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Based on WANG Xugao's “thirty methods of treating the liver”， it is believed that the occurrence and development of childhood tic disorders follow the dynamic progression from liver qi disease to liver fire disease and then liver wind disease. The basic pathogenesis of three stages are characterized by binding constraint of liver qi， liver fire hyperactivity， and internal stirring of liver wind. Moreover， liver-blood deficiency and stagnation， and malnutrition of liver yin as the main point in terms of the imbalance of liver qi， blood， yin， and yang should be considered， as well as the imbalance relationship of the five zang organs such as the involvement of other organs and the gradually reach of the other organs. Guided by the principles of “thirty methods of treating the liver”， the treatment of tic disorders in liver qi stage should focus on soothing the liver and rectifying qi， soothing the liver and unblocking the collaterals， using Xiaochaihu Decoction （小柴胡汤） and Sini Powder （四逆散）. The treatment of tic disorders in liver fire stage involves clearing， draining and resolving liver heat， using Longdan Xiegan Decoction （龙胆泻肝汤）， Xieqing Pill （泻青丸）， Danggui Longhui Pill （当归龙荟丸）， and Huagan Decoction （化肝煎）. The treatment of tic disorders in liver wind stage involves extinguishing wind and subduing yang， using Lingjiao Gouteng Decoction （羚角钩藤汤） and Liuwei Dihuang Pill （六味地黄丸）. Throughout the treatment process， attention should be paid to harmonizing the liver's qi， blood， yin， and yang， as well as addressing the pathology of other organs.
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Porcine epidemic diarrhea (PED) is a highly contagious disease that causes high mortality in suckling piglets. Although several licensed inactivated and live attenuated vaccines were widely used, the infection rate remains high due to unsatisfactory protective efficacy. In this study, mRNA vaccine candidates against PED were prepared, and their immunogenicity was evaluated in mice and pregnant sows. The mRNA PED vaccine based on heterodimer of viral receptor binding region (RBD) showed good immunogenicity. It elicited robust humoral and cellular immune responses in mice, and the neutralizing antibody titer reached 1:300 after a single vaccination. Furthermore, it induced neutralizing antibody level similar to that of the inactivated vaccine in pregnant sows. This study developed a new design of PED vaccine based on the mRNA-RBD strategy and demonstrated the potential for clinical application.
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Pregnancy , Animals , Female , Mice , Swine , Antibodies, Viral , Swine Diseases/epidemiology , Viral Vaccines/genetics , Antibodies, Neutralizing , Vaccines, Attenuated , Diarrhea/veterinaryABSTRACT
Objective@#To explore dynamics of parenting styles of adolescents from 1999 to 2019 from the perspective of intergenerational conflict, to provide support for family education and adolescent healthy development.@*Methods@#Using a multistage stratified cluster random sampling method, the unified questionnaire was administered to 2 590 students in the same sampling junior and senior high schools in 1999, 2009, and 2019 using the Egna Minnen av Barndoms Uppfostran own memories of parental rearing practices in childhood(EMBU).@*Results@#Overall there were differences in the nine factors of parenting styles across generations ( F = 12.07-72.52, P <0.01), with decreasing ratings of warmth and understanding of father and mother (F1, M1), over interference of father (F3) over generations(F1:46.72±9.41, 45.87±11.33, 43.61±11.27; M1:51.56±9.38, 51.03±11.59, 46.23± 12.27 ; F3:19.03±4.00, 18.29±4.32, 17.95±4.51), and all other parenting styles rated higher in 2019 than in 2009 and 1999(except for the over protection and over interference of mother, and punishment, firm control of mother). Parenting styles across generations (except for the rejection and denial of father among girls) showed gender difference.The overall gender trend coincided with the total population trend. Parenting styles across generations varied significantly among middle and high school students( F =3.92-47.27, P <0.05 ), changes in F1 and F3 factors coincided with the overall decreasing trend. Factor analysis showed that parenting styles could be classified into two dimensions, with varied factor loading across generation.@*Conclusion@#Intergenerational decreases in parental emotional warmth and paternal interfering are observed in a sex and grade specific manner. Based on the diversity of needs and population differentiation, optimal intervention for comprehensive health development of adolescents are in great need to keep pace with the times and promoting the high quality development of adolescents.
