Volume 95  ·  Issue 40  ·  2015

Clinical hematology is the medical science that mainly studies diseases of the blood and hematopoietic tissues. Clinical hematology research in China started late. In the old China, only a few big cities had some specialized clinical hematologists, even fewer blood experimental technicians, few published papers, and most of them were clinical case reports. After the founding of the People's Republic of China, clinical hematology in China has made continuous progress, especially in recent years, it has made world-renowned achievements. Some fields have reached the international leading level and occupied a place in the world^[1]。 2015 marks the 100th anniversary of the founding of Chinese Medical Journal. As a pioneer of medical journals in China, Chinese Medical Journal has provided a good communication platform for the development of clinical hematology in China and played a promoting role. This article reviews the progress and some outstanding contributions of clinical hematology research in China since the founding of the People's Republic of China.

Pathogenic diagnosis is the gold standard for the diagnosis of infectious diseases. Only by understanding the etiology and drug susceptibility results can we truly choose the correct antibacterial drugs and use them rationally, and at the same time avoid the occurrence of bacterial drug resistance. In the end, it can save medical expenses, reduce hospital stay, and reduce case mortality^[1]。 The key to the correctness of etiological diagnosis lies in specimen management, which directly affects the treatment strategy and efficacy, laboratory cost and efficiency. Therefore, clinical healthcare staff should be aware of the requirements of the microbiology laboratory for specimen collection and transportation, and the laboratory should also meet the needs of doctors and provide accurate and clinically meaningful results^[2]。

Pneumonia is a common infectious disease. There are many types of pathogens, and so are many types of specimens for microbiological examination. The best specimens are bronchoalveolar lavage fluid (BALF) and lung tissue, but because they are invasive methods, they are rarely used in China. This article only discusses coughing or aspirating sputum specimens. Sputum is the most common specimen for the diagnosis of pneumonia in China and in most clinical bacteriology laboratories. Pathogenic diagnosis of pneumonia with sputum specimens – this is a highly controversial topic. There are two common extreme views, or laboratory isolates are directly regarded as pathogens, and all of them are treated with antibacterial therapy; Or the sputum-coughing isolate is considered to be completely meaningless and does not require any analysis and disposal^[1]。 The former is definitely wrong, because the oropharyngeal colonization is contaminated, and common sense judgment can deny it. Is the latter wrong? Have sputum specimens been discarded internationally? According to a recent survey in the United States, in the case of common pneumonia, when respiratory tract specimens are required for etiological examination according to the guidelines, 23% of patients have sputum specimens, and 18% of the results have an impact on treatment^[2]。 It follows that neither of the above-mentioned extreme views is desirable. The author believes that sputum bacterial culture is valuable for the etiological diagnosis of pneumonia-the value is clear but limited.

Staphylococcus aureus is a common bacterium isolated in clinic, and the results of bacterial resistance surveillance in China show that^[1], which occupies the first place among gram-positive cocci, among which methicillin-resistant Staphylococcus aureus (MRSA) is a common multidrug-resistant bacterium^[2]This drug-resistant bacterium increases the difficulty of anti-infection treatment and costs a lot of medical expenses. Therefore, the United States clearly listed MRSA in the government decree "National Strategy to Fight Drug-resistant Bacteria in the United States" issued on September 18, 2014. It is one of the four types of bacteria of main concern, and many European countries have promulgated regulations on compulsory screening of MRSA. In recent years, surgical site infections caused by methicillin-sensitive Staphylococcus aureus (MSSA) have also received clinical attention^[3]。 Therefore, how to control the infection of Staphylococcus aureus from its colonization is a problem that clinical medical personnel should pay attention to.

To summarize the clinical and bacterial features of Klebsiella pnuemoniae liver abscess (KPLA) in order to provide the basis for the diagnosis and treatment of KPLA.

Retrospective study was conducted. One hundred and fifty–two medical records, from 3 teaching hospitals in Beijing, between January 2010 and December 2014, were collected. Among which 137 complete medical records were analyzed. String test was carried out to detect the hypermucoviscosity phenotype. PCR was performed to check the capsular serotype and the virulent genes. Disk diffusion method was operated to obtain the antimicrobial resistance rates. The results were analyzed by chi–square test.

