Chinese Medical Sciences Journal最新文献_第2页

Clinical Characteristics and Risk Factors of Coronary Artery Disease in Patients with Hypertension and Persistent Atrial Fibrillation 高血压合并持续性心房颤动患者冠状动脉疾病的临床特点及危险因素

Q2 Medicine

Chinese Medical Sciences Journal

Pub Date : 2025-09-01 DOI: 10.24920/004480

Jia-Qi Bai , Yi-Ning Liu , Rui-Zhe Li , Zong-Bin Li

Background and Objective

Hypertension (HT) and atrial fibrillation (AF) are highly prevalent cardiovascular conditions that frequently coexist. Coronary artery disease (CAD) is a major global cause of mortality. The co-occurrence of HT, AF, and CAD presents significant management challenges. This study aims to explore the clinical characteristics and risk factors associated with CAD in patients with HT and persistent AF (HT-AF).

Methods

In this retrospective cross-sectional study, data were collected from 384 hospitalized HT-AF patients at the People's Liberation Army General Hospital between January 2010 and December 2019. CAD diagnosis was confirmed by coronary angiography or computed tomography angiography. Clinical characteristics and comorbidities were compared between patients with and without CAD. Multivariate logistic regression analyses were performed to identify independent risk factors associated with CAD development.

Results

The prevalence of CAD among HT-AF patients was 66.41% (255/384). Cardiovascular complications, particularly heart failure (44.7% vs 25.6%, P < 0.05), were significantly more prevalent in the CAD group than in the non-CAD group. Only age was identified as an independent risk factor for CAD (adjusted OR: 1.047; 95% CI: 1.022–1.073; P = 0.000). Of all HT-AF patients, 54.7% had a CHA₂DS₂-VASc score of ≥4, indicating high stroke risk. There was a slightly higher anticoagulant usage rate in the CAD group than those without CAD (8.6% vs 4.7%, P = 0.157), and the overall anticoagulant usage remained low.

Conclusion

There is a high prevalence of CAD among hospitalized HT-AF patients, among whom age is the sole independent risk factor for CAD. Despite a high stroke risk, the utilization of oral anticoagulants is alarmingly low.

背景与目的：高血压（HT）和心房颤动（AF）是高度流行的心血管疾病，经常共存。冠状动脉疾病（CAD）是全球主要的死亡原因。HT、AF和CAD的同时发生给管理带来了重大挑战。本研究旨在探讨HT合并持续性心房颤动（HT- af）患者CAD的临床特征及相关危险因素。方法：在这项回顾性横断面研究中，收集了2010年1月至2019年12月在中国人民解放军总医院住院的384例HT-AF患者的数据。CAD诊断通过冠状动脉造影或计算机断层血管造影（CTA）证实。比较冠心病患者和非冠心病患者的临床特征和合并症。结果：HT-AF患者冠心病患病率为66.41%（255/384）。心血管并发症，尤其是心力衰竭（44.7% vs 25.6%, P < 0.05）在冠心病组明显高于非冠心病组。多因素logistic回归只发现年龄是CAD的独立危险因素（校正OR: 1.047; 95% CI: 1.022-1.073; P = 0.000）。在所有HT-AF患者中，54.7%的患者CHA2DS2-VASc评分≥4，表明卒中风险高。冠心病组的抗凝血药物使用率略高于非冠心病组（8.6% vs 4.7%, P = 0.157），总体抗凝血药物使用率仍然较低。结论：住院HT-AF患者CAD患病率较高，其中年龄是唯一的独立危险因素。尽管有较高的中风风险，口服抗凝剂的使用率却低得惊人。

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引用次数: 0

AI-Ready Competency Framework for Biomedical Scientific Data Literacy 生物医学科学数据素养的人工智能胜任力框架。

Q2 Medicine

Chinese Medical Sciences Journal

Pub Date : 2025-09-01 DOI: 10.24920/004522

Zhe Wang , Zhi-Gang Wang , Wen-Ya Zhao , Wei Zhou , Sheng-Fa Zhang , Xiao-Lin Yang

With the rise of data-intensive research, data literacy has become a critical capability for improving scientific data quality and achieving artificial intelligence (AI) readiness. In the biomedical domain, data are characterized by high complexity and privacy sensitivity, calling for robust and systematic data management skills. This paper reviews current trends in scientific data governance and the evolving policy landscape, highlighting persistent challenges such as inconsistent standards, semantic misalignment, and limited awareness of compliance. These issues are largely rooted in the lack of structured training and practical support for researchers. In response, this study builds on existing data literacy frameworks and integrates the specific demands of biomedical research to propose a comprehensive, lifecycle-oriented data literacy competency model with an emphasis on ethics and regulatory awareness. Furthermore, it outlines a tiered training strategy tailored to different research stages—undergraduate, graduate, and professional, offering theoretical foundations and practical pathways for universities and research institutions to advance data literacy education.

