Volume 90  ·   Issue 38  ·  2010

Clinical research occupies a very important position in medical research.The research object of clinical research is patients, and the research content is related to the diagnosis, treatment, prognosis and etiology of diseases.The research results form the evidence that evidence-based medicine relies on. Through the analysis and prospect of the existing problems in clinical research in China, this paper achieves the purpose of paying attention to and striving to improve the level of clinical research in China, thus ultimately benefiting patients and increasing China's voice in the diagnosis and treatment of diseases in the world medical field.

Objective To investigate the diagnosis, treatment and outcomes of bone lymphangioma associated with spinal deformity in children. Methods Eight cases of children with bone lymphangioma associated with spinal deformity at our hospital from 1983 to 2010 were reviewed and analyzed with the following criteria: clinical manifestations, imaging features, histopathological characteristics and therapeutic options. The outcomes of early intervention treatment were assessed. The key diagnostic points and therapeutic principles were summarized on the basis of our own as well as international and domestic experiences. Results Paraplegia developed in 2 cases because of delayed treatment. The remaining 6 cases were followed up for 10 months to 2 years with satisfactory effects. By curettage lesions, bone grafts,intralesional injection of bleomycin and pedicle screw-stick system maintaining the spinal stability, bone lymphangioma became smaller or disappeared and spinal deformity was effectively controlled. The mean scoliosis and kyphosis correction rates were 57. 0% and 58.4% respectively. Conclusions Bone lymphangioma in children is rare. If costa and vertebrae are involved, spinal deformity will progressively develop and lead eventually to paraplegia. With an early diagnosis and the administration of proper drugs,bone lymphangioma can be effectively controlled. Surgery for the stability of spinal deformity will effectively prevent the occurrence of paraplegia.

Objective To investigate the effect of different methods of anticoagulation after mechanical valve replacement. Methods Totally 172 cases of mechanical valve replacement performed from October 2005 to June 2008 were divided into two groups and then analyzed retrospectively. Patients on warfarin and heparin were classified as the heparin group while those on warfarin alone were classified as the warfarin group. The operation, anticoagulation, anticoagulation index and associated complications were recorded to compare the effect of anticoagulation between two groups. Results warfarin group: the overall anticoagulation effect was satisfactory except for cerebral embolism (n= 1, 1.1%) and lower gastrointestinal hemorrhage (n= 1, 1.1%) during hospitalization. Heparin group: no anticoagulation-related complication was found. The time to reach stable warfarin anticoagulation was shorter than the warfarin group and difference was of significance (8 d ± 3 d vs 11 d ± 4 d,P ＜ 0.01). Ater adjustment of potential confounding factors such as age, gender, weight by linear regression analysis, the result showed that, the time to reach stable warfarin anticoagulation was shortened than the warfarin group by 2.11 days. Statistical significance of difference was observed between two groups (P ＜ 0.01). Conclusion It is both safe and effective to anticoagulate the patients after mechanical valve replacement with warfarin and heparin.

Objective To study the feasibility of CD25 monoclonal antibody (basiliximab) in the treatment of severe Ⅲ-Ⅳ intestinal acute graft-versus-host disease (GVHD) following haploidentical hematopoietic stem cell transplantation (HSCT). Methods Twenty patients, 13 males and 7 females, who developed Ⅲ-Ⅳ intestinal acute GVHD after haplotypic HSCT between October 2004 and September 2009,diagnosis. The therapy was repeated in the second week if the intestinal symptoms showed no improvement. The therapeutic effect was analyzed and the adverse reaction and cytomegalovirus (CMV) infection were observed. Results Ten patients had a complete remission and 5 were in a partial remission. The total effective rate was 75.0%. The clinical symptoms started to lessen in 1-12 days after using basiliximab (average: 7 days). During the 6-64 month follow-up (average: 25 months), 8/10 cases with a complete remission had no acute GVHD relapse, and the other 2 relapsing patients experienced a remission after a readministration of basiliximab. Nine patients survived with a longest period of 64 months. Four withdrew corticosteroids and the other 5 stayed on a low-dose maintenance corticosteroid regimen. The 2-year diseasefree survival was 47.5% by Kaplan-Meier calculation. Conclusions Basiliximab is feasible in the treatment of Ⅲ-Ⅳ intestinal acute GVHD after haplotype HSCT. It does not increase the relapse of leukemia or the incidence of infections.

