中华外科杂志
2022年 · 第135卷第02期
出版日期 2022-01-20电子版 ￥0.00元
中华外科杂志
- 全部
- Review Article
- Systematic Review
- Meta Analysis
- Original Article
- Clinical Observation
- Technical Notes
- Correspondence
Review Article
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肺癌原发肿瘤定位的评价与管理Xueqi Xie, Xiaolin Li, Wenjie Tang, Peng Xie, Xuefen Tan
中华医学杂志英文版2022年 135卷 02期
DOI: 10.1097/CM9.0000000000001802
摘要
Lung cancer continues to be the leading cause of cancer-related death in the world, which is classically subgrouped into two major histological types: Non-small cell lung cancer (NSCLC) (85% of patients) and small-cell lung cancer (SCLC) (15%). Tumor location has been reported to be associated with the prognosis of various solid tumors. Several types of cancer often occur in a specific region and are more prone to spread to predilection locations, including colorectal cancer, prostate cancer, gastric cancer, ovarian cancer, cervical cancer, bladder cancer, lung tumor, and so on. Besides, tumor location is also considered as a risk factor for lung neoplasm with chronic obstructive pulmonary disease/emphysema. Additionally, the primary lung cancer location is associated with specific lymph node metastasis. And the recent analysis has shown that the primary location may affect metastasis pattern in metastatic NSCLC based on a large population. Numerous studies have enrolled the "location" factor in the risk model. Anatomy location and lobe-specific location are both important in prognosis. Therefore, it is important for us to clarify the characteristics about tumor location according to various definitions. However, the inconsistent definitions about tumor location among different articles are controversial. It is also a significant guidance in multimode therapy in the present time. In this review, we mainly aim to provide a new insight about tumor location, including anatomy, clinicopathology, and prognosis in patients with lung neoplasm.
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作为药物的复苏液：靶向内皮糖萼Guangjian Wang, Hongmin Zhang, Dawei Liu, Xiaoting Wang, Chinese Critical Ultrasound Study Group
中华医学杂志英文版2022年 135卷 02期
DOI: 10.1097/CM9.0000000000001869
摘要
Fluid resuscitation is an essential intervention in critically ill patients, and its ultimate goal is to restore tissue perfusion. Critical illnesses are often accompanied by glycocalyx degradation caused by inflammatory reactions, hypoperfusion, shock, and so forth, leading to disturbed microcirculatory perfusion and organ dysfunction. Therefore, maintaining or even restoring the glycocalyx integrity may be of high priority in the therapeutic strategy. Like drugs, however, different resuscitation fluids may have beneficial or harmful effects on the integrity of the glycocalyx. The purpose of this article is to review the effects of different resuscitation fluids on the glycocalyx. Many animal studies have shown that normal saline might be associated with glycocalyx degradation, but clinical studies have not confirmed this finding. Hydroxyethyl starch (HES), rather than other synthetic colloids, may restore the glycocalyx. However, the use of HES also leads to serious adverse events such as acute kidney injury and bleeding tendencies. Some studies have suggested that albumin may restore the glycocalyx, whereas others have suggested that balanced crystalloids might aggravate glycocalyx degradation. Notably, most studies did not correct the effects of the infusion rate or fluid volume; therefore, the results of using balanced crystalloids remain unclear. Moreover, mainly animal studies have suggested that plasma may protect and restore glycocalyx integrity, and this still requires confirmation by high-quality clinical studies.
Systematic Review
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既往感染新型冠状病毒病患者的再感染率：系统综述和荟萃分析Yinjun Mao, Weiwei Wang, Jun Ma, Shanshan Wu, Feng Sun
中华医学杂志英文版2022年 135卷 02期
DOI: 10.1097/CM9.0000000000001892
摘要
Background:
Asymptomatic or symptomatic infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) can be followed by reinfection. The protection conferred by prior infection among coronavirus disease 2019 (COVID-19) patients is unclear. We assessed the incidence of SARS-CoV-2 reinfection and the protection effect of previous infection against reinfection.
Methods:
We searched PubMed, EMBASE, Cochrane, Scopus, Web of Science, and ClinicalTrials.gov for publications up until the end date of May 1, 2021. The reinfection rate of recovered patients and the protection against reinfection were analyzed using meta-analysis.
