OBJECTIVE:To provide reference for the management of re-use of single-use devices (SUDs) in China. METH-ODS:The management situation of SUDs use in China and the management policy of SUDs re-use in America and Germany were introduced,the published literature of SUDs re-use was researched and the safety and ethicality were analyzed and discussed. RE-SULTS:China had no regulation for the clear definition of the range,standards and requirements of SUDs re-use;America and Germany had well-management for the SUDs re-use with different modes. Literature analysis showed that there were 3 results for the SUDs re-use,including supporting,opposition and classified management. In terms of safety,SUDs re-use needs the base of specific species and disinfection operations;in terms of ethicality,SUDs re-use should focus on the right to know of patients and the effects on cost savings and environment. CONCLUSIONS:China should establish and improve the management policy of SUDs re-use,develop the classification assessment of re-use,encourage third-party organizations participating in the recycling of SUDs and strengthen the monitoring of adverse reactions,etc.

Objective To explore the impact of insomnia status in university students on cognitive flexi-bility.Methods The cluster sampling method was adopted.A total of 802 undergraduates in a university of Chongqing conducted the questionnaire survey by cognitive flexibility inventory(CFI)and Pittsburgh sleep quality index(PSQI).A total of 770 effective questionnaires were recovered.Sixty-six university student vol-unteers were recruited as the study subjects.The subjects with the PSQI≥8 points and being in insomnia state after interview served as the insomnia group(n=28)and the subjects with the PSQI＜8 points and not being in insomnia state after interview served as the control group(n=38).The study subjects all participated in behavioral study(adopting the number-letter transition task assesses the cognitive flexibility of the subjects).The differences in the reaction time,accuracy rate and switching cost were compared between the two groups.Results The total scores of CFI and PSQI in the university students group were(70.43±12.85)points and(6.37±3.29)points,respectively.The detection rate of insomnia was 33.77％(260/770).The CFI score in in-somnia individual was significantly lower than that in the sleep normal individual,and the difference was sta-tistically significant[(68.15±11.65)points vs.(71.59±13.28)points,P＜0.05].The Spearman partial correlation analysis indicated that the cognitive flexibility was negatively correlated with the PSQI total score(r=-0.22),subjective sleep quality(r=-0.22),sleep latency(r=-0.12),sleep disorders(r=-0.16),hypnotic drug use(r=-0.14)and daytime dysfunction(r=-0.16).The average reaction time,reaction time for repeat trials,reaction time for switch trials and switching cost in the insomnia group were longer than those in the control group,the CFI score and switch trial accuracy rate were lower than those in the control group,and the differences were statistically significant(P＜0.05).Conclusion The cognitive flexibility of the university students with insomnia is lower than that of the university students with normal sleep.The insom-nia status should be intervened.

ObjectiveTo investigate the feasibility and safety of endoscopic retrograde cholangiopancreatography （ERCP） combined with oral cholangiopancreatography in the treatment of major duodenal papilla gallbladder polyps. MethodsA retrospective analysis was performed for the clinical data of eight patients with choledocholithiasis and gallbladder polyps who underwent ERCP and combined with oral cholangiopancreatography for major duodenal papilla cholecystectomy in Center of Digestive Endoscopy， Jilin People’s Hospital， from May 2022 to June 2024， and related data were collected， including the success rate of surgery， the technical success rate of gallbladder polyp removal， the superselective method of cystic duct， the time of operation， the time of gallbladder polyp removal， and surgical complications. ResultsBoth the success rate of surgery and the technical success rate of gallbladder polyp removal reached 100%， and of all eight patients， three patients used guide wire to enter the gallbladder under direct view， while five patients received oral cholangiopancreatography to directly enter the gallbladder. The time of operation was 51.88±12.34 minutes， and the time of gallbladder polyp removal was 23.13±10.94 minutes. The diameter of gallbladder polyp was 2‍ ‍—‍ ‍8 mm， and pathological examination showed inflammatory polyps in three patients， adenomatous polyps in one patient， and cholesterol polyps in four patients. There were no complications during or after surgery. The patients were followed up for 2‍ ‍—‍ ‍27 months after surgery， and no recurrence of gallbladder polyp was observed. ConclusionOral cholangiopancreatography is technically safe and feasible in endoscopic major duodenal papilla cholecystectomy.