Clinical efficacy of laparoscopic sleeve gastrectomy in obesity patients of different grades / 中华消化外科杂志

Objective:To investigate the clinical efficacy of laparoscopic sleeve gastrectomy (LSG) in obesity patients of different grades.Methods:The retrospective and descriptive study was conducted. The clinical data of 139 obesity patients of different grades who were admitted to the General Hospital of Ningxia Medical University from January 2018 to December 2021 were collected. There were 37 males and 102 females, aged (32±9)years. Of the 139 patients, there were 45 cases of grade Ⅰ obesity, 44 cases of grade Ⅱ obesity and 50 cases of grade Ⅲ obesity, respectively. Obser-vation indicators: (1) intraoperative and postoperative situations in obesity patients of different grades; (2)hematological related indicators in obesity patients of different grades; (3)body quality related indicators in obesity patients of different grades. Measurement data with normal distribution were represented as Mean± SD, and comparison within three groups was conducted using the One-way Anova test and comparison between groups was conducted using the LSD test. Measurement data with skewed distribution were represented as M(range), and comparison within three groups was conducted using the Kruskal-Wallis H test. Count data were described as absolute numbers, and comparison between groups was performed using the chi-square test or Fisher exact probability. Repeated measurement data were analyzed by the repeated ANOVA. Results:(1) Intraoperative and postoperative situations in obesity patients of different grades. The operation time,volume of intraoperative blood loss,duration of postoperative hospital stay and cases readmitted within 30 days after surgery were 2.0(range, 1.5-2.0)hours,50(range, 50-100)mL, 5(range, 4-6)days and 2 in the 45 cases of grade Ⅰ obesity. The above indicators were 2.0(range, 1.5-2.0)hours, 60(range, 50-187)mL, 5(range, 4-6)days and 4 in the 44 cases of grade Ⅱ obesity and 2.0(range, 1.5-2.1)hours, 60(range, 50-135)mL, 5(range, 4-7)days and 4 in the 50 cases of grade Ⅲ obesity. There was no significant difference in the operation time, volume of intraoperative blood loss,duration of postoperative hospital stay among the three groups of patients ( H=4.11, 0.77, 3.59, P>0.05) and there was no significant difference in cases readmitted within 30 days after surgery among the three groups of patients ( P>0.05). (2) Hematological related indicators in obesity patients of different grades. All 139 patients were followed up at postoperative 3, 6 and 12 month. The total cholesterol (TC) were (4.5±0.9)mmol/L, (4.6±0.9)mmol/L, (4.3±0.8)mmol/L, (4.6±1.1)mmol/L at preoperative and postoperative 3, 6 and 12 month in cases of grade Ⅰ obesity. The above indicators were (4.5±0.8)mmol/L, (4.4±0.8)mmol/L, (4.4±1.0)mmol/L, (4.3±0.9)mmol/L in cases of grade Ⅱ obesity and (4.4±1.0)mmol/L, (4.7±1.1)mmol/L, (4.5±0.8)mmol/L, (4.4±0.5)mmol/L in cases of grade Ⅲ obesity. The above indicators among the three groups not meeting the mauchly′s test of sphericity ( χ2=20.81, P<0.05) and results of multi-variate test showed that there was no significant difference in the time effect, intergroup effect and interaction effect of TC among the three groups( Ftime=0.45, Fgroup=0.40, Finteraction=0.66, P>0.05). The triglyceride (TG) were (2.0±1.1)mmol/L, (1.3±0.4)mmol/L, (1.0±0.4)mmol/L, (1.0±0.4)mmol/L at preoperative and postoperative 3, 6 and 12 month in cases of grade Ⅰ obesity. The above indicators were (2.2±1.1)mmol/L, (1.5±0.5)mmol/L, (1.1±0.3)mmol/L, (1.0±0.3)mmol/L in cases of grade Ⅱ obesity and (2.3±1.1)mmol/L, (1.7±0.7)mmol/L, (1.4±0.6)mmol/L, (1.2±0.4)mmol/L in cases of grade Ⅲ obesity. The above indicators among the three groups not meeting the mauchly′s test of sphericity ( χ2=290.49, P<0.05) and results of multi-variate test showed that there were significant differences in the time effect, intergroup effect and interaction effect of TG among the three groups ( Ftime=80.44, Fgroup=4.13, Finteraction=2.67, P<0.05). The vitamin D were (12.9±5.9)μg/L, (16.5±5.9)μg/L, (18.0±6.3)μg/L, (20.1±5.7)μg/L