Clinical observation of gastric bypass in treatment of type 2 diabetes / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Roux-en-Y gastric bypass (GBP) is the main surgical procedure used in type 2 diabetes. The objective of this study was to evaluate the different types of GBP in treatment of type 2 diabetes.</p><p><b>METHODS</b>Patients with type 2 diabetes were randomly divided into two groups: those who underwent gastrojejunal loop anastomosis bypass and those who underwent gastrojejunal Roux-en-Y bypass. Blood glucose alterations, operation time, and operation complications were observed.</p><p><b>RESULTS</b>Gastrojejunal loop anastomosis bypass and gastrojejunal Roux-en-Y bypass were both effective in the treatment of selected patients with type 2 diabetes. Compared with gastrojejunal Roux-en-Y bypass, gastrojejunal loop anastomosis bypass had the advantages of easier implementation, shorter operation time, and fewer operation complications.</p><p><b>CONCLUSIONS</b>Gastrojejunal loop anastomosis is effective in treatment of type 2 diabetes. It is safe, easy to implement, and worthy of clinical popularization.</p>

Effect of delayed-release 5-fluorouracil implants on colorectal cancer / 中华胃肠外科杂志

<p><b>OBJECTIVE</b>To study the antitumor effect of peri-tumor implantation of delayed-release 5-fluorouracil implants on xenograft colorectal tumor in mice.</p><p><b>METHODS</b>Fifty tumor-bearing nude mice were randomly divided into 5 groups. Group A and B were treated with peri-tumor implantation of 5-fluorouracil implants and the dose of 5-fluorouracil was 200 and 100 mg/kg, respectively. Group C and D were treated with peri-tumor injection of 5-fluorouracil solution and the dose of 5-fluorouracil was 200 and 100 mg/kg, respectively. Group E did not receive any treatment. A growth curve was plotted for changes in tumor volume, the weight of the tumor was measured and tumor inhibition rate was calculated.</p><p><b>RESULTS</b>The growth curve was mild in group A and B and steep in group C, D and E. There were statistical differences in tumor volume between groups A and B and other groups and there were no statistical differences in tumor volume among group C, D and E. After 12 days, tumor inhibition rate was 72% in group A, 51% in group B, 8% in group C, and 5% in group C. There were statistical differences in inhibition rate between group A, B and C, D (P<0.05). The weight changes before and after the treatment among the 5 groups were not statistically different. During the study, 1 mouse in group A died, 4 in group C and 1 in group D.</p><p><b>CONCLUSION</b>Delayed-release 5-fluorouracil implants can effectively inhibit tumor growth.</p>

Risk factors for recurrence and metastasis after radical anterior resection for rectal cancer / 中华胃肠外科杂志

<p><b>OBJECTIVE</b>To investigate the risk factors for local recurrence and distant metastasis after radical anterior resection for rectal cancer.</p><p><b>METHODS</b>Clinicopathological data of 957 patients who underwent radical anterior resection for rectal cancer from 1983 to 2000 were reviewed retrospectively. The risk factors for local recurrence and distant metastasis were analyzed.</p><p><b>RESULTS</b>There were 150 recurrent or metastatic cases (15.7%) after radical resection during a median follow- up of 71 months. Recurrence and metastasis sites included pelvics(6.0%, n=57), liver (4.9%, n=47), lung (4.2%, n=40) and other sites (0.6%, n=6). The median recurrent interval was 18 months (2-85 months),with a median survival of 8 months (1-62 months) after recurrence. Re-resection of the tumors was performed in 23 patients(15.3% ), and the median survival of such patients was 30 months with a 5- year survival rate of 13.0%. There were significant differences in recurrence and metastasis considering age,family history of tumor,CEA level,T staging,lymph node metastasis,venous cancerous emboli and signet cell carcinoma or mucinous adenocarcinoma. Logistic regression analysis revealed that family history (P=0.001), high CEA level (P=0.033), T3- 4 (P=0.000), lymph node metastasis (P=0.000),venous cancerous emboli (P=0.001),and signet cell carcinoma or mucinous adenocarcinoma (P=0.012) were risk factors for recurrence and metastasis.</p><p><b>CONCLUSIONS</b>There are several risk factors for recurrence after radical anterior resection for rectal cancer. The main recurrent or metastatic sites are pelvis,liver and lung. Resection of recurrent tumor can prolong the survival.</p>

Assay of carnitine in plasma and urine of healthy adults / 中国医学科学院学报

<p><b>OBJECTIVE</b>To determine the levels of carnitine in plasma and daily excretion of carnitine in urine of healthy adults so as to provide the reference standard for studying the changes of carnitine in patients.</p><p><b>METHODS</b>Carnitine in plasma and urine was assayed with high performance liquid chromatography (HPLC). The levels of total carnitine (TC), free carnitine (FC) and acetyl-carnitine (AC) in fasting plasma and the daily excretion of TC, FC and AC in urine were assayed in 40 healthy adults (20 men and 20 women) with standard diet.</p><p><b>RESULTS</b>Good linearity (r 2 > or = 0.999) was observed in assaying TC, FC and AC. The relative standard deviation (RSD) was lower than 9.1% and bias lower than 5.6%. It was showed that the plasmatic levels of TC, FC and AC in healthy men [(53.1 +/- 8.5), (41.2 +/- 6.1), (6.2 +/- 0.6) mumol/L] were significantly higher than those in healthy women [(45.4 +/- 5.6), (35.2 +/- 4.9), (5.7 +/- 0.7) mumol/L] (P = 0.002, 0.002, 0.035). The daily urinary excretion of TC, FC and AC in healthy men [(386.1 +/- 22.9), (180.5 +/- 31.8), (33.8 +/- 3.3) mumol] were also significantly higher than those in healthy women [(240.1 +/- 35.6), (112.7 +/- 22.6), (29.3 +/- 4.3) mumol] (P < 0.0005, < 0.0005, < 0.0005) when the adults were given standard diet. Both the plasmatic levels and the daily urinary excretion of TC, FC and AC were of significantly positive correlation with lean body mass (LBM) (r = 0.501-0.856). The (TC-FC)/FC ratios in plasma were 0.29 +/- 0.05 for male and 0.29 +/- 0.04 for female.</p><p><b>CONCLUSION</b>Good precision and accuracy were observed in assaying carnitine with HPLC. After standard diet, both the level of carnitine in fasting plasma and the daily urinary carnitine excretion of healthy adults were positively correlated with LBM.</p>