Chinese Medical Journal[JOURNAL]
Sun
200 papers
[Expert consensus on microbiological diagnosis, prevention, and treatment of carbapenem-resistant Enterobacterales infections (2026 edition)].
Clinical Microbiology Society of China International Exchange and Promotive Association for Medical and Health Care, Chinese Thoracic Society, Chinese Medical Association
Zhonghua Yi Xue Za Zhi · 2026 May · PMID 42161611 · Publisher ↗
Infections caused by carbapenem-resistant Enterobacterales (CRE) pose significant challenges in clinical practice. In practical work, laboratory detection of CRE, as well as the diagnosis, treatment, and prevention of re...
Infections caused by carbapenem-resistant Enterobacterales (CRE) pose significant challenges in clinical practice. In practical work, laboratory detection of CRE, as well as the diagnosis, treatment, and prevention of related clinical diseases, still face numerous difficulties due to a lack of consensus and standardization. To better guide clinical practice related to CRE in China, Clinical Microbiology Society of China International Exchange and Promotive Association for Medical and Health Care and Chinese Thoracic society, Chinese Medical Association invited experts in clinical microbiology, respiratory medicine, infectious diseases, critical care medicine, clinical pharmacy, epidemiology, and other relevant clinical fields to jointly discuss and formulate this consensus, and finally formed 15 recommendations. The consensus systematically summarizes information related to CRE, including terminology, mechanisms of formation, resistance mechanisms, transmission mechanisms, epidemiology, laboratory testing, clinical diagnosis, treatment, infection prevention and control, with the aim of standardizing laboratory and clinical aspects of CRE-related work.
High-salt diet in macrophage-associated metabolic disorders: Mechanisms and therapeutic implications.
Xiao K, Gu L, Ma J … +7 more , Rong S, Yue X, Liu Y, Liu S, Sun F, Zhang S, Wang C
Chin Med J (Engl) · 2026 Jul · PMID 42156155 · Full text
High-salt diet (HSD) has emerged as a prevalent environmental factor that exacerbates chronic inflammation and insulin resistance in obesity-associated type 2 diabetes (T2D) by modulating macrophage polarization, metabol...
High-salt diet (HSD) has emerged as a prevalent environmental factor that exacerbates chronic inflammation and insulin resistance in obesity-associated type 2 diabetes (T2D) by modulating macrophage polarization, metabolic reprogramming, and epigenetic imprinting. Current evidence demonstrates that HSD activates p38/mitogen-activated protein kinase (MAPK), nuclear factor kappa-B (NF-κB), and NOD-like receptor family pyrin domain containing 3 (NLRP3) inflammasome signaling pathways, by which it drives macrophage polarization toward a proinflammatory M1 phenotype while inducing a glycolysis-dominant metabolic shift, thereby establishing a persistent "metabolic memory". Moreover, HSD orchestrates metabolic memory in macrophages through coordinated epigenetic machinery, including histone modifications (Trimethylation of histone H3 at lysine 4 [H3K4me3] and Acetylation of histone H3 at lysine 27 [H3K27ac]), DNA methylation, and noncoding RNAs (e.g., long non-coding RNA MALAT1 and miR-155), leading to sustained inflammatory phenotypes. In multiple metabolic organs (e.g., adipose tissue, liver, pancreas, and gut), the HSD-macrophage axis aggravates systemic insulin resistance through shared proinflammatory signaling and other tissue-specific mechanisms. Most importantly, therapeutic strategies targeting the NLRP3 inflammasome, metabolic pathways, and epigenetic alterations offer novel approaches for managing metabolic inflammation. Future investigations are encouraged to leverage lineage tracing, single-cell sequencing, and spatial multi-omics technologies to advance the development of precision medicine for macrophage-associated metabolic disorders.
Macroscopic on-site evaluation based on core tissues length and weight during EBUS-TBNA using 22-gauge needles.
Zhang Y, Tian S, Wang X … +10 more , Li X, Wang Q, Xia Y, Liu Y, Zhang S, Chen Y, Zhang W, Dong Y, Bai C, Huang H
Chin Med J (Engl) · 2026 Jul · PMID 42156137 · Full text
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Differentiating the impact of hourly particulate air pollution on the onset of myocardial infarction with or without obstructive coronary arteries: A nationwide, case-crossover study.
He Q, Li J, Zhang P … +7 more , Jiang Y, Gao Y, Wong JMJ, Chen R, Yang J, Huang J, Dai Y
Chin Med J (Engl) · 2026 May · PMID 42152072 · Publisher ↗
BACKGROUND: Acute myocardial infarction comprises two distinct entities, myocardial infarction with obstructive coronary artery disease (MI-CAD) and myocardial infarction with nonobstructive coronary arteries (MINOCA), c...
