中国医学科学院学报最新文献

Objective To investigate the characteristics of symptom clusters and sentinel symptoms in lung cancer patients before and at the completion of radiotherapy,thus providing a theoretical basis for targeted symptom management. Methods A convenience sampling method was used to recruit patients from the Department of Radiotherapy at Yunnan Cancer Hospital between January and October 2024.A general information questionnaire and the Anderson symptom inventory-lung cancer module(revised) were employed for data collection.The exploratory factor analysis was performed for the symptoms with an incidence rate greater than 20% one day before and at the completion of radiotherapy to identify symptom clusters at different time points.The Apriori algorithm was then adopted to model the associations among symptoms within each cluster and to identify the sentinel symptoms. Results A total of 244 patients were included in this study.Three symptom clusters existed before radiotherapy:psychological symptom cluster(sadness,distress,and sleep disorder),lung cancer-related respiratory symptom cluster(cough,expectoration,chest tightness,and shortness of breath),and perception symptom cluster(pain and numbness).Distress and cough were the sentinel symptoms of psychological symptom cluster and lung cancer related respiratory symptom cluster,respectively.At the end of radiotherapy,the psychological symptom cluster and lung cancer-related respiratory symptom cluster remained unchanged.The radiotherapy side effect symptom cluster(dry mouth,pain,loss of appetite) appeared,and the perception symptom cluster expanded to encompass 5 items(amnesia,drowsiness,fatigue,nausea,and constipation).Pain and drowsiness were the sentinel symptoms of radiotherapy side effect symptom cluster and perception symptom cluster,respectively. Conclusions There are several symptom clusters in lung cancer patients before and at the completion of radiotherapy,and sentinel symptoms exist in symptom clusters at different periods.Nurses can take sentinel symptoms as the intervention targets to formulate effective and targeted nursing measures and reduce the incidence or severity of other symptoms in the cluster,thus diminishing the whole symptom cluster and reducing the burden of patients' symptoms.

Objective To identify key genes of lipid metabolism in diabetic nephropathy(DN) through machine learning models and animal model validation. Methods The limma R package was used for differential gene expression analysis on 69 samples from two transcriptome datasets of the Gene Expression Omnibus and 2 184 differentially expressed genes were identified.Subsequently,we adopted undifferentiated consensus clustering to classify DN samples into two specific subtypes.At the same time,we performed weighted gene co-expression network analysis to mine the gene modules significantly associated with DN.In addition,using least absolute shrinkage and selection operator,support vector machine-recursive feature elimination,and random forest machine learning techniques,combined with protein-protein interaction network analysis,we screened out three core genes.Finally,we constructed a mouse model of type 2 diabetes mellitus to verify the effectiveness of the expression of these key genes. Results Three core genes,APOO,ALDH7A1,and ALB,were predicted as potential biomarkers of lipid metabolism in DN,and their expression levels were downregulated in DN.Through experimental validation in a diabetic mouse model,we confirmed the altered expression of APOO,ALDH7A1,and ALB in DN,which supported their potential as diagnostic markers. Conclusions Our findings suggest that APOO,ALDH7A1,and ALB are new diagnostic markers associated with lipid metabolism in DN,which provides new perspectives for understanding the molecular mechanisms of lipid metabolism in DN.

Colorectal cancer(CRC),a common malignant tumor in the digestive system,has seen increases in global incidence and mortality.The occurrence and development of CRC is a multi-level complex process,which includes genetic variations within cancer cells and multiple influencing factors in the surrounding tumor microenvironment.More and more evidence suggests that tumor-associated macrophages(TAM),the main innate immune cell group in the tumor microenvironment,play a crucial role in CRC.Given the prognosis and clinical value of TAM,this article reviews the different roles of TAM in CRC and the potential applications of TAM-targeted technology.Although there is still controversy over the clinical evidence regarding the roles of TAM in CRC,elucidating the roles of TAM in the development of CRC and their importance in treatment may provide new insights for optimizing TAM-centered targeted therapies.

Alcoholic liver disease(ALD) is chronic liver disease that significantly impacts global health,posing challenges in both diagnosis and treatment.Therefore,delving into the pathogenesis of ALD is of utmost importance.The advent of cutting-edge multi-omics has paved a new way for exploring ALD.Genomics,proteomics,transcriptomics,metabolomics,and gut microbiota investigations have shed light on the pathogenesis of ALD.Alterations in gene and protein expression,variations in metabolome,and the impact of gut microbiota are deemed pivotal in the progression of ALD.This paper comprehensively reviews the research progress of multi-omics in pinpointing prospective biomarkers and therapeutic targets in ALD,aiming to steer the forthcoming fundamental research and clinical practices for ALD.

