Analysis of the anti-T2DM components in dichloromethane fraction of Schisandra sphenanthera and its mechanism

Background:The type 2 diabetes mellitus(T2DM)pharmacodynamic study of various parts of Schisandra sphenanthera was conducted in the previous stage,and it was found that dichloromethane extracted part(SDP)had a significant hypoglycemic effect.Therefore,the components of SDP were analyzed,and the specific mechanism of its anti-T2DM was explored.Methods:We used a high-fat,high-sugar diet in combination with streptozotocin to induce a T2DM rat model,and the model rats were divided into two groups according to body weight and blood glucose.Triglyceride,oral glucose tolerance test,fasting blood glucose,low density lipoprotein cholesterol,superoxide dismutase,insulin,glycated hemoglobin,total cholesterol,nonesterified free fatty acids,alanine aminotransferase,high-density lipoprotein cholesterol,aspartate aminotransferase,malondialdehyde,and glutathione peroxidase were measured,organ indices were calculated,and pathological sections of pancreas and liver were observed.The 16S rRNA V3–V4 region of intestinal flora was sequenced to explore the effect of SDP on biochemical indicators and intestinal flora.Based on the above indicators,the anti-T2DM mechanism of SDP in Schisandra sphenanthera was analyzed.Results:After six weeks of administration,the biochemical indices of diabetic rats were diminished compared to the control group.And SDP could significantly increase the gut microbialα-diversity index,resulting in significant changes in the flora of T2DM rats,with increased richness and diversity,reduced harmful flora,and significantly back-regulated the levels of acetic acid,propionic acid,and butyric acid.Conclusion:SDP can improve the symptoms associated with elevated blood glucose,dyslipidemia,elevated fasting insulin levels,and damaged glucose tolerance in rats.SDP against T2DM may be through the control of intestinal flora to normalize and exert anti-diabetic effect;its main active components may be lignans and terpenoids.

达格列净联合甘精胰岛素在老年T2DM患者糖代谢控制中的应用效果

目的分析老年2型糖尿病(Type 2 Diabetes Mellitu,T2DM)患者糖代谢控制中达格列净与甘精胰岛素联合应用的效果。方法选取2021年5月—2023年5月吉林省人民医院收治的100例老年T2DM患者为研究对象,以信封法分为观察组(n=50,行达格列净联合甘精胰岛素治疗)、比照组(n=50,行单纯甘精胰岛素治疗)。观察并对比两组患者临床疗效、糖代谢控制情况及不良反应总发生率。结果治疗3个月后,两组糖代谢水平均明显低于治疗前,且观察组空腹血糖(6.01±0.28)mmol/L、餐后2 h血糖(7.41±1.18)mmol/L、糖化血红蛋白(6.58±1.04)%均低于比照组,差异有统计学意义(t=2.171、2.595、2.077,P均<0.05)。观察组临床总有效率(96.00%)高于比照组,差异有统计学意义(χ^(2)=5.005,P<0.05)。两组不良反应总发生率对比,差异无统计学意义(P>0.05)。结论老年T2DM患者糖代谢控制中,达格列净联合甘精胰岛素的应用效果显著,糖代谢水平得到明显改善的同时,临床疗效更加显著,不良反应发生风险未产生明显升高情况,说明上述两种药物联合应用,具有较高的安全性。

Hepatitis B virus-related liver cirrhosis complicated with dermatomyositis: A case report

BACKGROUND Twenty percent of patients infected with hepatitis B virus(HBV)develop extrahepatic manifestations with HBV detected in the lymph nodes,spleen,bone marrow,kidneys,and skin.HBV infection has been associated with some autoimmune disorders.Dermatomyositis(DM)is an idiopathic inflammatory myopathy,which involves a viral infection,and DM has been identified in patients infected with HBV,but there is no direct histological evidence for an association between HBV and DM.CASE SUMMARY We describe a familial HBV-infected patient admitted with liver function abnormality,rashes,a movement disorder,and an elevated level of creatine kinase(CK).A computed tomography scan of the lung showed pulmonary fibrosis,and a liver biopsy identified nodular cirrhosis.An electromyogram revealed myogenic damage,and a muscle biopsy showed nuclear migration in local sarcolemma and infiltration of chronic inflammatory cells.Immunohistochemical staining showed negative results for HBsAg and HBcAg.Fluorescence in situ hybridization showed a negative result for HBV DNA.The patient was diagnosed with HBV-related liver cirrhosis complicated with DM and was treated with methylprednisolone,mycophenolate mofetil,and lamivudine.Eight months later,the patient was readmitted for anorexia and fatigue.The blood examination showed elevated levels of aminotransferases and HBV DNA,however,the CK level was within the normal range.The patient developed a virological breakthrough and lamivudine was replaced with tenofovir.CONCLUSION DM in chronic HBV-infected patients does not always associate with HBV.Antiviral and immunosuppressive drugs should be taken into consideration.

