MedNexus
2016年 · 第129卷第01期
出版日期 2016-01-05电子版 ￥0.00元
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Editorial
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新年，历史使命，新担当Bin Cao, Chen Wang
中华医学杂志英文版2016年 129卷 01期
DOI: 10.4103/0366-6999.172542
摘要
《中华医学杂志》（CMJ）创刊于1887年，是中国历史最悠久的医学期刊，是我们喜爱的期刊之一。我们从学医的时候就开始读这本杂志了。
Original Article
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韩国乙型肝炎病毒感染人群肝细胞癌筛查率的十年变化Hee Yeon Kim, Chang Wook Kim, Jong Young Choi, Chung-Hwa Park, Chang Don Lee, Hyeon Woo Yim
中华医学杂志英文版2016年 129卷 01期
DOI: 10.4103/0366-6999.172551
摘要
Background:
Evaluating a change in the screening rate for hepatocellular carcinoma (HCC) is critical for understanding screening implementation, and whether targeted population groups are receiving proper screening. This study examined recent nationwide changes in HCC screening use among hepatitis B virus (HBV)-infected populations after the introduction of the Korean National Cancer Screening Program and predictors of screening adherence.
Methods:
We analyzed 165 and 276 participants ≥40 years of age who were hepatitis B surface antigen-positive from 2001 (14,936 participants) to 2010–2011 (9159 participants) Korea National Health and Nutrition Examination Surveys, respectively. Demographic data, socioeconomic factors, and HCC screening use were collected by means of self-reported questionnaires.
Results:
The rate of HCC screening within the previous 2 years increased significantly from 17.5% in 2001 to 40.3% in 2010– 2011 (P < 0.0001). The rate of HCC screening use increased from 2001 to 2010–2011 in all study populations. Subjects who had a higher income status and were aware of their infection were more likely to have undergone recent HCC screening.
Conclusions:
This study showed a substantial increase in HCC screening in high-risk HBV-infected subjects from 2001 to 2010–2011. However, the HCC screening participation rate remained suboptimal despite the introduction of the nationwide screening program. Efforts should be made to identify high-risk individuals and increase attendance at HCC screening events among high-risk groups.
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80岁或以上的患者可能会遇到更多不适当的药物使用Li Mo, Ding Ding, Shi-Yun Pu, Qin-Hui Liu, Hong Li, Bi-Rong Dong, Xiao-Yan Yang, Jin-Han He
中华医学杂志英文版2016年 129卷 01期
DOI: 10.4103/0366-6999.172558
摘要
Background:
Polypharmacy and potentially inappropriate medications (PIMs) are prominent prescribing issues in elderly patients. This study was to investigate the different prevalence of PIM use in elderly inpatients between 65–79 years of age and 80 years or older, who were discharged from Geriatric Department in West China Hospital.
Methods:
A large-scale cohort of 1796 inpatients aged 65 years or over was recruited. Respectively, 618 patients were 65–79 years and 1178 patients were 80 years or older. Updated 2012 Beers Criteria by the American Geriatric Society was applied to assess the use of PIM among the investigated samples.
Results:
A review of the prescribed medications identified 686 patients aged 80 years or older consumed at least one PIM giving a rate of 58.2%. Conversely, 268 (43.4%) patients aged 65–79 years consumed at least one PIM (χ2 = 40.18, P < 0.001). Patients aged 80 years or older had higher hospitalization expenses, length of stay, co-morbidities, medical prescription, and mortality than patients aged 65–79 years (all with P < 0.001). Patients aged 80 years or older were prescribed with more benzodiazepines, drugs with strong anticholinergic properties, megestrol, antipsychotics, theophylline, and aspirin. In multiple regression analysis, PIM use was significantly associated with female gender, age, number of diagnostic disease, and number of prescribed medication.
Conclusions:
The finding from this study revealed that inpatients aged 80 years or older encountered more PIM use than those aged 65–79 years. Anticholinergic properties, megestrol, antipsychotics, theophylline, and aspirin are medications that often prescribed to inpatients aged 80 years or older. Doctors should carefully choose drugs for the elderly, especially the elderly aged 80 years or older.
