Table of Content

  

10 February 2018
Volume 56 Issue 2

Advances in the diagnosis and treatment of hepatic encephalopathy

ZHANG Zong, WANG Xiaohua

Journal of Shandong University (Health Sciences). 2018, 56(2):  1-8.  doi:10.6040/j.issn.1671-7554.0.2017.562

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Hepatic encephalopathy(HE)was defined as brain dysfunction resulting from liver insufficiency and/or portosystemic shunting, with different degree of neurological and psychiatric abnormalities syndrome, ranging from subclinical change to even coma. HE endangered the health and life of patients. This article briefly reviewed the latest advances in the diagnostic methods of minimal hepatic encephalopathy(MHE)and management of overt hepatic encephalopathy(OHE).

Effects of PRPS2 knockdown on the biological property of cervical cancer cells

CHEN Ying, ZHOU Xiaoqing, QI Mei, ZHANG Weifang, LIU Juan, ZHAO Weiming

Journal of Shandong University (Health Sciences). 2018, 56(2):  9-13.  doi:10.6040/j.issn.1671-7554.0.2017.952

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Objective To evaluate the role of phosphoribosyl-pyrophosphate synthetase 2(PRPS2)on the proliferation, metastasis, cell cycle and cell apoptosis of cervical cancer cells. Methods The basal expressions of PRPS2 in cervical cancer cells(HeLa cells)and normal epithelial cells were detected with Western blotting. HeLa cells were transfected with PRPS2-specific siRNA(siPRPS2)via Lipofectamine 2000, and then divided into the knockdown group and control group. The knockdown efficiency of PRPS2 was determined with Western blotting. The cell proliferation, migration and invasion were detected with CCK-8, colony formation and Transwell assays. The effect of PRPS2 on cell cycle and apoptosis were examined with flow cytometry. Results PRPS2 was highly expressed in HeLa cells, and siPRPS2 effectively inhibited the expression of PRPS2(inhibition ratio 70%). CCK-8 and colony formation assays indicated that PRPS2 knockdown significantly inhibited the viability(P<0.001)and proliferation(P<0.01)of HeLa cells. Transwell assays showed that PRPS2 knockdown obviously reduced the number of migrated(P<0.05)and invaded(P<0.001)cells through the membrane. PRPS2 knockdown contributed to G2/M arrest(P<0.001)and apoptosis of cervical cancer cells(P=0.012). Conclusion PRPS2 can promote the proliferation, metastasis and cell cycle of cervical cancer cells.

Efficacy of compound e-jiao slurry on marrow suppression of small-cell lung cancer after chemotherapy

ZHOU Yong, HOU Huaying, XU Ying, JIANG Yuhua

Journal of Shandong University (Health Sciences). 2018, 56(2):  14-17.  doi:10.6040/j.issn.1671-7554.0.2017.771

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Objective To observe the efficacy of compound e-jiao slurry on chemotherapy-resulted marrow suppression of small-cell lung cancer. Methods A total of 135 patients with small-cell lung cancer were divided into the control group(n=70)and treatment group(n=65). The control group was treated with EP chemotherapy program, while the treatment group took the compound e-jiao slurry(20 mL every time and three times every day)companying with EP chemotherapy program. The chemotherapy completion rates of patients were calculated. The marrow suppression, especially the change of hemoglobin, platelet, white blood cell(WBC)and neutrophil(NEUT)counts were observed. Results The chemotherapy completion rate of the treatment group is higher than that of the control group. The decreasing values of WBC and NEUT counts in these two groups were statistically significant(P<0.05). Conclusion Compound e-jiao slurry decreases the incidence rate of the chemotherapy-resulted marrow suppression(WBC, NEUT)and relieves the decrease of WBC and NEUT counts.

