Chinese Medical Journal[JOURNAL]
Sun
200 papers
Age of onset by temporal and spatial changes and prognostic value for esophageal cancer.
Zhong K, Song X, Zhao X … +19 more , Meng X, Wang R, Wei M, Ma L, Xu Q, Ku J, Zhang D, Lei L, Han W, Xu R, Huang J, Liu Y, Fan Z, Han X, Wang X, Li A, Luo H, Li B, Wang L
Chin Med J (Engl) · 2026 Jul · PMID 42401993 · Publisher ↗
BACKGROUND: Age plays a crucial role in the incidence and prognosis of esophageal cancer. In China, the age distribution of patients with esophageal cancer remains unclear, and comprehensive large-scale studies on its pr...
BACKGROUND: Age plays a crucial role in the incidence and prognosis of esophageal cancer. In China, the age distribution of patients with esophageal cancer remains unclear, and comprehensive large-scale studies on its prognostic impact are lacking. METHODS: Using a cohort of 294,523 patients with esophageal cancer, we compared onset age distributions across clinicopathological characteristics (χ2 test). Trends in the proportion of patients diagnosed under 60 years were analyzed using linear regression. Survival differences by age were assessed via Kaplan-Meier analysis and Cox regression (univariate and multivariate). Directed acyclic graphs defined causal relationships. Robustness was evaluated using multiple imputation and sensitivity analyses. Subgroup and propensity score matching analyses addressed confounding. Restricted cubic spline models explored nonlinear relationships between age and surgery rates, overall mortality risk, and perioperative mortality. RESULTS: The proportion diagnosed under age 60 years significantly declined over time (P <0.05, R2 = 0.96), with this younger demographic being more prevalent among males, high-incidence area, smokers, alcohol consumers, and those with family history (all P <0.001). Surgical rates decreased sharply beyond age 62 years. Advanced age was an independent predictor of poorer survival, with surgery offering the best prognosis compared with radiochemotherapy and untreated, supported by subgroup and post-propensity score matching survival analyses. Mortality risk increased most rapidly with age in untreated patients (inflection at 65 years), followed by radiochemotherapy (63 years) and surgery (60 years), while perioperative mortality rose steeply beyond age 60 years. CONCLUSIONS: Male, residence in high-incidence area, smoking, alcohol intake, and positive family history were associated with earlier onset age of esophageal cancer; the proportion of patients under 60 years old declined significantly over time. While advanced age independently predicted poorer survival, it should not absolutely contraindicate surgery. A precise perioperative risk assessment system is crucial to balance surgical benefits and risks in the elderly.
Secular trends in society-, school-, and individual-level factors related to physical activity and their associations with elevated blood pressure among 0.6 million children and adolescents.
Liu J, Song X, Ma Q … +12 more , Jiang J, Zhang Y, Wang R, Dong Z, Chen L, Qin Y, Yuan W, Guo T, Song Z, Ma J, Dong Y, Song Y
Chin Med J (Engl) · 2026 Jul · PMID 42401992 · Publisher ↗
BACKGROUND: Physical activity (PA) is a key modifiable factor for elevated blood pressure (EBP). We aimed to clarify the evolving relationships between PA and EBP in childhood or adolescence by examining multilevel facto...
BACKGROUND: Physical activity (PA) is a key modifiable factor for elevated blood pressure (EBP). We aimed to clarify the evolving relationships between PA and EBP in childhood or adolescence by examining multilevel factors within an ecological model. METHODS: National data were extracted from 2010, 2014, and 2019 cycles of the Chinese National Survey on Students' Constitution and Health, using a multistage stratified cluster sampling design. We defined EBP by the updated Chinese reference standards and obesity by sex- and age-specific body mass index (BMI) cutoffs. Inadequate PA was defined as <1 h/day; ecological factors at society-, school-, and individual-level were collected through a questionnaire. Multilevel logistic regression, interaction analyses, and population-attributable fractions were used to evaluate associations between multilevel ecological factors related to PA and EBP. RESULTS: We included 642,386 participants (7-18 years). The EBP prevalence increased from 13.6% to 17.9% alongside increasing obesity, while inadequate PA decreased in prevalence. Inadequate PA was associated with EBP in 2010, with the odds ratio (OR) of 1.17 (95% confidence interval [CI]: 1.04, 1.21) but attenuated during 2010-2019. The multilevel factors related to PA displayed interactions to reduce EBP risk (P for interaction <0.05). At the societal-level, urban residence was protective against EBP, whereas a lack of exercise facilities increases the odds. At the school-level, inadequate physical education and sports competitions, coupled with unhealthy dietary lifestyles at the individual-level, contributed to EBP (P <0.05). The contributions of individual-level ecological factors related to PA decreased but of societal- and school-level increased on EBP, independent of obesity. CONCLUSIONS: A rise in EBP burdens during 2010-2019 contrasted with an increase in PA. PA-related ecological factors across society-, school-, and individual-level exhibited complex interactions on EBP. Although the impact of individual-level lifestyles on EBP was waning and obesity remained a primary concern, there was increased recognition of societal- and school-level's ecological factors related to PA during 2010-2019. Promoting PA requires a comprehensive approach that addresses both facilitating and inhibiting factors, which is crucial for healthy blood pressure (BP).
