[6-Gingerol ameliorates adipose tissue insulin resistance in aging rats].

This study investigated the effects and mechanisms of 6-gingerol on adipose tissue insulin resistance in naturally aging rats with glycolipid metabolism disorders. Twenty-seven aging male SD rats were randomly divided into a model group(aged, n=9) and two groups treated with 6-gingerol at 0.05 mg·kg~(-1)(G-L, n=9) and 0.2 mg·kg~(-1)(G-H, n=9). Six young rats were randomly assigned to a normal control group(NC). Rats were treated for seven weeks by gavage. Non-esterified fatty acid(NEFA) and insulin content was determined by enzyme-linked immunosorbent assay(ELISA), and adipose tissue insulin resistance index(Adipo-IR) was calculated. HE staining was used to observe the size of adipocytes in epididymal white adipose tissue(eWAT). The gene and protein expression levels of adiponectin receptor 1(AdipoR1), AMP-activated protein kinase α(AMPKα), phosphorylated AMPK(p-AMPKα~(Thr172)), peroxisome proliferator-activated receptor-γ coactivator-1α(PGC-1α), phosphatidylinositol 3-kinase(PI3 K), protein kinase B(Akt), phosphorylated Akt(p-Akt~(Ser473)), tumor necrosis factor-α(TNF-α), c-Jun N-terminal kinase 1/2(JNK1/2), phosphorylated JNK1/2(p-JNK~(Thr183/Tyr185)), interleukin-1ß(IL-1ß), and interleukin-6(IL-6) in adiponectin(APN), insulin, and inflammatory factor signaling pathways were detected by Western blot and real-time RCR, respectively. The results showed that 6-gingerol at a high dose could significantly decrease the fasting plasma content of NEFA and insulin and reduce Adipo-IR. Additionally, 6-gingerol at a high dose significantly increased the protein and mRNA expression of APN, AdipoR1, PGC-1α, and PI3 K in eWAT, elevated the relative expression of p-AMPK~(Thr172) and p-Akt~(Ser 473), reduced the protein and mRNA expression of TNF-α, IL-1, and IL-6 in eWAT, and decreased the relative expression of p-JNK1 and p-JNK2. This study reveals that 6-gingerol can improve insulin sensitivity of adipose tissues in aging rats with glycolipid metabolism disorders, and this effect is presumedly achieved by enhancing the PI3 K/Akt signaling pathway, inhibiting adipose tissue inflammation, increasing APN synthesis, enhancing AdipoR1 expression, and activating its downstream AMPK/PGC-1α signaling pathway.

[Effect of electroacupuncture stimulation of "Fenglong" (ST 40) on expression of inflammatory cytokines of celiac macrophages in hyperlipidemia rats].

OBJECTIVE: To observe the effect of electroacupuncture (EA) stimulation of "Fenglong" (ST 40) on celiac inflammatory factors in rats with hyperlipemia (HLP), so as to reveal its mechanism underlying improvement of HLP. METHODS: A total of 40 SD rats were randomized into normal control, high fat forage, high fat + common forage, high fat + EA, and high fat + common forage+ EA groups, with 8 rats in each group. The HLP model was established by feeding the animals with high fat forage for 28 days. EA (2 mA, 2 Hz/100 Hz) was applied to bilateral ST 40 for 30 min, once daily for 28 days. Contents of plasma total cholesterol (TC), triglyceride (TG), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C) were detected by using an automatic biochemistry analyzer. Intercellular adhesion molecule-1 (ICAM-1), monocyte chemoattractant protein 1 (MCP-1), and interleukin-1 gamma (IL-1gamma) in macrophages of the abdominal cavity were detected using flow cytometry (FCM). RESULTS: Compared with the normal control group, the contents of plasma TC and LDL-C, and celiac macrophages' MCP-1, ICAM-1 and IL-1gamma contents were significantly increased in the high fat forage group and high fat + common forage group (P < 0.01). In comparison with the high fat forage group, contents of plasma TC and LDL-C, and macrophages' MCP-1, ICAM-1 and IL-1gamma were considerably down-regulated in the high fat + EA group (P < 0.01). Similarly, the levels of plasma TC and LDL-C, and macrophages' MCP-1, ICAM-1 and IL-1gamma were obviously lower in the high fat+ common forage+ EA group than in the high fat + common forage group (P < 0.01). No significant differences were found in plasma TG and HDL-C levels among the five groups (P > 0.05). CONCLUSION: EA stimulation of "Fenglong" (ST 40) has a role in down-regulating contents of plasma TC and LDL-C and celiac macrophages' MCP-1, ICAM-1 and IL-1gamma in the abdominal cavity in hyperlipemia rats, which may contribute to its effect in improving hyperlipemia.

