末稍微量血糖GDM筛查516例分析

目的 :探讨糖筛查试验异常对母儿预后的影响。方法 :将50g糖筛查异常而葡萄糖耐量试验正常即单纯糖筛查异常108例列为观察组 ,50g糖筛查正常者402例列为对照组 ,对照观察两组的母儿并发症。结果 :观察组母儿并发症 :羊水过多、感染、手术产、巨大儿、新生儿重度窒息、病理性黄疸发生高于对照组。结论 :对单纯糖筛查异常者应予监测及治疗 ,以改善母儿预后。

中文版血糖监测系统满意度调查量表信效度研究

背景随着糖尿病人群的增加,血糖监测设备越来越多种多样,采用量化的方式来精准地评估患者对血糖监测设备的满意度对患者的血糖管理积极性具有重要意义。血糖监测系统满意度调查(GMSS)量表在美国、丹麦等国家均具有良好的信效度,但是否适用于中国,还未经检验。目的本研究旨在检验中文版GMSS量表在糖尿病人群中应用的信度与效度。方法本研究采用便利抽样法于2018年6-10月选取北京市一街坊社区、二街坊东社区、田村路街道社区符合要求的糖尿病患者475例为调查对象。采用一般资料调查问卷、中文版GMSS量表、幸福感指数量表(WHO-5)、血糖监测系统评分问卷(BGMSRQ)、糖尿病痛苦量表(DDS)进行问卷调查。在征得GMSS量表原作者同意后,由作者及两名双语学者分别对中文版及英文版量表进行翻译和回译,形成初步的中文版GMSS-1型糖尿病(T1DM)量表和GMSS-2型糖尿病(T2DM)量表。将初步汉化的量表及评分表发给8名糖尿病相关领域的专家,专家对量表的内容效度和跨文化调适做出评价并给予修改意见,并且对量表的每个问题与“血糖监测系统满意度”之间的相关性进行评分,将修改后的量表返回专家再次进行评分,计算内容效度后形成最终的中文版GMSS量表。分析患者的一般资料;对患者的中文版GMSS-T1DM量表、GMSS-T2DM量表总分和各维度得分分别与WHO-5、BGMSRQ、DDS得分进行Pearson相关分析,计算相关系数,反映中文版GMSS量表的校标效度;采用探索性因子分析评价中文版GMSS量表的结构效度;采用Cronbach'sα系数评价中文版GMSS量表的内部一致性信度;2周后按照各社区样本量所占比例随机选取30例糖尿病患者重新发放中文版GMSS量表,以计算量表的重测信度。结果共发放问卷475份,回收有效问卷463份,问卷有效回收率为97.47%,其中T1DM患者256例,T2DM患者207例。经专家评定,中文版GMSS-T1DM量表平均内容效度指数(CVI)值为0.910,中文版GMSS-T2DM量表平均CVI值为0.925。中文版GMSS-T1DM量表总分、开放性维度得分、信任维度得分与WHO-5得分、BGMSRQ得分呈正相关,与DDS-T1DM得分呈负相关,情感负担维度得分、行为负担维度得分与WHO-5得分、BGMSRQ得分呈负相关,与DDS-T1DM得分呈正相关;中文版GMSS-T2DM量表总分、开放性维度得分与WHO-5得分、BGMSRQ得分呈正相关,与DDS-T2DM得分呈负相关,情感负担维度得分、行为负担维度得分与WHO-5得分、BGMSRQ得分呈负相关,与DDS-T2DM得分呈正相关,价值维度得分与WHO-5得分、BGMSRQ得分、DDS-T2DM得分均呈正相关(P<0.05)。探索性因子分析显示两版本中文版GMSS量表最终提取4个公因子,各条目因子负荷范围为0.612~0.913,中文版GMSS-T1DM累积方差贡献率为66.50%,中文版GMSS-T2DM累积方差贡献率为67.65%。中文版GMSS-T1DM量表内部一致性Cronbach'sα系数为0.87,开放性、情感负担、行为负担、信任4个维度的Cronbach'sα系数分别为0.82、0.83、0.81、0.83。中文版GMSS-T2DM量表内部一致性Cronbach'sα系数为0.90,开放性、情感负担、行为负担、价值4个维度的Cronbach'sα系数分别为0.81、0.80、0.84、0.85。中文版GMSS-T1DM量表与GMSS-T2DM量表的重测信度为0.86、0.91,分半信度系数为0.89、0.90。结论中文版GMSS量表两个版本的内容效度、效标效度、结构效度以及内部一致性信度均良好,可用于糖尿病患者的血糖监测系统满意度的评估。

