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慢性疾病与转化医学（英文）

慢性疾病与转化医学（英文）

Chronic Diseases and Translational Medicine
  • 发文量：201
  • 被引量：443
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  • 国内刊号/CN：10-1249/R
    国际刊号/ISSN：2095-882X
  • 发行周期：季刊
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  • 主管单位：中国科学技术协会
    主办单位：中华医学会
慢性疾病与转化医学（英文）-联系信息
  • 主编：胡大一
  • 电话：010-51322279
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  • 地址：北京市西城区宣武门东河沿街69号
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慢性疾病与转化医学（英文） >2023年第4期

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  • 摘要：Cardiomyopathies are diseases of the cardiac muscle and are often characterized by ventricular dilation, hypertrophy, and cardiac arrhythmia. Patients with cardiomyopathies often experience sudden death and cardiac failure and require cardiac transplantation during the course of disease progression. Early diagnosis, differential diagnosis, and genetic consultation depend on imaging techniques, genetic testing, and new emerging diagnostic tools such as serum biomarkers. The molecular genetics of cardiomyopathies has been widely studied recently. The discovery of mechanisms underlying heterogeneity and overlapping of the phenotypes of cardiomyopathies has revealed the existence of disease modifiers, and this has led to the emergence of novel disease-modifying therapy. This 2018-2019 state-of-the-art review outlines the pathogenesis, diagnosis, and treatment of cardiomyopathies in China.
  • 摘要：Objective: Clinical practice guidelines can improve healthcare processes and patient outcomes; however, the quality of these guidelines varies greatly in China. The aim of this study was to construct a comprehensive instrument for the appraisal of clinical practice guidelines in China （AGREE-CHINA）, and to validate its reliability as a tool for helping potential guideline users in assessing guideline quality.Methods: First, an interdisciplinary working group was established for developing the methods. They also created a checklist as a tool according to the Appraisal of Guidelines, Research and Evaluation II （AGREE II） standards, considering the particularity of Chinese clinical practice. Next, the first draft of AGREE-China was developed by vote, modification, preliminary trial, and cross-verification. To ensure the objectivity, credibility, and reproducibility of the draft assessment, all of the checklists and standards were cross-reviewed fairly widely. Finally, AGREE-CHINA and AGREE II were used to assess the Chinese guidelines published in the past five years, and the results were compared.Results: The presented AGREE-CHINA covered five main checkpoints （science and rigor, effectiveness and safety, economy, usability and feasibility, and conflicts of interest） with each point divided into several more specific checkpoints. Definitions and rationales for each main checkpoint appear in the Appendix. The quality ratings based on the total scores of AGREE-China and AGREE II were consistent （r = 0.508,P = 0.020）. Compared with AGREE II, the study showed a higher level of interrater-reliability for AGREE-CHINA overall （ICC = 0.957,P ＆ 0.001）. The mean time required for AGREE-CHINA was less than that for AGREE II; this was approximately 30 minutes for every assessment. User satisfaction was generally high.Conclusions: This paper has presented the first edition of the AGREE-CHINA appraisal tool for clinical guidelines. It is quick and easy to use; it assesses and performs well in comparison to AGREE II. This first version of AGREE-CHINA will require further development and validation.
  • 摘要：COVID-19 has become a pandemic and it has already spread to at least 171 countries/regions. Chronic kidney disease （CKD） is a global public health problem with a total of approximately 850 million patients with CKD worldwide and 119.5 million in China. Severe COVID-19 infection may damage the kidney and cause acute tubular necrosis, leading to proteinuria, hematuria and elevated serum creatinine. Since the SARS-CoV-2 enters the cells by binding to the angiotensin-converting enzyme 2 receptor, some doctors question its ability to increase the risk and severity of developing COVID-19. Neither clinical data nor basic scientific evidence supports this assumption. Therefore, patients who take angiotensin-converting enzyme inhibitor or angiotensin receptor blocker are not advised to change their therapy. Patients with CKD are generally the elderly population suffering from multiple comorbidities. Moreover, some patients with CKD might need to take glucocorticoids and immunosuppressants. Dialysis patients are recurrently exposed to a possible contaminated environment because their routine treatment usually requires three dialysis sessions per week. Considering all the above reasons, patients with CKD are more vulnerable to COVID-19 than the general population. The development of COVID-19 may worsen the impaired kidney function and further lead to rapid deterioration of kidney function and even death. Strict comprehensive protocols should be followed to prevent the spread of COVID-19 among patients with CKD. In this review, we provide some practical management recommendations for health care providers, patients with CKD, dialysis patients and dialysis facilities.
