Wang Y, Xu X, Shen WJ
… +3 more, Li H, Wu LL, Wang GY
Zhonghua Yi Xue Za Zhi
· 2026 Jun · PMID 42297585
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To investigate the effects of oliceridine versus sufentanil for anesthesia induction and postoperative patient-controlled intravenous analgesia (PCIA) on postoperative nausea and vomiting (PONV) in patients undergoing gy...To investigate the effects of oliceridine versus sufentanil for anesthesia induction and postoperative patient-controlled intravenous analgesia (PCIA) on postoperative nausea and vomiting (PONV) in patients undergoing gynecological laparoscopic surgery. This prospective study enrolled 70 patients scheduled for elective gynecological laparoscopic surgery under general anesthesia with planned postoperative PCIA at Beijing Tongren Hospital, Capital Medical University, from September to December 2025. Patients were randomly assigned using a random number table to either the oliceridine group (Group O, =35) or the sufentanil group (Group S, =35). Group O received oliceridine for anesthesia induction and PCIA, while Group S received sufentanil; both groups received ondansetron and flurbiprofen axetil in combination. The primary outcome was the incidence of PONV within 48 hours postoperatively. Secondary outcomes included the incidence of nausea and vomiting during 0-<24 h and 24-48 h postoperatively, severity of nausea within 24 hours postoperatively [assessed by the visual analog scale (VAS), with a score≥4 defined as moderate-to-severe], the impact of PONV (assessed by the Myles simplified scale, with a score≥5 defined as clinically important PONV), postoperative pain numerical rating scale (NRS) scores, recovery parameters, and adverse events. A total of 34 patients in Group O and 33 patients in Group S completed the study. The mean age was (39.3±9.2) years in Group O and (40.9±10.4) years in Group S, with no significant differences in baseline characteristics between the two groups (all >0.05). The incidence of PONV within 48 hours postoperatively was significantly lower in Group O than in Group S [35.3% (12/34) vs 66.7% (22/33), χ²=6.59, =0.010]. Within the first 24 hours postoperatively, Group O had a lower incidence of nausea [29.4% (10/34) vs 66.7% (22/33), χ²=9.32, =0.002] and a lower incidence of moderate-to-severe nausea [20.6% (7/34) vs 51.5% (17/33), χ²=6.97, =0.008] compared to Group S. The incidence of clinically important PONV was lower in Group O than in Group S, but the difference was not statistically significant [2.9% (1/34) vs 18.2% (6/33), =0.054]. There were no significant differences between the two groups in resting or movement NRS scores at any postoperative time point (all >0.05), and no patient required rescue analgesia. No significant differences were observed between the two groups in awakening time, time to first flatus, or overall incidence of adverse events (all >0.05). For patients at high risk of PONV undergoing gynecological laparoscopic surgery, oliceridine provides analgesic efficacy equivalent to sufentanil while significantly reducing the incidence and severity of postoperative nausea and vomiting, with a favorable safety profile.
Zhonghua Yi Xue Za Zhi
· 2026 Jun · PMID 42297584
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To investigate the cervical reasonable range of motion (ROM) after anterior cervical discectomy and fusion (ACDF), so that the intradiscal pressure (IDP) in adjacent segments of the fusion segments did not increase compa...To investigate the cervical reasonable range of motion (ROM) after anterior cervical discectomy and fusion (ACDF), so that the intradiscal pressure (IDP) in adjacent segments of the fusion segments did not increase compared with normal cervical spine. A three-dimensional finite element model of intact cervical spine (C-C) was established based on CT data from a healthy adult female cervical spine, and its effectiveness was verified. ACDF surgery was simulated at the C-C level, with implantation of interbody cage and screw-plate system to construct the ACDF model. A 1.0 Nm moment and 73.6 N follower load was applied to the intact model to determine the normal cervical ROMs. A displacement load was applied to the ACDF model under the same follower load to achieve a total C-C ROM equivalent to that of the intact model. The fitting function was employed to calculate the total C-C ROM of the ACDF model without increasing IDP in adjacent segments, which was defined as the reasonable ROM. Compared with the intact model, the ACDF model (C fusion) demonstrated significantly increased ROM at the adjacent segments C and C in all motion directions, with an increase of 13.07%-17.77% and 7.78%-18.15%, respectively. The IDP of C and C increased with increasing total C ROM. The IDP of C was higher than that of C in almost all motion directions, except for extension. Finally, the postoperative reasonable ROMs of ACDF model were 42.4°, 53.6°, 28.6° and 43.0° in flexion, extension, lateral flexion, and axial rotation, which decreased by 6.6%, 3.8%, 3.5% and 5.6% compared with the intact model, respectively. The postoperative reasonable ROM in flexion, extension, lateral bending, and axial rotation is 42.4°, 53.6°, 28.6°, and 43.0°, respectively. Moderately reducing cervical ROM may offset the increase in adjacent segment IDP, thereby providing a novel strategy for preventing adjacent segment disc degeneration after ACDF.
