MedNexus
2022年 · 第135卷第01期
出版日期 2022-01-05电子版 ￥0.00元
MedNexus
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Editorial
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外科治疗的新阶段：超级微创手术Enqiang Linghu
中华医学杂志英文版2022年 135卷 01期
DOI: 10.1097/CM9.0000000000001534
摘要
电视胸腔镜、腹腔镜、达芬奇机器人手术的应用，使外科治疗进入微创手术（MIS）阶段。[
Review Article
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微小RNA作为胰腺癌的潜在治疗靶点Xiangyu Chu, Dan Wei, Xinxin Liu, Di Long, Xiaodong Tian, Yinmo Yang
中华医学杂志英文版2022年 135卷 01期
DOI: 10.1097/CM9.0000000000001826
摘要
Pancreatic cancer is one of the most aggressive malignancies. The poor prognosis of pancreatic cancer patients is mainly attributed to low diagnostic rate at the early stage, highly aggressive nature coupled with the inadequate efficacy of current chemotherapeutic regimens. Novel therapeutic strategies are urgently needed for pancreatic cancer. MicroRNAs (miRNAs) play an important regulatory role in key processes of cancer development. The aberrant expression of miRNAs is often involved in the initiation, progression, and metastasis of pancreatic cancer. The discovery of tumor suppressor miRNAs provides prospects for the development of a novel treatment strategy for pancreatic cancer. We reviewed recent progress on the understanding of the role of miRNAs in pancreatic cancer, highlighted the efficient application of miRNAs-based therapies for pancreatic cancer in animal models and clinical trials, and proposed future prospects. This review focuses on the promise of integrating miRNAs into the treatment of pancreatic cancer and provides guidance for the development of precision medicine for pancreatic cancer.
Meta Analysis
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司库奇尤单抗与阿达木单抗和英夫利昔单抗治疗中重度斑块型银屑病的疗效比较Ran Pan, Xiaolun Wang, Min Shu, Jaydeep Das, Manik Kalra, Zhidong Wang
中华医学杂志英文版2022年 135卷 01期
DOI: 10.1097/CM9.0000000000001817
摘要
Background:
Psoriasis is a common, chronic, immune-mediated inflammatory skin disease with increased epidermal proliferation. The objective of this review was to systematically identify the evidence and perform a network meta-analysis (NMA) to estimate the relative efficacy of secukinumab (SEC) against adalimumab (ADA) and infliximab (INF) for the treatment of moderate-to-severe plaque psoriasis.
Methods:
A systematic literature review (SLR) was conducted according to a pre-specified protocol to identify relevant studies. Initially, the databases were searched from database inception till June 2013, and the SLR was updated in April 2020. The eligibility criteria included adult patients (≥18 years old) with moderate-to-severe plaque psoriasis, and the SLR included randomized controlled trials (RCTs). The comparators of interest were SEC, ADA, INF, and placebo (PLA), while outcomes of interest were Psoriasis Area and Severity Index (PASI) (50, 75, and 90) at weeks 12, 16, and 24. A Bayesian NMA for PASI was utilized with a framework that evaluated the probability of PASI responses in different categories of PASI thresholds within a single model.
Results:
A total of 23 RCTs that assessed the efficacy of SEC, ADA, and INF in patients with moderate-to-severe plaque psoriasis were identified. At 12 weeks, SEC was associated with a significantly better response compared with PLA and ADA for PASI 75 and 90, while response results were comparable against INF. At 12 weeks, risk ratio (95% confidence interval) derived from NMA for SEC vs. ADA and INF for PASI 75 was 1.35 (1.19, 1.57) and 1.01 (0.90, 1.18), respectively. At the 16-week and 24-week time interval, SEC was significantly better than PLA, ADA, and INF for PASI 75 and 90.
Conclusion:
Efficacy of SEC in the treatment of patient populations with moderate-to-severe plaque psoriasis is well demonstrated through NMA.
