北京大学学报（医学版）最新文献

{"title":"[Effect of intraoperative blood salvage autotransfusion on the prognosis of patients after carotid body tumor resection].","authors":"Weihao Li, Jing Li, Xuemin Zhang, Wei Li, Qingle Li, Xiaoming Zhang","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Objective: </strong>To investigate the effect of intraoperative blood salvage autotransfusion on local recurrence and long-term metastasis of patients after carotid body tumor resection.</p><p><strong>Methods: </strong>We retrospectively reviewed a consecutive series of 61 patients undergoing elective carotid body tumor resection from August 2009 to December 2020. Among them, 14 received intraoperative blood salvage autotransfusion (autotrasfusion group) and 47 did not (non-autotransfusion). Data of general information, surgical status and postoperative follow-up results were collected.</p><p><strong>Results: </strong>The proportion of Shamblin Ⅲ in the autotransfusion group was 85.7%, which was significantly higher than 31.9% in the non-autotransfusion group (<i>P</i>=0.003). The average operation time of the 14 patients in the autotransfusion group was (264±84) min, intraoperative blood loss was 1 200 (700, 2 700) mL, and autologous blood transfusion was 500 (250, 700) mL. Of these, 8 patients (57%) required concomitant allogeneic blood with 400 (260, 400) mL of allogeneic blood. The average operation time of the 47 patients in the non-autotransfusion group was (153±75) min, and the intraoperative blood loss was 300 (100, 400) mL. Of these, 6 (13%) required allogeneic blood transfusion, and 520 (400, 520) mL of allogeneic blood was used. Compared with the non-autotransfusion group, the average operation time in the autologous blood transfusion group was significantly longer (<i>P</i> < 0.001), and the intraoperative blood transfusion volume was larger (<i>P</i>=0.007). Of the 14 patients undergoing autotransfusion, 8 (57%) needed allogeneic blood at the same time; while in the 47 non-autologous transfusion patients, 6 (13%) needed allogeneic blood transfusion. The proportion of autotransfusion group using allogeneic blood at the same time was even higher (<i>P</i>=0.002). The incidence of nerve injury within 30 days after surgery was 29.5%, and there was no significant difference between the two groups. No early deaths occurred. The average follow-up was (76±37) months. One case of local recurrence occurred in the non-autotransfusion group. There was no distant metastasis. There were no tumor-related deaths. The estimated 5-year and 10-year overall survival rates were 96.4% and 83.8%, respectively. There was no significant difference in overall survival between the two groups (<i>P</i>=0.506).</p><p><strong>Conclusion: </strong>The use of intraoperative blood salvage autotransfusion increased no risk of local recurrence and distant metastasis in patients with carotid body tumor, which is safe and effective in carotid body tumor resection.</p>","PeriodicalId":8790,"journal":{"name":"北京大学学报（医学版）","volume":"57 2","pages":"272-276"},"PeriodicalIF":0.0,"publicationDate":"2025-04-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11992442/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143961004","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Abnormal elevation of growth hormone in patients with pituitary adenoma combined with cirrhosis: A case report].","authors":"Yanlei Wang, Min Duan, Jianzhong Xiao, Wenhui Zhao","doi":"","DOIUrl":"","url":null,"abstract":"&lt;p&gt;&lt;p&gt;The oral glucose growth hormone suppression test is commonly used in the clinical diagnosis of acromegaly, but its results can be influenced by a variety of factors. This case report discusses a patient with a pituitary tumor and concurrent liver cirrhosis, highlighting the complexities in interpreting test results under such conditions. The patient, a 54-year-old male, presented with blurred vision as his primary complaint. Notably, the physical examination revealed no changes in facial features, no enlargement of hands or feet, and no other symptoms typically associated with acromegaly, which might otherwise suggest excessive growth hormone activity. Magnetic Resonance Imaging (MRI) of the pituitary gland indicated that the gland was within normal size parameters, but a small low-intensity lesion mea-suring approximately 3 mm×2 mm identified. This finding was consistent with a pituitary microadenoma. The patient's fasting growth hormone levels were significantly elevated at 8.470 μg/L, compared with the normal range of less than 2.47 μg/L. Conversely, fasting insulin-like growth factor-1 (IGF-1) levels