MedNexus
2020年 · 第133卷第21期
出版日期 2020-11-05电子版 ￥0.00元
MedNexus
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Original Article
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司库奇尤单抗可显著持续改善强直性脊柱炎的体征和症状：为期52周、以中国为中心的III期研究结果，测量5Huang Feng, Sun Fei, Wan Wei-Guo, Wu Li-Jun, Dong Ling-Li, Zhang Xiao, Kim Tae-Hwan, Sengupta Raj, Šenolt Ladislav, Wang Yi 等
中华医学杂志英文版2020年 133卷 21期
DOI: 10.1097/CM9.0000000000001099
摘要
Background:
Secukinumab demonstrated sustained efficacy in patients with ankylosing spondylitis (AS) through 5 years in pivotal Phase III studies. Here, we present efficacy and safety results (52-week) of secukinumab in patients with AS from the MEASURE 5 study.
Methods:
MEASURE 5 was a 52-week, Phase III, China-centric study. Eligible patients were randomly assigned (2:1) to receive subcutaneous secukinumab 150 mg or placebo weekly for the first five doses and then once every 4 weeks (q4w). All placebo patients switched to secukinumab 150 mg q4w starting at Week 16. Primary endpoint was Assessments of SpondyloArthritis international Society (ASAS) 20 at Week 16. Randomization was stratified by region (China vs. non-China).
Results:
Of 458 patients (secukinumab 150 mg, N= 305; placebo, N= 153) randomized, 327 (71.4%) were from China and 131 (28.6%) were not from China. Of these, 97.7% and 97.4% patients completed Week 16 and 91.1% and 95.3% (placebo-secukinumab) patients completed Week 52 of treatment. The primary endpoint was met; secukinumab significantly improved ASAS20 response at Week 16 vs. placebo (58.4% vs. 36.6%; P < 0.0001); corresponding rate in the Chinese population was 56.0% vs. 38.5% (P < 0.01). All secondary efficacy endpoints significantly improved with secukinumab 150 mg in the overall population at Week 16; responses were maintained with a trend toward increased efficacy from Week 16 to 52. No new or unexpected safety signals were reported up to Week 52.
Conclusions:
Secukinumab 150 mg demonstrated rapid and significant improvement in signs and symptoms of AS. Secukinumab was well tolerated and the safety profile was consistent with previous reports. Efficacy and safety results were comparable between the overall and Chinese populations.
Trial registration:
ClinicalTrials.gov, NCT02896127; https://clinicaltrials.gov/ct2/show/NCT02896127?term=NCT02896127&draw= 2&rank=1.
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血清microRNA表达谱揭示肺腺癌潜在诊断生物标志物Shan Xia, Zhang Lan, Zhu Dan-Xia, Zhou Xin, Zhang Huo, Liu Qing-Xie, Tang Jian-Wei, Wen Wei, Wang Tong-Shan, Zhu Wei 等
中华医学杂志英文版2020年 133卷 21期
DOI: 10.1097/CM9.0000000000001100
摘要
Background:
Recent studies have demonstrated that microRNAs (miRNAs) in the blood circulation can serve as promising diagnostic markers for cancers. This four-stage study aimed at finding serum miRNAs as potential biomarkers for lung adenocarcinoma (LA) diagnosis.
Methods:
The study was carried out between 2016 and 2017. The Exiqon miRNA qPCR panel (3 LA vs. 1 normal control [NC] pooled serum samples) was used for initial screening to acquire miRNA profiles. Thirty-five dysregulated miRNAs were further evaluated in the training (24 LA vs. 24 NCs) and testing stages (110 LA vs. 110 NCs) using quantitative real-time polymerase chain reaction assays.
Results:
Four serum miRNAs (miR-133a-3p, miR-584-5p, miR-10b-5p, and miR-221-3p) were significantly overexpressed in LA patients compared with NCs. The diagnostic value of the four-miRNA panel was validated by an external cohort (36 LA vs. 36 NCs). The areas under the receiver operating characteristic curve of the four-miRNA panel in the training, testing, and external validation stages were 0.734, 0.803, and 0.894 respectively. Meanwhile, the expression level of miR-221-3p was much higher in LA tumor samples than that in the adjacent normal tissues (19 LA vs. 19 NCs). The expression level of miR-10b-5p was also elevated in the serum-derived exosomes samples (18 LA vs. 18 NCs). The expression of miR-133a-3p, miR-584-5p, and miR-10b-5p was significantly elevated in LA patients with epidermal growth factor receptor mutation compared with NCs.
