Zhonghua Yi Xue Za Zhi[JOURNAL]
Sun
200 papers
[Initial investigation on the discipline system for reviewology: medicine as an example].
Zhao YM, Getu RGT
Zhonghua Yi Xue Za Zhi · 2026 May · PMID 42103674 · Publisher ↗
Academic journal peer review lacks disciplinary support due to uneven quality of peer review and inconsistent comments. Based on long-term experience in peer review and professional journal publishing, the authors put fo...
Academic journal peer review lacks disciplinary support due to uneven quality of peer review and inconsistent comments. Based on long-term experience in peer review and professional journal publishing, the authors put forward some suggestions on establishing the discipline of reviewology. According to the requirements of the discipline system, this paper puts forward the basic framework of the theoretical system, methodology system and technical system of reviewology for academic discussion. The basic framework is mainly based on the universal rules involved in academic journal peer review, supplemented by special cases of medical research. This paper discusses the background of reviewology emergence, problems and challenges it faces, the social significance and academic value, as well as issues related to artificial intelligence.
[Chinese clinical practice guidelines for transarterial interventions of hepatocellular carcinoma (2026 edition)].
Clinical Guidelines Committee of Chinese College of Interventionalists
Zhonghua Yi Xue Za Zhi · 2026 Jun · PMID 42097631 · Publisher ↗
Transarterial interventions (TAI) for hepatocellular carcinoma (HCC) include transarterial chemoembolization (TACE), transarterial embolization (TAE), hepatic arterial infusion chemotherapy (HAIC), and selective internal...
Transarterial interventions (TAI) for hepatocellular carcinoma (HCC) include transarterial chemoembolization (TACE), transarterial embolization (TAE), hepatic arterial infusion chemotherapy (HAIC), and selective internal radiation therapy (SIRT). TACE remains the first-line treatment for unresectable HCC. Chinese College of Interventionalists (CCI) previously issued and updated the Chinese Clinical Practice Guidelines of TACE for HCC in 2018, 2021, and 2023, which have played a pivotal role in standardizing TACE procedures in China. In recent years, the application of HAIC and SIRT has become increasingly widespread and standardized in China. With the continuous advancement of TAI techniques, the evolution of therapeutic concepts, and the emergence of high-level evidence, CCI has comprehensively revised and expanded its previous guidelines. The updated Chinese clinical practice guidelines for transarterial interventions of hepatocellular carcinoma (2026 edition) now formally incorporates TACE, HAIC, and SIRT as standard treatment modalities. With the aims to further standardize the use of TAI in the management of HCC, this guideline is developed based on the most current evidence-based medical research, integrates China-specific clinical practices, and incorporates the latest advancements in TAI for HCC. It elaborates on clinical diagnostic criteria and staging, patient indications and contraindications, operational procedures and requirements, perioperative management, common complications management, follow-up and efficacy evaluation, combination therapy, quality control, as well as hot topics and prospects.
[Clinical and genetic characteristics of patients with mucosa-associated lymphoid tissue lymphoma transformed into diffuse large B-cell lymphoma].
Ma RJ, Zhou P, Liu YB … +11 more , Zhuo JH, Wang LF, Li S, Lu WY, Pei XH, Zuo SQ, Xu H, Jiang L, Chen XL, Yuan XL, Zhu ZM
Zhonghua Yi Xue Za Zhi · 2026 Jun · PMID 42097630 · Publisher ↗
To analyze the clinical and genetic characteristics of patients with mucosa-associated lymphoid tissue (MALT) lymphoma transformed into diffuse large B-cell lymphoma (DLBCL). A retrospective analysis was performed on pat...
To analyze the clinical and genetic characteristics of patients with mucosa-associated lymphoid tissue (MALT) lymphoma transformed into diffuse large B-cell lymphoma (DLBCL). A retrospective analysis was performed on patients diagnosed with MALT lymphoma at Henan Provincial People's Hospital from January 2016 to December 2025. According to whether DLBCL transformation occurred, the patients were divided into the transformed group (MALT lymphoma patients who developed DLBCL transformation) and the non-transformed group. The patients were followed up until December 30, 2025, and the clinical and genetic characteristics were compared between the two groups. A total of 175 patients were included, including 13 patients in the transformation group, 4 males and 9 females, aged (58±18) years; and 162 pattients in the non-transformed group, 73 males and 89 females, aged (57±12) years.The incidence of B symptoms in the transformed group [46.2% (6/13) vs 16.7% (27/162), =0.018], the proportion with a MALT-international prognostic index (IPI) score≥2 point [69.2% (9/13) vs 17.3% (28/162), <0.001], and lactate dehydrogenase (LDH) levels [227 (194, 262) vs 173 (146, 196) U/L, <0.001] were all higher than those in the non-transformed group. The mutation rate of gene in the transformed group [84.6% (11/13) vs 45.7% (74/162), =0.007] and the mutation rate of ≥2 genes [69.2% (9/13) vs 17.3% (28/162), <0.001] were both higher than those in the non-transformed group. The mutation rates of the NOTCH1 gene [23.1% (3/13) vs 3.7% (6/162), =0.021], the SOCS1 gene [15.4% (2/13) vs 0, =0.005], and the KRAS gene [15.4% (2/13) vs 0, =0.005] were all higher in the transformed group than those in the non-transformed group. Patients with MALT lymphoma who transformed to DLBCL are often accompanied by B symptoms, a higher MALT-IPI score, elevated LDH and multiple gene mutations, and the mutation frequencies of NOTCH1, SOCS1, and KRAS are higher.
[Causes and management strategies for unplanned reoperation after endoscopic middle ear surgery].
Zhou F, Wang ZL, Li YM … +1 more , Chen X
Zhonghua Yi Xue Za Zhi · 2026 Apr · PMID 42049527 · Publisher ↗
The clinical data of 24 patients (25 ears) aged (42.4±13.5) years who underwent unplanned reoperation in the Affiliated People's Hospital of Fujian University of Traditional Chinese Medicine between January 2018 and May...
