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Intervention effect of five senses awakening nursing mode based on the circadian rhythm on the conscious state of hospitalized patients with cerebral coma LYU Zhuobei, ZHU Lin, RONG Lan, LYU Xiaoqiong, CHU Jiani, CHENG Zhiying Journal of Internal Medicine Concepts & Practice    2025, 20 (04): 306-311.   DOI: 10.16138/j.1673-6087.2025.04.08 Abstract （570）   HTML （2）    PDF（pc） （883KB）（370）       Knowledge map    Save Objective To explore the impact of five senses awakening nursing mode based on the circadian rhythm in conscious hospitalized patients with cerebral coma. Methods Using convenience sampling method, a total of 43 patients with cerebral coma admitted to the Department of Geriatrics, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine from May 2023 to April 2024 were selected. The patients in the even-numbered wards were set as the observation group (n=22), and those in the odd-numbered wards were set as the control group (n=21). The control group received routine nursing mode while the observation group received five-sense awakening nursing mode in addition to routine nursing. A comparison was made between the two groups at different periods regarding Glasgow coma score (GCS), coma recovery scale-revised (CRS-R), recovery efficiency and recovery time. Results There was an interaction between the group factor and the time factor in the GCS score and the CRS-R score in the two groups (F=9.765, P<0.001; F=12.846, P<0.001). After the intervention, there were significant differences in the changes of the GCS and the CRS-R score at different time points between the two groups (F=243.934, P<0.001; F=239.111, P<0.001). There were statistical differences in the changes of the GCS and the CRS-R score between the two groups (F=5.040, P<0.05;F=7.779, P<0.05).The recovery rate of the observation group was higher than that of the control group (P<0.05), and the recovery time was shorter than that of the control group (P<0.01). Conclusions The five- sensory stimulation nursing approach based on the circadian rhythm, can improve the consciousness state of patients with cerebral coma and facilitate their awakening. Table and Figures | Reference | Related Articles | Metrics | Comments（0）

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A case of Sjögren syndrome with intestinal pseudo-obstruction as the initial symptom LIU Meilan, WANG Ling, YANG Rong, WANG Jiale, TU Huimin, LI Huilin Journal of Internal Medicine Concepts & Practice    2025, 20 (04): 319-321.   DOI: 10.16138/j.1673-6087.2025.04.11 Abstract （373）   HTML （7）    PDF（pc） （4329KB）（275）       Knowledge map    Save Sjögren syndrome (SS) is a systemic autoimmune disease primarily affecting exocrine glands. It has diverse clinical manifestations and is easily misdiagnosed. This article reports a case of SS presenting with intestinal pseudo-obstruction (IPO) as the initial symptom. A 31-year-old female presented with nausea, vomiting and bowel movement cessation. Imaging revealed colonic fecal impaction without mechanical obstruction. Serological tests showed positive anti-SSA/SSB/Ro-52 antibodies, and labial gland biopsy confirmed SS. The patient’s symptoms were relieved after receiving glucocorticoid and immunomodulatory therapy. This case highlights that SS may present with atypical gastrointestinal and neurological symptoms, suggesting the importance of multidisciplinary evaluation and autoantibody screening for early diagnosis. Table and Figures | Reference | Related Articles | Metrics | Comments（0）

