RESUMO
Obesity has become a global health problem. Lifestyle modification and medical treatment only appear to yield short-term weight loss. Roux-en-Y gastric bypass (RYGB) is the most popular bariatric procedure, and it sustains weight reduction and results in the remission of obesity-associated comorbidities for obese individuals. However, patients who undergo this surgery may develop hypoglycemia. To date, the diagnosis is challenging and the prevalence of post-RYGB hypoglycemia (PRH) is unclear. RYGB alters the anatomy of the upper gastrointestinal tract and has a combined effect of caloric intake restriction and nutrient malabsorption. Nevertheless, the physiologic changes after RYGB are complex. Although hyperinsulinemia, incretin effects, dysfunction of β-cells and α-cells, and some other factors have been widely investigated and are reported to be possible mediators of PRH, the pathogenesis is still not completely understood. In light of the important role of the gut microbiome in metabolism, we hypothesized that the gut microbiome might also be a critical link between RYGB and hypoglycemia. In this review, we mainly highlight the current possible factors predisposing individuals to PRH, particularly related to the gut microbiota, which may yield significant insights into the intestinal regulation of glucose metabolic homeostasis and provide novel clues to improve the treatment of type 2 diabetes mellitus.
RESUMO
Type 2 diabetes mellitus and metabolic disorders have become an epidemic globally. However, the pathogenesis remains largely unclear and the prevention and treatment are still limited. In addition to environmental factors during adulthood, early life is the critical developmental window with high tissue plasticity, which might be modified by external environmental cues. Substantial evidence has demonstrated the vital role of early-life nutrition in programming the metabolic disorders in later life. In this review, we aim to overview the concepts of fetal programming and investigate the effects of early-life nutrition on energy metabolism in later life and the potential epigenetic mechanism. The related studies published on PubMed database up to March 2020 were included. The results showed that both maternal overnutrition and undernutrition increased the riskes of metabolic disorders in offspring and epigenetic modifications, including DNA methylation, miRNAs, and histone modification, might be the vital mediators. The beneficial effects of early-life lifestyle modifications as well as dietary and nutritional interventions on these deleterious metabolic remolding were initially observed. Overall, characterizing the early-life malnutrition that reshapes metabolic disease trajectories may yield novel targets for early prevention and intervention and provide a new point of view to the energy metabolism.
RESUMO
Objective To understand the situation of Schistosoma japonicum infections in wild animals in transmission-controlled schistosomiasis-endemic areas in Jiangxi Province, so as to provide scientific evidence for implementing precision control interventions and achieving the goal of transmission interruption and elimination of schistosomiasis. Methods Five endemic villages from Ruichang City and Pengze County that were heavily endemic for schistosomiasis in Jiangxi Province, were selected as the study villages. Wild animals like wild mice were captured, and the livers of wild animals were purchased from the snail habitats in the study villages for detection of S. japonicum infections. In the study villages, S. japonicum human infections were screened using indirect hemagglutination assay (IHA) followed by parasitological examinations with miracidial hatching test and Kato-Katz method, and the S. japonicum infection in livestock was tested using a miracidial hatching test with a plastic tube. In addition, snail survey was conducted in the study villages by means of systematic sampling combined with environmental sampling, and the S. japonicum infection in snails was detected using a loop-mediated isothermal amplification (LAMP) assay. Results A total of 240 liver specimens were sampled or purchased from 5 species of wild animals in the study villages, including wild mice, weasels, pigs, deer and rabbits. A total of 172 wild mice were captured, with a 2.91% rate of S. japonicum infection, and there was no S. japonicum infection detected in other wild animals. The prevalence of Capillaria hepatica infection was 12.21%, 1.96% and 12.50% in wild mice, deer and pigs, respectively. In addition, there was no S. japonicum infection found in either humans or livestock in the study villages, and the mean snail density varied from 0.13 to 0.80 snails/0.1 m2 in the study villages. LAMP assay detected S. japonicum infection in 2 tubes in a study village. Conclusions The role of wild animals in schistosomiasis transmission and their potential risks can not be neglected in hilly schistosomiasis-endemic areas of Jiangsu Province after transmission control. Intensified surveillance and targeted control measures should be implemented to consolidate schistosomiasis control achievements.
