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中华医学杂志（英文版）
中华医学会
中华医学杂志（英文版）

中华医学会

照日格图

半月刊

0366-6999

renlihua@cma.org.cn

010-85158321

100710

北京市东城区东四西大街42号

中华医学杂志（英文版）/Journal Chinese Medical JournalCSCDCSTPCD北大核心SCI
查看更多>>1887年创刊，中华医学会主办。中华医学杂志英文版(Chinese Medical Journal)是中华医学会会刊，是中国惟一被SCI核心版收录、具有百年以上历史的医学期刊。重点报道我国医学各学科最新进展和高水平科研成果，目前已被《科学引文索引（SCI）》、《医学索引（IM）》、Medline等国际著名检索系统收录。2009年SCI影响因子0.952，SCI被引频次3407。2010年被国际医学期刊编辑委员会（ICMJE）吸收为新成员。多次获得国家期刊奖、科协专项基金、自然基金等奖项和资助。实行全文上网 （），网上投稿审稿()。
正式出版
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    Clinical application and management of temporary mechanical circulatory support:A clinical consensus

    Nianguo DongLiangwan ChenXin ChenHuishan Wang...
    1135-1139页
      原文链接:
    • 国家科技期刊平台
    • NETL
    • NSTL
    • 万方数据

    Dawn of CAR-T cell therapy in autoimmune diseases

    Yuxin LiuMinghao DongYunhui ChuLuoqi Zhou...
    1140-1150页
    查看更多>>摘要：Chimeric antigen receptor(CAR)-T cell therapy has achieved remarkable success in the treatment of hematological malignancies.Based on the immunomodulatory capability of CAR-T cells,efforts have turned toward exploring their potential in treating auto-immune diseases.Bibliometric analysis of 210 records from 128 academic journals published by 372 institutions in 40 countries/regions indicates a growing number of publications on CAR-T therapy for autoimmune diseases,covering a range of subtypes such as systemic lupus erythematosus,multiple sclerosis,among others.CAR-T therapy holds promise in mitigating several shortcomings,including the indiscriminate suppression of the immune system by traditional immunosuppressants,and non-sus-taining therapeutic levels of monoclonal antibodies due to inherent pharmacokinetic constraints.By persisting and proliferating in vivo,CAR-T cells can offer a tailored and precise therapeutics.This paper reviewed preclinical experiments and clinical trials involving CAR-T and CAR-related therapies in various autoimmune diseases,incorporating innovations well-studied in the field of hematological tumors,aiming to explore a safe and effective therapeutic option for relapsed/refractory autoimmune diseases.
      原文链接:
    • 国家科技期刊平台
    • NETL
    • NSTL
    • 万方数据

    Long non-coding RNA MALAT1 in hematological malignancies and its clinical applications

    Chunlan ZhangYun QinYu WuHeng Xu...
    1151-1159页
    查看更多>>摘要：Metastasis-associated lung adenocarcinoma transcript 1(MALAT1)is a well-established oncogenic long non-coding RNA,the higher expression of which is strongly correlated with cancer events such as tumorigenesis,progression,metastasis,drug resistance,and treatment outcome in solid cancers.Recently,a series of studies has highlighted its potential role in hematological malig-nancies in terms of these events.Similar to solid cancers,MALAT1 can regulate various target genes via sponging and epigenetic mechanisms,but the miRNAs sponged by MALAT1 differ from those identified in solid cancers.In this review,we systematically describe the role and underlying mechanisms of MALAT1 in multiple types of hematological malignancies,including regulation of cell proliferation,metastasis,stress response,and glycolysis.Clinically,MALAT1 expression is related to poor treatment outcome and drug resistance,therefore exhibiting potential prognostic value in multiple myeloma,lymphoma,and leukemia.Finally,we discuss the evaluation of MALAT1 as a novel therapeutic target against cancer in preclinical studies.
      原文链接:
    • 国家科技期刊平台
    • NETL
    • NSTL
    • 万方数据

