Chinese Medical Journal[JOURNAL]
Sun
200 papers
[Innovations in targeted therapies for pulmonary hypertension: advancing from vasodilation to vascular remodeling].
Cui XD, Chen JY, Wang J
Zhonghua Yi Xue Za Zhi · 2026 May · PMID 42135041 · Publisher ↗
Pulmonary hypertension (PH) is a heterogeneous disease driven by multiple pathological mechanisms. Its core characteristics include pulmonary vascular constriction and pulmonary vascular remodeling. Currently, the clinic...
Pulmonary hypertension (PH) is a heterogeneous disease driven by multiple pathological mechanisms. Its core characteristics include pulmonary vascular constriction and pulmonary vascular remodeling. Currently, the clinical treatment of PH primarily relies on vasodilatory drugs, including endothelin pathway antagonists, prostacyclin analogues, and regulators of the NO-sGC-cGMP pathway. Although these drugs can alleviate symptoms and improve hemodynamics to a certain extent, they are unable to fundamentally reverse pulmonary vascular remodeling and have limitations in improving the long-term prognosis of the disease. Therefore, developing drugs that can directly intervene and reverse pulmonary vascular structural abnormalities has become a new direction for treatment. Numerous studies, both at home and abroad, have demonstrated that targeted therapy has significant value in improving the prognosis of patients with PH. This article will discuss three aspects: the innovation of classic pathways, new drugs targeting remodeling, and cutting-edge translational research in metabolism and immunity, aiming to clarify the transformation of current treatment strategies from "vasodilation" to "inhibiting vascular remodeling".
[Current status and evolution of targeted therapy for pulmonary arterial hypertension in China].
Luo Q, Liu ZH
Zhonghua Yi Xue Za Zhi · 2026 May · PMID 42135040 · Publisher ↗
Pulmonary hypertension (PH), especially pulmonary arterial hypertension (PAH), is a complex and life-threatening disorder with poor prognosis. Over the past two decades, PAH-targeted therapy in China has evolved through...
Pulmonary hypertension (PH), especially pulmonary arterial hypertension (PAH), is a complex and life-threatening disorder with poor prognosis. Over the past two decades, PAH-targeted therapy in China has evolved through three distinct stages. Before 2006, the field was characterized by the absence of targeted therapies, limited disease awareness, and significant delays in diagnosis. Patients relied primarily on conventional treatments, with a 5-year survival rate of only 20.8%. Between 2006 and 2020, the introduction of targeted drugs such as iloprost and bosentan significantly improved patient outcomes. However, high costs and limited accessibility remained major barriers, with only around 20% of patients receiving targeted therapy and combination therapy used infrequently. Since 2020, expanded insurance coverage and the availability of domestic generics have substantially improved access to treatment. As a result, targeted therapy use has increased to nearly 80%, the 1-year mortality rate has declined to below 10%, and the 5-year survival rate now exceeds 70%. Meanwhile, clinical research has expanded rapidly, and nationwide specialist networks have been established, bringing standards of care closer to international levels. Looking forward, further efforts are needed to strengthen disciplinary development, promote multidisciplinary collaboration, and accelerate drug innovation to improve outcomes for patients with PAH in China.
[Thirty years of targeted drug therapy for pulmonary hypertension: the therapeutic paradigm transition from "vasodilation" to "reverse remodeling"].
Xiong CM, Zhai ZG, Liu ZH
Zhonghua Yi Xue Za Zhi · 2026 May · PMID 42135039 · Publisher ↗
Pulmonary hypertension, especially pulmonary arterial hypertension, is a progressive disease that is difficult to treat and has a poor prognosis. This article summarizes the remarkable progress in pulmonary hypertension...
Pulmonary hypertension, especially pulmonary arterial hypertension, is a progressive disease that is difficult to treat and has a poor prognosis. This article summarizes the remarkable progress in pulmonary hypertension treatment over the past 30 years since the first targeted drug for pulmonary hypertension became available in 1995. Key advancements include the transition from no available treatments to abundant targeted therapies, the shift from monotherapy to early combined treatment strategies, and the evolution of therapeutic goals from symptom improvement to mortality risk reduction and significant hemodynamic parameter enhancement. The treatment paradigm has transformed from mere "vasodilation" to "anti-vascular remodeling", aiming to deepen understanding of pulmonary hypertension and elevate diagnostic and therapeutic standards.
