MedNexus
2020年 · 第133卷第22期
出版日期 2020-11-20电子版 ￥0.00元
MedNexus
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Editorial
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慢性肝病和肝硬化的管理：现状和未来方向Xu Jing-Hang, Yu Yan-Yan, Xu Xiao-Yuan
中华医学杂志英文版2020年 133卷 22期
DOI: 10.1097/CM9.0000000000001084
摘要
慢性肝病（CLD）和肝硬化是世界范围内的重大健康负担。2017年，估计有15亿例病例，与2007年相比，年龄标准化患病率增加了10.4%。[
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服用血管紧张素转换酶抑制剂/血管紧张素II I型受体阻滞剂的患者：严重急性呼吸综合征冠状病毒2型感染风险较高但临床表现较轻？Deng Jie-Lin, Jiang Yun-Qiu, Guo Yan-Kai, Li Hong-Liang
中华医学杂志英文版2020年 133卷 22期
DOI: 10.1097/CM9.0000000000000996
摘要
最近，人们对新冠肺炎患者中血管紧张素转换酶2（ACE2）相关药物给药的话题产生了前所未有的兴趣，如血管紧张素转换酶抑制剂（ACEIs）/血管紧张素II I型受体阻滞剂（ARBs）。最近的一篇文章提出了服用ACEI/ARB的患者感染新冠肺炎的风险更高的担忧。[
Original Article
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结合机器学习建立的用于识别肝纤维化和早期肝硬化的放射组学模型的开发和验证Qiu Qing-Tao, Zhang Jing, Duan Jing-Hao, Wu Shi-Zhang, Ding Jia-Lin, Yin Yong
中华医学杂志英文版2020年 133卷 22期
DOI: 10.1097/CM9.0000000000001113
摘要
Background:
Liver fibrosis (LF) continues to develop and eventually progresses to cirrhosis. However, LF and early-stage cirrhosis (ESC) can be reversed in some cases, while advanced cirrhosis is almost impossible to cure. Advances in quantitative imaging techniques have made it possible to replace the gold standard biopsy method with non-invasive imaging, such as radiomics. Therefore, the purpose of this study is to develop a radiomics model to identify LF and ESC.
Methods:
Patients with LF (n = 108) and ESC (n = 116) were enrolled in this study. As a control, patients with healthy livers were involved in the study (n = 145). Diffusion-weighted imaging (DWI) data sets with three b-values (0, 400, and 800 s/mm2) of enrolled cases were collected in this study. Then, radiomics features were extracted from manually delineated volumes of interest. Two modeling strategies were performed after univariate analysis and feature selection. Finally, an optimal model was determined by the receiver operating characteristic area under the curve (AUC).
Results:
The optimal models were built in plan 1. For model 1 in plan 1, the AUCs of the training and validation cohorts were 0.973 (95% confidence interval [CI] 0.946-1.000) and 0.948 (95% CI 0.903-0.993), respectively. For model 2 in plan 1, the AUCs of the training and validation cohorts were 0.944, 95% CI 0.905 to 0.983, and 0.968, 95% CI 0.940 to 0.996, respectively.
Conclusions:
Radiomics analysis of DWI images allows for accurate identification of LF and ESC, and the non-invasive biomarkers extracted from the functional DWI images can serve as a better alternative to biopsy.
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基于中国乳腺外科学会资料的保乳手术多中心调查（CSBrS-005）Yu Li-Xiang, Shi Peng, Tian Xing-Song, Yu Zhi-Gang, Chinese Society of Breast Surgery
中华医学杂志英文版2020年 133卷 22期
DOI: 10.1097/CM9.0000000000001152
摘要
Background:
Although breast-conserving surgery is one of the standard treatments for breast cancer, few studies have assessed its recent implementation in China. We aimed to clarify the current real-world status of breast-conserving surgery in China.
Methods:
This cross-sectional survey relied on data collected by the Chinese Society of Breast Surgery (CSBrS) to examine patients who underwent this surgery between January 2018 and December 2018. The survey was conducted using a uniform electronic questionnaire to collect information, including clinical and pathological data on these patients.
