MedNexus
2024年 · 第137卷第16期
出版日期 2024-08-20电子版 ￥0.00元
MedNexus
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- Editorial
- Review Article
- Meta Analysis
- Original Article
- Clinical Observation
- Rapid Report
- Correspondence
Editorial
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改变局部晚期直肠癌术前放疗30年的常规：新瓶换新酒？Ruoxu Dou, Jianwei Zhang, Jianping Wang, Yanhong Deng
中华医学杂志英文版2024年 137卷 16期
DOI: 10.1097/CM9.0000000000002986
摘要
30多年来，放射治疗一直是局部晚期（II-III期）直肠癌标准术前治疗的一部分。虽然术前放疗已被证实可减少局部复发，但严重影响生活质量，不能提高长期生存率。随着全直肠系膜切除术（TME）的引入，局部复发急剧减少，旧酒是否仍然适合新瓶值得商榷。在本文中，我们在文献和我们中心超过10年的临床研究的背景下讨论了这一观点。
Review Article
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脂肪酸合酶对肿瘤的调控及相关疗法的研究进展Rilan Bai, Jiuwei Cui
中华医学杂志英文版2024年 137卷 16期
DOI: 10.1097/CM9.0000000000002880
摘要
Fatty acid synthase (FASN) is an essential molecule in lipid metabolic pathways, which are crucial for cancer-related studies. Recent studies have focused on a comprehensive understanding of the novel and important regulatory effects of FASN on malignant biological behavior and immune-cell infiltration, which are closely related to tumor occurrence and development, immune escape, and immune response. FASN-targeting antitumor treatment strategies are being developed. Therefore, in this review, we focused on the effects of FASN on tumor and immune-cell infiltration and reviewed the progress of related antitumor therapy development.
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电子烟的健康后果Xinmeng Li, Lingzhi Yuan, Fen Wang
中华医学杂志英文版2024年 137卷 16期
DOI: 10.1097/CM9.0000000000003098
摘要
The usage of electronic cigarettes (e-cigarettes) sparked an outbreak of unidentified vaping-related lung disease in the US during late 2019. With e-cigarettes becoming more and more popular, smokers have more options other than conventional cigarettes. Under these circumstances, a comprehensive evaluation of the general safety of new tobacco and tobacco-related products, represented by e-cigarettes, to human health is necessary. In this review, we summarize the current research on potential negative impacts of e-cigarette exposure on human health. In particular, studies detailing the relationship between e-cigarettes and the digestive system are summarized, with mechanisms mainly including hepatic metabolic dysfunction, impaired gut barrier, and worsened outcomes of inflammatory bowel disease (IBD). Although believed to be safer than traditional cigarettes, e-cigarettes exert adverse effects on systemic health and induce the development of multiple diseases including asthma, cardiovascular disease, and IBD. Moreover, nicotine-containing e-cigarettes have a negative impact on the childhood development and increase the risk of arterial stiffness compared to the non-nicotine e-cigarettes. However, non-nicotine e-cigarette components have detrimental effects including promoting liver damage and metabolic disorders.
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人类疾病中液-液相分离的生物信息学方法Jun Sun, Yilong Chen, Ruiye Bi, Yong Yuan, Haopeng Yu
中华医学杂志英文版2024年 137卷 16期
DOI: 10.1097/CM9.0000000000003249
摘要
Biomolecular aggregation within cellular environments via liquid–liquid phase separation (LLPS) spontaneously forms droplet-like structures, which play pivotal roles in diverse biological processes. These structures are closely associated with a range of diseases, including neurodegenerative disorders, cancer and infectious diseases, highlighting the significance of understanding LLPS mechanisms for elucidating disease pathogenesis, and exploring potential therapeutic interventions. In this review, we delineate recent advancements in LLPS research, emphasizing its pathological relevance, therapeutic considerations, and the pivotal role of bioinformatic tools and databases in facilitating LLPS investigations. Additionally, we undertook a comprehensive analysis of bioinformatic resources dedicated to LLPS research in order to elucidate their functionality and applicability. By providing comprehensive insights into current LLPS-related bioinformatics resources, this review highlights its implications for human health and disease.
Meta Analysis
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抗生素耐药性幽门螺杆菌东亚儿童和青少年的系统综述和荟萃分析Yuhang Zhou, Yanli Zhang, Shiyu Du
中华医学杂志英文版2024年 137卷 16期
DOI: 10.1097/CM9.0000000000002884
摘要
Background:
In East Asia, Helicobacter pylori (H. pylori) infection and related diseases are common, primarily during childhood and adolescence. The rates of primary antibiotic resistance in H. pylori among East Asian children and adolescents have not been extensively explored; few relevant systematic reviews or meta-analyses have been conducted. We evaluated the rates of antibiotic resistance in H. pylori among East Asian children and adolescents, with the goal of facilitating individualized treatment recommendations.
