MedNexus
2020年 · 第133卷第19期
出版日期 2020-10-05电子版 ￥0.00元
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Editorial
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中国乳腺癌外科：临床实践与研究Xin Ling, Li Jia-Yi, Yu Zhi-Gang, Liu Yin-Hua
中华医学杂志英文版2020年 133卷 19期
DOI: 10.1097/CM9.0000000000000992
摘要
根据国际癌症研究机构的全球癌症统计数据库GLOBOCAN 2018，乳腺癌是女性最常诊断的癌症。[
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从NAFLD到MAFLD：脂肪肝的“重新定义”时刻Zheng Kenneth I., Fan Jian-Gao, Shi Jun-Ping, Wong Vincent Wai-Sun, Eslam Mohammed, George Jacob, Zheng Ming-Hua
中华医学杂志英文版2020年 133卷 19期
DOI: 10.1097/CM9.0000000000000981
摘要
术语非酒精性脂肪性肝病（NAFLD）是在1980年创造的，用于描述一种类似于酒精性脂肪性肝病的疾病，该疾病发生在没有过量酒精摄入史的患者中。[
Original Article
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宫颈癌根治术后膀胱储能功能的尿动力学评价Cao Ting-Ting, Wen Hong-Wu, Gao Yu-Nong, Lyu Qiu-Bo, Liu Hui-Xin, Wang Sha, Wang Shi-Yan, Sun Hua-Xin, Yu Na, Wang Hai-Bo 等
中华医学杂志英文版2020年 133卷 19期
DOI: 10.1097/CM9.0000000000001014
摘要
Background:
After radical hysterectomy for cervical cancer, the most common complication is lower urinary tract symptoms. Post-operatively, bladder capacity can alter bladder function for a prolonged period. This study aimed to identify factors affecting bladder storage function.
Methods:
A multicenter, retrospective cohort study was conducted. Information of patients with stages IA2 to IIB cervical cancer with urodynamic study results were retrospectively collected from nine hospitals between June 2013 and June 2018 according to the inclusion criteria. Demographic, surgical, and oncological data were collected. The univariate and multivariate logistic regression was used to identify clinical factors associated with bladder storage function.
Results:
Two hundred and three patients with cervical cancer had urodynamic testing post-operatively. Ninety-five (46.8%) patients were diagnosed with stress urinary incontinence (SUI). The incidence of low bladder compliance (LBC) was 23.2%. Twenty-seven (13.3%) patients showed detrusor overactivity (DO). Fifty-seven patients (28.1%) presented with a decreased maximum cystometric capacity (DMCC). The probability of composite bladder storage dysfunction was 68.0%. Multivariate analysis confirmed that laparoscopy represents a protective factor for SUI with an odds ratio of 0.498 (P = 0.034). Patients who underwent a nerve-sparing procedure were less odds to experience SUI (P = 0.014). A significant positive correlation between LBC and DO was observed (P < 0.001). A greater length of the resected vagina and chemoradiotherapy were common risk factors for LBC and DO, while radiotherapy exerted a stronger effect than chemotherapy. Additionally, patients who received chemoradiotherapy frequently developed a DMCC. The follow-up time was not correlated with bladder storage function.
Conclusion:
A nerve-sparing procedure without longer resected vagina is recommended for protecting the bladder storage function.
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儿童青少年分化型甲状腺癌复发的预后分析Wang Xing, Wang Xiao-Lei
中华医学杂志英文版2020年 133卷 19期
DOI: 10.1097/CM9.0000000000000910
摘要
Background:
The standard treatment for pediatric differentiated thyroid carcinoma (DTC) still requires consideration because of a lack of clinical evidence. The purpose of this study was to summarize the clinical experiences and explore the risk factors for post-operative recurrence through a retrospective analysis to develop better clinical strategies for pediatric DTC.
Methods:
This study retrospectively analyzed children and adolescents with DTC who were treated between January 1999 and December 2014 at the Cancer Hospital, Chinese Academy of Medical Sciences. Clinicopathological results and outcomes were collected. A log-rank test of Kaplan-Meier curves and the Cox regression model were used to determine the factors associated with recurrence.