Results:
Overall, 19 studies of 1096 reinfection patients were included. The pooled reinfection rate was 0.65% (95% confidence interval [CI] 0.39-0.98%). The symptomatic reinfection rate was a bit lower (0.37% [95% CI 0.11-0.78%], I2 = 99%). The reinfection rate was much higher in high-risk populations (1.59% [95% CI 0.30-3.88%], I2= 90%). The protection against reinfection and symptomatic reinfection was similar (87.02% [95% CI 83.22-89.96%] and 87.17% [95% CI 83.09-90.26%], respectively).
Conclusions:
The rate of reinfection with SARS-CoV-2 is relatively low. The protection against SARS-CoV-2 after natural infection is comparable to that estimated for vaccine efficacy. These data may help guide public health measures and vaccination strategies in response to the COVID-19 pandemic. High-quality clinical studies are needed to establish the relevant risk factors in recovered patients.
Meta Analysis
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全膝关节置换术后患者基于虚拟现实的康复：随机对照试验的系统综述和荟萃分析Linbo Peng, Yi Zeng, Yuangang Wu, Haibo Si, Bin Shen
中华医学杂志英文版2022年 135卷 02期
DOI: 10.1097/CM9.0000000000001847
摘要
Background:
Physical therapy is regarded as an essential aspect in achieving optimal outcomes following total knee arthroplasty (TKA). The coronavirus disease 2019 (COVID-19) pandemic has made face-to-face rehabilitation inaccessible. Virtual reality (VR) is increasingly regarded as a potentially effective option for offering health care interventions. This systematic review and meta-analysis investigate VR-based rehabilitation’s effectiveness on outcomes following TKA.
Methods:
From inception to May 22, 2021, PubMed/Medline, Embase, Web of Science, the Cochrane Central Register of Controlled Trials, Scopus, PsycINFO, Physiotherapy Evidence Database, China National Knowledge Infrastructure, and Wanfang were comprehensively searched to identify randomized controlled trials (RCTs) evaluating the effect of VR-based rehabilitation on patients following TKA according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement and the Cochrane Handbook for Systematic Reviews of Interventions.
Results:
Eight studies were included in the systematic review, and seven studies were included in the meta-analysis. VR-based rehabilitation significantly improved visual analog scale (VAS) scores within 1 month (standardized mean difference [SMD]: -0.44; 95% confidence interval [CI]: -0.79 to -0.08, P = 0.02), the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) within 1 month (SMD: -0.71; 95% CI: -1.03 to -0.40, P < 0.01), and the Hospital for Special Surgery Knee Score (HSS) within 1 month and between 2 months and 3 months (MD: 7.62; 95% CI: 5.77 to 9.47, P < 0.01; MD: 10.15; 95% CI: 8.03 to 12.27, P < 0.01; respectively) following TKA compared to conventional rehabilitation. No significant difference was found in terms of the Timed Up and Go (TUG) test.
Conclusions:
VR-based rehabilitation improved pain and function but not postural control following TKA compared to conventional rehabilitation. More high-quality RCTs are needed to prove the advantage of VR-based rehabilitation. As the COVID-19 pandemic continues, it is necessary to promote this rehabilitation model.
Original Article
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机器人手术后乳糜性腹水的发生率较高，并且与直肠癌手术后无复发生存率较差相关Xiaojie Wang, Zhifang Zheng, Min Chen, Shenghui Huang, Xingrong Lu, Ying Huang, Pan Chi
中华医学杂志英文版2022年 135卷 02期
DOI: 10.1097/CM9.0000000000001809
摘要
Background:
Postoperative chylous ascites is an infrequent condition after colorectal surgery and is easily treatable. However, its effect on the long-term oncological prognosis is not well established. This study aimed to investigate the short-term and long-term impact of chylous ascites treated with neoadjuvant therapy followed by rectal cancer surgery and to evaluate the incidence of chylous ascites after different surgical approaches.
Methods:
A total of 898 locally advanced rectal cancer patients treated with neoadjuvant chemoradiotherapy followed by surgery between January 2010 and December 2018 were included. The clinicopathological data and outcomes of the patients with chylous ascites were compared with those of the patients without chylous ascites. The primary endpoint was recurrence-free survival (RFS). To balance baseline confounders between groups, propensity score matching (PSM) was performed for each patient with a logistic regression model.