Results:
Overall, 4459 breast-conserving surgeries were performed in 34 member units of CSBrS, accounting for 14.6% of all breast cancer surgeries performed in these units during the study period. In patients who underwent breast-conserving surgery with information on tumor size available, more than half (61.2%) of the tumors were smaller than 2 cm in diameter, and only 87 (3.2%) tumors were larger than 4 cm in diameter. Among patients who underwent breast-conserving surgeries, 457 (10.2%) patients received neoadjuvant therapy before the surgery. Among patients with a reported margin width, 34 (2.0%) patients had a margin of ≤2 mm, and 1530 (88.2%) of them had a margin of >5 mm.
Conclusions:
This study demonstrated the rates of breast-conserving surgery in member units of the CSBrS, and introduced the characteristics and surgical margins of patients who underwent this surgery. This information helps describe the real-world status of breast-conserving surgery in China.
Trial registration:
chictr.org.cn, ChiCTR1900026841; http://www.chictr.org.cn/showproj.aspx?proj=42783
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司库奇尤单抗在中国中重度斑块型银屑病患者中显示出52周的高疗效和良好的安全性特征Cai Lin, Zhang Jian-Zhong, Yao Xu, Gu Jun, Liu Quan-Zhong, Zheng Min, Zhang Shi-Fa, Xu Jin-Hua, Li Cheng-Xin, Cheng Hao 等
中华医学杂志英文版2020年 133卷 22期
DOI: 10.1097/CM9.0000000000001163
摘要
Background:
Psoriasis is a chronic inflammatory skin disease, affecting about 0.6% of the Chinese population. Many patients are not well controlled by conventional treatments, thus there is need for new treatment regimens. In this study, we assessed the efficacy and safety of secukinumab in Chinese patients with moderate to severe plaque psoriasis.
Methods:
This study was a 52-week, multicentre, randomized, double-blind, placebo-controlled, parallel-group, Phase 3 trial. A sub-population of study participants (≥18 years) of Chinese ethnicity were randomized to receive subcutaneous injections of 300 or 150 mg secukinumab, or placebo. The co-primary endpoints were psoriasis area severity index (PASI) 75 and Investigator’s Global Assessment (IGA) 0/1 at Week 12.
Results:
A total of 441 Chinese patients were enrolled in this study. Co-primary outcomes were achieved; 300 and 150 mg secukinumab were superior to placebo as shown in the proportion of patients that achieved PASI 75 (97.7% and 87.2% vs. 3.7%, respectively; P < 0.001), and IGA 0/1 (82.3% and 69.7% vs. 2.7%; P < 0.001) at Week 12. Treatment efficacy was maintained until Week 52. There was no increase in overall adverse events with secukinumab relative to placebo throughout the 52-week period. Conclusion: Secukinumab is highly effective and well tolerated in Chinese patients with moderate to severe plaque psoriasis.
Trial Registration:
ClinicalTrials.gov, NCT03066609; https://clinicaltrials.gov/ct2/show/record/NCT03066609.
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反复经皮冠状动脉介入治疗后早期和晚期药物洗脱支架支架内再狭窄的临床特征及中期预后Zheng Jian-Feng, Guo Ting-Ting, Tian Yuan, Wang Yong, Hu Xiao-Ying, Chang Yue, Qiu Hong, Dou Ke-Fei, Tang Yi-Da, Yuan Jin-Qing 等
中华医学杂志英文版2020年 133卷 22期
DOI: 10.1097/CM9.0000000000001135
摘要
Background:
The mechanism and characteristics of early and late drug-eluting stent in-stent restenosis (DES-ISR) have not been fully clarified. Whether there are different outcomes among those patients being irrespective of their repeated treatments remain a knowledge gap.
Methods:
A total of 250 patients who underwent initial stent implantation in our hospital, and then were readmitted to receive treatment for the reason of recurrent significant DES-ISR in 2016 were involved. The patients were categorized as early ISR (<12 months; E-ISR; n = 32) and late ISR (≥12 months; L-ISR; n = 218). Associations between patient characteristics and clinical performance, as well as clinical outcomes after a repeated percutaneous coronary intervention (PCI) were evaluated. Primary composite endpoint of major adverse cardiac events (MACEs) included cardiac death, non-fatal myocardial infarction (MI), or target lesion revascularization (TLR).
