Zhonghua yi xue za zhi最新文献

{"title":"[Multi-task learning with sleep features for interictal epileptiform discharge detection: a model development and validation study].","authors":"N Lin, P Hu, Z Y Chen, W F Gao, H B He, L Li, Z Liang, H Y Sun, Y S Dong, L Y Cui, Q Lu","doi":"10.3760/cma.j.cn112137-20250116-00141","DOIUrl":"https://doi.org/10.3760/cma.j.cn112137-20250116-00141","url":null,"abstract":"<p><p><b>Objective:</b> To establish and validate an automated detection model for interictal epileptiform discharges (IED) through a multi-task learning algorithm that integrates sleep features, providing more precise electroencephalogram (EEG) interpretation support for clinical practice. <b>Methods:</b> Based on convolutional neural networks, a multi-task learning model Siamese-ES that integrates sleep feature was developed. The dataset comprised EEG recordings from 150 patients at Peking Union Medical College Hospital Epilepsy Center from March 2019 to April 2023, of which 140 cases were diagnosed with epilepsy, and the other 10 cases were non-epileptic patients without IED. There were 79 male and 71 female patients, with an age of 27 (3-87) years. After EEG data preprocessing and time-frequency conversion, EEG features were put into two networks, Twins-Electron and Twins-Sleep, to extract the IED features and deep sleep features respectively. Then the features were fused for IED detection. Siamese-ES and two classic single-task IED detection models were trained on the same dataset EpiSet-260K for model comparisons. Additionally, ablation experiments of sleep features and multi-task learning modes were set up to verify the effectiveness. <b>Results:</b> The EpiSet-260K dataset contained 265, 551 samples. The multi-task learning Siamese-ES model integrated with sleep features showed better precision (71.18%), specificity(98.46%), F1 value(76.26%) and area under the curve [0.978 (95%<i>CI</i>:0.977-0.980)]. Moreover, the ablation experiments confirmed that integration of sleep features through a multi-task learning algorithm achieved better evaluation markers. At 80.00% sensitivity, sleep features can improve precision by 1.19%, and multi-task learning mode can improve precision by 2.18%. <b>Conclusions:</b> Our study demonstrates that the Siamese-ES model effectively improves the performance of IED detection model through sleep features and multi-task learning algorithm. The results provide future research directions for IED detection models in different real clinical scenarios.</p>","PeriodicalId":24023,"journal":{"name":"Zhonghua yi xue za zhi","volume":"105 31","pages":"2655-2660"},"PeriodicalIF":0.0,"publicationDate":"2025-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144971901","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":"[Brain network-based neuromodulation for epilepsy: current status and prospects].","authors":"Z S Li, Y C Lin, Y P Wang","doi":"10.3760/cma.j.cn112137-20250514-01177","DOIUrl":"https://doi.org/10.3760/cma.j.cn112137-20250514-01177","url":null,"abstract":"<p><p>Epilepsy is a common chronic neurological disorder, with approximately 30% of patients being drug-resistant epilepsy(DRE), posing significant challenges in clinical management. Advances in neuroimaging techniques and the development of brain network theory have defined epilepsy as a brain network disorder, providing a novel theoretical foundation for neuromodulation therapies. This review systematically summarizes recent progress in epilepsy network modulation, with a focus on the following key scientific issues: (1)precise identification and modulation of epileptic network hubs in focal epilepsy and direct neuromodulation; (2)brain network modulation strategies for generalized epilepsy; (3)current challenges in epilepsy brain network modulation; (4)theory-current status-future perspectives: the path to advancement in epilepsy network modulation. By critically analyzing current research, this article aims to explore new paradigms in epilepsy treatment, and advocate for a shift from traditional \"seizure control\" to a \"network remodeling-functional restoration\" approach, thereby facilitating more precise and personalized neuromodulation strategies for patients.