：Objective To investigatethe prevalence and characteristics of adrenal lesions in Chinese multiple endocrineneoplasia type 1 (MEN-1) patients. Methods Adrenal CT scan and clinical manifestationswere retrospectively reviewed in 32 consecutive MEN-1 patients who were evaluated at ourhospital during January 1986 to December 2009. Results Adrenal lesions were identified in16 of 32 (50%) MEN-1 patients. Five (31.3%) patents with adrenal involvement showedbilateral lesions, including bilateral adenoma (n= 1), bilateral hyperplasia (n= 2) andadenoma and hyperplasia on each side (n= 2). Unilateral adrenal lesion was presented in 11(68.7%) patients. Among which, 63.6% had adenomas with a mean diameter of 2.3 cm (0.8 -4.0 cm) and the remainder was of hyperplasia or enlargement. In two patients, functioningadrenal abnormalities were detected including Cushing adenoma (n= 1) andaldosterone-secreting adenoma (n= 1). Conclusions The prevalence of adrenal lesion inMEN-1 patient is similar between China and western countries. These tumors are mostlybenign, small and nonfunctioning. Taking into account a high incidence of adrenalcarcinoma in previous foreign studies,rourine screening and close surveillance are stillrecommended for adrenal lesions in MEN-1 patients.

Objective To explore the expression of phosphatase and tensin homolog deleted on chromosometen (PTEN) in low rectal cancer on neoadjuvant chemoradiotherapy with capecitabine plus week). Then the investigators analyzed the relationship between the preoperative neoadjuvant chemoradiotherapy and prognosis and measured the expression of PTEN during neoadjuvant chemoradiotherapy. Results 92.4% (61/66) of patients received neoadjuvant chemoradiotherapy as planned. 87.9% (58/66)tumor stages were down-staged, tumor size decreased while the distance from analedge increased. And curative resection with sphincter-sparing was carried out in all patients. The rate of sphincter preservation was 90.9% (60/66). Among which, 85.5% patients showed an excellent function of sphincter. The 2-year survival rate was 87.9% (58/66). The survival period was an average of 35.3 months (range: 25 -60). The PTEN mRNA and protein expression in cancer tissues on neoadjuvant chemoradiotherapy were significantly higher than those before neoadjuvant chemoradiotherapy (P= 0.0079,0.0269). Conclusions The preoperative neoadjuvant chemoradiotherapy in lower rectal cancer patients has shown its efficacy in down-staging cancer, enhancing resectability, offering sphincter preservation, upregulating PTEN expression, promoting the apoptosis of cancer cell and achieving a better survival rate. Thus preoperative neoadjuvant chemoradiotherapy is an effective adjuvant measure.

Objective To systematically collect and analyze the influencing factors of patient compliance with colorectal cancer screening in qualitative studies so as to provide a theoretical basis for improving compliance. Methods The databases of Pubmed, EMbase, CBMdisc, CNKI and VIP and the relevant articles were searched. According to the predefined inclusion and exclusion criteria, the qualitative studies of the influencing factors of patient compliance with screening were included. After selection and critical appraisal of the retrieved studies, a meta-analysis was performed. Results A total of 15 studies were included. It was found that several factors had a great impact on the patient compliance of screening. They included a lack of knowledge of cancer and screening, screening costs, a feeling of embarrassment, a fear of screening complications or discomfort, barriers to implementation of screening, a lack of communication with physicians and a lack of symptoms and awareness. Conclusion Screening compliance may be improved through enhancing cognitive function in patients, ameliorating physician-patient communication and lowing the screening costs.

Objective To evaluate the effect of out-hospital normalized management of coronary heart disease (CAD) on the end point events such as mortality, readmission, etc, and on the compliance of patients through normalized management by an alliance of community and hospital. Methods The samples were comprised of a total of 2000 patients in 15 communities. And 1642 patients agreed to a follow-up and signed a consent form. Ten communities were chosen as the intensive management group in which community clinicians were trained and the patient management plan was proposed and carried out. The remaining 5 communities were taken as the control group in which the community clinicians were not trained and the patients received only general management. Both groups received a follow-up of 23 months. Results Compared with the control group, the intensive manage group showed a lower risk of all-cause death, cardiac death and readmission due to cardiovascular events (CVE). They declined by 36.5% (OR 0. 635,95% CI 0.478-0.854),41.5%(OR0.585,95%CI 0.428-0.800) and 56.1%(OR0.439,95%CI0.315-0.612)respectively. The proportion of patients with NYHA Ⅲ in the intensive management and control groups increased by 3.6% and 7.7% while that of the counterparts of NYHA Ⅳ in two groups increased by 1.6% and 6. 4% respectively. The cardiac function in the patients of intensive management group was significantly superior to that in control group. Patients in both groups displayed an acceptable compliance to cardiac medications except for aspirin. The proportion of aspirin in the intensive management and control groups increased by 8.4% and 8.7% respectively (P ＜ 0.05). Conclusion Through normalized management provided by an alliance of community and hospital, the rates of all-cause death and readmission due to CVE decrease significantly concurrently with an improvement of cardiac function and quality of life in CAD patients.

