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AIM: To investigate the risk factors of refractive regression after correction of moderate and high myopia by femtosecond laser assisted in situ keratomileusis(FS-LASIK)for 1 a, and construct prediction model.METHODS: A retrospective analysis was performed on the clinical data of 400 patients(800 eyes)with moderate and high myopia undergoing FS-LASIK correction in Xi'an Gaoxin Hospital from June 2017 to November 2018, and the patients were randomly divided into modeling group(n=300)and verification group(n=100)according to a ratio of 3:1. The modeling group was divided into regression group and non-regression group according to the occurrence of refractive regression at 1 a after surgery. The changes of corneal curvature and corneal thickness were observed. Logistic regression analysis was used to screen the risk factors of refractive regression in patients with moderate and high myopia at 1 a after FS-LASIK correction, and the prediction model was built based on the regression coefficient. Receiver operating curve(ROC)was used to evaluate model differentiation.RESULTS:Refractive regression occurred in 44 eyes of the modeling group and 15 eyes of the verification group at 1 a after surgery. The anterior corneal surface curvature in the modeling group was lower than that in the regression group at 6 and 12 mo after surgery(all P<0.05). The degree of corneal hyperplasia in the regression group was greater than that in the non-regression group at 1, 3, 6 and 12 mo after surgery(all P<0.05). The regression equation of the probability value of refractive regression in patients with moderate and high myopia corrected by FS-LASIK at 1 a after surgery is as follows:P=1/[1+e-(-5.989+0.127×age+2.019×preoperative diopter-0.022×preoperative central corneal thickness+0.043×depth of cutting-1.569×diameter of cutting optical region)], Hosmer-Lemeshow detected the goodness of fit of the regression equation(P=0.818). Internal verification using the modeling group data showed that the area under ROC curve was 0.890(95%CI: 0.843-0.937), the sensitivity was 81.82%, and the specificity was 84.71%. The area under ROC curve was 0.838(95%CI: 0.717-0.959), the sensitivity was 80.00%, and the specificity was 87.57%.CONCLUSIONS:The established risk model has good discriminating validity and can be used to identify the high-risk group of refractive regression at 1 a after FS-LASIK in patients with moderate and high myopia.
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ObjectiveTo investigate the effect of rutin on the browning of 3T3-L1 preadipocytes and the mechanism. MethodCell counting kit-8 (CCK-8) assay was used to detect the effect of different concentration of rutin (3.125, 6.25, 12.5, 25, 50, 100, 200 μmol·L-1) on 3T3-L1 cell activity, and Western blot to examine the effect of rutin (12.5, 25, 50 μmol·L-1) on the expression of thermogenesis-associated proteins uncoupling protein 1 (UCP1), PR domain containing 16 (PRDM16) and peroxisome proliferator-activated receptor γ coactivator-1α (PGC-1α) in adipocytes. After the optimal concentration of rutin was determined, the effect of rutin on lipid droplet formation in adipocytes was observed based on oil red O staining, and the expression of nuclear respiratory factor 1 (NRF1), nuclear respiratory factor 2 (NRF2) and mitochondrial transcription factor A (TFAM), which were the landmark proteins of mitochondrial biosynthesis, was detected by Western blot. ResultCompared with the blank group, 200 μmol·L-1 rutin inhibited 3T3-L1 cell activity (P<0.01). Compared with the blank group, at the concentration of 12.5, 25, 50 μmol·L-1 rutin significantly promoted the expression of thermogenesis-associated proteins (UCP1, PRDM16, and PGC-1α) (P<0.01), which was determined as the optimal concentration. Compared with the blank group, 50 μmol·L-1 rutin significantly increased the immunofluorescence intensity of mitochondrial UCP1 protein in 3T3-L1 cells (P<0.01) and the expression of the markers of mitochondrial biosynthesis (NRF1, NRF2, and TFAM) (P<0.01). In addition, 50 μmol·L-1 rutin significantly inhibited lipid droplet formation of 3T3-L1 adipocytes (P<0.01). ConclusionRutin inhibited lipid droplet deposition in 3T3-L1 adipocytes and increased the expression of thermogenesis-related proteins (UCP1, PRDM16, and PGC-1α) and markers of mitochondrial biosynthesis (NRF1, NRF2, and TFAM), thereby inducing the browning of 3T3-L1 adipocytes. This lays a basis for the development of drugs that safely regulate the browning of white cells.