were notably low, recorded at 41 and 52 μg/L, whereas the normal range for a person of his age was between 87 and 234 μg/L. Other pituitary hormones, including those regulating the thyroid, adrenal cortex, and sex hormones, were found to be within normal ranges. Despite this, during the glucose growth hormone suppression test, an abnormal elevation of growth hormone was observed. To investigate further, the patient was administered branched-chain amino acids, and the suppression test was repeated. However, the abnormal elevation of growth hormone persisted, indicating a failure to normalize the response. Given the patient's lack of clinical signs typically associated with elevated growth hormone secretion, the history of liver cirrhosis became a significant consideration. The disparity between elevated growth hormone levels and reduced IGF-1 levels suggested that the pituitary lesion was a non-functional adenoma rather than a source of excess hormone production. Consequently, it was concluded that the abnormal response of growth hormone to the glucose suppression test was likely related to the patient's liver cirrhosis. In addition to chronic liver disease, various other conditions could influence the results of the oral glucose tolerance growth hormone suppression test. According to the literature, factors such as puberty, diabetes, anorexia nervosa, and protein malnutrition could also affect test outcomes. These conditions could cause similar abnormalities in growth hormone dynamics, complicating the diagnosis. Therefore, clinicians must be vigilant and consider these potential influences when interpreting test results.For an accurate diagnosis of acromegaly, it is essential to combine clinical symptoms, detailed medical history, and imaging studies. The presence of conditions like liver cirrhosis should prompt careful interpretation of t","PeriodicalId":8790,"journal":{"name":"北京大学学报（医学版）","volume":"57 2","pages":"400-402"},"PeriodicalIF":0.0,"publicationDate":"2025-04-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11992449/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143961184","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[A temporary trauma team established in primary hospital for disaster rescue].","authors":"Zhenzhou Wang, Xiujuan Zhao, Fuzheng Guo, Fengxue Zhu, Tianbing Wang","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Objective: </strong>To explore the feasibility of establishing a temporary trauma team led by trauma experts in primary hospitals for disaster medical rescue.</p><p><strong>Methods: </strong>In the coal mine flooding accident in Xiaoyi City, Shanxi Province on December 15, 2021, according to the local emergency plan and the characteristics of the accident, the trauma experts trained the medical staff from the local primary hospital on advanced trauma life support (ATLS) and damage control surgery (DCS) in the short time interval between the occurrence of the mine disaster and the admission of medical staff to the disaster scene. A temporary trauma team composed of trauma experts, ATLS team, and DCS team was formed to provide early diagnosis and treatment for survivors before and in the hospital.</p><p><strong>Results: </strong>The miners were found on the 36th hour of the disaster. All 22 miners were male, and 2 died underground. Another 20 people were rescued 39－43 hours after the disaster, with a median age of 48 years (34-57 years). All the survivors suffered from hypothermia, dehydration, maceration of feet and other injuries. There were 18 cases of acute inhalation tracheobronchitis, 14 cases of electrolyte acid-base disturbance, 6 cases of trunk contusion, 1 case of psoas major hematoma, and 1 case of lower extremity hematoma. Deep vein thrombosis was in 4 cases. The ATLS team focused on injury assessment, rewarming and rehydration within 50－60 minutes before admission, and completed auxiliary examinations within 2 hours after admission to clarify the diagnosis. The DCS team evaluated 6 patients with mechanical blunt trunk injury and excluded the indication of emergency surgery. The trauma experts conducted the whole process of supervision and quality control of disaster rescue. The positive rate of capillary refill test in the all survivors at the third hour of admission was significantly lower than that immediately after being rescued (75.0% <i>vs.</i> 15.0%, <i>P</i>=0.000 3), and they were discharged 4－7 days after admission.</p><p><strong>Conclusion: </strong>Under the leadership of trauma experts and relying on the medical staff of primary hospitals, it is feasible to establish and train a temporary trauma team with ATLS and DCS functions to participate in the medical rescue of disasters, which is in line with the current national conditions of China.