[Effects of electroacupuncture at "Fenglong" (ST 40) on formation of macrophage-derived foam cell and efflux of cholesterol in hyperlipidemia rats].

OBJECTIVE: To explore action mechanism of electroacupuncture (EA) at "Fenglong" (ST 40) for treatment of hyperlipidemia. METHODS: Forty SPF-grade SD rats were randomly divided into a normal group (group A), a model group (group B), a model diet-control group (group C), a model + EA group (group D) and model diet-control + EA group (group E), 8 cases in each one. The rats in group A were fed with normal diet continuously while those in the rest 4 groups were fed with high-fat diet to establish hyperlipidemia model. Afterwards, the rats in group C and group E were fed with normal diet, while EA at "Fenglong" (ST 40) was applied in group D and group E, 30 min per time, once a day. After 28 days of treatment, macrophage was collected in each group. Oil red O-staining was applied to detect the formation of foam cells, and enzyme-linked immunosorbent assay (ELISE) was adopted to measure the contents of total cholesterol (TC) in macrophage and analyze the rate of cholesterol efflux. RESULTS: The counts of positive cells of oil red O-staining and the contents of TC in the group B, group C and group D were significantly increased compared with those in the group A (all P < 0.01). The counts of positive cells and contents of TC in the group C, group D and group E were significantly clecreased compared with those in the group B (all P < 0.01), and the decline in group D was more obvious than that in the group C (all P < 0.01). Compared with group C and group D, the counts of positive cells and contents of TC in the group E was obviously decreased (all P < 0.01), which was not statistically different from group A (P > 0.05). In the meantime, compared with group C, the rate of cholesterol efflux in group D and group E was significantly increased (both P < 0.01), and the rise in group E was more obvious than that in the group D. CONCLUSION: The electroacupuncture at "Fenglong" (ST 40) could significantly prohibit the transformation of macrophage into foam cell and increase rate of cholesterol efflux in macrophage, which could prevent and reverse the formation of foam cell and play an essential role in treating hyperlipidemia and stopping it from developing into a further level.

Hospital-based integrated diabetes care management: an overview.

To provide continuous, accessible, and quality care, a diabetes share-care program has been in place in Taiwan for several years. Lukang Christian Hospital, a member of the diabetes share-care network, endeavors to provide "patient-centered" care aimed at increasing care quality and reducing diabetic complications. Information technology has been employed by the hospital for monitoring care quality and analyzing cost-effectiveness. Structured health-care programs have also been developed to ensure the completeness of diabetes care and to encourage self-management of individuals at high risk for diabetes. The implementation of these strategies has led to progressive improvement in quality measures and spawned novel and creative ways to deliver care services.

[Effect of electroacupuncture at fenglong (ST40) on expressions of inflammatory factors in macrophages of hyperlipidemia model rats].

