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Pyloric Sympathectomy: A Novel Way to Get Pylorus Relaxation? Report of Two Bariatric Cases

Surgical Science 2024年第6期15卷 381-395页

作者： Victor Ramos Mussa Dib Carlos Augusto Scussel Madalosso rui ribeiro Paulo Reis Esselin de Melo Fernando Fornari Victor Dib Institute Manaus Brazil Gastrobese Clinic Passo Fundo Brazil Lusadas Amadora Hospital Lisboa Portugal Paulo Reis Institute Goinia Brazil Alfredo Nasser University Center (UNIFAN) Goinia Brazil Faculdade de Medicina Universidade de Passo Fundo Passo Fundo Brazil Faculdade de Medicina Universidade Federal da Fronteira do Sul Chapec Brazil

Objective: This case report aimed to demonstrate a possible neuromuscular effect of pyloric sympathectomy on the pylorus motility, leading to its permanent relaxation, observed in two bariatric surgical cases, one primary and the other, revisional. Background: Pyloric sphincter is a physiological barrier to free gastric emptying. In sleeve gastrectomy and in Roux-en-Y gastric bypass revisions, that put the remnant stomach in transit, the pylorus can contribute to generate a high intragastric pressure, which could lead to acute gastric fistulas and/or chronic gastroesophageal reflux disease. The possibility of functionally relaxing the pylorus, promoting intragastric pressure reduction, could represent a protective maneuver against these complications. Methods: We describe herein a surgical maneuver applied in two cases of bariatric surgeries, with the intention of facilitating antrum-duodenal region exposure, in a sleeve gastrectomy and in a Roux-en-Y gastric bypass conversion to SADI-S. For this, a ligation of terminal peripyloric vessels was done, allowing a passage of a tape, which surrounded the pylorus, for its traction. In both cases, 30-day and 1-year endoscopic evaluations were done, to assess esophagitis signs, anastomosis healing and anatomical pouch aspect. A clinical evaluation was also done, to assess gastroesophageal symptoms (validated questionnaire). Results: In the postoperative endoscopic evaluations, no esophagitis were observed in any case and the gastric pouches had normal aspect, with the expected anatomical findings, compatible with the surgeries performed. The anastomosis healed without problems, in the revisional case. Interestingly, in both cases, it was observed a complete pyloric sphincter relaxation, which lasted until 1-year endoscopic evaluation. There were no fistulas, nor esophagitis in any of these cases. Clinically, there were no symptoms of gastroesophageal reflux disease (validated questionnaire). Conclusion: The observation of a

关键词： Roux-en-Y Gastric Bypass Sleeve Gastrectomy Sympathectomy Bariatric Surgery

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Functional Roux-en-Y Gastric Bypass (F-RYGB), with Preservation of Duodenal Access: Report of Two Revisional Cases of Sleeve Gastrectomy

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Surgical Science 2024年第3期15卷 135-158页

作者： Victor Ramos Mussa Dib Carlos Augusto Scussel Madalosso Paulo Reis Esselin de Melo rui ribeiro Paula Volpe Carlos Eduardo Domene Victor Dib Institute Manaus Brazil Gastrobese Clinic Passo Fundo Brazil Paulo Reis Institute of Bariatric Surgery Goi&#226nia Brazil Alfredo Nasser University Center (UNIFAN) Goi&#226nia Brazil Lusíadas Amadora Hospital Lisboa Portugal Integrated Center for Advanced Medicine (CIMAMED) S&#227o Paulo Brazil

Objective: This case report aimed to demonstrate a possible neuromuscular effect of Latarjet nerves transection or truncal vagotomy, in association with sleeve gastrectomy plus antrojejunostomy, in order to reproduce a Roux-en-Y gastric bypass (RYGB) mechanistic principles, in patients with previous Sleeve Gastrectomy (SG) who had had weight regain, with or without concomitant gastroesophageal reflux disease (GERD). Background: Sleeve gastrectomy (SG) is one of the most frequently performed bariatric operations worldwide. Nevertheless, weight regain and gastroesophageal reflux disease (GERD) have been consistently demonstrated, in association with this technique, which may require a revisional procedure. RYGB is an option in such a situation but, implies in gastrointestinal exclusions, which represents a shortcoming of this revision. Surpassing this inconvenient would be of great value for the patients. Methods: We describe herein two cases of SG revision for weight regain and GERD, with a follow-up of one year. Gastroesophageal reflux disease was evaluated by validated questionnaire, upper endoscopy, seriography, high resolution manometry (HRM) and impedance pHmetry (I-pHmetry), in the pre and postoperative periods. A re-Sleeve Gastrectomy with antrojejunal anastomosis was done in both cases, after informed consents. The Latarjet nerves were transected in one case, due to a bleeding in the left gastric vessels and a truncal vagotomy was required in the other, to appropriately treat an associated hiatal hernia. Results: In the postoperative evaluation it was observed a pyloric spasm in both cases, during seriography and endoscopy, kept until the one-year follow-up. There was unidirectional contrast flow to the gastrointestinal anastomosis, filling the jejunal limb, in radiologic contrast study. No contrast passed through the pylorus. Nonetheless, the duodenum was kept endoscopically accessible. In the one-year evaluation, weight loss was adequate and GERD resolution

