中华内科杂志最新文献

{"title":"[Heat shock protein family A member 5 regulation of ferroptosis alleviates acute-phase mucosal injury in ulcerative colitis].","authors":"J X Yan, X Y Bai, H Liang, F R Zhang, Y L Miao, J K Niu","doi":"10.3760/cma.j.cn112138-20240924-00601","DOIUrl":"https://doi.org/10.3760/cma.j.cn112138-20240924-00601","url":null,"abstract":"<p><p><b>Objective:</b> This study aimed to investigate the role of heat shock protein family A member 5 (HSPA5) in ferroptosis at its regulatory mechanisms in ulcerative colitis (UC), using both a dextran sulfate sodium (DSS)-induced mouse model of acute colitis and in vitro cell experiments. <b>Methods:</b> Differentially expressed genes in UC were identified using the GSE87466 dataset from the Gene Expression Omnibus, cross-referenced with the ferroptosis-related gene database FerrDB (version 2). A protein-protein interaction (PPI) network was constructed, identifying HSPA5 as a core hub gene. To validate its role in vivo, acute colitis was induced in C57BL/6 mice using DSS, followed by treatment with the ferroptosis inhibitor Ferrostatin-1 (Fer-1). Lipid peroxidation and ferroptosis levels were assessed by measuring malondialdehyde (MDA) and iron content in colon tissues. The expression of ferroptosis-related proteins, including prostaglandin-endoperoxide synthase 2 (PTGS2), glutathione peroxidase 4 (GPX4), ferritin light chain (FTL), activating transcription factor 4 (ATF4), and HSPA5, in addition to tight junction proteins ZO-1 and Occludin, were evaluated using immunohistochemistry and Western blotting. In vitro, an inflammatory model was established using lipopolysaccharide (LPS)-stimulated Caco-2 cells. Lentiviral knockdown of HSPA5 was performed to assess its regulatory effects on ferroptosis by assessing MDA levels, GPX4 activity, and the expression of related proteins. Statistical analyses were conducted with SPSS (version 29.1), with <i>t</i>-tests or one-way ANOVA for normally distributed data and the Mann-Whitney <i>U</i> test for ordinal data. Statistical significance was set at <i>P</i><0.05. <b>Results:</b> Based on the PPI analysis and previous research, HSPA5 emerged as a key gene linking UC and ferroptosis. In DSS-treated mice, colonic injury was accompanied by elevated MDA levels (<i>t</i>=5.72, <i>P</i><0.001) and iron accumulation (<i>t</i>=6.32, <i>P</i><0.001). DSS also increased the expression of PTGS2 and proteins in the ATF4-HSPA5 pathway, while reducing the levels of GPX4, FTL, ZO-1, and Occludin. These findings could be partially reversed by Fer-1 (MDA: <i>t</i>=2.92, <i>P</i><0.05; iron: <i>t</i>=5.84, <i>P</i><0.001). In Caco-2 cells, LPS treatment elevated the expression of PTGS2, ATF4, and HSPA5, and elevated the MDA content (<i>t</i>=9.63, <i>P</i><0.001), while reducing the expression of FTL, GPX4, ZO-1, and Occludin, as well as GPX4 enzyme activity (<i>t</i>=-11.20, <i>P</i><0.001). Knockdown of HSPA5 further exacerbated these changes, significantly increasing MDA levels (<i>t</i>=4.15, <i>P</i><0.01), decreasing GPX4 activity (<i>t</i>=-9.81, <i>P</i><0.001), and altering ferroptosis-related protein expression. <b>Conclusion:</b> HSPA5 appears to protect against intestinal damage in UC by enhancing GPX4 expression and activity, thereby reducing ferroptosis and preserving epithelial barrier integrity through ","PeriodicalId":68309,"journal":{"name":"中华内科杂志","volume":"64 7","pages":"643-651"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144555900","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":"[National guidelines for the integrated management of obesity in primary care (2025)].","authors":"","doi":"10.3760/cma.j.cn112138-20250422-00231","DOIUrl":"https://doi.org/10.3760/cma.j.cn112138-20250422-00231","url":null,"abstract":"<p><p>Obesity is a significant public health problem in China. The development of a proactive and effective model to combat the obesity epidemic could alleviate the disease burden, improve population