Objective To study the causes of mis diagnosis and the experience of diagnosis and management for cholelithiasis complicated with abdominal tumors.Methods Clinical data of 36 cases of cholelithiasis complicated with abdominal tumors were analyzed retrospectively.Among them,24 were male,12 female.The age ranged from 48 to 82 year old.Each case was diagnosis as cholelithiasis and admitted to our hospital.Results In 36 patients,18 was diagnosed as complecated with abdominal tumors preoperatively;12 was diagnosed intraoperatively,while in 6 cases the tumor was misdiagmosed for 5 days to 3 months,finally the tumor was comfirmed by reoperation and pathology.Among the 36 cases,the tumors cluding 5 of carcinoma of gallbladder(13.9%),4 of cholangiocarcinoma(11.1%),3 of hepatoma(8.3%),6 of pancreatic carcinoma(16.7%),6 of gastric carcinoma(16.7%),7 of colon carcinoma(19.4%),2 of rectal carcinoma(5.5%).Of them,2 cases refused operation,2 cases underwent intervention operation,the others reseived operation.During primary operation,radical resection of the tumor and cholecystectomy and/or common bile duct(CBD) exploration was performed in 18 patients,palliation resection and cholecystectomy and/or CBD exploration performed in 4 patients,exploratory laparotomy performed in 4 patients,and only LC and/or CBD exploration performed in 6 patients.Of the latters,reoperation was performed 5 days to 3 months after primary operation.4 patients had tumor radical resection,1 had palliation resection,and 1 had interventional therapy.Conclusions Cholelithiasis may complicated with abdominal tumor,especially with digestive tract tumor.For cholelithiasis patient the history-taking need to be done carefully before operation.For the senile patient and the patient without typical symptoms or physical signs,the systems checking shoud be done carefully preoperatively,and abdominal cavity should be checked carefully intraoperatvely to find the tumor,which may exist in abdominal cavity.the patient with syndrome of post-cholecystectomy shoud be carefully followed up to avoid the mis diagnosis and mistreatment of the tumor.

ObjectiveTo analyze the pharmacodynamic material basis of Hippophae Folium in the treatment of hyperlipidemia by network pharmacology and experimental verification. MethodThe hyperlipidemic HepG2 cell model induced by oleic and palmitic acid （molar ratio 2∶1） was established. The optimal concentration of Hippophae Folium containing serum was determined by cell counting kit （CCK）-8 method. The cells were intervened by the medicated serum， and oil red O staining was used to determine the success of the model. The contents of total cholesterol （TC） and triglyceride （TG） were determined by enzyme-linked immunosorbent assay （ELISA）. The possible mechanism of action was analyzed by network pharmacology， and molecular docking was performed to detect the binding ability of the potential targets. ResultCCK-8 assay showed that 10% medicated serum was the optimal concentration for cell growth. Oil red O staining proved that the hyperlipidemic cell model induced by oleic and palmitic acid has been built. After treatment with medicated serum， the contents of TG and TC decreased， indicating that Hippophae Folium had a good therapeutic effect on hyperlipidemia. Network pharmacology revealed that the core targets of Hippophae Folium in the treatment of hyperlipidemia were albumin （ALB）， peroxisome proliferative activated receptor γ （PPARγ） and matrix metalloprotein（MMP）-9， involving 755 biological processes， 73 molecular functions and 3 cellular components. By Kyoto Encyclopedia of Genes and Genomes（KEGG） analysis， it was found PPAR， hypoxia inducible factor（HIF）-1， AMP-activated protein kinase（AMPK） and other signal pathways were involved in the treatment of hyperlipidemia by Hippophae Folium. ConclusionHippophae Folium containing serum （10%） could reduce lipid accumulation and intracellular TG and TC levels in hyperlipidemic cell model， and its mechanism of action might be realized by activating PPAR signal pathway.

Pulmonary blast injury has become the main type of trauma in modern warfare, characterized by externally mild injuries but internally severe injuries, rapid disease progression, and a high rate of early death. The injury is complicated in clinical practice, often with multiple and compound injuries. Currently, there is a lack of effective protective materials, accurate injury detection instrument and portable monitoring and transportation equipment, standardized clinical treatment guidelines in various medical centers, and evidence-based guidelines at home and abroad, resulting in a high mortality in clinlcal practice. Therefore, the Trauma Branch of Chinese Medical Association and the Editorial Committee of Chinese Journal of Trauma organized military and civilian experts in related fields such as thoracic surgery and traumatic surgery to jointly develop the Clinical treatment guideline for pulmonary blast injury ( version 2023) by combining evidence for effectiveness and clinical first-line treatment experience. This guideline provided 16 recommended opinions surrounding definition, characteristics, pre-hospital diagnosis and treatment, and in-hospital treatment of pulmonary blast injury, hoping to provide a basis for the clinical treatment in hospitals at different levels.