MedNexus
2017年 · 第130卷第24期
出版日期 2017-12-20电子版 ￥0.00元
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Original Article
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质子泵抑制剂对经皮冠状动脉介入治疗后接受双重抗血小板治疗的患者药效学效应和临床结局的影响：倾向评分分析Pei Zhu, Zhan Gao, Xiao-Fang Tang, Jing-Jing Xu, Yin Zhang, Li-Jian Gao, Jue Chen, Shu-Bin Qiao, Yue-Jin Yang, Run-Lin Gao 等
中华医学杂志英文版2017年 130卷 24期
DOI: 10.4103/0366-6999.220304
摘要
Background:
Prior studies have reported controversial conclusions regarding the risk of adverse cardiovascular events in patients using proton-pump inhibitors (PPIs) combined with clopidogrel therapy, causing much uncertainty in clinical practice. We sought to evaluate the safety of PPIs use among high-risk cardiovascular patients who underwent percutaneous coronary intervention (PCI) in a long-term follow-up study.
Methods:
A total of 7868 consecutive patients who had undergone PCI and received dual antiplatelet therapy (DAPT) at a single center from January 2013 to December 2013 were enrolled. Adenosine diphosphate (ADP)-induced platelet aggregation inhibition was measured by modified thromboelastography (mTEG) in 5042 patients. Propensity score matching (PSM) was applied to control differing baseline factors. Cox proportional hazards regression was used to evaluate the 2-year major adverse cardiovascular and cerebrovascular events (MACCEs), as well as individual events, including all-cause death, myocardial infarction, unplanned target vessel revascularization, stent thrombosis, and stroke.
Results:
Among the whole cohort, 27.2% were prescribed PPIs. The ADP-induced platelet aggregation inhibition by mTEG was significantly lower in PPI users than that in non-PPI users (42.0±30.9% vs. 46.4±31.4%, t = 4.435, P< 0.001). Concomitant PPI use was not associated with increased MACCE through 2-year follow-up (12.7% vs. 12.5%, χ2 = 0.086, P= 0.769). Other endpoints showed no significant differences after multivariate adjustment, regardless of PSM.
Conclusion:
In this large cohort of real-world patients, the combination of PPIs with DAPT was not associated with increased risk of MACCE in patients who underwent PCI at up to 2 years of follow-up.
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18~45岁糖尿病患者冠状动脉旁路移植术与经皮冠状动脉介入治疗的疗效比较Yang Li, Ran Dong, Kun Hua, Tao-Shuai Liu, Shao-You Zhou, Ning Zhou, Hong-Jia Zhang
中华医学杂志英文版2017年 130卷 24期
DOI: 10.4103/0366-6999.220305
摘要
Background:
Debate on treatment for young patients with coronary artery disease still exists. This study aimed to investigate the intermediate- and long-term outcomes between coronary artery bypass grafting (CABG) and percutaneous coronary intervention (PCI) in patients aged 18–45 years with diabetes mellitus (DM).
Methods:
Between January 2006 and March 2016, a total of 2018 DM patients aged 18–45 years including 517 cases of CABG and 1501 cases of PCI were enrolled in the study. Using propensity score matching (PSM), 406 patients were matched from each group. The intermediate- and long-term data were collected. The primary end point of this study was long-term death. The secondary end points included long-term major adverse cardiovascular and cerebrovascular events (MACCEs), stroke, angina, myocardial infarction (MI), and repeat revascularization.
Results:
Before PSM, the in-hospital mortality was 1.2% in the CABG group and 0.1% in the PCI group, with statistically significant difference (P < 0.0001). The 10-year follow-up outcomes including long-term survival rate and freedom from MACCEs were better in the CABG group than those in the PCI group (97.3% vs. 94.5%, P= 0.0072; 93.2% vs. 86.3%, P< 0.0001), but CABG group was associated with lower freedom from stoke compared to PCI group (94.2% vs. 97.5%, P= 0.0059). After propensity score-matched analysis, these findings at 10-year follow-up were also confirmed. Freedom from MACCEs was higher in CABG group compared to PCI group, but no significant difference was observed (93.1% vs. 89.2%, P= 0.0720). The freedom from recurrent MI was significantly higher in CABG patients compared with PCI patients (95.6% vs. 92.5%, P= 0.0260). Furthermore, CABG was associated with a higher rate of long-term survival rate than PCI (97.5% vs. 94.6%, P= 0.0403). There was no significant difference in the freedom from stroke between CABG and PCI groups (95.3% vs. 97.3%, P= 0.9385). The hospital cost was greater for CABG (13,936±4480 US dollars vs. 10,926±7376 US dollars, P< 0.0001).