Methods:
We searched PubMed, Embase, and the Cochrane Library for studies in any language published up to February 2023 that explored antibiotic resistance in H. pylori among East Asian children and adolescents. We used MeSH and non-MeSH terms related to the topic, including terms related to children, adolescents, antibiotic resistance, H. pylori, and nations or regions. Additionally, we reviewed the reference lists of relevant articles. Studies that matched our strict predefined eligibility criteria were included in the screening process. Using established assessment methods, we evaluated the quality of the included studies.
Results:
We identified 15 observational studies involving 4831 H. pylori isolates, all published between 2001 and 2022. There was substantial primary antibiotic resistance in H. pylori isolates from East Asian children and adolescents. The rates of primary resistance were 51% (95% confidence interval [CI]: 40–62%) for metronidazole; 37% (95% CI: 20–53%) for clarithromycin; 19% (95% CI: 11–28%) for levofloxacin; and less than 3% each for amoxicillin, tetracycline, and furazolidone. Subgroup analysis revealed a prominent increase in metronidazole resistance over time. Clarithromycin and levofloxacin resistance rates fluctuated between 2005 and 2015, then remained stable; other antibiotic resistance rates were generally stable. Metronidazole, clarithromycin, and levofloxacin resistance rates were significantly higher in the Chinese mainland than in other East Asian regions. The rates of dual and multiple antibiotic resistance were 28% (95% CI: 21–36%) and 10% (95% CI: 7–14%), highlighting the potential for diverse resistance patterns.
Conclusions:
H. pylori isolates from East Asian children and adolescents exhibit high levels of metronidazole and clarithromycin resistance, particularly in the Chinese mainland. The non-negligible rates of dual and multiple resistance highlight the complexity of this problem.
Registration:
PROSPERO, No. CRD42023402510.
Original Article
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用于人类结果评估的人工智能系统体外受精衍生胚胎Ling Sun, Jiahui Li, Simiao Zeng, Qiangxiang Luo, Hanpei Miao, Yunhao Liang, Linling Cheng, Zhuo Sun, Wa Hou Tai, Yibing Han 等
中华医学杂志英文版2024年 137卷 16期
DOI: 10.1097/CM9.0000000000003162
摘要
Background:
In vitro fertilization (IVF) has emerged as a transformative solution for infertility. However, achieving favorable live-birth outcomes remains challenging. Current clinical IVF practices in IVF involve the collection of heterogeneous embryo data through diverse methods, including static images and temporal videos. However, traditional embryo selection methods, primarily reliant on visual inspection of morphology, exhibit variability and are contingent on the experience of practitioners. Therefore, an automated system that can evaluate heterogeneous embryo data to predict the final outcomes of live births is highly desirable.
Methods:
We employed artificial intelligence (AI) for embryo morphological grading, blastocyst embryo selection, aneuploidy prediction, and final live-birth outcome prediction. We developed and validated the AI models using multitask learning for embryo morphological assessment, including pronucleus type on day 1 and the number of blastomeres, asymmetry, and fragmentation of blastomeres on day 3, using 19,201 embryo photographs from 8271 patients. A neural network was trained on embryo and clinical metadata to identify good-quality embryos for implantation on day 3 or day 5, and predict live-birth outcomes. Additionally, a 3D convolutional neural network was trained on 418 time-lapse videos of preimplantation genetic testing (PGT)-based ploidy outcomes for the prediction of aneuploidy and consequent live-birth outcomes.
Results:
These two approaches enabled us to automatically assess the implantation potential. By combining embryo and maternal metrics in an ensemble AI model, we evaluated live-birth outcomes in a prospective cohort that achieved higher accuracy than experienced embryologists (46.1% vs. 30.7% on day 3, 55.0% vs. 40.7% on day 5). Our results demonstrate the potential for AI-based selection of embryos based on characteristics beyond the observational abilities of human clinicians (area under the curve: 0.769, 95% confidence interval: 0.709–0.820). These findings could potentially provide a noninvasive, high-throughput, and low-cost screening tool to facilitate embryo selection and achieve better outcomes.
Conclusions:
Our study underscores the AI model’s ability to provide interpretable evidence for clinicians in assisted reproduction, highlighting its potential as a noninvasive, efficient, and cost-effective tool for improved embryo selection and enhanced IVF outcomes. The convergence of cutting-edge technology and reproductive medicine has opened new avenues for addressing infertility challenges and optimizing IVF success rates.
