Chinese Medical Journal[JOURNAL]
Sun
200 papers
Corrigendum: Keratin 17 enhances the chemotaxis of neutrophils through regulating CXCL1 secretion in keratinocytes via PI3K/AKT/NF-κB pathway in psoriasis.
Chin Med J (Engl) · 2026 Jun · PMID 42299143 · Publisher ↗
Abstract loading — click title to view on PubMed.
Amyloid beta aggregation seeding activity as a new biomarker for Alzheimer's disease.
Song Y, Xie S, Li T … +5 more , Li Y, Nie S, Wang Z, Ma J, Jia J
Chin Med J (Engl) · 2026 Jun · PMID 42299128 · Publisher ↗
BACKGROUND: Blood-based biomarkers would greatly facilitate the clinical diagnosis of Alzheimer's disease (AD) as minimally invasive measurements. While several blood biomarkers for AD have emerged, the potential of plas...
BACKGROUND: Blood-based biomarkers would greatly facilitate the clinical diagnosis of Alzheimer's disease (AD) as minimally invasive measurements. While several blood biomarkers for AD have emerged, the potential of plasma β-amyloid (Aβ) aggregation seeding activity remains underexplored. In this study, we aim to evaluate the ability of this biomarker to distinguish AD and mild cognitive impairment (MCI) due to AD from cognitively unimpaired (CU) individuals and non-AD dementia. METHODS: A total of 549 participants were recruited from Xuanwu Hospital, Capital Medical University, between December 2020 and May 2024. Plasma Aβ aggregation seeding activity was measured using a real-time sonication-based protein misfolding cyclic amplification assay across discovery (n = 120: 30 CU, 30 MCI due to AD, 30 AD, 30 non-AD dementia) and validation (n = 429: 118 CU, 46 MCI due to AD, 141 AD, 124 non-AD dementia) stages. The diagnostic performance of plasma Aβ aggregation seeding activity as a biomarker was assessed using receiver operating characteristic (ROC) curves. RESULTS: In the validation stage, plasma Aβ aggregation seeding activity exhibited high diagnostic accuracy with optimal cutoff values (Thioflavin T fluorescence %) of 42.91 for distinguishing AD from CU (area under the ROC curve [AUC] = 0.93, 95% confidence interval [CI]: 0.91-0.96), 42.02 for AD from non-AD dementia (AUC = 0.91, 95% CI: 0.88-0.94), 43.17 for MCI due to AD from CU (AUC = 0.92, 95% CI: 0.87-0.96), and 43.24 for MCI due to AD from non-AD dementia (AUC = 0.90, 95% CI: 0.85-0.94). Plasma Aβ seeding activity significantly correlated with cognitive functions (Mini-Mental State Examination scores [MMSE]: rs = -0.68, P <0.001; Clinical Dementia Rating scores [CDR]: rs = 0.71, P <0.001). CONCLUSIONS: These findings indicate that plasma Aβ aggregation seeding activity could serve as a promising minimally invasive biomarker for identifying both AD and MCI due to AD. This biomarker potentially facilitates early detection and differential diagnosis of AD at different clinical stages.
Multiomics contributes to the discovery of common factors in alcohol- and hepatitis B virus-related liver fibrosis.
Dong Y, Guan Q, Zheng B … +3 more , Lv G, Wang X, Niu J
Chin Med J (Engl) · 2026 Jun · PMID 42299124 · Publisher ↗
BACKGROUND: Liver fibrosis due to alcohol consumption or chronic hepatitis B virus (HBV)-related liver disease is a major challenge for global health. Despite the different mechanisms of primary liver injury and disease-...
BACKGROUND: Liver fibrosis due to alcohol consumption or chronic hepatitis B virus (HBV)-related liver disease is a major challenge for global health. Despite the different mechanisms of primary liver injury and disease-specific cell responses, the progression of fibrotic liver disease follows a shared pattern. Our research aimed to identify key factors associated with shared patterns of alcohol- or HBV-related liver fibrosis. METHODS: Liver samples from three alcohol-related fibrosis patients, six HBV-related fibrosis patients, and five hepatic hemangioma patients were collected and grouped. Transcriptome and proteome sequencing were used to identify differentially expressed genes (DEGs) and differentially expressed proteins (DEPs) in alcohol- or HBV-related liver fibrosis hepatic stellate cells. Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway enrichment analyses were conducted to understand the functions of the DEGs or DEPs. Immunohistochemistry analysis, dual-luciferase reporter assays, Western blotting, real-time quantitative polymerase chain reaction, and chromatin immunoprecipitation were used to investigate annexin A2 (ANXA2) function and regulatory mechanisms. RESULTS: Transcriptomic analysis revealed 744 overlapping upregulated DEGs in patients with alcohol- or HBV-related liver fibrosis. GO and KEGG analyses revealed that 744 DEGs were involved in vasculature development and the extracellular matrix organization pathway. Proteomics revealed 99 overlapping upregulated DEPs in patients with alcohol- or HBV-related liver fibrosis. GO and KEGG analyses revealed that 99 DEPs were involved in phagosome and neutrophil degranulation. Integration of the transcriptome and proteome revealed that ANXA2 and perilipin 1 (PLIN1) might be key factors for the progression of liver fibrosis. Biochemical analysis revealed that ANXA2 positively regulates the process of liver fibrosis, whereas PLIN1 negatively regulates the process of liver fibrosis. Furthermore, the mechanisms by which ANXA2 is regulated by the NF-κB pathway during alcohol consumption and by the Janus kinase-signal transducer/activator of transcription 3 pathway during HBV infection are well proved. CONCLUSIONS: Our findings demonstrate that ANXA2 and PLIN1 are key factors involved in the progression of both alcohol- and HBV-related liver fibrosis, and further clarify the distinct regulatory mechanisms of ANXA2 mediated by the NF-κB pathway in alcohol-induced fibrosis and in HBV-related fibrosis.
Glioma microenvironment: Cellular crosstalk, immunosuppression, and novel therapeutic perspectives.