    Birth weight,ideal cardiovascular health metrics in adulthood,and incident cardiovascular disease

    Ying SunBin WangYuefeng YuYuying Wang...
    1160-1168页
    查看更多>>摘要：Background:Prenatal and postnatal factors may have joint effects on cardiovascular health,and we aimed to assess the joint association of birth weight and ideal cardiovascular health metrics(ICVHMs)prospectively in adulthood with incident cardio-vascular disease(CVD).Methods:In the UK Biobank,227,833 participants with data on ICVHM components and birth weight and without CVD at baseline were included.The ICVHMs included smoking,body mass index,physical activity,diet information,total cholesterol,blood pressure,and hemoglobin A1c.The Cox proportional hazards model was used to estimate the hazard ratios(HRs)and 95％confidence intervals(CIs)in men and women.Results:Over a median follow-up period of 13.0 years(2,831,236 person-years),we documented 17,477 patients with incident CVD.Compared with participants with birth weights of 2.5-4.0 kg,the HRs(95％CIs)of CVD among those with low birth weights was 1.08(1.00-1.16)in men and 1.23(1.16-1.31)in women.The association between having a birth weight＜2.5 kg and CVD risk in men was more prominent for those aged＜50 years than for those of older age(P for interaction=0.026).Lower birth weight and non-ideal cardiovascular health metrics were jointly related to an increased risk of CVD.Participants with birth weights＜2.5 kg and ICVHMs score 0-1 had the highest risk of incident CVD(HR[95％CI]:3.93[3.01-5.13]in men;4.24[3.33-5.40]in women).The joint effect(HR[95％CI]:1.36[1.17-1.58])could be decomposed into 24.7％(95％CI:15.0％-34.4％)for a lower birth weight,64.7％(95％CI:56.7％-72.6％)for a lower ICVHM score,and 10.6％(95％CI:2.7％-18.6％)for their additive interaction in women.Conclusions:Birth weight and ICVHMs were jointly related to CVD risk.Attaining a normal birth weight and ideal ICVHMs may reduce the risk of CVD,and a simultaneous improvement of both prenatal and postnatal factors could further prevent additional cases in women.
      原文链接:
    • 国家科技期刊平台
    • NETL
    • NSTL
    • 万方数据

    Weight change and all-cause and cause-specific mortality:A 25-year follow-up study

    Huan YangJianbing WangXiaokun WangWanyi Sun...
    1169-1178页
    查看更多>>摘要：Background:Whether the dynamic weight change is an independent risk factor for mortality remains controversial.This study aimed to examine the association between weight change and risk of all-cause and cause-specific mortality based on the Linxian Nutrition Intervention Trial(NIT)cohort.Methods:Body weight of 21,028 healthy residents of Linxian,Henan province,aged 40-69 years was measured two times from 1986 to 1991.Outcome events were prospectively collected up to 2016.Weight maintenance group(weight change＜2 kg)or stable normal weight group was treated as the reference.Cox proportional hazard model was performed to calculate hazard ratios(HRs)and 95％confidence intervals(95％CIs)to estimate the risk of mortality.Results:A total of 21,028 subjects were included in the final analysis.Compared with the weight maintenance group,subjects with weight loss ≥2 kg had an increased risk of death from all-cause(HRAll-cause=1.14,95％CI:1.09-1.19,P＜0.001),cancer(HRCancer=1.12,95％CI:1.03-1.21,P=0.009),and heart disease(HRHeartdiseases=1.21,95％CI:1.11-1.31,P＜0.001),whereas subjects with weight gain ≥5 kg had 11％(HRCancer=0.89,95％CI:0.79-0.99,P=0.033)lower risk of cancer mortality and 23％higher risk of stroke mortality(HRStroke=1.23,95％CI:1.12-1.34,P＜0.001).For the change of weight status,both going from overweight to normal weight and becoming underweight within 5 years could increase the risk of total death(HROverweight to normal=1.18,95％CI:1.09-1.27;HRBecoming underweight=1.35,95％CI:1.25-1.46)and cancer death(HROverweight to normal=1.20,95％CI:1.04-1.39;HRBecoming underweight=1.44,95％CI:1.24-1.67),while stable overweight could increase the risk of total death(HRStable overweight=1.11,95％CI:1.05-1.17)and death from stroke(HRStable overweight=1-44,95％CI:1.33-1.56).Interaction effects were observed between age and weight change on cancer mortality,as well as between baseline BMI and weight change on all-cause,heart disease,and stroke mortality(all Pinteraction＜0.01).Conclusions:Weight loss was associated with an increased risk of all-cause,cancer,and heart disease mortality,whereas excessive weight gain and stable overweight were associated with a higher risk of stroke mortality.Efforts of weight management should be taken to improve health status.Trial registration:https://classic.clinicaltrials.gov/,NCT00342654.
      原文链接:
    • 国家科技期刊平台
    • NETL
    • NSTL
    • 万方数据