随着数据密集型研究的兴起，数据素养已成为提高科学数据质量和实现人工智能（AI）准备的关键能力。在生物医学领域，数据具有高度复杂性和隐私敏感性的特点，需要强大和系统的数据管理技能。本文回顾了科学数据治理的当前趋势和不断发展的政策格局，强调了持续存在的挑战，如标准不一致、语义不一致和合规性意识有限。这些问题在很大程度上源于缺乏对研究人员的结构化培训和实际支持。因此，本研究在现有数据素养框架的基础上，结合生物医学研究的具体需求，提出了一个全面的、面向生命周期的数据素养能力模型，强调伦理和监管意识。此外，它还概述了针对不同研究阶段（本科、研究生和专业）量身定制的分层培训策略，为大学和研究机构推进数据素养教育提供理论基础和实践途径。

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引用次数: 0

Application of Assessment Scales in Palliative Care for Glioma: A Systematic Review 评估量表在胶质瘤姑息治疗中的应用：系统综述。

Q2 Medicine

Chinese Medical Sciences Journal

Pub Date : 2025-09-01 DOI: 10.24920/004416

Zhi-Yuan Xiao , Tian-Rui Yang , Ya-Ning Cao , Wen-Lin Chen , Jun-Lin Li , Ting-Yu Liang , Ya-Ning Wang , Yue-Kun Wang , Xiao-Peng Guo , Yi Zhang , Yu Wang , Xiao-Hong Ning , Wen-Bin Ma

Background and Objective

Patients with glioma experience a high symptom burden and have diverse palliative care needs. However, the assessment scales used in palliative care remain non-standardized and highly heterogeneous. To evaluate the application patterns of the current scales used in palliative care for glioma, we aim to identify gaps and assess the need for disease-specific scales in glioma palliative care.

Methods

We conducted a systematic search of five databases including PubMed, Web of Science, Medline, EMBASE, and CINAHL for quantitative studies that reported scale-based assessments in glioma palliative care. We extracted data on scale characteristics, domains, frequency, and psychometric properties. Quality assessments were performed using the Cochrane ROB 2.0 and ROBINS-I tools.

Results

Of the 3,405 records initially identified, 72 studies were included. These studies contained 75 distinct scales that were used 193 times. Mood (21.7%), quality of life (24.4%), and supportive care needs (5.2%) assessments were the most frequently assessed items, exceeding half of all scale applications. Among the various assessment dimensions, the Distress Thermometer (DT) was the most frequently used tool for assessing mood, while the Short Form-36 Health Survey Questionnaire (SF-36) was the most frequently used tool for assessing quality of life. The Mini Mental Status Examination (MMSE) was the most common tool for cognitive assessment. Performance status (5.2%) and social support (6.8%) were underrepresented. Only three brain tumor-specific scales were identified. Caregiver-focused scales were limited and predominantly burden-oriented.

Conclusions

There are significant heterogeneity, domain imbalances, and validation gaps in the current use of assessment scales for patients with glioma receiving palliative care. The scale selected for use should be comprehensive and user-friendly.

目的：胶质瘤患者经历高症状负担，并有不同的姑息治疗需求。然而，在姑息治疗中使用的评估量表仍然是非标准化和高度异质性的。为了评估目前在胶质瘤姑息治疗中使用的量表的应用模式，我们旨在确定差距并评估胶质瘤姑息治疗中疾病特异性量表的需求。背景和方法：我们对PubMed、Web of Science、Medline、EMBASE和CINAHL等5个数据库进行了系统检索，以获得关于胶质瘤姑息治疗中基于量表评估的定量研究。我们提取了有关尺度特征、域、频率和心理测量特性的数据。使用Cochrane ROB 2.0和ROBINS-I工具进行质量评估。结果：在最初确定的3405份记录中，纳入了72项研究。这些研究包含75种不同的量表，使用了193次。情绪（21.7%）、生活质量（24.4%）和支持性护理需求（5.2%）评估是最常见的评估项目，超过了所有量表应用的一半。在各种评估维度中，焦虑温度计（DT）是最常用的评估情绪的工具，而SF-36健康调查问卷（SF-36）是最常用的评估生活质量的工具。迷你精神状态检查（MMSE）是最常用的认知评估工具。表现状态（5.2%）和社会支持（6.8%）的代表性不足。仅确定了三种脑肿瘤特异性量表。以照顾者为中心的量表有限，主要以负担为导向。结论：目前对接受姑息治疗的胶质瘤患者使用的评估量表存在显著的异质性、域不平衡和验证空白。选择使用的比例尺应全面、方便使用。

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引用次数: 0

Postoperative Complications and 30-day Readmission in Patients Older than 80 Years with Chronic Kidney Disease after Hip Fracture 80岁以上慢性肾病髋部骨折患者的术后并发症和30天再入院

Q2 Medicine

Chinese Medical Sciences Journal

Pub Date : 2025-09-01 DOI: 10.24920/004446

Hua-Wen Zhang, Lu-Lu Ma, Xue-Rong Yu

Objective

This study aimed to explore the impact of chronic kidney disease (CKD) on prognosis of patients older than 80 years after hip fracture.