Hu Y, Liang J, Xu J … +1 more , Zhao L
Chin Med J (Engl) · 2026 Jun · PMID 42299115 · Publisher ↗
Glioma, the most aggressive primary brain malignancy, arises from glial cells within the central nervous system. Despite aggressive treatment, the prognosis remains poor, with all patients expected to experience recurren...
Glioma, the most aggressive primary brain malignancy, arises from glial cells within the central nervous system. Despite aggressive treatment, the prognosis remains poor, with all patients expected to experience recurrence. An important component of glioma growth is the interaction with the other cells in the brain environs. This complex ecosystem, termed the tumor microenvironment (TME), includes recruited immune cells and the resident cells in the central nervous system. Glioma cells recruit myeloid cells and reprogram their phenotype to fuel tumor growth. Tumor cells and reprogrammed myeloid cells further suppress adaptive immune responses. Additionally, glioma co-opts normal brain cells-including endothelial cells, neurons, and astrocytes-to create a microenvironment favoring tumor progression. Following this phenotypic shift, normal cells synergize with tumor cells to drive proliferation, invasion, immunosuppression, and angiogenesis. This review integrates recent advances in understanding the multidimensional interactions within the glioma TME, including insights gained from single-cell and spatial transcriptomics approaches that reveal its heterogeneous architecture and functional niches. By elucidating the underlying cellular and molecular mechanisms, we highlight how targeting the TME offers potential therapeutic opportunities to overcome treatment resistance and improve patient outcomes.
Mechanism of mitochondrial biogenesis regulated by PGC-1α/NR1D1 to increase the vulnerability of myocardial ischemia/reperfusion injury in diabetes.
Cui J, Gao S, Li L … +4 more , Jin X, Duan W, Xia Z, Qiu Z
Chin Med J (Engl) · 2026 Jun · PMID 42299075 · Publisher ↗
BACKGROUND: Peroxisome proliferator-activated receptor-γ coactivator 1α (PGC-1α) regulates the expression of clock gene nuclear receptor subfamily 1 group D member 1 (NR1D1) and is closely related to diabetes mellitus an...
BACKGROUND: Peroxisome proliferator-activated receptor-γ coactivator 1α (PGC-1α) regulates the expression of clock gene nuclear receptor subfamily 1 group D member 1 (NR1D1) and is closely related to diabetes mellitus and ischemic heart disease. However, the mechanism by which PGC-1α/NR1D1 increases the vulnerability of diabetic myocardium to ischemia/reperfusion (I/R) injury has yet to be elucidated. This study aimed to explore the roles of PGC-1α/NR1D1-mediated regulation of mitochondrial biogenesis in myocardial I/R injury of type 2 diabetic mice. METHODS: Type 2 diabetes was induced in C57BL/6 mice by a high-fat diet and streptozotocin. Diabetic and nondiabetic mice underwent I/R injury, with subsets receiving the NR1D1 agonist SR9009 or cardiac-specific Nr1d1 knockout. In parallel, rat cardiomyocyte-derived cell line H9c2 cardiomyocytes were exposed to high glucose and high fat and hypoxia/reoxygenation insult, with or without Pgc-1α overexpression by Pgc-1α lentivirus. Cardiac function in mice was assessed using an animal ultrasound system. Myocardial infarction size was determined by 2% 2,3,5-triphenyltetrazolium chloride (TTC) staining. Serum levels of troponin I (cTn-I) and lactate dehydrogenase (LDH) were measured by enzyme-linked immunosorbent assay (ELISA). The expression levels of NR1D1, PGC-1α, nuclear respiratory factor 1 (NRF1), transcription factor A (TFAM), autophagy-related protein 4 homolog B (ATG4B), and microtubule-associated protein 1 light chain 3 (LC3) in mouse myocardial tissue were detected by real-time quantitative polymerase chain reaction (RT-qPCR), Western blotting, and immunofluorescence. Meanwhile, the cell viability, apoptosis rate, mitochondrial reactive oxygen species (ROS), mitochondrial membrane potential (MMP), and mitochondrial morphology of H9c2 cardiomyocyte were evaluated using assay kits. RESULTS: Compared with nondiabetic mice, diabetic mice exhibited larger infarct size, higher serum LDH and cTn-I, and severe ultrastructural damage. Cardiac PGC-1α and NR1D1 expression decreased significantly after I/R, accompanied by reduced NRF1 and TFAM levels and impaired mitochondrial biogenesis. Nr1d1 knockout further worsened injury, shown by increased infarct size and decreased left ventricular ejection fraction (LVEF), whereas SR9009 pretreatment restored PGC-1α expression, activated NRF1/TFAM signaling, and reduced infarct size. In vitro, high glucose and high fat plus hypoxia/reoxygenation increased LDH release and apoptosis while decreasing MMP and elevating ROS. Overexpression of Pgc-1α reversed these effects, improving cell viability and reducing ROS by upregulating NR1D1 and NRF1/TFAM. CONCLUSIONS: These results indicate that disruption of PGC-1α/NR1D1 signaling impairs mitochondrial function, exacerbating diabetic myocardial I/R injury. Pharmacological activation of Nr1d1 or Pgc-1α overexpression alleviates injury by restoring mitochondrial function. Targeting this axis represents a promising strategy for cardioprotection in diabetes.
[Efficacy and safety of fourth-generation CAR-T cells targeting CD19 and BCMA with anti-IL-6 antibody secretion in refractory systemic lupus erythematosus].
Xu XX, Wang Q, Zhao XJ … +4 more , Xiang N, Hu BL, Wang XB, Chen Z
Zhonghua Yi Xue Za Zhi · 2026 Jun · PMID 42297600 · Publisher ↗
Clinical data of 3 patients with refractory systemic lupus erythematosus (rSLE) who received chimeric antigen receptor T-cell (CAR-T) therapy at the Department of Rheumatology and Immunology, the First Affiliated Hospita...
