MedNexus
2021年 · 第134卷第19期
出版日期 2021-10-05电子版 ￥0.00元
MedNexus
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Consensus Statement
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早期乳腺癌患者多基因检测临床实践指南：中国乳腺外科学会（CSBrS）实践指南2021Jiu-Jun Zhu, De-Chuang Jiao, Min Yan, Xu-Hui Guo, Ya-Jie Zhao, Xiu-Chun Chen, Cheng-Zheng Wang, Zhen-Duo Lu, Lian-Fang Li, Shu-De Cui 等
中华医学杂志英文版2021年 134卷 19期
DOI: 10.1097/CM9.0000000000001409
摘要
多基因检测在早期浸润性乳腺癌患者化疗决策中的作用已得到广泛认可。2017年，美国临床肿瘤学会（ASCO）多基因谱分析临床指南重点提高了MammaPrint临床使用的建议强度®.[
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乳房切除术后乳房重建临床实践指南：中国乳腺外科学会（CSBrS）实践指南2021Yan-Shuang Li, Jun-Xian Du, Hong-Chuan Jiang, Wei Zhu, Chinese Society of Breast Surgery
中华医学杂志英文版2021年 134卷 19期
DOI: 10.1097/CM9.0000000000001611
摘要
为促进中国乳房切除术后乳房重建的标准化，中国乳腺外科学会（CSBrS）通过文献综述和专家讨论确定了乳房切除术后乳房重建在临床实践中的关键问题，然后根据建议评估、开发和评估建议的分级，并基于中国临床实践的可及性，通过系统评估相关已发表证据，制定了CSBrS乳房切除术后乳房重建临床实践指南（2021版）。该指南为中国乳腺外科医生提供了参考。
Review Article
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肝细胞癌手术切除后经导管动脉化疗栓塞：关注其争议和最有可能受益患者的筛选Zhan-Qi Wei, Yue-Wei Zhang
中华医学杂志英文版2021年 134卷 19期
DOI: 10.1097/CM9.0000000000001767
摘要
Surgical resection (SR) is recommended as a radical procedure in the treatment of hepatocellular carcinoma (HCC). However, postoperative recurrence negatively affects the long-term efficacy of SR, and preoperative adjuvant therapy has therefore become a research hotspot. Some clinicians adopt transcatheter arterial chemoembolization (TACE) as a preoperative adjuvant therapy in patients undergoing SR to increase the resection rate, reduce tumor recurrence, and improve the prognosis. However, the findings of the most relevant studies remain controversial. Some studies have confirmed that preoperative TACE cannot improve the long-term survival rate of patients with HCC and might even negatively affect the resection rate. Which factors influence the efficacy of preoperative TACE combined with SR is a topic worthy of investigation. In this review, existing clinical studies were analyzed with a particular focus on several topics: screening of the subgroups of patients most likely to benefit from preoperative TACE, exploration of the optimal treatment regimen of preoperative TACE, and determination of the extent of tumor necrosis as the deciding prognostic factor.
Medical Progress
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脑出血与小血管疾病Qi Li, Zi-Jie Wang, Anand Viswanathan
中华医学杂志英文版2021年 134卷 19期
DOI: 10.1097/CM9.0000000000001620
摘要
自发性脑出血（ICH）是一种严重的危及生命的事件，发病率和死亡率最高。ICH是一种全球性负担，每年影响约200万人。据估计，超过三分之一的ICH患者在发病的第一个月内死亡，40%的幸存者仍然残疾。然而，缺乏针对ICH的循证疗法。[
Commentary
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评“一个简单易行的风险模型预测中国房颤患者1年缺血性卒中和全身栓塞”Yi-Gang Li, Chang-Qi Gong
中华医学杂志英文版2021年 134卷 19期
DOI: 10.1097/CM9.0000000000001608
摘要
在考虑抗凝治疗之前，缺血性卒中的风险分层对于房颤（AF）患者至关重要。根据目前的房颤管理指南，约90%的房颤患者应接受抗凝治疗，房颤患者卒中死亡的风险约为68%。因此，准确定义急需抗凝治疗的患者非常重要。在此背景下，Ma的研究结果等人[
Original Article
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一个简单易行的预测中国房颤患者1年缺血性卒中和全身栓塞的风险模型Chao Jiang, Tian-Ge Chen, Xin Du, Xiang Li, Liu He, Yi-Wei Lai, Shi-Jun Xia, Rong Liu, Yi-Ying Hu, Ying-Xue Li 等
中华医学杂志英文版2021年 134卷 19期
DOI: 10.1097/CM9.0000000000001515
摘要
Background:
Accurate prediction of ischemic stroke is required for deciding anticoagulation use in patients with atrial fibrillation (AF). Even though only 6% to 8% of AF patients die from stroke, about 90% are indicated for anticoagulants according to the current AF management guidelines. Therefore, we aimed to develop an accurate and easy-to-use new risk model for 1-year thromboembolic events (TEs) in Chinese AF patients.
