简介：Medicaltherapyfortype2diabetesmellitusisineffectiveinthelongtermduetotheprogressivenatureofthedisease,whichrequiresincreasingmedicationdosesandpolypharmacy.Conversely,bariatricsurgeryhasemergedasacost-effectivestrategyforobesediabeticindividuals;ithaslowcomplicationratesandresultsindurableweightloss,glycemiccontrolandimprovementsinthequalityoflife,obesity-relatedco-morbidityandoverallsurvival.Thefindingthatglucosehomeostasiscanbeachievedwithaweightloss-independentmechanismimmediatelyafterbariatricsurgery,especiallygastricbypass,hasledtotheparadigmofmetabolicsurgery.However,theprimaryfocusofmetabolicsurgeryisthealterationofthephysio-anatomyofthegastrointestinaltracttoachieveglycemiccontrol,metaboliccontrolandcardio-metabolicriskreduction.Todate,metabolicsurgeryisstillnotwelldefined,asitisusedmostfrequentlyforlessobesepatientswithpoorlycontrolleddiabetes.Themechanismofglycemiccontrolisstillincompletelyunderstood.Publishedresearchfindingsonmetabolicsurgeryarepromising,butmanyaspectsstillneedtobedefined.Thispaperexaminestheproposedmechanismofdiabetesremission,theefficacyofdifferenttypesofmetabolicprocedures,thedurabilityofglucosecontrol,andtherisksandcomplicationsassociatedwiththisprocedure.Weproposeatailoredapproachfortheselectionoftheidealmetabolicprocedurefordifferentgroupsofpatients,consideringtheindicationsandprognosticfactorsfordiabetesremission.

简介：Gapinducedpie-pulseinhibition(Gap-PPI)ofacousticstartlereflexhasbeenusedasameasurementoftinnitusinanimalmodels.However,whetherthistestissensitivetodetecttinnitusinhumansisstillunclear.Basedonthetestingprocedureusedinanimalstudies,ahumansubjecttestingmethodwasformulatedandconductedtoinvestigateifasimilarresultcouldbefoundintinnituspatients.Audiologicandtinnitusassessmentsandacousticstartlereflexmeasurementswereperformedonseventinnitussubjectsandnineagematchedsubjectswithouttinnitus.TherewasnosignificantdifferencefoundbetweenthecontrolandtinnitusgroupontheGap-PPlacrossthefrequenciesevaluated.Theamplitudeofthestartleresponseinthetinnitusgroupwithnormalhearingthresholdswassignificantlyhigherthanthecontrolgroupandthosewithtinnitusandhearingloss.Thispreliminaryresultsuggeststhathyperexcitabilityinthecentralauditorysystemmaybeinvolvedintinnitus.Therewasnocorrelationbetweenhearingthresholdsandtheincreasedamplitudeofstartleresponse.