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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 Abstract （892）   HTML （23）    PDF（pc） （917KB）（2305）       Knowledge map    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. Reference | Related Articles | Metrics | Comments（0）

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Research progress of Hashimoto thyroiditis TIAN Limin, FENG Jing Journal of Internal Medicine Concepts & Practice    2024, 19 (04): 217-223.   DOI: 10.16138/j.1673-6087.2024.04.01 Abstract （2896）   HTML （74）    PDF（pc） （973KB）（2174）       Knowledge map    Save Hashimoto thyroiditis (HT) is a very common organic autoimmune thyroid disease, and its incidence is increasing year by year. It not only causes hypothyroidism in clinical practice, but also has many connections with a variety of immune diseases, endocrine diseases, rheumatic diseases and thyroid cancer. Although the exact etiology of HT has not been fully clarified, the mainstream treatment is still based on management and alternative treatment of hypothyroidism. However, as the research further deepens, more clinical variants have been gradually discovered, more and more factors have been found to be related to the onset of HT, and new discoveries have been made in treatment methods. This article reviews the research progress on clinical manifestations, pathological features, diagnosis, pathogenesis, relationship with other diseases and treatment of HT. Reference | Related Articles | Metrics | Comments（0）

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Progress in treatment of activated phosphoinositide 3-kinase δ syndrome WU Tao, LIU Wenhui Journal of Internal Medicine Concepts & Practice    2024, 19 (02): 140-143.   DOI: 10.16138/j.1673-6087.2024.02.10 Abstract （666）   HTML （6）    PDF（pc） （904KB）（2096）       Knowledge map    Save Phosphoinositide 3-kinase δ (PI3Kδ) activated phosphoinositide 3-kinase δ syndrome (APDS) was first reported in 2013. APDS is an autosomal dominant primary immunodeficiency disease (PID) caused by mutations in the PIK3CD gene or PIK3R1 gene. The clinical manifestations of APDS are recurrent respiratory tract infection, non-neoplastic lymphoid hyperplasia, autoimmune diseases and lymphoma. In this paper, the treatment of APDS is introduced in detail. In addition to conventional treatment for immunodeficiency, treatment such as antimicrobial prophylaxis, immunoglobulin replacement therapy and hematopoietic stem cell transplantation were reviewed, and more specific mammalian target of rapamycin (mTOR) inhibitors and PI3Kδ inhibitors were also discussed. Reference | Related Articles | Metrics | Comments（0）

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Therapeutic effect of theta burst transcranial magnetic stimulation combined with speech training on aphasia after stroke ZENG Zhen, LU Chunhua, WANG Kai, ZHANG Qin Journal of Internal Medicine Concepts & Practice    2024, 19 (04): 231-235.   DOI: 10.16138/j.1673-6087.2024.04.03 Abstract （547）   HTML （4）    PDF（pc） （3195KB）（1999）       Knowledge map    Save Objective Analyzing the clinical treatment efficacy of continuous theta burst stimulation (cTBS), theta burst stimulation (TBS) combined with speech training on post stroke aphasia (PSA). Methods In this study, 90 PSA patients admitted to our hospital from February 2022 to January 2023 were divided into three groups according to different treatment methods, each 30 cases in each group. The basic group was given speech training, the observation group 1 was given cTBS combined speech training, and the observation group 2 was given iTBS combined speech training. The clinical efficacy, western aphasia battery (WAB) score, view naming test results, Boston diagnostic aphasia examination (BDAE) rating, stroke aphasia quality of life scale (SAQOL-39g) score were compared among the three groups. Results The total clinical effective rate (96.67%, 93.33%) in observation group 1 and observation group 2 were higher than that in basic group (60.00%) (P<0.05). After treatment, WAB score and correct number of view naming test in observation group 1 and observation group 2 were higher than those in basic group (P<0.05). The reaction time of view naming test in observation group 1 and observation group 2 were shorter than that in basic group (P<0.05). The improvement degree of BDAE grade in observation group 1 and observation group 2 after treatment were better than that in basic group (P<0.05). The SAQOL-39g score in observation group 1 and observation group 2 after treatment was higher than that in basic group (P<0.05). The total clinical response rate, WAB score after treatment, correct number of view naming tests, response time, improvement effect of BDAE classification, and SAQOL-39g score didn’t show significant difference between observation group 1 and group 2 (P>0.05). Conclusions Both cTBS and iTBS combined speech training can improve aphasia symptoms, view naming ability and quality of life in PSA patients. The clinical efficacy of them is comparable, and both are better than single speech training. Table and Figures | Reference | Related Articles | Metrics | Comments（0）

