MedNexus
2023年 · 第136卷第22期
出版日期 2023-11-20电子版 ￥0.00元
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Review Article
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免疫缺陷中的病毒组：我们目前所知Hu Wang, Siqi Xu, Shuang Li, Bin Su, Scott Sherrill-Mix, Guanxiang Liang
中华医学杂志英文版2023年 136卷 22期
DOI: 10.1097/CM9.0000000000002899
摘要
Over the past few years, the human virome and its complex interactions with microbial communities and the immune system have gained recognition as a crucial factor in human health. Individuals with compromised immune function encounter distinctive challenges due to their heightened vulnerability to a diverse range of infectious diseases. This review aims to comprehensively explore and analyze the growing evidence regarding the role of the virome in immunocompromised disease status. By surveying the latest literature, we present a detailed overview of virome alterations observed in various immunodeficiency conditions. We then delve into the influence and mechanisms of these virome changes on the pathogenesis of specific diseases in immunocompromised individuals. Furthermore, this review explores the clinical relevance of virome studies in the context of immunodeficiency, highlighting the potential diagnostic and therapeutic gains from a better understanding of virome contributions to disease manifestations.
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靶向HIV储库：用于HIV治愈的嵌合抗原受体疗法Shuang Li, Hu Wang, Na Guo, Bin Su, Olivier Lambotte, Tong Zhang
中华医学杂志英文版2023年 136卷 22期
DOI: 10.1097/CM9.0000000000002904
摘要
Although antiretroviral therapy (ART) can reduce the viral load in the plasma to undetectable levels in human immunodeficiency virus (HIV)-infected individuals, ART alone cannot completely eliminate HIV due to its integration into the host cell genome to form viral reservoirs. To achieve a functional cure for HIV infection, numerous preclinical and clinical studies are underway to develop innovative immunotherapies to eliminate HIV reservoirs in the absence of ART. Early studies have tested adoptive T-cell therapies in HIV-infected individuals, but their effectiveness was limited. In recent years, with the technological progress and great success of chimeric antigen receptor (CAR) therapy in the treatment of hematological malignancies, CAR therapy has gradually shown its advantages in the field of HIV infection. Many studies have identified a variety of HIV-specific CAR structures and types of cytolytic effector cells. Therefore, CAR therapy may be beneficial for enhancing HIV immunity, achieving HIV control, and eliminating HIV reservoirs, gradually becoming a promising strategy for achieving a functional HIV cure. In this review, we provide an overview of the design of anti-HIV CAR proteins, the cell types of anti-HIV CAR (including CAR T cells, CAR natural killer cells, and CAR-encoding hematopoietic stem/progenitor cells), the clinical application of CAR therapy in HIV infection, and the prospects and challenges in anti-HIV CAR therapy for maintaining viral suppression and eliminating HIV reservoirs.
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心房颤动的机制与临床治疗Zhicheng Hu, Ligang Ding, Yan Yao
中华医学杂志英文版2023年 136卷 22期
DOI: 10.1097/CM9.0000000000002906
摘要
Atrial fibrillation (AF), the most common sustained arrhythmia, is associated with a range of symptoms, including palpitations, cognitive impairment, systemic embolism, and increased mortality. It places a significant burden on healthcare systems worldwide. Despite decades of research, the precise mechanisms underlying AF remain elusive. Current understanding suggests that factors like stretch-induced fibrosis, epicardial adipose tissue (EAT), chronic inflammation, autonomic nervous system (ANS) imbalances, and genetic mutations all play significant roles in its development. In recent years, the advent of wearable devices has revolutionized AF diagnosis, enabling timely detection and monitoring. However, balancing early diagnosis with efficient resource utilization presents new challenges for healthcare providers. AF management primarily focuses on stroke prevention and symptom alleviation. Patients at high risk of thromboembolism require anticoagulation therapy, and emerging pipeline drugs, particularly factor XI inhibitors, hold promise for achieving effective anticoagulation with reduced bleeding risks. The scope of indications for catheter ablation in AF has expanded significantly. Pulsed field ablation, as a novel energy source, shows potential for improving success rates while ensuring safety. This review integrates existing knowledge and ongoing research on AF pathophysiology and clinical management, with emphasis on diagnostic devices, next-generation anticoagulants, drugs targeting underlying mechanisms, and interventional therapies. It offers a comprehensive mosaic of AF, providing insights into its complexities.