Dermatomyositis associated with hepatocellular carcinoma in an elderly female patient with hepatitis C virus-related liver cirrhosis

A 79-year-old female patient with hepatitis C virusrelated liver cirrhosis was diagnosed as having hepatocellular carcinoma （HCC） with a diameter of 2.0 cm. She refused therapy for HCC. Nine months after the diagnosis, she developed dermatomyositis when the HCC enlarged to a diameter of 6.0 cm. She underwent therapy for dermatomyositis, and then transcatheter arterial chemoembolization for HCC. Although the manifestations of dermatomyositis improved and entire tumor necrosis was achieved, she died of pneumonia 2 mo after the treatment of HCC. HCC and/or chronic hepatitis C virus infection might be involved in the pathogenesis of dermatomyositis.

Dermatomyositis associated with gallbladder carcinoma:A case report

Patients with gallbladder carcinoma can present with a variety of paraneoplastic syndromes,including Cushing's syndrome,hypercalcemia,acanthosis nigricans,bullous pemphigoid,dermatomyositis and the sign of Leser-Trélat.Surgical resection of the primary tumor results in resolution of these paraneoplastic syndromes.We present a 67-year old female with facial and cervical erythema who was initially diagnosed with dermatomyositis.However,an abdominal computed tomography(CT)and positron emission tomographyCT scan was suspicious for gallbladder carcinoma with lymph node metastasis.After surgical resection,her dermatomyositis was resolved.This case demonstrates that dermatomyositis may be a manifestation of preexisting gallbladder carcinoma.

基于区域分割和DM642的数字图像修复系统研究

由于数字图像中颜色通道之间关联性显著,改变某颜色分量,会导致剩余分量随之变化,使数字图像整体视觉效果出现变化,针对该问题,文中研究基于区域分割和DM642的数字图像修复系统。将DM642处理器作为系统核心处理器,在该处理器协助下,针对破损数字图像采用基于分通道自体理论的数字图像区域分割方法,利用图像颜色信息和像素间的空间关系,实现图像修复区域分割。针对需修复区域,通过基于Criminisi算法的数字图像修复方法提取修复像素点生成修复块,利用图像自相似性,在未破损区域找到与修复块匹配度最高的样本块,用此样本填充修补破损区域。实验结果表明,此系统能够有效分割数字图像的修复区域,修复视觉效果较好,且修复后数字图像不存在明显失真问题,可实现多图像并行快速修复。

Endoscopy is of low yield in the identification of gastrointestinal neoplasia in patients with dermatomyositis: A cross-sectional study

To determine the prevalence of gastrointestinal neoplasia among dermatomyositis patients who underwent an esophagogastroduodenoscopy and/or colonoscopy. METHODSA cross-sectional study examining the results of upper endoscopy and colonoscopy in adults with dermatomyositis at an urban, university hospital over a ten year period was performed. Chart review was performed to confirm the diagnosis of dermatomyositis. Findings on endoscopy were collected and statistical analyses stratified by age and presence of symptoms were performed. RESULTSAmong 373 adult patients identified through a code based search strategy, only 163 patients had dermatomyositis confirmed by chart review. Of the 47 patients who underwent upper endoscopy, two cases of Barrett’s esophagus without dysplasia were identified and there were no cases of malignancy. Of the 67 patients who underwent colonoscopy, no cases of malignancy were identified and an adenoma was identified in 15% of cases. No significant differences were identified in the yield of endoscopy when stratified by age or presence of symptoms. CONCLUSIONThe yield of endoscopy is low in patients with dermatomyositis and is likely similar to the general population; we identified no cases of malignancy. A code based search strategy is inaccurate for the diagnosis of dermatomyositis, calling into question the results of prior population-based studies. Larger studies with rigorously validated search strategies are necessary to understand the risk of gastrointestinal malignancy in patients with dermatomyositis.

