Effects of acupuncture at stellate ganglion on lower limb atherosclerosis of early diabetes mellitus

Objective To compare the efficacy between acupuncture at stellate ganglion combined with intravenous administration of alprostadil and simple intravenous administration of alprostadil on lower limb atherosclerosis of early diabetes mellitus.Methods Sixty patients of lower limb atherosclerosis of early diabetes mellitus were randomly divided into an observation group and a

Effect of sitagliptin combined with Yiqi yangyin huoxue decoction on clinical efficacy and hemorheology in early diabetic nephropathy

BACKGROUND Early diabetic nephropathy(DN)is a complication of diabetes mellitus.It mainly affects kidney microvessels and glomerular function,and its timely and effective treatment is critical for early DN.However,the effects of treatments comprising simple Western medicine are not optimal.With the promotion and implementation of integrated Chinese and western medicine treatments,remarkable results have been achieved for many diseases.To this end,we explored the clinical efficacy of integrated traditional Chinese and western medicines for the treatment of early DN.AIM To investigate the effect of sitagliptin tablets combined with Yiqi yangyin huoxue decoction on clinical efficacy and hemorheology in patients with early DN.METHODS Through a retrospective analysis,123 patients with early DN were admitted to the endocrinology clinic of the Changzhou NO.7 People’s Hospital from January 2021 to October 2022 and were selected as study subjects.After rigorous screening,100 patients with early DN were enrolled.The control group(CG,n=50)and the observation group(OG,n=50)were divided according to the treatment method.The CG were treated with sitagliptin,and the OG were treated with sitagliptin plus the Yiqi yangyin huoxue decoction.Both groups were treated for 3 mo.For both groups,the baseline data and clinical efficacy were compared,and changes in blood glucose levels,lipid levels,renal function,and hematological indicators before(T0)and after(T1)treatment were assessed.RESULTS The total effective rate for the OG was 94.00%and that of the CG was 80.00%(P<0.05).After treatment(T1),the levels of fasting blood glucose,2 h postprandial glucose,total cholesterol,triacylglycerol,and low-density lipoprotein cholesterol in OG patients were obviously lower than those in the CG(P<0.05),and cystatin C,homocysteine,urinary microalbumin,and blood creatinine values in OG patients were also obviously lower than those in the CG(P<0.05);erythrocyte deposition,plasma viscosity,whole blood high shear viscosity,and whole blood low shear viscosity were markedly lower in OG patients than in the CG(P<0.05).CONCLUSION Sitagliptin combined with Yiqi yangyin huoxue decoction has a remarkable effect when used to treat patients with early DN.Further,it is helpful in improving hemorheological indices and controlling disease progression.

Comparison of Snellen and Early Treatment Diabetic Retinopathy Study charts using a computer simulation

AIM：To compare accuracy,reproducibility and test duration for the Snellen and the Early Treatment Diabetic Retinopathy Study（ETDRS）charts,two main tools used to measure visual acuity（VA）.·M ETHODS：A computer simulation was programmed to run multiple virtual patients,each with a unique set of assigned parameters,including VA,false-positive and false-negative error values.For each virtual patient,assigned VA was randomly chosen along a continuous scale spanning the range between 1.0 to 0.0 log MAR units（equivalent to 20/200 to 20/20）.Each of 30 000virtual patients were run ten times on each of the two VA charts.·RESULTS：Average test duration（expressed as the total number of characters presented during the test±SD）was12.6±11.1 and 31.2±14.7 characters,for the Snellen and ETDRS,respectively.Accuracy,defined as the absolute difference（±SD）between the assigned VA and the measured VA,expressed in log MAR units,was superior in the ETDRS charts：0.12±0.14 and 0.08±0.08,for the Snellen and ETDRS charts,respectively.Reproducibility,expressed as test-retest variability,was superior in the ETDRS charts：0.23±0.17 and 0.11±0.09 log MAR units,for the Snellen and ETDRS charts,respectively.·CONCLUSION：A comparison of true（assigned）VA to measured VA,demonstrated,on average,better accuracy and reproducibility of the ETDRS chart,but at the penalty of significantly longer test duration.These differences were most pronounced in the low VA range.The reproducibility using a simulation approach is in line with reproducibility values found in several clinical studies.

Effect of Epalrestat combined with Huoxue Huayu preparation on early diabetic retinopathy and its effect on serum oxidative stress and inflammatory factors