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Advances in study of PCSK9 inhibitors in treatment of non-alcoholic fatty liver disease SHEN Yun, XU Yijiao, WEI Xiao, ZHANG Ruixiang, LIU Chao Journal of Internal Medicine Concepts & Practice    2024, 19 (02): 136-139.   DOI: 10.16138/j.1673-6087.2024.02.09 Abstract （647）   HTML （10）    PDF（pc） （842KB）（1821）       Knowledge map    Save Non-alcoholic fatty liver disease (NAFLD) is the chronic liver disease with the highest incidence rate, and its main cause is due to disorders of lipid metabolism and damage to the liver caused by ectopic fat deposition. Proprotein convertase bacillus subtilis/ kexin type 9 (PCSK9), as a lipid-regulating protease in vivo, plays a key role in abnormal lipid metabolism. Dyslipidemia levels can be significantly improved by inhibiting PCSK9 binding to receptors circulating in vivo. Therefore, PCSK9 inhibitors may improve the condition of NAFLD patients and achieve therapeutic effects. Reference | Related Articles | Metrics | Comments（0）

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Bioinformatics analysis and identification of cuproptosis characteristic genes for acute pancreatitis by machine learning WANG Zhuoxin, HUANG Xinyang, JIN Yixun, WANG Lifu Journal of Internal Medicine Concepts & Practice    2024, 19 (04): 224-230.   DOI: 10.16138/j.1673-6087.2024.04.02 Abstract （743）   HTML （15）    PDF（pc） （1760KB）（1816）       Knowledge map    Save Objective To discover the characteristic genes of cuproptosis in acute pancreatitis (AP). Methods The expression of cuproptosis-related genes (CRG) in the GSE1943 dataset was extracted and performed differential analysis and immune cell correlation analysis. The different subtypes were classified according to the expression of CRG, and metabolic pathway enrichment was performed using gene set variation analysis. Four machine learning algorithms, including generalized linear models, random forest, support vector machine and extreme gradient boosting were used to screen disease characteristic genes. Results A total of 13 CRG were differentially expressed in AP (P<0.05), and CRG were not only correlated to each other in different degrees, but also had correlation with multiple immune cells (P<0.05). There were four immune-related pathways among the two subtypes obtained by cluster analysis, in which the T-cell receptor signaling pathway was noteworthy. Further analysis revealed significant difference between the two subtypes of multiple T cells (P<0.05). Each machine learning algorithm screened out five characteristic genes, and dihydrolipoamide dehydrogenase (DLD) was obtained as the next target of research. Conclusions CRG-based machine learning and bioinformatics analyses could be used to explore CRG in AP to discover potential biomarkers. Table and Figures | Reference | Related Articles | Metrics | Comments（0）

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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 （830）   HTML （16）    PDF（pc） （828KB）（1756）       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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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 Abstract （876）   HTML （7）    PDF（pc） （850KB）（1636）       Knowledge map    Save 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. 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 （628）   HTML （6）    PDF（pc） （1005KB）（1398）       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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Pinocembrin alleviates BEAS-2B cell damage induced by chronic intermittent hypoxia through inhibiting autophagy HE Yanjie, HE Meijuan, WANG Yun, ZHU Chunxue, HUANG Hanpeng Journal of Internal Medicine Concepts & Practice    2024, 19 (02): 115-120.   DOI: 10.16138/j.1673-6087.2024.02.05 Abstract （576）   HTML （5）    PDF（pc） （1410KB）（1334）       Knowledge map    Save Objective To investigate the effect of pinocembrin (PIN) on BEAS-2B human bronchial epithelial cell injury induced by chronic intermittent hypoxia (CIH) and its possible regulatory mechanism. Methods The optimal CIH intervention duration and PIN treatment concentration were determined by cell counting kit 8 (CCK8) in BEAS-2B cells. BEAS-2B cells were divided into control group (CON group), CIH group and CIH+PIN group. The proliferation activity of BEAS-2B cells in different treatment groups was detected by CCK8. Western blotting (WB) was used to detect the protein expression levels of hypoxia-inducible factor 1α (HIF-1α), apoptosis related gene [cleaved caspase 3, B cell lymphoma 2 (Bcl-2), Bcl-2 associated X protein (Bax)] and autophagy related genes [light chain 3(LC3)-Ⅱ, beclin-1, P62]. After adding the autophagy inhibitor 3-methyladenine (3-MA), the cells were divided into five groups: CON group, CIH group, CIH+3-MA group, CIH+PIN group, and CIH+3-MA+PIN group, and the expression levels of HIF-1α, apoptosis and autophagy related genes in each group were detected. Results CCK8 showed that the proliferation activity of BEAS-2B cells significantly decreased between 24-48 h with the prolongation of hypoxia time. PIN could up-regulate the proliferative activity of BEAS-2B cells under CIH. The results of WB showed that compared with CON group, the protein expressions of HIF-1α, Bax, LC3-Ⅱ and beclin-1 were increased in CIH group (P<0.05). The expression of P62 and anti-apoptosis gene Bcl-2 protein was significantly down-regulated (P<0.05). After adding 3-MA, the protein expression level of HIF-1α was reduced, autophagy and apoptosis were inhibited. The same trend was observed after adding PIN. Conclusions PIN can reduce CIH-induced BEAS-2B cell damage and exert a protective effect. The mechanism may be related to down-regulating autophagy level and inhibiting cell apoptosis. Table and Figures | Reference | Related Articles | Metrics | Comments（0）