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血清乳酸消除率与肌萎缩侧索硬化进展相关Yuan-Jin Zhang, Dong-Sheng Fan
中华医学杂志英文版2016年 129卷 01期
DOI: 10.4103/0366-6999.172561
摘要
Background:
Mitochondrial dysfunction plays an important role in the pathogenesis of amyotrophic lateral sclerosis (ALS). We aimed to demonstrate mitochondrial dysfunction in ALS using a lactate stress test and to examine the relationship between mitochondrial dysfunction with motor deterioration.
Methods:
We enrolled 116 patients and observed clinical variables, including the survival state.
Results:
Patients with a rapid slope of revised ALS functional rating scales (ALSFRS-r) (>20 U/year) exhibited the slowest elimination rate (median −4.67 × 10−3 mmol∙L−1∙min−1, coefficient of variation, 590.15%), the shortest duration (0.63 ± 0.28 years) and the worst ALSFRS-r (32.59 ± 4.93). Patients with a moderate slope of ALSFRS-r (10–20 U/year) showed a moderate elimination rate (median −11.33 × 10−3 mmol∙L−1∙min−1, coefficient of variation, 309.89%), duration (1.16 ± 0.45 years), and ALSFRS-r (34.83 ± 6.11). The slower progressing (<10 U/year group) patients exhibited a rapid elimination rate (median: −12.00 × 10−3 mmol∙L−1∙min−1, coefficient of variation: 143.08%), longer duration (median: 3 years, coefficient of variation: 193.33%), and adequate ALSFRS-r values (39.58 ± 9.44). Advanced-phase ALS patients also showed slower elimination rate (ER, quartiles −17.33, −5.67, 4.00) and worse ALSFRS-r (34.88 ± 9.27), while early-phase patients showed a more rapid ER (quartiles −25.17, −11.33, −3.50) and better ALSFRS-r (39.28 ± 7.59). These differences were statistically significant. Multiple linear regression analysis revealed strong direct associations among ER, ALSFRS-r slope (standard beta = 0.33, P = 0.007), and forced vital capacity (predict %) (standard beta = −0.458, P = 0.006, adjusted for ALSFRS-r, course and onset region). However, the data obtained from 3 years of follow-up showed no statistically significant difference in the survival rates between the most rapid and slowest ER groups.
Conclusion:
There is a potential linear relationship between ER and motor deterioration in ALS. Slower ER might be associated with faster disease progression.
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中国终末期肺病患者等待肺移植的预后：一项单中心研究Wen-Xin He, Yu-Ling Yang, Yan Xia, Nan Song, Ming Liu, Peng Zhang, Jiang Fan, Ge-Ning Jiang
中华医学杂志英文版2016年 129卷 01期
DOI: 10.4103/0366-6999.172547
摘要
Background:
The factors affecting the outcome of patients referred for lung transplantation (LTx) still have not been investigated extensively. The aim of this study was to characterize the patient outcomes and identify the prognostic factors for death while awaiting the LTx.
Methods:
From January 2003 to November 2013, the clinical data of 103 patients with end-stage lung disease that had been referred for LTx to Department of Thoracic Surgery, Shanghai Pulmonary Hospital were analyzed retrospectively. The relationship between predictors and survival was evaluated using the Kaplan–Meier method and the Cox proportional hazards model.
Results:
Twenty-five patients (24.3%) died while awaiting the LTx. Fifty patients (48.5%) underwent LTx, and 28 patients (27.2%) were still on the waitlist. Compared to the candidates with chronic obstructive pulmonary disease (COPD), patients with idiopathic pulmonary fibrosis (IPF) had a higher mortality while awaiting the LTx (40.0% vs. 12.3%, P = 0.003). Patients requiring mechanical ventilation (MV) had a higher mortality while waiting than others (50.0% vs. 20.2%, P = 0.038). Two variables, using MV and IPF but not COPD as primary disease, emerged as significant independent risk factors for death on the waitlist (hazard ratio [HR]= 56.048, 95% confidence interval [CI]: 3.935–798.263, P = 0.003 and HR = 14.859, 95% CI: 2.695–81.932, P = 0.002, respectively).