Methods:
From the prospective China Atrial Fibrillation Registry cohort study, we identified 6601 AF patients who were not treated with anticoagulation or ablation at baseline. We selected the most important variables by the extreme gradient boosting (XGBoost) algorithm and developed a simplified risk model for predicting 1-year TEs. The novel risk score was internally validated using bootstrapping with 1000 replicates and compared with the CHA2DS2-VA score (excluding female sex from the CHA2DS2-VASc score).
Results:
Up to the follow-up of 1 year, 163 TEs (ischemic stroke or systemic embolism) occurred. Using the XGBoost algorithm, we selected the three most important variables (congestive heart failure or left ventricular dysfunction, age, and prior stroke, abbreviated as CAS model) to predict 1-year TE risk. We trained a multivariate Cox regression model and assigned point scores proportional to model coefficients. The CAS scheme classified 30.8% (2033/6601) of the patients as low risk for TE (CAS score = 0), with a corresponding 1-year TE risk of 0.81% (95% confidence interval [CI]: 0.41%-1.19%). In our cohort, the C-statistic of CAS model was 0.69 (95% CI: 0.65-0.73), higher than that of CHA2DS2-VA score (0.66, 95% CI: 0.62-0.70, Z = 2.01, P = 0.045). The overall net reclassification improvement from CHA2DS2-VA categories (low = 0/high ≥1) to CAS categories (low = 0/high ≥1) was 12.2% (95% CI: 8.7%-15.7%).
Conclusion:
In Chinese AF patients, a novel and simple CAS risk model better predicted 1-year TEs than the widely-used CHA2DS2- VA risk score and identified a large proportion of patients with low risk of TEs, which could potentially improve anticoagulation decision-making.
Trial Registration:
www.chictr.org.cn (Unique identifier No. ChiCTR-OCH-13003729).
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功能性二尖瓣反流合并舒张早期跨二尖瓣速度与舒张早期二尖瓣环速度比值增加与休克患者的不良预后相关Ran Zhou, Tongjuan Zou, Wanhong Yin, Xiaoting Wang, Yan Kang, Chinese Critical Ultrasound Study Group (CCUSG)
中华医学杂志英文版2021年 134卷 19期
DOI: 10.1097/CM9.0000000000001756
摘要
Background:
Functional mitral regurgitation (FMR) is common in critically ill patients and may cause left atrial (LA) pressure elevation. This study aims to explore the prognostic impact of synergistic LA pressure elevation and FMR in patients with shock.
Methods:
We retrospectively screened 130 consecutive patients of 175 patients with shock from April 2016 to June 2017. The incidence and impact of FMR and early diastolic transmitral velocity to early mitral annulus diastolic velocity ratio (E/e’) ≥ 4 within 6 h of shock on the prognosis of patients were evaluated. Finally, the synergistic effect of FMR and E/e’ were assessed by combination, grouping, and trend analyses.
Results:
Forty-four patients (33.8%) had FMR, and 15 patients (11.5%) had E/e’ elevation. A multivariate analysis revealed FMR and E/e’ as independent correlated factors for 28-day mortality (P = 0.043 and 0.028, respectively). The Kaplan-Meier survival analysis revealed a significant difference in survival between patients with and without FMR (χ2 = 7.672, P = 0.006) and between the E/e’ ≥ 14 and E/e’ < 14 groups (χ2 = 19.351, P < 0.010). Twenty-eight-day mortality was significantly different among the four groups (χ2 = 30.141, P < 0.010). The risk of 28-day mortality was significantly higher in group 4 (E/e’ ≥ 14 with FMR) compared with groups 1 (E/e’ < 14 without FMR) and 2 (E/e’ < 14 with FMR) (P = 0.001 and 0.046, respectively).
