Zhonghua Yi Xue Za Zhi[JOURNAL]
Sun
200 papers
[Psychological changes in tinnitus patients at different disease stages and related factors of comorbid somatic symptoms].
Diao TX, Han L, Yu LS … +1 more , Ma X
Zhonghua Yi Xue Za Zhi · 2026 Mar · PMID 41912402 · Publisher ↗
To investigate the psychological changes in tinnitus patients at different disease stages and associated factors of comorbid somatic symptoms (SS). This was a cross-sectional study. Tinnitus patients visited the Otolary...
To investigate the psychological changes in tinnitus patients at different disease stages and associated factors of comorbid somatic symptoms (SS). This was a cross-sectional study. Tinnitus patients visited the Otolaryngology, Head and Neck Surgery Outpatient Clinic of Peking University People's Hospital between January 2023 and June 2024 were enrolled. Baseline demographic and clinical data were collected, and tinnitus severity as well as psychological status were evaluated for all participants. All patients completed the Tinnitus Handicap Inventory (THI), Somatic Symptom Self-Rating Scale (SSSRS), Generalized Anxiety Disorder 7-item scale (GAD-7), and Patient Health Questionnaire 9-item(PHQ-9). Tinnitus characteristics and psychological status were analyzed across patients with different disease courses. Participants were stratified into the SS group (score≥30) and the non-SS group based on SSSRS scores. Multivariate logistic regression analysis was performed to identify factors associated with comorbid SS in tinnitus patients. A total of 691 tinnitus patients aged (44.8±13.1) years were enrolled, including 367 males and 324 females. Among them, 377 patients (54.6%) had chronic tinnitus (>6 months), 265 (38.4%) had comorbid anxiety, 312 (45.2%) had comorbid depression, and 394 (57.0%) had comorbid SS. Compared with the tinnitus patients with a disease duration of ≤3 months and >6 months, those with a disease duration of >3-6 months showed an increasing trend in THI scores, but the difference was not statistically significant (all >0.017). Multivariate logistic regression analysis revealed that female sex (=1.886, 95%: 1.267-2.806, =0.002), THI functional subscale (THI-F) score (=1.053, 95%: 1.033-1.073, <0.001), anxiety =2.454, 95%: 1.509-3.991, <0.001), and depression (=7.902, 95%: 4.886-12.782, <0.001) were independent associated factors for comorbid SS in tinnitus patients. Most tinnitus patients suffer from chronic tinnitus and are prone to comorbid psychological problems. Compared with the group with a disease duration of ≤3 months and >6 months, patients with a tinnitus duration of >3-6 months show an increasing trend in THI scores. Female gender, THI-F score, anxiety, and depression are associated factors for comorbid SS in tinnitus patients.
[Expert consensus on diagnosis and treatment of refractory inner ear disease (2026 edition)].
Otology Subdivision, Chinese Geriatrics Society, Subspecialty Group of Audiology, Society of Otorhinolaryngology Head and Neck Surgery, Chinese Medical Association, National Clinical Research Center for Otolaryngologic Diseases … +2 more , National Key Laboratory of Hearing and Balance, China Consortium for Refractory Inner Ear Diseases
Zhonghua Yi Xue Za Zhi · 2026 Mar · PMID 41912401 · Publisher ↗
Refractory inner ear disease (RIED) encompasses a group of diseases in which pathologic lesions involve both the cochlea and vestibule, disrupting auditory-vestibular conduction pathways and their central projections. Cl...
Refractory inner ear disease (RIED) encompasses a group of diseases in which pathologic lesions involve both the cochlea and vestibule, disrupting auditory-vestibular conduction pathways and their central projections. Clinically, RIED typically manifests as varying combinations of hearing loss, tinnitus, and vertigo. Despite adherence to standardized treatment protocols recommended by current clinical guidelines, a subset of inner ear diseases remain resistant to therapy and fail to achieve satisfactory outcomes. Recent epidemiological studies from both domestic and international sources indicate an increasing incidence of RIED, which not only compromises patients' hearing and balance function but also exerts profound effects on quality of life, mental health and social participation. These challenges impose a growing burden on healthcare systems and highlight the urgent need for more effective, evidence-based management strategies. To address these issues, a multidisciplinary expert panel encompassing otolaryngology, audiology, vestibular medicine, public health, and basic science in China has established the "China Consortium for Refractory Inner Ear Diseases" and formulated the "Expert consensus on the diagnosis and treatment of refractory inner ear disease (RIED)". This consensus comprehensively reviews the current understanding of RIED, including its epidemiology, pathogenesis, diagnostic criteria, differential diagnosis, therapeutic interventions, and long-term management. It further provides structured recommendations designed to promote standardization of clinical practice and improve diagnostic accuracy and treatment efficacy for RIED in China.
[Expert consensus on management of fever in children throughout the entire course (2026 edition)].
Pediatric Infection Group, Chinese Society of Infectious Diseases, Nutrition and Health Food Branch of the Chinese Nutrition Society, Child Development and Diseases Committee of the Chinese Maternal and Child Health Research Association
Zhonghua Yi Xue Za Zhi · 2026 Mar · PMID 41912400 · Publisher ↗
Fever is the most common symptom of illness in early childhood and the leading cause of pediatric visits. The management of childhood fever extends beyond antipyretic treatment and should emphasize comprehensive assessme...
Fever is the most common symptom of illness in early childhood and the leading cause of pediatric visits. The management of childhood fever extends beyond antipyretic treatment and should emphasize comprehensive assessment throughout the febrile episode, including symptom monitoring, etiological diagnosis, daily care, dietary adjustments, and nutritional supplements. These aspects represent core issues frequently encountered and addressed by both parents and pediatric healthcare professionals. The home is typically the primary setting for fever management. Although the internet provides abundant information on childhood fever for parents and caregivers, its variable quality often leads to parents' confusion. Concurrently, healthcare providers at all levels must stay abreast of advances in clinical evidence, continuously update diagnostic, therapeutic, and care concepts, and consistently improve the clinical management of childhood fever. Therefore, a multidisciplinary consensus working group comprising pediatric clinicians, clinical pharmacists, nurses, nutrition experts, and child health specialists was formed. Focusing on key and common issues in the holistic management of childhood fever, the expert group developed consensus recommendations based on existing literature and sound clinical practice principles. This consensus aims to provide primary care professionals, junior pediatric medical staff and pharmacists across healthcare institutions, and parents with a systematic knowledge base and practical guidance for the standardized, holistic management of childhood fever throughout the entire process.
