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Research progress of Hashimoto thyroiditis TIAN Limin, FENG Jing Journal of Internal Medicine Concepts & Practice    2024, 19 (04): 217-223.   DOI: 10.16138/j.1673-6087.2024.04.01 Abstract （2243）   HTML （37）    PDF（pc） （973KB）（932）       Knowledge map    Save Hashimoto thyroiditis (HT) is a very common organic autoimmune thyroid disease, and its incidence is increasing year by year. It not only causes hypothyroidism in clinical practice, but also has many connections with a variety of immune diseases, endocrine diseases, rheumatic diseases and thyroid cancer. Although the exact etiology of HT has not been fully clarified, the mainstream treatment is still based on management and alternative treatment of hypothyroidism. However, as the research further deepens, more clinical variants have been gradually discovered, more and more factors have been found to be related to the onset of HT, and new discoveries have been made in treatment methods. This article reviews the research progress on clinical manifestations, pathological features, diagnosis, pathogenesis, relationship with other diseases and treatment of HT. Reference | Related Articles | Metrics | Comments（0）

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Research progress on agranulocytosis caused by antithyroid drugs TIAN Ruochen, LI Jing Journal of Internal Medicine Concepts & Practice    2024, 19 (04): 264-268.   DOI: 10.16138/j.1673-6087.2024.04.09 Abstract （1677）   HTML （6）    PDF（pc） （970KB）（168）       Knowledge map    Save In China, antithyroid drugs are the first choice of treatment for hyperthyroidism. However, their side effects may result in agranulocytosis, which has an insidious onset and requires urgent treatment. Up to date，the mechanisms of agranulocytosis caused by antithyroid drugs is still unclear. Herein, the article reviewed the direct toxic activities, the immune effects, and the genetic susceptibility of antithyroid drugs, which may be helpful to provide better clinical treatment options and improve the prognosis of agranulocytosis caused by the drugs. Reference | Related Articles | Metrics | Comments（0）

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Study on efficacy and safety of Dioscorea bublifera L. in treatment of Graves disease CUI Yifan, ZHANG Ruixiang, WEI Xiao, LIU Chao Journal of Internal Medicine Concepts & Practice    2024, 19 (04): 273-277.   DOI: 10.16138/j.1673-6087.2024.04.11 Abstract （1505）   HTML （1）    PDF（pc） （955KB）（595）       Knowledge map    Save Hyperthyroidism is most common in Graves disease (GD), and traditional antithyroid medicine are often difficult to achieve satisfactory efficacy, and high recurrence rate and long course of treatment are the most prominent problems. Huangyaozi（Dioscorea bublifera L.）, a traditional Chinese medicine, has the effect of “Xiao Ying” and has been widely used in the treatment of GD in recent years, but long-term use may cause liver and kidney damage. Therefore, more research on the efficacy and safety of Huangyaozi need to be done in the treatment of GD. Reference | Related Articles | Metrics | Comments（0）

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Recent advances in diagnosis and treatment of subacute thyroiditis LI Yajie, CUI Dai Journal of Internal Medicine Concepts & Practice    2024, 19 (04): 259-263.   DOI: 10.16138/j.1673-6087.2024.04.08 Abstract （1494）   HTML （24）    PDF（pc） （939KB）（153）       Knowledge map    Save Subacute thyroiditis (SAT) is a common thyroid inflammatory disease that is frequently prone to misdiagnosis or underdiagnosis, which impact the quality of life for patients adversely. In this review, we summarize the pathogenesis, clinical manifestations, diagnosis, and treatment of SAT, aiming to improve clinician’s understanding of the disease. Table and Figures | Reference | Related Articles | Metrics | Comments（0）

