Objective To analyze the characteristics of viral hepatitis mortality and life loss among residents in Pudong New Area from 2003 to 2023, and to provide a basis for related prevention and control work. Methods Viral hepatitis mortality data were obtained from the Pudong New Area mortality monitoring system. The crude mortality rate (CMR), standardized mortality rate (SMR), potential years of life lost (PYLL), average years of life lost (AYLL), and standardized potential years of life lost (SPYLL) were calculated to analyze viral hepatitis deaths. The average annual change (AAPC) and annual percentage change (APC) of the mortality rate were calculated by Joinpoint regression analysis to analyze the trend of mortality. Results The CMR and SMR of viral hepatitis among residents in Pudong New Area from 2003 to 2023 were 3.89/100000 and 1.98/100000, respectively. Both CMR and SMR of viral hepatitis showed a decreasing trend over time (CMR:APC=-5.476, t=-13.581, P<0.001; SMR:APC=- 7.624, t= -21.253, P<0.001). The CMR for males was 4.75/100000 and the SMR for males was 2.65/100000; the CMR for females was 3.04/100000 and the SMR for females was 1.32/100000, with a higher mortality rate for males than for females（Z_CME=12.094，P<0.001; Z_SMR=-14.718，P<0.001). Deaths were concentrated in the age groups of 45-64 years old and 65 years old and above, accounting for 91.62% of the total deaths. The PYLL of deaths due to viral hepatitis among residents in Pudong New Area from 2003 to 2023 was 26912 person-years, with a PYLLR of 0.45% and an AYLL of 8.88 years per person. Conclusion The mortality rate of viral hepatitis among the residents of Pudong New Area in 2003-2023 shows a decreasing trend over time. The mortality rate of males is higher than that of females, and the deaths of middle-aged and elderly people account for a large proportion of the total deaths. Chronic hepatitis B is the main cause of death.

AIM:Study on the bioequivalence of rivaroxaban tablets from two different manufactur-ers in healthy subjects under fasting and postpran-dial conditions.METHODS:Adopting a single cen-ter,randomized,open,fasting and postprandial,four cycle,fully repeated crossover trial design.28 healthy male and female subjects were given oral administration of either the test or reference for-mulation(10 mg)on an empty stomach or in a post-prandial state,with a cleaning period of 7 days be-tween cycles.The concentration of rivaroxaban in the plasma(heparin sodium)of the subjects was measured using liquid chromatography tandem mass spectrometry(LC-MS/MS),and pharmacoki-netic(PK)parameters were calculated using Phoe-nix WinNonlin 7.0 software to evaluate the bio-equivalence of the test and reference formulations.RESULTS:Fasting group:After oral administration of the investigational drug,the Cmax of the test formula-tion and reference formulation were(200.96±68.99)ng/mL and(196.96±50.97)ng/mL,respec-tively,and the AUC0-t were(1 439.93±493.94)h·ng·mL-1 and(1 395.90±411.49)h·ng·mL-1,respectively,the AUC0-∞ were(1 506.56±511.47)h·ng·mL-1 and(1 451.94±417.89)h·ng·mL-1,respectively,the 90％confidence intervals for the geometric mean ratios of Cmax,AUC0-t,and AUC0-∞ were 91.87％-103.37％,95.00％-105.07％,95.33％-105.57％,respectively,the 90％CI of the intra-individual standard devia-tion ratio(SWT/SWR)for Cmax,AUC0-t,AUC0-∞were 0.88-1.73,0.74-1.45 and 0.72-1.41,respectively.Post-prandial group:After oral administration of the ex-perimental drug,the Cmax of the test and reference formulations were(241.23±54.44)ng/mL and(226.54±48.04)ng/mL,respectively,and the AUC0-t were(1 383.26±437.05)h·ng·mL-1 and(1 333.54±372.53)h·ng·mL-1,respectively,the AUC0-∞ were(1 404.01±439.89)h·ng·mL-1 and(1 352.31±374.45)h·ng·mL-1,respectively,the 90％confi-dence intervals for the geometric mean ratios of Cmax,AUC0-t,and AUC0-∞ were 100.92％-110.50％,98.30％-108.31％,and 98.46％-108.39％,respective-ly,the 90％CI of the intra-individual standard devia-tion ratio(SWT/SWR)for Cmax,AUC0-t and AUC0-∞ were 0.63-1.29,0.78-1.61 and 0.79-1.61,respectively.CONCLUSION:Bioequivalence of the two prepara-tions in fasting and postprandial state in healthy subjects.

