ObjectiveTo study the correlation of lymph node metastasis and recurrence with body mass index (BMI) and estrogen receptor (ER) in papillary thyroid carcinoma (PTC).MethodThe relevant literatures were retrieved in the past six years through the CNKI, VIP, Wanfang, CBM, PubMed, Medline, Embase, Cochrane Library, etc. databases for meta-analysis of relationship of lymph node metastasis and recurrence of PTC with BMI or ER and its subtypes.ResultsThe meta-analysis showed that the lymph node metastasis of PTC was associated with the BMI and ERα [OR=1.27, 95% CI (1.12, 1.42), P<0.000 1; OR=2.68, 95% CI (1.86, 3.86), P<0.000 01, respectively ], and which not associated with the ER and ERβ [OR=0.87, 95% CI (0.56, 1.35), P=0.53; OR=1.22, 95% CI (0.78,1.89), P=0.39, respectively ]. The ERα was associated with the PTC recurrence [OR=1.87, 95% CI (1.04, 3.35), P=0.04 ], but the BMI was not the risk factor for the recurrence of PTC [OR=1.187 1, 95% CI (0.930 0, 1.515 3), P=0.17 ].ConclusionsAlthough BMI was not found to be associated with PTC recurrence, high BMI promotes PTC metastasis, so lymph node dissection in obese patients should be more careful and comprehensive. Positive ERα increases risk of lymph node metastasis and recurrence of PTC, which can be used as a negative factor in evaluating prognosis of PTC and provide a new idea for endocrine therapy of PTC.
ObjectiveTo investigate the effect of sleeve gastrectomy on preventing adipose infiltration and LOX-1 expression in aortic epithelium of high-fat-diet-induced obese rats. MethodsTwenty-four Wistar rats were randomized into normal chow group (CO group), high-fat diet group (HD group), and high-fat diet combined with sleeve gastrectomy group (SG group). Rats of three groups before operation and CO group after operation were fed with normal diet, rats of HD and SG group were fed with high-fat diet. Body weight of all the rats were examined on day 10, 20, and 30 after operation, respectively. Animals were sacrificed on day 30 after operation and plasma HDL and LDL were detected by ELISA, LOX-1 and LOX-1 mRNA expression in aortic epithelium were measured by Western blot and real-time RT-PCR, respectively. Immunochemical histological Nile red stain was adopted in adipose infiltration examination of aorta. ResultsThe body weights in HD group were much higher than those of other groups （Plt;0.01）. The HDL in CO, HD, and SG groups was (32.9±6.2) mg/dl, (43.4± 4.0) mg/dl, and (37.5± 4.3) mg/dl, respectively. The LDL in CO, HD, and SG groups was (31.8±4.5) mg/dl, (53.3±5.1) mg/dl, and (40.5±3.7 ) mg/dl, respectively. The HDL and LDL values in HD group were higher than those of other two groups (Plt;0.05, Plt;0.01). The LOX-1 protein and mRNA expressions in HD group were much higher than those of other groups (Plt;0.01). Adipose staining in HD group was also ber than that of other groups. ConclusionsHigh-fat diet can induce elevation of LOX-1 protein and mRNA expression in aorta. Sleeve gastrecto my can relieve plasma LDL level, as a result, LOX-1 protein and mRNA expression should be down-regulated.
ObjectiveTo explore the effect of laparoscopic sleeve gastrectomy (LSG) on obesity and its comorbidities.MethodThe literatures about LSG in the treatment of obesity and its comorbidities were collected and summarized.ResultsLSG could not only effectively reduce the weight of patients with obesity, but also obviously alleviate comorbidities related to obesity, such as type 2 diabetes mellitus, obstructive sleep apnea syndrome, polycystic ovary syndrome, essential hypertension, hyperlipidemia, and so on.ConclusionsLSG has a definite and effective long-term weight loss effect, which is equal to other common weight loss methods. It has been recognized by more and more patients and clinicians because it has advantages of simple operation, safety, high efficiency and fewer complications. However, therapeutic effects of some comorbidities, such as gastroesophageal reflux disease, are still controversial and need further tobe studied.
Objectiveofthisstudyistoprognosethepossibilityofdevelopinggallstoneinsubjectswiththedyslipidemiaandobesity.Themultivariablelogisticregressionmodelwasusedtoevaluatetheoddsratio(OR)ofthedyslipidemiaandobesitytoinducetheformationofgallstone.ORgt;1indicatesdangerousfactor,ORlt;1protectivefactor,andOR=1nosignificance.Theresultsshowedthatiftriglyceride(TG)andverylowdensitylipoproteincholesterol(VLDLC)increasedanaveragelevelofnormalrespectively,andtherewouldbeORofTG2.43(Plt;0.05)andORofVLDLC6.09(Plt;0.05),thehighlevelsofTGandVLDLCwerethefactorsoflithogenesis.Highdensitylipoproteincholesterols(HDL1C,HDL2C,HDL3C),withORlessthanone,werethefactorsofprotectingagainsttheformationofgallstone.ORoflowdensitylipoproteincholesterol(LDLC)andORoftotalcholesterol(TC)werealsolessthanone,butpresentresearchindicatedthattheymaybeawayoflipidmetabolismnottobeaprotectivefactor.ORofBMIinmalesubjectswas1.16(Pgt;0.05),andinfemale1.38(Plt;0.05).Thesesuggestthatbothcorrectionofthemetabolismofdyslipidemiaandreductionofbodyweightareimportanttodecreasethemorbidityofcholecystolithiasis.