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Ultrasound features and clinical manifestations of two cases of thyroid metastatic cancer: pay attention to abnormal thyroid ultrasound spectrum LI Yuanyuan, DING Wenbo, JIANG Ziyu, CHEN Xi, LIU Binbin, CHEN Guofang, LIU Chao Journal of Internal Medicine Concepts & Practice    2024, 19 (04): 254-258.   DOI: 10.16138/j.1673-6087.2024.04.07 Abstract （1251）   HTML （18）    PDF（pc） （8859KB）（75）       Knowledge map    Save Ultrasonography plays an important role in early screening of thyroid cancer. This article introduced two cases of thyroid metastatic carcinoma secondary to renal clear cell carcinoma and cervical squamous cell carcinoma respectively, analyzed their clinical diagnosis and treatment process, ultrasound characteristics, and prognosis, as well as reviewed the related literature. As atypical thyroid lesions were detected through the ultrasound spectrum in patients with a history of malignant tumors, it should be alert to the possibility of metastatic cancer. Ultrasound-guided core-needle biopsy combined with immunohistochemical testing can help early diagnosis and timely treatment. Table and Figures | Reference | Related Articles | Metrics | Comments（0）

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Impact of maternal hyperthyroidism during pregnancy on neurological and psychiatric development of offspring YANG Ao, ZHANG Peiheng, ZHANG Yang, GAO Ying Journal of Internal Medicine Concepts & Practice    2024, 19 (04): 269-272.   DOI: 10.16138/j.1673-6087.2024.04.10 Abstract （1126）   HTML （3）    PDF（pc） （855KB）（26）       Knowledge map    Save Gestational hyperthyroidism can significantly increase health risks to both mother and fetal. However, there are few reports on its impact on the neuropsychological development of offspring. This article reviews the literature related to the effect of hyperthyroidism during pregnancy on brain structure, intelligence quotient (IQ) and neuropsychiatric disorders of offsprings. It was found that hyperthyroidism during pregnancy may be associated with reduced brain volume and cortical gray matter volume, lower IQ, and increase the risk of depression in offspring. However, its’ relationship with other mental and emotional well-being disorder of the offspring is unclear. Reference | Related Articles | Metrics | Comments（0）

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Screening and pathway analysis of autophagy-related genes in Alzheimer disease SHENG Zhaoqing, LIU Xiaohong Journal of Internal Medicine Concepts & Practice    2024, 19 (04): 236-242.   DOI: 10.16138/j.1673-6087.2024.04.04 Abstract （449）   HTML （0）    PDF（pc） （3101KB）（51）       Knowledge map    Save Objective Screen autophagy related genes of Alzheimer disease(AD) based on microarray analysis, conduct pathway analysis and identify key genes in order to explore potential pathogenesis and therapeutic targets. Methods The GSE33000 dataset was downloaded from GEO Database, and the differentially expressed genes of AD were obtained by R software limma package. Autophagy-related genes were downloaded from Human Autophagy Database, Human Autophagy Modulator Database and GeneCard Database, respectively, and the autophagy-related gene set was obtained. The AD autophagy-related genes were obtained through intersecting the differentially expressed genes with the autophagy-related gene set. The R software packages such as org.Hs.eg.db and clusterProfiler were used to perform gene ontology (GO) analysis and Kyoto Encyclopedia of Genes and Genomes (KEGG) analysis, the online software Search Tool for the Retrieval of Interacting Genes (STRING) was used to conduct protein-protein interaction network analysis, and the key genes were predicted based on MCC algorithm. Results A total of 66 autophagy related genes were obtained, of which 41 genes were up-regulated and 25 genes were down-regulated. Gene enrichment analysis showed that cellular components in GO analysis were mainly enriched in phagocytic vesicle membrane, secretory granule membrane, membrane microdomain, late endosome, etc., and molecular functions were mainly enriched in Toll-like receptor binding, ubiquitin-like protein ligase binding, etc., and biological processes were enriched in regulation of autophagy, positive regulation of cellular catabolic process, response to lipopolysaccharide, regulation of inflammatory response, cellular response to external stimulus, etc. In KEGG enrichment analysis, the differentially expressed autophagy-related genes were mainly concentrated in NOD-like receptor signaling pathway, lipid and atherosclerosis, forkhead box protein O(FoxO) signaling pathway, etc. Our research completed the construction of protein-protein interaction (PPI), identified 10 key genes, and screened out that interleukin-6(IL-6) and signal transducer and activator of transcription 3(STAT3) were closely related to AD. Conclusions Ten key autophagy-related genes were obtained in this study, among which IL-6 and STAT3 are more closely related to AD. Table and Figures | Reference | Related Articles | Metrics | Comments（0）

