Your browser doesn't support javascript.
loading
Show: 20 | 50 | 100
Results 1 - 20 de 33
Filter
Add filters








Year range
1.
Article in English | WPRIM | ID: wpr-929232

ABSTRACT

Natural products (NPs), especially those from traditional herbal medicines, can evidently modulate human gene expression at multiple levels, leading to a wide diversity of bioactivities. Although numerous bio-functions of NPs for human body have been found, there is little understanding about how NPs achieve it, as less attention was drawn to the definite mechnism by which NPs regulate gene expression. Furthermore, based on the rapidly advancing knowledge of mechanisms for gene regulation in recent years, newly-understood mechanisms, such as post-transcriptional regulation, are found to be involved in NP-elicited bio-effects, providing a new perspective on understanding the role of NPs in gene expression. Therefore, in the current review, we summarize the function of NPs in gene expression from the perspectives of transcriptional, post-transcriptional, and post-translational regulation, which will reinforce the understanding of NP-induced effects in gene expression and facilitate the exploration of more NPs with potential therapeutic effects.


Subject(s)
Biological Products/pharmacology , Gene Expression , Gene Expression Regulation , Humans
2.
Article in Chinese | WPRIM | ID: wpr-884663

ABSTRACT

Focal intrahepatic strictures (FIHS) refers to local strictures or stenosis of the intrahepatic bile duct induced by various factors. FIHS is easily leading to misdiagnosis and miss diagnosis. At present, most of the techniques or examinations for making position as well as qualitative diagnosis of FIHS have poor sensitivity. Paying more attention to the medical history and combined applications of various inspection methods might help to improve the diagnostic level of FIHS. In terms of treatment, we suggested for patients with suspected malignant strictures or those who were failure of medical treatment, dilation, drainage and pathological diagnosis of FIHS could be conducted by endoscopy before determining the indications and procedures of surgery based on a new anatomy classification system of FIHS.

3.
Article in Chinese | WPRIM | ID: wpr-908443

ABSTRACT

Based on current diagnosis and treatment of gallbladder disease, the occur-rence of incidental gallbladder cancer is partly caused by the irregular clinical diagnosis and treatment process of gallbladder disease, which leads to the failure to make the diagnosis of gallbladder cancer in time, carry out the correct preoperative and intraoperative staging, and cause R 1 or R 2 resection. The authors summarize standardized diagnosis and treatment process of gallbladder disease and technical details. In clinical practice, the concept of incidental gallbladder cancer should be discarded, and various gallbladder diseases should be taken as a whole. A more standardized diagnosis and treatment process should be established to improve the diagnostic accuracy of gallbladder cancer and achieve radical resection, which eventually improve survival of patients.

4.
Article in Chinese | WPRIM | ID: wpr-869939

ABSTRACT

Objective:To evaluate the effect of epidural block combined with general anesthesia on T helper (Th) cell balance and outcome after hepatectomy.Method:Seventy patients aged 18-64 yr, of American Society of Anesthesiologists physical status Ⅰ or Ⅱ, undergoing hepatectomy in our hospital, were randomly assigned into combined epidural-general anesthesia group (E+ G group, n=35) and general anesthesia group (G group, n=35). The consumption of anesthetics during operation and analgesics after operation was recorded.Blood samples were obtained on the morning of the operation day (T 0) and morning of 2nd and 3rd days after operation (T 1, 2). The concentrations of interferon (IFN)-γ, interleukin-4 (IL-4), IL-17, IL-10 and transforming growth factor (TGF)-β 1 were determined by enzyme-linked immunosorbent assay.The ratio of IFN-γ/IL-4 was calculated.The patients were followed up for 3 yr after operation, and the survival and tumor-free survival were recorded.Multivariate COX proportional hazards model was used for multivariate analysis of the factors associated with survival and tumor-free survival. Results:Sixty-one patients were finally included in this study, including 31 patients in E+ G group and 30 patients in G group.Compared with G group, the consumption of fentanyl, sevoflurane and postoperative morphine was significantly decreased, the plasma concentrations of IFN-γ and IL-4 at T 1 and IL-17 and TGF-β 1 at T 2 were decreased, the ratio of IFN-γ/ IL-4 was increased, and the overall survival rate and tumor-free survival rate were increased in E+ G group ( P<0.05). The results of multivariate COX proportional hazards model analysis showed that vascular invasion was a risk factor for tumor-free survival and overall survival ( P<0.05), and anesthesia method was not a risk factor for tumor-free survival ( P>0.05). Conclusion:Compared with general anesthesia alone, epidural block combined with general anesthesia is more helpful in maintaining the balance of Th cells and in improving the outcome of hepatectomy.

