MedNexus
2023年 · 第136卷第24期
出版日期 2023-12-20电子版 ￥0.00元
MedNexus
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- Special Report
- Consensus Statement
- Review Article
- Original Article
- Correspondence
Special Report
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2022年中国心血管健康与疾病报告摘要Zengwu Wang, Liyuan Ma, Mingbo Liu, Jing Fan, Shengshou Hu, on behalf of The Writing Committee of the Report on Cardiovascular Health and Diseases in China
中华医学杂志英文版2023年 136卷 24期
DOI: 10.1097/CM9.0000000000002927
摘要
Recent decades have seen the remarkable development of China in medical accessibility and quality index, and the application of a number of new advanced cardiovascular technologies benefits more patients. However, according to the Annual Report on Cardiovascular Health and Diseases in China published in this article, which was organized and summarized by National Center for Cardiovascular Diseases, there is still a huge population living with risk factors of cardiovascular diseases (CVD), and the morbidity and mortality of CVD are increasing. It is estimated that there are around 330 million patients suffering from CVD currently, including 245 million of hypertension, 13 million of stroke, 45.3 million of peripheral artery disease, 11.39 million of coronary heart disease (CHD), 8.9 million of heart failure, 5 million of pulmonary heart disease, 4.87 million of atrial fibrillation, 2.5 million of rheumatic heart disease, and 2 million of congenital heart disease. Tobacco use, diet and nutrition factors, physical activity, overweight and obesity, and psychological factors are what affect cardiovascular health, while hypertension, dyslipidemia, diabetes, chronic kidney disease, metabolic syndrome, and air pollution are the risk factors for CVD. In this article, in addition to risk factors for CVD, we also report the epidemiological trends of CVD, including CHD, cerebrovascular disease, arrhythmias, valvular heart disease, congenital heart disease, cardiomyopathy, heart failure, pulmonary vascular disease and venous thromboembolism, and aortic and peripheral artery diseases, as well as the basic research and medical device development in CVD. In a word, China has entered a new stage of transforming from high-speed development focusing on scale growth to high-quality development emphasizing on strategic and key technological development to curb the trend of increasing incidence and mortality of CVD.
Consensus Statement
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肝癌转换治疗肝功能整体管理中国专家共识（2022年版）Qinghua Meng, Zhengqiang Yang, Zhenyu Zhu, Juan Li, Xinyu Bi, Xiao Chen, Chunyi Hao, Zhen Huang, Fei Li, Xiao Li 等
中华医学杂志英文版2023年 136卷 24期
DOI: 10.1097/CM9.0000000000002950
摘要
原发性肝癌在中国是一个重大的健康问题，在所有恶性肿瘤中发病率排名第四，死亡率排名第二。[
Review Article
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严重缺血性脑卒中和大面积梗死患者的定义、预测、预防和管理Xing Hua, Ming Liu, Simiao Wu
中华医学杂志英文版2023年 136卷 24期
DOI: 10.1097/CM9.0000000000002885
摘要
Severe ischemic stroke carries a high rate of disability and death. The severity of stroke is often assessed by the degree of neurological deficits or the extent of brain infarct, defined as severe stroke and large infarction, respectively. Critically severe stroke is a life-threatening condition that requires neurocritical care or neurosurgical intervention, which includes stroke with malignant brain edema, a leading cause of death during the acute phase, and stroke with severe complications of other vital systems. Early prediction of high-risk patients with critically severe stroke would inform early prevention and treatment to interrupt the malignant course to fatal status. Selected patients with severe stroke could benefit from intravenous thrombolysis and endovascular treatment in improving functional outcome. There is insufficient evidence to inform dual antiplatelet therapy and the timing of anticoagulation initiation after severe stroke. Decompressive hemicraniectomy (DHC) <48 h improves survival in patients aged <60 years with large hemispheric infarction. Studies are ongoing to provide evidence to inform more precise prediction of malignant brain edema, optimal indications for acute reperfusion therapies and neurosurgery, and the individualized management of complications and secondary prevention. We present an evidence-based review for severe ischemic stroke, with the aims of proposing operational definitions, emphasizing the importance of early prediction and prevention of the evolution to critically severe status, summarizing specialized treatment for severe stroke, and proposing directions for future research.
