Budesonide nebulization in the treatment of neonatal ventilator associated pneumonia

Objective: To investigate the clinical effect of budesonide nebulization in the treatment of ventilator associated pneumonia of newborns and its safety

Methods: Forty-five newborns who had ventilator associated pneumonia and were admitted into the Binzhou People's Hospital between May 2014 and May 2015 were selected and included as an observation group. Moreover, another forty-five newborns who had ventilator associated pneumonia but did not undergo budesonide treatment in 2014 were randomly selected and included as a control group. Patients in the observation group were given budesonide suspension nebulization in addition to the conventional treatment. The evaluation indicators for therapeutic effect were compared between the two groups. The changes of head circumference, height and weight and death rate were observed by follow up after treatment

Results: The mechanical ventilation time, time for recovering from chest X-ray scan and hospitalization time of patients in the observation group were shorter than that of the control group, and the difference had statistical significance [P<0.05]

The oxygen index of the patients in the observation group was significantly improved compared to that of the control group, and the difference had statistical significance [P<0.05]. Patients in the two groups were followed up for six months after discharge. The head circumference, height and weight of the patients in the observation group in the 3[rd] and 6[th] month were compared to those of the control group, suggesting no significant differences [P>0.05]

The cumulative death rate of the observation group in the 6th month after treatment was significantly lower than that of the control group, and the difference had statistical significance [P<0.05]

Conclusion: Treating ventilator associated pneumonia of newborns with budesonide nebulization can effectively shorten mechanical ventilation time, time for recovering from chest X-ray scan and hospitalization time, improve pulmonary diffusion function and reduce the death rate, without affecting the growth and development of patients in the future

Effects of anti-inflammatory drugs of diacerein on glucose and lipid metabolism in type 2 diabetic rats / 医学研究生学报

Objective Recent studies have shown that inflammatory cytokines are involved in the occurrence and development of diabetes mellitus .The article aimed to investigate the effects of anti-inflammatory drug--diacerein on hepatic PPAR-γand GLUT-2 protein expression and its role in the regulation of glucose and lipid metabolism in rats with type 2 diabetes mellitus ( T2DM) . Methods 55 male SD rats were randomly divided into 4 groups:normal control group (n=10), T2DM group (n=15), pioglitazone intervention group(n=15), and diacerein treatment group(n=15) .Rats in normal control group were fed with normal diet , the other 3 groups were fed with high fat diet .At the end of 8th experi-ment week, rats in 3 groups fed with high fat diet were treated with intraperitoneal injection of 30mg/kg streptozotocin ( STZ) solution, while rats in normal control group were injected with the same volume of sterile sodium citrate solution .At the end of 10th week, OGTT modeling rats were screened .Rats in pioglitazone intervention group were treated with 10 mg/kg pioglitazone by intragastric administra-tion, rats in diacerein group was treated with 50mg/kg diacerein by intragastric administration , and rats in normal control group and T2DM group were given the same volume of normal saline .The intervention lasted 4 weeks.At the end of 8th, 10th and 14th week, the blood examination of glycolipid , FINS, IL-1βand liver function indexes was done on fasting rats .Fourteenth weeks later , after getting blood samples , all rats were sacrificed and liver tissues were isolated .Western blot was applied in the detection of PPAR γand immu-nohistochemistry was applied to detect GLUT-2 protein in livers. Results At the end of 8th week, the FBG level in pioglitazone in-tervention group increased compared with normal control group ( P0 .05) show-ing higher levels compared with T 2DM group ( P<0.01).At 14th weekend, the GLUT-2 expression levels in normal control group (0.209±0.023), pioglitazone intervention group (0.226±0.017) and diacerein treatment group (0.232±0.012) were higher than that of T2DM group (0.173±0.009,P<0.01);and the GLUT-2 expression levels in pioglitazone intervention group and diacerein treatment group were higher than that of normal control group (P<0.05).The expression level of liver PPAR-γwas in positive correlation with those of GLUT-2 protein, HDL-C, FINS, ISI ( r=0.815, 0.780, 0.747, P<0.01) and in negative correlation with those of FBG , HbA1c, TC, TG, AST, ALT, IL-1β(r=-0.465,-5.716,-0.615,-0.675,-0.617,-0.521,-4.827, P<0.05). Conclusion Diacerein can enhance liver PPAR-γand GLUT-2 expression levels and reduce the levels of IL-1β, HbA1c and blood lipid, thus im-prove insulin resistance in T 2DM rats.

Effects of diacerein on inflammatory cytokines and adipose metabolism as well asthe expression of chemerin in adipose tissue of type 2 diabetic rats / 西安交通大学学报(医学版)

