Zhonghua yi xue za zhi最新文献

{"title":"[Analysis of nutritional status of male children with Duchenne muscular dystrophy].","authors":"H M Zhou, Z H Miao, J W Wang, K Wang, M He, Q Y Wang, Y B Du, X N Wu","doi":"10.3760/cma.j.cn112137-20250330-00769","DOIUrl":"10.3760/cma.j.cn112137-20250330-00769","url":null,"abstract":"<p><p><b>Objective:</b> To analyze the nutritional status of male children with Duchenne muscular dystrophy (DMD). <b>Methods:</b> The male children aged 5-16 years old who were diagnosed with DMD at West China Second Hospital of Sichuan University from August 2023 to August 2024 were retrospectively included (DMD group). The healthy male children of the same age in the same period were classified as the control group. According to age, the two groups were divided into four age groups: 5-7, 7-9, 9-13, and 13-16 years old. General information and body composition analysis data [such as skeletal muscle mass (SMM), body fat, body fat percentage, visceral fat area (VFA), etc.] were collected, and the age-specific height Z-score (HAZ) and age-specific body mass index Z-score (BAZ) of the study subjects were calculated to detect body composition; The differences in general information, Z-score, and body composition analysis indicators were compared between two groups, and the Z-score results, correlation between body composition indicators and age, and differences in body composition indicators between different age groups were also compared between the two groups. <b>Results:</b> A total of 173 children were included, with 92 in the DMD group, aged (9.2±2.5) years and 81 in the control group, aged (9.5±2.6) years. The height [<i>M</i>(<i>Q</i><sub>1</sub>, <i>Q</i><sub>3</sub>)] [124 (113, 131) vs 133 (124, 145) cm], weight [28 (22, 33) vs 31 (24, 40) kg], and HAZ [-1.75 (-2.55, -1.10) vs -0.50 (-0.86, 0.08)] of the DMD group were lower than those of the control group, while the body mass index (BMI) [18 (16, 20) vs 17 (15, 19) kg/m<sup>2</sup>] and BAZ [1.12 (0.33, 1.65) vs 0.21 (-0.73, 0.95)] were higher than those of the control group (all <i>P</i><0.05); The incidence of growth retardation [42.4% (39/92) vs 1.2% (1/81)], overweight [35.9% (33/92) vs 21.0% (17/81)], obesity [16.3% (15/92) vs 3.7% (3/81)], and malnutrition [75.0% (69/92) vs 30.9% (25/81)] were all higher than those in the control group (all <i>P</i><0.05). There was statistically significant difference in the incidence of growth retardation among different age groups in the DMD group (both <i>P=</i>0.021). The SMM [9 (8, 10) vs 13 (10, 16) kg] of DMD patients was lower than that of the control group, while body fat [8 (5, 13) vs 4 (3, 7) kg], body fat percentage [29% (23%, 37%) vs 15% (11%, 21%)], and VFA [42 (28, 81) vs 19 (13, 26) cm<sup>2</sup>] were all higher than those of the control group (all <i>P</i><0.001). The age of DMD group showed a strong positive correlation with VFA (<i>r</i>=0.70), and a moderate positive correlation with body fat (<i>r</i>=0.68), SMM (<i>r</i>=0.68), and body fat percentage (<i>r</i>=0.55) (all <i>P</i><0.001); The age of the control group showed a strong positive correlation with SMM (<i>r</i>=0.89), a weak positive correlation with body fat (<i>r</i>=0.37) and VFA (<i>r</i>=0.24) (both <i>P</i><0.05), and no correlation with body fat percentage ","PeriodicalId":24023,"journal":{"name":"Zhonghua yi xue za zhi","volume":"105 35","pages":"3065-3070"},"PeriodicalIF":0.0,"publicationDate":"2025-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145070757","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":"[Improved detection methods and sequence characteristics of PML::RARA variant transcripts in patients with acute promyelocytic leukemia].","authors":"X L Ma, F Wang, X Chen, Y Zhang, J Q Chen, P X Cao, Z Wang, L L Yuan, Y C Tan, J C Fang, M Liu, X S Zhou, H X Liu","doi":"10.3760/cma.j.cn112137-20250217-00360","DOIUrl":"10.3760/cma.j.cn112137-20250217-00360","url":null,"abstract":"<p><p>A retrospective analysis was conducted on the European Collaboration Against Cancer-Real-time Fluorescence Quantitative polymerase chain reaction (EAC-qPCR) test results of 39 patients diagnosed with PML::RARA-V variant positive acute promyelocytic