Zhonghua Yi Xue Za Zhi[JOURNAL]
Sun
200 papers
[Clinical analysis of postoperative intestinal dysfunction in patients with advanced epithelial ovarian cancer].
Li XT, Xu ZY, Guo XY … +2 more , Liu Y, Liu SJ
Zhonghua Yi Xue Za Zhi · 2026 May · PMID 42135051 · Publisher ↗
To analyze the factors influencing early [postoperative prolonged ileus (PPOI)] and late [low anterior resection syndrome (LARS)] bowel dysfunction after primary cytoreductive surgery in patients with advanced ovarian ca...
To analyze the factors influencing early [postoperative prolonged ileus (PPOI)] and late [low anterior resection syndrome (LARS)] bowel dysfunction after primary cytoreductive surgery in patients with advanced ovarian cancer, and to evaluate the economic impact of postoperative bowel dysfunction. A retrospective study was conducted on 275 patients with advanced epithelial ovarian cancer who underwent cytoreductive surgery at the First Affiliated Hospital of Air Force Medical University from January 2020 to December 2024. Patients were grouped based on postoperative bowel dysfunction: PPOI group (=59) and non-PPOI group (=216). Among 119 patients who underwent rectosigmoid resection, 77 completed questionnaire assessment and were included in LARS analysis, categorized into LARS group (=30) and non-LARS group (=47). Perioperative clinical data were collected, and univariate and multivariate logistic regression models were used to identify risk factors for PPOI and LARS. A total of 275 patients with a mean age of (56.7±9.1) years were included, of whom 21.5% (59/275) developed PPOI. Among 77 patients who completed LARS assessment [mean age (55.2±10.1) years], 39.0% (30/77) developed LARS. Multivariate analysis showed that preoperative prognostic nutritional index (PNI)≤45 (=3.059, 95%: 1.481-6.593), history of prior abdominal surgery (=2.511, 95%: 1.196-5.274), total psoas area index (TPAI)≤266.2 mm/m (=7.725, 95%: 3.621-16.483), intraoperative rectal resection (=6.816, 95%: 3.143-14.782), and total pelvic peritonectomy (=2.947, 95%: 1.372-6.328) were independent risk factors for PPOI (all <0.05). Total pelvic peritonectomy (=3.547, 95%: 1.048-11.612) was identified as a risk factor for LARS (=0.036). Furthermore, the PPOI group had significantly higher hospitalization costs and longer hospital stays (all <0.001). Poor preoperative nutritional status and specific surgical procedures are risk factors for PPOI after cytoreductive surgery in advanced ovarian cancer patients, with total pelvic peritonectomy being a common risk factor for both PPOI and LARS. Additionally, PPOI increases the economic burden of medical care.
[Prediction of recurrence-free survival of T1 glottic carcinoma based on enhanced CT anterior commissure invasion and tumor volume].
Zhang HL, Li WF, Shen LF … +4 more , Ji XD, Li Q, Zhu XL, Xia S
Zhonghua Yi Xue Za Zhi · 2026 May · PMID 42135050 · Publisher ↗
To investigate the recurrent predictive value of morphologic features based on enhanced CT anterior commissure invasion (ACI) and tumor volume (TV) in patients with T1-stage glottic cancer (GC) following larynx-preservin...
To investigate the recurrent predictive value of morphologic features based on enhanced CT anterior commissure invasion (ACI) and tumor volume (TV) in patients with T1-stage glottic cancer (GC) following larynx-preserving surgery. The clinical and enhanced CT images of patients with T1-staging GC treated with larynx-preserving surgery in Tianjin First Central Hospital from January 2015 to December 2019 were retrospectively analyzed. According to the postoperative follow-up results, they were divided into recurrence group and non-recurrence group. The morphological characteristics of tumors, including ACI status and quantitative characteristics (length, thickness, volume), were evaluated on enhanced CT images. The optimal cut-off values of each quantitative parameter for evaluating recurrence were determined by receiver operating characteristic (ROC) curve analysis, and the single or pairwise morphological characteristics with statistically significant differences (<0.05) between groups were included in multivariate Cox regression to analyze the influencing factors of postoperative recurrence-free survival(RFS) and build morphological feature models. Harrell's concordance index (C-index) was used to compare the predictive power of morphological association features with the AJCC-T1 staging system for postoperative recurrence. Calibration curves and decision curve analysis (DCA) were used to assess the calibration and clinical suitability of the model, respectively. A total of 147 patients were included, the ratio of male to female was 11∶1, and the age was (62.6±8.7) years. The median follow-up time was 44 months, and there were 25 cases in relapse group and 122 cases in non-relapse group. ACI combined with TV, length combined with TV, thickness combined with TV were correlated with RFS (<0.05). ACI+TV≥118.55 mm was a risk factor for RFS (=4.17, 95%:1.85-9.37, =0.002). The C- index for predicting recurrence based on the combined morphological features of ACI and TV was higher than that of AJCC-T1 staging [0.73 (95%: 0.62-0.84) vs 0.65 (95%: 0.55-0.74), =2.84, =0.004]. Calibration curves showed good agreement between model-predicted recurrence-free survival and actual recurrence-free survival, and DCA results indicated good clinical net benefit from the model. Morphological characteristics of ACI combined with TV are associated with RFS after larynx-preserving surgery in patients with T1-staging GC, and anterior commissure invasion with larger tumor volume (ACI+TV≥118.55 mm) at initial treatment are risk factors for postoperative recurrence.
[Clinical characteristics of smoking asthma and efficacy of long-acting muscarinic antagonist in treating patients with smoking asthma].
