MedNexus
2021年 · 第134卷第11期
出版日期 2021-06-05电子版 ￥0.00元
MedNexus
- 全部
- Consensus Statement
- Review Article
- Ideas and Opinion
- Original Article
- Clinical Observation
- Correspondence
- Corrigendum
Consensus Statement
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中国基于人工智能平台的直肠癌分期识别系统应用指南（2021版）Yuan Gao, Yun Lu, Shuai Li, Yong Dai, Bo Feng, Fang-Hai Han, Jia-Gang Han, Jing-Jing He, Xin-Xiang Li, Guo-Le Lin 等
中华医学杂志英文版2021年 134卷 11期
DOI: 10.1097/CM9.0000000000001483
摘要
无论是手术治疗还是新辅助放化疗，影像学评估已成为执行治疗计划的重要依据。[
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肿瘤性骨软化症临床治疗共识Yan Jiang, Xiang Li, Li Huo, Yong Liu, Wei Lyu, Lian Zhou, Wei Yu, Huan-Wen Wu, Xiao-Ping Xing, Mei Li 等
中华医学杂志英文版2021年 134卷 11期
DOI: 10.1097/CM9.0000000000001448
摘要
肿瘤诱导的骨软化症(TIO)是一种罕见的副肿瘤综合征，由肿瘤产生过多的成纤维细胞生长因子23(FGF23)引起，通常起源于间充质来源。[
Review Article
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癌症免疫治疗的全新时代：突破与挑战Ri-Lan Bai, Nai-Fei Chen, Ling-Yu Li, Jiu-Wei Cui
中华医学杂志英文版2021年 134卷 11期
DOI: 10.1097/CM9.0000000000001490
摘要
Immunotherapy has opened a new era in cancer treatment. Drugs represented by immune checkpoint inhibitors have led to important breakthroughs in the treatment of various solid tumors, greatly improving the survival rate of cancer patients. Many types of immunotherapeutic drugs have become widely available; however, their efficacy is variable, and relatively few patients with advanced cancer experience life-altering durable survival, reflecting the complex and highly regulated nature of the immune system. The research field of cancer immunotherapy (CIT) still faces many challenges in pursuing the broader social goal of "curing cancer." Increasing attention has been paid to strengthening the understanding of the molecular or cellular drivers of resistance to immunotherapy, actively exploring more effective therapeutic targets, and developing combination therapy strategies. Here, we review the key challenges that have emerged in the era of CIT and the possible solutions or development directions to overcome these difficulties, providing relevant references for basic research and the development of modified clinical treatment regimens.
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果糖与代谢性疾病：太多而不好Ya-Nan Shi, Ya-Jin Liu, Zhifang Xie, Weiping J. Zhang
中华医学杂志英文版2021年 134卷 11期
DOI: 10.1097/CM9.0000000000001545
摘要
Excessive consumption of fructose, the sweetest of all naturally occurring carbohydrates, has been linked to worldwide epidemics of metabolic diseases in humans, and it is considered an independent risk factor for cardiovascular diseases. We provide an overview about the features of fructose metabolism, as well as potential mechanisms by which excessive fructose intake is associated with the pathogenesis of metabolic diseases both in humans and rodents. To accomplish this aim, we focus on illuminating the cellular and molecular mechanisms of fructose metabolism as well as its signaling effects on metabolic and cardiovascular homeostasis in health and disease, highlighting the role of carbohydrate-responsive element-binding protein in regulating fructose metabolism.
