Dietary Regulation of miR-33b and miR-29a in Relationship to Metabolic Biomarkers of Glucose and Lipids in Obese Diabetic Women: A Randomized Clinical Controlled Study

Background: MicroRNAs have recently been introduced as epigenetic regulators of glucose and lipid metabolic pathways, which are impaired in obesity and diabetes. Objectives: We evaluated the effects of calorie-restricted diet therapy on the circulating levels of miR-33b and miR-29a in relationship to glucose and lipid metabolic parameters in obese patients with type 2 diabetes mellitus (T2DM). Methods: This randomized clinical controlled trial was performed on 30 eligible obese women with T2DM, randomly divided into two groups (control group, n = 15; diet therapy group, n = 15) for 10 weeks. Ten healthy women with normal weight were enrolled at the baseline of the study as controls. Demographic information, dietary intake, and anthropometric and biochemical indices were obtained before and after the study. Circulating miR-33b and miR-29a were assessed for all subjects using quantitative RT-PCR, and the fold change of each circulating miRNA was compared between groups. Results: The circulating levels of miR-29a and miR-33b in the diabetic women were higher (0.40-fold) and lower (1.43-fold), respectively, than normal levels. Diet therapy significantly increased the circulating level of miR-33b (P = 0.023, 0.97-fold upregulation) to normal levels. This increase was independently correlated with caloric restriction (95%CI: -0.004 to -0.0001, P = 0.022) and 2hPPBS (95%CI: -0.009 to -0.001, P = 0.035). No remarkable change was observed in circulating levels of miR-29a. Conclusions: Our findings introduced a novel therapeutic effect of diet therapy on circulating miRNAs in obese patients with T2DM. MiR-33b is an important therapeutic target in the treatment and prevention of T2DM and its complication

Hysteroscopy for treating subfertility associated with suspected major uterine cavity abnormalities

Background : Observational studies suggest higher pregnancy rates after the hysteroscopic removal of endometrial polyps, submucous fibroids, uterine septum or intrauterine adhesions, which are detectable in 10% to 15% of women seeking treatment for subfertility. Objectives : To assess the effects of the hysteroscopic removal of endometrial polyps, submucous fibroids, uterine septum or intrauterine adhesions suspected on ultrasound, hysterosalpingography, diagnostic hysteroscopy or any combination of thesemethods inwomenwith otherwise unexplained subfertility or prior to intrauterine insemination (IUI), in vitro fertilisation (IVF) or intracytoplasmic sperm injection (ICSI). Search methods : We searched theCochraneMenstrualDisorders and Subfertility SpecialisedRegister (8 September 2014), theCochrane Central Register of Controlled Trials (The Cochrane Library 2014, Issue 9), MEDLINE (1950 to 12 October 2014), EMBASE (inception to 12 October 2014), CINAHL (inception to 11 October 2014) and other electronic sources of trials including trial registers, sources of unpublished literature and reference lists. We handsearched the American Society for Reproductive Medicine (ASRM) conference abstracts and proceedings (from January 2013 to October 2014) and we contacted experts in the field. Selection criteria : Randomised comparisons between operative hysteroscopy versus control in women with otherwise unexplained subfertility or undergoing IUI, IVF or ICSI and suspected major uterine cavity abnormalities diagnosed by ultrasonography, saline infusion/ gel instillation sonography, hysterosalpingography, diagnostic hysteroscopy or any combination of these methods. Primary outcomes were live birth and hysteroscopy complications. Secondary outcomes were pregnancy and miscarriage. Data collection and analysis : Two review authors independently assessed studies for inclusion and risk of bias, and extracted data. We contacted study authors for additional information. Main results : We retrieved 12 randomised trials possibly addressing the research questions. Only two studies (309 women) met the inclusion criteria. Neither reported the primary outcomes of live birth or procedure related complications. In women with otherwise unexplained subfertility and submucous fibroids there was no conclusive evidence of a difference between the intervention group treated with hysteroscopic myomectomy and the control group having regular fertility-oriented intercourse during 12 months for the outcome of clinical pregnancy. A large clinical benefit with hysteroscopic myomectomy cannot be excluded: if 21% of women with fibroids achieve a clinical pregnancy having timed intercourse only, the evidence suggests that 39% of women (95% CI 21% to 58%) will achieve a successful outcome following the hysteroscopic removal of the fibroids (odds ratio (OR) 2.44, 95% confidence interval (CI) 0.97 to 6.17, P = 0.06, 94 women, very low quality evidence). There is no evidence of a difference between the comparison groups for the outcome of miscarriage (OR 0.58, 95% CI 0.12 to 2.85, P = 0.50, 30 clinical pregnancies in 94 women, very low quality evidence). The hysteroscopic removal of polyps prior to IUI can increase the chance of a clinical pregnancy compared to simple diagnostic hysteroscopy and polyp biopsy: if 28% of women achieve a clinical pregnancy with a simple diagnostic hysteroscopy, the evidence suggests that 63% of women (95% CI 50% to 76%) will achieve a clinical pregnancy after the hysteroscopic removal of the endometrial polyps (OR 4.41, 95% CI 2.45 to 7.96, P < 0.00001, 204 women, moderate quality evidence). Authors' conclusions : A large benefit with the hysteroscopic removal of submucous fibroids for improving the chance of clinical pregnancy in women with otherwise unexplained subfertility cannot be excluded. The hysteroscopic removal of endometrial polyps suspected on ultrasound in women prior to IUI may increase the clinical pregnancy rate. More randomised studies are needed to substantiate the effectiveness of the hysteroscopic removal of suspected endometrial polyps, submucous fibroids, uterine septum or intrauterine adhesions in women with unexplained subfertility or prior to IUI, IVF or ICSI