health, and ultimately support the achievement of the Healthy China goals. Obesity research has made significant progress domestically and internationally, resulting in continuous improvements in basic public health services within primary care. Therefore, the National Office of Basic Public Health Service Program for Primary Diabetes Care has organized experts to issue the National Guidelines for the Integrated Management of Obesity in Primary Care (2025). The aim of this guide is to assist primary care physicians with evidence-based recommendations for diagnosing and evaluating obesity, promoting standardized and integrated management for patients with obesity. It includes essential guidelines for patient management, an overview of obesity, diagnostic and evaluation criteria, integrated management strategies, and protocols for follow-up and referral.</p>","PeriodicalId":68309,"journal":{"name":"中华内科杂志","volume":"64 7","pages":"604-613"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144555904","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":"[Analysis of gastrointestinal tract symptoms and related factors in patients with Parkinson's disease].","authors":"X Y Cheng, S Qian, X L Lou, J Y Jin, J R Zhang, C J Mao, C F Liu","doi":"10.3760/cma.j.cn112138-20241121-00773","DOIUrl":"https://doi.org/10.3760/cma.j.cn112138-20241121-00773","url":null,"abstract":"&lt;p&gt;&lt;p&gt;&lt;b&gt;Objective:&lt;/b&gt; To observe the characteristics of gastrointestinal tract symptoms in patients with Parkinson's disease (PD) and analyze the characteristics of these symptoms in patients with different PD subtypes. &lt;b&gt;Methods:&lt;/b&gt; A total of 297 PD patients who were admitted to the Neurology Department of the Second Affiliated Hospital of Soochow University from November 2022 to March 2024 were enrolled. The gastrointestinal symptoms of PD patients were evaluated using Drooling Severity and Frequency Scale (DSFS), Sialorrhea Clinical Scale for Parkinson's disease (SCS-PD), Drooling Rating Scale (DRS), Eating Assessment Tool 10 (EAT-10), Gastroparesis Cardinal Symptom Index (GCSI), and Rome Ⅳ diagnostic criteria. The patients were grouped based on the presence or absence of gastrointestinal symptoms. Additionally, they were stratified according to disease duration (≤2 years, 2-5 years, 5-10 years, and&gt;10 years) and motor symptom subtype [tremor-dominant (TD) vs. postural instability and gait difficulty (PIGD)]. One-way ANOVA and logistic regression analysis were applied to examine between-group differences while Spearman correlation analysis was employed to assess correlations between clinical symptoms. &lt;b&gt;Results:&lt;/b&gt; The average age of the patients with PD was 67.0 (60.0, 72.0) years, and 161 (54.2%) were male. The incidence of PD combined with gastrointestinal symptoms was, in descending order: constipation (191, 64.3%), salivation (155, 52.2%), gastroparesis (93, 31.3%), and dysphagia (68, 22.9%). Compared with PD patients without gastrointestinal symptoms, those with symptoms had higher scores in the RBD-HK [12.0 (5.0, 21.5) vs. 5.0 (0.0, 9.0), &lt;i&gt;Z=&lt;/i&gt;-3.74, &lt;i&gt;P=&lt;/i&gt;0.017], ESS [6.0 (2.0, 12.0) vs. 3.0 (0.0, 6.0), &lt;i&gt;Z&lt;/i&gt;=-3.20, &lt;i&gt;P&lt;/i&gt;=0.023], and MDS-UPDRS Part Ⅰ [9.0 (5.0, 14.0) vs. 5.0 (2.3, 9.0), &lt;i&gt;Z&lt;/i&gt;=-3.61, &lt;i&gt;P&lt;/i&gt;=0.014]. The severity of sialorrhea and deglutition disorders, along with the incidence of constipation, all increased with longer disease duration. Patients with the PIGD subtype had higher GCSI scores than those with the TD subtype [0.0 (0.0, 1.9) vs. 0.0 (0.0, 0.0), &lt;i&gt;Z&lt;/i&gt;=-3.57, &lt;i&gt;P&lt;/i&gt;=0.007]. Across the cohort, sialorrhea, deglutition disorders, gastroparesis, and constipation were positively associated with the H-Y stage, MDS-UPDRS Ⅰ, HAMD, NMSQ, and SCOPA-AUT; EAT-10 scores were negatively correlated with MoCA (&lt;i&gt;r&lt;/i&gt;=-0.171, &lt;i&gt;P&lt;&lt;/i&gt;0.05); and