MedNexus
2022年 · 第135卷第20期
出版日期 2022-10-20电子版 ￥0.00元
MedNexus
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- Review Article
- Original Article
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Editorial
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利用超深度宏基因组测序揭示新的人类肠道病毒组Harry Cheuk Hay Lau, Jun Yu
中华医学杂志英文版2022年 135卷 20期
DOI: 10.1097/CM9.0000000000002382
摘要
人类胃肠道包含数万亿的共生微生物，包括细菌、病毒和真菌，形成一个生态群落，通常称为肠道微生物组。作为肠道中第二个最主要的分类王国（占总微生物组DNA的5.8%），肠道病毒因其在塑造肠道微生物组的整体组成和维持人类健康中的作用而日益得到认可。[
Review Article
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支气管扩张与新冠肺炎感染：双向奔赴Grace Oscullo, Jose Daniel Gómez-Olivas, Thais Beauperthuy, Amina Bekki, Alberto Garcia-Ortega, Maria Gabriella Matera, Mario Cazzola, Miguel Angel Martinez-Garcia
中华医学杂志英文版2022年 135卷 20期
DOI: 10.1097/CM9.0000000000002447
摘要
Bronchiectasis (BE) has been linked to past viral infections such as influenza, measles, or adenovirus. Two years ago, a new pandemic viral infection severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) broke out and it still persists today, and a significant proportion of surviving patients have radiological and clinical sequelae, including BE. Our aim was to thoroughly review the information available in the literature on the bidirectional relationship between SARS-CoV-2 infection and the development of BE, as well as the impact of this infection on patients already suffering from BE. Available information indicates that only a small percentage of patients in the acute phase of coronavirus disease 2019 (COVID-19) pneumonia develop BE, although the latter is recognized as one of the radiological sequelae of COVID-19 pneumonia, especially when it is caused by traction. The severity of the initial pneumonia is the main risk factor for the development of future BE, but during the COVID-19 pandemic, exacerbations in BE patients were reduced by approximately 50%. Finally, the impact of BE on the prognosis of patients with COVID-19 pneumonia is not yet known.
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肿瘤相关巨噬细胞免疫抑制中的代谢重编程Ying Wang, Dan Wang, Li Yang, Yi Zhang
中华医学杂志英文版2022年 135卷 20期
DOI: 10.1097/CM9.0000000000002426
摘要
Tumor-associated macrophages (TAMs) are an essential proportion of tumor-infiltrating immune cells in the tumor microenvironment (TME) and have immunosuppressive functions. The high plasticity and corresponding phenotypic transformation of TAMs facilitate oncogenesis and progression, and suppress antineoplastic responses. Due to the uncontrolled proliferation of tumor cells, metabolism homeostasis is regulated, leading to a series of alterations in the metabolite profiles in the TME, which have a commensurate influence on immune cells. Metabolic reprogramming of the TME has a profound impact on the polarization and function of TAMs, and can alter their metabolic profiles. TAMs undergo a series of metabolic reprogramming processes, involving glucose, lipid, and amino acid metabolism, and other metabolic pathways, which terminally promote the development of the immunosuppressive phenotype. TAMs express a pro-tumor phenotype by increasing glycolysis, fatty acid oxidation, cholesterol efflux, and arginine, tryptophan, glutamate, and glutamine metabolism. Previous studies on the metabolism of TAMs demonstrated that metabolic reprogramming has intimate crosstalk with anti-tumor or pro-tumor phenotypes and is crucial for the function of TAMs themselves. Targeting metabolism-related pathways is emerging as a promising therapeutic modality because of the massive metabolic remodeling that occurs in malignant cells and TAMs. Evidence reveals that the efficacy of immune checkpoint inhibitors is improved when combined with therapeutic strategies targeting metabolism-related pathways. In-depth research on metabolic reprogramming and potential therapeutic targets provides more options for anti-tumor treatment and creates new directions for the development of new immunotherapy methods. In this review, we elucidate the metabolic reprogramming of TAMs and explore how they sustain immunosuppressive phenotypes to provide a perspective for potential metabolic therapies.
