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There have been no definite conclusions about the biliopancreatic limb (BPL) and alimentary limb (AL) lengths in Roux-en-Y gastric bypass (RYGB) operations for different populations and BMIs. Western scholars have performed many studies on the lengths of the BPL and AL in patients with a BMI ≥ 35 kg/m2. However, for diabetic Chinese patients with BMI

Metabolic surgery is an effective treatment for type 2 diabetes mellitus (T2DM) in patients with obesity. However, the efficacy in patients with body mass index (BMI) < 32.5 kg/m2, especially in Asian populations, has not been widely reported, and there are few studies on the prediction of diabetes remission. We evaluated 112 patients with T2DM who underwent metabolic surgery between October 2008 and November 2019. The basic data of the patients were collected, and clinical variables were measured at 6 months, 1 year, and 2 years after metabolic surgery. Four independent predictors of surgical outcomes were identified to construct the prediction score. Diabetes remission occurred for 38 of the 112 patients. Ninety patients underwent Roux-en-Y gastric bypass, while the remaining 22 patients underwent sleeve gastrectomy. Weight, glucose, and lipid metabolism parameters were improved significantly after metabolic surgery. Age, BMI, insulin use, and duration were independent predictors of T2DM remission. The above four factors were defined with scores and developed ABID (age, BMI, insulin use, duration) scoring system. Patients with greater ABID scores had a greater probability of diabetes remission (from 0% at score 0 to 100% at score 4). The ABID score is a simple and easy-to-implement prediction score system of diabetes remission after metabolic surgery for T2DM patients with a BMI < 32.5 kg/m2.

To evaluate the long-term efficacy of large gastric pouch surgery and revisional surgery in patients with a body mass index (BMI)

Colorectal cancer (CRC) is one of the most common cancers worldwide and a leading cause of carcinogenic death. To date, surgical resection is regarded as the gold standard by the operator for clinical decisions. Because conventional tissue biopsy is invasive and only a small sample can sometimes be obtained, it is unable to represent the heterogeneity of tumor or dynamically monitor tumor progression. Therefore, there is an urgent need to find a new minimally invasive or noninvasive diagnostic strategy to detect CRC at an early stage and monitor CRC recurrence. Over the past years, a new diagnostic concept called “liquid biopsy” has gained much attention. Liquid biopsy is noninvasive, allowing repeated analysis and real-time monitoring of tumor recurrence, metastasis or therapeutic responses. With the advanced development of new molecular techniques in CRC, circulating tumor cells (CTCs), circulating tumor DNA (ctDNA), exosomes, and tumor-educated platelet (TEP) detection have achieved interesting and inspiring results as the most prominent liquid biopsy markers. In this review, we focused on some clinical applications of CTCs, ctDNA, exosomes and TEPs and discuss promising future applications to solve unmet clinical needs in CRC patients.

Background Conflicting results on the prognostic value of the visceral adiposity index (VAI) in patients with metabolic-associated fatty liver disease (MAFLD) have been reported. This study aimed to assess the diagnostic value of the VAI in MAFLD patients. Methods The Cochrane Library, PubMed, Embase, and other databases were searched to collect all documents that met the inclusion criteria from the establishment of the database to September 2021. The methodological quality of the included studies was assessed using the Newcastle–Ottawa Scale. The heterogeneity among the studies was analysed by the Cochran Q test and I2 test, and the appropriate model was selected according to the heterogeneity results. The diagnostic efficacy of the VAI was evaluated by sensitivity, specificity, and area under the curve, and a Fagan diagram was generated to evaluate the diagnostic ability of the VAI. Results A total of 9 studies were included. The overall quality of the included studies was good. Meta-analysis showed that the combined sensitivity of the VAI for the diagnosis of MAFLD was 0.70 [95% CI (0.69–0.71)], the combined specificity was 0.67 [95% CI (0.67–0.68)], the combined positive likelihood ratio was 2.08 [95% CI (1.87–2.31)], the combined negative likelihood ratio was 0.39 [95% CI (0.34–0.44)], and the combined diagnostic odds ratio was 5.81 [95% CI (4.73–7.14)]. The corresponding area under the curve was 0.79 [95% CI (0.75–0.82)]. Meta-regression analysis showed that the diagnostic method was a potential source of heterogeneity (P Conclusions The VAI is an independent predictor in the diagnosis of MAFLD and may be helpful in the detection of MAFLD. A VAI > 2.33 suggests that patients have a high probability of having MAFLD.

