Type 2 diabetes is a hypermetabolic disease characterized with disorders of glucose/lipid metabolism, absolute or relative lack of insulin, and can induce skeletal muscle atrophy. Hyperglycemia, hyperlipidemia, insulin resistance, and abnormal release of inflammatory factors can lead to abnormal signal transduction in skeletal muscle, thus make protein synthesis and degradation imbalance and eventually causing muscle atrophy. Under normal conditions, insulin-like growth factor 1 (IGF-1)/insulin can activate phosphoinositide 3-kinase (PI3K)/protein kinase B (AKT). AKT not only increases protein synthesis through mammalian target protein of rapamycin (mTOR), but also phosphorylates forkhead box O (FoxO) transcription factor and then inhibits the transcription of several ubiquitin ligases (such as MAFbx/atrogin-1 and MuRF1), or autophagy related genes. The weakened IGF-1/PI3K/AKT pathway in type 2 diabetes is an important factor leading to skeletal muscle atrophy. Studies have shown that the commonly used anti-type 2 diabetic drugs have different effects in regulating the synthesis and degradation of skeletal muscle protein. Studies reported that drugs with effect of anti-diabetic muscle atrophy include thiazolidinediones, glucagon-like peptide analogs, glucose-sodium cotransporter 2 inhibitors, etc.; drugs that are still in controversial or even promote skeletal muscle atrophy include metformin, and some sulfonylurea or non-sulfonylurea insulin secretagogues. This article overviewed and analyzed the currently commonly used drugs for type 2 diabetes and summarized the related mechanisms, with the aim to provide references for the rational applications of drugs for type 2 diabetes.

The volatile oils of endophyte isolates R1 (Acremonium sp.) and R2 (Acremonium sp.) from Aqui-laria sinensis were extracted by solvent method. Twenty and sixteen ingredients were identified from the volatile oils of R1 and R2 by GC-MS, respectively. Fatty acids, such as oleic acid, linoleic acid, hexa-decanoic acid etc., were the main components, whereas terpenoids like 1,8-cineole, zingiberene, ar-curcumene were also found in both oils. It’s the first report about the volatile oil constituents of endophyte isolates from A. sinensis.

The hexane extract from marine actinomycetes 124092 showed potent inhibition on B16 cell line by MTT assay. The hexane extract was fractionationed on silica gel column by vacuum liquid chromatography to afford 6 fractions(Fr1~Fr6), and Fr6 showed cytotoxic activity. To determine the bioacitve components of hexane extract, Fr6 was analyzed by GC/MS. The main components were identified as palmitic acid (11.76%), oleic acid (12.16%), linoleic acid (14.77%), and lactobacillic acid (61.31%). It have been reported that palmitic acid, oleic acid, and linoleic acid possess cytotoxic activity on rat ascites tumor cells and linoleic acid have suppressive effect on human lung adenocarcinoma cells.

Seventy-two strains of endophytic fungi were isolated from the healthy bark, branches and leaves of Cephalotaxus hainanensis L.. Sixty-eight of them were morphologically classified into Fungi Imperfecti, thirty-three sporulated were identified to five genera. For those did not sporulate, one was identified to Rhizoctonia sp., the rest were tentatively classified into Mycelia Sterilia. Four were identified to Basidiomycetes. The result indicated the endophytic fungi of C. hainanensis show a degree of tissue specificity. There were significant differences about the quantity, genera and composition between the fungi isolated from bark and those from branches and leaves.

An HPLC-UV method has been developed for the determination of valibose, miglitol, voglibose and acarbose, the four anti-diabetic drugs. The separation was accomplished successfully by using reversed phase chromatography (Prevail carbohydrate column, 250 mm x 4.6 mm, 5 microm) with a gradient acetonitrile-phosphate buffer solution (pH 8.0) at a wavelength of 210 nm. Furthermore, the method of a high-performance liquid chromatography coupled with ESI-MS in positive ionization mode has been established. These two methods were successfully applied to the assay and qualitative detection of four alpha-glucosidase inhibitors in the potential counterfeit anti-diabetic drugs.
1-Deoxynojirimycin ; analogs & derivatives ; analysis ; Acarbose ; analysis ; Chromatography, High Pressure Liquid ; methods ; Chromatography, Reverse-Phase ; Glycoside Hydrolase Inhibitors ; Hypoglycemic Agents ; chemistry ; Inositol ; analogs & derivatives ; analysis ; Spectrometry, Mass, Electrospray Ionization ; methods ; Spectrophotometry, Ultraviolet ; alpha-Glucosidases ; analysis