Humidified heated high flow nasal cannula versus nasal continuous positive airway pressure for initial respiratory support of very low birth weight infants

JIANG Chunjie, QI Lu, XIAO Junchao, XUE Jiang

Journal of Shandong University (Health Sciences). 2018, 56(2):  18-22.  doi:10.6040/j.issn.1671-7554.0.2017.630

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Objective To assess the efficacy and safety of humidified heated high flow nasal cannula(HHHFNC)compared with nasal continuous positive airway pressure(NCPAP)for the initial respiratory support of very low birth weight(VLBW)infants. Methods A total of 106 VLBW infants with gestational age(GA)between 28-32 weeks who met the predefined criteria for noninvasive ventilation were randomized to either the HHHFNC group or NCPAP group. The evaluation indexes included the respiratory outcomes and the incidence of complications. Results The clinical data of 98 infants were analyzed. The incidence of nasal trauma was significantly lower in the HHHFNC group than in the NCPAP group(2.0% vs 14.6%, P=0.029). There were no differences in the other respiratory and clinical outcomes between the two groups(P>0.05). Conclusion Compared to NCPAP, HHHFNC appears to be safer while has a similar efficacy as an initial respiratory support in VLBW infants with GA between 28-32 weeks.

Clinical and radiological features of 36 adult patients with epidemic encephalitis B

MIAO Meng, JIA Guoyong, LIU Ying, WANG Cuilan

Journal of Shandong University (Health Sciences). 2018, 56(2):  23-27.  doi:10.6040/j.issn.1671-7554.0.2017.1013

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Objective To investigate clinical, cerebrospinal fluid(CSF)and radiological features of adult patients with epidemic encephalitis B. Methods The data were collected from 36 adult patients with epidemic encephalitis B who were diagnosed and treated in Qilu Hospital of Shandong University, from August to September in 2013. Results The patients with epidemic encephalitis B presented with fever(100%), consciousness and cognitive impairment, headache, nausea, vomiting(86.1%), and meningeal irritation(80.6%). Parkinson-like symptoms(30.6%)and seizure disorders(27.8%)were common. The IgM antibody against epidemic encephalitis B in serum and CSF was found. A total of 13 patients(54.2%)suffered intracranial hypertension, 22 patients displayed abnormal CSF cytology reaction, 16 patients(72.7%)displayed mixed-cell reaction, 6 patients(27.3%)appeared lymphocyte reaction. Protein content of 17 patients(70.8%)increased, IgG of 21 patients(87.5%)increased, IgA of 19 patients(79.2%)increased, and IgM of 23 patients(95.8%)increased. A total of 22 patients(61.1%)underwent brain MRI, 17 patients(47.2%)underwent brain CT. Neural damages displayed in thalamus(13 cases, 59.1%), midbrain(4 cases, 18.2%), basal ganglia(3 cases, 13.6%), hippocampus(3 cases, 13.6%)and other brain lobes(5 cases, 22.7%). A total of 4 patients(18.2%)were normal. Conclusion The patients with epidemic encephalitis B present acute encephalitic syndrome, 山 东 大 学 学 报 (医 学 版)56卷2期 -苗萌,等.36例成人流行性乙型脑炎临床分析和影像学特点 \=-accompanied with extrapyramid symptoms. The important features of CSF present the significant increase of the proportion of neutrophils and the prolonged duration of mixed-cell reaction. Neural damages commonly appear in thalamus.

Association between genetic polymorphisms of 5 genetic loci of TNF-α promoter and genetic susceptibility to cervical cancer

ZHAO Qingqing, YIN Geping

Journal of Shandong University (Health Sciences). 2018, 56(2):  28-33.  doi:10.6040/j.issn.1671-7554.0.2017.778

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Objective To investigate the correlation between the genotype and allele frequencies of 5 single nucleotide polymorphisms(SNPs)in the promoter region of tumor necrosis factor-α(TNF-α)gene(rs361525, rs1800629, rs1800750, rs1799964 and rs673)and the susceptibility of cervical cancer in Han women in Shandong Province. Methods The 5 SNPs of TNF-α were genotyped by TaqMan probe and compared with 452 cases of cervical cancer(104 cases of carcinoma in situ and 348 cases of invasive carcinoma)and 494 controls in gene type and frequency. The epidemiological survey and HPV subtype analysis were conducted in the two groups. Results Compared with the control 山 东 大 学 学 报 (医 学 版)56卷2期 -赵庆庆,等.TNF-α 启动子5个位点的基因多态性与山东省汉族妇女宫颈癌遗传易感性的相关性 \=- group, the genetic risk of cervical cancer with rs361525(CT), rs1800629(AG)and rs17999645(AG)genotypes were 3.040(95%CI: 1.761-5.248, P=0.001), 2.580(95%CI: 1.867-3.564, P=0.001), and 3.162(95%CI: 2.332-4.187, P=0.001). The frequency of rs1800750 and rs673 genotypes were not significantly different between cervical cancer group and control group(P=0.929, 0.670). The frequency of genotype of the 5 SNP loci were not statistically different between the invasive cancer group and carcinoma in situ group(P=0.124, 0.455, 0.437, 0.809, 0.868). The HPV infection rate in the cervical cancer group was 91.4%, which was higher than that in the control group(10.3%, P=0.001). The HPV infection rate in the in situ carcinoma was lower than that in invasive carcinoma(77.9% vs 95.4%, P=0.001). Conclusion The genetic polymorphisms of rs361525, rs1800629 and rs17999645 in TNF-α may be genetic risk factors for cervical cancer in Han women in Shandong Province, while there is no significant correlation between rs1800750 and rs673 loci and cervical cancer.