改良安德鲁低血糖危险因素分层量表在2型糖尿病患者低血糖管理中的应用效果

目的探究改良安德鲁低血糖危险因素分层量表在2型糖尿病(T2DM)患者低血糖管理中的应用效果。方法选取136例T2DM患者作为对照组,142例T2DM患者作为观察组。两组患者均给予规范化治疗及护理,观察组在此基础上应用改良安德鲁低血糖危险因素分层量表进行评估,依据评估结果进行分层管理。比较两组患者的低血糖发生率、低血糖知识掌握程度及住院满意度。结果观察组的低血糖发生率明显低于对照组(P<0.05)。干预后,两组的低血糖知识掌握程度各项评分均升高,且观察组明显高于对照组(P<0.05)。对照组的住院满意度明显高于观察组(P<0.05)。结论改良安德鲁低血糖危险因素分层量表在T2DM患者低血糖管理中的应用效果显著,能够显著降低低血糖发生率,提高患者低血糖知识掌握程度及住院满意度。

低血糖恐惧行为和忧虑与低血糖关系及影响因素

目的探讨低血糖恐惧量表中行为量表和焦虑量表分别与2型糖尿患者低血糖的关系,及两个量表的影响因素。方法门诊病程>1年的2型糖尿病患者478例,调查一般资料、低血糖恐惧忧虑量表、行为量表。结果262例调查者(54.8%)发生过低血糖。发生低血糖患者与行为量表及忧虑量表得分高于未发生者,差异有统计学意义(P<0.001);两个量表均与是否发生低血糖、近3月低血糖发生频次、低血糖发生类型相关(P<0.001)。运动、血糖监测频率、因低血糖入院、近3月低血糖发生频次、夜间发生低血糖是行为量表高评分的危险因素,使用磺脲类药物是保护性因素(均P<0.05)。因低血糖入院、近3月低血糖发生频次、住院频率、夜间低血糖、家庭人均月收入是忧虑量表高评分的危险因素,周围神经病变、糖化血红蛋白是保护性因素(P<0.05)。结论低血糖恐惧量表中行为量表和焦虑量表均与2型糖尿患者低血糖相关,两个量表影响因素不尽相同,需综合评估。

ICU患者早期胃肠内营养的临床观察及护理

目的 探讨ICU患者在接受早期胃肠内营养干预期间配合护理干预后获得临床效果。方法 将辽宁省辽阳市中心医院2016年8月至2019年4月收治的60例ICU患者通过数字奇偶法分组,综合护理组(30例)采用普通护理干预方式+综合护理干预方式配合完成早期胃肠内营养干预,对照组(30例)采用普通护理干预方式配合完成早期胃肠内营养干预,就组间血浆总蛋白、血清白蛋白、血糖、并发症发生情况展开对比。结果 护理前,综合护理组ICU患者血浆总蛋白水平、血清白蛋白水平、血糖水平分别为(62.99±7.05)g/L、(36.93±3.86)g/L、(5.32±2.35)mmol/L,同对照组的(62.99±7.89)g/L、(36.93±3.93)g/L及(5.29±2.36)mmol/L比较,差异无统计学意义(P> 0.05);护理后,综合护理组血浆总蛋白水平、血清白蛋白水平分别为(74.02±7.03)g/L、(45.06±4.96)g/L,均高于对照组的(69.08±7.89)g/L及(38.99±3.99)g/L,差异有统计学意义(P <0.05);综合护理组血糖水平为(5.92±2.59)mmol/L,与对照组的(5.95±2.46)mmol/L比较,差异无统计学意义(P> 0.05);两组ICU患者完成营养支持及护理后,其并发症主要集中于腹泻、堵管、脱管及压疮方面;综合护理组并发症总发生率(10.00%)低于对照组(53.33%),差异有统计学意义(P <0.05)。结论 综合护理干预方式的有效应用可使得ICU患者接受早期胃肠内营养干预后获得理想的效果,能够将患者血浆总蛋白、血清白蛋白显著改善,同时充分减少患者腹泻、堵管、脱管及压疮等症状的出现,最终实现ICU患者生活品质提升及有效预后。

Increased plasma malondialdehyde and fructosamine in anemic H pylori infected patients:Effect of treatment

