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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 （566）   HTML （27）    PDF（pc） （923KB）（138）       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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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 （517）   HTML （8）    PDF（pc） （828KB）（1121）       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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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 （444）   HTML （5）    PDF（pc） （1005KB）（855）       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 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 （390）   HTML （4）    PDF（pc） （891KB）（40）       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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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 （389）   HTML （2）    PDF（pc） （820KB）（15）       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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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 （355）   HTML （3）    PDF（pc） （902KB）（184）       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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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 （353）   HTML （3）    PDF（pc） （1245KB）（124）       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 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 （344）   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 （320）   HTML （3）    PDF（pc） （939KB）（262）       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 （318）   HTML （3）    PDF（pc） （825KB）（156）       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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Progress in diagnosis and treatment of oral ulcer with traditional Chinese medicine and Western medicine WU Jingyi, WANG Xiaoli, CHEN Jie, ZHENG Lan Journal of Internal Medicine Concepts & Practice    2025, 20 (01): 84-88.   DOI: 10.16138/j.1673-6087.2025.01.18 Abstract （315）   HTML （1）    PDF（pc） （997KB）（19）       Knowledge map    Save Oral ulcer is a common oral mucosal disease, the pathogenesis of it is complex. It may relate to genetics, immune disorders, nutritional deficiency, infection, drug response and psychological factors, while currently there is no specific treatment for the disease. In recent years, the research on the treatment of oral ulcers with traditional Chinese medicine has gradually increased, especially the combination of traditional Chinese medicine and Western medicine has showed a good application prospect. The article reviews the diagnosis and treatment of oral ulcer with traditional Chinese medicine and Western medicine to explore new ideas for further promotion relevant clinical research. Reference | Related Articles | Metrics | Comments（0）

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Efficacy analysis of Shuangbai tablets and irbesartan in treatment of proteinuria in chronic glomerulonephritis CHEN Zijin, YU Haijin, WANG Zhaohui, MA Jun, WANG Zhiyu, WANG Jie, XU Yaowen, ZHENG Lan, CHEN Xiaonong Journal of Internal Medicine Concepts & Practice    2025, 20 (01): 1-6.   DOI: 10.16138/j.1673-6087.2025.01.01 Abstract （313）   HTML （14）    PDF（pc） （1307KB）（23）       Knowledge map    Save Objective To compare the efficacy and safety of Shuangbai tablets and irbesartan in the treatment of proteinuria. Methods A retrospective analysis was conducted on patients with chronic glomerulonephritis who visited the outpatient department of Ruijin Hospital from January 2016 to February 2018. All the patients received irbesartan or Shuangbai tablets as monotherapy and were classified with syndrome differentiation of traditional Chinese medicine(TCM). Their clinical information, blood pressure and laboratory test were performed at 0, 4, 8, 12, and 24 weeks. Results One-hundred and nineteen patients were enrolled in the study, in which 54 cases were in the irbesartan group and 65 cases were in the Shuangbai tablet group. In all patients, the main TCM types were “pifeixiqu” type (56.3%), “pishenyangxu” type (20.2%), and “qiyinliangxu” type (21.8%). The 24-hour urinary protein of baseline level in the irbesartan group was 704 (448，1 090) mg/d, and it was significantly decreased to 456 (300,660), 428 (288,793), 510 (327,949), and 446 (273,801) mg/d at 4, 8, 12, and 24 weeks, respectively. The 24-hour urine protein level of baseline in the Shuangbai tablet group was 571 (390,1 049) mg/d, and it was significantly decreased to 491 (200，861), 432 (252，925), 478 (267，858) mg/d and 420 (175，742) mg/d at 4, 8, 12, and 24 weeks, respectively. There was no significant difference in proteinuria between the two groups. There was no statistical difference in the therapeutic effect among patients with different TCM syndrome types. The symptoms of lower back pain (59.3% vs 13.8%, P<0.001) and dry mouth and throat (24.1% vs 6.2%, P=0.005) in the Shuangbai tablet treatment group were significantly improved compared to those in the irbesartan group. The blood pressure of patients in the irbesartan treatment group decreased significantly at 12 and 24 weeks compared to it at enrollment. There were no significant adverse reactions in the Shuangbai tablet treatment group. Conclusions Shuangbai tablets can effectively reduce the urine protein level in chronic glomerulonephritis patients. It can also significantly improve the symptoms of lower back pain, dry mouth and throat in patients. Shuangbai tablet treatment showed a lower incidence of adverse reactions and can be used as an alternative medicine for patients with normal blood pressure, angiotensin-converting enzyme inhibitor(ACEI)/angiotensin receptor blocker(ARB) intolerance, or chronic glomerulonephritis without renal biopsy. Table and Figures | Reference | Related Articles | Metrics | Comments（0）