Medical Progress
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冷圈套器息肉切除术治疗结直肠息肉：目前的应用和进展Tengjiao Gao, Xiaoyun Ding
中华医学杂志英文版2022年 135卷 01期
DOI: 10.1097/CM9.0000000000001880
摘要
冷圈套器息肉切除术（CSP）是内镜切除技术之一，已被推荐用于切除小型息肉（<5 mm)或大小达10 mm的非癌性息肉，以降低结直肠癌的发病率和死亡率。[
Viewpoint
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大剂量静脉注射维生素C对冠状病毒疾病2019肺炎的潜在益处Bing Zhao, Mengjiao Li, Yun Ling, Yibing Peng, Jun Huang, Hongping Qu, Yuan Gao, Yingchuan Li, Bijie Hu, Shuihua Lu 等
中华医学杂志英文版2022年 135卷 01期
DOI: 10.1097/CM9.0000000000001746
摘要
冠状病毒疾病2019（新冠肺炎）已被世界卫生组织宣布为疫情。[
Original Article
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内镜特征预测活检诊断的胃低级别上皮内瘤变预后Long Zou, Qingwei Jiang, Tao Guo, Xi Wu, Qiang Wang, Yunlu Feng, Shengyu Zhang, Weigang Fang, Weixun Zhou, Aiming Yang
中华医学杂志英文版2022年 135卷 01期
DOI: 10.1097/CM9.0000000000001637
摘要
Background:
Endoscopic biopsy can underestimate gastric malignancies as low-grade intraepithelial neoplasia (LGIN). Definitively diagnosed LGIN would progress. This study aimed to evaluate predictive factors to identify malignancies misdiagnosed as LGIN by biopsy and LGIN at high risk of progression.
Methods:
The clinical records of patients diagnosed with gastric LGIN by endoscopic biopsy who underwent at least two endoscopies during the first year of follow-up between 2007 and 2017 were retrospectively collected. Three endoscopists reviewed photographs of the initial endoscopy, described lesion characteristics, and made endoscopic diagnoses. Logistic regression was used to analyze predictors to identify malignancies underestimated as LGIN. A receiver operating characteristic curve was used to evaluate the diagnostic accuracy of these predictors. Patient clinical outcomes of follow-up >1 year were collected. Kaplan-Meier estimates with log-rank tests and Cox proportional hazards regression were used to analyze predictors of progression.
Results:
Overall, 48 of 182 (26.4%) patients were proven to have malignancies. A single lesion, a large lesion size, and marked intestinal metaplasia (IM) were independent predictors of initially misdiagnosed malignancies. The area under the curve of these predictors was 0.871, with a sensitivity of 68.7% and specificity of 92.5%. Twelve of 98 patients (12.2%) progressed during the 33-month median follow-up period. A whitish appearance, irregular margins, marked IM, and histological diagnosis of LGIN more than twice within the first year were predictors for progression.
Conclusions:
Lesions diagnosed as LGIN by biopsy with marked IM and other predictors above should be prudently treated for high potential to be malignancies or progress. Endoscopic follow-up with repeated biopsies within the first year is recommended.
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静脉—静脉体外膜肺氧合治疗成人重度呼吸衰竭患者颅内出血和死亡率的危险因素Xiaojing Wu, Min Li, Ying Cai, Tianshu Zhai, Yi Zhang, Qingyuan Zhan, Sichao Gu
中华医学杂志英文版2022年 135卷 01期
DOI: 10.1097/CM9.0000000000001719
摘要
Background:
Intracerebral hemorrhage (ICH) is one of the most severe complications during veno-venous extracorporeal membrane oxygenation (VV-ECMO). This study aimed to determine the risk factors for ICH and mortality in such patients.
Methods:
We analyzed the clinical data of 77 patients who received VV-ECMO due to severe respiratory failure from July 2013 to May 2019 at China-Japan Friendship Hospital. Demographical data, laboratory indices, imaging characteristics, and other clinical information were collected. Multivariable logistic regression analyses were performed to identify risk factors for ICH and mortality.
Results:
Of 77 patients, 11 (14.3%) suffered from ICH, and 36 (46.8%) survived. The survival rate was significantly lower (18.2% [2/11] vs. 51.5% [34/66], P = 0.040) in patients with ICH than in those without ICH. Multivariable analysis revealed that factors independently associated with ICH were diabetes mellitus (adjusted odds ratio [aOR]: 12.848, 95% confidence interval [CI]: 1.129-146.188, P = 0.040) and minimum fibrinogen during ECMO (aOR: 2.557, 95% CI: 1.244-5.252, P = 0.011). Multivariable analysis showed that factors independently associated with mortality were acute hepatic failure during ECMO (aOR: 9.205, 95% CI: 1.375-61.604, P = 0.022), CO2 retention before ECMO (aOR: 7.602, 95% CI: 1.514-38.188, P = 0.014), and minimum platelet concentration during ECMO (aOR: 0.130, 95% CI: 0.029-0.577, P = 0.007).
