中国医学科学院学报最新文献

{"title":"Cellular and Histopathological Characteristics of Ultrasonically Underdiagnosed 3/4a Thyroid Nodules.","authors":"W U Wei-Qi, X U Cun-Bao, L I You-Jia, S U Chun-Yang, Zhang Feng-Shun, Chen Yi-Feng","doi":"10.3881/j.issn.1000-503X.16040","DOIUrl":"https://doi.org/10.3881/j.issn.1000-503X.16040","url":null,"abstract":"<p><p>Objective To analyze the cellular and histopathological characteristics of underdiagnosed thyroid nodules of Chinese thyroid imaging reporting and data system(C-TIRADS) categories 3 and 4a,thus improving the understanding of these lesions. Methods The data of ultrasound and fine needle aspiration cytology were collected from 683 nodules diagnosed based on pathological evidence in 549 patients undergoing thyroid surgery.The cellular and histopathological characteristics of C-TIRADS 3 and 4a nodules were analyzed. Results Two hundred and sixty-eight nodules were classified as C-TIRADS category 3,including 236 benign nodules,12 low-risk ones,and 20 (7.46%) malignant ones.Two hundred and twenty-one nodules were classified as C-TIRADS category 4a,including 133 benign nodules,7 low-risk ones,and 81 (36.65%) malignant ones.The malignancy rates differed between C-TIRADS 3 and 4a nodules (<i>χ²</i>=58.93,<i>P</i><0.001),and both were higher than the recommended malignancy rate in the guidelines for malignancy risk stratification of thyroid nodules (C-TIRADS) (both <i>P</i><0.001).According to the pathological evidence,the underdiagnosed C-TIRADS 3/4a nodules were mainly papillary thyroid carcinoma,especially in patients with Hashimoto thyroiditis.There was not a consistent one-to-one match between each ultrasound result and each cytological classification of low-risk thyroid nodules.Conclusions When the malignant features in preoprative ultrasound imaging are atypical or absent,papillary thyroid carcinoma (especially with Hashimoto thyroiditis),follicular carcinoma,and medullary carcinoma are likely to be underdiagnosed as C-TIRADS 3 or 4a nodules.Therefore,efforts should be made to fully understand the cellular and pathological characteristics of these lesions.</p>","PeriodicalId":6919,"journal":{"name":"中国医学科学院学报","volume":"47 1","pages":"23-28"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143622941","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 Characteristics of Patients With Idiopathic Multicentric Castleman Disease Complicated by Autoimmune Hemolytic Anemia.","authors":"Gao Yu-Han, L I Si-Yuan, Dang Yue, L I Jian, Zhang Lu","doi":"10.3881/j.issn.1000-503X.16135","DOIUrl":"https://doi.org/10.3881/j.issn.1000-503X.16135","url":null,"abstract":"<p><p>Objective To investigate the clinical characteristics,treatment responses,and prognosis of patients with idiopathic multicentric Castleman disease(iMCD)complicated by autoimmune hemolytic anemia(AIHA). Methods The patients diagnosed with iMCD in Peking Union Medical College Hospital from January 2010 to December 2023 and having complete baseline blood routine data were retrospectively enrolled in the study.The iMCD patients were further assigned into AIHA and non-AIHA groups based on baseline laboratory examinations,and the clinical characteristics and prognosis were compared between the two groups. Results A total of 341 patients with iMCD were enrolled in this study,including 277(81.2%)exhibiting anemia at baseline.Five(1.8%)patients were identified as having iMCD-AIHA,all of whom were iMCD-not otherwise specified type complicated by warm antibody-type AIHA,and two of them were simultaneously diagnosed with Evans syndrome.The timing relationship between the first onset of AIHA and iMCD diagnosis varied,with 2 patients experiencing their first hemolytic episode prior to the diagnosis of iMCD.In terms of treatment,the therapy targeting iMCD was effective in alleviating AIHA.The AIHA group had a poorer prognosis(<i>HR</i>=4.61,95% <i>CI</i>=1.08-19.80,<i>P</i>=0.040)and a lower 5-year survival rate(90% <i>vs.</i>60%,<i>P</i>=0.024)than the non-AIHA group.Conclusions iMCD-AIHA is clinically rare,and AIHA can occur at different stages of iMCD.Although the primary treatment principle remains targeting iMCD,great attention should be paid to the exacerbation of immune dysfunction caused by AIHA and the possible adverse prognosis it may bring.