Chinese Medical Journal最新文献

{"title":"Trends and cross-country inequalities in the global burden of female genital prolapse from 1990 to 2021: A population-based study.","authors":"Quan Zhou, Shuo Chen, Ping Chen, Mian Chen, Yanfeng Song","doi":"10.1097/CM9.0000000000004297","DOIUrl":"10.1097/CM9.0000000000004297","url":null,"abstract":"","PeriodicalId":10183,"journal":{"name":"Chinese Medical Journal","volume":" ","pages":""},"PeriodicalIF":9.1,"publicationDate":"2026-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148967062","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"5-HT2A receptor activation is dispensable for psilocybin-induced fear extinction and neuroplasticity in mice.","authors":"Yingjie Du, Xiangting Zhao, Quan Chen, Yafan Bai, Yue Zhang, Ruirong Chen, Guyan Wang","doi":"10.1097/CM9.0000000000004350","DOIUrl":"10.1097/CM9.0000000000004350","url":null,"abstract":"<p><strong>Background: </strong>Psilocybin facilitates fear extinction in rodents, but its clinical utility is hampered by 5-hydroxytryptamine (5-HT) 2A-receptor-mediated hallucinogenic effects. This study aimed to explore whether 5-HT2A receptor is obligatory for psilocybin's fear extinction and neuroplasticity effect.</p><p><strong>Methods: </strong>Male C57BL/6J mice underwent auditory-cue fear conditioning. Ketanserin (5-HT2A/2C antagonist) or MDL100907 (selective 5-HT2A antagonist) was administered 30 min before a single psilocybin (2.5 mg/kg, intraperitoneal) or vehicle injection. Mice were fear-conditioned 2 days before psilocybin administration, extinction training commenced 30 min after the psilocybin injection, and extinction testing was performed 24 h later. The mice were euthanized 1.5 h after behavioral testing in the MDL100907 antagonism experiment, and hippocampal and medial prefrontal cortex (mPFC) tissues were collected. Western blotting and enzyme-linked immunosorbent assay (ELISA) were used to detect brain-derived neurotrophic factor (BDNF) protein expression. Immunofluorescence staining was used to assess the number of doublecortin-positive cells in the hippocampal dentate gyrus (DG).</p><p><strong>Results: </strong>In extinction testing, mice that received psilocybin combined with either ketanserin or MDL100907 still exhibited a significantly lower freezing response than those treated with antagonist alone. MDL100907 pretreatment failed to block the psilocybin-evoked upregulation of BDNF in both hippocampus and mPFC. Likewise, the increase in doublecortin (DCX)-positive newborn neurons in the DG induced by psilocybin remained intact after MDL100907 blockade.</p><p><strong>Conclusions: </strong>The effects of psilocybin in facilitating fear extinction and increasing neuroplasticity in fear-conditioned mice are not dependent on 5-HT2A receptor activation, which supports that its therapeutic and hallucinogenic effects can be dissociated.</p>","PeriodicalId":10183,"journal":{"name":"Chinese Medical Journal","volume":" ","pages":""},"PeriodicalIF":9.1,"publicationDate":"2026-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148966980","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Immune checkpoint inhibitor-related colitis: Mechanisms, diagnosis, and treatment.","authors":"Xinyu Qiu, Zhengye Wei, Lei Zhu","doi":"10.1097/CM9.0000000000004294","DOIUrl":"https://doi.org/10.1097/CM9.0000000000004294","url":null,"abstract":"","PeriodicalId":10183,"journal":{"name":"Chinese Medical Journal","volume":" ","pages":""},"PeriodicalIF":9.1,"publicationDate":"2026-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148966925","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Seven-day and fourteen-day vonoprazan-based dual or triple regimens for first-line Helicobacter pylori eradication.","authors":"Shuangshuang Jiang, Hui Yang, Gang Ma, Xia Zhou, Jing Zhang, Guanya Guo, Hui Chen, Gui Jia, Xin Zhao, Na Wang, Weijie Wang, Jiaqiang Dong, Yulong Shang, Ying Han","doi":"10.1097/CM9.0000000000004313","DOIUrl":"https://doi.org/10.1097/CM9.0000000000004313","url":null,"abstract":"","PeriodicalId":10183,"journal":{"name":"Chinese