MedNexus
2021年 · 第134卷第04期
出版日期 2021-02-20电子版 ￥0.00元
MedNexus
- 全部
- Review Article
- Meta Analysis
- Perspective
- Viewpoint
- Ideas and Opinions
- Original Article
- Clinical Observation
- Correspondence
Review Article
开放获取
长非编码RNA在银屑病中作用的研究进展Jian-Kun Song, Shuang-Yi Yin, Wei Li, Xiao-Dong Li, Yue Luo, Ying Luo, Meng Xing, Bin Li, Le Kuai
中华医学杂志英文版2021年 134卷 04期
DOI: 10.1097/CM9.0000000000001243
摘要
Increasing evidence suggests that long non-coding RNAs (lncRNAs) are of vital importance for various biological processes, and dysregulation of lncRNAs is frequently associated with various diseases such as psoriasis. LncRNAs modulate gene expression at the transcriptional, post-transcriptional, and translational levels; however, the specific regulatory mechanisms of lncRNAs in psoriasis remain largely unexplored. This review provides an overview of recent studies investigating mechanisms and functions of lncRNAs in psoriasis, especially focusing on the role of lncRNAs in keratinocytes, T cells, and dendritic cells.
Meta Analysis
开放获取
鹰嘴截骨术vs保留三头肌切开复位内固定治疗肱骨远端髁间骨折的系统评价和荟萃分析Shuai Lu, Ye-Jun Zha, Mao-Qi Gong, Chen Chen, Wei-Tong Sun, Ke-Han Hua, Xie-Yuan Jiang
中华医学杂志英文版2021年 134卷 04期
DOI: 10.1097/CM9.0000000000001393
摘要
Background:
The open reduction and internal fixation (ORIF) was a standard treatment approach for fracture at distal humerus intercondylar, whereas the optimal way before ORIF remains inconclusive. We, therefore, performed a systematic review and meta-analysis to assess the efficacy and safety of olecranon osteotomy vs. triceps-sparing approach for patients with distal humerus intercondylar fracture.
Methods:
The electronic searches were systematically performed in PubMed, EmBase, Cochrane library, and Chinese National Knowledge Infrastructure from initial inception till December 2019. The primary endpoint was the incidence of excellent/good elbow function, and the secondary endpoints included Mayo elbow performance score, duration of operation, blood loss, and complications.
Results:
Nine studies involving a total of 637 patients were selected for meta-analysis. There were no significant differences between olecranon osteotomy and triceps-sparing approach for the incidence of excellent/good elbow function (odds ratio [OR]: 1.37; 95% confidence interval [CI]: 0.69-2.75; P = 0.371), Mayo elbow performance score (weight mean difference [WMD]: 0.17; 95% CI:-2.56 to 2.89; P = 0.904), duration of operation (WMD: 4.04; 95% CI: -28.60 to 36.69; P = 0.808), blood loss (WMD: 33.61; 95% CI: -18.35 to 85.58; P = 0.205), and complications (OR: 1.93; 95% CI: 0.49-7.60; P = 0.349). Sensitivity analyses found olecranon osteotomy might be associated with higher incidence of excellent/good elbow function, longer duration of operation, greater blood loss, and higher incidence of complications as compared with triceps-sparing approach.
Conclusions:
This study found olecranon osteotomy did not yield additional benefit on the incidence of excellent/good elbow function, while the duration of operation, blood loss, and complications in patients treated with olecranon osteotomy might be inferior than triceps-sparing approach.
