MedNexus
2019年 · 第132卷第06期
出版日期 2019-03-20电子版 ￥0.00元
MedNexus
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Original Article
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皮下和经静脉心律转复除颤器的比较结果Jin-Jun Liang, Hideo Okamura, Roshini Asirvatham, Andrew Schneider, David O. Hodge, Mei Yang, Xu-Ping Li, Ming-Yan Dai, Ying Tian, Pei Zhang 等
中华医学杂志英文版2019年 132卷 06期
DOI: 10.1097/CM9.0000000000000133
摘要
Background:
The comparative outcomes of subcutaneous implantable cardioverter-defibrillator (S-ICD) and transvenous ICD (T-ICD) have not been well studied. The aim of this study was to evaluate the safety and efficacy of currently available S-ICD and T-ICD.
Methods:
The study included 86 patients who received an S-ICD and 1:1 matched to those who received single-chamber T-ICD by gender, age, diagnosis, left ventricular ejection fraction (LVEF), and implant year. The clinical outcomes and implant complications were compared between the two groups.
Results:
The mean age of the 172 patients was 45 years, and 129 (75%) were male. The most common cardiac condition was hypertrophic cardiomyopathy (HCM, 37.8%). The mean LVEF was 50%. At a mean follow-up of 23 months, the appropriate and inappropriate ICD therapy rate were 1.2% vs. 4.7% (χ2 = 1.854, P = 0.368) and 9.3% vs. 3.5% (χ2 = 2.428, P = 0.211) in S-ICD and T-ICD groups respectively. There were no significant differences in device-related major and minor complications between the two groups (7.0% vs. 3.5%, χ2 = 1.055, P= 0.496). The S-ICD group had higher T-wave oversensing than T-ICD group (9.3% vs. 0%, χ2= 8.390, P= 0.007). Sixty-five patients had HCM (32 in S-ICD and 33 in T-ICD). The incidence of major complications was not significantly different between the two groups.
Conclusions:
The efficacy of an S-ICD is comparable to that of T-ICD, especially in a dominantly HCM patient population. The S-ICD is associated with fewer major complications demanding reoperation.
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环丙沙星在中国老年革兰阴性菌下呼吸道感染患者中的药代动力学—药效学分析Xiao-Yan Gai, Shi-Ning Bo, Ning Shen, Qing-Tao Zhou, An-Yue Yin, Wei Lu
中华医学杂志英文版2019年 132卷 06期
DOI: 10.1097/CM9.0000000000000136
摘要
Background:
Ciprofloxacin is usually used in the treatment of lower respiratory tract infections (LRTIs). Recent studies abroad have shown ciprofloxacin is inadequately dosed and might lead to worse outcomes. The aim of this study was to perform pharmacokinetic and pharmacodynamic analyses of ciprofloxacin in elderly Chinese patients with severe LRTIs caused by Gram-negative bacteria.
Methods:
From September 2012 to June 2014, as many as 33 patients were empirically administered beta-lactam and ciprofloxacin combination therapy. Patients were infused with 200 or 400 mg of ciprofloxacin every 12 h, which was determined empirically by the attending physician based on the severity of the LRTI and the patient’s renal condition. Ciprofloxacin serum concentrations were determined by high-performance liquid chromatography. Bacterial culture was performed from sputum samples and/or endotracheal aspirates, and the minimum inhibitory concentrations (MICs) of ciprofloxacin were determined. The ratios of the area under the serum concentration-time curve to the MIC (AUC/MIC) and of the maximum serum concentration of the drug to the MIC (Cmax/MIC) were calculated. The baseline data and pharmacokinetic parameters were compared between clinical success group and clinical failure group, bacteriologic success group and bacteriologic failure group.