Methods

This retrospective, observational, single-center study included patients older than 80 years who underwent hip fracture operations between Feburary 2013 to June 2021 at our hospital. Patients were divided into CKD and non-GKD groups based on the estimated glomerular filtration rate (eGFR) < 60 mL/(min·1.73m2)] or not. Outcomes were the incidence of in-hospital postoperative infectious and non-infectious complications, 30-day readmission, and in-hospital death. Logistic regression analysis was used to calculate the odds ratio (OR) of CKD on these outcomes.

Results

A total of 498 patients were included, 165 in the CKD group and 333 in the non-CKD group. Eighty-seven (52.7%) CKD patients experienced 140 episodes of postoperative complications. In comparison, 114 (34.2%) non-CKD patients had 158 episodes of postoperative complications. CKD patients were more likely to have postoperative complications than non-CKD patients (OR = 2.143, 95% CI: 1.465–3.134, P < 0.001). CKD increased the risk of cardiovascular complications (OR = 2.044, 95% CI: 1.245–3.356, P = 0.004), acute kidney injury (OR = 3.401, 95% CI: 1.905–6.072, P < 0.001), delirium (OR = 2.276, 95% CI: 1.140–4.543, P = 0.024), and gastrointestinal bleeding (OR = 4.151, 95% CI: 1.025–16.812, P = 0.031). The transfusion rate (OR = 2.457, 95% CI: 1.668–3.618, P < 0.001) and incidence of 30-day readmission (OR = 2.426, 95% CI: 1.203–4.892, P = 0.011) in CKD patients were significantly higher than those in patients without CKD.

Conclusion

CKD is associated with poor postoperative outcomes in geriatric hip fracture patients. Special attention should be paid to patients with CKD.

目的：本研究旨在探讨慢性肾脏疾病（CKD）对80岁以上髋部骨折患者预后的影响。方法：这项回顾性、观察性、单中心研究纳入了2013年2月至2021年6月在我院接受髋部骨折手术的80岁以上患者。根据估计的肾小球滤过率（eGFR）将患者分为两组：CKD组[eGFR < 60 mL/(min·1.73m2)]和非CKD组。结果是院内术后感染和非感染性并发症的发生率、30天再入院和院内死亡。使用逻辑回归计算CKD对这些结果的比值比（OR）。结果：共纳入498例患者，其中CKD组165例，非CKD组333例。87例CKD患者出现140次术后并发症。相比之下，114例非ckd患者发生了158次术后并发症。CKD患者比非CKD患者更容易出现术后并发症（OR = 2.143, 95% CI: 1.465-3.134, P < 0.001）。CKD增加了心血管并发症（OR = 2.044, 95% CI: 1.245-3.356, P = 0.004）、急性肾损伤（OR = 3.401, 95% CI: 1.905-6.072, P < 0.001）、谵妄（OR = 2.276, 95% CI: 1.140-4.543, P = 0.024）和胃肠道出血（OR = 4.151, 95% CI: 1.025-16.812, P = 0.031）的风险。CKD患者输血率（OR = 2.457, 95% CI: 1.668 ~ 3.618, P < 0.001）和30天再入院率（OR = 2.426, 95% CI:1.203 ~ 4.892, P = 0.011）均高于非CKD患者。结论：CKD与老年髋部骨折患者术后不良预后相关。CKD患者应特别注意。

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引用次数: 0

Association Between Introversion Personality and Social Media Usage-Related Social Anxiety Among Chinese College Students: Chain Mediating Effects of Interaction Anxiousness and Mobile Phone Addiction 中国大学生内向型人格与社交媒体使用相关社交焦虑的关系：互动焦虑与手机成瘾的连锁中介效应

Q2 Medicine

Chinese Medical Sciences Journal

Pub Date : 2025-09-01 DOI: 10.24920/004397

Su-Yan Wang , Wen-Hui Li , Hong-Liang Dai

Background and Objective

Social anxiety arising from intensive social media usage (SMU) among adolescents and youth has gained extensive attention in recent years due to its negative influence on mental health and academic performance. In spite of that, there is a dearth regarding the etiology of SMU-related social anxiety. This study aims to further clarify the influence of introversion personality on SMU-related social anxiety and the mechanism underlying such an association and provide a new perspective for developing effective intervention strategies for the highly prevailing SMU-related anxiety among Chinese college students.

