Chinese Medical Journal[JOURNAL]
Sun
200 papers
Transcranial photobiomodulation mitigates neuroinflammation by suppressing the activation of neurotoxic microglia through inhibition of the cGAS-STING pathway following intracerebral hemorrhage in mice.
Du Y, Wang S, Pan Y … +6 more , Ma H, Zhao Y, Wei Z, Lu H, Xie D, Zhang Y
Chin Med J (Engl) · 2026 Jun · PMID 42045151 · Full text
BACKGROUND: Neuroinflammation driven by microglial activation is a key contributor to secondary brain injury after intracerebral hemorrhage (ICH). This study aimed to determine whether transcranial photobiomodulation (tP...
BACKGROUND: Neuroinflammation driven by microglial activation is a key contributor to secondary brain injury after intracerebral hemorrhage (ICH). This study aimed to determine whether transcranial photobiomodulation (tPBM) modulates microglial activation and improves neurological outcomes following ICH. METHODS: In this study, we used a mouse model of ICH induced by collagenase to investigate the effects of tPBM at three different power levels (25, 50, and 100 mW) on neurological function, hematoma volume, brain edema, and blood-brain barrier (BBB) integrity. We conducted neurobehavioral assessments and analyzed the activation of the cyclic GMP-AMP synthase-stimulator of interferon genes (cGAS-STING) signaling pathway through quantitative polymerase chain reaction, Western blotting, and immunohistochemistry. In addition, we used the STING-specific inhibitor H151 and agonist diABZI to elucidate the role of the cGAS-STING pathway in neuroinflammation. RESULTS: tPBM treatment significantly improved neurological recovery, with optimal effects observed at 50 mW. This treatment reduced hematoma volume, alleviated brain edema, and preserved BBB integrity. Importantly, tPBM inhibited microglial polarization toward a neurotoxic phenotype by suppressing the activation of the cGAS-STING pathway. The use of H151 resulted in decreased neuronal apoptosis and inflammatory cytokine expression, whereas diABZI reinstated inflammatory processes, highlighting the detrimental role of cGAS-STING overactivation in ICH. CONCLUSIONS: tPBM effectively mitigates neuroinflammation and enhances functional recovery after ICH by modulating the cGAS-STING signaling pathway and suppressing neurotoxic microglial activation. This study underscores the potential of tPBM as a novel therapeutic intervention for improving outcomes in patients with ICH, warranting further exploration in clinical settings.
Therapeutic siRNA: Mechanisms, challenges, strategies, and clinical translation.
Jiang Q, Fu J, An Y … +1 more , Liu Y
Chin Med J (Engl) · 2026 Jun · PMID 42036903 · Full text
RNA interference is an ancient biological defense mechanism against external invasions. Mechanistically, small interfering RNA (siRNA) can specifically bind to any target gene, according to the principle of complementary...
RNA interference is an ancient biological defense mechanism against external invasions. Mechanistically, small interfering RNA (siRNA) can specifically bind to any target gene, according to the principle of complementary base pairing, to exert silencing effects. Therefore, siRNA has the potential to serve as an efficient therapeutic agent for various diseases. However, due to their susceptibility to nucleases, off-target effects, and low cellular uptake, the development of siRNA-based drugs remains challenging. Fortunately, with the advancement in chemical modifications and delivery systems, patisiran, the first siRNA therapeutic, was approved for the treatment of hereditary transthyretin amyloidosis by the United States Food and Drug Administration (FDA) in 2018, which represents a crucial milestone in the field of siRNA research. Subsequently, seven other siRNA drugs were introduced to the market. Thus, siRNA drugs are on their way to becoming standard pharmacotherapy tools. This review presents the mechanisms of action, delivery barriers, chemical modifications, and delivery platforms of siRNA. Furthermore, it also summarizes commercialized siRNA drugs and some clinical trials, thereby providing a comprehensive knowledge map of siRNA drug modifications, delivery strategies, action mechanisms, and updated clinical trials.
Metaproteomics characterizes host-microbiota responses to the time in range derived from continuous glucose monitoring in type 1 diabetes.
Zhou L, Xu J, Li S … +12 more , Deng M, Xiao X, Ma L, Sun H, Liu X, Guo Z, Ding L, Yu R, Liu J, Zhang Q, Xiao X, Sun W
Chin Med J (Engl) · 2026 Jun · PMID 42036894 · Full text
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Skin-localized sympathetic nerve-keratinocyte crosstalk fuels psoriatic inflammation via neutrophil recruitment.
Xiao C, Li Y, Dang E … +7 more , Zhang C, Yin A, Li K, Liu Q, Wang G, Wu Y, Chen K
Chin Med J (Engl) · 2026 Apr · PMID 42036893 · Publisher ↗
BACKGROUND: Psoriasis is a common immune-mediated inflammatory skin disease. The sympathetic nervous system (SNS), a complex network consisting of endocrine and local arms, holds a significant position in the modulation...