at preoperative and postoperative 3, 6 and 12 month in cases of grade Ⅰ obesity. The above indicators were (11.5±4.4)μg/L, (17.1±5.0)μg/L, (18.2±5.6)μg/L, (20.2±6.6)μg/L in cases of grade Ⅱ obesity and (9.8±3.5)μg/L, (17.2±4.6)μg/L, (18.1±4.7)μg/L, (19.5±5.2)μg/L in cases of grade Ⅲ obesity. The above indicators among the three groups not meeting the mauchly′s test of sphericity ( χ2=53.07, P<0.05) and results of multi-variate test showed that there were significant differences in the time effect and interaction effect of vitamin D among the three groups ( Ftime=150.88, Finteraction=3.86, P<0.05)and there was no significant difference in the intergroup effect of vitamin D among the three groups ( Fgroup=0.35, P>0.05). (3) Body quality related indicators in obesity patients of different grades. The body mass and body mass index (BMI) were (88±8)kg, (71±8)kg, (65±8)kg, (61±7)kg, (32±2)kg/m 2, (26±2)kg/m 2, (24±2)kg/m 2, (22±2)kg/m 2 at preoperative and postoperative 3, 6 and 12 month in cases of grade Ⅰ obesity. The above indicators were (106±11)kg, (82±8)kg, (75±9)kg, (70±9)kg, (37±1)kg/m 2, (29±2)kg/m 2, (26±2)kg/m 2, (25±3)kg/m 2 in cases of grade Ⅱ obesity and (131±20)kg, (101±15)kg, (89±13)kg, (79±12)kg, (45±6)kg/m 2, (35±5)kg/m 2, (31±4)kg/m 2, (27±4)kg/m 2 in cases of grade Ⅲ obesity. The above indicators among the three groups not meeting the mauchly′s test of sphericity ( χ2=194.60, 179.52, P<0.05) and results of multi-variate test showed that there were significant differences in the time effect, intergroup effect and interaction effect of body mass and BMI among the three groups( Ftime=492.59, 543.86, Fgroup=89.13, 95.91, Finteraction=13.97, 13.32, P<0.05). The percen-tage of excess weight loss (EWL%) were 61%±16%,84%±21%,96%±23% at postoperative 3, 6 and 12 month in cases of grade Ⅰ obesity. The above indicators were 55%±7%,72%±16%,85%±19% in cases of grade Ⅱ obesity and 45%±12%,64%±15%,78%±7% in cases of grade Ⅲ obesity. The above indicators among the three groups not meeting the mauchly′s test of sphericity ( χ2=51.61, P<0.05) and results of multi-variate test showed that there were significant differences in the time effect and intergroup effect of EWL% among the three groups ( Ftime=374.52, Fgroup=15.69, P<0.05) and there was no significant difference in the interaction effect of EWL% among the three groups ( Finteraction=1.08, P>0.05). The percentage of total body weight loss (TWL%) were 19%±5%, 26%±6%, 30%±6% at postoperative 3, 6 and 12 month in cases of grade Ⅰ obesity. The above indicators were 21%±6%, 29%±6%, 34%±7% in cases of grade Ⅱ obesity and 22%±7%, 32%±7%, 39%±8% in cases of grade Ⅲ obesity. The above indicators among the three groups not meeting the mauchly′s test of sphericity ( χ2=58.54, P<0.05) and results of multi-variate test showed that there were significant differences in the time effect, intergroup effect and interaction effect of TWL% among the three groups ( Ftime=290.61, Fgroup=12.32, Finteraction=5.49, P<0.05). The waist to hip ratio (WHR) and visceral fat area (VFA) were 0.92±0.04, 0.86±0.03, 0.84±0.03, 0.83±0.03, (129±19)cm 2, (79±17)cm 2, (63±15)cm 2, (57±14)cm 2 at preoperative and postoperative 3, 6 and 12 month in cases of grade Ⅰ obesity. The above indi-cators were 0.98±0.05, 0.90±0.05, 0.87±0.05, 0.86±0.05, (169±20)cm 2, (105±23)cm 2, (85±20)cm 2, (73±20)cm 2 in cases of grade Ⅱ obesity and 1.05±0.09, 0.94±0.06, 0.91±0.06, 0.89±0.05, (218±42)cm 2, (144±35)cm 2, (114±26)cm 2, (96±19)cm 2 in cases of grade Ⅲ obesity. The above indicators among the three groups not meeting the mauchly′s test of sphericity ( χ2 =289.99, 191.92, P<0.05) and results of multi-variate test showed that there were significant differences in the time effect, intergroup effect and interaction effect of WHR and VFA among the three groups ( Ftime=361.39, 707.60, Fgroup=34.28, 12.69, Finteraction=8.31, 94.89, P<0.05). Conclusion:Treatment of obesity patients of different grades with LSG can improve patients′ TG and vitamin D levels, and reduce patients′ body mass, BMI, EWL%, TWL%, WHR and VFA.

