Zhonghua yi xue za zhi最新文献

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[Comparation on clinical outcomes of 3D-printed intelligent manufacturing bionic artificial cervical disc versus Prestige LP artificial cervical disc in treating degenerative cervical disease]. [3d打印智能制造仿生人工颈椎间盘与Prestige LP人工颈椎间盘治疗退行性颈椎病的临床效果比较]。
Zhonghua yi xue za zhi Pub Date : 2026-09-15 DOI: 10.3760/cma.j.cn112137-20260716-01772
W L Yang, H P Zhang, B B Mi, Y T Zhao, Z W Xu, L Yan, B R He
{"title":"[Comparation on clinical outcomes of 3D-printed intelligent manufacturing bionic artificial cervical disc versus Prestige LP artificial cervical disc in treating degenerative cervical disease].","authors":"W L Yang, H P Zhang, B B Mi, Y T Zhao, Z W Xu, L Yan, B R He","doi":"10.3760/cma.j.cn112137-20260716-01772","DOIUrl":"https://doi.org/10.3760/cma.j.cn112137-20260716-01772","url":null,"abstract":"<p><p><b>Objective:</b> To compare the clinical efficacy of a 3D-printed intelligently manufactured biomimetic artificial cervical disc (with independent intellectual property rights) versus the Prestige LP artificial cervical disc in the treatment of degenerative cervical spondylosis. <b>Methods:</b> A retrospective analysis was conducted on clinical data from patients who underwent cervical disc replacement with either the Prestige LP or a domestically produced 3D-printed artificial cervical disc at Xi'an Honghui Hospital, Xi'an Jiaotong University, between May 2019 and December 2022, and all completed the follow-up. The two groups of patients were compared in terms of clinical efficacy [including Visual Analogue Scale (VAS) of pain, Japanese Orthopaedic Association (JOA) score, Neck Disability Index (NDI), and Odom's criteria], operative time, intraoperative blood loss, early complications (intraoperative adjacent organ injury, hematoma formation), postoperative cervical range of motion (ROM), incidence of heterotopic ossification (HO), and adjacent segment degeneration (ASD). <b>Results:</b> A total of 68 patients were enrolled, including 36 males and 32 females, with a mean age of (48.2±2.8) years. Among them, 33 patients received the Prestige LP disc, and 35 received the 3D-printed disc. The mean follow-up duration was (34.6±2.0) months in the Prestige LP group and (32.8±3.0) months in the 3D-printed group. There were no significant differences in baseline data, blood loss, drainage, or total hospitalization costs between groups (all <i>P</i>>0.05). The 3D-printed group had significantly shorter operative time (<i>P</i>=0.020) but significantly longer hospital stay (<i>P</i>=0.001) than the Prestige LP group. At the final follow-up, the VAS score in the Prestige LP group decreased from (7.0±1.6) to (1.7±0.1), and the Neck Disability Index (NDI) score decreased from (26.0±4.1) to (9.6±1.2); in the 3D-printed group, the VAS score decreased from (6.3±1.6) to (1.6±0.2), and the NDI score decreased from (29.0±3.7) to (10.1±1.7) (all <i>P</i><0.05), of which intergroup differences were not statistically significant (all <i>P</i>>0.05). The JOA recovery rate was 78.9%±13.6% in the Prestige LP group and 82.2%±12.4% in the 3D-printed group, with no significant difference (<i>P</i>=0.845). The excellent-to-good rate was 90.9% (30/33) in the Prestige LP group and 88.6% (31/35) in the 3D-printed group, also without significant difference (<i>P</i>=0.800). Radiographically, no significant loss of segmental ROM was observed in either group at the final follow-up (both <i>P</i>>0.05). The incidences of HO and ASD at the final follow-up were significantly lower in the 3D-printed group [8.6% (3/35) and 5.7% (2/35), respectively] compared with the Prestige LP group [15.2% (5/33) and 12.1% (4/33), respectively] (both <i>P</i><0.05). No severe perioperative complications occurred in either group, and no reoperations related to the index surgery were reported d","PeriodicalId":24023,"journal":{"name":"Zhonghua yi xue za zhi","volume":"106 34","pages":"3598-3605"},"PeriodicalIF":0.0,"publicationDate":"2026-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148971189","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}