Ideas and Opinion
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临界超声在血流动力学治疗中的应用Wei Huang, Da-Wei Liu, Xiao-Ting Wang, Chinese Critical Ultrasound Study Group (CCUSG)
中华医学杂志英文版2021年 134卷 11期
DOI: 10.1097/CM9.0000000000001391
摘要
由于该技术的快速发展，危重超声检查（CUS）几乎用于重症医学的每个分支。CUS支持目标导向、持续和动态的评估。CU在血流动力学治疗中的应用提供了对血流动力学的详细了解，并优化了血流动力学治疗。本文从多方面介绍了目前CUS在血流动力学治疗中的应用。
Original Article
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严重急性呼吸综合征冠状病毒2型灭活疫苗在健康成人中的免疫原性和安全性：随机、双盲和安慰剂对照1期和2期临床试验Hong-Xing Pan, Jian-Kai Liu, Bao-Ying Huang, Gui-Fan Li, Xian-Yun Chang, Ya-Fei Liu, Wen-Ling Wang, Kai Chu, Jia-Lei Hu, Jing-Xin Li 等
中华医学杂志英文版2021年 134卷 11期
DOI: 10.1097/CM9.0000000000001573
摘要
Background:
The significant morbidity and mortality resulted from the infection of a severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) call for urgent development of effective and safe vaccines. We report the immunogenicity and safety of an inactivated SARS-CoV-2 vaccine, KCONVAC, in healthy adults.
Methods:
Phase 1 and phase 2 randomized, double-blind, and placebo-controlled trials of KCONVAC were conducted in healthy Chinese adults aged 18 to 59 years. The participants in the phase 1 trial were randomized to receive two doses, one each on Days 0 and 14, of either KCONVAC (5 or 10 μg/dose) or placebo. The participants in the phase 2 trial were randomized to receive either KCONVAC (at 5 or 10 μg/dose) or placebo on Days 0 and 14 (0/14 regimen) or Days 0 and 28 (0/28 regimen). In the phase 1 trial, the primary safety endpoint was the proportion of participants experiencing adverse reactions/events within 28 days following the administration of each dose. In the phase 2 trial, the primary immunogenicity endpoints were neutralization antibody seroconversion and titer and anti-receptor-binding domain immunoglobulin G seroconversion at 28 days after the second dose.
Results:
In the phase 1 trial, 60 participants were enrolled and received at least one dose of 5-μg vaccine (n = 24), 10-μg vaccine (n = 24), or placebo (n = 12). In the phase 2 trial, 500 participants were enrolled and received at least one dose of 5-μg vaccine (n = 100 for 0/14 or 0/28 regimens), 10-μg vaccine (n = 100 for each regimen), or placebo (n = 50 for each regimen). In the phase 1 trial, 13 (54%), 11 (46%), and seven (7/12) participants reported at least one adverse event (AE) after receiving 5-, 10-μg vaccine, or placebo, respectively. In the phase 2 trial, 16 (16%), 19 (19%), and nine (18%) 0/14-regimen participants reported at least one AE after receiving 5-, 10-μg vaccine, or placebo, respectively. Similar AE incidences were observed in the three 0/28-regimen treatment groups. No AEs with an intensity of grade 3+ were reported, expect for one vaccine-unrelated serious AE (foot fracture) reported in the phase 1 trial. KCONVAC induced significant antibody responses; 0/28 regimen showed a higher immune responses than that did 0/14 regimen after receiving two vaccine doses.
Conclusions:
Both doses of KCONVAC are well tolerated and able to induce robust immune responses in healthy adults. These results support testing 5-μg vaccine in the 0/28 regimen in an upcoming phase 3 efficacy trial.
Trial Registration:
http://www.chictr.org.cn/index.aspx (No. ChiCTR2000038804, http://www.chictr.org.cn/showproj.aspx? proj=62350; No. ChiCTR2000039462, http://www.chictr.org.cn/showproj.aspx?proj=63353).
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苯达莫司汀治疗中国复发性惰性非霍奇金淋巴瘤患者：一项多中心、开放标签、单臂、3期研究Yuan-Kai Shi, Xiao-Nan Hong, Jian-Liang Yang, Wei Xu, Hui-Qiang Huang, Xiu-Bin Xiao, Jun Zhu, Dao-Bin Zhou, Xiao-Hong Han, Jian-Qiu Wu 等
中华医学杂志英文版2021年 134卷 11期
DOI: 10.1097/CM9.0000000000001463
摘要
Background:
Bendamustine was approved in China on May 26th, 2019 by the National Medical Product Administration for the treatment of indolent B-cell non-Hodgkin lymphoma (NHL). The current study was the registration trial and the first reported evaluation of the efficacy, safety, and pharmacokinetics of bendamustine in Chinese adult patients with indolent B-cell NHL following relapse after chemotherapy and rituximab treatment.