Role of incretins in Alzheimer's disease and their impact on behavioral aspects.
Yang J, Mao T, Gao L
Chin Med J (Engl) · 2026 Jun · PMID 42381275 · Publisher ↗
Recent studies highlight the therapeutic potential of glucagon-like peptide-1 (GLP-1) and glucose-dependent insulinotropic peptide (GIP), two key incretin components, in neurodegenerative diseases, particularly Alzheimer...
Recent studies highlight the therapeutic potential of glucagon-like peptide-1 (GLP-1) and glucose-dependent insulinotropic peptide (GIP), two key incretin components, in neurodegenerative diseases, particularly Alzheimer's disease (AD). Although the incretin pathway may also affect other neurodegenerative conditions, this discussion focuses on AD. The therapeutic benefits are largely attributed to their role in enhancing energy metabolism. In vivo and in vitro studies have demonstrated that GLP-1 and GIP exert neuroprotective effects through the inhibition of oxidative stress, neuroinflammation, and neuronal apoptosis, while improving cellular metabolic function. Additionally, an emerging but often overlooked body of evidence suggests that incretin may influence human behaviors, such as eating habits, sleep patterns, physical activity, and vulnerability to substance addiction. These behavioral changes could, in turn, support neural regeneration through various molecular mechanisms. This article summarizes recent advancements in the understanding of incretin's influence on human behavior and its implications for AD.
Asparagine-linked glycosyltransferase 6 deficiency suppresses tumorigenesis in clear cell renal cell carcinoma by regulating apoptosis and immunotherapy sensitivity.
Cui Z, Wang N, Liu Z … +1 more , Chen S
Chin Med J (Engl) · 2026 Jun · PMID 42374693 · Publisher ↗
BACKGROUND: Clear cell renal cell carcinoma (ccRCC) is the most common subtype of renal cell carcinoma (RCC) with a poor prognosis in advanced stages. One of the major challenges in ccRCC treatment is the resistance to t...
BACKGROUND: Clear cell renal cell carcinoma (ccRCC) is the most common subtype of renal cell carcinoma (RCC) with a poor prognosis in advanced stages. One of the major challenges in ccRCC treatment is the resistance to tyrosine kinase inhibitors or immune checkpoint inhibitors. Asparagine-linked glycosyltransferase 6 (ALG6) is a glycosyltransferase whose biological role in tumorigenesis remains largely unknown. Therefore, this study aims to investigate its function in ccRCC and its potential involvement in therapeutic resistance. METHODS: We first analyzed 32 paired ccRCC and adjacent normal tissues from Shandong Provincial Hospital, correlating ALG6 expression with clinicopathological features (age, sex, tumor size, Tumor-Node-Metastasis [TNM] stage). In vitro, CCK-8, colony formation, and apoptosis assays were performed to assess the functional role of ALG6 in ccRCC cell lines. In vivo, a subcutaneous C57BL/6J mouse model and flow cytometry was used to evaluate the effect of ALG6 on the immune microenvironment and anti-PD-1 antibody sensitivity. RESULTS: In this study, we found that ALG6 was significantly overexpressed in ccRCC. Elevated ALG6 expression was positively correlated with tumor size and TNM stage, but negatively associated with overall survival in patients with ccRCC. Functional experiments demonstrated that downregulation of endogenous ALG6 markedly suppressed ccRCC cell viability and promoted apoptosis both in vitro and in vivo. Mechanistically, knockdown of ALG6 triggered endoplasmic reticulum (ER) stress, as evidenced by the upregulation of glucose-regulated protein 78 (GRP78) and activation of C/EBP homologous protein (CHOP) in ccRCC cells. Notably, knockdown of ALG6 significantly reduced programmed cell death ligand 1 (PD-L1) expression by inhibiting PD-L1 glycosylation and promoting its ubiquitin-mediated degradation. Furthermore, in vivo experiments demonstrated that ALG6 depletion destabilized PD-L1, enhanced antitumor T-cell immunity, and improved the therapeutic efficacy of anti-PD-1 treatment. CONCLUSIONS: This study demonstrates that downregulation of ALG6 induces ER stress-mediated apoptosis and enhances antitumor immunity by regulating PD-L1 expression in ccRCC. These findings suggest that ALG6 may serve as a potential therapeutic target for ccRCC.
Impact of joint effect of parental anthropometrics on fetal growth trajectories: A national multicenter cohort study.
Liu Y, Ma J, Wang J … +22 more , Zhang L, You Y, Wei H, Zuo X, Zhou Y, Xing X, Meng Z, Lyu Q, Liu Z, Zhang J, Hu L, Li J, Li L, Chen C, Liu C, Sun G, Liu A, Chen J, Lyu Y, Zhao Y, Wei Y, Wu T
Chin Med J (Engl) · 2026 Jun · PMID 42374651 · Publisher ↗
Abstract loading — click title to view on PubMed.
[Clinical analysis of ultrasound-guided percutaneous sclerotherapy combined with radiofrequency ablation in the treatment of intrahepatic biliary cystadenoma].
