MedNexus
2020年 · 第133卷第13期
出版日期 2020-07-15电子版 ￥0.00元
MedNexus
- 全部
- Editorial
- Original Article
- Review Article
- Systematic Review
- Clinical Guideline
- Perspective
- Idea and Opinion
- Viewpoint
- Comment
- Clinical Observation
- Correspondence
- Corrigendum
Editorial
开放获取
全球抗击慢性呼吸道疾病联盟：迄今为止的旅程和未来Yorgancioglu Arzu, Khaltaev Nikolai, Bousquet Jean, Varghese Cherian
中华医学杂志英文版2020年 133卷 13期
DOI: 10.1097/CM9.0000000000000851
摘要
全球抗击慢性呼吸道疾病联盟（GARD）是一个由国家和国际组织、机构和机构组成的自愿联盟，致力于“一个所有人都能自由呼吸的世界”的愿景。[
Original Article
开放获取
全球抗击慢性呼吸道疾病联盟示范项目：维尔纽斯小学气溶胶污染及其季节性特征Prokopciuk Nina, Franck Ulrich, Dudoitis Vadimas, Tarasiuk Nikolaj, Juskiene Izabele, Cepuraite Daiva, Staras Kestutis, Valiulis Algirdas, Ulevicius Vidmantas, Valiulis Arunas
中华医学杂志英文版2020年 133卷 13期
DOI: 10.1097/CM9.0000000000000913
摘要
Background:
The growing public health concern caused by non-communicable diseases in urban surroundings cannot be solved by health care alone; therefore a multidisciplinary approach is mandatory. This study aimed to evaluate the airborne aerosol pollution level in primary schools as possible factor influencing origin and course of the diseases in children.
Methods:
Seasonal aerosol particle number concentration (PNC) and mass concentration (PMC) were studied in the randomly selected eleven primary schools in the Lithuanian capital, Vilnius, as model of a middle-size Eastern European city. Total PNC in the size range from 0.01 to >1.0 μm in diameter was measured using a condensation particle counter. Using an optical particle sizer, PNC was measured and PMC estimated for particles from 0.3 to 10.0 μm. A descriptive statistics was used to estimate the aerosol pollution levels.
Results:
During all seasons, local cafeterias in the absence of ventilation were the main sources of the elevated levels of indoor PMC and PNC (up to 97,500 particles/cm3). The other sources of airborne particulates were the children’s activity during the lesson breaks with PMC up to 586 μg/m3. Soft furniture, carpets in the classrooms and corridors were responsible for PMC up to 200 μg/m3. Outdoor aerosol pollution (up to 18,170 particles/cm3) was higher for schools in city center. Elevated air pollution in classrooms also resulted from intermittent sources, such as construction work during classes (200-1000 μg/m3) and petrol-powered lawn trimmers (up to 66,400 particles/cm3).
Conclusion:
The results of our survey show that even in a relatively low polluted region of Eastern Europe there are big differences in aerosol pollution within middle-sized city. Additional efforts are needed to improve air quality in schools: more frequent wet cleaning, monitoring the operation of ventilation systems, a ban on construction works during school year, on a use of sandblasting mechanisms in the neighborhood of schools.
开放获取
全球肺癌死亡率趋势与生活方式改变：初步分析Khaltaev Nikolai, Axelrod Svetlana
中华医学杂志英文版2020年 133卷 13期
DOI: 10.1097/CM9.0000000000000918
摘要
Background:
According to the Independent High-level Commission on Non-communicable Diseases (NCD) of the World Health Organization (WHO), global reduction in lung cancer mortality has been achieved since the year 2000, although this effect is not sufficient to reach the 30% reduction of mortality from NCDs by the year 2030, as stipulated by the United Nations Sustainable Development Goal 3.4. The objective of this study was to analyze whether the lifestyle changes implemented by the WHO at country level could have an impact on mortality from this form of cancer.
Methods:
WHO statistics, based on the unified mortality and causes-of-death reports of Member-State countries, were used to evaluate global lung cancer mortality trends and make comparisons and assessments of different types of community-based, country-wide interventions.
