MedNexus
2022年 · 第135卷第04期
出版日期 2022-02-20电子版 ￥0.00元
MedNexus
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- Editorial
- Review Article
- Meta Analysis
- Perspective
- Original Article
- Clinical Observation
- Technical Note
- Correspondence
Editorial
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我国乙型和丙型病毒性肝炎诊治进展Jidong Jia
中华医学杂志英文版2022年 135卷 04期
DOI: 10.1097/CM9.0000000000001886
摘要
乙型肝炎病毒（HBV）和丙型肝炎病毒（HCV）的慢性感染在全球范围内造成严重的公共卫生负担。在过去的三十年里，中国在慢性乙型肝炎（CHB）和丙型肝炎（CHC）的预防、诊断和治疗方面做出了巨大努力并取得了显著进展。[
Review Article
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免疫球蛋白G4相关疾病的分类、诊断和治疗进展Yu Chen, Shaozhe Cai, Lingli Dong, Hisanori Umehara
中华医学杂志英文版2022年 135卷 04期
DOI: 10.1097/CM9.0000000000001891
摘要
Immunoglobulin G4-related disease (IgG4-RD) is a newly recognized chronic fibro-inflammatory autoimmune disease, and its recognition has been constantly increasing worldwide over the last few years. A correct and timely recognition, as well as appropriate intervention, is crucial for the treatment of IgG4-RD. For certain subtypes of IgG4-RD, organ-specific criteria are formulated to make the diagnosis more accurate. New biomarkers have emerged in the recent years to aid the disease diagnosis, its prognosis prediction, as well as therapy response monitoring. Although recurrence is very common in IgG4-RD, glucocorticoid is still the first-line treatment for the majority of patients. The factors that affect the likelihood of disease relapse are multifaceted. The selection strategy of various steroid-sparing agents is still being explored. Besides, when patients have special sites involvement leading to severe clinical conditions, surgical operation or interventional therapy should also be considered. An update on classification, diagnosis, and management of IgG4-RD is provided in the current study to fully elucidate the recommended clinical practice of this mysterious disease.
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白细胞介素治疗黑色素瘤Xinyuan Xu, Wei Dai, Chunying Li
中华医学杂志英文版2022年 135卷 04期
DOI: 10.1097/CM9.0000000000001929
摘要
Interleukins (ILs) and associated cytokines serve as the means of communication for immune cells and non-immune cells. The use of ILs in harnessing the immune system to cancer treatment has been a promising approach. ILs not only nurture an environment enabling cancer growth but also simultaneously trigger a productive tumor-directed immune response. These properties of ILs are increasingly being explored as a strategy to improve the outcomes of cancer. Here, we describe recently innovative technological approaches that have been developed to improve the pharmacokinetics, safety, and efficacies of IL-2, 15, 10, and 18 in the treatment of melanoma. Furthermore, the combination of ILs and immune checkpoint inhibition may synergize to reshape the tumor environment, thus yielding better clinical benefits in the future.
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细菌感染和肠道微生物组对结直肠癌发生的影响Jun Sun
中华医学杂志英文版2022年 135卷 04期
DOI: 10.1097/CM9.0000000000001979
摘要
Accumulating evidence suggests that intestinal bacteria play an important role in the pathogenesis of colorectal cancer (CRC). Due to the complexity of the intestinal microbiome, identification of the specific causative microbial agents in CRC remains challenging, and the search for the causative microbial agents is intense. However, whether bacteria or their products can induce inflammation that results in tumorigenesis or directly causes CRC in humans is still not clear. This review will mainly focus on the progress of bacterial infection and CRC, and introduce the microbial contribution to the hallmarks of cancer. This article uses Salmonella and its chronic infection as an example to investigate a single pathogen and its role in the development of CRC, based on laboratory and epidemiological evidence. The bacterial infection leads to an altered intestinal microbiome. The review also discusses the dysfunction of the microbiome and the mechanism of host-microbial interactions, for example, bacterial virulence factors, key signaling pathways in the host, and microbial post-translational modifications in the tumorigenesis. Colonic carcinogenesis involves a progressive accumulation of mutations in a genetically susceptible host leading to cellular autonomy. Moving forward, more human data are needed to confirm the direct roles of bacterial infection in CRC development. Insights into the inhibiting infection will help to prevent cancer and develop strategies to restore the balance between host and microorganisms.