Wu J, Zhang YA, Dong G … +1 more , Sun JM
Zhonghua Yi Xue Za Zhi · 2026 Jun · PMID 42373473 · Publisher ↗
Intrahepatic bile duct cystadenoma(IBC) is rare in clinic, and some patients can not tolerate or refuse surgical treatment.The clinical data of patients with IBC who underwent ultrasound-guided percutaneous sclerotherapy...
Intrahepatic bile duct cystadenoma(IBC) is rare in clinic, and some patients can not tolerate or refuse surgical treatment.The clinical data of patients with IBC who underwent ultrasound-guided percutaneous sclerotherapy combined with radiofrequency ablation (RFA) in the First Affiliated Hospital of Zhengzhou University from January 2020 to November 2024 were retrospectively analyzed. A total of 11 patients were included, including 1 male and 10 females, aged from 35 to 73 years. All the 11 patients successfully completed the operation, and the postoperative complication rate was 36.4%, all of which were Clavien-Dindo grade Ⅰ. The median follow-up time was 36 months (range, 12-66 months), and the last follow-up date was December 1, 2025. One patient had recurrence one month after operation and was treated with ultrasound-guided sclerotherapy combined with RFA again. Up to the last follow-up, the patient had no recurrence or malignant transformation. There was no recurrence or malignant transformation in the remaining 10 patients.There were statistically significant differences in the volume of lesions between before operation and 1, 3, 6, 12 months after operation (all 0.05), and there were statistically significant differences in the reduction rate of lesion volume between 1 month after operation and 3, 6, 12 months after operation (all 0.05).This pilot study shows that ultrasound-guided sclerotherapy combined with RFA is safe and effective in the treatment of IBC.
[Metabolic profiles in umbilical cord blood associated with neonatal brain injury in selective fetal growth restriction].
Su ZY, Huang NN, Li YX … +6 more , Yuan PB, Yu Y, Sun XY, Liu JY, Zhao YY, Yang J
Zhonghua Yi Xue Za Zhi · 2026 Jun · PMID 42373472 · Publisher ↗
This study aimed to analyze metabolic characteristics of the umbilical cord blood associated with brain injury in neonates with selective fetal growth restriction (sFGR). A prospective cohort of 30 sFGR twin pairs delive...
This study aimed to analyze metabolic characteristics of the umbilical cord blood associated with brain injury in neonates with selective fetal growth restriction (sFGR). A prospective cohort of 30 sFGR twin pairs delivered at Peking University Third Hospital between September 2017 and December 2019 was enrolled. Maternal-fetal clinical data and information on neonatal complications, including brain injury, were collected for both the growth-restricted (sFGR-S) and larger (sFGR-L) fetuses. The mean maternal age at delivery was (30.7±3.9) years, and the mean gestational age at delivery was (32.7±2.2) weeks. Among the 30 sFGR cases, there were 12 cases of type Ⅰ, 11 type Ⅱ, and 7 type Ⅲ. The cohort comprised 30 male and 30 female neonates (50% each). Brain injury occurred in 12 (40%) of the sFGR-S group, including 7 cases of intracranial hemorrhage (IVH), 3 cases of periventricular leukomalacia (PVL), and 2 case with both. In the sFGR-L group, brain injury occurred in 9 (30%) neonates, including 6 cases of IVH, 2 cases of PVL, and 1 case with both. Receiver operating characteristic (ROC) curve analysis for the sFGR-S group yielded an area under the curve (AUC) of 0.853 (95%: 0.698-1.000) for tyrosine alone, and an AUC of 0.944 (95%: 0.859-1.000) for the combination of tyrosine and myristic acid. For the sFGR-L group, the AUC was 0.880 (95%: 0.708-1.000) for S-adenosyl methionine (SAM) alone, and 0.917 (95%: 0.749-1.000) for the combination of SAM and trans-vaccenic acid. In conclusion, neonates in the sFGR-S and sFGR-L groups exhibit distinct metabolic profiles, and differential metabolites with their related pathways hold potential predictive value for neonatal brain injury.
[Relationship between the consistency of auxiliary provocation tests with the supine roll test and treatment outcomes for horizontal semicircular canal benign paroxysmal positional vertigo].
Yun YN, Yun ZX, Xu XY … +4 more , Yang P, Li L, Chang HM, Xing JL
Zhonghua Yi Xue Za Zhi · 2026 Jun · PMID 42373471 · Publisher ↗
To explore the consistency of lateralization of the head-shaking test (HST), lying-down test (LDT), and rapid axial roll test (RART) with the supine roll test (SRT), and to investigate their relationship with repositioni...
