Zhonghua Yi Xue Za Zhi[JOURNAL]
Sun
200 papers
[Glycemic control and cardiovascular health in prediabetes: untiring exploration towards consensus].
Li GW
Zhonghua Yi Xue Za Zhi · 2026 Jun · PMID 42252235 · Publisher ↗
Diabetes-related cardiovascular diseases carry high rates of disability and mortality, and their medical costs are prohibitively expensive. Shifting management upstream is imperative. The risk of cardiovascular and cereb...
Diabetes-related cardiovascular diseases carry high rates of disability and mortality, and their medical costs are prohibitively expensive. Shifting management upstream is imperative. The risk of cardiovascular and cerebrovascular diseases in diabetic populations exists prior to the onset of diabetes. Can lifestyle interventions targeting the prevention of diabetes in people with pre-diabetes also extend to reducing cardiovascular risk? The Daqing Diabetes Prevention Study (DQDPOS) in China provided a definitive answer, though regrettably, this was not corroborated by comparable studies in the United States. Consequently, this has prevented the cardiovascular and diabetes communities from reaching consensus regarding early intervention strategies for cardiovascular disease. By 2024, the European Cardiovascular Community still did not include prediabetes in its cardiovascular disease management population. By late 2025, two landmark studies from China and the United States of America (DQDPOS and DPPOS) reported that individuals with prediabetes who achieved normal blood glucose levels experienced a substantial reduction in the risk of heart failure and cardiovascular mortality compared to those who did not normalize plasma glucose levels. It is hoped this new finding will spur the cardiovascular community to develop more proactive strategies for intensifying glycaemia control in prediabetic populations to reduce cardiovascular risk. Given the prediabetic population in China exceeding 300 million, effective cardiovascular risk management in this population would benefit the reduction of cardiovascular risk across the entire population.
[Effects of fasting on anxiety-and depression-like behaviors in mice and the role of the paraventricular thalamus in the underlying mechanism].
Jiang ZY, Zhou Y, Qiu ZT … +6 more , Pan XY, Wang XY, Ni WW, Xia JM, Li WX, Han Y
Zhonghua Yi Xue Za Zhi · 2026 Jun · PMID 42209176 · Publisher ↗
To investigate the effects of fasting on anxiety-and depression-like behaviors in mice, and to elucidate the underlying neural mechanisms. Eight-week-old male C57BL/6J mice (=44) and Fos-2A-iCreER transgenic mice (=48)...
To investigate the effects of fasting on anxiety-and depression-like behaviors in mice, and to elucidate the underlying neural mechanisms. Eight-week-old male C57BL/6J mice (=44) and Fos-2A-iCreER transgenic mice (=48) were randomly assigned using a random number table.The male C57BL/6J mice were divided into six groups (=36): anxiety-like models were established by 2-hour acute restraint stress (ARS), depression-like models were induced by intraperitoneal injection of lipopolysaccharide, and control groups were also set up. Within each model, mice were further divided into a fasting group (24-hour food deprivation) and an ad libitum feeding group. Fasting efficacy was assessed by monitoring changes in body weight and food intake. Anxiety-like behaviors were evaluated using the open field test and elevated plus maze test, while depression-like behaviors were assessed using the tail suspension test and forced swimming test. Whole-brain neuronal activation in response to fasting was detected in both fasted and non-fasted C57BL/6J mice (=8) was detected through c-Fos immunofluorescence staining. Subsequently, the Fos-2A-iCreER transgenic mice were selected. The targeted recombination into active promoters (TRAP) technique was employed to specifically label fasting-activated neurons, and chemogenetic techniques were employed to activate or inhibit fasting-related neuronal ensembles (=24 per experiment). Anxiety-like and depression-like models were re-established separately, and mice in each model were divided into a fasting group (24-hour food deprivation) and an ad libitum feeding group, in order to investigate the effects of activating or inhibiting neurons related to fasting on anxiety-and depression-like behaviors. The open field test and the elevated plus maze test provided evidence that anxiety-like models had been successfully established. In addition, the tail suspension test and the forced swimming test provided evidence that depression models had been successfully established. In comparison with the ad libitum feeding group, the mice fasted for 24 h showed lower body weight and higher food intake (all <0.05). Fasted mice demonstrated increased distance travelled, prolonged duration, and elevated entries in the central area of the open field, as well as greater distance traveled, higher percentage of duration, and more entries in the open arms of the elevated plus maze. Additionally, fasted mice showed shorter immobility times in both the tail suspension test and the forced swimming test. All differences were statistically significant (all <0.05). c-Fos staining revealed enhanced neuronal activation in the paraventricular thalamus (PVT) region after fasting (all <0.05). Chemogenetic activation of fasting-related neuronal ensembles in the PVT mimicked the anti-anxiety and anti-depression effects observed following fasting: anxious mice showed greater distance traveled, longer duration, and more entries in the central area of the open field, as well as greater distance traveled, higher percentage of duration, and more entries in the open arms of the elevated plus maze; depressed mice showed shorter immobility times in both the tail suspension test and the forced swim test (all <0.05).Conversely, chemogenetic inhibition of these neuronal ensembles reversed these effects (all <0.05). Fasting activates PVT-related neuronal ensembles to elicit anti-anxiety and antidepression effects in mice.
[Efficacy of endoscopic surgery versus microscopic surgery in the treatment of congenital ossicular malformations: a meta-analysis].
Chen ZY, Gan H, Liao SX … +3 more , Huang HM, Wu PN, Xiong H
Zhonghua Yi Xue Za Zhi · 2026 Jun · PMID 42209175 · Publisher ↗
To compare the clinical efficacy of endoscopic ear surgery (EES) and microscopic ear surgery (MES) in the treatment of congenital ossicular malformation. PubMed, Embase, Cochrane Library, China National Knowledge Infras...