Results:
The lung cancer mortality decline was associated with the anti-tobacco campaign initiated by the WHO in the last 15 to 20 years. Comprehensive tobacco control remained the major and most successful lifestyle modification measure. In countries with declining lung cancer mortality, 91% of countries had decreasing tobacco prevalence in males and 82% in females. Country-wide measures to increase physical activity had a strong tendency to be better implemented in countries with declining lung cancer mortality (t = 1.79, P > 0.05). Other WHO "best-buy" lifestyle modification campaigns (diet and alcohol) had been carried out for shorter periods, and their associations with lung cancer were less strong than tobacco. There was no significant difference between countries with declining and increasing lung cancer mortality in the measures for reduction of harmful alcohol use (t= 0.92, P > 0.05) and unhealthy diet reduction measures (t= 0.84, P > 0.05).
Conclusion:
Following WHO "best-buys" should facilitate to move countries towards the NCD including lung cancer mortality reduction targets. Governments and communities must embrace these targets with coordinated effective action for better health.
开放获取
起搏诱发心肌病的预后因素Zhang Hong, Zhou Yu-Jie, Zeng Yu-Jie
中华医学杂志英文版2020年 133卷 13期
DOI: 10.1097/CM9.0000000000000856
摘要
Background:
The detrimental outcomes of right ventricular pacing on left ventricular electromechanical function ultimately result in heart failure, a phenomenon termed pacing-induced cardiomyopathy (PICM) in clinical research. This study aimed to validate prognostic factors that can be used to identify patients with higher susceptibility to progress to the stage of cardiomyopathy before pacemaker implantation.
Methods:
This observational analysis enrolled 256 patients between January 2013 and June 2016, 23 (8.98%) of whom progressed to PICM after 1 year of follow-up. A Cox proportional hazard model was used to analyze the prognostic factors associated with PICM. Dose-response analysis was used to evaluate the relationship between significant indicators in multifactor analysis and PICM.
Results:
The mean values of left ventricular ejection fraction before and after pacemaker implantation in 23 patients diagnosed with PICM were 62.3% and 42.7%, respectively. Univariate analysis showed that sex, atrio-ventricular block, paced QRS duration, and ventricular pacing percentage were significantly associated with PICM. In the multivariate analysis, male sex (hazard ratio: 1.20, 95% confidence interval [CI]: 1.09-1.33, P < 0.005), paced QRS duration (hazard ratio: 1.95 per 1 ms increase, 95% CI: 1.80-2.12, P < 0.001), and ventricular pacing percentage (hazard ratio: 1.65 per 1% increase, 95% CI: 1.51-1.79, P < 0.001) were independent prognostic factors associated with the development of PICM. The ventricular pacing percentage and paced QRS duration level defined by the dose-response analysis were positively associated with PICM (P < 0.05).
Conclusions:
Our findings indicated that paced QRS duration and ventricular pacing percentage were the most sensitive prognostic factors for PICM.
开放获取
胃癌根治术后手术部位感染危险因素的研究Qiao Yong-Qi, Zheng Li, Jia Bei, Wang Wei-Hua, Zheng Xiao-Hao, Fan Lin-Lin, Xie Yi-Bin, Tian Yan-Tao
中华医学杂志英文版2020年 133卷 13期
DOI: 10.1097/CM9.0000000000000860
摘要
Background:
About 10% of patients get a surgical-site infection (SSI) after radical gastrectomy for gastric cancer, but SSI remains controversial among surgeons. The aim of this study was to explore the risk factors for SSIs after radical gastrectomy in patients with gastric cancer to guide clinical therapies and reduce the incidence of SSI.
Methods:
The study was a retrospective cohort study in patients who underwent radical gastrectomy for gastric cancer. SSI was defined in accordance with the National Nosocomial Infection Surveillance System. We evaluated patient-related and peri-operative variables that could be risk factors for SSIs. The Chi-squared test and logistic regression analysis were used to assess the association between these risk factors and SSI.