引用次数: 0
[Efficacy and safety of acute-phase transcutaneous auricular vagus nerve stimulation for herpes zoster-related pain in middle-aged and elderly patients with comorbid depression and anxiety]. [急性期经皮耳迷走神经刺激治疗伴抑郁焦虑中老年患者带状疱疹相关疼痛的疗效及安全性]。
Zhonghua yi xue za zhi Pub Date : 2026-09-15 DOI: 10.3760/cma.j.cn112137-20260302-00587
T T Zhou, Y Hou, X Li, H P Zhang
{"title":"[Efficacy and safety of acute-phase transcutaneous auricular vagus nerve stimulation for herpes zoster-related pain in middle-aged and elderly patients with comorbid depression and anxiety].","authors":"T T Zhou, Y Hou, X Li, H P Zhang","doi":"10.3760/cma.j.cn112137-20260302-00587","DOIUrl":"10.3760/cma.j.cn112137-20260302-00587","url":null,"abstract":"<p><p><b>Objective:</b> To evaluate the efficacy and safety of transcutaneous auricular vagus nerve stimulation (taVNS) during the acute phase in middle-aged and elderly patients with herpes zoster (HZ) comorbid depressive and anxiety states. <b>Methods:</b> This was a randomized controlled trial. Forty middle-aged and elderly patients with acute-phase HZ who attended the Department of Dermatology at Xuanwu Hospital, Capital Medical University, from June 2024 to June 2025 were enrolled and randomly assigned in a 1∶1 ratio using a random number table to receive either taVNS (<i>n</i>=20) or sham stimulation (<i>n</i>=20) for 5 consecutive days. Both groups received antiviral therapy and on-demand rescue analgesia. Pain, anxiety/depression, and sleep quality were evaluated using the Visual Analog Scale (VAS), the 4-item Patient Health Questionnaire (PHQ-4), and the Insomnia Severity Index (ISI), respectively. The primary outcome was the incidence of subacute pain at 30 days post-rash onset. Secondary outcomes included cumulative analgesic consumption at 1 and 2 weeks after treatment, the changes from baseline (Δ values) in PHQ-4 and ISI scores at 2 weeks, and the incidence of postherpetic neuralgia (PHN) at 90 days post-rash onset. <b>Results:</b> In the taVNS group, 7 patients (35%) were female, with a mean age of (64.1±9.7) years; in the sham group, 10 patients (50%) were female, with a mean age of (61.5±8.5) years. There were no statistically significant differences between the two groups in baseline VAS, PHQ-4, or ISI scores (all <i>P</i>>0.05). The incidence of subacute pain was significantly lower in the taVNS group than in the sham group [5% (1/20) vs 35% (7/20), <i>RD</i>=-30.0% (95%<i>CI</i>:-52.1%--4.9%); <i>RR</i>=0.14 (95%<i>CI</i>: 0.02-1.06); <i>P</i>=0.044]. At 2 weeks after treatment, the Δ values of PHQ-4 and ISI in the taVNS group were significantly greater than those in the sham group. The proportion of patients taking Lofentadine and the cumulative Lofentadine consumption at weeks 1 and 2 were both lower in the taVNS group than in the sham group (all <i>P</i><0.05). No serious adverse events occurred in either group, and the difference in PHN incidence between groups was not statistically significant (<i>P</i>>0.05). <b>Conclusions:</b> Acute-phase taVNS appears to be feasible and safe in middle-aged and elderly patients with HZ and comorbid depressive and anxiety, effectively reducing subacute pain and improving emotional and sleep outcomes.</p>","PeriodicalId":24023,"journal":{"name":"Zhonghua yi xue za zhi","volume":"106 34","pages":"3646-3653"},"PeriodicalIF":0.0,"publicationDate":"2026-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148971158","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}
引用次数: 0
[Expert consensus on evaluating large language models for aided diabetes diagnosis and treatment (2026 edition)]. [评估辅助糖尿病诊断和治疗的大型语言模型的专家共识(2026版)]。
Zhonghua yi xue za zhi Pub Date : 2026-09-08 DOI: 10.3760/cma.j.cn112137-20260313-00702