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The automatic recognition technology of muscle fatigue has widespread application in the field of kinesiology and rehabilitation medicine. In this paper, we used surface electromyography (sEMG) to study the recognition of leg muscle fatigue during circuit resistance training. The purpose of this study was to solve the problem that the sEMG signals have a lot of noise interference and the recognition accuracy of the existing muscle fatigue recognition model is not high enough. First, we proposed an improved wavelet threshold function denoising algorithm to denoise the sEMG signal. Then, we build a muscle fatigue state recognition model based on long short-term memory (LSTM), and used the Holdout method to evaluate the performance of the model. Finally, the denoising effect of the improved wavelet threshold function denoising method proposed in this paper was compared with the denoising effect of the traditional wavelet threshold denoising method. We compared the performance of the proposed muscle fatigue recognition model with that of particle swarm optimization support vector machine (PSO-SVM) and convolutional neural network (CNN). The results showed that the new wavelet threshold function had better denoising performance than hard and soft threshold functions. The accuracy of LSTM network model in identifying muscle fatigue was 4.89% and 2.47% higher than that of PSO-SVM and CNN, respectively. The sEMG signal denoising method and muscle fatigue recognition model proposed in this paper have important implications for monitoring muscle fatigue during rehabilitation training and exercise.
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Electromyography , Memory, Short-Term , Muscle Fatigue , Neural Networks, Computer , Recognition, PsychologyABSTRACT
From July to August 2021, 60 medical staff and general practice trainees in primary care institutions were randomly assigned in two groups with 30 in each group. The control group received conventional ECG training and the study group received ECG training with artificial intelligence image recognition system. The quantitative assessment was conducted before and 2 months after training. There was no significant difference in baseline scores between two groups (43.33±9.94 vs. 44.33±10.33, P>0.005); while the scores of the study group was significantly higher than that of the control group after training (76.00±11.92 vs. 68.00±9.61, P<0.05). Compared with the control group, the correct rates of atrial fibrillation/atrial flutter, sinus arrhythmia and atrioventricular block in study group were significantly higher than those in control group (100.0% vs. 70.0%, 96.7% vs. 73.3%, 86.7% vs. 43.3%; all P<0.05). It is suggested that the application of artificial intelligence ECG recognition system can significantly increase the teaching effect in primary medical training.
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Objective:To investigate the current situation of telephone cardiopulmonary resuscitation (T-CPR) in China, and analyze the reasons for the low implementation rate of T-CPR.Methods:This was a multicenter cross-sectional survey. Twenty cities were selected from six geographical regions of China by convenient sampling method. Anonymous online electronic questionnaires were sent to emergency medical service staffs in each city. All respondents were divided into the routine T-CPR group and control group. Student's t test and Chi-square test were used to analyze the difference between groups. Multivariate logistic regression was used to analyze the influencing factors of T-CPR. Results:⑴A total of 1 191 questionnaires were collected. 80.94% of respondents knew T-CPR. Nine hundred and sixty respondents, who knew T-CPR and completed the questionnaires, were included in the study, and were divided into the routine T-CPR group ( n=401) and control group ( n=559). Nine hundred and thirty-nine (97.81%) responders believed that T-CPR should be implemented for cardiac arrest patients that could be confirmed by telephone.⑵Four hundred and one (41.77%) responders routinely implemented T-CPR. Among them, 237 (24.68%) responders always did and 164 (17.08%) responders often did. ⑶Multivariate logistic regression analysis showed that male ( OR=1.787, 95% CI: 1.235-2.587, P=0.002), age ( OR=1.025, 95% CI: 1.004-1.047, P=0.020), clinical medicine background ( OR=2.926, 95% CI: 1.387-6.171, P =0.005), dispatcher ( OR=5.305, 95% CI: 3.463-8.126, P<0.01), using medical priority dispatch system (MPDS) system ( OR=1.941, 95% CI: 1.418-2.656, P<0.01), and T-CPR policy or procedure ( OR=3.879, 95% CI: 2.652-5.674, P<0.01) were favorable factors for T-CPR. ⑷The top three reasons for implementing T-CPR in the routine T-CPR group were that they had received T-CPR training (67.08%), believed that T-CPR could improve survival rate (63.59%), and had standard T-CPR process (63.09%). The top three reasons for not implementing T-CPR in the control group were that worrying about bystander compliance (42.04%), worrying about the quality of bystander cardiopulmonary resuscitation (CPR) (38.28%), and worrying about medical dispute (36.14%). Conclusions:The awareness and implementation of T-CPR among emergency medical service staffs need to be improved. The implementation of T-CPR depend on telephone dispatchers with clinical medicine background, clear T-CPR policy, standardized operation procedure, and professional assistant tools. To improve the public's awareness of cardiac arrest and cardiopulmonary resuscitation, and to improve the supporting legal system are also conducive to the implementation of T-CPR.
