Chinese Medical Sciences Journal最新文献

{"title":"Teaching Neuraxial Ultrasonography with a Virtual Reality Simulator of Spine: A Randomized Controlled Study.","authors":"Qing Yuan, Xu-Lei Cui, Xu Li, Gang Tan, Jie Yi, Yu-Guang Huang","doi":"10.24920/004567","DOIUrl":"https://doi.org/10.24920/004567","url":null,"abstract":"<p><strong>Objectives: </strong>To evaluate whether adjunctive virtual reality (VR) spine simulation in neuraxial ultrasound training improves performance competency among anesthesia residents compared with traditional didactic teaching alone.</p><p><strong>Methods: </strong>In this single-center, randomized controlled trial, anesthesia residents from the Department of Anesthesiology, Peking Union Medical College Hospital were recruited and randomized (1:1, computer-generated) to receive either a traditional 30-minute didactic lecture of spine ultrasonography (control group) or an identical teaching session followed by 30-minute VR spine simulation (VR group). After the training, participants were required to perform a preprocedural spine ultrasound scan. The primary outcome was a composite learning score evaluating the theoretical knowledge, practical skills, self-assessed satisfaction, and willingness to apply the technique in future practice. The secondary outcomes included scanning time, score of anatomic structure recognition, and accuracy of depth measurement to the posterior complex.</p><p><strong>Results: </strong>A total of 46 participants (23 per group) were enrolled. Compared to the control group, the VR group achieved significantly higher composite learning scores (0.80±0.05 <i>vs</i> 0.74±0.09, <i>P</i> = 0.01). The score of anatomic structure recognition (0.85±0.15 <i>vs</i> 0.72±0.20, <i>P</i> = 0.01) and the accuracy of depth measurement to the posterior complex (73.9% <i>vs</i> 43.5%, <i>P</i> = 0.03) were also significantly superior in the VR group.</p><p><strong>Conclusions: </strong>Among anesthesia residents, adjunctive VR simulator training improves the technical and cognitive performance in neuraxial ultrasound compared with traditional didactic teaching alone.</p>","PeriodicalId":35615,"journal":{"name":"Chinese Medical Sciences Journal","volume":"41 1","pages":"10-16"},"PeriodicalIF":0.0,"publicationDate":"2026-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147783483","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":"Wartime Healers: The Collective Awakening and National Mission of PUMC Medical Community during the Chinese People's War of Resistance against Japanese Aggression.","authors":"Qing Wang, Hai-Sheng Liu, Yun-Feng Wang, Guo-Xing Tang, Zong-Xin Wang, Jing Liu","doi":"10.24920/004579","DOIUrl":"https://doi.org/10.24920/004579","url":null,"abstract":"<p><p>This study focuses on eleven representative medical figures-including John Heng Liu and Robert K. S. Lim-to provide a historical account of their wartime service during the Chinese People's War of Resistance against Japanese Aggression. It reveals that the faculty and students of the Peking Union Medical College (PUMC) made distinguished contributions in three critical areas: battlefield medical relief, westward evacuation of the medical colleges and nursing school, and epidemic prevention research. Liu laid the groundwork for China's wartime medical system, while Lim organized and commanded the Medical Relief Corps of the Red Cross Society of China. Qizhen Shen established the Medical Division of the New Fourth Army, and James K. Shen oversaw the westward evacuation of the Central Hospital before serving on the Burma front. Shoukai Zhou drafted key health regulations. Together, these figures formed a wartime medical relief network spanning both the frontal battlefields and the resistance bases in enemy-occupied territories. In medical education, Xiaoqian Zhang led the westward evacuation of Hsiang-Ya Medical College, Zongen Li founded the National Guiyang Medical College, and Yuchan Nieh directed the evacuation of the PUMC School of Nursing-efforts that preserved the torch of medical education amid the flames of war. In scientific research, Feifan Tang overcame Western technological blockades to develop vaccines and penicillin; Wengui Chen exposed Japanese germ-warfare atrocities in his <i>Changde Plague</i><i>Report</i>; and Dushan Rong supported battlefield medicine through radiological services. Through their scientific expertise and patriotic commitment, these medical figures embodied the collective awakening of PUMC faculty at a moment of existential national crisis. Their service provided indispensable medical support that contributed significantly to China's ultimate victory.</p>","PeriodicalId":35615,"journal":{"name":"Chinese Medical Sciences Journal","volume":"41 1","pages":"45-53"},"PeriodicalIF":0.0,"publicationDate":"2026-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147783479","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":"Risk Factors for Postoperative Pulmonary Complications Following Posterior Spinal Fusion in Adolescent Scoliosis: A Retrospective Cohort Study.","authors":"Jing Zhan, Ai Hu, Huai-Yuan Wang, Yue-Lun Zhang, Wei-Yun Chen","doi":"10.24920/004580","DOIUrl":"https://doi.org/10.24920/004580","url":null,"abstract":"<p><strong>Objectives: </strong>Scoliosis is a prevalent spinal deformity that severely impacts the physical and psychological well-being of adolescents and often requires surgical correction. This study aimed to investigate the risk factors for postoperative pulmonary complications (PPCs) following posterior spinal fusion in adolescent scoliosis, with a specific focus on evaluating the predictive value of preoperative forced vital capacity (FVC) and etiological classification.