Methods

A cohort of 979 college students (266 males and 713 females) aged 20.90 ± 1.91 years was enrolled in this cross-sectional study. Four measures including the “extroversion” domain of Eysenck Personality Questionnaire Revised, Short Scale (EPQ-R-S E), Interaction Anxiousness Scale (IAS), Mobile Phone Addiction Index (MPAI), and Social Anxiety Scale for Social Media Users (SAS-SMU) were used to evaluate the influence of introversion personality on SMU-related social anxiety that was potentially mediated sequentially by interaction anxiousness and mobile phone addiction. Hayes PROCESS was used for correlation and mediation analysis.

Results

Interaction anxiousness (indirect effect = –1.331, 95% CI : –1.559 – –1.122) partially mediated the association between introversion personality and SMU-related social anxiety. Besides, a sequential mediation of interaction anxiousness and mobile phone addiction in the link between introversion personality and SMU-related social anxiety was revealed (indirect effect = –0.308, 95% CI : –0.404 – –0.220). No significant mediating effect was found with mobile phone addiction in the association between introversion personality and SMU-related social anxiety.

Conclusion

Targeting interaction anxiousness and mobile phone addiction may represent an efficient strategy alleviating SMU-related social anxiety among Chinese college students with introversion personality.

背景与目的：近年来，青少年社交媒体密集使用（SMU）引起的社交焦虑因其对心理健康和学习成绩的负面影响而受到广泛关注。尽管如此，关于smu相关社交焦虑的病因却缺乏研究。本研究旨在进一步阐明内向人格对新大相关社交焦虑的影响及其机制，并为制定有效的干预策略提供新的视角，以应对中国大学生高度流行的新大相关焦虑。方法：选取979名大学生（男266名，女713名），年龄为20.90±1.91岁。采用艾森克人格修正问卷的“外向性”域、短量表（EPQ-R-S E）、互动焦虑量表（IAS）、手机成瘾指数（MPAI）和社交媒体用户社交焦虑量表（SAS-SMU）四种测量方法，评估了内向人格对社交媒体用户社交焦虑的影响，其中互动焦虑和手机成瘾可能依次介导smu相关的社交焦虑。采用Hayes PROCESS进行相关性和中介分析。结果：交往焦虑（间接效应= -1.331,95% CI = -1.559 ~ -1.122）部分介导了内向人格与smu相关社交焦虑的关系。此外，互动焦虑和手机成瘾在内向人格与smu相关社交焦虑之间存在序向中介效应（间接效应= -0.308,95% CI = -0.404 ~ -0.220）。手机成瘾对内向人格与smu相关社交焦虑的关联中未发现显著的中介作用。结论：针对互动焦虑和手机成瘾可能是缓解中国内向型大学生smu相关社交焦虑的有效策略。

{"title":"Association Between Introversion Personality and Social Media Usage-Related Social Anxiety Among Chinese College Students: Chain Mediating Effects of Interaction Anxiousness and Mobile Phone Addiction","authors":"Su-Yan Wang , Wen-Hui Li , Hong-Liang Dai","doi":"10.24920/004397","DOIUrl":"10.24920/004397","url":null,"abstract":"<div><h3>Background and Objective</h3><div>Social anxiety arising from intensive social media usage (SMU) among adolescents and youth has gained extensive attention in recent years due to its negative influence on mental health and academic performance. In spite of that, there is a dearth regarding the etiology of SMU-related social anxiety. This study aims to further clarify the influence of introversion personality on SMU-related social anxiety and the mechanism underlying such an association and provide a new perspective for developing effective intervention strategies for the highly prevailing SMU-related anxiety among Chinese college students.</div></div><div><h3>Methods</h3><div>A cohort of 979 college students (266 males and 713 females) aged 20.90 ± 1.91 years was enrolled in this cross-sectional study. Four measures including the “extroversion” domain of Eysenck Personality Questionnaire Revised, Short Scale (EPQ-R-S E), Interaction Anxiousness Scale (IAS), Mobile Phone Addiction Index (MPAI), and Social Anxiety Scale for Social Media Users (SAS-SMU) were used to evaluate the influence of introversion personality on SMU-related social anxiety that was potentially mediated sequentially by interaction anxiousness and mobile phone addiction. Hayes PROCESS was used for correlation and mediation analysis.</div></div><div><h3>Results</h3><div>Interaction anxiousness (indirect effect = –1.331, 95% <em>CI</em> : –1.559 – –1.122) partially mediated the association between introversion personality and SMU-related social anxiety. Besides, a sequential mediation of interaction anxiousness and mobile phone addiction in the link between introversion personality and SMU-related social anxiety was revealed (indirect effect = –0.308, 95% <em>CI</em> : –0.404 – –0.220). No significant mediating effect was found with mobile phone addiction in the association between introversion personality and SMU-related social anxiety.</div></div><div><h3>Conclusion</h3><div>Targeting interaction anxiousness and mobile phone addiction may represent an efficient strategy alleviating SMU-related social anxiety among Chinese college students with introversion personality.</div></div>","PeriodicalId":35615,"journal":{"name":"Chinese Medical Sciences Journal","volume":"40 3","pages":"Pages 180-187"},"PeriodicalIF":0.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145182271","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}

