10~21岁病态肥胖患者行腹腔镜袖状胃切除术的疗效分析

目的探讨10~21岁病态肥胖患者行腹腔镜袖状胃切除手术(LSG)的疗效。方法回顾性分析2015年1月至2020年12月期间,暨南大学附属第一医院胃肠外科/减重中心行LSG 200例,对其中10~21岁病态肥胖患者89例(44.5%)的临床资料进行回顾性分析。主要观察指标为SG手术完成情况、围手术期间并发症发生情况和术后3、6、12及≥24个月时的减重相关指标以及糖代谢、血脂代谢、维生素、肝功能及其他生化指标检测结果,并与术前进行比较。符合正态分布的计量资料以x±s表示;由于每个随访时间点的例数与术前例数均不一致,故组间比较仍采用独立样本t检验;非正态分布的计量资料以M(Q_(1),Q_(3))表示,组间比较仍采用Mann-Whitney U检验。结果889例患者中男性35例(39.3%),年龄(18±2)岁;体质指数(38.5±4.8)kg/m^(2),>40 kg/m^(2)者37例;合并有脂肪肝63例(70.8%),高尿酸血症34例(38.2%),睡眠呼吸暂停综合征31例(34.8%),胃食管反流20例(22.4%),2型糖尿病8例(8.9%),高血压2例(2.2%)。89例患者均顺利完成LSG手术,无中转开腹。围手术期未出现大出血、胃漏以及感染病例;术后短期内出现明显的恶心、呕吐及疼痛症状,多于术后第2天可以缓解。术后3、6及12个月的体质指数值分别下降至(31.5±5.8)kg/m^(2)、(28.6±4.3)kg/m^(2)和(26.3±4.4)kg/m^(2),与术前相比,差异有统计学意义(均P<0.05)。术后12个月及≥24个月时,总体质量减少百分比(%TWL)分别为(31.3±9.3)%和(33.1±10.5)%,与术后3个月时(20.5±5.1)%相比,差异有统计学意义(均P<0.05)。多余体质量减少百分比(%EWL)术后12个月及≥24个月时分别为91%(70%,113%)和95%(74%,118%),与术后3个月时的56%(45%,72%)相比,差异也有统计学意义(均P<0.05)。丙氨酸转氨酶(ALT)和天冬氨酸转氨酶(AST)检测水平分别由术前的44.4(25.5,100.5)U/L和29.0(9.5,48.0)U/L下降到≥24个月时的14.0(10.8,18.3)U/L和13.0(10.5,17.3)U/L,糖化血红蛋白由术前5.6(5.3,5.8)%下降到术后≥24个月时的5.3(5.0,5.4)%;高密度脂蛋白则由术前1.0(0.9,1.2)mmol/L增加到术后≥24个月时的1.4(1.1,1.6)mmol/L;维生素B12由术前350.0(256.8,441.3)μg/L下降到术后≥24个月时的230.3(195.4,263.9)μg/L;与术前相比,差异均有统计学意义(均P<0.05)。结论LSG对于10~21岁的病态性肥胖患者疗效良好,但仍需要长期的多中心的随机对照试验进一步证实。

Effect of super-chilling storage on maintenance of quality and freshness of the Pacific oyster(Crassostrea gigas)

The quality changes of shelled Pacific oysters(Crassostrea gigas)were examined in relation to the effects of superchilling storage at-1 C for 28 d by measuring changes in biochemical properties(microbial analysis,adenosine triphosphate(ATP)-related compounds,pH,free amino acids)and sensory evaluations in this study.The results indicated that microorganism growth was significantly inhibited during superchilling storage.Adenosine diphosphate(ADP)and adenosine monophosphate(AMP)accumulated while ATP rapidly decreased in the adductor muscle.ATP and ADP were the primary components in the other 3 tissues including mantle,gill,and body trunk of oysters,and they remained relatively stable over time.The pH and adenylate energy charge in the adductor muscle could be utilized as freshness indicators for shelled oysters.However,there were no significant differences(P>0.05)among the free amino acids during whole storage.According to the sensory evalu-ations,oysters could be alive and tolerated up to 21 d at-1℃storage.The study demonstrated that superchilling storage at-1℃could better maintain the eating quality of shelled oysters and the shelf life was extended to 21 d.

Effects of flash-boil shucking on biochemical,sensorial and ultrastructural properties of Yesso Scallop(Mizuhopecten yessoensis)adductor muscle during refrigeration

Scallop adductor muscle has great popularity for raw consumption in Japan,but conventionally shucking live scallops with high vitality by knife requires skill and is time-consuming.Flash-boil shucking is a convenient shucking method in sushi restaurants for live scallops.However,the effects of this treatment on the quality of its main edible part,the adductor muscle,are not clear.This study was conducted to investigate the impact of flash-boil shucking on the quality of raw-edible scallop adductor muscle,focusing on flavor-enhancing components and ultrastructure.Thermal treatment could contribute to the formation of flavor-enhancing nucleotides in the external layer of the adductor muscle.Adenosine monophosphate content increased with the boiling time,which significantly increased to 1.47±0.42μmol/g in the 30 s-boiled group compared with 0.38±0.13μmol/g in the control group(p<0.05).The rapid adenosine monophosphate accumulation after boiling resulted in a faster accumulation of inosine and hypoxanthine during subsequent refrigeration,which could bring bitterness to aquatic products.Flash-boil shucking had no discernible effect on the proportion of free amino acids relevant to the flavor of scallop adductor muscle,despite the possibility of a reduction in total free amino acids.The external layer of the scallop adductor muscle could be hardened after flash-boil shucking.At the ultrastructural level,muscle fibers tend to aggregate transversely and contract longitudinally depending on the heating time.Flash-boil shucking is ideal for consuming the raw-edible scallop adductor muscle promptly.Flash-boil shucking treatment is recommended for households,restaurants,and small factories for treating scallops with high vitality.