Results:
Data of 150 patients were collected in this study. During the follow-up, there was only one disease-related death. The recurrence rates at 3, 5, and 10 years were 13.6%, 18.7%, and 28.6%, respectively. There was a significant difference in the rate of recurrence according to age (P < 0.001), extrathyroidal extension (P < 0.001), lymph node metastasis (P = 0.023), and invasion of the trachea and esophageal wall (P = 0.004). Cox regression analysis demonstrated that age (P = 0.006) and extrathyroidal extension (P = 0.013) were significant dependent factors of post-operative recurrence.
Conclusions:
The prognosis of DTC in children and adolescents is favorable. A close follow-up is recommended because of the high recurrence rate. A comparatively higher recurrence rate was observed in the younger age group, and new age-based divisions may be needed to conveniently evaluate the possibility of recurrence.
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抗磷脂抗体阳性和既往不良妊娠结局患者血清B细胞活化因子水平的变化及其意义Li Xin-Yi, Duan Hong-Ji, Liu Xiang-Yuan, Deng Xiao-Li
中华医学杂志英文版2020年 133卷 19期
DOI: 10.1097/CM9.0000000000000948
摘要
Background:
B-cell activating factor (BAFF) is vital for B cell survival. Serum BAFF levels are elevated in thrombotic antiphospholipid syndrome, but little is known about levels in patients with positive antiphospholipid antibodies (aPLs) and previous adverse pregnancy outcomes (APOs). We aimed to analyze serum BAFF concentrations of these patients in early pregnancy along with different pregnancy outcomes.
Methods:
Thirty-six pregnant patients positive for aPLs and previous APOs (patient group), 25 healthy pregnant females (HP group) and 35 healthy non-pregnant females (HNP group) from the Peking University Third Hospital, between October 2018 and March 2019, were enrolled in this study. Serum of HNP and serum of patients as well as HP in the first gestational trimester were collected. Enzyme-linked immunosorbent assay kits were used to measure serum BAFF and interferon-alpha (IFN-α) concentrations. Cytometric bead array analysis was used to measure serum concentrations of cytokines. The patient group was further divided into APOs and non-APOs (NAPOs) group, fetal loss and live birth group according to pregnancy outcomes. The Mann-Whitney U-test was used to assess significance between and within groups. Spearman rank-order was used to evaluate correlation coefficients between BAFF and related cytokines.
Results:
The serum BAFF level in HP group was significantly lower than HNP group (245.24 [218.80, 265.90] vs. 326.94 [267.31, 414.80] pg/mL, Z = -3.966, P < 0.001). The BAFF level was obviously elevated in patient group compared to that in HP group (307.77 [219.86, 415.65] vs. 245.24 [218.80, 265.90] pg/mL, Z = -2.464, P = 0.013). BAFF levels in APOs group tended to be higher than that in NAPOs group (416.52 [307.07, 511.12] vs. 259.37 [203.59, 375.81] pg/mL, Z = -2.718, P = 0.006). Compared to HP group, concentrations of IFN-α, interleukin (IL-6) and tumor necrosis factor were higher in patient group (33.37 [18.85, 48.12] vs. 13.10 [6.85, 25.47] pg/mL, Z = -2.023, P = 0.043; 39.16 [4.41, 195.87] vs. 3.37 [2.92, 3.90] pg/mL, Z = -3.650, P < 0.001; 8.23 [2.27, 64.46] vs. 1.53 [1.25, 2.31] pg/mL, Z = -3.604, P < 0.001, respectively). Serum BAFF levels had a positive correlation with the concentrations of both IL-6 and IL-10 (IL-6: r = 0.525, P = 0.002; IL-10: r = 0.438, P = 0.012).
Conclusions:
Serum BAFF levels are increased in patients with positive aPLs and previous APOs as compared to healthy pregnant females and tend to be higher in individuals with current APOs. The BAFF levels have a positive correlation with serum IL-6 and IL-10.
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吸烟状况对冠心病患者冠状动脉非靶病变临床结局影响的单中心血管造影研究Xu Hao-Bo, Wang Juan, Chen Ji-Lin, Guo Chao, Yuan Jian-Song, Duan Xin, Hu Feng-Huan, Yang Wei-Xian, Luo Xiao-Liang, Liu Rong 等
中华医学杂志英文版2020年 133卷 19期
DOI: 10.1097/CM9.0000000000001024
摘要
Background:
Coronary atherosclerotic plaque could go through rapid progression and induce adverse cardiac events. This study aimed to evaluate the impacts of smoking status on clinical outcomes of coronary non-target lesions.