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Mechanism of mitochondrial autophagy in myocardial ischemia-reperfusion injury GAO Yue, XING Shifeng Journal of Internal Medicine Concepts & Practice    2024, 19 (05): 328-332.   DOI: 10.16138/j.1673-6087.2024.05.08 Abstract （416）   HTML （7）    PDF（pc） （828KB）（1076）       Knowledge map    Save Cardiovascular disease is still one of the most common causes of death in the world. In the past, timely reperfusion treatment has greatly reduced the death rate of the disease while promoting blood recovery and cardiomyocyte recovery. Ischemia reperfusion (IR) injury is an inevitable pathological process in many clinical practices. The mechanisms of myocardial IR injury include a variety of pathological processes such as mitochondrial autophagy and apoptosis, and these signaling pathways are interrelated and act on each other. Among them, mitochondrial autophagy has attracted wide attention as a selective autophagy. Mitochondrial autophagy maintains the normal operation of cardiomyocytes by regulating the quality and quantity of mitochondria. However, as stimulated by oxidative stress, ischemia and hypoxia, excessive mitochondrial autophagy or insufficient mitochondrial autophagy can affect the function of cardiomyocytes and even lead to the death of cardiomyocytes. Therefore, the activation degree of mitochondrial autophagy in cardiomyocytes should be strictly controlled. This article reviews the mechanism and progress of mitochondrial autophagy in myocardial IR injury, aiming to provide some assistance in the study of myocardial IR injury. Reference | Related Articles | Metrics | Comments（0）

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Expert consensus on multidisciplinary diagnosis and treatment of primary Sjögren syndrome (2024 edition) CHENG Fang, ZHAO Futao, SHEN Xuemin, LI Jin, CHEN Xiangjun, WANG Guifang, LI Huilin, XUE Luan, QI Junyuan Journal of Internal Medicine Concepts & Practice    2024, 19 (06): 357-362.   DOI: 10.16138/j.1673-6087.2024.06.01 Abstract （353）   HTML （17）    PDF（pc） （923KB）（84）       Knowledge map    Save Primary Sjögren syndrome (PSS) is an autoimmune disease characterized by lymphocytic infiltration of exocrine glands and other organs. PSS shows strong clinical heterogeneity, presents different degrees of topical and systemic damage, and multidisciplinary collaboration are required to develop PSS treatment strategies. However, our country currently has not unified diagnosis and treatment consensus for PSS. Based on domestic and foreign diagnosis and treatment experience, consensus and guideline, experts from multiple related disciplines achieved consensus using the nominal group technique, providing guidance and reference for standardized diagnosis and treatment of PSS. Table and Figures | Reference | Related Articles | Metrics | Comments（0）

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Research progress on mechanism of traditional Chinese medicine in treating Parkinson disease by interfering with ferroptosis LI Yuanyuan, YAO Xiaoling, QU Yanjie, CHEN Jingxian Journal of Internal Medicine Concepts & Practice    2024, 19 (05): 351-356.   DOI: 10.16138/j.1673-6087.2024.05.13 Abstract （352）   HTML （3）    PDF（pc） （1005KB）（814）       Knowledge map    Save Ferroptosis is a newly recognized form of programmed cell death in recent years, and its core mechanism mainly involves the accumulation of iron-dependent lipid peroxides in cells. More and more studies suggest that ferroptosis plays a critical role in the onset and progression of Parkinson disease (PD). This article aims to review the molecular regulatory mechanism of ferroptosis in detail and the latest research progress on ferroptosis in treatment of PD and the therapeutic methods of traditional Chinese medicine for it. Through in-depth discussion of this emerging research field, the current status and progress of active ingredients and compounds of traditional Chinese medicine intervening process of PD through ferroptosis pathway were summarized, which was expected to provide a solid theoretical basis and innovative ideas for the application of targeting ferroptosis in the PD treatment. Reference | Related Articles | Metrics | Comments（0）