Conclusions:
In DM patients aged 18–45 years, the cumulative survival rate, and freedom from MI and repeat revascularization for CABG were superior to those of PCI. However, a better trend to avoid stroke was observed with PCI.
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放疗后全身治疗显著降低1-3例脑转移患者的死亡风险：250例患者的回顾性研究Bo Li, Zhao-Xia Dai, Yi-Dong Chen, Yan-Wei Liu, Shuai Liu, Xue-Nan Gu, Xiao-Guang Qiu
中华医学杂志英文版2017年 130卷 24期
DOI: 10.4103/0366-6999.220296
摘要
Background:
For patients with a brain metastasis (BM), systemic therapy is usually administered after the completion of radiotherapy, especially in cases of multiple BMs. However, the role of systemic therapy in patients with a limited number of BMs is not clear. Therefore, we conducted a retrospective study to explore this question.
Methods:
Consecutive patients with a pathologically confirmed malignancy and 1–3 intracranial lesions that had been documented within the last decade were selected from the databases of three hospitals in China.
Results:
A total of 250 patients were enrolled; of them, 135 received radiotherapy alone and 115 received radiotherapy plus systemic therapy. In patients receiving whole-brain radiation therapy (WBRT) as radiotherapy, 28 received WBRT alone and 35 patients received WBRT plus systemic therapy. Of the patients treated with stereotactic radiosurgery (SRS), 107 received SRS alone and 80 received SRS plus systemic therapy. Multivariate analysis revealed that systemic therapy significantly reduced the risk of mortality compared with radiotherapy alone (hazard ratio [HR] = 0.294, 95% confidence interval [CI] = 0.158- 0.548). Further, when the analysis was conducted in subgroups of WBRT (HR = 0.230, 95% CI = 0.081- 0.653) or SRS (HR = 0.305, 95% CI = 0.127–0.731), systemic therapy still showed the ability to reduce the risk of mortality in patients with BMs.
Conclusion:
Systemic therapy after either SRS or WBRT radiotherapy may significantly reduce the risk of mortality of patients with 1–3 BMs.
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眼睛靠近鲜红斑痣影响区域的青光眼患者具有侧向和性别偏好Yue Wu, Ru-Jing Yu, Di Chen, Li Xu, Mao Li, Li Zhu, Chun-Yu Guo, Wen-Yi Guo
中华医学杂志英文版2017年 130卷 24期
DOI: 10.4103/0366-6999.220319
摘要
Background:
The location of facial port-wine stain (PWS) may be helpful for predicting some associated anomalies; high glaucoma incidence is found in patients with eyes close to PWS-affected areas (V1, ophthalmic branch area of the trigeminal nerve). This study aimed to investigate the characteristics of glaucoma in V1-affected PWS.
Methods:
A total of 569 patients with V1 area-affected PWS were reviewed in the study. The large series was based on the referral system between the Department of Plastic and Reconstructive Surgery and the Department of Ophthalmology. All patients were screened for glaucoma with assessments of intraocular pressure, cup-to-disc ratio, corneal diameter (only for infants), and axial length.
Results:
Of the 569 patients, 110 (19.3%) patients had glaucoma. Among the patients, 18.1% (76/420) had early-onset glaucoma (under 4-year-old group). In the 4 to 18-year-old age group, 29.3% (29/99) of the patients had glaucoma. Compared with right lateral and bilateral PWS, left-sided PWS had a lower risk of glaucoma in this study (odds ratio = 0.432 [95% confidence interval, 0.264- 0.706], P= 0.01). The under 4-year-old group showed a slight predominance of males (61.8%) in glaucoma.
Conclusions:
High glaucoma incidence was observed in patients with eyes close to PWS. More attention should be paid to glaucoma screening for right lateral and bilateral PWS patients. The predominance of males in Sturge–Weber syndrome (SWS) early-onset glaucoma patients might be due to the limitation of the case number; however, it might also provide us a new clue of potential relationship between SWS and PCG.