Objective To analyze the outcomes and adverse effects of bortezomib-based regimen for the treatment of multiple myeloma (MM) patients. Methods A total of 110 MM patients were treated with a bortezomib-based regimen at our hospital from January 2006 to February 2010. The patients over 65 years old received bortezomib-prednisone ± thalidomide (PD ± T) regimen or velcade-melphalan-prednisone (VMP)regimen therapy and the patients under 65 years old or resistant to PD ± T regimen received bortezomibdoxorubicin-prednisone ± thalidomide (PAD ± T) regimen therapy. The outcomes and adverse effects of bortezomib-based regimen were retrospectively evaluated. Results There were 47 newly-diagnosed MM patients and 63 relapsing/refractory MM patients. The overall remission (OR) rate was 76. 4% (84/110)and the OR rate of newly-diagnosed MM patients was statistically higher than that of relapsing/refractory MM patients (83.0% vs 71.4%, P ＜0.05). The complete remission(CR) + very good partial remission (VGPR) rate in group bortezomib 1.0 mg/m2 was lower than that in group bortezomib 1.3 mg/m2 (newlydiagnosed 53. 6% vs 73.7%, relapsing/refractory 28. 9% vs 40. 0%, both P ＜0. 05). The OR rate of ISS Ⅲ stage patients was as better as that of ISS Ⅰ and Ⅱ stage patients (newly-diagnosed 82. 1% vs 83.6%,relapsing/refractory 69. 2% vs 72. 2%, both P ＞ 0. 05). Thirteen newly-diagnosed MM patients underwent autologous stem cell transplantation (ASCT) after induced therapy and achieved a VGPR or above. The median follow-up time was 13.0 (6. 0 -20. 0)months. Their conditions were stable except two patients with extramedullary plasmacytoma after ASCT. Thirteen relapsing/refractory MM patients were retreated with a bortezomib-based regimen. The CR rate was 15.4% (2/13), VGPR rate was 23.1% (3/13), partial remission (PR) rate was 23. 1% (3/13),OR rate 61.5% (8/13)and the median duration of remission (DOR) was 6. 7(3.0 -21.0) months. Six MM patients with extramedullary plasmacytoma were treated with a bortezomib-based regimen and all of them achieved a PR or above. The median DOR was 4.5 (2.0 -10.0) months. The main adverse effects were peripheral neuropathy, thrombocytopenia, neutropenia,fatigue, gastrointestinal symptoms, anemia, etc. Conclusion The bortezomib-based combination regimen is the front-line therapy for newly-diagnosed and relapsing/refractory MM patients.

Objective To compare the mRNA, protein expression of long leptin receptor (Ob-Rb)in human adrenal tissues and tumors and observe the plasma level of leptin in primary aldosteronism (PA),cortisol-secreting tumors (CS) and pheochromacytomas (PHEO). Methods Total RNA and protein were extracted from 6 normal human adrenal glands, 10 CS, 20 PHEO; and 14 aldosterone-producing adenomas (APA) (RNA), 10 APA (protein); plasma samples were drawn from 20 controls, 15 PHEO, 29 PA and 11 CS. Results The mRNA and protein of Ob-Rb were widely expressed in human adrenal glands and tumors. The mRNA (0. 32 ±0. 12) and protein (1.31 ±0. 26) expressions of Ob-Rb were higher in normal human adrenal cortex (C) than all other tissues (P ＜0. 05) while the mRNA expression of Ob-Rb in APA (0. 15 ± 0. 10) was higher than CS (0. 05 ± 0. 02) (P ＜ 0. 05). The mRNA expression of Ob-Rb in APA was positively correlated with plasma supine aldosterone level (r= 0. 670, P= 0. 024). The mRNA expression of Ob-Rb in CS was positively correlated with 24-hour urinary free cortisol level(r=0. 870, P=0. 005). The plasma level of leptin was higher in CS than in non-CS groups (P= 0. 001). Conclusions Ob-Rb is widely expressed in adrenal tissues and tumors. There is a differential expression in various tissues. Further studies are warranted to understand the relationship between leptin and adrenal gland.

