Zhonghua Yi Xue Za Zhi[JOURNAL]
Sun
200 papers
[Immuno-hematological indicator levels in patients with Meniere disease and their associations with clinical characteristics].
Chen JY, Chen JC, Liu D … +5 more , Tian E, Guo ZQ, Guo JQ, Wang J, Zhang SL
Zhonghua Yi Xue Za Zhi · 2026 Feb · PMID 41644458 · Publisher ↗
To investigate the levels of immuno-hematological parameters in patients with Meniere disease (MD) and their associations with clinical features. The clinical data from MD patients collected at Union Hospital, Tongji Me...
To investigate the levels of immuno-hematological parameters in patients with Meniere disease (MD) and their associations with clinical features. The clinical data from MD patients collected at Union Hospital, Tongji Medical College, Huazhong University of Science and Technology between May 2011 and April 2022 were retrospectively analyzed. The parameters were as follows: autoantibodies, humoral immunity markers, lymphocyte subsets, and complete blood counts. Levels of abovementioned parameters were compared between patients with disease duration of≤12 months and>12 months, and among those at audiological stages Ⅰ~Ⅳ. A total of 113 MD patients aged (52.3±12.8) years were included, with 37 males (32.7%) and 76 females (67.3%). There were 52.2% of patients (59/113) who had a disease duration of>12 months. Audiological staging included 16 stageⅠ, 20 stage Ⅱ, 61 stage Ⅲ, and 16 stage Ⅳ cases. The overall rate of antinuclear antibody (ANA) positivity was 20.5% (23/112), with rates of 25.9% (15/58) and 14.8% (8/54) in patients having a disease duration of>12 months and≤12 months, respectively (χ=1.835, =0.176). By stage, ANA positivity was 13.3% (2/15) in stage Ⅰ, 30.0% (6/20) in stage Ⅱ, 19.7% (12/61) in stage Ⅲ, and 18.8% (3/16) in stage Ⅳ(χ=1.708, 0.635). Among humoral markers, 5.5% (4/73) of patients had elevated IgG and 30.1% (22/73) had reduced complement C3, with no significant differences by duration or stage (all >0.05). Abnormal rates for lymphocyte subsets were26.4% (23/87) in total T cells, 33.3% (29/87) in CD4T cells, 29.9% (26/87) in CD8T cells, 21.8% (19/87) in B cells, and 27.6% (24/87) in natural killer (NK) cells, with no significant differences by duration or stage (all >0.05). MD patients exhibit certain immuno-hematological abnormalities, which do not directly correlate with disease duration or the degree of hearing impairment.
[Characteristics of peak expiratory flow and analysis of risk factors for its decline in stroke patients].
Wu WX, Lin JJ, Zhou XZ … +3 more , Zhou CY, Yu JY, Li HY
Zhonghua Yi Xue Za Zhi · 2026 Feb · PMID 41644457 · Publisher ↗
To analyze the characteristics of peak expiratory flow (PEF) and the risk factor for its decline in stroke patients. This was a case-control study. A total of 809 stroke patients hospitalized in the Department of Rehabi...
To analyze the characteristics of peak expiratory flow (PEF) and the risk factor for its decline in stroke patients. This was a case-control study. A total of 809 stroke patients hospitalized in the Department of Rehabilitation of the First Affiliated Hospital of Wenzhou Medical University from January 2020 to December 2022 were prospectively enrolled as the stroke group, and 801 age-and sex-matched healthy subjects from the hospital's Physical Examination Center during the same period served as the control group. The measured PEF was detected using an adult peak flow meter. The predicted PEF and PEF% (measured/predicted PEF×100%) were calculated based on age, sex, and height. The stroke group was further divided into a normal PEF group (PEF%≥80%) and a decreased PEF group (PEF%<80%). PEF metrics were compared within and between the stroke and control groups. A multivariate logistic regression was used to analyze risk factors for PEF decline in the stroke group. The stroke group (539 males, 270 females) aged (63.2±11.9) years and the control group (498 males, 303 females) aged (63.5±12.1) years. The measured PEF in the stroke group was lower than its predicted value [(243.89±139.38) vs (390.45±94.30) L/min, 0.001], while no significant difference was found between the measured and predicted PEF values in the control group (>0.05). Compared with the control group, the stroke group had lower measured PEF [(243.89±139.38) vs (371.52±114.78) L/min] and PEF% [(61.80±30.79)% vs (98.14±22.48)%], but higher predicted PEF [(390.45±94.30) vs (379.21±84.78) L/min] and a higher proportion of severe PEF% decline [48.6% (393/809) vs 4.5% (36/801)] (all <0.05). Within the stroke group, the decreased PEF group had higher proportions of smoking, alcohol drinking, atrial fibrillation, total anterior circulation infarction, higher NIHSS and mRS scores and a higher proportion of dysphagia compared with the normal PEF group (all <0.05). The decreased PEF group had a lower proportion of partial anterior circulation infarction, Barthel index score, and independent standing (all <0.05). Multivariate logistic regression identified smoking (=1.466, 95%: 1.014-2.118), increased NIHSS score (=1.072, 95%: 1.003-1.145), dysphagia (=1.691, 95%: 1.161-2.463), and increased mRS score (=2.286, 95%: 1.263-4.137) as risk factors for PEF decline in stroke patients. Stroke patients exhibit decreased measured PEF and PEF%, along with higher predicted PEF and a higher proportion of severe PEF% decline. Smoking, neurological dysfunction, impaired mobility, and dysphagia are risk factors for PEF decline in stroke patients.
[Effectiveness and safety of atezolizumab plus bevacizumab versus lenvatinib in patients with unresectable HBV-related hepatocellular carcinoma].
