Volume 85  ·   Issue 37  ·  2005

Since 1930s, surgery has been the first choice for the treatment of lung cancer. In 1933, Graham performed the first successful pneumonectomy for lung cancer, in 1937, Wang Datong performed the first successful pneumonectomy in China, and in 1942, Zhang Jizheng performed the first successful pneumonectomy in Peking Union Medical College Hospital. In 1952, Allison reported the first case of right upper lung cancer performed sleeve resection, which preserved the healthy lung tissue to the greatest extent and improved the quality of life of patients after operation.

At present, the study of bone quality has become a hot spot in academic circle.This is because the bone quality determines whether patients are prone to fracture.Besides the biochemical indexes of blood and urine can evaluate the bone loss rate,the annual bone loss rate can also be calculated by dual-function X-ray [1]. The World Health Organization (WHO) has established the standard for diagnosing osteoporosis.However, it is easy to misdiagnose osteoporosis by relying only on bone density, such as chondrosis. Therefore,the correct diagnosis can be obtained only by combining various clinical examinations,referring to the results of bone density measurement,and comprehensive analysis. Besides primary osteoporosis (including postmenopausal osteoporosis and senile osteoporosis), the most common patients with bone density reduction (i.e. bone quality reduction) in clinic often suffer from renal tubular diseases.Accurate mastery of this part of knowledge has important guiding significance for guiding our clinical work.

Between 1990 and 1999, the number of hospitalizations for newly diagnosed heart failure in the United States increased from 810,000 to 1 million per year. About 5 million American residents suffer from heart failure, and more than 550,000 new patients are added each year. There are 12 to 15 million visits and 6.5 million hospital days per year. Medical costs for the diagnosis and treatment of heart failure also exceed those of any other disease. The direct and indirect health costs for this disease in 2005 were estimated at $27.9 billion.

August 26, International Famous Academic Journals<Cell>published a research paper completed by the Sensory System Research Group of the Institute of Neuroscience, Shanghai Institute of Life Sciences, Chinese Academy of Sciences and its collaborators. The paper elaborated the relevant achievements of Zhang Xu and other scientists discovering a new principle of regulating the analgesic effect of opioids. This discovery broke through the traditional understanding of substance P and opioids in pain research, revealed that substance P precursor molecules are the key molecules that directly regulate the analgesic function and morphine tolerance of opioid system, and provided a new theoretical basis for the development of new analgesic drugs.

Atrial septal defect is the most common congenital heart disease, accounting for about 5%-10% of congenital heart diseases.The classical treatment method is the direct vision repair of cardiopulmonary bypass with median sternal incision.In order to reduce surgical trauma, in the 1990s, abroad performed atrial septal defect repair with small chest incision,robot-assisted laparoscopic atrial septal defect repair and catheter intervention atrial septal defect closure.In recent years, hybrid technology was adopted, that is, atrial septal defect closure with small chest incision under direct vision, which made the occluder line with atrial septal defect, with high success rate, safe, simple and fast operation.

The problem of irrational use and even abuse of antimicrobial drugs is widespread in the world, and it has aroused great attention of the international society. International organizations including the World Health Organization and countries around the world have taken active measures to strengthen the supervision of the use of antimicrobial drugs [1]. The problem of irrational use of antimicrobial drugs in China is also quite prominent, on the one hand, it increases the incidence of adverse reactions and drug-induced diseases of drugs, on the other hand, it also causes the increasing drug resistance of bacteria, causing some effective antimicrobial drugs to decrease or even fail, which not only affects the therapeutic effect of diseases, but also increases the economic burden of patients, and objectively promotes the irrational rise of medical expenses. This problem has aroused widespread attention of the whole society and produced strong repercussions [2].

