Journal of the Chinese Medical Association : JCMA最新文献

{"title":"Clinical and electrophysiological features for differentiating MMN from hand-onset ALS.","authors":"Shih-Yu Fang, Kang-Yang Jih, Yu-Chi Chao, Hou-Ping Sytwu, Yen-Cheng Shih, Yi-Chu Liao, Yi-Chung Lee","doi":"10.1097/JCMA.0000000000001387","DOIUrl":"10.1097/JCMA.0000000000001387","url":null,"abstract":"<p><strong>Background: </strong>Multifocal motor neuropathy (MMN) and amyotrophic lateral sclerosis (ALS) can be difficult to differentiate, particularly at early disease stages for patients with hand-onset weakness and without upper motor neuron (UMN) signs. This study aimed to identify clinical and electrophysiological features that may facilitate early differentiation between MMN and ALS.</p><p><strong>Methods: </strong>We retrospectively analyzed the clinical, laboratory, and electrophysiological characteristics of patients diagnosed with MMN and ALS who underwent an identical nerve conduction study protocol comprising extended motor stimulation.</p><p><strong>Results: </strong>A total of 125 patients (74 men and 51 women) were included, consisting of eight patients with MMN and 117 patients with ALS, including 42 with hand-onset ALS. The patients with MMN had a significantly younger mean age at symptom onset than those with ALS (43.1 vs 58.7 years, p = 0.004). The patients with ALS had greater muscle weakness, more frequent muscle atrophy and fasciculation, UMN signs, and body weight loss. Compared with both the overall ALS and hand-onset ALS groups, the MMN group had significantly lower serum creatine kinase (CK) levels and higher serum IgM levels. Elevated CK levels were observed in approximately one-third of patients with hand-onset ALS, whereas none of the MMN patients had elevated CK levels. Conduction blocks (CB) on nerve conduction studies were more common in the MMN group (87.5%) than in the overall ALS (19.7%, p < 0.001) and hand-onset ALS groups (31.0%, p = 0.005). MMN patients more frequently exhibited definite CBs involving multiple nerves (85.7%) compared with the overall ALS (17.4%, p = 0.002) and hand-onset ALS groups (7.7%, p = 0.001).</p><p><strong>Conclusion: </strong>Our findings suggest that a combination of clinical features, serum CK and IgM levels, and electrophysiological evidence of CB provides valuable clues for distinguishing MMN from ALS.</p>","PeriodicalId":94115,"journal":{"name":"Journal of the Chinese Medical Association : JCMA","volume":" ","pages":"437-444"},"PeriodicalIF":2.4,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13286338/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147877072","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ocular complications from glucagon-like peptide-1 receptor agonists: Clinical evidence, potential mechanisms, and clinical recommendations.","authors":"Tzu-En Wu, Harn-Shen Chen","doi":"10.1097/JCMA.0000000000001370","DOIUrl":"10.1097/JCMA.0000000000001370","url":null,"abstract":"<p><p>Glucagon-like peptide-1 receptor agonists (GLP-1 RAs)-central to type 2 diabetes mellitus (T2DM) management owing to their comprehensive benefits (glycemic control, weight reduction, cardiovascular benefits, and renal protection)-exhibit a concerning ocular safety profile. Clinical trial data, notably from SUSTAIN-6, revealed a higher incidence of diabetic retinopathy (DR) complications with semaglutide, particularly in patients with preexisting DR and rapid HbA1c reduction, reflecting early worsening. Conversely, the REWIND and LEADER trials reported no significant increase in DR risk, suggesting variability among agents and the potential influence of glycemic trajectory. Observational studies and meta-analyses provide mixed findings: some suggest increased DR progression risk in vulnerable populations, while others indicate a lower risk than insulin therapy. Beyond DR, recent pharmacoepidemiologic studies and pharmacovigilance reports have implicated GLP-1 RAs-especially semaglutide-in nonarteritic anterior ischemic optic neuropathy (NAION), leading the European Medicines Agency to classify NAION as a very rare adverse effect and prompting regulatory scrutiny. Conversely, real-world data suggest possible