最新刊期
卷 51 ， 期 1 ， 2026
- “介绍了其在急性创面领域研究进展，国内专家形成17条推荐意见，为提升我国急性创面临床救治水平提供参考。”
摘要：Acute wounds are common conditions in the Emergency Department, and their assessment and treatment require comprehensive consideration of multiple factors. Currently, there remains no unified protocol for the evaluation and treatment of acute wounds both nationally and internationally. To address this gap, the Emergency Physician Branch of the Chinese Medical Doctor Association, Professional Committee of Emergency Medicine of the People's Liberation Army (PLA), Beijing Society of Emergency Medicine, and Emergency Surgery Alliance jointly organized domestic experts in relevant fields to form a consensus drafting group. Based on relevant research from China and abroad, the group conducted multiple rounds of discussions focusing on clinical assessment and treatment issues related to acute wounds, and defined the scope of the consensus and 14 clinical questions. Through literature retrieval, evidence evaluation, and three rounds of in-depth consensus meetings, 17 recommendations were ultimately formulated. This consensus is intended to serve as a reference for healthcare professionals in Emergency Surgery, Burn Department, Wound Repair Department, and related fields in their clinical practice, with the aim of enhancing the standard of care for acute wounds in China.关键词：acute wounds;treatment;assessment;expert consensus595|344|0更新时间：2026-03-04
Guideline and Consensus
- “基于中国儿科体外生命支持组织数据库，专家构建并验证了基于7个关键特征的logistic回归预测模型，可有效评估VA - ECMO相关AKI患儿的死亡风险，为临床早期干预与个体化决策提供有力支持。”
摘要：ObjectiveTo explore the mortality risk factors for children with veno-arterial extracorporeal membrane oxygenation (VA-ECMO)-related acute kidney injury (AKI) and to develop and validate a mortality risk prediction model.MethodsData from 237 children with VA-ECMO-related AKI were obtained from the Chinese Pediatric Extracorporeal Life Support Organization Database (October 2017-May 2023), including patients from 6 hospitals: the First Medical Center of the Chinese PLA General Hospital, the Seventh Medical Center of the Chinese PLA General Hospital, Beijing Anzhen Hospital Affiliated to Capital Medical University, Shanghai Children's Medical Center, Henan Provincial People's Hospital, and Henan Children's Hospital. The data were randomly divided into a training set (n=166) and a validation set (n=71) at a 7:3 ratio. Eleven machine learning models were constructed based on the selected features in both sets, including logistic regression, k-nearest neighbors (KNN), neural network (NeuralNet), decision tree, AdaBoost, gradient boosting machine, extra trees, random forest, LightGBM, support vector machine (SVM), and extreme gradient boosting (XGBoost). After model construction, the top 5 best-performing models in the validation set were further compared in terms of their predictive performance. Model performance was comprehensively evaluated using multiple metrics: receiver operating characteristic (ROC) curve, calibration curve, area under the precision-recall curve (AUPRC), decision curve analysis (DCA), F1-score, and Brier score. To enhance model interpretability, Shapley Additive Explanations (SHAP) values were used to quantify feature contributions, and stepwise feature-incremental modeling was performed based on SHAP ranking. Differences in AUC among models with different feature sets were compared using the de-long test to determine the optimal subset of predictors. To improve clinical translational value, an online web application was developed using the R Shiny framework.ResultsA comparison of the 11 machine learning models' performance in the training and validation sets showed that the performance of the 11 models was similar within the training set. In the validation set, the five best-performing models were logistic regression, SVM, NeuralNet, KNN, and XGBoost. Among them, the logistic regression model performed best (AUC=0.886, AUPRC=0.903). DCA and calibration curves further confirmed its good clinical applicability and stability. Model simplification analysis showed that optimal performance was achieved when 7 key features were included: ECMO support duration, bleeding, cardiac complications, post-ECMO aspartate transaminase (AST) level, body weight, pre-ECMO eosinophil count, and pre-ECMO bicarbonate level. The model yielded an AUC of 0.848, F1-score of 0.829, accuracy of 0.831, and Brier score of 0.171. The de-long test showed no statistically significant difference in predictive performance between the 7-feature model and the full 17-feature model (P=0.158). SHAP analysis indicated that the top 3 contributors to mortality risk prediction were ECMO support duration, bleeding, and cardiac complications. The final model has been deployed as a web application, enabling individualized mortality risk prediction and SHAP-based visual interpretation.ConclusionsA logistic regression model based on 7 key features was developed and validated to effectively assess mortality risk in children with VA-ECMO-related AKI. The model has good discriminative ability, calibration performance, and clinical applicability, and has been developed as an online tool to support early clinical intervention and personalized decision-making.关键词：extracorporeal membrane oxygenation;acute kidney injury;children;clinical prediction model;machine learning505|289|0更新时间：2026-03-04 - “专家研究发现，肥胖青少年儿童的体重、BMI、TG等指标与高尿酸血症密切相关，LAP可作为潜在预警指标。”