Perspective
开放获取
长非编码RNA在紫外线诱导的皮肤病中的作用Yu-Jia Wang, Xian Jiang
中华医学杂志英文版2021年 134卷 04期
DOI: 10.1097/CM9.0000000000001062
摘要
长非编码RNA(lncRNA)包含不同类型的RNA聚合酶II转录的分子，表现出大于200个核苷酸的核苷酸长度并且不经历蛋白质翻译。由于其开放阅读框的特征，它们经常被标记为基因组转录的“噪音”。尽管lncRNAs是广泛转录的基因，但它们的表达水平低于蛋白质编码基因的表达水平。根据它们相对于基因组中蛋白质编码基因的位置，lncRNAs被分类为有义、反义、双向、内含子和基因间。最近已经表明，lncRNAs在调节细胞过程（细胞分化和个体发育）和疾病发展（病原感染、免疫破坏）中发挥重要作用。此外，它们已被认为是所有癌症的标志，lncRNA在肿瘤中的特异性表达可用于预测预后，其在循环体液（血浆和尿液）中的稳定性为癌症诊断和治疗的发展提供了新的基础。由于lncRNAs作为信号、诱饵、向导和支架分子在转录和转录后调节基因表达，阐明其功能和潜在的调节机制对生命科学研究的进展具有重要意义[
开放获取
机器学习在冠状动脉疾病诊断中的应用Hao Ling, Zi-Yuan Guo, Lin-Lin Tan, Ren-Chu Guan, Jing-Bo Chen, Chun-Li Song
中华医学杂志英文版2021年 134卷 04期
DOI: 10.1097/CM9.0000000000001202
摘要
心血管疾病仍然是全世界男性和女性死亡的首要原因。[
开放获取
成纤维细胞生长因子23在慢性肾脏病患者中的作用Song-Yan Wang, Fan Yang, Shuang Ma, Li-Juan Cui, Rui Zhang
中华医学杂志英文版2021年 134卷 04期
DOI: 10.1097/CM9.0000000000001148
摘要
成纤维细胞生长因子23(FGF23）是一种重要的骨细胞衍生激素，调节磷和1，25-二羟基维生素D(1，25[OH]的代谢2D）。1, 25(OH)2D和高膳食磷酸盐摄入上调FGF23表达，导致肾脏磷酸盐排泄增加和1，25(OH)减少2D合成，然后抑制FGF23，从而完成一个负反馈回路。几项针对肾脏疾病患者的临床研究报告称，血清FGF23水平升高与不良预后相关[
开放获取
他汀类药物作为冠状病毒疾病2019（COVID-19）的候选治疗剂Sheng-De Li, Shu-Yang Zhang, Bin Peng
中华医学杂志英文版2021年 134卷 04期
DOI: 10.1097/CM9.0000000000001205
摘要
他汀类药物是3-羟基-3-甲基戊二酰（HMG）-辅酶A（CoA）还原酶抑制剂，作用于HMG-CoA转化为L-甲羟戊酸的限速酶，以减少胆固醇生物合成。除了通过降低低密度脂蛋白胆固醇浓度来减少心血管事件外，他汀类药物的多效性胆固醇非依赖性功能，包括免疫调节和抗炎作用，也越来越被认识到。当前的冠状病毒病2019（COVID-19）大流行，由严重急性呼吸综合征冠状病毒2（新型冠状病毒）引起，[
Viewpoint
开放获取
越简单越好：微血管减压手术的个人哲学Jun Zhong
中华医学杂志英文版2021年 134卷 04期
DOI: 10.1097/CM9.0000000000001233
摘要
微血管减压术（MVD）已被广泛认为是治疗过度活跃的颅神经根病（如面肌痉挛和三叉神经痛）的最有效方法。[
Ideas and Opinions
开放获取
在冠状病毒疾病2019大流行期间，交感神经激活的不良影响不应被忽视Sheng Jin, Jing Dai, Xu Teng, Yu-Ming Wu
中华医学杂志英文版2021年 134卷 04期
DOI: 10.1097/CM9.0000000000001106
摘要
正在进行的冠状病毒疾病2019（新冠肺炎）疫情在全球范围内导致了相当大的发病率和死亡率。此外，感染人数正在迅速上升。本病由属于β-冠状病毒簇的严重急性呼吸综合征冠状病毒2型（新型冠状病毒）引起；该群集还包括引起严重急性呼吸窘迫综合征(SARS)和中东呼吸综合征的病毒。与SARS冠状病毒（CoV）类似，新型冠状病毒病毒利用血管紧张素转换酶2（ACE2）入侵其靶细胞；然而，新型冠状病毒对ACE2的结合亲和力更高。因此，与SARS-CoV可以被有效遏制不同，新型冠状病毒病毒的传染性更强，也更难控制。
Original Article
开放获取
深度学习应用于二维彩色多普勒血流成像超声图像显著提高乳腺肿块分类的诊断性能：一项多中心研究Teng-Fei Yu, Wen He, Cong-Gui Gan, Ming-Chang Zhao, Qiang Zhu, Wei Zhang, Hui Wang, Yu-Kun Luo, Fang Nie, Li-Jun Yuan 等
中华医学杂志英文版2021年 134卷 04期
DOI: 10.1097/CM9.0000000000001329
摘要
Background:
The current deep learning diagnosis of breast masses is mainly reflected by the diagnosis of benign and malignant lesions. In China, breast masses are divided into four categories according to the treatment method: inflammatory masses, adenosis, benign tumors, and malignant tumors. These categorizations are important for guiding clinical treatment. In this study, we aimed to develop a convolutional neural network (CNN) for classification of these four breast mass types using ultrasound (US) images.
