急性脑血管病应激性高血糖与血清胰岛素及神经功能缺损的研究

目的 探讨急性脑血管病(ACVD)应激性高血糖与血清胰岛素及神经功能缺损(NFI)的关系。方法 采用双盲法检测发病1周内ACVD病人空腹血糖(FBG)和空腹胰岛素(FINS)，FBG升高者为高血糖组，FBG正常者为正常血糖组，每组各100例，对照分析2组之间入院时及3周后NFI情况。结果 FBG与HNS、NFI之间呈正相关；FBG与NFI的恢复呈负相关。结论 ACVD应激性高血糖与胰岛素抵抗(IR)有关；应激性高血糖加重NFI并影响其恢复。     

参芪降糖颗粒联合吡格列酮治疗2型糖尿病的临床研究

目的探讨参芪降糖颗粒联合吡格列酮治疗2型糖尿病的临床疗效。方法选取2017年3月—2018年3月在川北医学院附属医院治疗的2型糖尿病患者94例,根据用药的差别分为对照组(47例)和治疗组(47例)。对照组口服盐酸吡格列酮片,起始剂量15 mg/次,1次/d,根据血糖变化调整剂量,最大剂量45 mg/次;治疗组在对照组基础上口服参芪降糖颗粒,3g/次,3次/d。两组患者均治疗4周。观察两组患者临床疗效,同时比较治疗前后两组患者血糖相关指标、肾功能指标、稳态模型评估-β细胞功能(HOMA-β)、稳态模型评估-胰岛素抵抗指数(HOMA-IR)和血清学指标。结果治疗后,对照组和治疗组临床有效率分别为80.85%和95.74%,两组比较差异具有统计学意义(P0.05)。治疗后,两组空腹血糖(FBG)、餐后2h血糖(2hPG)、糖化血红蛋白(HbA1c)和胰岛素水平(FINS)水平均显著降低(P0.05),且治疗组FPG、2 h PG、HbAlc和FINS水平明显低于对照组(P0.05)。治疗后,两组HOMA-β显著升高(P0.05),HOMA-IR显著降低(P0.05),且治疗组HOMA-β和HOMA-IR水平明显优于对照组(P0.05)。治疗后,两组半胱氨酸的酸性分泌蛋白(SPARC)、γ-谷氨酰转肽酶(γ-GT)、转化生长因子-β1(TGF-β1)和单核细胞趋化蛋白-1(MCP-1)水平均显著降低(P0.05),且治疗后治疗组这些指标比对照组降低的更明显(P0.05)。结论参芪降糖颗粒联合盐酸吡格列酮片治疗2型糖尿病可有效控制患者血糖水平,降低机体炎症反应,改善胰岛素抵抗及提高胰岛素敏感性,具有一定的临床推广应用价值。     

Evaluation of hypoglycemic activity of total lignans from Fructus Arctii in the spontaneously diabetic Goto-Kakizaki rats

Ethnopharmacological relevance

Fructus Arctii, called “Niubangzi” in China (Great burdock achene in English), is a well-known Chinese Materia Medica. It is the dried ripe fruit of Arctium lappa L. (family Asteraceae) and was included in the Chinese pharmacopoeia for its traditional therapeutic actions. Meanwhile it has been utilized extensively in a number of classical drug formulas as a major component for the treatment of noninsulin-dependent diabetes mellitus. It has also been reported recently that the clinical use of Fructus Arctii resulted in a satisfactory hypoglycemic effect in diabetic patients. The aim of this study was to investigate hypoglycemic activity of total lignans from Fructus Arctii (TLFA) in Goto-Kakizaki (GK) rats, a spontaneous type 2 diabetic animal model, and the mechanism of its hypoglycemic activity.

Materials and methods

Male GK rats and normal Wistar rats were used in this study, GK rats fed twice daily were given TLFA (300 mg/kg) or nateglinide (50 mg/kg) orally before each meal for 12 weeks. Besides common evaluation indexes of hypoglycemic activity such as blood glucose level, oral glucose tolerance test (OGTT), glycated hemoglobin, as well as lipid metabolism parameters such as cholesterol (CHOL), triglycerides (TG), et al., in rat serum. The effects of TLFA on insulin secretion and pancreas tissue sections, the levels of serum glucagon-like peptide-1 (GLP-1) and glucose-dependent insulinotropic polypeptide (GIP), and the α-glucosidase inhibitory activity of TLFA in vitro were investigated.

Results

TLFA demonstrated stable and long-lasting hypoglycemic activity in GK rats and showed significant improvement in glucose tolerance in glucose fed hyperglycemic GK rats. Both TLFA and nateglinide controlled the glycosylated hemoglobin levels of the experimental animals very well. Stimulation of insulin secretion was proved to be one of the hypoglycemic mechanism of TLFA, promoting the release of GLP-1 should be another one, and ɑ-glucosidase inhibitory activity of TLFA also contributes to its hypoglycemic activity. In this study, we didn't found that TLFA could effect the body weight of GK rats, which was also verified by the changes of biochemical parameters of blood in experimental rats.

Conclusion

The results of this study indicates that TLFA has significant hypoglycemic potential in GK rats, and it may be acting through stimulating insulin secretion, promoting the release of GLP-1, and decreasing intestinal absorption of glucose.     