Conclusions:
Diabetes mellitus and minimum fibrinogen concentration during ECMO are risk factors for ICH in patients with severe respiratory failure managed using VV-ECMO. This indicated that anticoagulants use and nervous system monitoring should be performed more carefully in patients with diabetes when treated with VV-ECMO due to severe respiratory failure.
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2000年至2019年全球和区域女性乳腺癌发病率和死亡率趋势及国家级相关因素Chenyu Luo, Na Li, Bin Lu, Jie Cai, Ming Lu, Yuhan Zhang, Hongda Chen, Min Dai
中华医学杂志英文版2022年 135卷 01期
DOI: 10.1097/CM9.0000000000001814
摘要
Background:
Female breast cancer (FBC) has become the most prevalent malignancy worldwide. We aimed to evaluate the global and regional burden in epidemiological trends and factors associated with the incidence and mortality of FBC.
Methods:
FBC incidence and mortality in 60 selected countries by cancer registry data integrity in 2020 were estimated from the GLOBOCAN database, and their association with the human development index (HDI) was further evaluated. Trends of age-standardized rates of incidence and mortality in 60 countries from 2000 through 2019 were evaluated by joinpoint regression analysis using data of Global Burden of Disease 2019. The association between potential behavioral, metabolic, and socioeconomic risk factor exposure at the nation level retrieved from the World Bank and Global Health Observatory and the incidence and mortality of FBC were evaluated by multivariate linear regression.
Results:
FBC incidence and mortality varied greatly in the 60 included countries. Higher incidence and mortality rates were typically observed in countries with higher HDIs and vice versa. During 2000 to 2019, significantly increasing trends in incidence and mortality were observed in 26 (average annual percent changes [AAPCs], 0.35-2.96) and nine countries (AAPC, 0.30-1.65), respectively, while significantly decreasing trends in both incidence and mortality were observed in 22 countries, most of which were high-HDI countries. Among the population aged ≥40 years, there were 26 and 11 countries showing significantly increased trends in incidence and mortality, respectively. Ecological analysis showed that countries with higher prevalence rates of high cholesterol and higher health expenditures were more likely to have higher FBC incidence, and countries with higher rates of obesity and poorer universal health coverage were more likely to have higher FBC mortality.
Conclusions:
Despite decreased or stabilized FBC incidence and mortality rates were observed in some countries with high HDI over the past decades, disease burden became even severer in developing countries, especially for the population aged ≥40 years. Effective targeted preventive programs are strongly encouraged to reduce the FBC disease burden worldwide.
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心力衰竭伴心房颤动患者的出院心率和1年临床结局Fuwei Xing, Xin Zheng, Lihua Zhang, Shuang Hu, Xueke Bai, Danli Hu, Bing Li, Jing Li
中华医学杂志英文版2022年 135卷 01期
DOI: 10.1097/CM9.0000000000001768
摘要
Background:
The association between heart rate and 1-year clinical outcomes in heart failure (HF) patients with atrial fibrillation (AF), and whether this association depends on left ventricular ejection fraction (LVEF), are unclear. We investigated the relationship between discharge heart rate and 1-year clinical outcomes after discharge among hospitalized HF patients with AF, and further explored this association that differ by LVEF level.
Methods:
In this analysis, we enrolled 1760 hospitalized HF patients with AF from the China Patient-centered Evaluative Assessment of Cardiac Events Prospective Heart Failure study from August 2016 to May 2018. Patients were categorized into three groups with low (<65 beats per minute [bpm]), moderate (65-85 bpm), and high (≥86 bpm) heart rate measured at discharge. Cox proportional hazard models were employed to explore the association between heart rate and 1-year primary outcome, which was defined as a composite outcome of all-cause death and HF rehospitalization.