</p>","PeriodicalId":24023,"journal":{"name":"Zhonghua yi xue za zhi","volume":"105 31","pages":"2616-2620"},"PeriodicalIF":0.0,"publicationDate":"2025-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144971941","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":"[Machine learning-based classification of temporal lobe epilepsy subtypes and surgical prognosis evaluation using PET metabolic networks].","authors":"H Y Zhu, L Xiao, B Xiao, S Hu, Y X Tang, L Feng, P Tang","doi":"10.3760/cma.j.cn112137-20250329-00764","DOIUrl":"https://doi.org/10.3760/cma.j.cn112137-20250329-00764","url":null,"abstract":"&lt;p&gt;&lt;p&gt;&lt;b&gt;Objective:&lt;/b&gt; To identify brain metabolic network features for temporal lobe epilepsy (TLE) subtype classification and surgical prognosis prediction using machine learning algorithms, thereby supporting clinical decision-making for TLE subtyping and outcome assessment. &lt;b&gt;Methods:&lt;/b&gt; ¹⁸F-FDG PET images from 137 patients with drug-resistant TLE treated at Xiangya Hospital's Comprehensive Epilepsy Center from January 2016 to June 2021 were retrospectively analyzed as the training cohort. Network connectivity data were derived using Kullback-Leibler divergence similarity estimation (KLSE), yielding 6 902 network attributes alongside relevant demographic and clinical features. Eight machine learning models (including decision tree and random forest) were trained. The resulting models classified TLE subtypes and were validated using ¹⁸F-FDG PET metabolic network data from an independent cohort of 92 drug-resistant TLE patients (from July 2021 to August 2023). Decision curve analysis was used to select the most clinically practical model for predicting the surgical prognosis of 138 temporal lobe epilepsy patients, including 105 with mesial TLE (76 in the training group and 29 in the independent test group) and 33 with neocortical TLE (23 in the training group and 10 in the independent test group). &lt;b&gt;Results:&lt;/b&gt; There were 84 males and 53 females in the training group, with an age of (22.0±8.0) years; in the independent test group, there were 45 males and 47 females, with an age of (24.2±12.8) years. The area under the receiver operating characteristic curve(AUC) of the 8 machine learning models in the training group ranged from 0.904 to 0.985; the AUC in the independent test group ranged from 0.859 to 0.946. According to the comparison of the performance of the above models, it was found that the prediction result of the random forest model was the most accurate and stable [AUC 0.985 (95%&lt;i&gt;CI&lt;/i&gt;: 0.985-0.986), accuracy 0.998(95%&lt;i&gt;CI&lt;/i&gt;: 0.995-1.000), sensitivity 0.950 (95%&lt;i&gt;CI&lt;/i&gt;: 0.898-1.000), specificity 1.000 (95%&lt;i&gt;CI&lt;/i&gt;: 1.000-1.000)]. For patients with mesial temporal lobe epilepsy who underwent surgery, the AUC for predicting surgical prognosis in the training group was 0.838 (95%: 0.753-0.923), and the accuracy was 0.838 (95%&lt;i&gt;CI&lt;/i&gt;: 0.836-0.841); the AUC in the independent test group reached 0.783(95%&lt;i&gt;CI&lt;/i&gt;: 0.549-1.000), with an accuracy of 0.793 (95%&lt;i&gt;CI&lt;/i&gt;: 0.782-0.804). For patients with neocortical temporal lobe epilepsy who underwent surgery, the AUC for predicting surgical prognosis in the training group was 0.962(95%&lt;i&gt;CI&lt;/i&gt;: 0.881-1.000), and the accuracy was 0.957 (95%&lt;i&gt;CI&lt;/i&gt;: 0.953-0.960); while the AUC in the independent test group also reached 0.800 (95%&lt;i&gt;CI&lt;/i&gt;: 0.408-1.000), with an accuracy of 0.900 (95%&lt;i&gt;CI&lt;/i&gt;: 0.882-0.918). &lt;b&gt;Conclusion:&lt;/b&gt; Machine learning models incorporating metabolic network features extracted from ¹⁸F-FDG PET data effectively support TLE subtype classification and surgi","PeriodicalId":24023,"journal":{"name":"Zhonghua yi xue za zhi","volume":"105 31","pages":"2645-2654"},"PeriodicalIF":0.0,"publicationDate":"2025-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144971875","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":"[Current status and challenges of disease-modifying therapy for epilepsy: from concept to practice].","authors":"Q Wang, X R Shi, F Zhu","doi":"10.3760/cma.j.cn112137-20250221-00416","DOIUrl":"https://doi.org/10.3760/cma.j.cn112137-20250221-00416","url":null,"abstract":"<p><p>Epilepsy, as a common neurological disorder, primarily relies on anti-seizure medications (ASM) for treatment, yet most existing drugs fail to prevent core pathological process. Disease-modifying therapies (DMT) for epilepsy, which aim to halt or delay the onset and progression of the disease, have emerged as a critical research direction to overcome the limitations of current therapeutic strategies. Investigating new therapeutic targets and developing effective drugs to prevent or reverse the onset and progression of epilepsy are important goals of clinical and preclinical researches. Based on the current studies, future directions should delve into the multimodal molecular network mechanisms, establish standardized animal models, and address the translational bottlenecks, providing more effective and tailored treatment plans for epilepsy patients from the perspective of disease modification.