Rivastigmine reduces "likely to use methamphetamine" in methamphetamine-dependent volunteers

Purpose

To study the prevalence of metabolic syndrome in patients with bipolar disorder.

Material and method

By using purposive random sampling 200 patients with bipolar disorder receiving treatment were evaluated for presence of metabolic syndrome using International Diabetes Federation (IDF) and modified National Cholesterol Education Program Adult Treatment Panel III (NCEP ATP-III) criteria.

Results

Eighty patients fulfilled IDF criteria and 82 patients met NCEP ATP-III criteria for metabolic syndrome. There was significant concordance between these two criteria sets for metabolic syndrome (Kappa value 0.979, p < 0.015). Among the individual parameters studied — increased waist circumference (70.1%) was the most common abnormality, followed by increased blood pressure (44.5%) and increased triglycerides levels (42%). Compared to patients without metabolic syndrome, patients with metabolic syndrome had significantly higher body mass index and higher percentage of them (74.4% vs 51.7%) were more than 35 years of age. Logistic regression analysis revealed that these two variables significantly predicted metabolic syndrome.

Conclusion

Findings of the present study suggest that abdominal obesity is the most common abnormality and metabolic syndrome is best predicted in patients with bipolar disorder by higher age and higher body mass index.     

Lipid metabolism and body composition in Gclm(-/-) mice

In humans and experimental animals, high fat diets (HFD) are associated with risk factors for metabolic diseases, such as excessive weight gain and adiposity, insulin resistance and fatty liver. Mice lacking the glutamate–cysteine ligase modifier subunit gene (Gclm(−/−)) and deficient in glutathione (GSH), are resistant to HFD-mediated weight gain. Herein, we evaluated Gclm-associated regulation of energy metabolism, oxidative stress, and glucose and lipid homeostasis. C57BL/6J Gclm(−/−) mice and littermate wild-type (WT) controls received a normal diet or an HFD for 11 weeks. HFD-fed Gclm(−/−) mice did not display a decreased respiratory quotient, suggesting that they are unable to process lipid for metabolism. Although dietary energy consumption and intestinal lipid absorption were unchanged in Gclm(−/−) mice, feeding these mice an HFD did not produce excess body weight nor fat storage. Gclm(−/−) mice displayed higher basal metabolic rates resulting from higher activities of liver mitochondrial NADH-CoQ oxidoreductase, thus elevating respiration. Although Gclm(−/−) mice exhibited strong systemic and hepatic oxidative stress responses, HFD did not promote glucose intolerance or insulin resistance. Furthermore, HFD-fed Gclm(−/−) mice did not develop fatty liver, likely resulting from very low expression levels of genes encoding lipid metabolizing enzymes. We conclude that Gclm is involved in the regulation of basal metabolic rate and the metabolism of dietary lipid. Although Gclm(−/−) mice display a strong oxidative stress response, they are protected from HFD-induced excessive weight gain and adipose deposition, insulin resistance and steatosis.     

老年COPD合并肺心病患者血栓前状态的研究

目的探讨老年COPD合并肺心病患者血栓前状态多种指标参数的变化。方法检测50例老年肺心病急性加重期患者凝血功能（PT,APTT,TT）;纤维蛋白原（FBG）;D-二聚体;血液流变学指标,包括红细胞压积、全血粘度、血浆粘度（高切、低切）;以及肺动脉收缩压（SPAP）、氧分压等指标,并同肺心病缓解期和正常健康老人相比较。结果老年COPD合并肺心病急性发作期与其缓解期以及对照组相比,PT,APTT,TT缩短,FBG,D-二聚体上升,差异有显著性;红细胞压积、血浆粘度、全血粘度升高,差异有显著性;SPAP增大,差异有显著性;老年COPD合并肺心病急性发作期患者的PaCO2与D-二聚体、FBG成正相关,PaO2与全血高切粘度、D-二聚体、FBG成负相关。结论血浆D-二聚体,FBG,血液流变学,凝血功能,SPAP的监测对评估疾病严重程度及其预后以及疗效观察提供有力的依据。     

Antihyperglycemic and antihyperlipidemic activities of methanol:water (4:1) fraction isolated from aqueous extract of Syzygium alternifolium seeds in streptozotocin induced diabetic rats

The present study was taken up to identify potent antihyperglycemic fraction from the aqueous extract of Syzygium alternifolium (SA) seeds, using bioassay guided fractionation. The isolated fraction C at a dose of 50 mg/kg.b.w produced the maximum fall of 83% in the blood glucose level in the diabetic rats after 6 h of the treatment. The administration of fraction C (50 mg/kg.b.w) once daily for 30 days in STZ diabetic rats resulted in a significant decrease in blood glucose, glycosylated haemoglobin with a significant rise in plasma insulin level. Further fraction C showed antihyperlipidemic activity as evidenced by significant decrease in serum TC, TG, LDL-C, VLDL-C levels coupled together with elevation of HDL-C level in diabetic rats. A significant decrease in the activities of SGOT, SGPT, ALP and decreased levels of serum urea and creatinine in diabetic treated rats when compared to diabetic untreated rats, indicate the protective role against liver and kidney damage and non-toxic property of the fraction C. A comparison was made between the action of fraction C and antidiabetic drug glibenclamide (20 mg/kg.b.w). The effect of fraction C was more prominent when compared to that of glibenclamide.