MedNexus
2017年 · 第130卷第17期
出版日期 2017-09-05电子版 ￥0.00元
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Editorial
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过敏与慢性阻塞性肺疾病Jian-Min Jin, Yong-Chang Sun
中华医学杂志英文版2016年 130卷 17期
DOI: 10.4103/0366-6999.213427
摘要
过敏、气道高反应性（AHR）和过敏性哮喘是慢性阻塞性肺疾病（COPD）的危险因素，COPD是一种具有各种表型的异质性疾病。最近描述了COPD的过敏表型，其特征是更严重的呼吸道症状和更高的急性加重风险。[
Original Article
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浙江省2009-2013年新发结核病患者耐多药结核病负担的观察性研究Ying Peng, Song-Hua Chen, Le Zhang, Bin Chen, Ming-Wu Zhang, Tie-Niu He, Fei Wang, Cheng-Liang Chai, Lin Zhou, Yu Zhang 等
中华医学杂志英文版2016年 130卷 17期
DOI: 10.4103/0366-6999.213413
摘要
Background:
Screening on multidrug-resistant tuberculosis (MDR-TB) has been limited to the serious TB subpopulations excluding the new TB patients. This study aimed to examine MDR-TB burden among the new TB patients.
Methods:
We conducted a study in Zhejiang Province during 2009-2013 to screen for MDR-TB patients among the low MDR-TB risk patients and five subpopulations of high MDR-TB risk patients. The number, prevalence, and trend of MDR-TB were compared while the logistic regression model was used to examine risk factors related to MDR-TB.
Results:
A total of 200 and 791 MDR-TB cases were, respectively, identified from the 9830 new TB cases and 2372 high-risk suspects who took MDR-TB screening from 2009 to 2013. The MDR-TB rates went down in both of the new TB patients and five MDR-TB high-risk groups over the study time, but the percentage of MDR-TB patients identified from the new TB patients in all diagnosed MDR-TB cases kept stable from 28.3% in 2011 to 27.0% in 2012 to 26.0% in 2013.
Conclusions:
The study indicated that MDR-TB burden among new TB patients was high, thus screening for MDR-TB among the new TB patients should be recommended in China as well as in the similar situation worldwide.
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热消融治疗非小细胞肺癌肾上腺转移：一项5年单中心经验Evanthia I Botsa, Ioanna L Thanou, Aspasia T Papatheodoropoulou, Loukas I Thanos
中华医学杂志英文版2016年 130卷 17期
DOI: 10.4103/0366-6999.210496
摘要
Background:
Treatment of adrenal metastasis from lung carcinoma may prolong survival in the selected patients. However, not all patients can undergo surgery; thus, minimally invasive ablation procedures such as radiofrequency ablation (RFA) and microwave ablation (MWA) have gained acceptance as alternative treatment methods. This study summarized a 5-year single-center experience regarding the evaluation of safety and efficacy of computed tomography (CT)-guided thermal ablation in the management of adrenal metastasis originating from non-small cell lung cancer (NSCLC).
Methods:
The data of NSCLC patients ablated for adrenal metastasis at the Department of Diagnostic Imaging and Interventional Radiology, General Hospital Sotiria, were retrospectively analyzed. Patients were divided into two groups: RFA group and MWA group according to the therapeutic approaches. Preprocedural blood tests included measurement of international normalized ratio, partial thromboplastin time, and platelet enumeration. A dual-phase contrast-enhanced spiral CT was performed immediately after the procedure to assess the immediate response after ablation and to screen for related complications. Follow-up was performed with CT or magnetic resonance imaging at 1, 3, 6 months and 1 year after ablation and every 6 months thereafter.
Results:
A total of 99 ablation sessions in 71 patients with adrenal metastasis originating from NSCLC were included in the final analysis. Self-limited, postablation syndrome occurred in 16/99 (16.1%) of ablation sessions. All procedures were technically successful. Immediate postablation imaging showed no contrast enhancement of the ablated tumor in all patients. Follow-up imaging at 3 months revealed local tumor progression in 8 (22.8%) patients of the RFA group and 7 (19.4%) patients of MWA group, all of them underwent a second session successfully. The 1-year assessment revealed local recurrence of the ablated tumor in six patients (17.1%) of RFA group and seven patients (19.4%) of MWA group. Among these 71 patients, those with tumor size >3.5 cm had a higher local recurrence rate (65.2%, 15/23) than those with tumors ≤3.5 cm (16.7%, 8/48; P = 0.012). There was no significant difference in the median survival time between RFA (14.0 months) and MWA (14.6 months) groups (P > 0.05).
