Risk factors analysis of lateral cervical lymph node metastasis in papillary thyroid carcinoma: a retrospective study of 830 patients.

OBJECTIVE: The aim of this study is to investigate the risk factors for lateral cervical lymph node metastasis in papillary thyroid carcinoma (PTC). METHODS: Clinicopathological data (age, gender, Hashimoto's thyroiditis, preoperative circulating tumor cells (CTCs), multifocal, maximum lesion diameter, invaded capsule, T stage, and lymph node metastasis) of 830 PTC patients diagnosed and treated in Meizhou People's Hospital from June 2021 to April 2023 were collected. The related factors of lateral cervical lymph node metastasis were analyzed. RESULTS: There were 334 (40.2%), and 103 (12.4%) PTC patients with central lymph node metastasis, and lateral cervical lymph node metastasis, respectively. Compared with patients without lateral cervical lymph node metastasis, PTC patients with lateral cervical lymph node metastasis had a higher proportion of multifocal, maximum lesion diameter > 1 cm, invaded capsule, T3-T4 stage. Regression logistic analysis showed that male (odds ratio (OR): 2.196, 95% confidence interval (CI): 1.279-3.769, p = 0.004), age < 55 years old (OR: 2.057, 95% CI: 1.062-3.988, p = 0.033), multifocal (OR: 2.759, 95% CI: 1.708-4.458, p < 0.001), maximum lesion diameter > 1 cm (OR: 5.408, 95% CI: 3.233-9.046, p < 0.001), T3-T4 stage (OR: 2.396, 95% CI: 1.241-4.626, p = 0.009), and invaded capsule (OR: 2.051, 95% CI: 1.208-3.480, p = 0.008) were associated with lateral cervical lymph node metastasis. CONCLUSIONS: Male, age < 55 years old, multifocal, maximum lesion diameter > 1 cm, T3-T4 stage, and invaded capsule were independent risk factors for lateral cervical lymph node metastasis in PTC.

Diagnostic value of circulating tumor cells in patients with thyroid cancer: a retrospective study of 1478 patients.

BACKGROUND: Circulating tumor cell (CTC) detection is one form of liquid biopsy. It is a novel technique that is beginning to be applied in the field of thyroid cancer. The present study was designed to evaluate the diagnostic value of CTCs in patients with thyroid cancer. METHODS: A total of 1478 patients were retrospectively analyzed and divided into malignant group (n = 747) and benign group (n = 731). Peripheral blood was collected, and CTCs were enriched and quantified before surgery. The baseline data of the two groups were matched by Propensity Score Matching (PSM). Receiver operating characteristic (ROC) curves were used to evaluate the diagnostic efficiency of different indicators for thyroid cancer. The malignant group before PSM was further divided into subgroups according to the BRAF V600E mutation and lymphatic metastasis (N stage), and the number of CTCs in different subgroups was compared. RESULTS: After 1:1 PSM, baseline characteristics of the malignant group and benign group were matched and assigned 315 cases in each group. The number of CTCs and the TPOAb values were comparable in the two groups (p > 0.05). The TgAb values [1.890 (1.110 - 16.010) vs 1.645 (1.030 - 7.073) IU/mL, p = 0.049] were significantly higher in the malignant group than in the benign group. After PSM, ROC analyses showed that the areas under the curve (AUCs) of CTC, TgAb and ultrasound were 0.537 (sensitivity 65.6%, specificity 45.8%), 0.546 (sensitivity 40.0%, specificity 70.8%) and 0.705 (sensitivity 77.1%, specificity 63.2%), respectively. The AUCs of the combined detection of 'CTC + ultrasound' (combine 1) and the combined detection of 'CTC + TgAb + ultrasound' (combine 2) were 0.718 (sensitivity 79.3%, specificity 61.7%) and 0.724 (sensitivity 78.0%, specificity 63.3%), respectively. The AUC of ultrasound was significantly higher than CTC (p < 0.001). There was no statistically significant difference in AUC between combination 1 and ultrasound, and between combination 2 and ultrasound (p > 0.05). The number of CTCs between the N0 and N1 subgroups, and between the BRAF mutant and BRAF wild subgroups was comparable (p > 0.05). CONCLUSIONS: As an emerging and noninvasive testing tool, the efficacy of CTCs in diagnosing thyroid cancer is limited.

FG-4592 protected haematopoietic system from ionising radiation in mice.

