MedNexus
2021年 · 第134卷第17期
出版日期 2021-09-05电子版 ￥0.00元
MedNexus
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- Original Article
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- Technical Notes
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Review Article
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急性呼吸窘迫综合征：关注继发性损伤Pan Pan, Long-Xiang Su, Da-Wei Liu, Xiao-Ting Wang
中华医学杂志英文版2021年 134卷 17期
DOI: 10.1097/CM9.0000000000001694
摘要
Acute respiratory distress syndrome (ARDS) is one of the most common severe diseases seen in the clinical setting. With the continuous exploration of ARDS in recent decades, the understanding of ARDS has improved. ARDS is not a simple lung disease but a clinical syndrome with various etiologies and pathophysiological changes. However, in the intensive care unit, ARDS often occurs a few days after primary lung injury or after a few days of treatment for other severe extrapulmonary diseases. Under such conditions, ARDS often progresses rapidly to severe ARDS and is difficult to treat. The occurrence and development of ARDS in these circumstances are thus not related to primary lung injury; the real cause of ARDS may be the "second hit" caused by inappropriate treatment. In view of the limited effective treatments for ARDS, the strategic focus has shifted to identifying potential or high-risk ARDS patients during the early stages of the disease and implementing treatment strategies aimed at reducing ARDS and related organ failure. Future research should focus on the prevention of ARDS.
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慢性阻塞性肺疾病小气道阻塞的计算机断层扫描识别表型Tao Li, Hao-Peng Zhou, Zhi-Jun Zhou, Li-Quan Guo, Linfu Zhou
中华医学杂志英文版2021年 134卷 17期
DOI: 10.1097/CM9.0000000000001724
摘要
Chronic obstructive pulmonary disease (COPD) is a heterogeneous disease characteristic of small airway inflammation, obstruction, and emphysema. It is well known that spirometry alone cannot differentiate each separate component. Computed tomography (CT) is widely used to determine the extent of emphysema and small airway involvement in COPD. Compared with the pulmonary function test, small airway CT phenotypes can accurately reflect disease severity in patients with COPD, which is conducive to improving the prognosis of this disease. CT measurement of central airway morphology has been applied in clinical, epidemiologic, and genetic investigations as an inference of the presence and severity of small airway disease. This review will focus on presenting the current knowledge and methodologies in chest CT that aid in identifying discrete COPD phenotypes.
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冠状病毒病2019疫苗：全球研究前景和潜在风险Hu-Da-Chuan Jiang, Yan-Yang Tao, Si-Yue Jia, Jing-Xin Li, Feng-Cai Zhu
中华医学杂志英文版2021年 134卷 17期
DOI: 10.1097/CM9.0000000000001688
摘要
With the outbreak of the coronavirus disease 2019 (COVID-19) pandemic, the importance of vaccines in epidemic prevention and public health has become even more obvious than ever. However, the emergence of multiple severe acute respiratory syndrome coronavirus 2 variants worldwide has raised concerns about the effectiveness of current COVID-19 vaccines. Here, we review the characteristics of COVID-19 vaccine candidates in five platforms and the latest clinical trial results of them. In addition, we further discuss future directions for the research and development of the next generation of COVID-19 vaccines. We also summarize the serious adverse events reported recently after the large-scale vaccination with the current COVID-19 vaccines, including the thromboembolism caused by the AstraZeneca and Johnson & Johnson vaccines.
Perspective
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2019年中国冠状病毒病后肺康复的未来展望Hong-Mei Zhao, Peng-Ming Yu, Chen Wang
中华医学杂志英文版2021年 134卷 17期
DOI: 10.1097/CM9.0000000000001700
摘要
有大量证据支持肺康复作为慢性呼吸系统疾病患者综合管理的一个安全且具有成本效益的组成部分的作用。[
Original Article
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实时逆转录-聚合酶链反应检测严重急性呼吸综合征冠状病毒2型及其变种Rou-Jian Lu, Li Zhao, Bao-Ying Huang, Fei Ye, Wen-Ling Wang, Wen-Jie Tan
中华医学杂志英文版2021年 134卷 17期
DOI: 10.1097/CM9.0000000000001687
摘要
Background:
With the ongoing worldwide coronavirus disease 2019 (COVID-19) pandemic, an increasing number of viral variants are being identified, which poses a challenge for nucleic acid-based diagnostic tests. Rapid tests, such as real-time reverse transcription-polymerase chain reaction (rRT-PCR), play an important role in monitoring COVID-19 infection and controlling its spread. However, the changes in the genotypes of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) variants may result in decreased sensitivity of the rRT-PCR assay and it is necessary to monitor the mutations in primers and probes of SARS-CoV-2 detection over time.
