MedNexus
2022年 · 第135卷第23期
出版日期 2022-12-05电子版 ￥0.00元
MedNexus
- 全部
- Review Article
- Meta analysis
- Perspective
- Original Article
- Clinical Observation
- Correspondence
Review Article
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中性粒细胞胞外陷阱在重症急性胰腺炎炎症演变中的作用Hongxin Kang, Yue Yang, Lv Zhu, Xianlin Zhao, Juan Li, Wenfu Tang, Meihua Wan
中华医学杂志英文版2022年 135卷 23期
DOI: 10.1097/CM9.0000000000002359
摘要
Severe acute pancreatitis (SAP) is a life-threatening acute abdominal disease with two peaks of death: the first in the early stage, characterized by systemic inflammatory response-associated organ failure; and the second in the late stage, characterized by infectious complications. Neutrophils are the main immune cells participating in the whole process of SAP. In addition to the traditional recognition of neutrophils as the origination of chemokine and cytokine cascades or phagocytosis and degranulation of pathogens, neutrophil extracellular traps (NETs) also play an important roles in inflammatory reactions. We reviewed the role of NETs in the occurrence and development of SAP and its fatal complications, including multiple organs injury, infected pancreatic necrosis, and thrombosis. This review provides novel insights into the involvement of NETs throughout the entire process of SAP, showing that targeting NETs might be a promising strategy in SAP treatment. However, precision therapeutic options targeting NETs in different situations require further investigation.
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长非编码RNA结肠癌相关转录物2：在人类癌症中的作用和功能Shuoshuo Ma, Wenjing Wang, Dengyong Zhang, Guanru Zhao, Zheng Lu
中华医学杂志英文版2022年 135卷 23期
DOI: 10.1097/CM9.0000000000002286
摘要
Long non-coding RNAs (lncRNAs) are a family of non-protein-coding RNAs that span a length of over 200 nucleotides. Research reports have illustrated that lncRNAs are involved in various cellular processes and that their abnormal expression leads to the occurrence and development of various tumors. Colon cancer-associated transcript 2 (CCAT2) was first reported as an oncogene in colon cancer. LncRNA CCAT2 is abnormally expressed in hepatocellular carcinoma, cholangiocarcinoma, lung cancer, breast cancer, ovarian cancer, glioma, and other tumors. In tumor tissues, abnormally overexpressed CCAT2 can affect cell proliferation, migration, epithelial-mesenchymal transition, apoptosis, and other biological behaviors through endogenous RNAs mechanisms, various signaling pathways, transcriptional regulation, and other complex mechanisms. Additionally, the overexpression of CCAT2 is also closely related to the tumor size, tumor node metastasis (TNM) stage, survival time, and other prognostic factors, suggesting that it is a potential prognostic indicator. This article reviews the biological functions of CCAT2 and its mechanisms of action in tumors from previous studies. In this review, we attempt to provide a molecular basis for future clinical applications of lncRNA CCAT2.
Meta analysis
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围手术期给予右美托咪定不能降低非心脏手术后急性肾损伤的风险：一项荟萃分析Bin Hu, Tian Tian, Xintao Li, Weichao Liu, Yinggui Chen, Tianyu Jiang, Peishan Chen, Fushan Xue
中华医学杂志英文版2022年 135卷 23期
DOI: 10.1097/CM9.0000000000002408
摘要
Background:
Post-operative acute kidney injury (AKI) is one of the most common and serious complications after major surgery and is significantly associated with increased risks of morbidity and mortality. This meta-analysis was conducted to evaluate the effects of perioperative dexmedetomidine (Dex) administration on the occurrence of AKI and the outcomes of recovery after non-cardiac surgery.
Methods:
The PubMed, Embase, Web of Science, and Cochrane Library databases were systematically searched for studies comparing the effects of Dex vs. placebo on kidney function after non-cardiac surgery, and a pooled fixed-effect meta-analysis of the included studies was performed. The primary outcome was the occurence of post-operative AKI. The secondary outcomes included the occurence of intra-operative hypotension and bradycardia, intensive care unit (ICU) admission, duration of ICU stay, and hospital length of stay (LOS).
