Chinese Medical Sciences Journal最新文献

{"title":"Emergency Management of Crushing Perineal Avulsion with Complete Urethral Disruption: A Case Report","authors":"Jie Wang,&nbsp;Gui-Zhong Li,&nbsp;Li-Bo Man","doi":"10.24920/004553","DOIUrl":"10.24920/004553","url":null,"abstract":"<div><div>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 <em>in situ</em> 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.</div></div>","PeriodicalId":35615,"journal":{"name":"Chinese Medical Sciences Journal","volume":"41 1","pages":"Pages 36-38"},"PeriodicalIF":0.0,"publicationDate":"2026-03-01","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,&nbsp;Zheng-Dao Yu,&nbsp;Xiao-Ning Wang,&nbsp;Zhen-Chang Zhang","doi":"10.24920/004558","DOIUrl":"10.24920/004558","url":null,"abstract":"<div><div>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.</div></div>","PeriodicalId":35615,"journal":{"name":"Chinese Medical Sciences Journal","volume":"41 1","pages":"Pages 17-28"},"PeriodicalIF":0.0,"publicationDate":"2026-03-01","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,&nbsp;Chun Zhang","doi":"10.24920/004537","DOIUrl":"10.24920/004537","url":null,"abstract":"<div><div>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.</div></div>","PeriodicalId":35615,"journal":{"name":"Chinese Medical Sciences Journal","volume":"41 1","pages":"Pages 39-44"},"PeriodicalIF":0.0,"publicationDate":"2026-03-01","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":"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}

{"title":"Adamantinoma‑like Ewing Sarcoma of Head and Neck: A Clinicopathologic Study of Three Cases Including One <i>EWSR1</i>-Negative Case with <i>NF1</i> Mutation.","authors":"Xiang-Nan Gou, Xia Tian, Feng-Wei Zhu, Zhi-Gang Song","doi":"10.24920/004531","DOIUrl":"10.24920/004531","url":null,"abstract":"<p><p>Adamantinoma-like Ewing sarcoma (ALES) is a rare variant of Ewing sarcoma that predominantly occurs in the head and neck region, characterized by epithelial differentiation and overlapping morphology with other small round cell tumors. We present three cases of head and neck ALES (two in the parotid gland and one in the nasal cavity) in patients aged 23-42 years. Histologically, the tumors exhibited a spectrum of features, including small round blue cells and basaloid squamous morphologies. Immunohistochemically, the tumor cells variably expressed CKpan, <i>p63</i>, CD99, <i>NKX2.2</i>, <i>FLI1</i>, CD56, and Syn. The Ki-67 proliferation index ranged widely from 15% to 90%. Notably, one case initially misdiagnosed as squamous cell carcinoma harbored a canonical <i>EWSR1</i>::<i>FLI1</i> fusion. Crucially, we report the first case of ALES had a negative <i>EWSR1</i> rearrangement but a somatic <i>NF1</i> mutation, expanding the molecular spectrum of this entity. Our findings underscore the diagnostic challenge of ALES and highlight the necessity of comprehensive molecular profiling, including next-generation sequencing, for accurate diagnosis and the identification of potential therapeutic targets, particularly in genetically atypical cases.</p>","PeriodicalId":35615,"journal":{"name":"Chinese Medical Sciences Journal","volume":"40 4","pages":"309-314"},"PeriodicalIF":0.0,"publicationDate":"2025-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145901295","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":"Openness to Others: The Task of Translating Palliative Carefor China.","authors":"Eric L Krakauer","doi":"10.24920/004527","DOIUrl":"https://doi.org/10.24920/004527","url":null,"abstract":"<p><p>The German philosopher Walter Benjamin, who died attempting to cross a border to escape persecution, described both the impossibility and the possibilities of translation^{[ 1]}. The impossibility is implicit in the very title of Benjamin's essay, Die Aufgabe des Übersetzers. The German word Aufgabe can mean \"task\" or \"endeavor\" but also a \"giving up\" or \"surrender.\" There is no English word that conveys the ambiguities and nuances of Aufgabe. And as I write this, I am aware that translating my English sentences into Chinese will create new impossibilities. But the impossibility of \"true\" or \"literal\" translation also opens new possibilities, for interpretation, adaptation, and (re)creation of new meaning. The same holds for translating palliative care: both the term and the discipline or practice.