An international symposium on the standard surgical treatment of morbid obesity and type 2 diabetes mellitus was held in Florida, USA in March 2011. An expert panel from all over the world attended the meeting. The expert panelists discussed and established International Sleeve Gastroectomy Expert Panel Consensus Statement : best practice guidelines based on experience of more than 12,000 cases, which made a very commendable attempt in standardized surgical pathway of sleeve gastroectomy. Based on clinical experience over 10 years and the understanding of the consensus , this paper discusses the learning curve, preoperative preparation, indications/contraindications, surgical technique, management and prevention of complications, and post operative management.
Consensus Development Conferences as Topic ; Gastrectomy ; methods ; Humans ; Obesity, Morbid ; surgery ; Practice Guidelines as Topic

Dental Prosthesis, Implant-Supported ; Humans ; Oral Hygiene ; Quality of Life

Objective To investigate the diagnostic value of neutrophil CD64 expression for bacterial infection in children . Methods 168 children were divided into the infection group (n=133) and non-infection group(n=35) according to the results of bacterial culture .CD64 reagents from Beckman company and BD company were employed to detect CD 64 in neutrophils and lym-phocytes .Flow cytometry was used to assay their average fluorescence intensity and the CD 64 indexes were calculated .Receiver operator characteristic(ROC) curve was adopted to analyze the diagnostic performance of CD64 indexes .Results Average fluores-cence intensity of neutrophil CD64 detected by CD64 reagents from Beckman company and BD company were 46 .16 ± 29 .21 , 28 .11 ± 17 .90 ,respectively ,with statistical difference(P<0 .01) ,and their CD64 indexes were 4 .98 ± 3 .09 ,4 .89 ± 3 .53 ,respective-ly ,without statistical difference(P>0 .05) .The CD64 index of children in infection group (7 .06 ± 4 .20) was higher than that in the non-infection group(2 .93 ± 0 .79)(P<0 .01) .When CD64 index cut-off point was 3 .37 ,the sensitivity and specificity for bacterial infection diagnosis of CD64 were 93 .2% and 82 .9% ,respectively .Conclusion CD64 index may be served as an effective indicator for early diagnosis of bacterial infection in children .

Objective To evaluate the efficacy and safety of low?level laser therapy(LLLT)for androgenetic alopecia, and to compare the therapeutic effect of LLLT alone versus in combination with finasteride tablets. Methods Thirty?nine male patients were randomly divided into the LLLT group(n=21)and combination group(n=18)to be treated with LLLT alone or in combination with oral finasteride tablets(1 mg/d)for 6 months. LLLT was given twice a week, and each session lasted 30 minutes. All the patients were photographed and asked to fill a questionnaire about subjective symptoms, and hair density (the number of hairs per unit area on the scalp) was determined by using a dermatoscope to evaluate the grade of alopecia, before the treatment, and 3 and 6 months after the treatment. Results The hair density in the LLLT group was significantly higher after 6 months than after 3 months of treatment and before the treatment(184.59 ± 21.17 vs. 169.24 ± 29.21 and 166.67 ± 32.94 hairs/cm2, both P<0.05), but was insignificantly different between before and after 3 months of treatment (P > 0.05). The hair density in the combination group significantly increased after 6 and 3 months of treatment compared with that before the treatment(201.80 ± 16.55 and 186.39 ± 17.97 vs. 157.85 ± 27.97 hairs/cm2, both P < 0.05), and was significantly higher after 6 months than after 3 months of treatment(P<0.05). No significant difference was observed in hair density between the two groups before the treatment(P>0.05), but the combination group showed increased hair density compared with the LLLT group after 3 and 6 months of treatment(both P<0.05). After 6 months of treatment, LLLT alone was effective in 17 patients, but ineffective in 4 patients, and the combination therapy was effective in 16 patients, but ineffective in 2 patients, with no significant difference in the response rate between the LLLT group and combination group (χ2 = 0.057, P > 0.05). During the treatment, 24(62%)patients felt less greasy, and 22(56%)reported less hair loss, with no discomforts reported by the patients except local warm feeling. Conclusion LLLT is indeed effective for the treatment of androgenetic alopecia with no adverse reactions.

Humans ; Infection ; etiology ; therapy ; Pancreatitis ; complications ; therapy

Zusanli (ST 36), Shangjuxu (ST 37) and Xiajuxu (ST 39) are considered as the lower He-sea points, which are located along the leg lines of stomach meridian of foot Yangming from top to bottom. According to the corresponding zang-fu of lower He-sea points, the distribution order from top to bottom is stomach, large intestine and small intestine. This is significantly different from digestive physiology function sequence of stomach, small intestine and large intestine in modern medicine. However, it conforms to their anatomical position from top to bottom. In order to make a further confirmation that the indication specificity of Zusanli (ST 36), Shangjuxu (ST 37) and Xiajuxu (ST 39) is closely associated with anatomical location, a great number of ancient and modern literature is reviewed. It is found that the functions of the three acupoints are obviously related to stomach, large intestine and small intestine, respectively, indicating that the sequence of Zusanli (ST 36), Shangjuxu (ST 37) and Xiajuxu (ST 39) is related to anatomical position of corresponding zang-fu. This study conclusion could play an important role for exploring the significance of anatomical location in indication specificity of acupoints.
Acupuncture Points ; Acupuncture Therapy ; history ; China ; History, Ancient ; Humans ; Intestine, Large ; physiopathology ; Medicine in Literature ; Meridians ; Stomach ; physiopathology