To compare the clinical efficacy of endoscopic ear surgery (EES) and microscopic ear surgery (MES) in the treatment of congenital ossicular malformation. PubMed, Embase, Cochrane Library, China National Knowledge Infrastructure (CNKI), Chinese Biomedical Literature Database (CBM), and Wanfang databases were systematically searched from inception to June 20, 2025, to identify comparative studies of EES versus MES in patients with congenital ossicular malformation. The evaluated outcomes included postoperative air-bone gap (ABG), ABG improvement, the proportion of patients achieving a postoperative ABG≤20 decibels hearing level (dB HL), operative time, and surgical complications. A total of seven retrospective cohort studies involving 304 patients (320 ears, age range: 3-62 years) were included. Of these, 148 ears underwent EES and 172 ears underwent MES. Qualitative analysis indicated that EES had a lower complication rate. Serious complications reported in the MES group, including chorda tympani nerve injury and sensorineural hearing loss, were not observed in the EES group. Quantitative analysis demonstrated that EES was associated with significantly shorter operative time (=-10.38 min, 95%:-14.05 to -6.72 min, <0.001) and greater postoperative ABG improvement (=4.22 dB HL, 95%: 0.05 to 8.39 dB HL, 0.048) compared with MES. No statistically significant differences were found between the two groups in preoperative ABG (=-0.96 dB HL, 95%:-3.09 to 1.17 dB HL, 0.379), postoperative ABG (=-1.95 dB HL, 95%:-3.98 to 0.08 dB HL, =0.059), or the proportion achieving postoperative ABG≤20 dB HL [EES, 80.0% (64/80) vs MES, 75.0% (75/100), =1.04, 95%: 0.89 to 1.22, 0.617]. For patients with congenital ossicular malformation, EES is associated with shorter operative time and greater postoperative ABG improvement than MES. EES may serve as a reasonable alternative to conventional MES.
[Classification and surgical outcomes of congenital middle ear malformations with concomitant facial nerve anomalies].
Shu F, Xu MQ, Zou TM … +4 more , Chen FY, Jiang SS, Cai JQ, Zhang HZ
Zhonghua Yi Xue Za Zhi · 2026 Jun · PMID 42209174 · Publisher ↗
To investigate the clinical classification and surgical outcomes of congenital middle ear malformations accompanied by facial nerve anomalies. A retrospective cohort study was conducted to analyze clinical data of patie...
To investigate the clinical classification and surgical outcomes of congenital middle ear malformations accompanied by facial nerve anomalies. A retrospective cohort study was conducted to analyze clinical data of patients with congenital middle ear malformations and concomitant facial nerve anomalies who received treatment in the Department of Otolaryngology, Zhujiang Hospital, Southern Medical University, between January 2021 and December 2024. Facial nerve anomalies were categorized into four distinct types: partial obstruction of the oval window, complete obstruction of the oval window, aberrant course over the promontory, and branching anomalies. Ossicular chain malformations were classified in accordance with the Teunissen classification system. Individualized hearing reconstruction strategies were implemented based on the specific anatomical characteristics of the anomalies. All patients were followed up for 3 to 24 months. Postoperative therapeutic efficacy was evaluated by comparing preoperative and postoperative mean air conduction thresholds and air-bone gaps (ABG), while monitoring surgical complications. Thirteen patients (17 ears) aged [ (, )] 15.0 (11.5, 21.0) years were included, with eight males and five females. Facial nerve anomalies were categorized as follows: partial obstruction of the oval window in six ears (three cases of Type Ⅰ, three cases of Type Ⅲ), complete obstruction of the oval window in three ears (one case of Type Ⅰ, two cases of Type Ⅲ), aberrant course over the promontory in six ears (all Type Ⅳ), and branching anomalies in two ears (both Type Ⅳ). Hearing reconstruction modalities employed included: incus-stapedial piston placement following vestibular fenestration in nine ears, malleus-stapedial piston placement following vestibular fenestration in two ears, partial ossicular replacement prosthesis (PORP) implantation in three ears, total ossicular replacement prosthesis (TORP) implantation in one ear, stapes mobilization in one ear, and laser-assisted ossicular chain release in one ear.Statistical analysis revealed that postoperative mean air conduction thresholds [(33.8±15.2) dB HL vs (60.1±13.8) dB HL, <0.001] and mean ABG [(14.6±6.9) dB vs (37.2±9.2) dB, <0.001] were significantly reduced compared with preoperative values. Postoperative ABG≤20 dB was achieved in 15 ears (88.2%). Postoperative complications were limited to transient vertigo in five cases and taste disturbance in two cases. No cases of facial paralysis, sensorineural hearing loss, tympanic membrane perforation, or tinnitus were observed. The median follow-up duration was 6.0 (5.5, 20.0) months. Individualized hearing reconstruction strategies based on the classification of facial nerve and ossicular chain anomalies can effectively protect the facial nerve and achieve significant hearing improvement, demonstrating favorable clinical outcomes.
[Efficacy of stapes prosthesis surgery for congenital stapes fixation or oval window atresia in pediatric patients].
Zhang R, Dang PH, Zhou DX … +6 more , Hu CY, Zhao HD, Zhao Y, Zhu J, Zhang Q, Fan MY
Zhonghua Yi Xue Za Zhi · 2026 Jun · PMID 42209173 · Publisher ↗
To explore the clinical efficacy of stapes prosthesis surgery for the treatment of congenital fixation of stapes or oval window atresia in pediatric patients. The clinical data of children with congenital fixation of st...
