Research progress of relationship in long-novel coronavirus syndrome and sarcopenia / 中华危重病急救医学

At present, the major public health challenges caused by novel coronavirus infection have gradually subside. However, a large number of people are still suffering from long-novel coronavirus syndrome or post-novel coronavirus syndrome. The clinical manifestations of long coronavirus syndrome are related to multiple systems, such as respiratory, circulatory, nervous, digestive and musculoskeletal systems, with various long-term persistent symptoms after novel coronavirus infection. At the same time, the infection of the novel coronavirus is an important cause of frailty and sarcopenia in the elderly population. However, at present, the scholars have not paid enough attention to the skeletal muscle weakness caused by the novel coronavirus. Therefore, this paper focuses on the long-novel coronavirus syndrome and sarcopenia to explore the pathological mechanism of skeletal muscle attenuation caused by the SARS-CoV-2 mediated "cytokine storm", mitochondrial damage, hypoxia state and other links, so as to raise the attention of clinical and academic researchers and improve the clinical strategy of frailty and sarcopenia after novel coronavirus infection.

Research progress of vaccination status, efficacy and safety in children with tumor / 中华预防医学杂志

Malignant tumors in children are one of the most important diseases that threaten the health and quality of life of children and are the second most common cause of death in children.With the continuous improvement and progress of treatment technology, the long-term survival rate of children with tumor has been significantly improved, but both the disease itself and the treatment can impair the immune function of children, which makes them vulnerable to various infectious diseases and secondary serious complications, and even become a source of infection, endangering the health of others. Vaccination is the most cost-effective measure to prevent infectious diseases. For children with normal immune functions, the benefits of vaccination usually outweigh the disadvantages. However, there is a lack of detailed data on the vaccination situation, efficacy and safety of vaccine use for such immunocompromised tumor survivors, and there are no authoritative and uniform vaccination recommendations. This article reviewed and summarized the literature and consensus of some domestic and foreign scholars on current status of post-treatment vaccination status, efficacy and safety of vaccination for children with tumors after treatment, with the aim of providing a reference for the practice in this field in China.

Research progress of vaccination status, efficacy and safety in children with tumor / 中华预防医学杂志

Malignant tumors in children are one of the most important diseases that threaten the health and quality of life of children and are the second most common cause of death in children.With the continuous improvement and progress of treatment technology, the long-term survival rate of children with tumor has been significantly improved, but both the disease itself and the treatment can impair the immune function of children, which makes them vulnerable to various infectious diseases and secondary serious complications, and even become a source of infection, endangering the health of others. Vaccination is the most cost-effective measure to prevent infectious diseases. For children with normal immune functions, the benefits of vaccination usually outweigh the disadvantages. However, there is a lack of detailed data on the vaccination situation, efficacy and safety of vaccine use for such immunocompromised tumor survivors, and there are no authoritative and uniform vaccination recommendations. This article reviewed and summarized the literature and consensus of some domestic and foreign scholars on current status of post-treatment vaccination status, efficacy and safety of vaccination for children with tumors after treatment, with the aim of providing a reference for the practice in this field in China.

Mechanism of pterostilbene reducing oxidative damage in endothelial cells in mouse hepatic sinus / 中国药理学通报

Aim To explore the mechanism of the natural phenolic compound pterostilbene(PTE)in the protection of liver ischemic/reperfusion. Methods A total of 40 C57 mice were divided into control group,model group,drug delivery group and treatment group and a 70% liver ischemic/reperfusion(ischemic 60 min)model was established,then primary LSECs were isolated by perfusion and digestion. Hepatic structural disruption was observed by HE staining. The ultrastructure of hepatic sinus endothelial cells was observed by transmission electron microscopy(TEM). The structure of LSECs fenestrae was observed by scanning electron microscopy(SEM). The expression level of heme oxygenase 1(HO-1)in LSECs was detected by Western blot. Results HE staining showed that PTE protected against hepatic ischemic injury. TEM observed that PTE had a protective effect on hepatic sinus endothelial cells,and the number of LSECs fenestrae in the blank control group was larger and the number of fenestrae in the liver I/R model group was reduced. The number of LSECs fenestrae in the liver I/R model group treated with PTE increased compared with the untreated liver I/R model group. Western blot result showed that PTE was able to induce HO-1 expression in LSECs. Conclusions PTE alleviates oxidative damage of endothelial cells in mouse hepatic sinus by inducing HO-1expression,and protects the liver from ischemia/reperfusion injury.

