Deep infiltrating endometriosis(DIE)is defined as endometriotic lesions infiltrating≥5 mm beneath the peritoneum,commonly affecting the uterosacral ligaments,rectovaginal septum,vaginal vault,and rectal wall.Due to nonspecific clinical manifestations and atypical imaging features,DIE is often misdiagnosed.This study reports a case of rectal DIE diagnosed preoperatively by endoscopic ultrasound-guided fine-needle aspiration(EUS-FNA)and summarizes the multidisciplinary treatment experience in conjunction with a literature review.A 35-year-old woman was admitted for defecation difficulty.MRI and EUS-FNA confirmed rectal DIE.After multidisciplinary team(MDT)evaluation involving colorectal,gynecologic,and urologic specialists,laparoscopic resection of the rectal lesion,sigmoid-rectal anastomosis,and protective ileostomy were performed.Pathology confirmed rectal DIE with negative margins.The stoma was successfully reversed 4 months later,and no recurrence was observed during 21 months of follow-up.These findings highlight the pivotal role of EUS-FNA in early diagnosis and demonstrate that an MDT approach led by colorectal surgeons can significantly enhance surgical safety and completeness,providing valuable guidance for the individualized management of complex pelvic endometriosis.

Deep infiltrating endometriosis(DIE)is defined as endometriotic lesions infiltrating≥5 mm beneath the peritoneum,commonly affecting the uterosacral ligaments,rectovaginal septum,vaginal vault,and rectal wall.Due to nonspecific clinical manifestations and atypical imaging features,DIE is often misdiagnosed.This study reports a case of rectal DIE diagnosed preoperatively by endoscopic ultrasound-guided fine-needle aspiration(EUS-FNA)and summarizes the multidisciplinary treatment experience in conjunction with a literature review.A 35-year-old woman was admitted for defecation difficulty.MRI and EUS-FNA confirmed rectal DIE.After multidisciplinary team(MDT)evaluation involving colorectal,gynecologic,and urologic specialists,laparoscopic resection of the rectal lesion,sigmoid-rectal anastomosis,and protective ileostomy were performed.Pathology confirmed rectal DIE with negative margins.The stoma was successfully reversed 4 months later,and no recurrence was observed during 21 months of follow-up.These findings highlight the pivotal role of EUS-FNA in early diagnosis and demonstrate that an MDT approach led by colorectal surgeons can significantly enhance surgical safety and completeness,providing valuable guidance for the individualized management of complex pelvic endometriosis.

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.

Analgesia is an important link in the treatment of severe patients after neurosurgery and plays a vital role in improving the prognosis of the patients.Understanding the status quo and influencing fac-tors of pain in severe patients after neurosurgery helps to predict the occurrence of pain,which is crucial for determining the new pain assessment methods and auxiliary analgesic methods and developing novel analgesic drugs.This paper reviews the pain status,pain evaluation and analgesic methods of severe patients after neuro-surgery in recent years so as to understand the pain management current status of the patients with severe neurological conditions and provide reference for the medical staff to implement the analgesic programs.

Objective To analyze the important abnormal results of physical examination of the staff in our hospital in recent 2 years,and to provide evidence for the health management of the staff in our hospital.Methods The physical examina-tion data of hospital staff in recent 2 years were retrospectively analyzed,and the important abnormal results were statistically ana-lyzed.Results A total of 3 584 employees participated in physical examination,including753 males and 2831 females.There were 92 cases with significant abnormal results,and the total detection rate was 2.57%.The detection rate of significant abnor-mal results was slightly lower in males(17cases,2.26%)than in females(75cases,2.65%),and the age of females[(48.89±19.53)years]was lower than that of males[(55.68±17.43)years].The age group with the most significant detec-tion rate of important abnormal results was 50-59 years old(3.07%),and the diseases detected by important abnormal results were as follows:There were 26 thyroid tumors,19 lung tumors,13 breast tumors,12 space occupying cases(3 liver,4 kidney,2 adrenal glands,1 adnexa,1 pancreas,1 mediastinum),9 vascular lesions,6 abnormal tumor markers,5 cervical lesions,1 tuberculosis,and 1 subdural hematoma.Among them,thyroid tumors,breast tumors,lung tumors and cervical lesions were the main cases in women,and vascular diseases,lung tumors,space-occupying lesions(liver and kidney)and thyroid tumors were the main cases in men.Conclusion Physical examination is of great significance in detecting important abnormal diseases.We should attach great importance to physical examination,detect serious diseases as early as possible,and strengthen health man-agement accordingly.

