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.

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.

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.

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.

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.

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

Long-Term Animal Feeding Trial of the Refined Konjac Meal Ⅱ. Effects of the Refined Konjac Meal on the Aging of the Brain, Liver, and Cardiovascular Tissue Cells in Rats

Rats of both sexes were fed on a basal feed containing 1% refined konjac meal (RKM) for 18 months and the effects of RKM on the cell aging were observed. A comparable group fed on the basic feed was used as the control. Results obtained demonstrate that the long-term feeding of RKM to rats can delay the course of cell aging of the gliocyte, cadiomyocyte, and the endothelial cell of the large and medium arteriases, hence it is likely to delay the occurrence of arteriosclerosis and improve the functions of the brain, heart and vascular system.

Long-Term Animal Feeding Trial of the Refined Konjac Meal Ⅰ. Effects of the Refined Konjac Meal on the Calcium and Phosphorus Metabolism and the Bone in Rat

Effects of refined konjac meal (RKM) on the calcium and phosphorus metabolism and bone parameters were observed in rats of both sexes fed with food containing 1% of RKM for 18 months. A comparable group of rats fed on basic diet only was used as a control.Results obtained indicate that all the measured parameters (serum calcium and phosphorus level, femur weight and its calcium and phesphorus content, and the osteometry of the tibia) showed no significant difference between the experimental and the control groups.Thus there is no adverse effect either on the calcium and phosphorus metabolism or on the bone after a long-term intake at a moderate dosage.

Effect of long-term low dose of aspirin on severity of disease following onset of acute cerebral infarction

BACKGROUND： Aspirin can decrease the incidence risk of high-risk crowdgroup of cerebral infarction, but there are still controversy if it might decrease the degree of disease in degree of patients with acute cerebral infarction. OBJECTIVE： To observe the effect of lower dose of aspirin during taking for a long time on disease degree of disease following onset of acute cerebral infarction. DESIGN： Grouping according to the admission time and 1：1 paired observation.SETTING ： Department of Neurology, Qilu Hospital of Shandong University.PARTICIPANTS ： The participants in present study were 321 patients with acute cerebral infarction who received treatments in the Department of Neurology, Qilu Hospital of Shandong University from January 1999 to June 2000. There were 190 male and 131 female ,with mean （65±11 ）years of age. Inclusive criteria： ① A focal neurological disturbance occurred suddenly and had lasted for more than 24 hours, patients were admitted within 3 days after onset of disease; ② A computed tomography of the brain was performed and excluded hemorrhage in all patients; ③ The patients were proved internal carotid occlusions by clinical features and image findings; ④ The functions of limbs were normal （before the first stroke） or almost normal （before the second stroke）. Exclusive criteria：①The patients who had have cardiogenic cerebral embolism; ②The patients who had taken warfarin orally and other platelet agglutination drugs. METHODS ：①All the patients were divided into 2 groups according to whether they had taken aspirin before： aspirin-treated group （n=110） and blank control group （n=211）. there were 70 male and 40 female in aspirin-treated group, with average（65±10） years of age.All patients had taken 50-100 mg/d aspirin for 6 months to 10 years before onset. There were 120 male and 91 female in blank control group, with average （65±13） years of age. Patients received a clinical scoring within 3 days and similar therapeutic measures （such as anti-platelet agglutination, improving cerebral circulation and metabolism-promoting reagent）. Two groups of patients had the same basic conditions except for taking aspirin or not before. ②The matched pairs were made between 50 cases selected from aspirin-treated group and 50 cases from non-aspirin-treated groups according to age, gender, and other stroke risk factors. ③ Evaluation： Degree of disease after onset was evaluated by means of Acute Cerebral Infarction Clinical Neurologic Impairment Degree Scoring Standard of Carotid Artery System. MAIN OUTCOME MEASURES： Acute Cerebral Infarction Clinical Neurologic Impairment Degree Scoring Standard of Carotid Artery System. RESULTS ： All 321 patients entered the stage of analysis with no loss in the midway. ① The symptom following onset of acute cerebral infarction was evaluated with clinical neurologic impairment scoring criteria, there were no significant differences between aspirin group and blank control group [（17.39±9.90） vs （16.22 ± 9.98） （t=1.025, P〉 0.05）]. ② No significant differences were found in 1：1 matched pairs of 100 cases from aspirin group and blank control group （t=1.74, P 〉 0.05）. CONCLUSION ： Taking a lower dose of aspirin during long time may not decrease the degree of disease following onset of acute cerebral infarction.

