The role of the gut microbiota in the pathogenesis of sarcopenia / 中华老年医学杂志

Sarcopenia is a progressive syndrome associated with aging, generalized loss of skeletal muscle mass, muscle strength and function.It is closely related to the occurrence of adverse events such as ambulatorydysfunction, falls and fractures in the elderly, and seriously affects the quality of life of the elderly.The etiology of sarcopenia has not been fully elucidated.Various pathophysiological mechanisms such as reduced exercise, genetic factors, age-related hormone changes, malnutrition and insufficient protein intake, decreased neuromuscular function, pro-inflammatory cytokines, and myocyte apoptosis are possible factors.Recent studies have found that intestinal microecological changes may be implicated in the occurrence and development of sarcopenia.In this article, we reviewed intestinal microecological changes and their possible role in the mechanisms underlying sarcopenia.

Teaching and thinking of evidence-based medicine in endocrinology standardized residency training / 中华医学教育探索杂志

In recent years, evidence-based medicine has developed rapidly, and its ideas and methods have been increasingly used in medical education. We have promoted the model, theory and practical methods of evidence-based medicine in the teaching of endocrinology standardized residency training, which has improved students' learning enthusiasm and initiative, and also enhanced students' mastery of professional knowledge and cultivation and innovation of clinical thinking. In view of the existing problems, this essay puts forward some solutions to help residents to meet the requirements of rapid developments in endocrinology and generally promote the standardization of residents' medical practice behavior.

Fenofibrate ameliorates insulin resistance in lipoprotein lipase heterozygous knockout mice and its possible mechanisms / 中华内分泌代谢杂志

Objective To investigate the effect of fenofibrate on glucolipid metabolism and insulin sensitivity in lipoprotein lipase heterozygous knockout ( LPL+/-) mice, and to explore its mechanism. Methods LPL+/- mice and wild type ( WT) C57 mice were selected and divided into 3 groups ( n=6 each group):LPL+/-( FB) group, LPL+/-(W)group,andWTgroup.MiceinLPL+/-(FB)groupweregavagedwithfenofibrate(50mg·kg-1·d-1)for8 weeks. Mice in LPL+/-( W) and WT groups were orally fed with the same volume water as that in LPL+/-( FB) group for 8 weeks. Body weight was observed. Plasma triglyceride ( TG ) and free fatty acid ( FFA ) were measured. Intraperitoneal glucose tolerance test in 3 groups of mice were performed. The glucose area under the curve ( AUCG) and homeostasis model assessment for insulin resistance index ( HOMA-IR) were calculated. Insulin-stimulated Ser473 Akt phosphorylation in liver and skeletal muscle was measured by Western blot. Reactive oxygen species ( ROS) levels in liver and skeletal muscle were determined by dihydroethidium staining method and superoxide dismutase ( SOD) and catalase ( CAT) mRNA expression levels were detected by real-time PCR. Results Compared with LPL+/-( W) mice, body weight of LPL+/-( FB) mice was lowered, plasma TG and FFA levels were decreased by about 46.0％and 76.5％respectively, and fasting insulin level and HOMA-IR were decreased while there were no significant differences in fasting glucose level and AUCG between two groups. Insulin-stimulated Ser473 Akt phosphorylation levels in liver and skeletal muscle of LPL+/-mice were enhanced by fenofibrate. ROS level in skeletal muscle of LPL+/-( FB) mice was lower than that in LPL+/-( W) mice while there was no significant difference in ROS of liver between two groups. Fenofibrate significantly increased SOD and CAT mRNA expressions in skeletal muscle of LPL+/-mice, but not in liver. Conclusion Fenofibrate reduces body weight, ameliorates lipid metabolism, and improves insulin sensitivity in LPL+/- mice, with reduced oxidative stress.

Association between HbA1C and plasma lipid profiles in newly diagnosed diabetic patients / 中华内分泌代谢杂志

[Summary] In newly diagnosed diabetic patients, fasting plasma glucose, HbA1C , and plasma lipid profiles were measured to analyze the association between HbA1C and plasma lipid profiles. HbA1C might affect plasma lipid profiles in newly diagnosed diabetic patients. Higher HbA1C was associated with the worse plasma lipid profiles and more severe insulin resistance.

