The Therapeutic Effectiveness of Laparoscopic Sleeve Gastrectomy Among Individuals with Low BMI Obesity (30-35 Kg/m2) and the Relationship of BMI to Weight Loss

Purpose

Investigating the therapeutic efficacy of Laparoscopic Sleeve Gastrectomy (LSG) in low BMI (30-35 kg/m2) patients with obesity, and exploring the correlation between patients' preoperative BMI and postoperative weight loss.

Methods

Comparing the weight loss, remission of comorbidities, occurrence of complications, and quality of life among the different BMI patients who underwent LSG. Analyzing the relationship between BMI and percentage of excess weight loss (%EWL) by using Spearman correlation analysis and linear regression analysis.

Results

The %EWL at 12 months after the surgical procedure was (104.26±16.41)%, (90.36±9.98)%, and (78.30±14.64)% for patients with Class I, II, and III obesity, respectively, P<0.05. Spearman correlation coefficients between %EWL and BMI at 1, 3, 6, and 12 months after surgery were R=-0.334 (P<0.001), R=-0.389 (P<0.001), and R=-0.442 (P<0.001), R=-0.641 (P<0.001), respectively. The remission of hypertension, diabetes and dyslipidaemia did not differ significantly between groups (P>0.05).

Conclusion

Individuals with obesity for varying BMI can experience favorable outcomes following LSG surgery. It is advisable to consider LSG treatment for patients with Class I obesity.

Esophageal bronchogenic cyst treated with submucosal tunneling endoscopic resection: two case reports

INTRODUCTION

Although esophageal bronchogenic cysts are benign diseases, they may be accompanied by serious complications and have the possibility of recurrence. Therefore, once confirmed, it is necessary to treat the esophagobronchial cyst when the contraindication is excluded. Endoscopic treatment is usually used for lesions with small diameter and shallow origin, and has the advantages of small surgical trauma and risk, which can reduce the psychological burden of patients to a certain extent, help them to recover quickly, and lower hospital costs.

CASE PRESENTATION

Case 1 is a 54-year-old Han Chinese man admitted to our hospital who complained of difficulty swallowing in the past 6 months. Case 2 is a 41-year-old Han Chinese man who was hospitalized in the past 3 months due to chest discomfort. Endoscopic ultrasound revealed a hypoechoic cystic lesion arising from the muscularis propria. Submucosal tunneling endoscopic resection was performed using a dual knife, and a cystic mass was observed between the mucosa and the muscular layers of the esophagus. On locating the cyst, an incision was made on the oral side of the lesion for evacuation. The cyst wall was excised using endoscopic argon plasma coagulation. We successfully removed the esophageal bronchogenic cyst lesion in the intrinsic muscle layer using submucosal tunneling endoscopic resection.

CONCLUSION

Esophageal bronchogenic cysts are rare in clinical practice and lack specificity in clinical manifestations. Multiple methods can be used to determine the location and nature of the lesion and ultimately determine the treatment plan. Surgical resection and endoscopic treatment are two different treatment methods, and appropriate treatment plans need to be selected on the basis of the origin layer, size, and relationship with the esophagus of the lesion to reduce complications and improve prognosis.

[Retracted] Potentiation of the antitumor activity of adriamycin against osteosarcoma by cannabinoid WIN‑55,212‑2

[This retracts the article DOI: 10.3892/ol.2015.3525.].

Hyperinsulinemia Influences the Short-Term Efficiency of Laparoscopic Sleeve Gastrectomy for Patients with Obesity and Insulin Resistance

Purpose

The effect of hyperinsulinemia on short-term outcomes after laparoscopic sleeve gastrectomy (LSG) in patients with obesity combined with insulin resistance is unclear.

Material and Methods

This was a retrospective analysis of patients who underwent LSG at our center between January 1, 2020, and December 31, 2021. Patients were divided into hyperinsulinemia (HINS) and nonhyperinsulinemia (NHINS) groups based on fasting insulin levels. The primary endpoint was weight change. Metabolic disease outcomes, postoperative complications, and quality of life score changes were secondary endpoints.

Results

A total of 92 patients were included in this study, with 59 in the HINS group and 33 in the NHINS group. At 6 months postoperatively, the median (P₂₅, P₇₅) %EWL was 76.01 (64.40, 86.99)% in the HINS group and 92.02 (86.78, 100.88)% in the NHINS group (P<0.001). The mean %TWL (SD) was 23.26 (7.14)% in the HINS group and 26.80 (6.55)% in the NHINS group (P=0.021). The remission of dyslipidemia and hypertension in the NHINS group and the HINS group were not significantly different (P>0.05 for all). The differences in QOL between groups were not statistically significant (P=0.788). In terms of postoperative complications, there was no statistically significant difference between the groups (P>0.05 for all).