</p>","PeriodicalId":24023,"journal":{"name":"Zhonghua yi xue za zhi","volume":"105 31","pages":"2625-2629"},"PeriodicalIF":0.0,"publicationDate":"2025-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144971921","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 on the efficacy and safety of eravacycline in the treatment of complicated intra-abdominal infections and common infections].","authors":"Y Ge, Y H Gong, W J Yang, X J Ma","doi":"10.3760/cma.j.cn112137-20250314-00632","DOIUrl":"https://doi.org/10.3760/cma.j.cn112137-20250314-00632","url":null,"abstract":"<p><p><b>Objective:</b> To evaluate the efficacy and safety of eravacycline in the treatment of complicated intra-abdominal infections (cIAI) and common infections. <b>Methods:</b> Literature search was conducted across PubMed, EMBASE, Cochrane Library, Web of Science, Chinese Biomedical Literature Database, China National Knowledge Infrastructure, Wanfang Data, and VIP Database to retrieve relevant literature on the treatment of bacterial infections with eravacycline. The search period spanned from the inception of each database to July 9, 2024. Two independent researchers screened the literature, extracted data and assessed the quality of the studies, based on predefined inclusion and exclusion criteria. The R 4.3.3 software was used to conducting the meta-analysis. The relative risk (<i>RR</i>) was used as the effect measure. Heterogeneity was assessed, and publication bias was evaluated. The analysis focused on randomized controlled trials (RCT) to compare the differences in clinical cure rates and risks of adverse events between the eravacycline group and the control group across four populations: the modified intent-to-treat population, the clinically evaluable population, the microbiologically evaluable population, and the microbiologically intent-to-treat population. Additionally, the clinical efficacy rate, microbiological clearance rate, 30 day all-cause mortality rate, and incidence of adverse events associated with eravacycline in non-RCT was analysed. <b>Results:</b> A total of 34 articles were included based on the inclusion and exclusion criteria, encompassing 31 studies involving 2 958 patients. The meta-analysis results from 4 RCT studies showed no statistically significant differences in clinical cure rates for cIAI between the eravacycline group and the control group across various populations (all <i>P</i>>0.05, all <i>I²</i><50%). The risk of adverse events occurring during treatment was higher in the eravacycline group compared to the control group (<i>RR</i>=1.23, 95%<i>CI</i>: 1.02-1.47, <i>I</i>²=43%), whereas no statistically significant difference was observed in the risk of serious adverse events between the two groups (<i>RR</i>=1.03, 95%<i>CI</i>: 0.65-1.63, <i>I</i>²=0). The meta-analysis results from 27 non-RCT studies indicated that the clinical efficacy rate of eravacycline against multi-site resistant bacterial infections was 71.8%(95%<i>CI</i>: 65.9%-77.7%), <i>I</i>²=86%, and the microbiological clearance rate was 84.1%(95%<i>CI</i>: 72.0%-96.3%), <i>I</i>²=58%. The 30 d all-cause mortality rate was 21.2%(95%<i>CI</i>: 15.7%-27.9%), <i>I</i>²=83%, the overall incidence of adverse events was 7.1%(95%<i>CI</i>: 1.6%-12.5%), <i>I</i>²=70%, and the incidence of treatment-related adverse events was 5.8%(95%<i>CI</i>: 2.2%-10.6%), <i>I</i>²=55%. <b>Conclusion:</b> Based on existing evidence from both RCT and non-RCT studies, eravacycline has demonstrated favorable efficacy and safety in the treatment of cIAI and com","PeriodicalId":24023,"journal":{"name":"Zhonghua yi xue za zhi","volume":"105 31","pages":"2661-2670"},"PeriodicalIF":0.0,"publicationDate":"2025-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144971888","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":"[Misdiagnosis and factors associated with drug resistance in idiopathic generalized epilepsy].","authors":"Q W Zhu, F