Chinese Medical Journal最新文献

{"title":"Efficacy and safety of benvitimod 1% cream for atopic dermatitis in patients aged 2 years and older: A phase III randomized clinical trial.","authors":"Yan Zhao, Zhu Wei, Yanyan Feng, Lin Ma, Danhong Jiao, Yong Cui, Jun Gu, Kunpeng Bian, Chao Ci, Jianjian Zhu, Tiechi Lei, Yujie Shi, Xiaohua Tao, Xiuping Han, Xiaoli Zhang, Litao Zhang, Ying Li, Genhui Chen, Jianzhong Zhang","doi":"10.1097/CM9.0000000000003769","DOIUrl":"10.1097/CM9.0000000000003769","url":null,"abstract":"<p><strong>Background: </strong>Benvitimod (tapinarof), an aryl hydrocarbon receptor (AhR) agonist approved for treating plaque psoriasis, is being investigated as a potential treatment for atopic dermatitis (AD). The aim of this study was to evaluate the efficacy and safety of benvitimod 1% cream in patients aged 2 years or older with AD.</p><p><strong>Methods: </strong>This randomized controlled trial enrolled 271 Chinese patients with AD aged ≥2 years, who received either benvitimod 1% cream ( n = 183) or vehicle cream ( n = 88) twice daily for 8 weeks in a 2:1 ratio at 35 sites in China from June to November 2023. The primary endpoint was the proportion of patients achieving a 75% improvement in the Eczema Area and Severity Index (EASI) 75 at week 8. Secondary endpoints included achievement of Investigator's Global Assessment (IGA) scores of 0/1, 90% EASI improvement (EASI 90), and ≥3-point reduction in Peak Pruritus Numerical Rating Scale (PP-NRS). Treatment-emergent adverse events (TEAEs) were monitored for safety evaluation. Furthermore, a subset of patients ( n = 43) opted into a 44-week open-label extension.</p><p><strong>Results: </strong>At week 8, a significantly higher proportion of patients treated with benvitimod achieved EASI 75 compared to those receiving vehicle (54.4% [ n = 183] vs. 25.5% [ n = 88]; P <0.001). The benvitimod group also showed superior results across all secondary endpoints: IGA 0/1 (46.2% [ n = 183] vs . 21.4% [ n = 88]; P <0.001), EASI 90 (33.9% [58/171] vs . 13.5% [10/74]; P <0.001), and ≥3-point decrease in PP-NRS (54.0% [47/87] vs . 27.9% [12/43]; P <0.01). TEAEs occurred in 51.4% (94/183) of benvitimod-treated patients vs. 43.2% (38/88) of vehicle-treated patients, with most events being mild to moderate in severity.</p><p><strong>Conclusion: </strong>Benvitimod 1% cream demonstrated favorable efficacy and safety in adult and pediatric patients with AD, supporting its potential as a novel topical treatment option.</p><p><strong>Trial registration: </strong>chinadrugtrials.org.cn , CTR20231413.</p>","PeriodicalId":10183,"journal":{"name":"Chinese Medical Journal","volume":" ","pages":"3076-3083"},"PeriodicalIF":9.1,"publicationDate":"2026-10-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145074489","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":"Molecular mechanisms, current therapeutics, and emerging strategies in esophageal cancer: A comprehensive review.","authors":"Yingnan Wang, Xiaowen Lian, Yukun Chen, Feng Wang","doi":"10.1097/CM9.0000000000004194","DOIUrl":"10.1097/CM9.0000000000004194","url":null,"abstract":"<p><strong>Abstract: </strong>Esophageal cancer (EC) is a prevalent and highly aggressive malignancy with an increasing global burden that is associated with significant mortality. The principal histological subtypes of EC, esophageal squamous cell carcinoma (ESCC) and esophageal adenocarcinoma (EAC), exhibit distinct etiological factors and genomic landscapes. This review systematically categorizes and synthesizes findings from key EC clinical trials conducted over the past five years. Specifically, we integrate the current understanding of molecular pathogenesis, targeted therapeutic approaches, the tumor immune microenvironment, and emerging treatment strategies. Immunotherapy has emerged as a breakthrough in the management of EC; however, the progress in