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Type 2 diabetes mellitus(T2DM), a common chronic metabolic disease, is often accompanied by internal heat syndrome. Heat-clearing prescriptions are widely used to treat different heat syndromes of T2DM from the aspects of clearing stagnant heat, excess heat, damp heat, phlegm heat, and heat toxin, demonstrating remarkable effects. The mechanism of blood sugar-lowering agents has always been a hotspot of research. Recently, the basic studies of heat-clearing prescriptions from different perspectives have been increasing year by year. To clarify the mechanisms of heat-clearing prescriptions and find specific mechanisms, we systematically reviewed the basic studies of heat-clearing prescriptions commonly used for the treatment of T2DM in the past decade, intending to provide a reference for related research.
Subject(s)
Humans , Diabetes Mellitus, Type 2/drug therapy , Drugs, Chinese Herbal/therapeutic use , Hot Temperature , Medicine, Chinese Traditional , Prescriptions , SyndromeABSTRACT
Objective:To discuss the effect of Sishenwan on phosphatidylinositol-3 kinase/protein kinase B/mammalian target of rapamycin（PI3K/Akt/mTOR） signaling pathway related genes and proteins in colon tissue and interleukin-1<italic>β</italic>（IL-1<italic>β</italic>） and interleukin-10（IL-10） expression levels in serum of ulcerative colitis （UC） model rats with spleen kidney Yang deficiency. Method:The 120 SPF Wistar rats were randomly divided into normal group and model group after 7 days of adaptive feeding in SPF laboratory. The model group were given dinitrobenzene sulfonate （DNBS）/ethanol solution enema+hydrocortisone subcutaneously injection+senna leaf gavage to establish UC model of spleen kidney yang deficiency. The rats who successfully established the model were randomly divided into five groups：model group， mesalazine （0.36 g·kg<sup>-1</sup>） group， and Sishenwan high， medium and low dose （3.2，1.6，0.8 g·kg<sup>-1</sup>） groups， the volume of which was 10 mL·kg<sup>-1</sup>. The model group and the blank group were given distilled water of the same volume. Once a day for 21 days. Observe the general conditions of the rats daily， and record the weight， fecal traits and occult blood of the mice for disease activity index （DAI） scoring.Take the rat colon tissue to observe the gross morphology and colon injury， and score the colon mucosal injury index （CMDI）. Hematoxylin-eosin （HE） staining was used to observe pathological changes. Real-time fluorescence quantitative polymerase chain reaction （Real-time PCR）was used to detect the expression level of PI3K， Akt， mTOR mRNA in colon tissue. The levels of IL-1<italic>β</italic> and IL-10 in serum were detected by enzyme-linked immunosorbent assay （ELISA）. Western blot was used to detect the expression level of PI3K， phosphorylation （p）-PI3K， Akt， p-Akt， mTOR， p-mTOR protein in colon tissue. Result:Compared with blank group， the general survival status of the rats in model group was relatively poor， the DAI score and the CMDI index were significantly increased （<italic>P<</italic>0.01）. The intestinal mucosa partially disappears， the glands disappear， and a large number of inflammatory cells infiltrate and gather in the mucosal layer and the base layer in the pathological sections of the model group. The expression levels of PI3K， Akt， and mTOR mRNA were significantly increased （<italic>P</italic><0.01）. The IL-1<italic>β</italic> content was significantly increased and the IL-10 content was significantly decreased （<italic>P</italic><0.01）. The expression levels of p-PI3K，p-Akt and p-mTOR protein were significantly increased （<italic>P</italic><0.01）. Compared with the model group， the DAI scores of Sishenwan high and medium dose groups and mesalazine group decreased （<italic>P</italic><0.05）. The CMDI index of mesalazine group and the high， middle and low dose groups of Sishenwan was significantly reduced （<italic>P</italic><0.01）. Pathological sections of rats showed that the inflammatory cells in the drug group decreased， and the mucosal layer structure returned to normal to varying degrees. The mesalazine group and the Sishenwan medium-dose group had the best effects， and the mucosal structure was close to the blank control group. The expression levels of PI3K， Akt， mTOR mRNA in the high and medium dose groups of Sishenwan， mesalazine group and Akt mRNA in low dose group of Sishenwan were significantly reduced （<italic>P</italic><0.05，<italic>P</italic><0.01）. The expression levels of PI3K and mTOR mRNA in low-dose group of Sishenwan decreased， but the difference was not statistically significant. The IL-1<italic>β</italic> content was significantly reduced and the IL-10 content was significantly increased in high， medium dose groups of Sishenwan and mesalazine groups （<italic>P</italic><0.05，<italic>P</italic><0.01）. The level of IL-1<italic>β</italic> decreased and the level of IL-10 increased in the low-dose group of Sishenwan， but the difference was not statistically significant. The expression levels of p-PI3K， p-Akt and p-mTOR protein in the high， medium， and low dose groups of Sishenwan and mesalazine group decreased to varying degrees， and the differences were statistically significant（<italic>P</italic><0.05，<italic>P</italic><0.01）. Conclusion:Sishenwan has the effect of improving the general condition and intestinal mucosal damage of ulcerative colitis model rats with spleen and kidney Yang deficiency. The mechanism may be related to the inhibition of PI3K/Akt/mTOR signaling pathway.
