MedNexus
2024年 · 第137卷第12期
出版日期 2024-06-20电子版 ￥0.00元
MedNexus
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- Review Article
- Original Article
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Consensus Statement
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早期乳腺癌患者新辅助治疗临床实践指南：中国乳腺外科学会实践指南2022Juliang Zhang, Ting Wang, Zhe Wang, Jing Fan, Xiaolong Xu, Jing Kong, Xinxin Wen, Rui Ling, Yinhua Liu
中华医学杂志英文版2024年 137卷 12期
DOI: 10.1097/CM9.0000000000003093
摘要
新辅助治疗可在有适应症的早期乳腺癌中产生临床益处。对新辅助治疗的适应证、治疗方案、疗效进行了研究，贡献了有价值的临床证据。[
Review Article
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双硫仑：一种新的癌症治疗药物Min Zeng, Baibei Wu, Wenjie Wei, Zihan Jiang, Peiqiang Li, Yuanting Quan, Xiaobo Hu
中华医学杂志英文版2024年 137卷 12期
DOI: 10.1097/CM9.0000000000002909
摘要
Cancer is a major global health issue. Effective therapeutic strategies can prolong patients’ survival and reduce the costs of treatment. Drug repurposing, which identifies new therapeutic uses for approved drugs, is a promising approach with the advantages of reducing research costs, shortening development time, and increasing efficiency and safety. Disulfiram (DSF), a Food and Drug Administration (FDA)-approved drug used to treat chronic alcoholism, has a great potential as an anticancer drug by targeting diverse human malignancies. Several studies show the antitumor effects of DSF, particularly the combination of DSF and copper (DSF/Cu), on a wide range of cancers such as glioblastoma (GBM), breast cancer, liver cancer, pancreatic cancer, and melanoma. In this review, we summarize the antitumor mechanisms of DSF/Cu, including induction of intracellular reactive oxygen species (ROS) and various cell death signaling pathways, and inhibition of proteasome activity, as well as inhibition of nuclear factor-kappa B (NF-κB) signaling. Furthermore, we highlight the ability of DSF/Cu to target cancer stem cells (CSCs), which provides a new approach to prevent tumor recurrence and metastasis. Strikingly, DSF/Cu inhibits several molecular targets associated with drug resistance, and therefore it is becoming a novel option to increase the sensitivity of chemo-resistant and radio-resistant patients. Studies of DSF/Cu may shed light on its improved application to clinical tumor treatment.
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母胎免疫耐受在妊娠建立和维持中的作用Jingjing Wang, Tao Han, Xiaoming Zhu
中华医学杂志英文版2024年 137卷 12期
DOI: 10.1097/CM9.0000000000003114
摘要
Normal pregnancy is a contradictory and complicated physiological process. Although the fetus carries the human leukocyte antigen (HLA) inherited from the paternal line, it does not cause maternal immune rejection. As the only exception to immunological principles, maternal–fetal immune tolerance has been a reproductive immunology focus. In early pregnancy, fetal extravillous trophoblast cells (EVTs) invade decidual tissues and come into direct contact with maternal decidual immune cells (DICs) and decidual stromal cells (DSCs) to establish a sophisticated maternal–fetal crosstalk. This study reviews previous research results and focuses on the establishment and maintenance mechanism of maternal–fetal tolerance based on maternal–fetal crosstalk. Insights into maternal–fetal tolerance will not only improve understanding of normal pregnancy but will also contribute to novel therapeutic strategies for recurrent spontaneous abortion, pre-eclampsia, and premature birth.
Original Article
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癌症发病率和死亡率的社会经济不平等：GLOBOCAN 2022分析Wei Cao, Kang Qin, Feng Li, Wanqing Chen
中华医学杂志英文版2024年 137卷 12期
DOI: 10.1097/CM9.0000000000003140
摘要
Background:
Given the recent updates in cancer burden estimates by GLOBOCAN 2022, this study was undertaken to provide pertinent perspectives within the context of the Human Development Index (HDI) and major world economies.