</p>","PeriodicalId":8790,"journal":{"name":"北京大学学报（医学版）","volume":"57 2","pages":"323-327"},"PeriodicalIF":0.0,"publicationDate":"2025-04-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11992455/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143964652","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Impact of concurrent use of goserelin on the efficacy of neoadjuvant chemotherapy in young breast cancer patients].","authors":"Miaoyu Liu, Siyuan Wang, Lin Pei, Shu Wang","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Objective: </strong>To explore the effect of concurrent administration of goserelin for ovarian function protection on the pathological complete response (pCR) rate and objective response rate (ORR) of neoadjuvant chemotherapy (NAC) in young breast cancer patients.</p><p><strong>Methods: </strong>The study enrolled breast cancer patients aged 18-45 with clinical stages ⅡA~ⅢC from January 2016 to May 2020. According to patients' willingness, they were divided into two groups: Those who chose to receive goserelin to protect ovarian function during NAC (goserelin group) and those who did not (chemotherapy group). The pCR rate and ORR were compared between the two groups, and subgroup analysis was conducted for patients with different molecular subtypes.</p><p><strong>Results: </strong>A total of 93 patients were included in this study (31 in the goserelin group and 62 in the chemotherapy group). After propensity score weighting (PSW) adjustment, baseline data such as age, preoperative clinical stage, postoperative pathological stage, pa-thological type, hormone receptor status, human epidermal growth factor receptor 2 (HER2) and Ki-67 expression, molecular subtypes, and chemotherapy regimens were well-matched between the two groups. There was no significant difference in the pCR rate between the goserelin group and the chemotherapy group, with rates of 29.0% and 25.8%, respectively (<i>P</i>=0.741). Similarly, there was no significant difference in ORR between the two groups (90.3% <i>vs</i>. 87.1%, <i>P</i>=0.746). Subgroup analysis revealed that among the patients with hormone receptor-positive tumors, there were no significant differences in pCR rate (6.3% <i>vs</i>. 7.7%, <i>P</i>=0.852) or ORR (87.5% <i>vs</i>. 82.1%, <i>P</i>=0.839) between the goserelin and chemotherapy groups. Among the patients with hormone receptor-negative tumors, there were also no significant differences in pCR rate (53.3% <i>vs</i>. 56.5%, <i>P</i>=0.847) or ORR (93.3% <i>vs</i>. 95.7%, <i>P</i>=0.975) between the two groups. One year after the completion of chemotherapy, the incidence of chemotherapy-induced amenorrhea (CIA) was significantly lower in the goserelin group compared with the chemotherapy group (9.5% <i>vs</i>. 33.3%, <i>P</i>=0.036).</p><p><strong>Conclusion: </strong>For young breast cancer patients with clinical stages of ⅡA~ⅢC, there was no statistical difference in pCR rate and ORR whether or not using goserelin during NAC. However, it is still necessary to expand the sample size and carry out a longer follow-up to evaluate the effect of goserelin on the long-term survival of young patients.</p>","PeriodicalId":8790,"journal":{"name":"北京大学学报（医学版）","volume":"57 2","pages":"291-297"},"PeriodicalIF":0.0,"publicationDate":"2025-04-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11992451/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143956185","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Correlation analysis of peri-implant health after single-tooth dental implant].","authors":"Fangru Lin, Zhihui Tang","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Objective: </strong>To observe the long-term health condition of the single-tooth dental implant at the first molar site, and to evaluate the related factors affecting the peri-implant health.</p><p><strong>Methods: </strong>In this study, 82 patients who were treated in the Second Clinical Division, Peking University School and Hos-pital of Stomatology from January 2008 to December 2020 were enrolled. Peri-implant tissue conditions were assessed by clinical and radiographic examination. The peri-implant probing depth (PPD), modified sulcus bleeding index (mSBI), modified plaque index (mPLI) and papilla index (PI) were recorded for 278 implants. The X-ray analysis included the restoration emergence angle (REA), the clinical crown-implant ratio (cC/I), the horizontal tooth-implant distance (HTID), the contact point level (CPL) and the embrasure surface area (ESA), etc. Kruskal-Wallis rank sum test and generalized estimation equation were used for statistical analysis.