Meta Analysis
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生物和靶向药物治疗类风湿性关节炎患者发生结核病的风险：随机临床试验的荟萃分析Xiaojian Ji, Lidong Hu, Yiwen Wang, Siliang Man, Xingkang Liu, Chuan Song, Jiaxin Zhang, Jian Zhu, Jianglin Zhang, Feng Huang
中华医学杂志英文版2022年 135卷 04期
DOI: 10.1097/CM9.0000000000001948
摘要
Background:
Concerns exist regarding the potential development of tuberculosis in patients with rheumatoid arthritis (RA) treated with biological and targeted drugs. We assessed systematically whether biological therapy increased the risk of tuberculosis in patients with RA by meta-analysis of randomized controlled trials (RCTs).
Methods:
A systematic literature search was conducted in PubMed, Embase, the Cochrane Library, and China Biology Medicine disc for RCTs evaluating biological therapy in patients with RA from inception through August 2021. Traditional meta-analysis and network meta-analysis were performed to compare the risk of tuberculosis for each biologics class in patients with RA. Peto odds ratio (Peto OR) and its 95% confidence interval (CI) were calculated as the primary effect measure.
Results:
In total, 39 studies with 20,354 patients were included in this meta-analysis, and 82 patients developed tuberculosis. The risk of tuberculosis was increased in patients treated with biologics compared with non-biologics (Peto OR: 3.86, 95% CI: 2.36-6.32, P < 0.001). Also, tumor necrosis factor-α (TNF-α) inhibitors had a higher probability of developing tuberculosis than placebo (Peto OR: 3.98, 95% CI: 2.30-6.88, P < 0.001). However, network meta-analysis demonstrated that there was no significant difference in the risk of tuberculosis for each biologics class in patients with RA. Noticeably, tuberculosis was significantly more common in patients treated with a high dose compared with patients receiving a low dose of tofacitinib (Peto OR: 7.39, 95% CI: 2.00-27.31, P = 0.003).
Conclusion:
This meta-analysis demonstrates the evidence of an elevated risk of tuberculosis in patients with RA treated with TNF-α inhibitors, and a dose-dependent elevated risk of tuberculosis in patients treated with tofacitinib.
Perspective
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新冠肺炎相关急性呼吸衰竭的无创呼吸支持João Carlos Winck, Joaquim Moreira
中华医学杂志英文版2022年 135卷 04期
DOI: 10.1097/CM9.0000000000001832
摘要
欧洲呼吸学会/美国胸科学会临床实践指南（仅推荐性）建议使用非侵入性呼吸支持疗法（NRST）作为避免低氧性急性呼吸衰竭（ARF）插管的预防策略。[
Original Article
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血压在卒中相关死亡率中的作用：中国45年随访研究Shengshu Wang, Shanshan Yang, Wangping Jia, Ke Han, Yang Song, Jing Zeng, Wenzhe Cao, Shaohua Liu, Shimin Chen, Zhiqiang Li 等
中华医学杂志英文版2022年 135卷 04期
DOI: 10.1097/CM9.0000000000001949
摘要
Background:
Hypertension is associated with stroke-related mortality. However, the long-term association of blood pressure (BP) and the risk of stroke-related mortality and the influence path of BP on stroke-related death remain unknown. The current study aimed to estimate the long-term causal associations between BP and stroke-related mortality and the potential mediating and moderated mediating model of the associations.
