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OBJECTIVE To explore the role and underlying mechanism of tournefolic acid B （TAB） on the improvement of glucose metabolism and renal function in diabetic nephropathy （DN） model mice. METHODS DN model mice were established by high-fat diet combined with streptozotocin， and then randomly divided into model group， positive control group （vitamin E， 20 mg/kg）， TAB low-dose， medium-dose and high-dose groups （1， 2， 4 mg/kg）， with 12 mice in each group； normal control group was given regular diet. Each group was given relevant medicine or normal saline intragastrically， once a day， for 4 consecutive weeks. The glucose metabolic function was estimated by fasting blood glucose， glucose tolerance test， insulin tolerance test and serum insulin concentration. The renal coefficients and biochemical indicators related to renal function [serum uric acid， blood urea nitrogen， creatinine levels， and ratio of urine microalbumin to creatinine] were detected in mice； the contents of biochemical indicators related to oxidative stress [superoxide dismutase （SOD）， glutathione peroxidase （GSH-Px）， malondialdehyde （MDA）， 8-hydroxydeoxyguanosine （8-OHdG）] were determined in renal tissue of mice； the pathological morphology of renal tissue was observed； the expressions of extracellular matrix （ECM） deposition related factors [transforming growth factor β1 （TGF- β1）， fibronectin （Fn）， type Ⅳ collagen （Col Ⅳ）] and protein kinase B （Akt）/nuclear factor erythroid 2-related factor 2 （Nrf2）/heme oxygenase-1 （HO-1） pathway related proteins were determined in renal tissue of mice. RESULTS Compared with normal control group， fasting blood glucose， area under glucose tolerance curve， area under insulin tolerance curve， serum insulin content， the levels of uric acid， urea nitrogen and creatinine @qq.com and ratio of urinary microalbumin to creatinine in serum， the contents of MDA and 8-OHdG and the protein expressions of TGF-β1， Fn and Col Ⅳ were increased significantly in model group （P＜0.05）， while the contents of SOD， GSH-Px and the protein expressions of p-Akt， Nrf2， HO-1 in renal tissue were decreased significantly （P＜0.05）； the significant thickening of the basement membrane， accumulation of mesangial matrix， glomerulosclerosis and interstitial fibrosis of the renal tubules were all found. Compared with model group， above indexes of mice were all reversed significantly in TAB groups （P＜0.05）， and pathological changes were alleviated in a dose-dependent manner. CONCLUSIONS TAB can improve blood glucose metabolism and kidney function and alleviate renal tubulointerstitial fibrosis in DN model mice， the mechanism of which may be associated with activating the Akt/Nrf2/HO-1 signaling pathway and suppressing ECM deposition.
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Objective To explore the effect of low-carbohydrate/high-monounsaturated fatty acids (LC/HMD) nutrition program for patients with diabetes mellitus and stroke. Methods Thirty-seven patients with diabetes mellitus and stroke after percutaneous endoscopic gastrostomy (PEG) were enrolled in this study, and these patients were treated with liquid food nutritional support. All patients were given high-carbohydrate (HCD) nutritional support at the first and second day and then changed to LC/HMD nutrition program. The blood glucose fluctuations were monitored by continuous glucose monitoring(CGM) system. Meanwhile the daily dose of insulin injections, glycosylated hemoglobin (HbA1c) and biochemical indicators were detected. for just admission and just give LC after/HMD nutrition program and three months later on HbA1c and blood biochemical indexes were detected. Results 3 months after LC/HMD nutrition program treatment, the levels of mean amplitude of plasma glucose excursions (MAGE), ratio of hyperglycemia to time, ratio of glycopenia to time, HbA1c, daily dose of insulin injections were significantly improved compared with those at the 2nd of LC/HMD nutrition program treatment and with HCD nutritional support (P < 0.05). Three months after LC/HMD nutrition program treatment, the levels of blood biochemistry index had no significant change (P > 0.05). Three months after LC/HMD nutrition program treatment, the blood glucose fluctuations significantly reduced in all patients. Conclusions For patients with diabetes mellitus and stroke and receiving liquid food treament, LC/HMD nutrition program can significantly improve glycemic index, reduce dependence on insulin, and lower blood sugar fluctuations.
