中华内科杂志最新文献

[A case of primary biliary cholangitis combined with autoimmune pancreatitis and autoimmune gastritis].

中华内科杂志 Pub Date : 2025-03-01 DOI: 10.3760/cma.j.cn112138-20240930-00622

X Y Huang, C Zhou, L Lei, Y Hu, L P Li, D Zhang

引用次数: 0

[Autoimmune diseases of digestive system: challenges and opportunities].

中华内科杂志 Pub Date : 2025-03-01 DOI: 10.3760/cma.j.cn112138-20250122-00055

Y L Shang, Y Han

引用次数: 0

[Characteristics and prognosis of patients with primary sclerosing cholangitis].

中华内科杂志 Pub Date : 2025-03-01 DOI: 10.3760/cma.j.cn112138-20241008-00663

S Chen, T T Meng, W J Duan, S X Li, T T Lyu, Y Wang, J D Jia, Y Y Kong, H You

{"title":"[Characteristics and prognosis of patients with primary sclerosing cholangitis].","authors":"S Chen, T T Meng, W J Duan, S X Li, T T Lyu, Y Wang, J D Jia, Y Y Kong, H You","doi":"10.3760/cma.j.cn112138-20241008-00663","DOIUrl":"https://doi.org/10.3760/cma.j.cn112138-20241008-00663","url":null,"abstract":"Objective: Primary sclerosing cholangitis (PSC) is a rare autoimmune disease. This study aims to describe the baseline characteristics and clinical outcomes of Chinese PSC patients and explore risk factors associated with prognosis, addressing the lack of long-term prognostic analysis in China. Methods: Clinical data of PSC patients were retrospectively collected from May 2009 to June 2023 in Beijing Friendship Hospital Affiliated to Capital Medical University, and patient follow-up was conducted through outpatient visits, telephone calls, and medical record reviews. The Cox proportional hazards model and the Kaplan-Meier method were employed to identify risk factors and estimate transplant-free survival. Results: A total of 65 PSC patients were enrolled, with male patients accounting for 50.8% and an average age of onset of 44 years. The disease types primarily included large duct PSC (57.9%) and whole duct PSC (22.8%). Most patients (78.5%) sought medical attention due to symptoms, with common clinical manifestations including jaundice (32.3%), fatigue (23.1%), abdominal discomfort (21.5%), pruritus (16.9%), and fever (10.8%). A total of 19 patients (29.2%) had concomitant ulcerative colitis. Compared to large duct PSC or whole duct PSC, small duct PSC showed a lower proportion of concomitant ulcerative colitis (P<0.001) and milder baseline disease severity. After a median follow-up of 29 months (interquartile range: 11,53), 19 patients experienced liver transplantations and/or liver disease-related deaths. The overall 2-year and 5-year transplant-free survival rates for PSC patients were 76.0% and 59.5%, respectively. Elevated bile acid levels were identified as an independent risk factor for poor outcomes in PSC patients. Conclusion: The study population of Chinese PSC patients predominantly consisted of middle-aged males, characterized by a low ratio of asymptomatic cases, a low incidence of associated inflammatory bowel disease, and a low rate of transplant-free survival. Elevated bile acid level was identified as an independent risk factor for poor outcomes in PSC patients.","PeriodicalId":68309,"journal":{"name":"中华内科杂志","volume":"64 3","pages":"206-211"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143574656","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}

引用次数: 0

[Diagnosis and treatment of serum IgG₄-negative type 1 autoimmune pancreatitis].

中华内科杂志 Pub Date : 2025-03-01 DOI: 10.3760/cma.j.cn112138-20240925-00605

C X Liu, X D Zhang, Y Zhang, X N Shen, C H Zhou, D W Zou

引用次数: 0

[Hot topic:selection of core needle versus fine needle for ultrasound-guided biopsy of thyroid nodules and cervical lymph nodes].

中华内科杂志 Pub Date : 2025-03-01 DOI: 10.3760/cma.j.cn112138-20241126-00780

H L Li, J J Ma, T T Zhou, S H Zhang, J Zhai, B Zhang

引用次数: 0

[Progress in the treatment of primary sclerosing cholangitis].

中华内科杂志 Pub Date : 2025-03-01 DOI: 10.3760/cma.j.cn112138-20241007-00656

T T Lyu, W J Duan, S X Li, S Chen, J D Jia, H You

引用次数: 0

[A rare case of celiac disease concurrent with ultra-long segment esophageal cancer].

中华内科杂志 Pub Date : 2025-03-01 DOI: 10.3760/cma.j.cn112138-20240930-00641

T Shi, Z Q Li, Ayinuer Maimaitireyimu, Halinan Halike, J Ma, F Gao

引用次数: 0

[Clinical characteristics of adult patients with eosinophilic esophagitis in China].