Methods:
This is a 45-year follow-up cohort study and a total of 1696 subjects were enrolled in 1976 and 1081 participants died by the latest follow-up in 2020. COX proportional hazard model was used to explore the associations of stroke-related death with baseline systolic blood pressure (SBP)/diastolic blood pressure (DBP) categories and BP changes from 1976 to 1994. The mediating and moderated mediating effects were performed to detect the possible influencing path from BP to stroke-related deaths. E value was calculated in the sensitivity analysis.
Results:
Among 1696 participants, the average age was 44.38 ± 6.10 years, and 1124 were men (66.3%). After a 45-year follow-up, a total of 201 (11.9%) stroke-related deaths occurred. After the adjustment, the COX proportional hazard model showed that among the participants with SBP ≥ 160 mmHg or DBP ≥ 100 mmHg in 1976, the risk of stroke-related death increased by 217.5% (hazard ratio [HR] = 3.175, 95% confidence interval [CI]: 2.297-4.388), and the adjusted HRs were higher in male participants. Among the participants with hypertension in 1976 and 1994, the risk of stroke-related death increased by 110.4% (HR= 2.104, 95% CI: 1.632-2.713), and the adjusted HRs of the BP changes were higher in male participants. Body mass index (BMI) significantly mediated the association of SBP and stroke-related deaths and this mediating effect was moderated by gender.
Conclusions:
In a 45-year follow-up, high BP and persistent hypertension are associated with stroke-related death, and these associations were even more pronounced in male participants. The paths of association are mediated by BMI and moderated by gender.
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超声造影联合经皮超声引导下细针穿刺在胰腺实性病变诊断中的价值Yang Gui, Menghua Dai, Zhilan Meng, Xiaoyan Chang, Li Tan, Jing Zhang, Xueqi Chen, Tongtong Zhou, Qing Zhang, Mengsu Xiao 等
中华医学杂志英文版2022年 135卷 04期
DOI: 10.1097/CM9.0000000000001638
摘要
Background:
Contrast-enhanced ultrasound (CEUS) can detect lesions hidden in inflammatory regions and find necrosis or areas of severe fibrosis within the lesion. This retrospective study aimed to compare the diagnostic accuracy of solid pancreatic lesions using percutaneous ultrasound (US)-guided fine-needle aspiration (FNA) with or without CEUS assessment.
Methods:
Clinical, imaging, and pathologic data of 181 patients from January 2014 to December 2018 in Pecking Union Medical College Hospital, with solid pancreatic masses who underwent percutaneous US-FNA and ThinPrep cytologic test were retrospectively evaluated. Patients were divided into CEUS and US groups according to whether CEUS was performed before the biopsy. According to FNA cytology diagnoses, we combined non-diagnostic, neoplastic, and negative cases into a negative category. The positive category included malignant, suspicious, and atypical cases. The final diagnosis was confirmed by pathology or clinical and radiological follow-up for at least 12 months. The sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy of US-FNA were evaluated between the two groups.
Results:
This study enrolled 107 male and 74 female patients (average age: 60 years). There were 58 cases in the US group and 123 cases in the CEUS group. No statistically significant differences in age, gender, or lesion size were found between the two groups. The diagnostic accuracy of the CEUS group was 95.1% (117/123), which was higher than the 86.2% (50/58) observed in the US group (P = 0.036). The sensitivity, specificity, PPV, and NPV of the CEUS group were increased by 7.5%, 16.7%, 3.4%, and 18.8%, respectively, compared with the US group. However, the differences of the two groups were not statistically significant.
Conclusions:
Compared with the conventional US, the use of CEUS could improve the biopsy accuracy and avoid the need for a repeat biopsy, especially for some complicated FNA cases.
