Medicine
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This study aimed to introduce this surgical technique laparoscopic sleeve gastrectomy combined with single-anastomosis duodenal-jejunal bypass (LDJB-LSG), and to confirm this new surgical technique was safe in the treatment of type 2 diabetes mellitus (T2DM) of patients with body mass index (BMI) higher than 27.5 kg/m but lower than 32.5 kg/m. A total of 34 T2DM patients with (BMI) higher than 27.5 kg/m but lower than 32.5 kg/m were admitted to our department between January 2014 and October 2016, of whom 25 received laparoscopic gastric bypass surgery (LRYGB) and 9 received LDJB-LSG. The efficacy and safety were compared between the 2 groups. ⋯ Patients received regular follow-up after surgery and none were lost to follow-up. Our study indicates LDJB-LSG is similar to LRYGB in the improvements of the body weight, blood glucose, insulin resistance, islet β cell function, blood lipid profile and serum uric acid, and thus LDJB-LSG is applicable in T2DM patients with 27.5 kg/m ≤ BMI ≤ 32.5 kg/m and risk for gastric cancer. However, long-term therapeutic effects need to be evaluated by studies with multicenter, large sample size, and long-term follow-ups.
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Mitochondrial respiratory chain complex I deficiency is one of common mitochondrial disorders. However, the information is relatively little about the features of Chinese patients. In this study, the clinical, biological, and genetic analyses were performed in the children with respiratory chain complex I deficiency, in order to further understand the characteristics of the disease. ⋯ The prevalence of isolated complex I deficiency was higher in the patients with mtDNA mutations (79.4%) than in the patients without mtDNA mutations (54.5%). Patients with nuclear DNA mutations are more likely to develop early onset in mitochondrial respiratory chain complex I deficiency. The patients with complex I deficiency of peripheral leukocytes may be more likely to be caused by mtDNA mutation.
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Observational Study
Long-term physical health consequences of abortion in Taiwan, 2000 to 2013: A nationwide retrospective cohort study.
The aim of this study was to quantitatively estimate the long-term risk of abortion-related consequences and comorbidities. We identified 36,375 patients with at least 2 diagnosed abortions from 2000 to 2013 and included them in the abortion group. This group was further subdivided into 4 subgroups: spontaneous abortion, induced abortion, nonspecific abortion, and mixed-type abortion groups. ⋯ The induced abortion group showed a statistically significant elevated adjusted HR of 1.291 for urinary tract infection (P = .008) but statistically insignificant HRs of 1.031 for pelvic inflammatory disease, 1.637 for ectopic pregnancy, 5.114 for placenta previa, 65.434 for placenta abruption, 0.998 for incompetent cervix, 0.285 for early onset of labor, and 1.019 for subsequent infertility with no subsequent conception. Clinicians encountering patients in a predicament such as spontaneous or induced abortion should unprejudicely and objectively inform the patients of the effects or influence of abortion on their physical health, including statistically significant and insignificant risks. Induced abortion may not be an independent risk factor for subsequent infertility.
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Observational Study
Diamond-shaped patch technique for right hepatic vein reconstruction in living-donor liver transplant: A simple method to prevent stenosis.
Patency of the right hepatic vein (RHV) of the liver graft is essential for successful living-donor liver transplant (LDLT). We developed a simple technique for RHV reconstruction that does not require the use of cadaveric veins or additional time to prevent stenosis. Of 159 patients who underwent LDLT at our institution between May 2010 and April 2016, we included 152 in this study. ⋯ Rates of intervention for RHV stenosis during the first month were significantly different between the conventional reconstruction and D-patch groups (19.2% vs 3.8%; P = .01). The time taken to perform the D-patch technique was similar to that for conventional reconstruction (anhepatic period, 104.9 ± 47.3 minutes vs 106.7 ± 42.0 minutes; P = .82). The D-patch technique for RHV reconstruction in LDLT is a simple, fast, and feasible surgical technique that can be performed without using cadaveric or saphenous veins.
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Observational Study
Anemia is inversely associated with serum C-peptide concentrations in individuals with type 2 diabetes.
The purpose of the study was to test the hypothesis that anemia is related with serum C-peptide concentrations in individuals with type 2 diabetes mellitus (DM). This cross-sectional study was carried out in 1300 individuals with type 2 DM. We measured fasting C-peptide, 2-hour postprandial C-peptide, and postprandial C-peptide minus fasting C-peptide (ΔC-peptide) concentrations. ⋯ According to the grade of anemia, the average C-peptide concentrations differed significantly after adjusting for other covariates. In the multivariable model, the statistically significant relation between anemia and serum C-peptide concentrations remained after adjusting for confounders, including age, gender, family history of diabetes, body mass index, duration of diabetes, glycated Hb, free fatty acids, hypertension, and hyperlipidemia (fasting C-peptide concentration: β = -0.057, P = .032; postprandial C-peptide concentration: β = -0.098, P < .001; ΔC-peptide concentration: β = -0.095, P < .001). Anemia was inversely associated with serum C-peptide concentrations in individuals with type 2 DM.