Results:
Most baseline characteristics are similar in both groups, except for the period of ISR, initial pre-procedure thrombolysis in myocardial infarction, and some serum biochemical indicators. The incidence of MACE (37.5% vs. 5.5%; P < 0.001) and TLR (37.5% vs. 5.0%; P < 0.001) is higher in the E-ISR group. After multivariate analysis, E-ISR (odds ratio [OR], 13.267; [95% CI 4.984-35.311]; P < 0.001) and left ventricular systolic dysfunction (odds ratio [OR], 6.317; [95% CI 1.145-34.843]; P = 0.034) are the independent predictors for MACE among DES-ISR patients in the mid-term follow-up of 12 months.
Conclusions:
Early ISR and left ventricular systolic dysfunction are associated with MACE during the mid-term follow-up period for DES-ISR patients. The results may benefit the risk stratification and secondary prevention for DES-ISR patients in clinical practice.
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内侧支撑钉和股骨近端钉抗旋转治疗反向倾斜转子间骨折（Arbeitsgemeinschaft fur Osteosynthesfrogen/骨科创伤协会31-A3.1）：有限元分析Nie Shao-Bo, Zhao Yan-Peng, Li Jian-Tao, Zhao Zhe, Zhang Zhuo, Zhang Li-Cheng, Tang Pei-Fu
中华医学杂志英文版2020年 133卷 22期
DOI: 10.1097/CM9.0000000000001031
摘要
Background:
The reverse obliquity inter-trochanteric fracture is a distinct fracture pattern that is mechanically different from most inter-trochanteric fractures and the optional treatment of it is still controversial. The purpose of this study was to compare differences in the efficacy of a novel nail (medial support nail [MSN-II]) and proximal femoral nail anti-rotation (PFNA-II) in the treatment of reverse obliquity inter-trochanteric fractures (Arbeitsgemeinschaft fur Osteosynthesfrogen/Orthopedic Trauma Association [AO/OTA] 31-A3.1) using finite-element analysis.
Methods:
Modeling software was used to establish a three-dimensional model of MSN-II and PFNA-II and an A3.1 inter-trochanteric fracture model. Abaqus software was used to implement different force loads to compare finite-element biomechanical parameters such as the maximum stress in implant and the displacement of fracture site.
Results:
The femoral stress, implant stress and fracture site displacement of MSN-II was less than that of PFNA-II. The results indicated that the maximal femoral stress was 581 MPa for PFNA-II and 443 MPa for the MSN-II. The maximum stress values in the PFNA-II and MSN-II models were 291 and 241 MPa, respectively. The maximal displacements of the fracture site were 1.47 and 1.16 mm in the PFNA-II and MSN-II models, respectively.
Conclusions:
Compared with PFNA-II for inter-trochanteric fracture (AO/OTA 31-A3.1), MSN-II which was designed with a triangular stability structure can provide better biomechanical stability. The MSN-II may be a feasible option for the treatment of reverse obliquity inter-trochanteric fracture.
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代谢综合征对颈动脉血运重建近期预后的影响：一项在中国人群中进行的大样本量研究Bai Xue-Song, Feng Yao, Wang Tao, Zhang Xiao, Yang Chang-Lin, Wang Ya-Bing, Hua Yang, Lu Jie, Zhu Feng-Shui, Chen Yan-Fei 等
中华医学杂志英文版2020年 133卷 22期
DOI: 10.1097/CM9.0000000000001038
摘要
Background:
Metabolic syndrome (MetS) is relatively common worldwide and an important risk factor for cardiovascular diseases. It is closely linked to arterial stiffness of the carotid artery. However, the association of MetS with the safety of carotid revascularization has been rarely studied. The aim of this study was to observe the current status of MetS and its components in Chinese carotid revascularized patients, and investigate the impact on major adverse clinical events (MACEs) after carotid endarterectomy (CEA) or carotid artery stenting (CAS).
