MedNexus
2022年 · 第135卷第06期
出版日期 2022-03-20电子版 ￥0.00元
MedNexus
- 全部
- Consensus Statement
- Review Article
- Meta Analysis
- Original Article
- Technical Notes
- Correspondence
- Corrigendum
Consensus Statement
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基于人工智能注释的上腹部磁共振图像的身体成分评估临床实践指南Han Lv, Mengyi Li, Zhenchang Wang, Dawei Yang, Hui Xu, Juan Li, Yang Liu, Di Cao, Yawen Liu, Xinru Wu 等
中华医学杂志英文版2022年 135卷 06期
DOI: 10.1097/CM9.0000000000002002
摘要
上腹部磁共振（MR）成像适用于身体成分分析。[
Review Article
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幽门螺杆菌可能通过调节肠道微生物群参与炎症性肠病的发展Xiaoyin Bai, Lingjuan Jiang, Gechong Ruan, Tingting Liu, Hong Yang
中华医学杂志英文版2022年 135卷 06期
DOI: 10.1097/CM9.0000000000002008
摘要
Inflammatory bowel disease (IBD) is a non-specific inflammatory disease of the gastrointestinal (GI) tract that is generally accepted to be closely related to intestinal dysbiosis in the host. GI infections contribute a key role in the pathogenesis of IBD; however, although the results of recent clinical studies have revealed an inverse correlation between Helicobacter pylori (H. pylori) infection and IBD, the exact mechanism underlying the development of IBD remains unclear. H. pylori, as a star microorganism, has been a focus for decades, and recent preclinical and real-world studies have demonstrated that H. pylori not only affects the changes in the gastric microbiota and microenvironment but also influences the intestinal microbiota, indicating a potential correlation with IBD. Detailed analysis revealed that H. pylori infection increased the diversity of the intestinal microbiota, reduced the abundance of Bacteroidetes, augmented the abundance of Firmicutes, and produced short-chain fatty acid-producing bacteria such as Akkermansia. All these factors may decrease vulnerability to IBD. Further studies investigating the H. pylori-intestinal microbiota metabolite axis should be performed to understand the mechanism underlying the development of IBD.
Meta Analysis
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通过血浆肾素活性或血浆肾素浓度计算的醛固酮与肾素比值在原发性醛固酮增多症中的诊断价值：一项荟萃分析Zhenjie Liu, Xiaohong Deng, Li Luo, Shaopeng Li, Man Li, Qinqin Deng, Weiguo Zhong, Qiang Luo
中华医学杂志英文版2022年 135卷 06期
DOI: 10.1097/CM9.0000000000001906
摘要
Background:
Since the diagnostic value of aldosterone to renin ratio (ARR) calculated by plasma renin concentration (PRC) or plasma renin activity (PRA) is still inconclusive, we conducted a meta-analysis by systematically reviewing relevant literature to explore the difference in the diagnostic efficacy of ARR calculated by PRC or PRA, so as to provide guidance for clinical diagnosis.
Methods:
We searched PubMed, Embase, and Cochrane Library from the establishment of the database to March 2021. We included studies that report the true positive, false positive, true negative, and false negative values for the diagnosis of primary aldosteronism, and we excluded duplicate publications, research without full text, incomplete information, or inability to conduct data extraction, animal experiments, reviews, and systematic reviews. STATA 15.1 was used to analyze the data.
Results:
The pooled results showed that ARR (plasma aldosterone concentration [PAC]/PRC) had a sensitivity of 0.82 (95% confidence interval [CI]: 0.78-0.86), a specificity of 0.94 (95% CI: 0.92-0.95), a positive-likelihood ratio (LR) of 12.77 (95% CI: 7.04-23.73), a negative LR of 0.11 (95% CI: 0.07-0.17), and symmetric area under the curve (SAUC) of 0.982, respectively. Furthermore, the diagnostic odds ratio (DOR) of ARR (PAC/PRC) was 180.21. Additionally, the pooled results showed that ARR (PAC/PRA) had a sensitivity of 0.91 (95% CI: 0.86-0.95), a specificity of 0.91 (95% CI: 0.90-0.93), a positive LR of 7.30 (95% CI: 2.99-17.99), a negative LR of 0.10 (95% CI: 0.04-0.26), and SAUC of 0.976, respectively. The DOR of ARR (PAC/PRA) was 155.52. Additionally, we conducted a subgroup analysis for the different thresholds (<35 or ≥35) of PAC/PRC. The results showed that the DOR of the cut-off ≥35 groups was higher than the cut-off <35 groups (DOR = 340.15, 95% CI: 38.32-3019.66; DOR= 116.40, 95% CI = 23.28-581.92).
