MedNexus
2015年 · 第128卷第12期
出版日期 2015-06-20电子版 ￥0.00元
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Original Article
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沙格雷酯与氯吡格雷双重抗血小板治疗在股腘动脉血管内介入治疗患者中的前瞻性随机研究：初步结果Yue-Xin Chen, Wen-Da Wang, Xiao-Jun Song, Yong-Quan Gu, Hong-Yan Tian, He-Jie Hu, Ji-Chun Zhao, Xiao-Qiang Li, Chang-Wei Liu
中华医学杂志英文版2015年 128卷 12期
DOI: 10.4103/0366-6999.158285
摘要
Background:
Sarpogrelate is a selective 5-hydroxytryptamine (5-HT) receptor subtype 2A antagonist which blocks 5-HT induced platelet aggregation and proliferation of vascular smooth muscle cells. We compared the efficacy of sarpogrelate-based dual antiplatelet therapies for the prevention of restenosis and target lesion revascularization (TLR) rates comparing with that of clopidogrel after percutaneous endovascular interventions (EVIs) of femoropopliteal (FP) arterial lesions.
Methods:
This prospective, multicenter, randomized clinical trial recruited a total of 120 patients with successful EVI of FP lesions at seven centers across China between January 2011 and June 2012. Patients were randomized to receive either sarpogrelate (100 mg trice daily for 6 months, n = 63) or clopidogrel (75 mg once daily for 6 months, n = 57). All patients also received oral aspirin (100 mg once daily for 12 months). Clinical follow-up was conducted up to 12 months postprocedure.
Results:
There was no significant difference between the two groups in basic demographic data. The restenosis rate was higher in the clopidogrel group (22.80%) than in sarpogrelate group (17.50%), but there was no significant difference between these two groups (P = 0.465). The TLR rate, ipsilateral amputation rate, mortality in all-cause and bleeding rate were also similar in the two groups (P > 0.05).
Conclusions:
Aspirin plus sarpogrelate is a comparable antithrombotic regimen to aspirin plus clopidogrel after EVI of FP arterial lesions. Dual antiplatelet therapies might play an important role in preventing restenosis after successful EVI of FP lesions.
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北京市小学生危险行为及其社会决定因素的聚类：一项横断面研究Yan Zhang, Ying Ji
中华医学杂志英文版2015年 128卷 12期
DOI: 10.4103/0366-6999.158289
摘要
Background:
Studies in developed countries reveal that poor lifestyle choices triggering diseases typically cluster among children. However, there is insufficient evidence on the clustering of risk behaviors among children in developing countries. This study aimed to determine the clustering of risk behaviors and their social determinants among 4th-and 5th-grade learners in Beijing, China.
Methods:
The sample comprised of 967 learners from six primary schools enrolled migrant and resident learners by two-stage stratified cluster sampling. Prevalence denoted the risk behaviors and their clustering. A log-linear model was used to explore the clustering patterns. Ordinal logistic regression determined the influence of demographic characteristics, school environment, and family context on behavioral clustering.
Results:
The prevalence of none, one, two, and three or more risk factors was 61.2%, 20.0%, 10.8%, and 8.1% for infectious diseases and 46.0%, 30.6%, 15.4%, and 8.0% for chronic diseases, respectively. Some behaviors appeared dependent and were more likely to be observed together. The three most influential factors for infectious diseases were school type (odds ratio [OR] =4.47, 95% confidence interval [CI] 3.00–6.66), school located in an inner suburb (OR = 0.27, 95% CI 0.18–0.38), and gender (OR = 0.56, 95% CI 0.42–0.74). Regarding risk behaviors for chronic diseases, clustering was not associated with household registration status and number of appliances, but was significantly associated with school type (OR = 5.36, 95% CI 3.72–7.73), school located in an inner suburb (OR = 0.59, 95% CI 0.43–0.81), and gender (OR = 0.61, 95% CI 0.47–0.78). School environment variables were the most significant contributor to the number of risk behaviors.
Conclusions:
The characteristics of schools enrolling migrants and residents influenced the number of risk behaviors. Therefore, improved school conditions and integrated behavioral interventions are particularly recommended for health promotion.