摘要：ObjectiveTo investigate the correlation between anthropometric and derived indicators and hyperuricemia (HUA) in obese children and adolescents.MethodsA retrospective analysis was conducted on clinical data from 120 obese children and adolescents in Changyang No.2 Primary School, Changyang Central Primary School, Liangxiang No.2 Middle School, and Liangxiang No.3 Middle School in Fangshan District, Beijing, who participated in the "Epidemiology and Monitoring Early Warning System for Childhood Obesity-Related Metabolic Diseases" project from February to December 2023. According to whether they had HUA, the subjects were divided into HUA group (n=63) and non-HUA group (n=57). The clinical characteristics of the two groups were documented and compared, including basic information such as height, weight, waist circumference, and body mass index (BMI), as well as levels of uric acid, blood lipids, and insulin, and calculated derivative indices including the lipid accumulation product (LAP), cardiometabolic index (CMI), tri-ponderal mass index (TWI), visceral adiposity index (VAI), and the triglyceride (TG)/high-density lipoprotein cholesterol (HDL-C) ratio. Logistic regression analysis was used to explore the association between various indices and the occurrence of HUA. The diagnostic value of each index for HUA was evaluated using the receiver operating characteristic (ROC) curve and the area under the curve (AUC). Restricted cubic splines (RCS) were applied to analyze the dose-response relationship between LAP and the risk of HUA.ResultsCompared with non-HUA group, HUA group showed significantly higher levels of BMI, TG, insulin, LAP, CMI, TWI, VAI, and the TG/HDL-C ratio (P<0.05). After adjusted age and gender, logistic regression analysis indicated that weight, BMI, TG, insulin, LAP, CMI, TWI, VAI, and the TG/HDL-C ratio were risk factors for HUA (P<0.05). ROC curve analysis suggested that LAP had the largest AUC value of 0.69 (95%CI 0.59-0.78), with a specificity of 0.51 (95%CI 0.39-0.63) and a sensitivity of 0.84 (95%CI 0.75-0.92). RCS analysis revealed a significant nonlinear dose-response relationship between LAP and the risk of HUA (P for nonlinearity <0.05).ConclusionsWeight, BMI, TG, insulin, LAP, CMI, TWI, VAI, and the TG/HDL-C ratio are closely associated with HUA. Among these, LAP is a potential early warning indicator for HUA in obese children and adolescents.关键词：obese children and adolescents;hyperuricemia;anthropometric indices;lipid accumulation product479|331|0更新时间：2026-03-04 - “解放军总医院专家研究发现，良性前列腺增生患者前列腺体积随年龄增长持续增大，且与BMI、tPSA、fPSA及NLR等指标密切相关，为临床风险评估及病理机制研究提供新依据。”
摘要：ObjectiveTo investigate the age-gradient changes in prostate volume and their associations with metabolic and renal function indicators in patients with benign prostatic hyperplasia (BPH), providing evidence for clinical risk assessment and elucidating its pathogenic mechanisms.MethodsA total of 23 742 patients diagnosed with BPH at the Department of Urology, the First Medical Center of the Chinese PLA General Hospital between January 2012 and August 2022 were retrospectively included. Among them, 292 patients had complete abdominal magnetic resonance imaging (MRI) with three-dimensional prostate measurements. Based on the relationship between age and BPH prevalence, patients were categorized into three age groups: younger group (≤50 years, n=6871), middle-aged group (51-70 years, n=13 260), and older group (≥71 years, n=3611). Prostate volume measured by transabdominal color Doppler ultrasound was used to analyze the overall age-related trend and potential inflection point(s). Subgroup analysis was performed using MRI-measured prostate volume. Correlation and linear regression analyses were conducted to assess the relationships between prostate volume and clinical indicators including body-mass index (BMI), serum creatinine, blood urea nitrogen (BUN), total prostate-specific antigen (tPSA), free PSA (fPSA), and neutrophil-to-lymphocyte ratio (NLR).ResultsOverall analysis revealed significant differences in prostate volume among the three age groups (P<0.001), with a progressive increasing trend. A segmented regression model identified no clear inflection point within the age range of 35-99 years, indicating a continuous, monotonic increase in prostate volume with age at an approximate rate of 0.487 cm³/year. This trend was consistent in the regression model based on precise MRI data. In the overall sample, creatinine (β=-0.001, P=0.001), BMI (β=0.001, P<0.001), tPSA (β=0.040, P=0.048), fPSA (β=0.521, P<0.001), and NLR (β=1.526, P<0.001) were significantly associated with prostate volume. Age-stratified analyses revealed that prostate volume was significantly associated with BMI (β=0.244, P<0.001; β=0.260, P<0.001; β=0.341, P=0.025), tPSA (β=0.437, P<0.001; β=0.454, P<0.001; β=-0.148, P<0.001), fPSA (β=8.617, P<0.001; β=-1.176, P<0.001; β=1.314, P<0.001), and NLR (β=-0.335, P=0.012; β=0.638, P<0.001; β=1.211, P<0.001).ConclusionsProstate volume in BPH patients increases continuously with age within the 35-99 year range, showing a steady upward trend without a distinct inflection point. Changes in prostate volume are primarily associated with BMI, tPSA, fPSA, and NLR, and serum creatinine may also hold indicative value.关键词：benign prostatic hyperplasia;prostatic volume;age;prostate-specific antigen;regression analysis422|222|0更新时间：2026-03-04 - “专家采用LASSO-logistic回归等方法筛选脓毒症相关性脑病危险因素，构建临床预测模型并验证，为临床诊治提供依据。”
摘要：ObjectiveTo identify risk factors for sepsis-associated encephalopathy (SAE) using methods including LASSO-logistic regression and recursive feature elimination (RFE), and to develop and validate a corresponding clinical prediction model.MethodsThis retrospective study analyzed data from 6258 sepsis patients retrieved from the public, de-identified Medical Information Mart for Intensive Care IV (MIMIC-IV, v2.2) database. Patients were divided into SAE group (n=3196) and non-SAE group (n=3062) based on the incidence of sepsis-associated encephalopathy (SAE) during their ICU stay, and their baseline clinical data were compared. The entire cohort was then randomly partitioned into a training set (n=4380) and an internal validation set (n=1878) at a 7:3 ratio. Within the training set, a multi-stage feature selection pipeline was employed: an initial screening integrating LASSO regression with univariate logistic regression (P<0.05) was conducted, followed by subsequent refinement using RFE and