MedNexus
2022年 · 第135卷第21期
出版日期 2022-11-05电子版 ￥0.00元
MedNexus
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Editorial
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胰岛素敏感性和β细胞功能与妊娠期糖尿病妇女的不良妊娠结局相关吗？Gang Hu
中华医学杂志英文版2022年 135卷 21期
DOI: 10.1097/CM9.0000000000002383
摘要
妊娠期糖尿病（GDM），定义为在妊娠期间发病或首次识别的任何程度的葡萄糖不耐受，是一种常见的妊娠结局。[
Review Article
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脂肪干细胞来源的外来体促进肌肉再生的信号通路Aoxuan Zhu, Na Liu, Yujia Shang, Yonghuan Zhen, Yang An
中华医学杂志英文版2022年 135卷 21期
DOI: 10.1097/CM9.0000000000002404
摘要
Severe muscle injury is still a challenging clinical problem. Exosomes derived from adipose stem cells (ASC-exos) may be a potential therapeutic tool, but their mechanism is not completely clear. This review aims to elaborate the possible mechanism of ASC-exos in muscle regeneration from the perspective of signal pathways and provide guidance for further study. Literature cited in this review was acquired through PubMed using keywords or medical subject headings, including adipose stem cells, exosomes, muscle regeneration, myogenic differentiation, myogenesis, wingless/integrated (Wnt), mitogen-activated protein kinases, phosphatidylinositol-4,5-bisphosphate 3-kinase/protein kinase B (PI3K/Akt), Janus kinase/signal transducers and activators of transcription, and their combinations. We obtained the related signal pathways from proteomics analysis of ASC-exos in the literature, and identified that ASC-exos make different contributions to multiple stages of skeletal muscle regeneration by those signal pathways.
Perspective
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无创检测技术在鲜红斑痣治疗中的应用Xue Wang, Yangxue Fu, Yan Liu, Wenjia Nie, Xingyu Su, Xianbiao Zou, Rusong Meng, Yan Li, Juan Tao
中华医学杂志英文版2022年 135卷 21期
DOI: 10.1097/CM9.0000000000002124
摘要
鲜红斑痣（PWS）是一种毁容性疾病，其分子发病机制仍不明确。目前PWS的金标准治疗是脉冲染料激光（PDL）；[
Viewpoint
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老年高血压患者血压干预策略对最佳血压目标的启示Xiaoqi Wang, Jun Cai
中华医学杂志英文版2022年 135卷 21期
DOI: 10.1097/CM9.0000000000002236
摘要
高血压作为心血管疾病的主要可改变危险因素，是死亡的首要原因，老年人是最脆弱的人群。[
Original Article
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妊娠期糖尿病妇女的胰岛素敏感性、β细胞功能和不良妊娠结局Yun Shen, Yanwei Zheng, Yingying Su, Susu Jiang, Xiaojing Ma, Jiangshan Hu, Changbin Li, Yajuan Huang, Yincheng Teng, Yuqian Bao 等
中华医学杂志英文版2022年 135卷 21期
DOI: 10.1097/CM9.0000000000002337
摘要
Background:
The potential impact of β cell function and insulin sensitivity on adverse pregnancy outcomes in women with gestational diabetes mellitus (GDM) remains uncertain. We aimed to investigate the association between β cell dysfunction, insulin resistance, and the composite adverse pregnancy outcomes.
Methods:
This observational study included 482 women diagnosed with GDM during pregnancy. Quantitative metrics on β cell function and insulin sensitivity during pregnancy were calculated using traditional equations. The association of β cell dysfunction and insulin resistance with the risk of the composite adverse pregnancy outcomes was investigated using multivariable-adjusted logistic regression models.