Conclusion:
The study established a four-miRNA signature in serum that could improve the diagnostic capability of LA.
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血清中三种microRNA作为甲状腺乳头状癌诊断的新生物标志物Zou Xuan, Gao Feng, Wang Zhi-Yan, Zhang Huo, Liu Qing-Xie, Jiang Lin, Zhou Xin, Zhu Wei
中华医学杂志英文版2020年 133卷 21期
DOI: 10.1097/CM9.0000000000001107
摘要
Background:
Accumulating evidence has revealed that circulating microRNAs (miRNAs) can serve as non-invasive biomarkers for cancer diagnosis. This study aimed to identify differentially expressed miRNAs in serum which might become potential biomarkers for non-invasive diagnosis of papillary thyroid carcinoma (PTC).
Methods:
The experiment was carried out between 2015 and 2017. In the screening stage, the Exiqon miRNA quantitative real-time polymerase chain reaction (qPCR) panel was applied to select candidate miRNAs. In the following training, testing, and external validation stages, the serum samples of 100 patients and 96 healthy controls (HCs) were analyzed to compare the expression levels of the identified miRNAs. The areas under the receiver operating characteristic curves (AUCs) were calculated to assess the diagnostic value of the identified signature.
Results:
Three miRNAs (miR-25-3p, miR-296-5p, and miR-92a-3p) in serum were consistently up-regulated in PTC patients compared with HCs. A three-miRNA panel was constructed by logistic regression analysis and showed better diagnostic performance than a single miRNA for PTC detection. The AUCs of the panel were 0.727, 0.771, and 0.862 for the training, testing, and external validation stage, respectively. Meanwhile, the panel showed stable capability in differentiating PTC patients from patients with benign goiters, with an AUC as high as 0.969. For further exploration, the three identified miRNAs were analyzed in tissue samples (23 PTC vs. 23 HCs) and serum-derived exosomes samples (24 PTC vs. 24 HCs), and the altered expression in the tumor also indicated their close relationship with PTC disease.
Conclusion:
We identify a three-miRNA panel in serum which might serve as a promising biomarker for PTC diagnosis.
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基于中华乳腺外科学会的炎性乳腺癌临床病理特征多中心研究（CSBrs-007）Zhou Qi, Zhang Hai-Ping, Zhao Ya-Ting, Wang Xiao-Hong, Xiong Wei, Liu Yun-Jiang, Zhang Jing-Hua, Chinese Society of Breast Surgery
中华医学杂志英文版2020年 133卷 21期
DOI: 10.1097/CM9.0000000000001104
摘要
Background:
Inflammatory breast cancer (IBC) is an aggressive type of cancer with poor prognosis and outcomes. This study aimed to investigate clinicopathological features, molecular characteristics, and treatments among Chinese patients diagnosed with IBC.
Methods:
We collected data of 95 patients with IBC who were treated by members of the Chinese Society of Breast Surgery, from January 2017 to December 2018. The data, including demographic characteristics, pathological findings, surgical methods, systemic treatment plans, and follow-up, were obtained using a uniform electronic questionnaire. The clinicopathological features of different molecular types in patients without distant metastases were compared using the Kruskal-Wallis (H) test followed by post hoc analyses.
Results:
Lymph node metastasis was noted in 75.8% of all patients, while distant metastasis was noted in 21.4%. Pathological findings indicated invasive ductal and lobular carcinomas in 86.8% and 5.3% of cases, respectively. Hormone receptor-positive (HR+)/human epidermal growth factor receptor 2-negative (HER2-) (41.5%) and HR-/HER2+ (20.1%) were the most common biologic subtypes, followed by HR+/HER2+ (19.1%) and HR-/HER2-(19.1%). Stage III IBC was treated via pre-operative neoadjuvant chemotherapy in 87.7% of the cases, predominantly using anthracycline and taxanes. A total of 91.9% of patients underwent surgical treatment. Among them, 77.0% of the patients underwent modified radical mastectomy, 8.1% of whom also underwent immediate breast reconstruction. The Kruskal-Wallis test revealed that the efficacy of chemotherapy significantly differed among those with HR+/HER2 -and HR-/HER2-tumors (adjusted P = 0.008), and Ki-67 expression significantly differed in HR-/HER2+ and HR+/HER2+ molecular subtypes (adjusted P = 0.008).
