Volume 88  ·   Issue 44  ·  2008

Ulcerative colitis (UC) is a common disease in gastroenterology, and it is also a disease that is difficult to cure and easy to relapse. The reason why it is difficult to cure is that the cause is unknown, and the reason why it is "easy to relapse" is that it cannot control its natural course. Until the discovery of biological targeted drugs, the main medical drugs for this disease were 5-aminosalicylic acid (5-ASA), glucocorticoids and various immunomodulators.

Inflammatory bowel disease (IBD), including Crohn's disease (CD) and ulcerative colitis (UC), is a kind of chronic non-specific intestinal inflammatory disease with recurrent episodes. The exact etiology and pathogenesis of IBD are still unknown, but it may be caused by the imbalance of immune and inflammatory response in genetically susceptible people under the action of environmental factors and intestinal flora.

Objective To evaluate the diagnostic value of antineutrophil cytoplasmic antibodies (ANCA) in patients with ulcerative colitis (UC). Methods Articles related to diagnosis of UC by ANCA test, published before November 2007, were retrieved in the databanks such as Chinese BioMedical Disc, Chinese Medical Current Contents, Chins National Knowledge Intrastructurre, and VIP databank. Related journals were searched manually. Meta-analysis was performed by summary receiver operating characteristic curve recommended by Diagnostic and Screening Group of the Cochrane Collaboration Web with the parameters such as sensitivity, specificity, accuracy, predictive values and likelihood ratio. Results Totally 10 studies including 381 patients met the inclusion criteria. Meta-analysis showed that the sensitivity and specificity of ANCA to the diagnosis of UC were 52. 2% and 99. 0% respectively. The positive and negative predictive values (PPV and NPV) were 98. 0% and 68.7% respectively. Meanwhile, the positive and negative likelihood ratio (+ LR and - LR) were 52. 2 and 0. 5, respectively. Conclusions ANCA is an immunological index related to UC. Positive ANCA helps diagnose UC, but is not sensible enough to screen UC.

Objective To explore the impact of secondary lymphoid tissue chemokine (SLC) on lymphocyte migration and the significance thereof in the pathogenesis of ulcerative colitis (UC). Methods Sixty SD rats were randomly divided into 3 equal groups: model group undergoing dripping of 40% acetone solution of dinitro-chlorobenzene (DNCB) on the back for 2 weeks and then enema of 6% DNCB acetone solution so as to establish models of UC, and then intravenous injection of normal saline (NS) for 5 days; SLC antibody intervention group undergoing intravenous injection of SLC antibody 15 μg· ml-1· kg-1 immediately after the establishing of model; and control group undergoing enema of NS nly and then intravenous injection of NS for 5 days. Six days after the establishing of model venous blood samples were collected from the portal veins of the 3 groups. Lymphocytes were isolated and cultured. RT-PCR was used to detect the mRNA expression of the SLC receptor CCR7. Boyden chamber system was used to examine the migration ability of the lymphocytes exposed to SLC of 20, 40, 60, 80, and 100 ng/ml respectively. ELISA was used to detect the expression of interleukin (IL) -10 and interferon (IFN) -γ in the supomatants of the lymphocytes of different groups. Results RT-PCR showed that the CCR7 mRNA expression level of the model group was (0. 792±0. 108), significantly higher than that of the intervention group (0. 386±0. 115, P =0. 0429), and the CCR7 mRNA expression levels of these 2 groups were both significantly higher than that of the control group (0. 106±0. 029, both P < 0. 01). SLC dese-dependently promoted the migration ability of the lymphocytes, but there existed a saturation phenomenon. Exposed to 80 ng/ml SLC the migration level of the iymphocytes of the model group peaked to (85.9±16.0), 3.7 times as high as that of the control group (20. 5±1.8, P < 0. 01), and the migration level of the lymphocytes of the intervention group was 38. 2±6. 3, significantly higher than that of the control group too (P <0. 05). SLC enhanced the expression of IFN-γ of the lymphocytes of the model group, while reduced the IL-10 level, and both effects peaked at the concentration of 80 ng/ml (P = 0. 042, P = 0. 036). Conclusion SIC promotes the lymphocyte migration and boosts the differentiation of lymphocytes, thus participating in the pathogenesis of UC.

