Effects of bariatric surgery on patients with obesity and polycystic ovary syndrome: a meta-analysis

BackgroundBariatric surgery is effective for polycystic ovary syndrome (PCOS), while the exact mechanism remains unclear.ObjectivesTo assess the impact of bariatric surgery on PCOS patients and further explore the possible mechanism.SettingA meta-analysis.MethodsWe searched PubMed, Web of Science, The Cochrane Library, and Embase to identify relevant studies published before November 2020.ResultsTwenty-one studies met our inclusion criteria, and we identified 552 patients with PCOS study. Results showed that the prevalence of preoperative PCOS, menstrual irregularity, hirsutism, type 2 diabetes (T2D), hypertension, infertility, and depression significantly decreased after bariatric surgery. Levels of total testosterone, fasting insulin, and luteinizing hormone (LH) decreased and estradiol increased, while levels of follicle-stimulating hormone (FSH) and LH/FSH did not show significant changes during the 3-month follow-up. There were decreases in testosterone and fasting insulin levels when the postoperative follow-up time was 6 months or ≥12 months. Levels of fasting blood glucose and triglycerides were significantly reduced after 6 months or ≥12 months of bariatric surgery. High-density lipoprotein (HDL) and sex hormone-binding globulin (SHBG) significantly improved ≥12 months after bariatric surgery.ConclusionSymptoms of PCOS and related complications are significantly alleviated after bariatric surgery. In addition, we found a significant improvement on anomalous secretion of gonadotropins, glucose metabolism, and lipid metabolism in patients with PCOS after bariatric surgery.     

术前炎性指标构建的列线图模型预测结直肠癌患者术后生存分析

目的探讨基于术前炎性指标构建的列线图模型预测结直肠癌患者术后生存的价值。方法采用队列研究设计,选取2011年1月至2014年6月空军第986医院行结直肠癌根治术的233例结直肠癌患者,根据5年随访结果,将患者分成生存组(99例)和死亡组(134例)。比较两组患者术前1 d炎性指标水平,单因素和Cox回归分析结直肠癌患者术后5年生存的影响因素,应用R软件建立列线图术后存活预测模型。结果两组患者术前淋巴细胞计数、中性粒细胞计数、血小板计数、C反应蛋白、血小板/淋巴细胞比值(PLR)、中性粒细胞/淋巴细胞(NLR)和C反应蛋白/白蛋白比值(CAR)等指标比较,差异有统计学意义(P<0.05),而白细胞计数和白蛋白比较,差异无统计学意义;肿瘤大小(OR=1.379,95%CI:1.094~1.737)、浸润深度(OR=2.020,95%CI:1.126~3.622)、NLR(OR=1.496,95%CI:1.009~2.219)、PLR(OR=1.927,95%CI:1.060~3.504)和CAR(OR=2.326,95%CI:1.479~3.657)是结直肠癌患者术后生存的独立影响因素(P<0.05)。列线图预测术后生存模型的C-index为0.831(95%CI:0.781~0.911),校准预测曲线和理想曲线拟合良好。结论术前NLR、PLR和CAR与结直肠癌术后生存呈负相关,且列线图具有预测结直肠癌患者术后生存情况的潜在价值。     

Indian Hedgehog信号通路在软骨细胞成熟及转分化过程中的调控作用

目的 探究Indian Hedgehog（IHH）信号通路对软骨内成骨过程中软骨细胞成熟以及转分化的影响。方法 取10日龄野生型小鼠的胫骨组织,采用原位杂交和免疫组织化学染色检测生长板区域IHH信号通路相关分子Ihh、Ptch1和Gli1的表达水平。构建肥大软骨细胞特异性Ihh基因敲除小鼠（Col10a1^Cre/+; Ihh^null/C）,并采用影像学检查和阿利新蓝染色评估该小鼠的骨骼发育状况。构建肥大软骨细胞IHH信号通路持续激活小鼠（Col10a1^Cre/+; R26Smo^M2/M2和 Col10a1^Cre/+; Ptch1^LacZ/C）,采用HE染色、原位杂交和TUNEL染色分别对受精15.5天胎鼠胫骨组织形态结构、Ihh（肥大软骨细胞分子标志物）和Col1a1（成骨细胞分子标志物）以及肥大软骨细胞凋亡水平进行检测;另外应用HE染色对10日龄小鼠的胫骨组织进行组织学分析。结果 肥大软骨细胞合成分泌IHH,但不表达Ptch1和Gli1。抑制肥大软骨细胞合成IHH蛋白会导致出生后小鼠出现侏儒症;X线检查结果显示小鼠出现严重的骨骼发育不良,包括胸廓狭小、球形头骨以及椎骨发育异常等表现。持续启动IHH信号通路时,胚胎早期软骨细胞成熟分化过程虽未见异常,但是出生后小鼠的骨小梁、骨内膜以及皮质骨等结构均出现一定的异常表现。结论 IHH信号通路虽然不参与肥大软骨细胞的终末分化过程,但在软骨细胞转分化的过程中起到了重要的调控作用。     

Anterior tibial artery injury is not the contraindication of medial plantar flap: digital subtraction angiography evidence and clinical application

