Long-term effectiveness,outcomes and complications of bariatric surgery

Dietary imbalance and overeating can lead to an increasingly widespread disease-obesity.Aesthetic considerations aside,obesity is defined as an excess of adipose tissue that can lead to serious health problems and can predispose to a number of pathological changes and clinical diseases,including diabetes;hypertension;atherosclerosis;coronary artery disease and stroke;obstructive sleep apnea;depression;weight-related arthropathies and endometrial and breast cancer.A body weight 20%above ideal for age,gender and height is a severe health risk.Bariatric surgery is a set of surgical methods to treat morbid obesity when other treatments such as diet,increased physical activity,behavioral changes and drugs have failed.The two most common procedures currently used are sleeve gastrectomy and gastric bypass.This procedure has gained popularity recently and is generally considered safe and effective.Although current data show that perioperative mortality is low and better control of comorbidities and short-term complications is achieved,more randomized trials are needed to evaluate the long-term outcomes of bariatric procedures.This review aims to synthesize and summarize the growing evidence on the long-term effectiveness,outcomes and complications of bariatric surgery.

The Immunogenic Connection of Thermal and Nonthermal Molecular Effects in Modulated Electro-Hyperthermia

Hyperthermia in oncology is an emerging complementary therapy. The clinical results depend on multiple conditional factors, like the type of cancer, the stage, the applied treatment device, and the complementary conventional therapy. The molecular effect could also be different depending on the temperature, heating dose, kind of energy transfer, and timing sequences compared to the concomitant treatment. This article examines the molecular impacts of a specific technique used in oncological hyperthermia called modulated electro-hyperthermia (mEHT). What sets mEHT apart is its emphasis on harnessing the combined effects of thermal and nonthermal factors. Nonthermal energy absorption occurs through the excitation of molecules, while the thermal component ensures the ideal conditions for this process. The applied radiofrequency current selects the malignant cells, and the modulation drives the nonthermal effects to immunogenic cell death, helping to develop tumor-specific antitumoral immune reactions. The synergy of the thermal and nonthermal components excites the lipid-assembled clusters of transmembrane proteins (membrane rafts) as the channels of transient receptor potentials (TRPs), the heat-shock proteins (HSPs), the voltage-gated channels, and the voltage-sensitive phosphatases (VSPs). All these transmembrane compartments channeling various ionic species (like calcium and proton) interact with the cytoskeleton and are involved in the apoptotic signal pathways.

Recent efficacy and long-term survival of Astragalus polysaccharide combined with gemcitabine and S-1 in pancreatic cancer

BACKGROUND Pancreatic cancer is a highly malignant tumor with a rapid progression rate and a high susceptibility to infiltration and metastasis.Astragalus polysaccharide(APS),a pure Chinese medicine preparation primarily made from the traditional Chinese herb Astragalus,plays a positive role in the treatment of many malignant tumors.AIM To explore the recent efficacy of APS combined with gemcitabine plus tegafur gimeracil oteracil potassium capsule(S-1)(GS)regimen in the treatment of pancreatic cancer and assess its effect on the immune function and long-term survival of patients.METHODS A total of 97 patients who were diagnosed with pancreatic cancer and received GS chemotherapy at The First Affiliated Hospital of Zhejiang Chinese Medical University(Zhejiang Provincial Hospital of Chinese Medicine)from March 2021 to December 2021 were included in the retrospective analysis.Among them,41 patients received APS combined with GS chemotherapy,and 56 patients received GS chemotherapy only.The recent efficacy,immune function,adverse reactions,and long-term survival were compared among these patients.RESULTS After 4 cycles of treatment,the objective response rate of patients receiving the combined therapy of APS and GS was 51.22%,and the disease control rate(DCR)was 56.10%,higher than those of patients receiving the monotherapy with GS alone(30.36%and 35.71%,respectively).Besides,the percentages of CD3+T cells(50.18%±9.57%)and CD4+T cells(31.52%±5.33%)in the peripheral blood of patients receiving the combined therapy of APS and GS were higher compared with those treated with GS regimen alone[(44.06%±8.55%)and(26.01%±7.83%),respectively].Additionally,the incidences of leukopenia,thrombocytopenia,and fatigue in patients receiving the combined therapy of APS and GS were significantly lower than those in patients receiving the monotherapy of GS alone(17.07%,9.76%,31.71%vs 37.50%,28.57%,60.71%).Moreover,the median survival time of patients receiving the combined therapy of APS and GS was 394 days,significantly longer than that of patients receiving the mono-therapy of GS alone(339 days)(hazard ratio:0.66;95%CI:0.45-0.99;P=0.036).All these differences were statistically si-gnificant(P<0.05).CONCLUSION The combined therapy of APS and GS improved the recent efficacy and long-term survival of patients with pancreatic cancer and alleviated chemotherapy-induced immune suppression and adverse reactions.

