Zhonghua yi xue za zhi最新文献

{"title":"[Blink patterns in mild thyroid-associated ophthalmopathy-related dry eye and their association with tear film stability].","authors":"F Hu, Y Y Ye, Q Kong","doi":"10.3760/cma.j.cn112137-20251231-03493","DOIUrl":"https://doi.org/10.3760/cma.j.cn112137-20251231-03493","url":null,"abstract":"<p><p><b>Objective:</b> To analyze the differences in blink patterns among patients with mild thyroid-associated ophthalmopathy (TAO, with eyelid retraction<2 mm), patients with primary dry eye disease (DED), and non-dry-eye controls, and to explore the association between these patterns and tear film stability. <b>Methods:</b> The data of patients who were admitted to the Department of Ophthalmology at Ningbo Medical Center Lihuili Hospital between July and September 2025 were retrospectively collected. Based on clinical features, patients were classified into three groups: mild TAO group, primary DED group, and non-dry-eye control group. All subjects underwent standardized ocular surface assessments. Dry eye-related parameters were measured, and spontaneous blink frequency and incomplete blink ratio were quantified. Intergroup differences were compared, correlations between blink patterns and dry eye parameters were analyzed, and multiple linear regression was performed to identify factors associated with incomplete blink ratio. <b>Results:</b> A total of 140 patients (140 eyes) were included. The mild TAO group comprised 45 patients (45 eyes; 19 males and 26 females), with a median age of 45 (31, 50) years. The primary DED group comprised 45 patients (45 eyes; 18 males and 27 females), with a median age of 40 (32, 54) years. The non-dry-eye control group comprised 50 subjects (50 eyes; 19 males and 31 females), with a median age of 40 (30, 50) years. No significant differences were observed in age or sex among the three groups (all <i>P</i>>0.05). Between the mild TAO group and the primary DED group, no significant differences were found in Schirmer test results, tear meniscus height, ocular redness score, meibomian margin morphology score, lipid layer saturation, or lipid spread speed (all <i>P</i>>0.05). However, non-invasive tear film breakup time (NIBUT) was significantly shorter in the mild TAO group than in the primary DED group [2.0 (2.0, 2.5) s vs 4.2 (2.4, 6.0) s, <i>P</i><0.001]. The meibomian gland area ratio was higher in the mild TAO group than that in the primary DED group (<i>P</i><0.001), but was comparable to that in the non-dry-eye control group (<i>P</i>=0.051). Blink frequency was lower in the mild TAO group than those in both the primary DED group (<i>P</i>=0.026) and the non-dry-eye control group (<i>P</i><0.001). The incomplete blink ratio in the mild TAO group [50.0% (31.7%, 70.7%)] was significantly higher than that in the primary DED group [16.7% (7.7%, 26.7%)] and the non-dry-eye control group [5.6% (0, 11.1%)] (both <i>P</i><0.001). In the mild TAO group, the incomplete blink ratio was strongly negatively correlated with NIBUT (<i>rₛ</i>=-0.826, <i>P</i><0.001) and positively correlated with ocular surface disease index (OSDI) score (<i>rₛ</i>=0.320, <i>P</i>=0.032). Multiple linear regression showed that shortened NIBUT (<i>β</i>=-0.061, 95%<i>CI</i>:-0.093--0.029, <i>P</i><0.001) and reduced blink frequency (<i>β<","PeriodicalId":24023,"journal":{"name":"Zhonghua yi xue za zhi","volume":"106 32","pages":"3374-3379"},"PeriodicalIF":0.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148906420","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":"[Clinical analysis of 26 littoral cell angioma of the spleen cases].","authors":"P L Ge, X X Li, Z Y Zhang, X Q Li, Y Wu","doi":"10.3760/cma.j.cn112137-20260104-00032","DOIUrl":"https://doi.org/10.3760/cma.j.cn112137-20260104-00032","url":null,"abstract":"<p><p>The clinical data of 26 patients with littoral cell angioma (LCA) of the spleen admitted to the First Affiliated Hospital of Zhengzhou University from January 2013 to August 2025 were retrospectively analyzed. There were 14 males and 12 females, with a mean age of (39.4±17.7) years. Ten patients presented with abdominal symptoms, and 5 had concurrent malignancies in other organs. CT/MRI findings predominantly showed single or multiple slightly hypodense/hypointense nodules within the spleen, with mild to moderate heterogeneous enhancement in the arterial phase and persistent enhancement in the venous phase. Pathological examination revealed that tumor cells co-expressed vascular endothelial markers (CD31, CD34, ERG, etc.) and histiocytic markers (CD68, etc.), with a biphenotypic expression rate of 17/18. Among 5 cases preoperatively suspected as splenic metastases, 2 were confirmed by needle biopsy and 3 were pathologically verified after simultaneous surgical resection. Twenty-four patients underwent splenectomy. All patients were alive without LCA-related recurrence, with a median follow-up and progression-free survival time both of 71 months (range: 3-144 months). The current study indicates that preoperative contrast-enhanced CT and MRI are helpful in the diagnosis of LCA. Splenectomy is the first choice for LCA treatment, and the prognosis is favorable.