中华内科杂志最新文献

{"title":"[Progress in diagnosis and treatment of primary biliary cholangitis].","authors":"Y S Liu, X Y Men, Y L Shang, Y Han","doi":"10.3760/cma.j.cn112138-20240930-00623","DOIUrl":"https://doi.org/10.3760/cma.j.cn112138-20240930-00623","url":null,"abstract":"","PeriodicalId":68309,"journal":{"name":"中华内科杂志","volume":"64 3","pages":"270-276"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143574816","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 characteristic analysis of refractory <i>Helicobacter pylori</i> infection of 637 patients].","authors":"B J Suo, Y X Zhang, C L Li, L Y Zhou, Z Q Song","doi":"10.3760/cma.j.cn112138-20241030-00714","DOIUrl":"https://doi.org/10.3760/cma.j.cn112138-20241030-00714","url":null,"abstract":"<p><p><b>Objective:</b> To evaluate the effectiveness of empiric eradication therapy recommendations and medication principles for refractory infections based on the 2022 <i>Helicobacter pylori</i> (<i>H. pylori</i>) infection treatment guidelines in China in clinical practice. <b>Methods:</b> A retrospective analysis was conducted to evaluate the eradication efficacy of <i>H. pylori</i> and the safety and treatment compliance among of 637 patients with refractory <i>H. pylori</i> infection in our center over the past 10 years. Risk factors affecting efficacy of <i>H. pylori</i> eradication were evaluated. <b>Results:</b> The overall eradication rate, incidence of adverse reactions and medication percentage of 14-day bismuth quadruple therapy were 92.3%, 40.3% and 92.2%, respectively. The eradication rate, incidence of adverse reactions, and proportion of administered treatments were as follows: 87.3%, 36.4% and 92.7% for amoxicillin+metronidazole; 91.1%, 39.2% and 93.7% for amoxicillin+tetracycline; 92.9%, 23.8% and 94.0% for amoxicillin+furazolidone; 92.1%, 47.1% and 90.0% for tetracycline+metronidazole; 94.5%, 41.7% and 92.0% for tetracycline+furazolidone, and 91.3%, 46.3% and 92.5% for furazolidone+metronidazole. Poor compliance was a risk factor for the failure of eradication therapy (94.7% vs. 64.0%, <i>P</i><0.05). There was no statistically significant difference (<i>P</i>>0.05) in the eradication rate among patients in terms of sex, age, body mass index, smoking status, alcohol consumption, previous eradication frequency, eradication interval, or eradication regimens. <b>Conclusion:</b> The empirical treatment regimens and medication principles recommended in the 2022 <i>H. pylori</i> infection treatment guidelines in China achieve good eradication efficacy, safety, and compliance.</p>","PeriodicalId":68309,"journal":{"name":"中华内科杂志","volume":"64 3","pages":"220-224"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143574742","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":"[Preliminary study on the value of serum pepsinogen in differentiating autoimmune gastritis].","authors":"K Liu, L W Miao, Y T She, W H Yu, H Tian, Y Z Wang, F L Du, Y Han, Z G Liu","doi":"10.3760/cma.j.cn112138-20241008-00657","DOIUrl":"https://doi.org/10.3760/cma.j.cn112138-20241008-00657","url":null,"abstract":"<p><p><b>Objective:</b> This study identifies independent predictive indicators to distinguish autoimmune gastritis from <i>Helicobacter pylori</i> (<i>H. pylori</i>)-induced atrophic gastritis and validates their diagnostic performance to compare laboratory indicators of autoimmune gastritis and <i>H. pylori</i>-induced atrophic gastritis. <b>Methods:</b> A retrospective comparison of laboratory examination indicators was conducted for chronic atrophic gastritis patients with involvement of the gastric fundus and corpus, who were followed up at the Department of Gastroenterology, Xijing Hospital, from January 2014 to September 2024. Receiver operating characteristic (ROC) curves were utilized to determine the optimal cutoff points and corresponding diagnostic thresholds. In addition, multivariate logistic regression analysis was conducted to identify independent predictive indicators for autoimmune gastritis, with further assessment in a validation cohort. <b>Results:</b> A total of 139 patients with autoimmune gastritis and 209 patients with <i>H. pylori</i>-induced atrophic gastritis were included. Pepsinogen (PG) Ⅰ levels and the PG Ⅰ/PG Ⅱ ratio in patients with autoimmune gastritis were significantly lower than in those with <i>H. pylori</i>-induced atrophic gastritis [11.0 (4.8, 22.5) vs. 41.8 (32.2, 59.9) μg/L, <i>U</i>=722.00, <i>P</i><0.001; 1.24 (0.75, 3.54) vs. 5.76 (4.31, 