Obesity and type 2 diabetes are common chronic diseases which severely threatens human's health and lives.In addition to behavioural and medical approaches,the bariatric surgery is increasingly being valued by medical workers.There are many kinds of surgical method of the bariatric surgery,but by far the most popular ones are Laparoscopic sleeve gastrectomy and Laparoscopic sleeve gastrectomy.The mechanism of the surgery may related to gastrointestinal hormones and fat metabolism,but no final conclusion has yet been reached on this matter.This paper is a literature review on the effect and mechanism of bariatric surgery.

Objective To monitor the distribution of pathogenic bacteria causing wound infection in trauma patients and their susceptibility to antibiotics in an effort to offer evidence for the rational clinical use of antibiotics.Methods Pathogens were identified by expressive type,but a very few was determined by the molecular methods.Micro-dilution or Kirby-Bauer method for minimum inhibitory concentration (MIC) was adopted for drug susceptibility test.Results A total of 121 species of pathogens numbering 1,257 bacterial strains were isolated from 1,066 patients.Strain number of the top 10 species accounted for 70.09％.Gram-positive cocci accounted for 48.93％ and Gram-negative bacilli for 49.72％.Among Staphylococcus aureus and epidermidis,methicillin-resistant bacterial strains accounted for 34.76％ and 71.08％ respectively,but none were resistant to vancomycin or linezolid.Enterococcus faecalis contained 6.06％ vancomycin-resistant enterococcal (VRE) and remained ＞ 90％ sensitive to teicoplanin,ampicilin and vancomycin.Enterococcus faecium contained 10.53％ VRE and remained ＞90％ sensitive to teicoplanin and ＞ 80％ sensitive to vancomycin.Baumanii contained 12.77％ multidrug resistant strains and remained ＞ 70％ sensitive to imipenem and meropenem.Baumanii/calcoaceticus complex contained 29.72％ multi-drug resistant strains and remained ＞ 50％ sensitive to imipenem and meropenem.Pseudomonas aeruginosa contained 3.73％ multi-drug resistant strains and remained ＞90％ sensitive to amikacin,meropenem,imipenem and piperacillin/tazobactam.No E.coli,klebsiella pneumoniae and enterobacter cloacae resistant to imipenem or meropenem were found.E.coli contained 69.51％ extended-spectrum β-lactamases (ESBLs)-producing strains and remained ＞ 90％ sensitive to piperacillin/tazobactam and ＞ 80％ sensitive to amikacin.Klebsiella pneumoniae contained 53.13％ ESBLs-producing strains and remained ＞ 80％ sensitive to amikacin.Conclusions Common bacteria are the leading cause of posttraumatic infection.Enterococcus faecalis and enterococcus faecium demonstrate higher susceptibility to teicoplanin; two kinds of acinetobacter demonstrate higher susceptibility to imipenem.

Objective To investigate the clinical application of pancreatic head resection with the second portion duodenectomy (PHRSPD). MethodsThe clinical data of 4 PHRSPD cases were analyzed retrospectively. ResultsThere were 3 benign and 1 low-grade malignant periampullary tumors. The mean surgical time was 417 min, mean blood transfusion was 533 ml, mean hospital stay was 28.6 days. Delayed gastric emptying was encounted in one case. There was no hospital morality or major surgical complications. All cases were alive in the follow-up ranging from 6 to 36 months. There was no newly developed diabetes mellitus or severe gastroenteral symptoms. No reccurrence was found in the case with low-grade malignant duodenal tumor after 26 months. ConclusionsPHRSPD is an efficient way to treat benign and low-grade periampullary neoplasm and accompanying massive bleeding episodes.

This article introduces the health management service specification for a chronic patient population. The concept of this specification comes from the whole process of people-centered and integrated health management of the chronic patient population. It is also based on the World Health Organization′s integrated chronic patient population management model. The completion of the specification has gone through several rounds of expert discussion in related fields in China. The contents include seven key links: suspect selection, clinical diagnosis, health assessment, intervention plan development, intervention plan implementation, follow-up, and health reassessment. It also includes establishing a professional team and developing a support system and mechanism of financing, compensation, and incentives. The specification aims at integrating regional health resources through standardizing service technology and scientific management concepts. It would help to improve the efficiency and quality of health management of chronic patient population in China, thereby reducing the economic burden of chronic diseases for patients and their families, and achieving the goal of improving residents′ health.

Objective:This study aimed to explore the status of radiological Kashin-Beck disease (KBD) among school-aged children in Chamdo City, Tibet, through a 3-year monitoring survey, providing epidemiological evidence for prevention and control strategies.Methods:The target areas for this study were Luolong, Bianba, and Basu counties in Chamdo City, Tibet Autonomous Region, identified as having the most severe historical cases of KBD. Children aged 7-12 years attending school were enrolled as study subjects. Anteroposterior X-ray films of the right-hand were taken, and radiological diagnoses were made based on the "Diagnosis of Kashin-Beck Disease" criteria (WS/T 207-2010). Two experienced researchers independently reviewed the X-rays, and intra- and inter-group consistency were assessed using weighted Kappa values and percentage agreement. Cross-sectional surveys were conducted in 2017 and 2020 to describe the X-ray detection rates of KBD, and logistic regression analysis was employed to construct a predictive model of risk factors for radiological KBD cases.Results:In 2017, a total of 5,711 children aged 7-12 years in Chamdo City, Tibet, participated in the baseline cross-sectional survey (average age 9.2 years, 48.0% female), with 28 cases of radiological KBD. The age- and gender-standardized prevalence rate was 0.527%. In 2020, 6,771 participants (average age 9.3 years, 49.5% female) underwent a second cross-sectional survey, with 9 cases of radiological KBD and a standardized prevalence rate of 0.134%. Logistic regression analysis indicated that older age [ OR=2.439, 95% CI(1.299, 4.580), P=0.006] and female gender [ OR=8.157, 95% CI(1.016, 65.528), P=0.048] were independent risk factors for radiological KBD cases. Conversely, higher residential altitude, under the premise of Tibet's high altitude, was a protective factor [ OR=0.995, 95% CI(0.990, 0.999), P=0.032). Conclusion:The radiographically positive detection rate of KBD among school-aged children in Chamdo City, Tibet Autonomous Region, is at an extremely low level and showing a declining trend, reaching the historical standard in 2020. Considering the absence of positive signs in affected children, it suggests that local KBD has been effectively eliminated.