Effects of metformin and insulin on gestational diabetes mellitus: A dual drugs therapy approach.

This study was aimed to investigate the combined effects of metformin hydrochloride and insulin during gestational diabetes mellitus. A total 136 patients were randomly divided into study and control group. The control group was treated with insulin only while the study group was additionally treated with metformin hydrochloride. Maternal-infant outcomes and the levels of fasting blood glucose (FBG), 2h postprandial blood glucose (2hPG), glycosylated hemoglobin (HbA1c), total cholesterol (TC), total bilirubin (TBil), uric acid (UA) and microalbunminuria (mAlb) before and after treatment were compared. In post-treatment, the levels of FBG, 2h PG and HbA1c were decreased significantly (p<0.05) in both groups compared with pre-treatment. The levels of TC, TBil, UA and mAlb in both groups were significantly improved compared with pre-treatment. Levels of TC, UA and mAlb in the study group were significantly lower while TBil level was higher than control group. Compared to the control group, the incidence of gestational hypertension and premature delivery were significantly lower in the study group. There was no significant difference in the incidence of neonatal respiratory distress. The combination of metformin hydrochloride and insulin has significant effect in the treatment of gestational diabetes mellitus.

Systematic review and meta-analysis of the effect of transcutaneous electrical acupoint stimulation on gastrointestinal function after laparoscopic surgery.

BACKGROUND: Postoperative gastrointestinal dysfunction (PGD) leading to nausea, vomiting, and abdominal distension are common complications after laparoscopic surgery for abdominal diseases. However, drugs cannot completely stop PGD. Over the years, transcutaneous electrical acupoint stimulation (TEAS) therapy has shown potential in preventing PGD, but there is no medical evidence that TEAS represents the best choice for the treatment of PGD. This network meta-analysis sought to evaluate the effectiveness of TEAS therapy in preventing PGD in patients after abdominal laparoscopic surgery. METHODS: Articles (published from the establishment of the databases to July 2021) were retrieved from the following databases: PubMed/Medline, Cochrane Library, Web of Science, Embase, China Biomedical Literature Database (CBM), China Technical Journal VIP Database (CQVIP), China Knowledge Infrastructure (CNKI), and the Wanfang Database. The Cochrane risk of bias tool was used to evaluate the quality of the included studies, and a network meta-analysis was performed using RevMan 5.20. RESULTS: A total of 7 randomized controlled trials, comprising 440 TEAS-treated patients and 468 control patients, were included in the meta-analysis. The meta-analysis showed that there was no significant difference between the TEAS treatment group and the control group in relation to postoperative nausea and vomiting [relative risk (RR) =0.66; 95% confidence interval (CI): 0.37-1.21; P=0.18], postoperative abdominal distension (RR =0.53; 95% CI: 0.40-0.72; P<0.0001), the time of first postoperative fart (imply gastrointestinal motility) [mean difference (MD) =-7.31; 95% CI: -11.33 to -3.30; P=0.0004], and the time of first postoperative bowel movement (MD =-5.28; 95% CI: -7.23 to -3.33; P<0.0001); there were significant differences among these 3 indicators. DISCUSSION: We found that TEAS can promote postoperative fart and bowel movement, and has good clinical value in promoting postoperative gastrointestinal function recovery.

Dimethyl Itaconate Alleviates the Inflammatory Responses of Macrophages in Sepsis.

