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

0.75).Conclusions The method of single-slice and multi-slice TSE sequence in T_2 measurement is feasible.For bone marrow and extremely long T_2 tissue(for instance,cerebrospinal fluid),however,there may be considerable discrepancy on T_2 values obtained by TSE sequence.

Thyroid-like papillary adenocarcinoma is an extremely rare neoplasm in the nasopharynx. We present a case with a pedunculated tumor in the nasopharyngeal vault. Complete tumor resection via nasal endoscopy was performed subsequently. Postoperative histopathological examinations and immunohistochemical studies confirmed the diagnosis of thyroid-like papillary adenocarcinoma. This rare neoplasm demonstrated a distinct etiology and nature from typical nasopharyngeal carcinomas and should be managed mainly by surgical resection.
Adenocarcinoma, Papillary ; Adult ; Carcinoma ; Female ; Humans ; Nasopharyngeal Carcinoma ; Nasopharyngeal Neoplasms

Proliferation and migration of vascular smooth muscle cells (VSMC) are common pathological features of diabetic vascular complications,such as atherosclerosis and hypertension. Phenotypic modulation of VSMC is the basis for VSMC proliferation and migration. Therefore, studies on VSMC phenotypic modulation and its mechanisms in diabetes mellitus were of important significance to the prevention and therapy of diabetic vascular complications. This paper introduces VSMC phenotypic modulation and the underlying mechanisms in diabetes mellitus, and summarizes advance of studies on traditional Chinese medicine intervention upon VSMC phenotypic modulation, so as to provide reference for preventing and treating diabetic vascular complications with traditional Chinese medicines.
Atherosclerosis ; drug therapy ; prevention & control ; Cell Movement ; drug effects ; Cell Proliferation ; drug effects ; Diabetes Mellitus ; drug therapy ; pathology ; Drugs, Chinese Herbal ; therapeutic use ; Humans ; Hypertension ; drug therapy ; prevention & control ; Medicine, Chinese Traditional ; Muscle, Smooth, Vascular ; drug effects ; Myocytes, Smooth Muscle ; drug effects ; Phenotype

Objective To observe the clinical efficacy of Tanreqing Injection combined with levofloxacin injection in treatment of acute episode of chronic bronchitis and its effect on bacterial clearance rate. Methods Totally 66 patients were randomly divided into treatment group and control group (33 cases for each). Both groups were given expectorant and antispasmodic treatment. The treatment group was given Tanreqing Injection combined with levofloxacin injection, while the control group was given levofloxacin injection only. The treatment course was 12 days. The clinical symptoms, signs, and sputum culture before and after treatment were observed. The clinical efficacy and the bacterial clearance rate of the two groups were compared. Results The markedly effective cases and the effective cases in the treatment group were 15 and 29 respectively, and those in the control group were 7 and 21 respectively, with statistical significance (P<0.05). The bacterial clearance rate was 89.5% (17/19) in the treatment group, while 55.6%(10/18) in the control group, with significant difference (P<0.05). Conclusion Acute episode of chronic bronchitis treated by Tanreqing Injection combined with levofloxacin injectcion is more effective than levofloxacin injection only.