Methods:
Datasets sourced from GLOBOCAN encompassed cancer cases and deaths across all cancer types in 2022, alongside projections up to 2050. Cancer incidences and deaths of the top 10 cancers within China and four distinct HDI-classified regions were compared using descriptive analyses. Age-standardized incidence rates (ASIRs) and mortality rates (ASMRs) worldwide for the most prevalent cancers in 2022 across ten largest economies and four-tier HDIs were examined. The top five cancer types concerning both incidence and mortality in China were delineated by sex and age group.
Results:
In males, prostate cancer predominated in countries with low, high (except China), and very high HDI. Prostate and liver cancers were prominent causes of death in countries with low HDI. In females, breast and cervical cancers predominated in countries with low-to-medium HDI. Lung and colorectal cancer incidence and deaths increased with high HDI for both sexes. ASIRs and ASMRs for breast, prostate, lung, and colorectal cancers in the top 10 economies were higher than the global average. However, liver, stomach, and cervical cancers in most Western countries exhibited lower rates. In China, hematologic malignancies (43%) were prevalent among children aged 0–14 years, whereas thyroid cancer led among adolescents and young adults aged 15–39 years. Regarding incidence and mortality, lung cancer predominated for individuals over 40 years, except for females aged 40–59 years, in whom breast cancer predominated. Projected trends indicated substantial increases in new cancer cases (76.6%) and deaths (89.7%) over the next three decades.
Conclusions:
Infection- and poverty-related cancer burdens are offset by increased prostate, breast, colorectal, and lung cancer incidence associated with rapid societal and economic transitions. Cancer incidence and mortality patterns in China feature characteristics of developed and developing countries, necessitating tailored, evidence-based, and comprehensive strategies for effective cancer prevention and control.
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中国肝癌筛查用乙型肝炎病毒感染调查：一项基于人群的横断面研究Yongjie Xu, Changfa Xia, He Li, Maomao Cao, Fan Yang, Qianru Li, Mengdi Cao, Wanqing Chen
中华医学杂志英文版2024年 137卷 12期
DOI: 10.1097/CM9.0000000000003171
摘要
Background:
Hepatitis B virus (HBV) infection is the primary cause of hepatocellular carcinoma (HCC) in China. The target population for HCC screening comprises individuals who test positive for hepatitis B surface antigen (HBsAg). However, current data on the prevalence of HBV infection among individuals who are eligible for HCC screening in China are lacking. We aimed to assess the seroepidemiology of HBV infection among Chinese individuals eligible for HCC screening to provide the latest evidence for appropriate HCC screening strategies in China.
Methods:
Questionnaires including information of sex, age, ethnicity, marital status, educational level, source of drinking water, as well as smoking and alcohol consumption history and serum samples were collected from females aged 45–64 years and males aged 35–64 years in 21 counties from 4 provinces in eastern and central China between 2015 and 2023. Enzyme-linked immunosorbent assay methods were used to detect the serum HBV marker HBsAg.
Results:
A total of 603,082 individuals were enrolled, and serum samples were collected for analysis from January 1, 2015 to December 31, 2023. The prevalence of HBsAg positive in the study population was 5.23% (31,528/603,082). The prevalence of HBsAg positive was greater in males than in females (5.60% [17,660/315,183] vs 4.82% [13,868/287,899], χ2 = 187.52, P <0.0001). The elderly participants exhibited a greater prevalence of HBV infection than younger participants (χ2 = 41.73, P <0.0001). Birth cohort analysis revealed an overall downward trend in HBV prevalence for both males and females. Individuals born in more recent cohorts exhibited a lower prevalence of HBV infection as compared to those born earlier.
Conclusions:
The current prevalence of HBV infection remains above 5% in populations eligible for HCC screening in China.
Further efforts should be made to increase the accessibility of HCC screening among individuals with HBV infection.