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上睑下垂在急性肺损伤中的分子机制及作用Tianchang Wei, Cuiping Zhang, Yuanlin Song
中华医学杂志英文版2022年 135卷 20期
DOI: 10.1097/CM9.0000000000002425
摘要
Acute lung injury (ALI) and acute respiratory distress syndrome (ARDS), which are characterized by excessive inflammation and accompanied by diffuse injury of alveoli, can result in severe respiratory failures. The morbidity and mortality of patients remain high because the major treatments for ALI/ARDS are mainly supportive due to the lack of effective therapies. Numerous studies have demonstrated that the aggravation of coronavirus disease 2019 (COVID-19) leads to severe pneumonia and even ARDS. Pyroptosis, a biological process identified as a type of programed cell death, is mainly triggered by inflammatory caspase activation and is directly meditated by the gasdermin protein family, as well as being associated with the secretion and release of proinflammatory cytokines. Clinical and experimental evidence corroborates that pyroptosis of various cells in the lung, such as immune cells and structural cells, may play an important role in the pathogenesis of "cytokine storms" in ALI/ARDS, including those induced by COVID-19. Here, with a focus on ALI/ARDS and COVID-19, we summarized the recent advances in this field and proposed the theory of an inflammatory cascade in pyroptosis to identify new targets and pave the way for new approaches to treat these diseases.
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从外科到内窥镜：减肥学科的演变Yongqiu Wei, Peng Li, Shutian Zhang
中华医学杂志英文版2022年 135卷 20期
DOI: 10.1097/CM9.0000000000002409
摘要
Obesity, with its increasing morbidity and prevalence, is now a worldwide public health problem. Obesity and its related comorbidities impose a heavy burden on societal health and the economy. The practice of bariatric surgery has evolved from its early surgical procedures, many of which are no longer routine operations. With clinical practice, research, and experience, bariatric surgery has gradually become an important last resort for the control of weight and obesity-related metabolic diseases in moderately and severely obese patients. However, there is still room for further improvements in bariatric surgical procedures, especially with regard to long-term issues and complications. Endoscopic weight loss technology has developed rapidly in recent years. The advantages of this technology include minimal invasiveness, an obvious weight loss effect, and few complications, thus filling the gap between medications and lifestyle adjustments and surgical treatment of obesity. Endoscopic weight loss technology may even replace surgical bariatric procedures. This review summarized the current status of bariatric metabolic surgery and newly developed bariatric endoscopic procedures.
Original Article
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抑制MYC抑制程序性细胞死亡配体-1表达增强三阴性乳腺癌免疫治疗Xintong Li, Lin Tang, Qin Chen, Xumin Cheng, Yiqiu Liu, Cenzhu Wang, Chengjun Zhu, Kun Xu, Fangyan Gao, Jinyi Huang 等
中华医学杂志英文版2022年 135卷 20期
DOI: 10.1097/CM9.0000000000002329
摘要
Background:
Cancer immunotherapy has emerged as a promising strategy against triple-negative breast cancer (TNBC). One of the immunosuppressive pathways involves programmed cell death-1 (PD-1) and programmed cell death ligand-1 (PD-L1), but many patients derived little benefit from PD-1/PD-L1 checkpoint blockades treatment. Prior research has shown that MYC, a master transcription amplifier highly expressed in TNBC cells, can regulate the tumor immune microenvironment and constrain the efficacy of immunotherapy. This study aims to investigate the regulatory relationship between MYC and PD-L1, and whether a cyclin-dependent kinase (CDK) inhibitor that inhibits MYC expression in combination with anti-PD-L1 antibodies can enhance the response to immunotherapy.
Methods:
Public databases and TNBC tissue microarrays were used to study the correlation between MYC and PD-L1. The expression of MYC and PD-L1 in TNBCs was examined by quantitative real-time polymerase chain reaction and Western blotting. A patient-derived tumor xenograft (PDTX) model was used to evaluate the influence of a CDK7 inhibitor THZ1 on PD-L1 expression. Cell proliferation and migration were detected by 5-ethynyl-2′-deoxyuridine (EdU) cell proliferation and cell migration assays. Tumor xenograft models were established for in vivo verification.
