Latest Issue

    2025 Year 40 Volume 4 Issue

      指南与共识

    • 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. Expert consensus has been formed on OCUS as a preliminary screening technique, aiming to standardize its popularization. This research lays the foundation for the construction of a preliminary gastric cancer ultrasound screening system that aligns 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
      2025, 40(4): 237-252. DOI: 10.24920/004548
      Chinese Expert Consensus on the Clinical Application of Ultrasound Screening for Gastric Cancer (2025 Edition)
      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   
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      智库论坛

    • 医疗健康领域数据集标准建设:挑战与策略 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 identifying critical 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.
      胡拯涌, 修晓蕾, 张靖玉, 胡万飞, 吴思竹
      2025, 40(4): 253-267. DOI: 10.24920/004520
      医疗健康领域数据集标准建设:挑战与策略
      Abstract:在医疗健康信息化建设中,数据集标准作为基础性技术规范,对提升数据质量和释放数据要素价值至关重要。本研究基于2011—2025年我国医疗健康领域数据集标准建设历程与态势,利用文献计量与内容分析结合的方法,系统梳理了其在类型、应用、机构和主题上的演进,着重强调了所取得的关键成就:数量激增、类型优化、应用场景创新(如健康决策支持)以及参与机构拓宽。当前存在若干关键挑战,包括发展不均衡、质量控制不足以及缺乏权威数据元映射和隐私标注等基本元数据,这些问题阻碍了智能服务的交付。为应对这些挑战,本研究提出了多管齐下的策略:优化标准体系架构、提升质量与实施以及加强数据治理(权威溯源、隐私保护)和智能服务,旨在推广数据集标准的应用,从而培育并保障医疗新质生产力的发展。  
      Keywords:医疗健康;数据集标准;数据标准化;数据管理   
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      评论

    • 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 address xx problems, opening up a new direction for research and laying the groundwork for the construction of the xx system.
      Eric L. Krakauer
      2025, 40(4): 268-270. DOI: 10.24920/004527
        
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      论著

    • 门诊患者慢性神经病理性癌性疼痛相关因素分析:一项前瞻性横断面研究 Enhanced Publication AI Introduction

      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.
      袁博儒, 孙琛, 李默晗, 陈思, 马璐璐, 裴丽坚
      2025, 40(4): 271-281. DOI: 10.24920/004542
      门诊患者慢性神经病理性癌性疼痛相关因素分析:一项前瞻性横断面研究
      Abstract:目的探讨慢性癌性疼痛门诊患者中慢性神经病理性癌性疼痛(chronic neuropathic cancer pain,CNCP)的患病率、分布特征及相关临床因素,为早期识别和规范化管理提供依据。方法本横断面研究于2025年6月至10月在北京协和医院疼痛门诊连续纳入符合国际疼痛研究学会(the International Association for the Study of Pain,IASP)慢性癌性疼痛诊断标准的患者。依据神经病理性疼痛特别兴趣小组(the Neuropathic Pain Special Interest Group,NeuPSIG)诊断标准,患者凡符合四项标准中的任意一项即归入CNCP组,不论是否合并内脏痛或骨痛。通过标准化访谈收集人口学、肿瘤学及疼痛相关数据,采用绝对标准差及卡方检验或t检验比较组间基线特征差异,并采用Logistic回归分析筛选与CNCP相关的临床因素。结果共纳入138例符合条件的慢性癌性疼痛患者,其中CNCP患者85例(61.6%),非CNCP患者53例(38.4%)。骨转移(adjusted OR=2.316,95% CI:1.074~5.178,P=0.032)、放射治疗史(adjusted OR=2.489,95% CI:1.119~5.803,P=0.025)及排尿异常(adjusted OR=5.470,95% CI:2.150~16.396,P<0.001)与CNCP显著相关。胰腺癌与CNCP呈负相关(OR=0.371,P=0.031)。CNCP患者中,仅5例(3.6%)接受针对神经病理性疼痛的特异性干预,表明当前镇痛治疗仍主要依赖单一模式。结论约三分之二的门诊慢性癌性疼痛患者存在CNCP。骨转移、放射治疗史及排尿异常与CNCP相关,识别这些因素有助于早期发现神经病理性疼痛成分,并采取基于疼痛机制的多模式镇痛管理策略。  
      Keywords:慢性癌性疼痛;神经病理性疼痛;门诊;骨转移;排尿异常;放射治疗   
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    • 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 methodologies 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.
      李敏, 孟紫妍, 李青, 杨俊涛, 闵开元, 胡志民
      2025, 40(4): 282-294. DOI: 10.24920/004535
      基于GBD 2021数据的中国孤独症谱系障碍患病率、发病率及伤残调整生命年的时间趋势分析(1990—2021)
      Abstract:目的探讨1990年至2021年中国孤独症谱系障碍(autism spectrum disorder,ASD)的患病率、发病率和伤残调整寿命年(disability-adjusted life years,DALYs)的时间趋势,并预测至2036年的未来疾病负担。方法数据来源于健康指标与评估研究所(Institute for Health Metrics and Evaluation,IHME)提供的2021年全球疾病负担(Global Burden of Disease,GBD)数据。采用连接点回归估算患病率、发病率和DALYs的年变化百分比(annual percentage change,APC)。采用年龄-时期-队列分析评估年龄、时期和队列的影响。采用分解分析量化人口增长、人口老龄化和流行病学变化的贡献。采用自回归积分滑动平均(AutoRegressive Integrated Moving Average,ARIMA)模型对截至2036年的未来趋势进行预测。结果1990年至2021年间,患病率的平均年变化百分比(average annual percentage changeAAPC)为0.22%(95%不确定区间[UI]:0.20~0.24),发病率为0.07%(95%UI:–0.14~0.28),DALYs为0.23%(95%UI:0.21~0.25)。ASD患病率和DALYs在0~5岁儿童中达到峰值,并在60岁后下降。患病率和DALYs的上升主要归因于人口增长(分别为89.7%和95.2%)和流行病学变化(分别为32.6%和36.2%),而老龄化抵消了增长(分别为–22.4%和–16.0%)。预测结果显示,两性年龄标准化发病率总体保持稳定,但患病率呈现性别差异趋势,男性持续上升而女性有所下降。结论中国ASD负担呈上升趋势,主要受人口学和流行病学因素驱动,其中低龄儿童和男性受影响最为显著。应优先加强早期筛查并实施性别敏感的干预策略。  
      Keywords:孤独症谱系障碍;中国;疾病负担   
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      综述