Methods:
This was a prospective, multicenter, open-label, single-arm, phase 3 study (NCT01596621; C18083/3076) with a 2-year follow-up period. Eligible patients received bendamustine hydrochloride 120 mg/m2 infused intravenously on days 1 and 2 of each 21-day treatment cycle for at least six planned cycles (and up to eight cycles). The primary endpoint was the overall response rate (ORR); and secondary endpoints were duration of response (DoR), progression-free survival (PFS), safety, and pharmacokinetics. Patients were classified according to their best overall response after initiation of therapy. Proportions of patients in each response category (complete response [CR], partial response [PR], stable disease, or progressive disease) were summarized along with a two-sided binomial exact 95% confidence intervals (CIs) for the ORR.
Results:
A total of 102 patients were enrolled from 20 centers between August 6th, 2012, and June 18th, 2015. At the time of the primary analysis, the ORR was 73% (95% CI: 63%-81%) per Independent Review Committee (IRC) including 19% CR and 54% PR. With the follow-up period, the median DoR was 16.2 months by IRC and 13.4 months by investigator assessment; the median PFS was 18.6 months and 15.3 months, respectively. The most common non-hematologic adverse events (AEs) were gastrointestinal toxicity, pyrexia, and rash. Grade 3/4 neutropenia was reported in 76% of patients. Serious AEs were reported in 29 patients and five patients died during the study. Pharmacokinetic analysis indicated that the characteristics of bendamustine and its metabolites M3 and M4 were generally consistent with those reported for other ethnicities.
Conclusion:
Bendamustine is an active and effective therapy in Chinese patients with relapsed, indolent B-cell NHL, with a comparable risk/benefit relationship to that reported in North American patients.
Clinical trial registration:
ClinicalTrials.gov, No. NCT01596621; https://clinicaltrials.gov/ct2/show/NCT01596621
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原发性干燥综合征患者单核细胞的全基因组DNA甲基化模式Xuan Luo, Yu Peng, Ying-Ying Chen, An-Qi Wang, Chui-Wen Deng, Lin-Yi Peng, Qing-Jun Wu, Yan Zhao, Yun-Yun Fei, Wen Zhang
中华医学杂志英文版2021年 134卷 11期
DOI: 10.1097/CM9.0000000000001451
摘要
Background:
Epigenetics, especially DNA methylation, plays an important role in the pathogenesis of primary Sjogren syndrome (pSS). Our study aimed to reveal the role of DNA methylation in peripheral monocytes of pSS patients.
Methods:
A total of 11 pSS patients and five age-matched healthy controls (HCs) were included in this study. Monocytes were isolated from peripheral blood mononuclear cells using magnetic microbeads. DNA methylation profiles were generated using Human Methylation 850K BeadChips.
Results:
In monocytes from pSS patients, we identified 2819 differentially methylated positions (DMPs), comprising 1977 hypomethylated- and 842 hypermethylated-DMPs, corresponding to 1313 unique genes when compared with HCs. IFI44L, MX1, PAARP9, and IFITM1, which influence the interferon (IFN) signaling pathway, were among the genes hypomethylated in pSS. Functional analysis of genes with a minimum of two DMPs showed involvement in antigen binding, transcriptional regulation, cell adhesion, IFN-γ pathway, type I IFN pathway, antigen presentation, Epstein-Barr virus infection, human T-lymphotropic virus type 1 virus infection, and metabolic disease-related pathways. In addition, patients with higher serum IgG levels exhibited enrichment in Notch signaling and metabolic-related pathways. Upon comparing monocytes with salivary gland epithelial cells, an important overlap was observed in the cell cycle, cell senescence, and interleukin-17 signaling pathways. The differentially methylated genes were more enriched in the ribosome- and AMP-activated protein kinase signaling pathway in anti-Ro/SSA and anti-La/SSB autoantibodies double-positive patients.
