Influence of sexual hormones on Chagas disease / Influencia de las hormonas sexuales en la enfermedad de Chagas

Abstract Objective: Analyze sex hormone's influence during Chagas disease. Methods: Male and female BALB/c mice were divided into six groups, four experimental (sham, orchiectomized, orchiectomized and supplemented with estradiol, orchiectomized supplemented with testosterone, oophorectomized, oophorectomized and supplemented with estradiol, and oophorectomized and supplemented with testosterone), and two control (healthy and intraperitoneally with T. cruzi strain NINOA infected). Clinical data were recorded daily, parasitemia was evaluated using a Neubauer chamber during the infection, and heart histopathological analysis was performed using the paraffin embedding technique. To analyze parasitemia curves and the area under the parametric curves, two-way ANOVA test was performed to correlate groups' data. P-values < 0.05 were considered statistically significant. Results: Higher mortality rates, cardiomegaly, hepatomegaly, ascites, edema, higher parasitemia levels, more amastigote nests, and more severe inflammatory infiltrate were found in higher testosterone concentration mice, whereas in higher estradiol concentration groups, paresia, prostration, edema, and necrosis were found. Conclusions: Our results showed that testosterone increased infection severity, whereas estradiol had the opposite effect. This research improves the understanding of sex hormones´ infuence upon this infection to contribute with the handling of Chagas´ disease.

Resumen Objetivo: Analizar la influencia de las hormonas durante la enfermedad de Chagas. Métodos: Se separaron grupos de ratones macho y hembras BALB/c, todos infectados con T. cruzi (cepa NINOA), 4 grupos experimentales de machos (Sham, orquidectamizados, orquidectimezados y suplementados con estradiol, orquidectamizaos y suplementados con testosterona). 4 grupos experimentales de hembras (oforectomizadas, oforectomizadas y suplementadas con estradiol, oforectomizadas y suplementadas con testosterona y sham), and y dos grupos control para cada sexo (sin infección e infectados intraperitonealmente con T. cruzi (cepa NINOA). Los datos clínicos fueron registrados diariamente, la parasitemia fue evaluada durante toda la infección utilizando una cámara de Neubauer y el análisis histopatológico del corazón fue realizada con la técnica de inclusión en parafina. Para el análisis de las curvas de parasitemia y el área bajo la curva, se realizó una prueba de ANOVA de dos vías, p < 0.05 fueron considerados estadísticamente diferentes. Resultados: Las mayores tasas de mortalidad, cardiomegalia, hepatomegalia y mayor infiltrado inflamatorio, se encontró en los ratones con una mayor concentración de testosterona. En contraste los ratones con mayor concentración de estradiol presentaron paresia, postración edema y necrosis. Conclusiones: Nuestros resultados ponen en manifiesto que la testosterona incrementa la severidad del curso de la enfermedad de Chagas, mientras que el estradiol tuvo el efecto opuesto. Este trabajo mejora el entendimiento del rol que juegan las hormonas sexuales en esta infección para contribuir en un mejor manejo de la enfermedad de Chagas.

Resposta Vascular da Triiodotironina sobre Anéis de Aortas Isoladas: Contribuição de Mecanismos Redox / Vascular Response of Triiodothyronine on Isolated Aortic Rings: Contribution of Redox Mechanisms

Resumo Fundamento A disfunção vascular constitui a etiologia de diversas doenças, incluindo infarto do miocárdio e hipertensão, diante da ruptura da homeostase oxi-redutiva ("redox"), desempenhando um papel no desequilíbrio do mecanismo de controle vasomotor. Nosso grupo demonstrou anteriormente que os hormônios tireoidianos melhoram a sinalização da angiogênese, exercendo efeitos protetores sobre o tecido aórtico de ratos infartados. Objetivos Investigar o papel da triiodotironina (T3) na resposta vascular, explorando seus efeitos em aortas isoladas e a presença de mecanismos redox vasculares. Métodos Anéis aórticos isolados (endotélio intacto e desnudado) pré-contraídos com fenilefrina foram incubados com T3 (10-8, 10-7, 10-6, 10-5 e 10-4 M) e a tensão foi registrada usando um transdutor de deslocamento de força acoplado a um sistema de coleta. Para avaliar o envolvimento do estresse oxidativo, os anéis aórticos foram pré-incubados com T3 e posteriormente submetidos a um sistema de geração de espécies reativas de oxigênio (ROS) in vitro. O nível de significância adotado na análise estatística foi de 5%. Resultados A T3 (10-4 M) promoveu o vasorrelaxamento dos anéis aórticos pré-contraídos com fenilefrina em endotélio intacto e desnudado. Os anéis aórticos pré-incubados na presença de T3 (10-4 M) também mostraram diminuição da vasoconstrição provocada pela fenilefrina (1 µM) em preparações de endotélio intacto. Além disso, o efeito vasorrelaxante da T3 (10-4 M) persistiu em anéis aórticos pré-incubados com éster metílico de NG-nitro-L-arginina (L-NAME, 10 µM), um inibidor inespecífico da NO sintase (NOS). Por fim, a T3 (10-4 M) exibiu, in vitro, um papel antioxidante ao reduzir a atividade da NADPH oxidase e aumentar a atividade da SOD nos homogenatos aórticos. Conclusão A T3 exerce efeitos dependentes e independentes de endotélio, o que pode estar relacionado ao seu papel na manutenção da homeostase redox.

Abstract Background Vascular dysfunction constitutes the etiology of many diseases, such as myocardial infarction and hypertension, with the disruption of redox homeostasis playing a role in the imbalance of the vasomotor control mechanism. Our group previously has shown that thyroid hormones exert protective effects on the aortic tissue of infarcted rats by improving angiogenesis signaling. Objective Investigate the role of triiodothyronine (T3) on vascular response, exploring its effects on isolated aortas and whether there is an involvement of vascular redox mechanisms. Methods Isolated aortic rings (intact- and denuded-endothelium) precontracted with phenylephrine were incubated with T3 (10-8, 10-7, 10-6, 10-5, and 10-4 M), and tension was recorded using a force-displacement transducer coupled with an acquisition system. To assess the involvement of oxidative stress, aortic rings were preincubated with T3 and subsequently submitted to an in vitro reactive oxygen species (ROS) generation system. The level of significance adopted in the statistical analysis was 5%. Results T3 (10-4 M) promoted vasorelaxation of phenylephrine precontracted aortic rings in both intact- and denuded-endothelium conditions. Aortic rings preincubated in the presence of T3 (10-4 M) also showed decreased vasoconstriction elicited by phenylephrine (1 µM) in intact-endothelium preparations. Moreover, T3 (10-4 M) vasorelaxation effect persisted in aortic rings preincubated with NG-nitro-L-arginine methylester (L-NAME, 10 µM), a nonspecific NO synthase (NOS) inhibitor. Finally, T3 (10-4 M) exhibited, in vitro, an antioxidant role by reducing NADPH oxidase activity and increasing SOD activity in the aorta's homogenates. Conclusion T3 exerts dependent- and independent-endothelium vasodilation effects, which may be related to its role in maintaining redox homeostasis.

