Observation on Therapeutic Effect of Lotus Needle Cupping Therapy for Removing Blood Stasis in Zhuang Medicine on PHN and Its Influ-ence on Inflammatory Mediators

[Objectives]To observe the clinical effect of the lotus needle cupping therapy for removing blood stasis in Zhuang medicine in treating PHNand its influence on inflammatory factors.[Methods]96 patients with PHN were randomly divided into three groups:lotus nee-dle cupping therapy group,TCM surrounding acupuncture group and gabapentin group.Venous blood and acupoint blood were collected at 0,21 and 42 d of treatment,and the expression levels of 5-HT,SP and CGRPinflammatory mediators were detected before and after treatment.The changes of VAS scores before,during and after treatment and the clinical efficacy were observed.[Results]The total effective rate of the lotus needle cupping group was 87.50%,which was better than that of the TCM acupuncture group(81.25%)and the gabapentin group(62.50%);after treatment,the VAS scores and the expression of inflammatory mediators in the three groups of patients were lower than those before treatment,and the decrease was more significant in the treatment group(P<0.05).[Conclusions]The lotus needle cupping therapy for removing blood stasis in Zhuang medicine is effective in treating PHN,and its mechanism is to reduce the release of inflammatory media-tors,reduce hyperalgesia,relieve pain and improve the quality of life of patients.

Differences in serum inflammatory mediators in early blood culture positive and negative patients with bacterial bloodstream infection

Objective: To study the differences in serum inflammatory mediators in early blood culture positive and negative patients with bacterial bloodstream infection. Methods: Patients who were hospitalized due to suspected bacterial bloodstream infection between December 2015 and September 2017 were divided into positive group and negative group according to the results of blood culture, and healthy volunteers who underwent medical examination during the same period were selected as control group. Peripheral blood specimens were collected from patients with suspected bacteremia on admission, the peripheral blood specimens were collected from the control group of volunteers during physical examination, and the levels of pro-inflammatory cytokines, anti-inflammatory cytokines, adhesion factors and chemokines were determined. Results: Serum PCT, CRP, IL-6, IL-17, IL-23, IL-4, IL-10, IL-13, sTM, ICAM-1, VCAM-1, EOTAXIN-3 and MCP-1 levels of positive group and negative group were significantly higher than those of control group, and serum PCT, CRP, IL-6, IL-17, IL-23, IL-4, IL-10, IL-13, sTM, ICAM-1, VCAM-1, EOTAXIN-3 and MCP-1 levels of positive group were significantly higher than those of negative group. Conclusions: Detection of serum inflammatory mediators can early predict the bacterial bloodstream infection.

A Clinical Study on the Treat ment of Chronic Pelvic Inflammation of Qi-stagnation with Blood Stasis Syndrome by Penyanqing Capsule (盆炎清胶囊)

Objective： To observe the clinical efficacy of Penyanqing Capsule （盆炎清胶囊, PYQC） in treating pelvic inflammation of Qi-stagnation with blood stasis syndrome. Methods： The randomized, single blinded, parallel positive drug controlled method was adopted, with 82 patients assigned into two groups by envelop method. The 42 patients in the treated group received PYQC 3 times a day, 4 capsules each time taken orally; the 40 patients in the control group were given orally Fuyankang tablets （妇炎康片, FYKT） 3 times a day, 6 tablets each time. The therapeutic course for both groups was 2 months, and 2 courses of treatment were given successively to observe the comprehensive effect, changes of symptoms and signs before and after treatment. The effects of PYQC on hemorrheological character in part of the patients and on the pathogenetic chlamydia and mycoplasma were also observed. Results： The total effective rate in the treated group was 83.3%, which was insignificantly different from that in the control group （77.5%, P〉0.05）. However, PYQC could significantly lower the hemorrheologic indexes in patients and showed definite influence on the pathogenetic chlamydia and mycoplasma. Conclusion： PYQC has good therapeutic effect in treating chronic pelvic inflammation of Qi-stagnation with blood stasis syndrome, and showed definite effect on chlamydia and mycoplasma.

