Volume 86  ·   Issue 14  ·  2006

In recent years, the incidence of pancreatic cancer has shown an obvious upward trend worldwide. In 2004, there were 31 860 new cases of pancreatic cancer in the United States, and at least 27 000 people died of pancreatic cancer every year, accounting for the fourth place among malignant tumors [1]; According to the statistics of Beijing and Shanghai in China, the incidence rate of pancreatic cancer is 5.1~10 people/100,000 [2,3], occupying the 8th place among malignant tumors, and the mortality rate is the 5th place, increasing from 1.83% in 1991 to 2.26% in 2000 [4]. The incidence of pancreatic cancer is dangerous, with short course of disease, rapid progression, poor treatment effect, high mortality rate, and median survival time is only 4~6 months.

Objective to investigate the drug resistance of influenza virus strains to amantadine. Methods RNA was extracted from epidemic strains isolated in Beijing from 2003 to 2005, and the M2 gene fragment of influenza virus was amplified by RT-PCR, and the amino acid loci related to drug resistance were determined by gel electrophoresis, nucleic acid sequencing and bioinformatics software analysis. Results Amantadine resistance was observed in 30 of 41 epidemic strains, the proportion of which was 75% (30/40). The variation of resistant strains showed that 31 amino acids were substituted by asparagine. Conclusion This variation is worthy of our great attention. We should carry out the surveillance of resistance to influenza virus in China, further determine the incidence frequency of resistant strains of influenza virus in China, and provide reference for formulating measures to deal with influenza pandemic.

Objective to study the protective effect of teprenone on gastric mucosal injury induced by concentrated culture supernatant (CCS) of toxin-producing Helicobacter pylori (Hp) in mice. Methods Sixty healthy male Balb/c mice were divided into four groups according to the random number table: normal saline group, simple injury group, sucralfate protected group and teprenone protected group, 15 mice in each group. The mice were gavaged with normal saline (first two groups), sucralfate and teprenone in advance, and then gavaged with normal saline (physiological saline group) and toxin-producing Hp CCS (last three groups). The histological changes of gastric mucosa were observed under light microscope and electron microscope, and the gastric mucosal epithelial injury score (EDS) of each group was measured respectively to evaluate the degree of gastric mucosal injury and the preventive and protective effect of drugs. Results The gastric mucosa of mice in simple injury group was significantly damaged, Including vacuolar degeneration, disordered gland arrangement, erosion and ulcer formation. Under electron microscope, intercellular space widening, vacuolar degeneration, cytoplasmic swelling, mitochondria and endoplasmic reticulum expansion, disordered arrangement and shedding of microvilli, and increased phagolysosome. The injury of the two drug-protected groups was significantly milder than that of the simple injury group. The gastric mucosal EDS of the saline group, the simple injury group, the sucralfate-protected group and the teprenone-protected group were 1.2±0.3, 2.5±0.6, 1.7±0.7, 1.7±0.7, respectively. The gastric mucosal EDS of the two protection groups was significantly lower than that of the simple injury group (P<There was no significant difference in EDS between the teprenone-protected group and the sucralfate-protected group (P>0.05). Conclusion Teprenone has a preventive and protective effect on gastric mucosal injury caused by Hp CCS in mice, and the effect is similar to that of sucralfate.