</p>","PeriodicalId":24023,"journal":{"name":"Zhonghua yi xue za zhi","volume":"106 32","pages":"3385-3388"},"PeriodicalIF":0.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148906659","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 maintenance therapy with or without pembrolizumab in patients with advanced gastric cancer after first-line chemotherapy].","authors":"B B Shi, P Y Hu, M P Bi, M Lou, Y M Shan, X W Yang, Y H Shen","doi":"10.3760/cma.j.cn112137-20251223-03404","DOIUrl":"https://doi.org/10.3760/cma.j.cn112137-20251223-03404","url":null,"abstract":"&lt;p&gt;&lt;p&gt;&lt;b&gt;Objective:&lt;/b&gt; To observe the efficacy of maintenance therapy with or without Pembrolizumab in patients with advanced gastric cancer after first-line chemotherapy. &lt;b&gt;Methods:&lt;/b&gt; A total of 182 patients with advanced gastric cancer who received first-line induction therapy in our hospital from August 2021 to August 2023 were retrospectively included. According to the maintenance treatment strategy, the patients were divided into two groups. Patients received single-agent maintenance therapy with Pembrolizumab were in the single-agent group, and patients received combined maintenance therapy with Pembrolizumab and chemotherapy were in the combination group. The follow-up period was until October 2025. The levels of tumor-related markers, immune function indexes, tumor response, progression-free survival, overall survival, and adverse reactions within 1 year of maintenance treatment between the two groups were compared. Kaplan-Meier method was used to estimate median progress free survival (PFS) and overall survival (OS), and the log-rank test was used to compare survival differences between groups. Multivariate Cox proportional hazards regression model was used to analyze the impact of different maintenance treatment strategies on survival. &lt;b&gt;Results:&lt;/b&gt; There were 98 cases in the monotherapy group, with an age of (64.81±7.55) years, and 84 cases in the combination therapy group, with an age of (64.55±8.47) years. The results of repeated measures analysis showed that during maintenance treatment, the levels of tumor markers such as carcinoembryonic antigen, cancer antigen(CA)125, CA199 in both the combination and monotherapy groups exhibited a decreasing trend, with a more pronounced decrease in the combination group (all &lt;i&gt;P&lt;/i&gt;&lt;0.05). Both the intergroup differences and the change trend differences in immunogloblin (Ig)A, IgG, and CD4+levels were statistically significant (all &lt;i&gt;P&lt;/i&gt;&lt;0.05); the monotherapy group remained relatively stable for these indicators, while the combination group showed a decreasing trend. The change trend differences in CD3+and CD8+levels between the two groups were statistically significant (all &lt;i&gt;P&lt;/i&gt;&lt;0.05), but the intergroup differences were not statistically significant (all &lt;i&gt;P&lt;/i&gt;&gt;0.05). Neither the intergroup difference nor the change trend difference in IgM level was statistically significant (all &lt;i&gt;P&lt;/i&gt;&gt;0.05). The RR of the combination group and the single drug group were 14.29% and 7.14%, and the DCR were 36.90% and 24.49%, respectively, with no significant difference (&lt;i&gt;P&lt;/i&gt;&gt;0.05). The median PFS in the combination group and the single drug group were 9.24 (95%&lt;i&gt;CI&lt;/i&gt;: 8.19-10.29) and 8.92 (95%&lt;i&gt;CI&lt;/i&gt;: 7.95-9.89) months, respectively, and the median OS in the combination group and the single drug group were 14.58 (95%&lt;i&gt;CI&lt;/i&gt;: 12.65-16.51) and 16.04 (95%&lt;i&gt;CI&lt;/i&gt;: 14.19-17.89) months, respectively, with no statistically significant difference (&lt;i&gt;P&lt;/i&gt;&gt;0.05). After adjusting for co","PeriodicalId":24023,"journal":{"name":"Zhonghua yi xue za zhi","volume":"106 32","pages":"3360-3367"},"PeriodicalIF":0.