Objective To investigate the distribution of different phenotypes of inhibitory killer cell immunoglobulin-like receptor (iKIR) and its ligand HLA-Cw in patients with inflammatory bowel disease (IBD), and to explore whether iKIR/HLA-Cw combinations are associated with IBD susceptibility. Methods Peripheral blood samples were collected from 100 patients with ulcerative colitis (UC), 73 patients with Crohn's disease, and 106 randomly selected ethnically matched healthy controls. Polymerase chain reaction with sequence-specific primers was used to analyze the iKIR phenotypes, and the HLA-Cw phenotypes was examined with HLA-C LOCUS SSP UNITRAY kit, and the combination of HLA-Cw and its corresponding iKIR in individual was analyzed subsequently. Results The KIR2.DL1 and KIR2DL3 gene phenotype frequencies in UC patients were 0. 710 and 0. 620 respectively, both significantly lower than those in healthy controls (0. 896, χ2 = 11. 405 P = 0. 001, and 0. 821, χ2 = 10. 362 P = 0. 001 respectively). The KIR2 DL1 gene phenotype frequency in CD patients was 0. 740, significantly lower than that in healthy controls (0.896, χ2 = 7.589, P = 0.006). The KIR2DL1 HLA-C2 combination (2DLI+-HLA-C2+)in UC patients and CD patients were 0. 380 and 0. 411 respectively, both significantly lower than that in healthy controls (0. 575, χ2 = 7. 876 P = 0. 005 and 0. 575, χ2 = 4. 681 P = 0. 030 respectively). Conclusion The susceptibility to IBD is associated with decreased KIR2DL1-HLA-C2 combination.

Objective To summarize the experience in diagnosis and treatment of pulmonary hypertension caused by sleep hypoventilation. Methods The clinical data of 4 patients in a family with pulmonary hypertension caused by sleep hypoventilation, full brothers and sisters, 2 (Cases 1 and 2) being treated presently and 2 (Cases 3 and 4) being deceased and traced by family medical history, were retrospectively analyzed. Results Three of the 4 cases (cases 1, 3, and 4) were misdiagnosed as with cor pulmonale combined with pulmonary hypertension, and one case (case 2) was misdiagnosed as with primary pulmonary hypertension. Polysomnography (PSG) revealed alveolar hypoventilation-indueed long period of oxygen desaturation at sleep in Cases 1 and 2, thus confirming the diagnosis. Pulmonary function test showed that the percentage of maximum inspiratory pressure (PImax) in predicted value (51.5% and 20. 9%) and the maximum expiratory pressure (PEmax) in predicted value (51.3% and 29. 6%) decreased, the percentage of mouth occlusion pressure (PO. 1) in predicted value (141% and 133%) compensatively increased, and the respiratory muscle strength decreased in Cases 1 and 2, which suggested that there was neuromuscular disorder in these patients. Treated by noninvasive ventilation the symptoms of these 2 patients were improved and they were discharge at last. Subsequently, they were treated by long-term night noninvasive ventilation at home, and returned to normal work and life. During the follow-up for 22 and 12 months respectively after discharge, PSG showed that the alveolar hypoventilation-induced long period oxygen desataration at sleep had been greatly improved, and echocardiogram showed that the pulmonary pressure was greatly decreased. Conclusion For the patients with unexplained pulmonary hypertension, PSG monitoring and pulmonary function tests such as Plmax, PEmax, and P0. 1 help determine the etiology, and long-term night noninvasive ventilation at home can improve the outcome of sleep hypoventilation-induced pulmonary hypertension.

