Therapeutic effect of laparoscopic Roux-en-Y gastric bypass in non-obese patients with type 2 diabetes / 浙江大学学报·医学版

OBJECTIVE@#To evaluate the effectiveness of laparoscopic Roux-en-Y gastric bypass (LRYGB) surgery for treatment of type 2 diabetes (TD) in patients with a body mass index (BMI) < 27.5 kg/m.@*METHODS@#We retrospectively analyzed the data of patients who underwent LRYGB surgery from March, 2012 to June, 2018 in the General Hospital of Guangzhou Military Command and Jinshazhou Hospital of Guangzhou University of Chinese Medicine. The changes in the parameters of glucose metabolism and physical indicators of the patients in the first, second and third years after the surgery were analyzed in patients in low BMI group and high BMI group.@*RESULTS@#All the 74 patients underwent LRYGB successfully without conversion to open surgery. One year after the surgery, fasting blood glucose (FBG), HbA1c, postprandial blood glucose, fasting insulin, HOMA-IR, fasting C-peptide, BMI, body weight and waistline were significantly improved compared with their preoperative values in low BMI group ( < 0.05). At 2 years after the operation, FBG, HbA1c, postprandial blood glucose, HOMA-IR, BMI, body weight and waistline were significantly improved compared with the preoperative values in low BMI group ( < 0.05). In the third year, FBG, HOMA-IR, fasting C-peptide, body weight and waistline were significantly improved compared with the preoperative values in low BMI group ( < 0.05). There was no significant difference in the parameters of glucose metabolism and islet function between low BMI group and high BMI group at different stages. No serious complications occurred in these patients after the surgery.@*CONCLUSIONS@#LRYGB is effective for treatment of T2D in Chinese patients with a BMI < 27.5. After the surgery, the patient show reduced waistline without significant weight loss. The long-term results of the surgery still require further investigations with a larger samples and longer follow-up.

Therapeutic effect of laparoscopic Roux-en-Y gastric bypass in non-obese patients with type 2 diabetes / 南方医科大学学报

OBJECTIVE@#To evaluate the effectiveness of laparoscopic Roux-en-Y gastric bypass (LRYGB) surgery for treatment of type 2 diabetes (TD) in patients with a body mass index (BMI) < 27.5 kg/m.@*METHODS@#We retrospectively analyzed the data of patients who underwent LRYGB surgery from March, 2012 to June, 2018 in the General Hospital of Guangzhou Military Command and Jinshazhou Hospital of Guangzhou University of Chinese Medicine. The changes in the parameters of glucose metabolism and physical indicators of the patients in the first, second and third years after the surgery were analyzed in patients in low BMI group and high BMI group.@*RESULTS@#All the 74 patients underwent LRYGB successfully without conversion to open surgery. One year after the surgery, fasting blood glucose (FBG), HbA1c, postprandial blood glucose, fasting insulin, HOMA-IR, fasting C-peptide, BMI, body weight and waistline were significantly improved compared with their preoperative values in low BMI group ( < 0.05). At 2 years after the operation, FBG, HbA1c, postprandial blood glucose, HOMA-IR, BMI, body weight and waistline were significantly improved compared with the preoperative values in low BMI group ( < 0.05). In the third year, FBG, HOMA-IR, fasting C-peptide, body weight and waistline were significantly improved compared with the preoperative values in low BMI group ( < 0.05). There was no significant difference in the parameters of glucose metabolism and islet function between low BMI group and high BMI group at different stages. No serious complications occurred in these patients after the surgery.@*CONCLUSIONS@#LRYGB is effective for treatment of T2D in Chinese patients with a BMI < 27.5. After the surgery, the patient show reduced waistline without significant weight loss. The long-term results of the surgery still require further investigations with a larger samples and longer follow-up.