BACKGROUND: Psoriasis is a common immune-mediated inflammatory skin disease. The sympathetic nervous system (SNS), a complex network consisting of endocrine and local arms, holds a significant position in the modulation of immune response, while the exact function varies depending on the specific disease type, the type of cell involved, and the intricate architecture of the SNS. Therefore, this study aimed to elucidate the precise role of sympathetic signaling in psoriasis. METHODS: Using an imiquimod-induced psoriasis mouse model, we evaluated the in vivo effects of sympathetic signaling intervention through gross phenotype observation, histology, and flow cytometric analysis of inflammatory cell infiltrations. Human primary keratinocytes (KCs), isolated from donor foreskins from patients under undergoing urological surgery at the Department of Urology, Xijing Hospital, were employed to investigate the role and mechanism of sympathetic signaling in regulating C-X-C motif chemokine ligand 1 (CXCL1) production and neutrophil recruitment, utilizing Western blot analysis, immunofluorescence and transwell assays. RESULTS: In psoriatic mice, local denervation of skin sympathetic fibers resulted in markedly reduced erythema, scaling, and epidermal thickness compared to controls, while systemic denervation did not. Local denervation also reduced neutrophil infiltration in skin lesions. This reduction was associated with sympathetic signaling that upregulated CXCL1 expression in KCs without altering Keratin 1, Keratin 10, or interleukin (IL)-25 levels. The β2-adrenergic receptor (ADRB2) was highly expressed in psoriatic KCs. KCs treated with norepinephrine (NE) or ADRB2 agonist salbutamol increased cyclic adenosine monophosphate response element-binding protein (CREB) phosphorylation and CXCL1 expression, effects that were abolished by an ADRB2 antagonist. In mice, topical salbutamol increased local CXCL1, accelerated early neutrophil infiltration, and worsened subsequent erythema, scaling, and epidermal thickening. Conversely, topical ADRB2 antagonist or CREB inhibitor application decreased epidermal thickening, reduced CXCL1 expression, and lowered neutrophil infiltration. CONCLUSIONS: Activation of skin local sympathetic signaling in KCs induces CXCL1 production via the ADRB2-CREB pathway, which contributes to recruiting neutrophils to the skin lesions and fuels psoriatic inflammation.
Role impairment of patients with mental disorders and physical diseases in China: Results from the China Mental Health Survey.
Muhai J, Liu Z, Zhang T … +14 more , Ding R, Li T, Xu G, Xu X, Wang L, Yan Y, Xiao S, Li L, Yan J, Yu Y, Xu X, Wang Z, Xu Y, Huang Y
Chin Med J (Engl) · 2026 Jun · PMID 42036891 · Full text
BACKGROUND: Role impairment due to health problems is a public health issue. China Mental Health Survey (CMHS) is a national epidemiological study in China, providing plenty of information on mental disorders and physica...
BACKGROUND: Role impairment due to health problems is a public health issue. China Mental Health Survey (CMHS) is a national epidemiological study in China, providing plenty of information on mental disorders and physical diseases.This study focused on the association between mental disorders and physical diseases with role impairment. METHODS: This study was based on CMHS, a cross-sectional study in a large-scale nationally representative sample across China from 2012 to 2015. Trained interviewers carried out face-to-face interviews with 28,140 respondents using the Composite International Diagnostic Interview-3.0 (CIDI-3.0). The prevalence of mental disorders and physical diseases was assessed. In addition, each respondent reported information about the number of days in the past month being totally and partially unable to work or carry out their other normal daily activities because of problems with either mental disorders or physical diseases. Associations of role impairment with physical diseases and mental disorders were analyzed by multiple regression. RESULTS: Overall, the weighted rate of role impairment was 3.68% in patients with any mental disorders and 8.75% in those with any physical diseases. Chronic pain ( β = 0.07, P <0.001) became the main physical disease associated with role impairment, while depressive disorder ( β = 0.12, P <0.001) became the main mental disorder associated with role impairment. Patients with more mental disorders or physical diseases experienced more days with role impairment. CONCLUSIONS: Common mental disorders and physical diseases account for a large proportion of the number of days out of role. It should be addressed to substantially increase the level of mental health in China.
Efficacy and toxicity of maintenance therapy with PD-1/PD-L1 inhibitors plus pemetrexed vs . immunotherapy alone for stage III/IV non-squamous non-small cell lung cancer: A real-world study.
Huang Z, Mei S, Liu J … +14 more , Zhang Q, Li Z, Jiang G, Wang F, Zhang C, Lu C, Zhang M, Chen Z, Deng Y, Xu C, Wu Y, Chang J, Feng W, Zhou Q
Chin Med J (Engl) · 2026 Jun · PMID 42036883 · Full text
BACKGROUND: It is a common challenge in clinical decision-making to optimize and select maintenance therapy (MT) regimens that balance efficacy and toxicity. This study compares the efficacy and toxicity of immune checkp...