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封堵器与房间隔长度比值预测儿童继发孔型房间隔缺损经导管封堵术后心律失常发生的价值Mei Jin, Wen-Hong Ding, Xiao-Fang Wang, Bao-Jing Guo, Yong-Mei Liang, Yan-Yan Xiao, Chu-Fan Sun
中华医学杂志英文版2015年 128卷 12期
DOI: 10.4103/0366-6999.158291
摘要
Background:
Transcatheter occlusion has been applied to treat ostium secundum atrial septal defect (OS ASD) since 1997. During the clinical practice, several postoperative complications including arrhythmia have been reported. This study aimed to evaluate the value of the ratio of atrial septal occluder (ASO) versus atrial septal length (ASL) for predicting arrhythmia occurrence after transcatheter closure in children with OS ASD.
Methods:
Six hundred and fifty-one children diagnosed with OS ASD underwent occlusion procedures after completing routine examinations. The onsets and types of arrhythmia both during and after the occlusion procedures were monitored. Treatments were given based on the individual types of arrhythmia. The binary logistic regression analysis and receiver-operating characteristic (ROC) curve were used in the analysis of value of the ratio of ASO/ASL for predicting postoperative arrhythmia occurrence.
Results:
Transcather occlusions were conducted in 651 children, among whom 7 children had different types and degrees of arrhythmia, with an incidence of 1.1%. The types of arrhythmia included sinus bradycardia, atrial premature beats, bundle branch block, and different degrees of atrioventricular block. Normal electrocardiograph findings were resumed in these 7 patients following active therapies such as corticoids, nutrition, and surgeries. The binary logistic regression and ROC analysis suggested that the ratio of ASO/ASL exhibited an intermediate predictive value for predicting arrhythmia occurrence after occlusion procedures. A cut-off value of 0.576 in the ratio provided a sensitivity of 87.5% and a specificity of 76.2% with an area under the ROC curve of 0.791 (95% confidence intervals, 0.655–0.926; P < 0.05) in predicting arrhythmia occurrence after the closure procedures.
Conclusions:
The ratio of ASO/ASL might be a useful index for predicting arrhythmia occurrence after closure procedures in children with OS ASD.
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在亚洲人群中使用高髋中心技术指导髋臼部件放置的髂骨横断面解剖Jian-Lin Xiao, Jian-Lin Zuo, Peng Liu, Yan-Guo Qin, Xue-Zhou Li, Tong Liu, Zhong-Li Gao
中华医学杂志英文版2015年 128卷 12期
DOI: 10.4103/0366-6999.158298
摘要
Background:
Many clinical studies have been published involving the use of a high hip center (HHC), achieved good follow-up. However, there is a little anatomic guidance in the literature regarding the amount of bone stock available for initial implant coverage in this area of the ilium. The purpose of this study was to evaluate the thickness and width of the human ilium and related acetabular cup coverage for guiding acetabular component placement in HHC.
Methods:
A total of 120 normal hips in 60 cases of adult patients from lower extremities computer tomographic angiography Digital Imaging and Communications in Medicine data were chosen for the study. After importing the data to the mimics software, we chose the cross sections every 5-mm increments from the rotational center of the hip to the cephalic of the ilium according the body sagittal axis, then we measured the thickness and width of the ilium for each cross section in axial plane, calculated the cup coverage at each chosen section.
Results:
At the acetabular dome, the mean thickness and width of the ilium were 49.71 ± 4.88 mm and 38.92 ± 3.67 mm, respectively, whereas at 1 cm above the dome, decreased to 41.35 ± 5.13 and 31.13 ± 3.37 respectively, and 2 cm above the dome, decreased to 31.25 ± 4.04 and 26.65 ± 3.43, respectively. Acetabular cup averaged coverage for 40-, 50-, and 60-mm hemispheric shells, was 100%, 89%, and 44% at the acetabular dome, 100%, 43.7%, and 27.5% for 1 cm above the dome, and 37.5%, 21.9%, and 14.2% for 2 cm above the dome.
Conclusions:
HHC reconstructions within 1 cm above the acetabular dome will be an acceptable and smaller diameter prosthesis would be better.
