Establishment and optimization of a hyperuricemic nephropathy mouse model / 药学学报

The aim of this study was to establish an efficient and stable mouse model of hyperuricemic nephropathy (HN) by testing different modes of administration of potassium oxonate (PO) combined with hypoxanthine (Hx). Animal welfare and experimental procedures were in accordance with the regulations of the Animal Ethics Committee of Guangdong Pharmaceutical University. Male C57BL/6 mice were randomly divided into a control group, a PO+Hx group (i.g.; 100 mg·kg-1·d-1 and 500 mg·kg-1·d-1, respectively), and a PO+Hx group (i.p.; 100 mg·kg-1·d-1, and 500 mg·kg-1·d-1). This HN model was induced by combination of PO and Hx administration once daily for 21 days. The results of serum biochemistry showed that the levels of serum creatinine and 24 h albuminuria were increased compared with the normal group in intragastric administration of PO combined with Hx (P < 0.05), but there was no significant difference in serum uric acid and hepatic levels of xanthine oxidase. The maximum value of serum uric acid and creatinine was 349.3 μmol·L-1 and 26.4 μmol·L-1, respectively, in mice injected with PO combined with Hx. The levels of liver xanthine oxidase and 24 h albuminuria were significantly increased in mice injected with PO combined with Hx (P < 0.01). Pathological data showed that renal tubules were dilated, the epithelial cells of renal tubules were disordered, and the production of collagen fibers, reactive oxygen species (ROS) and lipid peroxidase 4-hydroxynonenal (4-HNE) were slightly increased after intragastric administration of PO combined with Hx mice. Obvious infiltration of inflammatory cells and large area of collagen deposition, with a large amount of ROS and the lipid peroxide 4-HNE were produced in mice injected with PO combined with Hx. Western blot analysis showed that the expression of fibronectin (FN) and urate transporter 1 (URAT1) was increased after intragastric administration of PO combined with Hx in mice and further increased in mice injected with PO combined with Hx. This study demonstrates that injection with 100 mg·kg-1 potassium oxonate combined with 500 mg·kg-1 hypoxanthine establishes a stable and efficient mouse HN model.

Analysis on UPLC Fingerprint and Determination of Multi-index Components in Pipa Qingfeiyin / 中国实验方剂学杂志

Objective:To establish the ultraperformance liquid chromatography （UPLC） fingerprint of Pipa Qingfeiyin substance benchmark， and to establish a quantitative analysis method for simultaneous determination of the contents of five index components， so as to provide reference for the quality control and evaluation of this famous classical formula. Method:ACQUITY UPLC^® CSH^TM C₁₈ column （2.1 mm×100 mm， 1.7 μm） was used with mobile phase of acetonitrile （A）-0.1% formic acid aqueous solution （B） for gradient elution （0-7 min， 5%-7%A； 7-11 min， 7%-8%A； 11-22 min， 8%-14%A； 22-30 min， 14%-15%A； 30-35 min， 15%-25%A； 35-42 min， 25%-40%A； 42-45 min， 40%-50%A； 45-50 min， 50%-60%A）， the flow rate was 0.35 mL·min^-1， the column temperature was 25 ℃， the detection wavelengths were 278 nm and 248 nm. UPLC fingerprints of 15 batches of Pipa Qingfeiyin substance benchmark were established， and the "Similarity Evaluation System of Chromatographic Fingerprint of Traditional Chinese Medicine" software （2012 edition） was used for similarity analysis， and the common peaks were assigned. Cluster analysis （CA）， principal component analysis （PCA） and orthogonal partial least squares discriminant analysis （OPLS-DA） were used to evaluate the fingerprint data. UPLC fingerprint method was used to simultaneously determine the contents of five components in the substance benchmark. Result:The method validation of fingerprint and determination method was good， the similarities between 15 batches of Pipa Qingfeiyin substance benchmark and their control fingerprint were ≥0.997， 23 common peaks were identified and 11 chromatographic peaks were identified. CA， PCA and OPLS-DA divided 15 batches of the substance benchmark into two groups. The linear relationship of phellodendrine hydrochloride， chlorogenic acid， berberine hydrochloride， palmatine hydrochloride and ammonium glycyrrhizinate was good in a certain range of concentration （<italic>R</italic>²>0.999）， their average recovery was 96.47%-101.16%， and the contents of these five components in the substance benchmark were 0.87-2.00， 1.53-5.95， 18.45-33.97， 3.87-6.29， 1.02-4.12 mg·g^-1， respectively. Conclusion:The established UPLC fingerprint and multi-index component content determination methods have strong specificity， good resolution and high sensitivity， it can be characterized except for the Ginseng Radix et Rhizoma flavor， which can provide reference for the quality control and evaluation of Pipa Qingfeiyin compound preparation.