Objective To observe the clinical efficacy of withdrawal therapy based on regulating nutritive qi and defensive qi(shortened to Tiaohe Yingwei method)in treating sedative-hypnotic dependent insomnia of disharmony between nutritive qi and defensive qi type.Methods Ninety patients with sedative-hypnotic dependent insomnia of disharmony between nutritive qi and defensive qi type were randomly divided into the treatment group and the control group,with 45 patients in each group.The control group was given oral use of Estazolam by 25%of weekly dose-reduction,while the treatment group was treated with Chinese medicinal decoction of Tiaohe Yingwei Zhumian Prescription based on Tiaohe Yingwei method together with Estazolam.The treatment course for the two groups lasted for 4 weeks.The changes of Pittsburgh Sleep Quality Index(PSQI)scores,total TCM syndrome scores,and Drug-withdrawal Syndrome Scale(DWSS)scores in the two groups were observed before and after treatment.After treatment,the efficacy for improving sleep efficiency value(IUSEV)and clinical safety in the two groups were evaluated.Results(1)During the trial,2 cases fell off in the treatment group,and 43 cases included in the statistics;3 cases fell off in the control group,and 42 cases included in the statistics.(2)After 4 weeks of treatment,the total effective rate for improving IUSEV of the treatment group was 88.37%(38/43),and that of the control group was 61.90%(26/42).The intergroup comparison by non-parametric rank-sum test showed that the efficacy for improving IUSEV in the treatment group was significantly superior to that in the control group(P＜0.05).(3)After treatment,obvious reduction was shown in the overall PSQI scores and the scores of the items of sleep quality,time for falling asleep,sleep time,sleep efficiency,sleep disorder and daytime dysfunction in the two groups when compared with those before treatment(P＜0.05).The intergroup comparison showed that except for the items of sleep disorder and daytime dysfunction,the treatment group had stronger effect on decreasing the scores of the remaining items and the overall PSQI scores than the control group(P＜0.05).(4)After treatment,the total scores of TCM syndromes of both groups were significantly decreased compared with those before treatment(P＜0.05),and the decrease of the total scores of TCM syndrome in the treatment group was significantly superior to that in the control group(P＜0.05).(5)After treatment,the total DWSS scores of the two groups were significantly decreased compared with those before treatment(P＜0.05),and the effect on lowering the scores in the treatment group was significantly superior to that in the control group(P＜0.05).(6)During the course of treatment,no significant adverse reactions occurred in the two groups,or no abnormal changes were found in the safety indexes such as routine test of blood,urine and stool,liver and kidney function,and electrocardiogram of the patients.Conclusion Withdrawal therapy based on Tiaohe Yingwei method exerts certain effect for the treatment of sedative-hypnotic dependent insomnia of disharmony between nutritive qi and defensive qi type.The therapy is effective on improving the quality of sleep and reducing the incidence of drug-withdrawal syndrome,and has a high safety.

Adolescent ; Adult ; Aged ; Antithyroid Agents ; therapeutic use ; Female ; Graves Disease ; blood ; drug therapy ; Humans ; Iodides ; urine ; Iodine ; administration & dosage ; Male ; Middle Aged ; Propylthiouracil ; therapeutic use ; Prospective Studies ; Sodium Chloride, Dietary ; administration & dosage ; Thyroid Hormones ; blood

Female ; Hearing Disorders ; etiology ; Hearing Tests ; Humans ; Infant, Newborn ; Male ; Neonatal Screening ; Risk Factors

BACKGROUNDA monoclonal antibody would be an effective tool for the detection of circulating antigens in the serum of patients with schistosomiasis, but the traditional way of producing monoclonal antibodies is not cost-effective. The objective of this study was to find a new method for the large-scale production of monoclonal antibodies against Schistosoma japonicum (Sj).

METHODSA phage display antibody library for Sj was constructed. To obtain a single-chain variable fragment antibody (scFv) against Sj, the library was screened with metabolic antigens from adult Sj worms (Sj-MAg) using enzyme-linked immunosorbent assay. The soluble scFvs selected were used to detect Sj antigens in the serum of acute and chronic schistosomiasis patients.