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Screening of risk or protective factors for prognosis and their interaction in elderly patients with stroke XU Ting, RONG Jieli, GU Renli, XU Yang, LIU Xiaojiang Journal of Internal Medicine Concepts & Practice    2025, 20 (04): 296-300.   DOI: 10.16138/j.1673-6087.2025.04.06 Abstract （312）   HTML （1）    PDF（pc） （1052KB）（266）       Knowledge map    Save Objective To explore the risk or protective factors and their interactions for recurrence after acute ischemic stroke (AIS). Methods A total of 143 AIS patients admitted in our hospital from March 2020 to March 2023 were selected and followed up, and general clinical data were collected. Twelve patients were lost to follow-up. The end point of follow-up was stroke recurrence. The risk factors of stroke recurrence were screened by COX analysis, and the interaction between risk factors was analyzed. Results Univariate COX analysis showed that age, modified Rankin scale (mRS) score, the National Institutes of Health stroke scale (NIHSS) score, activated partial thrombin time and diabetes history were risk factors for poor prognosis in elderly patients with AIS [hazard ratio (HR) > 1, P < 0.05]. Montreal cognitive assessment scale (MoCA) score and fibrinogen are protective factors for good prognosis in elderly patients with AIS (HR < 1, P > 0.05). Multivariate COX analysis showed that mRS score and NIHSS score were independent risk factors for poor prognosis in elderly patients with AIS (HR > 1, P > 0.05). MoCA score and fibrinogen are protective factors for good prognosis in elderly patients with AIS (HR < 1, P > 0.05). Patients with high mRS score and high NIHSS score had worse prognosis (P < 0.001). Patients with high MoCA score and high fibrinogen level had better prognosis (P < 0.001). mRS score, NIHSS score, MoCA score and fibrinogen level had no significant interaction. Conclusions mRS score and NIHSS score are independent risk factors for poor prognosis in elderly patients with AIS. MoCA score and independent protective factor of good prognosis in elderly patients with AIS of fibrinogen. There was no significant interaction between these risk factors and protective factors. Table and Figures | Reference | Related Articles | Metrics | Comments（0）

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Progress in diagnosis and treatment of primary mediastinal large B-cell lymphoma CAI Lu, YI Hongmei, WANG Chaofu Journal of Internal Medicine Concepts & Practice    2025, 20 (06): 490-494.   DOI: 10.16138/j.1673-6087.2025.06.11 Abstract （306）   HTML （5）    PDF（pc） （452KB）（272）       Knowledge map    Save Primary mediastinal large B-cell lymphoma (PMBCL) is an aggressive non-Hodgkin lymphoma originating from thymic B cells. It typically presents as a rapidly growing anterior mediastinal mass, often accompanied by local symptoms such as chest tightness and shortness of breath, as well as systemic symptoms like fever and night sweats. R-CHOP (rituximab + cyclophosphamide + doxorubicin + vincristine + prednisone) and R-EPOCH (etoposide + prednisone + vincristine + cyclophosphamide + doxorubicin + rituximab) are the commonly used first-line treatments. Formulating precise diagnostic and therapeutic strategies requires a comprehensive understanding of its unique clinical, pathological, and molecular characteristics. This review delivers a comprehensive overview of the clinical features, pathological characteristics, molecular mechanisms, differential diagnosis, and recent advances in treatment of PMBCL, aiming to provide a reference for accurate diagnosis, optimized patient management, and improved therapeutic outcomes. Reference | Related Articles | Metrics | Comments（0）

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Construction of sensitivity indicators for perioperative nursing quality in percutaneous coronary intervention WU Shengjia, HUANG Sichao, KANG Lei, ZHU Weiyi, ZHA Qinghua, NI Xueping Journal of Internal Medicine Concepts & Practice    2025, 20 (06): 469-476.   DOI: 10.16138/j.1673-6087.2025.06.07 Abstract （295）   HTML （3）    PDF（pc） （550KB）（159）       Knowledge map    Save Objective To develop a scientifically reasonable set of sensitivity indicators for perioperative nursing quality in percutaneous coronary intervention (PCI). Methods Domestic and international literature was retrieved, and the Johns Hopkins evidence-based nursing practice model was employed to appraise the literature and grade the evidence. Indicators were screened and integrated to form a preliminary pool of sensitivity indicators for PCI perioperative nursing quality. Based on the theoretical basis of the Donabedian three-dimensional quality model, the Delphi method was utilized for expert consultation to construct the final indicator set. Results The response rates for both rounds of the expert consultation were 100%. The expert authority coefficients were both 0.889. The overall Kendall’ s coefficient of concordance were 0.496 and 0.523, respectively (P < 0.001). The final set of PCI perioperative nursing quality sensitivity indicators comprises 3 first-level, 13 second-level and 36 third-level indicators.Conclusions The developed sensitivity indicators for PCI perioperative nursing quality encompass multiple dimensions, including human resources, management systems, medical specialty training, nursing competency, medication and facility management, health education, preoperative/intraoperative/postoperative management, patient satisfaction, incidence of adverse events, nursing efficiency, and continuity of care. This indicator system can comprehensively measure PCI perioperative nursing quality and serves as a valuable tool for improving the overall standard of PCI perioperative nursing services. Table and Figures | Reference | Related Articles | Metrics | Comments（0）

