Tripterygium glycosides in treatment of henoch-schonlein purpura nephritis: a systematic review of randomized controlled trials / 中国中药杂志

To evaluate the clinical efficacy and safety of tripterygium glycosides (TG) in the treatment of henoch-schonlein purpura nephritis(HSPN). Seven English and Chinese databases (up to Nov. 9, 2017), were searched to collect the RCTs on TG for HSPN. Two researchers independently screened the literature according to inclusion criteria and exclusion criteria, extracted data, and evaluated the quality of the literature. After completion, cross-checking was performed and Meta-analysis was performed using RevMan 5.3 software. At the same time, different outcomes of the interventions were analyzed subgroupically. A total of 46 RCTs were included, with 1 659 in the experimental group and 1 596 in the control group. All the clinical studies showed a low quality. In terms of complete remission rate, the group with TG performed better than the group with conventional therapy or GC（RR=1.82，95%CI[1.39，2.39];RR=2.03，95%CI[1.37，2.99]），the group with TG+GC performed better than the group with GC（RR=1.46，95%CI[1.32，1.60]），and the group with CTX+GC performed better than the group with TG+GC（RR=0.35，95%CI[0.16，0.75]）. In terms of total effective rate, the group with TG performed better than the group with conventional therapy or GC（RR=1.44，95%CI[1.19,1.74];RR=1.30，95%CI[1.16，1.46]），the group with TG+GC performed better than the group with GC（RR=1.27，95%CI[1.21，1.34]），and the group with CTX+GC performed better than the group with TG+GC（RR=0.60，95%CI[0.43，0.85]）. No significant difference was found between the group with TG+GC and LEF+GC（RR=0.68，95%CI[0.30，1.53]）. In terms of urinary protein, urine occult blood negative time，the group with TG performed better than the group with conventional therapy（MD=-9.00，95% CI[-11.99，-6.01];MD=-12.00，95%CI[-16.13，-7.87]），the group with TG+GC performed better than the group with GC（MD=-8.86，95%CI[-10.08，-7.64];MD=-16.24，95%CI[-23.80，-8.67]）. In terms of recurrence rate, the group with TG+GC was lower than the group with GC（RR=0.13，95%CI[0.06，0.25]）, but there were no significant difference between the group with TG and conventional therapy（RR=0.43，95%CI[0.15，1.19]）. In adverse reactions, the common adverse effects of TG were gastrointestinal discomfort, liver damage and leucopenia. TG for the treatment of HSPN can improve clinical efficacy, reduce recurrence, and the adverse reactions are relatively safe. Due to the generally low methodological quality of the included studies, which affected the accuracy and reliability of the result. Therefore, more high-quality, large samples and multi-center randomized controlled trials are necessary for further evidence.

Finite element simulation of contact stress on a novel total knee prosthesis during gait cycle / 医用生物力学

Objective To perform finite element analysis on a type of newly designed total knee prosthesis, and investigate the influence from changing twist angle of the lateral condyle surface on mechanical environment of the knee joint. Methods Based on CT measurement data from a volunteer, 3 artificial knee prostheses with the same medial condyle were established. In Model 1, the twist angle of lateral condyle surface was 0°, while 10° and 20° in Model 2 and Model 3, respectively. The prosthesis models were imported into finite element software and applied with gait cycle data to simulate the motion of knee prosthesis during the gait cycle. The simulated stress results in the knee joint were then compared with the calculated results, which were obtained from theoretical formula of contact mechanics. Results The maximum stress of 3 models appeared at 13% of the gait cycle, when the axial force (2.6 kN) was also the maximum. The maximum stresses of medial and lateral condyle in Model 1, Model 2 and Model 3 were 35.5 and 30.6 MPa, 38.4 and 32.6 MPa, 38.3 and 43.1 MPa, respectively. The stress curves of Model 2 and Model 3 during the gait cycle were relatively smooth compared with those of Model 1. The simulated stress trend was basically similar to the theoretical calculation, except at a few moments in the gait cycle. Conclusions The mechanical environment of the total knee prosthesis can be improved by twist angle of the lateral condyle surface. This newly designed prosthesis can preserve implants from abrupt change of the stress during the gait cycle and prolong the service life of prostheses.

