MedNexus
2021年 · 第134卷第05期
出版日期 2021-03-05电子版 ￥0.00元
MedNexus
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- Consensus Statement
- Review Article
- Medical Progress
- Ideas and Opinion
- Original Article
- Clinical Observation
- Correspondence
Consensus Statement
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中国心源性卒中诊断专家共识（2019）Guang-Zhi Liu, Rong Hu, Dan-Tao Peng, Geriatric Neurology Group, Geriatric Branch of Chinese Medical Association, Writing Group of Chinese expert consensus on diagnosis of cardiogenic stroke
中华医学杂志英文版2021年 134卷 05期
DOI: 10.1097/CM9.0000000000001217
摘要
心源性卒中（CES）又称心源性卒中，是指由来自心脏的心源性栓子通过循环导致脑动脉栓塞，并因此导致相应的脑功能障碍而引起的临床综合征。与其他亚型缺血性卒中相比，CES与更大的严重程度、较差的结局和相对较高的复发率相关。[
Review Article
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靶向神经纤毛蛋白-1相互作用是一种有前途的抗肿瘤策略Shao-Dan Liu, Li-Ping Zhong, Jian He, Yong-Xiang Zhao
中华医学杂志英文版2021年 134卷 05期
DOI: 10.1097/CM9.0000000000001200
摘要
Neuropilins (NRP1 and NRP2) are multifunctional receptor proteins that are involved in nerve, blood vessel, and tumor development. NRP1 was first found to be expressed in neurons, but subsequent studies have demonstrated its surface expression in cells from the endothelium and lymph nodes. NRP1 has been demonstrated to be involved in the occurrence and development of a variety of cancers. NRP1 interacts with various cytokines, such as vascular endothelial growth factor family and its receptor and transforming growth factor β1 and its receptor, to affect tumor angiogenesis, tumor proliferation, and migration. In addition, NRP1+ regulatory T cells (Tregs) play an inhibitory role in tumor immunity. High numbers of NRP1+ Tregs were associated with cancer prognosis. Targeting NRP1 has shown promise, and antagonists against NRP1 have had therapeutic efficacy in preliminary clinical studies. NRP1 treatment modalities using nanomaterials, targeted drugs, oncolytic viruses, and radio-chemotherapy have gradually been developed. Hence, we reviewed the use of NRP1 in the context of tumorigenesis, progression, and treatment.
Medical Progress
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银屑病全身治疗与心血管风险的关系Li-Qing Shi, Ni Lian, Jia-Teng Sun, Li-Hao Liu, Min Chen
中华医学杂志英文版2021年 134卷 05期
DOI: 10.1097/CM9.0000000000001249
摘要
银屑病是一种慢性炎症性疾病，涉及先天免疫系统和适应性免疫系统之间复杂的致病相互作用，影响约2%的人群。据报道，在银屑病患者中，几种重要疾病的发病率高于在普通人群中观察到的发病率。其中，心血管疾病（CVDs）是银屑病患者发病和死亡的最常见原因。因此，有效和安全的治疗对于降低该患者群体的心血管风险至关重要。
Ideas and Opinion
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颈椎前路手术患者常规放置引流管：真的有必要吗？Yang Liu, Yang Meng, Hao Liu, Wen-Bin Shuai, Chen Ding, Bei-Yu Wang, Yi Yang, Ying Hong
中华医学杂志英文版2021年 134卷 05期
DOI: 10.1097/CM9.0000000000001253
摘要
随着世界各国老龄化进程的加快以及工作和生活习惯的改变，颈椎病日益流行，给社会和政府都带来了巨大的经济负担和医疗费用压力。[
Original Article
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中国ST段抬高型心肌梗死后拒绝侵入性策略的潜在因素分析He Zhang, Wen Zheng, Shuo Wu, Jing-Jing Ma, Guang-Mei Wang, Yong Li, Jia-Qi Zheng, Yuan Lyu, Meng-Yang Xue, Feng Xu 等
中华医学杂志英文版2021年 134卷 05期
DOI: 10.1097/CM9.0000000000001171
摘要
Background:
Reduced application of percutaneous coronary intervention (PCI) is associated with higher mortality rates after ST-segment elevation myocardial infarction (STEMI). We aimed to evaluate potential factors contributing to the refusal of PCI in STEMI patients in China.
