MedNexus
2022年 · 第135卷第05期
出版日期 2022-03-05电子版 ￥0.00元
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Editorial
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为了人民的健康——纪念135th成立周年中华医学杂志Daqing Zhang
中华医学杂志英文版2022年 135卷 05期
DOI: 10.1097/CM9.0000000000002134
摘要
这一年（2022年）标志着135th成立周年中华医学杂志.135年来，该刊见证了中国人民健康状况的巨大变化，见证了现代医学技术在增进健康、减少疾病、延长寿命方面的重要作用，见证了医疗卫生服务和社会保障体系的不断完善。
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中国孕妇HBV感染的预防、控制和管理：从生命周期的角度Jue Liu, Min Liu
中华医学杂志英文版2022年 135卷 05期
DOI: 10.1097/CM9.0000000000002040
摘要
乙型肝炎病毒（HBV）感染是一个全球性的公共卫生问题，在世界范围内造成高疾病负担。[
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超越白细胞介素-17靶向治疗：环境-遗传学-免疫学的复杂性需要解决Xin Wu, Huji Xu, Chen Dong
中华医学杂志英文版2022年 135卷 05期
DOI: 10.1097/CM9.0000000000002072
摘要
强直性脊柱炎（AS）是脊柱关节炎（SpA）的原型，具有脊柱的长期关节炎症。SpA表现还包括银屑病、葡萄膜炎和炎症性肠病，这表明这些疾病可能有一些共同的遗传背景。
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世界卫生组织2021年空气质量指南：对中国空气污染控制和气候目标的影响Haidong Kan
中华医学杂志英文版2022年 135卷 05期
DOI: 10.1097/CM9.0000000000002014
摘要
空气污染是对人类健康最大的环境威胁之一。2005年，世界卫生组织（WHO）发布了第一个针对颗粒物（PM）、臭氧（O3）、二氧化氮（否2)和二氧化硫。[
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生命早期1000天：预防成人疾病的机会Juan Juan, Huixia Yang
中华医学杂志英文版2022年 135卷 05期
DOI: 10.1097/CM9.0000000000001920
摘要
随着社会经济的快速发展、生活水平的提高和生活方式的改变，成人疾病，如心血管疾病、2型糖尿病(T2DM)、高血压、肥胖症等在过去几十年中急剧增加，这在中国人口和个人层面都造成了巨大的经济和健康负担。[
Review Article
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气道上皮屏障功能障碍在哮喘2型炎症中的作用及治疗意义Xiang Dong, Mei Ding, Jinjin Zhang, Ismail Ogülür, Yagiz Pat, Mübeccel Akdis, Yadong Gao, Cezmi A. Akdis
中华医学杂志英文版2022年 135卷 05期
DOI: 10.1097/CM9.0000000000001983
摘要
Type 2 inflammation is a complex immune response and primary mechanism for several common allergic diseases including allergic rhinitis, allergic asthma, atopic dermatitis, and chronic rhinosinusitis with nasal polyps. It is the predominant type of immune response against helminths to prevent their tissue infiltration and induce their expulsion. Recent studies suggest that epithelial barrier dysfunction contributes to the development of type 2 inflammation in asthma, which may partly explain the increasing prevalence of asthma in China and around the globe. The epithelial barrier hypothesis has recently been proposed and has received great interest from the scientific community. The development of leaky epithelial barriers leads to microbial dysbiosis and the translocation of bacteria to inter- and sub-epithelial areas and the development of epithelial tissue inflammation. Accordingly, preventing the impairment and promoting the restoration of a deteriorated airway epithelial barrier represents a promising strategy for the treatment of asthma. This review introduces the interaction between type 2 inflammation and the airway epithelial barrier in asthma, the structure and molecular composition of the airway epithelial barrier, and the assessment of epithelial barrier integrity. The role of airway epithelial barrier disruption in the pathogenesis of asthma will be discussed. In addition, the possible mechanisms underlying the airway epithelial barrier dysfunction induced by allergens and environmental pollutants, and current treatments to restore the airway epithelial barrier are reviewed.