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Objectives To investigate the cognition of dispatcher-initiated telephone cardiopulmonary resuscitation (TCPR) among emergency medical system(EMS) personnel and compare the cognition of TCPR among EMS personnel in different economic status,and to understand the current situation of TCPR cognition of EMS personnel in China.Methods This study is a multicenter crosssectional survey.The method of multi-level convenient sampling was adopted,and the test reliability and split half reliability of the questionnaire was tested.Questionnaire survey and data collection were conducted from December 2018 to June 2019.The ethical approval number is M2018264.SPSS 20.0 was used for analysis.x2 test was used to analyze the differences between groups.Results A total of 1191 electronic questionnaires were collected.Of them,80.94％ respondents knew TCPR,97.82％ respondents thought that TCPR should be implemented in cardiac arrest,36.62％ respondents thought that bystander cardiopulmonary resuscitation quality monitoring was needed in TCPR,and TCPR training courses were set up in the emergency department which recruited 25.83％ respondents.Emergency personnel in developed areas had a better understanding of the criteria for judging patients' breathlessness (11.69％ vs 7.89％,P=0.048),of TCPR need ncluding guidance of chest compression (92.45％ vs 87.49％,P=0.012) and of bystander cardiopulmonary resuscitation (BCPR) quality monitoring including the frequency of artificial respiration (84.42％ vs 74.87％,P=0.029) than those in underdeveloped areas,but there was no significant difference in other indicators (P＞0.05).Conclusions TCPR knowledge of EMS personnel in China is unsatisfactory.Further training is needed to improve their understanding of the criteria for judging cardiac arrest in out-of-hospital cardiac arrest patients via telephone,TCPR content and bystander cardiopulmonary resuscitation quality monitoring.There is difference in TCPR knowledge between the EMS personnel in developed and undeveloped areas in China.
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Objective@#To evaluate the effect of massage combined with external application of Xiaoji powder on Shenque point in treating children’s functional constipation (FC) of gastrointestinal heat accumulation syndrome.@*Methods@#A total of 88 FC children who met the inclusion criteria were randomly divided into two groups, 44 in each group. The control group was treated with viablebifidobacterium tetrad tablets orally, while the treatment group was treated with massage combined with external application of Xiaoji powder on Shenque point. Both groups were treated for 18 days. Before and after treatment, TCM syndromes were scored from the main symptoms and secondary symptoms to evaluate the clinical efficacy.@*Results@#The effective rate was 93.2% (41/44) in the treatment group and 65.9% (29/44) in the control group. There were significant differences between the two groups (χ2=9.058, P=0.004). After treatment, the scores of main symptoms (3.8 ± 0.6) and minor symptoms (1.7 ± 0.4) in the treatment group were significantly lower than those in the control group (6.8 ± 1.3) and (3.1 ± 0.4) (t=13.899, 16.417, respectively, P<0.05).@*Conclusions@#Massage combined with external application of Xiaoji powder on Shenque point can improve the constipation symptoms and clinical efficacy of children suffering from FC of gastrointestinal heat accumulation syndrome.