BACKGROUND: Acute myocardial infarction comprises two distinct entities, myocardial infarction with obstructive coronary artery disease (MI-CAD) and myocardial infarction with nonobstructive coronary arteries (MINOCA), characterized by divergent pathogenesis and potential links to particulate air pollution. This study aimed to investigate the differential impacts of such pollution on the onset of MI-CAD and MINOCA to inform precise prevention and control of myocardial infarction. METHODS: Based on the Chinese Cardiovascular Association Database-Chest Pain Center Registry, we performed a nationwide, time-stratified, case-crossover study from 2015 to 2021. Hourly concentrations of fine particulate matter (PM2.5) and inhalable particulate matter (PM10) were acquired through nearby fixed-site monitoring. We combined a conditional logistic regression model with polynomial distributed lag nonlinear models to differentiate the exposure-response relationships of the hourly concentrations of PM2.5 and PM10 with the onset of MI-CAD and MINOCA over 72 hours. We further calculated the attributable fractions (AFs) due to particulate air pollution accordingly. RESULTS: A total of 918,730 patients with MI-CAD and 83,802 patients with MINOCA were included. The risks of MINOCA and MI-CAD onset were highest at the concurrent exposure hour and diminished within 30 hours. Exposure to PM2.5 and PM10 was associated with a 1-2-fold higher risk of MINOCA compared with MI-CAD. Each interquartile range increase in the concentrations of PM2.5 and PM10 resulted in a 2.17% (95% CI: 0.82-3.53%) and 1.57% (95% CI: 0.23-2.94%) increased risk of MINOCA onset, respectively. The corresponding effect estimates for MI-CAD were 1.14% (95% CI: 0.74-1.55%) and 0.47% (95% CI: 0.13-0.81%), respectively. There were no apparent thresholds for these associations. The AFs of MINOCA attributable to PM2.5 and PM10 were 2.43% and 1.72%, respectively, which were almost one to two times greater than those of MI-CAD (1.27% and 0.54%, respectively). CONCLUSIONS: This nationwide study provides robust evidence that, compared with MI-CAD, MINOCA is more sensitive to particulate air pollution. This effect could occur during concurrent hours and under health-based air quality guidelines.
Characterization of real-time narrow-band imaging of diminutive colorectal polyp histology: A Chinese national nonaffiliated multicenter investigation.
Zhang Q, Jiao Y, Liu M … +26 more , Yu T, Ning Q, Li X, Qi H, Yi Y, Sheng J, Yi J, Fan H, Wang H, Liu S, Shen Y, Li S, Feng Q, Wu Z, Xin L, Lyu Z, Guo Y, Li H, Tuo B, Zheng X, He H, Meng R, Wan H, Ge Z, Zhang S, Li X
Chin Med J (Engl) · 2026 May · PMID 42144386 · Publisher ↗
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Global burden of gastric cancer from1990 to 2021: A systematic analysis for the Global Burden of Disease study 2021.
Cui X, Chen Y, Jiao Z … +4 more , Cheng F, Li J, Ning S, Zhang Z
Chin Med J (Engl) · 2026 May · PMID 42144384 · Publisher ↗
BACKGROUND: Gastric cancer (GC) represents a major global health issue. Understanding its current burden and divergent regional trends is critical for formulating effective prevention strategies. We report on the inciden...
BACKGROUND: Gastric cancer (GC) represents a major global health issue. Understanding its current burden and divergent regional trends is critical for formulating effective prevention strategies. We report on the incidence, mortality, and disability-adjusted life-years (DALYs) due to gastric cancer in 204 countries and territories from 21 regions between 1990 and 2021 and provide projections of future trends. METHODS: Using Global Burden of Disease 2021 data, we evaluated GC age-standardized incidence rates (ASIR), age-standardized death rates (ASDR), DALYs, and age-standardized DALY rates (ASDR) across 204 countries and territories from 1990 to 2021. Metrics were stratified by region, country, sociodemographic index (SDI), age, and sex. Trends were evaluated through joinpoint regression, and Bayesian age-period-cohort (BAPC) model was used to project incidence, mortality, and DALYs to 2045. RESULTS: In 2021, the global count estimated of GC-related deaths was 954,373.60, while the incidence exceeded 1.23 million cases. Notably, China alone accounted for 611,799 GC cases and 445,013 GC-related deaths in 2021. Global ASIR, ASDR, and ASR of GC declined annually by 1.77%, 2.18%, and 2.44%, respectively from 1990 to 2021. Males exhibit a higher ASIR, ASDR, and ASR. Andean Latin America and East Asia carry the heaviest burden of GC. The population aged 70-74 years has the highest number of incident cases and deaths. Higher-SDI regions demonstrated more rapid declines in mortality, incidence, and ASR than lower-SDI regions. Smoking and high-sodium diet were the primary risk factors for GC burden. Projections for 2045 suggest a continued decrease in GC burden. CONCLUSIONS: Since 1990, the global ASDR, ASIR, and ASR for GC have consistently declined. However, substantial disparities persist across regions, countries, age groups, and sexes. Tailored prevention and intervention strategies, informed by regional characteristics and risk factors, are essential to effectively reduce the global GC burden.