Conclusions:
Patients with shock can be identified by the presence of FMR. FMR and E/e’ are independent risk factors for a poor prognosis in these patients, and prognosis is worst when FMR and E/e’ ≥ 14 are present. It may be possible to improve prognosis by reducing LA pressure and E/e’.
Trial Registration:
ClinicalTrials.gov, NCT03082326.
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诺模图预测紧急卵母细胞冻融周期妊娠结局Yang Wang, Zi-Ru Niu, Li-Yuan Tao, Xiao-Ying Zheng, Yi-Feng Yuan, Ping Liu, Rong Li
中华医学杂志英文版2021年 134卷 19期
DOI: 10.1097/CM9.0000000000001731
摘要
Background:
Existing clinical prediction models for in vitro fertilization are based on the fresh oocyte cycle, and there is no prediction model to evaluate the probability of successful thawing of cryopreserved mature oocytes. This research aims to identify and study the characteristics of pre-oocyte-retrieval patients that can affect the pregnancy outcomes of emergency oocyte freeze-thaw cycles.
Methods:
Data were collected from the Reproductive Center, Peking University Third Hospital of China. Multivariable logistic regression model was used to derive the nomogram. Nomogram model performance was assessed by examining the discrimination and calibration in the development and validation cohorts. Discriminatory ability was assessed using the area under the receiver operating characteristic curve (AUC), and calibration was assessed using the Hosmer-Lemeshow goodness-of-fit test and calibration plots.
Results:
The predictors in the model of "no transferable embryo cycles" are female age (odds ratio [OR] = 1.099, 95% confidence interval [CI] = 1.003-1.205, P = 0.0440), duration of infertility (OR = 1.140, 95% CI = 1.018-1.276, P = 0.0240), basal follicle-stimulating hormone (FSH) level (OR = 1.205, 95% CI = 1.051-1.382, P = 0.0084), basal estradiol (E2) level (OR = 1.006, 95% CI = 1.001-1.010, P = 0.0120), and sperm from microdissection testicular sperm extraction (MESA) (OR = 7.741, 95% CI = 2.905-20.632, P < 0.0010). Upon assessing predictive ability, the AUC for the "no transferable embryo cycles" model was 0.799 (95% CI: 0.722-0.875, P < 0.0010). The Hosmer-Lemeshow test (P = 0.7210) and calibration curve showed good calibration for the prediction of no transferable embryo cycles. The predictors in the cumulative live birth were the number of follicles on the day of human chorionic gonadotropin (hCG) administration (OR = 1.088, 95% CI = 1.030-1.149, P = 0.0020) and endometriosis (OR = 0.172, 95% CI = 0.035-0.853, P = 0.0310). The AUC for the "cumulative live birth" model was 0.724 (95% CI: 0.647-0.801, P < 0.0010). The Hosmer-Lemeshow test (P = 0.5620) and calibration curve showed good calibration for the prediction of cumulative live birth.
Conclusions:
The predictors in the final multivariate logistic regression models found to be significantly associated with poor pregnancy outcomes were increasing female age, duration of infertility, high basal FSH and E2 level, endometriosis, sperm from MESA, and low number of follicles with a diameter >10 mm on the day of hCG administration.
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猪骨模型中高强度缝线重建胫骨后交叉韧带的生物力学评价Ming-Yi Duan, Rui Sun, Lei-Ting Zhuang, Hang-Zhou Zhang
中华医学杂志英文版2021年 134卷 19期
DOI: 10.1097/CM9.0000000000001725
摘要
Background:
Multiple techniques are commonly used for posterior cruciate ligament (PCL) reconstruction. However, the optimum method regarding the fixation of PCL reconstruction after PCL tears remains debatable. The purpose of this study was to compare the biomechanical properties among three different tibial fixation procedures for transtibial single-bundle PCL reconstruction.
Methods:
Thirty-six porcine tibias and porcine extensor tendons were randomized into three fixation study groups: the interference screw fixation (IS) group, the transtibial tubercle fixation (TTF) group, and TTF + IS group (n = 12 in each group). The structural properties of the three fixation groups were tested under cyclic loading and load-to-failure. The slippage after the cyclic loading test and the stiffness and ultimate failure load after load-to-failure testing were recorded.