引用次数: 0

Cost-Effectiveness of Denosumab for Treating Bone Metastases from Solid Tumors: A Systematic Review (2017-2023) Denosumab治疗实体瘤骨转移的成本-效果：一项系统综述（2017-2023）。

Q2 Medicine

Chinese Medical Sciences Journal

Pub Date : 2025-09-01 DOI: 10.24920/004368

Cong Wang , Jin-Yu Liu , Min Wan , Qi Yuan , Yu Zhang , Guang-Yi Yu , Ru-Xu You

Objective

This systematic review examines recent pharmacoeconomic literature on denosumab’ cost-effectiveness for bone metastasis treatment, providing evidence-based insights to guide healthcare policy decisions.

Methods

A comprehensive literature search was performed across Cochrane, PubMed, EMBASE (Ovid), CNKI, and Wanfang databases to identify original articles published between 2017 and 2023. Key words consisted of bone metastases, denosumab, and cost-effectiveness in the search strategy. The methodological quality of the included studies was assessed utilizing the revised Consolidated Health Economic Evaluation Reporting Standards (CHEERS 2022). Data was extracted regarding methodological characteristics and cost-effectiveness analyses.

Results

A total of 111 studies were retrieved, of which 6 met the inclusion criteria. All included studies were based on clinical trials and published literature data and exhibited high methodological quality. Up to 83% (5 out of 6) of comparisons demonstrated that denosumab was more cost-effective or dominant compared to zoledronic acid. The adjusted incremental cost-effectiveness ratios varied substantially by tumor type, ranging from CZK 436,339.09 to USD 136,234 per skeletal-related event avoided and from CZK 61,580.95 to USD 118,392.11 per quality-adjusted life year gained.

Conclusions

The majority of the included studies support denosumab as a more cost-effective treatment option for bone metastases in solid tumors compared to zoledronic acid. The application of CHEER (2022) enhances the reliability of pharmacoeconomic evaluations.

目的：本系统综述了最近关于denosumab治疗骨转移的成本效益的药物经济学文献，为指导医疗保健政策决策提供循证见解。方法：通过Cochrane、PubMed、EMBASE （Ovid）、CNKI和万方数据库进行综合文献检索，确定2017 - 2023年间发表的原创文章。关键词包括骨转移、denosumab和搜索策略的成本-效果。采用修订后的综合卫生经济评价报告标准（CHEERS 2022）对纳入研究的方法学质量进行评估。提取有关方法学特征和成本效益分析的数据。结果：共检索到111篇研究，其中6篇符合纳入标准。所有纳入的研究均基于临床试验和已发表的文献资料，并表现出较高的方法学质量。高达83%（6个中的5个）的比较表明，与唑来膦酸相比，denosumab更具成本效益或优势。调整后的增量成本-效果比因肿瘤类型而有很大差异，每个避免的骨骼相关事件从436,339.09捷克克朗到136,234美元不等，每个质量调整生命年从61,580.95捷克克朗到118,392.11美元不等。结论：与唑来膦酸相比，大多数纳入的研究支持denosumab作为实体瘤骨转移的更具成本效益的治疗选择。CHEER（2022）的应用提高了药物经济学评价的可靠性。

{"title":"Cost-Effectiveness of Denosumab for Treating Bone Metastases from Solid Tumors: A Systematic Review (2017-2023)","authors":"Cong Wang , Jin-Yu Liu , Min Wan , Qi Yuan , Yu Zhang , Guang-Yi Yu , Ru-Xu You","doi":"10.24920/004368","DOIUrl":"10.24920/004368","url":null,"abstract":"<div><h3>Objective</h3><div>This systematic review examines recent pharmacoeconomic literature on denosumab’ cost-effectiveness for bone metastasis treatment, providing evidence-based insights to guide healthcare policy decisions.</div></div><div><h3>Methods</h3><div>A comprehensive literature search was performed across Cochrane, PubMed, EMBASE (Ovid), CNKI, and Wanfang databases to identify original articles published between 2017 and 2023. Key words consisted of bone metastases, denosumab, and cost-effectiveness in the search strategy. The methodological quality of the included studies was assessed utilizing the revised Consolidated Health Economic Evaluation Reporting Standards (CHEERS 2022). Data was extracted regarding methodological characteristics and cost-effectiveness analyses.</div></div><div><h3>Results</h3><div>A total of 111 studies were retrieved, of which 6 met the inclusion criteria. All included studies were based on clinical trials and published literature data and exhibited high methodological quality. Up to 83% (5 out of 6) of comparisons demonstrated that denosumab was more cost-effective or dominant compared to zoledronic acid. The adjusted incremental cost-effectiveness ratios varied substantially by tumor type, ranging from CZK 436,339.09 to USD 136,234 per skeletal-related event avoided and from CZK 61,580.95 to USD 118,392.11 per quality-adjusted life year gained.</div></div><div><h3>Conclusions</h3><div>The majority of the included studies support denosumab as a more cost-effective treatment option for bone metastases in solid tumors compared to zoledronic acid. The application of CHEER (2022) enhances the reliability of pharmacoeconomic evaluations.</div></div>","PeriodicalId":35615,"journal":{"name":"Chinese Medical Sciences Journal","volume":"40 3","pages":"Pages 219-231"},"PeriodicalIF":0.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145303727","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}