Clinical data of 3 patients with refractory systemic lupus erythematosus (rSLE) who received chimeric antigen receptor T-cell (CAR-T) therapy at the Department of Rheumatology and Immunology, the First Affiliated Hospital of University of Science and Technology of China, from June to September 2024 was prospectively enrolled. After lymphodepleting preconditioning with cyclophosphamide combined with fludarabine, 2 patients received a low dose (0.5×10⁶/kg) and 1 patient received a medium dose (1.0×10⁶/kg) of a 4th-generation CAR-T cells (SCAR02) targeting cluster of differentiation 19 (CD19) and B-cell maturation antigen (BCMA) and secreting interleukin-6 (IL-6) antibodies. Follow-up was conducted at day 14 and months 1, 2, 3, 6, 9, and 12 post-infusion to systematically evaluate safety (including treatment-related adverse events, cytokines, and immunoglobulin levels) and efficacy (including cellular kinetics, clinical efficacy, and serological markers). All 3 patients were females, aged 37, 25, and 41 years, respectively. During the follow-up period, no cytokine release syndrome (CRS), immune effector cell-associated neurotoxicity syndrome (ICANS), or other serious adverse events occurred. CAR-T cells expanded well in all patients; peripheral blood CD19⁺ B cells were completely depleted on days 9-13 and gradually recovered over 3-5 months. By month 12, the SLE Disease Activity Index 2000 (SLEDAI-2K) scores of patients 1 to 3 decreased from 8, 8, and 9 at baseline to 0, 4, and 0, respectively; anti-double-stranded DNA antibodies all turned negative, and complement levels returned to normal. Two patients achieved drug-free complete remission based on the Definitions of Remission in SLE (DORIS) criteria, and 1 patient achieved an SLE Responder Index-4 (SRI-4) response. This study demonstrates that SCAR02 exhibits a good safety profile and preliminary efficacy in rSLE patients, and its function of secreting IL-6 antibodies may help alleviate CRS.
[Relationship between small vessel disease load and cerebral blood flow and white matter integrity in patients with subcortical ischemic vascular dementia].
Liu XJ, Tian Z, Liu X … +2 more , Xing MY, Zhang N
Zhonghua Yi Xue Za Zhi · 2026 Jun · PMID 42297599 · Publisher ↗
To evaluate markers of cerebral small vessel disease (SVD), cerebral blood flow (CBF), and white matter integrity in patients with subcortical ischemic vascular dementia (SIVD) using multimodal magnetic resonance imaging...
To evaluate markers of cerebral small vessel disease (SVD), cerebral blood flow (CBF), and white matter integrity in patients with subcortical ischemic vascular dementia (SIVD) using multimodal magnetic resonance imaging (MRI), and to analyze the impact of total SVD load on cerebral perfusion and white matter injury. Fifty SIVD patients who visited the Cognitive Disorders Clinic of Tianjin Medical University General Hospital between October 2017 and October 2022 were enrolled and underwent 3.0 T multimodal MRI examination. A total SVD load score was calculated based on the severity of white matter hyperintensities (WMH), lacunes, enlarged perivascular space (EPVS), and cerebral microbleeds (CMB). The patients were divided into a low total SVD load group (0-4 points, =32) and a high total SVD load group (5-6 points, =18). CBF and white matter integrity were assessed using arterial spin labeling (ASL) and diffusion tensor imaging (DTI), respectively. Independent-sample -test and χ test were used for intergroup comparison. Binary logistic regression model was adopted to analyze the correlation of various imaging markers with CBF and DTI parameters in all subjects. Compared with the low total SVD load group, the high total SVD load group exhibited reduced CBF in the right cerebellar posterior lobe and tonsil [(45.7±14.9) vs (59.6±12.5) ml·(100 g)·min, =3.52, <0.01], left superior frontal gyrus [(22.2±6.3) vs (26.8±6.0) ml·(100 g)·min, =2.55, =0.01], left middle frontal gyrus [(50.6±15.8) vs (60.5±14.8) ml·(100 g)·min, =2.22, =0.03], and right middle frontal gyrus [(58.7±16.1) vs (67.7±12.7) ml·(100 g)·min, =2.18, =0.04]. Decreased fractional anisotropy values (all <0.05) and increased mean diffusivity values (all <0.05) were observed in multiple white matter regions, including the corpus callosum, right cerebral peduncle, bilateral internal capsules, bilateral anterior corona radiata, bilateral posterior corona radiata, bilateral posterior thalamic radiation, bilateral cingulate gyri, and bilateral frontoparietal superior fasciculi. Meanshile, reduced CBF and impaired white matter integrity in these brain regions were correlated with scores of individual SVD markers and the total SVD load score (all <0.05). The total SVD load is closely associated with decreased cerebral perfusion and impaired white matter integrity in SIVD patients, which is an important pathological mechanism underlying brain dysfunction.
[The value of different endotoxin levels in early prognostic evaluation of patients with sepsis].
Wu BY, Zheng YK, Zhu YY … +2 more , Shi YJ, He ZJ
Zhonghua Yi Xue Za Zhi · 2026 Jun · PMID 42297598 · Publisher ↗
To explore the value of different plasma endotoxin levels in evaluating early prognosis of patients with sepsis. A total of 150 sepsis patients confirmed by plasma endotoxin from August 2024 to July 2025 in Department o...