Results:
After 1000 cycles of cyclic testing, no significant difference was observed in graft slippage among the three groups. For load-to-failure testing, the TTF + IS group showed a higher ultimate failure load than the TTF group and the IS group (876.34 ± 58.78 N vs. 660.92 ± 77.74 N [P < 0.001] vs. 556.49 ± 65.33 N [P < 0.001]). The stiffness in the TTF group was significantly lower than that in the IS group and the TTF + IS group (92.77 ± 20.16 N/mm in the TTF group vs. 120.27 ± 15.66 N/m in the IS group [P = 0.001] and 131.79 ± 17.95 N/mm in the TTF + IS group [P < 0.001]). No significant difference in the mean stiffness was found between the IS group and the TTF + IS group (P = 0.127).
Conclusions:
In this biomechanical study, supplementary fixation with transtibial tubercle sutures increased the ultimate failure load during load-to-failure testing for PCL reconstruction.
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Hsp90相关DNA复制检查点蛋白和蛋白酶体亚基成分参与年龄相关性黄斑变性Chen Xing, Xiao-Feng Liu, Chun-Feng Zhang, Liu Yang
中华医学杂志英文版2021年 134卷 19期
DOI: 10.1097/CM9.0000000000001773
摘要
Background:
Age-related macular degeneration (AMD) is the leading cause of vision loss worldwide. However, the mechanisms involved in the development and progression of AMD are poorly delineated. We aimed to explore the critical genes involved in the progression of AMD.
Methods:
The differentially expressed genes (DEGs) in AMD retinal pigment epithelial (RPE)/choroid tissues were identified using the microarray datasets GSE99248 and GSE125564, which were downloaded from the gene expression omnibus database. The overlapping DEGs from the two datasets were screened to identify DEG-related biological pathways using gene ontology and Kyoto Encyclopedia of Genes and Genomes enrichment analyses. The hub genes were identified from these DEGs through protein-protein interaction network analyses. The expression levels of hub genes were evaluated by quantitative real-time polymerase chain reaction following the induction of senescence in ARPE-19 with FK866. Following the identification of AMD-related key genes, the potential small molecule compounds targeting the key genes were predicted by PharmacoDB. Finally, a microRNA-gene interaction network was constructed.
Results:
Microarray analyses identified 174 DEGs in the AMD RPE compared to the healthy RPE samples. These DEGs were primarily enriched in the pathways involved in the regulation of DNA replication, cell cycle, and proteasome-mediated protein polyubiquitination. Among the top ten hub genes, HSP90AA1, CHEK1, PSMA4, PSMD4, and PSMD8 were upregulated in the senescent ARPE-19 cells. Additionally, the drugs targeting HSP90AA1, CHEK1, and PSMA4 were identified. We hypothesize that Hsa-miR-16-5p might target four out of the five key DEGs in the AMD RPE.
Conclusions:
Based on our findings, HSP90AA1 is likely to be a central gene controlling the DNA replication and proteasome-mediated polyubiquitination during the RPE senescence observed in the progression of AMD. Targeting HSP90AA1, CHEK1, PSMA4, PSMD4, and/or PSMD8 genes through specific miRNAs or small molecules might potentially alleviate the progression of AMD through attenuating RPE senescence.
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从急诊患者心电图筛查低钾血症的深度学习模型的开发和验证Chen-Xi Wang, Yi-Chu Zhang, Qi-Lin Kong, Zu-Xiang Wu, Ping-Ping Yang, Cai-Hua Zhu, Shou-Lin Chen, Tao Wu, Qing-Hua Wu, Qi Chen
中华医学杂志英文版2021年 134卷 19期
DOI: 10.1097/CM9.0000000000001650
摘要
Background:
A deep learning model (DLM) that enables non-invasive hypokalemia screening from an electrocardiogram (ECG) may improve the detection of this life-threatening condition. This study aimed to develop and evaluate the performance of a DLM for the detection of hypokalemia from the ECGs of emergency patients.
Methods:
We used a total of 9908 ECG data from emergency patients who were admitted at the Second Affiliated Hospital of Nanchang University, Jiangxi, China, from September 2017 to October 2020. The DLM was trained using 12 ECG leads (lead I, II, III, aVR, aVL, aVF, and V1-6) to detect patients with serum potassium concentrations <3.5 mmol/L and was validated using retrospective data from the Jiangling branch of the Second Affiliated Hospital of Nanchang University. The blood draw was completed within 10 min before and after the ECG examination, and there was no new or ongoing infusion during this period.