protective associations with other retinal disorders, including reduced incidence of neovascular age-related macular degeneration and diabetic macular edema, although findings remain inconsistent. The mechanistic pathways involve rapid metabolic shifts, vascular dysregulation, and potentially direct effects on retinal or optic nerve tissue. While GLP-1 RAs confer substantial systemic benefits, their ocular risks appear concentrated in high-risk subgroups. Individualized prescribing, baseline ophthalmic assessment, and interdisciplinary monitoring are essential until ongoing prospective trials clarify their long-term ocular impact.</p>","PeriodicalId":94115,"journal":{"name":"Journal of the Chinese Medical Association : JCMA","volume":" ","pages":"407-414"},"PeriodicalIF":2.4,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13286313/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147489143","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Fracture-isthmus diameter ratio predicts delayed union in tibial nailing.","authors":"Li-Kai Kuo, Chun-Yu Chen, Kai-Cheng Lin","doi":"10.1097/JCMA.0000000000001385","DOIUrl":"10.1097/JCMA.0000000000001385","url":null,"abstract":"<p><strong>Background: </strong>Intramedullary nailing is widely acknowledged as the preferred treatment for tibial shaft fractures. However, delayed union remains common in non-isthmal patterns. We aimed to assess the factors and imaging parameters associated with nonunion or delayed union following intramedullary nailing in these patients.</p><p><strong>Methods: </strong>This retrospective study included patients with non-isthmal tibial shaft fractures who underwent intramedullary nailing from 2015 to 2020. The fracture site diameter to the isthmus canal diameter ratio (FI ratio) was measured on pre- and postoperative anteroposterior (AP) radiographs. Delayed union was defined as no union at 6 months, with union by 12 months. The variables were tested with univariate analyses and multivariable logistic regression; receiver operating characteristic (ROC) analysis determined a cutoff.</p><p><strong>Results: </strong>A total of 66 patients were included, and delayed union occurred in 34 (51.5%). Forty-seven patients sustained infra-isthmal fractures, while 19 patients experienced supra-isthmal fractures. The postoperative FI ratio was higher in the delayed union group (median 1.67 vs 1.36; p = 0.001) and was the only independent predictor on multivariable analysis ( p = 0.007). A postoperative FI ratio ≥1.43 predicted delayed union with sensitivity 0.79 and specificity 0.66 (area under the curve [AUC] 0.74); delayed union was more frequent when FI ≥1.43 than <1.43 (27/39 [69.2%] vs 7/27 [25.9%], odds ratio [OR] = 6.43). Intraoperative blood loss was associated with univariate testing ( p = 0.013) but not after adjustment; nail-canal ratio, fracture length, and screw-fracture distance were not significant.</p><p><strong>Conclusion: </strong>The postoperative FI ratio is a feasible indicator of delayed union in patients who received intramedullary nailing for supra-isthmal or infra-isthmal tibial shaft fractures. A postoperative FI ratio ≥1.43 indicates a significantly higher risk of delayed union. In such cases, it may be recommended that patients undergo prolonged protected weight-bearing and shortened follow-up intervals.</p>","PeriodicalId":94115,"journal":{"name":"Journal of the Chinese Medical Association : JCMA","volume":" ","pages":"454-461"},"PeriodicalIF":2.4,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13286408/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147848109","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Inflammation and sarcopenia exhibit distinct associations with psychopathology and executive function in schizophrenia.","authors":"Yee-Lam E Chan, Chih-Yuan Hung, Wei-Chung Mao, Tung-Ping Su, Wang-Sheng Lin, Hsin-Yu Yang, Mao-Hsuan Huang","doi":"10.1097/JCMA.0000000000001388","DOIUrl":"10.1097/JCMA.0000000000001388","url":null,"abstract":"<p><strong>Background: </strong>Immune dysregulation and premature physical aging have been implicated in schizophrenia; however, few studies have concurrently examined inflammation, sarcopenia, psychopathology, cognitive function, and physical functioning within the same cohort. We investigated whether inflammation and sarcopenia exhibit distinct associations with clinical and cognitive outcomes in schizophrenia.