ADAM17 knockdown increases sensitivity of SW480 cells to cetuximad / 南方医科大学学报

OBJECTIVE@#To explore the association between expression of ADAM17 and cetuximad resistance in human colorectal cancer SW480 cells.@*METHODS@#The expression of ADAM17 was detected using Western blotting in different human colorectal cancer cell lines, and the cells highly expressing ADAM17 were selected as the target cells. SW480 cells were transfected with ADAM17-siRNA 1 and ADAM17-siRNA 2 and the changes in the expression of ADAM17 protein were detected using Western blotting. SW480 cells were exposed to cetuximad for 24 h and the cell apoptosis was analyzed using flow cytometry. Transwell assay was used to examine the migration ability of SW480 cells with different expression levels of ADAM17; Western blotting was used to analyze the changes in the expressions of AKT signaling pathway-related proteins in the treated cells.@*RESULTS@#The baseline expressions of ADAM17 were significantly higher in SW480 cells than in the other human colorectal cancer cell lines tested ( < 0.05). Both ADAM17-siRNA 1 and 2 effectively reduced the expression of ADAM17 protein in SW480 cells. Knockdown of ADAM17 with siRNA 1 significantly increased the sensitivity of SW480 cells to tocetuximad ( < 0.05), obviously inhibited the cell proliferation, migration and invasion, and significantly reduced the expressions of p-EGFR and p-AKT in the cells ( < 0.001).@*CONCLUSIONS@#ADAM17 knockdown obviously inhibits EGFR-AKT signaling pathway and increases the sensitivity of SW480 cells to tocetuximad.

Application of delta-shaped anastomosis in billroth-I reconstruction of totally laparoscopic distal gastric cancer radical operation / 重庆医学

Objective To evaluate the safety and short‐term efficacy of delta‐shaped anastomosis in the Billroth‐I reconstruc‐tion of totally laparoscopic distal gastric cancer radical operation (TLDG) .Methods The clinical data in 35 patients with TLDG Delta anastomosis(TLDG group) and 35 patients with laparoscopic assisted distal gastric cancer radical operation (LADG) extraper‐itoneal anastomosis (LADG group) in the gastroenterology department of our hospital from January to December 2014 were ana‐lyzed retrospectively .The intraoperative bleeding volume ,operative time ,gastroenterological function recovery time ,hospitalization duration ,postoperative pathological examination results and hospitalization total cost were compared between the two groups .Re‐sults Seventy cases successfully completed the operation without the cases of conversion to laparotomy and death .The TLDG group had no anastomotic leakage ,bleeding and stenosis after operation ;while the LADG group had 1 case of gastroparesis ,1 case of anastomotic bleeding and 2 cases of anastomotic leakage .The introperative bleeding volume ,tumor size ,number of lymph nodes dissection and distant and proximal incisal margin distance had no statistically significant differences between the two groups (P>0 .05);the operation time ,digestive tract reconstruction time ,first exhaustion time ,time taking liquid diet and postoperative hospital stay time in the TLDG group were significantly shorter than those in LADG group (P< 0 .05) ,but the hospitalization cost was higher than that in the LADG group ,the differences were statistically significant (P<0 .05) .Conclusion The delta‐shaped anasto‐mosis technique is safe and feasible for using in LADG ,moreover has better short‐term effect .

Association of ATBF1 and the growth and progression of malignant tumor / 国际外科学杂志

AT motif binding factor 1 (ATBF1) gene,is a new tumor suppressor gene,and one of its expression variants by alternative splicing,known as ATBF1-A,can bind to the enhancer AT-rich element of alpha fetoprotein (AFP) and down-regulate the transcription of AFP,which may suppress the development and induce the apoptpsis of some carcinoma cells.In this review,we attempted to analysis the pathway of ATBF1 behaves with other factors and its multiple biological functions;ATBF1 function as a suppressor gene,it was illustrated for the influence on the growth and invasion of breast,prostate or gastric cancer.We also discussed the application of the ATBF1 level function as a cancer predictor,and forecasted the significance to apply ATBF1 for the therapy of cancer.

Effect of Chitosan Gel on the Rectum Injury Induced by Acetic Acid in Rats / 医药导报

Objective To detect the effect of chitosan gel on rectal injury which was induced by acetic acid. Methods 36 rats were anesthetized, 4% acetic acid swab was placed into the rectum (3 cm in depth for 1 min) to establish rectum injury model. These rats were divided into model control group, positive control group and drug group with 12 rats each group randomly. Chitosan gel was given to the drug group through anus with the dose of 1 575 mg·kg-1 , and hemorrhoid cream (1 575 mg·kg-1 ) was administered in the positive control group for 6 successive days. At 30 min, 1, 4, 6 day( s) after administration, 3 rats of each group were sacrificed, and were dissected, rectal injury and rectal pathology morphology changing of each group at different time points of administration were compared through visual observation. Results At 30 min, 1, 4, and 6 day(s) after administrating chitosan gel, score of rectum mucosa injury in dury group was lower than those in model control and positive control group. Pathological changes ( including epithelial tissue necrosis, mesenchyme hyperemia, hemorrhage, edema, gland injury, infiltration of inflammatory cells) were significantly slighter in drug group than in model control group and positive control group. Those lesions were restored faster in drug group than in model control group and positive control group, and there was no obvious scar. Conclusion Chitosan gel can obviously alleviate the rectal injury caused by 4% acetic acid and has therapeutic effect.