Results:
Chylous ascites was detected in 3.8% (34/898) of the patients. The incidence of chylous ascites was highest after robotic surgery (6.9%, 6/86), followed by laparoscopic surgery (4.2%, 26/618) and open surgery (1.0%, 2/192, P = 0.021). The patients with chylous ascites had a significantly higher number of lymph nodes harvested (15.6 vs. 12.8, P = 0.009) and a 3-day longer postoperative hospital stay (P = 0.017). The 5-year RFS rate was 64.5% in the chylous ascites group, which was significantly lower than the rate in the no chylous ascites group (79.9%; P = 0.007). The results remained unchanged after PSM was performed. The chylous ascites group showed a nonsignificant trend towards a higher peritoneal metastasis risk (5.9% vs. 1.6%, P = 0.120). Univariate analysis and multivariate analysis confirmed chylous ascites (hazard ratio= 3.038, P < 0.001) as an independent negative prognostic factor for RFS.
Conclusions:
Considering the higher incidence of chylous ascites after laparoscopic and robotic surgery and its adverse prognosis, we recommend sufficient coagulation of the lymphatic tissue near the vessel origins, especially during minimally invasive surgery.
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成人肺移植术后急性肾损伤Lei Jing, Wenhui Chen, Li Zhao, Lijuan Guo, Chaoyang Liang, Jingyu Chen, Chen Wang
中华医学杂志英文版2022年 135卷 02期
DOI: 10.1097/CM9.0000000000001636
摘要
Background:
Acute kidney injury (AKI) is a common and serious complication following lung transplantation (LTx), and it is associated with high mortality and morbidity. This study assessed the incidence of AKI after LTx and analyzed the associated perioperative factors and clinical outcomes.
Methods:
This retrospective study included all adult LTx recipients at the China-Japan Friendship Hospital in Beijing between March 2017 and December 2019. The outcomes were AKI incidence, risk factors, mortality, and kidney recovery. Multivariate analysis was performed to identify independent risk factors. Survival analysis was presented using the Kaplan-Meier curves.
Results:
AKI occurred in 137 of the 191 patients (71.7%), with transient AKI in 43 (22.5%) and persistent AKI in 94 (49.2%). AKI stage 1 occurred in 27/191 (14.1%), stage 2 in 46/191 (24.1%), and stage 3 in 64/191 (33.5%) of the AKI patients. Renal replacement therapy (RRT) was administered to 35/191 (18.3%) of the patients. Male sex, older age, mechanical ventilation (MV), severe hypotension, septic shock, multiple organ dysfunction (MODS), prolonged extracorporeal membrane oxygenation (ECMO), reintubation, and nephrotoxic agents were associated with AKI (P < 0.050). Persistent AKI was independently associated with preoperative pulmonary hypertension, severe hypotension, post-operative MODS, and nephrotoxic agents. Severe hypotension, septic shock, MODS, reintubation, prolonged MV, and ECMO during or after LTx were related to severe AKI (stage 3) (P < 0.050). Patients with persistent and severe AKI had a significantly longer duration of MV, longer duration in the intensive care unit (ICU), worse downstream kidney function, and reduced survival (P < 0.050).
Conclusions:
AKI is common after LTx, but the pathogenic mechanism of AKI is complicated, and prerenal causes are important. Persistent and severe AKI were associated with poor short- and long-term kidney function and reduced survival in LTx patients.
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低温机灌注参数联合灌注液生物标志物对死亡供体肾移植的预测价值Yuxi Qiao, Chenguang Ding, Yang Li, Xiaohui Tian, Puxun Tian, Xiaoming Ding, Heli Xiang, Jin Zheng, Wujun Xue
中华医学杂志英文版2022年 135卷 02期
DOI: 10.1097/CM9.0000000000001867
摘要
Background:
Delayed graft function (DGF) is the main cause of renal function failure after kidney transplantation. This study aims at investigating the value of hypothermic machine perfusion (HMP) parameters combined with perfusate biomarkers on predicting DGF and the time of renal function recovery after deceased donor (DD) kidney transplantation.
Methods:
HMP parameters, perfusate biomarkers and baseline characteristics of 113 DD kidney transplantations from January 1, 2019 to August 31, 2019 in the First Affiliated Hospital of Xi’an Jiaotong University were retrospectively analyzed using univariate and multivariate logistic regression analysis.