The clinical data of 24 patients (25 ears) aged (42.4±13.5) years who underwent unplanned reoperation in the Affiliated People's Hospital of Fujian University of Traditional Chinese Medicine between January 2018 and May 2025 were retrospectively analyzed, including 12 males and 12 females. The main reasons for the reoperation were tympanic adhesion/granulation hyperplasia (68.0%, 17/25), displacement/dislocation of artificial ossicles (32.0%, 8/25), reperforation of tympanic membrane (32.0%, 8/25), and recurrence of cholesteatoma (28.0%, 7/25). The air-bone conductance differences at each frequency were significantly reduced after the reoperation (<0.001). The reoperation rate can be reduced by preserving the normal tympanic membrane mucosa, using anti-adhesion materials, repairing the tympanic membrane with the sandwich method, implanting the complete type artificial ossicle with the Ω-shaped base plate, and thoroughly removing the cholesteatoma epithelium, and other preventive and therapeutic strategies.
[Current status of artificial intelligence applications in cervical cancer screening: a systematic review].
Zhao ZY, Zheng QJ, Zhao XL … +2 more , Zhao FH, Zhang Y
Zhonghua Yi Xue Za Zhi · 2026 Apr · PMID 42049526 · Publisher ↗
To systematically summarize and evaluate the current application status and research progress of artificial intelligence (AI) in cervical cancer screening in China. Literature related to the application of AI in cervica...
To systematically summarize and evaluate the current application status and research progress of artificial intelligence (AI) in cervical cancer screening in China. Literature related to the application of AI in cervical cancer screening in China was searched in PubMed, Embase, Cochrane Library, IEEE, China National Knowledge Infrastructure (CNKI), and Wanfang Database using the keywords"cervical cancer","artificial intelligence","screening","machine learning","deep learning","neural network","uterine cervical neoplasms,"uterine cervical tumor","diagnosis", and"China". The search was limited to studies published in Chinese and English. As of July 2025, a total of 35 eligible articles were included. Basic information from the included studies was extracted and summarized. In addition, the National Medical Products Administration (NMPA) official website was searched using the term"cervix"to identify approved AI-assisted cervical cancer screening products. A total of 21 AI-assisted cervical cancer screening technologies were identified, including 17 technologies for primary screening, mainly AI-assisted cytology, and 4 technologies for colposcopic diagnosis. For AI-assisted cytology, the sensitivity ranged from 67.5% to 100.0% and the specificity ranged from 9.9% to 99.8% in hospital-based populations, with the overall accuracy of some technologies exceeding 90%. In community-based screening populations, the sensitivity ranged from 83.0% to 100.0% and the specificity ranged from 74.2% to 99.9%. Most studies suggested that AI could improve the diagnostic performance of pathologists to some extent, shorten the average slide-reading time, and enhance overall screening efficiency. A total of 24 AI-assisted cervical cancer screening products have been approved by the NMPA, all of which are AI-assisted cytology technologies, and corresponding studies were identified for 8 of these products. For AI-assisted colposcopic diagnosis used as a standalone screening modality, the sensitivity and specificity for identifying cervical intraepithelial neoplasia grade 2 (CIN2) or worse ranged from 43.6% to 95.5% and from 51.8% to 93.9%, respectively; for cervical intraepithelial neoplasia grade 3 (CIN3) or worse, the sensitivity ranged from 35.1% to 97.5% and the specificity ranged from 56.6% to 87.2%. In the physician-assisting mode, the sensitivity increased to 95.1%-97.5%, with improvements in interobserver consistency and diagnostic accuracy among less experienced colposcopists. AI has shown promising potential in cervical cancer screening in China. However, more scientific evidence is needed to determine whether it can be effectively integrated into the existing cervical cancer prevention and control system in China.
[Impact of perioperative transcutaneous auricular vagus nerve stimulation on pain and sleep quality after glaucoma surgery].
Wang Y, Shen WJ, Du YJ … +4 more , Xue JB, Xi CH, Li H, Wang GY
Zhonghua Yi Xue Za Zhi · 2026 Apr · PMID 42049525 · Publisher ↗
To investigate the effects of perioperative transcutaneous auricular vagus nerve stimulation (taVNS) on postoperative pain and early sleep quality in patients undergoing glaucoma surgery under general anesthesia. A tota...
To investigate the effects of perioperative transcutaneous auricular vagus nerve stimulation (taVNS) on postoperative pain and early sleep quality in patients undergoing glaucoma surgery under general anesthesia. A total of 94 hospitalized patients scheduled for elective glaucoma surgery under general anesthesia at Beijing Tongren Hospital, Capital Medical University, from April to August 2024 were prospectively enrolled and randomly assigned using a random number table to either the taVNS group (=47) or the sham stimulation group (s-taVNS group) (=47). In the taVNS group, active electrical stimulation was applied to the left auricular concha area starting from 2 days before surgery, while the s-taVNS group received electrode placement without current output. Stimulation was performed twice daily for 30 min each session until the first postoperative day. The primary outcome was the incidence of moderate to severe pain within 24 hours after surgery, defined as a Numeric Rating Scale (NRS) score≥4 score. Secondary outcomes included NRS scores at different time points, use of rescue analgesics, insomnia severity index (ISI) scores. Comparisons were made between the two groups regarding the primary and secondary outcome measures. The taVNS group included 27 males and 20 females, aged (56.5±11.3) years; the s-taVNS group included 26 males and 21 females, aged (58.4±9.7) years, with no significant differences in age or gender between the two groups (all >0.05). The incidence of moderate to severe pain within 24 hours after surgery was lower in the taVNS group than in the s-taVNS group [14.9% (7/47) v. 38.3% (18/47), =0.010]. The proportion of patients requiring acetaminophen for rescue analgesia within 24 hours postoperatively was lower in the taVNS group than in the s-taVNS group [8.5% (4/47) vs 23.4% (11/47), =0.049]. The ISI score on the first postoperative night was lower in the taVNS group than in the s-taVNS group [(3.1±2.7) score vs (5.7±4.3) score, =0.018]. Perioperative taVNS can effectively reduce the incidence of moderate to severe postoperative pain and improve early postoperative sleep quality in patients undergoing glaucoma surgery under general anesthesia.