Evolución clínica en pacientes con síndrome del túnel carpiano tratados con ultrasonido o infiltración con corticoesteroides / Clinical Evolution in Patients with Carpal Tunnel Syndrome Treated with Ultrasound or Corticosteroid Infiltration

Introducción. El Síndrome del túnel carpiano es la neuropatía periférica compresiva más común de la extremidad superior, que se produce por la compresión del nervio mediano. Los casos leves y moderados pueden tratarse con métodos conservadores como ultrasonido terapéutico o infiltración con corticoesteroides. Objetivo. Describir la evolución clínica de pacientes con síndrome de túnel carpiano tratados con terapia por ultrasonido e infiltración de corticoesteroides. Metodología. Ensayo clínico abierto, en pacientes con síndrome del túnel carpiano leve y moderado, que consultaron del 1 de octubre 2021 al 30 de mayo 2022. Se formaron dos grupos; el que recibió tratamiento con ultrasonido con 12 casos y el grupo tratado con infiltración con corticoesteroides con seis casos. Ambos grupos fueron intervenidos en la consulta inicial, y luego, en las cuatro y ocho semanas posteriores al inicio del tratamiento. Resultados. Se muestran los resultados descriptivos relacionados con la intensidad de dolor, valorada con la Escala Visual Numérica, la infiltración obtuvo dos casos sin dolor y cuatro con dolor moderado, contrario a ultrasonido que se mantuvo con cuatro casos leves, tres moderados y cinco intensos. En los síntomas, la infiltración redujo el número de casos en cuatro de los síntomas estudiados, en cambio el ultrasonido únicamente en dos. En severidad, valorada con el cuestionario de Boston para túnel carpal, con infiltración se obtuvieron dos casos asintomáticos y ninguno con ultrasonido. Respecto a los signos clínicos, el signo de Tinel desapareció en cuatro casos en ambos grupos, mientras que signo de Phalen desapareció en cuatro casos en ultrasonido y dos en infiltración. Conclusión. En intensidad de dolor y grado de severidad, la infiltración generó casos asintomáticos y redujo mayor cantidad de síntomas que el ultrasonido. Ambos tratamientos disminuyeron la presencia de signos clínicos

Introduction. Carpal tunnel syndrome is the most common compressive peripheral neuropathy of the upper extremity, which is caused by compression of the median nerve. Mild and moderate cases can be treated with conservative methods such as therapeutic ultrasound or corticosteroid infiltration. Objective. To describe the clinical evolution of patients with carpal tunnel syndrome treated with ultrasound therapy and corticosteroid infiltration. Methodology. A prospective open clinical trial was conducted in patients with mild and moderate carpal tunnel syndrome who consulted from October 1, 2021 to May 30, 2022. Two groups were formed: the group that received ultrasound treatment with 12 cases and the group treated with corticosteroid infiltration with six cases. Both groups were treated at the initial consultation and then at four and eight weeks after the start of treatment. Results. The descriptive results related to the intensity of pain, evaluated with the Visual Numeric Scale, are shown. Infiltration obtained two cases without pain and four with moderate pain, contrary to ultrasound which was maintained with four mild, three moderate and five intense cases. In symptoms, infiltration reduced the number of cases in four of the symptoms studied, while ultrasound reduced the number of cases in only two. In severity, assessed with the Boston carpal tunnel questionnaire, with infiltration, there were two asymptomatic cases and none with ultrasound. Regarding clinical signs, Tinel's sign disappeared in four cases in both groups, while Phalen's sign disappeared in four cases in ultrasound and two in infiltration. Conclusion. Infiltration produced asymptomatic patients and reduced more symptoms than ultrasonography in terms of pain intensity and severity. Clinical symptoms were less common with both treatments.

Morpho-physiological and phytohormonal changes during the induction of adventitious root development stimulated by exogenous IBA application in Magnolia biondii Pamp

Abstract Magnolia biondii Pamp is an important ornamental tree species widely grown and used as a rootstock in the propagation of different Magnolia varieties. In the current studies, anatomical, physiological and endogenous hormones were studied to check the effect of IBA 750 mg/L on the adventitious rooting and to provide theoretical and technical support for the propagation of Magnolia biondii Pamp through stem cuttings. Two thousand stem cuttings were prepared and divided into two groups i.e., IBA treated cuttings and water control. For the evaluation of antioxidant enzyme activities, and endogenous hormones levels, samples were collected on the day of planting and each 5th day and further steps were carried out in the laboratory according to the protocols and proper precautions. For the anatomical observations, samples were collected on the 13th, 15th, and 17th day for IBA treated cuttings while 21st, 23rd, and 25th day for control. Collected samples were preserved in the FAA solution and further observations were carried out in the laboratory. Anatomical observations showed that it took 13 days for the differentiation of root primordia to the appearance of young adventitious roots in IBA treated cuttings, while it took 21 days to develop primordia in the control. Antioxidant enzyme activities involved in ROS were significantly higher in the IBA treated cuttings compared to control. POD showed a peak on the 13th day before the emergence of roots in IBA treated cuttings while it showed a peak on the 21st day in the control. PPO showed a peak on the 21st day in the IBA treated cuttings while it showed a peak on the 29th day in the control. SOD showed a peak on the 17th day in IBA treated cuttings, while it showed a peak on the 25th day in the control. Exogenous application of IBA enhanced the endogenous IAA and GA3 levels compared to CK, while it reduced the levels of ABA continuously at the time of rooting and then increased gradually. Inclusively, our study suggests that IBA 750 mg/L is efficient for the rooting of Magnolia biondii Pamp cuttings, as it enhanced the process of antioxidant enzyme activities, endogenous hormones levels and reduced the time of root formation which is evident from the anatomical observations.

