Control Of Blood Glucose Levels Research Articles

A Biomineralized Bifunctional Patient-Friendly Nanosystem for Sustained Glucose Monitoring and Control in Diabetes.

Regular blood glucose monitoring and control is necessary for people with type 1 or advanced type 2 diabetes, yet diagnosing and treating patients with diabetes in an accurate, sustained and patient-friendly manner remains limited. Here, a glucose-responsive bifunctional nanosystem (PGOxMns) is constructed via one-pot biomineralisation of manganese dioxide with glucose oxidase and ε-poly-L-lysine. Under hyperglycaemic conditions, the cascade reactions that occur when glucose interacts with PGOxMns can trigger the production of Mn(II), which enhances the magnetic resonance imaging signal. Simultaneously, manganese dioxide catalyses the decomposition of toxic hydrogen peroxide into oxygen, which also maintains glucose oxidase (GOx)activity. In an in vivo model of diabetes, PGOxMns is used to monitor glucose levels (0-20mm) and allowed identification of diabetic mice via T1-weighted MRI. Furthermore, PGOxMns is found to have a high insulin-loading capacity (83.6%), likely due to its positive charge. A single subcutaneous injection of insulin-loaded nanosystem (Ins-PGOxMns) into diabetic mice resulted in a rapid and efficient response to a glucose challenge and prolonged blood glucose level control (< 200mgdL-1) for up to 50h. Overall, this proof-of-concept study demonstrates the feasibility of using biomineralised nanosystems to develop patient-friendly strategies for glucose monitoring and control.

Boron-doped g-C3N4 supporting Cu nanozyme for colorimetric-fluorescent-smartphone detection of α-glucosidase

BackgroundDue to that the higher activity of nanozymes would bring outstanding performance for the nanozyme-based biosensing strategies, great efforts have been made by researchers to improve the catalytic activity of nanozymes, and novel nanozymes with high catalytic activity are desired. Considering the crucial role in controlling blood glucose level, strategies like colorimetric and chemiluminescence to monitor α-glucosidase are developed. However, multi-mode detection with higher sensitivity was insufficient. Therefore, developing triple-mode detection method for α-glucosidase based on great performance nanozyme is of great importance. ResultsIn this work, a novel nanozyme Cu-BCN was synthesized by loading Cu on boron doped carbon substrate g-C3N4 and applied to the colorimetric-fluorescent-smartphone triple-mode detection of α-glucosidase. In the presence of H2O2, Cu-BCN catalyzed the generation of 1O2 from H2O2, 1O2 subsequently oxidized TMB to blue colored oxTMB. In the presence of hydroquinone (HQ), the ROS produced from H2O2 was consumed, inhibiting the oxidation of TMB, which endows the possibility of colorimetric and visual on-site detection of HQ. Further, due to that the fluorescence of Mg-CQDs at 444 nm could be quenched by oxTMB, HQ could also be quantified through fluorescent mode. Since α-glucosidase could efficiently hydrolyze α-arbutin into HQ, the sensitive detection of α-glucosidase was realized. Further, colorimetric paper-based device (c-PAD) was fabricated for on-site α-glucosidase detection. The LODs for α-glucosidase via three modes were 2.20, 1.62 and 2.83 U/L respectively, high sensitivities were realized. SignificanceThe nanozyme Cu-BCN possesses higher peroxidase-like activity by doping boron to the substrate than non-doped Cu-CN. The proposed triple-mode detection of α-glucosidase is more sensitive than most previous reports, and is reliable when applied to practical sample. Further, the smartphone-based colorimetric paper-based analytical device (c-PAD) made of simple materials could also detect α-glucosidase sensitively. The smartphone-based on-site detection provided a convenient, instrument-free and sensitive sensing method for α-glucosidase.

Evaluation of Antidiabetic Potential of Methanolic Extract of Myristica fragrans (Mace) and Cinnamomum Verum- A Comparative in Vitro Study

Myristica fragrans (mace) and Cinnamomum verum are traditional medicinal plants which are used as spices in flavouring of food. They exhibit various medicinal properties. Diabetes is a condition that impairs the body’s ability to process blood sugar levels. Anti-diabetic drugs are used to stabilize and control blood glucose levels. From the study, it was evident that the methanolic extract of Myristica fragrans (mace) exhibited significantly increased antioxidant and anti-diabetic potential when compared to that of Cinnamomum verum.

