Effect of metformin combined with clomiphene on insulin resistance, oxidative stress response and T cell immune response in patients with PCOS

Objective: To study the effect of metformin combined with clomiphene on insulin resistance, oxidative stress response and T cell immune response in patients with polycystic ovarian syndrome (PCOS). Methods: A total of 94 patients who were diagnosed with PCOS in Jingzhou Second People's Hospital between September 2014 and October 2016 were selected and randomly divided into the combined group who received the metformin combined with clomiphene therapy and the control group who received clomiphene therapy. The insulin resistance, oxidative stress response and T cell immune response were evaluated before treatment and 3 menstrual cycles after treatment. Results: 3 menstrual cycles after treatment, HOMA-IR level, serum F-Ins, F-CP, TOS, MDA, AOPP and IL-17 contents as well as peripheral blood RORγt mRNA expression of combined group were significantly lower than those before treatment while HOMA-β level, serum TAS, SOD, GSH-Px, VitC, VitE, IL-10 and TGF-β1 contents as well as peripheral blood Foxp3 mRNA expression were significantly higher than those before treatment;HOMA-IR and HOMA-β levels, serum F-Ins, F-CP, TOS, MDA, AOPP, IL-17, TAS, SOD, GSH-Px, VitC, VitE, IL-10 and TGF-β1 contents as well as peripheral blood Foxp3 and RORγt mRNA expression of control group were not different from those before treatment. Conclusion: Metformin combined with clomiphene can significantly improve the insulin resistance, oxidative stress response and T cell immune response in patients with PCOS.

Electroacupuncture Pretreatment at Neiguan (PC 6) attenuates autophagy in rats with myocardial ischemia reperfusion through the phosphatidylinositol 3-kinase-Akt-mammalian target of rapamycin pathway

OBJECTIVE: To investigate the protective efficacy of electroacupuncture(EA) pretreatment at Neiguan(PC6) on myocardial ischemia-reperfusion(I/R) in rats.METHODS: Fifty rats were randomly divided into five groups(n = 10): sham operation group, model group(underwent in vivo myocardial I/R), EA pretreatment group [EA at Neiguan(PC 6) 1 week before I/R], wortmannin group(1 week before I/R, the PI3K inhibitor, wortmannin, was injected), EA pretreatment + wortmannin group(both pretreatments were performed simultaneously). After establishing the I/R model, 2,3,5-triphenyltetrazolium chloride(TTC) staining was used to analyze the weight and area of the myocardial infarction tissue.The biosignal and pressure test system was used to determine the left ventricular systolic mean pressure(LVSP), left ventricular end-diastolic pressure(LVEDP), fractional shortening(FS), and ejection fraction(EF). Ultraviolet spectrophotometry was used to determine the expression of creatine kinase(CK)-MB, inducible nitric oxide synthase(i NOS), and total antioxidant capacity(T-AOC) in the serum. The expression of autophagy-related protein 13(ATG13), mammalian target of rapamycin(m TOR), and phosphatidylinositol 3-kinase(PI3K) in cardiac muscle cells was determined by immunofluorescence. Hematoxylin and eosin staining was used to observe autophagy-related pathological changes in rat cardiomyocytes, and ultrastructural changes of cardiomyocytes were examined by transmission electron microscopy.RESULTS: In this study, the infarction size and tissue weight of the EA pretreatment group were decreased compared with the model group(P <0.0001). Furthermore, compared with the model group, the LVEDP values of the EA pretreatment group were significantly reduced(P = 0.0091), and the LVSP, FS, and EF values were slightly increased (P = 0.0007, 0.0020, 0.0031). EA pretreatment also significantly decreased the expression of CK-MB and i NOS, while it increased the expression of T-AOC in the serum of rats with I/R injury(P <0.0001). Furthermore, EA pretreatment slightly widened the myocardial fiber space, reduced necrosis and myocardial cell swelling and maintained the nucleus and mitochondria structure intact.CONCLUSION: EA pretreatment promoted autophagy flux and alleviated myocardial I/R injury through the PI3K-Akt-m TOR pathway.

Clinical efficacy observation of'Tong Du Yun Pi'manipulation for infantile diarrhea in autumn

Objective:To observe the clinical efficacy of ‘Tong Du Yun Pi’(Governor Vessel-unblocking and spleen-promoting)manipulation in treating infantile diarrhea in autumn.Methods:Eighty-four kids were divided into a control group and an observation group using the random number table method,with 42 cases in each group.The control group was intervened by oral administration of montmorillonite powder;and the observation group was given additional‘Tong Du Yun Pi’pediatric massage(tuina)treatment.After treatment,the traditional Chinese medicine(TCM)symptoms scores,symptom improvement time,clinical efficacy and immune function indicators were compared between the two groups.Results:After treatment,the total effective rate was 95.2%in the observation group versus 76.2%in the control group,and the between-group difference was statistically significant(P<0.05);each item score in TCM symptoms was notably lower in the observation group than in the control group(all P<0.05);among the effective cases,the times to restore normal defecation,relieve abdominal bloating,arrest vomiting,and bring down the fever were markedly shorter in the observation group than in the control group,and the betwee regroup differences were statistically sign ificant(all P<0.05);the levels of immunoglobulin(Ig)G,IgM,CD4^(+)and CD4^(+)/CD8^(+)were significantly higher and CD8^(+)was significantly lower in the observation group than in the control group(all P<0.05).Conclusion:In the treatment of infantile diarrhea in autumn,based on oral administration of montmorillonite powder,‘Tong Du Yun Pi’manipulation can notably improve diarrheal symptoms,shorten disease duration,and strengthen the immunity of kids,producing more significant efficacy than oral administration of montmorillonite powder.