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The increased level of pro-inflammatory cytokines confirms the role of monocyte-driven inflammation in CNO patients. Cytokines may prove valuable as biomarkers and potential therapeutic targets for CNO.

The increased level of pro-inflammatory cytokines confirms the role of monocyte-driven inflammation in CNO patients. Cytokines may prove valuable as biomarkers and potential therapeutic targets for CNO.

Roux-en-Y gastric bypass (RYGB) has been widely used for type 2 diabetes (T2D) patients with overweight or obesity. However, the long-term outcomes of RYGB versus medical therapy have not been well compared.

To evaluate the long-term outcomes of RYGB versus medical therapy for patients with T2D.

University-affiliated hospital, China.

Four electronic databases-PubMed, EMBASE, the Cochrane Library, and ClinicalTrials.gov-were searched for articles published through February 2021. Eligible studies were randomized controlled trials.

Of 7 randomized controlled trials (15 articles), 477 patients were included 239 were randomly divided into RYGB groups and 238 to medical therapy groups. Statistically higher rates of T2D remission were observed in RYGB groups at 1 year (relative risk [RR], 18.01; 95% confidence interval [CI], 4.53- 71.70; P < .0001), 3 years (RR, 29.58; 95% CI, 5.92-147.82; P < .0001), and 5 years (RR, 16.92; 95% CI, 4.15-69.00; P < .0001). Meanwhile, statistically higher rates of achieving the American Diabetes Association's (ADA's) treatment goal were observed in RYGB groups at 1 year (RR, 3.99; 95% CI, 1.01-15.82; P = .05), 2 years (RR, 2.98; 95% CI, 1.62- 5.48; P = .0004), 3 years (RR, 3.16; 95% CI, 1.33-7.49; P = .009), and 5 years (RR, 6.18; 95% CI, 1.69-22.68; P = .006).

This meta-analysis indicated that RYGB led to higher rates of T2D remission than medical therapy at 1, 3, and 5 years, as well as higher rates of achieving ADA's composite goal at 1, 2, 3, and 5 years.

This meta-analysis indicated that RYGB led to higher rates of T2D remission than medical therapy at 1, 3, and 5 years, as well as higher rates of achieving ADA's composite goal at 1, 2, 3, and 5 years.Both mitochondrial and nuclear gene mutations can cause cytochrome c oxidase (COX, complex Ⅳ) dysfunction, leading to mitochondrial diseases. Although numerous diseases caused by defects of the COX subunits or COX assembly factors have been documented, clinical cases directly related to mitochondrial cytochrome c oxidase subunit 3 gene (MT-CO3) mutations are relatively rare. Here, we report a 47-year-old female patient presented with mitochondrial encephalopathy, lactic acidosis, and stroke-like episodes (MELAS) syndrome. Muscle pathology revealed ragged-red fibres and remarkable COX-deficient muscle fibres. Muscle mitochondrial DNA sequencing analysis identified a novel MT-CO3 variant (m.9553G>A) that changed a highly conserved amino acid to a stop codon (p.Trp116*). This variant was heteroplasmic in multiple tissues, where the mutation load was 13% in oral epithelial cells, 89% in muscle samples, and not detectable in the peripheral blood lymphocytes. Single muscle fiber PCR analysis showed clear segregation of the mutation load with COX deficient fibres. Western blot analysis of the muscle samples revealed a significant decrease in the levels of COX1, COX2, COX3, COX4 and UQCRC2. COX respiration activity was remarkably reduced (58.84%) relative to the controls according to spectrophotometric assays. selleck compound Taken together, our results indicated that this m.9553G>A variant may be responsible for the MELAS symdrome in the proband by affecting the stability and function of COX. The study expands the clinical and molecular spectrum of COX3-specific mitochondrial diseases.

To investigate how number of autotransplanted parathyroid glands (PGs) affects the incidence of postoperative hypoparathyroidism and the recovery of parathyroid function.

A systematic search was performed in the MEDLINE, Embase, and Cochrane Central Register of Controlled Trials databases. The evaluated indices included the incidence of postoperative transient and permanent hypoparathyroidism and parathyroid hormone (PTH) levels during follow-up.

Twenty articles with 7291 patients were included. A higher incidence of transient hypoparathyroidism was found in the PG autotransplantation group than in the preservation group (odds ratio [OR] 2.37; 95% confidence interval [CI] 1.90, 2.96). However, there was no significant difference between the two groups regarding permanent hypoparathyroidism (OR 1.17; 95% CI 0.71, 1.91). Parathyroid hormone (PTH) levels in the PG autotransplantation group changed significantly more than the preservation group at postoperative 1-day and 1-month, but became similar at the 6observed for permanent hypoparathyroidism.

Pancreatic trauma results in significant morbidity and mortality. However, few studies have investigated the postoperative prognostic factors in patients with pancreatic trauma.

A retrospective study was conducted on consecutive patients with pancreatic trauma who underwent surgery in a national referral trauma center. Clinical data were retrieved from the electronic medical system. Univariate and binary logistic regression analyses were performed to identify the perioperative clinical parameters that may predict the factors of mortality of the patients.