Ionising radiation exposure can lead to acute haematopoietic radiation syndrome. Despite significant advancements in the field of radioprotection, no drugs with high efficacy and low toxicity have yet been approved by the Food and Drug Administration. FG-4592, as a proline hydroxylase inhibitor, may play an important role in radioprotection of the haematopoietic system. Mice were peritoneal injected with FG-4592 or normal saline. After irradiation, the survival time, body weight, peripheral blood cell and bone marrow cell (BMC) count, cell apoptosis, pathology were analysed and RNA-sequence technique (RNA-Seq) was conducted to explore the mechanism of FG-4592 in the haematopoietic system. Our results indicated that FG-4592 improved the survival rate and weight of irradiated mice and protected the spleen, thymus and bone marrow from IR-induced injury. The number of BMCs was increased and protected against IR-induced apoptosis. FG-4592 also promoted the recovery of the blood system and erythroid differentiation. The results of RNA-Seq and Western blot showed that the NF-κB signalling pathway and hypoxia-inducible factor-1 (HIF-1) signalling pathway were upregulated by FG-4592. Meanwhile, RT-PCR results showed that FG-4592 could promote inflammatory response significantly. FG-4592 exhibited radioprotective effects in the haematopoietic system by promoting inflammatory response and targeting the NF-κB, HIF signalling pathway.

Scleroglucan protects the intestine from irradiation-induced injury by targeting the IL-17 signaling pathway.

BACKGROUND: Intestinal tissue is extremely sensitive to ionizing radiation (IR), which is easy to cause intestinal radiation sickness, and the mortality rate is very high after exposure. Recent studies have found that intestinal immune cells and intestinal stem cells (ISCs) may play a key role in IR-induced intestinal injury. METHODS: C57BL6 mice matched for age, sex and weight were randomly grouped and intraperitoneal injected with PBS, Scleroglucan (125.0 mg/kg) or Anti-mouse IL-17A -InVivo (10 mg/kg), the number of mice in each group was n ≥ 3.Survival time, body weight, pathology, organoids and immune cell markers of the mice after IR (10.0 Gy) were compared, and the mechanism of action in intestinal tissues was verified by transcriptome sequencing. RESULTS: Scleroglucan has significant radiation protective effects on the intestine, including improving the survival rate of irradiated mice, inhibiting the radiation damage of intestinal tissue, and promoting the proliferation and differentiation of intestinal stem cells (ISCs). The results of RNA sequencing suggested that Scleroglucan could significantly activate the immune system and up-regulate the IL-17 and NF-κB signaling pathways. Flow cytometry showed that Scleroglucan could significantly up-regulate the number of Th17 cells and the level of IL-17A in the gut. IL-17A provides radiation protection. After intraperitoneal injection of Scleroglucan and Anti-mouse IL-17A -InVivo, mice can significantly reverse the radiation protection effect of Scleroglucan, down-regulate the molecular markers of intestinal stem cells and the associated markers of DC, Th1 and Th17 cells, and up-regulate the associated markers of Treg and Macrophage cells. CONCLUSION: Scleroglucan may promote the proliferation and regeneration of ISCs by regulating the activation of intestinal immune function mediated by IL-17 signaling pathway and play a protective role in IR-induced injury.

Bowen's disease of the vulva and perianal area in a SLE patient successfully treated with Photodynamic therapy: A case report.

Photodynamic therapy (PDT) has emerged as a non-invasive treatment modality for superficial skin cancers. It has the advantage of greater tolerance and providing better cosmetic outcomes than conventional treatment methods. Because of the rarity of extensive Bowen's disease located in the genital area, evidence of efficacy for therapies is mainly based on case reports and clinical experience. This report presents a case of a 32-year-old female with Bowen's disease of the vulva and perianal area with systemic lupus erythematosus successfully treated by 5-aminolaevulinic acid PDT. There was no evidence of recurrence after five-years of follow-up.

FG-4592 protects the intestine from irradiation-induced injury by targeting the TLR4 signaling pathway.