Objective to investigate the protective effect of sodium ferulate pretreatment on ischemia/reperfusion injury in isolated rats and its related mechanism.Methods 56 SD rats were randomly divided into 7 groups (every 8 rats): normal control (Cont) group; Ischemic injury (I/R) group; ischemic preconditioning (IP) group; sodium ferulate (SF) group; L-arginine methyl ester (L-NAME) group; Glibenclamide (Glib) group; The changes of cardiac function indexes and the contents of superoxide dismutase (SOD), malondialdehyde (MDA), nitric oxide (NO) and guanosine cyclic phosphate (cGMP) before and after ischemia-reperfusion were observed by using Langendorff retrograde perfusion model of isolated rat heart. Results Compared with I/R group, sodium ferulate or IP group significantly improved cardiac function after I/R, which showed enhanced ventricular systolic function, increased left ventricular maximum systolic pressure (LVSP), and decreased incidence of arrhythmia (P<0.01). The NO content and cGMP concentration in ventricular myocardial tissue were significantly higher (P<0.01); There was no statistical difference between the sodium ferulate group and the IP group (P>0.05), but the myocardial protective effect of sodium ferulate with L-NAME and/or Glib was significantly weakened after pre-perfusion (P<Conclusion Sodium ferulate pretreatment can increase the production and release of NO, antagonize oxygen free radicals, and alleviate myocardial I/R injury; It is suggested that the opening of ATP-sensitive potassium channels through NO activation of cGMP-PKC pathway may be an important mechanism for preconditioning protection with sodium ferulate.

Objective to study the effects of HBV pre-S2/S (preS2/S) and C (core, C) genes in Escherichia coli (E.coli) in patients with chronic hepatitis B (CHB) Methods HBV genomic DNA was extracted from serum of 50 patients with chronic hepatitis B in Yunnan, China, and the HBV preS2/S and C genes amplified-cloned-sequenced by polymerase chain reaction (PCR) were inserted into the expression vector P λ pr, and recombinant P λ pr-S2S and P λ pr-C expression plasmids were constructed, and expressed in E. coli TOP10. The expression product of the non-fusion protein was determined by sodium lauryl sulfate-polyacrylamide gel electrophoresis (SDS-PAGE), and its antigenicity was detected by Western blot and ELISA. Results SDS-PAGE detected that the recombinant plasmids of P λ pr-S2S and P λ pr-C were stably and at high level expressed in E. coli TOP10. The relative molecular weight of the expressed non-fusion protein was 31 000 and 21 000, respectively. The concentration of non-fusion protein was about 16%, and the purity was 96%. Western blot and Conclusion HBV preS2/S and C genes are stably and highly expressed in E. coli TOP10 in chronic hepatitis B patients in Yunnan, China, and the expressed non-fusion proteins have antigenicity. These findings have potential application value for creating new vaccines.

Objective to detect serum protein in thyroid cancer patients, screen for specific protein markers, and construct a serum protein fingerprint model for early diagnosis of thyroid carcinoma. Methods the protein mass spectra of 81 serum samples (40 cases of thyroid cancer, 9 cases of thyroid adenoma and 32 cases of healthy people) were determined by surface enhanced laser desorption ionization main time-of-flight mass spectrometry (SELDI-TOF-MS). 66 randomly selected samples (32 cases of thyroid cancer, 9 cases of thyroid adenoma and 25 cases of healthy people) were used as training group, and the support vector machine was used to train and cross-validate, and the diagnostic model of thyroid cancer was established. Results The sensitivity and specificity of the model were 87.5% and 80%. The sensitivity and specificity of the model were 100% and 86%. The sensitivity and specificity of the diagnostic model to distinguish thyroid carcinoma from thyroid adenoma were 96.8% and 89%. The diagnostic model to distinguish papillary thyroid carcinoma from other pathological types of thyroid carcinoma was 97% and 71%. Conclusion the establishment of thyroid carcinoma serum protein fingerprint model by surface enhanced laser desorption ionization master time of flight mass spectrometry combined with support vector machine provides a new method with strong specificity and high sensitivity for early screening and diagnosis of thyroid carcinoma, which is worthy of further research and application.