Results:
A high MYC expression level was associated with a poor prognosis and could alter the proportion of tumor-infiltrating immune cells (TIICs). The positive correlation between MYC and PD-L1 was confirmed by immunostaining samples from 165 TNBC patients. Suppression of MYC in TNBC caused a reduction in the levels of both PD-L1 messenger RNA and protein. In addition, antitumor immune response was enhanced in the TNBC cancer xenograft mouse model with suppression of MYC by CDK7 inhibitor THZ1.
Conclusions:
The combined therapy of CDK7 inhibitor THZ1 and anti-PD-L1 antibody appeared to have a synergistic effect, which might offer new insight for enhancing immunotherapy in TNBC.
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微创食管切除术与开腹食管切除术治疗胸段食管癌淋巴结转移/清扫的比较Zhenhua Li, Chunyue Gai, Yuefeng Zhang, Shiwang Wen, Huilai Lv, Yanzhao Xu, Chao Huang, Bo Zhao, Ziqiang Tian
中华医学杂志英文版2022年 135卷 20期
DOI: 10.1097/CM9.0000000000002342
摘要
Background:
The study aimed to clarify the characteristics of lymph node metastasis (LNM) and to compare the oncologic outcomes of minimally invasive esophagectomy (MIE) with open esophagectomy (OE) in terms of lymph node dissection (LND) in thoracic esophageal cancer patients.
Methods:
The data from esophageal cancer patients who underwent MIE or OE from January 2016 to January 2019 were retrospectively reviewed. The characteristics of LNM in thoracic esophageal cancer were discussed, and the differences in numbers of LND, LND rate, and LNM rate/degree of upper mediastinum between MIE and OE were compared.
Results:
For overall characteristics of LNM in 249 included patients, the highest rate of LNM was found in upper mediastinum, while LNM rate in middle and lower mediastinum, and abdomen increased with the tumor site moving down. The patients were divided into MIE (n = 204) and OE groups (n = 45). In terms of number of LND, there were significant differences in upper mediastinum between MIE and OE groups (8 [5, 11] vs. 5 [3, 8], P < 0.001). The comparative analysis of regional lymph node showed there was no significant difference except the subgroup of upper mediastinal 2L and 4L group (3 [1, 5] vs. 0 [0, 2], P < 0.001 and 0 [0, 2] vs. 0, P = 0.012, respectively). Meanwhile, there was no significant difference in terms of LND rate except 2L (89.7% [183/204] vs. 71.1% [32/45], P = 0.001) and 4L (41.2% [84/204] vs. 22.2% [10/45], P = 0.018) groups. For LNM rate of T3 stage, there was no significant difference between MIE and OE groups, and the comparative analysis of regional lymph node showed that there was no significant difference except 2L group (11.1% [5/45] vs. 38.1% [8/21], P = 0.025). The LNM degree of OE group was significantly higher than that of MIE group (27.2% [47/173] vs. 7.6% [32/419], P < 0.001), and the comparative analysis of regional LNM degree showed that there was no significant difference except 2L (34.7% [17/49] vs. 7.7% [13/169], P < 0.001) and 4L (23.8% [5/21] vs. 3.9% [2/51], P= 0.031) subgroups.
Conclusion:
MIE may have an advantage in LND of upper mediastinum 2L and 4L groups, while it was similar to OE in other stations of LND.
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前直肠系膜形态：直肠癌局部复发的新预测指标Xiaojie Wang, Zhifang Zheng, Min Chen, Jing Lin, Xingrong Lu, Ying Huang, Shenghui Huang, Pan Chi
中华医学杂志英文版2022年 135卷 20期
DOI: 10.1097/CM9.0000000000002024
摘要
Background:
Pre-operative assessment with high-resolution magnetic resonance imaging (MRI) is useful for assessing the risk of local recurrence (LR) and survival in rectal cancer. However, few studies have explored the clinical importance of the morphology of the anterior mesorectum, especially in patients with anterior cancer. Hence, the study aimed to investigate the impact of the morphology of the anterior mesorectum on LR in patients with primary rectal cancer.
