ObjectiveTo observe the easing pain effect of being used Guishen Pain-Killer, a Chinese medicine, for improving the anaesthesia project which was used in using micro-wave heating among tissue to treat hemorrhoid.MethodsOn the basic of the original anaesthesia project, patients drunk the Chinese medicine Guishen Pain-Killer 50ml which was heated to 40℃ by microwave stove for pre-anaesthesia drug 10 minutes before the operation. The effect of adding drinking Guishen Pain-Killer and of merely using the original anaesthesia project were estimated with the McGill Questionnaire and stated the data with u test.ResultsThe pain estimation of those patients who drunk Guishen Pain-Killer before operation was (1.71±1.05) and (1.32±0.83), in operation and just after operation,while that of patients who didn't drink Guishen Pain-Killer before operation was (2.58±1.03) and (1.93±1.11),P<0.01.ConclusionGuishen Pain-Killer can be used as the pre-anaesthesia drug in micro-wave heating among tissue to treat hemorrhoids.

Objective To investigate the diagnosis and treatment of the blunt pancreatic injury.Methods The clinical data of 21 blunt pancreatic trauma patients admitted to our hospital in the past 5 years were analyzed retrospectively.Results 3 of 21 patients were simple blunt pancreatic injury, while the other 18 patients were complicated with other abdominal organs injuries.According to the grading criteria, the number of Ⅰ , Ⅱ, Ⅲ, Ⅳ, Ⅴ grade injury were 4, 7, 5, 3 and 2 cases, respectively, and only 9 patients were diagnosed by CT before operation, and the diagnosis was confirmed during the operation in 11 patients, and 1 was miediagnosed in the first operation.Single drainage or debridement and drainage were performed in 8 cases and distal pancreatectomy with and without spleen were performed in 5 and 3 cases, respectively, and 3patients received pancreaticojejunostomy, 1 received Whipple operation, the other 1 case underwent duodenorrhahy and diverticulation.The mortality rate was 9.5% (2/21), and the complications of pancreatic pseudocyst and fistula developed in 2 (9.5%, 2/21 ) and 5 (23.8%, 5/21 ) cases respectively, and they were cured by drainage, while the other 12 were cured completely.Conclusions The preoperative misdiagnosis rate of pancreatic trauma is high;CT scan should be used to confirm the diagnosis.Careful pancreatic exploration is mandatory and simple and effective surgical procedures with effective drainage is important for treatment success.

OBJECTIVE:To evaluate the effects of different doses of flurbiprofen axetil on analgesia effects of patients after laparoscopic cholecystectomy. METHODS:120 patients undergoing laparoscopic cholecystectomy were selected and randomly divid-ed into group A,B and C,with 40 cases in each group. Group A,B and C were given the mixture 100 ml of flurbiprofen axetil 100,150 and 200 mg combined with tramadol 600 mg and ondansetron 4 mg respectively and 0.9% Sodium chloride injection for patient controlled intravenous analgesia(PCIA)at the end of operation. Mean arterial pressure(MAP),heart rate(HR)and static and dynamic visual analogue scale(VAS)scores were observed in 3 groups at the end of operation,4,8,24 and 36 h after sur-gery. The incidence of incision pain,neck-shoulder pain and hypochondrium,the occurrence of ADR were recorded 36 h after oper-ation. RESULTS:After operation,There was no statistical significance in comparison of 3 groups with MAP,HR,static and dynam-ic VAS(P>0.05),4,8,24,and 36 h after operation,MAP,HR,static and dynamic VAS score of group B and C decreased sig-nificantly,there was statistical significance,compared with group A(P<0.05);there was no statistical significance in above indi-cators between group B and group C(P>0.05). After operation,the incidence of incision pain,neck-shoulder pain and hypochon-drium in group A were significantly higher than group B and C,with statistical significance(P<0.05),but there was no statistical significance between group B and group C(P>0.05). After operation,the incidence of ADR in group A and B were significantly lower than in group C,with statistical significance(P<0.05),but there was no statistical significance between group A and group B(P>0.05). CONCLUSIONS:Flurbiprofen axetil 150 mg combined with tramadol 600 mg and ondansetron 4 mg can improve he-modynamics and patient controlled intravenous analgesia in patients underwent laparoscopic cholecystectomy with lower incidence of ADR.