Conclusion:
Our study provides novel insight into clinicopathological characteristics and treatment status among patients with IBC in China, and might provide a direction and basis for further studies.
Trial registration:
chictr.org.cn, No. ChiCTR1900027179; http://www.chictr.org.cn/showprojen.aspx?proj=45030
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慢性获得性多灶性多发性神经病中神经脱髓鞘的不同分布Zhou Xia-Jun, Zhu Ying, Zhu De-Sheng, Han Lu, Liu Qian-Yun, Liang Xiao-Niu, Hao Yong, Li Ze-Zhi, Guan Yang-Tai
中华医学杂志英文版2020年 133卷 21期
DOI: 10.1097/CM9.0000000000001073
摘要
Background:
Multifocal motor neuropathy (MMN), Lewis-Sumner syndrome (LSS), and many chronic inflammatory demyelinating polyradiculoneuropathies (CIDPs) are representative of acquired multifocal polyneuropathy and are characterized by conduction block (CB). This retrospective study aimed to investigate the demyelinating distribution and the selective vulnerability of MMN, LSS, and CIDP with CB (CIDP-CB) in nerves.
Methods:
Fifteen LSS subjects (107 nerves), 24 MMN subjects (176 nerves), and 17 CIDP-CB subjects (110 nerves) were included. Their clinical information was recorded, blood and cerebrospinal fluid tests were conducted, and nerve conductions of the median, ulnar, radial, peroneal, and tibial nerves were evaluated. CB, temporal dispersion, distal motor latency (DML), and F-wave latency were recorded, and nerve conduction velocity, terminal latency index, and modified F-wave ratio were calculated.
Results:
CB was more likely to occur around the elbow in CIDP-CB than in MMN (78.6% vs. 6.8%, P < 0.01) but less likely to occur between the wrist and the elbow than in LSS (10.7% vs. 39.3%, P < 0.05). Tibial nerve CB was most frequently observed in MMN (47.4%, P < 0.05). CIDP-CB was characterized by a prolonged DML in all nerves, and slow motor nerve velocity of the upper limb was significant when CB nerves were excluded (P < 0.05).
Conclusions:
We report the different distributions of segmental and diffuse demyelination of the ulnar and tibial nerves in LSS, MMN, and CIDP-CB. These distinct distributions could help in differentiating among these conditions.
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心力衰竭患者心外膜脂肪组织环状RNA的表达Zheng Mei-Li, Du Xiang-Peng, Zhao Lei, Yang Xin-Chun
中华医学杂志英文版2020年 133卷 21期
DOI: 10.1097/CM9.0000000000001056
摘要
Background:
Recent studies have reported circular RNA (circRNA) expression profiles in various tissue types; however, circRNA expression profile in human epicardial adipose tissue (EAT) remains undefined. This work aimed to compare circRNA expression patterns in EAT between the heart failure (HF) and non-HF groups.
Methods:
RNA-sequencing was carried out to compare circRNA expression patterns in EAT specimens from coronary artery disease cases between the HF and non-HF groups. Quantitative real-time polymerase chain reaction was performed for validation. Comparisons of patient characteristics between the two groups were using t test, Mann-Whitney U test, and Chi-squared test.
Results:
A total of 141 circRNAs substantially different between the HF and non-HF groups (P < 0.05; fold change >2) were detected, including 56 up-regulated and 85 down-regulated. Among them, hsa_circ_0005565 stood out, for it had the highest fold change and was significantly increased in HF patients in quantitative real-time polymerase chain reaction validation. The top highly expressed EAT circRNAs corresponded to genes involved in cell proliferation and inflammatory response, including GSE1, RHOBTB3, HIPK3, UBXN7, PCMTD1, N4BP2L2, CFLAR, EPB41L2, FCHO2, FNDC3B, and SPECC1. The top enriched Gene Ontology term and Kyoto Encyclopedia of Genes and Genomes pathway were positive regulation of metabolic processes and insulin resistance, respectively.