Objective to investigate the bacteriological etiology of chronic prostatitis and provide assistance for clinical treatment. Methods Prostate samples were taken from 140 organ donors aged 20-35 years after sudden death. The tissues of the periprostatic zone were divided into two pieces, one for routine pathological examination, and the other for bacterial 16S rRNA gene detection by polymerase chain reaction. Results 32.9% (46/140) of the histopathology showed chronic prostatitis, all of which showed mild focal inflammation, including 42 cases of interstitial inflammation, 3 cases of interstitial with periglandulitis and 1 case of periglandulitis. The positive rate of 16S rDNA was 19.3% (27/140), among which the positive rate of prostatitis samples was 48.9% (22/46), and the positive rate of non-prostatitis samples was 5.3% (5/94). The positive rate of prostatitis samples was higher than that of non-prostatitis samples, and the difference was statistically significant (χ 2=36.910,P<0.001). Conclusion Bacterial infection may be an important cause of chronic prostatitis.

Objective to investigate the characteristics of postprandial blood glucose status in patients with normal glucose regulation (NGR) and type 2 diabetes mellitus (T2DM) and the relationship between preprandial and postprandial blood glucose and glycosylated hemoglobin (HbA1c) in patients with T2DM. Methods the blood glucose of 41 patients with NGR and 60 newly diagnosed T2DM in Shanghai were monitored for 3 consecutive days by dynamic blood glucose monitoring system. The peak and peak time of postprandial blood glucose, as well as the amplitude (PPGE), time and area under the curve (IAUC) of postprandial blood glucose drift were analyzed and compared. Results (1) The peak, peak time and PPGE of postprandial blood glucose in T2DM group (breakfast 16.45 mmol/L±0.43 mmol/L, 93.1 min±4.7 min, 6.84 mmol/L±0.28 mmol/L, lunch 14.75 mmol/L±0.50 mmol/L, 107.4 min±6.5 min, 4.93 mmol/L±0.31 mmol/L, dinner 14.91 mmol/L±0.45 mmol/L, 109.3 min±4.9 min, 5.84 mmol/L±0.28 mmol/L) significantly higher than that in the NGR group (breakfast 6.90 mmol/L ± 0.21 mmol/L, 40.8 min ± 2.9 min, 2.02 ± 0.17 mmol/L, 6.74 mmol/L ± 0.16 mmol/L, 43.7 min ± 3.1 min, 2.03 ± 0.12 mmol/L for lunch, 6.94 mmol/L ± 0.19 mmol/L, 53.5 min ± 3.8 min, 2.25 mmol/L ± 0.18 mmol/L for dinner, all P<Postprandial blood glucose drift time and IAUC were also significantly higher in T2DM group (14.1 h±0.3 h,2.04 mmol·L-1·d±0.09 mmol·L-1·d) than in NGR group (8.3 h±0.4 h,0.43 mmol·L-1·d±0.03 mmol·L-1·d, both P<0.01). (2) Blood glucose in T2DM group reached peak after breakfast (P<0.05), and the peak value was significantly higher than that at lunch and dinner (P<0.01), the order of PPGE from high to low was breakfast, dinner and lunch (P<0.05), the IAUC of dinner was significantly higher than that of breakfast and lunch (P<(3) The correlation between HbA1c and IAUC (r =0.29, P =0.03) disappeared after adjusting for preprandial blood glucose factors (P =0.05); PPGE was positively correlated with IAUC (r =0.93, P<(4) The contribution percentage of postprandial blood glucose to total intraday blood glucose in T2DM group was significantly higher than that in NGR group (18.1%±0.8% vs 8.0%±0.7%, P<0.01), but all of them were significantly lower than their preprandial blood glucose (P<(5) When HbA1c was less than 7.5%, the contribution of postprandial blood glucose increase to intraday hyperglycemia was greater than that of preprandial blood glucose (P<When HbA1c ≥7.5%, the relative effect of preprandial hyperglycemia gradually increased and accounted for the main effect (P<Conclusion (1) The patients with T2DM showed excessive postprandial glucose drift and lasted for a long time, accompanied by delayed blood glucose peak, and the acute postprandial hyperglycemia was most obvious in breakfast. (2) HbA1c could not reflect the postprandial glucose drift, and PPGE could be used as a simple clinical parameter to estimate the degree of postprandial glucose drift. (3) In patients with mild and moderate hyperglycemia, postprandial hyperglycemia played a major role, suggesting that the closer the control of blood glucose to the standard, the more important the control of postprandial blood glucose.