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Objective To analyze the impact of diagnostic staging laparoscopy in gallbladder carcinoma and hilar cholangiocarcinoma.Methods The Medline,Embase,Web of Science,Cochrane library and Google Scholar were searched for literature on staging laparoscopy (SL) in gallbladder carcinoma and hilar cholangiocarcinoma.The sensitivity,specificity and diagnostic accuracy of SL were evaluated.Results Eight studies were included in the meta-analysis.During laparoscopy,unresectable disease was found in 316 of 1 062 patients (29.8％),of whom 32.4％ were patients with suspected hilar cholangiocarcinoma (HC) and 27.6％ were patients with suspected gall-bladder cancer (GBC).The sensitivities were 0.556 (95％ CI:0.495-0.616) for patients with HC and 0.642 (95％ CI:0.579-0.701) for patients with GBC.The pooled specificity for SL was 100％ (95％ CI:0.993-1.000) for all the studies.Conclusion For patients with gallbladder cancer or hilar cholangiocarcinoma,SL combined with intraoperative ultrasound improved the accuracy of diagnosis and avoided unnecessary laparotomy.
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Objective:To observe the effect of intravenous anesthesia with target-controlled infusion (TCI) of remifentanil combined with propofol on hemodynamics in middle-aged and elderly patients with intracranial aneurysm clipping. Methods:Totally 40 cases of middle-aged and elderly patients undergoing intracranial aneurysm clipping were divided into combined anesthesia group and propofol group according to the random number table. The combined anesthesia group was treated with remifentanil combined with propofol target intravenous anesthesia, and propofol group was treated with propofol intravenous hypotension. The changes of mean arterial pressure(MAP),heart rate(HR),cardiac output(CO) and heart index(CI) before the induction of anesthesia (T1), tracheal intubation (T2), before aneurysm clipping(T3), after aneurysm clipping(T4) and extubation (T5) were observed. The anesthesia maintenance time, extubation time, postoperative wake-up time and adverse reactions were compared. Results:There were no significant differences in MAP and HR between the groups(P > 0.05), the levels of MAP,HR,CO and CI at T2,T3and T4were significantly lower than those at T1,and CO and CI were significantly lower in combined group than those in propofol group(P < 0.05). Conclusion:TCI remifentanil combined with propofol can maintain hemodynamic stability, shorten extubation time and wake-up time, and reduce the incidence of adverse reactions in the patients with intracranial aneurysm clipping.
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Objective To explore the multiple disciplinary model of emergent extracorporeal membrane oxygenation (ECMO) for cardiac arrest (CA) patients.Methods A retrospective investigation was done to analyze the general material,multiple disciplinary corporations,the complication and its treatment of patients who underwent emergent ECMO for non-surgery CA from January 2016 to August 2017.Results Three patients were all men with mean age 45.3 ± 20.3 years.Their mean cardiopulmonary resuscitation duration was 34 ± 10 min,and 2 patients returned to spontaneous circulation,yet hemodynamics instability.2 patients discharged with cerebral performance category 1-2,however the third died.3 cannulation of femoral artery and venous were all operated by cardiac surgery using surgical exposure via open cutdown.Mean duration of CA to ECMO pump-on was 132 ±93 min,while the mean duration of ECMO was 3 858 ± 1 092min.The implementation and maintenance of ECMO needed collaboration of emergent physicians,cardiovascular medicine and surgeon,anesthetists,nurses and so on.At the same time,incision site oozing blood,platelet counting decreasing,coagulopathy and other complications would occur,which needed interventional vascular surgeon and blood bank to participate in.Conclusions Emergent ECMO for CA patients need corporations of prehospital emergent medical system,emergent physicians,cardiovascular physicians and surgeons,anesthetists,perfusionists,blood bank and so on.Establishing coordination and cooperation model of multiple disciplinary quick response team with emergency department as the guide is the important guarantee for emergent department developing emergent extracorporeal resuscitation.