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一氧化氮合酶同工酶在有与无慢性阻塞性肺疾病吸烟者肺组织的表达Wen-Ting Jiang, Xian-Sheng Liu, Yong-Jian Xu, Wang Ni, Shi-Xin Chen
中华医学杂志英文版2015年 128卷 12期
DOI: 10.4103/0366-6999.158309
摘要
Background:
It has been demonstrated that only 10%–20% cigarette smokers finally suffer chronic obstructive pulmonary disease (COPD). The underlying mechanism of development remains uncertain so far. Nitric oxide (NO) has been found to be closely associated with the pathogenesis of COPD, the alteration of NO synthase (NOS) expression need to be revealed. The study aimed to investigate the alterations of NOS isoforms expressions between smokers with and without COPD, which might be helpful for identifying the susceptibility of smokers developing into COPD.
Methods:
Peripheral lung tissues were obtained from 10 nonsmoker control subjects, 15 non-COPD smokers, and 15 smokers with COPD. Neuronal NOS (nNOS), inducible NOS (iNOS), and endothelial NOS (eNOS) mRNA and protein levels were measured in each sample by using real-time polymerase chain reaction and Western blotting.
Results:
INOS mRNA was significantly increased in patients with COPD compared with nonsmokers and smokers with normal lung function (P < 0.001, P = 0.001, respectively). iNOS protein was also higher in COPD patients than nonsmokers and smokers with normal lung function (P < 0.01 and P = 0.01, respectively). However, expressions of nNOS and eNOS did not differ among nonsmokers, smokers with and without COPD. Furthermore, there was a negative correlation between iNOS protein level and lung function parameters forced expiratory volume in 1 s (FEV1) (% predicted) (r = −0.549, P = 0.001) and FEV1/forced vital capacity (%, r = −0.535, P = 0.001).
Conclusions:
The expression of iNOS significantly increased in smokers with COPD compared with that in nonsmokers or smokers without COPD. The results suggest that iNOS might be involved in the pathogenesis of COPD, and may be a potential marker to identify the smokers who have more liability to suffer COPD.
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在部分球形精子症患者中，卵胞浆内单精子注射受精率不取决于圆头精子、小顶体精子或形态正常精子的比例Ling-Ying Jiang, Ling-Yun Yang, Xiao-Mei Tong, Hai-Yan Zhu, Ya-Mei Xue, Wen-Zhi Xu, Yang Yang, Song-Ying Zhang
中华医学杂志英文版2015年 128卷 12期
DOI: 10.4103/0366-6999.158310
摘要
Background:
Generally, intracytoplasmic sperm injection (ICSI) may be the preferable method to treat partial globozoospermia, but whether there exist some correlations between ICSI fertilization rate and the proportion of round-headed sperm or morphologically normal sperm remains open. This study was to explore the correlation between ICSI fertilization rate and the sperm morphology in patients with partial globozoospermia.
Methods:
Thirty-four patients diagnosed with partial globozoospermia accepted the following assisted fertilization treatments - 2 cases accepted in-vitro fertilization (IVF) alone, 26 cases accepted ICSI alone, and 6 accepted split IVF/ICSI. Detailed morphological characteristics were described using Diff-Quik rapid staining. Sixty cases accepting IVF or ICSI treatment in our reproductive center were considered as the control group after being matched by relevant criteria. Fertilization rate, embryo quality, embryo implantation rate and clinical pregnancy rate were calculated.
Results:
Besides very high proportion of round-headed sperm, partial globozoospermia also showed very high proportion of small-acrosomal sperm and very low proportion of morphologically normal sperm. Fertilization rate of IVF (IVF alone plus split IVF) was very low in partial globozoospermia (25.4% ± 17.4%), but ICSI (ICSI alone plus split ICSI) achieved satisfying fertilization rate compared with the control group (66.2% ± 22.5% vs. 68.8% ± 29.4%, P > 0.05). In patients with partial globozoospermia, there were no correlations between ICSI fertilization rate and the proportion of round-headed sperm, small-acrosomal sperm, or morphologically normal sperm.
Conclusions:
There was high proportion of small-acrosomal sperm in partial globozoospermia. For patients with partial globozoospermia, ICSI is more preferable than IVF. ICSI fertilization rate does not depend on the proportion of round-headed sperm, small-acrosomal sperm, or morphologically normal sperm.
