Zhonghua nei ke za zhi最新文献

{"title":"[Recommendations for the diagnosis and treatment of Sjögren's syndrome in China].","authors":"W Zhang,&nbsp;Z Chen,&nbsp;X M Li,&nbsp;J Gao,&nbsp;Y Zhao","doi":"10.3760/cma.j.cn112138-20221027-00797","DOIUrl":"https://doi.org/10.3760/cma.j.cn112138-20221027-00797","url":null,"abstract":"<p><p>Sjögren's syndrome (SS) is a chronic systemic autoimmune disease characterized by lymphocyte proliferation and progressive exocrine gland damage. In addition to the impairment of salivary and lacrimal gland function, SS can present with multi-system and multi-organ involvement, accompanied by autoantibodies in serum and hyperimmunoglobulinemia. SS can be divided into primary and secondary forms based on the absence or presence, respectively, of concurrent connective tissue diseases such as systemic lupus erythematosus and rheumatoid arthritis. Based on evidence and guidelines from China and other countries, the Chinese Rheumatology Association drafted standardized criteria for the diagnosis and treatment of primary SS. The objectives were to standardize the detection and interpretation of key indicators for the diagnosis of SS, including serum anti-SSA antibody and labial gland pathology, suggest the use of the widely accepted European League Against Rheumatism (EULAR)-SS disease activity index for the evaluation of the disease, and standardize the rational management of SS patients with topical and systemic therapies.</p>","PeriodicalId":24000,"journal":{"name":"Zhonghua nei ke za zhi","volume":"62 9","pages":"1059-1067"},"PeriodicalIF":0.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10118779","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Pancreatic β cell regeneration: the opportunities and challenges in diabetes therapies].","authors":"J Li,&nbsp;R Wei,&nbsp;T P Hong","doi":"10.3760/cma.j.cn112138-20230309-00144","DOIUrl":"https://doi.org/10.3760/cma.j.cn112138-20230309-00144","url":null,"abstract":"恢复功能性胰岛β细胞数量（β细胞再生）是治疗糖尿病的重要策略。诱导干细胞定向分化、促进体细胞重编程、修复原有β细胞表型和功能是促进β细胞再生的重要路径，有望改变糖尿病的自然病程。然而，目前大多数干预方案面临β细胞再生效率低、难以获得功能完全成熟的β细胞、安全性尚待检验等挑战，未来需要进一步优化干预方案，并积累高质量的临床研究证据。.","PeriodicalId":24000,"journal":{"name":"Zhonghua nei ke za zhi","volume":"62 9","pages":"1046-1051"},"PeriodicalIF":0.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10127995","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[The effect of subclinical hypercortisolism on bone metabolism].","authors":"L P Ren,&nbsp;H Chen,&nbsp;T Zhang,&nbsp;Q Pan","doi":"10.3760/cma.j.cn112138-20230207-00065","DOIUrl":"https://doi.org/10.3760/cma.j.cn112138-20230207-00065","url":null,"abstract":"近年，随着影像学检查的进展及普及，肾上腺意外瘤（AI）的诊断率逐渐增多，随之发现有功能的AI中最为常见的是亚临床皮质醇增多症（SH）。SH患者无典型的库欣综合征症状及体征，但长期轻微过量的皮质醇增多也可引起糖脂代谢紊乱、心血管事件发生率增高及骨代谢异常。本文主要就AI所致SH患者的骨密度变化、骨折发生及机制进行综述。.","PeriodicalId":24000,"journal":{"name":"Zhonghua nei ke za zhi","volume":"62 9","pages":"1135-1138"},"PeriodicalIF":0.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10128002","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Recommendations for the diagnosis and treatment of rheumatic fever in China].","authors":"J R Gu,&nbsp;Z M Lin,&nbsp;Y L Wang,&nbsp;L Li,&nbsp;P T Yang,&nbsp;Y Zhao","doi":"10.3760/cma.j.cn112138-20221029-00802","DOIUrl":"https://doi.org/10.3760/cma.j.cn112138-20221029-00802","url":null,"abstract":"<p><p>Rheumatic fever is an autoimmune disease characterized by recurring acute or chronic systemic connective tissue inflammation caused by group A streptococcal infection in the throat. Although rheumatic fever is common in China, there is a lack of standardized criteria for the diagnosis and treatment of this condition. Based on evidence and guidelines from China and other countries, the Chinese Rheumatology Association developed standardized criteria for the diagnosis and treatment of this disease in China. The aim was to standardize rheumatic fever diagnosis methods, treatment opportunities, and strategies for both short-and long-term treatment, so as to reduce irreversible damage and improve prognosis.</p>","PeriodicalId":24000,"journal":{"name":"Zhonghua nei ke za zhi","volume":"62 9","pages":"1052-1058"},"PeriodicalIF":0.