Objective to investigate the characteristics and clinical significance of immunopathological changes in HIV/AIDS patients. Methods The clinical data of 263 patients with HIV/AIDS diagnosed and treated in Peking Union Medical College Hospital without antiviral treatment were collected. Anticoagulant blood samples were collected and analyzed by flow cytometry. The lymphocyte subsets, including B and NK cell subsets, CD4+ T and CD8+ T cell subsets, CD4+ T cell functional subsets (CD28+ CD4+), CD4+ T cell innocence (CD4+ CD45RA + CD62L +) and memory (CD4+ CD45RA-) subsets, and CD8+ T cell activation subsets (CD8+ CD38+) were detected. The plasma viral load was detected by branch DNA (bDNA) method, and the cases were divided into three groups: A, B and C according to the CD4+ T cell count (×106/L) less than 200, 200~350 and more than 350, and the differences between the groups were compared. Results the median (upper and lower quartile) of CD4+ T cell count and the proportion of innocent subsets in 263 HIV/AIDS patients were 205 (348, 63) ×106/L and 18.5 (32.0, 6.5) %, respectively, which were significantly lower than those in the normal control group (P<0.01); The proportion of CD4+ T cell functional subsets was 86.1 (94.0, 68.3) %, significantly decreased (P<0.01); There was a positive correlation between CD4+ T cell count and CD28 expression ratio (r =0.480, P<0.01); The percentage of CD8+ T cell activation subsets reached 84.3 (92.7, 69.0) %, which was significantly higher than that of the control group (P<0.01), and it was positively correlated with plasma viral load (r =0.331, P<According to the comparison of CD4+ T cell counts after grouping, the viral load, the proportion of CD8+ T cell activation subsets and the proportion of memory CD4+ T cells in group A were significantly higher than those in group B and group C (P<0.01), while the proportion of pure CD4+ T cells and functional subsets of CD4+ T cells were significantly lower than those of B and C groups (P<0.01); There was no significant difference in the proportion of CD4+ T functional subsets, innocent and memory CD4+ T and CD8+ T cell activation subsets between groups B and C. Conclusion The immunopathological changes of Chinese HIV/AIDS patients were mainly the decrease of CD4+ T cells and their innocent subsets, the decrease of CD28 expression and the abnormal activation of cellular immune.

Objective to evaluate the accuracy of magnetic resonance imaging (MRI) in predicting the stage and lateral margin involvement of rectal carcinoma. Methods 53 cases of rectal carcinoma confirmed by preoperative biopsy were evaluated by high resolution MRI. All cases underwent total mesorectal resection, and the surgical specimens were observed by serial pathological section method. The preoperative MRI and postoperative pathological results were compared to evaluate whether MRI could accurately predict T, N and CRM of rectal carcinoma. Results MRI had correct T stage in 41 cases and wrong in 12 cases. Among them, 4 cases were reported as T1~ T2 stage and 8 cases were reported as T1~ T2 stage. The total accuracy of T stage was 77.4% (41/53), among which the accuracy of T1~ T2 stage was 83.3% (20/24), T3 stage was 68.0% (17/25), and T4 stage was 100% (4/4). MRI could generally predict T stage, but the accuracy was not high (Kappa value was 0.602, P<MRI could predict CRM correctly in 37 cases and incorrectly in 16 cases, of which 10 cases were overestimated and 6 cases were underestimated. The accuracy rate was 69.8% (37/53), the sensitivity was 75% (18/24), and the specificity was 65.5% (19/29). MRI could not predict CRM accurately (Kappa value was 0.399, P =0.003). MRI could predict CRM correctly in 51 cases and incorrectly in 2 cases, of which 1 case was overestimated and 1 case was underestimated. The accuracy rate was 96.2% (51/53), the sensitivity was 80% (1/5), and the specificity was 97.9% (47/48). MRI could accurately predict CRM involvement (Kappa value was 0.779, P<Conclusion Preoperative MRI can not accurately predict the T and N stages of rectal cancer, but it can reliably predict the involvement of CRM.

