Ruptured gastric artery aneurysms in polyarteritis nodosa successfully treated with embolization

Dear editor,Polyarteritis nodosa(PAN) is a rare form of vasculitis involving small-and medium-sized vessels in multiple organs. Severe gastrointestinal(GI) hemorrhage in PAN due to multiple ruptures of aneurysms of arteries is uncommon and life-threatening.

Treatment of refractory anti-melanoma differentiation-associated gene 5 anbibody-positive dermatomyositis complicated by rapidly progressing interstitial pulmonary disease:Two case reports

BACKGROUND Anti-melanoma differentiation-associated gene 5 antibody-positive(anti-MDA5 Ab+)dermatomyositis complicated with rapidly progressive interstitial lung disease(anti-MDA5 Ab+DM-RP-ILD)has an unclear underlying mechanism with no recommended unified treatment plan.Herein,one of the cases that we report(Case 2)was successfully treated with tocilizumab despite having lung infection.CASE SUMMARY Case 1 was a 30-year-old woman who was admitted due to recurrent rash for 5 mo,fever and cough for 1 mo,and chest tightness for 3 d.She was diagnosed with non-myopathic dermatomyositis(anti-MDA5 Ab+)and interstitial pneumonia,and was treated with the combination of hormone therapy and cyclophosphamide followed by oral tacrolimus.Case 2 was a 31-year-old man admitted due to systemic rash accompanied by muscle weakness of limbs for more than 1 mo,and chest tightness and dry cough for 4 d.He was diagnosed with dermatomyositis(anti-MDA5 Ab+)and acute interstitial pneumonia with Pneumocystis jirovecii and Aspergillus fumigatus infections and was treated with hormone therapy(without cyclophosphamide)and the combination of tocilizumab and tacrolimus.The condition of both patients eventually improved and they were discharged and showed clinically stable condition at the latest follow-up.CONCLUSION Tocilizumab could be a salvage treatment for patients with anti-MDA5 Ab+DMRP-ILD who are refractory to intensive immunosuppression.

Therapeutic effect of okra extract on gestational diabetes mellitus rats induced by streptozotocin

Objective:To explore the effect of okra extract on gestational diabetes mellitus(GDM) rats and its probable molecular mechanism.Methods:A total of 30 female SD rats were caged with male rats for pregnancy,27 pregnant rats were obtained and weighed.The pregnant rats were equally randomized into the control group,GDM group and intervention group.Once the pregnancy was verified,GDM group and intervention group were given 45 mg/kg streptozotocin by peritoneal injection for inducing GDM,control group was given equal volume of citrate buffer.Once the model was established successfully,intervention group was administered orally the solution containing 200 mg/kg/d okra extract,the other groups were given the diet and water only.On the 19 th day of pregnancy,the blood samples and fetal rats of all groups were collected,fetal rats weight and placental weight was recorded and the serum glucose,lipids,serum insulin and C-peptide of pregnant rats before the delivery were determined.Results:The pregnant rats weight before the delivery,fetal rats weight and placental weight of GDM group were lower than control group and intervention group(P<0.05).After the treatment of okra extract,serum glucose and lipids levels of intervention group were both improved significantly(P<0.05),especially,the FBG,HDL,FINS,serum m insulin and hepatic glycogen levels were equivalent to control group(P>0.05).Antioxidant enzymes levels of GDM group in liver and pancreas tissues were lower than the other groups,and after treatment of okra extract,antioxidant enzymes levels in liver and pancreas tissues were equivalent to control group(P>0.05).Conclusions:Okra extract,rich in antioxidant substances,could avoid the excessive consuming of antioxidant enzymes,then,suppresses the oxidative stress and insulin resistance,thereby improving blood glucose level of GDM rats.