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高选择性初发cN1乳腺癌患者新辅助化疗后靶向腋窝清扫术：一项单中心前瞻性试验Xiuchun Chen, Zhenduo Lu, Chengzheng Wang, Minhao Lyu, Jianghua Qiao, Xianfu Sun, Lianfang Li, Chongjian Zhang, Zhenzhen Liu
中华医学杂志英文版2024年 137卷 12期
DOI: 10.1097/CM9.0000000000003007
摘要
Background:
Sentinel lymph node (SLN) biopsy is gradually accepted as the standard of care in breast cancer patients with down-staged axillary disease after neoadjuvant chemotherapy (NAC). However, it is still difficult to precisely define pre-NAC clinical node-positive (cN1) and post-NAC clinical node-negative (ycN0). This prospective single-center trial was designed to evaluate the feasibility and accuracy of standard targeted axillary dissection (TAD) after NAC in highly selective pre-NAC cN1 patients (not considering ultrasound-based axillary ycN staging).
Methods:
This prospective trial included patients with initial pre-NAC cT1–3N1M0 invasive breast cancer but with a rigorous definition of cN1 from the Affiliated Cancer Hospital of Zhengzhou University. When NAC was effective (including complete and partial responses) and preoperative axillary palpation was negative, preoperative ultrasound-based axillary staging was not considered, and all patients underwent TAD followed by axillary lymph node (LN) dissection. The detection rate (DR) and false-negative rate (FNR) of TAD were calculated.
Results:
A total of 82 patients were included, and 77 of them were eligible for data analysis. The DR for TAD was 94.8% (73/77). There were 26 patients with one abnormal LN at the time of diagnosis based on ultrasound, 45 patients with two, and 2 patients with three. One patient had one TAD LN, four patients had two TAD LNs, and 68 patients had three or more TAD LNs. Preoperative axillary palpation yielded negative results for all 73 patients who successfully underwent TAD. Preoperative ultrasound-based ycN0 and ycN+ conditions were detected for 52 and 21 cases, respectively. The FNR was 7.4% (2/27) for standard TAD (≥3 SLNs), which was lower than that of all successful TAD (≥1 SLN; 10.0%, 3/30).
Conclusions:
In rigorously defined pre-NAC cN1 breast cancer patients, standard TAD is feasible for those with negative axillary palpation after NAC, and FNR is also less than 10%.
Registration:
chictr.org.cn, ChiCTR2100049093
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胎儿危重型先天性心脏病宫内治疗的预后及转归Liqing Zhao, Lei Wang, Hongping Xia, Yurong Wu, Xianting Jiao, Hong Zhu, Sun Chen, Kun Sun
中华医学杂志英文版2024年 137卷 12期
DOI: 10.1097/CM9.0000000000002796
摘要
Background:
Intrauterine valvuloplasty is an innovative therapy, which promotes ventricular growth and function in some congenital heart diseases (CHDs). The technique remains challenging and can only be performed in a few centers. This study aimed to assess the feasibility and mid-term outcomes of fetal cardiac intervention (FCI) in fetuses with critical CHD in an experienced tertiary center.
Methods:
Five fetal aortic valvuloplasty (FAV) or fetal pulmonary valvuloplasty (FPV) procedures were performed in our fetal heart center between August 2018 and May 2022. Technical success was defined as crossing the aortic or pulmonary valve and balloon inflation, followed by evidence of increased blood flow across the valve and/or new regurgitation. Follow-up clinical records and echocardiography were obtained during the prenatal and postnatal periods.
Results:
Five fetuses received FAV or FPV, including critical aortic stenosis (n = 2) and pulmonary atresia with intact ventricular septum (n = 3). The mean maternal age was 33.0 ± 2.6 years. The median gestational age (GA) at diagnosis was 24 weeks (range, 22-26 weeks). The median GA at intervention was 29 weeks (range, 28-32 weeks). All five cases underwent successful or partially successful procedures. One patient had pulmonary valve perforation without balloon dilation. No procedure-related deaths or significant complications occurred. However, one neonatal death occurred due to heart and renal failure. The median follow-up period was 29.5 months (range, 8.0-48.0 months). The four surviving patients had achieved biventricular circulation, exhibited improved valve, and ventricular development at the last follow-up visit.