Objective to study the neuropathological mechanism of anxiety disorder by functional magnetic resonance imaging (fMRI). Methods A total of 20 subjects participated in the experiment, 10 patients with generalized anxiety disorder and 10 normal controls. The experimental mode was Block Design, and the stimulus material was presented by auditory. Two fMRI experiments were performed. In experiment 1, the emotion neutral words were alternated with the blank control without words, and in experiment 2, the threat words were alternated with the emotion neutral words. Then, the subjects were tested with anxiety state scale. Results The scores of anxiety state scale were 37 ± 3 in the control group and 57 ± 4 in the patient group. In experiment 2, the scores of the control group and 66 ± 6 in the patient group were 41 ± 4 in the control group and 66 ± 6 in the patient group. The differences in the scores of the two groups were statistically significant in the two experiments. Left inferior frontal gyrus (BA44/45); Bilateral anterior motor area (BA6); However, the activation intensity (mean T value) of the superior temporal gyrus on both sides in the patient group was stronger than that in the control group: left side (P =0.051) and right side (P =0.035), and the dorsolateral brain area of the prefrontal lobe (BA8/9) and the inferior parietal lobules on both sides (BA39/40) were additionally activated in the patient group. bilateral inferior frontal gyrus (BA44/45); Left dorsolateral prefrontal lobe (BA46/10); Bilateral inferior parietal leaflets (BA39/40); bilateral anterior motor area (BA6); anterior cingulate gyrus (BA8/24/32); Auxiliary motor area (BA6). The same test level (P<0.001, uncorrected), the normal control group did not activate the brain region, but after lowering the threshold (P<0.01), posterior left cingulate gyrus (BA29/30), anterior left cingulate gyrus (BA24/32) and left inferior parietal lobule (BA40) were activated. Conclusion There may be functional abnormalities in the prefrontal and temporal lobes of patients with generalized anxiety disorder, mainly manifested by overresponse to stimulus processing.

Objective to evaluate the diagnostic value of dynamic magnetic resonance enhanced scanning in pancreatic cancer and pancreatic endocrine tumors.Methods the MR findings of 22 cases of pancreatic cancer and 9 cases of pancreatic endocrine tumor underwent both plain magnetic resonance scanning and dynamic enhanced scanning before operation were compared and analyzed.Results In 22 cases of pancreatic cancer (4 cases without mass), 11 cases showed low signal on FS-T1WI, 6 cases showed slightly low signal, and 1 case showed isosignal; FS-T2WI showed high signal in 5 cases, slightly high signal in 7 cases, isosignal in 5 cases, and slightly low signal in 1 case. Among them, 13 cases showed uneven signal. The enhancement was obvious in pancreatic and portal phases, with isosignal in 5 cases, slightly low signal in 10 cases and low signal in 3 cases; Among the 5 cases of small pancreatic cancer, 4 cases had isosignal signal, 1 case had slightly low signal, and the degree of enhancement decreased in the delayed phase. 9 cases of pancreatic endocrine tumor (1 case had no mass), 5 cases had low signal on FS-T1WI, and 3 cases had slightly low signal; In FS-T2WI, 2 cases had high signal, 4 cases had high signal, 2 cases had isosignal, 2 cases had moderate enhancement in the enhanced arterial phase, and 6 cases had no significant enhancement; Conclusion Dynamic MRI enhancement is valuable in differentiating two lesions: (1) Pancreatic carcinoma can be enhanced to varying degrees, and the maximum enhancement does not exceed that of normal pancreatic tissue; (2) Most pancreatic endocrine tumors can have obvious enhancement, and the maximum enhancement degree can exceed that of normal pancreatic tissues. The thin-walled annular high-density enhancement around the tumor is the characteristic manifestation of this disease.

