Objective To summarize the diagnostic ideas, clinical characteristics and treatment methods of the rupture of pseudoaneurysm in the pararenal artery, so as to provide reference for the management of such condition.Methods The diagnosis and treatment process of a patient with massive retroperitoneal hemorrhage due to rupture of pseudoaneurysm in the left pararenal artery admitted to the Affiliated Hospital of Yan'an University were reported, and relevant literature was retrieved to summarize the etiology, pathogenesis, diagnosis and treatment of this disease.Results The patient was a 49-year-old male who presented with sudden onset of lumbar and abdominal pain.After admission, enhanced computed tomography (CT) scan indicated a cystic lesion in the left kidney, along with fluffy high-density and fluidic density shadows around the kidney.There was extensive extravasation of contrast agent in the lower polar artery of the left kidney, with rupture shadows, retention of contrast agent, and the extent of extravasation expanding in the venous phase and delayed phase, suggesting that the renal artery or pararenal artery had ruptured and bled.After consultation by the Department of Intervention, an urgent superselective left renal artery embolization procedure was performed.During the operation, angiography showed the “jetting sign” in the arterial phase, and the stenosis at the neck of the tumor.In the delayed phase, the contrast agent was retained accompanied with the “chimney sign”, which was consistent with the characteristics of a pseudoaneurysm.The final diagnosis was rupture and bleeding of a pseudoaneurysm of the left pararenal artery, along with the formation of a hematoma, as well as accumulation of blood and fluid in the abdominal and pelvic cavities.The patient recovered well after surgery.After a follow-up of 6 months, CT scan showed that the hematoma was basically absorbed and there were no obvious abdominal pain or other discomforts.Conclusion Rupture of pseudoaneurysm in the pararenal artery is rare in clinical practice.Treatment should be tailored to the anatomical features and the patients' condition.Multidisciplinary collaboration, precise imaging evaluation, and the application of interventional techniques can achieve efficient diagnosis and treatment, and protect the renal function to the greatest extent.

The new era imposes heightened demands on medical professionals,who must not only possess a solid theoretical foundation but also exhibit strong practical skills and innovative capabilities.The quality of medical func-tional laboratory construction is crucial for cultivating high-caliber medical talents.In light of the current developmental status and trends regarding functional experiment teaching within Chinese higher education institutions,particularly the disparities in development across various regions and institutions,the Functional Experiment Teaching Committee of the Chinese Pathophysiology Society has developed an expert consensus on laboratory construction standards.This consensus was established through comprehensive investigations,research,and extensive discussions to provide a reference for di-verse institutions to continuously enhance their levels of laboratory construction.

As an important abdominal surgical treatment, enterostomy holds a crucial position in the clinical management of digestive system disorders. After colostomy, the diversity and species richness of the intestinal flora in patients undergo significant alterations, which not only influence the surgical outcome but also directly associate with the occurrence and development of complications such as diversion colitis. The authors review the research progress on the changes of intestinal flora after enterostomy and its effect on complications, with the aim of avoiding the excessive use of enterostomy, optimizing the operation plan for enterostomy, preventing and reducing compli-cations, thereby providing a scientific basis and reference.

Raynaud syndrome is a clinical syndrome characterized by paroxysmal vasospasms of the acral small arteries,and its pathogenesis is closely associated with the dynamic imbalance of yin and yang as elucidated by the theory of"yang transforming qi and yin shaping up body."The theory of"yang transforming qi and yin shaping up body"originated in Huangdi Neijing,which is aimed at that yang can be tangible essence,blood,fluid,and other substances belonging to the yin into an invisible qi,promote the internal and external zang-fu organs and qi of the body's operation;yin qi is transformed into tangible substances under the gasification effect of yang qi to nourish the organism,to consolidate the essence of internal zang-fu organs,and to maintain the balance of yin and yang in the body.This study innovatively employs this theory to systematically elucidate the dynamic pathomechanism evolution of Raynaud syndrome:at the beginning of the disease,the ischemic stage is dominated by the deficiency of yang qi and the inability of qi to transform yin;then the disease enters into the hypoxic stage and the dilatation stage,which are mostly caused by the lack of yang depression,the blockage of qi,and the over-excessive formation of yin;and finally,the yang transforms qi too much and yin is damaged and weak,and then reaches the stage of complication.In Raynaud syndrome,the key mechanism and pathology of"yang transforming qi"and"yin shaping up body"as well as the stage of the disease should be clarified,so that yang qi can be used as the basis to make up for yang deficiency,yang depression can be stretched out,yin evils such as cold condensation,blood stasis and water dampness can be transformed,heat and toxin can be eliminated,yin fluids can be restored,and the extremities can be warmed up.The disease will be convalesced gradually.

