MedNexus
2024年 · 第137卷第20期
出版日期 2024-10-20电子版 ￥0.00元
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Review Article
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帕金森病的小脑受累：病理生理学和神经影像学Tao Qiu, Meichen Liu, Xinhui Qiu, Tianbai Li, Weidong Le
中华医学杂志英文版2024年 137卷 20期
DOI: 10.1097/CM9.0000000000003248
摘要
Parkinson’s disease (PD) is a neurodegenerative disease characterized by various motor and non-motor symptoms. The complexity of its symptoms suggests that PD is a heterogeneous neurological disorder. Its pathological changes are not limited to the substantia nigra-striatal system, but gradually extending to other regions including the cerebellum. The cerebellum is connected to a wide range of central nervous system regions that form essential neural circuits affected by PD. In addition, altered dopaminergic activity and α-synuclein pathology are found in the cerebellum, further suggesting its role in the PD progression. Furthermore, an increasing evidence obtained from imaging studies has demonstrated that cerebellar structure, functional connectivity, and neural metabolism are altered in PD when compared to healthy controls, as well as among different PD subtypes. This review provides a comprehensive summary of the cerebellar pathophysiology and results from neuroimaging studies related to both motor and non-motor symptoms of PD, highlighting the potential significance of cerebellar assessment in PD diagnosis, differential diagnosis, and disease monitoring.
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结核病在不孕症和体外受精-胚胎移植Xiaoyan Gai, Hongbin Chi, Rong Li, Yongchang Sun
中华医学杂志英文版2024年 137卷 20期
DOI: 10.1097/CM9.0000000000003255
摘要
Tuberculosis (TB) is a prominent infectious disease globally that imposes a substantial health burden. Genital TB (GTB), an extrapulmonary manifestation, leads to complications such as tubal adhesions, blockage, and diminished ovarian function, culminating in infertility, and is recognized as a prevalent cause of infertility in nations with high-burden TB. In regions with low TB rates, infertility and active TB during pregnancy have been reported to be most common among female immigrants from countries with high-burden TB. In the context of TB, pregnant women often exhibit exacerbated symptoms after in vitro fertilization-embryo transfer (IVF-ET), heightening the risk of dissemination. Miliary pulmonary TB and tuberculous meningitis pose a serious threat to maternal and fetal health. This article integrates recent epidemiological data and clinical research findings, delineating the impact of TB on infertility and assisted reproduction and particularly focusing on the diagnosis and treatment of GTB, underscored by the imperative of TB screening before IVF-ET. Our objective is to increase awareness among respiratory and reproductive health professionals, promoting multidisciplinary management to enhance clinical vigilance. This approach seeks to provide patients with judicious reproductive plans and scientifically rigorous pregnancy management, thereby mitigating adverse pregnancy outcomes related to TB activity.
Ideas and Opinion
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通过增加酒精消费税遏制酒精相关肝病Feiyu Zhang, Peng Xiao, Yali Liu, Tao Liu, Yanhang Gao
中华医学杂志英文版2024年 137卷 20期
DOI: 10.1097/CM9.0000000000003201
摘要
酒精相关性肝病（ALD）是由长期大量饮酒引起的。在美国和一些欧洲国家，该疾病仍然是肝病发病率负担的重要因素。在过去二十年中，在亚洲也观察到ALD发病率增加的趋势。[
Original Article
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单细胞RNA测序揭示了CA19-9的产生过程以及CA19-9（+）和CA19-9（-）PDAC之间免疫微环境的动态Deyu Zhang, Fang Cui, Kailian Zheng, Wanshun Li, Yue Liu, Chang Wu, Lisi Peng, Zhenghui Yang, Qianqian Chen, Chuanchao Xia 等
中华医学杂志英文版2024年 137卷 20期
DOI: 10.1097/CM9.0000000000003130
摘要
Background:
Pancreatic ductal adenocarcinoma (PDAC) is one of the main types of malignant tumor of the digestive system, and patient prognosis is affected by difficulties in early diagnosis, poor treatment response, and a high postoperative recurrence rate. Carbohydrate antigen 19-9 (CA19-9) has been widely used as a biomarker for the diagnosis and postoperative follow-up of PDAC patients. Nevertheless, the production mechanism and potential role of CA19-9 in PDAC progression have not yet been elucidated.
