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Objective To evaluate the clinical effects of the laparoscopic Roux-en-Y gastric bypass (LRYGB) on patients with type 2 diabetes mellitus (T2DM).Methods From Dec.2013 to Dec.2015,83 cases with T2DM received LRYGB were enrolled to this study.They were divided into low body mass index group (LBMI,25≤BMI＜28),intermediate body mass index group (IBMI,28≤BMI＜32) and high body mass index group (HBMI,BMI≥33).Meanwhile,the clinical effects and side-effects were evaluated among three groups.The factors of adverse effects were evaluated by Cox multivariate analysis.Results Only one patient in HBMI was conversed to open surgery,all the others received LRYGB.The surgery time,intraoperative blood loss and complica tion were positively related to BMI,and the difference was statistically significant between the 3 groups(P＜0.05).The main side-effect of LRYGB was gastrointestinal reaction.The level of fasting blood-glucose,postprandial 2 hours blood sugar,HbA1c and cholesterol total in three groups were lower than baseline (P＜0.05),however,there was no significant difference among the three groups (P＞0.05).The rate of clinical effects in three groups was 89.5％,89.3％ and 91.7％.There was no significant difference among the three groups(P＞0.05);In Cox multivariate analysis,cholesterol total and BMI were independent prognostic indicator for LRGB adverse.Conclusions LRYGB is a safe and effective method for patients with T2DM,which can effectively improve glucose and lipid metabolism.The increased BMI can increase the incidence of LRYGB complications.Total cholesterol is an independent prognostic indicator for the adverse of LRYGB.
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Objective To study the effect of intratumor angiogenesis and vascular growth factor(VEGF), basic fibroblase growth factor(bFGF), Platelet-derived growth factor (PDGF), and their receptors(flt-1 bFGFR.PDGFR) on the invasion, metaslasis of pancreatic carcimoma(PC) and the relationship between the expressions of three kinds of angiogenic factors, their receptors and microvessel count(MVC). Methods Tis- sue sections of 51 PC and 32 acute or chronic pancreatitis were examined by in situ hybridization for the expression of VEGF bFGF.PDGF, and by immunohistochemistry for the expression of the three kinds of angiogenic factor receptors and MVC. The correlation of the expressions and pathological characteristics of PC were also studied. Results The positive rate of VEGF mRNA,bFGF mRNA, PDGF mRNA and their receptors in PC were significantly higher than that in acute or chronic pancreatistis( P
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0.05).The infiltration of tumor to the muscularis mucosa or serosa layers was significantly correlated with the risk of GISTs(?~2=4.87,P
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Objective To evaluate the clinical application of endoscopic thyroidectomy(ESTC) via the approach of areola of breast.Methods The clinical data of 46 cases of endoscopic thyroidectomy via the breast areola approach from October 2004 to November 2006 were retrospectively analyzed.Results The operation was successfulmy completed endoscopically in 44 cases,including 18 cases of unilateral partial thyroidectomy,26 cases of bilateral partial thyroidectomy,and 2 cases were converted to open operation for thyroid cancer neck dissection.The operation time of ESTC was 80~160minutes(mean 110min),and the intraoperative blood loss was 25~45ml,(mean,33?9.5ml).Pathological findings showed 25 cases of thyroid adenoma,16 cases of nodular goiter,and 3 cases of Graves disease.The length of postoperative hospital stay was 3~6day(mean4.5d).Complications occurred in 2 cases,including 1case of bleeding from left puncture tract,and 1 case of temporary hoarseness.Conclusions Endoscopic thyroidectomy via breast areola approach is a technically feasible and safe procedure,and has the advantage of minimal trauma,and with excellent cosmetic outcomes.