Resumo Magnolia biondii Pamp é uma importante espécie de árvore ornamental muito cultivada e utilizada como porta-enxerto na propagação de diferentes variedades de Magnolia. Nos estudos atuais, hormônios anatômicos, fisiológicos e endógenos foram estudados para verificar o efeito do AIB na dose de 750 mg / L no enraizamento adventício e fornecer suporte teórico e técnico para a propagação de M. biondii Pamp por meio de estacas. Duas mil estacas foram preparadas e divididas em dois grupos, ou seja, tratadas com AIB e controle de água. Para a avaliação das atividades das enzimas antioxidantes e dos níveis de hormônios endógenos, as amostras foram coletadas no dia do plantio e a cada 5 dias, enquanto as demais etapas foram realizadas em laboratório de acordo com os protocolos e os devidos cuidados. Para as observações anatômicas, as amostras foram coletadas no 13º, 15º e 17º dias para estacas tratadas com AIB e no 21º, 23º e 25º dias para o controle. As amostras coletadas foram preservadas em solução FAA, e outras observações foram realizadas em laboratório. Observações anatômicas mostraram a necessidade de 13 dias para a diferenciação dos primórdios radiculares até o aparecimento de raízes adventícias jovens em estacas tratadas com AIB e de 21 dias para o desenvolvimento dos primórdios no controle. As atividades das enzimas antioxidantes envolvidas nas ROS foram significativamente maiores nas estacas tratadas com AIB em comparação com o controle. A POD apresentou pico no 13º dia antes da emergência das raízes nas estacas tratadas com AIB, enquanto no 21º dia apresentou pico no controle. A PPO teve pico no 21º dia nas estacas tratadas com AIB e no 29º dia no controle. A SOD apresentou pico no 17º dia nas estacas tratadas com AIB e no 25º dia no controle. A aplicação exógena de AIB aumentou os níveis endógenos de IAA e GA3 em relação ao controle, enquanto reduziu os níveis de ABA continuamente no momento do enraizamento e, em seguida, aumentou gradativamente. Inclusive, nosso estudo sugere que o AIB na dose de 750 mg / L é eficiente para o enraizamento de estacas de M. biondii Pamp, visto que potencializou o processo de atividades de enzimas antioxidantes e os níveis de hormônios endógenos, além de reduzir o tempo de formação de raízes, o que fica evidente nas observações anatômicas.

Correlation of FSHR gene polymorphism,BMI and sex hormone six with the risk of polycystic ovary syndrome / 解放军医学杂志

Objective To investigate the association between body mass index(BMI),sex hormone and single nucleotide polymorphisms(SNPs)of follicle-stimulating hormone receptor(FSHR)gene rs2268361 and rs2349415 and its correlation with the risk of polycystic ovary syndrome(PCOS).Methods Peripheral blood was collected from 213 PCOS patients and 207 healthy controls,attending the Department of Reproductive Medicine at the First Hospital of Shanxi Medical University,and 32 follicular fluids were randomly collected from each of the PCOS and control groups from March to August 2021.Calculation of BMI of the PCOS and control groups;The levels of follicle-stimulating hormone(FSH),luteinizing hormone(LH),estradiol(E2),testosterone(T),progesterone(P)and prolactin(PRL)in peripheral blood of the two groups were detected by immunochemiluminescence method.Polymerase chain reaction(PCR)and high-resolution melting curve(HRM)were used to analyze the polymorphisms of rs2268361 and rs2349415 in FSHR of the two groups.Quantitative real-time PCR was used to detect the expression of FSHR gene mRNA in peripheral blood and ovarian granulosa cells.Results There was a strong positive correlation between LH and LH/FSH(r=0.88,P<0.05);The levels of BMI,E2,LH,LH/FSH and T in PCOS group were significantly higher than those in control group(P<0.05);FSH level was significantly lower than that of control group(P<0.001).HRM analysis showed the frequencies of CC,CT and TT genotypes at rs2349415 were 55.9%,34.3%and 9.8%in PCOS group and 68.6%,23.2%and 8.2%in control group,respectively.The frequencies of C and T alleles were 73.0%and 27.0%in PCOS group and 80.2%and 19.8%in control group,respectively.There were significant differences in genotype frequencies and allele frequencies between the two groups(P<0.05);The expression level of FSHR mRNA was higher in ovarian granulosa cells in PCOS group than in control group(P=0.004),the expression level of FSHR mRNA in rs2349415 TT genotype was higher than that in CC(P=0.002)and CT(P=0.035)genotype.Conclusion High levels of BMI, LH, E2 and T allele of rs2349415 increased the risk of PCOS.

Effect of ropivacaine combined with dexmedetomidine in transversus abdominis plane block on postoperative stress hormone and cognitive function in patients undergoing laparoscopic radical gastrectomy / 新乡医学院学报

Objective To explore the effect of ropivacaine combined with dexmedetomidine in transversus abdominis plane block(TAPB)on postoperative stress hormones and cognitive function in patients undergoing laparoscopic radical gastrectomy.Methods A total of 80 patients undergoing laparoscopic radical gastrectomy at the First Affiliated Hospital of Xinxiang Medical University from April to October 2023 were selected as the research subjects.According to different anesthesia methods,the patients were divided into the observation group and the control group,with 40 patients in each group.Patients in the observation group were injected bilaterally with 2.5 g·L-1 ropivacaine and 0.5 μg·kg-1 dexmedetomidine for TAPB,with 20 mL injection on each side.Patients in the control group were injected bilaterally with 2.5 g·L-1 ropivacaine for TAPB,with 20 mL injection on each side.Mean arterial pressure(MAP)and heart rate(HR)were recorded at the time of admission to the operating room(T1),immediately after endotracheal intubation(T2),40 minutes after pneumoperitoneum(T3),and 15 minutes after extubation(T4).Radioimmunoprecipitation was used to detect serum cortisol(COR)level,and enzyme-linked immunosorbent assay was used to measure serum norepinephrine(NE)and epinephrine(E)levels at 1,6,12,and 24 hours after surgery.Visual analog scale(VAS)was used to assess pain at rest,and Ramsay sedation scale(RSS)was used to evaluate sedation depth.The doses of propofol and sufentanil were compared between the two groups.Serum β-amyloid(Aβ)and S100β protein levels at 1 day before surgery,1 and 3 days after surgery were detected by using the enzyme-linked immunosorbent assay,and cognitive function was assessed at the same time points by using the mini-mental state examination(MMSE).Results At T,and T2,there was no significant difference in MAP and HR between the control group and the observation group(P＞0.05).At T3 and T4,MAP and HR in the observation group were significantly lower than those in the control group(P＜0.05).At 1,6,and 12 hours postoperatively,VAS score in the observation group was significantly lower than that in the control group(P＜0.05).At 24 hours postoperatively,there was no significant difference in VAS score between the control group and observation group(P＞0.05).At 1 and 6 hours postoperatively,RSS score in the observation group was significantly higher than that in the control group(P＜0.05).At 12 and 24 hours postoperatively,there was no significant difference in RSS score between the control group and observation group(P＞0.05).At 1,6,and 12 hours postoperatively,COR,NE,and E levels in the observation group were significantly lower than those in the control group(P＜0.05).At 24 hours postoperatively,there was no significant difference in COR,NE,and E levels between the control group and observation group(P＞0.05).The doses of propofol and sufentanil in the observation group were significantly lower than those in the control group(P＜0.05).One day before surgery,there was no significant difference in MMSE score between the control group and observation group(P＞0.05).At 1 and 3 days postoperatively,MMSE score in the observation group was significantly higher than that in the control group(P＜0.05).One day before surgery,there was no significant difference in serum Aβ and S100β protein levels between the control group and observation group(P＞0.05).At 1 and 3 days postoperatively,serum Aβ and S100β protein levels in the observation group were significantly lower than those in the control group(P＜0.05).Conclusion Ropivacaine combined with dexmedetomidine in TAPB in radical gastrectomy can significantly reduce postoperative pain,increase sedative effect,prolong the duration of TAPB,and benefit patients'postoperative recovery with reduced cognitive impairment.