Results:
Multivariable-adjusted odds ratios (ORs) of adverse pregnancy outcomes across quartiles of homeostatic model assessment for insulin resistance (HOMA-IR) were 1.00, 0.95, 1.34, and 2.25, respectively (P for trend = 0.011). When HOMA-IR was considered as a continuous variable, the multivariable-adjusted OR of adverse pregnancy outcomes was 1.34 (95% confidence interval 1.16-1.56) for each 1-unit increase in HOMA-IR. Multivariable-adjusted ORs of adverse pregnancy outcomes across quartiles of homeostatic model assessment for β cell function (HOMA-β) were 1.00, 0.51, 0.60, and 0.53, respectively (P for trend = 0.068). When HOMA-β was considered as a continuous variable, the multivariable-adjusted OR of adverse pregnancy outcomes was 0.57 (95% CI 0.24-0.90) for each 1-unit increase in HOMA-β. However, other quantitative metrics were not associated with the composite adverse pregnancy outcomes.
Conclusions:
We demonstrated a significant association of β cell function and insulin sensitivity with the risk of adverse pregnancy outcomes. We have provided additional evidence on the early identification of adverse pregnancy outcomes besides the glycemic values.
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妊娠期糖尿病妇女产时和产后早期血糖特征的观察性研究Yu Ding, Xueying Zheng, Yujie Liu, Tian Wei, Tong Yue, Siqi Wang, Suyu Chen, Jianping Weng, Sihui Luo
中华医学杂志英文版2022年 135卷 21期
DOI: 10.1097/CM9.0000000000002423
摘要
Background:
Data on the glycemic profile of pregnant women with gestational diabetes mellitus (GDM) during the perinatal period are sparse. This study described the intrapartum and early postpartum glucose profiles among pregnant women with GDM, and analyzed factors potentially affecting glycemic parameters during the period.
Methods:
This was a prospective observational study conducted from March 2020 to November 2021. Pregnant women with GDM receiving lifestyle interventions alone during pregnancy and matched women with non-diabetic pregnancies (NDPs) were enrolled from among patients admitted to the obstetrics department for childbirth. Glucose monitoring was performed via a flash glucose monitoring (FGM) system on admission, and glucose readings during labor and early postpartum were analyzed. The clinical characteristics and FGM-based parameters of participants in the two groups were compared.
Results:
A total of 124 participants (mean age: 29.5 ± 3.5 years, 92 [74.2%] primipara) were included in the final analysis. A total of 17,571 glucose readings were retrieved. There were no significant differences in clinical characteristics between the GDM (n = 60) and NDP (n = 64) groups. The average glucose level was 92.2 mg/dL, and the level was higher in the GDM group (95.5 ± 12.1 mg/dL vs. 89.1 ± 13.4 mg/dL, P = 0.008) during the intrapartum and early postpartum periods. The data were split into the intrapartum period (from the start of labor to delivery of the placenta) and the early postpartum period (within 24 h after placental delivery) for analysis. During intrapartum, women with GDM exhibited glycemic profiles and fluctuations similar to those in the NDP group. However, women with GDM had higher postpartum glucose levels (97.7 ± 13.4 mg/dL vs. 90.8 ± 15.3 mg/dL, P = 0.009), a longer time spent >140 mg/dL (8.7 ± 9.3% vs. 5.9 ± 10.3%, P = 0.011), and greater glycemic fluctuations than those with NDP. Postpartum hyperglycemia in GDM might be associated with high parity and postprandial glucose abnormalities in GDM screening tests.
Conclusion:
Compared to those with normoglycemia, pregnant women with GDM receiving lifestyle interventions alone had similar intrapartum glucose profiles but higher early postpartum glucose levels and greater glucose variability, providing evidence for modification of the current perinatal glucose monitoring strategy for GDM.
Trial Registration:
ChiCTR.org.cn, ChiCTR2000030972
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新诊断糖尿病患者胰岛素抵抗和β细胞功能与血脂异常的关系Xiaohan Tang, Xiang Yan, Houde Zhou, Gan Huang, Xiaohong Niu, Hongwei Jiang, Heng Su, Xilin Yang, Xia Li, Zhiguang Zhou
中华医学杂志英文版2022年 135卷 21期
DOI: 10.1097/CM9.0000000000002075
摘要
Background:
Abnormal lipids are strong predictors of cardiovascular disease in type 1 diabetes mellitus (T1DM) and type 2 diabetes mellitus (T2DM). However, the potential associations of insulin resistance (IR) and beta-cell function (BCF) with abnormal lipids in newly diagnosed T1DM or T2DM patients are not fully understood.