Conclusion:
Intrauterine FCI could be performed safely with good prognosis in critical CHD.
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非急诊内镜逆行胰胆管造影前高碳水化合物流质饮食2小时与禁食过夜的安全性：一项单盲、多中心、随机对照试验Wenbo Meng, Joseph W. Leung, Zhenyu Wang, Qiyong Li, Leida Zhang, Kai Zhang, Xuefeng Wang, Meng Wang, Qi Wang, Yingmei Shao 等
中华医学杂志英文版2024年 137卷 12期
DOI: 10.1097/CM9.0000000000002820
摘要
Background:
Although overnight fasting is recommended prior to endoscopic retrograde cholangiopancreatography (ERCP), the benefits and safety of high-carbohydrate fluid diet (CFD) intake 2 h before ERCP remain unclear. This study aimed to analyze whether high-CFD intake 2 h before ERCP can be safe and accelerate patients’ recovery.
Methods:
This prospective, multicenter, randomized controlled trial involved 15 tertiary ERCP centers. A total of 1330 patients were randomized into CFD group (n = 665) and fasting group (n = 665). The CFD group received 400 mL of maltodextrin orally 2 h before ERCP, while the control group abstained from food/water overnight (>6 h) before ERCP. All ERCP procedures were performed using deep sedation with intravenous propofol. The investigators were blinded but not the patients. The primary outcomes included postoperative fatigue and abdominal pain score, and the secondary outcomes included complications and changes in metabolic indicators. The outcomes were analyzed according to a modified intention-to-treat principle.
Results:
The post-ERCP fatigue scores were significantly lower at 4 h (4.1 ± 2.6 vs. 4.8 ± 2.8, t = 4.23, P <0.001) and 20 h (2.4 ± 2.1 vs. 3.4 ± 2.4, t= 7.94, P <0.001) in the CFD group, with least-squares mean differences of 0.48 (95% confidence interval [CI]: 0.26–0.71, P <0.001) and 0.76 (95% CI: 0.57–0.95, P <0.001), respectively. The 4-h pain scores (2.1 ± 1.7 vs. 2.2 ± 1.7, t = 2.60, P = 0.009, with a least-squares mean difference of 0.21 [95% CI: 0.05–0.37]) and positive urine ketone levels (7.7% [39/509] vs. 15.4% [82/533], χ2 = 15.13, P <0.001) were lower in the CFD group. The CFD group had significantly less cholangitis (2.1% [13/634] vs. 4.0% [26/658], χ2 = 3.99, P = 0.046) but not pancreatitis (5.5% [35/634] vs. 6.5% [43/658], χ2 = 0.59, P = 0.444). Subgroup analysis revealed that CFD reduced the incidence of complications in patients with native papilla (odds ratio [OR]: 0.61, 95% CI: 0.39–0.95, P = 0.028) in the multivariable models.
Conclusion:
Ingesting 400 mL of CFD 2 h before ERCP is safe, with a reduction in post-ERCP fatigue, abdominal pain, and cholangitis during recovery.
Trail Registration:
ClinicalTrials.gov, No. NCT03075280.
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未接受治疗的成年男性HlV/AlDS患者BlC/FTC/TAF后血脂水平的变化及影响因素vs.3TC+EFV+TDFXi Wang, An Liu, Zaicun Li, Hongwei Zhang, Ruojun Esther Wu, Ying Shao, Jianwei Li, Jiangzhu Ye, Wei Liu, Lijun Sun
中华医学杂志英文版2024年 137卷 12期
DOI: 10.1097/CM9.0000000000003147
摘要
Background:
Antiretroviral therapy (ART) was often associated with dyslipidemia among human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome (AIDS) patients. This study aimed to assess treatment-naïve adult male patients with HIV/AIDS who initiated ART with either co-formulated bictegravir, emtricitabine, and tenofovir alafenamide (BIC/FTC/TAF) or lamivudine, efavirenz, and tenofovir disoproxil fumarate (3TC+EFV+TDF), monitoring at weeks 4, 12, 24, and 48.