中华内科杂志 Pub Date : 2025-03-01 DOI: 10.3760/cma.j.cn112138-20241010-00670

J H Hu, X Y Zhou, F Yu, C F Xu, Z Shen, H Ma

{"title":"[Clinical characteristics of adult patients with eosinophilic esophagitis in China].","authors":"J H Hu, X Y Zhou, F Yu, C F Xu, Z Shen, H Ma","doi":"10.3760/cma.j.cn112138-20241010-00670","DOIUrl":"https://doi.org/10.3760/cma.j.cn112138-20241010-00670","url":null,"abstract":"Objective: Eosinophilic esophagitis (EoE), an allergen/immune-mediated chronic disorder of the esophagus, is witnessing an incremental rise in its global incidence. However, data in China are very limited. This study aimed to clarify the characteristics of EoE in Chinese adults at our medical center. Methods: We collected information, including clinical characteristics and endoscopic findings, relative to all cases of adult patients who met the pathological diagnostic criteria for EoE at our institution from January 2019 to May 2024. Patients diagnosed with reflux esophagitis (RE) were matched in a 1∶1 ratio based on age and sex, and comparisons were made between the two groups. Results: The overall detection rate of EoE in our hospital was approximately 0.05%, with a trend increasing yearly. In total, 61 patients met the diagnostic criteria for EoE, of whom 42 (68.9%) were male. The median age was 53 years. The clinical manifestations of EoE patients were diverse, with common symptoms including dysphagia, acid reflux, and upper abdominal pain. Serological examination revealed that 23.1% (9/39) of patients had increased absolute eosinophil counts. Allergic diseases were observed in 73.8% (45/61) patients. Most patients exhibited typical mucosal changes in the esophagus during endoscopy, the median EREFS score was 3 points. The most commonly administered treatment included proton pump inhibitors, and 13 patients received steroid treatment. During a follow-up period, 42 patients (68.9%) exhibited clinical symptom improvement or pathological remission. In comparison to Western countries, patients with EoE in China typically presented with milder disease severity and a more favorable prognosis. No significant differences were observed between younger and older adult groups regarding clinical symptoms, the proportion of comorbid allergic diseases, medications, or the rate of improvement (P for all>0.05). Additionally, patients with EoE more commonly presented with dysphagia (29.5% vs. 1.6%, χ2=15.96, P<0.001), comorbid allergic diseases (73.8% vs. 13.1%, χ2=45.67, P<0.001), increased eosinophil counts (23.1% vs. 3.3%, χ2=7.61, P<0.01), and a positive response to corticosteroids when compared to patients with RE. Conclusions: This study systematically determined the clinical characteristics of adult EoE patients in China. Compared to Western countries, patients from China typically presented with milder disease severity and a more favorable prognosis. No significant clinical manifestations or prognosis differences were observed between younger and older patients. EoE can be differentiated from RE based on symptoms, the presence of comorbid allergic diseases, and the degree of serum eosinophil infiltration. For patients suspected of EoE, endoscopic esophageal biopsy will facilitate early diagnosis.","PeriodicalId":68309,"journal":{"name":"中华内科杂志","volume":"64 3","pages":"212-219"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143574744","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}

引用次数: 0

[Mendelian randomization study on the causal relationship between type 2 diabetes and osteoporosis].

中华内科杂志 Pub Date : 2025-03-01 DOI: 10.3760/cma.j.cn112138-20241108-00743

H Yu, Z B Li, F Hu, N Li, Y H Lu, C L Li

{"title":"[Mendelian randomization study on the causal relationship between type 2 diabetes and osteoporosis].","authors":"H Yu, Z B Li, F Hu, N Li, Y H Lu, C L Li","doi":"10.3760/cma.j.cn112138-20241108-00743","DOIUrl":"https://doi.org/10.3760/cma.j.cn112138-20241108-00743","url":null,"abstract":"Objective: To analyze the causal relationship between type 2 diabetes and lumbar bone mineral density and spinal fractures and to further explore the impact of central obesity on the diabetic bone paradox. Methods: A Mendelian randomization (MR) study was implemented. Single nucleotide polymorphisms (SNPs) associated with type 2 diabetes were selected from the data of genome-wide association studies as instrumental variables, with lumbar bone density and spinal fractures as the outcome variables. The inverse variance weighting method, weighted median method, and MR-Egger regression were applied to identify a causal relationship between type 2 diabetes and osteoporosis at the genetic level. Additionally, to analyze the impact of central obesity in the diabetic bone paradox, the waist-to-hip ratio was introduced as a new exposure variable, with type 2 diabetes and lumbar bone density as outcome variables, and the MR method was applied again to uncover the influencing factors. Results: The screening criteria were based on the three main assumptions of MR. Finally, 62 SNPs for type 2 diabetes and 241 SNPs for waist-to-hip ratio were included in the MR analysis. Using inverse variance weighting as the primary analysis, the causal association effect analysis indicated a causal relationship between type 2 diabetes and increased lumbar bone density (OR=1.047 6, P=0.007) and spinal fractures (OR=1.000 9, P=0.014). A causal relationship between waist-to-hip ratio and type 2 diabetes (OR=1.638 6, P<0.001) was identified, indicating that the waist-to-hip ratio was a risk factor for type 2 diabetes and may have a causal association with increased lumbar bone density (OR=1.096 3, P=0.044). This suggests that the waist-to-hip ratio may indirectly affect the relationship between diabetes and osteoporosis. The MR-Egger intercept test showed no horizontal pleiotropy in this study. The leave-one-out analysis indicated that no single SNP had a significant impact on the overall results. Furthermore, the MR-pleiotropy residual sum and outlier (MR-PRESSO) test results did not detect any outlier SNPs. Conclusion: MR analysis identified a causal relationship between type 2 diabetes and increased lumbar bone density as well as a higher risk of spinal fractures, a paradox that may be related to central obesity.","PeriodicalId":68309,"journal":{"name":"中华内科杂志","volume":"64 3","pages":"225-233"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143574806","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}

引用次数: 0

[Two cases of type 1 autoimmune pancreatitis diagnosed by duodenal papilla biopsy].

中华内科杂志 Pub Date : 2025-03-01 DOI: 10.3760/cma.j.cn112138-20240930-00637

F M Yang, X H Li, D C Wang, Y Y Ran, X Q Li, W Lu, R Zhu

引用次数: 0