Sleep fragmentation exacerbates myocardial ischemia‒reperfusion injury by promoting copper overload in cardiomyocytes.

Sleep disorders increase the risk and mortality of heart disease, but the brain-heart interaction has not yet been fully elucidated. Cuproptosis is a copper-dependent type of cell death activated by the excessive accumulation of intracellular copper. Here, we showed that 16 weeks of sleep fragmentation (SF) resulted in elevated copper levels in the male mouse heart and exacerbated myocardial ischemia-reperfusion injury with increased myocardial cuproptosis and apoptosis. Mechanistically, we found that SF promotes sympathetic overactivity, increases the germination of myocardial sympathetic nerve terminals, and increases the level of norepinephrine in cardiac tissue, thereby inhibits VPS35 expression and leads to impaired ATP7A related copper transport and copper overload in cardiomyocytes. Copper overload further leads to exacerbated cuproptosis and apoptosis, and these effects can be rescued by excision of the sympathetic nerve or administration of copper chelating agent. Our study elucidates one of the molecular mechanisms by which sleep disorders aggravate myocardial injury and suggests possible targets for intervention.

Mid-Term Diabetes Remission Outcome in Patients with BMI ≤ 30 kg/m2 Following Sleeve Gastrectomy.

BACKGROUND: Bariatric and metabolic surgery is recommended for Asian patients with type 2 diabetes mellitus (T2DM) and BMI ≥ 27.5 kg/m2. However, mid to long-term ·evidence is still lacking. METHODS: Patients' data that underwent laparoscopic sleeve gastrectomy (SG) as the primary surgery at the Affiliated Hospital of Xuzhou Medical University were analyzed. Patients with T2DM diagnosed with either fasting blood glucose (FBG) ≥ 7.0 mmol/L or glycosylated hemoglobin (HbA1c) level ≥ 7.0% and 27.5 ≤ BMI ≤ 30 kg/m2 were included. RESULTS: 24 patients (7 male and 17 female) were included in this study. With a mean follow-up duration of 4.5 ± 1.1 years, the mean percentage of total weight loss (%TWL) was 14.4 ± 6.7%. Postoperatively, nine patients (37%) still required oral anti-diabetic medications, while no patients used insulin. FBG and HbA1c levels declined to 6.3 ± 1.5 mmol/L and 6.0 ± 1.0%, respectively. Fifteen patients (63%) were with HbA1c levels < 7% and without medication requirements, five patients (21%) were with HbA1c levels < 7% with the help of oral anti-diabetic medication, and four patients (16%) were with HbA1c levels > 7% with the help of oral anti-diabetic medication. CONCLUSIONS: Our study provides further evidence that SG could result in both T2DM improvement and remission in patients with BMI ≤ 30 kg/m2. Longer follow-up duration and larger sample will be needed in the future.

The Prevalence of Small Intestinal Bacterial Overgrowth After Roux-en-Y Gastric Bypass (RYGB): a Systematic Review and Meta-analysis.

We reviewed the literature on the prevalence of small intestinal bacterial overgrowth (SIBO) after Roux-en-Y gastric bypass (RYGB). Eight studies examining 893 patients were included. The mean age of the patients was 48.11 ± 4.89 years. The mean BMI before surgery and at the time of SIBO diagnosis was 44.57 ± 2.89 kg/m2 and 31.53 ± 2.29 kg/m2, respectively. Moreover, the results showed a 29% and 53% prevalence of SIBO at < 3-year and > 3-year follow-up after RYGB, respectively. Symptoms included abdominal pain, diarrhea, bloating, nausea, vomiting, constipation, soft stool, frequent defecation, flatulence, rumpling, dumping syndrome, and irritable bowel syndrome. SIBO is prevalent after RYGB; digestive symptoms should prompt the consideration of SIBO as a potential etiology. Antibiotic therapy has proven to be therapeutic.

Comparison of three different anastomotic methods of sleeve gastrectomy with transit bipartition using an obese rodent model.