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obinutuzumab一线治疗滤泡性淋巴瘤的疗效和安全性：入组III期GALLIUM研究的中国患者亚组分析Xiaonan Hong, Yuqin Song, Yuankai Shi, Qingyuan Zhang, Wei Guo, Gang Wu, Junmin Li, Jifeng Feng, Anastasiia Kinkolykh, Andrea Knapp 等
中华医学杂志英文版2022年 135卷 04期
DOI: 10.1097/CM9.0000000000001737
摘要
Backgrounds:
GALLIUM is a global phase III study that demonstrated significant improvements in progression-free survival (PFS) for obinutuzumab plus chemotherapy (G-chemo) vs. rituximab plus chemotherapy (R-chemo) in previously untreated patients with follicular lymphoma (FL). This study aimed to report the results of a subgroup of patients in China.
Methods:
Patients were randomized to G-chemo or R-chemo. Responders received maintenance therapy for 2 years or until disease progression. The primary endpoint was investigator (INV)-assessed PFS. Secondary endpoints included the overall response rate (ORR) and complete response rate (CRR) at the end of induction chemotherapy, overall survival (OS), and safety.
Results:
Overall, 58 patients with FL were randomized to the G-chemo (n = 25) and R-chemo arms (n = 33). The INV-assessed PFS rate at 3 years was 81.8% in the G-chemo arm, vs. 70.2% in the R-chemo arm (hazard ratio 0.35; 95% confidence interval: 0.09-1.34; P = 0.1120). The INV-assessed CRRs (without positron emission tomography [PET]) in these arms were 24.0% and 21.2%, respectively, whereas the ORRs were 80.0% and 90.9%, respectively. INV-assessed CRR-PET was 52.6% in the G-chemo, vs. 60.9% in the R-chemo. Median OS was not reached in either arm. Grade 3 to 5 adverse events were more frequent in the R-chemo arm (97.0% vs. 88.0%).
Conclusions:
The results of this subgroup analysis were consistent with those of the global population, and they suggest that G-chemo has a positive benefit-risk profile in patients from China with FL.
Trial registration:
ClinicalTrials.gov, No. NCT01332968.
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腹主动脉球囊封堵术治疗胎盘早剥Weiran Zheng, Ruochong Dou, Jie Yan, Xinrui Yang, Xianlan Zhao, Dunjin Chen, Yuyan Ma, Weishe Zhang, Yiling Ding, Ling Fan 等
中华医学杂志英文版2022年 135卷 04期
DOI: 10.1097/CM9.0000000000001944
摘要
Background:
Massive bleeding is the main concern for the management of placenta percreta (PP). Intra-abdominal aortic balloon occlusion (IABO) is one method for pelvic devascularization, but the efficacy of IABO is uncertain. This study aims to investigate the outcomes of IABO in PP patients.
Methods:
We retrospectively reviewed the clinical data of PP cases from six tertiary centers in China between January 2011 and December 2015. PP cases with/without the use of IABO were analyzed. Propensity score matching analysis was performed to reduce the effect of selection bias. Postpartum hemorrhage (PPH) and the rate of hysterectomy, as well as neonatal outcomes, were analyzed.
Results:
One hundred and thirty-two matched pairs of patients were included in the final analysis. Compared with the control group, maternal outcomes, including PPH (68.9% vs. 87.9%, χ2= 13.984, P < 0.001), hysterectomy (8.3% vs. 65.2%, χ2= 91.672, P < 0.001), and repeated surgery (1.5% vs. 12.1%, χ2 = 11.686, P= 0.001) were significantly reduced in the IABO group. For neonatal outcomes, Apgar scores at 1 minute (8.67 ± 1.79 vs. 8.53 ± 1.68, t=-0.638, P= 0.947) and 5 minutes (9.43 ± 1.55 vs. 9.53 ± 1.26, t = 0.566, P = 0.293) were not significantly different between the two groups.
Conclusions:
IABO can significantly reduce blood loss, hysterectomies, and repeated surgeries. This procedure has not shown harmful effects on neonatal outcomes.