Huang XT, Wu LQ, Dai W … +7 more , Yu WW, Lin J, Shi SQ, Li HY, Ge XT, Chen M, Dai YR
Zhonghua Yi Xue Za Zhi · 2026 May · PMID 42135049 · Publisher ↗
To analyze the clinical characteristics of smoking asthmatic patients and to evaluate the efficacy of long-acting muscarinic antagonist (LAMA) in treating smoking asthmatic patients. The characteristic analysis study of...
To analyze the clinical characteristics of smoking asthmatic patients and to evaluate the efficacy of long-acting muscarinic antagonist (LAMA) in treating smoking asthmatic patients. The characteristic analysis study of smoking asthma was a case-control study, including 128 patients with bronchial asthma. According to whether the patients smoked, they were divided into the smoking asthma group and the non-smoking asthma group. The clinical data, blood indicators, lung function indicators [forced expiratory volume in one second (FEV), FEV/forced vital capacity (FEV/FVC), maximum mid-expiratory flow (MMEF 75/25)], and fractional exhaled nitric oxide (FeNO) were compared between the two groups. The efficacy of LAMA in treating smoking asthma patients was a randomized controlled trial. A total of 60 male patients with moderate to severe asthma, who were smokers and in a non-acute attack phase, were screened. According to computer-generated random numbers, they were divided into the intervention group [administered inhaled corticosteroid (ICS)+long-acting beta agonist (LABA)+LAMA for 1 month] and the control group (administered ICS+LABA for 1 month) in a 1∶1 ratio. Clinical characteristics, blood indicators, lung function indicators, asthma control test (ACT) scores, and Asthma Quality of Life Questionnaire (AQLQ) scores were collected before and after 1 month of treatment, and efficacy indicators were compared within and between groups before and after treatment. A total of 98 patients were included in the non-smoking asthma group, aged (61.9±14.3) years, and 30 were male. A total of 30 patients were included in the smoking asthma group, aged (60.4±15.2) years, all of whom were male. The proportion of males in the smoking asthma group [30.0 (100.0)% vs 30.0 (30.6)%], blood neutrophil count [(4.5±1.9)×10/L vs (3.3±2.0)×10/L], and blood neutrophil ratio [(64.0±16.5)% vs (51.2±23.2)%] were higher than those in the non-smoking asthma group (all <0.05). The blood eosinophil count of the non-smoking asthma group [(0.2±0.2)×10/L vs (0.1±0.1)×10/L], blood eosinophil ratio [(2.2±1.8)% vs (1.5±1.1)%], IgE [(374.5±496.5)u/ml vs (161.2±187.6) U/ml], FEV [(1.9±0.6)L vs (1.4±0.5) L], FEV/FVC [(74.9±11.4)% vs (65.8±11.7)%], MMEF 75/25 [(1.8±1.0)L/s vs (1.3±0.8) L/s], and FeNO [(, )][34.5 (17.3, 57.3) ppb vs 25.0 (17.0, 35.0) ppb (1 ppb=1×10)] were all higher than those in the smoking asthma group (all <0.05). In the study on the efficacy of LAMA treatment for smoking asthma, the intervention group included 30 cases, with an age of (49.6±10.5) years. There were 30 cases in the control group, aged (50.5±11.0) years. There was no significant difference between the two groups from baseline (all >0.05). The number of cigarettes smoked in both groups decreased before and after treatment [intervention group: (20.3±8.0) cigarettes/d vs (8.7±6.2) cigarettes/d; control group: (20.5±7.6) cigarettes/d vs (8.3±5.3) cigarettes/d], but there was no significant difference between the two groups before and after treatment (all >0.05). Intra-group comparison, FEV, FVC, FEV/FVC, MMEF 75/25, ACT score, and AQLQ score of intervention group after treatment were higher than those before treatment, and FeNO of intervention group after treatment was lower than before treatment (all <0.05). After treatment, the ACT score and AQLQ score of control group were higher than those before treatment (all <0.05). Between-group comparison showed that after treatment, the intervention group had higher FEV [(2.5±0.7) L vs (1.9±0.7) L], FVC [(3.2±0.9) L vs (2.7±0.9) L], FEV/FVC [(78.6±6.7)% vs (72.8±11.7)%], ACT score [23.0 (23.0, 24.0) points vs 21.5 (20.3, 24.0) points], and AQLQ score [101.0 (98.0, 104.0) points vs 97.5 (93.0, 101.3) points], and lower FeNO [14.5 (10.0, 28.3) ppb vs 25.0 (19.3, 51.5) ppb] than the control group (all <0.05). This study indicates that smoking asthmatic patients have worse pulmonary function but lower FeNO and peripheral blood eosinophil counts than non-smoking asthmatic patients. Compared to ICS+LABA alone, the addition of LAMA to ICS+LABA significantly improves pulmonary function, reduces FeNO, and enhances symptom control and quality of life in smoking asthmatic patients.
[Clinical practice guideline for integrated PET/MRI in refractory epilepsy(2026 edition)].
Chinese Society of Medical Imaging Technology, Chinese Society of Radiology, Chinese Society of Nuclear Medicine … +2 more , Beijing Society of Nuclear Medicine, Beijing Society of Radiology
Zhonghua Yi Xue Za Zhi · 2026 May · PMID 42135048 · Publisher ↗
To further standardize the clinical use of integrated PET/MRI brain imaging for refractory epilepsy in China, improve the level of individualized precision diagnosis and treatment, promote standardized management, and pr...