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Mulberry (Morus alba L.) leaf is a well-established traditional Chinese botanical and culinary resource. It has found widespread application in the management of diabetes. The bioactive constituents of mulberry leaf, specifically mulberry leaf flavonoids (MLFs), exhibit pronounced potential in the amelioration of type 2 diabetes (T2D). This potential is attributed to their ability to safeguard pancreatic β cells, enhance insulin resistance, and inhibit α-glucosidase activity. Our antecedent research findings underscore the substantial therapeutic efficacy of MLFs in treating T2D. However, the precise mechanistic underpinnings of MLF's anti-T2D effects remain the subject of inquiry. Activation of brown/beige adipocytes is a novel and promising strategy for T2D treatment. In the present study, our primary objective was to elucidate the impact of MLFs on adipose tissue browning in db/db mice and 3T3-L1 cells and elucidate its underlying mechanism. The results manifested that MLFs reduced body weight and food intake, alleviated hepatic steatosis, improved insulin sensitivity, and increased lipolysis and thermogenesis in db/db mice. Moreover, MLFs activated brown adipose tissue (BAT) and induced the browning of inguinal white adipose tissue (IWAT) and 3T3-L1 adipocytes by increasing the expressions of brown adipocyte marker genes and proteins such as uncoupling protein 1 (UCP1) and beige adipocyte marker genes such as transmembrane protein 26 (Tmem26), thereby promoting mitochondrial biogenesis. Mechanistically, MLFs facilitated the activation of BAT and the induction of WAT browning to ameliorate T2D primarily through the activation of AMP-activated protein kinase (AMPK)/sirtuin 1 (SIRT1)/peroxisome proliferator-activated receptor-gamma coactivator 1α (PGC-1α) signaling pathway. These findings highlight the unique capacity of MLF to counteract T2D by enhancing BAT activation and inducing browning of IWAT, thereby ameliorating glucose and lipid metabolism disorders. As such, MLFs emerge as a prospective and innovative browning agent for the treatment of T2D.
Subject(s)
Mice , Animals , Adipose Tissue, Brown , Sirtuin 1/pharmacology , Diabetes Mellitus, Type 2/metabolism , AMP-Activated Protein Kinases/metabolism , Morus/metabolism , Flavonoids/metabolism , Prospective Studies , Signal Transduction , Adipose Tissue, White , Plant Leaves , Uncoupling Protein 1/metabolism , Peroxisome Proliferator-Activated Receptor Gamma Coactivator 1-alpha/metabolismABSTRACT
ObjectiveTo investigate the medicinal effect of total flavonoids of mulberry leaves on regulating liver lipid metabolism disorder in diabetes mellitus type 2 (T2DM) rats, and the mechanism based on liver peroxidase proliferators activate receptors-α (PPAR-α) and carnitine palmityl transferase-1 (CPT-1) proteins. MethodTotal flavonoids of mulberry leaves were extracted and purified by ethanol extraction + macroporous resin purification and then identified. T2DM rat model was induced by high fat diet (HFD) + streptozocin(STZ)method. Rats with blood glucose ≥ 11.1 mmol·L-1 were divided into three administration groups with the high dose (300 mg·kg-1), medium dose (150 mg·kg-1), and low dose (75 mg·kg-1) of total flavonoids of mulberry leaves for 8 weeks, respectively, to observe the weight and blood glucose of the rats. The pathological changes of rat livers were observed by hematoxylin-eosin (HE) staining. Biochemical method was used to detect the levels of total cholesterol (TC), triglyceride (TG), low density lipoprotein-cholesterol (LDL-C), and high density lipoprotein-cholesterol (HDL-C) of blood lipid metabolism in rats. The messenger ribonucleic acid (mRNA) and protein expressions of PPAR-α and CPT-1 were determined by real-time quantitative polymerase chain reaction (Real-time PCR) and Western blot. ResultAfter 8 weeks of intervention of total flavonoids of mulberry leaves, compared with the control group, the food intake, liver index, and fasting blood glucose of rats in the model group increased significantly (P<0.01). Compared with the model group, the food intake, fasting blood glucose, and liver index of rats in the administration groups decreased significantly (P<0.01). The results of HE staining showed that the liver tissue structure of rats in the control group was complete and there was no obvious abnormality. The model group showed vacuolar degeneration and inflammatory infiltration of hepatocytes of rats. There was no obvious abnormality in the liver structure of rats in the administration groups. The results of blood lipid showed that compared with the control group, the levels of TC, TG, and LDL-C increased significantly (P<0.01), but the level of HDL-C decreased significantly (P<0.01) in the model group. Compared with the model group, the levels of TC, TG, and LDL-C decreased significantly (P<0.05, P<0.01), whereas the level of HDL-C increased significantly (P<0.01) in the administration groups. The results of Real-time PCR showed that compared with the control group, the mRNA expression of PPAR-α and CPT-1 of rats in the model group decreased significantly (P<0.01). Compared with the model group, the mRNA expressions of PPAR-α and CPT-1 of rats in the high-dose group increased significantly (P<0.01). The results of Western blot showed that compared with the control group, the protein expressions of PPAR-α and CPT-1 of rats in the model group decreased significantly (P<0.01). Compared with the model group, the protein expressions of PPAR-α and CPT-1 of rats in the high-dose group increased significantly (P<0.05, P<0.01). ConclusionTotal flavonoids of mulberry leaves can effectively reduce blood glucose and improve liver lipid metabolism disorder in T2DM rats. The total flavonoids of mulberry leaves could regulate lipid metabolism and play a hypoglycemic role by activating and regulating PPAR-α and CPT-1 proteins and promoting oxidative decomposition of fatty acids.