Li, Z J Wang, J Q Hu, W J Ming, M P Ding, C H Shen, S Wang","doi":"10.3760/cma.j.cn112137-20250211-00309","DOIUrl":"https://doi.org/10.3760/cma.j.cn112137-20250211-00309","url":null,"abstract":"<p><p><b>Objective:</b> To investigate and analyze the profiles of misdiagnosis and risk factors for drug resistance in patients with idiopathic generalized epilepsy (IGE). <b>Methods:</b> The data of 188 patients with IGE treated at the Epilepsy Center of the Second Affiliated Hospital of Zhejiang University School of Medicine from January 2014 to December 2022, who met the latest diagnostic criteria of the International League Against Epilepsy (ILAE) were retrospectively collected. All the patients were followed up for over 12 months. The rates of misdiagnosis and inappropriate medication use were determined. The differences in demographic, clinical and electroencephalography (EEG) characteristics between the drug-resistant and drug-responsive groups were compared. Multivariate logistic regression analysis was employed to identify risk factors for drug resistance in patients with IGE. <b>Results:</b> Among the 188 patients with IGE, there were 105 males and 83 females, with a median onset age of 14 years (Interquartile range: 12.0-16.0). Thirty-five patients (18.6%) were misdiagnosed with focal epilepsy, and 33 (28.0%) patients with juvenile absence or myoclonic epilepsy had ever received inappropriate medication. With a median follow-up duration of 3.8 years (1.4, 6.8), 25 patients(15.4%) were diagnosed with drug-resistant epilepsy at the end of follow-up. Risk factors associated with drug resistance included catamenial cycle-related epilepsy (<i>OR</i>=26.93, 95%<i>CI</i>: 3.44-211.04), presence of≥2 seizure types (<i>OR</i>=5.20, 95%<i>CI</i>: 1.15-23.46), coexistence of generalized and focal discharges on interictal EEG (<i>OR</i>=39.25, 95%<i>CI</i>: 1.76-873.31), and spike and slow wave complex burden grade ≥3 (<i>OR</i>=6.26, 95%<i>CI</i>: 1.59-24.64). <b>Conclusions:</b> Misdiagnosis and inappropriate medication use in IGE are not uncommon. Approximately 15% of patients develop drug-resistant epilepsy, while catamenial cycle-related epilepsy, multiple seizure types, and interictal epileptiform discharge characteristics may be risk factors for drug resistance.</p>","PeriodicalId":24023,"journal":{"name":"Zhonghua yi xue za zhi","volume":"105 31","pages":"2630-2636"},"PeriodicalIF":0.0,"publicationDate":"2025-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144971853","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":"[The value of simultaneous ¹⁸F-FDG PET/MR in detecting intracranial tubers in tuberous sclerosis complex patients with epilepsy and imaging-related factors associated with the presence of tubers in the epileptogenic zone].","authors":"Y Cai, S W Liu, L Y Mao, J Wang, H C Shi, J Ding, X Wang","doi":"10.3760/cma.j.cn112137-20250326-00739","DOIUrl":"https://doi.org/10.3760/cma.j.cn112137-20250326-00739","url":null,"abstract":"&lt;p&gt;&lt;p&gt;&lt;b&gt;Objective:&lt;/b&gt; To investigate the value of fluorine-18 fluorodeoxyglucose simultaneous positron emission tomography/magnetic resonance (&lt;sup&gt;18&lt;/sup&gt;F-FDG PET/MR) in detecting intracranial tubers in tuberous sclerosis complex (TSC) patients with epilepsy, and analyze the imaging-related factors associated with the presence of intracranial tubers in the epileptogenic zone. &lt;b&gt;Methods:&lt;/b&gt; Five TSC patients with epilepsy who visited Zhongshan hospital affiliated to Fudan University from 2018 to 2025 were included in this study. All of them underwent integrated &lt;sup&gt;18&lt;/sup&gt;F-FDG PET/MR. The MR sequences, including the T&lt;sub&gt;1&lt;/sub&gt; weighted imaging (T&lt;sub&gt;1&lt;/sub&gt;WI), T&lt;sub&gt;2&lt;/sub&gt; fluid attenuated inversion recovery (T&lt;sub&gt;2&lt;/sub&gt;-FLAIR) and double inversion recovery (DIR), were performed simultaneously with PET. The number of tubers detected by each MR and &lt;sup&gt;18&lt;/sup&gt;F-FDG PET/MR sequence using the Friedman test was compared. The tubers were categorized based on the patient's clinical symptoms, interictal or ictal EEG findings, and the nodules' location and characteristics. Tubers were classified as either in the epileptogenic zones or the non-epileptogenic zones. The multivariate logistic regression model was conducted to identify the imaging-related factors associated with the presence of intracranial tubers in the epileptogenic