Identification of a novel hypoglycemic small molecule, trans-2, 4-dimethoxystilbene by rectifying gut microbiota and activating hepatic AMPKα-PPARγ pathway through gut-liver axis.

With the increasing prevalence of metabolic disorders, hyperglycemia has become a common risk factor that endangers people's lives and the need for new drug solutions is burgeoning. Trans-2, 4-dimethoxystilbene (TDMS), a synthetic stilbene, has been found as a novel hypoglycemic small molecule from glucose consumption test. Normal C57BL/6 J mice, mouse models of type 1 diabetes mellitus and diet-induced obesity subjected to TDMS gavage were found with lower glycemic levels and better glycemic control. TDMS significantly improved the symptoms of polydipsia and wasting in type 1 diabetic mice, and could rise their body temperature at the same time. It was found that TDMS could promote the expression of key genes of glucose metabolism in HepG2, as do in TDMS-treated liver, while it could improve the intestinal flora and relieve intestinal metabolic dysbiosis in hyperglycemic models, which in turn affected its function in the liver, forming the gut-liver axis. We further fished PPARγ by virtual screening that could be promoted by TDMS both in-vitro and in-vivo, which was regulated by upstream signaling of AMPKα phosphorylation. As a novel hypoglycemic small molecule, TDMS was proven to be promising with its glycemic improvements and amelioration of diabetes symptoms. It promoted glucose absorption and utilization by the liver and improved the intestinal flora of diabetic mice. Therefore, TDMS is expected to become a new hypoglycemic drug that acts through gut-liver axis via AMPKα-PPARγ signaling pathway in improving glycemic metabolism, bringing new hope to patients with diabetes and glucose metabolism disorders.

Comparison of population characteristics and clinical outcomes of patients with type B aortic dissection or aortic intramural hematoma underwent thoracic endovascular aortic repair: a propensity score-matched analysis.

BACKGROUNDS: Survival and aortic-related adverse events after thoracic endovascular aortic repair (TEVAR) for aortic intramural hematoma (IMH) and aortic dissection (AD) are controversial. We aimed to assess the preoperative characteristics and to evaluate TEVAR outcomes of acute type B IMH and AD. METHODS: Between June 2002 and May 2021, 83 patients with acute type B IMH and 755 patients with acute type B AD underwent TEVAR at the General Hospital of Northern Theater Command. We retrospectively analyzed data from these patients, including clinical characteristics and follow-up outcomes. RESULTS: The patients with IMH were significantly older than the ones with AD (P < 0.001). Diabetes mellitus (P = 0.035) and ischemic cerebrovascular disease (P = 0.017) were more common in the IMH group than in the AD group. The results demonstrated a less long-term aortic-related death-free survival rate in the IMH group than the AD group for all the patients (P = 0.014) and the matched patients (P = 0.027). It also presents a lower long-term overall survival rate (P = 0.047) and aortic-related event-free rate (P = 0.048) in the IMH group than in the matched patients. CONCLUSIONS: Compared with AD patients, patients with IMH who underwent TEVAR had a worse long-term outcome of aortic-related survival in all and matched patients.

[Advances in research on immune mechanism of moxibustion for treating tumor].

Treatment of tumors, especially the malignant tumors, is a world-class medical problem and still plagues clinicians and medical scientists a lot nowadays. Moxibustion therapy has been used in the treatment of tumors in clinic practice for many years and the related mechanism researches have achieved a lot of achievements. In the present paper, we reviewed researches on moxibustion treatment for tumor from the self-regulation of the immune system in patients and animal models. Outcomes display that moxibustion therapy has an action in resisting tumors by 1) regulating innate immune defensive function and enhancing adaptive immunity (by up-regulating activities of natural killer [NK] cells, and phagocytic function of macrophages), 2) stimulating cellular immunity (by increasing the ratio of CD4＋/CD8＋， lymphocyte transformation rate, etc.), and B lymphocyte-mediated humoral immunity (via regulating contents of IgG, IgA, IgM, etc.), 3) modulating levels of cytokines as interleukins, interferons, tumor necrosis factor superfamily colony stimulating factor, chemokine growth factor, vascular endothelial growth factor，VEGF, etc., 4) regulating expression of many related proteins and genes, and 5) regulating related hormones, neurotransmitters, intracellular kinases signaling, etc., and other immune-related components.