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The incidence of diabetes has been on the rise as the result of lifestyle changes, especially the high-fat diet and reduced exercise. Thus, it has become a global public health problem and it is an urgent task to explore effective therapy. There has been an explosion of research on the relationship of transforming growth factor-β (TGF-β) signaling pathways with diabetes complications and tumors, but the role of the pathways in the occurrence and progression of diabetes remains unclear. TGF-β signaling pathways can be activated by many factors, directly or indirectly leading to the apoptosis of islet β cells and insulin resistance (IR), and thus they are expected to become new targets for the treatment of diabetes. TGF-β-related signaling pathways involve AMP-activated proteinkinase (AMPK), protooncogene (c-Myc), Ski-relatednovel protein N (SnoN), Smad ubiquitination regulatory factor 1 (Smurf1), miR-335-5p, and other signaling molecules. They participate in the occurrence and development of IR, apoptosis of islet β cells, insulin secretion disorder, fibrosis of adipocytes, and metabolic disorder of adipocytes, and inhibit the browning of white adipose tissue, playing an important part in the pathological process of human diabetes. According to traditional Chinese medicine (TCM), the pathogenesis of diabetes is the deficiency of Qi and Yin, and the late stage is characterized by the syndrome of Qi deficiency, and Yang deficiency and blood stasis, which should be treated according to the principle of replenishing Qi and nourishing Yin, warming Yang and activating blood. It has been found that the efficacy of some Chinese medicinals and compound prescriptions on diabetes is closely related to the TGF-β signaling pathways. This paper reviews TGF-β-associated signaling pathways, elucidating the roles of them in pathogenesis of diabetes, and analyzes the relationship of TGF-β-associated signaling pathways with the effect of compound Chinese medicine prescriptions against diabetes. This study is expected to lay a theoretical basis for the research on the treatment diabetes.
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Objective To explore the conditions, safety and efifcacy of exchange transfusion for extremely severe hyper-bilirubinemia in term newborns requiring mechanical ventilation. Methods Ten full-term newborns of extremely severe hyper-bilirubinemia requiring mechanical ventilation were selected from January 2010 to March 2013 in the department of neonatology. After stable vital sign was achieved by the use of conventional life support, peripheral arterial and venous synchronous exchange transfusion was performed. The bilirubin, platelets, blood calcium, blood coagulation and blood gas were monitored before and after exchange transfusion. The effects and adverse events of exchange transfusion in newborns on mechanical ventilation were observed. Results There was no death in the study, and the replacement rate of total bilirubin was 50.5%. The main adverse event was thrombocytopenia (80%). There was a signiifcant difference in platelet counting before and after exchange transfusion (P<0.05). There was no signiifcant difference in blood coagulation, pH/HCO3-of the blood gas, prothrombin time (PT) and acti-vated partial thromboplastin time (APTT) before and after exchange transfusion. Conclusions It is relatively safe to implement an exchange transfusion in the full-term newborns with severe hyperbilirubinemia in newborns requiring mechanical ventilation, but the use of conventional life support is prerequisite because it stabilizes vital signs. The relatively ideal replacement rate of bili-rubin and the low incidence of adverse reactions are expected. However long-term prognosis of neural system is still unknown.