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Objective:To analyze the feasibility, safety and clinical efficacy of laparoscopic side-to-side jejunoileal anastomosis in the treatment of non-obese type 2 diabetes patients (BMI≤32.5 kg/m 2). Methods:The clinical data of 135 patients who underwent laparoscopic side-to-side jejunoileal anastomosis at our hospital from Jan 2018 to Oct 2018 were retrospectively analyzed. They were followed up for 12 months until the end of Oct 2019. SPSS software was used to compare patients′ fasting blood glucose, glycosylated hemoglobin, c-peptide, insulin, body weight, BMI with the values after 12 months of the surgery, and then evaluate factors affecting the prognosis.Results:135 patients successfully completed laparoscopic side-to-side jejunoileal anastomosis without conversion to open surgery. After 12 months of the operation, the patients′ fasting blood glucose was (5.80±0.18)mmol/L, glycosylated hemoglobin was 5.9%±0.4%, fasting c-peptide was(1.32±0.21) nmol/L, and fasting insulin was (42±54) mU/L ( t=10.654, 12.657, 11.214, 10.698, all P<0.05). The body weight was (72.4±9.9)kg, BMI was( 25.6±2.8)kg/m 2, and the difference was not statistically significant ( t=7.658, 6.958, P>0.05). In patients with preoperative glycosylated hemoglobin controlled below 8% and the duration of T2DM less than 10 years, the chances being cured was better than that of those with glycosylated hemoglobin>8% and the medical history >10 years. Conclusion:Laparoscopic side-to-side jejunoileal anastomosis in the treatment of non-obese type 2 diabetes is effective, safe and reliable.
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<p><b>OBJECTIVE</b>To determine the role of zinc finger protein 1 (ZEB 1) in liver fibrosis and in regards to expression of the tumor growth factor-beta (TGFb) signaling factor using a rat model system.</p><p><b>METHODS</b>Sprague-Dawley rats were randomly divided into a normal (control) group, liver fibrosis (model) group and a liver fibrosis + therapy (ZEB1 intervention) group. The model group and the ZEB1 intervention group were given intraperitoneal injections of dimethylnitrosamine (DMN) for the first 3 days of each week over a 7-week period; starting at week 5, the ZEB 1 intervention group was started on a routine of every other day tail vein injections of recombinant ZEB1. During this 7-week period, the control group was given intraperitoneal injections of 0.9% NaC1 alone on the DMN schedule. Liver tissues were collected for pathological examination (with hematoxylin-eosin and Masson staining) and for detection of TGFb1 and ZEB 1 expression (by RT-PCR and western blotting). Measurement data were compared between groups using the single-factor analysis of variance test, followed by the least significant difference LSD test. Count data were analyzed by Fisher's exact test.</p><p><b>RESULTS</b>The model group's liver tissues showed degeneration and necrosis, as well as obvious fibrous septa accompanied by pseudo lobules. The ZEB 1 intervention group's liver tissues showed a significantly higher degree of fibrosis (x²=21.63, P=0), with more coarse fiber cords. The expression of ZEB1 and TGFb1 was significantly higher in the model group than in the control group (both P less than 0.05). However, the ZEB 1 intervention group showed the highest levels of ZEB 1 and TGFb1 expression (vs. model group, P less than 0.05).</p><p><b>CONCLUSION</b>ZEB 1 may promote the development of liver fibrosis in rats through a mechanism involving the TGFb/Smad signaling pathway.</p>
Subject(s)
Animals , Male , Rats , Homeodomain Proteins , Pharmacology , Liver , Metabolism , Liver Cirrhosis, Experimental , Metabolism , Rats, Sprague-Dawley , Transcription Factors , Pharmacology , Transforming Growth Factor beta1 , Metabolism , Zinc FingersABSTRACT
ObjectiveTo investigate the etiology, diagnosis and choice of treatment for massive hemobilia. MethodsA retrospective analysis was made on the clinical data of 20 patients with massive hemobilia treated from August 1998 to August 2008. ResultsInitially conservative therapy was used on 20 patients and bleeding stopped in 4 patients. For the seven patients who were treated with hepatic artery angiography and embolization, bleeding stopped in 6 patients. 10 patients were treated by operation and bleeding stopped in all these patients. No patient died in this series. ConclusionsHepatic artery angiography and embolization should be used to treat patients with massive hemobilia. Surgery should be offered if conservative therapy and hepatic artery embolization fail.
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Objectiye To evaluate the value of intraoperative bile leakage test during liver resection in preventing postoperation bile leakage. Methods Eighty-one cases were randomly divided into two groups,in the test group (41 cases) white fat emulsion(sterilized) was injected into common bile tract through cyst bile duct,the leakage points on the transect surface were observed and disposed. In the control group (40 cases) the transect surface were disposed by regular methods. The rate of postoperation bile leakage in the two groups were analyzed. Results The rate of postoperation bile leakage in the test group was 2. 4% (n=1), and the rate of postoperation bile leakage in the control group was 15% (n = 6). There was significant difference between the two groups (x2=4.04, P＜0.05). Conclusion The white bile leakage test is effective in preventing the postoperation bile leakage during liver resection and does not increase other complications.
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OBJECTIVE:To discuss the method to optimize the function of current "Nationwide Adverse Drug Reaction Monitoring Network". METHODS: To analyze the disadvantages of the current "Nationwide Adverse Drug Reaction Monitoring Network" from perspective of the contents of items and its operational function and put forward some suggestions for its modification. RESULTS & CONCLUSIONS: The current ADR collecting system should be upgraded and modified to ensure the validity, standardization and integrality of ADR reports in our country to a large extent.
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OBJECTIVE: To provide reference for the monitoring of adverse drug reactions(ADR).METHODS: All ADR reports collected during 2005～2007 were statistically analyzed and evaluated in accordance with the requirements on the writing of ADR reports in China.RESULTS: Of the 576 ADR reports collected,the average missing items totaled 13.86,12.16 and 13.61 respectively over the 3 years from 2005 to 2007.The number of ADR reports increased year by year,but no significant improvement was noted for the quality of the reports.The poor quality of the ADR reports manifested as serious missing of items,nonstandard writing of the content and the failure to meet standards in the proportion of serious cases etc.CONCLUSION: It is advisable that the special training of ADR reports should be done and the publicity of ADR knowledge should be strengthened so as to improve ADR reporters' cognition level on ADR report quality.