A total of 150 patients underwent laparotomy due to pancreatic trauma during the study period. 128(85.4%) patients survived and 22 (14.6%) patients died due to pancreatic injury (10 patients died of recurrent intra-abdominal active hemorrhage and 12 died of multiple organ failure). Univariate analysis showed that age, hemodynamic status, and injury severe score (ISS) as well as postoperative serum levels of C-reactive protein (CRP), procalcitonin, albumin, creatinine and the volume of intraoperative blood transfusion remained strongly predictive of mortality (P<0.05). Binary logistic regression analysis showed that the independent risk factors for prognosis after pancreatic trauma were age (P=0.010), preoperative hemodynamic instability (P=0.015), postoperative CRP ≥154mg/L (P=0.014), and postoperative serum creatinine ≥177μmol/L (P=0.027).

In this single-center retrospective study, we demonstrated that preoperative hemodynamic instability, severe postoperative inflammation (CRP ≥154mg/L) and acute renal failure (creatinine ≥177μmol/L) were associated with a significant risk of mortality after pancreatic trauma.

In this single-center retrospective study, we demonstrated that preoperative hemodynamic instability, severe postoperative inflammation (CRP ≥154 mg/L) and acute renal failure (creatinine ≥177 μmol/L) were associated with a significant risk of mortality after pancreatic trauma.

With the gradual advancement of laparoscopic technology, surgeries can be successfully performed with the help of laparoscopy increasingly. This study initially explored the difference between laparoscopic right posterior sectionectomy (LRPS) and open right posterior sectionectomy (ORPS)of liver in our center, discussed the effectiveness, benefits and safety of LRPS and introduce some surgical techniques in our center.

We retrospectively analyze 96 cases of liver tumor located in the right posterior lobe of liver in our institution from January 2015 to January 2018. There were 46 cases performed the LRPS surgery and 50 cases performed the ORPS surgery. Through analysis of the perioperative outcomes of these two groups by a case control study, we compare the differences between these two groups.

There was no significant difference between the LRPS and ORPS group in demographic and baseline characteristics before surgery. Patients in the LRPS group were significantly superior to ORPS in terms of postoperative liver function recovery, postoperative inflammatory factor level, pain sensation (3.03±0.79 vs 4.58±1.25), abdominal incision length (6.25±2.34 vs 32.15±3.21), carrying abdominal drainage tube time (3.26±0.77 vs 4.83±0.76), recovery of bowel function time (1.6±0.61 VS 3.05±0.85)and postoperative hospital stay (5.73±0.99 vs 7.16±0.95) (P<0.05).

Compared with the traditional ORPS, LRPS has the advantages of minor injury, faster recovery and mild inflammatory reaction. The LRPS is safe and feasible, and it should be gradually promoted in clinical practice.

Compared with the traditional ORPS, LRPS has the advantages of minor injury, faster recovery and mild inflammatory reaction. The LRPS is safe and feasible, and it should be gradually promoted in clinical practice.

Impact of previous history of choledochojejunostomy (PCJ) on the incidence of organ/space surgical site infection (SSI) after hepatectomy remains unclear. The aim of this study was to investigate the incidence and causes of SSI after hepatectomy.

Patients who underwent hepatectomy of ≤1 Couinaud's sector between January 2011 and September 2019 were retrospectively analyzed. Incidence of and risk factors for organ/space SSI (Clavien-Dindo grade ≥2) after hepatectomy were investigated.

Among 750 hepatectomies, 18 patients (2.4%) had a medical history of PCJ. Incidence of organ/space SSI was higher in patients with PCJ (50%) than in those without PCJ (3%, P<0.001), and the trend was consistent even after estimated propensity score matched cohort. Multivariate analysis showed PCJ was a strong risk factor for organ/space SSI (grade ≥2), with the highest odds ratios (OR) among all other clinicopathological risk factors (OR, 32.25; P<0.001). Among hepatectomies with PCJ, pneumobilia (OR, 12.25; P=0.015), operation time ≥171min (OR, 12.25; P=0.016), and liver steatosis (OR, 24.00; P≤0.005) were associated with organ/space SSI after hepatectomy.

Previous history of choledochojejunostomy was a strong risk factor for organ/space SSI after hepatectomy. The high rate of organ/space SSI after hepatectomy with PCJ might be attributed to intrahepatic bile duct contamination, increased operation time, and histological liver steatosis.

Previous history of choledochojejunostomy was a strong risk factor for organ/space SSI after hepatectomy. The high rate of organ/space SSI after hepatectomy with PCJ might be attributed to intrahepatic bile duct contamination, increased operation time, and histological liver steatosis.

natriuretic peptide is associated with myocardial fibrosis in animal models and among patients with heart disease. However, it remains unclear whether serum N-terminal pro-B-type peptide (NT-proBNP) levels are associated with histopathologically proven myocardial fibrosis among individuals without apparent heart disease. This study aimed to evaluate the association between serum NT-proBNP levels and the histopathologically estimated myocardial fibrotic area in autopsied samples from a community.

we selected 63 cases without apparent heart disease with available data of serum NT-proBNP concentrations within six years before death (average age 82 years; male 52%) from autopsied cases in a community, and evaluated the percentage areas of myocardial fibrosis in four cardiac segments from each case (i.e. 252 cardiac segments in total). The association between serum NT-proBNP levels and the percentage area of myocardial fibrosis was estimated using a linear mixed model for repeated measures.

serum NT-proBNP levels were positively correlated with myocardial fibrotic area [Pearson's correlation coefficient r=0.