Plant extracts in prevention of obesity.

Obesity has become a worldwide issue and is accompanied by serious complications. Western high energy diet has been identified to be a major factor contributing to the current obesity pandemic. Thus, it is important to optimize dietary composition, bioactive substances, and agents to prevent and treat obesity. To date, extracts from plants, such as vegetables, tea, fruits, and Chinese herbal medicine, have been showed to have the abilities of regulating adipogenesis and attenuating obesity. These plant extracts mainly contain polyphenols, alkaloids, and terpenoids, which could play a significant role in anti-obesity through various signaling pathways and gut microbiota. Those reported anti-obesity mechanisms mainly include inhibiting white adipose tissue growth and lipogenesis, promoting lipolysis, brown/beige adipose tissue development, and muscle thermogenesis. In this review, we summarize the plant extracts and their possible mechanisms responsible for their anti-obesity effects. Based on the current findings, dietary plant extracts and foods containing these bioactive compounds can be potential preventive or therapeutic agents for obesity and its related metabolic diseases.

Effect of Perinatal Bisphenol A Exposure on Serum Lipids and Lipid Enzymes in Offspring Rats of Different Sex.

Rats were exposed to 1 or 10 µg/mL bisphenol A (BPA) in water during pregnancy and lactation. Offspring rats were given normal water and a standard diet from weaning to postnatal day (PND) 50. Perinatal exposure to BPA resulted in significantly increased body weight, visceral adipose tissue, abnormal serum lipids, and lower adiponectin (ADP) levels in both female and male offspring rats. Liver adipose triglyceride lipase (Atgl) mRNA levels and ADP protein in visceral adipose tissue were significantly decreased in BPA-exposed offspring rats. In both female or male offspring rats, obesity and dyslipidemia induced by perinatal exposure to BPA were associated with down regulation of Atgl mRNA in liver and ADP protein in visceral adipose tissue.

[Effects of combined drought and salinity stress on germination and physiological characteristics of maize (Zea mays).] / 旱-盐复合胁迫对玉米种子萌发和生理特性的影响.

In this study, 15% PEG, 100 mmol·L-1 NaCl and PEG-NaCl mixed solution were employed to respectively simulate the drought (D), salinity (S) and the combined stress (D+S), and effects of these three stresses on the seed germination and the physiological characteristics of seedlings were investigated. The results showed that seed germination, seedling growth and biomass accumulation were significantly inhibited by these three stresses, and the impact of stress ranked as D>D+S>S. The content of reactive oxygen species like H2O2 and O-·2, as well as malondialdehyde (MDA) and membrane permeability were increased under these stresses, meanwhile, proline (Pro), soluble sugar and soluble proteins contents were significantly improved, which were higher in seedlings than in roots with a rank of D>D+S>S. The activities of antioxidant enzymes such as superoxide dismutase (SOD), peroxide (POD), catalase (CAT) and ascorbate peroxide (APX) were also obviously increased. In addition, SOD and APX induced by PEG-NaCl mixed solution were ranked in the middle compared to those induced by their single stress, but POD and CAT were more induced by PEG-NaCl mixed solution than their single stress. It was demonstrated that effect of drought-salinity combined adverse condition on maize seed germination and seedlings physiological characteristics were not simply additive of their single stress, compared with their single stress, drought-salinity combined adverse condition could reduce the effects of drought stress on maize seeding to a certain extent.

Highly expressed MT-ND3 positively associated with histological severity of hepatic steatosis.

Hepatic steatosis is the accumulation of an excess amount of triglycerides and other fats inside liver cells resulting from abnormal hepatic lipid metabolism. Mitochondrial structural and molecular defects are involved in the progression of hepatic steatosis pathogenesis. Hepatic methylation and transcriptional activity of the mitochondrial-encoded NADH dehydrogenase (MT-ND) play a critical role in the progression of non-alcoholic fatty liver disease (NAFLD). However, the expression of MT-ND3 in hepatic steatosis has not been extensively studied. In this study, liver specimens were collected from different patients, and were subjected to immunohistochemistry. Primary hepatocytes were treated with oxidative stress, hypoxia, and lipotoxicity to investigate the respective roles of these factors on MT-ND3 expression and cell apoptosis by western blotting and flow cytometry, respectively. We found that increased MT-ND3 expression in human hepatic steatosis was positively associated with histological severity of hepatic steatosis. Hypoxia, H2O2 , and saturated fatty acid treatment induced cell apoptosis mediated by mitochondria. These three factors all had effects on MT-ND3 expression in cultured hepatocytes. Taken together, MT-ND3 may play important roles in hepatic steatosis progress. Hypoxia, oxidative stress, and lipotoxicity could all influence expression of MT-ND3 and thus may play a role in the progression of hepatic steatosis.

