Bariatric and metabolic surgery is an effective treatment for obesity and metabolic syndrome with definite results. In recent years, bariatric and metabolic surgery has developed rapidly, and the surgical indications and procedures have gradually matured. At the same time, the complications have also been widely discussed, including those specific to bariatric metabolic surgery and the risks common to gastrointestinal surgery, of which gastrointestinal leak is one of the most important and serious complications, which can be life-threatening in severe cases. This paper will review the mechanisms, clinical manifestations, diagnostic strategies, prevention, and treatment advances related to gastrointestinal leak after bariatric metabolic surgery based on the two major procedures that cause gastrointestinal leak, namely, staple line leak after laparoscopic sleeve gastrectomy and gastrojejunostomy leak after laparoscopic Roux-en-Y gastric bypass.

Objective; To explore mechanism of Zhongjiling tablet treats experimental autoimmune myasthenia gravis on rats. Methods:Normal mice, immunosuppressive mice and EAMG rats were used to investigate the mechanism. Results:Zhongjiling tablet enhanced T and B cells proliferation of normal mice and immunosuppressive mice induced by ConA or LPS, and increased the production of IL-2. T cell proliferation of EAMG rats was improvement stimulated by AChR and decline by ConA. Zhongjiling tablet inhibited the improvement by AChR and enhanced the decline by ConA, and reduced the expression of IFN-? and IL-4 mRNA. Zhongjiling tablet also induced the apoptosis of CD4 + T lymphocyte stimulated by AChR. Conclusion: Zhongjiling tablet increased immunity of normal mice, immunosuppressive mice and EAMG rats. But it suppressed specific T lymphocyte proliferation induced by AChR and reduced the expression of IFN-? and IL-4 mRNA. It was probably one of mechanisms Zhongjiling tablet induced the apoptosis AChR specific CD4+T lymphocyte.

In the study, the inhibitory effect of epigallocatechin gallate (EGCG) on Calcium oxalate nephrolithiasis and its possible mechanism were investigated. The rat Calcium oxalate nephrolithiasis model was induced through the combined oral administration of ethylene glycol and ammonium chloride, which was intervened with EGCG. Rat blood samples were collected to detect blood creatinine (Cr), blood urea nitrogen (BUN) and blood calcium. Rat urine samples were collected to observe and compare 24-hour urine volume, oxalic acid (Ox) and calcium in urine. Renal samples were collected to prepare tissue slices and observe the pathological changes in Calcium oxalate nephrolithiasis. The expression of osteopontin (OPN) in renal tissues was evaluated by Real-time PCR and Western blot. According to the results, compared with normal rats, rats in the nephrolithiasis model showed significant increases in Cr, BUN, urine Calcium, urine Ox and renal OPN expression (P < 0.05), but obvious decrease in 24-hour urine volume (P < 0.05); Compared with rats with nephrolithiasis, those processed with EGCG revealed remarkable declines in Cr, BUN, urine Calcium and urine Ox (P < 0.05), with significant rise in 24-hour urine volume (P < 0.05) in a concentration-dependent manner. Additionally, compared with the control group, nephrolithiasis rats showed significant pathological changes in Calcium oxalate calculus. After ECCG treatment, the renal pathological changes and OPN expression attenuated significantly in a concentration-dependent manner. The results showed that EGCG inhibits the formation of calcium oxalate nephrolithiasis in rats and shows a notable protective effect on renal functions.
Animals ; Blood Urea Nitrogen ; Calcium ; blood ; Calcium Oxalate ; metabolism ; Catechin ; administration & dosage ; analogs & derivatives ; Creatinine ; blood ; Disease Models, Animal ; Humans ; Kidney ; drug effects ; metabolism ; Male ; Nephrolithiasis ; blood ; drug therapy ; genetics ; Osteopontin ; genetics ; metabolism ; Rats ; Rats, Wistar

Objective　To study the effect of gadolinium chl oride hexahydrate (GDCL3) on the structure and lipid peroxide (LPO) of rat hep atocellular mitochondria during liver cold ischemia storage. 　Methods　Forty Wistar rats were randomized into 8 gr oups ( 5 in each group). Group 1～4 served as control. The other 4 groups were p retreated with GDCL3 (7mg/kg). The ultrastructures of hepatocellular mitocho ndria were observed by electron microscope and LPO of hepatocellular mitochondri a were investigated. 　Results　LPO o f hepatocellular mitochondria in group 1h, 2h, 3h pretreated with GDCL3 for 1、 2、 3 h were 1.0±0.3、1.7±0.2、2.0±1.0, LPO was suppressed sign ificantly compared with control group (2.2±1.0、2.8±1.0、3.5±1.0、 P<0.05). With time prclonging of liver storage, the damage of hepatocellular mitochondria ultrastructure became more severe and LPO of hepatocellular mitoch ondria increased significantly. Pretreated with GDCL3, the damage of hepatocel lular mitochondria ultrastructures were lessened and the elevation of LPO was s uppressed significantly (1 hour、 2 hours、3 hours，P<0.05). 　Conclusion　Mitochondria damage is one of the sensitive characters of liver cold ischemia injury, GDCL3 inhibits rat hepatoc ellular injury during liver cold ischemia storage.