  • 摘要：As a highly infectious respiratory tract disease, coronavirus disease 2019 （COVID-19） can cause respiratory, physical, and psychological dysfunction in patients. Therefore, pulmonary rehabilitation is crucial for both admitted and discharged patients of COVID-19. In this study, based on the newly released pulmonary rehabilitation guidelines for patients with COVID-19, as well as evidence from the pulmonary rehabilitation of patients with severe acute respiratory syndrome, we investigated pulmonary rehabilitation for patients with COVID-19 having complications, such as chronic pulmonary disease, and established an intelligent respiratory rehabilitation model for these patients.
  • 摘要：The World Health Organization characterized coronavirus disease （COVID-19） as a pandemic on March 11, 2020. Peritoneal dialysis patients have a weakened immune system that is associated with a high morbidity of infection. Thus, COVID-19 prevention measures and management for patients on peritoneal dialysis are urgent and critical. Based on published research on COVID-19 and previous clinical practices for similar coronavirus outbreaks, we aimed to make recommendations to manage patients undergoing peritoneal dialysis.
  • 摘要：Coronavirus disease （COVID-19） was first diagnosed in Wuhan in December 2019. The World Health Organization defined the subsequent outbreak of COVID-19 worldwide as a public health emergency of international concern. Epidemiological data indicate that at least 20% of COVID-19 patients have severe disease. In addition to impairment of the respiratory system, acute kidney injury （AKI） is a major complication. Immune damage mediated by cytokine storms and concomitant AKI is a key factor for poor prognosis. Based on previous experience of blood purification for patients with severe acute respiratory syndrome and Middle East respiratory syndrome combined with clinical front-line practice, we developed a blood purification protocol for patients with severe COVID-19. This protocol is divided into four major steps. The first step is to assess whether patients with severe COVID-19 require blood purification. The second step is to prescribe a blood purification treatment for patients with COVID-19. The third step is to monitor and adjust parameters of blood purification. The fourth step is to evaluate the timing of discontinuation of blood purification. It is expected that blood purification will play a key role in effectively reducing the mortality of patients with severe COVID-19 through the standardized implementation of the present protocol.
  • 摘要：Since December 2019, increasing attention has been paid to the severe acute respiratory syndrome coronavirus 2 （SARS-CoV-2） epidemic in Wuhan, China. SARS-CoV-2 primarily invades the respiratory tract and lungs, leading to pneumonia and other systemic disorders. The effect of SARS-CoV-2 in transplant recipients has raised significant concerns, especially because there is a large population of transplant recipients in China. Based on the current epidemic situation, this study reviewed publications on this virus and coronavirus disease 2019 （COVID-19）, analyzed common features of respiratory viral pneumonias, and presented the currently reported clinical characteristics of COVID-19 in transplant recipients to improve strategies regarding the diagnosis and treatment of COVID-19 in this special population.
  • 摘要：＜正＞Since the first patient infected with the novel coronavirus （SARS-CoV-2） was identified in December 2019, the cumulative number of confirmed cases of coronavirus disease 2019 （COVID-19） has exceeded 2
  • 摘要：Coronavirus disease 2019 is a major threat to public health globally. Though its pathogenesis has not been fully elucidated, angiotensin-converting enzyme 2 （ACE2） has been recently identified as a receptor for the entry of severe acute respiratory syndrome coronavirus 2 （SARS-CoV-2） into the cell. Here, we aimed to clarify the potential role of ACE2 in SARS-CoV-2-induced acute lung injury and its underlying mechanism. As a receptor for coronavirus, ACE2 mediates the entry of SARS-CoV-2 into cells in a similar way as for severe acute respiratory syndrome coronavirus （SARS-CoV）. The high binding affinity of SARS-CoV-2 to ACE2 correlates with its efficient spread among humans. On the other hand, ACE2 negatively regulates the renin-angiotensin-aldosterone system （RAAS） primarily by converting angiotensin II to angiotensin 1-7, which exerts a beneficial effect on coronavirus-induced acute lung injury. Human recombinant ACE2 has been considered as a potential therapy for SARS-CoV-2 by blocking virus entry and redressing the imbalance of RAAS in SARS-CoV-2 infection. The level of ACE2 expression can be upregulated by treatment with an ACE inhibitor （ACEI） or angiotensin II type 1 receptor blocker （ARB）. To date, no evidence shows that ACEIs or ARBs increase the susceptibility and mortality of patients infected with SARS-CoV-2, and hence, it is not advisable to discontinue such drugs in patients with cardiovascular disease.