    Influenza and pneumococcal vaccination coverage and associated factors in patients hospitalized with acute exacerbations of COPD in China:Findings from real-world data

    Ruoxi HeXiaoxia RenKe HuangJieping Lei...
    1179-1189页
    查看更多>>摘要：Background:Influenza and pneumococcal vaccination are a priority in patients with chronic obstructive pulmonary disease(COPD).However,limited information is available on vaccination coverage among patients with acute exacerbations of COPD(AECOPD)in China.This study aimed to determine the rates and associated factors of influenza and pneumococcal vaccination in patients hospitalized with AECOPD.Methods:Baseline data from a national,multicenter,hospital-based study that included adult inpatients with AECOPD between 2017 and 2021 were analyzed.The outcomes of interest were the influenza vaccination in the past year and the pneumococcal vaccination in the past 5 years.To ensure national representativeness,rates were weighted according to the distribution of hospital levels and types enrolled in this study.Multivariable Poisson regression based on mixed-effects models were used to determine the associated factors.The independent variables included the region and hospital features where the participants were located,sociodemographic characteristics(age,sex,rural/urban residence,education,etc.),and clinical indicators(COPD disease history,lung function parameters,comorbidities,etc.).The treatment profiles of the vaccinated and unvaccinated participants were compared.Results:Of 6949 eligible participants,the weighted rates of influenza/pneumococcal,influenza,and pneumococcal vaccination were 2.72％(95％confidence interval[CI]:2.34％-3.10％),2.09％(95％CI:1.76％-2.43％),and 1.25％(95％CI:0.99％-1.51％),respectively.In multivariable models,age ≥60 years(60-69 years,odds ratio[OR]:1.90,95％CI:1.11-3.25;≥80 years,OR:2.00,95％CI:1.06-3.78),geographical regions(Northern China relative to Eastern China,OR:5.09,95％CI:1.96-13.21),urban residence(OR:1.69,95％CI:1.07-2.66),a higher education level(junior high school,OR:1.77,95％CI:1.21-2.58;senior high school or above,OR:2.61,95％CI:1.69-4.03),former smoking(OR:1.79,95％CI:1.15-2.79),and regular inhaled medication treatment(OR:3.28,95％CI:2.29-4.70)were positively associated with vaccination.Patients who had experienced severe exacerbations in the past year were less likely to be vaccinated(OR:0.65,95％CI:0.45-0.96).Compared with unvaccinated participants,vaccinated participants adhered better to pharmacological and non-pharmacological treatment.Conclusions:Influenza and pneumococcal vaccination coverage are extremely low.Urgent measures are necessary to increase vaccination coverage among inpatients with AECOPD in China.
      原文链接:
    • 国家科技期刊平台
    • NETL
    • NSTL
    • 万方数据

    Tildrakizumab for moderate-to-severe plaque psoriasis in Chinese patients:A12-week randomized placebo-controlled phase Ⅲ trial with long-term extension

