Association between bariatric surgery and anemia

ObjectivesSeveral studies have recently conducted to investigate the link between anemia and bariatric surgery (BS). The results from these studies, however, were inconsistent. Therefore, a meta-analysis was conducted to determine whether BS for weight loss is a risk factor for anemia.MethodsStudies were identified relevant papers published a cutoff date of May 2022 for meta-analysis by searching four electronic databases (PubMed, EMBASE, Web of Science and Cochrane Library). Pairs of authors conducted title and abstract, full-text assessment, data extraction and risk of bias assessment, and quality of articles. Random-effects models were used to estimate the pooled effect size and evaluated the overall quality of evidence. The sources of heterogeneity were assessed with I². The Newcastle-Ottawa scale (NOS) was used to assess the methodologic quality of selected studies. The publication bias was assessed using funnel plots and Egger's test statistics.ResultsIn all, eight studies comprising 3150 patients were finally included in the final study analysis. Of these, pooled analysis of eight studies detecting association between anemia and BS for weight loss yield a statistically significant correlation (SMD ?1.12 (?1.46—?0.78, I² = 93%). Subgroup analyses were performed according to postoperative follow-up time and operation method. Before 24 months postoperatively, no patient had a significant decrease in hemoglobin. More than 24 months after BS, patients show a significant reduction in hemoglobin. In addition, the hemoglobin level was not changed after sleeve gastrectomy (SG) and adjustable gastric banding (AGB) (SMD ?0.19 (?1.04—0.67, I² = 0% for SG; SMD ?0.30 (?0.82—0.22 for AGB), but the hemoglobin level was significantly reduced after Roux-en-Y gastric bypass (RYGB) (SMD ?1.19 (?1.52—?0.87, I² = 94.2%).ConclusionThis current meta-analysis found that at 24 months after RYGB, the patient's hemoglobin level was significantly reduced, increasing the risk of anemia. Therefore, attention should be paid to the occurrence of anemia after BS. A large, placebo-controlled, multi-center study is needed to clarify the role of BS for weight loss in this patient anemia.     

眼周年轻化治疗方案的选择

目的：为提高手术效果,综合分析患者的具体情况和要求,采取合适的术式矫正眼周老化征象。方法：根据患者眼周皮肤衰老情况选择肉毒素注射、眼袋整形术、重睑术、提眉术等个性化的手术方案。结果：本组85例患者,选择不同的个性化治疗方案,效果满意。结论：针对眼周制定个性化治疗方案,针对性强,效果可靠,患者满意度高,值得临床推广应用。     

Inhalation of glycopyrronium inhibits cigarette smoke-induced acute lung inflammation in a murine model of COPD

Glycopyrronium bromide (GB) is a muscarinic receptor antagonist that has been used as a long-acting bronchodilator in chronic obstructive pulmonary disease (COPD) patients. The aim of this study was to investigate the anti-inflammatory activity of inhaled GB in a cigarette smoke-induced acute lung inflammation mouse model. We found that aerosol pre-treatment with GB suppresses the accumulation of neutrophils and macrophages in the bronchoalveolar lavage fluid (BALF) in cigarette smoke (CS)-exposed mice. GB at doses of 300 and 600 μg/ml significantly inhibited the CS-induced increases in the mRNA and protein expression levels of interleukin (IL)-1β, tumor necrosis factor (TNF)-α, monocyte chemotactic protein (MCP)-1 and transforming growth factor (TGF)-β1 in lung tissues and the BALF. Moreover, GB at a dose of 600 μg/ml significantly inhibited the CS-induced changes in glutathione (GSH) and myeloperoxidase (MPO) activities in the BALF, decreased the CS-induced expression of matrix metalloproteinases (MMP)-9, and increased the CS-induced expression of tissue inhibitor of metalloproteinases (TIMP)-1, as determined through the immunohistochemical staining of lung tissue. Our results demonstrate the beneficial effects of inhaled GB on the inflammatory reaction in COPD.     

