The Effect Of Omental Fat Removal On Human Blood Pressure And The Effect Of Different Energy Ultrasound Intervention On Human Omental Adipose-derived Mesenchymal Stem Cells

Part ? The clinical study on the effect of surgical resection of the omental adipose tissue on human blood pressure ObjectiveSeveral studies have demonstrated that increased omental adipose is a risk factor for obesity and metabolic syndrome.It remains unclear whether it is responsible for hypertension as an independent risk.This study was designed to assess the impact of omental adipose removal by surgery on blood pressure in cancer patients with or without hypertension.MethodIn this monocenter,prospective cohort study,133 patients with gynecological cancer were divided into 3 groups: non-hypertensive and omentum removed(NH&OR),hypertensive and omentum removed(H&OR),and hypertensive and omentum present(H&OP).The patients were followed up in sitting office blood pressure,changes in related body mass index and metabolic indices.The time points of the 2 follow-up visits were 1 month ± 7 days after the operation before the start of chemotherapy and the endpoint of 8 ± 1 month.Omental adipose tissue from both non-hypertensive and hypertensive patients in surgery were collected.This followed an extensive study in which mRNA microarray was tested using omental adipose tissue.ResultsWe included 133 patients(84.2% female,20.3% Malignant gastric cancer and 79.7% Malignant gynecological cancer,78.2% omentum removal,48.9% hypertensive),and all completed follow-up.H&OR group showed significant reductions in SSBP and SDBP compare with baseline at 1-m(-16.94/-10.50 mmHg,both P < 0.001)and 8-m end point(-16.00/-5.50 mmHg,P < 0.001 and P = 0.004).Little reductions were observed with BMI of patients in 3 groups till the endpoint of study(H&OR group: 24.60 kg/m2 to 23.57 kg/m2,NH&OR group: 23.45 kg/m2 to 23.25 kg/m2,H&OP group: 25.74 kg/m2 to 25.24 kg/m2,all P > 0.05).No correlation was found between baseline BMI and 8-m change of SSBP and SDBP in omentum removed groups.In both groups,triglyceride levels were significantly increased at 4 ± 1 week after surgery(NH&OR 0.32 mmol/L,P = 0.006;H&OR 0.40 mmol/L,P = 0.010).mRNA microarray was tested and POU2AF1 and DERL3 were found expressed highly in hypertensive patients.There was no difference in the expression of catecholamine products in omental adipose between hypertensive and non-hypertensive patients.ConclusionResection of omental adipose tissue represents an effective strategy for reducing SSBP and SDBP at 8 months in hypertensive patients but not in non-hypertensive patients.The hypotensive effect of omental adipose resection had no significant association with the baseline BMI of the patients.Resection of omental adipose tissue also had hypotensive effect in the non-obese hypertensive population.This means omental adipose may be the target of hypertension and our study provided new thought and therapeutic approach for the therapy of hypertension.Part ? Different doses of Low-intensity pulsed ultrasound appears opposite effects on human omental adipose derived mesenchymal stem cellsObjectiveLow-intensity pulsed ultrasound(LIPUS)has been applied to medical therapy since 1950 s.It has been reported to accelerate the healing of bone fractures,but the efficacy and mechanism of LIPUS dealing with obesity especially visceral fat accumulation is elusive.MethodIn this study,we investigated different doses of LIPUS upon Human omental adipose derived mesenchymal stem cells(h AMSCs).LIPUS stimulation was applied for 1 min at a frequency of 0.5 MHz and a voltage of 44 V in a pulsed wave fashion with a 10 ms pulse burst at 1000-3000 cycles repetition frequency.Cell viability was examined by the CCK-8 assay and apoptosis was examined by flow cytometry.ResultsWe found that high dose of LIPUS promoted apoptosis of hAMSCs while low dose of LIPUS enhanced cell viability of h AMSCs.Furthermore,western blotting revealed that upon 3000 cycles phosphorylation of P38 significantly increased while upon 1000 cycles phosphorylation of P38 drastically decreased.Meanwhile restricting the p-p38 levels by SB203580 rescued the apoptosis promoting effect.ConclusionHigh dose of LIPUS promotes apoptosis while low dose of LIPUS enhances cell viability of h AMSCs,and phosphorylation of P38 is the potential key pathway of different effects of LIPUS.We will next confirm if LIPUS reduce visceral adipose in vivo and figure out the side effects and adverse reactions.LIPUS,as a safe and noninvasive therapy,would be a promising procedure to treat obesity and attenuate medical comorbidities.