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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
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    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.

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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
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    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.

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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
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    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.

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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
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    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.

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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
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    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.

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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
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    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.

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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
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    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.

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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
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    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.

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    Progress in treatment of adult acute lymphoblastic leukemia
    LIU Wenhui, WU Tao, ZHANG Xi
    Journal of Internal Medicine Concepts & Practice    2024, 19 (03): 201-206.   DOI: 10.16138/j.1673-6087.2024.03.10
    Abstract892)   HTML23)    PDF(pc) (917KB)(2340)       Save

    Acute lymphoblastic leukemia (ALL) is a hematological malignancy with abnormal proliferation of primitive naive lymphocytes and inhibition of normal hematopoiesis. It originates from B-lineage or T-lineage lymphoid progenitor cells, accounting for 20%-30% of adult acute leukemia. Although the complete remission rate of newly diagnosed adult ALL patients after multi-drug combination chemotherapy can reach more than 80%, most of the patients still show relapse and refractory. The 5-year long term survival rate in the patients is only 20%-40% and the clinical characteristics and prognosis are quite different. In recent years, with the advent of targeted drugs, immunotherapy, and chimeric antigen receptor (CAR) -T cell therapy, the clinical outcomes of adult ALL patients have been greatly improved. This article reviews the current progress of new therapeutic drugs for adult ALL in detail.

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    Interaction of bile acids with the gut microbiota and their effects on sepsis
    YANG Jin, WEI Yao, JIN Jun
    Journal of Internal Medicine Concepts & Practice    2024, 19 (03): 207-211.   DOI: 10.16138/j.1673-6087.2024.03.11
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    Numerous microorganisms inhabit the human intestine, participate in the digestion and absorption of nutrients, and produce a large number of metabolites, participate in regulating functions and protect the host from disease damage. Bile acids are produced by cholesterol metabolism and metabolized by the gut microbiota into secondary bile acids. Bile acids facilitate lipid digestion and absorption and interact with the gut microbiota. The composition and quantity of the gut microbiota also regulate bile acid metabolism. As sepsis occurs, the poor prognosis of the disease is associated with disturbances of the gut microbiota and bile acid metabolism. This paper reviews the metabolic process of bile acids, the interaction between bile acids and the gut microbiota, and the changes of gut microbiota and bile acids during sepsis, to provide new ideas for the prevention and treatment of sepsis.

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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
    Abstract830)   HTML16)    PDF(pc) (828KB)(1791)       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.

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    Research progress on behavior pattern of knowledge, attitude and practice and treatment compliance in hypertension population
    WANG Xiaoming, GONG Yanchun
    Journal of Internal Medicine Concepts & Practice    2024, 19 (03): 212-215.   DOI: 10.16138/j.1673-6087.2024.03.12
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    Hypertension is a common chronic disease that can endanger people’s health, which can cause a variety of complications and bring burden to people and society. The incidence rate of hypertension is high in elder patients. As age increased, the treatment compliance of patients with hypertension decreased under the influence of various factors, which can lead to poor blood pressure control. Poor blood pressure control has clearly correlation with cardiovascular disease. Knowledge, attitude and practice (KAP) is one of the basic pattern to promote human health behavior. Effective health intervention is helpful to improve cognitive level of elderly patients with hypertension, alleviate negative emotions, develop positive attitude to disease, which can improve treatment compliance and treatment effect and reduce the incidence of complications and mortality. This paper reviews the concept of KAP theory and its research status in hypertension, aiming to analyze the application and influence of KAP in hypertension population, so as to provide reference for health education and health management, and reduce the disease burden of the public.

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    Journal of Internal Medicine Concepts & Practice    2024, 19 (03): 166-166.  
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    Journal of Internal Medicine Concepts & Practice    2024, 19 (03): 158-158.  
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    Journal of Internal Medicine Concepts & Practice    2024, 19 (03): 179-179.  
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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
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    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.

