RESUMEN
BACKGROUND: This study aimed to investigate the influence of new biliopancreatic diversion (NBPD) and duodenal-jejunal bypass (DJB) surgery on blood glucose, lipids, gastrointestinal hormones, and insulin in Goto-Kakizaki (GK) rats, an animal model for type 2 diabetes, in order to elucidate the mechanisms underlying the therapeutic effect of these types of surgery on this clinical condition. METHODS: Thirty 30 male GK rats (SPF) aged 12 weeks were randomly assigned into three groups (n = 10 per group): sham group, NBPD group, and DJB group. Body weight, random plasma glucose, fasting plasma glucose (FPG), oral glucose tolerance (OGT), blood lipids, plasma insulin, glucagon like peptide-1 (GLP-1), and gastric inhibitory polypeptide (GIP) were measured before and after surgery. RESULTS: NBPD surgery improved glucose tolerance, decreased fasting free fatty acids, triglycerides, and cholesterol. It also increased fasting and postprandial GIP, but caused no change in GLP-1. DJB surgery produced results similar to NBPD surgery except for causing a decrease in postprandial GLP-1 and insulin, and a larger increase in fasting GIP. CONCLUSIONS: Moving the biliopancreatic duct outlet to the mid-jejunum (NBPD surgery) improves glucose tolerance and increases GIP, but does not change GLP-1. Adding duodenal bypass (DJB surgery) increases fasting GIP and decreases postprandial GLP-1.
Asunto(s)
Desviación Biliopancreática/métodos , Glucemia/metabolismo , Diabetes Mellitus Experimental/cirugía , Diabetes Mellitus Tipo 2/cirugía , Lípidos/sangre , Animales , Glucemia/análisis , Diabetes Mellitus Experimental/sangre , Duodeno/cirugía , Derivación Gástrica/métodos , Polipéptido Inhibidor Gástrico/sangre , Péptido 1 Similar al Glucagón/sangre , Prueba de Tolerancia a la Glucosa , Insulina/sangre , Resistencia a la Insulina , Yeyuno/cirugía , Metabolismo de los Lípidos/fisiología , Masculino , RatasRESUMEN
BACKGROUND: The purpose of this study was to investigate the hypoglycemic effect of new biliopancreatic diversion and duodenal-jejunal bypass in Goto-Kakizaki rats and observe effects of the new surgical procedure on the glucose tolerance of GK rats. METHODS: Twenty-four 10-week-old rats (SPF grade) were randomly divided into groups A, B, and C, each with eight rats. Group A underwent duodenal-jejunal bypass, group B underwent modified biliopancreatic diversion, and group C underwent a sham operation. Median rat body weight, fasting blood glucose, OGTT, and blood lipids were measured in fasting 1 week before surgery and 1, 2, 4, and 8 weeks after surgery. Changes in gastric inhibitory polypeptide, glucagon P-like peptide-1, and insulin levels were measured by ELISA 1 week before surgery and 8 weeks after surgery. RESULTS: Rats' mean body weight in groups A and B decreased significantly from 368.025 ± 11.726 and 373.100 ± 9.859 g preoperatively to 345.750 ± 11.403 and 343.260 ± 12.399 g at the early postoperative stage (P < 0.05), and with statistically significant differences compared to the weight of rats in group C (P < 0.05). Comparisons between fasting blood glucose before surgery and 8 weeks after surgery revealed no significant differences between all three groups (P > 0.05). Glucose tolerance in groups A and B decreased from preoperative 21.175 ± 3.684 and 20.820 ± 1.671 mmol/L to postoperative 8.950 ± 0.580 and 10.500 ± 1.509 mmol/L, and both were better than that of group C (P < 0.001). CONCLUSIONS: Both new biliopancreatic diversion and duodenal-jejunal bypass improve glucose tolerance of Goto-Kakizaki rats.
Asunto(s)
Desviación Biliopancreática/métodos , Diabetes Mellitus Experimental/cirugía , Duodeno/cirugía , Prueba de Tolerancia a la Glucosa , Yeyuno/cirugía , Animales , Glucemia/metabolismo , Peso Corporal , Diabetes Mellitus Experimental/sangre , Polipéptido Inhibidor Gástrico/sangre , Péptido 1 Similar al Glucagón/sangre , Insulina/sangre , Lípidos/sangre , Masculino , Distribución Aleatoria , Ratas , Ratas EndogámicasRESUMEN
OBJECTIVE: To observe and summarize the clinical effect of nasal septum surgery combined with multi-sinus surgery and to discuss the safety and feasibility. METHOD: Fifty-six patients with nasal sinuses and nasal cavity diseases received nasal septal reconstruction, Caldwell-Lue procedure, polypectomy, ethmoidectomy and partial middle or inferior turbinate resection simultaneously under local anesthesia, and the complications after surgery were observed. RESULT: Operation in fifty-six patients were completed successfully. Thirty cases were cured, the cure rate of 56 case was 53.57Y, 23 cases were effective recovered (41.07%), 3 cases didn't recover (5.36%). The clinical cure rate was 94.64%. No severe complications occurred. CONCLUSION: The nasal septal surgery combined with multi-sinus surgery simultaneously under local anesthesia is effective and safety procedure. It can decrease the recurrence rate of nasal polyp and sinusitis and don't increase the rate of complication occurring.