To explore the value of different plasma endotoxin levels in evaluating early prognosis of patients with sepsis. A total of 150 sepsis patients confirmed by plasma endotoxin from August 2024 to July 2025 in Department of Critical Care Medicine, Sun Yat-sen Memorial Hospital were prospectively enrolled. Clinical data was collected, including general information such as gender, age and underlying medical history, vital signs at enrollment, Acute Physiology and Chronic Health Evaluation Ⅱ (APACHEⅡ) score, Sequential Organ Failure Assessment (SOFA) score, laboratory and imaging results, infection-related indicators, and major treatment measures. Peripheral blood samples were collected after enrollment to detect endotoxin concentration. All patients were followed up for 28 days (follow-up assessments were conducted every 14 days following enrollment). The primary outcome was death within 28 days. Secondary outcomes were as follows: length of ICU stay, total hospital stay, and duration of mechanical ventilation. The relationship between different endotoxin levels and early prognosis in sepsis patients was analyzed. The X-tile software was used to determine the optimal cut-off value of endotoxin.Based on this cutoff value, patients were divided into a high-endotoxin group and a low-endotoxin group. Kaplan-Meier curves were plotted to calculate the 28-day cumulative survival rate and mortality rate. Univariate and multivariate Cox proportional hazards regression models were adopted to explore independent risk factors of early survival of sepsis patients. Among all enrolled patients, there were 101 males and 49 females, with the age of [ (, )] 60.0 (53.0, 72.8) years old. The cut-off value of endotoxin, calculated using X-tile software, was 0.23 EU/ml. Based on this value, the subjects were divided into the high-endotoxin group (=26) and the low-endotoxin group (=124). The 28-day mortality rate of the high-endotoxin group was significantly higher than that of the low-endotoxin group (42.3% vs 19.4%, =0.004). There were no statistically significant between-group differences in the secondary outcome indicators, including ICU stay duration, total hospital stay, and duration of mechanical ventilation. The Kaplan-Meier curve showed that the 28-day cumulative survival rate of the high-endotoxin group was lower than that of the low-endotoxin group (57.7% vs 80.6%, =0.004). The results of multivariate Cox regression analysis indicated that endotoxin (=2.307, 95%: 1.074-4.958), SOFA score (=1.172, 95%: 1.063-1.294), and total bilirubin (=1.004, 95%: 1.001-1.008) were influencing factors for early prognosis in sepsis patients. Plasma endotoxin has the potential to serve as a promising biomarker for early prognostic assessment of sepsis.
[Analysis of clinical characteristics and disease spectrum trend of children in short stature outpatient clinic of a tertiary hospital in Beijing in different years].
Lyu J, Wang C, Li YC … +1 more , Wu D
Zhonghua Yi Xue Za Zhi · 2026 Jun · PMID 42297597 · Publisher ↗
To analyze the clinical characteristics and disease spectrum trend of children in short stature outpatient clinic of Beijing Children's Hospital, Capital Medical University in different years. A retrospective analysis w...
To analyze the clinical characteristics and disease spectrum trend of children in short stature outpatient clinic of Beijing Children's Hospital, Capital Medical University in different years. A retrospective analysis was performed on the medical records of children attending the short stature outpatient department of Beijing Children's Hospital, Capital Medical University during the summer vacation (July 1 to September 30) in 2021, 2023 and 2025. Analyze the clinical characteristics and their distribution of children patients in 3 years. The Mantel-Haenszel trend χ² test was used to analyze the changing trends of various indicators and disease spectrum across the 3 years. A total of 5 862 children were enrolled, including 3 022 boys and 2 840 girls, with the age of (9.6±3.2) years and the height of (131.7±20.4) cm. The age of children in the three years was (9.0±3.3), (9.6±3.1), and (10.1±2.9) years, respectively. No infants were admitted to the short stature outpatient clinic in any of the 3 years. The proportion of children in the toddler and preschool periods decreased year by year, while that in the school-age and adolescent periods increased gradually (all <0.001). The height of children in the 3 years was (123.4±23.9), (131.6±19.9), and (139.9±21.2) cm, respectively. The proportion of children with low height percentile (<P, P-<P) showed a decreasing trend, whereas the proportions of children with moderate to high height percentile (P-<P to≥P) presented an increasing trend (all <0.05). The proportion of children with constitutional short stature decreased year by year, while the proportions of patients with adolescent short stature, slow or poor height growth, and precocious puberty increased annually (all <0.05). During the summer periods of 2021, 2023 and 2025, among patients visiting the short stature outpatient clinic of Beijing Children's Hospital, Capital Medical University, the proportions of school-age and adolescent children, children with height at≥P percentile, and cases of precocious puberty all increased year by year.
[Analysis of hospital associated infection characteristics in pediatric patients undergoing hematopoietic stem cell transplantation].
Wang YY, Wang XH, Zhang P … +7 more , Peng YG, Tian J, Jing YF, Chen FJ, Yang J, Wang P, Chen NN
Zhonghua Yi Xue Za Zhi · 2026 Jun · PMID 42297596 · Publisher ↗
To analyze the characteristics of hospital associated infection (HAI) in children undergoing hematopoietic stem cell transplantation (HSCT). The clinical data of children who underwent HSCT at Baoding Hospital, Beijing...
To analyze the characteristics of hospital associated infection (HAI) in children undergoing hematopoietic stem cell transplantation (HSCT). The clinical data of children who underwent HSCT at Baoding Hospital, Beijing Children's Hospital Affiliated to Capital Medical University and Beijing Children's Hospital Affiliated to Capital Medical University between July 2021 and August 2024 were retrospectively collected. Based on the occurrence of HAI, the patients were divided into the infected group (children who developed at least one HAI during hospitalization) and the uninfected group (children who did not develop HAI during multiple hospitalizations). The characteristics of HAI in the two groups were analyzed. A total of 651 patients were enrolled, including 138 patients (21.2%) in the infected group [93 males and 45 females; aged 8 (4, 12) years] and 513 patients in the uninfected group [328 males and 185 females; aged 7 (4, 11) years]. The infected group had 181 cases of HAI occurring during 150 hospitalizations among 138 pediatric patients. The incidence rate of HAI was 8.4% (episode incidence rate 10.1%), and the daily incidence rate of HAI was 3.3‰ (4.0‰). The mortality rate in the infected group was higher than that in the uninfected group [6.5% (9/138) vs 0.6% (3/513), <0.001]. The top five HAI were gastrointestinal infections (41.4%), vascular catheter-related bloodstream infections (19.3%), bloodstream infections (non catheter-related, sepsis type, 12.2%), lower respiratory tract infections (8.3%), and upper respiratory tract infections (6.6%). A total of 179 pathogenic microorganisms were detected in 181 cases of HAI in the infected group. The proportion of viruses in gastric intestinal infection accounted for 76.0% (57/75). The proportion of bacteria in catheter-related bloodstream infections was 100.0% (35/35), while in septic-type bloodstream infections it accounted for 90.1% (20/22). Lower respiratory tract infections were caused by bacteria and viruses in equal proportions, each accounting for 29.4% (5/15). The proportion of viruses in upper respiratory tract infections accounts for 91.7% (11/12), and bacteria accounted for 68.2% (15/22) of other infections. The median hospitalization duration for HAI was 21 (11, 38) days, with statistically significant difference in the timing of infection occurrence across various infection sites (=20.09, =0.001). A total of 117 cases (64.6%) of HAI were treated with antimicrobial agents, with a median duration of antimicrobial use of 7 (0, 18) days. There was a statistically significant difference in the duration of antibiotic use among different infection sites (=84.10, <0.001). The children with HAI have a higher mortality rate. Viral gastrointestinal infections are the most common type of HAI, followed by bacterial bloodstream infections; the timing of infection occurrence and the duration of antimicrobial use vary across different infection sites.