RESULTSSix positive clones with good reactivity to Sj-MAg were obtained from the phage display antibody library of about 1.07 x 10(6) individual clones. Only two of these six clones bound specifically to Sj-MAg and were chosen for further analysis. Specific soluble anti-Sj-MAg scFvs were produced by inducing the 2 clones with isopropyl-D-thiogalactopyranoside. The characteristics of the scFvs were then determined. The results of Western blot showed that these scFvs could bind to Sj-MAg specifically and had a molecular weight of about 31 kD. When testing serum from schistosomiasis patients with one of the two specific scFvs, its sensitivity was found to be 60% and 37% in acute and chronic patients, respectively, with a specificity of 90%. When the two specific scFvs were combined, their sensitivity was found to be 75% and 57% in acute and chronic patients, respectively, with a specificity of 85%.

CONCLUSIONSThe results indicate that the scFvs are potentially useful for the diagnosis of schistosomiasis. The library construction also provides a useful tool for the further screening of other antibodies for both diagnostic and immunotherapeutic applications and for epitope analysis and vaccine design.

Animals ; Antibodies, Helminth ; immunology ; Antibodies, Monoclonal ; immunology ; Antigens, Helminth ; blood ; Base Sequence ; Immunoglobulin Fragments ; immunology ; Mice ; Mice, Inbred BALB C ; Molecular Sequence Data ; Peptide Library ; Rabbits ; Schistosomiasis japonica ; diagnosis ; Sensitivity and Specificity ; Serologic Tests

OBJECTIVETo establish a community-based management model for heart failure patients under the professional guidance of upper first-class hospital staff.

METHODSTwo hundreds heart failure (New York Heart Function II-IV) patients aged from 35 to 85 in two communities of Chengdu city were divided into two groups by cluster randomization: the management group and the control group. The community hospital doctors were trained for the evaluation and management of heart failure according standardized guidelines by upper first-class hospital doctors, and responsible for the management of patients in the management group. Meanwhile, the management group patients also received self-care education. Patients in control group were treated by community doctors without special training. Data including the community hospital doctors' knowledge rate of heart failure, positive diagnosis rate, and the rate for standardized medication for heart failure; the patients' knowledge rate of heart failure, the rate of drug compliance, the rate of standardized drug taken for heart failure, the rate of self-care in daily-life, the quality of life, the incidence of cardiovascular events, hospitalization time and cost were compared between the two groups.

RESULTSThe community hospital doctors' knowledge rate of heart failure, the related knowledge for prevention and treatment on the causes of heart failure, the positive diagnosis rate, and the rate for standardized medication for heart failure [β receptor blocker 77.3% (17/22); angiotensin-converting enzyme inhibitors 63.6% (14/22)] were significantly higher than doctors in the control group (all P < 0.05). There were 96 in the management group and 97 in the control group. Data were similar between the two groups at baseline. After (18.5 ± 0.5) months, the patient's knowledge rate of heart failure [100% (96/96) vs. 71.1% (69/97)], the rate of drug compliance [78.1% (75/96) vs. 13.4% (13/97)], the rate of standardized drug taken for heart failure[β receptor blocker: 75.0% (72/96) vs. 8.2% (8/97); angiotensin-converting enzyme inhibitors: 60.4% (58/96)vs. 10.3% (10/97)], and the rate of self-care in daily-life [salt and food restriction:88.5% (85/96) vs. 29.9% (23/97); blood pressure monitoring: 83.3% (80/96) vs. 56.7% (55/97); weight monitoring:78.1% (75/96) vs. 13.4% (13/97)] were all significantly higher in the management group than in control group. For patients with New York Heart Function III-IV, the score of the LiHFe questionnaire (43.7 ± 9.2 vs. 49.5 ± 11.3), the incidence of cardiovascular events [63.3% (19/30) vs. 90.3% (28/31)], the days of hospitalization [(8.2 ± 3.2)days vs. (13.9 ± 10.9) days], and the cost for hospitalization [(2873.3 ± 401.6) Yuan vs. (4525.8 ± 6417.8) Yuan] were all significantly lower in the management group (n = 30) than in the control group (n = 31) (all P < 0.05).

CONCLUSIONSThe community-based management model for heart failure patients in the community level is effective to improve the management and outcome in this cohort.

Chronic Disease ; Community Medicine ; organization & administration ; Heart Failure ; prevention & control ; therapy ; Hospitals, General ; Humans ; Treatment Outcome