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双孔段通道2的缺乏通过调节细胞凋亡和细胞周期导致系统性红斑狼疮Keke Li, Jingkai Xu, Ke Xue, Ruixing Yu, Chengxu Li, Wenmin Fei, Xiaoli Ning, Yang Han, Ziyi Wang, Jun Shu 等
中华医学杂志英文版2022年 135卷 04期
DOI: 10.1097/CM9.0000000000001893
摘要
Background:
Systemic lupus erythematosus (SLE) is a complex autoimmune disease, and the mechanism of SLE is yet to be fully elucidated. The aim of this study was to explore the role of two-pore segment channel 2 (TPCN2) in SLE pathogenesis.
Methods:
Quantitative reverse transcription polymerase chain reaction (qRT-PCR) was used to detect the expression of TPCN2 in SLE. We performed a loss-of-function assay by lentiviral construct in Jurkat and THP-1 cell. Knockdown of TPCN2 were confirmed at the RNA level by qRT-PCR and protein level by Western blotting. Cell Count Kit-8 and flow cytometry were used to analyze the cell proliferation, apoptosis, and cell cycle of TPCN2-deficient cells. In addition, gene expression profile of TPCN2-deficient cells was analyzed by RNA sequencing (RNA-seq).
Results:
TPCN2 knockdown with short hairpin RNA (shRNA)-mediated lentiviruses inhibited cell proliferation, and induced apoptosis and cell-cycle arrest of G2/M phase in both Jurkat and THP-1 cells. We analyzed the transcriptome of knockdown- TPCN2-Jurkat cells, and screened the differential genes, which were enriched for the G2/M checkpoint, complement, and interleukin-6-Janus kinase-signal transducer and activator of transcription pathways, as well as changes in levels of forkhead box O, phosphatidylinositol 3-kinase/protein kinase B/mechanistic target of rapamycin, and T cell receptor pathways; moreover, TPCN2 significantly influenced cellular processes and biological regulation.
Conclusion:
TPCN2 might be a potential protective factor against SLE.
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蟾蜍灵通过EGFR途径抑制卵巢癌细胞增殖Lei Dou, Dan Zou, Feiran Song, Yuxin Jin, Yin Li, Yi Zhang
中华医学杂志英文版2022年 135卷 04期
DOI: 10.1097/CM9.0000000000001879
摘要
Background:
Previous studies have shown that bufalin exerts antitumor effects through various mechanisms. This study aimed to determine the antineoplastic mechanism of bufalin, an extract of traditional Chinese medicine toad venom, in ovarian cancer.
Methods:
The 3-(4,5-Dimethyl-2-thiazolyl)-2,5-diphenyl tetrazolium bromide (MTT), 5-ethynyl-2′-deoxyuridine (EdU), and colony formation assays were used to investigate the antiproliferative effect of bufalin on the ovarian cancer cell line SK-OV-3. Molecular docking was used to investigate the combination of bufalin and epidermal growth factor receptor (EGFR) protein. Western blotting was performed to detect the expression of EGFR protein and its downstream targets.
Results:
Bufalin inhibited the proliferation of SK-OV-3 cells in a dose- and time-dependent manner. Bufalin was confirmed to combine with EGFR protein using molecular docking and downregulate expression of EGFR. Bufalin inhibited phosphorylation of EGFR, protein kinase B (AKT), and extracellular signal-regulated kinase (ERK).
Conclusion:
Bufalin suppresses the proliferation of ovarian cancer cells through the EGFR/AKT/ERK signaling pathway.