    Chen YuSongmei GengBin YangYunhua Deng...
    1190-1198页
    查看更多>>摘要：Background:There is a need for effective and safe therapies for psoriasis that provide sustained benefits.The aim of this study was to assess the efficacy and safety of tildrakizumab,an anti-interleukin-23p19 monoclonal antibody,for treating moderate-to-severe plaque psoriasis in Chinese patients.Methods:In this multi-center,double-blind,phase Ⅲ trial,patients with moderate-to-severe plaque psoriasis were enrolled and randomly assigned(1:1)to receive subcutaneous tildrakizumab 100 mg or placebo at weeks 0 and 4.Patients initially assigned to placebo were switched to receive tildrakizumab at weeks 12,16,and every 12 weeks thereafter.Patients in the tildrakizumab group continued with tildrakizumab at week 16,and every 12 weeks until week 52.The primary endpoint was the Psoriasis Area and Severity Index(PASI 75)response rate at week 12.Results:At week 12,tildrakizumab demonstrated significantly higher PASI 75 response rates(66.4％[73/110]vs.12.7％[14/110];difference,51.4％[95％confidence interval(CI),40.72,62.13];P＜0.001)and Physician's Global Assessment(60.9％[67/110]vs.10.0％[11/110];difference,49.1％[95％CI,38.64,59.62];P＜0.001)compared to placebo.PASI 75 response continued to improve over time in both tildrakizumab and placebo-switching to tildrakizumab groups,reaching maximal efficacy after 28 weeks(86.8％[92/106]vs.82.4％[89/108])and maintained up to 52 weeks(91.3％[95/104]vs.87.4％[90/103]).Most trcatment-emergent adverse events were mild and not related to tildrakizumab.Conclusion:Tildrakizumab demonstrated durable efficacy through week 52 and was well tolerated in Chinese patients with moderate-to-severe plaque psoriasis.Trial registration:ClinicalTrials.gov,NCT05108766.
      原文链接:
    • 国家科技期刊平台
    • NETL
    • NSTL
    • 万方数据

    Early prediction of growth patterns after pediatric kidney transplantation based on height-related single-nucleotide polymorphisms

    Yi FengYonghua FengMingyao HuHongen Xu...
    1199-1206页
    查看更多>>摘要：Background:Growth retardation is a common complication of chronic kidney disease in children,which can be partially relieved after renal transplantation.This study aimed to develop and validate a predictive model for growth patterns of children with end-stage renal disease(ESRD)after kidney transplantation using machine learning algorithms based on genomic and clinical variables.Methods:A retrospective cohort of 110 children who received kidney transplants between May 2013 and September 2021 at the First Affiliated Hospital of Zhengzhou University were recruited for whole-exome sequencing(WES),and another 39 children who underwent transplant from October 2021 to March 2022 were enrolled for external validation.Based on previous studies,we comprehensively collected 729 height-related single-nucleotide polymorphisms(SNPs)in exon regions.Seven machine learning algorithms and 10-fold cross-validation analysis were employed for model construction.Results:The 110 children were divided into two groups according to change in height-for-age Z-score.After univariate analysis,age and 19 SNPs were incorporated into the model and validated.The random forest model showed the best prediction efficacy with an accuracy of 0.8125 and an area under curve(AUC)of 0.924,and also performed well in the external validation cohort(accuracy,0.7949;AUC,0.796).Conclusions:A model with good performance forpredicting post-transplant growth patterns in children based on SNPs and clinical variables was constructed and validated using machine learning algorithms.The model.is expected to guide clinicians in the management of children after renal transplantation,including the use of growth hormone,glucocorticoid withdrawal,and nutritional supplementation,to alleviate growth retardation in children with ESRD.
      原文链接:
    • 国家科技期刊平台
    • NETL
    • NSTL
    • 万方数据

    Reconstitution of double-negative T cells after cord blood transplantation and its predictive value for acute graft-versus-host disease