Methods:
We performed single-cell RNA sequencing on six samples pathologically diagnosed as PDAC (three CA19-9-positive and three CA19-9-negative PDAC samples) and two paracarcinoma samples. We also downloaded and integrated PDAC samples (each from three CA19-9-positive and CA19-9-negative patients) from an online database. The dynamics of the proportion and potential function of each cell type were verified through immunofluorescence. Moreover, we built an in vitro coculture cellular model to confirm the potential function of CA19-9.
Results:
Three subtypes of cancer cells with a high ability to produce CA19-9 were identified by the markers TOP2A, AQP5, and MUC5AC. CA19-9 production bypass was discovered on antigen-presenting cancer-associated fibroblasts (apCAFs). Importantly, the proportion of immature ficolin-1 positive (FCN1+) macrophages was high in the CA19-9-negative group, and the proportion of mature M2-like macrophages was high in the CA19-9-positive group. High proportions of these two macrophage subtypes were associated with an unfavourable clinical prognosis. Further experiments indicated that CA19-9 could facilitate the transformation of M0 macrophages into M2 macrophages in the tumor microenvironment.
Conclusions:
Our study described CA19-9 production at single-cell resolution and the dynamics of the immune atlas in CA19-9-positive and CA19-9-negative PDAC. CA19-9 could promote M2 polarization of macrophage in the pancreatic tumor microenvironment.
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2022年中国女性乳腺癌发病率、死亡率和残疾调整生命年Kexin Sun, Bailin Zhang, Shaoyuan Lei, Rongshou Zheng, Xin Liang, Li Li, Xiaolong Feng, Siwei Zhang, Hongmei Zeng, Yifei Yao 等
中华医学杂志英文版2024年 137卷 20期
DOI: 10.1097/CM9.0000000000003278
摘要
Background:
Breast cancer is ranked among the most prevalent malignancies in the Chinese female population. However, comprehensive reports detailing the latest epidemiological data and attributable disease burden have not been extensively documented.
Methods:
In 2018, high-quality cancer surveillance data were recorded in 700 population-based cancer registries in China. We extracted data on female breast cancers (International Classification of Diseases, Tenth Revision [ICD-10]: C50) and estimated the incidence and mortality in 2022 according to the baseline data and corresponding trends from 2010 to 2018. Pathological types were classified according to the ICD for Oncology, 3rd Edition codes. Disability-adjusted life years (DALYs) were calculated as the sum of the years of life lost (YLLs) and years lived with disability (YLDs).
Results:
In 2022, approximately 357,200 new female breast cancer cases and 75,000 deaths occurred in China, accounting for 15.59% and 7.94% of total new cancer cases and deaths, respectively. The age-standardized incidence rate (ASIR) was 33.04 per 100,000. When analyzed by pathological type, the ASIRs for papillary neoplasms, invasive breast carcinoma, rare and salivary gland-type tumors, and other types were 1.13, 29.79, 0.24, and 1.88 per 100,000, respectively. The age-standardized mortality rate (ASMR) was 6.10 per 100,000. A total of 2,628,000 DALYs were found to be attributable to female breast cancer in China, comprising 2,278,300 YLLs and 349,700 YLDs. The ASIR, ASMR, and age-standardized rate (ASR) for DALYs in urban areas were consistently higher than those in rural areas. We observed a four-fold increase in the ASIR and ASR for DALYs and an eight-fold increase in the ASMR among females over 55 years compared with those aged under 55 years.
Conclusion:
These data provide invaluable insights into the latest epidemiology of female breast cancer in China and highlight the urgency for disease prevention and control strategy formulation.
