中华内科杂志最新文献

{"title":"[Analysis of ultrasound as an adjunctive diagnostic tool for eosinophilic fasciitis].","authors":"J S Yang, H Zhang, M Li, F Sun, B Zhou, Q Q Zhao, Y H Wan, J Zhu, J L Zhang","doi":"10.3760/cma.j.cn112138-20240425-00263","DOIUrl":"https://doi.org/10.3760/cma.j.cn112138-20240425-00263","url":null,"abstract":"<p><p><b>Objective:</b> This study investigates the utility of ultrasound in diagnosing eosinophilic fasciitis (EF). <b>Methods:</b> A retrospective analysis was conducted on the clinical and ultrasound data of 109 EF patients seen at the center between January 1, 2006, and March 31, 2024. The diagnostic efficacy of ultrasound for EF was evaluated by comparing forearm fascia ultrasound findings among EF patients, systemic sclerosis (SSc) patients, and healthy controls (HC). <b>Results:</b> Among the 109 EF patients (male-to-female ratio 2.2︰1), the median age of onset was 36 (29, 48) years, with a median disease duration of 7 (3, 12) months. The study also included 20 SSc patients [median age 49 (35, 61) years] and 20 HC individuals [median age 48 (29, 54) years]. Ultrasound assessments of forearm fascia in EF patients revealed a median fascial thickness of 1.9 (1.4, 2.4) mm. The median fascial thickness was 0.8 (0.7, 0.9) mm in SSc patients and 0.7 (0.5, 0.9) mm in HC individuals. Fascial thickness in EF patients was greater than in SSc (<i>Z</i>=-11.16,<i>P</i><0.001) and HC groups (<i>Z</i>=-11.87, <i>P</i><0.001). There was a correlation between fascia thickness and C-reactive protein (<i>r</i>=0.148, <i>P</i>=0.004), erythrocyte sedimentation rate (<i>r</i>=0.143, <i>P</i>=0.005), and immunoglobulin G (<i>r</i>=0.120, <i>P</i>=0.020) in EF patients. Receiver operating characteristic (ROC) curve analysis demonstrated a sensitivity of 84.0% and specificity of 95.9% for EF diagnosis, with an area under the curve (AUC) of 0.921 and a cut-off value of 1.005 mm. <b>Conclusion:</b> Ultrasound detection of forearm fascial thickening (>1 mm) aids in diagnosing eosinophilic fasciitis, indicating that ultrasound is a supplementary diagnostic tool for EF.</p>","PeriodicalId":68309,"journal":{"name":"中华内科杂志","volume":"64 4","pages":"333-338"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143756162","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":"[Characteristics of cardiovascular and cerebrovascular diseases in patients with primary aldosteronism: a propensity score matching study].","authors":"S Wan, T Chen, H M Tian, Y Ren","doi":"10.3760/cma.j.cn112138-20240923-00599","DOIUrl":"https://doi.org/10.3760/cma.j.cn112138-20240923-00599","url":null,"abstract":"<p><p><b>Objective:</b> To analyze the characteristics of cardiovascular and cerebrovascular diseases in patients with primary aldosteronism (PA) and compare them with age-, sex-, and blood pressure-matched patients with essential hypertension (EH). <b>Methods:</b> This cross-sectional study was conducted at the West China Hospital of Sichuan University. Patients with PA and EH between December 2018 and December 2021 were included. Demographic characteristics, stroke events, coronary artery diseases, peripheral vascular diseases, and cardiac structure and function indicators were analyzed. Propensity score matching (PSM) was used to balance non-study data. The <i>t</i>-test, chi-square test, and Wilcoxon signed-rank test were used for data comparison. The cardiovascular and cerebrovascular damage in the patients with unilateral and bilateral PA were also compared. <b>Results:</b> A total of 336 and 369 patients with PA and EH, respectively, were enrolled in this study. One hundred and ninety-eight patients from each group were included after PSM; no significant differences were found in terms of age, gender, and blood pressure. The prevalence of stroke in the PA group was considerably higher than that in the EH group [12.6% (25/198) vs. 5.6% (11/198), <i>P</i>=0.014], due to the significantly greater risk of ischemic stroke [10.0% (20/198) vs. 4.5% (9/198), <i>P</i>=0.029]. The prevalence of hemorrhagic stroke, coronary artery disease, peripheral arterial stenosis, aorta atherosclerosis, and aneurysm in the PA group were also higher than those in the EH group, but there was no statistical significance (all <i>P</i>>0.05). More patients with PA had concurrent left ventricular hypertrophy [22.2% (44/198) vs. 9.1% (18/198)], left atrial enlargement [40.4% (80/198) vs. 30.3% (60/198)], ventricular septal