[Pulmonary embolism response team (PERT): development, implementation, and clinical impact].
Li HW, Xi LF, Zhang Y … +4 more , Chen YN, Duo MJ, Zhang Z, Zhai ZG
Zhonghua Yi Xue Za Zhi · 2026 Mar · PMID 41912399 · Publisher ↗
Pulmonary embolism (PE) is a common and potentially fatal venous thromboembolic disease. Traditional management paradigms, often characterized by insufficient multidisciplinary collaboration, frequently lead to inadequat...
Pulmonary embolism (PE) is a common and potentially fatal venous thromboembolic disease. Traditional management paradigms, often characterized by insufficient multidisciplinary collaboration, frequently lead to inadequate risk assessment and treatment delays. The pulmonary embolism response team (PERT), a patient-centered and multidisciplinary rapid-response model, has emerged to enhance therapeutic efficiency and promote standardized management. This review systematically elucidates the structural framework, operational mechanisms, and clinical implementation of PERT. Current evidence indicates that PERT effectively optimizes treatment selections for intermediate-high and high risk PE patients through a standardized "rapid activation, risk stratification, and collective decision-making" workflow. This approach has shown positive impacts on reducing in-hospital mortality, minimizing bleeding complications, and shortening the length of hospital stay. With increasing awareness of PE prevention and management, the PERT model is gradually being promoted nationwide in China, with ongoing exploration into leveraging internet-based medical technologies to enhance the treatment capabilities of primary healthcare institutions. Although the establishment of the PERT system remains subject to multifaceted challenges, with the deep integration of emerging technologies such as artificial intelligence and big data, it holds the potential to become the standard paradigm for optimizing PE resource allocation and elevating the overall standard of care.
[Interpretation of the "Expert consensus on diagnosis and treatment of refractory inner ear disease (2026 edition)"].
Zhang J, Wang HY, Wang DY … +1 more , Wang QJ
Zhonghua Yi Xue Za Zhi · 2026 Mar · PMID 41912398 · Publisher ↗
The incidence of refractory inner ear disease (RIED) has exhibited an upward trend in recent years, emerging as a significant clinical issue characterized by long-term patient functional impairment and an exacerbated soc...
The incidence of refractory inner ear disease (RIED) has exhibited an upward trend in recent years, emerging as a significant clinical issue characterized by long-term patient functional impairment and an exacerbated societal burden. However, considerable controversies persist regarding the therapeutic and intervention strategies for RIED. To address these challenges, the "Expert consensus on clinical diagnosis and treatment of refractory inner ear disease (2026 edition)" was jointly developed by the Otology Subdivision of the Chinese Geriatrics Society, the Audiology Group of the Otorhinolaryngology-Head and Neck Surgery Branch of the Chinese Medical Association, the National Clinical Research Center for Otorhinolaryngologic Diseases, the National Key Laboratory of Hearing and Balance, and the China Consortium for RIED. Grounded in the latest evidence-based medicine and clinical practice experience, this consensus adopts a modular format to accentuate key recommendations. It provides comprehensive clinical management guidance encompassing the epidemiology, pathogenesis, diagnosis, intervention strategies, and long-term management of RIED, thereby establishing standardized protocols for clinical practice. This article presents an in-depth interpretation of the developmental background, core principles, and key recommendations of the consensus. It aims to offer precise, systematic, and practical clinical references for healthcare professionals involved in RIED management, ultimately promoting the standardization of RIED diagnosis and treatment in China.
[Expert consensus on integrated traditional Chinese and western medicine treatment of postherpetic neuralgia (2026 edition)].
Headache and Sensory Disorders Group of the Neurology Physicians′ Branch of the Chinese Medical Doctor Association, Headache and Sensory Disorders Committee of the Chinese Research Hospital Association, Pain Society of the Chinese Medical Association … +1 more , Pain Physicians′ Branch of the Chinese Medical Doctor Association
Zhonghua Yi Xue Za Zhi · 2026 May · PMID 41876120 · Publisher ↗
Postherpetic Neuralgia (PHN), as the most common complication of herpes zoster, significantly affects the quality of life of patients. The clinical diagnosis and treatment guidelines for PHN urgently need to be improved....
Postherpetic Neuralgia (PHN), as the most common complication of herpes zoster, significantly affects the quality of life of patients. The clinical diagnosis and treatment guidelines for PHN urgently need to be improved. This consensus was jointly formulated by experts from departments such as neurology, traditional Chinese medicine, pain management, acupuncture, and evidence-based medicine in China. Following the principles of evidence-based medicine and based on clinical evidence, a combined Chinese and Western medicine diagnosis and treatment framework for PHN was systematically constructed. Regarding 9 clinical issues, a total of 22 recommendations were formed, including 3 for diagnosis and 19 for treatment. In terms of diagnosis, a diagnostic model combining "precise assessment by Western medicine and overall syndrome differentiation by traditional Chinese medicine" was proposed. In terms of treatment strategies, it is advocated that the combination of Western and Chinese medicine for treating PHN should follow the principle of early initiation to achieve synergistic treatment and reduce side effects. The formulation of this consensus provides an important evidence-based basis for the standardized diagnosis and treatment of PHN and has significant clinical guiding value.
[Clinical characteristics of 20 lung adenocarcinoma patients misdiagnosed as interstitial pneumonia].
Wu J, Wang ZG, Zhang QX
Zhonghua Yi Xue Za Zhi · 2026 Mar · PMID 41856615 · Publisher ↗
This study retrospectively collected the relevant clinical data of patients with lung adenocarcinoma who were initially misdiagnosed as interstitial pneumonia at the First Affiliated Hospital of Zhengzhou University from...