As an important abdominal surgical treatment, enterostomy holds a crucial position in the clinical management of digestive system disorders. After colostomy, the diversity and species richness of the intestinal flora in patients undergo significant alterations, which not only influence the surgical outcome but also directly associate with the occurrence and development of complications such as diversion colitis. The authors review the research progress on the changes of intestinal flora after enterostomy and its effect on complications, with the aim of avoiding the excessive use of enterostomy, optimizing the operation plan for enterostomy, preventing and reducing compli-cations, thereby providing a scientific basis and reference.

Raynaud syndrome is a clinical syndrome characterized by paroxysmal vasospasms of the acral small arteries,and its pathogenesis is closely associated with the dynamic imbalance of yin and yang as elucidated by the theory of"yang transforming qi and yin shaping up body."The theory of"yang transforming qi and yin shaping up body"originated in Huangdi Neijing,which is aimed at that yang can be tangible essence,blood,fluid,and other substances belonging to the yin into an invisible qi,promote the internal and external zang-fu organs and qi of the body's operation;yin qi is transformed into tangible substances under the gasification effect of yang qi to nourish the organism,to consolidate the essence of internal zang-fu organs,and to maintain the balance of yin and yang in the body.This study innovatively employs this theory to systematically elucidate the dynamic pathomechanism evolution of Raynaud syndrome:at the beginning of the disease,the ischemic stage is dominated by the deficiency of yang qi and the inability of qi to transform yin;then the disease enters into the hypoxic stage and the dilatation stage,which are mostly caused by the lack of yang depression,the blockage of qi,and the over-excessive formation of yin;and finally,the yang transforms qi too much and yin is damaged and weak,and then reaches the stage of complication.In Raynaud syndrome,the key mechanism and pathology of"yang transforming qi"and"yin shaping up body"as well as the stage of the disease should be clarified,so that yang qi can be used as the basis to make up for yang deficiency,yang depression can be stretched out,yin evils such as cold condensation,blood stasis and water dampness can be transformed,heat and toxin can be eliminated,yin fluids can be restored,and the extremities can be warmed up.The disease will be convalesced gradually.

Osteoradionecrosis of the jaws (ORNJ) is among the most severe oral complications following radiotherapy for head and neck tumors. It is essentially a form of pathological necrosis of the jawbone induced by radiation therapy. ORNJ is defined as bone damage, primarily characterized by inflammation and necrosis, occurring in the jawbone within the irradiated area and accompanied by soft tissue injury, persisting for more than 3 months without spontaneous healing. Diagnosis requires exclusion of other potential etiologies, including primary tumor recurrence, medication-related osteonecrosis, and radiation-induced neoplasms of the jawbone, etc. In this review, recent advances in the epidemiology, risk factors, diagnosis, classification and staging, dosimetric parameters, pathogenesis, treatment, and prevention of radiation-induced osteonecrosis of the jaws were summarized.

