Gut microbiota is essential for the function of peripherally-induced regulatory T (pTreg) cells. However, how commensal bacteria affect thymically derived fat-resident Treg cells that harbor a unique expression of peroxisome proliferator-activated receptor (PPAR)-γ and suppress inflammation in visceral adipose tissue (VAT), is not well defined. Here it is revealed that microbiota depletion causes a drastic decline in Treg cell population in VAT, particularly those expressing ST2 (ST2+ Treg), which are largely restored after gut microbiome reconstruction. Mechanistically, gut microbiota-derived butyrate increases VAT ST2+ Treg cells through binding PPARγ. Butyrate supplementation and high fiber diet increase VAT ST2+ Treg population in obese mice, and ameliorated glucose tolerance and visceral inflammation. Furthermore, human omental adipose Treg cells show positive correlation with fecal butyrate and certain butyrate-producing microbes. This study identifies the critical role of gut microbiota-butyrate-PPARγ axis in maintaining VAT Treg population, pinpointing a potential approach to augment VAT Treg population and ameliorate inflammation.

Background The metabolic benefits of bariatric surgery that contribute to the alleviation of metabolic dysfunction-associated steatotic liver disease (MASLD) have been reported. However, the processes and mechanisms underlying the contribution of lipid metabolic reprogramming after bariatric surgery to attenuating MASLD remain elusive.Methods A case-control study was designed to evaluate the impact of three of the most common adipokines (Nrg4, leptin, and adiponectin) on hepatic steatosis in the early recovery phase following sleeve gastrectomy (SG). A series of rodent and cell line experiments were subsequently used to determine the role and mechanism of secreted adipokines following SG in the alleviation of MASLD.Results In morbidly obese patients, an increase in circulating Nrg4 levels is associated with the alleviation of hepatic steatosis in the early recovery phase following SG before remarkable weight loss. The temporal parameters of the mice confirmed that an increase in circulating Nrg4 levels was initially stimulated by SG and contributed to the beneficial effect of SG on hepatic lipid deposition. Moreover, this occurred early following bariatric surgery. Mechanistically, gain- and loss-of-function studies in mice or cell lines revealed that circulating Nrg4 activates ErbB4, which could positively regulate fatty acid oxidation in hepatocytes to reduce intracellular lipid deposition.Conclusions This study demonstrated that the rapid effect of SG on hepatic lipid metabolic reprogramming mediated by circulating Nrg4 alleviates MASLD.

Although numerous prediction models are available for diabetes remission following metabolic bariatric surgery, few are based on sleeve gastrectomy (SG). This study aimed to establish a predictive model for type 2 diabetes mellitus (T2DM) remission following SG and evaluate the efficacy of existing predictive models. Patient data were gathered from a cohort study titled “Longitudinal Study of Bariatric Surgery in Western China.” The synthetic minority oversampling technique was implemented, with 70

腹腔镜胃袖状切除术(laparoscopic sleeve gastrectomy,LSG)是目前国内外开展最广泛的减重手术术式.随着手术的开展,术后复胖等各种原因造成的修正手术比例也逐年增加,如何个体化选择合适的修正术式并规范地开展修正手术是目前减重外科面临的热点问题之一.此文结合文献和作者临床经验就LSG术后修正手术的原因、术式选择等问题展开概述,为修正手术的规范化开展提供思路.