Modifiable risk factors and their joint impact on late-onset multiple sclerosis: Evidence from the UK Biobank.
Chen L, Pang X, Zhang L … +11 more , Li W, Zhang L, Zhu L, Zhou L, Dong M, Chu Y, Zhang H, Yang S, Wang W, Qin C, Tian D
Chin Med J (Engl) · 2026 May · PMID 42108522 · Publisher ↗
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Influence of local spontaneous activity and hippocampal volume on the relationship between APOE genotype, ATN biomarkers, and cognitive function across the Alzheimer's disease spectrum.
Zhu Y, Wang A, Wu Y … +7 more , Yang L, Duan Y, Zhao Y, Zhao X, Hu W, Qun S, Alzheimer’s disease Neuroimaging Initiative
Chin Med J (Engl) · 2026 May · PMID 42108496 · Publisher ↗
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Corrigendum: A novel intracoronary hypothermia device reduces myocardial reperfusion injury in pigs.
Chin Med J (Engl) · 2026 Jul · PMID 42108486 · Full text
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Neurophysiological mechanisms of spinal cord stimulation: From the perspective of disorder of consciousness.
Chen K, Ge Q, Han S … +2 more , Zhang X, He J
Chin Med J (Engl) · 2026 May · PMID 42108248 · Publisher ↗
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Age-related divergence of lipid dysregulation in Chinese patients with Wilson's disease.
Fan L, Xu W, Wang R … +2 more , Dong Y, Wu Z
Chin Med J (Engl) · 2026 May · PMID 42108231 · Publisher ↗
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Mechanisms of resistance in small cell lung cancer.
Yu W, Zhao S, Zheng Z … +6 more , Kang R, Sun C, Liu H, Wang H, Ma J, Yu J
Chin Med J (Engl) · 2026 Jun · PMID 42104213 · Full text
Small cell lung cancer (SCLC) is the most aggressive histological subtype of lung cancer and is characterized by rapid tumor proliferation, early dissemination, and poor prognosis. Currently, the standard first-line trea...
Small cell lung cancer (SCLC) is the most aggressive histological subtype of lung cancer and is characterized by rapid tumor proliferation, early dissemination, and poor prognosis. Currently, the standard first-line treatment for extensive-stage SCLC consists of platinum-based chemotherapy and immune checkpoint inhibitors. Although patients exhibit a high initial response rate to platinum-based chemotherapy, the majority develop acquired resistance within 6 months. Overcoming drug resistance and prolonging the duration of first-line therapy are critical for long-term survival in these patients. However, the definitive resistance mechanisms associated with chemotherapy and immunotherapy in SCLC remain unclear. In this context, we comprehensively review the diverse mechanisms contributing to therapeutic resistance in SCLC, including transcriptional subtype plasticity, the epithelial-mesenchymal transition, an enhanced DNA damage repair capacity, dysregulated autophagy and apoptosis, the presence of cancer stem cells, alterations in the tumor microenvironment, and the aberrant expression of cellular transporters. We particularly focus on the dynamic evolution of resistance from intrinsic to acquired states and the complex interplay among these mechanisms, aiming to provide an integrated theoretical framework to guide the development of rational combination strategies to overcome therapeutic resistance.
Systolic blood pressure time-in-target range and kidney outcomes in patients with hypertension: Findings from the STEP trial.
Zhuang M, Peng X, Song Q … +3 more , Bai J, Yu M, Cai J
Chin Med J (Engl) · 2026 Jun · PMID 42104210 · Full text
BACKGROUND: Time-in-target range (TTR) of systolic blood pressure (SBP) is determined by the proportion of time during which the SBP remains within a defined optimal range. The study aims to explore the association betwe...