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黑色素瘤的靶向治疗策略Shiwei Zhang, Ruxin Xie, Ai Zhong, Junjie Chen
中华医学杂志英文版2023年 136卷 24期
DOI: 10.1097/CM9.0000000000002692
摘要
Melanoma accounts for a small proportion of skin cancers diagnosed each year, but it has a high degree of malignancy and rapid progression, resulting in a short survival period for patients. The incidence of melanoma continues to rise, and now melanoma accounts for 1.7% of cancer diagnoses worldwide and is the fifth most common cancer in the United States. With the development of high-throughput sequencing technologies, the understanding of the pathophysiology of melanoma had also been improved. The most common activating mutations in melanoma cells are BRAF, NRAS, and KIT mutations, which disrupt cell signaling pathways related to tumor proliferation. The progress has led to the emergence of molecularly targeted drugs, which extends the survival of patients with advanced melanoma. A large number of clinical trials have been conducted to confirm that targeted therapy for patients with advanced melanoma can improve progression-free survival and overall survival, and for stage III patients after radical tumor resection targeted therapy can reduce the recurrence of melanoma. Patients who were originally stage III or IV inoperable have the opportunity to achieve tumor radical resection after targeted therapy. This article reviewed the clinical trial data and summarized the clinical benefits and limitations of these therapies.
Original Article
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HIV感染者HAART转换为TAF/FTC/BIC的原因、安全性和有效性分析Jiang Xiao, Guiju Gao, Yi Ding, Jialu Li, Chengyu Gao, Qiuhua Xu, Liang Wu, Hongyuan Liang, Liang Ni, Fang Wang 等
中华医学杂志英文版2023年 136卷 24期
DOI: 10.1097/CM9.0000000000002939
摘要
Background:
This study aimed to determine the reasons for conversion and elucidate the safety and efficacy of transition to tenofovir alafenamide/emtricitabine/bictegravir sodium (TAF/FTC/BIC) in highly active antiretroviral therapy (HAART)-experienced HIV-infected patients in real-world settings.
Methods:
We conducted a retrospective cohort study. The treatment conversion rationales, safety, and effectiveness in 1684 HIV-infected patients with previous HAART experience who switched to TAF/FTC/BIC were evaluated at Beijing Ditan Hospital from September 2021 to Auguest 2022.
Results:
Regimen simplification (990/1684, 58.79%) was the most common reason for switching, followed by osteoporosis or osteopenia (375/1684, 22.27%), liver dysfunction (231/1684, 13.72%), decline in tenofovir alafenamide/emtricitabine/elvitegravir/cobicistat (TAF/FTC/EVG/c) with food restriction (215/1684, 12.77%), virological failure (116/1684, 6.89%), and renal dysfunction (90/1684, 5.34%). In patients receiving non-nucleotide reverse transcriptase inhibitors (NNRTI)-containing regimens, lipid panel changes 1 year after switching indicated a difference of 3.27 ± 1.10 mmol/L vs. 3.40 ± 1.59 mmol/L in triglyceride (P = 0.014), 4.82 ± 0.74 mmol/L vs. 4.88 ± 0.72 mmol/L in total cholesterol (P = 0.038), 3.09 ± 0.70 mmol/L vs. 3.18 ± 0.66 mmol/L in low-density lipoprotein (P <0.001), and 0.99 ± 0.11 mmol/L vs. 0.95 ± 0.10 mmol/L in high-density lipoprotein (P <0.001). Conversely, among patients receiving booster-containing regimens, including TAF/FTC/EVG/c and lopinavir/ritonavir (LPV/r), lipid panel changes presented decreased trends. We also observed an improved trend in viral load suppression, and alanine transaminase (ALT), aspartate transaminase (AST), estimated glomerular filtration rate (eGFR), and serum creatinine levels after the transition (P <0.001).
Conclusion:
The transition to TAF/FTC/BIC demonstrated good treatment potency. Furthermore, this study elucidates the motivations behind the adoption of TAF/FTC/BIC in real-world scenarios, providing clinical evidence supporting the stable conversion to TAF/FTC/BIC for HAART-experienced patients.
