FNDC5 attenuates adipose tissue inflammation and insulin resistance via AMPK-mediated macrophage polarization in obesity

BackgroundObesity-induced chronic inflammation is critical in the pathogenesis of insulin resistance, and the recruitment and proinflammatory activation of adipose tissue macrophages (ATMs) is important for the development of this process. Here, we examined the effects of fibronectin type III domain-containing 5 (FNDC5) on inflammation and insulin resistance in high-fat diet-induced obese mice.Materials and MethodsMale wild-type (WT) and FNDC5^−/− mice were fed with standard chow (Ctrl) or high fat diet (HFD) for 20 weeks to induce obesity and insulin resistance. Firstly, effects of FNDC5 gene deletion on obesity, insulin resistance, macrophage accumulation and polarization and adipose tissue inflammation were determined in mice. Secondly, the macrophage polarity shift was further examined with flow cytometry in isolated stromal vascular fraction (SVF). Thirdly, the effects of exogenous FNDC5 on lipopolysaccharide (LPS)-induced macrophage polarization, inflammation and the underlying signaling mechanism were investigated in RAW264.7 macrophages and primary mouse peritoneal cavity macrophages (PMs). Finally, the therapeutic effects of FNDC5 overexpression were examined in HFD-induced obese WT and FNDC5^−/− mice.ResultsFNDC5 gene deletion aggravated obesity, insulin resistance, fat accumulation and inflammation accompanied with enhanced AMPK inhibition, macrophages recruitment and M1 polarization in mice fed with HFD. Exogenous FNDC5 inhibited LPS-induced M1 macrophage polarization and inflammatory cytokine production via AMPK phosphorylation in both RAW264.7 macrophages and PMs. FNDC5 overexpression attenuated insulin resistance, AMPK inhibition, M1 macrophage polarization and inflammatory cytokine production in adipose tissue of obese WT and FNDC5^−/− mice.ConclusionsFNDC5 attenuates adipose tissue inflammation and insulin resistance via AMPK-mediated macrophage polarization in HFD-induced obesity. FNDC5 plays several beneficial roles in obesity and may be used as a therapeutic regimen for preventing inflammation and insulin resistance in obesity and diabetes.     

成人骶前囊肿再手术10例临床分析

目的探讨成人骶前囊肿再手术的临床特点和原因。方法对成人骶前囊肿再手术10例的临床资料进行回顾性分析。结果本组再手术距首次手术时间1个月～3年。再手术经骶尾部入路9例,经腹及骶尾部联合入路1例,均完整切除囊壁,顺利完成手术,术后伤口愈合时间平均38 d,术后平均随访6.5个月,均无复发。结论导致成人骶前囊肿再手术的主要原因为对此病认识不足,其次为术中囊壁切除不彻底、形成窦道经久不愈。加强对此病的认识,完善术前影像学检查,选用恰当手术方式,完整切除囊壁,是避免骶前囊肿再手术的关键。     

临床护士共享治理在给药安全管理中的实践

目的 将共享治理的管理理念运用到给药安全管理中,提高护士给药安全的风险管理意识和参与度,降低给药错误隐患事件和给药错误发生率.方法 2019年7～12月将共享治理应用于病房给药安全管理中,并与2019年1～6月未实施共享治理时的给药隐患事件、给药错误发生率、护理人员决策参与程度等进行对比.结果 实施共享治理后给药隐患事件、给药错误发生率显著低于实施前(P＜0.05,P＜0.01);实施共享治理后护理人员决策参与度和给药安全理念得分显著高于实施前(均P＜0.01).结论 共享治理能有效提高护士给药安全的风险管理意识,降低给药错误及隐患事件的发生.     

舒芬太尼和芬太尼用于妇科手术后静脉自控镇痛的比较

目的 比较妇科手术术后等效剂量舒芬太尼和芬太尼静脉自控镇痛的镇痛效果和不良反应. 方法 将在全身麻醉下行妇科手术的400例患者按随机、对照、双盲的方法 分为两组,SF组200例,术后给予舒芬太尼0.5 μg.mL^-1镇痛,F组200例术后给予芬太尼5 μg.mL^-1镇痛; 记录术后~4,~12,~24 h两组患者静息和运动疼痛视觉模拟评分(VAS)、自控镇痛按压次数和药物消耗量、镇静评分和不良反应. 结果 SF组在术后~4,~12 h静息和运动VAS评分均小于F组(P<0.05); 术后24 h内自控镇痛按压总次数SF组低于F组(P<0.05); SF组术后呼吸抑制和恶心呕吐发生率低于F组(P<0.05); SF组对镇痛满意的患者自控镇痛药物消耗量个体间变异程度小于F组. 结论 相比芬太尼,舒芬太尼在带来更好术后镇痛效果的同时,其呼吸抑制和恶心呕吐发生率较低,且个体间用药变异程度较小.     

