Combined Effects of Chronic Obstructive Pulmonary Disease and Depression on Spatial Memory in Old Rats / 中国医学科学杂志(英文版)

Objective To investigate the combined effects of chronic obstructive pulmonary disease (COPD) and depression on spatial memory in old rats, aiming to better understand the comorbidity of the two diseases in geriatric patients. Methods The SD rats were assigned into five groups: adult control group (n=6), elderly control group (n=6), elderly COPD group (n=6), elderly depression group (n=6) and elderly COPD with depression group (n=6). Smoking and chronic unpredictable mild stress (CUMS) with solitary support were used to induce COPD model, depression model, respectively, and the both were applied for the comorbidity model. Learning and memory deficits were assessed by Morris water maze (MWM) test. The activity of superoxide dismutase (SOD) and the content of malondialdehyde (MDA) in serum and hippocampus tissue were determined by Xanthinoxidase method and Thiobarbituric acid reaction (TBAR) method, respectively. Results The results of pulmonary histology, lung function, open-field test and sucrose consumption demonstrated the comorbidity models of COPD and depression in elderly rats were successfully established using smoking and CUMS with solitary support. Compared with the elderly control group, the group of COPD with depression had obviously longer time of latency and longer travel distance to reach the platform in MWM test (LSD-t=-10.116, P=0.000; LSD-t=-6.448, P=0.000). The SOD activity in serum and hippocampus decreased significantly (LSD-t=2.629, P=0.014; LSD-t=2.215, P=0.044) and the MDA content in serum and hippocampus increased significantly (LSD-t=-2.140, P=0.042; LSD-t=-2.070, P=0.049) in elderly COPD with depression group. Conclusions COPD in comorbidity of depression could induce spatial memory deficit in old rats. The mechanisms might be related to the overloaded and free radical metabolic imbalance. These results suggest a potential therapeutic target for comorbidity of COPD and depression in geriatric patients.

Impact of psychosocial stress on airway inflammation and its mechanism in a murine model of allergic asthma / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>It has already been recognized that psychosocial stress evokes asthma exacerbation; however, the mechanism of how stress gets inside the body is not clear. This study aimed to observe the impact of psychosocial stress on airway inflammation and its mechanism in the ovalbumin-induced asthmatic mice combined with social disruption stress.</p><p><b>METHODS</b>Thirty-six male BALB/c mice were randomly divided into: control group, asthma group (ovalbumin-induced), asthma plus social disruption stress group (SDR), and SDR group. The open field video tracking system was used to assess animal behaviors. The invasive pulmonary resistance (RL) and dynamic lung compliance (cdyn) test system from Buxco was applied to detect pulmonary function. The enzyme-linked immunosorbent assay (ELISA) was utilized to determine OVA-IgE, T-helper type 2 (Th2) cytokines (IL-4, IL-5, IL-13) and corticosterone in mouse serum, the Th2 cytokines (IL-4, IL-5, IL-13, IL-6, TNF-α) in bronchoalveolar lavage fluid (BALF), and IL-6 and TNF-α levels in the supernatant of splenocytes cultured in vitro. Hematoxylin-eosin (H&E) staining was used to assess airway inflammation in lung histology. The cell count kit-8 assay (CCK-8) was applied to evaluate the inhibitory effect of corticosterone on splenocyte proliferation induced by lipopolysaccharide (LPS). Real time-PCR and Western blotting were utilized to determine glucocorticoid receptor (GR) mRNA and GR protein expression in lungs.</p><p><b>RESULTS</b>The open field test showed that combined allergen exposure and repeated stress significantly shortened the time the mice spent in the center of the open field (P < 0.01), increased ambulatory activity (P < 0.01) and the count of fecal boli (P < 0.01), but deceased vertical activity (P < 0.01). Results from pulmonary function demonstrated that airway hyperresponsiveness (AHR) was enhanced by psychosocial stress compared with allergy exposure alone. The ELISA results showed that cytokines in serum and BALF were significantly increased (P < 0.05). Moreover, the lung histology showed that infiltrated inflammatory cells were significantly increased in the asthma-SDR group compared with the asthma group (P < 0.05). Interestingly, serum corticosterone was remarkably raised by psychosocial stress (P < 0.05). In addition, the inhibitory effect of corticosterone on IL-6 and TNF-α in LPS-stimulated splenocyte cultures in vitro was diminished in the asthma-SDR group compared to the asthma group. The CCK-8 test revealed that the inhibition effect of corticosterone on splenocyte proliferation induced by LPS was significantly impaired in the SDR and asthma-SDR groups, while no significant effect was observed in the control and asthma groups. Furthermore, expression of GR mRNA and GR protein were significantly reduced in the lung tissues of the asthma-SDR group (P < 0.05).</p><p><b>CONCLUSIONS</b>Social disruption stress can promote anxiety behavior, activate the hypothalamic-pituitary-adrenal (HPA) axis, increase AHR and inflammation, and also impair glucocorticoid sensitivity and its function in a murine model of asthma. The down-regulation of GR expression induced by social disruption stress is in part associated with glucocorticoid insensitivity, which leads to asthma exacerbation.</p>

Effects of resolving method of Chinese medicine on the lipid metabolism in polycystic ovary syndrome accompanied with non-alcoholic fatty liver disease / 中国中西医结合杂志

