Volume 89  ·   Issue 26  ·  2009

Hypertension is an important cardiovascular disease in China, and its high prevalence and mortality and disability rate have become a major public health problem of general concern in the whole society. Sleep apnea syndrome (SAS) is a common sleep respiratory disease.

Obstructive sleep apnea syndrome (OSAS) is easy to cause hypertension, and the latter can further cause complications of heart, brain, kidney and other organs, which seriously endanger human health. OSAS-related hypertension occupies a large proportion of hypertension patients, and early detection and timely treatment are of great significance.

Whether or not sleep apnea syndrome (SAS) can cause hypertension and the mechanism of causing hypertension has been a hot topic in the research field of sleep apnea. Although there are many factors of damage to the body caused by SAS, such as increased upper airway resistance, destruction of sleep structure, abnormal fluctuation of intrathoracic pressure and intermittent sleep hypoxia, most studies have taken intermittent sleep hypoxia or chronic intermittent hypoxia (CIH) as the main factors.

The results of epidemiological studies abroad show that the prevalence of obstructive sleep apnea (OSA) in hypertensive patients is 30% ~50%. Kales et al. [1] confirmed that 15 (30%) of 50 hypertensive patients have OSA by polysomnography (PSC) surveillance, and their mean apnea-hypopnea index (AHI) is 22.4 times/h.

Objective To explore the role of vagal nerve in obstructive sleep apnea hypopnea syndrome (OSAHS) associated hypertension. Methods A total of 104 patients were diagnosed OSAHS via polysomnngraphy for at least 7 hours. Their blood pressures were measured before and after sleep. Pearson's and Spearman's correlation test were applied to analyze the relevance of body mass index (BMI), apneahypopnea index (AHI), nocturnal minimum of arterial oxygen saturation (nSaO2% mira), percentage of dwell time of arterial oxygen saturation lower than 90% (DT90%), deviation between minimal heart rate and maximal heart rate during apnea (DHR) to systolic blood pressure (SBP), diastolic blood pressure (DBP), and mean arterial blood pressure (MAP) before and after sleep. Logistic regression was performed to examine the risk factors of morning diastolic hypertension and systolic hypertension. Moreover, odds ratio (OR) and 95% confidence interval (CI) of each risk factor were calculated. Results Morning SBP, DBP and MAP in 104 subjects were (128.3±17.9), (88.6± 10.6) and (101.8 ±12.3) mm Hg respectively. They were significantly elevated as compared with their pre-sleep levels [(123.5 ± 17.8),(82.0 ±9.6) and (95.8 ± 11.5) mm Hg respectively, all P<0.01]. Thirty-seven eases (35.6%)met the diagnostic criteria of hypertension (SBP≥140 and/or DBP≥90 mm Hg) in their blood pressures before sleep while 49 cases (47. 1%) in their morning blood pressures. Spearman's correlation analysis shows that DBP after sleep was correlated with DHR (r =0.214, P<0.05). DHR in OSAHS patients with diastolic hypertension increased as compared with those without diastolic hypertension (P < 0.05). After adjusting for age, BMI, AHI, nSaO2% rain and DT90%, DHR was a predictor for the morning systolic hypertension (OR = 1. 253, 95% CI: 1. 057 - 1. 486, P < 0. 01). Conclusions Sleep apnea-associated heart rate variability is correlated with morning DBP in OSAHS patients. And it is also an independent predictive factor for morning systolic hypertension. This suggests that vagal regulation may be involved in OSAHS associated hypertension.