Objective To evaluate the imaging characteristics of atypical teratoid/rhab doid tumor (AT/RT) of central nervous system(CNS), and to improve the diagnostic ability of the disease. Methods The clinical and imaging findings of 9 patients were retrospectively analyzed. There were 5 male and 4 female, ages 7 months to 5 years,median age was 1.4 years. MR enhancement studies were obtained in all the cases. One case had CT enhancement examination. Results The lesions were seen in brain in 8 cases and in lumbosacral spinal cord in one case. The tumors size varied from 4.8—7.8 cm, Necrosis was seen in nine cases, cystic change in eight cases and hemorrhage in five cases. The tumors had high signal on DWI, and low signal on ADC map. Dura matter invasion(2 cases), cerebrospinal fluid spread(2 cases)and intracerebral metastasis were seen. Conclusion There are some relatively specific imaging findings of primary CNS AT/RT that could assist their diagnosis.

This study was aimed to investigate the research on pharmacological effects, relevant ideas and methods of Guangdong native heat-clearing and toxin-removing herbs. Literatures on pharmacological effects of Guangdong native heat-clearing and toxin-removing herbs were collected, summarized and analyzed. The results showed that most Guangdong native heat-clearing and toxin-removing herbs had obvious effects of anti-microbial, anti-bacterial endotoxin, anti-inflammatory, and antipyretic effect. It also had obvious antivenomous and analgesia effect. Based on research ideas and methods of Guangdong native heat-clearing and toxin-removing herbs, we clarified the confusion species as soon as possible, and adhered to the whole animal experiments in combination with in vitro experiments and computer molecular docking simulations for the complementation of each other. It was concluded that the study on pharmacological effects of Guangdongnative heat-clearing and toxin-removing herbs provided strong support in its clinical application. Ideas and methods provided in this article was the main way to explain pharmacological effects of Guangdong native heat-clearing and toxin-removing herbs.

Objective To study the preparation and quality control of Shehuang powder.Methods Medicinal materials were toasted,crushed into powder,and mixed in uniformity to make Shehuang powder.TLC was used to identify pronephrium triphyllum and rhubarb in the powder.Results TLC could identify effective reagents.The preparation method was simple and effective.Shehuang Powder prepared with this method was stable.Conclusion The compatibility of Shehuang powder was reasonable.The preparation method and quality Control was simple.

OBJECTIVE:To establish the quality criteria for Huangzhi oral liquid.METHODS:TLC was employed to for the qualitative identificaiton of Radix et Rhizoma Rhei,Leech and Fructus Arctii;the content of total nitrogen was determined by KjeLdahL determination and content of Chrysophanol in Radix et Rhizoma Rhei in Huangzhi oral liquids was determined by HPLC.RESULTS:The TLC chromatograms of Radix et Rhizoma Rhei,Leech and Fructus Arctii presented the spots of the same colors with those at the corresponding places in the chromatograms of the controls.There was a good linear relationship within the concentration range of 1.696～ 8.480? g? mL-1 for Chrysophanol(r=0.999 8).The average recovery was 99.60%(RSD=1.37%,n=9).CONCLUSION:The methods are accurate and reliable with a strong specificity and can be used for the quality control of Huangzhi oral liquid.

OBJECTIVE:To optimize the extraction process for Sihuang paste.METHODS:The Radix et Rhizoma Rhei,Radix Scutellariae were extracted with ethanol,and the effects of the concentration and dosage of ethanol,and the ext-racting time,extraction times on the content of emodin were investigated by orthogonal experiment.The Rhizoma coptidis and Cortex Phellodendri were extracted by water decoction method,and the effects of amount of water,the soaking time,the decoction time and decoction times on the content of tannin were investigated by orthogonal experiment.RESULTS:The optimum alcohol extracting condition for Radix et Rhizoma Rhei,Radix Scutellaria was as follows:adding 60% alcohol at a dose of 6 times that of the total medicinal substances and extracting for 1 h/time for 3 times.The optimum water extracting condition for Rhizoma Coptidis and Cortex Phellodendri was as follows:soaking medicinal substances in water(with the ratio of medicinal substances to water at 1∶6)for 0.5 h,decocting for 2 h and extracting for 3 times.CONCLUSION:The optimized methods are simple and stable,which provide theoretic basis for industrial production.