Zhonghua yi xue za zhi最新文献

{"title":"[Chinese guideline for the diagnosis, treatment and management of lupus nephritis (2025)].","authors":"","doi":"10.3760/cma.j.cn112137-20250327-00748","DOIUrl":"10.3760/cma.j.cn112137-20250327-00748","url":null,"abstract":"<p><p>Since the first edition of \"Chinese guideline for the diagnosis and treatment of lupus nephritis\" launched in 2019, extensive clinical research has been conducted both domestically and internationally regarding the diagnosis, treatment and management of lupus nephritis, yielding substantial new evidence. Therefore, it is necessary to update the guideline. To this end, a guideline working group consisting of multidisciplinary experts was convened and the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) system were employed to rate the quality of evidence and the strength of recommendations, in the form of \"Recommendation\" and \"Practical point\". The \"Chinese guideline for the diagnosis, treatment and management of lupus nephritis (2025)\" focused on updating the induction and maintenance treatment of lupus nephritis, and the treatment of special classes and refractory lupus nephritis. It also included the management of patients with lupus nephritis and the assessment and treatment of relevant complications. The current guideline aims to provide guidance and reference for clinicians in treatment decision-making and disease management.</p>","PeriodicalId":24023,"journal":{"name":"Zhonghua yi xue za zhi","volume":"105 ","pages":"1783-1819"},"PeriodicalIF":0.0,"publicationDate":"2025-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143988849","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Associations between blood thallium and lipid profile in Chinese adults aged 18-79 years].","authors":"C Ding, Z Y Hu, P J Sun, Y L Qu, Z Li, S S Ji, S Y Yan, W Q Hao, L Yu, M K Yu, Y B Lyu, X M Shi","doi":"10.3760/cma.j.cn112137-20250305-00524","DOIUrl":"https://doi.org/10.3760/cma.j.cn112137-20250305-00524","url":null,"abstract":"<p><p><b>Objective:</b> To analyze the association of the blood thallium exposure with lipid profile in Chinese adults aged 18-79 years. <b>Methods:</b> From 2017 to 2018, 9 795 adults aged 18-79 years were enrolled in China National Human Biomonitoring (CNHBM). The information about their demographic characteristics, lifestyles, and physical examinations were collected. Fasting venous blood samples were collected to measure blood thallium level. Total cholesterol (TC), triglycerides (TG), low-density lipoprotein cholesterol (LDL-C), and high-density lipoprotein cholesterol (HDL-C) concentrations were also under testing. Study subjects were divided into five groups (Q₁, Q₂, Q₃, Q₄ and Q₅) according to the blood thallium concentration. Weighed linear regression model was used to analyze the association of blood thallium and lipid levels. Restricted cubic spline (RCS) was used to analyze the dose-response relationship between blood thallium and lipid profile. <b>Results:</b> The weighed average age of the 9 795 participants was 47.42 (0.24) years, of which 4 912 were male. The median level of blood thallium <i>M</i>(<i>Q</i>₁,<i>Q</i>₃) was 0.03 (0.02,0.06) μg/L. The levels of TC, TG, LDL-C, and HDL-C were 5.12 (4.47, 5.84) mmol/L, 1.42 (1.02, 2.13) mmol/L, 2.90 (2.34, 3.52) mmol/L, and 1.37 (1.12, 1.68) mmol/L, respectively. Weighted linear regression model showed that thallium after natural logarithmic transformation was associated with TC and the β(95%<i>CI</i>) was 0.07 (0-0.13) (<i>P</i>=0.040). When TC was used as the dependent variable, compared with Q₁, the β(95%<i>CI</i>) of Q₂, Q₃, Q₄ and Q₅ were 0.13 (0.05-0.21), 0.12 (0.01-0.24), 0.12 (0.02-0.23) and 0.16 (0.03-0.30), respectively. When TG was used as the dependent variable, compared with Q₁, the β(95%<i>CI</i>) of Q₅ was 0.28 (0.13-0.42) (<i>P</i><0.001). In the RCS model, blood thallium was positively and linearly associated with TC and TG levels (<i>P</i>_linear 0.006, and 0.004, respectively), and had a nonlinear dose-response relationship with HDL-C (<i>P</i>_non-linear=0.027). <b>Conclusions:</b> Blood thallium exposure is associated with elevated TC and TG levels in Chinese adults aged 18-79 years. There is a nonlinear dose-response relationship between thallium and HDL-C.