Effect of the sodium-glucose cotransporter-2 inhibitor, DWP16001, as an add-on therapy to insulin for diabetic dogs: A pilot study.

Sodium-glucose cotransporter-2 (SGLT2) inhibitors are a novel class of anti-hyperglycaemic agents. This study aimed to evaluate the safety and the adjuvant glycaemic control effect of an SGLT2 inhibitor, DWP16001, in diabetic dogs receiving insulin treatment. Nineteen diabetic dogs receiving insulin treatment (NPH, porcine lente and glargine insulin) were divided into two groups according to dosing frequency: DWP TOD group (n=10) and DWP SID group (n=9). In the DWP TOD group, 0.025mg/kg of DWP16001 was administered once every 3 days, whereas, in the DWP SID group, 0.025mg/kg of DWP16001 was administered once a day. Food intake was maintained during the trial period. Hypoglycaemia, ketoacidosis or unexpected life-threatening reactions were assessed as adverse effects before and after DWP16001 administration. We compared insulin requirement reduction and blood glucose level control between two groups. No specific adverse effects were observed during the clinical trial, and haematological parameter remained unchanged. Moreover, the fasting glucose levels and daily insulin dose in the DWP TOD group were lower than the pre-administration values, but not significantly different for 8 weeks. Systolic blood pressure, fructosamine and insulin dose decreased significantly in the DWP SID group compared to the DWP TOD group at 8 weeks (p<0.05) without affecting food consumption. Among these patients, 10 patients were monitored while receiving DWP16001 for 12 months (DWP TOD group n=5, DWP SID group n=5). The fasting glucose and fructosamine levels and daily insulin dose were reduced in both groups at 12 months compared with those before receiving DWP16001. When DWP16001, an SGLT2 inhibitor, was supplied to dogs with type 1 diabetes, no adverse effects were observed, and it was confirmed that the administered insulin dose can be reduced in controlling blood glucose.

Beneficial Effects of PIN1 Inhibition on Diabetes Mellitus: A Concise Review.

Type 2 diabetes mellitus is a long-term medical illness in which the body either becomes resistant to insulin or fails to produce it sufficiently. Mostly, combinatorial therapy is required to control blood glucose levels. However, combinatorial therapy has detrimental side effects. The prevalence of the cases and subsequent increases in medical costs of the same intimidate human health globally. While there have been a lot of studies focused on developing diabetic regimens that work to lower blood glucose levels, their effectiveness is short-lived because of unfavorable side effects, such as weight gain and hypoglycemia. In recent years, the PIN1 (protein interacting with NIMA) enzyme has attracted the attention of researchers. Previous studies suggested that PIN1 may act on the various substrates that are involved in the progression of T2DM and also help in the management of diabetes-related disorders. Thus, the focus of the current review is to examine the correlation between PIN1, T2DM and its related disorders and explore the possibility of developing novel therapeutic targets through PIN1 inhibition.

Effect of intermittent fasting on fasting blood glucose, sirtuin 1, and total antioxidant capacity in rat models of diabetes mellitus

Background: Diabetes mellitus (DM) is a metabolic disease characterized by hyperglycaemia. DM therapy is mainly purposed to control blood glucose levels by adjusting diet and reducing body fat, which can be implemented with calorie restriction (CR) by intermittent fasting (IF), a diet that alternates periods between eating and fasting. Sirtuins, proteins activated by CR, can regulate glucose metabolism, regulate insulin secretion, and protect cells from oxidative stress, so IF is considered to be an opportunity for DM management.Objective: This study is to determine effects of IF on Fasting Blood Glucose (FBG) levels, sirtuin 1 (SIRT1) activity, and total antioxidants (TAOC) in rat models of Wistar with DM.Methods: This experimental study applied a post-test control group design involving 24 Wistar rats which were divided into 4 groups: K1 (rats with DM without IF), K2 (rats with DM treated with metformin 45 mg/kg BW, K3 (rats with DM treated with IF), and K4 (normal rats treated with IF). The diabetes condition were induced with intraperitoneal injection of streptozotocin (STZ). The rats received IF treatment, fasted for 16 hours and ate window open for 8 hours. This treatment was conducted for 14 days. The FBG levels were measured by using a glucometer, while SIRT1 activity and TAOC were measured by using the ELISA method.Results: The statistical analysis using the Kruskal Wallis test for the FBG levels indicated that there was a significant difference among the four groups (p = 0.000). The ANOVA test for SIRT1 activity revealed that there was a significant difference among the four groups (p = 0.001). The Kruskal Wallis test for TAOC pointed out that there was no significant difference among the four groups (p = 0.529).Conclusion: The IF method using a 16:8 regimen reduced the FBG levels and increased the sirtuin 1 activity, but it was not proven to increase the TAOC in the rat models of Wistar with DM.