Conclusion:
The type of end-stage lung disease, pulmonary hypertension, and MV may be distinctive prognostic factors for death while awaiting the LTx.
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靶向基因测序对两个中国色素异常症家系的鉴别诊断Jia-Wei Liu, Asan, Jun Sun, Sergio Vano-Galvan, Feng-Xia Liu, Xiu-Xiu Wei, Dong-Lai Ma
中华医学杂志英文版2016年 129卷 01期
DOI: 10.4103/0366-6999.172564
摘要
Background:
The dyschromatoses are a group of disorders characterized by simultaneous hyperpigmented macules together with hypopigmented macules. Dyschromatosis universalis hereditaria (DUH) and dyschromatosis symmetrica hereditaria are two major types. While clinical and histological presentations are similar in these two diseases, genetic diagnosis is critical in the differential diagnosis of these entities.
Methods:
Three patients initially diagnosed with DUH were included. The gene test was carried out by targeted gene sequencing. All mutations detected on ADAR1 and ABCB6 genes were analyzed according to the frequency in control database, the mutation types, and the published evidence to determine the pathogenicity.
Results:
Family pedigree and clinical presentations were reported in 3 patients from two Chinese families. All patients have prominent cutaneous dyschromatoses involving the whole body without systemic complications. Different pathogenic genes in these patients with similar phenotype were identified: One novel mutation on ADAR1 (c. 1325C>G) and one recurrent mutation in ABCB6 (c. 1270T>C), which successfully distinguished two diseases with the similar phenotype.
Conclusion:
Targeted gene sequencing is an effective tool for genetic diagnosis in pigmentary skin diseases.
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单纯腹腔镜肝切除术治疗肝脏恶性肿瘤：解剖性切除与非解剖性切除Ya-Xi Chen, Dian-Rong Xiu, Chun-Hui Yuan, Bin Jiang, Zhao-Lai Ma
中华医学杂志英文版2016年 129卷 01期
DOI: 10.4103/0366-6999.172567
摘要
Background:
Laparoscopic liver resection (LLR) has been considered to be safe and feasible. However, few studies focused on the comparison between the anatomic and nonanatomic LLR. Therefore, the purpose of this study was to compare the perioperative factors and outcomes of the anatomic and nonanatomic LLR, especially the area of liver parenchymal transection and blood loss per unit area.
Methods:
In this study, surgical and oncological data of patients underwent pure LLR procedures for malignant liver tumor were prospectively collected. Blood loss per unit area of liver parenchymal transection was measured and considered as an important parameter. All procedures were conducted by a single surgeon.
Results:
During nearly 5 years, 84 patients with malignant liver tumor received a pure LLR procedure were included. Among them, 34 patients received anatomic LLR and 50 received nonanatomic LLR, respectively. Patients of the two groups were similar in terms of demographic features and tumor characteristics, despite the tumor size was significantly larger in the anatomic LLR group than that in the nonanatomic LLR group (4.77 ± 2.57 vs. 2.87 ± 2.10 cm, P = 0.001). Patients who underwent anatomic resection had longer operation time (364.09 ± 131.22 vs. 252.00 ± 135.21 min, P < 0.001) but less blood loss per unit area (7.85 ± 7.17 vs. 14.17 ± 10.43 ml/cm2, P = 0.018). Nonanatomic LLR was associated with more blood loss when the area of parenchymal transection was equal to the anatomic LLR. No mortality occurred during the hospital stay and 30 days after the operation. Moreover, there was no difference in the incidence of postoperative complications. The disease-free and overall survival rates showed no significant differences between the anatomic LLR and nonanatomic LLR groups.