5.
Chinese Journal of Surgery ; (12): 27-30, 2020.
Article in Chinese | WPRIM | ID: wpr-798708

ABSTRACT

Gallbladder carcinoma(GBC) is one of the most malignant cancers of the digestive system with very poor prognosis due to its histopathological features of easy invasion to the liver, early lymph node metastasis and nerve infiltration, which result in low resection rate. It has been confirmed that radical surgery only makes sense to relatively early GBC in improving prognosis of patients. Therefore, based on recognition of biological characteristics of GBC and the theories of oncology, efforts should be focused on developing various adjuvant treatment methods for treating GBC including chemotherapy, radiotherapy, targeted therapy and immunotherapy.

6.
Article in Chinese | WPRIM | ID: wpr-849681

ABSTRACT

Post-transplant diabetes mellitus (PTDM) often occurs after solid organ transplantation, and treatment of PTDM is different from that of type 2 diabetes mellitus, the current research in this field is increasing gradually. The present paper summarizes the characteristics of blood glucose change in PTDM, risk assessment, the safety of hypoglycemic drugs, and the effect of immunosuppressive drugs on blood glucose in PTDM patients, and focuses on the efficacy and safety of new hypoglycemic drugs in PTDM patients, as well as the clinical research evidence such as the type of immunosuppressant used and the formula of administration has been summarized, so as to select a more optimized PTDM treatment options.

7.
Article in Chinese | WPRIM | ID: wpr-862163

ABSTRACT

Objective To prepare folate-targeted phase-transition nanoparticles carrying bismuth sulfide (FBS-PFH-NPs), in order to use for targeting performance and CT/ultrasound (US) imaging in vitro. Methods Rotary evaporator and probe-type sonication methods were used to prepare FBS-PFH-NPs. Basic characteristics of FBS-PFH-NPs were detected using several analytical methods. The targeting performance of FBS-PFH-NPs was verified through incubation with cervical cancer Hela cells in vitro. The echo intensity and temperature variation of FBS-PFH-NPs were observed after irradiating with HIFU using different acoustic powers (60, 90, 120, 150 and 180 W), respectively. The effects of FBS-PFH-NPs with different Bi2S3 concentrations (1.0, 2.0, 3.0, 4.0 and 5.0 mg/ml) for enhancing CT/US imaging were investigated. Results FBS-PFH-NPs were prepared with diameter (458.50±69.22)nm, which showed regular spherical morphology and uniform size under microscope. Bi2S3 nanoparticles randomly distributed in the lipid shell, and the concentration of Bi2S3 was 1.0 mg/ml. A mass of FBS-PFH-NPs was bond to Hela cells. The phase-transition of FBS-PFH-NPs occurred after irradiation with HIFU. The echo intensities and temperature of FBS-PFH-NPs gradually enhanced with increased HIFU powers (F=110.09, 440.69, both P<0.01). The echo intensities and CT value of FBS-PFH-NPs gradually enhanced with increased Bi2S3 concentrations (F=146.14, 16.74, both P<0.01). Conclusion FBS-PFH-NPs can not only target to Hela cell specifically, but also be applied in CT/US dual-modal imaging in vitro.

8.
Article in Chinese | WPRIM | ID: wpr-861219

ABSTRACT

The Consensus on Magnetic Resonance Imaging of Myocarditis, published in 2009, has played an important role in diagnosis of myocarditis. Cardiovascular MR (CMR) is expected to further improve diagnostic accuracy of myocarditis with the development of MR software and hardware, especially the introduction of T1 mapping, T2 mapping technology based on absolute quantitative myocardial tissue characteristics. Based on an expert recommendation (Expert Recommendation of 2018 Update of CMR Criteria for Non-ischemic myocardial inflammation) based on the new MR technology (mainly T1 mapping, T2 mapping) published in JACC main issue, the research progresses of CMR in diagnosis of myocarditis were reviewed in this article.