    • 盆底功能障碍性疾病数据库的发展演进、建设模式和未来展望 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.
      张靖玉, 王安然, 梁硕, 史宏晖, 朱兰, 吴思竹
      2025, 40(4): 295-308. DOI: 10.24920/004516
      盆底功能障碍性疾病数据库的发展演进、建设模式和未来展望
      Abstract:盆底功能障碍性疾病(pelvic floor dysfunction,PFD)包括压力性尿失禁、盆腔器官脱垂和大便失禁等,严重影响女性生活质量与身心健康。随着数字医学的发展,数据的系统化收集和数据库平台的高质量建设日益成为PFD领域的核心支撑。本研究中我们系统梳理PFD数据库的发展阶段、分析对比国际与国内具有代表性的数据库在整体组织与建设模式、数据来源与整合策略、数据库主要功能、数据质控与标准应用、数据安全访问控制、数据研究应用情况等方面的异同。最后,基于PFD数据库建设的国内外研究现状,我们对我国数据建设的发展提出建议。本研究为全球PFD数据库建设优化提供借鉴。  
      Keywords:盆底功能障碍;疾病登记;数据库;数据平台;疾病研究   
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      病例报告

    • Reporting on the latest medical advancements, researchers have made significant strides in understanding Adamantinoma-like Ewing sarcoma (ALES), a rare form of cancer. The study, which involved three cases of head and neck ALES, revealed a wide range of histological features and variable immunohistochemical expressions. Notably, it identified a case with a somatic NF1 mutation but without the typical EWSR1 rearrangement, broadening the molecular understanding of ALES. This discovery underscores the diagnostic complexity and the critical need for comprehensive molecular profiling, including next-generation sequencing, to ensure accurate diagnosis and to uncover potential therapeutic targets.
      缑向楠, 田侠, 朱凤伟, 宋志刚
      2025, 40(4): 309-314. DOI: 10.24920/004531
      头颈部釉质瘤样尤因肉瘤:三例病例的临床病理研究包括一例伴有<italic style="font-style: italic">NF1</italic>突变的EWSR1阴性病例
      Abstract:釉质瘤样尤因肉瘤(adamantinoma-like Ewing sarcoma,ALES)是一种罕见的尤因肉瘤亚型,主要发生在头颈部,其特征是具有上皮分化并与其他小圆细胞肿瘤在形态学上有重叠。本文报告了三例头颈部ALES病例(两例位于腮腺,一例位于鼻腔),患者年龄为23~42岁。组织学上,肿瘤呈多种特征,包括小圆蓝细胞和基底样鳞癌形态。免疫组化方面,肿瘤细胞对CKpan、p63、CD99、NKX2.2、FLI1、CD56和Syn的表达存在差异。Ki-67增殖指数范围跨度较大,从15%到90%。值得注意的是,一例最初误诊为鳞状细胞癌的病例具有经典的EWSR1::FLI1融合。更重要的是,我们报道了首例EWSR1重排阴性但具有体细胞NF1突变的ALES病例,扩展了该疾病的分子谱。我们的研究结果强调了诊断ALES的挑战,并凸显了进行全基因组分子分析的必要性,尤其是在基因异常的病例中。这些结果有助于实现准确诊断并识别潜在的治疗靶点。  
      Keywords:釉质瘤样尤因肉瘤;头颈部;腮腺;鼻腔;NF1;下一代测序   
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    • 1例基于Peplau人际关系理论的老年全髋关节置换患者术后全流程管理 AI Introduction

      In the field of elderly hip arthroplasty nursing, a comprehensive hospital-home-community management model was explored, which provides a replicable framework for the postoperative management of elderly surgical patients.
      艾景涵, 黄超, 罗静瑾
      2025, 40(4): 315-326. DOI: 10.24920/004485
      1例基于Peplau人际关系理论的老年全髋关节置换患者术后全流程管理
      Abstract:随着接受全髋关节置换术的老年患者数量不断增长,传统护理模式面临碎片化及延续性不足的困境。基于Peplau人际关系理论,我们以1例80岁女性全髋关节置换术后患者为对象,探索建立一套医院-居家-社区的全流程管理模式。此护理模式分为认识期、确认期、进展期与解决期4个阶段,包含结构化多学科团队、阶梯式健康教育体系、基于证据的术后护理及出院准备服务。出院后对患者实施中医特色疼痛管理、智能髋关节康复训练及循证便秘管理。干预6个月后,患者伤口愈合良好,假体定位理想。疼痛、便秘、睡眠质量、焦虑程度、髋关节功能均明显改善,自理能力和自我健康管理能力明显提升。此模式构建了涵盖评估、筛选、转诊、联络、家庭访视、多学科协作及持续追踪的闭环管理体系,弥合了院内与居家护理的衔接缺口,增加了护理连续性,提高了康复效果,为老年患者术后管理提供了可复制的框架。  
      Keywords:Peplau人际关系理论;全髋关节置换;老年;全流程管理   
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