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Research progress of coagulation factor XIII and venous thromboembolism XIE Xuemeng, HU Ling Journal of Internal Medicine Concepts & Practice    2024, 19 (05): 333-336.   DOI: 10.16138/j.1673-6087.2024.05.09 Abstract （324）   HTML （1）    PDF（pc） （820KB）（12）       Knowledge map    Save Venous thromboembolism (VTE) is the third most common cardiovascular disease worldwide, and its incidence continues to rise. Coagulation factor XIII (FXIII, factor XIII), also known as fibrin stabilization factor, is involved in multiple stages of the clotting cascade. Recent studies have found that FXIII is a key factor in determining the volume, structure and stability of venous thrombosis, and may play an important role in the formation, shedding or dissolution of deep venous thrombosis. This paper reviews the research progress of FXIII and VTE, in order to provide new ideas for the prevention, diagnosis and treatment of VTE. Reference | Related Articles | Metrics | Comments（0）

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Bioinformatics analysis and identification of cuproptosis characteristic genes for acute pancreatitis by machine learning WANG Zhuoxin, HUANG Xinyang, JIN Yixun, WANG Lifu Journal of Internal Medicine Concepts & Practice    2024, 19 (04): 224-230.   DOI: 10.16138/j.1673-6087.2024.04.02 Abstract （322）   HTML （14）    PDF（pc） （1760KB）（1151）       Knowledge map    Save Objective To discover the characteristic genes of cuproptosis in acute pancreatitis (AP). Methods The expression of cuproptosis-related genes (CRG) in the GSE1943 dataset was extracted and performed differential analysis and immune cell correlation analysis. The different subtypes were classified according to the expression of CRG, and metabolic pathway enrichment was performed using gene set variation analysis. Four machine learning algorithms, including generalized linear models, random forest, support vector machine and extreme gradient boosting were used to screen disease characteristic genes. Results A total of 13 CRG were differentially expressed in AP (P<0.05), and CRG were not only correlated to each other in different degrees, but also had correlation with multiple immune cells (P<0.05). There were four immune-related pathways among the two subtypes obtained by cluster analysis, in which the T-cell receptor signaling pathway was noteworthy. Further analysis revealed significant difference between the two subtypes of multiple T cells (P<0.05). Each machine learning algorithm screened out five characteristic genes, and dihydrolipoamide dehydrogenase (DLD) was obtained as the next target of research. Conclusions CRG-based machine learning and bioinformatics analyses could be used to explore CRG in AP to discover potential biomarkers. Table and Figures | Reference | Related Articles | Metrics | Comments（0）

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Research progress on prognostic biomarkers for colorectal cancer WANG Hongxiao, SU Qiying, YAN Hua Journal of Internal Medicine Concepts & Practice    2024, 19 (05): 337-341.   DOI: 10.16138/j.1673-6087.2024.05.10 Abstract （317）   HTML （3）    PDF（pc） （891KB）（30）       Knowledge map    Save Colorectal cancer (CRC) is one of the most common malignant tumors of digestive system in the world. Epidemiological statistics showed that the global incidence of CRC ranked third among all cancer types and its mortality rate ranked second in 2020, while the reasons for the increased incidence are still not clear. At present, it is believed that the occurrence of CRC is a multi-factor and multi-step chronic process. Because the onset of CRC is insidious and the early detection rate is low, most patients are diagnosed in the middle and late stage as symptoms develop, which leads to poor prognosis. The average 5-year survival rate of CRC in China was 56.9%, which was the lowest among surrounding Asia-Pacific countries. CRC has become a huge threat to the life and health of Chinese citizens. Therefore, further understanding of prognosis biomarkers of CRC are important in promoting individualized treatment and improving the survival rate and quality of life in CRC patients. This article reviews the research progress on prognostic biomarkers for CRC to provide some inspiration for future treatment of CRC. Reference | Related Articles | Metrics | Comments（0）