Correlation between the expression of serum preprotein convertase subtilisin/kexin type 9, secreted frizzled related protein-4 and sex hormone, glucose and lipid metabolism in patients with obese polycystic ovary syndrome / 中国医师进修杂志

Objective:To investigate the correlation between the expression of serum preprotein convertase subtilisin/kexin type 9 (PCSK9), secreted frizzled related protein-4 (SFRP-4) and sex hormone, glucose and lipid metabolism in obese polycystic ovary syndrome (PCOS) patients.Methods:A total of 130 patients with polycystic ovary syndrome diagnosed and treated in Xuzhou Maternal and Child Health Hospital from April 2021 to October 2022 were selected as the study subjects, the patients were divided into obese group (60 cases) and non obese group (70 cases) according to body mass index. Enzyme linked immunosorbent assay was applied to detect the serum levels of PCSK9 and SFRP-4. The correlation between serum PCSK9, SFRP-4 levels and sex hormones (luteinizing hormone, testosterone, follicle stimulating hormone), glucose metabolism indicators [fasting blood glucose (FPG), glycosylated hemoglobin (HbA 1c), fasting insulin (FINS), homeostatic model assessment insulin resistance index (HOMA-IR)], lipid metabolism indexes [total cholesterol (TC), triglyceride (TG), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C)] in patients with obese polycystic ovary syndrome was analyzed by Pearson method. Results:The serum levels of PCSK9 and SFRP-4 in obese group were significantly higher than those in non obese group: (679.36 ± 162.21) μg/L vs. (421.68 ± 103.74) μg/L, (302.87 ± 70.58) μg/L vs. (184.21 ± 52.45) μg/L, the difference was statistically significant ( P<0.05). Compared with the non obese group, the obese group had significantly higher levels of luteinizing hormone and testosterone: (18.36 ± 5.34) U/L vs. (9.47 ± 2.21) U/L, (3.61 ± 0.97) nmol/L vs. (3.02 ± 0.84) nmol/L ( P<0.05), and significantly lower levels of follicle stimulating hormone: (7.28 ± 1.62) U/L vs. (8.03 ± 2.10) U/L, with statistically significant differences ( P<0.05); the levels of FPG, HbA 1c, FINS and HOMA-IR in obese group were significantly higher than those in non obese group: (5.46 ± 0.67) mmol/L vs. (5.04 ± 0.49) mmol/L, (7.96 ± 0.98)% vs. (6.68 ± 0.77)%, (34.08 ± 3.64) U/L vs. (23.67 ± 2.52) U/L, 8.27 ± 1.84 vs. 5.30 ± 1.52, and the differences were statistically significant ( P<0.05); compared with the non obese group, the obese group had significantly increased levels of TC, TG and LDL-C: (4.86 ± 0.67) mmol/L vs. (4.12 ± 0.54) mmol/L, (1.64 ± 0.36) mmol/L vs. (1.06 ± 0.21) mmol/L and (2.81 ± 0.56) mmol/L vs. (2.14 ± 0.42) mmol/L ( P<0.05), and HDL-C level was significantly reduced: (1.11 ± 0.25) mmol/L vs. (1.52 ± 0.40) mmol/L, with statistically significant differences ( P<0.05); the levels of serum PCSK9 and SFRP-4 in obese polycystic ovary syndrome patients were positively correlated with luteinizing hormone, testosterone, FPG, HbA 1c, FINS, HOMA-IR, TC, TG and LDL-C ( P<0.05), and negatively correlated with follicle stimulating hormone and HDL-C ( P<0.05). Conclusions:The serum PCSK9 and SFRP-4 levels in obese polycystic ovary syndrome patients are elevated, which is related to sex hormones, glucose and lipid metabolism.

Metformin:A promising clinical therapeutical approach for BPH treatment via inhibiting dysregulated steroid hormones-induced prostatic epithelial cells proliferation / 药物分析学报

The occurrence of benign prostate hyperplasia(BPH)was related to disrupted sex steroid hormones,and metformin(Met)had a clinical response to sex steroid hormone-related gynaecological disease.How-ever,whether Met exerts an antiproliferative effect on BPH via sex steroid hormones remains unclear.Here,our clinical study showed that along with prostatic epithelial cell(PEC)proliferation,sex steroid hormones were dysregulated in the serum and prostate of BPH patients.As the major contributor to dysregulated sex steroid hormones,elevated dihydrotestosterone(DHT)had a significant positive rela-tionship with the clinical characteristics of BPH patients.Activation of adenosine 5'-monophosphate(AMP)-activated protein kinase(AMPK)by Met restored dysregulated sex steroid hormone homeostasis and exerted antiproliferative effects against DHT-induced proliferation by inhibiting the formation of androgen receptor(AR)-mediated Yes-associated protein(YAP1)-TEA domain transcription factor(TEAD4)heterodimers.Met's anti-proliferative effects were blocked by AMPK inhibitor or YAP1 over-expression in DHT-cultured BPH-1 cells.Our findings indicated that Met would be a promising clinical therapeutic approach for BPH by inhibiting dysregulated steroid hormone-induced PEC proliferation.

Clinical research on sensitivity to thyroid hormones and its association with nutrition and metabolism: progress and perspectives / 中华临床营养杂志

Thyroid hormones are crucial for energy metabolism. Thyroid dysfunction is closely related to a variety of metabolic disorders. However, evaluation relying solely on thyroid function indicators may come up short, considering the complex relationship between thyroid hormones and metabolic issues. There has been a growing recognition of sensitivity to thyroid hormones as a measure of thyroid function complementary to traditional indices. The indicators of thyroid hormone sensitivity include free triiodothyronine/free thyroxine, thyrotroph thyroxine resistance index, thyroid-stimulating hormone index and thyroid feedback quantile-cased index. It has been reported that impaired sensitivity to thyroid hormones can potentially interact with various nutritional imbalances and metabolic abnormalities, such as metabolic syndrome, osteoporosis and decreased vitamin D, which are not only of concern to those with thyroid dysfunction, but also to euthyroid individuals in terms of prevention and prophylaxis. With the aim of providing comprehensive insights, this review is intended to systematically summarize the existing evidence on the association between sensitivity to thyroid hormones and metabolic disorders.

