Impact of bariatric surgery on glucose and lipid metabolism and liver and kidney function in food-induced obese diabetic rats

BACKGROUND Obesity usually causes diabetes mellitus(DM)and is a serious danger to human health.Type 2 DM(T2DM)mostly occurs along with obesity.Foodborne obesityinduced DM is caused by an excessive long-term diet and surplus energy.Bariatric surgery can improve the symptoms of T2DM in some obese patients.But different types of bariatric surgery may have different effects.AIM To investigate the effect of bariatric surgery on glucose and lipid metabolism and liver and kidney function in rats.METHODS Male Sprague-Dawley rats aged 6-8 wk underwent Roux-en-Y gastric bypass surgery(RYGB),sleeve gastrectomy(SG),or gastric banding(GB).Glucose and insulin tolerance tests,analyses of biochemical parameters,histological examination,western blot,and quantitative real-time polymerase chain reaction were conducted.RESULTS In comparison to the sham operation group,the RYGB,SG,and GB groups had decreased body weight and food intake,reduced glucose intolerance and insulin insensitivity,downregulated biochemical parameters,alleviated morphological changes in the liver and kidneys,and decreased levels of protein kinase Cβ/P66shc.The effect in the RYGB group was better than that in the SG and GB groups.CONCLUSION These results suggest that RYGB,SG and GB may be helpful for the treatment of foodborne obesity-induced DM.

Polycystic Ovary Syndrome-Related Infertility Based on the Theory of“Liver and Kidney Homology”

Polycystic ovary syndrome(PCOS)is an endocrine disorder caused by hypothalamic-pituitary-ovarian(HPO)axis dysfunction.In the field of gynecology and reproduction,PCOS has emerged as both a research hot spot and a challenging area of study.According to Chinese medicine,this disease is related to kidney deficiency,phlegm and dampness obstruction,blood stasis and interconnection,Chong pulse impassability,the lack of Ren pulse,and the loss of uterine nourishment,all of which affect the normal development and maturation of eggs as well as the duration at which menstrual blood stores.In this paper,based on the theoretical basis of“liver collects blood,regulates the flow of qi,and is the master of drainage,”we explore the rationality of the treatment of this disease from the perspective of“liver and kidney have the same origin”and the development of PCOS-related infertility in relation to dysfunctional internal organs.We also explore the feasibility of treatment from the perspective of“liver and kidney homology,”expand the ideas for treatment,as well as develop and innovate the application of organ identification in PCOS in relation to infertility.

Combined liver and kidney transplantation in Guangzhou,China

BACKGROUND: When liver or kidney transplant can respectively cure end-stage liver or kidney disease, neither hepatic graft nor renal transplant alone can be used as a radical therapy for diseases which involve both liver and kidney. Combined liver and kidney transplantation commenced late in China, and the number of transplants has been limited. This study was designed to assess the effects of simultaneous combined liver and kidney transplantation (SLKT) on end-stage liver and kidney diseases. METHODS: Fifteen patients who had received SLKT from 1996 to 2006 in the First Affiliated Hospital of Sun Yat-Sen University were reviewed. They included 5 patients with polycystic liver and kidney, 5 patients with hepatic cirrhosis and renal failure, and 5 patients with fulminant hepatic failure and hepatorenal syndrome (11 men and 4 women; average age 43.5 years). All patients had combined liver and kidney transplantation. RESULTS: The 5 patients with polycystic liver and kidney have survived for more than one year after SLKT, and the longest survival has been 5 years. Three of the 5 patients with hepatic cirrhosis and renal failure have survived more than two years; one died perioperatively and the other died from recurrence of hepatitis B 18 months after the operation. Three of the 5 patients with fulminant hepatic failure and hepatorenal syndrome have survived for two years, and 2 died of multiple organ failure during the operation. CONCLUSIONS: SLKT is an effective therapy for end-stage liver and kidney disease but the indications of SLKT for hepatorenal syndrome should be strict. SLKT may immunologically protect the renal graft.