9.
Chinese Journal of Surgery ; (12): 6-9, 2019.
Article in Chinese | WPRIM | ID: wpr-804594

ABSTRACT

Hilar cholangiocarcinoma is one of the most difficult malignant tumors to treat in the biliary system. In Japan, 5-year survival rate of the disease has increased from 32.5% to 67.1% during the past 30 years. The impressive progress reflects the solid efforts in preoperative endoscopic diagnosis, innovation in surgery such as PTPE as well as hepato-pancreatoduodenectomy and perioperative treatment including replacement of the bile and synbiotic treatment, which have finally formed a set of standardized diagnosis and treatment systems. The present review intends to report the history, current status and remaining bottlenecks of the diagnosis and treatment system of hilar cholangiocarcinoma in Japan as follows.

10.
Article in Chinese | WPRIM | ID: wpr-843574

ABSTRACT

Objective • Using cone-beam computed tomography (CBCT) to compare alveolar bone changes in maxillary anterior area secondary to maxillary incisor retraction adjunct with tip (R&Tp) and retraction adjunct with torque (R&Tq) movements. Methods • Forty teenagers with Angle's class Ⅱ division 1 malocclusion who had completed orthodontic treatment met the inclusion criteria and were selected, and all of their 160 maxillary incisors were classified into two categories, namely R&Tp group and R&Tq group, according to their actual retraction pattern. Pre- and post-treatment CBCT images and 3D measurement software were used to measure and analyze tooth retraction and alveolar bone height and thickness changes within each group and to compare treatment changes of teeth and alveolar bone between two groups. Results • Anterior teeth in each group were intensively retracted and uprighted, with a longer retraction distance of incisal edge and a greater retraction angle of teeth in R&Tp group than in R&Tq group (both P=0.000). Alveolar bone thickness was significantly decreased at L3 and P1 in R&Tp group (both P<0.05), while it was significantly decreased at P1 and P2 in R&Tq group (both P<0.05). Total alveolar bone thickness decreased at T1 in R&Tp group (P=0.000) and at all levels in R&Tq group (all P=0.000). Finally, alveolar ridge height in two groups dropped both in the buccal (both P=0.000) and palatal (both P=0.000) sides, with a more prominent extent in the palatal side, and ridge height dropped most in palatal side of the teeth in R&Tq group. Conclusion • The buccal root apex area and the palatal alveolar ridge area of alveolar bone in the R&Tp group and the cervical and middle area of incisor root in palatal side of alveolar bone in the R&Tq group are high-risk areas for alveolar bone resorption when anterior teeth in teenagers with Angle's class Ⅱ division 1 malocclusion are intended to have en masse retraction.

11.
Chinese Journal of Surgery ; (12): 110-113, 2018.
Article in Chinese | WPRIM | ID: wpr-809820

ABSTRACT

Although more and more attention has been paid on the diagnosis and treatment of gallbladder cancer, the patients′ survival were still unsatisfied.Increasing the early diagnosis rate, the raise of awareness and treatment of unexpected gallbladder cancer, performing radical surgery for early stage patients and utilizing comprehensive treatment with adjuvant therapy for aggressive T2 or higher stage cases were the key points to improve patients′ prognosis of gallbladder cancer.

12.
Article in Chinese | WPRIM | ID: wpr-703573

ABSTRACT

Objective:To explore a fair and efficient way to realize the allocation of health resources that enable all people have equitable access to the public health resources in a fair and effective manner. Methods:Based on the data from 31 provincial regions in China from 2010 to 2014,this paper measured the efficiency of health resources al-location in each area with DEA model of super-efficiency, and investigated the fair allocation of health resources by the per capita financial subsidy incomes obtained by medical and health care institutions in various regions. This study analyzed statically and dynamically the differences of the health equity and efficiency of health resources. Re-sults:The results show that whether within or between regions,both the degree of difference in the fairness(Gini co-efficient) and the degree of consolidation (the curing degree of the equity) of health resources in China are greater than efficiency,and there exist two major problems for the equity of health resources which are insufficiency and irra-tionality. Conclusions:The central government should strengthen the fair adjustment of health resources allocation, supporting those areas with low fairness and low efficiency accurately and forming a stable incentive mechanism to a-chieve a sound development for the health service industry in China.