The long-term effects and safety of single-anastomosis sleeve ileal (SASI) bypass have not been confirmed. The one anastomosis procedure carries the risk of bile reflux, and Braun anastomosis has the capacity to reduce bile reflux. This study was designed to compare the influences of bile reflux and histological changes in the esogastric sections of rats. Obese Sprague-Dawley rats underwent sleeve gastrectomy with transit bipartition (RYTB) (n = 12), SASI (n = 12), SASI bypass with Braun anastomosis (BTB) (n = 12), esojejunostomy (EJ) (n = 12), and SHAM (n = 8) surgery. During the 12-week follow-up period, weight changes, glucose improvement, and changes in serum nutrition were evaluated. Histological expression and bile acid concentration in the rats in all groups were also evaluated. No significant differences in weight loss and glucose improvements were observed in the RYTB, SASI, and BTB groups. The RYTB and BTB groups had significantly lower bile acid concentration and albumin levels than the SASI group. In addition, mucosal height in the RYTB and BTB groups was significantly lower than in the SASI group. Braun anastomosis had a significant effect on anti-reflux. BTB may be a superior primary procedure due to its potential for parallel bariatric and metabolic improvements, effective anti-reflux effects, simplified operations, and avoidance of severe malnutrition. Further clinical studies are needed to confirm these findings.

Role of Circulating Tumor DNA in Colorectal Cancer.

Colorectal cancer (CRC) is a very common gastrointestinal tumor, ranking second in the global cause of cancer death. Because of the invasive nature of biopsy and cannot reflect the heterogeneity of tumor or monitor the dynamic progress of tumor, it is necessary to induce a novel noninvasive method to improve the current treatment strategies of colorectal cancer. Among all the components of liquid biopsy, circulating tumor DNA (ctDNA) may have the best future. CtDNA maintains the same genomic characteristics as those in matched tumor tissues, so it allows quantitative evaluation and analysis of mutation load in body fluid. Furthermore, because the half-life of ctDNA is from 16 min to several hours in circulation, the circulating ctDNA can be measured repeatedly within a certain period to monitor the response of CRC to treatment, the occurrence of drug resistance, and the diagnosis of recurrence.

Measurement of gastric wall thickness after laparoscopic sleeve gastrectomy: obesity comorbidities and gastric wall in Chinese patients with obesity.

Leakage of the sleeve remains constant after laparoscopic sleeve gastrectomy (LSG). This complication may be due to a mismatch between the staple height and gastric wall thickness (GWT). Our aim was to measure the GWT in Chinese patients with obesity and investigate the relationship between GWT and gender, body mass index (BMI), body weight, and obesity-related comorbidities. The GWT of 210 resected specimens after LSG was measured using a tissue measuring device, at a compression pressure of 8 g/mm2 at three predetermined locations: antrum, midbody, and fundus. Two hundred ten patients (171 female/39 male). The gastric wall was thickest at the antrum followed by the midbody and thinnest at the fundus (3.02 mm, 2.22 mm, and 1.6 mm, respectively). Patients with gastritis and those with reflux esophagitis had thicker GWT at the antrum; male had thicker GWT at the antrum and fundus; patients with body weight > 100 kg, and those with BMI > 40 kg/m2 had thicker GWT at the fundus. Linear regression analysis revealed a significant association between GWT with body weight and BMI at the antrum and fundus; Furthermore, hypertension associated with the GWT at the fundus (P < 0.01, P < 0.01, P < 0.02, P < 0.01; and P < 0.04, respectively). This study showed that the anatomical location of the gastric wall is a major predicting factor of GWT. Furthermore, gastritis, reflux esophagitis, male gender, BMI > 40 kg/m2, body weight > 100 kg, and hypertension may increase the GWT at the antrum and fundus in Chinese patients with obesity.

Regulation of Pancreatic TXNIP-Insulin Expression Levels after Bariatric Surgery Using Diabetic Rodent Model.

Purpose: The purpose of this study was to investigate the effect of bariatric surgery on pancreatic thioredoxin-interacting protein (TXNIP) and insulin expression levels. The research question is does bariatric surgery induce changes in the pancreatic TXNIP level, given that TXNIP has been proposed as a key glucose control factor? Methods: Using nondiabetic and diabetic rats, we investigated whether our streptozotocin-induced diabetic rat models exhibited changes in pancreatic TXNIP regulation. Following this confirmation, we randomly divided the diabetic rats into the following three groups: the gastric bypass group (n = 16), pair-fed group (n = 10), and sham group (n = 10). Preoperatively and 3 weeks postoperatively, all the rats underwent an oral glucose tolerance test, insulin tolerance test, and blood sampling procedures for hormonal analysis. Results: The TXNIP messenger ribonucleic acid (mRNA) and protein expression levels were significantly lower in the gastric bypass group than in the other groups. Regarding the gastric bypass group, the pancreatic mRNA expression levels of microRNA-204 (miR-204) and MafA were significantly lower and higher, respectively, than in the other groups. Furthermore, the levels of pancreatic insulin expression at the mRNA and protein levels were also significantly higher in the gastric bypass group than in the other groups. Conclusion: Bariatric surgery significantly improved glucose control and regulated the pancreatic insulin production pathways of TXNIP, miR-204, and MafA. The regulation of TXNIP, miR-204, and MafA might play an important role in the mechanism of diabetes remission following bariatric surgery.

