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Comparative evaluation in treating qi-yin deficiency and phlegm stasis syndrome of type 2 diabetes mellitus in a rat model

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Journal of Traditional Chinese Medical Sciences 2019年第1期6卷 59-66页

作者： Zongchun Yang Jing Zhao Jinna Liu Biyuan Liu Ming Xie School of Chinese Medicine Beijing University of Chinese Medicine Beijing 100029 China

Objective:To compare the efficacy of traditional Chinese medicine (TCM),western medicine and integrative medicine in treating type 2 diabetes mellitus (T2DM) in a rat model.Methods:The T2DM rat model was established with a high-fat diet (HFD) for 35 days and a single injection of streptozotocin (STZ,30 mg/kg).The T2DM-induced rats were divided into three groups,and treated with Yiqi Yangyin Huatan (YQYYHT) granules (3.84 g/kg per day),pioglitazone (1.35 mg/kg per day) or YQYYHT granules + pioglitazone (3.84 g/kg per day+1.35 mg/kg per day) respectively for 14 days.Clinical features and behavioral changes,as well as T2DM indicators,were recorded to evaluate therapeutics effects in each treatment group.Results:The T2DM rat model expressed insulin resistance (IR),with features similar to qi-yin deficiency and phlegm stasis syndrome,including decreased cyclic adenosine monophosphate/cyclic guanosine monophosphate (cAMP/cGMP) ratio,decreased levels of Na+-K+-ATPase,superoxide dismutase (SOD) and high density lipoprotein-cholesterol (HDL-C),and increased levels of serum triglyceride (TG),total cholesterol (TC) and low density lipoprotein (LDL-C).All three treatment groups showed significant decreases in fasting blood glucose (FBG) and fasting insulin (Fins),and improvement of TCM syndrome to different degrees.Importantly,YQYYHT improved the most of the indicators of T2DM,followed by integrative medicine and pioglitazone alone.Conclusion:Compared with western medicine or integrative medicine,prescription of TCM based on syndrome differentiation may offer more advantages in the prevention and treatment of T2DM.

关键词： Type 2 diabetes mellitus Qi-yin deficiency Phlegm stasis syndrome Integrative medicine Yiqi Yangyin Huatan prescription

Diabetes mellitus and male infertility

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Asian pacific Journal of Reproduction 2018年第1期7卷 6-14页

作者： Omolaoye Temidayo S du Plessis Stefan S Division of Medical Physiology Faculty of Medicine and Health SciencesStellenbosch UniversityTygerbergSouth Africa

Infertility is prevalent in about 10%-25% of couples in their reproductive age, analogous to 60-80 million infertile couples globally. Of these infertility cases, 10%-30% are exclusively attributed to a problem of the male. Several diseases have been implicated as contributors to deteriorating male fertility and diabetes mellitus (DM) is included. DM, a chronic non-communicable disease, has been considered as one of the most appreciable health threats, as it affects 9% (422 million) of the world's population as of 2014. It is characterised by hyperglycaemia, which can result from the inability of the pancreaticβ-cells to secrete insulin or from the target tissue becoming insensitive to insulin. DM has been reported to influence male reproductive function through diverse pathways and mechanisms. The adverse effects of reactive oxygen species and successive development of oxidative stress that occur due to DM have been investigated and implicated by several studies. The products of non-enzymatic glycosylation are reported to be widely distributed in the reproductive tract of diabetic men. Additionally, DM has been implicated to impair the processes of male sexual acts. Data reported in this review were extracted from PubMed, Google Scholar, Science Direct and Scopus with diabetes and male infertility as the key search words. In light of the aforementioned, the aim of this review is to provide brief background information on DM as well highlight and explain the likely mechanisms of male fertility which DM impacts.

关键词： Diabetes mellitus Male infertility Diabetic neuropathy Oxidative stress Reactive oxygen species Advanced glycated end products

Therapeutic effects of acupuncture on blood glucose level among patients with type-2 diabetes mellitus: A randomized clinical trial

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Journal of Traditional Chinese Medical Sciences 2019年第1期6卷 101-107页

作者： Amir Hooman Kazemi Wei Wang Yanping Wang Faezeh Khodaie Hossein Rezaeizadeh School of Persian Medicine Tehran University of Medical SciencesTehranIran School of Chinese Medicine Beijing University of Chinese MedicineBeijing 100029China School of Acupuncture Moxibustion and TuinaBeijing University of Chinese MedicineBeijing 100029China