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目标定位NUF2通过G2/M期阻滞和凋亡诱导抑制胃癌进展Bo Long, Huinian Zhou, Lixia Xiao, Xiangyan Jiang, Jian Li, Zhijian Ma, Na He, Wei Xin, Boya Zhang, Xiaoqin Zhu 等
中华医学杂志英文版2024年 137卷 20期
DOI: 10.1097/CM9.0000000000003006
摘要
Background:
Gastric cancer (GC), a malignant tumor with poor prognosis, is one of the leading causes of cancer-related deaths worldwide; consequently, identifying novel therapeutic targets is crucial for its corresponding treatment. NUF2, a component of the NDC80 kinetochore complex, promotes cancer progression in multiple malignancies. Therefore, this study aimed to explore the potential of NUF2 as a therapeutic target to inhibit GC progression.
Methods:
Clinical samples were obtained from patients who underwent radical resection of GC at Lanzhou University Second Hospital from 2016 to 2021. Cell count assays, colony formation assays, and cell-derived xenotransplantation (CDX) models were used to determine the effects of NUF2 on GC progression. Flow cytometry was used to detect the effect of NUF2 or quercetin on cell cycle progression and apoptosis. A live-cell time-lapse imaging assay was performed to determine the effect of NUF2 on the regulation of mitotic progression. Transcriptomics was used to investigate the NUF2-associated molecular mechanisms. Virtual docking and microscale thermophoresis were used to identify NUF2 inhibitors. Finally, CDX, organoid, and patient-derived xenograft (PDX) models were used to examine the efficacy of the NUF2 inhibitor in GC.
Results:
NUF2 expression was significantly increased in GC and was negatively correlated with prognosis. The deletion of NUF2 suppressed GC progression both in vivo and in vitro. NUF2 significantly regulated the mitogen-activated protein kinase (MAPK) pathway, promoted G2/M phase transition, and inhibited apoptosis in GC cells. Additionally, quercetin was identified as a selective NUF2 inhibitor with low toxicity that significantly suppressed tumor growth in GC cells, organoids, CDX, and PDX models.
Conclusions:
Collectively, NUF2-mediated G2/M phase transition and apoptosis inhibition promoted GC progression; additionally, NUF2 inhibitors exhibited potent anti-GC activity. This study provides a new strategy for targeting NUF2 to suppress GC progression in clinical settings.
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2016-2021年1750名极低出生体重婴儿的死亡率、发病率和护理实践Yang He, Meng Zhang, Jun Tang, Wanxiu Liu, Yong Hu, Jing Shi, Hua Wang, Tao Xiong, Li Zhang, Junjie Ying 等
中华医学杂志英文版2024年 137卷 20期
DOI: 10.1097/CM9.0000000000002923
摘要
Background:
Very low birth weight (VLBW) infants are the key populations in neonatology, wherein morbidity and mortality remain major challenges. The study aimed to analyze the clinical characteristics of VLBW infants.
Methods:
A retrospective cohort study was conducted in West China Second Hospital between January 2016 and December 2021. Neonates with a birth weight of <1500 g were included. Mortality, care practices, and major morbidities were analyzed, and compared with those of previous 7 years (2009-2015).
Results:
Of the total 1750 VLBW, 1386 were infants born with birth weight between 1000-1499 g and 364 infants were born with weight below 1000 g; 42.9% (751/1750) required delivery room resuscitation; 53.9% (943/1750) received non-invasive ventilation only; 38.2% (669/1750) received invasive ventilation; 1517 VLBW infants received complete treatment. Among them, 60.1% (912/1517) of neonates had neonatal respiratory distress syndrome (NRDS), 28.7% (436/1517) had bronchopulmonary dysplasia (BPD), 22.0% (334/1517) had apnea, 11.1% (169/1517) had culture-confirmed sepsis, 8.4% (128/1517) had pulmonary hemorrhage, 7.6% (116/1517) had severe intraventricular hemorrhage (IVH)/periventricular leukomalacia (PVL), 5.7% (87/1517) had necrotizing enterocolitis (NEC), and 2.0% (31/1517) had severe retinopathy of prematurity. The total and in-hospital mortality rates were 9.7% (169/1750) and 3.0% (45/1517), respectively. The top three diagnoses of death among those who had received complete treatment were sepsis, NRDS, and NEC. In 2009-2015, 1146 VLBW were enrolled and 895 infants received complete treatment. The proportions of apnea, IVH, and IVH stage ≥3/PVL, were higher in 2009-2015 compared with those in 2016-2021, while the proportions of NRDS and BPD were characterized by significant increases in 2016-2021. The total and in-hospital mortality rates were 16.7% (191/1146) and 5.6% (50/895) respectively in 2009-2015.
