Zhonghua Yi Xue Za Zhi[JOURNAL]
Sun
200 papers
[Analysis of risk factors and construction of a predictive model for the occurrence of heart failure with preserved ejection fraction in patients with type 2 diabetes mellitus complicated by coronary heart disease after percutaneous coronary intervention].
Yao WJ, Zhou QN, Song HN … +1 more , Zhang HB
Zhonghua Yi Xue Za Zhi · 2026 Apr · PMID 41986123 · Publisher ↗
To explore the risk factors and construct a prediction model for heart failure with preserved ejection fraction (HFpEF) after percutaneous coronary intervention (PCI) in patients with type 2 diabetes mellitus (T2DM) and...
To explore the risk factors and construct a prediction model for heart failure with preserved ejection fraction (HFpEF) after percutaneous coronary intervention (PCI) in patients with type 2 diabetes mellitus (T2DM) and coronary heart disease(CHD). A retrospective analysis was conducted on the clinical data of 210 patients with T2DM complicated with CHD who underwent PCI at Tianjin Medical University Chu Hsien-I Memorial Hospital from January 2021 to June 2024. Among them, 136 were males and 74 were females, with the age of (66.4±9.1) years. Patients were divided into a training set and a validation set at a ratio of 7∶3 using the random number generator built into R software. Based on the occurrence of HFpEF within 12 months after PCI, patients in the training set were further categorized into the HFpEF group and the non-HFpEF group. Differences between the two groups were compared. The least absolute shrinkage and selection operator (LASSO) regression analysis and multivariate logistic regression models were used to screen variables, and a nomogram of the prediction model was plotted. The area under the receiver operating characteristic curve (AUC), calibration curve, and decision curve analysis (DCA) were adopted to evaluate the predictive ability, calibration degree, and clinical applicability of the model. The training set included 147 patients, with 38 in the HFpEF group and 109 in the non-HFpEF group. In the training set, patients in the HFpEF group had higher values than those in the non-HFpEF group in terms of age, body mass index (BMI), duration of diabetes, fasting blood glucose, glycosylated hemoglobin (HbA1c), triglyceride levels, triglyceride-glucose (TyG) index, N-terminal pro-B-type natriuretic peptide (NT-proBNP), and the ratio of mitral early diastolic flow velocity(E) to mitral annular early diastolic velocity(e'). Conversely, they exhibited lower values in estimated glomerular filtration rate (eGFR), left ventricular ejection fraction (LVEF), the proportion of complete revascularization, and the proportion of sodium-glucose cotransporter 2 inhibitor usage (all <0.05). LASSO regression analysis screened out 8 variables, including age, BMI, TyG index, HbA1c, Ln(NT-proBNP), LVEF, E/e' ratio, and eGFR. Multivariate logistic regression analysis showed that advanced age (=1.070, 95%: 1.011-1.133), elevated TyG index (=8.560, 95%: 2.581-28.391), elevated Ln(NT-proBNP) (=3.880, 95%: 1.959-7.684), and elevated E/e' ratio (=1.480, 95%: 1.181-1.854) were risk factors for HFpEF after PCI in patients with T2DM complicated with CHD. A nomogram was constructed using the above parameters. In the training set, the AUC of the prediction model for HFpEF after PCI in patients with T2DM complicated with CHD was 0.886 (95%: 0.831-0.941), with a sensitivity of 84.2% and a specificity of 82.6%. In the validation set, the AUC was 0.871 (95%: 0.782-0.960), with the sensitivity of 81.3% and the specificity of 80.9%. The Hosmer-Lemeshow goodness-of-fit test indicated good calibration in both the training cohort (χ²=6.832, =0.554) and the validation set (χ²=5.127, =0.744). DCA demonstrated that the model achieved a high clinical net benefit when the threshold probability ranged from 10% to 90%. Advanced age, elevated TyG index, elevated Ln(NT-proBNP), and elevated E/e' ratio are risk factors for HFpEF in patients with T2DM complicated by CHD after PCI. The nomogram of the prediction model constructed based on these factors can intuitively evaluate the risk of HFpEF in patients with T2DM complicated by CHD after PCI.
[Full-endoscopic modified versus traditional foraminotomy for lumbar foraminal stenosis: a comparison of clinical outcomes].
Xiao X, Chen MM, Ge RL
Zhonghua Yi Xue Za Zhi · 2026 Apr · PMID 41986122 · Publisher ↗
To compare the clinical outcomes of modified full-endoscopic foraminotomy versus conventional foraminotomy in the treatment of lumbar foraminal stenosis. A retrospective analysis was conducted on the clinical data of pa...
To compare the clinical outcomes of modified full-endoscopic foraminotomy versus conventional foraminotomy in the treatment of lumbar foraminal stenosis. A retrospective analysis was conducted on the clinical data of patients who underwent uniportal full-endoscopic foraminotomy for foraminal stenosis at Beijing Friendship Hospital between January 2022 and December 2023. The patients were divided into two groups based on whether sublaminar resection of the superior vertebral lamina was performed: the modified group (superior articular process resection combined with ventral sublaminar decompression of the superior vertebral lamina) and the conventional group (superior articular process resection alone). The clinical data were collected for both groups, included age, gender, body mass index (BMI), stenotic segment, and stenosis grade. The visual analog scale (VAS) for low back pain and leg pain were recorded preoperatively and at 1 week, 6 months, 1 year postoperatively. Clinical outcomes at 1 year after the operation were evaluated using the modified MacNab criteria. Perioperative complications and the rate of reoperation within one year were recorded. The foraminal area before and after surgery was compared between the two groups using sagittal CT reconstruction. A total of 72 patients were included in this study, with 38 in the traditional group and 34 in the modified group. There was no statistically significant differences between the two groups in terms of age, gender, BMI, stenotic level, or grade of stenosis (all >0.05). No significant differences were observed in the VAS scores for low back pain between the two groups preoperatively or at 1 week, 6 months, 1 year postoperatively (all >0.05). There was no significant difference in preoperative leg pain VAS scores between the two groups (>0.05). The modified group demonstrated significantly lower postoperative VAS scores for lower limb pain compared to the traditional group at all follow-up time points: at 1 week [(1.91±0.57) vs (2.10±0.61) points, =0.004], at 6 months [(1.35±0.95) vs (2.05±0.61) points, <0.001], and at 1 year [(0.85±0.70) vs (1.55±0.98) points, =0.029]. According to the modified MacNab criteria, the excellent-to-good rate was 91.2% (31/34) in the modified group and it was 86.8% (33/38) in the traditional group (=0.559). The incidence of perioperative complications was comparable between the modified group (2.9%, 1/34) and the traditional group (5.3%, 2/38) (=0.623). The foraminal area was significantly enlarged in both groups postoperatively. The modified group exhibited a significantly larger postoperative foraminal area [(181.4±9.6) mm²] compared to the traditional group [(165.5±10.1) mm²) (<0.001). Full-endoscopic modified transforaminal decompression provides more extensive decompression and better improvement in leg pain symptoms compared to traditional transforaminal endoscopic decompression in patients with lumbar foraminal stenosis.