Methods:
Taking breast biopsy or pathological examinations as the reference standard, CNNs were used to establish models for the four-way classification of 3623 breast cancer patients from 13 centers. The patients were randomly divided into training and test groups (n = 1810 vs. n = 1813). Separate models were created for two-dimensional (2D) images only, 2D and color Doppler flow imaging (2D-CDFI), and 2D-CDFI and pulsed wave Doppler (2D-CDFI-PW) images. The performance of these three models was compared using sensitivity, specificity, area under receiver operating characteristic curve (AUC), positive (PPV) and negative predictive values (NPV), positive (LR+) and negative likelihood ratios (LR-), and the performance of the 2D model was further compared between masses of different sizes with above statistical indicators, between images from different hospitals with AUC, and with the performance of 37 radiologists.
Results:
The accuracies of the 2D, 2D-CDFI, and 2D-CDFI-PW models on the test set were 87.9%, 89.2%, and 88.7%, respectively. The AUCs for classification of benign tumors, malignant tumors, inflammatory masses, and adenosis were 0.90, 0.91, 0.90, and 0.89, respectively (95% confidence intervals [CIs], 0.87-0.91, 0.89-0.92, 0.87-0.91, and 0.86-0.90). The 2D-CDFI model showed better accuracy (89.2%) on the test set than the 2D (87.9%) and 2D-CDFI-PW (88.7%) models. The 2D model showed accuracy of 81.7% on breast masses ≤1 cm and 82.3% on breast masses >1 cm; there was a significant difference between the two groups (P < 0.001). The accuracy of the CNN classifications for the test set (89.2%) was significantly higher than that of all the radiologists (30%).
Conclusions:
The CNN may have high accuracy for classification of US images of breast masses and perform significantly better than human radiologists.
Trial registration:
Chictr.org, ChiCTR1900021375; http://www.chictr.org.cn/showproj.aspx?proj=33139.
开放获取
用于评估冠状动脉树描述和病变评估的观察者间和观察者内变异性©）急性心肌梗死患者血管造影评分系统Jin-Mei Liu, Yang He, Ruo-Ling Teng, Xiao-Dong Qian, Yun-Lang Dai, Jian-Ping Xu, Xin Zhao, Ting-Bo Jiang, Yong-Ming He
中华医学杂志英文版2021年 134卷 04期
DOI: 10.1097/CM9.0000000000001208
摘要
Background:
Previously, we developed a novel Coronary Artery Tree description and Lesion EvaluaTion (CatLet©) angiographic scoring system, which was capable of accounting for the variability in the coronary anatomy and assisting in the risk-stratification of patients with acute myocardial infarction (AMI). Our preliminary study revealed that the CatLet score better predicted clinical outcomes for AMI patients than the Synergy between Percutaneous Coronary Intervention with Taxus and Cardiac Surgery score. However, the reproducibility of the CatLet score in both inter-and intra-observer remains to be evaluated.
Methods:
A total of 30 consecutive AMI patients, admitted in September of 2015, were independently assessed by two experienced interventional cardiologists to evaluate the inter-observer reproducibility of the CatLet score. Another set of 49 consecutive AMI patients, admitted between September and October in 2014, were assessed by one of the two interventional cardiologists on two occasions 3 months apart to evaluate the intra-observer reproducibility of the CatLet score. The weighted kappa was used to express the degree of agreement.
Results:
The weighted kappa values (95% confidence interval) for the intra- and inter-observer reproducibility of the CatLet Score were 0.82 (0.59-1.00, Z= 7.23, P < 0.001) and 0.86 (0.54-1.00, Z= 5.20, P < 0.001), respectively, according to the tertile analysis (≤14, 15-22, >22). Regarding the adverse characteristics pertinent to lesions and dominance parameters, the kappa values for the inter-observer variability were 0.80 (0.56-1.00, Z = 6.47, P < 0.001) for total number of lesions, 0.57 (0.28-0.85, Z = 3.03, P < 0.001) for bifurcation, 0.69 (0.43-0.96, Z = 5.06, P < 0.001) for heavy calcification, 1.00 (0.72-1.00, Z= 6.93, P < 0.001) for tortuosity, 0.54 (0.26-0.82, Z = 3.78, P < 0.001) for thrombus, 0.69 (0.48-0.91, Z = 6.29, P < 0.001) for right coronary artery dominance, 0.69 (0.41-0.96, Z = 4.91, P < 0.001) for left anterior descending artery length, and 0.22 (0.06-0.51, Z = 1.56, P = 0.06) for diagonal size. Equivalent values for the intra-observer variability were moderate to almost perfect (range 0.54-1.00).