Scientific unknown-base in medical field: Supporting problem-oriented priority setting in basic research / 中华医学科研管理杂志

Objective:The present study delves into the realm of scientific unknowns, which serve as the primary representation of major scientific challenges and often give rise to subversive, non-consensus, and high-risk scientific problems. Addressing this pivotal aspect, we focus on the development of scientific unknown identification methods and tool platforms to provide essential data support for priority setting of basic research through a problem-oriented approach. Such efforts are imperative for managing the scientific and technological innovation system within the context of demands and problem-solving.Methods:While numerous knowledge bases have been established in the medical field, there remains a notable lack of focus on the unknown base. The paper synthesizes relevant literature and existing research, amalgamating the methodological paradigm of scientific big data research with text mining. This integration facilitates comprehensive interpretations and enlightening insights concerning the concept, identification methods, and construction of an unknown-base.Results:By systematically analyzing the concept of scientific unknowns, we present a recognition method based on cognitive state and logical rules. Furthermore, we discuss a classification framework and realization path for scientific unknowns from the dimensions of attribute, relationship, and disease, thereby providing foundational insights for the construction of a medical unknown database.Conclusions:Notably, the research on unknowns in medical science transcends disciplinary boundaries, encompassing the confluence of information science, data science, medical informatics, and science and technology management. As such, this paper seeks to expound upon the significance and application scenarios of unknown research in science, furnishing valuable ideas and references for scholars in the field.

Effectiveness of 13-valent pneumococcal conjugate vaccine against invasive disease caused by serotype 19A in children: a meta-analysis / 中华预防医学杂志

Objective: Using Meta-analysis to evaluate the vaccine effectiveness of 13-valent pneumococcal conjugate vaccine (PCV13) against invasive Streptococcus pneumoniae disease (IPD) caused by serotype 19A in children <5 years old. Methods: "Streptococcus pneumoniae infection""invasive pneumococcal disease""13-valent pneumococcal polysaccharide conjugate vaccine""PCV13""effectiveness""infant""child" and related terms were searched from China National Knowledge Infrastructure (CNKI), WANFANG DATA, PubMed, SCOPUS and Web of science with no limited on language, region and research institution. The retrieval time was limited from January 2010 to February 2023 and cohort study, case-control study and randomized controlled trial were included. Data were extracted from eligible studies by two independent reviewers, and after study quality assessment by NOS scale, Meta-analysis was completed using Stata 16.0 software. Results: A total of 2 340 related literatures were searched, and 10 literatures were finally included, including 5 case-control studies and 5 indirect cohort studies, which showed good literature quality. The vaccine effectiveness against serotype 19A IPD of PCV13 in children was 83.91% (95%CI: 78.92%-88.89%), and the subgroup analysis (P=0.240) showed there was no significant difference among the case-control study (VE=87.34%, 95%CI:79.74%-94.94%) and the indirect cohort study (VE=81.30%, 95%CI:74.69%-87.92%). The funnel plot and Egger test suggested that the possibility of publication bias was small. Conclusion: The present evidence indicates that PCV13 has a good vaccine effectiveness against serotype 19A IPD in children, and it is recommended to further increase the vaccination rate of PCV13 to reduce the disease burden of IPD in children <5 years old.

Effectiveness of 13-valent pneumococcal conjugate vaccine against invasive disease caused by serotype 19A in children: a meta-analysis / 中华预防医学杂志