13.
Article in Chinese | WPRIM | ID: wpr-699184

ABSTRACT

The 30th annual meeting of the Japanese Society of Hepato-Biliary-Pancreatic Surgery (JSHBPS) was held in Yokohama,Japan between June 7 and 9,2018.The latest research trends and advances in biliary tract cancer from this meeting were summarized and shared in this paper.The main content includes:history of biliary cancer surgery for recent 30 years and the future of HBP surgery for malignancies,establish of worldwide prospective database of biliary cancer and identify the optimal treatment for early gallbladder cancer,clinical research of neoadjuvant / adjuvant therapy,and progress in basic research of biliary malignancies.

14.
Article in Chinese | WPRIM | ID: wpr-660656

ABSTRACT

Objective · To explore the prognostic factors for postoperative radiotherapy for patients with locally advanced esophageal squamous cell carcinoma (ESCC) and the effects of lymph nodes metastasis status on the survival of patients and failure modes of treatment. Methods · Data of 121 patients with locally advanced ESCC who underwent radical resection and postoperative radiotherapy from 2006 to 2013 were collected. The overall survival (OS) and disease-free survival (DFS) were calculated using Kaplan-Meier. Univariate analysis and multivariate analysis were performed to investigate prognostic factors with the log-rank test and the Cox regression model. The differences in OS and recurrence patterns between patients with different lymph node metastasis status were compared. Results · The median DFS of all patients was 22.57 months and median OS was 32.90 months.Multivariate analysis showed that KPS score, length of lesion, and positive lymph nodes ratio (pLNR) were independent prognostic factors for DFS and OS. For patients with positive lymph nodes, the median DFS of patients with pLNR ≤ 0.15 and pLNR>0.15 were 33.43 and 19.20 months (P=0.04).Patients without nodal skip metastasis (NSM) had better median OS than patients with NSM, but the difference was not statistically significant. OS was significantly worse in patients with pLNR>0.15 and NSM than in other patients with positive lymph nodes (median OS of 14.33 vs 32.50 months, P=0.02).pLNR had a better prognostic value for OS than the number of positive lymph nodes (AUC=0.673, P=0.04). Analysis of the failure patterns showed that more distant metastases were observed in patients with pLNR>0.15, while more local and regional recurrences were observed in patients with pLNR ≤ 0. 15. Conclusion · The status of lymph nodes metastasis is associated with the prognosis of postoperative radiotherapy for patients with locally advanced ESCC. pLNR has a better prognostic value for OS for patients with positive lymph nodes. The recurrence pattern varies in patients with different pLNR after postoperative radiotherapy. The patients with high pLNR and NSM have poor prognosis.

15.
Article in Chinese | WPRIM | ID: wpr-658004

ABSTRACT

Objective · To explore the prognostic factors for postoperative radiotherapy for patients with locally advanced esophageal squamous cell carcinoma (ESCC) and the effects of lymph nodes metastasis status on the survival of patients and failure modes of treatment. Methods · Data of 121 patients with locally advanced ESCC who underwent radical resection and postoperative radiotherapy from 2006 to 2013 were collected. The overall survival (OS) and disease-free survival (DFS) were calculated using Kaplan-Meier. Univariate analysis and multivariate analysis were performed to investigate prognostic factors with the log-rank test and the Cox regression model. The differences in OS and recurrence patterns between patients with different lymph node metastasis status were compared. Results · The median DFS of all patients was 22.57 months and median OS was 32.90 months.Multivariate analysis showed that KPS score, length of lesion, and positive lymph nodes ratio (pLNR) were independent prognostic factors for DFS and OS. For patients with positive lymph nodes, the median DFS of patients with pLNR ≤ 0.15 and pLNR>0.15 were 33.43 and 19.20 months (P=0.04).Patients without nodal skip metastasis (NSM) had better median OS than patients with NSM, but the difference was not statistically significant. OS was significantly worse in patients with pLNR>0.15 and NSM than in other patients with positive lymph nodes (median OS of 14.33 vs 32.50 months, P=0.02).pLNR had a better prognostic value for OS than the number of positive lymph nodes (AUC=0.673, P=0.04). Analysis of the failure patterns showed that more distant metastases were observed in patients with pLNR>0.15, while more local and regional recurrences were observed in patients with pLNR ≤ 0. 15. Conclusion · The status of lymph nodes metastasis is associated with the prognosis of postoperative radiotherapy for patients with locally advanced ESCC. pLNR has a better prognostic value for OS for patients with positive lymph nodes. The recurrence pattern varies in patients with different pLNR after postoperative radiotherapy. The patients with high pLNR and NSM have poor prognosis.