GCSI scores were negatively correlated with MMSE and MoCA (&lt;i&gt;r&lt;/i&gt;=-0.154, &lt;i&gt;r&lt;/i&gt;=-0.169, both &lt;i&gt;P&lt;/i&gt;&lt;0.05). &lt;b&gt;Conclusions:&lt;/b&gt; Overall, 84.5% of the patients with PD had one or more gastrointestinal symptoms, and the incidence and severity of gastrointestinal symptoms increased with disease duration. The severity of gastroparesis was higher in the PIGD group than in the TD group. The scores of all gastrointestinal symptoms were positively correlated with the H-Y stage and MDS-UPDRS Ⅰ, while the GCSI scores were negatively correlated with the cogniti","PeriodicalId":68309,"journal":{"name":"中华内科杂志","volume":"64 7","pages":"635-642"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144555970","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":"[Immunomodulatory effects and research progresses of budesonide enteric-coated capsules in IgA nephropathy].","authors":"Q L Chen, J C Lyu","doi":"10.3760/cma.j.cn112138-20250403-00198","DOIUrl":"https://doi.org/10.3760/cma.j.cn112138-20250403-00198","url":null,"abstract":"","PeriodicalId":68309,"journal":{"name":"中华内科杂志","volume":"64 7","pages":"688-692"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144555901","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 and genetic characteristics of fibrocalculous pancreatic diabetes associated with SPINK1 gene mutations in a patient with type 1 diabetes].","authors":"W X Zhao, H Wang, B Huang, S W Li, K L Feng, J Q Cui, M Liu","doi":"10.3760/cma.j.cn112138-20241229-00867","DOIUrl":"https://doi.org/10.3760/cma.j.cn112138-20241229-00867","url":null,"abstract":"<p><p>To investigate the pathogenic mechanisms of a patient with type 1 diabetes mellitus (T1DM) complicated with fibrocalculous pancreatic diabetes at Tianjin Medical University General Hospital Airport Site in June 2024, clinical and genetic characteristic analyses were performed. Potential pathogenic genes were screened by whole-exome sequencing (WES), and Sanger sequencing validated the identified genetic variants within the family. The proband exhibited elevated blood glucose levels and positivity for tyrosine phosphatase antibodies, suggesting a diagnosis of T1DM. Multiple calcifications in the pancreas were observed in the proband. Genetic testing revealed that the proband carried two variants in the serine peptidase inhibitor Kazal type 1 (SPINK1) gene, namely, c.194+2T>C and c.-215G>A. According to the American College of Medical Genetics and Genomics (ACMG) guidelines, the c.194+2T>C mutation is preliminarily classified as pathogenic, while the c.-215G>A variant is classified as a variant of uncertain significance (VUS). Bioinformatics analysis indicated that the c.194+2T>C variant in the SPINK1 gene results in a truncated protein, affecting the three-dimensional structure and activity of the protein. This mutation is in complete linkage disequilibrium with the c.-215G>A variant, which may have a protective function and influence the clinical phenotype. Given that the patient also has T1DM and FCPD, there should be increased awareness of the co-occurrence of both types of diabetes to prevent misdiagnosis and underdiagnosis.</p>","PeriodicalId":68309,"journal":{"name":"中华内科杂志","volume":"64 7","pages":"675-679"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144555972","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":"[Multidisciplinary expert consensus on ultrasound-guided thermal ablation for non-lactating mastitis (2025 edition)].","authors":"","doi":"10.3760/cma.j.cn112138-20241206-00804","DOIUrl":"https://doi.org/10.3760/cma.j.cn112138-20241206-00804","url":null,"abstract":"<p><p>Non-lactational mastitis is a group of benign, non-specific inflammatory diseases with unknown causes that occur in non-lactating women. The main treatment methods are medication and surgery, but both of these methods have certain limitations and cannot meet the individualized needs of patients. In