Objective To investigate the effect of inducible nitric oxide synthase (iNOS) inhibitor aminoguanidine on pancreas islets cultured with cytokines TNF-α and IL-1β in rats. Methods Islets isolated from Wistar rats were purified and cultured. According to whether cytokines TNF-α, IL-1β and aminoguanidine were added into the medium respectively or not, islets were divided into 4 groups: cultured with islet only was taken as blank control group, cultured with TNF-α+IL-1β as cytokine group, cultured with aminoguanidine as aminoguanidine group, and cultured with TNF-α+IL-1β and aminoguanidine as aminoguanidine+cytokine group. NO level in culture medium and iNOS activity in islets tissue (Test Kit), apoptosis (TUNEL method) and viability of islets cell (acridine orange/ethidium bromide stain), and the function of islets (insulin release test) were measured. Results Compared with blank control group, the activity of iNOS in islet tissue and level of NO in culture medium increased, and the mass mortality and apoptosis appeared in islet cells, while insulin secretion decreased in cytokine group (P＜0.01). Compared with cytokine group, the activity of iNOS 〔（3.17±0.51） U/ml vs. （38.93±4.72） U/ml〕 and level of NO 〔（50.5±10.4） μmol/L vs. （313.0±35.4） μmol/L〕 decreased, the survival 〔（72.73±3.14）% vs. （57.07±5.07）%〕 increased and the apoptosis rate 〔（20.11±8.48）% vs. （41.17±6.87）%〕 decreased, the insulin secretion (secretion index: 3.50±0.27 vs. 1.96±0.19) improved； There were all significant differences in 2 groups (P＜0.01). Conclusion The iNOS inhibitor aminoguanidine could prevent the islet from the damage of iNOS/NO, alleviate the impairment of cytokines to islets, and ameliorate the survival and function of islets.
ObjectiveTo summarize the progress of research on the interaction between bariatric surgery and intestinal flora at home and abroad in recent years, in order to provide new ideas for promoting recovery after bariatric surgery. MethodThe domestic and international literature of intestinal flora changes after bariatric surgery was searched and reviewed. ResultsThe main changes of the intestinal flora after bariatric surgery showed that the abundance of thick-walled bacteria was decreased and the numbers of Bacteroides and Aspergillus were increased. Some common complications after bariatric surgery such as anastomotic fistula, nutritional deficiencies, and inflammation were related to the intestinal flora imbalance. Supplementation with probiotics, prebiotics, dietary interventions, or fecal microbial transplantation were expected to reduce the incidence of complications after bariatric surgery. ConclusionsBariatric surgery is a durable and effective method for treating obesity and its comorbidities. Changes in individual intestinal flora after bariatric surgery have an impact on both weight loss outcomes and postoperative complications, and it is important to find ways to reduce postoperative complications after bariatric surgery by improving intestinal flora.
ObjectiveTo explore the adjuvant treatment options for elderly patients or those with low cardiopulmonary function who cannot tolerate lobectomy for peripheral solid pathological stage ⅠA (pⅠA) non-small cell lung cancer (NSCLC). MethodsA retrospective analysis was conducted on the clinical data of patients with peripheral solid pⅠA stage NSCLC treated with lobectomy and compromised sublobar resection (CSR) in our center from 2018 to 2019. The incidence of postoperative complications and independent predictors of postoperative recurrence were analyzed. Patients in the CSR group were divided into targeted therapy, chemotherapy, and observation groups based on postoperative treatment measures. The 3-year recurrence-free survival (RFS) rate and 5-year overall survival (OS) rate of the three subgroups before and after propensity score matching (PSM) were compared. ResultsA total of 586 patients were included, including 288 males (49.15%) and 298 females (50.85%), with a median age of 64.00 years. There were 335 patients of lobectomy and 251 patients of compromised sublobar resection. There was no statistically significant difference in the incidence of postoperative complications between the lobectomy group and the CSR group (χ2=0.072, P=0.789). Multivariate analysis showed that gender, tumor location, and size were independent risk factors for recurrence after CSR. After PSM, 17 patients were enrolled in each of the three subgroups of CSR. Kaplan-Meier survival curve analysis showed that there was no statistically significant difference in the 3-year RFS rate (P=0.115) and 5-year OS rate (P=0.101) between the targeted therapy group and the chemotherapy group after PSM, but both were significantly better than the observation group (P=0.041, P=0.009). Compared with lobectomy, there was no statistically significant difference in the 3-year RFS rate (P=0.069) and 5-year OS rate (P=0.540) in the compromised sublobar resection targeted therapy group, while the chemotherapy group and observation group were significantly inferior to the lobectomy group (P<0.05). ConclusionCompromised sublobar resection for treating elderly patients or those with low cardiopulmonary function with peripheral solid pⅠA stage NSCLC does not increase the incidence of postoperative complications. Gender, tumor location, and size are independent risk factors for postoperative recurrence. In terms of 3-year RFS rate and 5-year OS rate, adjuvant targeted therapy after compromised sublobar resection is not only superior to chemotherapy or observation but is also not inferior to lobectomy.