Zhonghua Yi Xue Za Zhi[JOURNAL]
Sun
200 papers
[Expert consensus on the diagnosis and management of post-neurosurgical intracranial infection (2026 edition)].
Chinese Neurosurgical Society, Chinese Neurosurgery Intensive Care Management Collaboration Group, Beijing Neurosurgical Society
Zhonghua Yi Xue Za Zhi · 2026 Jun · PMID 42297594 · Publisher ↗
Post-neurosurgical intracranial infection (PNII) is a common complication of neurosurgery, which is associated with poor outcomes. Key strategies to reduce infection rates and improve prognosis include strict perioperati...
Post-neurosurgical intracranial infection (PNII) is a common complication of neurosurgery, which is associated with poor outcomes. Key strategies to reduce infection rates and improve prognosis include strict perioperative infection control, early diagnosis of postoperative intracranial infections, and standardized comprehensive treatment. Based on previous guidelines and consensus, the Chinese Society of Neurosurgery, the Chinese Neurosurgery Intensive Care Management Collaboration Group, and the Beijing Neurosurgical Society convened a multidisciplinary team of experts in neurosurgery, infectious diseases, and clinical microbiology. This consensus was developed through systematic literature reviews and evidence-based medicine, integrating domestic and international epidemiological and clinical research evidence. The Grading of Recommendations Assessment, Development and Evaluation (GRADE) system was used for evidence evaluation and recommendation formulation. After multiple rounds of expert discussions and voting, 30 recommendations were finally established. This consensus covers the epidemiology of PNII, pathogen profiles, diagnostic criteria, perioperative prevention strategies, antimicrobial selection, multidrug-resistant organisms management, surgical interventions, and complication management. It aims to provide standardized guidance for clinical practice and to promote more standardized and refined management of PNII.
[Expert consensus on the clinical diagnosis and management of sarcopenic obesity (2026 edition)].
Weight Management Branch of the Chinese Association of Health Management
Zhonghua Yi Xue Za Zhi · 2026 Jun · PMID 42297593 · Publisher ↗
Sarcopenic obesity is a distinct subtype of obesity characterized by excessive adiposity combined with reduced skeletal muscle mass and impaired muscle function, which exerts dual and superimposed adverse impacts on huma...
Sarcopenic obesity is a distinct subtype of obesity characterized by excessive adiposity combined with reduced skeletal muscle mass and impaired muscle function, which exerts dual and superimposed adverse impacts on human health. In accordance with the latest evidence-based medical evidence and clinical practical experience, the expert panel formulated the "Expert consensus on the clinical diagnosis and management of sarcopenic obesity (2026 edition)", aiming to provide standardized diagnosis and treatment regimens for clinicians. This consensus systematically elaborates on the definition, etiology, and epidemiological characteristics of sarcopenic obesity, the understanding of sarcopenic obesity in traditional Chinese medicine, diagnostic criteria, nutritional and exercise interventions, as well as the indications and safety of pharmacotherapy (including weight-loss medications and muscle-enhancing agents). Individualized management strategies are proposed for special populations, such as adolescents, the elderly, and menopausal individuals. Clinical decision-making and intervention intensity are recommended to be comprehensively evaluated by a multidisciplinary team, involving endocrinology, bariatric surgery, clinical nutrition, rehabilitation medicine, traditional Chinese medicine, general practice, and other related disciplines. Using the modified Delphi method as the core framework for consensus development, this consensus was established through systematic literature retrieval and refinement of key clinical issues to form a structured questionnaire. Consensus criteria were determined in accordance with international Delphi study protocols, and 9 recommendations were finally formulated. These recommendations systematically summarize nutritional intervention, exercise prescription, pharmacotherapy, and comprehensive management strategies for sarcopenic obesity, with the aim of promoting the standardization of clinical diagnosis and treatment of sarcopenic obesity in China.
[Current status and progress of prognostic evaluation in marginal zone lymphoma].
Liu YN, Fang J, Zhou FL … +1 more , Mei H
Zhonghua Yi Xue Za Zhi · 2026 Jun · PMID 42297592 · Publisher ↗
Marginal zone lymphoma (MZL) is an indolent B-cell non-Hodgkin lymphoma with marked heterogeneity. Currently, histological subtype, clinical stage, biochemical parameters, and clinical scoring systems represented by the...
Marginal zone lymphoma (MZL) is an indolent B-cell non-Hodgkin lymphoma with marked heterogeneity. Currently, histological subtype, clinical stage, biochemical parameters, and clinical scoring systems represented by the MZL-international prognostic index (MZL-IPI) remain the principal basis for risk stratification; however, their differentiation power is limited, particularly for intermediate-risk groups, and they can not fully reflect the biological heterogeneity of the disease. Molecular genetic studies have revealed the significant prognostic impact of mutations in genes such as , , , and , as well as chromosomal abnormalities including t(11;18) and 7q deletion, with mutations being closely associated with histological transformation and high-risk outcomes. In the field of imaging, F-fluorodeoxyglucose (F-FDG) positron emission tomography/computed tomography (PET/CT) has inherent limitations in MZL, whereas novel targeted tracers like C-X-C motif chemokine receptor type 4 (CXCR4) PET/CT show improved lesion detection rates and preliminary prognostic value, and imaging omics holds promise for non-invasively revealing tumor heterogeneity. This review systematically summarizes the current status and shortcomings of these prognostic factors, and proposes that future efforts should focus on integrating clinical, molecular genetics, imaging, and multi-omics data, and leveraging artificial intelligence technology to construct multicenter-validated, multidimensional prognostic models, so as to advance precision risk stratification and individualized treatment for MZL.
[Current status and progress of staging and efficacy evaluation of marginal zone lymphoma].