Infliximab is effective in the treatment of ulcerative colitis with dermatomyositis:A case report

BACKGROUND Joint,skin,oral cavity,and eye lesions are the most common extraintestinal manifestations of ulcerative colitis that can occur before or after its onset.The cases of ulcerative colitis with dermatomyositis(DM)are rare.In this study,we report a rare case of ulcerative colitis with DM that was effectively treated with infliximab.CASE SUMMARY The patient was a 57-year-old female with a 2-year history of DM.The patient was admitted to hospital with abdominal pain,diarrhea,and blood in stool lasting for more than 2 mo.Colonoscopy revealed multiple erosions and ulcers in the entire colon and rectum.Pathological sections showed chronic inflammatory cell infiltration,especially neutrophil infiltration,in the colonic mucosa;therefore,the patient was diagnosed with ulcerative colitis.Preparations of 5-aminosalicylic acid was added to her treatment based on the original treatment for DM,but its effect was unsatisfactory.The patient’s discomfort was relieved after infliximab treatment.CONCLUSION Infliximab can improve DM in the treatment of ulcerative colitis.Specialists need to raise awareness about patients with inflammatory bowel disease who have rare extraintestinal manifestations.

T2DM患者血清CD147、AngⅡ水平与肾损伤程度的关系

糖尿病(diabetes mellitus,DM)是一种影响蛋白质、脂肪及碳水化合物代谢的慢性疾病,发病率较高,其中2型糖尿病(type 2 diabetes mellitus,T2DM)占90%[1,2]。而2型糖尿病肾病(type 2 diabetic nephropathy,T2DN)是T2DM的主要并发症之一,其早期症状不明显,后期可快速进展为慢性肾衰竭[3]。探究适用于尽早检测T2DM患者肾脏受损的指标,对临床提高该病治疗效果具有重要意义。细胞外基质金属蛋白酶诱导因子(extracellular matrix metalloproteinase inducible factor,EMMPRIN/CD147)属于免疫球蛋白超家族,在T细胞发育、活化、增殖等阶段中发挥作用[4]。既往研究显示,CD147能够在肾小管上皮表达,同时参与其肾间质纤维化的过程[5]。

miR-125b, miR-200c Are Correlated with the Severity of Interstitial Lung Disease in Dermatomyositis/Polymyositis

Objective: To explore the correlations between miR-125b, miR-200c, and the severity of interstitial lung disease associated with dermatomyositis/polymyositis (DM/PM-ILD). Methods: 30 consecutive patients with DM/PM and 23 healthy controls were recruited into current study. Anti-JO-1, anti-SSA, muscle enzymes, the data of chest HRCT and pulmonary function test were collected. 9 consecutive DM/PM-ILD patients underwent bronchoalveolar lavage (BAL). TGF-β1 and surfactant protein D (SP-D) in BAL fluid (BALF) and plasma were detected by ELISA. miR-125b and miR-200c in PBMCs and bronchoalveolar cells were detected by QRT-PCR. All patients were classified into three groups: Mild or non-ILD group, moderate ILD group, and severe ILD group. The correlations between miRNAs and the severity of ILD, the lung damage markers, auto-antibodies, were analyzed. Results: The levels of miR-125b and miR-200c in bronchoalveolar cells were higher than in PBMCs, and the levels of TGF-β1 and SP-D were higher in BALF than in plasma in DM/PM-ILD patients. There were positive correlations between miR-125b, miR-200c in bronchoalveolar cells and SP-D in BALF. The levels of miR-125b and miR-200c in severe ILD group were higher than in mild or non-ILD and moderate ILD groups. There were negative correlations between miR-125b, miR-200c, and FEV1, and between miR-200c and DLCO. The patients with anti-JO-1 antibody had higher levels of miR-125b and miR-200c, and had more severe condition of ILD. Conclusion: miR-125b and miR-200c were positively correlated with the lung damage and severity of ILD in DM/PM, which could be important markers for judgement of disease condition in clinic.