  • 摘要：Background: The incidence of idiopathic membranous nephropathy （IMN） has recently increased remarkably. Immune dysfunction caused by disordered intestinal flora might be an important factor affecting IMN. The Jian Pi Qu Shi Formula （JPQSF） shows promise in treating IMN. Here, we sequenced 16S rRNA genes to compare intestinal flora between patients with IMN and healthy persons. We also conducted a randomized controlled clinical trial to further compare the intestinal flora of patients with IMN treated with traditional Chinese medicine （TCM） and western medicine （WM）.Methods: Among 40 patients with IMN treated at Department of Nephrology in Xiyuan Hospital, Chinese Academy of Traditional Chinese Medicine between July 2016 and December 2018, we compared 30 of them with 10 healthy persons （controls）. The IMN group was randomly assigned to receive JPQSF （TCM） or immunosuppressant WM therapy in （n = 15 per group） for 6 months. Intestinal microbiota diversity was analyzed using alpha diversity and beta diversity. Intestinal flora that significantly differed between the groups was analyzed using MetaStat. The effects and safety of the therapies were determined based on the values for plasma albumin, 24-h urine protein excretion, serum creatinine, urea nitrogen, estimate glomerular filtration rate （eGFR）, complete blood count, and liver enzymes. All data were statistically analyzed using Statistical Package for the Social Sciences （SPSS） 20.0 statistical software.Results: Baseline characteristics did not significantly differ between the IMN and healthy groups, or the TCM and WM groups. After six months of treatment, 24-h urinary protein significantly declined in the TCM and WM groups （before and after treatment: 3.24 ± 1.74 vs. 1.73 ± 1.85 g,P ＆ 0.05 and 3.94 ± 1.05 vs. 1.91 ± 1.18 g,P ＆ 0.05, respectively）. Plasma albumin was significantly increased in the TCM group （before vs. after treatment: 32.44 ± 9.04 vs. 39.99 ± 7.03 g/L,P ＆ 0.05）, but did not significantly change in the WM group （31.55 ± 4.23 vs. 34.83 ± 9.14 g/L,P ＆ 0.05）. Values for urea nitrogen, serum creatinine, and eGFR did not significantly change in either group. The alpha diversity index for intestinal flora differed between the IMN and healthy groups, and the TCM and WM groups. Comparisons of multiple samples （beta diversity） revealed differences in intestinal flora between the IMN and healthy groups, and the TCM and WM groups. The Metastat analysis findings showed that the main genera that differed between the IMN group before treatment and the healthy group were ChristensenellaceaeR-7group, Bifidobacterium （77）, Dorea, Escherichia-Shigella, Parabacteroides, Bifidobacterium, and Coprococcus3. After TCM therapy, the main differential genera were Butyricimonas, Bacteroides, Alistipes, and Lachnospira, and after WM therapy, these were Ruminococcus2, LachnospiraceaeND3007group, Lachnospira, Bifidobacterium, Alistipes, and [Eubacterium]ventriosumgroup.Conclusion: Patients with IMN might have disordered intestinal flora, and JPQSF can regulate intestinal flora in patients with IMN.
  • 摘要：Background: Regulated upon activation, normal T-cell expressed, and secreted （RANTES） is a chemokine actively involved in the initiation and progression of atherosclerosis （AS）, which is the major cause of ischemic cerebrovascular disease （ICVD）. This study aimed to determine the associations between circulating RANTES level and overall AS conditions of cardiac and cerebral vessel beds in patients with ICVD.Methods: Patients with ICVD admitted to the department of neurology of Xuanwu Hospital from April 1, 2019 to June 30, 2019 were prospectively enrolled in the study. Plasma RANTES level was measured by enzyme-linked immunosorbent assay to represent the circulating RANTES level. The integrated AS burden of the cervicocephalic and coronary arteries was examined using computed tomography angiography and reflected by "cardio-cerebral AS burden （CCAB）" as a continuous variable. Then, the relationship of plasma RANTES level and CCAB in patients with ICVD was analyzed by correlation analyses and general linear models.Results: A total of 40 patients with ICVD were included in the study. There was a significant positive correlation between CCAB and plasma RANTES level in ICVD （r = 0.786,P ＆ 0.001）, independent of age, sex, acute or chronic phase of ICVD, and mono or dual antiplatelet therapy （adjustedB forln RANTES, 12.063; 95% confidence interval, 7.572-16.533）. The association of plasma RANTES level with AS conditions （burden, severity, and extent） in single cardiac or cerebral vessel bed was similar to that with CCAB, but the correlation coefficient for CCAB was higher （increment ranged from 0.126 to 0.397）.Conclusions: Plasma RANTES level was an independent indicator for the integrated AS burden of the cervicocephalic and coronary arteries in ICVD. Comprehensive evaluation of AS conditions using the novel continuous index CCAB might be important in revealing the systematic relationship between circulating RANTES and AS in patients with ICVD.