The Protective Effect of Transit Bipartition and Its Modification Against Sleeve Gastrectomy-Related Esophagitis in a Rodent Model.

BACKGROUND: The protective effect of transit bipartition against esophagitis has not yet been proven. Thus, we investigate and compare the bariatric outcomes and esophagus' histological changes of sleeve gastrectomy (SG), SG with transit bipartition (SG-TB), and the proximal SG-TB (SG-PTB) in a rodent model. METHODS: This study included 45 diabetic Sprague-Dawley rats assigned to one of the four groups, SG-PTB (n = 15), SG-TB (n = 12), SG (n = 10), and SHAM (n = 8). Eight surviving rats from each group were included for further investigation. Histological analysis of the gastroesophageal junction was performed. Body weight, food intake, glucose control, and hormonal changes (glucagon-like peptide-1 and insulin) were assessed before and after surgery in all groups. RESULTS: Preoperatively, no significant differences were observed in food intake, body weight, and fasting blood glucose levels among the groups. Postoperatively, the SG-PTB and SG-TB groups showed significantly superior glucose control compared to the SG group following the gavage of glucose (p < 0.05). Postoperatively, the SG-PTB and SG-TB groups had higher postoperative GLP-1 levels than postoperative SG and SHAM groups. More severe esophageal hyperpapillomatosis (EHP) of the esophageal section was observed in the SG group. The mucosal height of the SG group was significantly higher than that of the SG-PTB, SG-TB, and SHAM groups (p < 0.05). CONCLUSION: The transit bipartition procedure may protect the distal esophagus from histological changes associated with esophagitis. Clinical studies are needed to confirm the anti-reflux effects of transit bipartition.

Comparison of the Outcomes of Single Anastomosis Duodeno-Ileostomy with Sleeve Gastrectomy (SADI-S), Single Anastomosis Sleeve Ileal (SASI) Bypass with Sleeve Gastrectomy, and Sleeve Gastrectomy Using a Rodent Model with Diabetes.

OBJECTIVE: Single anastomosis duodeno-ileostomy with sleeve gastrectomy (SADI-S) is a powerful form of bariatric surgery; however, it has a high risk of malnutrition. Single anastomosis sleeve ileal (SASI) bypass with sleeve gastrectomy may be used as an alternative procedure to avoid malnutrition associated with SADI-S; however, no comparison between the two procedures has been performed. METHODS: Sprague-Dawley rats with diabetes (n = 32) were divided into four groups: SADI-S (n = 8), SASI (n = 8), SG (n = 8), and SHAM (n = 8). Body weight, food intake, and fasting blood glucose were measured, and the oral glucose tolerance test (OGTT) and insulin tolerance test (ITT) were performed before and after surgery. Blood samples were collected before and after the surgery to assess the levels of glucagon-like peptide-1 (GLP-1), hemoglobin, albumin, vitamin B12, calcium, and iron. RESULTS: The SADI-S and SASI groups showed significantly greater weight loss and better glucose control than the SG group postoperatively. The SADI-S and SASI groups showed similar improvements in glucose control throughout the study. The SADI-S and SASI groups had significantly higher GLP-1 levels than the SG group at 6 months. The SADI-S and SASI groups presented with various degrees of deficiencies, with the SADI-S group showing a higher risk for hypoalbuminemia and iron deficiency than the SASI group. CONCLUSIONS: The SASI procedure may be a better alternative as it has excellent bariatric and metabolic results with lower risk for hypoalbuminemia and can be easily converted into either SADI-S or SG procedures. Nevertheless, further clinical results are needed.

lncRNA GAS8-AS1 regulates cancer cell proliferation and predicts poor survival of patients with gastric cancer.