To explore the clinical efficacy of stapes prosthesis surgery for the treatment of congenital fixation of stapes or oval window atresia in pediatric patients. The clinical data of children with congenital fixation of stapes or oval window atresia who underwent stapes prosthesis surgery in Xi'an Children's Hospital from January 2017 to July 2025 were retrospectively analyzed. All the children underwent high-resolution computed tomography (HRCT) of the temporal bone and pure-tone audiometry before and after the surgery. According to the type of auditory chain deformity, the children were divided into the stapes fixation group and the oval window atresia group. The surgical methods included incudovestibular fenestration (IVF) and malleovestibulopexy (MVP), with four types of opening methods, namely stapes footplate drilling, stapes resection, vestibular windowing, and vestibular semicircular canal interposition, respectively. The preoperative and postoperative air-conducted pure tone average (PTA), bone-conducted PTA, and air-bone conduction difference (ABG) were observed and compared. A total of 19 children (25 ears) aged (8.9±3.1) years were included, with 13 males and 6 females. There were 13 ears on the right side and 12 ears on the left side. Preoperative HRCT yielded a positive diagnostic rate of 56.0% (14/25), while the incidence of facial nerve malformation was 40.0% (10/25). Surgical intervention was performed in 24 of the 25 affected ears. Among these, 13 ears were diagnosed with stapes fixation, of which four underwent IVF and nine underwent MVP. The remaining 11 ears presented with oval window atresia, with four undergoing IVF and seven undergoing MVP. Six months postoperatively, both the stapes fixation group and oval window atresia group demonstrated statistically significant improvements in air-conduction PTA and ABG compared with preoperative values. In the stapes fixation group, air-conduction PTA decreased from (62.2±8.7) dB HL to (32.8±10.8) dB HL (=0.002), and ABG improved from (49.3±10.5) dB HL to (22.5±5.8) dB HL (<0.001). In the oval window atresia group, air-conduction PTA decreased from (66.2±8.4) dB HL to (42.0±11.6) dB HL (<0.001), and ABG improved from (54.0±5.0) dB HL to (31.1±11.7) dB HL (<0.001). No statistically significant differences were observed in bone-conduction PTA before and after surgery in either group (both >0.05). Intergroup comparisons revealed that the stapes fixation group exhibited significantly greater improvements in postoperative air-conduction PTA [(32.8±10.8) dB HL vs (42.0±11.6) dB HL] and ABG [(22.5±5.8) dB HL vs (31.1±11.7) dB HL] compared with the oval window atresia group (both <0.05). Subgroup analyses based on surgical technique showed that patients who underwent MVP in both the stapes fixation and oval window atresia groups achieved statistically significant reductions in ABG compared with preoperative levels (both <0.05). In contrast, IVF did not yield statistically significant improvements in ABG in either group (both >0.05). No statistically significant difference was detected in postoperative ABG between patients who underwent IVF versus MVP, nor among the four different types of window opening techniques (all >0.05).All patients received outpatient follow-up at six months postoperatively. Nineteen ears were followed up for≥1 year, with a mean duration of (25.1±12.4) months, while five ears were lost to follow-up (loss to follow-up rate: 20.8%). No serious complications, including sensorineural hearing loss or facial paralysis, were reported in any patient. Stapes prosthesis surgery for the management of congenital stapes fixation and oval window atresia in pediatric patients demonstrates a favorable safety profile and sustained therapeutic efficacy. Surgical outcomes for congenital stapes fixation are superior to those for oval window atresia. Neither the choice between IVF and MVP nor variations in window-opening techniques has a statistically significant effect on postoperative hearing outcomes.
[High-resolution computed tomography imaging features and endoscopic surgical outcomes of congenital ossicular chain malformation with concomitant external auditory canal stenosis].
Liao WX, Sun HJ, Ren DD
Zhonghua Yi Xue Za Zhi · 2026 Jun · PMID 42209172 · Publisher ↗
To investigate the high-resolution CT (HRCT) imaging characteristics and endoscopic surgical outcomes in patients with congenital ossicular chain malformation and concomitant external auditory canal stenosis. The clinic...
To investigate the high-resolution CT (HRCT) imaging characteristics and endoscopic surgical outcomes in patients with congenital ossicular chain malformation and concomitant external auditory canal stenosis. The clinical data from congenital ossicular chain malformation patients with concomitant external auditory canal stenosis who were admitted to the Eye and ENT Hospital of Fudan University between July 2017 and March 2025 were retrospectively analyzed. The clinical presentations, HRCT findings, endoscopic examinations, and postoperative follow-up results were summarized. A total of 54 patients (58 ears) aged [ (, )] 18.5 (12.0, 26.3) years were included, with 29 males and 25 females. The diagnostic concordance rates of HRCT for detecting incus, malleus, and stapes defects were 96.6% (56/58), 94.8% (55/58), and 53.4% (31/58), respectively. HRCT identified severe bony segment stenosis in 7 cases (12.1%) and mild bony segment stenosis in 35 cases (60.3%), whereas otoendoscopy revealed partially visualized stenosis in 16 cases (27.6%). Of the 58 affected ears, 44 underwent concurrent artificial ossicular implantation and external auditory canal reconstruction. Postoperative audiometric assessments at 3 to 12 months demonstrated statistically significant reductions in mean air conduction thresholds [(37.1±18.3) decibel hearing level (dB HL) vs (61.7±12.7) dB HL, <0.001], mean bone conduction thresholds [(18.5±12.3) dB HL vs (26.3±9.5) dB HL, =0.001], and air-bone gaps [(18.8±7.8) dB HL vs (35.3±9.6) dB HL, <0.001] compared with preoperative measurements. The integrated application of HRCT and otoendoscopy enables effective evaluation of the anatomical characteristics of ossicular chain malformation and external auditory canal stenosis. Concurrent ossicular chain reconstruction and external auditory canal reconstruction results in significant improvements in auditory outcomes.
[Expert consensus on a novel classification system, surgical management strategies, and prognostic evaluation for congenital ossicular chain malformations based on stapes footplate mobility and suprastructural integrity (2026 edition)].
Otoendoscopy Expert Committee of the Otorhinolaryngology Branch of the China Association of Integrative Medicine, National Center for Quality Control of Otorhinolaryngology Healthcare, Otorhinolaryngology-Head and Neck Surgery Branch of the Shanghai Medical Doctor Association
Zhonghua Yi Xue Za Zhi · 2026 Jun · PMID 42209171 · Publisher ↗
Congenital ossicular chain malformation (COCM) is a congenital developmental disorder that impairs hearing function. It most commonly presents unilaterally, either as an isolated anomaly or in association with a variety...
Congenital ossicular chain malformation (COCM) is a congenital developmental disorder that impairs hearing function. It most commonly presents unilaterally, either as an isolated anomaly or in association with a variety of systemic syndromes; in severe cases, it may coexist with malformations of the auricle and external auditory canal. Owing to its insidious onset and the presence of an intact tympanic membrane, affected children are frequently misdiagnosed with secretory otitis media. Bilateral COCM, if left untreated in a timely manner, can hinder speech and cognitive development, while specific anatomical variants may elevate the risk of cholesteatoma formation. Diagnosis is predicated on the presence of persistent conductive hearing loss from early childhood, with preoperative high-resolution temporal bone CT scanning serving as a pivotal tool for anatomical evaluation. The management of COCM is primarily guided by patient and family preferences, with therapeutic options encompassing hearing aid fitting and surgical intervention. To standardize the diagnosis and treatment of COCM, optimize the selection of surgical strategies, and enhance clinical outcomes, domestic otology experts have jointly developed the "Expert consensus on a novel classification system, surgical management strategies, and prognostic evaluation for congenital ossicular chain malformations based on stapes footplate mobility and suprastructural integrity (2026 edition)". This consensus is grounded in the latest research evidence and accumulated clinical experience, systematically summarizing the epidemiology, pathogenesis, clinical manifestations, auxiliary examinations, treatment principles, and complications of non-syndromic COCM. Building upon existing classification systems, the consensus introduces a novel clinical classification framework centered on stapes footplate mobility and the integrity of suprastapes structures, which directly informs surgical decision-making. This new classification prioritizes guiding surgical strategy formulation and predicting postoperative outcomes, thereby providing a robust reference for the standardized diagnosis and clinical management of COCM.