zone. &lt;b&gt;Result:&lt;/b&gt; A total of five patients aged (20.80±2.95) years were enrolled, including three males and two females. There were significant differences in the number of tubers detected among the six sets of images from MR sequences and &lt;sup&gt;18&lt;/sup&gt;F-FDG PET/MR sequences in TSC patients with epilepsy (&lt;i&gt;P&lt;/i&gt;&lt;0.001), with the highest average number detected by &lt;sup&gt;18&lt;/sup&gt;F-FDG PET/T&lt;sub&gt;2&lt;/sub&gt;-FLAIR [&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;): 13(12, 18)]. &lt;sup&gt;18&lt;/sup&gt;F-FDG PET/T&lt;sub&gt;2&lt;/sub&gt;-FLAIR detected a total of 70 nodules in five patients, among which 17 nodules were located in the epileptogenic zone and the remaining 53 nodules were in the non-epileptogenic zone. The proportion of tubers [(64.71%, 11/17) vs (5.66%, 3/53)] (&lt;i&gt;P&lt;/i&gt;&lt;0.001) and DIR signal value [(366±110) vs (258±74)] in the epileptogenic zone with adjacent hypometabolic cortex were higher than those in the non-epileptogenic zone, while PET standard uptake value (SUV) [1.95 (1.66, 2.21) vs 3.05 (2.41, 3.88)] and T&lt;sub&gt;1&lt;/sub&gt;WI signal intensity [(182±31) vs (207±47)] were lower than that those in the non-epileptogenic zone (all &lt;i&gt;P&lt;/i&gt;&lt;0.05). Low PET SUV values (&lt;i&gt;OR&lt;/i&gt;=0.066, 95%&lt;i&gt;CI&lt;/i&gt;: 0.008-0.583) and the presence of adjacent hypometabolic cortex (&lt;i&gt;OR&lt;/i&gt;=9.541, 95%&lt;i&gt;CI&lt;/i&gt;: 1.277-71.263) were identified as two imaging-related factors associated with intracranial sclerotic tubers located in the epileptogenic zone. &lt;b&gt;Conclusions:&lt;/b&gt; &lt;sup&gt;18&lt;/sup&gt;F-FDG PET/T&lt;sub&gt;2&lt;/sub&gt;-FLAIR is more effective in detecting intracranial tubers in patients with TSC and epilepsy. Low SUV values of intracranial tubers on PET ","PeriodicalId":24023,"journal":{"name":"Zhonghua yi xue za zhi","volume":"105 31","pages":"2637-2644"},"PeriodicalIF":0.0,"publicationDate":"2025-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144971894","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":"[Expert consensus on the early prevention of human papillomavirus related non-cervical diseases (2025 edition)].","authors":"","doi":"10.3760/cma.j.cn112137-20250519-01212","DOIUrl":"https://doi.org/10.3760/cma.j.cn112137-20250519-01212","url":null,"abstract":"<p><p>Human papillomavirus (HPV)-related diseases have become a significant public health issue, posing a serious threat to human health. However, currently, only cervical cancer has well-established prevention measures, primarily based on HPV vaccination and screening. For other HPV-related non-cervical diseases such as vulvar cancer, vaginal cancer, penile cancer, anal cancer, head and neck cancer, genital warts, and recurrent respiratory papillomatosis, there are no specific guidelines or consensus to systematically guide their early prevention strategies and measures in China. Therefore, Cancer Prevention and Control Committee, Chinese Preventive Medicine Association and Vaccine and Immunization Branch, Chinese Preventive Medicine Association comprehensively summarized the etiology and epidemiology of HPV, the disease burden of HPV-related non-cervical diseases, and the evidence for early prevention, and formed 13 recommendations. This consensus aims to comprehensively summarize the etiology and epidemiology of HPV infection, the disease burden of HPV-related non-cervical diseases, and the evidence for early prevention, providing recommendations and references for relevant personnel in disease prevention and control, maternal and child health care, clinical diagnosis and treatment, health management, policy-making, etc., and finally, reducing the risk of HPV infection, promoting early diagnosis and treatment of HPV-related non-cervical diseases, and decreasing the disease burden.</p>","PeriodicalId":24023,"journal":{"name":"Zhonghua yi xue za zhi","volume":"105 30","pages":"2536-2550"},"PeriodicalIF":0.0,"publicationDate":"2025-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144817695","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":"[Genomic characteristics of emerging toxigenic <i>Salmonella</i> <i>enterica</i> subsp. <i>diarizonae</i> 50:z₅₂:z₃₅/ST8433 cloning from diarrhea cases].","authors":"Z Q Wei, W Q Wang, J H Guan, C Tai, Y N Wang, M Zeng, M Zhou, X B Xu","doi":"10.3760/cma.j.cn112137-20250404-00830","DOIUrl":"https://doi.org/10.3760/cma.j.cn112137-20250404-00830","url":null,"abstract":"<p><p>To analyze the genomic and disease ecological background of two <i>Salmonella</i> <i>enterica</i> subsp. <i>diarizonae</i> (<i>S</i>.