Conclusions:
RFA and MWA showed comparable efficacy and safety in adrenal metastasis treatment.
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哮喘患者气道中促炎细胞因子和趋化因子的特征：与疾病严重程度和炎性细胞浸润的关系Ting Yang, Yan Li, Zhe Lyu, Kewu Huang, Chris J Corrigan, Sun Ying, Wei Wang, Chen Wang
中华医学杂志英文版2016年 130卷 17期
DOI: 10.4103/0366-6999.213428
摘要
Background:
Increased proinflammatory cytokines and chemokines might contribute to infiltration of inflammatory cells and remodeling in airways of asthma. Although these molecules may be associated with asthma, there is lack of systemic evidence showing which and how important these events are in the disease. We aimed to analyze the concentrations of these molecules in the airways and relationships with disease severity and with airway infiltration of inflammatory cells in a large cohort of asthmatics (n = 70, including 37 mild and 33 moderate/severe asthmatics) compared with controls (n = 30).
Methods:
Meso scale discovery system and commercial ELISA kits were used to measure the concentrations of proinflammatory cytokines interleukin (IL)-1β; tumor necrosis factor-alpha (TNF-α); IL-6; and IL-17 and CC and CXC chemokines CCL2, CCL4, CCL11, CCL13, CCL17, CCL22, and CCL26 and CXCL8, CXCL9, CXCL10, and CXCL11 in bronchoalveolar lavage fluid of asthmatics and controls.
Results:
The concentrations of IL-1, TNF-α, IL-6, CXCL8 and CXCL10, and CCL4, CCL11, CCL17, and CCL22 were significantly elevated in asthmatics compared with controls (P < 0.05). The concentrations of TNF-α and CXCL8, but not others, were negatively correlated with severity of disease (lung function forced expiratory volume in 1 s) (TNF-α vs. total: r= −0.359, P = 0.002 vs. moderate/severe: r= −0.541, P = 0.001; CXCL8 vs. total: r= −0.327, P = 0.006 vs. moderate/severe: r= −0.625, P = 0.0001, respectively). In addition, concentrations of these two molecules were also correlated with the absolute numbers of infiltrating eosinophils and neutrophils in asthmatic airways.
Conclusions:
Increased concentrations of TNF-α and CXCL8 are associated with pathogenesis of asthma. Targeting these molecules might provide an alternative therapeutic for this disease.
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空间血糖控制与常规血糖管理方案在危重患者血糖控制中的比较：一项前瞻性随机临床研究Biao Xu, Wei Jiang, Chun-Yao Wang, Li Weng, Xiao-Yun Hu, Jin-Min Peng, Bin Du
中华医学杂志英文版2016年 130卷 17期
DOI: 10.4103/0366-6999.213422
摘要
Background:
The Space Glucose Control (SGC) system is a computer-assisted device combining infusion pumps with the enhanced Model Predictive Control algorithm to achieve the target blood glucose (BG) level safely. The objective of this study was to evaluate the efficacy and safety of glycemic control by SGC with customized BG target range of 5.8–8.9 mmol/L in the critically ill patients.
Methods:
It is a randomized controlled trial of seventy critically ill patients with mechanical ventilation and hyperglycemia (BG ≥ 9.0 mmol/L). Thirty-six patients in the SGC group and 34 in the routine glucose management group were observed for three consecutive days. Target BG for both groups was 5.8–8.9 mmol/L. The primary outcome was the percentage time in the target range.
Results:
The percentage time within BG target range in the SGC group (69±15%) was significantly higher than in the routine management group (52±24%; P < 0.01). No measurement was ≤2.2 mmol/L, and there was only one episode of hypoglycemia (2.3–3.3 mmol/L) in each group. The average BG was significantly lower in the SGC group (7.8±0.7 mmol/L) than in the routine management group (9.1±1.6 mmol/L, P < 0.001). Target BG level was reached earlier in the SGC group than routine management group (2.5±2.9 vs. 12.1±15.3 h, P = 0.001). However, the SGC group performed worse for daily insulin requirement (59.8±39.3 vs. 28.4±36.7 U, P = 0.001) and sampling interval (2.0±0.5 vs. 3.7±0.5 h, P < 0.001) than the routine management group did. Multiple linear regression showed that the intervention group remained a significant individual predictor (P < 0.001) of the percentage time in target range.