Results:
Among the 590 patients, 386 were men and 204 were women. The mean age was 56.6 (28-82) years and 14.2% (84/590) of these patients had an SSI. Among them, incisional SSI was observed in 23 patients (3.9%) and organ/space SSI in 61 patients (10.3%). Multivariate logistic regression analysis identified sex (odds ratios [ORs] = 2.548, and 95% confidence interval [CI]: 1.268-5.122, P = 0.009), total gastrectomy (OR = 2.327, 95% CI: 1.352-4.004, P = 0.002), albumin level (day 3 after surgery) <30 g/L (OR= 1.868, 95% CI: 1.066-3.274, P = 0.029), and post-operative total parenteral nutrition (OR = 2.318, 95% CI: 1.026-5.237, P = 0.043) as independent risk factors for SSI.
Conclusions:
SSI was common among patients after radical gastrectomy for gastric cancer. The method supporting post-operative nutrition and the duration of prophylactic antibiotics may be important modifiable influencing factors for SSI.
Review Article
开放获取
全球对抗慢性呼吸道疾病联盟空气污染研讨会：概述和要点Schraufnagel Dean E.
中华医学杂志英文版2020年 133卷 13期
DOI: 10.1097/CM9.0000000000000877
摘要
A 1-day symposium before the annual meeting of the Global Alliance against Chronic Respiratory Diseases, gathered authorities and researchers from around the world to discuss the impact of air pollution on human and planetary health. Air quality is a high priority for Global Alliance against Chronic Respiratory Diseases and China, the host country. This article presents a summary, commentary, and amplification of the 17 presentations. Air pollution is closely linked with global warming and harms most body systems even at levels below international standards. Information about the genetic, cellular, and metabolic effects of exposure to air pollution is important for better understanding of individual responses and even potential therapeutic mediation. Reducing air pollution at its source leads to prompt and important benefits and should be the first priority for political and public action.
开放获取
气候变化、空气污染和过敏性呼吸道疾病：呼吁卫生专业人员采取行动Deng Shi-Zhou, Jalaludin Bin B., Antó Josep M., Hess Jeremy J., Huang Cun-Rui
中华医学杂志英文版2020年 133卷 13期
DOI: 10.1097/CM9.0000000000000861
摘要
Rising emissions of greenhouse gases in the atmosphere have warmed the planet substantially and are also accompanied by poor air quality. The increased prevalence of allergic airway disease worldwide can be partially attributed to those global environmental changes. Climate change and air pollution pose adverse impacts on respiratory allergies, and that the mechanisms are complex and interactive. Adverse weather conditions, such as extreme temperatures, can act directly on the respiratory tract to induce allergic respiratory illnesses. Thunderstorms and floods can alter the production and distribution of aeroallergens while wildfires and dust storms increase air pollution, and therefore indirectly enhance health risks. Concentrations of particulate matter and ozone in the air have been projected to increase with climate warming and air stagnation, and the rising temperatures and CO2 increase pollen, molds, and spores, which escalate the risk of allergic respiratory diseases. The synergistic effects of extreme heat and aeroallergens intensify the toxic effect of air pollutants, which in turn augment the allergenicity of aeroallergens. With the Earth’s climate change, migration of humans and plants shift the living environments and allergens of susceptible people. Urban residents are exposed to multiple factors while children are sensitive to environmental exposure. Since climate change may pose many unexpected and persistent effects on allergic respiratory diseases, health professionals should advocate for effective mitigation and adaptation strategies to minimize its respiratory health effects.
开放获取
全球抗击慢性呼吸道疾病联盟的示范项目：预测空气污染和过敏原暴露之间的相互作用——移动气道哨兵网络——空气污染对哮喘和鼻炎的影响方法Sofiev Mikhail, Palamarchuk Yuliia, Bédard Annabelle, Basagana Xavier, Anto Josep M., Kouznetsov Rostislav, Urzua Rodrigo Delgado, Bergmann Karl Christian, Fonseca Joao A., De Vries Govert 等
中华医学杂志英文版2020年 133卷 13期
DOI: 10.1097/CM9.0000000000000916
摘要
This review analyzes the state and recent progress in the field of information support for pollen allergy sufferers. For decades, information available for the patients and allergologists consisted of pollen counts, which are vital but insufficient. New technology paves the way to substantial increase in amount and diversity of the data. This paper reviews old and newly suggested methods to predict pollen and air pollutant concentrations in the air and proposes an allergy risk concept, which combines the pollen and pollution information and transforms it into a qualitative risk index. This new index is available in an app (Mobile Airways Sentinel NetworK-air) that was developed in the frame of the European Union grant Impact of Air POLLution on sleep, Asthma and Rhinitis (a project of European Institute of Innovation and Technology-Health). On-going transformation of the pollen allergy information support is based on new technological solutions for pollen and air quality monitoring and predictions. The new information-technology and artificial-intelligence-based solutions help to convert this information into easy-to-use services for both medical practitioners and allergy sufferers.
