MedNexus
2021年 · 第134卷第20期
出版日期 2021-10-20电子版 ￥0.00元
MedNexus
- 全部
- Consensus Statement
- Review Article
- Meta Analysis
- Medical Progress
- Perspective
- Viewpoint
- Original Article
- Clinical Observation
- Correspondence
Consensus Statement
开放获取
妊娠相关性乳腺癌临床实践指南：中国乳腺外科学会（CSBrS）实践指南2021Chen Qing, Qiu Yi-Ran, Zhang Ming-Di, Zhu Wei, Gu Wei-Rong, Wu Ke-Jin
中华医学杂志英文版2021年 134卷 20期
DOI: 10.1097/CM9.0000000000001686
摘要
妊娠相关乳腺癌（PABC），包括妊娠期乳腺癌（BCP）和产后乳腺癌（PBC），已经成为临床医生在诊断和治疗期间考虑母体和后代安全的关键问题。本指南中的建议主要基于目前可获得的高质量前瞻性研究、回顾性队列研究、荟萃分析以及国际公认或国家学会或协会发表的指南和共识文件。临床医生在建议是否终止妊娠或哺乳前，应仔细分析每种治疗的潜在益处和风险，平衡治疗的利弊，尊重患者的意愿。
Review Article
开放获取
脑胶质瘤术中标测与语言保护Weng Shi-Meng, Fang Sheng-Yu, Li Lian-Wang, Fan Xing, Wang Yin-Yan, Jiang Tao
中华医学杂志英文版2021年 134卷 20期
DOI: 10.1097/CM9.0000000000001751
摘要
The demand for acquiring different languages has increased with increasing globalization. However, knowledge of the modification of the new language in the neural language network remains insufficient. Although many details of language function have been detected based on the awake intra-operative mapping results, the language neural network of the bilingual or multilingual remains unclear, which raises difficulties in clinical practice to preserve patients’ full language ability in neurosurgery. In this review, we present a summary of the current findings regarding the structure of the language network and its evolution as the number of acquired languages increased in glioma patients. We then discuss a new insight into the awake intra-operative mapping protocol to reduce surgical risks during the preservation of language function in multilingual patients with glioma.
Meta Analysis
开放获取
区域麻醉与晚期癌症患者癌症复发：一项系统综述和荟萃分析Zhang Yue-Lun, Pei Li-Jian, Sun Chen, Zhao Meng-Yun, Che Lu, Huang Yu-Guang
中华医学杂志英文版2021年 134卷 20期
DOI: 10.1097/CM9.0000000000001676
摘要
Background:
Whether regional anesthesia may help to prevent disease recurrence in cancer patients is still controversial. The stage of cancer at the time of diagnosis is a key factor that defines prognosis and is one of the most important sources of heterogeneity for the treatment effect. We sought to update existing systematic reviews and clarify the effect of regional anesthesia on cancer recurrence in late-stage cancer patients.
Methods:
Medline, Embase, and Cochrane Library were searched from inception to September 2020 to identify randomized controlled trials (RCTs) and cohort studies that assessed the effect of regional anesthesia on cancer recurrence and overall survival (OS) compared with general anesthesia. Late-stage cancer patients were primarily assessed according to the American Joint Committee on Cancer Cancer Staging Manual (eighth edition), and the combined hazard ratio (HR) from random-effects models was used to evaluate the effect of regional anesthesia.
Results:
A total of three RCTs and 34 cohort studies (including 64,691 patients) were identified through the literature search for inclusion in the analysis. The risk of bias was low in the RCTs and was moderate in the observational studies. The pooled HR for recurrence-free survival (RFS) or OS did not favor regional anesthesia when data from RCTs in patients with late-stage cancer were combined (RFS, HR= 1.12, 95% confidence interval [CI]: 0.58-2.18, P = 0.729, I2 = 76%; OS, HR= 0.86, 95% CI: 0.63-1.18, P = 0.345, I2 = 48%). Findings from observational studies showed that regional anesthesia may help to prevent disease recurrence (HR = 0.87, 95% CI: 0.78-0.96, P = 0.008, I2 = 71%) and improve OS (HR = 0.88, 95% CI: 0.79-0.98, P = 0.022, I2 = 79%).
