Sleeve gastrectomy ameliorated high-fat diet (HFD)-induced non-alcoholic fatty liver disease and upregulated the nicotinamide adenine dinucleotide +/ Sirtuin-1 pathway in mice.

BACKGROUND: /Objective: Non-alcoholic fatty liver disease (NAFLD) is the most prevalent chronic liver disease, and effective treatments are lacking. Bariatric surgery, including sleeve gastrectomy (SG), is a potential therapeutic strategy for NAFLD, but the molecular mechanisms underlying its effects are not fully understood. In this study, the effects of SG and the underlying mechanisms were evaluated in a mouse model of high-fat diet (HFD)-induced NAFLD. METHODS: C57BL/6 mice were randomly divided into three groups: normal diet with sham operation (NC-Sham group), HFD with sham operation (HFD-Sham group), and HFD with sleeve gastrectomy (HFD-SG group). Glucose metabolism and fat accumulation in the body and liver were analyzed before and after SG. Lipid metabolism and inflammation in the liver were evaluated. Nicotinamide adenine dinucleotide (NAD+) levels as well as nicotinamide riboside kinase (NRK1) and Sirtuin-1 (SIRT1) expression levels were evaluated. RESULTS: SG attenuated the HFD-induced increases in glucose and insulin levels, fat accumulation, and lipid droplet accumulation. Fatty acid biosynthesis, the expression of the metabolism-related genes ACC1, FASN, SCD1, and DGAT1, and the levels of inflammatory factors were higher in HFD mice than in NC mice and decreased after SG. NAD + concentrations were 54.9 ± 13.4 µmol/mg in NC-Sham mice, 37.6 ± 8.1 µmol/mg in HFD-Sham mice, and 79.9 ± 13.0 µmol/mg in HFD-SG mice (p < 0.05). NRK1 and SIRT1 expression increased dramatically after SG at both the RNA and protein levels. CONCLUSION: SG significantly alleviated NAFLD in HFD-induced obese mice with increasing the hepatic NAD + levels and upregulating the NRK1/NAD+/SIRT1 pathway.

Total fat consumption and pancreatic cancer risk: a meta-analysis of epidemiologic studies.

Fat consumption has been hypothesized to influence pancreatic cancer risk, but the results of epidemiologic studies have been controversial. We conducted a systematic review and meta-analysis of case-control and cohort studies to investigate this issue. Relevant published studies were identified by searching MEDLINE (PubMed) through February 2014. Two authors (Q.-W.S. and Q.-Y.Y.) independently assessed eligibility and the extracted data. Study-specific relative risks (RRs) were pooled using a random-effects model. We also carried out heterogeneity and publication bias analyses. Six cohort and 13 case-control studies with 6159 pancreatic cancer cases and 1,068,476 noncases were included in this meta-analysis. The summary RR for pancreatic cancer for the highest versus lowest intake was 1.04 [95% confidence interval (CI)=0.90-1.20, I²=57.3%, P for heterogeneity=0.001] for total fat. In addition, when separately analyzed by study design, case-control (RR=1.03, 95% CI=0.83-1.27, I²=55.8%, P for heterogeneity=0.007) and cohort studies (RR=1.05, 95% CI=0.85-1.29, I²=66.7%, P for heterogeneity=0.010) yielded similar results. Furthermore, no statistically significant associations were observed in the subgroup analyses on the basis of fat source, geographic location, whether using energy-adjusted models, and whether adjusted for several potential confounders and important risk factors. There was no evidence of publication bias or significant heterogeneity between subgroups on meta-regression analyses. The results of this meta-analysis do not support an independent association between diets high in total fat and pancreatic cancer risk.

[Evaluation of the application of laparoscopic sleeve gastrectomy in bariatric and metabolic surgery].

Bariatric surgery is one of the most effective treatment options for obesity and type 2 diabetes mellitus. In recent years, laparoscopic sleeve gastrectomy has become increasingly popular due to simple operation, high safety and significant efficacy. In this article, the progress and the application evaluation of laparoscopic sleeve gastrectomy for the treatment of obesity and type 2 diabetes mellitus in the field of bariatric and metabolic surgery are reviewed.

[Laparoscopic parastomal hernia repair].

Abdominal hernia can only be cured by operations. However, it is still a challenge for surgeons to treat the parastomal hernia. Recently, mesh and laparoscopic technique are widely used in the treatment of parastomal hernias, and some progress have been made, but we have to face some problems, such as recurrence, unsatisfactory stomal function and poor outlooks. We applied our Lap-re-Do technique to repair the parastomal hernia not only closing and reinforcing the hernia ring by suturing and mesh, but also rebuild the stoma in situ.

Curative resection of pancreatic head carcinoma in recent 30 years: report of 377 cases.

OBJECTIVE: To evaluate retrospectively the relationship between the types of operation, characteristics of tumor, and survival rate after radical pancreatoduodenectomy for patients with carcinoma of the pancreatic head performed in recent 30 years. METHODS: Of 377 patients with carcinoma of the pancreas treated during 1970-1999, 75 were subjected to Whipple procedure or pancreatectomy with dissection of regional lymph nodes (10 patients receiving intervention therapy). The latter is beneficial to patients with carcinoma of the pancreatic head. The operation may be extended by resection of a segment of superior mensenteric-portal vein confluence if involved. RESULTS: The resection rate was increased from 9% in the 1970s to 28.2% in the 1990s. The 1-, 3-, 5-year-survival rates were 50%, 25%, 0 in the 1970s; 57.1%, 28.5%, 9% in the 1980s; and 61.1%, 27%, 11.1% in the 1990s, respectively. CONCLUSION: Despite its retrospective in nature, the present study suggests that in patients with pancreatic cancer without visceral or distant metastasis, resection should always be at tempted when there is no high operative risk factor and the operation is technically feasible.