Objective To review our experience in the diagnosis and treatment of nonfunctional islet cell tumors(NICT).Method The clinicopathological data of 26 cases of NICT were retrospectively analysed and the medical literature was reviewed.Results In addition to the 26 cases seen in our center,there were 569 cases published in 37 articles in the medical literature.In China,NICT was more common in women.The male to female ratio was about 3 ∶ 7.The mean age of onset of the disease was 35 years old.Most NICT were solitary and malignant,surgery was effective in prolonging long-term survival.Conclusions NICT is rare and it had no specific clinical presentation.BUS and CT are useful for diagnosis and surgery is effective.

Objective To investigate the indication,techniques,safety and efficacy of medical suture versus traditional suturein thoracoscopic surgery incision closure.Methods From October 2014 to January 2016,121 patients undergoing thoracoscopic surgery were divided into two groups according to the method of incision closure:53 cases of traditional suture group and 68 cases of medical suture hasp group.The time of closure,healing time,wound healing scores and patient's satisfaction were recorded and statistically analyzed.Results All patients were successfully operated without perioperative death.One patient underwent postoperative bleeding in the medical suture hasp group.The medical suture hasp was found to be reliable and easy to remove in secondary operation.The postoperative incision was changed to traditional suture.Two patients in each group had delayed healing.Two patients of medical suture hasp group were caused by incision bleeding,of whom one case switched to traditional suture,and one patient was treated with pressure bandage and healed.The wound closure time of the medical suture hasp group was significantly shorter than that of the traditional suture group:(110.0 ± 12.7) s vs.(305.0 ± 31.6) s,P ＜ 0.01.The wound healing scores of medical suture hasp group were higher than those of traditional suture group 2 weeks and 1 month after surgery (P ＜ 0.01).There was no significant difference in healing rate between two groups (P ＞ 0.05).The satisfaction scores of the patients in medical suture hasp group were higher than those in traditional suture group (P ＜ 0.01).Conclusions The use of medical suture hasp in the thoracoscopic surgical incision closure process is safe and reliable.It can accelerate the early repair of incision,and improve patient's satisfaction.

Objective To detect the damage incidence rate of liver and myocardium in infantile rotavirus (RV) enteritis.And to provide the basis for prevention and cure of liver and myocardium damage in infantile RV enteritis.Methods The liver function and myocardial enzyme detection results of 395 patients with infantile RV enteritis were collected .These results were compared with those of 40 healthy kids from health examinations . Results The levels of alanine aminotransferase ( ALT ) , aspartate amino transferase ( AST ) , serum creatine kinase (CK) and serum creatine kinase isozyme(CK-MB) from infantile patients were (34.49 ±29.13)U/L,(52.44 ± 24.10)U/L,(141.75 ±132.22)U/L and (48.69 ±32.53)U/L,respectively,which were higher than those of the healthy control [(16.00 ±3.24)U/L,(29.90 ±3.76)U/L,(101.82 ±64.56)U/L and (22.32 ±8.98)U/L,t=4.008,5.901,3.982,5.64,all P<0.05].The abnormal occurrence rates of ALT ,AST,CK and CK-MB in infantile patients were 19.49％,73.16％,12.15％,73.16％,respectively,which were higher than those in healthy controls (2.50％,20.00％,0.00％,0.00％),the differences were statistically significant (χ2 =7.128,47.397,5.464, 300.239,all P<0.05).The incidence rates of liver and myocardium damage were 19.49％and 73.16％,respectively. Conclusion There are higher incidence rates of liver and myocardium damage in infantile RV enteritis .So for the infantile RV enteritis patients ,it is necessary to detect the liver function and myocardial enzyme level .The treatment for infantile RV enteritis should be included liver and myocardial protection except antivirus and correcting dehydration .