This study retrospectively collected the relevant clinical data of patients with lung adenocarcinoma who were initially misdiagnosed as interstitial pneumonia at the First Affiliated Hospital of Zhengzhou University from April 2016 to October 2024. The clinical manifestations, laboratory tests, chest CT, misdiagnosis situations, treatment processes, and outcome in the patients were analyzed. A total of 20 patients were included, with 10 males and 10 females, aged (64.5±11.9) years. All 20 patients presented with cough, 15 had expectoration, 14 had chest tightness, 4 had fever, and 2 had chest pain. Carcinoembryonic antigen levels were elevated in 10 patients. There were 6 cases of the predominantly peripheral pleural type and 14 cases of the whole-lobe type. The lesions mostly manifested as ground-glass opacities, consolidation, or a combination of both. All 20 patients were initially misdiagnosed as interstitial pneumonia in the early stage and were later diagnosed with lung adenocarcinoma through lung biopsy or bronchoscopy biopsy for pathological examination. Four patients requested discharge without receiving treatment; 1 received symptomatic treatment; 1 was treated with a single immune checkpoint inhibitor, and the lesions progressed; 14 patients received chemotherapy-based comprehensive treatment, among them, 1 patient had a Kirsten rat sarcoma viral oncogene homolog (Kras) G12C mutation and was treated with sotorasib orally in combination with bevacizumab, achieving stable disease and remaining under follow-up. The median follow-up time for all patients was [(,)]12.2 (6.8, 13.7) months. Nineteen patients died, and 1 survived. The median progression-free survival was 3.0 (95%: 0.3-5.7) months (range: 0.5-9.6 months), and the median overall survival was 12.2 (95%: 7.6-16.8) months (range: 0.7-20.4 months). Diffuse interstitial lung adenocarcinoma is clinically rare and prone to misdiagnosis as interstitial pneumonia. Its imaging manifestations mainly include predominantly peripheral pleural or diffuse bilateral lung ground-glass opacities. The diagnosis mainly relies on CT-guided lung biopsy for pathological examination. Patients have a poor prognosis. Kras mutation-related targeted drugs may improve survival, but large-scale clinical studies are needed for verification.
[Effects and mechanisms of resveratrol on vascular smooth muscle cell proliferation and neointimal hyperplasia in a carotid artery injury model].
Li ZG, Zhou PL, Yuan HF … +1 more , Ma J
Zhonghua Yi Xue Za Zhi · 2026 Mar · PMID 41856614 · Publisher ↗
To investigate the effects of resveratrol on vascular smooth muscle cell (VSMC) proliferation and neointimal hyperplasia in the rat carotid artery balloon injury model after endovascular intervention, and to explore the...
To investigate the effects of resveratrol on vascular smooth muscle cell (VSMC) proliferation and neointimal hyperplasia in the rat carotid artery balloon injury model after endovascular intervention, and to explore the underlying mechanisms. Drug safety assessment: VSMC were assigned to a control group, a low-dose resveratrol group (10 μmol/L), and a high-dose resveratrol group (20 μmol/L). Cell viability was evaluated using the cell counting Kit-8 (CCK-8) assay. Pharmacodynamic assessment: VSMC were divided into a control group, a model group [20 ng/ml platelet-derived growth factor-BB (PDGF-BB)], a PDGF-BB+low-dose resveratrol group (20 ng/ml PDGF-BB+10 μmol/L resveratrol), a PDGF-BB+high-dose resveratrol group (20 ng/ml PDGF-BB+20 μmol/L resveratrol), and a positive control group (20 ng/ml PDGF-BB+20 nmol/L rapamycin). Relative cell proliferation was measured by CCK-8. Additionally, cell migration and Ki-67 expression were evaluated in the control, model, and resveratrol-treated groups (all at the previously described dose) using wound healing assays and immunofluorescence respectively. Mechanistic investigation: Western blotting was performed to quantify mammalian target of rapamycin (mTOR) pathway-related proteins, including mTOR, phosphorylated mTOR (p-mTOR), ribosomal S6 kinase (p70S6K), Cyclin D1, and proliferating cell nuclear antigen (PCNA). Rescue experiment: VSMC were divided into a control group, a model group, a resveratrol treatment group, and a mTOR agonist rescue group (10 μmol/L MHY1485 was added to the resveratrol treatment group). Cell proliferation and mTOR pathway protein levels (mTOR、p-mTOR and p70S6K) were assessed. In vivo study: the rat carotid artery balloon injury model was established. Rats were randomly allocated by a random number table to a sham-operated group, an injury group, and a treatment group (50 mg·kg·d resveratrol by intragastric administration for 21 days post-injury). On the day 21, hematoxylin-eosin (HE) staining was performed to calculate the intima/media (I/M) ratio. Ki-67 expression and mTOR pathway proteins (mTOR、p-mTOR and p70S6K) in arterial tissue were quantified by immunofluorescence and Western blotting, respectively. In the drug safety assessment, no significant differences in cell proliferation were observed among the control and resveratrol-only groups (>0.05). In the pharmacodynamic assessment, compared with the model group, relative cell proliferation, migration rate, and Ki-67 fluorescence intensity were reduced in the PDGF-BB+low-dose and PDGF-BB+high-dose resveratrol groups (all <0.01). There was no statistically significant difference in cell proliferation between the high-dose resveratrol group and the positive control group (>0.05). In the mechanistic investigation, the expression of mTOR, p-mTOR, p70S6K, Cyclin D1, and PCNA was lower in the resveratrol-treated groups than the model group (all <0.01). In the rescue experiment, the level of cell proliferation the expression of p-mTOR and p70S6K were both higher in the mTOR agonist rescue group than the resveratrol treatment group (all <0.01). In vivo, the treatment group exhibited a lower I/M ratio, reduced Ki-67 fluorescence intensity, and decreased expression of mTOR pathway proteins compared with the injury group (all <0.01). Resveratrol may inhibit VSMC proliferation and migration by suppressing mTOR signaling activity, thereby reducing neointimal hyperplasia after carotid balloon injury and alleviating post-intervention restenosis.
[Biocompatibility and anti-encrustation effect of IDP coating-modified ureteral stent materials in SD rat bladder stent retention model].