Methods:
A cross-sectional survey of 15,928 participants was conducted. Homeostasis model assessment and postprandial C-peptide levels were used to estimate IR and BCF. A restricted cubic spline (RCS) nested in binary logistic regression was used to examine the associations of IR and BCF with abnormal lipids.
Results:
High triglyceride (TG), low high-density lipoprotein cholesterol, and high low-density lipoprotein cholesterol (LDL-C) accounted for 49.7%, 47.8%, and 59.2% of the participants, respectively. In multivariable analysis, high IR was associated with an increased risk of high TGs (P for trend <0.001) in T1DM and is associated with an elevated risk of high TG and low HDL-C (all P for trend <0.01) in T2DM. Low BCF was not associated with risks of dyslipidemia in patients with T1DM or T2DM after adjustment for potential confounders.
Conclusion:
High IR had different associations with the risk of dyslipidemia in newly diagnosed T1DM and T2DM patients, suggesting that early treatment that improves IR may benefit abnormal lipid metabolism.
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诊断准确性和安全性屋尘螨用于皮肤点刺试验的提取物Rui Tang, Xiaohong Lyu, Yuxi Liu, Ruiqi Wang, Lianglu Wang, Hong Li, Jinlyu Sun, Yuxiang Zhi, Jianqing Gu, Kai Guan 等
中华医学杂志英文版2022年 135卷 21期
DOI: 10.1097/CM9.0000000000002262
摘要
Background:
Dermatophagoides pteronyssinus is a common allergen causing allergic diseases in China. The aim of this study was to evaluate the efficacy and safety of D. pteronyssinus extracts produced by Peking Union Medical College Hospital (PUMCH) for the skin prick test (SPT) in the diagnosis of D. pteronyssinus allergy.
Methods:
A total of 910 subjects with allergic diseases were prescribed D. pteronyssinus SPT and specific sIgE (sIgE) test among the Outpatients of Department of Allergy, PUMCH from August 10, 2015 to August 30, 2017. Receiver operating characteristic curve (ROC) analysis was performed according to the results of D. pteronyssinus-sIgE detection. The accuracy of D. pteronyssinus extracts used for SPT in the diagnosis of D. pteronyssinus allergy was evaluated under different cutoff values. Adverse events after SPT were recorded to evaluate safety.
Results:
There were 796 and 618 subjects in the full analysis set (FAS) and the per protocol set (PPS), respectively. The areas under the curve of FAS and PPS were 0.871 and 0.873, respectively. According to the ROC of PPS, the optimal and 95% specificity diagnostic cutoff values of D. pteronyssinus SPT mean wheal diameter were 3.25 and 3.75 mm, respectively. No adverse events occurred.
Conclusion:
The extracts of D. pteronyssinus for SPT were simple, highly accurate, and safe and should be considered for recommendation in the clinical diagnosis of D. pteronyssinus allergy.
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症状性膝关节骨关节炎排列不良进展的八年轨迹Mingyang Li, Yong Nie, Yi Zeng, Yuangang Wu, Limin Wu, Yuan Liu, Bin Shen
中华医学杂志英文版2022年 135卷 21期
DOI: 10.1097/CM9.0000000000002044
摘要
Background:
Although various therapies have been developed to treat malalignment in osteoarthritic knees, the pattern of malalignment progression is still unclear. This study aimed to identify homogeneous subgroups with distinct trajectories of malalignment progression in subjects with symptomatic knee osteoarthritis (KOA) and to determine corresponding risk factors.