Long-Term Continuous Light Exposure Affects Body Weight and Blood Glucose Associated with Inflammation in Female Rats

Studies have indicated that night lights interfere with the circadian rhythm in the human body and threaten human health. Our previous studies indicated that continuous light exposure severely damages the reproductive endocrine system of female rats resembles polycystic ovary syndrome in women. In this study, we used the continuous measurement method to observe changes in the basal physiological indicators of female rats in an abnormal light exposure environment. Our study results indicated that in female rats: 1) the body temperature first continuously and gradually increased followed by a gradually decrease;2) the increase in body weight slowed down at the late stage of the experimental process;3) the random blood glucose level increased, and the fasting serum insulin level decreased;and 4) the serum C-reactive protein level increased. Our study investigated for the first time the correlation between the duration of continuous light exposure in female rats and the continuously measured basal physiological indicators and preliminarily discussed the effect of continuous light exposure on female basal metabolism and the possible inflammation mechanism. We propose that long-term continuous exposure to night lights in females severely damages their immune and metabolic systems.

Novel Approach to Microbiological Study of Chronic Inflammations at Upper Respiratory Tract: Research of Blood L-Form Microbiota

Background: The recognition of human blood microbiota, consisting of cell wall-deficient microbes (L-forms), is a major challenge today in the field of microbiology. There are accumulating data confirming the concept of “internal” blood L-form microbiota and its significance for health and diseases. Finding out whether the blood microbiota can be of diagnostic and prognostic importance for detection and evaluation of chronic infections anywhere in the body is a major objective. In the context of chronically infected upper respiratory tract (URT), the aim of the current study was to understand whether a local infection can be a source for entry of bacteria and fungi in the blood. Methods: Blood samples from six persons with chronic inflammations in URT diagnosed with hypertrophied adenoids, chronic sinusitis, nasal polyps, chronic naso-pharyngitis and one control healthy person were studied. Blood microbiota assessment methodology that be used, included three phases: 1) isolation of L-form cultures from blood-development and propagation;2) cultivation directed to conversion of L-forms into bacterial and fungal cultures;3) isolation of pure classical bacterial and fungal cultures and their identification by MALDI-TOF method. Results: From the patients were isolated L-forms of opportunistic bacteria (Streptococcus mitis, Roseomonas mucosa, Dermacoccus nishinomiyaensis, Enterococcus faecalis, Acinetobacter johnsonii, Pseudomonas putida, Staphylococcus aureus, Pseudomonas luteola, Enterobacter cloacae) and fungi such as Rhodotorula mucilaginosa, Aspergillus niger, Aspergillus fumigatus and Mucorales. Conclusion: The novel innovative methodology for assessment of blood L-form microbiota was successfully applied for detection of microbes responsible for chronic infections at URT.

INTRACAMERAL INJECTION OF PLATELET ACTIVATING FACTOR AS A MEDIATOR OF INTRAOCULAR INFLAMMATION IN RABBIT EYES

Objective To evaluate platelet activating factor (PAF) induced aqueous liare, corneai edema, pupillary constriction and btphasic intraocular pressure (IOP) changes in the rabbit eyes. Methods PAF was delivered into anterior chamber by intracameral injection, other antagonists were administered systemically. Results PAF induced responses in a dose - dependent manner. All of the responses to PAF were inhibited by the PAF receptor antagonist, BN 52021 (20mg/kg, i.p.). The cyclooxygenase inhibitor, indomethacin (30mg/kg, i.P.) caused signofcant inhibition of the early phase PAF- induced aqueous flare, pupillary constriction and intraocular hypertension, but did not alfect PAF- induced corneal edema or intraocular hypotension. Nordihydroguaiaretic acid (NDGA) (10mg/kg, ip.), a lipoxygenase inhibitor, did not inhibit the inflammatory effects of PAF. Conclusion These data suggest that PAF may be an important mediator of intraocular inllammation and that some PAF- induced effects are prostaglandin dependent, while others may be independent of eicosanoid synthesis and release.