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表达TIGIT的CD8的弱新型冠状病毒特异性应答+HIV感染者接种第三剂新型冠状病毒灭活疫苗后的T细胞Junyan Jin, Xiuwen Wang, Yongzheng Li, Xiaodong Yang, Hu Wang, Xiaoxu Han, Jin Sun, Zhenglai Ma, Junyi Duan, Guanghui Zhang 等
中华医学杂志英文版2023年 136卷 24期
DOI: 10.1097/CM9.0000000000002926
摘要
Background:
T-cell immunoreceptor with immunoglobulin and immunoreceptor tyrosine-based inhibition motif domains (TIGIT), an inhibitory receptor expressed on T cells, plays a dysfunctional role in antiviral infection and antitumor activity. However, it is unknown whether TIGIT expression on T cells influences the immunological effects of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) inactivated vaccines.
Methods:
Forty-five people living with HIV (PLWH) on antiretroviral therapy (ART) for more than two years and 31 healthy controls (HCs), all received a third dose of a SARS-CoV-2 inactivated vaccine, were enrolled in this study. The amounts, activation, proportion of cell subsets, and magnitude of the SARS-CoV-2-specific immune response of TIGIT+CD4+ and TIGIT+CD8+ T cells were investigated before the third dose but 6 months after the second vaccine dose (0W), 4 weeks (4W) and 12 weeks (12W) after the third dose.
Results:
Compared to that in HCs, the frequency of TIGIT+ CD8+T cells in the peripheral blood of PLWH increased at 12W after the third dose of the inactivated vaccine, and the immune activation of TIGIT+CD8+ T cells also increased. A decrease in the ratio of both T naïve (TN) and central memory (TCM) cells among TIGIT+CD8+T cells and an increase in the ratio of the effector memory (TEM) subpopulation were observed at 12W in PLWH. Interestingly, particularly at 12W, a higher proportion of TIGIT+CD8+ T cells expressing CD137 and CD69 simultaneously was observed in HCs than in PLWH based on the activation-induced marker assay. Compared with 0W, SARS-CoV-2-specific TIGIT+CD8+ T-cell responses in PLWH were not enhanced at 12W but were enhanced in HCs. Additionally, at all time points, the SARS-CoV-2-specific responses of TIGIT+CD8+ T cells in PLWH were significantly weaker than those of TIGIT-CD8+ T cells. However, in HCs, the difference in the SARS-CoV-2-specific responses induced between TIGIT+CD8+ T cells and TIGIT-CD8+ T cells was insignificant at 4W and 12W, except at 0W.
Conclusions:
TIGIT expression on CD8+ T cells may hinder the T-cell immune response to a booster dose of an inactivated SARS-CoV-2 vaccine, suggesting weakened resistance to SARS-CoV-2 infection, especially in PLWH. Furthermore, TIGIT may be used as a potential target to increase the production of SARS-CoV-2-specific CD8+ T cells, thereby enhancing the effectiveness of vaccination.
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HIV感染者接种三剂新型冠状病毒灭活疫苗后的持久自然杀伤细胞应答Xiaodong Yang, Xiuwen Wang, Xin Zhang, Haifeng Ding, Hu Wang, Tao Huang, Guanghui Zhang, Junyi Duan, Wei Xia, Bin Su 等
中华医学杂志英文版2023年 136卷 24期
DOI: 10.1097/CM9.0000000000002947
摘要
Background:
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccine can induce a potent cellular and humoral immune response to protect against SARS-CoV-2 infection. However, it was unknown whether SARS-CoV-2 vaccination can induce effective natural killer (NK) cell response in people living with human immunodeficiency virus (PLWH) and healthy individuals.
Methods:
Forty-seven PLWH and thirty healthy controls (HCs) inoculated with SARS-CoV-2 inactivated vaccine were enrolled from Beijing Youan Hospital in this study. The effect of SARS-CoV-2 vaccine on NK cell frequency, phenotype, and function in PLWH and HCs was evaluated by flow cytometry, and the response of NK cells to SARS-CoV-2 Omicron Spike (SARS-2-OS) protein stimulation was also evaluated.