Antioxidant Machinery Related to Decreased MDA Generation by Thymus Algeriensis Essential Oil-induced Liver and Kidney Regeneration

Objective This study was conducted to determine the histopathological and biochemical effects of Thymus algeriensis essential oil （TEO） on hydrogen peroxide （H2O2）-induced oxidative stress in liver and kidney tissues of rats. Methods Rats were treated in six groups and were exposed for 2 weeks to low （LD; 100 μmol/L） and high doses （HD; 1 mmol/L） of H2O2 in the presence or absence of TEO （180 mg/kg）. Liver and kidney atrophy was measured by using biochemical and histopathological assays. Results Our study demonstrated that H2O2 induced liver and kidney atrophy, as evidenced by the significant elevation of serum aminotransferase, urea, and creatinine levels compared with those in the control rats. Urea levels were estimated by evaluating the activity of serum urease that hydrolyzes urea into CO2 and ammonia. However, TEO treatment significantly alleviated oxidative stress in the H2O2-induced liver and kidney toxicity model by reducing the levels of malondialdehyde concomitantly with marked elevations in superoxide dismutase, catalase, glutathione peroxidase, and glutathione S-transferase, as well as decrease in glutathione activity. Conclusion Our data demonstrated that TEO protected against H202 toxicity by decreasing oxidant levels and DNA damage, as well as increasing antioxidant levels, indicating that TEO has a spectrum of antioxidant and DNA-protective properties.

Mistletoe alkali inhibits peroxidation in rat liver and kidney

AIM： To explore the antioxidant and free radica scavenger properties of mistletoe alkali （MA）. METHODS： The antioxidant effect of mistletoe alkali on the oxidative stress induced by carbon tetrachloride （CCh） in rats was investigated. The rats were divided into four groups （n = 8）： CCh-treated group （1 mL/kg body weight）, MA -treated group （90 mg/kg）, CCh＋MA-treated group and normal control group. After 4 wk of treatment, the level of malondialdehyde （MDA）, a lipid peroxidation product （LPO） was measured in serum and homogenates of liver and kidney. Also, the level of glutathione （GSH）, and activities of glutathione reductase （GR）, glutathione peroxidase （GSPx）, superoxide dismutase （SOD）, and glutathione-S-transferase （GST） in liver and kidney were determined. Scavenging effects on hydroxyl free radicals produced in vitro by Fenton reaction were studied by ESR methods using 5,5-dimethyl-1-pyrroline-N-oxide （DMPO） as a spin trap reagent and H2O2/UV as the OH· source. Urinary 8-hydroxydeoxyguanosine （8-OHdG） was determined by competitive ELISA. RESULTS： In CCh-treated group, the level of LPO in serum of liver and kidney was significantly increased compared to controls. The levels of GSH and enzyme activities of SOD, GSPx and GR in liver and kidney were significantly decreased in comparison with controls. In CCl4＋MA-treated group, the changes in the levels of LPO in serum of liver and kidney were not statistically significant compared to controls. The levels of SOD, GSPx and GR in liver and kidney were significantly increased in comparison with controls. There was a significant differ- ence in urinary excretion of 8-OHdG between the CCh- treated and MA-treated groups. CONCLUSION： Oxidative stress may be a major mechanism for the toxicity of CCh. MA has a protective effect against CCl4 toxicity by inhibiting the oxidative damage and stimulating GST activities. Thus, clinical application of MA should be considered in cases with carbon tetrachloride-induced injury.

Influences of Chloropazine, Nimodipine and Their Combination on the Toxic Effects of Cadmium in Liver and Kidney of Mice

