[Summary] Nowadays ,obesity and diabetes mellitus have become an important worldwide public health problem. Bariatric surgery is an effective treatment method of morbid obesity and type 2 diabetes mellitus (T2DM ). Although nutrition‐related complications after surgery is relatively common ,these complications can be detected and prevented. The key is to establish a routine perioperative prophylaxis and postoperative long‐term monitoring system. Routine metabolic and nutritional monitoring is recommended after all bariatric surgical procedures ,which can help patients maintain long‐term weight loss ,timely detect and treat surgery‐related complications and improve clinical outcomes. In the present mini review ,the perioperative and postoperative nutrition management was introduced.

Phase angle (PA), derived by bioelectrical impedance analysis, has been used to evaluate nutritional status.It has a unique advantage in diagnosing early malnutrition related to diseases by the detection of human body cell membrane integrity and fluid composition change, and being associated with bad disease prognosis in part of clinical research.Because of its non-invasive, convenient, accurate and affordable technique, it has a wide prospect of clinical application.However, lack of uniform PA reference value somehow limited its application.We summarize the latest clinical research and application situation of PA, and explore the characteristics and the influence factors of PA in different disease group, in order to provide theoretical basis for the Chinese PA reference range.

Two human endometrial carcinoma cell lines, HEC-1-A and RL95-2, were treated with adiponectin,and then changes of cell count, apoptosis and cell cycle arrest were measured. The expression of phospho-AMPK(Thr172) and AMPK was determined by Western Blot. The results showed that adiponectin may exert direct anti-proliferative effects on HEC-1-A and RL95-2 cells by inducing cell cycle arrest and apoptosis, which may be mediated by AMPK pathway.

Objective To discuss spinal fusion effect of lumbar intertransverse process in rabbits by using bone marrow stromal stem cells(MSCs)in conjunction with bone morphogenetic protein(BMP)and freeze-dried demineralized bone matrix(FDBM)as scaffold.Methods To separate and cultivate MSCs in vitro,with FDBM as scaffold,osteogenesis was induced by BMP.Sixty Japan white rabbits were randomly divided into three groups.Group A was MSCs+FDBM+BMP,group B was FDBM,group C was autogenous ilium cancellous bone(AIB).Lumbar intertransverse process was fused in lumbar five to six.Rabbits were killed at 8 weeks after operation.The general observation and imageology were used to assess the fusion condition.To estimate the implantation using DR image.Gray scale analysis of DR image caculated the osteogenic density and acreage.The CT scan and three-dimensional reconstruction was used to observe the fusion configuration of lumbar intertransverse process.Results The fusion mass character in group A and C was hard,the morphology was not regulation.The fusion mass was almost absorbed in group B beside little tissue approach transverse process.There were high density image between intertransverse processes,osteogenic density were nonuniform in group A and C.There were nonunion in group B.Consistent callus were existed between intertransverse process in group A and C.There were not consistent callus in group B.Group A was similar to group C in osteogenesis density and acreage.Group B was the worst.There were cartilage and newly born bone trabecular formation in group A and group C.Between transverse process were mainly fiber tissue in group B.Conclusion MSCs in conjunction with BMP and FDBM has the similar osteogenic capability to the AIB and better osteogenic capability than that of FDBM alone when spinal fusion of lumbar intertransverse process is performed in rabbits.

Objective To observe the immediate effects of the sustained forced-blowing exercise (SFBE) on the phonation function in young healthy people. Methods 43 young healthy people were asked to pronounce a longest /a/ in a comfortable situation within one breath for 3 times before and after SFBE. The sound files were analyzed with computer sound analysis system, with the parameters of mean maximum phonation time (MMPT), mean frequency (MF) and mean sound pressure level (MSPL). Results The MMPT and MSPL increased (P< 0.01) after SFBE. There was no significant difference in the MF (P>0.05) before and after SFBE. Conclusion The SFBE can improve the MPT and MSPL of the healthy people obviously, without affections on the MF.