</p><p><strong>Methods: </strong>This cross-sectional study recruited inpatients with schizophrenia from Suao and YuanShan branches of Taipei Veterans General Hospital. Psychopathology was assessed using the Positive and Negative Syndrome Scale (PANSS). Sarcopenia was defined according to the Asian Working Group for Sarcopenia 2019 criteria. Cognitive function was assessed with the Wisconsin Card Sorting Test (WCST), 2-back, and Go/No-Go task. Circulating inflammatory markers (C-reactive protein [CRP], soluble interleukin-6 receptor, soluble interleukin-2 receptor [sIL-2R], and soluble tumor necrosis factor-α receptor type 1) were measured by ELISA. Multivariable general linear models were used to examine associations, adjusting for age, sex, education, body mass index, and medication use.</p><p><strong>Results: </strong>A total of 120 patients with schizophrenia aged 20 to 65 years were recruited; sarcopenia was present in 21 participants (17.5%), and low-grade systemic inflammation (CRP >3 mg/L) in 41 (34.2%). Patients with inflammation had higher PANSS scores and slower walking speed, and performed worse on WCST perseverative response (all p < 0.05). Patients with sarcopenia had higher PANSS total scores (74.76 vs 63.75; p = 0.014) but did not differ on cognitive measures. In multivariable analyses, CRP was positively associated with PANSS positive symptoms (B = 1.94 [unstandardized coefficient]; p = 0.009). Higher sIL-2R was associated with worse executive function (failure to maintain set), but not after multiple comparison correction. No significant inflammation-sarcopenia interactions were observed.</p><p><strong>Conclusion: </strong>These findings suggest that systemic inflammation and sarcopenia are independently associated with greater symptom severity in schizophrenia, highlighting the potential value of integrated metabolic and inflammatory assessment in clinical care.</p>","PeriodicalId":94115,"journal":{"name":"Journal of the Chinese Medical Association : JCMA","volume":" ","pages":"445-453"},"PeriodicalIF":2.4,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13286312/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147966320","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Determining acceptable duration for chemoradiation of esophageal squamous cell carcinoma.","authors":"Kam-Hong Kam, Cheng-Yen Lee, Jia-Ming Chang, Hsin-Yi Yang, Chih-Chia Chang, Yuk-Wah Tsang, Yu-Wen Wang, Wei-Yu Wang, Chin-Ho Kuo, Ming-Yang Lee, Yin-Che Lu, Yu-Ting Lee, Michael W Y Chan","doi":"10.1097/JCMA.0000000000001383","DOIUrl":"10.1097/JCMA.0000000000001383","url":null,"abstract":"<p><strong>Background: </strong>Chemoradiotherapy (CRT) remains the standard practice for patients with nonsurgical esophageal squamous cell carcinoma (ESCC). However, the impact of radiation duration is poorly understood. We aimed to determine the effect of CRT duration on the prognosis of patients with ESCC.</p><p><strong>Methods: </strong>We retrospectively analyzed patients with ESCC treated with CRT at the Ditmanson Medical Foundation Chia-Yi Christian Hospital between January 1, 2010 and December 31, 2021. Patients were either treated with continuous CRT or protracted CRT, which was interrupted due to reassessment of disease status. Differences in survival according to the treatment strategy were examined using propensity score matching (PSM). The risk factors for survival and recurrence were analyzed using Cox regression models.</p><p><strong>Results: </strong>A total of 238 patients who underwent CRT were included in our cohort. After 2:1 PSM, the continuous and protracted CRT groups comprised 41 and 82 patients, respectively. Median survival was 12.2 (interquartile range [IQR], 10.0-19.1) months for the protracted CRT group and 11.4 (IQR, 9.9-17.1) months for the continuous CRT group ( p = 0.395). The multivariable analysis revealed that duration of radiation >90 days was an independent risk factor for survival (adjusted hazard ratio [HR], 2.14; 95% CI, 1.23-3.70, p = 0.006) and progression-free survival (adjusted HR, 1.74; 95% CI, 1.08-2.80, p = 0.022). In addition, a neutrophil-to-lymphocyte ratio >3 was associated with poor prognosis (adjusted HR, 1.83; 95% CI, 1.09-3.05, p = 0.02).