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3岁以下患者全超声引导下微型经皮肾镜取石术：中国单中心初步经验Bo Xiao, Xin Zhang, Wei-Guo Hu, Song Chen, Yu-Hong Li, Yu-Zhe Tang, Yu-Bao Liu, Jian-Xing Li
中华医学杂志英文版2015年 128卷 12期
DOI: 10.4103/0366-6999.158312
摘要
Background:
Urolithiasis in pediatric population is a serious problem with the incidence increased these years. In the management of larger stones (diameters >2 cm), percutaneous nephrolithotomy (PCNL) is considered to be the gold standard. This study aimed to investigate the efficacy and safety of mini-PCNL under total ultrasonography in patients aged <3 years.
Methods:
We reviewed 68 patients (80 renal units) aged <3 years betweenAugust 2006 and December 2014 in Peking University People’s Hospital and Beijing Tsinghua Changung Hospital, including 36 renal units with a single stone, 6 with staghorn stones, 14 with upper ureteral stones, and 24 with multiple stones. The mean age of the patients was 24.2 months (range 6–36 months), and the mean maximum stone diameter was 19.2 mm (range 10–35 mm). The puncture site selection and tract dilation were guided by Doppler ultrasonography solely. All procedures were performed using 12–16 Fr tracts. Stones were fragmented using pneumatic lithotripsy and a holmium laser with an 8/9.8 Fr rigid ureteroscope.
Results:
Fifty-six patients with unilateral stones underwent a single session procedure, and 12 patients with bilateral stones underwent two procedures. The mean time to establish access was 2.8 min (range 1.8–5.0 min), the mean operative time was 36.5 min (range 20–88 min), the mean decrease in hemoglobin concentration was 8.9 g/L (2–15 g/L), and the stone-free rate (SFR) at hospital discharge was 94.0%. The mean postoperative hospital stay was 7.1 days (range 3–13 days). Postprocedure complications included fever (>38.5°C) in five patients and reactive pleural effusion in one patient. Blood loss requiring transfusion, sepsis, adjacent organ injury, and kidney loss were not observed.
Conclusions:
This study indicated that ultrasound-guided mini-PCNL is feasible and safe in patients aged <3 years, without major complications or radiation exposure.
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三维高各向同性分辨率磁共振成像对单侧颅内椎动脉发育不全的壁成像Xian-Jin Zhu, Wu Wang, Bin Du, Lei Liu, Xin-Xin He, Li-Bin Hu, Xue-Bin Zhang, Zun-Jing Liu, Wei-Jian Jiang
中华医学杂志英文版2015年 128卷 12期
DOI: 10.4103/0366-6999.158314
摘要
Background:
There are few studies for evaluating wall characteristics of intracranial vertebral artery hypoplasia (VAH). The aim of this study was to determine wall characteristics of VAH with three-dimensional volumetric isotropic turbo spin echo acquisition (3D VISTA) images and differentiate between acquired atherosclerotic stenosis and VAH.
Methods:
Thirty patients with suspicious VAH by luminograms were retrospectively enrolled between January 2014 and February 2015. The patients were classified as "acquired atherosclerotic stenosis" or "VAH" based on 3D VISTA images. The wall characteristics of VAH were assessed to determine the presence of atherosclerotic lesions, and the patients were classified into two subgroups (VAH with atherosclerosis and VAH with normal wall). Wall characteristics of basilar arteries and vertebral arteries were also assessed. The clinical and wall characteristics were compared between the two groups.
Results:
Five of 30 patients with suspicious VAH were finally diagnosed as acquired atherosclerotic stenosis by 3D VISTA images. 25 patients were finally diagnosed as VAH including 16 (64.00%) patients with atherosclerosis and 9 (36.00%) patients with normal wall. In the 16 patients with atherosclerosis, plaque was found in 9 patients, slight wall thickening in 6 patients, and thrombus and wall thickening in 1 patient. Compared with VAH patients with normal wall, VAH patients with atherosclerosis showed atherosclerotic basilar arteries and dominant vertebral arteries more frequently (P = 0.000).
Conclusions:
Three-dimensional VISTA images enable differentiation between the acquired atherosclerotic stenosis and VAH. VAH was also prone to atherosclerotic processes.