To further standardize the clinical use of integrated PET/MRI brain imaging for refractory epilepsy in China, improve the level of individualized precision diagnosis and treatment, promote standardized management, and provide evidence-based and consensus recommendations for clinicians and imaging professionals, experts in nuclear medicine, radiology, neurology, and related fields developed this guideline through a consensus process informed by the available research evidence and clinical practice. Epilepsy is one of the most common chronic neurological disorders, and accurate preoperative localization of the epileptogenic zone in patients with refractory epilepsy remains a major clinical challenge. Integrated PET/MRI enables simultaneous, one-stop acquisition of multidimensional information, including cerebral metabolism, high-resolution anatomical detail, and functional features, and can be used for epileptogenic focus localization, surgical planning, and assessment of important functional regions, making it an important imaging tool for precision care in refractory epilepsy. As integrated PET/MRI systems become increasingly available in China, broader clinical implementation continues to face challenges, including appropriate patient selection and indications, standardization of scanning workflows, image quality control, consistency in image interpretation, and reporting standards. With a focus on clinical feasibility, this guideline provides recommendations across key domains, including indications, examination and quality-control procedures, image interpretation, and standardized reporting, to promote the standardized use of integrated PET/MRI in the care of refractory epilepsy and advance related clinical translation.
[Clinical practice guideline for integrated PET/MRI in brain gliomas(2026 edition)].
Chinese Society of Medical Imaging Technology, Chinese Society of Radiology, Chinese Society of Nuclear Medicine … +2 more , Beijing Society of Nuclear Medicine, Beijing Society of Radiology
Zhonghua Yi Xue Za Zhi · 2026 May · PMID 42135047 · Publisher ↗
To further standardize the clinical application of integrated PET/MRI brain imaging for brain gliomas in China, improve the level of precision diagnosis and management, promote standardized care, and provide evidence-bas...
To further standardize the clinical application of integrated PET/MRI brain imaging for brain gliomas in China, improve the level of precision diagnosis and management, promote standardized care, and provide evidence-based and consensus recommendations for imaging professionals and clinicians, this guideline was jointly developed by the Chinese Society of Medical Imaging Technology, Chinese Society of Radiology, Chinese Society of Nuclear Medicine, the Beijing Society of Nuclear Medicine, and the Beijing Society of Radiology, with the participation of multidisciplinary experts from nuclear medicine, radiology, neurosurgery, neuro-oncology, and radiation oncology, through multiple rounds of consensus meetings. Brain gliomas are among the most common primary brain tumors of the central nervous system, encompassing a wide spectrum of tumor grades and diverse biological behaviors. Key aspects of their clinical management include accurate diagnosis and grading, tumor extent delineation, preoperative evaluation and radiation therapy target planning, as well as differentiation between post-treatment recurrence and treatment-related changes. Integrated PET/MRI enables simultaneous acquisition of PET molecular metabolic information and multiparametric MRI structural and functional information within a single examination, effectively facilitating the above processes and serving as an important imaging modality for the precise diagnosis and treatment of brain gliomas. As integrated PET/MRI systems become increasingly available in China, broader clinical implementation continues to face challenges in appropriate indication selection, standardization of imaging workflows and parameter settings, image post-processing and assessment, consistency of image interpretation, and reporting. Grounded in the current accessibility of integrated PET/MRI equipment and tracers in China and in the latest domestic and international evidence-based research, and closely aligned with the realities of Chinese clinical practice, this guideline provides recommendations across key domains-clinical indications, examination and quality-control workflows, image interpretation, and standardized reporting-with the aim of offering systematic and practical evidence-based guidance for imaging specialists and clinicians involved in glioma care.
[Vasomics: an emerging omics discipline for deciphering vascular health and disease].
Qi XL, Yang L, Wang CY … +5 more , Gu ZZ, Wang JA, Ji XM, Teng GJ, Fan XQ
Zhonghua Yi Xue Za Zhi · 2026 May · PMID 42135046 · Publisher ↗
The vascular system serves as the central architecture of the human circulatory network, whose structural and functional integrity is vital for maintaining homeostasis and is closely associated with the development and p...
The vascular system serves as the central architecture of the human circulatory network, whose structural and functional integrity is vital for maintaining homeostasis and is closely associated with the development and progression of major diseases, including cardiovascular diseases, cerebrovascular diseases, hepatic disorders, ocular diseases, and renal conditions. Traditional single-dimensional research models present evident limitations in deciphering the complex vascular system. In this context, this article formally introduces the concept of "Vasomics". Vasomics is an emerging omics discipline that integrates clinical medicine, basic medicine, biology, computer science and artificial intelligence to systematically analyze the vascular system using multimodal and cross-scale approaches. This article elaborates on Vasomics from six key aspects: its background, core technologies and phenotyping, methodological framework, research progress, applications, and challenges and prospects. By enabling the integration of multi-scale vascular phenotypes from macroscopic to microscopic levels, Vasomics is poised to offer a new paradigm for deciphering vascular health and disease.
[Progress in targeted therapy for chronic thromboembolic pulmonary hypertension].
Zhang M, Hu XH, Wan J
Zhonghua Yi Xue Za Zhi · 2026 May · PMID 42135045 · Publisher ↗
Chronic thromboembolic pulmonary hypertension (CTEPH) is a pulmonary vascular disease characterized by organized thrombotic obstruction of the pulmonary arteries and subsequent pulmonary vascular remodeling. The therapeu...