Methods:
Eight-year follow-up (from 2004 to 2012) data on 1252 participants with symptomatic KOA from the Osteoarthritis Initiative were included. Varus/valgus angle progression was characterized by group-based trajectory models. Time-varying covariates were introduced into the model to investigate how they affected trajectories. Multinomial logistic regression for trajectory group membership was applied to ascertain risk factors.
Results:
Five subgroups were identified. Participants in the varus worsening trajectory (n = 166) or valgus worsening trajectory (n = 118) proceeded to worsen malalignment over time. The neutral trajectory (n = 378), varus stable trajectory (n = 328), and valgus stable trajectory (n = 262) maintained close to the initial varus/valgus angle over 8 years. Higher baseline Kellgren and Lawrence grade (odds ratio [OR] = 4.35, P < 0.001 for varus; OR= 3.85, P < 0.001 for valgus) and "severe" baseline malalignment (OR = 13.57, P < 0.001 for varus; OR = 23.04, P < 0.001 for valgus) were risk factors for worsening trajectories. The cutoff point of the baseline varus/valgus angle to discriminate between stable or worsening trajectory was -4.5° for varus and 3.6° for valgus.
Conclusions:
This study identified the malalignment progression pattern — minor malalignment (-4.5° to +3.6°) tends to remain stable, while major baseline malalignment is likely to progress. This provides a reference for therapy to prevent malalignment from deteriorating and emphasizes the necessity of determining the trigger factors for malalignment onset.
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严重颈部成角对动脉瘤腔内修复术后血流动力学和临床结局的影响：血流动力学分析和回顾性队列研究Yang Liu, Ming Qing, Jichun Zhao, Bin Huang, Yi Yang, Tinghui Zheng, Ding Yuan
中华医学杂志英文版2022年 135卷 21期
DOI: 10.1097/CM9.0000000000002280
摘要
Background:
For patients with severe neck angulation (SNA), hemodynamic and clinical outcomes following endovascular aneurysm repair (EVAR) are still unclear. This study aimed to explore the influence of SNA on hemodynamic and clinical outcomes following EVAR.
Methods:
This study included a hemodynamic analysis and a retrospective cohort study from West China Hospital of Sichuan University between January 2011 and December 2020. The Cox regression model, inverse probability of treatment weighting (IPTW) analysis, sensitivity analysis, and subgroup analysis were applied. Primary outcome was type IA endoleak (T1AEL).
Results:
In this hemodynamic analysis, nine non-severe neck angulation (nSNA) and 16 SNA idealized models were constructed. We found a significant difference in drag force between SNA and nSNA models (7.016 ± 2.579 N vs. 4.283 ± 1.460 N, P = 0.008), and proximal neck angles were significantly associated with the magnitude of drag force (F = 0.082 × α-0.006 × β + 2.818, α: 95% confidence interval [CI] 0.070-0.094; P = 0.001; β: 95% CI -0.019 to 0.007; P = 0.319). In our cohort study, 514 nSNA patients (71.5 ± 8.5 years; 459 males) and 208 SNA patients (72.5 ± 7.8 years; 135 males) were included, with a median follow-up duration of 34 months (16-63 months). All baseline characteristics were well balanced after IPTW matching. We found that SNA was associated with a significant risk of adverse limb event (hazard ratio [HR] 2.18, 95% CI 1.09-3.12), yet was not associated with T1AEL, overall survival, or reintervention. In patients without proximal or distal additional procedures (DAP), subgroup analyses suggested a significant risk of T1AEL (Proximal: HR 5.25, 95% CI 1.51-18.23; Distal: HR 5.07, 95% CI 1.60-16.07) and adverse limb event (Proximal: HR 2.27, 95% CI 1.01-5.07; Distal: HR 2.91, 95% CI 1.30-6.54) in SNA patients. However, no noticeable difference was observed in patients with proximal or DAP.
Conclusions:
SNA has a critical influence on hemodynamic and clinical outcomes following EVAR. Appropriate additional procedures may be of great benefit to SNA patients.