Long non-coding (lnc)RNAs have been recognized as important regulators in gastric cancer. lncRNA GAS8-AS1 is considered a tumor suppressor in multiple types of cancer, such as papillary thyroid carcinoma, ovarian cancer and colorectal cancer. However, the specific role of GAS8-AS1 in gastric cancer remains to be fully elucidated. The aim of the present study was to investigate the role of GAS8-AS1 in gastric cancer and its potential underlying mechanisms of action. The expression levels of GAS8-AS1, microRNA (miR)-21-3p, PTEN and pyruvate dehydrogenase (E1) alpha subunit gene (PDHA1) in gastric cancer and non-cancerous tissues, as well as in gastric cancer cell lines, were detected using reverse transcription-quantitative PCR. Cell proliferation was detected by using a Cell Counting Kit-8 assay. Cell migration and invasion were detected using a Transwell assay. Results of the present study demonstrated that the expression levels of GAS8-AS1 in gastric cancer tissues were significantly decreased, whereas its expression did not differ among cancer tissues at different clinical stages. Low expression levels of GAS8-AS1 predicted poor 5-year survival rates for 70 patients with gastric adenocarcinoma from the Affiliated Hospital of Xuzhou Medical University (Xuzhou, China) during patient follow-up. In addition, the expression levels of miR-21-3p were markedly increased in cancer tissues, and miR-21-3p expression was negatively associated with the expression of GAS8-AS1. The direct interaction between GAS8-AS1 and miR-21-3p was predicted using the starBase database and was confirmed by using an RNA pull-down assay. In gastric cell lines, the overexpression of GAS8-AS1 reduced the expression levels of mature miR-21-3p but did not affect the expression of miR-21-3p precursor, while the overexpression of miR-21-3p did not, in turn, affect the expression of GAS8-AS1. In addition, the overexpression of GAS8-AS1 inhibited cancer cell proliferation, while the overexpression of miR-21-3p promoted cancer cell proliferation and attenuated the effects of GAS8-AS1. Overexpression of miR-21-3p promoted cancer cell migration and invasion, whereas overexpression of GAS8-AS1 did not affect cell migration or invasion. In summary, results of the present study have demonstrated that GAS8-AS1 acts as a tumor suppressor in gastric cancer, and it may inhibit cancer cell proliferation by downregulating miR-21-3p.

Association Between the Parental Weight Status and the Weight Loss Outcome in Patients After Sleeve Gastrectomy.

PURPOSE: Obesity is a complex multifactorial disease. Parents with obesity could have an impact on the weight loss outcome of their children following bariatric-metabolic surgery. Therefore, we aimed to investigate the association between the weight status of the parents and the weight loss outcome in patients undergoing sleeve gastrectomy (SG). METHODS: Patients undergoing SG with ≥ 3 years of follow-up between January 2016 and June 2018 were included in this study. The patients were categorized into three groups: (1) both parents did not have obesity (non-obesity parents, NOP); (2) one parent had obesity (single-parent obesity, SPO); (3) both parents had obesity (both parents' obesity, BPO). The main parameters for this study were the patients' preoperative and postoperative weight and the weight of the parents. RESULTS: A total of 218 SG patients were included in this study (NOP, n = 116; SPO, n = 64; BPO, n = 38). There was no statistically significant difference in the preoperative assessments. The main results for the NOP vs. SPO vs. BPO were as follows; parents' body mass index (BMI) 23.6 ± 2.5 vs. 27.9 ± 5.0 vs. 30.2 ± 3.3 kg/m2, percentage of total weight loss (%TWL) 30.2 ± 9.0 vs. 30.8 ± 10.4 vs. 23.8 ± 10.9%. The %TWL for the BPO group was significantly lower than the NOP and SPO groups (p < 0.05). CONCLUSION: The patient's weight loss outcome was significantly lower when both parents had obesity. Further controlled or prospective studies are needed to determine the best means to improve weight loss outcomes in such patients.

The effect of bariatric surgery on the expression of Growth Differentiation Factor-15/Macrophage-Inhibitory Cytokine-1 (GDF-15/MIC-1) in rat.

