Latest Issue
Volume 37 ， Issue 2 ， 2022
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Abstract：The mode of scientific thinking is undergoing rapid and profound changes. In the 21st century, macro and micro civilizations go parallel. A systematic and scientific methodology is required for the study of complex things. The thinking mode in modern medicine is gradually shifting from analytical, reductive thinking to holistic and systematic thinking. As such Western medicine and traditional Chinese medicine are gradually approaching the epistemology of health and disease state. The importance of scientific thinking in innovation has been expounded in this study. The development trends in medicine in the current era are analyzed, the importance of systems theory in the study of human bodies is discussed, and a new medical model named Novel Systems Medicine is proposed.Keywords：Scientific thinking;Innovation;Systems biology;emerging systems medicine30|736|0Updated：2024-04-10 - Abstract：Considering the limitations of medical science and the risks associated with medical treatments, we need to re-examine the connotation of medical science from the perspective of philosophy. Medical science is the natural expression of human kindness and human nature of rescuing the dying and healing the wounded. It is a combination of the natural sciences, social sciences, and humanities. From the perspectives of medical philosophy and humanistic care, this article expounds the concepts and ideas of evidence-based, translational, and precision medicine in modern medicine and emphasizes the importance of avoiding new technical bureaucracy, paying attention to achieving a holistic view and systematic understanding, and avoiding biases in development because of the loss of the humanistic spirit in modern medical practice.Keywords：epistemology;philosophy;humanistic care;evidence-based medicine;precision medicine;translational medicine36|346|0Updated：2024-04-10
- Abstract：The 19th National Congress of the Communist Party of China has proposed a national strategy for a healthy China, which includes the formulation of a new plan to promote high-quality development. Oral diseases have been included in the national “Medium- and Long-term Plan for the Prevention and Treatment of Chronic Diseases”. China’s national oral health strategy provides great opportunities for advancements in stomatology and for the improvement of the people’s oral health. This article discusses these opportunities for advancement in the field of stomatology in China from six aspects: societal needs of oral health; advances in science and technology; changed diagnosis and treatment modes; application of big data; multidisciplinary integration; and talent training.Keywords：stomatology;Healthy China strategy;high-quality development71|381|1Updated：2024-04-10
- Abstract：The burden of dental diseases is increasing in the Chinese population. However, the development of the dental industry falls behind the average development level of medical industry in China. The emergence of digital dental technologies has created significant opportunities for the development of the dental industry in China. This article explores the innovative development background of the Chinese dental industry, describes the current innovation status in Chinese medical colleges and enterprises, highlights key problems faced by the nation, enterprises, and hospitals, proposes solutions to these issues, and puts forwards a new concept of building an open and collaborative service system, a transformation path, and a whole-chain support system for innovations in dentistry.Keywords：dentistry;stomatology;dental technology;Innovation;translational medicine41|272|0Updated：2024-04-10
Think Tank Forum
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Abstract：Objective To explore the association between lipid profiles and left ventricular hypertrophy in a Chinese general population. Methods We conducted a retrospective observational study to investigate the relationship between lipid markers [including triglycerides, total cholesterol, low-density lipoprotein cholesterol, high-density lipoprotein (HDL) cholesterol, non-HDL-cholesterol, apolipoprotein A-I, apolipoprotein B, lipoprotein[a], and composite lipid profiles] and left ventricular hypertrophy. A total of 309,400 participants of two populations (one from Beijing and another from nationwide) who underwent physical examinations at different health management centers between 2009 and 2018 in China were included in the cross-sectional study. 