[Association of Toll-like receptor 5 gene polymorphism with the clinical efficacy of ustekinumab in patients with Crohn's disease].
Lu JH, Shao XX, Lin DP … +3 more , Xu Y, Ma GL, Jiang Y
Zhonghua Yi Xue Za Zhi · 2026 Apr · PMID 41986121 · Publisher ↗
To investigate the association of Toll-like receptor 5 (TLR5) gene polymorphisms with the clinical efficacy of ustekinumab (UST) in the treatment of Crohn's disease (CD) patients. The patients with active CD who receive...
To investigate the association of Toll-like receptor 5 (TLR5) gene polymorphisms with the clinical efficacy of ustekinumab (UST) in the treatment of Crohn's disease (CD) patients. The patients with active CD who received UST treatment were retrospectively recruited from the Department of Gastroenterology, the Second Affiliated Hospital of Wenzhou Medical University between January 2022 and April 2025. The loci rs5744168 and rs5744174 in TLR5 gene were genotyped by multiplex polymerase chain reaction-ligase detection reaction technique. The clinical response of CD patients was evaluated by Harvey-Bradshaw index (HBI) at week 8 of follow-up. The patients were divided into the response group (a decline of HBI≥ 3 points compared with week 0) and the non-response group. The mucosal healing was assessed by the Simplified Endoscopic Score for Crohn's disease (SES-CD) at week 32 of UST treatment. 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 TLR5 gene polymorphism were compared between the response group and the 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 unconditional logistic regression models to investigate the association between the gene polymorphisms of TLR5 and the clinical efficacy of UST treatment in CD patients. A total of 198 CD patients were included (133 males, 65 females), with age of (32±12) years. There were 117 cases in the response group and 81 cases in the non-response group at week 8 of UST treatment. The homozygous variant genotype (GG) [1.7% (2/117) vs 11.1% (9/81), corrected =0.024] and variant allele (G) [15.8% (37/234) vs 27.8% (45/162), corrected =0.008] of locus rs5744174 in the response group were less frequent than those in the non-response group. The homozygous variant genotype (GG) (=0.17, 95%: 0.04-0.83, =0.029) and variant allele (G) (=0.51, 95%: 0.31-0.85, =0.010) of locus rs5744174 were shown to be associated with the clinical response at week 8. There were 79 cases in the mucosal healing group and 119 cases in the mucosal non-healing group at week 32 of UST treatment. The frequency of variant genotype (GA+AA) [15.2% (12/79) vs 1.7% (2/119), corrected <0.001] and the frequency of variant allele (A) [9.5% (15/158) vs 0.8% (2/238), corrected <0.001] of locus rs5744168 in mucosal healing group were higher than those in the mucosal non-healing group. The variant genotype (GA+AA) (=8.94, 95%: 1.88-42.50, =0.006) and variant allele (A) (=9.54, 95%: 2.09-43.66, =0.004) of locus rs5744168 were found to be related with the mucosal healing at week 32. Among the patients with active CD receiving UST treatment, the variation of locus rs5744174 in TLR5 gene may be associated with a reduced clinical response rate at week 8. However, the variation of locus rs5744168 may be linked to an increased mucosal healing rate at week 32.
[Reflux, esophageal motility, and psychological characteristics of patients with gastroesophageal reflux disease-related chest pain and the association with chest pain symptom].
Huang X, Zhu LL, Ji XL … +3 more , Li TZ, Duan LP, Wang K
Zhonghua Yi Xue Za Zhi · 2026 Apr · PMID 41986120 · Publisher ↗
To analyze reflux, esophageal motility, and psychological characteristics of patients with gastroesophageal reflux disease (GERD)-related chest pain and the association with chest pain symptom. The patients with GERD wh...
To analyze reflux, esophageal motility, and psychological characteristics of patients with gastroesophageal reflux disease (GERD)-related chest pain and the association with chest pain symptom. The patients with GERD who underwent 24-hour impedance-pH monitoring and high-resolution esophageal manometry at Peking University Third Hospital from July 2016 to April 2024 were retrospectively included. The psychometric scale, reflux monitoring and esophageal manometry were collected. According to the presence of chest pain, the patients were divided into chest pain group (with chest pain symptom) and non-chest pain group. The reflux, esophageal motility and psychological characteristics were compared between the two groups. Correlation analysis was used to identify the related characteristics of chest pain, and multivariate logistic regression model was used to analyze the risk factors for chest pain symptom. A total of 272 patients with GERD were included, comprising 175 males and 97 females, with a median age[ (, )] of 49 (38, 58) years. There were 153 cases in the chest pain group and 119 cases in the non-chest pain group. The chest pain group exhibited a lower prevalence of hiatal hernia [17.6% (27/153) vs 37.8% (45/119)] and lower esophageal acid exposure time (AET) [2.0% (0.6%, 4.7%) vs 4.3% (1.1%, 8.2%)], compared to the non-chest pain group (all <0.001). The chest pain group demonstrated significantly higher scores on the Symptom Checklist-90 (SCL-90) [133 (112, 173) vs 108 (99, 134) scores, <0.001], Self-rating Anxiety Scale (SAS) [44 (38, 49) vs 39 (31, 45) scores, <0.001], and Self-rating Depression Scale (SDS) [48 (38, 57) vs 43 (34, 54) scores, =0.014], compared to the non-chest pain group. The occurrence of chest pain showed positive correlations with SAS (0.274), SDS (0.134), and SCL-90 (0.369)scores, whereas negative correlations were observed with hiatal hernia (-0.227) and AET (-0.215) (all <0.05). Multivariate logistic regression analysis identified elevated SCL-90 score (=1.02, 95%: 1.01-1.03) and SAS score (1.05, 95%: 1.01-1.10) as the risk factors for GERD-related chest pain. Compared with GERD patients without chest pain, those with chest pain had a lower incidence of esophageal hiatal hernia, lower AET, and increased mental and psychological abnormalities. Elevated SCL-90 and SAS scores were identified as the risk factors for GERD-related chest pain.
[The predictive value of combining psoas muscle index and paraspinal muscle fat infiltration rate for mechanical complications following corrective surgery in patients with degenerative scoliosis].