Simultaneous laparoscopic excision for rectal carcinoma and synchronous hepatic metastasis.

BACKGROUND: Rectal carcinoma patients are often accompanied by hepatic metastasis. The aim of this study was to evaluate the therapeutic efficacy of simultaneous laparoscopic excision for rectal carcinoma with synchronous hepatic metastasis. METHODS: A total of 41 patients with rectal carcinoma and synchronous hepatic metastasis detected by CT scan were included in this study. Among them, 23 patients underwent laparoscopic surgery and 18 patients underwent traditional open surgery to simultaneously remove the rectal tumor and hepatic metastasis lesions. All patients received postoperative adjuvant chemotherapy. All the patients were followed up from 36 to 72 months (mean 45.3 months). RESULTS: All the operations were performed successfully and no patient was turned to open surgery in laparoscopic group. The mean blood loss, the mean postoperative hospital stay, the mean blood transfusion and the mean intestinal functional recovery time showed a significant difference between the two groups (P < 0.05). The 1-, 3- and 5-year survival rates were 82.6%, 43.5% and 8.6% in the laparoscopic group, without significant difference compared with the open group (77.8%, 38.9% and 0) (P > 0.05). CONCLUSIONS: Simultaneous laparoscopic excision for rectal carcinoma and synchronous hepatic metastasis is safe and effective with similar survival achieved by the traditional open abdominal surgery.

[Applied anatomy of the inguinal region and laparoscopic inguinal hernia repair].

OBJECTIVE: To investigate the regional anatomy of the inguinal region and abdominal ring and provide accurate anatomic basis for the clinical application of total peritoneum intraperitoneal onlay mesh (TPIPOM). METHODS: The structures of the inguinal region and those surrounding the abdominal ring of 18 cadavers (11 males and 7 females, 36 sides) were dissected to measure the lengths from the nerves and vessels to the corresponding anatomical landmarks. RESULTS: The average distances from the point where the iliohypogastric nerve (IHN) ran through the obliquus internus abdominis to anterosuperior iliac spine and from the point where the IHN ran through the aponeurosis of the external oblique muscle of the abdomen to the superior margin of the symphysis pubica were 4.10±0.89 cm and 5.02±1.46 cm, respectively. The average distances from the point where the ilioinguinal nerve (IGN) ran through the obliquus internus abdominis to the anterosuperior iliac spine and from the point where IGN ran through the aponeurosis of the external oblique muscle of the abdomen to the superior surface of the tuberculum pubicum were 3.09±0.81 cm and 3.84±0.89 cm, respectively. We established the regional anatomy model of the structures surrounding the abdominal ring. CONCLUSION: The quantitative measurement of important structures of the inguinal region and establishment of the regional anatomy model of the surrounding structures of the abdominal ring can provide a valuable reference to reduce intraoperative and postoperative complications of TPIPOM.

[Effect of ROUX-en-Y anastomosis and Billroth-II anastomosis after subtotal gastrectomy on blood glucose in type 2 diabetic patients].

OBJECTIVE: To evaluate the effect of ROUX-en-Y anastomosis and Billroth-II anastomosis after subtotal gastrectomy on blood glucose in patients with type 2 diabetes. METHODS: From January 2006 to December 2009, 26 and 24 type 2 diabetic patients underwent subtotal gastrectomy for gastric cancer or gastric ulcer and received subsequent ROUX-en-Y anastomosis and Billroth-II anastomosis, respectively. Perioperative and postoperative blood glucose and glycosylated hemoglobin (HbA1c) were detected in these patients to identify the variations. RESULTS: In ROUX-en-Y group, the fasting blood glucose (FBG) of the patients decreased significantly in the first month after the operation (t=4.46, P<0.05), and the 2-hour postprandial glucose (2hPG) and HbA1c also underwent significant reductions in the first postoperative week and month, respectively (t=3.5, P<0.05; t=2.21, P<0.05). In Billroth-II group, the FBG decreased significantly till 6 months after the operation (t=2.0, P<0.05), and HbA1c reduction occurred 3 months after the operation (t=2.61, P<0.05). There were significant differences in FBG in the first postoperative month, 2hPG in the 6th month, and HbA1c in the 3rd month between the two groups (P<0.05). CONCLUSION: The ROUX-en-Y anastomosis and Billroth-II anastomosis after subtotal gastrectomy can both reduce blood glucose of type 2 diabetic patients, but the former approach has better effect.