Finite element simulation of contact stress on a novel total knee prosthesis during gait cycle / 医用生物力学

Objective To perform finite element analysis on a type of newly designed total knee prosthesis,and investigate the influence from changing twist angle of the lateral condyle surface on mechanical environment of the knee joint.Metheds Based on CT measurement data from a volunteer,3 artificial knee prostheses with the same medial condyle were established.In Model 1,the twist angle of lateral condyle surface was 0°,while 10° and 20° in Model 2 and Model 3,respectively.The prosthesis models were imported into finite element software and applied with gait cycle data to simulate the motion of knee prosthesis during the gait cycle.The simulated stress results in the knee joint were then compared with the calculated results,which were obtained from theoretical formula of contact mechanics.Results The maximum stress of 3 models appeared at 13％ of the gait cycle,when the axial force (2.6 kN) was also the maximum.The maximum stresses of medial and lateral condyle in Model 1,Model 2 and Model 3 were 35.5 and 30.6 MPa,38.4 and 32.6 MPa,38.3 and 43.1 MPa,respectively.The stress curves of Model 2 and Model 3 during the gait cycle were relatively smooth compared with those of Model 1.The simulated stress trend was basically similar to the theoretical calculation,except at a few moments in the gait cycle.Conclusions The mechanical environment of the total knee prosthesis can be improved by twist angle of the lateral condyle surface.This newly designed prosthesis can preserve implants from abrupt change of the stress during the gait cycle and prolong the service life of prostheses.

Comparison of HbA1c in Chinese patients with type 1 or type 2 diabetes randomized to twice daily insulin lispro low mix 25 or twice daily human insulin mix 30/70 / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Glycemic control prevents onset and progression of diabetes-related long-term complications. The objective of this study was to demonstrate that twice daily insulin lispro low mix 25 is noninferior to twice daily human insulin mix 30/70 in achieving glycemic control as measured by hemoglobin A1c (HbA1c), from baseline to endpoint, in patients with type 1 or 2 diabetes.</p><p><b>METHODS</b>In this phase IV, crossover, open-label, multicenter study, 117 Chinese patients with diabetes were randomly assigned to one of two treatment sequence groups. One group received 12-week treatment with twice daily human insulin mix 30/70 followed by 12-week treatment with twice daily insulin lispro low mix 25, while the other group received the reverse treatment sequence. HbA1c, baseline-to-endpoint change in HbA1c, proportion of patients achieving target HbA1c <or= 7% and <or= 6.5%, fasting blood glucose, and daily insulin doses were measured for each period. Safety and tolerability were also assessed.</p><p><b>RESULTS</b>A statistically significant reduction (P <or= 0.0001) of HbA1c was achieved after each treatment (human insulin mix 30/70: mean HbA1c = 7.91% (95%CI: 7.67%, 8.15%); insulin lispro low mix 25: mean HbA1c = 7.96% (95%CI: 7.72%, 8.20%)). The 95%CI (-0.20, 0.10) of the difference between the two treatments satisfied the prespecified noninferiority margin of 0.3% (lower limit of 95% CI > -0.3%). No statistically significant differences between treatments were observed for any of the secondary efficacy measures. The incidence of treatment-emergent adverse events and hypoglycemia between the two treatments and treatment sequence groups was similar. Three serious adverse events were reported (human insulin mix 30/70 group: 2 patients (1.7%, hypoglycemic coma and cardiac failure); insulin lispro low mix 25 group: 1 patient (0.9%, stroke)). All serious adverse events were resolved and no patients died during the study.</p><p><b>CONCLUSION</b>The results support noninferiority of twice daily insulin lispro low mix 25 versus twice daily human insulin mix 30/70 in HbA1c control in Chinese patients with type 1 or 2 diabetes.</p>

Association of SNP276 in adiponectin gene with type 2 diabetes mellitus and insulin sensitivity / 中华医学遗传学杂志

<p><b>OBJECTIVE</b>To investigate the distribution of SNP276 in adiponectin gene in Chinese Hans and its impact on type 2 diabetes mellitus and insulin sensitivity.</p><p><b>METHODS</b>The study population consisted of 417 Chinese Hans residents in Anhui province, including 141 subjects with normal glucose tolerance (NGT) and 276 with type 2 diabetes (T2DM). The islet beta-cell insulin secretion and tissue insulin sensitivity were assessed by formulae of homeostasis model assessment (HOMA-IR & HOMA beta). Firstly, polymerase chain reaction-single strand conformation polymorphism (PCR-SSCP) was used to determine whether variation exists in APM1. Then, exact variation was detected by automated DNA direct sequencing.</p><p><b>RESULTS</b>The genotypes of APM1 SNP276 were 0.489 GG, 0.418 GT and 0.092 TT and the major allele was G (frequency=0.699) in subjects with NGT. The distributions of genotypes and alleles of SNP276 both displayed significant difference between NGT and T2DM groups (P=0.031 and 0.013). The SNP276 non-TT (TG+GG) genotype was associated with increased risk of T2DM (OR=2.447, 95%CI: 1.067-5.612, P=0.035). In T2DM group, the subjects with SNP276 GG or GT genotype had higher body mass index, body fat content, fasting plasma glucose and HOMA-IR than did those with TT genotype (P < 0.05 or P < 0.01). Besides, GG genotype had higher systolic blood pressure (P=0.021). In NGT group, SNP276 non-TT carrier had increased body mass index, body fat content, waist hip ratio, fasting plasma insulin, oral glucose tolerance test 2 h plasma insulin and HOMA-IR when compared with TT genotype (P < 0.05 or 0.01).</p><p><b>CONCLUSION</b>SNP276 in APM1 was associated with T2DM and insulin sensitivity.</p>