Silica inflammation modulates lipoperoxide and thi-obarbituric acid reactive substances levels in liver and glucose concentration in blood of alloxan diabetic rats

Inflammatory granulomatous diseases are cha- racterized by a high concentration of granu- lomas in tissue interstitium in which phagocytic cells that produce active oxygen and nitrogen metabolites are accumulated. Because of their high reactivity, free radicals react with unsatu- rated fatty acids that are components of mem- brane phospholipids, activate lipid peroxidation processes (LPP), the products of which have a cytotoxic effect. The role of free radicals in the pathogenesis of diabetes and its complications has been proved. The purpose of the present work was to investigate the activity of lipid peroxidation processes in the liver of rats with silica-induced granulomatous inflammation, allo- xan diabetes and their combination. The expe- riment involved male albino rats divided into four main groups. The first group were rats with silica granulomatous inflammation (SL rats);the second group were alloxan diabetic rats (DB rats);and the third group were alloxan diabetic rats, in which silica granulomatous inflammation was induced 8 days after the disease onset (DB_SL rats), the fourth group were rats that were injected saline physiological solution into the tail vein (control rats). Rats were withdrawn from the experiment within different time pe- riods after the induction of pathological pro- cesses. LPP activity in liver homogenates was determined by the relative concentration of lipo- peroxides in the heptane-isopropanol system and the concentration of products of the reac- tion with 2-thiobarbituric acid-reactive substan- ces (TBARS). The severity of carbohydrate meta- bolism disorders was evaluated through the measurement of the blood level of glucose, daily urine volume and the relative weight of the kindneys. We found that silica administration activated LPP in the liver of SL rats;we ob- served the accumulation of primary products on day 1 after administration and later that of TBA- RS followed by normalization of their concen- tration by day 21 of the experiment. TBARS con- centration was higher in DB rats than in the control at all stages of the experiment indicating the maintenance of high LPP activity in the liver of DB rats. TBARS concentration in the liver of DB_SL rats decreased by 3 times by the end of the experiment compared to DB rats, at the same time, they displayed a decreased blood glucose concentration, reduced diuresis and relative weight of the kidneys caused by hyperglycemia and associated polyuria. We conclude that one of the possible mechanisms of the influence on silica granulomatous inflammation on the cour- se of alloxan diabetes can be 1) a reduced LPO activity in liver cells at the lates stages of gran- ulomagenesis process induced by a single dose of a suspension of silica microparticles and 2) a combined decrease in glucose production in the liver of alloxan diabetics rats.

Effects of blood purification combined with Xuebijing on coagulation, immunity, inflammation and vascular factors in sepsis patients

Objective:To investigate the effects of blood purification combined with Xuebijing on coagulation, immunity, inflammation and vascular factors in sepsis patients.Methods: 82 sepsis patients admitted to the Xuzhou Municipal Hospital Affiliated to Xuzhou Medical University from January 2017 to January 2019 were selected as the research objects. According to the random drawing method, 41 cases in the control group and 41 cases in the observation group were divided into two groups. The control group was treated with routine western medicine, including antibiotic therapy, blood sugar control, respiratory support and nutritional support. The observation group was treated with continuous blood purification combined with Xuebijing on the basis of the control group. The changes of coagulation index, immune factor, inflammatory reaction and vascular factor levels were observed before and after treatment in two groups.Results:After treatment, the levels of activated partial thromboplastin time (APTT), prothrombin time (PT), D-Dimer (DD), CD8+, procalcitonin (PCT), Tumor Necrosis Factor-α (TNF-α), high mobility group box-B1 (HMGB1) and soluble fms-like tyrosine kinase,(sFLT)in the two groups were significantly lower than those before treatment, while the levels of CD4+, CD4+/CD8+, and vascular endothelial growth factor (VEGF) were significantly higher than those before treatment;and the levels of APTT, PT, DD, CD8+, PCT, TNF-a, HMGB1 and sFLT in the observation group after treatment were significantly lower than those in the control group, the levels of CD4+, CD4+/CD8+, and VEGF in the observation group after treatment were significantly higher than those in the control group, there was a significant difference in each indexes between the different groups after treatment. Conclusions:Continuous blood purification combined with Xuebijing therapy can effectively improve the coagulation function of sepsis patients, enhance the immune mechanism of patients, reduce inflammation and protect vascular endothelial function. It has clinical popularization significance.