Conclusions:
The research results suggest that the determination of ARR (PAC/PRC) and ARR (PAC/PRA) was all effective screening tools for PA. The diagnostic accuracy and diagnostic value of ARR (PAC/PRC) are higher than ARR (PAC/PRA). In addition, within a certain range, the higher the threshold, the better the diagnostic value.
Original Article
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50万中国成年人的多病模式及其与死亡率的关系Junning Fan, Zhijia Sun, Canqing Yu, Yu Guo, Pei Pei, Ling Yang, Yiping Chen, Huaidong Du, Dianjianyi Sun, Yuanjie Pang 等
中华医学杂志英文版2022年 135卷 06期
DOI: 10.1097/CM9.0000000000001985
摘要
Background:
Few studies have assessed the relationship between multimorbidity patterns and mortality risk in the Chinese population. We aimed to identify multimorbidity patterns and examined the associations of multimorbidity patterns and the number of chronic diseases with the risk of mortality among Chinese middle-aged and older adults.
Methods:
We used data from the China Kadoorie Biobank and included 512,723 participants aged 30 to 79 years. Multimorbidity was defined as the presence of two or more of the 15 chronic diseases collected by self-report or physical examination at baseline. Multimorbidity patterns were identified using hierarchical cluster analysis. Cox regression was used to estimate the associations of multimorbidity patterns and the number of chronic diseases with all-cause and cause-specific mortality.
Results:
Overall, 15.8% of participants had multimorbidity. The prevalence of multimorbidity increased with age and was higher in urban than rural participants. Four multimorbidity patterns were identified, including cardiometabolic multimorbidity (diabetes, coronary heart disease, stroke, and hypertension), respiratory multimorbidity (tuberculosis, asthma, and chronic obstructive pulmonary disease), gastrointestinal and hepatorenal multimorbidity (gallstone disease, chronic kidney disease, cirrhosis, peptic ulcer, and cancer), and mental and arthritis multimorbidity (neurasthenia, psychiatric disorder, and rheumatoid arthritis). During a median of 10.8 years of follow-up, 49,371 deaths occurred. Compared with participants without multimorbidity, cardiometabolic multimorbidity (hazard ratios [HR] = 2.20, 95% confidence intervals [CI]: 2.14-2.26) and respiratory multimorbidity (HR= 2.13, 95% CI:1.97-2.31) demonstrated relatively higher risks of mortality, followed by gastrointestinal and hepatorenal multimorbidity (HR= 1.33, 95% CI:1.22-1.46). The mortality risk increased by 36% (HR= 1.36, 95% CI: 1.35-1.37) with every additional disease.
Conclusion:
Cardiometabolic multimorbidity and respiratory multimorbidity posed the highest threat on mortality risk and deserved particular attention in Chinese adults.
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抗磷脂抗体阳性患者独特队列中与血栓形成和妊娠发病率相关的其他危险因素Chun Li, Yu Zuo, Song Zhang, Una E. Makris, David R. Karp, Zhanguo Li
中华医学杂志英文版2022年 135卷 06期
DOI: 10.1097/CM9.0000000000001964
摘要
Background:
Antiphospholipid syndrome (APS) is an autoimmune prothrombotic condition with significant morbidity. The objective of this study was to identify additional clinical and epidemiological risks of arterial thrombosis, venous thrombosis, and pregnancy morbidities in a large cohort of persistent antiphospholipid antibodies (aPLs)-positive carriers.
Methods:
This was a cross-sectional cohort study of 453 consecutive patients with a documented positive aPL who attended Peking University People's Hospital. Among 453 patients screened, 297 patients had persistent positive aPL. We compared asymptomatic aPL carriers with thrombotic and obstetric APS patients. And the univariate analysis and multivariable logistic regression were used to evaluate the association between different risk factors and APS clinical manifestations. The levels of circulating markers of neutrophil extracellular traps (NETs) (cell-free DNA and citrullinated histone H3 [Cit-H3]) were assessed and compared among aPL-positive carriers with or without autoimmune disease and APS patients.
Results:
Additional risk factors associated with arterial thrombosis among aPL-positive carriers included: smoking (odds ratio [OR] = 6.137, 95% confidence interval [CI] = 2.408-15.637, P = 0.0001), hypertension (OR = 2.368, 95% CI = 1.249-4.491, P = 0.008), and the presence of underlying autoimmune disease (OR = 4.401, 95% CI = 2.387-8.113, P < 0.001). Additional risks associated with venous thrombosis among aPL carriers included: smoking (OR = 4.594, 95% CI = 1.681-12.553, P = 0.029) and the presence of underlying autoimmune disease (OR = 6.330, 95% CI = 3.355-11.940, P < 0.001). The presence of underlying autoimmune disease (OR = 3.301, 95% CI= 1.407-7.744, P = 0.006) is the additional risk, which demonstrated a significant association with APS pregnancy morbidity. Higher circulating levels of cell-free DNA and Cit-H3 were observed among APS patients and aPL patients with autoimmune diseases compared with those aPL carriers without underlying autoimmune diseases. Furthermore, control neutrophils that are conditioned with APS patients' sera have more pronounced NET release compared with those treated with aPL carriers' sera without underlying autoimmune diseases.