Objective to study the effect of protein kinase C (PKC) on hexokinase (HK) in peritoneal mesothelium cell (PMC) Methods The omentum was obtained from male SD rats, the primary culture and passage of PMC were used by trypsin-EDTA digestion, and indirect immunofluorescence staining of cytokeratin antibody was used for identification of PMC; The effects of PKC activator-phorbol ester (PMA, PDD) and classical PKC (cPKC) inhibitor-G (o) 6976 on the activity of HK were observed by coupled colorimetric method of glucose 6-phosphate dehydrogenase. The glucose consumption in the culture medium was measured by colorimetric method as an index of the net utilization of glucose by cells. Results the primary cultured PMC adhered to the wall for 24 h and fused for 5~8 d, forming a paving stone-like appearance, and cytokeratin expressed positively in the cytoplasm. The induction of HK activity by PMA was time-and dose-dependent, and the net utilization of glucose by PMC was increased by 0.01, 0.1 and 1 μ mol/L PMA for 24 h, the HK activity increased by 30.7%, 59.9% and 99.1%, respectively (P<0.05). The HK activity of 1 μ mol/L PMA on PMC was up-regulated after 6 h and reached a peak at 24 h (21.3% and 100.4%, respectively, P<0.05), and half of the glucose in the culture medium was consumed (2 mmol/L, P<0.05). The effect of 1 μ mol/L PDD on the induction of HK activity was similar to that of 1 μ mol/L PMA, but the structural analogue of PDD, 4 α-PDD, did not have the above effect on HK activity. G (o) 6976 inhibited the induction of HK activity by PMA. PMC pretreated with 10, 20, 30, 40 and 50 μ mol/L G (o) 6976 for 30 min and then incubated with 1 μ mol/L PMA for 24 h, the activity of HK was inhibited by 14.6%, 26.8%, 34.2%, 44.2% and 54.9% respectively (P<Conclusion PKC can up-regulate the activity of HK and increase the net utilization of glucose by cells, which may be related to the accelerated absorption of glucose by PMC after long-term peritoneal dialysis; The blocking of HK activity by cPKC inhibitors may be one of the effective ways to improve peritoneal dialysis ultrafiltration.

Objective to investigate the expression of TGF-β 1/Smads signal protein in high concentration glucose dialysate and the peritoneal tissue of rat peritoneal fibrosis model induced by inflammation and its possible role in the development of peritoneal fibrosis.Methods 24 male SD rats (180~200 g) were randomly divided into 4 groups, 6 rats in each group.The normal control group, the rats were not treated; In the LPS group, LPS was diluted with normal saline to 0.6 mg/100 ml, and injected intraperitoneally at 0.6 mg/kg body weight on the 1st, 3rd, 5th and 7th days; In the 4.25% dialysate group, rats were given daily intraperitoneal injection of 100 ml/kg body weight high glucose dialysate; In the LPS +4.25% dialysate group, in addition to the daily intraperitoneal injection of 100 ml/kg body weight high glucose dialysate, LPS was diluted with 4.25% dialysate to 0.6 mg/100 ml, and injected intraperitoneally at 0.6 mg/kg body weight on the 1st, 3rd, 5th and 7th days; The parietal and visceral peritoneal tissues were examined by light and electron microscopy on the 28th day of the experiment. The expression levels of α-SMA, TGF-β 1, Smad3, Smad7, p-Smad2/3, ColⅠ mRNA and protein were detected by RT-PCR, indirect immunofluorescence and Western hybridization. Results Masson staining showed that compared with the normal control group, the parietal peritoneal tissues of each group were significantly thickened at 4 weeks, with a large amount of collagen deposited, among which the thickness was the most significant in the LPS +4.25% dialysate group (vs LPS group: 42 μ m ± 3 μ m vs 35 μ m ± 4 μ m, P =0.007, vs 4.25% dialysate group, 42 μ m ± 3 μ m vs 20 μ m ± 4 μ m, P =0.000). Compared with the normal control group, the expression levels of α-SMA, COL Ⅰ, TGF-β 1, Smad3 and p-Smad2/3 in the visceral peritoneal tissue of the three groups were significantly up-regulated. The above changes were most significant in the LPS +4.25% dialysate group, with TGF-β 1 mRNA twice and Smad3 mRNA 1.8 times that of the normal control group; Compared with the normal control group, the mRNA and protein expression levels of inhibitory signal protein Smad7 were up-regulated in the other three groups, but the Western hybridization results showed that the ratio of p-Smad/Smad7 protein was still significantly increased; The results of electron microscopy showed that the mesothelial cells in all groups were damaged except the normal control group, and the mesothelial cells in the LPS +4.25% dialysate group were damaged most obviously, and there were obvious myofilaments and dense bodies in the cytoplasm. Conclusion the activation of TGF-β 1/Smads signal protein is a common pathway of peritoneal fibrosis induced by high concentration glucose dialysate and LPS.