Effects of acupuncture combined with Huatan and Progesterone prescription on IL-6,HOMA-IR,HS-CRP,sex hormone and pregnancy outcome in patients with polycystic ovary syndrome(phlegm-dampness and difficulty) / 中国免疫学杂志

Objective:To explore the effect of acupuncture combined with Huatan and Progesterone prescription on patients with polycystic ovary syndrome(phlegm-dampness and difficulty).Methods:Total 128 patients with polycystic ovary syndrome(phlegm-dampness and difficulty)were treated in the Third Affiliated Hospital of Beijing University of Chinese Medicine from Septem-ber 2017 to March 2021,and randomly divided into control group and observation group,with 64 patients in each group.Control group received conventional treatment in Western medicine,and observation group was treated with acupuncture and the Huatan and Progesterone prescription.After 3 menstrual cycles,the efficacy was compared.Results:After treatment,serum TGF-β1,IL-6 and high-sensitivity C-reactive protein(HS-CRP)levels of observation group were lower than that of control group(P<0.05),insulin resis-tance index(HOMA-IR),endometrial thickness and ovarian volume in observation group were lower than those in control group(P<0.05),serum estrogens(E2)level in observation group was higher than that in control group,while levels of luteinizing hormone(LH)and follicle-stimulating hormone(FSH)were lower than that in control group(P<0.05).After treatment,ovulation rate(79.69%)and pregnancy rate(57.81%)in observation group were higher than those in control group,and there was no significant difference in abor-tion rate between the two groups(P>0.05).Total incidence of adverse reactions in observation group(7.81%)was lower than that in control group(21.88%),and the difference was statistically significant(P<0.05).Conclusion:For patients with polycystic ovary syn-drome(phlegm-dampness and difficulty),combined acupuncture and Huatan and Progesterone prescription has significant effect,which can help to reduce inflammatory reaction,reduce insulin resistance,promote ovulation and pregnancy,and improve clinical efficacy.

Hipoacusia en el síndrome de Vogt-Koyanagi-Harada: reporte de caso y revisión de la literatura / Hearing loss in Vogt-Koyanagi-Harada syndrome: case report and literature review

El síndrome de Vogt-Koyanagi-Harada (VKH) es una rara enfermedad granulomatosa multisistémica caracterizada por aparición de panuveítis grave bilateral y desprendimiento seroso de retina; puede acompañarse de un amplio espectro de síntomas extraoculares como los auditivos, y la afección más frecuente es la hipoacusia neurosensorial. Su etiología se reconoce como respuesta autoinmune mediada por células T contra antígenos de melanocitos presentes en coroides, meninges, cóclea y piel. Asimismo, factores genéticos del huésped se han identificado como predisponentes para su aparición, y es la presencia del alelo HLA-DR4, en particular el subtipo HLA-DRB1 0405, el más estudiado hasta la fecha. El tratamiento se basa en administración de corticosteroides sistémicos en dosis altas, sin embargo, es escasa la evidencia que evalúa específicamente la eficacia de estos medicamentos sobre sus manifestaciones audiovestibulares. Este artículo expone un caso de síndrome de VKH con compromiso auditivo concomitante y realiza una breve revisión narrativa de la literatura.

Vogt-Koyanagi-Harada syndrome (VKHS) is a rare multisystemic granulomatous disease, characterized by severe bilateral panuveitis and serous retinal detachment; it can be associated with a wide spectrum of extraocular symptoms, such as auditory symptoms, and the most common condition is sensorineural hearing loss. Its etio-logy is recognized as a T-cell-mediated autoimmune response against melanocyte antigens present in the choroid, meninges, cochlea, and skin. Likewise, host genetic factors have been identified as predisposing for its development, specifically the pre-sence of the HLA-DR4 allele, the HLA-DRB1 0405 subtype is the most studied up to date. Treatment is based on the administration of high doses of systemic corticos-teroids, however, there is not much evidence that specifically evaluates the efficacy of these medications on their audiovestibular manifestations. This article presents a clinical case of VKH syndrome with concomitant hearing impairment and carries out a short narrative review of the literature.

Morpho-physiological and phytohormonal changes during the induction of adventitious root development stimulated by exogenous IBA application in Magnolia biondii Pamp / Alterações morfofisiológicas e fito-hormonais durante a indução do desenvolvimento radicular adventício estimulado pela aplicação exógena do AIB em Magnolia biondii Pamp

Magnolia biondii Pamp is an important ornamental tree species widely grown and used as a rootstock in the propagation of different Magnolia varieties. In the current studies, anatomical, physiological and endogenous hormones were studied to check the effect of IBA 750 mg/L on the adventitious rooting and to provide theoretical and technical support for the propagation of Magnolia biondii Pamp through stem cuttings. Two thousand stem cuttings were prepared and divided into two groups i.e., IBA treated cuttings and water control. For the evaluation of antioxidant enzyme activities, and endogenous hormones levels, samples were collected on the day of planting and each 5th day and further steps were carried out in the laboratory according to the protocols and proper precautions. For the anatomical observations, samples were collected on the 13th, 15th, and 17th day for IBA treated cuttings while 21st, 23rd, and 25th day for control. Collected samples were preserved in the FAA solution and further observations were carried out in the laboratory. Anatomical observations showed that it took 13 days for the differentiation of root primordia to the appearance of young adventitious roots in IBA treated cuttings, while it took 21 days to develop primordia in the control. Antioxidant enzyme activities involved in ROS were significantly higher in the IBA treated cuttings compared to control. POD showed a peak on the 13th day before the emergence of roots in IBA treated cuttings while it showed a peak on the 21st day in the control. PPO showed a peak on the 21st day in the IBA treated cuttings while it showed a peak on the 29th day in the control. SOD showed a peak on the 17th day in IBA treated cuttings, while it showed a peak on the 25th day in the control. Exogenous application of IBA enhanced the endogenous IAA and GA3 levels compared to CK, while it reduced the levels of ABA continuously at the time of rooting and then increased gradually. Inclusively, our study suggests that IBA 750 mg/L is efficient for the rooting of Magnolia biondii Pamp cuttings, as it enhanced the process of antioxidant enzyme activities, endogenous hormones levels and reduced the time of root formation which is evident from the anatomical observations.