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Objective To explore the distribution and antibiotic resistance of the pathogens in the patients with central venous catheter-related blood stream infection in neurosurgical intensive care unit (NSICU).Methods A total of 452 patients with central venous catheter were identified in NSICU from January 2014 to January 2017.Medical records were reviewed retrospectively to examine the incidence of central venous catheter-related blood stream infections,and the pathogen distribution and antibiotic resistance profile.Results The incidence of central venous catheter-related blood stream infection was 4.6％ (21/452).The incidence of such infection was significantly higher for the catheter in femoral vein (10.5％) than in internal jugular vein (4.0％) and subclavian vein (2.6％) (x2=9.755,P=0.008).Twenty-six strains of pathogen were isolated from the 21 patients,including 13 (50.0％) grampositive bacteria,11 (42.3％) gram-negative bacteria and 2 (7.7％) fungal strains (Candida albicans and Candida parapsilosis each).The most common gram-positive bacteria were Staphylococcus epidermidis(5) and Staphylococcus aureus(3).The most common gram-negative bacteria were Klebsiella pneumoniae(4) and Serratia marcescens(3).The most frequently isolated pathogen of central venous catheter-related blood stream infections was S.epidermidis (19.2％) and K.pneumoniae (15.4％).The antimicrobial susceptibility testing showed that gram-positive bacteria were highly resistant to penicillin,erythromycin,oxacillin and clindamycin.Gram-negative bacteria were highly resistant to cefazolin and piperacillin.The two fungal strain were highly sensitive to fluconazole,voriconazole,itraconazole and amphotericin B.Conclusions The predominant pathogens of central venous catheter-related blood stream infections in NSICU patients are gram-positive bacteria.S.epidermidis and K.pneumoniae are the major pathogens with high level of antibiotic resistance.Aseptic procedures and rational antibiotic therapy according to antimicrobial susceptibility test should be emphasized to control the resistant strains.
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Objective To explore the effect of low-carbohydrate/high-monounsaturated fatty acids (LC/HMD) nutrition program for patients with diabetes mellitus and stroke. Methods Thirty-seven patients with diabetes mellitus and stroke after percutaneous endoscopic gastrostomy (PEG) were enrolled in this study, and these patients were treated with liquid food nutritional support. All patients were given high-carbohydrate (HCD) nutritional support at the first and second day and then changed to LC/HMD nutrition program. The blood glucose fluctuations were monitored by continuous glucose monitoring(CGM) system. Meanwhile the daily dose of insulin injections, glycosylated hemoglobin (HbA1c) and biochemical indicators were detected. for just admission and just give LC after/HMD nutrition program and three months later on HbA1c and blood biochemical indexes were detected. Results 3 months after LC/HMD nutrition program treatment, the levels of mean amplitude of plasma glucose excursions (MAGE), ratio of hyperglycemia to time, ratio of glycopenia to time, HbA1c, daily dose of insulin injections were significantly improved compared with those at the 2nd of LC/HMD nutrition program treatment and with HCD nutritional support (P < 0.05). Three months after LC/HMD nutrition program treatment, the levels of blood biochemistry index had no significant change (P > 0.05). Three months after LC/HMD nutrition program treatment, the blood glucose fluctuations significantly reduced in all patients. Conclusions For patients with diabetes mellitus and stroke and receiving liquid food treament, LC/HMD nutrition program can significantly improve glycemic index, reduce dependence on insulin, and lower blood sugar fluctuations.
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Objective:To compare the immediate therapeutic effect and safety between esmolol and lanatoside in con-trolling ventricular rate for patients with rapid atrial fibrillation.Methods:A total of 72 patients with rapid atrial fi-brillation (ventricular rate ≥120 beats/min)were randomly and equally divided into esmolol group and lanatoside group.Esmolol group received first dosage of 0.5 mg/kg intravenously for 1 min,then were observed for 5 min,if ventricular rate still >100 beats/min or decreased 100 beats/min or decreased0.05)between two groups.Conclusion:Intravenous using esmolol is efficient and safe,and it can be regarded as pre-ferred therapy to control ventricular rate in patients with rapid atrial fibrillation.