BACKGROUND: It is a common challenge in clinical decision-making to optimize and select maintenance therapy (MT) regimens that balance efficacy and toxicity. This study compares the efficacy and toxicity of immune checkpoint inhibitors (ICIs) monotherapy vs . ICIs plus pemetrexed as MT following initial immunotherapy in non-small cell lung cancer (NSCLC) patients. METHODS: We performed a multicenter retrospective real-world study that included non-squamous NSCLC (nqNSCLC) patients who received 4-6 cycles of ICIs plus pemetrexed as the first-line treatment and continued ICIs monotherapy or ICIs plus pemetrexed as MT between April 1, 2018, and June 30, 2023. Progression-free survival (PFS) and overall survival (OS) were reported using the Kaplan-Meier method. Adverse events (AEs) were evaluated according to the Common Terminology Criteria for Adverse Events (CTCAE) version 5.0. RESULTS: Out of 1060 recorded patients, 328 met the inclusion criteria for the analysis: 235 received ICIs plus pemetrexed, and 93 received ICIs monotherapy as MT. Demographic characteristics were comparable between the two groups. No significant difference was observed in median PFS (15.0 vs . 14.6 months; P = 0.756) between the two groups, regardless of programmed death-ligand 1 (PD-L1) stratification. Similarly, median OS did not differ significantly (28.3 vs . 38.9 months; P = 0.799). Anemia incidence was higher in the ICIs plus pemetrexed MT group (48.5 vs . 32.3%). Patients who were rechallenged with ICIs as second-line therapy experienced improved OS compared to those who received non-ICI therapy (not reached vs . 20.4 months; P = 0.009). CONCLUSION: The absence of statistically significant survival difference and increased toxicity in the ICIs plus pemetrexed cohort suggest that chemotherapy may not be crucial in MT. Moreover, the significant benefits of ICIs-based therapy as a second-line treatment reinforce its value, offering confidence to both patients and physicians in making informed decisions regarding MT strategies and subsequent systemic therapies.
Dose-response relationship between gestational blood glucose levels and risk of pre-eclampsia in singleton pregnancies: A retrospective multicenter study.
Ma S, Gu T, Shi H … +2 more , Wei Y, Wang X
Chin Med J (Engl) · 2026 Apr · PMID 42036876 · Publisher ↗
BACKGROUND: Pre-eclampsia remains a leading cause of maternal and perinatal mortality and morbidity. Whether risks of pre-eclampsia are associated with severity of blood glucose concentrations or glycemic control is stil...
BACKGROUND: Pre-eclampsia remains a leading cause of maternal and perinatal mortality and morbidity. Whether risks of pre-eclampsia are associated with severity of blood glucose concentrations or glycemic control is still unknown. This study aimed to analyze the association of blood glucose concentrations during pregnancy and the risk of pre-eclampsia. METHODS: A retrospective cohort study was conducted using data of 53,054 singleton pregnant women aged 18-49 years from 121 maternity hospitals in China between 2015 and 2018. Logistic regression models with restricted cubic splines were performed to reveal a non-linear association of blood glucose concentrations in the first trimester and the gestational change with pre-eclampsia. The association of the categories of blood glucose concentrations with pre-eclampsia was further examined by performing robust Poisson regression. RESULTS: A total of 1356 (2.55%, 1356/53,054) participants were diagnosed with pre-eclampsia. Higher risk was observed in those with higher blood glucose in the first trimester and those with greater increase in blood glucose during gestation, with the incidence of pre-eclampsia ranging from 1.27% (24/1883) to 6.03% (29/481). Compared with women with blood glucose (BG) concentrations of <4.4 mmol/L in the first trimester, the risk of pre-eclampsia was significantly increased in women with 4.4 ≤BG <5.1 mmol/L (adjusted relative risk [aRR] = 1.347, 95% confidence interval [CI]: 1.185-1.531), 5.1 ≤BG <5.6 mmol/L (aRR = 1.750, 95% CI: 1.441-2.124), and BG ≥5.6 mmol/L (aRR = 2.431, 95% CI: 1.958-3.019), respectively, after adjusting for basic characteristics of women, including region, age, education, ethnicity, residential status, assisted reproductive technology, primigravida, pre-pregnancy body mass index and categories of gestational change of blood glucose concentrations. The association of gestational change of blood glucose concentrations during gestation with pre-eclampsia was presented as a U-shaped curve after controlling the blood glucose concentrations in the first trimester. CONCLUSIONS: The findings highlight that higher blood glucose concentration in the first trimester and greater gestational variations of blood glucose contribute to higher risks of pre-eclampsia. Therefore, maintaining optimal blood glucose in early pregnancy and minimizing gestational glucose fluctuations is recommended to reduce the risk of pre-eclampsia.
Performance evaluation and practice advice for multiplex PCR-based pathogen-targeted next-generation sequencing (ptNGS).
Hu J, Su Y, Chen G … +12 more , Du Z, Tang J, He Y, Zheng L, Zhang L, Zhang W, Zhou J, Yao Y, Xie Y, Ying B, Li W, Hu WW
Chin Med J (Engl) · 2026 Apr · PMID 42010742 · Publisher ↗
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Role of adipose tissue in cardiovascular health and diseases.
Hua Y, Lei Y, Chen M … +3 more , Zhuang T, Zuo J, Ruan C
Chin Med J (Engl) · 2026 Jun · PMID 42010729 · Full text
Adipose tissue is a complex endocrine organ that critically regulates cardiovascular health and disease. Different adipose depots vary in location and function, exerting distinct physiological and pathological effects on...
Adipose tissue is a complex endocrine organ that critically regulates cardiovascular health and disease. Different adipose depots vary in location and function, exerting distinct physiological and pathological effects on the cardiovascular system. This review examines the roles of three key depots: (1) epicardial adipose tissue (EpAT), (2) perivascular adipose tissue (PVAT), and (3) bone marrow adipose tissue (BMAT). We also focus on the functional differentiation of adipose tissue based on its anatomical location to provide a robust understanding of its diverse impacts on cardiovascular diseases (CVDs). We further explore pharmacological interventions targeting adiposity and obesity, including their mechanisms, clinical applications, and therapeutic potential in CVD management. By elucidating the intricate interactions between adipose depot dynamics and cardiovascular pathology, this work highlights emerging research directions and underscores the need for adipose-specific strategies in cardiovascular therapeutics.