Objective It is to investigate the effect of Feng-Liao-Chang-Wei-Kang（FLCWK） granules on glycolipid metabolism and glucagon like peptide-1（GLP-1） in obesity induced type 2 diabetic rats. Methods Seventy 7-week-old SD rats were selected, in which 10 rats were randomly selected as a blank group and fed with normal diet, the rest rats were fed with high-fat and high-sugar diet combined with intraperitoneal injection of streptozotocin to establish type 2 diabetic models. The successfully modeled type 2 diabetic rats were randomly divided into model group, sitagliptin group and FLCWK granules low, medium and high dose groups, with 10 rats in each group. The sitagliptin group was given sitagliptin 16.7 mg/kg by gavage, the FLCWK granules low, medium and high dose groups were given FLCWK granules 2.65 g/kg, 5.3 g/kg and 10.6 g/kg by gavage, respectively, and the blank group and model group were given physiological saline by gavage, all once a day, continuously treated for 4 weeks. The body weight of the rats in each group was measured at the end of modeling and after 4 weeks of intragastric administration, and the levels of blood glucose, serum insulin, blood lipids [cholesterol（TC）, triacylglycerol（TG）, low-density lipoprotein cholesterol（LDL-C）, high-density lipoprotein cholesterol（HDL-C）] and serum GLP-1 in the rats were measured after 4 weeks of intragastric administration, the expression of GLP-1 in ileum tissue was detected by immunohistochemistry. Results After 4 weeks of gavage, no statistically significant changes of body weight were found in the FLCWK granules medium and high dose groups and sitagliptin group compared with those after modeling（all P＞0.05）, the body weights of the rats in the model group and the FLCWK granules low-dose group were significantly reduced compared with those after modeling（all P＜0.05）. The levels of fasting blood glucose, 30 min post-load blood glucose, 60 min post-load blood glucose, 120 min post-load blood glucose and fasting insulin of the rats in the FLCWK granules medium and high dose groups and the sitagliptin group were significantly lower than those in the model group（all P＜0.05）; The levels of 60 min post-load blood glucose, 120 min post-load blood glucose of the rats in the FLCWK granules high dose group and the sitagliptin group were significantly lower than those in the FLCWK granules low dose group（all P＜0.05）; The levels of 60 min post-load fasting insulin of the rats in the FLCWK granules medium dose group and the sitagliptin group were significantly higher than that in the FLCWK granules low dose group（all P＜0.05）. The levels of serum TC, TG and LDL-C of the rats in the FLCWK granules high dose group and the selegiline group, and the levels of serum TC and TG in the FLCWK granules medium dose group were significantly lower than those in the model group（all P＜0.05）, and the level of HDL-C of the rats in the FLCWK granules medium dose group was significantly higher than that in the model group（P＜0.05）. The levels of serum GLP-1 in the FLCWK granules medium and high dose groups and sitagliptin group were significantly higher than that in the model group（all P＜0.05）, and the FLCWK granules high dose group and sitagliptin group were significantly higher than that in the low dose group（P＜0.05）. The mean optical density values of GLP-1 in the ileum tissues of rats in the FLCWK granules medium and high dose groups and the sitagliptin group were significantly higher than that in the model group（all P＜0.05）. Conclusion FLCWK granules can improve the blood glucose and glycolipid metabolism of type 2 diabetic rats induced by obesity, the effect may be achieved by regulating intestinal secretion of GLP-1.

目的 初步探讨腹腔镜胃袖状切除术(LSG)和腹腔镜Roux-en-Y胃旁路术(LRYGB)治疗肥胖合并中重度阻塞性睡眠呼吸暂停低通气综合征(OSAHS)术后2年疗效.方法 回顾性分析上海交通大学医学院附属第九人民医院普外科2016年1月至2019年6月接受LSG或LRYGB的肥胖合并中重度OSAHS病人116例病例资料.根据不同手术方式分为LSG组(77例)和LRYGB组(39例).比较两组病人术后2年疗效.结果 LSG组手术时间低于LRYGB组,而两组间术中出血量和术后住院时间差异均无统计学意义.术前与术后2年两组病人呼吸紊乱指数(AHI)值比较,分别为:LSG组[(64.2±21.6)次/h vs.(13.6±4.1)次/h]和LRYGB组[(59.8±10.5)次/h vs.(12.5±2.4)次/h],差异有统计学意义(P＜0.001).两组术后平均血氧饱和度(SaO2)和最低SaO2相较于术前均升高(P＜0.001).而两组间术后2年OSAHS相关各指标(AHI、平均SaO2、最低SaO2)比较差异均无统计学意义(P均＞0.05).减重手术治疗OSAHS的临床有效率为100.0％;LSG组的治愈率和显著有效率分别为15.6％和62.3％,LRYGB组的治愈率和显著有效率为15.3％和58.9％;两组间治愈率和显著有效率差异无统计学意义.两组病人术后2年肥胖各指标(体重、BMI、％TWL、颈围、腰围、胸围)均较术前降低(P＜0.001),而两组间术后2年肥胖各指标比较差异无统计学意义(P＞0.05).OSAHS病情改善情况与术后颈围下降具有相关性(LSG组:r=0.521,P=0.021;LRYGB组:r=0.4950,P=0.044).结论 LSG和LRYGB能够有效地治疗肥胖合并中重度OSAHS,OSAHS的残余问题需进一步密切随访和开展多学科协助诊治.