Lung ultrasound for evaluating the effect of pulmonary surfactant replacement therapy in preterm infants with respiratory distress syndrome

LI Ya, YUAN Peng, ZHANG Feixue, SHAO Guangrui

Journal of Shandong University (Health Sciences). 2018, 56(2):  34-40.  doi:10.6040/j.issn.1671-7554.0.2017.696

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Objective To evaluate the effects of pulmonary surfactant(PS)replacement therapy by using lung ultrasound in preterm infants with respiratory distress syndrome(RDS). Methods A total of 35 preterm infants diagnosed as RDS by clinical and radiographic signs in the Neonatal Intensive Care Unit(NICU)were enrolled into the study from Oct. 2016 to May 2017. Lung ultrasound was performed before and after surfactant replacement therapy within the first 20 hours to 24 hours by the same experienced ultrasonorgaphy physician. The transthoracic approach was performed with longitudinal scans of anterior, lateral and posterior chest walls. Ultrasound findings of each lung field were recorded and typed using the new system. A conventional chest X ray was performed immediately after lung ultrasound was finished. Results All the 35 patients(100%)showed an improvement of lung ultrasound findings observed in one lung field at least within 20 hours to 24 hours after surfactant administration. Three patients showed an improvement of lung ultrasound findings in one or two lung fields, and 32 patients showed an improvement in three or more than three lung areas. After surfactant administration, 30 patients(86%)showed an improvement of chest X ray,and 5 patients showed no improvement. Conclusion Lung ultrasound may enable an early detection of the effect of pulmonary surfactant replacement therapy in preterm RDS infants with the advantages of high sensitivity, non-ionizing and easy-operating.

Validity of SPECT/CT bone fusing imaging in the diagnosis of single bone metastasis of lung cancer

WANG Shanrong, DING Yueyun, ZHU Zongping, SHI Dedao, LIU Wanxia, ZHENG Feibo

Journal of Shandong University (Health Sciences). 2018, 56(2):  41-46.  doi:10.6040/j.issn.1671-7554.0.2017.827

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Objective To investigate the validity of single-photon emission computed tomography/computed tomography(SPECT/CT)bone fusing imaging in the diagnosis of single bone metastasis of lung cancer. Methods A retrospective study was conducted during June 2014 and June 2015 on 80 patients with confirmed lung cancer. All patients underwent ⁹⁹Tc-methylene diphosphonate whole-body planar bone scintigraphy and had suspected bone metastasis. These patients were then further evaluated with SPECT/CT. The diagnostic results of the two methods were compared. The final results were confirmed with pathology findings(n=3), with more than 2 kinds of radiological imaging findings(n=45), and with 1-year follow-up(n=32). The diagnostic sensitivity, specificity, accuracy, positive and negative predictive values of the two methods were compared. The results were analyzed with SPSS 17.0 software and χ2 test. Results For bone scintigraphy and SPECT/CT fusion imaging, the specificity was 58.3% vs 91.7%(χ2=10.67, P<0.05), accuracy was 71.3% vs 90.0% (χ2=9.002, P<0.05), positive predictive value was 70.6% vs 92.9%(χ2=7.318, P<0.05), sensitivity was 81.8% vs 88.6%(χ2=0.81, P>0.05), and the negative predictive value was 72.4% vs 86.8%(χ2=0.81, P>0.05). Conclusion In the diagnosis of single bone metastasis of lung cancer, the SPECT/CT 山 东 大 学 学 报 (医 学 版)56卷2期 -王善容,等.SPECT/CT融合骨显像诊断肺癌单发骨转移的价值 \=- bone fusion imaging was superior to whole-body planar bone scintigraphy for its specificity, accuracy and positive predictive value. SPECT/CT fusion bone imaging is of great value in the diagnosis of single bone metastasis of lung cancer.