Conclusion:
These data indicate EAT circRNAs may contribute to the pathogenesis of metabolic disorders causing HF.
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与ST11广泛耐药碳青霉烯酶产生菌广泛传播相关的遗传因素肺炎克雷伯菌医院内的菌株Li Dai-Xi, Zhai Yao, Zhang Zhao, Guo Ya-Tao, Wang Zhan-Wei, He Zi-Long, Hu Song-Nian, Chen Yu-Sheng, Kang Yu, Gao Zhan-Cheng
中华医学杂志英文版2020年 133卷 21期
DOI: 10.1097/CM9.0000000000001101
摘要
Background:
Carbapenemase-producing Klebsiella pneumoniae (CP-Kp) poses distinct clinical challenges due to extensively drug resistant (XDR) phenotype, and sequence type (ST) 11 is the most dominant blaKPC-2-bearing CP-Kp clone in China. The purpose of this current retrospective study was to explore the genetic factors associated with the success of XDR CP-Kp ST11 strains circulated in the intensive care unit (ICU) of a Chinese tertiary hospital.
Methods:
Six ST11 XDR CP-Kp strains were identified between May and December 2014 and validated by minimum inhibitory concentration examination, polymerase chain reaction, and pyrosequencing. The six ST11 XDR CP-Kp, as well as three multi-drug resistant (MDR) and four susceptible strains, were sequenced using single-molecule real-time method. Comprehensively structural and functional analysis based on comparative genomics was performed to identify genomic characteristics of the XDR ST11 CP-Kp strains.
Results:
We found that ST11 XDR blaKPC-2-bearing CP-Kp strains isolated from inpatients spread in the ICU of the hospital. Functionally, genes associated with information storage and processing of the ST11 XDR CP-Kp strains were more abundant than those of MDR and susceptible strains, especially genes correlative with mobile genetic elements (MGEs) such as transposons and prophages. Structurally, eleven large-scale genetic regions taken for the unique genome in these ST11 XDR CP-Kp strains were identified as MGEs including transposons, integrons, prophages, genomic islands, and integrative and conjugative elements. Three of them were located on plasmids and eight on chromosomes; five of them were with antimicrobial resistance genes and eight with adaptation associated genes. Notably, a new blaKPC-2-bearing ΔΔTn1721-blaKPC-2 transposon, probably transposed and truncated from ΔTn1721-blaKPC-2 by IS903D and ISKpn8, was identified in all six ST11 XDR CP-Kp strains.
Conclusion:
Our findings suggested that together with clonal spread, MGEs identified uniquely in the ST11 XDR CP-Kp strains might contribute to their formidable adaptability, which facilitated their widespread dissemination in hospital.
Review Article
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血-视网膜屏障是理解视网膜疾病发生和发展的关键Yang Xue, Yu Xiao-Wei, Zhang Dan-Dan, Fan Zhi-Gang
中华医学杂志英文版2020年 133卷 21期
DOI: 10.1097/CM9.0000000000001015
摘要
Clinical ophthalmologists consider each retinal disease as a completely unique entity. However, various retinal diseases, such as uveitis, age-related macular degeneration, diabetic retinopathy, and primary open-angle glaucoma, share a number of common pathogenetic pathways. Whether a retinal disease initiates from direct injury to the blood-retinal barrier (BRB) or a defect/injury to retinal neurons or glia that impairs the BRB secondarily, the BRB is a pivotal point in determining the prognosis as self-limiting and recovering, or developing and progressing to a clinical phenotype. The present review summarizes our current knowledge on the physiology and cellular and molecular pathology of the BRB, which underlies its pivotal role in the initiation and development of common retinal diseases.