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减少语言障碍，促进信息吸收和交流凡一Difei Wang, Guannan Chen, Lin Li, Shaodi Wen, Zijing Xie, Xiao Luo, Li Zhan, Shuangbin Xu, Junrui Li, Rui Wang 等
中华医学杂志英文版2024年 137卷 16期
DOI: 10.1097/CM9.0000000000003242
摘要
Interpreting genes of interest is essential for identifying molecular mechanisms, but acquiring such information typically involves tedious manual retrieval. To streamline this process, the fanyi package offers tools to retrieve gene information from sources like National Center for Biotechnology Information (NCBI), significantly enhancing accessibility. Additionally, understanding the latest research advancements and sharing achievements are crucial for junior researchers. However, language barriers often restrict knowledge absorption and career development. To address these challenges, we developed the fanyi package, which leverages artificial intelligence (AI)-driven online translation services to accurately translate among multiple languages. This dual functionality allows researchers to quickly capture and comprehend information, promotes a multilingual environment, and fosters innovation in academic community. Meanwhile, the translation functions are versatile and applicable beyond biomedicine research to other domains as well. The fanyi package is freely available at https://github.com/YuLab-SMU/fanyi.
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全球及中国六大类消化系统癌症负担Yueyang Zhou, Kai Song, Yuqing Chen, Yuelun Zhang, Min Dai, Dong Wu, Hongda Chen
中华医学杂志英文版2024年 137卷 16期
DOI: 10.1097/CM9.0000000000003225
摘要
Background:
Digestive system cancers constitute a significant number of cancer cases, but their burden is not uniform. As Global Cancer Observatory (GLOBOCAN) 2022 has recently updated its estimates of cancer burden, we aimed to investigate the burden of six major digestive system cancers both worldwide and in China, along with geographical and temporal variations in cancer-specific incidence and mortality.
Methods:
We extracted data on primary cancers of the esophagus, stomach, colorectum, liver, pancreas, and gallbladder from the GLOBOCAN database for 2022. Age-standardized incidence and mortality rates were calculated and stratified by sex, country, region, and human development index (HDI). We used the 2022 revision of the World Population Prospects (United Nations) to obtain demographic data for various age groups in China from 1988 to 2012 and used the joinpoint model and the average annual percentage change (AAPC) to analyze cancer incidence trends in China.
Results:
In 2022, the estimated global incidence of digestive system cancers reached 4,905,882, with an estimated 3,324,774 cancer-related deaths. Colorectal cancer was most prevalent in terms of incidence and mortality. There was a significant correlation between the burden of gastrointestinal cancers and country HDI. From 1988 to 2012, the incidence of esophageal, gastric, and liver cancers declined in China, whereas colorectal and pancreatic cancer incidences continued to increase. By 2050, colorectal and liver cancers are projected to remain the leading cancer types in China in terms of incidence and mortality, respectively.
Conclusions:
Digestive system cancers remain a significant public health challenge globally and in China. Although progress has been made in the prevention and control of some cancers, the burden of digestive system cancers persists. The implementation of tertiary prevention strategies must be intensified to reduce the incidence and mortality of digestive system cancers, mitigating their impact on public health.
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急性肺栓塞患者冠状动脉狭窄与心肌损伤关系的病例对照研究Yinjian Yang, Chao Liu, Jieling Ma, Xijie Zhu, Jingsi Ma, Dan Lu, Xinxin Yan, Xuan Gao, Jia Wang, Liting Wang 等
中华医学杂志英文版2024年 137卷 16期
DOI: 10.1097/CM9.0000000000003206
摘要
Background:
The potential impact of pre-existing coronary artery stenosis (CAS) on acute pulmonary embolism (PE) episodes remains underexplored. This study aimed to investigate the association between pre-existing CAS and the elevation of high-sensitivity cardiac troponin I (hs-cTnI) levels in patients with PE.
Methods:
In this multicenter, prospective case-control study, 88 cases and 163 controls matched for age, sex, and study center were enrolled. Cases were patients with PE with elevated hs-cTnI. Controls were patients with PE with normal hs-cTnI. Coronary artery assessment utilized coronary computed tomographic angiography or invasive coronary angiography. CAS was defined as ≥50% stenosis of the lumen diameter in any coronary vessel >2.0 mm in diameter. Conditional logistic regression was used to evaluate the association between CAS and hs-cTnI elevation.