Original Article
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多鲁替拉韦联合拉米夫定的疗效和安全性特征vs.bictegravir/恩曲他滨/替诺福韦艾拉酚胺治疗初治HIV-1成人患者Yinghua Wei, Jin Li, Ruhong Xu, Li Wen, Yiming Deng, Lixia He, Huijun Zhong, Yanhao Wang
中华医学杂志英文版2023年 136卷 22期
DOI: 10.1097/CM9.0000000000002907
摘要
Background:
Dual regimen dolutegravir (DTG) plus lamivudine (3TC) has demonstrated non-inferior efficacy compared to DTG-based three-drug regimens (3DRs), yet directly comparative data regarding the efficacy and safety of DTG + 3TC and bictegravir/emtricitabine/tenofovir alafenamide (B/F/TAF) for therapy-naïve people with human immunodeficiency virus (HIV)-1 (PWH) are still limited. We aimed to assess the antiviral potency and safety profiles of DTG + 3TC vs. B/F/TAF based on antiretroviral therapy (ART)-naïve PWH in China.
Methods:
This retrospective multicenter study enrolled PWH initiating ART with DTG + 3TC or B/F/TAF from 2020 to 2022 in Guangdong and Guangxi. We analyzed response rates based on target not detected (TND) status using intention-to-treat (ITT) analysis. Subgroups were formed based on baseline viral load (VL) (<100,000 vs. ≥100,000 copies/mL) and CD4+ cell count (<200 vs. ≥200 cell/µL). Median time to TND VL was assessed by Kaplan–Meier method. We also measured changes from baseline in CD4+ cell counts, CD4/CD8 ratio, lipid parameters, weight, creatinine (Cr), estimated glomerular filtration rate (eGFR), and drug-related adverse effects (DRAEs).
Results:
We enrolled 280 participants, including 137 (48.9%) on DTG + 3TC and 143 (51.1%) on B/F/TAF. At week 48, 96.4% (132/137) on DTG+3TC and 100% (143/143) on B/F/TAF achieved TND (P = 0.064). At week 12, TND responses were higher with B/F/TAF (78.3% [112/143]) than DTG+3TC (30.7% [42/137]) (P <0.001). This trend held across subgroups. B/F/TAF achieved TND faster (12 weeks) than DTG+3TC (24 weeks) (P <0.001). No differences were seen in CD4+ cell count and CD4/CD8 ratio, except in the high-VL subgroup, where B/F/TAF showed better recovery. DRAEs were significantly lower with B/F/TAF (4.9% [7/143]) than with DTG + 3TC (13.1% [18/137]) (P = 0.016). Lipid parameters, body weight, and Cr increased in both groups over 48 weeks, with DTG+3TC showing a more favorable effect on triglycerides, high-density lipoprotein (HDL) cholesterol, and weight gain.
Conclusions:
In this real-life study, B/F/TAF led to a faster viral decline and fewer DRAEs compared to DTG+3TC. No significant difference was observed in the TND rate at week 48, regardless of baseline VL and CD4+ cell count. CD4+ recovery was superior for B/F/TAF in participants with high VL. The DTG + 3TC regimen had less impact on metabolic changes than B/F/TAF.
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广东地区HBV/HIV合并感染患者抗逆转录病毒治疗期间乙型肝炎表面抗原血清清除率及相关因素Yaozu He, Weiyin Lin, Hong Li, Fei Gu, Huolin Zhong, Yun Lan, Yonghong Li, Pengle Guo, Fengyu Hu, Weiping Cai 等
中华医学杂志英文版2023年 136卷 22期
DOI: 10.1097/CM9.0000000000002886
摘要
Background:
Hepatitis B surface antigen (HBsAg) clearance is vital for a functional cure of hepatitis B virus (HBV) infection. However, the incidence and predictors of HBsAg seroclearance in patients co-infected with HBV and human immunodeficiency virus (HIV) remain largely unknown in Guangdong, China.
