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 observe the clinical efficacy of mind-regulating and meridians-dredging acupuncture combined with rehabilitation training in treating limb dysfunction in recovery period of cerebral infarction(CI).Methods A total of 110 cases of patients with limb dysfunction in recovery period of CI were randomly divided into observation group and control group,55 cases in each group,the control group was given routine rehabilitation training,and the observation group was treated with mind-regulating and meridians-dredging acupuncture on the basis of intervention of the control group,the course of treatment covered two consecutive weeks.After two weeks of treatment,the clinical efficacy of the two groups was evaluated,and the changes of scores of traditional Chinese medicine(TCM)syndrome,Fugl-Meyer Assessment(FMA),Berg Balance Scale(BBS)and Modified Barthel Index(MBI)before and after treatment of patients in the two groups were observed.The changes of electromyographic signal before and after treatment were compared between the two groups.And the safety and the occurrence of adverse reactions in the two groups were evaluated.Results(1)The total effective rate was 98.18%(54/55)in the observation group and 87.27%(48/55)in the control group.The efficacy of the observation group was superior to that of the control group,the difference being statistically significant(P<0.05).(2)After treatment,the TCM syndrome scores of patients in the two groups were significantly improved(P<0.05),and the improvement in the observation group was significantly superior to that in the control group,with a statistically significant difference(P<0.05).(3)After treatment,the FMA scores of patients in the two groups improved significantly(P<0.05),and the improvement in the observation group was significantly superior to that in the control group,the difference being statistically significant(P<0.05).(4)After treatment,the BBS scores and MBI scores of the patients in the two groups improved significantly(P<0.05),and the improvement in the observation group was significantly superior to that in the control group,the difference being statistically significant(P<0.05).(5)After treatment,the root mean square value(RMS)of biceps brachii muscle elbow flexion and triceps brachii muscle elbow extention of the two groups of patients improved significantly(P<0.05),and the improvement in the observation group was significantly superior to that in the control group,the difference being statistically significant(P<0.05).(6)During the treatment,there were no obvious adverse reactions occurred in both groups.Conclusion Mind-regulating and meridians-dredging acupuncture combined with rehabilitation training in treating limb dysfunction in recovery period of CI can significantly improve the motor ability of patients,and adjust the electromyographic signals of the affected limbs,with high safety.

Ketone bodies have beneficial metabolic activities, and the induction of plasma ketone bodies is a health promotion strategy. Dietary supplementation of sodium butyrate (SB) is an effective approach in the induction of plasma ketone bodies. However, the cellular and molecular mechanisms are unknown. In this study, SB was found to enhance the catalytic activity of 3-hydroxy-3-methylglutaryl-CoA synthase 2 (HMGCS2), a rate-limiting enzyme in ketogenesis, to promote ketone body production in hepatocytes. SB administrated by gavage or intraperitoneal injection significantly induced blood ß-hydroxybutyrate (BHB) in mice. BHB production was induced in the primary hepatocytes by SB. Protein succinylation was altered by SB in the liver tissues with down-regulation in 58 proteins and up-regulation in 26 proteins in the proteomics analysis. However, the alteration was mostly observed in mitochondrial proteins with 41% down- and 65% up-regulation, respectively. Succinylation status of HMGCS2 protein was altered by a reduction at two sites (K221 and K358) without a change in the protein level. The SB effect was significantly reduced by a SIRT5 inhibitor and in Sirt5-KO mice. The data suggests that SB activated HMGCS2 through SIRT5-mediated desuccinylation for ketone body production by the liver. The effect was not associated with an elevation in NAD⁺/NADH ratio according to our metabolomics analysis. The data provide a novel molecular mechanism for SB activity in the induction of ketone body production.
Mice ; Animals ; Butyric Acid/metabolism* ; Ketone Bodies/metabolism* ; Liver/metabolism* ; Hydroxybutyrates/metabolism* ; Down-Regulation ; Sirtuins/metabolism* ; Hydroxymethylglutaryl-CoA Synthase/metabolism*