The influences of the calmodulin antagonist chlorpromazine (CPZ), and calcium channel blocker nimodipine (NIMO) and their combination on cadmium (Cd) poisoning of mice were studied. A seties of biochemical parameters including urinary enzyme activities, blood and urine Cd levels, metallothionein (MT) contents in liver and kidney, hepatic ultrastructure and Ca2+ -Mg2+ AT-Pase activity in erythrocyte membrane were determined. Animal models for Cd poisoning were established by peritoneal injection of 1/5 LD50 CdCl2. The experimental groups were protected by administration of CPZ, NIMO and CPZ and NIMO in combination l h before the injection of CdCl2. Five days later, samples were collected for analysis. The data showed that Crs could protect kidney tissue against Cd-induced damage, as the urinary γ-glutamyl traspepti dase (γ- GT ) and N- acetyl-β-D-glucosaminidase (NAG) activities were reduced significantly. There was neither evidence of the protective effect of NIMO on kidney tissue nor an indication of a synergistic effecf of Crs and NIMO.Both CPZ and NIMO showed a considerable protective effect against the deerease in Ca2+ -Mg2+ AT-Pase activity, and a synergistic action was observed. Cd content in blood was reduced significanily by CPZ or the combination of CPZ and NIMO, but elevated by NIMO. Both CPZ and NIMO consideraby increased MT contents in livers and kidneys and ameliorated damaged to the hepatic ultrastructures caused by Cd. The results indicated that these inhibitors could protect mice against the toxic effects of Cd in liver and kidney tissues, while CPZ was more efficient than NIMO. The combination of CPZ and NIMO exerted a synergistic action. The protective action of these two drugs might be relevent to the function of MT.

Research Progress of Osteoporosis Based on the Theory of"Homology of Liver and Kidney"

Osteoporosis is a systemic chronic metabolic bone disease,mainly in the elderly and postmenopausal women.At present,most of the clinical treatment is western medicine,but the curative effect is not very significant.In the treatment of osteoporosis,traditional Chinese medicine(TCM)is mainly based on the overall concept of TCM.This article briefly analyzes osteoporosis from the theory of"liver and kidney homology,"discusses the research on osteoporosis in TCM,and hopes to provide reference for the clinical treatment and research of osteoporosis.

Role of Exogenous Reduced Glutathione on Time Dependent ^(203)Hg Distribution in Liver and Kidney of a Freshwater Teleost, Anabas testudineus

Time-dependent tissue distribution of mercury(Hg) was studied in a freshwater perch,Anabas testudineus which revealed that the liver and kidneys are the major sites of Hg reten tion. The role of reduced glutathione (GSH) in the clearance of Hg was also investigated to e valuate the ameliorative effect of this nucleophile. For this purpose, the perch was given GSH 15 min before or after they received 203Hg by injection. The fish were then sacrificed at 24 h and 48 h later. The results clearly indicate that exogenous GSH can significantly reduce Hg retention in both the liver and kidneys, demonstrating a direct role of this nucleophile in the amelioration of Hg-induced toxicity in the early phase of intoxication

Effects of Noise Pollution on Functions of the Liver and Kidney of Rats

To study the effects of noise pollution on the functions of the liver and kidney of rats, a total of 40 male SPF Wistar rats were randomly divided into a control group and three experimental groups. The rats in the experimental groups were respectively stimulated with 38, 55 and 70 dB noise for 15 days, and the levels of blood components were determined by an automatic biochemical analyzer. The results showed that in compari-son with the control group, the level of the blood glucose in the experimental groups increased by 23.53%, 52.94% and 88.24%, respectively, and the differences were statistically significant （P〈0.01）. The levels of triglyceride in the blood rose by 20.83%, 38.54% and 79.68%, respectively, and the differences were also statistically significant （P〈0.01）. The level of globulin in the blood increased by 16.49%, 21.13% and 51.78%, and the level of albumin in the blood rose by 9.51 %, 12.67% and 17.89%, respectively. The level of total bilirubin in the blood increased by 27.04%, 41.63% and 73.67%, respectively, and the differences were statistically significant （P〈0.01）. The level of creatinine in the blood rose by 9.72%, 10.21% and 20.99%, respectively. The level of amylase in the blood reduced by 6.6%, 13.05% and 23.89%, respectively. The level of creatine kinase in the blood decreased by 19.81%, 27.37% and 36.81 %, respectively, and the level of urea in the blood reduced by 11.19%, 12.77% and 19.26%, respectively. The results revealed that noise pollution could significantly affect the levels of blood components and the functions of the liver and kidney of rats.