To explore the consistency of lateralization of the head-shaking test (HST), lying-down test (LDT), and rapid axial roll test (RART) with the supine roll test (SRT), and to investigate their relationship with repositioning efficacy in patients with horizontal semicircular canal benign paroxysmal positional vertigo (HC-BPPV). Patients diagnosed with primary HC-BPPV using SRT and Dix-Hallpike test at the First Affiliated Hospital of Xi'an Jiaotong University between December 1, 2021 and June 30, 2024 were prospectively enrolled. Based on the order of their visits, all patients were semi-randomly assigned to subgroups to undergo the HST, LDT, or RART as auxiliary provocative tests. The nystagmus elicitation rates of the three tests and their consistency with SRT-based lateralization were compared, and the relationship between lateralization consistency and repositioning efficacy was analyzed. A total of 585 patients with HC-BPPV were included in the study: 199 cases in the HST group, 190 cases in the LDT group, and 196 cases in the RART group. There were no statistically significant differences in sex, age, body mass index, disease duration, and lesion side among the three groups (all >0.05). The nystagmus elicitation rate of RART (99.0%, 194/196) was higher than that of HST (31.7%, 63/199) and LDT (56.8%, 108/190), with statistically significant differences (both <0.017). The consistency rate of lateralization between RART and SRT (86.7%, 170/196) was higher than that of HST (17.6%, 35/199) and LDT (44.2%, 84/190), and there were statistically significant differences (both <0.017). The impact of lateralization distribution between auxiliary provocation tests and SRT on repositioning efficacy in HC-BPPV was analyzed. The results showed that the cure rate of the consistent lateralization group (92.4%, 267/289) was higher than that of the inconsistent lateralization group (55.3%, 30/76) and the nystagmus non-elicitation group (63.2%, 139/220), with statistically significant differences (both <0.017). In addition, the cure rate of the RART and SRT lateralization consistent group (98.2%, 167/170) was higher than that of the LDT group (88.1%, 74/84) and the HST group (74.3%, 26/35), with statistically significant differences (both <0.017). RART can serve as an effective auxiliary provocation test for the SRT, enhancing the accuracy of determining the affected side in HC-BPPV through a "dual verification" approach and providing valuable reference for clinical assessment.
[Early-and mid-trimester glycolipid metabolism indicators for predicting adverse pregnancy outcomes in normoglycemic women].
Zhang H, Shi CH, Sun XN … +2 more , Zhang J, Li H
Zhonghua Yi Xue Za Zhi · 2026 Jun · PMID 42373470 · Publisher ↗
To explore the predictive value of early-and mid-trimester glycolipid metabolic indicators for adverse pregnancy outcomes in pregnant women with normal glucose levels. A total of 12 457 pregnant women admitted to Yantai...
To explore the predictive value of early-and mid-trimester glycolipid metabolic indicators for adverse pregnancy outcomes in pregnant women with normal glucose levels. A total of 12 457 pregnant women admitted to Yantai Yantaishan Hospital from January 2020 to December 2024 were retrospectively included. According to the occurrence of adverse pregnancy outcomes, they were divided into an adverse pregnancy outcome group (=852) and a normal pregnancy outcome group (=11 605). General data, pregnancy-related information, lipid profile, and fasting plasma glucose (FPG) in early pregnancy (gestational age≤14 weeks; T1), and oral glucose tolerance test (OGTT) results in the second trimester (24-28 weeks; T2) were compared between the two groups. The participants were randomly assigned to a training set (=8 712) and a validation set (=3 745) in a 7∶3 ratio. Multivariable logistic regression was applied in the training set to identify independent risk factors for adverse pregnancy outcomes, and a nomogram prediction model was constructed. The area under the receiver operating characteristic curve (AUC), calibration curve, and decision curve were used to evaluate the discrimination, calibration, and clinical applicability of the model, respectively. The overall age was (30.9±3.8) years, BMI was (22.77±2.12) kg/m², T1 FPG was (4.43±0.29) mmol/L, T2 FPG was (4.51±0.27) mmol/L, the second-trimester 1 h glucose was (8.54±0.43) mmol/L, and the second-trimester 2 h glucose was (7.10±0.54) mmol/L. Multivariable logistic regression analysis showed that age (=1.126, 95%: 1.080-1.175), history of adverse pregnancy outcomes (=2.080, 95% 1.023-4.232), ΔMAP (the change in mean arterial pressure from the first to the second trimester) (=1.162, 95% 1.124-1.202), the TG/HDL-C ratio (=18.849, 95%: 11.512-30.862), T1 FPG (=3.191, 95% 2.120-4.803), ΔFPG (T2 FPG-T1 FPG) (=1.154, 95%: 1.036-1.285), ΔT2(1 h-FPG) (T2 1 h glucose-FPG) (=3.427, 95%: 2.674-4.391), and ΔT2(2 h-FPG) (T2 2 h glucose-FPG) (=4.155, 95%: 3.306-5.221) were risk factors for adverse pregnancy outcomes (all <0.05). The AUC of the nomogram was 0.902 (95%: 0.884-0.919) in the training set and 0.895 (95%: 0.877-0.913) in the validation set. The calibration curve showed good agreement between predicted and observed probabilities (Hosmer-Lemeshow test: training set, =0.708; validation set, =0.102), and decision curve analysis indicated a net clinical benefit over a threshold probability range of 0.05 to 0.95. Age, history of adverse pregnancy outcomes, ΔMAP, the TG/HDL-C ratio, and dglycemic dynamic indicators during early and mid-trimester are independent predictors of adverse pregnancy outcomes in pregnant women with normal perinatal glucose levels. The nomogram constructed based on these factors demonstrates good discrimination, calibration, and clinical utility, and can serve as a quantitative tool for early risk identification in this population.