{"title":"[Expert consensus on evaluating large language models for aided diabetes diagnosis and treatment (2026 edition)].","authors":"","doi":"10.3760/cma.j.cn112137-20260313-00702","DOIUrl":"10.3760/cma.j.cn112137-20260313-00702","url":null,"abstract":"<p><p>Large language models are being introduced into diabetes care at an accelerating pace, but their knowledge accuracy, safety boundaries, explainability, and real-world usability remains uncertain. A diabetes-specific evaluation framework is urgently needed. To address this gap, the National Clinical Research Center for Endocrine and Metabolic Diseases (Changsha) and Chinese Society of Endocrinology and Metabolism, Chinese Medical Doctor Association convened experts in diabetology, artificial intelligence, clinical research, biostatistics, medical informatics, public health, and ethics. Based on a systematic literature review and two Delphi rounds, we developed the consensus for primary use in Chinese clinical settings. This consensus is primarily intended for clinical application in China, emphasizes that physicians retain ultimate responsibility for diagnosis and treatment, and proposes a three-tier evaluation framework covering dimensions, methods, and indicators across five domains: accuracy and reliability, safety, clinical utility and value, user experience and interactivity, ethics and compliance. It provides a practical basis for the development, validation, adoption, and continuous monitoring of large language models for diabetes care.</p>","PeriodicalId":24023,"journal":{"name":"Zhonghua yi xue za zhi","volume":"106 33","pages":"3478-3491"},"PeriodicalIF":0.0,"publicationDate":"2026-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148907411","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}
引用次数: 0
[T-cell engagers: a transformative force or a redundant option in B-cell depletion therapy for rheumatic diseases?] t细胞接合物:风湿病b细胞耗竭疗法的变革力量还是多余选择?]
Zhonghua yi xue za zhi Pub Date : 2026-09-08 DOI: 10.3760/cma.j.cn112137-20260330-00853
Q B Li, X Guan, C L Mei, Jason Xu
{"title":"[T-cell engagers: a transformative force or a redundant option in B-cell depletion therapy for rheumatic diseases?]","authors":"Q B Li, X Guan, C L Mei, Jason Xu","doi":"10.3760/cma.j.cn112137-20260330-00853","DOIUrl":"https://doi.org/10.3760/cma.j.cn112137-20260330-00853","url":null,"abstract":"<p><p>The treatment of rheumatic diseases (RMD) is still challenged by long-term treatment dependence and refractory relapses. Therapeutic goals are therefore shifting from suppression of inflammation toward deep B-cell depletion and immune resetting. Conventional B-cell-depleting monoclonal antibodies have insufficient capacity for tissue B-cell depletion. Autologous chimeric antigen receptor T-cell (CAR-T) therapy has shown the potential for deep immune reconstitution, but its clinical use is constrained by individualized manufacturing, lymphodepleting conditioning, cost, and safety-management requirements. T-cell engagers (TCE) simultaneously bind cluster of differentiation (CD) 3 on T cells and target antigens on B cells or plasma cells. They redirect endogenous T cells to eliminate pathogenic target cells. TCE can offer the advantages of standardized manufacturing, no requirement for ex vivo cell preparation, and flexible adjustment of dose and treatment duration. Focusing on the latest advances in TCE therapy for rheumatic diseases, this review systematically summarizes studies targeting CD19, CD20, and B-cell maturation antigen (BCMA). Available evidence indicates that TCE can rapidly deplete B cells or plasma cells in systemic lupus erythematosus, systemic sclerosis, idiopathic inflammatory myopathies, and rheumatoid arthritis, and may reduce disease activity and promote remission. The main adverse events include cytokine release syndrome, infections, and hypogammaglobulinemia, most of which appear manageable. Accordingly, the clinical value of TCE in rheumatic diseases is becoming increasingly apparent. However, several key issues remain to be resolved, including the depth of tissue B-cell depletion, the quality of immune reconstitution, endogenous T-cell fitness, mechanisms of inadequate response, and long-term safety. TCE therapy is neither a costly duplication of existing B-cell-depleting therapies nor a definitive solution for immune resetting. Rather, it represents a more accessible and clinically manageable therapeutic approach that may offer a practical route toward immune resetting in RMD.</p>","PeriodicalId":24023,"journal":{"name":"Zhonghua yi xue za zhi","volume":"106 33","pages":"3423-3430"},"PeriodicalIF":0.0,"publicationDate":"2026-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148907478","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}