Results:
Among 1760 patients, 723 (41.1%) were women, the median age was 69 (interquartile range [IQR]: 60-77) years, median discharge heart rate was 75 (IQR: 69-84) bpm, and 934 (53.1%) had an LVEF <50%. During 1-year follow-up, a total of 792 (45.0%) individuals died or had at least one HF hospitalization. After adjusting for demographic characteristics, smoking status, medical history, anthropometric characteristics, and medications used at discharge, the groups with low (hazard ratio [HR]: 1.32, 95% confidence interval [CI]: 1.05-1.68, P = 0.020) and high (HR: 1.34, 95% CI: 1.07-1.67, P = 0.009) heart rate were associated with a higher risk of 1-year primary outcome compared with the moderate group. A significant interaction between discharge heart rate and LVEF for the primary outcome was observed (P for interaction was 0.045). Among the patients with LVEF ≥50%, only those with high heart rate were associated with a higher risk of primary outcome compared with the group with moderate heart rate (HR: 1.38, 95% CI: 1.01-1.89, P = 0.046), whereas there was no difference between the groups with low and moderate heart rate. Among the patients with LVEF <50%, only those with low heart rate were associated with a higher risk of primary outcome compared with the group with moderate heart rate (HR: 1.46, 95% CI: 1.09-1.96, P = 0.012), whereas there was no difference between the groups with high and moderate heart rate.
Conclusions:
Among the overall HF patients with AF, both low (<65 bpm) and high (≥86 bpm) heart rates were associated with poorer outcomes as compared with moderate (65-85 bpm) heart rate. Among patients with LVEF ≥50%, only a high heart rate was associated with higher risk; while among those with LVEF <50%, only a low heart rate was associated with higher risk as compared with the group with moderate heart rate.
Trail Registration:
Clinicaltrials.gov; NCT02878811.
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结核分枝杆菌潜伏相关抗原Rv1733c SLP提高活动性结核与潜伏性结核感染鉴别诊断的准确性Lifan Zhang, Huimin Ma, Shijun Wan, Yueqiu Zhang, Mengqiu Gao, Xiaoqing Liu
中华医学杂志英文版2022年 135卷 01期
DOI: 10.1097/CM9.0000000000001858
摘要
Background:
Differential diagnosis of active tuberculosis (ATB) and latent tuberculosis infection (LTBI) has been a challenge for clinicians in high TB burden countries. The purpose of this study was to improve the accuracy of differential diagnosis of ATB and LTBI by using fluorescent immunospot (FluoroSpot) assay to detect specific Th1 cell immune responses. The novel mycobacterium tuberculosis (MTB) latency-associated antigens Rv1733c and synthetic long peptides derived from Rv1733c (Rv1733c SLP) were used based on virulence factors early secreting antigen target-6 (ESAT-6) and culture filtrate protein-10 (CFP-10).
Methods:
Fifty-seven ATB cases, including 20 pathogen-confirmed ATB and 37 clinically diagnosed ATB, and 36 LTBI cases, were enrolled between January and December 2017. FluoroSpot assay was used to detect the interferon γ (IFN-γ) and interleukin 2 (IL-2) secreted by the specific T cells after being stimulated with MTB virulence factors ESAT-6 and CFP-10, MTB latency-associated antigens Rv1733c and Rv1733c SLP. The receiver operating characteristic (ROC) curve was used to define the best cutoff value of latency-associated antigens in the use of differentiating ATB and LTBI. The sensitivity, specificity, predictive value, and likelihood ratio of ESAT-6 and CFP-10-FluoroSpot combined with latency-associated antigen in the differential diagnosis of ATB and LTBI were also calculated.
Results:
Following the stimulation with Rv1733c and Rv1733c SLP, the frequency of single IL-2-secreting T cells stimulated by Rv1733c SLP had the largest area under the ROC curve, which was 0.766. With a cutoff value of 1 (spot-forming cells [SFCs]/2.5 × 105 peripheral blood mononuclear cells) for frequency, the sensitivity and specificity of distinguishing ATB from LTBI were 72.2% and 73.7%, respectively. ESAT-6 and CFP-10-FluoroSpot detected the frequency and proportion of single IFN-γ-secreting T cells; the sensitivity and specificity of distinguishing ATB from LTBI were 82.5% and 66.7%, respectively. Combined with the frequency of single IL-2-secreting T cells stimulated by Rv1733c SLP on the basis of ESAT-6 and CFP-10-FluoroSpot, the sensitivity and specificity increased to 84.2% and 83.3%, respectively.