16.
Article in Chinese | WPRIM | ID: wpr-317612

ABSTRACT

Surgical operation in treating obesity and type 2 diabetes is popularizing rapidly in China. Correct prevention and recognition of perioperation-related operative complications is the premise of ensuring surgical safety. Familiar complications of the operation include deep venous thrombosis, pulmonary artery embolism, anastomotic bleeding, anastomotic fistula and marginal ulcer. The prevention of deep venous thrombosis is better than treatment. The concrete measures contain physical prophylaxis (graduated compression stocking and intermittent pneumatic compression leg sleeves) and drug prophylaxis (unfractionated heparin and low molecular heparin), and the treatment is mainly thrombolysis or operative thrombectomy. The treatment of pulmonary artery embolism includes remittance of pulmonary arterial hypertension, anticoagulation, thrombolysis, operative thrombectomy, interventional therapy and extracorporeal membrane oxygenation (ECMO). Hemorrhage is a rarely occurred but relatively serious complication after bariatric surgery. The primary cause of anastomotic bleeding after laparoscopic gastric bypass is incomplete hemostasis or weak laparoscopic repair. The common bleeding site in laparoscopic sleeve gastrectomy is gastric stump and close to partes pylorica, and the bleeding may be induced by malformation and weak repair technique. Patients with hemodynamic instability caused by active bleeding or excessive bleeding should timely received surgical treatment. Anastomotic fistula in gastric bypass can be divided into gastrointestinal anastomotic fistula and jejunum-jejunum anastomotic fistula. The treatment of postoperative anastomotic fistula should vary with each individual, and conservative treatment or operative treatment should be adopted. Anastomotic stenosis is mainly related to the operative techniques. Stenosis after sleeve gastrectomy often occurs in gastric angle, and the treatment methods include balloon dilatation and stent implantation, and surgical treatment should be performed when necessary. Marginal ulcer after gastric bypass is a kind of peptic ulcer occurring close to small intestine mucosa in the junction point of stomach and jejunum. Ulcer will also occur in the vestige stomach after laparoscopic sleeve gastrectomy, and the occurrence site locates mostly in the gastric antrum incisal margin. Preoperative anti-HP (helicobacter pylorus) therapy and postoperative continuous administration of proton pump inhibitor (PPI) for six months is the main means to prevent and treat marginal ulcer. For patients on whom conservative treatment is invalid, endoscopic repair or surgical repair should be considered. Different surgical procedures will generate different related operative complications. Fully understanding and effectively dealing with the complications of various surgical procedures through multidisciplinary cooperation is a guarantee for successful operation.


Subject(s)
Anastomosis, Surgical , Anticoagulants , Therapeutic Uses , Bariatric Surgery , Catheterization , China , Conservative Treatment , Constriction, Pathologic , Therapeutics , Digestive System Fistula , Therapeutics , Endoscopy, Gastrointestinal , Methods , Extracorporeal Membrane Oxygenation , Gastrectomy , Gastric Bypass , Gastric Mucosa , Pathology , Gastric Stump , General Surgery , Gastrointestinal Hemorrhage , General Surgery , Hemostasis, Surgical , Methods , Hemostatic Techniques , Heparin , Therapeutic Uses , Humans , Intermittent Pneumatic Compression Devices , Intestine, Small , Pathology , Laparoscopy , Margins of Excision , Peptic Ulcer , Therapeutics , Postoperative Complications , Diagnosis , Therapeutics , Pulmonary Embolism , Therapeutics , Stents , Stockings, Compression , Thrombectomy , Thrombolytic Therapy , Venous Thrombosis , Therapeutics
17.
National Journal of Andrology ; (12): 827-833, 2016.
Article in Chinese | WPRIM | ID: wpr-262286