Methods:
A retrospective study was performed on 176 patients who underwent neoadjuvant treatment and curative-intent surgery. Patients were divided into two groups according to the morphology of the anterior mesorectum on sagittal MRI: (1) linear type: the anterior mesorectum was thin and linear; and (2) triangular type: the anterior mesorectum was thick and had a unique triangular shape. Clinicopathological and LR data were compared between patients with linear type anterior mesorectal morphology and patients with triangular type anterior mesorectal morphology.
Results:
Morphometric analysis showed that 90 (51.1%) patients had linear type anterior mesorectal morphology, while 86 (48.9%) had triangular type anterior mesorectal morphology. Compared to triangular type anterior mesorectal morphology, linear type anterior mesorectal morphology was more common in females and was associated with a higher risk of circumferential resection margin involvement measured by MRI (35.6% [32/90] vs. 16.3% [14/86], P = 0.004) and a higher 5-year LR rate (12.2% vs. 3.5%, P = 0.030). In addition, the combination of linear type anterior mesorectal morphology and anterior tumors was confirmed as an independent risk factor for LR (odds ratio = 4.283, P = 0.014).
Conclusions:
The classification established in this study was a simple way to describe morphological characteristics of the anterior mesorectum. The combination of linear type anterior mesorectal morphology and anterior tumors was an independent risk factor for LR and may act as a tool to assist with LR risk stratification and treatment selection.
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基于单细胞水平的2型糖尿病患者皮肤角质形成细胞特征分析Bingye Liao, Qiuyi Ouyang, Hongqin Song, Ziqi Wang, Jinhua Ou, Jinxin Huang, Liang Liu
中华医学杂志英文版2022年 135卷 20期
DOI: 10.1097/CM9.0000000000002323
摘要
Background:
Keratinocytes play an important role in wound healing; however, less is known about skin keratinocytes in patients with type 2 diabetes mellitus (T2DM). Therefore, this study aimed to search for the transcriptional characteristics of keratinocytes at the single-cell level from T2DM patients, and to provide experimental data for identifying the pathological mechanisms of keratinocytes under pathological conditions.
Methods:
We performed single-cell RNA sequencing on the skin tissue from two T2DM patients and one patient without diabetes-induced trauma using the BD RhapsodyTM Single-Cell Analysis System. With the help of bioinformatics R-based single-cell analysis software, we analyzed the results of single-cell sequencing to identify the single-cell subsets and transcriptional characteristics of keratinocytes at the single-cell level, including Kyoto Encyclopedia of Genes and Genomes and Gene Ontology analyzes.
Results:
In this study, we found specific highly expressed signature keratinocyte-related genes. We analyzed the transcriptome of keratinocytes from experimental and control groups and screened a total of 356 differential genes, which were subject to bioinformatics analysis. Enriched pathways included oxidative phosphorylation, antigen processing and presentation, prion and Huntingtons’ diseases, bacterial invasion of epithelial cells, thermogenesis, vasopressin-regulated water reabsorption, and protein processing in the endoplasmic reticulum.
Conclusions:
This study revealed the characteristics of keratinocytes at the single-cell level and screened a group of differentially expressed genes related to T2DM-associated keratinocytes, oxidative phosphorylation, cytokine receptor interactions, prion diseases, and other signaling pathways.
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肾缺血再灌注损伤后肾小管上皮细胞间microRNA-590-3p的外体转移通过靶向TRAF6调节自噬Yimeng Chen, Congya Zhang, Yingjie Du, Xiying Yang, Min Liu, Wenjing Yang, Guiyu Lei, Guyan Wang
中华医学杂志英文版2022年 135卷 20期
DOI: 10.1097/CM9.0000000000002377
摘要
Background:
Acute kidney injury (AKI) is a common complication in patients, especially elderly patients, who undergo cardiac surgery with cardiopulmonary bypass. Studies have indicated a protective role of autophagy in AKI. However, the mechanisms underlying the regulatory effect of autophagy in AKI among patients undergoing cardiac surgeries are poorly understood. In this study, we aimed to test the hypothesis that exosomal microRNAs (miRNAs) regulate autophagy in tubular epithelial cells after AKI.