引用次数: 0
[Clinical practice guideline for the application of intravenous to oral switch in adult inpatients (2026 edition)]. [成人住院患者静脉转口切换应用临床实践指南(2026版)]。
Zhonghua yi xue za zhi Pub Date : 2026-09-08 DOI: 10.3760/cma.j.cn112137-20260427-01141
{"title":"[Clinical practice guideline for the application of intravenous to oral switch in adult inpatients (2026 edition)].","authors":"","doi":"10.3760/cma.j.cn112137-20260427-01141","DOIUrl":"10.3760/cma.j.cn112137-20260427-01141","url":null,"abstract":"<p><p>Intravenous to oral switch (IVOS) is the core strategy to optimize the route of administration and reduce unnecessary intravenous infusion. Although the drug administration switching mode has been gradually implemented in China, there is still a lack of unified and implementable standardized guidance in key links such as patient evaluation and switching opportunity. Therefore, the National Pharmaceutical Affairs Management Medical Quality Control Center and the Clinical Pharmacy Branch of the Chinese Medical Association organized experts and scholars in related fields in China to compile this guidelines based on the latest evidence-based medicine evidence at home and abroad. This guidelines focus on the core contents of IVOS screening for adult inpatients, switching timing, evaluation criteria, operational procedures, etc. Finally 18 questions and 24 recommendations were formed, forming the clinical application guidelines for IVOS medication in adult inpatients, aiming at providing scientific and practical decision-making basis for clinical rational intravenous drug use, improving medical quality, ensuring the safety of patients' medication, and optimizing the allocation of medical resources.</p>","PeriodicalId":24023,"journal":{"name":"Zhonghua yi xue za zhi","volume":"106 33","pages":"3459-3477"},"PeriodicalIF":0.0,"publicationDate":"2026-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148907498","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}
引用次数: 0
[Comparison of clinical outcomes of DCB angioplasty versus DES implantation in patients with recently diagnosed cancer and coronary artery disease undergoing PCI]. [DCB血管成形术与DES植入术对新近确诊的癌症和冠状动脉疾病行PCI的临床效果比较]。
Zhonghua yi xue za zhi Pub Date : 2026-09-08 DOI: 10.3760/cma.j.cn112137-20260430-01184
X H Li, Y H Tan, H Li
{"title":"[Comparison of clinical outcomes of DCB angioplasty versus DES implantation in patients with recently diagnosed cancer and coronary artery disease undergoing PCI].","authors":"X H Li, Y H Tan, H Li","doi":"10.3760/cma.j.cn112137-20260430-01184","DOIUrl":"https://doi.org/10.3760/cma.j.cn112137-20260430-01184","url":null,"abstract":"&lt;p&gt;&lt;p&gt;&lt;b&gt;Objective:&lt;/b&gt; To investigate the difference of clinical outcomes of drug-coated balloon (DCB) angioplasty and drug-eluting stent (DES) implantation in patients with recently diagnosed cancer and concomitant coronary artery disease (CAD) undergoing percutaneous coronary intervention (PCI). &lt;b&gt;Methods:&lt;/b&gt; A total of 155 patients hospitalized in the Department of Cardiology, Beijing Chaoyang Hospital, Capital Medical University from January 2018 to December 2024 were restrspectively enrolled. All patients were definitively diagnosed with CAD via coronary angiography, underwent PCI, and had been diagnosed with cancer within 5 years prior to the current admission. Among them, 61 patients were treated with DCB and 94 with DES implantation. Demographic characteristics, cardiovascular risk factors, previous cardiovascular history, cancer type, as well as the number of diseased blood vessels, target vessels, in stent restenosis, bifurcation and small vessel lesions, use of interventional instruments, immediate postoperative blood flow, and intravascular imaging or