</p><p><strong>Results: </strong>The average age of the patients was (40.2±9.5) years (19 to 84 years), with 33 males and 49 females. The follow-up time was (4.9±3.3) years (1 to 10 years). According to the diagnostic criteria in 2018, the prevalence of peri-implantitis in this study was 14.03% on the implant level and 21.95% on the patient level. The peri-implant health rate was 19.06% on the implant level and 18.29% on the patient level. The prevalence of peri-implant mucositis was 66.91% on the implant level and 59.75% on the patient level. At the baseline, there were statistically significant differences between the peri-implant health group and peri-implantitis group in PPD, distal HTID and mesial/distal CPL, cC/I (<i>P</i> < 0.05), while there was no statistically significant difference in mSBI, mPLI, PI, mesial HTID, mesial/distal REA and mesial/distal ESA between the two groups. Among the differences between follow-up and baseline, there were statistically significant dif-ferences between the two groups in PPD, mesial/distal HTID, mesial/distal CPL and mesial/distal ESA (<i>P</i> < 0.05). Generalized estimation equation showed that PPD, mesial/distal HTID, mesial CPL, and mesial ESA had significant positive correlations with the risk of peri-implantitis in the difference between baseline and follow-up.</p><p><strong>Conclusion: </strong>Based on the results of this study, the peri-implant health rate is still unsatisfied, and the PPD, HTID, CPL, ESA may be related to the long-term health of the implant.</p>","PeriodicalId":8790,"journal":{"name":"北京大学学报（医学版）","volume":"57 2","pages":"347-353"},"PeriodicalIF":0.0,"publicationDate":"2025-04-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11992440/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143961642","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Pregnancy complicated by patent urachus: A case report].","authors":"Junjuan Yang, Lei Zhang, Yan Zhang","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>To improve clinicians' understanding, and to explore the diagnosis and treatment of pregnancy complicated with patent urachus. The clinical symptoms, ultrasound images, and delivery outcome of the pregnancy complicated with patent urachus were reported, and the literature was reviewed. The patient had umbilical leakage as a young child occasionally, the symptom of leakage was not obvious after she was 10 years old, and there was no asymptomatic before pregnancy and in the first and second trimesters. Umbilical leakage was present at gestational 33 weeks, and ultrasound showned a tubular structure (0.7 cm in width) was connected between the top of the bladder and the umbilicus, and there was anechoic areas inside. The pregnancy complicated with patent urachus was diagnosed. The patient was checked regularly, and kept the umbilicus clean and dry. Premature rupture of membranes occured at gestational 39 weeks 4 days. The patient was admitted to the obstetrics department, and she deliveried finally. After delivery, the symptoms of umbilical leakage urine relieved, and an elective resection of abnormal urachus was planned. The patent urachus creates a tube connection between the umbilicus and the anterosuperior wall of the bladder, it was termed an median umbilical ligament at birth as usual, which still communicated with the bladder after birth. The main clinical manifestations were umbilical leak and infection, which were the main diagnostic basis. Ultrasound, CT and MRI were important auxi-liary examination methods.The patients with symptoms in the neonatal and early childhood period were managed actively and had the potential for self resolution, especially for the children younger than 1 year. Therefore, patients under 1 year of age were offered surgery only if they had recurrent infections or failed to selfresolve. It is recommended to remove abnormal urachus before pregnancy for the women complica-ted with patent urachus. If the patent urachus was found during pregnancy, the umbilicus should be kept clean and dry to avoid infection. The pregnancy complicated with patient urachus is not contraindicated to vaginal delivery.