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中国某机构肺放线菌病的回顾性研究Xue-Feng Sun, Peng Wang, Hong-Rui Liu, Ju-Hong Shi
中华医学杂志英文版2015年 128卷 12期
DOI: 10.4103/0366-6999.158316
摘要
Background:
Actinomycosis is a rare indolent infectious disease caused by Actinomyces. Although pulmonary actinomycosis is thought to be more prevalent in developing countries, data from developing countries are scanty. This study was to reveal the current situation of pulmonary actinomycosis in developing countries and the difference from that in developed countries.
Methods:
Patients fulfilling the inclusion criteria for pulmonary actinomycosis from Peking Union Medical College Hospital in China between January 2003 and December 2014 were retrospectively analyzed. Baseline characteristics, clinical symptoms, underlying diseases, diagnostic methods, pulmonary function test results, chest computed tomography (CT) tests, fluoro-2-deoxy-D-glucose positron emission tomography (FDG-PET) tests, initial diagnosis, treatment and prognosis were retrieved from medical records and analyzed.
Results:
Twenty-six patients were included in this study (mean age 52.0 + 13.1 years). The ratio of male to female was 1.17:1. Most common clinical symptoms were cough (15/26), sputum (12/26) and hemoptysis (12/26). Chest CT findings presented as masses (13/26), nodules (10/26) and infiltrates (3/26). FDG-PET had an increased standardized uptake value and 4/6 patients were misdiagnosed as malignancy. Many kinds of antibiotics were used in the treatment of pulmonary actonomycosis and all got favorable results. Five patients receiving complete resection of the lesion were cured without postoperative use of antibiotic.
Conclusions:
Pulmonary actinomycosis is a rare disease even in developing countries, and both misdiagnosis and missed diagnosis are common. FDG-PET seems useless in the differential diagnosis, and complete resection of the pulmonary lesion without postoperative antibiotic therapy might be enough to achieve cure.
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速度血压指数预测脑高灌注综合征Zhi-Chao Lai, Bao Liu, Yu Chen, Leng Ni, Chang-Wei Liu
中华医学杂志英文版2015年 128卷 12期
DOI: 10.4103/0366-6999.158317
摘要
Background:
Cerebral hyperperfusion syndrome is an important complication of carotid endarterectomy (CEA). An >100% increase in middle cerebral artery velocity (MCAV) after CEA is used to predict the cerebral hyperperfusion syndrome (CHS) development, but the accuracy is limited. The increase in blood pressure (BP) after surgery is a risk factor of CHS, but no study uses it to predict CHS. This study was to create a more precise parameter for prediction of CHS by combined the increase of MCAV and BP after CEA.
Methods:
Systolic MCAV measured by transcranial Doppler and systematic BP were recorded preoperatively; 30 min postoperatively. The new parameter velocity BP index (VBI) was calculated from the postoperative increase ratios of MCAV and BP. The prediction powers of VBI and the increase ratio of MCAV (velocity ratio [VR]) were compared for predicting CHS occurrence.
Results:
Totally, 6/185 cases suffered CHS. The best-fit cut-off point of 2.0 for VBI was identified, which had 83.3% sensitivity, 98.3% specificity, 62.5% positive predictive value and 99.4% negative predictive value for CHS development. This result is significantly better than VR (33.3%, 97.2%, 28.6% and 97.8%). The area under the curve (AUC) of receiver operating characteristic: AUCVBI = 0.981, 95% confidence interval [CI] 0.949–0.995; AUCVR = 0.935, 95% CI 0.890–0.966, P = 0.02.
Conclusions:
The new parameter VBI can more accurately predict patients at risk of CHS after CEA. This observation needs to be validated by larger studies.
Meta Analysis
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C反应蛋白-717A>G和-286C>T>A基因多态性与缺血性卒中Yan Liu, Pei-Liang Geng, Fu-Qin Yan, Tong Chen, Wei Wang, Xu-Dong Tang, Jing-Chen Zheng, Wei-Ping Wu, Zhen-Fu Wang
中华医学杂志英文版2015年 128卷 12期
DOI: 10.4103/0366-6999.158371
摘要
Background:
Inflammation plays a pivotal role in the formation and progression of ischemic stroke. Recently, more and more epidemiological studies have focused on the association between C-reactive protein (CRP) −717A > G and −286C > T > A genetic polymorphisms and ischemic stroke. However, the findings of these researches are not conclusive.