Severe hypertriglyceridemia caused by autoimmune disease：Case summary and literature review / 中华内分泌代谢杂志

[Summary]_ Severe hypertriglyceridemia is the third common cause of acute pancreatitis following after alcohol abuse and cholelithiasis. Moreover, it is also an important risk factor of cardiovascular events. However, the cases of severe hypertriglyceridemia caused by autoimmune disease were rare in clinical, which would bring the difficulty for diagnosis and treatment. A better understanding of the clinical characteristics, possible pathogenesis, and corresponding therapy of the disease would be helpful, which would reduce the risk of complications, and finally improve both the survival rate as well as quality of life of these patients.

Glucolipid metabolism of lipoprotein lipase heterozygous mice and the mechanism of insulin resistance / 中华内分泌代谢杂志

Objective To investigate the glucolipid metabolism in lipoprotein lipase (LPL) gene knockout mice, and to explore the possible mechanisms of insulin resistance. Methods 16- and 40-week old LPL gene knockout heterozygous mice( LPL + / -) and wild type ( WT) C57 mice were selected and divided into 4 groups:16-week LPL+ / -(n=6), 16-week WT(n = 6), 40-week LPL+ / -(n = 6), and 40-week WT(n = 6) group. LPL activity of post-heparin serum was examined. Serum triglyceride( TG) and free fatty acid( FFA) were measuzed. Intraperitoneal glucose tolerance test(IPGTT) in 4 groups of mice were performed. The glucose area under the curve (AUCG) and homeostasis model assessment for insulin resistance index and β-cell function index ( HOMA-IR, HOMA-β) were calculated to evaluate insulin sensitivity and the function of islet β-cells. Serum malondialdehyde (MDA) and total antioxidant capacity ( TAOC) levels were determined by means of colorimetric method. Using dihydroethidium( DHE) fluorescent staining method, reactive oxygen species ( ROS) levels in liver and skeletal muscle were determined. Results LPL activity levels of both 16- and 40-week LPL+ / - mice were significantly lower than that in WT mice of the same age. Serum TG and FFA of 40-week old LPL+ / - mice were significantly higher than those in WT mice of the same age(P<0. 05), and they were also higher than those of 16-week old LPL+ / - mice(P<0. 05). IPGTT showed that compared with WT mice, blood glucose level in LPL+ / - mice was significantly higher than that in WT group at 30 and 120 minute(P<0. 05), and fasting insulin and HOMA-IR were increased significantly(P<0. 05). Serum MDA of 40-week old LPL+ / - mice was evidently higher than that in WT mice by the same week(P<0. 05), while TAOC level was lower than that of WT mice (P<0. 05). ROS in skeletal muscle of 16-week old LPL+ /- mice was significantly increased. Meanwhile, ROS in both liver and skeletal muscle of 40-week old LPL+ / - mice was significantly higher than that in WT mice of the same age. Conclusion As time goes by, lipid and glucose disorders of LPL+ / - mice are aggravating, and insulin resistance develops evidently. Insulin resistance in LPL+ / -mice with dyslipidemia may be related to oxidative stress.

Research about the tolerance of GK rats in stress hyperglycemia associated with acute sepsis / 中华内分泌代谢杂志

Objective To compare the differences in responsive ability and oxidative stress damage between type 2 diabetic rats and normal rats under acute sepsis associated with stress hyperglycemia.Methods GK rats with type 2 diabetes and Wistar rats were established critical ill models of sepsis by intraperitoneal injection of 5 mg/kg lipopolysaccharide(LPS).Before and after LPS injection,serum levels of proinflammatory cytokines tumor necrosis factor α (TNF-α),interleukin (IL)-1β3,and IL-6,and anti-inflammatory cytokine IL-10 were determined.Malondialdehyde (MDA) and total antioxidative capacity (T-AOC) levels in serum and tissues (lung,liver,kidney,heart) were measured by colorimetric determination.Results Before LPS injection,serum levels of TNF-α,IL-6,and IL-10 in GK rats were higher than those of Wistar rats.The serum levels of TNF-α,IL-6,and IL-10 after LPS injection were raised in both GK rats and Wistar rats (all P＜0.05).At baseline,serum MDA level of GK rats was higher than that of Wistar group [(25.76 vs 12.71) μmol/L,P＜0.05],while T-AOC level were lower [(0.60 vs 2.8) U/ml,P＜0.05].One hour after LPS injection,the serum MDA level in two kinds of rats significantly increased compared with those of their baseline levels [(32.30 and 20.19) μmol/L,both P＜0.05],while their serum T-AOC level decreased [(0.20 and 2.08) U/ml,P＜0.05]).There were no signigicant differences in the change trend of serum MDA and T-AOC between the two kinds of rats.MDA and T-AOC levels in tissues had no significant difference before and after LPS injection in GK and Wistar rats (P＞0.05).Conclusions The rats with type 2 diabetes had lowered level of proinflammatory factors and raised level of anti-inflammatory factors under acute sepsis,presenting better tolerance and lowered probability of inflammatory diffusion compared with normal rats.