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Clinical evaluation of the modified open wound sutureless labial gland biopsy technique for patient with Sjögren syndrome CHEN Yabing, GAO Jie, XU Xia, ZHAO Dongbao Journal of Internal Medicine Concepts & Practice    2025, 20 (04): 312-315.   DOI: 10.16138/j.1673-6087.2025.04.09 Abstract （261）   HTML （5）    PDF（pc） （855KB）（358）       Knowledge map    Save Objective To explore the clinical value of modified open-wound sutureless labial gland biopsy for patients with Sjögren syndrome. Methods A total of 24 patients who underwent labial gland biopsy in our department from March 2023 to April 2025 were divided into the sutureless labial gland biopsy (SLSGB) group and the traditional labial salivary gland biopsy (TLSGB) group. The numerical rating scale (NRS) 0-10 was used to evaluate the postoperative recovery time and incision pain at 2 h, 1 d, and 7 d after surgery in both groups. Results The postoperative recovery time score was (6.67±0.82) points in the TLSGB group and (2.00±0.00) points in the SLSGB group (P< 0.001). The NRS scores at 2 h, 1 d, and 7 d after surgery were (5.83±0.98), (2.67±0.52), and (2.00±0.63) points in the TLSGB group, and (1.72±0.46), 0, and 0 points in the SLSGB group, respectively. There were significant differences between the two groups at 2 h and 1 d after surgery (both P<0.05), but there was no statistical difference at 7 d after surgery (P>0.05). Conclusions Open incision labial gland biopsy is less invasive, less prone to secondary injury, does not require suture removal, is easy to operate, and rarely causes complications. It can reduce significantly the economic and time costs and it’s more easily accepted by patients. Table and Figures | Reference | Related Articles | Metrics | Comments（0）

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Development of a questionnaire on adult artificial airway management competence for ICU nurses and tests of its reliability and validity CHEN Hui, ZHANG Yin, QIAN Zhuping, YAO Yijin Journal of Internal Medicine Concepts & Practice    2025, 20 (06): 462-468.   DOI: 10.16138/j.1673-6087.2025.06.06 Abstract （258）   HTML （1）    PDF（pc） （525KB）（152）       Knowledge map    Save Objective To develop a questionnaire on adult artificial airway management competence for intensive care unit (ICU) nurses. Methods A preliminary questionnaire on the competence of ICU nurses in managing adult artificial airways was formulated through literature review, Delphi expert consultation and a pilot survey. Using convenience sampling, 366 ICU nurses from two tertiary grade A hospitals in Shanghai and Harbin were surveyed from April to June 2024. Item analysis, exploratory factor analysis, confirmatory factor analysis and reliability test were conducted. Results The final questionnaire consisted of 32 items across 4 dimensions: artificial airway suctioning, endotracheal tube cuff management, prevention of artificial airway complications and artificial airway extubation care. Exploratory factor analysis extracted four common factors, with item factor loadings ranging from 0.403 to 0.968, and the cumulative variance contribution rate was 68.97%. Confirmatory factor analysis results showed that the model fit indices met acceptable standards, indicating a stable questionnaire structure. The overall content validity index of the questionnaire was 1.00, the total Cronbach's α coefficient was 0.98, the split-half reliability was 0.93, and the test-retest reliability was 0.99. Conclusions The questionnaire on adult artificial airway management competence for ICU nurses demonstrates good reliability and validity, and can be used as a tool to evaluate the corresponding competence of ICU nurses. Table and Figures | Reference | Related Articles | Metrics | Comments（0）