Results:
Six studies, including four randomized controlled trials (RCTs) and two observational studies, with a total of 2586 patients were selected. Compared with placebo, Dex administration could not reduce the odds of post-operative AKI (odds ratio [OR], 0.44; 95% confidence interval (CI), 0.18-1.06; P= 0.07; I2= 0.00%, P= 0.72) in RCTs, but it showed a significant renoprotective effect (OR, 0.67; 95% CI, 0.48-0.95; P = 0.02; I2 = 0.00%, P = 0.36) in observational studies. Besides, Dex administration significantly increased the odds of intra-operative bradycardia and shortened the duration of ICU stay. However, there was no significant difference in the odds of intra-operative hypotension, ICU admission, and hospital LOS.
Conclusions:
This meta-analysis suggests that perioperative Dex administration does not reduce the risk of AKI after non-cardiac surgery. However, the quality of evidence for this result is low due to imprecision and inconsistent types of non-cardiac operations. Thus, large and high-quality RCTs are needed to verify the real effects of perioperative Dex administration on the occurrence of AKI and the outcomes of recovery after non-cardiac surgery.
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麻醉深度对术后疼痛和谵妄的影响：随机对照试验序贯分析的荟萃分析Yuqin Long, Xiaomei Feng, Hong Liu, Xisheng Shan, Fuhai Ji, Ke Peng
中华医学杂志英文版2022年 135卷 23期
DOI: 10.1097/CM9.0000000000002449
摘要
Background:
Whether anesthetic depth affects postoperative outcomes remains controversial. This meta-analysis aimed to evaluate the effects of deep vs. light anesthesia on postoperative pain, cognitive function, recovery from anesthesia, complications, and mortality.
Methods:
PubMed, EMBASE, and Cochrane CENTRAL databases were searched until January 2022 for randomized controlled trials comparing deep and light anesthesia in adult surgical patients. The co-primary outcomes were postoperative pain and delirium (assessed using the confusion assessment method). We conducted a meta-analysis using a random-effects model. We assessed publication bias using the Begg’s rank correlation test and Egger’s linear regression. We evaluated the evidence using the trial sequential analysis and Grading of Recommendations Assessment, Development and Evaluation (GRADE) methodology. We conducted subgroup analyses for pain scores at different postoperative time points and delirium according to cardiac or non-cardiac surgery.
Results:
A total of 26 trials with 10,743 patients were included. Deep anesthesia compared with light anesthesia (a mean difference in bispectral index of -12 to -11) was associated with lower pain scores at rest at 0 to 1 h postoperatively (weighted mean difference = -0.72, 95% confidence interval [CI] = -1.25 to -0.18, P= 0.009; moderate-quality evidence) and an increased incidence of postoperative delirium (24.95% vs. 15.92%; risk ratio = 1.57, 95% CI = 1.28-1.91, P < 0.0001; high-quality evidence). No publication bias was detected. For the exploratory secondary outcomes, deep anesthesia was associated with prolonged postoperative recovery, without affecting neurocognitive outcomes, major complications, or mortality. In the subgroup analyses, the deep anesthesia group had lower pain scores at rest and on movement during 24 h postoperatively, without statistically significant subgroup differences, and deep anesthesia was associated with an increased incidence of delirium after non-cardiac and cardiac surgeries, without statistically significant subgroup differences.
Conclusions:
Deep anesthesia reduced early postoperative pain but increased postoperative delirium. The current evidence does not support the use of deep anesthesia in clinical practice.