[Value of a deep learning-based visual model for predicting postoperative upper limb functional recovery after severe acute cervical spinal cord injury].
Deng MY, Li WB, Wang QY … +6 more , Li C, Xiong W, Cai BW, Xu LN, Yin GY, Fan J
Zhonghua Yi Xue Za Zhi · 2026 Jun · PMID 42373469 · Publisher ↗
To assess the value of a deep learning-based visual model for predicting postoperative upper limb functional recovery after severe acute cervical spinal cord injury. A retrospective study was conducted involving 162 pat...
To assess the value of a deep learning-based visual model for predicting postoperative upper limb functional recovery after severe acute cervical spinal cord injury. A retrospective study was conducted involving 162 patients with severe acute cervical spinal cord injury treated at the First Affiliated Hospital of Nanjing Medical University between 2020 and 2025. The Upper Extremity Motor Score (UEMS) was used to assess prognosis before treatment and at 6 months post-treatment. Patients with an improvement of ≥10 points were assigned to the good outcome group, and those with an improvement of <10 points to the poor outcome group. Variables showing statistical significance in univariate analysis were taken as initial inputs, and the least absolute shrinkage and selection operator (LASSO) was applied to identify variables associated with prognosis. The patients were divided into a training set (=97), a validation set (=32), and a test set (=33) at a ratio of 6∶2∶2. A predictive model was constructed based on a multilayer perceptron (MLP) and validated on the independent test set. Model performance was evaluated using the area under the receiver operating characteristic curve (AUC), sensitivity, and specificity. Among the 162 patients, 129 were male and 33 were female, with a mean age of (55.5±9.8) years. Based on univariate analysis and LASSO regression, the four variables, i.e., the BASIC score, SCC>50%, preoperative UEMS, and light touch score, were identified. An MLP prediction model was constructed using these four variables. The distributions of risk factors among the training, validation, and test sets were balanced (all >0.05). During model training, the training loss approached 0, while the validation loss gradually decreased and stabilized. In the training set, the AUC (95%) was 0.987 (0.969-0.999), with a sensitivity of 93.33% and a specificity of 89.55%. In the validation set, the AUC (95%) was 0.955 (0.868-1.000), with a sensitivity of 90.00% and a specificity of 95.45%. In the test set, the AUC (95%) was 0.930 (0.830-0.991), with a sensitivity of 80.00% and a specificity of 95.65%. Neural network weight analysis showed that preoperative UEMS was the strongest positive predictor, followed by the light touch score, SCC, and BASIC score; among them, the BASIC score and SCC were negative predictors, while preoperative UEMS and the light touch score were positive predictors. The calibration curve demonstrated good calibration ability of the model. The deep learning prediction model based on MLP demonstrates good predictive performance for predicting upper limb functional outcomes in patients with SACSCI,with preoperative UEMS being the most important predictor.
[Eosinophils and futile recanalization after thrombectomy in acute large vessel occlusion stroke: the mediating effect of malignant brain edema].
Guo CW, Guo ZL
Zhonghua Yi Xue Za Zhi · 2026 Jun · PMID 42373468 · Publisher ↗
To explore the mediating role of malignant brain edema (MBE) in the relationship between eosinophils and futile recanalization after mechanical thrombectomy in patients with acute large vessel occlusion (LVO) stroke. A...
To explore the mediating role of malignant brain edema (MBE) in the relationship between eosinophils and futile recanalization after mechanical thrombectomy in patients with acute large vessel occlusion (LVO) stroke. A retrospective analysis was performed on 399 patients with acute LVO who underwent mechanical thrombectomy in Department of Neurology, the Second Affiliated Hospital of Soochow University from May 2017 to January 2023, all achieving successful recanalization [modified Thrombolysis in Cerebral Infarction (mTICI)≥2b]. Patients were categorized into the ineffective recanalization group and the non-ineffective recanalization group according to the presence or absence of ineffective recanalization, and into the MBE group and the non-MBE group according to the presence or absence of MBE. Futile recanalization was defined as angiographically confirmed recanalization of the occluded vessel after thrombectomy instantly, but with a 90-day modified Rankin Scale (mRS) score of 3-6. Clinical data was collected, including demographic characteristics (age, sex), underlying diseases (hypertension, diabetes, etc.), baseline National Institutes of Health Stroke Scale (NIHSS) score, Alberta Stroke Program Early CT Score (ASPECTS), peripheral blood eosinophil count, and 90-day mRS score. Eosinophils were entered into the model as a -score standardized continuous variable and as a dichotomous variable using a median cutoff of 0.01×109/L(Based on this, it was divided into high eosinophil group and low eosinophil group). Multivariate logistic regression was used to analyze the association between eosinophils and MBE or futile recanalization respectively, and the association between MBE and futile recanalization. Mediation analysis was performed to verify the mediating effect of MBE. Among the 399 patients, there were 229 males and 170 females under the age of (65.5±13.6) years. There were 161 cases (40.35%) in the low eosinophil group and 238 cases (59.65%) in the high eosinophil group. MBE occurred in 84 patients (21.05%), and futile recanalization occurred in 242 patients (60.65%). Multivariate logistic regression analysis showed that lower eosinophil levels were independently associated with an increased risk of MBE [continuous variable: after -score standardization, =0.185 (95%: 0.058-0.589, =0.004); dichotomous variable: =0.136 (95%: 0.062-0.295, <0.001)] and futile recanalization [continuous variable: after score standardization, =0.621 (95%: 0.469-0.821, <0.001); dichotomous variable: =0.206 (95%: 0.109-0.387, <0.001)]; Following thrombectomy, MBE was identified as a risk factor for futile recanalization (=5.286, 95%: 2.054-13.606, <0.001). Mediation analysis revealed that MBE partially mediated the relationship between eosinophils and futile recanalization (indirect effect =-0.229, 95%:-0.688 to -0.057, <0.001), accounting for 12.44% of the total effect. Reduced eosinophils are associated with an increased risk of MBE, and MBE plays a partial mediating role in the association between eosinophils and post-thrombectomy futile recanalization.