Methods:
Consecutive patients with coronary heart disease who underwent two serial coronary angiographies were included. All coronary non-target lesions were recorded at first coronary angiography and analyzed using quantitative coronary angiography at both procedures. Patients were grouped into non-smokers, quitters, and smokers according to their smoking status. Clinical outcomes including rapid lesion progression, lesion re-vascularization, and myocardial infarction were recorded at second coronary angiography. Multivariable Cox regression analysis was used to investigate the association between smoking status and clinical outcomes.
Results:
A total of 1255 patients and 1670 lesions were included. Smokers were younger and more likely to be male compared with non-smokers. Increase in percent diameter stenosis was significantly lower (2.7 [0.6, 7.1]% vs. 3.5 [0.9, 8.9]%) and 3.4 [1.1, 7.7]%, P= 0.020) in quitters than those in smokers and non-smokers. Quitters tended to have a decreased incidence of rapid lesions progression (15.8% [76/482] vs. 21.6% [74/342] and 20.6% [89/431], P= 0.062), lesion re-vascularization (13.1% [63/482] vs. 15.5% [53/432] and 15.5% [67/431], P= 0.448), lesion-related myocardial infarction (0.8% [4/482] vs. 2.6% [9/342] and 1.4% [6/431], P= 0.110) and all-cause myocardial infarction (1.9% [9/482] vs. 4.1% [14/342] and 2.3% [10/431], P= 0.128) compared with smokers and non-smokers. In multivariable analysis, smoking status was not an independent predictor for rapid lesion progression, lesion re-vascularization, and lesion-related myocardial infarction except that a higher risk of all-cause myocardial infarction was observed in smokers than non-smokers (hazards ratio: 3.00, 95% confidence interval: 1.04-8.62, P= 0.042).
Conclusion:
Smoking cessation mitigates the increase in percent diameter stenosis of coronary non-target lesions, meanwhile, smokers are associated with increased risk for all-cause myocardial infarction compared with non-smokers.
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中国人近期基底节皮质下小梗死和邻近白质的形态学演变Wang Sha-Sha, Wei Sen, Song Bo, Xu Yu-Ming
中华医学杂志英文版2020年 133卷 19期
DOI: 10.1097/CM9.0000000000001041
摘要
Background:
Data on the evolution of recent small sub-cortical infarcts are limited, especially in the Chinese. Previous studies have reported a large heterogeneity in cavitation and infarct location; therefore, the present study assessed the morphology of small subcortical infarcts in the basal ganglia in a Chinese cohort.
Methods:
Patients who had experienced a recent, single, small sub-cortical infarct in the basal ganglia and received at least one follow-up magnetic resonance imaging (MRI) scan were retrospectively identified from January 2014 to June 2018. Time to follow-up imaging, baseline infarct size, vascular risk factors, and other clinical data, as well as the morphologic changes of the index infarct and surrounding white matter were recorded. Demographic, clinical and MRI characteristics were respectively compared among three groups (white matter hyper-intensitie [WMH] vs. cavitation vs. absent) and between with and without new WMH formation groups. In addition, logistic regression analyses were performed in investigating the determinate independent predictors for new WMH formation.
Results:
Seventy-eight subjects were included with a median follow-up time of 304 days (range: 124-552 days). We found a significant reduction in infarct size at follow-up: 46 of 78 (59.0%) infarctions showed some degree of cavitation, 19 of 78 (24.4%) index lesions resembled non-cavitated WMH, and 13 of 78 (16.7%) infarcts had disappeared at follow-up MRI. No factors were found to be associated with differential outcomes of the infarcts. In addition, 8 of 78 (10.3%) patients demonstrated new WMH formation surrounding the index infarct; white matter progression (odds ratio = 15.95, 95% confidence interval = 1.65-153.99; P = 0.017) was an independent risk factor of new WMH formation.
Conclusions:
More than half of the small sub-cortical infarcts in the basal ganglia progressed to cavities, demonstrating that these infarcts can be reduced and go undetected. The presence of new WMH around the infarct may be indicative of the worsening progression of cerebral small vessel diseases. Additionally, white matter progression is an independent risk factor, which may be a potential therapeutic target.