</p>","PeriodicalId":35615,"journal":{"name":"Chinese Medical Sciences Journal","volume":"40 4","pages":"268-270"},"PeriodicalIF":0.0,"publicationDate":"2025-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145901007","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":"Standardizing Healthcare Datasets in China: Challenges and Strategies.","authors":"Zheng-Yong Hu, Xiao-Lei Xiu, Jing-Yu Zhang, Wan-Fei Hu, Si-Zhu Wu","doi":"10.24920/004520","DOIUrl":"https://doi.org/10.24920/004520","url":null,"abstract":"<p><p>Standardized datasets are foundational to healthcare informatization by enhancing data quality and unleashing the value of data elements. Using bibliometrics and content analysis, this study examines China's healthcare dataset standards from 2011 to 2025. It analyzes their evolution across types, applications, institutions, and themes, highlighting key achievements including substantial growth in quantity, optimized typology, expansion into innovative application scenarios such as health decision support, and broadened institutional involvement. The study also identifies critical challenges, including imbalanced development, insufficient quality control, and a lack of essential metadata-such as authoritative data element mappings and privacy annotations-which hampers the delivery of intelligent services. To address these challenges, the study proposes a multi-faceted strategy focused on optimizing the standard system's architecture, enhancing quality and implementation, and advancing both data governance-through authoritative tracing and privacy protection-and intelligent service provision. These strategies aim to promote the application of dataset standards, thereby fostering and securing the development of new productive forces in healthcare.</p>","PeriodicalId":35615,"journal":{"name":"Chinese Medical Sciences Journal","volume":"40 4","pages":"253-267"},"PeriodicalIF":0.0,"publicationDate":"2025-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145901029","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":"Autism Spectrum Disorders in China: An Analysis of Temporal Trends in Prevalence, Incidence, and DALYs (1990-2021) Based on GBD 2021 Data.","authors":"Min Li, Zi-Yan Meng, Qing Li, Jun-Tao Yang, Kai-Yuan Min, Zhi-Min Hu","doi":"10.24920/004535","DOIUrl":"https://doi.org/10.24920/004535","url":null,"abstract":"<p><strong>Objectives: </strong>To examine the temporal trends in the prevalence, incidence, and disability-adjusted life years (DALYs) of autism spectrum disorder (ASD) in China from 1990 to 2021 and to project the future burden to 2036.</p><p><strong>Methods: </strong>Data were sourced from the Global Burden of Disease (GBD) 2021 provided by the Institute for Health Metrics and Evaluation (IHME). Join-point regression was applied to estimate the annual percentage change (APC) of prevalence, incidence, and DALYs. Age-period-cohort analysis was used to assess the effects of age, period, and cohort. Decomposition analysis quantified the contributions of population growth, demographic aging, and epidemiological changes. An AutoRegressive Integrated Moving Average (ARIMA) model was employed for projections to 2036.</p><p><strong>Results: </strong>Between 1990 and 2021, the average annual percentage change (AAPC) was 0.22% (95% uncertainty interval [UI]: 0.20%-0.24%) for prevalence, -0.07% (95% UI: -0.14%-0.28%) for incidence, and 0.23% (95% UI: 0.21%-0.25%) for DALYs. ASD prevalence and DALYs peaked in children aged 0-5 years and declined after age 60. Rising prevalence and DALYs were mainly attributable to population growth (89.7% and 95.2%) and epidemiological changes (32.6% and 36.2%), while aging offset growth (-22.4% and -16.0%). Projections indicated stable age-standardized incidence for both sexes but divergent prevalence trends, with rates increasing among males and decreasing among females.</p><p><strong>Conclusions: </strong>The ASD burden in China is rising, largely driven by demographic and epidemiological dynamics, with young children and males being the most affected groups. Prioritizing early detection and gender-sensitive interventions are recommended.</p>","PeriodicalId":35615,"journal":{"name":"Chinese Medical Sciences Journal","volume":"40 4","pages":"282-294"},"PeriodicalIF":0.0,"publicationDate":"2025-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145900533","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}