Lang X, Liu BY, Zeng J
Zhonghua Yi Xue Za Zhi · 2026 Feb · PMID 41644456 · Publisher ↗
To evaluate the efficacy and safety of first-line treatment with atezolizumab plus bevacizumab compared to lenvatinib in patients with unresectable hepatocellular carcinoma (HCC) associated with hepatitis B virus (HBV) i...
To evaluate the efficacy and safety of first-line treatment with atezolizumab plus bevacizumab compared to lenvatinib in patients with unresectable hepatocellular carcinoma (HCC) associated with hepatitis B virus (HBV) infection. This retrospective study included patients with unresectable HBV-related HCC from October 2020 to December 2024 at General Hospital of Tianjin Medical University. Baseline clinical characteristics, treatment response, and adverse events were collected. According to the different first-line treatment, patients were divided into the observation group (receiving atezolizumab combined with bevacizumab) and the control group (receiving oral lenvatinib monotherapy). Kaplan-Meier analysis was used for making survival curve. The overall survival (OS) and progression-free survival (PFS) were compared between two groups. And log-rank test was used to compare the survival differences between the two groups. Tumor response was evaluated per modified response evaluation criteria in solid tumors (mRECIST). The objective response rate (ORR), disease control rate (DCR) and safety were compared between the two groups. A total of 110 patients were included, of whom 56 were in the observation group, with an age of [(, )] 61 (39, 77) years, and 44 males; 54 were in the control group, with an age of 62 (38, 75) years, and 41 males. Overall, patients were predominantly classified as Child-Pugh class A for liver function, with a median follow-up time of 15.9 months. The median OS was significantly longer in the observation group compared to the control group (20.4 months vs 14.5 months), with 2-year OS rates of 33.7% vs 20.2%, respectively (=0.018). Median PFS was also longer in the observation group (7.5 months vs 5.6 months) with 1-year PFS rates of 37.2% vs 14.8% (=0.006). The ORR in the observation group and the control group was 32.1% and 20.4%, respectively, while the DCR was 75.0% and 72.2%, respectively. Grade≥3 treatment-related adverse events occurred in 46.4% (26/56) of patients in the atezolizumab plus bevacizumab group and 38.9% (21/54) in the lenvatinib group, with no statistically significant difference (=0.424). The most common adverse events differed between groups: in the observation group, fatigue (73.2%, 41/56), gastrointestinal reactions (62.5%, 35/56), hypertension (28.6%, 16/56), proteinuria (21.4%, 12/56) and liver toxicity (17.9%, 10/56) were more frequent; in the control group, fatigue (61.1%, 33/54), hypertension (48.1%, 26/54) and hand-foot skin reaction (24.1%, 13/54) were more common. No severe liver failure or treatment-related deaths were observed. In patients with unresectable HBV-related HCC, atezolizumab plus bevacizumab demonstrated a longer OS and higher ORR compared to lenvatinib with a manageable safety profile.
[Relationship between childhood trauma and depressive symptoms in adolescents with major depressive episodes and the mediating roles of perceived stress and abnormal brain structural development].
Ouyang YM, Zheng JJ, Yang JY … +6 more , Xu J, Zhao PF, Zhou JS, Wang LF, Zhu RX, Wang F
Zhonghua Yi Xue Za Zhi · 2026 Feb · PMID 41644455 · Publisher ↗
To explore the relationship between childhood trauma and depressive symptoms in adolescents with major depressive episodes (MDE), and the mediating roles of perceived stress and abnormal brain structural development. Ad...
To explore the relationship between childhood trauma and depressive symptoms in adolescents with major depressive episodes (MDE), and the mediating roles of perceived stress and abnormal brain structural development. Adolescents with MDE treated at the Early Intervention Department of Nanjing Brain Hospital from September 2021 to August 2024 were retrospectively enrolled. Childhood trauma was assessed using the Childhood Trauma Questionnaire (CTQ) and patients were categorized into groups with or without childhood trauma. Depressive symptom severity was evaluated with the Patient Health Questionnaire-9 (PHQ-9), and perceived stress was measured using the Perceived Stress Scale (PSS). Functional MRI scans were performed to acquire neuroimaging data. Individual deviations in cortical thickness, relative to healthy population norms, were compared between the two groups. Multiple linear regression was used to examine associations between different types of childhood trauma and depressive symptoms. Mediation analyses were conducted to explore whether perceived stress or cortical thickness deviations mediated the relationship between childhood trauma and depressive symptoms. A total of 300 patients were included. The childhood trauma group included 51 males and 103 females [mean age (15.1±1.4) years], and the non-trauma group included 49 males and 97 females [mean age (15.2±1.4) years], with no significant differences in age, sex, or diagnosis (all >0.05). The childhood trauma group exhibited significantly higher PHQ-9, PSS, and CTQ scores compared to the non-trauma group (all <0.05), and showed more pronounced negative deviations in cortical thickness in the left caudal middle frontal region (false discovery rate correction-corrected =0.027). Across all patients, multiple linear regression analysis indicated that emotional abuse (β=0.672，95%：0.447-0.897) and sexual abuse (β=0.637，95%：0.201-1.070) were associated with PHQ-9 scores. Mediation analysis revealed that perceived stress mediated the relationships between emotional abuse [β=0.424 (95%: 0.310-0.540), effect size=58.89%, <0.001] and sexual abuse [β=0.489 (95%: 0.151-0.864), effect size=45.74%, =0.007] with PHQ-9 scores, respectively. Additionally, cortical thickness deviation in the left caudal middle frontal region also mediated the association between emotional abuse and PHQ-9 scores [β=0.029 (95%: 0.003-0.070), effect size=4.03%, =0.026]. Specific types of childhood trauma are associated with depressive symptoms in adolescents with MDE, and this association may be partly explained through the mediating roles of perceived stress and abnormal brain structural development.
[Expert consensus on the clinical application of inhaled nitric oxide in the perioperative period of adult surgical procedures (2026 edition)].