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Objective:To explore the immunity provided to BALB/c mice by immunization with the recombinant ricin B chain protein (rRTB). Methods:Female BALB/c mice were randomly selected into rRTB-vaccinated group and PBS group. Mice were subcu-taneously (s. c. ) injected four times with 14 days immunization time interval. Changes of antibodies (IgG,IgG1and IgG2a) in serum were detected by ELISA. Meanwhile,the expression of IL-4 and IFN-γ were detected by flow cytometry. Results:The mean IgG titers reached 106 after the fourth immunization and a strong secondary response was induced in vaccinated mice when challenged with toxin. There was significant difference between rRTB-vaccinated group and PBS group ( P<0. 05 ) . The same result was shown in IgG1. However,no changed was detected in IgG2a. Meanwhile,there was significant difference for IL-4 between two groups (P<0. 05), while no significant difference for IFN-γwas observed. Conclusion:rRTB can produce higher levels of antigen-specific antibodies ( IgG and IgG1),and cytokine (IL-4) of splenocytes,which means the recombinant protein can induce the Th2-type immune response and trigger a good immune response. rRTB may be a potentially valuable vaccine candidate against human exposure to AT.
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Objective To investigate the expressions of carbohydrate antigen 19-9(CA19-9), carbohydrate antigen 15-3(CA15-3) and carbohydrate antigen 125(CA125) and their clinical significance in papillary thyroid carcinoma (PTC). Methods The expressions of CA19-9, CA15-3 and CA125 were detected by immunohistochemical MaxVision method in 80 cases of PTC and 80 cases of benign thyroid lesions (BTL), including 34 cases of nodular goiter, 26 cases of Hashimoto's thyroiditis and 20 cases of follicular adenoma. The relationship between expressions of CA19-9, CA15-3 and CA125 and the clinical pathological characteristics were analyzed. Results The expression rates of CA19-9, CA15-3 and CA125 in 80 cases of PTC were 85%, 100%and 43.8%respectively, compared with BTL, the difference was statistically significant (P 0.05). The sensitivity of CA19-9, CA15-3 and CA125 in the differential diagnosis of PTC and BTL were 85%, 100% and 43.8% respectively, and the specificity were 91.3%, 36.3%and 91.3%, respectively. Conclusion The expressions of CA19-9, CA153 and CA125 are helpful for the differential diagnosis of PTC and BTL.
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OBJECTIVE@#To evaluate the therapeutic effects of recombinant Exendin-4 and double-stranded adeno-associated virus (Exendin-4/dsAAV) on SD rats with type 2 diabetes (T2DM) through injecting it into submandibular gland (SG). @*METHODS@#The Exendin-4/dsAAV was injected into submandibular gland of diabetic rat. The insulin and α-amylase were detected by real-time PCR at the 2nd, 4th and 8th weeks. The immunohistochemisty was used to detect the insulin contents in SG at the 8th week. The concentration of blood glucose and levels of insulin secretion were detected after pancreatectomy. @*RESULTS@#The SG gland was bigger in Exendin-4/dsAAV group than that in the control group, but the changes in α-amylase were not significant. The Exendin-4 and insulin gene expression was increased in the Exendin-4/dsAAV group (P<0.05). The Exendin-4 and insulin were positive in the SG. The blood glucose was lower and insulin concentration was higher in the Exendin-4/dsAAV group than those in the control group after pancreatectomy (P<0.05), and the insulin content was also increased in the dsAAV groups. @*CONCLUSION@#Continuous expression of Exendin-4 in SG may improve glucose control and insulin secretion in T2DM rats through inducing expression of insulin.
