2015年 · 第95卷第28期

Achalasia is a rare esophageal motility disorder, which is currently believed to be caused by the loss of visceral neurons, which leads to esophageal peristalsis disorder and low esophageal sphincter (LES) relaxation disorder, thus causing a series of clinical symptoms. The diagnosis of achalasia mainly depends on the patient's symptoms and related auxiliary examinations. Common complaints of patients include: dysphagia, food reflux, chest pain, and some respiratory symptoms. Auxiliary examinations include: X-ray examination, gastroscopy combined with ultrasound gastroscopy, and esophageal motility detection. The treatment of achalasia mainly includes drug therapy, endoscopic therapy (including endoscopic botulinum toxin injection, balloon and stent expansion therapy, endoscopic myotomy) and surgical therapy (traditional surgical therapy and endoscopic surgical therapy). Drug therapy has limited efficacy and is only applicable to patients who are intolerable to other treatments; Endoscopic botulinum toxin injection was replaced by endoscopic dilatation treatment because of its high short-term recurrence rate; Traditional thoracotomy has been abandoned by surgeons with the popularization of laparoscopic techniques. Endoscopic balloon dilatation (PD) and laparoscopic Heller myotomy (LHM) have become two preferred measures for clinicians in the era of lack of precision medicine concepts and technologies because of their respective characteristics and good long-term efficacy.

colorectal cancer (CRC) is a malignant tumor originating from colorectal mucosal epithelium, and is one of the most common malignant tumors in clinic. There are more than 250,000 new cases of colorectal cancer and about 140,000 deaths in China every year. Both new and death cases account for 20% of colorectal cancer cases in the same period in the world [^1]。 Therefore, it is an urgent and important clinical scientific problem to reduce the morbidity and mortality of colon cancer in China.

Postherpetic neuralgia (PHN) is the most serious complication in patients with herpes zoster, which is characterized by persistent or intermittent burning pain, pruritus, numbness, tingling, and tactile-induced pain at the site of nerve involvement [^1,2]。 Although antiviral therapy is currently advocated for acute herpes zoster and vaccination against varicella-zoster virus is recommended to reduce the incidence of PHN, more than 25% of 60-year-old patients with herpes zoster can develop persistent neuropathic pain [^3,4]。 At present, there are many drug treatments for PHN, mainly including antiviral drugs, anticonvulsants, tricyclic antidepressants, local anesthetics, opioids, etc., but the overall efficacy is not good, and a large number of adverse reactions will occur. As a new technology, dorsal root ganglion pulse radiofrequency has achieved good clinical results in the treatment of neuropathic pain [^5]。 In this study, we measured the changes of visual analogue (VAS) scores and Pittsburgh sleep quality index (PSQI) scores before and after treatment, and observed the efficacy of pulsed radiofrequency of thoracic dorsal root ganglion combined with gabapentin in the treatment of elderly patients with PHN. At the same time, we measured CD3 in peripheral blood of patients with PHN^＋CD4^＋CD8^＋To explore the effect of this combination therapy on immune function.

A 31-year-old female was admitted to the hospital on 14 October 2014 mainly due to "headache with nausea and vomiting for 12 days". Twelve days before admission, he had a sudden severe headache in quiet state, accompanied by nausea and vomiting. The vomit was stomach content. There was no numbness and weakness of limbs, no pairing and rotation of vision, no choking and dysphagia during drinking water, unconsciousness and limb twitching. He came to the emergency department of Beijing Chaoyang Hospital on October 8th. High-density shadow of the straight sinus was seen on head CT. On October 9th, head MRI showed straight sinus thrombosis, and head MRV showed poor imaging of the inferior sagittal sinus and straight sinus. He was admitted to the neurology ward considering venous sinus thrombosis. Prior history of lupus erythematosus for 13 years, currently oral methylprednisolone tablets 8 mg, once/d; He has a history of hypothyroidism for 3 years and is currently treated with oral levothyroxine sodium tablets 125 μ g once a day. In vitro fertilization was planned 38 days before admission, and intramuscular injection of recombinant human follicle-stimulating hormone was given for 13 days. During this period, pleural effusion, ascites and oliguria occurred. Furosemide 10 mg, once/d, and diuresis was given for 3 days. Subcutaneous injection of low molecular weight heparin calcium was started 27 days before admission for 7 days to prevent thrombotic events. Physical examination: blood pressure 126/92 mmHg (1 mmHg =0.133 kPa), nervous system and medical examination showed no abnormal signs.

regulatory B cell (Breg) is a kind of B cell subset that has been hotly studied in recent years. It plays a role in immune regulation by producing inhibitory cytokines such as interleukin 10 (IL-10), transforming growth factor β (TGF-β) or secreting inhibitory antibodies to affect other immune cells. At present, the understanding of Breg cells is far less than that of regulatory T cells (Treg), and its application in hematological diseases is still in its infancy, which needs further research.