AIM： TO unravel the possible association of malondialdehyde （MDA） and fructosamine in anemic H pylori infected patients and to observe the alteration in MDA and fructosamine levels in these patients after treatment for one month. METHODS： Fructosamine, MDA and glucose were estimated in 22 anemic H pylori infected patients and 16 healthy controls. Hematological parameters were also evaluated in both the groups using Sysmex-K-100 automated cell counter. The H pylori infected patients were randomly divided into two groups. Hpylori infected patients in Group Ⅰ received both iron supplementation and anti-H pylori therapy, while patients in Group Ⅱ received only iron supplementation. All the biochemical and hematological parameters were estimated after one month of treatment. RESULTS： In anemic H pylori infected patients, while MDA （5.41 ± 2.16 vs 2.26 ± 0.50; P 〈 0.05） and fructosamine （2.64 ± 0.93 vs 1.60 ± 0.35; P 〈 0.05） were significantly increased, iron （32.72 ± 14.93 vs 110.25 ± 26.58; P 〈 0.05）, hemoglobin （6.9 ± 2.6 vs 12.66 ± 0.74; P 〈 0.05） and ferritin （28.82 ± 16.27 vs 140.43 ± 30.72; P 〈 0.05） levels were significantly decreased compared with the controls. With partial correlation analysis, fructosamine was found to have a significant positive correlation with MDA. In Group I, while MDA level decreased significantly （3.11 ± 1.73 vs 5.50 ± 2.46; P 〈 0.05）, there was a significant increase in iron （84.09 ± 29.51 vs 36.09 ± 17.81; P 〈 0.05）, hemoglobin （10.40 ± 1.11 vs 7.42 ± 1.90; P 〈 0.05） and ferritin （116.91 ± 63.34 vs 30.46 ± 17.81; P 〈 0.05） levels after one month. There was no significant change in the levels of fructosamine in group Ⅰ after treatment. Similarly, no significant alterations were noted in the levels of IDA, fructosamine, hemoglobin or ferritin in Group Ⅱ patients after one month of treatment. CONCLUSION： An increased level of fructosamine and MDA was found in anemic H pylori infected patients. Present data supports the premise that lipid peroxides per se do play a role in the glycation of plasma proteins. Furthermore, the findings from this study indicate that treatment for both anemia and H pylori infections is required for lowering the levels of lipid peroxides in these patients.

Phytogenic Feed Additive for Sows： Effects on Sow Feed Intake, Serum Metabolite Concentrations, IgG Level, Lysozyme Activity and Milk Quality

The objective of this study was to investigate the influence ofa phytogenic feed additive （PFA） to late-gestation （d 90） and lactation sows on their reproduction performance. Sixty Large White × Landrace primiparous sows were divided into four groups （fifteen sows per group）. The control group was fed with basal diet, the others were fed with basal diet supplemented with 0.02%, 0.04% and 0.06% PFA, respectively. Compared with the control, the sows in 0.04% PFA group had higher feed intake during lactation and higher litter weaning weight （P 〈 0.05）. At farrowing, glucose level in 0.04% PFA sows was higher than the control and sows in 0.02% PFA had the highest IgG content among the treatments （P 〈 0.05）. On day 7 of lactation, serum urea nitrogen contents were lower in response to PFA supplementation compared to the control （P 〈 0.05）. At the same time, sows fed the 0.06% PFA diet increased the lysozyme activity （P 〈 0.05）. The levels of milk lactose and IgG were increased in 0.02% and 0.04% PFA groups （P 〈 0.05）. In conclusion, feeding PFA improved sows and litter performance, serum metabolite concentrations, lgG level and lysozyme activity at postpartum and milk quality.

Non-invasive glucose measuring apparatus based on conservation of energy method

A new non-invasive blood glucose measuring apparatus (NBGMA) made up of MSP430F149 SCM (single chip micyoco) was developed,which can measure blood glucose level (BGL) frequently,conveniently and painlessly. The hardware and software of this apparatus were designed,and detecting algorithms based on conservation of energy method (COEM) were presented. According to the law of conservation of energy that the energy derived by human body equals energy consumed by metabolism,and the relationship between convection,evaporation,radiation and the BGL was established. The sensor module was designed. 20 healthy volunteers were involved in the clinical experiment. The BGL measured by an automatic biochemical analyzer (ABA) was set as the reference. Regression analysis was performed to compare the conservation of energy method with the biochemical method,using the 20 data points with blood glucose concentrations ranging from 680 to 1 100 mg/L. Reproducibility was measured for healthy fasting volunteers. The results show that the means of BGL detected by NBGMA and ANA are very close to each other,and the difference of standard deviation (SD) is 24.7 mg/L. The correlative coefficient is 0.807. The coefficient of variation (CV) is 4% at 921.6 mg/L. The resultant regression is evaluated by the Clarke error grid analysis (EGA) and all data points are included in the clinically acceptable regions (region A:100%,region B:0%). Accordingly,it is feasible to measure BGL with COEM.

