MedNexus
2024年 · 第137卷第23期
出版日期 2024-12-05电子版 ￥0.00元
MedNexus
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Editorial
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中国分离式肝移植：过去、现在和未来Xiao Feng, Shuhong Yi, Yang Yang
中华医学杂志英文版2024年 137卷 23期
DOI: 10.1097/CM9.0000000000003361
摘要
分割肝移植（SLT）是一种将完整的供体肝分割成两个解剖和功能独立的移植物，移植给两个受体的手术。SLT可有效扩大供肝来源，经过多年的探索和完善，已成为解决供肝短缺的优势手术方案。
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我们为下一次大流行做好准备了吗：监测人类和动物H5N1禽流感感染的增加Qing Wang, Yanxia Sun, Zhongjie Li, Weizhong Yang, Luzhao Feng
中华医学杂志英文版2024年 137卷 23期
DOI: 10.1097/CM9.0000000000003375
摘要
由某些甲型禽流感病毒株（如H5N1和H7N9）引起的人感染高致病性禽流感（HPAI），导致严重的急性呼吸道疾病，死亡率很高，其中前者对鸟类具有致病性。[
Review Article
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内皮反应对脓毒症相关器官功能障碍的影响Miao Wu, Yan Yan, Xinyu Xie, Jiawei Bai, Chengtai Ma, Xianjin Du
中华医学杂志英文版2024年 137卷 23期
DOI: 10.1097/CM9.0000000000003342
摘要
Sepsis-related organ dysfunction is associated with increased morbidity and mortality. Previous studies have found that the endothelium plays crucial roles in maintaining the vascular permeability during sepsis, as well as in regulating inflammation and thrombosis. During sepsis, endothelial cells may release cytokines, chemokines, and pro-coagulant factors, as well as express adhesion molecules. In general, endothelial responses during sepsis typically inhibit bacterial transmission and coordinate leukocyte recruitment to promote bacterial clearance. However, excessive or prolonged endothelial activation can lead to impaired microcirculation, tissue hypoperfusion, and organ dysfunction. Given the structural and functional heterogeneity of endothelial cells in different organs, there are potential differences in endothelial responses by organ type, and the risk of organ damage may vary accordingly. This article reviews the endothelial response observed in sepsis and its effects on organ function, summarizes current progress in the development of therapeutic interventions targeting the endothelial response, and discusses future research directions to serve as a reference for researchers in the field.
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血管性认知障碍：临床研究与治疗进展Tongyao You, Yingzhe Wang, Shufen Chen, Qiang Dong, Jintai Yu, Mei Cui
中华医学杂志英文版2024年 137卷 23期
DOI: 10.1097/CM9.0000000000003220
摘要
Vascular cognitive impairment (VCI) encompasses a wide spectrum of cognitive disorders, ranging from mild cognitive impairment to vascular dementia. Its diagnosis relies on thorough clinical evaluations and neuroimaging. VCI predominately arises from vascular risk factors (VRFs) and cerebrovascular disease, either independently or in conjunction with neurodegeneration. Growing evidence underscores the prevalence of VRFs, highlighting their potential for early prediction of cognitive impairment and dementia in later life. The precise mechanisms linking vascular pathologies to cognitive deficits remain elusive. Chronic cerebrovascular pathology is the most common neuropathological feature of VCI, often interacting synergistically with neurodegenerative processes. Current research efforts are focused on developing and validating reliable biomarkers to unravel the etiology of vascular brain changes in VCI. The collaborative integration of these biomarkers into clinical practice, alongside routine incorporation into neuropathological assessments, presents a promising strategy for predicting and stratifying VCI. The cornerstone of VCI prevention remains the control of VRFs, which includes multi-domain lifestyle modifications. Identifying appropriate pharmacological approaches is also of paramount importance. In this review, we synthesize recent advancements in the field of VCI, including its definition, determinants of vascular risk, pathophysiology, neuroimaging and fluid-correlated biomarkers, predictive methodologies, and current intervention strategies. Increasingly evident is the notion that more rigorous research for VCI, which arises from a complex interplay of physiological events, is still needed to pave the way for better clinical outcomes and enhanced quality of life for affected individuals.