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飞秒激光辅助后弹力层剥离自动内皮角膜移植术中角膜内皮细胞丢失的12个月随访研究Yun Feng, Hong-Qiang Qu, Jing Ren, Philipp Prahs, Jing Hong
中华医学杂志英文版2017年 130卷 24期
DOI: 10.4103/0366-6999.220320
摘要
Background:
Descemet’s stripping automated endothelial keratoplasty (DSAEK) surgery offers a more standardized approach and reliable method to create corneal grafts with an instrument such as a microkeratome. With the development of Descemet’s membrane endothelial keratoplasty, an excellent clinical outcome is seen in the treatment of corneal endothelial dysfunctions, which indicates that thinner corneal graft results in better clinical outcome. With the recent development of the femtosecond laser, ultrathin corneal graft preparation has become possible. This study aimed to report corneal graft endothelial cell loss (ECL) in a large series of cases undergoing DSAEK with femtosecond laser-assisted corneal graft preparation within a 12-month period.
Methods:
This study was designed as a prospective, noncomparative, interventional case series. Totally 126 consecutive eyes with endothelial failure of 120 patients, who had corneal endothelial decompensation and underwent femtosecond-assisted DSAEK using the VisuMax femtosecond laser system, were included in the study. Central endothelial cell density (ECD) was recorded postoperatively at 2 weeks (n = 126), 1 month (n = 126), 3 months (n = 110), 6 months (n = 101), and 12 months (n = 71) and then compared with the preoperative eye bank measurements. Pre- and postoperative central ECDs were evaluated using Heidelberg retina tomography-III confocal microscopy. ECL was calculated for each postoperative time point. Graft thickness was examined using anterior segment-optical coherence tomography.
Results:
Mean preoperative cell count was 3383±350 cells/mm2. Mean postoperative cell counts were 2382±707 cells/mm2, 2179 ± 685 cells/mm2, 2074 ± 688 cells/mm2, 1884 ± 662 cells/mm2, and 1723 ± 624 cells/mm2 at 2 weeks, 1, 3, 6, and 12 months, respectively; these represented the ECL of 29.7 ± 19.7%, 35.4 ± 19.5%, 38.6 ± 19.8%, 44.3 ± 18.9%, and 48.9 ± 18.4% at the each corresponding time point. The mean corneal graft thickness after surgery was 142 ± 48µm, 118 ± 41 µm, 108 ± 37 µm, 100 ± 32 µm, and 99 ± 32 µm at each corresponding study visit, respectively. There was no correlation between corneal graft thickness and corneal ECL (R = 0.039).
Conclusions:
Corneal ECL remained relatively stable up to 12 months after femtosecond laser-assisted ultrathin DSAEK in a large case series. No correlation between cell loss and corneal graft thickness was found, which indicated that corneal graft preparation by the femtosecond laser was safe. ECL was faster within the first 6 months and relatively stable thereafter.
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内镜入路切除不同颅底区域的颅内外肿瘤：单中心10年经验Qiu-Hang Zhang, Zhen-Lin Wang, Hong-Chuan Guo, Feng Kong, Bo Yan, Ming-Chu Li, Ge Chen, Jian-Tao Liang, Yu-Hai Bao, Feng Ling
中华医学杂志英文版2017年 130卷 24期
DOI: 10.4103/0366-6999.220306
摘要
Background:
Some problems have been found in the usually adopted combined approach for the removal of intra-extracranial tumors in skull base. Herein, we described a pure endoscopic transnasal or transoral approach (ETA) for the removal of intra-extracranial tumors in various skull base regions.
Methods:
Retrospectively, clinical data, major surgical complications, pre- and postoperative images, and follow-up information of a series of 85 patients with intra-extracranial tumors in various skull base regions who were treated by surgery via ETA in our skull base center during the past 10 years were reviewed and analyzed.
Results:
Gross total tumor removal was achieved in 80/85 cases (94.1%) in this study. All 37 cases with tumors in anterior skull base and all 14 cases with tumors in jugular foramen received total tumor removal. Thirteen and three cases with tumors in clivus received total and subtotal tumor removal, respectively. Total and subtotal tumor removal was performed for 16 cases and 2 cases in lateral skull base, respectively. The complications in this study included: cerebrospinal fluid leakage (n = 3), meningitis (n = 3), and new cranial nerve deficits (n = 3; recovered in 3 months after surgery). In the follow-up period of 40–151 months (median: 77 months), seven patients (8.8%) out of the 80 cases of total tumor removal experienced recurrence.