ABSTRACT

<p><b>Objective</b>To investigate the protective effect of Wuziyanzong Pills (WYP) in the rat model of oligoasthenospermia (OAS) and its action mechanism.</p><p><b>METHODS</b>Sixty male SD rats were equally randomized into six groups: normal control, OAS model, Shengjing Capsules (1.6 g per kg of the body weight), low-dose WYP (1 g per kg of the body weight), medium-dose WYP (2 g per kg of the body weight), and high-dose WYP (4 g per kg of the body weight). The OAS model was established by intragastric administration of Tripterygium glucoside at 30 mg per g per d for 6 weeks. From the 3rd week of modeling, the rats of the medication groups were treated intragastrically with corresponding drugs for 4 weeks. Then all the rats were sacrificed for measurement of the testicular and epididymal organ coefficients, examination of epididymal sperm quality and apoptosis, and detection of the openness of the sperm mitochondrial permeability transition pore (MPTP). Histopathological changes in the testis were observed by HE staining and the apoptosis of spermatogenic cells determined by Hochest staining.</p><p><b>RESULTS</b>WYP obviously improved the organ coefficients of the testis and epididymis, increased sperm concentration, motility and viability, decreased the apoptosis of spermatogenic cells, and inhibited the abnormal openness of MPTP in the OAS model rats. HE staining showed that the number and levels of spermatogenic cells were significantly increased while Hochest staining manifested that the apoptosis of spermatogenic cells was remarkably inhibited in the seminiferous tubules of the testis in the WYP-treated rats.</p><p><b>CONCLUSIONS</b>WYP can improve sperm quality and reduce the apoptosis of spermatogenic cells (including sperm) in OAS model rats, which may be related with its inhibitory effect on the abnormal openness of MPTP.</p>


Subject(s)
Animals , Apoptosis , Asthenozoospermia , Drug Therapy , Drugs, Chinese Herbal , Pharmacology , Epididymis , Male , Mitochondrial Membrane Transport Proteins , Oligospermia , Drug Therapy , Random Allocation , Rats , Rats, Sprague-Dawley , Sperm Count , Sperm Motility , Spermatozoa , Cell Biology , Testis , Tripterygium
18.
Article in Chinese | WPRIM | ID: wpr-488581

ABSTRACT

Objective To compare the difference between volume computed tomography dose index (CTDIvol) and size-specific dose estimates (SSDE) in evaluating the radiation dose of abdominal CT scan.Methods Abdominal CT scan were performed on 180 patients with a Philips 256-slices spiral CT.The anterior-posterior dimension (AP) and lateral dimension (LAT) of each patients were measured at the level of left renal vein, and the effective diameter (ED) and SSDE were calculated with recorded CTDIvol Patients were categorized into 3 groups depending on body mass index (BMI): group A, BMI < 20.0 kg/m2;group B, 20.0-24.9 kg/m2;group C, BMI > 24.9 kg/m2.The differences between CTDIvoland SSDE of 180 patients and three different BMI groups were compared respectively.Results There was a significant difference between CTDIvol and SSDE of the 180 patients (t =-13.354, P < 0.01), CTDIvol and SSDE were (9.91 ± 2.91) and (14.01 ± 2.82) mGy, respectively.For group A, CTDIvol and SSDE were (7.96 ± 1.83) and (12.83 ± 2.52) mGy, respectively (t =-8.417, P < 0.01).Group B, CTDIvol and SSDE were (9.28 ± 1.76) and (13.62 ±2.18) mGy, respectively (t =-15.051, P < 0.01).Group C, CTDIvol and SSDE were (12.19 ± 3.65) and (15.39 ± 3.47) mGy, respectively (t =-4.535, P < 0.01).In addition, the mean percentage values of difference between CTDIvol and SSDE for the three groups were 62.83%, 47.80%, 28.40%, respectively, which meant CTDIvol underestimated the radiation dose compared to SSDE.With the BMI increasing, the values of difference between CTDIvol and SSDE decreased.Conclusions SSDE can be used to estimate the radiation dose of abdominal CT scan for a given size person.