Results:
In this study, the DGF incidence was 17.7% (20/113); The multivariate logistic regression results showed that terminal resistance (OR: 1.879, 95% CI 1.145-3.56) and glutathione S-transferase (GST)(OR = 1.62, 95% CI 1.23-2.46) were risk factors for DGF; The Cox model analysis indicated that terminal resistance was an independent hazard factor for renal function recovery time (HR = 0.823, 95% CI 0.735-0.981). The model combining terminal resistance and GST (AUC = 0.888, 95% CI: 0.842-0.933) significantly improved the DGF predictability compared with the use of terminal resistance (AUC = 0.756, 95% CI 0.693-0.818) or GST alone (AUC = 0.729, 95% CI 0.591-0.806).
Conclusion:
According to the factors analyzed in this study, the combination of HMP parameters and perfusate biomarkers displays a potent DGF predictive value.
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入院时CONUT指数作为新冠肺炎健康结果的潜在预后指标的有效性Adrián K. Bengelloun, Guillermo J. Ortega, Julio Ancochea, Ancor Sanz-Garcia, Diego A. Rodríguez-Serrano, Guillermo Fernández-Jiménez, Rosa Girón, Elena Ávalos, Joan B. Soriano, J. Ignacio de Ulíbarri
中华医学杂志英文版2022年 135卷 02期
DOI: 10.1097/CM9.0000000000001798
摘要
Background:
In-hospital mortality in patients with coronavirus disease 2019 (COVID-19) is high. Simple prognostic indices are needed to identify patients at high-risk of COVID-19 health outcomes. We aimed to determine the usefulness of the CONtrolling NUTritional status (CONUT) index as a potential prognostic indicator of mortality in COVID-19 patients upon hospital admission.
Methods:
Our study design is of a retrospective observational study in a large cohort of COVID-19 patients. In addition to descriptive statistics, a Kaplan-Meier mortality analysis and a Cox regression were performed, as well as receiver operating curve (ROC).
Results:
From February 5, 2020 to January 21, 2021, there was a total of 2969 admissions for COVID-19 at our hospital, corresponding to 2844 patients. Overall, baseline (within 4 days of admission) CONUT index could be scored for 1627 (57.2%) patients. Patients’ age was 67.3 ± 16.5 years and 44.9% were women. The CONUT severity distribution was: 194 (11.9%) normal (0-1); 769 (47.2%) light (2-4); 585 (35.9%) moderate (5-8); and 79 (4.9%) severe (9-12). Mortality of 30 days after admission was 3.1% in patients with normal risk CONUT, 9.0% light, 22.7% moderate, and 40.5% in those with severe CONUT (P < 0.05). An increased risk of death associated with a greater baseline CONUT stage was sustained in a multivariable Cox regression model (P < 0.05). An increasing baseline CONUT stage was associated with a longer duration of admission, a greater requirement for the use of non-invasive and invasive mechanical ventilation, and other clinical outcomes (all P < 0.05). The ROC of CONUT for mortality had an area under the curve (AUC) and 95% confidence interval of 0.711 (0.676-0746).
Conclusion:
The CONUT index upon admission is potentially a reliable and independent prognostic indicator of mortality and length of hospitalization in COVID-19 patients.
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干扰素-γ抑制醛脱氢酶明亮的乳腺癌4T1小鼠模型中的癌症干细胞Xiufen Zhuang, Guilan Shi, Xiao Hu, Huiru Wang, Wen Sun, Yanhong Wu
中华医学杂志英文版2022年 135卷 02期
DOI: 10.1097/CM9.0000000000001558
摘要
Background:
Despite improvements in disease diagnosis, treatment, and prognosis, breast cancer is still a leading cause of cancer death for women. Compelling evidence suggests that targeting cancer stem cells (CSCs) have a crucial impact on overcoming the current shortcomings of chemotherapy and radiotherapy. In the present study, we aimed to study the effects of T cells and a critical anti-tumor cytokine, interferon-gamma (IFN-γ), on breast cancer stem cells.