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??OBJECTIVE To prepare oridonin-loaded cubosomes, and encapsulate oridonin(ORI) for the purpose of enhancing the solubility and prolonging the action time. METHODS Phytantriol (PYT) was firstly used to cooperate with Poloxamer 407-propylene glycol-water system to improve the solubility of ORI for developing ORI-loaded cubosomes. Polarizing microscope, small angel X-ray scattering (SAXS) and cryogenic transmission electron microscopy(cryo-TEM) were used to study the characters of cubosomes. RESULTS Under homogenization conditions of 1 200 bar for 9 cycles, the obtained PYT-based cubosomes had narrow particle size distribution with a mean particle size of (225.9??5.6) nm. The internal structures of cubosomes were revealed by small-angle X-ray scattering as a bicontinuous cubic liquid crystalline phase with Pn3m geometry. The encapsulation efficiency and drug loading determined by ultrafiltration centrifugation were (86.6??1.5)% and (3.69??0.06)mg??g^-1, the solubility of ORI had been increased by 5.20 times. CONCLUSION The optimized formulas of cubosomes show obvious 24 h-sustained release, and the in vitro release profiles fitt the Higuchi release model well, implying diffusion-control as main release mechanism.     

Sciadopitysin suppresses RANKL-mediated osteoclastogenesis and prevents bone loss in LPS-treated mice

Previous studies reported that sciadopitysin (Sc), a type of biflavonoids, protects reactive oxygen species (ROS)-mediated osteoblast dysfunction, but its role in osteoclastogenesis remains unclear. In this study, we observed that Sc dose-dependently suppressed RANKL-induced osteoclastogenesis and bone resorption. Our results indicated that Sc treatment strongly reduced RANKL-induced osteoclast-specific genes expression, including cathepsin K (CTSK), tartrate-resistant acid phosphatase (TRAP) and MMP-9. Furthermore, Sc apparently attenuated RANKL-increased expressions of c-Fos and NFATc1. Meanwhile, Sc also strikingly inhibited the activation of NF-κB without altering the phosphorylation of MAPKs (p38, JNK and ERK1/2). Finally, our study demonstrated that Sc administration could reverse the bone loss in LPS-induced mice model. This study suggests that Sc inhibits RANKL-induced osteoclastogenesis and bone loss by inhibiting NF-κB activation and reducing the expression of c-Fos and NFATc1. Therefore, Sc might be benefit for RANKL-mediated osteolytic bone diseases.     

The study of fetal-type posterior cerebral circulation on multislice CT angiography and its influence on cerebral ischemic strokes

PurposeThe purpose was to evaluate if patients with partial and full fetal-type posterior cerebral artery (PCA) could be more prone to lead to ischemic strokes on multislice computed tomographic angiography (MSCTA).MethodsA total of 202 patients who had undergone MSCTA examinations were divided into three groups: patients with full fetal-type posterior (FTP), patients with partial FTP, and patients without FTP. The odds ratio of having ischemic strokes was calculated.ResultsThe odds of having ischemic strokes in patients with full and partial FTP were 1.448 and 3.027, while P values were .391 and .0307, respectively.ConclusionPatients with a partial fetal-type PCA could be more prone to develop ischemic strokes.     

Perinatal risk factors for obstructive sleep apnea syndrome in children

ObjectiveThe aim of this study was to determine whether specific perinatal factors are associated with obstructive sleep apnea syndrome (OSAS) in children.MethodsA retrospective case–control study was conducted. All cases of OSAS were obtained from a tertiary pediatric hospital between April 2013 and April 2016. A total of 823 children who had been diagnosed with OSAS were designated as the case group, and 823 children without OSAS were selected with strict criteria to match with the case group by age, gender and body mass index. Logistic regression models were used to determine the perinatal factors associated with childhood OSAS.ResultsPreterm birth (adjusted odds ratio (aOR): 1.87, 95% confidence interval (CI): 1.13–3.08) and cesarean section (aOR: 1.32, 95% CI: 1.03–1.68) were significantly associated with OSAS. Exposure of the mother to smoke (aOR: 2.59, 95% CI: 1.57–4.26) was also associated with an increased risk of childhood OSAS. Mothers aged 35 years and above, performing manual labor, and living in suburban areas significantly increased the risk of childhood OSAS. Multiparous mothers decreased the risk of childhood OSAS (aOR: 0.59, 95% CI: 0.42–0.83). Maternal education, gravidity, prenatal care times, pregnancy-induced hypertension, multiple pregnancies, sex of the child and birth weight were not significantly associated with OSAS in children.ConclusionPerinatal risk factors are important for predicting childhood OSAS. Our findings provide evidence regarding several potentially useful factors for recognizing OSAS in children, which could be important in diagnosis of pediatric OSAS by physicians.