Objective:To analyze the risk factors and human papillomavirus (HPV) genotypes distribution in patients with condyloma acuminatum (CA) in two regions of Shandong province.Methods:From August 2019 to December 2020, an anonymous questionnaire survey of CA patients was conducted in three hospitals in Jinan City and Jining City, Shandong Province, and samples were collected for HPV typing. Multivariate binary logistic regression was used to analyze the risk factors of CA recurrence. HPV typing was detected by PCR-reverse dot blot hybridization.Results:A total of 653 questionnaires were collected, and the valid questionnaires accounted for 98.77% (645/653). Recurrence of the disease occurred in 174 patients, with a recurrence rate of 26.98%. Univariate analysis showed that there were statistically significant differences in the distribution of CA recurrence among residence time at current address, sexual frequency, genitalia cleaning, and knowledge of preventing HPV infection ( P<0.05). Multivariate binary logistic regression showed that knowing how to prevent HPV infection was a significant factor that influences CA recurrence. A total of 428 patients underwent HPV typing, and the positive detection rate of HPV was 98.60% (422/428). The top three positive rates were HPV6 (57.58%), HPV11 (36.49%) and HPV16 (11.37%). The main type of infection was low-risk HPV, accounting for 51.42% (217/422). Conclusions:CA patients have the phenomenon of "separation of knowledge and action" , so it is necessary to strengthen health education and behavioral intervention, guide the population to correctly treat sexual behavior, and improve self-prevention awareness and risk awareness.

Objective: To preliminarily evaluate the safety of the coplanar template-assisted ¹⁹²Ir hypofractionated stereotactic ablative brachytherapy (SABT) in patients with locally advanced non-small cell lung cancer (LA-NSCLC), and assess the effect of template-assisted technology upon the accuracy of SABT by comparing the consistency of dosimetric parameters between preoperative and operative plans. Methods: Fifteen patients histologically confirmed with LA-NSCLC (stage Ⅱ_B-Ⅲ_A) were recruited and received the template-assisted SABT delivered in a risk-adapted fractionation (30 Gy/1F). Preoperative planning, template-assisted needle implantation, operative planning and implementation were performed in all patients. Dosimetric results of preoperative and operative plans were statistically compared by assessing the dosimetric parameters of gross tumor volume (HI, CI, D₉₀, V₁₀₀ and V₁₅₀) and organ at risk(V₅, V₂₀ and mean dose of bilateral lung, D_2cc of spinal cord. The incidence of perioperative complications of SABT was recorded. The safety and feasibility of SABT were evaluated. Results: Slight changes were noted in terms of target dose and irradiated dose to the lung between preoperative and operative plans without statistical significance (both P>0.05). No severe adverse events, such as severe pneumothorax, hemothorax and hemoptysis were observed. Conclusions Application of the template-assisted SABT can enhance the accuracy of implantation, maintain the consistency of the dosimetric parameters between the preoperative and operative plans and guarantee the clinical efficacy.

Objective: To explore the relationship between adolescents gratitude and social adaptation, as well as the mediating roles of school boding including support from teacher, peers and school belonging in the association. Methods: A total of 1 304 adolescents from 6 schools and colleges in Xuzhou were investigated with Adolescent Gratitude Scale, School Bonding Scale and Social Adaptation Scale. Results: Adolescent gratitude varied significantly in gender and grade, with girl’s gratitude significantly higher than that of boys(F=38.09, P<0.01). Adolescent gratitude increased as adolescents grew older, and was positively associated with social adaptation(r=0.26, P<0.01). School bonding partially mediated the relationship between adolescent gratitude with social adaptation(β=0.06). Conclusion School bonding plays a partial mediating role in the relationship between adolescent gratitude and social adaptation,adolescent gratitude can make a direct influence on social adaptation,and can also play an indirect role through school bonding.