Medical Journal","volume":" ","pages":""},"PeriodicalIF":9.1,"publicationDate":"2026-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148967102","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Artificial intelligence in laboratory medicine: From machine learning to large language models.","authors":"Shichang Zhang, Yingjian Zhan, Kun Xu, Hongwei Zhou","doi":"10.1097/CM9.0000000000004291","DOIUrl":"10.1097/CM9.0000000000004291","url":null,"abstract":"<p><strong>Abstract: </strong>The integration of artificial intelligence (AI) into laboratory medicine has undergone a remarkable evolution over the past decade, shifting from traditional machine learning (ML) applied to structured laboratory data to the recent emergence of large language models (LLMs) capable of processing unstructured clinical text, interpreting complex laboratory findings, and supporting clinical decision-making. This narrative review traces that progression and critically compares four main AI paradigms accessible to laboratory professionals: conventional ML, deep learning, general-purpose LLMs, and laboratory-specific foundation models. We examine representative application domains-blood cell morphological analysis, autoverification, acute infectious risk stratification, interpretation of urinalysis data, clinical decision support, and report generation-and assess the maturity of the evidence for each domain. Laboratories contemplating AI adoption face a distinctive set of challenges: preanalytical variability, interplatform calibration differences, effects of the specimen quality, reagent-lot sensitivity, and the context dependence of result interpretation, all of which demand validation practices beyond those that are standard in general medical AI research. We conclude that AI is best positioned, in the near term, as an assistive layer rather than an autonomous agent. Its deployment requires a clear problem definition, disciplined data engineering, external validation, prospective silent trials, human-in-the-loop oversight, and postdeployment surveillance aligned with existing laboratory quality systems. We additionally discussed the rationale for developing vertically oriented, laboratory-specific foundation models that can integrate structured results, longitudinal patient data, quality-control metadata, instrument information, and clinical knowledge. Clinical accountability must remain with qualified laboratory professionals.</p>","PeriodicalId":10183,"journal":{"name":"Chinese Medical Journal","volume":" ","pages":""},"PeriodicalIF":9.1,"publicationDate":"2026-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148963017","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Artificial intelligence meets continuous glucose monitoring data: Genie in the bottle.","authors":"Jingyi Lu, Ziyi Zhang, Yaxin Wang, Jinghao Cai, Xia Yu, Geng Zong, Jian Zhou","doi":"10.1097/CM9.0000000000004229","DOIUrl":"10.1097/CM9.0000000000004229","url":null,"abstract":"","PeriodicalId":10183,"journal":{"name":"Chinese Medical Journal","volume":" ","pages":""},"PeriodicalIF":9.1,"publicationDate":"2026-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148963036","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Lysophosphatidylcholine-induced macrophage polarization imbalance and functional dysregulation in immune thrombocytopenia.","authors":"Nan Jiang, Zi Sheng, Shaoqiu Leng, Xiaoyu Zhang, Xinyue Liu, Rosa Ayala Diaz, Joaquín Martínez-López, Yanqi Zhang, Xiang Hu, Shuai Liu, Shuqian Xu, Jun Peng, Yan Liu, Shuwen Wang","doi":"10.1097/CM9.0000000000004172","DOIUrl":"10.1097/CM9.0000000000004172","url":null,"abstract":"<p><strong>Background: </strong>The pathogenesis of immune thrombocytopenia (ITP) involves platelet destruction driven by immune dysregulation, notably macrophage dysfunction. Lysophosphatidylcholine (LPC), a class of bioactive lipid, can modulate inflammation and immunity. This study aimed to determine whether LPC (16:0/0:0) reprograms macrophage metabolism and function in ITP, and to evaluate the therapeutic efficacy of dexamethasone (DXM) and atorvastatin (AT).