Conclusions:
Both anatomic and nonanatomic pure LLR are safe and feasible. Measuring the area of parenchymal transection is a simple and effective method to estimate the outcomes of the liver resection surgery. Blood loss per unit area is an important parameter which is comparable between the anatomic LLR and nonanatomic LLR groups.
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依托咪酯麻醉诱导老年大鼠记忆缺陷的潜在机制：即刻早期基因的关键作用Xu Li, Fen Lu, Wei Li, Jun Xu, Xiao-Jing Sun, Ling-Zhi Qin, Qian-Lin Zhang, Yong Yao, Qing-Kai Yu, Xin-Liang Liang
中华医学杂志英文版2016年 129卷 01期
DOI: 10.4103/0366-6999.172570
摘要
Background:
Etomidate (R-1-[1-ethylphenyl] imidazole-5-ethyl ester) is a widely used anesthetic drug that had been reported to contribute to cognitive deficits after general surgery. However, its underlying mechanisms have not been fully elucidated. In this study, we aimed to explore the neurobiological mechanisms of cognitive impairments that caused by etomidate.
Methods:
A total of 30 Sprague-Dawley rats were used and divided into two groups randomly to receive a single injection of etomidate or vehicle. Then, the rats’ spatial memory ability and neuronal survival were evaluated using the Morris water maze test and Nissl staining, respectively. Furthermore, we analyzed levels of oxidative stress, as well as cyclic adenosine 3’,5’-monophosphate response element-binding (CREB) protein phosphorylation and immediate early gene (IEG, including Arc, c-fos, and Egr1) expression levels using Western blot analysis.
Results:
Compared with vehicle-treated rats, the etomidate-treated rats displayed impaired spatial learning (day 4: 27.26 ± 5.33 s vs. 35.52 ± 3.88 s, t = 2.988, P = 0.0068; day 5: 15.84 ± 4.02 s vs. 30.67 ± 4.23 s, t = 3.013, P = 0.0057; day 6: 9.47 ± 2.35 s vs. 25.66 ± 4.16 s, t = 3.567, P = 0.0036) and memory ability (crossing times: 4.40 ± 1.18 vs. 2.06 ± 0.80, t = 2.896, P = 0.0072; duration: 34.00 ± 4.24 s vs. 18.07 ± 4.79 s, t = 3.023, P = 0.0053; total swimming distance: 40.73 ± 3.45 cm vs. 27.40 ± 6.56 cm, t = 2.798, P = 0.0086) but no neuronal death. Furthermore, etomidate did not cause oxidative stress or deficits in CREB phosphorylation. The levels of multiple IEGs (Arc: vehicle treated rats 100%, etomidate treated rats 86%, t = 2.876, P = 0.0086; c-fos: Vehicle treated rats 100%, etomidate treated rats 72%, t = 2.996, P = 0.0076; Egr1: Vehicle treated rats 100%, etomidate treated rats 58%, t = 3.011, P = 0.0057) were significantly reduced in hippocampi of etomidate-treated rats.
Conclusion:
Our data suggested that etomidate might induce memory impairment in rats via inhibition of IEG expression.
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一个红色毛癣菌基于重建人表皮-Episkin的感染模型®Pan-Pan Liang, Xin-Zhu Huang, Jin-Ling Yi, Zhi-Rui Chen, Han Ma, Cong-Xiu Ye, Xian-Yan Chen, Wei Lai, Jian Chen
中华医学杂志英文版2016年 129卷 01期
DOI: 10.4103/0366-6999.172573
摘要
Background:
Trichophyton rubrum represents the most common infectious fungus responsible for dermatophytosis in human, but the mechanism involved is still not completely understood. An appropriate model constructed to simulate host infection is the prerequisite to study the pathogenesis of dermatophytosis caused by T. rubrum. In this study, we intended to develop a new T. rubrum infection model in vitro, using the three-dimensional reconstructed epidermis - EpiSkin®, and to pave the way for further investigation of the mechanisms involved in T. rubrum infection.
