中华内科杂志最新文献

{"title":"[Hot topic:cervical lymph node biopsy and washout thyroglobulin measurement in ultrasound-guided biopsy of thyroid nodules and cervical lymph nodes].","authors":"H L Li, J J Ma, T T Zhou, S H Zhang, J Zhai, B Zhang","doi":"10.3760/cma.j.cn112138-20241125-00779","DOIUrl":"https://doi.org/10.3760/cma.j.cn112138-20241125-00779","url":null,"abstract":"","PeriodicalId":68309,"journal":{"name":"中华内科杂志","volume":"64 6","pages":"499-503"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144251055","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":"[Ulcerative colitis complicated with type 2 autoimmune pancreatitis: a case report].","authors":"L Yan, X M Zhang","doi":"10.3760/cma.j.cn112138-20241010-00671","DOIUrl":"https://doi.org/10.3760/cma.j.cn112138-20241010-00671","url":null,"abstract":"","PeriodicalId":68309,"journal":{"name":"中华内科杂志","volume":"64 6","pages":"568-570"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144251063","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 pulmonary hypertension related to chronic hemolytic anemia].","authors":"T T Cui, X X Guo, M Chen","doi":"10.3760/cma.j.cn112138-20250225-00098","DOIUrl":"https://doi.org/10.3760/cma.j.cn112138-20250225-00098","url":null,"abstract":"","PeriodicalId":68309,"journal":{"name":"中华内科杂志","volume":"64 6","pages":"571-576"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144250990","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":"[Risk factors for bleeding complications in patients undergoing percutaneous liver biopsy].","authors":"G Jia, D W Ding, Y Q Fang, T Li, L N Cui, Y L Shang, Y Han","doi":"10.3760/cma.j.cn112138-20241031-00720","DOIUrl":"https://doi.org/10.3760/cma.j.cn112138-20241031-00720","url":null,"abstract":"<p><p><b>Objective:</b> To investigate the effect of thrombocytopenia and coagulation dysfunction on bleeding complications in patients undergoing percutaneous liver biopsy. <b>Methods:</b> The clinical, laboratory, and demographic data of patients undergoing percutaneous liver biopsy at the First Affiliated Hospital of Air Force Medical University from January 2005 to January 2024 were retrospectively analyzed. The incidence of bleeding was recorded. Univariate and multivariate logistic regression analyses were used to assess the effects of thrombocytopenia and coagulation dysfunction on the risk of postoperative bleeding. Furthermore, we assessed the bleeding risk in patients with autoimmune hepatitis. <b>Results:</b> A total of 2 885 liver perforations were performed in 2 364 patients, 98.4% of whom had an autoimmune liver disease. There were 27 cases of postoperative bleeding (0.9%). The univariate logistic regression analysis showed that platelet count (PLT)(<i>P</i><0.05, <i>OR</i>=0.975), coagulation dysfunction (international normalized ratio; INR)(<i>P</i><0.05, <i>OR</i>=6.954), and cirrhosis (<i>P</i><0.05, <i>OR</i>=3.857) were associated with bleeding. The multivariate logistic regression analysis showed that PLT was an independent risk factor for bleeding (<i>P</i><0.05, <i>OR</i>=0.975). PLT scores of 40×10⁹/L and 65×10⁹/L can classify the bleeding risk of patients with thrombocytopenia into high, medium, and low risk. There was no difference in the risk of bleeding between the 40×10⁹/L<PLT≤50×10⁹/L and 50×10⁹/L<PLT≤99×10⁹/L groups (<i>P</i>>0.05, <i>χ</i>²=0.10). The risk of bleeding in the 31×10⁹/L≤PLT≤40×10⁹/L group was higher than that in the 40×10⁹/L<PLT≤99×10⁹/L group (<i>P</i><0.05, <i>χ</i>²=11.50) and was 0 in the 19×10⁹/L≤PLT≤30×10⁹/L group. The risk of bleeding in the 1.15<INR≤1.5 group was higher than that in the INR≤1.15 group, and the risk of bleeding was 0 when 1.5<INR≤2.5. Compared with other liver diseases, the risk of bleeding was not increased in patients with autoimmune hepatitis (<i>P</i>>0.05, <i>χ</i>²=0.10). Furthermore, the bleeding cases were considered mild as the bleeding stopped after pressure hemostasis. <b>Conclusions:</b> PLT is an independent risk factor for bleeding after hepatocentesis. When the PLT is >40×10⁹/L, hepatocentesis can still be performed safely with appropriate management measures.