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Animals , Rats , Blood Glucose , Dependovirus , Diabetes Mellitus, Experimental , Therapeutics , Diabetes Mellitus, Type 2 , Therapeutics , Exenatide , Genetic Therapy , Injections , Insulin , Chemistry , Peptides , Genetics , Therapeutic Uses , Rats, Sprague-Dawley , Real-Time Polymerase Chain Reaction , Recombinant Proteins , Genetics , Therapeutic Uses , Submandibular Gland , Chemistry , Venoms , Genetics , Therapeutic Uses , alpha-Amylases , ChemistryABSTRACT
A new method was developed for the separation and determination of inosine monophosphate (IMP) by ion chromatography (IC) with suppressed conductivity detection. Separation was achieved on an anion-exchange column Ionpac AS11-HC of high capacity within a short time. 30 mmol/L KOH produced by an EGC-KOH eluent generator was used for isocratic elution. No interferences existed between the seven common inorganic anions and IMP. Under the optimum conditions, the linear range of the calibration curve for IMP was 1. 0-200 mg/L, with correlation coefficient ( R2 ) of 0. 999. The relative standard deviations (RSDs) for retention time, peak height and peak area of IMP were 0. 16%, 0. 94% and 0. 86%, respectively, indicating good reproducibility of the method. The method was successfully applied to the determination of IMP in meat products, with spiked recovery ranging from 86. 0% to 110. 0%. This simple, accurate and reliable method could be served as a rapid and effective analytical tool for meat flavoring research.
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Objective To find the course of theme evolution for study of medical protection against nerve agents.Meth-ods A method of information visualization based on co-cited analysis was used.The research domain of medical protection against nerve agents was mapped using software VOSviewer.Results There were five research clusters including clinical research, oxime reactivators, detoxification and detection,and bioscavengers.Conclusion Theme evolution is described and research trends are predicted.
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Objective To provide reference for effective scientific literature novelty assessment by investigating its recognition in medical and health staff of a military area command and their use of information resources and need of information .Methods Knowledge of scientific literature novelty assessment , satisfaction of scientific literature novelty assessment report, need and use of information resources were investigated in 149 staff of 9 hospitals with self-de-signed questionnaire .Results The general recognition and satisfaction levels of scientific literature novelty assess-ment were good in medical and health staff of a military area command .However , the information resources were insufficiently used , which was related with the scientific research level and scientific literature novelty assessment popularization .Conclusion Scientific literature novelty assessment should be popularized , staff engaged in scientific literature novelty assessment should be trained, sharing of information resources should be strengthened , and infor-mation service should be expanded and deepened in military area commands.
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Objective:To observe the effect of metformin on the expression of SIRT1 and UCP2 in rat liver of type 2 diabetes mellitus (T2DM) with nonalcoholic fatty liver disease (NAFLD), and discuss the pathogenesis of T2DM with NAFLD, and the treatment with and possible mechanism of metformin.Methods:Thirty-six male SD rats were randomly divided into a normal control group (group NC, n=12), a T2DM with NAFLD group (group MC, n=12), and a metformin group (group A, n=12). We established the model of T2DM with NAFLD rats by feeding high-fat and high-sugar diet and injecting STZ. After the success establishment of the model, the metformin group was given metformin 300 mg/(kg.d) for 8 weeks. At the end of the experiment, we measured FBG, ALT, AST, TC, TG, HDL-C, LDL-C, VLDL, FFAs, FINs and HOMA-IR respectively in group NC, MC and A. We observed the change of liver tissue pathology by HE, determined the expression of SIRT1 and UCP2 in rat liver by immunohistochemical method and real-time quantitative method. Results:FBG, ALT, AST, TC, TG, LDL-C, VLDL, FFAs, FINs and HOMA-IR were higher in group MC than in group NC (P Conclusion:The expression of SIRT1 is low and the expression of UCP2 is high in rat liver of T2DM with NAFLD. Metformin can increase the expression of SIRT1 and reduce the expression of UCP2, with negative correlation between the expression of SIRT1 and UCP2.