关键词： Roux-en-Y Gastric Bypass Sleeve Gastrectomy Jejuno Gastric Bypass Vagus Nerve Vagotomy Bariatric Surgery

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Sleeve Gastrectomy with Duodenal Transit Bipartition (S-DTB): Preliminary Results and Technical Aspects of Its Metabolic Structure

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Surgical Science 2024年第4期15卷 244-264页

作者： Paulo Reis Esselin de Melo Ricardo Zorron Victor Ramos Mussa Dib Carlos Augusto Scussel Madalosso rui ribeiro Thonya Cruz Braga Paula Volpe Carlos Eduardo Domene Paulo Reis Institute Goiania GO Brazil Alfredo Nasser University Center (UNIFAN) Goiania GO Brazil Department of Bariatric and Metabolic Surgery CUF Descobertas Hospital Lisbon Portugal Victor Dib Institute Manaus AM Brazil Gastrobese Clinic Passo Fundo RS Brazil Lusiadas Amadora Hospital Lisbon Portugal Clianest Group Renaissance Hospital Goiania GO Brazil Integrated Center for Advanced Medicine (CIMAMED) Sao Paulo Brazil

Obesity is a significant and escalating health issue both in Brazil and globally, with over 650 million overweight adults worldwide. The treatment of obesity can be performed clinically, endoscopically or surgically;surgical treatment proves to be safe and more effective in terms of weight loss and long-term maintenance. Objective: This study aimed to monitor the progress of weight loss and comorbidity control in patients undergoing sleeve gastrectomy with duodenal bipartition. Methods: This pilot project involved 8 patients divided into 2 arms. In the first arm, patients underwent sleeve gastrectomy with Roux-en-Y duodenoileal transit bipartition (S-RYDITB), while in the second arm, patients underwent sleeve gastrectomy with Roux-en-Y duodenojejunal transit bipartition (S-RYDJTB). Both procedures involved Roux-en-Y reconstruction without duodenal exclusion. In S-RYDITB, the duodenal-ileal anastomosis was performed 300 cm from the ileocecal valve (ICV), creating a 250 cm common channel and a 50 cm alimentary channel. In S-RYDJTB, a biliopancreatic loop was created 200 cm from the angle of Treitz, with a 1 m alimentary channel. Results: Five patients underwent the procedures, with one undergoing S-RYDITB and four undergoing S-RYDJTB. No adverse events such as hospitalizations, readmissions, reoperations, fistulas, bleeding, pulmonary embolism, diarrhea, dumping syndrome, or hypoglycemia occurred during the study period. The mean length of hospital stay was 2 days. The average BMI decreased from 37.27 kg/m2 preoperatively to 29.48 kg/m2 after 6 months. The significant percentage of weight loss was 21.22%, with excess weight loss of 63.6%. Ninety-five percent remission of comorbidities, including hypercholesterolemia, hypertriglyceridemia, diabetes, hypertension, steatosis, and pre-diabetes. Two patients underwent sleeve gastrectomy with duodenal bipartition using a single anastomosis. Conclusion: Duodenal switch surgery has gained worldwide recog

关键词： Obesity Bariatric Surgery Metabolic Surgery Duodenal Switch

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Functional Roux-en-Y Gastric Bypass (F-RYGB), with Preservation of Duodenal Access: Report of Two Revisional Cases of Sleeve Gastrectomy

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Surgical Science（外科学） 2024年第3期 135页

作者： Victor Ramos Mussa Dib Carlos Augusto Scussel Madalosso Paulo Reis Esselin de Melo rui ribeiro Paula Volpe Carlos Eduardo Domene

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Strong and tough chitin hydrogel constructed by dehydration and rehydration strategy

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Nano Research 2024年第9期17卷 8192-8199页

作者： rui-rui Liu Li-Bo Mao Shu-Hong Yu Division of Nanomaterials and Chemistry Hefei National Research Center for Physical Sciences at the MicroscaleDepartment of ChemistryInstitute of Biomimetic Materials and ChemistryAnhui Engineering Laboratory of Biomimetic MaterialsUniversity of Science and Technology of ChinaHefei 230026China Institute of Innovative Materials Department of Materials Science and EngineeringDepartment of ChemistrySouthern University of Science and TechnologyShenzhen 518055China