Magnolia biondii Pamp é uma importante espécie de árvore ornamental muito cultivada e utilizada como porta-enxerto na propagação de diferentes variedades de Magnolia. Nos estudos atuais, hormônios anatômicos, fisiológicos e endógenos foram estudados para verificar o efeito do AIB na dose de 750 mg / L no enraizamento adventício e fornecer suporte teórico e técnico para a propagação de M. biondii Pamp por meio de estacas. Duas mil estacas foram preparadas e divididas em dois grupos, ou seja, tratadas com AIB e controle de água. Para a avaliação das atividades das enzimas antioxidantes e dos níveis de hormônios endógenos, as amostras foram coletadas no dia do plantio e a cada 5 dias, enquanto as demais etapas foram realizadas em laboratório de acordo com os protocolos e os devidos cuidados. Para as observações anatômicas, as amostras foram coletadas no 13º, 15º e 17º dias para estacas tratadas com AIB e no 21º, 23º e 25º dias para o controle. As amostras coletadas foram preservadas em solução FAA, e outras observações foram realizadas em laboratório. Observações anatômicas mostraram a necessidade de 13 dias para a diferenciação dos primórdios radiculares até o aparecimento de raízes adventícias jovens em estacas tratadas com AIB e de 21 dias para o desenvolvimento dos primórdios no controle. As atividades das enzimas antioxidantes envolvidas nas ROS foram significativamente maiores nas estacas tratadas com AIB em comparação com o controle. A POD apresentou pico no 13º dia antes da emergência das raízes nas estacas tratadas com AIB, enquanto no 21º dia apresentou pico no controle. A PPO teve pico no 21º dia nas estacas tratadas com AIB e no 29º dia no controle. A SOD apresentou pico no 17º dia nas estacas tratadas com AIB e no 25º dia no controle. A aplicação exógena de AIB aumentou os níveis endógenos de IAA e GA3 em relação ao controle, enquanto reduziu os níveis de ABA continuamente no momento do enraizamento e, em seguida, aumentou gradativamente. Inclusive, nosso estudo sugere que o AIB na dose de 750 mg / L é eficiente para o enraizamento de estacas de M. biondii Pamp, visto que potencializou o processo de atividades de enzimas antioxidantes e os níveis de hormônios endógenos, além de reduzir o tempo de formação de raízes, o que fica evidente nas observações anatômicas.

Research progress on mechanism of traumatic brain injury promoting fracture healing / 中国修复重建外科杂志

OBJECTIVE@#To summarize the research progress on the mechanism related to traumatic brain injury (TBI) to promote fracture healing, and to provide theoretical basis for clinical treatment of fracture non-union.@*METHODS@#The research literature on TBI to promote fracture healing at home and abroad was reviewed, the role of TBI in fracture healing was summarized from three aspects of nerves, body fluids, and immunity, to explore new ideas for the treatment of fracture non-union.@*RESULTS@#Numerous studies have shown that fracture healing is faster in patients with fracture combined with TBI than in patients with simple fracture. It is found that the expression of various cytokines and hormones in the body fluids of patients with fracture and TBI is significantly higher than that of patients with simple fracture, and the neurofactors released by the nervous system reaches the fracture site through the damaged blood-brain barrier, and the chemotaxis and aggregation of inflammatory cells and inflammatory factors at the fracture end of patients with combined TBI also differs significantly from those of patients with simple fracture. A complex network of humoral, neural, and immunomodulatory networks together promote regeneration of blood vessels at the fracture site, osteoblasts differentiation, and inhibition of osteoclasts activity.@*CONCLUSION@#TBI promotes fracture healing through a complex network of neural, humoral, and immunomodulatory, and can treat fracture non-union by intervening in the perifracture microenvironment.

Effects of antenatal corticosteroids on fetal hemodynamics: a longitudinal study / Efeitos do corticoide antenatal na hemodinâmica fetal: um estudo longitudinal

Abstract Objective: To study the effect of antenatal corticosteroid administration on fetal hemodynamics using longitudinal analysis of Doppler waveforms in the umbilical artery (UA) and middle cerebral artery (MCA). Materials and Methods: This was a retrospective study that included 30 fetuses at risk for preterm birth. Twenty-eight pregnant women were treated with betamethasone for fetal lung maturation. Doppler examinations of the UA and MCA were performed once before and three or eight times after corticosteroid administration. We used a Bayesian hierarchical linear model. Reference ranges were constructed, and associations between variables (gestational age and pre-eclampsia) were tested. Results: The mean maternal age, gestational age at betamethasone administration, and gestational age at delivery were 32.6 ± 5.89 years, 30.2 ± 2.59 weeks, and 32.9 ± 3.42 weeks, respectively. On UA Doppler, there was a significant decrease in the pulsatility index (PI) after corticosteroid administration, with a mean of 0.1147 (credibility interval: 0.03687-0.191) in three observations and a median of 0.1437 (credibility interval: 0.02509-0.2627) in eight observations. However, there was no significant change in the Doppler MCA PI, regardless of gestational age and the presence or absence of pre-eclampsia. Conclusion: Although antenatal corticosteroid administration induced a significant decrease in the Doppler UA PI, we observed no change in the cerebral vasculature.

Resumo Objetivo: Estudar o efeito da administração antenatal de corticosteroides na hemodinâmica fetal mediante análise longitudinal do Doppler na artéria umbilical e artéria cerebral média (ACM). Materiais e Métodos: Este foi um estudo retrospectivo que incluiu 30 fetos com risco de nascimento pré-termo. Vinte e oito gestantes foram tratadas com betametasona para maturação pulmonar fetal. Os exames de Doppler da AU e da ACM foram realizados uma vez antes e depois da administração de corticosteroides, num total de três ou oito observações. Utilizamos o modelo linear hierárquico com abordagem Bayesiana. Foram construídos os intervalos de referência e testadas associações entre variáveis (idade gestacional e pré-eclâmpsia). Resultados: A média ± desvio-padrão da idade materna, idade gestacional na administração de betametasona e idade gestacional no parto foram 32,6 ± 5,89 anos, 30,2 ± 2,59 semanas e 32,9 ± 3,42 semanas, respectivamente. No Doppler da AU, verificou-se diminuição significativa do índice de pulsatilidade (IP) com a terapêutica com corticosteroides (média: 0,1147 [0,03687-0,191]; em três observações) (mediana: 0,1437 [0,02509-0,2627]; em oito observações). No entanto, não foi observada alteração significativa no IP do Doppler da ACM, independentemente da idade gestacional e do diagnóstico de pré-eclâmpsia. Conclusão: Os corticosteroides pré-natais induziram diminuição significativa no IP do Doppler da AU, mas não houve alteração na vasculatura cerebral.

Avaliação da mortalidade associada ao status tireoidiano em uma coorte de pessoas idosas eutireoidianas de ambulatório de geriatria em hospital universitário / Assessment of mortality associated with thyroid status in a cohort of euthyroid older adults from a geriatric outpatient clinic at a university hospital

Resumo Objetivo Avaliar associações entre a média da tireotropina (TSH) e tiroxina livre (T4L) mantida durante follow-up, e mortalidade em pacientes idosos eutireoidianos definidos de acordo com a faixa de referência específica para a idade (FR-e) do TSH. Método Coorte retrospectiva tipo análise de sobrevivência incluindo pacientes idosos eutireoidianos acompanhados no ambulatório de hospital universitário entre 2010 e 2013. Todos os participantes haviam sido avaliados quanto ao risco de incapacidade funcional como critério para admissão nesse ambulatório. As médias dos valores de TSH e T4L foram calculadas através das dosagens obtidas no período de acompanhamento. Cada FR-e de TSH foi dividida em quatro partes iguais, considerando níveis mais baixos como variável de exposição (≤1,75 mUI/L para <80 e ≤2,0 mUI/L para ≥80 anos). Os níveis de T4L foram dicotomizados em duas categorias (< e ≥1,37 ng/dL). O desfecho foi o tempo até a morte. A regressão de risco proporcional de Cox foi empregada para estimar a hazard ratio (HR) e o intervalo de confiança (IC) de 95% Resultados 285 participantes (73% mulheres, idade média =80,4 anos) seguidos pela mediana de 5,7 anos (IQR =3,7-6,4; máximo =7), sendo que 114 faleceram. Após o modelo final ajustado, a mortalidade esteve associada ao TSH no limite inferior (HR=1,7; IC=1,1-2,7; p=0,016) e ao T4L mais elevado. (HR=2,0; IC=1,0-3,8; p=0,052). Conclusão Níveis médios de T4L mais altos e de TSH mais baixos foram associados ao risco de morte em coorte de idosos eutireoidianos usando FR-e de TSH.