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Study on the correlation between serum MG53 level and coronary artery calcification ZHANG Yu, ZHA Qing, YANG Ling, YE Jiawen, YANG Ke, LIU Yan Journal of Internal Medicine Concepts & Practice    2024, 19 (05): 303-309.   DOI: 10.16138/j.1673-6087.2024.05.03 Abstract （300）   HTML （3）    PDF（pc） （1245KB）（115）       Knowledge map    Save Objective To study the correlation between serum MG53 level and coronary artery calcification (CAC), and the correlation between serum MG53 level and the prognosis of patients with CAC. Methods A total of 195 patients admitted to the Department of Cardiovascular Medicine of Ruijin Hospital， Shanghai Jiao Tong University School of Medicine from 2016 to 2018 due to chest distress and other discomforts were selected. CAC was confirmed by coronary CT angiography (CTA) in all patients. Agatston integral was used to calculate CAC score, and serum MG53 level was detected by enzyme-linked immunosorbent assay. Patients were followed up for 5 years, and the endpoint events were recorded. Patients were grouped according to CAC score and serum MG53 level. Logistic regression was used to analyze the correlation between serum MG53 level and CAC level. Kaplan-Meier curve and COX proportional risk model were used to analyze the effect of serum MG53 level on the prognosis of CAC patients. The R software (4.2.2 version) was used to calculate the best cut-off value of serum MG53 level for predicting end-point events. Results Compared with the low-risk group，the serum MG53 level in the high-risk group was significantly lower [57.717 (28.548，139.965) pg/mL vs 33.553 (13.509，56.952) pg/mL, P<0.001]. Serum MG53 level was independently associated with the severity of CAC (OR=0.984, 95%CI：0.971-0.994, P<0.007). The risk of cardiovascular events was significantly increased in patients with low MG53 levels (OR=0.282, 95%CI：0.160-0.498, P<0.001). The cutoff value of MG53 was calculated as 18.36 pg/mL. Conclusions Serum MG53 level may be related to the degree of CAC and the prognosis of patients，suggesting that serum MG53 level may be a biomarker for predicting CAC and the prognosis of patients. Table and Figures | Reference | Related Articles | Metrics | Comments（0）

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Research progress on biomarkers for chronic obstructive pulmonary disease complicated with obstructive sleep apnea QIANG Shihao, DAI Qingxia, HUANG Lina, GUO Hua, CUI Xiaochuan Journal of Internal Medicine Concepts & Practice    2024, 19 (05): 322-327.   DOI: 10.16138/j.1673-6087.2024.05.07 Abstract （287）   HTML （2）    PDF（pc） （902KB）（176）       Knowledge map    Save The coexistence of obstructive sleep apnea (OSA) and chronic obstructive pulmonary disease (COPD) is referred to as COPD-OSA overlap, also known as overlap syndrome (OS). OS patients are more severe and have worse prognosis than those with OSA and COPD alone. Because pulmonary function and polysomnography cannot be conducted widely for patients, at present, there are many research to explore the clinical value of immunology, blood cell, gene protein，body fluid and other related biomarkers related to OS in assisting diagnosis, predicting the risk and severity of disease. This article reviews the recent research progress on OS-related biological markers. Table and Figures | Reference | Related Articles | Metrics | Comments（0）