[Effect of warm acupuncture at Yifeng (TE 17) on facial paralysis with periauricular pain during pregnancy].

OBJECTIVE: To compare the curative effect between the warm acupuncture at Yifeng (TE 17) combined with conventional acupuncture and TDP plus conventional acupuncture on facial paralysis with periauricular pain during pregnancy. METHODS: A total of 68 patients were randomized into an observation group (36 cases, 3 cases dropped off) and a control group (32 cases, 1 case dropped off). First week, TDP light was used on the affected side in the control group, and warm acupuncture at Yinfeng (TE 17) on the affected side was used in the observation group, both once a day. From the second week, both groups were given acupuncture at Chengjiang (CV 24) and the affected side of Cuanzhu (BL 2), Yangbai (GB 14), Taiyang (EX-HN 5), Yingxiang (LI 20), Dicang (ST 4), etc. and electroacupuncture (continuous wave, 2 Hz in frequency) was connected at Cuanzhu (BL 2) and Taiyang (EX-HN 5), Jiache (ST 6) and Dicang (ST 4). Both treatments were given every other day for 4 weeks totally. The visual analogue scale (VAS) score of the periauricular pain degree before treatment and after 1 week of treatment, the House-Brackmann (H-B) facial nerve function grading scale and facial disability index (FDI) score before treatment and after 2, 4 weeks of treatment were compared between the two groups. RESULTS: After 1 week of treatment, the VAS scores of both groups decreased (P<0.001), and the variation in the observation group was larger than the control group (P<0.01). After 2 and 4 weeks of treatment, the H-B grading of both groups were improved (P<0.01, P<0.05), and those in the observation group were better than the control group (P<0.05). After 2 and 4 weeks of treatment, the FDI physical function (FDIP) scores of both groups were higher (P<0.01), and the FDI social life function (FDIS) scores were lower than before treatment (P<0.05, P<0.01), and the FDIP scores in the observation group were higher than those in the control group (P<0.05). CONCLUSION: Warm acupuncture at Yinfeng (TE 17) combined with conventional acupuncture can effectively improve the periauricular pain and facial nerve function in patients of facial paralysis with periauricular pain during pregnancy, and the curative effect is better than TDP plus conventional acupuncture.

S­allyl­cysteine sulfoxide (alliin) alleviates myocardial infarction by modulating cardiomyocyte necroptosis and autophagy.

S­allyl­cysteine sulfoxide (alliin) is the main organosulfur component of garlic and its preparations. The present study aimed to examine the protective effect of alliin on cardiac function and the underlying mechanism in a mouse model of myocardial infarction (MI). Notably, alliin treatment preserved heart function, attenuated the area of infarction in the myocardium of mice and reduced lesions in the myocardium, including cardiomyocyte fibrosis and death. Further mechanistic experiments revealed that alliin inhibited necroptosis but promoted autophagy in vitro and in vivo. Cell viability assays showed that alliin dose­dependently reduced the necroptotic index and inhibited the expression of necroptosis­related receptor­interacting protein 1, receptor­interacting protein 3 and tumor necrosis factor receptor­associated factor 2, whereas the levels of Beclin 1 and microtubule­associated protein 1 light chain 3, which are associated with autophagy, exhibited an opposite trend upon treatment with alliin. In addition, the level of peroxisome proliferator­activated receptor γ was increased by alliin. Collectively, these findings demonstrate that alliin has the potential to protect cardiomyocytes from necroptosis following MI and that this protective effect occurs via the enhancement of autophagy.

[Clinical observation on time-effect of electroacupuncture for idiopathic facial paralysis].

