MedNexus
2024年 · 第137卷第10期
出版日期 2024-05-20电子版 ￥0.00元
MedNexus
- 全部
- Consensus Statement
- Review Article
- Original Article
- Clinical Observation
- Correspondence
Consensus Statement
开放获取
临时机械循环支持的临床应用与管理：临床共识Nianguo Dong, Liangwan Chen, Xin Chen, Huishan Wang, Yingbin Xiao, Xianqiang Wang, Jinsong Huang, Yang Yan, Pramod Bonde, Neel Sodha 等
中华医学杂志英文版2024年 137卷 10期
DOI: 10.1097/CM9.0000000000002980
摘要
临时机械循环支持（tMCS）在管理严重或难治性心源性休克（CS）、提供必要的血流动力学支持以及维持器官灌注数小时至数周甚至数月方面起着关键作用。在过去的十年中，TMC的使用在美国和欧洲国家显著增加。与此同时，在亚洲，构成TMC的新开发概念和设备也取得了快速进展。然而，显然缺乏共识或标准化指南，特别是对于考虑遗传多态性的亚洲人群。为了解决这一知识差距，该领域的八个协会/学会和专家在反复讨论后达成了目前的共识，更具体地说是针对亚洲人口。它全面阐明了常用的tMCS设备、患者选择标准、适应症和禁忌症、临床管理以及植入和断奶的最佳时机。该声明的目标是促进tMCS的规范应用，并在临床实践中做出合理的决策。共识的完整版本可在补充文件http：//links中找到。lww.com/CM9/B883.
Review Article
开放获取
CAR-T细胞治疗自身免疫性疾病的曙光Yuxin Liu, Minghao Dong, Yunhui Chu, Luoqi Zhou, Yunfan You, Xiaowei Pang, Sheng Yang, Luyang Zhang, Lian Chen, Lifang Zhu 等
中华医学杂志英文版2024年 137卷 10期
DOI: 10.1097/CM9.0000000000003111
摘要
Chimeric antigen receptor (CAR)-T cell therapy has achieved remarkable success in the treatment of hematological malignancies. Based on the immunomodulatory capability of CAR-T cells, efforts have turned toward exploring their potential in treating autoimmune diseases. Bibliometric analysis of 210 records from 128 academic journals published by 372 institutions in 40 countries/regions indicates a growing number of publications on CAR-T therapy for autoimmune diseases, covering a range of subtypes such as systemic lupus erythematosus, multiple sclerosis, among others. CAR-T therapy holds promise in mitigating several shortcomings, including the indiscriminate suppression of the immune system by traditional immunosuppressants, and non-sustaining therapeutic levels of monoclonal antibodies due to inherent pharmacokinetic constraints. By persisting and proliferating in vivo, CAR-T cells can offer a tailored and precise therapeutics. This paper reviewed preclinical experiments and clinical trials involving CAR-T and CAR-related therapies in various autoimmune diseases, incorporating innovations well-studied in the field of hematological tumors, aiming to explore a safe and effective therapeutic option for relapsed/refractory autoimmune diseases.
开放获取
长非编码RNAMALAT1恶性血液病及其临床应用Chunlan Zhang, Yun Qin, Yu Wu, Heng Xu, Yang Shu
中华医学杂志英文版2024年 137卷 10期
DOI: 10.1097/CM9.0000000000003090
摘要
Metastasis-associated lung adenocarcinoma transcript 1 (MALAT1) is a well-established oncogenic long non-coding RNA, the higher expression of which is strongly correlated with cancer events such as tumorigenesis, progression, metastasis, drug resistance, and treatment outcome in solid cancers. Recently, a series of studies has highlighted its potential role in hematological malignancies in terms of these events. Similar to solid cancers, MALAT1 can regulate various target genes via sponging and epigenetic mechanisms, but the miRNAs sponged by MALAT1 differ from those identified in solid cancers. In this review, we systematically describe the role and underlying mechanisms of MALAT1 in multiple types of hematological malignancies, including regulation of cell proliferation, metastasis, stress response, and glycolysis. Clinically, MALAT1 expression is related to poor treatment outcome and drug resistance, therefore exhibiting potential prognostic value in multiple myeloma, lymphoma, and leukemia. Finally, we discuss the evaluation of MALAT1 as a novel therapeutic target against cancer in preclinical studies.
