Chinese Medical Journal[JOURNAL]
Sun
200 papers
[Analysis of 3-year postoperative prognosis and influencing factors in patients with H3 K27-altered diffuse midline glioma].
Hu ZH, Shi SQ, Geng JY … +11 more , Zhao XY, Yang HZ, Xing HR, Zhou P, Jiang Y, Gu HQ, Li DL, Qi JL, Zhou MG, Zhang LW, Xiao D
Zhonghua Yi Xue Za Zhi · 2026 Jun · PMID 42252240 · Publisher ↗
To investigate the prognosis and influencing factors in patients with diffuse midline glioma, H3 K27-altered. Based on the National Brain Tumor Registry of China and the National Mortality Registration Information Manag...
To investigate the prognosis and influencing factors in patients with diffuse midline glioma, H3 K27-altered. Based on the National Brain Tumor Registry of China and the National Mortality Registration Information Management System, clinical data including baseline characteristics, tumor features, surgical intervention information, and postoperative treatment information of 154 patients with H3 K27-altered diffuse midline gliomas who underwent brain tumor resection at Beijing Tiantan Hospital, Capital Medical University, between January 1, 2020, and December 31, 2021 were collected. After discharge, the outcome indicators (median overall survival and 3-year overall survival rate) were tracked and confirmed through the National Brain Tumor Registry of China follow-up system, with follow-up conducted every 3 months. For patients lost to follow-up, cross-verification was conducted using the National Mortality Registration Information Management System. The Kaplan-Meier method was used to analyze median overall survival and 3-year overall survival rate. Univariate and multivariate Cox proportional hazards regression models were utilized to identify factors influencing patient prognosis. Among the 154 patients, 82 (53.2%) were male and 72 (46.8%) were female, with the age [, )] of 19.5 (9.0, 38.0) years. At the 3-year follow-up, 44 (28.6%) patients remained alive. The median overall survival was 19.8 months (95%: 15.0-25.2 months), and the 3-year overall survival rate was 28.6% (95%: 22.3%-36.7%). Brainstem location (=1.61, 95%: 1.02-2.54, =0.04) and the absence of systemic therapy (=1.67, 95%: 1.13-2.46, =0.01) were identified as influencing factors for 3-year postoperative mortality. Patients with H3 K27-altered diffuse midline gliomas exhibit short median overall survival and a low 3-year overall survival rate. Tumor location and whether systemic therapy is administered are the important factors affecting patient prognosis.
[Efficacy and safety of combining olorigliflozin with metformin in patients with type 2 diabetes mellitus inadequately controlled on metformin monotherapy].
He YF, Cheng ZF, Bian F … +17 more , Li S, Li LP, Shang JJ, Chen XW, Zeng ZY, Peng WX, Jin GX, Liu YH, Wang HF, Tian JH, Wang XY, Du LJ, Luo L, Li B, Gu Z, Zhang YJ, Yang WY
Zhonghua Yi Xue Za Zhi · 2026 Jun · PMID 42252239 · Publisher ↗
To evaluate the efficacy and safety of combining olorigliflozin with metformin in patients with type 2 diabetes mellitus (T2DM) inadequately controlled on metformin monotherapy. This study was a multicenter, randomized,...
To evaluate the efficacy and safety of combining olorigliflozin with metformin in patients with type 2 diabetes mellitus (T2DM) inadequately controlled on metformin monotherapy. This study was a multicenter, randomized, double-blind, parallel, placebo-controlled phase Ⅲ clinical trial. A total of 390 T2DM patients with inadequately controlled blood glucose and receiving oral metformin were prospectively enrolled from 62 research centers nationwide between February 2021 and June 2023. Using a block randomization method stratified by baseline glycated hemoglobin A1c (HbA) results (≤8.5% and>8.5%), patients were randomly allocated in a 1∶1∶1 ratio via an interactive response system to the placebo group, olorigliflozin 20 mg group, and olorigliflozin 50 mg group. All patients were treated with metformin in combination for 24 consecutive weeks. After 24 weeks of treatment, patients in the placebo group were randomly reassigned in a 1∶1 ratio using the aforementioned randomization method to either the placebo-to-olorigliflozin 20 mg group or the placebo-to-olorigliflozin 50 mg group, entering a 28-week extended treatment period. Patients in the olorigliflozin 20 mg and 50 mg groups maintained their original treatment regimens. The primary efficacy endpoint was the change in HbA from baseline at week 24, analyzed using the full analysis set. Secondary efficacy endpoints included the change in HbA from baseline at week 52 and HbA target achievement rates at weeks 24 and 52, analyzed using the full analysis set and the extended treatment analysis set, respectively. Safety was evaluated for volunteers throughout the study period using the safety set. Quantitative efficacy indicators were analyzed using a mixed-effects model for repeated measures, while the differences in the achievement rates across treatment groups were compared employing a logistic regression model. Safety outcomes were summarized with descriptive statistics. A total of 384 patients were included in the full analysis set, including 242 males and 142 females, with the age of (54.9±10.1) years. The placebo group, olorigliflozin 20 mg group, and olorigliflozin 50 mg group comprised 129, 125, and 130 patients, respectively. After 24 weeks of treatment, the least squares mean (LSM) changes (95%) in HbA from baseline in the three groups were -0.43%(-0.58% to -0.28%), -0.98%(-1.12% to -0.83%), and -1.04%(-1.18% to -0.90%), respectively. The proportions of patients with HbA<7.0% were 16.3%(21/129), 28.0%(35/125), and 40.8%(53/130), respectively. Logistic regression analysis showed that, compared with the placebo group, the OR values (95%) were 2.04(1.07-3.87) and 3.85(2.08-7.14) in the otigliflozin 20 mg group and 50 mg group, respectively. A total of 348 patients were included in the extended treatment analysis set, with 117, 121, 55, and 55 patients in the olorigliflozin 20 mg group, olorigliflozin 50 mg group, placebo-to-olorigliflozin 20 mg group, and placebo-to-olorigliflozin 50 mg group, respectively. At week 52, all 4 groups showed reductions in HbA from baseline (-1.0%±0.8%, -1.2%±0.7%, -1.2%± 1.0%, and -1.0%±0.8%, respectively). The proportions of patients with HbA<7.0% were 38.5%(45/117), 46.3%(56/121), 34.5%(19/55), and 32.7%(18/55), respectively. A total of 386 patients were included in the safety set during the 24week core treatment period, with 129, 127, and 130 patients in the placebo, olorigliflozin 20 mg, and olorigliflozin 50 mg groups, respectively. The incidence rates of treatmentemergent adverse events (TEAE) were 70.5%(91/129), 77.2%(98/127), and 75.4%(98/130), respectively. The incidence of TEAE leading to permanent discontinuation of the investigational product was 2.3%(3/129), 0.8% (1/127), and 2.3%(3/130), respectively. No serious adverse events related to the investigational product were reported. All hypoglycemic events occurred in the olorigliflozin treatment groups: the olorigliflozin 20 mg group had 2 cases of probable symptomatic hypoglycemia and 2 cases of hypoglycemic alert values, while all 5 events in the olorigliflozin 50 mg group were hypoglycemic alert values; all resolved completely. In the safety set for the 28week extended treatment period (group assignments and patient numbers identical to those in the extended treatment analysis set), the main types, incidence rates, and severity of TEAE were similar to those reported during the 24week core treatment period. For Chinese patients with T2DM inadequately controlled with metformin monotherapy, combining olorigliflozin can significantly improve glycemic control and has a good safety profile.
