中华内科杂志最新文献

{"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":"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":"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":"[Study of the occurrence of metabolic dysfunction-associated fatty liver disease in obstructive sleep apnea hypopnea syndrome and its risk factors].","authors":"Y L Guo, D Y Zhang, S J Xu, M J Zhang, J Li","doi":"10.3760/cma.j.cn112138-20240812-00506","DOIUrl":"10.3760/cma.j.cn112138-20240812-00506","url":null,"abstract":"<p><p><b>Objective:</b> To analyze the occurrence of metabolic dysfunction-associated fatty liver disease (MAFLD) and related inflammatory indicators in obstructive sleep apnea hypopnea syndrome (OSAHS) and explore the risk factors of MAFLD. <b>Methods:</b> A cross-sectional study. From January 2022 to October 2024,172 patients with sleep disorders were enrolled in the First Affiliated Hospital of Soochow University,including 38 patients with non-OSAHS,53 patients with mild OSAHS,37 patients with moderate OSAHS,and 44 patients with severe OSAHS. The occurrence of MAFLD was comprehensively judged from three aspects: metabolic dysfunction-associated fatty liver (MAFL),elevated liver enzymes,and liver fibrosis. The situation of MAFLD and the level of related inflammatory markers were compared among the four groups. Binary logistic regression was used to analyze the risk factors for MAFLD in OSAHS. <b>Results:</b> There were significant differences in the prevalence of MAFL,the percentage of elevated liver enzymes,and interleukin-6 and tumor necrosis factor-alpha levels among the four groups (<i>P</i><0.05). The differences of fibrosis-4 index and C-reactive protein among the four groups were not statistically significant (<i>P</i>>0.05). Binary logistic regression showed that BMI,triglycerides,longest time of sleep apnea and tumor necrosis factor-alpha were the risk factors for MAFL (<i>P</i><0.05). BMI,glucose,and apnea-hypopnea index were the risk factors for elevated liver enzymes (<i>P</i><0.05). <b>Conclusions:</b> OSAHS is strongly associated with MAFLD,and the involvement of OSAHS in the occurrence and development of MAFLD may be related to obesity,lipid metabolism disorders,insulin resistance,inflammatory responses,and intermittent hypoxia.</p>","PeriodicalId":68309,"journal":{"name":"中华内科杂志","volume":"64 2","pages":"128-133"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143043843","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 and prediction of the age-period-cohort model of disease burden of rheumatoid arthritis in China from 1990 to 2019].","authors":"X M Wei, J Zhang, W J Li, Z Y Zhang","doi":"10.3760/cma.j.cn112138-20240328-00200","DOIUrl":"10.3760/cma.j.cn112138-20240328-00200","url":null,"abstract":"<p><p>Using the Global Burden of Disease Study 2019 (GBD 2019) database, the Joinpoint regression model was used to analyze the trend of rheumatoid arthritis (RA) incidence and the standardized disability-adjusted life years (DALY) rate in China. The age, period, and cohort effects were discussed based on the age-period-cohort model. The grey prediction model GM (1, 1) was used to fit the trend of incidence and the standardized DALY rate of RA and predict the incidence and standardized DALY rate of RA in China from 2020 to 2034. From 1990 to 2019, the incidence, standardized incidence, and standardized DALY rate of RA showed a gradual upward trend, with an average annual increase of 1.41% (95%<i>CI</i> 1.32%-1.44%, <i>P</i><0.001); 0.10% (95%<i>CI</i> 0.01%-0.14%, <i>P</i><0.001); and 1.91% (95%<i>CI</i> 1.82%-2.12%, <i>P</i><0.001). The results of the age-period-cohort model showed that the longitudinal age curve of the incidence of RA from 1990 to 2019 showed a trend of increasing first and then decreasing, reaching a peak in the 60-64 years age group. The longitudinal age curve of the standardized DALY rate showed a gradual upward trend, reaching the peak in the 85-89 years age group. The results of period effect showed that the risk of RA increased first and then decreased from 1990 to 2019, with the highest risk from 2010 to 2014, and the risk of incidence was <i>RR</i>=1.03 (95%<i>CI</i> 1.00-1.06). The risk of DALY showed a fluctuating change, with a trend of decreasing first, then increasing, and then decreasing again. The highest risk of DALY in 2005-2009 period was <i>RR</i>=1.03 (95%<i>CI</i> 1.02-1.05). The results of the cohort effect showed that the later the birth, the higher the risk of morbidity and DALY. From 2020 to 2034, the projected incidence and standardized DALY rate of RA in China showed an upward trend. RA remains a major public health challenge. From 1990 to 2019, the incidence, standardized incidence, and standardized DALY rate of RA in China showed an increasing trend, which were affected by age, period effect, and cohort effect to varying degrees. Although the burden of RA in China is lower than the global average, it is still essential to take active preventive measures to reduce the burden of RA and identify and treat RA early.