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终末期肝病的细胞治疗：现状与临床挑战Lin Zhang, Yuntian Deng, Xue Bai, Xiao Wei, Yushuang Ren, Shuang Chen, Hongxin Deng
中华医学杂志英文版2024年 137卷 23期
DOI: 10.1097/CM9.0000000000003332
摘要
Liver disease involves a complex interplay of pathological processes, including inflammation, hepatocyte necrosis, and fibrosis. End-stage liver disease (ESLD), such as liver failure and decompensated cirrhosis, has a high mortality rate, and liver transplantation is the only effective treatment. However, to overcome problems such as the shortage of donor livers and complications related to immunosuppression, there is an urgent need for new treatment strategies that need to be developed for patients with ESLD. For instance, hepatocytes derived from donor livers or stem cells can be engrafted and multiplied in the liver, substituting the host hepatocytes and rebuilding the liver parenchyma. Stem cell therapy, especially mesenchymal stem cell therapy, has been widely proved to restore liver function and alleviate liver injury in patients with severe liver disease, which has contributed to the clinical application of cell therapy. In this review, we discussed the types of cells used to treat ESLD and their therapeutic mechanisms. We also summarized the progress of clinical trials around the world and provided a perspective on cell therapy.
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慢性乙型肝炎抗病毒治疗的现状与进展Juan Li, Siyi Liu, Qijuan Zang, Ruijie Yang, Yingren Zhao, Yingli He
中华医学杂志英文版2024年 137卷 23期
DOI: 10.1097/CM9.0000000000003178
摘要
Chronic hepatitis B virus (HBV) infection is a global public health concern. Existing antiviral drugs, including nucleos(t)ide analogs and interferon-α, can suppress HBV replication and improve the prognosis. However, the persistence of covalently closed circular DNA (cccDNA), the integration of HBV-DNA into the host genome, and compromised immune responses impede the successful treatment of hepatitis B. While achieving a functional cure of HBV remains elusive with the current treatment methods, this is the goal of new therapeutic approaches. Therefore, developing novel antiviral drugs is necessary for achieving a functional or complete cure for chronic hepatitis B. In recent years, substantial progress has been made in drug discovery and development for HBV infection. Direct-acting antiviral agents such as entry inhibitors, capsid assembly modulators, subviral particle release inhibitors, cccDNA silencers, and RNA interference molecules have entered clinical trials. In addition, several immunomodulatory agents, including toll-like receptor agonists, therapeutic vaccines, checkpoint inhibitors, and monoclonal antibodies, are also making their way toward clinical use. In this review, we summarize the recent progress and limitations of chronic hepatitis B treatment and discuss perspectives on approaches to achieving functional cure. Although it will take some time for these new antiviral drugs to be widely used in clinical practice, combination therapy may become a preferable treatment option in the future.
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的影响幽门螺杆菌胃肠道微生物群的感染和根除：最新评论和未来展望Yu Li, Cong He, Nonghua Lu
中华医学杂志英文版2024年 137卷 23期
DOI: 10.1097/CM9.0000000000003348
摘要
Helicobacter pylori (H. pylori) infects approximately half of the population worldwide and causes chronic gastritis, peptic ulcers, and gastric cancer. Test-and-treat strategies have been recommended for the prevention of H. pylori-associated diseases. Advancements in high-throughput sequencing technologies have broadened our understanding of the complex gastrointestinal (GI) microbiota and its role in maintaining host homeostasis. Recently, an increasing number of studies have indicated that the colonization of H. pylori induces dramatic alterations in the gastric microbiota, with a predominance of H. pylori and a reduction in microbial diversity. Dysbiosis of the gut microbiome has also been observed after H. pylori infection, which may play a role in the development of colorectal cancer. However, there is concern regarding the impact of antibiotics on the gut microbiota during H. pylori eradication. In this review, we summarize the current literature concerning how H. pylori infection reshapes the GI microbiota and the underlying mechanisms, including changes in the gastric environment, immune responses, and persistent inflammation. Additionally, the impacts of H. pylori eradication on GI microbial homeostasis and the use of probiotics as adjuvant therapy are also discussed. The shifts in the GI microbiota and their crosstalk with H. pylori may provide potential targets for H. pylori-related gastric diseases and extragastric manifestations.