Correlation between pulse wave velocity and cardiac autonomic nervous function in patients with type 2 diabetes mellitus and its influencing factors ／ / 心血管康复医学杂志

Objective :To study correlation between brachial‐ankle pulse wave velocity (baPWV ) and cardiac auto‐nomic nervous function in patients with type 2 diabetes mellitus (T2DM) and its influencing factors .Methods :A to‐tal of 293 T2DM patients ,who hospitalized in our hospital from May 2015 to May 2016 ,were selected .According to baPWV level ,patients were divided into normal baPWV group (n＝198 ,≤1400cm／s) and abnormal baPWV group (n＝95 ,＞1400cm／s).Blood pressure ,heart rate ,blood glucose ,renal function and heart rate variability (HRV) indexes were measured and compared between two groups .Multi‐factor Logistic regression analysis was used to ana‐lyze influencing factors of baPWV .Results :Compared with normal baPWV group , there were significant rise in age ,levels of systolic blood pressure (SBP) ,diastolic blood pressure (DBP) ,central venons pressure (CVP) , pe‐ripheral arterial pressure (PAP ) , percentage of peripheral neuropathy and mean heart rate and significant reduc‐tions in HRV indexes :lgTF (total frequency) ,lgHF (high frequency) ,lgSDNN (standard deviation of normal to normal RR intervals calculated over the 24 h period) and lgrMSSD (root‐mean square of differences between succes‐sive normal to normal intervals) and slgnificant rise in lgSDANN (standard deviation of normal to normal RR inter‐vals in all 5 min segments of the entire recording ) in abnormal baPWV group , P＜0. 05 or ＜0.01 .Multi‐factor Lo‐gistic regression analysis indicated that SBP ,DBP ,PAP ,CVP , heart rate SDANN and peripheral neuropathy were independent risk factors for baPWV (OR＝1.031－2. 108 , P＜0.05 or ＜0.01) ,while TF ,HF and rMSSD were its independent protective factors (OR＝0. 468－0. 595 , P＜0.05 or ＜0. 01) in T2DM patients .Conclusion :In patients with type 2 diabetes mellitus , abnormal pulse wave velocity is closely correlated with cardiac autonomic nervous function damage ,and it′s affected by blood pressure and blood glucose etc .

Preventive effect of sodium bicarbonate combined Vit C on contrast-induced nephropathy in patients with early diabetic nephropathy undergoing PCI / 心血管康复医学杂志