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Research on pharmacological activity of shikonin combined with low-intensity pulsed ultrasound to modulate ERK-JNK/NF-κB signaling pathway to inhibit arthritis LIU Xiaoxu, LIU Jinyu, ZHOU Benyuan, FAN Kaijian Journal of Internal Medicine Concepts & Practice    2024, 19 (06): 385-392.   DOI: 10.16138/j.1673-6087.2024.06.06 Abstract （275）   HTML （9）    PDF（pc） （3555KB）（10）       Knowledge map    Save Objective To investigate the possible mechanism of shikonin in inhibiting synovial cell proliferation and inflammatory response and the effect of combining with low-intensity pulsed ultrasound (LI-PUS) in the treatment of rheumatoid arthritis. Methods Abnormal proliferation of mouse synoviocytes were induced by lipopolysaccharide (LPS) in vitro experiments. CCK-8 and ELISA were performed to detect the proliferation of synoviocytes and the expression levels of inflammatory factors and antioxidants. Cell scratch assay was used to detect the migration of synoviocytes. Immunofluorescence was used to detect the expression of nuclear factor (NF)-κB in synoviocytes. In vivo experiments, a mouse rheumatoid arthritis (RA) model was induced by complete Freund’s adjuvant. Forty mice were equally divided into 4 groups, which were normal group, model control group, shikonin perilla treatment group, and shikonin perilla+LI-PUS combination treatment group. The arthritic swelling indexes of the mice were recorded in day 12 and day 24 of treatment. At the end of the experiment, the serum levels of inflammatory factors were tested, and the expression levels of c-Jun N-terminal protein kinase (JNK), extracellular signal-regulated kinase (ERK), and NF-κB in the synovial tissues of the knee joints in mice were detected by Western blot. Results Shikonin inhibited the expression of inflammatory cytokines in LPS-induced synoviocytes. Shikonin intervention was able to significantly reverse LPS-induced oxidative stress in synoviocytes. The migration of synoviocytes were significantly inhibited under the intervention of different concentrations of shikonin. The level of NF-κB protein expression in synovial cells was reduced after the intervention of shikonin. The results of animal experiments showed that adjuvant-induced arthritis mice had significantly higher joint swelling scores, which could be significantly reduced after the intervention of shikonin. Shikonin+LI-PUS group showed good therapeutic effect on mice. Shikonin inhibited the expression of inflammatory cytokines, in which IL-1β was significantly reduced, and the combination of shikonin+LI-PUS showed highly significant anti-inflammatory effect. Western blot results showed that the phosphorylation content of ERK, JNK and NF-κB in the synovial tissue of mice in the model group was significantly higher than that in the normal group, which was significantly suppressed in the shikonin group and the shikonin+LI-PUS combination treatment group, and the shikonin+LI-PUS combination treatment group was superior to the shikonin group. Conclusions Shikonin can inhibit LPS-induced abnormal proliferation of synoviocytes and exert anti-arthritic activity through the ERK-JNK/NF-κB signaling pathway, and the combination of traditional Chinese medicine and low-intensity pulsed ultrasound is superior to the treatment of traditional Chinese medicine alone. Table and Figures | Reference | Related Articles | Metrics | Comments（0）