[Key points and interpretation of Chinese expert's consensus on endocrine therapy of breast cancer (2026 edition)].
Zhang SH, Jiang ZF
Zhonghua Yi Xue Za Zhi · 2026 Jun · PMID 42209170 · Publisher ↗
Based on the 2023 consensus, the Chinese Breast Cancer Endocrine Therapy Consensus Group systematically reviewed the key points of endocrine therapy in the neoadjuvant, adjuvant, and metastatic settings, and updated the...
Based on the 2023 consensus, the Chinese Breast Cancer Endocrine Therapy Consensus Group systematically reviewed the key points of endocrine therapy in the neoadjuvant, adjuvant, and metastatic settings, and updated the 2026 edition consensus. We interpreted the key points of the consensus in this article. In precision testing, the consensus emphasized the standard immunohistochemical test for hormone receptor and human epidermal growth factor receptor 2 (HER2) receptor, defined HER2-low and ultra-low expression, clarified the timing and methods of genetic testing. For different treatment stages of breast cancer, the consensus defined the eligible population for neoadjuvant endocrine therapy, expanded adjuvant cyclin-dependent kinases 4/6 (CDK4/6) inhibitor application in moderate and high-risk patients, optimized treatment strategies for first-line endocrine therapy plus CDK4/6 inhibitors in metastatic breast cancer, and recommended preferred regimens for post-CDK4/6 inhibitor patients. In conclusion, clinicians should follow the consensus recommendations, so as to achieve precise and individualized treatment for patients with hormone receptor-positive breast cancer.
[Diagnosis and treatment for congenital ossicular chain malformations: current status, challenges, and future prospects].
Gao Z, Chi FL
Zhonghua Yi Xue Za Zhi · 2026 Jun · PMID 42209169 · Publisher ↗
Congenital ossicular chain malformation constitutes a pivotal etiological factor in conductive hearing loss. Despite its relatively low clinical incidence, the diagnosis and management of this condition persist as a form...
Congenital ossicular chain malformation constitutes a pivotal etiological factor in conductive hearing loss. Despite its relatively low clinical incidence, the diagnosis and management of this condition persist as a formidable challenge in contemporary otological practice. In recent years, the expeditious evolution of high-resolution imaging modalities, minimally invasive endoscopic surgical techniques, innovative artificial ossicular prostheses, advanced hearing implant systems, and artificial intelligence (AI)-assisted clinical decision-making frameworks has precipitated a paradigm shift in diagnostic and therapeutic paradigms. This article systematically elaborates on the diagnostic strategies, therapeutic modalities, and future research directions pertaining to congenital ossicular chain malformation, with the overarching goal of advancing the precision and individualization of clinical care for affected populations.
[Clinical practice guideline for renal replacement therapy in critically ill patients with acute kidney injury (2026 edition)].
Chinese Society of Critical Care Medicine, Chinese Medical Association
Zhonghua Yi Xue Za Zhi · 2026 May · PMID 42203644 · Publisher ↗
Acute kidney injury (AKI) is a common and severe complication in critically ill patients, associated with high morbidity and mortality. Renal replacement therapy (RRT) is a vital life-support modality for critically ill...
Acute kidney injury (AKI) is a common and severe complication in critically ill patients, associated with high morbidity and mortality. Renal replacement therapy (RRT) is a vital life-support modality for critically ill patients with AKI. However, there remains a lack of unified clinical standards for core issues including the timing of RRT initiation, treatment modality, anticoagulation strategy, and weaning from RRT.In response, the Chinese Society of Critical Care Medicine organized a multidisciplinary expert panel to develop the"Clinical practice guideline for renal replacement therapy in critically ill patients with acute kidney injury (2026 edition)"in accordance with the Grading of Recommendations Assessment, Development and Evaluation(GRADE) approach for grading evidence quality. This guideline was developed through systematic literature retrieval, meta-analysis, and evidence-based medical evidence synthesis, followed by multiple rounds of manuscript review and revision via online and offline meetings of the working group, and final approval by the Standing Committee of the Society. A total of 34 recommendations were finalized, covering key clinical topics including timing of RRT initiation, establishment and maintenance of vascular access, selection of treatment modalities, application of specialized membrane filters, anticoagulation regimens, replacement fluid formulations, prescribed treatment dose, and RRT weaning strategies. This guideline aims to provide scientific, standardized, and clinically actionable guidance for critical care practitioners in China, promoting standardized RRT management in adult critically ill patients with AKI.
[Clinical practice guidelines for the application of intelligent technology in spinal surgery (2026 edition)].
Spinal Trauma Group, Chinese Association of Orthopaedic Surgeons, Intelligent Orthopaedics Group, Chinese Association of Orthopaedic Surgeons, Shaanxi Medical Doctor Association Professional Committee on Orthopaedic Minimally Invasive Surgery
Zhonghua Yi Xue Za Zhi · 2026 Jun · PMID 42178936 · Publisher ↗
In response to the challenges of insufficient precision and limited safety associated with traditional techniques in the diagnosis and treatment of complex spinal diseases, intelligent technologies-represented by 3D visu...
In response to the challenges of insufficient precision and limited safety associated with traditional techniques in the diagnosis and treatment of complex spinal diseases, intelligent technologies-represented by 3D visualization, additive manufacturing (3D printing), surgical navigation and robotics, artificial intelligence, and telemedicine-are driving spine surgery into a new era of precision and personalized treatment. However, there is currently a lack of standardized protocols or guidelines for the clinical application of these intelligent technologies in spine surgery. To standardize and promote their clinical use, this guideline was developed through an initiative led by the Spinal Trauma Group of the Chinese Association of Orthopaedic Surgeons (CAOS) and the Intelligent Orthopaedics Group of CAOS, in collaboration with Shaanxi Medical Doctor Association Professional Committee on Orthopaedic Minimally Invasive Surgery. Multidisciplinary experts participated, formulating recommendations based on evidence-based medicine and multi-center Delphi expert consensus. This guideline systematically summarizes the application scope of intelligent technologies in spine surgery, covering six aspects: 3D visualization, 3D printing, surgical navigation and robotics, artificial intelligence, telemedicine, and the implementation of intelligent technologies. It finally forms 15 recommendations, clarifies the applicable scenarios, evidence levels, and recommendation strength for each technology, and aims to promote their scientific, standardized, and efficient application, provide practical suggestions for medical institutions at different levels, and ultimately enhance the overall clinical diagnosis and treatment level and clinical decision-making support capacity in spine surgery.