Chinese Society of Anesthesiology of Chinese Medical Association, Critical Care Branch of Beijing Perioperative Medicine Study Society, Critical Care Medicine Branch of Beijing Medical Association … +1 more , National Alliance of Geriatric Anesthesiology
Zhonghua Yi Xue Za Zhi · 2026 Feb · PMID 41644454 · Publisher ↗
Nitric oxide is a selective pulmonary vasodilator. In recent years, inhaled nitric oxide (iNO) has garnered significant attention for its application in adult perioperative care. To standardize its application during the...
Nitric oxide is a selective pulmonary vasodilator. In recent years, inhaled nitric oxide (iNO) has garnered significant attention for its application in adult perioperative care. To standardize its application during the adult perioperative period, the Chinese Society of Anesthesiology of Chinese Medical Association, the Critical Care Branch of Beijing Perioperative Medicine Study Society, the Critical Care Medicine Branch of Beijing Medical Association, and National Alliance of Geriatric Anesthesiology have jointly developed the"Expert consensus on the clinical application of inhaled nitric oxide in the perioperative period of adult surgical procedures (2026 edition)"based on Chinese clinical practice and the latest research advances. This consensus document addresses key aspects of iNO use in the adult perioperative setting, including dosing range, clinical benefits, equipment setup, patient assessment, and safety monitoring. The consensus presents 11 recommendations, aiming to standardize and enhance clinical understanding and practical competency regarding iNO therapy among relevant disciplines. This document serves as a guidance reference for the clinical use of iNO in the perioperative management of adult surgical patients.
[Exploration and implementation strategy of enhancing pregnant women's willingness to receive influenza vaccine based on behavior change mechanism].
Zhang LJ, Li JL, Shan N … +4 more , Huang S, Chen L, Qi HB, Tao Y
Zhonghua Yi Xue Za Zhi · 2026 Feb · PMID 41644453 · Publisher ↗
The disease burden caused by pregnant women contracting influenza is an important public health issue, which not only directly threatens the health of pregnant women themselves, but also has adverse effects on the health...
The disease burden caused by pregnant women contracting influenza is an important public health issue, which not only directly threatens the health of pregnant women themselves, but also has adverse effects on the health of fetuses and newborns through mother-to-child transmission and other means. Although pregnant women are the preferred group for influenza vaccination, their willingness to receive the vaccine is generally low due to multiple factors, such as psychological mechanisms, socio-cultural factors, and policy implementation barriers in the actual implementation process, resulting in an extremely low vaccination rate. Therefore, building a comprehensive and multi-level precision strategy system based on the behavior change mechanism in the three dimensions of individual-society-policy is of great significance for enhancing pregnant women's willingness to receive vaccinations and promoting their conversion of willingness into actual vaccination behavior. In the future, we will evaluate the effectiveness of strategies from a more in-depth, systematic, and comprehensive perspective, explore their synergistic effects in different intervention strategies and their adaptability in diverse target populations, thereby expanding the coverage of public health services and enhancing the accuracy and depth of services, aiming to promote the steady development of public health along the path of precision and efficiency, and provide solid and powerful guarantees for the health of the entire population.
[Smart healthcare for acute kidney injury management among elderly patients with comorbidities: current status and future directions].
Ding Y, Cheng QL
Zhonghua Yi Xue Za Zhi · 2026 Feb · PMID 41644452 · Publisher ↗
With the accelerating global trend of aging, the incidence of acute kidney injury (AKI) among elderly patients with comorbidities is increasing steadily. For elderly patients, AKI not only accelerates the progression of...
With the accelerating global trend of aging, the incidence of acute kidney injury (AKI) among elderly patients with comorbidities is increasing steadily. For elderly patients, AKI not only accelerates the progression of comorbidities, thereby increasing the difficulty of clinical diagnosis and treatment, but also significantly reduces patients' survival rates and quality of life. Therefore, it is of great importance to explore more optimized strategies for AKI management. In recent years, smart healthcare has shown broad application prospects in the management of AKI, covering early risk warning, accurate diagnosis and classification, individualized treatment decision-making, and rehabilitation management. This article systematically sorts out and reviews the application of smart healthcare in AKI management in elderly patients with comorbidities, with a focus on summarizing the advantages and shortcomings of existing technologies, aiming to provide insights into future research and clinical practice in the intelligent management of AKI and promote the transformation of AKI management strategies from disease treatment to proactive health maintenance.
[Comprehensive management strategy and practice for intrinsic capacity decline in older adults: screening, assessment, intervention, and follow-up].
Wang WJ, Li XX, Ma LN
Zhonghua Yi Xue Za Zhi · 2026 Feb · PMID 41644451 · Publisher ↗
With the accelerating global aging process, health issues among older adults have become increasingly severe. To address the challenges brought about by the aging population, a shift from a disease-centered to a function...
With the accelerating global aging process, health issues among older adults have become increasingly severe. To address the challenges brought about by the aging population, a shift from a disease-centered to a function-centered healthcare model is urgently needed. The World Health Organization (WHO) introduced the concept of intrinsic capacity and published the Integrated Care for Older People (ICOPE): Guidance for Person-Centred Assessment and Pathways in Primary Care providing an important framework for assessing and optimizing the functional status in older adults. This article systematically reviews the conceptual background and epidemiological characteristics of intrinsic capacity. It highlights that the WHO ICOPE screening tool has been adapted and validated in China, demonstrating high sensitivity in identifying declines in intrinsic capacity. Intervention studies indicate that multidomain interventions can improve intrinsic capacity, although high-quality evidence from randomized controlled trials is still lacking. Based on the WHO ICOPE guidelines, this article proposes a comprehensive management strategy covering screening, assessment, intervention and follow-up. It also recommends promoting implementation through three key aspects: establishing community-based screening systems for intrinsic capacity, improving multidisciplinary collaboration, and promoting the application of digital technologies. In the future, efforts should focus on accelerating the development of localized assessment tools, strengthening evidence-based research on integrated interventions, and promoting health data integration and intelligent early warning systems. These steps will support China in building a function-centered healthcare system for older adults and advance the achievement of healthy aging.