Conclusion:
Among VLBW infants born in 2016-2021, the total and in-hospital mortality rates were lower than those of neonates born in 2009-2015. Incidences of NRDS and BPD increased in 2016-2021, which affected the survival rates and long-term prognosis of VLBW.
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新型冠状动脉内低温装置减轻猪心肌再灌注损伤Zhiqiang Pei, Jin Qiu, Yongchao Zhao, Shuai Song, Rui Wang, Wei Luo, Xingxing Cai, Bin Liu, Han Chen, Jiasheng Yin 等
中华医学杂志英文版2024年 137卷 20期
DOI: 10.1097/CM9.0000000000003033
摘要
Background:
Hypothermia therapy has been suggested to attenuate myocardial necrosis; however, the clinical implementation as a valid therapeutic strategy has failed, and new approaches are needed to translate into clinical applications. This study aimed to assess the feasibility, safety, and efficacy of a novel selective intracoronary hypothermia (SICH) device in mitigating myocardial reperfusion injury.
Methods:
This study comprised two phases. The first phase of the SICH was performed in a normal porcine model for 30 minutes (n = 5) to evaluate its feasibility. The second phase was conducted in a porcine myocardial infarction (MI) model of myocardial ischemia/reperfusion which was performed by balloon occlusion of the left anterior descending coronary artery for 60 minutes and maintained for 42 days. Pigs in the hypothermia group (n = 8) received hypothermia intervention onset reperfusion for 30 minutes and controls (n = 8) received no intervention. All animals were followed for 42 days. Cardiac magnetic resonance analysis (five and 42 days post-MI) and a series of biomarkers/histological studies were performed.
Results:
The average time to lower temperatures to a steady state was 4.8 ± 0.8 s. SICH had no impact on blood pressure or heart rate and was safely performed without complications by using a 3.9 F catheter. Interleukin-6 (IL-6), tumor necrosis factor-α, C-reactive protein (CRP), and brain natriuretic peptide (BNP) were lower at 60 min post perfusion in pigs that underwent SICH as compared with the control group. On day 5 post MI/R, edema, intramyocardial hemorrhage, and microvascular obstruction were reduced in the hypothermia group. On day 42 post MI/R, the infarct size, IL-6, CRP, BNP, and matrix metalloproteinase-9 were reduced, and the ejection fraction was improved in pigs that underwent SICH.
Conclusions:
The SICH device safely and effectively reduced the infarct size and improved heart function in a pig model of MI/R. These beneficial effects indicate the clinical potential of SICH for treatment of myocardial reperfusion injury.
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艾诺韦林在人类免疫缺陷病毒感染个体中的群体药代动力学及暴露—反应分析Xiaoxu Han, Jin Sun, Yihang Zhang, Taiyi Jiang, Qingshan Zheng, Haiyan Peng, Yao Wang, Wei Xia, Tong Zhang, Lijun Sun 等
中华医学杂志英文版2024年 137卷 20期
DOI: 10.1097/CM9.0000000000002917
摘要
Background:
Ainuovirine (ANV) is a new generation of non-nucleoside reverse transcriptase inhibitor for the treatment of human immunodeficiency virus (HIV) type 1 infection. This study aimed to evaluate the population pharmacokinetic (PopPK) profile and exposure-response relationship of ANV among people living with HIV.
Methods:
Plasma concentration-time data from phase 1 and phase 3 clinical trials of ANV were pooled for developing the PopPK model. Exposure estimates obtained from the final model were used in exposure-response analysis for virologic responses and safety responses.
Results:
ANV exhibited a nonlinear pharmacokinetic profile, which was best described by a two-compartment model with first-order elimination. There were no significant covariates correlated to the pharmacokinetic parameters of ANV. The PopPK parameter estimate (relative standard error [%]) for clearance adjusted for bioavailability (CL/F) was 6.46 (15.00) L/h, and the clearance of ANV increased after multiple doses. The exposure-response model revealed no significant correlation between the virologic response (HIV-RNA <50 copies/mL) at 48 weeks and the exposure, but the incidence of adverse events increased with the increasing exposure (P value of steady-state trough concentration and area under the steady-state curve were 0.0177 and 0.0141, respectively).