Establishment of UPLC Fingerprint and Quantitative Analysis of Multi-components of Shengyutang / 中国实验方剂学杂志

Objective:To establish ultra performance liquid chromatography （UPLC） fingerprint of Shengyutang and quantitative analysis method of 11 index components in this famous classical formula. Method:UPLC-diode array detector/evaporative light scattering detector （UPLC-PDA/ELSD） was used， two chromatographic conditions were established by different detectors according to the polarity of chemical components. Conditions of fingerprint 1 were as follows：ACQUITY UPLC HSS T₃ column （2.1 mm×100 mm， 1.8 µm） with the mobile phase of acetonitrile （A）-0.6% formic acid solution （C） for gradient elution （0-4 min， 0-4%A； 4-8 min， 4%A； 8-9 min， 4%-8%A； 9-14 min， 8%-9%A； 14-21 min， 9%-15%A； 21-26 min， 15%-17%A； 26-30 min， 17%-20%A； 30-35 min， 20%-32%A； 35-40 min， 32%-40%A； 40-50 min， 40%-80%A； 50-55 min， 80%A）， the flow rate of 0.3 mL·min^-1， PDA with detection wavelengths of 280 nm and 321 nm， the column temperature at 30 ℃. Conditions of fingerprint 2 were as follows：the CORTECS C₁₈ column （3.0 mm×100 mm， 2.7 µm） with the mobile phase of acetonitrile （A）-water （D） for gradient elution （0-11 min， 19%A； 11-16 min， 19%-25%A； 16-34 min， 25%-28%A； 34-47 min， 28%-47%A； 47-60 min， 47%-80%A）， the flow rate of 0.4 mL·min^-1， ELSD with drift tube temperature of 95 ℃， the carrier gas （air） flow rate of 2.0 L·min^-1， and the column temperature at 30 ℃. UPLC-PDA/ELSD fingerprints of 15 batches of Shengyutang were established， and the similarity was evaluated by similarity evaluation system of chromatographic fingerprint of traditional Chinese medicine （2012 edition） issued by the Chinese Pharmacopoeia Commission， and the contents of eleven index components in this famous classical formula were determined. Result:The similarities of UPLC-PDA/ELSD fingerprints of 15 batches of Shengyutang were >0.98 by comparing with the control fingerprint， 27 and 16 common peaks were identified in fingerprint 1， 2， respectively. It was tested and verified that the precision， repeatability， stability， linear relationship and other results of this method all met the requirements of the 2020 edition of <italic>Chinese Pharmacopoeia</italic>. The contents of chlorogenic acid， ferulic acid， calycosin glucoside， verbascoside， senkyunolide I， senkyunolide H， senkyunolide A， ginsenoside Rg₁， ginsenoside Re， ginsenoside Rb₁ and astragaloside A in 15 batches of Shengyutang were 0.063-0.193， 0.509-0.638， 0.160-0.318， 0.012-0.056， 0.394-0.519， 0.110-0.143， 0.031-0.097， 0.382-0.595， 0.292-0.505， 0.590-0.803， 0.142-0.367 mg·g^-1， respectively. Conclusion:The established detection method meets the requirements of the 2020 edition of <italic>Chinese Pharmacopoeia</italic>， which can characterize the overall characteristics of chemical components in Shengyutang， and provide experimental basis for the quality standard research of this famous classical formula.

