MedNexus
2023年 · 第136卷第10期
出版日期 2023-05-20电子版 ￥0.00元
MedNexus
- 全部
- Consensus Statement
- Review Article
- Meta Analysis
- Medical Progress
- Original Article
- Technical Note
- Correspondence
- Corrigendum
Consensus Statement
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人血清白蛋白在成人心脏手术中的应用专家共识Fei Xiang, Fuhua Huang, Jiapeng Huang, Xin Li, Nianguo Dong, Yingbin Xiao, Qiang Zhao, Liqiong Xiao, Haitao Zhang, Cui Zhang 等
中华医学杂志英文版2023年 136卷 10期
DOI: 10.1097/CM9.0000000000002709
摘要
白蛋白是一种65kDa的肝脏合成蛋白，占总血浆蛋白的近50%，并贡献约80%的血管内溶胀压力。白蛋白有助于维持微血管完整性，起抗氧化剂的作用，并转运激素、脂肪酸、胆汁盐、胆红素、电解质(例如钙、镁、铜、锌，等人.)和药物。[
Review Article
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黄芪甲苷在癌症化学预防和治疗中的应用Yaning Wang, Zhuo Zhang, Zhaohua Cheng, Wei Xie, Hanjiao Qin, Jiyao Sheng
中华医学杂志英文版2023年 136卷 10期
DOI: 10.1097/CM9.0000000000002661
摘要
Tumor chemoprevention and treatment are two approaches aimed at improving the survival of patients with cancers. An ideal anti-tumor drug is that which not only kills tumor cells but also alleviates tumor-causing risk factors, such as precancerous lesions, and prevents tumor recurrence. Chinese herbal monomers are considered to be ideal treatment agents due to their multi-target effects. Astragaloside has been shown to possess tumor chemoprevention, direct anti-tumor, and chemotherapeutic drug sensitization effects. In this paper, we review the effects of astragaloside on tumor prevention and treatment and provide directions for further research.
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肝细胞癌的精确诊断Zhenxiao Wang, Hanjiao Qin, Shui Liu, Jiyao Sheng, Xuewen Zhang
中华医学杂志英文版2023年 136卷 10期
DOI: 10.1097/CM9.0000000000002641
摘要
Hepatocellular carcinoma (HCC) is the most common type of primary hepatocellular carcinoma (PHC). Early diagnosis of HCC remains the key to improve the prognosis. In recent years, with the promotion of the concept of precision medicine and more in-depth analysis of the biological mechanism underlying HCC, new diagnostic methods, including emerging serum markers, liquid biopsies, molecular diagnosis, and advances in imaging (novel contrast agents and radiomics), have emerged one after another. Herein, we reviewed and analyzed scientific advances in the early diagnosis of HCC and discussed their application and shortcomings. This review aimed to provide a reference for scientific research and clinical practice of HCC.
Meta Analysis
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急性胰腺炎积极液体复苏与控制性液体复苏：随机对照试验的系统综述和荟萃分析Kun He, Lin Gao, Zihan Yang, Yuelun Zhang, Tianrui Hua, Wenmo Hu, Dong Wu, Lu Ke
中华医学杂志英文版2023年 136卷 10期
DOI: 10.1097/CM9.0000000000002684
摘要
Background:
Early fluid resuscitation is one of the fundamental treatments for acute pancreatitis (AP), but there is no consensus on the optimal fluid rate. This systematic review and meta-analysis aimed to compare the efficacy and safety of aggressive vs. controlled fluid resuscitation (CFR) in AP.
Methods:
The Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, Embase, and Web of Science databases were searched up to September 30, 2022, for randomized controlled trials (RCTs) comparing aggressive with controlled rates of early fluid resuscitation in AP patients without organ failure on admission. The following keywords were used in the search strategy: "pancreatitis," "fluid therapy," "fluid resuscitation," and "randomized controlled trial." There was no language restriction. The Grading of Recommendations Assessment, Development and Evaluation (GRADE) framework was used to assess the certainty of evidence. Trial sequential analysis (TSA) was used to control the risk of random errors and assess the conclusions.
