Laparoscopic sleeve gastrectomy(LSG)is an effective intervention for obesity and its co-morbidities.The utilization rate of LSG in bariatric surgery continues to increase due to its high safety and sig-nificant efficacy.The utilization rate of LSG in bariatric surgery continues to increase.This procedure not only achieves sustained weight loss but also effectively improves metabolic complications in obese patients.Howev-er,studies have shown that LSG may potentially increase the risk of gastroesophageal reflux disease(GERD).Long-term reflux not only reduces postoperative quality of life but may also become an important risk factor for esophageal cancer.Therefore,preventing GERD after LSG in obese patients holds significant clinical impli-cations.In recent years,anti-reflux procedures have gradually gained prominence in the surgical treatment of GERD,demonstrating favorable outcomes.Nevertheless,the application of anti-reflux surgical techniques in bariatric surgery remains uncommon.This article reviews the current status of combining anti-reflux proce-dures with LSG in obese patients,discussing their feasibility,effectiveness,and potential advantages.

Objective To compare the safety and effectiveness of two different flow diverter devices between Tubridge flow diverter(TFD)and Surpass Streamline flow diverter(SFD)in the treatment of unruptured intracranial aneurysms.Methods A retrospective analysis from August 2020 to December 2023 was performed on the clinical data of 62 cases of unruptured aneurysms in the Department of Interventional Radiology(Shinan Branch),the Affiliated Hospital of Qingdao University treated with flow diverter.According to the type of implanted stents,they were divided into TFD group(32 cases)and SFD group(30 cases),general information about patients was collected,including age,sex,and past history(hypertension,diabetes,coronary heart disease),hospitalization time,surgical time(anesthesia start to anesthesia awakening time)and aneurysm location(anterior circulation,posterior circulation),type(giant aneurysm:maximum diameter ≥ 25 mm,large aneurysm:maximum diameter 15-＜25 mm,medium aneurysm:maximum diameter 5-＜15 mm,small aneurysm:maximum diameter＜5 mm),aneurysm morphology(saccular aneurysm,simple fusiform aneurysm,dissecting aneurysm),aneurysm maximum diameter,aneurysm neck,parent artery diameter,aneurysm wall enhancement in preoperative high-resolution MRI scan.Different types of flow diverters were selected according to the results of Surpass intracranial aneurysm embolization system pivotal trial to treat large or giant wide neck aneurysms(SCENT)and intracranial aneurysms managed by parent artery reconstruction using Tubridge flow diverter study(IMPACT).If"ejection sign"was found at the aneurysm neck on angiography immediately after the release of flow diverters,appropriate amount of coils were packed.Tamponade until there is no contrast filling in the aneurysm body on cerebral angiography,at which time the operation is terminated.If there is no"ejection sign"immediately after the release of the flow diverter,the procedure is terminated.Angiography was performed immediately after operation to evaluate the parent artery stenosis(patency[stenosis rate ≤50％],stenosis[stenosis rate＞50％]or occlusion[stenosis rate 100％])degree of aneurysm occlusion.O'Kelly-Marotta(OKM)classification was used to evaluate the degree of aneurysm occlusion.Effectiveness evaluation:DS A follow-up was performed≥1 month after operation,and the final angiographic result was taken as the final follow-up result to evaluate the postoperative aneurysm occlusion(OKM grade D:complete aneurysm occlusion,other grades:incomplete aneurysm occlusion),parent artery stenosis or occlusion.Safety evaluation:the clinical efficacy of patients at the last postoperative follow-up was evaluated by modified Rankin scale(mRS)score(mRS score 0-2:good clinical prognosis,mRS score 3-6:poor clinical prognosis),and perioperative(≤2 weeks after surgery)complications(ischemic complications,bleeding complications and other complications)were counted.The clinical effects and complications of the two groups were compared.Results A total of 62 aneurysms in 62 patients were included in the study.All patients were treated with a single flow diversion device.There were 28 males and 34females,aged 32 years to 76 years,with an average of(57±10)years.There were 39 anterior circulation aneurysms and 23 posterior circulation aneurysms.Among 62 patients,43 patients had saccular aneurysm,4 patients had simple fusiform aneurysm and 15 had dissecting aneurysm.Among them,38 saccular aneurysms were located in the anterior circulation and 5 in the posterior circulation;1 simple fusiform aneurysm was located in the anterior circulation and 3 in the posterior circulation;all dissecting aneurysms were located in the posterior circulation.The maximum diameter of the aneurysm ranged from 2.0 mm to 27.0 mm,with a median of 7.0(5.0,12.0)mm,and the aneurysm neck ranged from 2.0 mm to 18.5 mm,with a median of 5.0(4.0,6.7)mm.