Spearman's correlation analysis (|r|<0.5) to yield the final predictor variables. A multivariate logistic regression model was thereafter constructed and visualized through a nomogram. The model underwent comprehensive evaluation on the independent internal validation set: its discriminatory ability was evaluated by the area under the receiver operating characteristic curve (AUC), calibration was assessed using calibration curves, and clinical net benefit was evaluated by decision curve analysis (DCA). Finally, to verify the model's generalizability, external validation was performed on a cohort of 13 330 sepsis patients from the EICU database.ResultsFollowing a multi-stage selection process incorporating univariate analysis, LASSO, RFE, and Spearman correlation analysis, fifteen variables were ultimately included in the final prediction model, namely continuous renal replacement therapy (CRRT), acute kidney injury (AKI), mechanical ventilation, oxygen saturation (SpO₂), systemic inflammatory response syndrome (SIRS) score, serum sodium level, renal disease, systolic blood pressure, malignant tumor, body temperature, platelet count, age, paraplegia, serum potassium level, and peripheral vascular disease. The derived LASSO-logistic regression model was formulated as follows: logit(P)=-6.533+(1.807×CRRT)+(0.824×AKI)+(0.697×mechanical ventilation)+(0.024×SpO₂)+(0.243×SIRS)+(0.036×sodium)-(0.476×renal disease)+(0.003×systolic blood pressure)-(0.298×malignant tumor)-(0.108×body temperature)+(0.001×platelet count)+(0.002×age)+(0.766×paraplegia)+(0.200×potassium)+(0.238×peripheral vascular disease), where P=1/(1+e-Logit(P)). The model demonstrated good discriminative ability in the training set, with an AUC of 0.701 (95%CI 0.685-0.716); it was visualized as a nomogram and validated in the internal validation set, achieving an AUC of 0.693 (95%CI 0.671-0.716). The calibration curve indicated satisfactory agreement between predicted and observed probabilities. Decision curve analysis revealed that the model provided substantial net clinical benefit across a wide range of threshold probabilities (0%-50%). Furthermore, external validation on the EICU cohort yielded an AUC of 0.674 (95%CI 0.664-0.684), confirming its good generalizability and certain cross-center applicability.ConclusionsCRRT, AKI, mechanical ventilation, SpO₂, SIRS score, serum sodium level, renal disease, systolic blood pressure, malignant tumor, body temperature, platelet count, age, paraplegia, serum potassium level, and peripheral vascular disease are risk factors for SAE. The prediction model constructed based on these factors demonstrates good discrimination and calibration, providing clinicians with a reliable basis for diagnosis and treatment.关键词：sepsis-associated encephalopathy;sepsis;prediction model;LASSO regression;nomogram39|797|0更新时间：2026-03-04 - “最新研究发现，健康生活方式可显著降低消化道癌症发病风险。研究纳入51737名参与者，随访10.5年，发现与低-稳定组相比，高-稳定组消化道癌症发病风险降低25%。”
摘要：ObjectiveTo investigate the impact of different trajectories of a healthy lifestyle score on the incidence of digestive tract cancers.MethodsThis prospective cohort study enrolled 51 737 eligible participants who consecutively attended health examinations in 2006, 2008, and 2010. According to the healthy lifestyle scores recorded at each of the three examinations, participants were categorized into four trajectory groups: low-stable (n=11 560), high-low-moderate (n=8621), low-moderate (n=7995) and high-stable (n=23 561); the low-stable group served as the reference. Incidence density was calculated using the Kaplan-Meier method. Cox proportional hazards regression was used to analyze the longitudinal effect of healthy lifestyle score trajectories on incident digestive tract cancers. Participants diagnosed with digestive tract cancer within the first two years of follow-up were excluded to conduct sensitivity analyses.ResultsAmong 51 737 participants, 39 774 (76.9%) were men and 11 963 (23.1%) were women; mean age was (48.9±11.8) years. Over a mean follow-up period of (10.5±2.7) years, 870 incident digestive tract cancers were documented: 340 colorectal, 170 gastric, 168 liver, 90 oesophageal, 53 pancreatic, 26 gallbladder or extrahepatic bile duct, and 23 small-intestinal cancers. After adjustment for age, sex, triglycerides (TG), total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), low-density lipopotein cholesterol (LDL-C), high-sensitivity C-reactive protein (hs-CRP), body mass index (BMI), education background, marital status, history of hypertension, history of diabetes and family history of cancer, high-stable group was associated with a lower risk of overall digestive tract cancer than low-stable group (HR=0.75, 95%CI 0.62-0.91). Site-specific multivariate analyses showed that, compared with low-stable group, the risk of oesophageal-cancer was significantly lower in low-moderate and high-stable groups (HR=0.52, 95%CI 0.28-0.95; HR=0.29, 95%CI 0.16-0.53, respectively); the risk of gastric-cancer was reduced in low-moderate and high-stable groups (HR=0.68, 95%CI 0.44-0.96; HR=0.55, 95%CI 0.32-0.81); the risk of colorectal-cancer was reduced in low-moderate and high-stable groups (HR=0.85, 95%CI 0.63-0.97; HR=0.67, 95%CI 0.50-0.90); and the risk of liver-cancer was reduced in high-stable group (HR=0.87, 95%CI 0.56-0.96). No associations were observed for the risk of small-intestinal, gallbladder, extrahepatic bile-duct, or pancreatic cancers. Sensitivity analyses further confirmed the reduced risk of digestive tract in high-stable group (HR=0.79, 95%CI 0.70-0.92).ConclusionCompared with individuals who consistently maintained an unhealthy lifestyle, those who consistently maintained a healthy lifestyle have a 25% reduction in the risk of developing digestive tract cancers.关键词：healthy lifestyle;gastrointestinal cancer;trajectory;cohort study570|439|0更新时间：2026-03-04 - “最新研究聚焦阿莫西林致肾损伤风险，专家分析海量数据，发现高龄、高体重、静脉给药、长疗程及大剂量是关键危险因素，为临床安全用药敲响警钟。”
