Stroke is a prevalent acute cerebrovascular disease associated with significant morbidity and mortality,which highly demand effective prevention and treatment strategies.Glucagon-like peptide-1 receptor agonists(GLP-1RA)is a novel type of antidiabetic drug that exerts hypoglycemic and weight loss effects on GLP-1 receptors.Additionally,GLP-1RA possess the potential to reduce infarction size and promote nerve recovery by inhibiting inflammation,oxidative stress,apoptosis,and improving blood-brain barrier permeability and other pathologies.This paper provides a comprehensive summary of the role of GLP-1 in stroke occurrence while also explores the underlying mechanisms by which GLP-1RA influences stroke pathogenesis.Furthermore,it briefly reviews the therapeutic efficacy of GLP-RA in managing stroke.

Objective:To explore the role and mechanism of exogenous active peptide spexin in regulating insulin resistance in adipose tissue.Methods:High-fat diet induced obesity model(DIO) mice and diabetic model(db/db) mice were given intraperitoneal injection of spexin(50 μg/kg) for 3 consecutive weeks, while each control group was given an equal volume of saline. After the intervention, the body weight, visceral fat weight and plasma biochemical indexes of the mice in each group were analyzed. Real-time fluorescence quantitative PCR was used to detect mRNA levels of Krüppel-like transcription factor 9(KLF9), peroxisome proliferator-activated receptor γ coactivator-1α(PGC-1α) and glucose transporter 4(GLUT4); Western blotting was used to detect the protein levels of KLF9, PGC-1α, GLUT4 and p-p38/p38 in adipose tissue.Results:Compared with DIO control mice, spexin-treated DIO mice showed a significant reduction in body weight ( P=0.043), adiposity ( P<0.001), glucose ( P<0.001), insulin ( P=0.008), HOMA-IR ( P<0.001) and elevation in glucose tolerance ( P=0.006) and insulin tolerance levels ( P=0.002). Compared with db/db control mice, spexin-treated db/db mice showed a significant reduction in body weight ( P<0.001), adiposity ( P<0.001), glucose ( P=0.041), insulin ( P=0.009), HOMA-IR ( P=0.007) and elevation in glucose tolerance ( P=0.008) and insulin tolerance levels ( P=0.031). In addition, the gene and protein levels of KLF9, PGC-1α and GLUT4 were significantly increased in the adipose tissue of spexin-treated DIO mice compared with DIO control mice [genes ( P<0.001, P<0.001, P=0.005); proteins ( P=0.047, P=0.022, P=0.001)], while p-p38/p38 protein levels were significantly decreased in the adipose tissue of spexin-treated DIO mice compared with DIO control mice ( P=0.002). Moreover, the gene and protein levels of KLF9, PGC-1α and GLUT4 were significantly increased in the adipose tissue of spexin-treated db/db mice compared with db/db control mice [genes ( P<0.001, P<0.001, and P=0.005); proteins ( P=0.001, P=0.004, and P<0.001)], while p-p38/p38 protein levels were significantly decreased in the adipose tissue of spexin-treated db/db mice compared with db/db control mice ( P=0.001). Conclusion:These results suggested that spexin may play a role in ameliorating adipose tissue insulin resistance in DIO mice and db/db mice through regulating p38MAPK-mediated inflammation and KLF9-PGC-1α-GLUT4 pathway-mediated glucose uptake.