Objective To investigate whether ultraviolet A UVA)-induced CatK expression is regulated by the mitogen-activated protein kinases (MAPK) signaling pathway in human dermal fibroblasts in vitro.Methods Human dermal fibroblasts were obtained from circumcised foreskin of children,and subjected to primary culture.After several passages of subculture,some fibroblasts were irradiated with UVA at a dose of 10 J/cm2.Western blot was performed to measure the expressions of total and phosphorylated JNK (t-and p-JNK) and P38 (t-and p-P38) at 0.75,1.5,3 and 6 hours after the irradiation.Some fibroblasts were divided into six groups:control group receiving no treatment,SP group treated with SP600125 of 800 nmol/L,SB group treated with SB203580 of 10 μmol/L,UVA group irradiated with UVA at a dose of 10 J/cm2,UVA-SP group treated with SP600125 for 1 hour before and for 1.5 or 48 hours after UVA irradiation at 10 J/cm2,UVA-SB group treated with SB203580 for 1 hour before and for 1.5 or 48 hours after UVA radiation at 10 J/cm2.Subsequently,Western blot was performed to determine the expressions of p-c-Jun and p-MAPKAPK2 in these groups at 1.5 hours after the UVA irradiation,and reverse transcription (RT)-PCR and Western blot to detect the mRNA and protein expressions of CatK at 48 hours after the UVA irradiation,respectively.Statistical analysis was carried out by t test,one way analysis of variance and least significant difference (LSD)-t test.Results The expression levels (gray values) of p-JNK and p-P38 were significantly increased at 0.75 hour (4.77 ± 0.19 and 2.44 ± 0.13 respectively,both P ＜ 0.05) and 1.5 hours (4.68 ± 0.09 and 2.30 ± 0.04 respectively,both P ＜ 0.05),but showed no significant changes at 3 hours (both P ＞ 0.05) and 6 hours (both P ＞ 0.05) after the UVA irradiation compared with those before the irradiation (3.2 ± 0.27 and 1.61 ± 0.08 respectively).A significant decrease was observed in the expression of p-c-Jun in the UVA-SP group and p-MAPKAPK2 in the UVA-SB group compared with the UVA group (p-c-Jun,2.55 ± 0.48 vs.4.85 ±0.96; p-MAPKAPK2,1.16 ± 0.12 vs.2.46 ± 0.09,both P ＜ 0.05).The CatK mRNA and protein expressions were attenuated by 61.1％ and 44.3％ respectively in the UVA-SP group (both P ＜ 0.05),and by 71.3％ and 50.4％ respectively in the UVA-SB group (both P ＜ 0.05) in comparison with the UVA group.The UVA-SP group also showed a significant reduction in CatK mRNA and protein expressions as compared with the UVA-SB group (both P ＜ 0.05).Conclusion Both JNK and P38 signaling pathways,especially the JNK pathway,may contribute to the upregulation of CatK expression in dermal fibroblasts induced by UVA irradiation.

Objective To observe the expression changes of cathepsin K (CatK) in human dermal fibroblasts at different time points after different doses of ultraviolet A (UVA) irradiation.Methods Dermal fibroblasts were isolated from circumcised foreskins of children,and subjected to primary culture and subculture.Cells at third-tenth passage were used in the following experiment.Some fibroblasts were irradiated with UVA of 10 J/cm2 and collected at 24,48 and 72 hours separately after the irradiation,and some fibroblasts were irradiated with UVA of 10,20 and 30 J/cm2 separately and harvested 48 hours later.The fibroblasts receiving no irradiation served as the control group.Reverse transcription PCR and Western blot were carried out to detect the mRNA and protein expressions of CatK in fibroblasts,respectively.Results Compared with the control fibroblasts,those irradiated with UVA of 10 J/cm2 showed a significant elevation in the mRNA and protein expression levels of CatK on day 1 (0.351 ± 0.038 vs.0.177 ± 0.006,1.76 ± 0.27 vs.0.82 ± 0.45,respectively,both P＜ 0.05),day 2 (0.510 ± 0.017 vs.0.176 ± 0.002,2.97 ± 0.36 vs.1.58 ± 0.15,respectively,both P＜ 0.05) and day 3 (0.313 ± 0.012 vs.0.173 ± 0.002,2.23 ± 0.14 vs.1.29 ± 0.32,respectively,both P ＜ 0.05),with the highest expressions of CatK mRNA and protein observed on day 2.Within the range of 10-30 J/cm2,UVA enhanced the CatK mRNA and protein expression levels in a dose-dependent manner.In detail,at 48 hours after the irradiation with UVA of 10,20 and 30 J/cm2,the CatK mRNA expression level in the irradiated fibroblasts was 2.34,2.91 and 3.18 times,and the CatK protein expression level 1.77,2.82 and 3.64 times,respectively,that in the control fibroblasts (all P ＜ 0.05).Conclusion The expression of CatK is up-regulated in human dermal fibroblasts after UVA irradiation.

