The influence of different digestive tract reconstruction methods on blood sugar of T2DM patients after subtotal gastrectomy / 中华内分泌外科杂志

Objective To analyze the influence of different digestive tract reconstruction methods on blood sugar in T2DM patients after subtotal gastrectomy,and to explore the possible mechanism.Methods The clinical data of 64 cases of T2DM patients undergoing subtotal gastrectomy because of gastric ulcer or cancer were retrospectively analyzed.They were divided into Roux-en-Y group (34 cases) and Billroth Ⅱ group (30 cases) according to the different reconstruction methods of digestive tract,and they were treated by Roux-en-Y anasto-mosis and Billroth Ⅱ anastomosis respectively after subtotal gastrectomy.They were followed up for 6 months.BMI,fasting blood sugar,2 h postprandial blood glucose,glycosylated hemoglobin,fasting insulin,insulin resistance index (HOMA-IR),glucagon peptide 1 (GLP-1),gastric inhibitory peptides (GIP),and GIP/GLP-1 before surgery and one week,one month,3 months,and 6 months after surgery were compared between the two groups.Results BMI of the two groups 3 months,and 6 months after surgery was significantly lower than those before surgery (P＜0.05),and it had no statistical significance between the two groups at the same time point (P＞0.05).Compared with preoperative,the fasting blood sugar,2 h postprandial blood glucose,glycosylated hemoglobin,fasting insulin,HOMA-IR one week,one month,3 months,and 6 months after surgery in the two groups were significantly lower than those before surgery (P＜0.05).The fasting blood sugar,and 2 h postprandial blood glucose were lower in Roux-en-Y group than in Billroth Ⅱ group (P＜0.05).The glycosylated hemoglobin in Roux-en-Y group was lower than those in Billroth Ⅱ group at 3 months,and 6 months after surgery (P＜0.05).Compared with those before surgery,GIP and GIP/GLP-1 in the two groups at one week,one month,3 months,and 6 months were significantly decreased after operation (P＜0.05).Also,they were significantly lower in Roux-en-Y group compared with Billroth Ⅱ group at the same time point.Conclusion Roux-en-Y anastomosis after subtotal gastrectomy may be more beneficial?for reducing blood glucose in T2DM patients,which may be more beneficial for keeping the balance of entero-insular axis.

The influence of oral administration of glucose before surgery on insulin resistance and oxidative stress in castric cancer patients undergoing surgery / 中华内分泌外科杂志

Objective To explore the influence of oral administration of glucose before surgery on insulin resistance and oxidative stress in castric cancer patients undergoing surgery.Methods 63 cases of castric cancer patients undergoing surgery were divided into observation group (n=32) and the control group (n=31) according to random number table method.Patients were given fasting after ten o'clock the day before surgery.Patients in the observation group were dealed with 500 ml 100 g/L glucose solution orally,while patients in the control group were dealed with the same amount of distilled water 3 hours before surgery.The general information and operation indicators were recorded.Blood glucose (GLU),insulin,malondialdehyde (MDA) and superoxide dismutase (SOD) levels were detected before surgery and 4 hours after surgery.Insulin resistance index(HOMAIR) was recorded also.Results The general data between the two groups before the test started had no statistically significant difference (P＞0.05).All patients completed test successfully,and the complications such as choking cough,aspiration did not happen during the treatment.The operation time,Intraoperative fluid infusion,intraoperative blood loss and postoperative pathological stage between the two groups had no statistical difference (P＞0.05).GLU,insulin and HOMA-IR in the two groups after surgery increased significantly than those before surgery,and the difference had statistical significance (P＜0.05).GLU,insulin and HOMA-IR were significantly lower in the observation group than in the control group,and the difference had statistical significance (P＜0.05).SOD and MDA in the two groups after surgery increased significantly than those before surgery,and the difference had statistical significance (P＜0.05).SOD in the observation group was significantly higher,while MDA was significantly lower than those in the control group,and the difference had statistically significance(P＜0.05).Conclusion Oral administration of glucose before surgery in castric cancer patients undergoing surgery can reduce insulin resistance and oxidative stress,and it is safe.

Progress of research on the pathogenesis of obesity in Bardet-Biedl syndrome / 中华医学遗传学杂志

Bardet-Biedl syndrome (BBS) is a rare autosomal recessive disease characterized by retinopathy, obesity, and polydactyly. So far 21 candidate genes have been discovered, and mutations of such genes can all cause the BBS phenotype. As one of the main features of the disease, the obesity in BBS has been associated with leptin resistance and abnormal adipogenesis. However, its molecular etiology is not yet completely clear. Here the molecular mechanism of BBS-associated obesity is reviewed.

