ObjectiveTo investigate the therapeutic effect of proanthocyanidins （PC） on rats with type 2 diabetes mellitus （T2DM） complicated with cognitive impairment （CI） and to explore its potential mechanism by inhibiting the NOD-like receptor family pyrin domain-containing protein 3 （NLRP3）/cysteine-aspartic acid protease-1 （Caspase-1） pathway. MethodsA T2DM rat model was established by high-fat diet combined with intraperitoneal streptozotocin （STZ） injection. Thirty-six diabetic rats complicated with CI were screened by Morris water maze test and randomly divided into model group， PC low-dose （50 mg/kg） group， PC medium-dose （100 mg/kg） group， and PC high-dose （200 mg/kg） group. Another 9 normal rats served as the normal control group. Each group was administered with the corresponding doses of PC or an equal volume of distilled water by gavage for 8 weeks. After the intervention， spatial learning and memory abilities were evaluated using the Morris water maze test. Fasting blood glucose， body weight， and organ coefficients were measured. Pathological changes in the hippocampus were observed by hematoxylin-eosin （HE） staining. Reactive oxygen species （ROS） levels， as well as levels of inflammatory cytokines tumor necrosis factor-α （TNF-α） and interleukin-1β （IL-1β） in hippocampal tissue， were detected by enzyme-linked immunosorbent assay （ELISA）. The protein expression levels of NLRP3， Caspase-1， IL-1β， and IL-18 in the hippocampus were determined by Western blot. ResultsCompared with the normal control group， the model group exhibited significantly increased blood glucose and decreased body weight （P<0.05）. In the Morris water maze test， the model group showed prolonged escape latency， fewer platform crossings， and lower percentages of time and path length in the target quadrant （P<0.05）. Disordered arrangement and pyknotic nuclei were observed in hippocampal neurons. ROS and the levels of TNF-α and IL-1β were elevated， and the protein expression levels of NLRP3， Caspase-1， IL-1β and IL-18 were upregulated （P<0.05）. Compared with the model group， all PC-treated groups， especially the high-dose group， presented dose-dependent improvements in the above indicators， including reduced blood glucose （P<0.05）， improved spatial memory performance in the Morris water maze （P<0.01）， alleviated hippocampal pathological damage， decreased ROS and inflammatory cytokine levels （P<0.05）， and significantly downregulated expression of NLRP3/Caspase-1 pathway-related proteins （P<0.05）. ConclusionProanthocyanidins can ameliorate glycolipid metabolic disorder， visceral organ injury as well as cognitive dysfunction in T2DM rats. The underlying mechanism may be associated with reduced hippocampal ROS levels， inhibition of the NLRP3/Caspase-1 signaling pathway， and attenuated neuroinflammation in the hippocampus， with the optimal effect observed at a dose of 200 mg/kg.

To investigate the hypolipidemic effects of gypenosides granules and its combination with lipitor, a model of hyperlipidaemia C57BL/6J mice was established by high-fat diet feeding for 4 weeks. The mice were randomly divided into blank group, model group, lipitor group(10 mg/kg of lipitor), low dose group(90 mg/kg of gypenosides granules), medium dose group(120 mg/kg of gypenosides granules), high dose group(180 mg/kg of gypenosides granules)and the combination group(180 mg/kg of gypenosides granules and 10 mg/kg of lipitor). After 4 weeks of continuous administration, the contents of serum lipid indexes, serum ALT, AST and apolipoprotein B(ApoB)were measured. The liver tissues of mice were observed by H&E staining. The expression levels of key factors involved in hepatic cholesterol metabolism were observed by RT-PCR and Western blot methods, such as adenosine triphosphate combined box transporter A1(ABCA1), liver X receptor(LXRα), cholesterol 7 alpha hydroxylase(CYP7A1)and type BΙ scavenger receptor(SR-BΙ). The results revealed that gypenosides granules significantly decreased the mice body weight, total abdominal fat area and the level of serum total cholesterol(TC). The combination group showed a more significant reduction in TC level than the other administration groups. Moreover, gypenosides granules treatment remarkably increased the protein expression of ABCA1 and up-regulated the mRNA expression of ABCA1, CYP7A1 and SR-BI. The above results suggest that gypenosides granules can significantly reduce blood lipid contents, and the combination therapy with lipitor show better the lipid-lowering effect. Meanwhile, gypenosides granules can decrease the level of serum transaminase. Preliminary exploration suggests the lipid-lowering mechanism of gypenosides granules may be involved in cholesterol reversal to regulate the level of TC.

Objective To explore the effects of warm water insufflation applied in difficult colonoscopy on its success rate, insertion time, operation difficulty level and tolerance of patients. Method 200 cases of the difficult defecation of non-narcotic colonoscopy, IBS and always has a history of pelvic/abdominal surgery patients, were randomly divided into warm water infusion group (experimental group) and traditional method of air insufflation group (control group), then compare the differences of the success rate of the two groups of patients, the insertion time and degree of tolerance in patients. Results All the patients completed the investigation in this study, neither bowel perforation nor other complications occurred. Experimental group success rate of the whole colon examination, the insertion time, the operator satisfaction and check again wishes were significantly higher than that of control group (P < 0.05). In abdominal pressure and utilization, abdominal pain scoring position transformation, the former was significantly lower than the latter (P < 0.05). In abdominal pressure and utilization, abdominal pain scoring position transformation, the former was significantly lower than the latter (P < 0.05). There is no significant difference (P > 0.05) in Polyp detection rate. Conclusion Warm water insufflation colonoscopy can effectively improve the tolerance and accelerating the colonoscopy in patients with difficult insertion process, improve work efficiency, and is an ideal method, which is worth of promoting.