Results:
Among the 33 patients enrolled in the study, 17 were infected with Pseudomonas aeruginosa, 14 were infected with Acinetobacter baumannii, and two were infected with Klebsiella pneumoniae. The mean age of the patients was 76.9 ± 6.7 years. Thirty-one patients (93.4%) did not reach the target AUC/MIC value of >125, and 29 patients (87.9%) did not reach the target Cmax/MIC value of >8. The AUC/MIC and Cmax/MIC ratios in the clinical success group were significantly higher than those in the clinical failure group (61.1 [31.7–214.9] vs. 10.4 [3.8–66.1], Z=－4.157; 9.6 [4.2–17.8] vs. 1.3 [0.4–4.7], Z=－4.018; both P < 0.001). The AUC/MIC and Cmax/MIC ratios in the patients for whom the pathogens were eradicated were significantly higher than those in the patients without the pathogens eradicated (75.3 [31.7–214.9] vs. 10.5 [3.8–66.1], Z=－3.938; 11.4 [4.2–17.8] vs. 1.4 [0.4–5.4], Z =－3.793; P < 0.001 for both). Receiver operating characteristic curve analysis showed that the AUC/MIC and Cmax/MIC values were closely associated with clinical and bacteriologic efficacies (P < 0.001 in both).
Conclusions:
Ciprofloxacin is inadequately dosed against Gram-negative bacteria, especially for those with relatively high MIC values. Consequently, the target values, AUC/MIC > 125 and Cmax/MIC > 8, cannot be reached.
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免疫球蛋白A肾病的无创诊断模型和评估疾病严重程度的血清学标志物Qiu-Xia Han, Yong Wang, Han-Yu Zhu, Dong Zhang, Jing Gao, Zhang-Suo Liu, Guang-Yan Cai, Xiang-Mei Chen
中华医学杂志英文版2019年 132卷 06期
DOI: 10.1097/CM9.0000000000000121
摘要
Background:
Immunoglobulin A nephropathy (IgAN) is the most common pathological type of glomerular disease. Kidney biopsy, the gold standard for IgAN diagnosis, has not been routinely applied in hospitals worldwide due to its invasion nature. Thus, we aim to establish a non-invasive diagnostic model and determine markers to evaluate disease severity by analyzing the serological parameters and pathological stages of patients with IgAN.
Methods:
A total of 272 biopsy-diagnosed IgAN inpatients and 518 non-IgA nephropathy inpatients from the Department of Nephrology of Chinese People’s Liberation Army General Hospital were recruited for this study. Routine blood examination, blood coagulation testing, immunoglobulin-complement testing, and clinical biochemistry testing were conducted and pathological stages were analyzed according to Lee grading system. The serological parameters and pathological stages were analyzed. The receiver operating characteristic (ROC) analysis was performed to estimate the diagnostic value of the clinical factors. Logistic regression was used to establish the diagnostic model.
Results:
There were 15 significantly different serological parameters between the IgAN and non-IgAN groups (all P < 0.05). The ROC analysis was performed to measure the diagnostic value for IgAN of these parameters and the results showed that the area under the ROC curve (AUC) of total protein (TP), total cholesterol (TC), fibrinogen (FIB), D-dimer (D2), immunoglobulin A (IgA), and immunoglobulin G (IgG) were more than 0.70. The AUC of the "TC+ FIB+ D2+ IgA+ age" combination was 0.86, with a sensitivity of 85.98% and a specificity of 73.85%. Pathological grades of I, II, III, IV, and V accounted for 2.21%, 17.65%, 62.50%, 11.76%, and 5.88%, respectively, with grade III being the most prevalent. The levels of urea nitrogen (UN) (13.57 ± 5.95 vs. 6.06 ± 3.63, 5.92 ± 2.97, 5.41 ± 1.73, and 8.41 ± 3.72 mmol/L, respectively) and creatinine (Cr) (292.19 ± 162.21 vs. 80.42 ± 24.75, 103.79 ± 72.72, 96.41 ± 33.79, and 163.04 ± 47.51 μmol/L, respectively) were significantly higher in grade V than in the other grades, and the levels of TP (64.45 ± 7.56, 67.16 ± 6.94, 63.22 ± 8.56, and 61.41 ± 10.86 vs. 37.47 ± 5.6 mg/d, respectively), direct bilirubin (DB) (2.34 ± 1.23, 2.58 ± 1.40, 1.91 ± 0.97, and 1.81 ± 1.44 vs. 0.74 ± 0.57 μmol/L, respectively), and IgA (310.35 ± 103.78, 318.48 ± 107.54, 292.58 ± 81.85, and 323.29 ± 181.67 vs. 227.17 ± 68.12 g/L, respectively) were significantly increased in grades II–V compared with grade I (all P < 0.05).