recent years, thermal ablation technology has been widely used in clinical practice, with significant progress in the treatment and research of breast diseases, especially in the exploratory treatment of non-lactating mastitis, where it has achieved certain therapeutic effects. However, the use of thermal ablation technology in the treatment of non-lactational mastitis is still in its infancy and development stage. In order to standardize development and clinical practice protocols, Interventional Ultrasound Committee of Chinese College of Interventionalists,Tumor Ablation Committee of Chinese College of Interventionalists,The Society of Tumor Ablation Therapy of the Chinese Anti-Cancer Association,and The Ablation Expert Committee of the Chinese Society of Clinical Oncology(CSCO) organized a group of some domestic experts in the field of breast disease ablation treatment. Subsequently, based on the latest research progress and considering the actual clinical situation in China, these experts formulated the \"Multidisciplinary expert consensus on ultrasound-guided thermal ablation for non-lactating mastitis (2025 edition)\" which primarily covers (1) epidemiological and clinical characteristics; (2) diagnosis and staging; (3) operating procedures, indications, contraindications, and related complications of thermal ablation technology; and (4) efficacy evaluation and postoperative follow-up.</p>","PeriodicalId":68309,"journal":{"name":"中华内科杂志","volume":"64 7","pages":"625-634"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144555903","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":"[OPACCUS standard workflow for shock integrated with critical care ultrasound visualization].","authors":"Y Li, X T Wang, M G Yin","doi":"10.3760/cma.j.cn112138-20241106-00732","DOIUrl":"https://doi.org/10.3760/cma.j.cn112138-20241106-00732","url":null,"abstract":"","PeriodicalId":68309,"journal":{"name":"中华内科杂志","volume":"64 7","pages":"597-603"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144555905","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":"[Effects of allergens on the expression levels of interleukin 18, interleukin 18 binding protein a and interleukin 18 receptor α in the blood monocyte subtypes of patients with allergic asthma].","authors":"H B Wang, H Z Shao, X Dong, Y J Zhang, C Y Zhao, S H Liu, J Z Pan, B Y Qin, J L Wang","doi":"10.3760/cma.j.cn112138-20241212-00821","DOIUrl":"https://doi.org/10.3760/cma.j.cn112138-20241212-00821","url":null,"abstract":"&lt;p&gt;&lt;p&gt;&lt;b&gt;Objective:&lt;/b&gt; To assess the effects of allergens on interleukin-18 (IL-18), IL-18 binding protein a (IL-18BPa), and IL-18 receptor α (IL-18Rα) expression levels in different monocyte subtypes of the peripheral blood samples of allergic asthma (AA) patients, and the correlations between the percentage of IL-18&lt;sup&gt;+&lt;/sup&gt;classical monocytes and plasma levels of pro-inflammatory cytokines. &lt;b&gt;Methods:&lt;/b&gt; A cross-sectional study. Blood samples were collected from 28 healthy controls and 33 patients experiencing acute attack of AA based on a positive skin prick test of Henan Provincial People's Hospital from February 2023 to April 2024. Flow cytometry was used to assess the effects of allergens on IL-18, IL-18BPa, and IL-18Rα expression levels in the classical, intermediate, and non-classical monocytes of the peripheral blood samples of AA patients. Kruskal-Wallis test and Pairwise test were used to analyze statistical significance between groups. Plasma tumor necrosis factor α (TNF-α) and interleukin 1β (IL-1β) levels were estimated using Bioplex assays. Pearson correlation test was used to determine the association between the percentage of IL-18&lt;sup&gt;+&lt;/sup&gt;classical monocytes and the plasma levels of IL-1β and TNF-α. &lt;b&gt;Results:&lt;/b&gt; Compared with healthy controls, the percentages of classical and non-classical monocytes in the peripheral blood of AA patients were