Pembrolizumab autoimmune related diabetes:Moving forward,keep learning

Immune checkpoint inhibitors(and more specifically programmed cell death 1/programmed cell death ligand 1 inhibitors as Pembrolizumab)initiated a revolution in the field of melanoma and have now expanded to several tumor subtypes and in increasingly broader clinical contexts,including the adjuvant and neoadjuvant setting,with potentially curable patients and prolonged survival.The side effects related to these drugs include a wide spectrum of manifestations,with endocrinological adverse events being some of the most frequent.Pembrolizumab-induced type 1 diabetes mellitus is an infrequent but potentially serious and not clearly reversible side effect that possesses characteristic clinical features and has high morbidity and mortality,with a chronic impact on quality of life.The etiopathogenesis of this phenomenom needs to be further investigated and a collaborative effort through the involvement of oncologists and other medical specialists is necessary for the correct identification and management of patients at risk.

Addition of Urban Waste to Semiarid Degraded Soil:Long-term Effect

The addition of municipal solid wastes （MSW） is considered as a possible strategy for soil rehabilitation in southeast Spain. The objective of this study was to evaluate the long-term （17 years） effect of five doses of MSW addition on the microbiological, biochemical, and physical properties of semiarid soil. Increased values of several parameters that serve as indicators of general microbiological activity, such as, basal respiration, adenosine triphosphate （ATP） or dehydrogenase activity; microbial population size （microbial biomass C）, and extracellular hydrolase activity related to macronutrient cycles, such as, urease, 3-glucosidase, and N-a-benzoyl-L-argininamide protease, were observed in the amended soils. The highest MSW doses showed the highest values in these hydrolase activities. The incorporation of municipal waste resulted in a more dense development of the plant cover, 50% greater in higher doses than in the control treatment, which generated a substantial increase in several C fractions. Total organic carbon reached 12 g kg^-1 soil with the highest MSW doses, compared to 4.30 g kg^-1 soil in the control treatment. The physical properties of the soil were also improved, showing greater percentage of stable aggregates and water holding capacity. Positive correlation coefficients between C fractions and parameters related to microbial activity and aggregate stability were observed. Although these improvements were greater in the soils receiving the highest doses of organic amendment, the increases were not proportional to the amount added, demonstrating the existence of a threshold, above which an increase in the amount of organic matter added is not reflected in an increase in the soil＇s physical, biochemical, and microbiological properties. However, the addition of municipal solid wastes proved its suitability for improving soil quality, thereby indicating the potential of such an amendment, to prevent desertification in Mediterranean areas such as those studied.

Tracking Survey of Immune Effects of Highly Pathogenic Porcine Reproductive and Respiratory Syndrome (HP-PRRS) in Changping District, Beijing City

The epidemiology of highly pathogenic porcine reproductive and respiratory syndrome( HP-PRRS) in Changping District,Beijing City was investigated from 2010 to 2015. Through statistics of vaccine,immune procedure and antibody levels,the epidemic prevention effect of HP-PRRS in Changping District was scientifically assessed.

Evaluation of the long-term effect of foldable capsular vitreous bodies in severe ocular rupture

