内科医学年鉴的使命是促进医学卓越，使医生和其他医疗保健专业人员成为医学界和社会中消息灵通的成员，推进医学研究的实施和报告标准，并为改善患者的健康做出贡献全世界的人。为了实现这一使命，该杂志发表了与临床实践、医疗保健服务、公共卫生、医疗保健政策、医学教育、伦理和研究方法相关的各种原创研究、评论文章、实践指南和评论。此外，该杂志还出版了传达医学艺术的个人叙述。

The mission of the Annals of Internal Medicine is to promote excellence in medicine, making physicians and other healthcare professionals informed members of the medical community and society, advancing the implementation and reporting standards of medical research, and contributing to the improvement of health for patients worldwide. To achieve this mission, the journal publishes a variety of original research, review articles, practice guidelines, and commentaries related to clinical practice, healthcare services, public health, healthcare policy, medical education, ethics, and research methods. Additionally, the journal also publishes personal narratives that convey the art of medicine.

《Annals of Internal Medicine》的使命是促进医学卓越，使医生和其他医疗保健专业人员成为医学界和社会中消息灵通的成员，推动医学研究的实施和报告标准，并为改善全球患者的健康做出贡献。为实现这一使命，该杂志发表了与临床实践、医疗保健服务、公共卫生、医疗保健政策、医学教育、伦理和研究方法相关的各种原创研究、评论文章、实践指南和评论。此外，该杂志还出版了传达医学艺术的个人叙述。

Annals of Internal Medicine

The quality of reporting practice guidelines is often poor, and there is no widely accepted guidance or standards for such reporting in health care. The international RIGHT (Reporting Items for practice Guidelines in HealThcare) Working Group was established to address this gap. The group followed an existing framework for developing guidelines for health research reporting and the EQUATOR (Enhancing the QUAlity and Transparency Of health Research) Network approach. It developed a checklist and an explanation and elaboration statement. The RIGHT checklist includes 22 items that are considered essential for good reporting of practice guidelines: basic information (items 1 to 4), background (items 5 to 9), evidence (items 10 to 12), recommendations (items 13 to 15), review and quality assurance (items 16 and 17), funding and declaration and management of interests (items 18 and 19), and other information (items 20 to 22). The RIGHT checklist can assist developers in reporting guidelines, support journal editors and peer reviewers when considering guideline reports, and help health care practitioners understand and implement a guideline.

