Correlation of sleep disorders with serum Aβ 1-42 and P-Tau 181 in patients with Alzheimer's disease / 中华老年医学杂志

Objective:To investigate the correlation of sleep disorders(SD)with serum levels of amyloid β-proteins(Aβ 1-42)and tau phosphorylated at threonine(P-Tau 181)in patients with Alzheimer's disease(AD). Methods:A total of 126 patients with mild and moderate AD who met the inclusion criteria in the memory clinic, sleep clinic and geriatrics department of Jianghan Oilfield General Hospital affiliated to Yangtze University from February 2017 to January 2020 were included.The Pittsburgh Sleep Quality Index(PSQI)was used to evaluate sleep quality.Patients with PSQI scores ≥7 were included in the AD group with sleep disorders(AD-SD group), and patients with PSQI scores <7 were included in the AD group without sleep disorders(AD-NSD group). The Montreal Cognitive Assessment(MoCA), Global Deterioration Scale(GDS), Clinical Dementia Rating(CDR), Hamilton Rating Scale for Depression(HRSD)and Hamilton Anxiety Rating Scale(HAM-A)were used to evaluate cognitive and psychosocial symptoms.During the same time, biological markers such as serum Aβ 1-42, Aβ 1-40 and P-Tau 181 were detected by using enzyme-linked immunosorbent assays.Patients in the two groups received donepezil as an anti-dementia therapy, while the AD-SD group was treated additionally with a targeted sleep intervention.All patients underwent neuropsychological assessment and biochemical tests at enrollment and at the end of the 6th month, and results from all parameters at baseline and at the end of the 6th month were compared.At the end of the six-month treatment, patients in the AD-SD group were further divided into the recovery AD-SD sub-group and the no-recovery AD-SD sub-group based on the extent of sleep improvement. Results:Of the 126 AD patients, 93(73.8%)had sleep disorders.There was no statistically significant difference between the two groups in gender, age, onset age, educational level, course of disease, CDR, GDS, MoCA, Aβ 1-40 or Aβ 1-42/Aβ 1-40(all P>0.05). The scores of PSQI, HRSD and HAM-A and serum levels of Aβ 1-42 and p-Tau 181 showed statistically significant differences between the AD-ND and AD-NSD groups( P<0.05 or P<0.01). At the end of the 6th month, the scores of PSQI, GDS, HRSD and HAM-A and levels of Aβ 1-42, Aβ 1-40, and P-Tau 181 also showed statistically significant differences between the AD-ND and AD-NSD groups( P<0.05 or P<0.01). There was no statistically significant difference in results from other parameters( P>0.05). Spearman correlation analysis showed that PSQI was correlated with HRSD( r=0.271, P=0.009), HAM-A( r=0.479, P=0.000), Aβ 1-42( r=0.470, P=0.000), Aβ 1-42/ Aβ 1-40( r=0.479, P=0.000)and P-Tau 181( r=0.371, P=0.000)in the AD-SD group at baseline.Multivariate Logistic regression model showed that serum Aβ 1-42 and P-Tau 181 levels and HRSD had predictive effects on changes in sleep quality in AD patients( OR=1.897, 1.269 and 1.889, P=0.000, 0.003 and 0.000). The areas under the receiver operating characteristic(ROC)curves for Aβ 1-42, P-Tau 181 and HRSD were 0.926(95% CI: 0.860-0.991), 0.837(95% CI: 0.746-0.927)and 0.854(95% CI: 0.776-0.932), respectively. Conclusions:Sleep quality is correlated with serum Aβ 1-42and P-Tau 181 levels in AD patients.Elevated serum levels of Aβ 1-42 and P-Tau 181 and high HRSD scores are important predictors of SD in AD patients and may be used as indexes for clinical treatment efficacy.