Conclusions:
RCTs reveal that OS and RFS were similar between regional and general anesthesia in late-stage cancers. The selection of anesthetic methods should still be based on clinical evaluation, and changes to current practice need more support from large, well-powered, and well-designed studies.
Medical Progress
开放获取
蛋白激酶调节人类精子过度活化的运动Wang Ya-Yan, Sun Pei-Bei, Li Kun, Gao Tian, Zheng Dong-Wang, Wu Fang-Ping, Liu A-juan, Ni Ya
中华医学杂志英文版2021年 134卷 20期
DOI: 10.1097/CM9.0000000000001551
摘要
精子一旦进入女性生殖道，就会经历一个被称为获能的重要过程，这个过程涉及一系列确保受精的生理生化变化。在获能期间，钙离子（Ca2+）增加精子鞭毛的弯曲幅度。这导致过度激活，表现为鞭毛的不对称跳动。酪氨酸磷酸化也是人类精子过度活化的原因；弱精子症——即精子活力降低——发生在精子由于酪氨酸磷酸化受损而不能过度激活时。[
Perspective
开放获取
缺血性卒中小胶质细胞极化：复杂机制和治疗干预Mao Jia-Hao, Xu Yuan, Li Bo-Wen, Yang Yi-Lin, Peng Ya, Zhi Feng
中华医学杂志英文版2021年 134卷 20期
DOI: 10.1097/CM9.0000000000001711
摘要
中风是死亡的第二大原因，也是残疾调整生命年损失的第三大原因。所有卒中患者在卒中后1个月至5年的病死率为15%至50%。缺血性中风是最常见的中风类型，占所有中风病例的87%。[
Viewpoint
开放获取
中国脑卒中管理模式的初步建立：国家卫健委脑卒中防治项目委员会10年（2011-2020）Chao Bao-Hua, Tu Wen-Jun, Wang Long-De
中华医学杂志英文版2021年 134卷 20期
DOI: 10.1097/CM9.0000000000001856
摘要
脑卒中具有高复发率、高致残率、高死亡率的特点，在我国乃至世界范围内都有着沉重的经济负担。[
Original Article
开放获取
体外不明原因复发性流产患者的受精—胚胎移植Li Tai-Yang, Li Rong, Zeng Lin, Li Li, Qiao Jie, Liu Ping, Wang Hai-Yan
中华医学杂志英文版2021年 134卷 20期
DOI: 10.1097/CM9.0000000000001657
摘要
Background:
Empiric therapy for patients with unexplained recurrent pregnancy loss (URPL) is not precise. Some patients will ask for assisted reproductive technology due to secondary infertility or advanced maternal age. The clinical outcomes of URPL patients who have undergone in vitro fertilization-embryo transfer (IVF-ET) require elucidation. The IVF outcome and influencing factors of URPL patients need further study.
Methods:
A retrospective cohort study was designed, and 312 infertile patients with URPL who had been treated during January 2012 to December 2015 in the Reproduction Center of Peking University Third Hospital were included. By comparing clinical outcomes between these patients and those with tubal factor infertility (TFI), the factors affecting the clinical outcomes of URPL patients were analyzed.