Wang JH, Quan ZY, Wu D … +5 more , Yan WZ, Wang YR, Peng HL, He PC, Liang R
Zhonghua Yi Xue Za Zhi · 2026 Jun · PMID 42297591 · Publisher ↗
Marginal zone lymphoma (MZL) is characterized by high clinical heterogeneity, making individualized precision therapy highly contingent upon accurate staging and dynamic response assessment. This review systematically su...
Marginal zone lymphoma (MZL) is characterized by high clinical heterogeneity, making individualized precision therapy highly contingent upon accurate staging and dynamic response assessment. This review systematically summarizes the current status and progress in the evaluation of splenic MZL (SMZL), mucosa-associated lymphoid tissue (MALT) lymphoma, and nodal MZL (NMZL). In terms of staging modalities, selection should be based on subtype-specific characteristics; notably, as a novel radiotracer, 68Ga-Pentixafor positron emission tomography/computed tomography (PET/CT) provides crucial complementary value for evaluating lesions with low F-fluorodeoxyglucose (F-FDG) avidity. In terms of staging system, the modified Ann Arbor, Lugano classifications and MZL-specific designations (ⅠS, ⅡS) should be comprehensively applied. In terms of efficacy evaluation, the paradigm for response assessment is shifting from isolated morphological measurements toward a multidimensional model integrating functional imaging (Deauville score), molecular-level response monitoring [measurable residual disease (MRD) and circulating tumor DNA (ctDNA)], and patient-reported outcomes (PRO). Importantly, a sustained complete response at 24 months (CR24) has emerged as a critical surrogate endpoint for predicting long-term prognosis. Follow-up management necessitates risk stratification-based dynamic monitoring, with a focus on early warning of histological transformation. Ultimately, this review aims to provide a reference to further optimize the standardized clinical diagnosis, treatment and holistic management of MZL in China.
[Treatment options for marginal zone lymphoma].
Jiang Q, Wang X, Xiang XX … +2 more , Wang L, Zhang X
Zhonghua Yi Xue Za Zhi · 2026 Jun · PMID 42297590 · Publisher ↗
Marginal zone lymphoma (MZL) is a group of indolent B-cell lymphomas with high biological and clinical heterogeneity, including mucosa-associated lymphoid tissue, nodal, and splenic MZL. Despite diverse first-line treatm...
Marginal zone lymphoma (MZL) is a group of indolent B-cell lymphomas with high biological and clinical heterogeneity, including mucosa-associated lymphoid tissue, nodal, and splenic MZL. Despite diverse first-line treatment options, significant differences exist between guidelines and clinical practices, lacking a unified and standardized treatment pathway.Therefore, this article elaborates on the assessment of treatment indications of MZL, the initial therapies for different MZL subtypes, and summarizes the treatment for relapsed/refractory MZL, the selection of maintenance therapy, and management of treatment-related complications, aiming to offer evidence-based guidance and individualized therapeutic decision-making in clinical practice.
[Combining clinical and pathological features to explore the diagnostic challenges of marginal zone lymphoma].
Zhou XX, Yan WZ, Zhou P … +4 more , Fan SQ, Wei J, Lyu B, Peng HL
Zhonghua Yi Xue Za Zhi · 2026 Jun · PMID 42297589 · Publisher ↗
The diagnosis of marginal zone lymphoma (MZL) still relies on morphology, immunohistochemistry, and flow cytometry. Pathologists and clinicians have some difficulties in the diagnosis and differential diagnosis of MZL. T...
The diagnosis of marginal zone lymphoma (MZL) still relies on morphology, immunohistochemistry, and flow cytometry. Pathologists and clinicians have some difficulties in the diagnosis and differential diagnosis of MZL. The key difficulty lies in its diverse clinicopathological manifestations and the lack of characteristic biomarkers or molecular biological features. Combined with clinical and pathological features, this article focuses on some difficulties in the related differential diagnosis, such as the differentiation between extranodal MZL (EMZL) of mucosa associated lymphoid tissues and reactive lesions, between spleen MZL (SMZL) and other splenic lymphomas, as well as MZL with plasmacytic differentiation from lymphoplasmacytic lymphoma (LPL) and myeloma, which aims to provide insights for both clinicians and pathologists in the differential diagnosis of MZL.
[Efficacy of three hearing intervention strategies in microtia patients with concomitant ossicular malformation].
Pang JQ, Liu PY, Li CH … +3 more , Liang MJ, Chen SJ, Yang HD
Zhonghua Yi Xue Za Zhi · 2026 Jun · PMID 42297588 · Publisher ↗
A retrospective analysis was conducted on microtia patients with concomitant ossicular malformation who underwent hearing intervention at Sun Yat-sen Memorial Hospital, Sun Yat-sen University from August 2019 to November...
A retrospective analysis was conducted on microtia patients with concomitant ossicular malformation who underwent hearing intervention at Sun Yat-sen Memorial Hospital, Sun Yat-sen University from August 2019 to November 2024. A total of 22 patients aged (10.4±7.3) years were included. Among them, 11 patients underwent hearing reconstruction surgery, six were fitted with non-implantable bone conduction hearing aids, and five received bone-anchored hearing aid Attract (BAHA Attract). No significant intergroup differences were observed in pre-intervention air-conduction thresholds, bone-conduction thresholds, or air-bone gaps (all >0.05). In the hearing reconstruction group, postoperative air-conduction pure-tone averages (PTA) and air-bone gap were significantly decreased compared with preoperative values [(51.8±5.1) dB HL vs (74.4±5.0) dB HL, =0.003; (29.0±2.0) dB HL vs (51.3±3.9) dB HL, =0.001]. In the non-implantable bone conduction hearing aid group and the BAHA Attract group, the pre-intervention PTA were (58.5±2.4) dB HL and (76.8±4.6) dB HL, respectively, while the postoperative sound-field pure-tone averages were (27.5±1.9) dB HL and (28.5±3.1) dB HL, respectively. There was no significant difference in postoperative sound-field thresholds between the two groups (=0.790). No statistically significant difference was found in total costs among the three groups (=0.118). However, out-of-pocket costs differed significantly (=0.007), being higher in the bone conduction hearing aid group than in the hearing reconstruction group and the BAHA Attract group (both <0.05). Collectively, these findings demonstrate that all three intervention modalities yield favorable audiological outcomes, with comparable total treatment costs but distinct out-of-pocket financial burdens.