Conclusion

HINS negatively influences weight change in patients with obesity and insulin resistance, and the NHINS group had better postoperative weight loss. In terms of hypertension, dyslipidemia, and postoperative complications, there was no significant effect of HINS.

Clinical target volume and organs at risk segmentation for rectal cancer radiotherapy using the Flex U-Net network

Purpose/Objectives

The aim of this study was to improve the accuracy of the clinical target volume (CTV) and organs at risk (OARs) segmentation for rectal cancer preoperative radiotherapy.

Materials/Methods

Computed tomography (CT) scans from 265 rectal cancer patients treated at our institution were collected to train and validate automatic contouring models. The regions of CTV and OARs were delineated by experienced radiologists as the ground truth. We improved the conventional U-Net and proposed Flex U-Net, which used a register model to correct the noise caused by manual annotation, thus refining the performance of the automatic segmentation model. Then, we compared its performance with that of U-Net and V-Net. The Dice similarity coefficient (DSC), Hausdorff distance (HD), and average symmetric surface distance (ASSD) were calculated for quantitative evaluation purposes. With a Wilcoxon signed-rank test, we found that the differences between our method and the baseline were statistically significant (P< 0.05).

Results

Our proposed framework achieved DSC values of 0.817 ± 0.071, 0.930 ± 0.076, 0.927 ± 0.03, and 0.925 ± 0.03 for CTV, the bladder, Femur head-L and Femur head-R, respectively. Conversely, the baseline results were 0.803 ± 0.082, 0.917 ± 0.105, 0.923 ± 0.03 and 0.917 ± 0.03, respectively.

Conclusion

In conclusion, our proposed Flex U-Net can enable satisfactory CTV and OAR segmentation for rectal cancer and yield superior performance compared to conventional methods. This method provides an automatic, fast and consistent solution for CTV and OAR segmentation and exhibits potential to be widely applied for radiation therapy planning for a variety of cancers.

Apelin-13/APJ system delays intervertebral disc degeneration by activating the PI3K/AKT signaling pathway

OBJECTIVE

To study the effect of Apelin-13/APJ system on intervertebral disc degeneration and its mechanism.

PATIENTS AND METHODS

This study detected the expression of APJ in human intervertebral disc tissue with varying degrees of degeneration. IL-1β is used to stimulate the degeneration of nucleus pulposus cells. We used recombinant human Apelin-13 and Ala13 to activate and inhibit the APJ receptor, respectively. The inhibitor LY294002 was used to inhibit the PI3K/AKT signaling pathway. We studied the effects of Apelin-13/APJ system on nucleus pulposus cells and its mechanism by Western blot, RT-PCR, and so on.

RESULTS

APJ is lowly expressed in the nucleus pulposus of patients with a high degree of degeneration. IL-1β stimulates the nucleus pulposus cells and reduces the expression of APJ in nucleus pulposus cells. Recombinant human Apelin-13 reduces the degradation of nucleus pulposus extracellular matrix, promotes proliferation, and reduces the levels of apoptosis and inflammation. In addition, the Apelin-13/APJ system increases the expression of PI3K and AKT and activates the PI3K/AKT signaling pathway.

CONCLUSIONS

Apelin-13/APJ system activates PI3K/AKT signaling pathway activity, reduces the degradation of nucleus pulposus extracellular matrix, promotes proliferation, and reduces the level of apoptosis and inflammation, thus delaying the degeneration of the intervertebral disc.

HBP1 deficiency protects against stress-induced premature senescence of nucleus pulposus

OBJECTIVE

Senescence of nucleus pulposus (NP) cells is involved in the pathological process of intervertebral disc degeneration (IVDD). HMG-box transcription factor 1 (HBP1) is a transcriptional inhibitor that prevents proliferation and regulates premature senescence of cells. The aim of this study was to confirm whether HBP1 deficiency could protect stress-induced NP cells premature senescence.