Methods:
We developed two rRT-PCR assays to detect the RNA-dependent RNA polymerase (RdRp) and nucleocapsid (N) genes of SARS-CoV-2. We evaluated these assays together with our previously published assays targeting the ORF1ab and N genes for the detection and confirmation of SARS-CoV-2 and its variants of concern (VOCs). In addition, we also developed two rRT-PCR assays (S484K and S501Y) targeting the spike gene, which when combined with the open reading frames (ORF)1ab assay, respectively, to form duplex rRT-PCR assays, were able to detect SARS-CoV-2 VOCs (lineages B.1.351 and B.1.1.7).
Results:
Using a SARS-CoV-2 stock with predetermined genomic copies as a standard, the detection limit of both assays targeting RdRp and N was five copies/reaction. Furthermore, no cross-reactions with six others human CoVs (229E, OC43, NL63, HKU1, severe acute respiratory syndrome coronavirus and Middle East respiratory syndrome coronavirus) were observed using these assays. In addition, the S484K and S501Y assays were combined with the ORF1ab assay, respectively.
Conclusions:
Four rRT-PCR assays (RdRp, N, S484K, and S501Y) were used to detect SARS-CoV-2 variants, and these assays were shown to be effective in screening for multiple virus strains.
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核Dbf2相关激酶1通过磷酸化Yes相关蛋白在胶质母细胞瘤中发挥肿瘤抑制作用Bin Chen, Bin Liu, Tao Yu, Yun-Feng Han, Chao Wu, Zhen-Yu Wang
中华医学杂志英文版2021年 134卷 17期
DOI: 10.1097/CM9.0000000000001653
摘要
Background:
The Nuclear Dbf2-related (NDR1) kinase is a member of the NDR/LATS family, which was a supplementary of Hippo pathway. However, whether NDR1 could inhibit glioblastoma (GBM) growth by phosphorylating Yes-associated protein (YAP) remains unknown. Meanwhile, the role of NDR1 in GBM was not clear. This study aimed to investigate the role of NDR1-YAP pathway in GBM.
Methods:
Bioinformation analysis and immunohistochemistry (IHC) were performed to identify the expression of NDR1 in GBM. The effect of NDR1 on cell proliferation and cell cycle was analyzed utilizing CCK-8, clone formation, immunofluorescence and flow cytometry, respectively. In addition, the xenograft tumor model was established as well. Protein interaction was examined by Co-immunoprecipitation and immunofluorescence to observe co-localization.
Results:
Bioinformation analysis and IHC of our patients’ tumor tissues showed that expression of NDR1 in tumor tissue was relatively lower than that in normal tissues and was positively related to a lower survival rate. NDR1 could markedly reduce the proliferation and colony formation of U87 and U251. Furthermore, the results of flow cytometry showed that NDR1 led to cell cycle arrest at the G1 phase. Tumor growth was also inhibited in xenograft nude mouse models in NDR1-overexpression group. Western blotting and immunofluorescence showed that NDR1 could integrate with and phosphorylate YAP at S127 site. Meanwhile, NDR1 could mediate apoptosis process.
Conclusion:
In summary, our findings point out that NDR1 functions as a tumor suppressor in GBM. NDR1 is identified as a novel regulator of YAP, which gives us an in-depth comprehension of the Hippo signaling pathway.