Objective: Using Meta-analysis to evaluate the vaccine effectiveness of 13-valent pneumococcal conjugate vaccine (PCV13) against invasive Streptococcus pneumoniae disease (IPD) caused by serotype 19A in children <5 years old. Methods: "Streptococcus pneumoniae infection""invasive pneumococcal disease""13-valent pneumococcal polysaccharide conjugate vaccine""PCV13""effectiveness""infant""child" and related terms were searched from China National Knowledge Infrastructure (CNKI), WANFANG DATA, PubMed, SCOPUS and Web of science with no limited on language, region and research institution. The retrieval time was limited from January 2010 to February 2023 and cohort study, case-control study and randomized controlled trial were included. Data were extracted from eligible studies by two independent reviewers, and after study quality assessment by NOS scale, Meta-analysis was completed using Stata 16.0 software. Results: A total of 2 340 related literatures were searched, and 10 literatures were finally included, including 5 case-control studies and 5 indirect cohort studies, which showed good literature quality. The vaccine effectiveness against serotype 19A IPD of PCV13 in children was 83.91% (95%CI: 78.92%-88.89%), and the subgroup analysis (P=0.240) showed there was no significant difference among the case-control study (VE=87.34%, 95%CI:79.74%-94.94%) and the indirect cohort study (VE=81.30%, 95%CI:74.69%-87.92%). The funnel plot and Egger test suggested that the possibility of publication bias was small. Conclusion: The present evidence indicates that PCV13 has a good vaccine effectiveness against serotype 19A IPD in children, and it is recommended to further increase the vaccination rate of PCV13 to reduce the disease burden of IPD in children <5 years old.

Surveillance of adverse events following immunization with human papillomavirus vaccines in Hangzhou City from 2017 to 2021 / 预防医学

Objective@#To investigate the incidence of adverse events following immunization (AEFI) of human papillomavirus (HPV) vaccines in Hangzhou City from 2017 to 2021, so as to provide insights into safety monitoring and evaluation for HPV vaccines.@*Methods@#The AEFI caused by immunization of bivalent (HPV2), quadrivalent (HPV4) and nonavalent HPV vaccines (HPV9) reported in Hangzhou City from 2017 to 2021 were captured from the AEFI Surveillance Module of Chinese Disease Control and Prevention Information System, and HPV vaccination data were captured from the Zhejiang Municipal Immunization Information Management System. The incidence, temporal distributions and clinical symptoms of AEFI were analyzed.@*Results@#Totally 922 310 doses of HPV vaccines were immunized in Hangzhou City from 2017 to 2021, and 232 cases with AEFI were reported, with an overall incidence rate of 25.15/105 doses. The reported incidence rates of AEFI caused by HPV2, HPV4 and HPV9 vaccination were 31.13/105 doses, 25.93/105 doses and 22.01/105 doses, respectively. General reactions and abnormal reactions were predominant AEFI, and the reported incidence rates of general reactions and abnormal reactions were 21.58/105 doses and 2.60/105 dose, respectively. AEFI predominantly occurred 0 to 1 day post-immunization (165 cases, 71.12%), and the main clinical symptoms included local swelling of injection sites, hard tubercle and fever, with reported incidence rates of 10.30/105 doses, 5.96/105 doses and 6.18/105 doses, respectively. @*Conclusions@#Low incidence of AEFI was reported following HPV vaccination in Hangzhou City from 2017 to 2021, and all AEFI were mild. The safety of HPV2, HPV4 and HPV9 remains high.

A study about the epidemiological characteristics of rabies of the cases of medical treatment from a certain hospital in Beijing from 2011 to 2020 / 中华预防医学杂志

From 2011 to 2020, there were 111 213 cases of rabies exposed people recruited from the rabies immunization clinic of a hospital in Beijing. The monthly distribution of patients in each year was not statistically significant (P>0.05). The distribution of patients showed remarkable seasonality, with the exposure peak from May to October. The ratio of male to female was 1∶1.3. The majority of patients were aged 20-29 years old (39.1%) and in-service personnel (56.5%). Level-Ⅱ wounds (84.2%) were more common than level-Ⅲ wounds (14.9%). The number of visits to level-Ⅲwounds increased rapidly since 2017. The most common injured body part was hand (60.7%). Dogs were the most common animal for injuries (60.6%), followed by cats (32.3%), of which most were host animals (75.5%). The vaccination rate from 2016 to 2020 [49.8% (24 276/48 703)] was significantly higher than that from 2011 to 2015[18.6% (6 559/35 272)](χ²=8597.18, P<0.001).

