BACKGROUND:Skeletal muscle insulin resistance is the key pathological link of type 2 diabetes.The traditional Chinese medicine compound Roujishuncuiyin can effectively improve skeletal muscle insulin resistance,but its mechanism has not been clarified.OBJECTIVE:To explore the mechanism of Roujishuncuiyin on skeletal muscle insulin resistance in type 2 diabetes mice.METHODS:Forty db/db mice with type 2 diabetes mellitus were randomized into a model group,a low-dose Roujishuncuiyin group,a high-dose Roujishuncuiyin group,and a positive drug group,with 10 mice in each group.The latter three administration groups were given 157.5 mg/g and 630 mg/g Roujishuncuiyin and 200 mg/g metformin hydrochloride aqueous solution by gavage once a day,respectively.In addition,10 db/dm mice were selected as the blank control group.Mice in the model and blank control groups were given the same dose of 0.9％NaCl solution by gavage.After 12 weeks of intervention,fasting blood glucose was measured in each group of mice,and oral glucose tolerance test was performed to calculate the area under the blood glucose curve.ELISA was used to detect serum insulin level and calculate the resistance index.Mitochondrial structure of skeletal muscle tissue was observed under transmission electron microscopy.Western blot was used to detect the expression levels and phosphorylation levels of protein kinase B(AKT)and glycogen synthase kinase 3β(GSK-3β)proteins in skeletal muscle.RESULTS AND CONCLUSION:(1)Compared with the blank control group,fasting blood glucose,fasting insulin and insulin resistance index were significantly higher in the model group(P＜0.05),the area under the curve of the oral glucose tolerance test was significantly increased(P＜0.05),the expression of p-AKT and p-GSK3β proteins in tibialis anterior muscle was significantly decreased(P＜0.05),and there was a large amount of mitochondrial damage in tibialis anterior muscle and a large number of lipid droplets in the interstitium.(2)Compared with the model group,fasting blood glucose,fasting insulin,and insulin resistance index were significantly reduced in the low-and high-dose Roujishuncuiyin groups and the positive control group(P＜0.05),the area under the curve of the oral glucose tolerance test was reduced(P＜0.05),the expression of p-AKT and p-GSK3β proteins in the tibialis anterior muscle was significantly elevated(P＜0.05),and mitochondrial damage in the tibialis anterior muscle was significantly ameliorated,with decreased lipid droplets in the interstitium.(3)The above indexes were better in the high-dose Roujishuncuiyin group than the low-dose Roujishuncuiyin group(P＜0.05),while there was no significant difference between the high-dose Roujishuncuiyin group and positive control group(P＞0.05).To conclude,by upregulating the protein levels of p-AKT and p-GSK3β in skeletal muscle tissue,the traditional Chinese medicine compound Roujishuncuiyin can improve structural disorders and mitochondrial morphology in skeletal muscle tissue,reduce insulin resistance in the skeletal muscle and regulate glucose homeostasis in the body.

BACKGROUND:Skeletal muscle insulin resistance is the key pathological link of type 2 diabetes.The traditional Chinese medicine compound Roujishuncuiyin can effectively improve skeletal muscle insulin resistance,but its mechanism has not been clarified.OBJECTIVE:To explore the mechanism of Roujishuncuiyin on skeletal muscle insulin resistance in type 2 diabetes mice.METHODS:Forty db/db mice with type 2 diabetes mellitus were randomized into a model group,a low-dose Roujishuncuiyin group,a high-dose Roujishuncuiyin group,and a positive drug group,with 10 mice in each group.The latter three administration groups were given 157.5 mg/g and 630 mg/g Roujishuncuiyin and 200 mg/g metformin hydrochloride aqueous solution by gavage once a day,respectively.In addition,10 db/dm mice were selected as the blank control group.Mice in the model and blank control groups were given the same dose of 0.9％NaCl solution by gavage.After 12 weeks of intervention,fasting blood glucose was measured in each group of mice,and oral glucose tolerance test was performed to calculate the area under the blood glucose curve.ELISA was used to detect serum insulin level and calculate the resistance index.Mitochondrial structure of skeletal muscle tissue was observed under transmission electron microscopy.Western blot was used to detect the expression levels and phosphorylation levels of protein kinase B(AKT)and glycogen synthase kinase 3β(GSK-3β)proteins in skeletal muscle.RESULTS AND CONCLUSION:(1)Compared with the blank control group,fasting blood glucose,fasting insulin and insulin resistance index were significantly higher in the model group(P＜0.05),the area under the curve of the oral glucose tolerance test was significantly increased(P＜0.05),the expression of p-AKT and p-GSK3β proteins in tibialis anterior muscle was significantly decreased(P＜0.05),and there was a large amount of mitochondrial damage in tibialis anterior muscle and a large number of lipid droplets in the interstitium.(2)Compared with the model group,fasting blood glucose,fasting insulin,and insulin resistance index were significantly reduced in the low-and high-dose Roujishuncuiyin groups and the positive control group(P＜0.05),the area under the curve of the oral glucose tolerance test was reduced(P＜0.05),the expression of p-AKT and p-GSK3β proteins in the tibialis anterior muscle was significantly elevated(P＜0.05),and mitochondrial damage in the tibialis anterior muscle was significantly ameliorated,with decreased lipid droplets in the interstitium.(3)The above indexes were better in the high-dose Roujishuncuiyin group than the low-dose Roujishuncuiyin group(P＜0.05),while there was no significant difference between the high-dose Roujishuncuiyin group and positive control group(P＞0.05).To conclude,by upregulating the protein levels of p-AKT and p-GSK3β in skeletal muscle tissue,the traditional Chinese medicine compound Roujishuncuiyin can improve structural disorders and mitochondrial morphology in skeletal muscle tissue,reduce insulin resistance in the skeletal muscle and regulate glucose homeostasis in the body.