Conclusion:
Genome-wide DNA methylation profiling revealed significant differences in DNA methylation in monocytes isolated from patients with pSS.
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中国三级医院糖尿病患者心血管结局试验和真实世界患者的人群多样性Yi-Ling Zhou, Yong-Gang Zhang, Rui Zhang, You-Lian Zhou, Nan Li, Mi-Ye Wang, Hao-Ming Tian, She-Yu Li
中华医学杂志英文版2021年 134卷 11期
DOI: 10.1097/CM9.0000000000001407
摘要
Background:
Recent cardiovascular outcome trials (CVOTs) changed the therapeutic strategy of guidelines for type 2 diabetes. We compared the characteristics of patients from real-world hospital settings with those of participants in recent pragmatic randomized trials.
Methods:
This electronic medical record (EMR)-based retrospective observational study investigated the data of patients with diabetes from inpatient and outpatient settings in West China Hospital of Sichuan University from January 1, 2011, to June 30, 2019. We identified patients meeting the inclusion criteria of a pragmatic randomized trial (EMPA-REG OUTCOME) based on EMRs and compared their baseline characteristics with those of the trial participants. The cutoff for the clinical significance of each characteristic was set as its minimal clinically important difference based on expert consultation.
Results:
We included 48,257 inpatients and 36,857 outpatients with diabetes and found that 8389 (17.4%) inpatients and 2646 (7.2%) outpatients met the inclusion criteria for the EMPA-REG OUTCOME trial. Compared with the trial population, the realworld inpatients meeting the eligibility criteria of the EMPA-REG OUTCOME had similar age, blood pressure, and lipid profiles but comprised of fewer males, metformin users, anti-hypertensive drug users, and aspirin users, and had a lower body mass index. The group of outpatients meeting the eligibility criteria had fewer males, similar age, fewer metformin users, fewer insulin users, fewer anti-hypertensive drug users, and fewer aspirin users compared with the trial population.
Conclusions:
The trial population in EMPA-REG OUTCOME represents only a small portion of patients with diabetes from the inpatient and outpatient departments of a Chinese tertiary medical center. Evidence localization in different clinical settings and validation are essential to enabling extrapolation of the results from CVOTs in patients with diabetes to Chinese clinical practice.
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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的疗效和安全性：一项真实队列研究Yan Zhao, Lin Cai, Xiao-Yang Liu, Heng Zhang, Jian-Zhong Zhang
中华医学杂志英文版2021年 134卷 11期
DOI: 10.1097/CM9.0000000000001510
摘要
Background:
There have been few real-life dose-comparing studies on the efficacy and safety of secukinumab in Chinese patients with plaque psoriasis. We conducted a real-life cohort study to investigate the efficacy and safety of secukinumab 150 and 300 mg in Chinese patients with moderate-to-severe plaque psoriasis.
Methods:
A total of 106 patients with moderate-to-severe plaque psoriasis were included in this study. Patients received either secukinumab 150 mg or secukinumab 300 mg according to patients’ weights and severity of psoriasis. The treatment continued for at least 24 weeks. The efficacy was evaluated by improvement in the psoriasis area and severity index (PASI) scores. The safety was also analyzed.
Results:
Fifty-nine patients (55.7%) were treated with secukinumab 300 mg and 47 patients (44.3%) were treated with secukinumab 150 mg. After 12-week treatment, PASI75/90/100 responses were achieved in 100%, 97.8%, and 95.7% of patients, respectively, in secukinumab 150 mg group, and the efficacy was maintained to week 24. In secukinumab 300 mg group, PASI75/90/100 responses were achieved in 93.2%, 81.4%, and 76.3% of patients, respectively, at week 12. In this group, PASI75/90/100 responses reached 91.5%, 86.4%, and 79.9%, respectively, at week 24. Biologic-experienced patients had lower responses than biologic-naïve patients. Secukinumab 150 and 300 mg were well tolerated. Five patients discontinued treatment due to poor response, adverse event, or economic reasons.