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Roxadustat-induced central hypothyroidism in hemodialysis patients: a report of two cases XIA Yumiao, FU Peng, WU Hao Journal of Internal Medicine Concepts & Practice    2025, 20 (06): 487-489.   DOI: 10.16138/j.1673-6087.2025.06.10 Abstract （254）   HTML （3）    PDF（pc） （449KB）（283）       Knowledge map    Save Hypoxia-inducible factor prolyl hydroxylase inhibitor (HIF-PHI) is a novel class of oral medications for treating renal anemia, but adverse drug events have been reported both in China and internationally in recent years. This article reports two cases of reversible central hypothyroidism following the administration of the HIF-PHI roxadustat in patients undergoing regular hemodialysis with end-stage renal disease. Both patients gradually developed non-specific discomfort symptoms after one year of oral roxadustat treatment. Laboratory tests revealed abnormal thyroid function, while cranial magnetic resonance imaging showed no abnormalities. After discontinuation of roxadustat, thyroid function returned to normal and the symptoms resolved. These two cases suggest that it is necessary to monitor thyroid function in patients receiving oral roxadustat for renal anemia. Reference | Related Articles | Metrics | Comments（0）

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Clinical characteristic and treatment progress of neurologic immune-related adverse events associated with immune checkpoint inhibitors XIE Chong, WAN Wenbin, YAO Xiaoying, ZHANG Ying, WANG Gang Journal of Internal Medicine Concepts & Practice    2025, 20 (05): 359-364.   DOI: 10.16138/j.1673-6087.2025.05.02 Abstract （237）   HTML （8）    PDF（pc） （479KB）（210）       Knowledge map    Save In recent years, immune checkpoint inhibitor (ICI) has achieved remarkable success in cancer therapy. However, the occurrence of immune-related adverse event (irAE) has increasingly attracted attention. Among them, neurologic immune-related adverse event (n-irAE) is relatively uncommon, but can cause severe outcomes. n-irAE can involve multiple regions of the nervous system, including the peripheral nerves, neuromuscular junction, and central nervous system (CNS), and lead to myositis, myasthenia gravis, encephalitis, myelitis, and other disorders. The diagnosis of n-irAE requires a combination of evaluating the time correlation between symptoms and ICI medication, neurological localization assessments (neuroimaging, cerebrospinal fluid analysis, and electrophysiological studies), and the exclusion of alternative etiologies such as metastatic disease or infection. n-irAE is graded and treated based on clinical severity, and the common therapeutic approaches include corticosteroids, intravenous immunoglobulin, and plasma exchange. Multidisciplinary collaboration and early intervention are crucial for improving patient outcomes. Future efforts should focus on optimizing risk prediction models to achieve individualized management of n-irAE. Table and Figures | Reference | Related Articles | Metrics | Comments（0）

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Clinical application of renal artery ultrasound monitoring hemodynamic parameters and non-contrast-enhanced magnetic resonance angiography in evaluation of renal artery stenosis and anatomic abnormalities SUN Jie, XIE Jie, MA Hongkun, LIU Baolian, CHEN Xueying, HUANG Wenjie, HE Shuilin, CHEN Zijin, ZHANG Wen Journal of Internal Medicine Concepts & Practice    2025, 20 (04): 276-281.   DOI: 10.16138/j.1673-6087.2025.04.03 Abstract （227）   HTML （13）          Knowledge map    Save Objective To compare the clinical value of renal artery ultrasound hemodynamic parameters and non-enhanced magnetic resonance in evaluating renal artery stenosis and anatomical abnormalities. Methods A total of 149 patients with chronic kidney disease(CKD) were enrolled. Renal artery stenosis and anatomical variations were evaluated by non-enhanced renal artery magnetic resonance angiography (NEC-MRA). Color Doppler ultrasound was used to detect hemodynamic parameters of each segment of the renal artery. Renal function assessment was conducted through two methods: radionuclide renal dynamic imaging and the calculation of the estimated glomerular filtration rate (eGFR) using the CKD Epidemiology Collaboration (CKD-EPI) study equation formula. Results Among the 149 patients in this study, 17 cases (11.4%) were at CKD stage 1, 39 cases (26.2%) at stage 2, 44 cases (29.5%) at stage 3, 17 cases (11.4%) at stage 4, and 32 cases (21.5%) at stage 5. The resistance index (RI) of patients with initial renal artery stenosis was significantly higher than that of patients without stenosis (P=0.000), while there was no statistically significant difference in peak systolic velocity (PSV) (P= 0.443). There was no statistical difference in PSV and RI between the two groups with or without midstream stenosis (P=0.190, P=0.088). There was no significant difference in PSV and RI between the initial and middle segments of the anatomical variation group and the non-variation group (P > 0.05). The eGFR on the non-stenotic side of the initial segment of the renal artery was significantly higher than that on the stenotic side (Z=2.98, P=0.029), and eGFR on the non-stenotic side in the middle segment was significantly higher than that on the stenotic side (Z=4.025, P=0.001). There was no statistical difference in eGFR between the anatomical variant side and the non-variant side (Z=0.579, P=0.550). Conclusions Color Doppler ultrasound PSV and RI show higher value in diagnosing initial renal artery stenosis than middle renal artery stenosis and have no diagnostic value for anatomic variation of renal artery. Both initial and middle renal artery stenosis leads to a decrease in the ipsilateral renal GFR, while variations in renal artery anatomy does not affect ipsilateral renal GFR. Table and Figures | Reference | Related Articles | Metrics | Comments（0）