Prevalence and characteristics of celiac disease in Chinese children with gastrointestinal symptoms: A multicenter study.
Xu X, Yuan L, Xie X … +16 more , Fang Y, Li X, Zhao Y, You J, Zhang T, Nijiati M, Long Y, Zhang L, Wang Y, Wang L, Gao S, Xiao Y, Li J, Yu Y, Xu C, Wang X
Chin Med J (Engl) · 2026 Apr · PMID 42010719 · Publisher ↗
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Treatment-related neuroanatomical and functional consequences of hematopoietic stem cell transplantation: A comprehensive review of brain structure and function.
Alghabban HM
Chin Med J (Engl) · 2026 Apr · PMID 42009626 · Publisher ↗
Hematopoietic stem cell transplantation (HSCT) is a foundational treatment for hematological disorders. While its efficacy is established, the conditioning regimens required for HSCT (high-dose chemotherapy and radiother...
Hematopoietic stem cell transplantation (HSCT) is a foundational treatment for hematological disorders. While its efficacy is established, the conditioning regimens required for HSCT (high-dose chemotherapy and radiotherapy), along with transplant-related immunological and metabolic changes, can induce significant neurological complications. These treatment-related effects necessitate a comprehensive evaluation of their impact on brain structure and function. A synthesis of current evidence on these neurological outcomes is essential to guide clinical practice and future research. This review synthesizes literature on the effects of HSCT-associated treatments on neuroanatomy, cognitive performance, and long-term neurological sequelae. Evidence indicates consistent reductions in gray-matter volume, particularly within frontal, temporal, and parietal cortices, alongside diffuse white-matter alterations affecting major commissural and association tracts. These structural changes correlate with clinically meaningful deficits in attention, executive function, and memory. The underlying pathogenic mechanisms are multifactorial, involving direct neurotoxicity from conditioning regimens, systemic and neuroinflammatory responses, and oxidative stress. The findings underscore the importance of integrating thorough neurological evaluation and longitudinal monitoring into routine care for HSCT recipients. Future research should elucidate detailed mechanisms and develop personalized, evidence-based neuroprotective and rehabilitative strategies. A deeper understanding of these neurological consequences is paramount for improving outcomes and long-term quality of life.
[Expert consensus on the standardized construction and management of biobanks for allergic diseases (2026 edition)].
Allergy Prevention and Control Committee, Chinese Preventive Medicine Association, Chinese Society of Allergy, Chinese Medical Association, National Clinical Research Center for Respiratory Diseases … +2 more , Guangdong Preventive Medicine Association′s Translational and Innovative Committee of Laboratory Medicine, Guangdong Research Hospitals Association′s Translational and Development Committee of Laboratory Medicine
Zhonghua Yi Xue Za Zhi · 2026 Apr · PMID 42003112 · Publisher ↗
To standardize the construction and management of biobanks for allergic diseases in China and promote the deep integration of clinical resources with research needs, the Allergy Prevention and Control Committee of the Ch...
To standardize the construction and management of biobanks for allergic diseases in China and promote the deep integration of clinical resources with research needs, the Allergy Prevention and Control Committee of the Chinese Preventive Medicine Association, the Chinese Society of Allergy of the Chinese Medical Association, and the National Clinical Research Center for Respiratory Diseases, among other institutions, jointly led the development of the "Expert consensus on the standardized construction and management of biobanks for allergic diseases (2026 edition)". This consensus was formulated based on the "Guidelines for the Development/Revision of Clinical Practice Guidelines in China (2022 edition)" and the GRADE (Grading of Recommendations Assessment, Development and Evaluation) system, through multidisciplinary expert discussions and Delphi voting. The content covers strategic positioning, standardized collection and processing, ethical and privacy protection, information management and data governance, full-process quality control, biosafety risk prevention, and personnel development. The consensus puts forward 10 recommendations, emphasizes a collaborative mechanism of "co-construction, co-management, and sharing", and provides scientific and actionable practical guidance tailored to China's regional characteristics. It aims to advance the development of precision medicine for allergic diseases and contribute China's expertise to global allergy research.
Acute-on-chronic liver failure: From definition to pathogenesis and therapy.
Xu Y, Liu J, Shang D … +3 more , Rodrigues RM, Chen Y, Xiang X
Chin Med J (Engl) · 2026 Apr · PMID 42002875 · Full text
The concept of acute-on-chronic liver failure (ACLF) has been widely accepted around the world since it was proposed nearly 30 years ago, but there are still no universal criteria for the definition and diagnosis of ACLF...