摘要：ObjectiveTo systematically analyze amoxicillin-related renal adverse events (ARRAEs) in a real-world setting, evaluate potential risk factors, and provide reference for safe clinical medication.MethodsWe extracted adverse event reports from the U.S. Food and Drug Administration (FDA) Adverse Event Reporting System (FAERS) database, covering the first quarter (Q1) of 2004 to the third quarter (Q3) of 2024. The reporting odds ratio (ROR), proportional reporting ratio (PRR), Bayesian confidence propagation neural network (BCPNN), and multi-item gamma Poisson shrinker (MGPS) were used to quantify amoxicillin-related adverse event signals. Moreover, temporal trends in ARRAEs were examined. Univariate and multivariate logistic regression analyses were conducted to identify independent risk factors for ARRAEs. Finally, subgroup analyses were performed based on the route of amoxicillin administration.ResultsA total of 18 278 243 adverse event reports were collected, of which 38 738 were related to amoxicillin, involving 130 879 reported adverse events. Among these, 3 significantly disproportionate system organ classes (SOCs) and 562 preferred terms (PTs) met the criteria for all 4 algorithms. Additionally, 14 significantly disproportionate renal PTs were associated with amoxicillin, involving 1927 patients with ARRAEs. Trend analysis revealed that the number of ARRAE reports increased significantly since 2018 and remained at a high level from 2018 to 2023. Multivariable analysis indicated that advanced age, high body weight, intravenous administration, prolonged treatment course, and daily dosage >3000 mg were significant independent risk factors for ARRAEs. Notably, the risk of ARRAEs was significantly elevated when the daily dose of amoxicillin was >3000 mg (OR=6.514, 95%CI 4.232-10.024, P<0.001). Furthermore, the results of subgroup analyses indicated that a daily dose >3000 mg was an independent risk factor for ARRAEs in both oral and intravenous users.ConclusionsClose monitoring and targeted interventions are recommended for populations with risk factors including advanced age, high body weight, intravenous administration, prolonged treatment course, and daily dose >3000 mg, in order to reduce the risk of ARRAEs.关键词：amoxicillin;high-dose therapy;U.S. FDA Adverse Event Reporting System (FAERS);amoxicillin-related renal ad-verse events;real-world analysis33|298|0更新时间：2026-03-04 - “专家对含缬酪肽蛋白(VCP)基因c.464G>A变异展开研究，回顾性分析1例病例并检索文献，发现该变异临床表现高度异质，对包涵体肌病诊断关键，需长期随访。”
摘要：ObjectiveTo summarize the clinical characteristics of the patient with valosin-containing protein (VCP) gene c.464G>A variant, and to improve the understanding of this mutation-associated diseases through a literature review.MethodsThe clinical data of a case with the VCP gene c.464G>A variant who had only presented with myopathy for 7 years were retrospectively analyzed. Relevant case studies published in PubMed, Wanfang Data, and the China National Knowledge Infrastructure (CNKI) databases up to April 2025 were retrieved to summarize the clinical characteristics of cases with the same type of gene mutation.ResultsThe patient was a 43-year-old female with a 7-year disease duration, with a negative family history, and no developmental anomalies. The disease exhibited slow, progressive proximal limb muscle weakness, with initial symptoms originating in the lumbar region and subsequently extending to both lower and upper limbs. Later manifestations included muscle twitching, while serum muscle enzyme levels remained normal. Muscle magnetic resonance imaging (MRI) revealed fat infiltration and atrophy in the bilateral gluteal and thigh muscles. Histopathological examination of muscle tissue showed rimmed vacuoles, necrosis, regeneration, and hypertrophy within muscle fibers; some muscle fibers showed cytoplasmic bodies and intranuclear inclusion formation, consistent with pathological features of vacuolar myopathy. No abnormalities were detected on brain MRI, cognitive function screening, or bone mineral density assessment. Based on genetic testing results, the patient was diagnosed with inclusion body myopathy caused by VCP c.464G>A (p.Arg155His) mutation. Literature retrieval identified 8 patients carrying VCP R155H mutation (R155H), who predominantly presented with myopathy or frontotemporal dementia in the early disease stage.ConclusionsThe VCP gene c.464G>A variant exhibits marked clinical heterogeneity. Phenotyping of the VCP gene is critical for the diagnosis of related inclusion body myopathies. Currently, there is no specific treatment in clinical practice, requiring long-term close follow-up and observation of patients.关键词：myopathy;R155H mutation;valosin-containing protein;c.464G>A;inclusion body myopathy27|243|0更新时间：2026-03-04 - “南京医科大学专家研究发现，妊娠期糖尿病患者孕中期至晚期血脂水平与产后糖代谢异常存在相关性，为临床诊疗提供新方向。”
摘要：ObjectiveTo explore the correlation between maternal blood lipid levels from the mid-to-late pregnancy and postpartum abnormal glucose metabolism in patients with gestational diabetes mellitus (GDM).MethodsA total of 180 GDM patients admitted to the Fourth Affiliated Hospital of Nanjing Medical University from January 2018 to January 2023 were included. Based on the results of the 75-g oral glucose tolerance test (OGTT) performed 2 months postpartum, GDM patients were divided into abnormal glucose metabolism group (n=55) and normal glucose metabolism group (n=125). Univariate analysis was used to compare general data [age, family history of diabetes, gestational weight gain rate, insulin therapy, smoking history, education level, parity, history of adverse pregnancy outcomes, postpartum body mass index (BMI), breastfeeding, postpartum daily exercise time], blood pressure (diastolic and systolic blood pressure), laboratory indicators [OGTT fasting blood glucose (OGTT FPG), OGTT 2-hour plasma glucose (OGTT 2hPG), white blood cell count, red blood cell count, hemoglobin, platelet count, glycosylated hemoglobin (HbA1c), standard deviation of blood