PATIENTS AND METHODS

Firstly, HBP1 protein level in human degenerated intervertebral disc tissues was detected. Then, NP cells were isolated from disc samples and transfected with plasmid to upregulate HBP1expression. H2O2 and interleukin-1b (IL-1b) were used to induce NP cells premature senescence in a different manner. Thereafter, cell viability, proliferation, and apoptosis were measured, and the protein expressions of collagen II, HBP1, and p16, were determined by Western blot or immunofluorescence. Finally, the mRNA levels of aggrecan, collagen I, IL-6, Transforming Growth Factor-α (TNF-α), and matrix metalloproteinase-3 (MMP-3) were determined by quantitative Real Time-Polymerase Chain Reaction (qRT-PCR).

RESULTS

The data indicated that HBP1 was upregulated in degenerated NP tissues. HBP1 gene overexpression increased p16 expression, affected NP cell proliferation, and caused cell apoptosis. In addition, HBP1 also decreased the collagen II and aggrecan expressions but increased collagen I, IL-6, TNF-α, and MMP-3 levels. Moreover, the silencing of HBP1 markedly reversed the H2O2 and IL-1b induced NP cell senescence by reducing p16 expression, apoptotic cell population, and inflammatory response and by promoting cell proliferation.

CONCLUSIONS

In summary, HBP1 accumulation contributes to the senescence of NP cells, and HBP1 deficiency protects stress-induced NP cells premature senescence.

Tertiary syphilis in the lumbar spine: a case report

Background

The incidence of tertiary syphilis involvement in the spinal column with destructive bone lesions is very rare. It is difficult to establish the correct diagnosis from radiographs and histological examination alone. Limited data are available on surgical treatment to tertiary syphilitic spinal lesions. In this article, we report a case of tertiary syphilis in the lumbar spine with osteolytic lesions causing cauda equina compression.

Case presentation

A 44-year-old man who suffered with low back pain for 6 months and progressive radiating pain at lower extremity for 1 week. Radiologic findings showed osteolytic lesion and new bone formation in the parts of the bodies of L4 and L5. Serum treponema pallidum hemagglutination (TPHA) test was positive. A surgery of posterior debridement, interbody and posterolateral allograft bone fusion with instrumentation from L3 to S1 was performed. The low back pain and numbness abated after operation. But the follow-up radiographs showed absorption of the bone grafts and failure of instrumentation. A Charcot’s arthropathy was formed between L4 and L5.

Conclusion

It is challenging to diagnose the tertiary syphilis in the spine. Surgery is a reasonable auxiliary method to antibiotic therapy for patients who suffered with neuropathy. Charcot’s arthropathy should be considered as an operative complication.

Characterization of human induced pluripotent stem cell (iPSC) line from a 72year old male patient with later onset Alzheimer's disease

Peripheral blood was collected from a clinically diagnosed 72-year old male patient with later onset Alzheimer's disease. Peripheral blood mononuclear cells (PBMCs) were reprogrammed with the Yamanaka KMOS reprogramming factors using the Sendai-virus reprogramming system. The transgene-free iPSC line showed pluripotency verified by immunofluorescent staining for pluripotency markers, and the iPSC line was able to differentiate into the 3 germ layers in vivo. The iPSC line also showed normal karyotype. This in vitro cellular model will be useful for studying the pathological mechanism of Alzheimer's disease.

Correlation between the genetic polymorphism of ORMDL3 gene and asthma risk: a meta-analysis

While increasing scientific evidence suggests that the ORMDL3 rs7216389 polymorphism may contribute to a higher susceptibility to asthma, many of the current studies have yielded inconclusive results. This meta-analysis aimed to assess the association between the ORMDL3 rs7216389 polymorphism and the risk of asthma. An extensive literature search for relevant studies was conducted in PubMed, Embase, the Web of Science, the Cochrane Library, Chinese National Knowledge Infrastructure, and Google Scholar. This meta-analysis was performed using the STATA 12.0 software. Crude odds ratios (OR) and their 95% confidence intervals (CI) were calculated. Thirteen studies were included with a total of 14,851 subjects, comprised of 6739 patients with asthma and 8112 healthy controls. Our meta-analysis results revealed that the ORMDL3 rs7216389 polymorphism may be associated with an increased risk of asthma (allele model: OR = 1.39, 95%CI = 1.27-1.52, P < 0.001; dominant model: OR = 1.46, 95%CI = 1.31-1.62, P < 0.001; recessive model: OR = 1.57, 95%CI = 1.37-1.81, P < 0.001; homozygous model: OR = 1.58, 95%CI = 1.32-1.90, P < 0.001; heterozygous model: OR = 1.54, 95%CI = 1.30-1.82, P < 0.001). We also found significant associations in our subgroup analyses based on ethnicity and type of asthma. However, in our subgroup analysis based on sources of controls, an association was found in the population-based case-control subgroup but not in the hospital-based case-control subgroup. This meta-analysis indicates that ORMDL3 rs7216389 may contribute to increasing susceptibility to asthma.