Methods:
Between 2009 and 2019, patients co-infected with HBV/HIV undergoing antiretroviral therapy (ART) in Guangzhou Eighth People’s Hospital affiliated to Guangzhou Medical University were retrospectively reviewed with the endpoint on December 31, 2020. The incidence and risk factors for HBsAg seroclearance were evaluated using Kaplan–Meier and multivariate Cox regression analyses.
Results:
A total of 1550 HBV/HIV co-infected patients were included in the study, with the median age of 42 years and 86.0% (1333/1550) males. Further, 98.3% (1524/1550) received ART containing tenofovir disoproxil fumarate (TDF) plus lamivudine (3TC). HBV DNA was examined in 1283 cases at the last follow-up. Over the median 4.7 years of follow-up, 8.1% (126/1550) patients achieved HBsAg seroclearance, among whom 50.8% (64/126) obtained hepatitis B surface antibody, 28.1% (137/488) acquired hepatitis B e antigen seroconversion, and 95.9% (1231/1283) undetectable HBV DNA. Compared with patients who maintained HBsAg positive, cases achieving HBsAg seroclearance showed no differences in age, gender, CD4+ T cell count, alanine aminotransferase (ALT) level, or fibrosis status; however, they presented lower HBV DNA levels, lower HBsAg levels, and higher rates of HBV genotype B at the baseline. Multivariate analysis showed that baseline HBsAg <1500 cutoff index (COI) (adjusted hazard ratio [aHR], 2.74, 95% confidence interval [95% CI]: 1.48–5.09), ALT elevation >2 × upper limit of normal during the first six months after receiving ART (aHR, 2.96, 95% CI: 1.53–5.77), and HBV genotype B (aHR, 3.73, 95% CI: 1.46–9.59) were independent predictors for HBsAg seroclearance (all P <0.01).
Conclusions:
Long-term TDF-containing ART has high anti-HBV efficacy including relatively high overall HBsAg seroclearance in HBV/HIV co-infected patients. Lower baseline HBsAg levels, HBV genotype B, and elevated ALT levels during the first six months of ART are potential predictors of HBsAg seroclearance.
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人类免疫缺陷病毒感染的免疫无应答者的免疫细胞转录组图谱鉴定了控制病毒复制的标记基因Yahong Chen, Xin Li, Shuran Liu, Wen Ao, Jing Lin, Zhenting Li, Shouli Wu, Hanhui Ye, Xiao Han, Dongliang Li
中华医学杂志英文版2023年 136卷 22期
DOI: 10.1097/CM9.0000000000002918
摘要
Background:
Previous studies have examined the bulk transcriptome of peripheral blood immune cells in acquired immunodeficiency syndrome patients experiencing immunological non-responsiveness. This study aimed to investigate the characteristics of specific immune cell subtypes in acquired immunodeficiency syndrome patients who exhibit immunological non-responsiveness.
Methods:
A single-cell transcriptome sequencing of peripheral blood mononuclear cells obtained from both immunological responders (IRs) (CD4+ T-cell count >500) and immunological non-responders (INRs) (CD4+ T-cell count <300) was conducted. The transcriptomic profiles were used to identify distinct cell subpopulations, marker genes, and differentially expressed genes aiming to uncover potential genetic factors associated with immunological non-responsiveness.
Results:
Among the cellular subpopulations analyzed, the ratios of monocytes, CD16+ monocytes, and exhausted B cells demonstrated the most substantial differences between INRs and IRs, with fold changes of 39.79, 11.08, and 2.71, respectively. In contrast, the CD4+ T cell ratio was significantly decreased (0.39-fold change) in INRs compared with that in IRs. Similarly, the ratios of natural killer cells and terminal effector CD8+ T cells were also lower (0.37-fold and 0.27-fold, respectively) in the INRs group. In addition to several well-characterized immune cell-specific markers, we identified a set of 181 marker genes that were enriched in biological pathways associated with human immunodeficiency virus (HIV) replication. Notably, ISG15, IFITM3, PLSCR1, HLA-DQB1, CCL3L1, and DDX5, which have been demonstrated to influence HIV replication through their interaction with viral proteins, emerged as significant monocyte marker genes. Furthermore, the differentially expressed genes in natural killer cells were also enriched in biological pathways associated with HIV replication.