[Efficacy and safety of olorigliflozin monotherapy in patients with type 2 diabetes mellitus with poor glycemic control on diet and exercise interventions].
He YF, Ma JH, Wang HF … +18 more , Zeng JE, Li ZB, Pan TR, Chen XW, Guo KQ, Wang SH, Zhang Y, Zhang XJ, Liu YH, Deng WQ, Wang XY, Zhang Q, Hao YE, Luo L, Zhu J, Gu Z, Zhang YJ, Yang WY
Zhonghua Yi Xue Za Zhi · 2026 Jun · PMID 42252238 · Publisher ↗
To evaluate the efficacy and safety of olorigliflozin monotherapy in Chinese patients with type 2 diabetes mellitus (T2DM) inadequately controlled with diet and exercise. The study was a multicenter, randomized, double-...
To evaluate the efficacy and safety of olorigliflozin monotherapy in Chinese patients with type 2 diabetes mellitus (T2DM) inadequately controlled with diet and exercise. The study was a multicenter, randomized, double-blind and placebo-controlled phase Ⅲ clinical trial. A total of 396 T2DM patients with inadequate glycemic control despite diet and exercise were enrolled across 73 research centers nationwide between July 2021 and June 2022. Using a block randomization method stratified by baseline glycated hemoglobin A (HbA) results (≤8.5% and >8.5%) and prior diabetes treatment status, the patients were randomly allocated in a 1∶1∶1 ratio via an interactive response system to the olorigliflozin 20 mg group, 50 mg group, and placebo group. After 24 weeks, the patients in the placebo group were re-randomized in a 1∶1 ratio to the placebo-to-olorigliflozin 20 mg or placebo-to-olorigliflozin 50 mg for an additional 28 weeks using the same randomization method, while the patients in the olorigliflozin groups continued the original treatment. The primary efficacy endpoint was the change in HbA from baseline at week 24, with statistical analysis performed based on the full analysis set (FAS). Secondary efficacy endpoints included: change in HbA from baseline at weeks 52; HbA target achievement rates. The secondary endpoints included the change of from baseline at 52 weeks of treatment, and the HbA compliance rates at 24 weeks and 52 weeks of treatment were analyzed by FAS and FAS-completers(FASc), respectively. Safety set (SS) was used to evaluate the safety of subjects during the whole study period. A mixed-effects model for repeated measures was adopted to assess quantitative efficacy indicators, and descriptive statistics was used for safety evaluation. In FAS, there were 130, 129 and 131 patients in the ololegliflozin 20 mg, 50 mg and placebo groups, respectively; In SS, the corresponding number of patients was 130, 133 and 132, respectively; In FASc, the patient numbers were 123 and 119 in the ololegliflozin 20 mg and 50 mg groups, and 59 and 57 in the placebo-to-ololegliflozin 20 mg and placebo-to-ololegliflozin 50 mg groups, respectively. At week 24, the least squares mean differences (95%) in placebo-adjusted changes in HbA from baseline between groups for the olorigliflozin 20 mg group and 50 mg group were -0.94% (-1.14% to -0.74%; <0.001) and -1.01% (-1.21% to -0.81%; <0.001), respectively. The proportions of patients with HbA<7% in the placebo group, olorigliflozin 20 mg group and 50 mg group were 20.6% (27/131), 55.4% (72/130) and 56.6% (73/129), respectively; the proportions of patients with HbA≤6.5% were 7.6% (10/131), 31.5% (41/130) and 31.8% (41/129), respectively. At week 52, HbA continued to show decreasing trends. The mean changes from baseline in HbA were -1.33%±0.77%, -1.38%±0.81%, -1.30%±0.69% and -0.90%±0.83%, in the olorigliflozin 20 mg group, olorigliflozin 50 mg group, placebo-to-olorigliflozin 20 mg group, and placebo-to-olorigliflozin 50 mg group, respectively; The proportions of patients with HbA<7% were 59.3% (73/123), 61.3% (73/119), 49.2% (29/59) and 42.1% (24/57) in the four groups, respectively, and the proportions of patients with HbA≤6.5% were 36.6% (45/123), 42.0% (50/119), 33.9% (20/59) and 26.3% (15/57), respectively. Throughout the study period, olorigliflozin demonstrated good safety profile without any episodes of severe hypoglycemia or ketoacidosis. For Chinese patients with T2DM inadequately controlled by diet and exercise, monotherapy with olorigliflozin (20 mg and 50 mg) can effectively control blood glucose, and demonstrate good safety.