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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 Abstract （666）   HTML （6）    PDF（pc） （839KB）（1310）       Knowledge map    Save 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. Reference | Related Articles | Metrics | Comments（0）

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Expert consensus on multidisciplinary diagnosis and treatment of primary Sjögren syndrome (2024 edition) CHENG Fang, ZHAO Futao, SHEN Xuemin, LI Jin, CHEN Xiangjun, WANG Guifang, LI Huilin, XUE Luan, QI Junyuan Journal of Internal Medicine Concepts & Practice    2024, 19 (06): 357-362.   DOI: 10.16138/j.1673-6087.2024.06.01 Abstract （1588）   HTML （53）    PDF（pc） （923KB）（1286）       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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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 Abstract （644）   HTML （6）    PDF（pc） （913KB）（1284）       Knowledge map    Save 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. Reference | Related Articles | Metrics | Comments（0）

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Clinical efficacy of venetoclax combined with azacytidine in treatment of newly treated elderly patients with acute myeloid leukemia who were intolerant to intensive chemotherapy ZHAO Huijin, JIN Zhen, ZHANG Yunxiang, WU Min, ZHENG Yu, WU Wen, SHEN Yang, CHEN Qiusheng, LI Junmin, CHEN Yu Journal of Internal Medicine Concepts & Practice    2024, 19 (02): 89-94.   DOI: 10.16138/j.1673-6087.2024.02.01 Abstract （1081）   HTML （17）    PDF（pc） （996KB）（1241）       Knowledge map    Save Objective To investigate the clinical characteristics of 35 elderly patients with acute myeloid leukemia (AML) who were newly treated and intolerant to intensive chemotherapy and evaluate treatment efficacy and safety of venetoclax combined with azacytidine (VEN+AZA). Methods Between February 2021 and March 2022, 35 AML elderly patients who were intolerant to intensive therapy were enrolled in the study. They received VEN+AZA induction therapy. The disease characteristics, VEN+AZA induced remission and treatment safety were retrospectively analyzed and reported. Results The median age of enrolled patients was 68 year old, and there were 9 cases diagnosed with secondary AML. All patients completed bone marrow cytogenetic and molecular biology evaluation and were stratified by European LeukemiaNet (ELN) genetic risk classification. Thirty-five patients were classified as low risk group (10 of 35 cases), intermediate risk group (12 of 35 cases) and high risk group (13 of 35 cases). Common genetic mutations included DNA methyltransferase 3A (DNMT3A) (n=11), isocitrate dehydrogenase (IDH) 1/2 (n=11), ten-eleven translocation 2 (TET2) (n=9), NPM1 (n=8) and Fms-related tyrosine kinase 3-internal tandem duplication (FLT3-ITD) (n=6). The overall complete remission (CR) rate of treatment was 65.7% (n=23), and the CR rate of patients with mutation of NPM1, FLT3-ITD, IDH1/2 were 87.5%, 66.7% and 72.7%, respectively. The total negative rate of minimal residual disease (MRD) among CR patients was 73.9%, the median follow-up time was 10.1 months and median event-free survival (EFS) was 11.3 months. Among remission patients, MRD-negative patients had longer EFS and overall survival than MRD-positive patients（P<0.05）. The early mortality rate was 5.7%. The most common adverse reaction during treatment was hematological toxicity (treatment-induced grade 3-4 neutropenia 31.4%, grade 3-4 thrombocytopenia 25.7%, febrile neutropenia 48.6%) and pulmonary infection (17.1%). Conclusions Our results showed that VEN+AZA has a higher overall response rate in newly treatment elderly AML who were intolerant to intensive chemotherapy, which was similar with the clinical trial results. NPM1 mutation might indicate higher CR rate. The EFS and OS of MRD-negative patients were longer than those of MRD-positive patients, and the risk of death was reduced. In summary, VEN+AZA regime was currently one of the most promising strategies for newly treated elderly AML who couldn’t tolerate intensive chemotherapy. Table and Figures | Reference | Related Articles | Metrics | Comments（0）