Results:
SARS-CoV-2 vaccine inoculation elicited activation and degranulation of NK cells in PLWH, which peaked at 2 weeks and then decreased to a minimum at 12 weeks after the third dose of vaccine. However, in vitro stimulation of the corresponding peripheral blood monocular cells from PLWH with SARS-2-OS protein did not upregulate the expression of the aforementioned markers. Additionally, the frequencies of NK cells expressing the activation markers CD25 and CD69 in PLWH were significantly lower than those in HCs at 0, 4 and 12 weeks, but the percentage of CD16+ NK cells in PLWH was significantly higher than that in HCs at 2, 4 and 12 weeks after the third dose of vaccine. Interestingly, the frequency of CD16+ NK cells was significantly negatively correlated with the proportion of CD107a+ NK cells in PLWH at each time point after the third dose. Similarly, this phenomenon was also observed in HCs at 0, 2, and 4 weeks after the third dose. Finally, regardless of whether NK cells were stimulated with SARS-2-OS or not, we did not observe any differences in the expression of NK cell degranulation markers between PLWH and HCs.
Conclusions:
SARS-CoV-2 vaccine elicited activation and degranulation of NK cells, indicating that the inoculation of SARS-CoV-2 vaccine enhances NK cell immune response.
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使用康多外科机器人-01系统的机器人泌尿外科手术：一项单中心前瞻性分析Shengwei Xiong, Shubo Fan, Silu Chen, Xiang Wang, Guanpeng Han, Zhihua Li, Wei Zuo, Zhenyu Li, Kunlin Yang, Zhongyuan Zhang 等
中华医学杂志英文版2023年 136卷 24期
DOI: 10.1097/CM9.0000000000002920
摘要
Background:
The KangDuo-Surgical Robot-01 (KD-SR-01) system is a new surgical robot recently developed in China. The aim of this study was to present our single-center experience and mid-term outcomes of urological procedures using the KD-SR-01 system.
Methods:
From August 2020 to April 2023, consecutive urologic procedures were performed at Peking University First Hospital using the KD-SR-01 system. The clinical features, perioperative data, and follow-up outcomes were prospectively collected and analyzed.
Results:
A total of 110 consecutive patients were recruited. Among these patients, 28 underwent partial nephrectomy (PN), 41 underwent urinary tract reconstruction (26 underwent pyeloplasty, 3 underwent ureteral reconstruction and 12 underwent ureterovesical reimplantation [UR]), and 41 underwent radical prostatectomy (RP). The median operative time for PN was 112.5 min, 157.0 min for pyeloplasty, 151.0 min for ureteral reconstruction, 142.5 min for UR, and 138.0 min for RP. The median intraoperative blood loss was 10 mL for PN, 10 mL for pyeloplasty, 30 mL for ureteral reconstruction, 20 mL for UR, and 50 mL for RP. All procedures were successfully completed without conversion, and there were no major complications in any patient. The median warm ischemia time of PN was 17.3 min, and positive surgical margin was not noted in any patient. The overall positive surgical margin rate of RP was 39% (16/41), and no biochemical recurrence was observed in any RP patient during the median follow-up of 11.0 months. The surgical success rates of pyeloplasty and UR were 96% (25/26) and 92% (11/12) during the median follow-up of 29.5 months and 11.5 months, respectively.
Conclusion:
The KD-SR-01 system appears feasible, safe, and effective for most urological procedures, based on our single-center experience.
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激素受体阳性/人表皮生长因子受体2低表达早期乳腺癌临床病理特征及风险预测模型的多中心研究Ling Xin, Qian Wu, Chongming Zhan, Hongyan Qin, Hongyu Xiang, Min Gao, Xuening Duan, Yinhua Liu, Jingming Ye, Chinese Society of Breast Surgery (CSBrS) 等
中华医学杂志英文版2023年 136卷 24期
DOI: 10.1097/CM9.0000000000002831
摘要
Background:
In light of the significant clinical benefits of antibody-drug conjugates in clinical trials, the human epidermal growth factor receptor 2 (HER2)-low category in breast cancers has gained increasing attention. Therefore, we studied the clinicopathological characteristics of Chinese patients with hormone receptor (HR)-positive/HER2-low early-stage breast cancer and developed a recurrence risk prediction model.
Methods:
Female patients with HR-positive/HER2-low early-stage breast cancer treated in 29 hospitals of the Chinese Society of Breast Surgery (CSBrS) from Jan 2015 to Dec 2016 were enrolled. Their clinicopathological data and prognostic information were collected, and machine learning methods were used to analyze the prognostic factors.
