Improvement of high-glucose and insulin resistance of chromium malate in 3T3-L1 adipocytes by glucose uptake and insulin sensitivity signaling pathways and its mechanism

Previous study has revealed that chromium malate could improve insulin resistance and the regulation of fasting blood glucose in type 2 diabetic rats. This study was designed to investigate the effect of chromium malate on hypoglycemic and improve insulin resistance activities in 3T3-L1 adipocytes with insulin resistance and investigate the acting mechanism. The result indicated that chromium malate exhibited direct hypoglycemic activity in vitro. Compared with the model group, chromium malate could significantly promote the expression levels of GLUT-4, Akt, Irs-1, PPARγ, PI3K and p38-MAPK and their mRNA, increase p-AKT/AKT level, AKT and AMPKβ1 phosphorylation and reduce Irs-1 phosphorylation and p-Irs-1/Irs-1 level in 3T3-L1 adipocytes (p < 0.05). Chromium malate is more effective in regulating the proteins and mRNA expressions than those of chromium trichloride and chromium picolinate. Compared to the model group, pretreatment with the specific p38-MAPK inhibitor completely inhibited the GLUT-4 and Irs-1 proteins and mRNA expressions induced by the chromium malate. In conclusion, chromium malate had a beneficial influence on improvement of controlling glucose levels and insulin resistance in 3T3-L1 adipocytes with insulin resistance by regulating proteins productions and genes expressions in glucose uptake and insulin sensitivity signaling pathways.

Chromium malate could increase the related protein and mRNA levels in 3T3-L1 adipocytes with insulin resistant. Pretreatment with the inhibitor completely/partially inhibited the GLUT-4 and Irs-1 proteins and mRNA expression compared to model group.     

卫生化学实验“理论-实验一体化”教学改革实践

本研究探讨了“理论-实验一体化”特色型教学改革在卫生化学实验教学中的应用效果。通过将理论和实验课程统一打包安排,将理论与实验内容进行模块整合,开展多种形式的教学。实践表明,“理论-实验一体化”教学改革实践对提高卫生化学实验课程的教学质量,培养学生的综合素质方面有重要理论及实践意义。     

Rapid Reduction in Use of Antidiabetic Medication after Laparoscopic Sleeve Gastrectomy: The Newfoundland and Labrador Bariatric Surgery Cohort (BaSCo) Study

Background:

Patients who have undergone bariatric surgery generally need fewer medications as they experience improvement in, or even resolution of, various medical conditions, including type 2 diabetes mellitus, hypertension, and dyslipidemia. Published data on changes in medication use after laparoscopic sleeve gastrectomy, a type of bariatric surgery that is growing in popularity, are limited.

Objective:

To determine whether patients took fewer medications for management of type 2 diabetes, hypertension, and dyslipidemia after laparoscopic sleeve gastrectomy, relative to preprocedure medications.

Methods:

In this prospective, single-centre cohort study, a nurse practitioner used standard medication reconciliation and study data-extraction forms to interview adult patients who had undergone laparoscopic sleeve gastrectomy and determine their medication use and pertinent demographic data. The data were analyzed using generalized estimating equations and standard statistical software. Outcome measures included changes in the use of antidiabetic, antihypertensive, and antilipemic medications at 1, 3, and 6 months after the surgery.

Results:

A total of 65 patients who underwent laparoscopic sleeve gastrectomy between May 2011 and January 2014 met the study inclusion criteria. Before surgery, the 30 patients with type 2 diabetes were taking an average of 1.9 antidiabetic medications. One month after the procedure, 15 (50%) had discontinued all antidiabetic medications, with a further decline at 3 and 6 months (p < 0.001 at each time point). Among the patients who were taking antihypertensives (n = 48) and antilipemics (n = 33) before surgery, the decline in use occurred at a more modest rate, with 6 (12%) and 2 (6%), respectively, discontinuing these medication classes within 1 month, and 12 (25%) (p = 0.001) and 8 (24%) (p = 0.015) having discontinued by 6 months.