Objective: To investigate the correlation between serum melatonin level and cardiac function, blood lipid in patients of heart failure with preserved ejection fraction (HFpEF). Methods: One hundred and seventy patients with HFpEF (HFpEF group) in Ninth Hospital of Xi′an City from May 2016 to May 2018 were selected. According to the cardiac function grading of New York Heart Association (NYHA), Ⅱ grade (cardiac function Ⅱ grade) was in 98 cases, and Ⅲ grade (cardiac function Ⅲ grade) was in 72 cases. Then, 32 healthy volunteers were selected as control group. The 2 groups were sampled at 2:00 and 7:00, and the level of melatonin was detected by enzyme-linked immunosorbent assay. The correlation between serum melatonin level and cardiac function, blood lipid were analyzed (Pearson correlation), including triglyeride (TG), total cholesterol (TC), low density lipoprotein cholesterol (LDL-C), high density lipoprotein-cholesterol (HDL-C), N-terminal precursor brain natriuretic peptide (NTproBNP), hypersensitive C reactive protein (hs-CRP), ejection fraction, left ventricular end-diastolic volume index (LVEDVI), miral diastolic early and end-diastolic maximum blood flow velocity ratio (E/A) and peak value of early diastolic blood flow velocity in the mitral valve and peak value of the early diastolic velocity of the mitral annulus (E/e′). Results: The TG, TC, LDL-C, NTproBNP and hs-CRP in cardiac function Ⅲ grade patients were significantly higher than those in cardiac function Ⅱ grade patients: (1.51 ± 0.69) mmol/L vs. (1.15 ± 0.75) mmol/L, (4.03 ± 1.02) mmol/L vs. (3.47 ± 0.94) mmol/L, (1.42 ± 0.33) mmol/L vs. (1.17 ± 0.31) mmol/L, (3 438.54 ± 553.58) ng/L vs. (3 034.58 ± 557.35) ng/L and (4.26 ± 2.54) mg/L vs. (3.12 ± 2.13) mg/L, the HDL-C, ejection fraction and E/A were significantly lower than those in cardiac function Ⅱ grade patients: (2.44 ± 0.88) mmol/L vs. (2.97 ± 0.94) mmol/L, (56.23 ± 5.26)% vs. (61.11 ± 5.33)% and 0.82 ± 0.18 vs. 0.91 ± 0.17, and there were statistical differences (P<0.01). The melatonin levels at 2:00 and 7:00 in control group and cardiac function Ⅱgrade patients of HFpEF group were significantly higher than those in cardiac function Ⅲ grade patients of HFpEF group: (454.24 ± 123.54) and (432.68 ± 155.68) ng/L vs. (368.85 ± 98.52) ng/L, (483.25 ± 90.54) and (418.54 ± 103.57) ng/L vs. (345.85 ± 98.52) ng/L, the melatonin level at 7:00 in control group was significantly higher than that in cardiac function Ⅱ grade patients of HFpEF group, and there was statistical difference (P<0.01). In cardiac function Ⅱ grade patients of HFpEF group, the melatonin level was correlated with TG, TC, LDL-C and HDL-C (P<0.01); In cardiac function Ⅲ grade patients of HFpEF group, the melatonin level was correlated with NTproBNP, hs-CRP, ejection fraction, LVEDVI, E/A, E/e′, TG, TC, LDL-C and HDL-C (P<0.01 or <0.05). Conclusions The melatonin level is correlated with the level of blood lipid in HFpEF patients. Melatonin level is correlated with cardiac function Ⅲ grade patients, but this phenomenon is not observed in cardiac function Ⅱ grade patients.

Objective To observe the effect of berberine on the expression of GLUT4 and PGC-1α in mice with insulin resistance,and to explore the molecular mechanism of berberine in improving insulin resistance.Methods Mice models with insulin resistance were established,and berberine was used by intragastric administration to detect blood glucose,insulin and insulin sensitivity.RT-PCR was used to detect the expression level of GLUT4 and mRNA of PGC-1α in skeletal muscle.Results Berberine significantly reduced blood sugar,increased insulin sensitivity,and promoted the expression of GLUT4 and PGC-1α in skeletal muscle.Conclusion Berberine can improve the expression of PGC-lo,promote the expression of GLUT4 and improve insulin resistance.

Objective To observe the effect of berberine on the expression of GLUT4 and PGC-1α in mice with insulin resistance,and to explore the molecular mechanism of berberine in improving insulin resistance.Methods Mice models with insulin resistance were established,and berberine was used by intragastric administration to detect blood glucose,insulin and insulin sensitivity.RT-PCR was used to detect the expression level of GLUT4 and mRNA of PGC-1α in skeletal muscle.Results Berberine significantly reduced blood sugar,increased insulin sensitivity,and promoted the expression of GLUT4 and PGC-1α in skeletal muscle.Conclusion Berberine can improve the expression of PGC-lo,promote the expression of GLUT4 and improve insulin resistance.

Objective To explore the effect of ankle pump on wound healing of diabetic foot ulcer (DFU). Methods Using convenience sampling method, patients hospitalized in Podiatry Department of Tianjin Medical University Metabolic Diseases Hospital from July to December 2015 and eligible for inclusion-exclusion criteria were recruited to control group, and patients who were hospitalized from May to October 2016 were recruited to observation group according inclusion-exclusion criteria. A total of 162 patients with DFU were recruited and 156 patients completed the whole study, with 72 cases in observation group and 84 cases in control group. Routine treatment and nursing care of DFU were given to both groups, and on the basis of that ankle pump motion therapy training was given to the observation group. After treatment for 9 weeks, the foot ulcer area, healing condition, transcutaneous arterial oxygen tension (TcPO2), foot skin temperature and ankle brachial index (ABI) were compared. In addition, the adverse events throughout the process of the two groups were recorded. Results After 9-week treatment, the healing rate of observation group was higher than the control group, and the difference wasn't statistically significant (χ2=3.714, P=0.054). The area of foot ulcer of both groups decreased, and the difference wasn't statistically significant before and after treatment (P<0.01). Ulcer surface area in the intervention group decreased more significantly after treatment than the control group(P<0.01). Wagner grading Ⅲ, Ⅳ patients' TcPO2, skin temperature of both groups,and wagner grading Ⅲ patients' ABI of oberservation group all increased than before treatment, with statistical difference (P> 0.05). There was no statistical difference of TcPO2, ABI and skin temperature between the two groups before treatment (P> 0.05). In observation group, Wagner grading Ⅱ patients' skin temperature and ABI, Wagner grading Ⅲ patients' TcPO2 and skin temperature, Wagner grading Ⅳ patients' TcPO2were all higher than those of the control group, with statistical difference (P<0.01). There were 4 cases of asymptomatic hypoglycemia in each group, and there was no statistical difference of adverse event in both groups. Conclusions The ankle pump motion has a positive effect on the wound healing of DFU, which has the advantage of high safety.