Practical considerations for continuous glucose monitoring in elite athletes with type 1 diabetes mellitus: A narrative review.

Type 1 diabetes mellitus (T1DM) refers to a metabolic condition where a lack of insulin impairs the usual homeostatic mechanisms to control blood glucose levels. Historically, participation in competitive sport has posed a challenge for those with T1DM, where the dynamic changes in blood glucose during exercise can result in dangerously high (hyperglycaemia) or low blood glucoses (hypoglycaemia) levels. Over the last decade, research and technological development has enhanced the methods of monitoring and managing blood glucose levels, thus reducing the chances of experiencing hyper- or hypoglycaemia during exercise. The introduction of continuous glucose monitoring (CGM) systems means that glucose can be monitored conveniently, without the need for frequent fingerpick glucose checks. CGM devices include a fine sensor inserted under the skin, measuring levels of glucose in the interstitial fluid. Readings can be synchronized to a reader or mobile phone app as often as every 1-5min. Use of CGM devices is associated with lower HbA1c and a reduction in hypoglycaemic events, promoting overall health and athletic performance. However, there are limitations to CGM, which must be considered when being used by an athlete with T1DM. These limitations can be addressed by individualized education plans, using protective equipment to prevent sensor dislodgement, as well as further research aiming to: (i) account for disparities between CGM and true blood glucose levels during vigorous exercise; (ii) investigate the effects of temperature and altitude on CGM accuracy, and (iii) explore of the sociological impact of CGM use amongst sportspeople without diabetes on those with T1DM.

Correlation Between Blood Glucose Levels And Risk Of Non-Hemorrhagic Stroke: Analysis Of A Prospective Cohort Study In An Elderly Population

Stroke is one of the main cardiovascular diseases that causes death and disability throughout the world. One of the important risk factors for stroke is hyperglycemia or high blood sugar levels. This study aims to analyze the correlation between blood glucose levels and the risk of non-hemorrhagic stroke in the elderly population. This research utilizes a qualitative approach. The data source used is the scientific literature. The data that has been collected is then analyzed through the process of data reduction, data presentation, and conclusion drawing. The research findings show that there was a significant positive correlation between blood glucose levels and the risk of non-hemorrhagic stroke in the elderly population. Elderly people with high blood glucose levels have a higher risk of non-hemorrhagic stroke compared to elderly people with normal blood glucose levels. Good control of blood glucose levels can be an important strategy to reduce the risk of non-hemorrhagic stroke in the elderly. 

Android-Based Lifestyle Management Application for Type-2 Diabetes Mellitus Patients

Diabetes Mellitus (DM) Type-2 is a chronic disease that occurs due to uncontrolled blood glucose levels in the body. Uncontrolled glucose levels in people with Type-2 Diabetes Mellitus can cause various kinds of complications, therefore this research aims to create an Android application that can help people with Type-2 Diabetes Mellitus in controlling blood glucose levels. This application creation method includes the stages of preparation and application creation by conducting previous literature studies, which produce a theoretical model. The result of this research is a lifestyle management application for type 2 diabetes mellitus patients called Selfcare Glucose Management (SCGM), which has 4 kinds of features, including a feature that can calculate daily calorie needs by displaying various types of food with a predetermined weight and number of calories, an alarm feature that functions to remind patients to take medication and inject insulin, a physical activity training feature and a feature that contains educational material about Diabetes Mellitus. This application has been tested using application measurement methods in the form of repeated manual calculations or calibration and obtained results that match the expected values. It is hoped that this application can be developed to be more interactive and communicative in its use.