[Value and benefit of basic insulin/GLP-1RA weekly preparation in clinical treatment of type 2 diabetes in adults].
Zhang SC, Zang L, Cheng Y … +2 more , Mu YM, Hu X
Zhonghua Yi Xue Za Zhi · 2026 Jun · PMID 42161872 · Publisher ↗
The prevalence of type 2 diabetes mellitus has been rising continuously in China. However, glycemic control rates remain suboptimal, posing a significant public health challenge. Although traditional intensive insulin st...
The prevalence of type 2 diabetes mellitus has been rising continuously in China. However, glycemic control rates remain suboptimal, posing a significant public health challenge. Although traditional intensive insulin strategies are effective in improving glycemic control, they are often associated with risks such as hypoglycemia and weight gain. Fixed-ratio combinations of basal insulin and glucagon-like peptide-1 receptor agonist (GLP-1RA) offer complementary mechanisms of action, enhancing efficacy and safety while simplifying treatment regimens, making them a key focus of clinical development. Insulin icodec/semaglutide fixed-ratio combination (IcoSema), the first once-weekly dual-component preparation combining a basal insulin and a GLP-1RA, utilizes advanced formulation technology to achieve stable co-formulation of the ultra-long-acting once-weekly basal insulin and the once-weekly GLP-1RA, with the two components acting in a complementary and synergistic manner. The Phase 3 COMBINE clinical trial program demonstrated that, compared with insulin icodec, semaglutide(1.0 mg), or basal-bolus insulin regimens, IcoSema provides superior or equivalent glycemic control, and the risk of clinically significant or severe hypoglycemic events is comparable to that of semaglutide(1.0 mg). Once-weekly administration helps to simplify the treatment regimen and improve treatment adherence. The clinical application of IcoSema is expected to alleviate the dilemma in Chinese type 2 diabetes management of balancing effective glycemic control with safety and simplicity, offering a new therapeutic option for patients requiring insulin intensification that combines efficacy, safety, and convenience.
[Efficacy analysis of the "six-step" robot-assisted subxiphoid extended thymectomy for myasthenia gravis].
Lin JB, Zhuang RZ, Zhuo Y … +3 more , Lin NL, Yu FQ, Lai FC
Zhonghua Yi Xue Za Zhi · 2026 May · PMID 42161616 · Publisher ↗
To evaluate the clinical effect of the"six-step" robot-assisted subxiphoid extended thymectomy for myasthenia gravis. Clinical data of 45 patients with myasthenia gravis were retrospectively collected from the First Affi...
To evaluate the clinical effect of the"six-step" robot-assisted subxiphoid extended thymectomy for myasthenia gravis. Clinical data of 45 patients with myasthenia gravis were retrospectively collected from the First Affiliated Hospital of Fujian Medical University between November 2022 and June 2025, including 22 males and 23 females, with the age of (48.0±12.0) years. Robot-assisted subxiphoid extended thymectomy was performed using a "six-step" approach. Perioperative data were collected, including operative time, intraoperative blood loss, postoperative thoracic drainage time and volume, length of postoperative hospital stay, postoperative complications, pathologic findings, and follow-up outcomes. All 45 procedures were completed without conversion or incision extension. The operation time was (158±26) min, the intraoperative blood loss was 15(8, 20) ml, the thoracic drainage time was 3(2, 3) d, and the postoperative thoracic drainage volume were 180.0(17.5, 400.0) ml on postoperative day 1, 40.0(10.0, 65.0) ml on postoperative day 2, and 15.0(7.5, 35.0) ml on postoperative day 3. The length of postoperative hospital stay was 4(3, 5) d. Postoperative complications occurred in 4 patients, including 1 case of hoarseness, 1 case of myasthenic crisis, and 2 cases of pulmonary infection, all of whom improved or recovered after symptomatic treatment. Pathology showed thymic hyperplasia in 9 cases and thymoma in 36 cases,among which ectopic thymus tissue was identified in 19 cases. Follow-up was conducted up to October 31, 2025, with a follow-up duration of 24.0(14.0, 29.0) months. No recurrence of complications, tumor recurrence or metastasis, or death was observed during follow-up."six-step" robot-assisted subxiphoid extended thymectomy is safe and feasible with favorable short-term outcomes and offers a standardized, generalizable approach for myasthenia gravis surgery.
[Efficacy and safety of eliglustat tartrate in adults with Gaucher disease type 1].
Hu LY, Ren YS, Zhang L … +2 more , Yang R, Meng Y
Zhonghua Yi Xue Za Zhi · 2026 May · PMID 42161615 · Publisher ↗
To evaluate the efficacy and safety of eliglustat tartrate in adult patients with Gaucher disease type 1 (GD1). Adult patients with GD1 confirmed at the First Medical Center of Chinese People's Liberation Army General Ho...
To evaluate the efficacy and safety of eliglustat tartrate in adult patients with Gaucher disease type 1 (GD1). Adult patients with GD1 confirmed at the First Medical Center of Chinese People's Liberation Army General Hospital were prospectively enrolled from October 2023 to June 2024. They received eliglustat tartrate capsules treatment (oral, 84 mg, twice daily) for 52 weeks. The changes in glucosylsphingosine (Lyso-GL1), hemoglobin and platelet count, liver and spleen volumes, multiples of normal (MN) of liver and spleen volumes were observed before and after treatment, and adverse reactions during treatment were recorded. A total of 5 adult patients with GD1 type were included, and all were identified as extensive metabolizers (EMs) via CYP2D6 genotyping. Following 52 weeks of treatment, Lyso-GL1 levels decreased apparently from baseline. Hemoglobin levels and platelet count also increased. Both liver and spleen volumes decreased, with corresponding reductions in MN. One patient reported mild nausea and anorexia, which resolved spontaneously within 2 d without other adverse events. Eliglustat tartrate demonstrates favorable efficacy and safety in these 5 adult GD1patients with EMs.
