MedNexus
2021年 · 第134卷第09期
出版日期 2021-05-05电子版 ￥0.00元
MedNexus
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- Review Article
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Clinical Guideline
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浸润性乳腺癌诊疗临床实践指南：中国乳腺外科学会（CSBrS）实践指南2021Miao Liu, Chao-Bin Wang, Fei Xie, Yuan Peng, Shu Wang, Chinese Society of Breast Surgery
中华医学杂志英文版2021年 134卷 09期
DOI: 10.1097/CM9.0000000000001498
摘要
通过包括手术、放疗、全身治疗在内的综合治疗，乳腺癌患者的生存率大大提高，其中仍以手术治疗为主。乳腺外科医生不仅要掌握手术技巧，还要培养综合治疗疾病的能力。为提高我国乳腺外科医生早期诊断乳腺癌、进行合理手术治疗、提供综合治疗指导的能力，中国乳腺外科学会（CSBrS）通过意见征集和专家讨论，对浸润性乳腺癌诊治中的关键问题进行了报告。本集团使用分级建议评估、发展和评价系统评估相关证据，并制定了《浸润性乳腺癌患者诊断和治疗临床实践指南：CSBrS实践指南2021》，旨在为中国乳腺外科医生的临床实践提供指导。
Consensus Statement
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乳腺纤维腺瘤临床实践指南：中国乳腺外科学会（CSBrS）实践指南2021Yuan Peng, Fei Xie, Yi Zhao, Shu Wang, Chinese Society of Breast Surgery
中华医学杂志英文版2021年 134卷 09期
DOI: 10.1097/CM9.0000000000001462
摘要
乳腺纤维腺瘤是女性乳腺最常见的良性肿瘤，可发生于各个年龄段。然而，这些肿瘤更常见于15至35岁的女性。[
Review Article
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仅LIM结构域1：一种有助于多种癌症类型肿瘤发生的致癌转录辅因子Guo-Fa Zhao, Li-Qin Du, Lei Zhang, You-Chao Jia
中华医学杂志英文版2021年 134卷 09期
DOI: 10.1097/CM9.0000000000001487
摘要
The LIM domain only 1 (LMO1) gene belongs to the LMO family of genes that encodes a group of transcriptional cofactors. This group of transcriptional cofactors regulates gene transcription by acting as a key "connector" or "scaffold" in transcription complexes. All LMOs, including LMO1, are important players in the process of tumorigenesis. Unique biological features of LMO1 distinct from other LMO members, such as its tissue-specific expression patterns, interacting proteins, and transcriptional targets, have been increasingly recognized. Studies indicated that LMO1 plays a critical oncogenic role in various types of cancers, including T-cell acute lymphoblastic leukemia, neuroblastoma, gastric cancer, lung cancer, and prostate cancer. The molecular mechanisms underlying such functions of LMO1 have also been investigated, but they are currently far from being fully elucidated. Here, we focus on reviewing the current findings on the role of LMO1 in tumorigenesis, the mechanisms of its oncogenic action, and the mechanisms that drive its aberrant activation in cancers. We also briefly review its roles in the development process and non-cancer diseases. Finally, we discuss the remaining questions and future investigations required for promoting the translation of laboratory findings to clinical applications, including cancer diagnosis and treatment.
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表观遗传因素在1型糖尿病发病中的意义Jing Zhang, Long-Min Chen, Yuan Zou, Shu Zhang, Fei Xiong, Cong-Yi Wang
中华医学杂志英文版2021年 134卷 09期
DOI: 10.1097/CM9.0000000000001450
摘要
Type 1 diabetes (T1D) is an autoimmune disease that resulted from the severe destruction of the insulin-producing β cells in the pancreases of individuals with a genetic predisposition. Genome-wide studies have identified HLA and other risk genes associated with T1D susceptibility in humans. However, evidence obtained from the incomplete concordance of diabetes incidence among monozygotic twins suggests that environmental factors also play critical roles in T1D pathogenesis. Epigenetics is a rapidly growing field that serves as a bridge to link T1D risk genes and environmental exposures, thereby modulating the expression of critical genes relevant to T1D development beyond the changes of DNA sequences. Indeed, there is compelling evidence that epigenetic changes induced by environmental insults are implicated in T1D pathogenesis. Herein, we sought to summarize the recent progress in terms of epigenetic mechanisms in T1D initiation and progression, and discuss their potential as biomarkers and therapeutic targets in the T1D setting.
