Objective To assess the evidence-based support of short-term efficacy of sleeve gastrectomy and Roux-en-Y gastric bypass in obesity with metabolic syndrome by laparoscopy.Methods Electronic literature search was performed on PubMed,EMBASE,Cochrane Library,CNKI database for the efficacy of sleeve gostrectomy and Roux-en-Y gastric bypass in the treatment of obese patients with metabolic syndrome from Jan.2011 to Jun.2016.The inclusion and exclusion criteria were selected for quality evaluation,data extraction.Review Manager 5.3 software was used to conduct the statistical analysis.Results Thirteen articles were included in the Meta-analysis,including 5 randomized controlled trails,eight case-control studies with 18,850 cases,including 2,559 cases in the sleeve gastrectomy group and 16,291 cases in the Roux-en-Y gastric bypass group.The results of the Meta-analysis showed that there was no significant difference in the remission rate of type 2 diabetes rnellietus between sleeve gastrectomy and Roux-en-Y gastric bypass group (78.7％ vs 83.0％;RR =0.94,95％ CI:0.81 ～ 1.09,P ＞0.05),the reduction of body mass index was significantly higher in Roux-en-Y gastric bypass group than sleeve gastrectomy group from the short-term follow-up (MD =-2.03,95％ CI:-3.25 ～ 0.81,P ＜ 0.05).Both two surgeries can reduce the incidence of high blood lipids and hypertension,but there was no significant difference between them as well as type 2 diabetes mellitus remission.Conclusion Both sleeve gastrectomy and Roux-en-Y gastric bypass are effective in treating obesity complicated with metabolic syndrome,and can reduce the incidence of type 2 diabetes mellitus,hypertension and hyperlipidemia and reduce the body weight.Roux-en-Y gastric bypass is superior to sleeve gastrectomy in the treatment of obesity.

Humans ; Liver Function Tests ; methods ; Technetium Tc 99m Aggregated Albumin ; Technetium Tc 99m Pentetate

Objective To assess the quantitative relationship between the distribution of Himalayan marmot and its ecological environment,the terrain,the temperature and the precipitation,using remote sensing and geographic information system in Qinghai province.Methods The distribution of Himalayan marmot was located by Google Earth and ArcGIS software and by using field survey data provided by Chinese Center for Disease Control and Prevention.The corresponding ecological environment of marmot including terrain,temperature and precipitation were derived from the spatial information datasets.All results were processed according to the overlay and statistics analysis using ArcGIS software.Results Seventy-seven point twenty-seven percent(153/198) of Himalayan marmot were distributed in the area of elevation between 3000 and 4000 meters.The number of marmot reached the highest when the slope was between 0 and 17 degrees,and aspect range was between 91 and 270 degrees,180 degree was as south direction.During the period with the maximum temperature of the warmest month of 14.3-17.5 ℃,17.6-20.8 ℃ and 20.9-24.0 ℃,the distribution of marmot reached 95％(186/198) of the total area.Meanwhile,most of the marmot were presented in the area with average precipitation of 46-108 mm.Conclusions A quantitative analysis of appropriate ecological environment of Himalayan marmot in a large scope is carried uul successfully using remote sensing and geographic information system.The study indicates that spatial information technology has important applications in plague prevention and control.

Activation of microglia plays a vital role in the initiation and maintenance of specific neuropathic pain states. By activating microglia in central nervous system, Toll-like receptor 4 (TLR4) can promote the release of proinflammatory cytokines and neuroactive compounds, participate in the initiation and maintenance of neuropathic pain, and trigger the opiate side effects. Therefore, TLR4 may be a potential therapeutic target for neuropathic pain. Inhibition of TLR4 has shown some biological effects in neuropathic pain models and ibudilast (the TLR4 pathway-inhibiting agent) has been approved for for phase 2 clinical trials. This article briefly reviews the structure, function, and mechanism of TLR4 as well as the development of TLR4-targeted drugs.
Humans ; Neuralgia ; drug therapy ; physiopathology ; Toll-Like Receptor 4 ; antagonists & inhibitors ; physiology