Results:
A total of five RCTs, involving 481 participants, were included in this study. For primary outcomes, there was no significant difference in the development of severe AP (relative risk [RR]: 1.87, 95% confidence interval [CI] 0.95-3.68; P = 0.07; n = 437; moderate quality of evidence) or hypovolemia (RR: 0.98, 95% CI: 0.32-2.97; P = 0.97; n = 437; moderate quality of evidence) between the aggressive and CFR groups. A significantly higher risk of fluid overload (RR: 3.25, 95% CI: 1.53-6.93; P <0.01; n = 249; low quality of evidence) was observed in the aggressive fluid resuscitation (AFR) group than the controlled group. Additionally, the risk of intensive care unit admission (P = 0.02) and the length of hospital stay (P <0.01) as partial secondary outcomes were higher in the AFR group. TSA suggested that more studies were required to draw precise conclusions.
Conclusion:
For AP patients without organ failure on admission, CFR may be superior to AFR with respect to both efficacy and safety outcomes.
Registration:
PROSPERO; https://www.crd.york.ac.uk/PROSPERO/; CRD 42022363945.
Medical Progress
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黑色素瘤免疫治疗的应用现状Ruxin Xie, Ningning Wang, Caihui Peng, Shiwei Zhang, Ai Zhong, Junjie Chen
中华医学杂志英文版2023年 136卷 10期
DOI: 10.1097/CM9.0000000000002660
摘要
黑色素瘤占所有恶性皮肤肿瘤的三分之一（约6.8-20.0%）。在全球范围内，黑色素瘤的发病率和死亡率都在增加。[
Original Article
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单细胞RNA测序揭示缺血性急性肾损伤患者肾脏的转录组景观Rong Tang, Peng Jin, Chanjuan Shen, Wei Lin, Leilin Yu, Xueling Hu, Ting Meng, Linlin Zhang, Ling Peng, Xiangcheng Xiao 等
中华医学杂志英文版2023年 136卷 10期
DOI: 10.1097/CM9.0000000000002679
摘要
Background:
Ischemic acute kidney injury (AKI) is a common syndrome associated with considerable mortality and healthcare costs. Up to now, the underlying pathogenesis of ischemic AKI remains incompletely understood, and specific strategies for early diagnosis and treatment of ischemic AKI are still lacking. Here, this study aimed to define the transcriptomic landscape of AKI patients through single-cell RNA sequencing (scRNA-seq) analysis in kidneys.
Methods:
In this study, scRNA-seq technology was applied to kidneys from two ischemic AKI patients, and three human public scRNA-seq datasets were collected as controls. Differentially expressed genes (DEGs) and cell clusters of kidneys were determined. Gene ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway enrichment analysis, as well as the ligand-receptor interaction between cells, were performed. We also validated several DEGs expression in kidneys from human ischemic AKI and ischemia/reperfusion (I/R) injury induced AKI mice through immunohistochemistry staining.
Results:
15 distinct cell clusters were determined in kidney from subjects of ischemic AKI and control. The injured proximal tubules (PT) displayed a proapoptotic and proinflammatory phenotype. PT cells of ischemic AKI had up-regulation of novel pro-apoptotic genes including USP47, RASSF4, EBAG9, IER3, SASH1, SEPTIN7, and NUB1, which have not been reported in ischemic AKI previously. Several hub genes were validated in kidneys from human AKI and renal I/R injury mice, respectively. Furthermore, PT highly expressed DEGs enriched in endoplasmic reticulum stress, autophagy, and retinoic acid-inducible gene I (RIG-I) signaling. DEGs overexpressed in other tubular cells were primarily enriched in nucleotide-binding and oligomerization domain (NOD)-like receptor signaling, estrogen signaling, interleukin (IL) -12 signaling, and IL-17 signaling. Overexpressed genes in kidney-resident immune cells including macrophages, natural killer T (NKT) cells, monocytes, and dendritic cells were associated with leukocyte activation, chemotaxis, cell adhesion, and complement activation. In addition, the ligand-receptor interactions analysis revealed prominent communications between macrophages and monocytes with other cells in the process of ischemic AKI.
Conclusion:
Together, this study reveals distinct cell-specific transcriptomic atlas of kidney in ischemic AKI patients, altered signaling pathways, and potential cell-cell crosstalk in the development of AKI. These data reveal new insights into the pathogenesis and potential therapeutic strategies in ischemic AKI.