Results:
The clinical pregnancy rate (35.18% vs. 34.52% in fresh ET cycles, P = 0.877; 34.48% vs. 40.27% in frozen-thawed ET cycles, P = 0.283) and live birth rate (LBR) in fresh ET cycles (27.67% vs. 26.59%, P = 0.785) were not significantly different between URPL group and TFI group. URPL group had lower LBR in frozen-thawed ET cycles than that of TFI group (23.56% vs. 33.56%, P = 0.047), but the cumulative LBRs (34.69% vs. 38.26%, P = 0.368) were not significantly different between the two groups. The increased endometrial thickness (EMT) on the human chorionic gonadotropin day (odds ratio [OR]: 0.848, 95% confidence interval [CI]: 0.748-0.962, P = 0.010) and the increased number of eggs retrieved (OR: 0.928, 95% CI: 0.887-0.970, P = 0.001) were protective factors for clinical pregnancy in stimulated cycles. The increased number of eggs retrieved (OR: 0.875, 95% CI: 0.846-0.906, P < 0.001), the increased two-pronucleus rate (OR: 0.151, 95% CI: 0.052-0.437, P < 0.001), and increased EMT (OR: 0.876, 95% CI: 0.770-0.997, P = 0.045) in ET day were protective factors for the cumulative live birth outcome.
Conclusion:
After matching ages, no significant differences in clinical outcomes were found between the patients with URPL and the patients with TFI. A thicker endometrium and more retrieved oocytes increase the probability of pregnancy in fresh transfer cycles, but a better normal fertilization potential will increase the possibility of a live birth.
开放获取
循环肿瘤DNA的相关性EGFR晚期肺腺癌患者突变水平与临床预后的关系Liu Xiang-Liang, Bai Ri-Lan, Chen Xiao, Zhao Yu-Guang, Wang Xu, Ma Ke-Wei, Tian Hui-Min, Han Fu-Jun, Liu Zi-Ling, Yang Lei 等
中华医学杂志英文版2021年 134卷 20期
DOI: 10.1097/CM9.0000000000001760
摘要
Background:
Circulating tumor DNA (ctDNA) is a promising biomarker for non-invasive epidermal growth factor receptor mutations (EGFRm) detection in lung cancer patients, but existing methods have limitations in sensitivity and availability. In this study, we used the ΔCt value (mutant cycle threshold [Ct] value-internal control Ct value) generated during the polymerase chain reaction (PCR) assay to convert super-amplification-refractory mutation system (superARMS) from a qualitative method to a semi-quantitative method named reformed-superARMS (R-superARMS), and evaluated its performance in detecting EGFRm in plasma ctDNA in patients with advanced lung adenocarcinoma.
Methods:
A total of 41 pairs of tissues and plasma samples were obtained from lung adenocarcinoma patients who had known EGFRm in tumor tissue and were previously untreated. EGFRm in ctDNA was identified by using superARMS. Through making use of ΔCt value generated during the detection process of superARMS, we indirectly transform this qualitative detection method into a semi-quantitative PCR detection method, named R-superARMS. Both qualitative and quantitative analyses of the data were performed. Kaplan-Meier analysis was performed to estimate the progression-free survival (PFS) and overall survival (OS). Fisher exact test was used for categorical variables.
Results:
The concordance rate of EGFRm in tumor tissues and matched plasma samples was 68.3% (28/41). At baseline, EGFRm-positive patients were divided into two groups according to the cut-off ΔCt value of EGFRm set at 8.11. A significant difference in the median OS (mOS) between the two groups was observed (EGFRm ΔCt ≤8.11 vs. >8.11: not reached vs. 11.0 months; log-rank P = 0.024). Patients were divided into mutation clearance (MC) group and mutation incomplete clearance (MIC) group according to whether the ΔCt value of EGFRm test turned negative after 1 month of treatment. We found that there was also a significant difference in mOS (not reached vs. 10.4 months; log-rank P = 0.021) between MC group and MIC group. Although there was no significant difference in PFS between the two groups, the two curves were separated and the PFS of MC group tended to be higher than the MIC group (not reached vs. 27.5 months; log-rank P = 0.088). Furthermore, EGFRm-positive patients were divided into two groups according to the cut-off of the changes in ΔCt value of EGFRm after 1 month of treatment, which was set at 4.89. A significant difference in the mOS between the two groups was observed (change value of ΔCt >4.89 vs. ≤4.89: not reached vs. 11.0 months; log-rank P = 0.014).
Conclusions:
Detecting EGFRm in ctDNA using R-superARMS can identify patients who are more likely sensitive to targeted therapy, reflect the molecular load of patients, and predict the therapeutic efficacy and clinical outcomes of patients.