Fetal Medicine Group, Chinese Society of Perinatal Medicine, Chinese Medical Association, National Obstetric Professional Medical Quality Control Center of China, National Clinical Research Center for Obstetric and Gynecologic Diseases of China
Zhonghua Yi Xue Za Zhi
· 2026 Jun · PMID 42297583
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Stillbirth is one of the most common adverse pregnancy outcomes. It not only causes physical and psychological trauma to pregnant and puerperal women but also imposes heavy family and socioeconomic burdens. Standardized...Stillbirth is one of the most common adverse pregnancy outcomes. It not only causes physical and psychological trauma to pregnant and puerperal women but also imposes heavy family and socioeconomic burdens. Standardized clinical management of stillbirth is crucial for improving the quality of the birth population. Such management should be based on a multidisciplinary collaborative diagnosis and treatment model, covering a complete pathway including high-risk factor screening, risk stratification and early warning, whole-pregnancy monitoring, and intervention in subsequent pregnancies. Accordingly, this guideline was jointly developed by the Fetal Medicine Group of the Chinese Society of Perinatal Medicine (Chinese Medical Association), the National Obstetric Quality Control Center, and the National Clinical Research Center for Obstetric and Gynecologic Diseases of China. We followed the Grading of Recommendations Assessment, Development and Evaluation (GRADE) system and international reporting standards for practice guidelines. A multidisciplinary expert team was established to systematically review evidence on 32 key clinical questions in China and formulate evidence-based recommendations, so as to provide guidance for the standardized management of stillbirth in China. This guideline aims to provide a knowledge framework and practical guidance for primary healthcare professionals, obstetricians, clinical pharmacists, nurses at all levels of medical institutions, as well as pregnant women and their families.
Guidelines and Standards Research Center, Chinese Medical Association Publishing House; Research Unit of Evidence‑Based Evaluation and Guidelines (2021RU017), Chinese Academy of Medical Sciences; WHO Collaborating Centre for Guideline Implementation and Knowledge Translation; the Scientific, Transparent and Applicable Rankings (STAR) Working Group
Zhonghua Yi Xue Za Zhi
· 2026 Jun · PMID 42297582
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To further promote continuous quality improvement of clinical practice guidelines (CPGs) and expert consensuses (ECs) in China, the Scientific, Transparent, and Applicable Rankings (STAR) Working Group conducted its 2023...To further promote continuous quality improvement of clinical practice guidelines (CPGs) and expert consensuses (ECs) in China, the Scientific, Transparent, and Applicable Rankings (STAR) Working Group conducted its 2023-2024 biennial appraisal based on its previous work. In this round, 40 specialty committees and over 1 000 experts participated, and large language model technologies were integrated to comprehensively evaluate guidelines and consensuses led by Chinese scholars and published in journals between 2023 and 2024. A total of 305 guidelines and 1 153 consensuses were included for 2023, compared to 424 guidelines and 1 391 consensuses for 2024. The average scores for guidelines and consensuses increased from 41.0 and 28.8 in 2023 to 49.2 and 33.0 in 2024, respectively, indicating a significant upward trend compared with previous years. Among the evaluation domains, "Recommendations" achieved the highest scoring rate, whereas "Protocols" and "Funding and Conflict of Interest Disclosures" recorded the lowest. In terms of publication volume, Oncology, Traditional Chinese Medicine, and Pediatrics were the top three specialties. Overall, medical guidelines and consensus documents in China are at a critical stage of transitioning from"quantity-driven"expansion to"high-quality development."In the future, guideline developers, academic journals, and the STAR Working Group should establish long-term collaborative mechanisms to jointly promote the dynamic and intelligent evolution of the ranking system.