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中国健康成年人光学质量相关因素分析：一项基于社区的人群研究Zhang Xi-Fang, Qiao Li-Ya, Cai Xiao-Gu, Li Xiao-Xia, Tan Jia-Xuan, Guan Zheng, Zhang Ye, Cao Kai, Wang Ning-Li
中华医学杂志英文版2020年 133卷 19期
DOI: 10.1097/CM9.0000000000000994
摘要
Background:
In recent years, visual quality has been extensively investigated in various conditions. In this community-based population study, we analyzed the effects of aging, refraction, and Lens Opacification Classification System III (LOCSIII) score on retinal imaging quality in healthy Chinese adults.
Methods:
This cross-sectional study was conducted on sub-group subjects from The Handan Eye Study between October 2012 and January 2013. Healthy subjects over 30-years-old with logarithm of the minimal angle of resolution (logMAR) best-corrected visual acuity (BCVA) less than 0 were included. Retinal image quality was measured by optical quality analysis system (OQAS) and recorded as modulation transfer function cutoff frequency (MTFcutoff), OQAS value (OV) 100%, OV20%, OV9%, Strehl ratio (SR), and objective scatter index (OSI). The correlation between age, spherical equivalent refraction (SE), LOCSIII score, and optical quality parameters were investigated by multivariate analysis.
Results:
Among 1108 verified subjects, 690 subjects (1380 eyes) met the inclusion criteria. Their age ranged from 30 to 76 years, SE ranged from -4.75 to 2.75 D. They were divided into five age groups (30-39, 40-49, 50-59, 60-69, and ≥70 years) for further analysis. After multivariate analysis by mixed-effect linear model, SR (t = -3.03, P = 0.002), OV20% (t = -2.39, P = 0.017), and OV9% (t = -3.16, P = 0.001) significantly decreased with the increasing age, whereas logMAR BCVA (t = 4.42, P < 0.001) and OSI (t = 4.46, P < 0.001) significantly increased with age. As SE increased, SR (t = 2.74, P = 0.01), OV20% (t = 2.31, P = 0.02), and OV9% (t = 2.79, P = 0.005) significantly elevated, and OSI (t = -3.38, P < 0.001) significantly decreased. With the increase in cortical opacity score, all optical quality parameters except for SR significantly decreased, including MTFcutoff (t = -2.78, P = 0.01), OV100% (t = -2.78, P = 0.005), OV20% (t = -2.60, P = 0.009), and OV9% (t = -2.05, P = 0.04). As posterior sub capsular opacity score increased, MTFcutoff (t = -2.40, P = 0.02) and OV100% (t = -2.40, P = 0.01) significantly decreased, while OSI (t = 7.56, P < 0.001) significantly increased.
Conclusions:
In healthy Chinese adult population, optical quality-related parameters significantly decrease with the increasing age, and OSI significantly increases with age. In normal BCVA subjects, optical quality is significantly impacted by cortical and posterior sub capsular opacity rather than by nuclear opacity.
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中国汉族人群白细胞介素-18基因多态性与大动脉炎的关系Wen Dan, Zhou Xian-Liang, Du Xin, Dong Jian-Zeng, Ma Chang-Sheng
中华医学杂志英文版2020年 133卷 19期
DOI: 10.1097/CM9.0000000000001047
摘要
Background:
Interleukin-18 (IL18) gene polymorphisms are related to many inflammatory and autoimmune diseases. However, a correlation analysis between IL18-607C/A and -137G/C gene polymorphisms and Takayasu arteritis (TA) is lacking.
Methods:
This study enrolled 200 patients with TA as the case group and 334 region-, age-, and sex-matched healthy subjects as the control group. We genotyped alleles and genotypes at positions -607 and -137 of the IL18 gene and analyzed the distribution frequencies. Mann-Whitney U test, t test, Chi-squared test and Hardy-Weinberg equilibrium were performed.
Results:
After adjusting for risk factors, the adjusted odds ratios and 95% confidence intervals at position -607C/A were 0.533, 0.391 to 0.880 (P = 0.010); 0.266, 0.586 to 1.002 (P = 0.051); and 0.122, 0.552 to 1.420 (P = 0.613) under the dominant, additive, and recessive models, respectively. For the -137G/C polymorphism, the adjusted odds ratios and 95% confidence intervals were 1.571, 1.068 to 2.311 (P = 0.022); 1.467, 1.086 to 1.980 (P = 0.012); and 1.815, 0.901 to 3.656 (P = 0.095) under the dominant, additive, and recessive models, respectively. Moreover, regardless of the model used, we found no statistical difference in distribution frequency between the active and quiescent states of TA for the -607C/A (P = 0.355, 0.631, and 0.705, respectively) and -137G/C polymorphisms (P = 0.205, 0.385, and 0.208, respectively).