Objective:To compare the therapeutic effects of acupuncture with sham acupuncture on levels of fasting plasma glucose (FPG) and glycated hemoglobin (HbA1c) among patients with type-2 diabetes mellitus (T2DM) under treatment with metformin.Method:Eighty participants with T2DM were allocated randomly to treatment (n =40) and control (n =40) groups.In addition to metformin therapy,patients in the acupuncture group received acupoint stimulation with even manipulation at 15 acupoints,and needles were retained for 20 minutes.The sham-acupuncture group was treated with very small needles inserted at a very shallow depth (3-5 mm) without manipulation at non-acupoints 1 cm around the actual acupuncture points.Both groups were treated for 14 sessions during 10 weeks of treatment.The FPG level was measured before treatment as well as after 1,2,4,6 and 12 weeks of treatment.The HbA1c percentage was assessed once before treatment and once 12 weeks after treatment initiation.Results:Levels of FPG and HbA1c in both groups were reduced significantly in comparison with baseline measurements (both P <.01).However,acupuncture treatment led to a significant reduction in the FPG level as compared with sham acupuncture after 4 weeks or 10 sessions of treatment [mean difference (MD) =10.18,95% confidence interval (CI) =1.74 to 18.6,P =.019],after 6 weeks or 12 sessions of treatment (MD =10.53,95% CI =2.22 to 18.83,P =.014) and after 12-week follow-up (MD =8.8,95% Cl =0.66 to 16.94,P =.034).Acupuncture treatment reduced the HbA1c level significantly in comparison with that in the shamacupuncture group (MD =0.27,95%Cl =0.08 to 0.47,P =.007).Conclusion:Our study revealed that acupuncture (as a type of Chinese therapy) combined with metformin (as a conventional hypoglycemic medication) had a greater effect on glycemic control than that elicited in the placebo control group.Consequently,acupuncture could be used as adjuvant therapy among patients with T2DM.

关键词： Diabetes mellitus type 2 Acupuncture Glycated hemoglobin

Inhibitory effect and mechanism of acarbose combined with gymnemic acid on maltose absorption in rat intestine

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World Journal of Gastroenterology 2001年第1期7卷 9-15页

作者： Toshiaki Imoto Yasutake Hiji Departments of Physiology Faculty of Medicine Tottori University Yonago 683-0826 Japan

AIM To compare the combinative andindividual effect of acarbose and gymnemic acid(GA) on maltose absorption and hydrolysis insmall intestine to determine whether nutrientcontrol in diabetic care can be improved bycombination of them.METHODS The absorption and hydrolysis ofmaltose were studied by cyclic perfusion ofintestinal loops in situ and motility of theintestine was recorded with the intestinal ring invitro using Wistar rats.RESULTS The total inhibitory rate of maltoseabsorption was improved by the combination ofGA (0.1 g/L 1.0 g/L) and acarbose(0.1 mmol/L 2.0 mmol/L) throughout theireffective duration (P＜0.05, U test of Mann-Whitney), although the improvement only couldbe seen at a Iow dosage during the first hour.With the combination, inhibitory duration of acarbose on maltose absorption was prolonged to 3 h and the inhibitory effect onset of GA was fastened to 15min. GA suppressed the intestinal mobility with a good correlation (r-0.98) to the inhibitory effect of GA on maltose absorption and the inhibitory effect of 2mmol/L (high dose) acarbose on maltose hydrolysis was dual modulated by 1 g/L GA in vivo indicating that the combined effects involved the functional alteration of intestinal barriers.CONCLUSION There are augmented effects of acarbose and GA, which involve pre-cellular and paracellular barriers. Diabetic care can be improved by employing the combination.

关键词： diabetes mellitus maltose gymnemic acid alpha-glucosidases intestinal mucosa rats nutrition

Glycemic control indicators in patients with neonatal diabetes mellitus

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World Journal of Diabetes 2014年第2期5卷 198-208页

作者： Shigeru Suzuki Masafumi Koga Department of Pediatrics Asahikawa Medical University Department of Internal Medicine Kawanishi City Hospital

Neonatal diabetes mellitus(NDM) is a type of diabetes mellitus caused by genetic abnormality which devel ops in insulin dependent state within 6 mo after birth HbA1c is widely used in clinical practice for diabetes mellitus as the gold standard glycemic control indica tor; however, fetal hemoglobin(HbF) is the main he moglobin in neonates and so HbA1c cannot be used as a glycemic control indicator in NDM. Glycated albumin(GA), another glycemic control indicator, is not affected by HbF. We reported that GA can be used as a glycemic control indicator in NDM. However, it was later found that because of increased metabolism of albumin, GA shows an apparently lower level in relation to plasma glucose in NDM; measures to solve this problem were needed. In this review, we outlined the most recen findings concerning glycemic control indicators in neo nates or NDM.