Deteksi Dini Si Manis ( Silent Killer ) Di Dusun Tegalsari Desa Jabon Kecamatan Mojoanyar Kabupaten Mojokerto

Diabetes Mellitus is a metabolic disorder characterized by an increase in blood sugar due to decreased insulin secretion by pancreatic beta cells and impaired insulin function (insulin resistance). By measuring glycohemoglobin (HbA1c) you can find out what percentage of the red blood cell dye (hemoglobin) contains sugar. HbA1c is also recommended as the final goal of therapy and is recommended to be done at least twice a year. If the treatment target has not been achieved, it is recommended to check HbA1c 4 times a year. The aim of controlling blood glucose levels in DM is to minimize the occurrence of cardiovascular complications and improve the sufferer's quality of life. The benchmark for whether DM is controlled or not is by checking HbA1c in the blood. If the level is more than 7% then it needs to be treated with insulin or anti-diabetic drugs.

ASSOCIATION OF TYPE 2 DIABETES MELLITUS AND CANDIDIASIS : A TEN YEARS SYSTEMATIC REVIEW

Background: Diabetes mellitus is a chronic disease that may reduce resistance to microbial infection of tissues and decrease tissue repair capacity. It is both an endocrine and a metabolic dysfunction involving the control of blood glucose levels, resulting in hyperglycemia. The aim: The aim of this study to show about association of type 2 diabetes mellitus and candidiasis. Methods: By the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) 2020, this study was able to show that it met all of the requirements. This search approach, publications that came out between 2014 and 2024 were taken into account. Several different online reference sources, like Pubmed, SagePub, and Sciencedirect were used to do this. It was decided not to take into account review pieces, works that had already been published, or works that were only half done. Result: Five publications were found to be directly related to our ongoing systematic examination after a rigorous three-level screening approach. Subsequently, a comprehensive analysis of the complete text was conducted, and additional scrutiny was given to these articles. Conclusion: Diabetic patients had a higher candidal carriage rate and a variety of candidal species that were resistant to azole antifungal agents.

To Study Knowledge Regarding Healthy Lifestyle Modifications in Middle-Aged Diabetic Population

Background: Lifestyle plays a significant role in helping patients with diabetes control their blood sugar levels. Understanding early complications to prevent further adverse effects from uncontrolled sugar levels and a worsening healthy lifestyle is a prerequisite to knowledge regarding healthy lifestyle modifications. Exercise therapy has long been recommended for use in the management and prevention of type 2 diabetes. Dietary habits play an important role in the control of blood glucose levels in diabetic patients. An increase in calorie intake leads to poor glycemic control. Stress levels can affect the increased glucose levels. Middle-aged adults are at increased risk of developing diabetes, and this population may benefit from targeted interventions to promote healthy lifestyle modifications. Therefore, a study is needed to assess the level of knowledge and awareness of middle-aged diabetic populations regarding healthy lifestyle modifications. Materials and Methods: A validated questionnaire was prepared on Google Forms and distributed among the diabetic population. Data was calculated automatically on Google spreadsheet. Results: Patients with diabetes exhibit little awareness of recommended lifestyle changes. A poor understanding of diabetes and its complications is demonstrated by 83.87 % of the population. 77.41% of persons have a poor understanding of dietary adjustments for diabetes. 86.02% of respondents exhibit insufficient awareness of physical exercise therapies for diabetes. 52.68% of people are unaware of how stress affects insulin secretion. Conclusion: According to the study’s findings, Given the early onset of diabetes problems, middle-aged diabetics have an increasing need for knowledge regarding appropriate lifestyle adjustments due to their higher risk of diabetes.