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激活转录因子4通过调节肠道巨噬细胞分化保护小鼠免受脓毒症诱导的肠损伤Zhenliang Wen, Xi Xiong, Dechang Chen, Lujing Shao, Xiaomeng Tang, Xuan Shen, Sheng Zhang, Sisi Huang, Lidi Zhang, Yizhu Chen 等
中华医学杂志英文版2022年 135卷 21期
DOI: 10.1097/CM9.0000000000002543
摘要
Background:
Gut-resident macrophages (gMacs) supplemented by monocytes-to-gMacs differentiation play a critical role in maintaining intestinal homeostasis. Activating transcription factor 4 (ATF4) is involved in immune cell differentiation. We therefore set out to investigate the role of ATF4-regulated monocytes-to-gMacs differentiation in sepsis-induced intestinal injury.
Methods:
Sepsis was induced in C57BL/6 wild type (WT) mice and Atf4-knockdown (Atf4+/-) mice by cecal ligation and puncture or administration of lipopolysaccharide (LPS). Colon, peripheral blood mononuclear cells, sera, lung, liver, and mesenteric lymph nodes were collected for flow cytometry, hematoxylin and eosin staining, immunohistochemistry, quantitative reverse transcription polymerase chain reaction, and enzyme-linked immunosorbent assay, respectively.
Results:
CD64, CD11b, Ly6C, major histocompatibility complex-II (MHC-II), CX3CR1, Ly6G, and SSC were identified as optimal primary markers for detecting the process of monocytes-to-gMacs differentiation in the colon of WT mice. Monocytes-to-gMacs differentiation was impaired in the colon during sepsis and was associated with decreased expression of ATF4 in P1 (Ly6Chi monocytes), the precursor cells of gMacs. Atf4 knockdown exacerbated the impairment of monocytes-to-gMacs differentiation in response to LPS, resulting in a significant reduction of gMacs in the colon. Furthermore, compared with WT mice, Atf4+/- mice exhibited higher pathology scores, increased expression of inflammatory factor genes (TNF-α, IL-1β), suppressed expression of CD31 and vascular endothelial-cadherin in the colon, and increased translocation of intestinal bacteria to lymph nodes and lungs following exposure to LPS. However, the aggravation of sepsis-induced intestinal injury resulting from Atf4 knockdown was not caused by the enhanced inflammatory effect of Ly6Chi monocytes and gMacs.
Conclusion:
ATF4, as a novel regulator of monocytes-to-gMacs differentiation, plays a critical role in protecting mice against sepsis-induced intestinal injury, suggesting that ATF4 might be a potential therapeutic target for sepsis treatment.