Results:
The percentage of CAS was higher in the case group compared to the control group (44.3% [39/88] vs. 30.1% [49/163]; P = 0.024). In multivariable conditional logistic regression model 1, CAS (adjusted odds ratio [OR], 2.680; 95% confidence interval [CI], 1.243–5.779), heart rate >75 beats/min (OR, 2.306; 95% CI, 1.056–5.036) and N-terminal pro-B type natriuretic peptide (NT-proBNP) >420 pg/mL (OR, 12.169; 95% CI, 4.792–30.900) were independently associated with elevated hs-cTnI. In model 2, right CAS (OR, 3.615; 95% CI, 1.467–8.909) and NT-proBNP >420 pg/mL (OR, 13.890; 95% CI, 5.288–36.484) were independently associated with elevated hs-cTnI.
Conclusions:
CAS was independently associated with myocardial injury in patients with PE. Vigilance towards CAS is warranted in patients with PE with elevated cardiac troponin levels.
Clinical Observation
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基于E2F7/TSC1的模型预测超过米兰标准的肝细胞癌肝移植术后西罗莫司的疗效Lincheng Zhang, Wei Zhou, Shusen Zheng, Sunbin Ling, Xiao Xu
中华医学杂志英文版2024年 137卷 16期
DOI: 10.1097/CM9.0000000000003102
摘要
作为肝细胞癌（HCC）的根治性治疗，肝移植（LT）已成为某些HCC患者的理想治疗选择。对于超过米兰标准的患者，高HCC复发风险是影响预后的重要因素。西罗莫司是雷帕霉素（mTOR）抑制剂的第一代哺乳动物靶点，与基于钙调神经磷酸酶抑制剂（CNI）的无mTOR抑制剂免疫抑制相比，可降低复发率并延长总生存期（OS）。[
Rapid Report
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通过鞘内注射GC101使用单剂量AAV9介导的基因疗法治疗SMA 1型婴儿：一项开放标签、单臂研究Xiuwei Ma, Lu Zhuang, Wenhao Ma, Jun Li, Xiaodong Wang, Zhongqiu Li, Xinyang Jiang, Yongxia Wang, Ying Du, Yingqian Zhang 等
中华医学杂志英文版2024年 137卷 16期
DOI: 10.1097/CM9.0000000000003210
摘要
脊髓性肌萎缩症（SMA），一种由存活运动神经元1突变引起的神经退行性疾病（SMN1)导致存活运动神经元(SMN)蛋白表达降低，以常染色体隐性方式遗传。SMA 1型是SMA最常见的亚型，其特征是在出生6个月前发病，不能实现独立坐位，以及快速进行性呼吸和延髓恶化，导致2岁前死亡率>90%。[
Correspondence
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围手术期静脉血栓栓塞对子宫内膜透明细胞癌患者生存率的影响：一项10年单机构回顾性研究Xuesong Ding, Yuan Li, Dongyan Cao, Xirun Wan, Ming Wu, Lingya Pan, Junjun Yang, Yang Xiang
中华医学杂志英文版2024年 137卷 16期
DOI: 10.1097/CM9.0000000000002951
摘要
致编辑：子宫内膜癌(EC)是女性中诊断的第六种最常见的癌症，据报道其患病率在世界范围内正在增加。子宫内膜透明细胞癌（ECCC）占所有EC的2-5%，是一种罕见但不祥的高危EC亚型，预后较差，表现出更大的化疗耐药性。由于ECCC的罕见性，很少有临床试验专门纳入患有该疾病的患者，与其他更常见的EC亚型相比，关于其发病机制和临床进展的数据有限。
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右美托咪定对老年下肢骨科手术患者恢复期出现谵妄和脑电图的影响：一项随机、双盲、安慰剂对照临床试验Jun Li, Chenxuan Ye, Panpan Fang, Jing Qian, Zixiang Shang, Xuesheng Liu
中华医学杂志英文版2024年 137卷 16期
DOI: 10.1097/CM9.0000000000003191
摘要
致编辑：谵妄是老年患者常见的术后并发症，与多种不良临床结局相关。[
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揭示乳腺癌内分泌抵抗的复杂景观：长非编码RNA的新作用AGPG和超越Muhammad Babar Khawar, Shiyi Yu, Ali Afzal, Haibo Sun
中华医学杂志英文版2024年 137卷 16期
