Effect of short-term energy metabolism by which sleeve gastrotomy (SG) and gastric plication (GP) alter on obesity type 2 diabetes Zucker fatty rats / 中华内分泌外科杂志

Objective To investigate the effect of sleeve gastrotomy (SG) and gastric plication (GP) on the short-term metabolism in type 2 diabetes mellitus (T2DM) Zucker fatty rats.Methods Thirty healthy male rats were randomly allocated into three groups:Sham,SG and GP groups,and devices like metabolic cage were applied to detect the metabolic changes in the third week after operation.Results The body weight of the SG and GP group decreased,but no statistical significance was found when compared with that of the Sham group.Less food consumption were found in SG (P＜0.05) and GP (P＜0.05) groups compared with that of the Sham group.In the daytime,the energy expenditure of SG group was higher than that of the sham group(P＜0.01),while in the night,the energy expenditure of both the SG (P＜0.001) and GP (P＜0.001) groups were higher than that of the Sham group.In the night,the activity level of SG (P＜0.05) and GP (P＜0.05) groups were lower than that of the Sham group,and activity level in the night was lower than that in the daytime for SG group(P＜0.05).In the daytime,the respiratory exchange rate (RER) of the SG (P＜0.001) and GP (P＜0.001) group were lower than that of the Sham group,and the night RER of GP group was higher than that in the daytime (P＜0.05).No statistical significance was found in terms of the average speed among the three groups.The average speed of the Sham (P＜0.05) and SG (P＜0.05) group in the night were faster that in the daytime.The fasting plasma glucose (FPG) of SG and GP group were improved compared with that of the Sham group.Conclusion SG and GP procedures can improve the metabolism of diabetic rats in the short term.

Expression and clinical significance of GRHL2 in colorectal cancer / 中华肿瘤杂志

<p><b>OBJECTIVE</b>The purpose of this study was to detect the expression of GRHL2 in colorectal cancer (CRC) tissues, and to assess the relationship between GRHL2 expression and clinicopathological features.</p><p><b>METHODS</b>Immunohistochemistry was used to examine GRHL2 in 75 CRC tissues. GRHL2 mRNA and protein levels in the CRC tissues were also analyzed by qRT-PCR and Western blot. The relationship between GRHL2 and clinicopathological features was assessed by Pearson's chi-square (χ(2)) test.</p><p><b>RESULTS</b>Positive immunoreactivity for GRHL2 was detected in the nuclei of CRC cells. GRHL2 expression was increased in CRC tissues compared withthat in the paired non-tumor tissues (61.3% vs. 44.0%, P<0.01). Moreover, qRT-PCR results showed that the relative expression level of GRHL2 mRNA in the colorectal cancer tissue was (2.64±0.35), significantly higher than that of normal mucosa tissue (1.19±0.23, P<0.001). The expression level of GRHL2 mRNA was higher in stage III-IV patients (2.84±0.36) than that of stage I-II cases (2.31±0.32, P<0.05). Western blot results also showed that the expression level of GRHL2 protein in the colorectal carcinoma tissue was significantly higher than that in the normal mucosa (P<0.05). GRHL2 expression was positively correlated with tumor size, TNM stage and Ki-67 (P<0.05, respectively).</p><p><b>CONCLUSION</b>Taking together, our findings demonstrate that GRHL2 is overexpressed in CRC, and plays an important role in the progression of CRC.</p>

The optimal combination of mechanical ventilatory parameters under general anesthesia in obese patients undergoing laparoscopic surgery / 复旦学报（医学版）

Objective Pulmonary dysfunction is common in the obese patients after laparoscopic surgery. To reduce or avoid this complication caused by improper combination of mechanical ventilatory parameters,we conducted the following trial of 3 factors with 3 levels of mechanical ventilation in order to explore the optimal combination with low airway pressure. Methods Patients were randomly allocated into 9 groups (k=3,n=27) according to the "30≤BMI<40" obesity index (ASAⅠ-Ⅱ). Anesthesia machine parameters were set as follows: respiratory frequency (f), tidal volume (VT), respiratory ratio (I:E) as the three factors of A, B, C, with 3 levels of f=15, 12, 9 (bpm), VT=8, 10, 12 (mL/kg), I:E=1:2.5, 1:2.0, 1:1.5. By using L9(3~4)K=3 repeat orthogonal experimental design and analysis table, the variable factors that affect the respiratory index such as the end tidal carbon dioxide pressure (P_(ET)CO_2), peak airway pressure (PIP), mean airway pressure (P_(mean)), and the end of endogenous airway pressure (PEEPi) were analyzed. Results In this study, 27 cases undergoing laparoscopic surgery under general anesthesia were allocated into 9 experimental groups. The hemodynamics of these patients was stable, SPO_2 was kept at 100 percent during the operation. The results of different combinations were described as follows: ①P_(ET)CO_2: f and VT with different level had great impact on P_(ET)CO_2 (P<0.01), I:E had no significant difference in three levels (P>0.05);② PIP: f had great effect on PIP (P<0.05);VT and I:E in three levels also had significant effect on PIP(P<0.01);③ P_(mean): all the ventilation parameters with different combination had significant effect on P_(mean)(P<0.01). Conclusions The best combination of respiratory parameters is A3B1C2, i.e., f=9 bpm, VT=8 mL/kg, and I:E=1:2.0, which indicates that neither small tidal volume and faster frequency, nor slow frequency large tidal volume is a good choice. In order to let obese patients under general anesthesia obtain the best lung protective effect by low airway pressure with good ventilation, it is worth noting that: ①I:E has a great effect on airway pressure (PIP, P_(mean)), which is important for lung protection;②I:E has the opposite effect on PIP and P_(mean).