Methods:
BALB/c mice and BALB/c nude mice were subcutaneously injected with 4T1 tumor cells. Tumor growth and pulmonary metastasis were assessed. ALDEFLOURTM assays were performed to identify aldehyde dehydrogenasebright (ALDHbr) tumor cells. ALDHbr cells as well as T cells from tumor-bearing BALB/c mice were analyzed using flow cytometry. The effects of CD8+ T cells on ALDHbr tumor cells were assessed in vitro and in vivo. The expression profiles of ALDHbr and ALDHdim 4T1 tumor cells were determined. The levels of plasma IFN-γ were measured by enzyme-linked immunosorbent assay, and their associations with the percentages of ALDHbr tumor cells were evaluated. The effects of IFN-γ on ALDH expression and the malignancy of 4T1 tumor cells were analyzed in vitro.
Results:
There were fewer metastatic nodules in tumor-bearing BALB/c mice than those in tumor-bearing BALB/c nude mice (25.40 vs. 54.67, P < 0.050). CD8+ T cells decreased the percentages of ALDHbr 4T1 tumor cells in vitro (control vs. effector to target ratio of 1:1, 10.15% vs. 5.76%, P < 0.050) and in vivo (control vs. CD8+ T cell depletion, 10.15% vs. 21.75%, P < 0.001). The functions of upregulated genes in ALDHbr 4T1 tumor cells were enriched in the pathway of response to IFN-γ. The levels of plasma IFN-γ decreased gradually in tumor-bearing BALB/c mice, while the percentages of ALDHbr tumor cells in primary tumors increased. IFN-γ at a concentration of 26.68 ng/mL decreased the percentages of ALDHbr 4T1 tumor cells (22.88% vs. 9.88%, P < 0.050) and the protein levels of aldehyde dehydrogenase 1 family member A1 in 4T1 tumor cells (0.86 vs. 0.49, P < 0.050) and inhibited the abilities of sphere formation (sphere diameter <200 μm, 159.50 vs. 72.0; ≥200 μm, 127.0 vs. 59.0; both P < 0.050) and invasion (89.67 vs. 67.67, P < 0.001) of 4T1 tumor cells.
Conclusion:
CD8+ T cells and IFN-γ decreased CSC numbers in a 4T1 mouse model of breast cancer. The application of IFN-γ may be a potential strategy for reducing CSCs in breast cancer.
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CX3C-趋化因子受体1调节睡眠剥夺诱导的认知功能障碍Jiawei Xin, Chao Wang, Xiaojuan Cheng, Changfu Xie, Qiuyang Zhang, Yilang Ke, Xuanyu Huang, Xiaochun Chen, Xiaodong Pan
中华医学杂志英文版2022年 135卷 02期
DOI: 10.1097/CM9.0000000000001769
摘要
Background:
Microglia plays an indispensable role in the pathological process of sleep deprivation (SD). Here, the potential role of microglial CX3C-chemokine receptor 1 (CX3CR1) in modulating the cognition decline during SD was evaluated in terms of microglial neuroinflammation and synaptic pruning. In this study, we aimed to investigat whether the interference in the microglial function by the CX3CR1 knockout affects the CNS’s response to SD.
Methods:
Middle-aged wild-type (WT) C57BL/6 and CX3CR1-/- mice were either subjected to SD or allowed normal sleep (S) for 8 h to mimic the pathophysiological changes of middle-aged people after staying up all night. After which, behavioral and histological tests were used to explore their different changes.
Results:
CX3CR1 deficiency prevented SD-induced cognitive impairments, unlike WT groups. Compared with the CX3CR1-/- S group, the CX3CR1-/- SD mice reported a markedly decreased microglia and cellular oncogene fos density in the dentate gyrus (DG), decreased expression of pro-inflammatory cytokines, and decreased microglial phagocytosis-related factors, whereas increased levels of anti-inflammatory cytokines in the hippocampus and a significant increase in the density of spines of the DG were also noted.
Conclusions:
These findings suggest that CX3CR1 deficiency leads to different cerebral behaviors and responses to SD. The inflammation-attenuating activity and the related modification of synaptic pruning are possible mechanism candidates, which indicate CX3CR1 as a candidate therapeutic target for the prevention of the sleep loss-induced cognitive impairments.
