Surgical Treatment of Hand and Foot Gout Stone and Influence Factors on Prognosis.

Purpose: To explore the technique of surgical treatment of hand and foot gout stone by using 3D CT reconstruction images and influence factors on prognosis. Method: 48 cases of hand and foot gout were treated surgically and retrospective analyzed. Before operation, we used 3D CT reconstruction images to check the accurate site and amount of uric acid (white chalk foam) deposition. Different surgical methods were applied depending on the different deposition site of urine acid stone. The frequency of gout attack and blood uric acid was compared before and after surgery. Patients were followed up to observe the recovery and recurrence and then analyzed the reason of unsuccessful healing. Result: Sutures were removed 2 weeks after operation in all cases. The frequency of gout attack and blood uric acid of patients 3 months after operation was lower than those before operation, and the differences were statistically significant. Follow-up ranged from 1 to 3 years, with an average of 1.8 years. Three cases were not followed up. The remaining 45 cases were healed in the first stage. 40 cases had improved joint function, increased range of motion, and relieved discomfort after movement. 5 cases had no improvement in joint function after operation, and 3 of them had gout stone recurrence (nonoperative area) and were treated by second hospital operation. Conclusion: Surgical treatment of gout stone in hand and foot under the guidance of three-dimensional CT reconstruction image can effectively alleviate the local symptoms of gout stone and improve the function of hand and foot. Deep tissue can be thoroughly washed by the pressure of pulse gun after resection of the lesion, which can reduce the incidence of gout stone. Malnutrition, hypoproteinemia, and residual urine acid in the wound are the main reasons for unsuccessful healing.

Schisandra Chinensis Acidic Polysaccharide Improves the Insulin Resistance in Type 2 Diabetic Rats by Inhibiting Inflammation.

Polysaccharide from Schisandra chinensis has the effect of lowering blood glucose and improving insulin resistance (IR). However, its underlying mechanism remains unclear. In this study, a rat model of type 2 diabetes (T2D) was created to explore whether S. chinensis acidic polysaccharide (SCAP) would improve the IR in T2D rats by inhibiting inflammation. A combination of a high-fat diet and low dose of streptozotocin (STZ, 30 mg/kg, intraperitoneally) were administered to rats for establishing the T2D model. Then, these T2D rats were orally administered with SCAP (25, 50, or 100 mg/kg) for 8 weeks. The results indicated that SCAP significantly lowered the fasting blood glucose, elevated the fasting insulin, and improved glucose tolerance. SCAP also decreased the serum interleukin-1ß (IL-1ß), interleukin-6 (IL-6), tumor necrosis factor-α (TNF-α), C-reactive protein (CRP), and nuclear factor-κB (NF-κB) levels, as well as their mRNA expression in the liver tissue. Further, SCAP significantly inhibited the upregulation of phosphorylated c-Jun N-terminal kinase (p-JNK) and NF-κB protein, and it increased phosphorylated insulin receptor substrate-1 (p-IRS-1), phosphorylated phosphatidylinositol 3-kinase (p-PI3K), and phosphorylated protein kinase B (p-AKT) protein expression levels significantly. These results suggest that SCAP improves the IR in T2D rats by inhibiting inflammation.

Hypoglycemic Effect of Acidic Polysaccharide from Schisandra chinensis on T2D Rats Induced by High-Fat Diet Combined with STZ.

Polysaccharide is a key bioactive component of Schisandra chinensis and has significant pharmacological activities. The aim of this study was to evaluate the anti-diabetic effect of acidic polysaccharide from Schisandra chinensis (SCAP). Type 2 diabetic (T2D) rats were developed by giving a high-fat diet (HFD) combined with low-dose streptozotocin (STZ), and administered orally with SCAP (25, 50 mg/kg) for 8 weeks. Fasting blood glucose (FBG), fasting insulin (FINS), triglycerides (TG), total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), malondialdehyde (MDA), and superoxide dismutase (SOD) in the rat's serum were measured. Oral glucose tolerance test (OGTT) and pathological changes of pancreas were observed. Furthermore, expressions of c-Jun N-terminal kinase (JNK), B-cell lymphoma 2-associated X protein (BAX), B-cell lymphoma 2 (Bcl-2), and Cleaved Caspase-3 in pancreatic islet were detected. The results showed that SCAP decreased FBG, TG, TC, LDL-C and MDA levels, increased insulin, HDL-C levels and SOD activity, improved the pathological changes in pancreatic islet. Furthermore, SCAP inhibited the up-regulation of phosphorylated JNK, BAX and Cleaved Caspase-3 proteins, and increased Bcl-2 protein expression. These data indicate that SCAP has a therapeutic effect in T2D rats, and the mechanism may be related to its protection against ß-cells apoptosis by regulating apoptosis-related proteins expression to alleviate the injury caused by the oxidative stress.