Mechanism of effective components of Mori Folium in alleviating insulin resistance based on JNK signaling pathway / 中国中药杂志

A stable hepatoma cell line(Hep G2 cell) insulin resistance model was established and used to analyze the effect of effective components of Mori Folium in alleviating insulin resistance,and preliminary explore the mechanism for alleviating insulin resistance. The Hep G2 insulin action concentration and the duration of action were investigated using the glucose oxidase method(GOD-POD method) to establish a stable Hep G2 insulin resistance model. Normal control group,model group,Mori Folium polysaccharide group,Mori Folium flavonoid group and rosiglitazone group were divided to determine the glucose consumption. The effect of Mori Folium effective components on Hep G2 insulin resistance was analyzed. The mRNA expressions of JNK,IRS-1 and PDX-1 in each group were detected by Real-time quantitative PCR(qRT-PCR). The protein expressions of p-JNK,IRS-1 and PDX-1 were detected by Western blot. And the mechanism of effective components of Mori Folium in alleviating insulin resistance was investigated. The results showed that the glucose consumption was significantly decreased in the insulin resistance cells after incubation with 25. 0 mg·L-1 insulin for 36 h(P<0. 01),and the model was relatively stable within 36 h. Mori Folium polysaccharides and flavonoids all alleviated insulin resistance,among which Mori Folium flavonoids had better effect in alleviating Hep G2 insulin resistance(P<0. 05). The qRT-PCR analysis showed that Mori Folium polysaccharides and flavonoids could inhibit JNK and IRS-1 mRNA expressions,while enhancing PDX-1 mRNA expression. Western blot analysis displayed that Mori Folium polysaccharides and flavonoids could inhibit p-JNK and IRS-1 protein expressions,while enhancing PDX-1 protein expression. Mori Folium polysaccharides and flavonoids can alleviate insulin resistance in Hep G2 cells,and its mechanism may be the alleviation of insulin resistance by inhibiting JNK signaling pathway.

The effectiveness of traditional Chinese Medicine treatment of diabetic nephropathy in elderly patients / 中华老年医学杂志

Objective To assess the effectiveness of traditional Chinese Medicine (TCM ) syndrome differentiation treatment for diabetic nephropathy in elderly patients. Methods A total of 96 elderly patients with diabetic nephropathy admitted to our hospital from January 2015 to December 2017 were recruited and divided into a regular care group (n= 48)and a TCM group(n= 48).Both groups received conventional treatment ,with TCM syndrome differentiation treatment added to the TCM group. The effectiveness of the treatment modalities was compared. Results In the regular care group ,significant effectiveness was observed in 12 patients ,effectiveness in 24 patients ,and ineffectiveness in 12 patients ,with a total effectiveness rate of 75％ .In the TCM group ,significant effectiveness was seen in 18 patients ,effectiveness in 27 ,and ineffectiveness 3 ,with a total effectiveness rate of 93％. The total effectiveness rate of the TCM group was higher than that of the regular care group(χ2 =6.400 ,P=0.011).After treatment ,fasting blood glucose ,2 h postprandial blood glucose , urea nitrogen ,creatinine ,and 24 h urine protein in the TCM group were significantly lower than in the regular care group and than pre-treatment levels(P<0.05). Conclusions TCM differentiation can not only significantly improve the treatment effectiveness in elderly patients with diabetic nephropathy ,but also relieve the clinical symptoms.

Clinical efficacy of tripterygium wilfordii in the treatment of early diabetic nephropathy and its mechanism / 中国基层医药

Objective To investigate the clinical efficacy of tripterygium wilfordii in the treatment of early diabetic nephropathy and its mechanism .Methods 86 patients with early diabetic nephropathy admitted to Jiaxing Hospital of Zhejiang Provincial Armed Police Corps from December 2015 to December 2017 were selected as research subjects.They were randomly divided into two groups according to the digital table ,with 43 cases in each group .The control group was treated by conventional internal medicine , while the observation group was added tripterygium glycosides on the basis of the control group .The clinical efficacy of the two groups and the changes of serum matrix metalloproteinase-9 (MMP-9) and plasminogen activator -1 (PAI-1) before and after treatment were compared . Results The total effective rate of the observation group was significantly higher than that of the control group (86.04％vs.58.14％)(χ2 =8.323,P=0.004).The MMP-9 and PAI-1 levels and urinary protein of the two groups after treatment were significantly improved ,but the changes of the observation group [ ( 57 .36 ±10 .24 ) ng/L, (24.39 ±7.66)ng/mL,(70.35 ±12.58)μg/min] were more significant than those of the control group [(85.62 ± 15.42)ng/L,(29.64 ±8.61)ng/mL,(102.57 ±20.36)μg/min](t=10.011,P<0.001;t=2.987,P=0.004;t=3.828,P<0.001).Conclusion The therapeutic effect of tripterygium wilfordii in the treatment of early diabetic nephropathy is significant .The mechanism is related to improving the expression of MMP -9 in kidney tissue and reducing the level of PAI-1.