Objective :To explore preventive effect of sodium bicarbonate combined Vit C on contrast-induced nephropathy (CIN) in patients with early diabetic nephropathy (DN) undergoing percutaneous coronary intervention (PCI).Methods : A total of 420 patients with coronary heart disease complicated early DN treated in our department from Sep 2014 to Jul 2016 were selected ,randomly and equally divided into routine PCI group and combined treatment group (received sodium bicarbonate combined Vit C based on routine PCI group ) . Levels of serum creatinine (SCr ) ,glomerular filtration rate (GFR) ,creatinine clearance rate (Ccr) and blood urea nitrogen (BUN) after contrast use and incidence rate of CIN were measured ,recorded and compared between two groups ,and independent risk factors for CIN were analyzed .Results : After contrast use ,compared with routine PCI group ,there were significant reductions in levels of SCr [(110-32 ± 12-35) μmol／L vs.(100-30 ± 9-73) μmol／L] and BUN [ (11-23 ± 2-43) mmol／L vs.(7-16 ± 3-14) mmol／L] ,and significant rise in GFR [ (30-67 ± 9-56) ml·min－1 ·1-73m－2 vs.(37-26 ± 7-69) ml·min－1 ·1-73m－2 ] and Ccr [ (62-31 ± 19-73) ml／min vs.(68-07 ± 21-48) ml／min] in combined treatment group , P＜0-01 all ; percentages of SCr rise ≥44-2μmol／L (6-7% vs.1-9%) and SCr increase ≥25% (9-0% vs.2-9%) significantly reduced in combined treatment group , P＝0-016 ,0-007- Multi-factor Logistic regression analysis indicated that contrast dose was independent risk factor for CIN in DN patients (OR＝1-688 , P＝0-001) , while use of sodium bicarbonate combined Vit C was its independent protective factor (OR＝0-693 , P＝0-021).Conclusion : For patients with early DN undergoing PCI ,sodium bicarbonate combined Vit C can significantly reduce incidence rate of CIN ,effectively protect kidney function ,which is worth extending .

Comparative study of processed autogenous tooth bone and xenogeneic bovine bone in repairing an alveolar bone defect / 华西口腔医学杂志

<p><b>OBJECTIVE</b>This study was conducted to counter the osteogenesis effects of processed autogenous tooth bone and xenogeneic bovine bone following tooth extraction and to provide an experimental basis for clinical applications.</p><p><b>METHODS</b>Central incisors were extracted with general anesthesia on both sides of a maxillary arch in 12 rabbits, which were randomly divided into three groups, thereby containing four rabbits in each group. Three rabbits were assigned to the experimental groups and one was for the control group. In the experimental groups, the xenogeneic bovine bone was applied to the left incisor socket, whereas the processed autogenous tooth bone was applied to the right incisor socket. The blank control group only extracted the teeth and did not implant any bone powder. The three groups died after 4, 8, and 12 weeks, respectively. A mineralization degree of new bone tissues was observed by fluorescence staining and the formation of a new bone was observed by histology.</p><p><b>RESULTS</b>The sedimentary mineralization rate was greater in the processed autogenous tooth bone than in the xenogeneic bovine bone (P<0.05). The trabecular bone of the xenogeneic bovine bone was sparse and slender. The left sockets, which were filled with the xenogeneic bovine bone, had more woven and less lamellar bones than the right sockets, which were filled with the processed autogenous tooth bone.</p><p><b>CONCLUSIONS</b>The processed autogenous tooth bone offers more advantages as a bone-grafting material than the xenogeneic bovine bone in terms of bone increment.</p>

Correlation among levels of high sensitive C reactive protein,natriuretic peptide,endothelin-1 and nonvalvular atrial fibrillation / 心血管康复医学杂志

Objective:To explore correlation among levels of high sensitive C reactive protein (hsCRP),brain natri-uretic peptide (BNP),endothelin 1 (ET-1) and nonvalvular atrial fibrillation (NVAF).Methods:A total of 124 NVAF patients hospitalized in our department of cardiology were selected.According their heart rhythm character-istics,they were divided into paroxysmal NVAF group (n＝56) and chronic NVAF group (n＝68).Another 48 pa-tients with sinus rhythm,corresponding gender,age,disease condition to NVAF group were simultaneously enrolled as sinus rhythm group.Levels of hsCRP,BNP and ET-1 were measured and compared among all groups.Results:Compared with sinus rhythm group,there were significant rise in levels of hsCRP [ (1.52 ± 0.86) mg/L vs.(2.32 ± 1.38) mg/L vs.(3.35 ± 3.02) mg/L],BNP [ (225.31 ± 70.23) pg/ml vs.(352.42 ± 167.02) pg/ml vs.(403.12 ± 132.05) pg/ml] and ET-1 [ (1.42 ± 0.65) ng/ml vs.(1.96 ± 0.76) ng/ml vs.(2.34 ± 1.15) ng/ml] in paroxys-mal NVAF group and chronic NVAF group,and those of chronic NVAF group were significantly higher than those of paroxysmal NVAF group,P＜0.05 or ＜0.01.Pearson correlation analysis indicated that serum BNP level was significant positively correlated with ET-1 level in NVAF patients (r＝0.325,P＝0.001).Logistic regression analy-sis indicated that levels of BNP,hsCRP and left atrial diameter were independent risk factors for NVAF (OR＝1.42,1.21,1.33,P＜0.05 or ＜0.01).Conclusion:Levels of high sensitive C reactive protein,brain natriuretic peptide and endothelin-1 are closely correlated to nonvalvular atrial fibrillation.