</p><p><strong>Conclusion: </strong>This study demonstrated that continuous CRT and protracted CRT resulted in similar prognoses; however, a radiotherapy duration exceeding 90 days was associated with inferior survival. These findings have implications for treatment planning in patients with ESCC.</p>","PeriodicalId":94115,"journal":{"name":"Journal of the Chinese Medical Association : JCMA","volume":" ","pages":"462-469"},"PeriodicalIF":2.4,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13286309/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147793289","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Highlights.","authors":"Jong-Ling Fuh","doi":"10.1097/JCMA.0000000000001389","DOIUrl":"https://doi.org/10.1097/JCMA.0000000000001389","url":null,"abstract":"","PeriodicalId":94115,"journal":{"name":"Journal of the Chinese Medical Association : JCMA","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147944376","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":"An in trans NOTCH3 loss-of-function variant modifies disease severity in CADASIL: A family-based study.","authors":"Shih-Chun Lan, Yi-Hong Liu, Jui Lan, Yi-Chu Liao, Min-Yu Lan, Yi-Chung Lee","doi":"10.1097/JCMA.0000000000001371","DOIUrl":"10.1097/JCMA.0000000000001371","url":null,"abstract":"<p><strong>Background: </strong>Cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL) is caused by pathogenic NOTCH3 variants, most commonly heterozygous cysteine-altering variants. Disease severity varies widely, and the impact of reduced NOTCH3 dosage on CADASIL severity remains unclear. We describe a family of four individuals carrying a cysteine-altering NOTCH3 variant and/or a frameshift loss-of-function (LoF) variant, demonstrating marked intrafamilial phenotypic heterogeneity.</p><p><strong>Methods: </strong>Four related individuals underwent standardized clinical assessment, brain magnetic resonance imaging (MRI), genetic analysis, skin biopsy, and NOTCH3 complementary DNA (cDNA) sequencing.</p><p><strong>Results: </strong>The proband, carrying p.Cys1146Ser and p.Cys1024Valfs248 in trans, developed progressive gait disturbance, dysphagia, and slurred speech beginning in his mid-thirties. Brain MRI demonstrated extensive white matter hyperintensities, multiple lacunar infarcts, and numerous cerebral microbleeds. In contrast, the father (carrying p.Cys1146Ser alone) and the mother and brother (carrying p.Cys1024Valfs248 alone) exhibited milder clinical and imaging phenotypes. Only the carriers of the cysteine-altering variant demonstrated NOTCH3 extracellular domain (NOTCH3 ECD ) immunoreactivity in skin vessels. NOTCH3 cDNA sequencing from the skin tissue demonstrated reduced LoF allele expression.</p><p><strong>Conclusion: </strong>Reduced NOTCH3 dosage may modify the disease severity of CADASIL.</p>","PeriodicalId":94115,"journal":{"name":"Journal of the Chinese Medical Association : JCMA","volume":" ","pages":"393-397"},"PeriodicalIF":2.4,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13193278/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147635412","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prenatal depression and psychotropics in offspring asthma and atopic dermatitis.","authors":"Li-Chi Chen, Wei-Sheng Huang, Tzeng-Ji Chen, Mu-Hong Chen","doi":"10.1097/JCMA.0000000000001369","DOIUrl":"10.1097/JCMA.0000000000001369","url":null,"abstract":"<p><strong>Background: </strong>The associations of prenatal maternal depression and exposure to antidepressants and benzodiazepines/Z-drugs with the risks of offspring asthma and atopic dermatitis are unclear.</p><p><strong>Methods: </strong>The data from 1369 child-mother dyads with maternal depression and 13 690 birth year- and sex-matched child-mother dyads without maternal depression for the period from 2002 to 2009 were selected. Prenatal exposure to antidepressants and benzodiazepines/Z-drugs was also considered. All children were followed from their birth date to the end of 2011 to identify the development of asthma and atopic dermatitis.