[Clinical analysis of 10 cases of congenital middle ear cholesteatoma with concurrent congenital ossicular malformation].
Guo F, Chen XY, Zhang DJ … +2 more , Lin XX, Guan GF
Zhonghua Yi Xue Za Zhi · 2026 Jun · PMID 42297587 · Publisher ↗
The data of 10 congenital middle ear cholesteatoma (CMEC) patients with concurrent congenital ossicular anomalies (COAs), who were admitted to the Second Hospital of Jilin University between January 1, 2018, and July 31,...
The data of 10 congenital middle ear cholesteatoma (CMEC) patients with concurrent congenital ossicular anomalies (COAs), who were admitted to the Second Hospital of Jilin University between January 1, 2018, and July 31, 2025 were retrospectively reviewed. The cohort comprised 8 males and 2 females, with ages ranging from 4 to 36 years. The predominant clinical manifestations included aural fullness, tinnitus, and progressive hearing loss. Preoperative evaluations included high-resolution CT (HRCT) of the temporal bone, MRI of the ear (with non-contrast, diffusion-weighted, and contrast-enhanced sequences), and comprehensive audiological assessments. Combined with intraoperative findings, the results demonstrated that in these 10 CMEC patients, the ossicular abnormalities were congenital malformations (e.g., hypoplasia or aplasia) rather than ossicular destruction resulting from direct erosion by the CMEC itself. These findings suggest that CMEC with COAs may be a comorbid condition arising from an independent congenital developmental anomaly, rather than from erosion induced by the CMEC itself.
[Brain functional and cognitive features in schizophrenia patients with positive and negative symptom features based on resting-state functional MRI].
Han WY, Liu XZ, Liu K … +6 more , Li X, Cheng XG, Chen AR, Lyu LX, Li WW, Yang YF
Zhonghua Yi Xue Za Zhi · 2026 Jun · PMID 42297586 · Publisher ↗
To explore the brain functional and cognitive characteristics of schizophrenia (SZ) patients with predominant positive or negative symptoms using resting-state functional magnetic resonance imaging (rs-fMRI). SZ patient...
To explore the brain functional and cognitive characteristics of schizophrenia (SZ) patients with predominant positive or negative symptoms using resting-state functional magnetic resonance imaging (rs-fMRI). SZ patients who visited the Second Affiliated Hospital of Henan Medical University from March 2021 to June 2024 were prospectively included and evaluated with the Positive and Negative Syndrome Scale (PANSS). They were then divided into the positive symptom-dominant SZ group (SZ-Ⅰ group) and the negative symptom-dominant SZ group (SZ-Ⅱ group) based on the results. Healthy individuals were recruited from the surrounding communities as the control group. The cognitive function of SZ patients was assessed using the MATRICS Consensus Cognitive Battery (MCCB). Whole-brain rs-fMRI data was collected from all subjects, and low-frequency amplitude (ALFF), fractional ALFF (fALFF), and regional homogeneity (ReHo) were calculated. Brain regions with significant differences among the three groups were identified through inter-group comparisons and used as regions of interest (ROI) to calculate the whole-brain functional connectivity (FC) and perform inter-group comparisons. Partial correlation analysis was conducted to explore the correlations between rs-fMRI and MCCB subscale scores among the three groups. The SZ-Ⅰ group included 18 males and 20 females, with an average age of (28.2±7.8) years; the SZ-Ⅱ group included 19 males and 18 females, with an average age of (30.9±6.4) years; and the control group included 16 males and 20 females, with an average age of (32.6±9.3) years. There were no significant differences in gender and age among the three groups (all 0.05). The fALFF value of the right caudate nucleus showed significant differences among the three groups, with the SZ-Ⅰ group having a higher fALFF value than the SZ-Ⅱ group, and both SZ groups having higher fALFF values than the control group (all <0.05, FDR corrected). The FC values from the right caudate nucleus to the right angular gyrus and the right caudate nucleus to the right inferior parietal lobule were higher in the SZ-Ⅱ group than in the SZ-Ⅰ group (all <0.05, GRF corrected). In the SZ-Ⅰ group, the fALFF value of the right caudate nucleus was potentially negatively correlated with the maze test score (=-0.388, =0.340), and in the SZ-Ⅱ group, the fALFF value of the right caudate nucleus was potentially negatively correlated with the spatial span test (=-0.479, =0.100). There are differences in the brain functional activities and connections related to the right caudate nucleus in SZ patients with predominant positive or negative symptoms. The abnormal brain functional activities are associated with the specific cognitive impairments in SZ patients with different symptom characteristics, suggesting that the right caudate nucleus can be a potential functional imaging biomarker for differentiating SZ patients with different symptom characteristics.
[Effects of oliceridine versus sufentanil for anesthesia induction and postoperative analgesia on postoperative nausea and vomiting in patients undergoing gynecological laparoscopic surgery: a randomized controlled trial].