BACKGROUND: Severe ionizing radiation (IR)-induced intestinal injury associates with high mortality, which is a worldwide problem requiring urgent attention. In recent years, studies have found that the PHD-HIF signaling pathway may play key roles in IR-induced intestinal injury, and we found that FG-4592, the PHD inhibitor, has significant radioprotective effects on IR-induced intestinal injury. METHODS: In the presence or absence of FG-4592 treatment, the survival time, pathology, cell viability, cell apoptosis, and organoids of mice after irradiation were compared, and the mechanism was verified after transcriptome sequencing. The data were analyzed using SPSS ver. 19 software. RESULTS: Our results show that FG-4592 had significant radioprotective effects on the intestine. FG-4592 improved the survival of irradiated mice, inhibited the radiation damage of intestinal tissue, promoted the regeneration of intestinal crypts after IR and reduced the apoptosis of intestinal crypt cells. Through organoid experiments, it is found that FG-4592 promoted the proliferation and differentiation of intestinal stem cells (ISCs). Moreover, the results of RNA sequencing and Western blot showed that FG-4592 significantly upregulated the TLR4 signaling pathway, and FG-4592 had no radioprotection on TLR4 KO mice, suggesting that FG-4592 may play protective role against IR by targeting TLR4. CONCLUSION: Our work proves that FG-4592 may promote the proliferation and regeneration of ISCs through the targeted regulation of the TLR4 signaling pathway and ultimately play radioprotective roles in IR-induced injury. These results enrich the molecular mechanism of FG-4592 in protecting cells from IR-induced injury and provide new methods for the radioprotection of intestine.

Case Report: Triple Primary Malignant Tumors of the Esophagus, Stomach, and Colon in a Patient With Genetic Analysis.

The incidence of multiple primary malignant tumors (MPMTs) has increased greatly with the progress of tumor diagnosis and therapy technology. However, triple primary cancer is still very rare, and its genetic change is not clear yet. This case report described a 70-year-old Chinese male patient with triple primary cancers of the esophagus, stomach and right-sided colon. Pathological examination confirmed that each malignant tumor developed independently. Next-generation sequencing (NGS) using a 599-gene panel revealed five TP53 mutations in three tumor tissues. These variations might contribute to development of the triple primary malignant tumors in the patient. The patient underwent laparoscopic feeding jejunostomy and postoperative radiotherapy for synchronous esophageal and gastric carcinomas. Then, he underwent laparoscopic-assisted resection of right-sided colonic cancer and lysis of abdominal adhesions. By the time of submitting this manuscript, the patient had been well and no sign of recurrence or metastasis had been observed. To the best of our knowledge, this case is the first one to clarify the genetic abnormalities of triple primary cancers of esophagus, stomach and colon in a Chinese patient. It may contribute to understanding the molecular pathogenesis of multiple primary digestive malignancies and providing valuable treatment strategies for the similar patients in the future.

Does Incident Solar Ultraviolet Radiation Lower Blood Pressure?

Background Hypertension remains a leading global cause for premature death and disease. Most treatment guidelines emphasize the importance of risk factors, but not all are known, modifiable, or easily avoided. Population blood pressure correlates with latitude and is lower in summer than winter. Seasonal variations in sunlight exposure account for these differences, with temperature believed to be the main contributor. Recent research indicates that UV light enhances nitric oxide availability by mobilizing storage forms in the skin, suggesting incident solar UV radiation may lower blood pressure. We tested this hypothesis by exploring the association between environmental UV exposure and systolic blood pressure (SBP) in a large cohort of chronic hemodialysis patients in whom SBP is determined regularly. Methods and Results We studied 342 457 patients (36% black, 64% white) at 2178 US dialysis centers over 3 years. Incident UV radiation and temperature data for each clinic location were retrieved from the National Oceanic and Atmospheric Administration database. Linear mixed effects models with adjustment for ambient temperature, sex/age, body mass index, serum Na+/K+ and other covariates were fitted to each location and combined estimates of associations calculated using the DerSimonian and Laird procedure. Pre-dialysis SBP varied by season and was ≈4 mm Hg higher in black patients. Temperature, UVA and UVB were all linearly and inversely associated with SBP. This relationship remained statistically significant after correcting for temperature. Conclusions In hemodialysis patients, in addition to environmental temperature, incident solar UV radiation is associated with lower SBP. This raises the possibility that insufficient sunlight is a new risk factor for hypertension, perhaps even in the general population.

Combined laparoscopic and open technique for repair of congenital abdominal hernia: A case report of prune belly syndrome.