Conclusions:
The reproducibility of the CatLet angiographic scoring system for evaluation of the coronary angiograms ranged from substantial to excellent. The high reproducibility of the CatLet angiographic scoring system will boost its clinical application to patients with AMI.
开放获取
C型臂平板探测器锥束CT静脉造影诊断髂静脉压迫综合征Chang-Ming Wang, Wei-Liang Zhang, Xuan Li
中华医学杂志英文版2021年 134卷 04期
DOI: 10.1097/CM9.0000000000001046
摘要
Background:
C-arm-based flat-panel detector cone-beam computed tomography (CBCT) venography has never been used in the management of iliac vein compression syndrome (IVCS). This study aimed to determine the technical feasibility and safety of CBCT venography in the diagnosis of IVCS compared with conventional venography (CV).
Methods:
Twenty patients with clinical manifestations of lower extremity venous insufficiency were prospectively enrolled between May 2018 and December 2018. Each patient underwent both CV and CBCT venography. The feasibility and safety of CBCT venography were assessed by technical success rate and complication rate. The relationships between the clinical indexes and the results of CBCT venography and CV were analyzed with correlation analysis. The consistency of the diagnosis of IVCS using each modality was analyzed by the kappa test.
Results:
The technical success rate was 100% for CBCT venography and for CV, without any complications. Compared with CV, CBCT venography was able to show more details of adjacent tissues which might be helpful for making etiological diagnosis. The stenosis rate under CBCT venography had excellent consistency with that under CV (kappa= 0.78, Chi-square test). The stenosis rate under CBCT venography was positively correlated with the presence of collateral veins (odds ratio 1.12, 95% confidence interval: [1.00, 1.26], P= 0.049), while the stenosis rate under CV was not. Unexpectedly, only one patient had a venous pressure gradient of more than 2 mmHg (1 mmHg = 0.133 kPa).
Conclusions:
For the diagnosis of IVCS, C-arm-based CBCT venography was technically feasible, with good safety. The presence of collateral veins on CBCT was clinically significant. A C-arm fluoroscopy-based technique that combines CV and CBCT might be a promising protocol for the management of IVCS during a single session.
开放获取
正电子发射断层扫描（PET）纹理分析（TA）鉴别胃癌和胃淋巴瘤Yi-Wen Sun, Chang-Feng Ji, Han Wang, Jian He, Song Liu, Yun Ge, Zheng-Yang Zhou
中华医学杂志英文版2021年 134卷 04期
DOI: 10.1097/CM9.0000000000001206
摘要
Background:
Texture analysis (TA) can quantify intra-tumor heterogeneity using standard medical images. The present study aimed to assess the application of positron emission tomography (PET) TA in the differential diagnosis of gastric cancer and gastric lymphoma.
Methods:
The pre-treatment PET images of 79 patients (45 gastric cancer, 34 gastric lymphoma) between January 2013 and February 2018 were retrospectively reviewed. Standard uptake values (SUVs), first-order texture features, and second-order texture features of the grey-level co-occurrence matrix (GLCM) were analyzed. The differences in features among different groups were analyzed by the two-way Mann-Whitney test, and receiver operating characteristic (ROC) analysis was used to estimate the diagnostic efficacy.
Results:
InertiaGLCM was significantly lower in gastric cancer than that in gastric lymphoma (4975.61 vs. 11,425.30, z = -3.238, P = 0.001), and it was found to be the most discriminating texture feature in differentiating gastric lymphoma and gastric cancer. The area under the curve (AUC) of inertiaGLCM was higher than the AUCs of SUVmax and SUVmean (0.714 vs. 0.649 and 0.666, respectively). SUVmax and SUVmean were significantly lower in low-grade gastric lymphoma than those in high grade gastric lymphoma (3.30 vs. 11.80, 2.40 vs. 7.50, z = -2.792 and -3.007, P = 0.005 and 0.003, respectively). SUVs and first-order greylevel intensity features were not significantly different between low-grade gastric lymphoma and gastric cancer. EntropyGLCM12 was significantly lower in low-grade gastric lymphoma than that in gastric cancer (6.95 vs. 9.14, z = -2.542, P = 0.011) and had an AUC of 0.770 in the ROC analysis of differentiating low-grade gastric lymphoma and gastric cancer.
Conclusions:
InertiaGLCM and entropyGLCM were the most discriminating features in differentiating gastric lymphoma from gastric cancer and low-grade gastric lymphoma from gastric cancer, respectively. PET TA can improve the differential diagnosis of gastric neoplasms, especially in tumors with similar degrees of fluorodeoxyglucose uptake.