目的 观察恒清Ⅲ号方治疗缺血性脑卒中(IS)合并脑叶微出血(CMBs)的临床疗效,并分析其作用机制.方法 选取2019年11月—2020年10月上海交通大学附属第六人民医院收治的缺血性脑卒中合并脑叶微出血病人125例为研究对象,采用随机数字表法分为治疗组(63例)与对照组(62例).对照组给予基础治疗,治疗组在基础治疗上加用恒清Ⅲ号方.两组疗程均为8周.比较两组临床疗效、美国国立卫生研究院脑卒中量表(NIHSS)评分、改良Rankin量表(mRS)评分、脑叶微出血病灶数目及血清白细胞介素-1(IL-1)、白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)、钙结合蛋白100B(S100B)、血管内皮生长因子(VEGF)水平.结果 治疗组总有效率为87.30％,高于对照组的61.29％(P<0.01).治疗后,治疗组NIHSS评分、mRS评分低于对照组,脑叶微出血病灶数目少于对照组,差异均有统计学意义(P<0.05或P<0.01);治疗组治疗后血清IL-1、IL-6、TNF-α、S100B水平低于对照组(P<0.01),VEGF水平高于对照组(P<0.01).治疗过程中治疗组未发现明显不良反应.结论 恒清Ⅲ号方可能通过减轻炎症反应、促进血管形成、改善神经功能,从而治疗缺血性脑卒中合并脑叶微出血.

目的 观察恒清Ⅲ号方治疗缺血性脑卒中(IS)的临床疗效及安全性.方法 选取2019年6月—2021年6月在上海市第六人民医院就诊的缺血性脑卒中病人共270例,随机分为对照组、金纳多(银杏叶提取物片)组和恒清Ⅲ号方组,各90例.3组均按缺血性脑卒中指南进行基础治疗,金纳多组在对照组治疗基础上给予金纳多片治疗,恒清Ⅲ号方组在对照组治疗基础上给予恒清Ⅲ号方治疗.3组疗程均为8周.比较3组中医、西医临床疗效,于治疗前后对3组病人进行中医症状分级量表评分、美国国立卫生研究院卒中量表(NIHSS)评分、Barthel指数(BI)评分及改良Rankin量表(mRS)评分,检测3组病人脑动脉血流速度及安全性指标,记录试验过程中的不良反应发生情况.结果 恒清Ⅲ号方组中医、西医临床疗效总有效率均高于金纳多组、对照组(P<0.05或P<0.01);金纳多组、恒清Ⅲ号方组治疗后中医症状量化评分、NIHSS评分、mRS评分均低于对照组(P<0.05或P<0.01),且恒清Ⅲ号方组治疗后中医症状量化评分、NIHSS评分、mRS评分低于金纳多组(P<0.05).金纳多组、恒清Ⅲ号方组治疗后BI评分高于对照组(P<0.05或P<0.01),且恒清Ⅲ号方组治疗后BI评分高于金纳多组(P<0.05).与金纳多组比较,恒清Ⅲ号方组治疗后椎动脉(VA)、基底动脉(BA)的收缩峰血流速度(Vp)、舒张末期血流速度(Vd)、平均血流速度(Vm)均增加(P<0.05);与对照多组比较,恒清Ⅲ号方组治疗后Vp、Vm均增加(P<0.05).3组安全性指标、不良反应发生率比较差异均无统计学意义(P>0.05).结论 恒清Ⅲ号方治疗缺血性脑卒中疗效优于金纳多,且安全性较好,其作用机制可能与其增加缺血性脑卒中病人脑血流速度有关.