Conclusions:
Complete resection of intra-extracranial growing tumors in various skull base regions can be achieved via the pure ETA in one stage in selected cases. Surgical procedure for radical removal of tumors is feasible and safe.
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在阿尔茨海默病APPswe/PSEN1dE9小鼠模型的皮层和海马中观察到不同的Rab7相关的内体-自噬-溶酶体失调Li Ba, Xiao-Hua Chen, Yan-Lin Chen, Qing Nie, Zhi-Jun Li, Feng-Fei Ding, Min Zhang
中华医学杂志英文版2017年 130卷 24期
DOI: 10.4103/0366-6999.220311
摘要
Background:
Amyloid-β deposition and accumulation of autophagic vacuoles are pathologic features of Alzheimer’s disease (AD). Dysregulation of the endosomal–autophagic–lysosomal (EAL) pathway, which impairs amyloid precursor protein processing, is one of the earliest changes in AD. However, the precise role of EAL pathway in neurodegeneration remains unclear. This study aimed to investigate the role of EAL pathway in AD and further study the mechanism of EAL dysfunction.
Methods:
We used 3-, 7-, and 12-month-old APPswe/PSEN1dE9 (APP/PS1) mice to model different stages of AD with age- and gender-matched wild-type littermates as controls (4–7 mice per group) and detected the changes of EAL markers, endosomal organizers Rab5 and Rab7, autophagosome marker LC3B, and lysosomal proteins Lamp1/2 in cortex and hippocampus by immunohistochemistry and Western blotting analysis. To further explore the mechanism of EAL dysregulation in AD, components of the class III phosphatidylinositol 3-kinase (PI3KC3) complex, activators of Rab7 (Beclin1 and UVRAG), and the negative regulator of Rab7 (Rubicon) were also measured in this two brain regions.
Results:
In 7-month-old APP/PS1 brain that amyloid beta initiated to accumulate intracellularly, EAL pathway, and related PI3KC3 members, UVRAG and Beclin1 were upregulated both in cortex and hippocampus (all P< 0.05). By the age of 12 months old, when abundant amyloid plaques formed, EAL markers, UVRAG, and Beclin1 were also upregulated in the cortex (all P< 0.05). However, Rab7 was decreased significantly (P = 0.0447), accompanied by a reduction of its activating PI3KC complex component Beclin1 (P = 0.0215) and enhancement of its inhibiting component Rubicon (P = 0.0055) in the hippocampus.
Conclusions:
Our study implies that EAL pathway, represented as Rab7 and its PI3KC3 regulators’ expressions, showed temporal and spatial variation in brains at different stages of AD. It provides new insights into the role of EAL pathway in pathogenesis and indicates potential therapeutic targets in neurodegenerative diseases.
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成纤维细胞线粒体融合蛋白2表达与盆腔器官脱垂的相关性研究体外学习Ye Lu, Hua-Yun Chen, Xiao-Qing Wang, Jing-Xue Wang
中华医学杂志英文版2017年 130卷 24期
DOI: 10.4103/0366-6999.220307
摘要
Background:
Both Mitofusin 2 (Mfn2) and pelvic organ prolapse (POP) are related to aging. The aim of the present study was to investigate the variations of Mfn2 expression in the uterosacral ligaments of patients with and/or without POP and their correlations with the expression of procollagen.
Methods:
Fibroblasts were cultured using tissue specimens that were harvested from the uterosacral ligaments of POP and non-POP (NPOP) patients (n = 10 for each group) from September 2016 to December 2016. The Cell Counting Kit-8 (CCK-8) assay was used to compare the differences in cell proliferation between the two groups. Relative quantitative reverse transcription-polymerase chain reaction and Western blotting assays were employed to assess the differences in the mRNA and protein expression levels of Mfn2 and procollagen 1A1/1A2/3A1 between the two groups. The changes in procollagen expression were assessed following the downregulation of Mfn2 in the POP group using RNAi. The data were assessed with independent sample t-test or general linear model univariate analysis using the SPSS 13.0 software.