Results:
In total, 25,096 patients were diagnosed with breast cancer in 29 hospitals of CSBrS from Jan 2015 to Dec 2016, and clinicopathological data for 6486 patients with HER2-low early-stage breast cancer were collected. Among them, 5629 patients (86.79%) were HR-positive. The median follow-up time was 57 months (4, 76 months); the 5-year disease-free survival (DFS) rate was 92.7%, and the 5-year overall survival (OS) rate was 97.7%. In total, 412 cases (7.31%) of metastasis were observed, and 124 (2.20%) patients died. Multivariate Cox regression analysis revealed that T stage, N stage, lymphovascular thrombosis, Ki-67 index, and prognostic stage were associated with recurrence and metastasis (P <0.05). A recurrence risk prediction model was established using the random forest method and exhibited a sensitivity of 81.1%, specificity of 71.7%, positive predictive value of 74.1%, and negative predictive value of 79.2%.
Conclusion:
Most of patients with HER2-low early-stage breast cancer were HR-positive, and patients had favorable outcome; tumor N stage, lymphovascular thrombosis, Ki-67 index, and tumor prognostic stage were prognostic factors. The HR-positive/HER2-low early-stage breast cancer recurrence prediction model established based on the random forest method has a good reference value for predicting 5-year recurrence events.
Registritation:
ChiCTR.org.cn, ChiCTR2100046766
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与高级别浆液性卵巢癌转移和进展相关的候选因子的特征Huiping Liu, Ling Zhou, Hongyan Cheng, Shang Wang, Wenqing Luan, E Cai, Xue Ye, Honglan Zhu, Heng Cui, Yi Li 等
中华医学杂志英文版2023年 136卷 24期
DOI: 10.1097/CM9.0000000000002328
摘要
Background:
High-grade serous ovarian cancer (HGSOC) is the biggest cause of gynecological cancer-related mortality because of its extremely metastatic nature. This study aimed to explore and evaluate the characteristics of candidate factors associated with the metastasis and progression of HGSOC.
Methods:
Transcriptomic data of HGSOC patients’ samples collected from primary tumors and matched omental metastatic tumors were obtained from three independent studies in the National Center for Biotechnology Information (NCBI) Gene Expression Omnibus (GEO) database. Differentially expressed genes (DEGs) were selected to evaluate the effects on the prognosis and progression of ovarian cancer using data from The Cancer Genome Atlas (TCGA) database. Hub genes’ immune landscapes were estimated by the Tumor Immune Estimation Resource (TIMER) database. Finally, using 25 HGSOC patients' cancer tissues and 10 normal fallopian tube tissues, immunohistochemistry (IHC) was performed to quantify the expression levels of hub genes associated with International Federation of Gynecology and Obstetrics (FIGO) stages.
Results:
Fourteen DEGs, ADIPOQ, ALPK2, BARX1, CD37, CNR2, COL5A3, FABP4, FAP, GPR68, ITGBL1, MOXD1, PODNL1, SFRP2, and TRAF3IP3, were upregulated in metastatic tumors in every database while CADPS, GATA4, STAR, and TSPAN8 were downregulated. ALPK2, FAP, SFRP2, GATA4, STAR, and TSPAN8 were selected as hub genes significantly associated with survival and recurrence. All hub genes were correlated with tumor microenvironment infiltration, especially cancer-associated fibroblasts and natural killer (NK) cells. Furthermore, the expression of FAP and SFRP2 was positively correlated with the International Federation of Gynecology and Obstetrics (FIGO) stage, and their increased protein expression levels in metastatic samples compared with primary tumor samples and normal tissues were confirmed by IHC (P = 0.0002 and P = 0.0001, respectively).
Conclusions:
This study describes screening for DEGs in HGSOC primary tumors and matched metastasis tumors using integrated bioinformatics analyses. We identified six hub genes that were correlated with the progression of HGSOC, particularly FAP and SFRP2, which might provide effective targets to predict prognosis and provide novel insights into individual therapeutic strategies for HGSOC.
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裸盖菇素通过促进海马神经可塑性促进小鼠恐惧消除Yingjie Du, Yunfeng Li, Xiangting Zhao, Yishan Yao, Bin Wang, Liming Zhang, Guyan Wang
中华医学杂志英文版2023年 136卷 24期
DOI: 10.1097/CM9.0000000000002647
摘要
Background:
Posttraumatic stress disorder (PTSD) and depression are highly comorbid. Psilocybin exerts substantial therapeutic effects on depression by promoting neuroplasticity. Fear extinction is a key process in the mechanism of first-line exposure-based therapies for PTSD. We hypothesized that psilocybin would facilitate fear extinction by promoting hippocampal neuroplasticity.