functional evaluation of two groups of patients were collected. Continuous variables with normal distribution were compared using the independent-samples &lt;i&gt;t&lt;/i&gt; test, whereas categorical variables were compared using Pearson's &lt;i&gt;χ&lt;/i&gt;&lt;sup&gt;2&lt;/sup&gt; test or Fisher's exact test, as appropriate. Overall survival was estimated using the Kaplan-Meier method and Log-rank test. Cardiovascular and non-cardiovascular deaths were treated as competing events, and cumulative incidence function and Gray's test were used for competitive analysis. &lt;b&gt;Results:&lt;/b&gt; No significant between-group differences were observed in age, sex, body mass index, current smoking, dyslipidemia, hypertension, previous myocardial infarction, or chronic kidney disease (all &lt;i&gt;P&lt;/i&gt;&gt;0.05). The DCB group had higher proportion of diabetes mellitus, triple-vessel disease, in-stent restenosis, bifurcation lesions, and small-vessel disease, whereas the DES group had higher proportion of previous PCI, previous coronary artery bypass grafting (CABG), and left anterior descending artery interventions. Kaplan-Meier analysis demonstrated that overall survival was significantly lower in the DCB group than that in the DES group [82.0% (50/61) vs 95.7% (90/94), &lt;i&gt;P&lt;/i&gt;=0.005]. Competive risk analysis showed that the cumulative incidences of cardiovascular death were 4.9% (3/61) in the DCB group and 3.2% (3/94) in the DES group, with no statistically significant difference (&lt;i&gt;P&lt;/i&gt;=0.589). However, the cumulative incidence of non-cardiovascular death was significantly higher in the DCB group than that in the DES group [13.1% (8/61) vs 1.1% (1/94), &lt;i&gt;P&lt;/i&gt;=0.002]. &lt;b&gt;Conclusions:&lt;/b&gt; Among patients with recently diagnosed cancer and concomitant CAD undergoing PCI, DCB angioplasty was associated with lower overall survival than DES implantation, without a significant increase in cardiovascular mortality. The survival difference is m","PeriodicalId":24023,"journal":{"name":"Zhonghua yi xue za zhi","volume":"106 33","pages":"3492-3498"},"PeriodicalIF":0.0,"publicationDate":"2026-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148907421","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}
引用次数: 0
[Where is the way-out for prediabetes management?] 糖尿病前期管理的出路在哪里?]
Zhonghua yi xue za zhi Pub Date : 2026-09-08 DOI: 10.3760/cma.j.cn112137-20260608-01480
G W Li, R T Shao
{"title":"[Where is the way-out for prediabetes management?]","authors":"G W Li, R T Shao","doi":"10.3760/cma.j.cn112137-20260608-01480","DOIUrl":"https://doi.org/10.3760/cma.j.cn112137-20260608-01480","url":null,"abstract":"<p><p>The impact of prediabetes on cardiovascular health is a widely recognized fact. However, intervention worldwide at the community level has been challenging. Some experts believe the reason is that the term \"pre-stage\" is too mild, misleading the public and health authorities into underestimating the health risks to this population. To promote proactive intervention across society, there have been increasing recommendations in recent years to classify prediabetes as part of diabetes. Given the hundreds of millions of people with prediabetes, the multiplied medical burden caused by turning all of them into diabetes will be the biggest obstacle to this \"renaming\". How can we resolve the world-wide challenges? The new diabetes diagnostic criteria proposed by the International Diabetes Federation (IDF, one-hour blood glucose above 11.6 mmol/L) may offer us fresh ideas. It is worth considering designating the current World Health Organization (WHO) standard diabetes as diabetes (WHO) and those people with prediabetes who meet the IDF diagnostic criteria as diabetes (IDF). This approach will protect the legal health rights of the high-risk groups previously defined as prediabetes without excessively increasing the burden on the current medical payment system. Besides, great efforts should be made to educate the public to effectively improve the public's understanding of dangerous outcomes of prediabetes, and highly individualized interventions should be carried out based on the heterogeneity of the prediabetes population.</p>","PeriodicalId":24023,"journal":{"name":"Zhonghua yi xue za zhi","volume":"106 33","pages":"3405-3408"},"PeriodicalIF":0.0,"publicationDate":"2026-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148907461","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}