</p><p><strong>Results: </strong>The offspring of mothers with depression were more likely to develop atopic dermatitis (hazard ratio [HR], 1.16) and asthma (HR, 1.12) during the follow-up period relative to the control group. Prenatal exposure to benzodiazepines/Z-drugs was strongly associated with an increased risk (HR, 1.27) of offspring asthma. However, prenatal exposure to antidepressants was not associated with increased risks of offspring asthma and atopic dermatitis.</p><p><strong>Conclusion: </strong>The mechanisms underlying the complex relationship between maternal depression, exposure to benzodiazepines/Z-drugs, and the risk of offspring atopy warrant further investigation.</p>","PeriodicalId":94115,"journal":{"name":"Journal of the Chinese Medical Association : JCMA","volume":" ","pages":"334-339"},"PeriodicalIF":2.4,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13193307/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147489098","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Navigating complex interactions between psychiatric disorders and their treatment in pregnancy: Clinical implications.","authors":"Kai-Dih Juang","doi":"10.1097/JCMA.0000000000001373","DOIUrl":"10.1097/JCMA.0000000000001373","url":null,"abstract":"","PeriodicalId":94115,"journal":{"name":"Journal of the Chinese Medical Association : JCMA","volume":" ","pages":"321-322"},"PeriodicalIF":2.4,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13193304/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147648060","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Risk factors for sialocele after parotidectomy.","authors":"Chia-Hsien Wu, Hsueh-An Sun, Heng-Jui Hsu","doi":"10.1097/JCMA.0000000000001375","DOIUrl":"10.1097/JCMA.0000000000001375","url":null,"abstract":"<p><strong>Background: </strong>Parotidectomy, the surgical excision of the parotid gland to treat tumors, is frequently complicated by sialocele formation-a subcutaneous accumulation of saliva that presents clinically as a cystic mass. With reported incidences ranging from 0% to 44%, the specific etiology remains incompletely defined. This study aimed to identify independent predictors of postoperative sialocele formation to suggest targeted preventive strategies.</p><p><strong>Methods: </strong>A retrospective cohort study analyzed patients undergoing parotidectomy at a single tertiary center from 2014 to 2020. Data including patient demographics, comorbidities, lifestyle habits, operative details, and postoperative care were collected. The primary clinical outcome was clinically diagnosed sialocele. Independent predictors were evaluated using multivariable logistic regression, calculating adjusted odds ratios (aORs) and 95% CIs.</p><p><strong>Results: </strong>Among 597 subjects (mean age 52.2 ± 14.4 years; 58.5% male), 54 (9.0%) developed a sialocele. Multivariable analysis revealed significant independent predictors: betel nut use (aOR = 2.37; 95% CI, 1.13-4.97; p = 0.023), history of cerebrovascular accident (aOR = 4.10; 95% CI, 1.30-14.86; p = 0.032), surgical drain removal in <3 days (aOR = 1.89; 95% CI, 1.04-3.44; p = 0.036), and a diagnosis of mucoepidermoid carcinoma (aOR = 4.18; 95% CI, 1.37-12.78; p = 0.012). Variables like age, sex, tumor size, and operative method showed no significant association.</p><p><strong>Conclusion: </strong>Betel nut use, a history of stroke, early drain removal, and malignant pathology are significant independent risk factors for postoperative sialoceles. Adjusting perioperative management, particularly delaying drain removal, may lower this risk. Tumor size and operative method did not influence outcomes. Prospective studies are needed to confirm these single-center retrospective findings.</p>","PeriodicalId":94115,"journal":{"name":"Journal of the Chinese Medical Association : JCMA","volume":" ","pages":"378-382"},"PeriodicalIF":2.4,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13193285/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147648035","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}