Methods:
Plasma exosomal RNA was extracted from young and elderly AKI patients undergoing cardiac surgery, and the miRNAs expression during the perioperative period were analyzed using next-generation sequencing. The screened miRNAs and their target genes were subjected to gene oncology function and Kyoto Encyclopedia of Genes and Genome enrichment analyses. Renal tubular epithelial cell line (HK-2 cells) was cultured and hypoxia/reoxygenation (H/R) model was established, which is an in vitro renal ischemia/reperfusion (I/R) model. We used Western blot analysis, cell viability assay, transfection, luciferase assay to investigate the mechanisms underlying the observed increases in the levels of renal I/R injury-mediated exosomal miRNAs and their roles in regulating HK-2 cells autophagy.
Results:
miR-590-3p was highly enriched in the plasma exosomes of young AKI patients after cardiac surgery. Increased levels of miR-590-3p led to the increases in the expression of autophagy marker proteins, including Beclin-1 and microtubule associated protein 1 light chain 3 beta (LC3II), and prolonged the autophagic response in HK-2 cells after H/R treatment. These effects were achieved mainly via increases in the exosomal miR-590-3p levels, and the tumor necrosis factor receptor-associated factor 6 protein was shown to play a key role in I/R injury-mediated autophagy induction.
Conclusion:
Exosomes released from HK-2 cells after renal I/R injury regulate autophagy by transferring miR-590-3p in a paracrine manner, which suggests that increasing the miR-590-3p levels in HK-2 cell-derived exosomes may increase autophagy and protect against kidney injury after renal I/R injury.
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连续肾脏替代治疗中含钙与无钙替代溶液局部柠檬酸盐抗凝的比较：一项随机对照试验Tiantian Wei, Xin Tang, Ling Zhang, Li Lin, Peiyun Li, Fang Wang, Ping Fu
中华医学杂志英文版2022年 135卷 20期
DOI: 10.1097/CM9.0000000000002369
摘要
Background:
A simplified protocol for regional citrate anticoagulation (RCA) using a commercial calcium-containing replacement solution, without continuous calcium infusion, is more efficient for use in continuous renal replacement therapy (CRRT). We aim to design a randomized clinical trial to compare the safety and efficacy between calcium-free and calcium-containing replacement solutions in CRRT with RCA.
Methods:
Of the 64 patients receiving RCA-based postdilution continuous venovenous hemodiafiltration (CVVHDF) enrolled from 2017 to 2019 in West China Hospital of Sichuan University, 35 patients were randomized to the calcium-containing group and 29 to the calcium-free replacement solution group. The primary endpoint was circuit lifespan and Kaplan-Meier survival analysis was performed. Secondary endpoints included hospital mortality, kidney function recovery rate, and complications. The amount of 4% trisodium citrate solution infusion was recorded. Serum and effluent total (tCa) and ionized (iCa) calcium concentrations were measured during CVVHDF.
Results:
A total of 149 circuits (82 in the calcium-containing group and 67 in the calcium-free group) and 7609 circuit hours (4335 h vs. 3274 h) were included. The mean circuit lifespan was 58.1 h (95% CI 53.8-62.4 h) in the calcium-containing group vs. 55.3 h (95% CI 49.7-60.9 h, log rank P = 0.89) in the calcium-free group. The serum tCa and iCa concentrations were slightly lower in the calcium-containing group during CRRT, whereas the postfilter iCa concentration was lower in the calcium-free group. Moreover, the mean amounts of 4% trisodium citrate solution infusion were not significantly different between the groups (171.1 ± 15.9 mL/h vs. 169.0 ± 15.1 mL/h, P = 0.49). The mortality (14/35 [40%] vs. 13/29 [45%], P = 0.70) and kidney function recovery rates of AKI patients (19/26, 73% vs. 14/24, 58%, P = 0.27) were comparable between the calcium-containing and calcium-free group during hospitalization, respectively. Six (three in each group) patients showed signs of citrate accumulation in this study.