</p>","PeriodicalId":68309,"journal":{"name":"中华内科杂志","volume":"64 2","pages":"142-147"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143043786","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 bilateral aldosterone-producing adenoma diagnosed by ⁶⁸Ga-Pentixafor PET/CT].","authors":"X Y He, H Shen, Y Song, X S Zhang, W W He, Z P Feng, J B Hu, S M Yang, Q F Li","doi":"10.3760/cma.j.cn112138-20240715-00451","DOIUrl":"10.3760/cma.j.cn112138-20240715-00451","url":null,"abstract":"","PeriodicalId":68309,"journal":{"name":"中华内科杂志","volume":"64 2","pages":"173-177"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143043771","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":"[Efficacy and safety of transarterial chemoembolization combined with sintilimab and bevacizumab biosimilar for unresectable hepatocellular carcinoma].","authors":"H Yang, J T Huang, D Hu, B Y Zhong, J Shen, X L Zhu","doi":"10.3760/cma.j.cn112138-20240805-00492","DOIUrl":"10.3760/cma.j.cn112138-20240805-00492","url":null,"abstract":"<p><p><b>Objective:</b> To investigate the efficacy and safety of transarterial chemoembolization (TACE) combined with sintilimab and bevacizumab biosimilar in the treatment of unresectable hepatocellular careinoma (uHCC). <b>Methods:</b> The clinical data of 64 patients with unresectable HCC, who were admitted to the First Affiliated Hospital of Soochow University between January 2021 and December 2023, were retrospectively analyzed. The patients were divided into a combination group (<i>n</i>=43, receiving TACE combined with sintilimab and bevacizumab biosimilar) and control group (<i>n</i>=21, receiving only sintilimab and bevacizumab biosimilar). Survival curves were drawn by Kaplan-Meier method, and the median overall survival (mOS) and median progression-free survival (mPFS) were compared between the two groups. According to the mRECIST criterion, the objective response rate (ORR) and disease control rate (DCR) were compared between the two groups. The occurrences of adverse events in both groups were recorded. <b>Results:</b> The mOS and mPFS in the combination group were 22.3 months and 12.4 months, respectively, which in the control group was 11.6 months and 6.4 months, respectively. The differences between the two groups were statistically significant (<i>P</i>=0.001 and <i>P</i>=0.002). The ORR and DCR in the combination group were 62.8% and 95.3% respectively, which were significantly higher than 19.0% and 57.1% respectively in the control group (all <i>P</i><0.01). No statistically significant difference in the incidence of severe adverse events existed between the two groups (<i>P</i>=0.518). <b>Conclusion:</b> TACE combined with sintilimab and bevacizumab biosimilar has efficacy and safety than sintilimab and bevacizumab biosimilar alone.</p>","PeriodicalId":68309,"journal":{"name":"中华内科杂志","volume":"64 2","pages":"134-141"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143043752","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":"[Application value of CT in the assessment of spinal structural damage in axial spondyloarthritis].","authors":"S M Liao, J Zhu, F Huang","doi":"10.3760/cma.j.cn112138-20241010-00668","DOIUrl":"10.3760/cma.j.cn112138-20241010-00668","url":null,"abstract":"","PeriodicalId":68309,"journal":{"name":"中华内科杂志","volume":"64 2","pages":"178-182"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143043790","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 characteristics and associated factors of hand dysfunction in patients with rheumatoid arthritis].","authors":"Y W Zou, Y Yang, Z M Ouyang, J Pan, P W Jia, K M Yang, H W Zheng, T Wu, J Z Lin, J D Ma, Y Q Mo, L Dai","doi":"10.3760/cma.j.cn112138-20240626-00406","DOIUrl":"10.3760/cma.j.cn112138-20240626-00406","url":null,"abstract":"<p><p><b>Objective:</b> To investigate the characteristics of hand dysfunction and its associated factors in patients with rheumatoid arthritis (RA). <b>Methods:</b> A cross-sectional study. Patients