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Helicobacter Pylori, Microbiota and Cancer

  • Creator:   Chinese Medical Journal
  • Updated:   5/23/2023
  • Contains:  9 items
The 12 recommendations in this clinical practice guideline are formed with consideration for stakeholders' values and preferences, resource use, feasibility, and acceptability. Recommendations are generalizable to resource limited settings with similar antibiotic resistance pattern as China, and lower middle-income countries facing comparable sociological and technical challenges.

Diabetes Mellitus

  • Creator:   Chinese Medical Journal
  • Updated:   5/23/2023
  • Contains:  6 items
This study deeply revealed the clinical phenomenon of diabetes-promoting lymph node metastasis in gastric cancer, and found that the phenomenon of diabetes-promoting lymph node metastasis became more prominent with the progression of tumor primary lesions and the increase in the number of lymph node detections. Based on the gastric cancer database established by the Department of General Surgery of Southern Hospital, the study included the clinicopathological data of gastric adenocarcinoma cases undergoing gastrectomy and D2 lymph node dissection from November 2004 to December 2019, and excluded less than 16 cases detected in preoperative treatment and lymph nodes, and a total of 2142 cases met the enrollment criteria, including 149 diabetic patients and 1993 non-diabetic patients. The distance to lymph node metastasis (N3 station metastasis), high lymph node metastasis burden (N3b status) and number of lymph node metastasis in diabetic and non-diabetic patients were compared.

Advancements and Challenges in the Treatment of Cancer

  • Creator:   Chinese Medical Journal
  • Updated:   5/23/2023
  • Contains:  11 items
Immunotherapies targeting cancer neoantigens are safe, effective, and precise. Neoantigens can be identified mainly by genomic techniques such as next-generation sequencing and high-throughput single-cell sequencing; proteomic techniques such as mass spectrometry; and bioinformatics tools based on high-throughput sequencing data, mass spectrometry data, and biological databases. Neoantigen-related therapies are widely used in clinical practice and include neoantigen vaccines, neoantigen-specific CD8+ and CD4+ T cells, and neoantigen-pulsed dendritic cells. In addition, neoantigens can be used as biomarkers to assess immunotherapy response, resistance, and prognosis. Therapies based on neoantigens are an important and promising branch of cancer immunotherapy. Unremitting efforts are needed to unravel the comprehensive role of neoantigens in anti-tumor immunity and to extend their clinical application. This review aimed to summarize the progress in neoantigen research and to discuss its opportunities and challenges in precision cancer immunotherapy.

Update on Atrial Fibrillation

  • Creator:   Chinese Medical Journal
  • Updated:   5/23/2023
  • Contains:  5 items
Atrial fibrillation is a quivering or irregular heartbeat (arrhythmia) that can lead to blood clots, stroke, heart failure and other heart-related complications. It usually doesn’t have harmful consequences by itself. The real danger is the increased risk for stroke. Even when symptoms are not noticeable, atrial fibrillation can increase a person’s risks for stroke and related heart problems. Therefore, it is of great importance to study the pathogenesis and treatment of atrial fribrillation. In recent years, researchers explored the treatment strategies from various aspects including drugs, surgery such as catheter ablation as well as its risk factors and the mechanism in molecular level. We recommend several articles here about the recent progression in atrial fibrillation. Please enjoy!

Anethesiology and Assisted Ventilation

  • Creator:   Chinese Medical Journal
  • Updated:   5/23/2023
  • Contains:  9 items
Norepinephrine infusion decreases hypotension after spinal anesthesia during cesarean section. The second paper in this collection aimed to compare the efficacy of norepinephrine infusion and ephedrine bolus against post-spinal hypotension in parturients.In this double-blinded, randomized controlled clinical trial, parturients scheduled for elective cesarean section were randomly allocated to receive norepinephrine infusion just before spinal anesthesia continuing for 30 min or ephedrine bolus (0.15 mg/kg) just before spinal anesthesia. A rescue bolus (5 mu g norepinephrine for the norepinephrine group, and 5 mg ephedrine for the ephedrine group) was administered whenever hypotension occurred. The primary outcome was the incidence of hypotension within 30 min of spinal anesthesia administration. Secondary outcomes included maternal and neonatal outcomes 30 min after spinal block, and neonatal cerebral oxygenation 10 min after birth. Fewer patients suffered hypotension in the norepinephrine group than in the ephedrine group (29.5% vs. 44.9%, odds ratio [OR]: 0.51, 95% confidence interval [CI]: 0.28-0.95, P = 0.034). Moreover, the tachycardia frequency was lower in the norepinephrine group than in the ephedrine group (OR: 0.22, 95% CI: 0.11-0.44, P < 0.001), and patients suffered less nausea and vomiting (OR: 0.28, 95% CI: 0.11-0.70, P = 0.004). There was no difference in Apgar scores and umbilical arterial blood gas analysis between the two groups. However, neonatal cerebral regional saturations were significantly higher after birth in the norepinephrine group than in the ephedrine group (mean difference: 2.0%, 95% CI: 0.55%-3.45%, P = 0.008).

