Chinese Medical Sciences Journal最新文献

Objectives: 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.

Methods: 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 t-tests. Logistic regression analyses were conducted to identify clinical factors associated with CNCP.

Results: 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 OR = 2.316, 95% CI: 1.074-5.178, P = 0.032), radiotherapy (adjusted OR = 2.489, 95% CI: 1.119-5.803, P = 0.025), and voiding dysfunction (adjusted OR = 5.470, 95% CI: 2.150-16.396, P < 0.001) were independently associated with CNCP. Pancreatic cancer was inversely associated with CNCP (OR = 0.371, P = 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.

Conclusions: 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.

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.

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, p63, CD99, NKX2.2, FLI1, 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 EWSR1::FLI1 fusion. Crucially, we report the first case of ALES had a negative EWSR1 rearrangement but a somatic NF1 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.

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.

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.

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.

Objectives: 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.

Methods: 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.

Results: 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.

Conclusions: 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.

With a growing population of elderly patients undergoing hip arthroplasty, traditional nursing care often faces challenges dus to fragmented services and inadequate continuity. Based on Peplau's interpersonal relationship theory, we explored a comprehensive hospital-home-community management model for an 80-year-old female patient following total hip arthroplasty. This nursing model was structured into four sequential phases (orientation, identification, exploitation, and resolution) and incorporated a structured multidisciplinary team, a stepwise health education system, discharge preparation services, and evidence-based postoperative care. Post-discharge management integrated traditional Chinese medicine-based pain management, intelligent rehabilitation training, and evidence-based constipation management. After six months of intervention, the patient achieved satisfactory wound healing and optimal prosthesis positioning. Significant improvements were observed in pain, constipation, sleep, anxiety, hip function, self-care ability, and self-management competence. This approach established a closed-loop management system encompassing assessment, screening, referral, liaison, home visits, multidisciplinary collaboration, and continuous follow-up. This model bridges hospital-home care gap, enhances care continuity, and improves rehabilitation outcomes, thereby providing a replicable framework for the postoperative management of elderly surgical patients.