Results:
We used 6904 ECGs and 1726 ECGs as development and internal validation data sets, respectively. In addition, 1278 ECGs from the Jiangling branch of the Second Affiliated Hospital of Nanchang University were used as external validation data sets. Using 12 ECG leads (leads I, II, III, aVR, aVL, aVF, and V1-6), the area under the receiver operating characteristic curve (AUC) of the DLM was 0.80 (95% confidence interval [CI]: 0.77-0.82) for the internal validation data set. Using an optimal operating point yielded a sensitivity of 71.4% and a specificity of 77.1%. Using the same 12 ECG leads, the external validation data set resulted in an AUC for the DLM of 0.77 (95% CI: 0.75-0.79). Using an optimal operating point yielded a sensitivity of 70.0% and a specificity of 69.1%.
Conclusions:
In this study, using 12 ECG leads, a DLM detected hypokalemia in emergency patients with an AUC of 0.77 to 0.80. Artificial intelligence could be used to analyze an ECG to quickly screen for hypokalemia.
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两种天然衍生的小分子破坏sineoculis同源盒同源物1-眼睛缺失同源物1(SIX1-EYA1）相互作用以抑制结直肠癌细胞生长Jing Wu, Bin Huang, Hong-Bo He, Wen-Zhu Lu, Wei-Guo Wang, Hong Liu
中华医学杂志英文版2021年 134卷 19期
DOI: 10.1097/CM9.0000000000001736
摘要
Background:
Emerging evidence indicates that the sineoculis homeobox homolog 1-eyes absent homolog 1 (SIX1-EYA1) transcriptional complex significantly contributes to the pathogenesis of multiple cancers by mediating the expression of genes involved in different biological processes, such as cell-cycle progression and metastasis. However, the roles of the SIX1-EYA1 transcriptional complex and its targets in colorectal cancer (CRC) are still being investigated. This study aimed to investigate the roles of SIX1-EYA1 in the pathogenesis of CRC, to screen inhibitors disrupting the SIX1-EYA1 interaction and to evaluate the efficiency of small molecules in the inhibition of CRC cell growth.
Methods:
Real-time quantitative polymerase chain reaction and western blotting were performed to examine gene and protein levels in CRC cells and clinical tissues (collected from CRC patients who underwent surgery in the Department of Integrated Traditional and Western Medicine, West China Hospital of Sichuan University, between 2016 and 2018, n = 24). In vivo immunoprecipitation and in vitro pulldown assays were carried out to determine SIX1-EYA1 interaction. Cell proliferation, cell survival, and cell invasion were determined using the 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) assay, clonogenic assay, and Boyden chamber assay, respectively. The Amplified Luminescent Proximity Homogeneous Assay Screen (AlphaScreen) method was used to obtain small molecules that specifically disrupted SIX1-EYA1 interaction. CRC cells harboring different levels of SIX1/EYA1 were injected into nude mice to establish tumor xenografts, and small molecules were also injected into mice to evaluate their efficiency to inhibit tumor growth.
Results:
Both SIX1 and EYA1 were overexpressed in CRC cancerous tissues (for SIX1, 7.47 ± 3.54 vs.1.88 ± 0.35, t = 4.92, P = 0.008; for EYA1, 7.61 ± 2.03 vs. 2.22 ± 0.45, t = 6.73, P = 0.005). The SIX1/EYA1 complex could mediate the expression of two important genes including cyclin A1 (CCNA1) and transforming growth factor beta 1 (TGFB1) by binding to the myocyte enhancer factor 3 consensus. Knockdown of both SIX1 and EYA1 could decrease cell proliferation, cell invasion, tumor growth, and in vivo tumor growth (all P < 0.01). Two small molecules, NSC0191 and NSC0933, were obtained using AlphaScreen and they could significantly inhibit the SIX1-EYA1 interaction with a half-maximal inhibitory concentration (IC50) of 12.60 ± 1.15 μmol/L and 83.43 ± 7.24 μmol/L, respectively. Administration of these two compounds could significantly repress the expression of CCNA1 and TGFB1 and inhibit the growth of CRC cells in vitro and in vivo.
Conclusions:
Overexpression of the SIX1/EYA1 complex transactivated the expression of CCNA1 and TGFB1, causing the pathogenesis of CRC. Pharmacological inhibition of the SIX1-EYA1 interaction with NSC0191 and NSC0933 significantly inhibited CRC cell growth by affecting cell-cycle progression and metastasis.