RESUMO
Objective To understand the situation of Schistosoma japonicum infections in wild animals in transmission-controlled schistosomiasis-endemic areas in Jiangxi Province, so as to provide scientific evidence for implementing precision control interventions and achieving the goal of transmission interruption and elimination of schistosomiasis. Methods Five endemic villages from Ruichang City and Pengze County that were heavily endemic for schistosomiasis in Jiangxi Province, were selected as the study villages. Wild animals like wild mice were captured, and the livers of wild animals were purchased from the snail habitats in the study villages for detection of S. japonicum infections. In the study villages, S. japonicum human infections were screened using indirect hemagglutination assay (IHA) followed by parasitological examinations with miracidial hatching test and Kato-Katz method, and the S. japonicum infection in livestock was tested using a miracidial hatching test with a plastic tube. In addition, snail survey was conducted in the study villages by means of systematic sampling combined with environmental sampling, and the S. japonicum infection in snails was detected using a loop-mediated isothermal amplification (LAMP) assay. Results A total of 240 liver specimens were sampled or purchased from 5 species of wild animals in the study villages, including wild mice, weasels, pigs, deer and rabbits. A total of 172 wild mice were captured, with a 2.91% rate of S. japonicum infection, and there was no S. japonicum infection detected in other wild animals. The prevalence of Capillaria hepatica infection was 12.21%, 1.96% and 12.50% in wild mice, deer and pigs, respectively. In addition, there was no S. japonicum infection found in either humans or livestock in the study villages, and the mean snail density varied from 0.13 to 0.80 snails/0.1 m2 in the study villages. LAMP assay detected S. japonicum infection in 2 tubes in a study village. Conclusions The role of wild animals in schistosomiasis transmission and their potential risks can not be neglected in hilly schistosomiasis-endemic areas of Jiangsu Province after transmission control. Intensified surveillance and targeted control measures should be implemented to consolidate schistosomiasis control achievements.
RESUMO
Objective To determine the effect of early intensive blood pressure reduction on outcome in patients with cerebral hemorrhage.Methods Pubmed,Embase and Web of Science databases were searched to identify relevant randomized controlled trials(RCT)published before Sep 1st 2017.Meta analyzed the effect of early intensive blood pressure control and standard blood pressure control on outcome of patients with cerebral haemorrhage.Results Six RCTs include 4376 patients were included in analysis.The mortality in intensive and standard were 10.8%(235/2177)and 10.8%(238/2199), respectively; while the incidence of major disability was 38.1%(801/2103)and 39.9%(848/2123), respectively.Compare with standard blood pressure control, intensive blood pressure reduction did not reduce the mortality(RR=1.00,95%CI:0.84 -1.18,P=0.98;I2=0%)and the major disability incidence(RR=0.95,95%CI:0.88 -1.03,P=0.23;I2=0%)in patients with cerebral hemorrhage.Conclusion Early intensive blood pressure reduction can not significantly improve the outcome of cerebral hemorrhage patients.
RESUMO
OBJECTIVE@#To investigate the therapeutic effects of 4 different treatments for woman polycystic ovarian syndrome (PCOS) with infertility.@*METHODS@#One hundred and twenty women PCOS with infertility were divided into 4 Groups : patients in Group 1 were directly treated with clomiphene (CC)/CC + human menopausal gonadotropin (HMG) + human chorionic gonadotropin (HCG) to accelerate ovulation; patients in Group 2 were treated with the same way as Group 1 after taking marvolon for 2 cycles; patients in Group 3 took marvolon for 2 cycles and metformin for 8 weeks, and then were treated the same as Group 1; patients in Group 4 were treated with laparosocopy. The body mess index (BMI), emmenia period, weight, volume of ovary, LH, and T were measured before and after the treatment in all patients. The cycle ovulatory rate and occurrence rate of luteinized unruptued follicle syndrome (LUFS) within 2 months and the pregnancy rate within 6 months after the treatment were also observed.@*RESULTS@#In all patients, BMI, emmenia period, serum T, and serum LH decreased significantly (P <0.05 or 0.01). The body mess indexes were significantly lower in Group 2 and Group 3 than those in Group 4 and Group 1, and Group 4 was also lower than Group 1 (P < 0.05 or 0.01). There was no difference in emmenia period between the 4 groups (P = 0.289). The volumes of ovary were enlarged in Group 1, and they were shrunk in the residual groups, which was significantly lower in Group 4 than in Group 2 and 3 (P < 0.01). The cycle ovulation rates were 53%, 72 %, 78 %, and 76%; the pregnancy rates within 6 months were 20%, 47%, 50%, and 57%, respectively; and they were significantly higher in the Group 2, 3 and 4 than in Group 1 (P <0.01). The occurrence rates of LUFS were 32%, 16%, 15%, and 13%, and they were significantly lower in Group 2, 3 and 4 than in Group 1 (P <0. 01).@*CONCLUSION@#The effects of marvolon or marvolon and metformin are the same as those of laparoscopy not only in controlling the symptoms of PCOS, but also in increasing the cycle ovulation rate, pregnancy rate within 6 months, and decreasing the occurrence rate of LUFS. The symptoms of PCOS can be controlled better, but the cycle ovulation rate and pregnancy rate within 6 months can not be improved when clomiphene is used alone.