Conclusion:
Rv1733c SLP, combined with ESAT-6 and CFP-10, might be used as a candidate antigen for T cell-based tuberculosis diagnostic tests to differentiate ATB from LTBI.
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结合放射学特征预测艾滋病相关非霍奇金淋巴瘤患者总生存期的预后诺模图Xueqin Li, Ziang Pan, Xing Wang, Tianli Hu, Wen Ye, Dongmei Jiang, Wen Shen, Jinxin Liu, Yuxin Shi, Shuang Xia 等
中华医学杂志英文版2022年 135卷 01期
DOI: 10.1097/CM9.0000000000001785
摘要
Background:
Acquired immune deficiency syndrome (AIDS)-related non-Hodgkin lymphoma (AR-NHL) is a high-risk factor for morbidity and mortality in patients with AIDS. This study aimed to determine the prognostic factors associated with overall survival (OS) and to develop a prognostic nomogram incorporating computed tomography imaging features in patients with acquired immune deficiency syndrome-related non-Hodgkin lymphoma (AR-NHL).
Methods:
A total of 121 AR-NHL patients between July 2012 and November 2019 were retrospectively reviewed. Clinical and radiological independent predictors of OS were confirmed using multivariable Cox analysis. A prognostic nomogram was constructed based on the above clinical and radiological factors and then provided optimum accuracy in predicting OS. The predictive accuracy of the nomogram was determined by Harrell C-statistic. Kaplan-Meier survival analysis was used to determine median OS. The prognostic value of adjuvant therapy was evaluated in different subgroups.
Results:
In the multivariate Cox regression analysis, involvement of mediastinal or hilar lymph nodes, liver, necrosis in the lesions, the treatment with chemotherapy, and the CD4 ≤100 cells/μL were independent risk factors for poor OS (all P < 0.050). The predictive nomogram based on Cox regression has good discrimination (Harrell C-index = 0.716) and good calibration (Hosmer-Lemeshow test, P = 0.620) in high- and low-risk groups. Only patients in the high-risk group who received adjuvant chemotherapy had a significantly better survival outcome.
Conclusion:
A survival-predicting nomogram was developed in this study, which was effective in assessing the survival outcomes of patients with AR-NHL. Notably, decision-making of chemotherapy regimens and more frequent follow-up should be considered in the high-risk group determined by this model.
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血清代谢组学分析揭示评估多囊卵巢综合征妇女治疗的潜在生物标志物：一项随机对照试验Xuesong Ding, Yan Deng, Yanfang Wang, Wei Xue, Shiyang Zhu, Xiao Ma, Ruilin Ma, Aijun Sun
中华医学杂志英文版2022年 135卷 01期
DOI: 10.1097/CM9.0000000000001705
摘要
Background:
As one of the most common endocrinal disorders for women at childbearing age, the diagnostic criteria of polycystic ovary syndrome (PCOS) have been defined differently among different international health organizations. Phenotypic heterogeneity of PCOS also brings about difficulties for its diagnosis and management assessment. Therefore, more efficient biomarkers representing the progression of PCOS are expected to be integrated into the monitoring of management process using metabolomic approaches.
Methods:
In this prospective randomized controlled trial, 117 PCOS patients were enrolled from December 2016 to September 2017. Classical diagnostic parameters, blood glucose, and metabolome were measured in these patients before and at 2 months and 3 months of different medical interventions. The receiver operating characteristic (ROC) curves were built based on multivariate statistical analysis using data at baseline and 3 months’ management, and combinational biomarkers with appreciable sensitivity and specificity were selected, which then validated with data collected at 2 months.
Results:
A set of metabolites including glutamic acid, aspartic acid, 1-methylnicotinamide, acetylcarnitine, glycerophosphocholine, and oleamide were filtered out with high performance in representing the improvement through 3-month management of PCOS with high sensitivity and specificity in ROC analysis and validation with other two groups showed an appreciable area under the curve over 0.96.