Methods:
We performed a meta-analysis to determine whether these two polymorphisms are associated with the risk of ischemic stroke. Eligible studies were identified from the database of PubMed, Medline, Embase, Web of Science, CNKI, Weipu, and Wanfang. We calculated odds ratios (ORs) with 95% confidence intervals (CIs) to assess the strength of the association.
Results:
Four articles were included in our study, including 1926 cases and 2678 controls for −717A > G polymorphism, 652 cases and 1103 controls for −286C > T > A polymorphism. The results of meta-analysis showed that single nucleotide polymorphism (SNP) −717A > G was not significantly associated with the risk of ischemic stroke (GG vs. AA, OR = 1.12, 95% CI = 0.83–1.50, P = 0.207; GG + GA vs. AA, OR = 1.04, 95% CI = 0.93–1.17, P = 0.533; GG vs. GA + AA, OR = 1.10, 95% CI = 0.82–1.47, P = 0.220). Meta-analysis of SNP − 286C > T > A also demonstrated no statistical evidence of a significant association with the risk of ischemic stroke (AA vs. CC, OR = 0.86, 95% CI = 0.59–1.25, P = 0.348; AA vs. CC, OR = 0.92, 95% CI = 0.80–1.06, P = 0.609; AA vs. CC, OR = 0.89, 95% CI = 0.62–1.30, P = 0.374).
Conclusions:
This meta-analysis demonstrated little evidence to support a role of CRP gene −717A > G, −286C > T > A polymorphisms in ischemic stroke predisposition. However, to draw comprehensive and more reliable conclusions, further larger studies are needed to validate the association between CRP gene polymorphisms and ischemic stroke in various ethnic groups.
Perspective
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Sirtuins在衰老相关疾病中共同或分别作为调节剂发挥作用Qi-Lin Wang, Shang-Jing Guo
中华医学杂志英文版2015年 128卷 12期
DOI: 10.4103/0366-6999.158375
摘要
根据人口统计，2000年至2050年间，60岁以上的世界人口将翻一番，从6.05亿增至20亿。衰老是一个复杂的过程，在这个过程中，生物体及其对外部压力的反应能力逐渐下降。退行性衰老过程是衰老相关疾病的主要潜在原因，包括高血压、糖尿病、神经退行性疾病、癌症等[
Short Communication
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早期低温治疗难治性癫痫持续状态Guo-Ping Ren, Ying-Ying Su, Fei Tian, Yun-Zhou Zhang, Dai-Quan Gao, Gang Liu, Wei-Bi Chen
中华医学杂志英文版2015年 128卷 12期
DOI: 10.4103/0366-6999.158378
摘要
目前，控制难治性癫痫持续状态（RSE）的推荐疗法是静脉（IV）麻醉剂，如咪达唑仑、丙泊酚、巴比妥类药物等。然而，仍有15%-26%的RSE病例无法终止。三项病例系列研究表明，静脉麻醉剂和中度（30-31°C）或轻度（31-35°C）低温的组合成功终止了RSE患者的癫痫发作。[
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磁共振成像对中国成人大池的距离、深度和穿刺角度的研究Zong-Xin Cao, Qi-Wu Fang, Jian-Xiong An, Cai-Cai Liu, Xiao-Yan Qian, Rui-Qi Li, Doris K Cope, John P Williams
中华医学杂志英文版2015年 128卷 12期
DOI: 10.4103/0366-6999.158379
摘要
大池是位于小脑和延髓之间的空间，对于一些有腰椎穿刺禁忌或不可能的患者收集脑脊液（CSF）以及鞘内给药药物输注非常重要。[
