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Objective:To explore the differences in bacterial community structure between proximal colon cancer (PC), distal colon cancer (DC), and rectal cancer (RC), and the values of featured microbiota in differentiating PC with tumor markers.Methods:This case-control study enrolled 85 newly diagnosed colorectal cancer patients, including 22 PC, 15 DC and 48 RC patients, and 8 colorectal adenoma patients from May 2019 to July 2022 at the Department of General Surgery, Anyang Oncology Hospital. The blood and fecal samples were collected before surgery and then subjected to biochemical tests for tumor markers and 16S rDNA tests, respectively. SPSS (27.0.1) was applied to perform the t-test, one-way ANOVA, Mann-Whitney U test, Kruskal-Wallis H test, and Chi-Squared Test. Also, the receiver operating characteristic curve (ROC) was plotted on tumor markers and/or f_Bacteroidaceae with SPSS software .Results:All groups had significant differences in the CA125 ( F=3.543, P<0.05), CA72-4 ( F=3.596, P<0.05), and serum tumor-associated materials (TAM) levels ( F=5.787, P<0.01). In PC group, the levels of CA125 [PC vs RC, (36.84±6.30) kU/L vs (12.73±4.21) kU/L, P<0.01] and CA72-4 [PC vs RC, (45.56±10.86) kU/L vs (3.30±7.63) kU/L, P<0.01] were significantly higher than that of the RC group, while the level of TAM was remarkably elevated in PC group than in RC group [PC vs RC, (124.84±5.19) U/ml vs (102.44±3.63) U/ml, P<0.001] and CRA group [PC vs CRA, (124.84±5.19) U/ml vs (95.39±8.42) U/ml, P<0.01]. The LEfSe analysis showed that the featured microbiota in the PC group included f_Bacteroidaceae, f_Neisseriaceae, f_Clostridiaceae_1, f_Spirochaetaceae, and so on. The largest area under the ROC belonged to the combination of TAM and f_Bacteroidaceae, which reached 0.845 (95% CI 0.747-0.944), with sensitivity being 0.857 and specificity being 0.815. Conclusions:There is heterogeneity in gut microbiota composition among PC, DC, RC, and CRA. The combination of gut microbiota and tumor biomarkers demonstrated good differentiating effects in proximal colon cancers.
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Adenoid cystic carcinoma usually occurs in the salivary glands of the head and neck. It is a malignant tumor with a high degree of malignancy, resistance to radiotherapy and chemotherapy and poor prognosis. The clinical course of adenoid cystic carcinoma is slow and easy to be misdiagnosed. The main diagnosis and treatment means are individualized and precise treatment under the multi-disciplinary consultation mode, that is, surgical treatment and radiotherapy and chemotherapy. Adenoid cystic carcinoma is prone to relapse and hematologic metastasis, and the traditional radiotherapy and chemotherapy based therapies have not achieved satisfactory efficacy in the past three decades. How to detect, diagnose and treat early is an urgent task faced by clinicians.
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Humans , Carcinoma, Adenoid Cystic/pathology , Neoplasm Recurrence, Local , Neck/pathology , Oropharynx/pathology , Diagnostic ErrorsABSTRACT
The number of women of childbearing age having overweight or obesity problems keeps increasing globally. Besides diabetes, hypertension and other chronic conditions, these women may develop metabolic disorders of sex hormones, manifested by irregular menstruation, infertility and obstetric complications. Bariatric surgery offers prominent weight loss and improves obesity-related conditions. Women patients also benefit from elevated chances of pregnancy postoperatively. However, the timing of pregnancy for obese women after surgery has impact on the effects of weight loss surgery, pregnancy complications, delivery outcomes and long-term prospects of mother and child. This article reviews the clinical studies on the timing of pregnancies after bariatric surgery, weight loss results, as well as risks and outcomes.
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Submandibular gland excision was performed on two patients using trans-oral robotic surgery (TORS). Complications such as the injury of marginal mandibular branch of facial nerve, ranula in the floor of the mouth, and postoperative hemorrhage were not observed. Visible cervical scar can be avoided and esthetic outcome can be expected by using this surgical modality.