Objective To investigate the efficacy and possible mechanism of continuous positive airway pressure (CPAP) therapy upon blood pressure in patients with obstructive sleep apnea hypopnea syndrome (OSAHS) and resistant hypertension (RH). Methods Thirteen OSAHS patients with RH were recruited. Before and after 3-month CPAP therapy, their blood pressures at 10:00 PM, 2:00 AM and 6:00 AM were measured and their morning plasma concentrations of aldosterone (ALD) and plasma renin activity (PRA) tested at supine position with radioimmunoassay. Results Compared with blood pressure parameters at pre-CPAP therapy, there was a significant decrease in blood pressure before sleep at the end of 3-month CPAP therapy [(135.5±2.8)/(84.2±4.6) vs (152.2 ±19.2)/(98.9 ± 15.6) mm Hg, P<0.01], at night during sleep [(133. 1± 2.4)/(81.5 ± 4.6) vs (156.6 ± 19.4)/(102.8 ± 16.6)mm Hg, P<0.01] and in the early morning [(151.5±3.0)/(81.2 ±3.2) vs (172.1±23.7)/(98.1 ±6.5) mm Hg, P <0.01]. Comparison of plasma concentrations of ALD and PRA before and after 3-month CPAP therapy indicated that there was a significant difference in ALD [(538±42) vs (408±53) pmol/L,0.221]. Conclusions CPAP therapy could significantly improve RH and plasma ALD concentration.Elevated plasma ALD concentration is possibly involved in the pathogenesis of RH in OSAHS patients.

Objective To evaluate the effects of oral appliance (OA) treatment upon systemic blood pressure (BP) in mild to moderate patients with obstructive sleep apnea-hypopnea syndrome (OSAHS). Methods Forty-six consecutive patients diagnosed with OSAHS on polysonmography were divided into OA treatment group (OA group, 25 patients, 15 patients with hypertension) and non-tolerated OA treatment group (N-OA group, 21 patients, 13 patients with hypertension). Polysomnography and 24hour ambulatory blood pressure monitoring (ABPM) were performed at baseline in two groups.Polysomnography and ABPM were repeated after a completion of 12 weeks of treatment in OA group and after a cessation of treatment for 12 weeks in N-OA group. Hypertensive patients in two groups continued taking the same kind and the same dose of antihypertersive agents during the period of study. Results There was no significant difference between the two groups in age, body mass index, Epworth sleepiness score (ESS),apnoea-hypopnoea index (AHI), arousal index (AI) and minimum arterial oxygen saturation (MSaO2) atv baseline. After a 12-week treatment, OA group showed significant improvement in AHI [(7.0 ± 3.8) vs (21.0±6.5) per hour, P<0.01], .AI [(22.94±6.3) vs (32.2±9.3) per hour, P<0.01] and MSaO2(86.8% ±3.5% vs 80.0% ±5.2%, P<0. 01), while nocturnal mean systolic blood pressure (SBP) and diastolic blood pressure (DBP), 24-hour and diurnal SBP, and nocturnal mean artery pressure (MAP) were significantly reduced [(121.3±7.0) vs (125.3±9.3), (76. 1±6. 1) vs (78.8±6.8), (127.2 ±7.5) vs (129.4±8.8), (131.5±6.9) vs (133.64±8.1), and (91.2±6.4) vs (94.3±7.6) mmHg respectively, all P <0.01]. The reduction in nocturnal MAP was significantly correlated to improvement in AI (r = 0.37, P = 0. 005) and AHI (r = 0.32, P = 0.011), to baseline nocturnal mean blood pressure (SBP: r = 0.39, P = 0. 015 ; DBP: r = 0.30, P = 0.024). The N-OA group showed no differences in blood pressure variables between baseline and after a cessation of treatment for 12 weeks. Conclusion Oral appliance treatment for mild to moderate OSAHS may lead to a reduction in systemic blood pressure.