[Expert consensus on the essential elements for standardized medical laboratory datasets (2026 edition)].
National Clinical Research Center for Medical Auxiliary Technology (Laboratory Medicine), Intelligent Laboratory Medicine Group of the Laboratory Physicians Branch of the Chinese Medical Doctor Association, Collaborative Innovation Working Group for Artificial Intelligence in Laboratory Medicine
Zhonghua Yi Xue Za Zhi · 2026 Jun · PMID 42252237 · Publisher ↗
With the rapid advancement of artificial intelligence (AI) technologies, particularly the emergence of generative AI represented by large-scale models, the field of laboratory medicine is gradually entering a new stage o...
With the rapid advancement of artificial intelligence (AI) technologies, particularly the emergence of generative AI represented by large-scale models, the field of laboratory medicine is gradually entering a new stage of intelligent development. In this context, standardized laboratory medicine datasets have become increasingly critical as a fundamental basis for large model training, a key benchmark for model performance evaluation, and an essential support for the development of application scenarios. To strengthen consensus among professionals regarding the related concepts and construction specifications of standardized laboratory medicine datasets, and to address practical challenges in China such as difficulties in multicenter data integration, heterogeneous information systems, and substantial variability in data quality, National Clinical Research Center for Medical Auxiliary Technology (Laboratory Medicine), together with the Intelligent Laboratory Medicine Group of the Laboratory Physicians Branch of the Chinese Medical Doctor Association and the Collaborative Innovation Working Group for Artificial Intelligence in Laboratory Medicine, organized experts from multiple disciplines. Drawing systematically on relevant domestic and international guidelines and consensus documents, this expert consensus was developed across five key domains: the concept of standardized laboratory medicine datasets, construction significance and objectives, construction principles, construction methodologies, ethics and security, as well as their value and applications. This consensus proposes a laboratory medicine dataset construction and governance framework tailored to the Chinese context, with the aim of promoting the intelligent and standardized development of laboratory medicine in China.
[Expert consensus on the clinical application of intravenous insulin infusion (2026 edition)].
National Clinical Research Center for Endocrine and Metabolic Diseases (Changsha), National Diabetes Prevention & Control Center (DPCC), Diabetes Society of China National Health Association
Zhonghua Yi Xue Za Zhi · 2026 Jun · PMID 42252236 · Publisher ↗
Intravenous insulin infusion remains a cornerstone of clinical glycemic management. It is extensively utilized across diverse multidisciplinary settings, including hyperglycemic crises, the perioperative period, critical...
Intravenous insulin infusion remains a cornerstone of clinical glycemic management. It is extensively utilized across diverse multidisciplinary settings, including hyperglycemic crises, the perioperative period, critical illness, and nutritional support. Standardizing intravenous insulin infusion protocols across various clinical departments is essential for improving the overall prognosis of patients with diabetes and its associated comorbidities. Initiated by the National Clinical Research Center for Endocrine and Metabolic Diseases (Changsha), the National Diabetes Prevention & Control Center (DPCC), and the Diabetes Society of China National Health Association, the "Expert Consensus on the Clinical Application of Intravenous Insulin Infusion (2026 edition)" was developed through the collaborative efforts of experts in endocrinology, cardiology, general medicine, emergency medicine, critical care, nursing, and clinical pharmacy. By integrating multidisciplinary efforts, and in accordance with the standards and procedures of the grading of recommendations, development and evaluation (GRADE) system, 7 clinical questions and 9 recommendations were proposed regarding the clinical application of intravenous insulin infusion, including its clinical indications, operating procedures, precautions, and other relevant aspects. Its implementation aims to bridge the gap in clinical practice between endocrine and non-endocrine departments (including surgical and primary care units), thereby enhancing the standardization of intravenous insulin infusion and ultimately improving the overall therapeutic outcomes and prognosis for patients with diabetes and related metabolic disorders.
[Glycemic control and cardiovascular health in prediabetes: untiring exploration towards consensus].
Li GW
Zhonghua Yi Xue Za Zhi · 2026 Jun · PMID 42252235 · Publisher ↗
Diabetes-related cardiovascular diseases carry high rates of disability and mortality, and their medical costs are prohibitively expensive. Shifting management upstream is imperative. The risk of cardiovascular and cereb...
Diabetes-related cardiovascular diseases carry high rates of disability and mortality, and their medical costs are prohibitively expensive. Shifting management upstream is imperative. The risk of cardiovascular and cerebrovascular diseases in diabetic populations exists prior to the onset of diabetes. Can lifestyle interventions targeting the prevention of diabetes in people with pre-diabetes also extend to reducing cardiovascular risk? The Daqing Diabetes Prevention Study (DQDPOS) in China provided a definitive answer, though regrettably, this was not corroborated by comparable studies in the United States. Consequently, this has prevented the cardiovascular and diabetes communities from reaching consensus regarding early intervention strategies for cardiovascular disease. By 2024, the European Cardiovascular Community still did not include prediabetes in its cardiovascular disease management population. By late 2025, two landmark studies from China and the United States of America (DQDPOS and DPPOS) reported that individuals with prediabetes who achieved normal blood glucose levels experienced a substantial reduction in the risk of heart failure and cardiovascular mortality compared to those who did not normalize plasma glucose levels. It is hoped this new finding will spur the cardiovascular community to develop more proactive strategies for intensifying glycaemia control in prediabetic populations to reduce cardiovascular risk. Given the prediabetic population in China exceeding 300 million, effective cardiovascular risk management in this population would benefit the reduction of cardiovascular risk across the entire population.
Conversion surgery after immunotherapy and chemotherapy for gastric cancer with peritoneal metastasis or positive peritoneal cytology: A retrospective cohort study.
Liang H, Huang H, Xie Q … +8 more , Huang K, Li Z, Zhang H, Zhong R, Yan X, Lai M, Zhao L, Li G
Chin Med J (Engl) · 2026 Jun · PMID 42236320 · Publisher ↗
BACKGROUND: The efficacy of conversion therapy for gastric cancer with peritoneal metastasis (P1) and/or positive peritoneal lavage cytology (CY1) treated with immunotherapy remains unclear. This study aimed to clarify c...