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Objective@#To explore the feasibility of using da Vinci Surgical System to perform supraomohyoid neck dissection (SOND) to avoid visible scar and reduce trauma.@*Methods@#Between September 2017 and December 2018, twenty patients (two females and 18 males, mean age, 54.8 years) with oral cancer treated in the Department of Stomatology, Hainan Hospital of General Hospital of Chinese PLA were enrolled in this study. Eight patients were assigned into robotic surgery group, and received robot-assisted SOND with retroauricular hairline incision. After the da Vinci Surgical System robotic platform was positioned, the neck dissection was performed in level Ⅱb, Ⅱa, Ⅲ, Ⅰb and Ⅰa orderly from the near region to far region. The other 12 patients were assigned into traditional surgery group, and received SOND with a traditional incision. The operation time, bleeding and amount of lymph node dissected were compared between two groups.@*Results@#All the 8 cases of robot-assisted SOND were completed smoothly. Operation time [(4.5±1.0) h] was significantly longer in robotic surgery group than that [(2.5±1.0) h] in traditional surgery group (P<0.05). The amount of bleeding in robotic surgery group [30.0 (27.5) ml] was significantly lower than that in traditional surgery group [(100.0 (87.5) ml, P<0.05]. There′s no difference in the number of lymph nodes dissected between robotic surgery group (23.6±5.2) and traditional surgery group (22.8±6.0)(P>0.05). No postoperative hemorrhage, symptoms of nerve injury, flap necrosis and secondary healing were observed in robotic surgery group.@*Conclusions@#SOND through retroauricular hairline incision is feasible with the assistance of da Vinci Surgical System. The main advantage of this method is superior esthetic effects due to a hidden incision with minimal bleeding. There was no obvious differences in the amount of lymph nodes dissected and postoperative complications between two methods. However, robotic surgery costs a significantly longer operation time than traditional neck dissection.
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Objective To evaluate the efficacy and adverse reactions of preoperative intensity-modulated radiotherapy (IMRT) combined with mFOLFOX6 chemotherapy regimen for locally advanced rectal cancer (LARC). Methods A total of 86 patients with LARC who received preoperative IMRT combined with chemotherapy in Shanxi Provincial Cancer Hospital from June 2010 to December 2012 were enrolled. The patients were randomly divided into 2 groups according to the random number table method. Forty-six patients were treated with mFOLFOX6 regimen (mFOLFOX6 group) and 40 patients were treated with fluorouracil (5-Fu) single drug injection (5-Fu group). The total dose of IMRT target region was 45-54 Gy, 25 times in total. Short-term efficacy, adverse reactions, survival and metastasis were evaluated respectively. χ 2test or Fisher test were used to compare the count variable. Kaplan-Meier method was used to calculate the survival rates and Log-rank was used to detect. Results The total follow-up rate was 97.67 % (84/86). There were no statistical differences in the rate of resection (93.5 % vs. 80.0 %), pathological complete remission (pCR) rate (6.5 % vs. 0) and 3-year overall survival (OS) rate (87.0 % vs. 70.0 %) in the mFOLFOX6 group and 5-Fu group respectively (all P > 0.05). Down-staging rate, 3-year disease free survival (DFS) rate and distant metastasis free survival (DMFS) rate in the mFOLFOX6 group were significantly higher than those in 5-Fu group (58.7 % vs. 32.5 %, 79.1 % vs. 50.0 %, 89.1 % vs. 72.5 %, all P <0.05). Conclusions Preoperative IMRT combined with mFOLFOX6 regimen can decrease the preoperative staging of LARC patients, improve 3-year DFS rate and DMFS rate. The adverse reactions may increase, but it is tolerant.