Meta analysis
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胶质前负荷对剖宫产腰麻低血压发生率影响的系统评价和荟萃分析Rui-Song Gong, Xiao-Wen Liu, Wei-Xia Li, Jing Zhao
中华医学杂志英文版2021年 134卷 09期
DOI: 10.1097/CM9.0000000000001477
摘要
Background:
Hypotension is a common complication caused by spinal anesthesia (SA), which may have adverse impacts on the condition of the parturient and fetus. Liquid infusion was found to be relatively effective for reducing the incidence of hypotension. However, the question of whether colloid preload can optimize hemodynamic variables in the cesarean section remains controversial. This study aims to determine the effects of colloid preload on the incidence of hypotension induced by SA in elective cesarean section.
Methods:
Related keywords were searched on PubMed, EMBASE, and Cochrane Library from inception dates to May 2020. Studies included were evaluated for eligibility and quality. The primary outcome was the intra-operative incidence of hypotension and severe hypotension. The secondary outcomes included the lowest intra-operative systolic blood pressure, the maximal intra-operative heart rate, the intra-operative needs of ephedrine and phenylephrine, the incidence of maternal nausea and/or vomiting, and neonatal outcomes (umbilical artery pH and Apgar scores). Apart from the above, RevMan 5.3 was used for the data analysis.
Results:
Altogether nine randomized controlled trials were included in the meta-analysis. There were no significant differences in the incidence of intra-operative hypotension, severe hypotension, or neonatal outcomes between the colloid preload group and control group, except for the umbilical artery pH.
Conclusion:
This meta-analysis suggests that colloid preload does not significantly reduce the incidence of hypotension associated with SA in elective cesarean section.
Medical Progress
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的角色AKR1C3恶性肿瘤Xin-Zhu Xiao, Li-Ying Lin, Ming-Kai Zhuang, Can-Mei Zhong, Feng-Lin Chen
中华医学杂志英文版2021年 134卷 09期
DOI: 10.1097/CM9.0000000000001379
摘要
醛酮还原酶超家族（AKRs）由190多个成员组成，可分为16个不同的家族（访问www.med.upenn.edu/akr）。AKR1C3（醛固酮还原酶家族1的C3亚型）是指第一个AKR在家族1、亚家族C中，由AKR1C3基因。AKR1C3首先从人前列腺cDNA文库中克隆和表达。该蛋白是可溶性单体NADP(H)(烟酰胺腺嘌呤二核苷酸磷酸或烟酰胺腺嘌呤二核苷酸磷酸的还原形式)依赖性氧化还原酶。TheAKR蛋白质在氨基酸水平上表现出至少40%的序列同一性，并且在其结构内具有(α/β)8桶结构。尤其是，AKR1C3与具有86%序列同一性AKR1C1,AKR1C2，和AKR1C4[补充图1，http://links.lww.com/CM9/A460]。AKR1C3已知参与雌激素、雄激素、孕酮和前列腺素等的代谢和生物合成。[
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肿瘤免疫微环境中的共突变与免疫治疗Ling Ma, Ling-Jun Zhu, Zi-Jie Xu, Yong-Qian Shu
中华医学杂志英文版2021年 134卷 09期
DOI: 10.1097/CM9.0000000000001455
摘要
肿瘤微环境主要包括成纤维细胞、巨噬细胞、内皮细胞、免疫细胞。肿瘤免疫微环境（时间）的异质性影响不同患者对免疫治疗的反应。使用免疫检查点抑制剂（ICIs）的癌症免疫疗法可以通过单独或组合阻断程序性细胞死亡1（PD-1）/程序性死亡配体-1（PD-L1）或细胞毒性T淋巴细胞相关蛋白4（CTLA-4）途径的抗体来实现，促进了肿瘤学的新范式转变。然而，癌症患者对ICIs的应答率相对较低，并且报道的用于预测治疗功效的生物标志物的结果是相互矛盾的。因此，迫切需要新颖可靠的生物标志物来监测肿瘤特异性免疫应答，避免免疫相关不良事件，提高临床疗效。