BACKGROUND: The efficacy of conversion therapy for gastric cancer with peritoneal metastasis (P1) and/or positive peritoneal lavage cytology (CY1) treated with immunotherapy remains unclear. This study aimed to clarify clinical outcomes in this setting. METHODS: In this retrospective, single-institution cohort study, 144 patients with P1 and/or CY1 confirmed by staging laparoscopy at initial diagnosis received first-line immunotherapy with chemotherapy and/or trastuzumab between November 2019 and March 2024. Patients were divided into a conversion therapy group and a palliative therapy group. RESULTS: Of 144 patients, 75 showed a clinical response and underwent second-look laparoscopy. Negative peritoneal metastasis and cytology were confirmed in 36 patients, all of whom underwent conversion surgery. Compared with the palliative group, the conversion group had significantly longer median progression-free survival (22.9 vs. 5.8 months; P <0.001) and overall survival (33.4 vs. 12.3 months; P <0.001). Among those who had surgery, 27 patients (75.0%, 27/36) achieved R0 resection (complete resection with no residual tumor). Patients with peritoneal cancer index ≤2 had a significantly longer median overall survival than those with peritoneal cancer index >2 (not reached vs. 28.5 months; P <0.006). No serious treatment-related adverse events led to treatment discontinuation or death. CONCLUSIONS: Conversion surgery following immunochemotherapy provided a significant survival benefit for gastric cancer patients with P1 and/or CY1. When immunochemotherapy is effective, active staging laparoscopy should be performed to assess surgical feasibility.
National and regional lifetime risks of developing and dying from digestive system cancers in China: Findings of the Global Burden of Disease Study 2023.
Mao Q, Zhao Z, Liu J … +2 more , Zhou Y, Zhou M
Chin Med J (Engl) · 2026 Jun · PMID 42236318 · Publisher ↗
BACKGROUND: Digestive system cancers are a leading cause of death in China, with a growing projected burden. Yet, data on the lifetime risk (LTR) of these cancers remain limited. We aimed to estimate the LTR of digestive...
BACKGROUND: Digestive system cancers are a leading cause of death in China, with a growing projected burden. Yet, data on the lifetime risk (LTR) of these cancers remain limited. We aimed to estimate the LTR of digestive system cancers in China at national and regional levels for 2023. METHODS: For this population-based systematic analysis, we obtained estimates of incidence and mortality of digestive system cancers from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2023, alongside population data from the World Population Prospects, China Statistical Yearbook. The LTR of digestive system cancers was estimated with a standard method that adjusts for multiple primaries, taking into account competing risks of death from causes other than cancer and life expectancy. RESULTS: The LTR (95% uncertainty interval [UI]) of developing and dying from digestive system cancers in China in 2023 was 11.36% (10.90-12.01%) and 8.28% (7.76-8.87%), respectively. Males exhibited higher risks for both incidence (10.82% vs. 6.85% in females) and mortality (7.58% vs. 4.95% in females). The remaining LTR of digestive system cancers decreased with advancing age. Colorectal cancer showed the highest lifetime incidence risk (3.98%), while stomach cancer had the highest lifetime mortality risk (2.69%). Gallbladder cancer consistently demonstrated the lowest risks, with a lifetime incidence of 0.32% and mortality of 0.25%. Geographic disparities were evident, with the highest LTR observed in Eastern and Northeastern regions. Northwestern region had the lowest LTR. CONCLUSIONS: In China, approximately one in 9 people will develop and one in 12 will die from digestive system cancers during their lifetime. Significant regional variations highlight the need for precision prevention and tailored health planning.
Association of long-term exposure to lower low-density lipoprotein cholesterol with neuroimaging metrics: A population-based cohort study.
Sun J, Hui Y, Li J … +7 more , Zhao X, Zhao P, Li X, Chen S, Wu S, Wang Z, Lv H
Chin Med J (Engl) · 2026 Jun · PMID 42230333 · Publisher ↗
BACKGROUND: Limited evidence exists regarding the relationship between long-term exposure to low concentrations of low-density lipoprotein cholesterol (LDL-C) and brain structural integrity. This study aimed to examine t...
BACKGROUND: Limited evidence exists regarding the relationship between long-term exposure to low concentrations of low-density lipoprotein cholesterol (LDL-C) and brain structural integrity. This study aimed to examine the associations of cumulative low LDL-C exposure with a series of neuroimaging metrics. METHODS: This study included 987 participants (median age 55 years) from a population-based cohort study in China. Serum circulatory LDL-C concentrations were assessed biennially from 2006 to 2018. Prolonged LDL-C exposure was calculated using a time-weighted average (TWA) approach during that period. Brain MRI examinations were performed during 2020-2022. We used generalized linear model to investigate the multivariate-adjusted associations of TWA LDL-C levels with MRI markers of brain tissue volume, white matter microstructural integrity, and white matter hyperintensity (WMH). RESULTS: After full adjustments, TWA LDL-C concentrations of 70-100 mg/dL and less than 70 mg/dL were associated with lower fractional anisotropy value and higher mean diffusivity, axial diffusivity, and radial diffusivity value compared to LDL-C concentrations of 100-130 mg/dL. These associations were particularly prominent in male participants and older participants who were over 50 years. No association was found between relatively lower LDL-C levels and brain tissue volumes or WMH. CONCLUSION: LDL-C concentrations of 70-100 mg/dL and <70 mg/dL are associated with impaired microstructural integrity of brain white matter. TRIAL REGISTRATION: https://clinicaltrials.gov/, NCT05453877.
Guideline for the diagnosis and treatment of arthropathic psoriasis (psoriatic arthritis) (2026 edition).