目的:探讨恒清Ⅰ号方联合盐酸多奈哌齐对血管性痴呆(vascular dementia,VD)患者的作用及其机制.方法:将VD患者132例按随机数字表法分为治疗组65例及对照组67例.两组患者均给予基础治疗.对照组同时给予盐酸多奈哌齐治疗,治疗组在对照组基础上给予恒清I号方,两组疗程均为3个月.比较治疗前后两组患者日常生活能力量表(activity of daily living,ADL)评分、长谷川痴呆量表(hasegawa dementia scale,HDS)评分、简易精神状态量表(minimum mental state examination,MMSE)评分、血液流变学指标水平(红细胞压积、血浆黏度、全血低切还原黏度与高切还原黏度)、白细胞介素6(interleukin-6,IL-6)和肿瘤坏死因子α(tumor necrosis factorα,TNF-α)、同型半胱氨酸(homocysteine,Hcy)、超敏C反应蛋白(high-sensitivity C-reactive protein,hs-CRP)、D-二聚体(D-Dimer)水平及总有效率.结果:治疗后治疗组HDS、MMSE与ADL评分均高于对照组(P<0.01);血液流变学指标与IL-6、TNF-α水平及Hcy、hs-CRP、D-Dimer水平均低于对照组(P<0.05);总有效率治疗组为84.6％,高于对照组的68.7％,差异有统计学意义(P<0.05).结论:恒清I号方与多奈哌齐联用可以提高VD患者HDS、MMSE与ADL评分.其作用机制可能为改善VD患者血液流变学指标,减轻炎症反应,降低氧化损伤,改善微循环,修复神经元细胞,保护中枢神经元,从而改善VD患者的日常生活能力及认知功能.

阻塞性睡眠呼吸暂停低通气综合征(obstructive sleep apnea hypopnea syndrome,OSAHS)是一种发病隐匿的慢性、潜在致死性疾病,也是病态肥胖症的最常见合并症之一.由于面颅软硬组织解剖结构异于西方人种,东亚人种的OSAHS患病率更高,且程度更严重.减重代谢手术对肥胖合并OSAHS的治疗作用已获公认,但现减重代谢外科医师对OSAHS的认知仍严重不足.对减重代谢外科患者进行OSAHS筛查是完全必要且可行的,多导睡眠监测是诊断OSAHS的金标准.本文就减重代谢手术的术前正压通气治疗,术中气道管理、麻醉注意事项、麻醉药物选择、患者体位选择和手术方式选择等问题作一阐述,而整个诊治过程的标准化无疑可使更多的患者受益.

对于极重度肥胖病人的最优减重术式选择,一直是困扰减重代谢外科医生的难点之一.对于这类病人,常用的腹腔镜胃袖状切除术(laparoscopic sleeve gastrectomy,LSG)可能存在部分病例无法达到理想体重和复胖等问题,腹腔镜胃旁路手术(laparoscopic Roux-en-Y gastric bypass,LRYGB)也面临着大体重病人手术困难、吻合口溃疡以及维生素微量元素摄入不足等困境.1998年Hess等[1]在Scopinaro等[2]的胆胰分流(biliopancreatic diversion,BPD)基础上改良的胆胰分流并十二指肠转位术(biliopancreatic diversion du-odenal switch,BPD/DS)对极重度肥胖以及2型糖尿病等肥胖相关代谢疾病的疗效显著,但存在技术难度大,术后营养并发症发生率高等问题.2007年,Sánchez-Pernaute等[3]报道了在BPD/DS基础上改良的LSG联合单吻合口十二指肠回肠旁路术(single-anastomosis duodenoileal bypass with sleeve gastrectomy,SADI-S)在尽量维持BPD/DS疗效的前提下,简化手术流程和难度,并期望减少术后营养不良等并发症的发生率.