BACKGROUND: Reduced appetite and loss of preference to nutrition dense high-fat diet are present after bariatric surgery. But the mechanism responsible for these changes in biological activities remains unclear. Similar changes in biological activities have been observed with growth/differentiation factor-15/macrophage-inhibitory cytokine-1 (GDF-15/MIC-1) treatment alone. AIM OF STUDY: To assess the effect of bariatric surgery on GDF-15/MIC-1expression and circulating level in rodent model. SETTING: The Affiliated Hospital of Xuzhou Medical University, Xuzhou Jiangsu 221,006, P. R. China. METHODS: Among 40 fatty Sprague-dawley (SD) rats, 30 randomly receive low-dose STZ to induced diabetes and were randomly assigned to Roux en Y gastric bypass (RYGB, n = 10), Sleeve gastrectomy (SG, n = 10), and SHAM (n = 10). The remaining fatty SD rats were assigned to Normal control (NC, n = 10). Rats were followed for 8 weeks postoperatively. Circulating levels of GDF15 and tissue (gastrointestinal and liver) expression were assessed after surgery. Preoperative oral glucose tolerance test (OGTT), and Insulin tolerance test (ITT) were reassessed postoperatively. Changes in bodyweight and food intake were also recorded. RESULTS: Bariatric surgery significantly increased circulating plasma level of GDF15 (p < 0.05). Postoperatively, tissue expression of GDF15 was significantly higher in the stomach pouch, jejunum, and ileum of rats in the RYGB group as well as ileum of rats in the SG group compared to Sham and NC (p < 0.05). Higher Expression of GDF15 in the stomach pouch of the SG group was not statistically significant compared to the stomach of Sham and NC group. GDF15 expression in the liver was significantly less in the RYGB group (p < 0.05). CONCLUSION: Bariatric surgery significantly increases circulating levels and gastrointestinal tissue expression of GDF15. Given that GDF15 is an important regulator of energy homeostasis, further studies are needed to ascertain the relevance in bariatric surgery.

Safety of peripheral gastric vessel coagulation during laparoscopic sleeve gastrectomy.

INTRODUCTION: Staple-line bleeding (SLB) is a common issue during laparoscopic sleeve gastrectomy (SG). Identifying a method or technique intraoperatively to manage or reduce the prevalence of SLB is crucial. MATERIALS AND METHODS: Patients' data who had undergone primary laparoscopic SG from January 2018 to December 2019 at our hospital were retrospectively analysed. The patients in this study received peripheral gastric vessel coagulation intervention in addition to the standard SG procedure. Preoperative parameters included age, gender, body mass index (BMI), the prevalence of diabetes and hypertension. Intra- and postoperative parameters were prevalence of SLB, operative time, total postoperative stay, the prevalence of leakage and bleeding. Intraoperative SLB was identified and analysed through video recordings. RESULTS: 217 cases of laparoscopic SG were included in the study. The mean preoperative assessments were as follows: age, 34.2 ± 10.7 years; male/female, 98/119; BMI, 39.9 ± 7.6 kg/m2; prevalence of diabetes, 52 (24.0%) and hypertension, 90 (41.5%). Of 217 patients, 35 (16%) were found to have SLB following the new interventional procedure. The mean operative time was 93.2 ± 13.6 min. The mean total postoperative stay was 3.3 ± 1.3 days. The postoperative prevalence of leakage and bleeding were 0% and 0%, respectively. CONCLUSION: The technique of coagulating the peripheral gastric vessels to prevent SLB is safe and appears promising. A prospective study comparing with and without peripheral gastric vessel coagulation will be needed in the future.

The expression of long non-coding RNA LINC01279 in gastric adenocarcinoma and its clinical significance.

OBJECTIVE: To investigate the expression of long non-coding RNA LINC01279 in gastric cancer and its relationship with the clinicopathological features and prognosis of gastric cancer patients. METHODS: Serum, gastric cancer and adjacent tissue samples from 90-patients with gastric-cancer treated by surgery and serum samples from 90-healthy adults were collected. The expression level of LINC01279 was analyzed by RT-PCR. The clinical baseline data of gastric cancer patients were obtained. Correlation between the expression level of LINC01279 and the clinicopathological characteristics of gastric cancer patients was assessed. RESULTS: LINC01279 was highly expressed in gastric cancer tissues and serum of gastric cancer patients (P < 0.05). The expression level of lncRNA 01279 was closely related to vascular invasion, nerve invasion, T-stage, lymph node metastasis, and advanced clinical-stage of gastric cancer (P < 0.05). The expression level was not correlated with gender, age, tumor size, location, and differentiation. There was a significant negative correlation between the expression of LINC01279 and the overall survival of gastric-cancer patients (P < 0.05). CONCLUSION: LINC01279 is highly expressed in gastric-cancer tissues and serum, which is closely related to tumor-invasion. Serum LINC01279 is a better prognostic indicator of invasive cancer than current tumor markers.