引用次数: 0

Multi-Phase Contrast-Enhanced CT Clinical-Radiomics Model for Predicting Prognosis of Extrahepatic Cholangiocarcinoma After Surgery: A Single-Center Retrospective Study 多期增强CT临床放射组学模型预测肝外胆管癌术后预后：一项单中心回顾性研究。

Q2 Medicine

Chinese Medical Sciences Journal

Pub Date : 2025-09-01 DOI: 10.24920/004458

Shen-Bo Zhang , Zheng Wang , Ge Hu , Si-Hang Cheng , Zhi-Wei Wang , Zheng-Yu Jin

Objective

To develop and validate a preoperative clinical-radiomics model for predicting overall survival (OS) and disease-free survival (DFS) in patients with extrahepatic cholangiocarcinoma (eCCA) undergoing radical resection.

Methods

In this retrospective study, consecutive patients with pathologically-confirmed eCCA who underwent radical resection at our institution from 2015 to 2022 were included. The patients were divided into a training cohort and a validation cohort according to the chronological order of their CT examinations. Least absolute shrinkage and selection operator (LASSO)-Cox regression was employed to select predictive radiomic features and clinical variables. The selected features and variables were incorporated into a Cox regression model. Model performance for 1-year OS and DFS prediction was assessed using calibration curves, area under receiver operating characteristic curve (AUC), and concordance index (C-index).

Results

This study included 123 patients (mean age 64.0 ± 8.4 years, 85 males/38 females), with 86 in the training cohort and 37 in the validation cohort. The OS-predicting model included four clinical variables and four radiomic features. It achieved a training cohort AUC of 0.858 (C-index = 0.800) and a validation cohort AUC of 0.649 (C-index = 0.605). The DFS-predicting model included four clinical variables and four other radiomic features. It achieved a training cohort AUC of 0.830 (C-index = 0.760) and a validation cohort AUC of 0.717 (C-index = 0.616).

Conclusion

The preoperative clinical-radiomics models show promise as a tool for predicting 1-year OS and DFS in eCCA patients after radical surgery.

目的：建立并验证一种术前临床放射组学模型，用于预测肝外胆管癌（eCCA）根治性切除患者的总生存期（OS）和无病生存期（DFS）。方法：本回顾性研究纳入2015年至2022年在我院连续行根治性切除术的经病理证实的eCCA患者。根据患者CT检查的时间顺序，将患者分为训练组和验证组。采用最小绝对收缩和选择算子(LASSO)-Cox回归选择预测放射学特征和临床变量。选取的特征和变量纳入Cox回归模型。采用校准曲线、受试者工作特征曲线下面积（AUC）和一致性指数（C-index）评估模型预测1年OS和DFS的性能。结果：本研究纳入123例患者（平均年龄64.0±8.4岁，男性85例/女性38例），其中86例为训练组，37例为验证组。os预测模型包括4个临床变量和4个放射学特征。训练队列AUC为0.858 (C-index = 0.800)，验证队列AUC为0.649 （C-index = 0.605）。dfs预测模型包括4个临床变量和其他4个放射学特征。训练队列AUC为0.830 (C-index = 0.760)，验证队列AUC为0.717 （C-index = 0.616）。结论：术前临床放射组学模型有望作为预测根治性eCCA患者术后1年OS和DFS的工具。

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引用次数: 0

Development and Initial Validation of the Multi-Dimensional Attention Rating Scale in Highly Educated Adults 高学历成人多维注意力评定量表的编制与初步验证。

Q2 Medicine

Chinese Medical Sciences Journal

Pub Date : 2025-06-01 DOI: 10.24920/004481

Xin-Yang Zhang , Karen Spruyt , Jia-Yue Si , Lin-Lin Zhang , Ting-Ting Wu , Yan-Nan Liu , Di-Ga Gan , Yu-Xin Hu , Si-Yu Liu , Teng Gao , Yi Zhong , Yao Ge , Zhe Li , Zi-Yan Lin , Yan-Ping Bao , Xue-Qin Wang , Yu-Feng Wang , Lin Lu

Objective

To report the development, validation, and findings of the Multi-dimensional Attention Rating Scale (MARS), a self-report tool crafted to evaluate six-dimension attention levels.

