Objective: To observe the clinical effect of modified colon instillation in the patients with severe acute pancreatitis ( SAP) and intestinal paralysis. Methods:Totally 63 cases of patients with SAP and intestinal paralysis were randomly divided into the treatment group (32 cases) and the control group (31 cases), and they were treated with different enema methods for 15 days. The pe-ripheral venous blood was collected for the detection of serum amylase (AMS), C reactive protein (CRP) and tumor necrosis factor ( TNF-α) before and after the treatment. The abdominal pain, relief time of abdominal pain, recovery time of gastrointestinal function and complications were observed. Results:Compared with those before the treatment, the serum levels of AMS, CRP and TNF-αwere decreased in both groups after the treatment, and the decrease in the treatment group was more notable than that in the control group ( P<0. 05, P<0. 01). The duration of abdominal pain, relief time of abdominal pain and the recovery time of gastrointestinal function in the treatment group were shorter than those in the control group (P<0. 01, P<0. 05). The incidence of complications in the treatment group was 12. 50%, while that in the control group was 35. 48% (P<0. 05). Conclusion:Modified colon instillation can improve the clinical efficacy, shorten the recovery time of gastrointestinal function and reduce the incidence of complications, which is worthy of clinical promotion.

Objective To evaluate the diagnostic value of MSCT in the differentiation of thymic epithelial tumours (TET)with the maximum diameter equal or less than 3 cm.Methods A retrospective analysis of pathological and imaging data of 56 patients with pathologically confirmed TET with the maximum diameter equal or less than 3 cm was performed.According to the 2004 WHO classification,56 TETs were classified as low-risk thymomas(types A/AB/B1),high-risk thymomas (types B2/B3)and thymic carcinomas (type C).The CT manifestations of TET in each group,including shape of tumor,tumor edge (smooth or spiculate protuberance), presence of small nodule around tumor,enhancement degree,pleura invasion and fat space around tumor,were analyzed retrospectively.The differences in the CT manifestations among three types were compared using chi-square test.If the sample number was too small, Fisher 's exact test was used.Results Compared with high-risk thymomas (23 cases)and thymic carcinomas (6 cases),regular round shape was more often observed in low-risk thymomas (27 cases)(χ2 =73,P <0.001;χ2 =116,P <0.001)and the mediastinum-lung interface was more likely to bulge (χ2 = 3.41,P =0.046;χ2 =7.39,P =0.01).Blurred edge,spiculate protuberance and pleural invasion and so on were significantly more common in high-risk thymomas and thymic carcinomas (P <0.001)and they were the most common in thymic carcinomas (χ2 =11.5,P =0.009).There was a significant difference between type B2 thymomas and thymic carcinomas (χ2 =31.52, P <0.001),however there was no significant difference between type B3 thymomas and thymic carcinomas (χ2 =6.96,P =0.07). Conclusion MSCT can accurately show the shape of tumor,tumor edge,presence of small nodule around tumor,enhancement degree,pleura invasion,which can predict the histologic type of thymomas and also can provide information for preoperative diagnosis and prognosis evaluation.

Objective:To evaluate the safety and efficacy of intra-arterial tirofiban infusion during endovascular reperfusion therapy in patients with acute cardiogenic cerebral embolism.Methods:Clinical data of 72 patients with acute cardiogenic cerebral embolism caused by large artery occlusion were retrospectively analyzed in Department of Neurology, Strategic Support Force Medical Center from August 2015 to August 2020.Among those, 52 patients were treated with intra-arterial tirofiban, the other 20 patients were treated with control medication. The baseline characteristics, modified thrombolysis in cerebral infarction (mTICI) score of responsible vessels, modified Rankin scale (mRS) score 90 days after operation, incidence of symptomatic intracranial hemorrhage and mortality were evaluated and compared in two groups.Results:The proportion of effective recanalization of the offending vessels (mTICI≥2b) in tirofiban group was higher than that in control group (92.3% vs. 75.0%), but the difference was not statistically significant ( P=0.104). At 90 days after operation, the rate of patients with good prognosis (mRS≤2) in tirofiban group (61.5%) was significantly higher than that in control group (35.0%) ( P<0.05). The incidence of symptomatic intracranial hemorrhage and mortality were comparable between the two groups ( P>0.05). Conclusion:Intra-arterial tirofiban infusion in patients with acute cardiogenic cerebral embolism is effective and feasible, which improves the prognosis without increasing the risk of intracranial bleeding complications.

