中华内科杂志最新文献

{"title":"[Effectiveness of endoscopic ultrasound-guided biliary drainage in patients experiencing obstructive jaundice due to unsuccessful endoscopic retrograde cholangiopancreatography].","authors":"G Zhang, G P Zhao, Z Liang, S T Zhang","doi":"10.3760/cma.j.cn112138-20231213-00378","DOIUrl":"https://doi.org/10.3760/cma.j.cn112138-20231213-00378","url":null,"abstract":"<p><p><b>Objective:</b> To assess the treatment outcomes of endoscopic ultrasound-guided biliary drainage (EUS-BD) in patients with obstructive jaundice due to unsuccessful endoscopic retrograde cholangiopancreatography (ERCP). <b>Methods:</b> The clinical data of patients with obstructive jaundice who underwent EUS-BD due to ERCP failure at the Gastrointestinal Endoscopy Center of Beijing Friendship Hospital from September 2018 to November 2023, was retrospectively collected and analyzed. We explored the technical success, clinical success, and adverse events associated with EUS-BD. <b>Results:</b> In total, 43 EUS-BD procedures were performed in 39 patients with a technical success rate of 86.0% (37/43). The clinical success rate was 81.1% (30/37). Biliary drainage was not effectively achieved in seven cases, including two fatal cases and five cases of recurrent postoperative biliary obstruction. The incidence of adverse events was 21.6% (8/37), including two cases of postoperative bile leakage peritonitis, two cases of stent displacement, one case of stent dislocation, one case of perforation, and two cases of death. <b>Conclusion:</b> EUS-BD is a relatively safe and effective method for bile duct drainage, serving as a dependable alternative therapeutic option for patients with obstructive jaundice due to unsuccessful ERCP.</p>","PeriodicalId":68309,"journal":{"name":"中华内科杂志","volume":"63 10","pages":"975-981"},"PeriodicalIF":0.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142395633","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 outcomes of allogeneic hematopoietic stem cell transplantation from matched sibling donor for myelofibrosis].","authors":"R Ma, B R Tang, T T Han, X Y Luo, W Han, Y Chen, X D Mo, L P Xu, X H Zhang, Y Wang, X J Huang, Y Q Sun","doi":"10.3760/cma.j.cn112138-20240409-00225","DOIUrl":"https://doi.org/10.3760/cma.j.cn112138-20240409-00225","url":null,"abstract":"<p><p><b>Objective:</b> To evaluate the efficacy and safety of matched sibling donor allogeneic hematopoietic stem cell transplantation (allo-HSCT) for the treatment of myelofibrosis (MF). <b>Methods:</b> In this case series, the clinical data of 18 patients with MF who received allo-HSCT in the Department of Hematology, Peking University People's Hospital from December 2008 to December 2023 were retrospectively studied. Kaplan-Meier survival analysis and competitive risk model were used to evaluate the probabilities of 3-year overall survival (OS), disease-free survival (DFS), cumulative incidence of relapse (CIR), and transplant related mortality (TRM). The transplant related complications were also analyzed. <b>Results:</b> Among the 18 patients included, there were 12 males and 6 females, with a median age of 50 (range: 28-64) years. All 18 patients achieved neutrophil engraftment, and the time of neutrophil engraftment [<i>M</i> (<i>Q</i>₁, <i>Q</i>₃)] was 16.0 (11.8, 18.0) days. Twelve patients achieved platelet engraftment, and the platelet engraftment time was 21.0 (16.2, 43.2) days. Six patients had grade Ⅱ to Ⅳ acute graft-versus-host disease (GVHD), and six patients had chronic GVHD. The 3-year OS rate and DFS rate after transplantation were 62.2% and 52.2%, respectively. The 3-year CIR and TRM were 29.7% and 24.6%, respectively. Four patients died during follow-up, with the main cause of death being infections. <b>Conclusion:</b> Matched sibling allo-HSCT is a feasible option for the treatment of MF.</p>","PeriodicalId":68309,"journal":{"name":"中华内科杂志","volume":"63 10","pages":"961-967"},"PeriodicalIF":0.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142395632","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 insights into the application of gastrointestinal gases in inflammatory bowel disease].","authors":"X H Zhang, X L Zhang, Y S Yang","doi":"10.3760/cma.j.cn112138-20230911-00123","DOIUrl":"https://doi.org/10.3760/cma.j.cn112138-20230911-00123","url":null,"abstract":"","PeriodicalId":68309,"journal":{"name":"中华内科杂志","volume":"63 10","pages":"1018-1023"},"PeriodicalIF":0.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142395636","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 a family with Fabry disease with 15 patients].","authors":"J L Yang, J N Jiang, Z Y Wei, S Q Peng, B Wang, F M Wang, L Sun, W M He, X L Zhang","doi":"10.3760/cma.j.cn112138-20240124-00071","DOIUrl":"https://doi.org/10.3760/cma.j.cn112138-20240124-00071","url":null,"abstract":"","PeriodicalId":68309,"journal":{"name":"中华内科杂志","volume":"63 10","pages":"1001-1006"},"PeriodicalIF":0.