leukemia (APL) at Hebei Yandalu Daopei Hospital from April 2012 to September 2024. Gene sequence determination was also performed to analyze the sequence characteristics of the PML::RARA-V variant transcript. Based on the sequencing results, new detection primers for the PML::RARA-V variant were designed. A total of 39 patients with the PML::RARA-V variant were included, including 16 males and 23 females, aged 10 to 73 years. Nine cases (23.1%) could not be accurately detected by the EAC-qPCR protocol, among which 4 cases were misclassified and had abnormally low quantitative values, and 5 cases were false negatives; the remaining 30 cases could be accurately detected. Among the 39 patients, 20 completed gene sequence determination. The results showed that 7 cases had no intron sequence insertion, and 13 cases had insertion of the second intron sequence of the RARA gene. The PML gene breaks in 20 patients occurred in exon 6 (with different specific break sites), and the RARA gene of the fusion transcript started from exon 3, and all were in-frame fusions. The new detection primers VNF1 and VNF2 replace the upstream primer for the V variant in the EAC-qPCR protocol and can effectively identify all V variant transcripts. The sequence of the PML::RARA-V variant transcript is highly variable, leading to approximately 23.1% of V variant cases being missed or misidentified by the EAC-qPCR protocol. The new primers can improve the detection accuracy of V variant transcripts.</p>","PeriodicalId":24023,"journal":{"name":"Zhonghua yi xue za zhi","volume":"105 35","pages":"3095-3099"},"PeriodicalIF":0.0,"publicationDate":"2025-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145070814","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":"[Application effect of dural puncture epidural anesthesia in elderly patients undergoing hip fracture surgery].","authors":"T T Dai, L Wang, Y Y Li, Wally Elijah, N Yin","doi":"10.3760/cma.j.cn112137-20250424-01027","DOIUrl":"10.3760/cma.j.cn112137-20250424-01027","url":null,"abstract":"<p><p><b>Objective:</b> To analyze the application effect of dural puncture epidural anesthesia (DPE) in elderly patients undergoing hip fracture surgery. <b>Methods:</b> Elderly patients scheduled for elective unilateral hip fracture surgery at the Sir Run Run Hospital Affiliated to Nanjing Medical University from May to December 2024 were prospectively enrolled. They were randomly divided into the DPE group and the epidural anesthesia (EA) group (61 cases each) using a random number table. The two groups were compared in terms of the incidence of intraoperative incomplete block, time to achieve the T₁₀ sensory blockade level, the lowest mean arterial pressure (MAP) within 15 minutes after anesthesia, vasoactive drug usage rate, time for Bromage score to recovery to 0, visual analogue scale (VAS) of pain score at 6 and 12 h postoperatively, surgeon satisfaction, and incidence of anesthesia-related adverse events. <b>Results:</b> The DPE group had a median age of 69 (67, 72) years, with 36 males and 25 females, while the EA group had a median age of 69 (67, 72) years, with 38 males and 23 females. There were no significant differences between the two groups in age, gender, body mass index, American Society of Anesthesiologists classification, or types of comorbidities (all <i>P</i>>0.05). The DPE group had a lower incidence of incomplete blockade [11.5% (7/61) vs 27.9% (17/61)], a shorter time to achieve the T₁₀ sensory blockade level [(443±38) s vs (559±47) s], and higher surgeon satisfaction [10(9, 11) scores vs 9(9, 10) scores] compared to the EA group (all <i>P</i><0.05). There were no significant differences between the two groups in the lowest MAP within 15 minutes after anesthesia, vasoactive drug usage rate, time for Bromage score to return to 0, postoperative VAS of pain scores at 6 and 12 h, or incidence of anesthesia-related adverse events (all <i>P</i>>0.05). <b>Conclusion:</b> Compared to traditional EA, DPE offers superior block quality and faster onset of anesthesia in elderly patients undergoing hip fracture surgery without compromising hemodynamic stability or prolonging motor block.