The concept of acute-on-chronic liver failure (ACLF) has been widely accepted around the world since it was proposed nearly 30 years ago, but there are still no universal criteria for the definition and diagnosis of ACLF worldwide. In recent years, the key clinical features for describing ACLF, such as the underlying chronic liver diseases, acute intrahepatic or extrahepatic insults, acute hepatic decompensation, extrahepatic organ failure, short-term high mortality, and the reversible course of the disease, have gradually narrowed the differences and reached a consensus. The pathogenesis of ACLF has not been fully elucidated, and most relevant studies focus on systemic inflammation and immune dysfunction. In this review, we discuss the evolution in the clinical definition of ACLF during the last few years and suggest clear criteria for ACLF diagnostics. In addition, we summarize the current understanding of ACLF pathogenesis and review the latest therapeutic targets against this condition. Lastly, we present a novel experimental mouse model that has been proven to be instrumental for the assessment of novel potential therapies for ACLF.
Key to impaired information processing speed in individuals with white matter hyperintensities: Decreased efficiency of attentional and executive networks.
Jin J, Ma J, Wu J … +8 more , Li L, Lu J, Li K, Xiang Y, Huang R, Zheng M, Hua X, Xu J
Chin Med J (Engl) · 2026 Jul · PMID 41991502 · Full text
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[Clinical features of 13 children with neuronal ceroid lipofuscinosis type 2].
Liu K, Zhao HQ, Zhang Q … +4 more , Chen C, Chen J, Huang Y, Zou LP
Zhonghua Yi Xue Za Zhi · 2026 Apr · PMID 41986128 · Publisher ↗
Clinical data were retrospectively collected from 13 children with type 2 neuronal ceroid lipofuscinosis (CLN2) who underwent genetic testing for definitive diagnosis and were followed up at the Chinese PLA General Hospi...
Clinical data were retrospectively collected from 13 children with type 2 neuronal ceroid lipofuscinosis (CLN2) who underwent genetic testing for definitive diagnosis and were followed up at the Chinese PLA General Hospital from January 2018 to December 2023. The clinical features, disease progression, and prognosis were analyzed. The age at onset was [()] 3.7 (3.2, 4.5) years, including 7 males and 6 females. The follow-up was conducted once every 3 months during the first 2 years after diagnosis, and once every 6 months starting from the 3rd year, with the last follow-up until December 2025. All patients presented with epilepsy as the initial manifestation, of whom 8 patients had myoclonic seizures. Psychomotor regression occurred in 10 patients shortly after seizure onset. Tripeptidyl peptidase 1 (TPP1) activity was below the normal reference range in all patients, and all harbored biallelic pathogenic or likely pathogenic variants in the TPP1 gene. Brain magnetic resonance imaging revealed cerebellar atrophy in all cases, and electroencephalography demonstrated generalized abnormalities in all patients. Disease progression exhibited relatively distinct stage-wise features. Within>1-2 years of onset, eleven patients developed ataxia and 10 experienced language regression. Within>2-3 years, ten patients had lost independent ambulation and 9 had lost language function. Within>3-5 years, all patients lost motor and language abilities, and 10 developed severe dysphagia. Five patients died during follow-up. In conclusion, CLN2 typically presents in early childhood with epilepsy as the predominant initial manifestation, followed by progressive neurofunctional decline and cerebellar atrophy. Markedly reduced TPP1 activity together with pathogenic TPP1 variants supports the diagnosis.
[Efficacy of rituximab in patients with EB virus-related hemophagocytic syndrome caused by B lymphocyte infection].
Cao JW, Han Q, Qiao Y … +2 more , Wang Z, Wu L
Zhonghua Yi Xue Za Zhi · 2026 Apr · PMID 41986127 · Publisher ↗
To explore the efficacy of rituximab in treating patients with EB virus-related hemophagocytic syndrome (EBV-HLH) caused by B lymphocyte infection. A retrospective analysis was conducted on the data of patients diagnosed...
To explore the efficacy of rituximab in treating patients with EB virus-related hemophagocytic syndrome (EBV-HLH) caused by B lymphocyte infection. A retrospective analysis was conducted on the data of patients diagnosed with EBV-HLH, without hematopoietic stem cell transplantation and receiving rituximab treatment at Beijing Friendship Hospital, Capital Medical University from November 2021 to January 2025. All patients received treatment with a regimen containing rituximab, such as the R-DEP regimen (rituximab+liposomal doxorubicin+etoposide+methylprednisolone), the R+HLH-94 regimen (rituximab+dexamethasone+etoposide+cyclosporine), the R regimen (rituximab), and the R+P-Gemox regimen (rituximab+gemcitabine+oxaliplatin). Follow-up was conducted until August 2025 or until the patients' death to analyze the related efficacy. A total of 20 patients with EBV-HLH who received rituximab-containing regimens were enrolled. There were 11 males and 9 females, with a median age of 40 (range 5-70) years. There were 12, 5, 2, and 1 cases receiving the R-DEP, R, R+HLH-94, and R+P-Gemox regimens, respectively. The median EBV-DNA load in peripheral blood mononuclear cells before treatment was 7 000 (range 590-240 000) copies/ml. The median follow-up time [ (, )] was 15 (6, 24) months, the median survival time was 19 (7, 27) months, and 18 patients survived. The overall disease remission rate after treatment was 95% (19/20), and EBV-DNA was negative in 17 patients. For patients with B lymphocyte infection-related EBV-HLH, early application of a regimen centered on rituximab can effectively eliminate the virus, induce clinical remission, and improve the survival prognosis of patients.