Results:
The results from CCK-8 assay indicated that cell viability in the POP group was significantly lower compared with that of the NPOP group (td5,7,9,11= −5.925, −6.851, −9.129, and −9.661, respectively, all P< 0.001, from D5 to D11). The mRNA and protein expression levels of Mfn2 in the cultured fibroblasts of the POP group were significantly higher compared with those of the NPOP group (mRNA: t = 2.425, P= 0.032; protein: t = 2.392, P= 0.037, respectively), whereas only the expression levels of procollagen 1A1/1A2/3A1 were significantly higher in the NPOP group (mRNA: t= −2.165, P1A1 = 0.041; t= −2.741, P1A2 = 0.026; t= −2.147, P3A1 = 0.045, respectively; protein: t= −2.418, P1A1 = 0.029; t= −2.405, P1A2 = 0.033; t= −2.470, P3A1 = 0.012, respectively). The expression levels of procollagen in the POP group increased following the downregulation of Mfn2.
Conclusions:
The proliferation rate and cell viability of the fibroblasts in the POP group were significantly lower compared with those in the NPOP group. In the POP fibroblasts, Mfn2 expression was increased, while procollagen expression was decreased.
Meta Analysis
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成人对侧C7神经根移位对功能恢复的Meta分析Wen-Jun Li, Li-Yue He, Shan-Lin Chen, Yan-Wei Lyu, Shu-Feng Wang, Yang Yong, Wen Tian, Guang-Lei Tian, Yu-Dong Gu
中华医学杂志英文版2017年 130卷 24期
DOI: 10.4103/0366-6999.220316
摘要
Background:
Root avulsion to all 5 roots of the brachial plexus is a common presentation and keeps a major reconstructive challenge. The contralateral C7 (CC7) nerve transfer has been used in treating brachial plexus avulsion injury (BPAI) since 1986. However, the effectiveness of the procedure remains a subject of controversy. The aim of this meta-analysis was to study surgical outcomes regarding motor and sensory recovery after CC7 nerve transfer.
Methods:
Chinese or English (i.e., "contralateral c-7" , "contralateral c7" , "c7 nerve root" , and "seventh cervical nerve root" ) keywords were used for a literature search for articles related to CC7 nerve transfer in several databases (i.e., PubMed, Cochrane, Embase, CNKI, CQVIP, and Wanfang Data). Clinical research articles were screened, and animal studies as well as duplicate publications were excluded. Muscle strength and sensory recovery were considered to be effective only when the scores on the United Kingdom Medical Research Council scale were equal to or higher than M3 and S3, respectively.
Results:
The overall ipsilateral recipient nerve recovery rates were as follows: the efficiency rate for muscle strength recovery after CC7 nerve transfer was 0.57 (95% confidence interval [CI]: 0.48- 0.66) and for sensory recovery was 0.52 (95% CI: 0.46–0.58). When the recipient nerve was the median nerve, the efficiency rate for muscle strength recovery was 0.50 (95% CI: 0.39- 0.61) and for sensory was 0.56 (95% CI: 0.50–0.63). When the recipient nerve was the musculocutaneous nerve and the radial nerve, the efficiency rate for muscle strength recovery was 0.74 (95% CI: 0.65- 0.82) and 0.50 (95% CI: 0.31- 0.70), respectively.
Conclusions:
Transfer of CC7 nerves to musculocutaneous nerves leads to the best results. CC7 is a reliable donor nerve, which can be safely used for upper limb function reconstruction, especially for entirely BPAI. When modifying procedures, musculocutaneous nerves and median nerve can be combined as recipient nerves.
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既往抗血小板治疗对原发性脑出血预后影响的Meta分析Hai-Han Yu, Chao Pan, Ying-Xin Tang, Na Liu, Ping Zhang, Yang Hu, Ye Zhang, Qian Wu, Hong Deng, Gai-Gai Li 等
中华医学杂志英文版2017年 130卷 24期
DOI: 10.4103/0366-6999.220302
摘要
Background:
Antiplatelet therapy (APT) was prevalently being used in the prevention of vascular disease, but the influence of prior APT on the prognosis of patients with intracerebral hemorrhage (ICH) remains controversial. This meta-analysis was to explore the effects of prior APT on the prognosis of patients with primary ICH.