Shi Y, Dai S, Zhang Z … +3 more , Gu J, China Dermatologist Association; , Dermatology and Venereology Committee of the Chinese Association of Integrative Medicine
Chin Med J (Engl) · 2026 Jun · PMID 42219559 · Publisher ↗
Abstract loading — click title to view on PubMed.
Restoration of circadian rhythm as novel targets against sarcopenia.
Wang T, Hong Z
Chin Med J (Engl) · 2026 May · PMID 42218572 · Publisher ↗
Sarcopenia, characterized by the age-related decline in skeletal muscle mass, strength, and function, is associated with high healthcare costs and significant health risks, including falls, fractures, functional decline,...
Sarcopenia, characterized by the age-related decline in skeletal muscle mass, strength, and function, is associated with high healthcare costs and significant health risks, including falls, fractures, functional decline, and mortality. Despite its prevalence and extensive research, there are currently no Food and Drug Administration (FDA)-approved drugs to modify its course, likely due to an incomplete understanding of its underlying mechanisms. Recent evidence highlights two key factors in sarcopenia development: (1) Disrupted circadian rhythms affecting pathways such as protein remodeling, insulin resistance, and mitochondrial function; (2) systemic chronic low-grade inflammation (SCLGI). This review focuses on circadian rhythm regulators implicated in skeletal muscle deterioration, examining their roles, potential interactions, and the impact of circadian disruption on sarcopenia progression. Additionally, we explore how clock genes reciprocally influence the inflammatory profile, which is crucial for developing treatment strategies to mitigate the detrimental effects of sarcopenia. We also examine factors that influence the clock and have the potential to restore circadian rhythm mechanisms that are deregulated in sarcopenia. Drawing from these insights, strategies aimed at restoring circadian synchrony and resolving inflammation are proposed as a novel therapeutic approach to effectively mitigate the manifestations of sarcopenia.
Synopsis of the 2025 guideline for the diagnosis and management of adult primary immune thrombocytopenia.
Liu X, Hu Y, Hou M
Chin Med J (Engl) · 2026 May · PMID 42218570 · Publisher ↗
Abstract loading — click title to view on PubMed.
Life's Essential 8 and the incidence and progression trajectory of chronic lung diseases: A multistate analysis of a prospective cohort study.
Zou Y, Zhang L, Li Y … +7 more , Song X, Su Y, Chen Z, Pang Y, Ju Y, Fan M, Jiang X
Chin Med J (Engl) · 2026 May · PMID 42218565 · Publisher ↗
BACKGROUND: The association of Life's Essential 8 (LE8) with the development of first chronic lung disease (FCLD), progression to chronic lung multimorbidity (CLM), and subsequent mortality remains inconclusive. In addit...
BACKGROUND: The association of Life's Essential 8 (LE8) with the development of first chronic lung disease (FCLD), progression to chronic lung multimorbidity (CLM), and subsequent mortality remains inconclusive. In addition, the relative importance of individual LE8 components is unclear. METHODS: We used data from the UK Biobank, including 391,384 participants free of chronic lung diseases (CLDs) at baseline. CLM was defined as the coexistence of two or more CLDs, including asthma, chronic obstructive pulmonary disease (COPD), idiopathic pulmonary fibrosis (IPF), and lung cancer. A multistate model was used to estimate the impact of LE8 score on the dynamic progression of CLDs. Component-specific contributions were assessed using Heller's explained risk. RESULTS: During a median follow-up of 13.6 years, 27,934 participants developed FCLD, 4174 subsequently developed CLM, and 31,881 died. Higher LE8 scores were consistently associated with lower risks across all transition stages, with hazard ratios (95% confidence intervals) per 10-point increase of 0.75 (0.74-0.76) for transition from baseline to FCLD, 0.85 (0.83-0.87) from FCLD to CLM, 0.85 (0.84-0.86) from baseline to death, 0.92 (0.90-0.94) from FCLD to death, and 0.89 (0.85-0.92) from CLM to death. For CLD subtypes, LE8 scores showed heterogeneous associations with disease-specific transitions, even within the same transition stage. LE8 showed the strongest protective association with COPD incidence (a 36% risk reduction per 10-point increase), whereas its strongest protective association with disease progression was observed for asthma to CLM (a 27% risk reduction per 10-point increase). Among the component of LE8, smoking ranked highest in relative importance across nearly all transitions, while diet emerged as a comparably influential factor for the transition from CLM to death. CONCLUSIONS: Higher LE8 scores are associated with significant risk reductions for CLDs at all progression stages. Early LE8 optimization, particularly smoking avoidance, offers the greatest potential for CLDs prevention, while post-diagnosis benefits support lifelong adherence.
[Effects of fasting on anxiety-and depression-like behaviors in mice and the role of the paraventricular thalamus in the underlying mechanism].
Jiang ZY, Zhou Y, Qiu ZT … +6 more , Pan XY, Wang XY, Ni WW, Xia JM, Li WX, Han Y
Zhonghua Yi Xue Za Zhi · 2026 Jun · PMID 42209176 · Publisher ↗
To investigate the effects of fasting on anxiety-and depression-like behaviors in mice, and to elucidate the underlying neural mechanisms. Eight-week-old male C57BL/6J mice (=44) and Fos-2A-iCreER transgenic mice (=48)...