The protein function of lipoprotein lipase with Asn291Ser and Lys312insC compound mutation / 中华内分泌代谢杂志

To study the function of lipoprotein lipase (LPL)with Asn291 Ser and Lys312insC compound mutation in LPL gene knockout heterozygous (LPL~(+/-)) mice. The results showed that triglycerides, free fatty acids, blood glucose and weight of LPL~(+/-) mice were higher than those of c57 mice(P<0. 05). The expressions of LPL Mrna and LPL protein of LPL~(+/-) group were lower than those of c57 group(P<0.05). The injection of Asn291Ser +Lys312insC protein caused little change of the lipid mass and LPL activity,but the injection of normal LPL protein induced obvious decrease of lipid mass and increase of the LPL activity.

Clinical analysis of inpatients with hyperglycemia in the medical intensive care units——Data of Shanghai Renji Hospital from 2002 to 2009 / 中华内分泌代谢杂志

Objective To analyze the association of the morbidity,the management of blood glucose,and the prognosis of patients with hyperglycemia in the medical intensive care units(ICU).Methods Medical records of ICU patients of Renji Hospital from 2002 to 2009 were reviewed using Medical Record Inquiry System,and the data were retrospectively analyzed.Results(1)2631 subjects were included in the present study,blood glucose was determined at least once during hospitalization in 2168 of them.The incidence of hyperglycemia was 26.3%,in which 12.9% presented a known history of diabetes and 13.4% without.In the patients with diabetes history,93.2% of them received anti-diabetic treatment during hospitalization.mainly with oral anti-hyperglyeemic agents (53.0%)or subcutaneous insulin injection(24.9%).However,in the patients without diabetes history,84.4% were not treated against hyperglycemia.The mortality was increased in the latter group(30.4% vs13.9%,P<0.01).(2)In the patients with diabetes history,the mortality in patients whose blood glucose>10 mmol/L was higher than those with blood glucose≤7.0 mmol/L(20.5% vs 9.9%,P<0.05):while in the patients without diabetes history,the mortality began to rise as blood glucose>7.0 mmol/L(P<0.01).(3)Multiple stepwise regression analysis revealed that the average blood glucose level was an independent risk factor for death(OR=1.26).Conclusions The ICU patients showed a high prevalence of hyperglycemia,the management of hyperglycemia should be emphasized.Hyperglycemia in critically ill patients might be an independent risk factor of increased mortality.

Diabetes mellitus may not increase mortality of patients in intensive care units / 中华内分泌代谢杂志

In recent years,several studies have revealed that diabetic patients may have decreased mortality compared with non-diabetic patients from acute hyperglycemia in intensive care units (ICUs),and the patients without diabetic history are most likely to benefit from intensive insulin therapy.This probably suggests a potential "protective" effect in diabetic patients with critical illness.Possible "protective" mechanisms include the adaptive reaction to chronic oxidative stress state in diabetes,the decreased incidence of acute complications followed by critical illness,and some non-biological factors.Thus much more attention of glycemic management should be paid to those hyperglyemic patients without diabetic history in ICUs.

Thiazolidinediones combined with metformin in treatment of polycystic ovary syndrome:a systematic review / 第二军医大学学报

Objective To assess the efficacy and safety of thiazolidinediones combined with metformin in treatment of polycystic ovary syndrome.Methods Electronic database searching was performed on Medline,Cochrane Library,EMbase,EBSCO,ScienceDirect,OVID,Springer LINK,Wiley,Chinese biology and medicine(CBM),China National Knowledge Infrastructure(CNKI),and Chongqing VIP Database;meanwhile,unpubished literature,conference papers and dissertations were also searched manually.The data included those from the establishment to November 2009.Randomized or clinical controlled trials concerning the thiazolidinediones and metformin combination therapy for PCOS were selected and assessed for the methodological quality,and Meta-analysis was performed using statistical software Revman 5.0.Results Five randomized controlled trials met the inclusion criteria and were included.Compared to metformin group,thiazolidinediones combined with metformin significantly improved insulin resistance(P

FIBER PROJECTIONS FROM THE NUCLEI OF THE TRIGEMINAL NERVE TO THE CEREBELLAR CORTEX OF THE RAT——A STUDY WITH THE HRP METHOD / 解剖学报