[Efficacy and safety of transvaginal assisted total intracavitary orthotopic neobladder surgery for female urothelial carcinoma of the bladder].
Liang S, Qie YK, Jia KP … +5 more , Bai YD, Chen HY, Huang SW, Zhang Z, Hu HL
Zhonghua Yi Xue Za Zhi · 2026 Apr · PMID 41986126 · Publisher ↗
A retrospective analysis was conducted on the data of 9 female patients with bladder urothelial carcinoma who underwent robot-assisted radical cystectomy and transvaginal-assisted total intracavitary orthotopic neobladde...
A retrospective analysis was conducted on the data of 9 female patients with bladder urothelial carcinoma who underwent robot-assisted radical cystectomy and transvaginal-assisted total intracavitary orthotopic neobladder surgery in the Department of Urology, the Second Hospital of Tianjin Medical University from January 2022 to August 2025. Perioperative indicators (overall operation time, neobladder construction time, intraoperative blood loss, and recovery time of intestinal function) were observed postoperatively. The National Aeronautics and Space Administration-Task Load Index (NASA-TLX) score of the chief surgeon was evaluated and the learning curve was drawn using the cumulative sum (CUSUM) method. Postoperative complications within 30 days (using the Clavien-Dindo classification) and the recovery of urinary control function at 1, 6, and 12 months after surgery were followed up. The tumor control and other indicators were evaluated every 3 months within 2 years and every 6 months from the third year after surgery. The age of patients was (51.3±11.0) years, body mass index was (19.5±4.2) kg/m², and the American Society of Anesthesiologists score was 1-2 points. The overall operation time was (342.5±58.3) min, the neobladder construction time was (121.7±22.6) min, the intraoperative blood loss was (150±50) ml, the time to first postoperative exhaust was (1.74±0.63) d, and the NASA-TLX score of the chief surgeon was (66.3±5.5) points. The CUSUM learning curve of neobladder construction time and NASA-TLX score was divided into the learning stage (cases 1-5) and the proficient stage (cases 6-9). Four patients had early postoperative complications (within 30 days after surgery), all of which were Clavien-Dindo grade I-II. At 6 months after surgery, 8 patients had complete dryness during the day and night, and 1 patient had chronic urinary retention. The prognosis was good, with no tumor recurrence or metastasis. The cancer-specific survival (CSS) was 100%. In this study, the transvaginal natural orifice-assisted total intracavitary orthotopic neobladder surgery showed a promising clinical application prospect. The preliminary results indicated that this technique was feasible, had a short learning curve, and had good short-term tumor control and urinary control recovery effects.
[Effect and mechanism of taurocholic acid in promoting colorectal cancer liver metastasis by regulating neutrophil extracellular trap formation].
Yang KJ, Wang YF, Li PL … +2 more , Du LT, Wang CX
Zhonghua Yi Xue Za Zhi · 2026 Apr · PMID 41986125 · Publisher ↗
To investigate the effect and underlying mechanism by which taurocholic acid (TCA) promotes colorectal cancer liver metastasis (CRLM) through regulation of neutrophil extracellular trap (NET) formation. A total of 20 CR...
To investigate the effect and underlying mechanism by which taurocholic acid (TCA) promotes colorectal cancer liver metastasis (CRLM) through regulation of neutrophil extracellular trap (NET) formation. A total of 20 CRLM patients and 20 non-metastatic colorectal cancer (non-mCRC) patients admitted to Qilu Hospital of Shandong University from 2021 to 2022 were retrospectively included. The age of the CRLM patients was (57±12) years, including 11 males and 9 females; the age of the non-mCRC patients was (60±9) years, including 15 males and 5 females. Non-targeted metabolomics was employed to identify differential serum metabolites associated with liver metastasis, and the distinguish efficacy of TCA was evaluated by receiver operating characteristic (ROC) curve analysis. Neutrophils from healthy donors were isolated by density gradient centrifugation. The differentiated HL-60 (dHL-60) model was established by inducing the acute promyelocytic leukemia cell line HL-60 to differentiate into neutrophil-like cells with all-trans retinoic acid (ATRA). The expression characteristics of carcinoembryonic antigen-related cell adhesion molecule 8 (CD66b) and integrin subunit alpha M (CD11b) were detected by flow cytometry. The cell morphology and the proportion of live cells were assessed respectively by wright-giemsa staining and trypan blue staining. In neutrophils and dHL-60 models, cells were divided into a negative control group, a phorbol 12-myristate 13-acetate (PMA, 0.5 μmol/L) positive control group and different concentrations of TCA treatment groups (0.01, 0.1, 1, 10 and 100 μmol/L). The formation of the NET reticular structure after stimulation was observed by Sytox Green staining, and the content of double-stranded deoxyribonucleic acid (ds-DNA) released after stimulation was quantitatively evaluated by PicoGreen. Western blotting was used to detect the expression levels of p44/42 mitogen-activated protein kinase (p44/42 MAPK) and its phosphorylated form (p-p44/42 MAPK), mammalian target of rapamycin (mTOR) and its phosphorylated form (p-mTOR), and peptidylarginine deiminase 4 (PAD4) in dHL-60 following stimulation. NET induced by TCA were divided into a control group, a low-dose NET group (0.1 μg/ml) and a high-dose NET group (0.3 μg/ml) according to dose, and co-cultured respectively with colorectal cancer (CRC) cell lines DLD1 and HCT116. Transwell assay was used to analyze the effect of TCA-induced NET on the migration behavior of CRC cells. The expression levels of epithelial cadherin (E-cadherin), neural cadherin (N-cadherin), and vascular endothelial growth factor A (VEGFA) were detected by Western blotting in CRC cells after co-culture. Comparisons of measurement data between groups were performed using the independent samples -test, Mann-Whitney test, and one-way ANOVA. Comparisons of enumeration data between groups were performed using the χ test or Fisher's exact test. The relative abundance of 64 metabolites, including TCA [ (, )] [4.445 (1.669, 9.579) vs 0.956 (0.649, 1.372), <0.01], in the serum metabolic