2022年 · 第135卷第15期

出版日期 2022-08-05电子版￥0.00元

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Review Article

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细胞外囊泡在肺部疾病中的作用

Li Zhou, Hong Luo, Jae Woo Lee

中华医学杂志英文版2022年 135卷 15期

DOI: 10.1097/CM9.0000000000002118

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肺癌脑转移的肿瘤微环境

Wenwen Liu, Charles A Powell, Qi Wang

中华医学杂志英文版2022年 135卷 15期

DOI: 10.1097/CM9.0000000000002127

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新型冠状病毒：人工智能经受住了时间的考验吗

Mir Ibrahim Sajid, Shaheer Ahmed, Usama Waqar, Javeria Tariq, Mohsin Chundrigarh, Samira Shabbir Balouch, Sajid Abaidullah

中华医学杂志英文版2022年 135卷 15期

DOI: 10.1097/CM9.00000000000020S8

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Perspective

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脂肪干细胞外泌体促进伤口愈合的游离细胞治疗和机制：目前的认识和未来的应用

Na Liu, Yun Xie, Yonghuan Zhen, Yujia Shang, GuanhuiEr Wang, Lingjuan Zhu, Yang An

中华医学杂志英文版2022年 135卷 15期

DOI: 10.1097/CM9.0000000000001857

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Viewpoint

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肥胖和慢性腹泻：一种新综合征？

Enqiang Linghu

中华医学杂志英文版2022年 135卷 15期

DOI: 10.1097/CM9.0000000000002147

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Original Article

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术前肾上腺素和利多卡因鼻探针试验可缓解支气管镜检查中的插入并减少术后出血：一项随机对照试验

Wenjun Zhu, Yuchen Zhang, Jingyu Shi, Xiaoqin Wang, Renjiao Li, Jia Liu, Ping Li, Dan Liu, Fengming Luo

中华医学杂志英文版2022年 135卷 15期

DOI: 10.1097/CM9.0000000000002006

摘要

Background: Nasal insertion is the preferred method for non-intubated patients in flexible bronchoscopy; however, the relatively narrow nasal cavity results in difficulties related to bronchoscope insertion. This study aimed to investigate whether pre-operative nasal probe tests could reduce the time to pass the glottis, improve the first-pass success rate and patients’ tolerance, and reduce postoperative bleeding. Methods: This three-arm prospective randomized controlled trial was conducted in a tertiary hospital between May and October 2020. Three hundred patients requiring diagnosis and treatment using flexible bronchoscopy were randomly allocated to three groups: control group, simple cotton bud detection group (CD group), and adrenaline + lidocaine detection group (AD group). The primary outcome was the time to pass the glottis. Secondary outcomes included the first-pass success rate, the patients’ tolerance scores, and post-operative bleeding. One-way analysis of variance, Kruskal-Wallis H test, Chi-squared test, Fisher’s exact test, and Bonferroni’s multiple comparison tests were used in this study. Results: In total, 189 men and 111 women were enrolled in this study, with a mean age of 55.72 ± 12.86 years. The insertion time was significantly shorter in the AD group than in the control group (18.00 s [12.00–26.50 s] vs. 24.00 s [14.50–45.50 s], P = 0.005). Both the AD (99% vs. 83%, χ2 = 15.62, P < 0.001) and CD groups (94% vs. 83%, χ2 = 5.94, P = 0.015) had a significantly higher first-pass success rate than the control group. Compared with the control group, post-operative bleeding (1% vs. 13%, χ2 = 11.06, P < 0.001) was significantly lower in the AD group. However, no significant difference was found in the patients’ tolerance scores. Conclusions: Pre-operative nasal cavity probe tests especially with adrenaline and lidocaine during flexible bronchoscopy can significantly reduce the time to pass the glottis, improve the first-pass success rate, and reduce post-operative nasal bleeding. Pre-operative nasal probe tests are recommended as a time-saving procedure for patients undergoing flexible bronchoscopy. Trial registration: Chinese Clinical Trial Registry (ChiCTR), ChiCTR2000032668; http://www.chictr.org.cn/showprojen.aspx?proj=53321.