Objective to summarize the experience of diagnosis and treatment of intraductal papillary mucous tumor of pancreas (IPMN), and to improve the understanding and diagnosis and treatment level of this disease.Methods The clinical manifestations, pathological features and follow-up data of 38 cases of intraductal papillary mucous tumor of pancreas were retrospectively analyzed from May 1999 to the end of July 2005.Results There were 38 cases of IPMN in this group, 23 males and 15 females; The average age was 64.1 ± 10.7 years old (41-81 years old); The main clinical manifestations were jaundice and abdominal pain. 32 cases of pancreaticoduodenectomy; Body and tail of pancreas and splenectomy in 3 cases; A case of total pancreatectomy; There were 2 cases of biopsy, 1 case of perioperative death, 15 cases of main pancreatic duct type, 14 cases of branched pancreatic duct type, 1 case of mixed type, and 8 cases of unknown classification, all of which had different degrees of pancreatic duct dilation (mean 4.6 mm). According to the tumor invasiveness, 30 cases in the invasive group and 8 cases in the non-invasive group (benign, borderline and carcinoma in situ). The serum CA19-9 value of invasive IPMN was significantly higher than that of non-invasive IPMN. The median survival time of the whole group was 18.5 months, and the median survival time of the invasive group was 16.1 months; The survival rates of 1, 2 and 5 years were 54%, 31% and 21%, respectively. The median survival time of the non-invasive group was 24.3 months, and the survival rates of 1 and 2 were 58% and 38%, respectively. There was no significant difference between the groups. According to TNM stage, among the 34 malignant tumors in the whole group, 6 cases were stage 0, 15 cases were stage I, 9 cases were stage II and 4 cases were stage III. The median survival time of stage 0, stage I, stage II and stage III were 31.3, 27, 9.1 and 8.9 months, respectively (P =0.0124). Conclusion There is no specific clinical manifestation of intraductal papillary mucous tumor of pancreas, and dilatation of pancreatic duct is a characteristic imaging manifestation; Serum CA19-9 was significantly increased in invasive intraductal papillary mucinous tumors of pancreas, and the survival rate of intraductal papillary mucinous tumors of pancreas was significantly different in different TMN stages.

Objective to investigate the therapeutic effect of dendritic cells (DC) transfected with interleukin 23 (IL-23) gene loaded with apoptotic cancer cell antigen on pancreatic carcinoma in mice. Methods Eukaryotic double expression vector of IL-23 gene was cloned and constructed, and the phenotype and ability of autocrine IL-23 and IL-12 were detected after transfection into DC. The secretion of interferon gamma (IFN-γ) and IL-4 in spleen T lymphocytes in each group and the killing effect of cytotoxic T lymphocytes (CTL) induced by DC on pancreatic cancer cells were observed. The vaccine prepared by transfecting DC and loading tumor antigen had anti-tumor protective and tumor suppressive effects on mice. Results Gene sequencing confirmed that IL-23 gene cloning and dual expression vector were successfully constructed, and the expression of costimulatory molecules MHC-Ⅰ and MHC-Ⅱ was enhanced by DC transfection. DC-mediated immune response promoted the production of IFN-γ-producing Th1 cells. The secretion of IFN-γ in IL-23 transfected group (the highest was 535 pg/ml/106) every 24 h was compared with that in other groups (60 pg/ml/106 every 24 h in control group), P<0.01; the transfected DC vaccine induced high levels of CTL activity in vivo (P<The immune defense ability of mice vaccinated with IL-23 modified DC vaccine was significantly enhanced; Conclusion IL-23 can enhance DC antigen presenting ability, and IL-23 modified DC vaccine can enhance the CTL immune response of host against specific tumor, which can not only produce defensive immune response but also enhance autoimmune ability.