18F-fluorodeoxyglucose PET/CT as an independent predictor for patients with hepatocellular carcinoma combined with major portal vein tumor thrombus

Purpose@#Hepatocellular carcinoma (HCC) patients with major portal vein tumor thrombosis (mPVTT) complications were generally characterized by extremely poor prognoses. The aim of this study was to explore the role of 18F-fluorodeoxyglucose (18F-FDG) PET/CT imaging in predicting HCC complicated by mPVTT. @*Methods@#Five hundred one HCC patients received surgery in our hospital during November 2008 to December 2014, among which 32 patients (6.4%) were diagnosed as HCC complicated by mPVTT. Six cases were excluded for reasons of complex medical conditions, including 2 cases of salvage liver transplantation, 2 cases of re-resection, 1 case of mPVTT combined with inferior vina cava tumor thrombosis, and 1 case of residual portal vein tumor thrombosis. Ultimately, 26 cases were enrolled in this study. The maximal tumor standardized uptake value (SUVmax) was identified as a predictive factor and detected. The univariate and multivariate regression analyses were performed to identify the prognostic factors for recurrence-free survival (RFS) and overall survival (OS) of HCC patients complicated by mPVTT. @*Results@#Our results showed that the median OS was 16 months. The 1-, 3-, and 5-year cumulative OS was 55.6%, 31.7%, and 31.7%, respectively. The multivariate regression analysis revealed that SUVmax ≥ 4.65 was the only independent risk factor for RFS and OS. @*Conclusion@#SUVmax was an independent predictor for RFS and OS of patients suffering from both HCC and mPVTT. L ow SUVmax could serve as an effective factor for selecting candidates with low recurrence risks and for helping with improving patient survival after surgical resection.

18F-fluorodeoxyglucose PET/CT as an independent predictor for patients with hepatocellular carcinoma combined with major portal vein tumor thrombus

Purpose@#Hepatocellular carcinoma (HCC) patients with major portal vein tumor thrombosis (mPVTT) complications were generally characterized by extremely poor prognoses. The aim of this study was to explore the role of 18F-fluorodeoxyglucose (18F-FDG) PET/CT imaging in predicting HCC complicated by mPVTT. @*Methods@#Five hundred one HCC patients received surgery in our hospital during November 2008 to December 2014, among which 32 patients (6.4%) were diagnosed as HCC complicated by mPVTT. Six cases were excluded for reasons of complex medical conditions, including 2 cases of salvage liver transplantation, 2 cases of re-resection, 1 case of mPVTT combined with inferior vina cava tumor thrombosis, and 1 case of residual portal vein tumor thrombosis. Ultimately, 26 cases were enrolled in this study. The maximal tumor standardized uptake value (SUVmax) was identified as a predictive factor and detected. The univariate and multivariate regression analyses were performed to identify the prognostic factors for recurrence-free survival (RFS) and overall survival (OS) of HCC patients complicated by mPVTT. @*Results@#Our results showed that the median OS was 16 months. The 1-, 3-, and 5-year cumulative OS was 55.6%, 31.7%, and 31.7%, respectively. The multivariate regression analysis revealed that SUVmax ≥ 4.65 was the only independent risk factor for RFS and OS. @*Conclusion@#SUVmax was an independent predictor for RFS and OS of patients suffering from both HCC and mPVTT. L ow SUVmax could serve as an effective factor for selecting candidates with low recurrence risks and for helping with improving patient survival after surgical resection.

Can we delineate preoperatively the right and ventral margins of caudate lobe of the liver?