The medial plantar artery (MPA) is often sacrificed as the vascular pedicle of the medial plantar flap (MPF). However, for patients with ankle soft tissue defect caused by traffic accident, the anterior tibial artery (ATA) could be damaged and the blood supply of the distal foot would only come from the MPA and the lateral plantar artery (LPA). In this case, sacrificing the MPA for the MPF means that the LPA will become the mainly source of blood supply of the distal foot. Whether the blood supply of the distal foot is adequately guaranteed remains to be discussed. A total of seven patients with ankle soft tissue defect and ATA injury were enrolled in the study. The digital subtraction angiography (DSA) was performed to observe the hemodynamics of the ipsilateral foot. The MPF was harvested only when the foot arterial network consisting of the MPA, the LPA, the deep plantar arch, and the deep plantar artery of DPA, and the blood redistribution existed. DSA results showed the blood from the posterior tibial artery was redistributed to the ipsilateral foot and the MPA is not the dominant artery in the foot. Seven MPFs were harvested, and all flaps survived completely. No complications, such as pain, ulcer, and necrosis, occurred in the ipsilateral toes. The DSA could accurately and intuitively evaluate the hemodynamics of foot in patients with ATA injury. The DSA data and clinical practice proved that the ATA injury is not the contraindication of the MPF.     

FK228抑制EPO介导的人红系前体细胞的增殖与分化

目的:探讨组蛋白脱乙酰化酶抑制剂FK228在红细胞生成素(EPO)介导的人红系前体细胞增殖与分化中的调节作用。方法:从经粒细胞集落刺激因子动员的肿瘤患者外周血单核细胞中分离CD34 细胞,用含干细胞生长因子(SCF)、EPO或SCF IL-3及不同浓度FK228的无血清培养基培养7d,分别用抗GPA及抗CD36单克隆抗体(mAb)染色并行流式细胞术检测;将CD34 细胞用含SCF IL-3的无血清培养基培养7d,分离CD36 GPA-细胞,将细胞用含有EPO FK228的无血清培养基培养7d,并行细胞计数;将CD36 GPAlow/-细胞用含EPO加或不加FK228的无血清培养基培养,并进行annexin V和PI染色。结果:FK228以一种剂量依赖方式抑制CD36 GPAhigh、CD36 GPAlow和CD36 GPA-细胞的产生;FK228可诱导CD36 GPAhigh和CD36 GPAlow/-细胞在含EPO的培养基中发生细胞凋亡。结论:FK228可抑制EPO介导的人红系前体细胞的增殖与分化。     

The effect of magnetic stent on coronary restenosis after percutaneous transluminal coronary angioplasty in dogs

探讨磁化支架对经皮经腔冠状埃及成形术 (PTCA)后冠状动脉再狭窄的防治作用。方法　 2 0只健康杂种犬 ,超大球囊反复扩张损伤靶血管 (前降支或旋支中段 )制备PTCA术后冠状动脉狭窄模型(>5 0 % ) ,后随机分成对照组和实验组各 10只。对照组靶血管置入普通Palmaz支架 ,实验组靶血管置入磁化Palmaz支架。手术前后不用抗血小板药和抗凝药 ,术后 6个月冠状动脉造影 ,并处死犬切取靶血管 3cm进行组织病理学检查。结果　冠状动脉造影冠状动脉再狭窄率对照组 30 % ,实验组 0 ;组织病理学检查靶血管平均内膜厚度 (对照组 2 .98± 0 .5 6mm) ,(实验组 1.13± 0 .4 1mm)有显著差异 ,P <0 .0 5。结论　磁化支架对犬PTCA术后冠状动脉再狭窄可能具有防治作用。     

An experimental study on nerve regeneration and spinal neurons after CO2 laser anastomosis of rat sciatic nerve

Objective: Many methods have been used in an attempt to seal the epineurium and to prevent axonal outgrowth.In this study, the rat sciatic nerves were repaired with CO2 laser, the nerve regeneration and the morphology of spinal anterior horn neurons were investigated. Methods: Seventy-two male Sprague-Dawley rats were randomly divided into 6 groups of 12 rats. The animals were designed to observe the electrophysiology, the histopathology and the morphology of spinal anterior horn neurons. One of the rat sciatic nerve anastomosed with CO2 laser, the contralateral nerve was reconstructed by microsuture technique. At 2, 4, 6, 8 weeks postoperatively, neuromuscular functions, the regeneration of axons and neurons were evaluated by the electro-physiological and histopathological studies. The rats were killed at 4, 6 weeks postoperatively. Results: The recovery of toe spread and myodynamia in laser groups was better than that in suture groups (P＜0.05). The latency of foot withdraw caused by radiate heat and neuromuscular conduction velocity in laser groups were faster than that in suture groups (P＜0.05). The density of nerve fibers, percentage of axons passing through anastomotic area and numbers of neurons were better in laser groups than in suture groups. At 8 weeks postoperatively, the first grade dendrites of anterior horn neurons grew well. Their diameter, length, volume and total volume were much higher than that in control group. (P＜0.05, P＜0.01). Conclusion: CO2 laser repairing was effective in promoting the regeneration and the recovery of sciatic nerves in its earlypost-trauma stage. In addition, laser repairing was found to reduce regenerating axons misdirection and forming neuroma.     

Effect of rhBMP-2m on c-Myb gene expression in bone marrow of irradiated mice

Bonemorphogeneticproteins(BMPs),membersofthetransforminggrowthfactor(TGF)-βsuperfami-lyareagroupofrelatedproteinsthatarecapableofinducingtheformationofcartilageandbone.BMPsarenowregardedasmultifunctionalcytokines.rhBMP-2mcanbeusedtotreattheinjuryofacuteir-radiationsicknessinmicewhichisprobablyrelatedtoitspromotingtherecoveryofhematopoiesiscellsinbonemarrowafterirradiation[1],butthemechanismre-mainsunknown.c-Mybismosthighlyexpressedinhematopoieticcellsanditsoncogenicactivationleadstotransf…