Ⅲb) isolated from two children with diarrhea. A retrospective analysis was conducted on the clinical data of two pediatric patients who presented to the gastroenterology outpatient clinic of Fudan University Affiliated Children's Hospital with symptoms of fever and diarrhea and were ultimately diagnosed with bacterial enteritis. Both patients' fecal samples tested positive for <i>Salmonella</i> infection. Whole-genome sequencing results indicated that the strains were all <i>S</i>.Ⅲb 50:z₅₂:z₃₅/ST8433, which were not recorded in domestic or international databases. Antimicrobial susceptibility testing showed that <i>Salmonella</i> strain isolated from Case 1 was an antibiotic-sensitive strain, susceptible to 28 antimicrobial agents; <i>Salmonella</i> strain isolated from Case 2 was a multidrug-resistant strain, susceptible to only 11 antimicrobial agents, and resistant to β-lactam, quinolone, and macrolide antibiotics. The strain of case 1 carried aac(6')-Iaa and quinolone parC(T57S) resistance genes. The strain of Case 2 had a unique chromosome encoding the type Ⅲ secretion systems (T3SS) of <i>Yersinia enterocolitica</i>, and the number of invasion protein genes and typhoid toxin secreted by <i>Salmonella</i> type Ⅰ virulence island (SPⅠ-1) in case 2 were two and one more than those in case 1, respectively. Some important virulence factors were predicted in the genome sequences of both strains, including type Ⅵ secretion system (T6SS), protease (IcsP/SopA), temperature-sensitive hemagglutinin (Tsh), non-LEE encoding T3SS effector (NleC), and Iron uptake protein(iucA、iutA). The two strains identified in this study are clones of the same serotype, sequence type, and T6SS, but exhibit different antibiotic resistance profiles, and there is no history of common exposure among the infants with diarrhea. This suggests that <i>S</i>.Ⅲb 50:z₅₂:z₃₅/ST8433 clone possesses high recombination and virulence characteristics.</p>","PeriodicalId":24023,"journal":{"name":"Zhonghua yi xue za zhi","volume":"105 30","pages":"2581-2585"},"PeriodicalIF":0.0,"publicationDate":"2025-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144817717","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":"[From healthcare providers to patients: application prospects of the venous thromboembolism risk self-assessment tool].","authors":"L Xia, Z F Chen, Z G Zhai","doi":"10.3760/cma.j.cn112137-20250219-00391","DOIUrl":"https://doi.org/10.3760/cma.j.cn112137-20250219-00391","url":null,"abstract":"<p><p>Venous thromboembolism (VTE) is one of the most preventable fatal diseases, and accurate risk assessment is crucial for its prevention. Traditionally, VTE risk assessment has been predominantly conducted by healthcare providers, which is time-consuming and laborious. In recent years, research on patient self-assessment has increasingly attracted attention. This article mainly discusses the feasibility, effectiveness, and application prospects of patient self-assessment of VTE risk. Through the collation and analysis of multiple studies, it was found that the the Caprini risk score of venous thromboembolism based on the patient self-assessment model had shown certain effectiveness in different language versions and patient groups. It can significantly improve the efficiency of assessment, promote patients' attention to health and participation, and can be used as an effective supplement to the assessment of medical staff. However, during the patient self-assessment process, cognitive biases are prone to occur in some assessment options, and it is difficult for patients with special disease conditions to independently complete self-assessment. Therefore, in the future, it is necessary to further optimize assessment tools, leverage new technologies to achieve automated and intelligent assessment, and carry out high-quality multi-center and large-sample studies to improve the accuracy and efficiency of VTE risk assessment, and promote patient participation and improvement of clinical practice.</p>","PeriodicalId":24023,"journal":{"name":"Zhonghua yi xue za zhi","volume":"105 30","pages":"2531-2535"},"PeriodicalIF":0.0,"publicationDate":"2025-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144817696","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}