Methods:
We studied 957 patients diagnosed with STEMI in the emergency departments (EDs) of six public hospitals in China. The differences in baseline characteristics and 30-day outcome were investigated between patients who refused PCI and those who underwent PCI. Multivariable logistic regression was used to evaluate the potential factors associated with refusing PCI.
Results:
The potential factors contributing to refusing PCI were older than 65 years (odds ratio [OR] 2.66, 95% confidence interval [CI] 1.56-4.52, P < 0.001), low body mass index (BMI) (OR 0.91, 95% CI 0.84-0.98, P = 0.013), not being married (OR 0.29, 95% CI 0.17-0.49, P < 0.001), history of myocardial infarction (MI) (OR 2.59, 95% CI 1.33-5.04, P = 0.005), higher heart rate (HR) (OR 1.02, 95% CI 1.01-1.03, P = 0.002), cardiac shock in the ED (OR 5.03, 95% CI 1.48-17.08, P = 0.010), pre-hospital delay (>12 h) (OR 3.31, 95% CI 1.83-6.02, P < 0.001) and not being hospitalized in a tertiary hospital (OR 0.45, 95% CI 0.27-0.75, P = 0.002). Compared to men, women were older, were less often married, had a lower BMI and were less often hospitalized in tertiary hospitals.
Conclusions:
Patients who were older, had lower economic or social status, and had poorer health status were more likely to refuse PCI after STEMI. There was a sex difference in the potential predictors of refusing PCI. Targeted efforts should be made to improve the acceptance of PCI among patients with STEMI in China.
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基于ICD-10-CM词典的中国创伤死亡率预测模型的开发与内部验证：CMPMIT-ICD10Yan-Hua Wang, Tian-Bing Wang, Zi-Xiao Zhang, Hui-Xin Liu, Ting-Min Xu, Chu Wang, Bao-Guo Jiang
中华医学杂志英文版2021年 134卷 05期
DOI: 10.1097/CM9.0000000000001371
摘要
Background:
Models to predict mortality in trauma play an important role in outcome prediction and severity adjustment, which informs trauma quality assessment and research. Hospitals in China typically use the International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10-CM) to describe injury. However, there is no suitable prediction model for China. This study attempts to develop a new mortality prediction model based on the ICD-10-CM lexicon and a Chinese database.
Methods:
This retrospective study extracted the data of all trauma patients admitted to the Beijing Red Cross Emergency Center, from January 2012 to July 2018 (n = 40,205). We used relevant predictive variables to establish a prediction model following logistic regression analysis. The performance of the model was assessed based on discrimination and calibration. The bootstrapping method was used for internal validation and adjustment of model performance.
Results:
Sex, age, new region-severity codes, comorbidities, traumatic shock, and coma were finally included in the new model as key predictors of mortality. Among them, coma and traumatic shock had the highest scores in the model. The discrimination and calibration of this model were significant, and the internal validation performance was good. The values of the area under the curve and Brier score for the new model were 0.9640 and 0.0177, respectively; after adjustment of the bootstrapping method, they were 0.9630 and 0.0178, respectively.
Conclusions:
The new model (China Mortality Prediction Model in Trauma based on the ICD-10-CM lexicon) showed great discrimination and calibration, and performed well in internal validation; it should be further verified externally.
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中国成人24小时尿钠、钾、肌酐排泄的余弦节律测定Ya-Guang Peng, Jing-Jing Feng, Ying Zhang, Kun Li, Si-Yu Cai, Ruo-Hua Yan, Xiao-Xia Peng
中华医学杂志英文版2021年 134卷 05期
DOI: 10.1097/CM9.0000000000001319
摘要
Background:
The low accuracy of equations predicting 24-h urinary sodium excretion using a single spot urine sample contributed to the misclassification of individual sodium intake levels. The application of single spot urine sample is limited by a lack of representativity of urinary sodium excretion, possibly due to the circadian rhythm in urinary excretion. This study aimed to explore the circadian rhythm, characteristics, and parameters in a healthy young adult Chinese population as a theoretical foundation for developing new approaches.