Conclusions:

These findings suggest that patients with a history of type 2 diabetes mellitus, hypertension, and/or dyslipidemia who undergo laparoscopic sleeve gastrectomy are less likely to require disease-specific medications shortly after surgery.     

Effect of inflammatory factor‐induced cyclo‐oxygenase expression on the development of reperfusion‐related no‐reflow phenomenon in acute myocardial infarction

No reflow after reperfusion therapy for myocardial infarction is a strong predictor of clinical outcome. Increased levels of inflammatory factors, including C‐reactive protein (CRP), in patients with acute myocardial infarction (AMI) undergoing primary percutaneous coronary intervention (PCI) may affect myocardial perfusion. However, why the no‐reflow phenomenon increases in inflammation stress after PCI is not clear. The aim of the present study was to determine the effects and molecular mechanisms underlying the effects of CRP on the expression of cyclo‐oxygenase (COX) on the development of the no‐reflow phenomenon. There was a significant increase in plasma levels of CRP and interleukin (IL)‐6 in no‐reflow patients, suggesting that inflammatory factors play an important role in the development of the no‐reflow phenomenon. The mechanisms involved were further evaluated after reperfusion in a rat model mimicking the no‐reflow phenomenon. Compared with normal reflow rats, there were significant increases in both COX‐1 and COX‐2 in cardiac tissue from no‐reflow rats. The COX inhibitor indomethacin (5 mg/kg, i.p.) significantly reduced the no‐reflow area. In another series of experiments, human coronary artery endothelial cells (HCAEC) were treated with CRP at clinically relevant concentrations (5–25 μg/mL). C‐Reactive protein significantly increased COX‐1 and COX‐2 levels in a time‐ and concentration‐dependent manner. In addition, extracellular signal‐regulated kinase (ERK) and Jun N‐terminal kinase (JNK) were activated in CRP (5, 10, 25 μg/mL)‐treated HCAEC cultures. Furthermore, the ERK inhibitor pd98059 (30 μmol/L) and the JNK inhibitor sp600125 (10 μmol/L) blocked CRP‐induced COX‐1 and COX‐2 expression for 12 h. Together, the findings of the present study suggest that CRP can promote the development of the no‐reflow phenomenon by increasing COX‐1 and COX‐2 expression, which is regulated, in part, via ERK and JNK activity.     

湖州地区某体检人群高尿酸血症危险因素的Logistic回归分析

目的 调查湖州地区高尿酸血症(HUA)的患病率,并对其主要危险因素进行分析.方法 收集湖州市第一人民医院2 038例不同职业人群的体检结果,根据HUA临床诊断标准,分成尿酸正常组(1 709例)和HUA组(329例),应用多元Logistic回归方法确定HUA的危险因素.结果 2 038名体检者中有329例HUA患者,患病率为16.1％;男性患病率为23.9％(325/1 360),女性患病率为0.6％(4/678),两者比较差异有统计学意义(x2=181.56,P＜0.01).HUA组中高血压、脂肪肝、高血脂和肝功能异常的阳性率分别为31.3％、58.4％、45.6％和42.9％,均高于尿酸正常组,差异有统计学意义(x2=20.57、70.16、62.83和78.47,P均＜0.01).多元Logistic回归结果显示肝功能异常、脂肪肝、高血脂、高血压和男性是HUA的危险因素(OR=2.223、1.861、1.783、1.495、38.490).结论 肝功能异常、脂肪肝、高血脂、高血压、男性与HUA密切相关.定期查血尿酸水平有助于HUA的早发现、早诊断、早治疗.     