Role of intestinal flora in the pathogenesis of colorectal cancer / 国际外科学杂志

Colorectal cancer is one of common gastrointestinal malignant diseases,with a rising incidence in our country.Human gut is colonized by intestinal flora which impacts host nutrient and energy metabolism,immune function.And there is an emerging concept that intestinal flora also plays an important role in the pathogenesis of colorectal cancer.In this paper,the role of intestinal flora in the pathogenesis of colorectal cancer and possible mechanisms were reviewed.

A comparative study of three-dimensional versus two-dimensional laparoscopic subtotal thyroidectomy via a breast approach / 南方医科大学学报

<p><b>OBJECTIVE</b>To explore the safety, efficacy and feasibility of 3D laparoscopic subtotal thyroidectomy via a breast approach.</p><p><b>METHODS</b>The clinical data of 30 patients undergoing 3D laparoscopic subtotal thyroidectomy via a breast approach were analyzed in comparison with 30 patients receiving traditional laparoscopic subtotal thyroidectomy during the period from September, 2013 to December, 2013. The operation time, blood loss, postoperative drainage, postoperative hospital stay, and total hospitalization expenses were compared between the two groups.</p><p><b>RESULTS</b>The operation time in the 3D group was significantly shorter than that in the 2D group (45∓26.3 vs 62∓24.8 min, t=0.53, P<0.05). The intraoperative blood loss, postoperative drainage, postoperative hospital stay and total hospitalization expenses did not show significant differences between the two groups.</p><p><b>CONCLUSIONS</b>3D laparoscopic subtotal thyroidectomy via a breast approach is safe and effective and shortens the operation time, and can be used as a routine operation for subtotal thyroidectomy.</p>

Expression of Runx3 and C-myc in human colorectal cancer / 南方医科大学学报

<p><b>OBJECTIVE</b>To investigate Runx3 and C-myc expressions in colorectal cancer and their relationship with the clinicopathological parameters.</p><p><b>METHODS</b>Real-time quantitative PCR was used to detect Runx3 and C-myc mRNA expressions in 38 colorectal cancer tissues and matched adjacent tissues, and Runx3 and C-myc expressions was detected by Western blotting in 63 pairs of colorectal cancer and adjacent tissues. The results were stratified according to the clinicopathological characteristics to examine the relationship of Runx3 and C-myc expressions with the clinicopathological factors in the patients.</p><p><b>RESULTS</b>Runx3 expression was down-regulated and C-myc expression up-regulated at both mRNA and protein levels in colorectal cancer tissues compared with the normal tissues, and their protein expressions exhibited an inverse correlation (r=-0.398, P=0.001). Runx3 and C-myc expressions differed significantly between tumors with different Dukes stages, depths of tumor invasion, lymph node statuses, or histological differentiation (P<0.05); Runx3 down-regulation and C-myc up-regulation were more obvious in tumors in advanced Dukes stage and in poorly differentiated tumors.</p><p><b>CONCLUSION</b>Abnormal expressions in Runx3 and C-myc may contribute to the occurrence and development of colorectal cancer and are closed correlated with the patient's clinicopathological parameters.</p>

Research progress of three-dimensional laparoscope system / 南方医科大学学报

The lack of depth perception and spatial orientation in two-dimensional image of traditional laparoscopy require long-term training of the surgeons. Three-dimensional (3D) laparoscopy provides stereoscopic visions as compared to monocular views in a traditional laparoscopic system. In this review, the authors summarize the clinical application of 3D laparoscopy and its current research progress.

Application of three-dimensional high-definition laparoscope in laparoscopic radical resection of gastric cancer / 南方医科大学学报

<p><b>OBJECTIVE</b>To investigate the clinical value of three-dimensional (3D) high-definition (HD) laparoscope in laparoscopic radical resection of gastric cancer.</p><p><b>METHODS</b>From January to December, 2013, 40 patients underwent radical resection of gastric cancer with 3D HD laparoscopy (3D group) and another 40 patients received 2D HD laparoscopy (2D group). The duration of surgery, intra-operative blood loss, learning curve, and costs during hospitalization were compared between the two groups.</p><p><b>RESULTS</b>The average operation duration of 3D group was 2.8=0.6 h, significantly shorter that in the 2D group (3.2=0.8 h, P<0.05); the intraoperative blood loss in the 3D group was significantly less than that in the 2D group (110=18 ml vs 120=21 ml, P>0.05). The mean hospitalization cost was 75 000=16 000 RMB Yuan in 3D group, similar to significantly lower than that of 71 000=13 000 RMB Yuan in 2D group (P>0.05).</p><p><b>CONCLUSION</b>3D HD laparoscopy can provide three-dimensional vision and better sense of depth to facilitate precise operation and shorten the operation time. The high-definition 3D vision also allows surgeons to quickly improve surgical skills and shorten the learning curve.</p>