glucose (SDBG), number of euglycemic excursions (NEGE)], and blood lipid levels in the mid-to-late pregnancy between the two groups. Multivariate logistic regression was employed to identify independent risk factors for postpartum abnormal glucose metabolism in GDM patients, followed by clustering analysis of these factors. Stratified interaction analysis was conducted to examine the relationship between gestational lipid levels and glucose metabolism indicators. The association between late-pregnancy lipid levels and postpartum glucose metabolism status was further explored using restricted cubic spline (RCS) method. Additionally, after 1:1 propensity score matching (PSM) of the GDM patients, multivariate logistic regression analysis was performed to identify independent risk factors affecting postpartum abnormal glucose metabolism in GDM patients.ResultsThe incidence of postpartum abnormal glucose metabolism among 180 GDM patients was 26.2% (55/180). Compared with the normal glucose metabolism group, the abnormal glucose metabolism group had a higher proportion of individuals aged ≥35 years, those with a family history of diabetes, a gestational weight gain rate ≥30%, those requiring insulin therapy, those who breastfed, those with postpartum daily exercise <1 hour, as well as higher postpartum BMI, OGTT FPG, OGTT 2hPG, HbA1c, SDBG, and NEGE levels (P<0.05). Compared with the normal glucose metabolism group, the abnormal group had significantly higher levels of total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), and triglycerides (TG), and significantly lower levels of high-density lipoprotein cholesterol (HDL-C) in the mid-to-late pregnancy (P<0.05). Multivariate logistic regression identified the following as independent risk factors for postpartum abnormal glucose metabolism (P<0.05): age ≥35 years, family history of diabetes, gestational weight gain rate ≥30%, insulin therapy, TG ≥4.03 mmol/L, LDL-C ≥3.69 mmol/L, TC ≥6.34 mmol/L, and HDL-C <1.89 mmol/L. Stratified interaction analysis showed that the levels of TC, TG, LDL-C, and HDL-C remained significantly correlated with HbA1c, SDBG, and NEGE after model adjustment (P<0.05). RCS analysis indicated that late-pregnancy TC, TG, and LDL-C levels were negatively correlated with postpartum glucose metabolism, whereas HDL-C level was positively correlated with postpartum glucose metabolism. After PSM, multivariate logistic regression confirmed that TG ≥4.03 mmol/L, LDL-C ≥3.69 mmol/L, TC ≥6.34 mmol/L, and HDL-C <1.89 mmol/L remained independent risk factors for postpartum glucose metabolism abnormalities in GDM patients (P<0.05).ConclusionsPostpartum abnormal glucose metabolism in GDM patients is significantly associated with blood lipid levels during pregnancy. Close monitoring of blood lipid levels in the clinical management of GDM may help reduce the risk of postpartum glucose metabolism disorders.关键词：gestational diabetes mellitus;blood lipid levels;pregnancy trimesters;abnormal glucose metabolism32|79|0更新时间：2026-03-04
Clinical Research
- “专家评估了沸石 - 高岭土复合纱布在猪交界部位爆炸伤大出血模型中的止血效应，建立了相关模型，为解决止血问题提供了新方案。”
摘要：ObjectiveTo assess the haemostatic effect of zeolite-kaolin composite gauze (ZK) in a porcine model of massive haemorrhage from explosive injury at junctional sites.MethodsA model of massive haemorrhage from explosive injury at junctional sites induced by shock wave and fragments was established using 24 healthy landrace pigs. US Army combat gauze (CG, n=8), ZK gauze (n=8) or ordinary medical gauze/standard medical gauze (SG, n=8) were respectively used for rescue. Survival time was recorded, bleeding volume was calculated by weighing the gauze before and after disposal, and the blood clot was removed by dissection. Wound temperature was measured at 10, 30, 60, 120, and 180 min after injury. Vital signs, arterial blood gas indexes, coagulation function, thromboelastography, and other relevant indexes were measured 15 min before injury and at 10, 30, 60, 120, and 180 min after injury. Haemostatic effect was evaluated by blood loss and survival rate; haemostatic reliability was evaluated by post-exercise bleeding; overall therapeutic effect was evaluated by wound temperature and physiological indexes.ResultsThe early bleeding volume in ZK group was significantly lower than that in SG group [(58.56±24.29) ml vs. (159.38±64.51) ml, P<0.05], with no statistically significant difference compared with that in CG group (P>0.05). The total bleeding volume in ZK group was significantly lower than that in SG group [(347.90±138.80) ml vs. (528.97±99.79) ml, P<0.05], with no statistically significant difference compared with that in CG group (P>0.05). There were no significant differences in wound temperature changes, post-exercise bleeding, survival rate (all 100.0%), survival time (all survived until the end of observation), or arterial blood gas indexes among the three groups (P>0.05). However, the changes in thrombin time (TT) and thrombopoietic index (TPI) in coagulation function over time showed statistically significant intergroup differences (F=9.967, P<0.001; F=2.132, P=0.067).ConclusionZK gauze can effectively stop bleeding and exhibit good hemostatic efficacy within 9 minutes of application, which may be related to its ability to promote the local coagulation reaction process. No excessive exothermic phenomenon (observed with other zeolite-based products) was noted during its use.关键词：blast injury;massive haemorrhage;haemostatic materials;animal model565|151|0更新时间：2026-03-04 - “南方医科大学珠江医院专家研究发现，短双歧杆菌可抑制子宫内膜间质细胞增殖和迁移，降低子宫内膜异位症组织中促炎因子水平，有望预防该病症。”