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Rehabilitation efficacy of aerobic exercise on patients with overlap syndrome of chronic obstructive pulmonary disease and obstructive sleep apnea LIU Jie, ZHANG Yin, XU Yiming, REN Lei, SHEN Honghua Journal of Internal Medicine Concepts & Practice    2024, 19 (05): 295-302.   DOI: 10.16138/j.1673-6087.2024.05.02 Abstract （268）   HTML （2）    PDF（pc） （939KB）（258）       Knowledge map    Save Objective To evaluate the rehabilitation efficacy of moderate intensity aerobic exercise on patients with chronic obstructive pulmonary disease (COPD)-obstructive sleep apnea (OSA) overlap syndrome. Methods A retrospective cohort study was used in the study. The patients who were diagnosed with COPD-OSA overlap syndrome and applied positive airway pressure (PAP) from January 2021 to December 2023 were selected in the Department of Respiratory Rehabilitation, at the Fourth Rehabilitation Hospital of Shanghai. A total of 29 patients [aged (62.2±5.9) years, male 65.5%] with overlap syndrome received moderate intensity aerobic training for 20 weeks were enrolled as the intervention group (IG). At the same time, 29 patients [(64.6±6.9) years, male 62.1%] with overlap syndrome who didn’t receive aerobic training were selected as the control group (CG). The differences in motor function, daily living abilities, body composition, respiratory function, psychological state and sleep parameters between two cohorts of patients before and after treatment were compared. Results After 20 weeks of aerobic exercise, the various parameters of IG demonstrated significant improvement compared with those before treatment: a notable increase in the 6 min walk distance (6MWD) [(268.62±47.02) m vs (316.97±58.44) m], quadriceps muscle strength [22.40 (20.40, 27.45) kg vs 25.40 (20.00, 30.45) kg], Barthel index (BI) scores [(66.03±12.42) vs (76.72±11.82)], a reduction in the 5 times sit-to-stand test (5TSTS) [19.50 (15.94, 31.10) s vs 13.50 (11.75, 18.50) s], body mass index (BMI) [(25.16±3.17) kg/m2 vs (22.31±2.16) kg/m2] and fat mass (FM) [(24.13±9.22) kg vs (20.47±8.32) kg]. Additionally, there were significant enhancements observed in PSG parameters, blood gas analysis results, Hamilton depression scale (HAMD) and Hamilton anxiety scale (HAMA) scores after training in IG (all P<0.05). In contrast, the CG exhibited improvements in quadriceps muscle strength and the modified Medical Research Council (mMRC) as well as PSG parameters and psychological state; while there was an FM increase in this group (all P<0.05). Compared with the CG, the 6MWD [(316.97±58.44) m vs 239.93±37.80) m], quadriceps muscle strength [25.40 (20.00, 30.45) kg vs 23.70 (20.50, 25.60) kg], 5TSTS [13.50 (11.75, 18.50) s vs 19.50 (17.60, 23.12) s], BI [(76.72±11.82) vs （67.59±10.74)], mMRC, pH, PaO2, TS90%, BMI [(22.31±2.16) kg/m2 vs（26.17±3.83) kg/m2], FM, HAMD, HAMA of the IG patients showed significant improvement (all P<0.05). However, there were no significant differences observed between the two groups in terms of percentage of predicted forced expiratory volume in one second (FEV1%） (43.72%±9.49% vs 43.97%±7.22%), PaCO2, apnea hypopnea index, pulse oxygen saturation （L-SpO2）%, fat free mass and fat free mass index (P>0.05). Conclusions The combination of a 20-week moderate-intensity aerobic training and PAP demonstrates significant improvements in motor function, reduction in body fat, alleviation of hypoxia and respiratory difficulties, enhancement of psychological state and daily life abilities. This intervention may be considered suitable for patients with COPD-OSA overlap syndrome. Table and Figures | Reference | Related Articles | Metrics | Comments（0）