Methods:
A case-control retrospective study was conducted. The newly diagnosed HIV-infected individuals attending the sexual transmission disease (STD)/AIDS clinic of Beijing Youan Hospital, Capital Medical University, from January to December 2021. The patients were divided into BIC/FTC/TAF group or 3TC+EFV+TDF group. High-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), triglyceride (TG), and total cholesterol (TC) at different time points over 48 weeks between two groups were compared. A multivariate Cox regression model was used to identify relevant influencing factors for the population at high risk of increased LDL-C.
Results:
A total of 870 participants, with 510 in BIC/FTC/TAF group and 360 in 3TC+EFV+TDF group. There were no statistically significant differences in median age, baseline CD4/CD8 ratio, median body mass index (BMI) between the two groups. In both two groups, levels of TG, TC, and LDL-C were higher at 4 weeks, 12 weeks, and 24 weeks of treatment (all P <0.05), and there were no statistically significant differences at 48 weeks compared to those at baseline (all P >0.05). In addition, the differences in average changes of the level of TG, TC, HDL-C, and LDL-C from weeks 4, 12, 24, and 48 to baseline between two groups were not statistically significant (all P >0.05). Multivariate Cox proportional risk model analysis showed that initiating ART with HIV RNA ≥105 copies/mL (compared with <105 copies/mL) was associated with an increased risk of elevated LDL-C (hazard ratio = 1.26, 95% confidence interval: 1.07-1.48, P = 0.005).
Conclusions:
Transient elevations in blood lipid levels (TC, TG, HDL-C, and LDL-C) were observed in treatment-naïve adult male HIV/AIDS patients with BIC/FTC/TAF at 4 weeks, 12 weeks, and 24 weeks of treatment. However, these levels did not differ significantly from baseline after 48 weeks of treatment, regardless of whether patients were in the BIC/FTC/TAF or 3TC+EFV+TDF group.
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高三尖杉酯碱通过增强小鼠模型中调节性T细胞诱导促进同种异体心脏移植物接受Xia Qiu, Hedong Zhang, Zhouqi Tang, Yuxi Fan, Wenjia Yuan, Chen Feng, Chao Chen, Pengcheng Cui, Yan Cui, Zhongquan Qi 等
中华医学杂志英文版2024年 137卷 12期
DOI: 10.1097/CM9.0000000000002813
摘要
Background:
Homoharringtonine (HHT) is an effective anti-inflammatory, anti-viral, and anti-tumor protein synthesis inhibitor that has been applied clinically. Here, we explored the therapeutic effects of HHT in a mouse heart transplant model.
Methods:
Healthy C57BL/6 mice were used to observe the toxicity of HHT in the liver, kidney, and hematology. A mouse heart transplantation model was constructed, and the potential mechanism of HHT prolonging allograft survival was evaluated using Kaplan–Meier analysis, immunostaining, and bulk RNA sequencing analysis. The HHT-T cell crosstalk was modeled ex vivo to further verify the molecular mechanism of HHT-induced regulatory T cells (Tregs) differentiation.
Results:
HHT inhibited the activation and proliferation of T cells and promoted their apoptosis ex vivo. Treatment of 0.5 mg/kg HHT for 10 days significantly prolonged the mean graft survival time of the allografts from 7 days to 48 days (P <0.001) without non-immune toxicity. The allografts had long-term survival after continuous HHT treatment for 28 days. HHT significantly reduced lymphocyte infiltration in the graft, and interferon-γ-secreting CD4+ and CD8+ T cells in the spleen (P <0.01). HHT significantly increased the number of peripheral Tregs (about 20%, P <0.001) and serum interleukin (IL)-10 levels. HHT downregulated the expression of T cell receptor (TCR) signaling pathway-related genes (CD4, H2-Eb1, TRAT1, and CD74) and upregulated the expression of IL-10 and transforming growth factor (TGF) -β pathway-related genes and Treg signature genes (CTLA4, Foxp3, CD74, and ICOS). HHT increased CD4+ Foxp3+ cells and Foxp3 expression ex vivo, and it enhanced the inhibitory function of inducible Tregs.
