Objective To investigate the clinical effects of gastric bypass( GBP) on type 2 diabetes mel-litus(type 2 diabetes mellitus, T2DM)patients with different body mass index(BMI).Methods T2DM patients undergoing GBP from Sep.2012 to Jul.2013 were divided into 2 groups:obese group( BMI≥28 kg/m2 , 16 ca-ses)and overweight group(BMI<28 kg/m2,21 cases).Changes of fasting plasma glucose(FPG), insulin resist-ance index(HOMA-IR)and insulin stimulation release(INS), C peptide release, BMI, glycosylated hemoglobin ( HbA1c) at 3 and 6 months after surgery were observed.Results INS and C peptide improved 3 months after surgery(P<0.05),and they were close to normal at 6 months after surgery.HbA1c significantly decreased 3 months after surgery compared with that before surgery( P<0.05) and it was close to normal at 6 months after sur-gery.Patients in obese group had significantly declined weight 3 months after surgery compared with that before surgery, and reached the steady state 6 months after surgery.15 cases(93.7%) in the obese group had BMI<25 kg/m2 , and the difference had statistical significance ( P<0.05 ) .Patients in the overweight group had their weight declined but no statistical difference was found(P>0.05).Blood sugar in the obese group decreased with different degrees at 3 and 6 months after surgery.The effective rate was 92%for the obese group and 78%for the overweight group.The overall effective rate was 90%.Conclusion GBP has significant therapeutic value for T2DM patients with different BMI, especially for patients in obese group, which is worth of clinical promotion.

BACKGROUND:Plate fixation or intramedulary fixation for clavicle fractures has remained a matter of debate. At present, there is a need for a higher level of evidence to evaluate the advantages and disadvantages of two different surgical methods.
OBJECTIVE:To assess the clinical efficacy of intramedulary fixationversusplate fixation in the treatment of clavicle fractures.
METHODS:We conducted a computerized search of the electronic databases like Cochrane Library, PubMed, Embase, OVID, CBM, CNKI, Wanfang and VIP for relevant randomized controled trials on plate fixation or intramedulary fixation for clavicle fractures. The quality of the included studies was independently assessed with RevMan 5.3 software. The meta-analysis was performed in Stata 13.0.
RESULTS AND CONCLUSION:Eight randomized controlled trials with 527 patients were included in this meta-analysis. The meta-analysis results showed union time, surgery time, incision length, hospital stay and infection rate were less in the intramedullary fixation group than in the plate fixation group (P< 0.05). No significant difference in shoulder function score, upper limb function score, fracture nonunion and refracture was determined between the two groups (P< 0.05). The current evidences suggested that intramedullary fixation is the optimum choice in the treatment of clavicle fractures.

ABSTRACT:Objective To explore the protective effect of the antioxidant N‐acetylcysteine (NAC) on the retinal nerve tissue of early diabetic rats .Methods We randomly divided 60 healthy adult Sprague‐Dawley (SD) rats weighing between 180 g and 220 g into 2 groups:normal control (CON , n=20) and diabetic (DM , n=40) .By intraperitoneal injection of streptozotocin (60 mg/kg) ,the model of diabetic rats was established .The rats were considered diabetic only when they had hyperglycemia (set at ≥16 .7 mmol/L) (32) .The CON group was injected with the same amount of citric acid and sodium citrate buffer solution .After successful model establishment ,the diabetic rats were randomly divided into 1‐month diabetes group and 2‐month diabetes group ,with 16 rats in each group .The left eye of each experimental diabetic rat was set for diabetes control group (D) while the right eye was set as NAC treatment group (NAC) .At 2 weeks of diabetes ,4μL (1 .6μg/μL) of NAC was injected into the vitreous chamber of NAC group and 4μL (0 .01 mmol/L) of PBS was injected into the vitreous chamber of the other diabetic rats .The thickness changes of outer nuclear layer retina was observed by HE ,ultrastructural changes of retinal ganglion cells were observed under the transmission electron microscope ,and the number of retinal ganglion cells was detected by immunofluorescence method .Results At different time points ,retina outer nuclear layer in NAC group was thicker than in D group (P<0 .01) .However ,the NAC group and the CON group did not differ (P>0 .05) .Under the transmission electron microscope ,NAC group had more retinal ganglion cell organelles ,higher electron density of the cytoplasm ,and milder mitochondria swelling than D group .The NAC group did not differ from CON group in the ultrastructure of retinal ganglion cells . NAC group had an increased number of retinal ganglion cells at different time points compared with the D group (P<0 .01) ,but the NAC and CON groups did not differ in the number of retinal ganglion cells (P> 0 .05) .Conclusion The antioxidant N‐acetylcysteine has a protective effect on the retinal nerve tissue of early diabetic rats .

Resveratrol (RES), a natural polyphenolic phytochemical, has been suggested as a putative anti-aging molecule for the prevention and treatment of Alzheimer's disease (AD) by the activation of sirtuin 1 (Sirt1/Sir2). In this study, we tested the effects of RES and Sirt1/Sir2 on sleep and courtship memory in a Drosophila model by overexpression of amyloid precursor protein (APP), whose duplications and mutations cause familial AD. We found a mild but significant transcriptional increase of Drosophila Sir2 (dSir2) by RES supplementation for up to 17 days in APP flies, but not for 7 days. RES and dSir2 almost completely reversed the sleep and memory deficits in APP flies. We further demonstrated that dSir2 acts as a sleep promotor in Drosophila neurons. Interestingly, RES increased sleep in the absence of dSir2 in dSir2-null mutants, and RES further enhanced sleep when dSir2 was either overexpressed or knocked down in APP flies. Finally, we showed that Aβ aggregates in APP flies were reduced by RES and dSir2, probably via inhibiting Drosophila β-secretase (dBACE). Our data suggest that RES rescues the APP-induced behavioral deficits and Aβ burden largely, but not exclusively, via dSir2.
Animals ; Alzheimer Disease/metabolism* ; Amyloid beta-Peptides ; Amyloid beta-Protein Precursor/metabolism* ; Drosophila/physiology* ; Drosophila Proteins/metabolism* ; Resveratrol/pharmacology* ; Sirtuin 1 ; Sleep