3.Dynamic prediction of JC polyomavirus reactivation after kidney transplantation
Mengyao LI ; Chengfeng ZHANG ; Difei REN ; Xin LIANG ; Shuyu CHEN ; Yushi PENG ; Yanjie WANG ; Meng ZHANG ; Jian XU ; Zheng CHEN ; Yun MIAO ; Yibin WANG
Organ Transplantation 2026;17(4):635-643
Objective To construct a dynamic prediction model for JC polyomavirus (JCV) reactivation after kidney transplantation. Methods A retrospective analysis was conducted on the clinical data of 128 recipients who met the inclusion criteria and received kidney transplantation in Nanfang Hospital, Southern Medical University, from June 2021 to December 2024. Dynamic Cox regression and dynamic restricted mean survival time (RMST) regression based on the landmark method were adopted to establish the dynamic prediction models, and Monte Carlo cross-validation was used to evaluate model performance. Results The dynamic models could predict the incidence and onset time of JCV reactivation within the subsequent 3 months according to covariates at each landmark time point from the 1st to the 6th month after transplantation. Remuzzi score, body mass index and warm ischemia time were independent risk factors for JCV reactivation, while a history of urinary BK polyomavirus reactivation served as a protective factor. The median values of the area under the curve, C-index and Brier score of the dynamic Cox model were 0.873, 0.851 and 0.065 respectively, and the C-index of the dynamic RMST model was 0.829, all of which were superior to those of the static model. Conclusions The landmark-based dynamic models exhibit excellent predictive performance, which may integrate baseline data and post-transplant follow-up information to realize dynamic assessment of the risk and time window of JCV reactivation, thereby providing evidence for optimizing post-operative monitoring and individualized intervention strategies.
4.Current Status and Prospects of Artificial Intelligence Technologyin Minimally Invasive Gastric Cancer Surgery
Tao ZHANG ; Boer SU ; Guanxing LIANG ; Shiman DAI ; Jiawei CHEN ; Zhengjie LIU ; Cheng PENG ; Rong LIU ; Qinglan LIN ; Yidan WU ; Yuhui WU ; Jiaming WEN ; Hong WANG ; Hao CHEN ; Jiang YU
Medical Journal of Peking Union Medical College Hospital 2026;17(4):933-942
Gastric cancer remains a highly prevalent malignancy worldwide, with surgical resection currently constituting the cornerstone of treatment aimed at improving long-term patient survival. Owing to their notable advantages, including reduced surgical trauma and accelerated postoperative recovery, minimally invasive procedures are progressively supplanting conventional open surgery and have become the mainstream approach in gastric cancer management. Concurrently, the rapid advancement of artificial intelligence (AI) technologies has enabled real-time intraoperative monitoring of surgical scenes, thereby furnishing novel technical support for adjunctive decision-making, surgical navigation, and skill assessment during gastrectomy. This article provides a systematic review of the current status of AI applications in minimally invasive gastric cancer surgery, with a particular focus on research progress pertaining to instrument recognition, surgical phase identification, delineation of normal anatomical structures, detection of metastatic foci, and early warning of intraoperative adverse events. Furthermore, we discuss the potential value of AI in enhancing surgical efficiency, ensuring patient safety, and optimizing surgical education. On this basis, we further analyze the principal challenges and inherent risks confronting current AI systems, with the aim of informing future technological innovation and facilitating clinical translation.
5.An excerpt of APASL clinical practice guidelines on the management of chronic hepatitis B infection: A 2026 update
Shi LIU ; Wanying LIANG ; Jianlu WANG ; Yidan CHEN ; Jinghua CHEN ; Jian SUN
Journal of Clinical Hepatology 2026;42(7):1561-1567
On June 27, 2026, the Asian Pacific Association for the Study of the Liver (APASL) released updated management guidelines for chronic HBV infection, which systematically elaborates on screening, vaccination, antiviral treatment, and hepatocellular carcinoma surveillance and other aspects in 13 key areas, and provides comprehensive recommendations. This article summarizes and makes an excerpt of the key recommendations from the updated guidelines.