Changes of serum miR-33 level in type 2 diabetic patients with nonalcoholic fatty liver disease / 中国医师杂志

Objective:To investigate the changes of serum miR-33 in patients with type 2 diabetes mellitus (T2DM) with non-alcoholic fatty liver disease (NAFLD), and analyze the relationship between miR-33 and non-alcoholic fatty liver disease and type 2 diabetes mellitus.Methods:From July 2019 to January 2020, 25 healthy subjects (control group), 25 NAFLD patients (NAFLD group), 25 T2DM patients hospitalized in the department of endocrinology (T2DM group) and 25 T2DM patients with NAFLD (NAFLD combined with T2DM group) were selected. The basic data of the subjects were collected, and the levels of miR-33 and other biochemical indexes in the serum of the four groups were detected. The risk factors for type 2 diabetes mellitus with nonalcoholic fatty liver disease were analyzed.Results:There was no significant difference between T2DM group and T2DM group with NAFLD in course of disease, medication history and incidence of complications ( P<0.05). The levels of serum miR-33 in T2DM group, NAFLD group and T2DM combined with NAFLD group were higher than those in healthy people, and the level of serum miR-33 in the combined group was the highest ( P<0.05). The differences in systolic blood pressure, total cholesterol (TC), fasting blood glucose (FPG), glycosylated hemoglobin, triglycerides (HbA1c), triglycerides (TG), high density lipoprotein (HDL-C), uric acid (UA), serum creatinine (Scr), gamma-glutamyl transpeptidase (GGT), alanine aminotransferase (ALT), and aspartate aminotransferase (AST) in the four groups were statistically significant ( P<0.05). The level of miR-33 was positively correlated with systolic blood pressure, FPG, HbA1c, TG, UA and GGT ( P<0.05), and negatively correlated with the level of HDL-C ( P<0.05). MiR-33, systolic blood pressure and FPG increased the risk of NAFLD in T2DM patients ( OR=8.999, 1.083, 2.071, P<0.05). Conclusions:Serum miR-33 is the influencing factor of T2DM and NAFLD diseases and the risk factor of T2DM patients with NAFLD. It may affect the occurrence and development of metabolic diseases by participating in the regulation of glycolipid metabolism.

Exploring and practicing over 80 years in traditional Chinese medicine: the academic career of professor / 中国针灸

This paper reviewes the clinical and scientific research history of professor

Construction and application value of prognosis associated miRNA prediction model based on bioinforma-tics analysis in pancreatic cancer patients / 中华消化外科杂志