KPLA occurred mostly in middle–aged, male and diabetes mellitus patients. 92.7% (127/137) patients had fever. 80.3% (110/137) of the KLPA were single abscess, among which 80.9% (89/110) were in the right lobe and 33.6% (46/137) had air cavities.74.5% (102/137) of the white blood cell count, 83.2% (114/137) of the neutrophils' percentage, 78.1% (107/137) of alanine aminotransferase and 51.8% (71/137) of the total billrubin were elevated. 87.5% (133/152) of theKlebsiella pnuemoniae (Kpn) appeared to be hypermucoviscous, K1 was the most popular serotype, the second was K2, and the positive rates of virulent genes rmpA and aerobactin were 82.9% (126/152) and 88.2% (134/152), respectively. Among the isolates from the KPLA without other hepatobiliary diseases, the portion of K1 serotype, the positive rates of rmpA and aerobactin were 65.7%, 94.9% and 96.0%, respectively, higher than those of the 28.9%, 50.0% and 68.4% from the KPLA with other hepatobiliary diseases, while the undefined serotype potion was lower (5.1% vs 26.3%), the differences were statistically significant (χ²=14.98, 38.40, 17.61, 10.65, all P<0.01). Most of Kpn were susceptible to antimicrobials.

KPLA has certain clinical features, and are mostly caused by hypervirulent isolates that are hypermucoviscous with rmpA and aerobactin genes. Most of the isolates are susceptible to antimicrobials.

To study the genotypes and clinical characteristics of carbapenemase-producing Enterobacter cloacae (E.cloacae), and lay the foundation for active control of nosocomial infection.

E. cloacae isolates were collected from January 2007 to December 2014. Strains which showed decreased sensitivity to carbapenem were screened out by the modified Hodge test (MHT) and EDTA-disk synergy test. The genotype of bla_KPC, bla_IMP, bla_VIM, bla_OXA-48 and bla_NDM-1 were detected by PCR amplication, the product of PCR was sequenced and conducted by Blast (http: //blast.ncbi.nlm.nih.gov/Blast.cgi) . Conjugal transfer experiment was conducted to prove horizontal transmit of carbapenemase gene produced by E. cloacae. Meanwhile, the clinical epidemiological data of patients infected by selected strains were also analyzed.

Sixty-four carbapenemase producing E. cloacae were detected by MHT, EDTA-disk synergy test and PCR amplification. Forty-five strains (70.3%) out of 64 strains infection came from nosocomial infection, while 19 strains (29.7%) from the community infection. The strains were mainly isolated from secretions samples and sputum samples, which accounted for 65.6% (42/64) and 23.4% (15/64) separately. The mainly clinical departments were orthopaedics (43.8%), department of burn (21.9%), ICU (18.8%) and pediatrics (14.1%). Bed changing, invasive operation and indwelling catheter were risk factors for the transmission of carbapenemase producing E. cloacae, and infected patients had longer time of staying in hospital, lower cure rate and higher frequency of cephalosporins enzyme inhibitor compound or carbapenem agents administration (all P<0.05). Sixty-four strains showed increased MIC to most of the antibiotics except for polymyxin and tigecycline. Among the 64 strains, 29 strains were genotypebla_IMP-4 and 35 strains were genotype bla_IMP-8 by Blast alignment, no genotype bla_VIM, bla_OXA-48 and bla_NDM-1 were detected. Result of conjugal transfer experiment showed that receptor strain obtained carbapenem resistance, and the sequence of resistance gene of receptor strain was the same to the donator strain.

The drug resistance of E. cloacae are growing, IMP-4 and IMP-8 carbapenemase are the main enzymes produced by strains. As the resistance gene can horizontal transmit between strains through conjugal transfer system, the strains have been locally spread in hospital departments, thus it is important to control risk factors of transmission timely.

To investigate the molecular epidemiology of acinetobacter baumannii and pseudomonas aeruginosa isolated from clinical specimens from patients on mechanical ventilation.

From October to December, 2012, acinetobacter baumannii and pseudomonas aeruginosa strains were isolated from patients on mechanical ventilation. Antibiotic susceptibility data of all strains was collected. Homology of the strains was analyzed by the methods of pulsed field gel electrophoresis(PFGE) genotype, meanwhile, the clinical data was also analyzed.

Of the 15 pathogens isolated from patients on mechanical ventilation, 7 acinetobacter baumannii strains had different genotypes, indicating specific clustering in a specific location, so acinetobacter baumannii should be a scattered infection or colonized strains. Parts of 8 pseudomonas aeruginosa strains came from the same clone and confirm the existence of cross-infection of nosocomial infections.

The result shows that nosocomial infection outbreak doesn't occur, there is a small range of cross-infection of pseudomonas aeruginosa.