BACKGROUND: Prune belly syndrome (PBS) is a rare congenital disorder among adults, and the way for repairing abdominal wall musculature has no unified standard. MATERIALS AND METHODS: We described combining laparoscopic and open technique in an adult male who presented with PBS. Physical examination and radiological imaging verified the case of PBS. The deficiency of abdominal wall musculature was repaired by combining laparoscopic and open technique using a double-deck complex patch. RESULTS: The patient successfully underwent abdominal wall repair by combining laparoscopic and open technique. Postoperative recovery was uneventful, and improvement in symptom was significant in follow-up after 3, 6, 12, and 24 months. CONCLUSIONS: Combining laparoscopic and open technique for repair of deficiency of abdominal wall musculature in PBS was an exploratory way to improve life quality.

Combined Detection of Preoperative Neutrophil-to-Lymphocyte Ratio and CEA as an Independent Prognostic Factor in Nonmetastatic Patients Undergoing Colorectal Cancer Resection Is Superior to NLR or CEA Alone.

OBJECTIVE: To explore the role of combined detection of carcinoembryonic antigen (CEA) and neutrophil-to-lymphocyte ratio (NLR) in the prognostic assessment of colorectal cancer (CRC). METHODS: We investigated preoperative NLR and CEA in 125 surgical CRC patients, determined the patients' thresholds by receiver operating characteristic (ROC) curve analysis, and assessed their prognostic values by Kaplan-Meier curve and Cox regression models. In addition, we used nomograms of several risk factors to evaluate the risk in survival and predictive accuracy by using Harrell's concordance index (c-index). RESULTS: Results of multivariate analysis showed high NLR, high CEA, and high COCN (combination of CEA and NLR) were significantly correlated with decreased disease-free survival (DFS) [HR: 2.229, 95% CI: 1.012-4.911, and P = 0.047; HR: 3.652, 95% CI: 1.630-8.179, and P = 0.002; HR: 3.139, 95% CI: 1.800-5.472, and P < 0.001]. But high CEA and COCN remained significant only for decreased overall survival (OS) [HR: 3.713, 95% CI: 1.396-9.873, and P = 0.009; HR: 3.106, 95% CI: 1.576-6.123, and P = 0.001]. High NLR showed higher mortality rates with worse OS (P = 0.058), and nomograms containing NLR improved the predictive accuracy. Area under the curve of COCN was higher than that of CEA or NLR. CONCLUSION: COCN acts as a better independent prognostic biomarker of CRC than NLR or CEA alone.

Comparison of Laparoscopic Sleeve Gastrectomy and Laparoscopic Greater Curvature Plication Regarding Efficacy and Safety: a Meta-Analysis.

Laparoscopic sleeve gastrectomy (LSG) and laparoscopic greater curvature plication (LGCP) are two restrictive bariatric procedures. Eight studies (three randomized, controlled trials, four retrospective studies, and one prospective study) with 536 patients on LSG and LGCP were included by searching PUBMED, EMBASE, and the Cochrane Library. The software Review Manager 5.3 was used to evaluate operation time, adverse events, percent excess weight loss (%EWL), resolution of obesity-related comorbidities, and postoperative hospital stay. Despite the limitations, this meta-analysis suggests that LSG is superior to LGCP in terms of providing greater %EWL at the follow-up of 3, 6, and 12 months and 3 years. LSG gains shorter postoperative hospital stay than LGCP. No significant difference was found in operation time, adverse events, and the resolution of obesity-related comorbidities.

Combined open and laparoscopic technique for extraperitoneal mesh repair of large sac inguinal hernias.

BACKGROUND: Laparoscopic total extraperitoneal (TEP) hernia repair has been confirmed as an effective procedure in several studies but is considered technically demanding. Separating the hernial sac and spermatic cord is difficult when a large sac inguinal hernia is encountered. This study aimed to investigate the feasibility and effectiveness of a combined open and laparoscopic TEP repair of large sac inguinal hernias. METHODS: From June 2012 to May 2015, laparoscopic TEP (112 cases) and combined open and laparoscopic TEP (COL-TEP) (44 cases) were performed in patients with large sac hernia. There was no clear definition of large sac inguinal hernia; therefore, we defined a large sac as one with the sac base cranial to or over outer ring that could not be easily resected laparoscopically. Using this definition, the laparoscopic TEP group was divided into a small sac TEP (SS-TEP) group (68 cases) and a large sac TEP (LS-TEP) group (44 cases). Direct hernias were included in the SS-TEP group because the hernial sac was easily dissected laparoscopically. The patient demographics, perioperative parameters, complications, and recurrence were compared between the three groups. RESULTS: No significant differences were found between the groups in mean age, gender, body mass index, comorbidities, number of previous laparotomies, or recurrence rate. Compared with the LS-TEP group, both the SS-TEP and COL-TEP groups had a significantly lower surgical duration (51.4 ± 10.9 vs. 32.8 ± 13.1 and 36.2 ± 11.2 min, respectively), conversion rate (13.6 vs. 0 and 0 %, respectively), and total complication rate (27.3 vs. 13.2 and 11.3 %, respectively). CONCLUSION: The combined technique was safe and effective for repair of large sac inguinal hernias. The combined technique was associated with decreased technical difficulty, surgical duration, and conversion and total complication rates.

