OBJECTIVE: To evaluate the effectiveness of laparoscopic Roux-en-Y gastric bypass (LRYGB) surgery for treatment of type 2 diabetes (TD) in patients with a body mass index (BMI) < 27.5 kg/m. METHODS: We retrospectively analyzed the data of patients who underwent LRYGB surgery from March, 2012 to June, 2018 in the General Hospital of Guangzhou Military Command and Jinshazhou Hospital of Guangzhou University of Chinese Medicine. The changes in the parameters of glucose metabolism and physical indicators of the patients in the first, second and third years after the surgery were analyzed in patients in low BMI group and high BMI group. RESULTS: All the 74 patients underwent LRYGB successfully without conversion to open surgery. One year after the surgery, fasting blood glucose (FBG), HbA1c, postprandial blood glucose, fasting insulin, HOMA-IR, fasting C-peptide, BMI, body weight and waistline were significantly improved compared with their preoperative values in low BMI group ( < 0.05). At 2 years after the operation, FBG, HbA1c, postprandial blood glucose, HOMA-IR, BMI, body weight and waistline were significantly improved compared with the preoperative values in low BMI group ( < 0.05). In the third year, FBG, HOMA-IR, fasting C-peptide, body weight and waistline were significantly improved compared with the preoperative values in low BMI group ( < 0.05). There was no significant difference in the parameters of glucose metabolism and islet function between low BMI group and high BMI group at different stages. No serious complications occurred in these patients after the surgery. CONCLUSIONS LRYGB is effective for treatment of T2D in Chinese patients with a BMI < 27.5. After the surgery, the patient show reduced waistline without significant weight loss. The long-term results of the surgery still require further investigations with a larger samples and longer follow-up.
Body Mass Index ; Diabetes Mellitus, Type 2 ; surgery ; Gastric Bypass ; statistics & numerical data ; Humans ; Laparoscopy ; Retrospective Studies ; Treatment Outcome ; Weight Loss

OBJECTIVE: To evaluate the effectiveness of laparoscopic Roux-en-Y gastric bypass (LRYGB) surgery for treatment of type 2 diabetes (TD) in patients with a body mass index (BMI) < 27.5 kg/m. METHODS: We retrospectively analyzed the data of patients who underwent LRYGB surgery from March, 2012 to June, 2018 in the General Hospital of Guangzhou Military Command and Jinshazhou Hospital of Guangzhou University of Chinese Medicine. The changes in the parameters of glucose metabolism and physical indicators of the patients in the first, second and third years after the surgery were analyzed in patients in low BMI group and high BMI group. RESULTS: All the 74 patients underwent LRYGB successfully without conversion to open surgery. One year after the surgery, fasting blood glucose (FBG), HbA1c, postprandial blood glucose, fasting insulin, HOMA-IR, fasting C-peptide, BMI, body weight and waistline were significantly improved compared with their preoperative values in low BMI group ( < 0.05). At 2 years after the operation, FBG, HbA1c, postprandial blood glucose, HOMA-IR, BMI, body weight and waistline were significantly improved compared with the preoperative values in low BMI group ( < 0.05). In the third year, FBG, HOMA-IR, fasting C-peptide, body weight and waistline were significantly improved compared with the preoperative values in low BMI group ( < 0.05). There was no significant difference in the parameters of glucose metabolism and islet function between low BMI group and high BMI group at different stages. No serious complications occurred in these patients after the surgery. CONCLUSIONS LRYGB is effective for treatment of T2D in Chinese patients with a BMI < 27.5. After the surgery, the patient show reduced waistline without significant weight loss. The long-term results of the surgery still require further investigations with a larger samples and longer follow-up.
Body Mass Index ; Diabetes Mellitus, Type 2 ; Gastric Bypass ; Humans ; Laparoscopy ; Obesity, Morbid ; Retrospective Studies ; Treatment Outcome ; Weight Loss