[Immunological influence of iodine-125 implantation in patients with hepatocellular carcinoma resection].

OBJECTIVE: To investigate the effect of iodine-125 implantation on immune cell subsets and cytokine production in patients undergoing hepatocellular carcinoma (HCC) resection. METHODS: Sixty-eight patients with resectable HCC were randomly divided into intrahepatic iodine-125 embedding group and control group. The percentages of T lymphocyte phenotypes (CD3(+), CD4(+), CD8(+)), NK cells, and the plasma concentrations of IL-4, IL-10, IL-12 and IFN-gamma of the patients were determined with flow cytometry and ELISA, respectively. RESULTS: In the control group, the postoperative CD3(+) and CD4(+) immunocytes were (39.38-/+6.98)% and (24.34-/+3.18)%, significantly lower than the preoperative levels [(62.58-/+8.67)% and (30.63-/+4.19)%, respectively, P<0.05)]. The postoperative concentrations of IL-4 and IL-10 were (29.83-/+7.99) and (87.54-/+2.89) ng/L, significantly higher than the preoperative levels (10.35-/+8.76 and 64.25-/+2.54 ng/L, respectively, P<0.05). In the treatment group, the percentages of the immunocytes and cytokine concentrations underwent no significant changes after the operation, but postoperative IL-12 (89.46-/+11.43 ng/L) and IFN-gamma (47.78-/+5.45 ng/L) levels were significantly higher than the preoperative levels (36.13-/+9.16 and 7.14-/+2.17 ng/L, respectively, P<0.05). Significant differences were found between the two groups in the postoperative CD3(+) and CD4(+) immunocytes and IL-4, IL-10, IL-12 and IFN-gamma levels. CONCLUSION: Iodine-125 implantation can strongly stimulates the anti-tumor immune response in HCC patients by increasing CD3(+) and CD4(+) immunocytes and promoting Th2/Th1 deviation.

[Laparoscopy combined with endoscopic and digital subtraction angiography for treatment of severe acute pancreatitis].

OBJECTIVE: To study the effect of laparoscopy combined with endoscopic and digital subtraction angiography in the treatment of severe acute pancreatitis (SAP). METHODS: Nine-seven SAP patients were randomly divided into group A (n=32) with conventional treatment and group B (n=35) with combined treatment with laparoscopy, endoscopic and digital subtraction angiography in addition to the conventional treatment. The clinical indices and therapeutic effects in the 2 groups were compared. RESULTS: After treatment, the patients in group B had significantly lower APACHE score than those in group A (P<0.05), with also better hepatic, renal and lung functions (P<0.05). The serum TNF-alpha and IL-1beta levels was significantly lower, but IL-10 significantly higher in group B (P<0.05). The CT SPN was significantly lowered in group B as compared with that in group A (P<0.05). The patients in group B had significantly lower rate of organ failure (P<0.01) and higher successful rate in organ failure management (P<0.05), with also lowered inhospital mortality than those in group A (P<0.05). CONCLUSION: Laparoscopy combined with endoscopic pancreaticobiliary duct drainage and digital subtraction angiography in addition to conventional treatment significantly improves the outcome and decreases the mortality of SAP patients.

[Simultaneous laparoscopic excision for the treatment of rectal carcinoma and the synchronous hepatic metastasis].

OBJECTIVE: To evaluate the therapeutic efficacy of simultaneous laparoscopic excision for the treatment of rectal carcinoma and synchronous hepatic metastasis. METHODS: Totally 38 patients with rectal carcinoma and synchronous hepatic metastasis detected by CT scan were included in this study. Among them, 23 patients in the group A were treated with laparoscopic surgery, and the other 18 patients in the group B with traditional abdominal operation to resect the rectal tumor and hepatic metastasis simultaneously. All patients received postoperative chemotherapy. RESULTS: All the patients were treated successfully with no postoperative death in both groups. The mean operative time was 350 +/- 45 min in group A versus 342 +/- 38 min in group B (P > 0.05). The mean blood loss was 275 +/- 96 ml in group A versus 590 +/- 85 ml in group B (P < 0.01), and the average hospital stay was 12 +/- 1.5 days in group A versus 16 +/- 2.5 days in group B (P < 0.05). Only one patient in group A received blood transfusion of 200 ml during operation, while the average blood transfusion in group B was 500 +/- 100 ml (P < 0.01). The follow-up duration was from 36 to 72 months with an average duration of 45.3 months. The 1-, 3- and 5-year survival rates were 82.6%, 43.5% and 8.6% in the group A, versus 77.8%, 38.9% and 0% in group B, respectively (P > 0.05). CONCLUSION: Simultaneous laparoscopic excision of rectal carcinoma and synchronous hepatic metastasis is safe, effective and minimally invasive with a similar survival achieved by traditional open abdominal operation.