Conclusions:
We generated an atlas of immune cell transcriptomes in HIV-infected IRs and INRs. Host genes associated with HIV replication were identified as markers of, and were found to be differentially expressed in, different types of immune cells.
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基于快速区域卷积神经网络的原发性肝透明细胞癌诊断Bin Liu, Jianfei Li, Xue Yang, Feng Chen, Yanyan Zhang, Hongjun Li
中华医学杂志英文版2023年 136卷 22期
DOI: 10.1097/CM9.0000000000002853
摘要
Background:
Distinguishing between primary clear cell carcinoma of the liver (PCCCL) and common hepatocellular carcinoma (CHCC) through traditional inspection methods before the operation is difficult. This study aimed to establish a Faster region-based convolutional neural network (RCNN) model for the accurate differential diagnosis of PCCCL and CHCC.
Methods:
In this study, we collected the data of 62 patients with PCCCL and 1079 patients with CHCC in Beijing YouAn Hospital from June 2012 to May 2020. A total of 109 patients with CHCC and 42 patients with PCCCL were randomly divided into the training validation set and the test set in a ratio of 4:1. The Faster RCNN was used for deep learning of patients’ data in the training validation set, and established a convolutional neural network model to distinguish PCCCL and CHCC. The accuracy, average precision, and the recall of the model for diagnosing PCCCL and CHCC were used to evaluate the detection performance of the Faster RCNN algorithm.
Results:
A total of 4392 images of 121 patients (1032 images of 33 patients with PCCCL and 3360 images of 88 patients with CHCC) were uesd in test set for deep learning and establishing the model, and 1072 images of 30 patients (320 images of nine patients with PCCCL and 752 images of 21 patients with CHCC) were used to test the model. The accuracy of the model for accurately diagnosing PCCCL and CHCC was 0.962 (95% confidence interval [CI]: 0.931–0.992). The average precision of the model for diagnosing PCCCL was 0.908 (95% CI: 0.823–0.993) and that for diagnosing CHCC was 0.907 (95% CI: 0.823–0.993). The recall of the model for diagnosing PCCCL was 0.951 (95% CI: 0.916–0.985) and that for diagnosing CHCC was 0.960 (95% CI: 0.854–0.962). The time to make a diagnosis using the model took an average of 4 s for each patient.
Conclusion:
The Faster RCNN model can accurately distinguish PCCCL and CHCC. This model could be important for clinicians to make appropriate treatment plans for patients with PCCCL or CHCC.
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对胸腺癌和胸腺神经内分泌肿瘤的遗传学见解表明预后特征和途径Shuyuan Wang, Zhitao Gu, Lei Zhu, Yuchen Han, Hong Yu, Wentao Fang, Baohui Han
中华医学杂志英文版2023年 136卷 22期
DOI: 10.1097/CM9.0000000000002852
摘要
Background:
Thymic carcinomas (TCs) and thymic neuroendocrine neoplasms (TNENs) are two aggressive subtypes of thymic malignancy. Traditional therapy for advanced TCs and TNENs has limited outcome. New genomic profiling of TCs and TNENs might provide insights that contribute to the development of new treatment approaches.
Methods:
We used gene panel sequencing technologies to investigate the genetic aberrations of 32 TC patients and 15 TNEN patients who underwent surgery at Shanghai Chest Hospital between 2015 and 2017. Patient samples were sequenced using a 324-gene platform with licensed technologies. In this study, we focused on clinically relevant genomic alterations (CRGAs), which are previously proven to be pathogenic alterations, to identify the pathology-specific mutational patterns, prognostic signatures of TCs and TNENs.