开放获取
水通道蛋白5对雌激素诱导前列腺上皮细胞上皮-间质转化的调节作用Yu Fan, Tu-Run Song, Qiang Wei, Lu Yang, Tao Lin, Xiao-Bing Feng, Xian-Ding Wang, Zhong-Li Huang, Shi-Jian Feng
中华医学杂志英文版2021年 134卷 04期
DOI: 10.1097/CM9.0000000000001132
摘要
Background:
Estrogen is involved in the pathophysiological process of benign prostatic hyperplasia (BPH), in which epithelial-mesenchymal transition (EMT) plays an important role. Upregulation of aquaporin (AQP) 5, which is directly activated by estrogen, has been reported to promote EMT in multiple cells. This study aimed to examine the effects of AQP5 on estrogen-induced EMT in the prostate.
Methods:
Normal prostate (NP) tissue samples without any histopathological changes and BPH tissue samples with pathologically confirmed hyperplasia were obtained. An EMT cell model was subsequently established by adding estradiol (E2) to RWPE-1 cells, after which AQP5 knockdown was performed. Tissue morphological and immunohistochemical features were examined using hematoxylin-eosin and immunohistochemical staining. Western blot analysis was performed to determine the expression of AQPs, estrogen receptors, and EMT-related proteins. Cell proliferation was assessed and supernatants were collected for enzyme-linked immunosorbent assay to determine transforming growth factor-β1 (TGF-β1) concentrations. Immunofluorescence staining was performed to assess protein expressions in RWPE-1 cells.
Results:
BPH tissues exhibited greater EMT (TGF-β1: 1.362 ± 0.196 vs. 0.107 ± 0.067, P = 0.003; vimentin: 1.581 ± 0.508 vs. 0.221 ± 0.047, P < 0.001; E-cadherin: 0.197 ± 0.188 vs. 1.344 ± 0.088, P < 0.001), higher AQP5 (1.268 ± 0.136 vs. 0.227 ± 0.055, P < 0.001) and estrogen receptor (ER) α (1.250 ± 0.117 vs. 0.329 ± 0.134, P < 0.001) expression but lower ERβ (0.271 ± 0.184 vs. 1.564 ± 0.130, P < 0.001) expression than NP tissues. E2-stimulated cells had higher AQP5 expression (1.298 ± 0.058 vs. 1.085 ± 0.104, P = 0.049), increased cell proliferation (1.510 ± 0.089 vs.1.000 ± 0.038, P < 0.001), and EMT (TGF-β1 concentration: 0.352 ± 0.021 ng/mL vs. 0.125 ± 0.014 ng/mL, P < 0.001; vimentin: 1.641 ± 0.120 vs. 0.188 ± 0.020, P = 0.002; E-cadherin: 0.075 ± 0.030 vs. 0.843 ± 0.046, P < 0.001) than controls. E2-stimulated cells with AQP5 knockdown exhibited decreased EMT (TGF-β1 concentration: 0.223 ± 0.041 ng/mL vs. 0.352 ± 0.021 ng/mL, P= 0.016; vimentin: 0.675 ± 0.056 vs. 1.641 ± 0.120, P = 0.001; E-cadherin: 0.159 ± 0.037 vs. 0.075 ± 0.030, P = 0.040) than E2-stimulated cells with non-related small interfering RNA (siRNA).
Conclusion:
Our findings suggest that estrogen induces BPH possibly by promoting AQP5 expression. Hence, AQP5 might be a novel target for modulating EMT in prostate epithelial cells.
开放获取
DnaJA4通过调节HaCaT细胞F-肌动蛋白的表达参与高温反应Rui-Jiao Liu, Xue-Li Niu, Jin-Ping Yuan, Hong-Duo Chen, Xing-Hua Gao, Rui-Qun Qi
中华医学杂志英文版2021年 134卷 04期
DOI: 10.1097/CM9.0000000000001064
摘要
Background:
Hyperthermia in combination with DnaJA4-knockout (KO) obviously affects the anti-viral immunity of HaCaT cells. The mechanisms of this process are not yet fully explored. However, it is known that DnaJA4 interacts with actin cytoskeleton after hyperthermia. Our aim was to investigate the effects of DnaJA4 on F-actin in HaCaT cells following hyperthermia.
Methods:
Wild-type (WT) and DnaJA4-KO HaCaT cells were isolated at either 37°C (unheated) or 44°C (hyperthermia) for 30 min followed by testing under conditions of 37°C and assessing at 6, 12, and 24 h after hyperthermia. The cytoskeleton was observed with immunofluorescence. Flow cytometry and Western blotting were used to detect the expression of F-actin and relevant pathway protein.