profile of CRLM patients was higher than that of non-mCRC patients (all <0.05), while the relative abundance of 27 metabolites was lower than that of non-mCRC patients (all <0.05). In the ROC analysis distinguishing the 2 sample groups, TCA achieved an area under the curve (AUC) of 0.873 (95%: 0.741-0.984). In cell identification, both peripheral blood neutrophils and dHL-60 models displayed typical neutrophil morphology: nuclear lobulation and cytoplasm rich in fine neutral granules; the positive rates of CD66b/CD11b were>90%, and the cell viability was>90%. In stimulation of peripheral blood neutrophils for 1 h or 3 h, when the TCA stimulation concentration was greater than 0.01 μmol/L, the formation of NET was more than that of the negative control group (all <0.05). After intervention of dHL-60 for 4 h and 6 h, when the TCA stimulation concentration was greater than 0.1 μmol/L, the NET reticular structure was more than that of the negative control (all <0.05). When the TCA stimulation concentration was greater than 10 μmol/L, the ds-DNA release was higher than that of the negative control group (<0.001). The expression levels of p44/42 MAPK, p-p44/42 MAPK, mTOR, p-mTOR, and PAD4 in the TCA treatment group were higher than those in the negative control group (<0.001). In co-culture experiments of NET and CRC cells, after high-dose NET treatment of DLD1 cells, the expression of E-cadherin was lower than that of the control group (<0.001). After high and low-dose NET treatment of HCT116 cells, the expression of E-cadherin was lower than that of the control group (both <0.001). In both CRC cell lines, after high and low-doses of NET intervention, the expression of N-cadherin and VEGFA was higher than that of the control group (all <0.001), and their migration and invasion abilities were higher than those of the control group (all <0.001). CRLM patients exhibit distinct serum metabolic profiles, among which high-abundance TCA can induce NET release and thereby promote CRC cell metastasis. This process is associated with the activation of the p44/42 MAPK/mTOR signaling pathways in neutrophils and the epithelial-mesenchymal transition in CRC cells.
[Comparison of the efficacy between short-segment instrumentation and simple decompression in the treatment of degenerative lumbar scoliosis with lumbar spinal stenosis and a coronal Cobb angle<20°].
Jiang ZH, Zhang HJ, Cui HJ … +6 more , Ren ZS, Zhang BY, Yu H, Fu XH, Zhou MM, Zhu RS
Zhonghua Yi Xue Za Zhi · 2026 Apr · PMID 41986124 · Publisher ↗
To investigate the differences in imaging and clinical efficacy between simple decompression and short-segment internal fixation in the treatment of patients with degenerative scoliosis accompanied by lumbar spinal steno...
To investigate the differences in imaging and clinical efficacy between simple decompression and short-segment internal fixation in the treatment of patients with degenerative scoliosis accompanied by lumbar spinal stenosis with a coronal Cobb angle<20°. A retrospective analysis was conducted on 80 patients diagnosed with degenerative scoliosis complicated by coronal deformity who were admitted to the Department of Spinal Surgery, Tianjin Union Medical Center, between January 2019 and October 2024. According to the surgical approaches, the patients were divided into two groups: the short-segment fixation group (fixation segments≤3) and the simple decompression group (1-2 segments decompressed). For both groups, the following parameters were recorded respectively: gender, age, disease duration, operation time, intraoperative blood loss, length of hospital stay, surgical expenses, American Society of Anesthesiologists (ASA) score, preoperative and postoperative visual analog scale (VAS) scores for low back pain and leg pain, Oswestry Disability Index (ODI), Japanese Orthopaedic Association (JOA) low back pain score, intraoperative complications, as well as preoperative and postoperative spinopelvic parameters. The spinopelvic parameters included coronal Cobb angle, sagittal vertical axis (SVA), thoracic kyphosis (TK), lumbar lordosis (LL), pelvic incidence (PI), pelvic tilt (PT), and sacral slope (SS). Surgical complications were recorded too, included wound infection, cerebrospinal fluid leakage, pneumonia, cardio-cerebrovascular events, and junctional fusion failure. A total of 80 patients were enrolled, including 45 males and 35 females, with an age of (65.4±8.1) years. There were no significant differences in age, gender, body mass index (BMI), or ASA scores between the two groups before the operation (all >0.05). The short-segment fixation group exhibited significantly longer operation time, greater intraoperative blood loss, more intraoperative fluoroscopy times, and higher total hospitalization costs compared with the simple decompression group (all <0.05). At the 1-year follow-up, the low back pain VAS-B score, leg pain VAS-L score, JOA score, and ODI were significantly improved in both groups compared with preoperative values (all <0.001). At the 1-year follow-up, the VAS-B score was (2.2±0.7) points in the short-segment group and (2.9±1.1) points in the simple decompression group (<0.001), whereas no significant intergroup differences were observed in VAS-L, JOA score, or ODI index (all >0.05). Compared with preoperative values, at 1 year postoperatively, the short-segment group showed decreased SVA and increased SS, LL, and PT (all <0.001), while the simple decompression group showed decreased SVA and significantly increased PT and SS (all <0.001). At the 1-year follow-up, the TK value was 21.8°±9.9° and 29.3°±10.8° in the short-segment group and the simple decompression group, respectively, and the PT values was 22.4°±3.8° and 26.8°±5.9°, respectively (both <0.001), whereas no significant differences was detected in SS, PI, or LL between the two groups (all >0.05). There was no significant differences in incidence of complication between the two groups (=0.134). The clinical efficacy of simple decompression for degenerative scoliosis accompanied by lumbar spinal stenosis with a coronal Cobb angle<20° is similar to that of short-segment internal fixation. And simple decompression, with its shorter operative time and less blood loss, serves as a viable alternative for patients who wish to minimize surgical trauma or who have significant comorbidities.