Results:
The mutational profiles between TCs and TNENs were diverse. The genetic alterations that ranked highest in TCs were in CDKN2A, TP53, ASXL1, CDKN2B, PIK3C2G, PTCH1, and ROS1, while those in TNENs were in MEN1, MLL2, APC, RB1, and TSC2. Prognostic analysis showed that mutations of ROS1, CDKN2A, CDKN2B, BRAF, and BAP1 were significantly associated with worse outcomes in TC patients, and that mutation of ERBB2 indicated shortened disease-free survival (DFS) and overall survival (OS) in TNEN patients. Further investigation found that the prognosis-related genes were focused on signal pathways of cell cycle control, chromatin remodeling/DNA methylation, phosphoinositide 3-kinases (PI3K)/protein kinase B (AKT)/mammalian target of rapamycin (mTOR), and receptor tyrosine kinase (RTK)/RAS/mitogen-activated protein kinase (MAPK) signaling.
Conclusion:
We profiled the mutational features of 47 Chinese patients with thymic malignancy of diverse pathologic phenotypes to uncover the integrated genomic landscape of these rare tumors, and identified the pathology-specific mutational patterns, prognostic signatures, and potential therapeutic targets for TCs and TNENs.
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黄连素可能通过抑制B细胞功能的调节来阻断大肠癌的发生小韦荣氏菌Yun Qian, Ziran Kang, Licong Zhao, Huimin Chen, Chengbei Zhou, Qinyan Gao, Zheng Wang, Qiang Liu, Yun Cui, Xiaobo Li 等
中华医学杂志英文版2023年 136卷 22期
DOI: 10.1097/CM9.0000000000002752
摘要
Background:
Colorectal carcinogenesis and progression are related to the gut microbiota and the tumor immune microenvironment. Our previous clinical trial demonstrated that berberine (BBR) hydrochloride might reduce the recurrence and canceration of colorectal adenoma (CRA). The present study aimed to further explore the mechanism of BBR in preventing colorectal cancer (CRC).
Methods:
We performed metagenomics sequencing on fecal specimens obtained from the BBR intervention trial, and the differential bacteria before and after medication were validated using quantitative polymerase chain reaction. We further performed ApcMin/+ animal intervention tests, RNA sequencing, flow cytometry, immunohistochemistry, and enzyme-linked immunosorbent assays.
Results:
The abundance of fecal Veillonella parvula (V. parvula) decreased significantly after BBR administration (P = 0.0016) and increased through the development from CRA to CRC. Patients with CRC with a higher V. parvula abundance had worse tumor staging and a higher lymph node metastasis rate. The intestinal immune pathway of Immunoglobulin A production was activated, and the expression of TNFSF13B (Tumor necrosis factor superfamily 13b, encoding B lymphocyte stimulator [BLyS]), the representative gene of this pathway, and the genes encoding its receptors (interleukin-10 and transforming growth factor beta) were significantly upregulated. Animal experiments revealed that V. parvula promoted colorectal carcinogenesis and increased BLyS levels, while BBR reversed this effect.
Conclusion:
BBR might inhibit V. parvula and further weaken the immunomodulatory effect of B cells induced by V. parvula, thereby blocking the development of colorectal tumors.
Trial Registraion:
ClinicalTrials.gov, No. NCT02226185.