State of the Art 2023: Asthma

  • Creator:   Chinese Medical Journal
  • Updated:   5/23/2023
  • Contains:  7 items
Severe asthma is "asthma which requires treatment with high dose inhaled corticosteroids (ICS) plus a second controller (and/or systemic corticosteroids) to prevent it from becoming 'uncontrolled' or which remains 'uncontrolled' despite this therapy." The state of control was defined by symptoms, exacerbations and the degree of airflow obstruction. Therefore, for the diagnosis of severe asthma, it is important to have evidence for a diagnosis of asthma with an assessment of its severity, followed by a review of comorbidities, risk factors, triggers and an assessment of whether treatment is commensurate with severity, whether the prescribed treatments have been adhered to and whether inhaled therapy has been properly administered. Phenotyping of severe asthma has been introduced with the definition of a severe eosinophilic asthma phenotype characterized by recurrent exacerbations despite being on high dose ICS and sometimes oral corticosteroids, with a high blood eosinophil count and a raised level of nitric oxide in exhaled breath. This phenotype has been associated with a Type-2 (T2) inflammatory profile with expression of interleukin (IL)-4, IL-5, and IL-13. Molecular phenotyping has also revealed non-T2 inflammatory phenotypes such as Type-1 or Type-17 driven phenotypes. Antibody treatments targeted at the T2 targets such as anti-IL5, anti-IL5R alpha, and anti-IL4R alpha antibodies are now available for treating severe eosinophilic asthma, in addition to anti-immunoglobulin E antibody for severe allergic asthma. No targeted treatments are currently available for non-T2 inflammatory phenotypes. Long-term azithromycin and bronchial thermoplasty may be considered. The future lies with molecular phenotyping of the airway inflammatory process to refine asthma endotypes for precision medicine.

Gastric Cancer

  • Creator:   Chinese Medical Journal
  • Updated:   5/23/2023
  • Contains:  9 items
Gastric cancer (GC) is one of the most common malignant tumors worldwide. Its incidence ranks the 5th among all malignant tumors globally, and it is the 3rd leading cause of death among patients with cancer. Surgical treatment is the first choice in clinical practice. However, targeted therapy, immunotherapy, and other treatment methods have also become research hotspots at home and abroad with the development of individualized precision therapy in recent years, besides traditional radiotherapy and chemotherapy. At present, targeted therapy and immunotherapy are methods used for treating GC, and they have important clinical application value and prospects. This study aimed to review the research progress of targeted therapy and immunotherapy for GC, focusing on its mechanism of action and related important clinical trials, hoping to provide references for the clinical treatment of GC.

Psoriasis and Systemic Lupus Erythematosus

  • Creator:   Chinese Medical Journal
  • Updated:   5/23/2023
  • Contains:  12 items
Systemic lupus erythematosus (SLE) is an autoimmune disease in which antibodies and immune complexes mediate organ and tissue damage. The etiology of SLE is complex and the clinical manifestations of patients are diverse. If not treated in time, SLE will cause irreversible damage to the affected organs and eventually lead to death. Psoriasis is a chronic, persistent inflammatory autoimmune disease of the skin, which has become a common disease endangering public health. In 2021-2022, Chinese Medical Journal has published a lot of excellent on the pathogenesis, clinical features, diagnosis and treatment of the SLE and psoriasis

Rheumatoid Arthritis

  • Creator:   Chinese Medical Journal
  • Updated:   5/23/2023
  • Contains:  14 items
Rheumatoid arthritis (RA) is a chronic and disable disease with great adverse effect on patients’ quality of life, and its etiology has not been completely clarified. There has been a lot of progress in rheumatoid arthritis research, recently. In 2021-2022, Chinese Medical Journal has published a lot of excellent research on the pathogenesis, clinical features, diagnosis and treatment of the RA.

Obesity

  • Creator:   Chinese Medical Journal
  • Updated:   5/23/2023
  • Contains:  2 items
According to the Global Burden of Disease Survey, the prevalence of obesity and overweight in China is one of the fastest growing countries in the world among 204 countries/regions, reaching the 18th highest rate in the world (Figure A). Compared to 1990 data, the prevalence of obesity and overweight in China doubled in 2009 and doubled again in the following 10 years. Since 2010, the prevalence of obesity and overweight in China has increased twice the global average. During the same period, the increase in the prevalence of obesity and overweight in the European Union and the United States has stabilized or even begun to decline, and has fallen below the global average. In contrast, countries in South Asia, including India, have also seen high increases in the prevalence of overweight and obesity over the past 30 years.