Diagnostic value of ultrasonography for duodenal obstruction in children

MAO Yu, ZHOU Xin

Journal of Shandong University (Health Sciences). 2018, 56(2):  47-50.  doi:10.6040/j.issn.1671-7554.0.2017.823

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Objective To investigate the clinical significance of ultrasonography in the diagnosis of duodenal obstruction in children. Methods The clinical data of 188 cases of duodenal obstruction confirmed by surgery in our hospital during Jan. 2011 and Dec. 2015 were retrospectively analyzed. The ultrasonographic results and surgical outcomes were compared to summarize the essentials of diagnosis. Results Before operation, all children had varying degrees of vomiting. Ultrasonographic images showed obvious dilation and effusion in the part between stomach and the proximal end of the obstructed intestinal cavity. In some cases, the bowel wall thickened. The distal end of obstructed intestinal cavity was poorly filled, or even empty. Ultrasonographic results indicated that 153 cases were duodenal obstruction, including duodenal atresia or stenosis, annular pancreas, and intestinal malrotation. The diagnostic accordance rate was 76.32%(29/38), 73.02%(46/63)and 89.66%(78/87), respectively. Some cases had 2 types of obstructions. Conclusion Ultrasonography plays an important role in the diagnosis of obstructive duodenal diseases and the location of obstructive site. It can serve as the first choice for screening duodenal obstruction in children.

Comparison of the therapeutic effects of single-port and two-port laparoscope for inguinal hernia in children

LÜ Qigang, SUN Xiaogang, LI Jinliang, XU Jialong, WANG Junfeng, LI Dianguo

Journal of Shandong University (Health Sciences). 2018, 56(2):  51-55.  doi:10.6040/j.issn.1671-7554.0.2017.382

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Objective To compare the outcomes of single-port laparoscope(SPL)and traditional two-port laparoscope(TPL)in the treatment of inguinal hernia in children. Methods A total of 525 children with inguinal hernia during June 2010 and June 2016 were divided into single-port group(n=250)and two-port group(n=275). The average operation time, intraoperative blood loss, hospital stay, complications and hospitalization costs of the two groups were compared. Results No significant difference was observed between the two groups in average operation time, complications, blood loss, hospital stay and hospitalization costs. In terms of unilateral and bilateral inguinal hernia, there was no significant difference between two groups either. Conclusion Compared with traditional two-port laparoscope, single-port laparoscope is equally safe and effective in the treatment of inguinal hernia in children.

C-shaped root canal in mandibular posterior teeth evaluated by cone-beam computed tomography

ZHANG Jing, YANG Xinghua, LI Jianhua, GE Tangna, ZHANG Shucun, XIONG Shijiang

Journal of Shandong University (Health Sciences). 2018, 56(2):  56-61.  doi:10.6040/j.issn.1671-7554.0.2017.826

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Objective To evaluate the anatomical features of C-shaped canal system in mandibular posterior teeth using cone-beam computed tomography(CBCT)in order to provide imaging information for root canal therapy. Methods A total of 2 603 mandibular posterior teeth in 350 people were observed with CBCT. The incidence of C-shaped root canal was calculated, which was then checked with Fisher exact probability test in different age groups, and with Chi-square test in different gender and tooth position groups. Results (1) The incidence of C-shaped root canal was 2.60%, 0.00%, 0.16% and 31.65% among mandibular first premolars, second premolars, first molars and second molars. (2) In mandibular first premolar, the most common type of canal configuration was C4 in the coronal, followed by C3a in the middle and C4 in the apical. In mandibular second molar, the most common type was C1 in the coronal, followed by C2 in the middle and C3 in the apical. The deep longitudinal ditch of root surface appeared in the mesiolingual side(55.56%)of mandibular premolars and in the lingual side(97.00%)of second molars. (3) There were no significant difference in mandibular first premolars and second molars among different groups of teeth position and gender(P>0.05). Among different age groups, no significant difference was observed in mandibular first premolars(P>0.05), while in second molars, people aged 20-30 years and ≤20 years were more prone to have C-shaped root canal(P<0.001). Conclusion The C-shaped root canals in human mandibular posterior molars have various shapes, often occurring in the second molars, followed by the first premolars, and rarely occurring in the second premolars and first molars.