[Multicenter component-resolved study of inhalant allergen sensitization and cross-reactivity in airway allergic patients].
Liu L, Zhang JL, Chen QY … +3 more , Chang B, Luo WT, Sun BQ
Zhonghua Yi Xue Za Zhi · 2026 Apr · PMID 42049524 · Publisher ↗
To investigate the molecular sensitization profiles of inhalant allergens in Chinese patients with airway allergies using component-resolved diagnosis (CRD) and to analyze their distributional characteristics. In this c...
To investigate the molecular sensitization profiles of inhalant allergens in Chinese patients with airway allergies using component-resolved diagnosis (CRD) and to analyze their distributional characteristics. In this cross-sectional study, allergen component testing data were collected from 225 patients diagnosed with allergic rhinitis (AR) and/or allergic asthma (AS) across 20 medical centers in 13 provinces (Northern, Southern, and Northwestern China) between October 2019 and January 2023. Specific immunoglobulin E (sIgE) levels for 132 components were analyzed. Sensitization differences were compared across clinical phenotypes, age stratifications, and geographical regions. Spearman correlation analysis was employed to evaluate molecular cross-reactivity. Among the 225 patients [mean age: (19.40±17.53) years; 119 males, 106 females], children aged 0-6 and 7-14 years accounted for 58.67% (132/225). Regarding overall distribution, the predominant sensitizing components were (Art v 1, 43.11%), dust mites (Der p 2, 39.11%; Der f 2, 38.22%), and (Phl p 12, 39.11%). Phenotypically, while the AR combined with AS group exhibited the broadest polysensitization, the AR only group was distinct for its significantly higher sensitization to cat (Fel d 1, 68.42%) and dog (Can f 1,36.84%) dander (both <0.05). Conversely, pollen sensitization was relatively lower in the AS only group. Regarding age, children (0-6 and 7-14 years) showed early sensitization to pan-allergens (e.g., Phl p 12, Bet v 2) and fungi (Alt a 1), whereas dust mite components (Der f 2, Der p 2, Der p 23) showed lower prevalence in the 0-6 group (23.19%, 23.19%, and 10.14%, respectively). Regional analysis highlighted a "Northern Pollen vs Southern Mite" dichotomy: weeds (Artemisia>60%) and tree pollen dominated the Northwest and North, whereas mites (>60%) and cockroaches dominated the South (<0.001). Furthermore, extensive molecular cross-reactivity was confirmed within the Serum Albumin and Profilin families. Significant heterogeneity exists in sensitization profiles across phenotypes, ages, and regions. Mugwort and mites are core allergens. CRD facilitates the identification of cross-reactivity and guides precise, regionalized management.
[Impact of house dust mite subcutaneous immunotherapy on plasma protein profiles in children with asthma].
Li JY, Shen WX, Xu LN … +7 more , Wang YF, Zhou J, Yang QY, Li DZ, Zhang GG, Xue JT, Hao CL
Zhonghua Yi Xue Za Zhi · 2026 Apr · PMID 42049523 · Publisher ↗
Preliminary analysis of dynamic expression characteristics of plasma proteins in children with allergic asthma during subcutaneous immunotherapy (SCIT) with dust mite allergens based on multi-time-point proteomics techno...
Preliminary analysis of dynamic expression characteristics of plasma proteins in children with allergic asthma during subcutaneous immunotherapy (SCIT) with dust mite allergens based on multi-time-point proteomics technology. A cross-sectional study was conducted, enrolling 84 children with allergic asthma primarily sensitized to house dust mites (HDM) who visited the Children's Hospital of Soochow University between November 2024 and May 2025. Participants were categorized into five groups based on the duration of SCIT: 0M, 3M, 6M, 12M, and 24M. To detect the levels of specific immunoglobulin E (sIgE) and specific immunoglobulin G4 (sIgG4) against dust mite components (Der p1, Der f1, Der p2, Der f2, Der p5, Der p7, Der p10, Der p21, Der p23). Five subjects were randomly selected from each group using simple random sampling, and an additional 5 healthy children (HC) were included as the control group for plasma proteomic analysis. The temporal expression patterns of differentially expressed proteins were clustered via the Mfuzz algorithm and subjected to functional annotation. A total of 84 children were enrolled, with a mean age of (10.12±2.15) years, including 57 males and 27 females. Statistically significant differences were observed in Der p1-, Der f1-, Der p2-, and Der f2-specific IgG4 levels among the five groups (all P<0.05). The 24M group exhibited significantly higher levels of Der p1-, Der f1-, Der p2-, and Der f2-specific IgG4 compared with the 0M group [Der p1: 695.20 (57.85, 1 894.60) vs 44.35 (32.10, 51.10); Der f1: 70.15 (51.35, 1 141.03) vs 46.65 (35.30, 63.68); Der p2: 3 440.20 (892.20, 4 183.00) vs 66.85 (43.08, 189.98); Der f2: 2 015.50 (704.60, 2 523.10) vs 69.10 (45.80, 159.35), all <0.05]. Enrichment analysis of differentially expressed proteins in each group using the Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway database showed that: compared with the healthy control group, the 0M group exhibited upregulation of cholesterol metabolism and complement/coagulation cascades, and downregulation of cornified envelope formation and ECM-receptor interaction pathways. compared with the 0M group, the 3M group showed upregulation of ECM-receptor interaction and focal adhesion and downregulation of fatty acid metabolism. The 6M group showed upregulation of cell adhesion molecules and downregulation of cholesterol metabolism; the 12M and 24M groups showed upregulation of TGF-β and PI3K-Akt pathways. Fuzzy C-means clustering analysis revealed that proteins highly expressed in the 6M group were enriched in glutathione metabolism, while those in the 24M group were significantly enriched in B cell-mediated immune responses. Six potential regulatory proteins (ARPC3, LPL, ILF3, FARSB, USP14, and SLIT2) were initially identified. Furthermore, Spearman correlation analysis revealed that ARPC3 was significantly negatively correlated with the levels of Der f2-sIgE, Der p2-sIgG4, and Der f2-sIgG4 (=-0.44, -0.57, -0.54, respectively, all <0.05). Additionally, ILF3 was positively correlated with Der p21-sIgE (=0.57, <0.01), FARSB was negatively correlated with Der p2-sIgG4 (=-0.44, <0.01), and USP14 was negatively correlated with Der f1-sIgE (=-0.46, <0.05). Differences exist in allergen antibody and plasma protein expression profiles among children with allergic asthma across groups with different durations of SCIT. The differentially expressed proteins may be involved in pathways related to airway epithelial barrier, metabolic homeostasis and immune regulation.