</p>","PeriodicalId":6919,"journal":{"name":"中国医学科学院学报","volume":"47 1","pages":"10-15"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143622942","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":"Experience and Implications on Advance Medical Directives in Hong Kong.","authors":"Gao Xiao-Yi","doi":"10.3881/j.issn.1000-503X.16193","DOIUrl":"https://doi.org/10.3881/j.issn.1000-503X.16193","url":null,"abstract":"<p><p>Advance medical directives allow patients to plan in advance their medical decisions in the event of incurable diseases or at the end of their lives when they have the capacity to make such decisions.This institutional design not only breaks through the traditional medical decision-making model and enables patients to make autonomous decisions across time and space,but also demonstrates the law's respect for and protection of patients' right to make autonomous decisions and their dignity of life.The Hong Kong Special Administrative Region submitted the bill related to advance medical directives to the Legislative Council for review at the end of 2023.On November 20,2024,the Advance Decision on Life-Sustaining Treatment Bill was passed,a move that is of great significance to regulating the legal issues in medical decision-making.This paper will delve into the basic principles,main contents,and related considerations of advance medical directives in Hong Kong,aiming to provide insights and references for the future improvement of relevant laws in the Chinese mainland.</p>","PeriodicalId":6919,"journal":{"name":"中国医学科学院学报","volume":"47 1","pages":"68-73"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143622955","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":"Lymphatic and Venous Contrast-Enhanced Ultrasound Imaging for Differential Diagnosis of Cervical Lymph Node Metastasis in Thyroid Cancer.","authors":"L I Xu, Wan Wen-Bo, Gao Tian, Gou Tao-Hua, Zhang Yan","doi":"10.3881/j.issn.1000-503X.16120","DOIUrl":"https://doi.org/10.3881/j.issn.1000-503X.16120","url":null,"abstract":"<p><p>Objective To investigate the value of the novel lymphatic contrast-enhanced ultrasound(LCEUS)and conventional venous contrast-enhanced ultrasound(VCEUS)in the differential diagnosis of benign and malignant cervical lymph nodes in patients with thyroid cancer. Methods Patients with suspected thyroid cancer underwent conventional ultrasound,VCEUS,and LCEUS examinations of cervical lymph nodes before biopsy.The diagnostic abilities of conventional ultrasound,VCEUS,and LCEUS were compared with pathological results as the golden standard. Results Forty-four patients with 52 lymph nodes were included in the final data.Thirty-eight metastatic lymph nodes were confirmed by pathological results,and 14 were benign.The diagnostic sensitivity,specificity,and accuracy were 97.37%,71.43%,and 90.38% for LCEUS,92.11%,35.71%,and 76.92% for VCEUS,and 94.74%,21.43%,and 75.00% for conventional ultrasound,respectively.The area under the curve of LCEUS analyzed by the receiver operating characteristic curve was greater than that of VCEUS(<i>P</i>=0.020)and conventional ultrasound(<i>P</i><0.001). Conclusion LCEUS could significantly improve the differential diagnosis of cervical lymph node metastasis in the patients with thyroid cancer,providing a basis for precise clinical treatment.</p>","PeriodicalId":6919,"journal":{"name":"中国医学科学院学报","volume":"47 1","pages":"16-22"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143622986","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 in Effects of Vermiform Appendix on the Occurrence and Development of Diseases Related to Gut-Brain Axis.","authors":"M O Shu-Ting, Tian Zhe, Lei Xin, Han Chao, Chen Yu-Hua","doi":"10.3881/j.issn.1000-503X.16046","DOIUrl":"https://doi.org/10.3881/j.issn.1000-503X.16046","url":null,"abstract":"<p><p>The gut-brain axis is a bidirectional communication pathway connecting the central nervous system and gastrointestinal tract,playing a key role in the occurrence and development of diseases related to this axis.The vermiform appendix,as a part of the gut that is connected to the cecum,has a unique anatomical location,a rich microbiome,and abundant immune cells.Appendicitis and appendectomy have been found to be associated with the development of diseases related to the gut-brain axis.This review first introduces the anatomy and functions of the vermiform appendix and then expounds the associations of appendicitis and appendectomy with diseases related to the gut-brain axis.Furthermore,this review summarizes and prospects the mechanisms of the vermiform appendix in affecting the occurrence and development of diseases related to the gut-brain axis.