7,475 participants who had multiple physical examinations and initially did not have left ventricular hypertrophy constituted a longitudinal cohort to analyze the association between lipid markers and the new-onset of left ventricular hypertrophy. Left ventricular hypertrophy was measured by echocardiography and defined as an end-diastolic thickness of the interventricular septum or left ventricle posterior wall > 11 mm. The Logistic regression model was used in the cross-sectional study. Coxmodel and Coxmodel with restricted cubic splines were used in the longitudinal cohort. Results In the cross-sectional study, for participants in the highest tertile of each lipid marker compared to the respective lowest, triglycerides [odds ratio (OR): 1.250, 95%CI: 1.060 to 1.474], HDL-cholesterol (OR: 0.780, 95%CI: 0.662 to 0.918), and lipoprotein(a) (OR: 1.311, 95%CI: 1.115 to 1.541) had an association with left ventricular hypertrophy. In the longitudinal cohort, for participants in the highest tertile of each lipid marker at the baseline compared to the respective lowest, triglycerides [hazard ratio (HR): 3.277, 95%CI: 1.720 to 6.244], HDL-cholesterol (HR: 0.516, 95%CI: 0.283 to 0.940), non-HDL-cholesterol (HR: 2.309, 95%CI: 1.296 to 4.112), apolipoprotein B (HR: 2.244, 95%CI: 1.251 to 4.032) showed an association with new-onset left ventricular hypertrophy. In the Coxmodel with forward stepwise selection, triglycerides were the only lipid markers entered into the final model. Conclusion Lipids levels, especially triglycerides, are associated with left ventricular hypertrophy. Controlling triglycerides level potentiate to be a strategy in harnessing cardiac remodeling but deserve to be further investigated.Keywords：left ventricular hypertrophy;lipid;triglycerides;apolipoprotein50|749|0Updated：2024-04-10 -
Abstract：Objective To explore the clinical significance of the combined application of palpebral margin cleaning and antibiotic eye drops in inhibiting bacterial growth in the palpebral margin and conjunctival sacs before cataract extraction. Methods In this study, 61 patients (97 eyes) with age-related cataract who underwent phacoemulsification and intraocular lens implantation were selected, and randomly grouped. In the experimental group, the combined application of palpebral margin cleaning with cotton pads and levofloxacin eye drops was given for three days before the surgery. In the control group, levofloxacin eye drops alone were applied for three consecutive days. Bacteria samples from the conjunctival sac and eyelid margins were cultivated and identified before and three days after taking antimicrobial measures, respectively. Results In the experimental group, the positive rates of the two bacteria samples were 100% (50/50) and 40% (20/50) before and 10% (5/50) and 0% (0/50) after the treatment. In the control group, the positive rates of the two bacteria samples were 97.9% (46/47) and 29.8% (14/47) before and 40.4% (19/47) and 10.6% (5/47) after the treatment. The positive rates between the two groups were not significantly different before taking antimicrobial measures (P= 0.485 and 0.395), while they were significantly different after taking antimicrobial measures (P = 0.001 and 0.024). Conclusion Combined application of eyelid and palpebral margin cleaning with cotton pads and antibiotic eye drops before cataract extraction imparted excellent antibacterial effects.Keywords：antibiotic prophylaxis;cataract extraction;eyelid cleaning;microbiota21|389|0Updated：2024-04-10 -
Abstract：Objective To evaluate the efficacy and safety of prompt phacoemulsification, intraocular lens implantation, visco-goniosynechialysis, combined with pseudo-pupilloplasty for refractory acute primary angle closure (APAC) with atonic dilated pupil and to describe a feasible method of pupilloplasty. Methods A consecutive series of refractory APAC patients who had atonic dilated pupil and undergone prompt phacoemulsification combined with pseudo-pupilloplasty at our center were retrospectively analyzed. Pseudo-pupilloplasty referred to a method of pupilloplasty which included 4.5-mm capsulorhexis, postoperative opacification of anterior capsule residue, and ultimate pseudo-pupil formation. Preoperative and postoperative measurements included intraocular pressure (IOP), best corrected visual acuity (BCVA), and anterior chamber depth (ACD). Intraoperative and postoperative complications were documented. The process of pseudo-pupil formation was also observed. Results A total of 20 eyes of 19 APAC patients were followed up for 19.7 ± 9.8 months. IOP was lowered from preoperative 44.0 ± 9.8 mmHg to 15.5 ± 2.6 mmHg at final visit (t=11.945, P< 0.001). ACD was deepened from preoperative 1.77 ± 0.21 mm to 3.40 ± 0.20 mm at final visit (t=-27.711, P< 0.001). Twelve of 20 eyes had residual angle synechiae, whereas only 3 eyes needed anti-glaucoma medications. No severe complication was observed. All eyes had pseudo-pupil gradually formed within 3 months, accompanied with the gradual improvement of BCVA from preoperative 1.18 ± 0.55 to 0.58 ± 0.22, 0.26 ± 0.09, 0.11 ± 0.09, and 0.11 ± 0.09 at postoperative day 1, month 1, month 3, and last visit. Conclusions Prompt phacoemulsification-goniosynechialysis is effective and safe for refractory APAC with atonic dilated pupil. Pseudo-pupilloplasty is a feasible procedure for pupil reconstruction.Keywords：acute primary angle closure;phacoemulsification;pupilloplasty23|353|0Updated：2024-04-10 -
Abstract：Objective To summarize the clinical features of spontaneous remission in classic fever of unknown origin (FUO). Methods Medical records of 121 patients diagnosed with FUO at admission in Peking Union Medical College Hospital between January 2018 and June 2018 were reviewed retrospectively. Patients who were discharged without etiological diagnoses were followed for 2 years. The clinical features and outcomes of these patients were summarized. Multivariate logistic regression was used to analyze related factors of spontaneous remission of FUO. Results After excluding 2 patients who lost to follow-up, the etiology of 119 FUO patients were as follows: infectious diseases in 30 (25.2%) cases, connective tissue diseases in 28 (23.5%) cases, tumor diseases in 8 (6.7%) cases, other diseases in 6 (5.0%) cases, and unknown diagnoses in 47 (39.5%) cases. Totally, 41 patients experienced spontaneous remission of fever (the median time from onset to remission was 9 weeks, ranging from 4 to 39 weeks). In patients with spontaneous remission in FUO, lymphadenopathy was less common clinical manifestation, the levels of inflammatory markers including leukocyte count, neutrophil count, neutrophil ratio, C-reactive protein, and ferritin were lower, and the proportion of CD8 positive T lymphocytes expressing CD38 was lower. Multivariate logistic regression analysis of factors with a P-value < 0.05 in univariate analysis shown that white blood cell count (OR: 0.545, 95%CI: 0.306-0.971, P = 0.039), neutrophil count (OR: 2.074, 95%CI: 1.004-4.284, P = 0.049), and proportion of neutrophils (OR: 0.928, 95%CI: 0.871-0.990, P = 0.022) were independent significant factors associated with spontaneous remission in FUO. Conclusions This study suggested that most patients discharged with undiagnosed classic FUO would remit spontaneously. Thus, for patients with stable clinical conditions, follow-up and observation could be the best choice. Patients with lower level of some inflammatory factors may have a high likelihood of spontaneous remission in classic FUO.Keywords：fever of unknown origin;follow-up;spontaneous remission;diagnosis11|246|0Updated：2024-04-10 -
Abstract：Objective Iodothyronine deiodinases (DIOs) are important selenoproteins that play a key role in the bone and joint diseases. Osteoarthritis (OA) is the most prevalent joint disease especially in elders. This bioinformatic analysis was performed to explore the role of DIOs in OA pathogenesis. Methods The biological functions of selenoprotein DIOs were analyzed by bioinformatic techniques, including GenCLip 3.0, Database for Annotation, Visualization and Integrated Discovery (DAVID), STRING, Cytoscape, and Network Analyst. The expression of DIOs in the healthy individuals and OA patients was determined by mining OA-related microarray data in the gene expression omnibus (GEO) database of National Center for Biotechnology Information and performing a Meta-analysis of the data with Review Manager 5.3. Results Cluster analysis revealed that the function of the DIOs was associated with thyroid hormone receptor and iodothyronine; GO analysis showed that DIOs were mainly involved in biological processes, such as ethanol metabolism and phenol-containing compound metabolism and primarily involved in the cytochrome P450 metabolism of exogenous organisms and thyroid hormone signaling; SULT1A1 was the core node of the PPI network; miRNAs and thyroid hormones had some iterations with DIO1and DIO2; Meta-analysis showed that DIO3 expression was significantly up-regulated in OA patients (SMD = 0.31, 95%CI: 0.03, 0.59, P = 0.03). Conclusions The main biological functions of DIOs were closely associated with the regulation of thyroid hormone. And the up-regulated expression of DIO3 may have crucial impact on the occurrence of OA.Keywords：selenoprotein;iodothyronine deiodinase;osteoarthritis16|755|0Updated：2024-04-10 -