Zhonghua Yi Xue Za Zhi
· 2026 Jun · PMID 42297581
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Component-resolved diagnosis (CRD), a cornerstone of precision allergology, enables the identification of specific allergenic molecules and refines the diagnosis, risk stratification, and personalized management of aller...Component-resolved diagnosis (CRD), a cornerstone of precision allergology, enables the identification of specific allergenic molecules and refines the diagnosis, risk stratification, and personalized management of allergic diseases. However, its widespread clinical adoption, especially in primary care and non-specialist settings in China, remains constrained by the complexity of component-based data, limited interpretability among clinicians, and the absence of standardized clinical pathways. To address these challenges, the establishment of a systematic and tiered continuing medical education framework is essential. This article examines the technological foundations, clinical applications, and interpretation challenges of CRD, and proposes a structured educational framework incorporating competency-based tiered training, case-driven and problem-oriented learning, standardized interpretation workflows, multidisciplinary collaboration, and digital support tools. By strengthening the educational infrastructure, this approach can enhance clinicians' interpretive competence, facilitate the translation of CRD from a diagnostic tool into a clinical decision-making aid, and ultimately advance the precision and standardization of allergy care.
Chin Med J (Engl)
· 2026 Jun · PMID 42268296
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The development of organoid technology has led to notable advances in regenerative medicine, disease modeling, and drug screening. However, given the pivotal role of vascular systems in growth maintenance and nutrient de...The development of organoid technology has led to notable advances in regenerative medicine, disease modeling, and drug screening. However, given the pivotal role of vascular systems in growth maintenance and nutrient delivery, the lack of functional vascular networks within organoids limits the scalability and physiological functionality of these organoids. Efforts to explore strategies for organoid vascularization, such as co-culture, transcription factor induction, microfluidic technology, and the application of biomaterial scaffolds, are underway. These methods have shown distinct advantages across different types of organoids, partially addressing vascularization challenges. However, issues such as limited vascular network integration and insufficient functional maturity remain unresolved. Future efforts should prioritize the development of multi-tiered vascular networks, the application of smart biomaterials, and the creation of personalized vascularized organoids. This review summarizes the advances in this field and explores the potential translation of vascularized organoids into clinical practice, offering recommendations for further research.
Luo Z, Zhong X, Zhu Z
… +5 more, Lu X, Zhu W, Bian Y, Qian J, Weng X
Chin Med J (Engl)
· 2026 Jun · PMID 42268257
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BACKGROUND: Osteoarthritis (OA) in working-age individuals (aged 30-64 years) adversely affects health and reduces productivity. In this study, the disease burden and economic impact of OA on this demographic are examine...BACKGROUND: Osteoarthritis (OA) in working-age individuals (aged 30-64 years) adversely affects health and reduces productivity. In this study, the disease burden and economic impact of OA on this demographic are examined, and the trends from 1990 to 2021 are analyzed. METHODS: Using data from the 2021 Global Burden of Disease Study, incident cases, prevalent cases, years lived with disability (YLDs), and the corresponding age-standardized rates of OA in the working-age population from 1990 to 2021 were examined. To evaluate the changes in trends, the average annual percentage change (AAPC) of these age-standardized rates was calculated. Subgroup analyses based on sex, age, sociodemographic index (SDI) level, and joint site were conducted. The economic burden was assessed by integrating data from the World Health Organization (WHO), the World Bank, and the International Labour Organization (ILO). RESULTS: By 2021, 329 million working-age individuals had OA, a 123% increase over 1990. Age-standardized rates of incidence, prevalence, and YLDs increased globally by 116%, 123%, and 125%, respectively, with the most rapid growth occurring in low-middle-SDI regions. The total economic burden in 2021 was $350 billion, with $165 billion in direct medical costs and $185 billion in productivity losses, representing 0.32% of the global GDP. High-SDI regions bore a greater economic burden, representing approximately 50% of the total. CONCLUSION: The increasing prevalence of OA and its significant economic impact on the working-age population highlight the need for targeted policies and preventive strategies. The growing burden, especially in low-middle-SDI countries, underscores the importance of sustainable health development.