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非酒精性脂肪性肝病的无创检查Guanlin Li, Xinrong Zhang, Huapeng Lin, Lilian Yan Liang, Grace Lai-Hung Wong, Vincent Wai-Sun Wong
中华医学杂志英文版2022年 135卷 05期
DOI: 10.1097/CM9.0000000000002027
摘要
For the detection of steatosis, quantitative ultrasound imaging techniques have achieved great progress in past years. Magnetic resonance imaging proton density fat fraction is currently the most accurate test to detect hepatic steatosis. Some blood biomarkers correlate with non-alcoholic steatohepatitis, but the accuracy is modest. Regarding liver fibrosis, liver stiffness measurement by transient elastography (TE) has high accuracy and is widely used across the world. Magnetic resonance elastography is marginally better than TE but is limited by its cost and availability. Several blood biomarkers of fibrosis have been used in clinical trials and hold promise for selecting patients for treatment and monitoring treatment response. This article reviews new developments in the non-invasive assessment of non-alcoholic fatty liver disease (NAFLD). Accumulating evidence suggests that various non-invasive tests can be used to diagnose NAFLD, assess its severity, and predict the prognosis. Further studies are needed to determine the role of the tests as monitoring tools. We cannot overemphasize the importance of context in selecting appropriate tests.
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从MAFLD到肝细胞癌以及介于两者之间的一切Sarah Da Won Bae, Jacob George, Liang Qiao
中华医学杂志英文版2022年 135卷 05期
DOI: 10.1097/CM9.0000000000002089
摘要
Metabolic (dysfunction) associated fatty liver disease (MAFLD), previously known as non-alcoholic fatty liver disease, is the most common cause of chronic liver disease worldwide. Many risk factors contribute to the pathogenesis of MAFLD with metabolic dysregulation being the final arbiter of its development and progression. MAFLD poses a substantial economic burden to societies, which based on current trends is expected to increase over time. Numerous studies have addressed various aspects of MAFLD from its risk associations to its economic and social burden and clinical diagnosis and management, as well as the molecular mechanisms linking MAFLD to end-stage liver disease and hepatocellular carcinoma. This review summarizes current understanding of the pathogenesis of MAFLD and related diseases, particularly liver cancer. Potential therapeutic agents for MAFLD and diagnostic biomarkers are discussed.
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心血管疾病中的蛋白激酶Jiawen Chen, Yafei Li, Chong Du, Tianwen Wei, Tiankai Shan, Liansheng Wang
中华医学杂志英文版2022年 135卷 05期
DOI: 10.1097/CM9.0000000000001870
摘要
Cardiovascular disease (CVD) remains the leading cause of death worldwide. Therefore, exploring the mechanism of CVDs and critical regulatory factors is of great significance for promoting heart repair, reversing cardiac remodeling, and reducing adverse cardiovascular events. Recently, significant progress has been made in understanding the function of protein kinases and their interactions with other regulatory proteins in myocardial biology. Protein kinases are positioned as critical regulators at the intersection of multiple signals and coordinate nearly every aspect of myocardial responses, regulating contractility, metabolism, transcription, and cellular death. Equally, reconstructing the disrupted protein kinases regulatory network will help reverse pathological progress and stimulate cardiac repair. This review summarizes recent researches concerning the function of protein kinases in CVDs, discusses their promising clinical applications, and explores potential targets for future treatments.
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慢性乙型肝炎抗病毒新药研究进展Yanhua Tang, Hongyan Liang, Ge Zeng, Sheng Shen, Jian Sun
中华医学杂志英文版2022年 135卷 05期
DOI: 10.1097/CM9.0000000000001994
摘要
Chronic hepatitis B virus (HBV) infection remains a global health burden. Timely and effective antiviral therapy is beneficial for patients with HBV infection. With existing antiviral drugs, including nucleos(t)ide analogs and interferon-alfa, patients can achieve viral suppression with improved prognosis. However, the rate of hepatitis B surface antigen loss is low. To achieve a functional cure and even complete cure in chronic hepatitis B patients, new antivirals need to be developed. In this review, we summarized the advantages and disadvantages of existing antiviral drugs and focused on new antivirals including direct-acting antiviral drugs and immunotherapeutic approaches.