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Objective To evaluate the treatment outcome of laparoscopic Roux-en-Y gastric bypass on old patients (≥60 years old) 3 years after surgery.Methods The clinical data of 116 patients who underwent LRYGB from Jan.2011 to Mar.2014 were retrospectively examined.Patients were divided in two group:group≥ 60 years comprised of 46 patients,group <60 years comprised of 70 patients.Preoperative and postoperative weight,blood glucose,blood lipid,hypertension and complication were evaluated,and the efficacy on the two groups was compared.Results The average age of group≥60 years was (63.1±2.5)years and the mean duration of diabetes was (11.3±4.8) years.Mean weight decreased from (81.8±12.7)kg to (64.6±11.7)kg (P<0.01),mean BMI decreased from (30.5±3.8) kg/m2 to (24.0±4.1) kg/m2 (P<0.01),glycosylated hemoglobin(HbA1c) decreased from (9.0±2.0)% to (7.06±126)% (P<0.01),and the remission of diabetes was 45.7%.Significant difference was also found in weight,BMI,EWL%,FBG,PBG,HbA1c,HOMA-IR,Ch,TG,LDL-C,hypertension at 3 years after surgery (P<0.05),but HDL-C level was similar after the operation.There was no significant difference between group≥60 years and group <60 years(P>0.05) except HbA1c(P<0.05).The incidence of postoperative complicationswasnot statistically significant(P>0.05).Conclusions LRYGB is a safe and effective treatment for old patients with obesity and T2DM.The remission rate of T2DM 3 years after surgery was similar between the 2 groups.
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Objective To investigate the expression of miR-218 (microRNA-218) in breast cancer tissues and its clinical significance. Methods Totally 45 tissue biopsies gained from breast cancer patients and the adjacent normal tissue were collected. Real-time qPCR was used to detect the miR-218 expressions. The correlations of miR-218 expression with clinicopathological characteristics and prognosis of breast cancer patients were analyzed. Results The average expression level of miR-218 in breast cancer tissues was significantly lower than that in control tissues (P = 0.001). The average expression level of miR-218 in PR negative breast cancer tissues was significantly lower than that of PR positive breast cancer tissue (P = 0.037). The average expression level of miR-218 in Ki-67 positive breast cancer tissues was significantly lower than that in Ki-67 negative breast cancer tissue (P=0.018). Conclusion The expression of miR-218 is closely related to carcinogenesis ,progres-sion and prognosis of breast cancer ,so it may be served as a diagnostic biomarker and a prognostic predictor in breast cancer patients,which provides a new way for the treatment of breast cancer.
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Objective To evaluate the effects of laparoscopic Roux-en-Y gastric bypass and sleeve gastrectomy on weight control in morbidly obese patients.Methods 48 patients with morbidly obesity underwent obese surgery (laparoscopic Roux-en-Y gastric bypass and laparoscopic sleeve gastrectomy) from Dec.2013 to Dec.2015,and 1-year follow-up study.The general situation of obesity and biochemical indicators were compared and analyzed.Results There were 20 cases in gastric bypass group and 28 cases in sleeve gastrectomy group.The excess weight loss percentage(%EWL)was 73±0.04 in gastric bypass group and 59±0.05 in sleeve gastrectomy group(P=-0.03).There was no statistical difference in weight change between the two groups.Low density lipoprotein cholesterol (LDL) level in gastric bypass group was significantly lower than that in sleeve gastrectomy group at 1 year after surgery (2.42±0.16 vs 3.29±0.20,P=0.006),while folic acid level was significantly higher than that in sleeve gastrectomy group(15.58±1.99 vs 7.59±1.59,P=0.022).Conclusions The one-year follow up shows there is no significant difference in the efficacy of weight control between the two groups.Gastric bypass group may be superior to gastrectomy group in nutrition indexes.However,it is just a short-term postoperative efficacy in morbidly obese patients,long-term weight control effects and obesity related diseases control need to be further explored.