BACKGROUND: Time-in-target range (TTR) of systolic blood pressure (SBP) is determined by the proportion of time during which the SBP remains within a defined optimal range. The study aims to explore the association between SBP TTR and the occurrence of chronic kidney disease (CKD) in hypertensive patients. METHODS: A post hoc analysis of data from the Strategy of Blood Pressure Intervention in the Elderly Hypertensive Patients (STEP) trial was performed. The STEP trial compared intensive (110 to <130 mmHg) and standard (130 to <150 mmHg) SBP interventions in hypertensive individuals. The SBP TTR was calculated from baseline to 6 months using 110-130 mmHg and 130-150 mmHg as the target ranges for the intensive and standard groups, respectively. The primary outcome for this study was the first occurrence of CKD (estimated glomerular filtration rate <60 mL·min -1 ·1.73m -2 ). Cox proportional regression models were used to assess the association between SBP TTR and renal outcomes. RESULTS: Overall, 4924 participants were included in this study. Participants with a higher SBP TTR were likely to have a higher baseline diastolic blood pressure. In fully adjusted models, a 1-standard deviation increase in SBP TTR was associated with a 10% lower risk of poor kidney outcomes (hazard ratio [HR], 0.90; 95% confidence interval [CI], 0.83-0.98). Compared with participants in the lowest TTR group (T1: 0 to <38%), those in the highest TTR tertile (T3: 81% to <100%) had a lower risk of renal outcomes (HR: 0.76; 95% CI: 0.61-0.94). Sensitivity analysis showed consistent results when considering the competing risk of death and a combined target range of 110-140 mmHg for SBP. CONCLUSIONS: A higher SBP TTR was associated with a lower risk of kidney events in adults with hypertension. Therefore, the SBP TTR may be considered a potential therapeutic target and quality metric. REGISTRATION: No. NCT03015311 at ClinicalTrials.gov.
[Efficacy analysis of individualized surgical strategies for extracranial carotid artery aneurysms based on aneurysm location and parent-artery lesion characteristics].
Li XG, Zhu JB, Huang JZ … +4 more , Jin YF, Xia WP, Zhang WW, Zhou WM
Zhonghua Yi Xue Za Zhi · 2026 May · PMID 42103681 · Publisher ↗
The clinical data of 42 consecutive patients with extracranial carotid artery aneurysms (ECAA) who underwent surgical treatment in the Department of Vascular Surgery, the Second Affiliated Hospital of Nanchang University...
The clinical data of 42 consecutive patients with extracranial carotid artery aneurysms (ECAA) who underwent surgical treatment in the Department of Vascular Surgery, the Second Affiliated Hospital of Nanchang University, from January 2012 to December 2024 were retrospectively collected. Based on the Attigah classification of aneurysms, while evaluating anatomical characteristics such as bifurcation involvement, proximal and distal landing zone conditions, and parent artery tortuosity, combined with etiological risks including infection, inflammation, or trauma, individualized treatment plans were formulated. Ultimately, 36 patients underwent endovascular treatment and 6 cases underwent open surgical treatment. In the perioperative period, immediate postoperative digital subtraction angiography (DSA) or postoperative computed tomography angiography (CTA) was used to evaluate aneurysm exclusion and parent-artery patency. The patients were aged (53.3±7.3) years, including 17 females and 25 males. Among them, there were 20 true aneurysms, 19 pseudoaneurysms, and 3 dissecting aneurysms. The surgical technical success rate was 97.6% (41/42). During the perioperative period, 1 (2.2%) patient developed cranial nerve injury after open surgery. The postoperative follow-up time was (18.5±4.6) months, no deaths occurred, and 2 (4.8%) patients developed in-stent restenosis at 6 months postoperatively. Treatment of ECAA should be individualized according to etiology and anatomic characteristics, and endovascular therapy represents a relatively straightforward, safe, and effective option for ECAA.
[Feasibility of thoracolaparoscopic resection for adenocarcinoma of the esophagogastric junction with left intrathoracic anastomosis without patient repositioning].
Zhang YY, Zhang C, Liu WX … +5 more , Zhao Q, Zhang XF, Wang XD, He M, Li Y
Zhonghua Yi Xue Za Zhi · 2026 May · PMID 42103680 · Publisher ↗
To evaluate the feasibility of thoracolaparoscopic resection for adenocarcinoma of the esophagogastric junction with left intrathoracic anastomosis performed without patient repositioning. A retrospective analysis was pe...