开放获取
量化人员流动限制对2019年冠状病毒疾病传播的影响：来自中国344个城市的实证分析Tan Jing, Zhao Shao-Yang, Xiong Yi-Quan, Liu Chun-Rong, Huang Shi-Yao, Lu Xin, Thabane Lehana, Xie Feng, Sun Xin, Li Wei-Min
中华医学杂志英文版2021年 134卷 20期
DOI: 10.1097/CM9.0000000000001763
摘要
Background:
Since the outbreak of coronavirus disease 2019 (COVID-19), human mobility restriction measures have raised controversies, partly because of the inconsistent findings. An empirical study is promptly needed to reliably assess the causal effects of the mobility restriction. The purpose of this study was to quantify the causal effects of human mobility restriction on the spread of COVID-19.
Methods:
Our study applied the difference-in-difference (DID) model to assess the declines of population mobility at the city level, and used the log-log regression model to examine the effects of population mobility declines on the disease spread measured by cumulative or new cases of COVID-19 over time after adjusting for confounders.
Results:
The DID model showed that a continual expansion of the relative declines over time in 2020. After 4 weeks, population mobility declined by -54.81% (interquartile range, -65.50% to -43.56%). The accrued population mobility declines were associated with the significant reduction of cumulative COVID-19 cases throughout 6 weeks (ie, 1% decline of population mobility was associated with 0.72% [95% CI: 0.50%-0.93%] reduction of cumulative cases for 1 week, 1.42% 2 weeks, 1.69% 3 weeks, 1.72% 4 weeks, 1.64% 5 weeks, and 1.52% 6 weeks). The impact on the weekly new cases seemed greater in the first 4 weeks but faded thereafter. The effects on cumulative cases differed by cities of different population sizes, with greater effects seen in larger cities.
Conclusions:
Persistent population mobility restrictions are well deserved. Implementation of mobility restrictions in major cities with large population sizes may be even more important.
开放获取
心脏瓣膜手术后肺炎的临床风险评分Wang Da-Shuai, Huang Xiao-Fan, Wang Hong-Fei, Le Sheng, Du Xin-Ling
中华医学杂志英文版2021年 134卷 20期
DOI: 10.1097/CM9.0000000000001715
摘要
Background:
Postoperative pneumonia (POP) is one of the most common infections following heart valve surgery (HVS) and is associated with a significant increase in morbidity, mortality, and health care costs. This study aimed to identify the major risk factors associated with the occurrence of POP following HVS and to derive and validate a clinical risk score.
Methods:
Adults undergoing open HVS between January 2016 and December 2019 at a single institution were enrolled in this study. Patients were randomly assigned to the derivation and validation sets at 1:1 ratio. A prediction model was developed with multivariable logistic regression analysis in the derivation set. Points were assigned to independent risk factors based on their regression coefficients.
Results:
POP occurred in 316 of the 3853 patients (8.2%). Multivariable analysis identified ten significant predictors for POP in the derivation set, including older age, smoking history, chronic obstructive pulmonary disease, diabetes mellitus, renal insufficiency, poor cardiac function, heart surgery history, longer cardiopulmonary bypass, blood transfusion, and concomitant coronary and/or aortic surgery. A 22-point risk score based on the multivariable model was then generated, demonstrating good discrimination (C-statistic: 0.81), and calibration (Hosmer-Lemeshow χ2 = 8.234, P = 0.312). The prediction rule also showed adequate discriminative power (C-statistic: 0.83) and calibration (Hosmer-Lemeshow χ2 = 5.606, P = 0.691) in the validation set. Three risk intervals were defined as low-, medium-, and high-risk groups.
Conclusion:
We derived and validated a 22-point risk score for POP following HVS, which may be useful in preventive interventions and risk management.