Long-term effects of biodegradable versus durable polymercoated sirolimus-eluting stents on arterial wall morphology as assessed by virtual histology intravascular ultrasound

Objectives To assess long-term coronary arterial response to biodegradable polymer-coated sirolimus-eluting stent(BSES) in vivo by using virtual histology intravascular ultrasound(VH-IVUS).Methods 41 patients were enrolled in this study and VH-IVUS was performed to assess the native artery vascular responses to BSES compared with durable polymer-coated SES(DSES) during long-term follow-up(median =8 months).The presence of necrotic core abutting to the lumen was evaluated at follow-up.Results With similar in-stent late luminal loss(0.15[0.06,0.30]vs 0.19[0.03, 0.30]mm,P=0.772),the overall incidence of necrotic core abutting to the lumen was significantly less in BSES than DSES group(44%vs.63%,P=0.019)(proximal 18%,stented site 14%and distal 12%in BSES group,proximal 19%, stented site 28%and distal 16%in DSES group).Compared with stented segments each other,the DSES -treated segments had a significant higher incidence of necrotic core abutting to the lumen through the stent struts(73%vs.36%, P=0.005).In addition,more multiple necrotic core abutting to the lumen was observed in DSES group(overall:63%vs. 36%,P=0.015).Furthermore,among the total number of stented segments with necrotic core abutting to the lumen, DSES -treated lesions had more multiple necrotic core abutting to the lumen through the stent struts than BSES -treated lesions in evidence(74%vs.33%,P=0.027).Conclusions By VH-IVUS analysis at follow-up,a greater frequency of stable lesion morphometry was shown in lesions treated with BSESs compared with lesions treated with DSESs.The major reason was BSES produced less toxicity to the arterial wall and facilitated neointimal healing as a result of polymer coating on drug-eluting stent(DES) surface biodegraded as time went by.

Long-term feeding of sand rice(Agriophyllum squarrosum seed)can improve the antioxidant capacity of mice

Unhealthy eating habits with sugar-rich and high-fat foods can bring nutritional imbalance and other chronic diseases. At present, there is an increasing demand in regulating human sub-health through functional foods. Agriophyllum squarrosum(L.) Moq., a pioneer plant native to sand dunes with ecological restoration function, is a traditional food plant of sand regions and Mongolian folk medicine. Numerous studies have confirmed that A. squarrosum seed, also called sand rice, has high nutritional value. However, the long-term health effects of eating sand rice remain unclear. To better explore and evaluate its long-term effects, hereby, ICR mice were fed with sand rice flour at different ratios(control, 60% and 95%) for 100 days. Results show that the growth and blood glucose level curve of these experimental mice were lower and more stable than that of the control. In addition, mice fed pure sand rice ingredient(95%) gained more stable body weight and blood glucose after 28 days, which revealed that sand rice is a food with comprehensive nutritional value and rarely negatively impacts the body growth performance. Our data also demonstrates that, the content of triglyceride(TG), total cholesterol(TC), low-density lipoprotein cholesterol(LDL-C) and high-density lipoprotein cholesterol(HDL-C) provided the lowest level in the blood of mice with a diet of pure sand rice ingredient, 0.48, 4.14, 0.91, 3.03 mmol/L, respectively. Also, T-SOD and GSH-PX activity provided a high level in mice with pure sand rice gradient, which significantly increased by 36%(T-SOD)and 19%(GSH-PX) compared to the control. These results suggest that long term intake of the pure sand rice ingredients is more helpful for stabilizing blood lipid and improve antioxidant capacity and beneficial to people suffering from chronic disease. This study supplies the first animal evidence to support the claim that sand rice is a promising functional food with comprehensive nutrition in the future. We are confident that, with increasing demands of daily sand rice usage, planting A. squarrosum in the vast desert regions will further increase the local economy and ecological restoration when coping with global warming.