Role of probiotics in treatment of nonalcoholic fatty liver disease / 中华肝脏病杂志

Nonalcoholic fatty liver disease (NAFLD) is one of the most common chronic liver diseases in China and manifests as simple fatty liver, non-alcoholic steatohepatitis, liver cirrhosis, and hepatocellular carcinoma. Studies have shown that intestinal flora can affect the development and progression of NAFLD via the "gut-liver axis" . Probiotics are active microorganisms with beneficial effects on the host, and more and more studies have found that probiotics play a positive role in improving NAFLD. They are cheaper, less harmful, and safer compared with antibiotics and surgery, and therefore, it may become a new method for the prevention and treatment of NAFLD. This article reviews the research advances in probiotics in the treatment of NAFLD, in order to provide a basis for the treatment of NAFLD using probiotics.

Diagnosis of pancreatic cancer based on biological information of saliva:an analysis of current status / 临床肝胆病杂志

Pancreatic cancer is one of common malignant tumors in the digestive system.There is still no effective means for the early diag-nosis of pancreatic cancer.As a mixture of oral gland secretion and oral mucosal transudate,saliva contains abundant biological information including microorganisms,proteins,and nucleic acids,which will change when the disease occurs.So saliva can be used for the early diag-nosis of pancreatic cancer.Through summarizing and analyzing the current studies and advantages of its application for early diagnosis,this article suggests that saliva bioinformatics holds promise for the application in the early diagnosis of pancreatic cancer.

Preparation of budesonide sustained-release dry powder for inhalation and influence of lactose content / 药学学报

Using high pressure homogenization method combined with spray-drying, budesonide-loaded chitosan microparticles were prepared and the in vitro release profile was investigated. The microparticles were then blended with lactose using a vortex mixer, influence of mixing speed, mixing time on drug recovery rate and content homogeneity were investigated. Meanwhile, influence of lactose content on drug recovery rate, content homogeneity, powder flowability and in vitro deposition were studied. It turned out that budesonide was released from the microparicles in a sustained manner, with fine particle fraction as high as 46.0%, but the powder flowability was poor. After blending with 10 times of lactose, the drug recovery rate was 96.5%, with relative standard deviation of drug content 2.5%, and fine particle fraction of the formulation increased to 59.6% with good flowability. It's demonstrated that using a vortex mixer, budesonide sustained-release dry powder for inhalation with good recovery and content homogeneity could be prepared, the formulation had good flowability and was suitable for pulmonary inhaling.

Preparation and in vitro evaluation of a new terbinafine hydrochloride bioadhesive film-forming gel / 中国药科大学学报

@#The aim of this study was to conduct the preparation and pharmaceutical characterization of a new type of terbinafine hydrochloride bioadhesive film-forming gel. The viscosity of the gel of(13 299±51)mPa ·s, pH of 3. 50±0. 50, and the shearing viscosity of(196±4)g/cm2 was found. This new gel turned out to be a layer of solid film on the application site in a very short time. The remaining solid ratio of the resulting film was estimated to be(50. 74±2. 81)%; the tensile strength was(1. 17±0. 21)MPa; and the breaking elongation was(21. 42±3. 24)%. In vitro release behavior of terbinafine hydrochloride from the film was investigated according to the paddle over disk method in ChP2010. Terbinafine hydrochloride released continuously for 10 h from the film. Improved Franz type diffusion cells were used in vitro transdermal studies by the application of excised minipigs skins. No penetration of drug into the receptor medium across the skin existed and so it could imply the safety for local application. It was found that(93. 05±5. 66)% of drug stayed on the skin surface while(1. 15±0. 85)% entered into the skin, which was beneficial for the treatment of superficial skin fungal infection.