Objective To investigate the serum expressions and clinical significance of Dickkopf-1 in patients with rheumatoid arthritis (RA). Methods The clinical data of 139 patients with RA were retrospectively analyzed, including the disease history, tender joint count (TJC), swollen joint count (SJC), platelet, erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), rheumatoid factor (RF), anti-nuclear antibody (ANA), antikeratin antibody (AKA), anti-perinuclear factor (APF), anti cyclic citrullinated peptide antibody (anti-CCP), Dickkopf-1 and radiological (X-ray) staging. The disease activity scale (DAS) was evaluated, and the ESR and CRP levels were included. The relationship between Dickkopf-1 and the clinical data of RA, DAS44 score was analyzed. Results The serum level of Dickkopf-1 in patients with RA was (2.70 ± 0.46) μg/L. There was no relationship between serum Dickkopf-1 level and gender, age, course of disease, CRP, platelet, ANA, AKA, APF, RF, radiological staging in patients with RA (P>0.05). The serum Dickkopf-1 level was significantly associated with TJC, SJC, ESR, DAS44-ESR score, DAS44-CRP score and anti-CCP (r = 0.200, 0.291, 0.178, 0.222, 0.199 and 0.278, P = 0.019, 0.001, 0.037, 0.009, 0.028 and 0.012). Conclusions The serum Dickkopf-1 expression level is closely related to the occurrence and development of RA. Dickkopf-1 may contribute to diagnose the disease activity in patients with RA.

OBJECTIVE:To investigate the role of clinical pharmacists in the drug treatment of infected patients in neurosur-gery department. METHODS:Clinical pharmacists participated in the formulation of anti-infective treatment plan for a infected case after meningioma surgery. According to drug antibacterial spectrum,result of laboratory and image examinations and disease condition of patients,etc.,the patient was given cefoperazone sodium and sulbactam sodium (3 g,ivgtt,q8 h),rifampicin (0.45 g,ivgtt,q12 h)and vancomycin(1 g,ivgtt,q12 h);the body temperature of the patient increased again and clinical pharmacist suggested meropenem 1 g,ivgtt,q8 h and vancomycin 1 g,ivgtt,q12 h. RESULTS:After 53 d treatment,infection was timely brought under control. The patient was discharged from hospital after improved on 72th day. CONCLUSIONS:Through the partici-pation of clinical pharmacists in pharmaceutical care for anti-infective drug treatment in neurosurgery department contribute to ratio-nal drug use in the clinic and guarantee the safety of drug use.

Objective:To prepare silybin ( SLB) lipid emulsions and evaluate the drug release behavior in vitro. Methods:Silybin lipid emulsions were prepared by high-pressure homogenization method. Under the guidance of single-factor test, the best formula of SLB lipid emulsions was obtained by orthogonal design. Results:The encapsulation efficiency of SLB lipid emulsions prepared by the optimal formula was (91. 45 ± 0. 005 2) % with the particle size of (74. 42 ± 14)nm and PDI of 0. 106, Zeta potential of ( -30. 2 ± 2. 13)mV and pH of (6. 48 ± 0. 04). The drug release of SLB lipid emulsions was up to 90% within 12 hours. Conclusion:The opti-mized preparation of SLB with sustained-release property is obtained successfully.

Objective To investigate clinical features and antibiotic resistance of pseudomonas aeruginosa (PA) strains isolated from patients with diabetic foot infections (DFI) in Tianjin Metabolic Diseases Hospital.Methods Eighty-five PA strains were isolated from 428 patients with diabetic foot in the hospital from Jan 2008 to Dec 2010.The clinical features of patients were summarized.Relationships between the isolates and depth of ulcer or severity of infection were analyzed.The disk-diffusion method was performed to examine antimicrobial susceptibility.Results Gram positive (G+) and Gram negative (Gˉ) isolates were 50.47％ and 41.12％,respectively.Multidrug-resistant PA composed 32.9％ of the total PA isolates.The size of ulcers with PA infections was bigger than those with non-PA bacterial infections (P＜0.05).Compared to G+ strains,patients with PA strains were older,had lower hemoglobin,but higher serum sensitive C-reactive protein; and more frequently,they had ischemic ulcer and osteomyelitis.Compared to G+ strains,the PA strains were more frequently isolated from deeper ulcers and with more serious infections(P＜0.05).The resistant rates of PA to cephalosporins,fluoroquinolones,and aminoglycosides were between 32.9％-61.2％,37.6％-42.4％,and 37.6％-62.4％,respectively.Only one out of 85 PA strains was imipenem-resistant.However,sensitiveness of all PA isolates to cefoperazone and sulbactam reached 100％.Conclusion PA strains are mainly found in patients with deeper ulcers and more serious infections.Multidrug-resistant PA is common in DFI.It is important to isolate pathogens and determine their antibiotic resistance correctly in diabetic foot patients in order to provide appropriate drug administration and to reduce the production and dissemination of drug resistant strains.