To explore the value of pulse oximetry for diagnosing obstructive sleep apnea hypopnea syndrome (OSAHS) and evaluation of the effect of the continuous positive airway pressure (CPAP) therapy.

From January 2013 to March 2014, 244 OSAHS patients admitted to department of respiratory and critical care medicine of the first affiliated hospital of Fujian Medical University and department of respiratory and critical care medicine of People's Hospital of Peking University were recruited. According to apnea-hypopnea index (AHI), all patients were divided into mild, moderate and severe groups. The differences in pulse-associated indicators [nocturnal pulse elevation index (NPEI), namely counts of heart rate (HR) variation >6 bpm/h, average HR and standard deviation of HR] were compared among three groups before and after CPAP therapy. Spearman correlation analysis between pulse-associated indicators and AHI was performed to explore the optimal indicator. Receiver operating characteristic (ROC) curve were conducted and sensitivity and specificity were obtained.

NPEI after CPAP treatment were significantly lower than before among all the three groups (mild group 15.4±12.4 vs 19.4±13.3, moderate group 15.4±9.1 vs 24.1±11.9, severe group 21.9±14.8 vs 48.8±20.3, all P<0.05); there were significant correlations of AHI with average HR, standard deviation of HR and NPEI (r=0.334, 0.337 and 0.660, respectively) (all P<0.05); ROC curve showed a NPEI of 30beat per hour had a sensitivity of 68.0% and a specificity of 73.0% in diagnosing OSAHS.

Nocturnal oximetry could be a useful tool for screening OSAHS in clinical practice, and the NPEI can evaluate the efficacy of the CPAP therapy.

To evaluate the occurrence and clinical characteristics of sleep apnea syndrome (SAS) in heart failure (HF) patients with atrial fibrillation (AF) .

From HF patients hospitalized in the First Affiliated Hospital of Nanjing Medical University during June 2012 and June 2014, subjects were recruited based on electrocardiography examination, including 110 patients with AF (coexisting AF group) and 105 parallel control patients without AF but with matched age, gender and body mass index (simple HF group). Comparison was made about the occurrence and characteristics of SAS between two groups.

There was no statistical difference in causes of HF, complications, New York Heart Association class and basic medication between two groups. Compared with the patients in simple HF group, the patients in coexisting AF group had a significantly higher Epworth sleepiness scale score, larger cardiothoracic ratio (10.1±5.8 vs 8.2±5.5, 0.63±0.08 vs 0.57±0.07; both P<0.05), and shorter 6–minute walk distance [(305±70) vs (335±69) m,P<0.05]. There was no difference in left ventricular ejection fraction, left ventricular end–diastolic dimension and left ventricular end–systolic dimension between two groups. However, left atrial diameter was remarkably larger in coexisting AF group than that in simple HF group (P<0.05). The prevalence of SAS was higher in coexisting AF group than that in simple HF group (36.4% vs 20.0%,P<0.05). Compared with simple HF group, the coexisting AF group had a higher apnea/hypopnea index [4(1, 16) vs 3(1, 7) times/h,P<0.05]. No significant differences were detected between two groups among the rapid of eye movement sleep stage/total sleep time, arousal index, mean and lowest pulse oxygen saturation (SpO₂) and oxygen desaturation index.

HF patients with AF have a higher frequency of SAS, more severe daytime sleepiness and poorer physical activity than matched simple HF patients without AF.

To summarize the clinical characteristics of IgG4 related disease.

A retrospective analysis of clinical manifestation, radiography and pathological information of patients diagnosed with IgG4 related disease in Beijing Hospital.

Patients recruited in this study were 7 males and 7 females at the average age of (64.3±10.0) years old. Equal or greater than two organs were suffered in 10 patients. In these involved organs, pancreas was the most suffered organ with 10 times, bile duct and salivary gland was suffered 5 times respectively, lung was suffered 4 times and lacrimal gland was suffered 2 times. Laboratory examination of these 14 cases showed that 5 of these cases were with increased level of plasma IgG and all of the cases were with increased level of IgG4, 7 patients were with increased level of eosinophil count and 9 patients in 12 cases were with the increased level of IgE. All of the diagnosed patients were eusemia and 13 of them received the treatment of glucocorticoid. After usage of glucocorticoid, the clinical symptom and radiography findings were at great improvement, and the levels of IgG4 were decreased, but only two cases were down to normal level.

IgG4 related disease is a kind of disease with various manifestation and multiple organs are commonly suffered. The increase of IgG, IgE levels and eosinophil count could be considered as diagnosis clues.