Wang Y, Xu X, Shen WJ … +3 more , Li H, Wu LL, Wang GY
Zhonghua Yi Xue Za Zhi · 2026 Jun · PMID 42297585 · Publisher ↗
To investigate the effects of oliceridine versus sufentanil for anesthesia induction and postoperative patient-controlled intravenous analgesia (PCIA) on postoperative nausea and vomiting (PONV) in patients undergoing gy...
To investigate the effects of oliceridine versus sufentanil for anesthesia induction and postoperative patient-controlled intravenous analgesia (PCIA) on postoperative nausea and vomiting (PONV) in patients undergoing gynecological laparoscopic surgery. This prospective study enrolled 70 patients scheduled for elective gynecological laparoscopic surgery under general anesthesia with planned postoperative PCIA at Beijing Tongren Hospital, Capital Medical University, from September to December 2025. Patients were randomly assigned using a random number table to either the oliceridine group (Group O, =35) or the sufentanil group (Group S, =35). Group O received oliceridine for anesthesia induction and PCIA, while Group S received sufentanil; both groups received ondansetron and flurbiprofen axetil in combination. The primary outcome was the incidence of PONV within 48 hours postoperatively. Secondary outcomes included the incidence of nausea and vomiting during 0-<24 h and 24-48 h postoperatively, severity of nausea within 24 hours postoperatively [assessed by the visual analog scale (VAS), with a score≥4 defined as moderate-to-severe], the impact of PONV (assessed by the Myles simplified scale, with a score≥5 defined as clinically important PONV), postoperative pain numerical rating scale (NRS) scores, recovery parameters, and adverse events. A total of 34 patients in Group O and 33 patients in Group S completed the study. The mean age was (39.3±9.2) years in Group O and (40.9±10.4) years in Group S, with no significant differences in baseline characteristics between the two groups (all >0.05). The incidence of PONV within 48 hours postoperatively was significantly lower in Group O than in Group S [35.3% (12/34) vs 66.7% (22/33), χ²=6.59, =0.010]. Within the first 24 hours postoperatively, Group O had a lower incidence of nausea [29.4% (10/34) vs 66.7% (22/33), χ²=9.32, =0.002] and a lower incidence of moderate-to-severe nausea [20.6% (7/34) vs 51.5% (17/33), χ²=6.97, =0.008] compared to Group S. The incidence of clinically important PONV was lower in Group O than in Group S, but the difference was not statistically significant [2.9% (1/34) vs 18.2% (6/33), =0.054]. There were no significant differences between the two groups in resting or movement NRS scores at any postoperative time point (all >0.05), and no patient required rescue analgesia. No significant differences were observed between the two groups in awakening time, time to first flatus, or overall incidence of adverse events (all >0.05). For patients at high risk of PONV undergoing gynecological laparoscopic surgery, oliceridine provides analgesic efficacy equivalent to sufentanil while significantly reducing the incidence and severity of postoperative nausea and vomiting, with a favorable safety profile.
[Study on cervical reasonable range of motion to prevent adjacent segmental intervertebral disc degeneration after anterior cervical discectomy and fusion].
Yin P, Liang WS, Sun D … +2 more , Zhang BY, Hai Y
Zhonghua Yi Xue Za Zhi · 2026 Jun · PMID 42297584 · Publisher ↗
To investigate the cervical reasonable range of motion (ROM) after anterior cervical discectomy and fusion (ACDF), so that the intradiscal pressure (IDP) in adjacent segments of the fusion segments did not increase compa...
To investigate the cervical reasonable range of motion (ROM) after anterior cervical discectomy and fusion (ACDF), so that the intradiscal pressure (IDP) in adjacent segments of the fusion segments did not increase compared with normal cervical spine. A three-dimensional finite element model of intact cervical spine (C-C) was established based on CT data from a healthy adult female cervical spine, and its effectiveness was verified. ACDF surgery was simulated at the C-C level, with implantation of interbody cage and screw-plate system to construct the ACDF model. A 1.0 Nm moment and 73.6 N follower load was applied to the intact model to determine the normal cervical ROMs. A displacement load was applied to the ACDF model under the same follower load to achieve a total C-C ROM equivalent to that of the intact model. The fitting function was employed to calculate the total C-C ROM of the ACDF model without increasing IDP in adjacent segments, which was defined as the reasonable ROM. Compared with the intact model, the ACDF model (C fusion) demonstrated significantly increased ROM at the adjacent segments C and C in all motion directions, with an increase of 13.07%-17.77% and 7.78%-18.15%, respectively. The IDP of C and C increased with increasing total C ROM. The IDP of C was higher than that of C in almost all motion directions, except for extension. Finally, the postoperative reasonable ROMs of ACDF model were 42.4°, 53.6°, 28.6° and 43.0° in flexion, extension, lateral flexion, and axial rotation, which decreased by 6.6%, 3.8%, 3.5% and 5.6% compared with the intact model, respectively. The postoperative reasonable ROM in flexion, extension, lateral bending, and axial rotation is 42.4°, 53.6°, 28.6°, and 43.0°, respectively. Moderately reducing cervical ROM may offset the increase in adjacent segment IDP, thereby providing a novel strategy for preventing adjacent segment disc degeneration after ACDF.
[Clinical practice guidelines for standardized management of stillbirth (2026 edition)].
Fetal Medicine Group, Chinese Society of Perinatal Medicine, Chinese Medical Association, National Obstetric Professional Medical Quality Control Center of China, National Clinical Research Center for Obstetric and Gynecologic Diseases of China
Zhonghua Yi Xue Za Zhi · 2026 Jun · PMID 42297583 · Publisher ↗
Stillbirth is one of the most common adverse pregnancy outcomes. It not only causes physical and psychological trauma to pregnant and puerperal women but also imposes heavy family and socioeconomic burdens. Standardized...