</p>","PeriodicalId":8790,"journal":{"name":"北京大学学报（医学版）","volume":"57 2","pages":"393-395"},"PeriodicalIF":0.0,"publicationDate":"2025-04-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11992454/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143967963","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Expression and regulatory mechanism of miR-34a in neonatal rat model of bron-chopulmonary dysplasia induced by hyperoxia].","authors":"Mengyue Huo, Hua Mei, Yuheng Zhang, Yanbo Zhang, Chunli Liu","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Objective: </strong>To investigate the expression and possible regulatory mechanism of miR-34a in the lung tissue of neonatal rat model of bronchopulmonary dysplasia (BPD) induced by hyperoxia.</p><p><strong>Methods: </strong>In the study, 80 newborn SD rats were randomly divided into hyperoxia group (FiO₂=60%) and air group (FiO₂=21%) within 2 hours after birth, 40 rats per group. Lung tissue samples of the SD rats in each group were extracted on the 1st, 7th, 14th and 21st days after birth, and the pathological changes of lung tissue were observed under light microscope after HE staining. The number of radial alveolar counts (RAC) and the mean alveolar diameter (MAD) and the thickness of alveolar septal thickness (AST) were measured to evaluate the development of alveoli. Real-time fluorescence quantitative PCR was used to detect the expression of miR-34a, angiopoietin-1 (<i>Ang</i>-<i>1</i>) and tyrosine kinase receptor-2 (<i>Tie</i>-<i>2</i>) in lung tissue of rats in hyperoxia group and air group at different time points. Enzyme-linked immunosorbent assay (ELISA) was used to detect the proteins expression of Ang-1 and Tie-2 in the lung tissues of the two groups at different time points.</p><p><strong>Results: </strong>The weight of rats in the hyperoxia group on the 7th, 14th and 21st days after birth was significantly lower than that in the air group (<i>P</i> all < 0.05). With the prolongation of oxygen exposure, the number of alveoli decreased, the volume increased, the structure simplified, the alveolar cavity enlarged obviously and the alveolar septum thickened in the hyperoxia group. On the 7th, 14th and 21st days after birth, the RAC in the hyperoxia group was significantly lower than that in the air group (<i>P</i> all < 0.05). Compared with the air group, MAD and AST increased significantly on the 7th, 14th and 21st days after birth in the hyperoxia group, and the difference was statistically significant (<i>P</i> all < 0.05). The expression level of miR-34a in lung tissue of hyperoxia group was significantly higher than that of air group on the 7th, 14th and 21st days after birth, and the difference was statistically significant (<i>P</i> all < 0.05). Compared with the air group at the same time point, the expression levels of Ang-1 and Tie-2 mRNA and protein in the hyperoxia group were lower than those in the air group on the 14th and 21st days after birth (<i>P</i> all < 0.05).</p><p><strong>Conclusion: </strong>The new BPD model of newborn SD rats can be successfully established by continuous exposure to 60% hyperoxia. The expression of miR-34a was up-regulated in the lung tissue of the new BPD model of neonatal rats. MiR-34a may play an important role in the occurrence and development of BPD by regulating Ang-1/Tie-2 signal pathway.</p>","PeriodicalId":8790,"journal":{"name":"北京大学学报（医学版）","volume":"57 2","pages":"237-244"},"PeriodicalIF":0.0,"publicationDate":"2025-04-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11992441/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143960034","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Predictive value of coronary microcirculation dysfunction after revascularization in patients with acute myocardial infarction for acute heart failure during hospitalization].","authors":"Lan Wang, Yuliang Ma, Weimin Wang, Tiangang Zhu, Wenying Jin, Hong Zhao, Chengfu Cao, Jing Wang, Bailin Jiang","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Objective: </strong>To study incident and clinical characteristics of the coronary microcirculation dysfunction (CMD) in patients with acute myocardial infarction (AMI) after percutaneous coronary intervention (PCI) by myocardial contrast echocardiography (MCE) and to explore the predictive value of CMD for in-hospital acute heart failure event.</p><p><strong>Methods: </strong>One hundred and forty five patients with AMI who had received PCI and completed MCE during hospitalization in Peking University People' s Hospital from November 2015 to July 2021 were enrolled in our study. The patients were divided into CMD group and normal group according to the coronary microcirculation status detected by MCE. Clinical data and MCE data of the two groups were collected and analyzed. The acute heart failure event during hospitalization was described. A multivariate Logistic regression model was built to analyze the risk of acute heart failure in patients with CMD. A receiver operating characteristic (ROC) curve was drawn to evaluate the value of CMD in predicting acute heart failure event.