BRITISH JOURNAL OF HOSPITAL MEDICINE 成立于 1966 年，至今仍忠实于它的起源：一份针对医院医生和培训医生的月度、同行评审、多学科评审期刊。该期刊发表临床评论、教育和培训更新的权威组合、质量改进项目和案例报告，以及业内公认领导者的书评。医生的核心培训部分以易于访问的格式为接受培训的医生提供临床信息。英国医院医学杂志是医院医生在其职业生涯各个阶段的宝贵资源。该杂志被 MEDLINE、CINAHL、伊比利亚美洲社会索引DE INFORMACIÓN CIENTÍFICA 和 SCOPUS。

The British Journal of Hospital Medicine was established in 1966 and remains true to its origins as a monthly, peer-reviewed, multidisciplinary journal for hospital doctors and trainees. The journal publishes a reputable mix of clinical reviews, authoritative updates on education and training, quality improvement projects, case reports, and book reviews by recognized leaders in the field. The core training section provides clinical information in an accessible format for trainee doctors. The British Journal of Hospital Medicine is a valuable resource for hospital doctors at all stages of their careers and is indexed in MEDLINE, CINAHL, the Iberian American Scientific Information Index, and SCOPUS.

《British Journal of Hospital Medicine》成立于1966年，至今仍忠实于其创办宗旨：为医院医生和培训医生提供一份月度、同行评审的多学科期刊。该期刊发表临床评论、教育与培训更新的权威文章、质量改进项目和案例报告，以及业内公认领导者的书评。期刊的核心培训部分以易于理解的格式为在职培训医生提供临床信息。《British Journal of Hospital Medicine》是医院医生在职业生涯各个阶段的重要资源，已被MEDLINE、CINAHL、Iberian American Scientific Information Index和SCOPUS等数据库收录。

British journal of hospital medicine (London, England : 2005)

Medical errors resulting in treatment-related harm have been a challenge for many years, with particularly severe consequences in surgery. Efforts to improve safety should focus on system-based changes to response and rescue pathways, and will require further research and adequate engagement by clinical staff.

William Plath

Peter McCulloch

British Journal of Hospital Medicine

Br J Hosp Med

Quality and safety interventions in surgery

手术中的质量和安全干预措施

Attention deficit hyperactivity disorder is a persistent, pervasive neurodevelopmental disorder, characterised by the core features of hyperactivity, impulsivity and inattention. While previously thought to be a condition that only affects children, it is now well recognised that in a significant proportion of cases both symptoms and associated impairment will persist into adulthood. Nevertheless, many cases are missed or misdiagnosed because of the lack of awareness of attention deficit hyperactivity disorder as a potential diagnosis in adults, the number of symptoms that overlap with other psychiatric conditions, and the high rates of comorbidity. However, once correctly diagnosed, attention deficit hyperactivity disorder responds well to treatment, particularly pharmacological intervention. This article gives an overview of attention deficit hyperactivity disorder with special emphasis on the diagnosis and pharmacological treatment of attention deficit hyperactivity disorder in adults.

Joe Johnson

Sarah Morris

Sanju George

Attention deficit hyperactivity disorder in adults: what the non-specialist needs to know

成人注意缺陷多动障碍：非专科医生需要了解的内容

Large bowel obstruction is most commonly due to colorectal carcinoma, diverticular disease or volvulus. Rare causes of large bowel obstruction like endometriosis may occur in premenopausal women and diagnosis of large bowel endometriosis can be challenging to confirm preoperatively. Hence, clinicians should maintain a high index of suspicion for rare causes of large bowel obstruction like endometriosis. This may require complete surgical resection of the involved bowel to eliminate the risk of local recurrence.

Sridhar Dharmavaram

Sudhakar Unnam

Moses Amarjothi Joacquim

Rectosigmoid Endometriosis Causing Large Bowel Obstruction

直肠乙状结肠子宫内膜异位症致大肠梗阻

Gladman

Stroke units: are they cost effective?

卒中单元：它们是否具有成本效益？

J Wales

Slides in Pediatric Medicine .1.

儿科医学中的幻灯片 .1.

