ObjectiveTo investigate the possible mechanism of the improvement of type 2 diabetes mellitus with insulin resistance of skeletal muscles after Roux-en-Y gastric bypass surgery (RYGB). MethodsThirty GK rats were randomly divided into GK-RYGB group, sham operation group (GK-SO group), and control group (GK-control group); in addition, 10 Wistar rats served as normal control group.On day 28, the animals were sacrificed.The ghrelin concen-tration and PI3Kp85α, Akt/PKB, and GLUT4 levels were measured by ELISA, Western blot, and real-time PCR me-thods, respectively. Results①Compared with the GK-SO group and GK-control group, the plasma ghrelin levels were significantly increased in the normal control group (P < 0.01) and GK-RYGB group (P < 0.01).②Compared with the GK-SO group and GK-control group, p-/t-PI3Kp85α, p-/t-Akt/PKB, and m-/t-GLUT4 proteins were significantly incre-ased in the normal control group (P < 0.01, P < 0.05, and P < 0.01, respectively) and GK-RYGB group (P < 0.01, P < 0.05, and P < 0.01, respectively).③Compared with the GK-SO group and GK-control group, PI3Kp85α, Akt, and GLUT4 mRNA were significantly increased in the normal control group (P < 0.01, P < 0.05, and P < 0.05, respectively) and GK-RYGB group (P < 0.01, P < 0.05, and P < 0.05, respectively). ConclusionRYGB could elevate the ghrelin level obviously and upregulate PI3Kp85α, Akt/PKB, and GLUT4 levels and thus improve the insulin resistance of skeletal muscles of rats with T2DM.
ObjectiveTo study the effects of Ghrelin for glucose metabolism and insulin sensitivity of L6 rat myoblasts in palmitic acid induced, and to explore its possible mechanisms. MethodsThe L6 rat myoblasts were cultured until differentiation, then using palmitic acid(0.3 mmol/L) for 16 hours. The experimental group was treated with different doses of Ghrelin(1, 10, and 100 nmol/L) for 8 hours, then the glucose uptake was detected by using glucose oxidase peroxidase method(GOD-POD), the cell membrane glucose transporter 4(GLUT-4) protein staining was observated under confocal microscopy, and the expressions of total protein kinase B(Akt), phosphorylated protein kinase B(pAkt), total glycogen synthase kinase-3β(GSK-3β), and phosphorylated glycogen synthase kinase-3β(pGSK-3β) were detected by using immunoblotting(Western blot). ResultsGhrelin enhanced the glucose uptake of L6 rat myoblasts with insulin resistance, the cell membrane Glut-4 stain was deepen, the expressions of pAkt and pGSK-3βprotein increased, and this effect could be PI3K blocker(LY294002) eliminated. ConclusionGhrelin promotes the glucose uptake of L6 rat myoblasts through PI3K/Akt/GSK-3βsignaling pathway, so as to improve the sensitivity of insulin in L6 rats muscle cells.
ObjectiveTo evaluate the safety and efficacy of preoperation administration of enteral nutrition enriched ω-3 fatty acids for gastric cancer patients. MethodsA single center randomized controlled clinical trial was performed in 60 cases of gastric cancer in West China Hospital during January 2014 to June 2014, and cases were equally randomized divided into treatment group and control group. Cases of treatment group were given enteral nutrition enriched ω-3 fatty acids which was manufactured by Fresenius Kabi Deutschland GmbH for 5 consecutive days before operation, and cases of control group were given an isocaloric and isonitrogenous homogenized diet for 5 consecutive days before operation. The laboratory indexes of nutritional status and imflammatory factors were observed and compared between 2 groups on admission, preoperative day 1, postoperative day 3, and postoperative day 5. Liver and kidney function indexes which as the safety indexes were detected on admission and preoperative day 1. Vomiting, diarrhea, and infectious complications were recorded in addition. ResultsOn 3 days after operation, levels of interleukin-6 (IL-6) and α-acid glycoprotein (AAG) of treatment group were both lower than those of control group (P<0.05); on 5 days after operation, levels of C-reactive protein (CRP) of treatment group was lower than that of control group too (P<0.05); but at other time points, there were no significant differences in any index between the 2 groups (P>0.05). During the period of enteral nutrition, only 1 case suffered from bloating and 1 case suffered from diarrhea, both in treatment group, and the incidence of adverse reactions didn't differed between treatment group[6.7% (2/30)]and control group[0 (0/30)], P>0.05. Moreover, there were no significant differences between treatment group and control group in incidences of wound infection[3.3% (1/30) vs. 10.0% (3/30)], abdominal infection[0 (0/30) vs. 3.3% (1/30)], urinary infection[0 (0/30) vs. 3.3% (1/30)], and pulmonary infection[0 (0/30) vs. 6.7% (2/30)], but the total incidence of complication was lower in treatment group than that of control group[3.3% (1/30) vs. 23.3% (7/30)], P=0.026. ConclusionEnteral nutrition enriched ω-3 fatty acids can reduce the rate of infection-related complication for patients with gastric cancer, and has a sense of safety.