Conclusions:
The SGC system, with a BG target of 5.8–8.9 mmol/L, resulted in effective and reliable glycemic control with few hypoglycemic episodes in critically ill patients with mechanical ventilation and hyperglycemia. However, the workload was increased.
Trial Registration:
http://www.clinicaltrials.gov, NCT 02491346; https://www.clinicaltrials.gov/ct2/show/NCT02491346?term=NCT0 2491346&cond=Hyperglycemia&cntry1=ES%3ACN&rank=1.
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从血液中分离的肠杆菌科菌株的耐药性趋势：中国大陆10年流行病学研究（2004-2014）Xiang-Jun Liu, Yuan Lyu, Yun Li, Feng Xue, Jian Liu
中华医学杂志英文版2016年 130卷 17期
DOI: 10.4103/0366-6999.213407
摘要
Background:
Antimicrobial resistance is a serious problem that compromises the empirical treatment of infections, resulting in a lack of effective antibiotics and high medical expenses. Here, we aimed to monitor the trends in antimicrobial resistance among Enterobacteriaceae isolated from blood samples in mainland China.
Methods:
A total of 2240 Enterobacteriaceae isolates from blood were collected from hospitalized patients at 19 tertiary hospitals between October 2004 and June 2014. The minimum inhibitory concentrations of all isolates were determined using the agar dilution method according to the Clinical and Laboratory Standards Institute 2016 guidelines.
Results:
The most commonly isolated bacteria were Escherichia coli, compromising 47.0% (1053/2240) of the total isolates, followed by Klebsiella spp. (26.3%), Salmonella spp. (10.4%), and Enterobacter spp. (9.2%). The detection rates of extended-spectrum β-lactamases (ESBLs) among E. coli were 68.9% (2004-2005), 73.2% (2007–2008), 67.9% (2009-2010), 72.6% (2011-2012), and 58.4% (2013-2014), whereas those in ESBL-producing Klebsiella pneumoniae were slightly decreased (75.9%, 50.0%, 41.4%, 40.2%, and 43.0%, respectively). Carbapenems were the most potent agents against the Enterobacteriaceae isolates, followed by moxalactam, tigecycline, and amikacin. However, there was a decrease in the susceptibility rates for carbapenems in all species, particularly K. pneumoniae (decreased by 10.6% for imipenem) and Enterobacter aerogenes (decreased by 21.1% for imipenem). Reviving antibiotics (tigecycline and polymyxins) showed good in vitro activity against Enterobacteriaceae.
Conclusions:
The activity of antibiotics against Enterobacteriaceae isolated from blood was decreased overall. Large proportions of ESBL-producing isolates were identified among E. coli and Klebsiella spp. Carbapenem-resistant isolates have become a major challenge in the treatment of infections.
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大型不孕中心不孕妇女复发性自然流产流行病学调查及危险因素分析Hai-Yan Wang, Jie Qiao, Xiao-Xi Sun, Shu-Yu Wang, Xiao-Yan Liang, Yun Sun, Feng-Hua Liu
中华医学杂志英文版2016年 130卷 17期
DOI: 10.4103/0366-6999.213415
摘要
Background:
A higher frequency of spontaneous miscarriage has been observed in infertile couples, and there is a higher prevalence of infertility among patients with a history of recurrent spontaneous miscarriages (RSMs; ≥2 miscarriages). This study aimed to determine the proportion of infertile patients with RSM and examine risk factors associated in patients with RSM being treated with assisted reproductive technologies.
Methods:
This cross-sectional observational study was conducted at six reproductive medicine centers in three cities of China. Data of 751 patients with at least one spontaneous miscarriage were analyzed. Demographic data and etiological factors associated with infertility were compiled and compared between patients with a single spontaneous miscarriage (SSM) and those with RSM.