Type 2 diabetes mellitus (T2DM) with central obesity is a common clinical presentation in Chinese patients. Body mass index (BMI) is a criterion determining central obesity that, when combined with dual-energy X-ray absorptiometry (DXA), accurately reflects body composition and fat mass distribution. The utility of DXA-derived measures in the evaluation of metabolic surgery still needs to be investigated. In this cohort study, 78 Chinese patients with central obesity (WC ≥ 90 cm for males, WC ≥ 85 cm for females) or BMI above 27.5 kg/m2 underwent gastric bypass between October 2010 and October 2012. The patients were followed for 12 months. Preoperative, perioperative, and postoperative metabolic parameters and DXA results were prospectively collected and analyzed. A total of 57 of 78 cases (73.1%) were diagnosed with central obesity. There was a significant decrease in BMI, WC, and WHR at each point in time (P

The effect of bariatric surgery on the glycemic control of patients with obesity and type 2 diabetes mellitus is obvious. However, the effect in patients with body mass index (BMI)

Background A new device has been added to the Chinese MicroHand surgical robot family, developed based on the successful application of control algorithms. As a benefit of using these specialized control algorithms, the motion mapping relation can be accommodated into the system without the help of a built-in image system, resulting in a novel Chinese domestic surgical robot with two arms called MicroHand SII, which is different from the former MicroHand S and da Vinci systems. In this study, we investigate the performance of a novel MicroHand SII robotic platform in patients with obesity. Methods From March 2018 to April 2019, a total of 7 patients whose BMI ranged from 29.9 to 49.8 kg/m2 were operated on with the robot-assisted technique using the MicroHand SII surgical system. Data regarding demography, surgical procedure and the 3-month outcome postoperation were collected. Results There were 2 female and 5 male patients with a median age (range) of 35 (20–51) years. The median operative time was 160 (149–195) minutes. None were converted to open surgery. All anthropometry indices improved significantly (p Conclusions The initial experience showed that the Chinese domestic robot surgical system MicroHand SII could be feasibly and safely applied in sleeve gastrectomy in patients with obesity. Because of the unique design of this system such as a two-hand robot, an array of master–slave motion strategies, and a roll joint at the end of the instruments that allows 7 degrees of freedom, this robotic platform has presented its own obvious advantages.

Information is scarce on the five-year effect of laparoscopic Roux-en-Y Gastric Bypass (LRYGB) on body composition for Type 2 diabetes mellitus (T2DM) patients with a low BMI. This study aimed to evaluate the five-year changes in body composition in a Chinese T2DM cohort with a BMI < 32.5 kg/m2 after LRYGB. Twenty-seven T2DM patients were assessed preoperatively (baseline) and 3 months, 6 months, 1 year, 3 years, and 5 years after LRYGB with dual-energy X-ray absorptiometry (DXA). DXA assessments were completed in 100%, 85%, 85%, 85%, 48%, and 37% at baseline and 3 months, 6 months, 1 year, 3 years, and 5 years, respectively. For the whole body, fat-free mass and muscle mass decreased from 6 months to 5 years after LRYGB (P < 0.05), while bone mineral content decreased at 5 years after LRYGB (P < 0.05). Fat mass of different regions decreased from 3 months to 1 year (P < 0.05), and a similar magnitude of variation was observed in body fat mass percentage. A fat redistribution characterized by the regional fat proportion of trunk and android decreasing and the regional fat proportion of limbs gaining (P < 0.05) occurred at 5 years after LRYGB. For low BMI patients with T2DM, LRYGB led to a short-term reduction in FM and a lasting reduction in FFM. A metabolically healthy fat redistribution occurring 5 years after LRYGB might be a promising mechanism to explain the lasting benefits of LRYGB for T2DM patients with a low BMI.

In this paper we propose fast high-order numerical methods for solving a class of second-order semilinear parabolic equations in regular domains. The proposed methods are explicit in nature, and use exponential time differencing and Runge---Kutta approximations in combination with a linear splitting technique to achieve accurate and stable time integration. A two-step compact difference scheme is employed for spatial discretization to obtain fourth-order accuracy and make use of FFT-based fast calculations. Such methods can be applied to problems with stiff nonlinearities and boundary conditions of Dirichlet or periodic types. Linear stability analysis and various numerical experiments are also presented to demonstrate accuracy and stability of the proposed methods.

Roux-en-Y gastric bypass (RGB) has been endorsed by the “First World Congress on International Therapies for Type 2 diabetes” as a possible therapeutic option in patients with type 2 diabetes with a body mass index (BMI) of less than 35 kg/m2. In the present study, we assessed the improvement in clinical indicators associated with laparoscopic Roux-en-Y gastric bypass (LRYGB) in patients with non-obese type 2 diabetes mellitus (T2DM). LRYGB was performed in 30 T2DM patients with a BMI