Pharmacodynamic Interaction of Areca catechu with Gliclazide in Wistar Rats

Background and Purpose: In alloxan-induced diabetic rats, this study sought to evaluate the hypoglycemic potential of the hydroalcoholic seed extract of Areca catechu, also referred to as areca nut, both as a stand-alone treatment and in combination with the diabetic drug gliclazide. Methods: The hot percolation method was used to produce the hydroalcoholic seed extract of A. catechu. Rats were given alloxan monohydrate and developed type II diabetes. The hydroalcoholic seed extract of A. catechu (1000 mg/kg p.o.) alone or in different combinations of gliclazide (25 mg/kg p.o.) and A. catechu extract (250, 500, and 1000 mg/kg p.o.) were administered to the six diabetic rats. Body weights and blood glucose levels were measured on days 7, 14, 21, and 28 of the treatment. On the 28th day, the kidney, liver, and pancreas underwent histological investigations in addition to an oral glucose tolerance test (OGTT). Results: Blood glucose levels were significantly lowered upon administration of A. catechu’s hydroalcoholic seed extract, both alone and in conjunction with gliclazide. Comparing the diabetic control group to the A. catechu extract-treated group, histopathological examinations showed that high amounts of the extract, either by itself or in conjunction with gliclazide, caused the active proliferation of pancreatic beta cells, protecting against damage to the liver and kidneys. Conclusion: The hydroalcoholic seed extract of A. catechu showed promise as a monotherapy for controlling blood glucose levels, and as a co-administer for gliclazide, it showed signs of hypoglycemia. These results indicate A. catechu’s possible therapeutic benefit as an adjuvant diabetic treatment. To investigate the underlying mechanisms of action and evaluate its safety and effectiveness in clinical settings, more study is necessary.

Seaweeds as Nutraceutical Elements and Drugs for Diabetes Mellitus: Future Perspectives.

Diabetes mellitus is a chronic metabolic condition marked by high blood glucose levels caused by inadequate insulin synthesis or poor insulin use. This condition affects millions of individuals worldwide and is linked to a variety of consequences, including cardiovascular disease, neuropathy, nephropathy, and retinopathy. Diabetes therapy now focuses on controlling blood glucose levels through lifestyle changes, oral medicines, and insulin injections. However, these therapies have limits and may not successfully prevent or treat diabetic problems. Several marine-derived chemicals have previously demonstrated promising findings as possible antidiabetic medicines in preclinical investigations. Peptides, polyphenols, and polysaccharides extracted from seaweeds, sponges, and other marine species are among them. As a result, marine natural products have the potential to be a rich source of innovative multitargeted medications for diabetes prevention and treatment, as well as associated complications. Future research should focus on the chemical variety of marine creatures as well as the mechanisms of action of marine-derived chemicals in order to find new antidiabetic medicines and maximize their therapeutic potential. Based on preclinical investigations, this review focuses on the next step for seaweed applications as potential multitargeted medicines for diabetes, highlighting the bioactivities of seaweeds in the prevention and treatment of this illness.

Nutrient quality in dietary therapy for diabetes and diabetic kidney disease.

Dietary therapy is crucial for diabetes care with the aim of preventing the onset and progression of diabetes and its complications. The traditional approach to dietary therapy for diabetes has primarily focused on restricting the intake of the three major nutrients and rigorously controlling blood glucose levels. However, advancements in nutritional science have shown that within the three major nutrients - carbohydrates, proteins and lipids - there exist multiple types, each with distinct impacts on type 2 diabetes and its complications, sometimes even showing conflicting effects. In light of this, the present review shifts its focus from the quantity to the quality of the three major nutrients. It aims to provide an overview of how the differences in nutrient quality can influence onset and progression of type 2 diabetes and diabetic kidney disease, highlighting the diverse effects and, at times, contradictory impacts associated with each nutrient type.

The Effect of Diabetic Retinopathy and Blood Glucose Regulation on Corneal Biomechanical Parameters.