引用次数: 0
[Development and validation of an integrated intratumoral-peritumoral habitat radiomics model on multiparametric MRI for predicting biochemical recurrence in patients after radical prostatectomy]. [基于多参数MRI的综合瘤内-瘤周放射组学模型的开发和验证,用于预测根治性前列腺切除术后患者的生化复发]。
Zhonghua yi xue za zhi Pub Date : 2026-09-08 DOI: 10.3760/cma.j.cn112137-20251110-02923
Y T Ji, J Bao, L P Shen, X M Wang, J Ding, Y Song, J Zhang, H F Cai, L Cao
{"title":"[Development and validation of an integrated intratumoral-peritumoral habitat radiomics model on multiparametric MRI for predicting biochemical recurrence in patients after radical prostatectomy].","authors":"Y T Ji, J Bao, L P Shen, X M Wang, J Ding, Y Song, J Zhang, H F Cai, L Cao","doi":"10.3760/cma.j.cn112137-20251110-02923","DOIUrl":"https://doi.org/10.3760/cma.j.cn112137-20251110-02923","url":null,"abstract":"<p><p><b>Objective:</b> To develop and validate an MRI-based habitat radiomics model (EPM) integrating intra-and peritumoral features, and to build a combined clinical habitat model (CHPM) for predicting short-term biochemical recurrence (BCR) after radical prostatectomy (RP). <b>Methods:</b> A total of 429 patients who underwent RP were retrospectively enrolled from 2 institutions (Center 1: the First Affiliated Hospital of Soochow University, January 2015 to December 2018, <i>n</i>=335; Center 2: Zhangjiagang Hospital Affiliated with Soochow University, January 2015 to December 2023, <i>n</i>=94). Center 1 was split in a 7∶3 ratio into training (<i>n</i>=234) and internal test (<i>n</i>=101) sets by stratified random sampling based on BCR status; Center 2 served as the external test set (<i>n</i>=94). Follow-up data were retrospectively collected from inpatient and outpatient medical records, with follow-up censored at BCR or the last visit, and only patients with≥1 year of postoperative follow-up were included. Using multi-parametric magnetic resonance imaging (mpMRI), GMM clustering divided intra-and peritumoral (3 mm) regions into K habitat subregions for feature extraction. intratumor habitat (ITH), peritumoral habitat (PTH), and the combined EPM model were built. CHPM integrated ITH/PTH risk scores with independent clinical predictors selected by Cox regression. Model risk stratification was assessed by Kaplan-Meier curves. CHPM performance was evaluated using C-index, calibration curves, decision curve analysis (DCA), integrated discrimination improvement (IDI), and net reclassification improvement (NRI), and compared with CAPRA-S and EPM, with between-model C-index differences compared using Bootstrap resampling (1 000 resamples). <b>Results:</b> All 3 models stratified high-and low-risk patients in both test sets (all <i>P</i><0.05). CHPM showed a higher C-index than CAPRA-S (0.782 vs 0.672, <i>P</i>=0.036; 0.780 vs 0.689, <i>P</i>=0.042). C-index differences between EPM and CAPRA-S, and between EPM and CHPM, were not significant (all <i>P</i>>0.05). EPM and CHPM both outperformed CAPRA-S in calibration, net benefit, IDI, and NRI. <b>Conclusions:</b> EPM and CHPM had comparable C-index values for predicting short-term BCR after RP, and both outperformed CAPRA-S in calibration, net benefit, IDI, and NRI. CHPM showed the best overall performance, suggesting its potential as a noninvasive preoperative risk assessment tool.</p>","PeriodicalId":24023,"journal":{"name":"Zhonghua yi xue za zhi","volume":"106 33","pages":"3499-3511"},"PeriodicalIF":0.0,"publicationDate":"2026-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148907488","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}
引用次数: 0
[Genomic characteristics of multi-drug resistant of non-O1/non-O139 Vibrio cholerae ST1565 from sepsis cases]. [来自脓毒症病例的非o1 /非o139霍乱弧菌ST1565多重耐药的基因组特征]。