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Diagnosis and treatment of multiple myeloma peripheral neuropathy with traditional Chinese medicine WANG Yan, SUN Qingfang, ZHANG Jiaojiao, MI Jianqing, ZHU Weirong Journal of Internal Medicine Concepts & Practice    2024, 19 (05): 347-350.   DOI: 10.16138/j.1673-6087.2024.05.12 Abstract （312）   HTML （1）    PDF（pc） （912KB）（15）       Knowledge map    Save Multiple myeloma (MM) is a malignancy of plasma cells, and its peripheral neuropathy is one of the common complications. As Western medicine treatment shows limited efficacy, diagnosis and treatment of MM peripheral neuropathy with traditional Chinese medicine affords another option. Chinese medicine can relief patients’ symptoms and improve their quality of life through syndrome differentiation and comprehensive conditioning. This paper systematically analyzed the understanding and dialectical classification of MM peripheral neuropathy (MMPN) in traditional Chinese medicine (TCM). It also reviewed the commonly used Chinese medicine prescriptions, herbal fumigation and acupuncture to provide useful clinical guidance to treat disease. Reference | Related Articles | Metrics | Comments（0）

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Application of mesenchymal stem cells in systemic rheumatic diseases: current situation and prospects SU Chuanxin, ZHU Zhenhang, WANG Wang, LIANG Rongzhen, ZHENG Songguo, ZHAO Futao Journal of Internal Medicine Concepts & Practice    2024, 19 (06): 422-426.   DOI: 10.16138/j.1673-6087.2024.06.13 Abstract （310）   HTML （6）    PDF（pc） （893KB）（15）       Knowledge map    Save Mesenchymal stem cell (MSC), a type of cell with the ability to differentiate into multiple lineages and immunomodulatory properties, have gained widespread attention in the treatment of systemic rheumatic diseases recently. Systemic rheumatic diseases such as systemic lupus erythematosus, rheumatoid arthritis, ankylosing spondylitis, and Sjögren syndrome often led to a significant decline in patients’ quality of life, while current treatment methods have limitations. Therefore, it’s important to explore new method, and the application of MSC in these diseases has great significance. Current research indicates that MSC can exert therapeutic effects through various mechanisms, including regulating immune responses, promoting tissue repair, and reducing inflammation, and some clinical studies have showed the potential efficacy of MSC in systemic rheumatic diseases. However, many issues still need to be addressed, such as the source of cells, optimization of treatment protocols, and long-term safety assessments. This article systematically reviews the current application status of MSC in systemic rheumatic diseases, analyze their efficacy, safety, and future research directions, to provide a reference for development in this field. 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 （302）   HTML （3）    PDF（pc） （838KB）（25）       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）

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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 （301）   HTML （5）    PDF（pc） （1981KB）（61）       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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Effects of nursing management based on theory of planned behavior on self-efficacy, health attitude and health behaviors in patients during stroke convalescence LI Lingling, LIU Min, ZHANG Lijuan, WANG Xiaoping Journal of Internal Medicine Concepts & Practice    2024, 19 (06): 399-404.   DOI: 10.16138/j.1673-6087.2024.06.08 Abstract （294）   HTML （2）    PDF（pc） （959KB）（15）       Knowledge map    Save Objective To explore the effects of nursing management based on theory of planned behavior (TPB) on self-efficacy, health attitude and health behaviors in patients during stroke convalescence. Methods A total of 102 patients during stroke convalescence in the hospital from October 2022 to April 2023 were enrolled and randomly divided into observation group and control group, and each group had 51 patients. The control group was given routine nursing, while observation group was additionally given TPB-based nursing management. After 6 months of observation, the indexes including cognitive function, limb function [mini-mental state examination (MMSE), Fugl-Meyer assessment (FMA)], health belief [Champion health belief model scale (CHBMS)], self-efficacy [stroke self-efficacy questionnaire (SSEQ)], health behaviors [health promotion lifestyle profile (HPLP)], compliance of medication and life-style, and psychological state [Hamilton anxiety scale (HAMA), Hamilton depression scale (HAMD)] in the two groups were compared. Results After intervention, scores of MMSE, FMA, CHBMS, SSEQ and HPLP were higher in observation group than those in control group (all P<0.05). The compliance rates of medication (96.08%), diet control (90.20%), stopping smoking and drinking (96.08%), and appropriate exercise (82.35%) in observation group were respectively higher than those in control group (80.39%, 72.55%, 80.39%, 56.86%) (all P<0.05), while the score of HAMA and HAMD were lower in observation group than those in control group (all P<0.05). Conclusions TPB-based nursing management is beneficial to improve health attitude and self-efficacy in patients during stroke convalescence, thereby enhancing behavior control, promoting the maintenance of healthy behaviors, relieving negative psychological emotions and promoting health management. Table and Figures | Reference | Related Articles | Metrics | Comments（0）