Objective To investigate the relationship between symptoms of pancreatic cancerrelated depression and quality of life of patients. Methods Fifty inpatients with pancreatic cancer from 3 Guangzhou hospitals between June 2007 and October 2008 were enrolled. Hamilton rating scale for depression-24 (HAMD-24) questionnaire was used to assess the degree of depression. Quality of Life (QoL) was evaluated by European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-30 (EORTC QLQ-C30) and QLQ-PAN-26 respectively. Results Thirty-nine (78.0%) of these patients reported depression and 12 patients (30. 8%) had severe depression. The incidence of depression in pancreatic cancer patients with chemotherapy was 92.3% (24/26), which was significantly higher than that of patients with surgical therapy (62.5%, 15/24) (P = 0.011). The QoL of pancreatic cancer patients with depression in role functioning, emotional functioning and social functioning was significantly worse than that of patients without depression. The symptoms of fatigue, pain and appetite loss in pancreatic cancer patients with depression were significantly more than those without depression (P < 0.05). Conclusions Depressive symptoms are common psychological disturbance in pancreatic cancer patients. Moreover, depression significantly lowers quality of life for pancreatic cancer patients.

Objective To investigate the expression of CD147 in prostate cancer and discuss its diagnostic value in prostate cancer. Methods The method of immunohistechemical SP was employed to detect the expression of CD147 in 101 cases of prostate cancer, 90 cases of benign prostatic hyperplasia, 36 cases of normal prostate and 15 cases of embryonic prostate by so as to evaluate its clinical significance in the histological classification and prognosis of prostate cancer. Results The CD147 expression was positively expressed in 67/101 (66. 3%) of prostate cancer, 21/90 (23. 3%) of benign prostatic hypertrophy, 2/36 (5. 6%) of normal prostate and 0/15 (0.0) of embryonic prostate respectively. A positive expression of CD147 was dramatically associated with TNM stage (P < 0. 001), the depth of prostatic capsule invasion (P =0. 002) and histological grade (P =0. 006). Conclusions The detection of CD147 is helpful to raise the early diagnosis rate of prostate cancer. It will become a tumor marker of reflecting the malignant degree and predicting the prognosis of prostate cancer.

Objective To compare the rates of intravenous gamma globulin (IVIG) non-responder and coronary complication among early, conventional and late IVIG treatment in children with Kawasaki disease (KD). Methods All children with KD and IVIG treatment were retrospectively analyzed at 45 hospitals in Beijing during the 5-year period from 2000 through 2004. The time of IVIG treatment was classified as early (Day 1 -4), conventional (Day 5 -9) and late treatment group (Day 10 or later). The efficacy of IVIG was judged by the rate of IVIG non-responder. Echocardiography was used to assess the coronary complication at acute (1 - 2 weeks after onset) and sub-acute (3 - 6 weeks after onset) stage.Results A total of 1052 patients (680 boys, 372 girls) aged 2 months to 13.8 years were included. They were grouped as early, conventional and late treatment in 108, 763 and 181 children respectively. The rate of IVIG non-responders was higher in early (28.7% ,31/108) as compared with conventional (11.9% ,91/763) and late treatment group (7.2%, 13/181 ,both P <0.01). The incidences of coronary complications were similar in early (17.6% ,19/108 and 5.9% ,4/68) and conventional treatment group (18.3%, 140/ 763 and 5.5% ,25/452), while significantly higher in late treatment group (33.7% ,61/181 and 12.8%,15/117) in acute and sUblacute stages (both P < 0.01). Conclusions IVIG treatment in children with KD for a disease duration of 1 -4 days appeared to increase the rate of IVIG non-responders. Children with IVIG given at Day 10 or later had a higher incidence of acute and sub-acute coronary complications. IVIG given at Day 5 -9 seems to be the best time for IVIG therapy in KD.

Objective To evaluate the feasibility and experience of laparoscopic resection for Spiegel lobe associated with left liver lobe. Methods Three patients underwent laparoscopic resection ofSpiegel lobe associated with left liver lobe, Left hemihepatectomy or left lateral lobectomy was carried out firstly and then Spiegel lobe resected through the left-sided approach. Results A total of 3 cases were performed successfully. The median operative time was 197 rain and the median blood loss 467 ml. The postoperative period was uneventful without hemorrhage, bile leakage, infection or abdominal effusion.Conclusion Laparoacopic resection of Spiegel lobe associated with left liver lobe is safe and feasible when performed in selected cases and by experienced surgeons in laparoscopic hepatectomy.

