2015年 · 第95卷第47期

A 51-year-old male patient suddenly developed right lower abdominal pain without obvious trigger 18 h ago, which was intermittent, without radiating pain, unrelated to eating, accompanied by nausea and vomiting several times, without abdominal distension, diarrhea, chills and fever. Self-administered cephalosporins (specific unknown), the effect is not good, emergency admission, blood test routine: white blood cell count 14.9×10⁹/L, neutral granulometry ratio 0.85, right lower abdominal B-ultrasound showed no obvious abnormality, one year ago due to appendicitis underwent laparoscopic appendectomy, recovered smoothly after the operation and was discharged, so he was admitted to the hospital with "abdominal pain to be examined". Physical examination: There was abdominal breathing, no gastrointestinal peristaltic wave, soft abdomen, tenderness in the right lower abdomen, no rebound pain, no muscle guard, no palpable mass, negative mobile voiced sound, and normal intestinal sound. CT examination (Figure 1): The local intestinal wall in the proximal ileocecal area of the right ascending colon was thickened, the density in the intestinal lumen increased, and the local intestinal tube showed concentric circle-like changes, with speckled dense shadows, and the fat space around the intestine was still clear. Colonoscopy (Figure 2): The colonoscopy was delivered to the end of the ileum, and the appendix fossa was highly swollen, the appendix opening was congested and edematous, and the swollen appendix partially protruded into the cecum.

Event-related pot-entials (ERP) have the advantage of high temporal resolution that other brain imaging technologies can't match. This advantage gives ERP an important technology and means to deeply understand cognitive function, emotional changes and behavioral abnormalities in mental illness. In clinical practice, people always hope to find ERP that reflects the specific changes of mental diseases, and then use this ERP to dynamically evaluate, diagnose and predict the efficacy of diseases.

The most common primary sites of bone metastases are lung, breast and prostate^[1]Bone metastasis suggests poor prognosis^[2]。 Bone-related events (SREs) such as pathological fractures, spinal cord compression, hypercalcemia and pain caused by the "vicious circle" of bone metastases seriously affect the quality of life of patients. Bone metastasis of malignant tumors is a sequential multi-step process, including the escape of tumor cells ("seeds") with bone metastasis ability from the primary tissue, survival activation, bone marrow homing and "seeding", dormancy, and invasion and activation after termination of dormancy. Bone marrow homing and "seeding", the "vicious circle" of bone destruction and/or bone formation after the termination of dormancy are unique processes of bone metastasis of malignant tumors. Each step of the cascade of tumor bone metastasis is rich in biological targets and metastatic pathways, which provides an opportunity for the prevention and treatment of tumor bone metastasis.

Pituitary adenoma is a common benign tumor in the cranium, accounting for 10% ~25% of intracranial tumors^[1]。 Among them, non-functional pituitary adenomas account for about 30% of pituitary adenomas. Non-functioning pituitary adenomas are usually large in size, and transsphenoidal pituitary adenoma resection is currently the preferred treatment option for non-functioning pituitary adenomas. But the surgical resection rate is usually lower than that of other types of pituitary adenomas^[2]。 Postoperative radiotherapy can reduce the size of residual tumors in some patients, but it can cause complications such as hypopituitary function, optic neuropathy and cognitive dysfunction, and the results are not satisfactory^[3]。 Therefore, finding targeted drugs to inhibit tumor growth has important clinical significance for the clinical treatment of nonfunctional pituitary adenoma. PI3K/Akt/mTOR pathway is closely related to cell growth, differentiation and tumorigenesis. There have been many studies on targeting drugs for this pathway in nonfunctional pituitary adenomas. The current research status of PI3K/Akt/mTOR pathway in nonfunctional pituitary adenomas is summarized as follows.

idiopathic pulmonary arterial hypertension (IPAH) is a progressive disease characterized by a progressive increase in pulmonary vascular resistance, which eventually leads to right heart failure and even death^[1]。 Jia Weibin et al.^[2]A study of 161 patients with IPAH in China showed a mean age of (33 ± 15) years, predominantly female (70.2%). The diagnostic criteria proposed by the World Health Organization (WHO) are: mean pulmonary artery pressure (MPAP)>25 mmHg (1 mmHg =0.133 kPa) at sea level at rest or MPAP>30 mmHg under exercise, pulmonary capillary wedge pressure (PCWP) Or left ventricular end-diastolic pressure (≤15 mmHg) and pulmonary vascular resistance>3 Wood units (1 kPa =0.125 Wood units) (the latter two are not included in the diagnostic criteria for general pulmonary hypertension).