Trial Registration:
Chictr.org, ChiCTR1900028127; http://www.chictr.org.cn/showproj.aspx?proj=46932
开放获取
来自携带不同超氧化物歧化酶1突变的肌萎缩侧索硬化（ALS）患者的诱导多能干细胞衍生运动神经元再现了ALS的病理特征Liu Wen-Chao, Liu Na, Wang Yan, Huang Chen, Li Yan-Fang, Wang Hao, Li Xiao-Gang, Deng Min
中华医学杂志英文版2021年 134卷 20期
DOI: 10.1097/CM9.0000000000001693
摘要
Background:
Investigations of the pathogenic mechanisms in motor neurons (MNs) derived from amyotrophic lateral sclerosis (ALS) disease-specific induced pluripotent stem (iPS) cell lines could improve understanding of the issues affecting MNs. Therefore, in this study we explored mutant superoxide dismutase 1 (SOD1) protein expression in MNs derived from the iPS cell lines of ALS patients carrying different SOD1 mutations.
Methods:
We generated induced pluripotent stem cell (iPSC) lines from two familial ALS (FALS) patients with SOD1-V14M and SOD1-C111Y mutations, and then differentiated them into MNs. We investigated levels of the SOD1 protein in iPSCs and MNs, the intracellular Ca2+ levels in MNs, and the lactate dehydrogenase (LDH) activity in the process of differentiation into the MNs derived from the controls and ALS patients’ iPSCs.
Results:
The iPSCs from the two FALS patients were capable of differentiation into MNs carrying different SOD1 mutations and differentially expressed MN markers. We detected high SOD1 protein expression and high intracellular calcium levels in both the MN and iPSCs that were derived from the two SOD1 mutant patients. However, at no time did we observe stronger LDH activity in the patient lines compared with the control lines.
Conclusions:
MNs derived from patient-specific iPSC lines can recapitulate key aspects of ALS pathogenesis, providing a cell-based disease model to further elucidate disease pathogenesis and explore gene repair coupled with cell-replacement therapy. Incremental mutant expressions of SOD1 in MNs may have disrupted MN function, either causing or contributing to the intracellular calcium disturbances, which could lead to the occurrence and development of the disease.
开放获取
UBE2C通过AKT/mTOR信号通路影响乳腺癌增殖Lu Zi-Nan, Song Jia, Sun Tong-Hui, Sun Gang
中华医学杂志英文版2021年 134卷 20期
DOI: 10.1097/CM9.0000000000001708
摘要
Background:
Ubiquitin-conjugating enzyme E2C (UBE2C) has been shown to be associated with the occurrence of various cancers and involved in many tumorigenic processes. This study aimed to investigate the specific molecular mechanism through which UBE2C affects breast cancer (BC) proliferation.
Methods:
BC-related datasets were screened according to filter criteria in the Gene Expression Omnibus (GEO) database and The Cancer Genome Atlas (TCGA) database. Then differentially expressed genes (DEGs) were identified using Venn diagram analysis. By using DEGs, we conducted the following analyses including Gene ontology (GO), Kyoto Encyclopedia of Genes and Genomes (KEGG), protein-protein interaction (PPI), and survival analysis, and then validated the function of the hub gene UBE2C using quantitative reverse transcription-polymerase chain reaction (RT-qPCR), cell counting kit-8 (CCK-8) assay, transwell assay, and Western blot assay.
Results:
In total, 151 DEGs were identified from the GEO and TCGA databases. The results of GO analysis demonstrated that the DEGs were significantly enriched with mitotic nuclear division, lipid droplet, and organic acid-binding. KEGG analysis showed that the peroxisome proliferators-activated receptor (PPAR) signaling pathway, regulation of lipolysis in adipocytes, and proximal tubule bicarbonate reclamation were significantly enriched in the signal transduction pathway category. The top three hub genes that resulted from the PPI network were FOXM1, UBE2C, and CDKN3. The results of survival analysis showed a close relationship between UBE2C and BC. The results of CCK-8 and transwell assays suggested that the proliferation and invasion of UBE2C knockdown cells were significantly inhibited (P < 0.050). The results of Western blot assay showed that the level of phosphorylated phosphatase and tensin homology deleted on chromosome 10 (p-PTEN) was obviously increased (P < 0.050), whereas the levels of phosphorylated protein kinase B (p-AKT), phosphorylated mammalian target of rapamycin (p-mTOR), and hypoxia-inducible factor-1 alpha (HIF-1α) were dramatically decreased (P < 0.050) in the UBE2C knockdown cell.