Objective To apply bioinformatics analysis to study the potential mechanism of amifostine for the treatment of myelodysplastie syndrome (MDS) and optimize amifostine combination regimen to further improve the efficacy and prognosis of MDS. Methods Bioinformatics analysis: internetbased human gene expression open database was used to predict the genomic profiling by regulation of amifostine and gene expression of MDS. And then possible target genes of amifostine were screened to predict the feasibility of amifostine combination regimen. Finally, similar analysis of gene expression profiling was conducted to forecast the potential therapeutic drugs for MDS. Clinical investigation: eighteen patients with MDS, non-responding to traditional drugs, were enrolled. According to the latest WHO classification, the patients were divided into 7 patients of refractory anemia (RA), 2 patients of refractory anemia with ring siderublust (RAILS) and 9 patients of refractory cytopenia with multilineage dysplasia (RCMD).Distributions of age was 19-91 years old (mean: 79). There were 17 males and 1 female. The regimen of amifostine plus recombinant human erythropoietin (rhEPO) was used to treat the MDS patients.Administration formula was as follows : the intravenous drip of amifostine at a dosage of 0.4 gram per day was given 5 days weekly for 4 consecutive weeks ; the subcutaneous injection of rhEPO at a dosage of 6 000 IU was given 3 times weekly. Therapeutic effect was evaluated 2 weeks post-therapy. Results Approximately 2.6 percent of human gene involved in apoptosis, cell cycle and differentiation was regulated by amifostine.Especially, upregnlation of ELK1 expression, which belongs to downstream functional gene of EPO pathway,and downregulation of Cyclin D1 expression were successfully predicted. Based on the potential therapeutic mechanism amifostine for MDS, amifostine plus EPO had dual effects on MDS, i. e. promotion of hematopoiesis and inhibition of tumor cell proliferation. Clinical investigation showed that the response rates of hemoglobin, neutrophil and platelet were 83.3% , 66.7% and 55.6% respectively. The results suggested that the regimen of amifostine plus EPO had better therapeutic effects than a single agent. Conclusions The study successfully used bioinformaties analysis to screen target genes regulated by amifostine and optimize amifostine combination therapeutie regimen for MDS. Bioinformatics method is a convenient,economical and effective supplementary approach for studying the pathogenesis and therapeutics of MDS.

Objective To summarize the efficacy and safety of employing pneumatic compression therapy in infants with Kasabaeh-Merritt phenomenon (KMP). Methods Seventeen patients with KMP (11 males, 6 females) were treated with pneumatic compression therapy from October 1997 to May 2008. And their clinical characteristics, course of treatment and clinical and laboratory data were retrospectively analyzed. Among 17 patients, 8 eases were located in trunk, 5 in lower extremities and 4 in upper extremities. The diameters of lesions exceeded 8 cm in all patients. The platelet count was all < 100 × 109/Lwhile hemoglobin < 110 g/L and fibrinogen < 2. 0 g/L. The serf-designed device for pneumatic compression henmangioma therapy was employed (Patent No: ZL97232266.3). Biopsy and exairesis were performed from the local lesions with KMP in order to determine the pathological features. Results Two patients were cured after pneumatic compression therapy for 4 and 6 months respectively, and their lesions disappeared, blood parameters became normal and remained relapse-free after a 5/11-year follow-up. Eleven patients were effective after pneumatic compression therapy for 4 - 6 months, and improvement was demonstrated after 6 -24 months follow-up without any treatment. Two patients showed improvement after pneumatic compression therapy for 6 months after a follow-up for 5 months or 2 years without progression.After a 6-month pneumatic compression therapy, 2 ineffective patients underwent surgical resection. There were 14 cases of kaposiform hemangioendothelioma (KHE) and 3 cases of tufted hemangioma (TA).Conclusion Pneumatic compression therapy has definite curative effects for KMP lesiorts in extremities and trunk and its side effects are fewer.