</p><p><strong>Results: </strong>CMD detected by MCE occurred in 87 patients (60%). Compared with normal group, patients with CMD had higher troponin I (TnI) peak level [52.8 (8.1, 84.0) μg/L <i>vs</i>. 18.9 (5.7, 56.1) μg/L, <i>P</i>=0.005], poorer Killip grade on admission (<i>P</i>=0.030), different culprit vessel (<i>P</i> < 0.001) and more patients had thrombolysis in myocardial infarction (TIMI) flow pre-PCI less than grade 3 in culprit vessel (65.1% <i>vs</i>. 43.1%, <i>P</i>=0.025). Meanwhile, patients with CMD had poorer left ventricular ejection fraction (LVEF) [52% (43%, 58%) <i>vs</i>. 61% (54%, 66%)], poorer global longitudinal strain (GLS) [-11.2% (-8.7%, -14.0%) <i>vs</i>.-13.9% (-10.8%, -17.0%)] and worse wall motion score index (WMSI) (1.58±0.36 <i>vs</i>. 1.25± 0.24) (<i>P</i> all < 0.001). Acute left heart failure happened in 13.8% of the CMD patients, which were significant higher than that in the patients with normal coronary microcirculation perfusion (1.7%, <i>P</i>=0.013). After correcting for the culprit vessel, the TIMI flow pre-PCI in the culprit vessel and the peak TnI value, the risk of acute left heart failure in the patients with CMD was still high (<i>OR</i>=9.120, 95%<i>CI</i>: 1.152-72.192, <i>P</i>=0.036). The area under ROC curve (AUC) was 0.677 (95%<i>CI</i>: 0.551-0.804, <i>P</i>=0.035).</p><p><strong>Conclusion: </strong>The incidence of CMD detected by MCE in patients with AMI post-PCI was 60%. Patients with CMD have a higher risk of acute left heart failure during hospitalization.</p>","PeriodicalId":8790,"journal":{"name":"北京大学学报（医学版）","volume":"57 2","pages":"267-271"},"PeriodicalIF":0.0,"publicationDate":"2025-04-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11992466/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143960036","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Correlation between urination intermittences and urodynamic parameters in benign prostatic hyperplasia patients].","authors":"Ning Liu, Libo Man, Feng He, Guanglin Huang, Jianpo Zhai","doi":"","DOIUrl":"","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;To explore the impact factors and the clinical significance of the urination intermittences in benign prostatic hyperplasia (BPH) patients.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;A retrospective study was performed in BPH patients who underwent urodynamic studies in Beijing Jishuitan Hospital form January 2016 to June 2021. The patients were aged 45 to 84 years with a median age of 63 years, and all the patients had no previous history of neurological disease and had no positive findings in neurological examinations. All the patients had free uroflometry followed by urethral catheterization and urodynamic tests. The voiding work of bladder was calculated using the detrusor power curve method, and the voiding power of bladder and the voiding energy consumption were also calculated. The frequency of urination intermittences generated in uroflometry was also recorded and the patients were divided into different groups according to it. The detrusor pressure at maximal flow rate (P&lt;sub&gt;det&lt;/sub&gt;Q&lt;sub&gt;max&lt;/sub&gt;), the maximal flow rate (Q&lt;sub&gt;max&lt;/sub&gt;), the bladder contractile index (BCI), the bladder outlet obstruction index (BOOI), the voiding work, the voiding power, and the voiding energy consumption were compared among the different groups. Multiva-riate analyses associated with presence of urination intermittences were performed using step-wise Logistic regressions.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;There were 272 patients included in this study, of whom, 179 had no urination intermittence (group A), 46 had urination intermittence for only one time (group B), 22 had urination intermittence for two times (group C), and 25 had urination intermittence for three times and more (group D). The BCI were 113.4±28.2, 101.0±30.2, 83.3±30.2, 81.0±30.5 in groups A, B, C, and D, respectively; The voiding power were (29.2±14.8) mW, (16.4±9.6) mW, (14.5±7.1) mW, (8.5±5.0) mW in groups A, B, C, and D, respectively, and the differences were significant (&lt;i&gt;P&lt;/i&gt; &lt; 0.05). The BOOI were 41.6±29.3, 46.4±31.0, 41.4±29.0, 42.7±22.8 in groups A, B, C, and D, respectively; The voiding energy consumption were (5.41±2.21) J/L, (4.83±2.31) J/L, (5.02±2.54) J/L, (4.39±2.03) J/L in groups A, B, C, and D, respectively, and the differences were insignificant (&lt;i&gt;P&lt;/i&gt;&gt;0.05). Among the patients, 179 cases were negative in presence of urination intermittences and 93 cases were positive. Step-wise Logistic regression analysis showed that bladder power (&lt;i&gt;OR&lt;/i&gt;=0.814, 95%&lt;i&gt;CI&lt;/i&gt;: 0.765-0.866, &lt;i&gt;P&lt;/i&gt; &lt; 0.001), BCI (&lt;i&gt;OR&lt;/i&gt;=1.023, 95%&lt;i&gt;CI&lt;/i&gt;: 1.008-1.038, &lt;i&gt;P&lt;/i&gt;=0.003), and bladder work (&lt;i&gt;OR&lt;/i&gt;=2.232, 95%&lt;i&gt;CI&lt;/i&gt;: 1.191-4.184, &lt;i&gt;P&lt;/i&gt;=0.012) were independent risk factors for urination intermittences in the BPH patients.