Chinese Herbal Formula Xiao Yao San for Treatment of Depression: A Systematic Review of Randomized Controlled Trials

Objectives. To assess the beneficial and adverse effects of Xiaoyaosan for depression. Search Strategy. Electronic databases were searched until December 2009. Inclusion Criteria. We included randomized clinical trials testing Xiaoyaosan against placebo, antidepressants, or combined with antidepressants against antidepressants alone. Data Extraction and Analyses. Study selection, data extraction, quality assessment, and data analyses were conducted according to the Cochrane standards. Results. 26 randomized trials (involving 1837 patients) were included and the methodological quality was evaluated as generally low. The pooled results showed that Xiaoyaosan combined with antidepressants was more effective in comprehensive effect, the score of HAMD and the score of SDS compared with antidepressants alone. Xiaoyaosan was superior to antidepressants for the score of HAMD. However, Xiaoyaosan was not different from placebo for the score of SDS. There was no adverse effects reported in the trials from Xiaoyaosan. Conclusions. Xiaoyaosan appears to be effective on improving symptoms in patients with depression. However, due to poor methodological quality in the majority of included trials, the potential benefit from Xiaoyaosan need to be confirmed in rigorous trials and the design and reporting of trials should follow international standards

Current Situation of TCM Treatment of Schizophrenia

Schizophrenia is a common clinical disease in the department of psychiatry. Traditional Chinese medicine treatment of schizophrenia has a long history, rich experience, small side effects, to a certain extent can alleviate the condition of patients with schizophrenia. This article reviews the current situation of TCM treatment of schizophrenia in recent years from three aspects: TCM treatment, acupuncture treatment and catgut embedding treatment

The staining effect of different mouthwashes containing nanoparticles on dental enamel.

Background: This study aimed to evaluate the effects of several mouthwashes containing nanoparticles on discoloration of dental enamel, and compare the results with that of 0.2% chlorhexidine (CHX). Material and Methods: Sixty intact premolars were randomly assigned to six groups. A spectrophotometer was used to measure the color of the teeth (T1) according to the CIELAB system. The specimens in groups 1 to 4 were then immersed in colloidal solutions containing nanoTiO2 (Group 1), nanoZnO (Group 2), nanoAg (Group 3) and nanoCuO (Group 4). In groups 5 and 6, a 0.2% CHX mouthwash and distilled water were used as positive and negative controls, respectively. After 24 hours of immersion, color determination was repeated (T2). The third color assessment was accomplished after brushing (T3). The L, a, and b values were recorded and the color change (∆E) between different stages was calculated. Results: ANOVA revealed significant between-group differences in the color change between T1 and T2 stages, as well as between T1 and T3 time points ( p <0.05), whereas the color change between T2 and T3 was not signifi - cantly different among the study groups ( p =0.09). ∆ET1-T3 was significantly lower in the specimens immersed in distilled water or CHX as compared to the nanoparticle-containing mouthwashes ( p <0.05). The highest ∆E value pertained to the specimens immersed in nanoZnO-containing solution. The TiO2 nanoparticles caused the lowest staining among the tested nanoparticles. Conclusions: The mouthwashes containing nanoparticles produced comparable or even greater enamel discoloration compared to CHX. Brushing had little effect on removal of induced stain