Yaolong Chen

Kehu Yang

Ana Marušic

Amir Qaseem

Joerg J. Meerpohl

Signe Flottorp

Elie A. Akl

Holger J. Schünemann

Edwin S.Y. Chan

Yngve Falck-Ytter

Faruque Ahmed

Sarah Barber

Chiehfeng Chen

Mingming Zhang

Bin Xu

Jinhui Tian

Fujian Song

Hongcai Shang

Kun Tang

Qi Wang

Susan L. Norris

Ann Intern Med

A Reporting Tool for Practice Guidelines in Health Care: The RIGHT Statement

Context Studies in animals and humans suggest that sleep duration is an important regulator of metabolism. Contribution In this study, 12 young, healthy, normal-weight men exhibited reductions in the satiety hormone leptin, increases in the hunger hormone ghrelin, and increases in hunger after 2 nights of only 4 hours of sleep compared with after 2 nights of 10 hours of sleep. Implications Inadequate sleep seems to influence the hormones that regulate satiety and hunger in a way that could promote excess eating. The Editors Sleep plays an important role in energy balance. In rodents, food shortage or starvation results in decreased sleep (1), and, conversely, total sleep deprivation leads to marked hyperphagia (2). Leptin and ghrelin are peripheral signals that contribute to the central regulation of food intake. Leptin, a hormone released by the adipocytes, provides information about energy status to hypothalamic regulatory centers (3). In humans, circulating leptin levels rapidly decrease or increase in response to acute caloric shortage or surplus, respectively (4). These changes in leptin levels have been associated with reciprocal changes in hunger (4). Ghrelin, a peptide produced predominantly by the stomach, is also involved in energy balance regulation, but, in contrast to the anorexigenic effects of leptin, ghrelin stimulates appetite (5). It has been proposed that leptin and ghrelin represent the yinyang of one regulatory system that has developed to inform the brain about the current energy balance state (6). Over the past 40 years, sleep duration in the U.S. population has decreased by 1 to 2 hours (7-10). The proportion of young adults sleeping fewer than 7 hours per night has more than doubled between 1960 and 20012002 (from 15.6% to 37.1%) (7-10). The effect of sleep curtailment on the control of appetite and food intake is not known. Because of the well-documented associations between sleep and food intake (1, 2), we sought to determine whether sleep duration influences the daytime profiles of leptin and ghrelin. Methods Participants Twelve healthy men(mean age [SD], 22 2 years]; mean body mass index [SD], 23.6 2.0 kg/m2) who did not smoke or take any medications participated in the study. All of the men were within 10% of ideal body weight and had regular nocturnal time in bed of 7 to 9 hours. We excluded persons who had traveled across time zones less than 4 weeks before the study. Experimental Protocol The Institutional Review Board of the University of Chicago approved the protocol, and we obtained written informed consent from all participants. During the week preceding each study, we asked participants not to deviate from a fixed time in bed (11:00 p.m. to 7:00 a.m.) by more than 30 minutes. Naps were not allowed. The men participated in 2 studies that were conducted in a randomized order, were spaced at least 6 weeks apart, and were performed in the Clinical Research Center at the University of Chicago, Chicago, Illinois. Six of the 12 men first performed the study with restricted time in bed, and the remaining 6 men first performed the study with extended time in bed. Average weight did not change over the time period separating the 2 study conditions (75.2 kg in the sleep restriction condition vs. 75.4 kg in the sleep extension condition; P> 0.2). We obtained blood samples at 20-minute intervals from 8:00 a.m. to 9:00 p.m. after 2 consecutive nights of 10 hours in bed (10:00 p.m. to 8:00 a.m.; sleep extension) and after 2 consecutive nights of 4 hours in bed (1:00 a.m. to 5:00 a.m.; sleep restriction). Sleep was recorded every night. For both extension and restriction conditions, each overnight stay began at 7:00 p.m. with a standard hospital dinner, and the first overnight stay ended after breakfast, which was served at 8:00 a.m. We instructed the participants not to deviate from their usual eating habits between breakfast and dinner, but caloric intake was not otherwise monitored. Participants were readmitted in the early evening and, after receiving a standard hospital dinner at 7:00 p.m., remained at bed rest. At 8:00 a.m. after the second night, the participants' caloric intake was kept constant to avoid meal-related fluctuations of hunger and satiety and consisted of an intravenous glucose infusion at a constant rate of 5 g/kg of body weight every 24 hours. There was no other source of calories. Every hour from 9:00 a.m. to 9:00 p.m., the men completed validated visual analogue scales (0 to 10 cm) for hunger (11) and appetite for various food categories (12). To assess hunger, we asked participants to mark their response to the question How hungry do you feel right now? on a 10-cm scale (with not at all hungry on the left and extremely hungry on the right). To assess appetite, we