[Efficacy of F-fluorodeoxyglucose positron emission tomography/computed tomography-assisted navigation system in the debridement of chronic osteomyelitis of the extremities].
Wang B, Wang HH, He HY … +7 more , Duan ZX, Han L, Wu Z, Shi WD, Yang L, Li Q, Zhang JZ
Zhonghua Yi Xue Za Zhi · 2026 Feb · PMID 41611281 · Publisher ↗
This study explored the feasibility of an optical navigation system based on F-fluorodeoxyglucose (F-FDG) positron emission tomography/computed tomography (PET/CT) data for treating chronic osteomyelitis of long bones of...
This study explored the feasibility of an optical navigation system based on F-fluorodeoxyglucose (F-FDG) positron emission tomography/computed tomography (PET/CT) data for treating chronic osteomyelitis of long bones of extremities, and a retrospective analysis was conducted on 7 patients with chronic osteomyelitis of long bones of extremities admitted to the Department of Orthopedic Surgery, PLA General Hospital, from May 2023 to May 2024. Of the patients, there were 6 males and 1 female with a mean age of (47.4±13.7) years, and the lesion sites involved 1 case in the femur, 3 cases in the tibia, and 3 cases in the humerus. All the patients received treatment with the combination of an optical navigation system based on preoperative imaging planning via F-FDG PET/CT, where in the first-stage surgery, the scope of bone and soft tissue infection was determined according to imaging results, precise debridement and antibiotic-loaded bone cement packing were completed under real-time intraoperative navigation guidance, direct wound suture was performed in 6 cases, and flap transplantation was conducted for repair in 1 case due to poor soft tissue conditions. The bacterial culture results showed 5 cases of , 1 case of , and 1 case of . In the second-stage surgery, the navigation system was used to calculate the volume of bone defects, and bone reconstruction was implemented using the Masquelet technique combined with autologous bone grafting, with an average clinical healing time of (3.4±0.4) months; 12-month postoperative follow-up indicated that all patient scores were improved compared with preoperative values, specifically the Self-Rating Anxiety Scale (SAS) score, Activities of Daily Living (ADL) Scale score, Disabilities of the Arm, Shoulder and Hand (DASH) Scale score, Lower Extremity Functional Scale (LEFS) score, and visual analogue scale (VAS) of pain [(35.6±3.6) vs (49.4±3.9) points, (96.4±4.8) vs (53.6±11.8) points, (28.7±8.5) vs (60.3±7.0) points, (63.5±4.1) vs (20.8±4.8) points, (0.7±0.9) vs (5.6±1.1) points, all <0.05]. In conclusion, the F-FDG PET/CT-based navigation system can achieve preoperative independent planning, intraoperative lesion debridement with real-time monitoring, and precise treatment of chronic osteomyelitis of long bones of extremities.
[Analysis of factors influencing the prognosis of pediatric acute myeloid leukemia based on minimal residual disease with different detection methods].
Wang Z, Zhang N, Shao JB … +2 more , Li H, Wang D
Zhonghua Yi Xue Za Zhi · 2026 Feb · PMID 41611280 · Publisher ↗
A retrospective analysis was conducted on the clinical data of newly diagnosed pediatric acute myeloid leukemia (AML) children [excluding acute promyelocytic leukemia (APL)] in Shanghai Children's Hospital between Januar...
A retrospective analysis was conducted on the clinical data of newly diagnosed pediatric acute myeloid leukemia (AML) children [excluding acute promyelocytic leukemia (APL)] in Shanghai Children's Hospital between January 2019 and April 2024. The patients were followed up until April 30, 2025. Minimal residual disease (MRD) was detected to analyze the prognostic impact of MRD assessed by different methods on pediatric AML patients. Among the 52 enrolled patients, 35 were male and 17 were female. The median age at initial diagnosis was 99 months (range: 9-188 months), with a median follow-up [ (, )] of 3.2 (1.2, 4.7) years. The 3-year overall survival rates and event-free survival (EFS) rates were 80.7% and 69.4%, respectively. Multivariate Cox regression analysis revealed that gene MLL rearrangement (excluding MLL-AF9) (=3.071, 95%: 1.024-9.205) and positive molecular MRD after Induction Course Ⅱ therapy (=5.571, 95%: 1.244-24.957) were risk factors for EFS in pediatric AML patients.
[Clinical characteristics and prognostic factors in patients with cerebrospinal fluid torque teno virus positivity after allogeneic hematopoietic stem cell transplantation].
Ma XJ, Wang F, Han XT … +3 more , Fang F, Han LY, Liu HX
Zhonghua Yi Xue Za Zhi · 2026 Feb · PMID 41611279 · Publisher ↗
To investigate the clinical characteristics and prognostic factors for patients with cerebrospinal fluid positivity for torque teno virus (TTV) after allogeneic hematopoietic stem cell transplantation (allo-HSCT). A ret...