Laparoscopic Plicated Sleeve Gastrectomy: a Technical Report.

The standard approach to laparoscopic sleeve gastrectomy (LSG) involves sleeve-forming through a vertical gastrectomy, producing a narrow, tubular stomach. Considerable laparoscopic skills are required to find a suitable size at which the pressure of the sleeve is not excessive and the restriction is sufficient for obtaining good weight-loss effect without increasing the risk of complications. There is no doubt that considerable technical details are required to create a "perfect sleeve." We report our sleeve-forming technique for LSG involving both vertical gastrectomy and plication, which we have termed "laparoscopic plicated sleeve gastrectomy." This technique was shown to be safe and efficacious for the treatment of severe obesity and can reduce technical difficulties in the creation of a "perfect sleeve."

Laparoscopic Choledocholithotomy With a Novel Articulating Forceps.

PURPOSE: The aim of this study was to assess the safety and effectiveness of laparoscopic common bile duct (CBD) exploration with a novel articulating forceps. METHODS: A retrospective analysis was carried out of 90 patients who underwent laparoscopic transcholedochal CBD exploration for choledocholithiasis between May 2006 and June 2014. Forty-five patients underwent laparoscopic choledocholithotomy using the routine instruments (group A). Forty-five patients underwent laparoscopic choledocholithotomy using the routine instruments plus the novel articulating forceps (group B). The 2 group populations were similar with regard to demographic data and clinical presentations. RESULTS: Laparoscopic transcholedochal CBD exploration was successful in all 90 patients. The mean diameter of the CBD was 14.42 mm in group A and 14.73 mm in group B (P > .05). The average number of stones extracted per patient was 4.22 in group A and 4.67 in group B (P > .05). The patients in group A had a significantly longer operative time than the patients in group B (109.38 vs 80.49 minutes; P < .01). The intraoperative blood loss was minimal in both groups, and no major complications were observed in either group. The mean hospitalization stay was 6.60 days in group A and 5.58 days in group B (P < .01). CONCLUSION: Laparoscopic transcholedochal CBD exploration with the novel articulating forceps is a safe and effective approach to the management of choledocholithiasis that offers a short operating time and short postoperative hospital stay.

Correlation between ovarian neoplasm and serum levels of osteopontin: a meta-analysis.

The aim of this meta-analysis was to evaluate the clinical significance of serum osteopontin (OPN) levels in ovarian neoplasm in patients, with the goal of building a novel diagnostic score model. By searching the PubMed, Embase, Web of Science, Cochrane Library, CISCOM, CINAHL, Google Scholar, CBM, and China National Knowledge Infrastructure (CNKI) databases, we conducted a meta-analysis. Studies were pooled, and the standardized mean difference (SMD) and its corresponding 95 % confidence interval (CI) were calculated. Subgroup analyses and publication bias detection were also conducted. Version 12.0 STATA software was used for statistical analysis. We performed a final analysis of 1,653 subjects altogether (822 patients with psoriasis and 831 healthy controls) from 15 clinical case-control studies. The meta-analysis results showed a positive association between serum OPN levels and ovarian neoplasm (SMD = 2.60, 95 %CI 1.88-3.32, P < 0.001). The subgroup analysis by ethnicity detected that high levels of serum OPN may be the main risk factor for ovarian neoplasms in Asians (SMD = 2.91, 95 %CI 2.38-3.45, P < 0.001), but not in Caucasians (P > 0.05). The present meta-analysis indicated that serum OPN levels were generally elevated in ovarian neoplasm patients, and thus, serum levels of OPN could be useful in diagnosing ovarian neoplasm.

Laparoscopic splenectomy for hypersplenism secondary to liver cirrhosis and portal hypertension.