Objective To analyze the effect of needle arrangement on the lung dose in interstitial brachytherapy for lung cancer. Methods For 15 patients undergoing interstitial brachytherapy for lung cancer, a virtual radiotherapy plan in which needle arrangement was not restricted by the ribs was designed and compared with the original plan. For the two plans, V5, V20, V30, and mean lung dose(MLD)of the whole lung were determined when the prescribed doses were 10,30, 60, and 120 Gy, respectively. The data were analyzed by Wilcoxon signed-rank test. Results The lung V5,V20, V30, and MLD were significantly smaller in the virtual plan than in the actual plan(all P<0.05). Conclusions Irregular needle arrangement prevents a further reduction in the lung dose in interstitial brachytherapy for lung cancer. In the implantation surgery, therefore, the needles should be arranged as regularly as possible.

Objective To explore the relationship between the overlap volume of organ at risk (OAR) and target (Voverlap) and the mean dose to OAR (DmOAR) in intensity-modulated radiotherapy (IMRT).Methods Fifty randomly selected patients undergoing IMRT for nasopharyngeal carcinoma (NPC) and an equal number of patients undergoing radical IMRT for cervical cancer in our hospital were enrolled as subjects.The relationship between Voverlap and DmoAR in IMRT was analyzed.The Matlab software was used to generate function to fit the relationship between Voverlap and DmOAR for different OARs.Results The Voverlap varied among patients with NPC or cervical cancer.The ratio of Voverlap to the volume of OAR (VOAR) was positively correlated with the ratio of DmOAR to the prescribed dose (Dp) (all P=0.01).A function was generated to fit the correlation between Voverlap/VOAR ratio and DmOAR/Dp ratio.Conclusions In IMRT,patients have different Voverlap/VoAR ratios due to varicd target volume,disease stages,OAR filling status,and OAR volume.As criteria for plan verification,a specific DmOAR value for each OAR should be calculated before radiotherapy planning based on the corresponding correlation function and the Voverlap/VoAR ratio with a fixed dose prescription.It can be used to reduce the subjective influence on the optimization of radiotherapy planning.

Objective To study the iso-center point coincidence of two accelerators with treatment planning system (TPS) based on γ passing rates of intensity-modulated radiotherapy (IMRT) plan verification.Methods Twenty-one IMRT plans were verified by Varian accelerator and twenty by Elekta accelerator with a gamma criterion of 3 mm/3％.The passing rates were measured when the iso-center point of TPS had-2,-1,0,1,and 2 mm shift in the x or y direction.A binomial curve of γwas fit to figure out the values of the two accelerators on the x and y axes when γ value reached the maximum.The γ pass rate difference was analysed by x2 test.Results The mean values of γ-2,γ-1,γ0,γ1,and γ2 in the x direction were (92.56±3.27) ％,(96.53± 1.82) ％,(96.13± 1.41) ％,(90.14± 2.87) ％,and (82.28± 4.69) ％ for Varian accelerator,and (94.82± 2.04) ％,(97.05± 2.02) ％,(98.38± 1.33) ％,(97.96± 1.44) ％,and (94.49±2.34)％ for Elekta accelerator.There was no significant difference in the mean value of γ0between the two accelerators (P=0.332).When γvalue reached the maximum,the values on the x and y axes were0.65 and-0.30 mm for Varian accelerator and 0.01 and 0.30 mm for Elekta accelerator,respectively.Conclusions In the same TPS,different accelerators have different degrees of coincidence of the actual field center point with the iso-center point of TPS,to which more attention should be paid in clinical practice.

We applied Demons and accelerated Demons elastic registration algorithm in radiotherapy cone beam CT (CBCT) images, We provided software support for real-time understanding of organ changes during radiotherapy. We wrote a 3D CBCT image elastic registration program using Matlab software, and we tested and verified the images of two patients with cervical cancer 3D CBCT images for elastic registration, based on the classic Demons algorithm, minimum mean square error (MSE) decreased 59.7%, correlation coefficient (CC) increased 11.0%. While for the accelerated Demons algorithm, MSE decreased 40.1%, CC increased 7.2%. The experimental verification with two methods of Demons algorithm obtained the desired results, but the small difference appeared to be lack of precision, and the total registration time was a little long. All these problems need to be further improved for accuracy and reducing of time.
Algorithms ; Cone-Beam Computed Tomography ; Humans ; Image Interpretation, Computer-Assisted ; Imaging, Three-Dimensional ; Software