ObjectiveTo investigate on the antihypertensive therapy for hypertension patients in Wuhou District communities in Chengdu city and assess whether they have complied with the hypertension treatment guidelines. MethodsIn a survey of 1 539 community people, we selected 337 hypertensive patients who had detailed high blood pressure medication records. ResultsThe main characteristics of community hypertension treatment included higher proportions of single-drug therapy (70.3%), and traditional compound preparation (13.9%). Calcium channel blockers (CCB) and beta blockers were most commonly used in the dual step-down scheme (39.7%), while CCB, angiotensin converting enzyme inhibitors and beta blockers were mostly used in step-down triple combination. The control rate was 46.7% after antihypertensive drug treatment in the community. ConclusionIt is necessary to carry out hypertension education, strengthen the training of doctors at the basic level with hypertension prevention and control guidelines to improve the rates of treatment and control of hypertension.
ObjectiveTo explore optimal intensity of oral anticoagulation for patients with prosthetic heart valves in Northeast China. MethodsA total of 856 patients in Northeast China who underwent prosthetic heart valve replacement in the Department of Cardiovascular Surgery,Second Hospital of Jilin University from January 2005 to June 2013 were enrolled in this study. There were 406 male and 450 female patients with their age of 45.2±13.3 years. All the patients received low-intensity oral anticoagulation [international normalized ratio (INR) 1.5-2.2,aortic valve replacement (AVR):1.5-1.8,mitral valve replacement (MVR):1.8-2.2]. Patients were followed up after discharge,and the incidence of anticoagulation-related complications was summarized. ResultsThese patients were followed up for 1-78 (18.3±12.2) months,and the follow-up rate was 75.4%. Twelve patients (1.86%) had thromboembolic complications and 10 patients (1.55%) had hemorrhagic complications. Average warfarin dosage was 3.4±0.8 mg/day,and average INR was 1.94±0.54 during follow-up. ConclusionFor patients with prosthetic heart valves in Northeast China,low-intensity anticoagulation can produce satisfactory clinical outcomes to reduce the incidence of anticoagulation-related thromboembolic or hemorrhagic complications.
ObjectiveTo investigate the significance of using the term "high-normal blood pressure" and its intervention in the early stage. MethodsIn 1992 and 2007, we performed two similar investigations focusing on cardiovascular risk factors in 711 people in Chengdu city. Since 114 individuals were diagnosed with hypertension, 597 people without hypertension were eligible and divided into two groups:the normal-pressure[<120/80 mm Hg (1 mm Hg=0.133 kPa)] group and the high-normal blood pressure (systolic blood pressure 120-139 mm Hg and/or diastolic blood pressure 80-89 mm Hg) group. Data in the two investigations were compared to explore the relationship among high-normal blood pressure, cardiovascular disease (CVD) and hypertension. ResultsThe high-normal blood pressure group had a higher level of CVD risk factors both in 1992 and 2007, and the 15-year cumulative incidence of hypertension in the high-normal blood pressure group was higher than that of normal-pressure group (91.2% vs. 22.2%, P<0.001). After adjusting for serum lipid, body weight and other CVD risk factors, high-normal blood pressure could predict the progression into hypertension[HR=5.354, 95% CI (4.094, 7.002), P=0.001]. There was no statistics difference in CVD prevalence in the two groups in 1992, but in 2007 the prevalence of CVD tended to be higher in the high-normal blood pressure group (6.6% vs. 3.1%, P=0.052). ConclusionHigh-normal blood pressure is a special stage of blood pressure with high level of CVD risk factors and high potential to progress into hypertension. The term should be emphasized and intervention should be done in the early stage for high-normal blood pressure people to prevent from hypertension and CVD.
ObjectiveFor better health interventions, blood pressure control and reducing risk of cardiovascular events, we explored the effects of health education by nurses on hypertension patients after discharging. MethodsHypertensive discharging-patients from the department of cardiology of the West China Hospital of Sichuan University were enrolled from January to October in 2011. They were divided into two groups, including a health education group and a control group. The patients in the health education group were given all-side care, health guidance, education lectures and telephone follow-up by nurses. The control group got no intervention. After one year follow-up, the information about situation of blood pressure control, new-onset cardiovascular events and changes of life habits were collected from the two groups. SPSS 19.0 was used to perform statistic analysis. ResultsA total of 300 discharged hypertensive cases were included, with 150 cases in each group. The systolic blood pressure of patients in the health education group was significantly lower than that of the control group (P < 0.05). Both blood control rates and the habit of low salt intake in the health education group were also better than those of the control group (both P < 0.05). There was no significant difference in changes of smoking, drinking, physical exercise and new-onset cardiovascular events between the two groups. ConclusionHealth education by nurses could effectively improve the management of blood pressure in patients with hypertension.