Objective:To retrospectively analyze the efficacy and feasibility of surgical management in patients with cervical dysphagia secondary to Diffuse idiopathic skeletal hyperostosis(DISH)of the cervical spine.Methods:A retrospective analysis was conducted on 6 patients who presented with dysphagia as the primary symptom, were diagnosed with cervical DISH, and underwent surgical treatment in the Department of Otorhinolaryngology Head and Neck Surgery of The Second Xiangya Hospital of Central South University from January 2018 to February 2024. There were 5 males and 1 female, aged from 65 to 78 years (70.2±4.7 years). The duration of dysphagia prior to admission was 13 to 18 months (14.7±2.2 months). All patients had the symptom of dysphagia, and at least one other clinical manifestation of cervical DISH (dyspnea, restricted neck mobility, sleep apnea, odynophagia). One patient had undergone tracheotomy due to laryngeal obstruction before surgery. Surgical intervention was performed after failure of conservative management in all patients. All patients underwent anterior cervical osteophyte resection via the Smith-Robinson approach without concomitant spinal fusion. In the patient with prior tracheotomy for airway obstruction, epiglottoplasty and right arytenoidectomy were performed simultaneously. The swallowing function was evaluated by water swallow test, FEES, M. D. Anderson Dysphagia Inventory. Clinical and imaging evaluations were conducted for follow-uppostoperatively. Preoperative and 30-day post operative data were statistically analyzed using paired samples t-test.Results:Cervical computed tomography revealed osteophyte involvement from C2 to T1 with a median of 4 vertebral segments affected. The most frequently involved vertebral segments were C4-C6 (all 6 patients were involved). The anteroposterior diameter of the most prominent osteophyte was 12.0 to 20.0 mm (16±3.1 mm). The time to resumption of a regular diet was 6 to 20 days(12.7±5.3 days), and the time to remove the nasogastric tube was 8 to 25 days(15.2±6.2 days). In the patient with prior tracheotomy, the tracheostomy tube was successfully decannulated 30 days after initial tube capping following conversion to a metal tube. All cervical DISH-related symptoms except for limited neck mobility improved postoperatively. Both water swallow test and the Rosenbek Penetration-Aspiration Scale showed significant improvement postoperatively. At 30 days postoperatively, MDADI scores significantly improved in all domains: l global (73.33±10.33), emotional (85.56±8.35), functional (83.33±5.89), and physical (82.08±6.60). No major perioperative complications occurred. and the length of hospital stay was 7 to 10 days (7.8±1.2 days). The follow-up time was 12 to 84 months (43.7±27.2 months). All patients maintained sustained symptom relief, with no evidence of osteophyte recurrence during follow-up.Conclusion:Cervical DISH is an under-recognized causes of dysphagia in elderly patients and warrants attention from otolaryngologists. For patients erefractory to conservative treatment, anterior resection of cervical osteophytes via the Smith-Robinson approach is a safe, minimally invasive procedure with favorable short-and long-term outcomes in improving swallowing function.

Objective To observe the value of exercise for improving neuroplasticity in overweight and obese people using meta-analysis.Methods Articles of functional MRI(fMRI)studies about brain activation changes in overweight or obese people after exercise published in Web of Science,PubMed,PsycINFO and CNKI were searched from the establishment of database to August 1,2024.The data were analyzed with activation likelihood estimation(ALE),and the coordinates of brain activation clusters were obtained.Results A total of 11 articles were ultimately enrolled,including 186 overweight or obese subjects.After exercise,the activation of the right middle frontal gyrus increased in all subjects,while of the left anterior lobe of cerebellum,left precuneus and right cuneus decreased.Among them,activation of the right cingulate gyrus and right superior temporal gyrus in minors increased,while of the left anterior lobe of cerebellum and bilateral precentral gyrus decreased.And the activation of the bilateral lentiform nuclei,right middle frontal gyrus,right cingulate gyrus and right parahippocampal gyrus in adults increased,while of the bilateral precuneus decreased.Conclusion Exercise could improve activation level of brain regions related to executive function,working memory,attention and motor control in overweight or obese people,which were different between minors and adults.