the development of targeted therapies has been notably slower. To address this gap, promising future directions in targeted therapy may include tyrosine kinase inhibitors (TKIs), cyclin-dependent kinase 4/6 (CDK4/6) inhibitors, agents targeting the phosphoinositide 3-kinase (PI3K)/protein kinase B (AKT)/mammalian target of rapamycin (mTOR) pathway, and epigenetic modulators. Despite these significant therapeutic advances, EC remains a highly lethal disease, which underlines the critical and ongoing need to identify novel therapeutic vulnerabilities and explore innovative combination treatment regimens.</p>","PeriodicalId":10183,"journal":{"name":"Chinese Medical Journal","volume":" ","pages":"3003-3036"},"PeriodicalIF":9.1,"publicationDate":"2026-10-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148419289","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":"Keratin 8 enhances the efficacy of mesenchymal stem cells in preventing acute graft-versus-host disease.","authors":"Ya Zhou, Rui Wang, Zheng Wang, Hao Yu, Qing Xu, Yuxi Xu, Yuxuan He, Ziyi Hu, Qi Wang, Xiaodong Xie, Shijie Yang, Lingyu Zeng, Xiaoqi Wang, Qingxiao Song, Xi Zhang","doi":"10.1097/CM9.0000000000004277","DOIUrl":"10.1097/CM9.0000000000004277","url":null,"abstract":"<p><strong>Background: </strong>Acute graft-versus-host disease (aGVHD) remains a leading cause of morbidity and mortality after allogeneic hematopoietic stem cell transplantation (allo-HSCT). The development of methods that preserve graft-versus-leukemia (GVL) activity while preventing aGVHD remains a long-sought goal. Recent studies suggest that mesenchymal stem cells (MSCs), particularly human umbilical cord-derived MSCs (HUC-MSCs), are effective at mitigating aGVHD, yet their varied efficacy remains poorly understood.</p><p><strong>Methods: </strong>We performed a comprehensive analysis of MSCs heterogeneity through single-cell transcriptomic mapping across nine human tissue sources and identified the keratin 8 high-expression (KRT8 + ) subpopulation of HUC-MSCs with enhanced functional properties. We further validated the functional roles of the KRT8 + subpopulation through lentivirus-mediated KRT8 overexpression. Bulk RNA sequencing was used to analyze the genomic impact of KRT8 overexpression. Additionally, we examined the effects of KRT8 overexpression on cellular senescence via Western blotting and β-galactosidase (SA-β-gal) staining. The immunosuppressive function of HUC-MSCs was evaluated by coculturing them with CD3 + T cells and liver organoids. Cell migration ability was assessed through Transwell assays and PKH26 dye labeling in vivo . An MHC-mismatched GVHD mice model (C57BL/6J to BALB/c) was established to test the therapeutic effect of HUC-MSCs. Clinical signs of aGVHD were monitored, and pathological changes were analyzed using hematoxylin and eosin staining. The GVL effect was evaluated through the inoculation of luciferase-transfected A20 cells and bioluminescence imaging.</p><p><strong>Results: </strong>KRT8 was expressed predominantly in HUC-MSCs. Compared with the KRT8 low-expression (KRT8 lo ) subpopulation of HUC-MSCs, the KRT8 + subpopulation presented increased stemness and reduced immunogenicity. KRT8 overexpression in HUC-MSCs significantly ameliorated aGVHD in vivo . Importantly, increased KRT8 expression in HUC-MSC did not impaire GVL activity in A20 lymphoma cells. Functional experiments further confirmed that HUC-MSCs with increased KRT8 expression significantly reduced cellular senescence by increasing enhancer of zeste homolog 2 ( EZH2 )-mediated histone h3 lysine 27 trimethylation (H3K27me3). This upregulation resulted in increased secretion of hepatocyte growth factor (HGF). This, in turn, suppressed T-cell proliferation and activation, significantly reducing liver organoid damage in vitro .