2025年 · 第138卷第01期

出版日期 2025-01-05电子版￥0.00元

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Editorial

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JAK抑制剂治疗结缔组织病相关间质性肺病的疗效和安全性

Jiajia Wu, Chunli Mei, Zhijun Luo, Xujing Yuan, Wenxun Lin, Rong Du

中华医学杂志英文版2025年 138卷 01期

DOI: 10.1097/CM9.0000000000003359

摘要

Review Article

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糖尿病及其并发症的氧化应激：从病理生理学到治疗策略

Xingyu Chen, Na Xie, Lixiang Feng, Yujing Huang, Yuyao Wu, Huili Zhu, Jing Tang, Yuanyuan Zhang

中华医学杂志英文版2025年 138卷 01期

DOI: 10.1097/CM9.0000000000003230

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胶质瘤中血小板的研究进展

Mingrong Zuo, Tengfei Li, Zhihao Wang, Yufan Xiang, Siliang Chen, Yanhui Liu

中华医学杂志英文版2025年 138卷 01期

DOI: 10.1097/CM9.0000000000003282

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脑损伤生物标志物及其在神经系统疾病中的应用

Han Zhang, Jing Wang, Yang Qu, Yi Yang, Zhen-Ni Guo

中华医学杂志英文版2025年 138卷 01期

DOI: 10.1097/CM9.0000000000003061

摘要

Perspective

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钠-葡萄糖协同转运蛋白2抑制剂开始时估计的肾小球滤过率下降：对慢性肾脏疾病实践的意义

Ying Fan, Niansong Wang

中华医学杂志英文版2025年 138卷 01期

DOI: 10.1097/CM9.0000000000003273

摘要

Original Article

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中国听力损失患病率和疾病负担：来自省级分析的结果

Yu Wang, Yang Xie, Minghao Wang, Mengdan Zhao, Rui Gong, Ying Xin, Jia Ke, Ke Zhang, Shaoxing Zhang, Chen Du 等

中华医学杂志英文版2025年 138卷 01期

DOI: 10.1097/CM9.0000000000003096

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中国的康复需求：基于1990-2019年全球疾病负担研究的估计

Tian Tian, Lin Zhu, Qingzhen Fu, Shiheng Tan, Yukun Cao, Ding Zhang, Mingxue Wang, Ting Zheng, Lijing Gao, Daria Volontovich 等

中华医学杂志英文版2025年 138卷 01期

DOI: 10.1097/CM9.0000000000003245

摘要

Background: As an essential part of health services, rehabilitation is of great significance to improve the health and quality of life of the whole population. Accelerating aging calls for a significant expansion of rehabilitation services in China, but rehabilitation needs remain unclear. We conducted the study to explore the rehabilitation needs in China and project the trend of rehabilitation needs from 2020 to 2034. Methods: The data of health conditions that might potentially benefit from rehabilitation were obtained from Global Burden of Disease (GBD) study. Estimated annual percentage changes (EAPCs) were calculated to quantify the trends of the age-standardized rates. Projections of rehabilitation needs were made until 2034 using Bayesian age–period–cohort analysis (BAPC). Results: Approximately 460 million persons (33.3% of the total population) need rehabilitation in China, contributing to 63 million years lived with disabilities (YLDs) in 2019. The number of prevalent cases that need rehabilitation increased from around 268 (95% uncertainty interval [UI]: 257–282) million in 1990 to almost 460 (95% UI: 443–479) million in 2019, representing an increase of 71.3%. The highest contribution to the need for rehabilitation was musculoskeletal disorders with about 322 (95% UI: 302–343) million persons in seven aggregate disease and injury categories, and hearing loss with over 95 (95% UI: 84–107) million people among 25 health conditions. Based on the projection results, there will be almost 636 million people (45% of the total population) needing rehabilitation services in China by 2034, representing an increase of 38.3%. The rehabilitation needs of neoplasms, cardiovascular diseases, and neurological disorders are expected to increase significantly from 2019 to 2034, with increases of 102.3%, 88.8% and 73.2%, respectively. Conclusions: The need for rehabilitation in China substantially increased over the last 30 years. It is predicted that over two in five people will require rehabilitation by 2034, thus suggesting the need to develop rehabilitation services that meet individuals’ rehabilitation needs.