(1)There were statistically significant differences in aneurysm location and shape distribution between TFD group and SFD group(both P＜0.05),but there were no statistically significant differences in other general data(all P＞0.05).(2)The incidence of perioperative complications was 6.3％(2/32)in TFD group and 10.0％(3/30)in SFD group,and there was no significant difference between two groups(P=0.940).The good clinical outcome rate of both groups were 100.0％at the last follow-up.(3)All patients were followed up with DS A after operation.The follow-up time ranged from 55 d to 1 150 d,with a median follow-up time of 205.0(108.0,360.0)d.There was no significant difference in OKM classification distribution immediately after operation(P=0.607)and complete occlusion rate at the last follow-up(53.1％[17/32]vs.63.3％[19/30],P=0.416)between two groups.At the last follow-up,no parent artery stenosis or occlusion occurred in either group.Conclusions TFD has comparable efficacy and safety as SFD in the treatment of unruptured intracranial aneurysms.The results of this study need to be further verified by prospective large sample study.

ObjectiveTo provide reference for further strengthening the management of laboratory animals in Sichuan Province by reviewing and analyzing the results of parasitic and microbial quality inspections of laboratory animals from 2017 to 2023. Methods Sichuan Province has 31 licensed laboratory animal production units, with the main species including mice, rats, guinea pigs, rabbits, dogs, monkeys, and pigs. Sampling inspections and reports were conducted for units with laboratory animal production qualifications in accordance with current national and local standards for laboratory animal classification. The quality inspection results for various laboratory animals in Sichuan Province from 2017 to 2023 were analyzed. Results With the exception of 2018, annual quality inspections of laboratory animals were conducted every year between 2017 and 2023. Mice: In 2017, positive results for helminths, flagellates, Salmonella, murine hepatitis virus antibodies, and murine pneumonia virus antibodies were detected, with a pass rate of only 42.9%. In 2019, Staphylococcus aureus and Klebsiella pneumoniae were detected, with a pass rate of 86.7%. In 2021, Sendai virus antibodies were detected, yielding a pass rate of 85.7%.The pass rate in 2020, 2022, and 2023 was 100%. Rats: In 2017, positive results were found for helminths, mycoplasma antibodies, Staphylococcus aureus, Sendai virus antibodies, murine pneumonia virus antibodies, rat parvovirus RV strain antibodies, rat parvovirus (H-1) strain antibodies, and rat coronavirus antibodies, with a pass rate of 40.0%. In 2019, mycoplasma antibodies, Staphylococcus aureus and Klebsiella pneumoniae were detected, with a pass rate of 35.0%. No positive indicators were detected in 2020. In 2021, Sendai virus antibodies and rat parvovirus RV strain antibodies were detected, with a pass rate of 50.0%. In 2022, positive results for rat parvovirus RV strain antibodies were found, yielding a pass rate of 87.5%. In 2023, Pasteurella pneumotropica and Klebsiella pneumoniae were detected, with a pass rate of 85.7%. Dogs: In 2017 and 2019, the antibody titers for rabies virus and canine distemper virus were below the required standard, with pass rates of 33.3% and 20.0%, respectively. In 2020 and 2022, the pass rate was 100%. Guinea pigs (general grade): In 2019, positive results for Toxoplasma antibodies were detected, with a pass rate of 80.0%. In all other years, the pass rate was 100%. Monkeys: In 2019, positive results for Toxoplasma gondii and rhesus herpesvirus type I antibodies were found, with a pass rate of 87.5%.In 2020 and 2022, rhesus herpesvirus type I antibodies were positively detected, yielding pass rates of 93.3% and 97.5%, respectively. The pass rates in 2021 and 2023 were 100%. Clean guinea pigs, rabbits and pigs all passed the inspection each year. ConclusionIssues related to the parasitic and microbial quality of laboratory animals persist in Sichuan Province. Supervision and sampling inspections have proven to be effective in identifying these issues promptly, serving as a critical measure to ensure the quality of laboratory animals. The results of these inspections offer valuable data to support the healthy development of the laboratory animal industry in Sichuan Province.