To investigate the expression level of large tumor suppressor(LATS)1, LATS2 mRNA and its prognostic value in mantle cell lymphoma (MCL).

A total of 36 B–NHL cases (including MCL 16 cases, chronic lymphoblastic leukemia(CLL) 11 cases, splenic marginal zone cell lymphoma(SMZL) 9 cases)and 8 healthy donors were enrolled in this study from January 2008 to April 2011 in our Lymphoma Clinic Center. The mRNA level of Yap (effector of Hippo pathway) and LATS1, LATS2 mRNA were detected by using real–time quantitative PCR. Log expression values of real–time quantitative PCR data were used in this analysis.

The YAP mRNA expression level in MCL, CLL and SMZL patient were significantly higher than that in health donor(lg: 1.97±0.79, 1.83±0.54, 2.12±0.42 vs 1.21±1.56, all P<0.05). The expression level of LATS1, LATS2 mRNA in MCL was significantly correlated with molecular cytogenetic aberrations, progression free survival(PFS)and overall survival (OS). The LATS1 expression level was statistically lower in the group of MCL with delection P53 than the group of MCL without delection P53(lg: 0.75±0.27 vs 1.10±0.19,P=0.035). And the LATS1 expression level was statistically lower in the death group than the survival group(lg: 0.76±0.27 vs 1.15±0.17, P=0.026). The PFS and OS were significantly longer in the MCL patients with high level of LATS1 than that of other MCL patients((70.4±32.7)vs(5.6±2.2)months, P=0.044; (123.8±22.0)vs(7.7±2.2)months, P=0.017).

Hippo pathway is dysfunctional in B–NHL, especially in MCL.The reduced expression of LATS1, LATS2 in MCL patients is associated with progressive disease, and might be an important prognostic factor in MCL.

To investigate the treatment effect of laparoscopic hepatectomy and microwave ablation for colorectal liver metastases.

We retrospectively analyzed 126 patients who received treatment for colorectal liver metastases in our hospital during Jan. 2009 to Jan. 2015, and these patients were divided into laparoscopic surgical group (40 cases), microwave group (42 cases) and open surgical group (44 cases). The overall survival rate and disease–free survival rate were compared by using the Kaplan–Meier method.

The operation time in three groups were (120±35), (55±20), (100±30) min, respectively. The blood loss in the three groups were (300±120), (100±25), (250±95) ml, respectively. The operation time, blood loss and hospital stay in microwave group were less than the other two groups (P<0.05). There was no significant difference in survival time and postoperative complications in these groups (P>0.05).

Laparoscopic hepatectomy and microwave ablation in the treatment of colorectal liver metastases is effective compared to open hepatectomy. So the minimal invasive surgical techniques had benefit for patients with liver metastases from colorectal cancer.

To explore the impact of lifestyle and quantitative nutrition intervention on individuals with prediabetes.

A total of 214 prediabetic patients from epidemiologic survey in Ximazhuang and Guangrunmen community centers in Nanchang from January 2011 to January 2012 were enrolled in the study. All the participants were randomly divided into two groups: the intervention group and the control group, with 107 patients in each group. Intensified lifestyle and quantitative nutrition interventions were carried out in the intervention group, and routine lifestyle intervention was carried out in control group. Height and weight were measured, and the body mass index (BMI) was calculated. Blood glucose was tested by glucose oxidase method, and glycosylated hemoglobin (HbA1c) was detected by high performance liquid chromatography. Various parameter changes were compared between two groups after two year's follow-up, and the outcome data of patients was collected. The study was approved by the Ethics Committee of the Third Hospital of Nanchang.

There were no significant differences in each parameter between two groups before intervention (all P>0.05). No obvious change was found for the parameters in the control group after two year's follow-up (allP>0.05), but weight, BMI, fasting blood glucose, postprandial two-hour blood glucose and HbA1c decreased in the intervention group (P<0.05). There were 11 (13.1%) diabetic cases and 1 (1.2%) participant with normal glucose tolerance in the control group, and 3 (3.4%) diabetic cases and 7 (8.0%) participants with normal glucose tolerance in the intervention group (P<0.05). The risk of diabetes in two groups was performed using cox regression model analysis, and the primary end-point was the incidence of diabetes. The risk of diabetes in the control group was significantly higher than that in the intervention group [HR=3.903, 95%CI: 1.089–13.992, P=0.037].

The lifestyle and quantitative nutrition interventions may improve the blood glucose control and delay the progression of diabetes in prediabetes patients.