Zhang ZJ, Deng BD, Ou MJ … +2 more , Chen YX, Wen J
Zhonghua Yi Xue Za Zhi · 2026 Mar · PMID 41856613 · Publisher ↗
To investigate the biosafety of ureteral stents modified with intrinsically disordered protein family member-fused in sarcoma (IDP) coating in a rat intravesical stent retention model, and to evaluate its efficacy in pre...
To investigate the biosafety of ureteral stents modified with intrinsically disordered protein family member-fused in sarcoma (IDP) coating in a rat intravesical stent retention model, and to evaluate its efficacy in preventing encrustation on the stent surface. An IDP functional coating was constructed on the surface of polyurethane (PU) stents using a "two-step" method. Eighteen SD rats were randomly assigned to 4 groups: the PU group (=4), the ethylene-vinyl acetate (EVA) group (=4), the (PU+polyethylene glycol) (PEG) group (=5), and the (PU+IDP) group (=5). The corresponding stents were implanted into the rat bladders and harvested 14 days postoperatively. The mass of the encrustation on the stent surfaces was measured. Scanning electron microscopy (SEM) and energy dispersive spectroscopy (EDS) were employed to observe the morphology and chemical composition of the encrustation. Hematoxylin-eosin (HE) staining was performed to evaluate inflammatory cell infiltration in the bladder tissues. There was no statistically significant difference in body weight among the 4 groups (>0.05), indicating good tolerance to the materials. Significant differences in encrustation mass were observed across the 4 groups (=0.005). The (PU+IDP) group exhibited the lowest encrustation mass［（，）］11 (9, 48) mg, which was significantly lower than that of the PU group 124 (115, 146) mg and the EVA group 172 (121, 218) mg (both <0.05); however, no statistically significant difference was found between the (PU+IDP) and (PU+PEG) groups 93 (75, 96) mg (>0.05). SEM analysis showed only sparse, scattered encrustation on the (PU+IDP) surface, whereas surfaces in the other groups were heavily covered by mineral deposits. EDS analysis confirmed that the primary component of the encrustation was magnesium ammonium phosphate. HE staining revealed diffuse inflammatory cell infiltration accompanied by reactive epithelial hyperplasia in the PU, EVA, and (PU+PEG) groups. In contrast, the (PU+IDP) group exhibited a significantly attenuated inflammatory response, characterized by only focal, scattered inflammatory cells, intact mucosal structure, and the absence of significant edema or fibrosis. In a rat intravesical stent indwelling model, ureteral stents modified with IDP coating demonstrate excellent biosafety and effectively reduce the formation of magnesium ammonium phosphate encrustation on the stent surface.
[The effect of preoperative inflammatory indicators on the prognosis of patients with T1a renal cell carcinoma undergoing surgery and the construction of a predictive model].
Jiang S, Wang JH, Li HL … +6 more , Zhao YL, Zhang H, Zhu D, Wang JZ, Ge P, Wang JQ
Zhonghua Yi Xue Za Zhi · 2026 Mar · PMID 41856612 · Publisher ↗
To investigate the impact of preoperative immune-inflammatory indicators on the prognosis of patients with T1a renal cell carcinoma (RCC) undergoing surgery and to construct a prediction model. Clinical data of patients...
To investigate the impact of preoperative immune-inflammatory indicators on the prognosis of patients with T1a renal cell carcinoma (RCC) undergoing surgery and to construct a prediction model. Clinical data of patients with pT1aN0M0 RCC who underwent surgical treatment at the Affiliated Hospital of Xuzhou Medical University between January 2007 and December 2021 were retrospectively collected. Patients were followed up at the outpatient clinic at 3, 6, and 12 months post-discharge, and annually thereafter, with a maximum follow-up of 17 years. The primary endpoints were overall survival (OS) and recurrence-free survival (RFS). X-tile software was used to determine the optimal prognostic cut-off values for the following preoperative markers: albumin-to-alkaline phosphatase ratio (AAPR), fibrinogen-to-albumin ratio (FAR), neutrophil percentage-to-albumin ratio (NPAR), hemoglobin-albumin-lymphocyte-platelet (HALP) score, neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), systemic immune-inflammation index (SII), platelet-to-albumin ratio (PAR), and neutrophil-to-platelet ratio (NPR). Multivariate Cox regression analyses were performed to identify independent risk factors, based on which a prognostic nomogram was constructed. Model performance was evaluated using C-index, time-dependent receiver operating characteristic (Time-ROC) curves with the area under the curve (AUC), and the corresponding sensitivity and specificity at the maximum Youden index. The calibration curves along with the Hosmer-Lemeshow test were employed to assess the accuracy of the predicted probabilities, and the decision curve analysis (DCA) was applied to examine the clinical utility. Internal validation was conducted via the Bootstrap resampling method. A total of 784 patients were included, with the age of (57±12)years, and 521 were male and 263 were female. The follow-up time [(, )] was 80(51, 116) months. During follow-up, 61 deaths and 51 recurrences occurred. X-tile determined the optimal cut-off values as follows: AAPR 0.50, FAR 0.09, NPAR 16.17, HALP 39.85, NLR 1.87, PLR 179.00, SII 608.00, PAR 6.06, and NPR 0.02. Multivariate Cox regression analysis showed that age≥60 years (=5.45, 95%: 2.76-10.76) and radical nephrectomy (=1.91, 95%: 1.07-3.41) were risk factors for OS, while AAPR≥0.50 (=0.45, 95%: 0.26-0.79) was a protective factor for OS. For RFS, age≥60 years (=2.34, 95%: 1.30-4.19) and radical nephrectomy (=2.17, 95%: 1.10-4.27) were risk factors, while female sex (=0.48, 95%: 0.24-0.96) and AAPR≥0.50 (=0.50, 95%: 0.28-0.92) were protective factors. The OS prediction model constructed from age, surgical approach, and AAPR achieved a C-index of 0.83 (95%: 0.77-0.88). The Time-ROC analysis showed that the AUC values for 3-year OS was 0.80 (95%: 0.72-0.88), with a sensitivity of 82.4% and a specificity of 76.1%. For 5-year OS, the AUC values was 0.82 (95%: 0.76-0.89), with a sensitivity of 85.2% and a specificity of 78.5%. For 10-year OS, the AUC values was 0.80 (95%: 0.73-0.87), with a sensitivity of 79.6% and a specificity of 74.3%. Respectively, the Calibration curves for 5-year OS indicated good agreement between model-predicted probabilities and actual observed probabilities, the Hosmer-Lemeshow test indicated satisfactory calibration accuracy of the prediction model (χ=5.84, =0.67). The DCA for 5-year OS demonstrated that the model provided a higher net benefit than the"treat-all"or"treat-none"strategies (<0.001). After internal validation using the bootstrap method, the calibrated C-index was 0.80 (95%: 0.76-0.84) with an overall optimism of 0.03 (95%: 0.02-0.04). Age, surgical approach, and AAPR are significant factors influencing OS in patients with T1a RCC. The prognostic nomogram constructed based on these factors demonstrates favorable predictive performance.