Clinical Study of Acupotomy Trinity Lysis on Cervical Spondylotic Myelopathy with Liver and Kidney Deficiency Syndrome

Objective:To compare the therapeutic effects of acupotomy trinity lysis and traditional acupotomy on cervical spondylotic myelopathy.Methods:A total of 205 patients with cervical spondylotic myelopathy of liver and kidney deficiency syndrome were randomly divided into the experimental group(105 cases)and the control group(100 cases).The experimental group was relaxed with acupotomy in three positions:Heaven(tian),Human(ren)and Earth(di).Traditional acupotomy was used to relax Ashi acupoints of the affected vertebra in the control group.One treatment was conducted in one week,and the duration of one course of treatment was three weeks.The VAS,JOA score and NDI index were observed after treatment.Results:Before and after treatment,the total treatment efficiency of the treatment group was 95.23%,and that of the control group was 80.00%,there was significant difference between the two groups,P<0.05;Before operation,there was no significant difference in JOA score,NDI index score,and VAS score between the treatment group and the control group(P>0.05);there was no significant difference after 1 week(P>0.05),but there were significant differences between the two groups 2 weeks and 3 weeks after operation(P<0.05).Conclusion:Acupotomy trinity lysis is a safe,effective and economical treatment for cervical spondylotic myelopathy.

An analysis of Liver and Kidney pathogenesis and treatment based on the theory of interpromotion and restraint of the five elements

The interpromotion and restraint of the five elements is the self-regulation mechanism of the five elements system under normal conditions.For the human viscera,by comparing the images,deducing and classifying the attributes of things,the human viscera are connected with the five elements,and it is concluded that the Liver belongs to Wood and the Kidney belongs to Water.According to the law of mutual generation and restriction between the five elements,the pathogenic causes,pathogenesis and relationship with other viscera of the Liver and Kidney can be known,so as to establish corresponding treatment methods,such as"Nourishing Water and protecting Wood"(providing Kidney for the growth of Liver method),"Golden Water symbiosis"(generation between the Lung and Kidney),"Cultivating soil and generating gold"(warming the Kidney and benefited Spleen method),Supporting lung to suppress Liver,purging heart Fire to nourish renal Water method,etc.It is of referential significance for the treatment of Liver and Kidney diseases in the diagnosis and treatment of traditional Chinese medicine.

A single center experience of combined liver and kidney transplantation

Objective To summarize the experience of treating the end stage of liver disease complicated with renal failure using combined liver - kidney transplantation. Methods The clinical data of 28 cases receiving combined liver - kidney transplantation were retrospectively ana-

Effect of liver transplantation with primary hyperoxaluria type 1:Five case reports and review of literature

BACKGROUND Primary hyperoxaluria type 1(PH1)is a rare autosomal recessive disease stemming from a deficiency in liver-specific alanine-glyoxylate aminotransferase,resulting in increased endogenous oxalate deposition and end-stage renal disease.Organ transplantation is the only effective treatment.However,its approach and timing remain controversial.CASE SUMMARY We retrospectively analyzed 5 patients diagnosed with PH1 from the Liver Transplant Center of the Beijing Friendship Hospital from March 2017 to December 2020.Our cohort included 4 males and 1 female.The median age at onset was 4.0 years(range:1.0-5.0),age at diagnosis was 12.2 years(range:6.7-23.5),age at liver transplantation(LT)was 12.2 years(range:7.0-25.1),and the follow-up time was 26.3 mo(range:12.8-40.1).All patients had delayed diagnosis,and 3patients had progressed to end-stage renal disease by the time they were diagnosed.Two patients received preemptive LT;their estimated glomerular filtration rate was maintained at>120 mL/min/1.73 m2,indicating a better prognosis.Three patients received sequential liver and kidney transplantation.After transplantation,serum and urinary oxalate decreased,and liver function recovered.At the last follow-up,the estimated glomerular filtration rates of the latter 3 patients were 179,52 and 21 mL/min/1.73 m2.CONCLUSION Different transplantation strategies should be adopted for patients based on their renal function stage.Preemptive-LT offers a good therapeutic approach for PH1.