Methods:
Eighty-five participants (mean age 32.4 years) completed the 24-h urine collection by successively collecting each of the single-voided specimens within 24 h. The concentrations of the urinary sodium, potassium, and creatinine for each voided specimen were measured. Cosinor analysis was applied to explore the circadian rhythm of the urinary sodium, potassium, and creatinine excretion. The excretion per hour was computed for analyzing the change over time with repeated-measures analysis of variance and a cubic spline model.
Results:
The metabolism of urinary sodium, potassium, and creatinine showed different patterns of circadian rhythm, although the urinary sodium excretion showed non-significant parameters in the cosinor model. A significant circadian rhythm of urinary creatinine excretion was observed, while the circadian rhythm of sodium was less significant than that of potassium. The circadian rhythm of urinary sodium and creatinine excretion showed synchronization to some extent, which had a nocturnal peak and fell to the lowest around noon to afternoon. In contrast, the peak of potassium was observed in the morning and dropped to the lowest point in the evening. The hourly urinary excretion followed a similar circadian rhythm.
Conclusion:
It is necessary to consider the circadian rhythm of urinary sodium, potassium, and creatinine excretion in adults while exploring the estimation model for 24-h urinary sodium excretion using spot urine.
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三七皂苷R1靶向抑制乳腺癌进展CCND2和YBX3Hai-Long Qin, Xue-Jun Wang, Bi-Xian Yang, Bin Du, Xue-Lin Yun
中华医学杂志英文版2021年 134卷 05期
DOI: 10.1097/CM9.0000000000001328
摘要
Background:
Breast cancer (BC) is a common malignancy with highly female incidence. So far the function of notoginsenoside R1 (NGR1), the extract from Panax notoginseng, has not been clearly elucidated in BC.
Methods:
Optimal culture concentration and time of NGR1 were investigated by cell counting kit-8 assay. Cell proliferation ability was measured by colony formation assays. Transwell assay was used to detect the effect of NGR1 on cell migration and invasion. The apoptosis rate of cells between each group was measured by TUNEL assay.
Results:
NGR1 treatment has an inhibitory effect on proliferation, migration, invasion, and angiogenesis and a stimulating effect on cell cycle arrest and apoptosis of Michigan Cancer Foundation-7 (MCF-7) cells. The 50% growth inhibitory concentration for MCF-7 cells at 24 h was 148.9 mmol/L. The proportions of MCF-7 cells arrested in the G0/G1 phase were 36.94±6.78%, 45.06 ± 5.60%, and 59.46±5.60% in the control group, 75, and 150 mmol/L groups, respectively. Furthermore, we revealed that NGR1 treatment attenuates BC progression by targeted downregulating CCND2 and YBX3 genes. Additionally, YBX3 activates phosphatidylinositol 3-phosphate kinase (PI3K)/protein kinase B (Akt) signaling pathway by activating kirsten rat sarcoma viral oncogene, which is an activator of the PI3K/Akt signaling pathway.
Conclusion:
These results suggest that NGR1 can act as an efficacious drug candidate that targets the YBX3/PI3K/Akt axis in patients with BC.
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Th17细胞参与小鼠慢性阻塞性肺疾病合并侵袭性肺曲霉病Wan-Ru Geng, Hang-Yong He, Qing Zhang, Zhao-Hui Tong
中华医学杂志英文版2021年 134卷 05期
DOI: 10.1097/CM9.0000000000001183
摘要
Background:
The incidence of chronic obstructive pulmonary disease (COPD) complicated with invasive pulmonary aspergillosis (IPA) has increased in the last two decades. The mechanism underpinning susceptibility to and high mortality of COPD complicated with IPA is unclear, and the role of T helper cells 17 (Th17 cells) in the compound disease remains unknown. Therefore, this study aimed to assess the function of Th17 cells in COPD combined with IPA.
Methods:
COPD, IPA, and COPD+IPA mouse models were established in male wild type C57/BL6 mice. The amounts of Th17 cells and retinoic acid-related orphan receptors γt (RORγt) were tested by flow cytometry. Then, serum interleukin (IL)-17 and IL-23 levels were detected by enzyme-linked immunosorbent assay (ELISA) in the control, COPD, IPA and COPD+IPA groups. In addition, COPD+IPA was induced in IL-17 knockout (KO) mice, for determining the role of Th17 cells in COPD+IPA.