Aims/Background The clinical presentation of non-lactational mastitis (NLM) shares similarities with some symptoms and examination results of breast cancer (BC), which can lead to misdiagnosis or delayed treatment. Current studies on breast lesions mostly focus on the diagnostic performance of a single imaging technique. This study aims to construct a discrimination diagnostic model for NLM and BC based on such imaging features as ultrasound and magnetic resonance imaging (MRI) and to validate the application value of the model, assisting clinicians in improving disease diagnosis and refining medical decisions. Methods This study is a retrospective analysis. Clinical data of 108 patients suspected of NLM based on imaging diagnosis, admitted to The First Affiliated Hospital with Nanjing Medical University between May 2018 and August 2023, were collected. Among them, 94 cases were pathologically confirmed as NLM and 14 cases as BC. Univariate and multivariate logistic regression analyses were performed on the patients’ clinical data, ultrasound features, and MRI features to select the risk factors for discriminating NLM and BC, and construct a discrimination model. The discrimination performance of the model was analyzed with the receiver operating characteristic (ROC) curve, decision curve analysis (DCA), and calibration curve. Results In the NLM group, there were 24 cases of granulomatous lobular mastitis (25.53%) and 70 cases of plasma cell mastitis (74.47%). In the BC group, there were 2 cases of infiltrating ductal carcinoma, 2 cases of atypical hyperplasia, 3 cases of papillary carcinoma, and 7 cases of ductal carcinoma in situ. Age, internal blood flow, calcification, edge, enhancement characteristics, apparent diffusion coefficient (ADC) values, and time-intensity curve (TIC) type were independent factors for differentiating NLM and BC (p &lt; 0.05). The ROC analysis showed that the area under the curve of the model for discriminating NLM and BC was 0.920. The DCA results showed that the model had high net benefits for discriminating NLM and BC. The calibration curve analysis showed that the model had good consistency with the actual diagnosis of NLM and BC, with a chi-square value of 4.545 and a p-value of 0.155 according to the Hosmer–Lemeshow test. Conclusion Age, internal blood flow, calcification, edge, enhancement characteristics, ADC, and TIC curve types are important factors in distinguishing NLM and BC, and the model based on the above characteristics to distinguish NLM and BC has a high net benefit in distinguishing the two.

Jinjuan Peng

Meng Zhao

Shui Wang

Discrimination Model Construction for Non-Lactational Mastitis and Breast Cancer Based on Imaging Features

基于影像特征的非哺乳期乳腺炎与乳腺癌鉴别模型构建

Aims/Background The connection between lymph node (LN) metastases in papillary thyroid carcinoma (PTC) and chronic lymphocytic thyroiditis (CLT) has been examined in a number of prior investigations. However, there is ongoing debate over the effect of CLT on LN metastasis in PTC. In order to explain the relationship between CLT and LN metastasis more convincingly, we aimed to retrospectively review clinical data to investigate the correlation between CLT and LN metastasis in PTC using propensity score matching (PSM). Methods Data on PTC patients at Wenzhou Central Hospital were collected retrospectively between 1 January 2018, and 31 March 2022. The patients were split into two groups based on whether they had CLT or not. The clinicopathological characteristics of the two groups were compared using a PSM analysis. The relationship between CLT and LN metastases was analyzed using logistic regression analysis. Results Among the 773 PTC patients collected and examined, 213 showed simultaneous CLT. Prior to PSM, patients with CLT displayed a significantly lower incidence of LN metastasis (34.3% VS 44.8%, p = 0.008), a lower metastatic LN ratio (0 (0, 0.17) VS 0 (0, 0.38), p = 0.011), and a greater number of LNs dissected (7 (5, 11) VS 5 (3, 7), p &lt; 0.001). These differences persisted after the PSM of 208 pairs. After PSM, patients with CLT displayed a significantly lower incidence of LN metastasis (35.0% VS 44.7%, p = 0.045), a lower metastatic LN ratio (0 (0, 0.17) VS 0 (0, 0.33), p = 0.038), and a higher number of dissected LNs (7 (5, 11) VS 5 (3, 7), p ≤ 0.001). Additionally, the multivariate logistic regression analysis indicated that CLT had a protective role against LN metastasis in both the matched group (odds ratio (OR), 0.62; 95% confidence interval (CI): 0.39–0.96; p = 0.032) and the unmatched group (OR, 0.63; 95% CI: 0.44–0.91; p = 0.014). Conclusion Our data indicate that CLT may protect against LN metastases in patients with PTC. Patients having PTC with coexisting CLT have fewer LN metastases, a greater number of LNs dissected, and a lower metastatic LN ratio.

Jian Yu

Xiaoyang Li

Zhijian He

Jie He

Shangrui Rao

Chronic Lymphocytic Thyroiditis is a Protective Factor for Lymph Node Metastasis in Papillary Thyroid Carcinoma: A Propensity Score Matching Analysis

慢性淋巴细胞性甲状腺炎是甲状腺乳头状癌淋巴结转移的保护因素：倾向评分匹配分析

Lesions with central hypointensity and peripheral contrast enhancement are defined as ring-enhancing lesions. The aetiologies of ring-enhancing lesions may be various, including infections, tumours, demyelinating diseases, treatment-related conditions and hematoma. The imaging findings and their distinguishing features also vary among different ring-enhancing lesions. This review examines the magnetic resonance imaging findings of different ring-enhancing lesions and their distinguishing features.