Objective The treatment algorithm of donor middle hepatic vein (MHV) was made depending on the remnant liver volume of the total donor liver volume as calculated by computer tomography,estimated graft-to-recipient weight ratio and also MHV anatomy. The present study was to analyze the influence of this algorithm upon the safety of donors and recipients in right lobe living donor liver transplantation (LDLT) and to provide references for our future clinical practices. Methods Data of 73consecutive LDLT cases, operated and managed by the same surgical team according to the pre-operation MHV treatment algorithm, were analyzed. MHV was harvested in 28 cases and not in 45 cases. Donor and recipient gender, age, weight, operation time, blood loss volume, graft weight, non-bepatic phase, graft cold preservation time, perioperative survival rate and the incidence of small-for-size syndrome were compared, and also the peak post-operative values of ALT, AST, T-bilirubin and D-bilirubin. Results No donor needed blood transfusion and suffered small-for-size syndrome. One recipient recovered from small-forsize syndrome successfully by medical interventions. One recipient had acute hepatic necrosis at Day 6 postoperation and was converted into cadaveric liver transplantation. At Day 30 post-operation, one recipient died from disseminated infections and respiratory failure, but his liver function was normal. There was significant difference in donor and recipient age, actual GRWR, graft weight, graft cold preservation time and recipient's ALT peak value between the MHV harvest group and the MHV non-harvest group.Conclusion The MHV treatment algorithm is safe to beth donors and recipients.

Objective To investigate the immunological features and pancreatic β cell function of first-degree relatives of latent autoimmune diabetes in adults (LADA). Methods Oral glucose tolerance test (OGTT) was performed in 209 first-degree relatives of LADA patients and 340 first-degree relatives of classic T1DM patients. Radioligand assay was used to detect glutamic acid decarboxylase antibody (GADAb) and protein tyrosine phosphatase antibody (IA-2Ab). Intravenous glucose tolerance tests were performed in 39 normal controls and 46 first-degree relatives. Among them, 9 were GAD-Ab positive and 9 GAD-Ab negative first-degree relatives of patients with LADA while 12 were GAD-Ab positive and 16 GAD-Ab negative first-degree relatives of patients with classic T1DM. Results (1) Immunological characteristics of first-degree relatives of patients with LADA. Similar with the fast-degree relatives of patients with classic T1DM (18/340, 5.3 %), the detection rate of GAD-Ab was 4.3% (9/209) in first-degree relatives of patients with LADA. (2) Islet function of first-degree relatives of patients with LADA. Compared with the control group, the fast phase insulin release and the first phase insulin peak secretion averages were lower in the antibody positive group of first-degree relatives of patients with LADA(P <0.05) ; HOMA-IR was higher in the antibody negative group of first-degree relatives of patients with LADA(P < 0.05). (3) Analysis on detection rate of impaired glucose tolerance (IGT) was 16.7% (35/209) and diabetes (DM) rate 10.0 %group in first-degree relatives of patients with LADA (37.5% vs15.0%, P<0.05). Conclusions Among first-degree relatives of patients with LADA, a certain extent of islet autoimmune antibody markers could be measured, and insulin resistance and insulin secretion defects were detected. The rate of IGT was higher in the antibody positive group than the antibody negative group.