Objective:To construct a prognosis associated micro RNA(miRNA) prediction model based on bioinformatics analysis and evaluate its application value in pancreatic cancer patients.Methods:The retrospective cohort study was conducted. The clinicopathological data of 171 pancreatic cancer patients from the Cancer Genome Atlas (TCGA) (https: //cancergenome.nih.gov/) between establishment of database and September 2017 were collected. There were 93 males and 78 females, aged from 35 to 88 years, with a median age of 65 years. Of the 171 patients, 64 had complete clinicopathological data. Patients were allocated into training dataset consisting of 123 patients and validation dataset consisting of 48 patients using the random sampling method, with a ratio of 7∶3. The training dataset was used to construct a prediction model, and the validation dataset was used to evaluate performance of the prediction model. Nine pairs of miRNA sequencing data (GSE41372) of pancreatic cancer and adjacent tissues were downloaded from Gene Expression Omnibus database. The candidate miRNAs were selected from differentially expressed miRNAs in pancreatic cancer and adjacent tissues for LASSO-COX regression analysis based on the patients of training dataset. A prognosis associated miRNA prediction model was constructed upon survival associated miRNAs which were selected from candidate differentially expressed miRNAs. The performance of prognosis associated miRNA prediction model was validated in training dataset and validation dataset, the accuracy of model was evaluated using the area under curve (AUC) of the receiver operating characteristic curves and the efficiency was evaluated using the consistency index (C-index). Observation indicarors: (1) survival of patients; (2) screening results of differentially expressed miRNAs; (3) construction of prognosis associated miRNA model; (4) validation of prognosis associated miRNA model; (5) comparison of clinicopathological factors in pancreatic cancer patients; (6) analysis of factors for prognosis of pancreatic cancer patients; (7) comparison of prediction performance between prognosis associated miRNA model and the eighth edition TNM staging. Measurement data with normal distribution were represented as Mean± SD, comparison between groups was analyzed by the student- t test, and comparison between multiple groups was analyzed by the AVONA. Measurement data with skewed data were represented as M (range), and comparison between groups was analyzed using the Mann-Whitney U test. Count data were described as absolute numbers or percentages, and comparison between groups was conducted using the chi-square test. Ordinal data were analyzed using the rank sum test. Correlation analysis was conducted based on count data to mine the correlation between prognosis associated miRNA model and clinicopathological factors. COX univariate analysis and multivariate analysis were applied to evaluate correlation with the results described as hazard ratio ( HR) and 95% confidence interval ( CI). HR<1 indicated the factor as a protective factor, HR>1 indicated the factor as a risk factor, and HR equal to 1 indicated no influence on survival. The Kaplan-Meier method was used to draw survival curve and calculate survival rates, and the Log-rank test was used for survival analysis. Results:(1) Survival of patients: 123 patients in the training dataset were followed up for 31-2 141 days, with a median follow-up time of 449 days. The 3- and 5-year survival rates were 16.67% and 8.06%. Forty-eight patients in the validation dataset were followed up for 41-2 182 days, with a median follow-up time of 457 days. The 3- and 5-year survival rates were 15.63% and 9.68%. There was no significant difference in the 3- or 5-year survival rates between the two groups ( χ2=0.017, 0.068, P>0.05). (2) Screening results of differentially expressed miRNAs. Results of bioinformatics analysis showed that 102 candidate differentially expressed miRNAs were selected, of which 63 were up-regulated in tumor tissues while 39 were down-regulated. (3) Construction of prognosis associated miRNA model: of the 102 candidate differentially expressed miRNAs, 5 survival associated miRNAs were selected, including miR-21, miR-125a-5p, miR-744, miR-374b, miR-664. The differential expression patterns of pancreatic cancer to adjacent tissues were up-regulation, up-regulation, down-regulation, up-regulation, and down-regulation, respectively, with the fold change of 4.00, 3.43, 3.85, 2.62, and 2.35. A prognostic expression equation constructed based on 5 survival associated miRNAs = 0.454×miR-21 expression level-0.492×miR-125a-5p expression level-0.49×miR-744 expression level-0.419×miR-374b expression level-0.036×miR-664 expression level. (4) Validation of prognosis associated miRNA model: The C-index of prognosis associated miRNA model was 0.643 and 0.642 for the training dataset and validation dataset, respectively. (5) Comparison of clinicopathological factors in pancreatic cancer patients: results of COX analysis showed that the prognosis associated miRNA model was highly related with pathological T stage and location of pancreatic cancer ( Z=45.481, χ2=10.176, P<0.05). (6) Analysis of factors for prognosis of pancreatic cancer patients: results of univariate analysis showed that pathological N stage, radiotherapy, molecular targeted therapy, score of prognosis associated miRNA model were related factors for prognosis pf pancreatic cancer patients ( HR=2.471, 0.290, 0.172, 2.001, 95% CI: 1.012-6.032, 0.101-0.833, 0.082-0.364, 1.371-2.922, P<0.05). Results of multivariate analysis showed that molecular targeted therapy was an independent protective factor for prognosis of pancreatic cancer patients ( HR=0.261, 95% CI: 0.116-0.588, P<0.05) and score of prognosis associated miRNA model≥1.16 was an independent risk factor for prognosis of pancreatic cancer patients ( HR=1.608, 95% CI: 1.091-2.369, P<0.05). (7) Comparison of prediction performance between prognosis associated miRNA model and the eighth edition TNM staging: in the training dataset, there was a significant difference in the prediction probability for 3- and 5-year survival of pancreatic cancer patients between prognosis associated miRNA model and the eighth edition TNM staging ( Z=-1.671, -1.867, P<0.05). The AUC of the prognosis associated miRNA model and the eight edition TNM staging for 3- and 5-year survival prediction was 0.797, 0.935 and 0.737 , 0.703, with the 95% CI of 0.622-0.972, 0.828-1.042 and 0.571-0.904 , 0.456-0.951. The C-index was 0.643 and 0.534. In the validation dataset, there was a significant difference in the prediction probability for 3- and 5-year survival of pancreatic cancer patients between prognosis associated miRNA model and the eighth edition TNM staging ( Z=-1.729, -1.923, P<0.05). The AUC of the prognosis associated miRNA model and the eight edition TNM staging was 0.750, 0.873 and 0.721 , 0.703, with the 95% CI of 0.553-0.948, 0.720-1.025 and 0.553-0.889, 0.456-0.950, respectively. The C-index was 0.642 and 0.544. Conclusions:A prognosis associated miRNA prediction model can be constructed based on 5 survival associated miRNAs in pancreatic cancer patients, as a complementation to current TNM staging and other clinicopathological parameters, which provides individual and accurate prediction of survival for reference in the clinical treatment.