PURPOSE: Complete removal of the caudate lobe, which is sometimes necessary, is accomplished via isolated caudate lobectomy or hepatectomy that includes the caudate lobe. It is impossible, however, to confirm the right and ventral margins of the caudate lobe by preoperative imaging. This study was undertaken to determine whether we could identify the right and ventral margins of the caudate lobe preoperatively using Synapse 3D visualization software. METHODS: Ninety-four preoperative 3-dimensional (3D) computed tomographic images (1-mm slices) of the liver from candidate donors were examined. The images of the caudate lobe were subjected to a counter-staining method according to Synapse 3D to delineate their dimensions. We first examined whether the right margin of the caudate lobe exceeded the plane formed by the root of the right hepatic vein (RHV) and the right side of the inferior vena cava (IVC). Second, we determined whether the ventral margin of the caudate lobe exceeded the plane formed by the root of the middle hepatic vein (MHV) and the root of the RHV. RESULTS: For the right margin, 17 cases (18%) exceeded the RHV-IVC plane by a mean of 10.2 mm (range, 2.4–27.2 mm). For the ventral margin, 28 cases (30%) exceeded the MHV-RHV plane by a mean of 17.4 mm (range, 1.2–49.1 mm). CONCLUSION: Evaluating the anatomy of caudate lobe using Synapse 3D preoperatively could be helpful for more precise anatomical resection of the caudate lobe.

The 7th/8th American Joint Committee on Cancer and the Modified Union for International Cancer Control Staging System for Hepatocellular Carcinoma

PURPOSE: Although many staging systems have been proposed for hepatocellular carcinoma (HCC), there is no globally accepted system due to the extreme heterogeneity of the disease. We aimed to compare the results of the 7th/8th American Joint Committee on Cancer (AJCC) and the modified Union for International Cancer Control (mUICC) staging systems in patients with HCC. MATERIALS AND METHODS: We collected data from 792 patients who underwent hepatic resection at our center. The Kaplan-Meier method was used to determine disease-free survival and overall survival. To evaluate homogeneity, ‘-2 log likelihood’ was calculated using Cox proportional hazards regression. To measure discriminatory ability, the linear trend chi method and the Cochran-Armitage test for trend were used. The ability to accurately predict survival was verified by cross-validation analysis. RESULTS: Kaplan-Meier curves for disease-free survival and overall survival showed mUICC to be superior to the 7th/8th AJCC. The homogeneity test indicated that mUICC was the best for both disease-free survival and overall survival. In the discriminatory ability test, the chi-square value of mUICC was the best for disease-free survival, while the 7th AJCC had the best value for overall survival. In the cross-validation analysis, all three staging systems had significant predictive power. CONCLUSION: mUICC seemed to be superior to the 7th/8th AJCC after analyzing the data of our surgical patients, although the geographic heterogeneity of HCC might result in differences between the staging systems. We believe that, while the three staging systems allow for the clear stratification of patients into prognostic groups, mUICC may be more appropriate in HCC.

Effect of Rhizoma Polygoni Cuspidati and Ramulus Cinnamomi compatibility on uric acid metabolism and urinary neutrophil gelatinase-associated lipocalin and kidney injury molecule-1 in rats with hyperuricemia / 中国结合医学杂志

<p><b>OBJECTIVE</b>To explore the effects of Rhizoma Polygoni Cuspidati and Ramulus Cinnamomi compatibility (PR) on uric acid metabolism and the expression of urinary neutrophil gelatinase-associated lipocalin (NGAL) and kidney injury molecule-1 (KIM-1) in rats with hyperuricemia.</p><p><b>METHODS</b>Seventy male Sprague Dawley (SD) rats were randomly divided into 7 groups with 10 rats per group, including the normal group, model group, allopurinol group, benzbromarone group and PR groups at 3 doses (3.5, 7, 14 g/kg). Except the normal group, rats of the other groups were intragastrically administered 100 mg/kg hypoxanthine and 250 mg/kg ethambutol, and subcutaneously injected with 200 mg/kg potassium oxonate. All rats were continuously modeled for 17 days, and gavaged with corresponding drugs. The rats of the normal and model groups were gavaged with saline, once a day, for 2 weeks. The levels of serum uric acid (SUA), blood urea nitrogen (BUN) and creatinine (Cr) were determined. In addition, the contents of NGAL and KIM-1 in urine and the mRNA and protein expressions of xanthine oxidase (XOD) in liver of hyperuricemia rats were measured by reverse transcription polymerase chain reaction (RT-PCR) and Western blot, respectively. Moreover, the pathological changes of kidney were analyzed by hematoxylin and eosin (HE) stain method.</p><p><b>RESULTS</b>Compared with the normal group, the levels of SUA, BUN, NGAL and KIM-1 and the expressions of hepatic XOD mRNA and protein in the hyperuricemia rats were increased signifificantly (P<0.01). PR signifificantly decreased the levels of SUA, BUN, NGAL and KIM-1 and down-regulated the mRNA and protein expressions of hepatic XOD (P<0.05 or P<0.01). In addition, the pathological changes of kidney were signifificantly suppressed by oral administration of PR.</p><p><b>CONCLUSIONS</b>PR ameliorated uric acid metabolism and protected renal function, the underlying mechanism was mediated by decreasing the levels of SUA, BUN, NGAL and KIM-1, inhibiting the expression of hepatic XOD and ameliorating the pathological change of kidney.</p>

