depersonalization,and individual achievement dimension.Positive coping style had influence on emotional exhaustion and personal achievement dimension (R2=0.105-0.501,P＜0.01).Conclusions Pediatric nurses have higher professional burnout.Perceived stress and coping styles have an impact on professional burnout.Pediatric nurses should take more active measures to relieve perceived stress and reduce burnout.

This study was aimed to observe the effect ofGuava leaf total flavonoids on HIT-T15 pancreaticβcell insulin resistance. Effective part of FSL was prepared. The dosing time, concentration and high glucose concentration of FSL were confirmed by observing HIT-T15 pancreaticβ cell growth curve and the influences of HIT-T15 pancreaticβ cell proliferation by different concentrations of glucose and FSL. Afterwards, the influence of FSL on HIT-T15 pancreaticβ cell insulin secretion, the expression of insulin receptor mRNA and insulin receptor substrate (IRS) 1 protein were measured under the environment of high glucose. The results showed that 50 mmol·L-1 glucose can significantly inhibit the proliferation of HIT-T15 pancreaticβ cell (P < 0.01). The 50μg·mL-1 FSL can significantly promote the proliferation of HIT-T15 pancreaticβ cells (P < 0.01), the insulin secretion (P < 0.05), the expression of insulin receptor mRNA (P < 0.05), and the protein expression of IRS 1 (P <0.01). It was concluded thatGuava leaf total flavonoids can promote the insulin secretion of HIT-T15 pancreaticβ cells under the circumstance of high concentration of glucose which may be related to its effect of increasing expression of insulin receptor mRNA and IRS-1 protein.

This study was aimed to investigate the action mechanism ofHypoxis Hemerocallidea (African Potato, AP) on the AMPK signal pathway of skeletal muscles in diabetic rats. Among 40 male SD rats, 10 rats were used as the normal group, and the other 30 rats were fed with high-fat food for one month, and then injected with STZ for the model establishment. After the successful model establishment, rats were divided into the model group, pioglitazone hydrochloride group and the AP group. Intragastric administration was given for 5 weeks in each group. Then, the skeletal muscle tissues were embedded and sliced for immunohistochemistry test. The protein expression of p-AMPKα, p-AS16 and GLUT4 in skeletal muscles was detected by western blot. The 100 mmol·L-1 glucose was used in the establishment of C2C12 skeletal muscle cells insulin resistance model. AP drug-containing serum was used in the establishment of the treatment group. The control group was the normal cells. Glucose consumption, cell proliferation, SOD content, and MDA content were detected. And the protein expressions of p-AMPKα, p-AS160, GLUT4 were detected with the western blot and RT-PCR. The results showed that compared with the normal group, AP can up-regulate p-AMPKa protein express (P < 0.01), increase skeletal AS160 phosphorylation level (P < 0.01), and up-regulate the GLUT4 level (P < 0.01). Compared with the normal group, the high glucose caused the decrease of C2C12 skeletal muscle cell activity and the decrease of glucose consumption (P < 0.05), decrease of SOD, increase of MDA (P < 0.01), and the decrease of p-AMPKα, p-AS160, GLUT4 protein expression (P < 0.01). After 48 h intervention, the SOD of C2C12 skeletal muscle cells in the AP drug-containing serum group was significantly increased (P < 0.01), the MDA content was decreased (P < 0.05), the AMPKa and AS160 phosphorylation levels were increased (P < 0.01), the GLUT protein expression was increased (P < 0.01). It was concluded that the induced AMPKa and AS160 phosphorylation promoted GLUT 4 expression may be one of the action mechanism of insulin resistance of skeletal muscles in diabetes.

This study was aimed to explore the effect of Tang-Nai-Kang (TNK) on trans-differentiation of renal tubular epithelial cell in KKAy mice in order to discuss the possible mechanism. Fifty 12-week-old male KKAy mice were randomly divided into the model group, valsartan group, TNK high-dose, middle-dose and low-dose group, with 10 rats in each group. Ten C57BL/6J mice were used in the normal group. Rats in the model group and normal group were given 0.9% sodium chloride solution. Rats in other groups were given the corresponding drugs. After 8 weeks of gavage administration, kidneys of all mice were sampled and given Mosson and PAS dyeing. Expression distribution of α-smooth muscle actin (α-SMA) and E-cadherin in kidney tissues were observed under immunohistochemical staining. Expression of transforming growth factor-β1 (TGF-β1) was measured by western blot. The results showed that compared with the normal group, the area of renal fibrosis in the model group was significantly increased (P < 0.01); the expression of α-SMA was stronger; and the expression of E-cadherin was weaker. Compared with the model group, the area of renal fibrosis in the valsartan group, TNK high-dose, middle-dose and low-dose groups were significantly decreased (P< 0.01); the expression of α-SMA was weaker (P< 0.01);and the expression of E-cadherin was obviously increased (P < 0.05). The TGF-β1 expression in the model group was significantly higher than that in the normal group (P < 0.01). Compared with the model group, the TGF-β1 expression in the valsartan group, TNK low-dose, middle-dose and high-dose groups were significantly lowered (P<0.01). And the TGF-β1 expression in the TNK high-dose group was even lower than that in the valsartan group. It was concluded that TNK was able to suppress the epithelial-mesenchymal transition (EMT) of renal tubular epithelial cell, and lessen the renal tubule interstitial fibrosis, in order to protect the kidney.