Clinical Observation
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慢性阻塞性肺疾病严重恶化患者血嗜酸性粒细胞计数与细菌感染及临床预后的关系Fei Wang, Luoman Yang, Meng Wang, Bei He
中华医学杂志英文版2022年 135卷 04期
DOI: 10.1097/CM9.0000000000001690
摘要
慢性阻塞性肺疾病急性加重（AECOPD）的适当管理非常重要，因为这种加重会对患者的健康状况、疾病进展和死亡率产生负面影响。恶化发作主要由病毒和细菌感染引发，一项研究显示55%的AECOPD住院患者有细菌感染。[
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免疫球蛋白G4相关疾病复发与非复发患者病理表现的比较Hui Lu, Shan Wang, Mu Wang, Xiaowei Liu, Linyi Peng, Jiaxin Zhou, Jieqiong Li, Zheng Liu, Xuan Luo, Yu Peng 等
中华医学杂志英文版2022年 135卷 04期
DOI: 10.1097/CM9.0000000000001713
摘要
免疫球蛋白（Ig）G4相关疾病（IgG4-RD）是一种免疫介导的纤维炎性疾病，其特征是血清IgG4水平升高和多器官受累。IgG4-RD的特征性组织学发现是致密的淋巴浆细胞浸润、纤维化和浸润受影响组织的大量IgG4阳性浆细胞。[
Technical Note
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远外侧入路椎动脉周围脂肪垫引导下由外侧向内侧显露椎动脉Jiuhong Li, Linlin Song, Zhigang Lan, Wenke Liu, Yuekang Zhang, Xuhui Hui, Jianguo Xu, Xuesong Liu
中华医学杂志英文版2022年 135卷 04期
DOI: 10.1097/CM9.0000000000001947
摘要
远外侧入路（FLA）及其改良入路是手术切除位于枕骨大孔腹侧或腹外侧病变的基本手术入路。[
Correspondence
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中国类风湿性关节炎患者报告结局的系统综述和荟萃分析Heng Cao, Lijuan Yin, Ye Yu, Lihuan Yue, Lujing Zhan, Xin Liu, Wei Deng, Chen Liang, Jin Lin
中华医学杂志英文版2022年 135卷 04期
DOI: 10.1097/CM9.0000000000001582
摘要
致编辑：类风湿性关节炎（RA）是一种慢性自身免疫性疾病，不仅以关节症状为特征，还以关节外和全身表现为特征。[
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肥胖对膝骨关节炎影响的关键基因的鉴定Siming Dai, Juan Zhang, Xiaoying Zhu, Yuxuan Lin, Ying Cui, Zhiyi Zhang, Zhiguo Lin
中华医学杂志英文版2022年 135卷 04期
DOI: 10.1097/CM9.0000000000001670
摘要
致编辑：骨关节炎(OA)是一种与高发病率和高残疾相关的疾病。肥胖，通常测量为体重指数(BMI)≥30 kg/m2，是OA及其相关并发症发病的众所周知的危险因素。[
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SOX2杂合突变导致男孩多种眼外表型Yi Wang, Lijun Fan, Xiaoya Ren, Yanning Song, Beibei Zhang, Chunxiu Gong
中华医学杂志英文版2022年 135卷 04期
DOI: 10.1097/CM9.0000000000001805
摘要
致编辑：SRY相关的高迁移率群盒蛋白-2（SOX2）最显著地在眼睛，基板，前脑和下丘脑-垂体中表达，并参与早期胚胎发育。[
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中国人数字比对接触热诱发电位的影响Bo Sun, Hongfen Wang, Zhengqing He, Xusheng Huang, Zhaohui Chen, Fei Yang
中华医学杂志英文版2022年 135卷 04期
DOI: 10.1097/CM9.0000000000001868
摘要
致编辑：接触热诱发电位（CHEPs）已成为小纤维神经病变的重要电生理诊断方法，[