</p>","PeriodicalId":6919,"journal":{"name":"中国医学科学院学报","volume":"47 1","pages":"95-101"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143623083","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":"Thermal Ablation of Pulmonary Nodules by Electromagnetic Navigation Bronchoscopy Combined With Real-Time CT-Based 3D Fusion Navigation:Report of One Case.","authors":"Yuan Xu, Qun Liu, Chao Guo, Yi-Bo Wang, Xiao-Fang Wu, Chen-Xi Ma, Gui-Ge Wang, Qian-Shu Liu, Nai-Xin Liang, Shan-Qing Li","doi":"10.3881/j.issn.1000-503X.16198","DOIUrl":"10.3881/j.issn.1000-503X.16198","url":null,"abstract":"<p><p>A nodule in the right middle lobe of the lung was treated by a combination of cone-beam CT,three-dimensional registration for fusion imaging,and electromagnetic navigation bronchoscopy-guided thermal ablation.The procedure lasted for 90 min,with no significant bleeding observed under the bronchoscope.The total radiation dose during the operation was 384 mGy.The patient recovered well postoperatively,with only a small amount of blood in the sputum and no pneumothorax or other complications.A follow-up chest CT on the first day post operation showed that the ablation area completely covered the lesion,and the patient was discharged successfully.</p>","PeriodicalId":6919,"journal":{"name":"中国医学科学院学报","volume":" ","pages":"137-141"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142455403","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 Obesity-Associated Kidney Diseases.","authors":"Rui-Feng Yang, Wen Wu, Peng Zhang","doi":"10.3881/j.issn.1000-503X.16098","DOIUrl":"10.3881/j.issn.1000-503X.16098","url":null,"abstract":"<p><p>The pathogenesis of obesity-associated kidney disease (OAKD) involves many aspects,including the overactivation of the renin-angiotensin-aldosterone system,insulin resistance,chronic inflammation,disorder of lipid metabolism and imbalance of gut microecology.Treatment strategies for OAKD focus on lifestyle adjustments,pharmacotherapy,bariatric surgery,and fecal microbiota transplantation.A deeper understanding of the hazards of OAKD and its pathogenesis will contribute to the development of personalized and precise strategies for prevention,diagnosis and treatment of OAKD in the future.</p>","PeriodicalId":6919,"journal":{"name":"中国医学科学院学报","volume":" ","pages":"77-85"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142891337","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":"Multiple Organ Dysfunction Syndrome Caused by Human Herpes Virus 6B Infection in Adults:Report of One Case.","authors":"Q I Yan, Zhang Hong","doi":"10.3881/j.issn.1000-503X.16029","DOIUrl":"https://doi.org/10.3881/j.issn.1000-503X.16029","url":null,"abstract":"<p><p>Human herpes virus 6 (HHV-6) infection generally occurs in infancy,and the virus is mostly latent in monocytes and macrophages in the peripheral blood.HHV-6 is reactivated when the immune function is suppressed.HHV-6 DNA can be detected in peripheral blood mononuclear cells in more than 80% of healthy adults in China,while the incidence is low in the adults with normal immune functions.This paper reports a case of multiple organ dysfunction syndrome caused by HHV-6B infection in an adult with normal immune functions.High-throughput sequencing revealed the presence of HHV-6B with high confidence in blood and cerebrospinal fluid.</p>","PeriodicalId":6919,"journal":{"name":"中国医学科学院学报","volume":"47 1","pages":"150-154"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143623080","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 in Metabolism-Related Diseases and Formation Mechanism of Calcium Oxalate Stones.","authors":"Cen Wei-Hu, Shen Jun, Xia Sha-Sha, Wang Qiang","doi":"10.3881/j.issn.1000-503X.16038","DOIUrl":"https://doi.org/10.3881/j.issn.1000-503X.16038","url":null,"abstract":"<p><p>Kidney stones are a urinary system disease with a high incidence,among which calcium oxalate stones are the most common.Metabolic disorders such as hypertension,diabetes,obesity,hyperlipidemia,and hyperuricemia can cause changes in oxalate,uric acid,and pH and calcium ion concentrations in the urine through multiple pathways including inducing oxidative stress and inflammatory responses by generating reactive oxygen species,ultimately affecting the formation of calcium oxalate stones.This article reviews the possible pathways and mechanisms by which metabolic diseases influence the formation of calcium oxalate stones,providing new ideas for the clinical prevention and treatment of calcium oxalate stones.