Symptoms relieved after tumor removal in a case of dermatomyositis associated with hepatocellular carcinoma:case report and literature review

A case of dermatomyositis associated with hepatocellular carcinoma is reported in a 43-year-old man,in which removal of the tumor resulted in great improvement of dermatomyositis.The patient had shown aggravating symptoms of dermatomyositis including manifestations of typical skin rashes and muscle weakness six months before he came to our hospital.He had no history of drug allergy and took no medicine in these days.When first visiting the dermatological clinic,he complained of discomforts in skin and muscle manifestation and was diagnosed as having dermatomyositis.At the same time,A CT scan discovered a resectable liver tumor in the right lobe.Then he came to our hospital and asked for surgical treatment.Removal of the tumor resulted in great improvement of dermatomyositis and recurrence of liver tumor was followed by resumption of dermatomyositis.

Pneumocystis jiroveci pneumonia after total hip arthroplasty in a dermatomyositis patient:A case report

BACKGROUND Pneumocystis jiroveci pneumonia(PJP)is a serious opportunistic infection that occurs mostly in patients with immunodeficiency and long-term immunosuppressive therapy.In non-human immunodeficiency virus-infected patients,the most important risk factor for PJP is the use of glucocorticoids in combination with other immunosuppressive treatments.The management of glucocorticoids during the perioperative period in patients with dermatomyositis requires special care.CASE SUMMARY We report a case of PJP in the perioperative period.A 61-year-old woman with a history of anti-melanoma differentiation-associated gene 5(MDA5)-positive dermatomyositis and interstitial pneumonia was administered with long-term oral methylprednisolone and cyclosporine.The patient underwent right total hip arthroplasty in the orthopaedic department for bilateral osteonecrosis of the femoral head.She was given intravenous drip hydrocortisone before anesthesia and on the first day after surgery and resumed oral methylprednisolone on the second postoperative day.On the fifth day after surgery,the patient suddenly developed dyspnea.The computed tomography scan showed diffuse grid shadows and ground glass shadows in both lungs.Polymerase chain reaction testing of bronchoalveolar lavage fluid was positive for Pneumocystis jiroveci.The patient was eventually diagnosed with PJP and was administered with oral trimethoprim-sulfamethoxazole.At the 6-mo review,there was no recurrence or progression.CONCLUSION Continued perioperative glucocorticoid use in patients with anti-MDA5-positive dermatomyositis may increase the risk of PJP.

SGLT2抑制剂联合二甲双胍治疗T2DM患者的获益效果

评估达格列净作为SGLT2抑制剂与二甲双胍联用,对2型糖尿病(T2DM)患者的临床效果与潜在获益。方法 收集2022年12月至2023年12月间柳州市柳铁中心医院收治的50例2型糖尿病患者,通过随机数字表分为对照组和观察组,各25例。对照组接受阿卡波糖与二甲双胍治疗,观察组则采用二甲双胍结合SGLT2抑制剂达格列净方案。比较两组患者在治疗3个月及12个月后的血脂、糖化血红蛋白和红细胞压积变化。结果 在治疗3个月和12个月后,两组患者的总胆固醇、低密度脂蛋白胆固醇和甘油三酯水平均显著下降,且观察组降幅明显优于对照组(P<0.05);高密度脂蛋白胆固醇在这两个时间点上,组间差异无统计学意义(P>0.05)。糖化血红蛋白也呈现下降趋势,且观察组的降低程度更为显著(P<0.05)。另外,观察组的红细胞压积在治疗的两个时间点上均低于对照组(P<0.05),但组间差异未达统计学意义(P>0.05)。结论 SGLT2抑制剂达格列净联合二甲双胍治疗2型糖尿病患者,较阿卡波糖联合二甲双胍能更显著降低总胆固醇、低密度脂蛋白胆固醇、甘油三酯和糖化血红蛋白水平,且对红细胞压积也有一定的影响,提示其在2型糖尿病患者血糖及血脂管理中具有更好的临床获益效果。

Treatment of gastric cancer with dermatomyositis as the initial symptom:Two case reports and review of literature