Results:
Two hundred (26.6%, 95% confidence interval [CI]: 23.50-29.95%) patients experienced RSMs and 551 (73.4%) had a single miscarriage. The odds of RSM increased with increasing age (odds ratio [OR] = 1.06), uterine disorders (OR = 2.09), endocrine disorders (OR = 2.48), and immune disorders (OR = 2.98). Higher education level, masters or above, and a pelvic cavity disorder were associated with lower risk of RSM (OR = 0.27 and 0.46, respectively). Late spontaneous miscarriages were more frequent in patients with RSM than in those with a SSM (31.5% vs. 14.2%, respectively, P < 0.001) and were associated with a history of uterine cavity procedures (OR = 2.095) and cervical factors related to infertility (OR = 4.136, 95% CI: 1.012–16.90).
Conclusions:
Compared to patients with only a SSM, the conditions of patients with RSM are more complicated. To increase the success rate of assisted reproductive technology, factors including uterus cavity adhesion, cervical relaxation, endocrine disorders, and immune disorders should be treated before assisted reproduction is initiated. These data may provide treatment guidance for infertile patients with a history of RSM.
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治疗前中性粒细胞与淋巴细胞比值作为中国上尿路上皮癌患者预后因素的验证Zhen-Peng Cao, Bao Guan, Guang-Zhi Zhao, Dong Fang, Geng-Yan Xiong, Xue-Song Li, Li-Qun Zhou
中华医学杂志英文版2016年 130卷 17期
DOI: 10.4103/0366-6999.213414
摘要
Background:
The pretreatment neutrophil-to-lymphocyte ratio (NLR) has been reported to be a prognostic factor in various types of carcinomas. The aim of this study was to investigate the prognostic value of pretreatment NLR in a large cohort of Chinese patients with upper tract urothelial carcinoma (UTUC).
Methods:
We retrospectively analyzed the medical data of 656 UTUC patients who underwent radical nephroureterectomy (RNU) from 2001 to 2011 at Peking University First Hospital. Receiver operating characteristic (ROC) curve analysis was performed to calculate the optimal cutoff point of pretreatment NLR. Uni- and multi-variate analyses were used to identify the prognostic factors for cancer-specific survival (CSS) and intravesical recurrence-free survival (IVRFS).
Results:
The optimal cutoff point of pretreatment NLR was 2.40 by ROC curves, by which patients with high NLR (NLR ≥2.40) and low NLR (NLR <2.40) accounted for 314 (47.9%) and 342 (52.1%) patients, respectively. Patients with a high pretreatment NLR tended to have high tumor grades (χ2 = 15.725, P < 0.001), high tumor stages (χ2 = 25.416, P < 0.001), tumor sizes >5 cm (χ2 = 8.213, P = 0.005), ipsilateral hydronephrosis (χ2 = 4.624, P = 0.033), and concomitant carcinoma in situ (CIS) (χ2 = 9.517, P = 0.003). A high pretreatment NLR (hazard ratio [HR] = 1.820, P = 0.001), main tumor diameter >5 cm (HR = 1.789, P = 0.009), lymph node metastasis (HR = 1.863, P = 0.024), and high tumor stage (HR = 1.745, P < 0.001) independently predicted poor CSS after surgery, while only concomitant carcinoma in situ (CIS) (HR = 2.164, P = 0.034), ureteroscopy before surgery (HR = 1.701, P = 0.015), and high tumor grade (HR = 1.645, P = 0.018) were independent predictors of IVRFS after RNU.
Conclusions:
The pretreatment NLR was related to some adverse clinicopathological features and was an independent predictor of CSS, although not IVRFS, in Chinese UTUC patients.
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II期结直肠癌患者辅助化疗预测模型的回顾性研究Bo Wei, Xiao-Ming Zheng, Pu-Run Lei, Yong Huang, Zong-Heng Zheng, Tu-Feng Chen, Jiang-Long Huang, Jia-Feng Fang, Cheng-Hua Liang, Hong-Bo Wei
中华医学杂志英文版2016年 130卷 17期
DOI: 10.4103/0366-6999.213432
摘要
Background:
It remains controversial whether patients with Stage II colorectal cancer would benefit from adjuvant chemotherapy after radical resection. The aim of this study was to establish two mathematical models to identify the suitable patients for adjuvant chemotherapy.