Conclusions:
Our PopPK model supported ANV 150 mg once daily as the recommended dose for people living with HIV, requiring no dose adjustment for the studied factors. Optimization of ANV dose may be warranted in clinical practice due to an increasing trend in adverse reactions with increasing exposure.
Trial registration:
Chinese Clinical Trial Registry https://www.chictr.org.cn (Nos. ChiCTR1800018022 and ChiCTR1800019041).
Rapid Report
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不同剂量枸橼酸地氯雷他定二钠治疗中国汉族慢性自发性荨麻疹的疗效及安全性Ke Xue, Mengmeng Li, Lei Wang, Yi Sun, Tongxiang Zeng, Bing Liu, Yong Cui
中华医学杂志英文版2024年 137卷 20期
DOI: 10.1097/CM9.0000000000003170
摘要
慢性自发性荨麻疹(CSU)被定义为由于已知或未知原因而自发出现风团、血管性水肿或两者超过六周。与在欧洲（0.5%）和北美（0.1%）进行的研究相比，亚洲研究中CSU的患病率（1.4%）更高。指南建议标准剂量的第二代H1抗组胺药（sgAHs）作为CSU的一线治疗。[
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我国首例同种异体喉移植术：围手术期情况及半年随访Mailudan Ainiwaer, Zheng Jiang, Haiyang Wang, Zhongwei Zhang, Jiayin Yang, Yu Zhao, Peng Zhou, Weigang Gan, Min He, Zhengying Xu 等
中华医学杂志英文版2024年 137卷 20期
DOI: 10.1097/CM9.0000000000003266
摘要
喉功能的丧失深刻地影响了喉结构扭曲或全喉切除术的特定患者的生活质量，尤其是在社会背景下。因此，同种异体移植已成为恢复喉功能的潜在解决方案。该领域的一个重要里程碑是Strome成功进行的全喉移植等人[
Correspondence
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接受替格瑞洛与氯吡格雷治疗的急性冠状动脉综合征贫血患者的住院结局：中国心血管护理改善（CCC）-急性冠状动脉综合征项目的结果Zhiqiang Zhang, Yasong Wang, Jun Wang, Xiaofan Cao, Miaohan Qiu, Xiaoxiang Tian, Yaling Han, Xiaozeng Wang
中华医学杂志英文版2024年 137卷 20期
DOI: 10.1097/CM9.0000000000003279
摘要
致编辑：双重抗血小板治疗(DAPT)，包括阿司匹林加P2Y12受体抑制剂是减少患有冠状动脉疾病的个体的心脏和全身缺血事件的标准方法。[
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老年人吞咽相关咳嗽与健康状况：一项全国性横断面研究的结果Huai-Yu Wang, Minghua Bai, Jinwei Wang, Zhuqing Li, Ji Wang, Qi Wang
中华医学杂志英文版2024年 137卷 20期
DOI: 10.1097/CM9.0000000000003281
摘要
致编辑：吞咽相关咳嗽是口咽吞咽困难的常见表现，并证实了误吸和窒息的风险。[
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有创神经电刺激用于脑卒中后运动康复Xianze Li, Tao Xue, Zixiao Li, Jianguo Zhang
中华医学杂志英文版2024年 137卷 20期
DOI: 10.1097/CM9.0000000000003286
摘要
致编辑：中风是世界范围内死亡和残疾的首要原因。[
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癌细胞来源的外来体miRNA诱导和重编程雪旺细胞增加涎腺腺样囊性癌的神经周侵袭Jinjin Li, Chenzhou Wu, Nengwen Huang, Xianghe Qiao, Zhijie Weng, Yunkun Liu, Yongzhi Wu, Wei Li, Longjiang Li, Bo Li
中华医学杂志英文版2024年 137卷 20期
