Comparison of laparoscopic Roux-en-Y gastric bypass with laparoscopic sleeve gastrectomy for morbid obesity or type 2 diabetes mellitus: a meta-analysis of randomized controlled trials.

BACKGROUND: Laparoscopic Roux-en-Y gastric bypass (LRYGB) is one of the most widely used bariatric procedures, and laparoscopic sleeve gastrectomy (LSG) as a single-stage procedure for treating morbid obesity is becoming more popular. We compared both techniques to evaluate their efficacy in treating morbid obesity or type 2 diabetes mellitus (T2DM). METHODS: We searched the Cochrane Controlled Trials Register databases, Medline, Embase, ISI databases and the Chinese Biomedical Literature Database to identify randomized controlled trials (RCTs) of LRYGB and LSG for morbid obesity or T2DM published in any language. Statistical analyses were carried out using RevMan software. RESULTS: Five worldwide RCTs with 196 patients in the LRYGB group and 200 in the LSG group were included in our analysis. Compared with patients who had LSG, those who had LRYGB had a higher remission rate of T2MD, lost more weight and had lower low-density lipoprotein, triglycerides, homeostasis model assessment index and insulin levels. There was no difference in the reoperation rate between the groups. However, patients treated with LRYGB had a higher incidence of complication than those treated with LSG. CONCLUSION: Our meta-analysis demonstrates that LRYGB is more effective than LSG for the surgical treatment of T2DM and control of metabolic syndrome. However, LSG is safer and has a reduced rate of complications. Further high-quality RCTs with long follow-up periods are needed to provide more reliable evidence.

CONTEXTE: La dérivation gastrique laparoscopique Roux-en-Y (DGRY) est l'une des interventions bariatriques les plus utilisées, et la gastrectomie longitudinale laparoscopique (GLL) gagne en popularité comme intervention en une seule étape pour le traitement de l'obésité morbide. Nous avons comparé les 2 techniques pour en évaluer l'efficacité dans le traitement de l'obésité morbide ou du diabète de type 2 (DT2). MÉTHODES: Nous avons interrogé les bases de données du Registre des essais cliniques contrôlés de la Collaboration Cochrane, de même que les bases de données Medline, Embase, ISI et la base de données de la littérature biomédicale chinoise pour recenser les essais randomisés et contrôlés (ERC) publiés dans toutes les langues sur la DGRY et la GLL dans les cas d'obésité morbide ou de DT2. Les analyses statistiques ont été effectuées au moyen du logiciel RevMan. RÉSULTATS: Cinq ERC ont été recensés dans le monde et ont été inclus dans notre analyse, totalisant 196 patients soumis à la DGRY et 200 soumis à la GLL. Comparativement aux patients soumis à la GLL, les patients soumis à la DGRY ont présenté des taux de rémission plus élevés de leur DT2, ils ont perdu plus de poids et ont présenté des taux plus faibles de lipoprotéines de faible densité et de triglycérides, une baisse de leur indice d'évaluation du modèle d'homéostasie) et de leur taux d'insuline. On n'a noté aucune différence entre les groupes pour ce qui est du taux de réintervention. Toutefois, l'incidence des complications a été plus élevée chez les patients traités par DGRY que chez ceux traités par GLL. CONCLUSION: Notre méta-analyse démontre que la DGRY est plus efficace que la GLL pour le traitement chirurgical du DT2 et le contrôle du syndrome métabolique. Toutefois, la GLL est plus sécuritaire et s'accompagne d'un taux moindre de complications. Il faudra procéder à d'autres ERC de grande qualité comportant des suivis prolongés pour amasser des preuves plus fiables.

Meta-analysis of the effectiveness of prophylactic antibiotics in the prevention of postoperative complications after tension-free hernioplasty.