To investigate the effects of fasting on anxiety-and depression-like behaviors in mice, and to elucidate the underlying neural mechanisms. Eight-week-old male C57BL/6J mice (=44) and Fos-2A-iCreER transgenic mice (=48) were randomly assigned using a random number table.The male C57BL/6J mice were divided into six groups (=36): anxiety-like models were established by 2-hour acute restraint stress (ARS), depression-like models were induced by intraperitoneal injection of lipopolysaccharide, and control groups were also set up. Within each model, mice were further divided into a fasting group (24-hour food deprivation) and an ad libitum feeding group. Fasting efficacy was assessed by monitoring changes in body weight and food intake. Anxiety-like behaviors were evaluated using the open field test and elevated plus maze test, while depression-like behaviors were assessed using the tail suspension test and forced swimming test. Whole-brain neuronal activation in response to fasting was detected in both fasted and non-fasted C57BL/6J mice (=8) was detected through c-Fos immunofluorescence staining. Subsequently, the Fos-2A-iCreER transgenic mice were selected. The targeted recombination into active promoters (TRAP) technique was employed to specifically label fasting-activated neurons, and chemogenetic techniques were employed to activate or inhibit fasting-related neuronal ensembles (=24 per experiment). Anxiety-like and depression-like models were re-established separately, and mice in each model were divided into a fasting group (24-hour food deprivation) and an ad libitum feeding group, in order to investigate the effects of activating or inhibiting neurons related to fasting on anxiety-and depression-like behaviors. The open field test and the elevated plus maze test provided evidence that anxiety-like models had been successfully established. In addition, the tail suspension test and the forced swimming test provided evidence that depression models had been successfully established. In comparison with the ad libitum feeding group, the mice fasted for 24 h showed lower body weight and higher food intake (all <0.05). Fasted mice demonstrated increased distance travelled, prolonged duration, and elevated entries in the central area of the open field, as well as greater distance traveled, higher percentage of duration, and more entries in the open arms of the elevated plus maze. Additionally, fasted mice showed shorter immobility times in both the tail suspension test and the forced swimming test. All differences were statistically significant (all <0.05). c-Fos staining revealed enhanced neuronal activation in the paraventricular thalamus (PVT) region after fasting (all <0.05). Chemogenetic activation of fasting-related neuronal ensembles in the PVT mimicked the anti-anxiety and anti-depression effects observed following fasting: anxious mice showed greater distance traveled, longer duration, and more entries in the central area of the open field, as well as greater distance traveled, higher percentage of duration, and more entries in the open arms of the elevated plus maze; depressed mice showed shorter immobility times in both the tail suspension test and the forced swim test (all <0.05).Conversely, chemogenetic inhibition of these neuronal ensembles reversed these effects (all <0.05). Fasting activates PVT-related neuronal ensembles to elicit anti-anxiety and antidepression effects in mice.
[Efficacy of endoscopic surgery versus microscopic surgery in the treatment of congenital ossicular malformations: a meta-analysis].
Chen ZY, Gan H, Liao SX … +3 more , Huang HM, Wu PN, Xiong H
Zhonghua Yi Xue Za Zhi · 2026 Jun · PMID 42209175 · Publisher ↗
To compare the clinical efficacy of endoscopic ear surgery (EES) and microscopic ear surgery (MES) in the treatment of congenital ossicular malformation. PubMed, Embase, Cochrane Library, China National Knowledge Infras...
To compare the clinical efficacy of endoscopic ear surgery (EES) and microscopic ear surgery (MES) in the treatment of congenital ossicular malformation. PubMed, Embase, Cochrane Library, China National Knowledge Infrastructure (CNKI), Chinese Biomedical Literature Database (CBM), and Wanfang databases were systematically searched from inception to June 20, 2025, to identify comparative studies of EES versus MES in patients with congenital ossicular malformation. The evaluated outcomes included postoperative air-bone gap (ABG), ABG improvement, the proportion of patients achieving a postoperative ABG≤20 decibels hearing level (dB HL), operative time, and surgical complications. A total of seven retrospective cohort studies involving 304 patients (320 ears, age range: 3-62 years) were included. Of these, 148 ears underwent EES and 172 ears underwent MES. Qualitative analysis indicated that EES had a lower complication rate. Serious complications reported in the MES group, including chorda tympani nerve injury and sensorineural hearing loss, were not observed in the EES group. Quantitative analysis demonstrated that EES was associated with significantly shorter operative time (=-10.38 min, 95%:-14.05 to -6.72 min, <0.001) and greater postoperative ABG improvement (=4.22 dB HL, 95%: 0.05 to 8.39 dB HL, 0.048) compared with MES. No statistically significant differences were found between the two groups in preoperative ABG (=-0.96 dB HL, 95%:-3.09 to 1.17 dB HL, 0.379), postoperative ABG (=-1.95 dB HL, 95%:-3.98 to 0.08 dB HL, =0.059), or the proportion achieving postoperative ABG≤20 dB HL [EES, 80.0% (64/80) vs MES, 75.0% (75/100), =1.04, 95%: 0.89 to 1.22, 0.617]. For patients with congenital ossicular malformation, EES is associated with shorter operative time and greater postoperative ABG improvement than MES. EES may serve as a reasonable alternative to conventional MES.
[Classification and surgical outcomes of congenital middle ear malformations with concomitant facial nerve anomalies].
Shu F, Xu MQ, Zou TM … +4 more , Chen FY, Jiang SS, Cai JQ, Zhang HZ
Zhonghua Yi Xue Za Zhi · 2026 Jun · PMID 42209174 · Publisher ↗
To investigate the clinical classification and surgical outcomes of congenital middle ear malformations accompanied by facial nerve anomalies. A retrospective cohort study was conducted to analyze clinical data of patie...