Conclusion:
UBE2C can promote BC proliferation by activating the AKT/mTOR signaling pathway.
开放获取
5-氟尿嘧啶通过刺激真皮成纤维细胞分泌CXCL12的促色素作用Liao Zhi-Kai, Hu Shuang-Hai, Han Bin-Yu, Qiu Xie, Jiang Shan, Lei Tie-Chi
中华医学杂志英文版2021年 134卷 20期
DOI: 10.1097/CM9.0000000000001689
摘要
Background:
There is growing evidence that 5-fluorouracil (5-FU) combined with therapeutic trauma can effectively induce skin repigmentation in vitiligo patients who are unresponsive to conventional treatments. Previous studies have mainly focused on identifying the antimitotic activity of 5-FU for the treatment of skin cancer, but few studies have investigated its extra-genotoxic actions favoring melanocyte recruitment.
Methods:
We utilized the full thickness excisional skin wound model in Dct-LacZ transgenic mice to dynamically assess the migration of melanocytes in the margins of wounds treated with or without 5-FU. The in-situ expression of CXCL12 was examined in the wound beds using immunofluorescence staining. Quantitative real-time polymerase chain reaction and Western blotting analyses were performed to detect the expression levels of CXCL12 mRNA and protein in primary mouse dermal fibroblasts treated with or without 5-FU. Transwell assays and fluorescein isothiocyanate (FITC)-phalloidin staining were used to observe cell migration and filamentous actin (F-actin) changes of melan-a murine melanocytes.
Results:
Whole mount and cryosection X-gal staining showed that the cell numbers of LacZ-positive melanocytes were much higher in the margins of dorsal and tail skin wounds treated with 5-FU compared with the controls. Meanwhile, CXCL12 immunostaining was significantly increased in the dermal compartment of wounds treated with 5-FU (control vs. 5-FU, 22.47 ± 8.85 vs. 44.69 ± 5.97, P < 0.05). Moreover, 5-FU significantly upregulated the expression levels of CXCL12 mRNA (control vs. 5-FU, 1.00 ± 0.08 vs. 1.54 ± 0.06, P < 0.05) and protein (control vs. 5-FU, 1.00 ± 0.06 vs. 2.93 ± 0.10, P < 0.05) in cultured fibroblasts. Inhibition of the CXCL12/CXCR4 axis suppressed melanocyte migration in vitro using a CXCL12 small interfering RNA (siRNA) or a CXCR4 antagonist (AMD3100).
Conclusion:
5-FU possesses a pro-pigmentary activity through activation of the CXCL12/CXCR4 axis to drive the chemotactic migration of melanocytes.