Objective: To observe the therapeutic effect of dihydroartemisinin on pulmonary fibrosis in rats exposed to dust, and compare the therapeutic effects of dihydroartemisinin and tetrandrine. Methods: Sixty male Sprague-Dawley rats were randomly divided into control group, model group, treatment group 1 and treatment group 2, with 15 rats in each group. The model group and the treatment group were stained with disposable non-exposure silica tracheal instillation method. The drug was administered on the second day after the dust was applied. The treatment group was given with dihydroartemisinin 75 mg/kg, the treatment group was given tetrahexine 22 mg/kg, model group and control group were intragastrically administered with 1 ml of normal saline per 100 g of body mass. The drug was administered for 6 days per week for 28 days. Rats were sacrificed on the 7th, 14th and 28th day after dusting, and the lung tissues of rats were taken, detection of rat lung coefficient, ELISA was used to detect transforming growth factor-1(TGF-1)and Smad 2/3 in rat lung tissues, type I collagen (Col-I) expression level, pathological changes of rat lung tissue, immunohistochemical observation of rat lung tissue TGF-1 and Col-I protein expression. Statistial analysis was proformed with SPSS 19.0. The mean cornparis between graups wad perfomed using a completely randonized one-way (ANOVA). Results: The expressions of TGF-1, Smad 2/3 and Col-I in the lung tissue of the treatment group were significantly lower than those in the model group (P< 0.05), but the difference between the treatment group 1 and the treatment group 2 Not statistically significant (P>0.05). The results of immunohistochemistry showed that the TGF-1 and Col-I proteins in the interstitial of the model group showed strong positive expression. The expression of TGF-1 and Col-I protein in the lung interstitial of the treated group was weaker than that of the model group. Conclusion Dihydroartemisinin can down-regulate the level of inflammatory cytokines in rat lung tissue. It is possible to inhibit pulmonary fibrosis by intervening in the TGF-β1/Smad 2/3 signaling pathway, but the therapeutic effect between DHA and tetrandrine is not significantly different in a short time.

Objective: To investigate the relationship between renal injury and apoptosis in rats with nephrotic syndrome induced by mercury, in order to find out the pathogenesis. Methods: Forty-eight healthy male SPF-grade BN (Brown-Norway) rats were divided into the control group and the exposure group by random number table. The nephrotic syndrome was caused by subcutaneous injection of HgCl₂ (1 mg/ml) in the abdominal weight per kg of body weight. The control group was injected with the same volume of NaCl as the exposure group. Some rats were sacrificed on the 14th, 21st, 28th, and 35th days, and the serum kidney injury indicators creatinine (CRE) and urea nitrogen (BUN) were detected, and the renal tissue mercury content was detected; the in situ terminal transferase labeling technology (TUNEL) was detected Apoptosis, immunofluorescence detection of Cyt C content, Western blot detection of mitochondrial pathway apoptosis-related proteins [B-cell lymphoma 2 (Bcl-2) , Bcl-2 related X protein (BAX) , cysteine proteinase 3 (Caspase 3) ], mitogen-activated protein kinase (MAPK) signaling pathway-related proteins[p38 mitogen-activated protein kinase (P38MAPK) , extracellular regulatory protein kinase (ERK) ] expression. Results: Compared with the control group, the BUN content in the serum of rats in the exposure group was significantly increased on days 7, 21, and 28, the CRE content was significantly increased on 21 days, the CRE content was significantly decreased on 28 and 35 days, and the organ coefficient and renal mercury content were 14 to 35 days. Significantly increased, and the differences were statistically significant (P<0.05) . Compared with the control group, rats in the exposed group showed increased glomerular stroma, tubule dilatation and other renal cell apoptosis at 14 to 35 days, and Cyt C expression was obvious in the exposed groups at 14, 21 days. Compared with the control group, the BAX content of the rats in the exposed group was significantly increased on the 21st day, the content of Caspase 3 in the rats on the 14th and 21st days was significantly increased, and the content of the P38MAPK in the 35th day was significantly increased (P<0.05) . Conclusion HgCl₂ may cause renal cell damage through the mitochondrial pathway of apoptosis and cause nephrotic syndrome, and the MAPK signaling pathway may regulate this process and exert an inhibitory effect on apoptosis.

In the field of dental aesthetics,digital aesthetic design plays a crucial role in helping dentists to predict treatment outcomes vis-ually,as well as in enhancing the consistency of knowledge and understanding of aesthetic goals between dentists and patients.It serves as the foundation for achieving ideal aesthetic effects.However,there is no clear standard for this digital process currently in China and abroad.Many dentists lack of systematic understanding of how to carry out digital aesthetic design for treatment.To establish standardized processes for dental aesthetic design and to improve the homogeneity of treatment outcomes,Chinese Society of Digital Dental Industry(CSD-DI)convened domestic experts in related field to compile this consensus.This article elaborates on the key aspects of digital aesthetic data collection,integration steps,and the digital aesthetic design process.It also formulates a decision tree for dental aesthetics at macro level and outlines corresponding workflows for various clinical scenarios,serving as a reference for clinicians.