Analysis on blood glucose excursions in well-controlled patients with type 2 diabetes mellitus

Objective:To probe glycemic excursions in type 2 diabetic patients whose hemoglobin A1c(HbA1c) was kept ≤6.0%.Methods:Totally 36 cases with type 2 diabetes(T2DM) with HbA1c≤6.0% and 30 cases with normal glucose tolerance(NGT) from December 2005 to December 2007 in our department were subjected prospectively.Continuous glucose monitoring system(CGMS) was employed to record their continuous blood glucose level for 3 d.The blood glucose profiles including the mean blood glucose(MBG),standard differentiation(SD),mean amplitude of glycemic excursions(MAGE) and absolute means of daily differences(MODD) were analyzed.Results:T2DM group had obviously postprandial hyperglycemia,in about 2 h after meal,especially after breakfast.Fifty-two hypoglycemic episodes occurred during the monitoring period in T2DM groups,of which 73.1%(38 episodes) were absence of symptomatic hypoglycemia with the lowest value of blood glucose only 2.0 mmol/L.And 20 episodes took place during the day hours,while 32 episodes observed during the night hours.Compared with NGT groups,SD,MAGE and MODD were all significantly higher in T2DM groups.MBG was significantly correlated with HbA1c in T2DM groups,but SD,MAGE,NGE and MODD were all independent of HbA1c.MAGE was independent of MODD.Conclusion:The amplitude of glycemic excursions is higher in normol-controlled T2DM groups than the NGT groups.Thus ideally glycemic control is not only to make HbA1c reach standard,but also to lessen glycemic excursions and reduce hypoglycemia episodes.

Effect of Transport Times on Welfare of Pigs

The aim of the study was to investigate effect of transport times of up to 12 h on pigs＇ welfare. An observation box was located on the 3rd floor of the vehicle. Device to measure temperature, humidity and video camera to monitor pigs＇ behaviors were fitted in the box. Eighteen measurements were performed during two seasons for 4, 8, and 12 h of transport time with three replications. Meat samples were taken from longissimus dorsi （LD） and the carcases were chilled for 24 h at ＋4 ~C for pH determination. To determine cortisol, glucose, lactate, and creatine kinase concentration levels, blood samples were collected before and after transport from 90 pigs and from 20 controls that were not transported for control purposes. To evaluate behavioural alterations, frequency of events and durations were considered. Highest pH24 of 5.99 ＋ 0.29 occurred during summer at 12 h transport time. Cortisol concentrations elevated during short and decreased with an increase of transport time （P 〈 0.001）. Highest and lowest glucose concentrations for winter and summer were at 8 and 12 h transport time, respectively （P 〈 0.01）. Concentrations of lactate and creatine kinase positively correlated with transport time （P 〈 0.002）. Lying, sitting, rooting and vocalization behaviours correlated with transport time （P 〈 0.009）. Certain THI values during summer surpassed normal （〉 74） level during loading. The pH24 value correlated with transport time during summer. Lactate and creatine kinase concentrations increased with an increase in transport time but for Glucose, highest value was at 8 h transport time.

Effects of 95%ethanol extract of Aquilaria sinensis leaves on hyperglycemia in diabetic db/db mice

The leaves of Aquilaria sinensis（Lour.） Gilg have been used in folk medicine for the treatment of diabetes in Guangdong Province,China.In this study,effects of ethanol extract of Aquilaria sinensis leaves on hyperglycemia were investigated in diabetic db/db mice.After 4 weeks of administration,the 95%ethanol（EtOH） extract of Aquilaria sinensis leaves （AE）,especially at high dose level（600 mg/kg）,activated AMP-activated protein kinase（AMPK）,resulting in reduced fasting blood glucose and glycosylated hemoglobin levels in db/db mice.In addition,the oral glucose tolerance test（OGTT test） showed that AE could remarkably improve insulin resistance.Compared to Thiazolinediones（TZDs）,no weight gain was observed after AE administration,which is a severe side effect of TZDs.The data suggested that AE could act as an activator of AMPK,and might be used as an alternative to TZDs in the management of obesity-related diabetes.