OBJECTIVE: To observe the effect of different acupuncture frequency and duration of needle retention on idiopathic facial paralysis, and optimize the acupuncture treatment plan. METHODS: A total of 140 patients were randomized into a group A (37 cases, 3 cases dropped off), a group B (35 cases, 3 cases dropped off), a group C (34 cases, 1 case dropped off) and a group D (34 cases, 1 case dropped off). Under the same basic treatment, acupuncture intervention time (day 8 of morbidity), acupoint selection [Cuanzhu (BL 2), Yangbai (GB 14), Taiyang (EX-HN 5), Yingxiang (LI 20), Jiache (ST 6), Dicang (ST 4) on the affected side, Chengjiang (CV 24) and Hegu (LI 4) on the unaffected side] and electroacupuncture intervention, different acupuncture interval time and duration of needle retention were applied. In the group A, the treatment was given 20 min once a day, while the group B 30 min once a day, the group C 20 min once every 2 days, the group D 30 min once every 2 days. Totally 20-day treatment were required. The House-Brackmann (H-B) facial nerve function grading system was used to evaluate the improvement of clinical symptom, the situation and latency periods of the R1 wave in blink reflex and facial nerve motor conduction before and after treatment were observed in the 4 groups. RESULTS: After treatment, the cured rates in the 4 groups were 44.1% (15/34), 46.9% (15/32), 57.6% (19/33) and 51.5% (17/33), there was no significant difference among 4 groups (P>0.05). The situation and latency periods of the R1 wave in blink reflex and latency periods and amplitude of facial nerve motor conduction after treatment were improved in the 4 groups (P<0.01, P<0.05), there was no significant difference among 4 groups (P>0.05). CONCLUSION: Acupuncture 20 min once a day, 30 min once a day, 20 min once every 2 days and 30 min once every 2 days have significant effect on the recovery of idiopathic facial paralysis, and the effect is comparable.

[Clinical observation of acupuncture combined with sertraline hydrochloride tablets on tumor-related depression].

OBJECTIVE: To compare the clinical effects of acupuncture combined with sertraline hydrochloride and simple sertraline hydrochloride on tumor-related depression. METHODS: Sixty patients with tumor-related depression who met the inclusion criteria were randomly assigned to an observation group and a control group, 30 patients in each group. The routine treatment in department of oncology were given in both groups, oral sertraline hydrochloride (25 mg daily for the first 5 days, then 50 mg daily) was given in the control group; on the basis of the treatment in the control group, and acupuncture was applied at Hegu (LI 4), Neiguan (PC 6), Taichong (LR 3), Shenmen (HT 7)，etc. in the observation group，twice a week .The two groups were treated continuously for 4 weeks. The Hamilton depression scale (HAMD) score and the quality of life score (QLQ-C30 questionnaire) were compared between the two groups before and after treatment. RESULTS: After treatment, the HAMD scores in the two groups were significantly lower than those before treatment (both P<0.05), and the HAMD scores in the observation group were lower than those in the control group (P<0.05). In the observation group, the symptom scores of fatigue, pain, nausea and vomiting, dyspnea, insomnia, loss of appetite, constipation, and diarrhea were significantly lower than those before treatment (all P<0.05), and the physical, cognitive, emotional function, and the overall quality of life score were significantly higher than those before treatment (all P<0.05); in the control group, the symptom scores of insomnia decreased compared with that before treatment (P<0.05), and the emotional function and overall quality of life score were higher than those before treatment (both P<0.05); in addition to economic difficulties, roles and social functions, the other scores after treatment in the observation group were significantly improved than those in the control group (all P<0.05). CONCLUSION: The combination of acupuncture and sertraline hydrochloride tablets is better than simple sertraline hydrochloride in the treatment of tumor-related depression, and it can improve the accompanying symptoms and improve quality of life.

Senile Lemierre syndrome complicated with descending necrotizing mediastinitis: A case report.