Results:
Compared with the COPD group, the COPD+IPA group showed higher amounts of blood RORγt ([35.09 ± 16.12]% vs. [17.92 ± 4.91]%, P = 0.02) and serum IL-17 (17.96 ± 9.59 pg/mL vs. 8.05 ± 4.44 pg/mL, P = 0.02), but blood ([5.18 ± 1.09]% vs. [4.15 ± 0.87]%, P= 0.28) and lung levels of Th17 cells ([1.98 ± 0.83]% vs. [2.03 ± 0.98]%, P= 0.91), lung levels of RORγt ([9.58 ± 6.93]% vs. [9.63 ± 5.98]%, P = 0.49) and serum IL-23 (51.55 ± 27.82 pg/mL vs. 68.70 ± 15.20 pg/mL, P = 0.15) showed no significant differences. Compared with the IPA group, the COPD+IPA group displayed lower amounts of blood ([5.18 ± 1.09]% vs. [9.21 ± 3.56]%, P = 0.01) and lung Th17 cells ([1.98 ± 0.83]% vs. [6.29 ± 1.11]%, P = 0.01) and serum IL-23 (51.55 ± 27.82 pg/mL vs. 154.90 ± 64.60 pg/mL, P = 0.01) and IL-17 (17.96 ± 9.59 pg/mL vs. 39.81 ± 22.37 pg/mL, P = 0.02), while comparable blood ([35.09 ± 16.12]% vs. [29.86 ± 15.42]%, P = 0.25) and lung levels of RORγt ([9.58 ± 6.93]% vs. [15.10 ± 2.95]%, P = 0.18) were found in these two groups. Finally, Aspergillus load in IL-17 KO COPD+IPA mice was almost 2 times that of COPD+IPA mice (1,851,687.69 ± 944,480.43 vs. 892,958.10 ± 686,808.80, t= 2.32, P = 0.02).
Conclusion:
These findings indicate that Th17 cells might be involved in the pathogenesis of COPD combined with IPA, with IL-17 likely playing an antifungal role.
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miRNA-296-5p作为人骨肉瘤的潜在肿瘤抑制因子SND1Ya-Zeng Huang, Jun Zhang, Jian-Jian Shen, Ting-Xiao Zhao, You-Jia Xu
中华医学杂志英文版2021年 134卷 05期
DOI: 10.1097/CM9.0000000000001400
摘要
Background:
The pathogenesis of osteosarcoma (OS) is still unclear, and it is still necessary to find new targets and drugs for anti-OS. This study aimed to investigate the role and mechanism of the anti-OS effects of miR-296-5p.
Methods:
We measured the expression of miR-296-5p in human OS cell lines and tissues. The effect of miR-296-5p and its target gene staphylococcal nuclease and tudor domain containing 1 on proliferation, migration, and invasion of human OS lines was examined. The Student’s t test was used for statistical analysis.
Results:
We found that microRNA (miR)-296-5p was significantly downregulated in OS cell lines and tissues (control vs. OS, 1.802 ± 0.313 vs. 0.618 ± 0.235, t= 6.402, P < 0.01). Overexpression of miR-296-5p suppressed proliferation, migration, and invasion of OA cells. SND1 was identified as a target of miR-296-5p by bioinformatic analysis and dual-luciferase reporter assay. Overexpression of SND1 abrogated the effects induced by miR-296-5p upregulation (miRNA-296-5p vs. miRNA-296-5p + SND1, 0.294 ± 0.159 vs. 2.300 ± 0.277, t= 12.68, P = 0.003).
Conclusion:
Our study indicates that miR-296-5p may function as a tumor suppressor by targeting SND1 in OS.