BACKGROUND Dermatomyositis(DM) is a rare autoimmune disease involving the connective tissue.The association between DM and gastric cancer remains unclear.Patients with DM have an increased risk of cancer and higher mortality.It requires immunosuppressive therapy,heightened surveillance,and immunologic response to internal malignancy.CASE SUMMARY Two cases of gastric cancer with DM as the first symptom in Zhongshan Hospital,Fudan University(Shanghai,China) were reported.Two patients had a typical skin rash.The rash in the first patient involved mainly bilateral upper limbs and neck,while the second patient manifested rash associated mainly with the face,neck,and back.Both manifested muscle weakness in the extremities and elevated serum creatine kinase.Radical resection of the tumor dramatically improved DMrelated symptoms in the two patients.The literature review showed that gastric cancer is more commonly associated with DM in middle-aged and older male populations.CONCLUSION The findings suggest the need for comprehensive screening for malignant tumors in patients with DM refractory to long-term pharmacotherapy or hormone manipulation.

Safety of Transcranial Direct Current Electrical Stimulation in Dermatomyositis: A Case Report

Transcranial direct current stimulation (tDCS) has emerged as a nonpharmacological tool in physical rehabilitation. There have currently no studies that evaluated the safety and efficacy of tDCS in patients with dermatomyositis. Case-report: Three adult women with dermatomyositis were allocated randomly to intervention (i-tDCS, one patient) or not (sham-tDCS, two patients) of three consecutive days of tDCS and evaluated in four periods: before-tDCS (PRE), 15 minutes after-tDCS (0th POST), 15 days after-tDCS (15th POST), and 30 days after-tDCS (30th POST). The tDCS was safe throughout the protocol, without disease relapsing or adverse effects related to tDCS. Furthermore, the tDCS increased the muscle torque and total work of dominant and non-dominant elbow flexors in the patient with i-tDCS, when compared to two patients with sham-tDCS. Conclusions: The tDCS was safe and appeared to influence long-term strength in the limb of the patient with stable dermatomyo-sitis.

并行机器中基于干扰时间的间歇实时任务分区DM调度

间歇实时任务的分区DM(deadline-monotonic)调度是一个经典的研究问题,针对约束截止期间歇任务,提出一种具有更高处理器利用率的多核分区调度算法PDM-FFD(partitioned deadline-monotonic first-fit decrease).在PDM-FFD中,首先将任务按照其相对截止期以非递减顺序进行排序,然后采用first-fit策略选择处理器核分配任务,且在各处理器核上采用DM调度策略进行任务调度.最后通过对任务干扰时间的分析,得出一种更为紧凑的可调度性判定方法,并通过该可调度性方法来判定任务的可调度性.证明PDM-FFD的加速因子为3-(3Δ+1)/(m+Δ),时间复杂度为O(n^(2))+O(nm),其中Δ=_(Στj∈τ)C_(j)×u_(j)/D_(max),τ_(j)为任务集τ中的任务,C_(j)为该任务最差执行时间,u_(j)为该任务利用率,D_(max)为τ中的最大相对截止期,n为τ的任务数,m为处理器核数.该加速因子严格小于3-1/m,优于已有多核分区调度算法FBB-FFD.实验表明,PDM-FFD算法在4核处理器上的处理器利用率比其他算法提高了18.5%,且PDM-FFD的性能优势随着处理器核数、任务集利用率和任务数的增加而进一步扩大.由于PDM-FFD算法具有高性能特性,因此该算法可以广泛应用于资源受限的航天器、自动驾驶汽车、工业机器人等典型实时系统中.

Paraneoplastic Dermatomyositis Accompanying Nasopharyngeal Carcinoma

NASOPHARYNGEAL carcinoma （NPC） is a raredisease in North America and Western Europe,but is common in Asia and North Africa.1,2 Asmall percentage of NPC patients present withparaneoplastic syndrome and less than 0.1% with dermatomyositis.2 No prospective case-control double-blindedstudies of immunosuppressive therapy in dermatomyositishave been performed, let alone in paraneoplastic dermatomyositis.