Perspective
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哺乳动物雷帕霉素靶点对脓毒性心肌病铁下垂的调节：从机制到治疗Guoyu Zhao, Hao Wang, Na Cui
中华医学杂志英文版2022年 135卷 23期
DOI: 10.1097/CM9.0000000000002301
摘要
脓毒症是指宿主对感染的功能失调反应导致的多器官功能障碍。最重要的是，脓毒症患者的心肌损伤，即脓毒性心肌病（SIC），占医院死亡总数的1/3~1/2。SIC的发病机制在很大程度上仍不清楚，对此深入探讨对改善该患者群体的临床预后具有重要意义。
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间充质基质/干细胞：打破多器官功能障碍综合征治疗僵局Jinxiu Hu, Ye Li, Jie He, Xiaojuan Zhao, Mengdie Chen, Li Ye, Xinghua Pan
中华医学杂志英文版2022年 135卷 23期
DOI: 10.1097/CM9.0000000000002428
摘要
多器官功能障碍综合征（MODS）是一种以两个或多个系统或器官功能障碍为特征的临床综合征。这种内环境紊乱在严重创伤、休克或感染后24小时同时发生。MODS的病死率很高，从20%到100%不等。[
Original Article
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中国ST段抬高型心肌梗死患者的再灌注实践：来自改善中国心血管疾病护理-急性冠脉综合征项目的发现Yiqian Yang, Yongchen Hao, Jun Liu, Na Yang, Danqing Hu, Zhaoqing Sun, Dong Zhao, Jing Liu
中华医学杂志英文版2022年 135卷 23期
DOI: 10.1097/CM9.0000000000002257
摘要
Background:
Reperfusion therapy is fundamental for ST-segment elevation myocardial infarction (STEMI). However, the details of contemporary practice and factors associated with reperfusion therapy in China are largely unknown. Therefore, this study aimed to explore reperfusion practice and its associated factors among hospitalized patients with STEMI in China.
Methods:
Patients with STEMI who were admitted to 159 tertiary hospitals from 30 provinces in China were included in the Improving Care for Cardiovascular Disease in China-Acute Coronary Syndrome project from November 2014 to December 2019. The associations of the characteristics of patients and hospitals with reperfusion were examined using hierarchical logistic regression. The associations between therapies and in-hospital major adverse cardiovascular events were examined with a mixed effects Cox regression model.
Results:
Among the 59,447 patients, 37,485 (63.1%) underwent reperfusion, including 4556 (7.7%) receiving fibrinolysis and 32,929 (55.4%) receiving primary percutaneous coronary intervention (PCI). The reperfusion rate varied across geographical regions (48.0%-73.5%). The overall rate increased from 60.0% to 69.7% from 2014 to 2019, mainly due to an increase in primary PCI within 12 h of symptom onset. Timely PCI, but not fibrinolysis alone, was associated with a decreased risk of in-hospital major adverse cardiovascular events compared with no reperfusion, with an adjusted hazard ratio (95% confidence interval) of 0.64 (0.54,0.76) for primary PCI at <12 h, 0.53 (0.37,0.74) for primary PCI at 12 to 24 h, 0.46 (0.25,0.82) for the pharmaco-invasive strategy, and 0.79 (0.54,1.15) for fibrinolysis alone.
Conclusions:
Nationwide quality improvement initiatives should be strengthened to increase the reperfusion rate and reduce inequality in China.
Trial registration:
www.ClinicalTrials.gov, NCT02306616
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在中国队列中验证慢性心力衰竭风险评分预测1年死亡率的荟萃分析全球组Duo Xu, Yanjing Dong, Bo Zhang, Li Li, Chenyang Jiang
中华医学杂志英文版2022年 135卷 23期
DOI: 10.1097/CM9.0000000000002026
摘要
Background:
The Meta-Analysis Global Group in Chronic Heart Failure (MAGGIC) risk score was developed in 2013 to predict survival in heart failure (HF) patients. However, it has yet to be validated in a Chinese population. Our study aimed to investigate the ability of the score to predict 1-year mortality in a Chinese population.
Methods:
Consecutive patients with HF were retrospectively selected from the inpatient electronic medical records of the cardiology department in a regional hospital in China. A total integer score was calculated for each enrolled patient based on the value of each risk factor in the MAGGIC scoring system. Each enrolled patient was followed for at least 1 year. The observational endpoint of this study was all-cause mortality. The predictive ability of the MAGGIC score was assessed by comparing observed and predicted mortality within 1 year.
