中华内科杂志最新文献

{"title":"[A rare case of monoclonal gammopathy-associated fibrillary glomerulonephritis].","authors":"S X Ai, Y B Wen, G Chen, X S Zhao, K Zheng, Y Qin, X M Li","doi":"10.3760/cma.j.cn112138-20240724-00469","DOIUrl":"https://doi.org/10.3760/cma.j.cn112138-20240724-00469","url":null,"abstract":"","PeriodicalId":68309,"journal":{"name":"中华内科杂志","volume":"64 4","pages":"358-361"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143756135","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":"[Analysis of serum 25-hydroxyvitamin D₃ levels and prognosis in patients with amyotrophic lateral sclerosis].","authors":"H F Wang, H R Wang, Y C Lin, J M Bai, M Li, X S Huang","doi":"10.3760/cma.j.cn112138-20240728-00481","DOIUrl":"https://doi.org/10.3760/cma.j.cn112138-20240728-00481","url":null,"abstract":"<p><p><b>Objective:</b> To evaluate serum 25-hydroxyvitamin D₃ [25(OH)D₃] as a potential biomarker for amyotrophic lateral sclerosis (ALS) severity and to identify risk factors influencing ALS prognosis. <b>Methods:</b> This study included 217 ALS patients hospitalized at the Department of Neurology, First Medical Center, Chinese PLA General Hospital, between October 2018 and October 2021, who met the revised El Escorial diagnostic criteria. A cross-sectional analysis assessed differences in clinical indicators-including the ALS Functional Rating Scale-Revised (ALSFRS-R) and forced vital capacity percentage (FVC%)-across different serum 25(OH)D₃ levels. The correlation between 25(OH)D₃ levels and individual ALSFRS-R components was also examined. Conduct a prospective cohort study to identify independent risk factors affecting the survival time of ALS patients. <b>Results:</b> Among three groups categorized by serum 25(OH)D₃ levels, there were significant differences in the proportion of males (<i>χ</i>²=10.51, <i>P</i><0.05). Serum 25(OH)D₃ levels correlated positively with lower limb function scores in the ALSFRS-R (<i>r</i>=0.05, <i>P</i><0.05), but they were not identified as an independent risk factor for survival (<i>HR</i>=0.98, 95%<i>CI</i> 0.93-1.04, <i>P</i>>0.05). In contrast, delayed diagnosis(<i>HR</i>=0.94, 95%<i>CI</i> 0.89-0.99, <i>P</i><0.05) and reduced FVC%(<i>HR</i>=0.94, 95%<i>CI</i> 0.97-0.99, <i>P</i><0.05) were independent predictors of shorter survival. <b>Conclusion:</b> Serum 25(OH)D₃ levels differ by gender distribution and may be linked to better lower limb function in ALS patients. However, their role in prolonging survival remains uncertain.</p>","PeriodicalId":68309,"journal":{"name":"中华内科杂志","volume":"64 4","pages":"325-332"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143756154","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: complications and management 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.cn112138-20241125-00778","DOIUrl":"https://doi.org/10.3760/cma.j.cn112138-20241125-00778","url":null,"abstract":"","PeriodicalId":68309,"journal":{"name":"中华内科杂志","volume":"64 4","pages":"283-287"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143756189","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 on the application of multimodal magnetic resonance imaging in the assessment of brain injury in patients with Fabry disease].","authors":"Z R Sun, Z T Li, Y Chen, J Y Cao, J G Xia, W Z Tian","doi":"10.3760/cma.j.cn112138-20241006-00651","DOIUrl":"https://doi.org/10.3760/cma.j.cn112138-20241006-00651","url":null,"abstract":"","PeriodicalId":68309,"journal":{"name":"中华内科杂志","volume":"64 4","pages":"368-372"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143756198","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 serum 25-hydroxyvitamin D levels and 24-h urinary calcium excretion and hypercalciuria in Chinese adults].","authors":"L Shen, H Zhang, Q Lu, S S Li, C Gao, Y Z Mei, H Yue, X T Yu, Q Yao, Y N Huo, Y H Zeng, Y Jiang, Z J Xie, A J Chao, X L Jin, L Mao, Z L Zhang","doi":"10.3760/cma.j.cn112138-20240929-00619","DOIUrl":"https://doi.org/10.3760/cma.j.cn112138-20240929-00619","url":null,"abstract":"<p><p><b>Objective:</b> To investigate the association between serum 25-hydroxyvitamin D [25(OH)D] levels and 24-h urinary calcium excretion (24-h UCaE) and hypercalciuria in Chinese adults. <b>Methods:</b> This cross-sectional study was conducted from March 2022 to March 2023 in nine cities in China and included 1 239 residents. Demographic characteristics were collected through questionnaires and physical examinations, fasting blood samples were assessed for bone metabolism indicators, and 24-h urine samples were used to determine the 24-h UCaE. Multiple linear regression analysis was used to explore the relationship between serum 25(OH)D and 24-h UCaE and bone metabolism indexes. The relationship between serum 25(OH)D and hypercalciuria was analyzed using a multiple logistic regression model combined with restricted cubic spline modeling. <b>Results:</b> The mean participant age was (47.9±18.1) years, of which 453 (36.6%) were male. The percentages of vitamin D sufficiency, insufficiency, and deficiency were 7.6% (94/1 239), 29.0% (359/1 239), and 63.4% (786/1 239), respectively. The multiple linear regression model showed that after adjusting for the covariates the 24-h UCaE gradually increased with higher levels of 25(OH)D (<i>P</i> overall <0.001, <i>P</i> nonlinear <0.001). The logistic regression analysis revealed that compared with the vitamin D deficient group, the <i>OR</i> for the prevalence of hypercalciuria in the vitamin D sufficient and vitamin D insufficient groups were 3.290 (95%<i>CI</i> 1.745 to 6.202) and 3.742 (95%<i>CI</i> 2.458 to 5.697), respectively. The results of the restricted cubic spline modeling showed a positive nonlinear relationship between 25(OH)D and the prevalence of hypercalciuria (<i>P</i> overall <0.001, <i>P</i> nonlinear <0.001). The prevalence of hypercalciuria increased when 25(OH)D was >17.00 μg/L and peaked at 26.71 μg/L, after which there was a decreasing trend in the prevalence of hypercalciuria with increasing 25(OH)D. <b>Conclusion:</b> Associations between serum 25(OH)D levels and urinary calcium excretion and the prevalence of hypercalciuria were observed in the Chinese adult population.