Effects of complex salvia miltiorrhiza on blood coagulation, inflammation, oxidative stress and endothelial index in patients with acute pancreatitis

Objective: To investigate the effects of complex salvia miltiorrhiza on blood coagulation, inflammation, oxidative stress and endothelial index in patients with acute pancreatitis. Methods: A total of 122 patients with acute pancreatitis admitted to digestive system department in our hospital from April 2016 to November 2017 were randomly divided into control group (n=61) and observation group (n=61), the control group was treated with ulinastatin and the observation group was treated with complex salvia miltiorrhiza injection on the basis of the control group. The levels of coagulation, inflammation, oxidative stress and endothelial markers were compared between the two groups. Results: After treatment, the levels of APTT and PT in the two groups were significantly higher than those before treatment, while the levels of DD were significantly lower than those before treatment, and the levels of APTT and PT [(38.19±7.05) s,(17.60±3.68) s] in the observation group were significantly higher than those in the control group, while the levels of DD [(0.51±0.10) mg/L] in the observation group were significantly lower than those in the control group;the levels of CRP, PCT and TNF-α in the two groups were significantly lower than those before treatment, and the levels of CRP, PCT and TNF-α [(29.10±4.76) mg/L, (0.59±0.17) μg/L, (57.28±10.61) ng/L] in the observation group were significantly lower than those in the control group;the levels of SOD in the two groups were significantly higher than those before treatment, but MDA was significantly lower than that before treatment, and the level of SOD [(179.10±4.76) U/mL] in the observation group was significantly higher than that in the control group after treatment, while the level of MDA [(1.97±0.55) mmol/mL] in the observation group was significantly lower than that in the control group after treatment;the levels of NO in the two groups were significantly higher than those before treatment, while the levels of ET and vWF were significantly lower than those before treatment, and the levels of NO [(10.56±1.17) U/mL] in the observation group were significantly higher than those in the control group after treatment, while the levels of ET and vWF [(105.83±5.20) pg/mL, (102.47±16.91)%] in the observation group were significantly lower than those in the control group after treatment. Conclusions:Complex salvia miltiorrhiza injection can improve the blood coagulation function, alleviate inflammation, enhance antioxidant function and vascular endothelial function in patients with acute pancreatitis, which has clinical value of promotion.

New translational and experimental insights into the role of proresolving lipid mediators in inflammatory bowel disease

The resolution of inflammation is an active process,guided by specialized proresolution lipid mediators(SPMs).These mediators originate from polyunsaturated fatty acids,such as omega-3.Sufficient evidence suggests that the beneficial effects attributed to omega-3 are,at least in part,the result of the immunomodulatory action of the SPMs,which act systemically by overcoming inflammation and repairing tissue damage,without suppressing the immune response.Recent studies suggest that an imbalance in the synthesis and/or activity of these compounds may be associated with the pathogenesis of several inflammatory conditions,such as inflammatory bowel disease(IBD).Thus,this review highlights the advances made in recent years with regard to the endogenous synthesis and the biological role of lipoxins,resolvins,protectins,and maresins,as well as their precursors,in the regulation of inflammation;and provides an update on the participation of these mediators in the development and evolution of IBD and the therapeutic approaches that these immunomodulating substances are involved in this context.

Dynamic Non-Invasive Detection of NADH Based on Blood Flow-Mediated Skin Fluorescence (FMSF) Method

Nicotinamide adenine dinucleotide (NADH/NAD+) is involved in important biochemical reactions in human metabolism, including participation in energy production by mitochondria. The changes in fluorescence intensity as a function of time in response to blocking and releasing of blood flow in a forearm are used as a measure of oxygen transport with blood to the tissue, which directly correlates with the skin microcirculation status. In this paper, a non-invasive dynamic monitoring system based on blood flow-mediated skin fluorescence (FMSF) technology is developed to monitor the NADH fluorescence intensity of skin tissue during the process of blocking reactive hyperemia. Simultaneously, laser speckle contrast imaging (LSCI) and laser Doppler flowmetry (LDF) were used to observe blood flow, blood oxygen saturation (SOt2) and relative amount of hemoglobin (rHb) during the measurement process, which helped to explore NADH dynamics relevant physiological changes. A variety of parameters have been derived to describe NADH fluorescence curve based on the FMSF device. The experimental results are conducive to understanding the NADH measurement and the physiological processes related to it, which help FMSF to be a great avenue for in vivo physiological, clinical and pharmacological research on mitochondrial metabolism.