Original Article
开放获取
出生体重、成年后理想的心血管健康指标和心血管疾病发病率Ying Sun, Bin Wang, Yuefeng Yu, Yuying Wang, Xiao Tan, Jihui Zhang, Lu Qi, Yingli Lu, Ningjian Wang
中华医学杂志英文版2024年 137卷 10期
DOI: 10.1097/CM9.0000000000003043
摘要
Background:
Prenatal and postnatal factors may have joint effects on cardiovascular health, and we aimed to assess the joint association of birth weight and ideal cardiovascular health metrics (ICVHMs) prospectively in adulthood with incident cardiovascular disease (CVD).
Methods:
In the UK Biobank, 227,833 participants with data on ICVHM components and birth weight and without CVD at baseline were included. The ICVHMs included smoking, body mass index, physical activity, diet information, total cholesterol, blood pressure, and hemoglobin A1c. The Cox proportional hazards model was used to estimate the hazard ratios (HRs) and 95% confidence intervals (CIs) in men and women.
Results:
Over a median follow-up period of 13.0 years (2,831,236 person-years), we documented 17,477 patients with incident CVD. Compared with participants with birth weights of 2.5-4.0 kg, the HRs (95% CIs) of CVD among those with low birth weights was 1.08 (1.00-1.16) in men and 1.23 (1.16-1.31) in women. The association between having a birth weight <2.5 kg and CVD risk in men was more prominent for those aged <50 years than for those of older age (P for interaction = 0.026). Lower birth weight and non-ideal cardiovascular health metrics were jointly related to an increased risk of CVD. Participants with birth weights <2.5 kg and ICVHMs score 0-1 had the highest risk of incident CVD (HR [95% CI]: 3.93 [3.01-5.13] in men; 4.24 [3.33-5.40] in women). The joint effect (HR [95% CI]: 1.36 [1.17-1.58]) could be decomposed into 24.7% (95% CI: 15.0%-34.4%) for a lower birth weight, 64.7% (95% CI: 56.7%-72.6%) for a lower ICVHM score, and 10.6% (95% CI: 2.7%-18.6%) for their additive interaction in women.
Conclusions:
Birth weight and ICVHMs were jointly related to CVD risk. Attaining a normal birth weight and ideal ICVHMs may reduce the risk of CVD, and a simultaneous improvement of both prenatal and postnatal factors could further prevent additional cases in women.
开放获取
体重变化与全因和病因特异性死亡率：一项25年随访研究Huan Yang, Jianbing Wang, Xiaokun Wang, Wanyi Sun, Chenyunhao Tong, Jinhu Fan, Youlin Qiao, Christian C. Abnet
中华医学杂志英文版2024年 137卷 10期
DOI: 10.1097/CM9.0000000000002970
摘要
Background:
Whether the dynamic weight change is an independent risk factor for mortality remains controversial. This study aimed to examine the association between weight change and risk of all-cause and cause-specific mortality based on the Linxian Nutrition Intervention Trial (NIT) cohort.
Methods:
Body weight of 21,028 healthy residents of Linxian, Henan province, aged 40-69 years was measured two times from 1986 to 1991. Outcome events were prospectively collected up to 2016. Weight maintenance group (weight change <2 kg) or stable normal weight group was treated as the reference. Cox proportional hazard model was performed to calculate hazard ratios (HRs) and 95% confidence intervals (95% CIs) to estimate the risk of mortality.