Clinical Observation
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循环自身抗体相关的特发性肺纤维化：一项中国队列长期随访研究Hui Wang, Haoran Chen, Yin Liu, Xin Yan, Yujuan Gao, Hourong Cai, Jinghong Dai
中华医学杂志英文版2022年 135卷 02期
DOI: 10.1097/CM9.0000000000001834
摘要
具有自身免疫性特征的间质性肺炎（IPAF）一词基于临床、血清学和形态学领域（特异性胸部影像学特征、组织病理学特征或多室受累，包括非特异性间质性肺炎[NSIP]、机化性肺炎、NSIP伴机化性肺炎重叠和淋巴样间质性肺炎）的组合，旨在描述具有间质性肺病（ILD）和指示结缔组织病（CTD）的临床特征但不符合既定CTD分类标准的患者。[
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高屋尘螨血清特异性免疫球蛋白E表明高5年鼻炎—哮喘转换率：一项横断面研究Rui Tang, Xiaohong Lyu, Yuelun Zhang, Shi Chen, Hong Li
中华医学杂志英文版2022年 135卷 02期
DOI: 10.1097/CM9.0000000000001790
摘要
过敏性鼻炎（AR）是一种昂贵且高度流行的慢性疾病。[
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非脑血管痉挛因素和脑血管痉挛预测动脉瘤性蛛网膜下腔出血后迟发性脑缺血Yue Chen, Guanmin Li, Xiaoyong Chen, Dengliang Wang, Wenhua Fang, Dezhi Kang, Chenyu Ding
中华医学杂志英文版2022年 135卷 02期
DOI: 10.1097/CM9.0000000000001844
摘要
动脉瘤性蛛网膜下腔出血（aSAH）是一种典型的神经外科急症。患者的预后与初始疾病的严重程度和术后并发症有关，尤其是迟发性脑缺血（DCI）。DCI发生在高达30%的蛛网膜下腔出血（SAH）患者中，通常发生在出血后2周，是aSAH死亡和残疾的主要原因之一。目前，普遍认为DCI主要与脑血管痉挛（CVS）有关。然而，在积极的抗CVS治疗后，仍有一部分患者发生DCI，这表明CVS并不是DCI的全部原因。[
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之间的关系SLC26A7甲状腺乳头状癌的表达与甲状腺外转移Fengyan Huang, Juan Xiao, Lihua Wang, Yuxiang Xie, Hongying Jia
中华医学杂志英文版2022年 135卷 02期
DOI: 10.1097/CM9.0000000000001662
摘要
甲状腺乳头状癌（PTC）是甲状腺癌中最常见的类型（占80%以上）。[
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免疫功能低下人群中的新冠肺炎：来自中国湖北省同种异体肾移植受者整个爆发周期的数据Weijie Zhang, Fei Han, Xiongfei Wu, Zhendi Wang, Yanfeng Wang, Xiaojun Guo, Song Chen, Tao Qiu, Heng Li, Yafang Tu 等
中华医学杂志英文版2022年 135卷 02期
DOI: 10.1097/CM9.0000000000001538
摘要
冠状病毒疾病2019（新冠肺炎）是一种由新发现的冠状病毒引起的传染病，已迅速传播到世界大部分地区，并导致全球疫情。然而，很少有信息可用于描述新冠肺炎疫情免疫缺陷人群的特征，尤其是关注作为该人群典型代表的肾移植后患者的信息。了解该人群的易感性、临床特征、治疗策略和预后对于大流行中免疫缺陷患者的管理具有重要意义。
Technical Notes
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股骨直接纤维插入重建前交叉韧带的新技术Xianxiang Xiang, Rongjin Chen, Ruixin Li, Jue Gong, Jiang Yang, Chunhui Li, Weiming Wang
中华医学杂志英文版2022年 135卷 02期
DOI: 10.1097/CM9.0000000000001771
摘要
前交叉韧带（ACL）撕裂是运动医学门诊患者的常见病。为了恢复ACL损伤膝关节的静态和动态稳定性以及运动学，股骨和胫骨隧道的准确位置在ACL重建中起着重要作用，尤其是股骨隧道。[
Correspondence
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血小板捐献者数据库：中国人群同种免疫性血小板减少症患者专家捐献者数据库的研究及完整性评估Lilan Li, Zhoulin Zhong, Yan Zhou, Hengcong Li, Fang Lu, Lihong Jiang, Jierun Chen, Guoguang Wu