</p>","PeriodicalId":68309,"journal":{"name":"中华内科杂志","volume":"64 6","pages":"542-548"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144251061","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 cytomegalovirus and EB virus activation on hematopoietic reconstitution after intensive immunosuppressive therapy for severe aplastic anemia].","authors":"Q Zhang, H Wang, X L Li, M Miao, H X Ma, Y Y Shen, N Wei, K Zou, W X Su, J Q Yu, D P Wu, L M Liu","doi":"10.3760/cma.j.cn112138-20240913-00576","DOIUrl":"https://doi.org/10.3760/cma.j.cn112138-20240913-00576","url":null,"abstract":"<p><p><b>Objective:</b> To investigate the infection rate of cytomegalovirus (CMV) and Epstein-Barr virus (EBV) in patients with severe aplastic anemia (SAA) after intensive immunosuppressive therapy in combination with a thrombopoietin receptor agonist (lST+TPO-RA) as well as assess the clinical impact of treatment. <b>Methods:</b> A retrospective, case series study was undertaken involving patients with SAA who were admitted to Soochow Hopes Hematonosis Hospital, The First Affiliated Hospital of Soochow University, and Zhengzhou Third People's Hospital from June 2022 to February 2025. Thirty patients with complete CMV and EBV monitoring data after IST+TPO-RA treatment were enrolled. The first activation time of CMV and EBV, the maximum viral load, the first negative conversion time, and blood routine tests within 3 days before CMV and EBV positivity, during the positive period, and within 3 days after turning negative were recorded. The patients were followed up for 9 months after the completion of IST. One-way analysis of variance was used to compare the changes of blood routine before and after virus positivity and after turning negative. The <i>χ</i>² test was used to compare the viral infection rate and the therapeutic effect of IST between the two groups. <b>Results:</b> The 30 SAA patients comprised 15 males and 15 females with an average age of (40.0±16.9) years. Of the 30 patients, 18 (60.0%) were infected with CMV and 6 (20.0%) with EBV. Among them, 17 cases received rabbit anti-human thymocyte immunoglobulin (r-ATG) treatment (r-ATG group), 13 cases received porcine anti-human lymphocyte immunoglobulin (p-ALG) treatment (p-ALG group). The CMV infection rate was significantly higher in the r-ATG group than in the p-ALG group (15/17 vs. 3/13, <i>χ</i>²=13.03, <i>P</i><0.001); meanwhile, the rate of EBV infection was only slightly higher in the r-ATG group than in the p-ALG group, and the difference did not reach statistical significance (5/17 vs. 1/13, <i>χ</i>²=2.17, <i>P</i>=0.196). In patients infected with CMV, neutrophil, hemoglobin, and platelet counts were significantly decreased during the infection phase, followed by significant increases after CMV clearance (<i>F</i>=14.48, 11.38, 4.73; all <i>P</i><0.05). No significant differences in treatment efficacy were found between the r-ATG and p-ALG groups at 3, 6, and 9 months post-IST (all <i>P</i>>0.05). <b>Conclusions:</b> This preliminary study showed that the incidence of CMV and EBV infection in patients with SAA increased after IST, with CMV infections occurring significantly more frequently than EBV infections. The CMV infection rate was significantly higher in patients treated with r-ATG than in those receiving p-ALG. CMV infection was associated with notable alterations in hematological parameters, highlighting the need for close clinical monitoring.</p>","PeriodicalId":68309,"journal":{"name":"中华内科杂志","volume":"64 6","pages":"514-521"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144251062","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":"[Passing on and carrying forward, advancing with the times, and making unremitting efforts to safeguard people's health].","authors":"W P Jia","doi":"10.3760/cma.j.cn112138-20250417-00223","DOIUrl":"https://doi.org/10.3760/cma.j.cn112138-20250417-00223","url":null,"abstract":"","PeriodicalId":68309,"journal":{"name":"中华内科杂志","volume":"64 6","pages":"497-498"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144251058","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":"[Lenalidomide for adult Langerhans cell histiocytosis: a report of 4 cases].","authors":"X Kong, J Chen, Z H Lin, J Zhang, C C Fu, F Chen, H Y Qiu, D P Wu","doi":"10.3760/cma.j.cn112138-20250106-00014","DOIUrl":"10.3760/cma.j.cn112138-20250106-00014","url":null,"abstract":"","PeriodicalId":68309,"journal":{"name":"中华内科杂志","volume":"64 