BACKGROUND: Biomechanical changes of the trunk might be an important factor contributing to the pathogenesis and poor recovery of lumbar disc herniation.OBJECTIVE: To study the biomechanical changes of the trunk of patients with lumbar disc herniation by isokinetic test of the protruded lumbar disc.DESIGN: Non-randomized controlled retrospective study of concurrent patients.SETTING: Department of Rehabilitation Medicine, Changhai Hospital, Second Military Medical University of Chinese PLA.PARTICIPANTS: Thirty patients with lumbar disc herniation, admitted in the clinic of Department of Rehabilitation, Changhai Hospital affiliated to Second Military Medical University between February 2001 and January 2002, were enrolled in this study, with another 30 concurrent patients without lumbar disc herniation serving as the control group. Informed consent was obtained from all patients involved.METHODS: A Biodex Multi-joint Testing System was employed for measuring the peak torque(PT), peak torque to body weight(PT/BW), time to peak torque(TPT), torque at 0. 2 s(T@ 0. 2), total work(TW), average power(AP) and flexion to extension(F/E) ratio of the trunk muscles of the patients. The results were analyzed by t test using SPSS 9.0 software.MAIN OUTCOME MEASURES: Main outcome: isokinetic evaluation of the lumbar and dorsal flexors and extensors; secondary outcome: F/E ratio.RESULTS: The strength of the trunk flexors and extensors decreased significantly in patients with lumbar disc herniation at each testing speed of retraction, and the bursting strength and indices for work efficiency of the muscles also exhibited obvious changes. The flexors showed greater reduction in muscle strength than the extensors. The F/E ratios during isokinetic concentric contraction at 60°/s and 180°/s were 57.99 ±5.68 and 65.74 ± 8.12, respectively, in patients with lumbar disc herniation, in comparison with the ratios of 95.25 ±5. 18 and 83.03 ±7.61 in the control patients, showing significant difference between the two patient groups( P ＜ 0.01 ).CONCLUSION: Biomechanical changes of the trunk muscles of patients with lumbar disc herniation are definite, and proper rehabilitative treatment of these patients should consists of specific training protocols to restore the mechanical balance of the trunk and break the vicious cycle on the basis ofaccurate evaluation of such changes.

Z-Ligustilide, a major phthalide isolated from a widely used traditional Chinese medicine Ligusticum chuanxiong, possesses various pharmacological activities including neuroprotective, anti-inflammatory, antiproliferative and vasorelaxing effects. However, it is unstable and inclined to degrade in natural conditions, which limits its study and application greatly. In this study, degradation behavior of Z-ligustilide and its degradation products stored at room temperature under direct sunlight were investigated and structure elucidated by HPLC-UV, UPLC-QTOF-MS and NMR. Z-ligustilide degradation and total five degradation products were generated and detected. Two degradation products were unequivocally identified as senkyunolide I and senkyunolide H by comparison with reference compounds. Another two degradation products were further isolated by semi-preparative HPLC and structure elucidated as (E)-6, 7-trans-dihydroxyligustilide and (Z)-6, 7-epoxyligustilide by 1H and 13C NMR, respectively. The degradation pathways of Z-ligustilide were finally proposed. Oxidation, hydrolysis and isomerization are the major degradation reactions.

Objective:To identify the function of extracellular soluble vimentin that promotes proliferation, activation and chemotaxis of inflammatory cells. Methods: The proliferation of rat splenocytes stimulated with vimentin was evaluated in vitro. The lymphocyte counts and vimentin-antibody levels of peripheral blood in mice immunized with vimentin were detected in vivo. Peritoneal macrophages were collected and cultured with different concentrations of vimentin to detect the effect on phagocytosing chicken red blood cells. The chemotaxis of NIH3T3 fibroblast towards vimentin was observed in transwell chamber. Results:In vitro vimentin dose dependently promoted the proliferation of splenocytes. The proliferation indexes of primed and naive splenocytes cultured with 16μg/ml vimentin were reached up to ( 196. 0 ± 9. 7 )% and ( 208. 9 ± 4. 6 )% respectively without significant difference. In vivo vimentin significantly enhanced the lymphocytes number(109 L-1)of peripheral blood(5. 74±0. 51 vs. 1. 69±0. 13)and the levels of vimentin specific antibody( OD value 2. 31 ± 0. 06 vs. 0. 19 ± 0. 08 ) that shown no significant difference from immunization with vimentin plus CFA. In vitro vimentin dose dependently stimulated phagocytic ability of macrophages and performed the chemotactic effects on NIH3T3 fibroblasts. Conclusion:Extracellular soluble vimentin promotes the proliferation,activation and chemotaxis of concerned inflammatory cells and possesses the functions as an alarmin.

Objective To detect the cellular immune and humoral immune function in infants with Mycoplasma pneumoniae(Mp) infection,and to study its change regularity and the related clinical indexes.Methods The peripheral blood samples were collected from infantile patients with MP infection.The expression of CD3,CD4 and CD8 on the surface of T lymphocyte(T-cell)were detec-ted by the flow cytometry and the concentrations of IgG,IgA and IgM in serum were detected by the automatic biochemistry analy-zer.At the same time the normal control group was set up.Results The proportion of CD3 + and CD4 + T-cell,CD4 +/CD8 + ratio and the concentration of IgG,IgA in the patient group were significantly lower than those in the control group,while the concentra-tion of IgM in the patient group were significantly lower than those in the normal children.The concentration of IgM was higher than that in the normal children;the proportion of peripheral blood CD4 + T-cell and the concentration of IgM in the low-copy group were significantly lower than those in the high-copy group.Conclusion The immune status in children with Mp infection has obvi-ous change.The immune function of T-cell is suppressed.the humoral immune function has certain turbulence.