Objective To compare the short-term efficacies of laparoscopic adjustable gastric banding (LAGB) and laparoscopic sleeve gastrectomy (LSG) in the treatment of obesity and type 2 diabetes mellitus,and to investigate the relationship between the body weight loss and the decrease of glucose of the 2 treatment methods.Methods The clinical data of 40 patients with obesity combined with type 2 diabetes mellitus who were admitted to the Changhai Hospital of the Second Military Medical University from January 2010 to December 2011 were retrospectively analyzed.There were 14 patients treated by LAGB (LAGB group) and 26 by LSG (LSG group).The body weight loss and the decrease of glucose at postoperative year 1 of the 2 groups were compared.The differences in the body weight and glucose before and after operation within groups were compared using the paired t test,and the differences in the body weight and glucose between the 2 groups were compared using the multiple analysis of variance.The correlation between the body weight loss and the decrease of glucose was analyzed using the linear regression analysis.Results Laparoscopic surgery was successfully done without conversion to open surgery or intraoperative complications.The operation time and volume of blood loss were (69 ± 16)minutes and (31 ± 14)mL in the LAGB group,(120 ± 15) minutes and (148 ± 48) mL in the LSG group.Complications including postoperative malnutrition,electrolyte disturbance,delayed gastric emptying,bleeding,anastomotic leakage did not occurr in the 2 groups.Two patients were complicated with abdominal incision fat liquefaction,and were cured by symptomatic treatment.(1) The body weight,body mass index (BMI) and waistline had a decrease trend.The body weight,BMI and waistline in the LAGB group were decreased from (117 ± 28)kg,(40 ± 8)kg/m2 and (118 ± 15) cm before operation to (94 ± 28) kg,(33 ± 8) kg/m2 and (92 ± 15) cm at postoperative week 48.The body weight,BMI and waistline in the LSG group were decreased from (119 ± 25)kg,(42 ± 6)kg/m2 and (123 ± 14)cm before operation to (74± 16)kg,(26± 4)kg/m2 and (86 ± 13)cm at postoperative week 48.The EWL had an increase trend in the 2 groups.The EWL in the LAGB group was increased from 7％ ± 2％ at postoperative week 1 to 53％± 24％ at postoperative week 48,and the EWL in the LSG group was increased from 11％ ± 4％ at postoperative week 1 to 90％ ± 20％ at postoperative week 48.There were significant differences in the changes of body weight,BMI,waistline and EWL between the 2 groups (F =60.660,74.490,57.650,90.020,P ＜ 0.05).(2) The levels of glycosylated hemoglobin,fasting glucose,fasting insulin,HOMA-IR,triglyceride,total cholesterol,low-density lipoprotein and high density lipoprotein in the LAGB group were decreased from 8.1％± 0.8％,(8.4±0.6)mmol/L,(21±8)μmol/L,7.9 ±2.9,(1.68±0.50)mmol/L,(6.0±1.1)mmol/L (4.1 ± 0.8) mmol/L,(1.09 ±0.15)mmol/L to 6.4％ ±0.8％,(6.3 ±0.3) mmol/L,(10 ± 3) μmol/L,2.7 ±0.9,(1.04 ± 0.09) mmol/L,(4.3 ± 0.8) mmol/L,(2.3 ± 0.4) mmol/L,(1.22 ± 0.09) mmol/L at postoperative week 48 ; the levels of glycosylated hemoglobin,fasting glucose,fasting insulin,HOMA-IR,triglyceride,total cholesterol,low-density lipoprotein and high density lipoprotein in the LSG group were changed from 7.9％ ± 1.0％,(9.0±1.0)mmol/L,(21 ±9) μ mol/L,8.5 ±3.5,(2.09 ± 0.70) mmol/L,(6.0 ± 1.2)mmol/L,(3.9 ± 1.1) mmol/L,(1.06 ± 0.21) mmol/L before operation to 5.1％ ± 0.8％,(5.2 ± 0.4) mmol/L,(4 ± 1)μmol/L,0.9±0.2,(1.22±0.17)mmol/L,(4.2±0.8)mmol/L,(2.3 ±0.6)mmol/L,(1.30±0.13)mmol/L at postoperative week 48.There was a decrease trend of the glycosylated hemoglobin,fasting glucose,fasting insulin,HOMA-IR,trigluceride,total cholesterol and low density lipoprotein and a increase trend of the high density lipoprotein in the 2 groups.There were significant differences in the levels of glycosylated hemoglobin,fasting glucose,fasting insulin,HOMA-IR,triglyceride,total cholesterol,low-density lipoprotein and high density lipoprotein between the 2 groups (F =57.650,74.270,36.750,42.960,10.870,30.650,32.560,11.490,P ＜0.05).The levels of glucose of the LAGB group at postoperative month 1 and 3 were influenced by BMI (b =0.543,0.753,P ＜ 0.05),while the levels of glucose of the LAGB group did not be influenced by BMI at postoperative month 6 and year 1 (b =0.130,0.222,P ＞0.05).The levels of glucose of the LSG group did not be influenced by BMI at postoperative month 1,3,6 and year 1 (b =0.185,0.035,0.212,0.126,P ＞0.05).Conclusions The efficacy of LSG is superior to LAGB for the treatment of obesity combined with type 2 diabetes mellitus.The efficacy of LAGB is correlated with the change of body weight,while the efficacy of LSG does not correlated with the change of body weight.