目的 观察恒清Ⅱ号方联合盐酸多奈哌齐治疗阿尔茨海默病并发睡眠障碍的临床研究.方法 选取2019年1月—2020年1月上海市第六人民医院收治的阿尔茨海默病并发睡眠障碍病人105例,采用随机数字表法将病人分为对照组和观察组.对照组除了采用基础治疗外给予盐酸多奈哌齐片,观察组除了采用基础治疗外给予恒清Ⅱ号方+盐酸多奈哌齐片治疗,两组疗程均为3个月.比较两组治疗前后简易精神状态量表(MMSE)、阿尔茨海默病认知功能评定量表(ADAS-cog)、日常生活活动能力量表(ADL)、社会表现量表(PSP)、激越行为量表(CMAI)、匹兹堡睡眠质量指数量表(PSQI)、睡眠日记、失眠严重指数量表(ISI)、睡眠个人信念与态度量表(DBAS-16)、贝克抑郁量表(BDI)、贝克焦虑量表(BAI)、阿森斯失眠量表(AIS)评分等,检测血清5-羟色胺(5-HT)、P物质(SP)、多巴胺(DA)、白细胞介素-1β(IL-1β)、白细胞介素-6(IL-6)、白细胞介素-10(IL-10)、C-反应蛋白(CRP)及肿瘤坏死因子α(TNF-α)脑源性神经营养因子(BDNF)水平,记录两组治疗期间不良反应发生情况.结果 与治疗前比较,治疗后两组MMSE及PSP评分均升高,ADAS-cog、ADL及CMAI评分、PSQI总分及各因子评分均降低,入睡潜伏期及总觉醒时间均缩短,总睡眠时间延长,睡眠效率提高,ISI、BDI、BAI及AIS评分均降低,DBAS-16总分及各因子评分均升高,且观察组优于对照组(P<0.05或P<0.01).观察组不良反应发生率低于对照组,差异无统计学意义(1.89％和7.69％,P>0.05).治疗后,两组血清5-HT、BDNF及DA水平较治疗前均升高,SP、IL-1β、IL-6、IL-10、CRP及TNF-α水平较治疗前均降低,差异均有统计学意义(P<0.05或P<0.01);与对照组治疗后比较,观察组血清5-HT、BDNF及DA水平均升高,SP、IL-1β、IL-6、IL-10、CRP及TNF-α水平均降低,差异均有统计学意义(P<0.05或P<0.01).结论 恒清Ⅱ号方联合盐酸多奈哌齐片治疗阿尔茨海默病并发睡眠障碍,不仅改善病人精神状态、认知功能、生活能力、社会表现能力及激越行为等,还可改善睡眠障碍,且不良反应率低,其机制可能与升高血清5-HT、BDNF及DA水平,降低SP、IL-1β、IL-6、IL-10、CRP及TNF-α水平有关.

目的:探讨机体能量代谢变化对腹腔镜袖状胃切除术后体重下降量的影响.方法:选择67例行腹腔镜袖状胃切除术的肥胖患者作为研究对象,术后6个月将其分为获得理想减重效果组,即多余体重减少百分比(％EWL)≥50％及未获得理想减重效果组(％EWL<50％).对比分析术前及术后6个月能量代谢与体成分指标.结果:术后6个月,33例获得理想减重效果.相关性分析得出,％EWL与术后静息能量代谢(REE)/体重(BW)、△REE/BW、△去脂体重百分比呈正相关(r=0.473,P<0.001;r=0.372,P=0.002;r=0.493,P=0.003),％EWL与△呼吸商(RQ)、术后RQ呈现负相关(r=-0.613,P<0.001;r=-0.553,P<0.001).多元逐步Logistic回归分析显示,术后REE/BW、RQ与获得理想减重效果密切相关.结论:术后REE/BW的增加及术后RQ的下降是获得理想减重效果的有效预测因子.