[Efficacy of pre-pollen season medication for seasonal allergic rhinitis and asthma in children from Hohhot].
Zhang XH, Wang W, Wulan LTY … +5 more , Wang W, Na HY, Cai HJ, Wang HT, Zhang JJ
Zhonghua Yi Xue Za Zhi · 2026 Apr · PMID 42049522 · Publisher ↗
To investigate the efficacy and optimal timing of prophylactic medication before pollen season for children with seasonal allergic rhinitis (AR) and allergic asthma (AA) in Hohhot. A prospective, self-controlled study w...
To investigate the efficacy and optimal timing of prophylactic medication before pollen season for children with seasonal allergic rhinitis (AR) and allergic asthma (AA) in Hohhot. A prospective, self-controlled study was conducted. Children aged 4-14 years who were diagnosed with AR or AR+AA in Hohhot First Hospital from January to August 2024 were enrolled, with the same patients undergoing self-medication in 2024 pollen season as the controls. Before 2025 pollen season, children were stratified into eight groups based on disease type (AR/AR+AA), severity of disease (mild/moderate-severe), and onset season (spring/autumn). For each group, prophylactic medication was initiated at 5, 10, 15, and 20 days before the season, respectively. Symptom onset time, symptomatic days, visual analogue scale (VAS) score, total medication score (TMS), and childhood asthma control test (C-ACT) score were compared between the two groups. A total of 312 children were included in the study, consisting of 183 males (58.7%) and 129 females (41.3%), with a mean age of (8.6±3.0) years. After initiating medication 5, 10, and 15 days before the season for mild spring, moderate-severe spring and mild autumn, and moderate-severe autumn AR cases, respectively, children experienced significantly shorter symptomatic periods and lower VAS scores than those in the self-medication group (all <0.01). For children with AR+AA, clinical indicators (symptomatic days, VAS score, and C-ACT score) were significantly improved after initiating medication 15 days in advance for mild spring cases and 20 days in advance for other subgroups (all <0.01). The proportions of pre-season symptoms in the prophylactic medication groups were lower, and TMS scores were higher (all <0.01). Stratified prophylactic medication based on disease severity before the pollen season can delay symptom onset, alleviate symptom severity, and shorten the duration of symptoms in children with AR and AA.
[Arachidonic acid metabolic characteristics of allergic bronchopulmonary aspergillosis and their value in differential diagnosis].
Wang Q, Liu ZY, Liu MT … +3 more , Li J, Zheng PY, Sun BQ
Zhonghua Yi Xue Za Zhi · 2026 Apr · PMID 42049521 · Publisher ↗
To investigate the characteristics of 14 arachidonic acid (AA) metabolites in the serum of patients with allergic bronchopulmonary aspergillosis (ABPA), screen for differential metabolic biomarkers that can distinguish i...
To investigate the characteristics of 14 arachidonic acid (AA) metabolites in the serum of patients with allergic bronchopulmonary aspergillosis (ABPA), screen for differential metabolic biomarkers that can distinguish it from severe allergic asthma (SA), and construct a diagnostic model. A cross-sectional study was conducted. A total of 19 patients with ABPA, 19 patients with SA, and 19 healthy controls (HC) from the First Affiliated Hospital of Guangzhou Medical University between December 2024 and July 2025 were enrolled as the training set. Additionally, a validation set consisting of 12 SA patients and 12 ABPA patients was recruited from the same center between September to December 2025. Peripheral blood cell counts and immunological and biochemical parameters were measured in all participants. Absolute quantification of 14 AA metabolites in serum was performed using ultra-high performance liquid chromatography-tandem mass spectrometry (UPLC-MS/MS) based on 5-(diisopropylamino) pentylamine derivative. Differences among groups were compared to identify significantly altered metabolites. In the training set, a combined clinical and metabolic indicator model was constructed using binary logistic regression. The diagnostic performance, calibration and clinical utility of the model were evaluated using receiver operating characteristic (ROC) curves, calibration curves, and decision curve analysis, respectively. The model was further validated in the validation set. A total of 19 patients in the ABPA group were enrolled, aged 45 (33, 60) years, with 12 males; 19 patients in the SA group were aged 39 (29, 47) years, with 11 males; and 19 subjects in the HC group were aged 43 (34, 52) years, with 11 males. Compared with the SA group, patients with ABPA exhibited significantly higher levels of total IgE [1 578.00 (1 346.00, 2 538.00) U/ml vs 599.30 (382.20, 1 462.00) U/ml] and -specific IgE (.sIgE) [4.93 (0.95, 8.41) kUA/L vs 0.27 (0.13, 2.17) kUA/L] (both <0.05). Serum levels of arachidonic acid (AA), prostaglandin D (PGD), leukotriene B (LTB), 5-hydroxyeicosatetraenoic acid (HETE), 12-HETE, and 15-HETE were significantly higher in the ABPA group than in the HC group (all <0.05). Moreover, PGD [1.80 (0.82, 2.13) μg/L vs 0.63 (0.37, 1.15) μg/L] and 15-HETE levels [16.39 (11.15, 20.41) μg/L vs 9.31 (6.57, 10.86) μg/L] were significantly elevated in the ABPA group compared with the SA group. A four-indicator combined diagnostic model incorporating total IgE, .sIgE, PGD, and 15-HETE was constructed. In the training set, the area under the curve (AUC) of the four-indicator combined model was 0.96 (95%: 0.92-1.00), with a sensitivity of 0.93 and specificity of 0.95. In the validation set, the AUC was 0.91 (95%: 0.81-1.00), with a sensitivity of 0.92 and specificity of 0.83. Calibration curves showed good consistency for the four-indicator model across all datasets, and decision curve analysis indicated favorable clinical applicability. ABPA patients exhibit characteristic AA metabolic disorders, and their characteristically elevated serum PGD2 and 15-HETE are potential specific biomarkers for differentiating ABPA from SA. The constructed four-indicator combined model including total IgE, .sIgE, PGD, and 15-HETE has good diagnostic efficacy in differentiating ABPA from SA.