Evaluation of the blood coagulation function, degree of inflammation as well as apoptosis in brain tissue of rat models with heat stroke

Objective:To study the blood coagulation function, degree of inflammation as well as apoptosis in brain tissue of rat models with heat stroke. Methods: Healthy male SD rats were selected as experimental animals and randomly divided into heat stroke group and control group, heat stroke group were raised under the condition of environment temperature (40.0±0.5)℃and relative humidity 60%to establish heat stroke models, the anus temperature reached 42.5℃, and the control group were conventionally raised;60 and 120 min after model establishment, the blood coagulation function, serum inflammatory factor levels as well as brain water content, the number of apoptotic cells and apoptotic molecule expression were determined respectively. Results: (1) blood biochemical indexes:Activated partial thromboplastin time (APTT) and prothrombin time (PT) of heat stroke group were longer than those of control group, and serum D-Dimer content (D-D), tumor necrosis factor-α(TNF-α), interleukin-1β(IL-1β) and IL-6 levels were significantly higher than those of control group (P<0.05);(2) the brain tissue damage indexes:brain water content, the number of apoptotic cells, Caspase-3 expression and LC3-II/LC3-I ratio of heat stroke group were significantly higher than those of control group (P<0.05). Conclusions:There are blood coagulation dysfunction and systemic inflammation activation in heat stroke model rats, and the apoptosis in brain tissue increases obviously.

Influence of continuous blood purification on inflammation and target organ damage in patients with severe acute pancreatitis complicated by MODS

Objective:To study the influence of continuous blood purification on inflammation and target organ damage in patients with severe acute pancreatitis accompanied by MODS.Methods: A total of 78 patients with severe acute pancreatitis complicated by MODS who were treated in our hospital between June 2012 and March 2016 were selected and divided into control group (n=39) and observation group (n=39) according to random number table. Control group were treated with routine treatment, observation group were treated with conventional treatment plus continuous blood purification, and serum inflammatory factors, liver function indexes and renal function indexes were compared between two groups of patients before and after treatment.Results: Before treatment, differences in serum levels of inflammatory factors, liver function indexes and renal function indexes were not statistically significant between two groups of patients. After treatment, serum inflammatory factors IL-6, IL-8, MCP-1 and HMGB1 levels of observation group were lower than those of control group, liver function indexes ALT, AST, TBIL and ALP levels of observation group were lower than those of control group, and renal function indexes Scr and BUN levels of observation group were lower than those of control group.Conclusion: Continuous blood purification can reduce the systemic inflammatory response as well as liver and kidney injury in patients with severe acute pancreatitis complicated by MODS.

Genetic predisposition to inflammation:a new risk factor of Alzheimer's disease

Inflammation has been shown to play an important role in the progression of Alzheimer＇s disease （AD）. Recent epidemical study indicates that the incidence of AD in some populations is substantially influenced by the gene polymorphisms of the inflammation mediators. Meanwhile, an ensured risk factor, the ApoE ε4 allele is also reported to directly promote inflammation. Accordingly, it appears that an individual genetic background has partly determined his predisposition for AD by the extent of the inflammation response to the chronic stimulus by β-amyloid peptide （Aβ） deposits and other antigen stressor in the elderly. Hence we present a hypothesis that the inflammation genotypes may contribute to AD susceptibility. This may provide a new orientation both for future identification of individuals at risk and for personalized medication.

Helicobacter pylori and neurological diseases: Married by the laws of inflammation

The purpose of this paper is to review current infor-mation about the role of inflammation caused by He-licobacter pylori(H. pylori) infection in neurological diseases such as Parkinson's disease, Alzheimer's dis-ease, Guillain-Barré syndrome, multiple sclerosis, and other inflammatory diseases including ischemic stroke. Infection with H. pylori usually persists throughout life, resulting in a chronic inflammatory response with local secretion of numerous inflammatory mediators includ-ing chemokines [interleukin(IL)-8, macrophage che-motactic protein, growth-regulated oncogene(GRO)-α, chemokine(C-X-C motif) ligand 1] and cytokines [IL-1β, tumor necrosis factor-α, IL-6, IL-12, interferon-g], which can pass into the circulation and have a systemic effect. The persistence of detectable systemic and lo-cal concentrations of inflammatory mediators is likely to alter the outcome of neurological diseases. These proinflammatory factors can induce brain inflammation and the death of neurons and could eventually be asso-ciated to Parkinson's disease and also may be involved in the development of Alzheimer's disease. However,most neurological diseases are the result of a combina-tion of multiple factors, but the systemic inflammatory response is a common component and determinant in the onset, evolution, and outcome of diseases. How-ever, more studies are needed to allow understanding of the effects and mechanisms by which the inflamma-tory response generated by H. pylori infection affects neurological diseases.