Methods:
From January 2013 to December 2017, patients undergoing CEA or CAS in the Neurosurgery Department of Xuanwu Hospital were retrospectively recruited. The changes in prevalence of MetS and each component with time were investigated. The primary outcome was 30-day post-operative MACEs. Univariable and multivariable analyses were performed to identify the impact of MetS on CEA or CAS.
Results:
A total of 2068 patients who underwent CEA (766 cases) or CAS (1302 cases) were included. The rate of MetS was 17.9%; the prevalence rate of MetS increased with time. The occurrence rate of MACEs in CEA was 3.4% (26 cases) and in CAS, 3.1% (40 cases). There was no statistical difference between the two groups (3.4% vs. 3.1%, P = 0.600). For CEA patients, univariate analysis showed that the MACE (+) group had increased diabetes history (53.8% vs. 30.9%, P= 0.014) and MetS (34.6% vs. 15.8%, P = 0.023). For CAS patients, univariate analysis showed that the MACE (+) group had increased coronary artery disease history (40.0% vs. 21.6%, P = 0.006) and internal carotid artery tortuosity (67.5%% vs. 37.6%, P < 0.001). Furthermore, the MACE (+) group had higher systolic blood pressure (143.38 ± 22.74 vs. 135.42 ± 17.17 mmHg, P = 0.004). Multivariable analysis showed that the influencing factors for MACEs in CEA included history of diabetes (odds ratio [OR] = 2.345; 95% confidence interval [CI] = 1.057-5.205; P = 0.036) and MetS (OR = 2.476; 95% CI = 1.065-5.757; P = 0.035). The influencing factors for MACEs in CAS included systolic blood pressure (OR= 1.023; 95% CI= 1.005-1.040; P= 0.010), coronary artery disease (OR= 2.382; 95% CI= 1.237-4.587; P= 0.009) and internal carotid artery tortuosity (OR= 3.221; 95% CI= 1.637-6.337; P = 0.001).
Conclusions:
The prevalence rate of MetS increased with time in carotid revascularized patients. MetS is a risk for short-term MACEs after CEA, but not CAS.
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外伤性椎体终板骨折的影像学特征——附194例263个椎体骨折分析Wang Xiao-Rong, Xu Fei-Rong, Huang Qiu-Li, Wáng Yì Xiáng J.
中华医学杂志英文版2020年 133卷 22期
DOI: 10.1097/CM9.0000000000000919
摘要
Background:
The importance of identifying osteoporotic vertebral endplate or/and cortex fracture (ECF), which primarily includes endplate fracture (EPF) and vertebral anterior cortex buckling, has been recognized. However, some old traumatic ECFs with healing process in the elderly may be mistaken as osteoporotic. This study analyzes the radiological features of traumatic EPF.
Methods:
This was a retrospective analysis of 194 spine trauma patients with 263 vertebral fractures (mean age: 42.11 ± 9.82 years, 118 males and 76 females). All patients had traumatic EPF identified by X-ray/CT/MRI.
Results:
The involved vertebra was mostly L1 (29.7%), followed by T12 and L2. Except EPFs involved both superior and inferior endplates (12.6%), only 1.9% involved inferior endplate alone, with the majority involved superior endplate. If each endplate was divided into five segments of equal lengths (from anterior to posterior: a1, a2, m, p2, p1), the most depressed point of superior EPFs was mostly at segment-a2 (approximately 45%), followed by segment-a1 (approximately 20%) or segment-m (approximately 20%), and very rarely at segment-p1. The upper 1/3 of anterior vertebral wall was more likely to fracture, followed by middle 1/3 of anterior wall. For posterior vertebral wall fracture, 68.5% broke the bony wall surrounding the basivertebral vain. 58.6%, 30.0%, and 11.4% of vertebral fractures had <1/5, 1/5-1/3, and >1/3 vertebral body height loss. As the extent of vertebral height loss increased, the chance of having both superior and inferior EPFs also increased; however, the chance of having inferior EPF alone did not increase.
Conclusion:
Traumatic EPF features are characterized, which may help the differentiation of traumatic and osteoporotic EPFs.