Conclusions:
This real-life study demonstrated that high PASI 90 and PASI 100 responses were achieved in Chinese psoriasis patients receiving secukinumab 150 or 300 mg. Biologic-naïve was associated with better clinical efficacy.
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仅使用鞘内和全身化疗联合利妥昔单抗治疗中枢神经系统阳性伯基特淋巴瘤患儿的治疗结果Shuang Huang, Lin Jin, Jing Yang, Yan-Long Duan, Meng Zhang, Chun-Ju Zhou, Yong-Hong Zhang
中华医学杂志英文版2021年 134卷 11期
DOI: 10.1097/CM9.0000000000001386
摘要
Background:
With current chemotherapy treatment, >90% of survival has been obtained for Burkitt lymphoma (BL). In this study, the demographic characteristics and treatment outcomes are presented for 78 children in China with central nervous system-positive (CNS+) BL.
Methods:
This retrospective study consecutively enrolled 78 CNS+ BL patients in Beijing Children’s Hospital (BCH) from 2007 to 2019 who received the BCH B-cell non-Hodgkin’s lymphoma regimen (modified by French-American-British mature lymphoma B-cell 96 [FAB/LMB96] C1 arm ± rituximab). Clinical characteristics, methods of disease detection in the CNS, and outcomes were evaluated. Univariate and multivariate analyses were used to assess prognostic factors.
Results:
The median age of 65 boys and 13 girls at the time of diagnosis was 5.7 years (ranging from 1 to 14 years). Patients were followed up for a median time of 34 months (ranging from 1 to 72 months). Bone marrow invasion was found in 38 (48.7%) patients. There were 48 (61.5%), 44 (56.4%), and 25 (32%) patients with cranial nerve palsy, intracerebral mass (ICM), and parameningeal extension, respectively. Abnormal cerebrospinal fluid (CSF) morphology and CSF immunophenotype appeared in 15 (19.2%) and 15 (19.2%) patients, respectively. There were 69 (88.5%) patients treated with chemotherapy combined with rituximab, and nine patients were treated solely with chemotherapy. Finally, five patients died of treatment-related infection, recurrence occurred for 13, and one developed a second tumor. The 3-year overall survival and event-free survival rates were 78.9% ± 4.7% and 71.4% ± 6.0%, respectively. Treatment with chemotherapy only, ICM positivity, and >4 organs involved at diagnosis were independent risk factors.
Conclusions:
Rituximab combined with a modified LMB96 regimen has greatly increased the efficacy of treatment for Chinese children with CNS+ BL, and with the continuous collection of outcome data, treatment-related complications are decreasing. For further verification, a large sample multicentre randomized controlled study should be performed to explore a treatment scheme for Chinese children with even greater efficacy.
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自我给药定性试验性能的头对头比较vs基于实验室的定量粪便免疫化学试验检测结直肠肿瘤Ming Lu, Yu-Han Zhang, Bin Lu, Jie Cai, Cheng-Cheng Liu, Hong-Da Chen, Min Dai
中华医学杂志英文版2021年 134卷 11期
DOI: 10.1097/CM9.0000000000001524
摘要
Background:
Fecal immunochemical tests (FITs) are the most widely used non-invasive tests in colorectal cancer (CRC) screening. However, evidence about the direct comparison of the test performance of the self-administered qualitative a laboratory-based quantitative FITs in a CRC screening setting is sparse.
Methods:
Based on a CRC screening trial (TARGET-C), we included 3144 pre-colonoscopy fecal samples, including 24 CRCs, 230 advanced adenomas, 622 non-advanced adenomas, and 2268 participants without significant findings at colonoscopy. Three self-administered qualitative FITs (Pupu tube) with positivity thresholds of 8.0, 14.4, or 20.8 μg hemoglobin (Hb)/g preset by the manufacturer and one laboratory-based quantitative FIT (OC-Sensor) with a positivity threshold of 20 μg Hb/g recommended by the manufacturer were tested by trained staff in the central laboratory. The diagnostic performance of the FITs for detecting colorectal neoplasms was compared in the different scenarios using the preset and adjusted thresholds (for the quantitative FIT).
