In recent years, the importance of guanylate cyclase-C (GC-C) in digestive system diseases has received more and more attention. It plays a key role in regulating water and electrolyte balance, maintaining gastrointestinal function, relieving abdominal pain, controlling inflammation, regulating intestinal microecology, inhibiting tumor growth and regulating cell proliferation, and is considered as a potential therapeutic target for digestive tract diseases. This article reviews the role of GC-C in digestive system diseases and related intervention studies of agonists linaclotide and plecanatide in recent years, in order to better understand its intrinsic function and further guide the diagnosis and treatment of related clinical diseases.
Objective To explore the feasibility and operation points of establishing duodenal-jejunal bypass （DJB）surgery animal model in Goto-Kakizaki （GK） rats. Methods Sixteen GK rats were randomly divided into experimental group （n=8） and control group （n=8）. In a standardized preoperative， intraoperative， and postoperative operation， the rats of experimental group and control group received DJB and sham surgery respectively. The fasting plasma glucose and body mass were observed before operation， and 1， 2， 3， and 4 weeks after operation in order to evaluate whether the models were established successfully. Survival situation of rats were observed too. Results All experimental rats survived at 4 weeks after the operation. Compared with the levels before operation， the fasting plasma glucose levels of experimental group decreased significantly （P＜0.05） at 1 week after operation， and remained stable at 2， 3， and 4 weeks after operation.The fasting plasma glucose levels of control group did not change statistically at all time points after operation （P＞0.05）. Compared with control group at the same time point， the fasting plasma glucose level of experimental group was lower （P＜0.05）， indicating that DJB models were established successfully. After 4 weeks， the value of body mass added in experimental group was significantly lower than those of control group （P＜0.05）. Conclusions DJB is a feasible， safe， and effective hypoglycemic surgery. The application of this set of experimental operating procedures can reduce the risk of intraoperative and postoperative mortality， and can develop a stable DJB model in Goto-Kakizaki rats.
Objective To investigate the short-term effectiveness of proximal tibial lateral raft plate combined combined with or without Jail screw fixation in the treatment of tibial plateau collapse fractures involved posterior-lateral column. MethodsA retrospective analysis was performed on 106 patients (106 knees) with tibial plateau collapse fracture involved posterior-lateral column admitted between January 2016 and January 2021. According to the combination with Jail screw fixation or not, patients were divided into control group (treated by lateral raft plate without Jail screw fixation, 52 cases) and study group (treated by lateral raft plate with Jail screw fixation, 54 cases). There was no significant difference between the two groups in terms of gender, age, affected knee side, cause of injury, Schatzker classification, Tscherne-Gotzen classification, time from injury to operation, and preoperative lateral tibial plateau posterior slope angle (PSA), tibial plateau varus angle (TPVA), Rasmussen anatomical score (P>0.05). The operation time, cumulative fluoroscopy time, intraoperative blood loss, hospitalization stay, fracture healing time, complications, and lateral tibial plateau PSA, TPVA, Rasmussen anatomical score detected by X-ray films and CT before operation and at 1 year after operation of the two groups were recorded and compared. The number of cases of articular surface collapse in the two groups was recorded at 1 year after operation, and the effectiveness was evaluated by American Special Surgery Hospital (HSS) score. ResultsAll patients were followed up 12-32 months (mean, 19.5 months). There was no significant difference between the two groups in operation time, cumulative fluoroscopy time, intraoperative blood loss, hospitalization stay, and fracture healing time (P>0.05). There were 2 patients (3.7%) in the study group and 3 patients (5.8%) in the control group with superficial wound infection, which were cured after debridement and dressing change. There was no significant difference in the incidence between the two groups (χ2=0.252, P=0.616). There was no complication such as vascular and nerve injury, internal fixation failure, nonunion or malunion of fracture, and deep vein thrombosis of lower limbs in both groups. At 1 year after operation, 9 cases (17.3%) in the control group had joint collapse of 2-3 mm, while only 2 cases (3.7%) in the study group had joint collapse, showing significant difference (χ2=5.271, P=0.022). At 1 year after operation, the PSA, TPVA, and Rasmussen anatomical scores of the two groups were significantly improved when compared with preoperative ones (P<0.05); the differences of pre- and post-operative PSA, TPVA, Rasmussen anatomical score, and postoperative HSS score in the study group were significantly better than those in the control group (P<0.05). ConclusionThe lateral raft plate combined with or without Jail screw fixation can achieve satisfactory short-term effectiveness in the treatment of tibial plateau collapse fractures involved posterior-lateral column. Combined with Jail screw, it can enhance the fixation and avoid the occurrence of secondary articular surface collapse, which can be used as a better choice.