  • 摘要：Objective: The study aimed to detect and analyze long non-coding RNAs （lncRNAs） in plasma of children diagnosed with chronic gastritis, and to explore its biological functions and involved signaling pathways.Methods: The plasma samples were collected from six children that were diagnosed with chronic gastritis by physical examination, gastroscopy, and pathological examination and six healthy children. The plasma samples were assayed for determining the expression profiles of lncRNA based upon the gen chip detection. The specific expression of lcnRNA in plasma of children with chronic gastritis was analyzed and its biological functions were speculated.Results: Five lncRNAs （RP11-697M17.1,RP11-388M20.9,AFAP1-AS1,BC062758, andXLOC001406） were significantly upregulated, and five lncRNAs （UNQ697,BX571672.5,CYP4F35P,ANKRD20A5P, andAL832737） were observed to be significantly down-regulated. The lncRNAsRP11-697M17.1, andUNQ697 were detected with the highest up-regulation and down-regulation, respectively. The Kyoto Encyclopedia of Genes and Genomes （KEGG） pathway enrichment analysis showed that the up-regulated lncRNAs were significantly enriched in 20 signaling pathways such as phosphoinositide-3-kinase-protein kinase B （PI3K-Akt） pathway, and the down-regulated lncRNAs target genes were significantly enriched in 20 signaling pathways such as the metabolic pathway.Conclusion: The analysis of the lncRNA expression profiles in plasma of children with chronic gastritis revealed that the lncRNARP11-697M17.1, and lncRNAUNQ697 may act as plasma markers for predicting chronic gastritis in children.
  • 摘要：Background: Atrial fibrillation （AF） is the most common arrhythmia in patients with hypertrophic obstructive cardiomyopathy （HOCM）. Data regarding the correlations of thyroid dysfunction and the incidence of AF in HOCM are quite limited. This study aimed to reveal the correlations between different thyroid status and the corresponding incidence of AF in a large HOCM cohort.Methods: A total of 806 HOCM patients with complete information on thyroid function tests and comprehensive cardiac evaluations were recruited. The participants were divided into the AF group （n = 159） and non-AF group （n = 647） according to established medical history and results of Holter monitoring. The thyroid status of the study population and the corresponding incidence of AF were assessed and analyzed.Results: Hypothyroidism accounted for the greatest proportion of thyroid dysfunction in HOCM patients. The incidence of AF significantly increased in individuals with both overt （P = 0.022） and subclinical （P = 0.007） hypothyroidism. Compared with participants in the non-AF group, those with positive AF episodes presented with lower free triiodothyronine （FT3） （2.86 ± 0.52 pg/mL vs. 3.01 ± 0.42 pg/mL,P = 0.001）, higher free thyroxine （FT4） （1.24 ± 0.25 ng/dL vs. 1.15 ± 0.16 ng/dL,P ＆ 0.001）, and remarkably increased levels of thyrotropin （TSH） （12.6% vs. 5.3%,P = 0.001）. Multivariable analyses demonstrated that the concentrations of FT3 （odds ratio [OR] = 0.470, 95% confidence interval [CI]: 0.272-0.813,P = 0.007） and FT4 （OR = 17.992, 95% CI: 5.750-56.296,P ＆ 0.001）, as well as TSH levels above normal ranges （OR = 2.276, 95% CI: 1.113-4.652,P = 0.024） were independently associated with the occurrence of AF in the large HOCM cohort.Conclusions: This study indicated a strong link between low thyroid function and the presence of AF in HOCM. Hypothyroidism （both overt and subclinical states） seems to be valuable for assessing the incidence of AF in patients with HOCM.
  • 摘要：Primary aldosteronism （PA） is a common form of endocrine hypertension. The diagnostic process of PA includes a screening test, confirmatory test, and subtype classification. In this review, we have summarized the latest advances in the diagnosis of PA with regard to screening and confirmatory tests and provided some recommendations to improve clinical practice.
  • 摘要：Thirdhand smoke （THS）, the residual tobacco smoke remaining in the environment after tobacco has been smoked, represents a hidden and underestimated public health hazard. Evidence supports its widespread presence in indoor environments. Exposure to secondhand smoke （SHS）, a precursor of THS, has been well documented as a risk factor for human cancers, especially lung cancer. However, the concept of THS as a distinct entity that poses health risks for small children has developed only recently and the associations of THS with cancer risk and other chronic diseases are poorly understood due to limited numbers of studies to date. In this perspective, we mainly summarize all published studies on the genotoxicity and carcinogenic potential of THS exposure. These studies begin to fill the knowledge gap in our understanding of cancer risk of THS. Accumulating data from existing and future studies will help reduce the tobacco-related cancer incidence through changes in lifestyle and tobacco control policies.