</p><p><strong>Methods: </strong>This retrospective cohort study enrolled adolescents who underwent posterior spinal fusion for scoliosis correction at Peking Union Medical College Hospital between January 2018 and December 2022. The baseline demographic, clinical, and perioperative variables were collected. The primary endpoint was the occurrence of PPCs prior to hospital discharge. Univariate and multivariable binary logistic regression analyses were conducted to identify independent risk factors.</p><p><strong>Results: </strong>A total of 1,234 patients were included, of whom 29 (2.35%) developed PPCs and 1,205 did not. Univariate analysis revealed that 12 variables, including non-idiopathic scoliosis, a larger main thoracic curve, a decreased FVC% predicted, and increased perioperative blood transfusions, were significantly associated with PPCs (<i>P</i> < 0.05). Multivariable logistic regression model showed that non-idiopathic scoliosis emerged as the sole independent risk factor for PPCs [adjusted odds ratio (<i>OR</i>) = 5.478, 95% confidence interval: 2.017-19.148, <i>P</i> = 0.002]. Preoperative FVC% predicted (adjusted <i>OR</i> = 0.993, <i>P</i> = 0.497) and main thoracic curve (adjusted <i>OR</i> = 1.002, <i>P</i> = 0.736) did not demonstrate independent predictive value.</p><p><strong>Conclusions: </strong>Non-idiopathic scoliosis, rather than preoperative pulmonary function or curve severity, is an independent risk factor for PPCs following posterior spinal fusion in adolescents. During perioperative respiratory risk assessment, particular emphasis should be placed on the etiological classification of these patients.</p>","PeriodicalId":35615,"journal":{"name":"Chinese Medical Sciences Journal","volume":"41 1","pages":"1-9"},"PeriodicalIF":0.0,"publicationDate":"2026-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147783503","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":"Emergency Management of Crushing Perineal Avulsion with Complete Urethral Disruption: A Case Report.","authors":"Jie Wang, Gui-Zhong Li, Li-Bo Man","doi":"10.24920/004553","DOIUrl":"https://doi.org/10.24920/004553","url":null,"abstract":"<p><p>High-energy machinery entrapment can result in catastrophic perineal injuries involving complete urethral disruption, extensive soft tissue avulsion, and associated orthopedic trauma. We report a 24-year-old man who suffered a crushing roller injury, resulting in total perineal avulsion with bilateral testicular exposure, complete bulbar urethral transection, right pubo and ischial ramus avulsion, and an open ipsilateral tibiofibular fracture. Given the patient's hemodynamic stability following resuscitation and the intraoperative finding of cleanly transected urethral ends without rectal or bladder neck injuries, a single-stage surgical approach was pursued. Primary urethral anastomosis and <i>in situ</i> subcutaneous testicular burial were performed, with primary closure of the perineal wound. At 6 months postoperatively, debridement was repeated for non-healing wound secondary to infection, followed by regular dressing changes. Complete healing was achieved at 1 year postoperatively. At the 3-year follow-up, the patient could ambulate independently without assistance, void with a normal stream, and reported preserved erectile function. These favourable outcomes support the value of aggressive early single-stage reconstruction in carefully selected, hemodynamically stable patients sustaining devastating perineal avulsion injuries.</p>","PeriodicalId":35615,"journal":{"name":"Chinese Medical Sciences Journal","volume":"41 1","pages":"36-38"},"PeriodicalIF":0.0,"publicationDate":"2026-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147783453","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":"Time-Dependent Neuroprotection and Precision Interventions in Acute Ischemic Stroke in the Reperfusion Era.","authors":"Fu-Nan Shi, Zheng-Dao Yu, Xiao-Ning Wang, Zhen-Chang Zhang","doi":"10.24920/004558","DOIUrl":"https://doi.org/10.24920/004558","url":null,"abstract":"<p><p>Acute ischemic stroke ranks as the second leading cause of mortality among noncommunicable diseases globally. Although recent advancements in intravenous thrombolysis and endovascular thrombectomy have markedly increased recanalization rates in patients with large vessel occlusion, improvements in clinical outcomes have not been consistently observed. Accumulating evidence demonstrates that successful recanalization does not necessarily translate into effective tissue reperfusion. Accordingly, the concept of neuroprotection has evolved from a traditional focus on mitigating cellular necrosis toward a strategy aimed at delaying the progression of ischemic penumbra and preserving salvageable brain tissue. This review summarizes the dynamic processes underlying reperfusion injury, microcirculatory dysfunction, neurovascular unit disruption, and associated neuroprotective mechanisms. Particular emphasis is placed on reversible changes within penumbra, reperfusion-induced injury amplification, and emerging imaging-guided approaches and molecular biomarkers for precision interventions. These insights provide a framework for developing spatiotemporally coordinated, individualized neuroprotective strategies.