Methods:
First, we assessed the effects of psilocybin on percentage of freezing time in an auditory cued fear conditioning (FC) and fear extinction paradigm in mice. Psilocybin was administered 30 min before extinction training. Fear extinction testing was performed on the first day; fear extinction retrieval and fear renewal were tested on the sixth and seventh days, respectively. Furthermore, we verified the effect of psilocybin on hippocampal neuroplasticity using Golgi staining for the dendritic complexity and spine density, Western blotting for the protein levels of brain derived neurotrophic factor (BDNF) and mechanistic target of rapamycin (mTOR), and immunofluorescence staining for the numbers of doublecortin (DCX)- and bromodeoxyuridine (BrdU)-positive cells.
Results:
A single dose of psilocybin (2.5 mg/kg, i.p.) reduced the increase in the percentage of freezing time induced by FC at 24 h, 6th day and 7th day after administration. In terms of structural neuroplasticity, psilocybin rescued the decrease in hippocampal dendritic complexity and spine density induced by FC; in terms of neuroplasticity related proteins, psilocybin rescued the decrease in the protein levels of hippocampal BDNF and mTOR induced by FC; in terms of neurogenesis, psilocybin rescued the decrease in the numbers of DCX- and BrdU-positive cells in the hippocampal dentate gyrus induced by FC.
Conclusions:
A single dose of psilocybin facilitated rapid and sustained fear extinction; this effect might be partially mediated by the promotion of hippocampal neuroplasticity. This study indicates that psilocybin may be a useful adjunct to exposure-based therapies for PTSD and other mental disorders characterized by failure of fear extinction.
Correspondence
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青蒿素及其衍生物的抗病毒作用Hao Liu, Zhen Li, Yang Zhang, Lin Jia, Miaotian Cai, Rui Wang, Caiping Guo
中华医学杂志英文版2023年 136卷 24期
DOI: 10.1097/CM9.0000000000002934
摘要
致编辑：青蒿素是从药用植物中提取分离得到的具有过氧化物桥结构的倍半萜内酯化合物，黄花蒿多年来，现有研究揭示了青蒿素化合物在抗肿瘤、免疫调节、预防骨质疏松症、抗菌和抗病毒作用方面的广泛潜在应用，使其对一系列其他疾病有效，这拓宽了青蒿素的临床应用。在此，我们更新了青蒿素及其衍生物对多种病毒的抗病毒活性的当前知识，例如冠状病毒,疱疹病毒，和黄病毒对青蒿素类化合物抗病毒作用的研究可以为对抗新出现的尚无有效抗病毒药物的病毒性疾病提供新的思路。
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CD177升高之间的关系+HIV感染者中性粒细胞与慢性活化Lina Fan, Yue Hu, Liying Gao, Aiping Yu, Defa Zhang, Yue Wu, Fangfang Yu, Lei Li, Bei Li, Hongxin Zhao 等
中华医学杂志英文版2023年 136卷 24期
DOI: 10.1097/CM9.0000000000002958
摘要
致编辑：中性粒细胞作为先天细胞，在针对入侵病原体的免疫防御反应中发挥重要作用，并为T和B细胞的增殖和活化提供信号以启动适应性免疫。[
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CD8上的Glut1表达昏暗的T细胞与HIV-1感染个体的免疫恢复相关Xiuwen Wang, Xin Zhang, Xiaofan Lu, Zhen Li, Lifeng Liu, Hao Wu, Tong Zhang, Bin Su