  • 摘要：Objective: To identify risk factors of saphenous vein graft （SVG） failure and to investigate the utility of anatomical SYNTAX score （SS） and SYNTAX score II （SS-II） in predicting SVG failure.Methods: A total of 598 patients who underwent angiography for clinical reasons after coronary artery bypass grafting （CABG） were included. Baseline data and factors related to SVG failure were analyzed at the patient and graft levels. Patients were divided in tertiles by anatomical SS and in three groups by SS-II revascularization recommendation, and SVG patency was analyzed across these groups.Results: Patency rates were similar in all SS-stratified and SS-II recommendation groups within 1, 5, and 10 years after CABG. At the patient level, fasting blood glucose （FBG） level ＆7.0 mmol/L was less common in SVG failure （68.0%vs. 76.2%）. At the graft level, patients with SVG failure tended to have angiography later （4.0 yearsvs. 3.0 years）, poorer FBG control （FBG ＆7.0 mmol/L: 68.2%vs. 74.7%）, and more grafts anastomosed to the right coronary system （59.2%vs. 47.4%）. Longer time interval after CABG was related to SVG failure both at the patient and graft levels, and odds ratio （OR）/P values （OR/P） were 1.282/0.029 and 1.384/0.016, respectively. Using independent graft and grafting to the right artery system as risk factors at the graft level,OR/Ps were 3.094/0.000 and 2.524/0.000, respectively.Conclusions: Longer time interval after CABG, independent grafts, and grafting to the right artery system are associated with SVG failure. Anatomical SS or SS-II may not be reasonable tools for predicting SVG failure.
  • 摘要：Introduction: Tripterygium glycosides （TGs） have been widely used in China to treat diabetic nephropathy （DN）; however, proof of their use is scarce. The present study aimed to evaluate the effectiveness and safety of adding TGs to angiotensin-converting enzyme （ACE） inhibitors or angiotensin receptor blockers （ARBs）.Methods: By searching Embase, MEDLINE, Cochrane Library, SINOMED, China National Knowledge Infrastructure, VIP Information/Chinese Scientific Journals, and WANFANG databases, we identified previous studies that met the specific selection criteria and included them in the meta-analysis. Analyses were performed using Review Manager （version 5.3）.Results: Nine randomized controlled trials were included in the final meta-analysis. Patients were compared before and after treatment with ACE inhibitors or ARBs plus TGs, or ACE inhibitors or ARBs alone. The results revealed that treatment with ACE inhibitors or ARBs plus TGs resulted in significantly greater reductions in 24-h urinary total protein （UTP） levels （trial duration ＆2 months, mean difference [MD]: -0.25; 95% confidence interval [CI]: -0.32, -0.18; trial duration between 2 and 6 months, MD: -0.39; 95%CI: -0.44, -0.33; trial duration ＆6 months, MD: -2.09; 95%CI: -2.89, -1.29） compared with treatment using ACE inhibitors or ARBs alone. Additionally, ACE inhibitors or ARBs plus TGs showed better results after longterm administration. Treatment with ACE inhibitors or ARBs plus TGs resulted in significantly greater reductions in serum creatinine （SCr） compared with ACE inhibitors or ARBs alone （MD: -9.87; 95%CI: -13.76, -5.97）.Conclusion: In patients with DN, adding TGs to ACE inhibitors or ARBs significantly lowered both the 24-h UTP and SCr levels. Therefore, ACE inhibitors or ARBs plus TGs might improve the treatment of DN in patients.
  • 摘要：The tumor microenvironment of pancreatic ductal adenocarcinoma （PDAC） is non-immunogenic, which consists of the stellate cells, fibroblasts, immune cells, extracellular matrix, and some other immune suppressive molecules. This low tumor perfusion microenvironment with physical dense fibrotic stroma shields PDAC from traditional antitumor therapies like chemotherapy and various strategies that have been proven successful in other types of cancer. Immunotherapy has the potential to treat minimal and residual diseases and prevent recurrence with minimal toxicity, and studies in patients with metastatic and nonresectable disease have shown some efficacy. In this review, we highlighted the main components of the pancreatic tumor microenvironment, and meanwhile, summarized the advances of some promising immunotherapies for PDAC, including checkpoint inhibitors, chimeric antigen receptors T cells, and cancer vaccines. Based on our previous researches, we specifically discussed how granulocyte-macrophage colony stimulating factor based pancreatic cancer vaccine prime the pancreatic tumor microenvironment, and introduced some novel immunoadjuvants, like the stimulator of interferon genes.
  • 摘要：Despite the widespread use of chronic dialysis for end-stage renal disease （ESRD）, there is no consensus on the optimal timing of initiating renal replacement therapy. Over the past decade, a worldwide trend toward increasing glomerular filtration rate at the initiation of dialysis has been noted. However, available data indicate that early dialysis has no survival benefit or is harmful. Peritoneal dialysis （PD） is one alternative for ESRD and has potential survival factors different from those of hemodialysis. The association between the timing of PD initiation and survival is unclear. This review examines the effect of the timing of dialysis on clinical outcomes in PD patients.
