中华内科杂志最新文献

{"title":"[Experimental study of anti-tumor immunologic response functions after combined treatment of cryoablation with GM-CSF for colorectal cancer liver metastases].","authors":"J F Wang, Z Guo","doi":"10.3760/cma.j.cn112138-20241115-00757","DOIUrl":"https://doi.org/10.3760/cma.j.cn112138-20241115-00757","url":null,"abstract":"<p><p><b>Objective:</b> To assess the anti-tumor immune response after combined cryoablation and granulocyte-macrophage colony-stimulating factor (GM-CSF) treatment. <b>Methods:</b> A mouse model of colorectal liver metastases (CLM) was established using 80 BALB/c mice. All tumor-bearing mice were divided into a control group (<i>n</i>=20), a GM-CSF group (<i>n</i>=20), a cryoablation group (<i>n</i>=20), and a cryoablation+GM-CSF group (<i>n</i>=20). Cryoablation was applied using a 1.7-mm diameter cryosurgery needle from an argon-helium cryosurgery system. Tumor size and survival time were observed. Changes in the number of dendritic cells (DCs) in tumors were assessed by immunohistochemistry. Serum cytokine (IFN-γ, IL-4) levels were analyzed by enzyme-linked immunosorbent assay (ELISA), and the Th1/Th2 ratio was estimated from the IFN-γ/IL-4 ratio. One-way analysis of variance was used for data analysis. <b>Results:</b> Our findings showed that combining cryoablation and GM-CSF synergistically increased infiltrating DC numbers. Among the four groups, cryoablation+GM-CSF group exhibited the highest DC count post-treatment (control group: 1.4±0.5/HPF, GM-CSF group: 15.3±1.8/HPF, cryoablation group: 9.6±1.5/HPF, cryoablation+GM-CSF group:17.4±1.3/HPF; <i>F</i>=138.60,<i>P</i><0.05). Cryoablation, alone or combined with GM-CSF, elevated serum IFN-γ and reduced serum IL-4. IFN-γ levels of cryoablation group increased from 45.6±2.4 pg/ml to 57.8±3.3 pg/ml,<i>F</i>=170.09,<i>P</i><0.05,and IFN-γ levels of cryoablation+GM-CSF group increased from 45.6±2.4 pg/ml to 86.3±1.9 pg/ml,<i>F</i>=664.31,<i>P</i><0.05;and IL-4 levels of cryoablation group decreased from 7.21±0.63 pg/ml to 6.35±0.25 pg/ml,<i>F</i>=5.77,<i>P</i><0.05,IL-4 levels of cryoablation+GM-CSF group decreased from 7.21±0.63 pg/ml to 6.42±0.21 pg/ml,<i>F</i>=10.93,<i>P</i><0.05. Conversely, GM-CSF alone decreased serum IFN-γ and increased serum IL-4. Notably, combined cryoablation and GM-CSF significantly boosted Th1/Th2 ratios (cryoablation+GM-CSF group: from 6.32±0.45 to 13.43±0.64; <i>F</i>=379.95,<i>P</i><0.05). <b>Conclusion:</b> Combined cryoablation with GM-CSF treatment exerted a promising anti-tumor immune effect in the treatment of colorectal cancer liver metastases. This approach increased the number of DCs in the tumor microenvironment and improved the anti-tumor immunologic response in tumor-bearing mice.</p>","PeriodicalId":68309,"journal":{"name":"中华内科杂志","volume":"64 7","pages":"670-674"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144555899","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 pathogenesis and diagnosis of autoimmune gastritis].","authors":"K Liu, X Dong, Y Wang, Y T Zhe, L W Miao, Y Han, Z G Liu","doi":"10.3760/cma.j.cn112138-20240930-00631","DOIUrl":"https://doi.org/10.3760/cma.j.cn112138-20240930-00631","url":null,"abstract":"","PeriodicalId":68309,"journal":{"name":"中华内科杂志","volume":"64 7","pages":"693-697"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144555908","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":"[Two cases of autoimmune gastritis].","authors":"L Guan, X H Zhang, Y L Li","doi":"10.3760/cma.j.cn112138-20240930-00635","DOIUrl":"https://doi.org/10.3760/cma.j.cn112138-20240930-00635","url":null,"abstract":"","PeriodicalId":68309,"journal":{"name":"中华内科杂志","volume":"64 7","pages":"685-687"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144555909","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":"[Recurrent COVID-19 in a patient with Good's syndrome: a case report and literature review].","authors":"Y L Yang, T Zhang","doi":"10.3760/cma.j.cn112138-20241022-00704","DOIUrl":"https://doi.org/10.3760/cma.j.cn112138-20241022-00704","url":null,"abstract":"<p><p>We herein report a case of recurrent coronavirus disease 2019 (COVID-19) in a 56-year-old female with Good's syndrome (GS) at Peking Union Medical College Hospital in April 2024. The patient was previously treated with thymectomy for thymoma and her immunoglobulin assays and lymphocyte subset analysis confirmed an immunocompromised state characterized predominantly by humoral immunodeficiency, consistent with a diagnosis of GS. Clinical symptoms improved following two courses of nirmatrelvir/ritonavir and four courses of molnupiravir, administered alongside adjunctive glucocorticoids and regular intravenous immunoglobulin (IVIG) supplementation. By the end of August 2024, a review of the literature identified 40 reported cases of COVID-19 in patients with GS worldwide. Among them, 25 met the diagnostic criteria for severe or critical illness, and 12 experienced persistent or relapsing infections. Antiviral therapy was administered in approximately half of the cases, most commonly for a 5-day course. However, four patients required prolonged or multi-target antiviral regimens due to persistent or relapsing infection, with the longest duration reported at 20 days. Convalescent plasma or monoclonal antibodies were used in 15 patients, and adjunctive glucocorticoids in 13. The vast majority received regular IVIG supplementation. Ten patients (25%) with GS and COVID-19 died. Patients with GS are susceptible to prolonged or recurrent severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and are at increased risk of severe disease and mortality due to impaired antibody production. Upon diagnosis of GS, IVIG therapy should be initiated. In the context of COVID-19, potential treatment strategies include extended multi-agent antiviral therapy guided by viral load, use of convalescent plasma (where available), and glucocorticoids tailored to disease severity. Further research is needed to define the optimal duration and combination of antiviral and immunomodulatory therapies in this population.</p>","PeriodicalId":68309,"journal":{"name":"中华内科杂志","volume":"64 7","pages":"680-684"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144555907","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":"[Progresses and hot spots of psoriatic arthritis in the past decade].","authors":"H J Xu, R R Yao, Y Su","doi":"10.3760/cma.j.cn112138-20250106-00012","DOIUrl":"10.3760/cma.j.cn112138-20250106-00012","url":null,"abstract":"","PeriodicalId":68309,"journal":{"name":"中华内科杂志","volume":"64 7","pages":"589-596"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144555906","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":"[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":"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}