The aim of this study was to evaluate the effects of different stages of diabetic retinopathy (DR) and metabolic control of blood glucose levels on corneal biomechanical parameters. Diabetic patients were categorized into three groups: no DR group, nonproliferative DR (NPDR) group, and proliferative DR (PDR) group. Of the 141 eyes examined, 40 belonged to the control group, 34 to no DR group, 34 to NPDR group, and 33 to PDR group. Using an Ocular Response Analyzer to measure corneal hysteresis (CH), corneal resistance factor (CRF), Goldmann-correlated intraocular pressure (IOPg), and corneal-compensated IOP (IOPcc). IOP was assessed using a Tono-Pen, while central corneal thickness (CCT) was determined using an ultrasonic pachymeter. HbA1c levels were also recorded. We conducted comparisons among these groups across biomechanical parameters and IOP (tonopen), and CCT, while also investigating the impact of HbA1c levels on these parameters. Among any groups show a statistically significant difference in CCT, IOP (tonopen), CH, CRF, IOPg, and IOPcc. In diabetic patients, CRF, CTT, and IOPg values were significantly higher in those with HbA1c levels ≥ 7 mg/dl than in those with HbA1c levels < 7 mg/dl (p = 0.009, p = 0.013, p = 0.038), respectively, while there was no statistically significant difference in IOPcc, CH, and IOP (tonopen). Linear regression analysis showed that CH was positively associated with CCT (p < 0.001) and negatively associated with IOPcc (p < 0.001), while CRF was positively associated with CCT (p < 0.001), HbA1c (p < 0.05), and negatively associated with diagnosis of DR (p < 0.05). This study underscores the influence of metabolic control, as reflected by HbA1c levels, on corneal biomechanical parameters in diabetic patients, emphasizing the importance of monitoring and managing glycemic control in this population.

Insulin Analogs and the Mode of Insulin Delivery: Recent Advances and Challenges.

Diabetes is a medical condition associated with impaired glucose regulation caused either due to insufficient insulin production or resistance to insulin (Type 2 diabetes, gestational diabetes) or the absence of insulin through the selective killing of beta cells in the pancreas (Type 1 diabetes). Irregular insulin production leads to various health complications. To prevent such complications, patients must adhere to medical recommendations before availing of any advanced insulin therapy(ies), considered productive for the treatment. Natural insulin, although highly effective in controlling blood glucose levels, patients are often at risk of developing hypoglycemia and many other complications. This has led to the development of insulin analogs, the modified variants of natural insulin having a minimal risk of causing hypoglycemia. Besides the development of analogs, the mode of insulin delivery is also considered critical in achieving better glycemic control in diabetic patients. Until recently, various exogenous insulin delivery methods were practiced, but effective glycemic control without any associated risk and ease of delivery remains a subject of paramount concern. It countered attenuation or delayed onset of diabetes-associated complications without a permanent cure, raising an unmet demand for insulin formulations and delivery methods that offer stability, biocompatibility, reproducibility, precision dosing, non-immunogenicity, and safety. The current practice utilizes non-physiological delivery methods with less invasive administration routes, offering glycemic stability and therapeutic effectiveness. This review focuses on the recent advances made and future perspectives envisioned about newer insulin therapies and delivery methods that tend to improve the management of diabetes by inculcating ideas to reduce the disease's severity and improve the quality of life.

The influence of sociodemographic factors on the control of blood glucose levels among diabetic outpatients visiting various community pharmacies in Lahore

The influence of sociodemographic factors on the control of blood glucose levels among diabetic outpatients visiting various community pharmacies in Lahore

[Pancreaticoduodenectomy combined with longitudinal pancreaticojejunostomy in the treatment of chronic pancreatitis: initial experience in 11 cases].