BACKGROUND: Previous reviews of the effectiveness of antibiotic prophylaxis for elective inguinal hernia repair were not conclusive owing to the limited number of patients enrolled in randomized controlled trials (RCTs). However, since new RCTs involving patients undergoing tention-free hernioplasty have been published in recent years, we performed a new meta-analysis to evaluate the effectiveness of antibiotic prophylaxisin the prevention of postoperative complications after this procedure. METHODS: We performed a meta-analysis of RCTs studying the use of antibiotic prophylaxis to prevent postoperative complications in patients undergoing tension-free hernioplasty. RESULTS: We included 6 RCTs conducted around the world in our analysis. Compared with the control condition, antibiotic prophylaxis was associated with a lower incidence of incision infection (odds ratio [OR] 0.45, 95% confidence interval [CI] 0.26-0.77, p = 0.004). There were no significant differences in risk for incision hematoma (OR 1.57, 95% CI 0.60-4.10, p = 0.35), respiratory infection (OR 1.00, 95% CI 0.17-5.79, p > 0.99) or urinary tract infection (OR 1.81, 95% CI 0.38-8.52, p = 0.45) between the 2 conditions. CONCLUSION: Antibiotic prophylaxis use in patients undergoing tension-free hernioplasty decreases the rate of incision infection by 55%.

Pachymic acid inhibits growth and induces cell cycle arrest and apoptosis in gastric cancer SGC-7901 cells.

The aim of the present study was to elucidate the anticancer effect of pachymic acid (PA) in gastric cancer SGC-7901 cells and the potential molecular mechanisms involved. Cell Count kit-8 assay was performed to examine the effect of PA on the cell proliferation of SGC-7901 cells. Cell cycle, cell apoptosis, mitochondria membrane potential (Dψm) and reactive oxygen species (ROS) analysis were assessed by flow cytometry, respectively. DNA fragmentation assay was performed by Hoechst 33258 staining. Western blotting was performed to detect the effect of various concentrations of PA on the levels of BCL2 associated X protein (Bax) expression as well as B-cell lymphoma 2 (Bcl-2), cytochrome C (cyt-c) and caspase-3 in SGC-7901 cells. It was demonstrated that PA was able to significantly inhibit the viability and induce G0/G1 cell cycle arrest of SGC-7901 cells in a concentration-dependent manner. The apoptotic rate and ROS generation were markedly increased, while Dψm was decreased following the treatment of SGC-7901 cells with various concentrations of PA. Moreover, the expression of Bax, cytochrome c and caspase-3 were markedly increased and Janus kinase 2 (JAK2)/signal transducer and activator of transcription 3 (STAT3) was significantly inactivated and BCL-2 expression was decreased following PA treatment in SGC-7901 cells. Notably, JAK2 inhibitor (AG490) mimics the effects of PA on the viability and apoptosis of SGC-7901 cells. Further in vivo study indicated that treatment with PA significantly inhibited the growth of tumor in nude mice that were transplanted with SGC-7901 cells in a concentration-dependent manner. These results may advance the current understanding of the anticancer mechanisms of PA in gastric cancer.

Anticancer effect of salidroside on colon cancer through inhibiting JAK2/STAT3 signaling pathway.

Salidroside is considered to have anti-tumor properties. We investigate its effects on colon carcinoma SW1116 cells. Cell viability was assessed by CCK-8. Propidium iodide (PI) staining was used to determine the cell cycle by flow cytometry. The migration and invasion were detected by Transwell. Western blot was used to detect the expression of STAT3 signal related proteins. As the result, high concentrations of salidroside (10, 20. 50 µg/ml) significantly inhibited proliferation of SW1116 cells in a parallelly, cell cycle arrest was increased at the G0/G1 phase after salidroside treatment. Furthermore, salidroside inhibited migration and invasion of SW1116 cells. Salidroside treatment decreased proteins expression of phosphorylation levels in JAK2/STAT3 signaling, while MMP-2 and MMP-9 proteins levels were decreased and protein expression of VEGF and VEGFR-2 were down-regulated. In Conclusion, salidroside inhibited proliferation, decreased the migration and invasion of SW1116 cells in JAK2/STAT3-dependent pathway, the specific mechanisms need further study.