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148907153","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":"[Clinical practice guideline for renal replacement therapy in critically ill patients with acute kidney injury (2026 edition)].","authors":"","doi":"10.3760/cma.j.cn112137-20260402-00902","DOIUrl":"10.3760/cma.j.cn112137-20260402-00902","url":null,"abstract":"<p><p>Acute kidney injury (AKI) is a common and severe complication in critically ill patients, associated with high morbidity and mortality. Renal replacement therapy (RRT) is a vital life-support modality for critically ill patients with AKI. However, there remains a lack of unified clinical standards for core issues including the timing of RRT initiation, treatment modality, anticoagulation strategy, and weaning from RRT.In response, the Chinese Society of Critical Care Medicine organized a multidisciplinary expert panel to develop the \"Clinical practice guideline for renal replacement therapy in critically ill patients with acute kidney injury (2026 edition)\" in accordance with the Grading of Recommendations Assessment, Development and Evaluation(GRADE) approach for grading evidence quality. This guideline was developed through systematic literature retrieval, meta-analysis, and evidence-based medical evidence synthesis, followed by multiple rounds of manuscript review and revision via online and offline meetings of the working group, and final approval by the Standing Committee of the Society. A total of 34 recommendations were finalized, covering key clinical topics including timing of RRT initiation, establishment and maintenance of vascular access, selection of treatment modalities, application of specialized membrane filters, anticoagulation regimens, replacement fluid formulations, prescribed treatment dose, and RRT weaning strategies. This guideline aims to provide scientific, standardized, and clinically actionable guidance for critical care practitioners in China, promoting standardized RRT management in adult critically ill patients with AKI.</p>","PeriodicalId":24023,"journal":{"name":"Zhonghua yi xue za zhi","volume":"106 ","pages":"3327-3351"},"PeriodicalIF":0.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148044026","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":"[Neuroimaging features of white matter lesions related to patent foramen ovale].","authors":"J Yi, Y J Ma, X M Liu, Q L Zhou, D L Wei, G T Zhang, W J Wang, S J Li","doi":"10.3760/cma.j.cn112137-20250913-02384","DOIUrl":"https://doi.org/10.3760/cma.j.cn112137-20250913-02384","url":null,"abstract":"<p><p>A retrospective analysis was conducted on the neuroimaging features of white matter lesions related to patent foramen ovale and clinical characteristics (age, sex, history of hypertension and diabetes, etc.) of patients who underwent patent foramen ovale closure surgery at Fuwai Hospital, Chinese Academy of Medical Sciences, from February 2021 to June 2025. All patients were confirmed to have right-to-left shunt by contrast-enhanced transthoracic echocardiography and completed brain MRI examination. According to the results of contrast-enhanced transthoracic echocardiography, patients were divided into 2 groups (large-shunt group and non-large-shunt group). The distribution characteristics of white matter lesions were investigated from multiple dimensions, including anterior/posterior circulation, left/right hemisphere, and single/multiple lesions. A total of 118 patients were screened, among whom 100 with complete clinical data were included in the study. The age was (45.4±9.9) years. There were 62(62%) cases in the large-shunt group and 38(38%) cases in the non-large-shunt group. No statistically significant differences were found between the 2 groups in terms of age, gender, or history of hypertension, diabetes, stroke or transient ischemic attack (TIA). The proportion of multiple white matter lesions in the large-shunt group was significantly different [59.7%(37/62) vs 39.5%(15/38), <i>P</i>=0.049], as was the proportion of bilateral hemispheric distribution [62.9%(39/62) vs 42.1%(16/38), <i>P</i>=0.042]. The proportion of lesions distributed in the right hemisphere was higher [66.1%(41/62) vs 47.4%(18/38)], but the difference did not reach statistical significance (<i>P</i>=0.064). Among patients with a history of stroke or TIA, the proportions of multiple, bilateral, and involvement of both anterior and posterior circulation white matter lesions were significantly higher than those without such histor[66.1%(39/59) vs 31.7%(13/41), 67.8%(40/59) vs 36.6%(15/41), 62.7%(37/59) vs 26.8%(11/41), all <i>P</i><0.01]. No statistically significant difference in white matter lesions distribution was observed between patients with and without a history of migraine. Patients with patent foramen ovale and a large right-to-left shunt are more likely to present with bilateral and multiple cerebral white matter lesions on brain MRI, and these white matter lesions are more prone to occur in the right hemisphere.