Methods:
The current study comprised of two steps. In the first step, 353 patients with Stage II colorectal cancer who underwent surgical procedures at the Third Affiliated Hospital of Sun Yat-sen University between June 2006 and December 2015 were entered and followed up for 6–120 months. Their clinical data were collected and enrolled into the database. We established two mathematical models by univariate and multivariate Cox regression analysis to identify the target patients; in the second step, 230 patients under the same standard between January 2012 and December 2016 were entered and followed up for 3-62 months to verify the two models’ validation.
Results:
In the first step, totally 340 surgical patients with Stage II colorectal cancer were finally enrolled in this study. Statistical analysis showed that tumor differentiation (TD) (P < 0.001), lymphovascular invasion (LVI) (P < 0.001), uncertain or positive margins (UPM) (P < 0.001), and fewer lymph nodes (LNs) (<12) retrieved (P < 0.001) were correlated with the overall survival (OS) and disease free survival (DFS). We obtained two models: (1) OS risk score = 1.116 × TD + 2.202 × LVI + 3.676 × UPM + 1.438 × LN−0.493; (2) DFS risk score = 0.789 × TD + 2.074 × LVI + 3.183 × UPM + 1.329 × LN−0.432. According to the models and cutoff points [(0.07, 1.33) and (−0.04, 1.30), respectively], patients can be divided into three groups: low-risk, moderate-risk, and high-risk. Moreover, the high-risk group patients could benefit from adjuvant chemotherapy. In the second step, totally 221 patients were finally used to verify the models’ validation. The results proved that the models were accurate and feasible (P < 0.05).
Conclusions:
According to the predictive models, patients with Stage II colorectal cancer in the high-risk group are strongly recommended for adjuvant chemotherapy, thus facilitating the individualized and precise treatment.
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儿童急性白血病血流感染的临床特征：231例单中心经验Jia-Feng Yao, Nan Li, Jin Jiang
中华医学杂志英文版2016年 130卷 17期
DOI: 10.4103/0366-6999.213411
摘要
Background:
Acute leukemia is the most common pediatric hematological malignancy. Bloodstream infections (BSIs) are severe complications in these patients during chemotherapy. This study aimed to explore the clinical presentation and etiology of BSI, as well as the common sites of infection, and to provide a basis for the rational regarding antibiotic use.
Methods:
We performed a retrospective chart review of all pediatric patients who had acute leukemia accompanied by a BSI in our hospital from December 2011 to September 2015. All patients were selected based on clinical presentation and had to have at least one positive blood culture for inclusion. The basic clinical characteristics, blood culture results, and antimicrobial susceptibilities were analyzed.
Results:
All 231 patients had a fever; of them, 12 patients continued to have a fever. Twenty-five patients had nonremitting (NR) leukemia, and 206 patients achieved complete remission (CR). Differences in the duration of fever between the NR and CR groups were significant (9.6 ± 7.9 vs. 5.1 ± 3.8 days, P = 0.016). One hundred and eighty patients had agranulocytosis. Differences in fever duration between the agranulocytosis and nonagranulocytosis groups were significant (6.2 ± 5.1 vs. 4.1 ± 2.6 days, P = 0.001). The other sites of infection in these 231 patients were the lung, mouth, digestive tract, and rectum. Blood culture comprised 2635 samples. There were 619 samples, which were positive. Of the 619 positive blood culture samples, 59.9% had Gram-negative bacteria, 39.3% had Gram-positive bacteria, and 0.8% had fungus. The primary pathogens were Pseudomonas aeruginosa, Enterobactercloacae, Escherichia coli, and Klebsiella pneumoniae. Of these 231 patients, 217 patients were cured. The effective treatment ratio was 94%.
Conclusions:
Gram-negative bacteria were the main pathogenic bacteria in patients with acute leukemia in our center. NR primary illness, agranulocytosis, and drug-resistant pathogenic bacteria were all risk factors for poor prognosis.
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接受雄激素剥夺治疗的前列腺癌患者生活质量评定新量表的开发和初步验证Yao-Jun Dun, Hui-Xin Liu, Lu-Ping Yu, Qing Li, Xiao-Wei Zhang, Xu Tang, Cai-Peng Qin, Tao Xu
中华医学杂志英文版2016年 130卷 17期
DOI: 10.4103/0366-6999.213416
摘要
Background:
There has been no a specific scale to measure quality of life (QOL) for prostate cancer patients receiving androgen deprivation therapy (ADT) to date. This study aimed to develop and initially validate the scale to evaluate QOL for prostate cancer patients receiving ADT.