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Clinical effect of Shexiang Baoxin pill combined with sacubitril/valsartan in the treatment of acute myocardial infarction after percutaneous coronary intervention FANG Chunmei, LI Feng, SHEN Tongtong, ZHOU Yang Journal of Internal Medicine Concepts & Practice    2024, 19 (05): 310-313.   DOI: 10.16138/j.1673-6087.2024.05.04 Abstract （267）   HTML （2）    PDF（pc） （825KB）（118）       Knowledge map    Save Objective To investigate the clinical effect of Shexiang Baoxin pill combined with sacubitril/valasrtan in the treatment of acute myocardial infarction after percutaneous coronary intervention(PCI).Methods A total of 120 patients with acute myocardial infarction from January 2021 to November 2023 after PCI were selected and randomly assigned to observation group (60 cases) and control group (60 cases) in Chuzhou First People’s Hospital. The patients in both groups were given anticoagulation, antiplatelet, lipid-regulating, and other conventional treatment, while the control group was treated with sacubitril/valsartan, and the observation group was treated with sacubitril/valsartan combined with Shexiang Baoxin pill. The indexes including the changes of C-reactive protein(CRP), N-terminal pro-brain natriuretic peptide (NT-proBNP), blood pressure, left ventricular end-diastolic diameter(LVEDD), left ventricular end-systolic diameter(LVESD), fractional shortening(FS) rate, left ventricular ejection fraction (LVEF) were compared between the two groups. The incidence of arrhythmia and length of stay during hospitalization and the rate of re-hospitalization within six months due to adverse cardiac events were also compared between the two groups. Results After 4-week treatment, the levels of CRP and NT-proBNP in the observation group were significantly lower than those in the control group (all P<0.05). After 6-month treatment, the cardiac color ultrasound ultrasonography indexes (LVEDD, LVESD, FS, LVEF) in the observation group were better than those in the control group (all P<0.05). The incidence of atrial and ventricular arrhythmias in the observation group was lower than that in the control group duration of hospital stay (P<0.05), and length of hospitalization in the observation group was shorter than that in the control group (P<0.05). At the 6-month follow-up, the rate of rehospitalization in the observation group was lower than that in the control group (5.1% vs 26.3%, P<0.05).Conclusions The combination of Shexiang Baoxin pill and sacubitri/valsartan can effectively inhibit inflammatory response, reverse ventricular remodeling, improve cardiac function, reduce complications and improve prognosis in patients with acute myocardial infarction after PCI. Table and Figures | Reference | Related Articles | Metrics | Comments（0）

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Invasive pulmonary aspergillosis secondary to immunosuppressive therapy in nephrotic syndrome: a case report RUAN Yilin, XU Tian, FENG Xiaobei, XU Jing, SHI Hao, REN Hong Journal of Internal Medicine Concepts & Practice    2024, 19 (05): 318-321.   DOI: 10.16138/j.1673-6087.2024.05.06 Abstract （253）   HTML （4）    PDF（pc） （1981KB）（56）       Knowledge map    Save A 61-year-old male with a one-year history of membranous nephropathy was placed on combined therapy of glucocorticoids and rituximab. On the 12th day of treatment, the patient developed high fever, accompanied by mild cough and night sweats. Chest CT revealed multiple nodules and patchy opacities in both lungs. Bronchoalveolar lavage fluid (BALF) analysis using next-generation sequencing (NGS) identifed Aspergillus infection, and two consecutive β-D-glucan tests were positive. The clinical diagnosis of invasive pulmonary aspergillosis (IPA) was established. The patient received intravenous voriconazole for six months. Follow-up chest CT showed significant absorption of pulmonary lesions. The treatment regimen led to recovery of the patient and achieved partial remission of nephrotic. Table and Figures | Reference | Related Articles | Metrics | Comments（0）

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Research progress of postprandial hypotension and its relationship with cardiovascular and cerebrovascular damage in the elderly XIE Xiaomeng, GONG Yanchun Journal of Internal Medicine Concepts & Practice    2024, 19 (05): 342-346.   DOI: 10.16138/j.1673-6087.2024.05.11 Abstract （253）   HTML （2）    PDF（pc） （838KB）（16）       Knowledge map    Save The most common hypotensive syndromes in the elderly include orthostatic hypotension (OH), postprandial hypotension (PPH), carotid sinus syndrome, and vasovagal syncope type 1. Among them, PPH has a higher incidence. PPH was formally proposed in 1977, and evolving evidence suggests that PPH is a risk factor for different cardiovascular diseases. PPH is associated with cardiovascular disease and all-cause mortality in the elderly, but is often overlooked due to atypical symptoms. This article reviews the latest research progress of PPH and its relationship with cardiovascular and cerebrovascular damage in the elderly. Table and Figures | Reference | Related Articles | Metrics | Comments（0）