As a renewable,biocompatible,biodegradable soft material,chitin hydrogels have better advantages in stability,antibacterial activity,antifouling,cost,immunogenicity,and so on than most polymer ***,compared with other widely used polymer hydrogels with high strength and toughness,the practical applications of chitin-based hydrogels have been limited by their weak mechanical properties,such as cartilage repair and meniscus ***,we present the design and fabrication of chitin hydrogels with excellent mechanical strength and toughness by a dehydration and rehydration *** sequential dehydration and rehydration processes,the crystalline domains in the chitin hydrogels can be properly *** optimized crystallinity,the elastic modulus of the chitin hydrogels exceeds all previously reported values,and the fracture toughness is even comparable to some synthetic polymer hydrogels,while maintaining a high-water-content of about 80 wt.%.At the same water content,the mechanical properties of the chitin hydrogels are positively correlated with the hydrogel crystallinity,which proves that the change of mechanical properties of hydrogels is not simply dependent on weight *** hydrogels can be further strengthened by incorporating other biopolymers that are intrinsically weak,which makes the hydrogels promising for applications in fields such as cartilage repair and meniscus ***,the hydrogels enable loading and release of water-soluble and poorly water-soluble *** highly extendable strengthening and toughening strategy of chitin and chitin-based biopolymer hydrogels paves the way for their widely applications.

关键词： chitin hydrogel crystallinity rehydration chemical transformation strong and tough

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Construction of multifunctional lanthanum manganese mixed nanoparticles mediated by ionic liquids for selective aerobic oxidation of cyclohexane

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Rare Metals 2024年第5期43卷 2205-2221页

作者： Hao Li rui-rui Zhang Ke-Xin Li Shuang Wei Yu-Mei Liu rui-Xia Liu Beijing Key Laboratory of Ionic Liquids Clean Process CAS Key Laboratory of Green Process and EngineeringState Key Laboratory of Multiphase Complex SystemsInstitute of Process EngineeringChinese Academy of SciencesBeijing 100190China University of Chinese Academy of Sciences Beijing 100049China

Selective oxidation of alkanes to produce highvalue chemicals is an essential strategy and means to realize efficient utilization of *** this work,a strategy of lanthanum manganese mixed metal oxides(LMMO)regulated via a facile ionic liquid(IL)-assisted hydrothermal method was proposed to construct the multifunctional catalysts,which exhibited excellent catalytic performance in the selective aerobic oxidation of *** 8.9%cyclohexane conversion with 90%KA oi(cyclohexanol and cyclohexanone)selectivity was achieved over the optimal LMMO catalyst under mild *** effects of anion type,carbon chain length and concentration of ILs on the structure and properties of catalysts were investigated through various characterizations,indicating the structure-directing and template effect of ILs on the multifunctional *** formation of self-assembled spherical nanoparticles followed the"dissolution-nucleation-proliferation"mechanism with the introduction of 1-butyl-3-methylimidazolium hydrogen sulfate,ascribing the synergistic effect between the microenvironment of ILs and the hydrothermal ***,the high reactive oxygen concentration redox capacity,and suitable basic sites of LMMO catalysts mediated by ILs enhance the activation of C-H bonds and molecular oxygen,simultaneously influencing the adsorption and desorption of the substrate.A comprehensive understanding of the high KA oil selectivity and radical reaction mechanism was elucidated based on in situ diffuse reflectance infrared Fourier transform spectroscopy(DRIFTS)and radical trapping *** recycling and regeneration experiments further illuminated that the removal of adsorbed cyclohexanone acting on the LMMO catalyst was the key to achieve high KA oil selectivity.

关键词： Ionic liquids Nanoparticle Multifunctional catalyst Cyclohexane oxidation

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Origin and tectonic setting of low-Si alkaline magma

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Science China Earth Sciences 2024年第5期67卷 1417-1435页

作者： Qiushi ZHOU rui WANG State Key Laboratory of Geological Processes and Mineral Resources and Institute of Earth SciencesChina University of GeosciencesBeijing 100083China Frontiers Science Center for Deep-time Digital Earth China University of Geosciences(Beijing)Beijing 100083China