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Sodium-glucose linked transporter 2 inhibitors reduce serum uric acid in type 2 diabetic mellitus patients with early nephropathy WU Qianqian, GUO Jie, WANG Yifan, LIU Li, WANG Feng Journal of Internal Medicine Concepts & Practice    2025, 20 (05): 371-375.   DOI: 10.16138/j.1673-6087.2025.05.04 Abstract （224）   HTML （9）    PDF（pc） （503KB）（205）       Knowledge map    Save Objective To explore the reducing serum uric acid (SUA) effects of dapagliflozin, a sodium-glucose linked transporter 2 (SGLT2) inhibitor in patients with type 2 diabetes mellitus (T2DM) with early nephropathy and hyperuricemia. Methods Sixty-five patients with early T2 diabetic nephropathy and hyperuricemia admitted to our hospital from June 2020 to June 2023 were enrolled. After 4 weeks of treatment with dapagliflozin, a paired-sample T-test was used to analyze the changes in SUA, glycosylated hemoglobin (HbA1c), fasting plasma glucose (FPG), serum creatinine (SCr), total cholesterol (TC), triglyceride (TG), urine albumin-to-creatinine ratio (UACR), body weight and other clinical indexes. Linear regression analysis was performed to determine the relationship between the changes of SUA before (baseline) and after treatment. Results In this group of 65 T2DM patients with early nephropathy and hyperuricemia, 4 weeks of dapagliflozin reduced SUA [(436.1±39.5)vs (392.2±32.2) μmol/L,P<0.001], FPG [(7.66±2.23)vs (6.40±1.06) mmol/L,P<0.001], UACR [(211.3±73.2)vs (177.8±88.3) mg/g,P=0.005], and body weight [(63.1±9.7)vs (62.7±9.3) kg,P=0.038] significantly. Systolic blood pressure, diastolic blood pressure, HbA1c, TC, TG, SCr, estimated glomerular filtration rate (eGFR), and other levels were not changed (P>0.05). Linear regression analysis showed that the decreased levels of SUA positively correlated with the baseline levels of SUA (β=0.634,R2=0.401,P<0.001). Conclusions SGLT2 could effectively decrease blood glucose levels in patients with early T2DM nephropathy, and significantly reduce serum uric acid and urinary microalbumin. Table and Figures | Reference | Related Articles | Metrics | Comments（0）