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传出细胞增多症：脑卒中的新治疗靶点Li Gao, Anatol Manaenko, Feng Zeng, Jingchen Li, Lele Liu, Ruichuan Xie, Xiaohua Zhang, John H. Zhang, Qiyong Mei, Jiping Tang 等
中华医学杂志英文版2024年 137卷 23期
DOI: 10.1097/CM9.0000000000003363
摘要
Efferocytosis refers to the process that phagocytes recognize and remove the apoptotic cells, which is essential for maintaining tissue homeostasis both in physiological and pathological conditions. Numerous studies have demonstrated that efferocytosis can prevent secondary necrosis and proinflammatory factor release, leading to the resolution of inflammation and tissue immunological tolerance in numerous diseases such as stroke. Stroke is a leading cause of death and morbidity for adults worldwide. Persistent inflammation triggered by the dead cells or cell debris is a major contributor to post-stroke brain damage. Effective efferocytosis might be an efficient strategy to minimize inflammation and restore brain homeostasis for neuronal regeneration and function recovery. In this review, we will discuss the phagocytes in the brain, the molecular mechanisms underlying efferocytosis, the role of efferocytosis in inflammation resolution, and the potential therapeutic applications targeting efferocytosis in stroke.
Original Article
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中国炎症性肠病日益增长的负担：2021年全球疾病负担研究的结果和到2035年的预测Ziqing Yu, Gechong Ruan, Xiaoyin Bai, Yinghao Sun, Hong Yang, Jiaming Qian
中华医学杂志英文版2024年 137卷 23期
DOI: 10.1097/CM9.0000000000003345
摘要
Background:
Inflammatory bowel disease (IBD) imposes a significant economic and social burden in China. We aim to assess the epidemiological trends of IBD in China, and to predict the burden in the near future.
Methods:
The incidence, mortality, prevalence, and disability-adjusted life year (DALYs) of IBD from 1990 to 2021 were obtained from Global Burden of Disease Study 2021. Estimated annual percentage change (EAPC), average annual percent change, total percent change, and age-period-cohort model were used to access trends. Bayesian age-period-cohort model was utilized to predict the risk of incidence and mortality.
Results:
In 2021, IBD affected 168,077 people in China, with 24,941 new cases and 5640 deaths. The age-standardized rate (ASR) of incidence and death was 1.4 and 0.3, respectively. The incidence and prevalence in China were lower than the global and high socio-demographic index (SDI) regions, but the ASR of incidence and prevalence (EAPC: 2.93 and 2.54, respectively) had rapidly increased from 1990 to 2021. The ASR of death and DALYs had significantly decreased (EAPC: -3.05 and -2.93, respectively). Middle-aged and elderly populations faced a severe burden of incidence and prevalence, while the elderly population faced a severe mortality burden. It is projected that by 2035, the ASR of incidence will continue to rise, whereas the death rate will continue to decline.
Conclusions:
The burden of IBD in China is serious and increasingly severe. Establishing a comprehensive disease management system in China will help better control the medical burden of IBD.
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金砖国家气管、支气管和肺癌死亡率趋势：基于1990-2019年全球疾病负担研究的年龄-时期-队列分析Ruhai Bai, Wanyue Dong, Meng Chu, Bian Liu, Yan Li
中华医学杂志英文版2024年 137卷 23期
DOI: 10.1097/CM9.0000000000002977
摘要
Background:
Tracheal, bronchus, and lung cancer (TBL) is a major cause of mortality and top contributor to productivity loss in large emerging economies such as the BRICS (Brazil, Russia, India, China, and South Africa). We examined the time trends of TBL mortality across the BRICS to better understand the disease burden in these countries and inform public health and healthcare resource allocation.