</p><p><strong>Conclusions: </strong>Our results suggest that the infusion of KRT8 + HUC-MSCs enhances the efficacy of preventing aGVHD but does not interfere with the GVL effect. This strategy represents a promising therapeutic advancement in the setting of allo-HSCT.</p>","PeriodicalId":10183,"journal":{"name":"Chinese Medical Journal","volume":" ","pages":"3084-3095"},"PeriodicalIF":9.1,"publicationDate":"2026-10-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148825661","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 capnothorax versus single-lung ventilation in minimally invasive esophagectomy for esophageal cancer: A randomized controlled trial.","authors":"Yi-Min Gu, Yushang Yang, Qixin Shang, Hanlu Zhang, Chengyi Yan, Bowei Liu, Yixin Liu, Huahang Lin, Shixiang Liu, Lin Yang, Ruichen Cui, Haonan Lin, Weipeng Hu, Dong Tian, Yunke Zhu, Yang Hu, Yong Yuan, Long-Qi Chen, Wen-Ping Wang","doi":"10.1097/CM9.0000000000003628","DOIUrl":"10.1097/CM9.0000000000003628","url":null,"abstract":"<p><strong>Background: </strong>Artificial capnothorax during surgery potentially increases the risk of tumor cell dissemination and impacts survival. This trial aimed to investigate the effect of artificial capnothorax on the prognosis of patients with esophageal cancer who underwent minimally invasive esophagectomy.</p><p><strong>Methods: </strong>This prospective, randomized controlled trial was conducted in two high-volume hospitals in China. Between August 2019 and January 2020, 110 patients with resectable esophageal cancer were randomized to undergo single-lung ventilation ( n = 55) or capnothorax procedures ( n = 55). The analysis was based on the intention-to-treat principle. The final follow-up occurred in January 2023.</p><p><strong>Results: </strong>A total of 110 patients were included in the intention-to-treat analysis. After surgery, the incidence of patients exhibiting incremental changes in circulating tumor cell levels was 18.6% (8/43) in the capnothorax group and 2.7% (1/37) in the single-lung ventilation group ( P = 0.033) (mean changes, -3.9 ± 3.4 [FU/3 mL] vs. -2.4 ± 2.9 [FU/3 mL], respectively; P = 0.039). Compared with the capnothorax group, the single-lung ventilation group had better 3-year overall survival rates (81.6%, 95% confidence interval [CI]: 72.4-92.0% vs. 65.2%, 95% CI: 59.3-78.8%; P = 0.049) and disease-free survival rates (81.6%, 95% CI: 72.4-93.0% vs. 61.6%, 95% CI: 50.1-75.7%; P = 0.019). Multivariate analysis indicated that artificial pneumothorax potentially impaired overall survival (hazard ratio [HR]: 2.35, 95% CI: 1.05-5.24; P = 0.037) and disease-free survival (HR: 2.70, 95% CI: 1.23-5.94; P = 0.014).</p><p><strong>Conclusions: </strong>Artificial capnothorax appears to be associated with poor oncological outcomes in patients with esophageal cancer. Single-lung ventilation in minimally invasive esophagectomy is safer and more favorable than capnothorax.</p><p><strong>Trial registration: </strong>Chinese Clinical Trial Registry ( http://chictr.org.cn ), ChiCTR1900025262.</p>","PeriodicalId":10183,"journal":{"name":"Chinese Medical Journal","volume":" ","pages":"3066-3075"},"PeriodicalIF":9.1,"publicationDate":"2026-10-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144607627","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":"Glycemic control and long-term macrovascular outcomes in people with type 2 diabetes in China.","authors":"Feng Sun, Qi Pan, Meng Zhang, Peng Shen, Yexiang Sun, Hongbo Lin, Siyan Zhan, Lixin Guo","doi":"10.1097/CM9.0000000000004266","DOIUrl":"10.1097/CM9.0000000000004266","url":null,"abstract":"","PeriodicalId":10183,"journal":{"name":"Chinese Medical Journal","volume":" ","pages":"3152-3154"},"PeriodicalIF":9.1,"publicationDate":"2026-10-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148910867","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":"A randomized, double-blind, placebo- and self-controlled pilot