[Role of exogenous supplementation of umbilical cord blood immune cells in reconstructing immune function and restoring hematopoietic function in elderly high-risk myeloid neoplasms patients].
Du CX, Zhang HQ, Zhang YH … +8 more , Peng L, Luo SQ, Wang Y, Li YQ, Teng GS, Jiang EL, Chen B, Bai J
Zhonghua Yi Xue Za Zhi · 2026 Jun · PMID 42297595 · Publisher ↗
To investigate the effect of exogenous supplementation of umbilical cord blood (UCB) immune cells on immune function reconstruction and hematopoietic function recovery in elderly high-risk myeloid neoplasms (MN) patients...
To investigate the effect of exogenous supplementation of umbilical cord blood (UCB) immune cells on immune function reconstruction and hematopoietic function recovery in elderly high-risk myeloid neoplasms (MN) patients. The research includes clinical studies and cell experiments. Clinical data of elderly high-risk MN patients aged >60 years admitted to the Department of Hematology at the Second Hospital of Tianjin Medical University from January 2023 to June 2025 were retrospectively included. Based on treatment regimens, the patients were categorized into chemotherapy group ("3+7"regimen), demethylation therapy (HMA) group (decitabine-based therapy), and UCB group (venetoclax combined with azacitidine plus UCB reinfusion). At 28 days post-treatment, differences were compared among the groups regarding disease remission (complete remission rate), hematopoietic function reconstruction (recovery time of white blood cells and platelets), survival outcomes (overall survival rate and event-free survival rate), and cellular immune function reconstruction [levels of various CD4T cells, CD8T cells, natural killer (NK)cells, etc.]. To further confirm the role of UCB in the bone marrow microenvironment of MN patients, primary bone marrow cells were collected from 3 elderly high-risk MN patients in the UCB group (ileal bone marrow aspiration was performed on day 15 post-treatment and before UCB infusion, with 10 ml of bone marrow aspirated each time); additionally, UCB cells were obtained from 3 healthy donors (sourced from the Shandong Umbilical Cord Blood Hematopoietic Stem Cell Bank of China, all HLA 2/10 matched male donors). Based on different seeding methods of patient primary bone marrow cells and healthy donor UCB mononuclear cells in Transwell chambers, the cells were divided into a control group (patient bone marrow mononuclear cells cultured separately), an indirect co-culture group (non-contact co-culture of patient bone marrow mononuclear cells and UCB cells), and a direct co-culture group (contact co-culture of patient bone marrow mononuclear cells and UCB cells). After 48 hours of culture, the cells from the lower chamber and the supernatant were collected from each group. The proportional differences among immune cell subsets (various T-cell, B-cell, and NK cell subsets) were compared among the three groups, and the differences in cytokine levels among the three groups of the supernatants [tumor necrosis factor (TNF)-α, interferon (IFN)-γ, and interleukin (IL)-6] were also compared. A total of 109 patients were enrolled, including 54 males and 55 females, with an age range [ (, )] of 68 (60, 87) years. There were 38, 39, and 32 cases in the chemotherapy group, HMA group, and UCB group, respectively. Analysis of disease response revealed that the complete response rates in the UCB group [43.8% (14/32) vs 28.2% (11/39), <0.001] and the chemotherapy group [44.7% (17/38) vs 28.2% (11/39), <0.001] were higher than those in the HMA group. In terms of hematopoietic function recovery, the median time to achieve target leukocyte counts in the UCB group was shorter than that in the chemotherapy group [22 (14, 28) vs 28 (24, 37) days, <0.05] and the HMA group [22 (14, 28) vs 31 (21, 42) days, <0.05]. Similarly, the median time to achieve target platelet counts in the UCB group was shorter than that in the chemotherapy group [24 (17, 29) vs 28 (23, 33) days, <0.05] and the HMA group [24 (17, 29) vs 29 (22, 37) days, <0.05]. The survival analysis demonstrated that the 3-year overall survival rate in the UCB group was higher than that in the HMA group (39.1% vs 19.7%, <0.05), while no statistically significant difference was observed compared to the chemotherapy group (>0.05). Similarly, the 3-year event-free survival rate in the UCB group was higher than that in the HMA group (35.8% vs 25.5%, <0.05), with no statistically significant difference compared to the chemotherapy group (>0.05). Regarding the reconstruction of cellular immune function, the proportion of CD4central memory T cells in the UCB group at 28 days post-treatment was lower than that in the chemotherapy group [20% (9%, 29%) vs 32%(23%, 39%), <0.05], while no statistically significant difference was observed compared to the HMA group (>0.05). At 28 days post-treatment, the proportions of CD4naive T cells [45% (30%, 58%) vs 22% (10%, 34%)] and CD8naive T cells [41% (31%, 52%) vs 22% (8%, 36%)] in the UCB group were significantly higher than those in the HMA group (both <0.05), while no statistically significant difference was observed compared to the chemotherapy group (both >0.05). At 28 days post-treatment, the UCB group exhibited higher proportions of CD8effector T cells [40% (33%, 50%) vs 18% (8%, 28%)], CD19B cells [20% (13%, 27%) vs 12% (7%, 14%)], and NK cells [20% (15%, 26%) vs 14% (7%, 21%)] compared to the chemotherapy group (all <0.05). However, the UCB group showed lower proportions of regulatory T cells at 28 days post-treatment than both the chemotherapy group [4% (4%, 6%) vs 7% (7%, 8%), <0.05] and the HMA group [4% (4%, 6%) vs 8% (6%, 12%), <0.05]. In terms of cellular experiments, differential analysis of immune cells revealed that the indirect co-culture group exhibited higher levels of CD8naive T cells, CD4naive T cells, NK cells, and CD19B cell subsets compared to the control group; conversely, the levels of regulatory T cells and CD4central memory T cells were lower than those in the control group (all <0.05). Cytokine level analysis demonstrated that the direct co-culture group showed higher levels of TNF-α and IFN-γ, as well as lower levels of IL-6 compared to the control group (<0.001). Immunocytes such as NK cells in UCB may promote immune function reconstruction and hematopoietic recovery in patients, thereby improving their prognosis.
