Chinese Medical Journal最新文献

{"title":"Evidence and controversies of inositol in women's reproductive health.","authors":"Anna A Druzhinina, Safiya M Giulakhmedova, Olga S Alyautdina, Ekaterina M Eliseeva, Anna A Chistokhina","doi":"10.1097/CM9.0000000000004319","DOIUrl":"https://doi.org/10.1097/CM9.0000000000004319","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":"149179535","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":"Chronic obstructive pulmonary disease increases the risk of cardiovascular disease occurrence in nonsmokers: A nationwide cohort study.","authors":"Zhihan Jiang, Qiqiang Zhou, Yingying Dai, Jing Chang, Nan Li, Jun Lv, Yahong Chen, Ying Liang, Yongchang Sun","doi":"10.1097/CM9.0000000000004301","DOIUrl":"https://doi.org/10.1097/CM9.0000000000004301","url":null,"abstract":"<p><strong>Background: </strong>Chronic obstructive pulmonary disease (COPD) is among the leading causes of mortality worldwide, and patients experience a high prevalence of concomitant cardiovascular diseases (CVDs). In this study, we aimed to determine whether never smokers with COPD exhibit an increased risk of CVD compared with those without COPD and whether this risk parallels that observed in smokers with COPD.</p><p><strong>Methods: </strong>We conducted a prospective cohort study using data from the China Kadoorie Biobank (CKB). Spirometry was performed on all the participants, and COPD was defined as the ratio of forced expiratory volume in 1 second to forced vital capacity (FEV1/FVC) <0.7. Eligible participants in our study were free of diagnosed CVDs, including ischemic heart disease, heart failure, hypertension, or atrial fibrillation at baseline. The clinical outcomes were the incidences of these 4 CVDs and their overall incidence during follow-up. Cox proportional hazard models were used to estimate the associations of COPD and smoking status with incident CVD outcomes.</p><p><strong>Results: </strong>Among all eligible participants (n = 366,161, 20,887 with COPD), 40,861 incident cases of CVD events were observed during a median follow-up time of 10 years. Compared with never smokers without COPD, those with COPD exhibited a significantly higher risk of overall CVD, with hazard ratios (HRs) of 1.23 (95% CI: 1.09-1.39) for men and 1.24 (95% CI: 1.17-1.31) for women. Among male COPD participants, the incidence rates of overall CVD, ischemic heart disease, and hypertension, but not that of heart failure, were similar between never smokers and smokers. In contrast, female COPD participants who never smoked exhibited lower risks across all cardiovascular endpoints compared with their smoking counterparts. These results remained unchanged after propensity score matching.</p><p><strong>Conclusion: </strong>In never smokers, COPD per se serves as an independent risk factor for CVD. Among men with COPD, smoking exposure confers no added hazard, whereas women with COPD who smoke remain at higher risk for CVD than their never-smoking counterparts.</p>","PeriodicalId":10183,"journal":{"name":"Chinese Medical Journal","volume":" ","pages":""},"PeriodicalIF":9.1,"publicationDate":"2026-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149164266","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":"Mesenchymal stem cells in diabetic kidney disease: Potential regulatory mechanisms and related signaling pathways of mesenchymal stem cells.","authors":"Lunju Luo, Yiyao Deng, Yuqing Sun, Zhengsheng Li, Yongqiang Zhang, Huan Liu, Jie Ding, Zhi Yang, Yan Zha, Jing Yuan","doi":"10.1097/CM9.0000000000004298","DOIUrl":"https://doi.org/10.1097/CM9.0000000000004298","url":null,"abstract":"<p><strong>Abstract: </strong>Diabetic kidney disease (DKD) is a severe complication of diabetes and the leading cause of end-stage renal disease (ESRD). However, DKD treatment remains challenging owing to its complex etiology and unclear pathogenesis. Recent reports of the anti-inflammatory, antioxidant, antifibrotic, and regenerative properties of mesenchymal stem cells (MSCs) indicate that they may serve as potential