Study on association of PPP1R3 gene 5 bp deletion/insertion within 3'-untranslated region polymorphism with type 2 diabetes / 中华医学遗传学杂志

<p><b>OBJECTIVE</b>To determine whether the muscle-specific glycogen-targeting regulatory subunit of the glucogen bound protein phosphatase 1 (PPP1R3) gene 5 bp deletion/insertion(D/I) within 3'-untranslated region ( 3'-UTR) polymorphism is associated with type 2 diabetes in Chinese Han population in Hefei region of Anhui province.</p><p><b>METHODS</b>The PPP1R3 gene 3'-UTR 5 bp D/I polymorphism was detected by polymerase chain reaction in 268 patients with type 2 diabetes and 106 normal controls.</p><p><b>RESULTS</b>(1) The distributions of the frequency of three genotypes and two alleles of the PPP1R3 gene 5 bp D/I polymorphism showed no significant difference between the type 2 diabetic cases and the normal controls. (2) In both the cases and controls, there was no significant difference in age at onset, duration of disease, blood glucose, blood lipid profile, blood pressure, insulin sensitive index, body mass index, and waist hip ratio between the three genotypic groups(P 0.05). (3) The PPP1R3 gene 3'-UTR polymorphism in Chinese Han population in Hefei region of Anhui province was found to be similar to that in both Japanese population and Canadian population, and to be different from that in Piman Indians and the Caucasians in Sweden.</p><p><b>CONCLUSION</b>The PPP1R3 gene 5 bp D/I within 3'-UTR polymorphism taking on genetic variation among the different races of mankind may not play a critical role in the development of type 2 diabetes mellitus in Chinese Hans of Hefei region in Anhui province.</p>

Study on the association of PPP1R3 gene polymorphism with type 2 diabetes in Han population of Anhui province / 中华流行病学杂志

<p><b>OBJECTIVE</b>To study the association of muscle-specific glycogen-targeting regulatory subunit of the glucogen-bound protein phosphatase 1 (PPP1R3) gene codon 905 Asp/Tyr polymorphism with type 2 diabetes in Chinese Han population in Hefei region of Anhui province.</p><p><b>METHODS</b>PPP1R3 gene Asp905Tyr polymorphism was detected by polymerase chain reaction and appropriate restriction enzyme (PCR-RFLP) in 262 type 2 diabetic cases and 104 normal controls. Case and control groups were divided into subgroups by body mass index (BMI) 25 kg/m2.</p><p><b>RESULTS</b>When PPP1R3 gene Asp905Tyr polymorphism was not associated with type 2 diabetes mellitus. When subjects with BMI < 25 kg/m2 and Tyr/Tyr genotypes were used as reference. Subjects with Asp905 and BMI > or = 25 kg/m2 had a 3.69-fold increase of risk suffering from type 2 diabetes (OR = 3.69, 95% CI: 1.38-8.89, P=0.006).</p><p><b>CONCLUSIONS</b>PPP1R3 gene Asp905Tyr polymorphism did not seem to play a critical role in the development of type 2 diabetes mellitus in Han population of Chinese in Anhui province but interaction between the Asp905 and BMI cause the increase of risk of type 2 diabetes.</p>

Expression of adiponectin mRNA and related factors in greater omentum fat tissue in obese subjects / 中华内分泌代谢杂志

The expression of adiponectin mRNA in greater omentum fat tissue was measured in 43 subjects using RT-PCR.The results showed that the expression of adiponectin mRNA in greater omentum fat tissue was significantly lower in obese subjects than that in normal persons,and abdominal obesity,HOMA-IR and tumor necrosis factor-?were the main independent factors influencing the expression of adiponectin mRNA in greater omentum.

Effects of TNF-?on PPAR-?2 mRNA expression and adiponectin secretion in 3T3-L1 adipocytes / 中华内分泌代谢杂志

Undifferentiated and differentiated 3T3-L1 adipocytes were treated with 100 ng/ml tumor necrosis factor-?(TNF-?),and peroxisome proliferator-activated receptor-?2 (PPAR-?2) mRNA expression and adiponectin secretion in cultured cells were measured.The results showed that TNF-?suppressed PPAR-?2 mRNA expression and adiponeetin secretion in 3T3-L1 adipocytes (P