thickening [50.0% (99/198) vs. 36.9% (73/198)], and aortic widening [21.7% (43/198) vs. 13.1% (26/198)] than those with EH (all <i>P</i><0.05). Compared with the bilateral PA group, the unilateral PA group had higher prevalence of left ventricular hypertrophy [28.3% (51/180) vs. 13.4% (11/82), <i>P</i>=0.013]. <b>Conclusions:</b> Compared with well-matched patients with EH, patients with PA have significantly higher risks of cardiovascular and cerebrovascular diseases, which are mainly manifested in increased prevalence of stroke and severe damage to the cardiac structure. Patients with unilateral PA may suffer more severe cardiac damage than those with bilateral PA.</p>","PeriodicalId":68309,"journal":{"name":"中华内科杂志","volume":"64 4","pages":"302-308"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143756170","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":"[Expert consensus on endocrine hypertension screening (2025 version)].","authors":"","doi":"10.3760/cma.j.cn112138-20250103-00007","DOIUrl":"https://doi.org/10.3760/cma.j.cn112138-20250103-00007","url":null,"abstract":"<p><p>Endocrine hypertension is a common form of secondary hypertension. Affected patients often present without specific symptoms or signs, making the condition easy to overlook or misdiagnose. Early screening can greatly enhance the level of diagnosis while prompt treatment can improve the prognosis of patients. Based on clinical evidence and practice, the Chinese Endocrinologist Association and the Chinese Endocrine Hypertension Collaboration Group reached this consensus after extensive discussions on target populations, screening methods, interpretation of screening results, and other issues related to endocrine hypertension.</p>","PeriodicalId":68309,"journal":{"name":"中华内科杂志","volume":"64 4","pages":"288-301"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143756182","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 galectins family in rheumatoid arthritis].","authors":"X Y Ai, J W Guo, Y L Chen, J Y Xie, X P Hong, D Z Liu","doi":"10.3760/cma.j.cn112138-20241118-00762","DOIUrl":"https://doi.org/10.3760/cma.j.cn112138-20241118-00762","url":null,"abstract":"","PeriodicalId":68309,"journal":{"name":"中华内科杂志","volume":"64 4","pages":"373-376"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143756194","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":"[Role of cumulative hemoglobin A_1c levels and insulin doses in insulin resistance-related metabolic disorders in patients with type 1 diabetes].","authors":"M Shi, Y Zhang, W Q Fan, Y Chen, Y T Xie, C Deng, X Li","doi":"10.3760/cma.j.cn112138-20241117-00761","DOIUrl":"https://doi.org/10.3760/cma.j.cn112138-20241117-00761","url":null,"abstract":"<p><p><b>Objective:</b> To examine the effect of cumulative hemoglobin A_1c (HbA_1c) levels and insulin dosage on insulin resistance (IR)-related metabolic disturbances in newly diagnosed patients with type 1 diabetes (T1D). <b>Methods:</b> This retrospective cohort study included T1D patients admitted to the Second Xiangya Hospital of Central South University from November 2015 to March 2023. Clinical data collected comprised age, sex, disease duration, insulin dosage, body mass index, waist circumference, blood pressure, HbA_1c levels, islet autoantibodies, and fasting blood lipid profiles. IR-related metabolic disturbances assessed were overweight, obesity, central obesity, hypertension, and dyslipidemia. Cox regression and cluster analyses were applied to assess the influence of cumulative HbA_1c and insulin dosage on these metabolic disturbances. <b>Results:</b> A total of 235 patients were included, with 97 males (41.3%) and 138 females (58.7%). The median age was 19.8 (13.3, 31.1) years, and the median follow-up duration was 30.8 (20.8, 45.6) months. During follow-up, 41.6% (72/173) of patients developed IR-related metabolic disturbances. Multivariate Cox regression analysis revealed that a cumulative HbA_1c ≥60 mmol/mol was an independent risk factor for any IR-related metabolic disturbance [<i>HR</i> (95%<i>CI</i>): 1.739 (1.067-2.835) ] and for triglyceride abnormalities [<i>HR</i> (95%<i>CI</i>): 3.277 (1.176-9.127)]. Additionally, a cumulative insulin dosage ≥0.5 U·kg^-1·d^-1 was identified as an independent risk factor for overweight, obesity, or central obesity [<i>HR</i> (95%<i>CI</i>): 2.374 (1.059-5.323)]. Cluster analysis further identified that patients with higher levels