Despite of the relatively rare occurrence of alkaline igneous rocks on Earth, they are the most diverse group of igneous rocks due to variations in their mineral assemblages and geochemical compositions. Alkaline igneous rocks are generally characterized by Si undersaturation, and K-Na(and in some cases C) enrichment. Although there is no unified alkaline igneous rock classification scheme, diagrams such as total alkalis-SiO_(2) or K_(2)O-SiO_(2) can be used to classify alkaline igneous rocks. The origins of silica-saturated alkaline rocks(SiO_(2)>52 wt.%) are relatively complex because multiple episodes of magmatism are often involved, therefore most studies have focused on the origins of silica-undersaturated alkaline *** experimental petrological studies have been conducted in the past few decades. Initially, it was considered that enrichment of trace elements was only achieved by low-degree partial melting of mantle peridotite, but the experimental melts could not reproduce the geochemical composition of natural alkaline igneous rocks. Subsequent studies have focused on carbonate-bearing eclogites that represent the average component of subducted oceanic crust. Although experimental studies indicate that silica-undersaturated and alkali-oversaturated melts can be generated from eclogites, some studies have considered that natural silica-undersaturated alkaline igneous rocks are the result of multi-stage source enrichment by incompatible elements. Low-degree partial melts of the mantle can be emplaced in the lithospheric mantle, forming veins consisting of phlogopite, amphibole, and pyroxene. Melting experiments including these components show that the produced melts better reproduce the naturally occurring silica-undersaturated alkaline magmas. Silica-deficient alkaline igneous rocks occur in various tectonic settings. Those in intraplate and divergent settings(i.e., mainly continental rifts) normally involve contributions from recycled components su

关键词： Alkaline igneous rock Tectonic setting Petrogenesis Big data

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Sleeve Gastrectomy with Duodenal Transit Bipartition (S-DTB): Preliminary Results and Technical Aspects of Its Metabolic Structure

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Surgical Science（外科学） 2024年第4期 244页

作者： Paulo Reis Esselin de Melo Ricardo Zorron Victor Ramos Mussa Dib Carlos Augusto Scussel Madalosso rui ribeiro Thonya Cruz Braga Paula Volpe Carlos Eduardo Domene

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Dynamic analysis of tethered defunct satellites with solar panels

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Astrodynamics 2024年第2期8卷 297-309页

作者： rui Qi Yang Zhang Heng Jiang rui Zhong School of Aerospace Engineering Beijing Institute of TechnologyBeijing 100081China School of Aerospace Astronautics Beihang UniversityBeijing 100191China

A precise dynamic model for towing and removing a defunct satellite with solar panels in orbit using a tethered net often has low computational efficiency owing to the complex contact and collision between the net and panels,which is not conducive to *** solve this problem,a“single main tether–multiple subtether”bifurcation structure with beads was employed as the tethered net *** study investigated the dynamics of tethered defunct satellites with solar panels,particularly the behavior of the attitude of the tethered satellite,oscillation of the main tether,and vibration of solar panels under different *** results showed that different attachment configurations of the subtethers and the flexibility of the main tether have an evident impact on the dynamic characteristics of the system.

关键词： space debris flexible solar panels tethered towing Kane’s method dynamics modeling

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On the half-quantized Hall conductance of massive surface electrons in magnetic topological insulator films

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Science China(Physics,Mechanics & Astronomy) 2024年第6期67卷 127-136页

作者： rui Chen Shun-Qing Shen Department of Physics The University of Hong KongHong Kong 999077China Department of Physics Hubei UniversityWuhan 430062China

In topological insulators,massive surface states resulting from local symmetry breaking were thought to exhibit a half-quantized Hall conductance,obtained from the low-energy effective model in an infinite Brillouin *** a lattice model,the surface band is composed of a combination of surface states and bulk *** massive surface states alone may not be enough to support an exact one-half quantized surface Hall conductance in a finite Brillouin zone and the whole surface band always gives an integer quantized Hall conductance as enforced by the TKNN *** explore this,we investigate the band structures of a lattice model describing the magnetic topological insulator film that supports the axion insulator,Chern insulator,and semi-magnetic topological insulator *** reveal that the gapped and gapless surface bands in the three phases are characterized by an integer-quantized Hall conductance and a half-quantized Hall conductance,*** propose an effective model to describe the three phases and show that the low-energy dispersion of the surface bands inherits from the surface Dirac *** gapped surface band manifests a nearly half-quantized Hall conductance at low energy near the center of Brillouin zone,but is compensated by another nearly half-quantized Hall conductance at high energy near the boundary of Brillouin zone because a single band can only have an integer-quantized Hall *** gapless band hosts a zero Hall conductance at low energy but is compensated by another half-quantized Hall conductance at high energy,and thus the half-quantized Hall conductance can only originate from the gapless ***,we calculate the layer-resolved Hall conductance of the *** conclusion suggests that the individual gapped surface band alone does not support the half-quantized surface Hall effect in a lattice model.

关键词： magnetic topological insulator Dirac equation half-quantized Hall conductance

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