Abstract Objective To assess the associations between the mean thyrotropin (TSH) and mean free thyroxine (FT4), detected during follow-up, and mortality in a group of older euthyroid patients according to age-specific reference range (as-RR) for TSH. Method Retrospective survival analysis cohort including euthyroid elderly patients who were being monitored at the outpatient clinic of a university hospital from 2010 to 2013. All participants had been assessed for the risk of functional disability as a criterion for admission to this outpatient clinic. Mean TSH and FT4 values were calculated using hormone dosages obtained during the follow-up period. Each as-RR for TSH was divided into four equal parts, considering the lower levels as the main exposure variable (≤1.75 mlU/L for <80, and ≤2.0 mlU/L for ≥80 years). FT4 levels were explored according to two categories (< e ≥1.37 ng/dL). The outcome was time to death. We used Cox proportional hazard regression to estimate the hazard ratio (HR) and 95% confidence interval (CI). Results 285 participants (73% females, mean age =80.4 years) followed by a median of 5.7 years (IQR =3.7-6.4; maximum =7), of which 114 died. After the adjusted final model, mortality was associated with the lowest mean TSH (HR=1.7; CI=1.1-2.7; p=0.016) and with the upper mean of FT4 (HR=2.0; CI=1.0-3.8; p=0.052). Conclusions Higher FT4 and lower TSH mean levels were associated with risk of death in a cohort of euthyroid older adults using an as-RR of TSH.

Síndrome metabólico e hipotiroidismo: un estudio transversal en una población ecuatoriana

Introducción: el síndrome metabólico y el hipotiroidismo son condiciones muy frecuentes y a menudo superpuestas. Ambos son precursores bien establecidos de la enfermedad cardiovascular aterogénica. Objetivo: evaluar la asociación entre el hipotiroidismo y el síndrome metabólico en pacientes que asisten a la consulta de medicina interna del Hospital IESS de Riobamba, Ecuador. Metodología: se realizó una investigación de tipo descriptiva, correlacional con un diseño no experimental de corte transversal desde enero de 2022 hasta julio de 2023. Se incluyeron 985 sujetos de ambos sexos, mayores de 25 años. A todos los pacientes se les realizó un exhaustivo examen físico y se tomaron muestras de sangre para la realización de pruebas bioquímicas y hormonales. Resultados: 84,97% de los participantes eran eutiroideos, 1,93% presentaron hipotiroidismo manifiesto y 4,97% hipotiroidismo subclínico, mientras que 32,99% tenían síndrome metabólico. Se encontraron diferencias significativas en la edad, peso, circunferencia de cintura, colesterol total, LDL colesterol, triglicéridos, glucosa postpandrial y HOMA-IR entre los sujetos con hipotiroidismo manifiesto y los eutiroideos (p<0,05). Se observó una correlación positiva entre la TSH y todos los componentes del síndrome metabólico (p<0,05). La prevalencia de síndrome metabólico fue significativamente mayor en los sujetos con hipotiroidismo manifiesto (p < 0,05) que en los demás grupos. Se observó que los niveles de T4L (OR 8,82; IC 95% 1,56-49,8) y TSH (OR 1,61; IC 95% 1,19-2,18) son factores de riesgo para el desarrollo de síndrome metabólico. Conclusión: el hipotiroidismo y el síndrome metabólico están altamente asociados. Es recomendable que los sujetos con hipotiroidismo sean examinados para detectar síndrome metabólico y viceversa. La evaluación de la función tiroidea en pacientes con este síndrome puede ayudar a identificar y prevenir el riesgo de eventos cardiovasculares y cerebrovasculares.

Introduction: Metabolic syndrome and hypothyroidism are widespread and often overlapping conditions. Both are well-established precursors of atherogenic cardiovascular disease. Objective: To evaluate the association between hypothyroidism and metabolic syndrome in patients attending the internal medicine consultation at the IESS Hospital in Riobamba, Ecuador. Methodology: A descriptive, correlational research study was conducted with a non-experimental cross-sectional design from January 2022 to July 2023. Nine hundred eighty-five subjects of both sexes and over 25 years of age, were included. All patients underwent a thorough physical examination and blood samples were taken for biochemical and hormonal tests. Results: Eighty-four-point ninety-seven percent of the participants were euthyroid, 1.93% presented overt hypothyroidism, 4.97% had subclinical hypothyroidism, and 32.99% had metabolic syndrome. Significant differences in age, weight, waist circumference, total cholesterol, LDL cholesterol, triglycerides, postprandial glucose, and HOMA-IR were found between subjects with manifest hypothyroidism and euthyroid subjects (p<0.05). A positive correlation was observed between TSH and all components of the metabolic syndrome (p<0.05). The prevalence of metabolic syndrome was significantly higher in subjects with overt hypothyroidism (p < 0.05) than in the other groups. It was observed that the levels of FT4 (OR 8.82; 95% CI 1.56-49.8) and TSH (OR 1.61; 95% CI 1.19-2.18) were risk factors for the development of the metabolic syndrome. Conclusion: Hypothyroidism and metabolic syndrome are highly associated. It is recommended that subjects with hypothyroidism be screened for metabolic syndrome and vice versa. Evaluation of thyroid function in patients with this syndrome can help identify and prevent the risk of cardiovascular and cerebrovascular events.

Gender affirming hormone therapy and transgender women fertility: Histologic predictors of germ cell presence

Abstract Objective: Evaluate histological changes in testicular parameters after hormone treatment in transgender women. Methods: Cross-section study with patients who underwent gonadectomy at Hospital de Clínicas de Porto Alegre from 2011 to 2019. Hormone treatment type, route of administration, age at initiation and duration were recorded. Atrophy parameters were observed: testicular volume, tubular diameter, basal membrane length, presence of spermatogonia and spermatids (diploid and haploid spermatozoid precursors). Results: Eighty-six patients were included. Duration of hormone treatment is associated with testicular atrophy and spermatogenesis arrest. Other characteristics of hormone treatment such as age of initiation, route of administration and type of treatment were not associated with testicular histological changes. Testicular volume may predict spermatogenesis arrest. Basal membrane length and tubular diameter ratio is an interesting predictor of germ cell presence. Conclusion: Cross-sex hormone treatment affects testicular germ cell presence. Basal membrane length and tubular diameter ratio reduces inter variability of measurements and better exemplify how atrophic seminiferous tubules are. Fertility preservation should be addressed by healthcare providers in order to recognize gender affirming treatment impact on transgender health.