AIM:To evaluate the long-term effect of foldable capsular vitreous body(FCVB)in the treatment of severe ocular rupture to provide a practical basis for clinical selection.METHODS:A total of 26 patients(26 eyes),23 men and 3 women,with severe ocular rupture who underwent FCVB implantation between March 2018 and September 2018 were retrospectively analysed.All open ocular wounds located in zone III,with preoperative visual acuity grade IV and above(Snellen less than 4/200).The best corrected visual acuity(BCVA),intraocular pressure(IOP),cornea,anterior chamber,iris,lens,choroid,and retina were evaluated before and after the surgery.The subjective feeling and the location of FCVB were also assessed.RESULTS:The average age of the 26 patients was 36y(20-60y).Postoperative follow-up was from 10 to 14mo.At the end of follow up,BCVA was light perception(LP)in 10 cases,no light perception(NLP)in 13 cases,hand motions(HM)in 3 cases.IOP was 11±5 mm Hg.Corneal degeneration was in 3 cases and corneal endothelial dystrophy was in 7 cases.Shallow anterior chamber was in 8 cases and hyphema was in 8 cases.Organized membrane in the pupil was in 14 cases.Epiphora occurred in 3 cases.FCVB drainage tube exposed in 3 cases.All FCVBs were in their normal location and no rejection occurred.CONCLUSION:FCVB implantation is a long-term effective treatment and may provide a practical selection for severe ocular rupture.

Immunological effect of aqueous extract of Vernonia amygdalina and a known immune booster called immunace and their admixtures on HIV/AIDS clients:a comparative study

Objective:To investigate the immunological effect of Vernonia amygdalina(V.amygdalina) leaf extract and immunace on HIV infected patients taking highly active antiretrwiral therapy. Methods:Fresh V.amygdalina leaves were collected within Nsukka area in Enugu State.The leaves were rinsed with distilled water.Two handful of cleaned fresh leaves were soaked in 200 mL water and squeezed gently by hand to a mixture.Clients were divided into four groups and each group was given different combination.They took the medication for four weeks.The immune effect was tested against marketed immune booster in some retroviral clients.Results:The mean absolute CD4 count was increased in the client who took the extract or supplement.And the clients who took both the extract and supplement had a greater increase in the CD4 count.The increased CD4 was significant as compared with the control group(P<0.05).The skin rashes were also improved in the entire groups.Conclusions:It can be concluded that the aqueous extract of V.amygdalina and immunace or both have immunological effect on HIV infected patients. Therefore,we suggest that the V.amygdalina extract or immunace or both could be used as adjuvant in the management of HIV/AIDS clients.

Investigation of the immune effects of Scutellaria baicalensis on blood leukocytes and selected organs of the chicken＇s lymphatic system

Background： The health of chickens and the welfare of poultry industry are central to the efforts of addressing global food security. Therefore, it is essential to study chicken immunology to maintain and improve its health and to find novel and sustainable solutions. This paper presents a study on investigation of the effect of Scutellaria baicalensis root（SBR） on the immune response of broiler chicken, especially on lymphocytes and heterophils reactivity, regarding their contribution to the development of immunity of the chickens.Methods： The 121-day-old Hubbard Hi-Y male broiler hybrids were randomly assigned to four treatment groups,three SBR supplemented groups（0.5, 1.0, and 1.5% of SBR） and one control group. Each treatment was replicated five times with six birds per replicate pen in a battery brooder. Blood was collected after 3-（rd） and 6-（th）wk of the experiment, and hemoglobin and hematocrit values were determined, as well as total leukocyte count and differential count were performed. Nitroblue tetrazolium test and phagocytosis assay as nonspecific immune parameters and humoral immune responses to the antigenic challenge by sheep red blood cells were performed.Moreover, the ability of peripheral blood lymphocytes to form radial segmentation（RS） of their nuclei was analyzed.Body weight and relative weight of spleen, liver, and bursa of Fabricius were recorded.Results： Results showed that mean heterophile/lymphocyte ratio increased in the SBR groups compared to the control group and the blood of the chickens showed lymphocytic depletion. The results also demonstrated that the relative weight of bursa of Fabricius and spleen in groups fed with SBR significantly decreased compared to the control group. This study also showed that the addition of SBR significantly inhibited the formation of RS of nuclei compared to some cytotoxic substances.Conclusion： We found that SBR supplementation should be carefully evaluated when given to poultry. The excess intake of SBR supplementation may cause immunologic inhibition and may negatively affect the development of immune organs. SBR has inhibited the formation of radial segmentation nuclei showing antimetastatic properties and also the phagocytosis of chicken heterophils.