Conclusions:
The established diagnostic model that combined multiple factors (TC, FIB, D2, IgA, and age) might be used for IgAN non-invasive diagnosis. TP, DB, IgA, Cr, and UN have the potential to be used to evaluate IgAN disease severity.
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103例小儿上气道咳嗽综合征Fan Gao, Qing-Long Gu, Zi-Dong Jiang
中华医学杂志英文版2019年 132卷 06期
DOI: 10.1097/CM9.0000000000000118
摘要
Background:
In China, upper airway cough syndrome (UACS) is only less frequent than cough-variant asthma and accounts for 24.71% of chronic cough. This study aimed to determine the pathogenetic constituents and factors affecting UACS in children of different age groups, and to identify clinical clues for diagnosing UACS and a method for curative effect evaluation.
Methods:
A total of 103 children with UACS whose chief complaint was chronic cough were studied from January to November 2013 at Children’s Hospital, Capital Institute of Pediatrics. According to their age, children with UACS were divided into 3 groups: nursing children, pre-school children, and school-age children. We analyzed the differences in pathogenetic constituents and factors affecting UACS in children. The effect of UACS treatment was evaluated by the visual analog scale (VAS) and an objective examination. Chi-squared test and analysis of variance were performed with the SPSS 19.0 statistical software.
Results:
There was a high incidence of UACS in school-age children. Rhinitis with adenoid hypertrophy was the main cause of 103 suspected UACS cases. Adenoidal hypertrophy was the major cause of UACS in the pre-school children group, while rhinitis was the major reason in the nursing children and school-age children groups. Among the 103 children, there were 45 allergen-positive children, with no significant difference among different age groups. VAS scores in the different disease groups after treatment were lower than those before treatment (all P < 0.01). VAS scores in different disease groups showed significant differences, except for 12 vs. 24 weeks after treatment (P= 0.023). Different age groups had different secondary complaints.
Conclusions:
There are different pathogeneses in different UACS age groups. Clinical treatment efficacy of children with UACS can be evaluated by the VAS combined with an objective examination. We recommend that the course of treatment should be 12 weeks.
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水痘—带状疱疹病毒作为年轻患者急性视网膜坏死的病原体Hai-Yan Xu, Meng-Da Li, Jun-Jie Ye, Chan Zhao, Yun-Tao Hu, Yu Di
中华医学杂志英文版2019年 132卷 06期
DOI: 10.1097/CM9.0000000000000124
摘要
Background:
Herpes virus is considered to be the pathogen of acute retinal necrosis (ARN) infection. Previous studies have found that patients with ARN caused by the varicella-zoster virus (VZV) are often older, and patients with herpes simplex virus (HSV) induced ARN are considerably younger. However, in our clinical work, we find that VZV is also a pathogen in younger ARN patients. We, therefore, aimed to analyze the common etiology of younger ARN patients.
Methods:
A retrospective analysis was made of 20 eyes (18 patients) diagnosed as having ARN in the Department of Ophthalmology of Peking Union Medical College Hospital from 2014 to 2016. All patients were reviewed for demographic data, clinical course, clinical manifestations, time from onset to initial physician visit, duration of follow-up, visual acuity at both presentation and final visit, and treatment strategies. A paired t test was used to compare visual acuity between the presenting vision and those of final follow-up. Vitreous or aqueous specimens from 18 eyes of 18 patients were analyzed with multiplex polymerase chain reaction (mPCR)/quantitative PCR (qPCR) and xTAG-liquid chip technology (xTAG-LCT) to determine the causative virus of ARN.
Results:
Final best visual acuity (BCVA) improved significantly from 1.36 ± 0.95 (median 20/400) to 0.95 ± 0.82 (median 20/100) (t= 2.714, P= 0.015) after systemic and intravitreal antiviral treatment combined with or without pars plana vitrectomy. PCR and xTAG-LCT results showed four of the five samples in the younger group (32.2 ± 5.2 years) and 12 of the 13 samples in the senior group (53.6 ± 4.9 years) were positive for VZV, and two of the five samples in the younger group were positive for HSV-1.