Review Article
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我国直肠癌外科治疗现状Yang Yong, Wang Han-Yang, Chen Yong-Kang, Chen Jia-Jia, Song Can, Gu Jin
中华医学杂志英文版2020年 133卷 22期
DOI: 10.1097/CM9.0000000000001076
摘要
With the changing lifestyle and the acceleration of aging in the Chinese population, the incidence and mortality of colorectal cancer (CRC) have risen in the last decades. On the contrary, the incidence and mortality of CRC have continued to decline in the USA since the 1980s, which is mainly attributed to early screening and standardized diagnosis and treatment. Rectal cancer accounts for the largest proportion of CRC in China, and its treatment regimens are complex. At present, surgical treatment is still the most important treatment for rectal cancer. Since the first Chinese guideline for diagnosis and treatment of CRC was issued in 2010, the fourth version has been revised in 2020. These guidelines have greatly promoted the standardization and internationalization of CRC diagnosis and treatment in China. And with the development of comprehensive treatment methods such as neoadjuvant chemoradiotherapy, targeted therapy, and immunotherapy, the post-operative quality of life and prognosis of patients with rectal cancer have improved. We believe that the inflection point of the rising incidence and mortality of rectal cancer will appear in the near future in China. This article reviewed the current status and research progress on surgical therapy of rectal cancer in China.
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微生态研究：预防哮喘的新靶点Shi Hong-Lei, Lan Yu-Hao, Hu Zheng-Chuan, Yan Zi-Ning, Liu Ze-Zhong, Kadier Xiriaili, Ma Li, Yu Jin-Yan, Liu Jing
中华医学杂志英文版2020年 133卷 22期
DOI: 10.1097/CM9.0000000000001127
摘要
The incidence and prevalence of asthma have increased remarkably in recent years. There are lots of factors contributing to the occurrence and development of asthma. With the improvement of sequencing technology, it has been found that the microbiome plays an important role in the formation of asthma in early life. The roles of the microbial environment and human microbiome in the occurrence and development of asthma have attracted more and more attention. The environmental microbiome influences the occurrence of asthma by shaping the human microbiome. The specific mechanism may be related to the immune regulation of Toll-like receptors and T cells (special Tregs). Intestinal microbiome is formed and changed by regulating diet and lifestyle in early life, which may affect the development and maturation of the pulmonary immune system through the intestinal-pulmonary axis. It is well-recognized that both environmental microbiomes and human microbiomes can influence the onset of asthma. This review aims to summarize the recent advances in the research of microbiome, its relationship with asthma, and the possible mechanism of the microbiome in the occurrence and development of asthma. The research of the microbial environment and human microbiome may provide a new target for the prevention of asthma in children who have high-risk factors to allergy. However, further study of "when and how" to regulate microbiome is still needed.
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治疗中出现的中枢性睡眠呼吸暂停：一种独特的睡眠呼吸障碍Zhang Jing, Wang Le, Guo Heng-Juan, Wang Yan, Cao Jie, Chen Bao-Yuan
中华医学杂志英文版2020年 133卷 22期
DOI: 10.1097/CM9.0000000000001125
摘要
Treatment-emergent central sleep apnea (TECSA) is a specific form of sleep-disordered breathing, characterized by the emergence or persistence of central apneas during treatment for obstructive sleep apnea. The purpose of this review was to summarize the definition, epidemiology, potential mechanisms, clinical characteristics, and treatment of TECSA. We searched for relevant articles up to January 31, 2020, in the PubMed database. The prevalence of TECSA varied widely in different studies. The potential mechanisms leading to TECSA included ventilatory control instability, low arousal threshold, activation of lung stretch receptors, and prolonged circulation time. TECSA may be a self-limited disorder in some patients and could be resolved spontaneously over time with ongoing treatment of continuous positive airway pressure (CPAP). However, central apneas persist even with the regular CPAP therapy in some patients, and new treatment approaches such as adaptive servo-ventilation may be necessary. We concluded that several questions regarding TECSA remain, despite the findings of many studies, and it is necessary to carry out large surveys with basic scientific design and clinical trials for TECSA to clarify these irregularities. Further, it will be vital to evaluate the baseline demographic and polysomnographic data of TECSA patients more carefully and comprehensively.