[Early clinical efficacy of metaphyseal metal sleeves for AORI type 2B/3 severe bone defect in revision total knee arthroplasty].
Li DH, Wang Q, Kang PD
Zhonghua Yi Xue Za Zhi · 2026 Mar · PMID 41856611 · Publisher ↗
To investigate the early clinical efficacy and safety of metaphyseal metal sleeves in reconstructing Anderson Orthopedic Research Institute (AORI) type 2B/3 bone defects during revision total knee arthroplasty (rTKA). A...
To investigate the early clinical efficacy and safety of metaphyseal metal sleeves in reconstructing Anderson Orthopedic Research Institute (AORI) type 2B/3 bone defects during revision total knee arthroplasty (rTKA). A retrospective analysis was performed on the 32 patients with severe metaphyseal bone defects who underwent rTKA and received metaphyseal reconstruction using a metal sleeve at West China Hospital, Sichuan University, from July 2018 to December 2023. All patients were followed-up regularly at 1, 3, 6, and 12 months postoperatively, and then annually thereafter. The knee joint range of motion (ROM) was recorded preoperatively, postoperatively, and at each follow-up visit. The pain was evaluated using the visual analogue scale (VAS), the knee function was assessed with the American Knee Society Score (KSS), and the clinical effectiveness was determined by the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC). The integration quality of the sleeve-bone interface and prosthetic stability were evaluated by reviewing the full-length weight-bearing radiographs of both lower extremities as well as the anteroposterior and lateral radiographs of the knee joint obtained at the final follow-up. Compare the differences in indicators before the operation and at each follow-up. In this cohort, there were 13 males and 19 females, with a mean age of (65.5±8.8) years; there were 18 cases of left-side and 14 cases of right-side revision. All the patients were followed-up for (36.8±7.7) months. All indicators were significantly improved from preoperative to final follow-up, with statistically significant differences (all <0.05): the VAS score decreased from (4.8±2.3) points to (1.3±1.3) points; the knee joint ROM increased from 67.8°±14.1° to 98.8°±7.7°; the total KSS increased from (73.0±15.5) points to (177.6±8.2) points, among which the KSS functional score reached (88.0±5.5) points, significantly higher than the preoperative score of (30.5±15.2) points (<0.001); the WOMAC score decreased from (64.1±20.6) points to (34.4±12.6) points. Radiological examinations confirmed that continuous osseointegration zones formed around the sleeves in 30 patients (93.75%), and all periprosthetic radiolucent lines were less than 2 mm. Postoperative complications included 1 case of incisional infection (cured by debridement) and 1 case of periprosthetic fracture (cured by internal fixation), with no revision cases reported. Metaphyseal metal sleeves, applied for the reconstruction of AORI type 2B/3 severe bone defects in rTKA, can achieve reliable biological fixation and mechanical support. The osseointegration rate reached 94% at short-term follow-up, with significant pain relief, remarkable improvements in joint function and range of motion observed in patients. Complications were manageable, and the short-term clinical efficacy was definite.
[Establishment of a prediction model and analysis of influencing factors for postoperative infections in esophageal cancer patients].
Wang YD, Chen YY, Yang CY … +3 more , Wu M, Ma J, Lin YR
Zhonghua Yi Xue Za Zhi · 2026 Mar · PMID 41856610 · Publisher ↗
To analyze the influencing factors and construct a prediction model for postoperative infections in patients with esophageal cancer. A retrospective analysis was conducted on the clinical data of 787 esophageal cancer p...
To analyze the influencing factors and construct a prediction model for postoperative infections in patients with esophageal cancer. A retrospective analysis was conducted on the clinical data of 787 esophageal cancer patients who underwent surgical treatment at Liaocheng People's Hospital from January 2018 to March 2025. There were 599 male patients and 188 female patients, with the age of [(, )] 67(61, 71) years. The patients were divided into a training set (=552) and a validation set (=235) at a ratio of 7∶3 using a random sampling function. The training set was further categorized into the non-infected group (=422) and the infected group (=130) based on the occurrence of postoperative infection. Influencing factors for postoperative infections in esophageal cancer patients were screened using multivariate logistic regression, and a nomogram for the prediction model was constructed. The predictive performance, accuracy, and clinical applicability of the model were evaluated using the area under the receiver operating characteristic curve (AUC), calibration curves, and decision curve analysis, respectively. In the training set, the proportion of patients in the infected group who received neoadjuvant chemoradiotherapy before surgery, along with their levels of carbohydrate antigen 199 (CA199), neutrophil-to-lymphocyte ratio, systemic immune-inflammation index, duration of surgery, and the number of days with thoracic drainage tubes were all higher than those in the non-infected group (all <0.05). Conversely, the proportion of patients receiving intraoperative antibiotics and the rate of thoracic anastomosis were lower in the infected group than the non-infected group (both <0.05). Multivariate logistic regression analysis identified preoperative neoadjuvant chemoradiotherapy (=2.875, 95%: 1.136-7.277), CA199>18.3 kU/L (=4.251, 95%: 2.484-7.273), longer operative time (=1.173, 95%: 1.004-1.370), and prolonged chest tube drainage (=1.212, 95%: 1.107-1.326) as independent risk factors for postoperative infection. Intraoperative antibiotic administration (=0.612, 95%: 0.379-0.990) and intrathoracic anastomosis (=0.565, 95%: 0.347-0.922) were identified as protective factors. A nomogram prediction model was constructed using these variables. The model demonstrated an AUC of 0.743 (95%: 0.693-0.792) with a sensitivity of 72.3% and specificity of 65.0% in the training set, and an AUC of 0.714 (95%: 0.635-0.794) with a sensitivity of 74.5% and specificity of 65.0% in the validation set. Calibration curves for both sets indicated good model calibration (both >0.05). Decision curve analysis revealed stable net benefits across a clinical decision threshold range of 0.1 to 0.5 in both the training and validation sets. Preoperative neoadjuvant chemoradiotherapy, CA199>18.3 kU/L, prolonged operative time, and extended duration of chest tube drainage may increase the risk of postoperative infection in esophageal cancer patients, while intraoperative antibiotic administration and intrathoracic anastomosis can reduce such risk. The nomogram prediction model established based on these factors allows for a more intuitive assessment of postoperative infection risk in esophageal cancer patients.