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鉴别肺炎样原发性肺淋巴瘤与感染性肺炎的基于CT的放射组学模型的建立和验证：一项多中心研究Xinxin Yu, Bing Kang, Pei Nie, Yan Deng, Zixin Liu, Ning Mao, Yahui An, Jingxu Xu, Chencui Huang, Yong Huang 等
中华医学杂志英文版2023年 136卷 10期
DOI: 10.1097/CM9.0000000000002671
摘要
Background:
Pneumonia-like primary pulmonary lymphoma (PPL) was commonly misdiagnosed as infectious pneumonia, leading to delayed treatment. The purpose of this study was to establish a computed tomography (CT)-based radiomics model to differentiate pneumonia-like PPL from infectious pneumonia.
Methods:
In this retrospective study, 79 patients with pneumonia-like PPL and 176 patients with infectious pneumonia from 12 medical centers were enrolled. Patients from center 1 to center 7 were assigned to the training or validation cohort, and the remaining patients from other centers were used as the external test cohort. Radiomics features were extracted from CT images. A three-step procedure was applied for radiomics feature selection and radiomics signature building, including the inter- and intra-class correlation coefficients (ICCs), a one-way analysis of variance (ANOVA), and least absolute shrinkage and selection operator (LASSO). Univariate and multivariate analyses were used to identify the significant clinicoradiological variables and construct a clinical factor model. Two radiologists reviewed the CT images for the external test set. Performance of the radiomics model, clinical factor model, and each radiologist were assessed by receiver operating characteristic, and area under the curve (AUC) was compared.
Results:
A total of 144 patients (44 with pneumonia-like PPL and 100 infectious pneumonia) were in the training cohort, 38 patients (12 with pneumonia-like PPL and 26 infectious pneumonia) were in the validation cohort, and 73 patients (23 with pneumonia-like PPL and 50 infectious pneumonia) were in the external test cohort. Twenty-three radiomics features were selected to build the radiomics model, which yielded AUCs of 0.95 (95% confidence interval [CI]: 0.94-0.99), 0.93 (95% CI: 0.85-0.98), and 0.94 (95% CI: 0.87-0.99) in the training, validation, and external test cohort, respectively. The AUCs for the two readers and clinical factor model were 0.74 (95% CI: 0.63-0.83), 0.72 (95% CI: 0.62-0.82), and 0.73 (95% CI: 0.62-0.84) in the external test cohort, respectively. The radiomics model outperformed both the readers’ interpretation and clinical factor model (P <0.05).
Conclusions:
The CT-based radiomics model may provide an effective and non-invasive tool to differentiate pneumonia-like PPL from infectious pneumonia, which might provide assistance for clinicians in tailoring precise therapy.
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右心室-动脉解耦是伴有冠状动脉疾病的射血分数保留的急性心力衰竭的独立预后因素Hongdan Jia, Li Liu, Xile Bi, Ximing Li, Hongliang Cong
中华医学杂志英文版2023年 136卷 10期
DOI: 10.1097/CM9.0000000000002637
摘要
Background:
Right ventricular (RV)-arterial uncoupling is a powerful independent predictor of prognosis in heart failure with preserved ejection fraction (HFpEF). Coronary artery disease (CAD) can contribute to the pathophysiological characteristics of HFpEF. This study aimed to evaluate the prognostic value of RV-arterial uncoupling in acute HFpEF patients with CAD.
Methods:
This prospective study included 250 consecutive acute HFpEF patients with CAD. Patients were divided into RV-arterial uncoupling and coupling groups by the optimal cutoff value, based on a receiver operating characteristic curve of tricuspid annular plane systolic excursion to pulmonary artery systolic pressure (TAPSE/PASP). The primary endpoint was a composite of all-cause death, recurrent ischemic events, and HF hospitalizations.