[A machine learning diagnostic model for hereditary hearing loss based on and enes: construction and interpretability analysis].
Gu XN, Chen CX, Huang SS … +4 more , Cao ZF, Yang JY, Li XG, Yuan YY
Zhonghua Yi Xue Za Zhi · 2026 Jun · PMID 42373467 · Publisher ↗
To construct a machine learning diagnostic model for hereditary hearing loss based on and genes and perform interpretability analysis using SHapley Additive explanations (SHAP). The data of genetic variants and hearin...
To construct a machine learning diagnostic model for hereditary hearing loss based on and genes and perform interpretability analysis using SHapley Additive explanations (SHAP). The data of genetic variants and hearing status were collected from 1 539 individuals at the Deafness Molecular Diagnosis Center of the Chinese PLA General Hospital from June 2015 to August 2024. Participants were categorized by expert diagnosis as hereditary hearing loss patients or non-hereditary hearing loss individuals, and were randomly assigned to a training set (=1 077) and a test set (=462) in a 7∶3 ratio using a computer-generated random sequence. Using non-zero coefficient variants of and genes screened by least absolute shrinkage and selection operator (LASSO) regression, six machine learning models including logistic regression, decision tree, random forest, gradient boosting (GB), eXtreme Gradient Boosting and k-nearest neighbors were constructed. Model performance was evaluated using the area under the receiver operating characteristic curve (AUC) with the DeLong test, and accuracy, precision, sensitivity, F1 score and specificity were calculated. The best model was compared against intermediate-level physicians to assess its clinical value, and SHAP was applied for interpretation. A total of 748 hereditary hearing loss patients (391 males and 357 females) aged 29 (13, 36) years and 791 non-hereditary hearing loss individuals (405 males and 386 females) aged 27 (12, 36) years were included. LASSO regression yielded 121 non-zero coefficient variants: 34 in the gene and 87 in the gene. The GB model produced an AUC of 0.975 (95%: 0.967-0.983), outperforming each of the other five models (all <0.05). Moreover, the GB model also showed higher precision [98.5% (95%: 97.8%-99.2%) vs 92.6% (95%: 90.4%-94.4%)] and specificity [98.7% (95%: 98.1%-99.3%) vs 93.2% (95%: 91.2%-94.8%)] than intermediate-level physicians (both <0.001). SHAP identified the top 10 impactful variants in the GB model: nine pathogenic variants (: p.Leu79CysfsTer3, p.His100ArgfsTer14, p.Val37Ile, p.Gly59AlafsTer18; : c.919-2A>G, p.His723Arg, p.Asn392Tyr, p.Thr410Met, p.Val659Leu) and one benign variant (: p.Val27Ile). The model tends to diagnose individuals carrying pathogenic homozygous or compound heterozygous variants as hereditary hearing loss patients. The machine learning models incorporating the and genes are of referential value for the auxiliary diagnosis of hereditary hearing loss, with the GB model demonstrating the best diagnostic performance.
[Expert consensus on the implementation and management of multidisciplinary team care for chronic obstructive pulmonary disease(2026 edition)].
Consensus Expert Group for the Implementation and Management of Multidisciplinary Team Care for Chronic Obstructive Pulmonary Disease, Chronic Obstructive Pulmonary Disease Assembly, Chinese Thoracic Society
Zhonghua Yi Xue Za Zhi · 2026 Jun · PMID 42373466 · Publisher ↗
Chronic Obstructive Pulmonary Disease (COPD) is a highly heterogeneous airway disease, and often coexists with other pulmonary and extra-pulmonary diseases. The traditional single-disciplinary approach cannot meet the me...
Chronic Obstructive Pulmonary Disease (COPD) is a highly heterogeneous airway disease, and often coexists with other pulmonary and extra-pulmonary diseases. The traditional single-disciplinary approach cannot meet the medical needs of patients with COPD. A multidisciplinary team (MDT) approach, led by respiratory physicians, has been advocated for the care of patients with COPD, but standardized practice guidelines are still lacking. Therefore, the Chronic Obstructive Pulmonary Disease Assembly of the Chinese Thoracic Society convened experts from relevant fields to reach a consensus based on evidence-based medicine and clinical experience, and formulated 11 recommendations regarding the implementation process, target population, indications, and management of MDT care for COPD. This consensus aims to propose a standardized framework for the implementation and management of MDT, thereby improving the quality of multidisciplinary care for COPD in China.