Clinical Observation
开放获取
外阴佩吉特病手术策略的选择Liu Yu, Li Zheng-Yong, Zhong Ai, Adrian Wijaya Wilson, Peng Jing, Chen Jun-Jie
中华医学杂志英文版2021年 134卷 20期
DOI: 10.1097/CM9.0000000000001803
摘要
乳腺外佩吉特病（EMPD）是一种罕见的上皮内腺癌，往往发生在大汗腺丰富的地区。EMPD通常影响50至80岁的老年人。EMPD最常见的受影响区域是外阴；占外阴恶性肿瘤的1%~2%。[
开放获取
支气管扩张是重症冠状病毒疾病2019肺炎的指标之一Peng Peng, Wang Feng, Tang Zi-Ren, Liu Xiao, Zhang Zi-Hao, Song Huan, Zhu Bei-Lin, Liu Shi, Liu Yong, Xu Xiao-Guang 等
中华医学杂志英文版2021年 134卷 20期
DOI: 10.1097/CM9.0000000000001368
摘要
2019年以来，全球发生不明原因肺炎疫情。[
Correspondence
开放获取
2型糖尿病患者肌肉减少性超重与左室舒张功能障碍和重构的关系Zhang Yong-Ze, Huang Ling-Ning, Shen Xi-Mei, Lin Jie, Zhao Feng-Ying, Yan Sun-Jie
中华医学杂志英文版2021年 134卷 20期
DOI: 10.1097/CM9.0000000000001759
摘要
致编辑：左心室肥厚和舒张功能障碍在2型糖尿病（T2DM）患者中很常见[
开放获取
慢性肉芽肿病患者的关节感染Wang Xiu-Wen, Tang Xue-Yang, Lu Ling-Yun, Xie Ying, Liu Yi, Yu Xi-Jie
中华医学杂志英文版2021年 134卷 20期
DOI: 10.1097/CM9.0000000000001385
摘要
致编辑：一名7岁男孩在中国成都华西医院接受了手术，原因是左前臂远端出现肿块超过1个月。手术活检诊断为组织细胞增生症，疑似黄色肉芽肿。患者还患有伤口愈合不良，伴有脓性分泌物。术后两个月，患者因左脚踝疼痛肿胀超过10天而再次入院。彩超检查发现左踝关节滑膜炎、左胫骨后肌筋膜炎。患者自婴儿期起就有反复呼吸道感染病史，为此接受了抗结核治疗。然而，没有从患者身上分离出抗酸杆菌的记录。他的兄弟姐妹或父母也没有类似疾病的家族史。除了呼吸道感染，患者还在5岁时接受了耳后和颈后淋巴结脓肿开放引流术，在6岁时接受了肛周脓肿开放引流术。由于他反复出现多部位感染性病变，经常给他开双倍或三倍抗生素，如氧头孢齐特、万古霉素和亚胺培南。
开放获取
俄罗斯和中国右结肠癌患者肠系膜上血管解剖特征不同：基于计算机断层扫描的研究Efetov Sergey, Jiang Jun, Liu Zheng, Tulina Inna, Kim Valeriia, Schegelski Vladislav, Puzakov Kirill, Bergamaschi Roberto, Wang Xi-Shan, Tsarkov Petr
中华医学杂志英文版2021年 134卷 20期
DOI: 10.1097/CM9.0000000000001566
摘要
致编辑：文献记录了西方外科医生对扩大淋巴结清扫在右半结肠切除术中的作用相当感兴趣。关于肠系膜上静脉（SMV）和肠系膜上动脉（SMA）背侧淋巴结的收获，有很多不同的声音。[
开放获取
原发性肝肌皮细胞瘤和纵隔Castleman病并存1例18F-FDG PET/CT成像案例Ma Guang-Yu, Guan Zhi-Wei
中华医学杂志英文版2021年 134卷 20期
DOI: 10.1097/CM9.0000000000001626
摘要
致编辑：原发性肝肌皮细胞瘤（MPC）是一种少见的软组织肿瘤，肌皮细胞的概念最早由Dictor于1992年提出。[
开放获取
无X线技术经皮肾镜取石术在病态肥胖患者中的应用Xiao Bo, Zeng Xue, Zhang Gang, Jin Song, Hu Wei-Guo, Li Jian-Xing
中华医学杂志英文版2021年 134卷 20期
DOI: 10.1097/CM9.0000000000001758