Effects of the Chinese Medicinal Herb Com plex Additives on Non-specific Immunity of Amursturgeon( Acipenser schrencki Brandt)

This study was to investigate the effects of aqueous decotion from three Chinese medicinal herb additives （ Cyrtomium fortunei, prescription I and prescription II） on non-specific immunity of 1 ＋ age old Amur sturgeon （Acipenser schrencki Brandt） by oral perfusion. Cyrtomiumfortunei, prescription I and prescription II were orally given to 15 fishes for each experimental group once a day, with the concentration of 9,175 and 36 g/S0 kg body weight, respectively. The administration was lasted for 14 days. Meanwhile, distilled water was orally given as the control. After the experiment, some of the experimental fishes were stimulated with high temperature （30 ℃ ） for two hours. Sampling was performed from fishes treated at 22 ℃ and 30 ℃ for measuring the protein content in the serum, phagocytic activity of leucocytes and the activity of the lysozyme in six tissues. The results indicated that Cyrtomiumfortunei and prescription II could help to enhance the content of various proteins and the phagocytic activity of leucocytes. There was no significant change in the effects between these two additives at either the normal temperature or high temperature. Prescription I did not show an obvious effect on the immunity of fishes at the normal temperature, but it did in promo- ting high-efficiency response and improving immunoregulation of fish shocked by some stimuli.

LONG-TERM EFFECT OF HOMOHARRINGTONINE ON CHRONIC GRANULOCYTIC LEUKEMIA

Objective: To observe the long-term effect of homoharringtonine (HHT) on chronic granulocytic leukemia (CGL) and its pharmacological mechanism. Methods: 76 patients with newly diagnosed early chronic phase CGL received treatment of merely 1.5 mg/m2 daily HHT for induction remission and long-term maintenance treatment. The apoptosis rate of bone marrow CD34+ cells induced by HHT was assayed with flow cytometer. Results: 86.8% patients achieved CHR, 13.2% patients PHR and 31.8% patients got cytogenetic response in HHT treatment group, which was longer than 31 (8-54) months in hydroxyurea (HU) group (P<0.05). The effect of apoptosis induction HHT was stronger on CGL-CP patients bone marrow CD34+ cells than on normal person bone marrow CD34+ cells. Conclusion: HHT is a very effective drug for remission induction and long-term maintenance treatment in early chronic phase CGL patients.

Immunogenicity and tumor-inhibiting effects of HSP-antigen peptide complex in melanoma B16 cells in mice

目的 :黑色素瘤 B1 6细胞热休克蛋白 -抗原肽复合物 (HACs)及其粗提物 (HAC- CEs)的制备 ,以及它们的免疫原性和抑瘤效应的研究。方法 :应用 Sephacryl S- 2 0 0凝胶过滤制备HAC- CEs,应用亲和层析纯化 HACs,并测其免疫功能和抑瘤效应。结果 :应用凝胶过滤制备的HAC- CE3、HAC- CE4、HAC- CE5和应用亲和层析纯化的 HAC60 ,HAC75和 HAC97均不同程度地降低肿瘤发生率、延迟肿瘤发生时间和减少移植黑色素瘤 C57BL/6J小鼠死亡率 ;同时 ,伴有小鼠脾细胞 IFN-γ和 IL- 2分泌活性及 CTL杀伤率的增加。结论 :分子量为 60 0 0 0～ 970 0 0的 HACs具有免疫原性和抑瘤效应 ,本研究为制备肿瘤疫苗提供重要的实验依据。

Medium-term and Long-term Momentum and Contrarian Effects on China during 1994-2004

We examine momentum and contrarian effects in China＇s stock market during 1994-2004 and find that no medium momentum effects exist. Meanwhile, contrarian strategy works effectively over the horizon of 18-36 months. 1-month gap for avoiding bid-ask bounce and lead-lag effect make no considerable change to our empirical results. Transaction costs seem to have no significant impact on contrarian strategies＇ profit.