study on combined therapy with topical 0.1% tretinoin and narrow-band UVB for stable vitiligo.","authors":"Malalie, Yan Sun, Yan Wu, Yuqing Zhang, Xinghua Gao","doi":"10.1097/CM9.0000000000004292","DOIUrl":"https://doi.org/10.1097/CM9.0000000000004292","url":null,"abstract":"","PeriodicalId":10183,"journal":{"name":"Chinese Medical Journal","volume":" ","pages":""},"PeriodicalIF":9.1,"publicationDate":"2026-10-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149223383","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":"Metabolic processes and microenvironmental regulation in leukemia.","authors":"Binhe Chang, Yong Wang, Zijuan Li, Muying Zhao, Chuhan Deng, Yiyi Ren, Qijing Li, Xiaojian Sun, Lan Wang","doi":"10.1097/CM9.0000000000004226","DOIUrl":"https://doi.org/10.1097/CM9.0000000000004226","url":null,"abstract":"<p><strong>Abstract: </strong>Leukemia, a heterogeneous group of hematologic malignancies, continues to present significant therapeutic challenges owing to persistent issues, such as relapse, drug resistance, and treatment-related toxicity. While traditional research has primarily focused on genetic drivers, there is increasing recognition of the critical roles played by the bone marrow microenvironment (BMME) and metabolic reprogramming in disease pathogenesis. This review systematically elucidates the dynamic interplay between these 2 hallmarks of leukemia. We detailed how leukemia cells rewire their metabolic networks to sustain uncontrolled proliferation, emphasizing aberrant activation of glucose metabolism and dynamic remodeling of lipid metabolism via de novo synthesis, uptake, and oxidation. Additionally, we highlighted a critical dependency on specific amino acids, such as glutamine and serine. We investigated the use of BMME to create a protective niche for leukemia cells. These include supportive functions provided by bone marrow stromal cells via direct contact and paracrine signaling, the establishment of an immunosuppressive environment characterized by T cell and natural killer cell exhaustion, an increase in regulatory populations, and the driving force of chronic inflammatory signaling. Importantly, these processes are interdependent, and a reciprocal relationship exists wherein metabolic byproducts from leukemia cells remodel the BMME while simultaneously enabling this microenvironment to dictate metabolic phenotypes in leukemia cells. Targeting the intricate axis between metabolism and the microenvironment is a promising frontier for the development of novel and effective combination therapies against leukemia.</p>","PeriodicalId":10183,"journal":{"name":"Chinese Medical Journal","volume":" ","pages":""},"PeriodicalIF":9.1,"publicationDate":"2026-10-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149223378","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":"Standardization of nomenclature for new biomedical technologies.","authors":"Kaizhen Wang, Yifei Liu, Xinyi Du, Rui He, Qi Chen, Ping Liu, Fang Wu, Zhenhang Yu","doi":"10.1097/CM9.0000000000004366","DOIUrl":"https://doi.org/10.1097/CM9.0000000000004366","url":null,"abstract":"","PeriodicalId":10183,"journal":{"name":"Chinese Medical Journal","volume":" ","pages":""},"PeriodicalIF":9.1,"publicationDate":"2026-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149179599","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":"Perioperative care and follow-up results in laryngeal transplantation.","authors":"Dingyuan Wan, Yiyi Yang, Zhengying Xu, Shouping Wang, Fei Chen, Min He, Zhongwei Zhang","doi":"10.1097/CM9.0000000000004304","DOIUrl":"https://doi.org/10.1097/CM9.0000000000004304","url":null,"abstract":"","PeriodicalId":10183,"journal":{"name":"Chinese Medical Journal","volume":" ","pages":""},"PeriodicalIF":9.1,"publicationDate":"2026-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149179549","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":"Effect