Increased risk of hyperglycemia associated with the use of everolimus in patients with cancer: a systematic review and meta-analysis

Everolimus is an orally administered rapamycin analogue that has been approved to treat several types of solid tumors. However, some patients develop hyperglycemia after being treated with everolimus. In this meta-analysis, we aimed to evaluate the incidence and risk of hyperglycemia in patients with cancer who received everolimus. We searched the medical literature, as index in the Cochrane Library, PubMed, EMBASE, and abstracts from the top scientific meetings （AACR, ASCO, and ESMO）. Our meta-analysis included the randomly controlled trials published before November 2014. We calculated overall incidence, relative risk （RR） and 95% confidence intervals （CI） using fixed-effects or random-effects models, depending on the heterogene- ity among the trials. A total of 3377 patients （everolimus： 1971; control： 1406） from 8 randomized clinical trials were included in the meta-analysis. In the everolimus groups, the incidence of all grades of hyperglycemia was 20.0% （95% CI： 11.0%-29.0%）, while the incidence of high-grade hyperglycemia was 6.0% （95% CI： 3.0%-8.0%）. Patients treated with everolimus had an in- creased risk of hyperglycemia as compared with that of controls （all-grade RR： 2.94, 95% CI： 2.34-3.70; high-grade RR： 4.66, 95% CI： 2.75-7.89）. Everolimus significantly increased the risk of hyperglycemia. This risk may depend on the tumor type and the everolimus dosage.

Retrospective study of Traditional Chinese Medicine treatment of type 2 diabetes mellitus

OBJECTIVE: To provide clinical evidence in support of Dahuang Huanglian Xiexin decoction(DHXD) to treat type 2 diabetes mellitus(T2DM) and to introduce a new treatment option for clinicians.METHODS: Retrospective analysis was used to evaluate DHXD for the treatment of T2DM by analyzing clinical records of 183 cases. Patients with T2DM who met the inclusion criteria between January 1,2013 and January 1, 2014 were enrolled. The effects of the treatment were evaluated by the changes in fasting blood-glucose(FBG), postprandial blood sugar(PBG), hemoglobin A1c(Hb Alc), blood lipid profiles and body mass index(BMI) at 1, 2, 3 and 6 months. The changes in main symptoms were alsoevaluated. The dosage of Huanglian(Rhizoma Coptidis) and related factors were analyzed.RESULTS: There was a significant improvement in mean Hb A1C at 3 and 6 months after DHXD treatment compared with the baseline level(P < 0.01).There were also significant improvements in FBG,PBG, blood lipid series and BMI. DHXD also improved the main symptoms of stomach and intestine excessive heat syndrome in patients with obese T2DM. Huanglian(Rhizoma Coptidis) was the most frequently used in 678 clinical visits, the dosage of Huanglian(Rhizoma Coptidis) was related to age, BMI, DM duration, the level of blood glucose,and use of Western hypoglycemic drugs.CONCLUSION: This study suggests that DHXD could decrease blood glucose and improve T2DM symptoms and reduce body weight. The use of DHXD may indicate a new optional treatment for T2 DM.

Clinical Observations on the Dose-effect Relationship of Gegen Qin Lian Decoction (葛根芩连汤) on 54 Out-patients with Type 2 Diabetes

Objective: To observe the therapeutic effect of different dosages of Gegen Qin Lian Decoction (葛根芩连汤) on type 2 diabetic patients. Methods: Fifty-four type 2 diabetic patients from low dosage group (20 cases), medium dosage group (19 cases) and high dosage group (15 cases) were treated with different dosage of Gegen Qin Lian Decoction for 12 weeks. Fasting blood-glucose (FBG), postprandial blood sugar (PBG) and Hemoglobin A1c (HbAlc) were determined before and after treatment. Results: With the increase of dosage, the overall effective rate of glycaemic control increased, and FBG, PBG, HbAlc decreased. The overall effective rate of blood glucose control of high dosage, medium dosage and low dosage group were 80%, 47%, 30% respectively, and there were significant differences between high dosage group and low dosage group. The decrease of FBG, PBG and HbAlc of high dosage showed significant differences from low dosage too. These data was analyzed by trend χ2 test and covariance analysis. Conclusion: The result indicated that different dosage of Gegen Qin Lian Decoction has dose-effect relationship in reducing HbAlc and FBG.