Results:
Between January 2018 and December 2020, a total of 635 patients were included in the study: 57 (9.0%) of whom died within 1 year after discharge. The average age of all patients was 74.6 ± 11.2 years, 264 of them (41.6%) were male, and the average left ventricular ejection fraction was 50.7% ± 13.2%. The area under the receiver operating characteristic curve was 0.840 (95% confidence interval: 0.779, 0.901), which indicated a fair discriminatory ability of the score. The Hosmer-Lemeshow test result (χ2 = 12.902, degree of freedom = 8, P = 0.115) indicated that the MAGGIC score had good calibration. The decision curve analysis showed that the MAGGIC score yielded a good clinical net benefit and net reduction in interventions.
Conclusions:
This validation of the MAGGIC score showed that it has a good ability to predict 1-year mortality in Chinese patients with HF after discharge. Due to regional and inter-hospital differences, external validation studies need to be further confirmed in other centers.
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使用血管紧张素转换酶抑制剂或血管紧张素受体阻滞剂增加择期腹主动脉瘤腔内修复术后急性肾损伤的风险Yuwei Xiang, Yang Liu, Jichun Zhao, Bin Huang, Zhoupeng Wu, Xiyang Chen
中华医学杂志英文版2022年 135卷 23期
DOI: 10.1097/CM9.0000000000002352
摘要
Background:
Endovascular abdominal aortic aneurysm repair (EVAR) is the major treatment for abdominal aortic aneurysm (AAA); however, EVAR still carries a considerable risk of acute kidney injury (AKI). The present study aimed to investigate the risk factors for AKI after elective EVAR procedures.
Methods:
This was a retrospective observational study. Eligible patients who underwent EVAR from September 2011 to March 2019 in West China Hospital were included. The primary outcome was the occurrence of AKI within two days after EVAR, which was defined by the Kidney Disease Improving Global Outcomes Clinical Practice Guideline. Demographics, comorbidities, medications, laboratory tests, anatomical parameters of AAA, and relative operative details were collected as variables. Univariable and multivariable logistic regression analyses were applied to identify the risk factors among variables, and covariate interactions were further assessed.
Results:
A total of 679 eligible patients were included. The incidence of postoperative AKI was 8.2% (56/679) in the whole cohort, and it was associated with a lower 5-year survival rate (63.5% vs. 80.9%; χ2 = 4.10; P = 0.043). The multivariable logistic regression showed that chronic kidney disease (OR, 5.06; 95% CI: 1.43-17.95; P = 0.012), angiotensin-converting enzyme inhibitors (ACEIs)/angiotensin receptor blockers (ARBs) (OR, 2.60; 95% CI: 1.17-5.76; P = 0.019), and short neck (OR, 2.85; 95% CI: 1.08-7.52; P = 0.035) were independent risk factors for postoperative AKI. In the covariate interaction analysis, the effect of ACEIs/ARBs use on postoperative AKI was similar across all subgroups (P > 0.05), thereby suggesting a robust effect of ACEIs/ARBs use in all patients undergoing elective endovascular abdominal aortic aneurysm repair.
Conclusions:
Postoperative AKI was associated with lower survival rate, and the use of ACEIs/ARBs was the only adjustable independent risk factor. Clinicians should consider withdrawing ACEIs/ARBs in high-risk patients undergoing elective endovascular abdominal aortic aneurysm repair to prevent postoperative AKI.
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氨茶碱辅助治疗脓毒症的随机对照试验Ruifang Zhang, Huan Liu, Dongmei Dai, Xianfei Ding, Dong Wang, Yan Wang, Xuexiu Shi, Shuguang Zhang, Xiaoguang Duan, Haixu Wang 等
中华医学杂志英文版2022年 135卷 23期
DOI: 10.1097/CM9.0000000000002282
摘要
Background:
Sepsis is a serious disease caused by infection. Aminophylline has anti-asthma and anti-inflammatory effects. We aimed to explore the safety and effect of aminophylline in sepsis.
Methods:
We conducted a clinical randomized controlled trial involving 100 patients diagnosed with sepsis within 48 h after intensive care unit (ICU) admission in two sites. All patients were randomized in a 1:1 ratio to receive standard therapy with or without aminophylline. The primary clinical outcome was all-cause mortality at 28 days.