Results:
A total of 21,028 subjects were included in the final analysis. Compared with the weight maintenance group, subjects with weight loss ≥2 kg had an increased risk of death from all-cause (HRAll-cause = 1.14, 95% CI: 1.09-1.19, P <0.001), cancer (HRCancer = 1.12, 95% CI: 1.03-1.21, P = 0.009), and heart disease (HRHeart diseases = 1.21, 95% CI: 1.11-1.31, P <0.001), whereas subjects with weight gain ≥5 kg had 11% (HRCancer = 0.89, 95% CI: 0.79-0.99, P = 0.033) lower risk of cancer mortality and 23% higher risk of stroke mortality (HRStroke = 1.23,95% CI: 1.12-1.34, P <0.001). For the change of weight status, both going from overweight to normal weight and becoming underweight within 5 years could increase the risk of total death (HROverweight to normal = 1.18, 95% CI: 1.09-1.27; HRBecoming underweight = 1.35, 95% CI: 1.25-1.46) and cancer death (HROverweight to normal = 1.20, 95% CI: 1.04-1.39; HRBecoming underweight = 1.44, 95% CI: 1.24-1.67), while stable overweight could increase the risk of total death (HRStable overweight = 1.11, 95% CI: 1.05-1.17) and death from stroke (HRStable overweight = 1.44, 95% CI: 1.33-1.56). Interaction effects were observed between age and weight change on cancer mortality, as well as between baseline BMI and weight change on all-cause, heart disease, and stroke mortality (all Pinteraction <0.01).
Conclusions:
Weight loss was associated with an increased risk of all-cause, cancer, and heart disease mortality, whereas excessive weight gain and stable overweight were associated with a higher risk of stroke mortality. Efforts of weight management should be taken to improve health status.
Trial registration:
https://classic.clinicaltrials.gov/, NCT00342654.
开放获取
中国COPD急性加重住院患者流感和肺炎球菌疫苗接种覆盖率及相关因素：来自真实世界数据的发现Ruoxi He, Xiaoxia Ren, Ke Huang, Jieping Lei, Hongtao Niu, Wei Li, Fen Dong, Baicun Li, Ye Wang, Ting Yang 等
中华医学杂志英文版2024年 137卷 10期
DOI: 10.1097/CM9.0000000000002790
摘要
Background:
Influenza and pneumococcal vaccination are a priority in patients with chronic obstructive pulmonary disease (COPD). However, limited information is available on vaccination coverage among patients with acute exacerbations of COPD (AECOPD) in China. This study aimed to determine the rates and associated factors of influenza and pneumococcal vaccination in patients hospitalized with AECOPD.
Methods:
Baseline data from a national, multicenter, hospital-based study that included adult inpatients with AECOPD between 2017 and 2021 were analyzed. The outcomes of interest were the influenza vaccination in the past year and the pneumococcal vaccination in the past 5 years. To ensure national representativeness, rates were weighted according to the distribution of hospital levels and types enrolled in this study. Multivariable Poisson regression based on mixed-effects models were used to determine the associated factors. The independent variables included the region and hospital features where the participants were located, sociodemographic characteristics (age, sex, rural/urban residence, education, etc.), and clinical indicators (COPD disease history, lung function parameters, comorbidities, etc.). The treatment profiles of the vaccinated and unvaccinated participants were compared.
Results:
Of 6949 eligible participants, the weighted rates of influenza/pneumococcal, influenza, and pneumococcal vaccination were 2.72% (95% confidence interval [CI]: 2.34%-3.10%), 2.09% (95% CI: 1.76%-2.43%), and 1.25% (95% CI: 0.99%-1.51%), respectively. In multivariable models, age ≥60 years (60-69 years, odds ratio [OR]: 1.90, 95% CI: 1.11-3.25; ≥80 years, OR: 2.00, 95% CI: 1.06-3.78), geographical regions (Northern China relative to Eastern China, OR: 5.09, 95% CI: 1.96-13.21), urban residence (OR: 1.69, 95% CI: 1.07-2.66), a higher education level (junior high school, OR: 1.77, 95% CI: 1.21-2.58; senior high school or above, OR: 2.61, 95% CI: 1.69-4.03), former smoking (OR: 1.79, 95% CI: 1.15-2.79), and regular inhaled medication treatment (OR: 3.28, 95% CI: 2.29-4.70) were positively associated with vaccination. Patients who had experienced severe exacerbations in the past year were less likely to be vaccinated (OR: 0.65, 95% CI: 0.45-0.96). Compared with unvaccinated participants, vaccinated participants adhered better to pharmacological and non-pharmacological treatment.