Results:
DnaJA4-KO and hyperthermia changed the cytoskeleton morphology of HaCaT cells. F-actin expression levels were elevated in DnaJA4-KO cells compared with WT cells (6364.33 ± 989.10 vs. 4272.67 ± 918.50, P < 0.05). In response to hyperthermia, F-actin expression levels of both WT and DnaJA4-KO cells showed a tendency to decrease followed by an obvious recovery after hyperthermia (WT cells: unheated vs. 6 h after hyperthermia or 24 h after hyperthermia: 0.34 ± 0.02 vs. 0.24 ± 0.01, 0.31 ± 0.01, P < 0.001, P < 0.05; DnaJA4-KO cells: unheated vs. 6 h after hyperthermia or 24 h after hyperthermia: 0.44 ± 0.01 vs. 0.30 ± 0.01, 0.51 ± 0.02, P < 0.001, P < 0.01). WT cells restored to baseline levels observed in the unheated condition, while DnaJA4-KO cells exceeded baseline levels in the recovery. As the upstream factors of F-actin, a similar profile in rho-associated serine/threonine kinase 1 (ROCK 1) and RhoA expressions was observed after hyperthermia. While E-cadherin expression was decreased in response to hyperthermia, it was increased in DnaJA4-KO cells compared with WT cells.
Conclusions:
Hyperthermia affects the expression levels of F-actin in HaCaT cells. DnaJA4 knockout increases the expression of F-actin in HaCaT cells after hyperthermia. DnaJA4 regulates the expressions of F-actin and the related pathway proteins in response to hyperthermia in HaCaT cells.
开放获取
体重指数是血管迷走性晕厥患儿口服补液生理盐水反应的一个有希望的预测指标Chun-Yan Tao, Selena Chen, Xue-Ying Li, Chao-Shu Tang, Jun-Bao Du, Hong-Fang Jin
中华医学杂志英文版2021年 134卷 04期
DOI: 10.1097/CM9.0000000000001168
摘要
Background:
Vasovagal syncope (VVS) greatly impairs quality of life. The therapeutic efficacy of oral rehydration saline (ORS) for unselected VVS patients is not satisfactory due to the diverse mechanisms of the disease. Body mass index (BMI) was demonstrated to reflect blood volume to a certain extent. Therefore, the present study explored the capability of BMI to predict the therapeutic response of children with VVS to ORS treatment.
Methods:
Seventy-four children with VVS who visited the Syncope Unit of Pediatrics at Peking University First Hospital from November 2010 to June 2019 receiving ORS treatment were enrolled for this retrospective case-control study. A comparison of demographic, clinical, and hemodynamic characteristics was performed between responders and non-responders. The correlation between baseline BMI and response time was analyzed. To determine the value of baseline BMI in predicting the therapeutic efficacy of ORS in children with VVS, a receiver operating characteristic curve analysis was performed.
Results:
Fifty-two children were identified as responders, and the remaining 22 children were identified as non-responders. The baseline BMI of the responders was much lower than that of the non-responders (16.4 [15.5, 17.8] kg/m2vs. 20.7 ± 3.6 kg/m2, P < 0.001), and baseline BMI was positively correlated with response time in the head-up tilt test after adjusting for sex (r = 0.256, 95% confidence interval [CI]: 0.067-0.439, P = 0.029). The area under the receiver operating characteristic curve of baseline BMI was 0.818 (95% CI: 0.704-0.932, P < 0.001), and an optimal cut-off value of 18.9 kg/m2 yielded a sensitivity of 83% and a specificity of 73% to predict the efficacy of ORS in VVS.
Conclusion:
Prior to treatment, baseline BMI is a promising predictor of response to ORS in children with VVS.