To evaluate the feasibility of thoracolaparoscopic resection for adenocarcinoma of the esophagogastric junction with left intrathoracic anastomosis performed without patient repositioning. A retrospective analysis was performed on the clinical data of patients who underwent thoracolaparoscopic resection for adenocarcinoma of the esophagogastric junction with left intrathoracic anastomosis without patient repositioning at the Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College from August 2016 to January 2020. A total of 39 patients were enrolled (32 males and 7 females), with the age of (64.2±7.2) years. The patients' surgical status, postoperative pathological stage, postoperative complications, and follow-up information were analyzed. The survival curves were plotted using the Kaplan-Meier method. All 39 procedures were completed successfully with no conversion to thoracotomy or laparotomy. The operative time was 250.0 (223.5, 289.0) min, and intraoperative blood loss was (165±79) ml. Postoperative pathological stages were stage Ⅰ in 13, stage Ⅱ in 4, stage Ⅲ in 11, and stage Ⅳ in 11 patients. R0 resection was achieved in all patients. Postoperative complications included anastomotic leakage in 3 patients (7.7%, 3/39), pulmonary infection in 3 patients (7.7%, 3/39), arrhythmia in 3 patients (7.7%, 3/39), pleural effusion in 3 patients (7.7%, 3/39), incision infection in 1 patient (2.6%, 1/39), gastroesophageal reflux in 5 patients (12.8%, 5/39), and iatrogenic injury of the right mediastinal pleura in 3 patients (7.7%, 3/39). All complications were resolved after conservative treatment. There were no cases of chylothorax, reoperation, ICU admission, or perioperative death. The patients were followed up for a median of 55 (36, 60) months postoperatively. The 1-year and 3-year disease-free survival rates were 87.2% and 69.2%, respectively. The 1-year, 3-year, and 5-year overall survival rates were 92.3%, 74.4%, and 48.1%, respectively. Thoracolaparoscopic adenocarcinoma of the esophagogastric junction resection with left intrathoracic anastomosis performed without patient repositioning appears feasible and has clinical value for broader adoption.
[Comparison of quantitative smears prepared from EDTA-K anticoagulated bone marrow fluid and traditional bedside direct smears, and the clinical value of their combined use with peripheral blood smears].
Zhang L, Chen P, Gao HX … +6 more , Chen N, Zhang L, Zhu JF, Wang BL, Pan BS, Guo W
Zhonghua Yi Xue Za Zhi · 2026 May · PMID 42103679 · Publisher ↗
Compare the preparation effects between quantitative smears of bone marrow aspirate anticoagulated with ethylene diamine tetra-acetic acid dipotassium salt dihydrat (EDTA-K) and traditional bedside direct smear and evalu...
Compare the preparation effects between quantitative smears of bone marrow aspirate anticoagulated with ethylene diamine tetra-acetic acid dipotassium salt dihydrat (EDTA-K) and traditional bedside direct smear and evaluate the clinical application value of the new dual-smear combined testing mode (combining peripheral blood smears with anticoagulated quantitative smears). A prospective study was conducted, including 180 bone marrow aspirate specimens collected from patients who underwent bone marrow puncture examinations at Zhongshan Hospital, Fudan University, between January and June 2024. Both EDTA-K anticoagulated quantitative smears and bedside direct smears were prepared for each specimen. Based on the different preparation methods, the specimens were divided into an anticoagulated quantitative smear group(=180) and a bedside direct smear group(=180), and the differences in bone marrow cell morphology examinations between the two groups were compared. Using the RAND function in Excel, random numbers were generated for the 180 anticoagulated bone marrow aspirate specimens. These random numbers were then sorted in ascending order, and the first 10 EDTA-K anticoagulated bone marrow samples were selected. The impact of storage duration on cell morphology was evaluated after storage periods of 0, 1, 4, 8, 12, and 24 h, respectively. Additionally, the differences in clinical diagnostic concordance rates between the new dual-smear combined testing mode (combining peripheral blood smears with anticoagulated quantitative smears) and the traditional dual-smear combined testing mode (combining peripheral blood smears with bedside direct smears) were compared. Cohen's Kappa consistency analysis was used to evaluate the diagnostic agreement between the new dual-slide combined detection model and the traditional dual-slide combined detection model. The morphological quality score of the anticoagulated quantitative smear group was superior to that of the bedside direct smear group [(2.98±0.18) vs (2.58±0.80) points, <0.001], but the bone marrow smear quality score was lower than that of the bedside direct smear group [(3.08±0.83) vs (3.54±0.76) points, <0.001]. The proportions of hypercellular and markedly hypercellular smears, the percentage of granulocytic cells, the percentage of erythroid cells, and the total number of megakaryocytes per smear were lower in the anticoagulated quantitative smear group than in the bedside direct smear group, whereas the percentage of lymphocytes was higher. Preparing smears from anticoagulated bone marrow aspirate stored for≤4 h did not significantly affect cell morphology (the proportion of cells with morphological changes was<10% of the respective cell lineage). There were no statistically significant differences in diagnostic concordance rates between the new dual-smear combined testing mode and the traditional dual-smear combined testing mode for multiple myeloma and lymphoma [multiple myeloma: 72.8%(67/92) vs 68.5%(63/92), =0.388; lymphoma: 72.1%(31/43) vs 69.8% (30/43), =1.000]. Moreover, both modes demonstrated high diagnostic consistency for multiple myeloma and lymphoma (Kappa values of 0.686 and 0.718, respectively). The morphological quality of anticoagulated quantitative smears is superior to that of bedside direct smears, and it is recommended to prepare the smears within 4 h of bone marrow aspirate collection. The diagnostic concordance rates between the new dual-smear combined testing mode and the traditional dual-smear combined testing mode are similar, with high diagnostic consistency observed between the two modes.