Objective:To investigate the effect of Epalrestat combined with Huoxue Huayu preparation on early diabetic retinopathy and its effect on serum oxidative stress and inflammatory factors.Methods:132 patients with early diabetic retinopathy from June 2017 to July 2019 in our hospital were randomly divided into the control group(66 cases)and the observation group(66 cases);The control group was treated with epalrestat,and the observation group was treated with epalrestat combined with ginkgo damo injection;The treatment effect,blood rheology indexes,serum oxidative stress indexes and inflammatory factor indexes of the two groups were compared.Results:The treatment efficiency of the observation group(96.96%)was significantly higher than that of the control group(84.84%)(P<0.05).After 3 months of treatment,the high-cut whole blood viscosity(3.62±0.45 mPa/s),low-cut whole blood viscosity(1.54±0.26 mPa/s),erythrocyte sedimentation rate(15.63±2.97 mm/s)of the observation group compared with the control group(4.57±0.52 mPa/s,2.91±0.30 mPa/s,22.36±3.38 mm/s)were significantly lower(P<0.05).After 3 months of treatment,the SOD(93.41±10.17 nmol/mL)and TAC(20.57±3.76 u/mL)of the observation group compared with the control group(82.26±9.45 nmol/mL,18.26±3.63 u/mL)were significantly higher(P<0.05),and the MDA of the observation group(9.22±1.98 u/mL)was significantly lower than that of the control group(12.13±1.06 u/mL)(P<0.05).After 3 months of treatment,the CRP(9.74±1.12 mg/L),IL-2(70.37±12.13 ng/L),TNF-a(11.36±2.08 ng/L)of the observation group compared with the control group(15.28±1.73 mg/L L,82.46±10.58 ng/L,16.28±2.43 ng/L)were significantly lower(P<0.05).Conclusion:Epalrestat combined with Huoxue Huayu preparation is more effective in the treatment of early diabetic retinopathy,and can significantly improve the blood rheology indexes,serum oxidative stress indexes and inflammatory factor indexes of patients.

Cardiac functional and ultrastructural changes in early diabetic cardiomyopathy rabbits

Objectives It is not fully clarified how diabetes mellitus induced cardiac dysfunction and myocardial ultrastructural changes in the early state.In the present study,we provided an integrated approach to investigate early changes in myocardial function of diabetic rabbits and assessed the structural alteration.Methods and Results Diabetes was induced by alloxan injection.After 30 days,echocardio- graphy and left ventricular cannulation were performed in dia- betic(D,n=8) and control rabbits(C,n= 10).After catheterization, animals were killed for histological studies.Hema-toxylin -eosin and Masson’s Trichrome staining of the heart were analyzed.The ultrastructure of left ventricle was also examined with electron microscopy.Echocardiography revealed that early diabetic cardiomyopathy had impaired LV diastolic function expressed by diminished E-waves,increased Awaves, E/A ratio reversion and increased E-wave deceleration time(EDT).Concurrently,LV end-diastolic pressure(LVEDP) and diastolic time constant(T) were increased,minimum dP/ dt(LV-dp/dt)was reduced,obtained through cardiac catheterization.There were no significant differences in LV ejection fraction(EF),LV peak systolic pressure(LVSP), or maximum dP/dt(LV + dp/dt).Qualitative light microscopy revealed no histologic changes in myocardium from diabetic rabbits.The most evident ultrastructural change was spotted myofibrillar damage,while interstitial fibrosis was slight.Conclusions These results suggest that early diabetic cardiomyopathy in animal model is characterized by left ventricular diastolic dysfunction,both impaired active relaxation and increased passive chamber stiffness.Whereas,left ventricular systolic function can remain normal.It might partly contribute to myofibrillar damage,but not myocardial fibrosis.

Network Meta-analysis of Four Chinese Patent Medicines Combined with Angiotensin Converting Enzyme Inhibitors or Angiotensin Receptor Blockers in Early Diabetic Nephropathy Treatment

The objective of the study is to systematically evaluate the efficacy of four Chinese patent medicines in combination with angiotensin-converting enzyme inhibitors/angiotensin receptor blockers (ACEI/ARB) in the treatment of early diabetic nephropathy (DN). Retrospectively, previously published randomized controlled trials (RCTs) of four different Chinese patent medicines combined with ACEI or ARB in the treatment of patients with early DN were searched overall from databases. The data were analyzed by R, Generate Mixed Treatment Comparisons and STATA softwares. A total of 78 RCTs were finally included. Network meta-analysis showed that the total effective rate of the Jinshuibao capsule-ACEI/ARB combination group and Huangkui capsule-ACEI/ARB combination groups were better than the others;Jinshuibao capsule-ACEI/ARB combination group reduced the 24-h urinary protein excretion (24-h UTP), urine microalbumin excretion rate (UAER), serum creatinine (Scr), and glycosylated hemoglobin (HbAlc) values. The Huangkui capsule-ACEI/ARB combination demonstrated a better reduction of (blood urea nitrogen [BUN]). Reduced incidences of adverse effects were only observed on treatment with Bailing capsule-ACEI/ARB combination. In early DN, combination of Jinshuibao capsule-ACEI/ARB provided the highest effective rate;moreover, it could reduce the24-h values of UTP, UAER, Scr, and HbAlc;Huangkuai capsule-ACI/ARB combination group showed a good effect on reducing BUN. Bailing capsule-ACEI/ARB combination group had reduced the incidences of adverse reactions.

UTILITY OF ALBUSURE TEST IN SCREENING FOR EARLY STAGE OF DIABETIC NEPHROPATHY

all diabetic patients should be screened for the early stage of diabetic nephropathy,because microalbuminuria has a great prognostic significance.The albusure test(AT),alatex agglutination nephelometric immunoassay,is a rapid and low cost test for the detection of microalbuminurai of 30mg/L or more.

Association between interleukin- 1β- 511( C/T) gene polymorphism and early diabetic kidney disease

Objective To investigate the association between interleukin(IL)-1β-511(C/T)gene polymorphism and early diabetic kidney disease(EDKD)in Han population in Luzhou.Methods A total of 548 patients with type 2diabetes(T2DM)were enrolled in this study and divided into two groups:T2DM with normal albuminuria group(NA group,n=286)and T2DM with micro-albuminuria group(MA group,n=262).327 healthy subjects