Abstract：Objective To evaluate changes in morphology of the cesarean scar and uterus between one and two years after cesarean section using high-resolution, three dimensional T2-weighted sampling perfection with application optimized contrast using different flip angle evolutions Magnetic Resonance Imaging (3D T2w SPACE MRI). Methods This prospective study was performed to investigate morphological changes in the cesarean scars and uterus from one to two years after cesarean section using high-resolution, 3D T2w SPACE MRI. The healthy volunteers having no childbearing history were recruited as the controls. All data were measured by two experienced radiologists. All data with normal distribution between the one-year and two-year groups were compared using a paired-sample t test or independent t test. Results Finally, 46 women took a pelvic MR examination one year after cesarean section, and a subset of 15 completed the same examination again after two years of cesarean section. Both the uterine length and the anterior wall thickness after two years of cesarean section (5.75 ± 0.46 and 1.45 ± 0.35 cm) were significantly greater than those measured at one year (5.33 ± 0.59 and 1.25 ± 0.27 cm) (t = -2.363 and -2.175, P= 0.033 and 0.048). No significant difference was shown in myometrial thickness two years after cesarean section (1.45 ±0.35 cm) with respect to the control group (1.58 ± 0.21 cm, P= 0.170). Nine women who underwent MRI twice were considered to have scar diverticula one year after cesarean section, and still had diverticula two years after cesarean section. The thickness, height, and width of the uterine scar showed no significant change from one to two years (all P > 0.05). Conclusions 3D T2w SPACE MRI provides overall morphologic details and shows dynamic changes in the scar and the uterus between one and two years after cesarean section. Scar morphology after cesarean section reached relatively stable one year after cesarean section, and uterine morphology was closer to normal two years after cesarean section.Keywords：uterine cesarean;scar;uterine morphology;3D T2w SPACE MRI30|532|0Updated：2024-04-10
Original Article
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Abstract：A 2-year-old girl was diagnosed as Weill-Marchesani syndrome with typical systemic features of short stature, short and stubby hands and feet, language disorders and mental retardation. He developed bilateral angle closure glaucoma, ectopia lentis and suffered visual loss from the ocular features of Weill-Marchesani syndrome. The child was successfully treated by combined CO2 laser-assisted sclerectomy surgery and trabeculectomy.Keywords：pediatric glaucoma;refractory glaucoma;surgery;Weill-Marchesani syndrome;CO2 laser25|428|1Updated：2024-04-10 -
Abstract：Mandibular buccal bifurcation cyst is a rare inflammatory odontogenic cyst. We reported two cases who complained of painful swelling of extraoral soft tissue. Intraoral examination revealed the partially erupted mandibular first molar. Cone beam computed tomography showed a well-defined cystic lesion surrounding the first molar. Histopathologic images showed the cyst wall was infiltrated by a large number of plasma cells, neutrophils and eosinophils, and lined with a thin layer of non-keratinized stratified squamous epithelium. Finally, the two patients were diagnosed as mandibular buccal bifurcation cyst and treated with cyst enucleation and curettage.Keywords：buccal bifurcation cyst;odontogenic cyst;permanent first molar23|415|0Updated：2024-04-10 -
Abstract：Maturity-onset diabetes of the young 3 (MODY3) is an autosomal dominant monogenic diabetes mellitus characterized by defective β-cell function and non-insulin-dependent early-onset diabetes mellitus. The facts that patients with MODY3 are often misdiagnosed as type 1 and type 2 diabetes mellitus and genetic diagnosis is expensive, make its diagnosis very challenging. In this study, we reported a case of MODY3, which was verified to be caused by a mutation in hepatocyte nuclear factor 1α gene (c.598C>T, p.Arg200Trp). In addition, the patient had a neuroendocrine tumor simultaneously, and a KMT2D gene mutation (c.5587C>G, p.Pro1863Ala) might be associated with this leson.Keywords：maturity-onset diabetes of the young 3;intestinal neuroendocrine tumor;hepatocyte nuclear factor 1α;mutation14|338|0Updated：2024-04-10
Case Reports
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