Methods:
TBL mortality-related data between 1990 and 2019 were obtained from the Global Burden of Disease Study 2019 and analyzed using age-period-cohort models. Net drift (local drift) was used to describe the expected age-adjusted TBL mortality rate over time overall (each age group); the longitudinal age curve was used to reflect the age effect; the period rate ratios (RRs) were used to reflect the period effect; and the cohort RR was used to reflect the cohort effect.
Results:
In 2019, there were 958.3 thousand TBL deaths across the BRICS, representing 46.9% of the global TBL deaths. From 1990 to 2019, the age-standardized mortality rate (ASMR) of TBL decreased in Russia, Brazil, and South Africa while increased in China and India, with the largest reduction reported in Russia (-29.6%) and the largest increase in China (+22.4%). India showed an overall increase (+15.7%) in TBL mortality but the mortality risk decreased among individuals born after 1990 (men) and 1995 (women). Although South Africa and Brazil experienced an overall decline in TBL mortality, their recent birth cohorts, such as Brazilian individuals born after 1985 (men) and 1980 (women), and South African men born after 1995, had an increasing TBL mortality risk. China has experienced an overall increase in TBL mortality, with the mortality risk rising among individuals born after 1995 for both men and women. Russia, which had the highest TBL mortality among the BRICS countries in 1990, has demonstrated significant improvement over the past three decades.
Conclusions:
Over the past 30 years, the BRICS accounted for an increasing proportion of global TBL mortality. TBL mortality increased in older women in all the BRICS countries except Russia. Among the recent birth cohort, the risk of TBL mortality increased in Brazil, China, and South Africa. More effective efforts are needed in the BRICS to reduce the burden of TBL and help achieve the United Nation’s Sustainable Development Goals.
Perspective
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天然食用成分对表皮渗透屏障功能的益处Dongyun Lei, Xiaojie Liu, Ting Zhang, Jiaxing Chen, Junling Zhang, Litao Zhang
中华医学杂志英文版2024年 137卷 23期
DOI: 10.1097/CM9.0000000000003208
摘要
在过去的几十年中，表皮功能在皮肤和皮肤外功能的调节中的关键作用已经得到了很好的证明。表皮通透性屏障功能障碍增强表皮DNA和脂质合成，以及皮肤和全身炎症。[
Clinical Observation
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选择性COX-2抑制剂改善肝硬化患者临床结局和肝功能的回顾性研究Zhu Yang, Ming Chen, Yang Tai, Huan Tong, Zhiyin Huang, Jinhang Gao, Chengwei Tang
中华医学杂志英文版2024年 137卷 23期
DOI: 10.1097/CM9.0000000000003364
摘要
肝硬化在世界范围内与高发病率、死亡率和医疗费用相关。尽管经颈静脉肝内门体分流术（TIPS）已被证明可提高肝硬化患者的生存率，但全身炎症在失代偿期肝硬化的起始和进展中至关重要。我们之前的研究表明，塞来昔布是一种具有抗炎功效的选择性环氧合酶-2抑制剂（COX-2-I），可有效改善肝纤维化。[
Rapid Report