Conclusions:
We identified several potential additional risk factors for APS clinical manifestations among a large cohort of Chinese aPL carriers. Our data may help physicians to risk stratify aPL-positive Asian patients.
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Risk of gestational diabetes recurrence and the development of type 2 diabetes among women with a history of gestational diabetes and risk factors: a study among 18 clinical centers in ChinaYumei Wei, Juan Juan, Rina Su, Geng Song, Xu Chen, Ruiqin Shan, Ying Li, Shihong Cui, Shangrong Fan, Ling Feng 等
中华医学杂志英文版2022年 135卷 06期
DOI: 10.1097/CM9.0000000000002036
摘要
Background:
Gestational diabetes mellitus (GDM) brings health issues for both mothers and offspring, and GDM prevention is as important as GDM management. It was shown that a history of GDM was significantly associated with a higher maternal risk for GDM recurrence. The incidence of GDM recurrence was unclear because of the incidence of second-child was low before 2016 in China. We aim to investigate the prevalence of GDM recurrence and its associated high-risk factors which may be useful for the prediction of GDM recurrence in China.
Methods:
A retrospective study was conducted which enrolled participants who underwent regular prenatal examination and delivered twice in the same hospital of 18 research centers. All participants were enrolled from January 2018 to October 2018, where they delivered the second baby during this period. A total of 6204 women were enrolled in this study, and 1002 women with a history of GDM were analyzed further. All participants enrolled in the study had an oral glucose tolerance test (OGTT) result at 24 to 28 weeks and were diagnosed as GDM in the first pregnancy according to the OGTT value (when any one of the following values is met or exceeded to the 75-g OGTT: 0 h [fasting], ≥5.10 mmol/L; 1 h, ≥10.00 mmol/L; and 2 h, ≥8.50 mmol/L). The prevalence of GDM recurrence and development of type 2 diabetes mellitus were calculated, and its related risk factors were analyzed.
Results:
In 6204 participants, there are 1002 women (1002/6204, 16.15%) with a history of GDM and 5202 women (5202/6204, 83.85%) without a history of GDM. There are significant differences in age (32.43 ± 4.03 years vs. 33.00 ± 3.34 years vs. 32.19 ± 3.37 years, P < 0.001), pregnancy interval (4.06 ± 1.44 years vs. 3.52 ± 1.43 years vs. 3.38 ± 1.35 years, P = 0.004), prepregnancy body mass index (BMI) (27.40 ± 4.62 kg/m2vs. 23.50 ± 3.52 kg/m2vs. 22.55 ± 3.47 kg/m2, P < 0.001), history of delivered macrosomia (22.7% vs. 11.0% vs. 6.2%, P < 0.001) among the development of diabetes mellitus (DM), recurrence of GDM, and normal women. Moreover, it seems so important in the degree of abnormal glucose metabolism in the first pregnancy to the recurrence of GDM and the development of DM. There are significant differences in OGTT levels of the first pregnancy such as area under the curve of OGTT value (18.31 ± 1.90 mmol/L vs. 16.27 ± 1.93 mmol/L vs. 15.55 ± 1.92 mmol/L, P < 0.001), OGTT fasting value (5.43 ± 0.48 mmol/L vs. 5.16 ± 0.49 mmol/L vs. 5.02 ± 0.47 mmol/L, P < 0.001), OGTT 1-hour value (10.93 ± 1.34 mmol/L vs. 9.69 ± 1.53 mmol/L vs. 9.15 ± 1.58 mmol/L, P < 0.001), OGTT 2-hour value (9.30 ± 1.66 mmol/L vs. 8.01 ± 1.32 mmol/L vs. 7.79 ± 1.38 mmol/L, P < 0.001), incidence of impaired fasting glucose (IFG) (fasting plasma glucose ≥5.6 mmol/L) (31.3% vs. 14.6% vs. 8.8%, P < 0.001), and incidence of two or more abnormal OGTT values (68.8% vs. 39.7% vs. 23.9%, P < 0.001) among the three groups. Using multivariate analysis, the factors, such as age (1.07 [1.02-1.12], P = 0.006), prepregnancy BMI (1.07 [1.02, 1.12], P = 0.003), and area under the curve of OGTT in the first pregnancy (1.14 [1.02, 1.26], P = 0.02), have an effect on maternal GDM recurrence; the factors, such as age (1.28 [1.01-1.61], P = 0.04), pre-pregnancy BMI (1.26 [1.04, 1.53], P = 0.02), and area under the curve of OGTT in the first pregnancy (1.65 [1.04, 2.62], P = 0.03), have an effect on maternal DM developed further.
