中华内科杂志最新文献

{"title":"[The value of T1 mapping in the non-invasive assessment of the Oxford classification of IgA nephropathy].","authors":"C B Li, P Chen, S P Zhou, H H Kang, X W Wen, S C Yi, X Bai, Y Wang, L Zhang, H Y Wang","doi":"10.3760/cma.j.cn112138-20250523-00302","DOIUrl":"https://doi.org/10.3760/cma.j.cn112138-20250523-00302","url":null,"abstract":"<p><p><b>Objective:</b> To evaluate the diagnostic value of native T1 mapping in differentiating Oxford classification (MEST-C) scores in patients with IgA nephropathy. <b>Methods:</b> In this prospective study, patients who underwent both T1 mapping and renal biopsy at the First Medical Center of the Chinese PLA General Hospital between April 2023 and October 2024 were consecutively enrolled. Two radiologists, blinded to clinical and pathological information, measured renal T1 mapping parameters, including cortical T1 (cT1), medullary T1 (mT1), the corticomedullary difference (ΔT1), and the corticomedullary ratio (T1 ratio). Clinical and renal biopsy data based on the Oxford classification from patients with IgA nephropathy were collected. The Oxford classification includes five indicators: Mesangial hypercellularity (M), Endocapillary hypercellularity (E), Segmental glomerulosclerosis or adhesion (S), Tubular atrophy/interstitial fibrosis (T), and Cellular or fibrocellular crescents (C). Spearman correlation analysis was applied to evaluate the associations between MEST-C scores and T1 parameters. The diagnostic performance of T1 parameters for discriminating among scores of the Oxford classification was analyzed using the receiver operating characteristic (ROC) curve. <b>Results:</b> A total of 124 patients with IgA nephropathy were included in this study [66 males, 58 females; age 19-70 years, 39 (30, 51) years]. Except for the E indicator, M, S, T, and C were significantly correlated with renal T1 values (<i>ρ=</i>0.177-0.414, all <i>P</i><0.05). cT1 showed the best diagnostic efficacy for the S score, with an area under the curve (AUC) of 0.798, a sensitivity of 68.7%, and a specificity of 88.0%. The best T1 parameter for differentiating the T score was the T1 ratio, with an AUC of 0.687, a sensitivity of 57.9%, and a specificity of 79.1%. <b>Conclusion:</b> Native T1 mapping can be used for the non-invasive assessment of the S and T scores in the Oxford classification of patients with IgA nephropathy.</p>","PeriodicalId":68309,"journal":{"name":"中华内科杂志","volume":"64 10","pages":"954-962"},"PeriodicalIF":0.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145287880","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 on transcranial electromagnetic stimulation in improving non-motor symptoms of Parkinson's disease].","authors":"Y C Gao, S Zhuang, Q Zhang, Q M Jiang, J Y Wu, J Cheng, J R Zhang, X Y Cheng, W B Zheng, K W Xu, T H Qiu, C J Mao, C F Liu","doi":"10.3760/cma.j.cn112138-20250520-00293","DOIUrl":"https://doi.org/10.3760/cma.j.cn112138-20250520-00293","url":null,"abstract":"","PeriodicalId":68309,"journal":{"name":"中华内科杂志","volume":"64 10","pages":"1010-1016"},"PeriodicalIF":0.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145287875","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 analysis of immunoglobulin G₄-related disease with neurological involvement].","authors":"L J Guo, C J Li, H Wei, Y Ding, Y Zhao, Y S Piao, Y Guo, Y N Gao","doi":"10.3760/cma.j.cn112138-20241108-00742","DOIUrl":"https://doi.org/10.3760/cma.j.cn112138-20241108-00742","url":null,"abstract":"<p><p><b>Objective:</b> To improve the understanding of the clinical manifestation of immunoglobulin G₄-related disease (IgG₄-RD) with neurological involvement. <b>Methods:</b> Patients presenting with neurological symptoms and biopsy-confirmed IgG₄-RD were enrolled between March 2014 and March 2024 from the Department of Neurology of Xuanwu Hospital of Capital Medical University. Medical record data of all patients were retrospectively reviewed, including clinical manifestations, laboratory findings, radiological results, pathology, treatments, and outcomes. RD were enrolled between March <b>Results:</b> Nine patients (five males, four females; median age at onset: 63 years) were included in the study. Neurological manifestations consisted of pachymeningitis in six cases, peripheral nerve involvement in two, and brain parenchyma involvement in one. Four patients displayed isolated neurologic symptoms. The most common clinical manifestations were headache and cranial nerve palsy, each involving five cases. Magnetic resonance imaging showed thickening and enhancement of the dura mater in the six patients with pachymeningitis. Four of these cases involved the posterior cranial fossa, 3 presented with an inflammatory pseudotumor, and 2 involved the spinal cord. Four patients with pachymeningitis had normal serum IgG₄ concentrations. Eight