Objective to investigate the effect of bone morphogenetic protein-7 (BMP-7) on the transdifferentiation of human renal tubular epithelial cells induced by monocyte chemotactic protein-1 (MCP-1) in vitro, and to investigate the relationship between this effect and the expression changes of transforming growth factor-β 1 (TGF-β 1) and Smad 3. Methods HK-2 cells were divided into the following groups: negative control group; Positive control group: TGF-β 1 (5 ng/ml) treatment; MCP-1 (0.1, 1, 10 and 50 ng/ml) group, BMP-7 group (0.1, 1, 10, 50 ng/ml); MCP-1 (1 ng/ml) plus BMP-7 (50 ng/ml) group; The expression of α-smooth muscle actin (α-SMA) mRNA in HK-2 cells was detected by semi-quantitative RT-PCR, the secretion of type I collagen in the supernatant was determined by ELISA, and the expression of TGF-β 1 and Smad 3 in HK-2 cells was detected by Western blot. Results the expression of α-SMA mRNA in HK-2 cells in MCP-1 (0.1, 1 ng/ml) group was significantly higher than that in the negative control group (P<The secretion of type I collagen in the supernatant of MCP-1 (0.1, 1 ng/ml) group was significantly higher than that of the negative control group (P<After the co-action of MCP-1 neutralizing antibody and MCP-1 (1 ng/ml) for 24 h, α-SMA mRNA expression in HKC cells was almost completely inhibited (P<0.001), while the expression of α-SMA mRNA in HK-2 cells was only partially inhibited after the co-action of BMP-7 (50 ng/ml) and MCP-1 (1 ng/ml) for 24 h (P<0.01); Type Ⅰ collagen secretion was significantly lower than that of MCP-1 (1 ng/ml) group after 24 h of co-action with MCP-1 neutralizing antibody or BMP-7 (50 ng/ml) and MCP-1 (1 ng/ml) (P<0.05). The expression levels of TGF-β 1 and Smad 3 in HK-2 cells in MCP-1 (1 ng/ml) group were significantly up-regulated compared with those in the negative control group (P<0.01). The expression of TGF-β 1 in HK-2 cells was down-regulated by MCP-1 neutralizing antibody or BMP-7 (50 ng/mL) and MCP-1 (1 ng/mL) for 24 h, respectively, compared with MCP-1 (1 ng/mL) alone. The effect of MCP-1 neutralizing antibody was stronger (P<0.01, P<0.05); The expression of Smad3 was similarly downregulated after MCP-1 neutralizing antibody or BMP-7 for 24 h (P<0.01, P<Conclusion MCP-1 can induce the transdifferentiation of HK-2 cells in vitro, which may be related to the upregulation of TGF-β 1 and Smad3 expression.BMP-7 can partially inhibit the transdifferentiation of HK-2 cells induced by MCP-1, which may be related to the partial downregulation of TGF-β 1 and Smad3 expression; It also suggests that MCP-1-induced transdifferentiation may involve a non-TGF-β dependent cell signaling pathway, which needs further study.