Conclusions:
This study demonstrates that VZV is also a common causative virus for ARN in younger patients. Considering this finding, a systemic antiviral treatment protocol should be immediately changed to intravenous ganciclovir when the patient does not respond to acyclovir before determining the causative virus, especially in younger patients.
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苦参碱通过抑制上皮-间质转化抑制脂多糖诱导的人腹膜间皮细胞纤维化Yi-Zheng Li, Xi Peng, Yun-Hua Ma, Fu-Ji Li, Yun-Hua Liao
中华医学杂志英文版2019年 132卷 06期
DOI: 10.1097/CM9.0000000000000127
摘要
Background:
Peritoneal fibrosis is the primary reason that patients with end-stage renal disease (ESRD) have to cease peritoneal dialysis. Peritonitis caused by Gram-negative bacteria such as Escherichia coli (E. coli) were on the rise. We had previously shown that matrine inhibited the formation of biofilm by E. coli. However, the role of matrine on the epithelial-mesenchymal transition (EMT) in peritoneal mesothelial cells under chronic inflammatory conditions is still unknown.
Methods:
We cultured human peritoneal mesothelial cells (HPMCs) with lipopolysaccharide (LPS) to induce an environment that mimicked peritonitis and investigated whether matrine could inhibit LPS-induced EMT in these cells. In addition, we investigated the change in expression levels of the miR-29b and miR-129-5p.
Results:
We found that 10 μg/ml of LPS induced EMT in HPMCs. Matrine inhibited LPS-induced EMT in HPMCs in a dose-dependent manner. We observed that treatment with matrine increased the expression of E-cadherin (F= 50.993, P < 0.01), and decreased the expression of alpha-smooth muscle actin (F= 32.913, P < 0.01). Furthermore, we found that LPS reduced the expression levels of miR-29b and miR-129-5P in HPMCs, while matrine promoted the expression levels of miR-29b and miR-129-5P.
Conclusions:
Matrine could inhibit LPS-induced EMT in HPMCs and reverse LPS inhibited expressions of miR-29 b and miR-129-5P in HPMCs, ultimately reduce peritoneal fibrosis. These findings provide a potential theoretical basis for using matrine in the prevention and treatment of peritoneal fibrosis.
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雷帕霉素信号通路的哺乳动物靶点在普伐他汀治疗的子痫前期样小鼠模型中脂肪酸氧化调节中的作用Jing Huai, Zi Yang, Yan-Hong Yi, Guang-Jiao Wang
中华医学杂志英文版2019年 132卷 06期
DOI: 10.1097/CM9.0000000000000129
摘要
Background:
Fatty acid oxidation (FAO) disorder is involved in the pathogenesis of some cases of preeclampsia (PE). Several studies show that mammalian target of rapamycin (mTOR) signaling pathway is related to FAO. Pravastatin (Pra) can promote FAO in Nω-nitro-L-arginine methyl ester (L-NAME) PE-like mouse model in our previous study. This study aimed to investigate the effect of mTOR signaling pathway in PE-like model treated with Pra.
Methods:
Pregnant mice were randomly injected with L-NAME as PE-like model group or saline as control group respectively, from gestational 7th to 18th day. Giving Pra (L-NAME + Pra, Control + Pra, n = 8) or normal saline (NS; L-NAME + NS, Control + NS, n = 8) from gestational 8th to 18th day, the mice were sacrificed on day 18 and their liver and placental tissues were collected. Then the activation of mTOR and its substrates in the liver and placenta were detected. And the association between mTOR activation and serum free fatty acid (FFA) levels and the expression of long-chain 3-hydroxyacyl-coenzyme A dehydrogenase (LCHAD) were evaluated using Pearson correlation test. Differences between groups were analyzed using independent t-test or one-way analysis of variance (ANOVA).