Conclusions:
The history of GDM was significantly associated with a higher maternal risk for GDM recurrence during follow-up after the first pregnancy. The associated risk factors for GDM recurrence or development of DM include age, high pre-pregnancy BMI, history of delivered macrosomia, the OGTT level in the first pregnancy, such as the high area under the curve of OGTT, IFG, and two or more abnormal OGTT values. To prevent GDM recurrence, women with a history of GDM should do the preconception counseling before preparing next pregnancy.
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不同液体量对脓毒性休克患者液体激发的血流动力学影响Ting Yang, Li Weng, Wei Jiang, Shan Li, Bin Du
中华医学杂志英文版2022年 135卷 06期
DOI: 10.1097/CM9.0000000000001919
摘要
Background:
It is still unclear what the minimal infusion volume is to effectively predict fluid responsiveness. This study was designed to explore the minimal infusion volume to effectively predict fluid responsiveness in septic shock patients. Hemodynamic effects of fluid administration on arterial load were observed and added values of effective arterial elastance (Ea) in fluid resuscitation were assessed.
Methods:
Intensive care unit septic shock patients with indwelling pulmonary artery catheter (PAC) received five sequential intravenous boluses of 100 mL 4% gelatin. Cardiac output (CO) was measured with PAC before and after each bolus. Fluid responsiveness was defined as an increase in CO >10% after 500 mL fluid infusion.
Results:
Forty-seven patients were included and 35 (74.5%) patients were fluid responders. CO increasing >5.2% after a 200 mL fluid challenge (FC) provided an improved detection of fluid responsiveness, with a specificity of 80.0% and a sensitivity of 91.7%. The area under the ROC curve (AUC) was 0.93 (95% CI: 0.84-1.00, P < 0.001). Fluid administration induced a decrease in Ea from 2.23 (1.46-2.78) mmHg/mL to 1.83 (1.34-2.44) mmHg/mL (P = 0.002), especially for fluid responders in whom arterial pressure did not increase. Notably, the baseline Ea was able to detect the fluid responsiveness with an AUC of 0.74 (95% CI: 0.59-0.86, P < 0.001), whereas Ea failed to predict the pressure response to FC with an AUC of 0.50 (95% CI: 0.33-0.67, P = 0.086).
Conclusion:
In septic shock patients, a minimal volume of 200 mL 4% gelatin could reliably detect fluid responders. Fluid administration reduced Ea even when CO increased. The loss of arterial load might be the reason for patients who increased their CO without pressure responsiveness. Moreover, a high level of Ea before FC was able to predict fluid responsiveness rather than to detect the pressure responsiveness.
Trial registration:
ClinicalTrials.gov, NCT04515511
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地诺前列酮与单球囊导管引产对临界羊水过少足月未产妇的疗效及妊娠结局的比较Yongqing Zhang, Luping Chen, Guohui Yan, Menglin Zhou, Zhengyun Chen, Zhaoxia Liang, Danqing Chen
中华医学杂志英文版2022年 135卷 06期
DOI: 10.1097/CM9.0000000000001881
摘要
Backgrounds:
At present, there is no consensus on the induction methods in term pregnancy with borderline oligohydramnios. This study aimed to compare the effectiveness and pregnancy outcomes of labor induction with dinoprostone or single-balloon catheter (SBC) in term nulliparous women with borderline oligohydramnios.
Methods:
We conducted a retrospective cohort study from January 2016 to November 2018. During the study period, a total of 244 cases were enrolled. Of these, 103 cases were selected for induction using dinoprostone and 141 cases were selected for induction with SBC. The pregnancy outcomes between the two groups were compared. Primary outcomes were successful vaginal delivery rates. Secondary outcomes were maternal and neonatal adverse events. Multivariate logistic regression was used to assess the risk factors for vaginal delivery failure in the two groups.