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Objective:To observe the Toll-like receptor 4(TLR4)and its negative regulating factorInterleukin-1 receptor-associated kinase-M(IRAK-M)in colonic mucosa of rats with experimental ulcerative colitis(UC), and to discuss the mechanism of the Chinese medicine Sishenwan. Method:The 90 Wistar rats were randomly divide into six groups, blank group, model group, sulfasalazine group(0.36 g·kg-1), Sishenwan low, medium and high-dose group(2.5, 5, 10 g·kg-1), 15 cases in each group. A rat model of UC was prepared by using a solution of trinitrobenzenesulfonic acid/ethano.The histopathological changes of colon were observed by hematoxylin-eosin (HE) staining. The contents of serum free triiodothyroid acid (FT3), serum free thyroxine (FT4), immunoglobulin (Ig) E and interleukin (IL)-2 were determined by radioimmunoassay. The activity of superoxide dismutase (SOD) in rat serum was determined by xanthine oxidation method. The activity of malondialdehyde (MDA) in serum of rats was determined by thiobarbituric acid (TBA) colorimetry. Result:Compared with blank group, intestinal mucosal injury score of rats in model group was significantly increased (PP3, FT4, IL-2 and SOD were significantly decreased (PPPPPP3, FT4, IL-2, and SOD contents were significantly increased (PPPPPConclusion:The unbalanced expressions of TLR4 and its negative regulating factor IRAK-M are connected with the pathogenesis of UC.Sishenwan can cure UC and control the expression of TLR4 and promote the expression of IRAK-M.
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BACKGROUND: Hydroxyapatite ceramic is one of the bioactive ceramics commonly used in clinic. Accurate regulation of the surface microstructure of hydroxyapatite ceramics is favorable for improving its biological performance, which is needed to be investigated thoroughly. OBJECTIVE: To investigate the effect of surface roughness on the wettability and protein adsorption ability of hydroxyapatite ceramic as well as mesenchymal stem cell proliferation on its surface. METHODS: Hydroxyapatite powders were synthesized by chemical precipitation method. Hydroxyapatite ceramics were produced by cold isostatic pressing of the powders and then high-temperature sintering of the obtained green compacts. After the different grinding and polishing processes, the hydroxyapatite ceramics with three distinct surface roughness were fabricated. The phase composition, microstructure, surface roughness and water contact angle of the hydroxyapatite ceramics were evaluated. Bovine serum albumin was used as the protein model to study the effect of surface roughness on protein adsorption. The in vitro cell culture was carried out to investigate the effect of surface roughness of hydroxyapatite ceramics on the growth and proliferation of rat bone marrow mesenchymal stem cells. RESULTS AND CONCLUSION: The hydroxyapatite ceramics with no surface treatment had higher surface roughness, presenting with marked undulating surface; the hydroxyapatite ceramics with surface grinding had a reduction in the surface roughness, but still had an undulating surface; and the hydroxyapatite ceramics with polishing treatment had a smooth surface. The surface roughness of the three hydroxyapatite ceramics with different surface treatment as mentioned above was 448.4, 229.9 and 18.6 nm, respectively, and there was a significant difference between them. The results of contact angle tests indicated that water contact angle of the hydroxyapatite ceramic was influenced by its surface roughness. Lower surface roughness meant larger contact angle, leading to the decreased hydrophilicity of the hydroxyapatite ceramics. The protein adsorption experiment showed that the hydroxyapatite ceramics were favorable for bovine serum albumin adsorption, and the amount of the adsorbed bovine serum albumin was dependent on the surface roughness of the ceramic as well as the initial concentration of the protein solution. The hydroxyapatite ceramics with higher surface roughness would absorb more bovine serum albumin, and the bovine serum albumin adsorption increased with the increasing initial concentration of the protein solution. The in vitro cell culture confirmed that surface roughness impacted the proliferation of rat bone marrow mesenchymal stem cells. Although the good attachment and growth of bone marrow mesenchymal stem cells were observed on the three hydroxyapatite ceramics, faster proliferation of mesenchymal stem cells occurred on the hydroxyapatite ceramics with lower and nano-scaled surface roughness was observed. Therefore, the surface roughness of hydroxyapatite ceramics exerts great effects on hydrophobicity, protein adsorption, and cell proliferation and growth.