Changes in head posture after mid-palatal corticotomy assisted rapid maxillary expansion

ZHOU Ning, LU Lu, GUO Jing

Journal of Shandong University (Health Sciences). 2018, 56(2):  62-67.  doi:10.6040/j.issn.1671-7554.0.2017.1149

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Objective To observe the effects of mid-palatal corticotomy assisted rapid maxillary expansion(MCRME)on the head posture and its mechanism in adults. Methods A total of 20 patients with maxillary transverse discrepancy who were 26-32 years old were included(6 male and 14 female, average 28.30±1.97 years). All patients were subjected to MCRME treatment. Facial and dental photographs, lateral cephalometric radiographs and cone-beam computed tomography(CBCT)were taken before treatment(T0)and 6 months after the retention(T1). The mandibular position, hyoid bone position and head posture were measured and evaluated. The parameters were analyzed with SPSS 19.0 software. Results The mandible demonstrated an anticlockwise rotation as shown by the significant decrease of MP-FH, increase of the NBa-PtGn and Gn-PmTVL(all P<0.05). The hyoid bone position was changed as indicated by significant increase of H-VRP, decrease of H-PmTVL, H-HRP and H-ANS-Ba(all P<0.05). The head posture was 山 东 大 学 学 报 (医 学 版)56卷2期 -周咛,等. 腭中缝骨皮质切开辅助上颌骨快速扩弓治疗对头姿的影响 \=-significantly changed as revealed by the significant decrease in SN-OPT and SN-CVT(both P<0.05). In addition, the condylar position was changed with a significant decrease of MJS and increase of LJS(both P<0.05). Conclusion MCRME is a procedure capable of changing the head posture as well as causing anticlockwise rotation of mandible, and anterior and superior movement of hyoid bone.

Association among child abuse, coping styles and negative emotions in college students: an observational analysis

YANG Bei, ZHANG Huihui, GUO Chunhong, CAO Fenglin

Journal of Shandong University (Health Sciences). 2018, 56(2):  68-73.  doi:10.6040/j.issn.1671-7554.0.2017.798

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Objective To explore the association among childhood abuse, coping styles and negative emotions in college students. Methods A total of 1 802 students were involved in the questionnaire survey. The Self-rating Depression Scale(SDS)and Self-rating Anxiety Scale(SAS)were used to assess anxiety and depression symptoms, which served as observed variables of outcome. The Simplified Coping Style Questionnaire(SCSQ)was used to evaluate coping styles, and Childhood Trauma Questionnaire(CTQ-SF)was used to assess child trauma. Results Students with high CTQ level scored higher in anxiety and depression scores compared with those with low CTQ level(P<0.001). Both CTQ score and coping styles(both positive and negative)were strongly associated with anxiety and depression(P<0. 01), which were able to predict negative emotions. Multiple mediation modeling and bias corrected Bootstrap test showed that child trauma had indirect effects on negative emotions through the mediation effects of negative and positive coping styles(χ2/df=49.119, CFI=0.942, TLI=0.907, RMSEA=0.055). The differences between the intermediary effect was not significant ［95%CI(-0.006-0.470)］. Conclusion Both negative and positive coping styles exert multiple medication effects on the relationship between child trauma and negative emotions.

Rural elders demands of living care in Shandong Province and the influencing factors

HU Yan, XU Lingzhong, SU Lina, LI Mi, YU Rui

Journal of Shandong University (Health Sciences). 2018, 56(2):  74-79.  doi:10.6040/j.issn.1671-7554.0.2017.660

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Objective To investigate the demands of living care of the rural elderly and the influencing factors. Methods Based on the data of the 5th National Health Service Investigation in 2013, rural elder residents aged 60 years and above in Shandong Province were selected as the research objects. Their basic information and situation of care demands were analyzed, and single-factor analysis and Logistic regression were adopted to analyze the influencing factors. Results Of all rural elders investigated, 12.1% needed living care, and 97.4% were cared for by their children or grandchildren. Logistic regression results indicated that age, employment, times of weekly exercises, household with low income, number of chronic diseases,speaking ability,listening ability and eyesight could impact the demands of living care of the rural elders. Conclusion The demands of living care of rural elderly are great. Families are still the most important care givers. The elderly with chronic diseases, low income, sedentary life style and disability demand intensive living care.