Methods:
The scale was developed following international recommendations. Moreover, the items were all generated through literature review and referenced questionnaires. After being reviewed by expert panelists, the revised scale was formed and then completed by a convenience sample of 200 prostate cancer patients from our hospital. Explore factor analysis (EFA) was applied to test the construct validity, then split-half reliability, Cronbach’s alpha, and test-retest reliability were applied to assess the reliability and stability of the scale.
Results:
The revised scale contained 22 items and a total of 200 participants had completed the scale. One hundred participants were randomly selected from the total 200 participants to perform EFA with varimax rotation on the revised scale, and "hot flashes" item was deleted for low factor loading. We selected only 3 items from each factor, then, the final scale was formed with 18-items. We selected another 100 participants to perform the EFA again on the final scale. It was demonstrated that the structure with 6 factors explained 72.5% of total variance and factor loading value was above 0.40 in all items of the factors. Moreover, the split-half reliability coefficient, Cronbach’s alpha, and test-retest reliability coefficient were calculated to be 0.74, 0.63, and 0.89, respectively, exhibiting good reliability on the whole.
Conclusions:
The scale was identified to be a valid and reliable instrument to measure QOL for prostate cancer patients receiving ADT. Moreover, further research is needed to overcome the potential drawbacks.
Review Article
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肺微生物群在慢性阻塞性肺疾病发病机制中的作用Lei Wang, Ke Hao, Ting Yang, Chen Wang
中华医学杂志英文版2016年 130卷 17期
DOI: 10.4103/0366-6999.211452
摘要
Objective:
The development of culture-independent techniques for microbiological analysis shows that bronchial tree is not sterile in either healthy or chronic obstructive pulmonary disease (COPD) individuals. With the advance of sequencing technologies, lung microbiome has become a new frontier for pulmonary disease research, and such advance has led to better understanding of the lung microbiome in COPD. This review aimed to summarize the recent advances in lung microbiome, its relationships with COPD, and the possible mechanisms that microbiome contributed to COPD pathogenesis.
Data Sources:
Literature search was conducted using PubMed to collect all available studies concerning lung microbiome in COPD. The search terms were "microbiome" and "chronic obstructive pulmonary disease" , or "microbiome" and "lung/pulmonary" .
Study Selection:
The papers in English about lung microbiome or lung microbiome in COPD were selected, and the type of articles was not limited.
Results:
The lung is a complex microbial ecosystem; the microbiome in lung is a collection of viable and nonviable microbiota (bacteria, viruses, and fungi) residing in the bronchial tree and parenchymal tissues, which is important for health. The following types of respiratory samples are often used to detect the lung microbiome: sputum, bronchial aspirate, bronchoalveolar lavage, and bronchial mucosa. Disordered bacterial microbiome is participated in pathogenesis of COPD; there are also dynamic changes in microbiota during COPD exacerbations. Lung microbiome may contribute to the pathogenesis of COPD by manipulating inflammatory and/or immune process.
Conclusions:
Normal lung microbiome could be useful for prophylactic or therapeutic management in COPD, and the changes of lung microbiome could also serve as biomarkers for the evaluation of COPD.
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肾上腺素在院外心脏骤停中的应用：有益还是有害？Huan Shao, Chun-Sheng Li
中华医学杂志英文版2016年 130卷 17期
DOI: 10.4103/0366-6999.213429
摘要
Objective:
Epinephrine is the primary drug administered during cardiopulmonary resuscitation (CPR) to reverse cardiac arrest. The evidence for the use of adrenaline in out-of-hospital cardiac arrest (OHCA) and in-hospital resuscitation is inconclusive. We conducted a systematic review on the clinical efficacy of adrenaline in adult OHCA patients to evaluate whether epinephrine provides any overall benefit for patients.
Data Sources:
The EMBASE and PubMed databases were searched with the key words "epinephrine," "cardiac arrest," and variations of these terms.
Study Selection:
Data from clinical randomized trials, meta-analyses, guidelines, and recent reviews were selected for review.