Clinical observation on delayed encephalopathy after carbon monoxide poisoning treated with acupuncture to restore consciousness combined with hyperbaric oxygen treatment / 中国针灸

<p><b>OBJECTIVE</b>To compare the efficacy differences on delayed encephalopathy after carbon monoxide poisoning (DEACMP) between acupuncture to restore consciousness combined with hyperbaric oxygen treatment and simple hyperbaric oxygen treatment.</p><p><b>METHODS</b>Forty-one patients with DEACMP were randomly divided into an observation group (21 cases) and a control group (20 cases). In the observation group, acupuncture was applied at Neiguan (PC 6), Shuigou (GV 26), Baihui (GV 20), Sishencong (EX-HN 1), Fengchi (GB 20), Hegu (LI 4), Sanyinjiao (SP 6) and Taichong (LR 3), and hyperbaric oxygen treatment was given as well. In the control group, simple hyperbaric oxygen treatment was used. The treatment was adopted once every day, and continuous 5 days' treatment made one session in the two groups. There were two days at the interval between two sessions and 6 sessions in the two groups. The changes of scores of mini mental state examination (MMSE) and Barthel index (BI) for activity of daily life and routine electroencephalogram (EEG) before and after treatment were compared.</p><p><b>RESULTS</b>After treatment, the scores of MMSE and BI and EEG were all improved compared with those before treatment (all P<0.01). The raise of the scores of MMSE and BI in the observation group was more obvious than that in the control group (both P<0.05) and the improvement of EEG abnormal condition in the observation group was also superior to that in the control group after treatment (P<0.05).</p><p><b>CONCLUSION</b>Acupuncture to restore consciousness combined with hyperbaric oxygen could obviously improve the cognitive function, activity of daily life and changes of EEG, and it is better than simple hyperbaric oxygen treatment.</p>

The clinical curative effects of different full spectrum light times in the treatment of sleep disorder for Alzheimer's disease / 中华行为医学与脑科学杂志

Objective To evaluate the clinical efficacy and safety of different full spectrum light times in treating patients with Alzheimer's disease (AD).Methods A total of 127 AD patients with sleep disorder were randomly divided into a blank group (n=34),a 30 min group (n=31),a 60 min group (n=33) and a 120 min group (n=29).After one month treatment by 10 000 lux full spectrum fluorescent light,the improvements of sleep quality,excessive daytime sleepiness,cognitive ability,mental state,dementia degree were graded by Pittsburgh sleep quality index (PQSI),Epworth sleepiness scale (ESS),Neuropsychiatric inventory (NPI),mini-mental state examination (MMSE),global deterioration scale (GDS).The scores were compared among the groups before the treatment and after the treatment respectively.Results (1) Compared with before treatment,the scores of PQSI,ESS,NPI of the 30 min group,60min group and 120min group were statistically significant (in 30 min group 14.4 ±5.2vs 11.7±4.9,14.4±4.1 vs 11.8±3.7,14.2±1.3 vs 10.9±1.7,t=2.071,2.609,8.446.P=0.043,0.011,0.000; in 60 min group13.4±4.0 vs 8.1±3.7,14.5±3.0 vs 9.4±2.0,13.7±5.8 vs 8.7±4.3,t=5.650,8.209,3.902,all P＜0.01 ;in 120 min group 14.0±3.2 vs 7.0±2.3,14.7-±2.3 vs 7.0± 1.9,14.9±3.6 vs 8.1±3.7,t=9.474,13.926,7.062,all P＜0.01),but the scores of MMSE,GDS were not statistical significances(all P＞0.05).(2)Compared with the blank group,the scores of PQSI,ESS,NPI of 30 min group,60 min group and 120 min group were statistically significant (30 min group t=1.936,4.524,2.482,P=0.031,0.000,0.016.60 min group t=5.945,5.153,7.319,all P=0.000.120 min group t=7.896,6.767,10.776,all P=0.000), but the scores of MMSE,GDS were not statistical significances(all P＞0.05).(3)Compared with the 30 min group,the scores of PQSI,ESS,NPI of 60 min group and 120 min group were statistically significances (60 min group t =3.288,2.694,3.354,P=0.002,0.009,0.001.120 min group t=4.615,3.930,6.303,all P =0.000),the scores of MMSE,GDS were not statistical significances (all P＞0.05).Compared with the 60 min group,the scores of ESS of 120 min group was statistically significant(t=4.854,P=0.000),but the scores of PQSI,NPI,MMSE,GDS were not statistical significances (all P ＞ 0.05).Conclusion It is demonstrated good curative effects that light therapy treat patients on AD patients in the matter of sleep quality,excessive daytime sleepiness,mental state,but have not apparent effect for their cognitive ability and dementia degree.And the effect of light therapy with 60 or 120 minutes is better than that of 30 minute,illumination time of 120 minutes is superior to that of 60 minutes in improving excessive daytime sleepiness.Light therapy has no obvious impacts in the cognitive ability and the degree of dementia in the patients with AD and has not appear obvious adverse reaction in the process of treatment.