[Analysis of influencing factors and construction of a predictive model for permanent congenital hypothyroidism in neonates with congenital hypothyroidism].
Luo CW, Zhu XY, Li XL … +3 more , Zhang J, Liu JG, Lyu SB
Zhonghua Yi Xue Za Zhi · 2026 May · PMID 42161614 · Publisher ↗
To analyze the influencing factors and establish a predictive model for permanent congenital hypothyroidism (PCH) in neonates with congenital hypothyroidism (CH). A total of 682 neonates diagnosed with CH between Januar...
To analyze the influencing factors and establish a predictive model for permanent congenital hypothyroidism (PCH) in neonates with congenital hypothyroidism (CH). A total of 682 neonates diagnosed with CH between January and December 2021 at the Third Affiliated Hospital of Zhengzhou University were retrospectively enrolled, including 370 males and 312 females, with the diagnostic age of (17.6±4.3) d. According to the type of CH, the patients were divided into the PCH group (=212) and the transient CH (TCH) group (=470). Differences in various indicators between the two groups were analyzed. Multivariate logistic regression analysis was used to identify the influencing factors of PCH, and a nomogram of the predictive model was constructed. The predictive efficacy, accuracy, and clinical applicability of the model were evaluated using the area under the receiver operating characteristic curve (AUC), calibration curves, and decision curve analysis, respectively. The proportion of maternal thyroid disease history, levels of thyroid-stimulating hormone (TSH) at initial diagnosis, the rate of thyroid ectopia or agenesis, the proportion of pathogenic/likely pathogenic (P/LP) genetic variants, the proportion of biallelic DUOX2/DUOXA2 variants, and the proportion of TPO/TG gene variants were all higher in the PCH group than in the TCH group. In contrast, free thyroxine (FT4) at initial diagnosis, levothyroxine (L-T4) dosage at 1 year of age, and the proportion of normal or enlarged thyroid size were lower in the PCH group than in the TCH group(all <0.05). Multivariate logistic regression analysis showed that increased birth weight (=0.96, 95%: 0.92-0.99), greater gestational age (=0.90, 95%: 0.79-0.98), and higher FT4 at initial diagnosis (=0.79, 95%: 0.73-0.86) were protective factors for PCH. Conversely, maternal history of thyroid disease (=2.14, 95%: 1.52-3.81), elevated TSH at initial diagnosis (=1.12, 95%: 1.08-1.17), higher L-T4 dosage at 1 year of age (=1.94, 95%: 1.45-2.06), abnormal thyroid imaging (=6.83, 95%: 3.92-11.91), and P/LP genetic variants (=2.87, 95%: 1.63-5.06) were risk factors for PCH. Five variables (initial TSH, initial FT4, L-T4 dosage at 1 year of age, thyroid imaging characteristics, and P/LP gene variants) were selected to construct a nomogram prediction model for PCH risk. The AUC of the model for predicting PCH in CH neonates was 0.88(95%: 0.85-0.91), with a sensitivity of 84.0% and a specificity of 80.0%. The calibration curve indicated good calibration of the model, and decision curve analysis showed that the model achieved satisfactory net clinical benefit within the threshold probability range of 0.1-0.7. Higher TSH level at initial diagnosis, lower FT4 level at initial diagnosis, higher L-T4 dosage at 1 year of age, abnormal thyroid imaging, and pathogenic/likely pathogenic (P/LP) genetic variants are factors associated with the prediction of PCH. The nomogram established in this study shows favorable predictive performance and clinical applicability.
[Comparative analysis of the efficacy between endoscopic submucosal dissection combined with low-dose radiotherapy and direct surgical resection for T1a-MM/T1b-SM stage esophageal squamous cell carcinoma].
Geng YQ, Ding Y, Fu CG … +1 more , Shi RH
Zhonghua Yi Xue Za Zhi · 2026 May · PMID 42161613 · Publisher ↗
To compare the efficacy between endoscopic submucosal dissection (ESD) combined with low-dose radiotherapy and direct surgical resection in patients with T1a-MM/T1b-SM stage esophageal squamous cell carcinoma. A retrosp...
To compare the efficacy between endoscopic submucosal dissection (ESD) combined with low-dose radiotherapy and direct surgical resection in patients with T1a-MM/T1b-SM stage esophageal squamous cell carcinoma. A retrospective analysis was performed on the clinical data of 169 patients diagnosed with T1a-MM/T1b-SM stage esophageal squamous cell carcinoma at Zhongda Hospital Affiliated to Southeast University from January 1, 2016 to September 30, 2024. There were 124 males and 45 females, with the age of (65.9±7.9) years. According to different treatment regimens, the patients were divided into the ESD combined with low-dose radiotherapy group (=58) and the direct surgical resection group (=111). Propensity score matching (PSM) was used for 1∶2 matching with respect to lesion length, pathological grade and invasion depth. Follow-up was terminated at the time of patient death or September 30, 2024. The recurrence rate, mortality rate, complication rate and quality-of-life-related indicators were compared between the two groups after PSM. After PSM, a total of 40 patients were included, among whom 18 were in the ESD combined with low-dose radiotherapy group and 22 in the direct surgical resection group. After PSM, there were no statistically significant differences between the two groups in age, lesion length, lesion location, pathological grade, invasion depth, and resection margin status, (all >0.05). The follow-up time was 36.00 (25.75, 41.50) months in the ESD combined with low-dose radiotherapy group and 37.00 (34.25, 48.25) months in the direct surgical resection group, respectively. One death occurred in the ESD combined with low-dose radiotherapy group (due to myocardial infarction), while no deaths occurred in the direct surgical resection group, with no statistically significant difference between the two groups (=0.450). Three recurrences were observed in the ESD combined with low-dose radiotherapy group, whereas no recurrences occurred in the direct surgical resection group, with no statistically significant difference between the two groups (=0.083). The common complication was esophageal stenosis (2 cases in the ESD combined with low-dose radiotherapy group and 1 case in the direct surgical resection group). Complications in the ESD combined with low-dose radiotherapy group were mainly radiotherapy-related, including myelosuppression (4 cases), radiation esophagitis (3 cases), and radiation pneumonitis (2 cases).Complications in the direct surgical resection group mainly included pulmonary infection (4 cases) and anastomotic leakage (1 case). There was no statistically significant difference in the overall complication rate between the two groups (=0.072). The postoperative pain score was lower in the ESD combined with low-dose radiotherapy group than in the direct surgical resection group [(1.17±1.04) vs (2.09±0.81) points, =0.004]. However, there were no statistically significant differences in nutritional status or physical performance score between the two groups (all >0.05). The ESD combined with low-dose radiotherapy group was superior to the direct surgical resection group in all 6 core quality-of-life dimensions: physical function, role physical, bodily pain, general health, vitality, and social functioning(all <0.05). There were no statistically significant differences in role emotional or mental health between the two groups (all >0.05). For patients with T1a-MM/T1b-SM stage esophageal squamous cell carcinoma who have some choose and high-risk factors, ESD combined with low-dose radiotherapy exhibits short-term tumor-control efficacy comparable to that of direct surgical resection. Meanwhile, it demonstrates greater advantages in preserving esophageal function, degree of complications, alleviating postoperative pain and quality of life.