摘要
致编辑：经皮肾镜取石术（PNL）是复杂结石和鹿角结石的一线治疗方法。由于潜在风险和较高的发病率，在病态肥胖患者中进行PNL具有挑战性。[
开放获取
鱼精蛋白治疗射频消融术中急性心包填塞的争议Que Dong-Dong, Feng Li-Yun, Yang Ya-Shu, Song Xu-Dong, Yang Ping-Zhen
中华医学杂志英文版2021年 134卷 20期
DOI: 10.1097/CM9.0000000000001601
摘要
致编辑：在射频导管消融（RFCA）期间，急性心包填塞是一种常见但危及生命的事件，其中心包腔内的快速血液积聚压迫心脏并导致体循环恶化。紧急经皮心包穿刺术和立即自体输血是必要的。鱼精蛋白用于持续出血是有争议的，因为尽管肝素具有中和作用，心包血凝块可能会自发形成，甚至可能需要开胸手术。我们的目的是讨论鱼精蛋白给药的必要性和最佳给药时间，并探索预防血凝块形成的方法。
开放获取
上海市哮喘治疗依从性及相关因素分析Du Juan, Shi Yu-Heng, Duan Yu-Xiang, Wang Xiao-Ru, Zhou Min, Gu Wen-Chao, Wen Chi-Jun, Gong Yi, Du Chun-Ling, Peng Bo 等
中华医学杂志英文版2021年 134卷 20期
DOI: 10.1097/CM9.0000000000001680
摘要
致编辑：哮喘是一种常见的慢性呼吸道疾病。据估计，全世界有3亿人患有哮喘，至少50%的成人和儿童没有按照处方服用控制药物。[
开放获取
2019冠状病毒病（COVID-19）对男性生殖系统的影响，包括其预防和治疗Liu Kai, Tao Wei
中华医学杂志英文版2021年 134卷 20期
DOI: 10.1097/CM9.0000000000001375
摘要
致编辑：当前的冠状病毒疾病2019（COVID-19）大流行导致了前所未有的全球健康危机。中国政府将该综合征纳入《中国传染病防治法》规定的乙类传染病，按照甲类传染病执行预防和控制措施。2020年2月11日，世界卫生组织将该综合征命名为新冠肺炎。随后，国际病毒分类委员会（ICTV）将致病病毒命名为2019新型冠状病毒（2019新型冠状病毒）。随着我们对新冠肺炎的深入了解，其对泌尿生殖系统的潜在影响也逐渐受到公众的关注。病毒本身可能会对男性生殖系统产生影响，但流行期药物、环境因素、心理因素等多方面对生殖的影响也不容忽视。
开放获取
预测腹部相关急诊普外科疾病并发脓毒症术后住院不良结局的诺模图的开发和验证Sheng Wei-Yong, Cheng Ping, Xu Peng, Chen Qing-Yong, Wang Yang, Zhang Jin-Xiang
中华医学杂志英文版2021年 134卷 20期
DOI: 10.1097/CM9.0000000000001378
摘要
致编辑：接受紧急普通外科（EGS）手术的患者死亡的可能性是选择性接受相同手术的患者的八倍。[
开放获取
非侵入性胸部电生物阻抗技术推导的中国汉族成人血流动力学参考范围Meng Qing-Long, Sun Yan, He Hui-Jing, Wang Hao, Shan Guang-Liang
中华医学杂志英文版2021年 134卷 20期
DOI: 10.1097/CM9.0000000000001465
摘要
致编辑：连续监测血流动力学状态可用于发现早期异常循环，对危重病人的管理很有帮助。如今，不同的微创和无创监测系统可以测量功能性血流动力学参数，以指导治疗计划和改善患者护理。其中，胸部电生物阻抗（TEB）技术广泛可用，对大多数患者都是准确的，尤其是在心脏直视手术后。然而，血流动力学特征之间存在种族相关的差异，并且对同一心血管疾病的血流动力学反应在种族群体中不同。目前，没有全国性的血流动力学参数参考范围可用于中国汉族健康成人。中国血流动力学状态标志物的大规模、前瞻性研究调查尚未完全报道。因此，有必要为中国汉族人群建立种族特异性血流动力学参考范围，并评估这些参数与年龄/性别之间的关系，以促进临床实践中高效、准确的判断。2012年7月至2017年9月，由中华人民共和国科学技术部牵头设计、组织和实施了一项前瞻性全国性研究，以建立中国汉族人群血流动力学参数的正常参考范围，并确认年龄和性别对这些参数的影响。
本期目次
下载本期封面 下载本期目录
