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    Treatment strategies for renal impairment in multiple myeloma: a review of new drugs and novel therapies
    SHI Hao, WANG Zhaohui
    Journal of Internal Medicine Concepts & Practice    2025, 20 (03): 185-190.   DOI: 10.16138/j.1673-6087.2025.03.01
    Abstract43)   HTML9)    PDF(pc) (892KB)(12)       Save

    Multiple myeloma (MM) is associated with a high incidence of renal impairment, which correlates with decreased overall survival and increased risk of early mortality in these patients. In recent years, there has been great progress in the treatment of MM, and new drugs and therapies have improved prognosis of the patients. However, the prognosis of MM patients with concurrent renal impairment remains poorer compared with those with normal renal function. This article reviews the advancements in treatment and relevant strategies for MM patients with renal impairment. Current research supports the regime of combining monoclonal antibodies with proteasome inhibitors or immunomodulatory drugs in MM treatment. Chimeric antigen receptor T cells therapy, T-cell directing bispecific antibodies and antibody-drug conjugates have only been evaluated in small-scale retrospective studies for patients with renal impairment. Although the benefits of mechanical approaches aiming at rapid clearance of free light chains, such as plasmapheresis and high-cutoff hemodialysis, have not been confirmed, they may provide opportunities for renal recovery as combing with chemotherapy. The efficacy and safety of treatment in MM patients with renal impairment should be proactively assessed in prospective randomized controlled trials.

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    Medicine de-escalation strategies in inflammatory bowel disease for remission maintenance
    GU Yubei, HONG Yu
    Journal of Internal Medicine Concepts & Practice    2025, 20 (02): 101-106.   DOI: 10.16138/j.1673-6087.2025.02.01
    Abstract129)   HTML13)    PDF(pc) (968KB)(26)       Save

    Inflammatory bowel disease (IBD), including ulcerative colitis (UC) and Crohn disease (CD), requires long-term medication to maintain remission. Developing a medicine de-escalation strategies during remission is crucial for reducing side effects and alleviating economic burdens, but the risks and benefits of medicine discontinuation remain controversial. The dose of 5-aminosalicylic acid (5-ASA) can be reduced in partial UC patients during remission, but the risk of relapse increases after medicine discontinuation. Long-term use of immunomodulators such as azathioprine has safety issues, but safe discontinuation of the medicine can be achieved through a medicine monitoring systems. The relapse rate after discontinuation of biologics agents during remission is high, especially in patients who have not achieved deep remission. The medicine de-escalation strategy for patient receiving combination therapy requires comprehensive assessment. Relapse monitoring after medicine discontinuation is critical, endoscopy and biomarkers such as C-reactive protein (CRP) and fecal calprotectin (FCP) can be used as effective predictive tools. This review summarizes recent studies on medicine de-escalation in IBD remission to provide reference for clinical practice and promote shared decision-making between patients and physicians.

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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
    Abstract566)   HTML27)    PDF(pc) (923KB)(138)       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.

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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
    Abstract279)   HTML4)    PDF(pc) (887KB)(473)       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.

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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
    Abstract2442)   HTML47)    PDF(pc) (973KB)(1038)       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.

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    Association between sarcopenia and pneumonia in elderly and prevention strategies
    HUANG Yi, YANG Meng, LIU Hangxu
    Journal of Internal Medicine Concepts & Practice    2024, 19 (01): 1-5.   DOI: 10.16138/j.1673-6087.2024.01.01
    Abstract432)   HTML8)    PDF(pc) (862KB)(310)       Save

    Sarcopenia and pneumonia are common diseases in the elderly. Both diseases are closely related to the quality of life and the disease burden in society. Sarcopenia can cause functional impairments and affect the occurrence and prognosis of pneumonia, and occurrence of pneumonia will also increase the risk of sarcopenia or worsen its’ condition. Our article discussed the association between sarcopenia and pneumonia, summarized the related prevention strategies, and aimed to reduce the social health problems and disease burden caused by the diseases in the elderly.

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    Pay attention to clinical issues easy to be neglected in diagnosis and treatment of Legionella pneumonia
    CHEN Yu, LU Ye
    Journal of Internal Medicine Concepts & Practice    2024, 19 (01): 6-12.   DOI: 10.16138/j.1673-6087.2024.01.02
    Abstract375)   HTML19)    PDF(pc) (1160KB)(301)       Save

    Legionella pneumonia usually develops rapidly and has a high mortality. With the advancements of detection technology, the rate of identifying Legionella infections increases in recent years. However, misdiagnosis of the disease still exists, and delayed treatment is one of the reasons for patient death. Therefore, it’s crucial to identify the clinical characteristics of Legionella pneumonia early and provide timely and appropriate treatment. Although some clinical features of Legionella pneumonia have been clinically recognized, many issues still have been overlooked. This paper is a comprehensive review of the clinical manifestations, auxiliary examinations and treatment strategies of Legionella pneumonia, and it aims to improve clinicians’ understanding of the diagnosis and treatment of the disease to make patients’ prognosis better.

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    Issues requiring attention in clinical diagnosis and treatment of diabetes mellitus combined with pulmonary infection
    ZHENG Xiaoyan, YI Huahua, ZHOU Min
    Journal of Internal Medicine Concepts & Practice    2024, 19 (01): 13-18.   DOI: 10.16138/j.1673-6087.2024.01.03
    Abstract416)   HTML17)    PDF(pc) (974KB)(359)       Save

    The prevalence of diabetes is increasing and the risk of pulmonary infection among patients with diabetes mellitus is higher than that among people without diabetes mellitus. The clinical characteristics and prognosis of pulmonary infection patients with diabetic are also distinct from that of patients without diabetic. To improve the level of clinical diagnosis and treatment, it’s important to understand the mechanisms of pulmonary infection in diabetic patients and to be familiar with the clinical manifestations of bacterial, fungal and viral infections in them.

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    Is severe pneumonia ARDS?
    HE Quanying
    Journal of Internal Medicine Concepts & Practice    2024, 19 (01): 19-24.   DOI: 10.16138/j.1673-6087.2024.01.04
    Abstract488)   HTML15)    PDF(pc) (853KB)(741)       Save

    The acute respiratory distress syndrome (ARDS) is an acute hypoxic respiratory insufficiency caused by severe infection, shock, trauma and burns. It is easily confused with severe pneumonia combined with hypoxemia and severe COVID-19 pneumonia. In this paper, the concept, pathogenesis, pathological changes, pathophysiology and definition of ARDS were discussed, and the similarities and differences between ARDS and severe pneumonia combined with hypoxemia or severe COVID-19 pneumonia were analyzed and conducted in-depth interpretation.

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    Reinfection of COVID-19 and response
    JIE Zhijun, SHA Jiafeng, ZHANG Meng
    Journal of Internal Medicine Concepts & Practice    2024, 19 (01): 25-30.   DOI: 10.16138/j.1673-6087.2024.01.05
    Abstract389)   HTML16)    PDF(pc) (848KB)(81)       Save

    The global situation of the coronavirus disease 2019 (COVID-19) infection remains concerning. As the viruses continue to evolve, the risk of reinfection has markedly increased. COVID-19 vaccination history, previous infection history, antibody titers, age and immune escape can all affect the occurrence of reinfection. Scientific rehabilitation training can help to alleviate post-acute COVID-19 sequalae, and vaccination remains a crucial measure of infection prevention. In the paper, we discussed the current epidemic situation of COVID-19, epidemiology of reinfection and its’ related factors, and strategies to provide reference for epidemic prevention and control.

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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
    Abstract435)   HTML7)    PDF(pc) (909KB)(1877)       Save

    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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