Sleeve Gastrectomy with Braun Anastomosis Transit Bipartition (B-TB): a Potential Midway Between Single Anastomosis and Roux-en-Y Transit Bipartition.

PURPOSE: The single anastomosis sleeve ileal bypass (SASI) procedure is a simple modification of the Roux-en-Y transit bipartition (RYTB) procedure; however, SASI risks patients with possible biliary reflux. Braun anastomosis has been proposed to fix the biliary reflux of single anastomosis procedures. This study presented our early "sleeve gastrectomy with Braun anastomosis Transit Bipartition" (B-TB) outcomes. MATERIALS AND METHODS: Patients who underwent B-TB or RYTB between June 2020 and April 2021 at our hospital and have completed three months follow-up were included in this study. RESULTS: Ten patients with B-TB and forty patients with RYTB were included. No significant differences were observed between the B-TB and RYTB patients regarding the preoperative conditions. The B-TB procedure had significantly shorter operation time and postoperative hospitalization time than the RYTB procedure. There was no significant difference between the two groups regarding the 3-month percentage of total weight loss (B-TB vs RYTB: 19.7 ± 2.7% vs 22.2 ± 5.4%) and the postoperative complications before discharge. Preoperatively, two patients and eight patients achieved GERD-Q score ≥8 for the B-TB and RYTB group, respectively. At postoperative 3 months, those with GERD-Q score ≥8 was reduced to one patient and two patients for the B-TB and RYTB group, respectively. No patients have reported symptoms of greenish-yellow vomiting in both groups postoperatively. CONCLUSION: B-TB is an exciting procedure with potential benefits. However, as it is an investigational procedure, extra care should be maintained. Larger samples and more extended follow-up data are needed in the future.

The effect of sleeve ablation of gastric mucosa on body weight and glucose homeostasis in Sprague-Dawley rat model.

BACKGROUND: The gastric mucosa is an important endocrine organ, most of which is resected in sleeve gastrectomy (SG). The effect of removing most of the gastric mucosa has not been studied. OBJECTIVE: To assess the effect of ablating the gastric mucosa (an area proportional to that in SG), on obesity and diabetes in a rat model. SETTING: The Affiliated Hospital of Xuzhou Medical University in Xuzhou Jiangsu, P. R. China. METHODS: Among 34 fatty Sprague-Dawley rats, 26 randomly received low-dose streptozotocin (STZ) to induce diabetes and then were randomly assigned to gastric mucosa ablation (GMA, n = 10), sleeve gastrectomy (SG, n = 8), and sham (n = 8) groups. The remaining normal fatty rats were assigned to the non-diabetic gastric mucosa ablation (nGMA, n = 8) group. In the GMA groups, the gastric mucosa was thermally ablated using electrocautery. Rats were followed for 8 weeks postoperatively. Preoperative oral glucose tolerance test (OGTT), insulin tolerance test (ITT), and mixed meal tolerance test (MMTT) were repeated at designated time points postoperatively. Changes in body weight, food intake, and fasting blood glucose were also recorded. RESULTS: Fasting ghrelin concentration and area under curve (AUC) decreased significantly (P < .05) in the GMA groups and the SG group after surgery. Gastrin concentration remained unchanged in SG but decreased significantly in the GMA groups after surgery. Significantly increased GLP-1 AUC was found in the GMA groups and the SG group postoperatively. The decrease in fasting blood glucose did not differ significantly between the diabetic GMA and SG groups after surgery. Glucose AUC during OGTT in both SG and diabetic GMA groups was decreased significantly from the preoperative level, but the decreased glucose AUC in the SG group was significantly greater (P < .05). The decrease in body weight and food intake in the SG group was significantly greater than in the GMA groups. CONCLUSION: Ablation of most of the gastric mucosa along the greater curvature is effective in weight loss and glycemic control in a rodent model.