[Expert consensus on the diagnosis and management of post-neurosurgical intracranial infection (2026 edition)].
Chinese Neurosurgical Society, Chinese Neurosurgery Intensive Care Management Collaboration Group, Beijing Neurosurgical Society
Zhonghua Yi Xue Za Zhi · 2026 Jun · PMID 42297594 · Publisher ↗
Post-neurosurgical intracranial infection (PNII) is a common complication of neurosurgery, which is associated with poor outcomes. Key strategies to reduce infection rates and improve prognosis include strict perioperati...
Post-neurosurgical intracranial infection (PNII) is a common complication of neurosurgery, which is associated with poor outcomes. Key strategies to reduce infection rates and improve prognosis include strict perioperative infection control, early diagnosis of postoperative intracranial infections, and standardized comprehensive treatment. Based on previous guidelines and consensus, the Chinese Society of Neurosurgery, the Chinese Neurosurgery Intensive Care Management Collaboration Group, and the Beijing Neurosurgical Society convened a multidisciplinary team of experts in neurosurgery, infectious diseases, and clinical microbiology. This consensus was developed through systematic literature reviews and evidence-based medicine, integrating domestic and international epidemiological and clinical research evidence. The Grading of Recommendations Assessment, Development and Evaluation (GRADE) system was used for evidence evaluation and recommendation formulation. After multiple rounds of expert discussions and voting, 30 recommendations were finally established. This consensus covers the epidemiology of PNII, pathogen profiles, diagnostic criteria, perioperative prevention strategies, antimicrobial selection, multidrug-resistant organisms management, surgical interventions, and complication management. It aims to provide standardized guidance for clinical practice and to promote more standardized and refined management of PNII.
[Expert consensus on the clinical diagnosis and management of sarcopenic obesity (2026 edition)].
Weight Management Branch of the Chinese Association of Health Management
Zhonghua Yi Xue Za Zhi · 2026 Jun · PMID 42297593 · Publisher ↗
Sarcopenic obesity is a distinct subtype of obesity characterized by excessive adiposity combined with reduced skeletal muscle mass and impaired muscle function, which exerts dual and superimposed adverse impacts on huma...
Sarcopenic obesity is a distinct subtype of obesity characterized by excessive adiposity combined with reduced skeletal muscle mass and impaired muscle function, which exerts dual and superimposed adverse impacts on human health. In accordance with the latest evidence-based medical evidence and clinical practical experience, the expert panel formulated the "Expert consensus on the clinical diagnosis and management of sarcopenic obesity (2026 edition)", aiming to provide standardized diagnosis and treatment regimens for clinicians. This consensus systematically elaborates on the definition, etiology, and epidemiological characteristics of sarcopenic obesity, the understanding of sarcopenic obesity in traditional Chinese medicine, diagnostic criteria, nutritional and exercise interventions, as well as the indications and safety of pharmacotherapy (including weight-loss medications and muscle-enhancing agents). Individualized management strategies are proposed for special populations, such as adolescents, the elderly, and menopausal individuals. Clinical decision-making and intervention intensity are recommended to be comprehensively evaluated by a multidisciplinary team, involving endocrinology, bariatric surgery, clinical nutrition, rehabilitation medicine, traditional Chinese medicine, general practice, and other related disciplines. Using the modified Delphi method as the core framework for consensus development, this consensus was established through systematic literature retrieval and refinement of key clinical issues to form a structured questionnaire. Consensus criteria were determined in accordance with international Delphi study protocols, and 9 recommendations were finally formulated. These recommendations systematically summarize nutritional intervention, exercise prescription, pharmacotherapy, and comprehensive management strategies for sarcopenic obesity, with the aim of promoting the standardization of clinical diagnosis and treatment of sarcopenic obesity in China.
[Current status and progress of prognostic evaluation in marginal zone lymphoma].
Liu YN, Fang J, Zhou FL … +1 more , Mei H
Zhonghua Yi Xue Za Zhi · 2026 Jun · PMID 42297592 · Publisher ↗
Marginal zone lymphoma (MZL) is an indolent B-cell non-Hodgkin lymphoma with marked heterogeneity. Currently, histological subtype, clinical stage, biochemical parameters, and clinical scoring systems represented by the...