Results:
Both in the maternal liver and placenta, the activation of mTOR protein and its effect on substrates increased significantly in the L-NAME + NS group and decreased significantly in the L-NAME + Pra group. The p-mTOR/mTOR protein ratio decreased in the L-NAME + Pra group significantly than that in the L-NAME + NS group both in liver and placenta (liver: 0.74 ± 0.08 vs. 0.85 ± 0.06, t= 2.95, P < 0.05; placenta: 0.63 ± 0.06 vs. 0.77 ± 0.06, t= 4.64, P < 0.05). The activation of mTOR protein in the liver and placenta negatively correlated with the expression of LCHAD in the L-NAME+ NS group (liver: r= －0.745, P < 0.05; placenta: r= －0.833, P < 0.05) and that in the maternal liver negatively correlated with the expression of LCHAD (r= －0.733, P < 0.05) and positively with the serum FFA levels (r= 0.841, P < 0.05) in the L-NAME + Pra group.
Conclusion:
The inhibition of mTOR signaling pathway might be involved in the regulation of FAO in mouse model treated with Pra.
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培养的脂肪间充质干细胞聚集体—细胞外基质移植修复耳廓及耳道上皮缺损Wen-Jin Zhang, Lei-Guo Ming, Jian-Jun Sun
中华医学杂志英文版2019年 132卷 06期
DOI: 10.1097/CM9.0000000000000125
摘要
Background:
Several patients experience persistent otorrhea after a flawless surgical procedure because of insufficient epithelial healing. Several efforts, such as autologous tissue allograft and xenograft, have been made to halt otorrhea. However, a stable technology to induce temporal epithelial repair is yet to be established. Therefore, this study aims to investigate whether implantation of seeding adipose-derived mesenchymal stem cell (ADMSC) aggregates on extracellular matrix (ECM; herein, ADMSC aggregate-ECM) into damaged skin wound promotes skin regeneration.
Methods:
ADMSC aggregate-ECM was prepared using a previously described procedure that isolated ADMSCs from rabbits and applied to the auricle and auditory meatus wound beds of New Zealand white rabbits. Wound healing was assessed by general observation and hematoxylin and eosin (H&E) staining. Secretion of growth factor of the tissue was evaluated by western blotting. Two other groups, namely, ECM and control, were used. Comparisons of three groups were conducted by one-way analysis of variance analysis.
Results:
ADMSCs adhered tightly to the ECM and quickly formed cell sheets. At 2 weeks, general observation and H&E staining indicated that the wound healing rates in the ADMSC aggregate-ECM (69.02 ± 6.36%) and ECM (59.32 ± 4.10%) groups were higher than that in the control group (43.74 ± 12.15%; P= 0.005, P < 0.001, respectively) in ear auricle excisional wounds. At 7 weeks, The scar elevation index was evidently reduced in the ADMSC aggregate-ECM (2.08 ± 0.87) and ECM (2.31 ± 0.33) groups compared with the control group (4.06 ± 0.45; P < 0.001, P < 0.001, respectively). In addition, the scar elevation index of the ADMSC aggregate-ECM group reached the lowest rate 4 weeks in advance. In auditory meatus excisional wounds, the ADMSC aggregate-ECM group had the largest range of normal skin-like structure at 4 weeks. The ADMSC aggregate–ECM and ECM groups secreted increased amounts of growth factors that contributed to skin regeneration at weeks 1 and 2, respectively.
Conclusions:
ADMSC aggregate-ECM and ECM are effective repair materials for wound healing, especially ADMSC aggregate-ECM. This approach will provide a meaningful experimental basis for mastoid epithelium repair in subsequent clinical trials.
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白细胞介素-18在咪喹莫特诱导的银屑病小鼠模型中加重皮肤炎症并影响微脓肿和鳞屑形成Xue-Li Niu, Yu Huang, Ya-Li Gao, Yu-Zhe Sun, Yang Han, Hong-Duo Chen, Xing-Hua Gao, Rui-Qun Qi
中华医学杂志英文版2019年 132卷 06期
DOI: 10.1097/CM9.0000000000000140
摘要
Background:
As a potent pro-inflammatory cytokine of the interleukin (IL)-1 family, IL-18 was elevated in early active and progressive plaque-type psoriatic lesions and that serum or plasma levels of IL-18 correlated with the Psoriasis Area and Severity Index (PASI). Although results from previous studies have established that IL-18 may aggravate psoriatic inflammation, the mechanisms of this process remain unknown. In this study, IL-18 knock out (KO) mice and wild-type (WT) mice were used to investigate the effects of IL-18 within a mouse model of psoriasis.