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免疫球蛋白G受体IIa的Fc片段（FCGR2A）作为食管鳞状细胞癌新的潜在预后生物标志物Sifen Lu, Nan Li, Zhiqiang Peng, Zuhong Lu, Xingyue Tu, Wengeng Zhang, Yulin Kang
中华医学杂志英文版2022年 135卷 04期
DOI: 10.1097/CM9.0000000000001776
摘要
致编辑：食管鳞状细胞癌（ESCC）是最具侵袭性的癌症类型之一，给人类健康带来沉重负担。ESCC的早期诊断和预后监测对治疗具有重要意义。尽管最近ESCC的治疗方案取得了进展，但ESCC的预后仍然很差。[
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基于中国434例食管闭锁大体分类的详细校正Shen Yang, Ruizhe Yang, Xiaofan Ma, Shuangfeng Yang, Yun Peng, Qiang Tao, Kuai Chen, Junfeng Tao, Yanan Zhang, Jingbin Du 等
中华医学杂志英文版2022年 135卷 04期
DOI: 10.1097/CM9.0000000000001673
摘要
致编辑：食管闭锁（EA）是最常见的先天性食管异常。在70%至90%的出生时患有EA的患者中，同时发生气管食管瘘（TEF）。自沃格特以来[
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一磷酸腺苷活化蛋白激酶(AMPK)在肾脏中的作用Na Zhu, Min Han
中华医学杂志英文版2022年 135卷 04期
DOI: 10.1097/CM9.0000000000001831
摘要
致编辑：肾脏是一个高耗能器官，如果能量供应障碍，就容易受损。一磷酸腺苷（AMP）活化蛋白激酶（AMPK）是一种丝氨酸/苏氨酸激酶，在代谢、自噬、炎症和线粒体稳态中起关键作用。AMPK作为能量传感器参与肾脏的生理和病理过程。
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憩室炎致乙状结肠瘘Jeonghun Lee, Young Joo Lee, Youngsun Kim
中华医学杂志英文版2022年 135卷 04期
DOI: 10.1097/CM9.0000000000001753
摘要
致编辑：憩室病在世界范围内很常见，随着年龄的增长，该病的发病率增加。复杂性憩室炎是严重的，包括脓肿、瘘管、梗阻和腹膜炎。最终，对有症状并发症的患者建议进行手术治疗。其中，憩室炎引起的结肠瘘是罕见的发现，尤其是乙状结肠瘘是一种极其罕见的并发症。本报告描述一例憩室炎引起的乙状结肠-乙状结肠瘘。该病例的结果可能有助于医生认识到，治疗并发瘘管的憩室炎需要多学科管理和手术。
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混合弓修复术治疗DeBakey I型主动脉夹层的中期结果Liang Zhang, Zhan Peng, Cuntao Yu, Xiubin Yang, Juntao Qiu, De Wang
中华医学杂志英文版2022年 135卷 04期
DOI: 10.1097/CM9.0000000000001556
摘要
致编辑：全主动脉弓置换术（TAR）是一种与显著围手术期风险相关的外科手术，导致较高的死亡率和神经系统并发症。升主动脉或半弓置换术与不太复杂的手术相关，可用于有效切除近端内膜撕裂，并有可能提高这些患者的生存率。[
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低风险地区基于PCR筛查新型冠状病毒感染的低成本高效10合1检测Xiaosong Qin, Peng Gao, Zhijie Zhang, Zhijian Bo, Shijun Li, Mei Yang, Jianhua Liu, Lina Wu, Ting Li, Zuowei Zhao 等
中华医学杂志英文版2022年 135卷 04期
DOI: 10.1097/CM9.0000000000001627
摘要
致编辑：截至2020年8月9日，严重急性呼吸系统综合症冠状病毒2（新型冠状病毒）在全球已感染19,432,244人，导致721,594人死亡。为及时识别感染者，已对武汉、北京和新疆等已知有冠状病毒疾病19（COVID-19）病例的地区的高感染风险人群进行了核酸检测筛查。感染患者的快速识别和隔离措施的实施对于预防新型冠状病毒的传播具有重要作用。然而，存在一些与这种病毒的大规模筛查相关的问题。标本采集和检测的设备和试剂消耗高，导致筛查成本升高。而且，随着样本采集量的增加，医疗机构的检测能力已经达到饱和点，阻碍了大规模筛查的速度和范围。因此，在许多地区提出了RNA提取后(在从多个患者提取的核酸的混合物中检测)或RNA提取前(在核酸提取前从不同患者获得的咽拭子转移缓冲液的混合物中检测)的混合检测。[
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