Sepsis is an inflammatory disease characterized by dysregulation of inflammation. Macrophage-mediated inflammation has been implicated in the pathophysiology of sepsis. Itaconate is a metabolite produced in activated macrophages which has anti-inflammatory activities. In the present study, we investigated the potential effects of a cell-permeable itaconate derivative dimethyl itaconate on inflammation in sepsis. We established a lipopolysaccharide (LPS)-induced septic mouse model and administered dimethyl itaconate to the septic mice. The survival rate, serum level of pro-inflammatory cytokines, and lung pathology were evaluated. We also administered dimethyl itaconate to LPS-treated bone marrow-derived macrophages (BMDMs), and measured the cytokine production and Nrf2 expression. We also evaluated the effects of dimethyl itaconate on Nrf2-deficient mice. Administration of dimethyl itaconate enhanced survival rate, decreased serum level of TNF-α and IL-6, and ameliorated lung injury in septic mice. Dimethyl itaconate also suppressed LPS-induced production of TNF-α, IL-6, and NOS2 in BMDMs. Dimethyl itaconate activated Nrf2 and promoted the expression of Nrf2 and its downstream factor HO-1 and NQO-1. The regulatory activities of dimethyl itaconate on inflammatory cytokine production, mouse survival rate were abolished in septic Nrf2-/- mice. Dimethyl itaconate suppressed the inflammatory responses of macrophages in sepsis.

Tetramethylpyrazine attenuates placental oxidative stress, inflammatory responses and endoplasmic reticulum stress in a mouse model of gestational diabetes mellitus.

Gestational diabetes mellitus (GDM) is a disease characterized by insufficient insulin secretion and glucose metabolic disorder during pregnancy. Tetramethylpyrazine has been reported to inhibit endoplasmic reticulum (ER) stress and high glucose-induced inflammation, which are closely associated with GDM. This study aimed to investigate the effects of tetramethylpyrazine on inflammatory responses, ER stress and oxidative stress of the placenta in a mouse model of GDM. Our results showed that tetramethylpyrazine treatment significantly alleviated the GDM symptoms characterized by low body weight and serum insulin levels, high blood glucose, and decreased ß-cell function in pregnant C57BL/KsJdb/+ mice. In addition, tetramethylpyrazine reduced the level of malondialdehyde, and increased the levels of superoxide dismutase, glutathione peroxidase and glutathione. Moreover, tetramethylpyrazine decreased the total serum cholesterol, serum triglyceride, and serum low-density lipoprotein levels and increased the high-density lipoprotein level. Further, tetramethylpyrazine regulated the levels of serum and placental inflammatory factors and the expression of ER stress related proteins. Taken together, the present study demonstrated that tetramethylpyrazine attenuated placental oxidative stress, inflammatory responses and ER stress in GDM mice.

Pretreatment of ferulic acid attenuates inflammation and oxidative stress in a rat model of lipopolysaccharide-induced acute respiratory distress syndrome.

Acute respiratory distress syndrome (ARDS) is a fatal clinical condition that can be caused by pulmonary and non-pulmonary diseases. Oxidative stress and inflammation play key roles in the development of ARDS. In this study, we investigated whether ferulic acid (FA), an anti-oxidant, was beneficial for prophylaxis of ARDS. We established an ARDS rat model using lipopolysaccharide (LPS) administration. Lung injury was assessed by lung wet/dry ratio and broncho-alveolar lavage fluid (BALF) analysis. Hematoxylin and eosin staining was performed to evaluate the histological changes of the lungs. Enzyme-linked immunosorbent assay (ELISA) and immunoblotting were performed to detect proteins in BALF and lung tissue, respectively. Pulmonary function was determined by testing the oxygen level in BALF. FA pretreatment significantly alleviated LPS-induced pulmonary histological changes. FA reversed LPS-induced changes of lung wet/dry ratio, total protein in BALF, P(A-a)O2, and PaO2/FiO2. In addition, LPS dramatically up-regulated the secretion of interleukin (IL)-1ß, IL-6, tumor necrosis factor (TNF)-α, and IL-10 in BALF ( P < 0.01). However, pretreatment of FA significantly improved LPS-induced inflammation. We found that FA indeed reduced oxidative stress in the lungs by testing malondialdehyde level, myeloperoxidase level, and total anti-oxidant capacity. We also proved that FA inactivated multiple mitogen-activated protein kinase signaling pathways in the lungs. In conclusion, FA alleviated LPS-induced ARDS through its anti-inflammatory and anti-oxidant activities.