</p>","PeriodicalId":24023,"journal":{"name":"Zhonghua yi xue za zhi","volume":"105 34","pages":"2988-2992"},"PeriodicalIF":0.0,"publicationDate":"2025-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144993869","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":"[Chinese Medical Association guideline for clinical diagnosis and treatment of lung cancer (2025 edition)].","authors":"","doi":"10.3760/cma.j.cn112137-20250511-01152","DOIUrl":"10.3760/cma.j.cn112137-20250511-01152","url":null,"abstract":"<p><p>To further standardize lung cancer prevention and treatment measures in China, enhance the quality of diagnosis and treatment, improve patient prognosis, and provide evidence-based medical guidance for clinicians at all levels, the Chinese Medical Association convened experts from respiratory medicine, oncology, thoracic surgery, radiotherapy, imaging, and pathology to develop the Chinese Medical Association's Clinical diagnosis and treatment guidelines for lung cancer (2025 edition). This consensus resulted in several updates from the 2024 version. In the screening section, a new recommendation has been added to specify populations not advised to undergo lung cancer screening. It also emphasizes that individuals at high risk for lung cancer should be fully informed of the potential benefits and risks of low-dose CT (LDCT) screening before undergoing the examination. With the advancement of treatment options, updates have been made to the recommended genetic testing for patients with early-and mid-stage postoperative and advanced non-small cell lung cancer (NSCLC). For patients with advanced EGFR mutations, in addition to a broader range of monotherapy options, the application of combination therapies may offer better disease control for certain patients. Furthermore, more treatment options have been approved for patients undergoing immunotherapy-based neoadjuvant treatment and for those who develop resistance to epidermal growth factor receptor (EGFR)-tyrosine kinase inhibitors (TKI). For patients with previously limited treatment options, such as those with KRAS G12C mutations, HER2 mutations, or small cell lung cancer after resistance develops, the approval of novel drugs has brought significantly improved efficacy and prognosis. These recommendations are based on State-approved drug applications, international guidelines, and current clinical practices in China, integrating the latest evidence-based medical research in screening, diagnosis, pathology, genetic testing, immune molecular marker detection, treatment methods, and follow-up care. The goal is to provide comprehensive and reasonable recommendations for clinicians, imaging specialists, laboratory technicians, and other medical staff at all levels.</p>","PeriodicalId":24023,"journal":{"name":"Zhonghua yi xue za zhi","volume":"105 ","pages":"2918-2959"},"PeriodicalIF":0.0,"publicationDate":"2025-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144837964","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":"[Pay attention to the application value of artificial intelligence in the diagnosis, treatment and analysis of sepsis].","authors":"F Xu, W J Qin, F C Zhou","doi":"10.3760/cma.j.cn112137-20250418-00961","DOIUrl":"10.3760/cma.j.cn112137-20250418-00961","url":null,"abstract":"<p><p>In critical care medicine, sepsis management represents a critical barrier to improving clinical outcomes, primarily due to the disease's profound heterogeneity and the current inability to optimally identify patient subgroups benefiting from personalized therapies. Recent advances in Artificial Intelligence (AI) offer promising solutions to this challenge. This article reviews the current landscape of sepsis diagnosis and treatment, analyzes existing AI-enabled paradigms and their limitations, and explores feasible strategies and future directions for AI-enhanced sepsis care. By elucidating the nature of sepsis heterogeneity and meaningfully integrating AI tools into critical care workflows, we aim to develop and deploy a \"universal\" AI-powered predictive model aligned with China's critical care characteristics. This approach seeks to advance precision medicine for sepsis, ultimately addressing this significant global health burden.