with RA were recruited from January 2019 to April 2024 at the Department of Rheumatology and Immunology, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University. Demographic and clinical data were collected, including age, gender, active smoking, disease duration, time of morning stiffness, rheumatoid factor and anti-cyclic citrullinated peptide antibody, disease activity, radiographic indicators, and hand function assessment. Hand function was assessed by grip strength measures and self-reported items related to hand function in the Stanford Health Assessment Questionnaire. Factors related to hand function were analyzed by logistic regression analyses. <b>Results:</b> A total of 1 079 RA patients were recruited [mean age: (53.0±12.6) years]. Overall, 72.6% (783/1 079) patients experienced a decrease in grip strength, 57.2% (617/1 079) patients experienced a decreased grip strength in both hands, with the average grip strength of the left and right hands decreasing by 16.3% and 14.1%, respectively, compared to normal values; 39.9% (430/1 079) patients had self-reported hand dysfunction. There were 185 (17.1%) older RA patients (age ≥65 years). The proportion of older RA patients with decreased grip strength [89.7% (166/185) vs. 69.0% (617/894)] and degree of decrease in grip strength compared to normal values (left hand:-35.3%±30.6% vs. -12.3%±38.6%; right hand:-32.6%±32.3% vs. -10.3%±42.1%) were significantly higher than that in young patients, and the proportion of older patients with self-reported hand dysfunction was also significantly higher [53.0% (98/185) vs. 37.1% (332/894), all <i>P</i><0.001]. Multivariate logistic regression analysis showed that pain visual analogue scale (<i>OR</i>=1.375, 95%<i>CI</i> 1.020-1.854) was independently associated with grip strength decrease in older RA patients, while the 28-joint tender joint count (<i>OR</i>=1.151, 95%<i>CI</i> 1.063-1.246) and provider global assessment of disease activity (<i>OR</i>=1.381, 95%<i>CI</i> 1.171-1.628) were associated with self-reported hand dysfunction. <b>Conclusions:</b> Hand dysfunction is common in RA patients, especially among older RA patients, which is related to pain, joint tenderness and provider global assessment of disease activity. This result implies the importance of pain management in RA patients.</p>","PeriodicalId":68309,"journal":{"name":"中华内科杂志","volume":"64 2","pages":"119-127"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143043847","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 the perioperative management of co-ablation system therapy of liver tumors].","authors":"","doi":"10.3760/cma.j.cn112138-20240621-00396","DOIUrl":"10.3760/cma.j.cn112138-20240621-00396","url":null,"abstract":"<p><p>This study aims to improve the quality of clinical treatment and nursing care to standardize perioperative management for patients with liver tumors undergoing co-ablation system therapy. The Committee of Ablation Therapy in Oncology, China Anti-Cancer Association; the Expert Committee on Ablation Therapy; Chinese Society of Clinical Oncology (CSCO); and the Committee of Interventional, Perioperative, and Interventional Physician Branch of Chinese Medical Doctors Association organized medical and nursing experts in China. Based on the clinical practice of co-ablation system therapy in China and relevant domestic literature, an expert consensus about perioperative management was developed. The expert consensus included the key points of perioperative management, prevention, and care of complications; discharge guidance; and follow-up management for patients undergoing co-ablation system therapy of liver tumors. The consensus on the perioperative management of co-ablation system therapy for liver tumors has finally been formulated, serving as a reference and application for medical personnel in relevant fields based on hospital and patient conditions in clinical work.</p>","PeriodicalId":68309,"journal":{"name":"中华内科杂志","volume":"64 2","pages":"110-118"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143043753","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: indications and contraindications for 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.cn112138-20240805-00491","DOIUrl":"10.3760/cma.j.cn112138-20240805-00491","url":null,"abstract":"","PeriodicalId":68309,"journal":{"name":"中华内科杂志","volume":"64 2","pages":"95-100"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143043817","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}