asked participants to mark their response to how much they would enjoy eating foods from 7 different food categories on a 10-cm scale (with not at all on the left and very much on the right). They were asked to provide a score based only on their appetite at the moment, without concern for calories, fat, or a healthy diet. The food categories were sweets (such as cake, candy, cookies, ice cream, and pastry); salty foods (such as chips, salted nuts, pickles, and olives); starchy foods (such as bread, pasta, cereal, and potatoes); fruits and fruit juices; vegetables; meat, poultry, fish, and eggs; and dairy products (such as milk, cheese, and yogurt). Assays We measured serum leptin levels in all samples by using a human leptin radioimmunoassay kit (Linco Research, St. Charles, Missouri) with a sensitivity of 0.5 ng/mL and an intra-assay coefficient of variation of 8.3%. In 9 of the 12 participants, we also measured total ghrelin levels at hourly intervals by radioimmunoassay (Linco Research) with a sensitivity of 0.5 ng/mL and an intra-assay coefficient of variation of 7.9%. Statistical Analysis We performed paired comparisons by using the Wilcoxon matched-pairs signed-rank test. We calculated correlations by using the Spearman coefficient. The mean relative changes in leptin, ghrelin, hunger, and appetite between extended sleep (the reference category) and restricted sleep were calculated by using the ratios of the corresponding individual data and then deriving the mean across all individuals. Role of the Funding Sources This work was partially supported by grants from the National Institutes of Health, the European Sleep Research Society, the Belgian Fonds de la Recherche Scientifique Mdicale, the University of Chicago Diabetes Research and Training Grant, and The University of Chicago General Clinical Research Center. The funding sources had no role in the design, conduct, and reporting of the study or in the decision to submit the manuscript for publication. Results Leptin levels were stable across the daytime period under both sleep conditions, which was consistent with the fact that calories were exclusively delivered in the form of a constant glucose infusion. Average total sleep time was 9 hours and 8 minutes when the men spent 10 hours in bed and 3 hours and 53 minutes when the men spent 4 hours in bed (P< 0.01). When spending 4 hours in bed, the participants had mean leptin levels that were 18% lower (2.1 ng/mL vs. 2.6 ng/mL; P= 0.04) (Figure 1, part A) and mean ghrelin levels that were 28% higher (3.3 ng/mL vs. 2.6 ng/mL; P= 0.04) (Figure 1, part B) than when the participants spent 10 hours in bed. The ratio of the concentrations of orexigenic ghrelin to anorexigenic leptin increased by 71% (CI, 7% to 135%) with 4 hours in bed compared with 10 hours in bed. Sleep restriction relative to sleep extension was associated with a 24% increase in hunger ratings on the 10-cm visual analogue scale (P< 0.01) and a 23% increase in appetite ratings for all food categories combined (P= 0.01) (Figure 1, parts C and D, and Table 1). The increase in appetite tended to be greatest for calorie-dense foods with high carbohydrate content (sweets, salty foods, and starchy foods: increase, 33% to 45%; P= 0.06) (Table 1). The increase in appetite for fruits and vegetables was less consistent and of lesser magnitude (increase, 17% to 21%) (Table 1). Appetite for protein-rich nutrients (meat, poultry, fish, eggs, and dairy foods) was not significantly affected by sleep duration (Table 1). When we considered the changes in ghrelin and leptin in an integrated fashion by calculating the ghrelin-to-leptin ratio, the increase in hunger was proportional to the increase in ghrelin-to-leptin ratio (r= 0.87) (Figure 2). Almost 70% of the variance in increased hunger could be accounted for by the increase in the ghrelin-to-leptin ratio. Figure 1. Effect of sleep duration on daytime leptin levels, ghrelin levels, hunger, and appetite. A. B. C D C D Table. Average Ratings of Appetite after 2 Days of Sleep Restriction or Sleep Extension Figure 2. Association between the change in hunger ratings and the change in ghrelin-to-leptin ratio during the 12:00 noon to 9:00 p.m. time period when sleep is restricted as compared with extended. P Discussion We observed that sleep duration may affect the circulating levels of neuroendocrine factors that regulate hunger and appetite. Two days with 4 hours of time in bed each night were associated with an 18% decrease in the levels of the anorexigenic hormone leptin. By comparison, 3 days of underfeeding by approximately 900 calories per day in healthy lean volunteers has been reported to result in a decrease of leptin levels averaging 22% (4). Sleep curtailment was also associated with an almost 28% increase in daytime levels of the orexigenic factor ghrelin. The reciprocal changes in leptin and ghrelin that we observed in response to sleep restriction were associated with a 24% increase in hunger and a 23% increase in appetite. Appetite for calorie-dense nutrients with high carbohydrate content, including sweets, salty snacks, and starchy foods, increased by 33% to 45%. In contrast, appetite