[Transcript distribution, sequence characteristics and clinical outcomes of rare transcript types of BCR::ABL1 fusion gene-positive leukemia patients].
Wang F, Ma XL, Chen X … +12 more , Zhang Y, Wang Z, Tan YC, Liu MY, Wang N, Zhou L, Chen JQ, Cao PX, Fang JC, Liu M, Zhou XS, Liu HX
Zhonghua Yi Xue Za Zhi · 2026 May · PMID 42103678 · Publisher ↗
To investigate the transcript distribution, rare transcript sequence characteristics and clinical outcomes in patients with BCR::ABL1 fusion gene-positive leukemia. The patients with newly diagnosed and relapsed BCR::AB...
To investigate the transcript distribution, rare transcript sequence characteristics and clinical outcomes in patients with BCR::ABL1 fusion gene-positive leukemia. The patients with newly diagnosed and relapsed BCR::ABL1-positive leukemia who underwent leukemia fusion gene screening at Hebei Yanda Lu Daopei Hospital from April 2012 to December 2024 were retrospectively collected. The clinical data of the patients were collected. The distribution of BCR::ABL1 fusion gene transcripts and the sequences of rare transcripts were analyzed, and the clinical outcomes of patients with rare transcripts were observed. A total of 990 patients were enrolled, including 592 males and 398 females, with a median age of 37 years (range 1-94 years). All patients were tested positive for only one type of BCR::ABL1 transcript, and no co-expression of different transcripts was observed in the same patient. Common transcripts accounted for 96.3% (953 patients), while rare transcripts accounted for 3.7% (37 patients). Among 325 patients in chronic phase chronic myeloid leukemia (CML) and 85 patients in acute phase CML, P210 was the predominant type, observed in 310 (95.4%) and 80 (94.1%) cases, respectively; rare transcripts were identified in 14 (4.3%) and 5 (5.9%) cases, respectively. Among 511 acute acute B-lymphocytic leukemia (B-ALL) patients, P190 was the predominant type (70.5%), followed by P210 (26.8%) and rare transcripts (2.8%). Two acute T-lymphocytic leukemia (T-ALL) patients exhibited P190 and e6a2 transcripts, respectively. Common transcripts were also predominant in patients with acute myeloid leukemia (AML) and acute leukemias of ambiguous lineage (ALAL), with rare transcripts accounting for 3.8% (1/26) and 4.8% (2/41), respectively. Sequence analysis of 37 rare transcripts revealed that splicing variants occurred in ABL1 exon 3 (e1a3, e14a3, e13a3) in 23 patients (62.2%), and in different exons of BCR (e6a2, e8a2, variant e13a2, e19a2) in 14 patients (37.8%). Both e8a2 and variant e13a2 were associated with intronic insertions of varying lengths. Five patients with the e13a3 transcript responded well to tyrosine kinase inhibitor (TKI) therapy and achieved complete remission; among the 10 patients with e1a3 transcript and 5 patients with e19a2 transcript, 4 and 3 patients died or failed to achieve remission, respectively. In patients with BCR::ABL1 fusion gene positive leukemia, the transcripts are mainly of the common type, and the rare type is rare. The rare type transcripts show high heterogeneity. The splicing variations mainly occur in ABL1 exon 3 or different exons of BCR, and some are accompanied by intron sequence insertions. Patients with e13a3 type of rare transcripts respond well to TKI treatment, while patients with the e1a3 and e19a2 have poor prognosis.