Hu JT, Kiram A, Li J … +5 more , Wang M, Tian Z, Zhu ZZ, Qiu Y, Liu Z
Zhonghua Yi Xue Za Zhi · 2026 Apr · PMID 41986119 · Publisher ↗
To evaluate the predictability of psoas muscle index (PMI) and paraspinal muscle fat infiltration rate (PSM FI%) for mechanical complications (MC) in patients with degenerative scoliosis (DS). The clinical data of 89 DS...
To evaluate the predictability of psoas muscle index (PMI) and paraspinal muscle fat infiltration rate (PSM FI%) for mechanical complications (MC) in patients with degenerative scoliosis (DS). The clinical data of 89 DS patients who underwent corrective surgery in Nanjing Drum Tower Hospital from January 2019 to December 2022 were retrospectively analyzed. According to the presence of MC after corrective surgery, the patients were divided into MC group (=25) and non-MC group (=64). MC included proximal junctional kyphosis/failure (PJK/PJF), distal junctional kyphosis/failure (DJK/DJF), rod breakage and implant-related complications. The cross-sectional area (CSA) of psoas muscle and posterior paraspinal muscle and PSM FI% were measured at L-L level on preoperative MRI. The PMI was defined as the ratio of the total psoas CSA to height squared (cm²/m²). The PSM FI% and PMI were compared between MC group and non-MC group. In addition, the sagittal spinopelvic parameters were collected as covariates and incorporated into the analysis. The multivariate logistic regression analysis was performed to identify potential risk factors for MC following corrective surgery in patients with DS. The predictive efficacy of PMI and PSM FI% for MC was evaluated with receiver operating characteristic (ROC) curve, decision curve analysis (DCA), and calibration curve. Of the 89 patients with DS included in this study, there were 19 males and 70 females with a mean age of (62.2±6.6) years, and 25(28.1%) patients experienced MC. The patients in MC group demonstrated lower PMI at all the L-L levels and higher PSM FI% at L-L when compared with those in the non-MC group (all <0.05). The area under ROC curve (AUC) of PMI for predicting MC at L-L was 0.629, 0.678, 0.725, 0.645 and 0.651, respectively; while the AUC of PSM FI% was 0.608, 0.666, 0.732, 0.609 and 0.592, respectively. Both PMI and PSM FI% showed maximal predictive accuracy at the L level; and the threshold for predicting MC in DS patients following corrective surgery was L PMI<4.38 cm²/m² and L PSM FI%>25.5%, respectively. The multivariate logistic regression analysis indicated that lower L PMI (=0.363, 95%: 0.200-0.660, <0.001) and higher L PSM FI% (=1.101, 95%: 1.032-1.176, =0.004) were risk factors for MC in DS patients following corrective surgery. The combination of L PMI and L PSM FI% showed better predictability for MC in DS patients following corrective surgery with an AUC of 0.848 (sensitivity: 80.0%, specificity: 81.3%). The low PMI and high PSM FI% are risk factors of MC following corrective surgery in patients with DS. The combination of PMI and PSM FI% shows better predictive accuracy in MC in patients with DS after corrective surgery than individual parameter.
[Chinese clinical practice guideline on prescription fluids application for continuous renal replacement therapy (2026 edition)].
Critical Care Medicine Branch of China International Exchange and Promotion Association for Medical and Health Care, Chinese Cooperation Group of Critical Care Blood Purification
Zhonghua Yi Xue Za Zhi · 2026 Apr · PMID 41986118 · Publisher ↗
With the development of critical care techniques, continuous renal replacement therapy (CRRT) has become one of the most important life support methods. It is a key procedure to select and apply prescribed fluids for CRR...
With the development of critical care techniques, continuous renal replacement therapy (CRRT) has become one of the most important life support methods. It is a key procedure to select and apply prescribed fluids for CRRT correctly, which is helpful to guarantee the performance and effect of CRRT and avoid some adverse complications. Critical Care Medicine Branch of China International Exchange and Promotion Association for Medical and Health Care and the Chinese Cooperation Group of Critical Care Blood Purification (CCG-CCBP) have developed this guideline to improve the CRRT level of related medical personnel, promote the standardization of CRRT, and improve the prognosis of those patients who receive CRRT. This guideline addresses five aspects: common types and components of CRRT prescription solutions, solute loss and replenishment in CRRT, clinical use of CRRT prescription solutions, adjustments to CRRT prescription solutions in special circumstances, and local citrate anticoagulation. It raises 17 clinical questions and uses the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) grading method to assess the quality of evidence and the strength of recommendations, ultimately resulting in 22 recommendations.
[Current situation and consideration for eradication therapy in special populations].
Wang HC, Wang XJ, Peng RL … +3 more , Gao JH, Jie Q, Zhang ZY
Zhonghua Yi Xue Za Zhi · 2026 Apr · PMID 41986117 · Publisher ↗
(Hp) infection is associated with a wide range of diseases. Bismuth quadruple therapy is currently the first-line regimen for Hp eradication in China. However, potential adverse effects of the acid suppressants, antibiot...
(Hp) infection is associated with a wide range of diseases. Bismuth quadruple therapy is currently the first-line regimen for Hp eradication in China. However, potential adverse effects of the acid suppressants, antibiotics, and bismuth agents included in this regimen may increase the risk of adverse events in the elderly and patients with liver dysfunction, renal dysfunction, hypertension, diabetes and other diseases. Moreover, complex drug interactions between eradication therapies and medications for pre-existing conditions further elevate clinical risks. Currently, major domestic and international guidelines generally lack specific recommendations for Hp eradication in these special populations, posing significant challenges in clinical practice. To address this gap, the paper reviewed relevant guidelines on Hp treatment at home and abroad, and systematically summarized the pathophysiological characteristics and potential drug interactions in special populations, including the elderly and those with liver and renal dysfunction, cardio cerebrovascular and metabolic diseases. Based on the latest evidence, individualized treatment strategies, including drug selection, dose adjustment, use of dual therapy and susceptibility-guided precision therapy, were proposed, aiming to provide practical guidance for clinicians.
[Clinical and genetic characteristics of pseudohypoparathyroidism type 1].
Tian FY, Qing J, Zhu CF … +5 more , Li YN, He XY, Wang C, Lyu YY, Kong XD
Zhonghua Yi Xue Za Zhi · 2026 Apr · PMID 41946590 · Publisher ↗
A retrospective study was conducted to include patients with genetically confirmed pseudohypoparathyroidism (PHP) type 1 at the First Affiliated Hospital of Zhengzhou University from August 2016 to April 2025, aiming to...