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重症监护病房患者肠内营养不耐受的患病率及危险因素：一项回顾性研究

Kunrong Yu, Na Guo, Dingding Zhang, Ying Xia, Yanling Meng, Li Weng, Bin Du

中华医学杂志英文版2022年 135卷 15期

DOI: 10.1097/CM9.0000000000001974

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局部和全身炎症触发与抗肿瘤或促肿瘤巨噬细胞浸润相关的肿瘤生长的不同结果

Xinghan Liu, Qi Jiang, Sunan Shen, Yayi Hou

中华医学杂志英文版2022年 135卷 15期

DOI: 10.1097/CM9.0000000000001775

摘要

Background: Previous evidence suggests inflammation may be a double-edged sword with cancer-promoting and cancer suppressing function. In this study, we explore the impact of local and systemic inflammation on cancer growth. Methods: Female BALB/C mice were subcutaneously implanted with foreign body (plastic plates) to build up a local inflammation and intraperitoneally injected with PolyIC or lipopolysaccharides (LPS) to build up a systemic inflammation, followed by subcutaneous injection of 5 × 105 colon cancer cells. Immunohistochemistry and enzyme linked immunosorbent assay were utilized to detect the Ki67 and interleukin (IL) 6, IL-1β, and monocyte chemoattractant protein-1 expression in the tumor tissues and serum, respectively. The distributions of immune cells and expression of toll-like receptors (TLRs) were evaluated by flow cytometry (FCM) and quantitative real time-polymerase chain reaction. Results: The results showed that local inflammation induced by foreign body implantation suppressed tumor growth with decreased tumor weight (P = 0.001), volume (P = 0.004) and Ki67 index (P < 0.001). Compared with the control group, myeloid-derived suppressive cells sharply decreased (P = 0.040), while CD4+ T cells slightly increased in the tumor tissues of the group of foreign body-induced local inflammation (P = 0.035). Moreover, the number of M1 macrophages (P = 0.040) and expression of TLRs, especially TLR3 (P < 0.001) and TLR4 (P < 0.001), were significantly up-regulated in the foreign body group. Contrarily, tumor growth was significantly promoted in LPS or PolyIC-induced systemic inflammation (P = 0.009 and 0.006). FCM results showed M1 type macrophages (P = 0.017 and 0.006) and CD8+ T cells (P = 0.031 and 0.023) were decreased, while M2 type macrophages (P = 0.002 and 0.007) were significantly increased in tumor microenvironment of LPS or PolyIC-induced systemic inflammation group. In addition, the decreased expression of TLRs was detected in LPS or PolyIC group. Conclusions: The foreign body-induced local inflammation inhibited tumor growth, while LPS or PolyIC-induced systemic inflammation promoted tumor growth. The results suggested that the different outcomes of tumor growth might be attributed to the infiltration of anti-tumor or pro-tumor immune cells, especially M1 or M2 type macrophages into tumor microenvironment.

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人乳头瘤病毒、烟草和不良口腔卫生可以协同作用，调节核因子κ B信号通路的表达，促进巴基斯坦人群头颈癌的发展和进展

Sumaira Sarwar, Mushir Mulla, Munaz Mulla, Rida Tanveer, Maimoona Sabir, Aneesa Sultan, Salman A. Malik

中华医学杂志英文版2022年 135卷 15期

DOI: 10.1097/CM9.0000000000001970

摘要

Background: Head and neck cancers (HNCs) are a heterogeneous group of tumors that progress owing to varied enviromental and genetic risk factors. Viral infections are threatening and adept at altering the expression of cellular transcription factors such as nuclear factor kappa B (NF-κB) and deregulation of other cellular proteins like NF kappa B inhibitor alpha (IκBα). The present study was conducted to detect high-risk genotypes of human papillomavirus (HPV) and protein expression of NF-κB signaling pathway in HNC patients with HPV infection. Methods: For HPV detection, genomic DNA from 152 HNC tumors was extracted formalin-fixed paraffin-embedded tissue DNA kit. For genotyping, polymerase chain reaction (PCR) using a general primer, HPV type-specific primers and agarose gel electrophoresis were performed. Immunohistochemistry (IHC) was also performed on 4-μm thick tissue sections using HPV E6 monoclonal antibody. Protein expression analysis of NF-κB signaling pathway including p50, p65, and IκBα was performed using IHC. Results: PCR analysis showed that 24.3% (37/152) of HNC cases were HPV positive. Among HPV positive, 86.5% (32/37) were tobacco users, while among HPV negative, 66.9% (77/115) were tobacco users. A significant association of HPV positivity and tobacco user was observed by univariate analysis [P < 0.01; odds ratio (OR): 0.310, 95% confidence interval (CI): 0.110 to 0.870]. More HPV positive patients were with poor oral hygiene (78.3%) when compared with patients with good oral hygiene (21.6%) [P < 0.03, OR: 2.440, 95% CI: 1.650 to 3.600]. The results of the logistic regression analysis showed that age, tobacco use and oral hygiene are significant predictors (P < 0.02). PCR and IHC staining results confirmed that HPV16 was predominant among HNC cases (64.8%) when compared with HPV18 (35.2%). Expression of NF-κB proteins (p50, p65, and IκBα inhibitor) were also observed in HPV and non-HPV infected HNC tissues. IHC expression of p50, and p65 showed nuclear staining, while IκBα inhibitor showed cytoplasmic staining. Protein expression in HPV cases was higher as compared to HPV naive cases (P < 0.05). Conclusions: From the study, it can be established that the use of tobacco, oral hygiene, and HPV infection may be synergistically involved in modulating the expression of NF-κB signaling pathway for the development and progression of HNC in the Pakistani population.