Effects of Qishen Ultrafine Powder on Immune Efficacy in Chickens

[Objective] This paper aimed to observe the effects of Qishen ultrafine powder on immune efficacy of infectious bursal disease vaccine in chickens. [ Method] 360 1-day-old chickens were randomly divided into six groups equally, and group I -V were vaccinated with IBD live virus vaccine on the 21 th and 35th day, respectively. From 14th to 21th day, group I - Ⅲ were added with 1%, 0.5% of Qishen ultrafine powder and 2% of Qishan powder in basel diet, respectively, group IV was given Yupingfeng oral liquid and group VI was as a control group without vaccination. Be- fore the expedment （14-day-old chickens as DO ） and 7 （ D7 ）, 14 （ D14 ）, 21 （ D21 ）, 28 （ D26 ）, 35 （ D36 ）, 42 （ D42 ） days after the experiment, the dynamic change of serum IBD specific antibody was determined, respectively. On D7, D21 and D36, the dynamic change of peripheral T lymphocyte proliferation and IL-2 in serum were determined, respectively. The weight change was also observed. [Results] Compared with the immune control group, the immune effects of IBD vaccine of each administration group were significantly improved, and there was no significant difference between each other. [ Condusion] Qishen ultrafine powder could increase immune function of chickens at lower dosage.

Immune blockade inhibitors and the radiation abscopal effect in gastrointestinal cancers

The field of tumor immunology has produced in the recent years a revolution in cancer therapeutics putting an end in the long lasting frustration of investigators in the area stemming from largely unsuccessful strides to develop cancer vaccines. This progress has come from the introduction of immune checkpoint inhibitors, monoclonal antibodies blocking ligand/receptor pairs with inhibitory effects for immune cells. Through this blockade immune checkpoint blockers are able to ac-tivate the immune system and create an anti-tumoral effect. A significant sub-set of patients with various types of cancers such as melanoma, lung carcinomas and urothelial cancers benefit from treatment with these drugs and survivals have improved in some ca-ses. However other cancers are primarily resistant to immune blockers and secondary resistance is also the norm. Radiation therapy is often used in the palliative treatment of patients with advanced cancers and, in addition to the local effect in the irradiated field, it may in rare cases produce a systemic antitumor effect, termed "abscopal". This effect has been suggested to be produced by immune mechanisms. Thus an opportunity presents for a synergistic effect of immune stimulation between radiation and immune blockade inhibitors. The therapeutic opportunities presented with the combination of radiation and these drugs for gastrointestinal cancers will be discussed in this editorial overview.

Long-term effect of Chinese herbal medicine Tianqi Capsule on the incidence ofdiabetes： an 8-year cohort study protocol

Background： The rapid growth of type 2 diabetes mellitus （T2DM） remains a big challenge for clinicians worldwide.Traditional Chinese medicine may bring a new approach for solving this problem. The Tianqi Capsule DiabetesPrevention Study （REDUCES Study） reported that 1 years of therapy with Tianqi capsule reduced the risk of diabetes by32.1% compared with the placebo. Here we aimed to assess the long-term effect of Tianqi capsule on prevention ofT2DM in people with impaired glucose tolerance after discontinuation of active intervention. Methods/design： 420subjects will be followed-up for 8 years to assess the long-term effect of Tianqi capsule intervention. The causes of deathand the status of living subjects will be investigated. Follow-up data for living subjects will be collected by personalinterview and clinical examination and medical record review to determine diabetes status. Questionnaires will be givento all the subjects to investigate the factors that probably affect the diabetes status during the 8-year of discontinuation ofintervention. The primary outcome is the incidence of T2DM, and the secondary outcomes are body mass index, bloodglucose, blood lipids and blood pressure. The Cox proportional hazards model will be used to estimate the hazard ratiofor diabetes incidence. Analyses will be done with SAS 8.2 software package. Discussion： Results from this study mayprovide evidence for the long-term efficacy of Tianqi capsule in patients with prediabetes. The findings will provide abasis for further confirmatory studies. Ethics： The protocol has been approved by the Medical Ethics Committee ofGuang’anmen Hospital of China Academy of Chinese Medical Sciences （approval number 2016-046-KY-01）. Studyregistration number： ClinicalTrials.gov; NCT02848053.