[Relationships of interleukin-7 receptor gene polymorphisms with the risk of Crohn's disease and the efficacy of infliximab].
Dai CX, Xu JY, Chen WW … +3 more , Xu Y, Ma GL, Jiang Y
Zhonghua Yi Xue Za Zhi · 2026 May · PMID 42103677 · Publisher ↗
To explore the relationships of interleukin-7 receptor (IL-7R) gene polymorphisms with the risk of Crohn's disease (CD), as well as the efficacy of infliximab (IFX) in patients with CD. The CD patients (CD group) and he...
To explore the relationships of interleukin-7 receptor (IL-7R) gene polymorphisms with the risk of Crohn's disease (CD), as well as the efficacy of infliximab (IFX) in patients with CD. The CD patients (CD group) and healthy controls (control group) at the Second Affiliated Hospital of Wenzhou Medical University between January 2020 and May 2025 were retrospectively collected. Genotypes of IL-7R gene at loci rs6897932, rs1494555, rs1494558 were examined in both groups. According to Montreal CD Classification, the disease locations were divided into terminal ileal-type, colonic-type, ileocolic-type and upper gastrointestinal-type. Among CD patients receiving IFX treatment, the clinical response was evaluated by Crohn's Disease Activity Index (CDAI) at week 14 of follow-up. The patients were divided into the clinical response group (a decline of CDAI≥100 points compared with week 0) and the clinical non-response group. The efficacy of endoscopy was assessed by Simplified Endoscopic Score for Crohn's Disease (SES-CD) at week 32. The patients were divided into the mucosal healing group (SES-CD≤2 points or absence of mucosal ulcerations) and the mucosal non-healing group. The distribution differences of IL-7R gene polymorphisms were compared between CD group and control group, among CD patients with different clinical phenotypes, between the clinical response group and the clinical non-response group, as well as between the mucosal healing group and the mucosal non-healing group. The genotypes or alleles with distribution differences were included into multivariate logistic regression model to investigate the relationships of IL-7R gene polymorphisms with the risk of CD, the clinical phenotypes, and the clinical efficacy of IFX in CD patients. The CD group consisted of 303 participants [200 males and 103 females, aged 30 (23, 40) years]. The control group consisted of 514 participants [313 males and 201 females, aged 32 (26, 42) years]. The variant allele (T) [14.0% (85/606) vs 18.5% (190/1 028)] of locus rs6897932 were less frequent in the CD group than that in the control group, but the difference was not statistically significant after adjustment (adjusted =0.054). The homozygous variant genotype (TT) of locus rs6897932 in the patients with terminal ileal-type and ileocolic-type CD group were less frequent than that with colonic-type CD [0.8% (2/261) vs 9.5% (4/42), adjusted =0.009]. The homozygous variant genotype (TT) of locus rs6897932 (=0.06, 95%: 0.01-0.38) was the related factor influencing the terminal ileum involvement (the disease location is terminal ileal-type or ileocolic-type) in CD patients. A total of 112 CD patients were treated with IFX. There were 78 cases in the clinical response group and 34 cases in the clinical non-response group at week 14 of IFX treatment. The variant genotype (CT+TT) [38.5% (30/78) vs 11.8% (4/34), adjusted =0.015] and variant allele (T) [20.5% (32/156) vs 5.9% (4/68), adjusted =0.018] of locus rs6897932 in the clinical response group were more frequent than those in the clinical non-response group. The variant genotype (CT+TT) (=5.17, 95%: 1.54-17.36) of locus rs6897932 was the related factor influencing the clinical response at week 14. There were 43 cases in the mucosal healing group and 69 cases in the mucosal non-healing group at week 32 of IFX treatment. The variant genotype (TC+CC) [65.1% (28/43) vs 85.5% (59/69), adjusted =0.036] of locus rs1494558 in the mucosal healing group was less frequent than that in the mucosal non-healing group. The variant genotype (TC+CC) (=0.24, 95%: 0.09-0.71) of locus rs1494558 was the related factor influencing the mucosal healing at week 32. The homozygous variant genotype (TT) of locus rs6897932 in IL-7R gene may be related with a lower risk of terminal ileum involvement (the disease location is terminal ileal-type or ileocolic-type). In CD patients receiving IFX treatment, the variant genotype (CT+TT) of locus rs6897932 in IL-7R gene may be related with an increased clinical response rate at week 14, while the variant genotype (TC+CC) of locus rs1494558 may be related with a reduced mucosal healing rate at week 32.
