RESUMEN
OBJECTIVE@#To compare the clinical effect of lower extremity varicose veins between fire needling bloodletting and operation, and to explore the possible mechanism.@*METHODS@#A total of 60 patients were randomized into an observation group and a control group, 30 cases in each one. In the control group，the operation was adopted. The fire needling bloodletting was applied in the observation group, twice a week for 4 weeks. Before and after treatment, the venous clinical severity score (VCSS) and venous disability score (VDS) were recorded, the hemorheological indexes [blood viscosity, plasma viscosity, hematocrit, fibrinogen and erythrocyte sedimentation rate (ESR)], immune inflammatory response indexes[serum C-reactive protein (CRP), tumor necrosis factor-α(TNF-α) and interleukin-6 (IL-6)], vascular endothelial cell function indexes [the number of circulatingendothelial cell (CEC), plasma endothelin (ET-1) and NO)] and apoptosis indexes (Bcl-2, Bax and Caspase-3) were detected in the two groups.@*RESULTS@#Compared before treatment, the scores of VCSS and VDS, hemorheological indexes, immune inflammatory response indexes and levels of plasma NO after treatment were reduced in the two groups (<0.05). The level of serum Bax after treatment was reduced in the observation group (<0.05). The number of CEC and levels of plasma ET-1 after treatment were increased in the two groups (<0.05). The levels of serum Bcl-2 and Caspase-3 after treatment were increased in the observation group (<0.05). In the observation group, the scores of VCSS and VDS, hemorheological indexes，immune inflammatory response indexes, vascular endothelial cell function indexes and level of serum Bax after treatment were lower than the control group (<0.05), and the levels of Bcl-2 and Caspase-3 were higher than the control group (<0.05).@*CONCLUSION@#Fire needling bloodletting could effectively treat lower extremity varicose veins, and the mechanism may be related to the improvement of hemorheology, downregulation of immune inflammatory response, improvement of vascular endothelial cell function and inhibition of apoptosis.
RESUMEN
Diabetes is a kind of disease which poses a great threat to human health. Its occurrence and development are often related to many factors such as heredity and environment. According to the eighth edition of Diabetes Federation's diabetes map in 2017， there are about 425 million diabetics in the world. It is estimated that by 2045， the number of diabetics will increase to 700 million， becoming a health problem that has attracted increasing attention all over the world， among which the number of type 2 diabetics （T2DM）accounts for more than 90% of the total. Therefore， it is of great significance to study the pathological mechanism for the effective prevention and treatment of diabetes. Intestinal microflora coexists with human beings and forms an important micro ecosystem， which is involved in the metabolism of substance and energy. In recent years， with the development of high-throughput sequencing technology， a large number of studies have shown that in addition to obesity， genetic and insulin dysfunction， intestinal flora disorder may also lead to diabetes. The unbalanced diet structure of T2DM patients destroys the balance of intestinal flora. It is generally believed that the occurrence and development of T2DM may be one of the results of the intestinal microbial disorder caused by over nutrition. However， there is no clear mechanism of how intestinal flora participates in the development of T2DM. At present， it is generally believed that the intestinal flora may affect the metabolism of the body through the participation in bile acid metabolism， short chain fatty acid metabolism， low-level inflammatory response and other ways. At present， the prevention and treatment of T2DM is mainly based on drug control. Through surgical operation， increasing the number of probiotics， fecal transplantation and other methods to intervene the intestinal microflora to adjust the intestinal microflora， it provides a new means for the prevention and treatment of T2DM. This paper discusses the interaction between T2DM and intestinal microflora in recent years and the possible treatment measures in the future.