Based on the theory of "spleen functions as wei （卫） qi"， this paper discusses the mechanism of "inflammation-metabolism-immunity" regulation in colorectal cancer cachexia and the therapeutic strategy. It is proposed that spleen deficiency with failure in transportation， leading to the maldistribution of wei （卫） qi and pathogenic constraint transforming into fire， is the source of inflammation. Spleen deficiency with failure in transportation， leading to the maldistribution of subtle essences and loss of nourishment to the physical body， is the root of metabolic depletion. Spleen deficiency with failure in transportation， leading to wei qi depletion and healthy qi decline， is the cause of immune impairment. Accordingly， a spleen-centered strategy of fortifying the spleen and restoring its defensive function is established. The specific therapeutic approaches include fortifying the spleen and boosting qi， restoring defensive function and securing the exterior to replenish the source of wei qi， with modified Sijunzi Decoction （四君子汤）， fortifying the spleen and removing toxin， resolving phlegm and stasis to restrain exuberant internal toxin and constrained fire， with modified Baitouweng Decoction （白头翁汤）， activating the spleen and harmonizing the stomach， promoting the transportation and distribution of food essence to correct nutritional and metabolic disorders， with modified Xiangsha Liujunzi Decoction （香砂六君子汤）， and fortifying the spleen and nourishing the kidney， replenishing primordial qi and consolidating the root to restore immune competence， with Buzhong Yiqi Decoction （补中益气汤） and Zuogui Beverage （左归饮） as the basic prescription.

Based on the theory of "spleen functions as wei （卫） qi"， this paper discusses the mechanism of "inflammation-metabolism-immunity" regulation in colorectal cancer cachexia and the therapeutic strategy. It is proposed that spleen deficiency with failure in transportation， leading to the maldistribution of wei （卫） qi and pathogenic constraint transforming into fire， is the source of inflammation. Spleen deficiency with failure in transportation， leading to the maldistribution of subtle essences and loss of nourishment to the physical body， is the root of metabolic depletion. Spleen deficiency with failure in transportation， leading to wei qi depletion and healthy qi decline， is the cause of immune impairment. Accordingly， a spleen-centered strategy of fortifying the spleen and restoring its defensive function is established. The specific therapeutic approaches include fortifying the spleen and boosting qi， restoring defensive function and securing the exterior to replenish the source of wei qi， with modified Sijunzi Decoction （四君子汤）， fortifying the spleen and removing toxin， resolving phlegm and stasis to restrain exuberant internal toxin and constrained fire， with modified Baitouweng Decoction （白头翁汤）， activating the spleen and harmonizing the stomach， promoting the transportation and distribution of food essence to correct nutritional and metabolic disorders， with modified Xiangsha Liujunzi Decoction （香砂六君子汤）， and fortifying the spleen and nourishing the kidney， replenishing primordial qi and consolidating the root to restore immune competence， with Buzhong Yiqi Decoction （补中益气汤） and Zuogui Beverage （左归饮） as the basic prescription.

This case report presents an adolescent patient with type 3 pseudotumor associated with vascular hemophilia (von willebrand disease, VWD) of the femur. The patient experienced weakness and pain in the right knee joint for two months following physical activity, with no apparent history of trauma. Genetic testing identified two compound heterozygous mutations in the von willebrand factor (VWF) gene, consistent with a diagnosis of "VWD type 3". Laboratory results revealed a Factor VIII activity of 2.8%, a negative Factor VIII inhibitor test, VWF activity of 1%, and VWF antigen levels below 3%. The desmopressin infusion test (1 hours and 4 hours) showed VWF levels of less than 1%. Imaging studies revealed an osteolytic lesion in the right distal femoral epiphysis, characterized by discontinuous cortical resorption in the anterior femur, thinning of the medial, lateral, and posterior cortex, prominent sclerotic bands, and extension of the tumor into the distal femoral epiphysis without periosteal reaction. After multidisciplinary consultation, the diagnosis of VWD type 3 pseudotumor of the femur was confirmed. The patient had no history of coagulation factor supplementation and no significant knee trauma. Preoperatively, the VWF level was maintained above 80% with cryoprecipitate infusion. The lesion was surgically debrided, followed by bone grafting with autologous fibula and allograft bone. Postoperative follow-up at 5 months showed good recovery of knee function. Pseudotumor is a rare but serious manifestation of inherited bleeding disorders, predominantly observed in hemophiliacs. Skeletal muscle system pseudotumor in VWD is exceptionally rare, with previous reports limited to the maxilla and mandible. MRI is crucial for the diagnosis of hemophilic pseudotumor, with characteristic findings of peripheral enhancement without central enhancement on enhanced scans. Surgery remains the preferred and effective treatment, with adequate perioperative preparation being essential for success. In this case, a multidisciplinary approach was critical in developing a personalized treatment plan, contributing significantly to the patient's positive outcome.

The ulnar collateral ligament (UCL) of the elbow is the primary stabilizer to resist valgus stress. Its injury is common in overhead throwing athletes, mainly caused by repeated valgus forces, and can cause elbow pain and affect the career of athletes. A common treatment of ulnar collateral ligament injury for overhead throwing athletes is ulnar collateral ligament reconstruction (UCLR). At present, the UCLR techniques have been constantly improved, mainly in graft structure, incision exposure, management of the ulnar nerve, and methods of humeral and ulnar fixation. This paper is to review the anatomy and biomechanics of UCL, as well as techniques, key points, postoperative complications and rehabilitation of UCLR so as to deepen the understanding of UCLR in clinicians.