Objective to investigate whether non-selective endothelin receptor antagonist (bosentan) and angiotensin Ⅱ1 receptor antagonist (valsartan) can inhibit the progression of renal interstitial fibrosis in chronic aristolochic acid nephropathy (CAAN) rats. Methods Male SD rats were administered with guanmutong extract aqueous solution to induce CAAN model, and were divided into model group, bosentan group (100 mg·kg-1·d-1 gavage) and valsartan group (30 mg·kg-1·d-1 gavage). The control group was administered with tap water gavage. Six animals in each group. Body weight, 24 h urine protein quantification, β 2 microglobulin (β 2-MG) and serum creatinine (SCr) of rats were measured; Rats were sacrificed at 16 weeks, and kidney tissue sections were taken for Masson staining; The expressions of transforming growth factor-β 1 (TGF-β 1), connective tissue growth factor (CTGF), plasminogen activator inhibitor-1 (PAI-1), metalloproteinase tissue inhibitor-1 (TIMP-1) and collagen type Ⅰ (ColⅠ) mRNA and protein in renal tissues were detected by RT-PCR and immunohistochemistry. Results Compared with the control group, urine protein quantification, urine β 2-MG and SCr in the CAAN model group increased significantly to the later stage of the experiment (P<0.05 or 0.01); The area of renal interstitial fibrosis was significantly enlarged (P<0.01); The mRNA and protein expressions of TGF-β 1, CTGF, PAI-1, TIMP-1 and COL Ⅰ were significantly upregulated in renal tissues (P<0.01). The above up-regulated indexes were significantly inhibited in the bosentan and valsartan intervention groups (P<Conclusion Bosentan and valsartan can inhibit the progression of renal interstitial fibrosis and delay the progression of renal damage in CAAN rats, which may be obtained by inhibiting factors promoting extracellular matrix synthesis (TGF-β 1, CTGF) and inhibiting anti-extracellular matrix degradation factors (PAI-1, TIMP-1).

Objective to investigate the expression of estrogen and progesterone receptor (ER, PgR) in hilar cholangiocarcinoma, and to study the relationship between their expression and pathological type, grade and clinical stage of the tumor. Methods the expression of ER and PgR in 42 cases of hilar cholangiocarcinoma was detected by immunohistochemistry. Results the positive expression rates of ER and PgR in hilar cholangiocarcinoma were 66.7% and 64.3%, respectively. There were obvious differences in the expression of ER and PgR between well-differentiated and poorly differentiated types and between milky and sclerotic types. Conclusion the expression rates of ER and PgR in hilar cholangiocarcinoma were higher.

Objective to investigate the clinicopathological characteristics and surgical therapeutic effects of non-functional islet cell tumor. Methods 78 cases of non-functional islet cell tumor admitted to Peking Union Medical College Hospital from July 1968 to January 2005 were retrospectively analyzed, and their clinical manifestations, preoperative diagnosis, surgical management, pathological characteristics and immunohistochemical analysis were summarized. Results 27 cases (34.6%) were found by physical examination, and the most common symptoms were upper abdominal pain and upper abdominal discomfort (30.7% (24 cases) and 26.9% (21 cases), respectively; The most common sign was abdominal mass, accounting for 35.9% (28 cases). Bus and CT were the most commonly used preoperative examination methods, with positive rates of 98.6 (71/72) and 100% (53/53), respectively. The surgical mortality rate was 1.28%, and the 5-year survival rate of malignant radical resection was 75% (9/12). Immunohistochemical studies showed that 78.6% (55/70) of patients containing multiple peptide hormones, 91.4% (32/35) and 79.4% (27/34) of neuron-specific diluolase and chromaffin were positive, respectively. The positive rates of insulin, glucagon, pancreatic polypeptide, somatostatin, vasoactive intestinal peptide and gastrin were 64.6% (42/65), 47.5% (22/53), 45.8% (22/48), 37.5% (21/56), 23.9% (11/46) and 22.6% (7/31), respectively. Conclusion the symptoms of nonfunctional islet cell tumor lack specificity, Bus and CT should be the first choice examination methods. Surgery is an effective means to treat this disease and prolong the survival time of patients.