Methods

The MARS was developed based on Classical Test Theory (CTT). Totally 202 highly educated healthy adult participants were recruited for reliability and validity tests. Reliability was measured using Cronbach's alpha and test-retest reliability. Structural validity was explored using principal component analysis. Criterion validity was analyzed by correlating MARS scores with the Toronto Hospital Alertness Test (THAT), the Attentional Control Scale (ACS), and the Attention Network Test (ANT).

Results

The MARS comprises 12 items spanning six distinct dimensions of attention: focused attention, sustained attention, shifting attention, selective attention, divided attention, and response inhibition. As assessed by six experts, the content validation index (CVI) was 0.95, the Cronbach's alpha for the MARS was 0.78, and the test-retest reliability was 0.81. Four factors were identified (cumulative variance contribution rate 68.79%). The total score of MARS was correlated positively with THAT (r = 0.60, P < 0.01) and ACS (r = 0.78, P < 0.01) and negatively with ANT's reaction time for alerting (r = −0.31, P = 0.049).

Conclusion

The MARS can reliably and validly assess six-dimension attention levels in real-world settings and is expected to be a new tool for assessing multi-dimensional attention impairments in different mental disorders.

目的：报告多维注意力评定量表（MARS）的开发、验证和发现，这是一种评估六维注意力水平的自我报告工具。方法：根据经典测试理论（CTT）编制MARS问卷，由6名精神病学和心理学专家采用德尔菲法进行初步项目选择和内容验证。招募健康成人参与者完成MARS和相关量表，并进行现场测量。信度采用Cronbach’s alpha和重测信度测量。采用主成分分析探讨结构效度。通过将MARS评分与多伦多医院警觉性测试（THAT）、注意控制量表（ACS）和注意网络测试（ANT）相关联来分析标准效度。结果：MARS包括12个项目，跨越6个不同的注意维度：集中注意、持续注意、转移注意、选择注意、分离注意和反应抑制。MARS的Cronbach's alpha为0.78，重测信度为0.81。确定了4个因素（累积方差68.79%）。内容效度由6位专家进行评估，得出的平均内容效度指数（CVI）为0.95。MARS与THAT （r = 0.60, P < 0.01）、ACS （r = 0.78, P < 0.01）呈正相关（r = -0.31, P = 0.049），与ANT反应时间（RT）报警指标呈负相关（r = -0.31, P = 0.049）。结论：MARS能够可靠、有效地评估现实环境下的六维注意水平，有望成为评估不同精神障碍患者各种注意缺陷的新工具。

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引用次数: 0

Risk Identification and Regulation for China's Anti-Commercial Bribery in Medical Device Procurement and Sales Industry 中国医疗器械采购和销售行业反商业贿赂风险识别与监管

Q2 Medicine

Chinese Medical Sciences Journal

Pub Date : 2025-06-01 DOI: 10.24920/004450

Jie Fu, Jing-Yi Xu, Yue Wang

In China, the regulatory framework for medical device procurement and sales, particularly concerning anti-commercial bribery, relies heavily on punitive mechanisms applied after violations occur. Consequently, there is an urgent need to establish a scientific risk regulation framework as a complementary approach. Effective risk-oriented regulatory models require precise identification of risk areas in commercial bribery. Focusing on several major procurement scenarios such as centralized bulk-buying, tendering and bidding processes, in-hospital procurement, and online purchasing, this article analyzes the structural factors contributing to these risks, represented by the absence of certification mechanisms, lack of transparency in information disclosure, and inadequate checks and balances. Based on official risk assessment results, this study applies the theory of power and responsibility to propose a preventive regulatory framework that combines industry self-discipline and administrative oversight. By combining these approaches, the framework aims to develop regulatory measures that can effectively reduce commercial bribery risks and prevent illegal and non-compliant conduct.

在中国，医疗器械采购和销售的监管框架，特别是关于反商业贿赂的监管框架，在很大程度上依赖于违规发生后适用的惩罚机制。因此，迫切需要建立一个科学的风险监管框架作为补充方法。有效的以风险为导向的监管模式需要准确识别商业贿赂的风险领域。本文以集中批量采购、招标投标流程、医院内采购和在线采购等几个主要采购场景为重点，分析了导致这些风险的结构性因素，主要表现为缺乏认证机制、信息披露缺乏透明度以及制衡不足。本文基于官方风险评估结果，运用权责理论，提出了行业自律与行政监督相结合的预防性监管框架。通过结合这些方法，该框架旨在制定监管措施，有效降低商业贿赂风险，防止非法和不合规行为。