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10127998","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Application of the Chinese Expert Consensus on Diabetes Classification in clinical practice].","authors":"S T Yang,&nbsp;C Deng,&nbsp;B B He,&nbsp;X Chen,&nbsp;X Li,&nbsp;Z G Zhou","doi":"10.3760/cma.j.cn112138-20230131-00043","DOIUrl":"https://doi.org/10.3760/cma.j.cn112138-20230131-00043","url":null,"abstract":"<p><p><b>Objective:</b> To evaluate the diagnostic for classification of newly diagnosed diabetes patients and assess the application of the screening tests recommended by the 2022 Chinese Expert Consensus on Diabetes Classification. <b>Methods:</b> Retrospective case series study. The data from the electronic medical record system of patients with new-onset diabetes mellitus (within 1 year of disease onset) who attending the Diabetes Specialist Outpatient Clinic at the Second Xiangya Hospital of Central South University from January 1, 2018 to December 31, 2021 were collected for the analysis. Based on the consensus, patients were categorized according their age of onset, body mass index (BMI), and suspicion of type 1 diabetes mellitus (T1DM). The chi-square statistic was used to compare key classifier indicators, including C-peptide, islet autoantibodies, and genetic markers, in the subgroups. The diagnosis in suspected T1DM patients was also evaluated. The screening strategy recommended in the consensus was further assessed using a logistic regression model and the area under the receiver-operating curve (AUC). <b>Results:</b> A total of 3 384 patients with new-onset diabetes were included. The average age of disease onset was (46.3±13.9) years, and 61.0% (2 065/3 384) of the patients were male. The proportions of patients who completed C-peptide and glutamic acid decarboxylase antibody (GADA) tests were 36.6% (1 238/3 384) and 37.5% (1 269/3 384), respectively. There were no significant differences in C-peptide test results among the subgroups (all <i>P</i>>0.05). In contrast, the GADA detection rate was higher in patients with young age of onset (<30 years old), in those who were non-obese (BMI<24 kg/m²), and in those clinically suspected of T1DM (all <i>P</i><0.05). According to the diagnostic pathway proposed by the consensus, only 57.4% (1 941/3 384) of patients could be subtyped. For a definitive diagnosis, the remaining patients needed completion of C-peptide, islet autoantibody, genetic testing, or follow-up. Furthermore, among patients with clinical features of suspected T1DM, the antibody positivity rate was higher than in non-suspected T1DM patients [24.5% (154/628) vs. 7.1% (46/646), <i>P</i><0.001]. When the clinical features of suspected T1DM defined in the consensus were taken as independent variables and antibody positivity was considered the outcome variable in the logistic regression model, young onset, non-obese onset, and ketosis onset could enter the model. Based on AUC analysis, the accuracy of the diagnostic model was 0.77 (95%<i>CI</i> 0.73-0.81), suggesting that the clinical features of suspected T1DM in the consensus have good clinical diagnostic value for this patient subgroup. <b>Conclusions:</b> There was a significant discrepancy between the clinical practice of diabetes classification and the process recommended by the consensus, which was specifically reflected in the low proportions of both subtyping","PeriodicalId":24000,"journal":{"name":"Zhonghua nei ke za zhi","volume":"62 9","pages":"1085-1092"},"PeriodicalIF":0.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10127509","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Clinical characteristics of sudden sensorineural hearing loss with acute cerebral infarction].","authors":"H Y Li,&nbsp;Y Wang,&nbsp;Y P Tong,&nbsp;M Y Zhang,&nbsp;Y Ju,&nbsp;Y Xia","doi":"10.3760/cma.j.cn112138-20230405-00184","DOIUrl":"https://doi.org/10.3760/cma.j.cn112138-20230405-00184","url":null,"abstract":"<p><p><b>Objective:</b> To analyze the clinical and imaging features of patients with sudden sensorineural deafness and acute cerebral infarction in order to provide evidence for early recognition of such diseases. <b>Methods:</b> This was a case series reporting study. A retrospective analysis was performed on the clinical and imaging data of 29 patients with sudden hearing loss (SHL) who admitted to the Otolaryngology Head and Neck Surgery Department of Beijing Tiantan Hospital from January 2017 to December 2021 and diagnosed with acute cerebral infarction using MRI-DWI. <b>Results:</b> The patients were aged 31-71 years, with an average age of 56±12 years, and 82.8% (24/29) were men. In total, 82.8% (24/29) of the patients had three or more atherosclerotic risk factors, and 24.1% (7/29) had a history of SHL. The hearing types were flat and total deafness: 86.2% (25/29) of the patients had severe hearing loss, 27.6% (8/29) had bilateral SHL, 17.2% (5/29) had further hearing loss during hospitalization, and 