Hughes R, Lo Bello A, Liang RF
… +4 more, Pugliano CL, Zammarchi I, Ghosh S, Iacucci M
Chin Med J (Engl)
· 2026 Jun · PMID 42268244
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Artificial intelligence (AI) is rapidly transforming healthcare, supporting disease management and enabling outcome prediction across multiple clinical settings. Inflammatory bowel diseases (IBD) are complex, heterogeneo...Artificial intelligence (AI) is rapidly transforming healthcare, supporting disease management and enabling outcome prediction across multiple clinical settings. Inflammatory bowel diseases (IBD) are complex, heterogeneous conditions whose assessment relies on integrating several modalities, including endoscopy, histology, cross-sectional imaging, and omics data, all of which are critical for evaluating disease activity and predicting long-term outcomes. In recent years, numerous AI-based systems have been developed within each of these domains. In IBD endoscopy, deep learning algorithms have demonstrated high accuracy in objectively assessing mucosal inflammation and detecting colitis-associated dysplasia. In histology, AI applications enable automated, standardized evaluation of disease activity, reducing interobserver variability. Similarly, in cross-sectional imaging, AI models have shown promise in characterizing disease severity, identifying complications, and supporting outcome prediction. Beyond individual modalities, machine learning approaches are increasingly being explored to integrate complex clinical, imaging, and multi-omics data to predict disease trajectories and enable precision medicine strategies in IBD. The present review provides an overview of current AI applications across endoscopy, histology, imaging, and omics in IBD, highlighting its potential clinical impact and ability to advance precision medicine strategies through multimodal and multi-omics integration. Moreover, it discusses the main challenges, unmet needs, and limitations that remain barriers to adoption in clinical trials and routine clinical practice.
Wu L, Chen L, Li D
… +26 more, Zhu Y, Wang D, Wang J, Zhang G, Zhou Q, Wang J, Li G, Liu Z, Zhu H, Kong W, Zhang J, Zhang H, Zhao H, An J, Li J, Jin C, Huang X, Jiang K, Wang S, Yuan J, Zhang Y, Huang Z, Wang N, Deutsch S, Soumaoro I, Hou J
Chin Med J (Engl)
· 2026 Jun · PMID 42260790
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Liu W, Fan B, Qian Y
… +3 more, Shi H, Zhang H, Zhang X
Chin Med J (Engl)
· 2026 Jun · PMID 42260763
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Nanoparticles derived from various sources have been widely investigated as biological therapeutic agents and drug carriers for cancer treatment. Among them, plant-derived vesicle-like nanoparticles (PDVLNs) have attract...Nanoparticles derived from various sources have been widely investigated as biological therapeutic agents and drug carriers for cancer treatment. Among them, plant-derived vesicle-like nanoparticles (PDVLNs) have attracted considerable interest because of their wide availability, high yield, and ease of preparation. PDVLNs are primarily produced via active secretory mechanisms in plant cells in response to specific physiological and environmental stimuli. They can cross biological barriers while retaining the bioactive components of their parent plants, thereby exhibiting the dual capabilities of drug delivery and biological regulation. Currently, in the field of cancer treatment, PDVLNs sourced from ginger, grapes, green tea, and Brucea javanica have been successfully applied in monotherapy, combination therapy, and targeted drug delivery. This review systematically summarizes recent advances and the underlying molecular mechanisms of PDVLNs in cancer treatment, with an emphasis on engineering strategies designed to improve their performance as drug delivery systems, including drug loading techniques, surface modification approaches, and membrane fusion methods. Furthermore, the potential applications of PDVLNs in precision medicine and clinical translation are explored. By synthesizing current research progress and outlining future directions, this review provides a systematic theoretical foundation and practical insights to support the development of safe, effective, and clinically feasible antitumor nanotherapeutic platforms.