Conclusions:
The six metabolites were representative of the remission of PCOS through medical intervention, making them a set of potential biomarkers for assessing the outcome of PCOS management.
Trial Registration:
ClinicalTrials.gov, NCT03264638.
Clinical Observation
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多基因检测对多原发肺癌与肺癌肺内转移的鉴别诊断Liuyang Xu, Jin Chen, Yupeng Zeng, Xiao Li, Zhihong Zhang
中华医学杂志英文版2022年 135卷 01期
DOI: 10.1097/CM9.0000000000001739
摘要
全球健康意识提高的趋势导致吸烟减少，这有助于改善肺癌的控制和早期发现。[
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超声引导下经皮肺外周病变活检后肺出血的危险因素Qing Li, Zhixian Li, Xinhong Liao, Li Zhang, Lei Wang, Shi Tang, Xiyue Yang, Jihan Wang
中华医学杂志英文版2022年 135卷 01期
DOI: 10.1097/CM9.0000000000001788
摘要
肺癌是世界范围内癌症相关死亡的主要原因，并且肺癌的发病率和死亡率在过去几十年中增加。成像技术在提供明确诊断方面受到限制，这需要组织样本用于病理学评估。腺癌占所有肺癌的40%，往往发生在肺的外周，[
Rapid Report
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雷公藤红素通过调节mTOR表达促进软骨细胞自噬Siming Dai, Jiankun Fan, Yue Zhang, Zhenyong Hao, Huiming Yu, Zhiyi Zhang
中华医学杂志英文版2022年 135卷 01期
DOI: 10.1097/CM9.0000000000001552
摘要
骨关节炎（OA）是一种使人衰弱的疾病，治疗选择有限。[
Correspondence
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2019年重症冠状病毒病患者的细胞因子水平和病理特征：病例报告Kai Kang, Yang Gao, Mingyan Zhao, Dongsheng Fei, Ming Ye, Yan Gao, Wei Yang, Changsong Wang, Haitao Liu, Guangping Chang 等
中华医学杂志英文版2022年 135卷 01期
DOI: 10.1097/CM9.0000000000001540
摘要
致编辑：2019冠状病毒病（COVID-19）的临床谱似乎很广，从无症状到伴有呼吸衰竭、多器官衰竭甚至死亡的严重进行性肺炎。在这里，我们调查了一名死于重症新冠肺炎的患者的临床和病理特征。我们的发现将有助于更深入地了解新冠肺炎的发病机制和进展，并改善对抗该疾病的临床策略。
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成年期支链氨基酸摄入轨迹与2型糖尿病风险及其相关危险因素的关系Weiqi Wang, Tianshu Han, Wanying Hou, Xiyun Ren, Wei Duan, Zhipeng Liu, Changhao Sun
中华医学杂志英文版2022年 135卷 01期
DOI: 10.1097/CM9.0000000000001526
摘要
致编辑：2型糖尿病（T2D）在全球范围内的患病率不断上升，给医疗保健系统带来了巨大的负担。[
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人参皂苷Rg1和虾青素作用下丘脑对雌性小鼠生殖衰老的保护作用Xiaoman Dai, Guirong Zeng, Luyan Hong, Qinyong Ye, Xiaochun Chen, Jing Zhang
中华医学杂志英文版2022年 135卷 01期
DOI: 10.1097/CM9.0000000000001542
摘要
致编辑：由于生殖老龄化导致的女性不孕已成为人口中的一个突出问题。有证据表明，氧化应激是生殖衰老的主要机制之一。[
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糖尿病足溃疡患者高密度脂蛋白胆固醇与创面愈合的关系Lihong Chen, Wanxia Ma, Dawei Chen, Chun Wang, Yun Gao, Xingwu Ran
中华医学杂志英文版2022年 135卷 01期
DOI: 10.1097/CM9.0000000000001544
摘要