</p>","PeriodicalId":24023,"journal":{"name":"Zhonghua yi xue za zhi","volume":"106 31","pages":"3285-3290"},"PeriodicalIF":0.0,"publicationDate":"2026-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148798273","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":"[Development of a prediction model for acute heart failure based on B-type natriuretic peptide and multiple clinical indicators in acute dyspnea patients with varying renal function levels].","authors":"X J Li, X W Zhang, M Y Zhang, L Y Teng, X L Chen","doi":"10.3760/cma.j.cn112137-20260129-00331","DOIUrl":"https://doi.org/10.3760/cma.j.cn112137-20260129-00331","url":null,"abstract":"&lt;p&gt;&lt;p&gt;&lt;b&gt;Objective:&lt;/b&gt; To investigate the diagnostic value of B-type natriuretic peptide (BNP) for acute heart failure (AHF) in acute dyspnea patients with different renal function statuses and to develop a diagnostic model for AHF by integrating BNP with multiple clinical variables. &lt;b&gt;Methods:&lt;/b&gt; A retrospective analysis was conducted on patients presenting with acute dyspnea as the primary or initial symptom who were admitted to the Emergency Department of Peking University First Hospital between January 2019 and June 2023. Demographic characteristics, clinical features, and laboratory parameters were collected as candidate variables. Renal function was assessed using the estimated glomerular filtration rate (eGFR) and classified into different stages. Least absolute shrinkage and selection operator (LASSO) regression was applied to 34 candidate variables to identify variables associated with AHF diagnosis. Receiver operating characteristic (ROC) curve analysis was performed for the selected variables. The diagnostic performance of BNP across different renal function subgroups was further evaluated using ROC analysis. Subsequently, 5 predictive models, including logistic regression, random forest, Light Gradient Boosting Machine (LightGBM), Extreme Gradient Boosting (XGBoost), and Adaptive Boosting (AdaBoost), were developed based on the selected variables. Model performance was assessed using the area under the curve (AUC) of ROC, calibration curves, and decision curve analysis (DCA). Differences in the AUC across subgroups were compared using the DeLong test. Model interpretability was evaluated using Shapley additive explanations (SHAP). &lt;b&gt;Results:&lt;/b&gt; Among the 605 enrolled patients, 236 (39.0%) were diagnosed with AHF and 369 (61.0%) were classified as non-AHF. LASSO regression identified seven variables associated with AHF diagnosis, including history of diuretic use, diabetes mellitus, previous cardiac dysfunction, persistent atrial fibrillation, acute myocardial infarction, eGFR stage, and BNP level. Among the selected variables, BNP demonstrated the highest diagnostic performance for AHF, with an AUC of 0.949 (95%&lt;i&gt;CI&lt;/i&gt;: 0.931-0.967), an optimal cutoff value of 488 ng/L, a sensitivity of 80.9%, a specificity of 96.7%, and a Youden index of 0.777. In patients with eGFR≥60 ml·min&lt;sup&gt;-1&lt;/sup&gt;·(1.73 m&lt;sup&gt;2&lt;/sup&gt;)&lt;sup&gt;-1&lt;/sup&gt; and eGFR&lt;60 ml·min&lt;sup&gt;-1&lt;/sup&gt;·(1.73 m&lt;sup&gt;2&lt;/sup&gt;)&lt;sup&gt;-1&lt;/sup&gt;, the AUC of BNP for diagnosing AHF were 0.944 (95%&lt;i&gt;CI&lt;/i&gt;: 0.902-0.987) and 0.938 (95%&lt;i&gt;CI&lt;/i&gt;: 0.913-0.962), respectively, with no significant difference between the 2 groups (&lt;i&gt;P&lt;/i&gt;=0.793). The logistic regression, random forest, AdaBoost, LightGBM, and XGBoost models achieved AUC of 0.956 (95%&lt;i&gt;CI&lt;/i&gt;: 0.937-0.972), 0.944 (95%&lt;i&gt;CI&lt;/i&gt;: 0.925-0.962), 0.940 (95%&lt;i&gt;CI&lt;/i&gt;: 0.918-0.960), 0.931 (95%&lt;i&gt;CI&lt;/i&gt;: 0.909-0.952), and 0.929 (95%&lt;i&gt;CI&lt;/i&gt;: 0.905-0.951), respectively. The logistic regression model demonstrated the best overall discr","PeriodicalId":24023,"journal":{"name":"Zhonghua yi xue za zhi","volume":"106 31","pages":"3264-3272"},"PeriodicalIF":0.0,"publicationDate":"2026-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148798635","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 and mechanism of chloroquine on supressing the growth of pancreatic neuroendocrine tumors].","authors":"J X Bao, L Xu, M J Ye, X