Therapeutic observation of 'warming-unblocking needling technique'for knee osteoarthritis due to deficiency of liver and kidney

Objective:To compare the clinical efficacy between'warming-unblocking needling technique7 and reinforcing method by twirling in treating knee osteoarthritis(KOA)due to deficiency of liver and kidney.Methods:A total of 72 patients with KOA were divided into a warming-unblocking group and a reinforcing group by complete randomized method,with 36 cases in each group.Xuehai(SP 10),Heding(EX-LE 2),Liangqiu(ST 34);Neixiyan(EX-LE 4),Xizhong(Extra),Dubi(ST 35),Yinlingquan(SP 9),Zusanli(ST 36)and Yanglingquan(GB 34)were the main points in both groups.Taichong(LR 3),Taixi(Kl 3)and Sanyinjiao(SP 6)were the combined points.'Warming-unblocking needling technique'was applied in the warming-unblocking group,and reinforcing method by twirling was applied in the reinforcing group.The treatments were performed once a day,10 times as a treatment course,at a 2-day interval between two courses,for 3 courses in total.The scores of Western Ontario and McMaster Universities osteoarthritis index(WOMAC)in the two groups were observed before and after the treatment,and the clinical efficacy was compared.Results:After treatment,the total effective rate was 94.3%in the warming-unblocking group and 87.9%in the reinforcing group,and the difference between the two groups was statistically significant(P<0.05).The component scores of pain,stiffness and daily activities in WOMAC and total WOMAC scores in both groups decreased after treatment(all P<0.01).The component and total WOMAC scores in the warming-unblocking group were lower than those in the reinforcing group(P<0.05 or P<0.01).Conclusion:'Warming-unblocking needling technique' has significant efficacy than reinforcing method by twirling in treating KOA due to deficiency of liver and kidney.It can significantly improve pain,stiffness and daily functional activities of patients.

Retroperitoneal kidney transplantation with liver and native kidney mobilization:a safe technique for pediatric recipients

Background Pediatric kidney transplant(KT)using larger,deceased or living donor adult kidneys can be challenging in the pediatric population due to limited space in the retroperitoneum.Liver and native kidney(L/NK)mobilization techniques can be used in smaller and younger transplant recipients to aid in retroperitoneal placement of the renal allograft.Here,we compare the clinical outcomes of pediatric retroperitoneal KT with and without L/NK mobilization.Methods We retrospectively analyzed pediatric renal transplant recipients treated between January 2015 and May 2021.Donor and recipient demographics,intraoperative data,and recipient outcomes were included.Recipients were divided into two groups according to the surgical technique utilized:with L/NK mobilization(Group 1)and without L/NK mobilization(Group 2).Baseline variables were described using frequency distributions for categorical variables and means and standard errors for continuous variables.Tests of association with the likelihood of using L/NK mobilization were performed using standardχ2 tests,t tests,and the log-rank test.Results Forty-six pediatric recipients were evaluated and categorized into Group 1(n=26)and Group 2(n=20).Recipients in Group 1 were younger(6.7±0.8 years vs.15.3±0.7,P<0.001),shorter(109.5±3.7 vs.154.2±3.8 cm,P<0.001)and weighed less(21.4±2.0 vs.48.6±3.4 kg,P<0.001)than those in Group 2.Other baseline characteristics did not difer between Groups 1 and 2.One urologic complication was encountered in Group 2;no vascular or surgical complications were observed in either group.Additionally,no stents or drains were used in any of the patients.There were no cases of delayed graft function or graft primary nonfunction.The median follow-up of the study was 24.6 months post-transplant.Two patients developed death-censored graft failure(both in Group 2,P=0.22),and there was one death with a functioning graft(in Group 2,P=0.21).Conclusions Retroperitoneal liver/kidney mobilization is a feasible and safe technique that facilitates implantation of adult kidney allografts into pediatric transplant recipients with no increased risk of developing post-operative complications,graft loss,or mortality.

Research Progress on Chemical Constituents and Pharmacological Effect of Semen Cuscutae

In this paper,by summarizing the literature in recent years,it is considered that the chemical constituents of S.cuscutae are mainly flavonoids.The main pharmacological effects include improving osteoporosis,improving ovarian function,improving drug-induced reproductive toxicity,regulating spermatogenic cell apoptosis,resisting liver fibrosis,resisting inflammation,improving cardiovascular function,protecting fetus,protecting synapses and so on.By summarizing the chemical constituents and pharmacological effects of S.cuscutae,this study aims to better study the mechanism of anti-osteoporosis based on the fact that S.cuscutae has the function of tonifying liver and kidney.

