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    Value of serum N-terminal pro-brain natriuretic peptide levels in primary screening peritoneal dialysis patients with volume overload
    LI Hua, HUANG Xiaomin, ZHANG Chunyan, DU Lu, REN Hong, XU Tian
    Journal of Internal Medicine Concepts & Practice    2023, 18 (03): 157-164.   DOI: 10.16138/j.1673-6087.2023.03.005
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    Objective To explore the relationship between serum N-terminal pro-brain natriuretic peptide (NT-proBNP) level and hydration status and cardiac function indexes in the patients receiving peritoneal dialysis(PD) treatment,and to further analyze the factors affecting the level of NT-proBNP. Methods A total of 111 patients with PD who were followed up in the PD Center of Ruijin Hospital, Shanghai Jiao Tong University School of Medicine from May 2019 to January 2022 were enrolled and the data was analyzed retrospectively. According to the results of multi-frequency bioelectrical impedance body composition monitor (BCM), relative hydration status (DHS), the ratio obtained through dividing extracellular water (ECW) by overhydration (OH), the patients were divided into normal volume group (OH/ECW≤15%) and overhydration group (OH/ECW>15%). The relationship between serum NT-proBNP level and hydration status in two groups was compared, and the related factors affecting the level of NT-proBNP were further analyzed and discussed. Using BCM result as the“gold standard”, the receiver operator characteristic curve(ROC curve) determined the optimal threshold of NT-proBNP as the capacity was overloaded. The patients were divided into two groups according to NT-proBNP and their clinical data were compared. Results The indexes including systolic blood pressure, urine volume, urea clearance index (Kt/V), creatinine clearance rate(CCr), dialysate to plasma ratio for urea at 4 hours(4hD/PCr), types of antihypertensive drugs, type of diuretic, hemoglobin, serum albumin, log2(NT-proBNP), interventricular septal thickness (IVST), left ventricular posterior wall thickness(LVPWT), left atrial diameter(LAD), OH, TBW, ECW, OH/TBW, ECW/TBW and ECW/ICW were detected in volume overload group and normal volume group, and showed statistically significant (all P<0.05). log2(NT-proBNP) level was correlated with systolic blood pressure, dialysis duration, ultrafiltration volume, dialysis dose, antihypertensive drug group, IVST, LVPWT, LAD, left ventricular end-systolic dimension (LVESD), left ventricular end-diastolic dimension (LVEDD), OH, OH/ECW were positively correlated (all P<0.05). It was negatively correlated with urine volume, Kt/V, CCr, normalized protein catabolic rate (nPCR), hemoglobin, serum albumin and LVEF (all P<0.05). NT-proBNP 4 896 ng/L could be used as the critical value of initial screening capacity overload and was applied to divide the patients into two groups, and the systolic blood pressure, urine volume, ultrafiltration volume, Kt/V, CCr, IVST, LVPWT, OH/ECW indicators showed significant differences (all P<0.05) in two groups. Conclusions The level of NT-proBNP in PD patients is generally increased, and it indicates volume overload as its value is greater than 4 896 ng/L, which can be used as a simple monitoring index for the preliminary judgment of volume overload in PD patients.

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    Journal of Internal Medicine Concepts & Practice    2022, 17 (04): 344-348.   DOI: 10.16138/j.1673-6087.2022.04.015
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    Research progress of miRNA-206 on lung diseases
    ZHANG Lulu, WU Qiannan, HUO Rujie, et al
    Journal of Internal Medicine Concepts & Practice    2022, 17 (05): 413-417.   DOI: 10.16138/j.1673-6087.2022.05.014
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    COVID-19 vaccine induced thyroid disease: challenges and strategies
    YUAN Li, XIANG Pingping, CHEN Guofang, et al
    Journal of Internal Medicine Concepts & Practice    2023, 18 (02): 121-123.   DOI: 10.16138/j.1673-6087.2023.02.012
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    Novel coronavirus infection: a new challenge for the management of thyroid disease
    XIANG Pingping, LIU Chao
    Journal of Internal Medicine Concepts & Practice    2022, 17 (06): 486-490.   DOI: 10.16138/j.1673-6087.2022.06.013
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    Advances in human respiratory microbiome and detection techniques
    WU Wenjuan, TIAN Wenjie
    Journal of Internal Medicine Concepts & Practice    2024, 19 (01): 37-42.   DOI: 10.16138/j.1673-6087.2024.01.07
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    Human respiratory microbiome has great diversity and heterogeneity in healthy and diseased states, rapid and accurate microbial detection is the key to distinguish respiratory tract infection from non-infection. In recent years, new detection technologies represented by metagenomic technology have developed rapidly in the field of pathogen diagnosis, which improves the detection rate of pathogenic microorganisms, and also makes great breakthroughs in analyzing human host reaction and predicting drug resistance. This article reviews the research progress and achievements of molecular technology in the respiratory microbiome, inspiring readers to think about the development and clinical transformation of new technologies in the future, aiming to explore therapeutic strategies for respiratory diseases based on the respiratory microbiome.