</p>","PeriodicalId":35615,"journal":{"name":"Chinese Medical Sciences Journal","volume":"41 1","pages":"17-28"},"PeriodicalIF":0.0,"publicationDate":"2026-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147783548","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":"Endometrial Carcinoma Arising in Adenomyosis in the Myometrium with Uninvolved Endometrium: A Case Report.","authors":"Zhi-Qiang Wang, Chun Zhang","doi":"10.24920/004537","DOIUrl":"https://doi.org/10.24920/004537","url":null,"abstract":"<p><p>Endometrial carcinoma arising in adenomyosis (EC-AIA) is a rare entity that originates deep within the myometrium and often spares the endometrial lining. We report a 53-year-old woman who presented with a vascularized uterine mass invading the bladder (International Federation of Gynecology and Obstetrics [FIGO] stage ⅢB₂). Despite imaging findings suggesting malignancy, endometrial curettage yielded only atrophic cells, and hysterectomy confirmed a histologically normal endometrial cavity. Final pathology revealed endometrioid adenocarcinoma confined to adenomyotic lesions with lymph node involvement. This case underscores a critical diagnostic pitfall: negative endometrial sampling does not exclude EC-AIA. Moreover, applying current FIGO staging systems, designed for endometrial-origin tumors, to EC-AIA presents significant limitations, risking either underestimation of deep invasion or artificial upstaging.</p>","PeriodicalId":35615,"journal":{"name":"Chinese Medical Sciences Journal","volume":"41 1","pages":"39-44"},"PeriodicalIF":0.0,"publicationDate":"2026-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147783476","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":"Good Data Governance Practice and a Grading Initiative for Life Sciences Data.","authors":"Han Liu, Jing Li, Sheng-Fa Zhang, Yue-Qiong Cao, Zheng-Lin Du, Xiao-Feng Jia, Guo-Hui Ding","doi":"10.24920/004549","DOIUrl":"https://doi.org/10.24920/004549","url":null,"abstract":"<p><p>Life sciences have entered the era of big data, uncovering the complexity of human biological systems and advancing precision medicine and scientific wellness. In alignment with the Findable, Accessible, Interoperable, and Reusable (FAIR) principles, integrating population-level biological data resources from the academic and industrial sectors can substantially increase the efficiency of data utilization and foster innovative breakthroughs. Here, we introduce a novel framework for Good Data Governance Practice (GDGP) coupled with a grading initiative for the life sciences, focusing on traceability and openness. The GDGP framework systematically defines governance constraints, influencing factors, and functional capabilities to streamline data governance and management efficiency. This achievement lays the groundwork for compliant cross-institutional and cross-border data sharing and collaborative processing, poised to pave the way for standardized, ethical, and scalable data-driven research in precision medicine and beyond.</p>","PeriodicalId":35615,"journal":{"name":"Chinese Medical Sciences Journal","volume":"41 1","pages":"29-35"},"PeriodicalIF":0.0,"publicationDate":"2026-03-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147783507","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":"Associated Factors for Chronic Neuropathic Cancer Pain in Outpatients From Pain Clinic: A Perspective Cross-Sectional Study.","authors":"Bo-Ru Yuan, Chen Sun, Mo-Han Li, Si Chen, Lu-Lu Ma, Li-Jian Pei","doi":"10.24920/004542","DOIUrl":"https://doi.org/10.24920/004542","url":null,"abstract":"<p><strong>Objectives: </strong>To determine the prevalence, distribution, and associated clinical factors of chronic neuropathic cancer pain (CNCP) among outpatients with chronic cancer pain (CCP) and to inform improved recognition and management.</p><p><strong>Methods: </strong>In this cross-sectional study, consecutive outpatients with CCP diagnosed according to the International Association for the Study of Pain (IASP) criteria were recruited from the pain clinic at Peking Union Medical College Hospital between June and October 2025. CNCP was diagnosed based on the Neuropathic Pain Special Interest Group (NeuPSIG) criteria. Patients were classified into the CNCP group if they met at least one of the four NeuPSIG criteria, regardless of coexisting visceral or bone pain. Demographic, oncologic, and pain-related data were collected through standardized interviews. Between-group differences in baseline characteristics were assessed using absolute standardized differences and Chi-square or <i>t</i>-tests. Logistic regression analyses were conducted to identify clinical factors associated with CNCP.