A 70-year-old female patient presented with fatigue and edema for 3 months and was found to have elevated serum creatinine for 3 weeks. During the course of the disease, she had fever and cough. Examinations revealed multiple ground-glass opacities in both lungs and positivity for myeloperoxidase-anti-neutrophil cytoplasmic antibodies (ANCA), leading to a diagnosis of ANCA-associated vasculitis. The patient′s condition initially improved after pulse glucocorticoid therapy combined with cyclophosphamide. During treatment, however, the patient developed hematochezia, and colonoscopy revealed multiple colonic ulcers. Immunohistochemistry of colonic mucosal biopsy confirmed cytomegalovirus (CMV) positivity, establishing a diagnosis of CMV colitis. The patient was found to have concurrent Clostridioidesdifficile and pulmonary infections. During the disease course, the patient also developed deep vein thrombosis and roxadustat-associated central hypothyroidism. Given the presence of multiple comorbidities, rituximab was subsequently used for vasculitis treatment, resulting in sustained remission. This case highlights the importance of highly individualized treatment strategies for older patients with vasculitis, requiring adjustment of immunosuppressive therapy intensity based on disease progression.

A 70-year-old female patient presented with fatigue and edema for 3 months and was found to have elevated serum creatinine for 3 weeks. During the course of the disease, she had fever and cough. Examinations revealed multiple ground-glass opacities in both lungs and positivity for myeloperoxidase-anti-neutrophil cytoplasmic antibodies (ANCA), leading to a diagnosis of ANCA-associated vasculitis. The patient′s condition initially improved after pulse glucocorticoid therapy combined with cyclophosphamide. During treatment, however, the patient developed hematochezia, and colonoscopy revealed multiple colonic ulcers. Immunohistochemistry of colonic mucosal biopsy confirmed cytomegalovirus (CMV) positivity, establishing a diagnosis of CMV colitis. The patient was found to have concurrent Clostridioidesdifficile and pulmonary infections. During the disease course, the patient also developed deep vein thrombosis and roxadustat-associated central hypothyroidism. Given the presence of multiple comorbidities, rituximab was subsequently used for vasculitis treatment, resulting in sustained remission. This case highlights the importance of highly individualized treatment strategies for older patients with vasculitis, requiring adjustment of immunosuppressive therapy intensity based on disease progression.

A 53-year-old female patient with bone metastasis of breast cancer received targeted drugs (abemaciclib 150 mg orally twice daily, exemestane 25 mg orally once daily), zoledronic acid (4 mg IV infusion once per month), traditional Chinese medicine, and non-steroidal anti-inflammatory drugs. After 2 months, her serum creatinine (Scr) increased from 84 μmol/L before treatment to 156 μmol/L. Due to renal tissue puncture biopsy, the patient missed taking abemaciclib for 1 day. The laboratory tests next day showed that her Scr decreased from 151 μmol/L to 123 μmol/L. Comparing the estimated glomerular filtration rate calculated using serum cystatin C with that calculated using Scr, combined with the pathological examination results of renal biopsy tissue, the patient′s renal injury caused by other drugs could be ruled out, and the possibility of pseudo-elevation of Scr caused by abemaciclib was considered.

A 53-year-old female patient with bone metastasis of breast cancer received targeted drugs (abemaciclib 150 mg orally twice daily, exemestane 25 mg orally once daily), zoledronic acid (4 mg IV infusion once per month), traditional Chinese medicine, and non-steroidal anti-inflammatory drugs. After 2 months, her serum creatinine (Scr) increased from 84 μmol/L before treatment to 156 μmol/L. Due to renal tissue puncture biopsy, the patient missed taking abemaciclib for 1 day. The laboratory tests next day showed that her Scr decreased from 151 μmol/L to 123 μmol/L. Comparing the estimated glomerular filtration rate calculated using serum cystatin C with that calculated using Scr, combined with the pathological examination results of renal biopsy tissue, the patient′s renal injury caused by other drugs could be ruled out, and the possibility of pseudo-elevation of Scr caused by abemaciclib was considered.

In recent years, a number of studies have focused on malignant tumor patients with coagulant function abnormality, which causes thrombus complications, tumor growth, infiltration of closely related cells, transfer, and so on. These factors directly affect prog-nosis. Heparin is a widely known anticoagulant, and anticoagulation drugs have been included in malignant tumor treatment guide-lines. Ameaican Society of Clinical Oncology (ASCO), European Society for Medical Oncology (ESMO), and American College of Clinical Pharmacy (ACCP) recommend low-molecular-weight heparin as the first choice for the treatment of cancer thrombosis. However, the prophylactic use of anticoagulant drugs in patients with tumor control disease, as well as the prolonged PFS and OS mechanism, is still unclear. The recently publishedReport of incidence and mortality in China(2012) suggests that lung cancer incidence and mortality ranked first place. This review will introduce several aspects of anticoagulant drugs that can be used to control the recurrence of malig-nant tumor metastasis and prolong the survival mechanism of pathophysiology.

Objective To investigate the extracellular polysaccharide distribution and components of Ureaplasma urealyticum (Uu) after biofilm having been developed in.Methods The standard serotype 3 and serotype 14 belong to biovar Parvo,and the standard serotype 4 and serotype 8 belong to biovar T960 were employed to form biofilrns in vitro.Scanning electron microscope and confocal laser scanning microscope were used to analysis the biofilms and extracellular polysaccharide.We used combination of two different labeled lectins,Canavalia ensiformis(FITC-ConA) and Erythrina cristagalli(ECA) which bind to specific polysaccharide residues to visualize extracellular polysaccharide in biofilms,and average uorescence intensity was evaluated Results All the strains can form the biofilmsin vitro.The biofilm was honeycomb-Like structures mainly,and extracellular polymeric substances accounts for majority of proportions.All the extracellular polysaccharide could be combined with FITC-ConA and ECA,and the total average fluorescence intensity of FITC-ConA was higher than ECA( P＜0.001 ).Conclusion Ureaplasma urealyticum biofilm is honeycomb-like structures mainly.The extracellular polysaccharide contains,galactose,and N-acetyl glucan residual,and the glucose,mannose residual are the main components.