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非哺乳期妇女乳腺良性慢性炎性病变声像图特征及诊断分析Hai-Ya Lou, Jiang-Hong Lyu, Jin-Duo Shou, Bo-Wen Zhao, Ming-Ming Ma
中华医学杂志英文版2015年 128卷 12期
DOI: 10.4103/0366-6999.158380
摘要
良性慢性炎症性乳腺病变在非哺乳期妇女的临床实践中并不常见。然而，它们涉及广泛的病理类别，病因从感染到化学刺激。在临床实践中，这些不同病理类型的病变很容易相互混淆或误诊为乳腺恶性疾病，治疗策略也不同。将这些病变相互鉴别以及与恶性疾病鉴别是很重要的。超声（US）是观察乳腺病变形态学的重要工具。本研究的目的是寻找这些病变的一些有价值的声像图特征，并分析US的诊断效力，特别是与恶性疾病的鉴别。
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60例先天性血管环患儿的诊断和治疗：10年经验Guo-Qing Fang, Jing Li, Feng Xu, Yue-Qiang Fu, Ying-Fu Chen, Xiao-Juan Ji, He-Lin Zheng, Si-Si Chen
中华医学杂志英文版2015年 128卷 12期
DOI: 10.4103/0366-6999.158381
摘要
先天性血管环（VR）是一组罕见的心血管异常，由成对的主动脉弓或分支肺动脉的异常胚胎发育引起。VR的临床表现取决于其解剖结构、程度和压迫部位。喘鸣、复发性上呼吸道感染和进食困难是VR的常见症状。吞钡试验、超声心动图、计算机断层扫描（CT）和磁共振成像（MRI）是VR评估的有效诊断工具。有症状的VR患者需要手术干预，在大多数情况下会产生良好的结果。然而，气管狭窄（TS）经常会出现并成为手术失败的原因。
Clinical Practice
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瑞舒伐他汀短程给药的肝毒性Na Kyoung Hwang, Jin Sup Park, Kwang Soo Cha, Jin Suk Kang
中华医学杂志英文版2015年 128卷 12期
DOI: 10.4103/0366-6999.158382
摘要
他汀类药物可降低血脂异常的心血管发病率和死亡率。尽管通常耐受性良好，但10%-15%的患者会出现剂量依赖性不良事件。此外，高达3%的患者血清转氨酶水平在1圣很少与症状相关的多年治疗。我们报告了一例他汀类药物初治患者在接受非常短暂的瑞舒伐他汀疗程后出现具有临床意义的肝毒性的病例。
Viewpoint
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冠状动脉血流储备分数的无创测量：一个未开发的新大陆Guo-Xin Fan, Ruo-Shuang Han, Jia-Chen Luo, Bi-Sheng Huang, Tao Jiang, Ji-Kun Wang
中华医学杂志英文版2015年 128卷 12期
DOI: 10.4103/0366-6999.158383
摘要
在冠状动脉疾病（CAD）患者中，关于症状和结局的最重要因素是诱导性缺血的存在和程度。[
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黄色肉芽肿性胆囊炎及误诊分析Ya-Qiang Li, Jian Song, Zheng-Xin Liu, Dong-Yuan Xie, Tao Jiang, Guang-Hui Wei, Hua-Chong Ma, Jian-Xin Wang, Mu-Lan Jin
中华医学杂志英文版2015年 128卷 12期
DOI: 10.4103/0366-6999.158384
摘要
胃上皮下肿块（SEMs）是接受胃镜检查时相对常见的发现。这是一个可见的肿块、隆起或印象。计算机断层扫描（CT）和磁共振成像可以辅助诊断，但最终诊断取决于组织病理学检查。胃肠道间质瘤（GIST）是一种相对常见的胃肠道间质瘤。黄色肉芽肿性胆囊炎(XGC)是一种良性的慢性胆囊炎性疾病。胆囊急性炎症和结石性流出道梗阻是两种主要的发病机制。胆囊壁可出现不规则增厚，与周围组织粘连，瘘管可发展成邻近器官。在这种情况下，由于XGC，胆囊穿孔并粘附在胃壁上，导致误诊为GIST。
Correspondence
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左回旋动脉作为右冠状动脉的末端延伸Sait Demirkol, Turgay Celik, Cengiz Ozturk, Mustafa Aparci, Murat Unlu, Atila Iyisoy
中华医学杂志英文版2015年 128卷 12期
DOI: 10.4103/0366-6999.158385
摘要
编辑：冠状动脉异常通常是在诊断性冠状动脉造影或计算机断层扫描检查中偶然发现的。在其通常位置看不到冠状动脉可能被误解为完全闭塞。
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关于：“基德、凯尔、达菲、希安娜和RHCE江苏地区汉族人血型抗原多态性研究Cristiane Maria Colli, Marília Gonçalves Quirino, Ana Maria Sell, Jeane Eliete Laguila Visentainer
中华医学杂志英文版2015年 128卷 12期
DOI: 10.4103/0366-6999.158386
摘要
致编辑：我们一直在对巴西人群的血型系统进行基因分型[
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