Hematopoietic stem cells (HSC) are a class of adult stem cells with self-renewal and multidirectional differentiation potential, which can differentiate into all cells of the hematopoietic system. It was found that HSC is not randomly distributed in the bone marrow cavity, and it needs a specific microenvironment to maintain its relative homeostasis, keep HSC self-renewal but not differentiation, that is, maintain HSC "dryness". This hematopoietic microenvironment, also known as hematopoietic stem cell niche, is composed of various tissue cells, signaling molecules and extracellular matrix. We can think of the niche as a place to store stem cells, which not only protects HSC from depletion, but also prevents HSC from excessive proliferation, and also protects HSC from damage by the external environment. Without a proper niche, the HSC cannot perform its normal functions. In 1978, Schofield [^1]The concept of a stem cell niche was proposed for the first time. He used niches to describe the specific environment in the bone marrow, which is suitable for the survival of HSC, and also has an important regulatory role in the growth, proliferation, differentiation and apoptosis of HSC. On the one hand, the self-renewal of stem cells is determined by their own internal genes; On the other hand, it is influenced by the microenvironment in which it is located. According to the difference of position and function, we can divide the niches in the bone marrow into two categories, namely, endosteal niches [^2,3]and vascular endothelial cell niches [^4,5]。

Sepsis is a systemic inflammatory response syndrome caused by infection, and further development can lead to septic shock or even death. Sepsis is a common pathophysiological process manifested in the development of many diseases, which is widely involved in the transduction mechanism of multiple signal pathways. Mitogen-activated protein kinase (MAPK) is a class of molecules that carry extracellular stimulatory signals into the cell and amplify them in cascade. Its family members are widely involved in the pathological process of sepsis. The mechanism of action of MAPK in sepsis has attracted increasing attention.

Acid-base metabolism imbalance is very common in patients with end-stage renal disease (ESRD), among which metabolic acidosis is the most common. Cardiovascular events are a common cause of death in ESRD patients, accounting for more than 50% of their causes of death, while cardiovascular calcification is a common cause of cardiovascular disease development and development in ESRD patients [^1]Cardiovascular calcification is an active process involved in many genes and proteins regulated by cells. It is affected by the acid-base environment in vivo, and once it occurs, it is difficult to reverse, and even successful kidney transplantation cannot alleviate its progression [^2]。 Therefore, understanding the influence of acid-base environment on vascular calcification and its mechanism in ESRD patients is of great significance for preventing and treating vascular calcification, reducing the occurrence of cardiovascular events, improving the quality of life and reducing mortality.

In order to celebrate the 100th anniversary of the founding of Chinese Medical Journal, the first medical journal in modern times in China, the High-tech Medical Development and Internet Medical Summit Forum (Beijing Station) to celebrate the 100th anniversary of the founding of Chinese Medical Journal was jointly sponsored by the Editorial Committee of Chinese Medical Journal of Chinese Medical Association and the Sino-Japanese Hospital of the National Health and Family Planning Commission (SFPC). This academic activity is one of the series of activities organized by the Editorial Committee of Chinese Medical Journal "Celebrating the 100th Anniversary of the Founding of Chinese Medical Journal-A Hundred Expert Hospital Tour". This conference is co-sponsored by the Sino-Japanese Hospital of the National Health and Family Planning Commission and co-organized by Registration Network. Professor Gao Runlin, Editor-in-Chief of the Editorial Committee of Chinese Medical Journal and Academician of Chinese Academy of Engineering, Professor Hejie, Director of National Cancer Center, President of Cancer Hospital of Chinese Academy of Medical Sciences and Academician of Chinese Academy of Sciences, Professor Wang Chen, President of Sino-Japanese Hospital of National Health and Family Planning Commission and Academician of Chinese Academy of Engineering, respectively delivered speeches at the opening ceremony, congratulating the 100th anniversary of the founding of Chinese Medical Journal, highly appraising and fully affirming the contribution made by Chinese Medical Journal to the progress and development of Chinese medical science and the improvement of people's life and health in the past 100 years, and warmly congratulating the convening of the meeting and wishing the meeting a complete success. Vice President Liu Bing and Deputy Editor-in-Chief Shi Chaoyun of Chinese Medical Association Magazine attended the meeting and congratulated the meeting. More than 500 medical colleagues, including Professor Zhu Yuanjue, a famous respiratory expert in China, Professor Cui Liying, a neurology expert, and medical staff from Chinese and Japanese hospitals attended the conference. Forty media friends, including Fan Cunbin, editor and reviewer of the Journal Department of People's Medical Publishing House, and Sun Yu, president of PLA Military Medical Science Press, attended the commemorative conference.