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鼻咽癌患者放化疗前循环CD39+CD8+T细胞与预后的关系Dan-Ning Dong, Pei-Wen Fan, Ya-Ning Feng, Gui-Hai Liu, Yan-Chun Peng, Tao Dong, Ruo-Zheng Wang, Jin-Ming Yu
中华医学杂志英文版2021年 134卷 17期
DOI: 10.1097/CM9.0000000000001745
摘要
Background:
The mortality rate among patients with nasopharyngeal carcinoma (NPC) has improved significantly with the advent of chemoradiotherapy strategies. However, distant metastasis remains problematic. Tumor-specific reactivity in cancer patients has been detected exclusively in CD39+ T cells, particularly in CD39+CD103+ T cells. Circulating cancer-specific T cells are important for protecting against metastasis. This study aimed to evaluate the predictive value of circulating CD39+CD8+ T cells for metastasis in patients with NPC.
Methods:
We performed a cross-sectional, longitudinal study of 55 patients with newly diagnosed NPC of stage III-IVa. All patients were initially treated with standard combined chemoradiotherapy. Blood samples were obtained from 24 patients before and at 1 month and 6 months after treatment. T cell expression of CD39 and CD103, together with the markers of T cell exhaustion programmed death-1 (PD-1)/T cell immunoglobulin and mucin domain-containing protein 3 (Tim-3) and markers of cell differentiation CD27/CC-chemokine receptor 7/CD45RA, was examined by flow cytometry. The Wilcoxon rank-sum test analysis was used to analyze the differences between two groups. Kaplan-Meier analysis was used for analysis of progression-free survival (PFS).
Results:
The expression of circulating CD39+CD8+ and CD39+CD103+ CD8+ T cells was significantly higher in patients without distant metastasis (CD39+CD8+: 6.52% [1.24%, 12.58%] vs. 2.41% [0.58%, 5.31%], Z=-2.073, P=0.038 and CD39+CD103+ CD8+: 0.72% [0.26%, 2.05%] vs. 0.26% [0.12%, 0.64%], Z=-2.313, P = 0.021). Most CD39+ T cells did not express PD-1 or Tim-3. Patients with high expression of CD39+CD103+CD8+ T cells had better PFS than patients with low expression (log rank value = 4.854, P = 0.028). CD39+CD8+ T cells were significantly elevated at 1-month post-treatment (10.02% [0.98%, 17.42%] vs. 5.91% [0.61%, 10.23%], Z = -2.943, P = 0.003). The percentage of advanced differentiated CD8+ T cells also increased at 1-month post-treatment compared with pre-treatment (33.10% [21.60%, 43.05%] vs. 21.00% [11.65%, 43.00%], Z =-2.155, P = 0.031). There was a significant correlation between elevated CD39+CD8+ T cells and increased effector memory T cells (intermediate stage: r = 0.469, P = 0.031; advanced stage: r = 0.508, P = 0.019).
Conclusions:
CD39+CD8+ circulating T cells have preserved effector function, contributing to an improved prognosis and a reduced risk of metastasis among NPC patients. These cells may thus be a useful predictive marker for a better prognosis in patients with NPC.
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中国人血清尿酸水平与死亡率的关系Dong-Yuan Chang, Jin-Wei Wang, Min Chen, Lu-Xia Zhang, Ming-Hui Zhao
中华医学杂志英文版2021年 134卷 17期
DOI: 10.1097/CM9.0000000000001631
摘要
Background:
Whether there is an association between serum uric acid (SUA) level and risk of mortality in the general population remains unclear. Based on the China National Survey of Chronic Kidney Disease linked to mortality data, a population-based cohort study was performed to investigate the association between SUA level and all-cause mortality, cardiovascular disease (CVD) mortality, and cancer mortality in China.
Methods:
The survival status of participants in the cross-sectional survey was identified from January 1, 2006 to December 31, 2017. Only 33,268 individuals with complete SUA data among the 47,204 participants were included in the analysis. We determined the rates of all-cause mortality, CVD mortality, and cancer mortality. We used Cox proportional hazards regression models to evaluate the effect of the SUA level on mortality.
Results:
During a total of 297,538.4 person-years of follow-up, 1282 deaths occurred. In the Cox proportional hazards regression model, the rate of all-cause mortality, CVD mortality, and cancer mortality had a U-shaped association with SUA levels only in men, whereas no significant associations were detected in women. For all-cause mortality in men, the multivariable-adjusted hazard ratios (HRs) in the first, second, and fourth quartiles compared with the third quartile were 1.31 (95% confidence interval [CI] 1.04-1.67), 1.17 (95% CI 0.92-1.47), and 1.55 (95% CI 1.24-1.93), respectively. For CVD mortality, the corresponding HRs were 1.47 (95% CI 1.00-2.18), 1.17 (95% CI 0.79-1.75), and 1.67 (95% CI 1.16-2.43), respectively. For the cancer mortality rate, only a marginally significant association was detected in the fourth quartile compared with the third quartile with an HR of 1.43 (95% CI 0.99-2.08).
