Comparative effects of Roux-en-Y gastric bypass procedures preserving different gastric volume on blood glucose in Goto-Kakizaki rats / 中华胃肠外科杂志

<p><b>OBJECTIVE</b>To compare the effects of Roux-en-Y gastric bypass (RYGBP)procedures preserving different gastric volume on blood glucose of rats with non-obese type 2 diabetes.</p><p><b>METHODS</b>A total of 36 Goto-Kakizaki rats randomly underwent one of the following procedures: gastric bypass with different types of anastomosis including the Roux-en-Y of total stomach excision(n=12), the Roux-en-Y of partial stomach excision(n=12) and the Roux-en-Y of stomach preservation(n=12). Rats were observed for 24 weeks after surgery. Body weight, food intake and fasting blood glucose level were tested at 0(preoperative), 1, 3, 6, 12, 24 weeks. Hemoglobin A1c(HbA1c) level was measured at 0, 12, 24 weeks and glucose tolerance test (OGTT) was performed in conscious rats before (baseline) and then 30, 60, 120, and 180 minutes. Change of blood glucose over time was depicted. Area under curve(AUC) of glucose tolerance were calculated.</p><p><b>RESULTS</b>Compared with preoperative levels, the weight and food intake of all the rats were significantly decreased at 1 week after surgery(P<0.01). At 3 weeks after operation, the weight and food intake were significantly increased compared with 1 week after operation in the Roux-en-Y of partial stomach excision and the Roux-en-Y of stomach retention(P<0.01). In the Roux-en-Y of total stomach excision, the weight and food intake were significantly lower compared with other two groups(P<0.05). At 24 weeks after operation, the levels of fasting blood glucose were (7.3 ± 1.5), (7.5 ± 2.0) and (8.3 ± 1.3) mmol/L, which were lower than the preoperative levels [(13.2 ± 1.6), (13.6 ± 2.5) and (12.9 ± 2.0) mmol/L, P<0.01] in the three groups. There were no significant differences among the three groups(P>0.05). At 24 weeks after operation, the HbA1c levels were(6.3 ± 1.3)%, (6.4 ± 2.0)% and (7.0 ± 1.3)%, which were lower than the preoperative level[(10.2 ± 2.6)%, (9.6 ± 2.5) and (9.9 ± 2.0)%, P<0.01]. There were no significant differences among the three groups(P>0.05). The trend of the glucose tolerance test and AUC were similar in the three groups after operation.</p><p><b>CONCLUSION</b>Roux-en-Y gastric bypass in non-obese diabetic rats is effective in terms of glucose control and the efficacy of gastric bypass has no obvious association with the stomach volume.</p>

Effect of diabetes control after small intestine exclusion surgery in Goto-Kakizaki rat with non-obese type 2 diabetes mellitus / 中华外科杂志

<p><b>OBJECTIVE</b>To evaluate the effect and possible mechanisms of diabetes control after small intestine exclusion surgery in Goto-Kakizaki (GK) rat with non-obese type 2 diabetes mellitus.</p><p><b>METHODS</b>Forty GK rats with non-obese type 2 diabetes mellitus underwent duodenal bypass (Group A, n = 8), which creates a shortcut for ingested nutrients bypassing duodenum alone; duodenal-jejunal bypass (Group B, n = 8), a stomach-preserving RYGB that excludes the duodenum and proximal jejunum; duodenum and total jejunum exclusion (Group C, n = 8); sub-total small intestine exclusion (Group D, n = 8), which creates a shortcut for ingested nutrients bypassing duodenum, jejunum and sub-total ileum; controls were pair-fed (PF) sham-operated and untreated GK rats (Group SO, n = 8). The rats were observed for 24 weeks after surgery. Body weight, food intake and fasting blood glucose level were tested at 0, 1, 3, 6, 12, 24 weeks after the operation in those groups. The concentrations of insulin and glucagon-like peptide-1 (GLP-1) concentrations were measured before (baseline) and then 30, 60, 120, and 180 minutes after OGTT at 0, 12, 24 weeks after the operation.</p><p><b>RESULTS</b>Mean operating time of all groups was similar. The mean body weight and food intake decreased significantly at 1 week after surgery (P < 0.01) and with no differences among the groups. Fasting blood glucose level decreased significantly after surgery in all the operation groups through the entire follow-up period (P < 0.05). No significant changes in fasting blood glucose level in SO group was found in 12 weeks after the operation, and it increased at 12 and 24 weeks after. Fasting blood glucose levels in group B decreased significantly compared with group A (P < 0.05), but no difference was found among group B, C and D (P > 0.05). Oral glucose-stimulated peak (30 min) levels of blood insulin and GLP-1 increased markedly in operation groups (A, B, C and D) after surgery (P < 0.01). Compared with group A, peak levels of blood insulin and GLP-1 in group B were strikingly higher (P < 0.05), but no difference was found when compared with group C or D (P > 0.05).</p><p><b>CONCLUSIONS</b>In spontaneously non-obese type 2 diabetes mellitus rats, small intestinal exclusion including proximal gut is effective in terms of glucose control and has no direct relation with body weight and food intake loss. Restoration of the first-phase insulin secretion and high secretion of GLP-1 in type 2 diabetic subjects after gastrointestinal bypass surgery seem to be helpful to diabetes control. Taking intestinal nutrient absorption into consideration, duodenal-jejunal bypass may be a better surgery for diabetes control.</p>

Effects of Ginkgo biloba extract on expressions of IL-1beta, TNF-alpha, and IL-10 in U937 foam cells / 药学学报

This study is to investigate the protein and mRNA expressions of pro-inflammatory and anti-inflammatory cytokines in U937 foam cells and effects of Ginkgo biloba extract (GbE) on the cytokines. U937 cells were cultured with different concentrations of GbE (0.1, 1, and 10 microg x L(-1)), and stimulated by 100 mg x L(-1) oxidized low density lipoprotein (ox-LDL) for 24 h. The expressions of interleukin-1beta (IL-1beta), tumor necrosis factor-alpha (TNF-alpha) and interleukin-10 (IL-10) in culture solution were detected by enzyme-linked immunosorbant assay (ELISA) and reverse transcriptase polymerase chain reaction (RT-PCR). The results showed that incubated with 100 mg x L(-1) ox-LDL for 24 h, the U937 cells became foam cells, the protein or mRNA expressions of IL-1beta, TNF-alpha, IL-10, and its receptor IL-10R in U937 foam cells were higher markedly than those in normal U937 cells. When the cells were pretreated with GbE (0.1, 1, and 10 microg x L(-1)), the increases of IL-1beta and TNF-alpha in U937 foam cells were remarkably inhibited, but IL-10 expression increased greatly. Especially when cells were pretreated with 10 microg x L(-1) GbE, the protein and mRNA expressions of IL-1beta and TNF-alpha were markedly lower than those in U937 foam cells. The protein expression of IL-10 and mRNA expressions of IL-10 and its receptor IL-10R were markedly higher than those in U937 foam cells. GbE inhibited production of pro-inflammatory cytokines IL-1beta and TNF-alpha, but up-regulated the production of anti-inflammatory cytokine IL-10 and its receptor IL-10R in U937 foam cells, which might be related with its anti-atherosclerotic actions.