Systematic Review
开放获取
空气污染对健康的影响：南欧的观点Viegi Giovanni, Baldacci Sandra, Maio Sara, Fasola Salvatore, Annesi-Maesano Isabella, Pistelli Francesco, Carrozzi Laura, La Grutta Stefania, Forastiere Francesco
中华医学杂志英文版2020年 133卷 13期
DOI: 10.1097/CM9.0000000000000869
摘要
Objective:
To summarize the main updated evidence about the health effects of air pollution, with a special focus on Southern Europe.
Data sources:
Literature was obtained through PubMed Central and the official websites of European Agencies and Scientific Societies.
Study selection:
Recent shreds of evidence about the health effects of air pollution coming from international reports and original research were collected and described in this review.
Results:
Air pollution is an avoidable risk factor that causes a huge burden for society, in terms of death, health disorders, and huge socio-economic costs. The southern European countries face a more threatening problem because they experience the effects of both anthropogenic pollutants and natural dusts (particulate matter [PM]). The European Environment Agency reported the number of premature deaths in the 28 countries of the European Union attributable to air pollutant exposure in the year 2016: 374,000 for PM2.5, 68,000 for nitrogen dioxide, and 14,000 for ozone. In Italy, time series and analytical epidemiological studies showed increased cardiorespiratory hospital admissions and mortality, as well as increased risk of respiratory diseases in people living in urban areas.
Conclusions:
Based on abundant evidence, the World Health Organization, which hosts the Global Alliance against Chronic Respiratory Diseases (GARD), the scientific respiratory societies, and the patients’ associations, as well as others in the health sector, must increase their engagement in advocacy for clean air policies.
Clinical Guideline
开放获取
2019冠状病毒病成人患者管理指南Qu Jie-Ming, Wang Chen, Cao Bin
中华医学杂志英文版2020年 133卷 13期
DOI: 10.1097/CM9.0000000000000899
摘要
2019年12月，湖北省武汉市发现新型冠状病毒。[
开放获取