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Research progress of the association between intra-pancreatic fat deposition and atherosclerosis LI Chenxi, HU Yun, WU Wenjun Journal of Internal Medicine Concepts & Practice    2024, 19 (04): 278-282.   DOI: 10.16138/j.1673-6087.2024.04.12 Abstract （363）   HTML （3）    PDF（pc） （881KB）（1152）       Knowledge map    Save Intra-pancreatic fat deposition (IPFD) is the most common disease of pancreas in our country. In recent years, there has been increasing evidence that IPFD is closely related to atherosclerosis. However, some studies do not support the correlation between them, which may be affected by differences in study population, atherosclerosis detection methods, and IPFD diagnostic criteria. Therefore, large-sample prospective studies are urgently needed to further clarify the correlation between IPFD and atherosclerosis. The mechanisms involved in correlation between them may be related to inflammation, oxidative stress, hypoadiponectinemia and glucose metabolism. There is currently no specific treatment for IPFD, while weight loss has been shown to significantly reduce the amount of fat deposited in the pancreas. In addition to the treatment of IPFD itself, clinicians should also pay attention to the assessment of the risk of cardiovascular disease in IPFD patients to facilitate early diagnosis and early intervention. Reference | Related Articles | Metrics | Comments（0）

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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 Abstract （820）   HTML （8）    PDF（pc） （831KB）（1082）       Knowledge map    Save 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. Reference | Related Articles | Metrics | Comments（0）

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Role of gut microbiota in mediating metabolic and cardiovascular abnormalities in patients with obstructive sleep apnea and related mechanisms ZHU Xiaowen, WANG Hongchao, WU Wenjun Journal of Internal Medicine Concepts & Practice    2024, 19 (02): 130-135.   DOI: 10.16138/j.1673-6087.2024.02.08 Abstract （659）   HTML （7）    PDF（pc） （850KB）（974）       Knowledge map    Save Obstructive sleep apnea (OSA) is a common sleep disorder characterized by intermittent hypoxia and sleep fragmentation, which is closely associated with the development of hypertension, atherosclerosis, insulin resistance and other metabolic diseases. A lot of studies have found that OSA can cause the disturbance of gut microbiota and affect human health. This paper reviews the possible mechanisms of gut microbiota disturbance and related metabolic and cardiovascular changes caused by OSA in clinical trials and animal models, and the new complementary therapies derived from them. The aim of the paper is to use gut microbiota as an entry point to re-understand the relationship between OSA and metabolic and cardiovascular abnormalities, and provides new ideas for early intervention of OSA and related complications. Reference | Related Articles | Metrics | Comments（0）