Efficacy and safety of bismuth quadruple therapy containing minocycline and berberine for initial eradication of Helicobacter pylori : A noninferiority, randomized controlled trial.
Pang Q, Liu Z, Zhu X … +4 more , Zhang L, Wang N, Chen M, Shi Y
Chin Med J (Engl) · 2026 May · PMID 42135895 · Publisher ↗
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Development and validation of an interpretable machine learning model for predicting 30-day postoperative mortality in lung transplant recipients with pneumoconiosis.
Liu J, Liu J, Huang T … +8 more , Yang X, Shao J, Liu Y, Ding J, Zhang C, Yan T, Ye S, Chen J
Chin Med J (Engl) · 2026 May · PMID 42135891 · Publisher ↗
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[Correlation between the non-high-density lipoprotein cholesterol/high-density lipoprotein cholesterol ratio and the occurrence of dementia in patients undergoing maintenance hemodialysis].
Wang HQ, Yang YQ, Li Q … +2 more , Da JJ, Zha Y
Zhonghua Yi Xue Za Zhi · 2026 May · PMID 42135053 · Publisher ↗
To examine the association between the ratio of non-high-density lipoprotein cholesterol to high-density lipoprotein cholesterol (NHHR) and the occurrence of dementia in patients undergoing maintenance hemodialysis (MHD)...
To examine the association between the ratio of non-high-density lipoprotein cholesterol to high-density lipoprotein cholesterol (NHHR) and the occurrence of dementia in patients undergoing maintenance hemodialysis (MHD). A multicenter cross-sectional study was conducted, involving MHD patients from 10 hemodialysis centers in Guizhou Province between May 2019 and November 2023. Cognitive function was assessed using the mini-mental state examination (MMSE), and the presence of dementia was determined according to the corresponding criteria based on the patient's educational level. NHHR was used as a marker of lipid metabolism. Patients were categorized into four groups (Q1-Q4) according to NHHR quartiles: Q1 group (NHHR<1.89), Q2 group (NHHR 1.89-<2.55), Q3 group (NHHR 2.55-<3.42), and Q4 group (NHHR≥3.42). The association between NHHR and the risk of dementia was assessed through multivariate logistic regression, multiple linear regression, restricted cubic splines (RCS), subgroup analysis, and interaction testing. A total of 2 279 MHD patients (1 385 males and 894 females) aged 58 (49, 68) years were included in the study. Among these patients, 179 cases (7.9%) (103 males and 76 females) were diagnosed with dementia, with the age of 69 (60, 77) years. Multivariate logistic regression analysis revealed that, after adjusting for relevant confounding factors, the risk of dementia in the Q3 group was 1.98 times greater than that in the Q1 group (=1.98, 95%: 1.20-3.27, =0.007). Furthermore, the risk of dementia in the Q4 group was 2.56 times that of the Q1 group (=2.56, 95%: 1.56-4.20, <0.001). Multiple linear regression analysis indicated a negative correlation between NHHR and the total MMSE score (β=-0.25, 95%:-0.38--0.12, <0.001). Subgroup analysis demonstrated an interaction between gender and NHHR (=0.005). Among female MHD patients, the risk of dementia in the NHHR Q4 group was 6.04 times that of the Q1 group (=6.04, 95%: 2.59-16.54), whereas no significant correlation was observed between NHHR and dementia in male MHD patients (all >0.05). Restricted cubic splines analysis indicated a linear relationship between NHHR and the risk of dementia (=0.240). Elevated NHHR levels areassociated with an increased risk of dementia in MHD patients, with a more pronounced effect observed in female patients.
[Efficacy and safety between minimally invasive left intercostal small incision and median sternotomy coronary artery bypass grafting inmulti-vessel coronary disease patients with concomitant diabetes].
Sun YH, Zhao ZN, Zhang LL … +2 more , Li XY, Li Z
Zhonghua Yi Xue Za Zhi · 2026 May · PMID 42135052 · Publisher ↗
To compare the efficacy and safety of thoracoscopic-assisted left intercostal small incision and median sternotomy coronary artery bypass grafting (CABG) in the treatment of multi-vesselcoronary disease patients with con...