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Background and purpose:miRNA plays important roles in tumorigenesis. It has been reported that many kinds of serum miRNA serve as markers for tumor diagnosis and screening. This study aimed to detect the expression of serum miRNA-31 (miR-31) in colorectal cancer patients and to explore the effect of miR-31 on cell proliferation, apoptosis and cell cycle distribution. Methods: The expressions of miR-31 in 40 cases of colorectal cancer serum and 35 cases of the healthy control were examined by real-time lfuorescent quantitative polymerase chain reaction (RTFQ-PCR). The correlation between miR-31 expression and clinicopathological features of colorectal cancer (including age, gender, depth of inifltration, lymph node metastasis, clinical stage) were further analyzed. The miR-31 mimics, inhibitor and miR-control (negative control) were transfected into HCT116 cells. The effect of miR-31 on cell proliferation was evaluated by CCK-8 method. Flow cytometry was used to examine the change of cell apoptosis and cell cycle. Results:Relative expression of serum miR-31 was signiifcantly increased in cancer patients compared with healthy controls (P<0.01). Expression of serum miR-31 was higher in poorly differentiated carcinoma than that in well or moderately differentiated carcinoma (P<0.05). No correlation was found between serum miR-31 expression and other clinicopathological variables. CCK-8 assay showed that after transfection with miR-31 mimics, the cell proliferation was increased, compared with miR-31 inhibitor and negative control group. Meantime, the apoptotic cell number was signiifcantly decreased, particularly in late apoptosis. The cell number of G1 stage was remarkably increased in miR-31 inhibitor group, compared with miR-31mimics and negative control group. Conclusion:The expression of serum miR-31 is higher in colorectal cancer. miR-31 can promote cell proliferation and inhibit the apoptosis of HCT116 cells. It might be a potential biomarker for colorectal cancer.
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Objective:To review and compare the clinical features and treatment outcomes of oral and maxillofacial space infection (OMSI)between diabetic and non-diabetic patients.Methods:Clinical data of 43 diabetic patients with OMSI(simultaneoustly treated by blood sugar control)and 84 of non-diabetic patients with OMSI were reviewed,the clinical features and treatment outcomes were compared.Statistical analyses were conducted by T test,the chi square test and variance analysis.Results:Diabetic patients with OM-SI were older(P =0.000),had more spaces involved concurrently(P =0.035 )and had higher blood sugar at presentation(P =0.000).There was no significant difference between groups about the use and change of antibiotics,the incision times,hospital stay durition and the incidence of the complications.Conclusion:The prognosis of the diabetic patients with OMSI under the strict control of the blood glucose concentration has no significant difference from the non-diabetic patients with OMSI.Diabetic patients with OMSI have older age and more spaces involved,and special attention should be paid.
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BACKGROUND:The use of three-dimensional cel culture techniques can better simulate the cel ular microenvironment, providing new tools for tissue engineering research. OBJECTIVE:To analyze the biomaterial selection and application characteristics in three-dimensional cel culture as wel as applications in tumor tissue engineering. METHODS:We searched Wanfang database and PubMed database 1998-2015 years for relevant literature using keywords of“three-dimensional cultures;scaffold;cel growth;cel differentiation;tumor tissue engineering”in Chinese and English, respectively. RESULTS AND CONCLUSION:The selection and application of three-dimensional scaffold materials is one of the keys. So far, scaffold materials, such as col agen gels, gelatin sponge, agarose, chitosan, demineralized bone matrix, cannot provide the extracel ular matrix similar to the micro-environment in which seed cel growth and proliferation are not affected, and the ability to secrete type II col agen and glycosaminoglycan is decreased, although they can provide three-dimensional space for seed cel s. Biomimetic scaffold characterized as little trauma and strong plasticity gradual y shows its unique advantages. Three-dimensional culture conditions raise pro-angiogenic growth factor secretion from tumor cel s, and this feature is positively correlated with the occurrence of in vivo tumor angiogenesis.
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Objective To detect the expression of hypoxia-inducible factor-1α (HIF-1α) in breast can-cer and to investigate the feasibility of HIF-1α as a new therapy target for breast cancer. Methods 56 cancer tissue specimens of women with primary breast cancer admitted from Jan. 2013 to Dec. 2013 in the Fourth Hos-pital of Hebei Medical University Breast Center were selected. Immunohistochemistry was used to detect the ex-pression of HIF-1α protein in cancer tissues. The relation between HIF-1α protein expression and the clinico-pathological parameters was analyzed. Results The positive expression rate of HIF-1α protein in breast cancer was 73.2% (41/56) and its high expression rate was 41.1% (23/56), which were significantly higher than those in benign breast tumor group (P=0.000). HIF-1α protein expression was positively correlated with breast tumor size, stage, histological grade, lymph node metastasis and the expression of HER2, and it was negtively correlated with ER. Conclusions High expression of HIF-1α in breast cancer was significantly associated with poor prog-nosis. HIF-1α protein is also a risk factor for breast cancer as well as HER2, and they may have a synergistic role in the progression of breast cancer.