Meta-analysis
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内镜或腹腔镜切除治疗胃肠道小间质瘤：一项累积荟萃分析Cai Xian-Lei, Li Xue-Ying, Liang Chao, Xu Yuan, Zhang Miao-Zun, Yu Wei-Ming, Li Xiu-Yang
中华医学杂志英文版2020年 133卷 22期
DOI: 10.1097/CM9.0000000000001069
摘要
Background:
Despite the recent large number of studies comparing endoscopic and laparoscopic resection for small gastrointestinal stromal tumors (GISTs) (diameter ≤5 cm), the results remain conflicting. The objective of this work was to perform a cumulative meta-analysis to assess the advantages and disadvantages of endoscopic resection vs. laparoscopic resection.
Methods:
The meta-analysis followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement. We searched medical databases up to January 2020. Meta-analytical random or fixed effects models were used in pooled analyses. Meta-regression, cumulative meta-analyses, and sub-group analyses were performed to improve the accuracy of the conclusion. Sensitivity analyses were applied to assess the robustness of the results.
Results:
A total of 12 cohort studies with 1383 participants comparing endoscopic resection and laparoscopic resection were identified, while three cohort studies with 167 participants comparing endoscopic resection and laparoscopic and endoscopic cooperative surgery were found. We found that endoscopic resection had shorter operation times (weighted mean difference [WMD]= -27.1 min, 95% confidence interval [CI]: -40.8 to -13.4 min) and lengths of hospital stay (WMD = -1.43 days, 95% CI: -2.31 to -0.56 days) than did laparoscopic resection. The results were stable and reliable. There were no significant differences in terms of blood loss, hospitalization costs, incidence of complications or recurrence rates. For tumor sizes 2 to 5 cm, endoscopic resection increased the risk of positive margins (relative risk [RR] = 5.78, 95% CI: 1.31-25.46). Although operation times for endoscopic resection were shorter than those of laparoscopic and endoscopic cooperative surgery (WMD = -41.03 min, 95% CI: -59.53 to -22.54 min), there was a higher incidence of complications (RR = 4.03, 95% CI: 1.57-10.34).
Conclusions:
In general, endoscopic resection is an alternative method for gastric GISTs ≤5 cm. Laparoscopic and endoscopic cooperative surgery may work well in combination. Further randomized controlled trials are recommended to validate or update these results.
Perspective
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非酒精性脂肪性肝病的非侵入性纤维化评估S. Rios Rafael, I Zheng Kenneth, Targher Giovanni, Byrne Christopher D., Zheng Ming-Hua
中华医学杂志英文版2020年 133卷 22期
DOI: 10.1097/CM9.0000000000000989
摘要
据估计，非酒精性脂肪性肝病(NAFLD)影响全球约25%的成年人。[
Viewpoint
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乙型肝炎病毒感染期间宿主免疫应答的研究进展Yu Xiao-Qi, Zhang Xin-Xin
中华医学杂志英文版2020年 133卷 22期
DOI: 10.1097/CM9.0000000000001096