Blood Neutrophil-to-Lymphocyte Ratio Predicts Tumor Recurrence in Patients with Hepatocellular Carcinoma within Milan Criteria after Hepatectomy

PURPOSE: The systemic inflammation biomarker, Neutrophil-to-Lymphocyte Ratio (NLR), has been reported as one of the adverse prognostic factors for hepatocellular carcinoma (HCC) patient. The purpose of this study was to evaluate whether NLR could predict the risk of recurrence and death for the HCC patient, according to Milan criteria after hepatectomy. MATERIALS AND METHODS: Retrospective analysis was performed on a database of HCC patients who underwent hepatectomy between March 2001 and December 2011. The cutoff value of NLR was decided by receiver operating characteristic (ROC) curve analysis. Univariate and multivariate regression analyses were performed to identify predictive factors of recurrence and death. RESULTS: A total of 213 patients were included in the present study. The median follow-up period was 48 months. One hundred and seven patients were experienced tumor recurrence; forty of them recurred within 12 months (early recurrence). NLR ≥1.505, albumin ≤3.75 g/dL, microvascular invasion and high grade of cirrhosis were found to be independent factors for adverse recurrence-free survival in multivariate regression analysis. And NLR ≥1.945 was also found as a prognosis factor for early recurrence by univariate regression analysis. CONCLUSION: Elevated preoperative NLR can be easily obtained and reliable biomarker for assessing the tumor recurrence and early recurrence of Milan criteria HCC after the initial hepatectomy.

Surgical treatment for hepatocellular carcinoma with bile duct invasion

PURPOSE: There is still some debate on surgical procedures for hepatocellular carcinoma (HCC) patients with bile duct tumor thrombi (BDTT, Ueda type 3 or 4). What is adequate extent of liver resection for curative treatment? Is extrahepatic bile duct resection mandatory for cure? The aim of this study is to answer these questions. METHODS: Between February 1994 and December 2012, 877 consecutive HCC patients underwent hepatic resection at Ajou University Hospital. Thirty HCC patients (3.4%) with BDTT (Ueda type 3 or 4) were retrospective reviewed in this study. RESULTS: In total, 20 patients enrolled in this study were divided into 2 groups: patients who underwent hemihepatectomy with extrahepatic bile duct resection (group 1, n = 10) and with only removal of BDTT (group 2, n = 10). The 1-, 3- and 5-year overall survival rates were 75.0%, 50.0%, and 27.8%, respectively. The 1-, 3-, and 5-year survival rates of group 1 were 100.0%, 80.0%, and 45.7%, and those of group 2 were 50.0%, 20.0%, and 10.0%, respectively (P = 0.014). The 1-, 3-, and 5-year recurrences free survival rates of group 1 were 90.0%, 70.0%, and 42.0%, and those of group 2 were 36.0%, 36.0%, and 0%, respectively (P = 0.014). Thrombectomy and infiltrative growth type (Ig) were found as independent prognostic factors for recurrence free survival by multivariate analysis. Thrombectomy, Ig, and high indocyanine green retention rate at 15 minutes were found as independent prognostic factors for overall survival by multivariate analysis. CONCLUSION: We suggest that the appropriate surgical procedure for icteric HCC patients should be comprised of ipsilateral hemihepatectomy with caudate lobectomy and extrahepatic bile duct resection.