Objective To study the plasmid-mediated AmpC β-lactamases and the genotypes of Escherichia coli and Klebsieila spp. in children. Methods Escherichia coli and Klebsieila spp. of strains were isolated at our division from January to December 2009. Cefoxitin disk diffusion method was used to screen Escherichia coli and Klebsieila spp. for phenotypic AmpC enzyme. Multiple PCR method was adopted to test the genotypes of AmpC enzyme-positive Escherichia coli and Klebsieila spp. strains. Results Of all Escherichia coli and Klebsieila spp. , 65 were insensitive to cefoxitin disk and 17 strains carried DHA type AmpC gene. The prevalence of plasmid-mediated AmpC enzyme in Escherichia coli and Klebsieila spp. was 26. 2% (17/65). Among plasmid-mediated AmpC enzyme isolates, 14 (38.9%) Klebsiella pneurnoniae strains, 2 (7.7%) Escherichia coli strains and 1 (33.3%) Klebsiella oxytoca strains carried the DHA-1 AmpC gene. The genes of MOX, CIT, DHA, ACC, MIR and FOX were not found in other 48 strains. Conclusions The identified plasmid-mediated AmpC genes are all of DHA-1 genotype in Escherichia coli and Klebsieila spp. The prevalence of plasmid-mediated AmpC enzyme in Klebsiella pneumoniae isolates is relatively high in children.

Objective To investigate the possible mechanisms by which Somatostatin (SST)enhances the anti-tumor effect of doxorubicin (DOX) on gallbladder cancer cells. Methods GBC-SD cells were grouped into 4 groups: SST-treated group, DOX-treated group, SST + DOX co-treated group and control group. The concentrations of SST and DOX were 75 μg/ml and 5 μg/ml based on our previous studies. In control group, cells were cultivated with phosphate buffered saline (PBS). In experimental groups, cells were cultivated with medium and the corresponding drugs. After drug treatment, cell viability was examined by MTT assay at 6, 12, 24 and 36 h respectively. Meanwhile, intracellular concentrations of doxorubicin in each group was determined by microspectrofluorimetry; Real-time polymerase chain reaction (RT-PCR) was used to determine the expressions of MDR1 mRNA in the cells at different time points and the expressions of P-gp protein, a product of MDR1 mRNA, were determined by Western blot analysis. Results SST did not exhibit significant inhibitory effect on the proliferation of GBC-SD cells as compared to that of control group (P ＞ 0. 05). SST + DOX co-treatment group and DOX showed significantly inhibitory effect on the growth of GBC-SD cells at Hour 12 post-treatment. However no statistical difference was found between SST + DOX and DOX groups. Interestingly, at Hour 24 post-treatment, SST + DOX group showed more robust inhibitory effect on GBC-SD cells as compared to DOX alone group. Moreover, SST could significantly down-regulate the expressions of MDR1 mRNA and P-gp protein. SST could increase intracellular DOX concentration. And the difference of intracellular DOX concentration between SST + DOX group and DOX group at Hour 24 was statistically significant. Conclusions In our experiment, SST decreases the expression of MDR1 mRNA and P-gp protein so as to reduce the efflux of DOX and elevate DOX concentrations in GBC-SD cells. This eventually leads to enhanced cytotoxic effects of DOX on GBC-SD cells.

Objective To investigate the tumor-suppressing function of human esophageal cancer related gene 4 (ECRG4) in esophageal squamous cell carcinoma (ESCC). Methods The recombinant plasmid pcDNA3. 1-ECRG4 with ECRG4 open reading frame was constructed. The EC9706 cell was transfected with either pcDNA3. 1 or pcDNA3. 1-ECRG4. And the effects of ECRG4 on rumor cell were examined by in vivo assays of cell proliferation, adhesion, migration, invasion and tumor growth. The expression levels of P53 and P21 proteins were detected in EC9706 cell with transfection of ECRG4 gene by Western blotting. Results The final tumor volume and weight in ECRG4 transfection group were (264 ± 43)mm3 and(0. 39 ±0. 09)g, versus (464 ± 128)mm3 and (0. 76 ±0. 13)g in control group (both P ＜0. 05).And the capacities of tumor cells adhesion, migration and invasion decreased in ECRG4 transfection group versus that in control group(all P ＞ 0. 05). Furthermore, the expression levels of P53 and P21 proteins were higher in ECRG4 transfection group than those in control group (100. 00 ± 3.87, 35.71 ± 2. 36 vs 16. 6 ±1.92, 1.09 ± 0. 11, both P ＜ 0. 05). Conclusion As a novel candidate tumor suppressor in ESCC,ECRG4 may induce the up-regulation of p21 protein through p53 pathway to inhibit tumor growth in ESCC.

