Objective To summarize the diagnosis and treatment of abdominal Castleman disease.Methods The clinical data of 17 patients with abdominal Castleman disease who were admitted to Peking Union Medical College Hospital were retrospectively analysed. Eleven patients had no symptoms, two had an abdominal mass, two had oral ulcers and rash, one had edema and was short of breath and one had dull pain in the upper abdomen and vomiting. Two patients were examined by X-ray, 17 by ultrasound, and 13 by computed tomography(CT). Results Four patients were diagnosed with abdominal Castleman disease by CT preoperatively, and the remaining 13 patients were not conclusively diagnosed. Localized lesions of 14 patients were completely resected,and three patients with multicentric lessions received partial resection or biopsy. The diagnosis of all patients was confirmed by histopathological examination. The expression of CD3, CD20, CD21 and CD34 of 14 patients with hyaline-vascular type was positive, and the expression of CD3, CD68 and PCNA of three patients with plasma-cell type was positive. One patients was lost of follow up, and the remaining 16 patients were followed up for 3-12 months, and neither metastasis nor recurrence was observed. Conclusions The clinical manifestations of abdominal Castleman disease are nonspecific, and therefore, it is difficult to acquire a definite diagnosis before operation. Early complete resection should be applied to patients with localized Castleman disease, while for patients with multicentric Castleman disease, postoperative chemotherapy is necessary for a good prognosis.

Objective To investigate the diagnosis and treatment of mesenteric fibromatosis.Methods We analyzed retrospectively the clinical data including clinical manifestation,treatment and follow-up results of the mesenteric fibromatosis in 11 cases.ResultsNine patients presented with abdominal mass.Two cases were found during other operation occasionally.Before operation,3 cases were misdiagnosed as leiomyosarcoma,1 case as malignant neurilemmoma,1 case as lymphoma.All patients were underwent surgical resection,and were diagnosed as mesenteric fibromatosis by pathology.Following-up,from 7 months to 72 months,2 cases relapsed.Conclusions The clinical feature of mesenteric fibromatosis is nonspecific.It is difficult to make correct diagnosis preoperatively.Surgical resection is the first choice for cure of patients with mesenteric fibromatosis.

Aim: To investigate the chemical components in Zhizidahuang decoction( ZZDHD) to reveal the possible material therapeutic basis. Methods: High performance liquid chromatography coupled with photodiode array detector and tandem mass spectrometry ( HPLC-PDA-MS/MS) was applied to simultaneously characterize the chemical components and their structures in ZZDHD. The analysis was preformed on a Lichrospher C_(18) column using a binary eluent of 0. 1% acetic acid( A) and methanol( B) mixed under the gradient mode; UV spectra were scaned from 210 nm to 480 nm; negative ESI experiments in data-dependent scan mode were performed. Results: HPLC-PDA-MS/MS chromatogram of ZZDHD was achieved. Based on UV spectral data, information of molecular weight and mass fragmentation behaviors connected with extracted ion current( EIC) chromatogram, twenty kinds of components were detected and identified, including flavonoids, anthraquinones, iridoids and other constituents. Conclusion: The method presented in this study, which combined HPLC with UV and MS, allowes the characterization of compounds in the complex herbal system even without the reference standards.

Objective To investigate the functional changes of anastomosed vascular or neurovascular mini-muscle transfer and to provide experimental data to clinical application. Methods 32 New Zealand rabbits were operated on by anastomosed neurovascular mini-muscle transfer. In group A, 16 rabbits accepted the anastomosed vascular mini-muscle transfer. In group B, 16 rabbits accepted the anastomosed neurovascular mini-muscle transfer. The electromyography was measured 2 months and 3 months after operation. Results The amplitude of electrical muscle graph (EMG) data in the group A was (2.02±0.41)mV 2 months after operation, and (1.73±0.18) mV 3 months after operation. The EMG data in the group B was (3.90±0.52) mV 2 months after operation and (3.35±0.86) mV 3months after opera-tion. The difference between the two groups was significant (P<0.01). The EMG of anastomosed neu-rovasular mini-muscle transfer was significantly greater than that of anastomosed vasular transfer only.There was no significant difference in latent period of EMG between the two groups (P>0.05). Conclu-sions The muscle functional recovery of anastomosed neurovascular mini-muscle transfer is significant with less demage and no secondary deformity. The results suggest that this technique is worthy to apply for treating facial paralysis.

Objective To investigate the effects of single i.v. subanesthetic dose of ketamine on heart rate, blood pressure and oxygen saturation for antidepressant treatment. Methods Patients with severe depressive disorder were randomized to ketamine group (n=13) and control group (n=14). Ketamine group received ketamine (0.5mg/kg) single injection whereas control group received saline single injection. Escitalopram (10 mg/d) were orally administered for 4 weeks simultaneously. Comparisons were made on the heart rate, blood pressure and oxygen saturation at baseline, 40 min, 100 min, and 280 min after injection between the two groups. Results The main effects of time but not group were significant for all parameters including heart rate, systolic blood pressure and diastolic blood pressure, (P＜0.05). Interaction of time×group was significant (P＜0.05). All parameters including heart rate (F=16.85, P＜0.01), systolic blood pressure (F=15.82, P＜0.01) and diastolic blood pressure (F=8.63, P＜0.01) with time were significant in ketamine group. The heart rate, systolic blood pressure and diastolic blood pressure in ketamine group were significantly higher at 40 min than at other time points (P＜0.05), while were no significant difference among other time points (P＞0.05). There was no statistical significance of main effect of time, group and interaction of time×group in oxygen saturation between the two groups (P＞0.05). Conclusion Single subanesthetic dose ketamine intravenous drip for antidepressant therapy may cause a transient increase in heart rate and blood pressure.

The emergence and evolution of digital intelligent technology has profoundly influenced the development of minimally invasive research-oriented hepatobiliary and pancreatic surgery discipline. Over various periods, our team has always adhered to the principle of "being oriented by clinical issues and driven by clinical needs", continuously carried out innovative research across interdisciplinary boundaries, propelling the evolution of digital intelligent technology. Spanning over two decades, this journey includes the progression from digital virtual human, three-dimensional visualization, molecular fluorescence imaging, augmented reality and mixed reality, artificial intelligence, to the realm of human visualization meta-universe. This evolution facilitates the shift from two-dimensional empirical diagnoses of hepatobiliary and pancreatic surgical diseases to deep learning intelligent diagnostics, the transition from morphology-based tumor diagnoses to molecular imaging-based diagnostics, and from conventional empirical surgery to intelligent navigation surgery. The authors provide a comprehensive review of our developmental process and achievements within the realm of digital intelligent diagnostic and therapeutic technologies, with the aims to promote the development and application of digital intelligent medicine.