Results:
From September 27, 2018 to February 12, 2020, we screened 277 septic patients and eventually enrolled 100 patients, with 50 assigned to the aminophylline group and 50 to the usual-care group. At 28 days, 7 of 50 patients (14.0%) in the aminophylline group had died, compared with 16 of 50 (32.0%) in the usual-care group (P = 0.032). Cox regression showed that the aminophylline group had a lower hazard of death (hazard ratio = 0.312, 95% confidence interval: 0.129-0.753). Compared with the usual-care group, patients in the aminophylline group had a longer survival time (P = 0.039 by the log-rank test). The effects of aminophylline on vasopressor dose, oxygenation index, and sequential organ failure assessment score were time-dependent with treatment. There were no significant differences in total hospitalization days, ICU hospitalization days, and rates of serious adverse events (all P > 0.05). No adverse events were observed in the trial.
Conclusions:
Aminophylline as an adjunct therapy could significantly reduce the risk of death and prolong the survival time of patients with sepsis.
Trial registration:
ChiCTR.org.cn, ChiCTR1800019173.
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肝胰十二指肠切除术治疗晚期胆道恶性肿瘤Xiangsong Wu, Maolan Li, Wenguang Wu, Xu’an Wang, Huaifeng Li, Runfa Bao, Yijun Shu, Jun Shen, Jun Gu, Xuefeng Wang 等
中华医学杂志英文版2022年 135卷 23期
DOI: 10.1097/CM9.0000000000002067
摘要
Background:
Hepatopancreatoduodenectomy (HPD) has been considered the only curative treatment for metastatic cholangiocarcinoma and some locally advanced gallbladder cancers (GBCs). However, HPD has not yet been included in treatment guidelines as a standard surgical procedure in consideration of its morbidity and mortality rates. The aim of this study was to evaluate the safety and effectiveness of HPD in treating biliary malignancies.
Methods:
The medical records of 57 patients with advanced biliary cancer undergoing HPD from January 2009 to December 2019 were retrospectively retrieved. A case-control analysis was conducted at our department. Patients with advanced GBC who underwent HPD (HPD-GBC group) were compared with a control group (None-HPD-GBC group). Baseline characteristics, preoperative treatments, tumor pathologic features, operative results, and prognosis were assessed.
Results:
Thirteen patients with cholangiocarcinoma and 44 patients with GBC underwent HPD at our department. Significant postoperative complications (grade III or greater) and postoperative pancreatic fistula were observed in 24 (42.1%) and 15 (26.3%) patients, respectively. One postoperative death occurred in the present study. Overall survival (OS) was longer in patients with advanced cholangiocarcinoma than in those with GBC (median survival time [MST], 31 months vs. 11 months; P < 0.001). In the subgroup analysis of patients with advanced GBC, multivariate analysis demonstrated that T4 stage tumors (P = 0.012), N2 tumors (P = 0.001), and positive margin status (P = 0.004) were independently associated with poorer OS. Patients with either one or more prognostic factors exhibited a shorter MST than patients without those prognostic factors (P < 0.001).
Conclusion:
HPD could be performed with a relatively low mortality rate and an acceptable morbidity rate in an experienced high-volume center. For patients with advanced GBC without an N2 or T4 tumor, HPD can be a preferable treatment option.
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成纤维细胞生长因子5过表达通过调节磷酸肌醇-3-激酶/蛋白激酶B途径改善脂多糖诱导的肝细胞凋亡Shengyu Cui, Yuhua Li, Xutao Zhang, Bing Wu, Ming Li, Jixian Gao, Lin Xu, Hao Xia
中华医学杂志英文版2022年 135卷 23期
DOI: 10.1097/CM9.0000000000002540
摘要
Background:
Sepsis is a systemic inflammatory syndrome induced by several infectious agents. Multiple organs are affected by sepsis, including the liver, which plays an important role in metabolism and immune homeostasis. Fibroblast growth factors (FGFs) participate in several biological processes, although the role of FGF5 in sepsis is unclear.