7.12), <i>U</i>=817.00, <i>P</i><0.001], while gastrin levels were significantly higher [375 (84, 738) vs. 49 (35, 81) ng/L, <i>U</i>=378.00, <i>P</i><0.001]. PG Ⅰ was identified as an independent predictive variable, with an area under the ROC curve of 0.847 (95%<i>CI</i> 0.791-0.904), sensitivity of 77.6%, specificity of 91.8%, positive predictive value of 80.5%, and negative predictive value of 90.5%. <b>Conclusions:</b> Significant differences in laboratory indicators were observed between autoimmune gastritis and <i>H. pylori</i>-induced atrophic gastritis in chronic atrophic gastritis involving gastric fundus and corpus. Besides, PG Ⅰ demonstrated good diagnostic performance in identifying autoimmune gastritis and can effectively differentiate between different types of atrophic gastritis.</p>","PeriodicalId":68309,"journal":{"name":"中华内科杂志","volume":"64 3","pages":"200-205"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143574813","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":"[Drug conversion of enzyme replacement for Fabry disease: a case report].","authors":"Y Fu, J Zhang, L Liu, N Chen, Z F Sun","doi":"10.3760/cma.j.cn112138-20240830-00547","DOIUrl":"https://doi.org/10.3760/cma.j.cn112138-20240830-00547","url":null,"abstract":"","PeriodicalId":68309,"journal":{"name":"中华内科杂志","volume":"64 2","pages":"152-156"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143061599","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":"[To comprehensively improve the diagnosis and treatment of critical care medicine by focusing on cognition, recognition and workflow management].","authors":"X Y Zeng, M G Yin, Y Kang","doi":"10.3760/cma.j.cn112138-20241119-00765","DOIUrl":"10.3760/cma.j.cn112138-20241119-00765","url":null,"abstract":"","PeriodicalId":68309,"journal":{"name":"中华内科杂志","volume":"64 2","pages":"91-94"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143043851","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 rare case of PIK3R1 gene mutation associated SHORT syndrome].","authors":"X Zhang, L W H Lin, L Xie, K N Chen, H B Quan","doi":"10.3760/cma.j.cn112138-20240513-00303","DOIUrl":"https://doi.org/10.3760/cma.j.cn112138-20240513-00303","url":null,"abstract":"","PeriodicalId":68309,"journal":{"name":"中华内科杂志","volume":"64 1","pages":"60-64"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143056162","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 hypomagnesemia with secondary hypocalcemia caused by a novel compound heterozygous mutation of the TRPM6 gene].","authors":"Y J Wang, X N Hu, X L Wang, J M Ba, Z H Lyu","doi":"10.3760/cma.j.cn112138-20240701-00415","DOIUrl":"10.3760/cma.j.cn112138-20240701-00415","url":null,"abstract":"","PeriodicalId":68309,"journal":{"name":"中华内科杂志","volume":"64 1","pages":"65-68"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143056161","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 opinions on influenza vaccination for patients with common cardiovascular diseases].","authors":"","doi":"10.3760/cma.j.cn112138-20240719-00462","DOIUrl":"https://doi.org/10.3760/cma.j.cn112138-20240719-00462","url":null,"abstract":"<p><p>The influenza virus is classified as a single-stranded negative-sense RNA virus in Orthomyxoviridae family, with epidemiological properties distinct from common cold. Previous studies have found that influenza infection can cause cardiac damage through various pathways, and patients with cardiovascular diseases are at relatively higher risk of adverse disease outcomes. Influenza vaccination has been proven to provide protective effect on patients with cardiovascular diseases. Currently, there is insufficient emphasis placed by cardiologists and cardiovascular disease patients on the prevention of influenza infection, leading to a low influenza vaccination rate in China. Therefore, based on the current clinical research progress and relevant guidelines, combined with the safety, feasibility and health economic benefits of influenza vaccinating in patients with cardiovascular diseases, as well as clinical experience from experts, this article proposes expert opinions on influenza vaccination in common cardiovascular diseases aiming to raise awareness of influenza prevention and benefiting patients.