Marginal zone lymphoma (MZL) is an indolent B-cell non-Hodgkin lymphoma with marked heterogeneity. Currently, histological subtype, clinical stage, biochemical parameters, and clinical scoring systems represented by the MZL-international prognostic index (MZL-IPI) remain the principal basis for risk stratification; however, their differentiation power is limited, particularly for intermediate-risk groups, and they can not fully reflect the biological heterogeneity of the disease. Molecular genetic studies have revealed the significant prognostic impact of mutations in genes such as , , , and , as well as chromosomal abnormalities including t(11;18) and 7q deletion, with mutations being closely associated with histological transformation and high-risk outcomes. In the field of imaging, F-fluorodeoxyglucose (F-FDG) positron emission tomography/computed tomography (PET/CT) has inherent limitations in MZL, whereas novel targeted tracers like C-X-C motif chemokine receptor type 4 (CXCR4) PET/CT show improved lesion detection rates and preliminary prognostic value, and imaging omics holds promise for non-invasively revealing tumor heterogeneity. This review systematically summarizes the current status and shortcomings of these prognostic factors, and proposes that future efforts should focus on integrating clinical, molecular genetics, imaging, and multi-omics data, and leveraging artificial intelligence technology to construct multicenter-validated, multidimensional prognostic models, so as to advance precision risk stratification and individualized treatment for MZL.
[Current status and progress of staging and efficacy evaluation of marginal zone lymphoma].
Wang JH, Quan ZY, Wu D … +5 more , Yan WZ, Wang YR, Peng HL, He PC, Liang R
Zhonghua Yi Xue Za Zhi · 2026 Jun · PMID 42297591 · Publisher ↗
Marginal zone lymphoma (MZL) is characterized by high clinical heterogeneity, making individualized precision therapy highly contingent upon accurate staging and dynamic response assessment. This review systematically su...
Marginal zone lymphoma (MZL) is characterized by high clinical heterogeneity, making individualized precision therapy highly contingent upon accurate staging and dynamic response assessment. This review systematically summarizes the current status and progress in the evaluation of splenic MZL (SMZL), mucosa-associated lymphoid tissue (MALT) lymphoma, and nodal MZL (NMZL). In terms of staging modalities, selection should be based on subtype-specific characteristics; notably, as a novel radiotracer, 68Ga-Pentixafor positron emission tomography/computed tomography (PET/CT) provides crucial complementary value for evaluating lesions with low F-fluorodeoxyglucose (F-FDG) avidity. In terms of staging system, the modified Ann Arbor, Lugano classifications and MZL-specific designations (ⅠS, ⅡS) should be comprehensively applied. In terms of efficacy evaluation, the paradigm for response assessment is shifting from isolated morphological measurements toward a multidimensional model integrating functional imaging (Deauville score), molecular-level response monitoring [measurable residual disease (MRD) and circulating tumor DNA (ctDNA)], and patient-reported outcomes (PRO). Importantly, a sustained complete response at 24 months (CR24) has emerged as a critical surrogate endpoint for predicting long-term prognosis. Follow-up management necessitates risk stratification-based dynamic monitoring, with a focus on early warning of histological transformation. Ultimately, this review aims to provide a reference to further optimize the standardized clinical diagnosis, treatment and holistic management of MZL in China.
[Treatment options for marginal zone lymphoma].
Jiang Q, Wang X, Xiang XX … +2 more , Wang L, Zhang X
Zhonghua Yi Xue Za Zhi · 2026 Jun · PMID 42297590 · Publisher ↗
Marginal zone lymphoma (MZL) is a group of indolent B-cell lymphomas with high biological and clinical heterogeneity, including mucosa-associated lymphoid tissue, nodal, and splenic MZL. Despite diverse first-line treatm...
Marginal zone lymphoma (MZL) is a group of indolent B-cell lymphomas with high biological and clinical heterogeneity, including mucosa-associated lymphoid tissue, nodal, and splenic MZL. Despite diverse first-line treatment options, significant differences exist between guidelines and clinical practices, lacking a unified and standardized treatment pathway.Therefore, this article elaborates on the assessment of treatment indications of MZL, the initial therapies for different MZL subtypes, and summarizes the treatment for relapsed/refractory MZL, the selection of maintenance therapy, and management of treatment-related complications, aiming to offer evidence-based guidance and individualized therapeutic decision-making in clinical practice.
[Combining clinical and pathological features to explore the diagnostic challenges of marginal zone lymphoma].
Zhou XX, Yan WZ, Zhou P … +4 more , Fan SQ, Wei J, Lyu B, Peng HL
Zhonghua Yi Xue Za Zhi · 2026 Jun · PMID 42297589 · Publisher ↗
The diagnosis of marginal zone lymphoma (MZL) still relies on morphology, immunohistochemistry, and flow cytometry. Pathologists and clinicians have some difficulties in the diagnosis and differential diagnosis of MZL. T...
The diagnosis of marginal zone lymphoma (MZL) still relies on morphology, immunohistochemistry, and flow cytometry. Pathologists and clinicians have some difficulties in the diagnosis and differential diagnosis of MZL. The key difficulty lies in its diverse clinicopathological manifestations and the lack of characteristic biomarkers or molecular biological features. Combined with clinical and pathological features, this article focuses on some difficulties in the related differential diagnosis, such as the differentiation between extranodal MZL (EMZL) of mucosa associated lymphoid tissues and reactive lesions, between spleen MZL (SMZL) and other splenic lymphomas, as well as MZL with plasmacytic differentiation from lymphoplasmacytic lymphoma (LPL) and myeloma, which aims to provide insights for both clinicians and pathologists in the differential diagnosis of MZL.
[Efficacy of three hearing intervention strategies in microtia patients with concomitant ossicular malformation].
Pang JQ, Liu PY, Li CH … +3 more , Liang MJ, Chen SJ, Yang HD
Zhonghua Yi Xue Za Zhi · 2026 Jun · PMID 42297588 · Publisher ↗
A retrospective analysis was conducted on microtia patients with concomitant ossicular malformation who underwent hearing intervention at Sun Yat-sen Memorial Hospital, Sun Yat-sen University from August 2019 to November...