目的 探討胃袖狀切除附加改良空回腸旁路術的減肥效果及其在臨床中的應用價值。方法 分析我院1例行胃袖狀切除附加改良空回腸旁路術治療的病態性肥胖患者的臨床資料。結果 術后隨訪12個月，多余體重減少達70.8%，無胃腸功能紊亂、營養障礙等并發癥。結論 胃袖狀切除附加改良空回腸旁路術治療病態性肥胖近期減重效果確切、安全。
目的 觀察合理營養聯合運動干預對肥胖癥患者血脂水平的影響，為控制肥胖尋找有效的方法。 方法 將2006年12月-2008年7月收治的72例單純肥胖癥患者隨機分為試驗組及對照組，每組各36例。試驗組按照營養師的要求進行飲食和運動治療，對照組自行控制飲食和運動，觀察期為6個月。在治療前后分別測量兩組患者身高、體重、身體質量指數（BMI）、血壓及總膽固醇（TC）、甘油三酰（TG）、低密度脂蛋白膽固醇（LDL-C）及高密度脂蛋白膽固醇（HDL-C），并進行比較。 結果 經過6個月營養聯合運動的干預治療，試驗組與對照組相比較，體重、BMI 、TG、TC和LDL-C均降低，而HDL-C升高，差異有統計學意義（Plt;0.05）。 結論 營養聯合運動治療能夠有效降低肥胖癥患者的體重和BMI，改善其血脂狀況，起到調節異常內分泌代謝的作用。
Objective To assess the effectiveness of bariatric surgery for obese type 2 diabetes mellitus (T2DM) in Mainland China. Methods Such databases as the Cochrane Central Register of Controlled Trials (Issue 2, 2012), MEDLINE (1990 to February 2012), EMbase (1990 to February 2012), CBM (1990 to February 2012), CNKI (1990 to February 2012), WanFang Data (1999 to February 2012) and VIP (1996 to February 2012) were searched, and the references of the included literature were also retrieved. The studies were screened according to the predefined inclusion and exclusion criteria, the data were extracted, the quality was evaluated, and then the meta-analysis was performed using RevMan 5.2 software. Results A total of 6 controlled before-and-after studies involving 100 patients were included. The overall quality of all literature was as low as grade C. The results of meta-analysis showed that the following indexes after operation obviously decreased than before: 1-month postoperative fasting plasma glucose (MD= –2.27, 95%CI ?4.12 to ?0.42, P=0.02), 6-month postoperative fasting plasma glucose (MD= ?2.73, 95%CI ?2.91 to 2.56, Plt;0.000 01), and 6-month postoperative glycated hemoglobin (SMD= ?1.97, 95%CI ?2.98 to ?0.96, P=0.000 1), and the differences were statistically significant. The sensitivity analysis indicated the results of meta-analysis were credible and stable, but the funnel-plot analysis displayed publication bias might exist in the included studies. Conclusion Current studies show that bariatric surgery is effective for obese T2DM patients in mainland China. However, due to small sample size and low methodological quality of the included studies, its effect has to be proved by high quality, large sample, and long follow-up studies.
ObjectiveTo systematically review the efficacy and safety of orlistat in the treatment of overweight and obese type 2 diabetes mellitus (T2DM). Methods PubMed, EMbase, The Cochrane Library, CNKI, WanFang Data and VIP databases were electronically searched to collect randomized controlled trials (RCTs) on the efficacy and safety of orlistat in the treatment of overweight and obese T2DM patients from inception to June 29th, 2022. Two reviewers independently screened the literature, extracted data and assessed the risk of bias of the included studies; then, meta-analysis was performed by using Stata 16.0 software. Results A total of 24 RCTs involving 3 702 patients were included. The results of meta-analysis showed that compared with control group, orlistat group could significantly decrease the levels of fasting blood glucose (WMD=1.04, 95%CI 0.80 to 1.29, P<0.001), 2h postprandial blood glucose (WMD=1.17, 95%CI 0.78 to 1.56, P<0.001) and hemoglobin A1c (WMD=0.84, 95%CI 0.51 to 1.17, P<0.001), and the levels of total cholesterol, triglyceride, low density lipoprotein, body weight and body mass index also significantly decreased (P<0.001). The incidence of adverse events such as increased defecation and abdominal pain of orlistat was slightly higher than that of control group; however, most could be self-healing.Conclusion Current evidence shows that orlistat can effectively and safely improve blood sugar, lipid index in overweight and obese T2DM patients. Due to limited quality and quantity of the included studies, more high-quality studies are needed to verify the above conclusion.
ObjectiveTo explore a surgery of effective weight loss concentrating on gut hormone release. MethodsWistar rats were fed with high-fat diet for inducing obesity and which randomly divided into sleeve gastrectomy plus decent jejunoileal bypass (SJB) group (n=12), sleeve gastrectomy (SG) group (n=12), and sham operation (SO) group (n=11), the body weight reduction, food intake, plasma ghrelin level, and glucagon like peptide-1 (GLP-1) level were compared among three groups. ResultsThere were no differences of the body weight and food intake before operation among three groups (Pgt;0.05). Compared with the SO group, the body weight descended and the food intake decreased obviously on 1-8 weeks after operation in the SJB group (Plt;0.05), the body weight of rats on 1-8 weeks after operation in the SJB group significantly descended as compared with the SG group (Plt;0.05), and the food intake of rats on week 3, 6, 7, and 8 in the SJB group signicantly decreased as compared with the SG group (Plt;0.05). There were no differences of the levels of the plasma ghrelin and GLP-1 before operation among three groups (Pgt;0.05). Compared with SO group, the plasma ghrelin level decreased and the GLP-1 level increased in the SJB group and the SG group, meanwhile the SJB group significantly decreased level of plasma ghrelin and elevated level of plasma GLP-1 as compared with the SG group on week 8 after operation(Plt;0.05). ConclusionThe data demonstrate that SJB could represent an effective way of losing weight by interfering with food intake and obesity related hormone levels.