19.
Article in Chinese | WPRIM | ID: wpr-470327

ABSTRACT

Objective To investigate the efficacies of laparoscopic Roux-en-Y gastric bypass (LRYGB) surgery in the treatment of patients with different body mass indexes (BMI) and type 2 diabetes mellitus.Methods The clinical data of 40 patients with type 2 diabetes mellitus who underwent LRYGB surgery at the Shengjing Hospital of China Medical University from January 2013 to December 2013 were retrospectively analyzed.According to different BMI,8 patients with BMI < 27.5 kg/m2 were allocated into group 1,14 patients with BMI≥27.5 kg/m2 and <32.5 kg/m2 in group 2 and 18 patients with BMI≥32.5 kg/m2 in group 3.Forty patients were followed up via telephone interview and food habits questionnaire by weight loss file managers of Shengjing Hospital and the fourth Affiliated Hospital of China Medical University.All the patients received the reexamination of blood test and data collection at postoperative year 1.The preoperative and postoperative 1-year fasting plasma glucose,glycosylated hemoglobin (HbA1 c),BMI and C-peptide were collected and detected.The fasting plasma glucose < 7.00 mmol/L and HbA1 c < 7.00% were used as a standard of complete remission.Count data and comparison of rates were analyzed using the chi-square test.Measurement data with normal distribution were presented as x ± s and analyzed by the t test.Skew distribution data were described as M (range) and analyzed by the Wilcoxon rank sum test.Repeated measurement data were analyzed by the repeated measures ANOVA.Results Forty patients received successful LRYGB surgery without perioperative complications,and were followed up for 1 year at the Shengjing Hospital (23 patients),the fourth Affiliated Hospital (8 patients) and other hospitals (9 patients).Of the 40 patients,85.0% (34/40) of patients had no postoperative long-term obvious malnutrition,anastomotic stenosis,ion disorders and digestive tract dynamic obstacles,15.0% (6/40) of patients were not adapted to the change of life habits such as frequent nausea and vomiting.Five patients with different degrees of frequent vomiting,abdominal pain and night heartburn within postoperative 1 month had the remission of synptoms after symptomatic treatment.One patient in group 2 had a symptom of hypertonic coma due to intake of oral high-sugar drinks at postoperative 1 week and then was cured by hospitalization.The fasting plasma glucose,HbA1c and BMI in group 1 from preoperation to postoperation were decreased from 11.07 mmol/L (range,6.00-17.00 mmol/L) to 7.18 mmol/L (range,6.00-15.00 mmol/L),from 8.85% (range,6.00%-11.00%) to 6.35% (range,6.00%-9.00%) and from 26.0 kg/m2 (range,22.0-27.0 kg/m2) to 22.2 kg/m2 (range,20.0-25.0 kg/m2),with significant differences (F =2.413,3.256,6.750,P < 0.05).C-peptide from preoperation to postoperation was decreased from 1.20 nmol/L (range,1.00-3.00 nmol/L) to 1.07 nmol/L (range,1.00-2.00 nmol/L),with no significant difference (F =1.678,P > 0.05).The remission rate of diabetes in group 1 was 3/8.The fasting plasma glucose and HbA1c in group 2 from preoperation to postoperation were decreased respectively from 10.73 mmol/L (range,7.00-19.00 mmol/L) to 5.89 mmol/L (range,5.00-9.00 mmol/L) and from 8.00% (range,6.00%-15.00%) to 5.85% (range,5.00%-8.00%).The BMI from preoperation to postoperation was decreased from 31.0 kg/m2 (range,29.0-32.0 kg/m2) to 25.5 kg/m2 (range,21.0-29.0 kg/m2),with significant differences in the above 3 indexes (F =5.449,4.008,-3.296,P < 0.05).C-peptide from preoperation to postoperation was decreased from 1.53 nmol/L (range,1.00-5.00 nmol/L) to 1.52 nmol/L (range,1.00-6.00 nmol/L),with no significant difference (F =-0.251,P > 0.05).The remission rate of diabetes in group 2 was 10/14.The fasting plasma glucose,HbA1c and BMI in group 3 from preoperation to postoperation were decreased from 9.44 mmol/L (range,5.00-16.00 mmol/L) to 6.65 mmol/L (range,4.00-15.00 mmol/L),from 7.90% (range,6.00%-11.00%) to 6.45% (range,5.00%-9.00%) and from 36.9 kg/m2 (range,33.0-47.0 kg/m2) to 27.7 kg/m2 (range,23.0-34.0 kg/m2),with significant differences (F =-3.027,-3.410,-3.724,P < 0.05).C-peptide from preoperation to postoperation was decreased from 2.91 nmol/L (range,0.00-9.00 nmol/L) to 2.13 nmol/L (range,0.00-6.00 nmol/L),with no significant difference (F =-3.724,P > 0.05).The remission rate of diabetes in group 3 was 14/18.There was no significant difference in the remission rate of diabetes of 3 groups (x2 =4.460,P > 0.05).There were significant differences in the changing trends of fasting plasma glucose and BMI among the 3 groups (F =3.200,22.500,P < 0.05).There were no significant differences in the changing trends of HbA1c and C-peptide among the 3 groups (F =0.720,1.640,P > 0.05).Conclusion LRYGB surgery is feasible for the treatment of type 2 diabetes mellitus with effectively decreasing fasting glucose,and should be performed on patients with BMI ≥ 27.5 kg/m2 instead of patients with BMI < 27.5 kg/m2 according to a correlation of blood glucose control and preoperative BMI.