Induction of apoptosis by artemisinin relieving the severity of inflammation in caerulein-induced acute pancreatitis

AIM： To observe the apoptosis and oncosis of pancreatic acinar cells and secondary inflammatory reaction in pancreatic tissue from rats with acute pancreatitis （AP）, and the influences of artemisinin on them.METHODS： AP was induced by 4 intraperitoneal iojections of caerulein at 1 h intervals. To induce apoptosis, solution of artemisinin （50 mg/kg） was given intraperitoneally 1, 12, 24 and 36 h after the last caerulein injection. Histological examination of impairment of pancreatic tissue and detection of serum amylase were performed to evaluate the severity of acute pancreatitis. Apoptosis and oncosis were detected with acridine orange （AO） and ethylene dibromide （EB） staining. Caspase-3 and myeloperoxidase （MPO） activity were measured by colorimetric assay. Nuclear factor-kappa B （NF-KB） activation was detected by flow cytometry. Macrophage inflammatory protein-lα（MIP-1α） protein was measured by Western blot. Interleukin- 1β（IL-1β） mRNA was detected by RT-PCR.RESULTS： Addition of artemisinin increased the number of apoptotic cells （11.7%±1.4% vs 6.3%± 0.7%, P 〈 0.05）, while reduced the number of oncotic cells （13.0% ±2.4% vs 17.5%±2.2%, P 〈 0.05）. The activity of caspase-3 speeded up （1.52±0.21 vs 1.03±0.08, P 〈 0.05）, the pancreas pathological impairment was relieved （3.0±0.5 vs 4.0± 0.5, P 〈 0.05） and the level of serum amylase decreased （5642±721 U/dL vs 7821±653 U/dL, P 〈 0.05）. The activation of NF-1α （29%±4.1% vs 42%±5.8%）, MIP-1α protein （3.7±0.5 vs 5.8±0.7）,MPO （0.52±0.06 U/g vs 0.68±0.09 U/g）, IL-1β mRNA （1.7 ±0.3 vs 2.4 ±0.4） in the apoptosis inducing group was obviously decreased （P 〈 0.05）.CONCLUSION： Inducing apoptosis can relieve pathological impairment and inflammatory reaction in AP rats.

Fecal lactoferrin accurately reflects mucosal inflammation in inflammatory bowel disease

BACKGROUND Studies have demonstrated a potential role for fecal biomarkers such as fecal calprotectin(FC)and fecal lactoferrin(FL)in monitoring inflammatory bowel diseases(IBD)-Crohn's disease(CD)and ulcerative colitis(UC).However,their correlation to endoscopic scores,disease severity and affected intestinal surface has not been extensively investigated.AIM To correlate FL,and for comparison white blood cell(WBC)and C-reactive protein(CRP),with endoscopic scores,disease extent and location in CD and UC.METHODS Retrospective analysis in 188 patients who had FL,CRP and WBC determined within 30 d of endoscopy.Disease location,disease extent(number of intestinal segments involved),disease severity(determined by endoscopic scores),timing of FL testing in relation to colonoscopy,as well as the use of effective fast acting medications(steroids and biologics)between colonoscopy and FL measurement,were recorded.RESULTS In 131 CD and 57 UC patients,both CRP and FL-but not WBC-distinguished disease severity(inactive,mild,moderate,severe).In patients receiving fastacting(steroids or biologics)treatment in between FL and colonoscopy,FL showed a higher correlation to endoscopic scores when tested before vs after the procedure(r=0.596,P<0.001,vs r=0.285,P=0.15 for the Simple Endoscopic Score for CD;and r=0.402,P=0.01 vs r=0.054 P=0.84 for Disease Activity Index).Finally,FL was significantly correlated with the diseased mucosal surface(colon-ileocolon>small bowel)and the number of inflamed colon segments.CONCLUSION FL and CRP separated disease severity categories with FL showing lower discriminating P-values.FL showed a close correlation with the involved mucosal surface and with disease extent and was more closely correlated to endoscopy when determined before the procedure–this indicating that inflammatory activity changes associated with therapy might be rapidly reflected by FL levels.FL can accurately and timely characterize intestinal inflammation in IBD.