Medical Progress
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HIV相关血脂异常的发病机制及其治疗Zhikai Wan, Bohao Dai, Xueling Zhu, Ying Huang, Biao Zhu
中华医学杂志英文版2023年 136卷 22期
DOI: 10.1097/CM9.0000000000002879
摘要
随着联合抗逆转录病毒疗法（cART）的发展，人类免疫缺陷病毒（HIV）感染在过去二十年中已经从一种通常致命的疾病转变为一种可控制的慢性疾病。[
Rapid Report
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中国天津预处理整合酶链转移抑制剂耐药性Huan Xia, Zhangwen Ge, Defa Zhang, Yue Wu, Ping Ma
中华医学杂志英文版2023年 136卷 22期
DOI: 10.1097/CM9.0000000000002898
摘要
人类免疫缺陷病毒（HIV）感染是全世界公共卫生的一个重大而紧迫的问题。[
Correspondence
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比替格拉韦/恩曲他滨/替诺福韦艾拉酚胺与依法韦仑治疗方案在中国中部地区的结局：一项真实世界评估Yongquan Peng, Xujian Cao, Yating Wang, Weiwei Yu, Ziwei Zeng, Min Wang
中华医学杂志英文版2023年 136卷 22期
DOI: 10.1097/CM9.0000000000002888
摘要
致编辑：人类免疫缺陷病毒（HIV）流行病对全球公共卫生构成重大挑战。截至2022年，全球约有3900万人感染了艾滋病毒。[
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HIV相关性非霍奇金淋巴瘤患者外周血单个核细胞HIV-1 DNA水平Zhenyan Wang, Jingna Xun, Zichen Song, Yinzhong Shen, Li Liu, Jun Chen, Tangkai Qi, Jianjun Sun, Wei Song, Yang Tang 等
中华医学杂志英文版2023年 136卷 22期
DOI: 10.1097/CM9.0000000000002897
摘要
致编辑：即使在抗逆转录病毒治疗（ART）时代，人类免疫缺陷病毒（HIV）患者患非霍奇金淋巴瘤（NHL）的风险也会增加。[
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河南省治疗失败HIV感染者的耐药突变Jinjin Liu, Zhaoyun Chen, Shuguang Wei, Jie Ma, Xiaohua Zhang, Shuxian Zhao, Qingxia Zhao, Xuan Yang, Yuanyuan Li, Xuhui Chen 等
中华医学杂志英文版2023年 136卷 22期
DOI: 10.1097/CM9.0000000000002881
摘要
致编辑：涉及人类缺陷病毒1型（HIV-1）的耐药突变（DRMs）降低了当前抗逆转录病毒治疗（ART）方案的疗效，导致治疗失败。更好地了解导致ART失败的当地DRM的患病率可以为临床和政府层面的决策提供有价值的数据。基于对2018年6月至2022年4月郑州市第六人民医院PLWH血浆样本的分析，评估了ART难治性HIV（PLWH）（病毒载量>200拷贝/mL）感染者的DRM状态。此外，扩增、测序和分析部分聚合酶(pol)和完整整合酶基因编码序列以鉴定DRM。本研究经郑州市第六人民医院机构伦理委员会批准（编号：2019-04）。所有参与者在样本采集前签署了书面知情同意书。
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在第48周时不同基线HIV-1 RNA水平下，B/F/TAF在初治HIV患者中的疗效一致Kun He, Yihong Zhou, Honghong Yang, Yanqiu Lu, Qiuxiang Tan, Weiwei Qi, Min Liu
中华医学杂志英文版2023年 136卷 22期
DOI: 10.1097/CM9.0000000000002887
摘要
致编辑：先前的研究已经证明了比替格拉韦（B）、恩曲他滨（F）和替诺福韦艾拉酚胺（TAF）在人类免疫缺陷病毒（HIV）感染患者中实现病毒学抑制的功效。病毒学抑制可受多种因素影响，基线HIV-1 RNA是关键考虑因素。指南常将基线HIV RNA水平>500,000拷贝/mL作为药物选择的主要参考指标。[
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PD-1抑制剂在伴有严重合并症的HIV感染患者中的安全性和有效性：一项前瞻性观察队列研究Xueling Zhu, Xiang Liu, Zhikai Wan, Jiangjin Hui, Ran Tao, Xiaorong Peng, Junwei Su, Ying Huang, Biao Zhu
中华医学杂志英文版2023年 136卷 22期
DOI: 10.1097/CM9.0000000000002883
摘要