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用于预测溃疡性结肠炎生物治疗反应的潜在分子生物标志物Run-Feng Zhang, Shuang Liu, Yun-Wei Wang, Ji Li
中华医学杂志英文版2021年 134卷 09期
DOI: 10.1097/CM9.0000000000001390
摘要
溃疡性结肠炎(UC)和克罗恩病(CD)是炎症性肠病(IBD)的两种主要类型。近几十年来，包括抗肿瘤坏死因子(TNF)、抗整联蛋白、抗白细胞介素(IL)-12/IL-23和Janus激酶(JAK)抑制剂在内的生物制剂的使用促进了临床缓解和粘膜愈合并减少了手术，因此显著改善了IBD患者的生活质量。然而，据报道，在临床试验中，大约20%至30%的UC患者对抗TNF治疗没有反应（主要无反应者），另外15%至30%的患者随着时间的推移失去了反应。[
Perspective
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梵天相关基因1的作用（Brg1）在心脏病Wen-Bo Huang, Wen-Yang Liu, Gui-Ling Xie
中华医学杂志英文版2021年 134卷 09期
DOI: 10.1097/CM9.0000000000001480
摘要
心脏病是全世界人类死亡的主要原因。开关/蔗糖非发酵（SWI/SNF）复合物在心脏发育和心脏病中起着至关重要的作用。梵天相关基因1（Brg1），SWI/SNF复合物的关键三磷酸腺苷酶（ATP）催化亚基，通过利用ATP水解产生的能量来调节基因转录、DNA修复和DNA复制，参与几个生理和病理过程。和Brg1涉及全身性疾病，包括神经、心血管和免疫系统疾病。最近，作用Brg1在心脏病中得到了深入的研究。越来越多的证据表明Brg1氧化应激机制、凋亡、增殖和心脏病期间的心脏重塑。[
Original Article
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甲状腺功能与脂质代谢因果关系的评估：一项孟德尔随机化研究Jing-Jia Wang, Zhen-Huang Zhuang, Chun-Li Shao, Can-Qing Yu, Wen-Yao Wang, Kuo Zhang, Xiang-Bin Meng, Jun Gao, Jian Tian, Ji-Lin Zheng 等
中华医学杂志英文版2021年 134卷 09期
DOI: 10.1097/CM9.0000000000001505
摘要
Background:
Thyroid dysfunction is associated with cardiovascular diseases. However, the role of thyroid function in lipid metabolism remains partly unknown. The present study aimed to investigate the causal association between thyroid function and serum lipid metabolism via a genetic analysis termed Mendelian randomization (MR).
Methods:
The MR approach uses a genetic variant as the instrumental variable in epidemiological studies to mimic a randomized controlled trial. A two-sample MR was performed to assess the causal association, using summary statistics from the Atrial Fibrillation Genetics Consortium (n = 537,409) and the Global Lipids Genetics Consortium (n = 188,577). The clinical measures of thyroid function include thyrotropin (TSH), free triiodothyronine (FT3) and free thyroxine (FT4) levels, FT3:FT4 ratio and concentration of thyroid peroxidase antibodies (TPOAb). The serum lipid metabolism traits include total cholesterol (TC) and triglycerides, high-density lipoprotein, and low-density lipoprotein (LDL) levels. The MR estimate and MR inverse variance-weighted method were used to assess the association between thyroid function and serum lipid metabolism.
Results:
The results demonstrated that increased TSH levels were significantly associated with higher TC (β = 0.052, P = 0.002) and LDL (β = 0.041, P = 0.018) levels. In addition, the FT3:FT4 ratio was significantly associated with TC (β = 0.240, P = 0.033) and LDL (β = 0.025, P = 0.027) levels. However, no significant differences were observed between genetically predicted FT4 and TPOAb and serum lipids.
Conclusion:
Taken together, the results of the present study suggest an association between thyroid function and serum lipid metabolism, highlighting the importance of the pituitary-thyroid-cardiac axis in dyslipidemia susceptibility.