OBJECTIVE: The differences in the thickness of fibrous cap and the percentage of fatty core of the coronary atherosclerotic plaques between sudden coronary death (SCD) group and the control group were investigated. METHODS: Sixty-four autopsy cases were divided into SCD and control groups. Samples were taken from the most severely damaged portions of the coronary atherosclerotic plaques, sectioned, stained with HE, and the percentage of examined by light microscopy for morphologic changes and structural alternations. Image analysis system was adopted to compare the thickness of fibrous cap and percentage of fatty core in the whole plaque between the two groups, and allthe data were analyzed and calculated with SPSS 11.5 statistic software. RESULTS: There were 15 grade III and 21 grade IV atherosclerotic cases found in the SCD group, while there were 16 and 12 found in the control group, respectively. Although no significant differences on the severity of atherosclerosis were found between the two groups (P > 0.05), there were significant differences on the thickness of the fibrous cap and the percentage of fatty core found between the two groups (P < 0.01). CONCLUSION Our study indicates that there are significant differences in the thickness of fibrous cap and the percentage of fatty core in atherosclerosis plaques between the SCD group and the control group. These observed differences may be helpful for morphological diagnosis of SCD.
Adult ; Aged ; Cadaver ; Coronary Artery Disease/pathology* ; Coronary Vessels/ultrastructure* ; Death, Sudden, Cardiac/pathology* ; Female ; Fibrosis ; Humans ; Male ; Middle Aged ; Myocardium/pathology* ; Rupture, Spontaneous/pathology* ; Severity of Illness Index ; Young Adult

Objective To study the discharges regularity of ambulatory electroencephalogram (ambulatory,EEG,AEEG)during sleep and hyperventilation(HV)-induced EEG. Methods Features of epileptiform discharges of AEEG and HV-induced EEG were evaluated comparatively in 65 cases with frontal lobe epilepsy. Results The epileptiform discharge rate of HV-induced EEG was evidently lower than that of AEEG during the shallow sleep period (non-rapid-eye-movement phase 1 and 2,NREM phase 1 and 2),which had statistical significance(P＜0.01);however,the rate of HV-induced EEG had no significant difference from that of AEEG during the awake period and deep sleep period(NREM phase 3 and 4)(P＞0.05). Conclusions The epileptiform discharge rate of AEEG during the shallow sleep period is obviously higher than that of HV-induced EEG in patients with frontal lobe epilepsy,and thus sleep EEG is helpful to enhance the diagnostic rate of epileptiform discharges in these patients.

OBJECTIVETo investigate the application effect of damage control orthopedics for the treatment of severe multiple fractures.

METHODSFrom January 2014 to December 2016, 23 patients with severe multiple fractures were treated with the damage control orthopedics (DCO), included 14 males and 9 females with an average age of (41.57±8.29) years old ranging from 28 to 60 years old; the NISS averaged(27.70±5.44) points ranging from 18 to 40 points. As the control group, 27 patients with severe multiple fractures were treated by the early total care(ETC) technology from Jan. 2007 to Dec. 2019, included 16 males and 11 females with an average age of (38.33±9.99) years old ranging from 19 to 55 years old, the NISS averaged (31.07±6.46) points ranging from 20 to 43 points. The ICU recovery time, blood transfusion, total operation time, mortality, complication and length of hospital stay were observed and compared between two groups.

RESULTSIn the DCO group, there were 22 cases surviving and 1 case death, 3 cases of postoperative complication contained 2 cases of adult respiratory distress syndrome, 1 case pin of infection in external fixation. In ETC group, there were 25 cases surviving and 2 cases death, 10 cases of postoperative complication contained 4 cases of adult respiratory distress syndrome and 3 cases of pin infection in external fixation, 1 case of wound infection and 2 cases of multiple organ failure. There was statistically significant difference between two groups in blood transfusion in operation, the ICU recovery time, and complications(<0.05). There was no statistically significant difference in total operation time, length of hospital stay and mortality between two groups(>0.05).

CONCLUSIONSFor patients with severe multiple fractures, application of damage control orthopedics can significantly reduce the postoperative complications, ICU recovery time and intraoperative blood transfusion, provide a certain basis for clinical treatment of such patients.

OBJECTIVETo compare the predictive values of eight staging systems for primary liver cancer in the prognosis of combined hepatocellular-cholangiocellular carcinoma (cHCC-CC) patients after surgery.