Methods:
The reconstructed human epidermis (RHE) was infected by inoculating low-dose (400 conidia) and high-dose (4000 conidia) T. rubrum conidia to optimize the infection dose. During the various periods after infection, the samples were processed for pathological examination and scanning electron microscopy (SEM) observation.
Results:
The histological analysis of RHE revealed a fully differentiated epidermis with a functional stratum corneum, which was analogous to the normal human epidermis. The results of hematoxylin and eosin staining and the periodic acid-Schiff staining showed that the infection dose of 400 conidia was in accord with the pathological characteristics of host dermatophytosis caused by T. rubrum. SEM observations further exhibited the process of T. rubrum infection in an intuitionistic way.
Conclusions:
We established the T. rubrum infection model on RHE in vitro successfully. It is a promising model for further investigation of the mechanisms involved in T. rubrum infection.
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脂多糖诱导的新生儿胸腺退化中胸腺上皮细胞的变化Yong-Jie Zhou, Hua Peng, Yan Chen, Ya-Lan Liu
中华医学杂志英文版2016年 129卷 01期
DOI: 10.4103/0366-6999.172577
摘要
Background:
Vascular endothelial growth factor (VEGF) in the thymus was mainly produced by the thymic epithelial cells (TECs), the predominant component of the thymic microenvironment. The progression of TECs and the roles of VEGF in the neonatal thymus during sepsis have not been reported. This study aimed to explore the alterations of TECs and VEGF level in the neonatal thymus involution and to explore the possible mechanisms at the cellular level.
Methods:
By establishing a model of clinical sepsis, the changes of TECs were measured by hematoxylin-eosin staining, confocal microscopy, and flow cytometry. Moreover, the levels of VEGF in serum and thymus were assessed based on enzyme-linked immunosorbent assay and Western blotting.
Results:
The number of thymocytes and TECs was significantly decreased 24 h after lipopolysaccharide (LPS) challenge, (2.40 ± 0.46)×107 vs. (3.93 ± 0.66)×107 and (1.16 ± 0.14)×105 vs. (2.20 ± 0.19)×105, P < 0.05, respectively. Cortical TECs and medullary TECs in the LPS-treated mice were decreased 1.5-fold and 3.9-fold, P < 0.05, respectively, lower than those in the controls. The number of thymic epithelial progenitors was also decreased. VEGF expression in TECs was down-regulated in a time-dependent manner.
Conclusion:
VEGF in thymic cells subsets might contribute to the development of TECs in neonatal sepsis.
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乳房切除术后疼痛：患病率、疼痛特征及其对生活质量影响的横断面研究Serbülent Gökhan Beyaz, Jalan Şerbetçigil Ergönenç, Tolga Ergönenç, Özlem Uysal Sönmez, Ünal Erkorkmaz, Fatih Altintoprak
中华医学杂志英文版2016年 129卷 01期
DOI: 10.4103/0366-6999.172589
摘要
Background:
Postmastectomy pain syndrome (PMPS) is defined as a chronic (continuing for 3 or more months) neuropathic pain affecting the axilla, medial arm, breast, and chest wall after breast cancer surgery. The prevalence of PMPS has been reported to range from 20% to 68%. In this study, we aimed to determine the prevalence of PMPS among mastectomy patients, the severity of neuropathic pain in these patients, risk factors that contribute to pain becoming chronic, and the effect of PMPS on life quality.
Methods:
This cross-sectional study was approved by the Sakarya University, Medical Faculty Ethical Council and included 146 patients ranging in age from 18 to 85 years who visited the pain clinic, general surgery clinic, and oncology clinic and had breast surgery between 2012 and 2014. Patients were divided into two groups according to whether they met PMPS criteria: pain at axilla, arm, shoulder, chest wall, scar tissue, or breast at least 3 months after breast surgery. All patients gave informed consent prior to entry into the study. Patient medical records were collected, and pain and quality of life were evaluated by the visual analog scale (VAS) for pain, a short form of the McGill Pain Questionnaire (SF-MPQ), douleur neuropathique-4 (DN-4), and SF-36.