Objective To investigate the protective effects of L-carnitine upon testicular ischemiareperfusion injury in rats. Methods Sprague-Dawley rats were divided into 3 groups (n = 10). In those animals undergoing unilateral testicular torsion, right testes were rotated 720° for 2 h. Sham operated group served as a control group. Torsion group underwent 2 h torsion and saline was injected intraperitoneally at 30min pre-detorsion. Treatment group underwent similar torsion but L-carnitine (500 mg/kg) was infused intraoperatively. The right testes of 5 animals in each group were excised after 4 h reperfusion for measuring the levels of malondialdehyde (MDA) and heat shock protein 70 (HSPT0), evaluation of activities of antioxidant enzyme including superoxide dismutase (SOD), catalase (CAT) and glutathione peroxidase (GPx). Histopathoiogical changes and germ cell apoptosis indices (AI) were determined at 24 h postdetorsion in right testes of the remaining 5 animals in each group. Results The mean number of apoptotic nuclei per tubule cross section and the malondialdchyde level were significantly lower in treatment group as compared with torsion group[AI (6.87 ± 2.47) vs (17.13 ± 3.56), MDA (160 ± 15) vs (199 ± 15) nmol/g].Activities of antioxidant enzyme and the level of HSP70 were significantly higher in treatment group than those in torsion group[SOD(1638 ± 153) vs (1 078 ± 158) U/g, CAT(317 ± 28) vs (188 ± 33) U/g, GPx (667±94) vs (311±65) U/g,HSP70(0. 87 s0. 13) vs (0.25 ±0.04)]. The pathological damage of testes in the treatment group was lighter than that in the torsion group (all P < 0.05). Conclusions The administration of L-carnitine exerts a beneficial effect upon testicular ischemia-reperfusion injury. This effect may be achieved through an induced expression of HSP70.

Objective To investigate the mechanisms of erectile dysfunction induced by hyperlipidemia through studying the changes of contractility and relaxation of corpus cavernosum in hypercholesterolemic rabbit in vitro. Methods New Zealand white rabbits were randomly divided into control and experiment groups. The control group (n = 20) received a regular diet for 8 weeks while the experimental group (n =20) were fed a 1% cholesterol diet for 8 weeks. The authors conducted isometric tension studies with phenylephrine, endothelium-dependent vasodilators (acetylcholine), endotheliumindependent vasedilators (sodium nitroprusside) and rho kinase inhibitor (Fasudil) on isolated strips of corpus cavemosum. Results The weight and total serum cholesterol significantly improved (P < 0.01) in experimental group as compared with the non-fed experimental group. The total serum cholesterol significantly improved (P < 0. 01) in experimental group as compared with the control group. The contractility responses to phenylephrine in experiment group in doses (0.5, 1,5, 10, 50, 100 μmol) were 4.79%±2.00%, 8.84% ±2.95%, 12.81% ±3.77%, 14.63%±5.38%, 25.01% ±6. 14% and 34.69%±8.53% respectively. The contractility responses to phenylephrine in control group were 1.00%±0.13%, 2.60% ±0.72%, 4.28% ± 1.27%, 5.91% ±2.09%, 6.49% ±4.02% and 5.64% ±11.87%respectively. The contractility responses to phenylephrine significantly improved (P < 0.01) in experimental group in these doses as compared with the control group. The relaxation responses to acetylcholine in experimental group in doses (1, 10 and 100 μ mol) were 36.28% ± 4.71%, 48.81% ± 4.36% and 56.27% ± 11.93% respectively. The relaxation responses in control group were 48. 04% ± 4. 78%,69.12% ±5.27% and 78.23% ± 5.30% respectively. There was significant reduction (P <0.01) in experimental group in these doses as compared with the control group. No difference were found among the two groups in the relaxation response to sodium nitroprusside. The relaxation responses to fasudil in experimental group in doses (0.25, 1.25, 2.5 and 12.5 μmol) were 1.56% ±0.43%, 5.03% ±1.02%,8.28% ± 1. 35% and 16.77% ± 3.57% respectively. The relaxation responses in control group were 4.69% ±1.23%, 10.39% ±2.05%, 15.08% ±3.04% and 25.22% ±3.72% respectively. There was significant reduction (P <0.01) in experimental group in these doses as compared with the control group.Conclusion The improvement of cavernous smooth muscle contractility and the impairment of cavernous smooth muscle relaxation in response to endothelium-mediated stimuli are the mechanisms of erectile dysfunction induced by hyperlipidemia.