Results:
Sudden cardiac arrest causes 544,000 deaths in China each year, with survival occurring in <1% of cases (compared with 12% in the United States). The American Heart Association recommends the use of epinephrine in patients with cardiac arrest, as part of advanced cardiac life support. There is a clear evidence of an association between epinephrine and increased return of spontaneous circulation (ROSC). However, there are conflicting results regarding long-term survival and functional recovery, particularly neurological outcome, after CPR. There is currently insufficient evidence to support or reject epinephrine administration during resuscitation. We believe that epinephrine may have a role in resuscitation, as administration of epinephrine during CPR increases the probability of restoring cardiac activity with pulses, which is an essential intermediate step toward long-term survival.
Conclusions:
The administration of adrenaline was associated with improved short-term survival (ROSC). However, it appears that the use of adrenaline is associated with no benefit on survival to hospital discharge or survival with favorable neurological outcome after OHCA, and it may have a harmful effect. Larger placebo-controlled, double-blind, randomized control trials are required to definitively establish the effect of epinephrine.
Clinical Observation
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18非小细胞肺癌中F-氟脱氧葡萄糖摄取与切除修复交叉互补组1和核糖核苷酸还原酶亚基M1的表达Na Hu, Yun-Hua Wang, Dai-Qiang Li, Xiao-Huang Yang, Yan-Lin Tan
中华医学杂志英文版2016年 130卷 17期
DOI: 10.4103/0366-6999.213408
摘要
氟脱氧葡萄糖正电子发射断层扫描/计算机断层扫描（FDG PET/CT）广泛应用于非小细胞肺癌（NSCLC）。标准化摄取值（SUV）是一种半定量指标，在非小细胞肺癌的诊断、分期和疗效评估中起着至关重要的作用。有人提出，SUV马克斯基于显示SUV之间密切相关的研究，肿瘤的可能与化疗耐药相关生物标志物的存在或不存在相关马克斯和切除修复交叉互补组1（ERCC1）的表达水平[
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杜蒙的功效™支架治疗气道胃瘘16例Ming-Yao Ke, Rui Huang, Lian-Cheng Lin, Jun-Li Zeng, Xue-Mei Wu
中华医学杂志英文版2016年 130卷 17期
DOI: 10.4103/0366-6999.213420
摘要
气道胃瘘（AGF）是食管癌食管切除术后罕见但危险的并发症，发生率为0.3-1.9%。[
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激光性黄斑病变的早期治疗Yan-Yun Chen, Ning Lu, Ji-Peng Li, Jie Yu, Lan Wang
中华医学杂志英文版2016年 130卷 17期
DOI: 10.4103/0366-6999.213412
摘要
意外暴露于激光可能会导致视网膜损伤导致视力障碍。激光对黄斑的损害包括视网膜外破裂、视网膜中央凹出血、黄斑水肿、视网膜前膜、全层黄斑裂孔等。[
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原发性心脏淋巴瘤的影像学特征Su Hu, Li-Li Zhu, Jun Ke, Yue Sun, Chun-Hong Hu
中华医学杂志英文版2016年 130卷 17期
DOI: 10.4103/0366-6999.213425
摘要
原发性心脏淋巴瘤（PCL）是一种极其罕见的实体，仅占结外淋巴瘤的0.5%和心脏肿瘤的1.0%。[
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Castleman病：肾旁腹膜后罕见肿块，类似于其他肿瘤Yi Xie, Yi Zhao, Zhi-Gang Ji, Han-Zhong Li, Guang-Hua Liu, Quan-Zhong Mao
