Akt2 deficiency alleviates oxidative stress in the heart and liver via up-regulating SIRT6 during high-fat diet-induced obesity.

The present study aims to investigate the role of AKT2 in the pathogenesis of hepatic and cardiac lipotoxicity induced by lipid overload-induced obesity and identify its downstream targets. WT and Akt2 KO mice were fed either normal diet, or high-fat diet (HFD) to induce obesity model in vivo. Human hepatic cell line (L02 cells) and neonatal rat cardiomyocytes (NRCMs) were used as in vitro models. We observed that during HFD-induced obesity, Akt2 loss-of-function mitigated lipid accumulation and oxidative stress in the liver and heart tissue. Mechanistically, down-regulation of Akt2 promotes SIRT6 expression in L02 cells and NRCMs, the latter deacetylates SOD2, which promotes SOD2 activity and therefore alleviates oxidative stress-induced injury of hepatocytes and cardiomyocytes. Furthermore, we also proved that AKT2 inhibitor protects hepatocytes and cardiomyocytes from HFD-induced oxidative stress. Therefore, our work prove that AKT2 plays an important role in the regulation of obesity-induced lipid metabolic disorder in the liver and heart. Our study also indicates AKT2 inhibitor as a potential therapy for obesity-induced hepatic and cardiac injury.

Study on the Effect of Different Endoscopic Auxiliary Treatment of Gastric Mucosal Microtumor.

Objective: To explore the effect of endoscopy in the treatment of gastric mucosal microtumors. Methods: A total of 229 patients with gastric mucosal microtumors were treated in our hospital from January 2016 to December 2021. All patients were divided into three groups group A, group B, and group C. Group A was treated with a transparent cap combined with circle-assisted endoscopic resection, group B with ligator combined with circle-assisted endoscopic resection, and group C with endoscopic mucosal tumor resection. The effects of the three groups were observed. Results: There were 47 patients in group A, 17 males, and 30 females, aged 36-69 years, with an average age of 55.6 ± 9.2 years. There were 54 patients in group B, 18 males, and 36 females, aged 38-72 years, with an average age of 57.6 ± 7.7 years. There were 128 patients in group C, 29 males, and 99 females, aged 33-78 years, with an average age of 55.6 ± 8.4 years. There is no significant difference in age and sex between group A, group B, and group C (P > 0.05). The incidence of postoperative complications in group B (66.7%) was significantly higher than that in group A (57.4%) and group C (53.9%) (all P < 0.05). The incidence of postoperative complications in group A (57.4%) was higher than that in group C (53.9%), and the difference was statistically significant (P < 0.05). Conclusion: Endoscopic mucosal resection and ligation combined with circle-assisted endoscopic resection are effective and safe in the treatment of gastric mucosal microtumors, but it needs to be combined with targeted nursing measures. The transparent cap combined with ring-assisted endoscopic resection has a significant effect on the treatment of gastric mucosal micromasses, reducing operative complications.

Modified Lamaze Breathing Reduces Abdominal Pain in Patients during Colonoscopy.

Objective: To study the effects of modified Lamaze breathing on abdominal pain experienced during colonoscopy. Methods: Eighty-five patients who underwent common colonoscopy at our hospital between March 2021 and May 2021 were selected and randomly divided into the Lamaze group (n = 40) and a control group (n = 45). Their basic clinical information was collected, and the bowel cleanliness, the time for the endoscope to reach the ileocecal junction, and the degree of abdominal pain of the two groups were compared. Results: No significant difference was observed in age, gender, bowel cleanliness, and time of endoscope to reach the ileocecal junction between the two groups. However, the degree of abdominal pain (anal region, descending sigmoid colon junction, splenic flexure, and hepatic flexure) was significantly lower in the Lamaze group compared with the control group. Conclusion: Modified Lamaze breathing demonstrated promising effectiveness in reducing abdominal pain during colonoscopy and improving the quality of the examination.

Comparison of endoscopic radial incision and Savary-Gilliard's bougie dilation in efficacy on refractory esophagogastric anastomosis strictures.

BACKGROUND: Among patients with a benign stricture in the upper gastrointestinal tract, those with esophagogastric anastomosis stricture (EAS) due to complications after esophagectomy for esophageal carcinoma comprise the majority. Dilation is the primary surgical treatment for EAS, but its short-term effect is not remarkable and its long-term effect is worse. METHODS: We compared endoscopic radial incision (ERI) and Savary-Gilliard's bougie dilation (SGBD) for patients with refractory EAS, and evaluated overall efficacy and complications. Stooler's scale was used to grade the patients' dysphagia before surgery. The two groups were compared for the number of dilations or incisions, the degree of dilation of the EAS after surgery and postoperative complications, such as intraoperative bleeding (arteriopalmus bleeding requiring endoscopic intervention), postoperative bleeding (hematemesis, bloody stool or black stool), postoperative perforation (fistula formation confirmed by gastrointestinal radiography), and postoperative infection (including postoperative fever). RESULTS: The Exp group had 15 markedly effectively treated patients, 7 effectively treated patients, and 3 ineffectively treated patients, while the numbers of these patients in the Obs group were 5, 6, and 10, respectively. Thus, the Exp group had a significantly higher total effective rate than the Obs group (88.0% vs. 52.4%, P<0.05). Patients treated by ERI had higher overall therapeutic effect, better swallowing symptom grade, and lower incidence of complications. CONCLUSIONS: Thus, ERI is superior to SGBD in efficacy and safety for treating refractory EAS.

Risk factors for rebleeding in patients with obscure gastrointestinal bleeding from southern China.

BACKGROUND: To identify the risk factors associated with rebleeding in obscure gastrointestinal bleeding (OGIB) patients from southern China. METHODS: This retrospective study involved 229 patients who underwent small bowel endoscopy in our hospital between 1 January 2018 and 1 December 2020. The clinical characteristics and risk factors related to rebleeding were retrospectively evaluated. RESULTS: Rebleeding patients were significantly older than non-rebleeding patients (53.0 ± 15.9 vs. 46.2 ± 17.8 years), had lower hemoglobin concentrations (89.2 ± 28.1 vs. 126.2 ± 25.1 g/L), and higher blood urea nitrogen concentrations (5.4 ± 2.6 vs. 4.5 ± 2.2 µmol/L), respectively. A higher percentage of rebleeding patients had diabetes mellitus (13.9% vs. 2.9%) and overt bleeding (70.4% vs. 38.6%), and required blood transfusions (43.1% vs. 8.0%), compared with non-rebleeding patients, respectively. Multivariate logistic analysis indicated that drinking alcohol (odds ratio (OR): 9.27; 95% confidence interval (CI) = 1.35-63.78), anemia (OR: 17.38; 95% CI = 5.48-55.10), and blood transfusion (OR: 3.76; 95% CI = 1.04-13.56) increased the risk of rebleeding in OGIB patients. CONCLUSION: Our data suggested that OGIB patients who drink alcohol, have anemia, and require blood transfusion have an increased risk of rebleeding.