F Qian, Y Tian, J A Bai, Q Y Tang","doi":"10.3760/cma.j.cn112137-20251205-03203","DOIUrl":"https://doi.org/10.3760/cma.j.cn112137-20251205-03203","url":null,"abstract":"&lt;p&gt;&lt;p&gt;&lt;b&gt;Objective:&lt;/b&gt; To investigate the effect and mechanism of chloroquine on the growth of pancreatic neuroendocrine tumors (pNET). &lt;b&gt;Methods:&lt;/b&gt; This study was divided into animal experiments and cell experiments. (1) Animal experiments: ten male BALB/c nude mice, 6-8 weeks old, were selected. The suspension of QGP-1 cells (human pNET cell line) in the logarithmic growth phase was inoculated subcutaneously into the right axilla of nude mice to establish a subcutaneous xenograft tumor model. According to the random number table method, the mice were divided into a control group (intraperitoneal injection of physiological saline, once a day) and a chloroquine group (intraperitoneal injection of 50 mg/kg chloroquine, once a day), with 5 mice in each group. The treatment was administered continuously for 4 weeks. At the end of the 4th week, the mice were sacrificed, and the long diameter and weight of the transplanted tumors in each group were compared. The expression level of Ki-67 in tumor tissues was detected by immunohistochemistry (IHC) method, and tumor cell apoptosis was detected by TUNEL fluorescence staining. (2) Cell experiments: the cells used were human pNET cell line QGP-1 and pNET tissues (primary PNET cells) isolated from patients diagnosed with pNET at the First Affiliated Hospital of Nanjing Medical University who underwent surgical resection. Primary PNET cells were treated with 0, 10, 20, 40, 80, and 100 μmol/L chloroquine, and were respectively named the blank group [adding an equal volume of dimethyl sulfoxide (DMSO)] and 10, 20, 40, 60, 80, 100 μmol/L groups; QGP-1 cells were treated with 0, 20, 40, 60, 80, 100, and 160 μmol/L chloroquine, and were respectively named the blank group (adding an equal volume of DMSO) and 20, 40, 60, 80, 100, 160 μmol/L groups. After 24 hours of treatment, cell viability (absorbance &lt;i&gt;A&lt;/i&gt;&lt;sub&gt;450&lt;/sub&gt; nm value) was detected by cell counting kit-8 (CCK-8) method, and the half-maximal inhibitory concentration (IC50) was calculated. Based on the IC50 results, and combined with the long-term non-specific cytotoxicity, low-toxicity sub-lethal concentrations were selected for intervention in subsequent functional experiments. Cell proliferation ability was assessed by 5-ethynyl-2'-deoxyuridine (EdU) incorporation assay (proportion of EdU-positive cells) and plate colony formation assay (number of cloned cell formations). Cell migration (number of migrating cells) and invasion ability (number of invading cells) were detected using Transwell method. Cell cycle (proportion of cells in G0 or G1 phase) and apoptosis (early and late cell apoptosis rates) were analyzed by flow cytometry. Differentially expressed genes were screened using transcriptome sequencing, and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway enrichment analysis was performed. The expression levels of pathway-related phosphorylated proteins [phosphorylated phosphatidylinositol 3-kinase (p-PI3K), phosphorylated protein ki","PeriodicalId":24023,"journal":{"name":"Zhonghua yi xue za zhi","volume":"106 31","pages":"3273-3284"},"PeriodicalIF":0.0,"publicationDate":"2026-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148798667","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":"[Construction of obesity self-management education and support framework].","authors":"A Li, X H Guo, J Q Zhang","doi":"10.3760/cma.j.cn112137-20260309-00651","DOIUrl":"https://doi.org/10.3760/cma.j.cn112137-20260309-00651","url":null,"abstract":"<p><p>Obesity is a chronic metabolic disease requiring long-term intervention and sustained behavioral management. Given the current paucity of systematic education and support standards in obesity care, this paper proposes the obesity self-management education and support (OSMES) framework, modeled on the mature theoretical and practical foundations of diabetes self-management education and support framework. Grounded in the L.I.F.E.care four-dimensional model: load management (L), integration fitness (I), form optimization (F), and equilibrium mindset (E). The framework establishes 6 core standards: support system development, target population assessment, multidisciplinary team collaboration, service design and delivery, person-centered longitudinal care, and outcome evaluation with continuous quality improvement. Unlike traditional approaches focusing solely on weight reduction, OSMES elevates body form, functional capacity, and psychological well-being to equal importance alongside metabolic indicators. Considering China's healthcare context, the framework explores collaborative models between medical institutions and third-party organizations, diversified payment pathways, and digital remote support to provide an implementable reference for long-term obesity management.