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三维肢体容积超声（AVol/TVol）和腹围预测胎儿体重Li Kang, Qing-Qing Wu, Li-Juan Sun, Feng-Yun Gao, Jing-Jing Wang
中华医学杂志英文版2021年 134卷 09期
DOI: 10.1097/CM9.0000000000001413
摘要
Background:
Fetal weight is an important parameter to ensure maternal and child safety. The purpose of this study was to use three-dimensional (3D) limb volume ultrasound combined with fetal abdominal circumference (AC) measurement to establish a model to predict fetal weight and evaluate its efficiency.
Methods:
A total of 211 participants with single pregnancy (28-42 weeks) were selected between September 2017 and December 2018 in the Beijing Obstetrics and Gynecology Hospital of Capital Medical University. The upper arm (AVol)/thigh volume (TVol) of fetuses was measured by the 3D limb volume technique. Fetal AC was measured by two-dimensional ultrasound. Nine cases were excluded due to incomplete information or the interval between examination and delivery >7 days. The enrolled 202 participants were divided into a model group (134 cases, 70%) and a verification group (68 cases, 30%) by mechanical sampling method. The linear relationship between limb volume and fetal weight was evaluated using Pearson Chi-squared test. The prediction model formula was established by multivariate regression with data from the model group. Accuracy of the model formula was evaluated with verification group data and compared with traditional formulas (Hadlock, Lee2009, and INTERGROWTH-21st) by paired t-test and residual analysis. Receiver operating characteristic curves were generated to predict macrosomia.
Results:
AC, AVol, and TVol were linearly related to fetal weight. Pearson correlation coefficient was 0.866, 0.862, and 0.910, respectively. The prediction model based on AVol/TVol and AC was established as follows: Y=-481.965+ 12.194TVol + 15.358AVol + 67.998AC, R2adj = 0.868. The scatter plot showed that when birth weight fluctuated by 5% (i.e., 95% to 105%), the difference between the predicted fetal weight by the model and the actual weight was small. A paired t-test showed that there was no significant difference between the predicted fetal weight and the actual birth weight (t= -1.015, P = 0.314). Moreover, the residual analysis showed that the model formula’s prediction efficiency was better than the traditional formulas with a mean residual of 35,360.170. The combined model of AVol/TVol and AC was superior to the Lee2009 and INTERGROWTH-21st formulas in the diagnosis of macrosomia. Its predictive sensitivity and specificity were 87.5% and 91.7%, respectively.
Conclusion:
Fetal weight prediction model established by semi-automatic 3D limb volume combined with AC is of high accuracy, sensitivity, and specificity. The prediction model formula shows higher predictive efficiency, especially for the diagnosis of macrosomia.
Trial Registration:
ClinicalTrials.gov, NCT03002246; https://clinicaltrials.gov/ct2/show/NCT03002246?recrs=e&cond=fetal& draw=8&rank=67.
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食管癌家族史改变血脂与食管恶性病变的关系：“中国食管癌内镜筛查”试验的巢式病例对照研究Min-Min Wang, Chuan-Hai Guo, Feng-Lei Li, Rui-Ping Xu, Zhen Liu, Ya-Qi Pan, Fang-Fang Liu, Ying Liu, Hong Cai, Meng-Fei Liu 等
中华医学杂志英文版2021年 134卷 09期
DOI: 10.1097/CM9.0000000000001432
摘要
Background:
The association of lipids and cancer has varied greatly among different cancer types, lipid components and study populations. This study is aimed to investigate the association of serum lipids and the risk of malignant lesions in esophageal squamous epithelium.
Methods:
In the "Endoscopic Screening for Esophageal Cancer in China" (ESECC) trial, serum samples were collected and tested for total cholesterol (TC), triglycerides, low-density lipoprotein cholesterol (LDL-C), and high-density lipoprotein cholesterol at the time of subject enrollment. Cases were defined as malignant esophageal lesions identified by baseline endoscopic examination or by follow-up to May 31, 2018. Controls were randomly selected using incidence density sampling in the same cohort. Conditional logistic models were applied to identify the association of serum lipids and the risk of malignant esophageal lesions. Effect modification was evaluated by testing interaction terms of the factor under assessment and these serum lipid indicators.