Objective To discuss the effect of N-acetylcysteine (NAC) upon matrix metalloproteinases (MMP) in the atherosclerotic processes in rabbit carotid. Methods The atherosclerotic models were generated in vitro by injuring rabbit internal carotid with arterial canal balloon. These rabbits were divided into 3 groups (15 mg/kg NAC, 30 mg/kg NAC and control group) and treated for 8 weeks.HE staining and immunohistochemistry were used to observe the plaque formation and the distribution of MMPs and ox-LDL. ELISA was used to detect the level of ox-LDL. And the protein levels of MMP-2 and MMP-9 in rabbit venous blood were detected by SDS PAGE zymography. The mRNA level of MMP-2 and MMP-9 were measured by RT-PCR and electrophoresis. Results As compared with the control group, NAG (15 mg/kg) group had a reduction of neointima of arterial lumen [(1.79 ±0. 24) vs (2.78 ±0. 17)mm2].A decrease of endothelial thickness [(0. 16± 0.01) vs (0.24 ± 0. 02) mm2] and an increase of vascular cavity transverse [(0.58± 0.10) vs (0.33 ± 0.11) mm2] (P < 0.05) were observed. At week 8, the oxLDL levels decreased by 16% in NAC (30 mg/kg) group [(30.5± 1.2) vs (36.2 ± 1.8) mmol/L](P < 0.01). Serum levels of pro-MMP-2, MMP-2 and pro-MMP-9 decreased markedly [INT/mm2 : (311 ±19,208± 8,283±7 vs 619 ±17,574 ± 8,564 ± 10) respectively, P < 0.01] in NAC (30 mg/kg) group.The levels of mRNA expression of MMP-2 and MMP-9 were (2.4±0.4, 2.8 ±0.2)vs(3.4 ±0.3, 3.7 ±0.5) respectively (P < 0.05). Conclusion NAC inhibits the atherosclerotic formation, suppresses the levels of ox-LDL, MMP-9 and MMP-2 and downgrades the expression of matrix metalloproteinase mRNA.

A 70-year-old female, retired primary school teacher, was admitted to the nephrology department of our hospital on October 9, 2007 due to "fatigue, blood creatinine and blood calcium increased for 6 months".

Gastric cancer is one of the main malignant tumors that harm human health, and its pathogenesis is still not very clear. In recent years, the research of stem cells has deepened the understanding of tumor occurrence and development, and put forward the theory that tumor is derived from stem cells, and confirmed the existence of tumor stem cells.

Venous thromboembolism (VTE) is one of the common complications in patients with malignant tumor, the incidence rate is about 4% ~20% [1]. In recent years, the rapid development of surgery, chemotherapy and radiotherapy has prolonged the survival of patients with tumor, and with the improvement of awareness and technology of VTE diagnosis, the detection rate of VTE in patients with malignant tumor has been increasing.

The activation of complement cascade in renal transplantation is inevitable due to recipient-specific and non-specific immune responses. Complement activation plays an important role in the development of allograft nephropathy and is a common cause of delayed allograft failure.

The long course of anti-tuberculosis treatment and the increasing proportion of drug-resistant strains have become a difficult problem worldwide. Whether there is a new treatment method to shorten the time of curing tuberculosis and treating drug-resistant strains, the fluoroquinolone drug-moxifloxacin may be a promising new drug with anti-tuberculosis effect.

A 44-year-old male was admitted to the hospital on April 19, 2008 due to "intermittent fever accompanied by cough for more than 3 months and blood in sputum for 1 day". In December, 2007, the patient found an egg-sized boil on his back, and one small red nodule on the skin of his arm and abdomen. The local clinic performed incision and drainage of the back boil and intravenous treatment with penicillin. The boil gradually healed and the small nodule on the skin disappeared.