Conclusions:
Influenza and pneumococcal vaccination coverage are extremely low. Urgent measures are necessary to increase vaccination coverage among inpatients with AECOPD in China.
开放获取
Tildrakizumab治疗中国中重度斑块型银屑病患者：一项12周随机安慰剂对照III期试验，长期延长Chen Yu, Songmei Geng, Bin Yang, Yunhua Deng, Fuqiu Li, Xiaojing Kang, Mingye Bi, Furen Zhang, Yi Zhao, Weili Pan 等
中华医学杂志英文版2024年 137卷 10期
DOI: 10.1097/CM9.0000000000002873
摘要
Background:
There is a need for effective and safe therapies for psoriasis that provide sustained benefits. The aim of this study was to assess the efficacy and safety of tildrakizumab, an anti-interleukin-23p19 monoclonal antibody, for treating moderate-to-severe plaque psoriasis in Chinese patients.
Methods:
In this multi-center, double-blind, phase III trial, patients with moderate-to-severe plaque psoriasis were enrolled and randomly assigned (1:1) to receive subcutaneous tildrakizumab 100 mg or placebo at weeks 0 and 4. Patients initially assigned to placebo were switched to receive tildrakizumab at weeks 12, 16, and every 12 weeks thereafter. Patients in the tildrakizumab group continued with tildrakizumab at week 16, and every 12 weeks until week 52. The primary endpoint was the Psoriasis Area and Severity Index (PASI 75) response rate at week 12.
Results:
At week 12, tildrakizumab demonstrated significantly higher PASI 75 response rates (66.4% [73/110] vs. 12.7% [14/110]; difference, 51.4% [95% confidence interval (CI), 40.72, 62.13]; P <0.001) and Physician’s Global Assessment (60.9% [67/110] vs. 10.0% [11/110]; difference, 49.1% [95% CI, 38.64, 59.62]; P <0.001) compared to placebo. PASI 75 response continued to improve over time in both tildrakizumab and placebo-switching to tildrakizumab groups, reaching maximal efficacy after 28 weeks (86.8% [92/106] vs. 82.4% [89/108]) and maintained up to 52 weeks (91.3% [95/104] vs. 87.4% [90/103]). Most treatment-emergent adverse events were mild and not related to tildrakizumab.
Conclusion:
Tildrakizumab demonstrated durable efficacy through week 52 and was well tolerated in Chinese patients with moderate-to-severe plaque psoriasis.
Trial registration:
ClinicalTrials.gov, NCT05108766.
开放获取
基于身高相关单核苷酸多态性的儿童肾移植术后生长模式的早期预测Yi Feng, Yonghua Feng, Mingyao Hu, Hongen Xu, Zhigang Wang, Shicheng Xu, Yongchuang Yan, Chenghao Feng, Zhou Li, Guiwen Feng 等
中华医学杂志英文版2024年 137卷 10期
DOI: 10.1097/CM9.0000000000002828
摘要
Background:
Growth retardation is a common complication of chronic kidney disease in children, which can be partially relieved after renal transplantation. This study aimed to develop and validate a predictive model for growth patterns of children with end-stage renal disease (ESRD) after kidney transplantation using machine learning algorithms based on genomic and clinical variables.
Methods:
A retrospective cohort of 110 children who received kidney transplants between May 2013 and September 2021 at the First Affiliated Hospital of Zhengzhou University were recruited for whole-exome sequencing (WES), and another 39 children who underwent transplant from October 2021 to March 2022 were enrolled for external validation. Based on previous studies, we comprehensively collected 729 height-related single-nucleotide polymorphisms (SNPs) in exon regions. Seven machine learning algorithms and 10-fold cross-validation analysis were employed for model construction.
Results:
The 110 children were divided into two groups according to change in height-for-age Z-score. After univariate analysis, age and 19 SNPs were incorporated into the model and validated. The random forest model showed the best prediction efficacy with an accuracy of 0.8125 and an area under curve (AUC) of 0.924, and also performed well in the external validation cohort (accuracy, 0.7949; AUC, 0.796).