The Feasibility of Right Posterior Sector Graft in the Adult Living Donor Liver Transplantation / 대한이식학회지

BACKGROUND: The aim of this study is to evaluate the feasibility of living donor liver transplantation (LDLT) using an right posterior sector (RPS) graft selected by liver volumetry of living donors. METHODS: From April 2008 to August 2014, 132 LDLTs were performed in our hospital. Of these, 20 recipients (15.1%) received an RPS graft. Perioperative data of LDLTs using an RPS graft were analyzed retrospectively. RESULTS: Mean of the Model for End-stage Liver Disease score of the 20 recipients was 12.1+/-6.2. The mean right liver volume was 72.4%+/-3.1% of total liver volume (TLV) and the mean volume of RPS was 38.2%+/-5.3% of TLV. Anatomical anomalies were found in the portal vein (PV) of 14 donors (70%), in the hepatic artery of one donor (5%), and bile duct of seven donors (35%). All donors were discharged with normal liver function. Two donors (10%) developed bile leakage after RPS donation. None of the recipients experienced complication associated with hepatic artery and PV anastomosis. One recipient had in-hospital mortality due to pneumonia. The remaining 19 recipients were discharged with good graft function. Four recipients (20%) developed biliary stricture and one (5%) had a liver abscess during follow-up. CONCLUSIONS: The RPS donor had a high incidence of abnormal anatomy of PV. LDLT using an RPS graft might have high incidence of biliary complications. We think that selection of an RPS graft from a donor with an inappropriately large right lobe volume could expand the donor pool and be a feasible option in LDLT.

Outcomes after laparoscopic surgery for 219 patients with obesity / 中华胃肠外科杂志

<p><b>OBJECTIVE</b>To evaluate the outcomes after laparoscopic gastrointestinal surgery for patients with obesity and type 2 diabetes mellitus(T2DM).</p><p><b>METHODS</b>From June 2003 to June 2010, 219 patients underwent laparoscopic gastrointestinal surgery for obesity and T2DM, including laparoscopic adjustable gastric banding(LAGB, n=201), laparoscopic mini gastric bypass(LMGB, n=13), and laparoscopic sleeve gastrectomy(LSG, n=5). Clinical data were analyzed retrospectively.</p><p><b>RESULTS</b>The mean body mass index(BMI) of patients who received LAGB was 37.9 kg/m(2), and decreased to 32.4 kg/m(2) at 6 months and to 29.7 kg/m(2) at 12 months. In 43 patients who had concurrent T2DM, 11(25.6%) showed clinical partial remission(CPR) and 16(37.2%) clinical complete remission (CCR). Postoperative complications occurred in 26 patients(12.9%). The mean BMI of patients undergoing LMGB was 34.7 kg/m(2), and decreased to 31.6 kg/m(2) at 6 months and 26.9 kg/m(2) at 12 months after surgery. Ten patients had T2DM before operation, of whom 2(20.0%) had CPR and 7(70.0%) CCR postoperatively. Postoperative complications occurred in 2 patients(15.4%). The mean BMI of patients who underwent LSG was 43.8 kg/m(2), and was reduced to 38.1 kg/m(2) at 6 months and 34.3 kg/m(2) at 12 months after operation. Three patients were diagnosed with T2DM before operation. One patient (33.3%) had CPR and 1(33.3%) reached CCR after operation. There was 1(20.0%) patient who developed complication. No perioperative death occurred.</p><p><b>CONCLUSION</b>Laparoscopic gastrointestinal surgery may result in satisfactory weight loss and clinical remission of T2DM with few complications.</p>

Application of neoadjuvant chemotherapy in laparoscopic gastrectomy for advanced gastric cancer / 中华胃肠外科杂志