[Clinical practice guidelines for perioperative monitoring in elderly patients (2026 edition)].
Geriatric Anesthesia and Perioperative Management Group of the Chinese Society of Anesthesiology, National Alliance of Geriatric Anesthesia
Zhonghua Yi Xue Za Zhi · 2026 Apr · PMID 42049520 · Publisher ↗
Standardizing perioperative monitoring practices for elderly patients hold significant importance for systematic surgical risk management, optimizing healthcare resource allocation, and implementing the "Healthy Aging" s...
Standardizing perioperative monitoring practices for elderly patients hold significant importance for systematic surgical risk management, optimizing healthcare resource allocation, and implementing the "Healthy Aging" strategy. Accordingly, the Geriatric Anesthesia and Perioperative Management Group of the Chinese Society of Anesthesiology, in collaboration with the National Alliance of Geriatric Anesthesia has developed the "Clinical practice guidelines for perioperative monitoring in elderly patients (2026 edition)" based on China's clinical realities and available evidence. The guideline covers core perioperative monitoring domains, including basic vital signs and cerebral, cardiac, pulmonary, coagulation, renal, and hepatic functions, resulting in 26 recommendations. It aims to provide standardized perioperative monitoring guidance for elderly surgical patients, transforming advanced age as an independent risk factor into quantifiable and intervenable clinical pathways.
[Clinical practice guideline for integrated PET/MRI in Parkinson's disease (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 Apr · PMID 42049519 · Publisher ↗
To advance the precise diagnosis and treatment of Parkinson's disease (PD) and related movement disorders, standardize the clinical application of integrated PET/MRI, enhance diagnostic efficacy, and optimize patient man...
To advance the precise diagnosis and treatment of Parkinson's disease (PD) and related movement disorders, standardize the clinical application of integrated PET/MRI, enhance diagnostic efficacy, and optimize patient management, the was developed jointly by multiple expert groups. This initiative was led by the Chinese Society of Medical Imaging Technology, the Radiological Society of Chinese Medical Association, the Chinese Society of Nuclear Medicine, the Beijing Society of Nuclear Medicine, and the Beijing Society of Radiology, in collaboration with a multidisciplinary panel of experts from Nuclear Medicine, Radiology, Neurology, and Functional Neurosurgery, following several rounds of consensus meetings. Compared to previous consensus statements or technical specifications, the key updates of this guideline include: in the clinical application pathway, it clarifies the advantages and appropriate scenarios for utilizing integrated PET/MRI over single-modality imaging when the clinical diagnosis of PD is uncertain; it emphasizes the value of simultaneous acquisition and fusion analysis in assessing both the function of the nigrostriatal dopaminergic pathway (e.g., via PET tracers) and structural alterations (e.g., via MRI neuromelanin imaging, diffusion tensor imaging, etc.). With the development and validation of novel tracers, the guideline provides a hierarchical recommendation for the differential diagnosis between PD and atypical parkinsonian syndromes (such as multiple system atrophy, progressive supranuclear palsy, and corticobasal degeneration), based on multimodal imaging biomarkers. Based on the premise of the accessibility of current integrated PET/MRI equipment and tracers in China, and grounded in the latest international and domestic evidence-based research, this guideline is meticulously aligned with the realities of Chinese clinical practice. It systematically delineates the technical specifications, clinical indications, and image interpretation criteria for the use of integrated PET/MRI in the diagnosis, differential diagnosis, disease severity assessment, and therapeutic decision support for PD. The aim is to provide systematic and practical evidence-based guidance for clinicians and imaging specialists involved in the care of patients with Parkinson's disease.
[Clinical practice guideline for integrated PET/MRI in Alzheimer's disease (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 Apr · PMID 42049518 · Publisher ↗
To further standardize the clinical use of integrated PET/MRI brain imaging for Alzheimer's disease (AD) in China, improve early identification and precision diagnosis and management of AD, promote standardized care, and...
To further standardize the clinical use of integrated PET/MRI brain imaging for Alzheimer's disease (AD) in China, improve early identification and precision diagnosis and management of AD, promote standardized care, 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. AD is one of the most common forms of dementia in older adults, with an insidious course; early diagnosis and timely intervention are crucial to improving patient outcomes. Integrated PET/MRI enables the simultaneous, one-stop acquisition of multidimensional information-including cerebral amyloid burden, brain metabolism, and high-resolution anatomical detail-and can be used for early diagnosis, clinical staging, assessment of disease progression, and clinical trial research, making it an important imaging tool for precision care in AD. 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-indications, examination and quality-control procedures, image interpretation, and standardized reporting-with the aim of promoting the standardized use of integrated PET/MRI in AD care and advancing research and translation of relevant imaging biomarkers.
[Precision medicine in the diagnosis of allergic airway diseases: current applications and future directions].
Liu ZY, Wang Q, Sun BQ
Zhonghua Yi Xue Za Zhi · 2026 Apr · PMID 42049517 · Publisher ↗
The rapid advancement of precision medicine is shifting the clinical diagnosis of allergic airway diseases away from traditional models that rely solely on symptoms and phenotypes, and toward individualized, precision-ba...
The rapid advancement of precision medicine is shifting the clinical diagnosis of allergic airway diseases away from traditional models that rely solely on symptoms and phenotypes, and toward individualized, precision-based diagnoses that are molecularly driven. This review describes the role of established biomarker systems, such as eosinophil count, fractional exhaled nitric oxide, and specific immunoglobulin E, in inflammatory endotyping and targeted therapy. Furthermore, the integration of multi-omics technologies and artificial intelligence algorithms facilitates the elucidation of disease heterogeneity and molecular mechanisms, thereby advancing precision stratification. The proposal of this article is an integrated precision diagnostic framework combining multi-dimensional data integration, dynamic monitoring, and intelligent analysis. By establishing a systematic biomarker evaluation pathway, this framework aims to promote the application of real-time monitoring technologies and AI-assisted decision-making, thereby providing a reference for the optimization and evolution of next-generation precision diagnostic systems.