To describe the side effects of bortezomib in treatment of multiple myeloma(MM), especially the incidence of peripheral neuropathy (PN).

Information of 107 patients with MM who were treated with bortezomib in the First Affiliated Hospital of Zhejiang University from 2009 to 2014, were collected and analyzed retrospectively, to analyze the occurrence of adverse events during the treatment, especially the incidences of PN in each cycle and in different patients.

A total of 40(37%) patients suffered from PN, among which 13 patients were grade 3 PN and no patients reported grade 4 PN. Other common treatment–related side effects were thrombocytopenia, gastrointestinal reactions, fatigue, lung infection, herpes zoster in turn. In 44 MM patients treated strictly with bortezomib 1.3 mg/m² (days 1, 4, 8, 11) of each 3–week cycle, 20(45%) patients suffered from PN, of which 6 (14%) patients got grade 3 PN. In other 63 patients who received bortezomib less than 1.3 mg/m^2, 20 (32%) patients got PN and 7(11%) patients were grade 3 PN. There was no significant difference in the incidence of PN between the two groups of MM patients mentioned above(P=0.149), as well as the incidence of grade 3 PN(P=0.694). Univariate and multivariate analyse revealed that gender, age, a history of hypertensive disease, diabetes or hepatitis B virus infection, baseline PN symptoms and a history of neurotoxicity drug therapy were all not risk factors for PN(all P>0.05).

The reduction of bortezomib do not decrease the incidence of PN in bortezomib treatment of MM. Age, a history of diabetes and baseline PN symptoms are not risk factors for PN in bortezomib treatment of MM.

To study the status of hospital infection management staff of the Inner Mongolia Autonomous Region.

The respondents completed the unified questionnaire. The person entered into the computer after checking, using EXCEL software for analysis.

This survey involved 341 hospital infection management staffs, with an average age of 41.59 years. Professional background in nursing accounted for 59.53%. Bachelor degree or above accounted for 52.20%.The number of senior professional titles accounted for 40.47%. 78.09% of the staffs did not involve in the research. 36.58% of the staffs had special training or experience to lecture. Received provincial and national professional training staff accounted for 41.08% and 13.62%. Never received professional training in management of hospital infection accounted for 27.70%. 59.95% of the staff was never participated in academic exchanges.

The hospital should give appropriate preferential treatment to the hospital infection management department in term of introduction of talent, job promotion, research, conference expenses and so on. Construction of a high–quality management team to improve the hospital infection management in our region.

To investigate the optimal treatment and prognostic factors of renal cell carcinoma with brain metastases (RCCBM) by the analysis of clinical features.

The clinical data of 10 patients with RCCBM in our hospital from Jul.2003 to Aug.2011 were analyzed retrospectively. The age range of the patients was 48–80 years, and the mean age was 64 years old. Nine patients were male and one patient was female. Six patients had neurological symptoms. Brain metastasis and kidney cancer were found in the same period in 7 patients. Two patients had brain metastases alone, and 8 patients had metastasis in brain and other parts. There were 4 patients had more than 3 brain metastatic foci. Brain metastatic foci located in: frontal lobe in 6 patients, parietal lobe in 2 patients, occipital lobe in 2 patients, cerebellum in 2 patients, temporal lobe in 1 patient, thalamus and basal ganglia in 1 patient.

The overall survival (OS) of 10 patients with RCCBM was 0.8 to 62.6 months, with an average OS of 12.7 months. Two patients refused therapy and those average OS is only 1.4 months. Three patients were performed stereotactic radiotherapy (SRS). The tumor volume of 1 patient reduced >25% and 2 patients showed no progression in magnetic resonance images at 2-months after SRS. Two patients accepted sorafenib treatment and the average OS was 16.7 months. Patients with 3 or more brain metastases had an average OS of 1.9 months, and the average OS of those with less than 3 brain metastases was 20 months. Patients with synchronous or metachronous brain metastases of renal cell carcinoma had an average OS of 6.8 or 26.5 months, respectively. Patients with or without neurological symptoms had an average OS of 17.9 or 4.9 months, respectively.

For RCCBM patients, SRS could effectively control the local brain metastases while sorafenib could extend the overall survival. With 3 or more metastases, synchronous brain metastases and no neurological symptoms were the adverse prognostic factors of RCCBM.

To investigatethe effect of NVP–BKM120 on the triple–negative breast cancer cell lines.

