Latest Issue

    Volume 40 Issue 4 2025

      Guideline & Consensus

    • Reporting on the latest advancements in gastric cancer screening, China is making strides with the development of a high-quality screening system tailored to its national conditions. Gastric oral contrast ultrasonography (OCUS) emerges as a promising, non-invasive screening tool, offering a painless and radiation-free alternative. This document, based on two 2020 OCUS consensuses, analyzes national gastric cancer screening strategies and challenges, detailing the key aspects of OCUS, including indications, contraindications, operator requirements, contrast agent standards, and essential scanning protocols. It introduces the standardized ultrasound sections and the Stomach Ultrasound Report and Data System (Su-RADS), proposing 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, aiming to standardize the popularization of OCUS. The consensus also 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.
      Gastrointestinal Ultrasound Section, Ultrasound Medicine Specialized Committee of National Health Commission Capacity Building and Continuing Education, National Major Chronic Disease Prevention and Control Innovation and Integration Pilot Project Management Committee, Gastrointestinal Ultrasound Collaborative Group, Institute of Ultrasound Medicine, Tongji University, Gastrointestinal Ultrasound Section, Ultrasound Specialized Committee, China Medical Education Association, Gastrointestinal Ultrasound Expert Committee, Chinese Ultrasound Medicine Training Project, Abdominal Specialized Committee, Chinese Association of Ultrasound in Medicine and Engineering, Ultrasound Medicine Branch of Sino-Japan Medical Science and Technology Exchange Association, Gastrointestinal Ultrasound Branch of Beijing Association of Holistic Integrative Medicine, Ultrasound Medicine Branch of China National Health Association, Chinese Anti-Cancer Association Science Popularization Committee, Ultrasound Medicine Branch of Cross-Straits Medicine Exchange Association, Engineering Research Center of Digestive Endoscopy, Minimally Invasive Diagnostic and Therapeutic Technologies, Ministry of Education
      Vol. 40, Issue 4, Pages: 237-252(2025) DOI: 10.24920/004548
      Abstract: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.  
      Keywords:oral contrast ultrasonography;gastric cancer screening;gastric contrast-enhanced ultrasound;gastric filling ultrasound;contrast agent;Stomach Ultrasound Report and Data System;expert consensus   
      14
      |
      5
      |
      0
      <HTML>
      <L-PDF>
      <Citation> <Bulk Citation> 144369476 false
      Updated:2025-12-31

      Think Tank Forum

    • Standardizing Healthcare Datasets in China: Challenges and Strategies AI Introduction

      In the field of healthcare informatization, this study introduces its research progress. It examines China's healthcare dataset standards from 2011 to 2025, analyzing their evolution and highlighting key achievements and challenges. The study proposes a multi-faceted strategy to optimize the standard system's architecture, enhance quality and implementation, and advance data governance and intelligent service provision, laying a foundation for the construction of a robust healthcare dataset standard system.
      Zheng-Yong Hu, Xiao-Lei Xiu, Jing-Yu Zhang, Wan-Fei Hu, Si-Zhu Wu
      Vol. 40, Issue 4, Pages: 253-267(2025) DOI: 10.24920/004520
      Standardizing Healthcare Datasets in China: Challenges and Strategies
      Abstract: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.  
      Keywords:healthcare;dataset standards;data standardization;data management   
      53
      |
      45
      |
      0
      <HTML>
      <L-PDF>
      <Citation> <Bulk Citation> 139313730 false
      Updated:2025-12-31

      Commentary

    • Openness to Others: The Task of Translating Palliative Carefor China AI Introduction

      In the field of xxx, expert xx has made significant research progress. By establishing the xx system/exploring the xx topic/verifying the xx conjecture, xx has provided solutions to solve xx problems/open up a new direction for xx research/lay a foundation for the construction of the xx system.
      Eric L. Krakauer
      Vol. 40, Issue 4, Pages: 268-270(2025) DOI: 10.24920/004527
        
      22
      |
      6
      |
      0
      <HTML>
      <L-PDF>
      <Citation> <Bulk Citation> 143119494 false
      Updated:2025-12-31