[Expert consensus on the standardized construction and management of biobanks for allergic diseases (2026 edition)].
Allergy Prevention and Control Committee, Chinese Preventive Medicine Association, Chinese Society of Allergy, Chinese Medical Association, National Clinical Research Center for Respiratory Diseases … +2 more , Guangdong Preventive Medicine Association′s Translational and Innovative Committee of Laboratory Medicine, Guangdong Research Hospitals Association′s Translational and Development Committee of Laboratory Medicine
Zhonghua Yi Xue Za Zhi · 2026 Apr · PMID 42003112 · Publisher ↗
To standardize the construction and management of biobanks for allergic diseases in China and promote the deep integration of clinical resources with research needs, the Allergy Prevention and Control Committee of the Ch...
To standardize the construction and management of biobanks for allergic diseases in China and promote the deep integration of clinical resources with research needs, the Allergy Prevention and Control Committee of the Chinese Preventive Medicine Association, the Chinese Society of Allergy of the Chinese Medical Association, and the National Clinical Research Center for Respiratory Diseases, among other institutions, jointly led the development of the "Expert consensus on the standardized construction and management of biobanks for allergic diseases (2026 edition)". This consensus was formulated based on the "Guidelines for the Development/Revision of Clinical Practice Guidelines in China (2022 edition)" and the GRADE (Grading of Recommendations Assessment, Development and Evaluation) system, through multidisciplinary expert discussions and Delphi voting. The content covers strategic positioning, standardized collection and processing, ethical and privacy protection, information management and data governance, full-process quality control, biosafety risk prevention, and personnel development. The consensus puts forward 10 recommendations, emphasizes a collaborative mechanism of "co-construction, co-management, and sharing", and provides scientific and actionable practical guidance tailored to China's regional characteristics. It aims to advance the development of precision medicine for allergic diseases and contribute China's expertise to global allergy research.
[Clinical features of 13 children with neuronal ceroid lipofuscinosis type 2].
Liu K, Zhao HQ, Zhang Q … +4 more , Chen C, Chen J, Huang Y, Zou LP
Zhonghua Yi Xue Za Zhi · 2026 Apr · PMID 41986128 · Publisher ↗
Clinical data were retrospectively collected from 13 children with type 2 neuronal ceroid lipofuscinosis (CLN2) who underwent genetic testing for definitive diagnosis and were followed up at the Chinese PLA General Hospi...
Clinical data were retrospectively collected from 13 children with type 2 neuronal ceroid lipofuscinosis (CLN2) who underwent genetic testing for definitive diagnosis and were followed up at the Chinese PLA General Hospital from January 2018 to December 2023. The clinical features, disease progression, and prognosis were analyzed. The age at onset was [()] 3.7 (3.2, 4.5) years, including 7 males and 6 females. The follow-up was conducted once every 3 months during the first 2 years after diagnosis, and once every 6 months starting from the 3rd year, with the last follow-up until December 2025. All patients presented with epilepsy as the initial manifestation, of whom 8 patients had myoclonic seizures. Psychomotor regression occurred in 10 patients shortly after seizure onset. Tripeptidyl peptidase 1 (TPP1) activity was below the normal reference range in all patients, and all harbored biallelic pathogenic or likely pathogenic variants in the TPP1 gene. Brain magnetic resonance imaging revealed cerebellar atrophy in all cases, and electroencephalography demonstrated generalized abnormalities in all patients. Disease progression exhibited relatively distinct stage-wise features. Within>1-2 years of onset, eleven patients developed ataxia and 10 experienced language regression. Within>2-3 years, ten patients had lost independent ambulation and 9 had lost language function. Within>3-5 years, all patients lost motor and language abilities, and 10 developed severe dysphagia. Five patients died during follow-up. In conclusion, CLN2 typically presents in early childhood with epilepsy as the predominant initial manifestation, followed by progressive neurofunctional decline and cerebellar atrophy. Markedly reduced TPP1 activity together with pathogenic TPP1 variants supports the diagnosis.
[Efficacy of rituximab in patients with EB virus-related hemophagocytic syndrome caused by B lymphocyte infection].
Cao JW, Han Q, Qiao Y … +2 more , Wang Z, Wu L
Zhonghua Yi Xue Za Zhi · 2026 Apr · PMID 41986127 · Publisher ↗
To explore the efficacy of rituximab in treating patients with EB virus-related hemophagocytic syndrome (EBV-HLH) caused by B lymphocyte infection. A retrospective analysis was conducted on the data of patients diagnosed...
To explore the efficacy of rituximab in treating patients with EB virus-related hemophagocytic syndrome (EBV-HLH) caused by B lymphocyte infection. A retrospective analysis was conducted on the data of patients diagnosed with EBV-HLH, without hematopoietic stem cell transplantation and receiving rituximab treatment at Beijing Friendship Hospital, Capital Medical University from November 2021 to January 2025. All patients received treatment with a regimen containing rituximab, such as the R-DEP regimen (rituximab+liposomal doxorubicin+etoposide+methylprednisolone), the R+HLH-94 regimen (rituximab+dexamethasone+etoposide+cyclosporine), the R regimen (rituximab), and the R+P-Gemox regimen (rituximab+gemcitabine+oxaliplatin). Follow-up was conducted until August 2025 or until the patients' death to analyze the related efficacy. A total of 20 patients with EBV-HLH who received rituximab-containing regimens were enrolled. There were 11 males and 9 females, with a median age of 40 (range 5-70) years. There were 12, 5, 2, and 1 cases receiving the R-DEP, R, R+HLH-94, and R+P-Gemox regimens, respectively. The median EBV-DNA load in peripheral blood mononuclear cells before treatment was 7 000 (range 590-240 000) copies/ml. The median follow-up time [ (, )] was 15 (6, 24) months, the median survival time was 19 (7, 27) months, and 18 patients survived. The overall disease remission rate after treatment was 95% (19/20), and EBV-DNA was negative in 17 patients. For patients with B lymphocyte infection-related EBV-HLH, early application of a regimen centered on rituximab can effectively eliminate the virus, induce clinical remission, and improve the survival prognosis of patients.
