A 65-year-old female patient was given treatment scheme of bevacizumab(0. 386 g,the first day),oxaliplatin(150 mg,the first day)and capecitabine(1 g,twice daily,the first day to the 14th day)for colon cancer with liver metastasis. Twenty-three days after administration,the patient developed upper abdominal pain. She was diagnosed of gastrointestinal perforation and diffuse peritonitis by abdominal X-ray and CT scan. Emergency exploratory laparotomy was performed and a perforation with a size about 5 cm × 2 cm was found at the location of ascending colon 5 cm away from ileocecus. Then an ascending colon and terminal ileum fistula operation was performed. After the patientˊs condition was stable,she was given oxaliplatin and capecitabine to continue treatment.

A 65-year-old female patient was given treatment scheme of bevacizumab(0. 386 g,the first day),oxaliplatin(150 mg,the first day)and capecitabine(1 g,twice daily,the first day to the 14th day)for colon cancer with liver metastasis. Twenty-three days after administration,the patient developed upper abdominal pain. She was diagnosed of gastrointestinal perforation and diffuse peritonitis by abdominal X-ray and CT scan. Emergency exploratory laparotomy was performed and a perforation with a size about 5 cm × 2 cm was found at the location of ascending colon 5 cm away from ileocecus. Then an ascending colon and terminal ileum fistula operation was performed. After the patientˊs condition was stable,she was given oxaliplatin and capecitabine to continue treatment.

Prostaglandin (PG) D_2 is one of unsaturated fatty acids with 20 carbon atoms, which is synthesized by PGD synthase (PGDS) in the brain. PGD_2 has been identified to be a sleep-inducing substance that becomes bound to the DP receptor (DPR) exclusively localized on the surface of the basal forebrain, leading to an increase in extracellular adenosine levels there. Through A_ 2A receptors (A_ 2A R), the adenosine activates neurons in the ventrolateral preoptic area (VLPO), a putative sleep center, and inhibits neurons in the histaminergic tuberomammillary nucleus (TMN), a putative wake center, via GABA to induce sleep. Studying the effect and the molecular mechanisms of sleep-induced by PGD_2 would be helpful in the development of novel sleeping drugs for more rational treatment of sleep disorders.