关键词： Glycemic control HbA1c Glycated albumin Fructosamine 1,5-anhydroglucitol Neonatal diabetes mellitus

Risk factors associated with the development of ischemic colitis

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World Journal of Gastroenterology 2010年第36期16卷 4564-4569页

作者： Joaquín Cubiella Fernández Luisa Núez Calvo Elvira González Vázquez Maria Jesús García García Maria Teresa Alves Pérez Isabel Martínez Silva Javier Fernández Seara Department of Gastroenterology Complexo Hospitalario de Ourense32005 OurenseSpain Department of Internal Medicine Complexo Hospitalario de Ourense32005 OurenseSpain Department of Internal Medicine Fundación Pública Hospitalaria de Verín32600 VerinSpain Research Support Unit Complexo Hospitalario de Orense32005 OurenseSpain Biostatistic Unit University of Santiago de Compostela15703 Santiago de CompostelaSpain

AIM:To ascertain the role of cardiovascular risk factors,cardiovascular diseases,standard treatments and other diseases in the development of ischemic colitis(IC).METHODS:A retrospective,case-control study was designed,using matched data and covering 161 incident cases of IC who required admission to our hospital from 1998 through 2003.IC was diagnosed on the basis of endoscopic findings and diagnostic or compatible his-tology.Controls were randomly chosen from a cohort of patients who were admitted in the same period and required a colonoscopy,excluding those with diagnosis of colitis.Cases were matched with controls(ratio 1:2),by age and sex.A conditional logistic regression was performed.RESULTS:A total of 483 patients(161 cases,322 con-trols)were included;mean age 75.67±10.03 years,55.9%women.The principal indications for colonos-copy in the control group were lower gastrointestinal hemorrhage(35.4%),anemia(33.9%),abdominal pain(19.9%)and diarrhea(9.6%).The endoscopic findings in this group were hemorrhoids(25.5%),diverticular disease(30.4%),polyps(19.9%)and colorectal cancer(10.2%).The following variables were associated with IC in the univariate analysis:arterial hypertension(P= 0.033);dyslipidemia(Pmellitus(P =0.025);peripheral arterial disease(P=0.004);heart failure(P=0.026);treatment with hypotensive drugs(P=0.023);angiotensin-converting enzyme inhibitors;(P=0.018);calcium channel antagonists(P=0.028);and acetylsalicylic acid(ASA)(Pmellitus[odds ratio(OR)1.76,95%confidence interval(CI):1.001-3.077,P=0.046];dyslipidemia(OR 2.12,95%CI:1.26-3.57,P=0.004);heart failure(OR 3.17,95%CI:1.31-7.68,P=0.01);peripheral arterial disease(OR 4.1,95%CI:1.32-12.72,P=0.015);treatment with digoxin(digitalis)(OR 0.27,95%CI:0.084-0.857,P=0.026);and ASA(OR 1.97,95%CI:1.16-3.36,P=0.012).CONCLUSION:The development of an episode of IC was independently associated with diabetes,dyslipid-emia,presence of heart

关键词： Ischemic colitis Diabetes mellitus Dyslipidemia Acetylsalicylic acid Peripheral arterial disease Digoxin

Milestones in the history of diabetes mellitus:The maincontributors

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World Journal of Diabetes 2016年第1期7卷 1-7页

作者： Marianna Karamanou Athanase Protogerou Gregory Tsoucalas George Androutsos Effie Poulakou-Rebelakou Department of History of Medicine Medical SchoolUniversity of Athens11527 AthensGreece Department of Pathophysiology “Laiko”HospitalMedical SchoolUniversity of Athens11527 AthensGreece

Diabetes mellitus is a group of metabolic diseases involving carbohydrate, lipid, and protein metabolism. It is characterized by persistent hyperglycemia which results from defects in insulin secretion, or action or both. Diabetes mellitus has been known since antiquity. Descriptions have been found in the Egyptian papyri, in ancient Indian and Chinese medical literature, as well as, in the work of ancient Greek and Arab physicians. In the 2^(nd) century AD Aretaeus of Cappadocia provided the first accurate description of diabetes, coining the term diabetes, while in 17^(th) century Thomas Willis added the term mellitus to the disease, in an attempt to describe the extremely sweet taste of the urine. The important work of the 19^(th) century French physiologist Claude Bernard, on the glycogenic action of the liver, paved the way for further progress in the study of the disease. In 1889, Oskar Minkowski and Joseph von Mering performed their famous experiment of removing the pancreas from a dog and producing severe and fatal diabetes. In 1921, Frederick Banting and Charles Best extended Minkowski's and Mering's experiment. They isolated insulin from pancreatic islets and administrated to patients suffering from type 1 diabetes, saving thus the lives of millions and inaugurating a new era in diabetes treatment.