DOI: 10.1097/CM9.0000000000003228
摘要
致编辑：乳腺癌（BC）是女性中最常见的癌症，每年影响226万人，68万人死亡。约70%的病例涉及雌激素激活的雌激素受体（ER），其通过基因调控和细胞信号传导促进肿瘤生长。没有配体的ER再激活有助于治疗耐药性。雌激素受体阳性（ER+）乳腺肿瘤中的内分泌抵抗可由ER突变、与辅激活因子/辅阻遏因子相互作用改变或与生长因子受体和致癌途径的串扰引起。[
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核心减压后全髋关节置换术：事件发生时间分析和危险因素Chengsi Li, Tianyu Wang, Dongwei Wu, Haichuan Guo, Zhenbang Yang, Xinqun Cheng, Yanbin Zhu, Yingze Zhang
中华医学杂志英文版2024年 137卷 16期
DOI: 10.1097/CM9.0000000000003227
摘要
致编辑核心减压（CD）是治疗股骨头塌陷前骨坏死（ONFH）的主要保髋手术，以其改善的短期结果和相对较低的术后并发症发生率而闻名；然而，文献中报道的中长期生存率各不相同，并且是一个有争议的主题。因此，我们进行了一项大型前瞻性队列研究，以评估从CD转换为全髋关节置换术（THA）的频率和时间及其相关因素。
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abrocitinib在中国中重度特应性皮炎患者中的疗效和安全性事后JADE方案3期试验分析Hang Li, Hao Cheng, Qianjin Lu, Wei Lai, Xiaohua Tao, Gerardo A. Encinas, Shefali Vyas, Bo Wang, Xin Luo, Shiqi Li
中华医学杂志英文版2024年 137卷 16期
DOI: 10.1097/CM9.0000000000003159
摘要
致编辑：特应性皮炎（AD）是一种慢性炎症性皮肤病，病程复发缓解，需要灵活给药。[
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基于围手术期危险因素预测小儿肝移植术后早期血栓并发症的诺模图的开发和验证Qiang You, Enze Qu, Kaining Zeng, Jianrong Liu, Qing Yang, Hui Tang, Xiao Feng, Jia Yao, Xinru Huang, Tong Zhang 等
中华医学杂志英文版2024年 137卷 16期
DOI: 10.1097/CM9.0000000000003137
摘要
致编辑：尽管小儿肝移植（LT）的预后有了显著改善，但术后并发症仍然是移植物和患者死亡的主要原因。由于病因的差异、发育不全导致的肝血管狭窄、更细致的手术技术和其他因素，儿童接受者比成人接受者具有更高的血栓并发症风险。[
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生物治疗对银屑病患者肠道菌群的影响Zhuyuan Wen, Xiaoling Lu, Hao Nie, Jing Xu, Yang Zou, Kun Huang, Aijun Chen, Yichi Zhang, Min Cao, Qi Yin 等
中华医学杂志英文版2024年 137卷 16期
DOI: 10.1097/CM9.0000000000003223
摘要
致编辑：银屑病是一种常见的慢性炎症性皮肤病，在世界范围内发生，在任何年龄都有表现。[
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XEN45植入、小梁切除术的手术结果vs开角型青光眼穿透性小管成形术：一项非随机比较研究Haishuang Lin, Wenzhe Zhou, Jinxin Li, Wenqing Ye, Xuanli Zheng, Changrong Lei, Jiaqian Li, Rui Wan, Ningli Wang, Yuanbo Liang
中华医学杂志英文版2024年 137卷 16期
DOI: 10.1097/CM9.0000000000003128
摘要
致编辑：青光眼是全世界不可逆失明的主要原因。[
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失眠与饮食质量及饮食行为的关系Guliyeerke Jigeer, Zhe Huang, Jiaojiao Zou, Siwei Zhu, Yaqi Li, Shuohua Chen, Qishan Yang, Liang Sun, Shouling Wu, Xiang Gao
中华医学杂志英文版2024年 137卷 16期
DOI: 10.1097/CM9.0000000000003115
摘要
致编辑：失眠影响着全球30%-50%的成年人，导致生活质量下降，并增加了发展身体和精神需求障碍的风险。[
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甲状腺功能与自身免疫指标的关系体外甲状腺功能正常的PCOS妇女的受精/卵胞浆内单精子注射结局Huahua Jiang, Lixue Chen, Ning Huang, Huifeng Shi, Hongbin Chi, Rui Yang, Xiaoyu Long, Jie Qiao
中华医学杂志英文版2024年 137卷 16期
DOI: 10.1097/CM9.0000000000003035
摘要
致编辑：多囊卵巢综合征（PCOS）的特征是少无排卵、高雄激素血症和多囊卵巢，是最常见的内分泌疾病，影响5-15%的育龄妇女。[
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