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白细胞端粒长度与消化系统疾病风险的关系：一项大规模队列研究

Hongqun Yang, Lanlan Chen, Yahui Liu

中华医学杂志英文版2025年 138卷 01期

DOI: 10.1097/CM9.0000000000002994

摘要

Background: Leukocyte telomere length (LTL) shortening, a biomarker of telomere attrition, has been linked to multiple diseases. However, the relationship between LTL and digestive diseases remains uncertain. This study aimed to investigate the association between LTL and the risk of digestive diseases. Methods: A cohort analysis of over 500,000 participants from the UK Biobank (UKB) between 2006 and 2021 was conducted to estimate the associations of LTL with more than 90 common digestive diseases. LTL was quantified using multiplex quantitative polymerase chain reaction, and cases of each disease were determined according to inpatient and primary care data. Multivariable Cox proportional hazards regression analysis was used to evaluate the associations of LTL with the risk of digestive diseases. Furthermore, such associations were also evaluated after stratification by sex and ethnicity. Results: After a mean follow-up time of 11.8 years, over 20 International Classification of Diseases, 10th Revision (ICD-10) codes were showed to be associated with telomere attrition. LTL shortening is associated with an increased risk of several digestive diseases, including gastroesophageal reflux disease (K21: hazard ratio [HR] = 1.30, 95% confidence interval [95% CI]: 1.19–1.42), esophageal ulcer (K221: HR = 1.81, 95% CI: 1.22–2.71), Barrett’s esophagus (K227: HR = 1.58, 95% CI: 1.14–2.17), gastritis (K29: HR = 1.39, 95% CI: 1.26–1.52), duodenal ulcer (K26: HR = 1.55, 95% CI: 1.14–2.12), functional dyspepsia (K30X: HR = 1.36, 95% CI: 1.06–1.69), non-alcoholic fatty liver disease (NAFLD) (K760: HR = 1.39, 95% CI: 1.09–1.78), liver cirrhosis (K74: HR = 4.73, 95% CI: 3.27–6.85), cholangitis (K830: HR = 2.55, 95% CI: 1.30–5.00), and hernia (K43: HR = 1.50, 95% CI: 1.17–1.94; K44: HR = 1.29, 95% CI: 1.17–1.42). The risk of rectal polyps (K621: HR = 0.77, 95% CI: 0.63–0.92) decreased per unit shortening of LTL. Conclusions: This study suggests that LTL shortening is associated with an increased risk of most digestive diseases except for rectal polyps. These findings may provide some clues for understanding the pathogenesis of digestive diseases.

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基于转录组学方法的肾性骨营养不良小鼠模型中鞘脂代谢信号的作用

Yujia Wang, Yan Di, Yongqi Li, Jing Lu, Bofan Ji, Yuxia Zhang, Zhiqing Chen, Sijie Chen, Bicheng Liu, Rining Tang

中华医学杂志英文版2025年 138卷 01期

DOI: 10.1097/CM9.0000000000003261

摘要

Background: Renal osteodystrophy (ROD) is a skeletal pathology associated with chronic kidney disease-mineral and bone disorder (CKD-MBD) that is characterized by aberrant bone mineralization and remodeling. ROD increases the risk of fracture and mortality in CKD patients. The underlying mechanisms of ROD remain elusive, partially due to the absence of an appropriate animal model. To address this gap, we established a stable mouse model of ROD using an optimized adenine-enriched diet and conducted exploratory analyses through ribonucleic acid sequencing (RNA-seq). Methods: Eight-week-old male C57BL/6J mice were randomly allocated into three groups: control group (n = 5), adenine and high-phosphate (HP) diet group (n = 20), and the optimized adenine-containing diet group (n = 20) for 12 weeks. We assessed the skeletal characteristics of model mice through blood biochemistry, microcomputed tomography (micro-CT), and bone histomorphometry. RNA-seq was utilized to profile gene expression changes of ROD. We elucidated the functions of differentially expressed genes (DEGs) using gene ontology (GO) analysis, Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway analysis, and gene set enrichment analysis (GSEA). DEGs were validated via quantitative real-time polymerase chain reaction (qRT-PCR). Results: By the fifth week, adenine followed by an HP diet induced rapid weight loss and high mortality rates in the mouse group, precluding further model development. Mice with optimized adenine diet-induced ROD displayed significant abnormalities in serum creatinine and blood urea nitrogen levels, accompanied by pronounced hyperparathyroidism and hyperphosphatemia. The femur bone mineral density (BMD) of the model mice was lower than that of control mice, with substantial bone loss and cortical porosity. ROD mice exhibited substantial bone turnover with an increase in osteoblast and osteoclast markers. Transcriptomic profiling revealed 1907 genes with upregulated expression and 723 genes with downregulated expression in the femurs of ROD mice relative to those of control mice. Pathway analyses indicated significant enrichment of upregulated genes in the sphingolipid metabolism pathway. The significant upregulation of alkaline ceramidase 1 (Acer1), alkaline ceramidase 2 (Acer2), prosaposin-like 1 (Psapl1), adenosine A1 receptor (Adora1), and sphingosine-1-phosphate receptor 5 (S1pr5) were successfully validated in mouse femurs by qRT-PCR. Conclusions: Optimized adenine diet mouse model may be a valuable proxy for studying ROD. RNA-seq analysis revealed that the sphingolipid metabolism pathway is likely a key player in ROD pathogenesis, thereby providing new avenues for therapeutic intervention.