Conclusions:
The association between SUA and mortality differed by sex. We demonstrated a U-shaped association with SUA levels for all-cause and CVD mortalities among men in China.
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小猪肝高频不可逆电穿孔与不可逆电穿孔消融的比较：DCE-MRI随访及病理观察Jing Li, Xiao-Bo Zhang, Jing-Jing Wang, Lu-Jia Jin, Hu-Sheng Shan, Xiao Zhang, Li Ma, Xiao-Dong Xue, Xin Zhang, Zhong-Liang Zhang 等
中华医学杂志英文版2021年 134卷 17期
DOI: 10.1097/CM9.0000000000001663
摘要
Background:
High-frequency irreversible electroporation (H-FIRE) is a novel, next-generation nanoknife technology with the advantage of relieving irreversible electroporation (IRE)-induced muscle contractions. However, the difference between IRE and H-FIRE with distinct ablation parameters was not clearly defined. This study aimed to compare the efficacy of the two treatments in vivo.
Methods:
Ten Bama miniature swine were divided into two group: five in the 1-day group and five in the 7-day group. The efficacy of IRE and H-FIRE ablation was compared by volume transfer constant (Krans), rate constant (Kep) and extravascular extracellular volume fraction (Ve) value of dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI), size of the ablation zone, and histologic analysis. Each animal underwent the IRE and H-FIRE. Temperatures of the electrodes were measured during ablation. DCE-MRI images were obtained 1, 4, and 7 days after ablation in the 7-day group. All animals in the two groups were euthanized 1 day or 7 days after ablation, and subsequently, IRE and H-FIRE treated liver tissues were collected for histological examination. Student’s t test or Mann-Whitney U test was applied for comparing any two groups. One-way analysis of variance (ANOVA) test and Welch’s ANOVA test followed by Holm-Sidak’s multiple comparisons test, one-way ANOVA with repeated measures followed by Bonferroni test, or Kruskal-Wallis H test followed by Dunn’s multiple comparison test was used for multiple group comparisons and post hoc analyses. Pearson correlation coefficient test was conducted to analyze the relationship between two variables.
Results:
Higher Ve was seen in IRE zone than in H-FIRE zone (0.14 ± 0.02 vs. 0.08 ± 0.05, t= 2.408, P = 0.043) on day 4, but no significant difference was seen in Ktrans or Kep between IRE and H-FIRE zones at all time points (all P > 0.05). For IRE zone, the greatest Ktrans was seen on day 7, which was significantly higher than that on day 1 (P = 0.033). The ablation zone size of H-FIRE was significantly larger than IRE 1 day (4.74 ± 0.88 cm2vs. 3.20 ± 0.77 cm2, t = 3.241, P = 0.009) and 4 days (2.22 ± 0.83 cm2vs. 1.30 ± 0.50 cm2, t = 2.343, P = 0.041) after treatment. Apoptotic index (0.05 ± 0.02 vs. 0.73 ± 0.06 vs. 0.68 ± 0.07, F = 241.300, P < 0.001) and heat shock protein 70 (HSP70) (0.03 ± 0.01 vs. 0.46 ± 0.09 vs. and 0.42 ± 0.07, F= 64.490, P < 0.001) were significantly different between the untreated, IRE and H-FIRE zones, but no significant difference was seen in apoptotic index or HSP70 between IRE and H-FIRE zone (both P > 0.05). Electrode temperature variations were not significantly different between the two zones (18.00 ± 3.77°C vs. 16.20 ± 7.45°C, t = 0.682, P = 0.504). The Ktrans value (r = 0.940, P = 0.017) and the Kep value (r = 0.895, P = 0.040) of the H-FIRE zone were positively correlated with the number of hepatocytes in the ablation zone.