Results:
The successful vaginal delivery rates were similar between the dinoprostone group and the SBC group (64.1% [66/103] vs. 59.6%, [84/141] P = 0.475), even after adjustment for potential confounding factors (adjusted odds ratio [aOR]: 1.07, 95% confidence interval [CI]: 0.57-2.00, P = 0.835). The incidence of intra-amniotic infection was lower in the dinoprostone group than in the SBC group (1.9% [2/103] vs. 7.8% [11/141], P < 0.001), but the presence of non-reassuring fetal heart rate was higher in the dinoprostone group than in the SBC group (12.6% [13/103] vs. 0.7%, [1/141] P < 0.001). Multivariate logistic regression showed that nuchal cord was a risk factor for vaginal delivery failure after induction with dinoprostone (aOR: 6.71, 95% CI: 1.96-22.95). There were three factors related to vaginal delivery failure after induction with SBC, namely gestational age (aOR: 1.51, 95% CI: 1.07-2.14), body mass index (BMI) >30 kg/m2 (aOR: 2.98, 95% CI: 1.10-8.02), and fetal weight >3500 g (aOR: 2.49, 95% CI: 1.12-5.50).
Conclusions:
Term nulliparous women with borderline oligohydramnios have similar successful vaginal delivery rates after induction with dinoprostone or SBC, with their advantages and disadvantages. In women with nuchal cord, the risk of vaginal delivery failure is increased if dinoprostone is used in the induction of labor. BMI >30 kg/m2, large gestational age, and estimated fetal weight >3500 g are risk factors for vaginal delivery failure after induction with SBC.
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低分子肝素降低中度新冠肺炎患者动脉血乳酸含量并增加估计肾小球滤过率Li Ma, Yigang Zeng, Bing Zhao, Lili Xu, Jian Li, Tongyu Zhu, Enqiang Mao
中华医学杂志英文版2022年 135卷 06期
DOI: 10.1097/CM9.0000000000001923
摘要
Background:
Coronavirus disease 2019 (Covid-19) remains a serious health threat worldwide. We aimed to investigate whether low molecular weight heparin (LMWH) can promote organ function recovery in moderate Covid-19 pneumonia patients.
Methods:
We initiated an LMWH protocol in Covid-19 patients with increased D-dimer, body mass index >30 kg/m2 or a history of diabetes from January 18, 2020 at Shanghai Public Health Clinical Center. In this retrospective study, we assigned moderate Covid-19 pneumonia patients admitted between January 18th and April 18, 2020 receiving the LMWH protocol to the LMWH group. Moderate patients who met the inclusion criteria but did not receive LMWH protocol were included in the control group by 1:2 propensity score matching. General clinical information, indicators for renal function, arterial blood gas analyses, arterial blood lactic acid content (mmol/L), and coagulation indexes at 0 day, 3 days, 7 days, and 11 days after admission were recorded and compared between the two groups.
Results:
There were 41 patients in the LMWH group and 82 patients in the control group. General information in both groups were similar. Compared to the control group, the arterial blood lactic acid content (mmol/L) at day 11 (1.3 [1.1, 1.7] vs. 1.2 [0.9, 1.3], P = 0.016) was reduced in the LMWH group. The estimated glomerular filtration rate (eGFR) in the LMWH group was higher than that in the control group at day 7 (108.54 [89.11, 128.17] vs. 116.85 [103.39, 133.47], P= 0.039) and day 11 (113.74 [94.49, 126.34] vs. 128.31 [112.75, 144.12], P = 0.003). The serum creatinine levels (Scr) in the LMWH group were lower than that in the control group at day 7 (62.13 [51.47, 77.64] vs. 55.49 [49.50, 65.75], P= 0.038) and day 11 (63.35 [50.17, 75.73] vs. 51.62 [44.62, 61.24], P = 0.005).
Conclusions:
LMWH treatment can reduce arterial blood lactic acid levels and improve eGFR in moderate Covid-19 pneumonia patients. Randomized controlled trials are warranted to further investigate this issue.
Trial registration:
ChiCTR.org.cn, ChiCTR2000034796.
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中国人表皮生长因子受体2低阳性表达早期乳腺癌临床病理特征及复发风险预测模型的多中心研究（中华乳腺外科学会021）Ling Xin, Qian Wu, Chongming Zhan, Hongyan Qin, Hongyu Xiang, Ling Xu, Jingming Ye, Xuening Duan, Yinhua Liu, Chinese Society of Breast Surgery (CSBrS) 等
中华医学杂志英文版2022年 135卷 06期
DOI: 10.1097/CM9.0000000000002056
摘要
Background:
Breast cancer with low-positive human epidermal growth factor receptor 2 (HER2) expression has triggered further refinement of evaluation criteria for HER2 expression. We studied the clinicopathological features of early-stage breast cancer with low-positive HER2 expression in China and analyzed prognostic factors.
Methods:
Clinical and pathological data and prognostic information of patients with early-stage breast cancer with low-positive HER2 expression treated by the member units of the Chinese Society of Breast Surgery and Chinese Society of Surgery of Chinese Medical Association, from January 2015 to December 2016 were collected. The prognostic factors of these patients were analyzed.