Chronic thromboembolic pulmonary hypertension (CTEPH) is a pulmonary vascular disease characterized by organized thrombotic obstruction of the pulmonary arteries and subsequent pulmonary vascular remodeling. The therapeutic strategy has evolved from a solely surgical approach to a comprehensive system incorporating pulmonary endarterectomy, balloon pulmonary angioplasty and targeted drugs. Although riociguat remains the only drug formally approved for patients with inoperable or residual/recurrent pulmonary hypertension in China, accumulating evidence suggests that other targeted agents, such as treprostinil, may also show clinical benefits in CTEPH. Current evidence highlights the importance of multimodal therapy. This review aims to comprehensively summarize recent advances in targeted drugs for CTEPH patients and to examine the current applications and unresolved challenges associated with multimodal therapy strategies in this field.
[Progress in targeted drug therapy for pulmonary hypertension associated with hypoxia].
Liu L, Yang YH
Zhonghua Yi Xue Za Zhi · 2026 May · PMID 42135044 · Publisher ↗
Hypoxia-associated pulmonary hypertension (PH) is a severe complication secondary to chronic lung diseases and/or hypoxia, significantly increasing patient mortality risk. Its core pathophysiological mechanisms involve m...
Hypoxia-associated pulmonary hypertension (PH) is a severe complication secondary to chronic lung diseases and/or hypoxia, significantly increasing patient mortality risk. Its core pathophysiological mechanisms involve multiple pathways, including hypoxic pulmonary vasoconstriction, active pulmonary vascular remodeling, endothelial dysfunction, and inflammatory responses. Targeted drug therapy in this field has long faced significant challenges. Clinical trials of classic targeted drugs for pulmonary arterial hypertension (PAH) in hypoxia-associated PH have yielded inconsistent results; some drugs may even exacerbate the disease by potentially worsening ventilation/perfusion mismatch. While research on classic targeted therapies continues, studies investigating drugs targeting alternative pathways, such as directly reversing pulmonary vascular remodeling, are gaining momentum. This article will focus on the progress of both classic and emerging targeted drug research for hypoxia-associated PH.
[Advances in targeted pharmacotherapies for pulmonary hypertension associated with left heart disease].
Yao H, Zhang Y
Zhonghua Yi Xue Za Zhi · 2026 May · PMID 42135043 · Publisher ↗
Pulmonary hypertension associated with left heart disease (PH-LHD) represents the most prevalent form of pulmonary hypertension. The concomitant elevation in pulmonary arterial pressure significantly exacerbates disease...
Pulmonary hypertension associated with left heart disease (PH-LHD) represents the most prevalent form of pulmonary hypertension. The concomitant elevation in pulmonary arterial pressure significantly exacerbates disease morbidity and mortality, leading to unfavorable prognosis. Despite sharing similar pathophysiological characteristics with pulmonary arterial hypertension (PAH), current clinical guidelines do not recommend PAH-targeted therapies for PH-LHD, as clinical trials conducted to date have failed to demonstrate the efficacy and safety benefits of such agents in PH-LHD patients. Novel therapeutic agents with distinct mechanisms-such as activin signaling inhibitors and long-acting relaxin analogs-have shown potential benefits in preliminary studies. It is anticipated that ongoing clinical investigations may yield favorable outcomes, thereby paving new avenues for the treatment of pulmonary hypertension associated with heart failure with preserved ejection fraction and improving clinical prognosis.
[Advances in targeted therapy for pulmonary arterial hypertension].
Luo CJ, Wang L
Zhonghua Yi Xue Za Zhi · 2026 May · PMID 42135042 · Publisher ↗
Pulmonary arterial hypertension (PAH) is a severe cardiovascular disorder characterized by progressive elevation in pulmonary vascular resistance and sustained increase in right ventricular afterload, which may lead to r...
Pulmonary arterial hypertension (PAH) is a severe cardiovascular disorder characterized by progressive elevation in pulmonary vascular resistance and sustained increase in right ventricular afterload, which may lead to right heart failure and sudden death as the disease advances. This article focuses on PAH-targeted drug research, reviews the development of classical pathway agents, and elaborates on the molecular mechanisms and translational prospects of novel pathway therapeutics. Evidence indicates that continuous advancements in targeted pharmacotherapies for PAH have significantly improved clinical outcomes, offering new directions for the management of this condition.
[Innovations in targeted therapies for pulmonary hypertension: advancing from vasodilation to vascular remodeling].
Cui XD, Chen JY, Wang J
Zhonghua Yi Xue Za Zhi · 2026 May · PMID 42135041 · Publisher ↗
Pulmonary hypertension (PH) is a heterogeneous disease driven by multiple pathological mechanisms. Its core characteristics include pulmonary vascular constriction and pulmonary vascular remodeling. Currently, the clinic...
Pulmonary hypertension (PH) is a heterogeneous disease driven by multiple pathological mechanisms. Its core characteristics include pulmonary vascular constriction and pulmonary vascular remodeling. Currently, the clinical treatment of PH primarily relies on vasodilatory drugs, including endothelin pathway antagonists, prostacyclin analogues, and regulators of the NO-sGC-cGMP pathway. Although these drugs can alleviate symptoms and improve hemodynamics to a certain extent, they are unable to fundamentally reverse pulmonary vascular remodeling and have limitations in improving the long-term prognosis of the disease. Therefore, developing drugs that can directly intervene and reverse pulmonary vascular structural abnormalities has become a new direction for treatment. Numerous studies, both at home and abroad, have demonstrated that targeted therapy has significant value in improving the prognosis of patients with PH. This article will discuss three aspects: the innovation of classic pathways, new drugs targeting remodeling, and cutting-edge translational research in metabolism and immunity, aiming to clarify the transformation of current treatment strategies from "vasodilation" to "inhibiting vascular remodeling".