Results:
TAPSE/PASP ≤0.43 provided good accuracy in identifying patients with RV-arterial uncoupling (area under the curve, 0.731; sensitivity, 61.4%; and specificity, 76.6%). Of the 250 patients, 150 and 100 patients could be grouped into the RV-arterial coupling (TAPSE/PASP >0.43) and uncoupling (TAPSE/PASP ≤0.43) groups, respectively. Revascularization strategies were slightly different between groups; the RV-arterial uncoupling group had a lower rate of complete revascularization (37.0% [37/100] vs. 52.7% [79/150], P <0.001) and a higher rate of no revascularization (18.0% [18/100] vs. 4.7% [7/150], P <0.001) compared to the RV-arterial coupling group. The cohort with TAPSE/PASP ≤0.43 had a significantly worse prognosis than the cohort with TAPSE/PASP >0.43. Multivariate Cox analysis showed TAPSE/PASP ≤0.43 as an independent associated factor for the primary endpoint, all-cause death, and recurrent HF hospitalization (hazard ratios [HR]: 2.21, 95% confidence interval [CI]: 1.44-3.39, P <0.001; HR: 3.32, 95% CI: 1.30-8.47, P = 0.012; and HR: 1.93, 95% CI: 1.10-3.37, P = 0.021, respectively), but not for recurrent ischemic events (HR: 1.48, 95% CI: 0.75-2.90, P = 0.257).
Conclusion:
RV-arterial uncoupling, based on TAPSE/PASP, is independently associated with adverse outcomes in acute HFpEF patients with CAD.
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LY01005与戈舍瑞林植入剂在中国前列腺癌患者中的疗效和安全性比较：一项多中心、随机、开放标签、III期、非劣效性试验Chengyuan Gu, Zengjun Wang, Tianxin Lin, Zhiyu Liu, Weiqing Han, Xuhui Zhang, Chao Liang, Hao Liu, Yang Yu, Zhenzhou Xu 等
中华医学杂志英文版2023年 136卷 10期
DOI: 10.1097/CM9.0000000000002638
摘要
Background:
LY01005 (Goserelin acetate sustained-release microsphere injection) is a modified gonadotropin-releasing hormone (GnRH) agonist injected monthly. This phase III trial study aimed to evaluated the efficacy and safety of LY01005 in Chinese patients with prostate cancer.
Methods:
We conducted a randomized controlled, open-label, non-inferiority trial across 49 sites in China. This study included 290 patients with prostate cancer who received either LY01005 or goserelin implants every 28 days for three injections. The primary efficacy endpoints were the percentage of patients with testosterone suppression ≤50 ng/dL at day 29 and the cumulative probability of testosterone ≤50 ng/dL from day 29 to 85. Non-inferiority was prespecified at a margin of -10%. Secondary endpoints included significant castration (≤20 ng/dL), testosterone surge within 72 h following repeated dosing, and changes in luteinizing hormone, follicle-stimulating hormone, and prostate specific antigen levels.
Results:
On day 29, in the LY01005 and goserelin implant groups, testosterone concentrations fell below medical-castration levels in 99.3% (142/143) and 100% (140/140) of patients, respectively, with a difference of -0.7% (95% confidence interval [CI], -3.9% to 2.0%) between the two groups. The cumulative probabilities of maintaining castration from days 29 to 85 were 99.3% and 97.8%, respectively, with a between-group difference of 1.5% (95% CI, -1.3% to 4.4%). Both results met the criterion for non-inferiority. Secondary endpoints were similar between groups. Both treatments were well-tolerated. LY01005 was associated with fewer injection-site reactions than the goserelin implant (0% vs. 1.4% [2/145]).
Conclusion:
LY01005 is as effective as goserelin implants in reducing testosterone to castration levels, with a similar safety profile.
Trial registration:
ClinicalTrials.gov, NCT04563936.
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中国神经内分泌肿瘤发病率和生存率与美国的比较Rongshou Zheng, Hong Zhao, Lan An, Siwei Zhang, Ru Chen, Shaoming Wang, Kexin Sun, Hongmei Zeng, Wenqiang Wei, Jie He
中华医学杂志英文版2023年 136卷 10期
DOI: 10.1097/CM9.0000000000002643
摘要
Background:
Neuroendocrine neoplasms (NENs) are rare tumors characterized by variable biology and delayed diagnosis. However, the nationwide epidemiology of NENs has never been reported in China. We aimed to estimate the incidence and survival statistics of NENs in China, in comparison to those in the United States during the same period.