Clinical Observation
开放获取
急性缺血性脑卒中机械取栓术后碘外渗的半定量评价Xin Gao, Qing-Tao Hui, Yu-Dan Li, Miao Peng, Dan Xu, Bin Ming, Chun Ma
中华医学杂志英文版2021年 134卷 04期
DOI: 10.1097/CM9.0000000000001236
摘要
碘外渗常见于成功机械取栓后的卒中患者。碘外渗可能与患者预后相关，更多的碘外渗与严重出血性转化（HT）的发展高度相关。因此，有必要确定动脉内治疗后的早期出血和可以预测晚期出血转化的影像学指标。一些研究使用不同的定量和非定量方法来评估碘外渗。然而，他们得出了不同的结果。[
开放获取
血浆游离脂肪酸与糖尿病收缩性心力衰竭患者缺血性心肌病和心功能不全严重程度相关Xue-Mei Wei, Wen-Bo Yang, Xiu-Xiu Su, An-Di Zhang, Wei Jin, Yue-Hua Fang
中华医学杂志英文版2021年 134卷 04期
DOI: 10.1097/CM9.0000000000001167
摘要
心力衰竭（HF）是一个世界性的问题，因为心血管疾病患者的发病率和死亡率很高。最近，PARADIGM-HF试验（血管紧张素受体-脑啡肽酶抑制剂[ARNI]与血管紧张素转换酶抑制剂[ACEI]确定对心力衰竭总体死亡率和发病率影响的前瞻性比较试验）显示，缺血性心脏病是HF最常见的病因，占射血分数降低HF（HFrEF）的60%。[
开放获取
严重急性呼吸综合征冠状病毒2型快速免疫球蛋白G/免疫球蛋白M联合抗体检测的诊断指标Ying Liu, Yue-Ping Liu, Bo Diao, Jin-Ya Ding, Meng-Xue Yuan, Fei-Fei Ren, Yue Wang, Qian-Chuan Huang
中华医学杂志英文版2021年 134卷 04期
DOI: 10.1097/CM9.0000000000001204
摘要
针对严重急性呼吸综合征冠状病毒2型（新型冠状病毒）的抗体检测是逆转录聚合酶链式反应（RT-PCR）检测的补充选项，无论是免疫球蛋白M（IgM）、免疫球蛋白G（IgG）还是联合检测。然而，关于IgM/IgG检测的敏感性和特异性的数据不足，这对于决定是否、何时以及如何使用IgM/IgG抗体检测至关重要。本研究的目的是评估IgM/IgG抗体检测的敏感性、特异性、准确性、阳性预测值(PPV)和阴性预测值(NPV)，特别是与本研究中定义为标准诊断的新型冠状病毒RT-PCR相比的抗干扰能力和κ系数。
开放获取
体内颈椎病患者颈部动态运动时颈椎节段的活动范围Tao Guo, Yan Yu, Chao-Chao Zhou, Kamran Khan, Hai-Ming Wang, Guo-An Li, Thomas Cha
中华医学杂志英文版2021年 134卷 04期
DOI: 10.1097/CM9.0000000000001209
摘要
颈椎病是指轴下颈椎的退行性改变。颈椎病引起的症状包括中轴性颈痛、神经根型颈椎病和脊髓型颈椎病。最常用的手术治疗方法之一是前路颈椎间盘切除术和融合术（ACDF）；据报道，ACDF导致超过90%的患者发生进行性邻近节段变性（ASD），高达25.6%的患者因症状性ASD而需要再次手术。[
Correspondence
开放获取
30天时金属蛋白酶组织抑制剂-基质金属蛋白酶生物标志物对未接受再灌注治疗的急性心肌梗死患者的预后价值Hui-Fang Pang, Yan Gao, Jia-Min Liu, Jia-Peng Lu, Yan-Ping Wang, Si-Ming Wang, Li-Bo Hou, Ao-Xi Tian, Yan Gao
中华医学杂志英文版2021年 134卷 04期
DOI: 10.1097/CM9.0000000000001144
摘要
致编辑：缺血性冠状动脉疾病是心力衰竭（HF）的主要原因，心力衰竭是全世界主要的公共卫生负担。在过去的几十年里，新的药物疗法的开发和早期再灌注策略的实施有助于显著降低与急性心肌梗死（AMI）相关的死亡率。然而，急性心脏缺血事件生存率的提高扩大了易发生心脏重塑和不良心血管（CV）结局的患者群体。
开放获取
实时血管内超声双腔微导管用于慢性完全闭塞再通Yan-Zhuo Ma, Guang-Dao Hou, Zhi-Wen Li, Xiao-Jiang Zhang, Xiao-Ye Wang, Gang Wang, Yu-Hong Peng, Lei-Sheng Ru
中华医学杂志英文版2021年 134卷 04期
DOI: 10.1097/CM9.0000000000001182
摘要
