Objective:To explore the effect of moderate-intensity swimming exercise on liver glucose and lipid metabolism disorder in type 2 diabetic rats and possible mechanism. Method:Eight-week-old male SD rats were randomly selected as a blank control group(negative control group,NC group)and fed with normal food,while the rest were fed with high-fat and high-sugar adaptively for one week.Streptozotocin(Streptozotocin,STZ,30mg/kg)was injected intraperitoneally to produce the T2DM rat model.Sixteen rats were randomly selected as type 2 diabetes model group(diabetic model group,DC group)and type 2 diabetes aerobic exercise group(diabetic swimming group,DS group),with eight rats in each group.Aerobic exercise was intervened by non-weight-bearing swimming.After 3 days of adaptive train-ing,the exercise time was 15min/day,and gradually increased to 60min/day,5 days/week,for a total of 8 weeks of training.During the experiment,the body weight,blood sugar,and liver index of rats in each group were detected;ELISA was used to detect the serum insulin(insulin),tumor necrosis factor-α(TNF-α),interleukin-6(IL-6),interleukin-1β(IL-1β),serum total cholesterol(TC),triglyceride(TG),low-density lipo-protein cholesterol(LDL-C),HDL Lipoprotein cholesterol(HDL-C)and serum alanine aminotransferase(ALT)and aspartate aminotransferase(AST)levels;the expression changes of peroxisome proliferator-activat-ed receptor γ(PPARγ),nuclear factor-κB(NF-κB)and adiponectin(ADPN)in liver tissue were detected. Result:After 8 weeks of aerobic exercise intervention,compared with the DC group,the rats in the DS group had significantly increased body weight,signifiicantly decreased blood sugar(P＜0.01),and significantly increased serum insulin and HDL-C levels(P＜0.01).The serum TNF-α,IL-6,IL-1β and TC,TG,LDL-C,ALT,AST levels were significantly decreased(P＜0.05 or P＜0.01).The liver index and oil red O staining pos-itive area decreased significantly(P＜0.01).The positive area of liver glycogen staining increased significantly(P＜0.01),with neatly arranged liver tissue cells and alleviated fat vacuoles,lipid droplets and inflammatory cell infiltration.The protein and mRNA expression levels of PPARγ,GLUT4 and ADPN in the liver were sig-nificantly increased(P＜0.05 or P＜0.01),and the levels of PPARγ and ADPN immunofluorescence positive cells were significantly increased(P＜0.01).The levels of mRNA and immunofluorescence positive cells of NF-κB were significantly decreased(P＜0.05 or P＜0.01).The mRNA level of ADIPOR2 was also significantly in-creased(P＜0.05),and the protein levels of NF-κB and IL-6 were significantly decreased(P＜0.01). Conclusion:8-week moderate-intensity swimming exercise can improve the disturbance of glucose and lipid me-tabolism by regulating the inflammatory response in the liver of T2DM rats,and the mechanism may be relat-ed to the PPARγ/NF-κB/ADPN pathway.

Objective:To systematically evaluate of the efficacy and safety of Tip-flexible suction ureteral access sheath and ordinary ureteral access sheath combined with flexible ureteroscopy to treat upper urinary tract stones.Methods:The databases CNKI, Wanfang, VIP, CBM, PubMed, Cochrane, Embase, Web of Science, MEDLINE and Google Scholar were searched from their inception to May 31, 2024 for related studies about Tip-flexible suction ureteral access sheath compared with ordinary ureteral sheath combined with flexible ureteroscopy to treat upper urinary tract stones. Literature screening and data extraction were performed independently by two researchers, the quality assessment of randomized controlled trials was assessed using the Cochrane risk of bias assessment scale, the Newcastle-Ottawa risk of bias assessment scale was used to assess the quality of retrospective studies, and finally Meta-analysis of data was conducted using Review Manager 5.3 software.Results:A total of 14 literatures involving 1947 patients with upper urinary tract stones (1017 in the Tip-flexible suction sheath group and 930 in the ordinary sheath group) were included. Meta-analysis showed that the stone free rate of the Tip-flexible suction sheath group was higher than that of the ordinary sheath group (immediate postoperative stone free rate 80.7% vs. 60.0%, OR = 3.04, 95% CI 2.30-4.03, P<0.05; 1 month after surgery stone free rate 94.4% vs. 79.4%, OR=4.39, 95% CI 3.12-6.19, P<0.05). The total complication rate of the Tip-flexible suction sheath group was lower than that of the ordinary sheath group (5.4% vs. 17.3%, OR=0.29, 95% CI 0.21~0.40, P<0.05). There was no significant difference in the decrease of hemoglobin level between the Tip-flexible suction sheath group and the ordinary sheath group at 1 day after surgery( MD=-0.30, 95% CI -2.61-2.02, P>0.05). The postoperative fever in the Tip-flexible suction sheath group was less than that in the ordinary sheath group (1.9% vs. 7.5%, OR=0.28, 95% CI 0.15-0.54, P<0.05). There was no significant difference in operation time between the Tip-flexible suction sheath group and the ordinary sheath group( MD=-4.93, 95% CI -11.48-1.62, P>0.05). The postoperative hospital stay in the Tip-flexible suction sheath group was shorter than that in the ordinary sheath group ( MD=-0.20, 95% CI -0.25--0.16, P <0.05). Conclusions:Compared with ordinary ureteral access sheath combined with flexible ureteroscope to treat upper urinary tract stones, Tip-flexible suction ureteral access sheath has a higher stone free rate, less postoperative fever, low total complication rate, shorter postoperative hospital stay, which is conducive to postoperative recovery and is safer and more effective.

