Scope
This study aims to investigate the effect of Urolithin A (UA) on diabetes‐associated cognitive impairment in type 2 diabetes mellitus (T2DM) mouse model induced by high‐fat diet (HFD) and streptozotocin (STZ).
Methods and Results
The UA‐treated T2DM mice display an attenuated cognitive impairment as well as reduced levels of metabolic endotoxemia and proinflammatory cytokines in serum. A systemic restraint of gut/brain inflammation in UA‐treated T2DM mice is also observed as the downregulation of TLR4 and Myd88 in colon along with the inhibition of GFAP, Iba‐1, NLRP3, and inflammation‐related genes in brain. Moreover, UA ameliorates gut barrier dysfunction by upregulating tight‐junction proteins levels. Furthermore, UA restores the hyperglycemia‐mediated downregulation of genes involved in N‐glycan biosynthesis both in vivo and in vitro, which plays a crucial role in barrier integrity. Although UA shares similar beneficial effects on diabetes with metformin, unlike metformin, the effect of UA is independent of gut microbiome and short chain fatty acids. Taken together, these data suggest that feeding UA can attenuate diabetes‐associated cognitive impairment by ameliorating systemic inflammation and intestinal barrier dysfunction via N‐glycan biosynthesis pathway. The study implies UA as a potential novel pharmaceutic target for diabetes therapy via manipulating gut‐brain axis and N‐glycan metabolism.
Objective: Severe trauma to the hand or forearm often results in the deep soft tissue defect with the exposure of tendon or bone, which needs to be repaired by skin flaps. In this study, we introduced the use of paraumbilical perforator flap in the repair of such defects, and discussed its advantages and disadvantages.Methods: From Jan. 2006 to Dec. 2016, 14 patients with deep soft tissue defects in the hand and forearm were admitted into our clinic. The defects were caused by hot-crush injury (n=2), electrical injury (n=4), severe burn (n=2), crush injury (n=3), and avulsion injury (n=3). After admission, the patients underwent the debridement, vacuum suction, and skin graft to repair partial wound. The deep defects with the exposure of tendon and bone were repaired by paraumbilical perforator flap finally.Results: All of the 14 flaps survived after the transfer in the first-stage operation. The width of the flap's pedicle ranged from 6 cm to 8 cm, and the length ranged from 16 cm to 20 cm. 1620 days later, the second-stage operation was done to divide the pedicle. After the division, 11/14 of the flaps survived well. The remaining 3/14 flaps had the partial necrosis of the margin, which healed with changing dressing. In the follow-up period, most of the flaps had satisfying appearance. 2 flaps were bulky and thinned by surgery.
Conclusions:The paraumbilical perforator flap has reliable blood supply, good texture, sufficient area, and is convenient to transfer. It's an ideal choice for the repair of the deep soft tissue defect in the hand and forearm.
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