A retrospective study was conducted to include patients with genetically confirmed pseudohypoparathyroidism (PHP) type 1 at the First Affiliated Hospital of Zhengzhou University from August 2016 to April 2025, aiming to analyze their clinical and genetic characteristics. A total of 15 patients with PHP type 1 were enrolled, including 7 males and 8 females, with a median age of onset at 12.0 years (range: 3.5-40.0 years). Among them, 4 cases were PHP 1A and 11 cases were PHP 1B. All patients exhibited elevated parathyroid hormone levels, and 14 had hypocalcemia. Hyperphosphatemia was observed in all pediatric patients, while serum phosphate levels were normal in adult patients. Six patients had hypokalemia. Two patients had hypertension (including one with idiopathic hyperaldosteronism). Three patients had concurrent autoimmune thyroid diseases. There was significant clinical phenotypic overlap between PHP 1A and PHP 1B. In addition to the typical features of parathyroid hormone resistance and hypocalcemia, patients with PHP type 1 could also present with age-related serum phosphate abnormalities, hypokalemia, hypertension, autoimmune thyroid diseases, and other atypical phenotypes. Regarding genetic characteristics, 4 cases of PHP 1A exhibited maternally inherited inactivating variants in the GNAS gene. Among the 11 PHP 1B cases, 10 had methylation defects in the GNAS gene imprinting control region (including 3 familial cases and 7 sporadic cases), while the remaining 1 case had a copy number variation [20(chr20:?_44996182-62737512_?)*2 ROH], representing paternal uniparental disomy of chromosome 20q, consistent with sporadic PHP1B. In clinical practice, precise classification requires the integration of clinical phenotypes with molecular genetic findings, along with systematic evaluation and long-term follow-up.
[Analysis of the efficacy of an endotherapy rob-assistant system in the treatment of gastrointestinal polyps in beagle dogs].
Wang ZX, Peng LH, Yan B … +5 more , Yang J, Wang ZK, Wang HB, Chen J, Yang YS
Zhonghua Yi Xue Za Zhi · 2026 Apr · PMID 41946589 · Publisher ↗
To evaluate the efficacy of the endotherapy rob-assistant (ERA) system in treating gastrointestinal polyps in beagle dogs. Sixteen beagle dogs, aged 10-20 months and weighing 8-15 kg, were enrolled. They were randomly d...
To evaluate the efficacy of the endotherapy rob-assistant (ERA) system in treating gastrointestinal polyps in beagle dogs. Sixteen beagle dogs, aged 10-20 months and weighing 8-15 kg, were enrolled. They were randomly divided into an experimental group (ERA-assisted, =8) and a control group (assisted by an instrument nurse, =8) using a random number table. Artificial polyps were created in the gastric antrum, gastric body, gastric fundus, and colon using high-frequency electrocoagulation marking. Endoscopic mucosal biopsy and endoscopic mucosal resection were then performed. Procedural success rate, operation time, and complications were compared between the groups. Wound healing was assessed two weeks postoperatively. All the artificial polyp models were successfully established, success rate: 100% (16/16). All procedures were completed without intraoperative complications, and postoperative wound healing was favorable. Compared with the control group, the experimental group showed no statistically significant difference in EMR operation time[ (, )] [344 (330, 388) vs 372 (330, 422) s, >0.05]. Both the instrument transfer time [upper endoscopy: 9 (8, 9) vs 10 (8, 13) s; colonoscopy: 8 (8, 9) vs 11 (10, 13) s, all 0.05] and the biopsy operation time [upper endoscopy: 67 (53, 79) vs 79 (73, 87) s; colonoscopy: 64 (51, 72) vs 77 (71, 81) s, all 0.05] were significantly shorter in the experimental group, compared to the control group. Furthermore, the incidence of risky maneuvers was significantly lower than that of the control group [43% (100/233) vs 0, 0.05]. The ERA system is safe and effective for treating gastrointestinal polyps in beagle dogs.
[Radiographic characteristics of sciatic scoliosis secondary to lumbar disc herniation].
Xu ZM, Zhao QH, Wang B … +3 more , Zhu ZZ, Qiu Y, Sun X
Zhonghua Yi Xue Za Zhi · 2026 Apr · PMID 41946588 · Publisher ↗
To investigate the radiographic characteristics of lumbar disc herniation (LDH) associated with sciatic scoliosis and to compare coronal and sagittal alignment parameters between adolescent and adult patients. A retrosp...
To investigate the radiographic characteristics of lumbar disc herniation (LDH) associated with sciatic scoliosis and to compare coronal and sagittal alignment parameters between adolescent and adult patients. A retrospective analysis was conducted on patients with LDH who underwent unilateral endoscopic discectomy or unilateral laminotomy with discectomy at Nanjing Drum Tower Hospital, the Affiliated Hospital of Nanjing University Medical School, between January 2017 and July 2025. A total of 86 adolescents with LDH complicated by sciatic scoliosis were included as the adolescent group. Using a random number table, 172 adult patients who met the identical diagnostic and treatment criteria during the same period were selected and matched in a 1∶2 ratio to form the adult group. Based on sagittal balance status, patients were further classified into a balanced group [sagittal vertical axis (SVA)≤40 mm] and an imbalanced group (SVA>40 mm). Spinopelvic sagittal parameters were evaluated. Differences in sagittal and coronal alignment between groups were compared. Furthermore, the associations among the side of disc herniation, the direction of scoliotic curvature, and trunk shift were analyzed. In patients with LDH complicated by sciatic scoliosis, the mean lumbosacral curve was 15.3°±5.8°, the thoracic/thoracolumbar curve was 16.9°±5.4°, apical vertebral translation was (2.9±1.6) cm, and trunk shift was (3.0±1.5) cm. Overall, 79.8% (206/258) of the patients exhibited lumbosacral curve convexity on the same side as the disc herniation, while 81.0% (209/258) demonstrated trunk shift toward the side contralateral to the herniation (both <0.01). Compared with the imbalanced group, the balanced group showed smaller trunk shift and apical vertebral translation [(2.8±1.2) vs (3.3±1.7) cm and (2.7±1.4) vs (3.1±1.7) cm, respectively, both <0.05]. Further analysis revealed that adolescents had lower thoracic kyphosis (TK), lumbar lordosis (LL), lower lumbar lordosis, and sacral slope (SS) than adults (13.2°±9.8° vs 17.4°±11.0°, 19.5°±14.2° vs 30.3°±15.6°, 16.7°±11.9° vs 23.8°±11.6°, and 23.4°±6.4° vs 26.7°±8.3°, respectively); while, the SVA and pelvic tilt (PT) were significantly greater than those in adults [(70.5±58.4) vs (41.8±52.6) mm, and 25.7°±10.5° vs 20.8°±9.3°, respectively] (all <0.05). Patients with LDH complicated by sciatic scoliosis typically exhibit characteristic imaging features, including trunk tilt toward the side contralateral to the herniation, herniation predominantly on the convex side of the lumbosacral curve, and sagittal imbalance. Sagittal imbalance is coupled with coronal deformity and more pronounced in adolescent patients.