</p>","PeriodicalId":24023,"journal":{"name":"Zhonghua yi xue za zhi","volume":"105 22","pages":"1847-1854"},"PeriodicalIF":0.0,"publicationDate":"2025-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144249958","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Effect of diabetes mellitus on ¹⁸F-FDG PET-CT myocardial metabolism image quality in patients with coronary artery disease].","authors":"Y H Lyu, L H Li, D Liang, F Y Hong, S S Li, X L Lan, C X Qin","doi":"10.3760/cma.j.cn112137-20250417-00952","DOIUrl":"https://doi.org/10.3760/cma.j.cn112137-20250417-00952","url":null,"abstract":"<p><p><b>Objective:</b> To analyze the effect of combined diabetes mellitus (DM) on the image quality of ¹⁸F-fluorodeoxyglucose (¹⁸F-FDG) PET-CT myocardial metabolism imaging in patients with coronary artery disease (CAD). <b>Methods:</b> A cross-sectional study was conducted. Patients with CAD who underwent myocardial viability assessment in the Department of Nuclear Medicine at Wuhan Union Hospital from December 2018 to June 2023 were retrospectively enrolled as study subjects. Prior to radiotracer injection, oral glucose and intravenous insulin were used to regulate blood glucose levels. Corridor 4DM software was utilized to review images. Image quality and semi-quantitative myocardial ¹⁸F-FDG uptake indices were analyzed. The image quality (IQ) was evaluated through visual assessment, which was rated on a scale from 0 to 4 points. And patients were divided into the good IQ group (0-2 points) and the poor IQ group (3-4 points). On fused PET-CT images, regions of interest were respectively delineated in the left ventricle, the blood pool and the right posterior lobe of the liver, and the semi-quantitative indices of myocardial ¹⁸F-FDG uptake were calculated, including the maximum standardized uptake value (SUV_max) and the mean standardized uptake value (SUV_mean) of the left ventricle, the myocardium-to-blood pool ratio (MBR) and the myocardium-to-liver ratio (MLR). Multivariate logistic regression model to analyze the factors affecting IQ. <b>Results:</b> A total of 135 CAD patients were enrolled, including 116 males and 19 females, aged (56±11) years. The ¹⁸F-FDG uptake indices of myocardium (SUV_max, SUV_mean, MBR, MLR) in the good IQ group were significantly higher than those in the poor IQ group, all <i>P</i><0.001. And patients in good IQ group showed lower blood glucose levels during the oral glucose loading and intravenously injection of insulin protocol (all <i>P</i><0.0.05). The combination of DM (<i>OR</i>=3.295, 95%<i>CI</i>: 1.109-9.792, <i>P</i>=0.032) and fasting blood glucose (<i>OR</i>=1.265, 95%<i>CI</i>: 1.018-1.572, <i>P</i>=0.034) were related factors affecting the quality of myocardial metabolic imaging. <b>Conclusions:</b> The combination of DM significantly affect myocardial glucose uptake in CAD patients, resulting in poor image quality. It is crucial to prepare well before PET imaging and to actively manage blood sugar individually for patients with DM in clinical.</p>","PeriodicalId":24023,"journal":{"name":"Zhonghua yi xue za zhi","volume":"105 22","pages":"1834-1839"},"PeriodicalIF":0.0,"publicationDate":"2025-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144249920","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Call for attention to the role of nuclear molecular imaging in the diagnosis of inflammation in cardiovascular disease].","authors":"F F Zhang, Y T Wang","doi":"10.3760/cma.j.cn112137-20250213-00323","DOIUrl":"https://doi.org/10.3760/cma.j.cn112137-20250213-00323","url":null,"abstract":"<p><p>Inflammation is a key pathological feature and significant pathogenic factor in the development and progression of cardiovascular diseases (CVD). Nuclear molecular imaging enables non-invasive visualization and quantification of CVD related inflammation, reflecting its pathological evolution. Nuclear molecular imaging plays a crucial role and holds immense potential in the precise diagnosis of inflammation in CVD. This review highlights the clinical applications and future prospects of nuclear inflammation imaging in vulnerable atherosclerotic plaques, acute myocardial infarction, infective endocarditis, large vessel vasculitis and cardiac sarcoidosis.