Results:
At the thresholds preset by the manufacturers, apart from the qualitative FIT-3, significantly higher sensitivities for detecting advanced adenoma were observed for the qualitative FIT-1 (33.9% [95% CI: 28.7-39.4%]) and qualitative FIT-2 (22.2% [95% CI: 17.7-27.2%]) compared to the quantitative FIT (11.7% [95% CI: 8.4-15.8%]), while at a cost of significantly lower specificities. However, such difference was not observed for detecting CRC. For scenarios of adjusting the positivity thresholds of the quantitative FIT to yield comparable specificity or comparable positivity rate to the three qualitative FITs accordingly, there were no significant differences in terms of sensitivity, specificity, positive/negative predictive values and positive/negative likelihood ratios for detecting CRC or advanced adenoma between the two types of FITs, which was further evidenced in ROC analysis.
Conclusions:
Although the self-administered qualitative and the laboratory-based quantitative FITs had varied test performance at the positivity thresholds preset by the manufacturer, such heterogeneity could be overcome by adjusting thresholds to yield comparable specificities or positivity rates. Future CRC screening programs should select appropriate types of FITs and define the thresholds based on the targeted specificities and manageable positivity rates.
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Circ_0049447通过减少胃癌的增殖、迁移、侵袭和上皮-间质转化而起到肿瘤抑制作用Kai-Wen Tang, Zhe-Xu Guo, Zhong-Hua Wu, Cen Zhou, Jie Sun, Xin Wang, Yong-Xi Song, Zhen-Ning Wang
中华医学杂志英文版2021年 134卷 11期
DOI: 10.1097/CM9.0000000000001494
摘要
Background:
Although increasing abnormal expression of circular RNAs (circRNAs) has been revealed in various cancers, there were a small number of studies about circRNAs in gastric cancer (GC). Here, we explored the expression and function of a novel circRNA, circ_0049447, in GC.
Methods:
A total of 80 GC tissues and non-tumorous tissues were collected from the First Affiliated Hospital of China Medical University. And all cells were cultured with 10% fetal bovine serum and incubated at 37°C and 5% CO2. The expression of circ_0049447 was quantified by real-time polymerase chain reaction. The biological function of circ_0049447 on proliferation, migration, invasion, and epithelial-mesenchymal transition (EMT) was evaluated by cell counting kit-8 (CCK-8), colony formation assay, transwell migration and invasion assay, and Western blotting. Luciferase report assay was used to verify the direct binding between circ_0049447 and predicted microRNA (miRNA). Furthermore, a xenograft mouse model was used to validate the function of circ_0049447 in vivo.
Results:
We demonstrated that circ_0049447 was downregulated in GC (P < 0.001). The area under the receiver operating characteristic curve reached 0.838, while sensitivity was 82.3% and specificity was 77.2%. CCK-8 and colony formation assay showed that overexpression of circ_0049447 could inhibit the proliferation (P < 0.05). Transwell migration and invasion assay showed upregulated circ_0049447 could impede migration in GC cells (P < 0.05). In addition, overexpression of circ_0049447 could impede GC cell EMT. Upregulation of miR-324-5p in GC specimens and direct binding between miR-324-5p with circ_0049447 proven by luciferase reporter assay indicated that circ_0049447 may inhibit GC by sponging certain miRNA.
Conclusion:
Circ_0049447 acts as a tumor suppressor in GC through reducing proliferation, migration, invasion, and EMT, and it is a promising biomarker for diagnosis.