摘要：ObjectiveTo investigate the effect of Bifidobacterium breve (B. breve) on the alleviation of endometriosis (EM) in mice.MethodsA retrospective analysis was performed on 47 EM patients admitted to Zhujiang Hospital of Southern Medical University from June 2021 to August 2022, including 21 patients with early-stage EM and 26 patients with late-stage EM. The fecal content of three common Bifidobacterium species in these patients was measured using qPCR. The effects of different concentrations of B. breve supernatant on the proliferation and migration of human endometrial stromal cells (ESCs) were assessed using the CCK-8 assay, scratch assay, and Transwell assay. Sixteen female mice were randomly divided into a control group and groups A, B, and C, with four mice in each group. The control group received no special treatment, while groups A, B, and C were used to establish a mouse EM model via allogeneic intraperitoneal injection of endometrial fragments. Additionally, B. breve was administered by gavage to group A at 7 days after modeling, to group B simultaneously with modeling, and to group C 1 week before modeling. Twenty-one days after modeling, the maximum weight and number of EM lesions in each group were compared. Pathological changes in mouse EM tissues were observed using HE staining, and the expression levels of inflammatory factors [interleukin-6 (IL-6), IL-8, IL-1β, and IL-17, tumor necrosis factor-α (TNF-α)] in mouse EM tissues were detected using qPCR.ResultsqPCR results showed that the fecal content of B. breve in late-stage EM patients was significantly lower than that in early-stage EM patients (0.705±0.828 vs. 1.715±1.685, P<0.05). The CCK-8 assay results indicated that ESCs almost completely lost their proliferative activity when treated with B. breve supernatant at concentrations >20%. Transwell and scratch assay results showed that, compared with control group, the number of successfully migrated ESCs treated with 1% and 10% B. breve supernatant was significantly reduced (P<0.001). After B. breve gavage, the maximum weight and number of EM lesions in groups A, B, and C were reduced compared to those in control group. The maximum weight and number of EM lesions in group C were smaller than those in group B, and the maximum weight and number of EM lesions in group B were smaller than those in group A, with statistically significant differences (P<0.05). HE staining results showed that obvious glandular structures were observed in the EM lesions of mice. q-PCR results revealed that, compared with control group, the expression level of IL-6 in the EM lesions of group A was significantly decreased (P<0.05), the expression level of IL-8 in the EM lesions of group B was significantly decreased (P<0.05), and the expression levels of TNF-α, IL-8, and IL-6 in the EM lesions of group C were significantly decreased (P<0.05 or P<0.01). However, no statistically significant differences were observed in the expression levels of IL-1β and IL-17 among the groups (P>0.05).ConclusionsB. breve can inhibit the proliferation and migration of ESCs, reduce the levels of pro-inflammatory factors in EM tissues, and suppress EM progression. B. breve intervention may have a preventive effect against EM.关键词：endometriosis;gut microbiota;Bifidobacterium breve;inflammatory factors;endometrial stromal cells19|166|0更新时间：2026-03-04 - “最新研究发现，低压低氧运动对大鼠多裂肌急性损伤后骨骼肌卫星细胞自我更新与运动功能有积极影响。”
摘要：ObjectiveTo investigate the effects of hypobaric hypoxic exercise on skeletal muscle satellite cell self-renewal and motor function following acute injury of the multifidus muscle of rats.MethodsFifty healthy adult male SD rats were randomly divided into 5 groups (n=10): control group, BaCl2 group, hypobaric hypoxic+BaCl2 group (HH+BaCl2 group), exercise+BaCl2 group (E+BaCl2 group), and hypobaric hypoxic+exercise+BaCl2 group (HH+E+BaCl2 group), with 10 rats in each group. The E+BaCl2 and HH+E+BaCl2 groups underwent running training under normoxic normobaric and hypobaric hypoxic conditions, respectively, for 21 d. After the training period, all groups except the control group received an injection of 1.2% BaCl2 solution into the L4-L5 multifidus muscle to construct a rat multifidus muscle injury model, while the control group received an injection of normal saline. The Open field test, Rotarod test, and mechanical withdrawal threshold (MWT) measurement were performed before modeling and on days 1, 7 and 14 after modeling. Another 45 rats were grouped and treated in the same way and were sacrificed on days 3, 7 and 14 post-modeling to harvest the multifidus muscle. Evans blue and HE staining were performed. Western blotting was used to detect the protein expression levels of Notch1, Notch1 intracellular domain (N1ICD), and RNA binding protein-J (RBP-J), and immunofluorescent staining was used to detect the expression of paired box protein 7 (Pax7).ResultsAt 14 days after modeling, HH+E+BaCl2 group showed significantly longer total distance traveled in the Open field, higher maximum falling speed on the Rotarod test, and higher MWT values compared with those in BaCl2, HH+BaCl2, and E+BaCl2 groups (P<0.05 or P<0.01). Evans blue staining indicated the multifidus muscle in HH+E+BaCl2 group had the least damage at 14 days after modeling. HE staining revealed that the average cross-sectional area of multifidus muscle cells in HH+E+BaCl2 group was significantly larger than that in BaCl2, HH+BaCl2, and E+BaCl2 groups at 14 days after modeling (P<0.01). Western blotting results showed that the protein expression levels of Notch1, N1ICD, and RBP-J in HH+E+BaCl2 group were significantly higher than those in BaCl2, HH+BaCl2,and E+BaCl2 groups (P<0.05 or P<0.01). Immunofluorescent staining demonstrated that the number of Pax7+ cells in HH+E+BaCl2 group was significantly greater than that in BaCl2, HH+BaCl2,and E+BaCl2 groups (P<0.05 or P<0.01).ConclusionHypobaric hypoxic exercise may promote multifidus muscle regeneration and the recovery of acute low back pain by enhancing self-renewal capacity of multifidus muscle satellite cells.关键词：hypobaric hypoxic exercise;multifidus muscle;skeletal muscle satellite cells;self-renewal;low back pain28|137|0更新时间：2026-03-04 - “专家研究薏梅败酱方对炎症相关性结直肠癌小鼠肠上皮间质转化的影响，发现其可改善小鼠生长情况，减少肿瘤数量，降低炎症因子水平，延缓EMT进程，为预防结直肠癌提供新思路。”