Methods:
PubMed and Embase were searched to identify the eligible studies. The studies comparing the mortality of ICH patients with or without prior APT were included. The quality of these studies was evaluated by the Newcastle–Ottawa quality assessment scale. The adjusted or unadjusted odds ratio (OR) for mortality between ICH patients with and without prior APT were pooled with 95% confidence interval (95% CI) as the effect of this meta-analysis.
Results:
Twenty-two studies fulfilled the inclusion criteria and exhibited high qualities. The pooled OR was 1.37 (95% CI: 1.13–1.66, P= 0.001) for univariate analysis and 1.41 (95% CI: 1.05–1.90, P= 0.024) for multivariate analysis. The meta-regression indicated that for each 1-day increase in the time of assessment, the adjusted OR for the mortality of APT patients decreased by 0.0049 (95% CI: 0.0006–0.0091, P= 0.026) as compared to non-APT patients.
Conclusion:
Prior APT was associated with high mortality in patients with ICH that might be attributed primarily to its strong effect on early time.
Review Article
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Tau介导的神经变性及其在阿尔茨海默病诊断和治疗中的潜在意义Xi-Lin Wu, Juan Piña-Crespo, Yun-Wu Zhang, Xiao-Chun Chen, Hua-Xi Xu
中华医学杂志英文版2017年 130卷 24期
DOI: 10.4103/0366-6999.220313
摘要
Objective:
To review recent research advances on tau, a major player in Alzheimer’s disease (AD) pathogenesis, a biomarker for AD onset, and potential target for AD therapy.
Data Sources:
This review was based on a comprehensive search using online literature databases, including PubMed, Web of Science, and Google Scholar.
Study Selection:
Literature search was based on the following keywords: Alzheimer’s disease, tau protein, biomarker, cerebrospinal fluid (CSF), therapeutics, plasma, imaging, propagation, spreading, seeding, prion, conformational templating, and posttranslational modification. Relevant articles were carefully reviewed, with no exclusions applied to study design and publication type.
Results:
Amyloid plaques enriched with extracellular amyloid beta (Aβ) and intracellular neurofibrillary tangles comprised of hyperphosphorylated tau proteins are the two main pathological hallmarks of AD. Although the Aβ hypothesis has dominated AD research for many years, clinical Aβ-targeting strategies have consistently failed to effectively treat AD or prevent AD onset. The research focus in AD has recently shifted to the role of tau in AD. In addition to phosphorylation, tau is acetylated and proteolytically cleaved, which also contribute to its physiological and pathological functions. Emerging evidence characterizing pathological tau propagation and spreading provides new avenues for research into the molecular and cellular mechanisms underlying AD pathogenesis. Techniques to detect tau at minute levels in CSF and blood have been developed, and improved tracers have facilitated tau imaging in the brain. These advances have potential to accurately determine tau levels at early diagnostic stages in AD. Given that tau is a potential therapeutic target, anti-tau immunotherapy may potentially be a viable treatment strategy in AD intervention.
Conclusion:
Detecting changes in tau and targeting tau pathology represent a promising lead in the diagnosis and treatment of AD.
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前列腺癌治疗的现状与争议De-Xin Dong, Zhi-Gang Ji
中华医学杂志英文版2017年 130卷 24期
DOI: 10.4103/0366-6999.220317
摘要
Objective:
The optimal management strategy for prostate cancer (PCa) remains controversial. We performed a systemic review of current progress and controversies regarding the diagnosis and treatment of PCa.
Data Sources:
We searched PubMed for recently published articles up to July 2017 using the following key words: "prostate cancer," "progress," "controversy," "immunotherapy," and "prevention."
Study Selection:
Articles were obtained and reviewed to provide a systematic review of the current progress and controversies regarding PCa management.
Results:
The value of serum prostate-specific antigen (PSA) screening remains controversial, but PSA screening is recommended to facilitate the early diagnosis of PCa in high-risk groups. Prostate biopsy via the transrectal or perineal approach has both advantages and disadvantages. There was a significant correlation between testosterone levels and PCa prognosis. The current research is focused on the mechanisms responsible for PCa. Active surveillance has been proposed as a management strategy for low-risk, localized PCa, but there is an urgent need for further clinical studies to establish the criteria for recommending this approach. The main complications of radical resection for PCa are urinary incontinence and erectile dysfunction, though three-dimensional laparoscopic and robot-assisted laparoscopic techniques have obvious advantages over radical surgery. Radiotherapy is also a therapeutic option for PCa, while immunotherapies may alter the prostate tumor microenvironment. Ongoing studies aim to provide guidance on effective sequential and combination strategies. Prevention remains an important strategy for reducing PCa morbidity and mortality.