[Expert consensus on the diagnosis and treatment of allergic bronchopulmonary aspergillosis with integrated traditional Chinese and western medicine (2026 edition)].
Allergy Committee of Chinese Association of Integrative Medicine
Zhonghua Yi Xue Za Zhi · 2026 May · PMID 42103676 · Publisher ↗
Allergic bronchopulmonary aspergillosis (ABPA) is a hypersensitivity lung disease triggered by sensitization to Aspergillus fumigatus or other Aspergillus species, with 1.0%-3.5% incidence in asthma patients and 7%-15% i...
Allergic bronchopulmonary aspergillosis (ABPA) is a hypersensitivity lung disease triggered by sensitization to Aspergillus fumigatus or other Aspergillus species, with 1.0%-3.5% incidence in asthma patients and 7%-15% incidence in cystic fibrosis patients. It is more common in patients with asthma or cystic fibrosis. Clinical manifestations include recurrent bronchial obstruction, cough, pulmonary infiltrates, and bronchiectasis. However, its actual incidence is likely underestimated due to complex diagnostic criteria and insufficient clinical awareness. To standardize the integrated traditional Chinese and western medicine practice for ABPA, exert the advantage of synergistic efficacy of Chinese and western medicine, and improve the comprehensive diagnostic and therapeutic level, the Professional Committee of Allergy of the Chinese Association of Integrated Traditional and western Medicine organized multidisciplinary experts to formulate this consensus. This consensus defines diagnostic criteria, clinical classification and long-term management plans of ABPA, emphasizes the importance of environmental control and screening in high-risk populations, and systematically outlines an integrated diagnosis and treatment strategy combining western and traditional Chinese medicine. Western medicine is based on corticosteroids and antifungal agents, with biologics such as omalizumab representing an emerging option, while traditional Chinese medicine contributes through syndrome differentiation and treatment-addressing patterns such as "wind invading the lung" and "phlegm-stasis binding"-combined with proprietary Chinese medicines and acupuncture to enhance efficacy, with the aim of providing standardized guidance for clinical practice.
[Expert consensus on external cerebrospinal fluid drainage management in neurocritical care patients (2026 edition)].
Chinese Society of Neurosurgery, Chinese Neurocritical Care Management Collaborative Group
Zhonghua Yi Xue Za Zhi · 2026 May · PMID 42103675 · Publisher ↗
Extracerebral cerebrospinal fluid drainage is a commonly used treatment in the management of neurosurgical intensive care patients, primarily including external ventricular drainage (EVD) and lumbar cistern drainage (LD)...
Extracerebral cerebrospinal fluid drainage is a commonly used treatment in the management of neurosurgical intensive care patients, primarily including external ventricular drainage (EVD) and lumbar cistern drainage (LD). To further standardize the clinical application and management of extracerebral cerebrospinal fluid drainage in neurosurgical intensive care patients, Chinese Society of Neurosurgery and China Neurocritical Care Management Collaborative Group organized experts in the field to update and revise the based on the latest evidence-based medical evidence. This consensus systematically reviews domestic and international literature, covering the indications for EVD and LD, the management of drainage procedures, and the handling of complications. Through two rounds of Delphi method expert evaluations, 24 recommendations were ultimately formulated to provide scientific and standardized guidance for clinical practice, enhancing the safety and efficacy of extracerebral cerebrospinal fluid drainage.
[Initial investigation on the discipline system for reviewology: medicine as an example].
Zhao YM, Getu RGT
Zhonghua Yi Xue Za Zhi · 2026 May · PMID 42103674 · Publisher ↗
Academic journal peer review lacks disciplinary support due to uneven quality of peer review and inconsistent comments. Based on long-term experience in peer review and professional journal publishing, the authors put fo...