New Advances in Cancer

  • Creator:   Chinese Medical Journal
  • Updated:   5/23/2023
  • Contains:  10 items
Brain metastasis (BM) is the leading cause of mortality in lung cancer patients. The process of BM is a complex process for which few tumor cells complete the entire process. Recent research on BM of lung cancer has recently stressed the essential role of tumor microenvironment (TME) in assisting tumor cells in the completion of each BM step. This review summarizes recent studies regarding the effects of TME on tumor cells in the entire process of BM derived from lung cancer. The identification of vulnerable targets in the TME and their prospects to provide novel therapeutic opportunities are also discussed.

New Advances in Chronic Airway Diseases

  • Creator:   Chinese Medical Journal
  • Updated:   5/23/2023
  • Contains:  10 items
Extracellular vesicles (EVs) are anuclear particles composed of lipid bilayers that contain nucleic acids, proteins, lipids, and organelles. EVs act as an important mediator of cell-to-cell communication. Under physiological conditions, EVs play an essential role in maintaining the homeostasis of the pulmonary milieu, but they can also be involved in promoting the pathogenesis and progression of various respiratory diseases. In addition, EVs derived from mesenchymal stem cells have shown promising therapeutic effects on reducing and repairing lung injuries. Furthermore, researchers have explored different methods for modifying EVs or enhancing EVs-mediated drug delivery to produce more targeted and beneficial effects. This article reviewed the characteristics and biogenesis of EVs and their role in lung homeostasis and various acute and chronic lung diseases and the potential therapeutic application of EVs in the field of clinical medicine.

Dermatology

  • Creator:   Chinese Medical Journal
  • Updated:   12/29/2022
  • Contains:  10 items
Interleukins (ILs) and associated cytokines serve as the means of communication for immune cells and non-immune cells. The use of ILs in harnessing the immune system to cancer treatment has been a promising approach. ILs not only nurture an environment enabling cancer growth but also simultaneously trigger a productive tumor-directed immune response. These properties of ILs are increasingly being explored as a strategy to improve the outcomes of cancer. Here, we describe recently innovative technological approaches that have been developed to improve the pharmacokinetics, safety, and efficacies of IL-2, 15, 10, and 18 in the treatment of melanoma. Furthermore, the combination of ILs and immune checkpoint inhibition may synergize to reshape the tumor environment, thus yielding better clinical benefits in the future.

Focus on Burden of Disease

  • Creator:   Chinese Medical Journal
  • Updated:   5/23/2023
  • Contains:  18 items
The disease burden of pancreatitis in China has declined in the past 30 years, but the exacerbation of population aging poses a challenge to prevention and control of pancreatitis. Alcohol use has gradually become an important factor in the disease burden of pancreatitis in recent years. GBTC is becoming a major health burden in China, particularly among males and older individuals. Given the aging population and increasing burden, effective strategies and measurements are urged to prevent or reduce the number of new cases and deaths of GBTC.Substantial discrepancies were observed in the premature mortality burden of CRC across China. Targeted considerations were needed to promote a healthy lifestyle, expand cost-effective CRC early screening and diagnosis, and improve medical treatment to reduce CRC mortality among high-risk populations and regions with inadequate healthcare resources.

Hepatocellular Carcinoma

  • Creator:   Chinese Medical Journal
  • Updated:   5/23/2023
  • Contains:  10 items
Metabolic (dysfunction) associated fatty liver disease (MAFLD), previously known as non-alcoholic fatty liver disease, is the most common cause of chronic liver disease worldwide. Many risk factors contribute to the pathogenesis of MAFLD with metabolic dysregulation being the final arbiter of its development and progression. MAFLD poses a substantial economic burden to societies, which based on current trends is expected to increase over time. Numerous studies have addressed various aspects of MAFLD from its risk associations to its economic and social burden and clinical diagnosis and management, as well as the molecular mechanisms linking MAFLD to end-stage liver disease and hepatocellular carcinoma. This review summarizes current understanding of the pathogenesis of MAFLD and related diseases, particularly liver cancer. Potential therapeutic agents for MAFLD and diagnostic biomarkers are discussed.