Conclusions:
The diagnosis, treatment, and prevention of PCa are complex issues, worthy of intensive study. Further studies are needed to improve the management of PCa.
Perspective
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周围神经损伤修复与重建的进展Bao-Guo Jiang, Na Han, Feng Rao, Yi-Lin Wang, Yu-Hui Kou, Pei-Xun Zhang
中华医学杂志英文版2017年 130卷 24期
DOI: 10.4103/0366-6999.220299
摘要
周围神经损伤是临床上常见的问题，因为远端肢体功能障碍严重影响患者的生活质量，并由此造成巨大的社会和经济负担。[
Clinical Observation
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老年人上颌前磨牙根管形态研究Zhi-Yun Shi, Nan Hu, Xiao-Wei Shi, Xi-Xi Dong, Long Ou, Jun-Kai Cao
中华医学杂志英文版2017年 130卷 24期
DOI: 10.4103/0366-6999.220295
摘要
据报道，上颌前磨牙是进行牙髓治疗最复杂的牙齿，[
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在夜间睡眠受限的受试者中，孤立的促甲状腺素升高与夜间睡眠不足相关Yue-Rong Yan, Jia-Qi Li, Ye-Rong Yu
中华医学杂志英文版2017年 130卷 24期
DOI: 10.4103/0366-6999.220303
摘要
轻度促甲状腺激素（TSH）升高非常普遍，而大部分TSH升高的个体没有慢性自身免疫性甲状腺疾病。TSH分泌表现出每日昼夜节律，我们之前报道过睡眠障碍患者的TSH水平明显高于对照组。[
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美白产品致汞中毒的特点Gui-Fang Sun, Wen-Tao Hu, Zhi-Hao Yuan, Bo-Ai Zhang, Hong Lu
中华医学杂志英文版2017年 130卷 24期
DOI: 10.4103/0366-6999.220312
摘要
由于汞的美白作用，汞通常被添加到美白产品中。美国食品药品监督管理局（FDA）将化妆品中的汞含量限制在1 ppm以下。尽管如此，许多化妆品含有1000 ppm以上的汞，以增加美白效果。在研究中的一组特殊患者中，疼痛、肾损害和神经精神症状是观察到的主要症状。
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药物性肝损伤梅氏鳞翅目（玛咖）药酒An Xiao, Hai-Ying He, Qing Chen, Shi-Wu Ma
中华医学杂志英文版2017年 130卷 24期
DOI: 10.4103/0366-6999.220314
摘要
药物性肝损伤（DILI）是最常见和最严重的药物不良反应之一。特异性DILI比内源性DILI更常见，可分为肝细胞损伤、胆汁淤积性损伤、肝细胞-胆汁淤积性混合性损伤和血管损伤。[
Clinical Challenge
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13号染色体镶嵌环胎儿的分子和细胞遗传学特征：一个非常罕见的病例Xin-Rong Zhao, Xu Han, Yan-Lin Wang, Wen-Jing Hu
中华医学杂志英文版2017年 130卷 24期
DOI: 10.4103/0366-6999.220308
摘要
环状染色体形成的主要机制被认为是由于染色体长臂和短臂上的断裂点处的断裂和重聚。该融合事件可以产生末端臂倒位、缺失和重复，其决定所得表型。[
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的一种新突变PRKAR1A在一名中国患者中引起卡尼综合征Xiao-Ling Cai, Jing Wu, Ying-Ying Luo, Ling Chen, Xue-Yao Han, Li-Nong Ji
中华医学杂志英文版2017年 130卷 24期
DOI: 10.4103/0366-6999.220309
摘要
原发性色素结节性肾上腺皮质疾病（PPNAD）引起促肾上腺皮质激素（ACTH）非依赖性库欣综合征（CS），这是卡尼复合体（CNC）最常见的内分泌表现。[
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巨大先天性左心耳动脉瘤He-Qing Wang, Zhe Zhang, Hang Yang, Song Wu, Yuan-Hao Fu, Zhi-Ming Song, Feng Wan