Clinical Observation
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局部溶栓联合球囊扩张治疗重症脑静脉窦血栓形成Min-Jian Qiu, Shui-Jiang Song, Feng Gao
中华医学杂志英文版2021年 134卷 05期
DOI: 10.1097/CM9.0000000000001315
摘要
脑静脉窦血栓形成（CVST）是一种涉及脑静脉和窦血栓形成的罕见疾病。如果CVST没有得到及时和适当的治疗，可能会发生严重的后果，包括由于静脉阻塞导致的颅内高压和脑静脉梗塞，可导致癫痫、严重的神经系统疾病，甚至死亡。[
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利拉鲁肽通过5'-一磷酸腺苷(AMP)激活的蛋白激酶信号通路抑制子宫内膜癌细胞增殖Xin-Xin Zhu, Zong-Hao Feng, Lin-Zhi Liu, Yan Zhang
中华医学杂志英文版2021年 134卷 05期
DOI: 10.1097/CM9.0000000000001363
摘要
本研究研究了利拉鲁肽（人胰高血糖素样肽-1[GLP-1]的类似物）对Ishikawa（IK）和人子宫内膜癌（HEC）-1B子宫内膜癌（EC）细胞系增殖的影响，鉴定了利拉鲁肽是否增强孕酮的抗肿瘤作用，并探索了利拉鲁肽在EC细胞系孕酮受体（PGR）表达中的作用和潜在途径。
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基于炎症的格拉斯哥预后评分作为血管免疫母细胞性T细胞淋巴瘤患者的独立预后因素Guan-Jun Chen, Zhi-Jun Wuxiao, Yang Liang, Chun Li, Bi-Bo Fu, Hua Wang
中华医学杂志英文版2021年 134卷 05期
DOI: 10.1097/CM9.0000000000001345
摘要
血管免疫母细胞性T细胞淋巴瘤（AITL）是一种侵袭性外周T细胞淋巴瘤（PIT），预后不良。以淋巴结肿大、B症状（不明原因反复发热（常在38℃以上）、盗汗、6个月内不明原因体重减轻10%以上）、多克隆高丙种球蛋白血症、自身免疫性溶血为特征。[
Correspondence
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急性脑卒中患者血管内取栓术前是否应使用阿替普酶？Min Yuan, Huang-Yan Zhou, Ling-Feng Wu, Wen-Feng Cao, Ren-Shi Xu
中华医学杂志英文版2021年 134卷 05期
DOI: 10.1097/CM9.0000000000001178
摘要
致编辑：中风是脑血液循环障碍的突然发作；其发病率越来越高，已成为全球第二大常见死因、第四大生产力丧失原因和主要致残原因，[
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潜在特发性肺纤维化相关微小RNA和信使RNA调控网络的构建Yu-Feng Zhang, Li-Na Gu, Jia Qi, Qing-Qing Xia, Li-Jun Tian, Wei-Long Jiang, Meng-Shu Cao
中华医学杂志英文版2021年 134卷 05期
DOI: 10.1097/CM9.0000000000001276
摘要
致编辑：特发性肺纤维化（IPF）是一种病因不明、以慢性、进行性肺纤维化为特征的肺部疾病，其病理表现为通常的间质性肺炎。[
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2019冠状病毒病（COVID-19）爆发期间，山西省部署到武汉的医护人员的心理反应及其应对方式Li-Na Dong, Ya-Li Zhao, Yi Liu, Yu-Zhi Wu, Jun-Ping Wang
中华医学杂志英文版2021年 134卷 05期
DOI: 10.1097/CM9.0000000000001201
摘要
致编辑：自2019冠状病毒病（COVID-19）爆发以来，大量医护人员自愿离开熟悉的工作和生活环境，前往湖北省承担应急响应工作。对于大多数前往湖北省的医务工作者来说，这是他们第一次参与这样的危机情况。此前有研究报道，医护人员面临高强度工作和高心理压力的双重打击，特别容易出现心理健康困难。[
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2019冠状病毒病对中国乳腺癌临床诊疗的影响Yi-Ran Si, Feng Du, Nan-Lin Hu, Xue Wang, Jian Yue, Pei-Di Jiang, Bing-He Xu, Peng Yuan, the Breast Cancer Group, Chinese Association for Clinical Oncologist
中华医学杂志英文版2021年 134卷 05期
DOI: 10.1097/CM9.0000000000001347
摘要