</p><p><strong>Results: </strong>Of 138 eligible patients with CCP, 85 (61.6%) were classified into the CNCP group and 53 (38.4%) into the non-CNCP group. Multivariable logistic regression analysis revealed that bone metastasis (adjusted <i>OR</i> = 2.316, 95% <i>CI</i>: 1.074-5.178, <i>P</i> = 0.032), radiotherapy (adjusted <i>OR</i> = 2.489, 95% <i>CI</i>: 1.119-5.803, <i>P</i> = 0.025), and voiding dysfunction (adjusted <i>OR</i> = 5.470, 95% <i>CI</i>: 2.150-16.396, <i>P</i> < 0.001) were independently associated with CNCP. Pancreatic cancer was inversely associated with CNCP (<i>OR</i> = 0.371, <i>P</i> = 0.031). Only 5 (3.6%) patients in the CNCP group received neuropathic pain-specific interventions, indicating a predominant reliance on single-modality pain management.</p><p><strong>Conclusions: </strong>CNCP was present in nearly two-thirds of outpatients with CCP. The identified associations with bone metastasis, radiotherapy, and voiding dysfunction may aid in the early recognition of neuropathic pain components and support the adoption of mechanism-based multimodal pain management strategies.</p>","PeriodicalId":35615,"journal":{"name":"Chinese Medical Sciences Journal","volume":"40 4","pages":"271-281"},"PeriodicalIF":0.0,"publicationDate":"2025-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145901324","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Chinese Expert Consensus on the Clinical Application of Ultrasound Screening for Gastric Cancer (2025 Edition).","authors":"","doi":"10.24920/004548","DOIUrl":"10.24920/004548","url":null,"abstract":"<p><p>The five-year survival rate of gastric cancer in China is close to those in European and North American countries but far lower than those in the Republic of Korea and Japan where national gastric cancer screening systems have been established. It is of great significance to build a high-quality gastric cancer screening system adaptive to China's national conditions. Due to the large number of people at risk of gastric cancer and the uneven distribution of medical resources, it is still difficult for China to carry out a nationwide gastroscopy screening program for gastric cancer. Gastric oral contrast ultrasonography (OCUS) is a promising, non-invasive tool for initial gastric cancer screening, offering a painless, radiation-free alternative. Based on two 2020 OCUS consensuses, this document analyzes national gastric cancer screening strategies and challenges to elaborate on the necessity, feasibility, and current problems of preliminary ultrasound screening in China. It details the key aspects of OCUS, including indications, contraindications, operator requirements, contrast agent standards, and essential scanning protocols. It also introduces the standardized ultrasound sections and the Stomach Ultrasound Report and Data System (Su-RADS) and proposes the relevant consensus opinions. After several rounds of discussions and voting by experts from multiple societies, a total of 17 consensus opinions have been formed on OCUS as a preliminary screening technique for gastric cancer, with the aim of standardizing the popularization of OCUS. In addition, the consensus calls for conducting nationwide multicenter prospective studies to improve the level of evidence and provide big data support for the construction of a preliminary gastric cancer ultrasound screening system that is in line with China's national conditions.</p>","PeriodicalId":35615,"journal":{"name":"Chinese Medical Sciences Journal","volume":"40 4","pages":"237-252"},"PeriodicalIF":0.0,"publicationDate":"2025-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145900456","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":"Pelvic Floor Dysfunction Databases: Evolution, Current Landscape, and Future Development.","authors":"Jing-Yu Zhang, An-Ran Wang, Shuo Liang, Hong-Hui Shi, Lan Zhu, Si-Zhu Wu","doi":"10.24920/004516","DOIUrl":"10.24920/004516","url":null,"abstract":"<p><p>Pelvic floor dysfunction (PFD), including conditions such as stress urinary incontinence, pelvic organ prolapse, and fecal incontinence, significantly affects women's quality of life and their physical and mental health. With advancement of digital medicine, the systematic collection of data and the high-quality development of database platforms have increasingly become central pillars of PFD research and management. We systematically review the developmental stages of PFD-related databases. We then conduct a comparative analysis of representative international and domestic platforms, examining key aspects including organizational structures and construction models, data sources and integration strategies, core functionalities, data quality control and standardization, data security and access management, and research applications. Finally, based on the current status of PFD database development both globally and in China, we offer recommendations to strengthen data infrastructure and guide future directions. The findings may serve as a valuable reference for the optimization of PFD databases worldwide.</p>","PeriodicalId":35615,"journal":{"name":"Chinese Medical Sciences Journal","volume":"40 4","pages":"295-308"},"PeriodicalIF":0.0,"publicationDate":"2025-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145900988","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}