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;The presence of urination intermittences in the BPH patients was mainly influenced by bladder contractile functions, and was irrelevant to the degree of bladder outlet obstruction. The increase","PeriodicalId":8790,"journal":{"name":"北京大学学报（医学版）","volume":"57 2","pages":"328-333"},"PeriodicalIF":0.0,"publicationDate":"2025-04-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11992446/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144062067","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Observation of the efficacy of dupilumab for treatment of atopic dermatitis in the elderly].","authors":"Ran Sun, Yuhao Wu, Mei DI, Xiaoyang Wang","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the efficacy and safety of dupilumab in the treatment of atopic dermatitis in the elderly.</p><p><strong>Methods: </strong>In this study, elderly patients with atopic dermatitis treated with dupilumab for at least 16 weeks in the Department of Dermatology and Venereology of Beijing Anzhen Hospital from January 2021 to October 2023 were retrospectively collected. Clinical indicators were compared before, during and after treatment, including pruritus numerical rating score (PNRS), eczema area and severity index (EASI), dermatology life quality index (DLQI) score, and the incidence of adverse events was recorded. The expression of interferon γ (IFN-γ), interleukin-4 (IL-4) and interleukin-6 (IL-6) in peripheral blood were compared before treatment and after 16 weeks of treatment.</p><p><strong>Results: </strong>A total of 90 elder patients with atopic dermatitis were included, EASI, PNRS and DLQI scores all showed a gradual downward trend during the treatment period, which was manifested as a rapid decline in the first 4 weeks after starting treatment, and then the decline gradually leveled off. The results of point-to-point comparison showed that EASI, PNRS and DLQI scores in 4 weeks after treatment were significantly lower than those before treatment (<i>P</i> < 0.001); In the 16th week after treatment, the scores of the above therapeutic indicators were further reduced, and the difference was statistically significant compared with the 4th week (<i>P</i> < 0.01); The EASI score was significantly lower at each time point than the previous time point, indicating that the patients' skin lesions continued to improve significantly. The overall efficacy of dupliumab was evaluated. After 4 weeks of treatment, 62.89% of patients achieved EASI-50 (EASI score decreased by ≥50%), and 74.4% of patients' DLQI score decreased by ≥4 points. After 16 weeks of treatment, 57.8% of the patients achieved EASI-75, 32.2% achieved EASI-90, and the PNRS and DLQI scores of all the patients decreased by ≥4 points. After 16 weeks of treatment, the expression levels of IL-4 and IL-6 were (31.62±6.23) ng/L and (14.36±2.25) ng/L, respectively, which were significantly lower than those before treatment (<i>P</i> < 0.001), and the expression level of IFN-γ was (15.37±3.14) ng/L, which was higher than before treatment (<i>P</i> < 0.001).The main adverse reactions were conjunctivitis (2 cases), injection site reaction (3 cases) and multiple bacterial folliculitis of the back (2 cases), which could be alleviated by symptomatic treatment, and no serious adverse reactions occurred.</p><p><strong>Conclusion: </strong>Dupilumab has shown good efficacy in the treatment of elderly atopic dermatitis, which can effectively improve clinical symptoms such as itching and skin lesions, improve the quality of life of patients, and no serious adverse reactions occurred during treatment, so it is safe and worthy of clinical promotion.</p>","PeriodicalId":8790,"journal":{"name":"北京大学学报（医学版）","volume":"57 2","pages":"298-302"},"PeriodicalIF":0.0,"publicationDate":"2025-04-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11992437/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143974834","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}