Results:
Twenty-nine hospitals provided valid cases. From 2015 to 2016, a total of 25,096 cases of early-stage breast cancer were treated, 7642 (30.5%) of which had low-positive HER2 expression and were included in the study. After ineligible cases were excluded, 6486 patients were included in the study. The median follow-up time was 57 months (4-76 months). The disease-free survival rate was 92.1% at 5 years, and the overall survival rate was 97.4% at 5 years. At the follow-up, 506 (7.8%) cases of metastasis and 167 (2.6%) deaths were noted. Multivariate Cox regression analysis showed that tumor stage, lymphvascular invasion, and the Ki67 index were related to recurrence and metastasis (P < 0.05). The recurrence risk prediction model was established using a machine learning model and showed that the area under the receiving operator characteristic curve was 0.815 (95% confidence interval: 0.750-0.880).
Conclusions:
Early-stage breast cancer patients with low-positive HER2 expression account for 30.5% of all patients. Tumor stage, lymphvascular invasion, and the Ki67 index are factors affecting prognosis. The recurrence prediction model for breast cancer with low-positive HER2 expression based on a machine learning model had a good clinical reference value for predicting the recurrence risk at 5 years.
Trial registration:
ChiCTR.org.cn, ChiCTR2100046766.
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粪便移植可以通过调节肠道菌群和促进5-羟色胺分泌来减轻抽动秽语综合征小鼠模型的抽动严重程度Hua Li, Yong Wang, Changying Zhao, Jian Liu, Lei Zhang, Anyuan Li
中华医学杂志英文版2022年 135卷 06期
DOI: 10.1097/CM9.0000000000001885
摘要
Background:
Tourette syndrome (TS) is a neuropsychiatric disorder with onset in childhood that warrants effective therapies. Gut microbiota can affect central physiology and function via the microbiota-gut-brain axis. Therefore, the gut microbiota plays an important role in some mental illnesses. A small clinical trial showed that fecal microbiota transplantation (FMT) may alleviate TS symptoms in children. Herein, FMT effects and mechanisms were explored in a TS mouse model.
Methods:
TS mice model (TSMO) (n = 80) were established with 3,3＇-iminodipropionitrile, and 80 mice were used as controls. Mice were grouped into eight groups and were subjected to FMT with feces from children or mice with or without TS, or were given probiotics. Fecal specimens were collected 3 weeks after FMT. 16S rRNA sequencing, behavioral observation, and serum serotonin (5-HT) assay were performed. Differences between groups were analyzed using Mann-Whitney U test and Kolmogorov-Smirnov (KS) tests.
Results:
A total of 18 discriminative microbial signatures (linear discriminant analysis score > 3) that varied significantly between TS and healthy mice (CONH) were identified. A significant increase in Turicibacteraceae and Ruminococcaceae in TSMO after FMT was observed (P < 0.05). Compared with non-transplanted TSMO, the symptoms of those transplanted with feces from CONH were alleviated (W = 336, P = 0.046). In the probiotic and FMT experiments, the serum 5-HT levels significantly increased in TSMO that received probiotics (KS = 1.423, P = 0.035) and in those transplanted with feces from CONH (W= 336.5, P = 0.046) compared with TSMO without transplantation.
Conclusions:
This study suggests that FMT may ameliorate TS by promoting 5-HT secretion, and it provides new insights into the underlying mechanisms of FMT as a treatment for TS.
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circBIRC6通过调节microRNA-217/淀粉样β前体蛋白结合蛋白2轴参与非小细胞肺癌的发展Da Ni, Jiping Teng, Youshuang Cheng, Zhijun Zhu, Bufeng Zhuang, Zhiyin Yang
中华医学杂志英文版2022年 135卷 06期
DOI: 10.1097/CM9.0000000000001940
摘要
Background:
Circular RNAs (circRNAs) are considered to be important regulators in cancer biology. In this study, we focused on the effect of circRNA baculoviral inhibitor of apoptosis protein (IAP) repeat containing 6 (circBIRC6) on non-small cell lung cancer (NSCLC) progression.