[Expert consensus on the clinical practice of modified electroconvulsive therapy for outpatients with mental disorders (2026 edition)].
Chinese Psychiatrist Association, Professional Committee of Physical Therapy, Mental Health Association of Guangdong Province
Zhonghua Yi Xue Za Zhi · 2026 Jun · PMID 42373465 · Publisher ↗
Modified electroconvulsive therapy (MECT) is one of the key physical treatments for mental disorders. Despite the rapidly growing demand for outpatient MECT among patients with mental disorders, a unified set of standard...
Modified electroconvulsive therapy (MECT) is one of the key physical treatments for mental disorders. Despite the rapidly growing demand for outpatient MECT among patients with mental disorders, a unified set of standardized operational guidelines has not yet been established in China. This expert consensus was initiated and developed by the Chinese Psychiatrist Association in collaboration with the Professional Committee of Physical Therapy, Mental Health Association of Guangdong Province. Under the guidance of the steering committee, based on evidence-based medical evidence and multidisciplinary expert opinions from psychiatry, anesthesiology and other related fields, this consensus systematically introduces the operational standards of outpatient MECT, covering core components including patient inclusion criteria, facility and equipment requirements, team composition, personnel qualifications and job responsibilities, treatment procedures, quality control and safety management, professional training and continuing medical education. Finally, 11 recommendations were formulated. This expert consensus aims to provide standardized and practical operational guidance for clinicians, ensure patient treatment safety, and promote the standardized application and sustainable development of outpatient MECT.
[Guideline for the diagnosis and treatment of psoriasis arthropathica (psoriatic arthritis) in China (2026 edition)].
China Dermatologist Association, Chinese Dermatovenerology Society of Integrative Medicine
Zhonghua Yi Xue Za Zhi · 2026 Jun · PMID 42373464 · Publisher ↗
Psoriasis arthropathica, also known as psoriatic arthritis (PsA), is a highly heterogeneous systemic inflammatory disease. In addition to involving the skin with characteristic psoriatic lesions such as erythematous scal...
Psoriasis arthropathica, also known as psoriatic arthritis (PsA), is a highly heterogeneous systemic inflammatory disease. In addition to involving the skin with characteristic psoriatic lesions such as erythematous scaly plaques, it may also affect the joints, leading to joint pain, swelling, stiffness, and functional impairment, thereby substantially reducing patients' quality of life. To develop clinical practice guidelines that align with international standards for guideline development while reflecting Chinese clinical practice, the China Dermatologist Association, in collaboration with the Chinese Dermatovenerology Society of Integrative Medicine, initiated a guideline project focusing on 14 key clinical questions in the diagnosis and management of PsA in China. Evidence-based recommendations were formulated accordingly. This guideline systematically reviews recent domestic and international advances in the diagnosis and treatment of PsA, and covers diagnosis, disease activity assessment, therapeutic strategies, comorbidity management, and pharmacotherapy in special populations. The guideline aims to improve the overall standard of PsA diagnosis and management in China and ultimately enhance patient outcomes.
[Irreparable massive rotator cuff tears: current treatment status and prospects in reconstruction].
Tian XP, Zhou BH
Zhonghua Yi Xue Za Zhi · 2026 Jun · PMID 42373463 · Publisher ↗
Irreparable massive rotator cuff tears represent a highly challenging clinical problem in shoulder sports medicine, and their surgery strategy remains a major focus and persistent challenge in the field. In recent years,...
Irreparable massive rotator cuff tears represent a highly challenging clinical problem in shoulder sports medicine, and their surgery strategy remains a major focus and persistent challenge in the field. In recent years, with the deepening of basic research and the accumulation of clinical experience, notable progress has been made in fundamental theories, surgical techniques, and graft selection for reconstructive treatment. This article systematically reviews the latest advances in the reconstruction of irreparable massive rotator cuff tears, covering emerging theories, innovative surgical procedures, and the application of grafts. It also offers insights into the future directions of clinical diagnosis and treatment and scientific research, aiming to provide valuable references for further development in this area.
[Application and prospects of transcranial temporal interference stimulation in the treatment of mental disorders].
Fan XY, Wang HH, Guan XY … +3 more , Zhang JJ, Fang YR, Zhang CC
Zhonghua Yi Xue Za Zhi · 2026 Jun · PMID 42373462 · Publisher ↗
Transcranial temporal interference stimulation (tTIS) generates a low-frequency envelope through the interference of two high-frequency electric fields, enabling non-invasive and precise neuromodulation of deep brain reg...
Transcranial temporal interference stimulation (tTIS) generates a low-frequency envelope through the interference of two high-frequency electric fields, enabling non-invasive and precise neuromodulation of deep brain regions. This article systematically reviews the technical principles, neuromodulatory mechanisms, and preliminary applications of tTIS in the treatment of mental disorders. It analyzes the impact of key parameters on therapeutic efficacy, including target selection, frequency difference, current intensity, stimulation protocol, and individualized computational modeling. The review also summarizes current research evidence for tTIS in major depressive disorder, bipolar disorder, schizophrenia, and substance use disorders. Finally, this article discusses future directions, including mechanistic exploration, validation through randomized controlled trials, multi-target intelligent stimulation, and combination therapies, aiming to provide a reference for the clinical translation of tTIS.