2019年成人冠状病毒病呼吸康复建议Zhao Hong-Mei, Xie Yu-Xiao, Wang Chen, Chinese Association of Rehabilitation Medicine, Respiratory Rehabilitation Committee of Chinese Association of Rehabilitation Medicine, Cardiopulmonary Rehabilitation Group of Chinese Society of Physical Medicine and Rehabilitation
中华医学杂志英文版2020年 133卷 13期
DOI: 10.1097/CM9.0000000000000848
摘要
自2019年12月以来，冠状病毒病2019（新冠肺炎）已成为突发公共卫生事件。根据《中华人民共和国传染病防治法》，新冠肺炎已被列为乙类传染病，并已采取甲类传染病的控制措施。国家卫健委也公布了诊疗方案，指导临床诊疗。随着临床上救治新冠肺炎患者特别是重症、危重症患者经验的积累，我们对新冠肺炎的认识也在不断加深。针对患者不同程度的呼吸、躯体、心理功能障碍，[
Perspective
开放获取
多环芳烃：环境来源、与肺功能改变的关系和潜在机制Cao Li-Min, Mu Ge, Chen Wei-Hong
中华医学杂志英文版2020年 133卷 13期
DOI: 10.1097/CM9.0000000000000880
摘要
多环芳烃（PAH）分子是一大类有机化合物，具有两个或多个以各种构型排列的稠合苯环。[
Idea and Opinion
开放获取
冠状动脉搭桥术后大隐静脉移植失败的危险因素及可能机制Song Yan-Qiu, Xu Yue, Guo Zhi-Gang
中华医学杂志英文版2020年 133卷 13期
DOI: 10.1097/CM9.0000000000000872
摘要
冠心病（CHD）是一种复杂的代谢综合征，导致一条或多条冠状动脉的动脉粥样硬化病变。CHD在世界范围内与高发病率和死亡率相关。冠状动脉旁路移植术（CABG）是严重CHD，尤其是三支病变和左主干病变侵入性治疗的金标准。隐静脉（SVs）由于其足够的长度和便利性而通常用于CABG，但SV移植物（SVG）失败是患者中的常见发现。大约20%的SVG在CABG后1年内失败，10年CABG后通畅率为60%。[
Viewpoint
开放获取
中国清洁空气行动与健康计划Chen Chen, Fang Jian-Long, Shi Wan-Ying, Li Tian-Tian, Shi Xiao-Ming
中华医学杂志英文版2020年 133卷 13期
DOI: 10.1097/CM9.0000000000000888
摘要
中国一直在经历一些世界上最严重的空气污染，尤其是2013年1月席卷中国的严重雾霾事件，引起了国际社会的广泛关注。中国已努力了解和减轻环境空气污染对公众健康的影响，以解决这种污染。全国范围内开展的清洁空气行动大大降低了细颗粒物2.5）近年来的污染。[
Comment
开放获取
在计算机上评估2019年新型冠状病毒基因组变异对已发表的实时定量聚合酶链反应检测分析效率的影响Fan Hang, Zhang Xiang-Li-Lan, Zhang Ya-Wei, Huang Yong, Teng Yue, Guo Yan, Mi Zhi-Qiang, Yang Rui-Fu, Song Ya-Jun, Cui Yu-Jun
中华医学杂志英文版2020年 133卷 13期
DOI: 10.1097/CM9.0000000000000817
摘要
致编辑：2019年12月，中国武汉市发生由2019年新型冠状病毒（2019新型冠状病毒）引起的2019冠状病毒病疫情。现在，它已经对全球公共健康构成威胁。实时定量聚合酶链反应（RT-qPCR）被推荐为一种有效的病原体检测方法，并在当前疫情的防控中发挥了重要作用。许多研究机构已经发布了他们用于RT-qPCR的引物组。如果变异位点位于引物区域，RT-qPCR的效率将会降低，从而可能导致假阴性结果，并对患者的诊断和此次疫情的控制导致不可预测的影响。因此，有必要对2019新型冠状病毒基因组变异进行全面调查，以评估当前发布的RT-qPCR方法的有效性。
Clinical Observation
开放获取
间变性骨髓瘤的临床和组织病理学分析Huang Jun-Xia, Meng Fan-Jun, Feng Xian-Qi, Lyu Xiao, Wang Xin
中华医学杂志英文版2020年 133卷 13期
DOI: 10.1097/CM9.0000000000000902
摘要
作为多发性骨髓瘤（MM）的形态学亚型，间变性骨髓瘤（AM）包括间变性多发性骨髓瘤和间变性浆细胞瘤，是一种侵袭性进展的罕见疾病。据报道，它对化疗非常耐药，预后不良。[
Correspondence
开放获取
性染色体非整倍体非侵入性产前筛查的表现与父母决策Song Jie-Ping, Jiang Yu-Fei, Gao Tang-Xin-Zi, Yao Yan-Yi, Liu Li-Jun, Xu Run-Hong, Yi Mei-Qi, Yu Chun-Jiao, Wang Wei-Peng, Li Hui