Progress in diagnosis and treatment of anastomotic leakage after anterior resection of rectal cancer / 国际外科学杂志

Anastomotic leakage was one of the severe complications after anterior resection of rectal cancer.Its occurrenc was correlated with age,weight and nutrtion,basic diseases,preoperative radio-chemotherapy,surgical technique and stage of the tumor.Anastomotic leakage could be diagnosed by symptoms,physical signs,drainagefluid and imaging examinations.Most of the anastomotic leakage could be cured non-operatively.Much attention should be pay on the prevention of anastomotic leakage,protective stomy should be made in high risk population,while the complications of protective stomy should be pay attention to.

Mechanism and relative signal pathway of RunX3 in tumor suppression / 国际外科学杂志

The study of RunX3 in tumor pathogenesis is a rapidly expanding area of cancer research.Functional inactivation of RunX3 is frequently observed in tumors of diverse origins.RunX3 can bind directly to the TGF-β signaling effectors for synergistic induction,enhancing the growth inhibitory effect of TGF-β signal pathway.Additionally,RunX3 can also bind to the complex TCF4-β-catenin in Wnt signal pathway for inhibiting its tumorigenicity.Through the two signal pathway mentioned above,RunX3 can regulate the epithelial mesenchymal transitions process.Moreover,the transcription of claudin-1 can be directly regulated by RunX3.RunX3 has also been described to have an oncogenic function in a subset of tumors,but how RunX3 switches from tumor suppression to oncogenic activity is yet unknown.This review focuses on summarizing the important findings about the mechanism and relative signal pathway of RunX3 in tumor suppression from the articles published recently.

Research progress of artificial anus plugging device in the treatment of fecal incontinence / 国际外科学杂志

Colostomy,which is an important means of surgical treatment of colorectal cancer,leads to the colostomy fecal leakage,odor,skin infections and other complications.Artificial anus plugging device as an alternate device to colostomy bag,can achieve bowel control,streamline operations,good blocking effect and mprove the quality of life.Therefore,in this review,the author will discuss the research progress of artificial anus plugging device,including its froms,materials and functions in the treatment of fecal incontinence.

Screening molecular markers in early breast cancer of the same pathological types but with different prognoses using Agilent gene chip / 南方医科大学学报

<p><b>OBJECTIVE</b>To screen molecular markers in early breast cancer and establish gene subtyping-based diagnostic criteria for predicting the prognosis of early breast cancers.</p><p><b>METHODS</b>Tumor tissue specimens were obtained from 8 patients with early breast cancer for analysis of the differentially expressed genes using Agilent custom 8×15 000 chips in combination with the prognostic data of the patients. Another 42 tumor tissue specimens were used to validate the differential genes by real-time fluorescent quantitative PCR.</p><p><b>RESULTS</b>Gene microarray analysis identified 132 differentially expressed genes between the patients with favorable and poor prognosis, and 44 of these genes were significantly up-regulated (by over two folds) and 88 down-regulated in patients with poor prognoses.</p><p><b>CONCLUSION</b>The gene expression profiles differ in early breast cancer tissues of the same pathological type but with different clinical stages and prognoses, and CD44, MKI67, NTRK2, Nek2, C16orf60, TOP2A, ANCCA, and RRM2 genes can be used as the prognostic markers for early breast cancer.</p>

Progress and application of sensors in medicine / 生物医学工程学杂志

Sensors are apparatus that can percept specific matter information and change them into useful signals. They are widely used in medicine and are core components of medical equipments, and have become one of critical factors to accelerate the development of medicine. The applications of sensors in medical domain such as assistant examination, monitoring, treatment, disease prevention etc., and their progress tendency, were described detailedly in this article.