      Research Article

    • In a cross-sectional study at Peking Union Medical College Hospital, nearly two-thirds of outpatients with chronic cancer pain were found to have chronic neuropathic cancer pain. The study identified associations with bone metastasis, radiotherapy, and voiding dysfunction, which may aid in early recognition and support the adoption of multimodal pain management strategies.
      Bo-Ru Yuan, Chen Sun, Mo-Han Li, Si Chen, Lu-Lu Ma, Li-Jian Pei
      Vol. 40, Issue 4, Pages: 271-281(2025) DOI: 10.24920/004542
      Associated Factors for Chronic Neuropathic Cancer Pain in Outpatients From Pain Clinic: A Perspective Cross-Sectional Study
      Abstract:ObjectiveTo 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.MethodsIn 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.ResultsOf 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.ConclusionsCNCP 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.  
      Keywords:chronic cancer pain;neuropathic pain;outpatients;bone metastasis;voiding dysfunction;radiotherapy   
      37
      |
      5
      |
      0
      <HTML>
      <L-PDF>
      <Citation> <Bulk Citation> 143357501 false
      Updated:2025-12-31
    • Reporting on the latest research, the study delves into the temporal trends of autism spectrum disorder (ASD) in China from 1990 to 2021, utilizing data from the Global Burden of Disease 2021. The research employs advanced statistical methods such as join-point regression, age–period–cohort analysis, and ARIMA modeling to project the future burden of ASD to 2036. The findings reveal a rising ASD burden, significantly influenced by demographic shifts and epidemiological changes, with young children and males being disproportionately affected. This underscores the need for early detection and gender-sensitive interventions.
      Min Li, Zi-Yan Meng, Qing Li, Jun-Tao Yang, Kai-Yuan Min, Zhi-Min Hu
      Vol. 40, Issue 4, Pages: 282-294(2025) DOI: 10.24920/004535
      Autism Spectrum Disorders in China: An Analysis of Temporal Trends in Prevalence, Incidence, and DALYs (1990–2021) Based on GBD 2021 Data
      Abstract:ObjectiveTo 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.MethodsData 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.ResultsBetween 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.ConclusionsThe 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.  
      Keywords:Autism spectrum disorder;Disease burden;China   
      28
      |
      7
      |
      0
      <HTML>
      <L-PDF>
      <Citation> <Bulk Citation> 143947119 false
      Updated:2025-12-31

      Review Article

    • Pelvic Floor Dysfunction Databases: Evolution, Current Landscape, and Future Development AI Introduction

      In the field of pelvic floor dysfunction, experts systematically review the development stages of PFD-related databases and conduct comparative analysis of international and domestic platforms. The findings provide solutions to strengthen data infrastructure and guide future directions, laying a foundation for the construction of PFD database systems.
      Jing-Yu Zhang, An-Ran Wang, Shuo Liang, Hong-Hui Shi, Lan Zhu, Si-Zhu Wu
      Vol. 40, Issue 4, Pages: 295-308(2025) DOI: 10.24920/004516
      Pelvic Floor Dysfunction Databases: Evolution, Current Landscape, and Future Development
      Abstract: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.  
      Keywords:pelvic floor dysfunction;disease registry;database;data platform;disease research   
      50
      |
      39
      |
      0
      <HTML>
      <L-PDF>
      <Citation> <Bulk Citation> 135814897 false
      Updated:2025-12-31

      Case Report

    • Reporting on the latest medical research, Adamantinoma-like Ewing sarcoma (ALES), a rare variant of Ewing sarcoma, has been studied in three new cases. The research, which provides solutions to accurately diagnose ALES and identify potential therapeutic targets, underscores the diagnostic challenge of ALES and highlights the necessity of comprehensive molecular profiling.
      Xiang-Nan Gou, Xia Tian, Feng-Wei Zhu, Zhi-Gang Song
      Vol. 40, Issue 4, Pages: 309-314(2025) DOI: 10.24920/004531
      Adamantinoma‑like Ewing Sarcoma of Head and Neck: A Clinicopathologic Study of Three Cases Including One <italic style="font-style: italic">EWSR1</italic>-Negative Case with <italic style="font-style: italic">NF1</italic> Mutation
      Abstract: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.  
      Keywords:adamantinoma-like Ewing sarcoma;head and neck;parotid gland;nasal cavity;NF1;next generation sequencing   
      31
      |
      4
      |
      0
      <HTML>
      <L-PDF>
      <Citation> <Bulk Citation> 144369576 false
      Updated:2025-12-31
    • In the field of elderly hip arthroplasty care, a comprehensive hospital-home-community management model was explored, which provides a replicable framework for the postoperative management of elderly surgical patients.
      Jing-Han Ai, Chao Huang, Jing-Jin Luo
      Vol. 40, Issue 4, Pages: 315-326(2025) DOI: 10.24920/004485
      A Case Study of Comprehensive Postoperative Management for Elderly Total Hip Arthroplasty Patients Based on Peplau's Interpersonal Relationship Theory
      Abstract: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.  
      Keywords:Peplau's interpersonal relationship theory;total hip arthroplasty;elderly;comprehensive management   
      35
      |
      19
      |
      0
      <HTML>
      <L-PDF>
      <Citation> <Bulk Citation> 139313709 false
      Updated:2025-12-31
    0