[Causes of failure in arthroscopic anterior cruciate ligament reconstruction and outcomes of revision surgery].
Wei YL, Wang HC, Zhao Z … +1 more , Bai LH
Zhonghua Yi Xue Za Zhi · 2026 Apr · PMID 41946587 · Publisher ↗
To investigate the causes of failure following arthroscopic anterior cruciate ligament (ACL) reconstruction and to evaluate the outcomes of revision surgery. A total of 102 patients who underwent revision surgery due to...
To investigate the causes of failure following arthroscopic anterior cruciate ligament (ACL) reconstruction and to evaluate the outcomes of revision surgery. A total of 102 patients who underwent revision surgery due to failed ACL reconstruction between January 2017 and December 2022 at Shengjing Hospital of China Medical University were included in this study. All the patients included in the study underwent single-bundle, stage Ⅰ arthroscopic revision ACL reconstruction. Knee function was evaluated using the International Knee Documentation Committee (IKDC) score, Tegner activity scale, Lysholm score, and knee laxity. These parameters were assessed preoperatively and postoperatively at 6, 12, 18, 24, and 30 months to compare the clinical outcomes. Among the patients, there were 70 males and 32 females, with a mean age of (33.2±3.6) years. The primary cause of ACL reconstruction failure was abnormal bone tunnel placement, observed in 56 cases (54.9%). Additionally, 37 failures (36.3%) were attributed to secondary trauma postoperatively, 8 cases (7.8%) resulted from graft fixation failure, and 1 case (1.0%) was due to graft disappearance caused by rejection. Medial compartment cartilage damage was the most frequently observed intraarticular lesion (35 cases, 34.3%). The mean follow-up duration was (26.8±4.0) months. At 6 months post-revision, no significant improvements were observed in IKDC or Tegner scores [(37.3±3.2) vs (36.3±5.8) points, (4.0±0.4) vs (4.0±0.7) points, respectively, both >0.05], whereas the Lysholm score improved from (56.2±7.2) points to (83.2±4.1) points (<0.001), and the KT-3000 side-to-side difference at 30° of knee flexion decreased from (6.6±1.3) mm to (2.3±0.2) mm (<0.001) when compared with those before the revision operation. From 12 months onward, all functional scores and stability parameters continued to improve. At the final follow-up, the IKDC, Lysholm, and Tegner scores reached (82.2±3.3), (87.2±3.5) and (7.2±2.3) points, respectively, while the KT-3000 difference at 30° and 90° flexion was (2.2±0.7) mm and (1.8±0.5) mm, respectively; all showing significant improvement when compared with those preoperative values (all <0.001). Malpositioned bone tunnels represent the leading cause of failure after arthroscopic ACL reconstruction. Revision surgery significantly improves knee function and stability during follow-up.
[Correlation analysis of serum transforming growth factor-β stimulated clone 22 domain family member 4 with type 2 diabetes mellitus combined with metabolic associated fatty liver disease].
Gao Q, Kang Y, Quan JX … +3 more , Yang Z, Li M, Liu JX
Zhonghua Yi Xue Za Zhi · 2026 Apr · PMID 41946586 · Publisher ↗
To explore the correlation between serum transforming growth factor-β stimulated clone 22 domain family member 4 (TSC22D4) and type 2 diabetes mellitus (T2DM) combined with metabolic associated fatty liver disease (MAFLD...
To explore the correlation between serum transforming growth factor-β stimulated clone 22 domain family member 4 (TSC22D4) and type 2 diabetes mellitus (T2DM) combined with metabolic associated fatty liver disease (MAFLD). Prospectively, 257 patients with T2DM who were hospitalized at Gansu Provincial Hospital from April 2024 to April 2025 were included in this study, comprising 168 males and 89 females, with the age of [(, )] 53(47, 58) years. Based on their disease status, the patients were divided into the simple T2DM group (=127) and the T2DM+MAFLD group (=130). Additionally, healthy individuals from the physical examination center during the same period were enrolled as the normal control group (=132), including 80 males and 52 females, with the age of 51(47, 57) years. Clinical data were collected, and differences in clinical indicators among the three groups were compared. Spearman correlation analysis was employed to examine the correlations between TSC22D4 and metabolic and inflammatory indicators. A multivariate logistic regression model was employed to analyze the influencing factors of T2DM complicated with MAFLD. The body mass index (BMI), visceral fat area (VFA), fasting blood glucose (FBG), fasting insulin (FINS), homeostasis model assessment of insulin resistance index (HOMA-IR), glycated hemoglobin (HbA1c), TSC22D4, interleukin-6 (IL-6), and high-sensitivity C-reactive protein (hs-CRP) levels were all higher in both the simple T2DM group and the T2DM+MAFLD group compared to the normal control group. Moreover, all these indicators were significantly elevated in the T2DM+MAFLD group compared to the simple T2DM group (all <0.05). Conversely, high-density lipoprotein cholesterol levels were lower in both the simple T2DM group and the T2DM+MAFLD group compared to the normal control group, with the T2DM+MAFLD group exhibiting even lower levels than the simple T2DM group (all <0.05). Among the 257 T2DM patients, Spearman correlation analysis revealed that TSC22D4 was positively correlated with BMI, VFA, FBG, FINS, HOMA-IR, HbA1c, triglycerides, total cholesterol, low-density lipoprotein cholesterol, IL-6, and hs-CRP (all <0.05). The results of the multivariate logistic regression model analysis revealed that elevated BMI (=1.286, 95%:1.128-1.465), longer duration of diabetes (=1.098, 95%:1.036-1.163), and elevated TSC22D4 levels (=1.031, 95%:1.021-1.040) were associated factors contributing to the increased risk of T2DM complicated with MAFLD. Elevated TSC22D4 is a relevant factor contributing to the increased risk of developing T2DM complicated with MAFLD Serum TSC22D4 may contribute to the development and progression of MAFLD in T2DM patients by exacerbating insulin resistance and inflammatory responses.
[Expert consensus on techniques and material selection for dural closure in neurosurgery (2026 edition)].
Neurosurgery Branch of the Chinese Medical Association
Zhonghua Yi Xue Za Zhi · 2026 Apr · PMID 41946585 · Publisher ↗
To standardize dural closure techniques and material selection in neurosurgery and reduce the incidence of postoperative complications such as cerebrospinal fluid leakage, led by the Neurosurgery Branch of the Chinese Me...