  • 摘要：Objective: To explore genes potentially co-expressed with cyclin E in gastric cancer and discover possible targets for gastric cancer treatment.Methods: The Cancer Genome Atlas （TCGA） stomach adenocarcinoma sequencing data were used to predict genes co-expressed with cyclin E. Co-expression genes predicted by cBioPortal online analysis with Pearson correlation coefficient ≥0.4 were analyzed by gene ontology （GO） enrichment annotation using the PANTHER online platform （Ver. 7）. Interactions between proteins encoded by these genes were analyzed using the STRING online platform （Ver. 10.5） and Cytoscape software （Ver. 3.5.1）. Genes displaying a high degree of connection were analyzed by transcription factor enrichment prediction using FunRich software （Ver. 3）. The significant transcription factor and cyclin E expression levels and their impact on gastric cancer progression were analyzed by Western blotting and Kaplan-Meier survival curve analysis.Results: After filtering the co-expression gene prediction results, 78 predicted genes that included 73 protein coding genes and 5 non-coding genes with Pearson correlation coefficient ≥0.4 were selected. The expressions of the genes were considered to be correlated with cyclin E expression. Among the 78 genes co-expressed with cyclin E, 19 genes at the central of the regulatory network associated with cyclin E were discovered. Nuclear transcription factor Y subunit alpha （NF-YA） was identified as a significant transcription factor associated with cyclin E co-expressing genes. Analysis of specimen donors’ clinical records revealed that high expression of NF-YA tended to be associated with increased cyclin E expression. The expression of both was associated with progression of gastric cancer. Western blotting results showed that compared with normal tissues, NF-YA and cyclin E were highly expressed in tumor tissues （P ＆ 0.001）. Survival curve analysis clearly demonstrated relatively poor overall survival of gastric cancer patients with high cyclin E or high NF-YA expression level, compared to patients with low cyclin E or NF-YA expression （P ＆ 0.05）.Conclusions: NF-YA may promote gastric cancer progression by increasing the transcription of cyclin E and other cell cycle regulatory genes. NF-YA might be a potential therapeutically useful prognostic factor for gastric cancer.
  • 摘要：＜正＞Dear Editor ,Artificial intelligence （AI） is the theory and development of computer systems that are able to perform tasks that normally require human intelligence, such as visual perception, speech r
  • 摘要：Treatment intended to lower cardiovascular （CV） risk in patients with diabetes has always been a primary goal of diabetes treatment. Due to the subdued effects of reducing hemoglobin A1c （HbA1c） on macrovascular complications, controlling other CV risk factors such as hypertension and hyperlipidemia instead of hyperglycemia has been the mainstay treatment to improve CV outcome in patients with type 2 diabetes mellitus （T2DM） until recent years. This review is intended to summarize and compare the results from the available cardiovascular outcome trials （CVOTs） for the two classes of glucose lowering drug: sodium-glucose cotransporter 2 inhibitor （SGLT2i） and glucagon-like peptide-1 receptor agonist （GLP-1 RA）. The results including the EMPA-REG, CANVAS program and DECLARE-TIMI 58 trials for SGLT2i, and the ELIXA, LEADER, SUSTAIN-6, EXSCEL and HARMONY trials for GLP-1 RA were summarized. The potential mechanisms of these CV beneficial effects and the optimal CV risk reduction treatment in patients with T2DM based on patient risk stratification and evidence from these CVOTs in real-world setting were discussed.
  • 摘要：Objective: The aim of this study was to investigate the effect and possible mechanism of action of roof plate-specific spondin1 （Rspo1） in the apoptosis of rat bone marrow mesenchymal stem cells （BMSCs）.Methods: Osteogenic and adipogenic differentiation of BMSCs was identified by Alizarin Red and Oil Red O staining, respectively. BMSC surface markers （cluster of differentiation 29 [CD29], CD90, and CD45） were detected using flow cytometry. BMSCs were transfected with an adenoviral vector encodingRspo1 （BMSCs-Rspo1 group）. The expression levels ofRspo1 gene and Rspo1 protein in the BMSCs-Rspo1 group and the two control groups （untransfected BMSCs group and BMSCs-green fluorescent protein [GFP] group） were analyzed and compared by quantitative polymerase chain reaction and Western blot. The occurrence of apoptosis in the three groups was detected by flow cytometry and acridine orange-ethidium bromide （AO-EB） double dyeing. The activity of the Wnt/β-catenin signaling pathway was evaluated by measuring the expression levels of the key proteins of the pathway （β-catenin, c-Jun N-terminal kinase [JNK], and phospho-JNK）.Results: Osteogenic and adipogenic differentiation was confirmed in cultured BMSCs by the positive expression of CD29 and CD90 and the negative expression of CD45. Significantly increased expression levels of Rspo1 protein in the BMSCs-Rspo1 group compared to those in the BMSCs （0.60 ± 0.05vs. 0.13 ± 0.02;t=95.007,P=0.001） and BMSCs-GFP groups （0.60 ± 0.05vs. 0.10 ± 0.02;t=104.842,P=0.001） were observed. The apoptotic rate was significantly lower in the BMSCs-Rspo1 group compared with those in the BMSCs group （[24.06 ± 2.37]%vs. [40.87 ± 2.82]%;t =49.872,P =0.002） and the BMSCs-GFP group （[24.06 ± 2.37]%vs. [42.34 ± 0.26]%;t =62.358,P =0.001）. In addition, compared to the BMSCs group, the protein expression levels of β-catenin （2.67 ± 0.19vs. 1.14 ± 0.14;t =-9.217,P =0.000） and JNK （1.87 ± 0.17vs. 0.61 ± 0.07;t =-22.289,P =0.000） were increased in the BMSCs-Rspo1 group. Compared to the BMSCs-GFP group, the protein expression levels of β-catenin （2.67 ± 0.19vs. 1.44 ± 0.14;t =-5.692,P =0.000） and JNK （1.87 ± 0.17vs. 0.53 ± 0.06;t =-10.589,P =0.000） were also upregulated in the BMSCs-Rspo1 group. Moreover, the protein expression levels of phospho-JNK were increased in the BMSCs-Rspo1 group compared to those in the BMSCs group （1.89 ± 0.10vs. 0.63 ± 0.09;t =-8.975,P =0.001） and the BMSCs-GFP group （1.89 ± 0.10vs. 0.69 ± 0.08;t =-9.483,P =0.001）.Conclusion: The Wnt/β-catenin pathway could play a vital role in the Rspo1-mediated inhibition of apoptosis in BMSCs.
