Experimental Research Progress on Prevention and Treatment of Cognitive Dysfunction in Diabetes Mellitusby Traditional Chinese Medicine / 中国实验方剂学杂志

Cognitive dysfunction of diabetes mellitus is one of the complications of diabetes mellitus. Its clinical manifestations include decreased memory ability, learning ability, language expression and comprehension ability, and inattention. The pathogenesis is complex, which is related to various factors such as abnormal glucose metabolism, abnormal lipid metabolism, insulin resistance, abnormal phosphorylation of Tau protein, inflammatory reaction, oxidative stress, cholinergic system injury, neuronal cell apoptosis, et al. Although traditional hypoglycemic drugs such as metformin and glibenclamide have a little effect in controlling diabetic cognitive impairment, but there has no effective drugs for this disease which causes a heavy burden on families and society. The concepts of holism and preventing disease of traditional Chinese medicine(TCM)have obvious advantages in delaying the occurrence and development the complications.TCM believes that the basic pathogenesis of diabetic cognitive dysfunction is based on deficiency complicated with excess. The therapeutic principles includes tonifying the kidney essence, reinforcing Qi and nourishing Yin, dissipating phlegm for resuscitation, and promoting blood circulation to remove blood stasis.In recent years, there have been a lot of research achievements on the prevention and treatment of cognitive dysfunction in diabetes mellitus with TCM. Researchers of TCM do abundant researches, and find that TCM can improve cognitive dysfunction by lowering blood glucose,promoting intracellular cholesterol excretion, improving insulin resistance, lowering p-Tau, anti-oxidative stress, inhibiting inflammatory reactions, improving the function of cholinergic nerve, inhibiting neuronal apoptosis. The article reviews the experimental research on the prevention and treatment of cognitive dysfunction of diabetes mellitus by TCM and its extracts and reveals the target and mechanism, in order to provide sufficient scientific basis for TCM to prevent cognitive dysfunction of diabetes mellitus.

Effect of Modified Gegen Qinlian Tang on Inflammatory Factors in Hippocampus for Diabetic Rats / 中国实验方剂学杂志

Objective: To investigate the effect of modified Gegen Qinlian Tang on learning and memory ability and interleukin-1β(IL-1β), tumor necrosis factor-α(TNF-α), nuclear factor-κB(NF-κB) protein expression in hippocampus of type 2 diabetic (T2DM) rats. Method: A total of 62 rats were randomly divided into normal group (n=12),and the remaining 50 rats were established by feeding high sugar and high fat diet and injecting with low dosage of streptozocin(STZ) to T2DM. The successful modeling rats were selected and randomly divided into model group, Saxagliptin and modified Gegen Qinlian Tang group. The normal group and the model group received 10 mL·kg-1·d-1 nomal saline by intragastric administration. 0.005 g·kg-1·d-1 Saxagliptin crude drug and 0.435 g·kg-1·d-1 modified Gegen Qinlian Tang crude drug were given in Saxagliptin group and modified Gegen Qinlian Tang group, and all the treatment lasted for 8 weeks. Learning and memory ability of rats was observed by using Morris water maze. Histopathological changes of hippocampus was observed by hematoxylin-eosin staining.Western blot was used to test the NF-κB p65 in the cytoplasmic and nucleus in rat hippocampus. Enzyme-linked immunosorbent assay(ELISA) was used to test the levels of IL-1β and TNF-α. Result: Compared with normal group, the mean incubation period of model group was significantly prolonged on the 4th day(PPκB p65 in the nucleus was significantly increased (Pβ, TNF-α in the hippocampus were significantly increased (PPPPPβ, TNF-α and NF-κB p65 in hippocampus were significantly improved. Conclusion: Modified Gegen Qinlian Tang could obviously improve the learning and memory ability of the T2DM rat model which was induced by the high-sugar, high-lipid diet and low-dose STZ, and the mechanism may be achieved by suppressing the inflammation of the rat' s hippocampus.