Results:
No consistent association between serum lipid levels and esophageal malignant lesions were found in a pooled analysis of 211 cases and 2101 controls. For individuals with a family history of esophageal cancer (EC), high TC, and LDL-C were associated with a significantly increased risk of having malignant lesions (odds ratio [OR]Highvs.Low TC = 2.22, 95% confidence interval [CI]: 1.14-4.35; ORHighvs.Low LDL-C = 1.93, 95% CI: 1.01-3.65). However, a negative association was observed in participants without an EC family history (ORHighvs.Low TC = 0.69, 95% CI: 0.48-0.98, Pinteraction = 0.002; ORHighvs.Low LDL-C = 0.50, 95% CI: 0.34-0.76, Pinteraction < 0.001).
Conclusions:
In this study, we found that the association of serum lipids and malignant esophageal lesions might be modified by EC family history. The stratified analysis would be crucial for population-based studies investigating the association of serum lipids and cancer. The mechanism by which a family history of EC modifies this association warrants further investigation.
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正常眼压或高血压原发性开角型青光眼与对照组角膜生物力学的比较Ya-Hui Wei, Yu Cai, Bonnie N.K. Choy, Bai-Bing Li, Ruo-Shi Li, Chen Xing, Xia Wang, Tian Tian, Yuan Fang, Mei Li 等
中华医学杂志英文版2021年 134卷 09期
DOI: 10.1097/CM9.0000000000001399
摘要
Background:
Normal tension glaucoma (NTG) is a less pressure-dependent type of glaucoma with characteristic optic neuropathy. Recently, the biomechanical mechanism has been thought to account for glaucomatous optic neuropathy to some degree. We intended to compare dynamic corneal response parameters (DCRs) among patients with primary open-angle glaucoma with normal tension or hypertension and controls. The correlations between DCRs and known risk factors for glaucoma were also analyzed.
Methods:
In this cross-sectional study, 49 NTG subjects, 45 hypertension glaucoma (HTG) subjects, and 50 control subjects were enrolled. We compared the differences in DCRs using corneal visualization Scheimpflug technology among the NTG, HTG, and control groups. We also analyzed the correlations between DCRs and known risk factors for glaucoma (eg, central corneal thickness [CCT], intraocular pressure [IOP], etc).
Results:
The maximum inverse concave radius (NTG: 0.18 [0.17, 0.20] mm-1; control: 0.17 [0.16, 0.18] mm-1; P= 0.033), deformation amplitude ratio of 2 mm (DAR 2 mm, NTG: 4.87 [4.33, 5.39]; control: 4.37 [4.07, 4.88]; P < 0.001), and DAR 1 mm (NTG: 1.62 [1.58, 1.65]; control: 1.58 [1.54, 1.61]; P < 0.001) were significantly higher in NTG than in the controls. The integrated radius (IR, NTG: 8.40 ± 1.07 mm-1; HTG: 7.64 ± 1.31 mm-1; P = 0.026) and DAR 2 mm (NTG: 4.87 [4.33, 5.39]; HTG: 4.44 [4.12, 5.02]; P < 0.007) were significantly higher, whereas the stiffness parameter at the first applanation (SP-A1, NTG: 91.23 [77.45, 107.45]; HTG: 102.36 [85.77, 125.12]; P = 0.007) was lower in NTG than in HTG. There were no significant differences in the DCRs between HTG and control groups (P > 0.05). In the univariate and multivariate analyses, some of the DCRs, such as IR, were negatively correlated with CCT and IOP, whereas SP-A1 was positively correlated with CCT and IOP.
Conclusions:
The cornea was more deformable in NTG than in HTG or controls. There were no significant differences in corneal deformability between HTG and controls. The cornea was more deformable with the thinner cornea and lower IOP.
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骨桥蛋白在饮食诱导大鼠棕色胆结石形成中的作用Chang-Guo Jin, Feng-Ru Jiang, Jie Zhang, Jun-Ren Ma, Xiao-Feng Ling
中华医学杂志英文版2021年 134卷 09期
DOI: 10.1097/CM9.0000000000001519
摘要
Background:
Although osteopontin (OPN) is expressed in the liver and pigment gallstones of patients with hepatolithiasis, its role in pigment gallstone formation remains unclear. This study aimed to explore the function of OPN in pigment gallstone formation.