关键词： History of endocrinology Metabolic disorder Diabetes mellitus Aretaeus of Cappadocia Insulin

Gestational diabetes: weight gain during pregnancy and its relationship to pregnancy outcomes

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Chinese Medical Journal 2019年第2期132卷 154-160页

作者： Bao-Hua Gou Hui-Min Guan Yan-Xia Bi Bing-Jie Ding Department of Gynaecology and Obstetrics Beijing Friendship HospitalCapital Medical UniversityBeijing 100050China Department of Clinical Nutrition Beijing Friendship HospitalCapital Medical UniversityBeijing 100050China

Background:Weight gain during pregnancy reflects the mother's nutritional status.However, it may be affected by nutritional therapy and exercise interventions used to control blood sugar in gestational diabetes mellitus (GDM).This study aimed to evaluate weight gain during gestation and pregnancy outcomes among women with GDM.Methods:A retrospective study involving 1523 women with GDM was conducted between July 2013 and July 2016.Demographic data, gestational weight gain (GWG), blood glucose, glycated-hemoglobin level, and maternal and fetal outcomes were extracted from medical records.Relationships between GWG and pregnancy outcomes were investigated using multivariate logistic regression.Results:In total, 451 (29.6%) women showed insufficient GWG and 484 (31.8%) showed excessive GWG.Excessive GWG was independently associated with macrosomia (adjusted odds ratio [aOR] 2.20, 95% confidence interval [CI] 1.50-3.52, P<0.001), large for gestational age (aOR 2.06, 95% CI 1.44-2.93, P<0.001), small for gestational age (aOR 0.49, 95% CI 0.25-0.97, P=0.040), neonatal hypoglycemia (aOR 3.80, 95% CI 1.20-12.00, P=0.023), preterm birth (aOR 0.45, 95% CI 0.21-0.96, P=0.040), and cesarean delivery (aOR 1.45, 95% CI 1.13-1.87, P=0.004).Insufficient GWG increased the incidence of preterm birth (aOR 3.53, 95% CI 1.96-6.37, P<0.001).Conclusions:Both excessive and insufficient weight gain require attention in women with GDM.Nutritional therapy and exercise interventions to control blood glucose should also be used to control reasonable weight gain during pregnancy to decrease adverse pregnancy outcomes.

关键词： Gestational diabetes mellitus Weight gain Pregnancy outcomes

G protein-coupled receptor kinase 2 inhibition improves erectile function through amelioration of endothelial dysfunction and oxidative stress in a rat model of type 2 diabetes

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Asian Journal of Andrology 2019年第1期21卷 74-79页

作者： Zhi-Hua Wan Yuan-Jie Zhang Lin Chen Yong-Lian Guo Guo-Hao Li Ding Wu Yong Wang Department of Urology The Central Hospital of WuhanTongll Medical CollegeHuazhong University of Science and TechnologyWuhan 430014China

Type 2 diabetes mellitus (T2DM)is a common cause of erectile dysfunction (ED).It has been demonstrated that G protein-coupled receptor kinase 2 (GRK2)overexpression contributes to diabetic endothelial dysfunction and oxidative stress,which also underlies ED in T2DM.We hypothesized that GRK2 overexpressed and attenuated endothelial function of the cavernosal tissue in a rat model of T2DM.T2DM rats were established by feeding with a high-fat diet (HFD)for 2 weeks and then administering two intraperitoneal (IP) injections of a low dose of streptozotocin (STZ),followed by continuous feeding with a HFD for 6 weeks.GRK2 was inhibited by IP injection of paroxetine,a selective GRK2 inhibitor,after STZ injection.Insulin challenge tests,intracavernous pressure (ICP), GRK2 expression,the protein kinase B (Akt)/endothelial nitric oxide synthase (eNOS)pathway,nicotinamide adenine dinucleotide phosphate (NADPH)oxidase subunit gp91phox,nitric oxide (NO),reactive oxygen species (ROS)production,and apoptosis in cavernosal tissue were examined.Less response to insulin injection was observed in T2DM rats 2 weeks after HFD.Markedly increased GRK2 expression,along with impaired Akt/eNOS pathway,reduced NO production,increased gp91phox expression and ROS generation,increased apoptosis and impaired erectile function were found in T2DM rats.inhibition of GRK2 with paroxetine ameliorated Akt/eNOS signaling,restored NO production,downregulated NADPH oxidase,subsequently inhibited ROS generation and apoptosis,and ultimately preserved erectile function.These results indicated that GRK2 upregulation may be an important mechanism underlying T2DM ED,and GRK2 inhibition may be a potential therapeutic strategy for T2DM ED.

关键词： endothelial dysfunction erectile dysfunction G protein-coupled receptor kinase 2 oxidative stress type 2 diabetes mellitus