[Development and validation of a prediction model for sarcopenia in male patients with liver cirrhosis].
Dong Y, Xu CY, Hu YY … +3 more , Gong YY, Yu TF, Cheng WF
Zhonghua Yi Xue Za Zhi · 2026 Mar · PMID 41856609 · Publisher ↗
To develop and validate a predictive model for muscle atrophy (referred to as sarcopenia) in male patients with liver cirrhosis. A retrospective analysis was conducted on clinical data from male patients with liver cirr...
To develop and validate a predictive model for muscle atrophy (referred to as sarcopenia) in male patients with liver cirrhosis. A retrospective analysis was conducted on clinical data from male patients with liver cirrhosis admitted to the First Affiliated Hospital of Nanjing Medical University between January 1, 2023 and May 31, 2024. The patients were divided into a modeling cohort and a validation cohort at a 7:3 ratio using a random number table method. Based on the skeletal muscle index derived from CT images at the third lumbar vertebra (L-SMI), the patients were divided into sarcopenia group (L-SMI<44.77 cm²/m²) and non-sarcopenia group. The logistic regression model was used to analyze and screen the predictors of sarcopenia in the modeling cohort, and verify the interaction, and finally a nomogram model was constructed. The effectiveness and clinical applicability of the model were evaluated using the area under the receiver operating characteristic curve (AUC), calibration curves, and decision curve analysis (DCA). A total of 278 male patients with liver cirrhosis, aged (58±13) years, were enrolled in this study. There were 195 patients in the modeling cohort (88 cases in sarcopenia group, 107 cases in non-sarcopenia group) and 83 patients in the validation cohort. Based on the data of the modeling group, age (=1.061, 95%: 1.027-1.097, <0.001), dry body mass index (dBMI, = 0.695, 95%:0.614-0.787, <0.001), and platelet count (=1.009, 95%: 1.003-1.015, =0.004) were predictors of sarcopenia in male patients with liver cirrhosis. No statistically significant interaction effects were observed among these variables (all >0.05). The constructed column chart shows that the AUC, sensitivity, and specificity of the modeling group are 0.848 (95%: 0.795-0.900), 65.9%, and 86.9%, respectively. The AUC, sensitivity, and specificity of the validation group are 0.841 (95%: 0.755-0.928), 78.0%, and 83.3%, respectively. Calibration curves indicated column chart has good calibration ability. DCA curves confirmed the model's decision-making has good clinical applicability. Age, dBMI, and platelet count served as predictors of sarcopenia in male patients with liver cirrhosis, and the column chart model constructed based on the above indicators can effectively predict the risk of sarcopenia in male patients with liver cirrhosis.
[Mutation characteristics and prognosis of patients with Fanconi anemia signaling pathway gene mutation myeloproliferative neoplasm].
Zhang YH, Teng GS, Hu X … +11 more , Du CX, Wang Y, Zhang HQ, Li YQ, Peng L, Duan YF, Zhao YH, Shao ZH, Yuan WP, Zhou Y, Bai J
Zhonghua Yi Xue Za Zhi · 2026 Mar · PMID 41856608 · Publisher ↗
To analyze the mutation characteristics of myeloproliferative neoplasm (MPN) patients with Fanconi anemia (FA) signaling pathway gene mutation. MPN patients with FA signaling pathway gene mutations (mutation group) diag...
To analyze the mutation characteristics of myeloproliferative neoplasm (MPN) patients with Fanconi anemia (FA) signaling pathway gene mutation. MPN patients with FA signaling pathway gene mutations (mutation group) diagnosed in the Second Hospital of Tianjin Medical University from September 2017 to October 2024 were retrospectively included. MPN patients without FA signaling pathway gene mutations (non-mutation group) were included by propensity score matching (1∶6 pairing). The patients were followed up to January 31, 2025. The clinical characteristics of the both groups were compared, and the influencing factors of survival time of MPN patients were analyzed by multivariate Cox regression model. There were 22 patients in the mutation group, 8 males and 14 females, with an age [ (, )] of 65 (30, 81) years, including 6, 10 and 6 patients with polycythemia vera (PV), essential thrombocythemia (ET) and primary myelofibrosis (PMF), respectively; PV patients had the highest proportion of both BRCA2 and FANCD2 mutations (both are 2/6), ET patients had the highest proportion of BRCA2 mutations (3/10), and PMF patients had the highest proportion of FANCD2 mutations (4/6). There were 132 patients in the non-mutation group, 48 males and 84 females, aged 65 (32, 85) years. The proportions of splenomegaly [45.5% (10/22) vs 14.4% (19/132)], secondary myelofibrosis [27.3% (6/22) vs 9.8% (13/132)], secondary myelodysplastic syndrome (MDS) [4.5% (1/22) vs 0], and secondary acute myeloid leukemia (AML) patients [4.5 (1/22) vs 0] in the mutation group were higher than those in the non-mutation group (all <0.05); There were no statistica differences in age, sex, initial blood routine hemoglobin, hematocrit, white blood cell count, platelet count, chromosome karyotype abnormalities, thrombosis, secondary cancer, and the proportion of deceased patients between the two groups (all >0.05). The median follow-up time was 4 (2, 9) years. The 10-year overall survival rate of the mutation group was lower than that of the non-mutation group (82.4% vs 96.2%, =0.037). FA signaling pathway gene mutation (=2.646, 95%: 0.316-22.178, =0.017) was the influencing factor of survival time of MPN patients. The common FA signaling pathway gene mutations in MPN patients are BRCA2, FANCD2; FA signaling pathway gene mutation is an influencing factor for survival of MPN patients.