Methods:
In this study, lipopolysaccharide (LPS) was administrated to mice to establish a sepsis-induced liver injury. A similar in vitro study was conducted using L-02 hepatocytes. Western blot and immunohistochemistry staining were performed to evaluate the FGF5 expression level in liver tissues and cells. Inflammatory cell infiltrations, cleaved-caspase-3 expressions, reactive oxygen species and levels of inflammatory cytokines were detected by immunofluorescence, dihydroethidium staining, and reverse transcription quantitative polymerase chain reaction analysis, respectively. Flow cytometry was used to detect the apoptosis level of cells. In addition, ribonucleic acid (RNA)-sequencing was applied to explore the possible mechanism by which FGF5 exerted effects.
Results:
LPS administration caused FGF5 down-regulation in the mouse liver as well as in L-02 hepatocytes. Additionally, with FGF5 overexpression, liver injury and the level of hepatocyte apoptosis were ameliorated. Further, RNA sequencing performed in hepatocytes revealed the phosphoinositide-3-kinase/protein kinase B (PI3K/AKT) pathway as a possible pathway regulated by FGF5. This was supported using an inhibitor of the PI3K/AKT pathway, which abrogated the protective effect of FGF5 in LPS-induced hepatocyte injury.
Conclusion:
The anti-apoptotic effect of FGF5 on hepatocytes suffering from LPS has been demonstrated and was dependent on the activation of the PI3K/AKT signaling pathway.
Clinical Observation
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快速现场评估与径向支气管内超声相结合对周围型肺部感染性病变的诊断价值Min Li, Jiaqi Cao, Qian He, Ming Zhang, Qianqian Xu, Wenya Su, Chunlai Feng
中华医学杂志英文版2022年 135卷 23期
DOI: 10.1097/CM9.0000000000002490
摘要
周围性肺部病变（PPLs）被肺实质包围，在内窥镜下看不见。常规支气管镜检查对PPLs的检出率较低。径向支气管内超声（R-EBUS）可以克服这些限制，因为它可以通过特征性超声信号定位外周支气管病变。
Correspondence
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补液和脱水对犬感染性休克模型静脉回流的影响Wei Du, Jianhua Sun, Huan Chen
中华医学杂志英文版2022年 135卷 23期
DOI: 10.1097/CM9.0000000000002464
摘要
致编辑：当前指南建议在识别脓毒性休克患者后立即用≥30 mL/kg晶体液进行复苏。[
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影响成人住院心脏骤停后心肺复苏和生存结局的因素分析：一项回顾性观察研究Chaolan Wang, Yulei Gao, Yancun Liu, Ying Yao, Chen Li, Qingsong Li, Yanfen Chai
中华医学杂志英文版2022年 135卷 23期
DOI: 10.1097/CM9.0000000000002333
摘要
致编辑：心肺复苏（CPR）指南，尤其是美国心脏协会（AHA）最新发布的2020年指南，都强调了高质量CPR的重要性。[
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我国体外心肺复苏的现状、疗效和安全性Ying Liu, Xiaoning Han, Qi Qi, Zhiyong Yuan, Fuhua Wang, Kai Song, Xiaotong Hou, Jinyan Xing