致编辑：2019年12月以来，2019冠状病毒病（COVID-19）疫情成为中国乃至全球关注的焦点。尽管中国疫情得到有效控制，但全球COVID-19疫情形势不容乐观，已逐渐成为2020年的全球威胁。新冠肺炎可能导致老年人和心血管疾病、恶性肿瘤和其他基础疾病患者的高死亡率。[
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体表面积：中国成人2型糖尿病患者糖尿病视网膜病变的一种新的人体测量方法：一项医院登记病例对照研究Yi-Fan Zhong, Xin-Yu Wang, Xiang Li, Li-Tong Yao, Jing-Yang Wu, Jin Geng, Yun Zhou, Jia-Hua Zhang, Jun Chen, Peng Guan 等
中华医学杂志英文版2021年 134卷 05期
DOI: 10.1097/CM9.0000000000001071
摘要
致编辑：糖尿病视网膜病变（DR）是一种以糖尿病视网膜微血管损伤为特征的疾病。作为成人失明的主要原因，DR已经成为世界范围内的公共卫生问题，并威胁着糖尿病患者甚至健康人群的预后。DR与以体重指数（BMI）为代表的常见人体测量值之间的相关性仍有争议。[
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心源性死亡后使用一名肥胖供体的中度脂肪变性移植物进行右后段缩小挽救性肝移植Zhi-Xi Zhang, Xing-Yu Pu, Jian Yang, Li Jiang, Jia-Yin Yang, Lu-Nan Yan
中华医学杂志英文版2021年 134卷 05期
DOI: 10.1097/CM9.0000000000001272
摘要
致编辑：与大多数在儿科接受者中进行的缩小尺寸肝移植（RSLT）相比，[
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胆道闭锁Kasai术后肝内胆道囊肿与肝衰竭时间的相关性Xue-Qiang Yan, Jin-Fu Jia, Jiang-Hua Zhan, Chen Yu, Xi-Qian Xiong, Sheng-Qiao Zhao, Wei Gao
中华医学杂志英文版2021年 134卷 05期
DOI: 10.1097/CM9.0000000000001260
摘要
致编辑：胆道闭锁（BA）是一种影响婴幼儿生活的胆道梗阻性疾病。Kasai手术（KP）改善了BA的预后，但尚未成功解决BA术后胆管炎症和肝纤维化、肝内胆管囊性扩张（肝内胆管囊肿，IBC）、门静脉高压症、肝功能衰竭，etc因此，大多数儿童仍然需要肝移植（LT）。[
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儿童活体肝移植术后早期肝动脉血栓形成：一项单中心经验Zhi-Gui Zeng, Liu-Xin Zhou, Li-Ying Sun, Lin Wei, Wei Qu, Ying Liu, Yu-Le Tan, Hai-Ming Zhang, Xiao-Jie Chen, Zhi-Jun Zhu
中华医学杂志英文版2021年 134卷 05期
DOI: 10.1097/CM9.0000000000001250
摘要
致编辑：作为肝移植（LT）后最严重的血管并发症之一，早期肝动脉血栓形成（eHAT）可能导致缺血性肝坏死和缺血性胆道并发症如胆漏并最终导致移植物或患者丢失。[
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粪便免疫化学试验和基于问卷的风险评估检测近端和远端晚期结直肠腺瘤的不同检出率Hong-Da Chen, Ming Lu, Yu-Han Zhang, Min Dai
中华医学杂志英文版2021年 134卷 05期
DOI: 10.1097/CM9.0000000000001346
摘要
致编辑：粪便免疫化学试验(FIT)是设计用于检测人血红蛋白以指示结肠瘤形成发生的免疫测定，其已广泛用于全球结肠直肠癌(CRC)筛查项目。先前的诊断研究表明，位点特异性敏感性存在很强的梯度，位于远端结肠/直肠的晚期腺瘤的发生率通常高于近端部分，这可以通过影响血红蛋白降解的结肠转变时间以及不同解剖区域腺瘤的形状（有蒂、扁平和无蒂）来解释。[
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一例伴有不明原因贫血和感冒相关症状的膀胱移行细胞癌患者罕见并发冷凝集素病Shuo Li, Lu Zhang, Wei Wang
中华医学杂志英文版2021年 134卷 05期
DOI: 10.1097/CM9.0000000000001277
摘要
致编辑贫血是一种非常常见的临床情况，可由多种疾病引起。虽然很常见，但有时很难找出贫血的潜在原因，尤其是对于复杂的病例。在此，我们报告了一例看似明显的贫血（血尿）原因的老年患者，后来被诊断为罕见的冷凝集素（CA）病（CAD），这被证实是其严重贫血的主要病因。
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