of transcutaneous auricular vagus nerve stimulation on perioperative psychological symptoms in patients undergoing elective thoracoscopic lung resection: A randomized controlled trial.","authors":"Zhengxiu Sun, Song Zhang, He Liu, Mingshu Tao, Yuanyuan Wang, Junda Chen, Xingyu Xiong, Qian Deng, Yumei Yu, Yongao Lin, Tianxi Ma, Mingkai Zhou, Pinghao Li, Xiaoqing Guo, Jinling Liu, Chuyu Hang, Mingyuan Wang, Yuan Han, Hongxing Zhang, Junli Cao","doi":"10.1097/CM9.0000000000004326","DOIUrl":"https://doi.org/10.1097/CM9.0000000000004326","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Perioperative anxiety is highly prevalent in patients undergoing thoracoscopic lung resection, adversely affecting postoperative recovery. Transcutaneous auricular vagus nerve stimulation (taVNS) has emerged as a promising noninvasive neuromodulatory intervention with demonstrated efficacy in various psychiatric and stress-related conditions. This study aimed to evaluate the efficacy and safety of taVNS in reducing perioperative anxiety in this population.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;This single-center, parallel-group, randomized, double-blind, superiority trial was conducted at the Department of Anesthesiology and Thoracic Surgery, the Affiliated Hospital of Xuzhou Medical University between October 10, 2024, and April 30, 2025. A total of 176 eligible patients aged ≥18 years with ASA physical status I-III and scheduled for elective thoracoscopic lung resection were enrolled. Patients with neuropsychiatric disorders, auricular lesions, severe cardio-cerebrovascular diseases, implanted electronic devices, Mini-Mental State Examination (MMSE) score &lt;15, long-term psychotropic medication use or postural tachycardia syndrome were excluded. All participants were randomly allocated to receive four sessions of either active taVNS or sham taVNS. Stimulation was delivered via the auricular branch of the vagus nerve at the cymba conchae of the left ear at four predefined perioperative time points: the afternoon before surgery, the morning of surgery, immediately after tracheal extubation, and the afternoon of the first postoperative day. The primary outcome was the incidence of perioperative anxiety, assessed from the initiation of the first taVNS session through 3 days postoperatively. All participants, healthcare providers, outcome assessors and data analysts were blinded to group assignment during the whole study.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;A total of 176 patients were randomly assigned, with 88 participants in the active taVNS group and 88 in the sham taVNS group. After excluding 2 patients (1 patient from each group) who were transferred to the ICU postoperatively, a total of 174 patients (median age, 58 years; 105 women [60.4%]) completed the study and were analysed for the primary outcome, including 87 patients in each group. The incidence of perioperative anxiety was significantly lower in the active taVNS group than in the sham taVNS group (50.6% vs. 73.6%; relative risk [RR], 0.59; 95% confidence interval [CI], 0.41-0.85; χ2 = 9.76; P = 0.002). Compared with sham stimulation, active taVNS was associated with reductions in anxiety and depression scores, postoperative pain intensity, and physiological stress indices and improvement in sleep quality and overall postoperative recovery. No severe adverse events were observed in either group. The main mild adverse reactions included nausea, vomiting, local tingling, dizziness and headache, and the incidence of adverse events was similar between the two groups.&lt;","PeriodicalId":10183,"journal":{"name":"Chinese Medical Journal","volume":" ","pages":""},"PeriodicalIF":9.1,"publicationDate":"2026-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149179558","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}