Methods:
WT and IL-18 KO mice were divided into four groups, including imiquimod (IMQ)-treated IL-18 KO group (n= 11) and WT group (n= 13) as well as their respectively gene-matched control mice (receiving vaseline; n= 12). PASI scores were used to evaluate psoriatic lesions in IMQ-treated mice. Pathological features and dermal cellular infiltration were investigated by hematoxylin and eosin staining. The levels of psoriasis-related cytokines including IL-23, IL-17, IL-12, IL-1β, IFNγ, IL-15, IL-27, and IL-4 were tested by real-time polymerase chain reaction (PCR). The protein level of IL-1β, IL-27, CXCL1, and Ly6 g were investigated by immunohistochemistry (IHC).
Results:
Acanthosis (98.46 ± 14.12 vs. 222.68 ± 71.10 μm, P < 0.01) and dermal cell infiltration (572.25 ± 47.45 vs. 762.47 ± 59.59 cells/field, P < 0.01) were significantly milder in IMQ-induced IL-18 KO mice compared with that in WT mice. IMQ-induced IL-18 KO mice manifested larger areas of Munro microabscesses (11,467.83 ± 5112.09 vs. 4093.19 ± 2591.88 μm2, P < 0.01) and scales (100,935.24 ± 41,167.77 vs. 41,604.41 ± 14,184.10 μm2, P < 0.01) as compared with WT mice. In skin lesions of IL-18 KO mice, the expressions of IL-1β, IL-4, and IL-27 were all significantly upregulated but IL-17 was decreased. Histologically, strong positive signals of Ly6g were observed within the epidermis of IL-18 KO mice but expressions of CXCL1 were decreased.
Conclusions:
IL-18 may exacerbate prominent inflammation and influence pathological features in IMQ-induced mouse model of psoriasis. IL-18 may upregulate pro-inflammatory cytokines and reduce protective cytokines, thus aggravating psoriatic inflammation. In addition, IL-18 may be involved in the formation of Munro microabscesses and scales.
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高压氧通过激活基质细胞衍生因子-1/CXC趋化因子受体4轴和促进脑源性神经营养因子表达促进脊髓损伤后大鼠功能恢复Xiang-Long Meng, Yong Hai, Xi-Nuo Zhang, Yun-Sheng Wang, Xue-Hua Liu, Lin-Lin Ma, Rong Yue, Gang Xu, Zhuo Li
中华医学杂志英文版2019年 132卷 06期
DOI: 10.1097/CM9.0000000000000115
摘要
Background:
Spinal cord injury (SCI) is a worldwide medical concern. This study aimed to elucidate the mechanism underlying the protective effect of hyperbaric oxygen (HBO) against SCI-induced neurologic defects in rats via exploring the stromal cell-derived factor-1 (SDF-1)/CXC chemokine receptor 4 (CXCR4) axis and expression of brain-derived neurotrophic factor (BDNF).
Methods:
An acute SCI rat model was established in Sprague-Dawley rats using the Allen method. Sixty rats were divided into four groups (n= 15 in each group): sham-operated, SCI, SCI treated with HBO (SCI+ HBO), and SCI treated with both HBO and AMD3100 (an antagonist of CXCR4; SCI+ HBO+ AMD) groups. The rats were treated with HBO twice a day for 3 days and thereafter once a day after the surgery for up to 28 days. Following the surgery, neurologic assessments were performed with the Basso-Bettie-Bresnahan (BBB) scoring system on postoperative day (POD) 7, 14, 21, and 28. Spinal cord tissues were harvested to assess the expression of SDF-1, CXCR4, and BDNF at mRNA and protein levels, using quantitative real-time polymerase chain reaction, Western blot analysis, and histopathologic analysis.