Conclusions:
H-FIRE showed a comparable ablation effect to IRE. DCE-MRI has the potential to monitor the changes of H-FIRE ablation zone.
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LncRNA AFAP1-AS1/miR-27b-3p/VEGF-C轴调节宫颈癌细胞干细胞特性Meng Xia, Li-Jun Duan, Bi-Nan Lu, Yu-Zhou Pang, Zong-Ran Pang
中华医学杂志英文版2021年 134卷 17期
DOI: 10.1097/CM9.0000000000001665
摘要
Background:
Long non-coding RNA (lncRNA) actin filament-associated protein 1 antisense RNA 1 (AFAP1-AS1) functions as a competing endogenous RNA to regulate target genes expression by sponging microRNAs (miRs) to play cancer-promoting roles in cancer stem cells. However, the regulatory mechanism of AFAP1-AS1 in cervical cancer (CC) stem cells is unknown. The present study aimed to provide a new therapeutic target for the clinical treatment of CC.
Methods:
Hyaluronic acid receptor cluster of differentiation 44 variant exon 6 (CD44v6)(+) CC cells were isolated by flow cytometry (FCM). Small interfering RNAs of AFAP1-AS1 (siAFAP1-AS1) were transfected into the (CD44v6)(+) cells. The levels of AFAP1-AS1 were measured by quantitative real-time PCR (qRT-PCR). Sphere formation assay, cell cycle analysis, and Western blotting were used to detect the effect of siAFAP1-AS1. RNA pull-down and luciferase reporter assay were used to verify the relationship between miR-27b-3p and AFAP1-AS1 or vascular endothelial growth factor (VEGF)-C.
Results:
CD44v6(+) CC cells had remarkable stemness and a high level of AFAP1-AS1. However, AFAP1-AS1 knockdown with siAFAP1-AS1 suppressed the cell cycle transition of G(1)/S phase and inhibited self-renewal of CD44v6(+) CC cells, the levels of the stemness markers octamer-binding transcription factor 4 (OCT4), osteopontin (OPN), and cluster of differentiation 133 (CD133), and the epithelial-mesenchymal transition (EMT)-related proteins Twist1, matrix metalloprotease (MMP)-9, and VEGF-C. In the mechanism study, miR-27b-3p/VEGF-C signaling was demonstrated to be a key downstream of AFAP1-AS1 in the CD44v6(+) CC cells.
Conclusions:
LncRNA AFAP1-AS1 knockdown inhibits the CC cell stemness by upregulating miR-27b-3p to suppress VEGF-C.
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3级子宫内膜样癌淋巴转移相关的临床特征：一项回顾性横断面研究Bo Wang, Qian Wang, Yue Shi, Wen-Yu Shao, Jiong-Bo Liao, Xue-Zhen Luo, Xiao-Jun Chen, Chao Wang
中华医学杂志英文版2021年 134卷 17期
DOI: 10.1097/CM9.0000000000001749
摘要
Background
Endometrial cancer (EC) has been one of the most general cancers with respect to gynecological malignancies; however, there are debates on clinical strategies concerning treatments especially for patients with grade 3 (G3) endometroid endometrial cancer (EEC). Present study aimed to evaluate the lymphatic metastasis (LM) related factors and figure out the necessity of lymphadenectomy for G3 EEC patients.
Methods
From January 2009 to April 2019, 3751 EC patients were admitted to Obstetrics and Gynecology Hospital of Fudan University. Clinical characteristics include age, grade, stage, and clinical pathological features. A total of 1235 EEC patients were involved in the multivariable analysis. Three hundred and eighty-one patients were involved in the survival analysis and the data attributed to sufficient follow-up information. Kaplan-Meier curve and log-rank test were utilized to analyze the survival rate.
Results
Among the 1235 EEC patients, 181 (14.7%) were categorized as G3 and 1054 (85.3%) were grade 1 to grade 2 (G1-2). Multivariate analysis demonstrated that lymphovascular space invasion, adnexal involvement, and cervical stroma involvement were independent risk factors of LM in G3 cohort with odds ratio 3.4, 5.8, and 8.9; 95% confidence interval 1.1-10.6, 1.5-22.4, and 2.8-28.0, respectively. LM rates increased from 3.3% (3/92) to 75% (9/12) for G3 EEC cohort as related factor numbers increased from one to three. There were no differences between G3 and G1-2 EEC in overall survival and progression free survival. Additionally, no survival advantage was observed for G3 EEC patients at early stage with different plans of adjuvant treatment.