</p>","PeriodicalId":24023,"journal":{"name":"Zhonghua yi xue za zhi","volume":"105 33","pages":"2827-2830"},"PeriodicalIF":0.0,"publicationDate":"2025-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144971848","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":"[Efficacy of <i>Saccharomyces boulardii</i> combined with minocycline quadruple therapy for <i>Helicobacter Pylori</i> infection].","authors":"L Chen, Y Ding, Y Liu, J J Jiang, Z Wang, X C Yin, H X Li, Q Lu, R H Shi","doi":"10.3760/cma.j.cn112137-20250226-00463","DOIUrl":"https://doi.org/10.3760/cma.j.cn112137-20250226-00463","url":null,"abstract":"<p><p>To assess the efficacy of <i>Saccharomyces boulardii</i> combined with minocycline quadruple therapy in treating patients with <i>Helicobacter pylori</i> (<i>Hp</i>) infection. Data from patients who underwent initial eradication treatment for <i>Hp</i> infection were retrospectively collected from Zhongda Hospital of Southeast University, Liangjiang Hospital of Southeast University, and the Second Affiliated Hospital of Zhejiang University School of Medicine from January 1, 2023 to April 30, 2024. The patients were divided into two groups according to the sterilization regimen: bismuth quadruple group (combined application of vonoprazan, colloidal bismuth pectin, amoxicillin, minocycline), <i>Saccharomyces boulardii</i> group (combined application of vonoprazan, <i>Saccharomyces boulardii</i>, amoxicillin, minocycline). After the breath test was completed, each patient was followed up in the outpatient department of gastroenterology. The rates of <i>Hp</i> eradication [intention-to-treat analysis (ITT) and pre-protocol set (PP) were used to analysed], incidence of adverse eventst were compared between the two groups. A total of 398 patients were included, with 192 patients in the bismuth quadruple group: 100 males and 92 females, aged (46.9±14.5) years; 206 patients in the <i>Saccharomyces boulardii</i> group: 102 males and 104 females, aged (44.1±14.2) years. The median follow-up time [<i>M</i> (<i>Q</i>₁, <i>Q</i>₃)] was 6.9 (6.0, 8.1) weeks. One hundred and eighty-eight patients in the bismuth group and 200 patients in the <i>Saccharomyces boulardii</i> group completed treatment and follow-up, respectively. The TT eradication rate was 93.8% (180/192) and 92.2% (190/206), and the PP eradication rate was 95.7% (180/188) and 95.0% (190/200), respectively, in the bismuth quadruple group and <i>Saccharomyces boulardii</i> group. There were no significant differences (both <i>P</i>>0.05). The overall incidence of adverse events in <i>Saccharomyces boulardii</i> group was lower than that in bismuth quadruple group [20.4% (42/206) vs 51.0% (98/192), (<i>P</i><0.001)]. The efficacy of <i>Saccharomyces boulardii</i> combined with minocycline quadruple therapy is comparable to that of quadruple therapy, but with fewer adverse events.</p>","PeriodicalId":24023,"journal":{"name":"Zhonghua yi xue za zhi","volume":"105 33","pages":"2887-2890"},"PeriodicalIF":0.0,"publicationDate":"2025-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144971891","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":"[Analysis of a family with maturity-onset diabetes of the young type 6 due to a mutation in the NEUROD1 gene].","authors":"G Y Dai, B Xu, H Zhang, Y F Tu, W L Ge, R Zhang, Y Q Bao, C Hu, H Y Yu","doi":"10.3760/cma.j.cn112137-20250301-00489","DOIUrl":"10.3760/cma.j.cn112137-20250301-00489","url":null,"abstract":"<p><p>This study reported a family with maturity-onset diabetes of the young (MODY) type 6, and analyzed the clinical characteristics and pathogenic variant of the family. A retrospective analysis was conducted on a 38-year-old female patient with early-onset diabetes who presented to the Department of Endocrinology and Metabolism at Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine on June 6, 2024 due to \"intermittent dry mouth, polydipsia, and polyphagia for 11 years, worsening for more than 20 days\". Whole exome sequencing revealed that the patient carried a heterozygous variant in the neurogenic differentiation factor 1(NEUROD1)gene (c.1043C>A: p.A348D). Diagnosed as MODY6. Subsequently, Sanger sequencing was performed on four other