Objective To investigate the 5-year efficacy of laparoscopic sleeve gastrectomy for the treatment of morbid obesity.Methods The clinical data of 31 patients with severe morbid obesity and related complications who were admitted to the Shengjing Hospital of Chinese Medical University from January 2006 to December 2007 were retrospectively analyzed.The 31 patients received laparoscopic sleeve gastrectomy and were followed up for 5 years to observe the perioperative condition,incidence of long-term complications,application of hypoglycemic drug and insulin before and after operation,the body mass index (BMI) was detected 6 months,1,2,3,4,5 years after operation,and the decrease of excess weight loss (EWL) was analyzed.The remission rate of complications,incidence of complications and the patient satisfaction score were recorded.The count data were analyzed using the chi-square test or Fisher exact probability.Repeated measurement data were analyzed using the repeated measure ANOVA,a Greenhouse-Geisser adjustment was used to correct serial dependency.Results Twenty-five patients were followed up for 5 years postoperatively.Of the 25 patients,4 (16.0％) had gastroesophageal reflux disease,and were cured by medical treatment; 1 patient (4％) had anastomotic stenosis; the percentage of EWL of 2 patients (8.0％) was under 60％ ; 4 patients (16.0％) had occasional obdominal pain.The percentage of patients with diabetes mellitus was decreased from preoperative 9.7％ (3/31) to postoperative 4.0％ (1/25),with a significant difference (P ＜ 0.05).The percentage of patients with fatty liver was decreased from preoperative 93.5％ (29/31) to postoperative 32.0％(8/25),with significant difference (x2=19.10,P ＜ 0.05).The percentage of patients with hyperlipidemia was decreased from preoperative 77.4％ (24/31) to postoperative 12.0％ (3/25),with significant difference (x2 =35.51,P ＜ 0.05).The level of BMI was decreased from preoperative (38.8 ±4.2) kg/m2 to postoperative (28.5 ± 3.1) kg/m2,with significant difference (F =113.36,P ＜ 0.05).The percentage of EWL was increased from preoperative 42％ ± 11％ to postoperative 69％ ± 16％,with significant difference (F =41.71,P ＜0.05).There was no significant difference in the patient satisfaction score between each year within the 5 years (F =0.92,P ＞ 0.05).Conclusions Laparoscopic sleeve gastrectomy is effective in losing weight with few long-term complications.

Objective To examine whether ghrelin has beneficial effect on survival of pancreatic INS-1 beta cell.Methods Rat INS-1 cells were cultured separately in 5.6 mmol/L glucose (NG group),33.3 mmol/L glucose (HG group),33.3 mmol/L glucose plus 10 nmol/L acylated ghrelin (HG+AG group),and 33.3 mmol/L glucose plus 10 μmol/L unacylated ghrelin(HG+UG group).After being incubated for different hours,cell suvival rate was determined by MTT.Activity of caspase-3 was estimated by spectrophotometry,activity of GRP78,and cytochrome c was analyzed by confocal microscopy.Results Both acylated ghrelin and unacylated ghrelin inhibited the rise in activity of GRP78,caspase-3,and cytochrome c induced by sustained high glucose.Conclusions These findings indicate that ghrelin is able to inhibit endoplasmic reticulum stress and mitochondrial dysfunction of INS-1 β-cell caused by persistent high glucose,and the effect of ghrelin is not affected by acylation.