Conclusions:
HHT promotes Treg cell differentiation and enhances Treg suppressive function by attenuating the TCR signaling pathway and upregulating the expression of Treg signature genes and IL-10 levels, thereby promoting mouse heart allograft acceptance. These findings may have therapeutic implications for organ transplant recipients, particularly those with viral infections and malignancies, which require a more suitable anti-rejection medication.
Correspondence
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EGFR-携带突变型非小细胞肺癌患者CDK4扩增显示对阿法替尼有良好反应：2例病例报告Shuting Zhan, Bo Cheng, Xiwen Liu, Jianfu Li, Ge Bai, Qi Cai, Huiting Wang, Yang Xiang, Chunyan Li, Jianxing He 等
中华医学杂志英文版2024年 137卷 12期
DOI: 10.1097/CM9.0000000000003136
摘要
致编辑：表皮生长因子受体酪氨酸激酶抑制剂（EGFR-TKIs）在敏感的晚期非小细胞肺癌（NSCLC）患者中显示出显著的疗效EGFR突变，并显著延长这些患者的生存期。然而，大多数患者会出现耐药性。先前的研究表明细胞周期蛋白依赖性激酶4/6（CDK4/6）基因扩增是EGFR-TKI奥希替尼的耐药机制之一，削弱了其疗效。治疗方案EGFR-突变型非小细胞肺癌患者CDK4扩增仅限于添加CDK4抑制剂。
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非规范的影响ALK非小细胞肺癌靶向治疗疗效的融合研究Hao Zeng, Qi Wei, Yuan Tang, Yuanyuan Zhang, Sihan Tan, Qin Huang, Xin Pu, Yalun Li, Panwen Tian
中华医学杂志英文版2024年 137卷 12期
DOI: 10.1097/CM9.0000000000002913
摘要
致编辑：随着下一代测序（NGS）的广泛应用，许多EML4-ALK融合伙伴或共存（非）-EML4-ALK和非-EML4-ALK已在非小细胞肺癌(NSCLC)中检测到。尽管针对转移性非小细胞肺癌和可操作突变患者的靶向治疗极大地改变了这些患者的治疗方式，但研究表明，基于不同的治疗方法，患者的无进展生存期(PFS)存在差异ALK融合伙伴。[
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结直肠癌筛查有效性和安全性的meta分析Pei Li, Xueyang Zeng, Zuoxiang Liu, Jichun Yang, Yueying Li, Le Gao, Hongmei Zeng, Lin Zhang, Feng Sun
中华医学杂志英文版2024年 137卷 12期
DOI: 10.1097/CM9.0000000000003113
摘要
致编辑：结直肠癌（CRC）是中国癌症死亡的第四大常见原因，被视为公共健康威胁，每年约占所有癌症死亡人数的10%。[
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妊娠期卵巢恶性肿瘤：诊断评估、最佳治疗和未来展望Yaru Sheng, Jiangjing Yuan, Yuhong Li, Yudong Wang
中华医学杂志英文版2024年 137卷 12期
DOI: 10.1097/CM9.0000000000002872
摘要
致编辑：在妊娠期诊断的妇科恶性肿瘤中，妊娠期恶性卵巢肿瘤（MOTP）仅次于宫颈癌排名第二，当今大多数妇女希望维持妊娠和保留生育能力，这使肿瘤治疗复杂化，因为应仔细考虑母亲和胎儿的所有潜在并发症和预后。建议由妇科肿瘤学家、产科医生和病理学家组成的多学科团队采取协调方法，应根据几个重要因素对每位患者进行单独管理，包括初始诊断时的孕周（GW）、组织学类型、国际妇产科联合会（FIGO）分期以及患者是否终止妊娠的偏好。在维持妊娠的情况下，应谨慎进行手术干预和化疗。对肿瘤的治疗效果和对胎儿的潜在有害事件应适当平衡。尽管先前的研究表明此类恶性肿瘤的预后与非妊娠状态相似，但应谨慎解释结果，因为这些研究中的样本量不足以控制所有预后因素。[