RATIONALE: Senile patients with LS complicated with DNM are rarely seen in clinical practice, and extensive cervical incision and drainage plus administration of effective antibiotics are the basis for treatment. Currently, the treatment controversy mainly has focused on whether mediastinal incision and drainage is necessary for patients with type I DNM, and whether anticoagulation therapy is required for jugular venous emboli and distant metastatic emboli induced by LS. PATIENT CONCERNS: A female, 76 years old, developed pain of tonsil on right side 5 days ago, and felt that the pain aggravated complicated with dysphagia and swelling pain of neck on both sides since then. DIAGNOSES: She was diagnosed with LS complicated with type I DNM. INTERVENTIONS: Tazobactam and Piperacillin 4.5 q8h and Ornidazole 100 ml q6h ivgtt were administered empirically,and secondary extensive cervical incision and drainage was performed under general anesthesia, after which low molecular weight heparin 4250 U q12h SC was administered. G test was performed 3 days later, which showed (1,3)-ß-D-glucan >1000 pg/ml. Bridging anticoagulation therapy, low molecular weight heparin 4250 U q12h SC, and Warfarin 2.5 mg qd po were given one week later. Low molecular weight heparin SC was discontinued and only Warfarin po was administered after treatment of bridging therapy for 3 days. OUTCOMES: CT of head and neck was reexamined on post-admission d24 and revealed that neck infection was improved on both sides, jugular vein distension on right side was restored to normal, abscess and pneumatosis of superior mediastinum were improved, distension of pulmonary artery on both sides was normalized, WBC was 9.94×109/L, neutrophil count was 4.43×109/L, CRP level was 9.8mg/L, D-D level was 0.81mg/L, PCT level was 0.800ng/mL and G test suggested (1,3)-ß-D-glucan pf 27.1 pg/mL. LESSONS: Concomitant use of anticoagulants on the basis of repeated cervical incision and drainage + administration of effective antibiotics can obtain excellent therapeutic efficacy in the treatment of patient with LS complicated with type I DNM.

Treatment of cryotherapy and orthotopic transplantation following chondromyxoid fibroma of zygomatic bone: A case report.

INTRODUCTION: Chondromyxoid fibrotherma (CMF) is a rare benign cartilage tumor that occurs more frequently in young males at the age of 20 to 30. It occurs more frequently on long bones, but rarely involves craniofacial bones. CASE PRESENTATION: This study mainly introduced a 30-year-old male with CMF of zygomatic bone. Single tumor excochleation was conducted initially. However, CMF reoccurred, and then the following steps were adopted: firstly, the tumor was extensively excised; secondly, in vitro tumor excochleation was conducted; thirdly, the excised tumor bone was placed in liquid nitrogen for 3 cycles of cryoablation; finally, the orthotopic transplantation was performed to reconstruct the zygomatic appearance, with satisfactory follow-up efficacy obtained. CONCLUSIONS: Orthotopic transplantation after tumorectomy and cryopreservation of tumor bone in liquid nitrogen could lead to excellent therapeutic efficacy and deserves to be widely applied in clinical practice in the treatment of a male patient with CMF of zygomatic bone, because it not only radically eliminates the tumor and kills tumor cells, but also provides bony skeleton for the growth of new bone, thus greatly promoting postoperative aesthetic degree and reducing the occurrence rates of complications.

[Effect of Grain-moxibustion on IL-6 and STAT 3 in Inflammatory Microenvironment of Lewis Lung Cancer Mice].

OBJECTIVE: To observe the effect of grain-moxibustion on serum interleukin-6(IL-6) and signal transducers and activators of transcription 3 (STAT 3) in inflammatory microenvironment of Lewis lung cancer mice, so as to explore its possible mechanism underlying relieving Lewis lung cancer. METHODS: C 57 BL/6 mice were randomly divided into blank control group, model group, and moxibustion group (n=10 in each group). Lewis lung cancer model was established by hypodermic injection of Lewis tumor cell suspension. Mice in the moxibustion group were treated by grain-moxibustion at bilateral "Housanli"(ST 36), 5 zhuang each acupoint, once a day for 10 days. The body weight, survival state score, volume of tumor, and survival rate were observed. Serum IL-6 level was detected by ELISA, and the expression of STAT 3 in tumor tissue was determined by Wes-tern blot. RESULTS: Compared with the blank control group, the body weight was significantly increased in the model group (P<0.05). The volume of tumor increased significantly in the model group, while it markedly decreased in the moxibustion group after 8 and 10 days treatment compared with the model group (P<0.05). The survival state of mice deteriorated companied with decreased survival rate in the model group, however, after 6, 8 or 10 days treatment, the survival state scores were increased in the moxibustion group than in the model group (P<0.05). Compared with the blank control group, both serum IL-6 level and STAT 3 expression in tumor tissue were increased significantly in the model group (P<0.001). Compared with the model group, both serum IL-6 level and STAT 3 expression in tumor tissue were decreased significantly in the moxibustion group (P<0.001). CONCLUSIONS: Grain-moxibustion has remarkable effect on Lewis lung cancer, by improving survival state, reducing death rate, and controlling growth rate of tumor, which might be associated with its function of inhibiting the activation of IL-6 and STAT 3 in inflammatory microenvironment.