扇贝养殖季烟台近海CH_(4)和DMS的时空分布及影响因素

甲烷(CH_(4))和二甲基硫(Dimethylsulfide,DMS)是重要的挥发性生源活性气体,在调节气候变化方面具有重要意义。本文为探究筏式扇贝养殖对CH_(4)和DMS分布与释放通量的影响,分别于2019年5、6、7、8、9和11月对烟台近海进行现场调查。结果表明,贝类滤食可以间接将水中的有机物质输入到沉积物中,导致扇贝养殖区底层CH_(4)平均浓度比非养殖区高25.64%。贝类滤食也可以将浮游植物体内的二甲基巯基丙磷(Dimethylsulfo niopropionate,DMSP)转化为海水中的颗粒态DMSP,增加DMSP向DMS的转化,与非养殖区相比,养殖区表层DMS浓度增加了24.13%。另外,表层海水CH_(4)浓度处于过饱和状态,而DMSP可能是表层海水CH_(4)重要的潜在来源。整个扇贝养殖周期内,调查海域CH_(4)海-气通量约为9.69×10^(6) g,DMS海-气通量约为3.33×10^(7) g,是大气CH_(4)和DMS重要的源。

Carcinoma of unknown primary and paraneoplastic dermatomyositis

Dermatomyositis is known to be associated with neoplastic disorders,however the presentation of carcinoma of unknown primary as dermatomyositis is rare. We describe a case index of 50-year-old female who presented with enlarged inguinal lymph nodes accompanied with symmetric proximal muscle weakness and erythematous plaques. Conventional basic work-up did not reveal the diagnosis,however,positron emission tomography-computed tomography and re-staining of the pathology specimen suggested the ovaries as the primary site. Chemotherapy including carboplatin paclitaxel and bevacizumab led to complete response of disease and improvement in the dermatomyositis. The present case emphasizes the importance of a thorough directed evaluation for the underlying cancer in patients with carcinoma of unknown primary presenting as dermatomyositis. We further provide an up-to-date detailed review of published data describing these clinical entities.

Clinical Phenotype of Japanese Patients with Dermatomyositis—Classification Based on Dermatomyositis-Specific Autoantibodies

Objectives: To correlate the precise specificity of autoantibodies in Japanese dermatomyositis (DM) patients with their clinical phenotypes. Methods: Serum samples from 94 adult DM patients (67 with classical DM and 27 with clinically amyopathic dermatomyositis, CADM) were screened for autoantibodies using immunoprecipitation assays. Patients with antibodies against aminoacyl transfer RNA synthetase (ARS), Mi-2 or who had other autoantibodies were assessed for clinical symptoms and laboratory findings. Results: Sera from 27 of 94 DM patients (29%) were found to have anti-ARS antibodies. Nineteen (20%) had anti-CADM-140/MDA5, 5 (5%) had anti-Mi-2, and 8 (6%) had anti-p155/TIF1-γ. Anti-MJ/NXP-2 was not found in our series of adult DM. Seventeen patients with anti-ARS had fever and 22 had arthritis and interstitial lung disease (ILD), compatible with a diagnosis of anti-ARS syndrome. Seventeen of 19 (89%) with anti-CADM-140/MDA5 had ILD, 16 (84%) of whom developed rapidly progressive ILD (RP-ILD). Four of 5 (80%) with anti-Mi-2 had heliotrope rash and/or Gottron’s sign/papules, and 2 (40%) had V-sign and/or shawl-sign rash, whereas no ILD or malignancy was detected. As seen with anti-Mi-2-positive patients, a low frequency of ILD (13%) was found in patients with anti-p155/TIF1-γ but 6 of 8 (75%) had malignancy during their course. The frequency of ILD was significantly higher in patients with anti-ARS or anti-CADM-140/MDA5 compared with anti-Mi-2 or anti-p155/TIF1-γ (81% and 89%, respectively). It should be noted that anti-CADM-140/MDA5-positive patients suffered significantly more RP-ILD compared to patients with anti-ARS (84% vs. 7%, P < 0.0001). On the other hand, anti-p155/TIF1-γ positive patients had a significantly higher rate of malignancy compared with anti-ARS-, anti-CADM-140/MDA5-and anti-Mi-2-positive patients (75% vs. 7%: P = 0.0004, 5%: P = 0.0006, 0%: P = 0.02, respectively). Conclusions: These results indicate that in addition to antibodies previously identified as specific for DM, autoantibodies newly found in these patients are useful for stratifying them into clinical subgroups.