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Advances in diagnosis and treatment of radiation-induced brain injury HUANG Renhua, BAI Yongrui Journal of Internal Medicine Concepts & Practice    2025, 20 (05): 352-358.   DOI: 10.16138/j.1673-6087.2025.05.01 Abstract （212）   HTML （9）    PDF（pc） （482KB）（340）       Knowledge map    Save Radiation-induced brain injury is a common complication after radiotherapy for head and neck tumors. It can occur at any time after radiotherapy. The common sites are closely related to the radiotherapy regimen and are more frequently seen in areas receiving the highest radiotherapy dose. Early symptoms include fatigue, dizziness and headaches. In the later stage, epileptic seizures, personality changes and progressive decline in neurocognitive function may occur. Brain computed tomography (CT) often shows focal low-density images, and brain magnetic resonance imaging (MRI) presents with “finger-like” edema in the white matter of the brain during the edema stage. The use of multimodal MRI, positron emission tomography (PET) and other imaging techniques can help to make early diagnosis and differential diagnosis of radiation-induced brain injury. The treatment options include medication, hyperbaric oxygen therapy, surgery and mesenchymal stem cell transplantation. Commonly used drugs in clinical practice include bevacizumab, dexamethasone, citicoline and gangliosides. With the increasing attention paid to radiation-induced brain injury, the research on related mechanisms has been continuously deepened and the corresponding therapeutic drugs have achieved good therapeutic effects. However, effective prevention is more important than treatment. As the brain has complicated structure and functions, damage to functional areas can lead to disability or even death. Optimizing radiotherapy techniques can achieve precise irradiation of tumors and reduce the volume of normal brain tissue exposed to radiation. Radiotherapy plans should be formulated based on factors such as the patient’s age, underlying diseases, and tumor location to avoid excessive exposure to radiation-sensitive areas. Using hippocampal protective radiotherapy to reduce the radiation dose to the hippocampal region can significantly decrease the risk of memory decline and allow the reasonable control of the radiotherapy. The diagnosis and treatment of radiation-induced brain injury is a multidisciplinary collaborative process. It is necessary to strengthen the full life cycle management of patients with head and neck tumors undergoing radiotherapy. Through technological innovation and individualized treatment, the incidence and harm of brain injury should be further reduced. Reference | Related Articles | Metrics | Comments（0）

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Mechanisms of frailty in postmenopausal women and the role of menopausal hormone therapy MU Rui, JIANG Jie, RAHMAN Mukadas, TONG Jianjing Journal of Internal Medicine Concepts & Practice    2025, 20 (06): 505-509.   DOI: 10.16138/j.1673-6087.2025.06.14 Abstract （212）   HTML （5）    PDF（pc） （469KB）（190）       Knowledge map    Save Frailty is an age-related geriatric syndrome characterized by multisystem functional decline, which increases vulnerability to external stressors and raises the risk of adverse health outcomes. Epidemiological studies indicate a higher prevalence of frailty in women than in men, significantly influenced by the abrupt decline in estrogen levels after menopause, leading to deterioration in skeletal, muscular, metabolic, and immune functions. As an approach to postmenopausal management, menopausal hormone therapy (MHT) remains to have a debated impact on frailty risk. Studies show that MHT has demonstrated clear benefits on frailty-related physiological indicators; however, its overall efficacy in frailty prevention requires further validation through high-quality studies. This review summarizes current evidence linking menopause and frailty, with a focus on the role and limitations of MHT. Future research should focus on personalized treatment strategies, effects of combined intervention, and the role of psychosocial factors in frailty management. Reference | Related Articles | Metrics | Comments（0）

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Advances in stem cell therapy for scleroderma LIN Ruilian, MA Lili, CHEN Jia Journal of Internal Medicine Concepts & Practice    2025, 20 (04): 340-344.   DOI: 10.16138/j.1673-6087.2025.04.15 Abstract （209）   HTML （0）    PDF（pc） （940KB）（380）       Knowledge map    Save Scleroderma is an autoimmune connective tissue disorder characterized by fibrosis of the skin and internal organs. Currently, there is no fully satisfactory treatment for this condition. In recent years, stem cells have emerged as a promising therapeutic strategy for a variety of diseases, owing to their capacities for self-renewal and multilineage differentiation. Substantial advances have been achieved in applying stem cell therapy to scleroderma. This review summarizes the mechanisms and clinical progress of stem cell-based treatments for scleroderma, with the aim of providing new insights for basic research and supporting evidence for future clinical applications. Reference | Related Articles | Metrics | Comments（0）