Clinical Observation
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早期替莫唑胺化疗能否推迟年轻高危低级别胶质瘤患者的放疗需求？Ze-Yang Li, Shi-Wen Yuan, Yan-Yan Song, N.U. Farrukh Hameed, Hong Chen, Dong-Xiao Zhuang, Jun-Feng Lu, Fang-Yuan Gong, Abudumijit Aibaidula, Zhi-Feng Shi 等
中华医学杂志英文版2021年 134卷 11期
DOI: 10.1097/CM9.0000000000001434
摘要
神经胶质瘤是进行性和浸润性原发性脑肿瘤。国家综合癌症网络指出，对于高危人群中的低级别胶质瘤（LGGs）患者（<40岁和次全切除），标准策略是最大限度安全切除加放疗和辅助化疗；然而，指南没有解决患者是否需要在诊断后立即进行辅助治疗的问题，因为RTOG 9802。[
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an引起的Weill-Marchesani样综合征FBN1低外显率突变Guo-Yuan Yang, Xi Huang, Bing-Jie Chen, Zhu-Ping Xu
中华医学杂志英文版2021年 134卷 11期
DOI: 10.1097/CM9.0000000000001406
摘要
Weill-Marchesani综合征(WMS)是一种罕见的结缔组织疾病，其特征为短指、身材矮小、关节僵硬、心血管异常和眼部异常，包括微球、白内障、晶状体异位、近视和继发性青光眼。不完全WMS体征的患者被诊断为Weill-Marchesani样综合征（WMS样）。迄今为止，已报道了WMS的常染色体显性(AD)和常染色体隐性(AR)遗传模式。WMS的遗传异质性表明这些基因之间存在联系。仅凭临床表现无法明确区分AR和AD WMS。[
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国人C1矢状管直径的标准值及C1发育不全的定义Yang Wang, Yan An, Wei Tian, Yi-Min Ma
中华医学杂志英文版2021年 134卷 11期
DOI: 10.1097/CM9.0000000000001497
摘要
测量矢状管直径（SCD）对于颈椎评估至关重要。一个小的SCD使患者易患脊髓病。[
Correspondence
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治疗银屑病的小分子抑制剂研究进展Wen-Juan Chen, Chen Peng, Jia-Jing Lu, Yang-Feng Ding, Xing-Zi Li
中华医学杂志英文版2021年 134卷 11期
DOI: 10.1097/CM9.0000000000001351
摘要
致编辑：银屑病是一种慢性多系统炎症性疾病。白细胞介素（IL）-23/T辅助细胞（Th）17通路、肿瘤坏死因子-α和许多炎性细胞因子参与银屑病的发病和发展，相关细胞因子生物学靶点的发现改变了银屑病治疗范式。尽管生物制剂在治疗此类疾病方面是有效的，但应用仍然有限。因此，小分子抑制剂（SMIs）由于简化的合成方法、低成本生产以及口服或局部给药的可能性而在研究人员中获得了相当大的关注。本文总结了临床开发中的SMIs和已批准用于治疗银屑病的SMIs。
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银屑病流行病学筛查工具中文版和银屑病患者早期关节炎问卷的验证Chao-Fan Lu, Xiao-Mei Leng, Xiao-Feng Zeng, Yin Long, Yu Shi
中华医学杂志英文版2021年 134卷 11期
DOI: 10.1097/CM9.0000000000001460
摘要
致编辑：银屑病关节炎(PsA)是一种与银屑病相关的慢性肌肉骨骼疾病。银屑病患者有很高比例的PsA漏诊，这会导致治疗延迟、身体功能变差、影像学进展严重。
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甲襞微循环微量分析检测冠状动脉慢流现象的异常He-Xi Zhang, Nan Ye, Fei Peng, Li-Jian Pan, Yi-Jun Shi, Hui Gong
中华医学杂志英文版2021年 134卷 11期
DOI: 10.1097/CM9.0000000000001437
摘要
致编辑：冠状动脉慢流现象(CSFP)最早由Tambe报道等人1972年。[