致编辑糖尿病足溃疡(DFU)是糖尿病(DM)患者发病的重要原因。糖尿病患者足部溃疡的患病率为4%至10%，终生发病率估计在19%至34%之间。[
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经动脉化疗栓塞联合索拉非尼和碘125粒子近距离放射治疗肝癌合并门静脉癌栓的回顾性对照研究Jingjun Huang, Mingyue Cai, Wensou Huang, Yongjian Guo, Jingwen Zhou, Licong Liang, Liteng Lin, Zhimei Zhou, Hui Lian, Mingji He 等
中华医学杂志英文版2022年 135卷 01期
DOI: 10.1097/CM9.0000000000001537
摘要
致编辑：门静脉癌栓（PVTT）在诊断时存在于10%至40%的肝细胞癌（HCC）患者中，对预后有深远的不利影响。[
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冠心病患者择期经皮冠状动脉介入治疗期间术后不输注比伐卢定的疗效和安全性：一项真实世界研究Ping Wang, Xin Zhao, Qimin Yuan, Xiaoxue Yu, Lin Yang, Xiaozeng Wang
中华医学杂志英文版2022年 135卷 01期
DOI: 10.1097/CM9.0000000000001757
摘要
致编辑：抗血栓治疗对于预防经皮冠状动脉介入治疗（PCI）期间和之后的不良缺血事件至关重要。PCI期间的抗凝最常见的是肝素或比伐卢定。比伐卢定不激活血小板，不与血浆蛋白结合，具有线性药代动力学，半衰期较短，为25分钟。[
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应用红外热像技术检测胸腔镜节段切除术中的节段间平面Chengrun Li, Yang Liu
中华医学杂志英文版2022年 135卷 01期
DOI: 10.1097/CM9.0000000000001806
摘要
致编辑：肺段切除术是治愈早期肺癌的有效手术方法。精确设计的肺段切除术能最大限度地保留肺功能，术后生存率相当。但仍存在手术经验、解剖熟悉程度、节段间平面识别等因素，影响节段切除术的应用。
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测量距离和暴露于寒冷的室外环境对使用非接触式红外测温仪测量温度的影响Rui Peng, Yuanshen Huang, Xuejun Zhu, Xueying Li, Hang Li
中华医学杂志英文版2022年 135卷 01期
DOI: 10.1097/CM9.0000000000001546
摘要
致编辑：发热检测对于高传染性发热性疾病的筛查和控制至关重要。腋窝或直肠温度虽然被认为是临床上发热检测的金标准，[
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程序性细胞死亡-1（PD-1）过表达对心脏骤停患者自主循环恢复后早期循环Th1和Th2细胞的影响Yanan Yu, Miaorong Xie, Jiabao Li, Chenchen Hang, Fei Shao, Chunsheng Li
中华医学杂志英文版2022年 135卷 01期
DOI: 10.1097/CM9.0000000000001764
摘要
致编辑：心脏骤停（CA）是全球住院患者发病率和死亡率的主要原因，总生存率较低。在恢复自主循环（ROSC）后，CA和全身缺血/再灌注损伤患者可表现为脓毒症样综合征和增加感染风险的免疫紊乱。CD4+T淋巴细胞在器官缺血再灌注损伤中起重要作用。辅助性T（Th）1型和2型细胞是CD4的经典亚群+T细胞。对它们在感染性和免疫相关炎症性疾病中的功能的广泛研究表明，这两个亚群都参与宿主防御和直接免疫反应。来自CA/心肺复苏猪模型和患者的数据揭示了Th1/Th2细胞比率的失衡。[
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CD19靶向嵌合抗原受体修饰T细胞诱导脐血移植后复发急性B淋巴细胞白血病患者缓解Qianwen Xu, Hui Xu, Lei Xue, Min Wang, Guiwang Pan, Xuhan Zhang, Kaidi Song, Wen Yao, Xiang Wan, Juan Tong 等
中华医学杂志英文版2022年 135卷 01期
DOI: 10.1097/CM9.0000000000001491
摘要
致编辑：在没有相容供体的情况下，脐带血移植（UCBT）可作为治疗B细胞急性淋巴细胞白血病（ALL）患者的替代选择。然而，疾病复发提出了一个困难的挑战。嵌合抗原受体（CAR）-T细胞疗法是治疗复发/难治性ALL患者的一种有前途的方法。在移植后输注CAR-T细胞的深入研究中，很少有人关注在UCBT后复发后接受CAR-T治疗的患者。在这里，我们报告了10例复发性急性B淋巴细胞白血病（B-ALL）儿童和年轻人在UCBT后给予CD19 CAR-T细胞的应答率、毒性和生存率。
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