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Anti-inflammatory effects and safety evaluation of decursin in atherosclerosis CHEN Hui, YANG Ling, ZHAO Anqi, ZHA Qing, YANG Ke, LIU Yan Journal of Internal Medicine Concepts & Practice    2025, 20 (06): 457-461.   DOI: 10.16138/j.1673-6087.2025.06.05 Abstract （200）   HTML （5）    PDF（pc） （867KB）（173）       Knowledge map    Save Objective To investigate the anti-inflammatory effects and safety of decursin in atherosclerosis, and to verify its regulatory role in macrophage inflammatory responses. Methods An atherosclerosis model was established using apolipoprotein E deficient (ApoE-/-) male mice fed a high-fat diet. RAW 264.7 macrophages were stimulated with oxidized low-density lipoprotein (oxLDL) to induce foam cell formation. Oil Red O (ORO) staining was employed to measure the reduction in aortic plaque area. Western blotting was performed to detect the phosphorylation levels of nuclear factor-κB (NF-κB). Inflammatory cytokine levels in serum and cell supernatants were analyzed using inflammatory cytokine arrays. Systemic toxicity of decursin was assessed by hematoxylin-eosin (HE) staining. Results Decursin significantly reduced aortic plaque area and inhibited the excessive activation of NF-κB in oxLDL-stimulated macrophages. It downregulated the expression of pro-inflammatory cytokines [interleukin (IL)-2 and interferon (IFN)-γ] while upregulating anti-inflammatory cytokines (IL-4 and IL-10). Furthermore, in the ApoE-/- mouse model, decursin similarly significantly lowered serum levels of pro-inflammatory cytokines and elevated those of anti-inflammatory cytokines. HE staining results showed that decursin caused no obvious pathological damage to major organs.Conclusions Decursin exerts significant anti-inflammatory effects by regulating macrophage inflammatory responses, alleviates atherosclerotic lesions, and demonstrates a high safety profile, suggesting its potential as a therapeutic agent for atherosclerosis. Table and Figures | Reference | Related Articles | Metrics | Comments（0）

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Relationship between triglyceride-glucose index and risk of acute myocardial infarction in patients with atrial fibrillation CHEN Liangguo, DENG Kewu, LIU Yue, ZHONG Peng, BAI Ying Journal of Internal Medicine Concepts & Practice    2025, 20 (06): 435-439.   DOI: 10.16138/j.1673-6087.2025.06.02 Abstract （195）   HTML （9）    PDF（pc） （529KB）（174）       Knowledge map    Save Objective To explore the relationship between triglyceride-glucose (TyG) index and the occurrence of acute myocardial infarction (AMI) in patients with atrial fibrillation (AF). Methods A total of 4 277 hospitalized AF patients from Beijing Tongren Hospital and Beijing Friendship Hospital affiliated to Capital Medical University were enrolled. They were divided into a non-AMI group [AMI(−), 3 725 cases] and an AMI group [AMI(+), 552 cases] based on whether they were admitted for AMI. Logistic regression was used to assess the association between the TyG index and AMI, and subgroup analyses were performed according to the presence of diabetes at baseline. Results Among AF patients, the TyG index was significantly higher in the AMI(+) group than in the AMI(−) group (8.83 ± 0.73 vs. 8.56 ± 0.66, P < 0.001). Additionally, patients in the AMI(+) group were older and had more comorbidities (both P < 0.05). Multivariate Logistic regression showed that high TyG index was an independent risk factor for AMI in AF patients [odds ratio(OR) = 1.824, 95%CI 1.540−2.161, P < 0.001], and the area under the receiver operating characteristic (ROC) curve for the TyG index in predicting AMI was 0.614 (95%CI 0.589−0.640, P < 0.001), with a cut-off value of 8.79. In AF patients, the TyG index was positively associated with the risk of AMI regardless of the presence of diabetes. Conclusions The TyG index is positively associated with the risk of AMI in AF patients, which is not affected by diabetes status. Table and Figures | Reference | Related Articles | Metrics | Comments（0）

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Progress in noninvasive assessment of cardiac amyloidosis ZHANG Maosen, CHE Zigang, GUO Wanhua, ZHONG Yeming, FENG Chengyan, WEI Xuan Journal of Internal Medicine Concepts & Practice    2025, 20 (06): 495-499.   DOI: 10.16138/j.1673-6087.2025.06.12 Abstract （194）   HTML （12）    PDF（pc） （466KB）（215）       Knowledge map    Save Amyloidosis is a group of disorders caused by misfolded proteins that deposit in tissues and impair the function of vital organs. Systemic amyloidosis frequently involves the heart and is a leading cause of death in affected patients. Cardiac amyloidosis is difficult to diagnose and carries a poor prognosis, making early diagnosis and assessment crucial for treatment and prognosis. This article reviews several noninvasive techniques for diagnosing and evaluating cardiac amyloidosis. Reference | Related Articles | Metrics | Comments（0）