To standardize dural closure techniques and material selection in neurosurgery and reduce the incidence of postoperative complications such as cerebrospinal fluid leakage, led by the Neurosurgery Branch of the Chinese Medical Association, domestic experts in neurosurgery and related fields were organized to follow the principles of evidence-based medicine and grading of recommendations assessment, development and evaluation (GRADE) system. The consensus was formulated based on a systematic review of high-quality international evidence combined with clinical practice in China. The consensus underscores the pivotal role of achieving "Watertight Dural Closure (WTDC)" and establishes a stepwise material selection strategy: prioritizing autologous tissue as the primary choice, supplemented by dural patches, and reinforced by dural sealants. For the first time, this consensus introduces a four-type morphological classification for dural incisions (Types Ⅰ-Ⅳ) and a five-grade classification for dural closure integrity (Grades A-E), upon which a quantitative risk assessment system has been established. Addressing key clinical issues, including repair material characteristics, technique application based on incision types and closure grades, site-specific repair strategies for different anatomical locations, management of special populations, and postoperative outcome evaluation, the Consensus formulates a total of 19 recommendations, aiming to provide a systematic and standardized clinical decision-making framework and operational guidance for dural repair in neurosurgery.
[Expert consensus on the use of interleukin-1 inhibitors for autoimmune inflammatory diseases (2026 edition)].
Committee of Chinese Primary Health Care Foundation for Rheumatologists and Immunologists
Zhonghua Yi Xue Za Zhi · 2026 Apr · PMID 41946584 · Publisher ↗
Interleukin-1 (IL-1) plays a core role in the pathogenesis of autoimmune inflammatory diseases (AIID). Blocking the inflammatory cascade driven by IL-1 has become a critical strategy for the treatment of various AIID. Si...
Interleukin-1 (IL-1) plays a core role in the pathogenesis of autoimmune inflammatory diseases (AIID). Blocking the inflammatory cascade driven by IL-1 has become a critical strategy for the treatment of various AIID. Since IL-1 inhibitors were approved on the market in China on October 2023, they have attracted great attention in clinical practice and have been increasingly used in clinical settings. In order to reduce the clinical uncertainties and potential risks that may be brought about by off-label drug use, the Rheumatology and Immunology Professional Committee of the China Primary Health Care Foundation organized experts from multiple disciplines to focus on 12 clinical issues regarding the treatment of AIID with IL-1 inhibitors. Based on the latest evidence-based medical evidence and China's national conditions, fourteen recommendations on crystal-induced arthropathies, autoinflammatory syndrome and periodic fever syndrome have been formulated, aiming to standardize the clinical application and pharmaceutical management of IL-1 inhibitors in China.
[Association between molecular typing and prognosis with recurrence pattern in triple-negative breast cancer patients].
Chen ZJ, Dai LJ, Wang H … +3 more , Shao ZM, Ma D, Jiang YZ
Zhonghua Yi Xue Za Zhi · 2026 Mar · PMID 41913624 · Publisher ↗
To analyze the association between molecular typing and prognosis with recurrence pattern in triple-negative breast cancer (TNBC) patients based on long-term follow-up of a multi-omics cohort. A retrospective analysis w...
To analyze the association between molecular typing and prognosis with recurrence pattern in triple-negative breast cancer (TNBC) patients based on long-term follow-up of a multi-omics cohort. A retrospective analysis was performed on the clinical data and transcriptomic data of patients diagnosed with TNBC at Department of Breast Surgery, Fudan University Shanghai Cancer Center from January 1, 2007, to December 31, 2014. The survival status of patients was documented, and the follow-up continued until the patients' death or August 31, 2025. According to the"Fudan subtype", the patients were categorized into the basal-like immune suppressed (BLIS), immunomodulatory (IM), luminal androgen receptor (LAR), and mesenchymal-like (MES). Survival curves were plotted using the Kaplan-Meier method, and the log-rank test was employed to evaluate the differences in overall survival (OS), disease-free survival (DFS) and recurrence-free interval (RFI) among TNBC patients with different molecular subtypes. Multivariate Cox proportional hazards regression analysis was used to assess the association between"Fudan subtype"and OS, DFS and RFI. Differential expression analysis and subsequent gene set enrichment were conducted. Competing-risk models were used to calculate the cumulative incidence of lung metastasis after accounting for competing events, and the differences were assessed using the Fine-Gray test. After excluding 9 patients lost to follow-up, a total of 351 patients with TNBC were included in the analysis. The mean age at baseline was 53.46±11.36 years, and the median follow-up duration was 102.09 months. During follow-up, 72 patients died and 84 experienced recurrence or metastasis. Among them, 134 patients were classified as the BLIS subtype, with 27 deaths (20.15%); 86 patients were classified as the IM subtype, with 11 deaths (12.79%); 81 patients were classified as the LAR subtype, with 22 deaths (27.16%); and 50 patients were classified as the MES subtype, with 12 deaths (24.00%). The 10-year RFI rates for the BLIS, IM, LAR, and MES subtypes were 80.12% (95%: 73.41%-87.44%), 92.35% (95%: 86.64%-98.43%), 81.92% (95%: 73.39%-91.44%), and 72.95% (95%: 61.37%-86.71%), respectively. Kaplan-Meier survival curves showed that the differences of RFI among the four molecular subtypes of patients were statistically significant (=0.040). Multivariate analysis showed that LAR subtype (LAR vs IM, =2.41, =0.042) was the independent risk factor for DFS, and BLIS subtype (BLIS vs IM, =4.17, =0.011), LAR subtype (LAR vs IM, =3.49, =0.040) and MES subtype (MES vs IM, =3.98, =0.019) were independent risk factors for RFI. The BLIS subtype is more likely to develop recurrence or metastasis in the early postoperative period, particularly lung metastasis. Differential gene expression analysis showed that BLIS subtype-specific genes, including those involved in proliferation and cell cycle activity, were predominantly upregulated in tumors with early recurrence or metastasis. Competing-risk analysis demonstrated that BLIS patients had a higher cumulative incidence of lung metastasis both overall and within the first 5 years after surgery compared with non-BLIS patients (both <0.05). The"Fudan subtype"was significantly associated with RFI in early-stage TNBC patients. In addition, recurrence and metastasis were more likely to be observed in the early postoperative period in the BLIS subtype, particularly early lung metastasis.
[Reliability and validity of the Chinese version of the Prodromal Questionnaire-Brief Child Version].
Zhou JS, Womer Y, Karcher R … +4 more , Zhang R, Zhu Y, Yu YN, Wang F
Zhonghua Yi Xue Za Zhi · 2026 Mar · PMID 41912407 · Publisher ↗
To translate and culturally adapt the Prodromal Questionnaire-Brief Child Version (PQ-BC) into Chinese and to evaluate its reliability and validity among primary and secondary school students. Following the Brislin tran...
