Objective To discuss the effect of Billroth Ⅱ gastrectomy on glucose metabolism in patients with gastric cancer complicated with type 2 diabetes mellitus(T2 DM).Methods A retrospective study on the serum level of glucose in 7 patients with gastric cancer complicated with T2 DM undergone Billroth Ⅱ gastrectomy.The therapeutic regime for T2DM after the operation was also analyzed.Results Billroth Ⅱ gastrectomy was completed in all of the 7 patients by open surgery(3) or laparoscopy(4).No serious intra- and post-operative complications occurred in the series.The preoperative level of fasting plasma glucose(FPG) was between 6.6 and 9.0 mmol/L(mean 8.1 mmol/L) and glycosylated hemoglobin concentrations(HbA1c) between 6.8% and 9.5%(mean 7.8%).While 1 to 8 months after the surgery,the FPG decreased to 4.8-7.9 mmol/L(mean 6.4 mmol/L) and HbA1c 5.5% to 7.2%(mean 6.3%).According to the criteria from ADA,4 patients were cured and 3 were improved.Conclusion Billroth Ⅱ gastrectomy is effective for type 2 diabetes mellitus in patients with gastric cancer.

Objective To evaluate the efficacy of laparoscopic Roux-en-Y gastric bypass(LRYGB)in the treatment of morbid obesity complicated with type 2 diabetes mellitus,and to discuss the mechanism of LRYGB in the treatment of type 2 diabetes mellitus.Methods The clinical data of 30 type 2 diabetes mellitus patients with body mass index(BMI)≥35.00 who had undergone LRYGB from January 2007 to July 2007 in Cleveland Clinic were prospectively analyzed.The pre-and postoperative clinical parameters wcl"e analyzed by t test.Results The BMI,fasting plasma glucose and glycosylated hemoglobin were significantly decreased 6 months after the operation(t=27.399,23.025.15.593,P＜0.05).The cure rate at the end ofthe second month was 70%(21/30),and it was increased to 90%at the end of sixth month(27/30).The condition of the remaining 3 patients were improved.At the end of the second and sixth month',ffter operation,the BMIs of the patients who were cured by LRYGB were decreased by 27.89%±5.51%and 45.73%±2.82%.and the BMIs of the patients whose condition was improved were decreased by 35.65%±1.97%and 58.00%±3.05%(t=5.755,7.081,P＜0.05).Conclusions LRYGB is effective in the treatment of morbid obesity complicated with type 2 diabetes mellitus.The curability of morbid obesity increases as the BMI decreases.

0.05. Statistics from 7 papers revealed the mean survival rate of TCM group was 335. 4 days, that of chemotherapeutic group 231. 8, test of significance P = 0. 1489. MA results showed that the features of TCM treatment on NSCL were: high stability, low effectiveness, however, with certain dominance. Authors' address: Institute of Oncology, Shijiazhuang, Hebei 050011

0 8*!cm) found by ultrasound. As a result tentative diagnosis of Mirizzi's syndrome was established in 54 cases accounting for 0 56% of all LC patients.Results Laparoscopic procedure was successful in 46 out of 50 type Ⅰ cases. Four cases suffering from iatrogenic bile duct injury received primary repairment under laparoscopy. Fistulae repairment was successful laparoscopically in 3 out of 4 cases of type Ⅱ Mirizzi syndrome.Conclusion Type Ⅰ and type Ⅱ Mirizzi syndromes can be safely and successfully managed under laparoscopy in the hand of careful and skilled operators.

Objective To investigate the effect of laparoscopic vertical banding gastroplasty (LVBG) on hepatic steatosis and metabolic abnormalities in morbidly obese patients one year after surgery.Methods A total of 11 morbidly obese patients with CT diagnosis of liver steatosis were studied to compare the following data before and one year after LVBG,including weight,body mass index(BMI),waist circumference,fasting plasma glucose(FPG),fasting insulin(FINS),insulin resistance index (HOMA IR), total cholesterol(TC),triglyceride(TG) and liver enzymes.Results With the loss of weight,BMI,waist circumference,FINS,HOMA IR and TG were declined,while liver CT values increased significantly after LVBG.The change of waist circumference was correlated with the change of FINS and that of HOMA IR significantly (P

Aim To examine the influence of tetramethylpyrazine on learning and memory function of hypoxic hypoxia rats, and the expression of gamma aminobutyric acid(GABA) receptor and forkhead box P2(FOXP2) in hippocampus of rats.Methods A total of 120 Sprague Dawley rats were randomly divided into low hypoxic hypoxia and high hypoxic hypoxia groups, then according to different time points every group was divided into 1 d, 3 d, 7 d 15 d, 30 d group, with 12 rats per each group.Experiment group and the control group were treated with tetramethylpyrazine and 0.9% normal saline, respectively.The hypoxic hypoxia environment was achieved by putting the rats in a hypobaric chamber at a simulated altitude of 5 500 meters for different days.The capabilities of learning and memory of rats were detected by Morris water maze test.The expression of GABA receptor and FOXP2 protein in hippocampus of rat was determined by Western blot.Results ① Morris water maze test showed that the total distance of rats in the simulated hypobaric hypoxia control group was longer than that in the tetramethylpyrazine group(P<0.01) and the number of crossing the bestride platform increased compared with that in the hypobaric hypoxia control group(P<0.01) from the third day;② Western blot results showed that the expression of GABAAα1 receptor have no statistical significance(P>0.05);however,GABAB1 receptor and FOXP2 protein rose from the third day(P<0.05).The expression of GABAAα1 receptor and FOXP2 protein expression were correlated to total distance of Morris water maze in the control group(r=-0.738, P<0.05;r=-0.693, P<0.05), and the expression of GABAB1 receptor was correlated with FOXP2 protein level(r=0.834, P<0.05).Conclusion The simulated high-altitude hypobaric hypoxia can decrease the learning and memory abilities of rats, which may be ameliorated by tetramethylpyrazine intervention, and this effect might be related to the increase of GABAB1R receptor and FOXP2 expression in hippocampus of rats.