Analysis of Famous TCM Doctor Zan Qiang's Experience in the Treatment of Perimenopausal Osteoporosis

The purpose of this study was to analyze the clinical experience of Zan Qiang,a famous doctor of Traditional Chinese Medicine in Shaanxi province,in the treatment of perimenopausal osteoporosis.Zan believed that the main etiology and pathogenesis of perimenopausal osteoporosis were "deficiency of kidney essence,decreased marrow and bone",deficiency of liver and kidney"and"stasis caused by deficiency".Although it is a chronic physiological disease,and the pathological process is irreversible,the treatment groups of"tonifying kidney and filling essence","tonifying liver and tonifying kidney"and "tonifying deficiency and promoting blood circulation" can significantly improve the symptoms of patients,slow down the progress of the disease and improve the quality of life of patients.

Chief Physician Defen Wang’s Clinical Experience in Dialectical Treatment with Mediation Method of Perimenopausal Sweating

The objective of this paper is to outline Chief Physician Defen Wang’s clinical experience in perimenopausal sweating syndrome differentiation and treatment,to inherit Mr.Gao’s academic concept of mediation technique,and to integrate multiple prescriptions under Mr.Gao’s thinking.The deficiency is based on the deficiency of liver and kidney Yin,the weakness of spleen and stomach,and the standard is the imbalance of Ying and Wei,the imbalance of Qi,blood and body fluid,and the main method of treatment is nourishing liver and kidney,soothing liver and invigorating spleen,regulating Ying and Wei,as well as tonifying Qi and absorbing fluid.

Treatment of Polycystic Ovary Syndrome from the Theory of "Yigui Homology"

Traditional medicine believes that emotional,room labor and other factors lead to the lack of blood circulation after the weather,and the consumption of Yin blood is too much,which can lead to the deficiency of blood essence.Over time,the deficiency of menstrual blood can not nourish the kidney essence,leading to abnormal pregnancy.The liver is congenital for women,and the kidney is congenital.The disharmony of liver and kidney is the key factor of women's disease.Starting from the"homology of Yi and GUI",this paper analyzes the main etiology and pathogenesis of the disease from three aspects:deficiency of blood essence,imbalance of Zang and Xie,and Yin not controlling Yang.Following the principle of simultaneous treatment of liver and kidney,starting from the three methods of "regulating and tonifying liver and kidney,tonifying kidney and activating blood circulation,and balancing yin and Yang",the liver and kidney are reconciled,and pregnancy is sometimes the best choice.The main purpose is to benefit PCOS patients.

Evaluation of a granulated formula for the nerve root type and vertebral artery type of cervical spondylosis：a multicenter,single-blind,randomized,controlled,phase Ⅲ clinical trial

OBJECTIVE:To evaluate the effectiveness and safety of cervical spondylosis formula granules in reducing the symptoms of patients with the nerve root type and the vertebral artery type of cervical spondylosis.METHODS:This was a multicenter, single-blind,randomized, controlled trial.From April 2002 to November 2003, 499 patients were randomly assigned to either the treatment or the control group.The treatment group was orally administered granules prepared with a formula for cervical spondylosis, while the control group was given Jingfukang granules.The treatment course was 1 month for both groups.RESULTS:In patients with the nerve root type of cervical spondylosis, the total effect rate in the treatment group(87.21%) was significantly higher than that in the control group(80.70%, P < 0.01).After the treatment period in both groups, the treatment group had a significantly greater rate of resolution of pain, numbness of the upper limbs, muscle strength of the upper limbs, and fatigue than the control group(all P < 0.05).In patients with the vertebral artery type of cervical spondylosis, the total effect rate in the treatment group(82.07%) was similar to that in the control group(71.21%, P >0.05).After the treatment period in both groups,the treatment group had a significantly greater rate of resolution of weakness of the waist and knees than the control group(P < 0.05).CONCLUSION:The cervical spondylosis formula granules significantly improve numbness, muscle strength, and fatigue, and reduce pain in patients with the nerve root type of cervical spondylosis,and improve the weakness of the waist and knees in patients with the vertebral artery type of cervical spondylosis.