METHODSThe clinical data of 54 cHCC-CC patients who underwent hepatectomy or liver transplantation from May 2005 to Augest 2013 in Chinese PLA General Hospital were collected. We evaluated the prognostic value of the Okuda staging system, Cancer of the Liver Italian Program (CLIP) score, French staging system, Barcelona Clinic Liver Cancer (BCLC) staging system, 7th edition of tumour-node-metastasis (TNM) staging system for hepatocellular carcinoma and intrahepatic cholangiocarcinoma (ICC), Japan Integrated Staging (JIS) score, and Chinese University Prognostic Index. The distribution, Kaplan-Meier method, Log-rank test, and area under a receiver operating characteristic curve were used to compare the prognosis-predicting ability of these different staging systems in 54 cHCC-CC patients after surgery.

RESULTSThe TNM staging system for ICC and JIS score had a better distribution of cases. The 12-and 24-month survivals of the entire cohort were 65.5% and 56.3%, respectively. A Log-rank test showed that there was a significant difference existing in the cumulative survival rates of different stage patients when using TNM staging system for ICC (stage 1 vs. stage 2, P=0.012; stage 2 vs. stage 3-4, P=0.002), Okuda staging system (stage 1 vs. stage 2, P=0.025), and French staging system (stage A and stage B, P=0.045). The 12-and 24-month area under curve of TNM staging system for ICC, BCLC staging system, JIS score, and CLIP score were 0.836 and 0.847, 0.744 and 0.780, 0.723 and 0.764, and 0.710 and 0.786, respectively.

CONCLUSIONThe 7th edition of TNM staging system for ICC has superior prognostic value to other seven staging systems in cHCC-CC patients undergoing surgical treatment.

Bile Duct Neoplasms ; diagnosis ; surgery ; Carcinoma, Hepatocellular ; diagnosis ; surgery ; Cholangiocarcinoma ; diagnosis ; surgery ; Hepatectomy ; Humans ; Liver Neoplasms ; diagnosis ; surgery ; Neoplasm Staging ; methods ; Predictive Value of Tests ; Prognosis ; ROC Curve ; Survival Rate

OBJECTIVESTo evaluate the application of two-dimensional electrophoresis and mass spectrometry in the research of proteins expressed in testis.

METHODSProtein from adult ICR mouse testes was extracted by two-dimensional electrophoresis. Two protein spots were cut from the gel, then the proteins were digested in-gel by enzyme and the generated peptides were measured by matrix assisted laser desorption/ionization-time of flight mass spectrometry. The proteins were identified through database searching.

RESULTSTwo spots in Commasie Brilliant Blue-stained gel were identified as serum albumin and protein disulfide isomerase by database searching.

CONCLUSIONSThis rapid high resolution and efficient method is a very powerful way to analyze testicular proteins.

Animals ; Electrophoresis, Gel, Two-Dimensional ; Male ; Mass Spectrometry ; Mice ; Mice, Inbred ICR ; Proteins ; analysis ; Testis ; chemistry

OBJECTIVETo observe the therapeutic effect of acupoint magnetic medicated plaster therapy on cirrhosis after hepatitis.

METHODSOne hundred and twenty patients with cirrhosis after hepatitis were randomly divided into 2 groups. The control group (n=60) were treated by the hepatic protective therapy (diammonium glyeyrrhiznate, Silymarin, compound Tanshin, vitamin E), and the treatment group were treated by the liver-protective therapy and acupoint magnetic medicated plaster therapy, for 2-6 therapeutic courses. Clinical symptoms, hepatic function, serum markers of hepatitis B virus and indexes of hepatic fibrosis were investigated.

RESULTSThe markedly effective rate and the total effective rate were 65.0% and 95.0% in the treatment group, and 43.3% and 91.7% in the control group, and the serum indexes of hepatic fibrosis decreased signficantly, with significantly diferences (all P < 0.05).

CONCLUSIONAcupoint magnetic medicated plaster therapy can improve clinical symptoms, rapidly restore hepatic function, decrease serum indexes of hepatic fibrosis in the patient of cirrhosis after hepatitis.

Acupuncture Points ; Biomarkers ; Digestion ; Hepatitis ; Humans ; Liver Cirrhosis ; drug therapy