目的 探讨恒清方对脑缺血再灌注损伤的保护作用及其机制.方法 将48只雄性SD大鼠随机分为假手术组、模型组、恒清方低剂量组、恒清方中剂量组、恒清方高剂量组和尼莫地平组,各8只.造模前1周灌胃给药(低剂量、中剂量、高剂量恒清方或尼莫地平),假手术组与模型组给予等体积生理盐水.末次给药30 min后,建立大鼠大脑中动脉局灶性栓塞(MCAO)模型,造模1.5 h再灌注24 h后,评估大鼠神经功能,测定脑指数、脑含水量、脑梗死面积,采用酶联免疫吸附法测定(ELISA)检测脑组织超氧化物歧化酶(SOD)活性、丙二醛(MDA)、一氧化氮(NO)及血清白介素-6(IL-6)、白介素-1β(IL-1β)、肿瘤坏死因子(TNF)水平.结果 恒清方可降低大鼠神经功能评分、脑指数、脑含水量(P<0.05或P<0.01),减小脑梗死面积(P<0.05或P<0.01),提高脑组织SOD活性(P<0.05或P<0.01),降低MDA、NO水平(P<0.05或P<0.01),降低血清IL-6、TNF、IL-1β水平(P<0.05或P<0.01),且量效关系呈正相关,高剂量恒清方作用优于尼莫地平(P<0.05).结论 恒清方可改善大鼠脑缺血再灌注损伤,且量效关系呈正相关,其机制可能与抑制炎症反应和抗氧化作用有关.

目的 探讨恒清Ⅰ号方对血管性痴呆(VD)大鼠学习记忆能力的保护作用.方法 将36只SD大鼠随机分为假手术组、模型组、奥拉西坦组及恒清Ⅰ号方组,各9只.以双侧颈总动脉结扎术制备VD大鼠模型,造模7 d后,恒清Ⅰ号方组大鼠给予中药恒清Ⅰ号方灌胃,奥拉西坦组给予奥拉西坦胶囊溶液灌胃,假手术组和模型组给予生理盐水灌胃,每日2次,灌胃干预4周、8周后,分别以Morris水迷宫实验评价各组大鼠学习记忆能力.结果 与模型组比较,药物干预组(恒清Ⅰ号方组和奥拉西坦组)干预4周、干预8周大鼠逃避潜伏期(EL)均缩短,平台所在象限时间占比(PTSTQ)均增加,差异均有统计学意义(P<0.05或P<0.01);奥拉西坦组干预4周与8周比较,EL和PTSTQ无明显变化,差异均无统计学意义(P>0.05).与恒清Ⅰ号方组干预4周比较,恒清Ⅰ号方组干预8周EL缩短,PTSTQ增加,差异均有统计学意义(P<0.05).与奥拉西坦组干预8周比较,恒清Ⅰ号方组干预8周EL缩短,PTSTQ增加,差异均有统计学意义(P<0.05).结论 恒清Ⅰ号方可明显改善VD大鼠学习记忆能力,恒清Ⅰ号方干预8周优于干预4周,且优于奥拉西坦干预8周.