[Efficacy and safety of transvaginal assisted total intracavitary orthotopic neobladder surgery for female urothelial carcinoma of the bladder].
Liang S, Qie YK, Jia KP … +5 more , Bai YD, Chen HY, Huang SW, Zhang Z, Hu HL
Zhonghua Yi Xue Za Zhi · 2026 Apr · PMID 41986126 · Publisher ↗
A retrospective analysis was conducted on the data of 9 female patients with bladder urothelial carcinoma who underwent robot-assisted radical cystectomy and transvaginal-assisted total intracavitary orthotopic neobladde...
A retrospective analysis was conducted on the data of 9 female patients with bladder urothelial carcinoma who underwent robot-assisted radical cystectomy and transvaginal-assisted total intracavitary orthotopic neobladder surgery in the Department of Urology, the Second Hospital of Tianjin Medical University from January 2022 to August 2025. Perioperative indicators (overall operation time, neobladder construction time, intraoperative blood loss, and recovery time of intestinal function) were observed postoperatively. The National Aeronautics and Space Administration-Task Load Index (NASA-TLX) score of the chief surgeon was evaluated and the learning curve was drawn using the cumulative sum (CUSUM) method. Postoperative complications within 30 days (using the Clavien-Dindo classification) and the recovery of urinary control function at 1, 6, and 12 months after surgery were followed up. The tumor control and other indicators were evaluated every 3 months within 2 years and every 6 months from the third year after surgery. The age of patients was (51.3±11.0) years, body mass index was (19.5±4.2) kg/m², and the American Society of Anesthesiologists score was 1-2 points. The overall operation time was (342.5±58.3) min, the neobladder construction time was (121.7±22.6) min, the intraoperative blood loss was (150±50) ml, the time to first postoperative exhaust was (1.74±0.63) d, and the NASA-TLX score of the chief surgeon was (66.3±5.5) points. The CUSUM learning curve of neobladder construction time and NASA-TLX score was divided into the learning stage (cases 1-5) and the proficient stage (cases 6-9). Four patients had early postoperative complications (within 30 days after surgery), all of which were Clavien-Dindo grade I-II. At 6 months after surgery, 8 patients had complete dryness during the day and night, and 1 patient had chronic urinary retention. The prognosis was good, with no tumor recurrence or metastasis. The cancer-specific survival (CSS) was 100%. In this study, the transvaginal natural orifice-assisted total intracavitary orthotopic neobladder surgery showed a promising clinical application prospect. The preliminary results indicated that this technique was feasible, had a short learning curve, and had good short-term tumor control and urinary control recovery effects.
[Effect and mechanism of taurocholic acid in promoting colorectal cancer liver metastasis by regulating neutrophil extracellular trap formation].
Yang KJ, Wang YF, Li PL … +2 more , Du LT, Wang CX
Zhonghua Yi Xue Za Zhi · 2026 Apr · PMID 41986125 · Publisher ↗
To investigate the effect and underlying mechanism by which taurocholic acid (TCA) promotes colorectal cancer liver metastasis (CRLM) through regulation of neutrophil extracellular trap (NET) formation. A total of 20 CR...
To investigate the effect and underlying mechanism by which taurocholic acid (TCA) promotes colorectal cancer liver metastasis (CRLM) through regulation of neutrophil extracellular trap (NET) formation. A total of 20 CRLM patients and 20 non-metastatic colorectal cancer (non-mCRC) patients admitted to Qilu Hospital of Shandong University from 2021 to 2022 were retrospectively included. The age of the CRLM patients was (57±12) years, including 11 males and 9 females; the age of the non-mCRC patients was (60±9) years, including 15 males and 5 females. Non-targeted metabolomics was employed to identify differential serum metabolites associated with liver metastasis, and the distinguish efficacy of TCA was evaluated by receiver operating characteristic (ROC) curve analysis. Neutrophils from healthy donors were isolated by density gradient centrifugation. The differentiated HL-60 (dHL-60) model was established by inducing the acute promyelocytic leukemia cell line HL-60 to differentiate into neutrophil-like cells with all-trans retinoic acid (ATRA). The expression characteristics of carcinoembryonic antigen-related cell adhesion molecule 8 (CD66b) and integrin subunit alpha M (CD11b) were detected by flow cytometry. The cell morphology and the proportion of live cells were assessed respectively by wright-giemsa staining and trypan blue staining. In neutrophils and dHL-60 models, cells were divided into a negative control group, a phorbol 12-myristate 13-acetate (PMA, 0.5 μmol/L) positive control group and different concentrations of TCA treatment groups (0.01, 0.1, 1, 10 and 100 μmol/L). The formation of the NET reticular structure after stimulation was observed by Sytox Green staining, and the content of double-stranded deoxyribonucleic acid (ds-DNA) released after stimulation was quantitatively evaluated by PicoGreen. Western blotting was used to detect the expression levels of p44/42 mitogen-activated protein kinase (p44/42 MAPK) and its phosphorylated form (p-p44/42 MAPK), mammalian target of rapamycin (mTOR) and its phosphorylated form (p-mTOR), and peptidylarginine deiminase 4 (PAD4) in dHL-60 following stimulation. NET induced by TCA were divided into a control group, a low-dose NET group (0.1 μg/ml) and a high-dose NET group (0.3 μg/ml) according to dose, and co-cultured respectively with colorectal cancer (CRC) cell lines DLD1 and HCT116. Transwell assay was used to analyze the effect of TCA-induced NET on the migration behavior of CRC cells. The expression levels of epithelial cadherin (E-cadherin), neural cadherin (N-cadherin), and vascular endothelial growth factor A (VEGFA) were detected by Western blotting in CRC cells after co-culture. Comparisons of measurement data between groups were performed using the independent samples -test, Mann-Whitney test, and one-way ANOVA. Comparisons of enumeration data between groups were performed using the χ test or Fisher's exact test. The relative abundance of 64 metabolites, including TCA [ (, )] [4.445 (1.669, 9.579) vs 0.956 (0.649, 1.372), <0.01], in the serum metabolic profile of CRLM patients