direct family members, identifying the same variant in the patient's mother, diagnosed with diabetes at the age of 62, and the patient's son. Bioinformatics analysis suggested that the NEUROD1 p.A348D variant is likely pathogenic, and the encoded amino acid is located in the α-helix of the transcription activation domain of the NEUROD1 protein. This study identified the potential pathogenic role of the NEUROD1 p.A348D variant for the first time. The findings not only expand the existing clinical and genetic mutation profiles of MODY6, but also lay a foundation for the deeper understanding of the pathogenic role of the NEUROD1 gene.</p>","PeriodicalId":24023,"journal":{"name":"Zhonghua yi xue za zhi","volume":"105 33","pages":"2878-2882"},"PeriodicalIF":0.0,"publicationDate":"2025-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144971900","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":"[Awake prone positioning in critically ill patients: mechanisms, evidence and future directions].","authors":"Q Sun, H B Qiu, L Liu","doi":"10.3760/cma.j.cn112137-20250427-01053","DOIUrl":"https://doi.org/10.3760/cma.j.cn112137-20250427-01053","url":null,"abstract":"<p><p>Awake prone positioning (APP), as an essential therapeutic strategy for acute hypoxemic respiratory failure, has demonstrated significant clinical value, especially during the coronavirus disease 2019 (COVID-19) pandemic. This article systematically summarizes three physiological mechanisms underlying the oxygenation improvement associated with APP, namely enhanced ventilation in gravity-dependent regions, reduction of dead space, and optimization of the ventilation-perfusion ratio. Furthermore, we comprehensively analyze clinical evidence regarding the role of APP in reducing intubation rates and improving right ventricular function, and discuss key factors influencing its efficacy, including initiation timing, duration, and respiratory support modalities. Based on recent research findings, we propose a personalized \"4T\" principle (Timing, Target population, Technique, and Time duration) for optimizing APP implementation. Finally, we highlight promising directions for future research, such as phenotype stratification and development of intelligent monitoring devices, providing evidence-based guidance in COVID-19 related acute respiratory failure patients for clinical practice.</p>","PeriodicalId":24023,"journal":{"name":"Zhonghua yi xue za zhi","volume":"105 33","pages":"2809-2813"},"PeriodicalIF":0.0,"publicationDate":"2025-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144971864","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":"[Efficacy of establishing surgical access for hip arthroscopy using the combined internal-external approach].","authors":"Q Jia, Z Y Zhao, Y He, K K Yu, H R Teng, Z K Guo, Y D Wu, M Y An, C B Li","doi":"10.3760/cma.j.cn112137-20250209-00290","DOIUrl":"10.3760/cma.j.cn112137-20250209-00290","url":null,"abstract":"<p><p><b>Objective:</b> To evaluate the clinical efficacy of the combined internal-external approach in establishing surgical portals for hip arthroscopy. <b>Methods:</b> A prospective analysis was conducted on patients who underwent hip arthroscopy at the General Hospital of the People's Liberation Army from March 2021 to May 2023. The patients were divided into a trial group (using the combined internal-external approach) and a control group (using the traditional puncture method) based on their voluntary choices of surgical plans. All patients underwent imaging examinations before surgery. During the operation, the time taken to establish the anterolateral approach (AL approach), the time taken to establish the mid-anterior auxiliary approach (MA approach), and the total surgical time were recorded. After surgery, a 1-year follow-up was carried out. Indicators such as the visual analog scale (VAS) of pain, the modified Harris Hip Score (mHHS), the International Hip Outcome Tool-12 (iHOT-12) score, the Hip Outcome Score-Activities of Daily Living Subscale (HOS-ADL), and the Hip Outcome Score-Sports Subscale (HOS-SSS) were recorded and compared for the two groups. <b>Results:</b> A total of 77 patients were enrolled with a mean age of (37.9±12.6) years(48 males and 29 females). There were 37 cases in the trial group[ with a mean age of (38.0±11.8) years, 24 males and 13 females] and 40 patients in the control group[ with a mean age of (37.8±13.4) years, 24 males and 16 females]. All indicators in both groups demonstrated significant improvement postoperatively compared with the preoperative values (all <i>P</i><0.001). No significant intergroup differences existed in the indicators preoperatively (all <i>P</i>>0.05). Postoperatively, there was no significant defferences in VAS of pain [(2.3±2.1) vs (2.4±1.9) points], mHHS [(83.3±7.4) vs (80.2±9.2) points], iHOT-12 [(72.8±15.5) vs (71.1±17.4) points], HOS-ADL [(81.4±16.9) vs (84.0±15.0) points] and HOS-SSS [(55.7±23.4) vs (56.1±19.1) points] or AL approach time [(5.3±0.5) vs (5.4±0.4) min] between the trial group and the control group(all <i>P</i>>0.05); however, the MA approach time [(9.0±0.6) vs (14.8±1.3) min] and total operative time [(105.2±8.8) vs (119.4±4.7) min] in the trial group were both shorter than those in the control group (both <i>P</i><0.001). The trial group had a lower postoperative complication rate than the control group, but the difference was not statistically significant [5.4% (2/37) vs 15.0% (6/40), <i>P</i>=0.263]. <b>Conclusion:</b> Portal establishment using the combined internal-external approach significantly reduces operative time and postoperative complication rate when compared to the traditional puncture technique, representing a safer and more efficient method for hip arthroscopy.</p>","PeriodicalId":24023,"journal":{"name":"Zhonghua yi xue za zhi","volume":"105 ","pages":"2846-2851"},"PeriodicalIF":0.0,"publicationDate":"2025-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144286640","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":"[Guidelines for the capacity building and advancement of critical care medicine in China (2025 edition)].","authors":"","doi":"10.3760/cma.j.cn112137-20250404-00829","DOIUrl":"https://doi.org/10.3760/cma.j.cn112137-20250404-00829","url":null,"abstract":"<p><p>Critical care medicine (CCM) is a clinical discipline that focuses on the pathological mechanisms and comprehensive treatment of critically ill patients. The intensive care unit (ICU), as the clinical base of CCM, is responsible for implementing comprehensive management of critically ill patients throughout their entire care cycle, encompassing a series of integrated measures ranging from early warning to rehabilitation. Driven by national policy, the discipline achieved rapid advancement. In 2024, the National Health Commission and seven other ministries jointly issued the \"Framework on Strengthening Critical Care Medical Service Capabilities\", marking the discipline's entry into a high-quality development phase. Accordingly, the Chinese Society of Critical Care Medicine (CSCCM) formulated the\"Guidelines for the capacity building and advancement of critical care medicine in China (2025 edition)\". The guidelines focus on key aspects of discipline construction and development, covering nine areas: ICU infrastructure planning, professional staffing and technical competencies, equipment standardization, quality management, continuing education, scientific research, emergency preparedness, and service model innovation. The Recommendation development process involved initiation, literature retrieval and screening, and the synthesis of medical evidence to establish preliminary recommendations. These recommendations underwent multiple rounds of expert review, including correspondence review, remote and in-person meetings, revisions, and voting by the CSCCM Standing Committee, ultimately leading to the final version. The recommendations apply to ICUs in secondary and tertiary healthcare institutions and serve as a scientific framework for discipline planning, construction, and management, aiming to enhance the quality of critical care services.</p>","PeriodicalId":24023,"journal":{"name":"Zhonghua yi xue za zhi","volume":"105 33","pages":"2831-2845"},"PeriodicalIF":0.0,"publicationDate":"2025-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144971906","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}