Methods:
The NSCLC and adjacent non-tumor tissues were collected at Shanghai Ninth People's Hospital. Quantitative real-time polymerase chain reaction was conducted for assessing the levels of circBIRC6, amyloid beta precursor protein binding protein 2 (APPBP2) messenger RNA (mRNA), baculoviral IAP repeat containing 6 mRNA (BIRC6), and microRNA-217 (miR-217). Western blot assay was adopted for measuring the protein levels of APPBP2, E-cadherin, N-cadherin, and vimentin. Colony formation assay, transwell assay, and flow cytometry analysis were utilized for evaluating cell colony formation, metastasis, and apoptosis. Dualluciferase reporter assay and RNA immunoprecipitation assay were carried out to determine the interaction between miR-217 and circBIRC6 and APPBP2 in NSCLC tissues. The murine xenograft model assay was used to investigate the function of circBIRC6 in tumor formation in vivo. Differences were analyzed via Student's t test or one-way analysis of variance. Pearson's correlation coefficient analysis was used to analyze linear correlation.
Results:
CircBIRC6 was overexpressed in NSCLC tissues and cells. Knockdown of circBIRC6 repressed the colony formation and metastasis and facilitated apoptosis of NSCLC cells in vitro and restrained tumorigenesis in vivo. Mechanically, circBIRC6 functioned as miR-217 sponge to promote APPBP2 expression in NSCLC cells. MiR-217 inhibition rescued circBIRC6 knockdown-mediated effects on NSCLC cell colony formation, metastasis, and apoptosis. Overexpression of miR-217 inhibited the malignant phenotypes of NSCLC cells, while the effects were abrogated by elevating APPBP2.
Conclusion:
CircBIRC6 aggravated NSCLC cell progression by elevating APPBP2 via sponging miR-217, which might provide a fresh perspective on NSCLC therapy.
Technical Notes
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经口内镜肌切开术联合粘膜下和肌肉剥离术（POEM-SSMD）治疗贲门失弛缓症伴严重层间粘连的长期疗效Jiancong Feng, Ningli Chai, Wengang Zhang, Longsong Li, Xiaowei Tang, Jiale Zou, Lu Ye, Enqiang Linghu
中华医学杂志英文版2022年 135卷 06期
DOI: 10.1097/CM9.0000000000001971
摘要
既往多项研究证实了经口内镜肌切开术（POEM）治疗贲门失弛缓症的有效性和安全性。然而，严重的层间粘连排除了粘膜下隧道的建立，然后导致POEM程序流产。为了应对这一挑战，我们在2014年推出了同时粘膜下和肌肉解剖的POEM（POEM-SSMD）。[
Correspondence
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Lisfranc损伤合并跟骨前外侧压缩性骨折的治疗Wenqi Gu, Rui Zhang, Wanjun Liu, Zhongmin Shi, Guohua Mei, Jianfeng Xue, Jian Zou, Xiaokang Wang, Jiantao Jiang
中华医学杂志英文版2022年 135卷 06期
DOI: 10.1097/CM9.0000000000001924
摘要
致编辑：Lisfranc损伤的机制很复杂，可能导致中足复合体不同模式的骨折或脱位。外展力损伤是一种特殊的损伤模式，可引起Lisfranc关节外侧柱，尤其是长方体的骨折或（和）脱位。[
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前蛋白转化酶枯草杆菌蛋白酶/克新9型抑制剂evolocumab在重度高甘油三酯血症患者中的应用Yanren Peng, Danxia Guo, Sijie Jiang, Hua Zheng
中华医学杂志英文版2022年 135卷 06期
DOI: 10.1097/CM9.0000000000001896
摘要
致编辑：前蛋白转化酶枯草杆菌蛋白酶/kexin 9型（PCSK9）抑制剂evolocumab可与血浆中的PCSK9结合，减少PCSK9-低密度脂蛋白（LDL）受体复合物的降解，从而降低LDL水平。[
