Recently ,metabolic surgery has received much concern for its notable and everlasting effectiveness on glucose control ,weight loss and other metabolic disorders and concomitant diseases. Previous clinical practice and guidelines mostly focused on surgical indications ,especially BM I cut‐off point. In recent years ,BMI cut‐off point in guidelines has shown a downtrend and BMI cut‐off value has tended to become obscure ,which harvested from that clinical staff have realized the importance of comprehensive control for long‐term multiple metabolism and risk factors and overall benefit of the patients through increased clinical evidences and no longer limited to the improvement of obesity and diabetes itself.

The value of surgery in the diabetes mellitus treatment receives much attention in the medical field,however,Chinese metabolic surgeons adopt the surgical experience from surgeries for morbid obesity in western countries.There are many controversies on the operative indication,operation method and postoperative follow-up of surgery for diabetes mellitus with low body mass index (BMI).Our nation has a large number of patients with diabetes mellitus and low BMI,in which uncheckedoperative indication,unstandard operation method and non-systematic follow-up are common problems.It has profound significance to investigate operative indication,operation method and efficacy evaluation for patients with diabetes mellitus and low BMI.

Objective: To understand the study status of Extended Release Venlafaxine (Venlafaxine ER) in the treatment of depression and its efficacy in China. Methods: 8 papers on Venlafaxine ER treatment of depression were indexed and reviewed with evidence-based medicine method. Results:7 of 8 studies were RCT. The effect size of Venlafaxine ER in the treatment of depression at the end of week 2 was more significant than that of SSRIs (Z=-2.17,P

Despite the progress in the comprehensive management of colorectal cancer,locally advanced (T3 and T4 stages) and metastatic colorectal cancer is still a challenging problem.Although researches on neoadjuvant therapy and targeted therapy have obtained many encouraging results,many unanswered questions still remain.These include the indication of multivisceral resection for locally advanced colorectal cancer,the optimal management of patients with hepatic and (or) pulmonary metastasis.R0 resection was the first choice for the treatment of metastatic colorectal cancer,but it is only suitable for selected patients.Chemotherapy and targeted therapy are effective in converting some unresectable liver metastasis into resectable disease.This review focuses on recent improvements in the management of locally advanced colorectal cancer,as well as the management of hepatic and (or) pulmonary metastasis.

Objective To explore the etiopathology of slow transit constipation(STC). Methods The model of rat with cathartic colon was established and the changes of colonic electromyography and reaction to acetylcholine(Ach) were examined. Result The frequency, amplitude of slow wave and colon reaction to Ach of rats with cathartic colon decreased markedly. Conclusion Long term abuse of stimulant laxatives could damage enteric nervous system(ENS) and accelerate the pathological changes of STC.

Objective To observe the distribution of ER? in the sigmoid colon specimens from the patients with slow transit constipation(STC).Methods The expression of ER? was detected by immunohistochemical staining in formalin-fixed,paraffin-embedded sigmoid colon tissues from 16 cases of STC,and from 8 cases of rectal cancer at Dukes' stage A,2 cases of rectal villous adenoma(10 as control).The positive cells were analyzed by computer assistant image analysis system.Results ER? immunoreactivity was present in normal epithelium and interstitial cells of the sigmoid colon tissues in the two groups,but nucleus-positive in STC group and cytoplasm-positive in control group.In comparison with the control group,the ER? immunoreactivity in STC group was much lower(P

Objective To investigate the expressions of ER? protein and ER? isoform mRNA in sigmoid colon of female slow transit constipation patients. Methods RT-PCR and Western blot were used to detect the expression of ER? protein and ER? isoform mRNA of 20 patients with STC and 20 age-matched controls. Results ER? protein and ER?1, ER?2 and ER?5 mRNA were detected in the two groups lower in STC group than that in control group (P

Roux-en-Y gastric bypass (RYGB) is the preferred surgical procedure for obesity and type 2 diabetes mellitus (T2DM).Currently,it is controversial how long the roux limb and biliopancreatic limb should be selected during RYGB.Based on the survey of American Society for Bariatric Surgery (ASBS) (2008),the Roux limb ranged from 10 cm to 250 cm and the biliopancreatic limb ranged from 35 cm to 250 cm.The length of small bowel exclusion may affect the postoperative results.Shorter jejunum exclusion may affect the curative effect,while overlong jejunum exclusion may result in nutritional disorders,diarrhea and other complications.Under the condition of fixed jejunal exclusion,it is worth exploring the relationship between the postoperative outcome and different parameters of small bowel exclusion.Lacking of consensus and criteria in this field,authors focused on the related references published recent years to summarize the valuable information.

laparoscopic technology has been widely used in the fields of surgery such as general surgery etc. It has several advantages,such as directly showing abdominal organs,demonstrating operation procedure and being easy to make and spread operation video material. Laparoscopic system should be used for intern teaching in general surgery department to improve their learning and performance.

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