Objective To observe the value of exercise for improving neuroplasticity in overweight and obese people using meta-analysis.Methods Articles of functional MRI(fMRI)studies about brain activation changes in overweight or obese people after exercise published in Web of Science,PubMed,PsycINFO and CNKI were searched from the establishment of database to August 1,2024.The data were analyzed with activation likelihood estimation(ALE),and the coordinates of brain activation clusters were obtained.Results A total of 11 articles were ultimately enrolled,including 186 overweight or obese subjects.After exercise,the activation of the right middle frontal gyrus increased in all subjects,while of the left anterior lobe of cerebellum,left precuneus and right cuneus decreased.Among them,activation of the right cingulate gyrus and right superior temporal gyrus in minors increased,while of the left anterior lobe of cerebellum and bilateral precentral gyrus decreased.And the activation of the bilateral lentiform nuclei,right middle frontal gyrus,right cingulate gyrus and right parahippocampal gyrus in adults increased,while of the bilateral precuneus decreased.Conclusion Exercise could improve activation level of brain regions related to executive function,working memory,attention and motor control in overweight or obese people,which were different between minors and adults.

Objective:To assess the effects of probiotic supplementation following bariatric surgery on weight loss outcomes, glycemic and lipid metabolism profiles, and nutritional status.Methods:Searches were conducted across China National Knowledge Infrastructure (CNKI), WanFang, VIP, Web of Science, and PubMed using Chinese or English search words including probiotics, morbid obesity, severe obesity, bariatric surgery, sleeve gastrectomy, Roux-en-Y gastric bypass, SG, and RYGB up to May 31, 2024. Meta-analysis was performed using Review Manager 5.3. Study quality was evaluated using Cochrane risk of bias tool.Results:In the 12 randomized controlled trials (RCTs) containing 663 severely obese patients who underwent bariatric surgery, 329 were in the probiotic group (receiving probiotic supplementation following bariatric surgery) and 334 in the control group (using placebo). Compared with the control group, the probiotic group had significantly lower fasting blood glucose ( WMD=-4.42 mg/dL, 95% CI: -7.71–-1.13, P=0.009) and triglyceride ( WMD=-18.75 mg/dL, 95% CI: -35.83–-1.67, P=0.03) and significantly increased vitamin B 12 ( SMD=0.52, 95% CI: 0.02–1.02, P=0.04). However, the two groups showed no significant differences in body mass index, waist circumference, weight, % excess weight loss, hemoglobin A1c, insulin, homeostasis model assessment of insulin resistance, total cholesterol, low-density lipoprotein, high-density lipoprotein, or vitamin D levels (all P>0.05). Conclusion:Supplementing probiotics after bariatric surgery can improve glucose and lipid metabolism and increase vitamin B 12 absorption, whereas its potential effect on weight loss remains unclear.

Objective:To assess the effects of probiotic supplementation following bariatric surgery on weight loss outcomes, glycemic and lipid metabolism profiles, and nutritional status.Methods:Searches were conducted across China National Knowledge Infrastructure (CNKI), WanFang, VIP, Web of Science, and PubMed using Chinese or English search words including probiotics, morbid obesity, severe obesity, bariatric surgery, sleeve gastrectomy, Roux-en-Y gastric bypass, SG, and RYGB up to May 31, 2024. Meta-analysis was performed using Review Manager 5.3. Study quality was evaluated using Cochrane risk of bias tool.Results:In the 12 randomized controlled trials (RCTs) containing 663 severely obese patients who underwent bariatric surgery, 329 were in the probiotic group (receiving probiotic supplementation following bariatric surgery) and 334 in the control group (using placebo). Compared with the control group, the probiotic group had significantly lower fasting blood glucose ( WMD=-4.42 mg/dL, 95% CI: -7.71–-1.13, P=0.009) and triglyceride ( WMD=-18.75 mg/dL, 95% CI: -35.83–-1.67, P=0.03) and significantly increased vitamin B 12 ( SMD=0.52, 95% CI: 0.02–1.02, P=0.04). However, the two groups showed no significant differences in body mass index, waist circumference, weight, % excess weight loss, hemoglobin A1c, insulin, homeostasis model assessment of insulin resistance, total cholesterol, low-density lipoprotein, high-density lipoprotein, or vitamin D levels (all P>0.05). Conclusion:Supplementing probiotics after bariatric surgery can improve glucose and lipid metabolism and increase vitamin B 12 absorption, whereas its potential effect on weight loss remains unclear.