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    Application in evidence-based predictive nursing on patients with relapsed/refractory B-cell lymphoma receiving chimeric antigen receptor T-cell immunotherapy
    ZHENG Xin, CHEN Lian
    Journal of Internal Medicine Concepts & Practice    2025, 20 (03): 248-253.   DOI: 10.16138/j.1673-6087.2025.03.10
    Abstract727)   HTML1)    PDF(pc) (930KB)(199)       Save

    Objective To explore the clinical application and effectiveness of evidence-based predictive nursing on patients with relapsed/refractory B-cell lymphoma undergoing chimeric antigen receptor (CAR) T-cell therapy. Methods Eighty patients with relapsed/refractory B-cell lymphoma who underwent CAR T-cell therapy at Ruijin Hospital between January 2022 and May 2023 were enrolled in the study. Using the envelope method, the patients were randomly assigned to either a control group (n=40), receiving standard nursing care, or an intervention group (n=40), receiving predictive nursing based on evidence-based practice. The intervention included structured problem identification, targeted evidence collection, and implementation of proactive nursing strategies. Clinical outcomes which were compared between the two groups included psychological status, fatigue severity, and treatment-related complications. Results Before nursing intervention, there were no significant differences in anxiety or depression scores between the two groups. After intervention, the intervention group showed significantly lower anxiety and depression scores (P<0.05). Fatigue levels and related dimensions (behavioral, emotional, cognitive, and sensory) also improved significantly in the intervention group compared with the control group (P<0.05). The incidence of cytokine release syndrome (CRS) and immune effector cell-associated neurotoxicity syndrome (ICANS) was lower in the intervention group (65.00% and 15.00%, respectively) than that in the control group (82.50% and 27.50%). There was no significant difference in the overall rate of adverse events between the two groups. There was one case of grade 3-4 CRS and none grade 3-4 ICANS in the intervention group, while there were three cases of grade 3-4 CRS and one case of grade 3-4 ICANS in the control group. Conclusions Evidence-based predictive nursing demonstrates clear clinical value in the management of patients undergoing CAR T-cell therapy with relapsed/refractory B-cell lymphoma. It effectively alleviates psychological distress, reduces fatigue, lowers the risk of severe toxicities, and enhances overall safety and quality of care. These findings support its broader implementation in clinical practice.

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    Salt diet assessment in community residents with salt-sensitive hypertension
    YUAN Xinyan, GONG Yanchun
    Journal of Internal Medicine Concepts & Practice    2024, 19 (03): 197-200.   DOI: 10.16138/j.1673-6087.2024.03.09
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    Salt sensitivity has been proven to be closely related to the occurrence and development of hypertension, and high salt intake is one of the important risk factors for hypertension in community residents. This article provides a literature review of domestical and international research, introducing the relationship between salt sensitivity and hypertension, the current state of salt intake in the diet of community residents, application and effect of a salt-restricted dietary pattern, the different evaluation method of salt intake, and the application of multiple theoretical models in the assessment of salt intake. The article points out the importance of salt restriction dietary behavior of community residents in the prevention and treatment of hypertension. Therefore, it is crucial to investigate and evaluate the current status of salt-restricted diets in order to help to form a good habit and promote healthy behaviors among community residents.

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    Journal of Internal Medicine Concepts & Practice    2024, 19 (03): 184-184.  
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    Acute myeloid leukemia with CEBPA double mutation combined with GATA2 germline mutation: one case report
    AN Huihui, WU Tao, LI Yunyun, LIU Wenhui, TIAN Sirui, LIU Yang, GAO Mingmin
    Journal of Internal Medicine Concepts & Practice    2024, 19 (03): 185-187.   DOI: 10.16138/j.1673-6087.2024.03.06
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    The patient was diagnosed as acute myeloid leukaemia with CEBPA double mutation, GATA2 and IKZF1 mutation in 2021, and relapsed after giving two courses of IA treatment (idarubicin, cytosine arabinoside). There was transient remission after four additional courses of azacitidine combined with venetoclax. The patient relapsed again due to lack of regular treatment. This paper mainly analyses the therapeutic and prognostic role of CEBPA double mutation combined with GATA2 germline mutation in acute myeloid leukaemia.

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