Objective To investigate the prevention and treatment of biliary tract complications following adult-adult living donor liver transplantation (A-A LDLT). Methods One hundred and eight patients, aged 38 (18 -63), underwent A-A LDLT, including transplantation of the right liver graft without middle hepatic vein (MHV) in 102 cases and dual graft transplantation in 6 cases (of left lobe from relative in 1 case, of right lobe + left lobe from relative in 3 cases, of right lobe from relative + cadaveric left lobe in 2 cases). Preoperative 3-dimensional computerized tomography (3D CT) and intra-operafive cholangiography were employed to reveal the state of the liver, caution was exercised to protect the peripheral vasculature of the right hepatic duct during resection. The bile duct was reconstructed by duct-to-duct (D-D) biliary anastomosis or Roux-en-Y anastomosis of the hepatic duct and jejunum (H-J). Results Twenty-four of the 108 patients (22. 2%) suffered from complications, including bile leakage (n = 4), cutting surface bile leakage (n = 1), and anastomotic biliary stricture (n=3), etc. Seven donors (6. 3%) suffered from complications too, including 2 cases of bile leakage from the remnant cut surface. All the biliary tract complications were properly managed with good outcomes, except for 1 case of recipient death. Conclusion Measures such as improvement of pre- and intra-surgical examinations and assessments, choice of appropriate approach of biliary tract reconstruction, employment of subtle operations of microscopic procedures, and timely detection and management of complications may reduce the incidence and mortality of biliary tract complications following A-A LDLT.

Objective To evaluate the long-term survival rates of the adults with benign end-stage liver disease (BELD) after liver transplantation (LT) and the causes of death. Methods The common causes of late death (after more than 1 year) after LT were retrospectively analyzed in 203 consecutive patients with BELD who underwent LT from Oct. 2003 to May. 2006. Results The 1,2 and 3-year survival rates were 88. 7%, 85. 5%, and 81.2% respectively. The 2-year and 3-year survival rates of the patients with HBV-related liver disease were 88.4% and 84. 5% respectively, not significantly different from those of patients with non-HBV-related liver disease (75. 6% and 64. 0% respectively, P =0. 144) . 165 recipients survived for more than 1 year and 21 recipients died during the period between 12 and 48 months after LT with a mean of (22. 7±6. 6) months. The common causes of late death included related to infectious complications (4. 8%, 8/165), biliary tract complications (3.6%, 6/165), HBV re-infection (1.8%, 3/ 165), chronic rejection (1.2%, 2/165), renal functional lesion (0. 6%, 1/165), and hepatic arterial complication (0. 6% 1/165). Conclusion Satisfactory long-term survival can be achieved in most adult recipients with BELD after LT and the major causes that influence the long-term survival are infectious complications, biliary tract complications, and HBV re-infection. Prevention of these complications, rational use of immunosuppressant, and regular follow-up are essential to improve long-term survival.

Objective To investigate the effects of transketolase-like gene TKTL1 on the occurrence and metastasis of human nasopharyngeal carcinoma (NPC). Methods Real-time PCR was used to determine the mRNA expression levels of transketolase gene family (TKT, TKTL1, and TKTL2) in the 65 biopsy specimens of human nasopharyngeal carcinoma, 9 at stage Ⅰ ,15 at stage Ⅱ , 16 at stage Ⅲ, 13 at stage Ⅳ A, and 12 at stage ⅣB, 42 with metastasis and 232 without metastasis, and 9 biopsy specimens of chronic nasopharyngitiss. Results The TKL activity level of the NPC tissues was 21.6±2.8, significantly higher than that of the chronic nasopharyngitis tissues (6.2±1.3, P <0. 01). The TKL activity level of the NPC tissues with metastasis was 26. 5±3.2, significantly higher than that of the NPC tissues without metastasis (17. 6 ± 2. 1, P < 0. 01). There was no significant difference in the expression levels of TKT and TKTL2 genes between the human NPC and chronic nasopharyngitis tissues (both P > 0. 05). The expression level of TKTL1 gene in the NPC tissues was 5.25±0. 32, significantly higher than that in the chronic nasopharyngitis tissues (0. 98±0. 11, t = 6. 23, P < 0. 01), and the expression level of TKTL1 gene in the NPC tissues with lymph node metastasis was 5.86±0. 38, significantly higher than that in the NPC tissues without lymph node metastasis (4. 18±0.22, t =3.28,P <0.01). Conclusion TKTL1 may play an important role in the occurrence and metastasis of human NPC and become a potential target for novel anti-cancer therapy.