Methods:
Based on the data from 246 population-based cancer registries covering 272.5 million people of China, we calculated age-specific incidence on NENs in 2017 and multiplied by corresponding national population to estimate the nationwide incidence in China. The data of 22 population-based cancer registries were used to estimate the trends of NENs incidence from 2000 to 2017 through the Joinpoint regression model. We used the cohort approach to analyze the 5-year age-standardized relative survival by sex, age group, and urban-rural area between 2008 and 2013, based on data from 176 high-quality cancer registries. We used data from the Surveillance, Epidemiology, and End Results (SEER) 18 program to estimate the comparable incidence and survival of NENs in the United States.
Results:
The overall age-standardized rate (ASR) of NENs incidence was lower in China (1.14 per 100,000) than in the United States (6.26 per 100,000). The most common primary sites were lungs, pancreas, stomach, and rectum in China. The ASRs of NENs incidence increased by 9.8% and 3.6% per year in China and the United States, respectively. The overall 5-year relative survival in China (36.2%) was lower than in the United States (63.9%). The 5-year relative survival was higher for female patients than male patients, and was higher in urban areas than in rural areas.
Conclusions:
The disparities in burden of NENs persist across sex, area, age group, and site in China and the United States. These findings may provide a scientific basis on prevention and control of NENs in the two countries.
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ACR TI-RADS联合三维剪切波弹性成像对ACR TI-RADS 4、5甲状腺结节的诊断价值Lijun Hao, Peiqing Liu, Changwei Ding, Jing Li, Yingchun Zhang
中华医学杂志英文版2023年 136卷 10期
DOI: 10.1097/CM9.0000000000002655
摘要
Background:
Three-dimensional shear wave elastography (3D-SWE) is a promising method in distinguishing benign and malignant thyroid nodules. By combining with conventional method, it may further improve the diagnostic value. The study aimed to assess the diagnostic value of American College of Radiology (ACR) thyroid imaging reporting and data system (TI-RADS) combined with 3D-SWE in ACR TI-RADS 4 and 5 thyroid nodules.
Methods:
All nodules were examined by conventional ultrasonography, ACR TI-RADS classification, and 3D-SWE examination. Conventional ultrasonography was used to observe the location, size, shape, margin, echogenicity, taller-than-wide sign, microcalcification, and blood flow of thyroid nodules, and then ACR TI-RADS classification was performed. The Young’s modulus values (3D-C-Emax, 3D-C-Emean, and elastography standard deviation [3D-C-Esd]) were measured on the reconstructed coronal plane images. According to the receiver operating characteristic (ROC) curve, the best diagnostic efficiency among 3D-C-Emax, 3D-C-Emean, and 3D-C-Esd was selected and the cut-off threshold was calculated. According to the surgical pathology, they were divided into benign group and malignant group. And appropriate statistical methods such as t-test and Mann-Whitney U test were used to compare the difference between the two groups. On this basis, 3D-SWE combined with conventional ACR TI-RADS was reclassified as combined ACR TI-RADS to determine benign or malignant thyroid nodules.
Results:
Of the 112 thyroid nodules, 62 were malignant and 50 were benign. The optimal cut-off value of three-dimensional maximum Young’s modulus in coronal plane (3D-C-Emax) was 51.5 kPa and the area under the curve (AUC) was 0.798. The AUC, sensitivity, specificity, and accuracy of conventional ACR TI-RADS were 0.828, 83.9%, 66.0%, and 75.9%, respectively. The AUC, sensitivity, specificity, and accuracy of combined ACR TI-RADS were 0.845, 90.3%, 66.0%, and 79.5%, respectively. The difference between the two AUC values was statistically significant.
Conclusions:
Combined ACR TI-RADS has higher diagnostic efficiency than conventional ACR TI-RADS. The sensitivity and accuracy of combined ACR TI-RADS showed significant improvements. It can be used as an effective method in the diagnosis of thyroid nodules.