Clinical Observation
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肝癌患者周末择期肝切除术的安全性Junlong Dai, Junyi Shen, Xiaoyun Zhang, Wei Peng, Tianfu Wen, Chuan Li
中华医学杂志英文版2022年 135卷 21期
DOI: 10.1097/CM9.0000000000001722
摘要
肝细胞癌（HCC）的发病率呈逐年上升趋势。国际癌症研究机构（IARC）报告称，2020年有超过63万人被诊断患有HCC，超过一半的HCC新病例发生在中国。越来越多的病人使医疗系统不堪重负，手术前的等待时间越来越长。这对传统手术管理模式的适用性提出了新的挑战。周末进行的择期手术可以为这个问题提供有效的解决方案。然而，周末手术的安全性存在争议，因为与工作日相比，手术患者在周末的严重并发症发生率和术后死亡率更高（ie、周末效应）。一瞥和艾尔[
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以分类为导向的腹腔镜解剖性肝切除术治疗侵犯左叶两个或两个以上（亚）节段的肝癌Haifeng Wan, Tian Lan, Ting Duan, Kunlin Xie, Jiwei Huang, Jiayin Yang, Yong Zeng, Li Jiang, Hong Wu
中华医学杂志英文版2022年 135卷 21期
DOI: 10.1097/CM9.0000000000002470
摘要
随着腹腔镜肝切除术的技术进步和新的导航设备，如柔性腹腔镜超声探头、吲哚菁绿（ICG）荧光成像和三维成像，腹腔镜肝段切除术（LS）在确保足够的手术切缘的同时，最大限度地保留了功能性肝储备和未来重复肝切除术的可能性，已成为治疗肝细胞癌（HCC）的可行替代方案。[
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特发性嗜酸性粒细胞增多综合征的新治疗流程：一项单中心回顾性队列研究Rui Tang, Shubin Lei, Shuyun Wang, Yuanyuan Guan, Hong Li
中华医学杂志英文版2022年 135卷 21期
DOI: 10.1097/CM9.0000000000002086
摘要
嗜酸性粒细胞增多综合征（HES）是一种罕见的全身性疾病，于1968年首次被描述。作为HES的一种亚型，特发性嗜酸性粒细胞增多综合征（IHES）被定义为不明原因的嗜酸性粒细胞增多，不包括肿瘤、感染、过敏和免疫系统疾病。在大多数情况下，IHE患者中超过1个器官受到影响。[
Correspondence
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2型糖尿病动脉粥样硬化性心血管疾病风险的估计Xiaoling Cai, Chu Lin, Linong Ji
中华医学杂志英文版2022年 135卷 21期
DOI: 10.1097/CM9.0000000000002045
摘要
致编辑：糖尿病的全球患病率正在急剧增加。[
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1型糖尿病患者外周血单个核细胞单核细胞相关转录组特征的鉴定Min Yin, Yan Zhang, Juan Huang, Xinyu Li, Haibo Yu, Xia Li
中华医学杂志英文版2022年 135卷 21期
DOI: 10.1097/CM9.0000000000002142
摘要
致编辑：1型糖尿病(T1D)是由自身免疫介导的胰岛β细胞破坏引起的，其中胰岛自身免疫是T1D发病机制中的基本成分。[
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1例糖皮质激素超敏反应综合征患者Chenwei Wu, Anran Ma, Quanya Sun, Xiaolong Zhao
中华医学杂志英文版2022年 135卷 21期
DOI: 10.1097/CM9.0000000000001977
摘要
致编辑：原发性全身性糖皮质激素超敏反应是一种罕见的疾病，其特征是对糖皮质激素的全身性、部分靶组织超敏反应。因此，低浓度的糖皮质激素足以有效维持患者的细胞生理效应，抑制下丘脑-垂体-肾上腺轴。我们的研究旨在为何时应考虑糖皮质激素超敏反应以及如何诊断提供一些见解。我们还根据我们的经验和以前的文献综述，首次提出了糖皮质激素超敏反应的诊断流程图。该研究由复旦大学华山医院机构审查委员会审查并批准（编号：KY2020-049）。
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5%乙醇酸复合物和20%乙醇酸治疗面部轻中度寻常痤疮的疗效观察Jian Zhao, Boyang Zhou, Yan Hou, Linfeng Li, Fenglin Zhuo
中华医学杂志英文版2022年 135卷 21期
DOI: 10.1097/CM9.0000000000002287
摘要
