ObjectiveTo observe the effects of Jiangtang No. 3 prescription on inflammatory pathways and insulin resistance-related indicators in rats with type 2 diabetes mellitus （T2DM）， and to elucidate its molecular mechanism in combating diabetes. MethodsA T2DM rat model was established using a high-fat diet combined with intraperitoneal injection of streptozotocin （STZ）. Successfully modeled rats were randomly assigned to the model group， metformin group， and low-， medium-， and high-dose Jiangtang No. 3 prescription groups， and a normal group was also set. Daily gavage was administered for 8 weeks as follows： metformin at 0.1 g·kg^-1·d^-1， Jiangtang No. 3 prescription granules at 1.62， 3.24， 6.48 g·kg^-1·d^-1 for the respective dose groups， and sterile water for the normal and model groups. Rat body weight， fasting blood glucose （FBG）， oral glucose tolerance test （OGTT）， and insulin tolerance test （ITT） were measured. After drug intervention， enzyme-linked immunosorbent assay （ELISA） was used to determine serum levels of total cholesterol （TC）， triglycerides （TG）， low-density lipoprotein cholesterol （LDL）， high-density lipoprotein cholesterol （HDL）， non-esterified fatty acids （NEFA）， interleukin （IL）-1β， IL-18， and insulin （INS）. Hematoxylin-eosin （HE） staining was used to observe morphological changes in adipose tissue. Real-time quantitative PCR was used to detect the mRNA expression of Toll-like receptor 4 （TLR4）， nuclear factor-κB （NF-κB）， NOD-like receptor protein 3 （NLRP3）， Caspase-1， IL-1β， IL-18， and gasdermin D （GSDMD） in adipose tissue. Western blot was used to measure the corresponding protein expression levels. ResultsCompared with the model group， Jiangtang No. 3 prescription groups exhibited significantly increased body weight （P<0.05， P<0.01）， significantly reduced FBG （P<0.05， P<0.01）， significant reductions in TC， TG， NEFA， and LDL （P<0.05， P<0.01）， and a significant increase in HDL （P<0.01）. Serum levels of inflammatory mediators IL-1β and IL-18 were significantly decreased （P<0.01）， the homeostatic model assessment of insulin resistance （HOMA-IR） index was significantly reduced （P<0.05， P<0.01）， and adipose tissue pathology was improved. The protein expression levels of TLR4， NF-κB， NLRP3， Caspase-1， IL-1β， IL-18， and GSDMD were markedly decreased （P<0.05， P<0.01）， and the mRNA expression levels of these indicators were also significantly downregulated （P<0.05， P<0.01）. Some effects were superior to those of the positive control drug metformin， and certain indicators exhibited dose-dependent improvements. ConclusionT2DM rats display significant inflammatory responses， disordered glucose and lipid metabolism， and insulin resistance. Jiangtang No. 3 prescription effectively suppresses inflammatory mediators， improves glucose and lipid metabolism and insulin resistance， and ameliorates pathological changes in adipose tissue. Its mechanism may be related to the regulation of the TLR4/NF-κB/NLRP3 signaling pathway in visceral adipose tissue， thereby influencing downstream inflammatory mediators.