[Current status and evolution of targeted therapy for pulmonary arterial hypertension in China].
Luo Q, Liu ZH
Zhonghua Yi Xue Za Zhi · 2026 May · PMID 42135040 · Publisher ↗
Pulmonary hypertension (PH), especially pulmonary arterial hypertension (PAH), is a complex and life-threatening disorder with poor prognosis. Over the past two decades, PAH-targeted therapy in China has evolved through...
Pulmonary hypertension (PH), especially pulmonary arterial hypertension (PAH), is a complex and life-threatening disorder with poor prognosis. Over the past two decades, PAH-targeted therapy in China has evolved through three distinct stages. Before 2006, the field was characterized by the absence of targeted therapies, limited disease awareness, and significant delays in diagnosis. Patients relied primarily on conventional treatments, with a 5-year survival rate of only 20.8%. Between 2006 and 2020, the introduction of targeted drugs such as iloprost and bosentan significantly improved patient outcomes. However, high costs and limited accessibility remained major barriers, with only around 20% of patients receiving targeted therapy and combination therapy used infrequently. Since 2020, expanded insurance coverage and the availability of domestic generics have substantially improved access to treatment. As a result, targeted therapy use has increased to nearly 80%, the 1-year mortality rate has declined to below 10%, and the 5-year survival rate now exceeds 70%. Meanwhile, clinical research has expanded rapidly, and nationwide specialist networks have been established, bringing standards of care closer to international levels. Looking forward, further efforts are needed to strengthen disciplinary development, promote multidisciplinary collaboration, and accelerate drug innovation to improve outcomes for patients with PAH in China.
[Thirty years of targeted drug therapy for pulmonary hypertension: the therapeutic paradigm transition from "vasodilation" to "reverse remodeling"].
Xiong CM, Zhai ZG, Liu ZH
Zhonghua Yi Xue Za Zhi · 2026 May · PMID 42135039 · Publisher ↗
Pulmonary hypertension, especially pulmonary arterial hypertension, is a progressive disease that is difficult to treat and has a poor prognosis. This article summarizes the remarkable progress in pulmonary hypertension...
Pulmonary hypertension, especially pulmonary arterial hypertension, is a progressive disease that is difficult to treat and has a poor prognosis. This article summarizes the remarkable progress in pulmonary hypertension treatment over the past 30 years since the first targeted drug for pulmonary hypertension became available in 1995. Key advancements include the transition from no available treatments to abundant targeted therapies, the shift from monotherapy to early combined treatment strategies, and the evolution of therapeutic goals from symptom improvement to mortality risk reduction and significant hemodynamic parameter enhancement. The treatment paradigm has transformed from mere "vasodilation" to "anti-vascular remodeling", aiming to deepen understanding of pulmonary hypertension and elevate diagnostic and therapeutic standards.
[Efficacy analysis of individualized surgical strategies for extracranial carotid artery aneurysms based on aneurysm location and parent-artery lesion characteristics].
Li XG, Zhu JB, Huang JZ … +4 more , Jin YF, Xia WP, Zhang WW, Zhou WM
Zhonghua Yi Xue Za Zhi · 2026 May · PMID 42103681 · Publisher ↗
The clinical data of 42 consecutive patients with extracranial carotid artery aneurysms (ECAA) who underwent surgical treatment in the Department of Vascular Surgery, the Second Affiliated Hospital of Nanchang University...
The clinical data of 42 consecutive patients with extracranial carotid artery aneurysms (ECAA) who underwent surgical treatment in the Department of Vascular Surgery, the Second Affiliated Hospital of Nanchang University, from January 2012 to December 2024 were retrospectively collected. Based on the Attigah classification of aneurysms, while evaluating anatomical characteristics such as bifurcation involvement, proximal and distal landing zone conditions, and parent artery tortuosity, combined with etiological risks including infection, inflammation, or trauma, individualized treatment plans were formulated. Ultimately, 36 patients underwent endovascular treatment and 6 cases underwent open surgical treatment. In the perioperative period, immediate postoperative digital subtraction angiography (DSA) or postoperative computed tomography angiography (CTA) was used to evaluate aneurysm exclusion and parent-artery patency. The patients were aged (53.3±7.3) years, including 17 females and 25 males. Among them, there were 20 true aneurysms, 19 pseudoaneurysms, and 3 dissecting aneurysms. The surgical technical success rate was 97.6% (41/42). During the perioperative period, 1 (2.2%) patient developed cranial nerve injury after open surgery. The postoperative follow-up time was (18.5±4.6) months, no deaths occurred, and 2 (4.8%) patients developed in-stent restenosis at 6 months postoperatively. Treatment of ECAA should be individualized according to etiology and anatomic characteristics, and endovascular therapy represents a relatively straightforward, safe, and effective option for ECAA.
[Feasibility of thoracolaparoscopic resection for adenocarcinoma of the esophagogastric junction with left intrathoracic anastomosis without patient repositioning].
Zhang YY, Zhang C, Liu WX … +5 more , Zhao Q, Zhang XF, Wang XD, He M, Li Y
Zhonghua Yi Xue Za Zhi · 2026 May · PMID 42103680 · Publisher ↗
To evaluate the feasibility of thoracolaparoscopic resection for adenocarcinoma of the esophagogastric junction with left intrathoracic anastomosis performed without patient repositioning. A retrospective analysis was pe...