Objective to summarize the therapeutic effects of 413 GK-2 prosthetic heart valves in 20 years, and evaluate the long-term efficacy of domestic GK-2 single-leaflet mechanical valves. Methods 327 patients undergoing heart valve replacement between 1985 and 2004 were followed up. 123 males and 204 females, aged 1.6~68 years (38.62 ± 10.14 years), 21 patients with cardiac function grade Ⅱ, 216 patients with cardiac function grade Ⅲ, and 90 patients with cardiac function grade Ⅳ. The surgical procedures were mitral valve replacement (MVR) in 205 cases (62.69%), mitral and aortic valve replacement (DVR) in 86 cases (26.30%), aortic valve replacement (AVR) in 31 cases (9.48%), and tricuspid valve replacement (TVR) in 5 cases (1.52%). A total of 296 GK-2 mitral valves and 117 aortic valves were used. The follow-up was 0.5~19.6 years (9.05 ± 4.59 years), and the total number of follow-up years was 2440.7 patient-years. Results 11 patients died early, the mortality rate was 3.36% (11/327), and 24 patients died long-term, the mortality rate was 0.98% patient-year. 5 This type of valve has many advantages, the incidence of valve-related events is at a low level, and the long-term effect is satisfactory.

Objective to study the quality of life of patients with malignant tumors in China after autologous hematopoietic stem cell transplantation (ASCT). Methods the Chinese version of the European Organization for Cancer Research and Treatment (EORTC) QLQ-C30 3.0 Quality of Life Questionnaire was used to analyze the quality of life of 89 patients who received ASCT from 1991 to 2004 and were currently in a disease-free state. Results the overall health status and functional scores were close to or above 80 points, and more than 80% of the patients had good overall health status and functional status. The patients with moderate to severe economic difficulties, sleep disorders, fatigue, dyspnea and diarrhea accounted for 72.5% (65 cases), 50.6% (45 cases), 42.7% (38 cases), 33.7% (30 cases) and 32.5% (29 cases), respectively; The symptom scores of dyspnea were significantly higher in female patients than in males (P =0.024); The scores of overall health status, physical function, role function and social function increased significantly with the prolongation of time (P =0.000,0.000,0.031,0.029), while the scores of asthenia symptoms decreased significantly (P =0.020); The scores of nausea, vomiting and dyspnea were significantly higher in patients with Hodgkin's lymphoma than in patients with non-Hodgkin's lymphoma (P =0.002, 0.006); There was no significant difference in the scores of patients at different ages at the time of transplantation and evaluation. Conclusion After ASCT treatment, most of the patients had good general health and functional status, and the main symptoms affecting their quality of life were financial difficulty, fatigue, dyspnea, sleep disturbance and diarrhea. The symptoms of dyspnea in female patients are more prominent, and the quality of life of patients will improve gradually with the prolongation of the time after transplantation. Hodgkin's lymphoma patients have more symptoms and complaints than non-Hodgkin's lymphoma patients, and the age at the time of transplantation and evaluation has no effect on the quality of life of patients.

Objective to evaluate the efficacy and safety of glicinide sustained-release (Dameikang sustained-release 30 mg tablet) in patients with type 2 diabetes mellitus who were previously treated with other oral hypoglycemic drugs.Methods 154 patients with type 2 diabetes mellitus who were previously treated with diet control and other oral hypoglycemic drugs were treated with glicinide sustained-release tablets for 16 weeks, and their efficacy was evaluated by glycosylated hemoglobin, fasting blood glucose and 2h postprandial blood glucose; Results After 16 weeks of treatment, glycosylated hemoglobin decreased by 1.89% and 21.6%, fasting blood glucose and 2 h postprandial blood glucose decreased by 2.31mmol/L and 3.94mmol/L, respectively, 24.5% and 27.8% compared with those before treatment.