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To analyze the regularities of prescriptions in "a guide to clinical practice with medical record" (Ye Tianshi) for diarrhoea based on traditional Chinese medicine inheritance support system(V2.5), and provide a reference for further research and development of new traditional Chinese medicines in treating diarrhoea. Traditional Chinese medicine inheritance support system was used to build a prescription database of Chinese medicines for diarrhoea. The software integration data mining method was used to analyze the prescriptions according to "four natures", "five flavors" and "meridians" in the database and achieve frequency statistics, syndrome distribution, prescription regularity and new prescription analysis. An analysis on 94 prescriptions for diarrhoea was used to determine the frequencies of medicines in prescriptions, commonly used medicine pairs and combinations, and achieve 13 new prescriptions. This study indicated that the prescriptions for diarrhoea in "a guide to clinical practice with medical record" are mostly of eliminating dampness and tonifying deficienccy, with neutral drug property, sweet, bitter or hot in flavor, and reflecting the treatment principle of "activating spleen-energy and resolving dampness".
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<p><b>OBJECTIVE</b>To analyze the clinical characteristics and surgery approach for patients with brainstem cavernous malformation (BSCM).</p><p><b>METHODS</b>The clinical data of 23 BSCM patients (5 cases at midbrain, 16 cases at pons, and 2 cases at medulla) treated in the Second Affiliated Hospital Zhejiang University School of Medicine from July 2003 to June 2014 were retrospectively reviewed. The medical history, radiological findings, operation records, postoperative course and follow-up results were analyzed.</p><p><b>RESULTS</b>Suboccipital approach, retrosigmoid approach, subtentorial supracerebella approach, Poppen approach, pterional approach, Kawase approach, interhemispheric transcallosal third ventrical approach were applied for the surgery of BSCM patients. Among them, Kawase approach and interhemispheric transcallosal third ventrical approach were firstly reported in treatment of BSCM. Total resection was achieved in 22 cases. Neurological function was improved in 15 cases, unchanged in 7 cases and deteriorated in 1 case. Fifteen cases were followed up for a mean period of 3.5 years and signs of recurrence was found.</p><p><b>CONCLUSION</b>Proper selection of surgical approach is important to assure total resection of the lesions, to protect surrounding normal vital structures and to avoid post-surgical complications.</p>
Subject(s)
Humans , Medulla Oblongata , Pathology , General Surgery , Mesencephalon , Pathology , General Surgery , Neurosurgical Procedures , Methods , Pons , Pathology , General Surgery , Postoperative Period , Recurrence , Retrospective Studies , Treatment OutcomeABSTRACT
<p><b>OBJECTIVE</b>To investigate risk factors for the occurrence of shunt-dependent hydrocephalus in patients with aneurysmal subarachnoid hemorrhage (aSAH).</p><p><b>METHODS</b>A cohort of 136 consecutive patients who were treated for ruptured aneurysms within 72 h after onset of aSAH from January 2011 to January 2013 were retrospectively analyzed. Lumbar drainage was performed during the surgery in all patients. The risk factors of shunt-dependent hydrocephalus were analyzed.</p><p><b>RESULTS</b>Of 136 patients, 23 (16.91%) underwent shunt operation to treat shunt-dependent hydrocephalus. Univariate analysis showed that Hunt-Hess grade at admission (P<0.01), Fisher grade (P<0.01), the presence of intraventricular hemorrhage (P<0.01), location of ruptured aneurysm (P=0.001), and the average daily volume of cerebrospinal fluid drainage (CSF) (P=0.047) were associated with shunt-dependent hydrocephalus.</p><p><b>CONCLUSION</b>The aSAH patients with poor Hunt-Hess grade at admission, high Fisher grade, the presence of intraventricular hemorrhage, ruptured aneurysm in posterior circulation, and abnormal average daily volume of CSF are more likely to develop shunt-depended hydrocephalus.</p>
Subject(s)
Adult , Aged , Female , Humans , Male , Middle Aged , Aneurysm, Ruptured , Arteriovenous Shunt, Surgical , Hydrocephalus , Intracranial Aneurysm , Retrospective Studies , Risk Factors , Subarachnoid Hemorrhage , General SurgeryABSTRACT