6.Current status and prospects of perioperative depression, anxiety and related interventions in lung cancer patients
Xinyu YUAN ; Zijian XU ; Nengke LIN ; Zhiming CHEN ; Zhizhi WANG ; Jiansong XU ; Jinyu CHEN ; Shaobin LI ; Siyang FENG ; Di LU ; Kaican CAI
Chinese Journal of Clinical Thoracic and Cardiovascular Surgery 2026;33(09):1388-1394
Psychological problems are significant factors that contribute to the occurrence of postoperative complications, reduced quality of life, and prolonged hospital stays. Lung cancer patients who require surgery often experience high psychological stress related to both the disease and the treatment, making them more susceptible to depression and anxiety. Therefore, timely intervention to address these psychological issues is crucial for promoting postoperative recovery and improving patients' quality of life. This paper will review the current status, impact, and interventions for depression and anxiety-related psychological problems in lung cancer surgery patients.
7.Patient guideline for non-pharmacological management of core symptom clusters in lung cancer patients undergoing chemotherapy
Ruiqi XI ; Lil ZHANG ; Lin XIAO ; Benxiang ZHU ; Qi QIAN ; Yuanyuan LUO ; Jingxia MIAO ; Peijuan CHEN
Chinese Journal of Clinical Thoracic and Cardiovascular Surgery 2026;33(10):1515-1526
Objective Patients with lung cancer often experience interrelated symptoms such as fatigue, pain, and sleep disturbances during chemotherapy, forming a core symptom cluster that significantly impacts daily functioning, treatment experience, and quality of life. Currently, evidence on non-pharmacological management of this core symptom cluster is scattered, and there is a lack of standardized, patient- and caregiver-friendly guidance tools that are easy to understand and implement. This patient guideline aims to provide decision support for self-management of the core symptom cluster in patients undergoing chemotherapy for lung cancer. Methods Guided by evidence-based methodology, qualitative interviews and on-site questionnaire surveys were conducted to identify the health-related needs of stakeholders. Domestic and international guideline websites, relevant professional association websites, and comprehensive databases were systematically searched according to the inclusion and exclusion criteria. The included literature was evaluated for quality, and recommendations were extracted, integrated, and graded to form a summary of the best evidence. Based on the identified health issues and evidence summary, preliminary recommendations for the patient guideline were developed. The recommendations were then revised through two rounds of Delphi expert consultation, and consensus was reached on the strength of recommendations, forming the final version of the patient guideline. Results The patient guideline covered four major sections: screening and assessment of core symptom clusters, daily management, intervention measures, and timing of referral. The core content included nine aspects: screening of core symptom clusters, assessment, lifestyle habits, dietary interventions, sleep environment, exercise interventions, psychological interventions, Traditional Chinese Medicine interventions, and referral indications. In total, the guidelines addressed 16 health issues and provided 25 recommendations. Conclusion The development process of this patient guideline is rigorous and fully considered the needs of patients. Expert review concludes that the recommendations are highly feasible and appropriate.
8.Chinese medical and pharmaceutical expert consensus on the clinical application of romosozumab
Liqian MO ; Zefu CHEN ; Huiyi WU ; Ping ZHENG ; Zhongmin ZHANG ; Yilei LI
China Pharmacy 2026;37(20):2640-2646
OBJECTIVE To standardize the rational clinical use of romosozumab in China, define suitable patient populations, optimize full-course treatment strategies, and strengthen medication risk management.METHODS This consensus was initiated by the Pharmacy Administration Committee of Guangdong Province Hospital Association and registered on the International Practice Guidelines Registry Platform. Twenty-five experts in pharmacy and orthopedics were organized to identify 7 core clinical questions through 2 rounds of questionnaires and seminars. Chinese and English databases were systematically retrieved, and the Grading of Recommendations Assessment, Development and Evaluation approach was used to assess evidence quality and recommendation strength and to formulate consensus recommendations, which were refined based on expert review.RESULTS Seven recommendations were developed, covering the applicable populations of romosozumab, sequential and switching therapy, and management of fractures and cardiovascular risk during treatment. The pharmaceutical characteristics of romosozumab, as well as other key points for clinical application, including efficacy monitoring, management of missed doses, contraindications, major adverse reactions, and medication adherence, were also summarized.CONCLUSIONS This consensus provides evidence-based guidance and practical reference for the safe, effective, and standardized use of romosozumab in Chinese patients, which may facilitate individualized treatment of patients with osteoporosis at high fracture risk and reduce fracture risk.