</p>","PeriodicalId":68309,"journal":{"name":"中华内科杂志","volume":"64 1","pages":"11-22"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142959598","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 510th case: fever of unknown origin, acute kidney injury].","authors":"Y R Shou, Y L Mai, F P Guo, H Zheng, C W Jia, X Y Li, Z Y Liu, T S Li","doi":"10.3760/cma.j.cn112138-20240508-00293","DOIUrl":"https://doi.org/10.3760/cma.j.cn112138-20240508-00293","url":null,"abstract":"<p><p>A 65-year-old male was admitted to Peking Union Medical College Hospital. The patient had intermittent fever for 2 months with a maximum body temperature of 39.3 ℃ and elevated serum creatinine levels for 1 week. He had no other suggestive symptoms or positive signs. Laboratory test results suggested acute kidney injury and a sharp elevation in serum lactic dehydrogenase levels. Abdominal enhanced computed tomography (CT) revealed multiple low-density lesions, and further biopsy pathology demonstrated chronic inflammation. Thereafter, positron emission tomography (PET)/CT showed abnormally elevated uptake value for the bones throughout the entire body, in addition to the liver and brain. Repeated bone marrow biopsy finally confirmed metastatic bone cancer, which possibly originated from the kidney according to immunohistochemical staining. In this rare case of fever of unknown origin, the primary lesion was a renal tumor with bone, liver, and brain metastases. Enhanced CT and PET/CT provided negative results, and the diagnosis was eventually confirmed by repeated bone marrow pathology.</p>","PeriodicalId":68309,"journal":{"name":"中华内科杂志","volume":"64 1","pages":"83-87"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142959668","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":"[Analyses of the risk factors of delayed extubation after extended thymectomy in patients with myasthenia gravis].","authors":"M P Wang, X Q Sun, L Jiang, R Lou, Q Si, T T Wang, G J Lu","doi":"10.3760/cma.j.cn112138-20240905-00555","DOIUrl":"https://doi.org/10.3760/cma.j.cn112138-20240905-00555","url":null,"abstract":"<p><p><b>Objective:</b> To explore the risk factors of delayed extubation after expanded thymectomy in patients with myasthenia gravis. <b>Methods:</b> Patients with myasthenia gravis who underwent expanded thymectomy from May 2021 to January 2024 and were admitted to Intensive Care Unit (ICU) after surgery were retrospectively analyzed. Patients were divided in to the delayed extubation and successful extubation according to the length of mechanical ventilation whether exceeding than 48 hours. Multivariable logistics regression was used to explore the risk factors for delayed extubation after expanded thymectomy in patients with myasthenia gravis. <b>Results:</b> A total of 95 patients were included.15 (15.8%) of whom were delayed extubation. Compared with the successful extubation patients, the length of mechanical ventilation (94.0 h vs. 15.5 h, <i>P</i><0.001), ICU station (7.1 days vs. 1.7 days, <i>P</i><0.001), and hospitalization station (16.0 days vs. 9.1 days, <i>P</i><0.001) were significantly prolonged in the delayed extubation patients. Adjusted for age,gender, BMI, clinical classification, pathological classification of thymoma, dose of pyridostigmine preoperative, perioperative pneumonia, preoperative pulmonary dysfunction, SBT passing for the first time, neck lift time greater than 20 seconds, the multivariable logistic regression shown, the risk of delayed extubation increased by 29% (<i>OR</i>=1.290, 95%<i>CI</i> 1.090-1.714), 1% (<i>OR</i>=1.009, 95%<i>CI</i> 1.002-1.034), 3.9-fold (<i>OR</i>=4.977, 95%<i>CI</i> 1.486-10.939), and 64% (<i>OR</i>=1.635, 95%<i>CI</i> 1.396-2.682) for every 60 mg/day increase in preoperative dose of pyridostigmine, pathological classification of thymoma, perioperative pneumonia, and preoperative pulmonary dysfunction, respectively. Neck lift time greater than 20 seconds can reduce the risk of delayed extubation 48% (<i>OR</i>=0.524, 95%<i>CI</i> 0.322-0.794). <b>Conclusion:</b> Preoperative administration of a large dose of pyridostigmine, pulmonary dysfunction, pathological classification of thymoma, and perioperative pneumonia were risk factors for delayed extubation after thymectomy in these patients. And neck lift time greater than 20 seconds decreased the risk of delayed extubation. In the clinical practice,for high risk of MG patients with delayed extubation, the neck lifting test may be used to assess muscle strength and reduce the occurance of tracheal reintubation and its advise effects.</p>","PeriodicalId":68309,"journal":{"name":"中华内科杂志","volume":"64 1","pages":"52-59"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142959661","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}