Yang W, Yang Q, Wang Z
… +9 more, Zhao X, Deng J, Xia X, Wang J, Xia L, Wang Y, Cui F, Tan R, Yuan J
Chin Med J (Engl)
· 2026 Jun · PMID 42260757
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Cerebral ischemia (CI) is an acute central nervous system disorder resulting from the abrupt interruption of blood flow to brain tissue. The restoration of blood flow during treatment is frequently accompanied by cerebra...Cerebral ischemia (CI) is an acute central nervous system disorder resulting from the abrupt interruption of blood flow to brain tissue. The restoration of blood flow during treatment is frequently accompanied by cerebral ischemia/reperfusion (CI/R) injury, a secondary injury mechanism that substantially limits the overall efficacy of reperfusion therapy. The phosphatidylinositol 3-kinase (PI3K)-protein kinase B (Akt) signaling pathway, a central regulator of cell survival, proliferation, and stress response, has attracted growing interest for its role in CI and CI/R injury. During the early ischemic phase, PI3K-Akt activation in neurons and brain microvascular endothelial cells serves as a crucial endogenous protective mechanism, inhibiting apoptosis and maintaining energy metabolic homeostasis, thereby mitigating initial brain damage. As ischemia progresses, downregulation of this pathway in microglia and infiltrating macrophages can promote excessive release of proinflammatory factors, such as tumor necrosis factor-α (TNF-α) and interleukin-1β (IL-1β), exacerbating local inflammation and tissue injury. In the reperfusion phase, reactivation of the PI3K-Akt pathway exerts multi-level neuroprotection: It counteracts neuronal apoptosis and oxidative stress, promotes angiogenesis and blood-brain barrier (BBB) repair in endothelial cells, and modulates neuroinflammation in glial cells. Importantly, the PI3K-Akt pathway does not function in isolation but engages in complex crosstalk with multiple signaling cascades, such as Wnt/β-catenin, nuclear factor erythroid 2-related factor 2 (Nrf2)/heme oxygenase-1 (HO-1), and mammalian target of rapamycin (mTOR). Moreover, it shapes the immune microenvironment by fine-tuning the functions of immune cells, including regulatory T cells (Tregs). This intricate network dynamically governs the survival of the neurovascular unit by regulating mitochondrial function, oxidative stress, inflammation, and autophagy. This review systematically explores the dynamic changes, cell-specific functions, and interactive mechanisms of the PI3K-Akt pathway during CI and CI/R injury, and discusses its potential for precision treatment strategies and clinical translation.
Zhang B, Chen T, Chen Y
… +8 more, Ji D, Li G, Chen X, Tuo B, Wang W, Li P, Lun W, Linghu E
Chin Med J (Engl)
· 2026 Jun · PMID 42260742
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BACKGROUND: This is a multicenter, randomized, double-blind, placebo-controlled interventional clinical study to evaluate the efficacy and safety of pronase in improving visibility in colonoscopy and to evaluate whether...BACKGROUND: This is a multicenter, randomized, double-blind, placebo-controlled interventional clinical study to evaluate the efficacy and safety of pronase in improving visibility in colonoscopy and to evaluate whether pronase can increase the detection rate of intestinal lesions and the colonoscopist's satisfaction. METHODS: From June 2023 to December 2023, a total of 1942 patients undergoing air insufflation colonoscopy in 10 hospitals (The First Medical Center, Chinese PLA General Hospital, et al) were selected as the study subjects. They were randomly divided into two groups: (1) the experimental group (n = 969) was given pronase for flushing in colonoscopy; and (2) the control group (n = 973) was given physiological saline for flushing in colonoscopy. The improvement of the visibility at the target site (region of interest) in colonoscopy was evaluated in two groups to verify the efficacy of pronase in improving visibility in colonoscopy. The safety of pronase for flushing in colonoscopy was evaluated by comparing the incidence of adverse events between the two groups. RESULTS: After the use of pronase in colonoscopy, the patient's vital signs remained stable, without serious adverse reactions. The improvement rate of visibility in the pronase group was significantly higher than that in the physiological saline group (97.21% [942/969] vs. 86.74% [844/973], P <0.0001), and the subgroup analysis (Boston Bowel Preparation Scale ≥6 points) showed similar results to the overall ones. The physician's satisfaction score in the pronase group was significantly increased. There was no significant statistical difference in the detection rates of adenoma, colorectal cancer, minimal lesions, non-polypoid colorectal lesions, polyps, and precancerous lesions between the two groups. CONCLUSIONS: Pronase can improve the visibility in colonoscopy and help physicians observe the lesions better. Pronase demonstrates good safety in colonoscopy, with no significant difference compared to physiological saline.