Results:
HBO treatment recovered SCI-induced descent of BBB scores on POD 14, (1.25 ± 0.75 vs. 1.03 ± 0.66, P < 0.05), 21 (5.27 ± 0.89 vs. 2.56 ± 1.24, P < 0.05), and 28 (11.35 ± 0.56 vs. 4.23 ± 1.20, P < 0.05) compared with the SCI group. Significant differences were found in the mRNA levels of SDF-1 (mRNA: day 21, SCI+ HBO vs. SCI+ HBO+ AMD, 2.89 ± 1.60 vs. 1.56 ± 0.98, P < 0.05), CXCR4 (mRNA: day 7, SCI+ HBO vs. SCI, 2.99 ± 1.60 vs.1.31 ± 0.98, P < 0.05; day 14, SCI+ HBO vs. SCI+ HBO+ AMD, 4.18 ± 1.60 vs. 0.80 ± 0.34, P < 0.05; day 21, SCI+ HBO vs. SCI, 2.10 ± 1.01 vs.1.15 ± 0.03, P < 0.05), and BDNF (mRNA: day 7, SCI+ HBO vs. SCI, 3.04 ± 0.41 vs. 2.75 ± 0.31, P < 0.05; day 14, SCI+ HBO vs. SCI, 3.88 ± 1.59 vs. 1.11 ± 0.40, P < 0.05), indicating the involvement of SDF-1/CXCR4 axis in the protective effect of HBO.
Conclusions:
HBO might promote the recovery of neurologic function after SCI in rats via activating the SDF-1/CXCR4 axis and promoting BDNF expression.
Review Article
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围手术期针灸医学：替代针灸麻醉的新概念Wei Yuan, Qiang Wang
中华医学杂志英文版2019年 132卷 06期
DOI: 10.1097/CM9.0000000000000123
摘要
Objective:
To confirm that acupuncture applied to patients would improve the clinical curative effect and accelerate the patient’s recovery by introducing the application of acupuncture in pre-operation, during operation, and post-operation.
Data sources:
Literature cited in this review was retrieved from PubMed, Web of Science, and China National Knowledge Infrastructure (CNKI) and was primarily published in English or Chinese from 2010 to 2018, with keywords of "acupuncture," "electroacupuncture," "perioperative period," "sedation," "analgesia," and "recovery." Relevant citations in the retrieved articles were also screened to include more data.
Study selection:
All retrieved literature was scrutinized, most typical articles related on perioperative acupuncture application in clinical study were reviewed.
Results:
Acupuncture could relieve anxiety and stress during the preoperative stage. It reduces the usage of narcotics and stress response, and maintains the respiratory stability and homeostasis during surgery. It also exerts a protective effect on vital organs, and during the postoperative stages, enhances the recovery while effectively alleviating the postoperative pain. This phenomenon prevents common postoperative discomforts such as nausea and vomiting. In addition, it might improve the patients’ long-term prognosis.
Conclusions:
The novel concept "perioperative acupuncture medicine" is to focus on the optimal treatment in the perioperative period of surgical patients. The review reveals the important role of acupuncture in enhancing rapid recovery of patients during the perioperative period.
Correspondence
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一例MELAS和线粒体DNA T14487C突变患者的迟发性线粒体疾病Xue-Bi Xu, Kun-Qian Ji, Jing-Wei Lyu, Shu Zhang, Xiao-Qing Lyu, Chang Liu, Wei Li, Chuan-Zhu Yan, Yu-Ying Zhao