patients exhibited elevated serum C-reactive protein or erythrocyte sedimentation rates, with some also showing decreased complement C3 and C4 levels. Cerebrospinal fluid immunoglobulin was elevated in all nine cases. In all cases, histopathologic biopsy results showed extensive infiltration of lymphocytes and plasma cells, with the latter displaying IgG₄⁺abnormalities. All patients received glucocorticoid therapy, with six also receiving immunosuppressants. All patients were followed up for a median of 30 months, with outcomes including two complete remissions, five partial remissions, one unchanged condition, and one death. Six patients experienced a relapse. <b>Conclusions:</b> Isolated hypertrophic pachymeningitis is the most common manifestation of IgG₄-RD, often occurring in the absence of elevated serum IgG₄ levels. Peripheral nerve and brain parenchyma involvement can also be seen. Clinical manifestations are non-specific, and histopathologic biopsy is frequently required for diagnosis. Although the disease responds well to hormone treatment, recurrence is common. Early combined immunosuppressive therapy can improve prognosis.</p>","PeriodicalId":68309,"journal":{"name":"中华内科杂志","volume":"64 10","pages":"963-970"},"PeriodicalIF":0.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145287830","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 mechanisms of kidney aging and intervention strategies: a research review].","authors":"M K Li, Y B Zhang, X W He, Q G Ao","doi":"10.3760/cma.j.cn112138-20250413-00211","DOIUrl":"https://doi.org/10.3760/cma.j.cn112138-20250413-00211","url":null,"abstract":"","PeriodicalId":68309,"journal":{"name":"中华内科杂志","volume":"64 10","pages":"997-1002"},"PeriodicalIF":0.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145287906","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 standardization process and clinical challenges in the diagnosis and treatment of IgA nephropathy in China:commentary on the clinical practice guidelines for adult patients with IgA nephropathy and IgA vasculitis-associated nephritis in China (2025)].","authors":"M H Zhao, L J Liu","doi":"10.3760/cma.j.cn112138-20250813-00482","DOIUrl":"https://doi.org/10.3760/cma.j.cn112138-20250813-00482","url":null,"abstract":"","PeriodicalId":68309,"journal":{"name":"中华内科杂志","volume":"64 10","pages":"911-913"},"PeriodicalIF":0.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145287818","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 melanin-concentrating hormone and polycystic ovary syndrome and its androgen levels].","authors":"Y Deng, Y C Ba, Q Q Wang, X Y Hong, Z Y Tan, Q Huang, Q Wang, L Zhang, X Y Yuan, X Liao","doi":"10.3760/cma.j.cn112138-20250505-00255","DOIUrl":"https://doi.org/10.3760/cma.j.cn112138-20250505-00255","url":null,"abstract":"&lt;p&gt;&lt;p&gt;&lt;b&gt;Objective:&lt;/b&gt; To investigate the changes in and correlations between melanin-concentrating hormone (MCH) and androgen levels in the serum of patients with polycystic ovary syndrome (PCOS), aiming to provide a novel research perspective for its diagnosis. &lt;b&gt;Methods:&lt;/b&gt; A cross-sectional study. A total of 307 subjects were enrolled from the physical examination center and endocrinology clinic of the Affiliated Hospital of Zunyi Medical University from June 2023 to June 2024. The cohort comprised 114 healthy controls and 193 patients with PCOS, diagnosed according to the Rotterdam criteria. The patients were grouped into four phenotypes: Phenotype A (hyperandrogenemia [HA]+ovulatory dysfunction [OA]+polycystic ovarian morphology [PCOM], &lt;i&gt;n&lt;/i&gt;=44), Phenotype B (HA+OA, &lt;i&gt;n&lt;/i&gt;=50), Phenotype C (HA+PCOM, &lt;i&gt;n&lt;/i&gt;=46), and Phenotype D (OA+PCOM, &lt;i&gt;n&lt;/i&gt;=53). Clinical data were collected for all subjects. Serum MCH levels were determined by enzyme-linked immunosorbent assay. The relationship between MCH and androgen-related risk factors for PCOS was analyzed using Spearman partial correlation analysis and stepwise multiple linear hierarchical regression. Binary logistic regression was used to analyze factors influencing PCOS onset. The diagnostic value of MCH for PCOS was evaluated using a receiver operating characteristic (ROC) curve. &lt;b&gt;Results:&lt;/b&gt; There were no significant differences in age and height between the healthy control group and the PCOS phenotypic groups (both &lt;i&gt;P&lt;/i&gt;&gt;0.05). MCH levels [17.63 (12.69, 22.00), 17.31 (11.05, 20.09), 17.82 (11.47, 19.40), 16.50 (11.14, 19.41) μg/L vs. 12.14 (9.78, 15.05) μg/L], homeostatic model assessment of insulin resistance, fasting plasma glucose, fasting serum lisulin, body mass index, and weight were significantly higher across all four PCOS phenotypes (A, B, C, and D) than in healthy controls (all &lt;i&gt;P&lt;/i&gt;&lt;0.05), whereas sex hormone-binding