Preliminary study on simulating sensory nerves of intestinal contents using ultrasound detecting system / 生物医学工程学杂志

Successful assessing intestinal lumen content with ultrasound signals might lay a strong basis for the development of the artificial anal sphincter. In the present study, we utilized a modified MLU02-212 ultrasonic gas bubble detector to test the distal part of proximal colon in each rabbit, for the group of twenty healthy New Zealand rabbits. Voltage signals of solid, liquid, gas and empty content of the lumen were collected and compared. The results indicated that there were significant differences among the voltage signals in the 4 conditions (P = 0.000), respectively. Multiple comparison showed significant differences existed in any pair of the four conditions (P = 0.000). Three signal non-overlapping regions existed in these 4 conditions. Thus it seemed that ultrasound could be utilized to distinguish various contents inside the intestinal lumen and could act as "artificial sensory nerve".

Advancement of operation robot / 国际外科学杂志

Operation robot has 3D vision and 7 activity degrees of freedom,also has vibration elimination system and operation scale system.These can ensure its operative precise in limited space.Meanwhile the console meets vito dynamics can relieve fatigue of doctors.Operation robot has great effect in many subjects.But it still needs to be improved because it lacks of feedback system,mechanical failure and software failure.Furthermore,its price demands to decrease.The newest progress was reviewed for better use of operation robot.

Cosmetic assessment of radiofrequency ablation combined with endoscopic breast conservation surgerv for treatment of early breast cancer / 中华医学美学美容杂志

Objective Radiofrequency ablation (RFA) and endoscopic breast conserving surgery (EBCS) has been developed as a potential means for treating breast tumors with minimal disruption to adjacent soft tissues.The purpose of this study was to evaluate the cosmetic outcomes of RFA assisted by EBCS on patients with early breast carcinoma (T1 -2 N0-1 M0).Methods Twenty-three patients with biopsy proven invasive breast carcinoma ( ≤3 cm in diameter),were treated with ultrasound (US)guided percutaneous-RFA for the local tumors followed by sentinel lymph node biopsy and endoscopic auxiliary node dissection and lumpectomy.The reactions to breast cosmetics were observed and compared to the conventional approaches using the breast asymmetry score for EBCS and a self -assessment questionnaire targeting objective and subjective data about treatment related breast change.Results Twenty-three patients were successfully treated with RFA.Complete coagulation necrosis of the tumor was visualized at US and mammography in 22 of 23 patients (95.6 ％).22 patients being per formed RFA and EBCS presented little scars and the breasts preserved more cosmetically acceptable than the reported results of traditional protocols.Self-assessment acceptable rate was 100 ％,aesthetic outcome as good or excellent rated in 95.5 ％(21/22).Within the follow-up of above 36 months,there were no local recurrence,metastasis,wound infection or necrosis,nerve damage,haematoma,as well as upper limb swelling or lymphoedema,no reduced upper limb mobility and tumor seeding.Conclusions RFA with endoscopic breast conservation therapy for the treatment of early breast carcinoma is more effective and cosmetically acceptable than the traditional approaches.

Treatment of human pancreatic cancer with adenovirus-mediated fusion gene system driven by KDR promoter in nude mice / 中华肝胆外科杂志

Objective To investigate the curative effect of the adenovirus-mediated fusion gene system driven by KDR promoter (AdKDR-CDglyTK) on a model of pancreatic cancer. Methods By using transplantation of the cultivated cells, human pancreatic cell line Capan-2 was injected subcutaneously on the back of nude mice to establish the animal model of the pancreatic cancer. Twenty nude mice were divided randomly and equally into four groups. The mice in group Ⅰ were injected with AdKDR-CDglyTK and 5-FC/GCV, those in group Ⅱ were injected with 5-FC/GCV, those in group Ⅲwere injected with AdKDR-CDglyTK and those in group Ⅳ received no any injection. AdKDR-CDglyTK was injected directly into the tumor and 5-FC/GCV was given by intraperitoneal injection. The observing parameters included common status, tumor bulk, tumor weight, inhibition rate of tumor growth, pathology, immunohistochemistry and treatment effect in each group. Electron microscopy was performed to observe the pathological changes of cells. The apoptotic cells in tumor were detected using the TUNEL assay. The expression of CDglyTK in tumors from each group was examined by RT-PCR. Results Tumor growth was dramatically inhibited in group Ⅰ. Tumor growth has no significant difference among groupⅡ , group Ⅲ and group Ⅳ. The apoptotic rate (34.20±4.60)% was significantly increased in group Ⅰ (F= 243. 22, P= 0. 00) and it had no significant difference among groupⅡ , group Ⅲ and group Ⅳ (P＞0.05). Conclusion AdKDR-CDglyTK with 5-FC/GCV can obviously inhibit the growth of human KDR-expressing pancreatic cell line Capan-2 and induce the cell apoptosis in vivo. The probable molecular mechanism lies in the facts that the system can cause a decline in the level of Bcl-2.