Selection and validation of internal reference genes for qPCR in Polygonatum cyrtonema tubers at different development stages and in response to abiotic stress / 中国中药杂志

In order to analyze the expression of genes involved in steroidal saponin biosynthesis pathway in Polygonatum cyrtonema tubers, it is very important to select internal reference genes that are stably expressed at different development stages and in response to abiotic stress. According to the previously established P. cyrtonema transcriptome database and reported internal reference genes in plant, this study systematically analyzed eight candidate internal reference genes including histone H2 A, glyceraldehyde-3-phosphate dehydrogenase, ACTIN, β-tubulin, ubiquitin-conjugating enzyme-E2-10, elongation factor 1-alpha isoform, 18 S rRNA and α-tubulin 4 for expression stability in P. cyrtonema tubers at different development stages and in response to methyl jasmonate(MeJA) stress by using Real time fluorescence quantitative PCR(qPCR). Based on the statistical analysis of qPCR results by using GeNorm, NormFinder and BestKeeper softwares, the expression of ubiquitin-conjugating enzyme-E2-10 and elongation factor 1-alpha isoform are the most stable in P. cyrtonema tubes at different development stages and in response to MeJA stress. The two internal reference genes were further validated by analyzing the expression of 4 genes involved in steroidal saponin biosynthesis pathways. In conclusion, ubiquitin-conjugating enzyme-E2-10 and elongation factor 1-alpha isoform can be used as the most appropriate internal reference genes for qPCR analysis in P. cyrtonema. This study also provide a foundation for future investigate the molecular mechanism of steroidal saponin biosynthesis pathways in P. cyrtonema.

Single-blind randomized controlled comparison of 3D and 2D assistive functions in transoral endoscopic thyroid surgery / 中华内分泌外科杂志

Objective:To explore the clinical value of 3D and 2D assistive functions in transoral endoscopic thyroid surgery.Methods:The clinical data of patients of transoral thyroid surgery from May. 2018 to Apr. 2019 were retrospectively collected. According to the surgical procedure, they were divided into 3D group and 2D group, 30 cases in each group. Data were analyzed by SPSS 20.0 statistical software, including operation time, postoperative hospital stay, number of lymph nodes removed, postoperative complication rate, etc. The two groups were measured by t test or Wilcoxon test. The count data were analyzed by McNemar paired χ2 test. Results:There was no significant difference between the two groups in the baseline characteristics of the population ( P>0.05) . There was also no significant difference in the intraoperative indexes including the operation time[ (118.20±19.50 vs 123.90±18.20) min], the intraoperative blood loss[ (8.00±3.00 vs 8.90±2.60) ml], the number of lymph nodes removed (8.20±3.30 vs 8.40±2.90) , and the lymph node metastasis rate (40.0% vs 33.3%) . The incidence of recurrent laryngeal nerve paralysis (0.0% vs 3.3%) and transient hypocalcemia (0.0% vs 3.3%) were slightly lower in the 3D group, though there was no statistical difference. There was no significant difference in the postoperative index comparisons, including postoperative hospital stay[ (2.90±0.85 vs 2.87±0.82) Days], 24-hour postoperative drainage[ (58.00±19.50 vs 61.50±16.10) ml], pain scores (1.30±0.60 vs 1.20±0.60) , and patient satisfaction scores (8.90± 0.70 vs 8.80±0.60) . Conclusions:3D assisted operation is feasible in transoral endoscopic thyroid surgery. It may be beneficial to the reduction of the operation time as well as incidence of postoperative complications, and may be worthwhile to promote for further clinical application.