To compare the efficacy and safety of thoracoscopic-assisted left intercostal small incision and median sternotomy coronary artery bypass grafting (CABG) in the treatment of multi-vesselcoronary disease patients with concomitant type 2 diabetes mellitus (T2DM). The clinical data of multi-vessel coronary disease patients with concomitant T2DM who were admitted to Fuwai Huazhong Cardiovascular Hospital from January 2020 to January 2024 were retrospectively collected. According to the treatment regimen, patients who underwent minimally invasive left intercostal small incision CABG were included in the minimally invasive group, and patients who underwent median sternotomy CABG were included in the traditional group. The perioperative indicators, intraoperative bypass grafts, and the incidence of major adverse cardiac and cerebrovascular events (MACCE) at 1 year after operation were compared between the two groups. After propensity score matching, there were 51 patients in the minimally invasive group, including 28 males and 23 females, with an average age of (62.6±2.1) years. There were 51 patients in the traditional group, including 31 males and 20 females, with an average age of (63.2±2.7) years. No statistically significant differences were detected in age, gender, body mass index, preoperative fasting blood glucose, glycosylated hemoglobin, comorbidities, smoking history, previous myocardial infarction history, left ventricular ejection fraction, SYNergy between percutaneous coronary intervention with TAXus and cardiac surgery (SYNTAX) score, and duration of diabetes between the two groups (all >0.05). The operation time in the minimally invasive group was longer than that of the traditional group [(245.3±35.1) min vs (215.7±28.4) min]. However, the postoperative mechanical ventilation time [(10.2±2.3) h vs (14.8±3.2) h], length of intensive care unit (ICU) stay [(25.3±4.1) h vs (28.4±6.3) h], and hospitalization time [(7.8±1.5) d vs (10.9±2.4) d] were shorter in the minimally invasive group than in the traditional group (all <0.05). The perioperative blood transfusion rate [9.8% (5/51) vs 31.4% (16/51)] and the incidence of complications [7.8% (4/51) vs 37.3% (19/51)] were lower than those in the traditional group (all <0.05). No significant differences were observed between the two groups in the mean blood flow and pulsatility index of all bypass grafts [(35.2±8.7) ml/min vs (36.1±9.2) ml/min; 2.4±0.6 vs 2.3±0.5], the left internal mammary artery (LIMA) [(28.1±6.8) ml/min vs (27.8±7.1) ml/min; 1.9±0.5 vs 2.0±0.5], or the great saphenous vein [(45.6±10.3) ml/min vs (46.7±11.0) ml/min; 2.8±0.7 vs 2.7±0.6] (all >0.05). The total incidence of MACCE at 1 year after operation in the minimally invasive group was 5.9% (3/51), which was not significantly different from that in the traditional group [9.8% (5/51)] (=0.475). Compared with median sternotomy CABG, thoracoscopic-assisted left intercostal small incision CABG has a lower proportion of postoperative blood transfusion and a shorter recovery process in the treatment of multi-vessel coronary artery disease patients with concomitant T2DM. The incidence of MACCE is similar between the two procedures at 1 year after surgery.
[Clinical analysis of postoperative intestinal dysfunction in patients with advanced epithelial ovarian cancer].
Li XT, Xu ZY, Guo XY … +2 more , Liu Y, Liu SJ
Zhonghua Yi Xue Za Zhi · 2026 May · PMID 42135051 · Publisher ↗
To analyze the factors influencing early [postoperative prolonged ileus (PPOI)] and late [low anterior resection syndrome (LARS)] bowel dysfunction after primary cytoreductive surgery in patients with advanced ovarian ca...
To analyze the factors influencing early [postoperative prolonged ileus (PPOI)] and late [low anterior resection syndrome (LARS)] bowel dysfunction after primary cytoreductive surgery in patients with advanced ovarian cancer, and to evaluate the economic impact of postoperative bowel dysfunction. A retrospective study was conducted on 275 patients with advanced epithelial ovarian cancer who underwent cytoreductive surgery at the First Affiliated Hospital of Air Force Medical University from January 2020 to December 2024. Patients were grouped based on postoperative bowel dysfunction: PPOI group (=59) and non-PPOI group (=216). Among 119 patients who underwent rectosigmoid resection, 77 completed questionnaire assessment and were included in LARS analysis, categorized into LARS group (=30) and non-LARS group (=47). Perioperative clinical data were collected, and univariate and multivariate logistic regression models were used to identify risk factors for PPOI and LARS. A total of 275 patients with a mean age of (56.7±9.1) years were included, of whom 21.5% (59/275) developed PPOI. Among 77 patients who completed LARS assessment [mean age (55.2±10.1) years], 39.0% (30/77) developed LARS. Multivariate analysis showed that preoperative prognostic nutritional index (PNI)≤45 (=3.059, 95%: 1.481-6.593), history of prior abdominal surgery (=2.511, 95%: 1.196-5.274), total psoas area index (TPAI)≤266.2 mm/m (=7.725, 95%: 3.621-16.483), intraoperative rectal resection (=6.816, 95%: 3.143-14.782), and total pelvic peritonectomy (=2.947, 95%: 1.372-6.328) were independent risk factors for PPOI (all <0.05). Total pelvic peritonectomy (=3.547, 95%: 1.048-11.612) was identified as a risk factor for LARS (=0.036). Furthermore, the PPOI group had significantly higher hospitalization costs and longer hospital stays (all <0.001). Poor preoperative nutritional status and specific surgical procedures are risk factors for PPOI after cytoreductive surgery in advanced ovarian cancer patients, with total pelvic peritonectomy being a common risk factor for both PPOI and LARS. Additionally, PPOI increases the economic burden of medical care.