Intratracheally Administered Liposomal α-Tocopherol Protects the Lung against Long-Term Toxic Effects of Paraquat

Paraquat is a broad-spectrum herbicide known to produce lung injury via oxidative stress-mediated mechanisms. Different pharmacological strategies have been explored to reduce the formation of these reactive oxygen species and/or prevent their toxic effects in the treatment of paraquat poisoning. The present study was carried out to investigate whether the antioxidant (L-tocopherol, incorporated into liposomes and delivered directly to the lungs of rats, could protect the organ against the long-term toxic effects of paraquat.Plain liposomes (composed of dipalmitoylphosphatidylcholine, DPPC) or α-tocopherol liposomes (8 mg α-tocopherol/kg body weight) were administered intratracheally to animals 24 h prior to an intraperitoneal injection of paraquat dichloride (20 mg/kg) and rats wefe killed 0, 1, 4, 6, 8, 10, 12, 16, 19 or 24 days after paraquat treatment. Results of this study showed that lungs of animals treated with paraquat were extensively damaged,as evidenced by significant increases in lung weight and decreases in lung angiotensin converting enzyme (ACE) and alkaline phosphatase enzyme (AKP) activities. Moreover,paraquat treatme; resulted in a significant reduction in the number of neutrophils in the blood of rats with a concurrent increase in the pulmonary myeloperoxidase activity,suggestive of neutrophil infiltration in the lungs of treated animals. Pretreatment of rats with liposomes alone did not significantly alter the paraquat-induced changes of all parameters examined. On the other hand, pretreatment of rats with (t-tocopherol liposomes,24 h prior to paraquat challenge, attenuated paraquat-induced changes in ACE, AKP and myeloperoxidase activities but failed to prevent increases in lung weight. Thus, pretreatment of rats with liposome-associated α-tocopherol appears to protect the lung against some of the toxic effects of paraquat

The immune-modulating effects of viable Weissella cibaria JW15 on RAW 264.7 macrophage cells

The objective of this study is to investigate the immune-enhancing ability of viable and heat-killed Weissella cibaria JW15(JW15)isolated from Kimchi in RAW 264.7 macrophages.The immune effects were evaluated by measuring the production of NO,cytokines,inflammatory enzyme,and activation of NF-κB.Viable JW15 executed higher activity on stimulating the release of TNF-αas well as activating NF-κB compared to that of heatkilled JW15.Additionally,viable and heat-killed JW15 significantly increased the production of NO,IL-6 and TNF-αmore than that of Lactobacillus rhamnosus GG(LGG).Furthermore,viable JW15 induced higher production of i NOS compared with that of viable LGG.Collectively,our finding indicates that viable JW15 had similar,if not more,immune-enhancing activities as heat-killed JW15.In addition,viable JW15 had higher immune-enhancing activity than commercial strain LGG.Therefore,viable JW15 has the potential to be used as a functional food to improve the host immune response.

RADIOIMMUNOTOXICOLOGICAL EFFECT OF ENRICHED URANIUM ON CENTRAL AND PERIPHERAL IMMUNE CELLS AND THE PROTECTIVE ACTION OF IL－1 AND IL－2

Accumulation of enriched 235U-UO2F2 in the body had injurious effects on theimmune function of central and peripheral immune cells. After an intravenousinjection of beaU--UO,F,, the spontaneous ’H--TdR incorporation in thymocytes andbone marrow cells decreased, with the thymocytes damaged more markedly. Theproliferation ability of spleen T and B lymphocytes were both inhibited, with Blymphocytes inhibited more severely. In spleen B lymphocytes the IL-- 1 production andIL--2 consumption were diminished. The inhibition of spleen B lymphocyteproliferation by 'U-- UOZFZ was partially restored by adding exogenous IL-- 1 or IL--2to the cultured lymphocytes obtained from 'U injected mice.

Systemic adverse effects and toxicities associated with immunotherapy:A review

Immunotherapy is rapidly evolving secondary to the advent of newer immunotherapeutic agents and increasing approval of the current agents by the United States Food and Drug Administration to treat a wide spectrum of cancers.Immunotherapeutic agents have gained immense popularity due to their tumorspecific action.Immunotherapy is slowly transforming into a separate therapeutic entity,and the fifth pillar of management for cancers alongside surgery,radiotherapy,chemotherapy,and targeted therapy.However,like any therapeutic entity it has its own adverse effects.With the increasing use of immunotherapeutic agents,it is vital for physicians to acquaint themselves with these adverse effects.The aim of this review is to investigate the common systemic adverse effects and toxicities associated with the use of different classes of immunotherapeutic agents.We provide an overview of potential adverse effects and toxicities associated with different classes of immunotherapeutic agents organized by organ systems,as well as an extensive discussion of the current recommendations for treatment and clinical trial data.As we continue to see increasing usage of these agents in clinical practice,it is vital for physicians to familiarize themselves with these effects.