Effects of testosterone therapy in adult males with hypogonadism and T2DM: A meta-analysis and systematic review

Background and aimsTestosterone supplementation therapy (TST) is a longstanding treatment for hypogonadal men with type 2 diabetes mellitus (T2DM), even though the benefits of TST are variable among trials. This meta-analysis was done to determine the specific role of TST in hypogonadal men with T2DM.MethodsPubMed, Embase, and Google Scholar were queried to discover eligible randomized controlled trials (RCTs) and observational studies. To quantify the specific effects of TST, we estimated pooled mean differences (MDs) and relative risks with 95% confidence intervals (CIs).ResultsOur meta-analysis included 1596 hypogonadal T2DM subjects from 12 randomized controlled trials and one observational study. TST can significantly enhance glycemic control compared to placebo by decreasing homeostatic model assessment of insulin resistance (WMD = ?1.55 [-2.65, ?0.45]; p = 0.26; I2 = 20.2%), fasting glucose (WMD = ?0.35 [-0.79, 0.10]; p = 0.07; I2 = 69.7%), fasting insulin (WMD = ?2.88 [-6.12, 0.36]; p = In addition, TST can decrease cholesterol (WMD = ?0.28 [-0.47, ?0.09] p = 0.0008; I2 = 91%) and triglyceride (WMD = ?0.23 [-0.43, ?0.03] p = 0.03; I2 = 79.2%). Furthermore, Testosterone therapy is related to a significant rise in total testosterone levels (WMD = 5.08 [2.90, 7.26] p = 0.0002; I2 = 92.9%). Pooling of free testosterone levels indicated a larger increase in the patients who got TST than placebo (WMD = 81.21 [23.87, 138.54] p = 0.07; I2 = 70%).ConclusionOur findings suggested that TST can enhance glycemic control and hormone levels and reduce total cholesterol, triglyceride, LDL cholesterol whereas increase HDL cholesterol in hypogonadal T2DM patients. Therefore, in these patients, we propose TST alongside anti-diabetic treatment.     

Ganglionic Antibody Level as a Predictor of Severity of Autonomic Failure

Objective

To assess antibody level as a test of autonomic failure (AF) associated with ganglionic nicotinic acetylcholine receptor antibody (AChR-Ab) autoimmunity.

The effect of neonatal bacille Calmette-Guérin vaccination on purified protein derivative skin test results in Canadian aboriginal children

BACKGROUND: The effect that neonatal bacille Calmette-Guérin (BCG) vaccination has on tuberculin skin test (TST) results is not well evaluated in preschool children. METHODS: This was a retrospective cohort study of TST results in aboriginal children in Saskatchewan reserve communities. Records from the centralized provincial tuberculosis program were searched for aboriginal children aged 0 to 4 years during the time period 1991 to 1999. Only the first TST result reported as part of infant and preschool screening programs was considered. Children with active tuberculosis and those evaluated as part of a contact-tracing program were excluded. The BCG-vaccinated and unvaccinated groups were compared using wheal size cut points of 5 mm, 10 mm, and 15 mm. RESULTS: Data from 1,086 children with neonatal BCG vaccination and 1,867 unvaccinated children were analyzed. The rate of TST reactions was higher in vaccinated children at all ages, using a cut point of 5 mm. The rate of TST reactions was no different in vaccinated children >or= 1 year old when using a cut point of 15 mm. When using a cut point of 10 mm, the rate of TST reactions was higher at age 1 year but not different at age 4 years in the vaccinated children. CONCLUSION: The rate of TST reactions in preschool aboriginal children living on a reserve who have received neonatal BCG vaccination is affected by the cut point and age. The BCG vaccination status and age should therefore be considered when interpreting TST reactivity in the clinical assessment of aboriginal children participating in a tuberculosis control program.     

TST加微创手工处理术结合中医辨证施治治疗环状混合痔的临床观察

目的:120例环状混合痔患者分别采用TST加微创手工处理术及传统外剥内扎术,结合中医辨证施治治疗,对比两组的情况。方法:患者分为TST加微创手工处理术组和传统外剥内扎术对照组,分别采用不同的手术方式及中药辨证治疗,观察手术疗效、术后并发症、住院时间及治疗费用等方面进行对比分析,通过分析得出差异,并对肛管口径、肛管直肠压力等数据进行对比观察,比较两组在各方面的影响。结果:两组在手术疗效、伤口愈合后肛管直肠压力对比、伤口出血及术后发热对比上无明显差异(P0.05);在住院时间、治疗费用、伤口疼痛、伤口水肿、伤口愈合后肛管口径测量对比、术后尿潴留方面,治疗组优于对照组(P0.05)。提示:TST加微创手工处理术优于传统外剥内扎术。     

Antidepressant-like effect of the methanolic extract from Bupleurum falcatum in the tail suspension test