中华医学杂志英文版2016年 130卷 17期
DOI: 10.4103/0366-6999.213418
摘要
卡斯尔曼病（CD）是一种罕见的淋巴增生综合征，通常累及纵隔肿块。肾旁区CD应与淋巴瘤疾病相鉴别。我们分析了10例模拟其他肿瘤的肾旁腹膜后CD患者的临床特征，以总结我们的一些经验并进行文献综述。
Clinical Challenge
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肺部诺卡菌病伴继发性噬血细胞性淋巴组织细胞增多症一例Teng Han, Ying-Mei Liu, Ting Yang, Hua-Ping Dai, Xiao-Lei Zhang
中华医学杂志英文版2016年 130卷 17期
DOI: 10.4103/0366-6999.213421
摘要
肺诺卡菌病是一种机会性感染，尤其是在免疫功能低下的患者中。噬血细胞性淋巴组织细胞增多症（HLH）是一种罕见但可能致命的疾病。我们报告一例肺部诺卡菌病伴继发性HLH。
Clinical Picture
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盲肠内呈细长形的炎性纤维瘤息肉1例Yan Zhao, Yi-Wei Fu, Wen-Chao Wang, Ting Lu
中华医学杂志英文版2016年 130卷 17期
DOI: 10.4103/0366-6999.213424
摘要
炎性纤维瘤息肉（IFP）是一组罕见的遍布胃肠道的良性间叶肿瘤。受累部位最多的是胃和大肠，其次是小肠、食管和肛管。然而，即使在胃中，其发病率也仅为所有胃息肉的0.1%。[
Correspondence
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以坏疽性脓皮病为首发表现的小细胞肺癌伴皮肌炎Man Li, Tian Guan, Zhang-Lei Mu, Qian-Xi Xu, Lin Cai, Xue Chen
中华医学杂志英文版2016年 130卷 17期
DOI: 10.4103/0366-6999.213426
摘要
致小编：54岁男性，一个月前颈部出现疼痛性溃疡，继而出现眶周水肿。溃疡随后扩散到他的躯干、背部和上臂。在过去的三周里，他出现肌肉无力、活动时轻度肌肉酸痛和吞咽食物困难。他在当地医院被诊断为药疹，并接受了两周的不定期皮质类固醇治疗。此后，溃疡开始愈合。他有40年的吸烟史。患者消瘦，体格检查发现heliotrope征、涉及面部的异皮病、胸部和上臂的“V”征、甲襞毛细血管扩张、腹部、背部和上臂的大范围明确溃疡，无Gottron征[
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寻常型狼疮合并丘疹坏死性结核和盘状红斑狼疮一例Ting-Ting Wang, Hong-Jie Liu, Lin Wang
中华医学杂志英文版2016年 130卷 17期
DOI: 10.4103/0366-6999.213417
摘要
致编者：一名48岁女性，左耳轮出现斑块，持续20年，双耳垂出现红斑和鳞屑9个月，双大腿出现丘疹6个月。她和她的家人都没有任何特殊的历史。体格检查发现她的左耳轮有一个边界清晰的暗红色斑块，双耳垂有红色红斑，双大腿有附着鳞屑和对称分布的红色丘疹，有结痂和鳞屑[
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由右心耳引起的房性早搏Xiang-Fei Feng, Jian Sun, Rui Zhang, Yi-Gang Li
中华医学杂志英文版2016年 130卷 17期
DOI: 10.4103/0366-6999.213430
摘要
致编者：房性早搏（APCs）或房性心动过速（AT）是室上性（SV）心律失常的常见形式。起源于右心耳（RAA），通常对射频（RF）消融反应良好；然而，在该解剖区域成功消融可能具有挑战性。在此，我们报告一例成功治疗的病例。
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伪装成克罗恩病的原发性小肠弥漫性大B细胞淋巴瘤1例Xiao-Hong Lu, Yuan-Jie Yu, Shi-Yun Tan, Yi-Juan Ding
中华医学杂志英文版2016年 130卷 17期
DOI: 10.4103/0366-6999.213409
摘要
致编者：早期原发性胃肠道非霍奇金淋巴瘤是一个诊断挑战，很容易被误诊为克罗恩病或肠结核。[
Ideas and Opinions
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特发性肺纤维化：一种全身性疾病？Luo Man, Peng Hong
中华医学杂志英文版2016年 130卷 17期
DOI: 10.4103/0366-6999.213423
摘要
特发性肺纤维化（IPF）是一种特殊类型的慢性进行性纤维化间质性肺炎，与常见间质性肺炎的组织病理学模式相关。IPF通常被认为是肺限制性病症。尽管IPF的主要表现本质上是肺部的，但由于其与合并症和并发症的强烈相关性，IPF越来越被认为是一种全身性疾病。
Comments
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中国新发结核病人耐多药结核病筛查前景Hui Zhang, Zhong-Wei Jia
中华医学杂志英文版2016年 130卷 17期
DOI: 10.4103/0366-6999.213433
摘要
彭等人.[
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