致编辑：慢性冠状动脉完全闭塞（CTO）后血运重建可以缓解心绞痛症状，改善心功能和临床预后。[
开放获取
胶质母细胞瘤异柠檬酸脱氢酶1 G131D突变Lei-Ming Wang, Chao Song, Ying-Xue Li, Xue-Dong Zhang, Yu-Hang Ji, Wen-Juan Wen
中华医学杂志英文版2021年 134卷 04期
DOI: 10.1097/CM9.0000000000001172
摘要
致编辑：一名68岁男性出现失语症2个月。磁共振成像扫描显示左颞叶异常信号，呈不均匀强化[
开放获取
真实世界研究与传统随机对照试验在头颈癌中的比较作用：一项基于文献的分析Guang-Li Zhu, Cheng Xu, Si-Qi Tang, Lei Chen, Yan-Ping Mao, Ling-Long Tang, Guan-Qun Zhou, Qing Liu, Ying Sun, Jun Ma
中华医学杂志英文版2021年 134卷 04期
DOI: 10.1097/CM9.0000000000001231
摘要
致编辑：在循证医学时代，传统的随机对照试验（RCT）处于证据层次金字塔的顶端。通过控制良好的纳入和排除标准、随机化和严格的干预方案，传统的RCT构建了理想的医疗环境，在这种环境下，结果和干预之间的因果关系可以更好地解释。然而，这也会使传统RCT的外部效度和可推广性受到限制。[
开放获取
支气管扩张严重程度评估预测再入院：一项单中心前瞻性队列研究Xiao-Yue Wang, Ru Li, Wan-Ying Wang, De-Shuai Li, Yu-Yan Zhou, Xiao-Ting Chen, Xiao-Ning Bu
中华医学杂志英文版2021年 134卷 04期
DOI: 10.1097/CM9.0000000000001051
摘要
致编辑：支气管扩张是一种慢性呼吸系统疾病，其特征是反复咳嗽、咳痰和呼吸道感染。近年来，支气管扩张的治疗越来越受到重视。[
开放获取
单细胞测序在自身免疫性疾病中的应用Liang-Yu Mi, Jin-Fang Gao, Dan Ma, Li-Yun Zhang, Gai-Lian Zhang, Ke Xu
中华医学杂志英文版2021年 134卷 04期
DOI: 10.1097/CM9.0000000000001050
摘要
致编辑：人类基因组计划解码生命的奥秘，探索疾病的发病机制，为疾病的诊断和治疗提供科学依据。传统的测序方法主要提供全基因组序列信息和细胞类型混合的平均值，这没有考虑细胞之间和亚型之间的异质性。基因组测序技术的进步使得单细胞测序（SCS）的发展成为可能。
开放获取
儿科病例报告：成功进行双侧肺移植治疗一名因表面活性蛋白(SP)-C基因突变导致肺间质纤维化的8岁女孩Feng Liu, Yu-Lin Jin, Hui-Xing Li, Yuan Chen, Bo Wu, Lin-Zhi Shi, Jing-Yu Chen
中华医学杂志英文版2021年 134卷 04期
DOI: 10.1097/CM9.0000000000001053
摘要
致编辑：小儿肺移植是一种针对儿童终末期肺病的高度专业化疗法，在世界各地仅有少数移植中心进行。在过去的十年中，全世界每年约有100例小儿肺移植手术。大多数中心每年进行1至4例儿科肺移植，只有5个中心每年进行5例以上。自2007年以来，我们的团队已经为12名儿科患者进行了肺移植，其中11名患者年龄超过10岁。
开放获取
前置胎盘类型与剖宫产出血及子宫切除术预测因素的相关性Xing Wu, Fang Guo, Tao Ying, Guo-Fang Shen
中华医学杂志英文版2021年 134卷 04期
DOI: 10.1097/CM9.0000000000001210
摘要
致编辑：前置胎盘是妊娠晚期和分娩时出血的主要原因之一。根据胎盘下缘与宫颈内侧的关系，前置胎盘可分为不完全性前置胎盘（IPP）和完全性前置胎盘（CPP）。IPP表示胎盘下缘到达但不超过子宫颈内部。CPP是指胎盘的下边缘覆盖并超过子宫颈内部。该通用分类标准适用于子宫肌层完整，仅胎盘前置的病例。然而，当以前通过剖宫产分娩的孕妇在当前妊娠中出现前置胎盘，并且胎盘附着在子宫疤痕上时，产后出血和各种并发症的风险显著增加。这些病例被赋予了一个新的名称，恶性前置胎盘（PPP）。[
开放获取
3岁火棉胶婴儿睑外翻所致结膜高度水肿的手术治疗Di Chen, Xiao-Wei Liu
中华医学杂志英文版2021年 134卷 04期
DOI: 10.1097/CM9.0000000000001060
摘要
致编辑：火棉胶婴儿是一种极其罕见的先天性疾病的描述性术语，其特征是出生时存在覆盖全身的羊皮纸样或玻璃纸样膜。[
本期目次
下载本期封面 下载本期目录