</p>","PeriodicalId":24023,"journal":{"name":"Zhonghua yi xue za zhi","volume":"105 22","pages":"1777-1782"},"PeriodicalIF":0.0,"publicationDate":"2025-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144249960","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Impact of stress-related neural activity on major adverse cardiovascular events in non-small cell lung cancer patients using ¹⁸F-FDG PET-CT].","authors":"W Li, J H Li, J C Zhu, X G Wang, J Wu, L J Zhang, G F Yang","doi":"10.3760/cma.j.cn112137-20250421-00982","DOIUrl":"https://doi.org/10.3760/cma.j.cn112137-20250421-00982","url":null,"abstract":"&lt;p&gt;&lt;p&gt;&lt;b&gt;Objective:&lt;/b&gt; To explore the associations between stress-related neural activity (SNA) and major adverse cardiovascular events (MACE) in non-small cell lung cancer (NSCLC) patients based on [&lt;sup&gt;18&lt;/sup&gt;F] Fludeoxyglucose positron emission tomography-computed tomography (&lt;sup&gt;18&lt;/sup&gt;F-FDG PET-CT). &lt;b&gt;Methods:&lt;/b&gt; Patients with pathologically confirmed diagnosis of NSCLC and with at least one-year follow up were retrospectively collected in Nanjing Jinling Hospital between January 2018 and December 2019. All the patients undergoing &lt;sup&gt;18&lt;/sup&gt;F-FDG PET-CT and chest CT at baseline. The maximum target-to-background ratio (TBR&lt;sub&gt;max&lt;/sub&gt;) values of amygdala, which represented as SNA, and bone marrow, which represented as bone marrow activity (BMA), coronary artery calcium volume and coronary artery calcium score (CACS) were measured. Patients were grouped according to presence or absence of MACE. The baseline clinical variable, SNA, BMA and CACS were compared between two groups. Patients were divided as low-and high-amygdala TBR&lt;sub&gt;max&lt;/sub&gt; groups according to the median of amygdala TBR&lt;sub&gt;max&lt;/sub&gt;. According to the CACS, patients with CACS=0 were classified as non-calcification group, while those with CACS&gt;0 are classified into the calcification group. The Kaplan-Meier analysis was used to plot survival curves, the log-rank test was employed to compare intergroup differences in MACE incidence and the Cox proportional hazards model was performed to analyze risk factors for MACE. &lt;b&gt;Results:&lt;/b&gt; A total of 94 NSCLC patients were included, aged (61.7±11.1) years and including 62 males (66.0%). There were 13 patients (13.8%) in the MACE goup and 81 patients (86.2%) in the non-MACE group. The amygdala TBR&lt;sub&gt;max&lt;/sub&gt;, coronary artery calcium volume and CACS in the MACE group were higer than those in non-MACE group. The follow-up time was [&lt;i&gt;M&lt;/i&gt; (&lt;i&gt;Q&lt;/i&gt;&lt;sub&gt;1&lt;/sub&gt;, &lt;i&gt;Q&lt;/i&gt;&lt;sub&gt;3&lt;/sub&gt;), 41 (19, 58)] months. The cumulative incidence of MACE in the high-amygdala TBR&lt;sub&gt;max&lt;/sub&gt; group was higher than that in the low-amygdala TBR&lt;sub&gt;max&lt;/sub&gt; group (29.8% vs 2.6%, &lt;i&gt;P&lt;/i&gt;=0.006). The cumulative incidence of MACE in the calcification group was higher than that in the noncalcification (39.9% vs 5.2%, &lt;i&gt;P&lt;/i&gt;=0.010). Multivariate Cox regression analysis showed that compared with low-amygdala TBR&lt;sub&gt;max&lt;/sub&gt; group, the incidence rate of MACE increased in high-amygdala TBR&lt;sub&gt;max&lt;/sub&gt; group (&lt;i&gt;HR&lt;/i&gt;&lt;sub&gt;adj&lt;/sub&gt;=11.832, 95%&lt;i&gt;CI&lt;/i&gt;: 1.328-105.457, &lt;i&gt;P&lt;/i&gt;=0.027). Further, patients were grouped according to amygdala TBR&lt;sub&gt;max&lt;/sub&gt; combined with CACS, high-amygdala TBR&lt;sub&gt;max&lt;/sub&gt; with CACS&gt;0 group had increased risk for MACE compared to the remaining groups (&lt;i&gt;HR&lt;/i&gt;&lt;sub&gt;adj&lt;/sub&gt;=18.613, 95%&lt;i&gt;CI&lt;/i&gt;: 1.587-218.315, &lt;i&gt;P&lt;/i&gt;=0.020). &lt;b&gt;Conclusions:&lt;/b&gt; SNA was associated with the incidence of MACE in NSCLC patients. The incidence of MACE in high-amygdala TBR&lt;sub&gt;max&lt;/sub&gt; group was higher than that in low-amygdala ","PeriodicalId":24023,"journal":{"name":"Zhonghua yi xue za zhi","volume":"105 22","pages":"1827-1833"},"PeriodicalIF":0.0,"publicationDate":"2025-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144249921","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Visual ultrasound guided naso-jejunal tube replacement in situ].","authors":"R Y Zhu, X H Tang, J M Qu, Z Y Fan","doi":"10.3760/cma.j.cn112137-20241203-02713","DOIUrl":"https://doi.org/10.3760/cma.j.cn112137-20241203-02713","url":null,"abstract":"<p><p>To address the problems of traditional naso-jejunal tube replacement in post-pyloric feeding, such as high blind insertion failure rate, high radiation exposure and high risk of complications, this study proposed a naso-jejunal tube replacement technique with real-time ultrasound guidance and zebra guide wire, and applied it to the clinical practice of a 67-year-old male patient with severe traumatic brain injury. The patient needed long-term post-pyloric enteral nutrition support due to severe traumatic brain injury, but blind tube insertion was difficult (the first tube insertion was assisted by gastroscope), which increased the difficulty of regular replacement of the tube. By using the modified Seldinger technique and zebra guide wire with flexible and hydrophilic coating characteristics, the changes of duodenal horizontal image characteristics were dynamically monitored by visual ultrasound, and the naso-jejunal tube was accurately replaced in situ. The key imaging steps for ultrasound-guided duodenal horizontal part evaluation include: \"double-track sign\" after the verification of the former tube patency; After the guide wire is placed, the real-time image changes into \"five-line sign\". The \"bright strip sign\" when the original tube is withdrawn and the \"five-wire sign\" after the new tube is placed and the \"double-track sign\" when the guide wire is removed. Position verified by abdominal X-ray. The whole course took about 10 minutes. The catheter tip was precisely positioned behind the pylorus. There were no complications such as bleeding and perforation, and the enteral nutrition was well tolerated. The technique is able to effectively reduce or replace X-ray verification through ultrasonic dynamic visualization navigation, and zebra guide wire can effectively reduce the risk of tissue damage.</p>","PeriodicalId":24023,"journal":{"name":"Zhonghua yi xue za zhi","volume":"105 21","pages":"1751-1754"},"PeriodicalIF":0.0,"publicationDate":"2025-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144249957","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[A historical review and future outlook of neurosurgery in China].","authors":"J Z Zhao","doi":"10.3760/cma.j.cn112137-20250325-00727","DOIUrl":"https://doi.org/10.3760/cma.j.cn112137-20250325-00727","url":null,"abstract":"<p><p>Since its inception in the early 20th century at Peking Union Medical College Hospital, neurosurgery in China has gone through a century-long process from its initial establishment, development to modernization, forming a complete system, covering vascular diseases, tumors, epilepsy, and other diseases. This article reviews the key pioneers and historical milestones in Chinese neurosurgery, highlights the founding and advancement of the Society of Neurosurgery of Chinese Medical Association, and shows major achievements in standardization, training, and international cooperation, etc. At present, with the application of technologies such as artificial intelligence and brain-computer interfaces, network-based neurosurgery has emerged and developed rapidly, marking the transition to Neurosurgery 4.0. In the future, Chinese neurosurgery is poised to further promote interdisciplinary integration and clinical translation in support of the high-quality development of brain science.