Conclusions:
The IL18-607C/A gene polymorphism may decrease the risk of TA, and thus is a protective factor, whereas -137G/C may increase the risk of TA, and thus is a risk factor. However, neither polymorphism was related to activity (active vs. quiescent) of TA.
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拓扑异构酶II α通过激活磷脂酰肌醇3-激酶/蛋白激酶B/雷帕霉素信号通路的哺乳动物靶点促进胆囊癌增殖和转移Lyu Wen-Jie, Shu Yi-Jun, Liu Ying-Bin, Dong Ping
中华医学杂志英文版2020年 133卷 19期
DOI: 10.1097/CM9.0000000000001075
摘要
Background:
Topoisomerase II alpha (TOP2A) has been reported to play a crucial role in the tumorigenesis of various cancer types. However, the biological role of TOP2A in gallbladder cancer (GBC) remains unknown. The current study aimed to explore the function and potential mechanism of TOP2A in GBC.
Methods:
Based on Gene Expression Profiling Interactive Analysis data, we found TOP2A was significantly up-regulated in GBC tissues and resulting in shorter overall survival. Quantitative real-time polymerase chain reaction and immunohistochemistry were conducted to detect the expression of TOP2A in 45 pairs of GBC tissues and adjacent non-tumor tissues. In vitro, cell proliferation, migration, and invasion ability were examined by cell counting kit-8 and transwell assay, respectively. Epithelial-mesenchymal transition (EMT) related and phosphatidylinositol 3-kinase/protein kinase B/mammalian target of rapamycin (PI3K/Akt/mTOR) pathway-related markers were measured by Western blotting. Xenograft model assay was performed to evaluate the effect of TOP2A in vivo.
Results:
TOP2A was found up-regulated in GBC (tumor vs. normal, 12.62 vs. 0.34) and correlated with the late tumor node metastasis stage (P = 0.0032), present of lymph node metastasis (P = 0.0273), and poor prognosis in GBC patients (log-rank P = 0.028). In vitro and in vivo assays showed that knockdown of TOP2A notably inhibited cell proliferation, migration, invasion, EMT process, and tumor growth in GBC. In addition, TOP2A down-regulation significantly decreased the protein levels of phosphor (p)-PI3K, p-Akt, and p-mTOR.
Conclusion:
Our study demonstrates that TOP2A was overexpressed in GBC and associated with poor prognosis in GBC patients. TOP2A promotes GBC cell proliferation, migration, invasion, EMT process, and tumor growth through activating PI3K/Akt/mTOR signaling pathway, and may serve as a novel prognostic biomarker and therapeutic target for GBC.