Original Article
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2022年中国和美国癌症统计：概况、趋势和决定因素Changfa Xia, Xuesi Dong, He Li, Maomao Cao, Dianqin Sun, Siyi He, Fan Yang, Xinxin Yan, Shaoli Zhang, Ni Li 等
中华医学杂志英文版2022年 135卷 05期
DOI: 10.1097/CM9.0000000000002108
摘要
Background:
The cancer burden in the United States of America (USA) has decreased gradually. However, China is experiencing a transition in its cancer profiles, with greater incidence of cancers that were previously more common in the USA. This study compared the latest cancer profiles, trends, and determinants between China and USA.
Methods:
This was a comparative study using open-source data. Cancer cases and deaths in 2022 were calculated using cancer estimates from GLOBOCAN 2020 and population estimates from the United Nations. Trends in cancer incidence and mortality rates in the USA used data from the Surveillance, Epidemiology, and End Results program and National Center for Health Statistics. Chinese data were obtained from cancer registry reports. Data from the Global Burden of Disease 2019 and a decomposition method were used to express cancer deaths as the product of four determinant factors.
Results:
In 2022, there will be approximately 4,820,000 and 2,370,000 new cancer cases, and 3,210,000 and 640,000 cancer deaths in China and the USA, respectively. The most common cancers are lung cancer in China and breast cancer in the USA, and lung cancer is the leading cause of cancer death in both. Age-standardized incidence and mortality rates for lung cancer and colorectal cancer in the USA have decreased significantly recently, but rates of liver cancer have increased slightly. Rates of stomach, liver, and esophageal cancer decreased gradually in China, but rates have increased for colorectal cancer in the whole population, prostate cancer in men, and other seven cancer types in women. Increases in adult population size and population aging were major determinants for incremental cancer deaths, and case-fatality rates contributed to reduced cancer deaths in both countries.
Conclusions:
The decreasing cancer burden in liver, stomach, and esophagus, and increasing burden in lung, colorectum, breast, and prostate, mean that cancer profiles in China and the USA are converging. Population aging is a growing determinant of incremental cancer burden. Progress in cancer prevention and care in the USA, and measures to actively respond to population aging, may help China to reduce the cancer burden.
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颅内大动脉狭窄导致的慢性低灌注与脑β-淀粉样蛋白沉积和脑萎缩无关Dongyu Fan, Huiyun Li, Dongwan Chen, Yang Chen, Xu Yi, Heng Yang, Qianqian Shi, Fangyang Jiao, Yi Tang, Qiming Li 等
中华医学杂志英文版2022年 135卷 05期
DOI: 10.1097/CM9.0000000000001918
摘要
Background:
Insufficient cerebral perfusion is suggested to play a role in the development of Alzheimer disease (AD). However, there is a lack of direct evidence indicating whether hypoperfusion causes or aggravates AD pathology. We investigated the effect of chronic cerebral hypoperfusion on AD-related pathology in humans.
Methods:
We enrolled a group of cognitively normal patients (median age: 64 years) with unilateral chronic cerebral hypoperfusion. Regions of interest with the most pronounced hypoperfusion changes were chosen in the hypoperfused region and were then mirrored in the contralateral hemisphere to create a control region with normal perfusion. 11C-Pittsburgh compound-positron emission tomography standard uptake ratios and brain atrophy indices were calculated from the computed tomography images of each patient.
