2015年 · 第95卷第43期

With the enhancement of people's health awareness and the progress of examination technology, in recent years, a large number of lung nodules have been detected, some of which are early lung cancer. This article only sorts out the screening, diagnosis and follow-up of early lung cancer, so as to provide reference for further standardization of related work.

A 39-year-old female, married, was admitted to Naval General Hospital mainly for "numbness of left limb for more than 1 month and intermittent headache for 20 days". The patient developed numbness on the lateral side of left upper limb and trunk without obvious trigger on 20 November 2013, and the numbness on the lateral side of left trunk gradually disappeared after 1 week. On November 26, 2013, he developed numbness in his left knee. He went to the neurology department of a hospital. The MRI of his neck was considered to be "spinal cord demyelinating disease". He was given oral B vitamins and other drugs, but his condition was not significantly relieved, and he experienced loss of appetite and general weakness. On December 20, 2013, I had an intermittent headache, which was dull, the location of the pain was uncertain, and hallucinations occurred. When I looked at someone else's head, I felt my scalp beating outward, and something like jujube shook on my chest, which was not paid attention to. On December 23, 2013, he suddenly became unable to speak and unconscious. He was rushed to a local hospital. After being dehydrated with mannitol, his consciousness gradually became clear and he could speak. However, he could only describe the nature and use of some things, but he could not name them, and he felt that his vision was incomplete. Skull MRI performed on December 27, 2013 showed that the left temporal insula occupied space, and glioblastoma was likely; Odontoid level cervical intramedullary mass occupation, glioma? The patient lost 5 kg of weight since the onset of the disease. Past history: In May 2013, I gave birth to a daughter at full term. She is currently lactating, and there is no special remainder.

coronary artery spasm (CAS) is one of the common pathological bases of many ischemic heart diseases. It is not only an important pathological mechanism of variant angina pectoris, but also can lead to acute coronary syndrome and even sudden cardiac death^[1]。 The pathogenesis of CAS is not fully understood, and it is currently believed that it may be related to endothelial dysfunction and chronic inflammatory reaction. Inflammatory reaction is also closely related to the occurrence and development of atherosclerosis^[2]。 C-reactive protein (CRP) is not only an important inflammatory marker in human body, but also an important cause of coronary vascular disease. In early 2003, the Centers for Disease Control and Prevention and the American Heart Association (CDC/AHA) jointly recommended the inclusion of high-sensitivity C-reactive protein (hs-CRP) levels in clinical coronary vascular disease risk assessments. A large number of studies have focused on CRP as a predictive marker of coronary spasm, but there is little attention to the pathogenic role of CRP in the occurrence and progression of CAS.

Microcirculation refers to the circulatory system between arterioles and venules. Its main components include endothelial cells and smooth muscle cells arranged on the inner wall of microvessels and red blood cells, white blood cells, platelets and plasma components in the lumen. The perfusion of microcirculation is regulated by myogenic, neurological and humoral metabolic factors. Early studies were influenced by monitoring methods. There were relatively few observational studies on microcirculation. With the development of microcirculation monitoring technology and its clinical application, the observation of microcirculation in sepsis became more intuitive^[1,2]。 A large number of studies have shown that microcirculation disorders exist in sepsis, and their severity and duration are significantly correlated with prognosis^[3,4,5]。 Microcirculation plays an important role in the mechanism of hemodynamic disorders in sepsis^[6]Studies have shown that microcirculatory disorders occur earlier than systemic circulation^[7,8]and can cause and exacerbate systemic circulatory disorders. Microcirculatory alterations in sepsis involve different pathophysiological changes of multiple components.

Liver cancer is a serious threat to human life and health, and is one of the common malignant tumors. In China, its morbidity and mortality are second only to lung cancer, ranking second^[1]。 Its therapeutic methods include surgery, radiotherapy and chemotherapy, and novel molecular targeted therapy. The formation of neovascularization is a necessary condition for the growth of liver cancer, and it is also the structural basis of hematogenous metastasis. The accurate evaluation of the degree of vascularization in tumors is not only beneficial to the differential diagnosis of lesions, but also can understand the biological behavior of tumors, and provide guiding information for diagnosis and curative effect. With the development of molecular imaging, quantitative analysis of magnetic resonance imaging (MRI) has become one of the main methods in the diagnosis and efficacy evaluation of liver cancer by monitoring the blood flow of the lesions.