Objective To evaluate the role of imaging diagnosis in surgical treatment of primary aldosteronism(PA). MethodsFrom Jan 1995 to Dec 2004,245 patients with PA were hospitalized in our hospital.Before the operations,all the patients underwent B-ultrasonography and CT scaning,240 received intravenous pyelography and 75 MRI.The preoperative imaging diagnosis were compared with the findings during the operations and postoperative pathologic results. Results Compared with the findings during the operations,the accuracy rates of localized diagnosis for PA with B-ultrasonography,CT scanning and MRI were 92.7%,98.2% and 90.4%,respectively.Compared with the postoperative pathologic results,the accuracy rates of qualitative diagnosis for aldosterone-producing adenoma(APA) with B-ultrasonography,CT scanning and MRI were 83.0%,90.7% and 72.2%,respectively. Conclusion The comprehensive imaging data are helpful in the localized diagnosis of PA.Correct preoperative qualitative diagnosis of APA is the key step for the surgical treatment for PA.

OBJECTIVETo compare the regulatory effects of electro-acupuncture (EA) at acupoints Zusanli (ST36) and Hegu (LI4) on the visceral hyper-sensitivity in the rat model of irritable bowel syndrome (IBS), and to explore the acting targets and specialty of acupoints.

METHODSExcept 8 rats of the normal control group, the rest 32 rats were prepared to set up the IBS models. IBS animal model was prepared by enema with acetic acid. Model rats were divided into three groups. Except for rats in the model group for control, those in the other two groups were treated 20 min by EA on ST36 (EA-ST36) and LI4 (EA-LI4) respectively for 2 weeks to observe the effect on behavior response of viscera sensitivity. The changes of neuropeptide (NPY), the somatostatin (SS) levels in blood and tissues of brain and intestine were monitored as well.

RESULTSThe volume thresholds for abdomen uplifting and back hunching were obviously increased after EA-ST36 (P<0.05), but showed insignificant change after EA-LI4. NPY contents lowered and SS contents increased in model rats; both EA-ST36 and EA-LI4 could raise the level of thalamic NPY (P<0.01 and P<0.05, respectively), but showed insignificant effects on NPY in colonic tissue. As for SS content, its colonic level could be reduced by EA-S36 and EA-LI4 (P<0.01 and P<0.05, respectively), however, its blood level was affected only by EA-ST36 (P<0.05).

CONCLUSIONSEA-ST36 or EA-LI4 could regulate the NPY in thalamus and SS in colonic tissue, the former could affect blood level of SS as well. It is deemed that NPY and SS may be the key substances for regulating the action of acupuncture in the brain-intestinal axis; their different levels could be regarded as an indicator for the functional difference between the acupoints.

Acupuncture Points ; Animals ; Brain ; metabolism ; Electroacupuncture ; methods ; Irritable Bowel Syndrome ; metabolism ; physiopathology ; Neuropeptide Y ; metabolism ; Rats ; Rats, Wistar ; Somatostatin ; metabolism ; Viscera ; physiopathology

We describe a case of systemic sclerosis (SSc) complicated with portal hypertensive ascites which did not improve with diuretics and ascitic drainage. When corticosteroid added, her ascites diminished dramatically. Though portal hypertension can be imputed to other causes, such as polycystic liver in this case, it can occur in limited SSc with positive anti-centromere antibody and respond to corticosteroid treatment.
Adrenal Cortex Hormones ; therapeutic use ; Aged ; Female ; Humans ; Hypertension, Portal ; diagnostic imaging ; drug therapy ; Radiography ; Scleroderma, Systemic ; diagnostic imaging ; drug therapy

Abstract　　 Demethylating agents (HMAs) hold an important status in therapy for elderly acute myeloid leukemia, who are not eligible for intensive chemotherapy (ICT). Beyond the edge of monotherapy, domestic and foreign scholars have carried out a lot of studies on combination strategies, such as HMAs with low-intensity therapy (G-CSF, low-dose cytarabine and aclarubicin, CAG), with targeted therapy (BCL-2 inhibitor), with immunotherapy (immune checkpoint inhibitors, ICI), and with other epigenetic therapys (isocitrate dehydrogenase or histonedeacetylase inhibitor）. Some of these researches have obtained positive results and discussed the mechanisms of combination strategies besides. In this review, the combination of HMAs with other drugs are summraized briefly.
Aclarubicin ; Aged ; Antineoplastic Combined Chemotherapy Protocols ; Cytarabine ; Granulocyte Colony-Stimulating Factor ; Humans ; Isocitrate Dehydrogenase ; Leukemia, Myeloid, Acute