[Prediction of recurrence-free survival of T1 glottic carcinoma based on enhanced CT anterior commissure invasion and tumor volume].
Zhang HL, Li WF, Shen LF … +4 more , Ji XD, Li Q, Zhu XL, Xia S
Zhonghua Yi Xue Za Zhi · 2026 May · PMID 42135050 · Publisher ↗
To investigate the recurrent predictive value of morphologic features based on enhanced CT anterior commissure invasion (ACI) and tumor volume (TV) in patients with T1-stage glottic cancer (GC) following larynx-preservin...
To investigate the recurrent predictive value of morphologic features based on enhanced CT anterior commissure invasion (ACI) and tumor volume (TV) in patients with T1-stage glottic cancer (GC) following larynx-preserving surgery. The clinical and enhanced CT images of patients with T1-staging GC treated with larynx-preserving surgery in Tianjin First Central Hospital from January 2015 to December 2019 were retrospectively analyzed. According to the postoperative follow-up results, they were divided into recurrence group and non-recurrence group. The morphological characteristics of tumors, including ACI status and quantitative characteristics (length, thickness, volume), were evaluated on enhanced CT images. The optimal cut-off values of each quantitative parameter for evaluating recurrence were determined by receiver operating characteristic (ROC) curve analysis, and the single or pairwise morphological characteristics with statistically significant differences (<0.05) between groups were included in multivariate Cox regression to analyze the influencing factors of postoperative recurrence-free survival(RFS) and build morphological feature models. Harrell's concordance index (C-index) was used to compare the predictive power of morphological association features with the AJCC-T1 staging system for postoperative recurrence. Calibration curves and decision curve analysis (DCA) were used to assess the calibration and clinical suitability of the model, respectively. A total of 147 patients were included, the ratio of male to female was 11∶1, and the age was (62.6±8.7) years. The median follow-up time was 44 months, and there were 25 cases in relapse group and 122 cases in non-relapse group. ACI combined with TV, length combined with TV, thickness combined with TV were correlated with RFS (<0.05). ACI+TV≥118.55 mm was a risk factor for RFS (=4.17, 95%:1.85-9.37, =0.002). The C- index for predicting recurrence based on the combined morphological features of ACI and TV was higher than that of AJCC-T1 staging [0.73 (95%: 0.62-0.84) vs 0.65 (95%: 0.55-0.74), =2.84, =0.004]. Calibration curves showed good agreement between model-predicted recurrence-free survival and actual recurrence-free survival, and DCA results indicated good clinical net benefit from the model. Morphological characteristics of ACI combined with TV are associated with RFS after larynx-preserving surgery in patients with T1-staging GC, and anterior commissure invasion with larger tumor volume (ACI+TV≥118.55 mm) at initial treatment are risk factors for postoperative recurrence.
[Clinical characteristics of smoking asthma and efficacy of long-acting muscarinic antagonist in treating patients with smoking asthma].
Huang XT, Wu LQ, Dai W … +7 more , Yu WW, Lin J, Shi SQ, Li HY, Ge XT, Chen M, Dai YR
Zhonghua Yi Xue Za Zhi · 2026 May · PMID 42135049 · Publisher ↗
To analyze the clinical characteristics of smoking asthmatic patients and to evaluate the efficacy of long-acting muscarinic antagonist (LAMA) in treating smoking asthmatic patients. The characteristic analysis study of...