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Screening and pathway analysis of autophagy-related genes in Alzheimer disease SHENG Zhaoqing, LIU Xiaohong Journal of Internal Medicine Concepts & Practice    2024, 19 (04): 236-242.   DOI: 10.16138/j.1673-6087.2024.04.04 Abstract （897）   HTML （2）    PDF（pc） （3101KB）（941）       Knowledge map    Save Objective Screen autophagy related genes of Alzheimer disease(AD) based on microarray analysis, conduct pathway analysis and identify key genes in order to explore potential pathogenesis and therapeutic targets. Methods The GSE33000 dataset was downloaded from GEO Database, and the differentially expressed genes of AD were obtained by R software limma package. Autophagy-related genes were downloaded from Human Autophagy Database, Human Autophagy Modulator Database and GeneCard Database, respectively, and the autophagy-related gene set was obtained. The AD autophagy-related genes were obtained through intersecting the differentially expressed genes with the autophagy-related gene set. The R software packages such as org.Hs.eg.db and clusterProfiler were used to perform gene ontology (GO) analysis and Kyoto Encyclopedia of Genes and Genomes (KEGG) analysis, the online software Search Tool for the Retrieval of Interacting Genes (STRING) was used to conduct protein-protein interaction network analysis, and the key genes were predicted based on MCC algorithm. Results A total of 66 autophagy related genes were obtained, of which 41 genes were up-regulated and 25 genes were down-regulated. Gene enrichment analysis showed that cellular components in GO analysis were mainly enriched in phagocytic vesicle membrane, secretory granule membrane, membrane microdomain, late endosome, etc., and molecular functions were mainly enriched in Toll-like receptor binding, ubiquitin-like protein ligase binding, etc., and biological processes were enriched in regulation of autophagy, positive regulation of cellular catabolic process, response to lipopolysaccharide, regulation of inflammatory response, cellular response to external stimulus, etc. In KEGG enrichment analysis, the differentially expressed autophagy-related genes were mainly concentrated in NOD-like receptor signaling pathway, lipid and atherosclerosis, forkhead box protein O(FoxO) signaling pathway, etc. Our research completed the construction of protein-protein interaction (PPI), identified 10 key genes, and screened out that interleukin-6(IL-6) and signal transducer and activator of transcription 3(STAT3) were closely related to AD. Conclusions Ten key autophagy-related genes were obtained in this study, among which IL-6 and STAT3 are more closely related to AD. Table and Figures | Reference | Related Articles | Metrics | Comments（0）

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Discussion on understanding of the essence of chronic obstructive pulmonary disease from the definitions of chronic obstructive pulmonary disease in GOLD over the years HE Quanying Journal of Internal Medicine Concepts & Practice    2024, 19 (05): 289-294.   DOI: 10.16138/j.1673-6087.2024.05.01 Abstract （430）   HTML （6）    PDF（pc） （887KB）（895）       Knowledge map    Save This article reviewed the definition of chronic obstructive pulmonary disease (COPD) in Global Initiative for Chronic Obstructive Lung Disease (GOLD) over the years, from which it can be seen that our understanding of the nature of COPD has gradually deepened and comprehensively. However, there are still some deficiencies in definition of COPD, including airway inflammation, etiology, disease heterogeneity, etc. The comorbid diagnosis and intervention of COPD requires multidisciplinary collaboration. Reference | Related Articles | Metrics | Comments（0）

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Effect of Shenfu injection on immune function in elderly patients with sepsis LIU Di, QÜ Hongping, XÜ Zhihong, CAO Jiumei, ZHENG Lan, BAI Tingting Journal of Internal Medicine Concepts & Practice    2024, 19 (03): 153-158.   DOI: 10.16138/j.1673-6087.2024.03.01 Abstract （535）   HTML （16）    PDF（pc） （1022KB）（884）       Knowledge map    Save Objective To explore the effect of Shenfu injection on immune function in elderly patients with sepsis. Methods This study was a retrospective analysis. The elderly patients(n=126) with sepsis admitted to 4 hospitals including Shanghai Ruijin Hospital from January 2019 to December 2020 were divided into two groups according to whether Shenfu injection was used (61 cases in Shenfu group, 65 cases in control group). Basic data, comorbidities, relevant test results (including inflammatory factors, humoral immune indicators, cellular immune indicators, etc.), disease severity score, mortality rate, etc., were collected for statistical analysis. Results After seven days of Shenfu injection treatment, the indexes including the mean artery pressure (MAP), lactate (Lac), C-reactive protein (CRP), procalcitonin (PCT), prothrombin time (PT), activated partial thromboplastin time (APTT), interleukin-6(IL-6), IL-10, tumor necrosis factor-α(TNF-α), CD3 count, CD4 count, CD8 count, IgG, IgA and IgM of patients in 2 groups were significantly improved (all P<0.05). Compared with the control group, MAP(P=0.034), and the absolute count of CD3(P=0.002) and CD4(P=0.002) were significantly increased in the Shenfu treated group. Conclusions Shenfu injection combined with standard bundled regimen can improve the immune function and reduce inflammation in elderly patients with sepsis. Table and Figures | Reference | Related Articles | Metrics | Comments（0）