9.Development of a smartphone-integrated handheld automated biochemical analyzer for point-of-care testing of urinary albumin
Ze WU ; Peng ZHANG ; Wei XIAO ; Qian CHEN ; Wangrun LIN ; Peipei CHEN ; Kangwei CHEN ; Qiangqiang FU ; Zhijian WANG ; Lei ZHENG
Journal of Pharmaceutical Analysis 2025;15(3):577-584
The level of urinary albumin is a critical indicator for the early diagnosis and management of chronic kidney disease(CKD).However,existing methods for detecting albumin are not conducive to point-of-care testing due to the complexity of reagent addition and incubation processes.This study presents a smartphone-integrated handheld automated biochemical analyzer(sHABA)designed for point-of-care testing of urinary albumin.The sHABA features a pre-loaded,disposable reagent cassette with re-agents for the albumin assay arranged in the order of their addition within a hose.The smartphone-integrated analyzer can drive the reagents following a preset program,to enable automatic sequential addition.The sHABA has a detection limit for albumin of 5.9 mg/L and a linear detection range from 7 to 450 mg/L.The consistency of albumin level detection in 931 urine samples using sHABA with clinical tests indicates good sensitivity(95.78%)and specificity(90.16%).This research advances the field by providing an automated detection method for albumin in a portable device,allowing even untrained individuals to monitor CKD in real time at the patient's bedside.In the context of promoting tiered diagnosis and treatment,the sHABA has the potential to become an essential tool for the early diagnosis and comprehensive management of CKD and other chronic conditions.
10.The Role of Complement in MHC Class I Antibody-mediated Transfusion-related Acute Lung Injury
Ze ZHANG ; Dawei CHEN ; Jiansen HE ; Hanshen YE ; Yongshui FU
Journal of Sun Yat-sen University(Medical Sciences) 2025;46(6):1006-1014
ObjectiveTransfusion-Related Acute Lung Injury (TRALI) is a common fatal transfusion adverse reaction. Major Histocompatibility Complex (MHC) class I is an important factor involved in the pathogenesis of TRALI; however, the role of complement in itspathogenesis has not been fully elucidated. This study aims to explore the role of complement in MHC class I antibody-mediated TRALI, so as to provide a theoretical basis for clinical prevention and treatment. MethodsThis study established a murine model of transfusion-related acute lung injury (TRALI) based on the "two-hit" theory, with lipopolysaccharide (LPS) as the first hit and MHC class I antibody as the second hit. Male Balb/c mice were randomly divided into seven groups (n=5 per group per experiment): Naive (blank control), LPS (first hit only), Isotype (isotype antibody control), TRALI (model group), C5aR1 inhi (C5aR1 antagonist intervention), C5aR2 inhi (C5aR2 antagonist intervention), and Anti-C5 (anti-complement C5 antibody intervention). Rectal temperature was monitored after MHC class I antibody injection. After sample collection, the severity of pulmonary edema was assessed by measuring the lung wet-to-dry weight ratio, histological analysis, and immunohistochemistry. Serum and bronchoalveolar lavage fluid were collected to measure cytokine and complement levels. ResultsMice in the TRALI group exhibited a significant decrease in rectal temperature, an increased lung wet-to-dry weight ratio, elevated serum cytokine levels, and markedly heightened complement C5a levels in bronchoalveolar lavage fluid (P<0.000 1). Histopathological examination revealed substantial infiltration of inflammatory cells, predominantly neutrophils accompanied by fewer lymphocytes, plasma cells, and monocytes, along with increased deposition of the membrane attack complex C5b-9 in lung tissues. In contrast, mice treated with anti-C5 antibody demonstrated no significant decrease in rectal temperature. The lung wet-to-dry weight ratio in this group showed no statistical difference compared to either the Naive or Isotype control groups (P>0.05). Furthermore, these mice displayed reduced serum cytokine levels, a significant attenuation of inflammatory cell infiltration in the lungs, and a 100% survival rate at the 2-hour time point. However, mice administered either the C5aR1 antagonist or the C5aR2 antagonist failed to be protected and subsequently developed TRALI. ConclusionComplement activation, which forms the membrane attack complex C5b-9, plays a critical role in MHC class I antibody-mediated TRALI. Blocking complement C5 activation can effectively prevent the occurrence of TRALI.

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