To evaluate the feasibility of thoracolaparoscopic resection for adenocarcinoma of the esophagogastric junction with left intrathoracic anastomosis performed without patient repositioning. A retrospective analysis was performed on the clinical data of patients who underwent thoracolaparoscopic resection for adenocarcinoma of the esophagogastric junction with left intrathoracic anastomosis without patient repositioning at the Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College from August 2016 to January 2020. A total of 39 patients were enrolled (32 males and 7 females), with the age of (64.2±7.2) years. The patients' surgical status, postoperative pathological stage, postoperative complications, and follow-up information were analyzed. The survival curves were plotted using the Kaplan-Meier method. All 39 procedures were completed successfully with no conversion to thoracotomy or laparotomy. The operative time was 250.0 (223.5, 289.0) min, and intraoperative blood loss was (165±79) ml. Postoperative pathological stages were stage Ⅰ in 13, stage Ⅱ in 4, stage Ⅲ in 11, and stage Ⅳ in 11 patients. R0 resection was achieved in all patients. Postoperative complications included anastomotic leakage in 3 patients (7.7%, 3/39), pulmonary infection in 3 patients (7.7%, 3/39), arrhythmia in 3 patients (7.7%, 3/39), pleural effusion in 3 patients (7.7%, 3/39), incision infection in 1 patient (2.6%, 1/39), gastroesophageal reflux in 5 patients (12.8%, 5/39), and iatrogenic injury of the right mediastinal pleura in 3 patients (7.7%, 3/39). All complications were resolved after conservative treatment. There were no cases of chylothorax, reoperation, ICU admission, or perioperative death. The patients were followed up for a median of 55 (36, 60) months postoperatively. The 1-year and 3-year disease-free survival rates were 87.2% and 69.2%, respectively. The 1-year, 3-year, and 5-year overall survival rates were 92.3%, 74.4%, and 48.1%, respectively. Thoracolaparoscopic adenocarcinoma of the esophagogastric junction resection with left intrathoracic anastomosis performed without patient repositioning appears feasible and has clinical value for broader adoption.
[Comparison of quantitative smears prepared from EDTA-K anticoagulated bone marrow fluid and traditional bedside direct smears, and the clinical value of their combined use with peripheral blood smears].
Zhang L, Chen P, Gao HX … +6 more , Chen N, Zhang L, Zhu JF, Wang BL, Pan BS, Guo W
Zhonghua Yi Xue Za Zhi · 2026 May · PMID 42103679 · Publisher ↗
Compare the preparation effects between quantitative smears of bone marrow aspirate anticoagulated with ethylene diamine tetra-acetic acid dipotassium salt dihydrat (EDTA-K) and traditional bedside direct smear and evalu...
Compare the preparation effects between quantitative smears of bone marrow aspirate anticoagulated with ethylene diamine tetra-acetic acid dipotassium salt dihydrat (EDTA-K) and traditional bedside direct smear and evaluate the clinical application value of the new dual-smear combined testing mode (combining peripheral blood smears with anticoagulated quantitative smears). A prospective study was conducted, including 180 bone marrow aspirate specimens collected from patients who underwent bone marrow puncture examinations at Zhongshan Hospital, Fudan University, between January and June 2024. Both EDTA-K anticoagulated quantitative smears and bedside direct smears were prepared for each specimen. Based on the different preparation methods, the specimens were divided into an anticoagulated quantitative smear group(=180) and a bedside direct smear group(=180), and the differences in bone marrow cell morphology examinations between the two groups were compared. Using the RAND function in Excel, random numbers were generated for the 180 anticoagulated bone marrow aspirate specimens. These random numbers were then sorted in ascending order, and the first 10 EDTA-K anticoagulated bone marrow samples were selected. The impact of storage duration on cell morphology was evaluated after storage periods of 0, 1, 4, 8, 12, and 24 h, respectively. Additionally, the differences in clinical diagnostic concordance rates between the new dual-smear combined testing mode (combining peripheral blood smears with anticoagulated quantitative smears) and the traditional dual-smear combined testing mode (combining peripheral blood smears with bedside direct smears) were compared. Cohen's Kappa consistency analysis was used to evaluate the diagnostic agreement between the new dual-slide combined detection model and the traditional dual-slide combined detection model. The morphological quality score of the anticoagulated quantitative smear group was superior to that of the bedside direct smear group [(2.98±0.18) vs (2.58±0.80) points, <0.001], but the bone marrow smear quality score was lower than that of the bedside direct smear group [(3.08±0.83) vs (3.54±0.76) points, <0.001]. The proportions of hypercellular and markedly hypercellular smears, the percentage of granulocytic cells, the percentage of erythroid cells, and the total number of megakaryocytes per smear were lower in the anticoagulated quantitative smear group than in the bedside direct smear group, whereas the percentage of lymphocytes was higher. Preparing smears from anticoagulated bone marrow aspirate stored for≤4 h did not significantly affect cell morphology (the proportion of cells with morphological changes was<10% of the respective cell lineage). There were no statistically significant differences in diagnostic concordance rates between the new dual-smear combined testing mode and the traditional dual-smear combined testing mode for multiple myeloma and lymphoma [multiple myeloma: 72.8%(67/92) vs 68.5%(63/92), =0.388; lymphoma: 72.1%(31/43) vs 69.8% (30/43), =1.000]. Moreover, both modes demonstrated high diagnostic consistency for multiple myeloma and lymphoma (Kappa values of 0.686 and 0.718, respectively). The morphological quality of anticoagulated quantitative smears is superior to that of bedside direct smears, and it is recommended to prepare the smears within 4 h of bone marrow aspirate collection. The diagnostic concordance rates between the new dual-smear combined testing mode and the traditional dual-smear combined testing mode are similar, with high diagnostic consistency observed between the two modes.