Preparation of budesonide sustained-release dry powder for inhalation and influence of lactose content / 药学学报

Using high pressure homogenization method combined with spray-drying, budesonide-loaded chitosan microparticles were prepared and the in vitro release profile was investigated. The microparticles were then blended with lactose using a vortex mixer, influence of mixing speed, mixing time on drug recovery rate and content homogeneity were investigated. Meanwhile, influence of lactose content on drug recovery rate, content homogeneity, powder flowability and in vitro deposition were studied. It turned out that budesonide was released from the microparicles in a sustained manner, with fine particle fraction as high as 46.0%, but the powder flowability was poor. After blending with 10 times of lactose, the drug recovery rate was 96.5%, with relative standard deviation of drug content 2.5%, and fine particle fraction of the formulation increased to 59.6% with good flowability. It's demonstrated that using a vortex mixer, budesonide sustained-release dry powder for inhalation with good recovery and content homogeneity could be prepared, the formulation had good flowability and was suitable for pulmonary inhaling.

Risk factors of portal vein thrombosis after splenectomy in cirrhotic patients: a Meta-analysis / 中华肝胆外科杂志

Objective To study the perioperative predictors of portal vein thrombosis (PVT) after splenectomy in cirrhotic patients.Methods We searched the Web of Science,PubMed,EMBASE,Science Direct,CNKI,VIP,CSCD,and Wan Fang Databases up to April 2014.Only case-controlled studies which evaluated predictive factors of portal vein thrombosis (PVT) after splenectomy in cirrhotic patients were included.The Stata 12 software was used to perform the meta-analysis.Results Twenty-four casecontrolled studies were included.The sample size was 4 335,and the incidence rate of PVT was 25.0％.The risk factors of PVT included splenic volume (WMD =13.75,95％ CI:6.47 ～21.00),splenic vein diameter (WMD =1.34,95％ CI:0.39 ～ 2.30),portal vein diameter (WMD =1.54,95 ％ CI:0.56 ～ 2.52 ;WMD=2.09,95％CI:0.55 ～3.64),portal venous flow (WMD =-5.78,95％ CI:-10.46 ～-1.10;WMD =-5.57,95 ％ CI:-5.92 ～-5.22),difference in portal venous pressure (WMD =1.90,95 ％ CI:1.29～2.50) and ascites (OR =1.83,95％ CI:1.19,2.82).There were no significant differences between patients with and without PVT in terms of sex,age,Child-Pugh classification,prothrombin time,PLT,D-dimer,operating time.Conclusion The risk factors of portal vein thrombosis after splenectomy in cirrhotic patients were splenic volume,splenic vein diameter,portal vein diameter,portal venous flow,difference in portal venous pressure and ascites.

Advances of study on laboratory examination and diagnosis technology of myelodysplastic syndromes / 白血病·淋巴瘤

Myelodysplastic syndromes (MDS) comprises a heterogeneous group of malignant disorders. it has been purified clonal hematopoietic stem cell disorder from the initial initial dysplasia hematopoietic syndrome.The diagnosis of MDS has changed from completely morphological diagnosis to multi-parameter diagnosis. In this review, the laboratory examination and diagnosis technology of MDS are discussed.

Searching for genes interacting with human PCIA1 gene by using the bacterial two-hybrid system / 中华医学遗传学杂志

<p><b>OBJECTIVE</b>To search for the genes which could interact with newly found homo sapiens cross-immune reaction antigen (PCIA1) gene and accordingly to provide insights into the study of the gene function.</p><p><b>METHODS</b>The Stratagene's BacterioMatch Two-Hybrid System and BacterioMatch Fetal Kidney Library were adopted and the recombinant bait plasmid pBT-PCIA1 was cotransformated with the target plasmid pTRG-cDNA library DNA into the reporter stain. After screening and isolation of positive pTRG clones, the target genes were identified by DNA sequencing and bioinformation analysis.</p><p><b>RESULTS</b>Among all the seven detected target genes, three genes' function were not known, the other four genes had important functions. Their mutations or abberant expression resulted in severe diseases and overexpression of ACTN4 (actinin, alpha 4), PSAP (prosaposin) or EIF3S10 (eukaryotic translation initiation factor 3, subunit 10 theta) could promote tumor development and progression.</p><p><b>CONCLUSION</b>The bacterial two-hybrid system technique is an efficient method, which can provides insights into the study of novel genes' function by detecting protein-protein interactions. This study indicates that PCIA1 gene expression correlates with tumor formation, invasion and metastasis.</p>