Stillbirth is one of the most common adverse pregnancy outcomes. It not only causes physical and psychological trauma to pregnant and puerperal women but also imposes heavy family and socioeconomic burdens. Standardized clinical management of stillbirth is crucial for improving the quality of the birth population. Such management should be based on a multidisciplinary collaborative diagnosis and treatment model, covering a complete pathway including high-risk factor screening, risk stratification and early warning, whole-pregnancy monitoring, and intervention in subsequent pregnancies. Accordingly, this guideline was jointly developed by the Fetal Medicine Group of the Chinese Society of Perinatal Medicine (Chinese Medical Association), the National Obstetric Quality Control Center, and the National Clinical Research Center for Obstetric and Gynecologic Diseases of China. We followed the Grading of Recommendations Assessment, Development and Evaluation (GRADE) system and international reporting standards for practice guidelines. A multidisciplinary expert team was established to systematically review evidence on 32 key clinical questions in China and formulate evidence-based recommendations, so as to provide guidance for the standardized management of stillbirth in China. This guideline aims to provide a knowledge framework and practical guidance for primary healthcare professionals, obstetricians, clinical pharmacists, nurses at all levels of medical institutions, as well as pregnant women and their families.
[Scientific, transparent and applicable rankings of Chinese guidelines and consensus published in the medical journals between 2023 and 2024].
Guidelines and Standards Research Center, Chinese Medical Association Publishing House; Research Unit of Evidence‑Based Evaluation and Guidelines (2021RU017), Chinese Academy of Medical Sciences; WHO Collaborating Centre for Guideline Implementation and Knowledge Translation; the Scientific, Transparent and Applicable Rankings (STAR) Working Group
Zhonghua Yi Xue Za Zhi · 2026 Jun · PMID 42297582 · Publisher ↗
To further promote continuous quality improvement of clinical practice guidelines (CPGs) and expert consensuses (ECs) in China, the Scientific, Transparent, and Applicable Rankings (STAR) Working Group conducted its 2023...
To further promote continuous quality improvement of clinical practice guidelines (CPGs) and expert consensuses (ECs) in China, the Scientific, Transparent, and Applicable Rankings (STAR) Working Group conducted its 2023-2024 biennial appraisal based on its previous work. In this round, 40 specialty committees and over 1 000 experts participated, and large language model technologies were integrated to comprehensively evaluate guidelines and consensuses led by Chinese scholars and published in journals between 2023 and 2024. A total of 305 guidelines and 1 153 consensuses were included for 2023, compared to 424 guidelines and 1 391 consensuses for 2024. The average scores for guidelines and consensuses increased from 41.0 and 28.8 in 2023 to 49.2 and 33.0 in 2024, respectively, indicating a significant upward trend compared with previous years. Among the evaluation domains, "Recommendations" achieved the highest scoring rate, whereas "Protocols" and "Funding and Conflict of Interest Disclosures" recorded the lowest. In terms of publication volume, Oncology, Traditional Chinese Medicine, and Pediatrics were the top three specialties. Overall, medical guidelines and consensus documents in China are at a critical stage of transitioning from"quantity-driven"expansion to"high-quality development."In the future, guideline developers, academic journals, and the STAR Working Group should establish long-term collaborative mechanisms to jointly promote the dynamic and intelligent evolution of the ranking system.
[Clinical implementation challenges of component-resolved diagnostics in allergy and countermeasures through continuing medical education].
Luo WT, Chang B, Sun BQ … +1 more , Huang HM
Zhonghua Yi Xue Za Zhi · 2026 Jun · PMID 42297581 · Publisher ↗
Component-resolved diagnosis (CRD), a cornerstone of precision allergology, enables the identification of specific allergenic molecules and refines the diagnosis, risk stratification, and personalized management of aller...
Component-resolved diagnosis (CRD), a cornerstone of precision allergology, enables the identification of specific allergenic molecules and refines the diagnosis, risk stratification, and personalized management of allergic diseases. However, its widespread clinical adoption, especially in primary care and non-specialist settings in China, remains constrained by the complexity of component-based data, limited interpretability among clinicians, and the absence of standardized clinical pathways. To address these challenges, the establishment of a systematic and tiered continuing medical education framework is essential. This article examines the technological foundations, clinical applications, and interpretation challenges of CRD, and proposes a structured educational framework incorporating competency-based tiered training, case-driven and problem-oriented learning, standardized interpretation workflows, multidisciplinary collaboration, and digital support tools. By strengthening the educational infrastructure, this approach can enhance clinicians' interpretive competence, facilitate the translation of CRD from a diagnostic tool into a clinical decision-making aid, and ultimately advance the precision and standardization of allergy care.
[Analysis on the efficacy of ustekinumab in the patients with isolated perianal Crohn disease].
Zhang YL, Jiang SJ, Xiong YJ … +4 more , Lin DP, Ma GL, Xu Y, Jiang Y
Zhonghua Yi Xue Za Zhi · 2026 Jun · PMID 42252241 · Publisher ↗
To analyze the efficacy of ustekinumab (UST) in the patients with isolated perianal Crohn disease (ipCD). ipCD patients who received UST therapy in the Second Affiliated Hospital of Wenzhou Medical University between Jan...