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早期食管癌内镜下黏膜下剥离术手术时间的预测因素Jing Wen, Zhong-Sheng Lu, Cui-Hua Liu, Xu-Qiang Bian, Jin Huang
中华医学杂志英文版2021年 134卷 11期
DOI: 10.1097/CM9.0000000000001355
摘要
致编辑：内镜粘膜下剥离术（ESD）已发展成为广泛用于治疗早期食管癌的先进技术。然而，ESD的缺点是其技术困难，并且它与并发症的高发生率、对复杂内窥镜技术的需求和冗长的手术时间有关。研究证实，ESD时间与穿孔、出血、深静脉血栓形成、术后肺炎、CO密切相关2保留，或增加医疗费用。[
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完全外伤性半骨盆切除术的救生治疗1例Jing-Hong Zheng, Hong-Jiang Chen, Xiao-Hui Lu, Di Zhao, Shao-Wei Luo, You-Bin Chen, Jian-Kun Xu, Wen Chen, Yong-Ming Zeng, Lin-Xi Huang 等
中华医学杂志英文版2021年 134卷 11期
DOI: 10.1097/CM9.0000000000001372
摘要
致编辑：创伤性半骨盆切除术（THP）由Turnbull于1978年首次描述，是一种不稳定的韧带或骨性半骨盆损伤，涉及骨盆神经血管束（开放或闭合被膜）的破裂。[
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有助于良好卵母细胞能力和利用率的因素体外高应答者的受精或卵胞浆内单精子注射Wei Xue, Duo-Duo Zhang, Jing-Ran Zhen, Qi Yu
中华医学杂志英文版2021年 134卷 11期
DOI: 10.1097/CM9.0000000000001356
摘要
致编辑：卵母细胞利用率（OUR）描述了卵母细胞发育成可以移植或冷冻保存的可用胚胎的能力。除母体年龄外，卵巢内和/或卵巢外因素引起的异常可能影响卵母细胞-颗粒细胞相互作用、成熟和合子发育。在这项研究中，我们将OUR定义为适用胚胎（卵裂球和囊胚）的数量除以从相应刺激周期中回收的卵母细胞数量。我们用至少15个卵母细胞比较了高和低OUR周期，以确定导致好和差OUR之间巨大差距的因素，以指导有希望的OUR体外受精（IVF）结果。
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肠系膜上动脉压迫综合征合并胃食管反流病的诊治Rui Zhang, Zhi-Tong Li, Xin-Wei Han, Li-Dan Liang, Zhong-Gao Wang, Feng Ji
中华医学杂志英文版2021年 134卷 11期
DOI: 10.1097/CM9.0000000000001430
摘要
致编辑：肠系膜上动脉压迫综合征（SMAS）是一种相对罕见的疾病，是由于腹主动脉与肠系膜上动脉夹角变窄，从而压迫十二指肠第三段。[
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肺典型类癌的特征及治疗策略：一项基于人群的研究Ying Cao, Wen-Cang Gao, Hong-Ye Zhu, Cheng Yao
中华医学杂志英文版2021年 134卷 11期
DOI: 10.1097/CM9.0000000000001433
摘要
致编辑：肺类癌（PC）是一种罕见的高分化神经内分泌肿瘤，仅占所有恶性肺部肿瘤的约2%。[
Corrigendum
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勘误表：脂肪间充质干细胞外来体对角膜基质成纤维细胞活力和细胞外基质合成的影响中华医学杂志英文版2021年 134卷 11期
DOI: 10.1097/CM9.0000000000001481
摘要
在发表于第131卷第6期704-712页的文章“脂肪来源间充质干细胞外来体对角膜基质成纤维细胞活力和细胞外基质合成的影响”中中华医学杂志,[
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勘误表：第一代和第二代药物洗脱支架在稳定型冠状动脉疾病患者中的疗效和安全性比较：一项单中心回顾性研究中华医学杂志英文版2021年 134卷 11期
DOI: 10.1097/CM9.0000000000001482
摘要
在第130卷第14期第1655页的文章《第一代和第二代药物洗脱支架在稳定型冠状动脉疾病患者中的疗效和安全性比较：一项单中心回顾性研究》中中华医学杂志,[
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