摘要：ObjectiveTo investigate the effect of Yimei Baijiang formula(YMBJF) on intestinal epithelial-mesenchymal transition (EMT) in mice with inflammation-associated colorectal cancer (CAC).MethodsSixty male BALB/c mice aged 6-8 weeks were randomly divided into blank group, model group, capecitabine group (0.83 g/kg), and low-, medium-, and high-dose groups of YMBJF (4.63, 9.25, 18.5 g/kg), with 10 mice in each group. In addition to blank group that was injected with normal saline (10 mg/kg) intraperitoneally, the rest of the mice were injected with azoxymethane (10 mg/kg) intraperitoneally once and given 2.5% dextran sulfate sodium cyclically to drink daily to establish the CAC model. Intervention was conducted at the 5th week after the modeling began. Mice in each group were treated with the drug for 2 weeks and given a 1-week break (drug holiday); during the break, they were given normal saline by gavage. The experiment ended on the 77th day. During the experiment, the general state of the mice was observed; after sacrifice, the colorectal length and the number of tumors were measured. Hematoxylin-eosin (HE) staining was used to observe the pathological changes of colorectal tissues. Enzyme-linked immunosorbent assay (ELISA) was used to detect the levels of serum inflammatory factors [tumor necrosis factor‑α (TNF‑α), interferon‑γ (IFN‑γ) and interleukin-10 (IL-10)]; immunohistochemistry (IHC) was used to observe the expression of TNF‑α, IFN‑γ, and IL-10 in colorectal tissues. Real-time fluorescence quantitative PCR (qRT-PCR) was used to determine the expression of E-cadherin, N-cadherin, and Vimentin mRNA in colorectal tissues. Western blotting was used to detect the expression of N-cadherin and E-cadherin proteins in colorectal tissues.Results(1) HE staining results showed that, compared with blank group, model group showed decreased body weight (P<0.05), poorer general conditions, significantly shortened colorectal length (P<0.05), a notable increase in the number of tumors >3 mm (P<0.05), and obvious colorectal pathological damage. In comparison with model group, medium- and high-dose YMBJF groups exhibited increased body weight (P<0.05), improved general conditions, longer colorectal length (P<0.05), reduced number of tumors >3 mm (P<0.05), and alleviated pathological damage. (2) ELISA and IHC results showed that, compared with blank group, the expression of IFN-γ and TNF-α in serum and intestinal tissues of model group was significantly increased, while the expression of IL-10 was significantly decreased (P<0.05). Compared with model group, capecitabine group and medium- and high-dose YMBJF groups showed opposite trends in the expression of these factors (P<0.05). (3) qRT-PCR and Western blotting results showed that, compared with blank group, the expression of N-cadherin (protein and mRNA) and Vimentin mRNA was significantly increased in model group, while the expression of E-cadherin (protein and mRNA) was significantly decreased (P<0.05). Compared with model group, medium- and high-dose YMBJF groups exhibited opposite changes in the expression of these genes and proteins (P<0.05).ConclusionYMBJF can improve the general growth condition of mice with inflammation-associated colorectal cancer, reduce the number of tumors, lower the levels of inflammatory factors, and delay the EMT process, thereby preventing colorectal cancer.关键词：Yimei Baijang formula;inflammatory-associated colorectal cancer;epithelial-mesenchymal transition;inflammatory factors25|224|0更新时间：2026-03-04 - “姜黄素对化疗药物诱发的周围神经损伤大鼠的神经保护作用和对巨噬细胞极化的影响，以及对胚胎发育相关的音猬因子信号的调控机制。”
摘要：ObjectiveTo investigate the neuroprotective effect of curcumin (Cur) on chemotherapy-induced peripheral neuropathy (CIPN) in rats, its impact on macrophage polarization, and the regulatory mechanism involving sonic hedgehog (SHH) signaling pathway.MethodsFifty male SD rats were randomly divided into five groups (n=10 per group): sham operation group (Sham group), model group (CIPN group), Cur low-dose group (Cur-L group), Cur high-dose group (Cur-H group), and cyclopamine group (CPA group). The CIPN model was established by intraperitoneal injection of paclitaxel. CPA, a specific inhibitor of SHH pathway, was used for the functional rescue experiment. The mechanical withdrawal threshold (MWT), thermal withdrawal latency (TWL), and sensory nerve conduction velocity (SNCV) were detected in each group. Flow cytometry was used to analyze macrophage phenotype switching in rat serum. Apoptosis in sciatic nerve tissue of rat was assessed by terminal deoxynucleotidyl transferase dUTP nick end labeling (TUNEL). mRNA expression levels of the inflammatory factors interleukin (IL)-4, IL-10, IL-1β, and IL-6 were detected by qRT-PCR. The expression levels of brain-derived neurotrophic factor (BDNF) were detected by immunofluorescence. The protein expression levels of B-cell lymphoma-2 (Bcl-2) and Bcl-2-associated X protein (Bax) were detected by immunohistochemistry. The protein expression levels of SHH, smoothened (Smo), patched1 (Ptch1) and glioma-associated oncogene homolog 1 (GLI1) were detected by Western blotting.ResultsCompared with Sham group, rats in CIPN group showed significant decreases in MWT, TWL, and SNCV, the proportion of M2 macrophages, the mRNA levels of IL-4 and IL-10 in sciatic nerve tissue, and the expression levels of BDNF, Bcl-2, SHH, Ptch1, Smo, and GLI1 (P<0.05). Conversely, the proportion of M1 macrophages, the apoptosis rate, the mRNA levels of IL-1β and IL-6, and the protein expression levels of Bax were significantly increased (P<0.05). Compared with CIPN group, rats in Cur-L and Cur-H groups showed significant increases in MWT, TWL, SNCV, the proportion of M2 macrophages, the mRNA levels of IL-4 and IL-10, and the protein expression levels of BDNF, Bcl-2, SHH, Ptch1, Smo, and GLI1 (P<0.05). Conversely, the proportion of M1 macrophages, the apoptosis rate, the mRNA levels of IL-1β and IL-6, and the expression levels of Bax in sciatic nerve tissue were significantly decreased (P<0.05). Compared with Cur-H group, rats in CPA group showed significant decreases in MWT, TWL, SNCV, the proportion of M2 macrophages, the mRNA levels of IL-4 and IL-10, and the protein expression levels of BDNF, Bcl-2, SHH, Ptch1, Smo, and GLI1 (P<0.05). Conversely, the proportion of M1 macrophages, the apoptosis rate, the mRNA levels of IL-1β and IL-6, and the protein expression level of Bax were significantly increased (P<0.05).ConclusionsCurcumin alleviates paclitaxel-induced CIPN in rats by reducing the proportion of M1 macrophages and the apoptosis rate in sciatic nerve tissue, upregulating the proportion of M2 macrophages and the expression of BDNF, and inhibiting inflammatory stress. These beneficial effects may be mediated through the regulation of the SHH signaling pathway.