20.
Article in Chinese | WPRIM | ID: wpr-446832

ABSTRACT

Objective To compare the effects of different anesthetic and postoperative analgesic methods on the immune function of helper T lymphocytes and tumor metastasis after orthotopic liver cancer resection in rats.Methods Orthotopic liver cancer was induced by intrahepatic tumor implantation (IHTI) with Morris hepatoma 3924A.Thirty male ACI rats receiving IHTI,aged 12-18 weeks,weighing 240-300 g,were randomized into 3 groups (n =10 each) using a random number table:control group (group C),general anesthesia combined with epidural block-postoperative epidural analgesia group (group GE + EA),and general anesthesia-postoperative intravenous analgesia group (group G + IA).The liver cancer resection was performed on 14th day after IHTI,group G + IA inhaled 5% sevoflurane for induction of anesthesia and inhaled 2%-3% sevoflurane and received intraperitoneal injection of morphine 20 μg/100 g for maintenance of anesthesia.In group GE + EA,general anesthesia was performed as the method previously described in group G + IA,and epidural block was performed with 0.25 % bupivacaine 25 μl after tracheal intubation.Within 3 days after operation,0.125 % bupivacaine 150 μl + morphine 20 μg were injected daily via an epidural catheter once every 4 h (25μl per time) for postoperative analgesia in group GE + EA,and postoperative analgesia was performed with intraperitoneal morphine 240 μg injected daily once every 4 h (40 μg per time) in group G+ IA.Before surgery (T1) and on 2nd,7th and 30th days after sugery (T2-4),blood samples were collected to detect the levels of plasma interferon-γ (IFN-γ),interleukin-4 (IL-4),IL-17,IL-10 and tumor growth factor-β1 (TGF-β1).IFN-γ/IL-4 ratio was calculated.The rats were sacrificed after collecting blood samples at T4,and the development of abdominal lymph node metastasis,malignant ascites,implantation metastasis to abdominal wall and visible pulmonary metastasis nodules were observed.Results Compared with C group,the incidence of pulmonary metastasis,abdominal lymph node metastasis,and malignant ascites was significantly decreased,the plasma IFN-γ and IL-17 levels at T2 and IL-4 and TGF-β at T2,3 were increased,and IFN-γ/IL-4 ratio was decreased at T2,3 in group G+ IA,and the incidence of pulmonary metastasis,abdominal lymph node metastasis,malignant ascites and implantation metastasis to abdominal wall was significantly decreased,the plasma levels of IFN-γ,IL-4,IL-17,IL-10 and TGF-β1 were increased at T2(P < 0.05),and no significant change was found in IFN-γ/IL-4 ratio in GE + EA group (P > 0.05).Compared with G + IA group,the incidence of pulmonary metastasis and abdominal lymph node metastasis was significantly decreased,the plasma levels of IFN-γ and IL-17 at T2 and IL-4 and IL-10 at T3 were decreased,the plasma levels of IFN-γ at T4 and TGF-β1 at T2 and IFN-γ/IL-4 ratio at T3,4 were increased in GE + EA group (P < 0.05).Conclusion The inhibitory degree of the immune function of helper T lymphocytes is decreased and development of tumor metastasis is reduced after orthotopic liver cancer resection in rats when general anesthesia combined with epidural block-postoperative epidural analgesia is applied as compared with those when general anesthesia-postoperative intravenous analgesia is applied.

SELECTION OF CITATIONS
SEARCH DETAIL