Objective To study the effect of p38MAPK on the activity and c-myc protein expression in rat acetaldehyde-induced hepatic stellate cell(HSC),and to investigate the alcoholic liver fibrosis related mechanism.Methods The different concentrations of SB203580 as the p38 specific blocker was adopted to conduct the intervention on rat acetaldehyde-induced HSC.The cellular mor-phological change was observed by the microscope.The cell proliferation was detected by MTT,the cell cycle was analyzed by flow cytometry(FCM),and the expression of c-myc protein was examined by the SABC method.Results (1)after acetaldehyde stimula-tion,HSC was increased in size and proliferated rapidly,but with the added SB203580 concentration increase,the cellular prolifera-tion was slowed down,the cells size was diminished and the deformed cells were increased.(2)The proliferation of acetaldehyde-in-duced HSC was inhibited by different doses of SB203580,and the higher concentration has the more significant inhibiting effect.(3) With the SB203580 concentration increase,the cells at the phase G0 and G1 were increased,while the cells at the phase S were de-creased,at the same time the expression positive rate of c-myc protein was decreased.Conclusion Blocking p38MAPK pathway ac-tivity could inhibit the proliferation of acetaldehyde-induced HSC,which may be related to the down-regulation of C-myc protein ex-pression and blocking the DNA synthesis in cells entering from G0/G1 phase to S phase.

Objective To investigate the prevalence of year-round respiratory viral infection in children with lower respiratory tract infection (LRTI), and the relationship between respiratory viral infection and allergen sensitization in exacerbating asthma. Methods A total of 231 hospitalized children with acute LRTI were investigated from May 2013 to April 2014. The 5 most common respiratory viruses were isolated from nasopharyngeal aspirate using multiplex reverse transcription-polymerase chain reaction, including respiratory syncytial virus (RSV), adenovirus (AV), parainfluenza virus (PIV), influenza virus (IFV) and rhinovirus (RV). Atopic sensitization was defined if more than 1 serum specific immunoglobulin E level measured using immunofluorescence experiment was over 0.35 IU/mL. Results RSV was the most common pathogen of bronchiolitis in hospitalized children through the year. RV or IFV infections were more prevalent in asthma exacerbations compared to other LRTIs. AV was more likely to cause pneumonia. RV and IFV were associated with asthma exacerbations in children with atopic sensitization, but not in nonatopic children. Conclusion RV and IFV are associated with hospitalization for asthma exacerbation in children with atopic sensitization.

Objective To identify the risk factors for severe acute lower respiratory infections (ALRI) in children and to provide scientific basis for prevention and treatment of ALRI. Methods Several databases including Pubmed, Databases-Medline (Ovid), Embase, CINAHL and Global Health Library, CNKI, VIP and Wanfang Date were searched (1990.1-2014.12) for references. All selected studies were about risk factors of ALRI in children. The screening and quality evalua? tion of the literature data was conducted independently by two reviewers according to the inclusion and exclusion criteria. Stata 11.0 software was used for Meta-analysis. Results Meta-analysis of 27 included literature showed that seven risk fac?tors were significantly associated with severe ALRI:low birth weight, lack of exclusive breastfeeding, crowded household, ex?posure to indoor air pollution, malnutrition, living in a house with smokers or smoking in pregnant and HIV-exposed unin?fected condition. Conclusion The above seven risk factors play the important role in the development of ALRI in children. Furthermore, it emphasizes the need for further studies investigating other potential risk factors to decrease the possibility of childhood ALRI.