globulin (SHBG) contents were significantly lower (&lt;i&gt;P&lt;/i&gt;&lt;0.05). Free androgen index (FAI), total testosterone (TES) and dehydroepiandrosterone (DHEA) levels were significantly higher in PCOS phenotypes A, B, and C than in the control group and PCOS phenotype D (all &lt;i&gt;P&lt;/i&gt;&lt;0.05). Spearman partial correlation analysis revealed no significant correlation between MCH and TES, DHEA, or FAI in healthy controls and patients with non-HA PCOS (all &lt;i&gt;P&lt;/i&gt;&gt;0.05). However, in PCOS patients with HA, MCH showed a significant positive correlation with TES and DHEA (&lt;i&gt;r&lt;/i&gt;=0.227 and 0.196, respectively; both &lt;i&gt;P&lt;/i&gt;&lt;0.05), but not FAI (&lt;i&gt;P&lt;/i&gt;&gt;0.05). Stepwise multiple linear hierarchical regression analysis showed that MCH was positively correlated with TES, DHEA and luteinizing hormone and negatively correlated with SHBG (all &lt;i&gt;P&lt;/i&gt;&lt;0.05). Binary logistic regression indicated that an increase in MCH may be a potential risk factor for PCOS occurrence (&lt;i&gt;OR=&lt;/i&gt;1.113, 95%&lt;i&gt;CI&lt;/i&gt; 1.012-1.224, &lt;i&gt;P=&lt;/i&gt;0.028). ROC analysis showed that MCH has diagnost","PeriodicalId":68309,"journal":{"name":"中华内科杂志","volume":"64 9","pages":"838-844"},"PeriodicalIF":0.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144994530","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":"[New perspectives in critical care: eight key points].","authors":"W Huang, D W Liu, M G Yin, X K Chen, X T Wang","doi":"10.3760/cma.j.cn112138-20250531-00317","DOIUrl":"10.3760/cma.j.cn112138-20250531-00317","url":null,"abstract":"","PeriodicalId":68309,"journal":{"name":"中华内科杂志","volume":"64 9","pages":"807-811"},"PeriodicalIF":0.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144994496","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":"[Chinese guidelines on the multidisciplinary management of Duchenne muscular dystrophy].","authors":"","doi":"10.3760/cma.j.cn112138-20250412-00210","DOIUrl":"10.3760/cma.j.cn112138-20250412-00210","url":null,"abstract":"<p><p>Duchenne muscular dystrophy (DMD) is an X-linked recessive myopathy caused by mutations in the dystrophin gene, which is divided into presymptomatic, early ambulatory, late ambulatory, early non-ambulatory, and late non-ambulatory stages according to its disease progression. Some patients experience non-progressive cognitive developmental delays in the presymptomatic stage. DMD patients gradually develop osteoporosis, cardiomyopathy, decreased respiratory function, delayed puberty, and gastrointestinal symptoms as the disease progresses. The required multidisciplinary management strategies vary across different disease stages. To standardize the multidisciplinary management of DMD, we established the DMD Guideline Writing Committee under the authorization of Chinese Medical Association Rare Disease Branch. Combined with the questions raised by patients in multiple consultations, neuromuscular experts drafted the DMD guidelines based on published clinical evidence, current practices, and expert recommendations. A consensus was reached on the best-practice recommendations for DMD management after extensive consultations with specialists from multiple relevant disciplines. The resulting recommendations have been endorsed by Chinese Medical Association Rare Disease Branch. This guideline provides practical and reasonable recommendations for all healthcare professionals and caregivers involved in DMD management, ensuring that patients can receive high-standard medical treatment and care across our country, which also serves as a reference for government staff involved in DMD management.</p>","PeriodicalId":68309,"journal":{"name":"中华内科杂志","volume":"64 9","pages":"812-824"},"PeriodicalIF":0.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144994541","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 catheter ablation for patients with atrial fibrillation and heart failure].","authors":"C Yuan, N Xie","doi":"10.3760/cma.j.cn112138-20250318-00163","DOIUrl":"10.3760/cma.j.cn112138-20250318-00163","url":null,"abstract":"","PeriodicalId":68309,"journal":{"name":"中华内科杂志","volume":"64 9","pages":"886-890"},"PeriodicalIF":0.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144994414","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":"[Progression of pericoronary adipose tissue imaging features and cardiovascular risk prediction].","authors":"L Zhang, D M Yang, J Zhong, L J Zhang","doi":"10.3760/cma.j.cn112138-20250327-00182","DOIUrl":"10.3760/cma.j.cn112138-20250327-00182","url":null,"abstract":"","PeriodicalId":68309,"journal":{"name":"中华内科杂志","volume":"64 9","pages":"881-885"},"PeriodicalIF":0.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144994515","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}