To investigate the clinical characteristics and prognostic factors for patients with cerebrospinal fluid positivity for torque teno virus (TTV) after allogeneic hematopoietic stem cell transplantation (allo-HSCT). A retrospective analysis was conducted on the patients who received allo-HSCT at Hebei Yanda Lu Daopei Hospital from 2022 to 2023 year and showed positive cerebrospinal fluid metagenomic next-generation sequencing (mNGS) results post-transplantation, with their clinical data collected accordingly. The patients were categorized into TTV-negative and TTV-positive groups based on the detection of TTV in cerebrospinal fluid. The TTV-positive group was further subdivided into low-RPM [TTV reads per million sequencing reads (TTV-RPM)<1] and high-RPM (TTV-RPM≥1) subgroups using the threshold of TTV-RPM. The patients were followed until December 9, 2025, to investigate the clinical features of cerebrospinal fluid TTV positive patients after allo-HSCT. The survival curve was drawn to compare the difference of survival rate between groups. The influencing factors of patient prognosis were analyzed using a multivariate Cox regression model. A total of 134 patients were enrolled: sixty in the TTV-negative group, including 35 males and 25 females, aged [ (, )] 30 (14, 42) years, and 74 in the TTV-positive group, including 45 males and 29 females, aged 24 (15, 40) years. Within the TTV-positive group, 44 were classified as low-RPM subgroup and 30 as high-RPM subgroup. Baseline characteristics, including gender, age, primary disease, donor type, neutrophil engraftment time, platelet engraftment time, whether acute graft-versus-host disease (aGVHD) occurred, and other microbial infections in cerebrospinal fluid, showed no significant differences between the TTV-negative and TTV-positive groups, or between the low-RPM and high-RPM subgroups (all >0.05). The median follow-up time was 30.0(18.0, 35.4) months, the median survival period was not reached in the low-RPM subgroup, while that in the high-RPM subgroup was 25.6 months (95%: 5.3-45.9), and the 3-year survival rate was lower than that in the low-RPM subgroup (41.1% vs 76.8%, =0.014). Multivariate Cox regression analysis confirmed high TTV-RPM level (≥1) in cerebrospinal fluid as a risk factor for mortality in allo-HSCT patients (2.57 95%: 1.09-6.08). There is no difference in clinical characteristics among allo-HSCT patients with or without TTV infection or with different TTV viral loads. A high TTV-RPM value (≥1) in cerebrospinal fluid is a risk factor for mortality in allo-HSCT patients.
[Analysis of the efficacy and safety of magaldrate granules quadruple therapy in the treatment of infection].
Dong XH, Liu JX, Gao W … +24 more , Hu FL, Meng FD, Zhang ST, Yang GB, Zhu YM, Sun J, Zou DW, Yuan YZ, Jiang XF, Wang JB, Ye F, Zhang GX, Liu SD, Wang XK, Huang H, Zheng PY, Ding XL, Tian ZB, Yang L, Li L, Li Y, Xu MH, Zhang GY, Yao C
Zhonghua Yi Xue Za Zhi · 2026 Feb · PMID 41611278 · Publisher ↗
To evaluate the efficacy and safety of a quadruple therapy consisting of magaldrate granules combined with rabeprazole, amoxicillin, and clarithromycin for (). The patients diagnosed with chronic gastritis and positiv...
To evaluate the efficacy and safety of a quadruple therapy consisting of magaldrate granules combined with rabeprazole, amoxicillin, and clarithromycin for (). The patients diagnosed with chronic gastritis and positive via gastroscopy for the first time were prospectively collected from 11 centers in China from June 2021 to May 2024. The patients were divided into three groups according to random number table method: Group A (magaldrate granules quadruple therapy for 14 days), Group B (magaldrate granules quadruple therapy for 10 days and magaldrate granules for 18 days), and Control Group (bismuth quadruple therapy for 14 days). The patients were followed up 3 days after treatment, and 4 weeks after the end of treatment. The analysis data set was used for effectiveness analysis [the eradication rate of was analyzed using the full analysis dataset (FAS) and the per-protocol dataset (PPS)], and non-inferiority evaluation was conductedusing (comparing the rate difference and 95% of the eradication rate of . If the lower limit was greater than the preset -10%, the non-inferiority test standard was met). The occurrence of symptoms and adverse reactions were analyzed in each group. A total of 557 patients were enrolled, with 227 males and 330 females, aged (46±12) years (18-65 years). The eradication rates according to FAS were 84.6% (159/188) in Group A, 83.2% (153/184) in Group B, and 85.4% (158/185) in Control Group, respectively. A total of 527 cases were included in PPS analysis, and the eradication rates were 88.8% (158/178), 88.8% (150/169),and 87.2% (157/180) in the three groups, respectively. In the FAS and PPS analyses, there was no significant difference in the eradication rates between Group A and Control Group, or Group B and Control Group (all >0.05). The rate differences and 95% were -0.83% (-8.08%-6.42%) and 1.54% (-5.19%-8.27%) between Group A and Control Group. The rate differences and 95% were -2.25% (-9.68%-5.17%) and 1.54% (-5.28%-8.35%) between Group B and Control Group. The lower limits of all confidence intervals exceeded the pre-specified non-inferiority margin of -10%, meeting the criteria for non-inferiority. All three groups of patients exhibited symptoms such as epigastric distension, belching, epigastric pain, and poor appetite. After 3 days of treatment, the relief rate from epigastric pain in Group A [85.9% (55/64)] and Group B [91.2% (52/57)] was higher than Control Group [70.2% (40/57)] (both <0.05). Adverse reactions of varying severity, including dizziness, nausea, vomiting, abdominal pain, diarrhea, and rash, were reported in all three patient groups. No statistically significant differences were found in the incidence rates of these adverse events between Group A and Control Group, or Group B and Control Group (all >0.05). The quadruple therapy combining magaldrate granules with rabeprazole, amoxicillin, and clarithromycin demonstrates good eradication efficacy and high safety.
[Analysis of the efficacy and prognosis of neuroendoscopic ventricular hematoma evacuation in the treatment of ventricular cast hemorrhage in high-altitude areas].
Zhang L, Luo Q, Chen YY … +3 more , Zhang Q, Liu S, Wang XS
Zhonghua Yi Xue Za Zhi · 2026 Feb · PMID 41611277 · Publisher ↗
To explore the effect and prognosis of neuroendoscopic intraventricular hematoma evacuation for ventricular cast hemorrhage (VCH) in high-altitude regions. A total of 66 VCH patients who underwent surgical treatment at...