[The 2026 Surviving Sepsis Campaign guidelines: from evidence updates to practice implementation].
Xue M, Xie JF, Qiu HB … +1 more , Liu L
Zhonghua Yi Xue Za Zhi · 2026 Jun · PMID 42373461 · Publisher ↗
The 2026 Surviving Sepsis Campaign guidelines represent a systematic update built upon the 2021 version. The core changes are reflected not only in the adjustment of clinical recommendations but also, more significantly,...
The 2026 Surviving Sepsis Campaign guidelines represent a systematic update built upon the 2021 version. The core changes are reflected not only in the adjustment of clinical recommendations but also, more significantly, in the restructuring of the methodological framework. This article provides an in-depth analysis of the new guidelines across four key dimensions: methodological innovations, evolution of clinical diagnostic and treatment strategies, extension of whole-course management, and the establishment of an independent recommendation system for resource-limited settings. The 2026 guidelines achieve four major paradigm shifts: transitioning from simple evidence updates to methodological restructuring, from uniform recommendations to risk-stratified precision medicine, from acute-phase treatment to whole-course management, and from a high-resource medical center perspective to a global health equity perspective. However, systematically identifying evidence gaps, integrating effective strategies into clinical practice, and placing greater emphasis on patients' long-term functional recovery and life quality remain future research priorities.
Novel treatments for Parkinson's disease.
Yin Y, Gao J, Zhang K … +2 more , Meng F, Feng T
Chin Med J (Engl) · 2026 Jun · PMID 42366511 · Publisher ↗
Parkinson's disease (PD) is a progressive neurodegenerative disorder associated with a rapidly rising global disease burden and a substantial decline in patients' quality of life. Although currently approved therapies of...
Parkinson's disease (PD) is a progressive neurodegenerative disorder associated with a rapidly rising global disease burden and a substantial decline in patients' quality of life. Although currently approved therapies offer symptomatic relief, their clinical efficacy inevitably wanes over time. This review provides a comprehensive summary of recent advancements in both symptomatic treatments and experimental therapies focused on neuroprotection and disease modification. These novel treatments for PD include continuous dopaminergic stimulation, adaptive deep brain stimulation, transcranial temporal interference stimulation, anti-α-synuclein immunotherapies, oral anti-α-synuclein therapies, non-receptor tyrosine kinase inhibitors, glucagon-like peptide-1 (GLP-1) receptor agonists, iron chelators, fecal microbiota transplantation, glucosylceramide synthase inhibitors, as well as stem cell therapies and gene therapies. However, the majority of these novel treatments are still in the investigational phase and necessitate additional validation via randomized controlled trials. Future research should also focus on optimizing trial methodologies, including the timing of intervention, stratification of PD subjects, and selection of treatment endpoints.
Incidence, DALYs, and death rates of chronic kidney disease in China, 1990-2023: Results from the Global Burden of Disease Study 2023.
Wang J, Zhao M, Zhang L
Chin Med J (Engl) · 2026 Jun · PMID 42366491 · Publisher ↗
BACKGROUND: Chronic kidney disease (CKD) is a global public health concern that causes a remarkable disease burden. Although the prevalence of CKD in China has been investigated by previous national surveys, the incidenc...
BACKGROUND: Chronic kidney disease (CKD) is a global public health concern that causes a remarkable disease burden. Although the prevalence of CKD in China has been investigated by previous national surveys, the incidence, disability-adjusted life years (DALYs), and death of CKD and their temporal trends over the past decades have not been well studied. METHODS: Incidence, DALYs, and death of CKD, as well as risk-attributable DALYs and death in China from 1990 to 2023, were checked from the Global Burden of Diseases, Injuries, and Risk Factors Study 2023. The temporal trend of each indicator was estimated by join point analysis. RESULTS: In 2023, in China, there were 156.15 (95% uncertainty interval: 146.77-167.88) million patients with CKD. The incidence, DALYs, and death rates of CKD were 240.59 (222.83-266.12), 355.86 (303.29-407.63), and 10.73 (8.96-12.70) per 100,000 population, respectively. Females had a higher incidence but lower DALYs and death rates than males. The elderly population had a much higher disease burden than middle-aged and young people. Incidence rates markedly increased, DALY rates slightly decreased, while death rates mildly increased from 1990 to 2023 with the respective average annual percent change of 1.67%, -0.17%, and 0.40%. However, the metrics all tended to decline after age standardization. Metabolic risk factors accounted for higher risk-attributable DALYs and deaths than other risk factors. High fasting plasma glucose ranked first in 2023 for risk-attributable DALYs and death, while high body mass index was the only risk factor maintaining a nondeclining contribution when comparing 2010 to 2023. CONCLUSIONS: CKD bears high levels of incidence, DALYs, and death in China, with an increasing trend for incidence observed from 1990 to 2023. The aging of the population and metabolic diseases are the main drivers of the CKD burden. Priority should be given to curb the CKD epidemic.
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