Conclusions:
A model with good performance for predicting post-transplant growth patterns in children based on SNPs and clinical variables was constructed and validated using machine learning algorithms. The model is expected to guide clinicians in the management of children after renal transplantation, including the use of growth hormone, glucocorticoid withdrawal, and nutritional supplementation, to alleviate growth retardation in children with ESRD.
开放获取
脐血移植后双阴性T细胞重建及其对急性移植物抗宿主病的预测价值Tianzhong Pan, Peng Ding, Aijie Huang, Baolin Tang, Kaidi Song, Guangyu Sun, Yue Wu, Shiying Yang, Xingchi Chen, Dongyao Wang 等
中华医学杂志英文版2024年 137卷 10期
DOI: 10.1097/CM9.0000000000002807
摘要
Background:
With an increasing number of patients with hematological malignancies being treated with umbilical cord blood transplantation (UCBT), the correlation between immune reconstitution (IR) after UCBT and graft-versus-host disease (GVHD) has been reported successively, but reports on double-negative T (DNT) cell reconstitution and its association with acute GVHD (aGVHD) after UCBT are lacking.
Methods:
A population-based observational study was conducted among 131 patients with hematological malignancies who underwent single-unit UCBT as their first transplant at the Department of Hematology, the First Affiliated Hospital of USTC, between August 2018 and June 2021. IR differences were compared between the patients with and without aGVHD.
Results:
The absolute number of DNT cells in the healthy Chinese population was 109 (70-157)/μL, accounting for 5.82 (3.98-8.19)% of lymphocytes. DNT cells showed delayed recovery and could not reach their normal levels even one year after transplantation. Importantly, the absolute number and percentage of DNT cells were significantly higher in UCBT patients without aGVHD than in those with aGVHD within one year (F = 4.684, P = 0.039 and F = 5.583, P = 0.026, respectively). In addition, the number of DNT cells in the first month after transplantation decreased significantly with the degree of aGVHD increased, and faster DNT cell reconstitution in the first month after UCBT was an independent protective factor for aGVHD (HR = 0.46, 95% confidence interval [CI]: 0.23-0.93; P = 0.031).
Conclusions:
Compared to the number of DNT cells in Chinese healthy people, the reconstitution of DNT cells in adults with hematological malignancies after UCBT was slow. In addition, the faster reconstitution of DNT cells in the early stage after transplantation was associated with a lower incidence of aGVHD.
开放获取
Ebstein畸形的外科治疗策略与技巧Qingyu Wu, Xiaoya Zhang, Mingkui Zhang, Hongyin Li, Dongya Zhang, Lianyi Wang, Qingfeng Wu
中华医学杂志英文版2024年 137卷 10期
DOI: 10.1097/CM9.0000000000002854
摘要
Background:
Ebstein’s anomaly (EA) is a rare and complex congenital heart anomaly, and the effect of surgical treatment is not ideal. This study aims to introduce our experience in management strategies, surgical techniques, and operative indications for patients with Ebstein’s anomaly.
Methods:
A retrospective study of 258 operations was performed in 253 patients by the same cardiac surgeon in The First Hospital of Tsinghua University between March 2004 and January 2020. 32 patients had previously received cardiac surgery in other hospitals. The clinical data including diagnosis, operative indications, techniques, pathological changes, and survival rates were collected and analyzed.
Results:
Anatomical correction was performed in 203 (78.7%) operations, 1½ ventricle repair in 38 (14.7%) operations, tricuspid valve repair only in four operations (1.6%), tricuspid valve replacement in ten (3.9%), total cavopulmonary connection (TCPC) in two (0.8%), and Glenn operation in one operation (0.4%). Reoperation was performed in five patients (2.0%) during hospitalization. Among them, tricuspid valve replacement was performed in one patient, 1½ ventricle repair in two patients, and tricuspid valve annulus reinforcement in two patients. Five patients died with an early mortality rate of 2.0%. Complete atrioventricular conduction block was complicated in one patient (0.4%). A total of 244 patients was followed up (four in the 253 patients lost) with a duration of 3.0-168.0 (87.6 ± 38.4) months. Cardiac function of 244 patients improved significantly with mean New York Heart Association (NYHA) functional class recovery from 3.5 to 1.1. The mean grade of tricuspid valve regurgitation improved from 3.6 to 1.5. Three late deaths (1.2%) occurred. The survival rates at five and ten years after surgery were 98.6% and 98.2%, respectively. Reoperation was performed in five patients (2.0%) during the follow-up period.