Results:
Patient mean age was 55.2 ± 11.8 years (33.0–83.0 years). PMPS prevalence was 36%. Mean scores on the VAS, SF-MPQ, and DN-4 in PMPS patients were 1.76 ± 2.38 (0–10), 1.73 ± 1.54 (0–5), and 1.64 ± 2.31 (0–8), respectively. Of these patients, 31 (23.7%) had neuropathic pain characteristics, and 12 (9.2%) had phantom pain according to the DN-4 survey. Patients who had modified radical mastectomy were significantly more likely to develop PMPS than patients who had breast-protective surgery (P = 0.028). Only 2 (2.4%) of PMPS patients had received proper treatment (anticonvulsants or opioids).
Conclusions:
PMPS seriously impacts patients’ emotional situation, daily activities, and social relationships and is a major economic burden for health systems. We conclude that the rate of PMPS among patients receiving breast cancer surgery in Turkey is 64.1% and that challenges to the proper treatment of these patients deserve further investigation.
Protocol
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中国以患者为中心的心脏事件评估急性心肌梗死前瞻性研究：研究设计Jing Li, Rachel P Dreyer, Xi Li, Xue Du, Nicholas S Downing, Li Li, Hai-Bo Zhang, Fang Feng, Wen-Chi Guan, Xiao Xu 等
中华医学杂志英文版2016年 129卷 01期
DOI: 10.4103/0366-6999.172596
摘要
Background:
Despite the rapid growth in the incidence of acute myocardial infarction (AMI) in China, there is limited information about patients’ experiences after AMI hospitalization, especially on long-term adverse events and patient-reported outcomes (PROs).
Methods:
The China Patient-centered Evaluative Assessment of Cardiac Events (PEACE)-Prospective AMI Study will enroll 4000 consecutive AMI patients from 53 diverse hospitals across China and follow them longitudinally for 12 months to document their treatment, recovery, and outcomes. Details of patients’ medical history, treatment, and in-hospital outcomes are abstracted from medical charts. Comprehensive baseline interviews are being conducted to characterize patient demographics, risk factors, presentation, and healthcare utilization. As part of these interviews, validated instruments are administered to measure PROs, including quality of life, symptoms, mood, cognition, and sexual activity. Follow-up interviews, measuring PROs, medication adherence, risk factor control, and collecting hospitalization events are conducted at 1, 6, and 12 months after discharge. Supporting documents for potential outcomes are collected for adjudication by clinicians at the National Coordinating Center. Blood and urine samples are also obtained at baseline, 1- and 12-month follow-up. In addition, we are conducting a survey of participating hospitals to characterize their organizational characteristics.
Conclusion:
The China PEACE-Prospective AMI study will be uniquely positioned to generate new information regarding patient’s experiences and outcomes after AMI in China and serve as a foundation for quality improvement activities.
Review Article
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肾素-血管紧张素-醛固酮系统双重阻断在2型糖尿病肾病中的作用Yan-Huan Feng, Ping Fu
中华医学杂志英文版2016年 129卷 01期
DOI: 10.4103/0366-6999.172599
摘要
Objective:
To examine the efficacy and safety of dual blockade of the renin-angiotensin-aldosterone system (RAAS) among patients with type 2 diabetic kidney disease.
Data Sources:
We searched the major literature repositories, including the Cochrane Central Register of Controlled Trials, MEDLINE and EMBASE, for randomized clinical trials published between January 1990 and October 2015 that compared the efficacy and safety of the use of dual blockade of the RAAS versus the use of monotherapy, without applying any language restrictions. Keywords for the searches included "diabetic nephropathy," "chronic kidney disease," "chronic renal insufficiency," "diabetes mellitus," "dual therapy," "combined therapy," "dual blockade," "renin-angiotensin system," "angiotensin-converting enzyme inhibitor," "angiotensin-receptor blocker," "aldosterone blockade," "selective aldosterone blockade," "renin inhibitor," "direct renin inhibitor," "mineralocorticoid receptor blocker," etc.