<p><b>OBJECTIVE</b>To explore the benefit of neoadjuvant chemotherapy in advanced gastric cancer patients treated by laparoscopy.</p><p><b>METHODS</b>Fifteen patients with histologically proved gastric adenocarcinomas (stages II(, III(, IIII(M(0)) were treated with FOLFOX7 neoadjuvant chemotherapy followed by laparoscopy between June 2005 and March 2007( trial group). Thirty patients were assigned to the control group with only laparoscopic treatment in the same period. The clinicopathological data were compared between two groups.</p><p><b>RESULTS</b>All the patients in trial group accepted four cycles of preoperative chemotherapy and the toxicity was less than grade 3. Two of them achieved complete response, 10 achieved partial response and 3 kept stable disease. Ten patients of trial group underwent laparoscopic-assisted radical gastrectomy. The rates of R(0)-resection(80.0%) and pN(0) (60.0%) in trial group were significantly higher than those in control group(46.7% and 20.0%), while the rate of positive lymph node 11.0%(34/309) was significantly lower than that of control group 23.8%(142/596). The operation time and postoperative complication were similar in two groups.</p><p><b>CONCLUSIONS</b>Advanced gastric cancer after neoadjuvant chemotherapy can be down-regulated in the stage, increase the rate of R(0)-resection, diminish the infiltration extent of tumor, decrease the metastasis of lymph node, and increase the possibility of laparoscopic radical gastrectomy.</p>

Laparoscopic adjustable gastric banding in the treatment of obesity: analysis of 172 cases / 中华胃肠外科杂志

<p><b>OBJECTIVE</b>To evaluate the outcome of weight loss by laparoscopic adjustable gastric banding (LAGB) on obesity patients and the improvement of comorbidity.</p><p><b>METHODS</b>From June 2003 to June 2009, the data 172 obesity patients(119 women, 53 men, mean age 28.5 years, mean body mass index 38.5 kg/m(2)) were analyzed. Comorbidities included 28 cases with diabetes, 36 with hypertension, 85 with dyslipidemia, 56 with sleep apnea and 138 with fatty liver.</p><p><b>RESULTS</b>Mean body mass index(BMI) at 1,3,6,12, 24, 36 and 48 months was 37.2 kg/m(2),35.9 kg/m(2), 34.5 kg/m(2), 32.9 kg/m(2), 30.7 kg/m(2), 29.2 kg/m(2) and 28.1 kg/m(2), respectively. The percentage of excess weight loss(% EWL) at 1, 3, 6, 12, 24, 36, and 48 months was 10.1%, 16.2%, 25.1%, 37.4%, 51.3%, 59.0% and 62.1%, respectively. At 24, 36 and 48 months, respectively, 50.7%, 63.6% and 70.0% of patients had more than 50% excess weight loss. Complications included 6 cases of port infection, 3 of other port problem, 7 of gastric pouch dilatations, 4 of slippage and 1 of chronic intestinal obstruction. Bands of 5 patients were explanted. No death occurred. Blood glucose of 60.7% patients with diabetes was controlled well without any drug. The blood pressure of 22 hypertensive patients became normal. The blood fat of 49 hyperlipidemia cases returned to normal. The symptom of 29 patients with sleep apnea disappeared. All the patients with fatty liver were improved in different degree.</p><p><b>CONCLUSION</b>Gastric banding provides good weight loss and significant reduction in comorbidities with few and minor complications.</p>

Short-term outcome of laparoscopic gastric bypass and minigastric bypass on obesity patients with type 2 diabetes mellitus / 中华胃肠外科杂志