Methods:
Rats were fed a chow diet (CD) or lithogenic diet (LD) for 10 consecutive weeks; blocking tests were then performed using an OPN antibody (OPN-Ab). Incidence of gallstones and levels of several bile components, OPN, tumor necrosis factor alpha (TNF-α), and cholesterol 7 alpha-hydroxylase (CYP7A1) were analyzed. To determine TNF-α expression in hepatic macrophages and both CYP7A1 and bile acid (BA) expression in liver cells, recombinant rat OPN and recombinant rat TNF-α were used to treat rat hepatic macrophages and rat liver cells, respectively. Chi-square or Fisher exact tests were used to analyze qualitative data, Student t-test or one-way analysis of variance were used to analyze qualitative data.
Results:
Incidence of gallstones was higher in LD-fed rats than in CD-fed rats (80% vs. 10%, P < 0.05). BA content significantly decreased in bile (t= -36.08, P < 0.01) and liver tissue (t= -16.16, P < 0.01) of LD-fed rats. Both hepatic OPN protein expression (t= 9.78, P < 0.01) and TNF-α level (t= 8.83, P < 0.01) distinctly increased in the LD group; what’s more, CYP7A1 mRNA and protein levels (t= -12.35, P < 0.01) were markedly down-regulated in the LD group. Following OPN-Ab pretreatment, gallstone formation decreased (85% vs. 25%, χ2 = 14.55, P < 0.01), liver TNF-α expression (F = 20.36, P < 0.01) was down-regulated in the LD group, and CYP7A1 expression (F = 17.51, P < 0.01) was up-regulated. Through CD44 and integrin receptors, OPN promoted TNF-α production in macrophage (F= 1041, P < 0.01), which suppressed CYP7A1 expression (F = 48.08, P < 0.01) and reduced liver BA synthesis (F= 119.4, P < 0.01).
Conclusions:
We provide novel evidence of OPN involvement in pigmented gallstone pathogenesis in rats.
Clinical Observation
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永久性左束支区起搏对有起搏指征的左束支传导阻滞患者QRS时限和短期心功能的影响Qi-Jun Shan, Hai Xu, Xiu-Juan Zhou, Qing Chang, Ling Ji, Chun Chen, Zhi-Xin Jiang
中华医学杂志英文版2021年 134卷 09期
DOI: 10.1097/CM9.0000000000001380
摘要
1986年，伯克霍夫和佐川[
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有症状的颈内动脉慢性近全闭塞或全闭塞的混合手术Chang-Ming Wang, Jin-Tao Han, Zi-Chang Jia, Guang-Xin Yang, Xuan Li
中华医学杂志英文版2021年 134卷 09期
DOI: 10.1097/CM9.0000000000001373
摘要
中风是全球第二大死亡原因，估计全球每年有550万人死亡。[
Technical Note
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腹腔镜子宫内膜成形术治疗双体子宫：手术技术和结果Qiao-Yun Zhou, Sotirios Saravelos, Xiao-Wu Huang, Ning Ma, Tinchiu Li, En-Lan Xia
中华医学杂志英文版2021年 134卷 09期
DOI: 10.1097/CM9.0000000000001266
摘要
由于诊断成像方式的改进，先天性子宫异常（CUA）的发病率似乎高于以前认为的。[
Rapid Report
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顺铂联合热疗对腹膜后脂肪肉瘤生物学特性的影响Cheng-Li Miao, Shahbaz Hanif, Lin Zhang, Xiao-Bing Chen, Mei Huang, Shi-Bo Liu, Cheng-Hua Luo