Objective to analyze the abnormal expression of p53, p16 and cyclooxygenase-2 (COX-2) proteins in pancreatic cancer tissues, adjacent tissues and normal tissues by high-throughput tissue microarray technique, and to explore their correlation and clinical significance. Methods The expression of p53, p16 and COX-2 proteins in 104 cases of pancreatic cancer tissues, adjacent tissues and normal tissues was detected by tissue microarray technique and immunohistochemistry. Results the positive expression rate of p53, p16 and COX-2 in pancreatic cancer tissues was significantly higher than that in non-cancerous tissues<There was no correlation between p53 and p16 protein expression (P>0.05), but there was correlation between p53 and COX-2, p16 and COX-2 protein expression (all P<The interaction of p53 and COX-2 has a statistically significant effect on the incidence of pancreatic cancer (OR =19.686). Conclusion Tissue microarray is an effective method for large-scale parallel detection of multi-gene protein expression; The occurrence of pancreatic cancer is related to p53, p16 and COX-2, especially the interaction of the latter may play a more important role.

Fluoroquinolone is one of the most used antibiotics, and its various adverse reactions are gradually recognized. Some data show that gatifloxacin can increase the risk of hypoglycemia and hyperglycemia compared with other fluoroquinolone drugs currently used. The mechanism of occurrence is still unknown. Animal experiments suggest that gatifloxacin can promote insulin release and hypoglycemia by blocking ATP-sensitive potassium channels on pancreatic islet cells, and can induce vacuolar degeneration of pancreatic islet B cells, resulting in decreased insulin level and hyperglycemia.

In the United States, about 70 million people suffer from cardiovascular diseases of varying degrees, which is the leading cause of death and disability in the United States. In 2005 alone, Americans spent 394 billion US dollars on cardiovascular diseases. The American Heart Association hopes to improve the prognosis and outcome of cardiovascular diseases by improving the quality of patient-centered services, so as to reduce the economic and social burden caused by cardiovascular diseases.

The patient, 16 years old, female, was admitted to hospital on July 19, 2005 due to menarche. The patient was raised as a girl since childhood, and her height increased at the same rate as that of her peers, but her strength was stronger than that of her peers. The mammary gland and axillary pubic hair began to grow 5 years ago, the voice began to appear hoarse and thicker 3 years ago, and the Adam's apple protrusion 1 year ago.

A 39-year-old woman suffered from headache and fatigue for 1 week and was admitted to the hospital for 1 day with disorder of consciousness. One week ago, she developed headache and fatigue after drinking 250 g of yellow wine, but did not pay attention to it. One day ago, she suddenly became confused and was admitted to the emergency department. She was in good health. Physical examination at admission: body temperature 37.5℃, pulse 100 beats/min, breathing 20 beats/min, blood pressure 119/79 mm Hg, inconsciousness, moderate yellowing of sclera, equal size and round pupils on both sides, and light reflection.

Colorectal hemangioma is a rare benign vascular disease. Since Phillips reported the first case in 1839, more than 200 cases have been found, most of which invade the rectum and sigmoid colon. Extensive hemangioma involving the whole colon and rectum is even rarer, and there are few related reports in China.

Cerebral cryptococcal granulomatosis was treated with traditional antifungal drugs, with a long course of treatment and poor efficacy, and more reports of combined surgical treatment [1]. In this paper, two cases of cerebral cryptococcal granulomatosis were treated sequentially with amphotericin B combined with itraconazole injection/oral liquid for the first time, and successfully, and the reports are as follows.

The detection of ankle brachial index (ABI), as a simple, non-invasive and low-cost detection method, has been widely used in clinical diagnosis and evaluation of peripheral arterial disease (PAD) abroad [1-2]. ABI is the ratio of systolic blood pressure of individual ankle artery or dorsal pedis artery to systolic blood pressure of brachial artery. Relevant studies at home and abroad, especially several large-scale epidemiological studies abroad, have confirmed that ABI is associated with major cardiovascular risk factors, and is an important risk factor for cardiovascular events and death [3, 4].