Conclusion:
Based on our management strategies and operative principles and techniques, anatomical correction of EA is capable of achieving excellent long-term results, and low rates of TCPC, 1½ ventricle repair and valvular replacement.
Clinical Observation
开放获取
中国健康女性多中心尿流率测定研究Xiaodong Liu, Lingfeng Meng, Jiawen Wang, Tianming Ma, Benkang Shi, Hai Huang, Qingwei Wang, Min Chen, Limin Liao, Hong Shen 等
中华医学杂志英文版2024年 137卷 10期
DOI: 10.1097/CM9.0000000000003100
摘要
尿流术是一种用于记录排尿量（VV）和流速的尿流测量技术，可帮助临床医生客观评价下尿路功能。目前，很少有尿流率研究关注女性人群，[
Correspondence
开放获取
静脉—动脉体外膜肺氧合作为晚期心力衰竭患者的桥梁：中国的初步经验Jing Wang, Jian Wang, Sizhe Gao, Gang Liu, Qian Wang, Shujie Yan, Boyi Zhou, Yuan Yuan, Guodong Gao, Bingyang Ji
中华医学杂志英文版2024年 137卷 10期
DOI: 10.1097/CM9.0000000000002822
摘要
致编辑：静脉-动脉体外膜肺氧合（VA-ECMO）已被用作等待心脏移植（HTx）的晚期心力衰竭（AdHF）患者的桥梁。发达国家报道的多项研究证实了VA-ECMO在桥接至左心室辅助装置（LVAD）或HTx方面的优势，具有稳定病情和提高患者进一步治疗的可能性。[
开放获取
1990-2019年全球家庭空气污染导致的视力丧失负担：趋势分析和10年预测Cong Li, Zuoqian Jing, Jianbo Shen, Shunming Liu, Lei Liu, Xiaohong Yang, Honghua Yu
中华医学杂志英文版2024年 137卷 10期
DOI: 10.1097/CM9.0000000000003051
摘要
致编辑失明和视力丧失（BVL）是一个日益严重的问题，影响着不断扩大的全球人口。[
开放获取
α-Gal综合征Mengyuan Zhan, Shaohui Chen, Tengda Xu, Jia Yin, Hao Li, Zhouxian Pan, Ning Cui, Liping Wen
中华医学杂志英文版2024年 137卷 10期
DOI: 10.1097/CM9.0000000000003063
摘要
致编辑：肉类是蛋白质的重要来源，大致可分为红肉和白肉。白肉，包括家禽、鱼虾等海鲜和爬行动物等。，其特征是未煮熟时颜色较浅。红肉基本上是哺乳动物肉，包括家畜肉，如猪肉、牛肉、羊肉，以及某些地区的野生动物肉，如袋鼠、海豹、鲸鱼。由于骨骼肌中存在肌红蛋白，未煮熟的哺乳动物肉呈现红色。哺乳动物肉过敏的临床表现包括两种类型的过敏反应，即速发型和延迟型，尽管两者都是由免疫球蛋白E(IgE)介导的。速发型超敏反应表现为摄入红肉后不久出现的过敏症状，主要由血清白蛋白和免疫球蛋白触发，血清白蛋白和免疫球蛋白是主要的过敏原成分。这是食物过敏的典型模式。迟发型超敏反应的特征是在摄入红肉后2-6小时过敏症状延迟发作，并由寡糖α-gal特异性IgE介导，这是最近发现的食物过敏模式。[
开放获取
慢性阻塞性肺疾病中的铁下垂：从细胞机制到治疗应用Mengli Yan, Shiyu Xu, Han Wang, Shoujin Dong, Chunheng Mo
中华医学杂志英文版2024年 137卷 10期
DOI: 10.1097/CM9.0000000000003079
摘要