中华医学杂志英文版2022年 135卷 23期
DOI: 10.1097/CM9.0000000000002455
摘要
致编辑：院外和院内心脏骤停的常规心肺复苏（CCPR）的存活率在9%至20%之间。[
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炎症中的甲基CpG结合结构域蛋白2（MBD2）Qian Lei, Wei Zhang
中华医学杂志英文版2022年 135卷 23期
DOI: 10.1097/CM9.0000000000002482
摘要
致编辑：甲基CpG结合域蛋白2（MBD2）属于组蛋白去乙酰化酶家族，通过抑制甲基化促进多基因表达，参与多种疾病的病理过程。细胞凋亡和炎症反应是导致多种免疫性疾病的主要机制。MBD2作为一种重要的甲基化蛋白阅读器，近年来已被证明在炎症反应中是不可或缺的。本文总结了目前对炎症MBD2生物学的认识，并通过总结目前对MBD2在炎症性疾病中的调节机制以及可能调节功能障碍的炎症途径的认识，为炎症机制的研究提供了额外的方向。截至2022年5月，PubMed、Embase和万方数据被搜索，没有语言限制，以查找MBD2在炎症途径、免疫细胞分化和巨噬细胞极化等方面的报告。鉴定的文献表明，MBD2可以在炎性疾病相关细胞中产生变化，并通过影响经典的炎症途径丝裂原活化蛋白激酶、免疫细胞T辅助（Th）细胞17（Th17）、Th1和Th2细胞以及巨噬细胞极化来调节炎症过程。因此，我们推断MBD2可能是炎症性疾病的有效治疗靶点，这应该有助于未来的研究。
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循环线粒体DNA水平与脓毒症患者的早期诊断和预后相关Gaosheng Zhou, Jingjing Liu, Hongmin Zhang, Xiaoting Wang, Dawei Liu
中华医学杂志英文版2022年 135卷 23期
DOI: 10.1097/CM9.0000000000002485
摘要
致编辑：已知病原体相关分子模式和损伤相关分子模式（DAMPs）都会增强脓毒症期间的炎症和组织损伤水平。线粒体是DAMPs的主要来源，因为它们在脓毒症期间释放线粒体（mt）DNA片段。与细菌DNA类似，循环mtDNA可以激活信号通路并传播炎症。此前，普斯卡里奇等人[
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机器学习预测重症监护室急性胰腺炎患者急性肾损伤Yisong Cheng, Jie Yang, Qin Wu, Lili Cao, Bo Wang, Xiaodong Jin, Yan Kang, Zhongwei Zhang, Min He
中华医学杂志英文版2022年 135卷 23期
DOI: 10.1097/CM9.0000000000002531
摘要
致编辑：急性肾损伤（AKI）是重症监护病房（ICU）中急性胰腺炎的一种众所周知的严重并发症。发生AKI的急性胰腺炎患者的死亡率显著高于未发生AKI的患者。[
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液相色谱-串联质谱诊断肾淀粉样变性：来自中国单中心队列研究的经验Ying Sun, Jian Sun, Jianling Tao, Wei Sun, Xuemei Li, Mingxi Li
中华医学杂志英文版2022年 135卷 23期
DOI: 10.1097/CM9.0000000000002155
摘要
致编辑：淀粉样变性是由组织中不溶性β-折叠蛋白原纤维的细胞外沉积引起的，根据组成蛋白进行分类。淀粉样变性的病因可以追溯到30多种错误折叠的蛋白质，准确的淀粉样蛋白分型对于适当的治疗至关重要。[
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基于RNA结合蛋白的肝癌患者预后预测风险评分模型Shengjun Xu, Ning Ding, Sheng Zheng, Jun Chen, Yafeng Wan, Sunbin Ling, Xiao Xu
中华医学杂志英文版2022年 135卷 23期
DOI: 10.1097/CM9.0000000000002232
摘要
致编辑：据估计，肝癌是第六大致死性肿瘤，约占所有癌症相关死亡的5.0%。[
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银甲丸抑制持续性沙眼衣原体感染Mei Luo, Rongjing Hu, Ziyi Zhao, Lanshuang Li, Ming Xia
中华医学杂志英文版2022年 135卷 23期
DOI: 10.1097/CM9.0000000000002038
摘要
致编辑：沙眼衣原体（C.trachomatis）是专性细胞内病原体，通常由于宿主炎性免疫应答以及持续感染而导致慢性疾病和组织损伤的发展，[
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有骨关节炎风险的膝关节三个区室软骨损伤的轨迹和预测因素Limin Wu, Yuan Liu, Haibo Si, Mingyang Li, Yi Zeng, Yuangang Wu, Bin Shen
中华医学杂志英文版2022年 135卷 23期
DOI: 10.1097/CM9.0000000000002402
摘要
致编辑：骨关节炎（OA）是一种突出的致残疾病，其特征在于进行性关节软骨损伤以及软骨下骨和关节的其他结构的退化，并且被列为导致全球残疾的第12大疾病。[
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