[Relationships of PAI-1 gene polymorphisms with the efficacy of ustekinumab in the treatment of patients with Crohn disease].
Xu JY, Xiong YJ, Lan RT … +3 more , Chen R, Zhu XY, Jiang Y
Zhonghua Yi Xue Za Zhi · 2026 May · PMID 42161612 · Publisher ↗
To explore the relationships of plasminogen activator inhibitor 1 (PAI-1) gene polymorphisms with the efficacy of ustekinumab (UST) in the treatment of patients with Crohn disease (CD). The patients with active CD who r...
To explore the relationships of plasminogen activator inhibitor 1 (PAI-1) gene polymorphisms with the efficacy of ustekinumab (UST) in the treatment of patients with Crohn disease (CD). The patients with active CD who received UST treatment at the Department of Gastroenterology, the Second Affiliated Hospital of Wenzhou Medical University between January 2021 and January 2025 were retrospectively enrolled. Genotypes of PAI-1 gene at loci rs2227631, rs7242 and rs6092 were examined. The clinical response was evaluated based on the Crohn disease activity index (CDAI) at week 8 of follow-up. All the patients were divided into response group (a decline of CDAI≥100 points compared with week 0 or total CDAI<150 points) and non-response group. According to the CDAI and the simplified endoscopic score for Crohn disease (SES-CD), the deep remission was assessed in the patients who had undergone re-examination of colonoscopy at week 32 of follow-up. These patients were divided into deep remission group (CDAI<150 points, plus SES-CD≤2 points or absence of ulcerations) and non-deep remission group. Those patients who achieved clinical response at week 8 and underwent re-examination of colonoscopy at week 32 were further stratified into deep remission subgroup (CDAI<150 points, plus SES-CD≤2 points or absence of ulcerations) and non-deep remission subgroup. The distribution differences of PAI-1 gene polymorphisms were compared between response group and non-response group, deep remission group and non-deep remission group, as well as deep remission subgroup and non-deep remission subgroup. The genotypes or alleles with distribution differences were included into unconditional logistic regression models to explore the relationships of PAI-1 gene polymorphisms with the efficacy of UST treatment in CD patients. A total of 191 CD patients were enrolled, 128 males and 63 females, aged (33±12) years. At week 8 of UST treatment, there were 118 patients in response group and 73 patients in non-response group. The homozygous variant genotype (GG) of locus rs2227631 was less frequent in response group than that in non-response group [36.4% (43/118) vs 54.8% (40/73), =0.039]. The homozygous variant genotype (GG) (=0.48, 95%: 0.26-0.87) of locus rs2227631 was a factor associated with the clinical response at week 8. At week 32, 176 patients received re-examination of colonoscopy, with 52 patients in deep remission group and 124 patients in non-deep remission group. No significant distribution differences of PAI-1 gene polymorphisms existed between both groups (all >0.05). Among the 118 patients who achieved clinical response at week 8, 110 patients completed re-examination of colonoscopy, with 39 patients in deep remission subgroup and 71 patients in non-deep remission subgroup. Compared with non-deep remission subgroup, the homozygous variant genotype (GG) [33.3% (13/39) vs 12.7% (9/71), =0.030] and variant allele (G) [59.0% (46/78) vs 38.7% (55/142), =0.012] of locus rs7242 were more frequent in deep remission subgroup. The homozygous variant genotype (GG) (=2.45, 95%: 1.12-5.37) and variant allele (G) (=1.88, 95%: 1.17-3.03) of locus rs7242 were factors related with the deep remission at week 32 in those patients who achieved clinical response at week 8. The variation of locus rs2227631 may be associated with a reduced clinical response rate at week 8 in CD patients treated with UST. The variation of locus rs7242 may be related to an increased deep remission rate at week 32 in CD patients who achieved clinical response at week 8. However, the variation of locus rs6092 may not affect the efficacy of UST treatment in CD patients.
[Expert consensus on microbiological diagnosis, prevention, and treatment of carbapenem-resistant Enterobacterales infections (2026 edition)].
Clinical Microbiology Society of China International Exchange and Promotive Association for Medical and Health Care, Chinese Thoracic Society, Chinese Medical Association
Zhonghua Yi Xue Za Zhi · 2026 May · PMID 42161611 · Publisher ↗
Infections caused by carbapenem-resistant Enterobacterales (CRE) pose significant challenges in clinical practice. In practical work, laboratory detection of CRE, as well as the diagnosis, treatment, and prevention of re...
Infections caused by carbapenem-resistant Enterobacterales (CRE) pose significant challenges in clinical practice. In practical work, laboratory detection of CRE, as well as the diagnosis, treatment, and prevention of related clinical diseases, still face numerous difficulties due to a lack of consensus and standardization. To better guide clinical practice related to CRE in China, Clinical Microbiology Society of China International Exchange and Promotive Association for Medical and Health Care and Chinese Thoracic society, Chinese Medical Association invited experts in clinical microbiology, respiratory medicine, infectious diseases, critical care medicine, clinical pharmacy, epidemiology, and other relevant clinical fields to jointly discuss and formulate this consensus, and finally formed 15 recommendations. The consensus systematically summarizes information related to CRE, including terminology, mechanisms of formation, resistance mechanisms, transmission mechanisms, epidemiology, laboratory testing, clinical diagnosis, treatment, infection prevention and control, with the aim of standardizing laboratory and clinical aspects of CRE-related work.
[Correlation between the non-high-density lipoprotein cholesterol/high-density lipoprotein cholesterol ratio and the occurrence of dementia in patients undergoing maintenance hemodialysis].