[Clinical guidelines for neuromodulation therapy in epilepsy (2026 edition)].
Electroencephalogram and Epilepsy Group, Neurology Branch of Chinese Medical Association, Neuromodulation Collaboration Group, Neurology Branch of Chinese Medical Association
Zhonghua Yi Xue Za Zhi · 2026 Mar · PMID 41856607 · Publisher ↗
Epilepsy is a common chronic neurological disorder, with approximately one-third of patients showing poor response to antiepileptic drugs. As a key therapeutic strategy for drug-resistant epilepsy, neuromodulation has de...
Epilepsy is a common chronic neurological disorder, with approximately one-third of patients showing poor response to antiepileptic drugs. As a key therapeutic strategy for drug-resistant epilepsy, neuromodulation has demonstrated considerable clinical efficacy, yet the treatment outcomes remain inconsistent. There is an urgent need for standardized treatment plan to enhance both efficacy and safety. To address this issue, based on the latest national and international developments, the Electroencephalogram and Epilepsy Group and Neuromodulation Collaboration Group of Neurology Branch of the Chinese Medical Association organized experts and scholars in relevant fields in China to develop Clinical Guidelines for Neuromodulation Therapy in Epilepsy (2026 edition) through Delphi method. The guideline presents 18 recommendations covering multiple aspects of neuromodulation therapy for epilepsy, including treatment efficacy, selection of stimulation targets, improvements in emotional and cognitive functioning as well as quality of life, and adverse reactions. It aims to further guide and standardize the clinical management of epilepsy using neuromodulation therapy in China.
[Clinical practice guideline for the use of new-generation tetracycline-class antibiotics in pediatrics (2026 edition)].
Pediatric Infection Group, Chinese Society of Infectious Diseases, Chinese Medical Association, Antibiotics Committee, Chinese Pharmaceutical Association, National Children′s Medical Center(Shanghai)
Zhonghua Yi Xue Za Zhi · 2026 Mar · PMID 41856606 · Publisher ↗
The first-generation tetracyclines were natural products derived from microbial metabolism and approved for the treatment of various bacterial infections. After being widely used in clinical treatment, tetracyclines were...
The first-generation tetracyclines were natural products derived from microbial metabolism and approved for the treatment of various bacterial infections. After being widely used in clinical treatment, tetracyclines were found to cause adverse effects such as permanent tooth discoloration and enamel hypoplasia in children<8 years of age. Consequently, for more than half a century, warnings related to tooth discoloration have been included in the labels of all tetracycline-class agents, and they are not recommended for use in children under 8 years of age. Subsequently, the second-generation and third-generation tetracyclines (doxycycline, minocycline, tigecycline) are not recommended for use in children below 8 years of age. The new-generation tetracycline-class antibacterials play an important role in treating infections caused by various special pathogens and drug-resistant bacteria. In recent years, as the clinical demand for using new new-generation tetracyclines for the treatment of pediatric infectious diseases has been increasing, the clinical indications and safety have become issues of concern. A guideline development group composed of experts in pediatric infection and respiratory specialties, clinical pharmacy and guideline methodologist jointly conducted a comprehensive evidence-based research on the clinical issues related to the pediatric indications, safety, and effectiveness of the three new-generation tetracyclines (doxycycline, minocycline, tigecycline) that have been approved for domestic market and recommended for use in children, aiming to provide guidance for rational drug use in pediatrics in China and to address the practical challenges of off-label drug use.
[Perspectives and strategic approaches on unmet therapeutic needs in systemic lupus erythematosus].
Li Y, Chen S, Zhao DB
Zhonghua Yi Xue Za Zhi · 2026 Mar · PMID 41856605 · Publisher ↗
Systemic lupus erythematosus (SLE) is a severe autoimmune disease with an incompletely elucidated pathogenesis and multi-organ damage, imposing substantial health and economic burdens on patients. Current treatments exhi...
Systemic lupus erythematosus (SLE) is a severe autoimmune disease with an incompletely elucidated pathogenesis and multi-organ damage, imposing substantial health and economic burdens on patients. Current treatments exhibit significant unmet needs in disease remission, flare and long-term prognosis. Insufficient adoption of treat-to-target (T2T) strategy, overreliance on glucocorticoids, limited application of innovative therapies such as biological agents, and a lack of precision medicine approaches collectively represent the core challenges in optimizing SLE management in China. This article systematically analyzes the unmet needs in the treatment of SLE in China and proposes a series of recommendations about treat-to-target strategies, aiming to provide references for clinical practice management.
[Perioperative stroke after cardiac surgery: prevention and treatment strategies].
Li SJ, Ma YJ
Zhonghua Yi Xue Za Zhi · 2026 Mar · PMID 41856604 · Publisher ↗
Compared with other non-cardiac surgeries, patients undergoing cardiac surgery have a high risk of perioperative stroke. Once a stroke occurs, it will have a significant impact on the patients' prognosis and medical cost...
Compared with other non-cardiac surgeries, patients undergoing cardiac surgery have a high risk of perioperative stroke. Once a stroke occurs, it will have a significant impact on the patients' prognosis and medical costs. Perioperative stroke after cardiac surgery poses clinical challenges such as complex etiology, multi-factor interaction, and great difficulty in prevention and treatment. Therefore, this article summarizes the epidemiology, risk factors, and etiological mechanisms of perioperative stroke in cardiac surgery. It aims to reduce the risk of stroke and poor prognosis through preoperative risk assessment, intraoperative strategy optimization, and postoperative management, thereby enhancing the understanding of perioperative stroke in cardiac surgery, emphasizing the prevention and treatment of perioperative stroke in cardiac surgery, and improving the prognosis of patients.
[Prevalence and influencing factors of chronic kidney disease-associated pruritus in patients undergoing maintenance hemodialysis].