To investigate the clinical classification and surgical outcomes of congenital middle ear malformations accompanied by facial nerve anomalies. A retrospective cohort study was conducted to analyze clinical data of patients with congenital middle ear malformations and concomitant facial nerve anomalies who received treatment in the Department of Otolaryngology, Zhujiang Hospital, Southern Medical University, between January 2021 and December 2024. Facial nerve anomalies were categorized into four distinct types: partial obstruction of the oval window, complete obstruction of the oval window, aberrant course over the promontory, and branching anomalies. Ossicular chain malformations were classified in accordance with the Teunissen classification system. Individualized hearing reconstruction strategies were implemented based on the specific anatomical characteristics of the anomalies. All patients were followed up for 3 to 24 months. Postoperative therapeutic efficacy was evaluated by comparing preoperative and postoperative mean air conduction thresholds and air-bone gaps (ABG), while monitoring surgical complications. Thirteen patients (17 ears) aged [ (, )] 15.0 (11.5, 21.0) years were included, with eight males and five females. Facial nerve anomalies were categorized as follows: partial obstruction of the oval window in six ears (three cases of Type Ⅰ, three cases of Type Ⅲ), complete obstruction of the oval window in three ears (one case of Type Ⅰ, two cases of Type Ⅲ), aberrant course over the promontory in six ears (all Type Ⅳ), and branching anomalies in two ears (both Type Ⅳ). Hearing reconstruction modalities employed included: incus-stapedial piston placement following vestibular fenestration in nine ears, malleus-stapedial piston placement following vestibular fenestration in two ears, partial ossicular replacement prosthesis (PORP) implantation in three ears, total ossicular replacement prosthesis (TORP) implantation in one ear, stapes mobilization in one ear, and laser-assisted ossicular chain release in one ear.Statistical analysis revealed that postoperative mean air conduction thresholds [(33.8±15.2) dB HL vs (60.1±13.8) dB HL, <0.001] and mean ABG [(14.6±6.9) dB vs (37.2±9.2) dB, <0.001] were significantly reduced compared with preoperative values. Postoperative ABG≤20 dB was achieved in 15 ears (88.2%). Postoperative complications were limited to transient vertigo in five cases and taste disturbance in two cases. No cases of facial paralysis, sensorineural hearing loss, tympanic membrane perforation, or tinnitus were observed. The median follow-up duration was 6.0 (5.5, 20.0) months. Individualized hearing reconstruction strategies based on the classification of facial nerve and ossicular chain anomalies can effectively protect the facial nerve and achieve significant hearing improvement, demonstrating favorable clinical outcomes.
[Efficacy of stapes prosthesis surgery for congenital stapes fixation or oval window atresia in pediatric patients].
Zhang R, Dang PH, Zhou DX … +6 more , Hu CY, Zhao HD, Zhao Y, Zhu J, Zhang Q, Fan MY
Zhonghua Yi Xue Za Zhi · 2026 Jun · PMID 42209173 · Publisher ↗
To explore the clinical efficacy of stapes prosthesis surgery for the treatment of congenital fixation of stapes or oval window atresia in pediatric patients. The clinical data of children with congenital fixation of st...
To explore the clinical efficacy of stapes prosthesis surgery for the treatment of congenital fixation of stapes or oval window atresia in pediatric patients. The clinical data of children with congenital fixation of stapes or oval window atresia who underwent stapes prosthesis surgery in Xi'an Children's Hospital from January 2017 to July 2025 were retrospectively analyzed. All the children underwent high-resolution computed tomography (HRCT) of the temporal bone and pure-tone audiometry before and after the surgery. According to the type of auditory chain deformity, the children were divided into the stapes fixation group and the oval window atresia group. The surgical methods included incudovestibular fenestration (IVF) and malleovestibulopexy (MVP), with four types of opening methods, namely stapes footplate drilling, stapes resection, vestibular windowing, and vestibular semicircular canal interposition, respectively. The preoperative and postoperative air-conducted pure tone average (PTA), bone-conducted PTA, and air-bone conduction difference (ABG) were observed and compared. A total of 19 children (25 ears) aged (8.9±3.1) years were included, with 13 males and 6 females. There were 13 ears on the right side and 12 ears on the left side. Preoperative HRCT yielded a positive diagnostic rate of 56.0% (14/25), while the incidence of facial nerve malformation was 40.0% (10/25). Surgical intervention was performed in 24 of the 25 affected ears. Among these, 13 ears were diagnosed with stapes fixation, of which four underwent IVF and nine underwent MVP. The remaining 11 ears presented with oval window atresia, with four undergoing IVF and seven undergoing MVP. Six months postoperatively, both the stapes fixation group and oval window atresia group demonstrated statistically significant improvements in air-conduction PTA and ABG compared with preoperative values. In the stapes fixation group, air-conduction PTA decreased from (62.2±8.7) dB HL to (32.8±10.8) dB HL (=0.002), and ABG improved from (49.3±10.5) dB HL to (22.5±5.8) dB HL (<0.001). In the oval window atresia group, air-conduction PTA decreased from (66.2±8.4) dB HL to (42.0±11.6) dB HL (<0.001), and ABG improved from (54.0±5.0) dB HL to (31.1±11.7) dB HL (<0.001). No statistically significant differences were observed in bone-conduction PTA before and after surgery in either group (both >0.05). Intergroup comparisons revealed that the stapes fixation group exhibited significantly greater improvements in postoperative air-conduction PTA [(32.8±10.8) dB HL vs (42.0±11.6) dB HL] and ABG [(22.5±5.8) dB HL vs (31.1±11.7) dB HL] compared with the oval window atresia group (both <0.05). Subgroup analyses based on surgical technique showed that patients who underwent MVP in both the stapes fixation and oval window atresia groups achieved statistically significant reductions in ABG compared with preoperative levels (both <0.05). In contrast, IVF did not yield statistically significant improvements in ABG in either group (both >0.05). No statistically significant difference was detected in postoperative ABG between patients who underwent IVF versus MVP, nor among the four different types of window opening techniques (all >0.05).All patients received outpatient follow-up at six months postoperatively. Nineteen ears were followed up for≥1 year, with a mean duration of (25.1±12.4) months, while five ears were lost to follow-up (loss to follow-up rate: 20.8%). No serious complications, including sensorineural hearing loss or facial paralysis, were reported in any patient. Stapes prosthesis surgery for the management of congenital stapes fixation and oval window atresia in pediatric patients demonstrates a favorable safety profile and sustained therapeutic efficacy. Surgical outcomes for congenital stapes fixation are superior to those for oval window atresia. Neither the choice between IVF and MVP nor variations in window-opening techniques has a statistically significant effect on postoperative hearing outcomes.
[High-resolution computed tomography imaging features and endoscopic surgical outcomes of congenital ossicular chain malformation with concomitant external auditory canal stenosis].
Liao WX, Sun HJ, Ren DD
Zhonghua Yi Xue Za Zhi · 2026 Jun · PMID 42209172 · Publisher ↗
To investigate the high-resolution CT (HRCT) imaging characteristics and endoscopic surgical outcomes in patients with congenital ossicular chain malformation and concomitant external auditory canal stenosis. The clinic...