  • 摘要：Immuno-oncology is a fast evolving field of cancer therapy and immune checkpoint inhibitors （ICIs） are clearly a breakthrough in this field. Cardiotoxicity with conventional anti-cancer therapies has been well studied in the past and clear guidelines for management of these side effects are available in the literature. However, cardiotoxicity with novel agents such as ICIs has been fairly under-reported and/or underestimated and we are yet to formulate clear guidelines for management of these rare side effects. In the last few years, there has been an overall increase in the number of cases of cardiotoxicity related to ICIs. In this literature review, we describe the mechanism of action of the most widely used ICIs and their related cardiotoxicities. The increase in number of case reports about the potential of cardiotoxicities with these novel agents clearly indicates the need for a new insight into the field of cardio-immuno-oncology.
  • 摘要：Hodgkin’s lymphoma is a highly treatable malignancy. It has high cure rates yet there are many patients who relapse or are refractory to treatment. Traditionally, treatment has been with conventional chemotherapy; however, the development of brentuximab vedotin and immune checkpoint inhibitors has revolutionized the care of Hodgkin’s lymphoma. This is a review of the current advances in the management of Hodgkin’s lymphoma and a review of ongoing clinical trials in the field.
  • 摘要：Objective: The aim of this study was to explore the relationship between fasting glucose levels and all-cause and cause-specific mortality in Chinese population.Methods: The role of fasting blood glucose levels as a predictor of all-cause and cause-specific mortality was estimated in 9930 participants from four Chinese general populations with a 20-year follow-up. Multivariate Cox proportional hazard models were used to identify the relationship between fasting glucose and mortality.Results: There were 1471 deaths after a median follow-up of 20.2 years （a total of 187,374 person-years）, including 310 cardiovascular deaths, 581 cancer deaths, and 580 other-cause deaths. After adjustment for age, sex, urban or rural, northern or southern of China, types of work, education level, physical exercise, smoking status, drinking status, body mass index, systolic blood pressure, and serum total cholesterol at baseline, the hazard ratios （HRs） and 95% confidence intervals （CIs） for all-cause mortality in the fasting blood glucose categories of ＆60, 60-69, 70-79, 90-99, 100-109, 110-125, and ≥126 mg/dl were 1.38 （1.04-1.84）, 1.20 （1.01-1.43）, 1.18 （1.03-1.36）, 1.18 （0.99-1.41）, 1.48 （1.16-1.88）, 1.17 （0.84-1.62）, and 2.23 （1.72-2.90）, respectively, in contrast to the reference group （80-89 mg/dl）. TheHRs and 95%CIs for cardiovascular disease mortality in these groups were 2.58 （1.44-4.61）, 1.41 （0.95-2.10）, 1.56 （1.15-2.11）, 1.29 （0.88-1.89）, 1.36 （0.78-2.37）, 1.05 （0.52-2.11）, and 2.73 （1.64-4.56）, respectively.Conclusions: Both low and high fasting glucose were significantly associated with increased risk of all-cause and cardiovascular mortality in Chinese general population.