Carbon disulfide induced embryo implantation by changing the polarization and functional of ovarian corpus luteum macrophages

ZHANG Tongchao, WANG Zhiping

Journal of Shandong University (Health Sciences). 2018, 56(2):  80-87.  doi:10.6040/j.issn.1671-7554.0.2017.804

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Objective To investigate the polarization and functional changes of ovarian corpus luteum macrophages in pregnant mice exposed to carbon disulfide(CS₂)and to explore the role of macrophages in implantation failure induced by CS₂ from the perspective of immune injury. Methods The animal model of exposure to CS₂ at different time points was established. Single dose of CS₂(0.4 LD₅₀, 631.4 mg/kg)was injected intraperitoneally at the third(GD3), fourth(GD4), and fifth(GD5)day of gestation, and the solvent control group was set up(equal volume of olive oil). The continuous observation endpoints were designed at different time points after exposure. Ovarian tissues were collected for HE staining, immunohistochemistry, and real-time quantitative PCR detection, and the polarization and functional changes of macrophages were also determined. Results (1) The polarization balance of ovarian corpus luteum macrophages changed from the M1 type of macrophages(M1>M2, such as GD3-treated group at GD4 observation endpoint, t=10.000, P<0.001)to the M2 type of macrophages(M1<M2, such as GD5-treated group at GD6 observation endpoint, F=10.235, P=0.003). (2) The expression of TNF-α and Vegfa mRNA increased significantly(such as Vegfa in GD4- 山 东 大 学 学 报 (医 学 版)56卷2期 -张同超,等.二硫化碳通过改变卵巢黄体巨噬细胞极化和功能导致胚胎植入障碍 \=-treated group at GD7 observation endpoint, F=6.801, P=0.007). The ovarian corpus luteum mainly characterized by vasodilatation and congestion, and structural changes(such as the structure evaluation of GD4-treated group at GD5 observation endpoint, F=8.638, P=0.019). The expression of Cox2 and Hif1-α mRNA showed a tendency of initial increase and then decrease(such as Cox2 in GD3-treated group at GD5 observation endpoint, F=6.184, P=0.035). Conclusion The mechanism of embryo implantation failure induced by CS₂ exposure may be due to the polarization and functional changes of ovarian corpus luteum macrophages, which triggers and aggravates the damage in the structure and function of ovarian corpus luteum.

Hypoglycemic effects of whole rye flour on experimental diabetic mice

MA Xiao, WANG Shue, CAI Yunxi, LIU Houfu, HE Tianyu, ZHAO Changfeng

Journal of Shandong University (Health Sciences). 2018, 56(2):  88-92.  doi:10.6040/j.issn.1671-7554.0.2017.900

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Objective To explore the hypoglycemic effects of whole rye flour(WRF)on alloxan-induced diabetic mice. Methods The diabetic mice models were established by intraperitoneal injection with alloxan, and then divided into 8 groups: blank control group, diabetic model group, low dose ordinary whole rye flour(low OWRF group), medium OWRF group, high OWRF group, low dose ultra fine whole rye flour group(low UFWRF group), medium UFWRF group, and high UFWRF group. After 6 weeks of intervention, the fasting blood glucose(FBG), oral glucose tolerance test(OGTT), serum glycogen, fructosamine, insulin and C-peptide were determined. Results After 6 weeks of the intervention, FGB was significantly lower in the medium and high OWRF groups and all three UFWRF groups than before intervention. FBG was significantly lower in high UFWRF group than in the diabetic model group. Compared with the diabetic model group, the other groups had higher serum glycogen; the high OWRF group and the three UFWRF groups had lower fructosamine; the medium and high OWRF and UFWRF groups had higher insulin level; the differences were statistically significant(all P<0.05). Conclusion Certain dose of WRF diet has a positive effect in regulating blood glucose. The high UFWRF group shows the most obvious hypoglycemic effect.