82.8% (24/29) had dizziness or vertigo at the onset. The signs of central nervous system involvement mainly included speech impairment, diplopia, dysphagia, central facial paralysis, facial and limb hypoesthesia, ataxia, and decreased muscle strength. Imaging evaluation showed that 21 cases were located in the posterior circulation supply area and 8 cases in the anterior circulation supply area. Additionally, 82.8% (24/29) patients had vertebrobasilar artery stenosis, and 58.6% (17/29) patients had severe vertebrobasilar artery stenosis or occlusion. <b>Conclusions:</b> Patients with SHL who progress to cerebral infarction often have multiple atherosclerotic risk factors and SHL. Most of the patients are middle-aged and older men who often complain of dizziness or dizziness accompanied by severe flat and total deafness with unilateral or bilateral SHL. Imaging findings suggest that most patients have posterior circulation infarction, often accompanied by severe stenosis or occlusion of the vertebrobasilar artery.</p>","PeriodicalId":24000,"journal":{"name":"Zhonghua nei ke za zhi","volume":"62 9","pages":"1121-1125"},"PeriodicalIF":0.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10116683","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Advances in the diagnosis and treatment of invasive fungal disease in HIV-infected patients].","authors":"M L Zhou,&nbsp;L Zhang,&nbsp;T S Li,&nbsp;Z Y Liu","doi":"10.3760/cma.j.cn112138-20221008-00737","DOIUrl":"https://doi.org/10.3760/cma.j.cn112138-20221008-00737","url":null,"abstract":"侵袭性真菌病是HIV/AIDS患者机会性感染和死亡的主要原因。近2年来国内外多部关于HIV/AIDS感染者侵袭性真菌病诊断与治疗的指南与共识相继发布，真菌病原学诊断、抗原抗体检测、分子生物学检测方法均取得了新的进展。治疗方面，国内外对于念珠菌病、隐球菌病、肺孢子菌肺炎等HIV/AIDS患者不同类型侵袭性真菌病的治疗方案求同存异，新型抗真菌药物的研发及抗逆转录病毒疗法的优化也进一步推动了侵袭性真菌病诊疗的进步。本研究针对HIV/AIDS患者侵袭性真菌病相关的诊断及治疗进展予以综述，以期为临床诊疗工作提供参考。.","PeriodicalId":24000,"journal":{"name":"Zhonghua nei ke za zhi","volume":"62 9","pages":"1148-1154"},"PeriodicalIF":0.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10128001","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Stem cell therapy in diabetes: a promising future].","authors":"Y P Wang,&nbsp;L Zang,&nbsp;Y M Mu","doi":"10.3760/cma.j.cn112138-20230626-00332","DOIUrl":"https://doi.org/10.3760/cma.j.cn112138-20230626-00332","url":null,"abstract":"干细胞以其自我更新和多向分化的生物学优势，通过免疫调节功能、组织修复功能及分化功能，在糖尿病的治疗中展现出良好的应用前景。间充质干细胞移植对1型和2型糖尿病患者有一定疗效，但临床结果不能令人满意，需要提高间充质干细胞体内存活时间及疗效。干细胞诱导分化的胰岛素分泌细胞为胰岛衰竭型糖尿病的治疗提供了理想的胰岛细胞补充来源，但免疫排斥及安全性问题仍是干细胞诱导分化的胰岛素分泌细胞应用中面临的主要问题，尚需开展临床研究探索其有效性及安全性。.","PeriodicalId":24000,"journal":{"name":"Zhonghua nei ke za zhi","volume":"62 9","pages":"1039-1042"},"PeriodicalIF":0.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10125562","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[A novel approach for the treatment of type 1 diabetes mellitus: transplantation of pancreatic islets derived from human chemically induced pluripotent stem cells].","authors":"Y Y Du,&nbsp;H K Deng","doi":"10.3760/cma.j.cn112138-20230713-00365","DOIUrl":"https://doi.org/10.3760/cma.j.cn112138-20230713-00365","url":null,"abstract":"基于人多能干细胞的再生医学为1型糖尿病的治疗带来了全新的可能。人多能干细胞具备无限的增殖潜能和向人体任何细胞分化的潜能，通过定向分化技术，可以利用人多能干细胞在体外大规模制备人胰岛细胞，用于糖尿病的细胞替代治疗。.","PeriodicalId":24000,"journal":{"name":"Zhonghua nei ke za zhi","volume":"62 9","pages":"1043-1045"},"PeriodicalIF":0.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10127996","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Recommendations for the diagnosis and treatment of gout in China].","authors":"D Xu,&nbsp;X X Zhu,&nbsp;H J Zou,&nbsp;H Lin,&nbsp;Y Zhao","doi":"10.3760/cma.j.cn112138-20221027-00796","DOIUrl":"https://doi.org/10.3760/cma.j.cn112138-20221027-00796","url":null,"abstract":"<p><p>Gout is a metabolic disease resulting from the accumulation of monosodium urate (MSU) in joints, leading to crystal-induced arthritis. In China, gout is common, but there is insufficient knowledge regarding standardized criteria for the diagnosis and treatment of this condition. Based on evidence and guidelines from China and other countries, the Chinese Rheumatology Association developed standardized criteria for the diagnosis and treatment of gout in China. The purpose was to standardize gout diagnosis methods as well as treatment opportunities and strategies in order to reduce misdiagnosis, missed diagnosis, and irreversible damage.</p>","PeriodicalId":24000,"journal":{"name":"Zhonghua nei ke za zhi","volume":"62 9","pages":"1068-1076"},"PeriodicalIF":0.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10118774","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}