目的 基于PI3 K/AKT信号通路及自噬研究恒清Ⅰ号方治疗血管性痴呆的作用机制.方法 将60只健康雄性SD大鼠随机分为假手术组、模型组、恒清Ⅰ号方低剂量组、恒清Ⅰ号方中剂量组、恒清Ⅰ号方高剂量组和欧来宁组,每组10只.除假手术组外,其余组均采用双侧颈总动脉永久性结扎法建模.术后7 d,恒清Ⅰ号方低、中、高剂量组分别给予0.268 g/mL、0.535 g/mL、1.070 g/mL的恒清Ⅰ号方灌胃,欧来宁组给予欧来宁14.8 g/kg灌胃,假手术组、模型组给予等量生理盐水灌胃,均2次/d,持续灌胃30 d.灌胃结束后采用Morris水迷宫实验测试各组大鼠的逃避潜伏期、穿越平台次数,以ELISA法检测海马组织中肿瘤坏死因子-α(TNF-α)、核因子-κB(NF-κB)含量,以Western blot法检测海马组织中PI3 K、AKT、p-AKT、LC3-Ⅰ及LC3-Ⅱ蛋白表达情况.结果 水迷宫实验第1～4天,模型组大鼠逃避潜伏期均明显长于假手术组(P均<0.05);恒清Ⅰ号方中、高剂量组和欧来宁组大鼠逃避潜伏期均明显短于模型组和恒清Ⅰ号方低剂量组(P均<0.05),且恒清Ⅰ号方高剂量组明显短于恒清Ⅰ号方中剂量组和欧来宁组(P均<0.05);模型组大鼠穿越平台次数明显少于假手术组(P<0.05),恒清Ⅰ号方中、高剂量组和欧来宁组大鼠穿越平台次数均明显多于模型组和恒清Ⅰ号方低剂量组(P均<0.05),且恒清Ⅰ号方高剂量组明显多于恒清Ⅰ号方中剂量组和欧来宁组(P均<0.05).与假手术组比较,模型组大鼠海马组织中TNF-α、NF-κB含量和LC3-Ⅱ/LC3-Ⅰ比值均明显增高(P均<0.05),PI3K、AKT、p-AKT蛋白表达量均明显降低(P均<0.05);与模型组和恒清Ⅰ号方低剂量组比较,恒清Ⅰ号方中、高剂量组和欧来宁组大鼠海马组织中TNF-α、NF-κB含量和LC3-Ⅱ/LC3-Ⅰ比值均明显降低(P均<0.05),PI3K、AKT、p-AKT蛋白表达量均明显升高(P均<0.05);与恒清Ⅰ号方中剂量组和欧来宁组比较,恒清Ⅰ号方高剂量组大鼠海马组织中TNF-α、NF-κB含量和LC3-Ⅱ/LC3-Ⅰ比值均明显降低(P均<0.05),PI3 K、AKT、p-AKT蛋白表达量均明显升高(P均<0.05).结论 恒清Ⅰ号方可以呈量效关系改善血管性痴呆大鼠的学习记忆能力,且高剂量恒清Ⅰ号方的作用优于欧来宁,可能与其抑制炎症反应、阻滞细胞自噬和调控PI3 K/AKT信号通路有关.

目的 统计分析我国多地区2019年度减重与代谢手术开展情况.方法 基于大华北减重与代谢手术临床资料数据库数据登记工作,统计分析2019年度各地区开展减重与代谢手术情况,并对病人人口学信息、肥胖相关疾病、手术信息等进行统计学描述和分析.结果 2019年度来自19个省市、自治区及直辖市、38家中心提交数据,登记有效病例2259例.病人术前BMI为37.6 (22.0,77.7).女性病人1655例(73.3％),年龄中位数为31(11,71)岁;男性病人602例(26.7％),年龄中位数为31(14,71)岁.腹腔镜胃袖状切除术(LSG)占82％,腹腔镜Roux-en-Y胃旁路术(LRYGB)占8％,腹腔镜胃袖状切除联合空肠旁路术(LSG-JJB)占7％、单吻合口胃旁路术(OAGB)占2％、腹腔镜胃袖状切除联合袢式十二指肠空肠旁路术(LSG-Loop DJB)占0.2％、腹腔镜胃袖状切除联合Roux-en-Y十二指肠空肠旁路术(LSG-DJB)占0.1％、其他手术方式占0.7％.28.5％的病人在术前合并2型糖尿病,51.4％的病人术前合并阻塞性呼吸睡眠暂停综合征,17.8％的病人术前合并多囊卵巢综合征,11.5％的病人术前合并胃食管反流病.结论 大华北减重与代谢手术临床资料数据库的搭建为我国减重与代谢手术的大数据登记工作奠定了坚实基础.基于目前数据,尽管手术方式呈现多样性,LSG是2019年度我国多地区减重与代谢手术的主流术式.

六神丸系中医经典名方,源于雷允上诵芬堂方,由麝香、蟾酥、雄黄等组成,具有清凉解毒、消炎止痛之功,主治咽喉肿痛、痈疡疔疮、无名肿毒等.现代药理学研究表明其具有消炎、抗病毒、镇痛等作用. 随着临床实践的不断深入,六神丸被广泛地应用到临床各科,屡获良效.下面就几个方面给大家简单介绍一下.