关键词：curcumin;chemotherapy-induced peripheral neuropathy;paclitaxel;macrophage polarization;sonic hedgehog29|319|0更新时间：2026-03-04
Basic Research
- “帕金森病是全球第二大神经退行性疾病，其非运动症状复杂且隐匿，易导致诊断延误。专家综述了国内外常用帕金森病动物模型非运动症状的特点，为相关研究提供了重要参考。”
摘要：Parkinson`s disease (PD) is the second largest neurodegenerative disease worldwide, with clinical symptoms including motor symptoms and nonmotor symptoms (NMS). NMS mainly includes dysosmia, sleep disorders, somatoform autonomic dysfunction, cognitive impairment, and psychiatric symptoms. The appearance of NMS often precedes typical motor symptoms, but it often leads to delayed diagnosis and treatment due to its complex and insidious nature. Clarifying NMS and its pathogenesis is of great significance for the early diagnosis and treatment of PD. This article reviews the NMS of commonly used PD models at home and abroad, aiming to provide a reference for the study of NMS.关键词：Parkinson's disease;nonmotor symptoms;animal model44|530|0更新时间：2026-03-04 - “细胞死亡是生物体内复杂且相互关联的过程，在维持组织稳态及预防疾病方面起着至关重要的作用。专家全面综述了程序性及非程序性细胞死亡的分子机制、调控网络及其在病理生理中的交互作用，为疾病治疗提供新视角。”摘要：Cell death is complex and interconnected process within living organisms, playing a crucial role in maintaining tissue homeostasis and preventing disease. This article provides a comprehensive review of the molecular mechanisms, regulatory networks, and interactions in pathophysiology of programmed and non-programmed cell death. Programmed cell death encompasses classic pathways (such as autophagy, apoptosis, necroptosis, and pyroptosis) as well as emerging forms (such as ferroptosis, cuproptosis, and panoptosis), with their molecular characteristics and signaling pathways becoming increasingly well-defined. Although non-programmed death (such as necrosis) lacks strict regulatory mechanisms, its pathological mechanisms and associations with diseases are becoming clearer.Furthermore, this article elucidates the dynamic interactions between different modes of cell death, such as the switch between apoptosis and necroptosis via caspase-8/receptor-interacting protein kinase 1 signaling; the reciprocal regulation of ferroptosis and autophagy through lipid peroxidation and mitochondrial quality control; and the permeability of lysosomal membranes, which can simultaneously activate apoptosis, necrosis, and ferroptosis. Meanwhile, microenvironmental factors can drive the transition among the aforementioned cell death modes by modulating the functions of mitochondria and lysosomes. For example, the acidic microenvironmental pH in inflammatory processes can switch the cell death mode from necroptosis to apoptosis. These interactive regulatory networks highlight the spatiotemporal specificity of cell death and its dependence on pathological context. In this regard, inhibition of a single cell death mode alone may not yield satisfactory therapeutic efficacy. Therefore, future research should focus on developing highly specific inhibitors and multi-target intervention strategies to overcome the limitations of insufficient specificity and drug resistance associated with current inhibitors, and in-depth elucidation of the molecular mechanisms underlying cell death will provide new perspectives for disease treatment and facilitate the integrated development of precision medicine and translational meidical research.关键词：cell death;autophagy;ferroptosis;cuproptosis;PANoptosis56|1952|0更新时间：2026-03-04
- “介绍了军事训练伤致肩关节前向不稳合并SLAP损伤的研究进展，专家们探索了其发病机制，为早期精准诊断和优化治疗方案提供了重要参考。”
摘要：Anterior shoulder instability combined with superior labrum anterior-posterior (SLAP) lesions is common in military training. This complex injury has a high incidence and postoperative recurrence rate among the military training population, severely impairing training efficiency and unit combat readiness. The pathogenic mechanism of anterior shoulder instability combined with SLAP injury caused by military training-related injuries is complex. Arthroscopy is the gold standard for diagnosing this injury. The choice of surgery must be individualized based on the extent of glenoid bone defect and the type of SLAP injury. Early surgical intervention is crucial for preventing postoperative recurrence and degenerative shoulder changes. The management of anterior shoulder instability combined with SLAP injuries in military personnel should emphasize early and precise diagnosis, comprehensive surgical repair, enhanced postoperative rehabilitation, and long-term follow-up. Future trends in diagnosis and treatment will move toward individualization, precision, intelligence, and multidisciplinary collaboration, necessitating enhanced military-specific clinical research and the development of dedicated databases. This review summarizes the epidemiology, pathological mechanisms, key points of clinical diagnosis and treatment, and therapeutic strategies for this complex injury, aiming to provide references for its early and precise diagnosis and treatment optimization.关键词：shoulder instability;shoulder dislocation;shoulder labrum injury;military training;arthroscopy36|243|0更新时间：2026-03-04
Review
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