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引用次数: 0

Chinese Expert Consensus on the Definitions of Palliative Care and Hospice Care (2025) 中国姑息治疗和临终关怀定义专家共识（2025）。

Q2 Medicine

Chinese Medical Sciences Journal

Pub Date : 2025-06-01 DOI: 10.24920/004496

Chinese Expert Consensus Working Group on the Definition of Palliative Care

<div><h3>Background and Objective</h3><div>The development of modern palliative care in China began in the 1980s and is currently in an accelerating phase. However, inconsistencies in terminology and concepts have hindered policymaking, clinical practice, and academic research. The Terminology of Clinical Medicine (2023 edition) has determined <em>huan-he-yi-liao</em> (缓和医疗) and <em>an-ning-liao-hu</em> (安宁疗护) as the formal terms of “palliative care” and “hospice care”, respectively. To align with these terms, this study aims to establish expert consensus definitions tailored to the Chinese context.</div></div><div><h3>Methods</h3><div>We systematically retrieved and collected domestic and international literature and policy documents related to the definition of palliative care, then deconstructed and analyzed the relevant conceptual elements of these definitions. Core expert panel built the initial recommended definition upon the conceptual elements and consensus definition of palliative care by the International Association for Hospice and Palliative Care (IAHPC) through two rounds of online discussions. After nomination and selection, 61 professionals in the field of palliative care in China were invited to participate in the consensus expert group. Two rounds of Delphi consultation were conducted among the consensus experts, who were asked to score their agreement using Likert scale to the items in the initial recommended definition and the definition statements of palliative care and hospice care. Agreement rate of over 80% was considered as reaching consensus for each items. The core expert panel revised the items and the statements of recommended definitions based on the results from Delphi surveys. The final recommended definitions were formulated after feedback from patient and public involvement (PPI) group members.</div></div><div><h3>Results</h3><div>The response rates for the first and second round of Delphi surveys were 83.6% and 100.0%, respectively. The agreement rates of the items and statements of the recommended definitions exceeded 90%. Accordingly, the definitions based on Chinese expert consensus are recommended. Palliative care is an active holistic approach aimed at patients of all ages suffering from life-threatening illness and their families and caregivers. It seeks to improve their quality of life by preventing, assessing, and relieving physical, psychological, social, and spiritual suffering. Hospice care is an integral part of palliative care, focusing on holistic care for patients at the end of life and their families and caregivers. Its goal is to help patients to maintain dignity and achieve a good death by alleviating physical, psychological, social, and spiritual distress without intentionally hastening or postponing death, meanwhile improve the quality of life for families and caregivers.</div></div><div><h3>Conclusions</h3><div>This study has established the Chinese expert consensus definitions of palliative

背景与目的：中国现代姑息治疗的发展始于20世纪80年代，目前正处于加速发展阶段。然而，术语和概念的不一致阻碍了政策制定、临床实践和学术研究。《临床医学术语》（2023版）将“Huan-He-Yi-Liao（）”和“An-Ning-Liao-Hu（）”分别确定为“姑息治疗”和“临终关怀”的正式术语。为了与这些术语保持一致，本研究旨在建立适合中国背景的专家共识定义。方法：系统检索和收集国内外与姑息治疗定义相关的文献和政策文件，对这些定义的相关概念要素进行解构和分析。核心专家小组通过两轮在线讨论，根据国际安宁疗护与缓和疗护协会（IAHPC）对缓和疗护的概念要素和共识定义，建立了最初推荐的定义。经提名和遴选，邀请61名中国姑息治疗领域的专业人士参加共识专家组。在达成共识的专家中进行了两轮德尔菲咨询，他们被要求使用李克特量表对最初推荐定义和姑息治疗和临终关怀定义陈述中的项目进行评分。协议率达到80%以上即为各项目达成共识。核心专家小组根据两轮德尔菲调查的结果修订了项目和建议定义的说明。最终推荐的定义是在患者和公众参与（PPI）小组成员反馈后制定的。结果：第一轮和第二轮德尔菲调查的应答率分别为83.6%和100.0%。推荐定义的项目和表述的符合率超过90%。因此，推荐基于中国专家共识的定义。姑息治疗是一种积极的整体方法，针对患有危及生命的疾病的所有年龄的患者及其家属和照顾者。它寻求通过预防、评估和减轻身体、心理、社会和精神上的痛苦来改善他们的生活质量。临终关怀是姑息治疗的一个组成部分，重点是对临终病人及其家属和照顾者的整体护理。其目标是在不故意加速或推迟死亡的情况下，通过减轻身体、心理、社会和精神上的痛苦，帮助患者保持尊严，实现美好的死亡，同时提高家属和照顾者的生活质量。结论：本研究建立了中国姑息治疗和安宁疗护的专家共识定义，以及两者之间的关系。这些定义强调了姑息治疗的整体性，为学科发展、临床实践和公众交流提供了基础。

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