Xie S, Lyu F, Gao K
… +11 more, Chen Q, Chen M, Yan X, Li T, Li H, Zhao Y, Qu L, Chen P, Li X, Zhang Y, Hu B
Chin Med J (Engl)
· 2026 Jun · PMID 42260317
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BACKGROUND: Sepsis, a critical and life-threatening condition, is one of the most common causes of death among inpatients. Emerging evidence suggests that active metabolites derived from gut microbe-associated metabolism...BACKGROUND: Sepsis, a critical and life-threatening condition, is one of the most common causes of death among inpatients. Emerging evidence suggests that active metabolites derived from gut microbe-associated metabolism of dietary essential amino acid L-tryptophan (Trp) help the host in combating infectious diseases. This study aims to investigate the mechanisms through which these active metabolites regulate sepsis progression. METHODS: The effects of dietary Trp and indole-3-pyruvate (IPyA) on the mouse septic model were evaluated by 72-hour survival rate monitoring, organ pathological injury score, bacterial load, and inflammatory factor expression. The changes in gut microbiota composition caused by dietary Trp were detected by 16S rRNA gene sequencing. The changes in Trp bacterial metabolites were detected by liquid chromatography-tandem mass spectrometry (LC-MS/MS). The effects of IPyA on macrophage phagocytosis were evaluated by flow cytometry and plate colony formation assay. The interaction between IPyA and G protein-coupled receptor 37 (GPR37) was evaluated by Western blot and surface plasmon resonance. Gpr37 knockout mice, small interfering RNA transfection in macrophages, and macrophage adoptive transfer assay were used to explore the detailed mechanism of IPyA in protecting sepsis. RESULTS: It is revealed that dietary Trp supplementation alleviated septic organ injury by modulating the abundance of key commensal microbes and their metabolic function. Furthermore, we found that GPR37 activation in macrophages by a key microbial metabolite, IPyA, raised after dietary Trp supplementation, protected the host against sepsis. Mechanistically, IPyA bound directly to GPR37 in macrophages, causing activation of small GTPases Ras-related C3 botulinum toxin substrate 1/Cell division cycle 42 (RAC1/CDC42) and increased expression of actin-related protein (Arp) 2/3, ultimately enhancing bacterial phagocytosis in macrophages. In addition, IPyA exhibited the potential to promote bacterial phagocytosis in macrophages obtained from patients. CONCLUSION: Targeting GPR37 through dietary Trp supplementation may be a potential prophylactic strategy to optimize gut microbiota metabolic functioning and ameliorate septic bacterial infections.
Zhang YL, Jiang SJ, Xiong YJ
… +4 more, Lin DP, Ma GL, Xu Y, Jiang Y
Zhonghua Yi Xue Za Zhi
· 2026 Jun · PMID 42252241
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To analyze the efficacy of ustekinumab (UST) in the patients with isolated perianal Crohn disease (ipCD). ipCD patients who received UST therapy in the Second Affiliated Hospital of Wenzhou Medical University between Jan...To analyze the efficacy of ustekinumab (UST) in the patients with isolated perianal Crohn disease (ipCD). ipCD patients who received UST therapy in the Second Affiliated Hospital of Wenzhou Medical University between January 2021 and September 2025 were retrospectively recruited. Each patient received the first dose of UST (6 mg/kg) for intravenous induction, followed by the same dose of intravenous UST every 8 weeks for maintenance treatment. At week 16, the fistula clinical response was evaluated based on perianal disease activity index (PDAI) (a decline of more than 50% in PDAI compared with week 0). Follow-up was conducted until week 40, at week 40, the fistula clinical remission was assessed based on PDAI (PDAI score≤4 scores). The radiologic outcome events of perianal fistula were evaluated based on pelvic MRI data and Van Assche index, and the fistula radiologic response consisted of healing and partial response. A total of 16 ipCD patients were included, all of whom were male, with a diagnosed age of (31±6) years. At week 16 of UST therapy, the PDAI of 16 ipCD patients was decreased compared with week 0 [(7.3±2.5) vs (13.1±2.2) scores, <0.001], and 10 patients obtained the fistula clinical response. At week 40, the average PDAI [(4.4±2.3) vs (13.1±2.2) scores, <0.001], and the median Van Assche index [9 (8, 12) vs 16 (12, 16) scores, =0.002] of 16 patients were lower compared with week 0; Eleven patients achieved the fistula clinical remission, and 10 patients obtained the fistula radiologic response. During 40-week follow-up, no adverse event related to UST treatment occurred in the ipCD patients. The UST therapy may demonstrate favorable clinical efficacy and safety in patients with ipCD.