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免疫检查点抑制剂诱导的1型糖尿病Zhang Rui, Cai Xiao-Ling, Liu Liu, Han Xue-Yao, Ji Li-Nong
中华医学杂志英文版2020年 133卷 21期
DOI: 10.1097/CM9.0000000000000972
摘要
With the increasing use of immune checkpoint inhibitors (ICI) including anti-cytotoxic T lymphocyte associated antigen-4 (CTLA-4) and anti-programmed cell death-1 (PD-1) in cancers, ICI-induced type 1 diabetes has been reported throughout the world. In this review, we aim to summarize the characteristics of this disease and discuss the mechanism of it. As an immune-related adverse event, type 1 diabetes developed after the administration of anti-PD-1 or anti-PD-ligand 1 (PD-L1) in the combination with or without anti-CTLA-4. It usually presented with acute onset, and 62.1% of the reported cases had diabetic ketoacidosis. Only a third of them had positive autoantibodies associated with type 1 diabetes. Susceptible HLA genotypes might be associated. T-cell-stimulation by blocking of the interaction of PD-1 and PD-L1 in pancreatic β cells was the main mechanism involved in the pathology. Insulin was the only effective treatment of ICI-induced type 1 diabetes. In conclusions, ICI-induced type 1 diabetes is a potentially life-threating adverse event after the immunotherapy of cancers. Screening and early recognition is important. Further investigation of the mechanism may help to better understand the pathology of type 1 diabetes.
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肾缺血-再灌注损伤的关键中枢：内质网-线粒体束缚复合物Zhao Huan-Huan, Han Qiu-Xia, Ding Xiao-Nan, Yan Jing-Yao, Li Qi, Zhang Dong, Zhu Han-Yu
中华医学杂志英文版2020年 133卷 21期
DOI: 10.1097/CM9.0000000000001091
摘要
Mitochondrial injury and endoplasmic reticulum (ER) stress are considered to be the key mechanisms of renal ischemia-reperfusion (I/R) injury. Mitochondria are membrane-bound organelles that form close physical contact with a specific domain of the ER, known as mitochondrial-associated membranes. The close physical contact between them is mainly restrained by ER-mitochondria tethering complexes, which can play an important role in mitochondrial damage, ER stress, lipid homeostasis, and cell death. Several ER-mitochondria tethering complex components are involved in the process of renal I/R injury. A better understanding of the physical and functional interaction between ER and mitochondria is helpful to further clarify the mechanism of renal I/R injury and provide potential therapeutic targets. In this review, we aim to describe the structure of the tethering complex and elucidate its pivotal role in renal I/R injury by summarizing its role in many important mechanisms, such as mitophagy, mitochondrial fission, mitochondrial fusion, apoptosis and necrosis, ER stress, mitochondrial substance transport, and lipid metabolism.