中华医学杂志英文版2022年 135卷 02期
DOI: 10.1097/CM9.0000000000001561
摘要
致编辑：由于血小板抗原，特别是血型抗原（如ABO抗原）、人白细胞抗原（HLA）、人血小板抗原（HPA）、CD36（血小板糖蛋白IV）具有免疫原性，可通过输血、妊娠、药物等免疫因素产生相应的同种抗体，患者血小板抗原和抗体的免疫反应会导致各种类型的同种免疫性血小板减少症，包括免疫性血小板输血难治性、输血后紫癜、胎儿/新生儿同种免疫性血小板减少症。[
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ruxolitinib治疗急性粒细胞白血病化疗过程中噬血细胞性淋巴组织细胞增多症的成功消退Yue Song, Jingshi Wang, Xinkai Wang, Yini Wang, Zhao Wang
中华医学杂志英文版2022年 135卷 02期
DOI: 10.1097/CM9.0000000000001559
摘要
致编辑：噬血细胞性淋巴组织细胞增多症（HLH）是一种严重甚至致命的炎症。恶性HLH（M-HLH）是继发性HLH（sHLH）最常见的类型之一，尤其是在成人中。HLH可以作为恶性疾病的初始表现（此处称为“恶性肿瘤触发的HLH”）或在化疗引起的医源性免疫抑制的情况下发生（“化疗期间的HLH”或Ch-HLH）。[
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血清皮质醇水平异常患者的凝血障碍Yifan Liu, Tianrui Yang, Yong Yao, Ming Feng, Mengyao Wan, Shanshan Feng, Xiaohai Liu, Kan Deng, Bing Xing, Lin Lu 等
中华医学杂志英文版2022年 135卷 02期
DOI: 10.1097/CM9.0000000000001567
摘要
致编辑：皮质醇与止血密切相关。[
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强光疗法对帕金森病非运动症状的治疗潜力Yun Shen, Siyi Gong, Yulu Liu, Jie Li, Kangping Xiong, Chengjie Mao, Yali Wang, Dan Li, Fen Wang, Hua Hu 等
中华医学杂志英文版2022年 135卷 02期
DOI: 10.1097/CM9.0000000000001732
摘要
致编辑：昼夜节律的改变似乎是帕金森病（PD）睡眠障碍、抑郁和其他非运动症状的偶然原因。[
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藏族患者活检证实的肾病综合征分析Rongshuang Huang, Jing Liu, Min Shi, Shenju Gou, Liang Ma, Ping Fu
中华医学杂志英文版2022年 135卷 02期
DOI: 10.1097/CM9.0000000000001721
摘要
致编辑：肾病综合征（NS）是一种常见的临床综合征，以大量蛋白尿和低白蛋白血症为特征，但从未在藏族人群中进行过研究。这是一项针对2009年至2016年在四川大学华西医院接受肾活检的藏族患者的单中心、回顾性研究。纳入了所有14岁以上的患者。排除标准为病理材料不足、移植肾活检和妊娠。根据世界卫生组织标准和组织学肾小球疾病分类方案定义肾脏病理特征。定量和定性数据分别表示为平均值±标准偏差和百分比。学生的t检验或Mann-Whitney检验分别用于比较参数或非参数连续变量。χ2和Fisher精确检验用于比较定性变量。所有统计数据均通过SPSS 23.0软件（SPSS Inc.，芝加哥，伊利诺伊州，美国）进行分析；P<0.05被认为具有统计学意义。
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代谢组学和转录组学的整合揭示了2型糖尿病衰老小鼠的主要代谢途径和潜在生物标志物Jie Meng, Jiajia Liu, Dongmei Chen, Dandan Li, Jing Wang
中华医学杂志英文版2022年 135卷 02期
DOI: 10.1097/CM9.0000000000001554
摘要
致编辑：衰老会引起人体代谢能力的变化[
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来那度胺在中国多发性骨髓瘤患者中的药代动力学及生物等效性评价Tiantao Gao, Xinghong Liu, Qi Shen, Zhu Luo, Ping Feng, Jia Miao, Li Zheng, Donglin Chen, Jin Xiang
中华医学杂志英文版2022年 135卷 02期
DOI: 10.1097/CM9.0000000000001695
摘要
致编辑：多发性骨髓瘤（MM）目前被认为是一种无法治愈的肿瘤和全身性疾病，一线治疗在MM患者中起着至关重要的作用，因为大多数患者在一线治疗后不能存活。[
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