</p><p><strong>Methods: </strong>Bone marrow (BM) samples were collected from 61 patients with ITP and 46 healthy controls (HCs) at Qilu Hospital of Shandong University between July 2023 and June 2025. Flow cytometry was used to assess macrophage subsets. Untargeted metabolomics and transcriptomics were performed on sorted BM macrophages. The in vitro effects of LPC (16:0/0:0) on interleukin-10 (IL-10) expression, phagocytosis, and T-cell differentiation, as well as the impact of DXM, AT, or their combination, were tested. Passive and active ITP murine models were used for in vivo validation.</p><p><strong>Results: </strong>ITP patients had significantly elevated M1 macrophages and decreased IL-10 levels compared to HCs. Integrated metabolomic and transcriptomic analyses revealed enrichment in the glycerophospholipid metabolism pathway, identifying LPC (16:0/0:0) as the most significantly elevated metabolite. Elevated LPC (16:0/0:0) levels correlated with severe thrombocytopenia. In vitro , LPC (16:0/0:0) suppressed IL-10 secretion by macrophages and enhanced M1 macrophage phagocytosis of platelets. It also reduced regulatory T cells (Treg) proportions and increased helper T cell (Th) 1, Th2 and Th22 differentiation. Treatment with DXM or AT restored IL-10 levels and inhibited phagocytosis; DXM suppressed Th1 and Th2 differentiation, AT restored Treg proportions. In vivo , LPC (16:0/0:0) decreased platelet counts and promoted M1 macrophage polarization. DXM and AT promoted platelet recovery and macrophage repolarization, with combination therapy demonstrating superior efficacy.</p><p><strong>Conclusions: </strong>LPC (16:0/0:0) drives ITP pathogenesis by reprogramming macrophage metabolism and function, promoting inflammation and platelet destruction. The DXM-AT combination exerts synergistic therapeutic effects by complementary targeting of metabolic and immune pathways in the LPC-driven pathogenic axis, effectively restoring immune homeostasis.</p>","PeriodicalId":10183,"journal":{"name":"Chinese Medical Journal","volume":" ","pages":""},"PeriodicalIF":9.1,"publicationDate":"2026-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148963121","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy and safety of vonoprazan, amoxicillin, and berberine hydrochloride triple therapy as first-line Helicobacter pylori eradication therapy.","authors":"Qiqi Guo, Qimeng Pang, Ju Zhang, Xiaojing Zhu, Weiyue Li, Danyang Zhao, Mengqi Liang, Rong Yan, Min Chen, Yongquan Shi","doi":"10.1097/CM9.0000000000004236","DOIUrl":"10.1097/CM9.0000000000004236","url":null,"abstract":"","PeriodicalId":10183,"journal":{"name":"Chinese Medical Journal","volume":" ","pages":""},"PeriodicalIF":9.1,"publicationDate":"2026-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148963095","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical practice guidelines on liver transplantation for extended criteria donor grafts in China (2025 edition).","authors":"Kai Wang, Fengqiang Gao, Lin Fan, Junli Chen, Ze Xiang, Haijun Guo, Gang Xu, Wenjie Zhang, Jun Zheng, Xinyu Yang, Caide Lu, Zhengxin Wang, Jiayin Yang, Xiao Xu","doi":"10.1097/CM9.0000000000004232","DOIUrl":"10.1097/CM9.0000000000004232","url":null,"abstract":"","PeriodicalId":10183,"journal":{"name":"Chinese Medical Journal","volume":" ","pages":""},"PeriodicalIF":9.1,"publicationDate":"2026-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148963044","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Converging endoscopic techniques and artificial intelligence for diagnosis and risk stratification of pancreatic cystic neoplasms.","authors":"Yaoyu Guo, Xiao Li, Xiaoxi Xie, Xi Liao, Chunhui Wang, Rui Wang","doi":"10.1097/CM9.0000000000004233","DOIUrl":"10.1097/CM9.0000000000004233","url":null,"abstract":"","PeriodicalId":10183,"journal":{"name":"Chinese Medical Journal","volume":" ","pages":""},"PeriodicalIF":9.1,"publicationDate":"2026-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148963082","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}