中华医学杂志英文版2017年 130卷 24期
DOI: 10.4103/0366-6999.220301
摘要
左心耳动脉瘤（LAAA）是一种极为罕见的心脏异常，主要表现为左心耳局限性或弥漫性扩张。[
Clinical Picture
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腹腔镜成功治疗14周原发性肝异位妊娠合并子宫角残留Ren-Feng Zhao, Shun-Rong Huang, Li-Li Xu, Ni-Ping Liu, Ning Liang
中华医学杂志英文版2017年 130卷 24期
DOI: 10.4103/0366-6999.220298
摘要
腹内妊娠是罕见的，大约每10,000名新生儿中就有1人受到影响。它发生在1.4%的异位妊娠中，死亡率为5.1/1000例，是非腹部异位妊娠的7.7倍。本研究旨在介绍一例使用超声、计算机断层扫描（CT）和磁共振成像（MRI）诊断并使用腹腔镜显微手术治疗的14周原发性肝异位妊娠活体病例。
Correspondence
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拟除虫菊酯的副作用及洋葱对雄性大鼠精子发生的支持作用Arash Khaki, Asghar Rajabzadeh, Amir Afshin Khaki
中华医学杂志英文版2017年 130卷 24期
DOI: 10.4103/0366-6999.220297
摘要
致编者：氯菊酯是一种伟大的手工化学制剂，拟除虫菊酯I型，以顺式和反式两种主要异构体存在。[
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结节性硬化症患者的肺淋巴管肌瘤病伴肾和肝血管平滑肌脂肪瘤肿块Hong-Sheng Lu, Xue-Quan Cao, Wei-Fei Chen
中华医学杂志英文版2017年 130卷 24期
DOI: 10.4103/0366-6999.220310
摘要
致编辑：结节性硬化症(TSC)是一种罕见的常染色体显性和可变外显率，每10万人中约有10人受到影响。[
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滑膜肉瘤皮肤转移1例Xue Zeng, Li Li, Wa-Li Liu
中华医学杂志英文版2017年 130卷 24期
DOI: 10.4103/0366-6999.220318
摘要
编辑：滑膜肉瘤（SS）是一种相对罕见的软组织肉瘤，约占所有软组织肉瘤的8%。SS常发生于四肢的关节旁结构，主要见于下肢。其他涉及的侵犯部位是肺、淋巴结和骨。然而，皮肤很少涉及。[
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复合杂合丙氨酰-tRNA合成酶2突变引起的无卵巢衰竭的脑白质营养不良Jian Sun, Chao Quan, Su-Shan Luo, Lei Zhou, Chong-Bo Zhao
中华医学杂志英文版2017年 130卷 24期
DOI: 10.4103/0366-6999.220300
摘要
致编辑：线粒体丙氨酰-tRNA合成酶2基因突变（AARS2)导致慢性进行性脑白质营养不良或婴儿心肌病。迄今为止，已有15例患者报告患有慢性进行性脑白质营养不良。值得注意的是，所有女性患者（9/15）都出现卵巢衰竭，描述为“卵巢白质营养不良”。[
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Pagetoid Bowen病1例Tian Zhu, Tao Wang, Dong-Lai Ma, Ya-Nan Wang, Li Li
中华医学杂志英文版2017年 130卷 24期
DOI: 10.4103/0366-6999.220315
摘要
致编者：一位65岁的女性，在过去的7年里，左大腿后部出现了一个红棕色的皮肤斑块。最初，病变为轻度隆起、界限分明的斑块，表面光滑，直径约1cm，无任何症状。多年来，它慢慢延伸成表面粗糙的隆起斑块，经常在轻微摩擦后出血。体格检查发现左大腿后部有一明显隆起、界限分明的红棕色斑块（3.0 cm × 2.7 cm），被结痂覆盖[
Erratum
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勘误表：上海评分：为中国肝癌根治性切除术后患者构建的预后和辅助治疗评估系统中华医学杂志英文版2017年 130卷 24期
DOI: 10.4103/0366-6999.220321
摘要
在题为“上海评分：为中国肝癌根治性切除术后患者构建的预后和辅助治疗评估系统”的文章中，发表在第130卷第22期第2650-2660页中华医学杂志,[
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