Histologic analysis and long-term effect of acellular dermal matrix combined with autologous thin split-thickness skin graft

Objective To evaluate the long-term therapeutic effect and histologic result of ADM combined with autologous thin split-thickness skin graft.Methods 23 patients were treated with acellalar dermal matrix(ADM) combined with autoiogous

Calculation of effective temperature for pavement rutting using numerical simulation methods

In order to predict the long-term rutting of asphalt pavement, the effective temperature for pavement rutting is calculated using the numerical simulation method. The transient temperature field of asphalt pavement was simulated based on actual meteorological data of Nanjing. 24-hour rutting development under a transient temperature field was calculated in each month. The rutting depth accumulated under the static temperature field was also estimated and the relationship between constant temperature parameters was analyzed. Then the effective temperature for pavement rutting was determined based on the rutting equivalence principle. The results show that the monthly effective temperature is above 40 t in July and August, while in June and September it ranges from 30 to 40 Rutting development can be ignored when the monthly effective temperature is less than 30 t. The yearly effective temperature for rutting in Nanjing is around 38. 5 t. The long-term rutting prediction model based on the effective temperature can reflect the influences of meteorological factors and traffic time distribution.

Long-term outcome of chronic hepatitis C patients with sustained virological response to peginterferon plus ribavirin

AIM: To assess the clinical, biochemical and virological long-term outcome in chronic hepatitis C (CHC) patients with a sustained virological response (SVR) after peginterferon (PEG-IFN) plus ribavirin combination therapy. METHODS: One hundred and fifty three patients with a SVR after treatment with PEG-IFN plus ribavirin were included in a 5-year follow-up study in a single Spanish center, based on standard clinical practice. Clinical anamnesis, biochemical analysis, hepatitis C virus RNA and alpha-fetoprotein measurement, ultrasonography and transient elastography were performed annually. RESULTS: The mean follow-up period of the 153 patients was 76 ± 13 mo after they obtained a SVR. Five patients (3.26%) presented with cirrhosis before treatment and 116 (75.8%) had genotype 1. No patient showed evidence of hepatic decompensation. One patient (0.65%) developed a hepatocellular carcinoma at month 30 after achieving SVR. There were no virological relapses during this follow-up period. Persistently elevated alanine aminotransferase was found in only one patient (0.65%). At the end of the 5-year follow-up, the mean value of transient elastography was 7 ± 4.3 kPa (F1). There were no deaths and no other tumors. CONCLUSION: The long-term outcome of 153 CHC patients with SVR to PEG-IFN plus ribavirin was good. No evidence of a virological relapse was seen. One patient (0.65%) developed a hepatocellular carcinoma.

Long-term acupuncture treatment has a multitargeting regulation on multiple brain regions in rats with Alzheimer＇s disease：a positron emission tomography study

The acute effect of acupuncture on Alzheimer＇s disease,i.e.,on brain activation during treatment,has been reported.However,the effect of long-term acupuncture on brain activation in Alzheimer＇s disease is unclear.Therefore,in this study,we performed long-term needling at Zusanli（ST36）or a sham point（1.5 mm lateral to ST36）in a rat Alzheimer＇s disease model,for 30 minutes,once per day,for 30 days.The rats underwent 18F-fluorodeoxyglucose positron emission tomography scanning.Positron emission tomography images were processed with SPM2.The brain areas activated after needling at ST36 included the left hippocampus,the left orbital cortex,the left infralimbic cortex,the left olfactory cortex,the left cerebellum and the left pons.In the sham-point group,the activated regions were similar to those in the ST36 group.However,the ST36 group showed greater activation in the cerebellum and pons than the sham-point group.These findings suggest that long-term acupuncture treatment has targeted regulatory effects on multiple brain regions in rats with Alzheimer＇s disease.