<p><b>OBJECTIVE</b>To observe the therapeutic effect of resolving method of Chinese medicine (CM) on the lipid metabolism in polycystic ovary syndrome (PCOS) patients accompanied with non-alcoholic fatty liver disease (NAFLD), to analyze the correlation between PCOS and NAFLD, and to study its mechanisms.</p><p><b>METHODS</b>Totally 70 female PCOS patients in the reproductive age (20 -40 years old) were recruited. Among them, 35 PCOS patients accompanied with NAFLD were recruited as Group A, and 35 PCOS patients without complicated NAFLD were recruited as Group B. At the same time, 20 healthy female volunteers were recruited as the control group. All subjects had their personal medical records after relevant questionnaire. Their clinical data including body height (BH), body weight (BW), body mass index (BMI), waist circumference (WC), hip circumference (HC), testosterone (T), prolactin (PRL), follicle stimulating hormone (FSH), luteinizing hormone (LH), estradiol (E2), leptin, fasting blood glucose (FBG), fasting insulin (FINS), 2 h postprandial blood glucose (2 h PBG), homeostatic model assessment for insulin resistance (HOMA-IR), total cholesterol (TC), triglyceride (TG), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), etc. were detected. Patients in Group A were treated by the resolving method for 3 months. The follow-up was continued for 6 months after ending treatment.</p><p><b>RESULTS</b>The levels of BW, BMI, WHR, T, LH, LH/FSH, leptin, FINS, 2 h PBG, HOMA-IR, and LDL-C were significantly higher in Group B than in the control group (P < 0.05). The level of FSH was significantly lower in Group B than in the control group (P < 0.05). The levels of BW, BMI, WC, HC, waist-hip-ratio (WHR), leptin, FINS, 2 h PBG, HOMA-IR, TG, LDL-C, ALT, and AST were significantly higher in Group A than in Group B (P < 0.05). The HDL-C level was significantly lower in Group A than in Group B (P < 0.05). In Group A after treatment by resolving method of CM, the menstrual cycle was recovered in 83.87% patients (26/31 cases), reduced fatty liver degree or disappearance of fatty liver degree occurred in 32.26% patients (10/31 cases), with the total effective rate being 85.71% (24/28 cases).48.28% (14/29) patients were pregnant. The levels of BW, BMI, FBG, leptin, TG, ALT, and AST significantly decreased when compared with those before treatment (P < 0.05). The level of SHBG significantly increased (P < 0.05). There was no significant difference in the levels of HOMA-IR, FINS, T, FSH, LH, or LH/FSH between before and after treatment (P > 0. 05).</p><p><b>CONCLUSIONS</b>The metabolic disorder of glycolipid exists in PCOS patients, and more serious in PCOS patients accompanied with NAFLD. Resolving method can effectively restore the metabolic disturbance in PCOS patients accompanied with NAFLD, recover their fatty liver degrees, recover normal menstrual cycles, and elevate their pregnancy rates. Further studies are necessary on whether its mechanisms lie on lowering leptin levels and correcting lipid metabolisms to relieve patient's clinical symptoms.</p>

Pathogenesis of idiopathic pulmonary fibrosis: from initial apoptosis of epithelial cells to lung remodeling? / 中华医学杂志(英文版)

Idiopathic pulmonary fibrosis (IPF) is a progressive and often fatal form of interstitial lung disease. Despite extensive efforts in research during recent years, the mechanisms of the disease remain poorly understood. Evidence of an inflammatory mechanism, both supportive and contrary, is briefly reviewed in this paper. However, growing evidence has indicated that the apoptosis of alveolar epithelial cells (AECs) may be the early driving force of progression, with subsequent disrupted integrity of the alveolar-capillary basement membrane leading to an abnormal wound healing pathway. Thus, this paper will focus on outlining a process of pathogenesis of IPF from initial apoptosis of AECs to end lung remodeling.

Study on the relation between Pi-deficiency pattern and metabolic syndrome in patients with polycystic ovarian syndrome / 中国中西医结合杂志

<p><b>OBJECTIVE</b>To evaluate the relation between Pi-deficiency syndrome (PDS) pattern and metabolic syndrome (MS) in patients with polycystic ovarian syndrome (PCOS), for exploring their internal pathologic mechanism.</p><p><b>METHODS</b>Among the 102 PCOS patients, 22 complicated with MS (PCOS-MS) and 80 not complicated with MS (PCOS-NMS), the Chinese medicine syndrome pattern was differentiated as PDS in 50 patients and non-PDS in 52. The clinical data, in terms of fasting blood glucose (FBG), fasting insulin (FINS), waistline, body weight (BW), stature, blood pressure (BP), etc. was collected and compared and the relation between data was analyzed.</p><p><b>RESULTS</b>Levels of FINS and homeostasis model of assessment for insulin resistence index (HOMA-IR), in PCOS-MS patients were significantly higher than those in PCOS-NMS patients, also higher in patients of PDS pattern than those of non-PDS pattern (P < 0.01); the occurrences of MS and PDS were highly positively correlated with levels of FINS and HOMA-IR (P < 0.01); incidence of MS in patients of PDS pattern was significantly higher than those in patients of non-PDS pattern (P < 0.05); presenting of PDS was positively related with the existence of MS (P < 0.05), but in case of the FINS or HOMA-IR factor being controlled, statistical meaning of the relativity between them turned to insignificant (P > 0.05).</p><p><b>CONCLUSIONS</b>PCOS patients of PDS pattern are the high-risk population of MS, which might be related with the insulin resistance. So, early treatment of PCOS, especially on patients of PDS pattern, is of important significance for preventing the complication, as MS, of the disease.</p>