[Laparoscopic placement of total peritoneum intraperitoneal onlay mesh in patients with inguinal hernia].

OBJECTIVE: To study the efficacy of laparoscopic placement of total peritoneum intraperitoneal onlay mesh (TPIPOM) for treatment of inguinal hernia. METHODS: TPIPOM was placed laparoscopically in 125 cases of inguinal hernia, and the clinical outcomes of the patients were observed and compared with 64 patients receiving transabdominal preperitoneal laparoscopic mesh repair (TAPP) and 53 with total extraperitoneal laparoscopic hernioplasty (TEP). RESULTS: The laparoscopic operations were successfully performed in all the patients. In TPIPOM, TAPP and TEP groups, the operating time was 30.8-/+10.3 min, 68.4-/+22.4 min and 69.5-/+23.4 min (P<0.05), the mean hospital stay was 3.8-/+1.3 days, 4.3-/+1.5 days and 4.5-/+1.6 days (P<0.05), the average time to ambulation was 1.2-/+0.5 days, 1.8-/+0.7 days and 2.2-/+0.8 days (P<0.05), the duration of pain was 1.0-/+0.5 days, 1.6-/+0.9 days and 1.9-/+0.8 days (P<0.05), and the cost was 5000.8-/+800.5 yuan, 8000.5-/+950.6 yuan and 8900.2-/+750.3 yuan (P<0.05), respectively. No scrotum edema occurred in these patients. The patients were followed up for 59.9-/+6.5 months and recurrence was found. CONCLUSION: TPIPOM is safe and effective for management of inguinal hernia with such advantages as minimal invasion, simple procedures, shorter operation time, reduced relapse and quick recovery.

[Laparoscopy and digital subtraction angiography in the treatment of severe acute pancreatitis].

OBJECTIVE: To study the effect of laparoscopy and digital subtraction angiography in the treatment of severe acute pancreatitis (SAP). METHODS: Seventy-five SAP patients were randomly divided into tow groups: (1) Conventional treatment group (group A, n = 35); (2) Conventional treatment combined with laparoscopy and digital subtraction angiography treatment group (group B, n = 40). The clinical parameters and treatment results in the 2 groups were compared. RESULTS: After treatment, APACHE II score in group B was significantly lower than that in group A (P < 0.05). The functions of liver, renal and lung were recovered (P < 0.05, respectively), levels of serum TNF-alpha and IL-1 beta were significantly lower, but IL-10 significantly elevated (P < 0.05), the CT SPN was much lower (P < 0.05); rate of organ failure significantly decreased (P < 0.01), the successful rate of organ failure treatment was increased (P < 0.05); the in hospital mortality decreased (all P < 0.05). CONCLUSIONS: Laparoscopy and digital subtraction angiography in combination with conventional treatment for SAP significantly improves the outcome and decrease the mortality of SAP.

[Total colectomy and proctocolectomy under laparoscopic for familial adenomatous polyposis].

OBJECTIVE: To evaluate the efficacy and characteristics of treating familial adenomatous polyposis (FAP) by total colectomy and proctocolectomy under laparoscopy. METHODS: The perioperative data, including surgical outcomes, safety, and recovery of 8 FAP patients, 5 males and 3 females, aged 39 (28 approximately 65), who underwent laparoscopic total colectomy and proctocolectomy were analyzed retrospectively and follow-up of 46.8 months (32 approximately 58 months) between April 2001 and January 2003 were analyzed and compared with the data of 6 patients undergoing conventional open surgery before 2001. RESULTS: Laparoscopic total colectomy and proctocolectomy were performed successfully without severe complications on the 8 patients. The mean operation time of the laparoscopy group was 178 min, not significantly different from that of the conventional group (170 min, P>0.05). The mean intra-operative blood loss, anal exsufflation time, and hospital stay, and incision length of the laparoscopy group was 110 ml, 1.2 d, 12.5 d, and 0 cm, all significantly shorter than those of the conventional group (211 ml, 3.1 d, 17.4 d, and 22.3 cm, P<0.05 or P<0.01). Follow-up showed no local recurrence. The function of stool controlling was good 9 months after the operation. CONCLUSION: With less trauma and pain, rapid recovery, and shorter hospital stay, laparoscopic total colectomy and proctocolectomy is feasible and safe for FAP. It must be performed by skilled and experienced surgeons.