Objective:To explore the outcomes and mechanisms of coronary endarterectomy combined with electrocautery in patients with diffused coronary artery disease undergoing coronary artery bypass grafting (CABG).Methods:From January 2017 to September 2018, 300 patients undergoing CABG with left anterior descending artery endarterectomy were randomly divided into two groups, after fully informed the risks and other related issues regarding the operations. All the patients in the two groups were treated with CABG. In the study group, patients underwent electrocautery immediately after endarterectomy, whereas in the control group, patients underwent endarterectomy only. The electrocardiogram and serological examination (TNI, IL-6 and TNF-a) were performed at 2 h, 24 h, 72 h and 120 h after operation. The follow-up duration was 1 year.Results:Nine patients in the study group, and 25 patients in the control group had ST segment elevation. The levels of TNI, IL-6 and TNF-a were continuously increased in both groups, and reached the peak at 24 h, then decreased slowly. The levels of TNF-a were significantly lower at 2 h postoperatively in the study group ( P=0.01). There was no significant difference in the levels of TNI and IL-6 between the two groups. The levels of TNI, TNF-a and IL-6 were significantly lower in the electrocautery group at 24 h, 72 h, and 120 h after operation( P<0.05). One year after operation, incidences of ST segment elevation in the study group were significantly lower than that in the control group, and there was no significant difference in restenosis rate and myocardial infarction rate. Conclusion:Endarterectomy combined with electrocautery may prevent the restenosis of the lumen and blood turbulence, smooth the inner wall of the vessel, slow down the release of inflammatory factors in the peripheral blood, inhibit the expression of inflammatory factors in the vessels, and reduce the myocardial damage. The short-term effect was satisfactory; the long-term anti-inflammatory and antithrombotic effect still need further investigations.

BACKGROUNDSepsis-induced myocardial injury (SIMI) is caused by a variety of mechanisms. The aim of the study is to investigate the effects of metalloproteinase-8 (MMP-8) on SIMI and its mechanisms in rats.

METHODSForty male Sprague Dawley rats were randomly divided into four groups: MMP-8 inhibitor (M8I), dexamethasone (DEX), sepsis, and sham groups. The sepsis model was established by cecal ligation and puncture (CLP). Rats in the M8I group immediately received an intraperitoneal injection of M8I (0.1 mg/kg) after CLP. Rats in the DEX group immediately received an intraperitoneal (IP) injection of DEX (2 mg/kg). Rats in the sepsis and sham groups received intraperitoneal injections of normal saline. Rats were sacrificed 12 hours after CLP. Paraffin sections were stained with hematoxylin and eosin to observe the myocardium. The myocardial ultrastructure was observed with transmission electron microscopy. MMP-8, tumor necrosis factor-α (TNF-α), and interleukin-1β (IL-1β) were detected by immunohistochemistry. The expression of MMP-8 was measured by Western blotting. TNF-α and IL-1β levels in serum and myocardial tissue were determined by enzyme-linked immunosorbent assay.

RESULTSCompared with the sham group, the myocardium in the sepsis group was seriously injured. MMP-8, TNF-α and IL-1β expression was higher in the sepsis group than in the sham group. Treatment with M8I or DEX, however, attenuated sepsis induced histopathological changes in the heart, and was associated with significant reductions in serum and myocardial levels of TNF-α and IL-1β (P < 0.05). M8I significantly inhibited MMP-8 expression in myocardial tissue (P < 0.05). In addition, treatment with DEX was not associated with a change in myocardial levels of MMP-8 (P > 0.05).

CONCLUSIONMMP-8 inhibitor attenuated myocardial injury in septic rats, which might be related to reduced expression of TNF-α and IL-1β.

Animals ; Dexamethasone ; therapeutic use ; Disease Models, Animal ; Enzyme-Linked Immunosorbent Assay ; Heart Diseases ; drug therapy ; etiology ; Interleukin-1beta ; metabolism ; Male ; Matrix Metalloproteinase 8 ; metabolism ; Matrix Metalloproteinase Inhibitors ; therapeutic use ; Rats ; Rats, Sprague-Dawley ; Sepsis ; complications ; drug therapy ; Tumor Necrosis Factor-alpha ; metabolism

BACKGROUNDCoronary heart disease (CHD) is the most common type of heart disease and cause of heart attacks. This study investigated the epidemiological characteristics of CHD and its risk factors in Jiaozhou, Shandong province, to ultimately find a way of reducing the prevalence of cardiovascular disease, and to provide a theoretical basis for establishing a cardiovascular disease management path under the regional medical collaborative mechanism.