To analyze the clinical characteristics of smoking asthmatic patients and to evaluate the efficacy of long-acting muscarinic antagonist (LAMA) in treating smoking asthmatic patients. The characteristic analysis study of smoking asthma was a case-control study, including 128 patients with bronchial asthma. According to whether the patients smoked, they were divided into the smoking asthma group and the non-smoking asthma group. The clinical data, blood indicators, lung function indicators [forced expiratory volume in one second (FEV), FEV/forced vital capacity (FEV/FVC), maximum mid-expiratory flow (MMEF 75/25)], and fractional exhaled nitric oxide (FeNO) were compared between the two groups. The efficacy of LAMA in treating smoking asthma patients was a randomized controlled trial. A total of 60 male patients with moderate to severe asthma, who were smokers and in a non-acute attack phase, were screened. According to computer-generated random numbers, they were divided into the intervention group [administered inhaled corticosteroid (ICS)+long-acting beta agonist (LABA)+LAMA for 1 month] and the control group (administered ICS+LABA for 1 month) in a 1∶1 ratio. Clinical characteristics, blood indicators, lung function indicators, asthma control test (ACT) scores, and Asthma Quality of Life Questionnaire (AQLQ) scores were collected before and after 1 month of treatment, and efficacy indicators were compared within and between groups before and after treatment. A total of 98 patients were included in the non-smoking asthma group, aged (61.9±14.3) years, and 30 were male. A total of 30 patients were included in the smoking asthma group, aged (60.4±15.2) years, all of whom were male. The proportion of males in the smoking asthma group [30.0 (100.0)% vs 30.0 (30.6)%], blood neutrophil count [(4.5±1.9)×10/L vs (3.3±2.0)×10/L], and blood neutrophil ratio [(64.0±16.5)% vs (51.2±23.2)%] were higher than those in the non-smoking asthma group (all <0.05). The blood eosinophil count of the non-smoking asthma group [(0.2±0.2)×10/L vs (0.1±0.1)×10/L], blood eosinophil ratio [(2.2±1.8)% vs (1.5±1.1)%], IgE [(374.5±496.5)u/ml vs (161.2±187.6) U/ml], FEV [(1.9±0.6)L vs (1.4±0.5) L], FEV/FVC [(74.9±11.4)% vs (65.8±11.7)%], MMEF 75/25 [(1.8±1.0)L/s vs (1.3±0.8) L/s], and FeNO [(, )][34.5 (17.3, 57.3) ppb vs 25.0 (17.0, 35.0) ppb (1 ppb=1×10)] were all higher than those in the smoking asthma group (all <0.05). In the study on the efficacy of LAMA treatment for smoking asthma, the intervention group included 30 cases, with an age of (49.6±10.5) years. There were 30 cases in the control group, aged (50.5±11.0) years. There was no significant difference between the two groups from baseline (all >0.05). The number of cigarettes smoked in both groups decreased before and after treatment [intervention group: (20.3±8.0) cigarettes/d vs (8.7±6.2) cigarettes/d; control group: (20.5±7.6) cigarettes/d vs (8.3±5.3) cigarettes/d], but there was no significant difference between the two groups before and after treatment (all >0.05). Intra-group comparison, FEV, FVC, FEV/FVC, MMEF 75/25, ACT score, and AQLQ score of intervention group after treatment were higher than those before treatment, and FeNO of intervention group after treatment was lower than before treatment (all <0.05). After treatment, the ACT score and AQLQ score of control group were higher than those before treatment (all <0.05). Between-group comparison showed that after treatment, the intervention group had higher FEV [(2.5±0.7) L vs (1.9±0.7) L], FVC [(3.2±0.9) L vs (2.7±0.9) L], FEV/FVC [(78.6±6.7)% vs (72.8±11.7)%], ACT score [23.0 (23.0, 24.0) points vs 21.5 (20.3, 24.0) points], and AQLQ score [101.0 (98.0, 104.0) points vs 97.5 (93.0, 101.3) points], and lower FeNO [14.5 (10.0, 28.3) ppb vs 25.0 (19.3, 51.5) ppb] than the control group (all <0.05). This study indicates that smoking asthmatic patients have worse pulmonary function but lower FeNO and peripheral blood eosinophil counts than non-smoking asthmatic patients. Compared to ICS+LABA alone, the addition of LAMA to ICS+LABA significantly improves pulmonary function, reduces FeNO, and enhances symptom control and quality of life in smoking asthmatic patients.
[Clinical practice guideline for integrated PET/MRI in refractory epilepsy(2026 edition)].
Chinese Society of Medical Imaging Technology, Chinese Society of Radiology, Chinese Society of Nuclear Medicine … +2 more , Beijing Society of Nuclear Medicine, Beijing Society of Radiology
Zhonghua Yi Xue Za Zhi · 2026 May · PMID 42135048 · Publisher ↗
To further standardize the clinical use of integrated PET/MRI brain imaging for refractory epilepsy in China, improve the level of individualized precision diagnosis and treatment, promote standardized management, and pr...