Breast cancer cell line MDA–MB–231 and Cal51 were divided into control group and experimental group. The inhibitory effects of BKM120 were evaluated by MTT assays. The drug effects on CSC population and characteristics were investigated through mammosphere formation assay and colony formation assay. Western blot was used to observe the expressionof related protein. The BALB/c mice were injected with stem cells (SCs) and different treatments were administered subsequently.

In MDA–MB–231 cell lines, IC₅₀ of BKM120 was (20.01±3.46)μmol/L for SCs and(3.07±0.14)μmol/L for total cells.BKM120 significantly inhibit the cell growth, in vitrocloning and microspheres formed of triple–negative breast cancer cells.BKM120 can inhibit tumor growth in nude mice without significant adverse reactions.

BKM120 can significantly inhibit the proliferation of the triple–negative breast cancer cell lines.

To observe the effects of metformin (MET) on podocalyxin(PCX) expression in renal tissue from type 2 diabetes mellitus (T2DM) model rats and investigate its protective effects against glomerular podocyte injury.

The rat model of T2DM was established by feeding with high–fat diet and intraperitoneal injection of low dose of streptozotocin (STZ). All the rats were divided into four groups: diabetic group ( n=9), metformin group (300 mg·kg^–1·d^–1,n=8), glibenclamide group (5 mg·kg^–1·d^–1,n=8 ) and normal group (n=8). After 8 weeks, urinary PCX and creatinine, blood glucose(BG) and glycated hemoglobin (HbA1c) were detected in all the rats. Immunohistochemistry was used to observe the protein expression of PCX in renal tissue. Real–time polymerase chain reaction (PCR) was performed to detect mRNA expression of PCX. Pathological changes of renal tissue were observed by electron microscope.

Metformin and glyburide treatment decreased the levels of BG and HbA1c [(9.6±1.1) and (9.9±1.1) vs (15.6±1.6) mmol/L, (7.0±0.3)% and (8.0±1.0)% vs (12.4±0.6)%, all P<0.05], compared with diabetes group, while there was no statistically significant difference between the two intervention groups (P>0.05). The level of urinary PCX/urinary creatinine (UPCR) in diabetic rats were higher than that of normal group [(697±136) vs (94±25 ) ng/g,P<0.05), meanwhile the levels of protein and mRNA expression of PCX in kidney tissue reduced remarkably [(0.75±0.11) vs (3.18±0.14), (0.08±0.09) vs (1.00±0.02), bothP<0.05]. Above–mentioned indicators could be ameliorated by metformin and glyburide treatment compared to normal group (P<0.05), and there were statistically significant difference between the two intervention groups [(404±83) vs (516±38) ng/g, (1.54±0.06) vs(1.06±0.10), (0.23±0.01) vs (0.16±0.04), allP<0.05)]. Further observation found that basement membrane thickness of kidney [(267±22) vs (106±10)nm )]and fusion rate of foot process (0.80±0.07 vs 0)increased in the rats of diabetic group, and metformin or glyburide treatment can significantly reduced the above changes (P<0.05), additionally, the changes were remarkable different between metformin and glyburide group [(151±17) vs (204±22 ) nm, (0.49±0.04) vs (0.57±0.03), bothP<0.05)].

Metformin has protective effect on glomerular podocytes by regulating the expression of PCX in renal tissue, independent of its hypoglycemic effect.

Vascular calcification is a common pathological feature of atherosclerosis, diabetes, chronic kidney disease and other diseases. It is an active, preventable and reversible highly regulated biological process in which calcium salts are deposited in vascular tissues mediated by various cytokines^[1]。 With the increase of age, vascular calcification will gradually aggravate, usually manifested as decreased vascular compliance and increased cardiac load, which is easy to lead to thrombosis, plaque rupture, myocardial ischemia, left ventricular hypertrophy and heart failure. Vascular calcification is one of the important causes of high morbidity and mortality of cardiovascular and cerebrovascular diseases. According to statistics, about 85% of vascular calcified plaques will be secondary to thrombosis, thus leading to the occurrence of acute cardiovascular events^[2]。 At the same time, vascular calcification is also an important predictor of cardiovascular acute events, stroke and peripheral vascular disease^[3]。 Therefore, it is of great significance to deeply understand the basic research of vascular calcification and actively carry out its clinical application for preventing the harm of vascular calcification, predicting the occurrence of acute cardiovascular events, and reducing the incidence and mortality of cardiovascular and cerebrovascular diseases^[4]。 Therefore, this article now summarizes the basic and clinical progress of vascular calcification as follows.