Objective:To investigate whether the immunohistochemical results of two markers PMS2 and MSH6 (2-MMR) could replace the four markers MLH1, PMS2, MSH2 and MSH6 (4-MMR) to detect mismatch repair deficient (dMMR) cancers.Methods:A retrospective analysis was conducted with summary of immunohistochemical data from 7 867 cases of gastric cancer, colorectal cancer, endometrial cancer, and other diseases in the Affiliated Drum Tower Hospital of Nanjing University Medical School, Nanjing, China, from March 2018 to March 2023. The consistency of 2-MMR and 4-MMR results was examined. Microsatellite instability (MSI) and next-generation sequencing (NGS) were performed in patients with specific phenotypes.Results:The Cohen κ values of 2-MMR and 4-MMR in gastric cancer, colorectal cancer, endometrial cancer and other diseases were 0.88, 0.99, 0.88 and 1.00, respectively. The overall consistency, sensitivity and specificity were 0.97, 99.6%, and 100.0%, respectively. Both 2-MMR and 4-MMR could detect the difference between various clinicopathological features. 24 (0.3%) of the 7 867 patients were found to have a special phenotype of MMR, and 6 of them were selected for MSI and NGS molecular testing. MSI analysis showed MSI-H in all cases, while NGS found that 5 of them had MMR-related gene mutations and 1 had POLE p.S297F mutation.Conclusions:Compared with 4-MMR, 2-MMR has high consistency, specificity and sensitivity. The cases with special phenotype only account for extremely low proportion. Therefore, 4-MMR may be replaced with 2-MMR in dMMR screening.

Objective To investigate the relationship between cerebral perfusion status,blood pressure variability,and prognosis in patients with moyamoya disease following cerebral revascularization.Methods A retrospective analysis was conducted on 108 patients who underwent their first combined cerebral revascularization between January 2019 and July 2022 at the Department of Neurosurgery,First Affiliated Hospital of Henan University,and Henan Provincial People's Hospital.Based on postoperative cerebral perfusion improvement,patients were categorized into a"good"group and a"general"group.Baseline characteristics,key imaging parameters,blood pressure variability,and symptom scores were compared and analyzed between the two groups.Results In this study,there were 55 cases in the good group and 53 cases in the general group.According to the comparative analysis of the postoperative indicators between the good group and the general group,Statistically significant differences were observed in symptom improvement[42(79.25%)vs.52(94.55%)],TIA[22(41.51%)vs.11(20.00%)],and cerebral infarction[6(11.32%)vs.0(0.00%)],mRS score and the Matsushima classification(P<0.05).However,there was no statistically significant difference in the BPV-related index between the two groups of patients before the operation(all P>0.05).When comparing nine blood pressure variability(BPV)-related indices including the mean of 24-hour,daytime,and nighttime systolic blood pressure,coefficient of variability(CV),and average real variability(ARV)between the two groups,no significant differences were observed in the BPV-related indices before surgery between the two groups(P>0.05).The differences in the BPV-related indices before and after surgery(postoperative index-preoperative index)between the two groups were statistically significant(P<0.05).Postoperative cerebral perfusion status was positively correlated with prognosis and negatively correlated with BPV.Conclusion Patients with good improvement in cerebral perfusion status after combined revascularization for moyamoya disease have less blood pressure variability and better prognosis.

Carbon dioxide(CO2),a colorless,odorless,low-density negative contrast agent with no nephrotoxicity or allergic reactions,has seen increasingly widespread application in the field of vascular imaging in recent years,particularly in patients with iodine allergy or renal insufficiency.When combined with digital subtraction angiography,CO2 angiography has demonstrated high-quality imaging in various arterial and venous sites such as the abdominal aorta,renal arteries,iliac arteries,lower limb arteries,and inferior vena cava.It has also shown safety and efficacy in clinical scenarios such as peripheral arterial disease,dialysis access evaluation,and transjugular intrahepatic portosystemic shunt procedures.This review systematically summarizes domestic and international research progress on CO2 angiography,outlines its physicochemical properties,injection dosages and parameters,clinical indications,and imaging characteristics,and compares its image quality with that of iodine-based contrast agents.Common complications,their mechanisms,and preventive measures are also discussed.Although the image quality of CO2 is slightly inferior to that of iodine agents,it remains sufficient for most diagnostic and therapeutic needs,with a low overall incidence of mainly mild and transient adverse effects.With the development of automated injection systems and digital variance angiography technology,CO2 imaging quality is expected to continue improving,and its application scope is likely to expand further.Future efforts should focus on strengthening multicenter clinical research and establishing standardized operational protocols to promote the broader adoption and regulated use of this technology.