Comparative analysis of two hybrid technique in treating multilevel cervical spondylotic myelopathy via anterior approach / 中国骨伤

OBJECTIVE@#To compare the clinical effects and complications of two hybrid decompression techniques in treating multilevel (>=3) cervical spondylotic myelopathy(MCSM).@*METHODS@#The clinical data of 124 patients with multilevel (>=3) cervical spondylotic myelopathy treated by surgery and follow-up from January 2008 to December 2016 were retrospectively analyzed. According to the different operative methods, the patients were divided into group A and group B. Anterior cervical discectomy and fusion (ACDF) combined with anterior cervical corpectomy and fusion with preserved posterior vertebral wall (PWCF) were performed in group A; ACDF combined with anterior cervical corpectomy and fusion(ACCF) were performed in group B. There were 44 males and 16 females in group A with an average age of (60.43±7.52) years old, 46 males and 18 females in group B with an average age of (61.61±6.39) years old. No significant differences were found in gender, age between two groups. The operative time, intraoperative blood loss, hospital stay, rate of complications, postoperative Japanese Orthopaedic Association (JOA) score and improvement of cervical curvature were compared between two groups.@*RESULTS@#All the operations were successful. The follow-up time was 13 to 28(23.0±12.1) months in group A and 12 to 30(24.0±11.5) months in group B. The operative time, intraoperative blood loss, hospital stay in group B were higher than those in group A(0.05). The physiological curvature of cervical vertebra was improved significantly after operation, and there was no significant difference between two groups(>0.05).@*CONCLUSIONS@#Both surgical methods can obtain satisfactory clinical efficacy for multilevel(>=3) cervical spondylotic myelopathy, but compare with group B (ACDF combined with ACCF), group A (ACDF combined with PWCF) has shorter operation time, less trauma, less bleeding, and lower incidence of complications. ACDF combined with PWCF can be preferentially selected for the patients who corresponding to the indications.

Clinical observation of qiyao xiaoke capsule in intervening 76 patients with type 2 pre-diabetes / 中国中西医结合杂志

<p><b>OBJECTIVE</b>To observe the clinical effects of Qiyao Xiaoke Capsule (QXC) on patients with type 2 pre-diabetes.</p><p><b>METHODS</b>Totally 116 pre-diabetes patients were randomly assigned to the Chinese medicine group (CM, 76 cases) and the blank control group (BC, 40 cases) in the ratio of 2: 1. All patients received proper diet control, health education, and exercises, and so on. Besides, patients in the CM group took QXC (0.4 g/pill), 6 pills each time, three times a day. But patients in the BC group were intervened by life style alone. The fasting blood glucose (FBG), postprandial blood glucose (PBG), insulin (FINS, 2h INS), glycosylated hemoglobin (HbAlc), blood lipids (TG, TC, HDL-C, and LDL-C), and efficacy of CM symptoms were observed in the two groups before and after intervention. The sequelae were observed at the end of the treatment and at follow-ups.</p><p><b>RESULTS</b>After treatment FBG, PBG, and HbA1c decreased in all patients of the two groups (P<0.05, P<0.01), with 2 h PBG decreased more significantly. But there was no statistical difference between the two groups (P>0.05). The two methods could improve the secretion of FINS. Especially 2 h INS decreased more significantly in the CM group, showing statistical difference when compared with the BC group (P<0.05). The two methods could improve the metabolism of blood lipids. CM could significantly lower TG and elevate HDL-C, showing statistical difference when compared with before treatment (P<0.05). After treatment the CM symptoms were obviously improved, showing statistical difference when compared with the BC group (P<0.05). The normalization rate was better in the CM group than in the BC group at the end of the treatment and at follow-ups (P<0.05).</p><p><b>CONCLUSIONS</b>QXC combined life style intervention could improve fasting and postprandial insulin secretion of type 2 pre-diabetes patients, regulate glycolipid metabolism, correct the insulin resistance state, and improve the symptoms of qi-yin insufficiency. It could postpone or hinder the occurrence and development of type 2 diabetes. It was more effective and durable than changing the life style alone.</p>

Effects of Qiyao Xiaoke capsule on glycolipid metabolism in liver and skeletal muscle of rats with catch-up growth induced by high-fat diet / 中国中西医结合杂志