Objective To study the effects of diacerein and its metabolite rhein on plasma inflammatory cytokine level and expression of perirenal adipose tissue chemerin in type 2 diabetes mellitus (T2DM) rats and its role in regulating glucose and lipid metabolism.Methods We randomly divided 56 SD male rats into 5 groups: normal control group (Group A), T2DM group (Group B), pioglitazone group (Group C), diacerein group (Group D), and pioglitazone+diacerein group (Group E).Group A was fed with ordinary feed whereas the other groups were fed with high-fat diet.At the end of week 8, rats in Groups B, C, D and E were injected intraperitoneally with 30mg/kg of STZ solution to create the model.Those in Group A were injected with the same volume of sterile sodium citrate solution.OGTT examination was taken to screen the model rats at the end of week 10.The successful mode was chosen according to OGTT result.Then Group C was treated with pioglitazone 10mg/(kg·d) orally, Group D with diacerein 50mg/(kg·d), Group E with pioglitazone 10mg/(kg·d)+diacerein 50mg/(kg·d), and Group A and B were given the same volume of normal saline.The intervention lasted 4 weeks.At the end of experiment weeks 10 and 14, FBG, FINS, TC, TG, LDL-C, IL-1β, IL-6, and TNF-α were detected in the fasting rats with free access to water.After blood sample was taken at the end of week 14, all rats were killed and theperirenal adipose tissue was isolated, the expression of chemerin in perirenal adipose tissue was detected by Western blotting.Results At the end of week 10, FBG, FINS, TG, TC, LDL-C, IL-1β, IL-6, and TNF-α were higher in Groups B, C, D and E than in Group A while HDL-C was lower (all P<0.01).At the end of week 14, TC, TG, and LDL-C were lower in Groups C, D and E than in Group B but higher than Group A while HDL-C was lower than in Group A (all P<0.05).Group E had greater changes in glucose and lipid metabolism and inflammatory cytokine level than Groups C and D (P<0.05).Western blotting results showed that the expression of chemerin in perirenal adipose tissue increased higher in Group B than in Groups A, C, D and E (P<0.05).The expression of chemerin were also higher in Groups C and D than in Groups A and E (P<0.05), but there was no significant difference between Groups A and E.Conclusion Diacerein can regulate the metabolism of glucose and lipid, improve insulin resistance by reducing the expression of chemerin and the level of inflammatory cytokines.

The variance of serum IL-18 level and lymphocyte subpopulations in the patients with obese diabetic / 中国基层医药

Objective To observe on the variance of serum IL-18 level and lymphocyte subpopulations in the patients with obese diabetic(T2DM).Methods The diabetic obese group contained 31 cases,the non-diabetic obese group contained 33 cases,healthy normal body weight group contained 23 cases,the blood glucose(FPG),insulin (FPI),blood total cholesterol(TC),triglyceride(TG),IL-18 and the cell population of lymphocyte subpopulations CD3+and CD4+、CD8+ in peripheral blood were determined,the insulin sensitivity index were calcnlated.Results Compared with the healthy normal body weight group,the blood fat,FPG,FPI,IL-18 of T2DM patients significantly increased,there were significant statistical difference(P ＜ 0.05 or P ＜ 0.01).The ISI significantly decreased(P ＜ 0.01).Compared with the non-diabetic obese group,the blood fat and IL-18 of T2DM patients significantly increased (P＜0.05).Compared with the diabetic obese group,the subpopulations cell population of CD3+、CD4+、CD8+ in the non-diabetic obese group significantly decreased,the ratio of CD4+/CD8+ significantly increased,there were significant statistical difference(P＜0.05 or P＜0.01)in the two groups comparison.Compared with the non-diabetic obese CD4+/CD8+ significantly increased(P＜0.05).Conclusion T2DM patients should prevent the hyperinsulinemia,control blood sugar,reduce insulin resistance,sustain normal lipid metabolism,boost immune function.

An experimental study on the relationship between interleukin-18 and the pathogenesis of type 2 diabetes mellitus / 中国医师杂志

Objective To investigate the relationship between interleukin-18(IL-18)and the pathogenesis of type 2 diabetes melli-tus.Methods 72 healthy Sprague-Dawlay male rats were randomly divided into four groups, NC group,NCS group,HF group and HFS group.At the end of the 8th week,NCS group and HFS group were injected with STZ(25mg/kg)into abdominal cavity.At the end of the 10th week,diabetic rats were screened by oral glucose tolerance test(OGTT).The blood sample was collected when the rats were killed at the end of the 14th and 20th week.The levels of serum IL-18,IL-6 and tumor necrosis factor-α(TNF-α)were assayed with ELISA.Results Most rats in HFS group were achieved the diagnostic standard of diabetic rat, and their insulin sensitivity index(ISI)were decreased.At the end of the 14th week and 20th week,the levels of serum IL-18,IL-6 and TNF-α in HFS group were significantly higher than those in NC group(P＜0.01).In HFS group,the levels of serum IL-18,IL-6 and TNF-α at the end of the 20th week were higher than those at the end of the 14th week,but it had no statistic significance(P＞0.05).Pearson linear correlation analysis showed that the level of serum IL-18 in HFS group was positive correlated with FBG,IL-6,and TNF-α(r=0.90,P＜0.01 or r≥0.73,P＜0.05),and negative correlated with ISI(r=-0.86,P＜0.01).Condusions Our results show that IL-18 is related with the pathogenesis of type 2 diabetes mellitus and chronic inflammation plays an important role in the development of type 2 diabetos mellitus.

Weight-reducing by Electroacupuncture in 28 Cases / 针灸推拿医学（英文版）

Treated 28 cases of obesity by electroacu-puncture plus auricular-press therapy, and 15 cases got significant effect, 10 cases got effectiveness, 2 cases got improvement and 1 case had no effect.

Effects of short-term insulin pump treatment on pancreatic ?-cells in newly diagnosed type 2 diabetes mellitus / 西安交通大学学报(医学版)

Objective To explore the effects of insulin pump on pancreatic ?-cells in type 2 diabetes mellitus accompanied with hyperglycaemia.Methods We treated 46 cases of newly diagnosed type 2 diabetes mellitus with fasting blood glucose≥10.0 mmol/L by insulin pump for 2 weeks.Their blood sugar and insulin were determined before and after treatment by oral glucose tolerance test and insulin releasing test.We then calculated the function index,morning secretion of pancreatic ?-cells and insulin resistance index.The patients were followed up for 6 months and the blood glucose was monitored.Results After treatment,insulin,function index and the morning secretion were increased significantly,while the blood sugar and resistance index were decreased.In all the patients,16 could maintain ideal blood glucose only by alimentary control and exercise.Conclusion With the insulin pump in a short term,patients with type 2 diabetes mellitus can rapidly control blood glucose,obviously improve pancreatic ?-cells,and reduce insulin resistance.