Clinical Observation
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局部组织血氧饱和度作为剖宫产腰麻后低血压的预测指标Hong Wei, Han-Kun Tu, Shang-Long Yao, Xi Wu
中华医学杂志英文版2021年 134卷 19期
DOI: 10.1097/CM9.0000000000001647
摘要
自从神经轴阻滞被发现以来，腰麻被频繁用于剖宫产手术。根据一份关于低血压管理的国际共识声明，Kinsella等人[
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环孢素A有效治疗放化疗继发再生障碍性贫血Jing Ruan, Bing Han
中华医学杂志英文版2021年 134卷 19期
DOI: 10.1097/CM9.0000000000001365
摘要
再生障碍性贫血（AA）是一种骨髓衰竭综合征，可分为先天性或获得性AA。大多数获得性AA病例是特发性的，其中异常的免疫系统攻击骨髓造血干细胞及其微环境。[
Technical Notes
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患者特异性脑室穿刺轨迹平面和穿刺轨迹：一种额脑室穿刺的新方法Chen-Yu Ding, Jun-Yu Lin, Yue Chen, Yue Pang, Xiao-Yong Chen, Wen-Hua Fang, Fang-Yu Wang, Yuang-Xiang Lin, De-Zhi Kang
中华医学杂志英文版2021年 134卷 19期
DOI: 10.1097/CM9.0000000000001696
摘要
脑室穿刺是一种常见的神经外科手术，通常使用体表解剖标志作为靶向参考徒手进行。[
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图像引导、手术机器人辅助经皮穿刺卵圆孔和茎乳突孔：一项尸体研究Fan-Hao Meng, Yu Song, Bo Qiao, Neng-Hao Jin, Yan-Ming Zhu, Bo-Fu Liang, Deng-Fa Gao, Hai-Zhong Zhang
中华医学杂志英文版2021年 134卷 19期
DOI: 10.1097/CM9.0000000000001783
摘要
手术机器人已经在手术中得到了广泛的应用。目前，达芬奇手术系统（Intuitive Surgery，Inc.，Sunnyvale，CA，USA）是临床环境中使用的最常见的机器人系统。该系统已被证明可用于隐匿位置的病变，如舌根肿瘤、舌根和颌下腺结石。与传统的开放外科手术相比，它的创伤更小；然而，它是否适合穿刺仍有争议。Remebot（北京百汇维康科技有限公司；中国北京）是一种手术机器人，目前正在用于神经外科手术。基于术中导航，它可以同时帮助外科医生确定穿刺的方向和深度。虽然据报道它可以达到1.330±0.566 mm的精度[
Correspondence
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穴位起源的人体间质液循环网络Hong-Yi Li, Fang Wang, Min Chen, Zhi-Jian Zheng, Ya-Jun Yin, Jun Hu, Hua Li, Andreas Sammer, Georg Feigl, Norbert Maurer 等
中华医学杂志英文版2021年 134卷 19期
DOI: 10.1097/CM9.0000000000001796
摘要
致编辑：自1027年首次为医疗从业者介绍显示穴位和经络的天圣铜像以来，它已经演变为中医目前使用的穴位和经络图谱。[
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非典型梭形细胞脂肪瘤/非典型多形性脂肪瘤和非典型乳腺型肌纤维母细胞瘤：临床病理学、免疫组织化学和多重荧光原地杂交分析Zhang Zhang, Nan Liu, Min Chen, Ran Peng, Hui-Jiao Chen, Hong-Ying Zhang
中华医学杂志英文版2021年 134卷 19期
DOI: 10.1097/CM9.0000000000001692
摘要
致编辑：具有梭形细胞成分和不典型特征的脂肪瘤性肿瘤是罕见的软组织肿瘤。非典型脂肪瘤(ALT)/高分化脂肪肉瘤(WDLPS)是最常见的脂肪肉瘤之一MDM2(12q13-15)基因扩增。然而，最近一些研究认为，被命名为“非典型梭形细胞脂肪瘤”（ASLT）和非典型多形性脂肪瘤（APLT）的独特脂肪瘤应与WDLPS区分开来，因为它们具有更好的预后。[
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80例卵巢Sertoli-Leydig细胞肿瘤单中心回顾性长期分析Ni Yang, Ting Gui, Dong-Yan Cao, Keng Shen, Yan You
中华医学杂志英文版2021年 134卷 19期
DOI: 10.1097/CM9.0000000000001489
摘要
