To explore the changes of pulmonary function in obese patients 6 months after treatment with laparoscopic sleeve gastrectomy (LSG), and to evaluate its correlation with adipokines and inflammatory factors.

A retrospective analysis was made on 116 obese patients who underwent LSG surgery in the second affiliated Hospital of Anhui Medical University from January 2019 to May 2020. The changes of body weight, BMI, pulmonary function, adipose factors and inflammatory mediators were compared before and 6 months after operation, and the correlation between the changes of pulmonary function and inflammatory mediators and adipose factors was further analyzed. A total of 116 obese patients undergoing LSG were included in this study, including 53 males and 63 females, with an average age of (32.52±6.08) years and BMI of (43.35±7.20) kg/m².

Weight, BMI, neck circumference, waist circumference, and abdominal circumference were significantly lower at 6 months after surgery (P<0.05), and pulmonary function indexes such as FVC, FEV1, FEV1/FVC (%), and MMEF75/25 were significantly lower after surgery (P<0.05). The levels of leptin, TNF-a, IL-6, and CRP were significantly reduced at 6 months after surgery (P<0.05); IL -10 and adiponectin were significantly increased at 6 months after surgery (P<0.05). Before surgery, TNF-a, IL-6, CRP and Leptin were negatively correlated with FEV1, adiponectin was positively correlated with FVC, while TNF-a and leptin was negatively correlated with FVC; and at 6 months after surgery, IL-6 is negatively correlated with FEV1; adiponectin is significantly positively correlated with FVC; and TNF-a is negatively correlated with FVC.

LSG can significantly improve the lung function of obese patients. The improvement of lung function may be related to the changes of postoperative adipose factors and inflammatory mediators.

To investigate the short-term effect of laparoscopic sleeve gastrectomy (LSG) on serum asprosin level in obesity, and to analyze the correlation with clinical outcomes.

20 adults with obesity (BMI>35 kg/m²) receiving LSG at Department of Bariatric and Metabolic Surgery, The First Affiliated Hospital with Nanjing Medical University were included to this study between Nov 2017 and Oct 2018. Clinical measurements and laboratory determinations were performed before surgery and 3 months after surgery. The body composition indexes were measured by inbody770 and the biochemical indexes were measured by automatic biochemical analyzer. Homeostasis model assessment of insulin resistance index (HOMA-IR) was calculated. Fasting serum asprosin was analyzed by ELISA.

3 months after LSG, mean total body weight decreased from (105.37±17.79) kg at baseline to (90.13±16.13) kg (P<0.001). The subjects showed a marked weight loss accompanied by significantly lower BMI values (pre, 37.85±4.64 kg/m², vs. post, 32.31±4.10 kg/m², P<0.001) after LSG. Meanwhile, insulin resistance improved remarkably after LSG as displayed by reductions in HOMA-IR levels (pre, 8.44±5.24 vs. post, 3.17±1.44, P<0.001). Serum fasting asprosin levels markedly reduced from 347.33 (267.25, 451.18) pg/mL to 254.95 (233.94, 311.88) pg/ml at 3 month after LSG (P<0.01). Multivariate analyses showed that the fasting serum asprosin was positively correlated with HOMA-IR (r=0.564, P=0.01) before LSG. Moreover, when assessing 3-months postoperative changes, a positive correlation was found between the variation of asprosin and the reduction of HOMA-IR (r=0.517, P=0.019). However, there was no association between asprosin and the changes of body weight, BMI, fasting glucose and blood lipids in our study.

Fasting serum asprosin in obesity was closely related to insulin resistance before surgery and reduced significantly in the short term after LSG. Moreover, the early change of asprosin was strongly associated with the improvement of insulin resistance. Asprosin may play an important role in insulin resistance, obesity and diabetes.

To compare the clinical effect of laparoscopic sleeve gastrectomy (LSG) and laparoscopic Roux-en-Y gastric bypass (LRYGB) in treating obese type 2 diabetes mellitus.

Clinical data of 52 patients with obese type 2 diabetes mellitus undergoing metabolic surgery in China-Japan Friendship Hospital affiliated to Jilin Univerity between July 2014 and February 2016 were retrospectively studied. The informed consents of all patients were obtained and the local ethical committee approval had been received. The patients were divided into the LSG group and LRYGB group according to different surgical approaches. Among the 29 patients of LSG group, 8 were males and 21 were females with an average age of (38±14) years old. Among the 23 patients of LRYGB groups, 11 were males and 12 were females with an average age of (44±12) years old. Levels of weight, body mass index (BMI), fasting plasma glucose (FPG), glycosylated hemoglobin A1c (HbA1c), 2-hour postprandial blood glucose (2hPG), triglyceride and total cholesterol before and 3, 6 months after surgery were compared between the two groups. Clinical data of the two groups were compared using t test and χ² test.

At 6 months after surgery, FPG, 2hPG, HbA1c, BMI, triglyceride and total cholesterol level of the LSG group patients were (5.5±0.8) mmol/L, (7.9±0.6) mmol/L, (6.1±0.8)%, (30±7) kg/m²、(1.0±0.5) mmol/L and (4.0±0.7) mmol/L respectively, which had no statistical difference with (5.9±1.1) mmol/L, (7.8±0.7) mmol/L, (5.7±0.7)%, (31±12) kg/m², (1.1±0.6) mmol/L and (3.8±0.6) mmol/L of the LRYGB group (t=1.13, 1.15, 1.75, 0.28, 0.53, 1.81, P>0.05).

LSG and LRYGB can both reduce weight and improve diabetes effectively in a short time, but the difference between their curative effect remains to be defined by extending follow-up time and increasing sample sizes.

To investigate the application value of comprehensive therapy in treating postmenopausal osteoporosis.

A total of 500 patients with postmenopausal osteoporosis in the Second People’s Hospital of Jiedong District, Jieyang between December 2013 and December 2014 were included in this prospective study. These patients were divided into the comprehensive therapy group (study group) and the basic therapy group (control group) according to the random number table method. Two hundred and fifty patients were included into the study group with an average age of (65±11) years old, while other 250 patients were included into the control group with an average age of (66±13) years old. The informed consents of all patients were obtained and the local ethical committee approval had been received. Patients in the study group were given comprehensive therapy including regulation of calcium metabolism, hormone replacement therapy, promotion of calcium absorption and pain relief treatment. Patients in the control group were only given basic therapy including promotion of calcium absorption and pain relief treatment. C-terminal cross-linking telopeptide of typeⅠcollagen (β-CTX), bone mineral density and the SRS-22 questionnaire score were compared between the two groups after 6 months of treatment. These data of two groups were compared using t test.

After six months of treatment, the average bone mineral density level of the femoral neck and Wards triangle in the study group was (771±97) mg/cm³ and (549±91) mg/cm³ respectively; which was significantly higher than (741±91) mg/cm³ and (537±87) mg/cm³ of the control group respectively (t=8.963, 9.689, P<0.05). The average SRS-22 questionnaire score of the study group was 81±15, which was significantly higher than 70±13 of the control group (t=9.131, P<0.05); β-CTX of the study group was (0.49±0.08) μg/L, which was significantly higher than (0.47±0.08) μg/L of the control group (t=2.795, P<0.05).

Comprehensive therapy has a better clinical curative effect on patients with postmenopausal osteoporosis than basic therapy, allowing to significantly release pain and greatly improve bone mineral density level and quality of life.