Study Selection:
The selected articles were carefully reviewed. We excluded randomized clinical trials in which the kidney damage of patients was related to diseases other than diabetes mellitus.
Results:
Combination treatment with an angiotensin-converting enzyme inhibitor supplemented by an angiotensin II receptor blocking agent is expected to provide a more complete blockade of the RAAS and a better control of hypertension. However, existing literature has presented mixed results, in particular, related to patient safety. In view of this, we conducted a comprehensive literature review in order to explain the rationale for dual blockade of the RAAS, and to discuss the pros and cons.
Conclusions:
Despite the negative results of some recent large-scale studies, it may be immature to declare that the dual blockade is a failure because of the complex nature of the RAAS surrounding its diversified functions and utility. Further trials are warranted to study the combination therapy as an evidence-based practice.
Short Communication
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1型胶原α 1突变导致成骨不全症在一个中国家庭中从轻度到围产期死亡Hong-Yan Liu, Jia Huang, Dong Wu, Tao Li, Liang-Jie Guo, Qian-Nan Guo, Hong-Dan Wang, Rui-Li Wang, Yue Wang
中华医学杂志英文版2016年 129卷 01期
DOI: 10.4103/0366-6999.172600
摘要
成骨不全症（OI），也称为脆性骨病或洛布斯坦综合征，其特征是蓝色或灰色巩膜、可变身材矮小、牙本质形成不全症、听力损失和复发性骨折。基于临床、遗传学和放射学特征，沉默等人.[
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保留股四头肌的全膝关节置换术会增加下肢和部件对位不良的风险吗？至少5年的随访研究Yan-Song Qi, Bo Yang, Jia-Kuo Yu, Ji-Ying Zhang, Ai-Bing Huang, Hai-Jun Wang
中华医学杂志英文版2016年 129卷 01期
DOI: 10.4103/0366-6999.172601
摘要
传统的全膝关节置换术（TKA）是晚期关节炎患者缓解疼痛和改善不良功能最成功的外科手术。然而，术后疼痛和延迟康复是传统方法的最大抱怨。最近，已经开发了各种微创手术（MIS）TKA技术来解决该问题。MIS-TKA显示术后疼痛更少，住院时间更短，术后恢复更快。
Clinical Experience
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赵氏人工气管的临床体会Wei Zhao, Li-Xin Tian, Xiao-Rui Zhou, Feng-Rui Zhao
中华医学杂志英文版2016年 129卷 01期
DOI: 10.4103/0366-6999.172602
摘要
迄今为止，人工气管假体的实践一直是全世界整个外科领域的重大挑战。以前应用的假体是“内支架”型，不能用天然气管进行生物学愈合。[
Clinical Practice
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3 β-羟基-Δ 5-C27-类固醇脱氢酶基因的新突变（HSD3B7）在新生儿胆汁淤积患者中He-Yu Huang, Hua Zhou, Hong Wang, Ya-Xian Chen, Feng Fang
中华医学杂志英文版2016年 129卷 01期
DOI: 10.4103/0366-6999.172603
摘要
胆汁酸合成缺陷（BASD）是一种罕见的遗传性疾病，约占婴儿持续性胆汁淤积的2%。[
Viewpoint
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部分流量储备：从家园到殖民地Guo-Xin Fan, Jia-Chen Luo, Zhi Zhou, Yue-Ye Wang, Ji-Kun Wang