：Objective To investigatethe effects of 4- hydroxytamoxifen (OHT) on the proliferation and apoptosis of prostatesmooth muscle cells and the expression of estrogen receptor (ER) and androgen receptor(AR). Methods Prostate smooth muscle cells were isolated from the reseeted specimens ofprostate glands of 10 patients with benign prostatic hypertrophy (BPH) , cultured, andexposed to estradiol (E2), diethylstilbestrol (DES), and OHT of different concentrations(1 ×10-8 - 1×10-5 mol/L) or mixture of E2(1×10-8 - 1×10-6 tool/L) with OHT (1×10-7mol/L). Flow eytometry was used to test the proliferation and apoptosis of the cells, andimmunoeytochemistry was used to test the expression of estrogen and androgen receptors.Results E2 and DES promoted the proliferation of the prostate smooth muscle cells in acertain concentration range, but not dose-dependently, and OHT at the concentration of 1×10-8mol/L slightly increased the G2-M peak rate of the prostate smooth muscle cells, butsuppressed the G2-M peak rate dose-dependently when its concentration was ≥1×10-7mol/L (P < 0. 05) and this suppression effect was dose-dependently (r = - 0. 312, P =0. 011). E2 at the concentration ≥1×10-5 mol/ L and DES at theconcentration ≥ 1×10-6 mol/L slightlypromoted the apoptosis of the prostate smooth muscle cells, but not dose-dependently, andOHT at the concentrations from 1×10-8 mol/L to 1×10-5 mol/L promoted the apoptosis ofthe prostate smooth muscle cells dose-dependently (r =0. 363, P =0. 021) and this effectcould not be reversed by administration of E2 at the concentration 1×10-8 - 1×10-6 mol/L(P>0. 05). E2, DES, and OHT of different concentrations all increased the ERα and AR positive staining rates ofthe prostate smooth muscle cells (all P < 0. 05). Contusions OHT suppresses theproliferation and promotes the apoptosis of prostate smooth muscle cells, and thesefunctions do not depend on the estrogen receptor pathway. Low blood OHT concentrationafter oral administration of TAM and up-regulation of estrogen receptors by OHT may be thecaused of the inefficiency of TAM for treatment of BPH.

Objective To investigate the clinical features of Epstein-Barr virus (EBV) reactivation or infection-induced post-transplant lymphoproliferative disease (PTLD) and EBV-associated pneumonia after hematopoietic stem cell transplantation (HSCT). Methods The clinical data of 7 patients with PTLD, 6 from the 239 patients undergoing allo-HSCT and 1 from the 84 patients undergoing auto-HSCT, were analyzed. Results All the 7 patients had extravisceral lymph node enlargement as the primary presentation. Five cases were diagnosed as with diffuse large B-cell lymphoma, 1 case as with polymorphic B-cell hyperplasia, and 1 case peripheral T-cell lymphoma-unspecified. Sex chromosome analysis showed that the tumor cells originated from the donors. ELISA showed that plasma EBV DNA was positive in 6 of the 7 patients and was negative in 1 patient. Chest CT revealed multifocal patches and diffuse ground-glass attenuation in both lungs. EBV-DNA was positive in the bronchoalveolar lavage (BAL) fluid. The T cells in all of the BAL fluid were mainly CD3 + T cells without CD19 + and CD20 + B cells. Lung biopsy showed interstitial and intra-alveolar infiltration, constituted mainly by CD3 + T cells and partly by CD68 + macrophages, however, without CD19 + and CD20 + B cells. The 3 patients with PTLD accompanied by EBV associated-pneumonia had hyperpyrexia and dyspnea, and their condition aggravated rapidly and eventually all the 3 patients died of respiratory failure, of which 1 case with multiple organ failure died within 2 weeks since the onset of PTLD. Conclusions EBV-associated PTLD accompanied by EBV-associated pneumonia is not rare and is always severe. Cytology of BAL fluid and lung biopsy help diagnose.