To further standardize the clinical use of integrated PET/MRI brain imaging for refractory epilepsy in China, improve the level of individualized precision diagnosis and treatment, promote standardized management, and provide evidence-based and consensus recommendations for clinicians and imaging professionals, experts in nuclear medicine, radiology, neurology, and related fields developed this guideline through a consensus process informed by the available research evidence and clinical practice. Epilepsy is one of the most common chronic neurological disorders, and accurate preoperative localization of the epileptogenic zone in patients with refractory epilepsy remains a major clinical challenge. Integrated PET/MRI enables simultaneous, one-stop acquisition of multidimensional information, including cerebral metabolism, high-resolution anatomical detail, and functional features, and can be used for epileptogenic focus localization, surgical planning, and assessment of important functional regions, making it an important imaging tool for precision care in refractory epilepsy. As integrated PET/MRI systems become increasingly available in China, broader clinical implementation continues to face challenges, including appropriate patient selection and indications, standardization of scanning workflows, image quality control, consistency in image interpretation, and reporting standards. With a focus on clinical feasibility, this guideline provides recommendations across key domains, including indications, examination and quality-control procedures, image interpretation, and standardized reporting, to promote the standardized use of integrated PET/MRI in the care of refractory epilepsy and advance related clinical translation.
[Clinical practice guideline for integrated PET/MRI in brain gliomas(2026 edition)].
Chinese Society of Medical Imaging Technology, Chinese Society of Radiology, Chinese Society of Nuclear Medicine … +2 more , Beijing Society of Nuclear Medicine, Beijing Society of Radiology
Zhonghua Yi Xue Za Zhi · 2026 May · PMID 42135047 · Publisher ↗
To further standardize the clinical application of integrated PET/MRI brain imaging for brain gliomas in China, improve the level of precision diagnosis and management, promote standardized care, and provide evidence-bas...
To further standardize the clinical application of integrated PET/MRI brain imaging for brain gliomas in China, improve the level of precision diagnosis and management, promote standardized care, and provide evidence-based and consensus recommendations for imaging professionals and clinicians, this guideline was jointly developed by the Chinese Society of Medical Imaging Technology, Chinese Society of Radiology, Chinese Society of Nuclear Medicine, the Beijing Society of Nuclear Medicine, and the Beijing Society of Radiology, with the participation of multidisciplinary experts from nuclear medicine, radiology, neurosurgery, neuro-oncology, and radiation oncology, through multiple rounds of consensus meetings. Brain gliomas are among the most common primary brain tumors of the central nervous system, encompassing a wide spectrum of tumor grades and diverse biological behaviors. Key aspects of their clinical management include accurate diagnosis and grading, tumor extent delineation, preoperative evaluation and radiation therapy target planning, as well as differentiation between post-treatment recurrence and treatment-related changes. Integrated PET/MRI enables simultaneous acquisition of PET molecular metabolic information and multiparametric MRI structural and functional information within a single examination, effectively facilitating the above processes and serving as an important imaging modality for the precise diagnosis and treatment of brain gliomas. As integrated PET/MRI systems become increasingly available in China, broader clinical implementation continues to face challenges in appropriate indication selection, standardization of imaging workflows and parameter settings, image post-processing and assessment, consistency of image interpretation, and reporting. Grounded in the current accessibility of integrated PET/MRI equipment and tracers in China and in the latest domestic and international evidence-based research, and closely aligned with the realities of Chinese clinical practice, this guideline provides recommendations across key domains-clinical indications, examination and quality-control workflows, image interpretation, and standardized reporting-with the aim of offering systematic and practical evidence-based guidance for imaging specialists and clinicians involved in glioma care.
[Vasomics: an emerging omics discipline for deciphering vascular health and disease].
Qi XL, Yang L, Wang CY … +5 more , Gu ZZ, Wang JA, Ji XM, Teng GJ, Fan XQ
Zhonghua Yi Xue Za Zhi · 2026 May · PMID 42135046 · Publisher ↗
The vascular system serves as the central architecture of the human circulatory network, whose structural and functional integrity is vital for maintaining homeostasis and is closely associated with the development and p...
The vascular system serves as the central architecture of the human circulatory network, whose structural and functional integrity is vital for maintaining homeostasis and is closely associated with the development and progression of major diseases, including cardiovascular diseases, cerebrovascular diseases, hepatic disorders, ocular diseases, and renal conditions. Traditional single-dimensional research models present evident limitations in deciphering the complex vascular system. In this context, this article formally introduces the concept of "Vasomics". Vasomics is an emerging omics discipline that integrates clinical medicine, basic medicine, biology, computer science and artificial intelligence to systematically analyze the vascular system using multimodal and cross-scale approaches. This article elaborates on Vasomics from six key aspects: its background, core technologies and phenotyping, methodological framework, research progress, applications, and challenges and prospects. By enabling the integration of multi-scale vascular phenotypes from macroscopic to microscopic levels, Vasomics is poised to offer a new paradigm for deciphering vascular health and disease.
[Progress in targeted therapy for chronic thromboembolic pulmonary hypertension].