reduced by 20.2% (&lt;i&gt;Z&lt;/i&gt;=-3.89, &lt;i&gt;P&lt;/i&gt;&lt;0.001) and 45.8% (&lt;i&gt;Z&lt;/i&gt;=-4.01, &lt;i&gt;P&lt;/i&gt;&lt;0.001), respectively. Allergens increased the percentages of classical, intermediate, and non-classical monocytes in AA patients &lt;i&gt;in vitro&lt;/i&gt; by 13.1%-61.5% (all &lt;i&gt;P&lt;/i&gt;&lt;0.05). Compared with healthy controls, the percentages of IL-18 expression in classical monocytes of AA patients was elevated by 1.08-fold (&lt;i&gt;Z&lt;/i&gt;=-6.40, &lt;i&gt;P&lt;/i&gt;&lt;0.001), whereas the percentages of IL-18 expression in intermediate and non-classical monocytes were reduced by 52.7% (&lt;i&gt;Z&lt;/i&gt;=-6.40, &lt;i&gt;P&lt;/i&gt;&lt;0.001) and 3.23% (&lt;i&gt;Z&lt;/i&gt;=-3.13, &lt;i&gt;P&lt;/i&gt;=0.001), respectively. Allergens upregulated IL-18 expression by 16.4%-67.8% in the classical and intermediate monocytes of AA patients (all &lt;i&gt;P&lt;/i&gt;&lt;0.05). Compared with healthy controls, IL-18BPa expression level was lower in the three monocyte subtypes of AA patients (all &lt;i&gt;P&lt;/i&gt;&lt;0.05). However, allergens upregulated IL-18BPa expression by 8.9% and 13.3% in the classical monocytes (both &lt;i&gt;P&lt;/i&gt;&lt;0.05). Compared with healthy controls, IL-18Rα expression was elevated by 1.29-fold in the classical monocytes of AA patients (&lt;i&gt;Z&lt;/i&gt;=-6.40, &lt;i&gt;P&lt;/i&gt;&lt;0.001). Allergens upregulated IL-18Rα expression by 17.6%-39.2% in the three monocyte subtypes of AA patients (all &lt;i&gt;P&lt;/i&gt;&lt;0.05). Plasma levels of IL-1β and TNF-α in the AA patients were increased compared to those in healthy controls (all &lt;i&gt;P&lt;/i&gt;&lt;0.001), and correlated with the percentage of IL-18&lt;sup&gt;+&lt;/sup&gt;classical monocytes (&lt;i&gt;r&lt;/i&gt;=0.451, 0.714; both &lt;i&gt;P&lt;/i&gt;&lt;0.05). &lt;b&gt;Conclusions:&lt;/b&gt; Allergens may participate in the inflamm","PeriodicalId":68309,"journal":{"name":"中华内科杂志","volume":"64 7","pages":"660-669"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144555898","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 and endoscopic features of autoimmune gastritis with gastric neoplastic lesions].","authors":"S Lei, X G Liu, Y Pan, C P Gao, L P Li, Y Hu, P Wang","doi":"10.3760/cma.j.cn112138-20241008-00660","DOIUrl":"https://doi.org/10.3760/cma.j.cn112138-20241008-00660","url":null,"abstract":"&lt;p&gt;&lt;p&gt;&lt;b&gt;Objective:&lt;/b&gt; Autoimmune gastritis (AIG) is characterized by the loss of acid-secreting glands, resulting in hypochlorhydria and hypergastrinemia, conditions that significantly increase the risk of developing gastric neuroendocrine tumors (NETs) and gastric adenocarcinoma. In recent years, AIG has garnered increasing attention in both clinical and research settings. However, comprehensive studies on the clinical and endoscopic characteristics of AIG particularly cases complicated by gastric neoplastic lesions remain limited in China. This study aims to comprehensively summarize the clinical and endoscopic features of AIG and its associated gastric neoplastic lesions. &lt;b&gt;Methods:&lt;/b&gt; A retrospective analysis was conducted using medical records from patients with AIG diagnosed at Sichuan Provincial People's Hospital between 2019 and 2024. Data collected included demographic information, medical history, serological test results, imaging findings, and endoscopic observations. The clinical and endoscopic features of AIG patients with gastric NETs or epithelial-derived tumors were compared to those without gastric neoplastic lesions to identify potential risk factors and diagnostic indicators for tumor development in AIG. &lt;b&gt;Results:&lt;/b&gt; A total of 72 patients with AIG were included, of whom 62.5% (45/72) were female, with an age range of 30 to 79 years old (mean age: 57±11 years). Parietal cell antibody (PCA) positivity was observed in 93.1% (67/72), intrinsic factor antibody (IFA) positivity in 45.8% (33/72), and &lt;i&gt;Helicobacter pylori&lt;/i&gt; (&lt;i&gt;H&lt;/i&gt;. &lt;i&gt;pylori&lt;/i&gt;) co-infection in 48.6% (35/72). Endoscopically, 84.7% (61/72) showed prominent corpus-dominant advanced atrophy; 47.2% (34/72) had sticky adherent mucus; and 41.7% (30/72) displayed residual oxyntic mucosa in the gastric body or fundus. Only 23.6% (17/72) had normal antrum mucosa, and just 16.7% (12/72) showed a circular wrinkle-like pattern. Gastric neoplastic lesions were identified in 35 patients (48.6%), including 15 cases (20.8%) with NETs and 20 cases (27.8%) with epithelial-derived tumors (four adenocarcinomas, three adenomas, and 13 cases of intraepithelial neoplasia). No significant differences were found between tumor and non-tumor groups in terms of age, gender, PCA/IFA positivity, gastrin levels, anemia status, folic acid, or serum iron levels. However, patients with NETs had significantly lower vitamin B&lt;sub&gt;12&lt;/sub&gt; levels compared to those without tumors (183±111 ng/L vs. 323±159 ng/L, &lt;i&gt;t&lt;/i&gt;=2.47, &lt;i&gt;P&lt;/i&gt;=0.042). Additionally, AIG patients with NETs were more likely to be &lt;i&gt;H.&lt;/i&gt; &lt;i&gt;pylori&lt;/i&gt;-negative compared to both the non-tumor group (66.7% vs. 35.1%, &lt;i&gt;χ&lt;/i&gt;&lt;sup&gt;2&lt;/sup&gt;&lt;i&gt;=&lt;/i&gt;5.26, &lt;i&gt;P&lt;/i&gt;=0.072) and the epithelial-derived tumor group (66.7% vs. 30.0%, &lt;i&gt;χ&lt;/i&gt;&lt;sup&gt;2&lt;/sup&gt;=5.80, &lt;i&gt;P=&lt;/i&gt;0.055). The incidence of reverse atrophy in the epithelial-derived tumor group was significantly lower than that in the non-tumor group (65.0% vs. 91.9%, &lt;i&gt;χ&lt;/i&gt;&lt;su","PeriodicalId":68309,"journal":{"name":"中华内科杂志","volume":"64 7","pages":"652-659"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144555971","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":"[Multidisciplinary expert consensus on thermal ablation for benign thyroid diseases, low-risk thyroid carcinoma, and metastatic cervical lymph nodes (2025 edition)].","authors":"","doi":"10.3760/cma.j.cn112138-20250210-00076","DOIUrl":"https://doi.org/10.3760/cma.j.cn112138-20250210-00076","url":null,"abstract":"<p><p>Thermal ablation has proven an effective treatment modality for certain thyroid diseases. However, its indications remain the subject of significant debate both domestically and internationally. Over recent years, several international academic organizations have issued consensus statements, position papers, and guidelines concerning thyroid thermal ablation. In China, the Chinese College of Interventionalists (CCI), in collaboration with other relevant academic organizations, released the \"Expert consensus on thermal ablation for thyroid benign nodes, microcarcinoma and metastatic cervical lymph nodes (2018 edition)\". This consensus statement received widespread recognition within the field and contributed significantly to the standardization of thyroid thermal ablation therapy in China. With the continuous accumulation of evidence-based medical data, the need for a more stringent and standardized approach to thyroid thermal ablation has become evident. Accordingly, the Interventional Ultrasound Committee of the CCI, in collaboration with multiple academic organizations and experts, conducted extensive discussions and multiple revisions before finalizing the \"Multidisciplinary expert consensus on thermal ablation for benign thyroid diseases, low-risk thyroid carcinoma, and metastatic cervical lymph nodes (2025 edition)\". This updated consensus builds on the framework of the 2018 edition, refining indications and contraindications, emphasizing standardized treatment, and outlining future directions for research and clinical applications of thyroid thermal ablation technology.</p>","PeriodicalId":68309,"journal":{"name":"中华内科杂志","volume":"64 7","pages":"614-624"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144555902","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}