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龟甲胶对大鼠少弱精子症模型的影响Wen Sheng, Wenjing Xu, Hailin Hu, Dan Xiao, Qinghu He
中华医学杂志英文版2022年 135卷 06期
DOI: 10.1097/CM9.0000000000001658
摘要
致编辑：不孕症是现代社会的公共卫生问题。少弱精子症（OA）是男性不育的主要原因之一，影响着全球约5%的育龄夫妇。OA的病因和发病机制仍然知之甚少。OA的特征包括总数减少（<33 × 106每次射精或<12 × 106/mL）或精子浓度，以及低或无精子活力（<32%).[
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不同预后自身免疫性肝炎肝功能衰竭的临床特征及肝组织学比较Huili Wu, Hongbo Shi, Hui Liu, Yanmin Liu, Zhongping Duan
中华医学杂志英文版2022年 135卷 06期
DOI: 10.1097/CM9.0000000000001677
摘要
致编辑：自身免疫性肝炎（AIH）是一类由肝细胞自身免疫反应介导的肝实质炎症。AIH以前被认为是一种慢性肝病，但最近的观察者证实AIH患者可以急性发作甚至肝功能衰竭（AIH-LF）。[
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中国原发性阴道透明细胞癌的临床病理特征及子宫内膜异位症恶变病例Sikai Chen, Zhiyue Gu, Jian Sun, Boju Pan, Qingbo Fan, Ping Zheng, Shu Wang, Jinhua Leng, Yang Xiang, Jinghe Lang
中华医学杂志英文版2022年 135卷 06期
DOI: 10.1097/CM9.0000000000001734
摘要
致编辑：原发性阴道癌是一种罕见的恶性疾病，仅占女性生殖器恶性肿瘤的约1%至2%。阴道腺病定义为阴道壁内存在化生宫颈或子宫内膜上皮，并且与阴道癌的高风险相关。在产前暴露于己烯雌酚（DES）的妇女中，高达90%的人可能出现阴道腺病，这些通常与阴道透明细胞腺癌有关。[
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与中国老年患者再入院相关的共病Chunyang Li, Hyokyoung G. Hong, Zhiye Ying, Xiaoxi Zeng, Yi Li
中华医学杂志英文版2022年 135卷 06期
DOI: 10.1097/CM9.0000000000001854
摘要
致编辑：中国是人口最多的国家，老龄化速度比世界上几乎任何其他国家都要快。根据Worldometer的数据，[
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牛磺酸对早期角膜碱烧伤的疗效及可能机制Yuan Tan, Min Zhang, Yingzhe Pan, Lixia Xie
中华医学杂志英文版2022年 135卷 06期
DOI: 10.1097/CM9.0000000000001570
摘要
致编辑：角膜碱烧伤（CABs）长期以来一直是临床治疗的难题。严重者出现失明；因此，研究角膜损伤的修复机制对于确定潜在的治疗靶点尤为重要。碱诱导的角膜损伤通常会引发侵袭性无菌性炎症反应，这是自身免疫反应的关键。[
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中国成年人鸡蛋消费习惯与血脂的纵向关系：中国动脉粥样硬化性心血管疾病风险预测项目的结果Xinyu Zhang, Fangchao Liu, Jianxin Li, Sihan Huang, Xue Xia, Keyong Huang, Qiong Liu, Jichun Chen, Xueli Yang, Xiaoqing Liu 等
中华医学杂志英文版2022年 135卷 06期
DOI: 10.1097/CM9.0000000000001555
摘要
致编辑：根据西方国家和中国的指南，低胆固醇摄入量的饮食模式已被广泛推荐以维持理想的脂质水平。鸡蛋作为优质蛋白质和膳食胆固醇的主要来源之一，一直是饮食方面的焦点。尽管随机对照试验（RCT）已经揭示了高鸡蛋摄入诱导的脂质水平增加，但由于超过7个鸡蛋/周或甚至14个鸡蛋/周的高剂量鸡蛋摄入，它们可能不足以反映习惯性鸡蛋摄入的影响。此外，RCT通常具有约3个月的较短干预期，由于人类胆固醇代谢的稳态，这可能不会观察到稳定的关联。[
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中国创伤性脑损伤后重症监护病房患者肾脏清除率提高的横断面研究Zilong Dang, Hong Guo, Bin Li, Maohua Zhen, Jian Liu, Yuhui Wei, Hongyan Qin, Zhimin Dou, Lei Zhang, Lei Zhu 等
中华医学杂志英文版2022年 135卷 06期
DOI: 10.1097/CM9.0000000000001572
摘要
致编辑：增强的肾清除率(ARC)是指肾脏以统计学上高于正常水平的速率增强对循环溶质(包括药物)的消除。在重症监护室（ICU）入院的第一天，ARC的发生可能预示肌酐清除率（CrCl）持续升高1天至数周。[
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不同核黄素溶液离子导入后角膜上皮的组织学检查Na Li, Zhengjun Fan, Xiujun Peng
中华医学杂志英文版2022年 135卷 06期
DOI: 10.1097/CM9.0000000000001579
摘要
致编辑：目前，从病理学角度来看，用核黄素进行角膜胶原交联（CXL）是控制圆锥角膜进展的唯一新疗法。核黄素作为一种光敏剂，在紫外线照射角膜后可被激活，防止其损伤眼内组织。因此，在治疗过程中，角膜基质中核黄素的浓度必须维持在足够的水平。[
Corrigendum
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胸腺肽α 1作为免疫调节治疗对R0切除后非小细胞肺癌患者长期生存的影响：倾向评分匹配分析中华医学杂志英文版2022年 135卷 06期
DOI: 10.1097/CM9.0000000000001819-1
摘要
在《中华医学杂志》第134卷第22期2700-2709页发表的《胸腺素α 1作为免疫调节疗法对非小细胞肺癌患者R0切除术后长期生存的影响：倾向评分匹配分析》一文中，[
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