Zhonghua yi xue za zhi Pub Date : 2026-09-08 DOI: 10.3760/cma.j.cn112137-20251229-03459
F Q Ai, W Q Wang, J H Guan, Y R Tian, J Y Du, Y M Ma, C Tai, Y N Wang, X B Xu
{"title":"[Genomic characteristics of multi-drug resistant of non-O1/non-O139 <i>Vibrio cholerae</i> ST1565 from sepsis cases].","authors":"F Q Ai, W Q Wang, J H Guan, Y R Tian, J Y Du, Y M Ma, C Tai, Y N Wang, X B Xu","doi":"10.3760/cma.j.cn112137-20251229-03459","DOIUrl":"https://doi.org/10.3760/cma.j.cn112137-20251229-03459","url":null,"abstract":"<p><p>To analyze the genomic characteristics of multi-drug resistant of non-O1/non-O139 <i>Vibrio cholerae</i> ST1565 from sepsis cases. An 88 years old male patient admitted to Huashan Hospital in Shanghai on July 2, 2025, who was retrospectively analyzed. The clinical diagnosis was severe bacterial enteritis and secondary NOVC sepsis. Blood culture confirmed the presence of non-O1/non-O139 group <i>Vibrio cholerae</i>. The strain was a multidrug-resistant isolated of ST1565 as determined by whole-genome sequencing. The ResFinder database predicted 11 resistance genes for 6 classes of antibiotics: qnrVC5, sul2, floR, tet(59), aph(6)-Id, aph(3'')-Ib, dfrA15, dfrA31, almE, almF, and almG. Except for the quinolone qnrVC5, which was not expressed, the other resistance genes were consistent matched the phenotypic results. Additionally, 8 insertion sequences were identified: ISVch1, ISVvu4, ISVch6, ISVvu8, ISVpa3, ISVpa4, ISVsa3, and ISShfr9. Important virulence factors included 3 secreted protein toxin genes: <i>Vibrio cholerae</i> hemolysin, repeat toxin, and <i>Vibrio parahaemolyticus</i> thermostable direct hemolysin. The patient was cured after sequential treatment with meropenem, levofloxacin, and doxycycline. NOVC/ST1565 is a newly identified sequence type in China, which exhibits multidrug-resistant and hypervirulent phenotypes.</p>","PeriodicalId":24023,"journal":{"name":"Zhonghua yi xue za zhi","volume":"106 33","pages":"3512-3516"},"PeriodicalIF":0.0,"publicationDate":"2026-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148907454","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}
引用次数: 0
[From PCOS to PMOS: nomenclature revision and paradigm shift in disease perception]. [从多囊卵巢综合征到PMOS:术语修订和疾病认知的范式转变]。
Zhonghua yi xue za zhi Pub Date : 2026-09-08 DOI: 10.3760/cma.j.cn112137-20260616-01565
Y F Shao, Y Yang, K Wang, C Liu
{"title":"[From PCOS to PMOS: nomenclature revision and paradigm shift in disease perception].","authors":"Y F Shao, Y Yang, K Wang, C Liu","doi":"10.3760/cma.j.cn112137-20260616-01565","DOIUrl":"10.3760/cma.j.cn112137-20260616-01565","url":null,"abstract":"<p><p>In May 2026, <i>Lancet</i> published an online global consensus statement on the unified renaming of polycystic ovary syndrome (PCOS). Developed with participation from 56 international organizations, tens of thousands of patient survey datasets, and multidisciplinary expert deliberations, the consensus officially replaced the nearly 90-year-old term PCOS with polyendocrine metabolic ovarian syndrome (PMOS). This nomenclature revision rectifies misleading terminology and accurately reflects the disease's core nature of concurrent endocrine, metabolic, and ovarian dysfunction. This paper reviews the background, methodological rationale, and core connotations of the global renaming consensus, illustrates the paradigm shifts in disease understanding, standardized screening, stratified therapy, and chronic disease management driven by the name change, and proposes targeted countermeasures and transitional management recommendations for endocrinology and metabolism specialties tailored to clinical practice in China. It aims to deliver actionable practical guidance for frontline clinicians.</p>","PeriodicalId":24023,"journal":{"name":"Zhonghua yi xue za zhi","volume":"106 ","pages":"3409-3414"},"PeriodicalIF":0.0,"publicationDate":"2026-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148798710","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}
引用次数: 0
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