Consensus Statement
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水洗微生物群移植方法学南京共识Fecal Microbiota Transplantation-standardization Study Group
中华医学杂志英文版2020年 133卷 19期
DOI: 10.1097/CM9.0000000000000954
摘要
粪便微生物群移植（FMT）的方法和相关结果在世界各地的中心之间差异很大。因此，方法学标准化可以改善FMT的临床实践和试验。来自15个城市的22家医院或研究所的28名专家组成的小组为目前关于洗涤微生物群移植（WMT）的共识做出了贡献。[
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糖尿病肾病诊断与管理专家共识Diabetic Kidney Disease Cooperative Group of Peking University Health Science Center
中华医学杂志英文版2020年 133卷 19期
DOI: 10.1097/CM9.0000000000001049
摘要
在过去的几十年里，经济的快速增长和生活方式的转变导致了中国糖尿病患病率的快速上升。由于中国糖尿病肾病（DKD）的预防和管理缺乏标准流程，北京大学医学部组织肾脏病学和内分泌学领域专家制定了DKD中国共识声明。该共识强调循证调查，重点关注以下三个主题：（1）DKD发病和进展的危险因素；（2）DKD的诊断及肾活检指征；（3）DKD的整体管理。
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2019中国梅毒诊疗专家共识声明National Center for Sexually Transmitted Disease Control, China Centers for Disease Control and Prevention, Committee of Sexually Transmitted Disease, Branch of Dermatovenereology, Chinese Medical Association, Committee of Sexually Transmitted Disease, Branch of Dermatologists, Chinese Medical Doctor Association
中华医学杂志英文版2020年 133卷 19期
DOI: 10.1097/CM9.0000000000001035
摘要
梅毒，由梅毒螺旋体亚种苍白球(T.苍白球），是一种通过性接触传播的慢性、全身性人类疾病。梅毒在我国的发病率和流行率仍然很高。[
Review Article
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内分泌治疗联合靶向治疗激素受体阳性转移性乳腺癌Bian Li, Xu Feng-Rui, Jiang Ze-Fei
中华医学杂志英文版2020年 133卷 19期
DOI: 10.1097/CM9.0000000000000923
摘要
Increasing numbers of targeted drugs are used in hormone receptor (HR)-positive metastatic breast cancer (MBC) to overcome or delay resistance to endocrine therapy. This study will systemically review the progress made in endocrine therapy combined with targeted therapy in the treatment of HR-positive MBC. From the "AI (aromatase inhibitor) era" represented by aromatase inhibitors, we have gradually entered the "post-AI era" represented by fulvestrant. Under the guidance of research on the molecular mechanism of endocrine therapy resistance, the "combination of endocrine therapy and targeted therapy" era is approaching. The development of drugs that target endocrine therapy resistance has concentrated on cyclin-dependent kinase 4/6 inhibitors, histone deacetylase inhibitors, and inhibitors of drug targets in the phosphatidylinositol 3 kinase-protein kinase B-mammalian target of rapamycin (PI3K-AKT-mTOR) pathway, providing new strategies for HR-positive MBC. Exploring biomarkers to guide the more precise use of targeted drugs in endocrine therapy for MBC is the focus of current and future research.
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目前检测子宫内膜异位症的生物标志物Tian Zhao, Chang Xiao-Hong, Zhao Yan, Zhu Hong-Lan
中华医学杂志英文版2020年 133卷 19期
DOI: 10.1097/CM9.0000000000001063
摘要
A clinically reliable non-invasive test for endometriosis is expected to reduce the diagnostic delay. Although varieties of biomarkers have been investigated for decades, and cancer antigen-125, cancer antigen-199, interleukin-6, and urocortin were the most studied ones among hundreds of biomarkers, no clinically reliable biomarkers have been confirmed so far. Some emerging technologies including "omics" technologies, molecular imaging techniques, and microRNAs are promising in solving these challenges, but their utility to detect endometriosis has yet to be verified. New combinations of researched indicators or other non-invasive methods and further exploration of the emerging technologies may be new targets and future research hotspots for non-invasive diagnosis of endometriosis. In conclusion, researches of biomarkers for the detection of endometriosis are still ongoing and may benefit from novel molecular biology, bioinformatics methods and a combination of more diverse monitoring methods. Though it will be a daunting task, the identification of a specific set of diagnostic biomarkers will undoubtedly improve the status of endometriosis.
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硬膜外分娩镇痛对新生儿和儿童结局的潜在影响Liu Zhi-Hua, Wang Dong-Xin
中华医学杂志英文版2020年 133卷 19期
DOI: 10.1097/CM9.0000000000000900
摘要
This review summarizes recent evidences regarding the potential influences of epidural labor analgesia (ELA) on the outcomes of neonates and children. Terms and relevant words including "ELA," "ELA and neonatal outcomes," "ELA and children’s development," and "ELA and children’s neurocognitive development" were used to search articles published in PubMed database up to October 2019. Original articles and reviews regarding potential influences of ELA on neonates and children were identified. Relevant references of the selected articles were also screened. The anesthetics used during ELA can be absorbed, enter the fetus, and produce neonatal depression; however, these effects are less severe than those during systematic opioid analgesia. The impact of anesthetic exposure during ELA on children’s neurodevelopment has not been fully studied, but would be mild if any. ELA increases the risk of intrapartum maternal fever; the latter may be harmful to neonatal outcomes. The use of ELA may increase birth injury by increasing instrumental delivery, although long-term adverse events are rare. On the other hand, ELA may reduce maternal depression and, thus, produce favorable effects on neurocognitive development in childhood; but evidences are still lacking in this aspect. ELA may produce both favorable and unfavorable effects on neonates and children. These effects should be discussed with parturient women before making decisions. The potential harmful effects should be carefully managed. The overall impacts of ELA on neonatal and children’s outcomes need to be studied further.