Objective to investigate the immunoprotective effect and mechanism of Helicobacter pylori (Hp) vaccine adjuvant with chitosan. Methods BALB/C mice were randomly divided into 9 groups: ① blank control group; ② Chitosan acid solution group; ③ chitosan particle group; ④Hp antigen group; ⑤ Hp antigen + chitosanic acid solution group; ⑥Hp antigen + chitosan particle group; ⑦Hp antigen + cholera toxin (CT) group; ⑧Hp antigen + chitosanic acid solution + cholera toxin group; After 4 weeks, Hp infection in gastric mucosa was detected by quantitative Hp culture and pathologically modified Giemsa staining. Anti-HpIgA in saliva and gastric mucosa was detected by enzyme-linked immunosorbent assay (ELISA), Th1 and Th2 cytokines in gastric mucosa were detected by quantitative ELISA, and endocrine IgA (sIgA) in gastric mucosa was detected by SP immunohistochemistry. Results (1) The immunoprotective rate of Hp vaccine adjuvant with chitosan was 60%, which was similar to that of Hp vaccine adjuvant with cholera toxin (58.33%), and significantly higher than that of Hp antigen alone and other groups without Hp antigen (P<0.01 or P<At the same time, the protection rate of Hp vaccine adjuvant with cholera toxin + chitosan was 84.62% and 85.71%, and the colonization score of Hp was significantly lower than that of the group without adjuvant and cholera toxin adjuvant (P<0.01 or P<(2) The levels of sIgA and specific anti-HPIgA in gastric mucosa were significantly higher in the chitosan-adjuvant group than in the cholera toxin-adjuvant group (P>0.05), while the combination of chitosan and cholera toxin was significantly higher than that in the cholera toxin-adjuvant group (P<0.01 or P<(3) There was no significant difference in the content of interleukin (IL) -2 in gastric mucosa before challenge (P>0.05). After challenge, the content of interleukin (IL) -2 in gastric mucosa was significantly higher than that in the control group (P>0.05)<0.01 or P<0.05), and all groups containing Hp antigen after challenge were significantly higher than those before challenge (P<(4) The content of IL-10 in gastric mucosa before challenge was significantly higher in the group with chitosan as adjuvant than in the group without adjuvant (P<0.01 or P<0.05), there was no significant difference between the groups after challenge (P>0.05), and the adjuvant-containing group after challenge was significantly lower than that before challenge (P>0.05)<(5) The content of IL-4 in gastric mucosa before challenge was significantly higher in the group with chitosan as adjuvant than in the group without adjuvant (P<After challenge, the group with chitosan granules as adjuvant was significantly higher than that with cholera toxin as adjuvant (P<0.05), and the chitosan solution as adjuvant group was significantly higher than that of the control group, the no adjuvant group and the cholera toxin in the adjuvant group (P<0.01 or P<0.05), and the adjuvant-containing group after challenge was significantly lower than that before challenge (P<0.01 or P<Conclusion (1) Hp vaccine with chitosan as adjuvant has immunoprotective effect against Hp infection and can successfully induce local specific humoral immune response in mucosa, which may play a role in its immune defense; (2) Hp vaccine with chitosan as adjuvant can promote the mixed immune response of Th1 and Th2, reverse the inhibition of Th2 response after challenge, and restore the imbalance of Th1/Th2 caused by Hp infection, so as to exert its immunoprotective effect.