中华医学杂志英文版2019年 132卷 06期
DOI: 10.1097/CM9.0000000000000139
摘要
致编辑：线粒体脑肌病伴乳酸酸中毒和卒中样发作（MELAS）是最常见的多系统线粒体疾病之一，具有广泛的临床表现。[
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副肿瘤性运动神经元病1例Man-Ge Liu, Jing-Wen Niu, Li-Ying Cui
中华医学杂志英文版2019年 132卷 06期
DOI: 10.1097/CM9.0000000000000128
摘要
致编辑：运动神经元疾病(MND)的特征是上(UMN)或下(LMN)运动神经元体征和症状，[
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延迟血管内介入和亚低温治疗基底动脉闭塞成功Dong-Mei Wang, Zhen-Zhou Lin, Sheng-Nan Wang, Yong-Ming Wu, Yue Pan, Su-Yue Pan, Zhong Ji
中华医学杂志英文版2019年 132卷 06期
DOI: 10.1097/CM9.0000000000000131
摘要
致编辑：急性基底动脉闭塞（BAO）是卒中的一种灾难性变异，约占所有卒中的1%。[
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新生儿合并气管食管瘘、食管闭锁和十二指肠梗阻的外科治疗Zhu-Ping Cao, Qi-Feng Li, Shi-Qi Liu, Jian-Hua Niu, Jing-Ru Zhao, Ya-Jun Chen, Da-Yong Wang, Xiao-Song Li
中华医学杂志英文版2019年 132卷 06期
DOI: 10.1097/CM9.0000000000000102
摘要
致编辑：在新生儿中，食管闭锁（EA）和气管食管瘘（TEF）的发生率约为1/3000。[
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一例18岁成人罕见的右侧先天性膈疝伴回肠和结肠疝入胸腔Hui-Hui Chen, Yan Chen, Jin-Hui Zhu, Yi-Ding Chen, Jiao-Jiao Zhou
中华医学杂志英文版2019年 132卷 06期
DOI: 10.1097/CM9.0000000000000135
摘要
致编辑：先天性膈疝是一种先天性异常，成人少见。成人先天性膈疝的延迟表现可导致诊断困境。对于这些患者，建议立即腹腔镜修复。在这里，我们提出了一个18岁的男性主诉胸痛和腹部不适的病例。X线和计算机断层扫描(CT)显示右侧胸膜-腹膜裂孔疝，位于后外侧膈，也称为Bochdalek疝。
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巨大腹膜后副神经节瘤致术后急性肾衰竭和切口皮肤坏死Zhong Jia, Jia-Qing Huang, Shi-Jie Li
中华医学杂志英文版2019年 132卷 06期
DOI: 10.1097/CM9.0000000000000113
摘要
致编辑：患者男，68岁，出现持续1年的蛋白尿。腹部检查发现一个22cm × 18cm的巨大固定肿块。实验室检查显示重度蛋白尿（3.0 g/24 h）和重度低白蛋白血症29 g/L（正常范围：40-55 g/L）。患者主诉排出泡沫尿约1年，入院前20天症状似乎恶化。炎症和肿瘤标志物正常，但腹部对比增强计算机断层扫描[
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肺癌血液转移患者血小板参数及活化标志物分析Si-Si Zhang, Mei Zhang, Lei Yuan, Zhi-Qiang Zou
中华医学杂志英文版2019年 132卷 06期
DOI: 10.1097/CM9.0000000000000138
摘要
致编辑：尽管肺癌（LC）的病因和机制仍不清楚，但随着科学技术的进步和研究方法的进步，已经表明肿瘤细胞与血小板（PLTs）聚集并逃避免疫系统的识别。它们粘附在远处的血管内皮细胞上，并通过血液循环继续转移、侵袭和生长。[
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Hailey-Hailey病伴肛门周围苔藓样病变Yi-Man Wang, Yue-Ping Zeng, Wen-Ling Zhao, Yue-Hua Liu, Li Li
中华医学杂志英文版2019年 132卷 06期
DOI: 10.1097/CM9.0000000000000097
摘要
致编辑：由霍华德和休·海利兄弟首次发现的海利-海利病（HHD），[
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功能性磁共振成像检测非动脉炎性前部缺血性视神经病变患者自发脑活动异常Peng-De Guo, Peng-Bo Zhao, Han Lv, Feng-Yuan Man, Yan Su, Jing Zhao, Ming Liu, Yun-Xiang Chen, Yan Wang, Hai-Qin Hua 等
中华医学杂志英文版2019年 132卷 06期
DOI: 10.1097/CM9.0000000000000134
摘要
致编辑：非动脉炎性前部缺血性视神经病变(NAION)以突然发作的单侧无痛性视力丧失和视盘肿胀为特征，是50岁以上患者中最常见的急性视神经病变形式。[
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斑点追踪成像评价法洛四联症修复后儿童右心室应变Jing-Ya Li, Rong-Juan Li, Ning Ma, Fang-Yun Wang, Xiao-Lin Zhang, Jin-Jie Xie, Jing Yang, Ya Yang
中华医学杂志英文版2019年 132卷 06期
DOI: 10.1097/CM9.0000000000000126
摘要
致编辑：法洛四联症(TOF)于1955年首次手术修复。使用经环右心室流出道补片进行初始TOF修复以缓解梗阻。然而，该手术导致长期肺动脉瓣反流和右心室（RV）容量增加，导致心律失常和猝死。[
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