Objective:To explore the effect of mind mapping based on evidence-based theme in health education of patients undergoing thoracentesis and drainage.Methods:From September 2020 to December 2021, 78 patients with pleural effusion and thoracentesis drainage diagnosed by infection in Beijing Chaoyang Hospital affiliated to Capital Medical University were selected by convenience sampling as the research object. The patients from September 2020 to March 2021 were set as the control group, and the patients from May to December 2021 were set as the observation group, with 39 cases each. The control group was given traditional health education, while the observation group received evidence-based health education with mind mapping. The health education knowledge examination score, self-care ability, adverse event rate and nursing satisfaction were compared between the two groups.Results:The scores of health education knowledge examination in the observation group were higher than those in the control group before , 24 hours after catheterization and before decannulation, with statistically significant differences ( P<0.01) . The total score and each dimension score of self-care ability in the observation group were higher than those in the control group, with statistically significant differences ( P<0.01) . The incidence of adverse events in the observation group was lower than that in the control group, and the score of Nursing Satisfaction Questionnaire was higher than that in the control group, with statistical differences ( P<0.05) . Conclusions:The mind mapping on the basis of evidence-based themes can effectively improve patients' health education knowledge and self-care ability, reduce the incidence of adverse events, and increase nursing satisfaction.

Objective:To evaluate the clinical efficacy of neck pricking combined with oral pricking in the treatment of dysphagia after stroke.Methods:Seventy-four patients with post-stroke dysphagia who met the inclusion criteria were randomly divided into the treatment group (acupuncture + rehabilitation training group) and the control group (rehabilitation training group) according to random number table method, 37 cases for each group. Both groups of patients were given conventional drug therapy and rehabilitation of Chinese and Western medicine. On this basis, the control group used swallowing rehabilitation training. The treatment group used acupuncture combined with neck pricking and oral pricking based on swallowing rehabilitation training. Both groups were treated for 3 weeks. Before and after the treatment, three different traits of sputum (liquid, mushy and paste) videofluoroscopic swallowing study (VFSS) were observed for each patient, and the swallowing conditions were observed. The primary outcome measures were the oral swallowing scale score, the pharyngeal swallowing scale score, the Rosenbek infiltration/aspiration scale score, and the standard swallowing function rating scale (SSA). The improvement in swallowing function and aspiration was compared between the two groups.Results:After treatment, the SSA score of the treatment group (25.05 ± 5.27 vs. 28.66 ± 5.33, t=2.884) was lower than that of the control group ( P<0.05). Compared with the same group before treatment, treatment group and control group of oral stage VFSS liquid ( t=5.199, 5.413), mushy ( t=4.761, 4.824) and pasty ( t=5.295, 4.428) scores, throat stage liquid ( t=4.986, 3.919), mushy ( t=4.789, 4.170) and pasty ( t=4.136, 3.673) scores were increased ( P<0.01), but there was no statistically significant difference between the groups ( P>0.05). After treatment, Rosenbek's leakage-aspiration degree classification was significantly reduced ( Z values were 4.224, 2.956, all Ps<0.01), but there was no statistically significant difference between the groups ( P>0.05). The total effective rate was 89.2% (33/37) in the treatment group and 74.3% (26/35) in the control group. There was no statistically significant difference between the two groups ( Z=1.125, P=0.261). Conclusions:Neck pricking combined with oral pricking and rehabilitation training for stroke dysphagia is better than simple rehabilitation training, and could significantly improve swallowing-feeding function, which could be promoted in clinical rehabilitation.

Objective To investigate the prevalence and progression process of atopic diseases in adolescents, and to assess their relationship with filaggrin(FLG)mutations. Methods Totally, 334 adolescents aged from 11 to 19 years in a middle school in shanghai were enrolled into this study. A clinical interview was carried out to determine the prevalence of atopic diseases (such as ichthyosis, atopic dermatitis (AD), asthma, rhinitis, etc)in these subjects. Peripheral blood samples were collected from 285 out of the 334 adolescents for screening for common FLG mutations, including 3321delA and K4671X. Five years later, these adolescents were followed up for reevaluation of clinical presentations of atopic diseases. Statistical analysis was carried out by the chi-square test with the SPSS 20.0 software. Results As the baseline survey showed, 19 (5.69%)of the 334 adolescents had AD, 14 (4.19%)had ichthyosis vulgaris, 36(10.78%)had allergic rhinitis, and 4(1.20%)had asthma. FLG mutations were observed in 24(8.42%) of the 285 adolescents. Five years later, 265 adoscents completed the follow-up, and 69 (20.66%)were lost to follow-up. Of the 265 adolescents reevaluated, 13(4.89%)had AD, 15(5.64%)had ichthyosis vulgaris, 27(10.15%)had allergic rhinitis, and 1 (0.38%)had asthma. By the time the second survey was performed, 6 out of the 19 patients initially diagnosed with AD had achieved complete regression, 13 had experienced a marked decrease in SCORing atopic dermatitis (SCORAD)score, and symptoms had disappeared in 9 of the 36 patients initially diagnosed with allergic rhinitis. The frequency of FLG mutations was 10.0%in patients with AD, 55.6%in those with ichthyosis, and 40.0%in those with both AD and ichthyosis, and the development of ichthyosis was associated with FLG mutations(P<0.001). Conclusions The frequency of common FLG mutations was 8.42%in these adolescents. FLG gene may be a semidominant gene associated with ichthyosis vulgaris, and multiple factors influence its expression.