Wang HQ, Yang YQ, Li Q … +2 more , Da JJ, Zha Y
Zhonghua Yi Xue Za Zhi · 2026 May · PMID 42135053 · Publisher ↗
To examine the association between the ratio of non-high-density lipoprotein cholesterol to high-density lipoprotein cholesterol (NHHR) and the occurrence of dementia in patients undergoing maintenance hemodialysis (MHD)...
To examine the association between the ratio of non-high-density lipoprotein cholesterol to high-density lipoprotein cholesterol (NHHR) and the occurrence of dementia in patients undergoing maintenance hemodialysis (MHD). A multicenter cross-sectional study was conducted, involving MHD patients from 10 hemodialysis centers in Guizhou Province between May 2019 and November 2023. Cognitive function was assessed using the mini-mental state examination (MMSE), and the presence of dementia was determined according to the corresponding criteria based on the patient's educational level. NHHR was used as a marker of lipid metabolism. Patients were categorized into four groups (Q1-Q4) according to NHHR quartiles: Q1 group (NHHR<1.89), Q2 group (NHHR 1.89-<2.55), Q3 group (NHHR 2.55-<3.42), and Q4 group (NHHR≥3.42). The association between NHHR and the risk of dementia was assessed through multivariate logistic regression, multiple linear regression, restricted cubic splines (RCS), subgroup analysis, and interaction testing. A total of 2 279 MHD patients (1 385 males and 894 females) aged 58 (49, 68) years were included in the study. Among these patients, 179 cases (7.9%) (103 males and 76 females) were diagnosed with dementia, with the age of 69 (60, 77) years. Multivariate logistic regression analysis revealed that, after adjusting for relevant confounding factors, the risk of dementia in the Q3 group was 1.98 times greater than that in the Q1 group (=1.98, 95%: 1.20-3.27, =0.007). Furthermore, the risk of dementia in the Q4 group was 2.56 times that of the Q1 group (=2.56, 95%: 1.56-4.20, <0.001). Multiple linear regression analysis indicated a negative correlation between NHHR and the total MMSE score (β=-0.25, 95%:-0.38--0.12, <0.001). Subgroup analysis demonstrated an interaction between gender and NHHR (=0.005). Among female MHD patients, the risk of dementia in the NHHR Q4 group was 6.04 times that of the Q1 group (=6.04, 95%: 2.59-16.54), whereas no significant correlation was observed between NHHR and dementia in male MHD patients (all >0.05). Restricted cubic splines analysis indicated a linear relationship between NHHR and the risk of dementia (=0.240). Elevated NHHR levels areassociated with an increased risk of dementia in MHD patients, with a more pronounced effect observed in female patients.
[Efficacy and safety between minimally invasive left intercostal small incision and median sternotomy coronary artery bypass grafting inmulti-vessel coronary disease patients with concomitant diabetes].
Sun YH, Zhao ZN, Zhang LL … +2 more , Li XY, Li Z
Zhonghua Yi Xue Za Zhi · 2026 May · PMID 42135052 · Publisher ↗
To compare the efficacy and safety of thoracoscopic-assisted left intercostal small incision and median sternotomy coronary artery bypass grafting (CABG) in the treatment of multi-vesselcoronary disease patients with con...
To compare the efficacy and safety of thoracoscopic-assisted left intercostal small incision and median sternotomy coronary artery bypass grafting (CABG) in the treatment of multi-vesselcoronary disease patients with concomitant type 2 diabetes mellitus (T2DM). The clinical data of multi-vessel coronary disease patients with concomitant T2DM who were admitted to Fuwai Huazhong Cardiovascular Hospital from January 2020 to January 2024 were retrospectively collected. According to the treatment regimen, patients who underwent minimally invasive left intercostal small incision CABG were included in the minimally invasive group, and patients who underwent median sternotomy CABG were included in the traditional group. The perioperative indicators, intraoperative bypass grafts, and the incidence of major adverse cardiac and cerebrovascular events (MACCE) at 1 year after operation were compared between the two groups. After propensity score matching, there were 51 patients in the minimally invasive group, including 28 males and 23 females, with an average age of (62.6±2.1) years. There were 51 patients in the traditional group, including 31 males and 20 females, with an average age of (63.2±2.7) years. No statistically significant differences were detected in age, gender, body mass index, preoperative fasting blood glucose, glycosylated hemoglobin, comorbidities, smoking history, previous myocardial infarction history, left ventricular ejection fraction, SYNergy between percutaneous coronary intervention with TAXus and cardiac surgery (SYNTAX) score, and duration of diabetes between the two groups (all >0.05). The operation time in the minimally invasive group was longer than that of the traditional group [(245.3±35.1) min vs (215.7±28.4) min]. However, the postoperative mechanical ventilation time [(10.2±2.3) h vs (14.8±3.2) h], length of intensive care unit (ICU) stay [(25.3±4.1) h vs (28.4±6.3) h], and hospitalization time [(7.8±1.5) d vs (10.9±2.4) d] were shorter in the minimally invasive group than in the traditional group (all <0.05). The perioperative blood transfusion rate [9.8% (5/51) vs 31.4% (16/51)] and the incidence of complications [7.8% (4/51) vs 37.3% (19/51)] were lower than those in the traditional group (all <0.05). No significant differences were observed between the two groups in the mean blood flow and pulsatility index of all bypass grafts [(35.2±8.7) ml/min vs (36.1±9.2) ml/min; 2.4±0.6 vs 2.3±0.5], the left internal mammary artery (LIMA) [(28.1±6.8) ml/min vs (27.8±7.1) ml/min; 1.9±0.5 vs 2.0±0.5], or the great saphenous vein [(45.6±10.3) ml/min vs (46.7±11.0) ml/min; 2.8±0.7 vs 2.7±0.6] (all >0.05). The total incidence of MACCE at 1 year after operation in the minimally invasive group was 5.9% (3/51), which was not significantly different from that in the traditional group [9.8% (5/51)] (=0.475). Compared with median sternotomy CABG, thoracoscopic-assisted left intercostal small incision CABG has a lower proportion of postoperative blood transfusion and a shorter recovery process in the treatment of multi-vessel coronary artery disease patients with concomitant T2DM. The incidence of MACCE is similar between the two procedures at 1 year after surgery.
About
- Frequency
- Sun
- Papers found
- 200
- RSS feed
- Subscribe