中华医学杂志英文版2023年 136卷 24期
DOI: 10.1097/CM9.0000000000002933
摘要
致编辑：约占人类免疫缺陷病毒(HIV)感染个体的10-40%的免疫无应答者(INR)已接受有效治疗并表现出对病毒复制的持续抑制，但其CD4+T细胞计数未恢复。与免疫应答者（IRs）相比，他们可能具有增加的非获得性免疫缺陷综合征（AIDS）相关发病率和死亡率的风险。[
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机器学习识别单核细胞中与HIV序列相关的遗传特征Xiaorong Peng, Biao Zhu
中华医学杂志英文版2023年 136卷 24期
DOI: 10.1097/CM9.0000000000002932
摘要
致编辑：在接受或未接受抗逆转录病毒治疗(ART)的HIV感染个体分离的循环单核细胞中检测到人类免疫缺陷病毒(HIV)DNA。[
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肺癌微创新辅助治疗后袖状切除术Ao Liu, Wenxing Du, Zhe Wu, Wenjie Jiao
中华医学杂志英文版2023年 136卷 24期
DOI: 10.1097/CM9.0000000000002924
摘要
致编辑：袖状切除术是一种切除和重建支气管和/或肺动脉的手术，被认为是中心位置肺癌的有效治疗方法。随着综合治疗理念的确立和发展，针对局部晚期分期的中心部位肺癌应用新辅助免疫治疗等新辅助治疗是有效的。新辅助治疗可能会缩小肿瘤大小，以增加完全切除的机会，并实现保留实质的袖状切除手术。一般来说，袖状切除术改善了术后呼吸功能和生活质量，并实现了较低的术后发病率和死亡率，肿瘤学结局与新辅助治疗后的全肺切除术相似。
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脊柱转移瘤小鼠模型的实验研究Kun Zhang, Yi Feng, Xiaochen Qiao, Yang Yu, Zelong Song, Zhuohao Liu, Zhi Tian, Song Chen, Xuesong Zhang, Xiangyu Wang
中华医学杂志英文版2023年 136卷 24期
DOI: 10.1097/CM9.0000000000002922
摘要
致编辑：脊柱是肿瘤转移的常见部位。脊柱转移瘤患者由于肿瘤侵犯脊柱骨而出现疼痛、病理性骨折和脊柱畸形。目前，小鼠模型是脊柱转移相关研究的一个非常重要的工具。[
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心房颤动联合导管消融左心耳封堵术对左心房结构的影响Zhentao Fei, Ming Liu, Pengcheng Yao, Mingzhe Zhao, Changqi Gong, Mu Chen, Yudong Fei, Binfeng Mo, Rui Zhang, Yichi Yu 等
中华医学杂志英文版2023年 136卷 24期
DOI: 10.1097/CM9.0000000000002746
摘要
致编辑：心房颤动（AF）是左心房（LA）结构重塑的公认原因。[
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围手术期心肌损伤预测TAVR术后不良短期预后：一项来自中国的单中心回顾性分析Qi Liu, Kaiyu Jia, Yijun Yao, Yijian Li, Tianyuan Xiong, Fei Chen, Yuanweixiang Ou, Xi Wang, Yujia Liang, Xi Li 等
中华医学杂志英文版2023年 136卷 24期
DOI: 10.1097/CM9.0000000000002843
摘要
致编辑：大约2%的>65岁的人患有主动脉瓣狭窄（AS）。[
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子宫内球囊支架或口服雌激素预防经宫颈子宫间隔切除术后粘连的疗效：中国一项随机对照多中心研究的研究方案Shan Deng, Zichen Zhao, Limin Feng, Xiaowu Huang, Sumin Wang, Xiang Xue, Lei Yan, Baorong Ma, Lijuan Hao, Xueying Li 等
中华医学杂志英文版2023年 136卷 24期
DOI: 10.1097/CM9.0000000000002376
摘要
致编辑：隔膜子宫是最常见的子宫异常，与不良生殖结局的风险增加有关。经宫颈鼻中隔切除术（TCRS）广泛用于具有不良生殖结局的患者。的发生率再一次TCRS后的宫内粘连（IUAs）约为5%至25%。[
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免疫检查点阻断的高进展性疾病样本中的转录组失调Dan Xue, Tengteng Zhu, Hongguang Lin, Peilin Guo, Mengling Li, Mei’e Yu, Fan Yang, Sheng Yang, Xiangqi Chen
中华医学杂志英文版2023年 136卷 24期
DOI: 10.1097/CM9.0000000000002550
摘要
致编辑：肿瘤免疫治疗近年来进展迅速。然而，免疫检查点阻断（ICB）治疗可能会导致过度进行性疾病（HPD）的临床症状，特别是对于驱动基因发生改变或扩增的患者，如小鼠双分钟2（MDM2),表皮生长因子受体（EGFR）和成纤维细胞生长因子4（FGF4).近日，镰田等人[
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