  • 摘要：Objectives: To describe the extent to which irritable bowel syndrome （IBS）, fibromyalgia syndrome （FMS）, and chronic fatigue syndrome （CFS） exhibit symptom overlap, and to validate a patient-derived, generic symptom questionnaire.Methods: A patient-derived 61-item symptom-frequency questionnaire was completed by participants recruited through IBS, FMS and CFS self-help websites. Principal axis factor analysis with oblimin rotation was performed separately for those reporting an IBS, FMS or CFS diagnosis.Results: Questionnaires were completed by 1751 participants of whom 851 reported more than one of the three diagnoses. Stomach pain on at least a weekly basis was reported by 79% of IBS, 52% of FMS, and 43% of CFS single diagnosis participants. Pain increasing the day after activity was reported by 32% of IBS, 94% of FMS, and 85% of CFS single diagnosis participants. Waking still tired at least once weekly was reported by 75% of IBS, 97% of FMS, and 95% of CFS single diagnosis participants. Exploratory factor analysis produced consistent results across all three diagnostic groups, the 61 items loading on 12 correlated factors with a single higher order factor on which all items loaded. Frequency analysis led to the rejection of one item （cold sores on or near lips）, and freeform reporting by participants of additional symptoms identified an additional five, namely, restless legs, hair loss/brittle hair/thinning, dizziness/balance problems, blurred vision and urination problems.Conclusions: IBS, FMS and CFS are polysymptomatic spectrum disorders with a wide range of overlapping symptoms, many of which are unrelated to diagnostic criteria. Frequency analysis and factor analysis confirm the validity of using the same questionnaire across different diagnostic categories. The 65-item general symptom questionnaire （GSQ-65） is a valid generic symptom scale suitable for assessing the many different symptoms of people with IBS, FMS and CFS.
  • 摘要：Objective: Handgrip strength （HGS） exercise has been reported to reduce blood pressure in both hypertensive and normotensive patients. In this study, we evaluated the association of HGS with hypertension in a Chinese Han Population.Methods: A total of 11,151 subjects mainly consisting of a rural population were recruited with a multi-stage sampling method in Jurong city, Jiangsu Province, China. Besides hypertension and diabetes, major chronic diseases were excluded. HGS was categorized into tertiles by age and gender. Logistic regression was used to estimate the association of HGS and hypertension with the odds ratio （OR） and 95% confidence interval （CI）.Results: From low to high tertiles of HGS, diastolic blood pressure （DBP） was significantly increased （74.52 ± 7.39, 74.70 ± 7.03, and 75.54 ± 7.01 mmHg, respectively;Ptrend = 0.001）, as well as in females （Ptrend=0.003）. The differences in DBP among the tertiles of HGS were still significant in females even after adjusting for covariates （Ptrend=0.048）. No significant differences in systolic blood pressure （SBP） were observed among the tertiles of HGS （P＆0.05）. Compared to low HGS, high HGS was significantly associated with hypertension after adjustment for age and gender （adjustedOR, 1.19; 95%CI, 1.06-1.34;P=0.004）. A stratified analysis showed that the significant association of high HGS and hypertension was also observed with the following factors even after adjusting for age and gender: female gender （adjustedOR, 1.25; 95%CI, 1.08-1.46;P=0.004）, ages of 60-69 years （adjustedOR, 1.29; 95%CI, 1.06-1.57;P=0.011）, and married （adjustedOR, 1.20; 95%CI, 1.06-1.37;P=0.005）. However, no significant associations were found after adjusting for age, gender, smoking status, drinking status, body mass index, physical activity level, glucose, high- and low-density lipoprotein cholesterol, total cholesterol, and triglyceride （P＆0.05）.Conclusion: The findings of the current study suggest that HGS was positively correlated with DBP in a rural population, and high HGS was associated with hypertension in females; however, the association may be modified by smoking status, drinking status, body mass index, physical activity, cholesterol level, and glucose level. Further utilization of HGS exercises to intervene in the development and prognosis of hypertension should be verified in the future.
  • 摘要：Objective: This study assesses the attitudes and preferences of Chinese clinicians toward their involvement in shared decision making （SDM）.Methods: From May 2014 to May 2015, 200 Chinese clinicians from two hospitals were enrolled to complete a survey on their attitude towards SDM. We conducted the survey via face-to-face interviews before and after an educational intervention on SDM among young Chinese clinicians. The clinicians were asked to give the extent of agreement to SDM. They also gave the extent of difficulty in using decision aids （DAs） during the SDM process. The variation in the range of responses to each question before and after the SDM intervention was recorded. The frequency of changed responses was analyzed by using JMP 6.0 software. Data were statistically analyzed using Chi-square and Mann-WhitneyU tests, as appropriate to the data type. Multiple logistic regressions were used to test for those factors significantly and independently associated with preference for an approach for each scenario.Results: Of the 200 young Chinese clinicians sampled, 59.0% indicated a preference for SDM and a desire to participate in SDM before receiving education or seeing the DA, and this number increased to 69.0% after seeing the DA with the sample video of the SDM process on Statin Choice. However, 28.5% of the respondents still reported that, in their current practice, they make clinical decisions on behalf of their patients. The clinicians who denied a desire to use the DA stated that the main barriers to implement SDM or DA use in China are lack of time and knowledge of SDM.Conclusions: Most young Chinese clinicians want to participate in SDM. However, they state the main barriers to perform SDM are lack of experience and time. The educational intervention about SDM that exposes clinicians to DAs was found to increase their receptivity.

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