OBJECTIVE: To explore the association between expression of ADAM17 and cetuximad resistance in human colorectal cancer SW480 cells. METHODS: The expression of ADAM17 was detected using Western blotting in different human colorectal cancer cell lines, and the cells highly expressing ADAM17 were selected as the target cells. SW480 cells were transfected with ADAM17-siRNA 1 and ADAM17-siRNA 2 and the changes in the expression of ADAM17 protein were detected using Western blotting. SW480 cells were exposed to cetuximad for 24 h and the cell apoptosis was analyzed using flow cytometry. Transwell assay was used to examine the migration ability of SW480 cells with different expression levels of ADAM17; Western blotting was used to analyze the changes in the expressions of AKT signaling pathway-related proteins in the treated cells. RESULTS: The baseline expressions of ADAM17 were significantly higher in SW480 cells than in the other human colorectal cancer cell lines tested ( < 0.05). Both ADAM17-siRNA 1 and 2 effectively reduced the expression of ADAM17 protein in SW480 cells. Knockdown of ADAM17 with siRNA 1 significantly increased the sensitivity of SW480 cells to tocetuximad ( < 0.05), obviously inhibited the cell proliferation, migration and invasion, and significantly reduced the expressions of p-EGFR and p-AKT in the cells ( < 0.001). CONCLUSIONS ADAM17 knockdown obviously inhibits EGFR-AKT signaling pathway and increases the sensitivity of SW480 cells to tocetuximad.
ADAM17 Protein ; genetics ; metabolism ; Antineoplastic Agents, Immunological ; pharmacology ; Apoptosis ; Cell Line, Tumor ; Cell Movement ; Cell Proliferation ; Cetuximab ; pharmacology ; Colorectal Neoplasms ; drug therapy ; genetics ; metabolism ; pathology ; Drug Resistance, Neoplasm ; genetics ; ErbB Receptors ; metabolism ; Gene Knockdown Techniques ; Humans ; Neoplasm Invasiveness ; Oncogene Protein v-akt ; metabolism ; RNA, Small Interfering ; Signal Transduction ; Transfection ; methods

Objective To evaluate the safety and short‐term efficacy of delta‐shaped anastomosis in the Billroth‐I reconstruc‐tion of totally laparoscopic distal gastric cancer radical operation (TLDG) .Methods The clinical data in 35 patients with TLDG Delta anastomosis(TLDG group) and 35 patients with laparoscopic assisted distal gastric cancer radical operation (LADG) extraper‐itoneal anastomosis (LADG group) in the gastroenterology department of our hospital from January to December 2014 were ana‐lyzed retrospectively .The intraoperative bleeding volume ,operative time ,gastroenterological function recovery time ,hospitalization duration ,postoperative pathological examination results and hospitalization total cost were compared between the two groups .Re‐sults Seventy cases successfully completed the operation without the cases of conversion to laparotomy and death .The TLDG group had no anastomotic leakage ,bleeding and stenosis after operation ;while the LADG group had 1 case of gastroparesis ,1 case of anastomotic bleeding and 2 cases of anastomotic leakage .The introperative bleeding volume ,tumor size ,number of lymph nodes dissection and distant and proximal incisal margin distance had no statistically significant differences between the two groups (P>0 .05);the operation time ,digestive tract reconstruction time ,first exhaustion time ,time taking liquid diet and postoperative hospital stay time in the TLDG group were significantly shorter than those in LADG group (P< 0 .05) ,but the hospitalization cost was higher than that in the LADG group ,the differences were statistically significant (P<0 .05) .Conclusion The delta‐shaped anasto‐mosis technique is safe and feasible for using in LADG ,moreover has better short‐term effect .

Objective To detect the effect of chitosan gel on rectal injury which was induced by acetic acid. Methods 36 rats were anesthetized, 4% acetic acid swab was placed into the rectum (3 cm in depth for 1 min) to establish rectum injury model. These rats were divided into model control group, positive control group and drug group with 12 rats each group randomly. Chitosan gel was given to the drug group through anus with the dose of 1 575 mg·kg-1 , and hemorrhoid cream (1 575 mg·kg-1 ) was administered in the positive control group for 6 successive days. At 30 min, 1, 4, 6 day( s) after administration, 3 rats of each group were sacrificed, and were dissected, rectal injury and rectal pathology morphology changing of each group at different time points of administration were compared through visual observation. Results At 30 min, 1, 4, and 6 day(s) after administrating chitosan gel, score of rectum mucosa injury in dury group was lower than those in model control and positive control group. Pathological changes ( including epithelial tissue necrosis, mesenchyme hyperemia, hemorrhage, edema, gland injury, infiltration of inflammatory cells) were significantly slighter in drug group than in model control group and positive control group. Those lesions were restored faster in drug group than in model control group and positive control group, and there was no obvious scar. Conclusion Chitosan gel can obviously alleviate the rectal injury caused by 4% acetic acid and has therapeutic effect.

AT motif binding factor 1 (ATBF1) gene,is a new tumor suppressor gene,and one of its expression variants by alternative splicing,known as ATBF1-A,can bind to the enhancer AT-rich element of alpha fetoprotein (AFP) and down-regulate the transcription of AFP,which may suppress the development and induce the apoptpsis of some carcinoma cells.In this review,we attempted to analysis the pathway of ATBF1 behaves with other factors and its multiple biological functions;ATBF1 function as a suppressor gene,it was illustrated for the influence on the growth and invasion of breast,prostate or gastric cancer.We also discussed the application of the ATBF1 level function as a cancer predictor,and forecasted the significance to apply ATBF1 for the therapy of cancer.