Objective To assess the human papillomavirus(HPV)testing and infection status among men who have sex with men(MSM)using geosocial networking apps in China and explore the influencing factors,thus providing evidence for designing effective prevention and control strategies for this population. Methods The participants were recruited via the Blued7.23 app from July 15 to August 2,2024.Univariate and multivariate Logistic regression models were used to analyze the factors associated with HPV testing and infection among MSM. Results Among the 1 080 participants,23.3% had undergone HPV testing,and 43.3% of those tested were positive for HPV.The main reason for HPV testing was the presence or suspicion of HPV-related symptoms(n=224,58.9%).The multivariate Logistic regression analysis showed that the MSM who had higher levels of HPV knowledge,had higher income,and self-identified as homosexuals were more likely to undergo HPV testing.Moreover,the MSM who had higher levels of HPV knowledge,self-identified as homosexuals,had sex with women in the past six months,and had infected human immunodeficiency virus were identified as high-risk groups for HPV infection. Conclusions In China,the HPV testing rate is low among MSM using geosocial networking apps.However,the prevalence of HPV infection remains high.Therefore,the government and communities should enhance HPV knowledge dissemination,promote HPV testing,and improve the accessibility and quality of HPV testing services.These measures can increase the testing coverage and effectively control the spread of HPV among MSM.

Objective To develop the belief scale of conducting the standardized prevention and treatment of allergic diseases for medical practitioners,thus assessing their beliefs of conducting the standardized approaches and providing an evaluation tool for the further research. Methods With the Health Belief Model as the theoretical framework,the dimensions and items of the scale were preliminarily developed through literature review and semi-structured interviews.The Delphi method was used to conduct 2 rounds of consultation with 25 experts for revising the scale.The positive coefficient,authority coefficient,degree of concentration,and degree of coordination were calculated as the criteria to build the scale. Results The recovery rates of the two rounds were 100% and 96%.The authority coefficients were 0.838 in both rounds,and the Kendall's coefficients of concordance were 0.127(χ²=145.803,P<0.001) and 0.084(χ²=78.520,P<0.001).The final scale was developed,encompassing 39 items in 6 dimensions. Conclusion The belief scale of conducting standardized prevention and treatment of allergic diseases for medical practitioners is preliminarily developed via the Delphi method,which demonstrates high rationality.

Objective To compare the diagnostic value of transabdominal intestinal ultrasound (IUS) and magnetic resonance enterography (MRE) for intestinal stenosis in inflammatory bowel disease (IBD). Methods A retrospective analysis was conducted on the imaging features of 51 IBD patients who underwent both IUS and MRE at Beijing Friendship Hospital,Capital Medical University,between January 2021 and February 2025.With endoscopy as the gold standard,the diagnostic performance of the two methods was compared. Results The sensitivity (84.2% vs. 52.6%,P=0.008) and accuracy (66.7% vs. 45.1%,P=0.035) of IUS for stenosis were higher than those of MRE.In the localization of stenosis,IUS demonstrated higher sensitivity than MRE for detecting stenosis in the terminal ileum (78.6% vs. 35.7%,P=0.070) and colorectum (86.7% vs. 53.3%,P=0.060).Furthermore,IUS showed higher diagnostic accuracy than MRE for terminal ileum stenosis (70.6% vs. 29.4%,P=0.039).The intestinal wall thickness[(8.2±2.7) mm vs. (10.3±3.8) mm;t=3.20,P=0.002)] and stenosis inner diameter[(3.0±1.6) mm vs. (4.3±1.8) mm;t=2.15,P=0.035] measured by IUS were lower than those measured by MRE,with a moderate level of consistency (ICC:0.19-0.53).In addition,IUS demonstrated a higher detection rate for mesenteric fat hypertrophy (70.6% vs. 27.5%,Kappa=0.27,P=0.005),whereas MRE was more sensitive in detecting lymphadenopathy (90.2% vs. 56.9%,Kappa=0.16,P=0.080). Conclusions IUS is superior to MRE in the diagnosis and localization sensitivity for intestinal stenosis in IBD.However,the two methods showcase poor consistency in detecting and quantitating some inflammatory signs.IUS can be used as a first-line screening method for diagnosing intestinal stenosis in IBD patients,while its clinical application should be combined with specific needs to optimize diagnosis.

Hiatal hernia (HH) refers to a common digestive system disorder in which the stomach or other abdominal organs protrude into the thoracic cavity through the esophageal hiatus.With changes of people's lifestyles,accelerated aging,and rising rates of obesity and overweight,the incidence of HH in China has been steadily increasing.Early diagnosis and accurate classification of HH are critical for guiding treatment decisions. Conventional diagnostic methods-such as barium swallow X-ray,gastroscopy,computed tomography,and high resolution esophageal manometry-have limitations,including invasiveness,radiation exposure,high costs,or inadequate dynamic assessment.Gastric contrast-enhanced ultrasound,as a novel non-invasive imaging technique,has demonstrated unique advantages in the evaluation of HH in recent years.This article reviews the technical principles,clinical applications,and recent advancements of gastric contrast-enhanced ultrasound.