[Transcript distribution, sequence characteristics and clinical outcomes of rare transcript types of BCR::ABL1 fusion gene-positive leukemia patients].
Wang F, Ma XL, Chen X … +12 more , Zhang Y, Wang Z, Tan YC, Liu MY, Wang N, Zhou L, Chen JQ, Cao PX, Fang JC, Liu M, Zhou XS, Liu HX
Zhonghua Yi Xue Za Zhi · 2026 May · PMID 42103678 · Publisher ↗
To investigate the transcript distribution, rare transcript sequence characteristics and clinical outcomes in patients with BCR::ABL1 fusion gene-positive leukemia. The patients with newly diagnosed and relapsed BCR::AB...
To investigate the transcript distribution, rare transcript sequence characteristics and clinical outcomes in patients with BCR::ABL1 fusion gene-positive leukemia. The patients with newly diagnosed and relapsed BCR::ABL1-positive leukemia who underwent leukemia fusion gene screening at Hebei Yanda Lu Daopei Hospital from April 2012 to December 2024 were retrospectively collected. The clinical data of the patients were collected. The distribution of BCR::ABL1 fusion gene transcripts and the sequences of rare transcripts were analyzed, and the clinical outcomes of patients with rare transcripts were observed. A total of 990 patients were enrolled, including 592 males and 398 females, with a median age of 37 years (range 1-94 years). All patients were tested positive for only one type of BCR::ABL1 transcript, and no co-expression of different transcripts was observed in the same patient. Common transcripts accounted for 96.3% (953 patients), while rare transcripts accounted for 3.7% (37 patients). Among 325 patients in chronic phase chronic myeloid leukemia (CML) and 85 patients in acute phase CML, P210 was the predominant type, observed in 310 (95.4%) and 80 (94.1%) cases, respectively; rare transcripts were identified in 14 (4.3%) and 5 (5.9%) cases, respectively. Among 511 acute acute B-lymphocytic leukemia (B-ALL) patients, P190 was the predominant type (70.5%), followed by P210 (26.8%) and rare transcripts (2.8%). Two acute T-lymphocytic leukemia (T-ALL) patients exhibited P190 and e6a2 transcripts, respectively. Common transcripts were also predominant in patients with acute myeloid leukemia (AML) and acute leukemias of ambiguous lineage (ALAL), with rare transcripts accounting for 3.8% (1/26) and 4.8% (2/41), respectively. Sequence analysis of 37 rare transcripts revealed that splicing variants occurred in ABL1 exon 3 (e1a3, e14a3, e13a3) in 23 patients (62.2%), and in different exons of BCR (e6a2, e8a2, variant e13a2, e19a2) in 14 patients (37.8%). Both e8a2 and variant e13a2 were associated with intronic insertions of varying lengths. Five patients with the e13a3 transcript responded well to tyrosine kinase inhibitor (TKI) therapy and achieved complete remission; among the 10 patients with e1a3 transcript and 5 patients with e19a2 transcript, 4 and 3 patients died or failed to achieve remission, respectively. In patients with BCR::ABL1 fusion gene positive leukemia, the transcripts are mainly of the common type, and the rare type is rare. The rare type transcripts show high heterogeneity. The splicing variations mainly occur in ABL1 exon 3 or different exons of BCR, and some are accompanied by intron sequence insertions. Patients with e13a3 type of rare transcripts respond well to TKI treatment, while patients with the e1a3 and e19a2 have poor prognosis.
[Relationships of interleukin-7 receptor gene polymorphisms with the risk of Crohn's disease and the efficacy of infliximab].
Dai CX, Xu JY, Chen WW … +3 more , Xu Y, Ma GL, Jiang Y
Zhonghua Yi Xue Za Zhi · 2026 May · PMID 42103677 · Publisher ↗
To explore the relationships of interleukin-7 receptor (IL-7R) gene polymorphisms with the risk of Crohn's disease (CD), as well as the efficacy of infliximab (IFX) in patients with CD. The CD patients (CD group) and he...