中华医学杂志英文版2020年 133卷 13期
DOI: 10.1097/CM9.0000000000000868
摘要
致编辑：性染色体非整倍体（SCAs）是常见的染色体畸变，通常在出生后诊断。它会导致身体发育异常或不孕。产前发病率高达1/435，通常通过染色体核型鉴定。SCA的特征在于性染色体数量异常，包括单体(45，X)、三体(47，XXX，47，XXY和47，XYY)、其他非整倍体和各种形式的性染色体镶嵌。SCA患者的表型多种多样。胎儿SCA的产前诊断影响父母，需要临床咨询。此外，早期诊断很重要，因为它为SCA儿童提供了早期治疗和未来医疗保健的机会。
开放获取
“医师科学家”培养模式构想——医学博士双学位探索Dong Wei-Jiang, Liu Wen-Bin, Gong Hui-Lin, Cheng Yan-Bin, Zhang Ming, Lyu Yi, Wu Xiao-Jian, Meng Xiao-Jun, Lyu She-Min, Chen Li-Na 等
中华医学杂志英文版2020年 133卷 13期
DOI: 10.1097/CM9.0000000000000870
摘要
致编辑：随着中国经济的快速增长和人民生活水平的提高，预计对高水平医疗服务的需求将越来越大。这些期待正在给临床医生的发展带来新的挑战。然而，传统的医生培训途径不足以应对这些挑战，因为临床和科学实践对医生来说都很重要，但很难融入医学教育。因此，当前的医学培训体系面临着将科研培训与常规临床培训相结合的挑战。为了提供可能的解决方案，*安安交通大学（XJTU）健康科学中心（HSC）一直在探索一种培养医师科学家的新模式：双博士项目（DDP）。
开放获取
更多的突变积累淋球菌（NG）对头孢曲松敏感性降低的NGLiang Jing-Yao, Jiang Yi-Qi, Cao Wen-Ling, Li Xiao-Dong, Li Dong-Mei, Wang Jian-Qin, Sun Si-Long, Zhang Xi-Bao
中华医学杂志英文版2020年 133卷 13期
DOI: 10.1097/CM9.0000000000000884
摘要
致编辑：淋病奈瑟菌（NG）随着对头孢曲松（CRO）和头孢克肟（一线抗菌单药治疗的最后选择）的敏感性降低，在全球范围内传播。到目前为止，已经报告了十多例CRO临床治疗失败，最低抑菌浓度（MIC）范围为0.5至2.0 mg/L。[
开放获取
皮质脑炎伴重叠抗N-甲基-D-天冬氨酸受体与抗髓鞘少突胶质细胞糖蛋白抗体：2例报告Gao Mei-Chun, Yao Xiao-Ying, Ding Jie, Zhang Ying, Guan Yang-Tai
中华医学杂志英文版2020年 133卷 13期
DOI: 10.1097/CM9.0000000000000894
摘要
致编辑：反-N-甲基-D-天冬氨酸受体(NMDAR)脑炎(NMDAR)是一种潜在致死性自身免疫性疾病。抗髓鞘少突胶质细胞糖蛋白（MOG）抗体（Ab）可以代表不同范围的中枢神经系统（CNS）炎性脱髓鞘疾病（IDDs）的诊断生物标志物。在此，我们报告了两例NMDAR-Ab和MOG-Ab均呈阳性的病例，表现为皮质脑炎和随后的脱髓鞘。
开放获取
魁北克血小板紊乱伴间质性肺炎1例Wang Yong-Jing, Liu Jian-Qiang, Guo Ya-Nan, Liu Xiao-Li, Jiang Yang, Kong De-Xiao, Wang Ying-Xue, Zheng Cheng-Yun, Dou Ai-Xia
中华医学杂志英文版2020年 133卷 13期
DOI: 10.1097/CM9.0000000000000892
摘要
致编辑：纤溶酶的活性是复杂的。异常出血可由纤溶酶原激活物过度表达或纤溶抑制剂缺乏引起。魁北克血小板疾病(QPD)，一种常染色体显性疾病，基因表达增加普劳编码尿激酶纤溶酶原激活剂（u-PA），导致纤溶中的功能获得性异常。组织型纤溶酶原激活物（t-PA）存在于多种组织和细胞中。当肺间质细胞受损时，t-PA可释放，促进纤溶酶原激活。间质性肺纤维化（IPF）可引起血管损伤和t-PA渗漏，导致其在肺泡中升高。[
Corrigendum
开放获取
勘误表：多重连接依赖性探针扩增联合巢式聚合酶链反应诊断地中海贫血患者HKaa携带者的准确基因型中华医学杂志英文版2020年 133卷 13期
DOI: 10.1097/CM9.0000000000000985
摘要
在题为“使用多重连接依赖性探针扩增结合巢式聚合酶链反应诊断地中海贫血患者HKaa携带者的准确基因型”的文章中，该文章发表在第10期第1175-1181页。133的中华医学杂志,[
本期目次
下载本期封面 下载本期目录