Blood-brain barrier pathology in cerebral small vessel disease

Cerebral small vessel disease is a neurological disease that affects the brain microvasculature and which is commonly observed among the elderly.Although at first it was considered innocuous,small vessel disease is nowadays regarded as one of the major vascular causes of dementia.Radiological signs of small vessel disease include small subcortical infarcts,white matter magnetic resonance imaging hyperintensities,lacunes,enlarged perivascular spaces,cerebral microbleeds,and brain atrophy;however,great heterogeneity in clinical symptoms is observed in small vessel disease patients.The pathophysiology of these lesions has been linked to multiple processes,such as hypoperfusion,defective cerebrovascular reactivity,and blood-brain barrier dysfunction.Notably,studies on small vessel disease suggest that blood-brain barrier dysfunction is among the earliest mechanisms in small vessel disease and might contribute to the development of the hallmarks of small vessel disease.Therefore,the purpose of this review is to provide a new foundation in the study of small vessel disease pathology.First,we discuss the main structural domains and functions of the blood-brain barrier.Secondly,we review the most recent evidence on blood-brain barrier dysfunction linked to small vessel disease.Finally,we conclude with a discussion on future perspectives and propose potential treatment targets and interventions.

Clematichinenoside protects blood brain barrier against ischemic stroke superimposed on systemic inflammatory challenges through up-regulating A20

Suppression of excessive inflammation can ameliorate blood brain barrier （BBB） injury, which shows therapeutic potential for clinical treatment of brain injury induced by stroke superimposed on systemic inflammatory diseases. In this study, we investigated whether and how clematichinenoside （AR）, an anti-inflammatory triter- pene saponin, protects brain injury from stroke superimposed on systemic inflammation. Lipopolysaccharide （LPS） was intraperitoneally injected immediately after middle cerebral artery occlusion （MCAO） in rats. Rat microvessel endothelial cells （rBMECs） were exposed to hypoxia/reoxygenation （H/R） coexisting with LPS. The results re- vealed that AR suppressed the excessive inflammation, restored BBB dysfunction, alleviated brain edema, de- lessened neurological dysfunction, and decreased infarct rate. Further study demon- creased neutrophil infiltration, inducible nitric oxide synthase （iNOS） , strated that the expression of nucleus nuclear factor kappa B （NF-KB）, intercellular adhesion molecule-1 （ ICAM-1 ）, tumor necrosis factor-α （TNF-α） and interlukin-1β （ IL-1β） were suppressed by AR via zinc finger protein A20. Besides, AR increased in vitro BBB integrity through A20. In con- clusion, AR alleviated cerebral inflammatory injury through A20-NF-KB signal pathway, offering an alternative medication for stroke associated with systemic inflammatory diseases.

Adverse Effects of Sedentary Lifestyles: Inflammation, and High-Glucose Induced Oxidative Stress—A Double Blind Randomized Clinical Trial on Diabetic and Prediabetic Patients

Sedentary lifestyles promote adipose tissue accumulation that generates systemic inflammation and oxidative damage. Physical activity induces cardiovascular fitness, increases muscle mass, and healthy blood glucose regulation, while reducing visceral fat, triglycerides and low-density lipoproteins. It is theoretically possible to develop a long-term multi-exercise regimen for health management and enhancement. Pragmatically, time and career restraints, individual choices, genetic factors, or demoralization due to the draconian commitment involved in weight loss, have rendered over a billion of individuals obese, or overweight, burdened by excess lipids, insulin resistance, elevated glucose levels, and inflammation, that foster a number of medical conditions including diabetes. Strenuous overtraining has ensued adverse effects, including an upsurge of proinflammatory cytokines, and hyperglycemia. We implemented an one-month long innovative method with 20 diabetic and prediabetic patients. Results demonstrated a statistically significant reduction of both fasting and PP blood glucose. Fasting and PP insulin reached optimal levels. There was a substantial decline in dyslipidemia, reflecting a reverse relationship of elevated HDL versus triglycerides descending towards the normal range. The notable visceral fat reduction was validated by sonography reports that indicated no evidence of fatty liver in seven patients previously diagnosed with hepatic steatosis. These findings have important implications in improving the health status of obese diabetic and prediabetic individuals, by helping them jumpstart an active lifestyle, or by serving as an exercise alternative to reduce lipids, blood glucose levels and insulin resistance.