To investigate the high-resolution CT (HRCT) imaging characteristics and endoscopic surgical outcomes in patients with congenital ossicular chain malformation and concomitant external auditory canal stenosis. The clinical data from congenital ossicular chain malformation patients with concomitant external auditory canal stenosis who were admitted to the Eye and ENT Hospital of Fudan University between July 2017 and March 2025 were retrospectively analyzed. The clinical presentations, HRCT findings, endoscopic examinations, and postoperative follow-up results were summarized. A total of 54 patients (58 ears) aged [ (, )] 18.5 (12.0, 26.3) years were included, with 29 males and 25 females. The diagnostic concordance rates of HRCT for detecting incus, malleus, and stapes defects were 96.6% (56/58), 94.8% (55/58), and 53.4% (31/58), respectively. HRCT identified severe bony segment stenosis in 7 cases (12.1%) and mild bony segment stenosis in 35 cases (60.3%), whereas otoendoscopy revealed partially visualized stenosis in 16 cases (27.6%). Of the 58 affected ears, 44 underwent concurrent artificial ossicular implantation and external auditory canal reconstruction. Postoperative audiometric assessments at 3 to 12 months demonstrated statistically significant reductions in mean air conduction thresholds [(37.1±18.3) decibel hearing level (dB HL) vs (61.7±12.7) dB HL, <0.001], mean bone conduction thresholds [(18.5±12.3) dB HL vs (26.3±9.5) dB HL, =0.001], and air-bone gaps [(18.8±7.8) dB HL vs (35.3±9.6) dB HL, <0.001] compared with preoperative measurements. The integrated application of HRCT and otoendoscopy enables effective evaluation of the anatomical characteristics of ossicular chain malformation and external auditory canal stenosis. Concurrent ossicular chain reconstruction and external auditory canal reconstruction results in significant improvements in auditory outcomes.
[Expert consensus on a novel classification system, surgical management strategies, and prognostic evaluation for congenital ossicular chain malformations based on stapes footplate mobility and suprastructural integrity (2026 edition)].
Otoendoscopy Expert Committee of the Otorhinolaryngology Branch of the China Association of Integrative Medicine, National Center for Quality Control of Otorhinolaryngology Healthcare, Otorhinolaryngology-Head and Neck Surgery Branch of the Shanghai Medical Doctor Association
Zhonghua Yi Xue Za Zhi · 2026 Jun · PMID 42209171 · Publisher ↗
Congenital ossicular chain malformation (COCM) is a congenital developmental disorder that impairs hearing function. It most commonly presents unilaterally, either as an isolated anomaly or in association with a variety...
Congenital ossicular chain malformation (COCM) is a congenital developmental disorder that impairs hearing function. It most commonly presents unilaterally, either as an isolated anomaly or in association with a variety of systemic syndromes; in severe cases, it may coexist with malformations of the auricle and external auditory canal. Owing to its insidious onset and the presence of an intact tympanic membrane, affected children are frequently misdiagnosed with secretory otitis media. Bilateral COCM, if left untreated in a timely manner, can hinder speech and cognitive development, while specific anatomical variants may elevate the risk of cholesteatoma formation. Diagnosis is predicated on the presence of persistent conductive hearing loss from early childhood, with preoperative high-resolution temporal bone CT scanning serving as a pivotal tool for anatomical evaluation. The management of COCM is primarily guided by patient and family preferences, with therapeutic options encompassing hearing aid fitting and surgical intervention. To standardize the diagnosis and treatment of COCM, optimize the selection of surgical strategies, and enhance clinical outcomes, domestic otology experts have jointly developed the "Expert consensus on a novel classification system, surgical management strategies, and prognostic evaluation for congenital ossicular chain malformations based on stapes footplate mobility and suprastructural integrity (2026 edition)". This consensus is grounded in the latest research evidence and accumulated clinical experience, systematically summarizing the epidemiology, pathogenesis, clinical manifestations, auxiliary examinations, treatment principles, and complications of non-syndromic COCM. Building upon existing classification systems, the consensus introduces a novel clinical classification framework centered on stapes footplate mobility and the integrity of suprastapes structures, which directly informs surgical decision-making. This new classification prioritizes guiding surgical strategy formulation and predicting postoperative outcomes, thereby providing a robust reference for the standardized diagnosis and clinical management of COCM.
[Key points and interpretation of Chinese expert's consensus on endocrine therapy of breast cancer (2026 edition)].
Zhang SH, Jiang ZF
Zhonghua Yi Xue Za Zhi · 2026 Jun · PMID 42209170 · Publisher ↗
Based on the 2023 consensus, the Chinese Breast Cancer Endocrine Therapy Consensus Group systematically reviewed the key points of endocrine therapy in the neoadjuvant, adjuvant, and metastatic settings, and updated the...
Based on the 2023 consensus, the Chinese Breast Cancer Endocrine Therapy Consensus Group systematically reviewed the key points of endocrine therapy in the neoadjuvant, adjuvant, and metastatic settings, and updated the 2026 edition consensus. We interpreted the key points of the consensus in this article. In precision testing, the consensus emphasized the standard immunohistochemical test for hormone receptor and human epidermal growth factor receptor 2 (HER2) receptor, defined HER2-low and ultra-low expression, clarified the timing and methods of genetic testing. For different treatment stages of breast cancer, the consensus defined the eligible population for neoadjuvant endocrine therapy, expanded adjuvant cyclin-dependent kinases 4/6 (CDK4/6) inhibitor application in moderate and high-risk patients, optimized treatment strategies for first-line endocrine therapy plus CDK4/6 inhibitors in metastatic breast cancer, and recommended preferred regimens for post-CDK4/6 inhibitor patients. In conclusion, clinicians should follow the consensus recommendations, so as to achieve precise and individualized treatment for patients with hormone receptor-positive breast cancer.
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