Objective To compare the safety and effectiveness of two different flow diverter devices between Tubridge flow diverter(TFD)and Surpass Streamline flow diverter(SFD)in the treatment of unruptured intracranial aneurysms.Methods A retrospective analysis from August 2020 to December 2023 was performed on the clinical data of 62 cases of unruptured aneurysms in the Department of Interventional Radiology(Shinan Branch),the Affiliated Hospital of Qingdao University treated with flow diverter.According to the type of implanted stents,they were divided into TFD group(32 cases)and SFD group(30 cases),general information about patients was collected,including age,sex,and past history(hypertension,diabetes,coronary heart disease),hospitalization time,surgical time(anesthesia start to anesthesia awakening time)and aneurysm location(anterior circulation,posterior circulation),type(giant aneurysm:maximum diameter ≥ 25 mm,large aneurysm:maximum diameter 15-＜25 mm,medium aneurysm:maximum diameter 5-＜15 mm,small aneurysm:maximum diameter＜5 mm),aneurysm morphology(saccular aneurysm,simple fusiform aneurysm,dissecting aneurysm),aneurysm maximum diameter,aneurysm neck,parent artery diameter,aneurysm wall enhancement in preoperative high-resolution MRI scan.Different types of flow diverters were selected according to the results of Surpass intracranial aneurysm embolization system pivotal trial to treat large or giant wide neck aneurysms(SCENT)and intracranial aneurysms managed by parent artery reconstruction using Tubridge flow diverter study(IMPACT).If"ejection sign"was found at the aneurysm neck on angiography immediately after the release of flow diverters,appropriate amount of coils were packed.Tamponade until there is no contrast filling in the aneurysm body on cerebral angiography,at which time the operation is terminated.If there is no"ejection sign"immediately after the release of the flow diverter,the procedure is terminated.Angiography was performed immediately after operation to evaluate the parent artery stenosis(patency[stenosis rate ≤50％],stenosis[stenosis rate＞50％]or occlusion[stenosis rate 100％])degree of aneurysm occlusion.O'Kelly-Marotta(OKM)classification was used to evaluate the degree of aneurysm occlusion.Effectiveness evaluation:DS A follow-up was performed≥1 month after operation,and the final angiographic result was taken as the final follow-up result to evaluate the postoperative aneurysm occlusion(OKM grade D:complete aneurysm occlusion,other grades:incomplete aneurysm occlusion),parent artery stenosis or occlusion.Safety evaluation:the clinical efficacy of patients at the last postoperative follow-up was evaluated by modified Rankin scale(mRS)score(mRS score 0-2:good clinical prognosis,mRS score 3-6:poor clinical prognosis),and perioperative(≤2 weeks after surgery)complications(ischemic complications,bleeding complications and other complications)were counted.The clinical effects and complications of the two groups were compared.Results A total of 62 aneurysms in 62 patients were included in the study.All patients were treated with a single flow diversion device.There were 28 males and 34females,aged 32 years to 76 years,with an average of(57±10)years.There were 39 anterior circulation aneurysms and 23 posterior circulation aneurysms.Among 62 patients,43 patients had saccular aneurysm,4 patients had simple fusiform aneurysm and 15 had dissecting aneurysm.Among them,38 saccular aneurysms were located in the anterior circulation and 5 in the posterior circulation;1 simple fusiform aneurysm was located in the anterior circulation and 3 in the posterior circulation;all dissecting aneurysms were located in the posterior circulation.The maximum diameter of the aneurysm ranged from 2.0 mm to 27.0 mm,with a median of 7.0(5.0,12.0)mm,and the aneurysm neck ranged from 2.0 mm to 18.5 mm,with a median of 5.0(4.0,6.7)mm.