To explore the effect and prognosis of neuroendoscopic intraventricular hematoma evacuation for ventricular cast hemorrhage (VCH) in high-altitude regions. A total of 66 VCH patients who underwent surgical treatment at Changdu Municipal People's Hospital between September 2023 and December 2024 were enrolled and divided into two groups based on the surgical procedure: the high-altitude endoscopy group and the high-altitude drainage group. Additionally, 29 VCH patients who underwent surgical treatment at the First Affiliated Hospital of Chongqing Medical University between September 2022 and December 2024 were included as the plain drainage group. The operation duration, hematoma clearance rate, complication rate, duration of drainage catheter indwelling, hospital stay, Glasgow Coma Scale (GCS) score at 15 days postoperatively, and Glasgow Outcome Scale (GOS) score at 3 months postoperatively were compared respectively between the high-altitude endoscopy group and the high-altitude drainage group, as well as between the high-altitude drainage group and the plain drainage group to evaluate the therapeutic effect and prognosis. A total of 95 VCH patients (62 males and 33 females)with an age of [(, )] 55 (51, 58) years, comprising 36 cases in the high-altitude endoscopy group, 30 cases in the high-altitude drainage group, and 29 cases in the plain drainage group. No statistically significant differences were observed among the three groups in terms of gender, age, volume of hemorrhage, or GCS score on admission (all >0.05).The hematoma clearance rates in the high-altitude drainage group on postoperative days 1, 3, and 7 were 47% (46%, 50%), 61% (56%, 71%), and 72% (68%, 75%), respectively, which were lower than those in the plain drainage group [56% (53%, 58%), 71% (62%, 76%), and 78% (75%, 82%), respectively], and the incidence of various complications was also higher than that in the plain drainage group. The catheter indwelling duration 7 (7, 8) days and hospital stay (23.3±3.4) days in the high-altitude drainage group were higher than those in the plain drainage group, which were 5(5, 6) days and (19.0±4.7) days . Furthermore, the high-altitude drainage group had lower GOS score a at 3 months after operation [3.5 (2.8, 4.0)], compared to that in the plain drainage group [4.0 (3.0, 5.0)] (all <0.025).In comparison with the high-altitude drainage group, the high-altitude endoscopy group demonstrated higher hematoma clearance rates [82% (80%, 85%), 87% (84%, 89%), and 93% (92%, 96%)] on days 1, 3, and 7, respectively(all <0.025) .Compared with the high-altitude drainage group, patients in the high-altitude endoscopy group had reduced complication rate, shorter hospital stay[(20.2±4.8) d], and higher GOS scores at 3 months[4.0(4.0, 5.0)] postoperatively (all <0.025). External ventricular drainage alone yields suboptimal outcomes for VCH patients in high-altitude regions compared to those in plain areas. Neuroendoscopic hematoma evacuation in high-altitude areas can reduce postoperative complications and improve short-term prognosis compared to external ventricular drainage.
[Classification of neurological recovery trajectories in patients with spontaneous intracerebral hemorrhage and construction of a meteorological factor-based predictive model for neurological function outcomes].
Zhang RT, Zou HY, Huang L … +6 more , Wang XA, Zhang HY, Yuan KK, Wang YK, Wang T, Shi HZ
Zhonghua Yi Xue Za Zhi · 2026 Feb · PMID 41611276 · Publisher ↗
To identify neurological recovery trajectories in patients with spontaneous intracerebral hemorrhage (ICH) using a latent class mixed model (LCMM), to examine the related clinical and meteorological factors, and to devel...
To identify neurological recovery trajectories in patients with spontaneous intracerebral hemorrhage (ICH) using a latent class mixed model (LCMM), to examine the related clinical and meteorological factors, and to develop a predictive model for adverse neurological outcomes. A total of 1 067 patients with spontaneous ICH admitted to the First Affiliated Hospital of Harbin Medical University in 2023 were retrospectively enrolled. Demographic, clinical, imaging, and meteorological data on the day of onset were collected. All patients were followed up from the time of admission at a unified time point, and modified Rankin Scale (mRS) scores were recorded at discharge and at 3, 6, and 12 months after discharge. Based on the mRS scores, LCMM was applied to identify neurological recovery trajectories. Univariate and multivariate multinomial logistic regression analyses were performed to determine influencing factors. On the basis of the LCMM-derived categories, certain subgroups were strategically merged to construct a binary predictive model for risk of poor neurological outcomes in patients. Model performance and interpretability were evaluated through ROC curve, calibration curves, and SHAP (Shapley Additive Explanations) analysis. A total of 1 067 ICH patients [690 males (64.7%) and 377 females (35.3%)], aged[(, )] 61 (53, 69)years, were included. Four neurological function recovery trajectories were identified in the study: partial improvement group(611 cases, 57.3%), gradual improvement group(203 cases, 19.0%), rapid improvement group(182 cases, 17.1%), and persistent disability group(71 cases, 6.7%). Different trajectory types were associated with GCS scores, hematoma location, hematoma volume, and meteorological variables. The patients in the gradual improvement group were associated with higher maximum temperature (=1.10, 95%: 1.06-1.15), lower minimum temperature (=0.91, 95%: 0.88-0.95), smaller diurnal temperature variation (=0.83, 95%: 0.78-0.88), onset in autumn (=4.06, 95%: 1.87-8.85), onset in winter (=4.18, 95%: 1.74-10.03), no history of cardio-cerebrovascular disease (=1.64, 95%: 1.08-2.50), higher GCS scores (=1.29, 95%: 1.18-1.40), and lobar hemorrhage (=2.66, 95%: 1.37-5.14). The patients in the rapid improvement group were associated with no history of cardio-cerebrovascular disease (=2.35, 95%: 1.45-3.84), shorter hospital stays (=0.93, 95%: 0.88-0.98), higher GCS scores (=2.29, 95%: 1.87-2.80), no midline shift (=2.10, 95%: 1.09-4.06), right-sided hemorrhage (=1.64, 95%: 1.10-2.46), as well as lobar hemorrhage (=3.58, 95%: 1.70-7.51) and infratentorial hemorrhage (=3.02, 95%: 1.61-5.66). The patients in the persistent disability group were associated with smaller diurnal temperature variation (=0.89, 95%: 0.81-0.97), shorter hospital stays (=0.95, 95%: 0.91-1.00), lower GCS scores (=0.82, 95%: 0.74-0.90), larger hematoma volumes (=1.02, 95%: 1.00-1.03), and infratentorial hemorrhage (=4.71, 95%: 1.67-13.30). The constructed binary predictive model for neurological functional outcomes demonstrated good performance(AUC=0.812, 95%: 0.786-0.838) and satisfactory calibration curve fit(Brier score=0.168). SHAP analysis identified GCS score and meteorological variables(maximum temperature, minimum temperature, and diurnal temperature range)(mean absolute Shapley values of 1.07, 0.50, 0.45, 0.32)as the most influential predictors in the model. LCMM can effectively identify dynamic neurological recovery trajectories in ICH patients. GCS score and meteorological factors are key predictors, and the constructed model exhibited good predictive performance and interpretability.