DOI: 10.1097/CM9.0000000000003262
摘要
致编辑：涎腺腺样囊性癌（SACC）的特征是肿瘤进展过程中高频率的神经周围侵犯（PNI）行为。然而，SACC细胞和周围非恶性细胞之间的细胞间通讯对PNI的影响仍不清楚。雪旺细胞作为周围神经系统的主要组成细胞，已有报道与PNI过程密切相关。癌细胞来源的外来体通常作为癌细胞和局部微环境之间的重要信号介质。因此，本研究旨在阐明癌症PNI期间癌细胞和雪旺细胞之间通过外来体的相互作用，并确定PNI的潜在治疗靶点。
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STING在肺腺癌中的预后意义及机制Haohua Zhu, Yufeng Cao, Jingyu Lu, Lei Guo, Rongrong Luo, Huiyang Shi, Yu Feng, Yutao Liu, Puyuan Xing, Hongyu Wang 等
中华医学杂志英文版2024年 137卷 20期
DOI: 10.1097/CM9.0000000000003187
摘要
致编辑：基因组不稳定性是癌症的标志，遗传变化和DNA损伤增加。肿瘤基因组中累积的突变可以产生新抗原，从而触发抗肿瘤免疫反应。此外，作为基因组不稳定性的结果，核DNA的泄漏可以直接提醒免疫系统恶性细胞的存在。环磷酸鸟苷-磷酸腺苷合酶（cGAS）是触发先天免疫应答的主要DNA传感器。[
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微动脉瘤必须与类似大小的点状出血区分吗？Yueqing He, Xi Huang, Sheng Gao, Meixia Zhang, Junjun Zhang
中华医学杂志英文版2024年 137卷 20期
DOI: 10.1097/CM9.0000000000003166
摘要
致编辑：中国现在拥有世界上最多的糖尿病（DM）患者，使糖尿病视网膜病变（DR）成为中国劳动年龄人口中致盲的主要原因。[
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外周血活细胞治疗雄激素性脱发的机制及临床疗效Zigang Zhao, Xin Zhang, Xiaoyan Qu, Yaguang Zhou, Shui Yu, Qinyi Wang, Qian Zhang
中华医学杂志英文版2024年 137卷 20期
DOI: 10.1097/CM9.0000000000003212
摘要
致编辑：雄激素性脱发（AGA）是一种常见的慢性脱发疾病，通常始于青春期，伴有毛囊小型化。[
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一种简化工具对中国患者以便秘为主的肠易激综合征的诊断准确性：一项多中心、前瞻性、观察性研究Mei Luo, Jinsong Liu, Zhe Zhang, Jin Tao, Youxiang Chen, Xiuling Li, Xiaoping Zou, Jing Sun, Jie Jin, Huahong Wang 等
中华医学杂志英文版2024年 137卷 20期
DOI: 10.1097/CM9.0000000000003246
摘要
致编辑：肠易激综合征（IBS）是最常见的成人功能性胃肠疾病（FGIDs）之一，估计全球患病率为1.5-11.2%。焦虑和抑郁症状和障碍的患病率强调了对IBS患者的心理影响，强调了对针对特定人群的综合诊断工具的需求。[
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一种减轻腹腔镜结直肠手术术后并发症的简便麻醉策略Huixian Li, Yuan Li, Yulin Sun, Dazhuang Ge, Zhaoxu Zheng, Wei Tang, Hui Zheng, Tao Yan
中华医学杂志英文版2024年 137卷 20期
DOI: 10.1097/CM9.0000000000003163
摘要
致编辑：腹部外科手术与术后肺部并发症（PPC）的高发生率有关，可通过麻醉期间给予肺保护性机械通气来缓解。[
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应用创伤定制桥系统重建临界大小的股骨和胫骨缺损：有限元分析、骨整合和临床结果Bingchuan Liu, Xingcai Li, Zhengguang Wang, Zhuo Chen, Fang Zhou, Zhongwei Yang, Guojin Hou, Min Liu, Kai Song, Caimei Wang 等
中华医学杂志英文版2024年 137卷 20期
DOI: 10.1097/CM9.0000000000003235
摘要
致编辑：骨是不断经历动态生物重塑的复杂组织。然而，当骨缺损超过自修复阈值时，它们被视为临界大小的骨缺损（CBDs），[
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