Academic journal peer review lacks disciplinary support due to uneven quality of peer review and inconsistent comments. Based on long-term experience in peer review and professional journal publishing, the authors put forward some suggestions on establishing the discipline of reviewology. According to the requirements of the discipline system, this paper puts forward the basic framework of the theoretical system, methodology system and technical system of reviewology for academic discussion. The basic framework is mainly based on the universal rules involved in academic journal peer review, supplemented by special cases of medical research. This paper discusses the background of reviewology emergence, problems and challenges it faces, the social significance and academic value, as well as issues related to artificial intelligence.
Chondrocytes in fracture healing: A review of chondrocyte journey.
Zhang T, Wang J, Jia S … +6 more , Ding K, Du X, Lyu H, Hou Z, Chai R, Chen W
Chin Med J (Engl) · 2026 Jun · PMID 42098082 · Full text
Previous studies have confirmed that chondrocytes are derived from mesenchymal stem cells (MSCs) and mature into hypertrophic chondrocytes during endochondral ossification. This maturation is followed by apoptosis, which...
Previous studies have confirmed that chondrocytes are derived from mesenchymal stem cells (MSCs) and mature into hypertrophic chondrocytes during endochondral ossification. This maturation is followed by apoptosis, which induces vascular invasion, cartilage matrix degradation, and osteoblast differentiation. In addition to this classical transdifferentiation pathway, recent studies have shown that chondrocytes can also be derived from periosteal stem cells (PSCs). Using lineage-tracing techniques to detect the transdifferentiated forms of chondrocytes during endochondral ossification, several new models of transdifferentiation have been discovered, such as a chondrocyte-to-osteoblast precursor transdifferentiation model, a chondrocyte dedifferentiation and redifferentiation model, and a chondrocyte-to-osteoblast direct transdifferentiation model. These findings expand current understanding of chondrocyte origins and their fate during endochondral ossification. In the endochondral ossification process of fracture healing, chondrocytes, as core cells, coexist with a variety of cell types and crosstalk with each other in the callus. This article comprehensively describes the endochondral ossification models in the process of bone development and fracture healing with chondrocytes as the core. The signal pathways and key factors regulating chondrocyte differentiation, maturation, hypertrophy, apoptosis, dedifferentiation, and transdifferentiation into osteoblasts in different models are summarized.
[Chinese clinical practice guidelines for transarterial interventions of hepatocellular carcinoma (2026 edition)].
Clinical Guidelines Committee of Chinese College of Interventionalists
Zhonghua Yi Xue Za Zhi · 2026 Jun · PMID 42097631 · Publisher ↗
Transarterial interventions (TAI) for hepatocellular carcinoma (HCC) include transarterial chemoembolization (TACE), transarterial embolization (TAE), hepatic arterial infusion chemotherapy (HAIC), and selective internal...
Transarterial interventions (TAI) for hepatocellular carcinoma (HCC) include transarterial chemoembolization (TACE), transarterial embolization (TAE), hepatic arterial infusion chemotherapy (HAIC), and selective internal radiation therapy (SIRT). TACE remains the first-line treatment for unresectable HCC. Chinese College of Interventionalists (CCI) previously issued and updated the Chinese Clinical Practice Guidelines of TACE for HCC in 2018, 2021, and 2023, which have played a pivotal role in standardizing TACE procedures in China. In recent years, the application of HAIC and SIRT has become increasingly widespread and standardized in China. With the continuous advancement of TAI techniques, the evolution of therapeutic concepts, and the emergence of high-level evidence, CCI has comprehensively revised and expanded its previous guidelines. The updated Chinese clinical practice guidelines for transarterial interventions of hepatocellular carcinoma (2026 edition) now formally incorporates TACE, HAIC, and SIRT as standard treatment modalities. With the aims to further standardize the use of TAI in the management of HCC, this guideline is developed based on the most current evidence-based medical research, integrates China-specific clinical practices, and incorporates the latest advancements in TAI for HCC. It elaborates on clinical diagnostic criteria and staging, patient indications and contraindications, operational procedures and requirements, perioperative management, common complications management, follow-up and efficacy evaluation, combination therapy, quality control, as well as hot topics and prospects.
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