Mechanism of metabolic surgery mediated FGF21 in improving insulin resistance / 国际外科学杂志

Insulin resistance refers to a decrease in the physiological utilization of normal concentrations of insulin by target organs such as liver and adipose tissue.Insulin resistance is central to a variety of metabolic diseases caused by obesity.FGF21 is a novel regulator of glycolipid metabolism,which has the effects of improving insulin resistance,reducing body weight,regulating blood lipids,promoting fatty acid oxidation,and increasing energy consumption.Metabolic surgery is effective in the treatment of obesity and insulin resistance,and the level of FGF21 changes after surgery.This article will review the possible mechanisms of metabolic surgery to mediate FGF21 to improve insulin resistance.

Effect and mechanism of liraglutide on the apoptosis of human hepatocellular carcinoma HepG2 cells induced with palmitic acid / 中华肝脏病杂志

Objective@#To observe whether liraglutide protects HepG2 cells from lipotoxicity by affecting mitogen-activated protein kinase (MAPKs) pathway.@*Methods@#HepG2 cells were induced with 400μmol/L palmitic acid, and cells were treated with a final concentration of 100 nmol/L liraglutide. In addition, JNK inhibitor (SP600125) and p38 MAPK inhibitor (SB203580) were added in advance, respectively. Apoptosis rate, malondialdehyde (MDA) content, and caspase3 activity were detected. Western blot was used to detect p38 mitogen-activated protein kinase (p38 MAPK), c-jun amino terminal kinase (JNK), cytochrome oxidase P450 2E1 (CYP2E1), glucose regulatory protein 78 (GRP78), activated caspase 3, B cell lymphoma associated Protein X (Bax), B cell lymphoma 2 (Bcl-2), and expression of C/EBP homologous protein (CHOP) protein. LSD or Dunnett’s T3 test were used to compare the mean of multiple samples.@*Results@#Palmitic acid increased the phosphorylation of p38 MAPK and JNK in HepG2 cells (P< 0.05). Furthermore, it increased the expression of GRP78, CHOP, CYP2E1, MDA, Bax, caspase3 and apoptosis rate, but inhibited the expression of Bcl-2 (Pvalue < 0.05). SP600125 and SB203580 had inhibited oxidative stress and apoptosis induced by palmitic acid (including CYP2E1, MDA, Bax, Bcl-2, caspase3, CHOP) (P< 0.05). The phosphorylation level of p38 MAPK and JNK was reduced with liraglutide and the expression of apoptosis-related proteins (Bax, Bcl-2, caspase3, CHOP) (P< 0.05) was regulated. There was no significant difference in the effect of liraglutide on apoptotic proteins (Bax, Bcl-2, caspase-3, CHOP) (P> 0.05) after pretreatment with those two inhibitors.@*Conclusion@#Palmitic acid has strong lipotoxicity to HepG2 cells and induces apoptosis. Glucagon-like peptide-1 analogue, liraglutide may improve lipotoxicity of palmitic acid by mediating p38 MAPK and JNK pathways.

Influence of type 2 diabetes treatment on patients with non-alcoholic fatty liver disease / 中国实用内科杂志

Non-alcoholic fatty liver disease(NAFLD), the incidence of which grows rapidly, has become the main cause of abnormal liver enzymes in healthy individuals. By now, no clear consensus has been reached on the treatment due to the multi-factorial pathogenesis of NAFLD. It has been indicated by a lot of studies that there is a close association between the pathogenesis, treatment and prognosis of non-alcoholic fatty liver disease and type 2 diabetes. So some measures of type 2 diabetes, including lifestyle intervention, medication and bariatric surgery, have been gradually used for NAFLD patients. This article introduces and summarizes the above-mentioned treatment for nonalcoholic fatty liver disease.

