《新英格兰医学杂志》综述及养老院老人疫苗接种等问题

May 20th, 2021 (摘要)：

Featuring articles on efficacy of the ChAdOx1 nCoV-19 vaccine against the B.1.351 variant, NVX-CoV2373 vaccine efficacy against B.1.351 in South Africa, endovascular therapy for basilar-artery stroke, intensive or standard blood-pressure control, and on geneediting for congenital neutropenia; 

A review article on monoclonal gammopathy of renal significance; a case report of a woman with nausea, diarrhea, andacute kidney failure; and 

Perspective articles on minority tax reform, on training future health justice leaders, and on finding a way to break through the fog.

如果您能|赞赏|小编的工作，那是最大鼓励；感谢您分享给医生们，他们有会喜欢的。

《NEJM》主编访谈：

美国养老院老人疫苗接种和重症监护研究

单克隆肾脏疾病的意义

具有肾脏重要性的单克隆丙种球蛋白病是一种不符合癌症标准的B细胞，或浆细胞克隆性疾病。

该疾病产生导致肾脏损伤或疾病的单克隆免疫球蛋白。本篇综述讨论了其发病机理，评估和管理。

如何破解患者的“脑雾”

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老人接种疫苗后再感染新冠病毒

在这篇社论中，作者讨论了REHAB-HF试验，在该临床试验中，研究人员对患有急性心力衰竭的老年人进行了康复训练的效果，并非如人们所期望的结果。

Exercise rehabilitation has a long history in the management of chronic heart failure, with the first randomized trial of exercise training dating back to 1990 — and by the late 1990s, it had become an integral part of therapy. 

There is solid evidence from multiple trials and meta-analyses that exercise training improves exercise capacity and reduces symptoms in patients with stable heart failure. 

However, trial data showing a reduction in the risk of hospitalization or death in patients with heart failure who participated in exercise training are lacking, although the results from a large trial, HF-ACTION

罕见的惰性B细胞癌毛细胞白血病通常是由激活BRAF突变驱动。

抑制BRAF会引起反应。在维罗非尼治疗中加用利妥昔单抗，可导致30例复发或难治性疾病患者中26例患者完全缓解。

治疗方法如下：

麻省总医院大查房案例：

一名25岁的男子突然出现肢体瘫痪。实验室研究表明钾水平为每升1.6 mmol。诊断为甲状腺毒性周期性麻痹。开始补充钾和磷酸盐。

阿兹海麻省总医院案例讨论