Objective To solve the problems of clinical laboratory module in mobile medical unit such as miscellaneous and mixed equipment,disordered packages,and weak mobility and responsiveness.Methods The concept of modularization was used for the secondary optimization of clinical laboratory equipment and consumables.The specialized vehicle for clinical laboratory was designed with considerations on the advantages of clinical laboratory shelter in equipment and medical vehicle in mobility,so as the values of clinical laboratory module were enhanced in mobile medical unit.Results Modular and standardized management of clinical laboratory equipment was realized to solve the existing problems of equipment.Conclusion The equipment supportability and mobility are enhanced in mobile medical unit,so that the requirements can be fulfilled for medical support missions at peace time and wartime.

Histone methyltransferase SMYD3 (SET and MYND domain containing 3) is a protein which has the function of histone methylation found in recent years,it has an important role in transcriptional regulation.The research shows that SMYD3 inhibit apoptosis and promote cell proliferation,invasion and metastasis.More and more data shows SMYD3 highly expressed in liver cancer and is low in normal tissues which is even undetectable.SMYD3 level was significantly associated with prognosis,and gene silencing experiments in SMYD3 tumor cell growth was inhibited.Therefor,SMYD3 is closely related with the development and prognosis of HCC occurrence,which suggests that people can suppress the expression SMYD3 to block tumor cell growth,migration and improve prognosis to provide new goals and direction for the future of cancer treatment.

Hepatocellular carcinoma (HCC) greatly threatens human health. In clinical treatment, the therapeutic strategies for HCC are attracting more attention. With the research advances in the pathogenesis of HCC and the rapid development of molecular biology techniques, the therapies with molecular-targeted antitumor drugs for advanced HCC have become a hot research topic, and significant efficacy has been achieved in clinical practice. This article summarizes the research advances in clinical application of molecular-targeted drugs for the treatment of HCC and related issues, discusses the future perspectives of therapeutic strategies, and provides a new direction and reference for the clinical treatment of HCC.

Hepatic myelopathy is one of special category changes of nervous system,which was secondary to the end-stage hepatic diseases and is a syndrome of myeleterosis.It usually occurred after portosystemic shunt surgery or collateral circulation of portosystemic vein.The prognosis of hepatic myelopathy is poor,and the progression of this disease is slow.Surgical approaches such as dissociation of colon and anastomosis of ileum and rectum aimed at reducing the absorption of toxic substance and thus to breakdown the blood ammonia and improve the symptoms of nervous system,but the effects are not satisfactory.The clinical data of 1 patient with hepatic myelopathy who received liver transplantation at the Second Affiliated Hospital of Dalian Medical University in April 2012 were retrospectively analyzed.The clinical symptoms and physical signs were improved,and muscle strength was effectively recovered in the patient.Liver transplantation might be an effective method for the treatment of hepatic myelopathy.

ObjectiveTo detect the mutations of GJB3 and GJB4 genes in two sporadic cases of erythrokeratodermia variabilis(EKV).MethodsGenomic DNA was extracted from two sporadic patients with EKV,their family members,and 100 normal human controls.All the exons and adjacent splice sites of GJB3 and GJB4 genes were amplified by PCR.Mutation scanning was carried out via direct bidirectional DNA sequencing.ResultsA G134C mutation was found at the GJB3 gene in patient 1,which caused a substitution of glycine by alanine at codon 45 (G45A).No mutation was found in the GJB4 gene in case 1 or GJB3 and GJB4 genes in case 2.ConclusionA missence mutation G45A in GJB3 gene is found in a patient with EKV.

Objective To study the effect of dexmedetomidine and midazolam on hemodynamics and sedation in patients with nasal intubation.Methods Forty patients whose ASA grade Ⅰ-Ⅱ and anticipated difficult airway were randomly divided into dexmedetomidine group(group D,20 cases)and midazolam group(group M,20 cases)according to the admission number.In group D,dexmedetomidine 1 μ g/kg were constant speed pumped in 10 minutes.In group M,midazolam 0.03 mg/kg were intravenous injected.Then nasal intubation were carried.Systolic blood pressure(SBP),diastolic blood pressure(DBP),mean arterial blood pressure(MAP),heart rate(HR),pulse oxygen saturation(SpO2),Ramsay sedation score,rate-pressure product(RPP),tip perfusion index(TPI)were recorded and compared before anesthesia (T0),fiberoptic bronchoscope pass by later nostril(T1),to spy on epiglottis(T2),intubation succeed(T3),after intubation 1 minute(T4)and after intubation 3 minutes(T5).Airway score and postoperative visit were evaluated.Results SBP,DBP,MAP,HR,RPP in group M were significantly higher at T1-T3 than those at T0 (P＜0.05),and were significantly higher than those in group D at the same time(P＜ 0.05).There was no significant difference in group D(P ＞ 0.05).Ramsay sedation score and TPI at T1-T3 in group M were significantly lower than those at To(P ＜0.05).Ramsay sedation score and TPI at T1-T5 in group D were significantly higher than those at T0(P ＜ 0.05),and were significantly higher than those in group M at the same time(P ＜ 0.05).The rate of airway score 1 score and intubation satisfaction in group D were significantly higher than those in group M[100％(20/20)vs.30％(6/20),90％(18/20)vs.50％(10/20)](P＜ 0.05).The rate of throat ache in group D was significantly lower than that in group M[5％(1/20)vs.35％(7/20)](P ＜0.05).Conclusions For difficult airway patients with nasal intubation during dexmedetomidine infusion,hemodynamics is stable and sedation is satisfied.