Effect of exercise on adiponectin in aged obese rats / 中国应用生理学杂志

OBJECTIVE@#To explore effects of exercise on the expression of adiponectin mRNA and protein in visceral adipose tissue, plasma adiponectin concentration, and insulin resistance of aged obese rats.@*METHODS@#Male SD rats age to 21 days old were fed with high-fat diet (fat percentage was 36.3% to 40.0%) for three stages of adolescence, maturity and old age to establish elderly obesity rats model. When the rats aged to 60 weeks old, natural growing elderly rats were randomly divided into control group (C) and aged exercise group (AE), =6; elderly obesity rats were randomly divided into obesity control group (OC) and obesity exercise group (OE), =6. The treadmill grade was 0°, the exercise speed and time were 15 m/min×15 min, 4 groups each time, between consecutive groups the rats had 5 minutes rest, the rats were exercised for 60 minutes every day, five days a week, continuous exercise for 8 weeks. Then, the expressions of adiponectin mRNA and protein in visceral adipose tissue were determined. The concentrations of blood glucose, plasma adiponectin and insulin were measured. Insulin resistance was calculated.@*RESULTS@#Comparison with control group, the expressions of adiponectin mRNA and protein were obviously decreased, the concentration of blood glucose and insulin resistance were significantly increased in obesity control group, while the expressions of adiponectin mRNA and protein were obviously increased. Comparison with obesity control group, the expressions of adiponectin mRNA and protein, the concentration of plasma adiponectin were obviously increased, the concentration of blood glucose and insulin resistance were significantly decreased in obesity exercise group.@*CONCLUSIONS@#Adiponectin mRNA and protein expression in visceral adipose tissue is decreased and accompanied by high blood glucose and insulin resistance in elderly obesity rats. Exercise can increase the adiponectin mRNA and protein expression in visceral adipose tissue, elevate levels of plasma adiponectin, and decrease the level of blood glucose and insulin resistance in elderly obesity rats.

The influence of liraglutide on ERp46 in non-alcoholic fatty liver disease rats / 中华内分泌代谢杂志

Objective Rats were fed with high-fat diet and were successfully induced the models with non-alcoholic fatty liver disease,and to investigate the effects of liraglutide on the expression of ERp46.Methods Thirty male Sprague-Dawley rats were assigned to normal chow group(NC,n=10)and high-fat diet group(n=20),after 12 weeks,the high-fat diet group rats were divided into high-fat diet group(HF,n=10)and liraglutide group(100L,n=10) and treated with normal saline and liraglutide(100 μg/kg)for 4 weeks respectively. Liver tissues were measured by hematoxylin-eosin(HE),Oil Red O staining,hepatic triglyceride(TG),and hyperinsulinemic-euglycemic clamp test(HECT). Hepatocyte apoptosis rate were evaluated by TdT-mediated dUTP nick-end labeling(TUNEL),and the expressions of ERp46 mRNA and protein were measured.Results Compared with the NC group,the liver tissues in the HF group have steatosis,insulin resistance,and the percentage of apoptosis was significantly increased. ERp46 mRNA and protein expressions were decreased(P<0.05). Compared with the HF group,liraglutide treatment was sufficient to reduce steatosis,insulin resistance,apoptosis,and increase the ERp46 mRNA and protein(P<0.05). Furthermore,the expression of ERp46 protein in the liver was negatively correlated with hepatocyte apoptosis rate,and positive correlated with glucose infusion rate(GIR, P<0. 05). Conclusion Liraglutide may up-regulate the expression of ERp46 to improve IR and hepatocyte apoptosis in NAFLD rats.

Correlation between sex hormone binding globulin and type 2 diabetes retinopathy / 中国医师杂志

Objective To investigate the relationship between sex hormone binding globulin (SHBG) in serum and diabetic retinopathy (DR) in patients with type 2 diabetic mellitus (T2DM).Methods A total of 160 hospitalized people with T2DM was enrolled into the study.The patients were divided into two groups with or without merged DR.Clinical and laboratorial data were collected, and the correlation was analyzed between sex hormone binding globulin and diabetic retinopathy.Results (1) Compared to the group without DR, patients in T2DM with DR had significant lower SHBG concentration, triglyceride (TG) and total cholesterol (TC) concentration were increased significantly (P ＜ 0.01).(2) The level of SHBG was associated with waist circumference, body weight, fasting blood glucose, and glycosylated hemoglobin (P ＜ 0.05).(3) While the level of SHBG was significantly increased from Quartile 1 to Quartile4, the prevalence of DR was also significantly decreased (A:70％, B:51.2％,C:40.5％, D:29.7％) (P ＜ 0.01).(4) Logistic regressing analysis shows that with the decrease of SHBG level, the increase of triglyceride levels, the risk of DR was significantly increased (SHBG:OR:0.616,95％ CI:0.447-0.850,P ＜ 0.01;TG:OR:1.323,95％ CI:1.025-1.707,P＜0.05).Conclusions With the decrease of SHBG, the prevalence of DR is significantly increased, lower SHBG may be one of the hazards of T2DM patients with DR.