Medical Progress
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可注射磷酸钙骨水泥的临床应用研究进展Wang Xiao-Hui, Jia Shuai-Jun, Hao Ding-Jun
中华医学杂志英文版2020年 133卷 21期
DOI: 10.1097/CM9.0000000000001092
摘要
自体移植、同种异体移植和异种移植是最广泛使用的增强骨缺损有效重建的方法，但天然供体骨存在一些缺陷，如供应有限、移植供应部分过度损伤、生长受限和并发症发生率高。[
Perspective
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循环肿瘤DNA作为妇科肿瘤生物标志物的评价Liu Kang-Sheng, Tong Hua, Li Tai-Ping, Chen Ya-Jun
中华医学杂志英文版2020年 133卷 21期
DOI: 10.1097/CM9.0000000000001140
摘要
循环肿瘤DNA（ctDNA）是凋亡或坏死的肿瘤细胞释放到外周血中的DNA片段，携带基因突变后的基本遗传信息。ctDNA的检测和分析可以提供肿瘤大小和发展的基因组信息；因此，它被认为是一种新兴且有前途的肿瘤生物标志物，用于癌症进展、复发和术后常规监测。尽管由于ctDNA的稳定性，分离方法相对简单，但ctDNA的丰度极低，并且由于背景无细胞DNA(cfDNA)的高含量、个体之间的大差异以及需要预测的检测位点，因此有必要以综合的方式分析ctDNA。目前，以敏感性和特异性满足ctDNA检测需求的主要方法有扩增难治性突变系统PCR（ARMS-PCR）、数字PCR（dPCR）和高通量测序。其中，dPCR在实用性方面具有优势，可实现单分子DNA的绝对定量，检测和追踪DNA分子并进行定量分析，为临床监测肿瘤复发和微小残留病提供可靠依据。本文就ctDNA在妇科肿瘤中的检测及潜在价值作一综述。
Clinical Observation
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我国甲状腺素运载蛋白相关性家族性淀粉样多发性神经病的临床和遗传学特征Liu Lei, Li Xiao-Bo, Hu Zheng-Mao, Huang Shun-Xiang, Tang Bei-Sha, Zhang Ru-Xu
中华医学杂志英文版2020年 133卷 21期
DOI: 10.1097/CM9.0000000000001094
摘要
甲状腺素运载蛋白相关家族性淀粉样多发性神经病（TTR-FAP）是一种常染色体显性、危及生命且可治疗的疾病，由TTR突变。其特征是外周神经和主要器官（包括心脏、肾脏和眼睛）中的淀粉样蛋白沉积。到目前为止，超过130TTR已经确定了突变，其中P.Val 30Met在流行国家最常见。TTR-FAP已在29个国家报告，包括欧洲、美国、日本、中国和印度的许多国家。TTR-FAP的临床和遗传学特征在欧洲和日本已经比较明确，然而，在中国仍需开展。在这里，我们报告了8个中国TTR-FAP家系的临床和遗传学特征。
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基因微阵列检测新诊断多发性骨髓瘤内源性RNA网络He Yu-Qin, Zhang Zhi-Yao, Zhou Hui-Xing, Ye Fang, Chen Wen-Ming
中华医学杂志英文版2020年 133卷 21期
DOI: 10.1097/CM9.0000000000001108
摘要
多发性骨髓瘤（MM）是一种以浆细胞克隆性增殖为特征的血液恶性肿瘤，使血、尿中单克隆免疫球蛋白数量增加，引起靶器官损害。据报道，长非编码RNA（lncRNAs）具有高遗传异质性，并参与MM的恶性肿瘤形成、进展和转移。[
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肝移植术后胆道并发症患者免疫状态受损Lei Hong, Tian Min, Zhang Xiao-Gang, Meng Lie-Su, Zhu Wen-Hua, Liu Xue-Min, Wang Meng-Zhou, Wang Tao, Chang Peng-Kang, Chen Huan 等
中华医学杂志英文版2020年 133卷 21期
DOI: 10.1097/CM9.0000000000001088
摘要
免疫抑制（IS）对于肝移植（LTx）患者控制主要由T细胞介导的不需要的同种免疫反应是不可或缺的。然而，T细胞的抗原非依赖性稳态对于维持长期T细胞介导的免疫至关重要，过量的IS可能增加机会性感染和恶性肿瘤的风险。因此，LTx患者的IS治疗应根据个体患者的免疫状态进行定制。[
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裸金属支架治疗关节水平动脉损伤Li Shuai, Yang Zhen, Li Min, Zhu Jian-Zhong, Zhang Xi-Quan
中华医学杂志英文版2020年 133卷 21期
DOI: 10.1097/CM9.0000000000001103
摘要
报告表明，外周动脉损伤尤其具有挑战性，因为它们与肢体丧失的高风险相关。需要快速诊断和干预来提供肢体挽救，并且可以挽救生命。随着血管内技术和工具的不断发展，开放修复已经不是治疗创伤性血管损伤的唯一选择。类似地，微创经皮血管内治疗提供了一种有吸引力的治疗选择。由于血管内治疗几乎同时进行诊断评估和治疗干预，急性创伤性血管病变的保肢可能会得到改善。