Karine Spiegel

Esra Tasali

Plamen Penev

Eve Van Cauter

Brief Communication: Sleep Curtailment in Healthy Young Men Is Associated with Decreased Leptin Levels, Elevated Ghrelin Levels, and Increased Hunger and Appetite

简讯：健康年轻男性睡眠不足与瘦素水平降低、胃饥饿素水平升高以及饥饿感和食欲增加相关

The new coronavirus, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has caused more than 210 000 deaths worldwide. However, little is known about the causes of death and the virus's pathologic features.To validate and compare clinical findings with data from medical autopsy, virtual autopsy, and virologic tests.Prospective cohort study.Autopsies performed at a single academic medical center, as mandated by the German federal state of Hamburg for patients dying with a polymerase chain reaction-confirmed diagnosis of COVID-19.The first 12 consecutive COVID-19-positive deaths.Complete autopsy, including postmortem computed tomography and histopathologic and virologic analysis, was performed. Clinical data and medical course were evaluated.Median patient age was 73 years (range, 52 to 87 years), 75% of patients were male, and death occurred in the hospital (n = 10) or outpatient sector (n = 2). Coronary heart disease and asthma or chronic obstructive pulmonary disease were the most common comorbid conditions (50% and 25%, respectively). Autopsy revealed deep venous thrombosis in 7 of 12 patients (58%) in whom venous thromboembolism was not suspected before death; pulmonary embolism was the direct cause of death in 4 patients. Postmortem computed tomography revealed reticular infiltration of the lungs with severe bilateral, dense consolidation, whereas histomorphologically diffuse alveolar damage was seen in 8 patients. In all patients, SARS-CoV-2 RNA was detected in the lung at high concentrations; viremia in 6 of 10 and 5 of 12 patients demonstrated high viral RNA titers in the liver, kidney, or heart.Limited sample size.The high incidence of thromboembolic events suggests an important role of COVID-19-induced coagulopathy. Further studies are needed to investigate the molecular mechanism and overall clinical incidence of COVID-19-related death, as well as possible therapeutic interventions to reduce it.University Medical Center Hamburg-Eppendorf.