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142395631","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":"[Relationship between epilepsy and patent foramen ovale].","authors":"X Zhang, C J Shao, D S Li, R Ao, X B Shi, X Q Wang","doi":"10.3760/cma.j.cn112138-20240105-00011","DOIUrl":"https://doi.org/10.3760/cma.j.cn112138-20240105-00011","url":null,"abstract":"<p><p>This study aimed to investigate the prevalence and clinical characteristics of epilepsy in patients with patent foramen ovale (PFO) and the effect of PFO closure on seizures. Patients diagnosed with PFO were recruited and underwent brain magnetic resonance imaging, electrocardiography, transesophageal echocardiography, and transthoracic echocardiography with right ventriculography. In patients with epilepsy, electroencephalography was performed. A total of 110 patients completed the assessment. A chief complaint of chest tightness or palpitations was proportionately higher in patients aged<18 years, whereas headaches and seizures were higher in patients aged≥18 years (<i>χ</i>²=4.69<i>,P</i><0.05). Comorbid epilepsy was observed in 20.9% of patients with PFO. The age at admission in the epileptic group (14-66(27±14)years) was significantly lower than that in the non-epileptic group (16-81(38±21)years) and that in patients with headache as the chief complaint (16-68(39±12)years) (<i>t</i>=3.29, <i>P</i><0.05). The multivariate analysis found no risk factors related to the prognosis of epilepsy. The incidence of epilepsy was significantly higher in patients with PFO than in the general population.</p>","PeriodicalId":68309,"journal":{"name":"中华内科杂志","volume":"63 10","pages":"993-995"},"PeriodicalIF":0.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142395640","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 clinical characteristics of adult anti-nuclear matrix protein-2 antibody positive dermatomyositis].","authors":"C Y Li, S S Li","doi":"10.3760/cma.j.cn112138-20240328-00201","DOIUrl":"https://doi.org/10.3760/cma.j.cn112138-20240328-00201","url":null,"abstract":"","PeriodicalId":68309,"journal":{"name":"中华内科杂志","volume":"63 10","pages":"1029-1032"},"PeriodicalIF":0.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142395642","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":"[Percutaneous transhepatic papillary balloon dilation combined with dual-frequency double-pulse laser lithotripsy for large-diameter common bile duct stones].","authors":"Y R Sun, T Jiang, H G Shang, G Chen, W Wang, Y Z Wang, Y L Li, W J Wang","doi":"10.3760/cma.j.cn112138-20231201-00358","DOIUrl":"https://doi.org/10.3760/cma.j.cn112138-20231201-00358","url":null,"abstract":"<p><p><b>Objective:</b> To evaluate the safety and efficacy of percutaneous transhepatic papillary balloon dilation (PTPBD) combined with flexible ureteroscopy-guided dual-frequency double-pulse ND:YAG (FREDDY) laser lithotripsy (PTPBD-FREDDY) for the treatment of giant (>1.5 cm diameter) common bile duct stones. <b>Methods:</b> A retrospective analysis was conducted on 26 patients with large-diameter difficult choledocholithiasis admitted to two medical centers from December 2017 to October 2021. Among these patients, four could not tolerate surgery or endoscopic treatment, six experienced failure of endoscopic treatment, and 16 refused to undergo endoscopic or surgical treatment. All patients underwent the PTPBD-FREDDY procedure. The FREDDY laser lithotripsy was performed under ureteroscopic guidance, followed by a balloon to push the stones into the duodenum. The primary endpoint was the technical success rate, and the secondary endpoints included the rate of stone recurrence and related complications. <b>Results:</b> All 26 patients successfully completed the operation, achieving a technical success rate of 100%. The average lithotripsy frequency and operation time for bilirubin stones were significantly higher than those of mixed stones and cholesterol stones (<i>P</i><0.01). The main postoperative complications included mild fever (<i>n</i>=3), abdominal pain (<i>n</i>=3), nausea (<i>n</i>=2) and vomiting (<i>n</i>=1). One patient experienced biliary tract bleeding, which improved after conservative treatment. No serious complications such as pancreatitis, sepsis, or biliary perforation were observed. After 2 years of follow-up, no cases of stone recurrence were observed. <b>Conclusions:</b> PTPBD-FREDDY is a safe and effective treatment for patients with giant common bile duct stones. It provides a new therapeutic option for patients with giant choledocholithiasis who can not tolerate surgery or have failed endoscopic treatment, demonstrating promising prospects.</p>","PeriodicalId":68309,"journal":{"name":"中华内科杂志","volume":"63 10","pages":"982-986"},"PeriodicalIF":0.