Yang G, Wan HT, Qian YJ … +22 more , Lu GY, Chen FL, Cao J, Shen JS, Lou JZ, Jiang CM, Liu CH, Zheng DH, Wang HW, Chen XL, Dai HY, Wang L, Liu B, Yang M, Zhou H, Li M, He JQ, Sun D, Zhang LY, Zhang YL, Xing CY, Mao HJ
Zhonghua Yi Xue Za Zhi · 2026 Mar · PMID 41820058 · Publisher ↗
To determine the prevalence, clinical characteristics, and associated factors of chronic kidney disease-associated pruritus (CKD-aP) among patients undergoing maintenance hemodialysis (MHD). A multicenter, cross-section...
To determine the prevalence, clinical characteristics, and associated factors of chronic kidney disease-associated pruritus (CKD-aP) among patients undergoing maintenance hemodialysis (MHD). A multicenter, cross-sectional study was conducted from July to October 2024 via the Jiangsu Provincial Dialysis Information Platform. A total of 39 212 MHD patients were enrolled. CKD-aP was diagnosed if pruritus persisted≥6 weeks after exclusion of other dermatoses, and its severity was graded with the modified Duo pruritus scale. Patients were categorized into mild to moderate pruritus group (1-12 points) and severe pruritus group (>12 points) based on the severity of itching. Demographic, laboratory, and dialysis parameters were collected. Multivariable logistic regression was used to identify independent associated factors, and differences in treatment and comorbidities across pruritus severity groups were compared. Overall, 3 638 patients were diagnosed with CKD-aP, yielding a prevalence of 9.28%; 985 patients (27.08%, 985/3 638) had severe pruritus. Multivariable analysis showed that elevated corrected serum calcium (=16.115, 95%: 3.215-81.424), hyperphosphatemia (=2.568, 95%: 1.072-6.100), and lower body mass index (BMI) (=0.892, 95%: 0.804-0.991) were independently associated with CKD-aP. The severe pruritus subgroup exhibited significantly higher prevalences of sleep disturbance [71.57% (705/985) vs 28.65% (760/2 653)], cardiovascular disease [38.48% (379/985) vs 28.87% (766/2 653)], and cerebrovascular disease [10.66% (105/985) vs 4.07% (108/2 653)] than the mild-to-moderate subgroup (all <0.001). Topical emollients (27.30%, 993/3 638) and gabapentin (13.80%, 502/3 638) were the most frequently used antipruritic agents, whereas the κ-opioid receptor agonist nalfurafine hydrochloride was used in only 1.35% (49/3 638) of patients. Although the prevalence of CKD-aP among MHD patients in Jiangsu Province is relatively low, a considerable proportion suffers from severe pruritus. The occurrence of CKD-aP is related to calcium-phosphorus metabolic disorder and low BMI. Compared with mild-to-moderate pruritus, patients with severe pruritus showed a higher prevalence of sleep disturbances, cardiovascular disease, and cerebrovascular disease.
[Effectiveness of Lanzhou lamp rotavirus vaccine against rotavirus gastroenteritis in children based on propensity score matching test negative case-control design].
Tang L, Xiu YX, Wang FZ … +10 more , Wang L, Li Z, Liu J, Li D, Li XY, Yi Y, Zhang F, Yu L, Wu JF, Yin ZD
Zhonghua Yi Xue Za Zhi · 2026 Mar · PMID 41820057 · Publisher ↗
To evaluate the vaccine effectiveness (VE) of the Lanzhou lamb rotavirus vaccine (LLR) against rotavirus gastroenteritis (RVGE) in children using a propensity score-matched (PSM) test-negative case-control design. Based...
To evaluate the vaccine effectiveness (VE) of the Lanzhou lamb rotavirus vaccine (LLR) against rotavirus gastroenteritis (RVGE) in children using a propensity score-matched (PSM) test-negative case-control design. Based on electronic health records from medical institutions and the National Immunization Program Information System, demographic information, disease diagnoses, rotavirus pathogen test results, and rotavirus vaccination details (vaccine type, number of doses, dates) were collected for acute gastroenteritis cases aged 2 months to 4 years in Chaoyang District (Beijing), Guangdong Province, and Wuhan City (Hubei Province) from 2020 to 2024. Patients were divided into a case group (rotavirus-positive) and a control group (rotavirus-negative) based on etiological test results, and vaccination proportions were calculated for each group. To reduce effects of confounding factors, a PSM test-negative case-control design was employed. The VE of LLR against different clinical outcomes was calculated using a conditional logistic regression model, and the VE of LLR against healthcare visits for rotavirus infection across different age groups was calculated using a multivariate logistic regression model. A total of 16 460 children with acute gastroenteritis aged 2 months to 4 years were collected, with an age [ (, )] of 1.4 (0.7, 2.7) years, and 9 713 (59.01%) were male. The number of children who received 1, 2, and 3 doses of LLR was 2 391 (14.53%), 894 (5.43%), and 180 (1.09%) cases, respectively. There were 1 799 cases (10.93%) in the case group. Among them, the majority were from Hubei Province (953 cases, 52.97%), with a visiting age of 2-4 years (947 cases, 52.64%), males (1 082 cases, 60.14%), in the outpatient department (1 430 cases, 79.49%), with a visiting month of April (574 cases, 18.73%), and with 0 doses of vaccination (1 523 cases, 84.66%). There were statistically significant differences in province, age, case type, month of visit and dose of vaccination between the case and the control groups (<0.001). After PSM matching, the VE (95%) of 1-dose and 2-dose LLR against the RVGE visits were 55.66% (45.83%-63.71%) and 59.37% (45.48%-69.72%), respectively, and for RVGE hospitalizations were 63.87% (38.96%-78.62%) and 82.95% (58.37%-93.01%), respectively. Multivariate logistic regression models analysis showed that among the RVGE visits, the VE of children aged 2 months to 1 year and 1 to 2 years after one dose of LLR was greater than that of children aged 2-4 years [54.96% (16.42%-78.62%) vs 59.29% (45.69%-69.98%) vs 49.53% (37.22%-59.75%), all <0.001]. LLR has a good protective effect on children aged 2 months to 4 years. Two doses provide better protection against rotavirus infection, especially for hospitalized patients with RVGE and children under 2 years old.
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