致编辑：Sertoli-Leydig细胞肿瘤（SLCTs）是一种罕见的卵巢性索间质肿瘤，占<占所有卵巢肿瘤的0.5%。[
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中国健康人群年龄相关性肾功能与血管亚临床状态的关系Nan Wang, Xiao-Juan Bai, Lu-Lu Han, Wen Han, Xue-Feng Sun, Xiang-Mei Chen
中华医学杂志英文版2021年 134卷 19期
DOI: 10.1097/CM9.0000000000001422
摘要
致编辑：衰老与肾功能障碍和心血管疾病风险增加有关。即使在肾功能不全的早期阶段，心血管系统和肾功能之间的联系也是显而易见的。胱抑素C(CYSC)是在所有有核细胞中表达的胱抑素超家族之一，被认为是评价肾功能的最佳指标之一。[
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猕猴脂肪干细胞的诱导分化体外Jun-Liang Jiang, Tao Li, Xin Bi, Zhao-Xiang Wu, Kai-Yu Hou, Zhong Chen
中华医学杂志英文版2021年 134卷 19期
DOI: 10.1097/CM9.0000000000001486
摘要
致编辑：骨髓间充质干细胞（BMSCs）是研究最多的成体干细胞。然而，BMSCs的缺陷仍然存在，如其纯化率低、数量有限、对人体的创伤等。近年来，一些研究表明，脂肪组织提取物中的一些细胞具有与BMSCs相似的功能，即分化成各种组织的潜力，称为脂肪衍生干细胞（ADSCs）。[
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糖尿病急性输尿管绞痛患者结石自发排出的预测因素Yi Shao, Juan Fulla, Donald Fedrigon, Phornphen Prasanchaimontri, Cheng Ma, Marlie Elia, Manoj Monga
中华医学杂志英文版2021年 134卷 19期
DOI: 10.1097/CM9.0000000000001456
摘要
致编辑：根据国家健康和营养检查调查（2007-2010）的数据，美国（US）人群中肾结石的患病率为8.8%。[
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韩国2型糖尿病患者rs1761667 CD36多态性与卒中风险的关系Dong-Hwa Lee, Gun Woo Won, Yong Hee Lee, Jong Sung Shin, Eu Jeong Ku, Tae Keun Oh, Hyun Jeong Jeon
中华医学杂志英文版2021年 134卷 19期
DOI: 10.1097/CM9.0000000000001501
摘要
致编辑：由于普通人群卒中的患病率比2型糖尿病（T2DM）患者低2至3倍，其中卒中占所有死亡的11.0%，卒中显然是增加T2DM患者死亡率和发病率的主要大血管并发症。[
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肝移植术后乙型肝炎复发危险因素的系统评价和meta分析Min Liu, Li-Ying Sun, Zhi-Jun Zhu, Shan-Shan Wu
中华医学杂志英文版2021年 134卷 19期
DOI: 10.1097/CM9.0000000000001580
摘要
致编辑：乙型肝炎病毒（HBV）感染是与肝脏相关的发病率和死亡率相关的主要全球健康问题。慢性HBV感染，定义为乙型肝炎表面抗原（HBsAg）阳性，影响全球约2.57亿人。慢性HBV感染可导致肝硬化、肝衰竭和肝细胞癌（HCC）的发展。肝移植（LT）仍然是治疗HBV相关终末期肝病的唯一治疗方法。[
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舒更葡糖对接受非心脏手术的心脏患者恢复情况的影响Bing Li, Ling Zhou, He Huang
中华医学杂志英文版2021年 134卷 19期
DOI: 10.1097/CM9.0000000000001599
摘要
致编辑人口老龄化的全球趋势和冠心病（CHD）的流行导致CHD患者的非心脏手术量增加。[
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血压中的短链脂肪酸，朋友还是敌人Xiao-Feng Chen, Si-Chong Ren, Guo Tang, Chuan Wu, Xiangqi Chen, Xiao-Qiang Tang
中华医学杂志英文版2021年 134卷 19期
DOI: 10.1097/CM9.0000000000001578
摘要
致编辑：肠道微生物群，即生活在人类和啮齿动物肠道中的数万亿微生物，在心血管疾病（包括高血压和动脉粥样硬化）中起着关键作用。心血管疾病中肠道微生物群功能的关键机制之一是微生物群衍生的代谢物，如短链脂肪酸（SCFAs）。新出现的证据表明，肠道微生物群衍生的代谢物——SCFAs可以维持稳定的血压。[
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