Digital technologies have become an integral part of complete denture restoration. With advancement in computer-aided design and computer-aided manufacturing (CAD/CAM), tools such as intraoral scanning, facial scanning, 3D printing, and numerical control machining are reshaping the workflow of complete denture restoration. Unlike conventional methods that rely heavily on clinical experience and manual techniques, digital technologies offer greater precision, predictability, and efficacy. They also streamline the process by reducing the number of patient visits and improving overall comfort. Despite these improvements, the clinical application of digital complete denture restoration still faces challenges that require further standardization. The major issues include appropriate case selection, establishing consistent digital workflows, and evaluating long-term outcomes. To address these challenges and provide clinical guidance for practitioners, this expert consensus outlines the principles, advantages, and limitations of digital complete denture technology. The aim of this review was to offer practical recommendations on indications, clinical procedures and precautions, evaluation metrics, and outcome assessment to support digital restoration of complete denture in clinical practice.
Humans ; Denture, Complete ; Computer-Aided Design ; Denture Design/methods* ; Consensus ; Printing, Three-Dimensional

Acute lateral ankle sprain (ALAS) is one of the most common sport injuries, with high incidence, recurrence and disability rates. Currently, exercise rehabilitation-based non-surgical treatment is the primary management approach for ALAS. However, there remain improper practices such as excessive immobilization or uncontrolled activity, which contribute to recurrent sprains and chronic ankle instability, significantly impairing patients′ athletic function and quality of life. To standardize the non-surgical management of ALAS, improve the cure rates, and reduce the recurrence and disability rates, Chinese Sports Rehabilitation Medicine Training Project of Chinese Medical Association, Foot and Ankle Basics and Orthopedics Group, Orthopedic Branch of Chinese Medical Doctor Association, and Sports Medicine Branch of Jiangsu Medical Association organized relevant experts to formulate Expert consensus on non-surgical treatment for acute lateral ankle sprain ( version 2025), following the principles of scientific vigor, practicality, and innovation. Thirteen recommendations were proposed for standardized treatment protocols across different healing phases, aiming to provide references for standard management of ALAS and improve the therapeutic outcomes.

Objective:To investigate the clinical characteristics of left-sided infective endocarditis (IE) without underlying valvular heart diseases (VHD).Methods:This was a retrospective study. Clinical data of 206 patients with left-sided IE (age: (50.4±16.1) years; 144 males (69.9%)) discharged from Shanghai Sixth People′s Hospital Affiliated to Shanghai Jiao Tong University School of Medicine from June 2011 to May 2021 were retrospectively analyzed, including 129 cases with underlying VHD (IE+VHD group) and 77 cases without underlying VHD (IE group). The 6-month survival rate of patients after discharge was analyzed with Kaplan-Meier survival curve; and the 6-month survival rates of the patients with different sizes of endocardial vegetation and different treatment modalities in the IE group were further analyzed with log-rank method.Results:The proportions of patients with age ≥65 years old, arrhythmia and aortic valve involvement, and the in-hospital mortality in the IE group were significantly lower than those in the IE+VHD group ( P<0.05). However, the proportion of patients with fever and speech vague/limb movement disorder/headache, those with mitral valve involvement in the IE group were significantly higher than those in the IE+VHD group ( P<0.05). The median value of C-reactive protein (CRP) in the IE group was significantly higher than that in the IE+VHD group ( P<0.05). Nevertheless, the median value of N-terminal pro-B-type natriuretic peptide (NT-proBNP) in the IE group was significantly lower than that in the IE+VHD group ( P<0.05). There were as no significant differences in the positive rates of bacterial/fungal blood cultures and the proportion of patients with mitral and aortic valve involvement of endocardial vegetation between the two groups (all P>0.05). Kaplan-Meier survival curve analysis showed that there was no significant difference in 6-month survival rate of patients between the IE group and IE+VHD group (88.7% vs. 93.6%, log-rank χ2=0.887, P=0.346). In the IE group, the 6-month survival rate after discharge in patients with maximum diameter of vegetation ≤10 mm was higher than that in patients with maximum diameter of vegetation >10 mm (96.3% vs. 80.7%, log-rank χ2=4.111, P=0.043). There was no significant difference in 6-month survival rate between patients treated with antibiotics combined with surgery and those treated with antibiotics alone (96.2% vs. 78.6%, log -rank χ 2=2.976, P=0.084). Conclusion:Compared to left-sided IE patients with underlying VHD, patients without underlying VHD are likely to have a younger age, more mitral valve involvement and lower in-hospital mortality; for those patients with maximum diameter of vegetation ≤10 mm there is a higher survival rate, and antibiotics combined with surgery may help to improve the survival rate.