Assessment of Long-Term Compost Application on Physical, Chemical, and Biological Properties, as Well as Fertility, of Soil in a Field Subjected to Double Cropping

The aim of this article was to assess the influence of long-term application of compost on the physical, chemical, and biological properties, as well as the fertility, of soil in a field subjected to double cropping (paddy rice and barley), mainly by integrating previous studies of the effects of compost and manure on soil qualities. Continuous compost application, especially at a high level (30 Mg·ha-1·y-1), into the double cropping soils increased the activities of organic C-, N-, and P-decomposing enzymes and the contents of organic C, total N, and microbial biomass N, as well as the cation exchange capacity, thereby contributing to the enhancement of soil fertility. Also, the compost application increased the degree of water-stable soil macroaggregation (>0.25 mm), which was correlated significantly (r > 0.950, p < 0.05) with the contents of hydrolyzable carbohydrates (with negative charge) and active Al (with positive charge), and resulted in the modification of soil physical properties. Furthermore, the application increased the amount of soil organic matter, including humic acid with a low degree of darkening and fulvic acid, and contributed to C sequestration and storage. Physical fractionation of soil indicated that about 60% of soil organic C was distributed in the silt-sized (2 - 20 μm) aggregate and clay-sized (<2 μm) aggregate fractions, while about 30% existed in the decayed plant fractions (53 - 2000 μm). The results obtained unambiguously indicate that long-term application of compost can improve soil qualities in the field subjected to double cropping, depending on the amount applied.

Long-term efficacy of capecitabine plus oxaliplatin chemotherapy on stage Ⅲ colon cancer: A meta-analysis

BACKGROUND Many clinical studies for the long-term survival or efficacy of capecitabine plus oxaliplatin(XELOX)in colon cancer have already been studied,but its clinical benefit is controversial.AIM To evaluate the long-term efficacy of XELOX regimen in comparison with other adjuvant chemotherapy protocols in colon cancer.METHODS By searching the PubMed,EMBASE and Cochrane databases,a total of 12 randomized controlled trials involving 6698 stageⅢcolon cancer cases(XELOX protocol:n=3298 cases;other adjuvant chemotherapy protocol:n=3268 cases)were included.The parameter outcomes included the overall survival and the disease-free survival.The quality control of selected literature was based on the Jadad scale and the GRADE system.RESULTS In comparison to other adjuvant chemotherapy regimen,XELOX regimen showed a better overall survival(odds ratio=1.29,95% confidence interval:1.15-1.44,P<0.0001)and a better disease-free survival(odds ratio=1.32,95%confidence interval:1.18-1.46,P<0.0001)for colon cancer patients,suggesting the XELOX regimen can be a good option for postoperative treatment of stage III colon cancer.CONCLUSION The XELOX regimen can be a preferred option for adjuvant treatment of stageⅢcolon cancer after surgery.

Kaposi’s Sarcoma Associated with Gastrointestinal Bleeding: A Rare Complication of Long-Term Corticosteroid Therapy

Corticosteroid therapy has revolutionized the treatment of many diseases in medicine. The most concerned diseases are chronic inflammatory diseases. Its use may be either short-term or long-term, thus generating several side effects, some of which are conventional and known, but others are rare, such as Kaposi’s sarcoma. We report here a particular clinical observation. Observation: This is a patient of 37 years, who consults in Internal Medicine for the treatment of mucocutaneous lesions, papular nodular, hyper pigmented, budding and disseminated appeared after six months of corticosteroid therapy. This treatment was introduced for the treatment of acoustic neurinoma. The patient is not diabetic or alcoholic and has a negative HIV status. The diagnosis of Kaposi’s sarcoma was made by histology of biopsied skin lesions which concluded for a regular proliferation without atypia spindle cell or mitosis. The lesions persisted over a month despite discontinuation of corticosteroid therapy. Treatment with Bleomycin was necessary. The outcome was favorable under treatment with progressive and complete disappearance of lesions after 15 treatments. Conclusion: The classical side effects of long-term corticosteroid are known, but Kaposi sarcoma complicating long-term corticosteroid is rare in the literature. It is vital that any long-term corticosteroid should be the subject of careful and regular monitoring.