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Objective To explore the volume size of mastoid pneumatization in normal adults and the relation‐ship with a history of recurrent otitis media in childhood .Methods A total of in 40 adults (80 ears) ,based on with or without otitis media in childhood ,were divided into the study group (n= 20) and the control group (n=20) . The volume sizes of mastoid pneumatization were measured by temporal bone CT scanning of three-dimensional re‐construction ,and the relationship with the history of childhood ear infections was studied .Results The average vol‐ume of pneumatization in all 80 temporal bones was 10 .4 ± 1 .8 ml .The average volume of pneumatization in sub‐jects without otitis media history (48 ears) and subjects with a history of otitis media (32 ears) were 9 .7 ± 2 .2 ml and 6 .3 ± 1 .7 ml ,respectively .The difference was statistically significant (P0 .05) .Conclusion The volumes of mastoid pneumatization in normal ears have a wide range .The subjects with a history of recurrent otitis media in childhood may be the cause of the volume decrease of mastoid pneumatization in adulthood .
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BACKGROUND: We aimed to examine the effect of Roux-en-Y gastric bypass surgery (RYGB) on erectile dysfunction (ED), cavernosal morphological vasculopathy, and carotid wall alterations in severely obese Chinese men. METHODS: We performed a retrospective cohort study of 39 obese men with ED who underwent RYGB between 2011 and 2012. Erectile function was assessed by the International Index of Erectile Function-5 (IIEF-5) before and 1 year after surgery. Intima-media thickness of carotid and cavernosal arteries and cavernosal peak systolic velocity (PSV) were investigated by color Doppler ultrasound. Endothelial function was assessed with the L-arginine test. RESULTS: Eighteen (46.2%) men had cavernosal vasculopathy and 21 (53.8%) had carotid vasculopathy before surgery, and these proportions decreased to 15.4% and 23.1% after surgery, respectively. There was a significant improvement in carotid and cavernosal intima-media thickness postoperatively. IIEF-5 (17.3 to 23.8, P < 0.05), PSV (23 to 37, P < 0.05), and endothelial scores (6.1 to 8.2, P < 0.05) were all improved after RYGB. The increase in endothelial function scores was positively associated with changes in pre- to postoperative IIEF-5 scores (r = 0.438, P = 0.017). Younger age, being married, and lower preoperative IIEF-5 scores were independently related to greater improvement in erectile function. CONCLUSIONS: ED can be relieved after RYGB in obese Chinese patients, accompanied by the improvement of cavernosal morphological vasculopathy and carotid wall alterations. Changes in endothelial function may contribute to this improvement, while preoperative body mass index and the amount of weight loss do not.
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Erectile Dysfunction/epidemiology , Gastric Bypass , Obesity, Morbid/epidemiology , Adult , Body Mass Index , Carotid Arteries/diagnostic imaging , Carotid Intima-Media Thickness , Endothelium, Vascular/physiopathology , Erectile Dysfunction/physiopathology , Humans , Male , Metabolic Syndrome/epidemiology , Middle Aged , Obesity, Morbid/physiopathology , Obesity, Morbid/surgery , Retrospective Studies , Ultrasonography, Doppler, Color , Young AdultABSTRACT
Objective Pathogens from the nosocomial infection have been analyzed by MALDI‐TOF microbial identification system ,to evaluate mass spectrometry analysis advantage and explore the mass spectrometry method .Methods The pathogens have been analyzed by MALDI‐TOF microbial identification system ,by compared with the VITEK‐2 compact detection in the tes‐ting time ,detection rate and the amounts of identified strains .The homology differences have been analyzed by comparison calcula‐tion of common peaks from the fingerprint spectrums .Results Thirty‐one Escherichia coli strains ,28 Klebsiella pneumonia strains and 9 unusual pathogen strains have been identified by MALDI‐TOF MS for only 1 hours .It has more advantages than VITEK‐2 in the testing time and other aspects .Conclusion Nosocomial infection of pathogen shows a point source propagation mode centering on the department .MALDI‐TOF mass spectrometry is able to rapidly and correctly identify the pathogen .MALDI‐TOF microbial i‐dentification system is expected to be the major detecting technique in the field of the pathogen monitor and resistance monitoring a ‐nalysis .