Objective To study the disease-cansing gene mutations in familial hypertrophic cardiomyopathy (HCM) in Chinese and to reveal the relationship between the genotype and the phenotype. Methods Peripheral blood samples were collected from 12 members of a HCM family, and 120 healthy volunteers in China. PCR and double deoxygenation chain termination method were used to analyze the cardiac troponin T gene (TNNT2), beta-myosin heavy chain gene (MYH7) gene and myosin binding protein C gene (MYBPC3) and to detect mutations. Results Mutation G14452A was identified in exon 22 of MYH7 gene in 4 family members, causing the conversion of glycine (G) into glutamic acid (E). The onset ages and clinical manifestations of the family members carrying the mutation G823E, including 2 patients (the proband, male, with the onset age of 51, and his 26-year-old second son with the onset age of 20), and 2 carriers (his 31-year-old elder son and 29-year-old elder daughter), presented significant individual differences. Conclusions The G823E mutation of MYH7 gene is the causal mutation of familial HCM. The heterogeneity of phenotypes suggests that multiple factors may be involved in the pathogenesis of HCM.

Objective To study the anti-tumor effect of intravesical perfusion of recombinant adeno-associated virus-endostatin (rAAV-ES) in treatment of bladder cancer. Methods Forty-five C57BL/6 mice underwent intravesical perfusion of mouse bladder cancer cells of the line MB49 so as to establish orthotopic routine bladder cancer models and were divided into 3 equal groups, 3 days later to undergo intravesical perfusion of rAAV-ES, rAAV-EYFP,and PBS respectively once per week for 6 times. The anti-tumor effect of rAAV-ES on the tumor bearing mice was studied. Results The tumor weight of the rAAV-ES group was (145±30) mg, significantly lighter than those of the rAAV-EYFP and PBS groups [(250±32) mg and (250±30) mg respectively, both P <0. 05]. The survival time of the rAAV-ES-treated mice was (46±7) d, significantly longer than those of the rAAV-EYFP- and PBS-treated groups [(38±7)d and (38±6)d respectively, both P < 0.05]. Conclusion An effective biologic agent in bladder cancer gene therapy, intravesical treatment with rAAV-ES inhibits the angiogenesis, thus inhibiting the tumor formation and progression.

Objective To investigate the effects of N-benzyloxycarbonyl-Val-Ala-Asp-fluoromethylketone (Z-VAD-FMK), a broad caspase inhibitor, on allergic contact dermatitis (ACD). Methods A Balb/c mouse was killed and its back skin was peeled, put into a Franz diffusion cell, and smeared with Z-VAD-FMK. High performance liquid chromatography was used to examine the permeation rate. Dinitro-fluorobenzene (DNFB) was applied on the depilated back of mice as inducer and then on the back-side of right ear as provocative agent 6 days later so as to establish mouse ACD models. Two hours after the provocation 24 mouse models were divided into 4 equal groups to undergo the application of Z-VAD-FMK at the concentration of 0. 1,0. 5, 2. 5, and 5 mmoL/L on the back-side of right ear twice. PBS was applied in the negative control group. Then the mice were killed with their 2 ears cut off. Microscopy was used to measure the right ear swelling degree, and differences in weight and thickness between the 2 ears. ELISA was used to detect the levels of IL-2 and INF-T in the ear tissues. Results The transdermal permeation rates of Z-VAD-FMK at the time points 6, 12, and 24 h were 2. 15% , 9. 62%, and 12. 85% respectively. The right ear swelling degree, and differences in weight and thickness between the 2 ears in the 2. 5 mmol/L Z-VAD-FMK group were (12.5 ±1.4)×10-2 mm, (3.2±0.3) mg, and (11.8±1.3)×10-2mm respectively, all significantly lower than those of the negative control group [(19.1±2. 0)×10-2 mm, (4. 3±0. 4) mg, and (16. 8±1.7)×10-2 mm, all P <0. 05]. The IL-2 and INF-γ levels in the ear skin lesion of the 2. 5 mmol/L Z-VAD-FMK group were (148 ±10) and (650±45) pg/ml respectively, beth significantly lower than those of the negative control group [(205±18) and (1030±58) pg/ml, beth P < 0. 05]. Conclusion Z-VAD-FMK can permeate through mouse skin and inhibit the activation and proliferation of T lymphocytes, leading to the inhibitory effect of contact allergic reaction.