Objective To study the current research status of minichromosome maintenance protein 2 (MCM2), the cell cycle proliferation marker, in the diagnosis of colorectal carcinoma. Methods Literatures about the application of MCM2 in the study of colorectal carcinoma were collected and reviewed.Results MCM2, as a marker of cell dysplasia and malignancy, was usually used in the study of carcinoma. The study on expression of MCM2 in the cell of colorectum in different proliferational stage might help to screen colorectal carcinoma as early as possible. Conclusion As a relatively specific and sensitive marker of cell proliferation, MCM2 might become a promising mark for diagnosing colorectal carcinoma in the early stage.

Objective:To analyze immune mechanisms of total glycoside from Cornus officinalis (TGCO) against rheumatoid arthritis.Methods:Rat immunized by CⅡ in CFA were treated with TGCO ,at different times after immunization,CⅡ-specific antibodies in serum,lymphnode cells(LNC) IFN-? production was studied and cell proliferation response were also detected.Results:Treatment inhibit disease severity to a greater extent. TGCO effectively decreased anti-CⅡantibody titer in serum, considerably reduced IFN-? secretion before the onset arthritis and the acute stage of arthritis and suppressed T cell differentiation or proliferation.Conclusion:The both lead to supprese arthritis.

Objective To study on the changes of the IL-6、IL-8、TNF-? in the type 2 diabetes with insulin resistance and the relation of plasma glucose or insulin resistance and cytokines. Methods (1) To assay the serum level of cytokines in 90 cases with type 2 diabetes mellitus (T2DM) and 30 normal controls. (2)To measure the level of fasting plasma glucose (FPG),hemoglohin A_1c (HBA_1c),fasting insulin(FINS),fasting C-peptide (FCP).(3) To analysis the relation of the level of FPG,HBA_1c,FINS,FCP and cytokines. Results (1) The serum levels of cytokines in T2DM group were significantly increase than in control groups,IL-6 and TNF-? in T2DM group with insulin resistance were significantly increase than in T2DM group without insulin resistance (2) There was significantly positively correlated between insulin resistance and the increasing of cytokine levels. Conclusion There is an excess activation of cytokines in T2DM,which is significantly correlated with insulin resistance. Cytokines play the important role in the occurrence and development of T2DM and insulin resistance.

Objective To summarize the experience on treatment of esophageal leiomyoma and mesenchymoma with video-assisted thoracoscope under the assistance of a fiber gastroscope.Methods The clinical data of 14 cases of esophageal leiomyoma and 2 cases of esophageal mesenchymoma treated with video-assisted thoracoscope under the assistance of fiber gastroscope from October 2004 to December 2009 was retrospectively analyzed.Selected different surgical path and operation hole position according to the lesion site.Fiber gastroscope was conductive to accurately find lesion positions,and detected esophageal mucosa was breaked or not.Extra-mucosal excision was conducted in 16 cases.Results Ihere was no death and severe complications during perioperative period.Patients were diagnosed by pathological examination.Thirteen cases were followed up for 6-48(18.5 ±9.5)months,all patients ate unobstructed,and without relapse.Conclusion Treatment of esophageal leiomyoma and mesenchymoma with video-assisted thoracoscope under the assistance of fiber gastroscope has the advantages of intraoperative accurate positioning,minimally invasive,thoroughly,fewer complications,and it is the first choice of esophageal benign tumor treatment.

Objective To analyze laboratory turnaround time (TAT) and find effective ways to shorten TAT.Methods Data associated with cardiac panel (CK,cTnI and Mb) were collected in 2011 including 19 906 outpatient data and 22 973 inpatient data.The medians and the average medians of the quality indicators on TAT were calculated and the results were transformed to the Six Sigma scale to estimate the degree of control over related process.Processes were considered well controlled when σ ≥4.Based on the results of data analysis,an improvement plan was decided by laboratory quality management meeting and clinical communication meeting.The effect of the improvement plan was evaluated through 2011-2012 satisfaction surveys of outpatients and clinicians.Results The average median of overtime reports for outpatient from specimen collection to reception was 2.78％ (3.5σ),and 17.82％ (2.5σ) for inpatients.The average median of overtime reports for outpatient from specimen reception to result reporting was 3.39％ (3.4σ),and 2.96％ (3.4σ) for inpatients.The average median of overtime reports for outpatient from specimen collection to result reporting was 3.93％ (3.3σ),and 12.18％ (2.7σ) for inpatient.The results of TAT satisfaction surveys for outpatients from 2011 to 2012 were similar,which were 78％ in 2011 and 79％ in 2012; the results for clinicians showed an increase from 80％ in 2011 to 90％ in 2012,including an increase from 75％ to 79％ for very satisfaction choice.Conclusions Outside the laboratory TAT is a key step in sickroom patients delay TAT.The implementation for ten improvement suggestions enabled to shorten TAT effectively.

Noninvasive early diagnosis of colorectal cancer is conducive for patients to reduce the mortality rate and their suffering from diagnosis procedures.One of the most significant methods to proceed noninvasive early diagnosis of colorectal cancer is analysis of stool DNA.Extracting high quality and great quantity of human genomic DNA from stools guarantees diagnosis accuracy.However,the complexity of stool component hinders DNA extraction.Hence,it is crucial to develop highly efficient extraction methods of human genomic DNA from stools for the DNA analysis-based early diagnosis of colorectal cancer.Currently,two kinds of extraction strategies are employed:one is to directly extract total DNA from stools,the other is to enrich exfoliated colonocytes in stools before DNA extraction.This article reviews the advances on these two kinds of extraction techniques and summarizes their applications.