Study on the relationship between Chinese medicine constitutive susceptibility and diversity of syndrome in diabetic nephropathy / 中国结合医学杂志

<p><b>OBJECTIVE</b>To explore the relationship between Chinese medicine (CM) constitutive susceptibility and syndrome diversity in diabetic nephropathy (DN).</p><p><b>METHODS</b>Epidemiologic investigation on constitution adopting the "Constitution in Chinese Medicine Questionnaire" (CCMQ), and survey on syndrome type by CM syndrome scale (preliminary) were carried out in 180 DN patients. Cluster analysis on symptom items was used to determine the syndrome type, and canonical correlation analysis was used to analyze the relationship between patients' constitution and syndrome.</p><p><b>RESULTS</b>Baseline levels in all enrolled patients were not different statistically. Cluster analysis showed 8 syndromes existed in DN patients, namely: I, qi-yin deficiency with qi-stagnancy type; II, yin-yang deficiency with heat-water-blood stasis type; III, qi-yin deficiency with dampness-heat type; IV, yin-yang deficiency with blood-stasis and heat type; V, qi-yin deficiency with stagnant heat type; VI, yin-yang deficiency with inner dampness-heat stagnancy type; VII, yin deficiency with heat stagnancy type; and VIII, Kidney (Shen)-Spleen (Pi) deficiency with stagnant heat type. Correlation analysis on the 8 syndromes and the 9 constitutions showed statistical significant correlations between syndrome III and dampness-heat constitution (P=0.0001); syndrome IV and blood-stasis constitution (P=0.0001); and syndrome VII and yin-deficiency constitution (P=0.0180).</p><p><b>CONCLUSION</b>Certain relationship revealed between CM constitutions and syndrome types; constitution decides the disease genesis, its syndrome type and prognosis, as well as the change of syndromes.</p>

Study on anti-inflammatory, eliminating phlegm and bacteriostatic action of Yuxuan granule / 国际中医中药杂志

Objective To reveal the mechanism of Yuxuan granule(YXG) in treating pharyngitis from anti-inflammatory,expectorant,and antibacterial actions.Methods Xylene-induced ear edema and cotton pellet induced granuloma mice models were adopted to observe the anti-inflammatory effects of YXG Phenol red secretion in mice test was adopted to observe the expectorant activity of YXG Five bacteria by tube dilution method was adopted to observe antimicrobial action of YXG Besides,the changes of routine indexes in blood and tumor necrosis factor (TNF),interleukin-1 (IL-1) in serum were measured in acute pharyngitis models.Results YXG has shown a dose-dependent of its anti-inflammatory action.In the test of xylene induced mice ear swelling and cotton ball induced granuloma,the swelling degree of the control group,positive control groupand YXG high (6.14g/kg),medium (3.07g/kg) and low (1.53g/kg) concentration group were (9.00± 1.50) mg,(3.50±0.10)mg,(4.25±1.08)mg,(5.54±0.97)mg,(8.05±0.08)mg and (1.22±1.50)mg,(0.50±0.10)ag,(0.45± 0.08) mg,(0.75± 0.97) mg,(0.70 ± 0.08) mg respectively.YXG also had obviously expectorant effect to the golden staphylocoecus ameus,hemolytic streptococcus,streptococcus pneumoniae,salmonella typhi and corynebacterium diphtheriae,with the minimum inhibition concentration of 55,100,68 and 35 mg/ml respectively; YXG also reduced leukocyte count [percentage of leukocyte was (9.88± 1.22) × 109/L,(7.50± 1.58) ×109/L,(6.02± 1.05) × 109/L,(8.38± 1.13) × 109/L,(8.75 ± 1.08) × 109/L in the five groups respectively],neutrophils [the value was (35.62±5.00)×109/L,(28.49±3.40)×109/L,(28.89±5.22)× 109/L,(29.34±4.83)×109/L,(33.43 ± 4.27) × 109/L in the five groups respectively],lymphocytes [the value was (70.72± 5.04) ％,(67.89 ±4.37)％,(60.14±3.88)％,(65.38±4.45)％,(65.65±4.28)％ in the five groups respectively],TNF in blood serum [the value was (90.25±2.29)ng/ml,(80.23 ± 0.60) ng/ml,(76.83±0.33)ng/ml,(78.00 ± 0.34) ng/ml,(80.52±1.14)ng/ml in the five groups respectively] and IL-1 [the value was (222.06±50.22)pg/ml,(149.55±50.02)pg/ml,(130.37 ± 30.61)pg/ml,(158.68 ± 40.00)pg/ml,(178.76 ± 39.26)pg/ml in the five groups respectively] in the acute pharyngitis rat.Conclusion Through the anti-inflammatory,expectorant,antimicrobial activity and reducing levels of TNF,IL-1 YXG achieves the goal of treating pharyngitis.