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Survey and analysis on satisfaction of special nursing vest for outpatient with implantable venous access port ZHAO Junjie, ZHA Qinghua, HE Yang, DING Lin, FENG Xianfeng, ZHU Liping Journal of Internal Medicine Concepts & Practice    2024, 19 (05): 314-317.   DOI: 10.16138/j.1673-6087.2024.05.05 Abstract （291）   HTML （2）    PDF（pc） （839KB）（23）       Knowledge map    Save Objective To explore the satisfaction with the special nursing vest for outpatients in implantable venous access port. Methods The encounter sampling method was used to selected patients undergoing maintenance of importable venous access port in the outpatient department of a tertiary general hospital in Shanghai from July 2023 to October 2023, and they were surveyed using questionnaire made by the research team. Results A total of 81 valid questionnaires were collected, and the overall satisfaction of the special nursing vest for the patients with implantable venous access port was high in this study. Among the evaluation, the category “windproof insulation, reducing exposure, ensuring privacy”achieved the highest score, while the category “simple design, aesthetically pleasing colors, conforming to mainstream aesthetics” obtained the lowest score. The patient age was the main factor affecting overall satisfaction of the special nursing vest (P < 0.05). Conclusions The overall satisfaction of patients using special nursing vest is high, and the design can be further improved according to the needs of patients to promote the use of the special nursing vest. Table and Figures | Reference | Related Articles | Metrics | Comments（0）

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Prospects and challenges of applying chimeic antigen receptor cell therapy in autoimmune diseases GAO Jie Journal of Internal Medicine Concepts & Practice    2024, 19 (06): 363-366.   DOI: 10.16138/j.1673-6087.2024.06.02 Abstract （284）   HTML （8）    PDF（pc） （849KB）（9）       Knowledge map    Save In recent years, chimeric antigen receptor (CAR) cell therapy, as an emerging immunotherapy method, has achieved significant results in the field of hematological cancer treatment. However, applying CAR cell therapy to autoimmune diseases remains a relatively novel and challenging method. Autoimmune diseases are caused by an individual’s immune system mistakenly attacking their own tissues, and their complex etiology and diverse symptoms make traditional treatment methods and biologics still unable to meet clinical needs. CAR cell therapy, using engineering T cells or other immune cells to recognize and kill specific antigens, is highly targeted and durable, which providing new hope for the treatment of autoimmune diseases. This article systematically reviews the latest research progress and challenges of using CAR cell therapy in the treatment of autoimmune diseases, such as safety, immune response issues, and difficulties in clinical application. Reference | Related Articles | Metrics | Comments（0）

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Correlation of endogenous opioid peptides in diagnosis and treatment of depression GAN Xinyi, LIU Wanying, ZHANG Fuxu, BAI Yujie, HU Hao, GUO Qian, LIU Xiaohua Journal of Internal Medicine Concepts & Practice    2024, 19 (06): 393-398.   DOI: 10.16138/j.1673-6087.2024.06.07 Abstract （284）   HTML （2）    PDF（pc） （941KB）（10）       Knowledge map    Save Objective To explore the difference of plasma endogenous opioid peptide level in patients with depression and its relationship with the severity of depression or anxiety, and analyze whether endogenous opioid peptide is helpful to the diagnosis and treatment of depression. Methods A total of 96 patients with depression who visited our hospital from June 2020 to February 2023 were enrolled as the depression group, and 50 healthy subjects were recruited as the control group. General demographic and clinical data [Hamilton depression scale 17(HAMD-17), Hamilton anxiety scale 14(HAMA-14), inventory of depressive symptomatology 30(IDS-30)] were collected. Peripheral blood was collected, plasma was extracted, and plasma β-endorphin (β-EP) and enkephalin (ENK) were compared between the two groups using enzyme-linked immunosorbent assay (ELISA). Due to the repeated impact of the epidemic, only 28 patients agreed to follow-up studies and blood collection plans. During the follow-up period, the treatment was in accordance with the plan made by outpatient physician, and there was not any research intervention. After 8 weeks of follow-up, 24 patients finished the studies, and their clinical data and blood samples were collected and compared. Results The plasma β-EP level in depression group was significantly higher than that in control group [49.48（36.79,61.14） ng/mL vs 30.84（23.51,38.14）ng/mL， P<0.05], while the plasma ENK level was significantly lower than that in control group [15.85（10.51,19.56）ng/mL vs 23.72（21.44,26.98）ng/mL， P<0.05]. Correlation analysis showed that there was no significant correlation between β-EP and ENK levels at baseline and the scores of the three scales (P > 0.05). There were no significant differences in plasma β-EP and ENK levels between cured group and non-cured group after 8-week of treatment compared to baseline (P > 0.05). Conclusions β-EP and ENK are expected to be biomarkers of depression. Table and Figures | Reference | Related Articles | Metrics | Comments（0）