[Post-marketing study on clinical safety of ginkgo diterpene lactone meglumine injection in 6 300 patients with ischemic stroke].

To further evaluate the safety of ginkgo diterpene lactone meglumine injection in the clinical use in ischemic stroke patients. Clinical safety study was conducted in 82 clinical units and 6 300 cases were completed and included from June 2013 to December 2014 by using multicenter, prospective, open and uncontrolled design methods for clinical research. A total of 29 cases of adverse reactions were observed in the experiment. Adverse reaction ratio (ADR) was 0.46%, and about 86.21% (25 cases) of them was mild with transient response which could be alleviated or disappeared without intervention; about 13.79% (4 cases) was moderate, including 2 cases of headache, 1 case of dizziness and 1 case of rash; no serious adverse reactions were found. The adverse reactions occurred in this study were pre-known adverse reactions or common adverse reactions of Chinese medicine injection. The overall incidence of adverse reactions was low, and the risk was controllable.

[Effect on Postoperative Complications of Mixed Hemorrhoids Treated with Electroacupuncture at Chengshan(BL 57), Dachangshu(BL 25)and Erbai(EX-UE 2)].

OBJECTIVE: To evaluate the effect on postoperative complications of mixed hemorrhoids treated with electroacupuncture(EA) at Chengshan(BL 57)，Dachangshu(BL 25)and Erbai(EX-UE 2). METHODS: A total of 60 patients with mixed hemorrhoids were randomly divided into control and EA groups，30 cases in each group. In addition to basic treatment, EA was applied at BL 57, BL 25 and EX-UE 2 for 30 min (2 Hz/15 Hz，0.5－2 mA) each day for 3 days after surgery in the EA group, while the control group received basic treatment after surgery. Postoperative complications after treatment were evaluated each day. RESULTS: Following surgery, anal pain, anal pendant expansion and hematochezia were observed in both the EA group and control group. On the first day after surgery, symptom improvement was not statistically significantly different between the two groups (P>0.05)．On the 2nd and 3rd days after surgery, anal pain, anal pendant expansion and hematochezia were markedly improved in the EA group compared with those in the control group (P<0.05). CONCLUSIONS: Electroacupuncture can reduce anal pain, anal pendant expansion and hematochezia after surgery in patients with mixed hemorrhoids.

Prognostic value of TTF-1 expression in patients with non-small cell lung cancer: A meta-analysis.

BACKGROUND: Observational studies on the prognostic role of thyroid transcription factor 1 (TTF-1) in non-small-cell lung cancer (NSCLC) are controversial. METHODS: To clarify the impact of TTF-1 in NSCLC survival, we performed this meta-analysis that included eligible studies. The combined hazard ratios and their corresponding 95% confidence intervals were calculated in terms of overall survival. RESULTS: A total of 17 studies with 2235 patients were evaluable for this meta-analysis. The studies were categorized by histology, disease stage and patient race. Our results suggested that TTF-1 overexpression had a favorable impact on survival of patients with NSCLC, the HR (95% CI) was 0.49 (0.42 to 0.55) overall, 0.46 (0.38-0.54) in Asian patients, 0.52 (0.42-0.63) in non-Asian patients, 0.45 (0.38-0.52) in adenocarcinoma, 0.63 (0.39-0.86) in stage I NSCLC, and 0.43 (0.33-0.53) in stage IIIb-IV NSCLC. The data collected were not sufficient to determine the prognostic value of VEGF in patients with squamous cell lung carcinomas. But there was a high heterogeneity between the studies. CONCLUSION: TTF-1 overexpression indicates a favorable prognosis for patients with NSCLC, this effect appears also significant when the analysis is restricted in lung AC patients, stage I and stage IIIb-IV NSCLC.