Objective to establish the gene expression profiles of stage IB and stage IIIA lung squamous cell carcinoma and to screen the specific gene related to stage IB of lung squamous cell carcinoma. Methods the normal lung and clinical stage IB and stage IIIA lung squamous cell carcinoma tissues were collected, and the total RNA was extracted and cDNA was prepared. The biotin-labeled cRNA probe was synthesized, and the results were analyzed and processed by MSV 5.0 software, and the information was queried in Affymetrix database. The results of the detection on the chip were verified by reverse transcription-polymerase chain reaction (RT-PCR). The results were co-screened according to the principle of parallel comparison of multiple groups, and the signal log ratio (SLR) was all greater than 1 as the screening criterion. The differentially expressed genes of lung squamous cell carcinoma were 1764 in stage IB, of which 571 were up-regulated and 1193 were down-regulated; There were 554 genes in stage Ⅲa, 128 up-regulated and 426 down-regulated. Compared with the gene expression profile of stage Ⅲa, there were 1329 differentially expressed genes specific for stage Ⅰb, of which 482 up-regulated and 847 down-regulated. The biological functions of these genes were classified, including 480 related to metabolism, 227 related to signal transduction, 136 related to cell proliferation, 136 related to immune, 94 related to cell adhesion, 88 related to transcriptional regulation, 86 related to cell cycle, 73 related to cytoskeleton, 45 related to cell differentiation, 42 related to apoptosis and 31 related to extracellular matrix. The results of RT-PCR detection of FOXM1 and TNXB genes were consistent with the results of gene microarray detection. Conclusion The gene expression profiles of stage Ⅰb and stage Ⅲa lung squamous cell carcinoma were established in the whole genome and the specific gene related to stage Ⅰb of lung squamous cell carcinoma were screened, which laid a foundation for further study of carcinogenesis mechanism and identification of early diagnostic molecular markers of lung squamous cell carcinoma.

The incidence of spinal cord injury after thoracoabdominal aortic aneurysm (TAAA) is high [1]. We treated 23 patients with thoracoabdominal aortic aneurysm who could not tolerate large surgical invasion with modified Hardy method (i.e., artificial blood vessel bypass drainage of the aorta to supply the distal organs and limbs, incomplete ligation of the neck of the tumor, absent aneurysm) to repair TAAA, and the clinical effect was good [2]. To confirm the effect of this procedure on spinal cord blood supply and tumor cavity pressure, we analyzed the effect of this procedure on hemodynamics and spinal cord blood supply through canine model.

A 48-year-old male was admitted to the hospital on July 24, 2003 due to pain in the left hip for 29 days. The pain in the left hip appeared 29 days ago, which was persistent and dull, gradually aggravated, especially at night, and radiated to the left ankle, accompanied by limited movement of the left hip. There was no previous history of hemorrhagic disease. Physical examination on admission: body temperature 37.0 ℃, blood pressure 130/70 mm Hg (1 mm Hg =0.133 kPa), no anemia, no yellowing stain of skin and sclera, no bleeding spots and ecchymosis in oral mucosa and other parts, no abnormalities in heart and lung, and no palpation of liver and spleen.

Since Warren et al. [1] successfully isolated Helicobacter pylori (Hp) from human gastric mucosa in 1982, a lot of studies have been carried out on it. At present, it has been confirmed that Hp is closely related to four kinds of upper gastrointestinal diseases: chronic gastritis, peptic ulcer disease, gastric cancer and gastric mucosa-associated lymphoid tissue (MALT) malignant lymphoma. The World Health Organization and the National Institutes of Health of the United States have officially designated Hp as a class I carcinogen of gastric cancer [2]. The pathogenic mechanism of Hp is very complex. At present, it is believed that the pathogenic mechanism of Hp includes: colonization of Hp, gastric mucosal damage caused by toxin, gastric mucosal damage mediated by host immune response, and abnormal gastric acid secretion caused by imbalance of gastrin and somatostatin regulation after Hp infection [3].

A 30-year-old male was admitted to the Sir Run Run Shaw Hospital of Zhejiang University School of Medicine on July 6, 2004 due to repeated pain in the left hypochondrial region and chest and back for more than 2 months. Two months ago, the patient felt pain in the left hypochondrial region and chest and back without obvious trigger, which was tolerable, aggravated when moving or exerting, and relieved after resting. There was no fever, no night sweats, no muscle soreness in the limbs, no restricted movement, no nausea, vomiting, no abdominal pain, diarrhea, no dizziness and headache.