6","pages":"558-560"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144251056","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":"[Progress of treatment for autoimmune hepatitis].","authors":"T Y Mao, X Xiao, X Ma","doi":"10.3760/cma.j.cn112138-20240930-00640","DOIUrl":"https://doi.org/10.3760/cma.j.cn112138-20240930-00640","url":null,"abstract":"","PeriodicalId":68309,"journal":{"name":"中华内科杂志","volume":"64 6","pages":"584-588"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144251059","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":"[Research progress of intestinal-hepatic axis in primary biliary cholangitis].","authors":"K L Wang, L B Zhang, W H Li, P P Li, X M Zhang","doi":"10.3760/cma.j.cn112138-20241012-00677","DOIUrl":"https://doi.org/10.3760/cma.j.cn112138-20241012-00677","url":null,"abstract":"","PeriodicalId":68309,"journal":{"name":"中华内科杂志","volume":"64 6","pages":"577-583"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144251060","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":"[Correlation between soluble CD146 and systemic vasculitis].","authors":"J W Gao, Z Peng, Y Liu, H X Yu, Y Wu, X P Tian","doi":"10.3760/cma.j.cn112138-20240702-00418","DOIUrl":"https://doi.org/10.3760/cma.j.cn112138-20240702-00418","url":null,"abstract":"<p><p><b>Objective:</b> To determine the correlation between serum soluble CD146 (sCD146) levels and disease activity in patients with systemic vasculitis and the potential of sCD146 as a novel biomarker. <b>Methods:</b> We recruited 304 patients from the systemic vasculitis cohort at Peking Union Medical College Hospital from July 2013 to December 2022. The cohort comprised 200 patients with Takayasu arteritis (TAK) and 104 with antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV). The patient's demographic and clinical data, including age, sex, disease duration, disease type, laboratory results, and disease status, were extracted from the database. The serum sCD146 concentration was measured using a sandwich enzyme-linked immunosorbent assay (ELISA). Continuous variables were presented as mean±standard deviation if normally distributed, with between-group comparisons conducted using the <i>t</i>-test. For non-normally distributed data, median (<i>Q</i>₁,<i>Q</i>₃) was used, and comparisons between groups were performed using the Mann-Whitney <i>U</i> test. Categorical data were expressed as percentages, and comparisons between groups were conducted using the Chi-square test or Fisher's exact test,as appropriate. Kendall's tau-b's rank correlation coefficient was calculated to evaluate the correlation between sCD146 and variables associated with systemic vasculitis. A two-sided <i>P</i> value <0.05 was considered statistically significant. <b>Results:</b> Serum sCD146 levels were significantly lower in patients with active disease compared to those in remission in both cohorts [TAK: 246 (218, 287) vs. 277 (230, 322) μg/L, <i>Z</i>=-2.58, <i>P</i>=0.010; AAV: (301±90) vs. (344±81) μg/L, <i>t</i>=-2.56, <i>P</i>=0.007]. Serum sCD146 levels were positively correlated with age and disease duration (TAK: <i>τ</i>=0.09, 0.12, <i>P</i>=0.040, <i>P</i>=0.009; AAV: <i>τ</i>=0.28, 0.15, <i>P</i><0.001, <i>P</i>=0.020). In patients with TAK, sCD146 levels were negatively correlated with IL-6, C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), and disease activity status (<i>τ</i>=-0.17, -0.18, -0.16, -0.16; <i>P</i>=0.001, <i>P</i><0.001, <i>P</i>=0.003, <i>P</i>=0.010). In patients with AAV, sCD146 levels were negatively correlated with platelet count (PLT),disease activity status,and the Birmingham Vasculitis Activity Score (<i>τ</i>=-0.36, -0.27, -0.27; <i>P</i><0.001, <i>P</i>=0.007, <i>P=</i>0.001). <b>Conclusion:</b> Serum sCD146 levels were significantly lower in patients with active systemic vasculitis than in remission, displaying a negative correlation with disease activity. These findings suggest that sCD146 has potential as a novel biomarker for assessing disease activity in systemic vasculitis.</p>","PeriodicalId":68309,"journal":{"name":"中华内科杂志","volume":"64 6","pages":"532-541"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144251053","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}