使用手术夹的小鼠的套管胃切除术
1Cardiovascular Division, Internal Medicine Department,Min-Sheng General Hospital, 2Department of Nutrition and Health Sciences, School of Healthcare Management,Kai-Nan University, 3Institute of Clinical Medicine,National Yang-Ming University, 4Food Science and Biotechnology, College of Biotechnology and Bioresources,University of Da-Yeh, 5Department of Surgery,Min-Sheng General Hospital, 6Department of Critical Care Medicine,Taipei Veterans General Hospital, 7Division of Cardiology, Department of Internal Medicine,Taipei Veterans General Hospital, 8Division of Cardiology, Heart Center,Cheng-Hsin General Hospital, 9Taipei Medical University
Summary
全世界糖尿病和肥胖症的患病率在不断增加。需要进一步研究糖尿病、肥胖症及其相关死亡率和共病之间的机制。在这里，我们提出了一个协议，袖口胃切除术（SG）在动物作为一个简单的临床前模型的减肥手术。
Abstract
在成人和青少年中，超重和肥胖者的数量在不断增加。这与2型糖尿病（T2D）和其他代谢问题的普遍性现象增加相吻合。减肥手术，如SG，是目前最有效和常用的长期治疗肥胖和T2D之一，但他们之间的关联尚未完全探讨。根据临床前动物研究，可以研究人类减肥手术后的结果所依据的机制。SG 可降低体重、葡萄糖水平和许多代谢参数，并且易于执行，并发症发生率较低。这项工作的目标是为研究人员提供一个简单的方法和简单的动物减肥手术临床前模型。
Introduction
自1975年以来，全世界肥胖率增加了近三倍。2016年，超过19亿18岁成年人超重，超过6.5亿成年人肥胖。T2D在成人人口的患病率也翻了一番，从4.7%上升到8.5%，从1980年至2014年全球1.08亿成年人上升到4.22亿。大多数减肥手术导致显著减肥，减少身体脂肪，并改善葡萄糖耐受性，胰岛素抵抗和糖尿病控制2。除了T2D的减肥和缓解外，减肥手术还产生了额外的健康优势，如高血压控制，以及某些类型肥胖相关癌症的发病率下降和进展3。减肥手术还诱导T2D的持久完整、部分缓解，降低十年性大冠心病（CHD）的风险和某种程度的脑血管风险。然而，基本机制并不完全了解4。
有几种手术的减肥/代谢手术。限制性手术和胃肠道旁路手术对新陈代谢5有积极的影响。在减肥手术模型中，SG和改良的Roux-en-Y胃旁路具有较高的成功率和较低的死亡率，并证明可靠的限制性和胃肠道旁路手术模型在小鼠6。虽然胃肠道旁路手术提供了更多的减肥和显著改善葡萄糖耐受性及肝硬化比限制性程序长期，SG仍然产生良好的控制体重和葡萄糖水平，并易于执行与并发症发生率低6。从2008年到2014年，SG的比例从30%增加到54%，Roux-en-Y胃旁路手术从52%降至32%。目前，腹腔镜SG是在美国学术中心内最常进行的减肥手术。虽然已经发表了许多关于减肥手术、糖尿病和肥胖症之间病理生理过程的报告，但我们需要更多的动物实验来进一步探索未知的机制。
该协议旨在产生一种动物方法，以研究人类减肥手术后的结果基础的机制。目前的转化研究可能提供从SG肥胖和T2D治疗的机制的见解。
Protocol
所有动物使用程序均经国家阳明大学机构动物护理和使用委员会批准，并符合《实验室动物护理和使用指南》。第8版 ，2011年”。麻醉程序是根据国家阳明大学实验动物的疼痛控制、麻醉、术前和术后护理指南进行的，ICAUC-016，2015年，第 1版。 1. 动物准备 从国家实验室动物中心（NLAC）获得20只8周大的野生C57BL/6雄性小鼠，体重约16-18克。随机分配这些小…
Representative Results
操作结果如图3 和图 4 所示。研究成活率为90%。一只老鼠因虚弱而死在假群中，另一只老鼠在手术后的第三天因不明原因在SG组死亡。HFD喂养小鼠手术后（图3A）的减肥结果与人类观察到的非常相似，最终体重减轻约15-20。13研究还表明，在HFD喂养小鼠的SG手术后，胆固醇水平（图3B）显著?…
Discussion
大多数前瞻性队列研究已经证实，增加身体质量指数与死亡率增加有关。肥胖与糖尿病、心血管疾病 （CVD） 和两性死亡的较高风险相关。特定的病理过程已经建立了糖尿病、肥胖症和死亡率14之间的联系。系统回顾表明减肥手术在减少心血管疾病危险因素方面的好处，有心室肥大回归和改善舒张功能的证据。减肥/代谢手术可以改善肥胖糖尿病患者的传统CVD危?…
Divulgaciones
The authors have nothing to disclose.
Acknowledgements
我们感谢伊莎贝尔·卢小姐的英语旁白。
Materials
| 0.9% normal saline | China Chemical & Pharmaceutical Co., Ltd. | ||
| 5-0 monofilament suture | Shineteh Inc. Taiwan | Ethicon | |
| Alm | Shineteh Inc. Taiwan | ST-A072PK | UNIK |
| Animal Anesthesia | Step Technology | 0712VAP11076 | Matrx |
| Barraqer-Troutman forceps | Shineteh Inc. Taiwan | ST-N309(H-4410) | UNIK |
| cefazolin | Taiwan veteran pharmacy company | ||
| Chow diet | Research Diets | ||
| Glucose strips and glucometer | BeneCheck | BKM13-1 | BeneCheck |
| HbA1c kit | Level | OKEH00661 | |
| Hematology system | Fuji | FUJI DRI-CHEM 4000i | Europe |
| High Fat diet | Research Diets | 1810724 | LabDiet |
| Iris Forceps | Shineteh Inc. Taiwan | ST-1210 | UNIK |
| Iris Scissors | Shineteh Inc. Taiwan | ST-S011 | UNIK |
| Isoflurane | Panion & BF biotech INC | 8547 | Panion & BF |
| Ketoprofen | Sigma | 22071154 | Sigma-Aldrich |
| Stereo microscope | MicroTech | SZ-5T | MicroTech |
| Surgical clip (M) | Echicon Inc., Somerville, NJ | Size M, 5mm | |
| Vidisic gel | Dr. Gerhard Mann Chem.-pharm. Fabrik GmbH |
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Citar este artículo
Wei, J., Yeh, C., Lee, W., Lin, S., Huang, P. Sleeve Gastrectomy in Mice using Surgical Clips. J. Vis. Exp. (165), e60719, doi:10.3791/60719 (2020).