Objective To investigate the incidence, clinical patterns, and species distribution of pathogenic fungi of onychomyeosis in patients with chronic viral hepatitis (CVH), and to analyze the relationship between onychomycosis and CVH. Methods From November 2005 to October 2006, direct microscopy and fungal culture were performed on nail samples from CVH patients with clinically suspected onychomycosis in the two largest institutions for communicable disease control in Guangzhou city. The incidence, clinical patterns, and species distribution of pathogenic fungi of onychomycosis were assessed based on the findings in mycologic examinations. Results The study randomly recruited 995 patients with CVH, and onychomycosis was diagnosed in 116 patients. The incidence of onychomycosis was 11.66% in total, 6.20%, 8.59%, 14.09%, 19.67% in patients with mild, moderate, severe and extremely severe CVH respectively, 7.09%, 17.29%, 19.13% and 27.27% in patients with a clinical course of CVH of 0.5-9 years, 10-19 years, 20-29 years, ≥30 years respectively. The most common clinical pattern was distal and lateral subungual onychomycosis (DLSO, 69.83%), followed by total dystrophic onychomycosis (TDO, 14.66%). Among the pathogenic fungi, dermatophytes amounted to 71.43%, yeasts 21.43%, moulds 7.14%, and Trichophyton rubrum was the most frequently isolated fungus (42.86%). Conclusions The incidence of onychomycosis in patients with CVH is correlated with the severity and course of CVH. Among these patients, the most common clinical pattern is DLSO with the most frequent fungal species being dermatophytes and predominant fungal isolate being Trichophyton rubrum.

Objective To evaluate the technical feasibility and clinical efficacy of retroperitoneal and transperitoneal laparoscopic nephrectomy for nonfunctional kidney with giant hydronephrosis. Methods The clinical data of retroperitoneal group (26 patients) and transperitoneal group (23 patients) who underwent laparoscopic nephrectomy for nonfunctional kidney with giant hydronephrosis were analyzed retrospectively. Compared with operating time,kidney size, blood loss, postoperative intestinal function recovery time, postoperative hospital stay and operative efficacy of the two groups. Results All the operations were performed successfully. Operating time,kidney size and blood loss were not significantly different between two groups(P＞ 0.05). While in retroperitoneal group, postoperative intestinal function recovery time and postoperative hospital stay were significantly reduced than those in transperitoneal group [( 18.0 ± 1.2)h vs. (48.0 ±2.0) h, (5.5± 1.6) d vs. (7.5 ± 1.6) d](P＜0.05). All patients were followed up 1 -3months,no abnormal. Conclusions The retroperitoneal and transperitoneal laparoscopic nephrectomy for nonfunctional kidney with giant hydronephrosis can be performed efficiently and effectively. Retroperitoneal laparoscopic is better than transperitoneal laparoscopic on postoperative recovery aspects.

Objective To investigate the use of parenteral nutrition in hospitalized patients and to examine the process of care of patients receiving parenteral nutrition (PN) in hospital, in light of European Nutrition Day study, and to preliminarily explore the possible main risk factors for complications.Methods We recruited 314 adult hospitalized patients (≥18 years) requiring PN on a predetermined day (November 25, 2013) in 6 hospitals in Beijing and investigated their disease status, nutrition risk, the use of PN and venous infusion related complications using the European Nutrition Day survey questionnaire.Results Of the 314 patients, 311 completed the survey.In the 311 patients, the proportion of patients who received PN of all-in-one mixed preparation was 76.2％ (237/311), the proportion of patients receiving multibottle system was 23.8％ (74/311);PN was administered via central vein in 56.8％ (171/301) of the patients and via peripheral veins in 43.2％ (130/301) of the patients.The mean duration of infusion was (12.5 ±5.1) hours.The ratio of glucose to fat was 0.84 and the ratio of non-protein to calories 531.1.The total energy provision was less than the recommended intake.38.6％ (120/311) of the patients reported that PN infusion would affect activity, and 33.4％ (104/311) thought PN affected their sleep, and the incidence of infusion-related pain was 19.9％ (62/311).Multivariate analysis result showed that the most important factors of infusion-related pain were intravenous route of PN (x2 =25.911,P =0.000) and total venous infusion volume (x2 =6.053, P =0.014).Conclusions The total energy provision of PN is generally inadequate in hospitalized patients in Beijing.The key factor for reducing transfusion-related pain and enhancing PN tolerance is to establish appropriate infusion route.