Conclusions
For G3 EEC patients without other pathological positive factor, the LM rate is lower than those with other pathological positive factor. Survival analysis showed no difference between G3 cohort and G1-2 cohort. Also, different adjuvant treatments had no impact on the overall survival for G3 EEC patients.
Clinical Observation
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2019冠状病毒病（COVID-19）患者气管插管：中国横断面调查Zhen Liu, Hong-Yu Zhao, Ming-Zhang Zuo
中华医学杂志英文版2021年 134卷 17期
DOI: 10.1097/CM9.0000000000001635
摘要
冠状病毒疾病2019（新冠肺炎）在全球范围内造成了巨大的人类生命损失。住院患者的气管插管率估计为2.3%。[
Technical Notes
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三维打印模型上鼻内入路和翼点入路夹闭前交通动脉瘤的比较分析Kun Qin, Yue Wang, Ge Tian, Jian-Tao Zheng, Hui Jiang, Kai Tang, Hang Shu, Dong Zhou, Guang-Zhong Chen
中华医学杂志英文版2021年 134卷 17期
DOI: 10.1097/CM9.0000000000001593
摘要
前交通动脉（ACoA）动脉瘤在颅内动脉瘤中所占比例最大，最容易破裂。[
Rapid Report
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间充质干细胞通过调节卵清蛋白诱导的哮喘小鼠辅助性T细胞17/调节性T细胞平衡减轻气道炎症Shao-Lin Zeng, Juan Cui, Ke Hu, Han-Xiang Nie, Yun-Ting Zhang
中华医学杂志英文版2021年 134卷 17期
DOI: 10.1097/CM9.0000000000001699
摘要
哮喘被认为是以慢性气道炎症和重塑为特征的免疫失调。越来越多的证据表明，哮喘表现出各种炎症特征和细胞类型。最近，调节性T细胞（Tregs）和T辅助细胞（Th）17细胞被描述为与Th1和Th2细胞不同的两个亚群，并且Treg/Th17失衡与哮喘的发展相关。
Correspondence
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基于培美曲塞的再激发化疗为最初受益的晚期肺腺癌患者提供了一种选择Jia-Ni Wang, Quan-Hui Qiao, Xing-Sheng Hu, Yu-Tao Liu, Zhi-Jie Wang, Jian-Chun Duan, Yu Feng, Hao-Hua Zhu
中华医学杂志英文版2021年 134卷 17期
DOI: 10.1097/CM9.0000000000001511
摘要
致编辑：培美曲塞加铂（顺铂或卡铂）化疗双联疗法被广泛推荐作为未发现基因突变的非小细胞肺癌（NSCLC）的标准一线治疗。[
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2019年冠状病毒病大流行期间使用单个器官供体的肺进行双叶肺移植和单肺移植Feng Liu, Michael K.Y. Hsin, Ming Wu, Man Huang, Jing-Yu Chen
中华医学杂志英文版2021年 134卷 17期
DOI: 10.1097/CM9.0000000000001630
摘要
致编辑：在中国2019冠状病毒病（COVID-19）疫情期间，尸体器官捐赠急剧减少，这加剧了肺移植（LTx）患者的等候名单发病率和死亡率。我们报告了一个病例，其中我们能够通过使用供体的左肺为一个受体进行单个左侧LTx来最大限度地利用来自单个尸体供体的肺，并且通过将供体的右肺进行二分，我们能够为另一个受体进行双侧肺叶移植。
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肺腺癌免疫微环境中预后基因的鉴定Lian-Kui Han, Qi-Lin Huai, Wei Guo, Peng Song, De-Miao Kong, Shu-Geng Gao
中华医学杂志英文版2021年 134卷 17期
DOI: 10.1097/CM9.0000000000001367
摘要