致编辑：寻常痤疮是一种慢性、炎性和毁容性皮肤病，伴有病变、炎症后色素沉着过度和疤痕。化学脱皮是一种简单且耐受性良好的治疗轻度至中度痤疮的方法。乙醇酸（GA）是水溶性的，在所有α-羟基酸中分子量最小。高浓度GA（20%-70%），在医院或美容诊所以2至4周的间隔应用，已被证明对痤疮有效。[
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爆发海洋分枝杆菌中国与处理鲈鱼相关的感染Qing Zhao, Fangfang Bao, Zihao Mi, Zhenzhen Wang, Pengcheng Huai, Qing Pan, Zheng Pang, Yaoming Li, Nan Cao, Xiaotong Xue 等
中华医学杂志英文版2022年 135卷 21期
DOI: 10.1097/CM9.0000000000002078
摘要
致编辑：海洋分枝杆菌是一种非结核分枝杆菌，可引起人类机会性感染，范围从单一皮肤病变到播散性疾病。[
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乳腺外佩吉特病侵袭行为的基因表达和转录组谱Yurong Li, Guohong Zhang, Chunxia Zhao, Chong Zhang, Hang Li
中华医学杂志英文版2022年 135卷 21期
DOI: 10.1097/CM9.0000000000002296
摘要
致编辑：乳腺外佩吉特病（EMPD）是一种罕见的皮肤表皮内腺癌，起源有争议，常发生在男性的阴茎阴囊区。原发性EMPD起源于表皮或顶汗腺，通常是一种原地局限于表皮的疾病预后良好，而继发性EMPD被认为与潜在的内部恶性肿瘤有关。EMPD原地有可能成为转移率较高、预后较差的侵袭性EMPD。[
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司库奇尤单抗治疗中轴性脊柱关节炎的实际有效性和安全性：一项单中心研究Yuankai Sun, Jiajia Wang, Yulu Qiu, Shiyu Lin, Fang Wang, Wenfeng Tan
中华医学杂志英文版2022年 135卷 21期
DOI: 10.1097/CM9.0000000000002047
摘要
致编辑：中轴性脊柱关节炎（axSpA）是一种慢性炎症性疾病。[
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中轴性脊柱关节炎：合成磁共振成像在骶髂关节病变检测中的应用Ke Zhang, Jing Zheng, Jielin Pan, Yunping Jiang, Yingying Zhan, Wenjuan Li, Hua Zhang, Guobin Hong
中华医学杂志英文版2022年 135卷 21期
DOI: 10.1097/CM9.0000000000001987
摘要
致编辑：中轴性脊柱关节炎(axSpA)的特征在于骶髂关节炎症、脊柱炎症、骨破坏和成骨。脊柱和/或髋关节强直可能发生在后期，显著影响患者的生活质量。骶髂关节炎作为axSpA最早和最常见的影像学表现，可分为早期活动性病变和晚期结构性病变。磁共振成像（MRI）不仅检测计算机断层扫描（CT）或X射线中无法发现的活动性炎症变化，而且在检测结构性病变方面具有与CT相似的敏感性。[
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依那西普治疗中轴性脊柱关节炎Gui Luo, Jian Zhu
中华医学杂志英文版2022年 135卷 21期
DOI: 10.1097/CM9.0000000000001986
摘要
致编辑：中轴性脊柱关节炎（axSpA）是一种影响脊柱和骶髂（SI）关节的慢性和进行性疾病，引起炎性背痛、僵硬并诱导新骨形成（严重形式的联合韧带增生和最终强直）。axSpA由两个亚组患者组成：非放射学axSpA（nr-axSpA）患者和强直性脊柱炎（AS）患者，也称为放射学axSpA。AxSpA与患者和医疗保健系统的大量临床和经济负担相关。axSpA患者的身体限制会对就业、工作效率、休闲活动、情绪和人际关系产生不利影响。
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一种新的剪接变体TMC1基因导致一个中国家庭非综合征性听力损失Beiping Zeng, Hongen Xu, Yongan Tian, Qianyu Lin, Haifeng Feng, Zhifeng Zhang, Siqi Li, Wenxue Tang
中华医学杂志英文版2022年 135卷 21期
DOI: 10.1097/CM9.0000000000001966
摘要
致编辑：听力损失是人类最常见的感觉障碍。每1000名新生儿中就有一例先天性耳聋，在50%的病例中，耳聋是遗传性的。耳聋表现出高度的遗传异质性。迄今为止，已经鉴定了超过110个非综合征性耳聋基因(https://hereditaryhearingloss.org/)。这些基因中的许多可导致常染色体显性听力损失(ADNSHL)和常染色体隐性非综合征性听力损失(ARNSHL)TMC1（编码跨膜通道样1）就是其中之一。TMC1（OMIM：606706）是位于9q21.13的TMC家族成员。该蛋白包含760个氨基酸，具有6个跨膜区。TMC1在耳蜗的内毛细胞和外毛细胞中表达。一个TMC1突变在2002年首次被证明会导致耳聋。[
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