[Analysis of circulating lung cancer cells in the peripheral blood in patients with lung cancer by flow cytometry]

BACKGROUND

To analyze circulating lung cancer cells in the peripheral blood in patients with lung cancer by flow cytometry (FCM).

METHODS

The monocyte fraction in peripheral blood was isolated by Ficoll-Hypaque gradient centrifugation. The cells obtained were labeled with antibodies against CD45, cytokeratin (CK) and antigen (2F7/S5A). The CD45(-) CK(+) 2F7/S5A(+) cells were analyzed by FCM.

RESULTS

Fifty cases out of 165 patients with lung cancer (30.30%) were found to have cancer cells in the peripheral blood. Positive rate in non-small cell lung cancer was 30.67%(45/150) and that in small cell lung cancer was 33.33%(5/15) respectively. Meanwhile, there was distinct correlation between detective rate of cancer cells in the peripheral blood and pathological stage(P<0.05).

CONCLUSIONS

Examination of lung cancer presented in the peripheral blood by FCM might be helpful for staging and finding metastatic potential of lung cancer.

The Role of T-Helper 17 (Th17) Cells in Patients with Medulloblastoma

As a new member of the CD4+ effector T-cell family, T-helper 17 (Th17) cells, have emerged as an important mediator in inflammatory and autoimmune diseases. Th17 cells preferentially produce interleukin (IL)-17A, IL-17F, IL-21, IL-22, and IL-26 in humans. Recent studies suggest a potential role for Th17 cells in tumour development. The current study was designed to investigate the possible involvement of Th17 cells in the brain tumour medulloblastoma. Compared with 17 healthy volunteers, 23 patients with medulloblastoma had a higher proportion of Th17 cells in their peripheral blood. Increased populations of Th17 cells were also present in medulloblastoma-infiltrating T-cells. Furthermore, the mRNA levels for Th17-related factors (IL-17, IL-23 and retinoid orphan nuclear receptor) in tumour tissues and the serum concentrations of IL-17 and IL-23 protein were significantly increased in patients with medulloblastoma. The results indicate that Th17 cells may contribute to medulloblastoma pathogenesis.

An Acupuncture-like Quantitative Mechanical Stimulator

A stimulator that analogs the needle puncture has been designed to deliver quantitative mechanical stimulus to a small area of muscle. A friction coupler is designed to transmit the driving force from motor to a needle which is used to deliver stimulus. Rotation of the needle may be stopped but the friction will be maintained between the needle and the tissue when this friction moment comes to the driving moment of the coupler. Experiments were done on 6 hindlimb muscles in 2 cats and the results show the value of the stimulator in probing the mechanisms of acupuncture.

Remodelling of zero-stress state of small intestine in streptozotocin-induced diabetic rats. Effect of gliclazide

BACKGROUND

Biomechanical properties in terms of residual strains in diabetic small intestine have not been studied. Furthermore, no data have been reported on affect of gliclazide on gastrointestinal complications of diabetes.

AIMS

To determine remodelling of zero-stress state of small intestine in streptozotocin-induced diabetic rats and effect of gliclazide treatment.

MATERIALS

Morphological properties and residual strains were studied in duodenum, jejunum and ileum obtained from diabetic rats, gliclazide-treated diabetic rats and normal rats (n = 8 each group).

METHODS

Diabetes was induced by single intraperitoneal injection of 65 mg/kg streptozotocin. Gliclazide (10 mg kg(-1) day(-1) was injected directly into stomach lumen by intragastric gavage twice daily. Experimental period was 35 days. To approach no-load state; intestinal segments were surgically excised and cut transversely into short ring-shaped segments. Each ring was cut radially to obtain geometry of zero-stress state. Circumferential length, the wall thickness and opening angle were measured from digital images of each specimen and residual strains were computed.

RESULTS

Blood glucose level of diabetic group (approximately 20 mmol/l) was consistently higher than that in normal group (approximately 4 mmol/l) after induction of diabetes (p < 0.001). Gliclazide lowered average blood glucose level to between 10 and 15 mmol/l (p < 0.001). Plasma insulin levels of both diabetic groups (average between 10 and 15 pmol/l) were significantly lower than those in normal group (average approximately 18 pmol/l, p < 0.05). Wet weight per unit length and wall thickness of duodenum, jejunum and ileum were significantly higher in Diabetes group than those in Normal group (p < 0.05). Opening angle and absolute value of residual strain were significantly smaller in duodenum and larger in jejunum and ileum in Diabetes group than in Normal group (p < 0.001). Gliclazide treatment partly restored these changes (p < 0.05).