</p>","PeriodicalId":24023,"journal":{"name":"Zhonghua yi xue za zhi","volume":"105 21","pages":"1679-1685"},"PeriodicalIF":0.0,"publicationDate":"2025-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144249935","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[A meta-analysis of efficacy and safety of sulodexide in the prevention and treatment of venous thromboembolism].","authors":"F K Zou, Q J Jiang, L F Qu","doi":"10.3760/cma.j.cn112137-20250317-00652","DOIUrl":"https://doi.org/10.3760/cma.j.cn112137-20250317-00652","url":null,"abstract":"<p><p><b>Objective:</b> To evaluate the efficacy and safety of sulodexide in preventing venous thromboembolism (VTE) in high-risk populations and reducing recurrence in established VTE patients. <b>Methods:</b> A literature search was conducted in databases including China National Knowledge Infrastructure, Wanfang Data, VIP Chinese Periodical Database, China Biology Medicine disc, PubMed, Embase, the Cochrane Library, and Web of Science to retrieve relevant literature on sulodexide in the treatment of VTE, with the retrieval time frame set from the establishment of the databases to April 2024. According to the inclusion and exclusion criteria, two researchers independently screened the literature and extracted the data. The Cochrane risk of bias tool or the Newcastle-Ottawa Scale was used to evaluate the quality of the included studies. Meta-analysis was performed using Revman5.4.1 software, with the <i>RR</i> value as the effect measure. The trial group comprised high-risk individuals or VTE patients treated with sulodexide, while the control group consisted of patients treated with other traditional anticoagulants or placebos. The outcome measures included the incidence and recurrence rate of VTE, the incidence of post-thrombotic syndrome (PTS), and the risk of bleeding, among others. <b>Results:</b> A total of 11 articles involving 11 studies and 3 364 patients were included according to the inclusion and exclusion criteria. For high-risk populations of VTE, prophylactic use of sulodexide was more effective than the control group in reducing the incidence of VTE in high-risk individuals [2.2% (3/138) vs 10.9% (15/138), <i>RR</i>=0.25, 95%<i>CI</i>: 0.09-0.72, <i>P</i>=0.010]. For VTE patients, sulodexide was more effective than control group in reducing the recurrence rate of VTE [5.6% (56/996) vs 9.7% (198/2 043), <i>RR</i>=0.59, 95%<i>CI</i>: 0.44-0.80, <i>P</i><0.001]. There was no statistically significant difference in the incidence of PTS between patients treated with sulodexide and those treated with other traditional anticoagulants [14.0% (36/257) vs 16.6% (149/897), <i>RR</i>=0.86, 95%<i>CI</i>: 0.61-1.20, <i>P</i>=0.370]. Moreover, the incidence of bleeding events was lower in patients treated with sulodexide compared to those treated with other traditional anticoagulants [0.8% (2/251) vs 6.1% (40/656), <i>RR</i>=0.11, 95%<i>CI</i>: 0.03-0.37, <i>P</i><0.001]. <b>Conclusion:</b> Sulodexide exhibits favorable efficacy and safety for VTE prevention in high-risk populations and recurrence reduction in VTE patients.</p>","PeriodicalId":24023,"journal":{"name":"Zhonghua yi xue za zhi","volume":"105 21","pages":"1728-1736"},"PeriodicalIF":0.0,"publicationDate":"2025-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144249936","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Evidence-based clinical guidelines of acute atlas fractures in adults (2025 edition)].","authors":"","doi":"10.3760/cma.j.cn112137-20241225-02933","DOIUrl":"https://doi.org/10.3760/cma.j.cn112137-20241225-02933","url":null,"abstract":"<p><p>In 2015, the Spinal Trauma Working Group of the Chinese Association of Orthopaedic Surgeons (CAOS) developed the Evidence-Based Clinical Guidelines of Acute Atlantoaxial Fractures in Adults based on literature published prior to 2014. Over the past decade, extensive research of acute atlantoaxial fractures in adults has been conducted globally, with the number of published studies in Chinese and