T2 relaxation time measurements in the brains of scalded rats

This study aimed to evaluate the T2 relaxation time of the brain in severely scalded rats using a magnetic resonance （MR） T2 mapping sequence, and to investigate the correlation between T2 relaxation time and plasma glucose level. Twenty-eight Wistar rats were randomly divided into the scalded group （n = 21）and control group （n = 7）. Magnetic resonance scans were performed with T1WI, T2WI, and T2-mapping sequences in the scalded group; the scans were performed 1 day prior to scalding and 1, 3, 5, and 7 days post-scalding; in addition, identical MR scans were performed in the control group at the same time points. T2-maps were generated and T2 relaxation times were acquired from the following brain regions： the hippocampus, thalamus, caudate-putamen, and cerebrum. Pathological changes of the hippocampus were observed. The plasma glucose level of each rat was measured before each MR scan, and a correlation analysis was performed between T2 relaxation time and plasma glucose level. We found that conventional T 1WI and T2WI did not reveal any abnormal signals or morphological changes in the hippocampus, thalamus, caudate-putamen,： or cerebrum post-scalding. Both the T2 relaxation times of the selected brain regions and plasma glucose levels increased 1, 3, and 5 days post-scalding, and returned to normal levels 7 days post-scalding. The most marked increase of T2 relaxation time was found in the hippocampus; similar changes were also revealed in the thalamus, caudate-putamen, and cerebrum. No correlation was found between T2 relaxation time and plasma glucose level in scalded rats. Pathological observation of the hippocampus showed edema 1, 3, and 5 days post-scalding, with recovery to normal findings at 7 days post-scalding. Thus, we concluded that T2 mapping is a sensitive method for detecting and monitoring scald injury in the rat brain. As the hippocampus is the main region for modulating a stress reaction, it showed significantly increased water content along with an increased plasma glucose level post-scalding.

Effect of Yiqihuoxue prescription on myocardial energy metabolism after myocardial infarction via cross talk of liver kinase B1-depen-dent Notch1 and adenosine 5'-monophosphate-activated protein kinase

OBJECTIVE: To investigate the effect of Yiqihuoxue prescription(YQHX) from Traditional Chinese Medicine(TCM) on myocardial glucose and lipid metabolism after myocardial infarction via the cross talk between the liver kinase B1(LKB1)-dependent Notch1 and adenosine 5'-monophosphate(AMP)-activated protein kinase(AMPK). YQHX was prepared with substances with properties that benefit, to activate blood circulation based on the TCM theory.METHODS: Animal models of myocardial infarction were established by ligating Sprague Dawley rats' left anterior descending coronary arteries. The animals were randomly divided into a myocardial infarction(MI) group, a YQHX group, a perindopril group, a γ-secretase inhibitor, Notch signal inhibitor(DAPT) group, a DAPT+YQHX group and a sham group. The related drugs were administered on the second day after operation, and changes in the relevant indexes were examined on weeks 1 and 4.Changes in cardiac structure and function were examined by echocardiography. The glucose and free fatty acids(FFA) were examined by ELISA. The expression of Notch, LKB1 and AMPK m RNA was examined by a real-time fluorescence quantitative method. The expression of glucose transporter 4(GLUT4), and the expression of total acetyl-Co A carboxylase(ACC) and its phosphorylation were examined by western blotting.RESULTS: Compared with the sham group, the expression of Notch, LKB1 and AMPK m RNA in the MI group was lower. Compared with the MI group, the expression of these m RNAs in the YQHX and perindopril groups was higher, and their expression in the DAPT group was lower. At all time points, the protein expression of GLUT4 and p ACC decreased in the MI group. On week 1, the expression of p ACC protein was higher. In the DAPT group, the expression of p ACC protein decreased. Compared with the YQHX group, the expression of p ACC protein in the DAPT + YQHX group was lower. On week 4,compared with the MI group, the expression of GLUT4 protein in the YQHX group and the perindo-pril group was higher. The expression of GLUT4 protein in the DAPT group decreased. Compared with the YQHX group, the expression of GLUT4 protein in the DAPT+YQHX group was lower. There was no significant difference in the expression of ACC protein between the groups.CONCLUSION: YQHX promoted cross talk between the LKB1-dependent Notch1 and AMPK in myocardial tissue after myocardial infarction. Furthermore,it regulated the glucose and lipid metabolism of cardiomyocytes at different time points, thereby ameliorating the cardiac energy metabolism via different mechanisms and protecting the heart.