[Association of latent class growth model-derived Glasgow Coma Scale trajectories with in-hospital mortality in intracerebral hemorrhage].
Wang J, Dai W, Xu MM … +3 more , Peng Z, Zhao PL, Hang CH
Zhonghua Yi Xue Za Zhi · 2026 Feb · PMID 41611275 · Publisher ↗
To investigate the association between latent class growth model (LCGM)-derived dynamic Glasgow Coma Scale (GCS) trajectories and in-hospital mortality in patients with intracerebral hemorrhage (ICH). Eligible ICH patie...
To investigate the association between latent class growth model (LCGM)-derived dynamic Glasgow Coma Scale (GCS) trajectories and in-hospital mortality in patients with intracerebral hemorrhage (ICH). Eligible ICH patients were retrospectively included from the Medical Information Mart for Intensive Care Ⅳ (MIMIC-Ⅳ, 2008-2022), the eICU Collaborative Research Database (eICU, 2014-2015), and the Neurosurgical Intensive Care Unit cohort of Nanjing Drum Tower Hospital (NSICU, 2024-2025). GCS scores within 120 h after ICU admission were time-gridded at 8-h intervals, and trajectory subtypes were identified using LCGM. Cox proportional hazards regression model was applied to evaluate the association between GCS trajectory classes and in-hospital mortality. Kaplan-Meier curves for in-hospital survival within 28 d after ICU admission were generated, and differences between groups were copmared using the log-rank test. A total of 5 443 patients with cerebral hemorrhage were included [2 893 males and 2 550 females, aged (64±16) years]. Five GCS trajectory classes were identified: consistently high (33.0%, =1 796), rapidly improving (39.0%, =2 121), persistently moderate (16.2%, =879), gradually deteriorating (5.2%, =283), and persistently low (6.7%, =364). In the fully adjusted Cox model, in-hospital mortality risk for the rapidly improving, persistently moderate, gradually deteriorating, and persistently low classes were significantly higher than that of consistently high class, with of 3.06 (95%: 2.09-4.50), 10.13 (95%: 6.86-14.97), 13.27 (95%: 8.85-19.88), and 33.71 (95%: 22.44-50.64), respectively (all <0.001). Kaplan-Meier analysis demonstrated significant differences in 28-day in-hospital survival among the five classes (<0.001), with cumulative survival rates of 89.8%, 85.7%, 60.8%, 56.1% and 33.6%, respectively. LCGM-derived dynamic GCS trajectories are closely associated with in-hospital mortality in ICH and may aid early risk stratification and in-hospital mortality risk assessment.
[Expert consensus on analgesia, sedation and delirium management in adult patients receiving extracorporeal membrane oxygenation(2025 edition)].
Extracorporeal Life Support Professional Committee of Chinese Medical Doctor Association, Chinese Society of Anesthesiology
Zhonghua Yi Xue Za Zhi · 2026 Feb · PMID 41611274 · Publisher ↗
Pain management, sedation, and delirium control are critical components in managing adult patients receiving extracorporeal membrane oxygenation (ECMO). Appropriate management of these interventions is essential for miti...
Pain management, sedation, and delirium control are critical components in managing adult patients receiving extracorporeal membrane oxygenation (ECMO). Appropriate management of these interventions is essential for mitigating pain-induced stress, maintaining patient-ventilator synchrony, and reducing complications. However, as an extracorporeal life support technology, ECMO may significantly alter the pharmacokinetics and pharmacodynamics of analgesics and sedatives through mechanisms such as drug adsorption and an increased volume of distribution. Additionally, the complex pathophysiological status of ECMO patients, including multi-organ dysfunction and exacerbated inflammatory responses, further amplifies challenges in analgesia, sedation, and delirium management. Currently, there are no specific guidelines addressing ECMO patients globally, resulting in substantial heterogeneity and uncertainty in clinical practice. To address this gap, the Extracorporeal Life Support Professional Committee of the Chinese Medical Doctor Association and Chinese Society of Anesthesiology developed this expert consensus based on evidence-based principles. Through systematic literature analysis and a modified Delphi method for expert opinion aggregation, 15 key clinical questions were refined, culminating in 25 evidence-based recommendations. This consensus aims to standardize analgesia-sedation strategies, optimize delirium management protocols, and provide a scientific, consistent framework for clinical practice to improve patient outcomes.
[Expert consensus on neurosurgical robot-assisted deep brain stimulation surgery (2026 edition)].