Dominic Wichmann

Jan-Peter Sperhake

Marc Lütgehetmann

Stefan Steurer

Carolin Edler

Axel Heinemann

Fabian Heinrich

Herbert Mushumba

Inga Kniep

Ann Sophie Schröder

Christoph Burdelski

Geraldine de Heer

Axel Nierhaus

Daniel Frings

Susanne Pfefferle

Heinrich Becker

Hanns Bredereke-Wiedling

Andreas de Weerth

Hans-Richard Paschen

Sara Sheikhzadeh-Eggers

Axel Stang

Stefan Schmiedel

Carsten Bokemeyer

Marylyn M. Addo

Martin Aepfelbacher

Klaus Püschel

Stefan Kluge

Autopsy Findings and Venous Thromboembolism in Patients With COVID-19

Liming Lu

Chen Chen

Yiming Chen

Yu Dong

Rouhao Chen

Xiaojing Wei

Chenyang Tao

Cui Li

Yuting Wang

Baochao Fan

Xiaorong Tang

Shichao Xu

Zhiqiu He

Guodong Mo

Yiliang Liu

Hong Gu

Xiang Li

Fang Cao

Hongxia Xu

Yuqing Zhang

Guowei Li

Xinxia Liu

Jingchun Zeng

Chunzhi Tang

Nenggui Xu

Effect of Acupuncture for Methadone Reduction

针灸对美沙酮减量的影响

Ideas and Opinions14 March 2023Written by Humans or Artificial Intelligence? That Is the QuestionMichiel Schinkel, MD, Ketan Paranjape, MSc, PhD, and Prabath Nanayakkara, MD, PhDMichiel Schinkel, MDAmsterdam University Medical Center, University of Amsterdam, Center for Experimental and Molecular Medicine, and Amsterdam University Medical Center, Vrije Universiteit Amsterdam, Department of Internal Medicine, Amsterdam Public Health Research Institute, Amsterdam, the Netherlands (M.S.)Search for more papers by this author, Ketan Paranjape, MSc, PhDAmsterdam University Medical Center, Vrije Universiteit Amsterdam, Department of Internal Medicine, Amsterdam Public Health Research Institute, Amsterdam, the Netherlands (K.P., P.N.).Search for more papers by this author, and Prabath Nanayakkara, MD, PhDAmsterdam University Medical Center, Vrije Universiteit Amsterdam, Department of Internal Medicine, Amsterdam Public Health Research Institute, Amsterdam, the Netherlands (K.P., P.N.).Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/M23-0154 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail Let us start with a quiz. In the Table, we present part of the introduction of an article published in Annals of Internal Medicine, next to an introduction generated by a software application called Chatbot that uses artificial intelligence (AI) (1, 2). Which of the 2 is generated by AI?Table. Part of the Introduction of an Article Published in Annals and a Version Generated by the AI-Powered ChatbotIntroductionOn 21 January 1677, “Brief Rule to Guide the Common People of New England How to Order Themselves and Theirs in the Small Pocks, or Measles” became the first medical publication ...References1. ChatGPT: Optimizing Language Models for Dialogue. Accessed at https://openai.com/blog/chatgpt on 11 January 2023. Google Scholar2. Scott IA. Machine learning and evidence-based medicine. Ann Intern Med. 2018;169:44-46. [PMID: 29710098] doi:10.7326/M18-0115 LinkGoogle Scholar3. Image 1 of Brief rule to guide the common people of New England how to order themselves and theirs in the small pocks, or measles. Boston, printed and sold by John Foster. 1677. [Facsimile]. Library of Congress. Accessed at www.loc.gov/resource/rbpe.03300900 on 11 January 2023. Google Scholar4. Densen P. Challenges and opportunities facing medical education. Trans Am Clin Climatol Assoc. 2011;122:48-58. [PMID: 21686208] MedlineGoogle Scholar5. King MR; ChatGPT. A conversation on artificial intelligence, chatbots, and plagiarism in higher education [Editorial]. Cell Mol Bioeng. 2023;16:1-2. [PMID: 36660590] doi:10.1007/s12195-022-00754-8 CrossrefMedlineGoogle Scholar6. King MR. The future of AI in medicine: a perspective from a chatbot [Editorial]. Ann Biomed Eng. 2023;51:291-295. [PMID: 36572824] doi:10.1007/s10439-022-03121-w CrossrefMedlineGoogle Scholar7. Balan S. English as the language of research: but are we missing the mark. Explor Res Clin Soc Pharm. 2021;3:100043. [PMID: 35480598] doi:10.1016/j.rcsop.2021.100043 CrossrefMedlineGoogle Scholar8. Bolton E, Hall D, Yasunaga M, et al. Stanford CRFM introduces PubMedGPT 2.7B. 15 December 2022. Accessed at https://hai.stanford.edu/news/stanford-crfm-introduces-pubmedgpt-27b on 1 February 2023. Google Scholar9. Singhal K, Azizi S, Tu T, et al. Large language models encode clinical knowledge. arXiv. Preprint posted online 26 December 2022. doi:10.48550/arxiv.2212.13138 CrossrefGoogle Scholar10. GPTZero. Accessed at https://gptzero.me on 11 January 2023. Google Scholar Author, Article, and Disclosure InformationAffiliations: Amsterdam University Medical Center, University of Amsterdam, Center for Experimental and Molecular Medicine, and Amsterdam University Medical Center, Vrije Universiteit Amsterdam, Department of Internal Medicine, Amsterdam Public Health Research Institute, Amsterdam, the Netherlands (M.S.)Amsterdam University Medical Center, Vrije Universiteit Amsterdam, Department of Internal Medicine, Amsterdam Public Health Research Institute, Amsterdam, the Netherlands (K.P., P.N.).Disclosures: Authors have reported no disclosures of interest. Forms can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M23-0154.Corresponding Author: Michiel Schinkel, MD, Center for Experimental and Molecular Medicine (CEMM), Amsterdam UMC, Location Academic Medical Center, Meibergdreef 9, Amsterdam 1105 AZ, the Netherlands; e-mail, m.[email protected]nl.Author Contributions: Conception and design: P. Nanayakkara, K. Paranjape, M. Schinkel.Analysis and interpretation of the data: P. Nanayakkara, K. Paranjape.Drafting of the article: P. Nanayakkara, K. Paranjape, M. Schinkel.Critical revision for important intellectual content: P. Nanayakkara, M. Schinkel.Final approval of the article: P. Nanayakkara, K. Paranjape, M. Schinkel.Administrative, technical, or logistic support: P. Nanayakkara, K. Paranjape, M. Schinkel.Collection and assembly of data: P. Nanayakkara, K. Paranjape.This article was published at Annals.org on 14 March 2023. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics LatestKeywordsArtificial intelligenceHealth careInformation technology ePublished: 14 March 2023 Copyright & PermissionsCopyright © 2023 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...