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EZH2/miR-142-3p/HMGB1轴通过调节内质网应激介导膝骨关节炎软骨细胞上睑下垂

Yang Chen, Shanshan Dong, Xin Zeng, Qing Xu, Mingwei Liang, Guangneng Liao, Lan Li, Bin Shen, Yanrong Lu, Haibo Si

中华医学杂志英文版2025年 138卷 01期

DOI: 10.1097/CM9.0000000000003186

摘要

Background: Knee osteoarthritis (OA) is still challenging to prevent or treat. Enhanced endoplasmic reticulum (ER) stress and increased pyroptosis in chondrocytes may be responsible for cartilage degeneration. This study aims to investigate the effect of ER stress on chondrocyte pyroptosis and the upstream regulatory mechanisms, which have rarely been reported. Methods: The expression of the histone methyltransferase enhancer of zeste homolog 2 (EZH2), microRNA-142-3p (miR-142-3p), and high mobility group box 1 (HMGB1) and the levels of ER stress, pyroptosis, and metabolic markers in normal and OA chondrocytes were investigated by western blotting, quantitative polymerase chain reaction, immunohistochemistry, fluorescence in situ hybridization, fluorescein amidite-tyrosine-valine-alanine-aspartic acid-fluoromethyl ketone (FAM-YVAD-FMK)/Hoechst 33342/propidium iodide (PI) staining, lactate dehydrogenase (LDH) release assays, and cell viability assessments. The effects of EZH2, miR-142-3p, and HMGB1 on ER stress and pyroptosis and the hierarchical regulatory relationship between them were analyzed by chromatin immunoprecipitation, luciferase reporters, gain/loss-of-function assays, and rescue assays in interleukin (IL)-1β-induced OA chondrocytes. The mechanistic contribution of EZH2, miR-142-3p, and HMGB1 to chondrocyte ER stress and pyroptosis and therapeutic prospects were validated radiologically, histologically, and immunohistochemically in surgically induced OA rats. Results: Increased EZH2 and HMGB1, decreased miR-142-3p, enhanced ER stress, and activated pyroptosis in chondrocytes were associated with OA occurrence and progression. EZH2 and HMGB1 exacerbated and miR-142-3p alleviated ER stress and pyroptosis in OA chondrocytes. EZH2 transcriptionally silenced miR-142-3p via H3K27 trimethylation, and miR-142-3p posttranscriptionally silenced HMGB1 by targeting the 3′-UTR of the HMGB1 gene. Moreover, ER stress mediated the effects of EZH2, miR-142-3p, and HMGB1 on chondrocyte pyroptosis. In vivo experiments mechanistically validated the hierarchical regulatory relationship between EZH2, miR-142-3p, and HMGB1 and their effects on chondrocyte ER stress and pyroptosis. Conclusions: A novel EZH2/miR-142-3p/HMGB1 axis mediates chondrocyte pyroptosis and cartilage degeneration by regulating ER stress in OA, contributing novel mechanistic insights into OA pathogenesis and providing potential targets for future therapeutic research.