口腔黏膜白斑凋亡相关蛋白 Bcl－2和 Bax 的表达及意义

目的：通过探讨凋亡相关蛋白在口腔白斑病变过程中细胞凋亡状况和凋亡蛋白 Bcl－2、Bax 的表达的研究,探讨白斑发病机制及恶变机理。方法采用免疫组织化学检测法,与正常口腔粘膜对照,观察分析29例口腔白斑中 Bcl－2、Bax 蛋白的表达水平。结果上皮异常增生各组的凋亡指数均高于正常,Bcl－2、Bax 在上皮单纯增生、异常增生显过度表达,表达强度、分布也发生了改变。结论癌前病变中,上皮细胞凋亡状况发生了改变,Bcl－2可能对增生组织向恶变的转化发挥阶段性的促进作用,促凋亡因子 Bax 作用加强;凋亡因子的发挥即相互协同又相互制约。     

QTc离散度测定的重复性

为评价QT间期离散度（QTcd）测定的重复性，研究了同一观测者不同时间及两个观测者同一时间测定的46例急性心肌梗塞者的QTCd测定值的变化。结果发现同一观测者不同时间测定的QTcd的绝对误差为6ms，相对误差为20.1％，二者的相关系数r＝0．71，P＜o.01；两个观测者同一时间测定的QTcd的绝对误差为8ms，相对误差为23．9％，二者的相关系数r＝0．65，P＜0．01。提示，QTcd测定的重复性较差。     

还原型谷胱甘肽片改善酒精性肝损伤的作用及机制研究*

目的：探讨还原性谷胱甘肽片对酒精性肝损伤小鼠模型的保护作用及机制。方法：60只雄性ICR小鼠均分6组：空白组、模型组、水飞蓟宾组、还原型谷胱甘肽片（200、400、800 mg·kg-1）3个剂量组。采用50%的乙醇溶液连续灌胃小鼠6周的方法,构建小鼠酒精性肝损伤动物模型,采用还原性谷胱甘肽片灌胃治疗模型小鼠,检测小鼠体质量、肝脏指数、血清生化指标（ALT、AST、ALP、TC、TG、LDL-c、HDL-c）、肝脏炎症（TNF-α、HMGB-1、IL-6）基因表达水平及肝脏脂滴空泡数,研究还原性谷胱甘肽片的保肝作用。结果：与空白组相比,模型组肝脏指数、血清生化指标（ALT、AST、ALP、TC、TG、LDL-c）、肝脏炎症（TNF-α、HMGB-1、IL-6）基因表达和因子水平均显著升高（P<0.01、P<0.05）,血清中HDL-c水平显著下降（P<0.01、P<0.05）,脂滴空泡数显著增加（P<0.01）;还原型谷胱甘肽片（200、400、800 mg·kg-1）治疗后,模型动物肝脏指数血清（ALT、AST、ALP、TC、TG、LDL-c）、肝脏（TNF-α、HMGB-1、IL-6）基因表达和因子水平均显著降低（P<0.01、P<0.05）,血清中HDL-c水平显著升高（P<0.01、P<0.05）,肝脏细胞病理状态改善,脂滴空泡数显著减少（P<0.01、P <0.05）。结论：还原性谷胱甘肽片能够对酒精性肝损伤小鼠模型具有保护作用,其机制可能与减轻肝脏炎症和减少脂滴沉积有关。     

智能分布式药品柜管控系统在儿童重症监护病房的应用

目的:探讨智能分布式药品柜管控系统在儿童重症监护病房(PICU)药品管理中的作用。方法:临床药师参与完善智能分布式药品柜管控系统的组成功能、工作流程并比较使用前后的工作模式及数据。结果:智能分布式药品柜管控系统与医院信息系统(HIS)对接后,实现了药品补充、取药、盘点、监控等信息化的管理。与使用前比较,智能分布式药品柜管控系统的应用降低了库存误差率(P<0.05),提高了账物相符率(P<0.05),节约了盘点时间(P<0.01)。结论:智能分布式药品柜管控系统确保了药品的存储安全,降低了用药错误,明确了责任分工,提高了经济效益,为病区的药品管理提供了新的方式与思路。