Michiel Schinkel

Ketan Paranjape

Prabath Nanayakkara

Written by Humans or Artificial Intelligence? That Is the Question

人类撰写还是人工智能创作？这是个问题

Alina Kurolap

Chofit Chai Gadot

Orly Eshach Adiv

Tova Hershkovitz

Emily Avitan-Hersh

Ludovic Martin

Helene Humeau

Ulrich A. Schatz

Dominik S. Westphal

Silvia Lobmaier

Efrat Sofrin-Drucker

Patrick Stafler

Joshua Bugis

Irit Chermesh

Emilia Hardak

Polina Geva

Yaniv Zohar

Dov Hershkovitz

Adi Mory

Sumit Chatterji

Shoshana Greenberger

Michal Shteinberg

Hagit Baris Feldman

Impaired Wnt/Planar Cell Polarity Signaling in Yellow Nail Syndrome

黄甲综合征中Wnt/平面细胞极性信号受损

Claire L. Vale

Peter J. Godolphin

David J. Fisher

Julian P.T. Higgins

Alexandra McAleenan

Francesca Spiga

Tobias Tritschler

Pedro Gabriel Melo de Barros e Silva

David D. Berg

Jeffrey S. Berger

Lindsay R. Berry

Behnood Bikdeli

Marc Blondon

Erin A. Bohula

Marco Cattaneo

Riccardo Colombo

Valeria Coluccio

Maria T. DeSancho

Michael E. Farkouh

Valentin Fuster

Massimo Girardis

Judith S. Hochman

Thomas P. Jensen

Vivekanand Jha

Peter Jüni

Ajay J. Kirtane

Patrick Lawler

Grégoire Le Gal

Ramon Lecumberri

Steven R. Lentz

Renato D. Lopes

Elizabeth Lorenzi

Marco Marietta

Carlos Henrique Miranda

Nuccia Morici

Susan C. Morpeth

David A. Morrow

Zoe K. McQuilten

Nuria Muñoz-Rivas

Matthew D. Neal

Suman Pant

Sahil A. Parikh

Usha Perepu

Parham Sadeghipour

Sanjum Sethi

Michelle Sholzberg

Alex C. Spyropoulos

Gregg W. Stone

Azita Hajhossein Talasaz

Steven Tong

James Totterdell

Balasubramanian Venkatesh

Maddalena Alessandra Wu

Ryan Zarychanski

Stephane Zuily

Julie Viry

Jamie Rylance

Neill K.J. Adhikari

Janet V. Diaz

John C. Marshall

Jonathan A.C. Sterne

Srinivas Murthy

Anticoagulation Among Patients Hospitalized for COVID-19

COVID-19住院患者中的抗凝治疗

Merlin Kochunilathil

Annals Graphic Medicine - Medical School: Standardized Patient Feedback

《年鉴：图形医学 - 医学院：标准化病人反馈》

Claire N. Shappell

George L. Anesi

Anticoagulation for COVID-19: Seeking Clarity and Finding Yet More Gray

COVID-19的抗凝治疗：寻求清晰，却发现更多灰色地带

Jeremy B. Sussman

Linnea M. Wilson

James F. Burke

Boback Ziaeian

Timothy S. Anderson

Clinical Characteristics and Current Management of U.S. Adults at Elevated Risk for Heart Failure Using the PREVENT Equations: A Cross-Sectional Analysis

使用PREVENT方程评估美国成年人心力衰竭高风险患者的临床特征及当前管理：一项横断面分析

Abbreviation	Ann Intern Med
Journal Impact	19.43
Quartiles(Global)	MEDICINE, GENERAL & INTERNAL(Q1)

ISSN	0003-4819, 1539-3704
h-index	433
Top Journals	Yes

Publication Information	Publisher: American College of Physicians，Publishing cycle: Semimonthly，Journal Type: journal，Open Access Journals: No
Basic data	Year of publication: 1945，Proportion of original research papers: 81.94%，Self Citation Rate:2.60%， Gold OA Rate: 0.44%
Average review cycle	网友分享经验：一般,3-8周
Average recruitment ratio	网友分享经验：很难

Annals of Internal Medicine

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