To analyze the efficacy of ustekinumab (UST) in the patients with isolated perianal Crohn disease (ipCD). ipCD patients who received UST therapy in the Second Affiliated Hospital of Wenzhou Medical University between January 2021 and September 2025 were retrospectively recruited. Each patient received the first dose of UST (6 mg/kg) for intravenous induction, followed by the same dose of intravenous UST every 8 weeks for maintenance treatment. At week 16, the fistula clinical response was evaluated based on perianal disease activity index (PDAI) (a decline of more than 50% in PDAI compared with week 0). Follow-up was conducted until week 40, at week 40, the fistula clinical remission was assessed based on PDAI (PDAI score≤4 scores). The radiologic outcome events of perianal fistula were evaluated based on pelvic MRI data and Van Assche index, and the fistula radiologic response consisted of healing and partial response. A total of 16 ipCD patients were included, all of whom were male, with a diagnosed age of (31±6) years. At week 16 of UST therapy, the PDAI of 16 ipCD patients was decreased compared with week 0 [(7.3±2.5) vs (13.1±2.2) scores, <0.001], and 10 patients obtained the fistula clinical response. At week 40, the average PDAI [(4.4±2.3) vs (13.1±2.2) scores, <0.001], and the median Van Assche index [9 (8, 12) vs 16 (12, 16) scores, =0.002] of 16 patients were lower compared with week 0; Eleven patients achieved the fistula clinical remission, and 10 patients obtained the fistula radiologic response. During 40-week follow-up, no adverse event related to UST treatment occurred in the ipCD patients. The UST therapy may demonstrate favorable clinical efficacy and safety in patients with ipCD.
[Analysis of 3-year postoperative prognosis and influencing factors in patients with H3 K27-altered diffuse midline glioma].
Hu ZH, Shi SQ, Geng JY … +11 more , Zhao XY, Yang HZ, Xing HR, Zhou P, Jiang Y, Gu HQ, Li DL, Qi JL, Zhou MG, Zhang LW, Xiao D
Zhonghua Yi Xue Za Zhi · 2026 Jun · PMID 42252240 · Publisher ↗
To investigate the prognosis and influencing factors in patients with diffuse midline glioma, H3 K27-altered. Based on the National Brain Tumor Registry of China and the National Mortality Registration Information Manag...
To investigate the prognosis and influencing factors in patients with diffuse midline glioma, H3 K27-altered. Based on the National Brain Tumor Registry of China and the National Mortality Registration Information Management System, clinical data including baseline characteristics, tumor features, surgical intervention information, and postoperative treatment information of 154 patients with H3 K27-altered diffuse midline gliomas who underwent brain tumor resection at Beijing Tiantan Hospital, Capital Medical University, between January 1, 2020, and December 31, 2021 were collected. After discharge, the outcome indicators (median overall survival and 3-year overall survival rate) were tracked and confirmed through the National Brain Tumor Registry of China follow-up system, with follow-up conducted every 3 months. For patients lost to follow-up, cross-verification was conducted using the National Mortality Registration Information Management System. The Kaplan-Meier method was used to analyze median overall survival and 3-year overall survival rate. Univariate and multivariate Cox proportional hazards regression models were utilized to identify factors influencing patient prognosis. Among the 154 patients, 82 (53.2%) were male and 72 (46.8%) were female, with the age [, )] of 19.5 (9.0, 38.0) years. At the 3-year follow-up, 44 (28.6%) patients remained alive. The median overall survival was 19.8 months (95%: 15.0-25.2 months), and the 3-year overall survival rate was 28.6% (95%: 22.3%-36.7%). Brainstem location (=1.61, 95%: 1.02-2.54, =0.04) and the absence of systemic therapy (=1.67, 95%: 1.13-2.46, =0.01) were identified as influencing factors for 3-year postoperative mortality. Patients with H3 K27-altered diffuse midline gliomas exhibit short median overall survival and a low 3-year overall survival rate. Tumor location and whether systemic therapy is administered are the important factors affecting patient prognosis.
[Efficacy and safety of combining olorigliflozin with metformin in patients with type 2 diabetes mellitus inadequately controlled on metformin monotherapy].
He YF, Cheng ZF, Bian F … +17 more , Li S, Li LP, Shang JJ, Chen XW, Zeng ZY, Peng WX, Jin GX, Liu YH, Wang HF, Tian JH, Wang XY, Du LJ, Luo L, Li B, Gu Z, Zhang YJ, Yang WY
Zhonghua Yi Xue Za Zhi · 2026 Jun · PMID 42252239 · Publisher ↗
To evaluate the efficacy and safety of combining olorigliflozin with metformin in patients with type 2 diabetes mellitus (T2DM) inadequately controlled on metformin monotherapy. This study was a multicenter, randomized,...