Objective To explore the relationship between the fibroblast growth factor 2 (FGFR2) gene polymorphism (rs 2981582 ,rs 1219648 ,rs 2420946) and the breast cancer risk in Tibetan population ,Qinghai province .Methods This is a case con‐trol study .Peripheral blood samples from 210 breast cancer patients and 230 healthy women in Qinghai area were collected .DNA samples were extracted from peripheral blood cells .FGFR2 gene polymorphism (rs 2981582 ,rs 1219648 ,rs 2420946) were typed by Taqman‐MGB probe based on PCR and DNA sequencing ,then analyzed its correlation with breast cancer in Tibetan population , Qinghai province .Results The genotype frequencies of rs 2981582 CC ,CT and TT were 40 .48% ,39 .05% and 20 .47% among the breast cancer patients while 36 .09% ,48 .69% and 15 .22% among the controls .The genotype frequencies of rs 1219648 GG ,AG and AA were 24 .76% ,26 .19 % and 49 .05% among the patients while 23 .91% ,47 .39% and 28 .70% among the controls .The genotype frequencies of rs 2420946 CC ,CT and TT were 29 .05% ,45 .24% and 25 .71% among the patients while 30 .87% , 51 .74% and 17 .39% among the controls .The genotype frequencies of all genetic loci had no significant difference between rs 2981582 and rs 2420946 (P>0 .05) .But the genotype frequencies of rs 1219648 AA have statistical sense (P< 0 .05) ,compared with GG ,the incidence of breast cancer was remarkably increased with AA [OR=1 .65 ,95% CI= (1 .01 ,2 .69)] .Conclusion This study shows that FGFR2 rs1219648 AA is related to breast cancer risk among Tibetan population .

Objective To evaluate the feasibility of getting retroperitoneal lymph node biopsy via technique of natural orifice transluminal endoscopic surgery(NOTES)in human being with current available devices.Methods We performed trans-gastric endoscopic biopsy of retroperitoneal lymph node with the aid of laparoscopy in a 50-year-old man,who presented with abdominal pain and enlarged retroperitoneal lymph nodes and signed a written informed consent before the procedure.After routine anesthesia and abdominal skin sterilization,a pneumoperitoneum was induced with a Veress needle placed in the umbilical area,followed by the introduction of a 5-mm trocar.Gastral cavity Was sterilized with antibiotics and povidone iodine.Under laparoscopie optical control,we made a styliform incision in the anterior wall of gastric corpus with a needle knife,and enlarged the incision by a dilatation balloon and then entered the peritoneal cavity with a sterile endoscope.We got two biopsies from the enlarged lymph node with a heat forceps assisted by laparoscopy.The specimen was taken out by retrieval basket through the stomach.The gastric incision Was closed with metal clips.Results The biopsy by means of NOTES was successfully performed without intra-or postoperative complications.The diagnosis was confirmed as lymphoma pathologically.The patient received chemotherapy and was discharged on the sixth postoperative day.There was no short or long-term complication.Conclusion Transgastric access for laparoscopy-assisted biopsy of retroperitoneal lymph node is feasible and safe in human being.

Objective To evaluate the nutritional status of morbid obesity (MO) before and after laparoscopic adjustable gastric banding (LAGB), and the safety of LAGB.Methods LAGB was performed in 15 cases from Jun.2003 to Nov.2003.Patients′ nutritional parameters were determined before and 1, 3 and 6 months postoperatively.Results There was a significant reduction of weight and body mass index (BMI) ( P 0.05).Conclusion No major nutritional deficiencies were found following LAGB.It is an effective and safe procedure for the treatment of morbid obesity.

OBJECTIVETo improve the water solubility and biological activity of neoligans (magnolol and honokiol) and test the antitumor activity of the modified compounds.

METHODSThe glycosylated products of magnolol and honokiol were obtained by enzymatic synthesis using a UDP-glycosyltransferase (YjiC) from Bacillus. The products were characterized by high-performance liquid chromatography (HPLC), liquid chromatography-mass spectrometry (LC-MS), and nuclear magnetic resonance (NMR) analysis. MTT assay was used to detect the growth inhibition of 4 human cancer cell lines induced by the compounds.

RESULTSWe obtained two glucosides of neolignans (magnolol and honokiol) for the first time by enzymatic synthesis using a UDP-glycosyltransferase. Based on the spectroscopic data, the glucosides were identified as magnolol-2- O-β-D-glucopyranoside (1) and honokiol-4'-O-β-D-glucopyranoside (2). Compounds 1-4 exhibited moderate anti-proliferative activities against the 4 human cancer cell lines, with IC50 values ranging from 9.41 to 111.21 µmol/L.

CONCLUSIONThe glycoslated products show enhanced water solubility and drug sensitivity against SMMC7721 cells, suggesting their value as potential therapeutic drugs.

Antineoplastic Agents, Phytogenic ; chemistry ; Biphenyl Compounds ; chemistry ; Cell Line, Tumor ; Chromatography, High Pressure Liquid ; Glucosides ; chemistry ; Glycosylation ; Humans ; Lignans ; chemistry ; Magnetic Resonance Spectroscopy ; Mass Spectrometry