Since the first laparoscopic splenectomy (LS) was reported in 1991, LS has become the gold standard for the removal of normal to moderately enlarged spleens in benign conditions. Compared with open splenectomy, fewer postsurgical complications and better postoperative recovery have been observed, but LS is contraindicated for hypersplenism secondary to liver cirrhosis in many institutions owing to technical difficulties associated with splenomegaly, well-developed collateral circulation, and increased risk of bleeding. With the improvements of laparoscopic technique, the concept is changing. This article aims to give an overview of the latest development in laparoscopic splenectomy for hypersplenism secondary to liver cirrhosis and portal hypertension. Despite a lack of randomized controlled trial, the publications obtained have shown that with meticulous surgical techniques and advanced instruments, LS is a technically feasible, safe, and effective procedure for hypersplenism secondary to cirrhosis and portal hypertension and contributes to decreased blood loss, shorter hospital stay, and less impairment of liver function. It is recommended that the dilated short gastric vessels and other enlarged collateral circulation surrounding the spleen be divided with the LigaSure vessel sealing equipment, and the splenic artery and vein be transected en bloc with the application of the endovascular stapler. To support the clinical evidence, further randomized controlled trials about this topic are necessary.

A systematic review of gastric plication for the treatment of obesity.

BACKGROUND: Laparoscopic gastric plication (LGP) is a relatively new restrictive bariatric procedure that requires no gastrectomy or foreign body placement. OBJECTIVES: The authors' aim in this article is to conduct a systematic review of the currently available literature regarding the outcomes of LGP for the treatment of obesity. SETTING: University Hospital, China METHODS: The authors' systematic review yielded 14 studies encompassing 1,450 LGP patients. Perioperative data were collected from each study and recorded. RESULTS: Mean preoperative body mass index (BMI) ranged from 31.2 to 44.5 kg/m(2), and 80.8% of the patients were female. Operative time ranged from 50 to 117.9 minutes (average 79.2 min). Hospital stay varied from .75 to 5 days (average 2.4 days). The percentage of excessive weight loss (%EWL) for LGP varied from 31.8% to 74.4% with follow-up from 6 months to 24 months. No mortality was reported in these studies and the rate of major complications requiring reoperation ranged from 0% to 15.4% (average 3.7 %). CONCLUSION: Early reports with LGP are promising with a favorable short-term safety profile. However, it remains unclear if weight loss following LGP is durable in the long term. Additional prospective comparative trials and long-term follow-up are needed to further define the role of LGP in the surgical management of obesity.

Laparoscopic greater curvature plication: surgical techniques and early outcomes of a Chinese experience.

BACKGROUND: Laparoscopic greater curvature plication (LGCP) is a novel restrictive bariatric procedure that can reduce the gastric volume by infolding the gastric greater curvature without gastrectomy. The objective of this study was to describe the surgical technique of LGCP and validate the efficacy and safety of LGCP for the treatment of obesity in obese Chinese patients with a relatively low body mass index (BMI). METHODS: Twenty-two obese patients (mean age 33.8±6.0 years; mean BMI 37.0±7.0 kg/m(2)) underwent LGCP between September 2011 and September 2012. After dissecting the greater omentum and short gastric vessels, the gastric greater curvature plication with 2 rows of nonabsorbable suture was performed under the guidance of a 32-F bougie. The data were collected during follow-up examinations performed at 1, 3, 6, and 12 months postoperatively. RESULTS: All procedures were performed laparoscopically. The mean operative time was 84.1 minutes (50-120 min), and the mean length of hospital stay was 3.8 days (2-10 d). There were no deaths or postoperative major complications that needed reoperation. The mean percentage of excess weight loss (%EWL) was 22.9%±6.9%, 38.6%±9.8%, 51.5%±13.5%, and 61.1%±15.9% at 1, 3, 6, and 12 months postoperatively. At 6 months, type 2 diabetes was in remission in 2 (50%) patients, hypertension in 1 (33.3%) patient, and dyslipidemia in 11 (78.6%) patients. Decreases in the index for homeostasis model assessment of insulin resistance (HOMA-IR) and in insulin and glucose concentrations were observed. CONCLUSIONS: The early outcomes of LGCP as a novel treatment for obese Chinese with a relatively low BMI are satisfactory with respect to the effectiveness and low incidence of major complications. Additional long-term follow-up and prospective, comparative trials are still needed.