CONCLUSIONS

Diabetes induced morphometric and biomechanical remodelling in intestine. Gliclazide partly restored these changes.

[Detection of telomerase activity in the blood of patients with lung cancer]

BACKGROUND

To study the telomerase activity in blood cancer cells by TRAP for monitoring tumor metastasis in blood.

METHODS

Twenty-five patients with lung cancer surgically treated and 35 patients before chemotherapy were determined for telomerase activity of cancer cells in the blood by TRAP, and 30 patients with non-tumor diseases as control.

RESULTS

In the operative group,13 patients(52%) showed telomerase activity in pulmonary artery blood during operation, which was much higher than that of peripheral blood before operation (24%,P<0.05). Telomerase positive rate was significantly higher in stage III to IV (64%) than that in stage I to II (30%,P<0.05).In the peripheral blood of patients with non-tumor diseases, telomerase was negative.

CONCLUSIONS

Telomerase activity may be an indicator for detecting lung cancer cells in peripheral blood as well as tumor metastasis and relapse.

[An establishment of murine drug-resistant cell line transfected with human MDR-1 gene.]

BACKGROUND

To investigate the relationship between MDR-1 gene expression and drug resistance in lung cancer cells.

METHODS

The multidrug resistant cell line (3LL-MDR-1) was established by transfecting human MDR-1 gene expressing vector into a murine Lewis lung cancer cell line (3LL) . Drug resistance and the effect of valapamil (VLP) on the resistance were evaluated by MTT assay. The expression of MDR-1 gene product , P-gp , was measured immunohistochemically. The influx and efflux of Rhodamine 123 was tested with flow cytometry.

RESULTS

The MDR cell line expressing P-gp was established , which exhibited a typical drug resistance to vincristine (VCR) , vindesin (VDS) , etoposide (VP-16) , mitomycin (MMC) , taxol and navelbine (NOR) . Valapamil was able to reverse the resistance of the gene-transfected cells and the reversion was dose-dependent. Flow cytometric analysis showed that the resistant cells had much higher ability to export Rhodamine 123 than the parent cells did. The expression of P-gp protein was visualized immunohistochemically.

CONCLUSIONS

The results indicate that drug resistance in lung cancer cells is closely related to the MDR-1 gene expression.

[Experimental studies on human lung cancer gene-therapy with HSV-TK/GCV system]

OBJECTIVE

Evaluate the clinical potential of HSV-TK/GCV system in gene-therapy of tumors by using this system to treat human lung cancer A549 cells in vitro and in vivo.

METHOD

The in vitro sensitivity levels of A549/TK (TK-tranfered A549) cells and wild type A549 cells to GCV were expressed as IC50 which was measured with MTT assay after treating both cells for 72 hrs. In vivo study, The nude mice bearing A549/TK tumor or A549 tumor were used as experimental models. All the animals were divided into 3 groups. Group 1, the animals bearing A549/TK tumor would be treated with GCV. Group 2, The animals bearing A549/TK tumor would be treated with saline. Group 3, The animals bearing A549 tumor would be treated with GCV. When the tumors reached to 200-300 mg the animals would be injected intraperitoneally with GCV solution (100 mg.kg-1.day-1) or equal volume of saline for two weeks. In this period and the following four weeks, the tumor weights were measured and calculated with the experience formula once every three or four days.

RESULT

In vitro study showed that the A549/TK cells were apparently killed in a 20 mumol/L GCV solution while the wild type A549 cells grew normally under the same condition. The IC50 of A549/TK cells in GCV solution was 0.5 mumol/L and that of A549 cells 500 mumol/L, showing a 1,000 fold difference (P < 0.01). In vivo experiment GCV had compelled the A549/TK tumors to lead to a regression of 92%, meanwhile the A549 tumors treated with GCV increased 3.9 times in weight in the first seventeen days of experiment. Group 2 tumors A549/TK tumors which were treated with saline, grew as well as group 3 did. There was a significant difference (P < 0.01) between group 1 and other groups.

CONCLUSION

GCV could specifically and effectively kill the TK-transfered A549 cells in vitro and in vivo. This result suggested that the HSV-TK/GCV system may have a clinical potential for gene therapy of lung cancer.