novel treatments for kidney disease-particularly DKD. However, current MSC-based therapies for DKD are at the initial clinical stage of research with the precise underlying mechanisms requiring further investigation. Current studies have predominantly concentrated on the renal protective effects mediated by classical signaling pathways such as Wnt/β-catenin, phosphatidylinositol 3-kinase/protein kinase B/mammalian target of rapamycin (PI3K/Akt/mTOR), vascular endothelial growth factor (VEGF), transforming growth factor-β1 (TGF-β1)/Smad, and nuclear factor-erythroid 2-related factor 2 (Nrf2), whereas other potentially relevant pathways remain insufficiently investigated. This review comprehensively discusses the key MSC-regulated signaling pathways and their therapeutic potential to provide a theoretical foundation for DKD-related drug development and its clinical translation.</p>","PeriodicalId":10183,"journal":{"name":"Chinese Medical Journal","volume":" ","pages":""},"PeriodicalIF":9.1,"publicationDate":"2026-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149163707","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":"Klotho ameliorates renal fibrosis and the regulation of Klotho levels by natural products.","authors":"Qianqian Zhao, Meihua Jin, Qiang Zhao, Xinyue Zhao, Yujiao Gao, Ran Tao, Donghe Han","doi":"10.1097/CM9.0000000000004290","DOIUrl":"https://doi.org/10.1097/CM9.0000000000004290","url":null,"abstract":"","PeriodicalId":10183,"journal":{"name":"Chinese Medical Journal","volume":" ","pages":""},"PeriodicalIF":9.1,"publicationDate":"2026-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149165293","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":"ESR1 alterations in breast cancer: Mechanisms, detection, and therapeutic implications.","authors":"Mengjia Shen, Xiaoxia Yao, Xiu Zhao, Yidan Gong, Libo Yang, Mengna Feng, Mengyuan Shao, Bing Wei, Hong Bu, Zhang Zhang","doi":"10.1097/CM9.0000000000004327","DOIUrl":"https://doi.org/10.1097/CM9.0000000000004327","url":null,"abstract":"<p><strong>Abstract: </strong>Endocrine therapy plays a central role in the treatment of hormone receptor-positive (HR+) breast cancer, but acquired resistance remains a major clinical challenge. Increasing evidence suggests that ESR1 alterations are key molecular events that maintain estrogen receptor (ER) signaling and drive endocrine treatment failure. In this review, we summarize the biological basis of ESR1/ERα signaling and place it within the broader context of the nuclear ER family, including the partially opposing role of ESR2/ERβ and its potential influence on the prognostic and predictive value of conventional ER/progesterone receptor (PR) status. We then discuss the main categories of ESR1 alterations in breast cancer, including ligand-binding domain (LBD) mutations, structural rearrangements/fusions, copy-number changes, and splice isoforms. Hotspot mutations such as Y537S and D538G cause ligand-independent receptor activation and are commonly detected after aromatase inhibitor exposure, supporting their central role in acquired endocrine resistance. ESR1 fusions, amplification, and isoform diversity further broaden the complexity of ER signaling through transcriptional reprogramming, bypass pathway activation, and nongenomic signaling. We also review the clinical application of circulating tumor DNA (ctDNA) in dynamic molecular monitoring and summarize current therapeutic advances, including oral selective ER degraders (SERDs), proteolysis-targeting chimera (PROTAC) ER degraders, and mechanism-based combination strategies targeting cyclin-dependent kinases 4/6 (CDK4/6), phosphoinositide 3-kinase (PI3K)-protein kinase B-mammalian target of rapamycin (mTOR), fibroblast growth factor receptor (FGFR), human epidermal growth factor receptor 2, and related pathways. Finally, we propose a stratified treatment framework that integrates alteration type, mutation subtype, ctDNA dynamics, treatment line, and coalterations to guide individualized therapy. Standardized molecular testing, real-time ctDNA surveillance, and next-generation ER-targeted therapies, together with a clearer understanding of the wider ER family, may provide new opportunities for precision treatment of endocrine-resistant breast cancer.