<p><b>OBJECTIVE</b>To observe the effect of Qiyao Xiaoke Capsule (QXC, a Chinese preparation for invigorating qi and nourishing yin) on glycolipid metabolism in the liver and skeletal muscle of rats with catch-up growth (CUG) induced by high-fat diet.</p><p><b>METHODS</b>CUG model rats were made by limiting forge followed by high-fat diet, and intervened with different dosages [1.8 (g/kg x d), 0.6 g/(kg x d)] of QXC. And the experiment was controlled with pioglitazone. Levels of blood glucose, serum free fatty acid (FFA), serum insulin (Fins), plasma adiponcetin (AC) and insulin resistance index (IRI) as well as the weights of peri-epididymis and peri-renal fat and their ratio to body weight were observed 8 weeks later. The contents of total cholesterol (TC), triglyceride (TG) and glucose uptake in skeletal muscle and liver were also determined.</p><p><b>RESULTS</b>Insulin resistance in CUG rats can be induced by high-fat diet. Compared with the un-treated model rats, levels of Fins and AC were higher, IRI and FFA were lower in CUG rats after intervened by QXC (P < 0.05 or P < 0.01). Moreover, QXC at large dose showed the effects of reducing TG content in liver and skeletal muscle, advancing the glucose uptake in skeletal muscle, displaying an efficacy similar to that of pioglitazone (P > 0.05).</p><p><b>CONCLUSION</b>QXC could improve the glycolipid metabolism in high-fat diet-induced CUG rats through different pathways of intervention to alleviate/delay the occurrence and development of insulin resistance in the liver and skeletal muscle.</p>

Experimental study on the preventive and treatment function of cortex mori for peripheral nervous lesion at the early stage of diabetes rats / 中国应用生理学杂志

<p><b>AIM</b>To observe the preventive function of cortex mori for peripheral nervous lesion at the early stage in diabetes rats, and probe into the mechanism of that formula.</p><p><b>METHODS</b>Set up the diabetes rat model evoked by alloxan. According to different blood sugar values, randomly divide the rats into normal group, model group, cortex mori(high dosage and low dosage) group and methylcobalamin control group, respectively administer the rats with saline and cortex mori of different dosages by ig (1.875 g/kg, 0.625 g/kg), while 300 microg/kg methylcobalamin for control group, one time each day. Two months after the administration, determine the FBG, body weight, SOD and MDA in blood serum of rats in each group, observe the changes on final product of glycosylation, CGMP and CAMP of sciatic nerve and the synapsin of rats' sciatic nerves. Conduct the pathological observation on area of myelin sheath, extramedullary fiber and the cross section of myelin sheath of sciatic nerves. And observe the changes of ultrafine form of sciatic nerve through transmission electron microscope. In the mean time, determine the MNCV, SNVC and SL, and the tail-flicking test should be undertaken for checking the sensory nerve.</p><p><b>RESULTS</b>Cortex mori can effectively enlarge the area of myelin sheath, extramedullary fiber and the cross section of myelin sheath.</p><p><b>CONCLUSION</b>Cortex mori can obviously ease up the pathological changes of peripheral nerve at the early stage of the diabetes rats, and the overall curative effect is better than that of methylcobalamin.</p>

Epidemic survey on TCM syndrome typing and preliminary discussion on TCM etiology and pathogenesis of fatty liver / 中国中西医结合杂志

<p><b>OBJECTIVE</b>To investigate the common TCM syndrome types of fatty liver by way of epidemic questionnaire, their occurrence ratio, and the correlation between various syndrome types and objective indexes.</p><p><b>METHODS</b>A total of national wide 503 subjects with fatty liver were enrolled, the TCM syndromes, body mass index (BMI), abdominal perimeter/hip circumference, liver function, blood lipids, B ultrasonic examination and CT in them were observed and recorded.</p><p><b>RESULTS</b>In the 46 symptoms investigated in total, the first ten symptoms in order of appearing rate were lassitude, obese, oral dryness, vertigo, hypochondriac distending pain, soreness and pain in loin, spiritlessness, oral bitterness, aching and weakness in knee and abdominal distention. The mostly appeared tongue figures were pale and corpulent or pale dim tongue proper, white greasy or yellow greasy tongue coating, and the mostly appeared pulse figures were taut, taut-thin and taut slippery. Statistical cluster analysis showed that syndromes of fatty liver could be typed into 4 TCM types, the asthenia Pi-Shen with Gan-stagnation type, the asthenia Pi-Shen type, the asthenia Pi with phlegm-heat type and the unclassified type. Among them the asthenia Pi-Shen with Gan-stagnation type was the commonest one, which accounted to 62.32%.</p><p><b>CONCLUSION</b>The mostly appeared syndrome type of fatty liver was asthenia Pi-Shen with Gan-stagnation type. The TCM pathogenesis of fatty liver was deficiency of origin, mainly deficiency of Shen, involving Pi, with excess superficiality, the turbid-phlegm and blood stasis.</p>