Establishment and Analysis of Reference Intervals for Thyroid Hormones in Pregnant Women from Sanming City / 中山大学学报(医学科学版)

ObjectiveTo establish the reference intervals of thyroid hormones in pregnant women from Sanming city and compare them with those from other areas in China. MethodsThe study recruited 605 pregnant women and 229 non-pregnant healthy women who visited Sanming First Hospital between March 29 and June 28， 2023. Blood samples were sequentially collected from the participants to determine the serum levels of thyroid stimulating hormone （TSH）， free triiodothyronine （FT3） and free thyroxine （FT4）. The reference intervals of thyroid hormones were established by using a percentile range of P2.5 to P97.5 and their changes in different periods of pregnancy were analyzed and compared with those from other areas in China. ResultsThere were significant differences in levels of TSH， FT4 and FT3 at different periods of pregnancy （all P <0.05）. Compared with non-pregnant women， women in first trimester had significantly decreased levels of TSH and FT4， but similar level of FT3. Since the second trimester， TSH level displayed rising tendency， while FT3 and FT4 levels showed gradual decrease. The reference intervals of thyroid hormones in the first， second and third trimester of pregnancy in Sanming city were TSH （0.068， 2.943） μU/mL， FT3 （4.302， 6.888） pmol/L， FT4 （8.240， 14.719） pmol/L； TSH （0.419， 3.274） μU/mL， FT3 （4.074， 6.629） pmol/L， FT4 （6.726， 11.980） pmol/L； TSH （0.422， 3.570） μU/mL， FT3 （3.741， 5.850） pmol/L， FT4 （6.103， 10.347） pmol/L， respectively. Significant differences were found in the reference intervals of thyroid hormones during pregnancy among different areas in China. ConclusionsThe levels of TSH， FT3， FT4 during pregnancy are different from those during non-pregnancy， and also significantly differ in different periods of pregnancy. Reference intervals of thyroid hormones in pregnant women are affected by various factors such as geographic location， ethnicity and laboratory test method， etc. Therefore， establishing the population-specific reference intervals of thyroid hormones will benefit for the diagnosis and treatment of thyroid disease in pregnant women from Sanming city.

Curative Effect and Mechanism of Traditional Chinese Medicine in Treatment of Diabetic Gastroenteropathy： A Review / 中国实验方剂学杂志

Diabetic gastroenteropathy is a serious chronic complication that accompanies the progression of diabetes mellitus， severely impacting patients' quality of life and overall health. Nearly half of diabetic patients experience symptoms such as nausea， vomiting， early satiety， abdominal distension， and abdominal pain， which increases their anxiety and depression， prompting frequent medical visits and further burdening the healthcare system. In-depth research into the pathogenesis of diabetic gastroenteropathy has identified several core mechanisms， including hyperglycemia， autonomic and enteric nervous system dysfunction， abnormal secretion of gastrointestinal hormones， macrophage polarization， brain-gut axis dysregulation， microRNA deficiency， and oxidative stress-induced damage and apoptosis of interstitial cells of Cajal （ICC）. Current clinical treatments mainly rely on prokinetic and antiemetic drugs. However， their notable adverse effects and diminishing efficacy with long-term use remain pressing issues. Traditional Chinese medicine （TCM）， with its unique theoretical framework and extensive practical experience， potent in prescription formulation and acupoint selection guided by holistic concepts and syndrome differentiation， has gradually become an important option for treating diabetic gastroenteropathy. Numerous studies have confirmed that mechanisms include improving gastrointestinal hormone secretion， repairing ICC damage， regulating the nervous system， reducing oxidative stress， and modulating the brain-gut axis. These findings provide new insights into the treatment of diabetic gastroenteropathy. This article summarized the pathogenesis of diabetic gastroenteropathy and reviewed recent research on Chinese medicine and acupuncture-moxibustion therapy in improving gastrointestinal motility for diabetic gastroenteropathy treatment， aiming to offer clinical treatment insights and highlight the need for further research to explore comprehensive and individualized treatment approaches， providing better strategies for managing diabetic gastroenteropathy.

Effects of astragaloside Ⅳ on insulin resistance and MAPK/ERK pathway in obese rat model of polycystic ovary syndrome / 中成药

AIM To investigate the effects of astragaloside IV on improving insulin resistance(IR)in obese rat model of polycystic ovary syndrome(PCOS),and to analyze its effect on ovarian MAPK/ERK pathway as well.METHODS The obese PCOS rat models established by feeding of letrozole combined with high-fat and high-sugar diet were randomly divided into the model group,the metformin(135 mg/kg)group and the low-dose and high-dose astragaloside Ⅳ(25,50 mg/kg)groups,with 8 rats in each group in contrast to those of the control group.After 21 days oral administration,the rats had their body weight recorded;their ovarian index calculated;their levels of fasting blood glucose(FBG),serum triglyceride(TG),total cholesterol(TC),follicle-stimulating hormone(FSH),testosterone(T),estradiol(E2),luteinizing hormone(LH)and fasting insulin(FINS)measured;their HOMA-IR and LH/FSH values calculated;their ovarian expressions of MAPK/ERK pathway related proteins detected by Western blot;and their ovarian expression of vascular endothelial growth factor(VEGF)protein detected by immunofluorescence staining.RESULTS Compared with the control group,the model group showed increased polycystic pathological changes,levels of body weight,ovarian index,serum TG,TC,LH,FSH,T,FINS,and FBG,values of LH/FSH and HOMA-IR,and ovarian p-ERK1/2/ERK1/2,p-MEK1/2/MEK1/2,p-Raf/Raf,and VEGF protein expressions(P<0.01);and decreased serum E2 level(P<0.01).Compared with the model group,both astragaloside Ⅳ and metformin groups shared significantly alleviated ovarian polycystic lesions,and decreased body weight,levels of ovarian index,serum TG,TC,LH,FSH,T,FINS,and FBG,values of LH/FSH and HOMA-IR,ovarian p-ERK1/2/ERK1/2,p-MEK1/2/MEK1/2,p-Raf/Raf,and VEGF protein expressions(P<0.05,P<0.01),and increased serum E2 level(P<0.05,P<0.01).CONCLUSION Upon the obese PCOS rat models,astragaloside Ⅳ can antagonize their IR,improve their hormone levels and alleviate their ovarian lesions via inhibiting the activation of MAPK/ERK pathway.