<p><b>OBJECTIVE</b>To evaluate the short-term outcome of laparoscopic gastric bypass on obesity patients with type 2 diabetes mellitus.</p><p><b>METHODS</b>Seven obesity patients with type 2 diabetes mellitus received laparoscopic gastric bypass(n=1) or laparoscopic minigastric bypass(n=6), and their data of treatment outcomes were analyzed.</p><p><b>RESULTS</b>The operations were all successfully performed without any complications. The average operation time was 125 minutes(range: 100 to 170 minutes). The patients underwent 1-18 months follow-up after operation. Diabetic indicators returned to normal without any medication and body weight reduced by on average of 24.3 kg.</p><p><b>CONCLUSION</b>Laparoscopic gastric bypass and minigastric bypass have good short-term outcome in the treatment of obesity patients with type 2 diabetes mellitus.</p>

Effects of duodenal-jejunal bypass and sleeve gastrectomy on the expression of liver glucokinase in diabetic rats / 中华胃肠外科杂志

<p><b>OBJECTIVE</b>To investigate the effects of duodenal-jejunal bypass(DJB) and sleeve gastrectomy(SG) on the expression of liver glucokinase(GCK) in diabetic rats.</p><p><b>METHODS</b>Animal models of Goto-Kakizaki rats and Sprague-Dawley rats were established by DJB and SG. Results of fasting glycemia and insulin were compared. Liver tissue was harvested 8 weeks postoperatively.Quantitative real-time PCR and Western blot were used to detect liver GCK mRNA and protein expression after operation.</p><p><b>RESULTS</b>Fasting plasma glucose levels of DJB group and SG group in GK rats were markedly declined 3 day and 1, 2, 4, 6, 8 weeks postoperatively(all P <0.01), while Sham group only dropped 3 day and 1 week postoperatively, and there were no significant differences 2 weeks postoperatively(P >0.05). Fasting plasma glucose levels of each group in SD rats did not change after operation. In GK rats, GCK mRNA level (1.45 +/-0.29) and protein expression (494.25 +/-30.25) after DJB were higher than Sham group (1.05 +/-0.19 and 409.13 +/-26.86) and control group (1.04 +/-0.17 and 404.75 +/-30.90). GCK mRNA level and protein expression after SG were 0.65 +/-0.25 and 345.25 +/-28.13 respectively, which were significantly lower than those in control group(all P <0.01). All the groups in SD rats experienced similar GCK expression change.</p><p><b>CONCLUSION</b>Both DJB and SG can decrease the plasma glucose levels of GK rats, while there are different effects on the expression of liver GCK.</p>

Diagnosis and treatment of postoperative complications after laparoscopic adjustable gastric banding procedure / 中华外科杂志

<p><b>OBJECTIVE</b>To investigate the diagnosis and treatment of the complications in patients after laparoscopic adjustable gastric banding (LAGB) procedure.</p><p><b>METHODS</b>Retrospectively analyze the data of the 23 patients who received the LAGB procedure from June 2003 to November 2004.</p><p><b>RESULTS</b>Of the 23 LAGB operations, 3 (13%) cases of vomiting and nausea, 1 (4.3%) case of access-port infection and 5 (21.4%) cases of food intolerance occurred. One band (4.3%) and one injection reservoir (4.3%) displaced and were removed by laparoscopy. No death and thrombo-embolism occurred.</p><p><b>CONCLUSIONS</b>The diagnosis and treatment of complications after LAGB in morbid obesity was special, if managed properly, the result would be satisfactory.</p>

Study on anti-tumor effect of medicinal fungi Phellinus igniarius extracts / 中国中药杂志

<p><b>OBJECTIVE</b>To study the inhibiting effect of medicinal fungi Phellinus igniarius extracts on S180 tumor and the immunoregulation effect on the S180-induced tumor mice.</p><p><b>METHOD</b>S180 mice were orally given 100, 200, 400 mg x kg(-1) dosage of P. igniarius extracts, then the inhibition grow effect, spleen index, and thyme index were measured.</p><p><b>RESULT</b>Medicinal fungi P. igniarius extracts can increase the spleen index and thyme index and the inhibiting tumor rate was 31.88%, 46.25%, 53.13%, respectively. Also, medicinal fungi P. igniarius extracts can prolong life in mice.</p><p><b>CONCLUSION</b>The medicinal fungi P. igniarius extracts show obviously anti-tumor effect and immunoregulation effect.</p>