ACUPUNCTURE TREATMENT OF FEMALE OBESITY COMPLICATED WITH PREMENSTRUAL TENSION SYNDROME

Objective： To explore mechanisms of acupuncture for the treatment of obesity complicated with prernenstrual tension syndrome （PTS）. Methods： By means of syndrome-differentiation, 45 female simple obese （SO） patients with PTS （SO＋ PTS group and 35 simple obesity patients （SO group） were treated with body acupuncture combined with ear acupuncture. Thirtythree normal women subjects were assigned to control group. Changes in symptoms, signs, obesity index, clinical indices of disease and syndrome, equilibrium index of the vegetative nervous system （Y value）, blood estradiol （E2）, progesterone （P）, aldosterone （Aid） and lipid levels were detected and compared before and after the treatment. Results： Before acupuncture treatmerit, the obesity index, clinical indices of disease and syndrome, Y value, E2/P ratio and Aid in these patients were obviously increased, and E2 and P levels decreased. After the treatment, the body weight of the patients was reduced, and the increased obesity index, clinical indices of diseases and syndromes, Y value, E2/P ratio and Aid were markedly lowered （P〈0.05, or P 〈 0.01）, and the decreased E2 and P levels elevated significantly （P〈 0.01）. Conclusion： Acupuncture exerts favorable regulative function on clinical indices of disease and syndrome, Y value, E2, P, Aid, lipid and E2/P in obese patients with PTS, which may be related to its resultant improvement of the functions of the hypothalamo-pituitary-gonedal axis, hypothalamo-pituitary-adrenal axis and the vegetative nervous system.

A case of asymptomatic fungal and bacterial colonization of an intragastric balloon

Intragastric balloon therapy, as a part of a multidisciplinary weight management program, is an effective short-term intervention for weight loss. Although the insertion procedure is easy and generally well tolerated by patients, a few complications can occur. We report here a heavy smoker with intragastric balloon inser-tion complicated by colonization with opportunistic organisms. The 27-year-old female, body mass index 35.5 kg/m2, had a BioEnterics Intragastric Balloon inserted under conscious sedation without any perioperative complications. Six months later, when the standard removal time arrived, the balloon was seen to be covered with a necrotic white-gray material. Microbiological examination revealed Enterobacter cloacae and Candida species yeast colonies. We recommend that asymptomatic fungal and/or bacterial colonization should be considered among the complications of the intragastric balloon procedure, despite its rarity.

Combined non-alcoholic fatty liver disease and type 2 diabetes in severely obese patients-medium term effects of sleeve gastrectomy versus Roux-en-Y-gastric bypass on disease markers

Background:We aimed to evaluate the medium-term efficacy of sleeve gastrectomy(SG)vs.Roux-en-Y gastric bypass(RYGB)on remission of non-alcoholic fatty liver disease(NAFLD)in patients with type 2 diabetes mellitus(T2DM).Methods:We identified severely obese patients[body mass index(BMI)>35 kg/m^(2)]with NAFLD(as defined by the Longitudinal Assessment of Bariatric Surgery Study)and T2DM(as defined by the American Association of Clinical Endocrinologists and the American College of Endocrinology)who underwent SG or RYGB in a single university surgical centre.The cohorts were match-paired and data were analysed after at least 3 years of follow up.The key outcomes measured were:(I)the improvement of liver function tests and NAFLD markers;(II)glycemic control and insulin resistance.Results:Ninety-six patients were investigated;44(45.8%)were women.The mean pre-operative BMI was 45.2 kg/m2 in the SG and 42.0 kg/m^(2) in the RYGB group.SG and RYGB both significantly reduced serum liver enzyme concentrations.NAFLD markers resolved 2 years after SG in all patients.In contrast,only 78%and 80%of patients achieved remission of NAFLD 2 and 3 years after RYBG respectively.Both procedures resulted in comparable rates of remission of T2DM.Conclusions:Bariatric surgery with SG may be preferable to RYGB for obese patients with NAFLD and T2DM based on the rates of remission of markers of these co-morbidities.However,our results need to be confirmed in prospective trials.Understanding the metabolic effects of specific bariatric surgical procedures may facilitate the development of a personalised approach to weight-loss surgery.