[Effect of moxa-grain-moxibustion on serum Th 1/Th 2 type cytokines in Lewis tumor-bearing mice].

OBJECTIVE: To observe the effect of moxa-grain-moxibustion on serum IL-2 and IL-10 levels and T-lymphocyte proliferation activity in Lewis tumor-bearing mice, so as to reveal its mechanism underlying improvement of immune function under lung cancer condition. METHODS: Thirty Lewis tumor-bearing mice were randomly divided into control group, tumor-bearing model group and moxibustion group (n = 10 in each group). Lung tumor model was established by subcutaneous inoculation of Lewis tumor cell suspension (0. 2 mL). The ignited moxa-grain was applied to bilateral "Housanli" (ST 36) one session a day for 10 sessions. The animals' daily life activity and the lung tumor growing status were observed every day. MTT [3-(4,5-dimethylthiazol- 2-yl)-2,5-diphenyl tetrazolium bromide] colorimetry was used to determine T lymphocyte proliferation activity, and serum IL-2 and IL-10 contents were detected by ELISA. RESULTS: Following moxibustion, no statistical differences were found in the gross tumor volume and body weight between tumor-bearing model and moxibustion groups and between pre-moxibustion and post-moxibustion in the same one group (P>0.05). Compared with the blank control group, serum IL-2 content in the model group were significantly decreased (P<0. 05),while serum IL-10 level was significantly increased in the model group (P<0. 05). After moxibustion, the T-lymphocyte proliferation rate and serum IL-2 were markedly increased(P<0. 05), but serum IL-10 level was considerably decreased in the moxibustion intervention group in comparison with the tumor-bearing model group(P<0. 05). CONCLUSION: Moxa-grain-moxibustion can effectively up-regulate T lymphocyte proliferation activity and balance Th 1/Th 2 in tumor-bearing mice, suggesting an enhancement of the body's anti-tumor ability after moxibustion.

[Clinical observation on the effect of acupuncture-assisted anesthesia for 40 cases of mixed hemorrhoids surgery].

OBJECTIVE: To observe the efficacy of comined administration of acupuncture and anesthetics for mixed hemorrhoids surgery and its postoperative complications. METHODS: A total of 40 cases of mixed hemorrhoid patients were randomized into acupuncture-assisted anesthesia (AAA) group and narcotic drug group (control), with 20 cases in each. For patients of AAA group, electroacupuncture (EA, 2 Hz/100 Hz, 9 mA) was applied to Changqiang (GV 1) and Yaoshu (GV 2) for 20 min, and 1% lidocaine (5 mL) was injected into GV 1. For patients of control group, 20 mL and 10 mL of 1% lidocaine were injected into GV 2 and GV 1, separately. The patients' pain response, anus muscular relaxion state, and postoperative complications were observed to evaluate their clinical efficacy. RESULTS: Of the 20 cases in AAA and control groups, 16 and 18 cases had a striking analgesic effect, 4 and 2 were effective, respectively. No significant difference was found between two groups in the analgesic efficacy for surgery (P>0.05). Postoperative urinary retention, pain severity I and II and the cases with intoxic response in AAA and control groups were 1 and 8, 16 and 6, 4 and 14, and 1 and 9, separately. The effects of AAA group were significantly superior to those of control group in lessening urinary retention and toxication, and in inducing analgesia (P<0.05). CONCLUSION: Acupuncture combined with narcotic drugs is superior to simple anesthetics for mixed hemorrhoids surgery in reducing postoperative complications.