To translate and culturally adapt the Prodromal Questionnaire-Brief Child Version (PQ-BC) into Chinese and to evaluate its reliability and validity among primary and secondary school students. Following the Brislin translation model, the PQ-BC was translated, back-translated, and culturally adapted to develop the Chinese version. Using stratified cluster random sampling, students from ten primary and secondary schools across three regions in Jiangsu Province were selected between August and October 2024 to complete the Chinese PQ-BC, the Depression-Anxiety-Stress Scale-21 (DASS-21), and the Strengths and Difficulties Questionnaire (SDQ). Item analysis was performed for the PQ-BC. Structural validity was examined using exploratory and confirmatory factor analyses, and criterion validity was assessed using the DASS-21 and SDQ. Reliability was evaluated by internal consistency and split-half reliability. All item scores and distress scores of the PQ-BC were significantly positively correlated with their respective total scores (item score: =0.345-0.668; distress score: =0.337-0.668, all <0.001). Exploratory factor analysis supported a one-factor structure for both item and distress scores, explaining 70.2% and 69.5% of the variance, respectively. Both total scores and total distress scores were positively correlated with all factors of DASS-21 and SDQ (except prosocial behavior) (=0.214-0.587, all <0.001). Cronbach's α was 0.930 for symptom scores and 0.938 for distress scores, and split-half reliability coefficients were 0.932 and 0.942, respectively. The Chinese version of the PQ-BC demonstrates a stable one-factor structure with excellent reliability and validity in primary and secondary school students, supporting its use for early identification and stratified screening of psychotic-like experiences.
[Machine learning and radiomics-based model for predicting response to lenvatinib combined with TACE in patients with unresectable hepatocellular carcinoma].
Chen B, Gan YY, Zou EG … +7 more , Zhang KC, Zhao R, Chen QW, Chen YX, Zhong CY, Wu F, Chen G
Zhonghua Yi Xue Za Zhi · 2026 Mar · PMID 41912406 · Publisher ↗
To evaluate the predictive value of machine learning combined with radiomics for treatment response to lenvatinib combined with transarterial chemoembolization (TACE) in patients with unresectable hepatocellular carcinom...
To evaluate the predictive value of machine learning combined with radiomics for treatment response to lenvatinib combined with transarterial chemoembolization (TACE) in patients with unresectable hepatocellular carcinoma (uHCC). This retrospective study enrolled 117 uHCC patients treated with lenvatinib-TACE at the First Affiliated Hospital of Wenzhou Medical University from January 2020 to December 2023. Patients were randomly divided into a training set (=81) and an internal validation set (=36) at a 7∶3 ratio. An additional 24 uHCC patients treated with lenvatinib-TACE between January and December 2024 were included as an external validation set. The follow-up period concluded in September 2025. Patients were stratified into a non-response group (PD+SD) and a response group (PR) based on therapeutic outcomes. Overall survival (OS) and progression-free survival (PFS) were estimated using the Kaplan-Meier method, with differences between groups compared via the log-rank test. Additionally, abdominal contrast-enhanced CT features were extracted from uHCC patients, and the top 25 most representative features were selected using the maximum relevance minimum redundancy (mRMR) algorithm. Six machine learning algorithms-multilayer perceptron (MLP), decision tree (DT), random forest (RF), logistic regression (LR), extreme gradient boosting (XGBoost), and support vector machine (SVM)-were employed to develop predictive models based on enhanced CT radiomic features after feature selection and dimensionality reduction. Model performance was evaluated using receiver operating characteristic (ROC) curves and area under the curve (AUC), and the differences in AUC were compared using Delong test. Calibration curves and decision curve analysis (DCA) were used to validate model accuracy and clinical utility, respectively. The response group consisted of 57 patients [mean age: (60.5±9.8) years; 50 males], while the non-response group comprised 84 patients [mean age: (58.9±13.8) years; 74 males]. The overall median follow-up time was 31.7(25.3,44.8) months. Notably, both OS and PFS were significantly superior in the response group compared to the non-response group (both <0.05). The MLP model yielded an AUC of 0.856 (95%: 0.805-0.906) in the training set, 0.790 (95%: 0.641-0.927) in the internal validation set, and 0.836 (95%: 0.585-1.000) in the external validation set. In terms of model comparison, the MLP significantly outperformed the DT, RF, and XGBoost models in the training set, and surpassed the DT model in the internal validation set (all <0.05); however, no statistically significant differences were observed against other models in the external validation set. Notably, the MLP was the only model to demonstrate consistent calibration across all three datasets, and DCA confirmed its superior clinical net benefit. This study developed six machine learning prediction models based on imaging data, among which the MLP model demonstrated optimal performance in predicting treatment response to the combination therapy of lenvatinib and TACE, enabling effective efficacy prediction and clinical decision-making guidance for uHCC patients.
[Correlation between cardiac right-to-left shunt and clinical characteristics and treatment outcomes in patients with sudden sensorineural hearing loss].
Huang QL, Wang Q, Wu DX … +2 more , Zeng LL, Zeng XL
Zhonghua Yi Xue Za Zhi · 2026 Mar · PMID 41912405 · Publisher ↗
To explore the correlation between cardiac right-to-left shunt (RLS) and clinical characteristics and treatment outcomes in patients with sudden sensorineural hearing loss (SSNHL). Patients with SSNHL admitted to the Th...