Technical Note
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应用“神话”支架系统改善B型主动脉夹层TEVAR术后主动脉重构Chengkai Hu, Jue Yang, Wei Wang, Xiangchen Dai, Xinwu Lu, Youfei Qi, Hongpeng Zhang, Yuchong Zhang, Ye Yuan, Enci Wang 等
中华医学杂志英文版2023年 136卷 10期
DOI: 10.1097/CM9.0000000000002658
摘要
已知与标准胸主动脉腔内修复术（TEVAR）相比，近端延伸诱导完全附着（衬裙）技术改善了远端主动脉重塑。[
Correspondence
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自然孔标本提取手术（NOSES）治疗结肠癌：手术和术后短期结果的双中心病例匹配研究Petr Tsarkov, Zheng Liu, Albina Zubayraeva, Anastasia Marchuk, Grigoriy Korolev, Enrui Liu, Xishan Wang, Sergey Efetov
中华医学杂志英文版2023年 136卷 10期
DOI: 10.1097/CM9.0000000000002663
摘要
致编辑：自然口标本提取手术（NOSES）是一种积极发展的提取标本和进行非切口结直肠癌手术的方法。既往研究表明，其在直肠癌手术治疗中的有效性和安全性与常规腹腔镜手术相似。NOSES被证明是传统腹腔镜检查的一种可能的替代方法，传统腹腔镜检查使用小型剖腹手术提取标本，因为在手术特征和短期结果方面没有差异。[
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无柄锯齿状病变的鉴别内镜特征Wen Shi, Yuelun Zhang, Hanyue Ding, Feng Xie, Yang Chen, Martin C.S. Wong, Jingnan Li, Dong Wu
中华医学杂志英文版2023年 136卷 10期
DOI: 10.1097/CM9.0000000000002672
摘要
致编辑：结肠直肠癌（CRC）仍然是全球癌症相关死亡的主要原因。[
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中国淋巴浆细胞淋巴瘤/Waldenström巨球蛋白血症患者的细胞遗传学异常Wenjie Xiong, Tingyu Wang, Ying Yu, Yang Jiao, Jiawen Chen, Yi Wang, Chengwen Li, Rui Lyu, Qi Wang, Wei Liu 等
中华医学杂志英文版2023年 136卷 10期
DOI: 10.1097/CM9.0000000000002656
摘要
致编辑：作为一种罕见的惰性B细胞非霍奇金淋巴瘤，淋巴浆细胞淋巴瘤/Waldenström巨球蛋白血症（LPL/WM）具有独特的临床和生物学特征。[
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活检证实的糖尿病肾病患者肾功能快速下降的临床和组织病理学预测因素Yiyang Zhao, Dongyuan Chang, Liang Wu, Xiaojuan Yu, Suxia Wang, Minghui Zhao, Min Chen
中华医学杂志英文版2023年 136卷 10期
DOI: 10.1097/CM9.0000000000002673
摘要
致编辑：糖尿病肾病（DKD）已成为终末期肾病（ESKD）的主要原因。根据肾脏疾病改善总体结局（KDIGO）指南，DKD的快速肾功能下降定义为估计肾小球滤过率（eGFR）斜率≤-5mL·min-1·1.73米-2·年份-1eGFR快速下降的患者预后通常较差。在一项多中心回顾性研究中，377例（61%）活检证实的DKD患者中有230例是快速衰退者。[
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新生儿气管切开术后患者预后的回顾性病例对照研究Jie Yu, Fengzhen Zhang, Fei Jin, Jingwen Weng, Yaguang Peng, Jingjing Zhou, Yan Chen, Jie Zhang, Mingyan Hei
中华医学杂志英文版2023年 136卷 10期
DOI: 10.1097/CM9.0000000000002269
摘要