METHODSA questionnaire survey was performed including 1 952 people aged 35 years or older who were questioned by means of stratified, cluster, proportional sampling to investigate the prevalence of CHD and its risk factors. The data were inputted into SPSS11.0 statistical software for processing and analysis. We advised the local medical institutions to establish health files for the residents with CHD and risk factors. They were followed up regularly. Their risk factors and life-style were monitored, and advice was given as to proper medications. Green channels were established, and the patients were transmitted in a timely manner to superior hospitals for better treatment if the necessary treatments were not available in the local hospitals. The control of risk factors was observed after the follow-up for half a year.

RESULTSIn Jiaozhou, the rates of coronary artery disease, hypertension, diabetes, hyperlipidemia and overweight were 8.15%, 28.54%, 11.43%, 35.46%, and 18.70% respectively. The rates of hypertension, diabetes, hyperlipidemia and overweight were higher than the data published in "The report of Chinese cardiovascular disease 2012"; which are 24%, 9.7%, 18.6%, and 9.7%, respectively. The control of risk factors improved significantly after the guidance of the residents lifestyle and medication for six months.

CONCLUSIONSThe high prevalence of coronary artery disease in Jiaozhou is closely related to age, gender, diet structure, family history of cardiovascular disease, hypertension, diabetes, hyperlipidemia, overweight, and unhealthy lifestyle. Under the regional medical coordination mechanism, the collaborative management of cardiovascular disease can provide new management concepts for the areas short of medical resources, so as to reduce the prevalence of cardiovascular disease.

Adult ; Aged ; China ; epidemiology ; Coronary Disease ; epidemiology ; Female ; Humans ; Incidence ; Male ; Middle Aged ; Risk Factors

Objective To investigate the therapeutic effect of stage treatment of severe complicated injuries in palmar forearm and wrist.Methods From March 2008 to Novemler 2011, eleven cases with skin lost combined with fracture and lost of flexor tendon, ulnar radial arteries, median and ulnar nerves,and some of them had fracture of ulnar and radius were treated in the first stage with vacuum sealing drainage after emergency debridement and tissue repair. Secondary microsurgical repair was performed after the VSD was removed. The lost of median and ulnar nerves was repaired with transplantation of sural nerve,and the wound was repaired with free flaps and complex tissue flaps. Results Eleven cases were treated with vacuum sealing drainage for 7 to 10 days.Infections were under control,wound areas reduced and most wound areas were covered by granulation tissues.Flaps and skin grafts were survived.After postoperative follow-up for 3 to 36 months (average 13 months),three cases was received flexor tendolysis.As result,the blood circulation of hand was good, the sensor of injured nerve was higher than S3, and there was a good functional rehabilitation of hand muscles. Conclusion Using vacuum sealing drainage after emergency debridement and tissue repair, there was a good repairing effect of secondary repair with flaps and skin grafts for severe complicated tissue defect in palmar forearm and wrist,and it is an effective choice of operation.

Objective To investigate the effects of uterine resection and uterine arterial embolization on the function of ovary. Methods The serum concentrations of estrin(E 2), progestogen(P), follicule stimulating hormone(FSH), luteotropic hormone(LH) and prolactin(PRL) were measured in 15 patients with uterine resection and 22 patients with uterine arterial embolization; including 23 patients with uterine leiomyoma and 29 normal women. We compared the results of the five hormones in each group. Results The serum concentrations of E 2 and P in the group of uterine resection were lower than the normal control group, there was a significant difference between them. Compared the serum concentrations of E 2 and P in the group of uterine arterial embolization and normal control group, there was no significant difference. The serum concentration of PRL in the group of uterine leiomyoma was higher than the normal control group with significant difference. When the uterus was resected or uterine artery was embolished, the serum concentration of PRL decreased remarkably. Conclusions Uterine resection has effects on the function of ovary, but uterine arterial embolization would not. PRL may be one of the factors causing the formation of uterine leiomyoma.