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Objective To discuss the application value of the peritoneal catheter via pneumoperitoneum puncturation in cerebral spinal fluid (CSF) peritoneal shunt surgery. Methods The clinical data of 490 hydrocephalus patients admitted to Zhejiang Provincial Tongde Hospital from June 2002 to December 2016 were retrospectively analyzed, among them 147 cases accepted ventriculoperitoneal shunt (VPS) operation from June 2002 to January 2009 were assigned as a control group (open abdomenal catheterization group), and 343 cases accepted pneumoperitoneum puncturation from February 2009 to December 2016 were arranged as an observation group (abdominal paracentesis group). The patients in the abdominal paracentesis group were further subdivided into a VPS group (228 cases) and a lumboperitoneal shunt (LPS) group (115 group) according to different ways of catheterization. The clinical data such as infection, shunt obstruction (blockage), bleeding and other complications (such as insufficient or excessive drainage, bleeding, epilepsy, intestinal obstruction) 6 mouths after operation were collected in open catheterization group and abdominal paracentesis group, the difference of incidences of complication in each group were compared. Results The incidences of infection [10.20% (15/147) vs. 3.79% (13/343)], shunt obstruction [14.29% (21/147) vs. 7.58% (26/343)], other complications [23.13% (34/147) vs. 10.79% (37/343)] in open catheterization group were significantly higher than those in abdominal paracentesis group (all P < 0.05); the rate of shunt obstruction in VPS group was higher than that in LPS group [9.65% (22/228) vs. 3.48% (4/115), P < 0.05]. Conclusions Pneumoperitoneum puncturation is a simple, safe, minimally invasive technique to implant an abdominal cavity shunt catheter in CSF peritoneal shunt surgery, and it can effectively reduce the rates of infection and shunt blockage; LPS is more effective than VPS in reducing the incidence of the blockage by this paracentesis method.
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Objective To investigate the effects of RNA interference (RNAi) targeting angiotensinconverting enzyme (ACE) on blood glucose,insulin resistance,as well as oxidative stress in type 2 diabetic rats.Methods Type 2 diabetic rats were divided into diabetes control group (caudal intravenation with control adenovirus named Ad5),gene treatment group (caudal intravenation with recombinant adenoviral vectors named Ad5-ACE-shRNA,expressing ACE gene-specific shRNA),and enalapril group (intragastric administration with enalapril every day).At the same time,the normal blood glucose control group was set up.All rats were injected two times during the experiment period.Blood glucose was measured before and after the intervention.At the third day of the experiment,expressions of ACE mRNA and protein in pancreas were evaluated by RT-PCR and Western blot,and serum concentrations of ACE and Ang Ⅱ were measured by ELISA.By the end of the experiment,insulin sensitivity index was calculated and expressions of glucose transporter 4 (GLUT4) protein of epididymal adipose tissue and NAD (P) H (p22phox) protein of pancreas were measured.Results Blood glucose levels in the gene treatment group [(17.8 ±1.1) mmol/L] and the enalapril group [(17.9 ± 1.2) mmol/L] were lower than that in the diabetes control group [(24.9 ± 1.3) mmol/L] when the experiment was finished.ACE mRNA and protein expressions in pancreas of the gene treatment group were significantly decreased compared with the diabetes control group (P ＜ 0.05).Serum concentrations of ACE and Ang Ⅱ in the gene treatment group were (16.37 ± 3.01) ng/ml and (18.24 ± 3.69)pg/ml,significantly lower than those of the diabetes control group [(46.67 ± 3.92) ng/ml and (44.93 ± 4.12) pg/ml respectively,both P＜0.05].Insulin sensitivity indexes of the gene treatment group and the enalapril group were (-5.14 ± 0.41) and (-5.17 ± 0.38),being all significantly higher than that of the diabetes control group (-6.18 ±0.46,both P＜0.05).Expressions of GLUT4 protein in epididymal adipose tissue were higher and expressions of p22phox protein in pancreas were lower in the gene treatment group and the enalapril group than those of the diabetes control group (both P＜0.05).Conclusions RNAi targeting ACE gene may delay the progress of hyperglycaemia and improve the situation of insulin resistance and oxidative stress.The RNAi technology may be used as a new strategy of gene therapy for diabetes mellitus.
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Objective Ventriculoperitoneal shunt (VPS)is preferable in treatment for normal pressure hydrocephalus (NPH). In this study, the factors related to the motor recovery after VPS were analysed.Method Twenty-six patients were treated with VPS, and four factors, that are duration of symptoms, open lumbar puncture(LP) pressure, improvement after LP ,and motor recovery of twelve months after operation,were assessed. Results Twelve months after VPS, the better motor recovery after VPS was related to shorter duration of symptoms, higher open LP pressure, and symptom improvement after LP. Conclusion The patients with shorter duration of symptoms, higher open LP pressure, and symptom improvement after LP are often responsive to VPS.
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Objective To evaluate the effects of the short-term intervention lifestyle intervention on metabolic measurements of community patients with impaired glucose regulation (IGR). Methods A total of 90 IGR participants were randomly assigned to the control group (n=45) or the intervention group (n= 45). The subjects in the control group received routine diet and physical exercise advice once a month. The subjects in the intervention group received additional individualized diet counseling and circuit-type resistance training. Metabolic parameters were compared before or after the intervention between the two groups. Results In oral glucose tolerance test (OGTT),2-h plasma glucose (PG) and homeostasis model of insulin resistance index (HOMA-IR) were significantly decreased in the intervention group at 3 months(F= 13.47 or 82.25 ,both P < 0.05). Body mass index (t=-2.44, P<0.05), systolic blood pressure (t= -3.39, P<0.05), diastolic blood pressure (t=-3.97, P<0.05), fasting plasma glucose (t=-3.89, P<0.05),2-h PG (t=-7.22,P <0.05) ,total cholesterol (t=-2.72,P<0.05),low-density lipoprotein cholesterol (t=-2.74, P<0.05), and glycosylated hemoglobin A1 C (t=-3.73, P<0.05) were significantly declined in the intervention group compared to the control group (all P<0.05). Conclusions Intensive lifestyle intervention can significantly improve the metabolic markers of IGR subjects and should be used to prevent type 2 diabetes.
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Objective To study the effect of phosphodiesterase inhibitor pentoxifylline (PTX) on type 1 diabetes in NOD mice and its possible mechanism.Methods Blood glucose, urinary glucose, insulitis and incidence of diabetes were investigated in NOD mice treated with PTX, insulitis was observed by HE staining and the expressions of IFN ?, TNF ?, IL 10 in pancreas were measured by RT PCR technique. Results The incidence of diabetes in the PTX group was 30.0% which was significantly lower than 67.9% in the control group (P