of cumulative HbA_1c and insulin dosage, particularly those with adolescent-onset diabetes, had the highest likelihood of developing hypertension (<i>HR</i>=2.460, 95%<i>CI</i> 1.008-6.005), overweight/obesity/central obesity (<i>HR</i>=2.707, 95%<i>CI</i> 1.062-6.900), triglyceride abnormalities (<i>HR</i>=5.495, 95%<i>CI</i> 1.842-16.391), high-density lipoprotein cholesterol abnormalities (<i>HR</i>=11.054, 95%<i>CI</i> 4.107-29.751), and any IR-related metabolic disturbance (<i>HR</i>=5.833, 95%<i>CI</i> 2.602-13.077). <b>Conclusions:</b> Elevated cumulative HbA_1c and insulin dosage levels in T1D patients are associated with an increased risk of developing IR-related metabolic disturbances. These findings underscore the urgent need for novel therapeutic strategies tailored to this population.</p>","PeriodicalId":68309,"journal":{"name":"中华内科杂志","volume":"64 4","pages":"309-317"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143756205","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":"[Screening for Fabry disease in patients with kidney disease].","authors":"C Yu, Z Li, R Wang, Y M Zhou","doi":"10.3760/cma.j.cn112138-20240804-00490","DOIUrl":"https://doi.org/10.3760/cma.j.cn112138-20240804-00490","url":null,"abstract":"<p><p>This study aimed to determine the prevalence of Fabry disease in patients with kidney disease and observe its clinical features. A total of 1 693 patients in the Renal Department of Shandong Provincial Hospital Affiliated to Shandong First Medical University with proteinuria or renal insufficiency were included from June 2020 to December 2023. The α-galactosidase A level in males and globotriaosylsphingosine (Lyso-GL-3) level in females were detected, and GLA gene detection was performed in those with abnormalities. The GLA gene mutation rate was 0.297% (3/1 010) in males, 1.025% (7/683) in females, and 0.591% (10/1 693) overall. The prevalence of Fabry disease was 0.297% (3/1 010) in males, 0.293% (2/683) in females, and 0.295% (5/1 693) overall. The clinical manifestations of Fabry patients with kidney disease are complex and varied, with high heterogeneity. The pathogenicity of GLA gene mutations in patients with kidney disease requires further comprehensive analysis. Some GLA gene mutations are non-pathogenic and are mostly found in females. Patients with primary or secondary kidney disease should not be ignored regarding screening for Fabry disease.</p>","PeriodicalId":68309,"journal":{"name":"中华内科杂志","volume":"64 4","pages":"344-348"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143756208","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 brief discussion on the standardized management strategy of glucocorticoid withdrawal syndrome].","authors":"P Pang, Z H Lyu","doi":"10.3760/cma.j.cn112138-20250206-00069","DOIUrl":"https://doi.org/10.3760/cma.j.cn112138-20250206-00069","url":null,"abstract":"","PeriodicalId":68309,"journal":{"name":"中华内科杂志","volume":"64 4","pages":"277-282"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143756122","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 case report of VEXAS syndrome].","authors":"P Song, Z Yao","doi":"10.3760/cma.j.cn112138-20240520-00326","DOIUrl":"https://doi.org/10.3760/cma.j.cn112138-20240520-00326","url":null,"abstract":"","PeriodicalId":68309,"journal":{"name":"中华内科杂志","volume":"64 4","pages":"355-357"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143756129","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":"[Microwave ablation for primary hyperparathyroidism related to multiple endocrine neoplasia type 1 in 3 cases of a family].","authors":"Q Q Lyu, X Han, Y T Zhao, Y Z Zhang, Z W He, Y Xing, C Liu, S H Xu","doi":"10.3760/cma.j.cn112138-20241104-00728","DOIUrl":"https://doi.org/10.3760/cma.j.cn112138-20241104-00728","url":null,"abstract":"","PeriodicalId":68309,"journal":{"name":"中华内科杂志","volume":"64 4","pages":"349-354"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143756192","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":"[Diagnostic evaluation on bilateral adrenal lesions].","authors":"P An, K Chen, Y M Mu","doi":"10.3760/cma.j.cn112138-20241018-00694","DOIUrl":"https://doi.org/10.3760/cma.j.cn112138-20241018-00694","url":null,"abstract":"","PeriodicalId":68309,"journal":{"name":"中华内科杂志","volume":"64 4","pages":"362-367"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143756179","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}