    Tianzhong PanPeng DingAijie HuangBaolin Tang...
    1207-1217页
    查看更多>>摘要：Background:With an increasing number of patients with hematological malignancies being treated with umbilical cord blood transplantation(UCBT),the correlation between immune reconstitution(IR)after UCBT and graft-versus-host disease(GVHD)has been reported successively,but reports ondouble-negative T(DNT)cell reconstitution and its association with acute GVHD(aGVHD)after UCBT are lacking.Methods:A population-based observational studywas conducted among 131 patients with hematological malignancies who underwent single-unit UCBT as their first transplant at the Department of Hematology,the First Affiliated Hospital of USTC,between August 2018 and June 2021.IR differences were compared between the patients with and without aGVHD.Results:The absolute number of DNT cells in the healthy Chinese population was 109(70-157)/pL,accounting for 5.82(3.98-8.19)％of lymphocytes.DNT cells showed delayed recovery and could not reach their normal levels even one year after transplantation.Importantly,the absolute numberand percentage of DNT cells were significantly higher in UCBT patients without aGVHD than in those with aGVHD withinone year(F=4.684,P=0.039 and F=5:583,P=0.026,respectively).In addition,the number of DNT cells in the first month-after transplantation decreased significantly with the degree of aGVHD increased,and faster DNT cell reconstitution in the first month after UCBT was an independent protective factor for aGVHD(HR=0.46,95％confidence interval[CI]:0.23-0.93;P=0.031).Conclusions:Compared to the number of DNT cells in Chinese healthy people,the reconstitution of DNT cells in adults with hematological malignancies after UCBT was slow.In addition,the faster reconstitution of DNT cells in the early stage after transplantation was associated with a lower incidence of aGVHD.
      原文链接:
    • 国家科技期刊平台
    • NETL
    • NSTL
    • 万方数据

    Strategy and technique for surgical treatment of Ebstein's anomaly

    Qingyu WuXiaoya ZhangMingkui ZhangHongyin Li...
    1218-1224页
    查看更多>>摘要：Background:Ebstein's anomaly(EA)is a rare and complex congenital heart anomaly,and the effect of surgical treatment is not ideal.This study aims to introduce our experience in management strategies,surgical techniques,and operative indications for patients with Ebstein's anomaly.Methods:A retrospective study of 258 operations was performed in 253 patients by the same cardiac surgeon in The First Hospital of Tsinghua University between March 2004 and January 2020.32 patients had previously received cardiac surgery in other hospitals.The clinical data including diagnosis,operative indications,techniques,pathological changes,and survival rates were collected and analyzed.Results:Anatomical correction was performed in 203(78.7％)operations,1½ ventricle repair in 38(14.7％)operations,tricuspid valve repair only in four operations(1.6％),tricuspid valve replacement in ten(3.9％),total cavopulmonary connection(TCPC)in two(0.8％),and Glenn operation in one operation(0.4％).Reoperation was performed in five patients(2.0％)during hospitalization.Among them,tricuspid valve replacement was performed in one patient,1½ ventricle repair in two patients,and tricuspid valve annulus reinforcement in two patients.Five patients died with an early mortality rate of 2.0％.Complete atrioventricular conduction block was complicated in one patient(0.4％).A total of 244 patients was followed up(four in the 253 patients lost)with a duration of 3.0-168.0(87.6±38.4)months.Cardiac function of 244 patients improved significantly with mean New York Heart Association(NYHA)functional class recovery from 3.5 to 1.1.The mean grade of tricuspid valve regurgitation improved from 3.6 to 1.5.Three late deaths(1.2％)occurred.The survival rates at five and ten years after surgery were 98.6％and 98.2％,respectively.Reoperation was performed in five patients(2.0％)during the follow-up period.Conclusion:Based on our management strategies and operative principles and techniques,anatomical correction of EA is capable of achieving excellent long-term results,and low rates of TCPC,1½ ventricle repair and valvular replacement.
      原文链接:
    • 国家科技期刊平台
    • NETL
    • NSTL
    • 万方数据