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.

Rebound effect and its decomposition-an analysis based on energy types in China

Rebound effect derived from energy efficiency improvement has been widely invested.However,most of studies focus on the rebound effect of the energy composite level and neither distinguish nor compare different energy types.We compare the differences in energy saving and energy rebound between primary and secondary energy sources,and further decompose the rebound effect into production rebound part and final demand component.To do so,we add a module for rebound into a comparative state China-CGE model.We design and test two simulation scenarios using the model.In Scenario 1,all production sectors' energy efficiency of using primary energy increases by 5%.In Scenario 2,all production sectors' energy efficiency of using secondary energy increases by 5%.The results show that Scenario 2 leads to more GDP growth and more energy saving.Our scenarios show rebound effects range between 9.6% and 27.9%,and in general are higher when energy efficiency of using primary energy sources is improved.Our decomposition analysis shows that improving energy efficiency in production sectors would stimulates energy use of final demand.Indeed,the consumption side has significant contribution to rebound in secondary energy use,especially in crude oil and gas.This study reveals that improving efficiency of using secondary energy is better than improving that of primary energy,both in terms of economic impact and energy rebound.And complementary policies that prevent energy services prices from falling too much can be adopted to reduce rebound.Controlling residential energy use could also be effective in reducing rebound,this has particular implication to economies in which residential energy consumption are far from saturation.

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.

The rebound effect of dematerialization and decoupling:a case of energy efficiency

The two essential terms in environmental sciences-dematerialization and decoupling-have always been controversial. This study aims to trace the evolution path on the methodologies, the evidences and the policies, and to reflect on the implications of the development. We specifically present several classical definitions so as to summarize the similarities and differences thereinafter. Several commonly used methodologies, which are employed for evaluating the levels of dematerialization and decoupling, are discussed. As expected, the empirical evidences rarely support the absolute dematerialization and decoupling, which challenge the relevant policies implemented worldwide. In this context, the rebound effect, which is regarded as the main obstacle, is necessary to be examined in the various sectors and areas. However, the results of the rebound levels are far from unanimous. This article has a further discussion on the possible direction for the inconclusive debate in a broader perspective.

Energy Efficiency and Rebound Effect:Does Energy Efficiency Save Energy?

The aim of this study is to examine the theoric and empirical literature about “rebound effect”. This study summarizes energy efficiency policy and programs in general and in Turkey. Also it gives defination of the “rebound effect” concept. The rebound effect is related to consumer’s tendency to consume more energy due to economic benefit from efficiency improvement. The ‘rebound effect’ is the focus of a long-running dispute of energy economics but it is very new concept in the most developing countries. In literature according to some economist gains in energy efficiency will also reduce the real per unit price of energy services and hence the consumption of energy will rise and partially offset the initial reduction in the usage of energy sources. However for others size of the rebound effect is too small to take attention. The empirical literature shows that the size of rebound effect can change from country to country and sector to sector.

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

农业碳排放回弹及机制分析———基于农业技术进步的视角

新发展格局下,探究农业碳排放回弹效应及其影响机制对减排政策制定意义重大。利用1990—2020年中国29个省份的面板数据,采用非期望产出超效率SBM模型、GML指数分解、空间动态面板系统GMM模型,分析技术进步引致的碳排放回弹效应及其影响机制。研究发现:中国农业碳排放存在“部分回弹效应”,回弹效应均值约为0.88,表明技术进步带来的减排作用,会被回弹效应部分抵消。时间维度上,大部分年份表现出“回火效应”,表明在这些年份,技术进步反而致使农业碳排放总量增加;空间维度上,东北地区的碳排放回弹效应最大,且存在“回火效应”,西部地区回弹效应最小。机制分析发现,农业技术进步确实导致了农业碳排放回弹效应。农业技术进步通过提升农业碳排放效率直接引致回弹效应,通过促进农地经营规模扩大间接加剧回弹效应。

新能源回弹效应的理论逻辑、生成机理及规制取向

能源技术变革与能源效率的提升,既促进了新能源产品的推广与应用,也引致了新能源回弹效应。通过阐释新能源回弹效应的理论逻辑和生成机理,进而探讨该效应的规制取向。研究结果表明:在短期内,新能源及其产品的生产与消费可能呈现明显的回弹效应;在新能源政策的制定及其相关制度安排中,应审慎考虑新能源回弹效应的制约,建议完善新能源政策设计机制、优化新能源政策工具组合、扩大新能源消费节能减排效应。

数字经济、要素作用转变与城市碳排放——基于调节效应和门槛效应的检验

利用我国280个地级及以上城市的面板数据,基于要素作用转变视角系统探究数字经济对碳排放的影响及作用机制,通过构建调节效应模型,分别实证检验了数字经济对人口、经济和技术三种主要碳排放要素的调节作用,并进一步考察了SFA测算方法下技术进步在数字化驱动减排过程中的门槛异质效应。研究发现:数字经济与碳排放之间存在显著的倒U型关系;数字经济对碳减排的影响具有边际报酬递减的后发劣势,非特大城市以及三、四、五线城市将是未来数字化驱动减排的难点和痛点;城市数字经济的发展能明显改善传统经济要素、人口要素与碳排放之间的正相关关系,但却引发了技术要素的回弹效应;技术水平在数字经济减排效应中发挥着“双门槛”作用。因此,应加快能源结构转型,推进城市群和智慧城市建设,强化产业数字化转型和数字人才培育,积极推广碳交易制度,助力“双碳”目标实现。