Background:Esophageal non-variceal hemorrhage is relatively uncommon in clinical,however,it can be life-threatening in severe cases. Thus,retrospective analysis of esophageal non-variceal hemorrhage could provide important evidence for its diagnosis and treatment. Aims:To analyze the clinical characteristics of esophageal non-variceal hemorrhage. Methods:A total of 175 cases of esophageal non-variceal hemorrhage from January 2006 to December 2016 at Daping Hospital were enrolled. Gender,age,cause of bleeding,location of bleeding,season of onset,treatment and prognosis were retrospectively analyzed. Results:The ratio of male to female was 3. 5: 1 in 175 patients with esophageal non-variceal hemorrhage,73. 1％ of patients were middle-aged and elderly. The main cause of bleeding of esophageal non-variceal hemorrhage were cardiac mucosal laceration syndrome (46. 9％),esophageal cancer (23. 4％),esophageal ulcer (12. 6％)and esophageal foreign body (12. 0％). The most common site of bleeding was lower esophagus (70. 9％). Fifty-one patients accepted endoscopic treatment or surgery. After treatment,142 patients (81. 1％)were cured or improved,and death was occurred in 27 patients (15. 4％). Conclusions:The incidence of esophageal non-variceal hemorrhage is higher in male than in female,and is commonly seen in middle-aged and elderly patients. The most common cause of bleeding of esophageal non-variceal hemorrhage is cardiac mucosal laceration syndrome,and the most common site of bleeding is lower esophagus. Medicine combined with endoscopic treatment is effective for most of the patients.

Liver failure is a common critical medical disease, and extensive liver cell necrosis within a short period of time exceeds the regeneration capacity of liver cells and thus results in an extremely high fatality rate. Promotion of effective liver regeneration is the key to antagonizing liver failure. Recent studies have shown that bile acid, farnesoid X receptor (FXR), and intestinal microecology play an important role in liver failure and liver regeneration. This article reviews the association between bile acid, FXR, and intestinal microecology and their role in liver failure and liver regeneration, so as to provide new ideas for the treatment of liver failure in clinical practice.

The Wnt signaling pathway plays an important role in maintaining liver homeostasis and liver regeneration. In healthy livers， the Wnt signaling pathway is mostly inactive， but it is continuously overactivated during cell renewal or regeneration processes， as well as in certain pathological conditions， diseases， precancerous states， and cancers. Persistent liver cell injury often leads to chronic liver diseases such as liver fibrosis， liver cirrhosis， and liver cancer. This article summarizes the basic structural features of the Wnt signaling pathway and analyzes its important role in the pathological progression of various liver diseases， so as to provide new ideas for the prevention and treatment of liver diseases in clinical practice.

OBJECTIVE To explore the the reg ulation of intestinal flora and effects of Qingjie huagong decoction on intestinal mucosal barrier in severe acute pancreatitis （SAP）mode rats . METHODS SAP rat model was induced by intraperitoneal injection of caerulein and lipopolysaccharide.The survival state of rats in each group were observed.The levels of serum amylase ，interleukin 10（IL-10），IL-18 and IL- 1β in serum were all detected. The pathological changes of pancreatic and small intestinal tissue were observed. The expressions of Occludin，ZO-1 and HMGB1 were detected in small intestinal tissue of rats. The structure and relative abundance of intestinal microflora in rats were detected by 16S rRNA high throughput sequencing. RESULTS After the intervention of Qingjie huagong decoction ，abdominal distension symptoms of SAP model rats were significantly relieved ，and their mental state recovered better ；the levels of serum amylase and IL- 18 in serum were decreased significantly （P＜0.05），while the level of IL- 10 was increased significantly （P＜0.05）. The necrotic area of pancreatic tissue and the infiltration of inflammatory cells were reduced ， the degree of intestinal epithelial cell structural disorder was alleviated ，and the shedding of intestinal mucosal epithelium was reduced.The protein expression of HMGB 1 in small intestinal tissue was decreased significantly （P＜0.05），and the protein expression of Occludin and ZO- 1 were increased significantly . Results of 16S rRNA high throughput sequencing showed that Qingjie huagong decoction could increased the relative abundance of probiotics such as Bacteroidea and Lactobacillus in rat intestine ，reduced the colonization of harmful bacteria such as Firmicutes. CONCLUSIONS Qingjie huagong decoction can improve the intestinal barrier by up-regulating the expression of Occludin and ZO- 1 in small intestinal tissue and down-regulating the protein expression of HMGB 1. It can also adjust the relative abundances of different flora to protect the intestinal tract.