致编辑：高度恶性的肺腺癌（LUAD）是肺癌最常见的组织学亚型，也是世界上癌症相关死亡的主要原因。[
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基于m6A RNA甲基化调节因子的肺腺癌标记的建立和验证Wei Guo, Qi-Lin Huai, Si-Jin Sun, Lei Guo, Xue-Min Xue, Peng Song, Jian-Ming Ying, Yi-Bo Gao, Shu-Geng Gao, Jie He
中华医学杂志英文版2021年 134卷 17期
DOI: 10.1097/CM9.0000000000001528
摘要
致编辑：原发性肺癌是最常诊断的恶性肿瘤类型，是全球癌症死亡的主要原因。非小细胞肺癌(NSCLC)占原发性肺癌总发病率的80%至85%，并分为两种不同的组织学亚型：肺腺癌(LUAD)和肺鳞状细胞癌(LUSC)。LUAD占所有原发性肺癌病例的近30%至35%，并且在大多数国家其复发似乎正在增加。[
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新冠肺炎患者病毒清除的时间和危险因素Chao-Jie Wei, Xing-Xing Hu, Guang-Ming Ye, Jian-Ming Yang, Zhen-Shun Cheng, Xing-Huan Wang
中华医学杂志英文版2021年 134卷 17期
DOI: 10.1097/CM9.0000000000001467
摘要
致编辑：2019冠状病毒病（COVID-19）已成为全球大流行。为了最大限度地降低病毒在社区传播的风险，一些国家要求对相隔≥24小时采集的鼻咽拭子进行两次严重急性呼吸综合征冠状病毒2型（新型冠状病毒）RNA逆转录聚合酶链反应（RT-PCR）阴性结果，以便出院和停止隔离。因此，了解病毒清除的时间至关重要。然而，报告新冠肺炎患者病毒清除时间及其危险因素的数据有限。[
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胰腺癌患者循环瘦素和脂联素水平的研究Qi-Hang Yuan, Li-Long Zhang, Yao Xu, Xu Chen, Biao Zhang, Lun-Xu Li, Shuang Li, Dong Shang
中华医学杂志英文版2021年 134卷 17期
DOI: 10.1097/CM9.0000000000001509
摘要
致编辑：胰腺癌（PC）的病因和发病机制知之甚少。人们早就认识到，各种相互交织的因素，包括遗传易感性和环境刺激（如香烟、糖尿病和肥胖），是PC患者高发病率和高死亡率的潜在危险因素。[
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识别KIF20A作为透明细胞肾细胞癌的肿瘤生物标志物和转运蛋白Wen Xiao, Ke Chen, Hua-Geng Liang, Xiao-Ping Zhang
中华医学杂志英文版2021年 134卷 17期
DOI: 10.1097/CM9.0000000000001331
摘要
致编辑：肾细胞癌（RCC）是成人中十大主要癌症类型之一。目前的研究表明，透明细胞肾细胞癌（ccRCC）仍然是一种致命的肿瘤疾病，并与大多数癌症相关的死亡有关。[
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全身性自身免疫性疾病与复发性妊娠丢失的诊治研究进展Rui Gao, Xun Zeng, Lang Qin
中华医学杂志英文版2021年 134卷 17期
DOI: 10.1097/CM9.0000000000001691
摘要
致编辑：复发性妊娠丢失（RPL）被定义为妊娠24周前两次或两次以上的妊娠丢失，它影响约1%至2%的夫妇。[
Corrigendum
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勘误表：淀粉样蛋白和tau阳性轻度认知障碍：痴呆进展的临床和生物标志物特征中华医学杂志英文版2021年 134卷 17期
DOI: 10.1097/CM9.0000000000001765
摘要
在文章“淀粉样蛋白和tau阳性轻度认知障碍：痴呆进展的临床和生物标志物特征”中，该文章出现在第134卷第14期第1709页中华医学杂志，应在作者部分添加以下文字“阿尔茨海默病神经成像倡议”。完整的作者应更正为“Hong-Chun Wei1,李冰1, Kok Pin Ng2、清-*赋3,董胜杰4,毛文巴1,闵孔5;阿尔茨海默病神经影像计划”。第1717页，资助部分应更正为“本研究得到山东省重点研发项目（编号：2018GSF118235）、山东省自然科学基金（编号：ZR2016HL16）和青岛大学附属烟台毓璜顶医院青年科研启动基金（编号：2020-25）的资助。”
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