Obesity has emerged as a major global public health challenge, accompanied by a significant rise in obesity-related comorbidities. Although conventional bariatric surgery achieves reliable outcomes, its invasiveness, potential risks, and irreversible anatomical alterations have limited widespread application. With the rapid advancement of digestive endoscopy, endoscopic bariatric therapies are increasingly recognized as minimally invasive alternatives that combine safety and efficacy. This review summarized the current progress and clinical applications of various endoscopic bariatric techniques, including intragastric balloons, endoscopic sleeve gastroplasty, and primary obesity surgery endoluminal procedures that reduced gastric volume via space-occupying, or suture and anastomosis technology achieved by oral devices. In addition, aspiration therapy, which removes gastric contents, and innovative methods such as duodenal-jejunal bypass liners and duodenal mucosal resurfacing that mimic surgical bypass or induce mucosal remodeling were discussed. Endoscopic bariatric technologies showed promising prospects and were expected to become an important component of comprehensive obesity management.

Objective To evaluate the efficacy of femoral neck system (FNS) and cannulated screw (CS) in the treatment of femoral neck fracture in adults during perioperative and conjunctional periods. Methods By searching CNKI, Wanfang, VIP, CBM, PubMed, Embase and Cochrane databases, relevant literatures on the efficacy comparison of the two internal fixation regimens were collected. Review Manager 5.3 software was used to conduct a meta-analysis of the literature finally included in the study. Results A total of 24 retrospective cohort studies were included in this study, with a total of 1 661 participants, including 783 participants in the FNS group (FNS treatment) and 878 participants in the CS group (CS treatment). In the FNS group, intraoperative fluoroscopy times (MD=-9.69, 95%CI, -11.27 to -8.11, P < 0.01), complete weight-bearing time (MD=-1.69, 95%CI, -2.88 to -0.50, P < 0.01), fracture healing time (MD=-1.15, 95%CI, -1.57 to -0.73, P < 0.01), Harris score at last follow-up (MD=-1.5, 95%CI, 2.30 to 4.59, P < 0.01) and femoral head necrosis rate (OR=0.48, 95%CI, 0.26 to 0.91, P=0.02) were superior in the CS group; however, intraoperative blood loss (MD=17.72, 95%CI, 9.88 to 25.55, P < 0.01) and incision length (MD=0.39, 95%CI, 0.04 to 0.73, P=0.03) in the FNS group were higher than those in the CS group. There were no significant differences between the two groups in terms of operation time (MD=-3.78, 95%CI, -7.95 to 0.39, P=0.08) and total hospitalization days (RR=-0.14, 95%CI, -0.43 to 0.14, P=0.32). Conclusion FNS in the treatment of adult femoral neck fractures has the advantages of less intraoperative fluoroscopy, earlier complete weight-bearing time, faster fracture healing and higher hip Harris score, but compared with CS, it has more intraoperative blood loss and larger incision area.

Objective To investigate the value of iFlow color-coding technique in quantitative real-time analysis of hemodynamic changes after transarterial chemoembolization (TACE) for hepatocellular carcinoma (HCC) . Methods A total of 31 patients who were diagnosed with HCC in Shanghai Fifth People's Hospital from December 2015 to January 2017 were enrolled. No patient underwent surgical operation or ablation. All patients underwent TACE with the same contrast agent, high-pressure injector parameters, and place of angiographic catheter. The iFlow technique was used to generate two-dimensional color-coded images and time-density curve (TDC) before and after surgery and measure the opening of the angiographic catheter and the time to peak (TTP) of the starting and ending points of the major tumor feeding arteries, as well as the ratio of the areas under the curve (AUC) of TDC of tumor tissue and the opening of the angiographic catheter. The paired t-test was used for comparison of continuous data between groups. Results TTP of the major tumor feeding arteries was 4.64 ± 0. 49 s before TACE and 5. 97 ± 0. 84 s after TACE (t = 11. 57, P ＜ 0. 01), and there was a significant difference in AUC between the tumor tissue and the opening of the angiographic catheter (0. 53 ± 0. 15 vs 0. 16 ± 0. 12, t = 25. 85, P ＜ 0. 01) . There was no significant difference in TTP between the opening of the angiographic catheter and the major tumor feeding arteries before and after TACE (P＞ 0. 05) .Before TACE, the TDC of tumor feeding arteries had a shape of"rapid increase-rapid reduction"with relatively high slope and peak value, while after TACE, the TDC had a shape of "increase-flat-reduction"with reductions in slope and peak value. Conclusion The iFlow technique can perform real-time measurement of TTP and TDC of the region of interest and helps with quantitative evaluation of hemodynamic changes in HCC. Therefore, it can provide objective quantitative indices for evaluating the degree of tumor embolism.