Zhang M, Hu XH, Wan J
Zhonghua Yi Xue Za Zhi · 2026 May · PMID 42135045 · Publisher ↗
Chronic thromboembolic pulmonary hypertension (CTEPH) is a pulmonary vascular disease characterized by organized thrombotic obstruction of the pulmonary arteries and subsequent pulmonary vascular remodeling. The therapeu...
Chronic thromboembolic pulmonary hypertension (CTEPH) is a pulmonary vascular disease characterized by organized thrombotic obstruction of the pulmonary arteries and subsequent pulmonary vascular remodeling. The therapeutic strategy has evolved from a solely surgical approach to a comprehensive system incorporating pulmonary endarterectomy, balloon pulmonary angioplasty and targeted drugs. Although riociguat remains the only drug formally approved for patients with inoperable or residual/recurrent pulmonary hypertension in China, accumulating evidence suggests that other targeted agents, such as treprostinil, may also show clinical benefits in CTEPH. Current evidence highlights the importance of multimodal therapy. This review aims to comprehensively summarize recent advances in targeted drugs for CTEPH patients and to examine the current applications and unresolved challenges associated with multimodal therapy strategies in this field.
[Progress in targeted drug therapy for pulmonary hypertension associated with hypoxia].
Liu L, Yang YH
Zhonghua Yi Xue Za Zhi · 2026 May · PMID 42135044 · Publisher ↗
Hypoxia-associated pulmonary hypertension (PH) is a severe complication secondary to chronic lung diseases and/or hypoxia, significantly increasing patient mortality risk. Its core pathophysiological mechanisms involve m...
Hypoxia-associated pulmonary hypertension (PH) is a severe complication secondary to chronic lung diseases and/or hypoxia, significantly increasing patient mortality risk. Its core pathophysiological mechanisms involve multiple pathways, including hypoxic pulmonary vasoconstriction, active pulmonary vascular remodeling, endothelial dysfunction, and inflammatory responses. Targeted drug therapy in this field has long faced significant challenges. Clinical trials of classic targeted drugs for pulmonary arterial hypertension (PAH) in hypoxia-associated PH have yielded inconsistent results; some drugs may even exacerbate the disease by potentially worsening ventilation/perfusion mismatch. While research on classic targeted therapies continues, studies investigating drugs targeting alternative pathways, such as directly reversing pulmonary vascular remodeling, are gaining momentum. This article will focus on the progress of both classic and emerging targeted drug research for hypoxia-associated PH.
[Advances in targeted pharmacotherapies for pulmonary hypertension associated with left heart disease].
Yao H, Zhang Y
Zhonghua Yi Xue Za Zhi · 2026 May · PMID 42135043 · Publisher ↗
Pulmonary hypertension associated with left heart disease (PH-LHD) represents the most prevalent form of pulmonary hypertension. The concomitant elevation in pulmonary arterial pressure significantly exacerbates disease...
Pulmonary hypertension associated with left heart disease (PH-LHD) represents the most prevalent form of pulmonary hypertension. The concomitant elevation in pulmonary arterial pressure significantly exacerbates disease morbidity and mortality, leading to unfavorable prognosis. Despite sharing similar pathophysiological characteristics with pulmonary arterial hypertension (PAH), current clinical guidelines do not recommend PAH-targeted therapies for PH-LHD, as clinical trials conducted to date have failed to demonstrate the efficacy and safety benefits of such agents in PH-LHD patients. Novel therapeutic agents with distinct mechanisms-such as activin signaling inhibitors and long-acting relaxin analogs-have shown potential benefits in preliminary studies. It is anticipated that ongoing clinical investigations may yield favorable outcomes, thereby paving new avenues for the treatment of pulmonary hypertension associated with heart failure with preserved ejection fraction and improving clinical prognosis.
[Advances in targeted therapy for pulmonary arterial hypertension].
Luo CJ, Wang L
Zhonghua Yi Xue Za Zhi · 2026 May · PMID 42135042 · Publisher ↗
Pulmonary arterial hypertension (PAH) is a severe cardiovascular disorder characterized by progressive elevation in pulmonary vascular resistance and sustained increase in right ventricular afterload, which may lead to r...
Pulmonary arterial hypertension (PAH) is a severe cardiovascular disorder characterized by progressive elevation in pulmonary vascular resistance and sustained increase in right ventricular afterload, which may lead to right heart failure and sudden death as the disease advances. This article focuses on PAH-targeted drug research, reviews the development of classical pathway agents, and elaborates on the molecular mechanisms and translational prospects of novel pathway therapeutics. Evidence indicates that continuous advancements in targeted pharmacotherapies for PAH have significantly improved clinical outcomes, offering new directions for the management of this condition.
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