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腹腔镜骶阴道固定术治疗盆腔器官脱垂，随访时间超过7年的前瞻性观察队列Jianbin Guo, Xiaochen Song, Shuo Liang, Yuan Wang, Yang Ye, Qianqian Gao, Juan Chen, Lan Zhu
中华医学杂志英文版2024年 137卷 12期
DOI: 10.1097/CM9.0000000000002835
摘要
致编辑：盆腔器官脱垂（POP）是老年妇女常见的盆底疾病，是健康相关生活质量显著下降的原因。随着女性寿命的延长，持久性有机污染物正成为一个主要的健康问题。[
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比拉斯汀的有效性和安全性vs.左西替利嗪治疗慢性特发性荨麻疹：一项多中心、双盲、双模拟、III期、非劣效性、随机临床试验Xue Chen, Xiuping Han, Bo Cheng, Hui Li, Lingling Liu, Songmei Geng, Linfeng Li, Jie Li, Qing Guo, Guoyi Zhang 等
中华医学杂志英文版2024年 137卷 12期
DOI: 10.1097/CM9.0000000000003071
摘要
致编辑：慢性荨麻疹在全球流行，在中国呈上升趋势，主要影响中青年女性，影响她们的生活质量（QoL）。[
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基于结构磁共振成像的阿尔茨海默病计算机辅助诊断Yihang Huang, Keyi Shan, Yuzi Yan, Wan Li
中华医学杂志英文版2024年 137卷 12期
DOI: 10.1097/CM9.0000000000003180
摘要
致编辑：阿尔茨海默病（AD）是一种不可逆的慢性神经退行性疾病。AD最初影响短期记忆、思维和行为。然后严重扰乱患者及其家人的正常生活，最终可能导致死亡。轻度认知障碍（MCI）被认为是AD的早期阶段。一些研究表明，近20%的MCI患者在未来四年内有发展为AD的风险。[
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中国一种新型反应性神经刺激系统治疗药物难治性局灶性癫痫的安全性和有效性：首次人体研究Kailiang Wang, Yongzhi Shan, Penghu Wei, Liankun Ren, Liang Chen, Junming Zhu, Guoguang Zhao
中华医学杂志英文版2024年 137卷 12期
DOI: 10.1097/CM9.0000000000002821
摘要
致编辑：最近的研究将耐药性癫痫（DRE）描述为本质上是一种神经网络疾病。[
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急性肾损伤儿童供体单肾移植受者的预后：一项单中心试点研究Qiang Zhang, Yanxu Chen, Haiyue Yu, Jun Li, Chenglin Wu, Sizhe Long, Pengan Li, Qian Fu, Huanxi Zhang, Xiaojun Su 等
中华医学杂志英文版2024年 137卷 12期
DOI: 10.1097/CM9.0000000000003119
摘要
致编辑：用于移植的已故供体(DD)肾脏的短缺仍然是一个持续关注的问题。尽管急性肾损伤（AKI）病变具有潜在的可逆性，但来自患有AKI的儿科供体的肾脏通常未得到充分利用，尤其是在儿科移植的背景下。通过实施从儿科供体到儿科受体（PTP）的单肾移植（SKT），我们可以优化可用肾脏的利用，增加儿科受体的数量。
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中国原发性肾小球肾炎患者长期肾移植结局：一项中国多中心研究Kenan Xie, Jinsong Chen, Longshan Liu, Rending Wang, Baoshan Gao, Xiaopeng Hu, Xiaotian Tang, Zheng Jin, Ming Zhang, Yong Han 等
中华医学杂志英文版2024年 137卷 12期
DOI: 10.1097/CM9.0000000000003107
摘要
致编辑：中国终末期肾病（ESKD）的首要病因是慢性肾小球肾炎（GN），占ESKD患者的45%。[
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