<p><b>BACKGROUND</b>Glioma is the most common type of malignant brain tumor and the prognosis of glioma is still poor. Moreover, the prognosis of patients diagnosed with grade III gliomas varies significantly. In this study, we assessed the factors that contribute to the prognosis of patients with grade III gliomas.</p><p><b>METHODS</b>Data from 97 patients with grade III glioma who received surgery from 2000 to 2005 were included in this study. Kaplan-Meier survival analysis and Cox regression analysis were used to analyze the prognostic effects of 16 different factors selected from clinical characteristics, results from neuroimaging and pathological examinations, as well as different treatment schemes.</p><p><b>RESULTS</b>The results indicated that age, preoperative Karnofsky Performance Scale score, extent of tumor invasion, tumor resection degree, residual tumor shown by postoperative magnetic resonance imaging (MRI), and postoperative radiotherapy and chemotherapy all correlated with patient prognosis. Furthermore, Cox multivariate analysis also showed the age (P < 0.01), extent of tumor invasion (P < 0.01), residual tumor shown by postoperative MRI (P < 0.05), and postoperative radiotherapy (P < 0.05) significantly correlated with patients' prognosis.</p><p><b>CONCLUSIONS</b>Age, postoperative radiotherapy and residual tumor indicated by MRI after surgery correlated significantly with the prognosis of patients with grade III glioma. The extent of tumor invasion may be an independent prognostic factor for patients with grade III glioma.</p>
Subject(s)
Female , Humans , Male , Middle Aged , Brain Neoplasms , Pathology , General Surgery , Glioma , Pathology , General Surgery , Kaplan-Meier Estimate , Karnofsky Performance Status , Multivariate Analysis , Neoplasm, Residual , Radiotherapy , Prognosis , Proportional Hazards ModelsABSTRACT
<p><b>OBJECTIVE</b>To evaluate reimplantation of devitalized autogenous calvarial bone flaps and the fixation of titanium clamps (CranioFix) for cranioplasty.</p><p><b>METHODS</b>From March 2000 to December 2003, 21 patients underwent (1) delayed reimplantation of preserved autogenous bone flaps, which were removed during the initial operations for increased intracranial pressure and stored in a freezer and autoclaved before use, or (2) immediate reimplantation of tumor invaded bone flaps that were devitalized by boiling. All of these flaps were fixed with titanium clamps (CranioFix). Resorption of the bone flaps was monitored by skull roentgenograms and computed tomography (CT). The clinical and aesthetic results were evaluated.</p><p><b>RESULTS</b>During the follow-up period of 6 to 30 months, no complications were found. There was slight resorption of the bone flaps in all cases, but the edge of the bone flaps was within the range of the titanium clamps according to skull roentgenograms and CT. Clinical and aesthetic results were highly satisfactory.</p><p><b>CONCLUSIONS</b>It is simple and practical using devitalized autogenous calvarial bone flaps for cranioplasty. The firmness decreasing of the reimplanted bone flap due to resorption can be prevented greatly by titanium clamps (CranioFix).</p>
Subject(s)
Adolescent , Adult , Aged , Female , Humans , Middle Aged , Young Adult , Bone Transplantation , Methods , Craniotomy , Methods , Skull , General Surgery , Surgical Flaps , Titanium , Transplantation, AutologousABSTRACT
<p><b>OBJECTIVE</b>To summarize the experience in applying acupunctural anesthesia (AA) with new combination principle (NCP) of acupoints in supratentorial craniocerebral operation of tumor in functional area or deep site of brain.</p><p><b>METHODS</b>With the acupoints selection of AA changed from the previous combination principle of near segmental and peri-operational region to the NCP of near-remote along corresponding meridian, craniotomy was carried out under AA in 23 patients.</p><p><b>RESULTS</b>Operation was performed successfully in all the patients, 82.6% of them with the effectiveness reaching I A grade. In those operated on the vital functional area, such as central anterior/posterior gyrus and language center, the accidental functional injury could be well prevented.</p><p><b>CONCLUSION</b>AA with NCP of acupoints has satisfactory effect in supratentorial craniocerebral operation of functional area or deep site of brain, it is especially valuable in monitoring the effect of operation on function of around normal cerebral area to avoid accident injury.</p>