致编辑：尽管新生儿重症监护室（NICU）患者发生新生儿上气道阻塞的报道很常见，但新生儿气管切开术很少见，这可能是由于患者数量少，设备齐全的医院在新生儿中成功进行手术的数量更少。然而，尽管合格的、熟练的新生儿科医生和儿科耳鼻喉科医生在进行新生儿气管切开术方面做出了广泛的努力，一些新生儿没有接受这种手术。当新生儿符合气管切开术的指征，但他/她的父母拒绝做手术时，他/她面临着按照父母意愿违背医疗建议出院的更高风险(DAMA)。为探讨中国新生儿气管切开术的初步证据，以及了解新生儿在符合手术指征时行气管切开术与未行气管切开术的结局差异，我们进行了一项回顾性研究。患者在北京儿童医院接受治疗。根据父母是否签署气管切开同意书并最终完成气管切开，将患者分为气管切开组或非气管切开组。本研究经首都医科大学附属北京儿童医院伦理委员会批准（编号：[2021]-E-139-R），并在中国临床试验注册中心注册（编号：ChiCTR2100050720）。所有参与者的父母/监护人都提供了书面知情同意书。
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中医药治疗结肠炎相关性大肠癌Yuewen Yang, Zhihui Liu, Hongbo Lyu, Xinrui Guo, Haozheng Jiang, Lihong Liu, Dapeng Chen
中华医学杂志英文版2023年 136卷 10期
DOI: 10.1097/CM9.0000000000002667
摘要
致编辑：结直肠癌是全球范围内最常见的癌症之一，结肠炎尤其是溃疡性结肠炎引起的慢性炎症会增加患结直肠癌的风险。与以无翼/β-catenin信号和腺癌序列组成型激活为标志的散发性结直肠癌相比，P53和K-Ras在结肠炎相关结直肠癌（CAC）的进展过程中，较早发生的突变导致结肠腺瘤性息肉病较晚发生。手术和化疗是CAC的首选治疗方法，但长期使用5-氟尿嘧啶或伊立替康等一线化疗药物受到耐药性或不良反应的限制。因此，我们有必要对“绿色”药品进行鉴别。中药是复杂多样的，存在于自然界中。中药的抗炎、抗菌、抗病毒、抗氧化、抗肿瘤、抗辐射和免疫调节活性已被广泛研究。中药比合成药物更能防止炎症发展为癌症。现就中医药治疗CAC的优势进行综述。
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无肝素静脉-静脉体外膜肺氧合在非创伤患者手术中的应用Hongya Chen, Jinsheng Liu, Lili Wu, Cunliang Ji, Tong Li, Guyan Wang
中华医学杂志英文版2023年 136卷 10期
DOI: 10.1097/CM9.0000000000002651
摘要
致编辑：对于手术中严重气管狭窄的患者，体外膜肺氧合（ECMO）可能是确保最终气道安全的最后也是最安全的选择。肝素形式的全身抗凝是典型的选择。然而，肝素本身充满了并发症，包括患者出血和回路内凝血。[
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免疫相关遗传预后指数预测急性髓系白血病预后和免疫检查点抑制剂治疗疗效Xunhong Cao, Xiaojun Huang, Xiangyu Zhao
中华医学杂志英文版2023年 136卷 10期
DOI: 10.1097/CM9.0000000000002657
摘要
致编辑：急性髓性白血病（AML）是一种以骨髓中异常成髓细胞增殖为特征的异质性疾病。传统治疗，如化疗联合或不联合造血干细胞移植（HSCT）已被用作AML的一线治疗。然而，由于多种因素，如肿瘤免疫微环境(TME)，AML患者的临床结局差异很大。[
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水痘—带状疱疹病毒感染后并发横贯性脊髓炎和格林—巴利综合征Danmei Lan, Lingyu Liu
中华医学杂志英文版2023年 136卷 10期
DOI: 10.1097/CM9.0000000000002662
摘要
致编辑：目前已知的急性感染后或炎性脱髓鞘综合征包括急性播散性脑脊髓炎、脑炎、横贯性脊髓炎(TM)和格林-巴利综合征(GBS)。脱髓鞘通常局限于中枢或外周神经系统。脊髓炎和脱髓鞘周围神经病变并存的报道仅见于少数儿童[
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基于加权基因共表达网络分析的HER2+乳腺癌预后相关基因Yujie Weng, Rong Jia, Zhongxian Li, Wei Liang, Yucheng Ji, Ying Liang, Pengfei Ning
中华医学杂志英文版2023年 136卷 10期
DOI: 10.1097/CM9.0000000000002313
摘要
致编辑：乳腺癌是导致女性死亡的恶性疾病之一，严重威胁女性健康。随着医学治疗的进步，治疗乳腺癌的方法有很多，如药物治疗、激素治疗等。其中，分子靶向治疗极大地提高了乳腺癌的治疗效果。因此，寻找重要的分子标记至关重要。[
Corrigendum
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勘误表：连接蛋白43修饰的骨髓基质细胞通过Ca逆转K562细胞的伊马替尼耐药性2+-依赖性缝隙连接细胞间通讯中华医学杂志英文版2023年 136卷 10期
DOI: 10.3760/cma.j.issn.0366-6999.2023.10.101
摘要
在最初的文章发表之后，[
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