OBJECTIVE: To explore the mechanism of Chaiqin Chengqi Decoction (CQCQD) in treatment of rats with acute necrotizing pancreatitis (ANP). METHODS: Thirty SD rats were randomly divided into 3 groups: sham-operated (SO) group, ANP group and CQCQD-treated group. ANP was induced by retro-pumping 3.5% sodium cholate to common bile duct. Blood sample was collected from abdominal vein for examination and the pancreatic tissue samples were taken for making pathology section 6 hours later. The pancreatic tissue (HE staining) was observed by light microscope. The content of tumor necrosis factor-alpha (TNF-alpha) and interleukin-6 (IL-6) was detected with the method of enzyme-linked immunosorbent assay, and the activation of nuclear factor-kappaB (NF-kappaB) in pancreas was detected by immunohistochemical method. RESULTS: Compared with the SO group, there was dramatic increase in the white blood cell (WBC) counts and AMY level in the ANP group (P<0.05, P<0.01). Compared with the ANP group, the WBC counts and AMY level in CQCQD-treated group were significantly reduced (P<0.05). The edema, inflammatory infiltration, haemorrhage and necrosis scores and total pathological score in the ANP group were obviously higher than those in the SO group (P<0.01). The edema, haemorrhage and inflammatory infiltration scores and the total pathological score in CQCQD-treated group were decreased (P<0.05). The integral optical density of NF-kappaB p65 positive cells of pancreas in CQCQD-treated group was lower than that in the ANP group (P<0.05). CONCLUSION: CQCQD can reduce the content of serum TNF-alpha and IL-6, depress the activation of NF-kappaB, and lessen the pancreatic lesions.

Objective To explore the diagnostic value of MRI in adnexal torsion.Methods A retrospective study was conducted on 32 patients with adnexal torsion confirmed by surgery and pathology.The MRI features were analyzed in combination with clinical data.Results Among the 32 cases of adnexal torsion,there were 12 cases of ovarian cyst,5 cases of cystic ovarian teratoma,4 cases of theca cell tumor,6 cases of ovarian cystadenoma,1 case of high-grade serous carcinoma,1 case of corpus luteum hematoma,1 case of simple ovarian torsion,1 case of ovarian goiter,1 case of fibrotheca cell tumor with serous cystadenoma;There were 13 cases on the left side and 19 cases on the right side;The torsion angle of adnexal was about 90 °-1 440 °.MRI showed that 13 of 32 patients were cystic masses and 19 were cystic solid masses;torsion pedicle can be seen near the mass,of which 13 cases showed"whirlpool sign",27 cases showed"T2WI dot low signal sign",10 cases showed"nodule sign",5 cases showed"triangle sign",and 9 cases had structural disorder around the mass.Enhancement showed no obvious enhancement in 12 cases,and mild enhancement in 20 cases.Thirty cases complicated with pelvic effusion;The uterus moved to the affected side in 9 cases,to the healthy side in 20 cases,and no obvious deviation in 3 cases.Conclusion The MRI imaging features of adnexal torsion are characteristic,which are cystic or cystic solid lesions.The torsion pedicle is characterized by"whirlpool sign"and"T2WI dot low signal sign",etc.The enhancement is mild or no enhancement.Combined with the clinical history,it is of great value for the preoperative diagnosis and treatment of adnexal torsion.

End-stage renal disease (ESRD) patients undergoing outpatient hemodialysis (HD) and home peritoneal dialysis (PD) are high risk population of severe and critical types caused by SARS-CoV-2 infection. In order to improve the quality of diagnosis and treatment in dialysis patients with SARS-CoV-2 infection, we wrote this recommendation for primary care clinicians. During the epidemic period of SARS-CoV-2 infection, all patients should be instructed to strengthen self-management. Once the SARS-CoV-2 infection was found in dialysis patients, early stratified management should be carried out within 72 hours after the first positive nucleic acid or antigen test results, which includes early antiviral therapy, early recognition, and transferring severe patients from community or primary hospital to a referral hospital promptly. Guidance for dietary and sports rehabilitation after SARS-CoV-2 infection should also be started as soon as possible.