2016年 · 第96卷第28期

Since the advent of antibiotics in the 1940s, human infectious diseases have been effectively controlled, and the mortality rate has dropped significantly. However, with the widespread use of antibiotics in medicine, agriculture, animal husbandry and aquaculture, the problem of bacterial drug resistance has become increasingly serious, which has become an important medical and social problem^[1,2,3]。

With the rapid development of modern medicine, the high-tech means of prolonging life are constantly updated. Some medical measures not only prolong life, but also bring more pain to patients. In the face of incurable patients with advanced diseases, medical staff often feel helpless and don't know how to face and comfort such patients and their families. Palliative care aims to provide overall positive medical care to end-stage patients who have not responded to and benefited from curative treatment, with the aim of improving the quality of life of patients in the end-stage. Palliative care is a concept and model of end-of-life care actively promoted all over the world, and there is a complete education and training system. With the aging population and the sudden increase of cancer patients in China, palliative care has been paid more and more attention, and it is urgent to promote palliative care in medical education.

Mechanical ventilation is a commonly used supportive measure in the treatment of severe respiratory failure. Clinically, pneumothorax related to mechanical ventilation is prone to occur due to underlying diseases such as chronic obstructive pulmonary disease (COPD), diffuse pulmonary interstitial fibrosis, and improper setting of mechanical ventilation parameters^[1]。 Immediately after pneumothorax, closed drainage with intercostal cannula and water-sealed bottle is the most commonly used treatment^[2]。 However, due to the underlying lung diseases, some patients still have difficulty in ensuring ventilation support. We used fiberoptic bronchoscope to explore the segmental bronchus communicating with the visceral pleural rupture with balloon catheter in such patients, and then blocked the segmental bronchus with bio-glue, and received good results, which are reported as follows.

Popliteal artery entrapment syndrome (PAES) is a disease in which the popliteal artery is compressed due to anatomical abnormalities in the popliteal fossa, resulting in corresponding lower limb ischemia symptoms. The medial head of gastrocnemius is gradually displaced in the popliteal fossa with embryonic development, and the arterial structure in the popliteal fossa is rearranged. During this process, the abnormal anatomical relationship between the popliteal artery and the surrounding muscles or tendons will lead to the occurrence of PAES^[1]。 The incidence of PAES is about 0.2% ~3.5%^[2,3], patients are generally young males, age<50% of 50-year-old patients with calf claudication are caused by this disease^[2,3,4]。

In recent years, the incidence of acid-related diseases has been gradually increasing, and proton pump inhibitors (PPIs) have potent inhibition of H^＋-K^＋-ATPase activity, gastric acid secretion and killing Helicobacter pylori are favored, and are widely used in the treatment of clinical acid-related diseases with remarkable curative effects. With the extensive application of proton pump inhibitors in clinical practice, clinicians have gradually paid attention to the rational application and adverse reactions in clinical practice. However, there are no rational application norms and guidelines for proton pump inhibitors. Therefore, this paper analyzed 200 medical records randomly selected from Linyi People's Hospital of Shandong Province who had used proton pump inhibitors, so as to provide corresponding basis and suggestions for clinical medication, reduce adverse reactions, reduce the risk of medication, and maximize the benefit of patients.

The prevalence of iron deficiency was high in all age groups^[1]It has great influence on human body's intelligence, physical development, immune function, digestion and absorption function and labor ability. Therefore, it is of great clinical and social significance to study and prevent iron deficiency in depth.

In recent years, tumor immunotherapy has made rapid development, leading a major breakthrough in the field of tumor treatment. The American Society of Clinical Oncology (ASCO) Annual Report on Cancer Research Progress, released on February 4, 2016, ranked immunotherapy as the largest progress in cancer research in 2015^[1]。 At present, the successful fields of tumor immunotherapy and research hotspots mainly focus on immune checkpoint inhibitors. A series of clinical studies have shown that immune checkpoint inhibitors are effective against a variety of malignancies. Three immune checkpoint inhibitors, ipilimumab, nivolumab and pembrolizumab, have been approved by the U.S. Food and Drug Administration (FDA) as standard treatment for the treatment of advanced non-small cell lung cancer (NSCLC), advanced melanoma or advanced kidney cancer^[2,3]。 The relevant research is summarized as follows.

Takayasu arteritis (TA) is a chronic non-specific inflammatory artery disease. The inflammation mainly involves the aorta and its main branches, including the pulmonary and coronary arteries^[1]。 It is more common in young Asian women and was once called "Oriental Beauty Disease". Stenosis or occlusion of the lumen caused by thickening of the vessel wall is the most common type of lesion, and some patients can develop aneurysms due to decreased elasticity of the vessel wall. Therefore, the clinical manifestations are mostly ischemia of the corresponding organs, such as hypertension, asymmetric pulse and blood pressure of the limbs, cerebral ischemia, intermittent claudication and vascular murmur^[2,3]。 Heart failure secondary to the above-mentioned lesions is the main cause of death in TA.

Hepatic ischemia-reperfusion injury (IRI) refers to the phenomenon that liver ischemia caused by lobectomy, liver transplantation, hemorrhagic shock, etc. When blood supply and reperfusion are restored, not only can liver function not be restored, but also aggravate liver cell dysfunction and structural damage. The mechanism of IRI in liver is very complex and has not been completely defined. To explore its mechanism and its prevention and treatment strategies has always been one of the hot spots in clinical and basic medical research for many years. The process of this injury may be related to calcium overload, inflammatory reaction, oxygen free radical (ROS) and lipid peroxidation, etc. The morphological changes are mainly swelling of hepatic sinusoidal endothelial cells, neutrophil infiltration and hepatocyte necrosis^[1,2,3]。 In addition to necrosis, there are also apoptosis and autophagy in the way of death of liver cells^[4,5]。 Apoptosis and autophagy have independent signaling pathways, but recent studies have confirmed that there are many intersections between them, which are both synergistic and antagonistic^[6,7]。