The lack of depth perception and spatial orientation in two-dimensional image of traditional laparoscopy require long-term training of the surgeons. Three-dimensional (3D) laparoscopy provides stereoscopic visions as compared to monocular views in a traditional laparoscopic system. In this review, the authors summarize the clinical application of 3D laparoscopy and its current research progress.
Imaging, Three-Dimensional ; instrumentation ; methods ; Laparoscopy ; methods

OBJECTIVETo investigate the clinical value of three-dimensional (3D) high-definition (HD) laparoscope in laparoscopic radical resection of gastric cancer.

METHODSFrom January to December, 2013, 40 patients underwent radical resection of gastric cancer with 3D HD laparoscopy (3D group) and another 40 patients received 2D HD laparoscopy (2D group). The duration of surgery, intra-operative blood loss, learning curve, and costs during hospitalization were compared between the two groups.

RESULTSThe average operation duration of 3D group was 2.8=0.6 h, significantly shorter that in the 2D group (3.2=0.8 h, P<0.05); the intraoperative blood loss in the 3D group was significantly less than that in the 2D group (110=18 ml vs 120=21 ml, P>0.05). The mean hospitalization cost was 75 000=16 000 RMB Yuan in 3D group, similar to significantly lower than that of 71 000=13 000 RMB Yuan in 2D group (P>0.05).

CONCLUSION3D HD laparoscopy can provide three-dimensional vision and better sense of depth to facilitate precise operation and shorten the operation time. The high-definition 3D vision also allows surgeons to quickly improve surgical skills and shorten the learning curve.

Adult ; Aged ; Aged, 80 and over ; Humans ; Imaging, Three-Dimensional ; Laparoscopy ; methods ; Middle Aged ; Stomach Neoplasms ; surgery

OBJECTIVETo explore the safety, efficacy and feasibility of 3D laparoscopic subtotal thyroidectomy via a breast approach.

METHODSThe clinical data of 30 patients undergoing 3D laparoscopic subtotal thyroidectomy via a breast approach were analyzed in comparison with 30 patients receiving traditional laparoscopic subtotal thyroidectomy during the period from September, 2013 to December, 2013. The operation time, blood loss, postoperative drainage, postoperative hospital stay, and total hospitalization expenses were compared between the two groups.

RESULTSThe operation time in the 3D group was significantly shorter than that in the 2D group (45∓26.3 vs 62∓24.8 min, t=0.53, P<0.05). The intraoperative blood loss, postoperative drainage, postoperative hospital stay and total hospitalization expenses did not show significant differences between the two groups.

CONCLUSIONS3D laparoscopic subtotal thyroidectomy via a breast approach is safe and effective and shortens the operation time, and can be used as a routine operation for subtotal thyroidectomy.

Blood Loss, Surgical ; Breast ; Drainage ; Humans ; Laparoscopy ; methods ; Length of Stay ; Postoperative Period ; Thyroidectomy ; methods

OBJECTIVETo investigate Runx3 and C-myc expressions in colorectal cancer and their relationship with the clinicopathological parameters.

METHODSReal-time quantitative PCR was used to detect Runx3 and C-myc mRNA expressions in 38 colorectal cancer tissues and matched adjacent tissues, and Runx3 and C-myc expressions was detected by Western blotting in 63 pairs of colorectal cancer and adjacent tissues. The results were stratified according to the clinicopathological characteristics to examine the relationship of Runx3 and C-myc expressions with the clinicopathological factors in the patients.

RESULTSRunx3 expression was down-regulated and C-myc expression up-regulated at both mRNA and protein levels in colorectal cancer tissues compared with the normal tissues, and their protein expressions exhibited an inverse correlation (r=-0.398, P=0.001). Runx3 and C-myc expressions differed significantly between tumors with different Dukes stages, depths of tumor invasion, lymph node statuses, or histological differentiation (P<0.05); Runx3 down-regulation and C-myc up-regulation were more obvious in tumors in advanced Dukes stage and in poorly differentiated tumors.

CONCLUSIONAbnormal expressions in Runx3 and C-myc may contribute to the occurrence and development of colorectal cancer and are closed correlated with the patient's clinicopathological parameters.

Blotting, Western ; Cell Differentiation ; Colorectal Neoplasms ; genetics ; metabolism ; Core Binding Factor Alpha 3 Subunit ; genetics ; metabolism ; Down-Regulation ; Humans ; Proto-Oncogene Proteins c-myc ; genetics ; metabolism ; RNA, Messenger ; Real-Time Polymerase Chain Reaction ; Up-Regulation