English exceeding the cumulative total of all previous literature. To address evolving clinical needs and align with evidence-based principles, CAOS initiated a comprehensive revision of the guidelines. Following the methodology framework of the 2015 edition, the expert panel systematically retrieved, screened, and synthesized literature published between January 1, 2015, and December 31, 2023, integrating evidence from the original guideline. The expert panel carefully analyzed the medical evidence provided by the literature and rigorously graded it according to evidence-based medicine standards. The 2025 guidelines retain prior recommendations while introducing updates and integrating new evidence, ultimately proposing 6 clinical questions paired with 6 evidence-based recommendations. Each recommendation is accompanied by detailed interpretations and supporting rationale to enhance clinical understanding and application.</p>","PeriodicalId":24023,"journal":{"name":"Zhonghua yi xue za zhi","volume":"105 21","pages":"1686-1699"},"PeriodicalIF":0.0,"publicationDate":"2025-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144249952","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Immediate component precision and surgical safety in robot-assisted reverse shoulder arthroplasty].","authors":"T Zhang, W Han, M J Li, Z Jia, A J Shen, M Q Gong, X Y Jiang, J Q Wang","doi":"10.3760/cma.j.cn112137-20241126-02650","DOIUrl":"https://doi.org/10.3760/cma.j.cn112137-20241126-02650","url":null,"abstract":"<p><p><b>Objective:</b> To evaluate the immediate component precision and surgical safety in robot-assisted reverse shoulder arthroplasty (RSA). <b>Methods:</b> A retrospective cohort study was conducted on 32 patients with proximal humeral fractures treated at the Intelligent Orthopedic Research Ward of Beijing Jishuitan Hospital, Capital Medical University between May 2023 and October 2024. The patients were divided into two groups according to surgical options: the robotic group and the conventional group. The robotic group underwent preoperative planning and glenoid baseplate positioning using the TiRobot^®, while the conventional group used standard manufacturer-provided instrumentation. Postoperative computed tomography (CT) scans were analyzed via the Picture Archiving and Communication System (PACS) to measure angular deviations (anteversion and inferior tilt) of the glenoid baseplate relative to preoperative plans. Operative time, intraoperative blood loss, and complications were compared between two groups. <b>Results:</b> A total of 32 patients were included, with 15 in the robotic group [6 males, 9 females, mean age: (63.1±3.1) years] and 17 in the conventional group [9 males, 8 females, mean age: (64.9±3.6) years]. No significant differences were observed between the two groups in demographics, Neer classification, or time from injury to surgery (all <i>P</i>>0.05). All surgeries were successfully completed without intraoperative complications. The robotic group demonstrated significantly lower angular deviations in glenoid baseplate positioning compared to the conventional group:0.77°±0.30° (anteversion) vs 3.35°±1.03° (<i>P</i><0.001) and 0.81°±0.21° (inferior tilt) vs 5.14°±2.30° (<i>P</i><0.001). There was no significant differences between the robotic group and the conventional group in surgical duration [(167.0±45.3) min vs (158.0±40.3) min] or intraoperative blood loss [200 (150, 200) ml vs 200 (200, 250) ml] (both <i>P</i>>0.05). Additionally, no surgical adverse events or related complications were observed in either group. <b>Conclusion:</b> Robot-assisted RSA achieves significantly higher immediate precision in glenoid baseplate positioning compared to conventional surgery, without increasing operative time, blood loss, or complication risks.</p>","PeriodicalId":24023,"journal":{"name":"Zhonghua yi xue za zhi","volume":"105 21","pages":"1715-1720"},"PeriodicalIF":0.0,"publicationDate":"2025-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144249955","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}