致编辑：慢性阻塞性肺病（COPD）是一个全球性的公共卫生挑战，目前没有有效的治疗方法，影响全球超过3亿人。需要全面了解本病的发病机制。最近，铁下垂（一种由铁依赖性脂质过氧化驱动的细胞死亡形式）与COPD的发病机制有关。[
开放获取
儿科和青少年妇科外科疾病的住院疾病谱和临床特征：中国12年数据的单研究所研究He Huang, Siyun Wang, Ruixi Zhan, Ling Yin, Yongchun Hu, Donglai Yang, Yangyang Shi
中华医学杂志英文版2024年 137卷 10期
DOI: 10.1097/CM9.0000000000003086
摘要
致编辑：儿科和青少年妇科（PAG）是妇科的一个专业分支，专注于妇女从婴儿期到青春期的生殖健康问题。[
开放获取
中国脊髓性肌萎缩症患儿的营养和血脂状况：一项回顾性病例对照研究Yijie Feng, Jia Wei, Mei Yao, Jianing Jin, Yiqin Cui, Qi Long, Fei Chen, Yi Hong, Dongming Zhou, Jingjing Hu 等
中华医学杂志英文版2024年 137卷 10期
DOI: 10.1097/CM9.0000000000003049
摘要
致编辑：5q脊髓性肌萎缩症（5qSMA）是一种常染色体隐性神经肌肉疾病，由缺乏由SMN1基因，位于5q11.2-q13.3。[
开放获取
早期冠状动脉疾病患者罕见单基因疾病谱Yaqun Teng, Tian Du, Siqin Feng, Ran Tian, Yaping Liu, Jian Guo, Lei Wang, Zhiyu Zhang, Xiaodong Luan, Shan He 等
中华医学杂志英文版2024年 137卷 10期
DOI: 10.1097/CM9.0000000000002996
摘要
致编辑：在年轻人群中，过早冠状动脉疾病（CAD）的全球负担正在增加。过早CAD通常是指老年男性和女性发生阻塞性冠状动脉粥样硬化血栓性病变<55岁及<65岁，尤其是老年人<45年了。[
开放获取
射血分数正常的心力衰竭中明显充血的预后意义及其与螺内酯的相互作用：来自TOPCAT的见解Yingwen Lin, Hengli Zhao, Dongtu Hu, Jia Huang, You Peng, Juncong Li, Dingli Xu, Qingchun Zeng
中华医学杂志英文版2024年 137卷 10期
DOI: 10.1097/CM9.0000000000002870
摘要
致编辑：射血分数保留的心力衰竭（HFpEF）是一种以舒张功能受损为特征的临床实体。直到最近，很少有研究直接评估容量状态如何影响HFpEF患者未来的心脏事件。支持螺内酯在HFpEF中应用的证据主要来源于一项醛固酮拮抗剂治疗保留心功能的心力衰竭（TOPCAT）试验。尽管试验的初步分析得出了中性结果，但亚组和随后的事后分析证实了其在选定患者组中的疗效，表明确定受益于螺内酯治疗的潜在患者亚组是重要的。[
开放获取
原发性干燥综合征合并恶性淋巴瘤的免疫学特征及预测危险因素：一项多中心病例对照研究Yuebo Jin, Linqing Hou, Hao Li, Liyun Zhang, Yuanhong Peng, Naidi Wang, Jing He
中华医学杂志英文版2024年 137卷 10期
DOI: 10.1097/CM9.0000000000002912
摘要
致编辑：原发性干燥综合征（pSS）是一种以外分泌腺（主要是唾液腺和泪腺）受累为特征的多系统自身免疫性疾病，导致口干症和眼干症。[
开放获取
腹主动脉瘤修复术后患者全因死亡率术前预测模型的建立和验证Tan Li, Guangxiao Li, Yijun Wu, Chao Yang, Jun Yang, Liping Sun, Chunyan Ma
中华医学杂志英文版2024年 137卷 10期
DOI: 10.1097/CM9.0000000000003069
摘要
致编辑：腹主动脉瘤（AAA）是一种危及生命的血管疾病。当AAA的最大直径达到男性5.5 cm和女性5.0 cm的阈值时，或者当AAA经历大于1.0 cm/年的快速扩张时，通常建议进行手术干预。[
本期目次
下载本期封面 下载本期目录