[Laparoscopic high ligation of hernia sac and median umbilical fold covering internal ring in treating pediatric indirect inguinal hernia].

OBJECTIVE: To investigate the effect and clinic practice of laparoscopic high ligation of hernia sac and median umbilicus fold covering internal ring in pediatric indirect inguinal hernia. METHODS: Five hundred and fifty-two children with indirect inguinal hernia were randomly divided into group A (control group) and group B (combination group) according to their check-in dates (odd or even). In group A, 275 children were treated with laparoscopic high ligation of hernia sac. In group B, 277 children were treated with laparoscopic high ligation of hernia sac and suturing the median umbilical fold to internal ring. RESULTS: The operation was successfully performed in all 552 patients. The operating time in group A and B were (12.3 +/- 5.5) min and (20.6 +/- 4.2) min (P<0.05) respectively; and the hospital stay were (2.2 +/- 1.5) d and (2.4 +/- 1.3) d (P>0.05); the day of restoring normal active were (1.2 +/- 0.5) d and (1.3 +/- 0.6) d (P>0.05); the recurrence rate were 2.2% (6/275) and 0 (0/277) (P<0.05). No complications, such as abdominal cavity infection and scrotum hematoma occurred during the follow-up of 22 months to 55 months. CONCLUSIONS: Laparoscopic high ligation of hernia sac and median umbilical fold covering internal ring is safe and effective in treating indirect inguinal hernia of the children.

[Endoscopic thyroidectomy: a comparison of the trans-axilloareolar approach and the trans-thoracoareolar approach].

OBJECTIVE: To evaluate the advantages and shortcomings of endoscopic thyroid surgery by trans-axilloareolar approach and trans-thoracoareolar approach. METHODS: Endoscopic thyroidectomy was performed in 238 cases from December 2003 to January 2006. The patients were randomly divided into two groups. One hundred and twenty-three patients received the trans-axilloareolar approach and 115 patients randomly received the trans-thoracoareolar approach procedure. RESULTS: All the operations were succeed. The operating duration of trans-axilloareolar approach group and trans-thoracoareolar approach group were (69 +/- 29) min and (70 +/- 25) min (P > 0.05), the blood lost were (38 +/- ll) ml and (40 +/- 13) ml (P > 0.05), the average hospitalized days were (4 +/- 1.3) d and (4.5 +/- 1.2) d (P > 0.05), the rate of satisfaction with the cosmetic effects of the procedures were 97.5% and 85.2% (P <0. 05). There were no conversions to open surgery or any complications. The drainage was removed at 24 h to 36 h after the operation. CONCLUSIONS: Endoscopic thyroidectomy through trans-axilloareolar approach and trans-thoracoareolar approach is feasible, safe and cosmetic. The cosmetic effects of the trans-axilloareolar approach is better than the trans-thoracoareolar approach. The procedure selection depends on both the patient request and the technology of the surgeons.

[Intraoperative radiofrequency ablation and 125I therapy for preventing local recurrence in hepatocellular carcinoma after hepatectorny].

OBJECTIVE: To evaluate the efficacy of intraoperative radiofrequency ablation and 125I therapy for preventing local recurrence in hepatocellular carcinoma (HCC) after hepatectomy. METHODS: Seventy-eight HCC patients with a tumor close to the first or the second hepatic portal underwent hepatectomy with a resection margin less than 1 cm from 1999 to 2001. All patients were randomly divided into control group and combined treatment group according to their check-in date (odd or even). In the control group, 38 patients were treated with hepatectomy alone, whereas in the combined group, 40 patients were treated with hepatectomy plus radiofrequency ablation and 125I implantation on surgical margin. All patients were followed up regularly. RESULTS: the 1-, 3- and 5-year recurrent rate was 7.5%, 30.0% and 45.0% in the combined treatment group versus 18.4%, 60.5% and 86.8% in the control group, respectively, with a significant difference in the 3-year (chi2 = 7.340, P < 0.01) and 5-year recurrent rates (chi2 = 15.740, P < 0.01). The 1-, 3- and 5-year survival rate was 92.5%, 67.5% and 30.0% in the combined group versus 81.5%, 39.4% and 18.4%, respectively. CONCLUSION: Intraoperative radiofrequency ablation and 125I therapy on the resection margin is effective to prevent local recurrence in HCC patients after hepatectomy, and to prolong their postoperative tumor free survival.