致编辑：与健康人群相比，携带人类免疫缺陷病毒（PLWH）的人更有可能患癌症，具有更严重的癌症临床病程，并且具有更高的死亡率。由于联合抗逆转录病毒疗法（cART）疗效和预期寿命的改善，用于癌症的标准治疗和免疫疗法（如免疫检查点抑制剂（ICIs））越来越多地用于治疗PLWH的非获得性免疫缺陷综合征定义的癌症。[
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未接受过抗逆转录病毒治疗的HIV感染者往往会出现更严重的COVID-19症状Jinfeng Sun, Rui Jiang, Yueming Shao, Jingjing Hu, Zhihang Zheng, Luling Wu, Li Liu, Junyang Yang, Yinzhong Shen, Renfang Zhang 等
中华医学杂志英文版2023年 136卷 22期
DOI: 10.1097/CM9.0000000000002902
摘要
致编辑：由严重急性呼吸系统综合症冠状病毒2（新型冠状病毒）引发的2019冠状病毒病（COVID-19）已表现为一场可怕的全球大流行，引发了重大的经济影响并导致广泛的死亡。与此同时，由人类免疫缺陷病毒（艾滋病毒）引起的获得性免疫缺陷综合症（艾滋病）流行病仍然是一个突出的全球卫生紧急情况。截至2022年底，艾滋病相关病理累计造成约4040万人死亡，全球现存艾滋病毒人口约3900万艾滋病毒感染者（PLWH），作为一个潜在的免疫功能低下人群，在新冠肺炎研究领域受到的关注有限。大多数现有研究将接受HIV治疗的受试者与HIV阴性的受试者进行了比较。在全球艾滋病毒病例总数中，估计有920万未接受抗逆转录病毒治疗（ART）的PLWH人可能比接受ART的人面临更明显的免疫缺陷风险。[
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预先存在的低频耐药突变增加了HIV-1初治患者抗逆转录病毒治疗失败的风险Yifan Su, Rentian Cai, Yinyin Zhu, Mingli Zhong, Mingxue Qi, Chen Chen, Zi Ye, Hongying Zhang, Hongxia Wei
中华医学杂志英文版2023年 136卷 22期
DOI: 10.1097/CM9.0000000000002901
摘要
致编辑：通过常规耐药性测定检测到的高频耐药性（通常≥15-25%的病毒准种）长期以来一直与抗逆转录病毒疗法（ART）抑制病毒复制的失败有关，[
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膳食维生素改变了膳食铁与二型糖尿病的关系：2003-2014年全国健康和营养检查调查Xiaoyan Wu, Jian Gao, Lin Zhu, Wenjie Wang, Yunlong Zhang
中华医学杂志英文版2023年 136卷 22期
DOI: 10.1097/CM9.0000000000002874
摘要
致编辑糖尿病的流行在世界范围内构成了主要的公共健康威胁。在美国，2型糖尿病（T2D）的患病率影响了13.9%的成年人，并且将继续增加。[
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体内基于超声的糖尿病周围神经病变足底形态和力学特性的无创研究Qiang Zhou, Ying Li, Lei Ren, Boxin Yu, Xiao Zhang, Zhihui Qian, Jianan Wu, Ruixia Xu, Jing Liu, Luquan Ren
中华医学杂志英文版2023年 136卷 22期
DOI: 10.1097/CM9.0000000000002900
摘要
致编辑：糖尿病并发症的发生率随着糖尿病发病率的增加而增加。糖尿病周围神经病变（DPN）是糖尿病患者最常见的并发症之一。DPN危害很大，是糖尿病足和截肢的重要原因。DPN患者的截肢率比非糖尿病患者高10-20倍。每隔30秒，在世界的某个地方，就会有一名患者的下肢或部分下肢因DPN而被手术截肢。[
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缺血性卒中合并糖尿病患者出院后收缩压与临床结局风险的关系：一项队列研究Pinni Yang, Zhengbao Zhu, Shuyao Wang, Mengyao Shi, Yanbo Peng, Chongke Zhong, Aili Wang, Tan Xu, Hao Peng, Tian Xu 等
中华医学杂志英文版2023年 136卷 22期
DOI: 10.1097/CM9.0000000000002819
摘要
致编辑：高血压是糖尿病和缺血性脑卒中发病和预后的重要危险因素。糖尿病和缺血性中风都是常见的疾病，经常一起发生，高达约34%的急性缺血性中风患者还患有糖尿病。[
Corrigendum
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勘误表：可切除食管癌的治疗：从传统全身治疗到免疫治疗中华医学杂志英文版2023年 136卷 22期
DOI: 10.3760/cma.j.issn.0366-6999.2023.22.101
摘要
作者声明，在《可切除食管癌的治疗：从传统全身治疗到免疫治疗》一文中[
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