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ObjectiveTo investigate the effect of Dendrobii Caulis mixture on cell inflammatory response and apoptosis in diabetic rat with non-alcoholic fatty liver disease（NAFLD） and its possible mechanism. MethodForty male SD rats were randomly divided into blank group and model group of type 2 diabetes mellitus（T2DM） with NAFLD according to body weight. The model was established by high-sugar and high-fat diet combined with intraperitoneal injection of streptozotocin（STZ）， which was randomly divided into the model group， Dendrobii Caulis mixture group（16.67 g·kg-1·d-1） and metformin group（100 mg·kg-1·d-1） according to blood glucose and body weight， and 10 rats in each group. Rats in each group were administered by continuous gavage for 4 weeks， the blank and model groups were given saline by gavage at 10 mL·kg-1·d-1. Fasting blood glucose（FBG）， serum insulin（INS）， glycosylated serum protein（GSP）， triglyceride（TG）， total cholesterol（TC）， high density lipoprotein（HDL-C）， low density lipoprotein（LDL-C）， alanine aminotransferase（ALT） and aspartate aminotransferase（AST） were detected in each group of rats. The liver tissues of rats in each group were stained with hematoxylin-eosin（HE） to observe the pathological changes， and the positive expressions of nuclear transcription factor（NF）-κB， NOD-like receptor heat protein structural domain-related protein 3（NLRP3）， interleukin（IL）-1β and tumor necrosis factor（TNF）-α were observed by immunohistochemistry. Western blot and fluorescence quantitative polymerase chain reaction（Real-time PCR） were used to detect the protein and mRNA expression of B-cell lymphoma-2（Bcl-2）， Bcl-2 associated X protein（Bax）， Caspase-3 and NF-κB p65， NLRP3， IL-1β， TNF-α in liver tissue of rats in each group. ResultCompared with the blank group， FBG， GSP， TC， TG， LDL-C， AST and ALT levels were increased， INS and HDL-C levels were decreased， Bax， Caspase-3， NLRP3， IL-1β， TNF-α protein and mRNA expression were increased in model group， the ratio of p-NF-κB/NF-κB protein increased， the expression of Bcl-2 protein and mRNA decreased， and the positive immunohistochemical expression of NF-κB， NLRP3， IL-1β and TNF-α increased， and the differences were statistically significant（P<0.01）. The morphological structure of the liver was disrupted， and obvious fat vacuoles were seen. Compared with the model group， FBG， GSP， TC， TG， LDL-C， AST and ALT levels of Dendrobii Caulis mixture group and metformin group were decreased， INS and HDL-C levels were increased， and protein and mRNA expressions of Bax， Caspase-3， NLRP3， IL-1β and TNF-α were decreased， the protein ratio of p-NF-κB/NF-κB decreased， the expression of Bcl-2 protein and mRNA increased， and the positive immunohistochemical expressions of NF-κB， NLRP3， IL-1β and TNF-α decreased， and the differences were statistically significant（P<0.01）. The liver morphology and structure were relatively complete， and the fat vacuoles were reduced. ConclusionDendrobii Caulis mixture can inhibit cell apoptosis， reduce inflammatory response and alleviate liver injury in rats with T2DM and NAFLD， the mechanism may be related to inhibiting the activation of NF-κB pathway， blocking the activation of NLRP3 inflammatory vesicles， reducing IL-1β secretion， attenuating Caspase-3 activity and reducing the ratio of Bcl-2/Bax.