OBJECTIVE: To observe the effect of electroacupuncture (EA) at Fenglong (ST40) on inflammatory factors in macrophages of hyperlipemia (HLP) rats, and to explore the role of EA in treating HLP. METHODS: Totally 50 adult male SD rats were selected. After one-week adaptative feeding, they were randomly divided into 5 groups, i.e., the blank control group (Group A), the model group (Group B), the diet control group (Group C), the EA group (Group D), the diet control + EA group (Group E), 10 in each group. By the end of treatment, all rats were sacrificed to get blood from the carotid artery. The contents of serum total cholesterol (TC), triglyceride (TG), high density lipoprotein cholesterol (HDL-C), and low density lipoprotein cholesterol (LDL-C) were determined. Peritoneal macrophages were isolated. Contents of intercellular adhesion molecule-1 (ICAM-1), monocyte chemoattractant protein 1 (MCP-1), tumor necrosis factor-alpha (TNF-alpha), and interleukin 6 (IL-6) were detected using flow cytometry (FCM) after adding the fluorescein-labeled molecule antibodies of inflammatory factors. RESULTS: Compared with Group A, the serum contents of TC and LDL-C obviously increased and HDL-C significantly decreased in Group B (all P < 0.01). There was no obvious change in the content of TG between Group A and Group B (P > 0.05). Compared with Group B, the contents of TC and LDL-C significantly decreased in Group C, D, and E (P < 0.01). Compared with Group C, serum contents of TC and LDL-C obviously decreased in Group D and E (P < 0.01). Compared with Group B, the content of macrophages significantly increased in Group A (P < 0.01). Compared with Group B, the content of macrophages significantly decreased in Group D and E (P < 0.01), more obviously in Group E (P < 0.01). Compared with Group C, the content of macrophages significantly decreased in Group E (P < 0.05). Compared with Group A, levels of ICAM-1, MCP-1, TNF-alpha, and IL-6 in the peritoneal macrophages significantly increased in Group B (P < 0.01). Compared with Group B, levels of ICAM-1, MCP-1, TNF-alpha, and IL-6 significantly decreased in Group C, D, and E, but more obviously in Group E (P < 0.01). Compared with Group C, levels of ICAM-1, MCP-1, TNF-alpha (P < 0.05, P < 0.01), and IL-6 (P < 0.05) significantly decreased in Group E. CONCLUSION: EA at Fenglong (ST40) could obviously downregulate the serum levels of TC and LDL-C in HLP rats, reduce the contents of macrophages, ICAM-1, MCP-1, TNF-alpha, and IL-6, thus arriving at the therapeutic effect in treating HLP.

[Effect of electroacupuncture of "Fenglong" (ST 40) on levels of blood lipid and macrophage TNF-alpha and IL-6 in hyperlipidemic rats].

OBJECTIVE: To observe the effect of electroacupuncture (EA) stimulation of "Fenglong" (ST 40) on blood lipid contents and inflammatory factor levels in hyperlipemia rats so as to elucidate its mechanism underlying improvement of hyperlipemia. METHODS: Fifty male SD rats were randomized into 5 groups: normal, model, diet -control, EA intervention (EA), diet-control + EA groups, with 10 rats in each group. Hyperlipemia model was established by feeding the animals with high-fat diet for 30 days. After modeling, rats in the diet-control group were fed with routine fodder. EA was applied to bilateral "Fenglong" (ST 40) for 30 min, once daily for 30 days. Following intraperitoneal injection of 1640 culture fluid, the peritoneal fluid was collected and centrifuged for extracting macrophages. Flow cytometry (FCM) was employed to determine the levels of tumor necrosis factor alpha (TNF-alpha) and interleukin-6 (IL-6) after adding fluoresce-labeled antibodies. RESULTS: The contents of serum TC and LDL-C were remarkably higher and HDL-C level was significantly lower in the model group than in the normal group (P < 0.01). After EA intervention, serum TC and LDL-C showed an apparent decrease (P < 0.01). Compared with the normal group, percentages of CD11 b, TNF-alpha and IL-6 were significantly increased in the model group (P < 0.01), while in comparison with the model group, percentages of CD11 b in both EA and diet-control + EA groups, TNF-alpha and IL-6 percentages of macrophages in the diet-control, EA and diet-control + EA groups were notably decreased (P < 0.05, P < 0.01). The effects of the diet-control + EA group were considerably superior to those of the diet-control group in lowering CD11 b, TNF-alpha and IL-6 percentages (P < 0.05, P < 0.01). No significant differences were found between the diet-control and EA groups in the aforementioned indexes (P > 0.05). CD11 b level indicates changes of macrophage level due to its specific marker character. CONCLUSION: EA stimulation of "Fenglong" (ST 40) is effective in lowering serum TC, LDL-C, and macrophage TNF-alpha and IL-6 levels in hyperlipemia rats.