To evaluate the efficacy and safety of combining olorigliflozin with metformin in patients with type 2 diabetes mellitus (T2DM) inadequately controlled on metformin monotherapy. This study was a multicenter, randomized, double-blind, parallel, placebo-controlled phase Ⅲ clinical trial. A total of 390 T2DM patients with inadequately controlled blood glucose and receiving oral metformin were prospectively enrolled from 62 research centers nationwide between February 2021 and June 2023. Using a block randomization method stratified by baseline glycated hemoglobin A1c (HbA) results (≤8.5% and>8.5%), patients were randomly allocated in a 1∶1∶1 ratio via an interactive response system to the placebo group, olorigliflozin 20 mg group, and olorigliflozin 50 mg group. All patients were treated with metformin in combination for 24 consecutive weeks. After 24 weeks of treatment, patients in the placebo group were randomly reassigned in a 1∶1 ratio using the aforementioned randomization method to either the placebo-to-olorigliflozin 20 mg group or the placebo-to-olorigliflozin 50 mg group, entering a 28-week extended treatment period. Patients in the olorigliflozin 20 mg and 50 mg groups maintained their original treatment regimens. The primary efficacy endpoint was the change in HbA from baseline at week 24, analyzed using the full analysis set. Secondary efficacy endpoints included the change in HbA from baseline at week 52 and HbA target achievement rates at weeks 24 and 52, analyzed using the full analysis set and the extended treatment analysis set, respectively. Safety was evaluated for volunteers throughout the study period using the safety set. Quantitative efficacy indicators were analyzed using a mixed-effects model for repeated measures, while the differences in the achievement rates across treatment groups were compared employing a logistic regression model. Safety outcomes were summarized with descriptive statistics. A total of 384 patients were included in the full analysis set, including 242 males and 142 females, with the age of (54.9±10.1) years. The placebo group, olorigliflozin 20 mg group, and olorigliflozin 50 mg group comprised 129, 125, and 130 patients, respectively. After 24 weeks of treatment, the least squares mean (LSM) changes (95%) in HbA from baseline in the three groups were -0.43%(-0.58% to -0.28%), -0.98%(-1.12% to -0.83%), and -1.04%(-1.18% to -0.90%), respectively. The proportions of patients with HbA<7.0% were 16.3%(21/129), 28.0%(35/125), and 40.8%(53/130), respectively. Logistic regression analysis showed that, compared with the placebo group, the OR values (95%) were 2.04(1.07-3.87) and 3.85(2.08-7.14) in the otigliflozin 20 mg group and 50 mg group, respectively. A total of 348 patients were included in the extended treatment analysis set, with 117, 121, 55, and 55 patients in the olorigliflozin 20 mg group, olorigliflozin 50 mg group, placebo-to-olorigliflozin 20 mg group, and placebo-to-olorigliflozin 50 mg group, respectively. At week 52, all 4 groups showed reductions in HbA from baseline (-1.0%±0.8%, -1.2%±0.7%, -1.2%± 1.0%, and -1.0%±0.8%, respectively). The proportions of patients with HbA<7.0% were 38.5%(45/117), 46.3%(56/121), 34.5%(19/55), and 32.7%(18/55), respectively. A total of 386 patients were included in the safety set during the 24week core treatment period, with 129, 127, and 130 patients in the placebo, olorigliflozin 20 mg, and olorigliflozin 50 mg groups, respectively. The incidence rates of treatmentemergent adverse events (TEAE) were 70.5%(91/129), 77.2%(98/127), and 75.4%(98/130), respectively. The incidence of TEAE leading to permanent discontinuation of the investigational product was 2.3%(3/129), 0.8% (1/127), and 2.3%(3/130), respectively. No serious adverse events related to the investigational product were reported. All hypoglycemic events occurred in the olorigliflozin treatment groups: the olorigliflozin 20 mg group had 2 cases of probable symptomatic hypoglycemia and 2 cases of hypoglycemic alert values, while all 5 events in the olorigliflozin 50 mg group were hypoglycemic alert values; all resolved completely. In the safety set for the 28week extended treatment period (group assignments and patient numbers identical to those in the extended treatment analysis set), the main types, incidence rates, and severity of TEAE were similar to those reported during the 24week core treatment period. For Chinese patients with T2DM inadequately controlled with metformin monotherapy, combining olorigliflozin can significantly improve glycemic control and has a good safety profile.
[Efficacy and safety of olorigliflozin monotherapy in patients with type 2 diabetes mellitus with poor glycemic control on diet and exercise interventions].
He YF, Ma JH, Wang HF … +18 more , Zeng JE, Li ZB, Pan TR, Chen XW, Guo KQ, Wang SH, Zhang Y, Zhang XJ, Liu YH, Deng WQ, Wang XY, Zhang Q, Hao YE, Luo L, Zhu J, Gu Z, Zhang YJ, Yang WY
Zhonghua Yi Xue Za Zhi · 2026 Jun · PMID 42252238 · Publisher ↗
To evaluate the efficacy and safety of olorigliflozin monotherapy in Chinese patients with type 2 diabetes mellitus (T2DM) inadequately controlled with diet and exercise. The study was a multicenter, randomized, double-...
To evaluate the efficacy and safety of olorigliflozin monotherapy in Chinese patients with type 2 diabetes mellitus (T2DM) inadequately controlled with diet and exercise. The study was a multicenter, randomized, double-blind and placebo-controlled phase Ⅲ clinical trial. A total of 396 T2DM patients with inadequate glycemic control despite diet and exercise were enrolled across 73 research centers nationwide between July 2021 and June 2022. Using a block randomization method stratified by baseline glycated hemoglobin A (HbA) results (≤8.5% and >8.5%) and prior diabetes treatment status, the patients were randomly allocated in a 1∶1∶1 ratio via an interactive response system to the olorigliflozin 20 mg group, 50 mg group, and placebo group. After 24 weeks, the patients in the placebo group were re-randomized in a 1∶1 ratio to the placebo-to-olorigliflozin 20 mg or placebo-to-olorigliflozin 50 mg for an additional 28 weeks using the same randomization method, while the patients in the olorigliflozin groups continued the original treatment. The primary efficacy endpoint was the change in HbA from baseline at week 24, with statistical analysis performed based on the full analysis set (FAS). Secondary efficacy endpoints included: change in HbA from baseline at weeks 52; HbA target achievement rates. The secondary endpoints included the change of from baseline at 52 weeks of treatment, and the HbA compliance rates at 24 weeks and 52 weeks of treatment were analyzed by FAS and FAS-completers(FASc), respectively. Safety set (SS) was used to evaluate the safety of subjects during the whole study