A retrospective analysis was conducted on microtia patients with concomitant ossicular malformation who underwent hearing intervention at Sun Yat-sen Memorial Hospital, Sun Yat-sen University from August 2019 to November 2024. A total of 22 patients aged (10.4±7.3) years were included. Among them, 11 patients underwent hearing reconstruction surgery, six were fitted with non-implantable bone conduction hearing aids, and five received bone-anchored hearing aid Attract (BAHA Attract). No significant intergroup differences were observed in pre-intervention air-conduction thresholds, bone-conduction thresholds, or air-bone gaps (all >0.05). In the hearing reconstruction group, postoperative air-conduction pure-tone averages (PTA) and air-bone gap were significantly decreased compared with preoperative values [(51.8±5.1) dB HL vs (74.4±5.0) dB HL, =0.003; (29.0±2.0) dB HL vs (51.3±3.9) dB HL, =0.001]. In the non-implantable bone conduction hearing aid group and the BAHA Attract group, the pre-intervention PTA were (58.5±2.4) dB HL and (76.8±4.6) dB HL, respectively, while the postoperative sound-field pure-tone averages were (27.5±1.9) dB HL and (28.5±3.1) dB HL, respectively. There was no significant difference in postoperative sound-field thresholds between the two groups (=0.790). No statistically significant difference was found in total costs among the three groups (=0.118). However, out-of-pocket costs differed significantly (=0.007), being higher in the bone conduction hearing aid group than in the hearing reconstruction group and the BAHA Attract group (both <0.05). Collectively, these findings demonstrate that all three intervention modalities yield favorable audiological outcomes, with comparable total treatment costs but distinct out-of-pocket financial burdens.
[Clinical analysis of 10 cases of congenital middle ear cholesteatoma with concurrent congenital ossicular malformation].
Guo F, Chen XY, Zhang DJ … +2 more , Lin XX, Guan GF
Zhonghua Yi Xue Za Zhi · 2026 Jun · PMID 42297587 · Publisher ↗
The data of 10 congenital middle ear cholesteatoma (CMEC) patients with concurrent congenital ossicular anomalies (COAs), who were admitted to the Second Hospital of Jilin University between January 1, 2018, and July 31,...
The data of 10 congenital middle ear cholesteatoma (CMEC) patients with concurrent congenital ossicular anomalies (COAs), who were admitted to the Second Hospital of Jilin University between January 1, 2018, and July 31, 2025 were retrospectively reviewed. The cohort comprised 8 males and 2 females, with ages ranging from 4 to 36 years. The predominant clinical manifestations included aural fullness, tinnitus, and progressive hearing loss. Preoperative evaluations included high-resolution CT (HRCT) of the temporal bone, MRI of the ear (with non-contrast, diffusion-weighted, and contrast-enhanced sequences), and comprehensive audiological assessments. Combined with intraoperative findings, the results demonstrated that in these 10 CMEC patients, the ossicular abnormalities were congenital malformations (e.g., hypoplasia or aplasia) rather than ossicular destruction resulting from direct erosion by the CMEC itself. These findings suggest that CMEC with COAs may be a comorbid condition arising from an independent congenital developmental anomaly, rather than from erosion induced by the CMEC itself.
[Brain functional and cognitive features in schizophrenia patients with positive and negative symptom features based on resting-state functional MRI].
Han WY, Liu XZ, Liu K … +6 more , Li X, Cheng XG, Chen AR, Lyu LX, Li WW, Yang YF
Zhonghua Yi Xue Za Zhi · 2026 Jun · PMID 42297586 · Publisher ↗
To explore the brain functional and cognitive characteristics of schizophrenia (SZ) patients with predominant positive or negative symptoms using resting-state functional magnetic resonance imaging (rs-fMRI). SZ patient...
To explore the brain functional and cognitive characteristics of schizophrenia (SZ) patients with predominant positive or negative symptoms using resting-state functional magnetic resonance imaging (rs-fMRI). SZ patients who visited the Second Affiliated Hospital of Henan Medical University from March 2021 to June 2024 were prospectively included and evaluated with the Positive and Negative Syndrome Scale (PANSS). They were then divided into the positive symptom-dominant SZ group (SZ-Ⅰ group) and the negative symptom-dominant SZ group (SZ-Ⅱ group) based on the results. Healthy individuals were recruited from the surrounding communities as the control group. The cognitive function of SZ patients was assessed using the MATRICS Consensus Cognitive Battery (MCCB). Whole-brain rs-fMRI data was collected from all subjects, and low-frequency amplitude (ALFF), fractional ALFF (fALFF), and regional homogeneity (ReHo) were calculated. Brain regions with significant differences among the three groups were identified through inter-group comparisons and used as regions of interest (ROI) to calculate the whole-brain functional connectivity (FC) and perform inter-group comparisons. Partial correlation analysis was conducted to explore the correlations between rs-fMRI and MCCB subscale scores among the three groups. The SZ-Ⅰ group included 18 males and 20 females, with an average age of (28.2±7.8) years; the SZ-Ⅱ group included 19 males and 18 females, with an average age of (30.9±6.4) years; and the control group included 16 males and 20 females, with an average age of (32.6±9.3) years. There were no significant differences in gender and age among the three groups (all 0.05). The fALFF value of the right caudate nucleus showed significant differences among the three groups, with the SZ-Ⅰ group having a higher fALFF value than the SZ-Ⅱ group, and both SZ groups having higher fALFF values than the control group (all <0.05, FDR corrected). The FC values from the right caudate nucleus to the right angular gyrus and the right caudate nucleus to the right inferior parietal lobule were higher in the SZ-Ⅱ group than in the SZ-Ⅰ group (all <0.05, GRF corrected). In the SZ-Ⅰ group, the fALFF value of the right caudate nucleus was potentially negatively correlated with the maze test score (=-0.388, =0.340), and in the SZ-Ⅱ group, the fALFF value of the right caudate nucleus was potentially negatively correlated with the spatial span test (=-0.479, =0.100). There are differences in the brain functional activities and connections related to the right caudate nucleus in SZ patients with predominant positive or negative symptoms. The abnormal brain functional activities are associated with the specific cognitive impairments in SZ patients with different symptom characteristics, suggesting that the right caudate nucleus can be a potential functional imaging biomarker for differentiating SZ patients with different symptom characteristics.
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