中华医学杂志英文版2016年 129卷 01期
DOI: 10.4103/0366-6999.172604
摘要
在目前的导管研究中，关于血流储备分数（FFR）有3个主要方向，包括瞬时无波比、FFR的无创测量以及FFR从冠状动脉循环转移到其他缺血诱导循环。最近，发表了一项有趣的研究，其中进行了FFR来诊断和指导慢性肠系膜缺血（CMI）支架植入术。[
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青少年特发性脊柱侧凸脊柱融合的植骨选择Xi-Ming Xu, Gong Zhang, Fei Wang, Xian-Zhao Wei, Ming Li
中华医学杂志英文版2016年 129卷 01期
DOI: 10.4103/0366-6999.172605
摘要
青少年特发性脊柱侧凸（AIS）是青少年中最常见的疾病之一，全球发病率为1-3%，至少0.02%的患者需要手术治疗。[
Correspondence
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透射电镜鉴定Orf一例Fen Peng, Zhou Chen, Shu-Ying Zheng, Hou-Min Li, Juan Du, Jian-Zhong Zhang
中华医学杂志英文版2016年 129卷 01期
DOI: 10.4103/0366-6999.172606
摘要
致编辑：一位20岁的女性主诉她的左手食指上有两个疼痛瘙痒的病变。一个月前，她的食指被一只羔羊咬了；两天后羔羊死了。被咬五天后，她注意到左手食指上有两个逐渐增大的丘疹。体格检查发现两个直径分别为8毫米和10毫米的硬结结节，每个结节都有中央脐部，周围有红色光环[
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骶髂关节炎和脊柱炎伴胸锁骨骨质增生：SAPHO还是强直性脊柱炎变体？Kai Shen, Cheng-Lu Yang, Geng Yin, Qi-Bing Xie
中华医学杂志英文版2016年 129卷 01期
DOI: 10.4103/0366-6999.172607
摘要
编者：SAPHO综合征是一种以滑膜炎、痤疮、脓疱病、骨质增生和骨炎为特征的异质性疾病。如果没有典型的皮肤表现，其诊断可能很困难。我们报告了一例SAPHO综合征，该综合征也符合强直性脊柱炎（AS）的当前诊断标准。
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双主动脉弓患者远端C1夹层动脉瘤的血管内治疗Jia-Ping Xu, Ji-Jun Shi, Guo-Dong Xiao, Guang-Xin Duan, Chun-Yuan Zhang, Yong-Jun Cao
中华医学杂志英文版2016年 129卷 01期
DOI: 10.4103/0366-6999.172608
摘要
致编者：双主动脉弓（DAA）是一种罕见的先天性心血管疾病，通常因气管或食道阻塞引起的呼吸困难或吞咽困难而在早期被诊断并进行手术矫正。[
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首次人类感染克拉苏诺卡氏菌在免疫活性患者中Usiakimi Igbaseimokumo, Sittana El Shafie, Abdul Latif Al Khal
中华医学杂志英文版2016年 129卷 01期
DOI: 10.4103/0366-6999.172609
摘要
致编辑：诺卡氏菌种属革兰氏阳性，部分耐酸芽孢杆菌存在于土壤和水中。诺卡菌脑脓肿很罕见，但死亡率很高，文献中对这些病变是否应该常规切除或简单抽吸存在争议。[
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低质量试验是羟乙基淀粉130/0.4或0.42与脓毒症超额死亡率相关性的异质性来源Christian J Wiedermann
中华医学杂志英文版2016年 129卷 01期
DOI: 10.4103/0366-6999.172611
摘要
致编辑：在他们的荟萃分析中，Ma等人.[
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在随机对照试验中，研究液和对照液之间不可比较的后续效应可能会导致可疑结果Ma Peng-Lin, Wang Yang, Hu Xiao-Lan
中华医学杂志英文版2016年 129卷 01期
DOI: 10.4103/0366-6999.172612
摘要
Wiedermann博士评论了我们的系统综述和荟萃回归，这些综述和荟萃回归报告了脓毒症患者HES 130/0.4或0.42相关超额死亡率的试验中的异质性来源[
Corrigendum
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勘误表：口服更昔洛韦防治复发性单纯疱疹性角膜炎的临床疗效中华医学杂志英文版2016年 129卷 01期
DOI: 10.4103/0366-6999.172610
摘要
在题为“口服更昔洛韦预防和治疗复发性单纯疱疹性角膜炎的临床疗效”的文章中，第1期，第128卷，第46-50页中华医学杂志[
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