</p>","PeriodicalId":10183,"journal":{"name":"Chinese Medical Journal","volume":" ","pages":""},"PeriodicalIF":9.1,"publicationDate":"2026-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149165477","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":"Outcomes of kidney transplantation with kidneys from donors undergoing ischemia-free liver procurement.","authors":"Zehuan Chen, Xutao Chen, Weiqiang Ju, Maogen Chen, Jun Li, Xinhua Chang, Chenglin Wu, Gang Huang, Bowen Xu, Guodong Chen, Jiang Qiu, Qian Fu, Longshan Liu, Huanxi Zhang, Zhiyong Guo, Qiang Zhao, Yinghua Chen, Jiguang Fei, Yi Ma, Changxi Wang, Suxiong Deng, Xiaoshun He, Ronghai Deng","doi":"10.1097/CM9.0000000000004336","DOIUrl":"https://doi.org/10.1097/CM9.0000000000004336","url":null,"abstract":"","PeriodicalId":10183,"journal":{"name":"Chinese Medical Journal","volume":" ","pages":""},"PeriodicalIF":9.1,"publicationDate":"2026-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149164754","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":"Second allogeneic hematopoietic stem cell transplantation treatment for post-transplant relapse in myeloid hematologic malignancies.","authors":"Haixiao Zhang, Weijie Cao, Jia Liu, Ping Zhang, Wenwen Guo, Caidong Hu, Bo Nie, Qianwen Hu, Hongye Gao, Zhongxing Jiang, Guifang Ouyang, Aiming Pang, Yi He, Sizhou Feng, Mingzhe Han, Mingxia Shi, Ting Yang, Fuxu Wang, Xi Zhang, Erlie Jiang","doi":"10.1097/CM9.0000000000004303","DOIUrl":"https://doi.org/10.1097/CM9.0000000000004303","url":null,"abstract":"","PeriodicalId":10183,"journal":{"name":"Chinese Medical Journal","volume":" ","pages":""},"PeriodicalIF":9.1,"publicationDate":"2026-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149148244","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":"Interaction of maternal PM2.5 exposure and psychosocial state on newborn macrosomia: A nationwide population-based study.","authors":"Jiaqi Qiang, Yunyun Luo, Yuelun Zhang, Zhibo Zhou, Xiaoyuan Guo, Yiling He, Hanze Du, Hongbo Yang, Huijuan Zhu, Shi Chen, Hui Pan","doi":"10.1097/CM9.0000000000004256","DOIUrl":"https://doi.org/10.1097/CM9.0000000000004256","url":null,"abstract":"","PeriodicalId":10183,"journal":{"name":"Chinese Medical Journal","volume":" ","pages":""},"PeriodicalIF":9.1,"publicationDate":"2026-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149147500","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":"Iron imbalance and colorectal cancer risk: Genetic and dietary influence.","authors":"Denise Goh, Dongke Xu, Joe Yeong","doi":"10.1097/CM9.0000000000004159","DOIUrl":"https://doi.org/10.1097/CM9.0000000000004159","url":null,"abstract":"","PeriodicalId":10183,"journal":{"name":"Chinese Medical Journal","volume":" ","pages":""},"PeriodicalIF":9.1,"publicationDate":"2026-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149147742","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 phase 2 study of venetoclax plus azacitidine as induction therapy in fit middle-aged patients with newly diagnosed acute myeloid leukemia.","authors":"Rui Huang, Xiaonan Lin, Yaling Zheng, Yuming Zhang, Honghua He, Yongzhong Su, Feiheng Chen, Shaoze Lin, Caixia Wang, Zhenqian Huang, Yaya Wang, Jihao Zhou, Lina Hu, Xiong Zhang, Ying Dong, Yuexiong Liang, Pengcheng Huang, Shuyi Mo, Jinxiong Huang, Xiaotao Wang, Fang Jiang, Xuekui Gu, Zenghui Liu, Ying Zhao, Xiaoli Xu, Ming Wu, Xuan Zhou, Zhao Liang, Sanfang Tu, Chunyan Yue, Shaojie Wu, Chaoyang Song, Yanjie He, Yuhua Li","doi":"10.1097/CM9.0000000000004325","DOIUrl":"https://doi.org/10.1097/CM9.0000000000004325","url":null,"abstract":"","PeriodicalId":10183,"journal":{"name":"Chinese Medical Journal","volume":" ","pages":""},"PeriodicalIF":9.1,"publicationDate":"2026-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149147387","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}