Expression of antisense thrombin receptor gene inhibits intimal hyperplasia of rat carotid artery after balloon injury / 中华病理学杂志

<p><b>OBJECTIVE</b>To study the mechanism of restenosis after angioplasty and to clarify the effect of thrombin and its receptor on restenosis development.</p><p><b>METHODS</b>Balloon catheter-induced injury was adopted to induce intimal hyperplasia of the carotid arteries in rats. Antisense thrombin receptor (ATR) cDNA was transfected by perfusing recombinant LXSN ATR plasmid/nanoparticle complex into the segment of the injured carotid artery.</p><p><b>RESULTS</b>PCR result showed integration of the recombined gene. Dot blot showed the expression of antisense TR mediated by recombinant LXSN ATR plasmid/nanoparticle complex in the wall of common carotid arteries of the experimental group rats, which enabled to inhibit TR gene expression and intimal hyperplasia of the injured arteries.</p><p><b>CONCLUSIONS</b>Thrombin and its receptor play an important role in the formation of neointima after the injury, which provides a potential clue in developing a new approach for prevention and treatment of restenosis after angioplasty.</p>

Effect of NF-kappaB on the induction of PDGF-B transcription by angiotensin II in the ECV304 cell line / 中华医学杂志(英文版)

<p><b>OBJECTIVE</b>To examine the effect of angiotensin II (Ang II) on nuclear factor-kappa B (NF-kappaB) activation in human endothelial cell line ECV304 and the molecular mechanism by which Ang II activates NF-kappaB.</p><p><b>METHODS</b>ECV304 cells were transiently cotransfected with an NF-kappaB/luciferase reporter gene and inactive NF-kappaB-inducing kinase (NIK), IkappaB kinase alpha (IKK(alpha)), IkappaB kinase beta (IKK(beta)) mutants or vectors, respectively. The effect on NF-kappaB was detected by using an electrophoretic mobility shift assay (EMSA) and overexpression of the mutants enabled blocking of reporter gene activation induced by Ang II. With immunofluorescence and immuno-electronic microscope techniques, including confocal microscopy and gold particle labeled electronic microscopy, definite cytoplasmic-to-nuclear translocations of NF-kappaB activation were detected using subunits p50 and p65 induced by Ang II.</p><p><b>RESULTS</b>The translocation of p50 in nuclei was highly remarkable 2 hours after Ang II stimulation, and the activity was somewhat reduced 6 hours after stimulation to the 18th hour. Northern blot also showed PDGF-B mRNA increased by stimulation of Ang II for 18 hours.</p><p><b>CONCLUSION</b>Ang II is effective in stimulating NF-kappaB activation through a pathway dependent on NIK, IKK(alpha) and IKK(beta), and induces PDGF-B transcription in the endothelial cell line, ECV304.v</p>

Effect of oxLDL on the uptake and clearance rate of cholesterol in v-SMC originated from human apoA1 transgenic mice / 中华医学杂志(英文版)

<p><b>OBJECTIVE</b>To study the inhibition effect of oxLDL on the uptake and clearance of intra-cellular (3)H-cholesterol in v-SMC from the human-apoA1 transgenic mice (C57BL/6) and the changes in human-apoA1 mRNA expression in v-SMC from human apoA1 transgenic mice after oxLDL stimulation.</p><p><b>METHODS</b>v-SMC originally isolated from human apoA1 transgenic mice connected with a recombined mouse metallothionein-I (MT-I) promoter was used, and the effect of oxLDL on the uptake and clearance of intracellular (3)H-cholesterol was studied in v-SMC of the transgenic and control mice respectively, the study of h-apoA I mRNA expression from v-SMC of the transgenic mice were done by RT-PCR and Northern blot.</p><p><b>RESULTS</b>oxLDL (30 microg/ml) strongly promoted the SMC proliferation. No difference was found in (3)H-cholesterol uptake between nSMC and trSMC, and the uptake rates of both kinds of SMC rose 100% after oxLDL stimulation. The efflux rates of (3)H-cholesterol in trSMC were much higher than those of nSMC (40% - 50%). After oxLDL stimulation, the clearance rates fell by 28% and 10%, respectively, for nSMC and trSMC. The result of RT-PCR and Northern blot showed that h-apoA1 gene expression was markedly increased by the stimulation of oxLDL.</p><p><b>CONCLUSION</b>Expression of the h-apoA1 gene in C57BL/6 mice enables them to reduce the accumulation of cholesterol in v-SMC. The trSMC can alleviate the harmful effect of oxLDL due to the increase of h-apoA1 expression.</p>