Objective:To systematically evaluate of the efficacy and safety of Tip-flexible suction ureteral access sheath and ordinary ureteral access sheath combined with flexible ureteroscopy to treat upper urinary tract stones.Methods:The databases CNKI, Wanfang, VIP, CBM, PubMed, Cochrane, Embase, Web of Science, MEDLINE and Google Scholar were searched from their inception to May 31, 2024 for related studies about Tip-flexible suction ureteral access sheath compared with ordinary ureteral sheath combined with flexible ureteroscopy to treat upper urinary tract stones. Literature screening and data extraction were performed independently by two researchers, the quality assessment of randomized controlled trials was assessed using the Cochrane risk of bias assessment scale, the Newcastle-Ottawa risk of bias assessment scale was used to assess the quality of retrospective studies, and finally Meta-analysis of data was conducted using Review Manager 5.3 software.Results:A total of 14 literatures involving 1947 patients with upper urinary tract stones (1017 in the Tip-flexible suction sheath group and 930 in the ordinary sheath group) were included. Meta-analysis showed that the stone free rate of the Tip-flexible suction sheath group was higher than that of the ordinary sheath group (immediate postoperative stone free rate 80.7% vs. 60.0%, OR = 3.04, 95% CI 2.30-4.03, P<0.05; 1 month after surgery stone free rate 94.4% vs. 79.4%, OR=4.39, 95% CI 3.12-6.19, P<0.05). The total complication rate of the Tip-flexible suction sheath group was lower than that of the ordinary sheath group (5.4% vs. 17.3%, OR=0.29, 95% CI 0.21~0.40, P<0.05). There was no significant difference in the decrease of hemoglobin level between the Tip-flexible suction sheath group and the ordinary sheath group at 1 day after surgery( MD=-0.30, 95% CI -2.61-2.02, P>0.05). The postoperative fever in the Tip-flexible suction sheath group was less than that in the ordinary sheath group (1.9% vs. 7.5%, OR=0.28, 95% CI 0.15-0.54, P<0.05). There was no significant difference in operation time between the Tip-flexible suction sheath group and the ordinary sheath group( MD=-4.93, 95% CI -11.48-1.62, P>0.05). The postoperative hospital stay in the Tip-flexible suction sheath group was shorter than that in the ordinary sheath group ( MD=-0.20, 95% CI -0.25--0.16, P <0.05). Conclusions:Compared with ordinary ureteral access sheath combined with flexible ureteroscope to treat upper urinary tract stones, Tip-flexible suction ureteral access sheath has a higher stone free rate, less postoperative fever, low total complication rate, shorter postoperative hospital stay, which is conducive to postoperative recovery and is safer and more effective.

Objeetive To investigate the clinical efficacy of treating stomach cance belonging to spleen and stomach deficient cold type with self-designed formula and chemotherapy.Methods 100 patients of stomach cancer belonging to stomach and spleen deficient cold were randomly grouped into a control group and a treatment group,with 50 cases in each group.The control group was only treated with chemotherapy,and the treatment group was additionally treated with self-designed Chinese formula on the basis of the control group.After 3 months' treatment,the curative effect,the improvement of life quality,the changes of body weight,the improvement of peripheral blood and immune function,and the occurrence of adverse reaction were observed.The survival rate of patients after 1,3 and 5 years' treatment was investigated.Results ① Short term curative effect:the total effectiveness of the control group and the treatment group was 60.0％ (30/50) and 30.0％ (15/50) respectively,with the treatment group being better than the control group(Z=-2.100,P＜0.05);② life quality:theimprovement rate of life quality in the treatment group and the control group was 64.0％ (32/50) and 20.0％ (10/50) respectively,with the treatment group being better than the control group (Z=-3.259,P＜0.05); ③ body weight:the improvement rate of body weight in the treatment group and the control group was 24.0％ and 16.0％ respectively,and there was no significant difference (Z=-1.815,P＞0.05) ; ④ peripheral blood:the peripheral blood abnormality rates of treatment group was obviously lower than the control group (Z=-4.286,P＜0.05) ;⑤ immune function changes:CD4+、CD8+、and the activity of NK cell of two groups after the treatment [the treatment group was (40.8 ± 4.1)％,(26.1-3.2)％,(83.57-2.52)％ respectively; the control group was (31.7±2.9)％、(33.8±3.0)％、(92.88±3.83)％ respectively] wasobviously improved compared with the same group before the treatment [the treatment group was (34.2±3.5)％,(31.0±2.0)％,(85.01±2.92)％ respectively; the control group was (34.0±3.2)％,(30.9±2.2)％,(85.02± 3.48) ％ respectively].The immune indexes (CD4+、CD8++、CD4+/CDg+and the activity of NK cell)in the treatment group presented significant difference (P＜0.01) than the control group after the treatment.⑥adverse reaction:compared with the control group,the occurrence rate of adverse reaction of the treatment group was obviously lower than the control group,and there was significant difference (Z=-5.297,P＜0.05).⑦survival rate:the survival rate of patients after 1,3 and 5 years' treatment in the treatment group was better than the control group,and there was significant difference (x2=5.263,12.96,7.895,P＜0.05).Conclusion The combination of self-designed Chinese formula and chemotherapy could effectively relieve the clinical symptoms,improve the immunity,reduce the occurrence of adverse reaction,and improve the life quality of patients with stomach cancer belonging to stomach and spleen deficient cold type.