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中国HIV感染者血脂异常患病率及相关危险因素分析Lei Li, Yanping Zhang, Aiping Yu, Ziyu Wang, Jing Song, Fangfang Yu, Wenli Lu, Zhulin Ma, Ping Ma
中华医学杂志英文版2024年 137卷 23期
DOI: 10.1097/CM9.0000000000003336
摘要
血脂异常是一种代谢紊乱，在人类免疫缺陷病毒（HIV）感染者中患病率高于普通人群，它显著增加心血管疾病（CVD）的风险。[
Correspondence
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Tapinarof通过诱导耐受性树突状细胞和Foxp3抑制银屑病炎症+特雷格斯Yan Zhao, Chenyu Wu, Lin Cai, Zhanglei Mu, Xiaoyang Liu, Wenge Zhang, Jianzhong Zhang
中华医学杂志英文版2024年 137卷 23期
DOI: 10.1097/CM9.0000000000003260
摘要
致编辑：Tapinarof是一种芳香烃受体（AhR）配体，衍生自发光光杆菌.[
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经导管主动脉瓣置换术后的体重指数和预后结果：来自中国心血管病协会数据库-国家经导管瓣膜治疗注册中心的见解Qiong Liu, Sanjay Jaiswal, Qifeng Zhu, Jianfang Luo, Yan Wang, Daxin Zhou, Mao Chen, Xianbao Liu, Jian’an Wang
中华医学杂志英文版2024年 137卷 23期
DOI: 10.1097/CM9.0000000000003347
摘要
致编辑：经导管主动脉瓣置换术（TAVR）在全球范围内迅速兴起，并成为治疗主动脉瓣狭窄患者的可行替代方案。肥胖是心血管疾病发展的公认风险因素，显著增加疾病负担。对主要来自西方国家的TAVR患者的研究强调了与超重或肥胖相关的风险降低，[
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穴位埋线增强骨科开放手术术后镇痛效果Huixing Zhang, Muzhen Guo, Tianjuan Wang, Zhen Li, Fang Zhu, Guozhong Chen, Cheng Li, Hui Chen, Lize Xiong
中华医学杂志英文版2024年 137卷 23期
DOI: 10.1097/CM9.0000000000003161
摘要
致编辑：穴位埋线（ACE）是起源于我国针灸疗法的一种传统外治法，已广泛用于治疗急慢性疾病。[
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微创肝脏外科培训未满足的需求Ahmed Elgendi
中华医学杂志英文版2024年 137卷 23期
DOI: 10.1097/CM9.0000000000003366
摘要
致编辑：我叫Ahmed Elgendi，埃及亚历山大大学肝胆外科医生。我写这封信是为了分享我在华西医院（中国成都）参加作为一带一路倡议一部分的微创肝脏外科培训项目的经验，以及它对改变我们的概念和实践产生的影响。
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儿童脊柱畸形的生长友好型植入物有什么新进展？Chenkai Li, Bingtai Han, Shengru Wang, Jianguo Zhang, You Du, Yiwei Zhao, Xiaohan Ye, Dihan Sun
中华医学杂志英文版2024年 137卷 23期
DOI: 10.1097/CM9.0000000000003239
摘要
致编辑：小儿脊柱畸形的治疗原则是既要控制脊柱畸形，又要保持脊柱和胸部的发育和脊柱的活动度。为了实现这一目标，在过去二十年中已经引入了各种生长友好型植入物，其可分为三类，包括基于牵引的、基于压缩的和引导生长系统。本文旨在全面综述目前可用的儿童脊柱畸形生长友好型植入物，特别是近几十年来取得的进展，为临床治疗和植入物设计提供参考。
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肺癌的光动力治疗：现状与未来Wen Sun, Qi Zhang, Xi Wang, Zhou Jin, Yuan Cheng, Guangfa Wang
中华医学杂志英文版2024年 137卷 23期
DOI: 10.1097/CM9.0000000000003313
摘要
致编辑：肺癌是全球癌症相关死亡的主要原因，其中非小细胞肺癌(NSCLC)占大多数病例。[
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肠道微生态失衡与阻塞性睡眠呼吸暂停相关高血压关系的前瞻性观察研究Chih-Yuan Ko, Li Zhang, Zhixing Zhu, Yiming Zeng
中华医学杂志英文版2024年 137卷 23期
DOI: 10.1097/CM9.0000000000003314
摘要
致编辑：阻塞性睡眠呼吸暂停（OSA）和高血压是两种密切相关的疾病，在临床上经常共存。[
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LEER模式下术后康复促进系统的构建与开发Zehua Lei, Xin Zhao, Qingyun Xie, Jie Yang, Kangyi Jiang, Jie Gong, Jinqiang Fu, Guojun Zeng
中华医学杂志英文版2024年 137卷 23期
DOI: 10.1097/CM9.0000000000003381
摘要
致编辑：增强术后恢复（ERAS）的概念因其令人印象深刻的成果和不断扩大的应用领域而引起了全世界的关注，并得到了许多政府的大力认可和支持。[
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