</p>","PeriodicalId":24023,"journal":{"name":"Zhonghua yi xue za zhi","volume":"106 31","pages":"3193-3199"},"PeriodicalIF":0.0,"publicationDate":"2026-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148798733","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 clinical application of nutrient-stimulated hormone receptor agonist in the treatment of type 2 diabetes mellitus (2026 edition)].","authors":"","doi":"10.3760/cma.j.cn112137-20260527-01398","DOIUrl":"10.3760/cma.j.cn112137-20260527-01398","url":null,"abstract":"<p><p>Hypoglycemic drugs targeting at nutrient-stimulated hormone (NuSH) receptors, including glucagon like peptide-1 (GLP-1) receptor agonists, dual glucose-dependent insulinotropic polypeptide (GIP)/GLP-1 receptor agonists and dual glucagon (GCG)/GLP-1 receptor agonists, not only exhibit the beneficial metabolic effects, such as lowering blood glucose, reducing body weight, lowering blood pressure, improving lipid profiles and attenuating hepatic steatosis, but also have demonstrated cardiovascular and renal benefits. The continual innovation and advancement of novel drugs, along with the continuous accumulation of evidence-based medical evidence, have offered more options for the clinical management of type 2 diabetes mellitus (T2DM). Based on these developments, Endocrinology and Metabolism Professional Committee, National Association of Health Industry and Enterprise Management searched recent literature and evaluated its evidence, and organized endocrinology specialists to conduct multiple rounds of rigorous deliberation and repeated revisions to complete the update of the consensus, on the basis of the 2020 version of the <i>Consensus recommendations on utilizing glucagon-like peptide-1 (GLP-1) receptor agonists in the treatment of type 2 diabetes mellitus</i>.The consensus focuses on the timing and applicable population of NuSH receptor agonists in T2DM, the precautions when combined with other hypoglycemic drugs, the impacts on cardiovascular, renal or hepatic outcomes, forming 10 recommended opinions aimed at providing reference for clinical doctors to standardize the use of such drugs and better serve T2DM patients.</p>","PeriodicalId":24023,"journal":{"name":"Zhonghua yi xue za zhi","volume":"106 31","pages":"3222-3233"},"PeriodicalIF":0.0,"publicationDate":"2026-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148798297","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 advances in adjuvant therapy after curative resection for pancreatic neuroendocrine tumors: from recurrence risk identification to therapeutic decision-making].","authors":"Y M Zhang, C C Liu, L Liu, W Q Wang","doi":"10.3760/cma.j.cn112137-20260215-00488","DOIUrl":"https://doi.org/10.3760/cma.j.cn112137-20260215-00488","url":null,"abstract":"<p><p>The incidence of pancreatic neuroendocrine tumor (pNET) is increasingly year by year. While curative resection is the primary treatment, with observation and follow-up generally adopted postoperatively, the risk of recurrence after surgery is high. The role of adjuvant therapy for patients with pNET after surgery remains controversial, with international guidelines favoring a risk-stratified approach and Chinese guidelines recommending adjuvant therapy for high-risk patients (with lymph node metastasis or high-grade tumors). Combining domestic and international guidelines as well as research evidence, this article systematically elaborates on the current status and advances of postoperative adjuvant therapy in patients with pNET, ranging from identification of risk factors for postoperative recurrence (clinical and pathological factors, biochemical markers, imaging factors, and predictive models) to therapeutic decision-making [somatostatin analogs (SSA), targeted therapy, chemotherapy, peptide receptor radionuclide therapy (PRRT)], so as to provide reference for clinical decision-making.</p>","PeriodicalId":24023,"journal":{"name":"Zhonghua yi xue za zhi","volume":"106 31","pages":"3214-3221"},"PeriodicalIF":0.0,"publicationDate":"2026-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148798655","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}