Functional Neurosurgery Group, Neurosurgery Branch of the Chinese Medical Association, Functional Neurosurgery Group, Neurosurgeon Branch of the Chinese Medical Doctor Association, Neuromodulation Professional Committee, Chinese Medical Doctor Association … +2 more , National Expert Steering Committee on Neurosurgical Robots, Minimally Invasive Neurosurgery Committee, Chinese Research Hospitals Association
Zhonghua Yi Xue Za Zhi · 2026 Feb · PMID 41611273 · Publisher ↗
Robot-assisted deep brain stimulation (DBS) surgical systems in neurosurgery have demonstrated significant advantages in enhancing operative precision, reducing complications, and improving clinical outcomes. With advanc...
Robot-assisted deep brain stimulation (DBS) surgical systems in neurosurgery have demonstrated significant advantages in enhancing operative precision, reducing complications, and improving clinical outcomes. With advancements in robot-assisted surgical systems and surgical techniques, coupled with their wider adoption in DBS procedures, there is a growing need to further standardize and improve surgical workflows, technical details,etc. This consensus focuses on neurosurgery robot-assisted DBS surgery. Through proposing recommendation questions, summarizing and evaluating evidence, formulating recommendations, expert discussions and clinical practice, eight recommendations were developed covering aspects such as indications, preoperative preparation, surgical planning, registration, anesthesia, key operative steps, and postoperative assessment. The aim is to enhance surgical precision and safety, improve patient prognosis, comprehensively present the latest research progress in robot-assisted DBS surgery, and the collective expertise and opinions of experts in the field, thereby providing guidance for the clinical practice of DBS surgery.
[Neuromodulation in bone homeostasis and injury repair].
Gong W, Jiang Q
Zhonghua Yi Xue Za Zhi · 2026 Feb · PMID 41611272 · Publisher ↗
Bone homeostasis essentially represents a balanced interplay among bone cells, dynamically maintaining bone mass and structural stability under the influence of both internal and external factors of the body. Bone tissue...
Bone homeostasis essentially represents a balanced interplay among bone cells, dynamically maintaining bone mass and structural stability under the influence of both internal and external factors of the body. Bone tissue receives various types of neural innervation and, through the secretion of signaling factors, influences the function of bone cells, collectively forming the core framework of the "neuro-skeletal axis". This review systematically analyzes the roles of multiple neural regulatory mechanisms in the maintenance of bone homeostasis and the repair of bone injuries, as well as their translational applications. The autonomic nervous system mainly regulates immune niches and maintains the dynamic balance between osteogenesis and osteoclastogenesis by coordinating sympathetic and parasympathetic nerve tones. Sensory nerves promote bone regeneration through neuropeptides and mechanosignal coupling. The central nervous system further integrates peripheral signals and exerts feedback regulation on bone metabolism through multiple pathways. Although approaches such as receptor blockers, neural magnetic stimulation, and bioengineered scaffolds have gradually shown clinical application potential, their safety, efficacy, and underlying mechanisms still require further investigation. Future research should focus on multidisciplinary efforts to develop precise and controllable neural modulation strategies, providing novel cross-scale interventions for diseases such as osteoporosis and fractures.
[Diagnosis and prevention of sarcopenic obesity should be emphasized].
Zhu MW, Luan XY, Xi H
Zhonghua Yi Xue Za Zhi · 2026 Feb · PMID 41611271 · Publisher ↗
Sarcopenic obesity is a clinical syndrome in which sarcopenia coexists with obesity. It is characterized by a decline in muscle mass and function combined with an increase in fat mass, thereby increasing the risk of adve...
Sarcopenic obesity is a clinical syndrome in which sarcopenia coexists with obesity. It is characterized by a decline in muscle mass and function combined with an increase in fat mass, thereby increasing the risk of adverse clinical outcomes in patients. For a long time, the lack of standardized diagnostic criteria has made it difficult to accurately determine the prevalence of sarcopenic obesity. In 2022, the European Society for Clinical Nutrition and Metabolism (ESPEN) and the European Association for the Study of Obesity (EASO) jointly launched an initiative, for the first time reaching an expert consensus on the definition and diagnostic standards for sarcopenic obesity. This article focuses on recent advances in sarcopenic obesity, systematically summarizing its pathogenesis from four aspects: body composition changes, lifestyle and dietary alterations, metabolic/hormonal dysregulation, and gut microbiota dysbiosis, with emphasis on domestic and international diagnostic strategies. Meanwhile, it further explores the multifaceted detrimental effects on elderly quality of life and life expectancy, and proposes a comprehensive prevention and treatment framework centered on combined lifestyle and nutritional interventions, supplemented by pharmacotherapy, with multidisciplinary treatment (MDT) as the key strategy, aiming to provide theoretical basis and practical direction for clinical diagnosis and treatment of this disease.
[Surgical treatment for spontaneous intracerebral hemorrhage: exploration and evidence-based advances].
Hu X, Liu Y, You C
Zhonghua Yi Xue Za Zhi · 2026 Feb · PMID 41611270 · Publisher ↗
Spontaneous intracerebral hemorrhage (ICH) is characterized by acute onset and high rates of disability and mortality. Although surgical intervention is theoretically capable of decreasing intracranial pressure efficient...
Spontaneous intracerebral hemorrhage (ICH) is characterized by acute onset and high rates of disability and mortality. Although surgical intervention is theoretically capable of decreasing intracranial pressure efficiently and mitigating secondary brain injury, its clinical benefit has long lacked high-level evidence. This article systematically reviews the evolution of ICH surgical treatment-from empirical attempts in the 17th century, through the establishment of early evidence-based guidelines in the CT era of the 20th century, to the conceptual innovation driven by minimally invasive technology in the 21st century. Currently, critical unresolved issues include optimal timing of surgery, selection of surgical approach, intelligent surgical technologies, selection for deep hemorrhage patients, and the surgery in brainstem hemorrhage. Future progress requires multicenter, high-quality clinical research to advance standardized, visualized, precise, intelligent, and homogeneous surgical interventions, thereby providing high-quality evidence from Chinese populations for the diagnosis and treatment of spontaneous ICH worldwide.
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