</p>","PeriodicalId":6919,"journal":{"name":"中国医学科学院学报","volume":"47 1","pages":"124-130"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143623089","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 Level of Small Nuclear Ribonucleoprotein D1 in Gastric Cancer and Its Effect on Prognosis.","authors":"Yin Li-Xia, Yang Jing-Jing, Niu Min-Zhu, Geng Zhi-Jun, L I Jiang-Yan, L I Jing","doi":"10.3881/j.issn.1000-503X.16097","DOIUrl":"https://doi.org/10.3881/j.issn.1000-503X.16097","url":null,"abstract":"&lt;p&gt;&lt;p&gt;Objective To investigate the expression of small nuclear ribonucleoprotein D1 (SNRPD1) in the gastric cancer tissue and evaluate the predictive value of SNRPD1 expression level for the long-term prognosis of gastric cancer patients and the possible functioning mechanism of SNRPD1. Methods The UALCAN and Gene Expression Profiling Interactive Analysis (GEPIA) were employed to analyze the expression level of SNRPD1 in pan-cancer and its relationship with the prognosis of gastric cancer.The clinical data of 109 patients who underwent radical surgery for gastric cancer from January 2014 to January 2017 in the First Affiliated Hospital of Bengbu Medical University were retrospectively analyzed.Gastric cancer and paracancerous tissue samples were collected,and the expression of SNRPD1 was detected by immunohistochemical staining.Lentiviral transfection was employed to construct the BGC-823 gastric cancer cell models with stable high and low expression of SNRPD1,respectively.The CCK-8 assay and colony formation assay were employed to measure the proliferation of gastric cancer cells,and flow cytometry was used to analyze the cell cycle.Western blotting was employed to determine the expression levels of proteins in the signaling pathway. Results The data from UALCAN and GEPIA showed that SNRPD1 was highly expressed in the tissue of malignant tumors including gastric cancer (&lt;i&gt;P&lt;/i&gt;&lt;0.001).The expression level of SNRPD1 in the gastric cancer tissue was higher than that in the paracancerous tissue (&lt;i&gt;P&lt;/i&gt;&lt;0.001).Moreover,the expression level of SNRPD1 was positively correlated with the levels of carcinoembryonic antigen (&lt;i&gt;P&lt;/i&gt;&lt;0.001),carbohydrate antigen 19-9 (&lt;i&gt;P&lt;/i&gt;&lt;0.001),G stage (&lt;i&gt;P&lt;/i&gt;=0.042),T stage (&lt;i&gt;P&lt;/i&gt;=0.002),and N stage (&lt;i&gt;P&lt;/i&gt;=0.027) in the patients with gastric cancer.The high expression of SNRPD1 had a predictive value for the long-term prognosis of gastric cancer (&lt;i&gt;P&lt;/i&gt;&lt;0.001),and it was an independent risk factor for the death of gastric cancer patients (&lt;i&gt;P&lt;/i&gt;=0.003).The results of gene ontology and kyoto encyclopedia of genes and Genomes enrichment analyses showed that SNRPD1 was involved in the regulation of the cell cycle.The results of CCK-8 and colony formation assays showed that up-regulation of SNRPD1 promoted the proliferation of gastric cancer cells (&lt;i&gt;P&lt;/i&gt;&lt;0.001,&lt;i&gt;P&lt;/i&gt;&lt;0.001).The up-regulation of SNRPD1 up-regulated the expression of cyclin-dependent kinase 6 and G&lt;sub&gt;1&lt;/sub&gt;/S-specific cyclin-D1 (&lt;i&gt;P&lt;/i&gt;&lt;0.001,&lt;i&gt;P&lt;/i&gt;=0.002),whereas the interference in SNRPD1 led to opposite results (&lt;i&gt;P&lt;/i&gt;=0.004,&lt;i&gt;P&lt;/i&gt;&lt;0.001).SNRPD1 accelerated the G&lt;sub&gt;1&lt;/sub&gt;/S phase transition of gastric cancer cells (&lt;i&gt;P&lt;/i&gt;&lt;0.001).The overexpression of SNRPD1 promoted the expression of phosphorylated phosphatidylinositol 3-kinase (PI3K) and phosphorylated protein kinase B (Akt) in gastric cancer cells (&lt;i&gt;P&lt;/i&gt;=0.043,&lt;i&gt;P&lt;/i&gt;&lt;0.001),whereas disruption of SNRPD1 inhibited their expression (both &lt;i&gt;P&lt;/i&gt;&lt;0.001).Insulin-li","PeriodicalId":6919,"journal":{"name":"中国医学科学院学报","volume":"47 1","pages":"1-9"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143622973","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}