To explore the correlation between cardiac right-to-left shunt (RLS) and clinical characteristics and treatment outcomes in patients with sudden sensorineural hearing loss (SSNHL). Patients with SSNHL admitted to the Third Affiliated Hospital of Sun Yat-sen University from December 2023 to January 2025 were retrospectively included. They were divided into the RLS-positive group and RLS-negative group according to their RLS status. Clinical characteristics, audiogram types and therapeutic efficacy were compared between the two groups. Meanwhile, differences in the degree of initial hearing loss among patients with different RLS grades in the RLS-positive group were analyzed, and a logistic regression model was used to explore the correlation between RLS and therapeutic efficacy of hearing loss. A total of 149 patients (75 males and 74 females) aged (45.0±18.0) years were enrolled, with 81 cases in the RLS-positive group and 68 cases in the RLS-negative group. Compared with the RLS-negative group, the RLS-positive group had lower mean age [(41.0±17.5) years vs (50.8±16.5) years, <0.001], hypertension prevalence [14.8% (12/81) vs 39.7% (27/68)] and fasting blood glucose level [(5.49±1.54) mmol/L vs (6.27±2.78) mmol/L] (all <0.05), but with a higher initial hearing threshold [(83.5±25.2) dB HL vs (74.4±30.0) dB HL, =0.038]. There was no statistically significant difference in the distribution of audiogram types between the two groups (=0.554). The hearing threshold improvement amplitude after treatment in the RLS-positive group was larger than that in the RLS-negative group [27.0 (3.5, 50.5) dB HL vs 13.0 (0, 34.3) dB HL, =0.013], and the therapeutic effective rate of the RLS-positive group was higher than that of the RLS-negative group [67.9% (55/81) vs 51.5% (35/68), =0.041]. No statistically significant difference was found in the distribution of hearing loss degree among patients with different RLS grades in the RLS-positive group (=0.194). Multivariate logistic regression analysis showed that after adjusting for age, mean initial pure tone audiometric threshold, fasting blood glucose level and hypertension status, RLS was not significantly correlated with the therapeutic efficacy of SSNHL (with "ineffective" as the reference: =1.458, 95%: 0.705-3.015, =0.309). Compared with the RLS-negative group, the RLS-positive group has a higher mean initial pure tone audiometric threshold, as well as lower age, hypertension prevalence and fasting blood glucose level. RLS shows no significant correlation with therapeutic efficacy. RLS screening should be emphasized in young patients with SSNHL.
[Effects and influencing factors of acupuncture as an adjunctive therapy for primary subjective tinnitus].
Zhang JX, Li YQ, Cao X … +2 more , Yu LL, Bing D
Zhonghua Yi Xue Za Zhi · 2026 Mar · PMID 41912404 · Publisher ↗
To investigate the efficacy of acupuncture as an adjunctive therapy for primary subjective tinnitus and analyze influencing factors of prognosis. Patients diagnosed with primary subjective tinnitus at Tongji Hospital, T...
To investigate the efficacy of acupuncture as an adjunctive therapy for primary subjective tinnitus and analyze influencing factors of prognosis. Patients diagnosed with primary subjective tinnitus at Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology between March 2024 and October 2025 were enrolled. Participants were divided into an acupuncture group and a control group based on whether they received acupuncture intervention. Changes in Tinnitus Handicap Inventory (THI) scores after treatment and the proportion of patients achieving the minimal clinically important difference (MCID) in THI were compared between the two groups. Key factors influencing tinnitus prognosis and acupuncture efficacy were analyzed using linear and logistic regression. A total of 134 patients (61 males and 73 females) aged (42.9±11.8) years with primary subjective tinnitus were included. Among them, 74 were assigned to the control group and 60 to the acupuncture group. There were 68 cases of acute tinnitus and 66 of chronic tinnitus. After treatment, the reduction in THI score was greater in the acupuncture group than that in the control group [8.0 (0, 22.0) vs 3.0 (-8.0, 10.0), =0.003], and a higher proportion of patients in the acupuncture group achieved the THI MCID [40.0% (24/60) vs 21.6% (16/74), =0.034]. After adjusting for age, sex, body mass index (BMI), extraversion and conscientiousness dimension scores, and baseline tinnitus visual analogue scale (VAS) score in multivariate linear regression analysis, acupuncture intervention remained significantly associated with changes in THI total score after treatment (β=9.58, 95%: 1.86-17.31, =0.015). Multivariate logistic regression analysis of the acupuncture group showed that conscientiousness dimension score (=1.15, 95%: 1.01-1.33), openness dimension score (=1.17, 95%: 1.02-1.37), and baseline tinnitus VAS score (=1.39, 95%: 1.05-1.91) were associated with achieving clinically meaningful improvement in THI. Acupuncture as an adjunct to conventional treatment can improve tinnitus severity. The therapeutic effect of combined treatment is associated with baseline tinnitus severity and personality dimension scores.
[Gender differences in comorbidity characteristics among patients with sudden sensorineural hearing loss].
Wu XN, Liu CY, Liu YT … +6 more , Cao Y, Li J, Zhang J, Guan J, Wang DY, Wang QJ
Zhonghua Yi Xue Za Zhi · 2026 Mar · PMID 41912403 · Publisher ↗
To investigate gender differences in comorbidity profiles among patients with sudden sensorineural hearing loss (SSNHL). The study was a cross-sectional analysis based on patients with SSNHL enrolled from the Chinese Re...
To investigate gender differences in comorbidity profiles among patients with sudden sensorineural hearing loss (SSNHL). The study was a cross-sectional analysis based on patients with SSNHL enrolled from the Chinese Refractory Inner Ear Disease Cohort, which covered 29 provinces (autonomous regions/municipalities) in China. Patients were consecutively included between July 2024 and November 2025. Demographic characteristics, lifestyle factors, systemic comorbidities, and inner ear comorbidities were collected using a standardized questionnaire. Baseline characteristics and comorbidity distributions were compared between males and females. Multivariable logistic regression models were applied to evaluate the associations between gender and inner ear comorbidities. A total of 2 844 patients aged 48.7 (37.0, 60.3) years were included, with 1 217 males and 1 627 females. Male patients had significantly higher proportions of smoking, alcohol consumption, and noise exposure, whereas a history of motion sickness was more common in females (<0.001). Regarding systemic comorbidities, female patients showed higher prevalences of migraine, thyroid dysfunction, cervical spondylosis, and autoimmune diseases, while male patients had higher prevalences of hypertension, coronary heart disease, diabetes mellitus, hyperlipidemia, and cerebrovascular disease (all <0.05). Multivariable logistic regression analysis demonstrated that, compared with females, males had increased risks of hypertension (=2.28, 95%: 1.62-3.22), coronary heart disease (=3.10, 95%: 1.53-6.29), cerebrovascular disease (=2.26, 95%: 1.15-4.41), and sinusitis (=1.59, 95%: 1.13-2.22), but lower risks of migraine (=0.18, 95%: 0.10-0.32), thyroid disease (=0.20, 95%: 0.09-0.41), cervical spondylosis (=0.43, 95%: 0.30-0.60), and autoimmune disease (=0.34, 95%: 0.11-0.90). Regarding inner ear comorbidities, aural fullness (77.7%, 2 189/2 816) and tinnitus (87.1%, 2 454/2 816) were highly prevalent, with no significant differences between males and females (all >0.05). Age-stratified analysis showed that among patients older than 45 years, males had a significantly lower risk of tinnitus compared with females (=0.58, 95%: 0.36-0.95). Gender differences exist in the comorbidity spectrum of patients with SSNHL. Male patients are more likely to be accompanied by hypertension, coronary heart disease, cerebrovascular disease, and sinusitis, whereas female patients are more prone to migraine, thyroid disease, cervical spondylosis, and autoimmune diseases. Among patients older than 45 years, males have a lower risk of tinnitus than females.
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