Medical Progress
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无驱动基因突变非小细胞肺癌脑转移患者的放射治疗Li Pei-Jie, Luo Jie, Liu Guang-E, Liu Da-Hai, Shen Sha-Sha, Li Xin-Juan, Ma Hu
中华医学杂志英文版2020年 133卷 19期
DOI: 10.1097/CM9.0000000000001044
摘要
肺癌脑转移（BM）在肿瘤发展过程中并不少见。诊断为BM的患者在不接受放疗的情况下，总生存期（OS）仅为3.6个月。随着BM治疗的快速发展，可以实现约16个月的中位生存期(MST)。[
Perspective
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门静脉高压症的药物治疗：现状与未来Gao Zhu-Qing, Han Ying, Li Lei, Ding Hui-Guo
中华医学杂志英文版2020年 133卷 19期
DOI: 10.1097/CM9.0000000000001004
摘要
门静脉高压症（PHT）是肝硬化严重并发症的触发因素，包括食管胃静脉曲张出血（EVB）、腹水、肝性脑病、肝硬化心肌病、急性肾损伤和肝肾综合征（AKI-HRS），这些并发症可能导致死亡或增加肝移植的需要。[
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神经干细胞如何通过免疫调节促进脑损伤修复Jiang Cheng, Hou Bo-Ru, Wang Ze-Ning, Chen Yi, Wang Dong, Ren Hai-Jun
中华医学杂志英文版2020年 133卷 19期
DOI: 10.1097/CM9.0000000000001039
摘要
脑损伤，如创伤性脑损伤和中风，是世界范围内导致死亡和长期残疾的重要原因。[
Viewpoint
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新辅助化疗：中国早期乳腺癌患者的实践与思考Wang Xue-Fei, Shen Song-Jie, Lin Yan, Li Yan, Huang Xin, Wang Chang-Jun, Sun Qiang
中华医学杂志英文版2020年 133卷 19期
DOI: 10.1097/CM9.0000000000000940
摘要
尽管有研究者假设新辅助化疗可能会改善乳腺癌患者的预后，因为它可以让他们更早地接受全身治疗，但没有大型随机对照试验证实这一假设。因此，普遍认为接受乳腺癌新辅助或辅助化疗的患者在无病生存期(DFS)或总生存期(OS)方面没有差异。[
Clinical Observation
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利用遗传分析鉴定系统性硬化症和局限性硬皮病的共同易感位点Li Yun, Wang Wen-Jun, Chen Wei-Wei, Fan Xue, Cao Lu, Xing Ze-Yu, Zhen Qi, Xu Qiong-Qiong, Zhu Chen-Yu, Ge Hui-Yao 等
中华医学杂志英文版2020年 133卷 19期
DOI: 10.1097/CM9.0000000000001054
摘要
硬皮病是一种自身免疫性纤维化病症，可进一步亚分类为局限性硬皮病(LSc)和系统性硬化症(SSc)。LSc的特征是硬化性和色素性皮肤病变，而SSc是涉及许多器官的更普遍的结缔组织病症。SSc的特征是真皮胶原束增厚、纤维化和内脏器官中的血管异常。[
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中性粒细胞与淋巴细胞比值对2型糖尿病患者药物洗脱支架再狭窄的预测价值Wang Zhi-Chao, Zhang Jian-Ning, Zhou Zhe, Tao Jun
中华医学杂志英文版2020年 133卷 19期
DOI: 10.1097/CM9.0000000000001045
摘要
尽管经皮冠状动脉介入治疗（PCI）和抗血栓治疗取得了重大进展，但支架内再狭窄（ISR）仍然是PCI后具有挑战性的临床问题。确定ISR风险分层的新参数和潜在的药理学靶点非常重要。我们之前回顾了中性粒细胞与淋巴细胞比率（NLR）可能是血细胞几个参数中ISR的最佳预测因子。2型糖尿病（T2DM）与炎症密切相关，是ISR的独立危险因素。然而，很少有研究评估NLR的动态变化对T2DM患者ISR的预测作用。因此，我们旨在分析第一次PCI和第二次冠状动脉造影（CAG）中的术前NLR值，并评估其对T2DM患者ISR的预测价值。