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槐耳颗粒对乳腺癌预后影响的单中心倾向评分匹配回顾性研究

Qianqian Guo, Yuting Peng, Ge Zhang, Huan Lin, Qianjun Chen

中华医学杂志英文版2025年 138卷 01期

DOI: 10.1097/CM9.0000000000002966

摘要

Clinical Observation

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粪便铁载体基因是溃疡性结肠炎的潜在生物标志物

Jingshuang Yan, Rongrong Ren, Zhengpeng Li, Wanyue Dan, Xinyi Ma, Xiaohan Zhang, Xiaoyan Chi, Lihua Peng, Yunsheng Yang

中华医学杂志英文版2025年 138卷 01期

DOI: 10.1097/CM9.0000000000003424

摘要

Correspondence

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儿童和青少年屈光障碍的患病率、时间趋势、负担和预测

Jie Zhang, Tingling Xu, Yongze Li, Cong Li, Chunping Wang, Jing Zhang, Lei Liu, Maigeng Zhou

中华医学杂志英文版2025年 138卷 01期

DOI: 10.1097/CM9.0000000000003377

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全肝调强放疗作为肝移植术后急性移植物抗宿主病的抢救治疗

Dong Chen, Yuanyuan Zhao, Guangyuan Hu, Bo Yang, Limin Zhang, Zipei Wang, Hui Guo, Qianyong Zhao, Lai Wei, Zhishui Chen

中华医学杂志英文版2025年 138卷 01期

DOI: 10.1097/CM9.0000000000003367

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自体CD19嵌合抗原受体T细胞治疗疗效与复发或难治性弥漫性大B细胞淋巴瘤风险的评估模型

Bin Xue, Yifan Liu, Min Zhang, Gangfeng Xiao, Xiu Luo, Lili Zhou, Shiguang Ye, Yan Lu, Wenbin Qian, Li Wang 等

中华医学杂志英文版2025年 138卷 01期

DOI: 10.1097/CM9.0000000000003343

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粒细胞集落刺激因子在CAR-T细胞治疗后中性粒细胞减少症治疗中的应用：难治性/复发性B细胞急性淋巴细胞白血病的安全性和有效性评价

Xinping Cao, Meng Zhang, Ruiting Guo, Xiaomei Zhang, Rui Sun, Xia Xiao, Xue Bai, Cuicui Lyu, Yedi Pu, Juanxia Meng 等

中华医学杂志英文版2025年 138卷 01期

DOI: 10.1097/CM9.0000000000003353

摘要

致编辑：在接受嵌合抗原受体T（CAR-T）细胞治疗后，超过90%的患者出现轻度或重度血细胞减少症，3-4级中性粒细胞减少症的患病率为53%至94.3%。^[1,2]粒细胞集落刺激因子（G-CSF）以其增强中性粒细胞增殖和分化的能力而闻名，已广泛用于预防和治疗各种情况下的中性粒细胞减少症。然而，其在CAR-T细胞治疗后的难治性/复发性B细胞急性淋巴细胞白血病（R/R B-ALL）患者中的应用仍然是一个争论的话题。^[3]几项研究表明，G-CSF可能通过调节炎性因子如白细胞介素-12(IL-12)、TNF-α和IFN-γ的释放或通过影响T细胞亚群的分化而发挥抗炎作用。^[4]然而，其他研究人员认为G-CSF可能通过增强抗原呈递细胞功能而加重细胞因子释放综合征（CRS）和免疫效应细胞相关神经毒性综合征（ICANS）。此外，已经发现ICANS的严重程度与B-ALL中血清G-CSF水平升高密切相关。^[5]为了为该主题提供知识基础，需要进一步的研究，其中应包括G-CSF的额外临床和实验研究，以及评估G-CSF对B-ALL内容中CRS和ICANS的影响。这些全面的信息将使临床医生在为患者制定治疗策略时做出更明智的决策。因此，我们对2017年6月至2022年12月在天津市第一中心医院接受CD19 CAR-T细胞治疗后一个月内出现中性粒细胞减少症的168例R/R B-ALL患者进行了回顾性分析。在天津市第一中心医院获得所有患者及其家属参与本临床试验的知情同意书（在www.chictr.org.cn注册为ChiCTR-ONN-16009862和ChiCTR1800015164）。本研究经天津市第一中心医院伦理委员会批准（编号：2015002X），相关临床试验完全符合赫尔辛基宣言在这些患者中，89例患者接受了2.5-5.0 mg·kg剂量的G-CSF⁻¹·日⁻¹在中性粒细胞减少期间（G-CSF组），79例患者未接受G-CSF（对照组）。总生存期（OS）定义为从CAR-T细胞输注到任何原因死亡的持续时间。无进展生存期（PFS）定义为从CAR-T细胞输注到疾病进展或死亡的时期。使用SPSS Statistics 26.0（IBM Corp，Armonk，NY，USA）和GraphPad Prism 9.0（GraphPad Software，CA，USA）进行统计分析。