Results:
The median age of the 10 participants, consisting of 4 males and 6 females, was 64 years (47-76 years). We found that there were no differences in standard uptake ratios of the cortex (volume of interest [VOI]: P = 0.721, region of interest [ROI]: P = 0.241) and grey/white ratio (VOI: P = 0.333, ROI: P = 0.445) and brain atrophy indices (Bicaudate, Bifrontal, Evans, Cella, Cella media, and Ventricular index, P > 0.05) between the hypoperfused regions and contralateral normally perfused regions in patients with unilateral chronic cerebral hypoperfusion.
Conclusion:
Our findings suggest that chronic hypoperfusion due to large vessel stenosis may not directly induce cerebral β-amyloid deposition and neurodegeneration in humans.
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强化光疗vs.换血治疗新生儿高胆红素血症：一项多中心回顾性队列研究Meng Zhang, Yang He, Jun Tang, Wenbin Dong, Yong Zhang, Benjin Zhang, Hong Wan, Quanmin Deng, Lirong Guan, Bin Xia 等
中华医学杂志英文版2022年 135卷 05期
DOI: 10.1097/CM9.0000000000001962
摘要
Background:
Intensive phototherapy (IPT) and exchange transfusion (ET) are the main treatments for extreme hyperbilirubinemia. However, there is no reliable evidence on determining the thresholds for these treatments. This multicenter study compared the effectiveness and complications of IPT and ET in the treatment of extreme hyperbilirubinemia.
Methods:
This retrospective cohort study was conducted in seven centers from January 2015 to January 2018. Patients with extreme hyperbilirubinemia that met the criteria of ET were included. Patients were divided into three subgroups (low-, medium-, and high-risk) according to gestational week and risk factors. Propensity score matching (PSM) was performed to balance the data before treatment. Study outcomes included the development of bilirubin encephalopathy, duration of hospitalization, expenses, and complications. Mortality, auditory complications, seizures, enamel dysplasia, ocular motility disorders, athetosis, motor, and language development were evaluated during follow-up at age of 3 years.
Results:
A total of 1164 patients were included in this study. After PSM, 296 patients in the IPT only group and 296 patients in the IPT plus ET group were further divided into the low-, medium-, and high-risk subgroups with 188, 364, and 40 matched patients, respectively. No significant differences were found between the IPT only and IPT plus ET groups in terms of morbidity, complications, and sequelae. Hospitalization duration and expenses were lower in the low- and medium-risk subgroups in the IPT only group.
Conclusions:
In this study, our results suggest that IPT is a safe and effective treatment for extreme hyperbilirubinemia. The indication of ET for patients with hyperbilirubinemia could be stricter. However, it is necessary to have a contingency plan for emergency ET as soon as IPT is commenced especially for infants with risk factors. If IPT can be guaranteed and proved to be therapeutic, ET should be avoided as much as possible.
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配对盒5通过促进p53信号活性增加食管鳞癌细胞的化疗敏感性Weiwei Zhang, Wenji Yan, Niansong Qian, Quanli Han, Weitao Zhang, Guanghai Dai
中华医学杂志英文版2022年 135卷 05期
DOI: 10.1097/CM9.0000000000002018
摘要
Background:
Gene promoter methylation is a major epigenetic change in cancers, which plays critical roles in carcinogenesis. As a crucial regulator in the early stages of B-cell differentiation and embryonic neurodevelopment, the paired box 5 (PAX5) gene is downregulated by methylation in several kinds of tumors and the role of this downregulation in esophageal squamous cell carcinoma (ESCC) pathogenesis remains unclear.
Methods:
To elucidate the role of PAX5 in ESCC, eight ESCC cell lines, 51 primary ESCC tissue samples, and eight normal esophageal mucosa samples were studied and The Cancer Genome Atlas (TCGA) was queried. PAX5 expression was examined by reverse transcription-polymerase chain reaction and western blotting. Cell apoptosis, proliferation, and chemosensitivity were detected by flow cytometry, colony formation assays, and 3-(4,5-dimethyl-2-thiazolyl)-2,5-diphenyl-2-H-tetrazolium bromide assays in ESCC cell lines with PAX5 overexpression or silencing. Tumor xenograft models were established for in vivo verification.