period. A mixed-effects model for repeated measures was adopted to assess quantitative efficacy indicators, and descriptive statistics was used for safety evaluation. In FAS, there were 130, 129 and 131 patients in the ololegliflozin 20 mg, 50 mg and placebo groups, respectively; In SS, the corresponding number of patients was 130, 133 and 132, respectively; In FASc, the patient numbers were 123 and 119 in the ololegliflozin 20 mg and 50 mg groups, and 59 and 57 in the placebo-to-ololegliflozin 20 mg and placebo-to-ololegliflozin 50 mg groups, respectively. At week 24, the least squares mean differences (95%) in placebo-adjusted changes in HbA from baseline between groups for the olorigliflozin 20 mg group and 50 mg group were -0.94% (-1.14% to -0.74%; <0.001) and -1.01% (-1.21% to -0.81%; <0.001), respectively. The proportions of patients with HbA<7% in the placebo group, olorigliflozin 20 mg group and 50 mg group were 20.6% (27/131), 55.4% (72/130) and 56.6% (73/129), respectively; the proportions of patients with HbA≤6.5% were 7.6% (10/131), 31.5% (41/130) and 31.8% (41/129), respectively. At week 52, HbA continued to show decreasing trends. The mean changes from baseline in HbA were -1.33%±0.77%, -1.38%±0.81%, -1.30%±0.69% and -0.90%±0.83%, in the olorigliflozin 20 mg group, olorigliflozin 50 mg group, placebo-to-olorigliflozin 20 mg group, and placebo-to-olorigliflozin 50 mg group, respectively; The proportions of patients with HbA<7% were 59.3% (73/123), 61.3% (73/119), 49.2% (29/59) and 42.1% (24/57) in the four groups, respectively, and the proportions of patients with HbA≤6.5% were 36.6% (45/123), 42.0% (50/119), 33.9% (20/59) and 26.3% (15/57), respectively. Throughout the study period, olorigliflozin demonstrated good safety profile without any episodes of severe hypoglycemia or ketoacidosis. For Chinese patients with T2DM inadequately controlled by diet and exercise, monotherapy with olorigliflozin (20 mg and 50 mg) can effectively control blood glucose, and demonstrate good safety.
[Expert consensus on the essential elements for standardized medical laboratory datasets (2026 edition)].
National Clinical Research Center for Medical Auxiliary Technology (Laboratory Medicine), Intelligent Laboratory Medicine Group of the Laboratory Physicians Branch of the Chinese Medical Doctor Association, Collaborative Innovation Working Group for Artificial Intelligence in Laboratory Medicine
Zhonghua Yi Xue Za Zhi · 2026 Jun · PMID 42252237 · Publisher ↗
With the rapid advancement of artificial intelligence (AI) technologies, particularly the emergence of generative AI represented by large-scale models, the field of laboratory medicine is gradually entering a new stage o...
With the rapid advancement of artificial intelligence (AI) technologies, particularly the emergence of generative AI represented by large-scale models, the field of laboratory medicine is gradually entering a new stage of intelligent development. In this context, standardized laboratory medicine datasets have become increasingly critical as a fundamental basis for large model training, a key benchmark for model performance evaluation, and an essential support for the development of application scenarios. To strengthen consensus among professionals regarding the related concepts and construction specifications of standardized laboratory medicine datasets, and to address practical challenges in China such as difficulties in multicenter data integration, heterogeneous information systems, and substantial variability in data quality, National Clinical Research Center for Medical Auxiliary Technology (Laboratory Medicine), together with the Intelligent Laboratory Medicine Group of the Laboratory Physicians Branch of the Chinese Medical Doctor Association and the Collaborative Innovation Working Group for Artificial Intelligence in Laboratory Medicine, organized experts from multiple disciplines. Drawing systematically on relevant domestic and international guidelines and consensus documents, this expert consensus was developed across five key domains: the concept of standardized laboratory medicine datasets, construction significance and objectives, construction principles, construction methodologies, ethics and security, as well as their value and applications. This consensus proposes a laboratory medicine dataset construction and governance framework tailored to the Chinese context, with the aim of promoting the intelligent and standardized development of laboratory medicine in China.
[Expert consensus on the clinical application of intravenous insulin infusion (2026 edition)].
National Clinical Research Center for Endocrine and Metabolic Diseases (Changsha), National Diabetes Prevention & Control Center (DPCC), Diabetes Society of China National Health Association
Zhonghua Yi Xue Za Zhi · 2026 Jun · PMID 42252236 · Publisher ↗
Intravenous insulin infusion remains a cornerstone of clinical glycemic management. It is extensively utilized across diverse multidisciplinary settings, including hyperglycemic crises, the perioperative period, critical...
Intravenous insulin infusion remains a cornerstone of clinical glycemic management. It is extensively utilized across diverse multidisciplinary settings, including hyperglycemic crises, the perioperative period, critical illness, and nutritional support. Standardizing intravenous insulin infusion protocols across various clinical departments is essential for improving the overall prognosis of patients with diabetes and its associated comorbidities. Initiated by the National Clinical Research Center for Endocrine and Metabolic Diseases (Changsha), the National Diabetes Prevention & Control Center (DPCC), and the Diabetes Society of China National Health Association, the "Expert Consensus on the Clinical Application of Intravenous Insulin Infusion (2026 edition)" was developed through the collaborative efforts of experts in endocrinology, cardiology, general medicine, emergency medicine, critical care, nursing, and clinical pharmacy. By integrating multidisciplinary efforts, and in accordance with the standards and procedures of the grading of recommendations, development and evaluation (GRADE) system, 7 clinical questions and 9 recommendations were proposed regarding the clinical application of intravenous insulin infusion, including its clinical indications, operating procedures, precautions, and other relevant aspects. Its implementation aims to bridge the gap in clinical practice between endocrine and non-endocrine departments (including surgical and primary care units), thereby enhancing the standardization of intravenous insulin infusion and ultimately improving the overall therapeutic outcomes and prognosis for patients with diabetes and related metabolic disorders.
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