(1)There were statistically significant differences in aneurysm location and shape distribution between TFD group and SFD group(both P＜0.05),but there were no statistically significant differences in other general data(all P＞0.05).(2)The incidence of perioperative complications was 6.3％(2/32)in TFD group and 10.0％(3/30)in SFD group,and there was no significant difference between two groups(P=0.940).The good clinical outcome rate of both groups were 100.0％at the last follow-up.(3)All patients were followed up with DS A after operation.The follow-up time ranged from 55 d to 1 150 d,with a median follow-up time of 205.0(108.0,360.0)d.There was no significant difference in OKM classification distribution immediately after operation(P=0.607)and complete occlusion rate at the last follow-up(53.1％[17/32]vs.63.3％[19/30],P=0.416)between two groups.At the last follow-up,no parent artery stenosis or occlusion occurred in either group.Conclusions TFD has comparable efficacy and safety as SFD in the treatment of unruptured intracranial aneurysms.The results of this study need to be further verified by prospective large sample study.

Objective:To investigate the hippocampal subfield volumes before and after taking hydrochloric donepezil in patients with mild Alzheimer's disease (AD). Methods:From January, 2017 to June, 2018, 25 mild AD patients accepted hydrochloric donepezil (treatment group), 25 patients accepted placebo (placebo group) and 25 age- and gender-matched healthy old people (control group) were scanned with magnetic resonance imaging (MRI) under 3D-T₁ TFE sequence before and after a six-month treatment, and the automated segmentation of the hippocampus subfields was fulfilled with FreeSurfer and the hippocampus subfield volumes were compared, while the patients were assessed with Mini-Mental State Examination (MMSE). Results:Compared with the control group, the volumes of left CA1， CA2-3 and CA4-DG, and right CA1 and CA2-3 were reduced in patients before treatment (t > 2.294, P < 0.05). The volume of left CA4-DG increased in the treatment group compared with that of the placebo group after treatment (t = 2.196, P < 0.05), and the volume of bilateral CA1 and CA2-3 tended to increase but not significantly (t < 1.888, P > 0.065). The MMSE score was more in the treatment group than in the placebo group after treatment (t = 2.764, P < 0.05). Conclusion:The association with asymmetric atrophy in the hippocampal subfields has been found in mild AD patients, especially in left CA4-DG, which may be used as a valuable marker for diagnosis and evaluation for treatment at early stage.

Post-traumatic tetanus is the main type of non-neonatal tetanus.To reduce the incidence and mortality rateof tetanus and guide the primary medical institutions to prevent and control tetanus after trauma,the National Immunization Planning Technical Working Group of the Chinese Center for Disease Control and Prevention has compiled this document in the reference with Position Paper by World Health Organization,and the latest research progress both at home and abroad.The guidelines focus on the basic procedures for the prevention and treatment of post-traumatic tetanus,the application of tetanus vaccines and immune preparation,and pre-exposure immunization in high-risk populations of trauma.

Post-traumatic tetanus is the main type of non-neonatal tetanus. To reduce the incidence and mortality rate of tetanus and guide the primary medical institutions to prevent and control tetanus after trauma, National Immunization Planning Technical Working Group of the Chinese Center for Disease Control and Prevention has compiled this document in the reference with Position Paper by World Health Organization, the latest research progress from home and abroad. The guidelines focus on the basic procedures for the prevention and disposition of post-traumatic tetanus, the application of tetanus vaccines and immune preparation, and the pre-exposure immunization in high-risk populations of trauma.