Objective To investigate the effects of early oral fluid resuscitation on organ functions and survival in severe burn shock. Methods Eighteen male Beagle dogs were surgically prepared for measurement, subjected to 50% total body surface area (TBSA) full-thickness flame injury 24 hours later, and then randomly divided into 3 equal groups: oral fluid resuscitation group(OR group) undergoing gastric infusion of glucose-electrolyte solution(GES) according to Parkland formula 0. 5 hour after burn with the dose of 4 ml·kg-1 %TBSA-1 ,1/2 being given in the first 8 h and 1/2 in the latter 16 h . Intravenous (Ⅳ) resuscitation of GES group (VR group) undergoing Ⅳ infusion of GES with the same dose as mentioned above, and no fluid resuscitation (NR) group given with GES during the first 24 h. In the second 24 hours all dogs received Ⅳ fluid resuscitation. At the end of 72-hours-period experiment, the mortality was recorded. The mean arterial pressure (MAP), plasma blood volume (PV), hematocrit (HCT), urinary output, alanine aminotransferase (ALT) , creatinine (Cr), and MB isoenzyme of creatine kinase (CK-MB) were examined before injury and at 2, 4, 8, 24, 48 and 72 hours after injury. Results At the end of 72-hours-period experiment, all dogs died in the NR group, 3 dogs died in the OR group, and no dog died in the VB group. The MAP and PV were significantly reduced after burn compared with those before-injury in the NR group, with the lowest levels of (34±9) mm Hg and (32. 7±3.5) ml/kg (both P < 0. 05) 8 h after burn, and the HCT, ALT, Cr, and CK-MB levels of the NR group peaked 8 h after burn to the levels of (61.7±2.7)%, (121.1±4.8) U/L, (91.0±6. 1) μmol/L, and (13 891±297) U/L respectively. Eight hours after burn 4 dogs of the NB group showed anuria, and the rest two had the urine volume of 1.2 and 2. 1 mL/kg respectively. Eight hours after burn the MAP, PV, and urinary output levels of the OR group were (84. 3±17.1)mm Hg, (41.7±3.6) ml/kg, and (2. 6±1.8) ml/kg respectively, all significantly higher than those of the NR group (all P < 0. 05), but significantly lower than those of the VR group [(113.0±10.0)mm Hg, (50.3±5.2)ml/kg, and (7.0±1.9) ml/kg respectively, all P<0.05]. The plasma ALT level of the OR group was (81.4±10. 8) U/L, significantly lower than that of the NR group (P < 0. 05), but significantly higher than that of the VB group [(66.3±7.6) U/L, P < 0. 05]. The levels of plasma ALT at other time points, as well as the Cr and CK-MB levels at all time points of the OR group were all significantly higher than those of the VB group (all P <0. 05). The MAP, PY, HCT and urinary output levels of the two resuscitation groups returned to the pre-injury levels 72 h after burn, but the ALT, Cr, and CK-MB levels were still significantly higher than the pre-injury levels. Conclusions Although oral resuscitation with GES is not as efficient as Ⅳ resuscitation in 50% TBSA burn, it still can maintain the MAP and PV, protect the organ functions and reduce the mortality comparing to no resuscitation. Oral resuscitation may be an ideal alternative way of Ⅳ resuscitation, especially in wars or other site of mass casualties.