To explore the relationships of interleukin-7 receptor (IL-7R) gene polymorphisms with the risk of Crohn's disease (CD), as well as the efficacy of infliximab (IFX) in patients with CD. The CD patients (CD group) and healthy controls (control group) at the Second Affiliated Hospital of Wenzhou Medical University between January 2020 and May 2025 were retrospectively collected. Genotypes of IL-7R gene at loci rs6897932, rs1494555, rs1494558 were examined in both groups. According to Montreal CD Classification, the disease locations were divided into terminal ileal-type, colonic-type, ileocolic-type and upper gastrointestinal-type. Among CD patients receiving IFX treatment, the clinical response was evaluated by Crohn's Disease Activity Index (CDAI) at week 14 of follow-up. The patients were divided into the clinical response group (a decline of CDAI≥100 points compared with week 0) and the clinical non-response group. The efficacy of endoscopy was assessed by Simplified Endoscopic Score for Crohn's Disease (SES-CD) at week 32. The patients were divided into the mucosal healing group (SES-CD≤2 points or absence of mucosal ulcerations) and the mucosal non-healing group. The distribution differences of IL-7R gene polymorphisms were compared between CD group and control group, among CD patients with different clinical phenotypes, between the clinical response group and the clinical non-response group, as well as between the mucosal healing group and the mucosal non-healing group. The genotypes or alleles with distribution differences were included into multivariate logistic regression model to investigate the relationships of IL-7R gene polymorphisms with the risk of CD, the clinical phenotypes, and the clinical efficacy of IFX in CD patients. The CD group consisted of 303 participants [200 males and 103 females, aged 30 (23, 40) years]. The control group consisted of 514 participants [313 males and 201 females, aged 32 (26, 42) years]. The variant allele (T) [14.0% (85/606) vs 18.5% (190/1 028)] of locus rs6897932 were less frequent in the CD group than that in the control group, but the difference was not statistically significant after adjustment (adjusted =0.054). The homozygous variant genotype (TT) of locus rs6897932 in the patients with terminal ileal-type and ileocolic-type CD group were less frequent than that with colonic-type CD [0.8% (2/261) vs 9.5% (4/42), adjusted =0.009]. The homozygous variant genotype (TT) of locus rs6897932 (=0.06, 95%: 0.01-0.38) was the related factor influencing the terminal ileum involvement (the disease location is terminal ileal-type or ileocolic-type) in CD patients. A total of 112 CD patients were treated with IFX. There were 78 cases in the clinical response group and 34 cases in the clinical non-response group at week 14 of IFX treatment. The variant genotype (CT+TT) [38.5% (30/78) vs 11.8% (4/34), adjusted =0.015] and variant allele (T) [20.5% (32/156) vs 5.9% (4/68), adjusted =0.018] of locus rs6897932 in the clinical response group were more frequent than those in the clinical non-response group. The variant genotype (CT+TT) (=5.17, 95%: 1.54-17.36) of locus rs6897932 was the related factor influencing the clinical response at week 14. There were 43 cases in the mucosal healing group and 69 cases in the mucosal non-healing group at week 32 of IFX treatment. The variant genotype (TC+CC) [65.1% (28/43) vs 85.5% (59/69), adjusted =0.036] of locus rs1494558 in the mucosal healing group was less frequent than that in the mucosal non-healing group. The variant genotype (TC+CC) (=0.24, 95%: 0.09-0.71) of locus rs1494558 was the related factor influencing the mucosal healing at week 32. The homozygous variant genotype (TT) of locus rs6897932 in IL-7R gene may be related with a lower risk of terminal ileum involvement (the disease location is terminal ileal-type or ileocolic-type). In CD patients receiving IFX treatment, the variant genotype (CT+TT) of locus rs6897932 in IL-7R gene may be related with an increased clinical response rate at week 14, while the variant genotype (TC+CC) of locus rs1494558 may be related with a reduced mucosal healing rate at week 32.
[Expert consensus on the diagnosis and treatment of allergic bronchopulmonary aspergillosis with integrated traditional Chinese and western medicine (2026 edition)].
Allergy Committee of Chinese Association of Integrative Medicine
Zhonghua Yi Xue Za Zhi · 2026 May · PMID 42103676 · Publisher ↗
Allergic bronchopulmonary aspergillosis (ABPA) is a hypersensitivity lung disease triggered by sensitization to Aspergillus fumigatus or other Aspergillus species, with 1.0%-3.5% incidence in asthma patients and 7%-15% i...
Allergic bronchopulmonary aspergillosis (ABPA) is a hypersensitivity lung disease triggered by sensitization to Aspergillus fumigatus or other Aspergillus species, with 1.0%-3.5% incidence in asthma patients and 7%-15% incidence in cystic fibrosis patients. It is more common in patients with asthma or cystic fibrosis. Clinical manifestations include recurrent bronchial obstruction, cough, pulmonary infiltrates, and bronchiectasis. However, its actual incidence is likely underestimated due to complex diagnostic criteria and insufficient clinical awareness. To standardize the integrated traditional Chinese and western medicine practice for ABPA, exert the advantage of synergistic efficacy of Chinese and western medicine, and improve the comprehensive diagnostic and therapeutic level, the Professional Committee of Allergy of the Chinese Association of Integrated Traditional and western Medicine organized multidisciplinary experts to formulate this consensus. This consensus defines diagnostic criteria, clinical classification and long-term management plans of ABPA, emphasizes the importance of environmental control and screening in high-risk populations, and systematically outlines an integrated diagnosis and treatment strategy combining western and traditional Chinese medicine. Western medicine is based on corticosteroids and antifungal agents, with biologics such as omalizumab representing an emerging option, while traditional Chinese medicine contributes through syndrome differentiation and treatment-addressing patterns such as "wind invading the lung" and "phlegm-stasis binding"-combined with proprietary Chinese medicines and acupuncture to enhance efficacy, with the aim of providing standardized guidance for clinical practice.
[Expert consensus on external cerebrospinal fluid drainage management in neurocritical care patients (2026 edition)].
Chinese Society of Neurosurgery, Chinese Neurocritical Care Management Collaborative Group
Zhonghua Yi Xue Za Zhi · 2026 May · PMID 42103675 · Publisher ↗
Extracerebral cerebrospinal fluid drainage is a commonly used treatment in the management of neurosurgical intensive care patients, primarily including external ventricular drainage (EVD) and lumbar cistern drainage (LD)...
Extracerebral cerebrospinal fluid drainage is a commonly used treatment in the management of neurosurgical intensive care patients, primarily including external ventricular drainage (EVD) and lumbar cistern drainage (LD). To further standardize the clinical application and management of extracerebral cerebrospinal fluid drainage in neurosurgical intensive care patients, Chinese Society of Neurosurgery and China Neurocritical Care Management Collaborative Group organized experts in the field to update and revise the based on the latest evidence-based medical evidence. This consensus systematically reviews domestic and international literature, covering the indications for EVD and LD, the management of drainage procedures, and the handling of complications. Through two rounds of Delphi method expert evaluations, 24 recommendations were ultimately formulated to provide scientific and standardized guidance for clinical practice, enhancing the safety and efficacy of extracerebral cerebrospinal fluid drainage.
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