Update of Hot Topics in Neuralogic Diseases

  • Creator:   Chinese Medical Journal
  • Updated:   5/23/2023
  • Contains:  8 items
We summarized several high-cited articles in the field of neurology, such as relevant studies on Alzheimer's disease and other hot topics. Cerebral amyloid angiopathy-related inflammation (CAA-RI) is a relatively rare and rapidly progressive subtype of cerebral amyloid angiopathy. The clinical symptoms are diverse and nonspecific, and the most common manifestations are subacute cognitive decline or mental disorders, headaches, seizures, etc. Asymmetric white matter hyperintensity on T2 sequence and multiple strictly lobar cerebral microbleeds are relatively characteristic imaging findings. The first article systematically summarized the pathogenesis, pathology, clinical and imaging manifestations, diagnostic criteria, treatment and prognosis of CAA-RI, and puts forward the unsolved problems and future directions for research. Numerous clinical and preclinical studies have shown that gut microbiota dysbiosis is associated with a variety of neurological diseases, e.g., Parkinson’s disease, Alzheimer’s disease, and myasthenia gravis. However, the underlying molecular mechanisms are complex and remain unclear. In the second article, authors reviewed the dysbiosis of gut microbiota and the corresponding mechanisms in common neurological diseases and discussed the potential roles that the gut microbiome may play in the diagnosis and treatment of neurological disorders.

Alzheimer's Disease

  • Creator:   Chinese Medical Journal
  • Updated:   12/28/2022
  • Contains:  7 items
Alzheimer's disease (AD) refers to a particular onset and course of cognitive and functional decline associated with age together with a particular neuropathology. Metabolic, vascular, and inflammatory changes, as well as comorbid pathologies are key components of the disease process. The clinical diagnosis may be difficult, but diagnostic methods have been introduced and proven to be accurate in supporting the clinical diagnosis. Application of these methods increases, partly due to improved awareness of cognitive symptoms and the relevance of early detection and diagnosis, in particular when more efficient disease-modifying drugs become available.

Intestinal Microbiota

  • Creator:   Chinese Medical Journal
  • Updated:   12/28/2022
  • Contains:  9 items
The digestive tract harbours the largest and most complex microbial community of the human body, the intestinal microbiota, including about 800 different bacteria species. Bacterial colonization of human gut by environmental microbes, beginning immediately after birth, becomes more complex with increasing age, with a high degree of variability among human individuals. The gastrointestinal tract is the main site where environmental microorganisms and antigens interact with the host, through intensive cross-talks. Gut microbiota is essential for intestinal development, homeostasis and protection against pathogenic challenge.

Cardiology

  • Creator:   Chinese Medical Journal
  • Updated:   12/28/2022
  • Contains:  10 items
Cardiovascular disease (CVD) remains the leading cause of deaths nationwide. However, little is understood about its temporal trend and corresponding influence on longevity improvements. This study described the updated tendency in CVD mortality and to quantify its impact on life expectancy (LE) increase in China.During 2013 to 2018, the age-standardized mortality rate of CVD decreased from 289.69 (95% confidence interval [CI]: 289.03, 290.35)/100,000 to 272.37 (95% CI: 271.81, 272.94)/100,000, along with a decline in probability of CVD premature deaths from 9.05% (95% CI: 9.02%, 9.09%) to 8.13% (95% CI: 8.10%, 8.16%). The gap in CVD mortality across sexes expanded with more remarkable declines in females, especially for those aged 15 to 64 years. Among major subtypes, the probability of premature deaths from hemorrhage stroke declined fastest, while improvements of ischemic stroke and ischemic heart disease were limited, and there was an increase in stroke sequelae. LE in China reached 77.04 (95% CI: 76.96, 77.12) years in 2018 with an increase of 1.38 years from 2013. Of the total LE gains, 21.15% (0.29 years) were attributed to reductions of CVD mortality in the overall population, mostly driven by those aged >65 years.

Tumor Epidemiology and Public Health

  • Creator:   Chinese Medical Journal
  • Updated:   12/28/2022
  • Contains:  8 items
This collection is dominated by a range of epidemiological studies, including oncology epidemiology, chronic non-communicable disease epidemiology and infectious disease epidemiology, covering a range of important public health issues. We particularly recommend the first paper, which provides a detailed interpretation of changes in the global and Chinese cancer spectrum based on Globocan 2020 data, and provides a basis for the development of cancer prevention strategies in China.

HIV-AIDS

  • Creator:   Chinese Medical Journal
  • Updated:   12/28/2022
  • Contains:  8 items
Acquired immunodeficiency syndrome (AIDS) is a chronic, potentially life-threatening condition caused by the human immunodeficiency virus (HIV). By damaging your immune system, HIV interferes with your body's ability to fight infection and disease. HIV is a sexually transmitted infection (STI). It can also be spread by contact with infected blood or from mother to child during pregnancy, childbirth or breast-feeding. Without medication, it may take years before HIV weakens your immune system to the point that you have AIDS. There's no cure for HIV/AIDS, but medications can dramatically slow the progression of the disease.

Important Coronavirus Articles

  • Creator:   Chinese Medical Journal
  • Updated:   2/16/2023
  • Contains:  17 items