was higher than that of non-mCRC patients (all <0.05), while the relative abundance of 27 metabolites was lower than that of non-mCRC patients (all <0.05). In the ROC analysis distinguishing the 2 sample groups, TCA achieved an area under the curve (AUC) of 0.873 (95%: 0.741-0.984). In cell identification, both peripheral blood neutrophils and dHL-60 models displayed typical neutrophil morphology: nuclear lobulation and cytoplasm rich in fine neutral granules; the positive rates of CD66b/CD11b were>90%, and the cell viability was>90%. In stimulation of peripheral blood neutrophils for 1 h or 3 h, when the TCA stimulation concentration was greater than 0.01 μmol/L, the formation of NET was more than that of the negative control group (all <0.05). After intervention of dHL-60 for 4 h and 6 h, when the TCA stimulation concentration was greater than 0.1 μmol/L, the NET reticular structure was more than that of the negative control (all <0.05). When the TCA stimulation concentration was greater than 10 μmol/L, the ds-DNA release was higher than that of the negative control group (<0.001). The expression levels of p44/42 MAPK, p-p44/42 MAPK, mTOR, p-mTOR, and PAD4 in the TCA treatment group were higher than those in the negative control group (<0.001). In co-culture experiments of NET and CRC cells, after high-dose NET treatment of DLD1 cells, the expression of E-cadherin was lower than that of the control group (<0.001). After high and low-dose NET treatment of HCT116 cells, the expression of E-cadherin was lower than that of the control group (both <0.001). In both CRC cell lines, after high and low-doses of NET intervention, the expression of N-cadherin and VEGFA was higher than that of the control group (all <0.001), and their migration and invasion abilities were higher than those of the control group (all <0.001). CRLM patients exhibit distinct serum metabolic profiles, among which high-abundance TCA can induce NET release and thereby promote CRC cell metastasis. This process is associated with the activation of the p44/42 MAPK/mTOR signaling pathways in neutrophils and the epithelial-mesenchymal transition in CRC cells.
[Comparison of the efficacy between short-segment instrumentation and simple decompression in the treatment of degenerative lumbar scoliosis with lumbar spinal stenosis and a coronal Cobb angle<20°].
Jiang ZH, Zhang HJ, Cui HJ … +6 more , Ren ZS, Zhang BY, Yu H, Fu XH, Zhou MM, Zhu RS
Zhonghua Yi Xue Za Zhi · 2026 Apr · PMID 41986124 · Publisher ↗
To investigate the differences in imaging and clinical efficacy between simple decompression and short-segment internal fixation in the treatment of patients with degenerative scoliosis accompanied by lumbar spinal steno...
To investigate the differences in imaging and clinical efficacy between simple decompression and short-segment internal fixation in the treatment of patients with degenerative scoliosis accompanied by lumbar spinal stenosis with a coronal Cobb angle<20°. A retrospective analysis was conducted on 80 patients diagnosed with degenerative scoliosis complicated by coronal deformity who were admitted to the Department of Spinal Surgery, Tianjin Union Medical Center, between January 2019 and October 2024. According to the surgical approaches, the patients were divided into two groups: the short-segment fixation group (fixation segments≤3) and the simple decompression group (1-2 segments decompressed). For both groups, the following parameters were recorded respectively: gender, age, disease duration, operation time, intraoperative blood loss, length of hospital stay, surgical expenses, American Society of Anesthesiologists (ASA) score, preoperative and postoperative visual analog scale (VAS) scores for low back pain and leg pain, Oswestry Disability Index (ODI), Japanese Orthopaedic Association (JOA) low back pain score, intraoperative complications, as well as preoperative and postoperative spinopelvic parameters. The spinopelvic parameters included coronal Cobb angle, sagittal vertical axis (SVA), thoracic kyphosis (TK), lumbar lordosis (LL), pelvic incidence (PI), pelvic tilt (PT), and sacral slope (SS). Surgical complications were recorded too, included wound infection, cerebrospinal fluid leakage, pneumonia, cardio-cerebrovascular events, and junctional fusion failure. A total of 80 patients were enrolled, including 45 males and 35 females, with an age of (65.4±8.1) years. There were no significant differences in age, gender, body mass index (BMI), or ASA scores between the two groups before the operation (all >0.05). The short-segment fixation group exhibited significantly longer operation time, greater intraoperative blood loss, more intraoperative fluoroscopy times, and higher total hospitalization costs compared with the simple decompression group (all <0.05). At the 1-year follow-up, the low back pain VAS-B score, leg pain VAS-L score, JOA score, and ODI were significantly improved in both groups compared with preoperative values (all <0.001). At the 1-year follow-up, the VAS-B score was (2.2±0.7) points in the short-segment group and (2.9±1.1) points in the simple decompression group (<0.001), whereas no significant intergroup differences were observed in VAS-L, JOA score, or ODI index (all >0.05). Compared with preoperative values, at 1 year postoperatively, the short-segment group showed decreased SVA and increased SS, LL, and PT (all <0.001), while the simple decompression group showed decreased SVA and significantly increased PT and SS (all <0.001). At the 1-year follow-up, the TK value was 21.8°±9.9° and 29.3°±10.8° in the short-segment group and the simple decompression group, respectively, and the PT values was 22.4°±3.8° and 26.8°±5.9°, respectively (both <0.001), whereas no significant differences was detected in SS, PI, or LL between the two groups (all >0.05). There was no significant differences in incidence of complication between the two groups (=0.134). The clinical efficacy of simple decompression for degenerative scoliosis accompanied by lumbar spinal stenosis with a coronal Cobb angle<20° is similar to that of short-segment internal fixation. And simple decompression, with its shorter operative time and less blood loss, serves as a viable alternative for patients who wish to minimize surgical trauma or who have significant comorbidities.
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