Results:
PAX5 methylation was found in 37.3% (19/51) of primary ESCC samples, which was significantly associated with age (P = 0.007) and tumor-node-metastasis stage (P = 0.014). TCGA data analysis indicated that PAX5 expression was inversely correlated with promoter region methylation (r = -0.189, P = 0.011 for cg00464519 and r = -0.228, P = 0.002 for cg02538199). Restoration of PAX5 expression suppressed cell proliferation, promoted apoptosis, and inhibited tumor growth of ESCC cell lines, which was verified in xenografted mice. Ectopic PAX5 expression significantly increased p53 reporter luciferase activity and increased p53 messenger RNA and protein levels. A direct interaction of PAX5 with the p53 promoter region was confirmed by chromatin immunoprecipitation assays. Re-expression of PAX5 sensitized ESCC cell lines KYSE150 and KYSE30 to fluorouracil and docetaxel. Silencing of PAX5 induced resistance of KYSE450 cells to these drugs.
Conclusions:
As a tumor suppressor gene regulated by promoter region methylation in human ESCC, PAX5 inhibits proliferation, promotes apoptosis, and induces activation of p53 signaling. PAX5 may serve as a chemosensitive marker of ESCC.
Clinical Observation
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下肢旋转对全膝关节置换术后长腿X线冠状位测量准确性的影响Mieralimu Muertizha, Baochao Ji, Abudousaimi Aimaiti, Nueralijiang Yushan, Li Cao
中华医学杂志英文版2022年 135卷 05期
DOI: 10.1097/CM9.0000000000001982
摘要
全膝关节置换术（TKA）后在冠状面上恢复正确的下肢对齐可以减少骨水泥—植入物界面的应力、聚乙烯磨损和植入物松动。负重长腿X线片（LLR）用于评估冠状面的机械轴，识别股骨和胫骨的解剖变异，并在术前计划骨切除程度。然而，下肢的旋转或屈曲可能影响来自LLR的对准参数测量的准确性。此外，已知的旋转相关线性变化可用于将下肢旋转程度与股骨和胫骨的对准参数以及髋-膝-踝(HKA)角度相关联。[
Correspondence
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固体燃料或烟草烟雾引起的慢性气流阻塞患者的特征Huanyu Long, Zhenzhen Xing, Di Chai, Weiming Liu, Yaqi Tong, Yuxia Wang, Yali Ma, Mingming Pan, Jia Cui, Yanfei Guo
中华医学杂志英文版2022年 135卷 05期
DOI: 10.1097/CM9.0000000000002009
摘要
致编辑：慢性气流阻塞(CAO)是慢性阻塞性肺疾病(COPD)的特征，并且由于通常与暴露于有害颗粒或气体相关的气道和/或肺泡异常而发生。[
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新生儿重症监护病房人群中遗传病的高危表型Tiantian Xiao, Qi Ni, Huiyao Chen, Huijun Wang, Lin Yang, Bingbing Wu, Yun Cao, Guoqiang Cheng, Laishuan Wang, Liyuan Hu 等
中华医学杂志英文版2022年 135卷 05期
DOI: 10.1097/CM9.0000000000001959
摘要
致编辑：遗传疾病导致生命第一年死亡的35%，并且是重症监护的重要原因。[
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延胡索乙素通过抑制肝星状细胞内质网应激减轻肝纤维化Yuanyuan Xuan, Shiyun Chen, Xin Ding, Lexun Wang, Shengwen Li, Guizhi Yang, Tian Lan
中华医学杂志英文版2022年 135卷 05期
DOI: 10.1097/CM9.0000000000001883
摘要
致编辑：肝纤维化的特征是肝星状细胞（HSC）的活化和细胞外基质沉积。肝纤维化的发病机制涉及多方面。研究发现，HSC中的内质网应激（ERS）可导致HSC活化，加重肝纤维化。[
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