Objective: To analyze the clinical characteristics of patients with adult onset Still's disease (AOSD) with interstitial lung diseases (ILD), and review the literature. Methods: The medical records of inpatients with AOSD and ILD from January 2000 to October 2017 were retrospectively analyzed, and pa-pers were searched and summarized with the key words "adult onset Still's disease" and "interstitial lung diseases". Kolmogorov-Smirnov test was used to test if variables met normal distribution. Measurement data which was normally distributed was described as Mean±SD. Measurement data which was not normally distributed was described as median and interquartile range. Results: Among the 15 patients included in the study, six were male, and nine were female, and the mean age was (50±12) years. All of the 15 patients had fever, and the average temperature was (39.4±0.4) ℃. Eleven patients had rash, and 12 patients had arthralgia, seven patients presented with cough, and eight patients presented with short of breath. The high resolution computed tomography of the chest presented as ground glass opacity in nine patients, grid shadow in three patients and consolidation in three patients. All the 15 patients received glucocorticoids, and 10 patients received immunosuppressants at the same time. One patient was lost to follow up, four patients died (three patients died of respiratory failure and one patient died of myocardial infarction), 10 patients improved. Conclusion Patients with AOSD can also have ILD, which should be alerted by clinicians. Early treatment with glucocorticoids and immunosuppressants if infection is excluded may bring good prognosis, and it is easy to relapse when glucocorticoids is tapered off.

Objective:To explore the material basis and potential mechanism of Sanhuang Yishen Capsules in the treatment of diabetes through network pharmacology, molecular docking and experimental verification.Methods:The active components and targets of Sanhuang Yishhen Capsules were screened using China Natural product chemical composition database and SymMap database, and the related targets of T2DM were screened by GeneCards database. The "Chinese materia medica-active component-target" network was constructed, and the intersection genes were enriched by GO and KEGG using R language. Key active components were selected for molecular docking verification with potential core targets. 60 rats were divided into normal group, model group, and Sanhuang Yishen Capsules group according to random number table method, with 15 rats in each group. In addition to the normal group, the diabetic rat model was prepared in the other groups, and the corresponding drugs were intragastric in each group for 8 weeks. The levels of fasting blood glucose (FBG), fasting insulin (FINS) and insulin resistance index (HOMA-IR) were measured by radioimmunoassay. Western blotting was used to detect protein expressions of epidermal growth factor receptor (EGFR), epidermal growth factor (EGF), Akt serine/threonine kinase 1 (AKT1), recombinant tumor protein p53 (TP53), and recombinant caspase 3 (CASP3).Results:A total of 160 active components and 298 targets of Sanhuang Yishen Capsules, 2194 targets related to T2DM, and 166 intersection targets were obtained. GO and KEGG analyzed a series of biological reaction processes mainly involved in signal transduction, oxidative stress, apoptosis, etc., and mainly involved in the regulation of P13K/Akt, P53, CASP3 and other targets. The results of molecular docking showed that the main active components obtained by screening had strong binding with the target. Compared with model group, FBG, FINS, HOMA-IR, TP53 and CASP3 in Sanhuang Yishen Capsules group decreased ( P<0.05), EGFR, EGF and Akt1 proteins increased ( P<0.05). Conclusion:The mechanism of Sanhuang Yishen Capsules for the treatment of may be related to the regulation of EGF/EGFR/P13K/Akt signaling pathway, TP53 signaling pathway, CASP3 signaling pathway, PPARG signaling pathway, ESR1 signaling pathway, PTGS2 signaling pathway, CAT signaling pathway and CTNNB1 signaling pathway.

Patients with severe trauma require an extremely timely treatment and transfusion plays an irreplaceable role in the emergency treatment of such patients. An increasing number of evidence-based medicinal evidences and clinical practices suggest that patients with severe traumatic bleeding benefit from early transfusion of low-titer group O whole blood or hemostatic resuscitation with red blood cells, plasma and platelet of a balanced ratio. However, the current domestic mode of blood supply cannot fully meet the requirements of timely and effective blood transfusion for emergency treatment of patients with severe trauma in clinical practice. In order to solve the key problems in blood supply and blood transfusion strategies for emergency treatment of severe trauma, Branch of Clinical Transfusion Medicine of Chinese Medical Association, Group for Trauma Emergency Care and Multiple Injuries of Trauma Branch of Chinese Medical Association, Young Scholar Group of Disaster Medicine Branch of Chinese Medical Association organized domestic experts of blood transfusion medicine and trauma treatment to jointly formulate Chinese expert consensus on blood support mode and blood transfusion strategies for emergency treatment of severe trauma patients ( version 2024). Based on the evidence-based medical evidence and Delphi method of expert consultation and voting, 10 recommendations were put forward from two aspects of blood support mode and transfusion strategies, aiming to provide a reference for transfusion resuscitation in the emergency treatment of severe trauma and further improve the success rate of treatment of patients with severe trauma.