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142395637","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":"[Gastrointestinal involvement in Ehlers-Danlos syndrome: A case series and systematic review].","authors":"Y P Shao, S Q Pan, Y Li, J Li, X Q Li","doi":"10.3760/cma.j.cn112138-20240328-00203","DOIUrl":"https://doi.org/10.3760/cma.j.cn112138-20240328-00203","url":null,"abstract":"<p><p><b>Objective:</b> To explore the clinical and genetic characteristics of patients with Ehlers-Danlos syndrome (EDS) and gastrointestinal involvement. <b>Methods:</b> We retrospectively collected the clinical data of patients with EDS and gastrointestinal involvement from the electronic medical records at Peking Union Medical College Hospital (PUMCH) from January 2003 to September 2023. Additionally, we conducted a systematic review by searching cases with EDS and gastrointestinal involvement in PubMed, Embase, Web of Science, and the Cochrane Library databases from January 2000 to September 2023. <b>Results:</b> Ninety-four patients with EDS and gastrointestinal involvement were retrieved, including five patients from PUMCH and 89 patients from 80 published articles. The average age of patients was (29±14) years. The most common manifestation of gastrointestinal involvement was gastrointestinal perforation (<i>n</i>=46, 48.9%), followed by functional gastrointestinal symptoms (<i>n</i>=33, 35.1%), and digestive arterial disorders (<i>n</i>=10, 10.6%). The most common clinical subtype was vascular-EDS (vEDS) (<i>n=</i>50, 53.2%) followed by hypermobile-EDS (hEDS) (<i>n</i>=20, 21.3%). The most frequent genetic mutation occurred in the COL3A1 gene (<i>n=</i>30, 31.9%). Among patients with vEDS, gastrointestinal manifestations included gastrointestinal perforation (<i>n=</i>33, 66.0%), arterial lesions (<i>n=</i>9, 18.0%), and functional gastrointestinal symptoms (<i>n=</i>7, 14.0%). Among patients with hEDS, gastrointestinal manifestations included functional gastrointestinal symptoms (<i>n</i>=18, 90.0%), visceral prolapse (<i>n</i>=3, 15.0%) and intestinal volvulus (<i>n</i>=1, 5.0%). <b>Conclusions:</b> The most common subtypes of gastrointestinal involvement in EDS were vEDS and hEDS. Patients with hEDS mainly presented with functional gastrointestinal symptoms, whereas those with vEDS primarily showed gastrointestinal perforation and digestive arterial disorders.</p>","PeriodicalId":68309,"journal":{"name":"中华内科杂志","volume":"63 10","pages":"987-992"},"PeriodicalIF":0.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142395635","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 diagnosis and subtyping of Gaucher disease & assessment and monitoring of neurological symptoms].","authors":"X L Zhang, W H Yan, H Liu, R J Zhang","doi":"10.3760/cma.j.cn112138-20240523-00339","DOIUrl":"10.3760/cma.j.cn112138-20240523-00339","url":null,"abstract":"","PeriodicalId":68309,"journal":{"name":"中华内科杂志","volume":"63 10","pages":"1011-1017"},"PeriodicalIF":0.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142395630","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 clinical application of bifidobacterium tetravaccine tablets for digestive diseases].","authors":"","doi":"10.3760/cma.j.cn112138-20240229-00135","DOIUrl":"https://doi.org/10.3760/cma.j.cn112138-20240229-00135","url":null,"abstract":"<p><p>Based on the fact that the human gut microbiota dysbiosis can cause various diseases, probiotics have a regulatory effect on human microecological imbalance and can be used to alleviate symptoms of some diseases and/or preventing and treating certain diseases. Probiotics have been widely applied in digestive diseases in both children and adults. Bifidobacterium tetravaccine tablets as a probiotic product contains Bifidobacterium infantis (CGMCC 0460.1), Lactobacillus acidophilus (CGMCC 0460.2), Enterococcus faecalis (CGMCC 0460.3), and Bacillus cereus (CGMCC 0460.4). By combining the unique characteristics of different strains, it exerts therapeutic effects through enhancing intestinal colonization resistance, improving intestinal mucosal barrier function, and modulating immune function, thereby maintaining gut and overall health. Bifidobacterium tetravaccine tablets have been widely used for digestive diseases, with a large number of fundamental and clinical research findings accumulated in the past years, a unified clinical guideline has yet to be achieved. To standardize and guide the rational clinical use of bifidobacterium tetravaccine tablets, this expert consensus have been formulated based on the summary and update of evidence-based medical data, providing a reference for its clinical application.</p>","PeriodicalId":68309,"journal":{"name":"中华内科杂志","volume":"63 10","pages":"927-960"},"PeriodicalIF":0.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142395634","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}