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Objective: To explore the expression of microRNA-21 8 (miR-218): in breast cancer tissues and the effect of miR-218 on the proliferation, apoptosis and cell cycle of breast cancer MCF-7 cells. Methods: The expression levels of miR-218 and B cell-specific MLV integration site 1 (BMN): mRNA in breast cancer tissues and the corresponding adjacent paracancerous tissues were detected by real-time fluorescence quantitative PCR. After miR-218 mimics transfection into MCF-7 cells, the expression levels of miR-218 and BMI1 mRNAs were detected by real-time fluorescence quantitative PCR, the proliferation ability of MCF-7 cells was detected by CCK-8 assay, and the cell cycle distribution and apoptosis were examined by flow cytometry (FCM). Results: The expression level of miR-21 8 in breast cancer tissues was significantly lower than that in corresponding adjacent paracancerous tissues (P < 0.01), and the expression level of BMIl mRNA was opposite (P < 0.05). The expression level of miR-218 in MCF-7 cells after transfection with miR-218 mimics was significantly higher than those in the negative control group [MCF-7 cells transfected with miR-218 negative control (miR-218 NC):] and the blank control group (MCF-7 cells without any transfection): (both P < 0.01), and the expression level of BMIl mRNA was opposite (P < 0.01). The proliferation ability of MCF-7 cells after transfection with miR-21 8 mimics was inhibited (P < 0.05); the proportion of G1-stage cells was decreased while the proportion of S-stage cells was increased, and the apoptosis rate was increased (all P < 0.01). Conclusion: The expression level of miR-218 is down-regulated in breast cancer tissues. miR-218 may inhibit the proliferation of breast cancer MCF-7 cells, promote apoptosis, and affect cell cycle distribution.
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Objective To explore molecular mechanisms underlying the in vitro counteracting effect of curcumin on malignant melanoma.Methods Cultured A375 and C8161 human melanoma cells were cultivated in vitro,and randomly divided into several test groups and a control group to be treated with different concentrations of curcumin and dimethyl sulfoxide respectively for different durations.Then,methyl thiazolyl tetrazolium (MTT) assay,Transwell assay,flow cytometry and Western blot were performed to evaluate the effect of curcumin on the proliferation,invasion and cell cycle of,as well as expressions of AKT/mTOR signaling pathway-related proteins in A375 and C8161 cells respectively.Statistical analysis was carried out by using t test.Results MTT assay showed that the treatment with curcumin of 5-35 mg/L for 24-96 hours significantly inhibited the proliferation of both A375 and C8161 cells compared with that with dimethyl sulfoxide (all P < 0.001),and the inhibitory effect was in a dose-dependent manner within the range of 5-15 mg/L for A375 cells and within the range of 5-10 mg/L for C8161 cells,and in a time-dependent manner from 0 to 48 hours for both cells.After treatment for 24 hours,the 50% inhibitory concentration (IC50) of curcumin against A375 cells and C 8161 cells was 10 mg/L and 5 mg/L respectively.Transwell assay demonstrated that the invasion of A375 and C8161 cells was significantly suppressed by 72-hour treatment with curcumin at 10 mg/L and 5 mg/L respectively (both P < 0.001).Flow cytometry showed that the cell cycle of A375 and C8161 cells was arrested at G2/M phase after 24-hour treatment with curcumin at 10 mg/L and 5 mg/L respectively,with significant differences in the proportion of A375 cells and C8161 cells in G2/M phase between the test group and control group (A375 cells:35.00% ± 3.54% vs.120.80% ± 7.46%,P< 0.001;C8161 cells:19.33% ± 4.04% vs.85.00% ± 9.53%,P < 0.001).Western blot revealed that the expressions of AKT/mTOR signaling pathway-related proteins were decreased in A375 and C8161 cells after 24-hour treatment with 10 mg/L and 5 mg/L curcumin respectively.Conclusion Curcumin can inhibit the proliferation and invasion of A375 and C8161 cells,likely by blocking cell cycle and inhibiting activation of the AKT/mTOR signaling pathway.