Objective To compare the sensitivity and specificity in molecular identification in different DNA regions of Trichosporon species and to study the genotype of T. asahii isolated from clinical specimens in China. Methods DNA was extracted from the cells of all experimental strains by using a method of glass bead method. The D1/D2, ITS and IGS1 regions were amplified by PCR with specific primers, the PCR products were cloned and sequenced. The sequences were referred to GenBank and compared with the other sequences of the Trichosporon species from GenBank by the software CLUSTAL X 1.83. Phylogenetic trees were constructed and genotypes were determined. Results The D1/D2 regions in T. asahii(CBS2479), T. dermatis, and T. laibachii were 640,639, and 637 bp in length respectively, the ITS regions were 541,528, and 531 bp respectively in length, and the IGS1 regions were 643, 515, and 411 bp respectively. The sequence similarity of the D1/D2 region was 89% - 99%, that of ITS and IGS1 regions were 85% - 99% and 11% - 95% respectively. The clinically isolated strains BZP07001, BZP07002, BZP07004, and BZP07005 belonged to genotype Ⅰ , and the strain BZP07003 to genotype Ⅳ. Conclusion The sensitivity and specificity of the IGS1 region was higher than those of the D1/D2 and ITS regions in identification of phylogenetically closely related Trichosporon species. T. asahii isolated from clinical specimens in China belongs to either genotype Ⅰ or genotype Ⅳ.

Chronic obstructive pulmonary disease (COPD) is a chronic inflammation involving central airway, peripheral airway, pulmonary parenchyma and pulmonary vessels, which is related to the abnormal inflammatory response of the lungs to harmful particles or gases.

The 8th National Congress on Digestive Diseases of the Chinese Medical Association was held in Xi'an, Shaanxi Province from October 10 to 13, 2008. Academician Fan Daiming, Chairman of the Digestive Branch of the Chinese Medical Association, gave an important report on the hot spots and prospects of digestive diseases research. The conference also invited Professor SK Lam from Hong Kong, Professor KM Fock from Singapore, Professor KL Goh from Malaysia, the former president of the Asia Pacific Gastroenterology Society, and renowned domestic scholars to give wonderful speeches.

The "2008 Academic Forum on Focus Issues in General Surgery" jointly sponsored by the Organizing Committee of the Forum on Focus Issues in General Surgery of China, the Chinese Medical Journal of Chinese Medical Association, the Chinese Medical Journal, the First Hospital of Lanzhou University and the Third Affiliated Hospital of Sun Yat-sen University was held in Lanzhou, Gansu Province from July 11 to 14, 2008. Professor Zhao Yupei, Chairman of the Surgical Branch of Chinese Medical Association and President of Peking Union Medical College Hospital of Chinese Academy of Medical Sciences, and Professor Zhu Xueguang of Peking University People's Hospital served as the chairmen of the conference. More than 300 general surgery experts and representatives from all over the country attended the conference.

Recently, the plastic surgery hospital of Chinese Academy of Medical Sciences celebrated its 50th anniversary. In order to commemorate the glorious course of plastic surgery in China for 50 years, the plastic surgery hospital of Chinese Academy of Medical Sciences held a grand ceremony on October 10, 2008, and held the first global Chinese plastic surgeon conference and the third international symposium on breast plastic surgery and reconstruction.

According to the cell biological characteristics of vascular diseases, Mulliken and Glowacki [1] proposed in 1982 to distinguish them into two categories: hemangioma and vascular malformations. This view has been widely accepted at home and abroad.

Cetuximab is a monoclonal antibody directly targeting epidermal growth factor receptor (EGFR), which can improve the overall survival and progression-free survival of patients with colon cancer who are ineffective to chemotherapy, and improve their quality of life. However, about 50% of patients have ineffective treatment with Cetuximab.

Multiple sclerosis (MS) is a common autoimmune disease characterized by inflammatory demyelination of the central nervous system. It has the characteristics of recurrence-remission, and most patients will eventually progress to secondary progression, with severe neurological deficits.

A 66-year-old female was admitted to hospital on September 21, 2000 with chest tightness, palpitations and yellow urine aggravated for 2 months for 10 days. Two months ago, electrocardiogram showed paroxysmal atrial fibrillation.

The patient, a 76-year-old female, was admitted to hospital for 14 days due to pain in chest, waist and lower limbs caused by the earthquake. During the Wenchuan earthquake in Sichuan Province on May 12, 2008, the patient's chest, waist and lower limbs were crushed by heavy objects, and was rescued and sent to the local hospital. X-ray examination showed compression fracture of thoracic 12 vertebrae, multiple rib fractures and comminuted fracture of left lower femur.