Association of Chinese medicine constitution susceptibility to diabetic nephropathy and transforming growth factor-β1 (T869C) gene polymorphism / 中国结合医学杂志

<p><b>OBJECTIVE</b>To explore the association of Chinese medicine constitution susceptibility to diabetic nephropathy (DN) and transforming growth factor (TGF)-β1 (T869C) gene polymorphism.</p><p><b>METHODS</b>TGF-β1 gene polymorphism detected with polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) was screened for 180 DN cases and 180 type 2 diabetic mellitus (T2DM) cases without combined DN. Patients with DN were surveyed epidemiologically with constitution in the Chinese medicine questionnaire (CCMQ). Binary logistic regression analysis was utilized to study the correlation between nine types of Chinese medicine constitution and TGF-β1 (T869C) gene polymorphisms.</p><p><b>RESULTS</b>The DN group has a higher frequency of TGF-β1 (T869C) gene polymorphism than the T2DM group, and CC/CT genotypes than the T2DM group [CC, CT, TT (DN group): 88, 87, 5 (cases) versus (T2DM group) 71, 73, 36 (cases), P<0.05]. The phlegm-dampness constitution, damp-heat constitution, and blood stasis constitution have correlations with TGF-β1 (T869C) gene polymorphism.</p><p><b>CONCLUSION</b>Chinese medicine constitutions were associated with TGF-β1 (T869C) gene polymorphism, a potential predictor of susceptibility to DN in T2DM patients.</p>

The design of inferior rectus abdominis flap and its study of applied anatomy / 华西口腔医学杂志

<p><b>OBJECTIVE</b>To describe the anatomy of inferior epigastric artery and its correlation with rectus abdominis muscle in order to provide anatomical basis for reconstruction of defect in the oral and maxillofacial region.</p><p><b>METHODS</b>10 Chinese adult specimens fixed by 10% formalin were simulated for the design of inferior rectus abdominis flap, and then observing, taking a photograph during the cadavers were being operated and measuring by image analysis software in the end.</p><p><b>RESULTS</b>The original external diameters of inferior epigastric artery and length of its trunk were (2.58 +/- 0.60) mm and (85.87 +/- 14.90) mm respectively. Its perforators distribute intensively toward hilum.</p><p><b>CONCLUSION</b>Whether rectus abdominis myocutaneous flap or deep inferior epigastric perforator flap adapts to reconstruct the defect of oral and maxillofacial region due to invariable traveling of inferior epigastric artery and its wide original external diameters relatively.</p>

Correlative study on TCM syndrome and laboratory indices in 265 cases of diabetic nephropathy renal failure / 中华中医药杂志

Objective:To discuss relativity of different TCM syndrome with sex,age and laboratory indices in 265 cases of diabetic nephropathy renal failure,and this work is meaningful to open out the naure of TCM syndrome.Methods:The research proceeded the questionary of diabetic nephropathy established according to task group.Including commonly instances,four diagnostic methods information of TCM and correlative laboratory indices.Canonical correlative analysis was adopted to research the relativity of laboratory indices with different TCM syndrome.Results:The results of canonical correlative analysis displayed that phlegm-dampness and BMI,dampness-turbid and creatinine clearance rate,deficiency of yin and glycosylated hemoglobin had pertinence(P