Objective To study the effects of drynaria total flavonoid on osteogenic differentiation of bone marrow mesenchymal stem cells (BMSCs) at different glucose concentrations. Methods BMSCs of SD rats were isolated, cultivated in vitro, and divided into 6 groups to be induced to differentiate into osteoblasts was used to examine the level of ALP. The ALP staining positive rate was examined with modified calcium cobalt method. Alizarin red staining was adopted to observe the number of calcium nodes.Immunohistochemistry was used to detect type Ⅰ collagen level. Advanced glycosylation end products (AGEs) were tested by ELISA. Results The A value indicating the ALP activity, ALP staining positive rate, calcium node number, and type Ⅰ collagen expression score of the low glucose + drynaria total flavonoid group were (0.439 ± 0.024), 48.7%, (9.75 ± 1.71) nodes/HP, and (2.21 ±0.07)respectively, all significantly higher than those of the sodium glycerophophate + vitamin C + dexamethasone [(0. 385 ± 0. 029), 35.0%, (6. 25 ± 0. 96) nodes/HP, and (1.93 ± 0. 13) respectively, all P ＜ 0. 05].The A value, ALP staining positive rate, calcium node number, and type Ⅰ collagen expression score of the high glucose with drynaria total flavonoid group were (0. 352 ±0. 022), 25. 3%, (4.50 ± 1.29)/HP, and (1.70 ± 0. 03) respectively, all significantly higher than those of the sodium glycerophophate + vitamin C +dexamethasone [(0. 139 ±0.013), 22.7%, (3.25 ± 1.50)/HP, and (1.28 ±0.27) respectively, all P ＜0. 05]. The AGE expression levels of the high glucose classical induction group and high glucose +drynaria total flavonoid group were both significantly higher than those of the low glucose classical induction group and low glucose + + drynaria total flavonoid group (both P ＜ 0. 05) . Ther were no significant differences in the AGE level among the low glucose control, low glucose classical induction, and low glucose +drynaria total flavonoid groups (all P ＜ 0. 05); and among the high glucose control, high glucose classical induction, and high glucose + drynaria total flavonoid groups (all P ＞＜ 0. 05). However, the AGE levels of the high glicose groups were all significantly higher than those of the corresponding low glucose groups (all P ＜ 0. 05). Glucose increased the AGE levels dose- and time-dependently. The concentrations of AGEs were significantly negatively correlated with the expression of type Ⅰ collagen (r= - 0. 410, P ＜ 0. 05).Conclusions Drynaria total flavonoid promotes the osteogenic differentiation of BMSCs and relieves the inhibitory effect of osteogenic differentiation by glucose at high concentration. Thus drynaria total flavonoid may provide a potential therapy for diabetic osteoporosis.

Objective To explore an ideal procedure of alimentary tract reconstructions after subtotal distal gastrectomy. Methods Thirty-two healthy adult beagle dogs were randomly divided into experimental groups A, B, C and control group (n= 8). Groups A, B, C operated by subtotal distal gastrectomy underwent 3 different reconstruction methods: continual jejunal interposition (CJI), Billroth Ⅱ and Roux-en-Y. The control group received a sham operation. Dogs were observed for 12 weeks postoperation. The different parameters of body weight, food intake, PNI (prognostic nutritional index) and peripheral blood concentration of ghrelin were measured in 4 groups. Results The body weight, food intake and PNI in Groups A, B, C decreased significantly at post-operation versus pre-operation. There was a slow elevation of body weight, food intake and PNI at Week 12. Group A was significantly better than Groups B and C (P ＜ 0. 05) while there was no significant difference between Groups B and C. The plasma ghrelin concentrations in Groups A, B, C were significantly reduced at Day 1 post-operation versus pre-operation.But no difference was observed among Groups A, B and C. However an elevated ghrelin concentration was observed at Week 1 post-operation. At Week 12 post-operation, the plasma ghrelin concentration in Group A increased significantly versus Groups B and C (both P ＜0. 05). However, the plasma ghrelin concentration,food intake and PNI were not significantly changed in control group (P ＞ 0. 05). Conclusions The CJI reconstruction procedure is ideally suited for the preservation of duodenal passage after subtotal distal gastrectomy. Subsequently it leads to a significant elevation of circulating ghrelin concentration and a rapid post-operative recovery of food intake, body weight and PNI.