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潜在冠状动脉疾病患者中肺动脉高压和心力衰竭的患病率、危险因素和生存率：一项在中国进行的全国性前瞻性、多中心注册研究

Li Huang, Lingpin Pang, Qing Gu, Tao Yang, Wen Li, Ruilin Quan, Weiqing Su, Weifeng Wu, Fangming Tang, Xiulong Zhu 等

中华医学杂志英文版2022年 135卷 15期

DOI: 10.1097/CM9.0000000000002112

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亚甲基四氢叶酸脱氢酶、环水解酶和甲酰四氢叶酸合成酶1多态性是否会改变地方性氟中毒地区学龄儿童的智力变化？

Zichen Feng, Ning An, Fangfang Yu, Jun Ma, Na Li, Yuhui Du, Meng Guo, Kaihong Xu, Xiangbo Hou, Zhiyuan Li 等

中华医学杂志英文版2022年 135卷 15期

DOI: 10.1097/CM9.0000000000002062

摘要

Background: Excessive exposure to fluoride can reduce intelligence. Methylenetetrahydrofolate dehydrogenase, cyclohydrolase, and formyltetrahydrofolate synthetase 1 (MTHFD1) polymorphisms have important roles in neurodevelopment. However, the association of MTHFD1 polymorphisms with children’s intelligence changes in endemic fluorosis areas has been rarely explored. Methods: A cross-sectional study was conducted in four randomly selected primary schools in Tongxu County, Henan Province, from April to May in 2017. A total of 694 children aged 8 to 12 years were included in the study with the recruitment by the cluster sampling method. Urinary fluoride (UF) and urinary creatinine were separately determined using the fluoride ion-selective electrode and creatinine assay kit. Children were classified as the high fluoride group and control group according to the median of urinary creatinine-adjusted urinary fluoride (UFCr) level. Four loci of MTHFD1 were genotyped, and the Combined Raven’s Test was used to evaluate children’s intelligence quotient (IQ). Generalized linear model and multinomial logistic regression model were performed to analyze the associations between children’s UFCr level, MTHFD1 polymorphisms, and intelligence. The general linear model was used to explore the effects of gene-environment and gene-gene interaction on intelligence. Results: In the high fluoride group, children’s IQ scores decreased by 2.502 when the UFCr level increased by 1.0 mg/L (β= –2.502, 95% confidence interval [CI]: –4.411, –0.593), and the possibility for having "excellent" intelligence decreased by 46.3% (odds ratio = 0.537, 95% CI: 0.290, 0.994). Children with the GG genotype showed increased IQ scores than those with the AA genotype of rs11627387 locus in the high fluoride group (P < 0.05). Interactions between fluoride exposure and MTHFD1 polymorphisms on intelligence were observed (Pinteraction < 0.05). Conclusion: Our findings suggest that excessive fluoride exposure may have adverse effects on children’s intelligence, and changes in children’s intelligence may be associated with the interaction between fluoride and MTHFD1 polymorphisms.

Technical Notes

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腹膜前间隙，是内镜下腹疝修补术的理想层吗？

Weidong Wu, Huiyong Jiang, Rui Tang, Xiangzhen Meng, Guozhong Liu, Yizhong Zhang, Nan Liu, Nina Wei

中华医学杂志英文版2022年 135卷 15期

DOI: 10.1097/CM9.0000000000001884

摘要