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Objective To investigate the incidence of cholelithiasis after laparoscopic Roux-en-Y gastric bypass(LRYGB) for treatment of type 2 diabetes mellitus with obesity.Methods The clinical data of 89 obese patients with type 2 diabetes mellitus who underwent LRYGB at the Sixth People's Hospital Affiliated to Shanghai Jiaotong University from March 2011 to March 2013 were retrospectively analyzed.Sixty-six patients without postoperative gallstone and sludge were divided into the nornal group and 23 with postoperative gallstone or sludge into the gallstone group.The waistline,hipline,body weight,body mass index (BMI),excess weight loss (EWL),fasting blood glucose,postprandial 2-hour blood glucose,glycosylated hemoglobin (HbAlc),homeostasis model assessment-insulin resistance (HOMA-IR),total cholesterol (TC),triglyceride (TG),high-density lipoprotein cholesterol (HDL-c),low-density lipoprotein cholesterol (LDL-c),serum total bile acid at postoperative month 6,12,24 were analyzed.The patients were followed up by inpatient,outpatient examination and telephone interview till April 2015.Measurement data with normal distribution were presented as x ± s,comparison between groups and repeated measures data were analyzed using the t test and repeated measures ANOVA,respectively.Count data were analyzed by the chi-square test.Results All the 89 patients underwent successful LRYGB and were fol lowed up for 31 months (range,24-48 months).The EWL,HbAlc and serum total bile acid at postoperativemonth 6,12,24 were 113%±43%,117%±64%,119%±84% and 6.1%±0.8%,6.2%± 1.1%,6.4%± 1.0% and (4.6 ± 3.8) μmol/L,(4.5 ± 3.6) μmol/L,(4.6 ± 3.8) μmol/L in the normal group and 157 % ± 96%,152%±102%,151%±93% and 5.9%±0.8%,5.8%±0.6%,5.9%±0.8% and (23.9 ±9.0) μmol/L,(11.8 ± 7.3) μmol/L,(10.5 ± 9.6) μmol/L in the gallstone group,respectively,showing significant differences in changing trend between the 2 groups (F =6.896,5.226,5.351,P < 0.05).There were significant differences in the EWL at postoperative month 6,12,24 between the 2 groups (t =2.814,2.628,2.099,P < 0.05).There were significant differences in the HbAlc at postoperative month 12 and serum total bile acid at postoperative month 6,24 between the 2 groups (t =2.018,-1.378,-1.990,P < 0.05).Conclusion There is incidence risk of cholelithiasis after LRYGB in obese patients with type 2 diabetes mellitus.The rapid decreasing of weight is associated with cholelithiasis in which patients have higher level of serum bile acid.
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Objective To observe the impact of laparoscopic Roux-en-Y gastric bypass on bowel habits in patients with type 2 diabetes mellitus(T2DM).Methods 70 cases of T2DM undergoing laparoscopic Roux-en-Y gastric bypass were studied.Changes in bowel habits, frequency and odor of flatulence, and social life were estimated at least 6 months after surgery using a self-administered questionnaire.Results 67.1%of the patients had normal bowel habit, 68.6%of patients maintained normal flatus before undergoing surgery, and visual ana-logue scale reveals bowel and flatus habit would cause little trouble on daily life.47.1% of patients maintained their normal bowel habit, and 45.7%of patients had loose stools and diarrhea after surgery.The number of pa-tients with loose stools significantly increased(28/70, 40% after surgery vs 5/70, 7.1% before surgery), with statistical difference( P<0.001) .42.9%patients believed that eating high-fat diet was related with loose stools (P<0.001).Patients with constipation decreased significantly after surgery(5/70, 7.1% vs the preoperative 16/70, 22.9%), with statistical difference(P=0.016).Visual analogue scale showed that 57.1% of patients thought their daily life and social activities were not affected(P=0.05).50%of patients considered an increase flatus, and 55.7%had malodorous flatus, which had statistical significance compared with those before surgery ( P<0.001) .A visual analogue scale showed that 60%of patients thought that this change would not affect their daily life and social activities( P=0.212) .Conclusions After laparoscopic Roux-en-Y gastric bypass surgery, some patients had loose stod, diarrhea, increased flatus and and offensive odor, but after proper treatment these changes do not affect their daily life and social activities.