Elif Peker

Sena Ünal

Sena Bozer Uludağ

Nil Sezer Yılmazer Zorlu

Ring-Enhancing Lesions—Differentiation with MRI

环增强病变——MRI鉴别诊断

Aims/Background Hematospermia, characterized by blood in the ejaculate, is a common and distressing condition in urology. Identifying the underlying causes, including translucent membranes in the prostatic utricle, is crucial for effective management. Despite advancements in diagnostic techniques, reliable predictive tools are needed to enhance preoperative planning and patient outcomes. This study aimed to develop a novel nomogram to predict the presence of translucent membranes in the prostatic utricle of hematospermia patients. Methods In total, 284 patients were selected from The Second People’s Hospital of Hefei database based on inclusion and exclusion criteria. The cohort was divided into a training set (198 patients) and a validation set (86 patients). To identify risk factors associated with the prostatic utricle translucent membrane, multivariable logistic regression analysis was employed. The identified risk factors were then used to construct a predictive nomogram model. The performance of the nomogram was evaluated using several statistical tools: receiver operating characteristic (ROC) curves to assess discriminative ability, calibration curves to evaluate prediction accuracy, and decision curve analysis (DCA) to determine clinical utility. Results The findings revealed that age, duration of disease, history of seminal vesiculitis, and seminal vesicle dimensions (width, length, and thickness) were independent risk factors for the presence of a prostatic utricle translucent membrane in patients with hematospermia. Using these variables, a nomogram was developed. The nomogram demonstrated strong predictive capability, as evidenced by its performance in ROC and calibration curve analyses. Furthermore, the DCA indicated that the nomogram offered significant clinical net benefits in predicting the presence of a translucent membrane. Conclusion Clinical use of the developed nomogram can assist clinicians in identifying patients with hematospermia who have translucent membrane in the prostatic utricle and in developing individualized treatment.

Lang Wang

Zhen Wang

Mingmin Shao

Zhenzhen Jia

Zhiwen Huang

Mingming Lu

Junfeng Jing

Yanbin Zhang

Identifying Prostatic Utricle Translucent Membrane in Hematospermia Patients Using a Novel Nomogram

使用新型诺模图识别血精症患者前列腺囊透明膜

Aims/Background Both membranous nephropathy (MN) and immunoglobulin A nephropathy (IgAN) are immune complex-mediated glomerular diseases, but the concurrent occurrence of these two conditions in the same patient is not common, a phenomenon that is currently not supported by clinical data in terms of treatment and prognosis. This study explores the clinical and pathological characteristics, as well as the treatment outcomes, of patients affected by MN and IgAN simultaneously. Methods The clinical data, pathological features, and diagnostic and therapeutic information of seven cases of MN complicated by IgAN, treated between December 2015 and December 2022, were retrospectively analyzed. Results Among the seven cases, there were two male and five female patients, with an average age of 57.3 ± 9.2 years. All patients presented with clinical manifestations of proteinuria and edema upon admission, with an average 24-hour urine protein of 3716.6 ± 1519.4 mg/24 h. Phospholipase A2 receptor (PLA2R) expression was detected in all seven cases, and nephrotic syndrome was clinically diagnosed in five cases. Additionally, all seven cases showed microscopic hematuria, with intermittent gross hematuria in two cases. All seven patients included in this study underwent renal biopsy. After disease staging, the patients had MN stages I–III and IgAN stages II–III. Pathological findings revealed abnormal glomerular basement membrane (GBM) and diffuse immunoglobulin G (IgG) deposition in the subepithelial space, predominantly of the IgG4 subtype. Simultaneously, there was diffuse mesangial zone deposition of immunoglobulin A (IgA) to varying degrees, co-localization of complement component C3 and IgA, and mesangial cell proliferation. Treatment strategies included angiotensin-converting enzyme inhibitors (ACEI) or angiotensin receptor blockers (ARB) in combination with steroids or immunosuppressive therapies such as tacrolimus, cyclophosphamide, and rituximab. After 2–6 months of treatment, all patients achieved complete remission with a favourable prognosis. Conclusion MN accompanied by IgAN tends to occur more frequently in middle-aged and elderly individuals, with a relatively low incidence. The latent feature of the comorbidities manifests as a form of IgAN superimposed on the background of MN. Utilizing ACEI or ARB in combination with steroids or various immunosuppressive therapies represents a potentially effective treatment strategy.

Beilei Xu

Qiuhong Bao

Wei Shen

Quxia Hong

Clinicopathological Features of Membranous Nephropathy Complicated by IgA Nephropathy: A Retrospective Analysis of Seven Cases

膜性肾病合并IgA肾病的临床病理特征：七例回顾性分析

短名	Br J Hosp Med
Journal Impact	0.92
国际分区	MEDICINE, GENERAL & INTERNAL(Q3)
期刊索引	SCI Q4中科院 4 区

ISSN	0007-1064, 1750-8460, 1759-7390
h-index	34
国内分区	医学(4区)医学医学内科(4区)

出版信息	出版商: MA Healthcare Ltd，出版周期: ，期刊类型: journal，开源期刊: 否
基本数据	创刊年份: 2005，原创研究文献占比: ，自引率:， Gold OA占比:

British journal of hospital medicine (London, England : 2005)

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