The trigemino-cerebellar projections of rats were studied by introducing HRP microelectrophoretically into various areas of the cerebellar cortex. The results indicate that the following parts of the cerebellum receive bilateral (mostly ipsilateral) trigeminal projections, namely, the simple lobule, the crusa Ⅰ and Ⅱ, the paramedian lobuIe, the dorsal paraflocculus, the lateral part of the lobule Ⅷ and the vermal cortex of the lobules Ⅵ～Ⅸ.Fibers from the interpolar subnucleus and the principal sensory nucleus of the trigeminal nerve project to all of the above mentioned areas.The caudal subnucleus projects to the crus Ⅰ, the paramedian lobule, the dorsal paraflocculus, the lateral part of the lobule Ⅷ and the vermal cortex of the lobules Ⅵ～Ⅸ.The oral subnucleus gives its projections to the crus Ⅱ, the paramedian lobule, the lateral part of the lobule Ⅷ and the vermal cortex of the lobules Ⅶ～Ⅸ.The mesencephalic nucleus of the trigeminal nerve sends fibers to the crura Ⅰ and Ⅱ, the paramedian lobule, the lateral part of the lobule Ⅷ and the vermal cortex of lobules Ⅶ～Ⅸ.A few labeled neurons were found in the motor nucleus of the trigeminal nerve; while in the region ventro-lateral to the motor nucleus, in the root of the trigeminal nerve and in areas adjacent to it large amount of labeled cells were seen in all the cases studied.Unexpectedly, several labeled neurons were seen in a semilunar ganglion of the trigeminal nerve.

LOCALIZATION OF THE CELL BODIES OF THE PHRENIC MOTOR AND SENSORY NEURONES IN RABBIT BY HRP METHOD / 解剖学报

Eight rabbits were used in this study.The position of the phrenic nucleus in thespinal cord,the morphology of the phrenic motoneurones and position of the cellbodies of the sensory neurons of the phrenic nerve were determined by using themethod of HRP labelling through the centralcutting end of the left phrenic nerve atthe root of the neck.The results were as follows:1.The phrenic nucleus in the rabbit was located in C_3,C_4,and C_5 segments.Itis a longitudinal cell column lying between the ventromedial and the ventrolateralcolumns of the ventral horn of the spinal cord.2.Phrenic motoneurones differed in shape and size.Most of the cell bodies ofthe rabbit's phrenic motoneurones were round or oval in shape,ranging from 5 to45 ?m(mean 25 ?m)in diameter.3.The rabbit phrenic nerve arises from the ventral rami of the 3 rd,4 th and5 th cervical nerves,and the nucleus of this nerve does not extend beyond the 3 rd-5 th segments——the location of the nucleus corresponds with the segmental rootsfrom which the phrenic nerve arises.4.The cell bodies of the sensory neurones of the rabbit's phrenic nerve werelocated in the dorsal root ganglia of the third and fourth cervical nerves.Besides,50 rabbits were dissected,and the origin of their phrenic nerves werestudied.

FIBER PROJECTIONS FROM THE NucLEI OF THE TRIGEMINAL NERVE TO THE CEREBELLAR NUCLEI OF THE RAT / 解剖学报

The trigemino-cerebellar projections of the rats were studied by introducing HRP microelectrophoretically in to various deep icerebellar nuclei (dentate nucleus, ND; interpositus nucleus, anterior part, NIA; interpositus nucleus, posterior part, NIP; fastigial nucleus, NF). The results indicate that all nuclei of the trigeminal nerve give their projections to bilateral (mostly ipsilateral) deep cerebellar nuclei. Most of them come from the interpolar and oral subnuclei of the spinal nucleus of the trigeminal nerve. The caudal subnucleus of the spinal nucleus of the trigeminal nerve and the principal sensory nucleus of the trigeminal nerve (VP) take the second place. Least of all come from the mesencephalic nucleus (ME) and the motor nucleus (MO) of the trigeminal nerve. In addition, cells in the region ventrolateral to the motor nucleus (VMO) and in the root of the trigeminal nerve (VR) also project to deep cerebellar nuclei. Fibers coming from ME terminate mostly in NF and NIA. Fibers from the spinal nucleus of the trigeminal nerve and VP terminate more in NIP and ND. Fibers from MO terminate in NF, NIA and ND. Fibers from VMO and VR have the same termination as those from the sensory nuclear complex of the trigeminal nerve.