The patient was a 32-year-old male with recurrent abdominal pain and diarrhea accompanied by fever for 9 months. Nine months before admission, the patient had persistent dull pain in the right lower abdomen with diarrhea without obvious trigger. It was a yellow paste stool, ranging from 2 to 6 times a day, without mucus, pus and blood, and no tenesmus. The local hospital considered "acute appendicitis" and "appendectomy". Eight months ago, the above symptoms recurred, and the patient developed fever, with the highest body temperature of 39.0℃. When he went to another local hospital, the colonoscopy showed "extensive erosion and congestion of the intestinal tract above the descending colon", the blood routine showed "white blood cells 24.99×109/L, neutrophils 0.881", and the stool routine showed "white blood cells 1+, red blood cells 6~8/high power scope field (HP)". After general anti-infective treatment for 1 week, there was no improvement. After suspected "intestinal tuberculosis", he was treated with "isoniazid 300 mg orally once/d, rifapentine 450 mg orally twice/week, ethambutol 750 mg orally once/d" for more than 10 days, but the abdominal pain and fever did not relieve. Biopsy showed "moderate chronic inflammation of mucosa with erosion and focal necrosis, superficial ulcer formation".

Nonalcoholic fatty liver disease (NAFLD) refers to a pathological state in which lipid disorder causes fat to accumulate in the liver. In many countries, NAFLD has become the most common cause of chronic liver injury [1]. NAFLD is a broad term, it is a general term for a series of liver damage from simple steatosis to non-alcoholic steatosis hepatitis, the latter can lead to liver cirrhosis and liver failure, and there is a risk of hepatocellular carcinoma [2]. At the same age and gender, even simple steatosis, the risk of death is higher than that of healthy people [3]. Insulin resistance is the main pathophysiological mechanism of NAFLD, and the incidence of NAFLD is significantly increased in pathological conditions of insulin resistance such as diabetes, obesity and metabolic syndrome [4]. In 2007, Zhou Jian et al. [5] investigated hospitalized patients with type 2 diabetes, and showed that about 2/5 of patients had NAFLD, and the latter was closely related to metabolic syndrome.

acute lung injury (ALI) and acute respiratory distress syndrome (ARDS) are common respiratory critical diseases in clinic.Although the cure rate of ALI/ARDS has improved with the application of broad-spectrum antibiotics and the improvement of mechanical ventilation mode, the overall mortality rate is still as high as 40% at present [1]. The early pathological changes of ALI/ARDS are endothelial surface damage and alveolar-capillary barrier destruction, so endothelium-targeted treatment is considered to be a potentially effective method [2]. However, endothelium-targeted drugs such as surfactants, pulmonary vasodilators, antioxidants and statins have failed to reduce the mortality of ALI/ARDS, which has prompted researchers to look for more effective means of endothelium preservation and repair [3-4].

Acquired immunodeficiency syndrome (AIDS) is an infectious disease caused by human immunodeficiency virus (HIV). There are two types of HIV: HIV-1 and HIV-2, among which HIV-1 is the main pathogen causing the global AIDS epidemic. Since the first case of AIDS was discovered in 1981, although the clinical treatment of AIDS has made great progress, there is still no effective cure to solve this scientific problem.

Pulmonary embolism is a general term for a group of diseases or clinical syndromes caused by various emboles obstructing the pulmonary artery system. The most common type is pulmonary thromboembolism (PTE), and malignant tumor is one of its important secondary risk factors. However, pulmonary sarcomatoid carcinoma with pulmonary embolism as the first manifestation is extremely rare. Pulmonary sarcomatoid carcinoma is a group of non-small cell lung cancer containing sarcoma morphological cells or sarcomatoid differentiated components, with low incidence and poor prognosis, and is easily misdiagnosed or misdiagnosed. A case of pulmonary sarcomatoid carcinoma diagnosed by pathology admitted to our hospital is discussed as follows in combination with relevant literatures.