In traditional Oriental medicine, some herbal combinations that include Bupleurum falcatum (BFM) as a major ingredient are known to effectively treat depressive-like disorders. In the present study, the antidepressant-like effect of methanolic extract of BFM and its neuropharmacological mechanism were investigated in mice. After oral administration of BFM extract, a tail suspension test (TST) and open field test (OFT) were performed to assess the antidepressant activity and psycho-stimulant side-effects, respectively. Pre-treatment with p-chlorophenylalanine (PCPA, a serotonin synthesis inhibitor) and α-methyl-p-tyrosine (AMPT, a catecholamine synthesis inhibitor) was used to assess the influence of BFM extract on the antidepressant activity in the TST. At doses of 150 and 300 mg/kg body weight, p.o., the BFM extract significantly reduced the total duration of immobility in the TST, while individual differences in locomotor activities between experimental groups were not observed in the OFT. Moreover, pre-treatment with PCPA (100 mg/kg i.p., for 4 consecutive days) or AMPT (100 mg/kg i.p.) significantly inhibited the antidepressant-like activity of BFM extract (300 mg/kg p.o.), as well as we confirmed the reversal of the antidepressant effect of fluoxetine (30 mg/kg i.p.) by PCPA and bupropion (20 mg/kg i.p.) by AMPT in the TST. Taken together, these findings suggest that the methanolic BFM extract has dose-dependent possibility of antidepressant-like activity valuable to alternative therapy for depression and that the mechanism of action involves the serotonergic and noradrenergic systems although underlying mechanism still remains to be further elucidated.     

Diagnosis of latent tuberculosis infection: the potential role of new technologies

Tuberculosis (TB) is a major cause of morbidity and mortality worldwide. TB control programmes need improvement in the diagnosis of latent TB infection. The tuberculin skin test (TST) is far from a 'gold' standard as it often gives false results. Interferon-gamma assays are newly available tests to detect latent TB infection, but they are currently not routinely used. They are based on immune responses to purified protein derivative (PPD) or to region of difference 1 (RD1) specific antigens. Assays based on RD-1 specific antigens perform better than both PPD based assays and TST. They correlate with TB exposure and are less likely to give false results in non-tuberculous mycobacterial disease, Bacille Calmette-Guerin (BCG) vaccination and immunosuppression. More accurate diagnosis of latent TB infection with RD-1 specific antigen based interferon-gamma assays may allow targeting of chemoprophylaxis to reduce the burden of active TB while decreasing wastage of health care resources due to false results associated with TST. However, further research and development is required to verify that new tests can predict the risk of later development of active TB and to make it feasible to perform these tests in a reproducible fashion at low cost, particularly in developing countries.     

Antidepressant evaluation of polysaccharides from a Chinese herbal medicine Banxia-houpu decoction

Banxia-houpu decoction, a traditional Chinese medicine has been used in the treatment of depression. The present study confirmed that oral administration of polysaccharides from Banxia-houpu decoction, exhibited a reduction in the immobility time in the tail suspension and in the forced swimming tests in mice in a time-dependent manner. This effect at a dose of 320 mg/kg was more potent than that at a dose of 640 mg/kg. The polysaccharides from Banxia-houpu decoction were active in animal models of depression with comparable effects to known antidepressants. The oral administration of the polysaccharides at a low dose for 4 weeks resulted in a significant increase in the monoamine neurotransmitter 5-hydroxytryptamine (5-HT) and dopamine (DA) levels in whole mouse brain, but produced no significant increase in 5-hydroxyindoleacetic acid (5-HIAA) and norepinephrine (NE) concentrations. The effect of polysaccharides on the brain neurotransmitter levels appeared to be quite different from the effect of fluoxetine, a serotonin specific reuptake inhibitor. The results indicate that the mode of action of polysaccharides from Banxia-houpu decoction in depression might be related to both 5-HT and DA systems.     

A 50-Hz electromagnetic field impairs sleep

In view of reports of health problems induced by low frequency (50-60 Hz) electromagnetic fields (EMF), we carried out a study in 18 healthy subjects, comparing sleep with and without exposure to a 50 Hz/1 mu Tesla electrical field. We found that the EMF condition was associated with reduced: total sleep time (TST), sleep efficiency, stages 3 + 4 slow wave sleep (SWS), and slow wave activity (SWA). Circulating melatonin, growth hormone, prolactin, testosterone or cortisol were not affected. The results suggest that commonly occurring low frequency electromagnetic fields may interfere with sleep.     

中药SXY-006的抗抑郁作用研究

目的：研究中药SXY-006的抗抑郁作用。方法：采用小鼠悬尾实验、小鼠强迫游泳实验、大鼠单次及多次给药后强迫游泳实验、5一羟色胺酸（5．HTP）诱导的小鼠甩头实验、利血平引起的小鼠睁眼不能以及运动不能实验、大鼠慢性不可预知性抑郁症造模后的敞箱（open—field）实验，评价SXY-006的抗抑郁作用。结果：SXY-006中（100mg·1000g-1）、高（300mg·1000g-1）剂量均能明显减少小鼠悬尾实验和强迫游泳实验的不动时间（P〈0．01），SXY-006低（25mg·1000g-1）、中（100mg·1000g-1）、高（300mg·1000g-1）剂量均能减少大鼠单次和多次给药后强迫游泳实验的不动时间（P〈0．01—0．05），均能显著增加5-HTP诱导的甩头实验的小鼠甩头次数（P〈0．01）。均能明显拮抗利血平引起的小鼠的睁眼不能和运动不能（P〈0．01），均能增加大鼠慢性不可预知性抑郁症造模后大鼠的水平得分（P〈0．05），明显增加其垂直得分（P〈0．01）。结论：中药SXY-006具有抗抑郁的作用。     

Smith-Magenis syndrome: a case report of improved sleep after treatment with beta1-adrenergic antagonists and melatonin

This report describes the case of a 4-year-old boy diagnosed with Smith-Magenis syndrome in whom treatment with a beta(1)-adrenergic antagonist in the morning (to suppress the diurnal melatonin secretion) and melatonin in the evening (to generate a nocturnal peak of melatonin) improved his sleep quality, evaluated by polysomnographic studies.