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Objective To analyze the hypothalamic-pituitary-adrenal axis function in type 2 diabetes mellitus(T2DM) patients combined with depression with different courses.Methods Forty T2DM without depression patients (T2DM without depression group) and 42 T2DM combined with depression patients (T2DM combined with depression group) were divided into 3 groups according to the courses:＜ 5years,5-15 years,＞ 15 years.Thirty healthy person were selected as control group.The levels of serum adrenocorticotropic hormone (ACTH),cortisol (Cor),fasting blood glucose (FPG),glycosylated hemoglobin (HbA1c),24 h urinary-free cortisol (UFC) were determined at 8:00 Am.Results The levels of serum ACTH,24 h UFC in T2DM without depression group were higher than those in control group [(241.7 ±132.6) pg/L vs.(174.1 ± 108.2) pg/L and (96.67 ± 15.92) μg vs.(76.04 ±24.60) μg],and there were significant differences (P ＜ 0.05 or ＜ 0.01).There were no significant differences in the levels of serum ACTH,Cor,24 h UFC among ＜ 5 years,5-15 years,＞ 15 years in T2DM without depression group (P＞0.05).The levels of serum Cor,24 h UFC in T2DM combined with depression group were higher than those in T2DM without depression group and control group,and there were significant differences (P ＜ 0.01),but compared with those in T2DM without depression group with the same courses,only ACTH was different in ＜5 years (P ＜ 0.01),Cor,24 h UFC was different in ＞ 15 years (P ＜ 0.01).There was significant difference in the level of serum ACTH between ＜ 5 years and 5-15 years,＞ 15 years in T2DM combined with depression group (P ＜ 0.01),Cor had no difference among different courses (P ＞ 0.05),24 h UFC had difference between ＞ 15 years and ＜ 5 years,5-15 years (P＜ 0.01 or ＜ 0.05).In T2DM without depression group,the level of serum Cor was positively correlated with FPG (P ＜ 0.01),the level of serum ACTH was positively correlated with FPG (P ＜0.05).In T2DM combined with depression group,the level of serum Cor was positively correlated with FPG,HbA1c (P ＜ 0.01),the level of serum ACTH was no relationship with others,the level of serum 24 h UFC was positively correlated with FPG,HbA1c (P＜ 0.01).Conclusion With the prolonged courses of diabetes,the function of hypothalamic-pituitary-adrenal axis gets worse in T2DM patients combined with depression.
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<p><b>OBJECTIVE</b>To observe the expression of SIRT1 and mitochondrial uncoupling protein 2 (UCP2) in the liver of rats with type 2 diabetes mellitus (T2DM) and nonalcoholic fatty liver (NAFLD) and explore the possible pathogenesis of T2DM and NAFLD.</p><p><b>METHODS</b>Twenty-four male SD rat were randomized equally into control group and T2DM and NAFLD group (MC group), fed with standard diet and high-fat and high-sugar diet, respectively. At 12 weeks, the rats in MC group received a single dose of STZ (30 mg/kg) injected into the abdominal cavity for pancreatic islet destruction, and those in the control group received an equivalent volume of citric acid buffer. At 14 weeks, the body weight, FBG, hepatic function, blood lipid levels, FFAs, FINs and HOMA-IR of the rats were measured, and the liver pathology was examined with HE staining. The expression of SIRT1 and UCP2 in the rat liver was detected by immunohistochemistry and real-time quantitative PCR.</p><p><b>RESULTS</b>At 14 weeks, FBG, ALT, AST, TC, TG, LDL-C, VLDL, FFAs, FINs and HOMA-IR were significantly higher and HDL-C was significantly lower in MC group than in the control group (P<0.05). Pathological examination showed good structural integrity of the liver in the control group, and the liver cells were closely arranged with rich cytoplasm and round cell nuclei; in MC group, moderate to severe fatty liver was detected, and the liver cells showed severe ballooning degeneration and contained lipid vacuoles in the cytoplasm. The expression of SIRT1 was significantly lower and UCP2 significantly higher in MC group than in the control group (P<0.05).</p><p><b>CONCLUSION</b>The expression of SIRT1 is significantly lowered and UCP2 increased in the liver of rats with T2DM and NAFLD.</p>