Conclusions:
When compared with calcium-free replacement solution, RCA-based CVVHDF with calcium-containing replacement solution had a similar circuit lifespan, hospital mortality and kidney outcome. Since the calcium-containing solution obviates the need for a separate venous catheter and a large dose of intravenous calcium solution preparation for continuous calcium supplementation, it is more convenient to be applied in RCA-CRRT practice.
Registration:
Chinese Clinical Trial Registry (www.chictr.org.cn, ChiCTR-IPR-17012629)
Clinical Observation
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前列腺苗勒管上皮透明细胞癌的临床病理特征及基因改变Shaoan Chen, Fengyun Cui, Peizhi Zhang, Li Chen, Wei Song, Qingchao Meng, Xiude Chen, Qinghua Xia, Weiting Kang
中华医学杂志英文版2022年 135卷 20期
DOI: 10.1097/CM9.0000000000002252
摘要
前列腺苗勒管囊肿常见于年轻男性，是相对罕见的临床并发症。中等大小的囊肿表现为尿路梗阻、尿路刺激、随后的尿频、尿急和排尿困难。较大的囊肿可压迫精囊或射精管，引起顽固性血精或梗阻性无精子症。苗勒管囊肿恶变更为罕见。在以前的研究中仅报告了10例苗勒管恶性肿瘤。[
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超级微创手术的结果vs.食管切除术治疗浅表性食管鳞癌：一项基于倾向评分匹配的单中心研究Jiancong Feng, Ningli Chai, Enqiang Linghu, Xiuxue Feng, Longsong Li, Chen Du, Wengang Zhang, Qingzhen Wu
中华医学杂志英文版2022年 135卷 20期
DOI: 10.1097/CM9.0000000000002365
摘要
超级微创手术（SMIS）是2016年提出的一个新概念，定义为“在保持人体器官解剖结构完整性的同时治愈疾病”。[
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评估血小板功能可减少接受剖宫产术的血小板减少症妇女的血小板输注需求Zhun Xing, Yang Li, Chang Xu, Liqiang Zheng, Qiushi Wang, Yan Zhao
中华医学杂志英文版2022年 135卷 20期
DOI: 10.1097/CM9.0000000000002207
摘要
血小板减少症是妊娠期常见的合并症。血小板（PLT）计数<100 × 109/L作为血小板减少症的诊断。血小板减少症在临床环境中的主要不良反应是不同严重程度的出血。[
Correspondence
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胃神经内分泌肿瘤的临床病理特征、内镜特征及治疗分析Ju Huang, Xi Wu, Tianming Xu, Jingnan Li
中华医学杂志英文版2022年 135卷 20期
DOI: 10.1097/CM9.0000000000002437
摘要
致编辑：胃神经内分泌肿瘤（gNENs）是源自胃中不同神经内分泌细胞的高度异质性肿瘤。最近的流行病学证据表明，gNENs占所有胃恶性肿瘤的0.3%至1.8%。[
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髓外骨髓瘤髓外染色体异常的特点及预后价值Yuan Xia, Yu Shi, Zhi Chen, Jue Zhang, Yu Zhu, Rui Guo, Run Zhang, Qinglin Shi, Jianyong Li, Lijuan Chen
中华医学杂志英文版2022年 135卷 20期
DOI: 10.1097/CM9.0000000000002351
摘要
致编辑：多发性骨髓瘤（MM）是第二常见的血液恶性肿瘤，由浆细胞的克隆性增殖引起，其特征包括贫血、骨痛、肾功能不全和高钙血症。骨髓瘤细胞与骨髓（BM）微环境的粘附导致MM主要受累于髓内，然而，有时浆细胞可以播散并浸润到髓外（EM）部位，称为髓外疾病（EMD）。MM中EMD的患病率在初始诊断时为6%至8%，在疾病进展/复发期间可高达10%至30%。[