[Analysis of risk factors and construction of a predictive model for the occurrence of heart failure with preserved ejection fraction in patients with type 2 diabetes mellitus complicated by coronary heart disease after percutaneous coronary intervention].
Yao WJ, Zhou QN, Song HN … +1 more , Zhang HB
Zhonghua Yi Xue Za Zhi · 2026 Apr · PMID 41986123 · Publisher ↗
To explore the risk factors and construct a prediction model for heart failure with preserved ejection fraction (HFpEF) after percutaneous coronary intervention (PCI) in patients with type 2 diabetes mellitus (T2DM) and...
To explore the risk factors and construct a prediction model for heart failure with preserved ejection fraction (HFpEF) after percutaneous coronary intervention (PCI) in patients with type 2 diabetes mellitus (T2DM) and coronary heart disease(CHD). A retrospective analysis was conducted on the clinical data of 210 patients with T2DM complicated with CHD who underwent PCI at Tianjin Medical University Chu Hsien-I Memorial Hospital from January 2021 to June 2024. Among them, 136 were males and 74 were females, with the age of (66.4±9.1) years. Patients were divided into a training set and a validation set at a ratio of 7∶3 using the random number generator built into R software. Based on the occurrence of HFpEF within 12 months after PCI, patients in the training set were further categorized into the HFpEF group and the non-HFpEF group. Differences between the two groups were compared. The least absolute shrinkage and selection operator (LASSO) regression analysis and multivariate logistic regression models were used to screen variables, and a nomogram of the prediction model was plotted. The area under the receiver operating characteristic curve (AUC), calibration curve, and decision curve analysis (DCA) were adopted to evaluate the predictive ability, calibration degree, and clinical applicability of the model. The training set included 147 patients, with 38 in the HFpEF group and 109 in the non-HFpEF group. In the training set, patients in the HFpEF group had higher values than those in the non-HFpEF group in terms of age, body mass index (BMI), duration of diabetes, fasting blood glucose, glycosylated hemoglobin (HbA1c), triglyceride levels, triglyceride-glucose (TyG) index, N-terminal pro-B-type natriuretic peptide (NT-proBNP), and the ratio of mitral early diastolic flow velocity(E) to mitral annular early diastolic velocity(e'). Conversely, they exhibited lower values in estimated glomerular filtration rate (eGFR), left ventricular ejection fraction (LVEF), the proportion of complete revascularization, and the proportion of sodium-glucose cotransporter 2 inhibitor usage (all <0.05). LASSO regression analysis screened out 8 variables, including age, BMI, TyG index, HbA1c, Ln(NT-proBNP), LVEF, E/e' ratio, and eGFR. Multivariate logistic regression analysis showed that advanced age (=1.070, 95%: 1.011-1.133), elevated TyG index (=8.560, 95%: 2.581-28.391), elevated Ln(NT-proBNP) (=3.880, 95%: 1.959-7.684), and elevated E/e' ratio (=1.480, 95%: 1.181-1.854) were risk factors for HFpEF after PCI in patients with T2DM complicated with CHD. A nomogram was constructed using the above parameters. In the training set, the AUC of the prediction model for HFpEF after PCI in patients with T2DM complicated with CHD was 0.886 (95%: 0.831-0.941), with a sensitivity of 84.2% and a specificity of 82.6%. In the validation set, the AUC was 0.871 (95%: 0.782-0.960), with the sensitivity of 81.3% and the specificity of 80.9%. The Hosmer-Lemeshow goodness-of-fit test indicated good calibration in both the training cohort (χ²=6.832, =0.554) and the validation set (χ²=5.127, =0.744). DCA demonstrated that the model achieved a high clinical net benefit when the threshold probability ranged from 10% to 90%. Advanced age, elevated TyG index, elevated Ln(NT-proBNP), and elevated E/e' ratio are risk factors for HFpEF in patients with T2DM complicated by CHD after PCI. The nomogram of the prediction model constructed based on these factors can intuitively evaluate the risk of HFpEF in patients with T2DM complicated by CHD after PCI.
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