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Objective:To analyze the perinatal outcomes of unicornuate uterus pregnancy.Methods:The clinical data of patients with unicornuate uterus pregnancy who delivered between January 2009 and December 2018 in Women′s Hospital, School of Medicine, Zhejiang University, were reviewed retrospectively. Live birth was defined as the delivery of a baby after at least 28 weeks gestational age. Ninety-eight patients were diagnosed as unicornuate uterus, while 4 cases of stillbirth and 4 cases of twin pregnancy and 10 cases of incomplete data were excluded, and 80 patients with unicornuate uterus were included in the observation group. By matching the age, gestational age and delivery mode, 160 patients were randomly selected as the control group. The perinatal outcomes such as delivery mode, cesarean section indication sequence, postpartum hemorrhage, vaginal delivery time, newborn birth weight and Apgar score were analyzed retrospectively.Results:In the unicornuate uterus group, there were 10 cases of vaginal delivery and 70 cases of cesarean section, among which the primary indication of premature cesarean section and full-term cesarean section was abnormal fetal position, accounting for 7/18 and 50.0% (26/52), respectively. While in the control group, there were 20 cases of vagianl delivery and 140 cases of cesarean section, among which the main indications of premature cesarean section were placenta previa, intrahepatic cholestasis during pregnancy and scar uterus, accounting for 19.4% (7/36), and the primary indication of full-term cesarean section was abnormal fetal position, accounting for 23.1% (24/104). The postpartum hemorrhage of the vaginal delivery in the unicornuate uterus group and the control group was (319±161) and (261±152) ml, respectively, and the postpartum hemorrhage of the cesarean section delivery was (257±106) and (272±123) ml, respectively. There were no significant differences between the two groups statistically (all P>0.05). The time of the first stage of labor was (502±386) and (465±296) minutes in the unicornuate uterus group and the control group, and the time of the second stage was (74±73) and (47±30) minutes, respectively. There were no significant differences between the two groups statistically (all P>0.05). The neonatal birth weight in the unicornuate uterus group and the control group was (3 018±548) and (3 080±562) g, respectively, and there was no significant difference between the two groups statistically ( P=0.42). According to preterm birth and different pre-pregnancy body mass index, the neonatal birth weight of the two groups were compared, and the differences were not statistically significant (all P>0.05). One-minute Apgar score of premature in the unicornuate uterus group and the control group were 10 (9.25-10) and 10 (10-10), 5-minute Apgar score were 10 (10-10) and 10 (10-10), respectively. One-minute Apgar score of full-term in the unicornuate uterus group and the control group were 10 (10-10) and 10 (10-10), 5-minute Apgar score were 10 (10-10) and 10 (10-10), respectively. There were no statistically significant differences between the two groups, respectively (all P>0.05). Conclusions:The patients with unicornuate uterus could give birth vaginally in the absence of other operation indications. The perinatal outcome of women with unicornuate uterus is similar to that of women with non-uterine abnormalities. It is found that the abnormal fetal position with unicornuate uterus is the main reason for cesarean section.
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Objective This study examined the prevalence of underweight and its related risk factors of community-dwelling patients with schizophrenia. Methods Five hundred and three community-dwelling patients with schizophrenia and 323 healthy controls were recruited in a cross-sectional study. Body mass index less than 18.5 was defined as underweight. Their demographic and clinical data including anthropometric data, plasma glucose and lipid parameters were collected. The Positive and Negative Syndrome Scale (PANSS) was used to assess patients' psychopathology. Results The prevalence of underweight was 9.9% (50/503) in schizophrenia patients versus 1.5% (5/323) in the control group ( P<0.01). Further logistic regression analysis showed that male ( OR=2.43, 95%CI:1.74~3.39), smoking behavior (OR=1.50, 95%CI: 1.21~1.86), hospitalization times (OR=1.18, 95% CI: 1.06~1.31), PANSS negative score (OR=1.09, 95% CI: 1.04~1.14) were significant predictors for underweight (all P<0.05). Conclusion The prevalence of underweight is higher in Chinese patients with schizophrenia than in the general population. Some demographic and clinical variables are risk factors for underweight in schizophrenia.
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Objective To compare cognitive function and alexithymia between the schizophrenic patients treated with chlorpromazine and those treated with clozapine. Methods The patients with schizophrenia in stable condition that received maintenance treatment either with chlorpromazine or clozapine and normal control subjects were recruited (n=24 per group). Neuropsychological tests, including Digit Vigilance Test, Controlled Oral Word Association Test, Trail Making Test-A&B (TMT-A&B), Animal Naming Test, Stroop Color-Word Test, Block Design and Spatial Span Test were used to assess the participant’s cognitive function. The twenty-item Toronto Alexithymia Scale (TAS-20) were used to evaluate the participant’s alexithymia. Results The significant differences were found between the patients and the controls in all items of cognitive function and all factor scores of TAS-20 (P0.05). Multivari? ate linear regression analysis showed that in the clozapine group, attention function associated with the total score of TAS (β=-0.20, P<0.05), executive function associated with TAS factor 1 (β=-0.26, P=0.03), spatial function associated with TAS factor 2 (β=-0.24, P<0.01). In the chlorpromazine group, attention function associated with TAS factor 2 (β=-1.24, P<0.01), executive function associated with TAS factor 2 (β=-0.33, P=0.02). Conclusions Patients with schizophrenia in maintenance period have widely cognitive impairment and alexithymia, both of which are related to each other.