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    Research progress on pathogenesis of diabetic nephropathy
    BI Liming, WANG Zhaohui
    Journal of Internal Medicine Concepts & Practice    2023, 18 (03): 201-205.   DOI: 10.16138/j.1673-6087.2023.03.014
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    Journal of Internal Medicine Concepts & Practice    2022, 17 (03): 258-261.   DOI: 10.16138/j.1673-6087.2022.03.017
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    Journal of Internal Medicine Concepts & Practice    2022, 17 (03): 267-272.   DOI: 10.16138/j.1673-6087.2022.03.019
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    Journal of Internal Medicine Concepts & Practice    2022, 17 (03): 202-207.   DOI: 10.16138/j.1673-6087.2022.03.006
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    Geometric deep learning and computational medicine research prospects of “preventing disease” in pre diabete
    RUAN Ming, HOU Tianzhichao, WANG Haiyan, et al
    Journal of Internal Medicine Concepts & Practice    2022, 17 (06): 475-481.   DOI: 10.16138/j.1673-6087.2022.06.011
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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
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    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.

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    Application of pulsed electric field ablation in atrial fibrillation
    ZHANG Zhi, TANG Xuechao, HUANG Xinmiao, et al
    Journal of Internal Medicine Concepts & Practice    2022, 17 (05): 400-404.   DOI: 10.16138/j.1673-6087.2022.05.011
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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
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    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.

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    Progress in clinical application of leadless pacemaker
    TANG Baopeng, ZHANG Jianghua, GUO Yankai
    Journal of Internal Medicine Concepts & Practice    2022, 17 (05): 365-368.   DOI: 10.16138/j.1673-6087.2022.05.003
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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
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    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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    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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    Expert consensus on diagnosing and evaluating sacroiliitis using magnetic resonance imaging
    DAI Shengming, BAO Chunde, ZOU Hejian, et al
    Journal of Internal Medicine Concepts & Practice    2023, 18 (02): 65-69.   DOI: 10.16138/j.1673-6087.2023.02.001
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    An update on complement targeted treatment of IgA nephropathy
    ZHANG Huijian, LI Guisen
    Journal of Internal Medicine Concepts & Practice    2023, 18 (03): 197-200.   DOI: 10.16138/j.1673-6087.2023.03.013
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    Development of preliminary scales for elderly sarcopenia based on Delphi method
    LI Feika, YANG Wenli, JIANG Qianwen, FANG Fang, BAI Tingting, XU Gang, WU Fang, HE Qing
    Journal of Internal Medicine Concepts & Practice    2022, 17 (03): 238-242.   DOI: 10.16138/j.1673-6087.2022.03.012
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    Objective To develop the preliminary scales suitable to the comprehensive assessment scale for elderly sarcopenia in China (including self-evaluation and evaluation from others). Methods Through searching and reviewing literatures, the scales related to sarcopenia were selected and a preliminary item pool was formed. The items were screened through two rounds of Delphi consultation questionnaires completed by 16 domestic experts in related fields. Through analyzing the expert positive coefficient, expert authority level, coordination coefficient of the importance of expert opinions, average value of each index score, coefficient of variation and the full score rate, the preliminary scales for evaluating sarcopenia in the elderly were developed. Results After literature collection and expert discussion, the initial item pools of self-assessment (3 first-level items, 5 second-level items, 21 third-level items) and assessment from others (2 first-level items, 4 second-level items and 17 third-level items) were developed. The expert positive coefficient in the first round of Delphi consultation was 100%, and the coefficient of expert authority was Cr=0.956. In the self-evaluation and evaluation from others, the Kendall coordination coefficients of the importance of experts to all items were 0.424 and 0.449, and χ2 were 133.534 (P<0.001) and 114.591 (P<0.001), respectively. The positive coefficient of expert in second round of Delphi consultation was 100%, and the authority coefficient of expert was Cr=0.968. In self-evaluation and evaluation from others, the Kendall coordination coefficients of the importance of experts to all items were 0.350 and 0.400, and χ2 are 84.119 (P<0.001) and 67.546 (P<0.001), respectively. According to two rounds scores of Delphi consultation and the expert opinions of modification, the item pools of self-assessment (3 first-level items, 5 second-level items and 10 third-level items) and assessment from others(2 first-level items, 4 second-level items and 13 three-level items) were finally formed. Conclusions The preliminary scales for comprehensive assessment of elderly sarcopenia developed through Delphi expert consultation method involved active participation of experts, and presented high level of expert authority, and well concentrated and coordinated opinions from experts.

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