Objective: To investigate the surgical strategy for chronic pancreatitis complicated with suspected malignant lesions in the pancreatic head and pancreatolithiasis in the distal pancreas. Methods: This is a retrospective cohort study. Clinical data from 11 patients with chronic pancreatitis who underwent pancreaticoduodenectomy combined with longitudinal pancreaticojejunostomy(PD-L) were retrospectively collected(PD-L group) from the Department of Hepatobiliary Surgery of the First Affiliated Hospital of Xi'an Jiaotong University between December 2021 and September 2023. All patients were male with an age of (49.0±11.2) years(range:32 to 70 years). Their primary preoperative diagnoses included pancreatic lesions, chronic pancreatitis, pancreatolithiasis, and dilatation of the pancreatic duct. Data from 248 patients who underwent pancreaticoduodenectomy(PD) during the same period were retrospectively collected(PD group). There were 157 males and 91 females in the PD group, with an age of (61.5±10.8) years(range:27 to 82 years). Among them, 87 cases were diagnosed as pancreatic cancer or chronic pancreatitis. The propensity score matching method was used to reduce confounding bias between the two groups. The caliper value of 0.1 was used and the 1∶4 nearest neighbor matching method was used for the matching. Comparisons between the two groups were made using the independent sample t test, Mann-Whitney U test or χ2 test,respectively. Results: After complete excision of the specimen during pancreaticoduodenectomy, the key surgical step of PD-L was longitudinal pancreaticojejunostomy in the remaining pancreas. Intraoperative blood loss in the PD-L group was lower than that in the PD group [M(IQR)](300(200)ml vs. 500(500)ml, respectively; P<0.05). Similarly, hospitalization days(21.0(7.0)days vs. 25.0(8.5)days) and postoperative hospitalization days(13.0(8.0)days vs. 17.0(5.0) days) were also lower in the PD-L group compared to the PD group (P<0.05). There were no significant differences in the operation time and postoperative complication rate between the two groups(P>0.05). In the PD-L group, the postoperative follow-up time was 5(5)months(range: 3 to 21 months). One case was lost for follow-up. Abdominal pain was relieved in 10 patients. Additionally, abdominal distension and steatosis were alleviated in 8 cases. Furthermore, 5 cases of diabetes mellitus showed improved control of HbA1c and fasting blood glucose levels after surgery. Conclusions: PD-L treatment can be used to treat chronic pancreatitis complicated by suspected malignant lesions in the pancreatic head and pancreatolithiasis in the distal pancreas. PD-L also has advantages in removing stones from the pancreatic duct and evaporation of pancreatic fluid. However, due to the single-center design and the small sample size of this study, further practice and long-term follow-up are still necessary.

UDP-Glucose/P2Y14 Receptor Signaling Exacerbates Neuronal Apoptosis After Subarachnoid Hemorrhage in Rats.

Subarachnoid hemorrhage (SAH) is a severe subtype of stroke with poor outcomes. Abnormal glucose metabolism often occurs after SAH, but the strict control of blood glucose levels is not always beneficial. This study aimed to investigate the contribution of uridine diphosphate glucose (UDP-G), an intermediate of glucose/glycogen metabolism, and its receptor P2Y14 (P2Y purinoceptor 14) to SAH pathology and explored the potential targeted treatments in rats. A total of 218 Sprague-Dawley male rats were used. SAH was induced by endovascular perforation. Brain expressions of P2Y14, uridine diphosphate glucose (UDP-G), and its converting enzyme UGP2 (UDP-G pyrophosphorylase-2) were evaluated. Exogenous UDP-G or selective P2Y14 inhibitor was administered intranasally at 1 hour after SAH to explore their potential effects. Intranasal Ugp2 or P2ry14 siRNA was delivered 24 hours before SAH for mechanistic evaluation. Primary neuron culture and hemoglobin stimulation were used as in vitro model of SAH. Post-SAH evaluation included liquid chromatography-mass spectrometry measurement of brain endogenous UDP-G level, neurobehavioral assessments, Western blotting, immunohistochemistry, TUNEL staining, and Nissl staining. There was an acute elevation of endogenous brain UDP-G and UGP2 after SAH, and P2Y14 was expressed in neurons. Although P2Y14 inhibitor decreased neurological dysfunction, neuronal apoptosis, and proapoptotic molecules, exogenous UDP-G exacerbated these outcomes at 24 hours after SAH. Early inhibition of P2Y14 preserved long-term neuronal survival in the hippocampus, amygdala, and cortex with improved neurocognition and depressive-like behavior. In addition, in vivo knockdown of Ugp2- and P2ry14-reduced neurological deficits and proapoptotic molecules at 24 hours after SAH, and furthermore in vitro knockdown of P2ry14-reduced apoptosis in hemoglobin stimulated primary neuron. These findings suggest a detrimental role of brain UDP-G/P2Y14 signaling in SAH, as a part of glucose metabolic pathology at the tissue level. P2Y14 inhibitor 4-[4-(4-piperidinyl)phenyl]-7-[4-(trifluoromethyl)phenyl]-2-naphthalenecarboxylic acid hydrochloride may serve as a potential therapeutic target in treating patients with SAH.