支气管腔内超声图像评分系统在肺结节良恶性诊断中的应用

目的建立基于支气管腔内超声(EBUS)图像的评分系统从而判别肺结节良恶性。 方法回顾性纳入自2018年5月1日至2020年3月1日期间于苏北人民医院气管镜室行气管镜检查的患者资料,所有患者胸部计算机断层扫描(computer tomography, CT)检查见肺部≤3 cm的肺结节而行常规支气管镜检查未见明显异常。使用超声探头引导下在病变处进行活检与刷检协助诊断,未能明确诊断者行进一步侵袭性操作或治疗后随访观察至少3个月获得最终诊断。分析镜下超声图像形态特征,包括病灶外形、边缘、边界、内部回声强弱、内部回声同质或异质、支气管充气征、不规则无回声区、同心圆影8种不同EBUS图像特点与病灶良恶性的关系,建立简易评分系统,使用SPSS软件分析处理数据。 结果114例肺结节患者中,良性病变65例,恶性病变49例。EBUS图像中的三种图像特征,包括病灶圆形或类圆形外形、边缘不连续、病灶异质性,差异有统计学意义(P<0.05);根据建立的简易评分系统,绘制ROC曲线,当评分以7为界点时,敏感度(65.3%)和特异度(78.5%)最高,以该点为最佳诊断点;当评分≥7时,诊断肺恶性病变的准确率较高。计算Kappa一致性：系数为0.441(95%CI为0.274～0.607,P<0.01),具有中等强度一致性。 结论EBUS图像特征可用于鉴别肺结节良恶性,基于该图像的评分系统在鉴别肺结节良恶性中有较好的应用价值。     

Habitual intakes of sugar-sweetened beverages associated with gut microbiota-related metabolites and metabolic health outcomes in young Chinese adults

Background and aimsReducing consumption of sugar-sweetened beverages (SSBs) is a global public health priority because of their limited nutritional value and associations with increased risk of obesity and metabolic diseases. Gut microbiota-related metabolites emerged as quintessential effectors that may mediate impacts of dietary exposures on the modulation of host commensal microbiome and physiological status.Methods and resultsThis study assessed the associations among SSBs, circulating microbial metabolites, and gut microbiota–host co-metabolites, as well as metabolic health outcomes in young Chinese adults (n = 86), from the Carbohydrate Alternatives and Metabolic Phenotypes study in Shaanxi Province. Five principal component analysis-derived beverage drinking patterns were determined on self-reported SSB intakes, which were to a varying degree associated with 143 plasma levels of gut microbiota-related metabolites profiled by untargeted metabolomics. Moreover, carbonated beverages, fruit juice, energy drinks, and bubble tea exhibited positive associations with obesity-related markers and blood lipids, which were further validated in an independent cohort of 16,851 participants from the Regional Ethnic Cohort Study in Northwest China in Shaanxi Province. In contrast, presweetened coffee was negatively associated with the obesity-related traits. A total of 79 metabolites were associated with both SSBs and metabolic markers, particularly obesity markers. Pathway enrichment analysis identified the branched-chain amino acid catabolism and aminoacyl-tRNA biosynthesis as linking SSB intake with metabolic health outcomes.ConclusionOur findings demonstrate the associations between habitual intakes of SSBs and several metabolic markers relevant to noncommunicable diseases, and highlight the critical involvement of gut microbiota-related metabolites in mediating such associations.     

基于SEER数据库的肿瘤直径大于7.0厘米的非小细胞肺癌患者预后分析

目的 区分肿瘤直径>7.0 cm的非小细胞肺癌（NSCLC）患者死亡风险,评估手术及非手术治疗的临床价值。方法 基于SEER数据库收集2010—2015年肿瘤直径>7.0 cm非小细胞肺癌患者数据。寿命表法计算1、2、3年生存率,Kaplan-Meier法绘制生存曲线,单因素及多因素Cox回归模型分析预后影响因素。结果 纳入的5 519例患者1、2、3年累计生存率分别为51.8%、33.0%、25.0%。单因素、多因素Cox回归分析显示肿瘤大小、淋巴结N分期、治疗方式是影响NSCLC的预后独立危险因素（P<0.001）。结论 N0~N1期肿瘤直径>7.0 cm非小细胞肺癌患者,手术治疗有利于患者生存预后。N2期肿瘤直径7.0~9.0 cm组,手术治疗在改善患者预后方面存在优势。N2期肿瘤直径≥9.0 cm组以及N3期患者手术与非手术患者预后方面差异未见统计学意义。姑息治疗不能改善患者预后。