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标准化巴马小型猪内镜袖状胃成形术的动物实验学习曲线分析Yongqiu Wei, Peng Li, Shanshan Wu, Shutian Zhang
中华医学杂志英文版2022年 135卷 20期
DOI: 10.1097/CM9.0000000000002412
摘要
致编辑：内镜袖状胃成形术（ESG）是最近开发的一种无切口经口胃镜减肥手术，可以通过内镜全层缝合将胃腔缩小成类似于外科袖状胃切除术的管状结构。临床实践证明其安全性、耐用性、微创性、长期减肥效果接近减肥手术。[
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一项评价纤维蛋白封闭剂辅助硬膜缝合修补术疗效和安全性的多中心、前瞻性、随机临床研究Rutong Yu, Wei Zhu, Richard Kocharian, Bogdan Ilie, Zhong Wang, Dezhi Kang, Gang Zhao, Hua Yang, Kai Shu, Xianzhi Liu 等
中华医学杂志英文版2022年 135卷 20期
DOI: 10.1097/CM9.0000000000002413
摘要
致编辑：脑脊液（CSF）渗漏增加了颅骨手术后术后并发症的风险，其进展并不总是可预测的。目前，外科医生使用各种方法来实现CSF的水密闭合，包括合成密封剂、胶原或明胶基海绵，[
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弧形电极导线同时植入桥脚核和丘脑底核的安全性和可行性Wei Wang, Xiaoyong Chen, Deyuan Chen, Yue Chen, Lianghong Yu, Yuanxiang Lin, Dezhi Kang, Xiangrong Chen, Chenyu Ding
中华医学杂志英文版2022年 135卷 20期
DOI: 10.1097/CM9.0000000000002398
摘要
致编辑：联合核团刺激可能对控制神经系统疾病症状和改善生活质量具有协同作用。[
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生成醛固酮的肾上腺皮质癌的临床特点及术前诊断标准Xinyi Zhang, Qingguo Lyu, Jinfang Ma, Xiaohui Pan, Qiang Wei, Jianwei Li, Yuchun Zhu, Sumin Shen, Jing Li, Yun Ou 等
中华医学杂志英文版2022年 135卷 20期
DOI: 10.1097/CM9.0000000000002415
摘要
致编辑：原发性醛固酮增多症以高血压为特征，伴有或不伴有低钾血症，是内分泌性高血压最常见的形式，多由双侧肾上腺增生或产生醛固酮的肾上腺皮质腺瘤（APAA）引起。然而，它也可以由产生醛固酮的肾上腺皮质癌（APAC）诱导，这是罕见的。由于APAC的罕见性和恶性，APAC的临床特征以及APAC与APAA的差异仍不清楚，APAC的术前诊断是有价值的。因此，我们旨在通过从APAC患者病例报告和APAA临床文献中提取数据并制定APAC的术前诊断标准来比较APAA和APAC的临床特征。
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类风湿性关节炎患者2型糖尿病患病率：一项大型回顾性研究Zhenge Han, Qi Zhou, Hairong Han, Weizhen Qiao, Zhonghong Qie, Dongyi He
中华医学杂志英文版2022年 135卷 20期
DOI: 10.1097/CM9.0000000000002378
摘要
致编辑：类风湿性关节炎(RA)是一种慢性炎性疾病，其特征在于心血管疾病(CVD)风险过高，估计比一般人群高至少50%。[
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髋关节后囊压痛试验提高了FADIR试验诊断股骨髋臼撞击的敏感性和阳性预测价值Guanying Gao, Cheng Wang, Jianquan Wang, Yingfang Ao, Yan Xu
中华医学杂志英文版2022年 135卷 20期
DOI: 10.1097/CM9.0000000000002418
摘要
致编辑：许多体检测试用于诊断股骨髋臼撞击（FAI）。屈曲、外展和外旋（FABER）试验与屈曲、内收和内旋（FADIR）试验对FAI诊断的敏感性和特异性有很大差异。因此，基于临床实践，我们提出了增加体检测试的可能性，以提高传统体检的准确性。
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