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How to accurately understand and define early diagnosis of chronic obstructive pulmonary disease HE Quanying Journal of Internal Medicine Concepts & Practice    2025, 20 (06): 431-434.   DOI: 10.16138/j.1673-6087.2025.06.01 Abstract （193）   HTML （8）    PDF（pc） （412KB）（180）       Knowledge map    Save This article discusses the challenges in the early diagnosis of chronic obstructive pulmonary disease (COPD) in light of the 2024 Global Initiative for Chronic Obstructive Lung Disease (GOLD) report. It analyzes and distinguishes between the concepts such as “early COPD” and “pre-COPD”, noting their differences in meaning from practical early diagnosis. Currently, early diagnosis faces difficulties in identifying high-risk individuals, determining disease onset, and assessing the stability of pulmonary function results. Therefore, the author argues that priority should be given to improving the overall diagnostic rate of COPD, and suggests that standardized pulmonary function screening for high-risk populations, combined with long-term management, represents the most feasible early intervention method at present. Reference | Related Articles | Metrics | Comments（0）

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Advances in age-associated B cell in systemic lupus erythematosus FAN Yuxin, BIN Zexuan, ZHANG Xin, LUO Jing, WANG Caihong Journal of Internal Medicine Concepts & Practice    2025, 20 (04): 328-333.   DOI: 10.16138/j.1673-6087.2025.04.13 Abstract （191）   HTML （6）    PDF（pc） （969KB）（596）       Knowledge map    Save Age associated B cell (ABC) is a new type of effector B cell subset, which is characterized by continuous expansion with age. However, it is abnormally expressed prematurely in patients with certain autoimmune diseases and/or infectious diseases. ABC highly expresses CD11c and transcription factor T-bet in mice and human, and lowly expresses CD21. ABC is considered a memory B cell subtype driven by autoantigen and has the potential to differentiate into plasmablasts and produce autoantibodies. In systemic lupus erythematosus (SLE), ABC is abnormally amplified and correlated with disease activity and organ involvement. An important mechanism to promote the production of autoantibodies and accelerate disease progression is the single gene mutation inducing the proliferation and differentiation of ABC into extrafollicular effector B cell. Recent studies have revealed that zinc finger E-box binding homeobox 2 (ZEB2) is a key transcription factor for the specialization of the ABC cell lineage, and the ZEB2-Janus kinase (JAK)-signal transducer and activator of transcription (STAT) pathway play a core role in their differentiation. Further study on the role of ABC in the pathogenesis of SLE will help to provide new targets for clinical treatment. Reference | Related Articles | Metrics | Comments（0）

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Exploring and practicing “integrated residency and fellowship teaching rounds” in neurology YANG Xiaodong, TAN Yuyan, REN Rujing, FU Yi, LIU Jun, LI Xiaoyang Journal of Internal Medicine Concepts & Practice    2025, 20 (06): 510-514.   DOI: 10.16138/j.1673-6087.2025.06.15 Abstract （186）   HTML （2）    PDF（pc） （471KB）（188）       Knowledge map    Save The standardized fellowship and the standardized residency training are important components of China's post-graduation medical education system. According to the national guidelines for standardized fellowship, it is necessary to establish a structured training system, which, together with residency training, forms a complete educational system. Therefore, further exploration is needed on effective integration of residency and fellowship in medical education and training, optimal utilization of teaching resources and faculty at training sites, and the establishment of teaching models that promote the coordinated development of resident and specialist training. The Department of Neurology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, has proposed and implemented an “integrated residency and fellowship teaching round model”, which involves specialists mentoring residents, facilitating mutual learning and professional growth for both groups. This article introduces the model with an aim to further enrich the content of fellowship and residency training, improve training quality, so as to comprehensively enhance the clinical teaching abilities of specialists and provide a reference for innovating postgraduate medical education models. Table and Figures | Reference | Related Articles | Metrics | Comments（0）