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Objectives To investigate the effect of nutritional therapy on body composition and resting energy expenditure(REE) post bariatric surgery in patients with obesity. Methods Six-step post-operative nutrition therapy during 3 months was performed for 47 patients undergoing bariatric surgery with laparoscopic sleeve gastrectomy. Body composition, REE and nutritonal biochemical indexes were determined in pre-surgery and post-surgery 1, 3 months. Predictive REE was calculated with Bernestin Formula. Repeated ANOVA analysis was done for the changes in the indicators of patients. Results Muscle mass reduced 8.33%±3.49% in post-surgery 1 month, and 2.86%±3.96% in post-surgery 3 months. Fat mass reduced 14.73%±5.44% in post-surgery 1 month and 16.61%±8.26% in post-surgery 3 months. There was no significant difference between REE and predicted REE with (9 339.16±2 620.59) kJ vs. (9 058.06±2 098.61) kJ in pre-surgery, P=0.593; and (7 228.20±2 066.61) kJ vs. (7 973.15±1 747.49) kJ in post-surgery 3 months, P=0.098. However, predicted REE (8 286.81±1 764.25) kJ was significant higher than REE (7 418.33±1 764.25) kJ in post-surgery 1 month, P=0.032. There was no significant difference in levels of vitamin-A, vitamin-B1, vitamin-B2, vitamin-B6, vitamin-C and serum ferritin between pre-surgery and post-surgery 1 month and post-surgery 3 months(P>0.05). A significant reduction of C-reactive protein was present with (9.03±9.42) mg/L in pre-surgery, (6.61±7.89) mg/L in post-surgery 1 month and (4.69±4.66) mg/L in post-surgery 3 months, P=0.020. Conclusions Nutritional therapy after bariatric surgery 3 months could delay the loss of skeletal muscle mass and adapt REE and reduce the inflammation level in patients with obesity.

Objective: To analyze the short-term efficacy of distal pancreatectomy with en bloc celiac axis resection (DP-CAR) in the treatment of locally advanced pancreatic body or tail cancer and the effect of vascular variation on morbidity after DP-CAR. Methods: A retrospective study was undertaken of 43 cases with pancreatic ductal adenocarcinoma diagnosed by pathological examination in the treatment of DP-CAR. R0 resection, morbidity and mortality were analyzed perioperatively with the effect of vascular variation. Results: R0 resection by DP-CAR was 81.4% in this study with mortality 7.0% and morbidity 45.6%. Eight cases were found with vascular variation. The postoperative morbidity in the group with vascular variation and in the group without vascular variation was 3/8 (37.5%) vs 17/35 (48.5%) and the mortality 1/8 (12.5%) vs 2/35 (5.7%), respectively. There was no significant difference statistically in morbidity and mortality between 2 groups. Conclusions: DP-CAR has the advantage of safety and feasibility. There would be no effect of vascular variation on morbidity after DP-CAR.