</p>","PeriodicalId":68309,"journal":{"name":"中华内科杂志","volume":"64 4","pages":"318-324"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143756175","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":"[Expression and clinical significance of CXCR3 on effector T cells in the peripheral blood of patients with Alzheimer's disease].","authors":"Z Z Ren, S S Jia, X L Zhong, Y F Zhang, T T Li, F Qiu","doi":"10.3760/cma.j.cn112138-20240813-00511","DOIUrl":"https://doi.org/10.3760/cma.j.cn112138-20240813-00511","url":null,"abstract":"<p><p><b>Objective:</b> This study investigated the expression of C-X-C motif chemokine receptor 3 (CXCR3) on CD45RO⁺ T cells in the peripheral blood of patients with Alzheimer's disease (AD) and its association with clinical features. <b>Methods:</b> A total of 41 AD patients and 30 age-and sex-matched healthy controls (HCs) were recruited from the Department of Neurology at the Medical Division of PLA General Hospital between September 2022 and March 2024. Flow cytometry was used to quantify CXCR3 expression on CD45RO⁺ T cell subsets in peripheral blood. Dementia severity in AD patients was assessed using the Mini-Mental State Examination (MMSE) and Montreal Cognitive Assessment (MoCA). Spearman correlation analysis examined the relationship between CD45RO⁺CXCR3⁺ T cell levels and cognitive function in the AD group. Receiver operating characteristic (ROC) curve analysis determined the predictive utility of CD45RO⁺CXCR3⁺ T cells for AD, quantified by the area under the curve (AUC). <b>Results:</b> Compared to healthy controls, AD patients exhibited significantly elevated levels of CD8⁺CD45RO⁺CXCR3⁺ T cells [17.8% (7.2%, 40.3%) vs. 8.2% (5.1%, 12.3%), <i>Z</i>=-2.59, <i>P</i><0.05]. However, no significant differences were observed for CD4⁺CD45RO⁺CXCR3⁺ T cells, CD4⁺CD45RO⁻CXCR3⁺ T cells, or CD8⁺CD45RO⁻CXCR3⁺ T cells (<i>P</i>>0.05). Spearman correlation analysis revealed a negative correlation between CD8⁺CD45RO⁺CXCR3⁺ T cell levels and cognitive scores (MMSE: <i>r</i>=-0.72, <i>P</i><0.05; MoCA: <i>r</i>=-0.70, <i>P</i><0.05). ROC analysis demonstrated an AUC of 0.81 for CD8⁺CD45RO⁺CXCR3⁺ T cells in predicting AD, with a sensitivity of 59.0% and specificity of 93.3%. <b>Conclusions:</b> CXCR3 expression is significantly upregulated on CD8⁺CD45RO⁺ T cells in AD patients, and its levels correlate with cognitive impairment severity. These findings suggest that CD8⁺CD45RO⁺CXCR3⁺ T cells may serve as a potential biomarker for AD diagnosis and progression monitoring.</p>","PeriodicalId":68309,"journal":{"name":"中华内科杂志","volume":"64 4","pages":"339-343"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143756186","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 of primary biliary cholangitis combined with autoimmune pancreatitis and autoimmune gastritis].","authors":"X Y Huang, C Zhou, L Lei, Y Hu, L P Li, D Zhang","doi":"10.3760/cma.j.cn112138-20240930-00622","DOIUrl":"https://doi.org/10.3760/cma.j.cn112138-20240930-00622","url":null,"abstract":"","PeriodicalId":68309,"journal":{"name":"中华内科杂志","volume":"64 3","pages":"244-246"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143574631","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":"[Autoimmune diseases of digestive system: challenges and opportunities].","authors":"Y L Shang, Y Han","doi":"10.3760/cma.j.cn112138-20250122-00055","DOIUrl":"https://doi.org/10.3760/cma.j.cn112138-20250122-00055","url":null,"abstract":"","PeriodicalId":68309,"journal":{"name":"中华内科杂志","volume":"64 3","pages":"183-185"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143574653","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 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":"<p><p><b>Objective:</b> 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. <b>Methods:</b> 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. <b>Results:</b> 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 (<i>P</i><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. <b>Conclusion:</b> 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.</p>","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}

{"title":"[Diagnosis and treatment of serum IgG₄-negative type 1 autoimmune pancreatitis].","authors":"C X Liu, X D Zhang, Y Zhang, X N Shen, C H Zhou, D W Zou","doi":"10.3760/cma.j.cn112138-20240925-00605","DOIUrl":"https://doi.org/10.3760/cma.j.cn112138-20240925-00605","url":null,"abstract":"","PeriodicalId":68309,"journal":{"name":"中华内科杂志","volume":"64 3","pages":"266-269"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143574749","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}