摘要
乙型肝炎病毒（HBV）感染是一个全球性的健康问题，可导致严重的危及生命的肝病，如肝硬化和肝细胞癌。[
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冠状病毒疾病2019疫情：戴口罩意味着什么？Yang Yong, Song Can, Wang Han-Yang, Chen Yong-Kang, Chen Jia-Jia, Gu Jin
中华医学杂志英文版2020年 133卷 22期
DOI: 10.1097/CM9.0000000000001016
摘要
2019冠状病毒病（COVID-19）爆发后，已采取不同措施控制疫情蔓延。大多数国际组织、国家/地区都发布了防疫指引或行政指引，其中建议市民注意个人卫生（如勤洗手、打喷嚏时捂住口鼻）、保持社交距离、避免聚集活动等等。[
Clinical Observation
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与胆囊息肉数量相关的临床因素Lu Wen-Juan, Liu Chang-Sheng, Li Hong-Yan, Zang Lan-Lan, Meng Fan-Zhi, Liu Jing-Hua
中华医学杂志英文版2020年 133卷 22期
DOI: 10.1097/CM9.0000000000001065
摘要
胆囊息肉（GBPs）被定义为从胆囊粘膜突出的病理改变，是胆囊切除术入院的主要原因之一。在中国，GBPs的发病率为4.2~9.5%。[
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ACC/AHA风险评分预测中国人群冠状动脉疾病存在和严重程度：一项横断面研究Wang Yao, Zhang Jie-Fang, Chen Song-Zan, Lyu Qing-Bo, Lyu Xue, Zhang Wen-Bin
中华医学杂志英文版2020年 133卷 22期
DOI: 10.1097/CM9.0000000000001123
摘要
冠状动脉疾病（CAD）是最常见的心血管疾病（CVD）类型，仍然是发展中国家和发达国家的主要死亡原因，2013年约有1730万人死亡，高于1990年的数据。[
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院内碳青霉烯类耐药的流行病学特征及危险因素分析肠杆菌科儿童感染Li Zhe, Lin Xi-Xi, Liu Cai-Xia, Ye Wen-Jing, Liu Pei-Ning, Li Hai-Yan, Dong Lin
中华医学杂志英文版2020年 133卷 22期
DOI: 10.1097/CM9.0000000000001006
摘要
碳青霉烯类耐药肠杆菌科（CRE）已经作为全球性威胁在世界范围内传播，并且CRE感染与显著的死亡率相关。然而，关于儿童CRE感染的流行病学和治疗的数据相对缺乏。[
Correspondence
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中/下胃癌幽门下淋巴结转移模式：一项多中心前瞻性观察性研究（IPA-ORIGIN）的探索性分析Baheti Tasiken, Miao Ru-Lin, Zhao Gang, Wang Da-Guang, Liu Feng-Lin, Yu Jiang, Ren Shuang-Yi, Ye Kai, Yan Su, Yang Kun 等
中华医学杂志英文版2020年 133卷 22期
DOI: 10.1097/CM9.0000000000000995
摘要
致编辑：胃癌是我国最常见的癌症之一。主要见于胃中/下部，[
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目前评估慢性肝病肝纤维化的超声相关策略Xue Li-Yun, Ding Hong
中华医学杂志英文版2020年 133卷 22期
DOI: 10.1097/CM9.0000000000001136
摘要
致编辑：肝纤维化是几种慢性肝病(CLD)的结果。准确评估纤维化严重程度对于CLD患者的管理非常重要。肝活检是跟踪纤维化进展的参考标准，但它受到其侵入性、采样误差以及观察者内和观察者间可变性的限制。因此，开发非侵入性方法对于肝纤维化评估至关重要。
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胃癌胃微生物群生物标志物的鉴定Dang Yi-Ni, Dong Yu, Mu Yan-Zhao, Yan Jin, Lu Min, Zhu Yong-Liang, Zhang Guo-Xin
中华医学杂志英文版2020年 133卷 22期
DOI: 10.1097/CM9.0000000000001081
摘要
致编辑：胃癌（GC）是世界范围内最常见的恶性肿瘤之一。[
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磁压缩技术在袖状胃切除术中的应用Liu Kang, Lu Qiang, Huang Gao-Bo, Zhou Jing-Wen, Wang Xin-Ying, Chang Peng-Kang, Zhang Wei, Yu Jia-Wei, Lyu Yi, Wang Shan-Pei
中华医学杂志英文版2020年 133卷 22期
DOI: 10.1097/CM9.0000000000001131
摘要
致编辑：肥胖正在成为一个世界性的健康问题，并且肥胖的患病率持续增加。[
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皮肤镜联合木灯诊断面部五种色素性病变的观察性研究Lu Quan-Sheng, Chen Xi, Wang Shan, Xu Shan-Shan, Wu Tong, Jiang Guan
中华医学杂志英文版2020年 133卷 22期
DOI: 10.1097/CM9.0000000000001009
摘要
致编辑：色素沉着过度的皮肤病变，尤其是面部疾病，如黄褐斑、颧骨褐青色痣、太田痣、雀斑和瑞尔黑变病，在临床上很常见。这些疾病有时很难识别，严重影响患者的容貌。鉴于患者经常出于美容目的来到医院，并且组织病理学活检很困难，非侵入性诊断对于治疗选择非常重要。
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