ObjectiveTo investigate the role and possible mechanism of action of rhubarb decoction （RD） retention enema in improving inflammatory damage of brain tissue in a rat model of mild hepatic encephalopathy （MHE）. MethodsA total of 60 male Sprague-Dawley rats were divided into blank group （CON group with 6 rats） and chronic liver cirrhosis modeling group with 54 rats using the complete randomization method. After 12 weeks， 40 rats with successful modeling which were confirmed to meet the requirements for MHE model by the Morris water maze test were randomly divided into model group （MOD group）， lactulose group （LT group）， low-dose RD group （RD1 group）， middle-dose RD group （RD2 group）， and high-dose RD group （RD3 group）， with 8 rats in each group. The rats in the CON group and the MOD group were given retention enema with 2 mL of normal saline once a day； the rats in the LT group were given retention enema with 2 mL of lactulose at a dose of 22.5% once a day； the rats in the RD1， RD2， and RD3 groups were given retention enema with 2 mL RD at a dose of 2.5， 5.0， and 7.5 g/kg， respectively， once a day. After 10 days of treatment， the Morris water maze test was performed to analyze the spatial learning and memory abilities of rats. The rats were analyzed from the following aspects： behavioral status； the serum levels of alanine aminotransferase （ALT）， aspartate aminotransferase （AST）， interleukin-1β （IL-1β）， interleukin-6 （IL-6）， and tumor necrosis factor-α （TNF-α） and the level of blood ammonia； pathological changes of liver tissue and brain tissue； the mRNA and protein expression levels of phosphatidylinositol 3-kinase （PI3K）， protein kinase B （AKT）， and mammalian target of rapamycin （mTOR） in brain tissue. A one-way analysis of variance was used for comparison of continuous data between multiple groups， and the least significant difference t-test was used for further comparison between two groups. ResultsCompared with the MOD group， the RD1， RD2， and RD3 groups had a significantly shorter escape latency （all P<0.01）， significant reductions in the levels of ALT， AST， IL-1β， IL-6， TNF-α， and blood ammonia （all P<0.05）， significant alleviation of the degeneration， necrosis， and inflammation of hepatocytes and brain cells， and significant reductions in the mRNA and protein expression levels of PI3K， AKT， and mTOR in brain tissue （all P<0.05）， and the RD3 group had a better treatment outcome than the RD1 and RD2 groups. ConclusionRetention enema with RD can improve cognitive function and inflammatory damage of brain tissue in MHE rats， possibly by regulating the PI3K/AKT/mTOR signaling pathway.

ObjectiveTo investigate effect of conducting training of autism spectrum disorder （ASD） early screening skill on improving the ability to early identify ASD of medical staffs in primary care hospitals. MethodsIn September 2021， the training of ASD early screening skills was carried out for medical staffs from 20 primary care hospitals in Chengdu. After training， the training effect was evaluated. The numbers of referrals from primary care hospitals to superior hospitals， confirmed ASD as well as their average diagnostic age of children with ASD before and after training were used as evaluation indicators. ResultsAfter training， the number of children with suspected ASD referred by primary care hospitals was more than that before training ［（16.65±11.60） vs. （3.40±2.23）， t=5.431， P<0.01］， the number of children diagnosed with ASD was more than that before training［（6.85±4.93） vs. （2.45±1.67）， t=4.171， P<0.01］， and the differences were statistically significant. As for the diagnosed age of ASD children， after training， the average age was lower than that before training ［（34.95±11.67） vs. （42.2±14.64）， t=-2.553， P=0.019］. ConclusionTraining of ASD early screening skills for medical staffs in primary care hospitals may help to improve their ability to early screening ASD children.