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预防性外用5%利多卡因贴剂预防开颅术后疼痛：一项多中心、随机、三盲、安慰剂对照临床试验方案Meng Lan, Chen Zheng, Yang Jun, Luo Fang
中华医学杂志英文版2020年 133卷 19期
DOI: 10.1097/CM9.0000000000001066
摘要
48%至69%的患者在开颅术后48小时内经历中度至重度疼痛。[
Rapid Report
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乳腺癌乳头分泌物中存在外泌体Wang Ya-Wen, Liu Yao, Li Qiang, Wang Jian-Li, Zhang Wei-Guo, Zhang Kai, Zhang Li, Yu Chao-Qun, Shabbir Arzoo, Cai Qian 等
中华医学杂志英文版2020年 133卷 19期
DOI: 10.1097/CM9.0000000000001043
摘要
外来体是一类膜囊泡，其直径约为50至100nm；它们从各种细胞释放到细胞外基质中。[
Correspondence
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51岁男性颈动脉夹层伴高同型半胱氨酸血症导致后循环缺血Wang Ruo-Jun, Guo Zhi-Liang, Huang Zhi-Chao, Ou Zhi-Jie, Zhang Xia, You Shou-Jiang, Cao Yong-Jun
中华医学杂志英文版2020年 133卷 19期
DOI: 10.1097/CM9.0000000000001026
摘要
致编辑：持续性三叉神经动脉（PTA）是最常见的残余胎儿吻合之一。在胚胎发育期间，颈动脉和椎基底循环之间的联系通常会退化。颈动脉夹层（CAD）是年轻人脑缺血的常见原因，可由基因突变引起的高同型半胱氨酸血症（HHcy）引起。我们报告一例由CAD引起的后循环缺血。
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反向痤疮与银屑病和Dowling-Degos病共存，PSENEN-Notch信号受损Xiao Xue-Min, Zhou Peng-Jun, Zhu Chang-Hua, Lin Li-Hang, Liu Jing-Jing, Han Yue
中华医学杂志英文版2020年 133卷 19期
DOI: 10.1097/CM9.0000000000001040
摘要
致编辑：反向痤疮（AI），也称为化脓性汗腺炎，是一种慢性复发性炎症性皮肤病，其特征是深部疼痛性结节和脓肿，产生的疤痕主要分布在摩擦间区域。γ-分泌酶(GS)基因的功能丧失突变是家族性AI的原因。[
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食管碰撞瘤5例报告Zhang Guo-Chao, Wang Bing-Zhi, Wang Li-Yu, Wang Ya-Long, Guo Wei, Sun Nan, Gao Shu-Geng, Xue Qi, He Jie
中华医学杂志英文版2020年 133卷 19期
DOI: 10.1097/CM9.0000000000000982
摘要
致编辑：碰撞肿瘤是罕见的肿瘤，包括两个细胞群，这两个细胞群彼此并置发育，很少或没有混合区域。[
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经皮肺动脉可降解支架：对抗肺动脉狭窄的新武器？Zou Hai, Li Sheng-Qing
中华医学杂志英文版2020年 133卷 19期
DOI: 10.1097/CM9.0000000000001061
摘要
致编辑：肺动脉狭窄可由多种因素引起，如法洛四联症、肺动脉闭锁、三尖瓣闭锁伴肺动脉狭窄、闭锁合并另一种先天性心脏病和肺循环发育不良，[
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有布加综合征病史的木村病1例Wang Tao, Mei Yong-Jun, Li Zhi-Jun
中华医学杂志英文版2020年 133卷 19期
DOI: 10.1097/CM9.0000000000001008
摘要
致编辑：患者男，25岁，主诉右颈部有肿大结节3个月，无疼痛、瘙痒或皮炎。患者自2016年起患有布加综合征（BCS），2017年接受介入治疗（血管成形术伴支架置入术）及后期适当处理后得到良好控制。患者无高血压或糖尿病病史。患者右颈部出现椭圆形皮下肿胀。查体发现肿块边界清楚，与邻近组织无粘连，测量直径2.5 cm。血压和心率分别为128/84 mmHg和76次/min。
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