中华医学杂志英文版2021年 134卷 09期
DOI: 10.1097/CM9.0000000000001326
摘要
病理上，腹膜后脂肪肉瘤（RPLS）是一组恶性肿瘤，起源于腹膜后间隙的脂肪组织，几乎占所有腹膜后肿瘤的70%。RPLS没有最佳治疗方法。手术切除（R0/R1)是最有效的疗法；然而，复发率非常高。严重不完全手术切除（R2）是RPLS早期复发的重要危险因素。[
Correspondence
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妊娠期母体类风湿性关节炎对儿童的不良影响Rong Li, Dan Ma, Ya-Zhen Su, Gai-Lian Zhang, Ke Xu, Li-Yun Zhang
中华医学杂志英文版2021年 134卷 09期
DOI: 10.1097/CM9.0000000000001374
摘要
致编辑：类风湿性关节炎（RA）是一种以侵袭性关节炎为特征的自身免疫性疾病，影响约1%的全球人口。中青年女性易患RA，在病程中可经历一次或多次妊娠。健康和疾病的发展起源描述了年轻时发生的健康危害如何影响一个人晚年的健康。[
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宫腔镜子宫内膜活检联合免疫组化诊断子宫内膜炎Yan Zhang, Wei-Yan Li, Jing Lu
中华医学杂志英文版2021年 134卷 09期
DOI: 10.1097/CM9.0000000000001275
摘要
致编辑：慢性子宫内膜炎（CE）是一种微妙类型的炎症，其特征是子宫内膜基质中持续存在浆细胞，通常无症状，仅有轻微症状，如异常子宫出血、骨盆疼痛、性交困难或白带。
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循环Dickkof-1作为类风湿性关节炎相关间质性肺病患者预后的潜在生物标志物Jing Xue, Yu-Jiao Wang, He-Chun Xia, Xue-Yun Liang, Jie-Da Cui, Min Yu, Xiao-Ming Liu, Shu-Hong Chi, Juan Chen
中华医学杂志英文版2021年 134卷 09期
DOI: 10.1097/CM9.0000000000001267
摘要
致编辑：间质性肺病（ILD）是包括类风湿性关节炎（RA）在内的结缔组织疾病（CTD）患者中常见的关节外表现，其显著增加了疾病负担和超额死亡率。[
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气象因素对皮肤病日门诊量影响的时间序列研究Wei Zhang, Yu-Jiao Zhang, Xiao-Ping Shen, Gui-Cai Ning, Yu-Jia Wei, Wen Zeng, De-Hou Yu, Hong-Guang Lu
中华医学杂志英文版2021年 134卷 09期
DOI: 10.1097/CM9.0000000000001290
摘要
致编辑：关于皮肤科门诊就诊与气象因素之间的关联的证据有限。以往的一项研究集中在气象因素对某一种疾病的影响上，似乎缺乏针对一类疾病的系统分析。[
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梗阻性肥厚型心肌病并发感染性心内膜炎1例并文献复习Zi-Wen Wu, Hui Yan
中华医学杂志英文版2021年 134卷 09期
DOI: 10.1097/CM9.0000000000001265
摘要
致编辑：感染性心内膜炎（IE）是肥厚性心肌病（HCM）的一种罕见并发症，如果感染得不到有效控制，可能导致致命的结局。我们报告了3例肥厚梗阻性心肌病（HOCM）并发IE的病例，其中2例因对抗生素缺乏临床反应、心力衰竭恶化和严重二尖瓣反流而成功接受二尖瓣置换术（MVR）和间隔肌切除术（SM）治疗。
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急性胰腺炎可能是暴发性1型糖尿病的致病因素Ya-Ning Chen, Ming-Wei Zhao, Jia Cui, He-Bin Yao
中华医学杂志英文版2021年 134卷 09期
DOI: 10.1097/CM9.0000000000001274
摘要
致编辑：暴发性1型糖尿病(FT1DM)的特征是β细胞功能快速丧失、胰岛细胞抗体阴性、酮症酸中毒和胰酶升高。[
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以三角肌后部为受体，术中电生理检查在高位上肢截肢者靶向肌肉再支配中的质量控制Hua-Wei Yin, Jun-Tao Feng, Yun-Dong Shen, Yan-Song Wang, Ding-Guo Zhang, Wen-Dong Xu
中华医学杂志英文版2021年 134卷 09期
DOI: 10.1097/CM9.0000000000001261
摘要
致编辑：靶向肌肉再神经支配（TMR）是一种多神经转移的外科技术，通过表面肌电图（sEMG）在高位上肢截肢者中提供了改善直观假体控制的潜力。[
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成人发病的溃疡性结肠炎仅仅局限于结肠吗？Ling-Na Ye, Jie Mao, Zhi-Nong Jiang, Qian Cao
中华医学杂志英文版2021年 134卷 09期
DOI: 10.1097/CM9.0000000000001384
摘要
致编辑：溃疡性结肠炎(UC)传统上已知局限于大肠。上胃肠（GI）受累的存在长期以来被认为是克罗恩病（CD）而不是UC的标志。然而，先前在UC中有上消化道和小肠受累的报道。[
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