Correspondence
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有效P2Y12抑制剂的疗效和安全性vs.氯吡格雷治疗老年急性冠脉综合征Luo Li-Man, Pang Zhan-Qi, Fu Meng-Lu, Li Yuan-Yuan, Tu Ling, Xu Xi-Zhen
中华医学杂志英文版2020年 133卷 21期
DOI: 10.1097/CM9.0000000000001119
摘要
致编辑：目前的指南建议急性冠状动脉综合征（ACS）患者如果没有禁忌症，应接受阿司匹林加P2Y12抑制剂（氯吡格雷、普拉格雷或替格瑞洛）的双重抗血小板治疗。到目前为止，关于强效抗血小板药物在老年ACS患者中的临床疗效和安全性的信息有限，尤其是在高龄人群（年龄≥75岁）中。我们搜索了2000年1月至2019年12月的PubMed、Cochrane图书馆、Web of Science、EMBASE（摘录医学数据库）。使用Stata软件12.0版（StataCorp LP，College Station，TX，USA）进行数据分析。总体调查结果记录为双侧风险比(RR)和95%置信区间(CI)P价值观。最后，本荟萃分析纳入了7项临床研究，包括8848名老年ACS患者（年龄≥65岁）口服强效P2Y12抑制剂与氯吡格雷的比较。[
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程序性细胞死亡配体1检测和免疫检查点抑制剂肿瘤突变负荷检测治疗晚期非小细胞肺癌的成本效益Li Wen-Qian, Li Ling-Yu, Bai Ri-Lan, Qian Lei, Chen Nai-Fei, Cui Jiu-Wei
中华医学杂志英文版2020年 133卷 21期
DOI: 10.1097/CM9.0000000000001120
摘要
致编辑：在世界范围内，肺癌，特别是非小细胞肺癌(NSCLC)是肿瘤相关死亡的主要原因。成本效益分析显示，晚期非小细胞肺癌患者接受化疗无经济效益。[
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中国人腓骨肌萎缩症患者的基因图谱Ouyang Zhi-Yuan, Chen You, Qin Da-Qiang, Cen Zhi-Dong, Zheng Xiao-Sheng, Xie Fei, Chen Si, Wang Hao-Tian, Yang De-Hao, Chen Xin-Hui 等
中华医学杂志英文版2020年 133卷 21期
DOI: 10.1097/CM9.0000000000001095
摘要
致编辑：Charcot-Marie-Tooth病(CMT)包括一组遗传异质性遗传性神经病，其特征是进行性远端肌肉无力和萎缩、感觉缺陷、肌腱反射受损和足部畸形。[
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清醒卒中超急性期褪黑素、皮质醇和时钟基因表达的昼夜节律：研究设计和测量Zhang Xian-Xian, Cai Xiu-Ying, Zhao Hong-Ru, Wang Hui, Wang Da-Peng, Zhang Quan-Quan, Wang Han, Fang Qi
中华医学杂志英文版2020年 133卷 21期
DOI: 10.1097/CM9.0000000000001111
摘要
致编辑：唤醒卒中(WUS)是主要在夜间睡眠期间发生的缺血性卒中的名称，约占所有急性缺血性卒中(AIS)病例的20%。流行病学研究表明，AIS呈昼夜节律分布，早晨频率较高，睡眠期间频率较低。[
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甲状腺结节中“肿瘤新生血管样模式”和“回声区”并存的声像图特征：在预测乳头状癌中的诊断性能Tong Meng-Ying, Qiu Meng, Feng Xiao, Guo Li-Ying, Xie Wen-Long, Jia Juan-Juan, Che Ying
中华医学杂志英文版2020年 133卷 21期
DOI: 10.1097/CM9.0000000000001077
摘要
致编辑：许多经过充分研究的超声特征已在临床上用于评估甲状腺结节的恶性肿瘤。美国放射学院甲状腺成像、报告和数据系统（TI-RADS）提出的超声灰度特征包括成分、回声、形状、边缘和回声病灶。[
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颈椎前路椎间盘摘除融合术中钛板与椎体终板之间的间隙可能影响融合过程Deng Yi-Fei, Meng Yang, Liu Hao, Rong Xing, Hong Ying, Wang Bei-Yu, Ding Chen, Yang Yi
中华医学杂志英文版2020年 133卷 21期
DOI: 10.1097/CM9.0000000000001129
摘要
致编辑：颈椎前路椎间盘切除融合术（ACDF）是保守治疗失败的脊髓型颈椎病患者的“金标准”。[
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使用改良附件夹进行左心耳截肢：一项实验性犬研究Zhang Shuo, Li Hong-Xin, Sun Fang-Li, Guo Zhen-Wei, Zhu Mei, Feng Juan, Guo Wen-Bin, Wang Xi-Ming
中华医学杂志英文版2020年 133卷 21期
DOI: 10.1097/CM9.0000000000001122
摘要
致编辑：心房颤动（AF）是在普通人群中观察到的最常见的心律失常之一。与AF相关的中风的主要原因是血栓形成在左心耳（LAA）中并从其脱落。超过90%的心源性血栓形成起源于LAA，因为LAA的囊状和复杂形态诱导血流停滞。[
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