Chinese Medical Sciences Journal

Quick Entry

Submission
Guide for Authors
Peer Review
Editorial Office

Latest Articles
Articles in Press
Achives

Volume 41 Issue 2，2026

Research Article
A predictive model for heart failure in patients with hypertension and persistent atrial fibrillation: A retrospective single-center study

Wang Qun-Yuan, Pan Cui-Ping, Zou Yu-Ting, Bai Jia-Qi, Zhang Ming-Lei, Liu Yi-Ning, Jin Yu-Feng, Li Rui-Zhe, Li Zong-Bin

Vol. 41, Issue 2, Pages: 55-61(2026) DOI: 10.1016/j.cmsj.2026.07.001

Abstract：Objective: This study aimed to develop and validate a predictive nomogram for heart failure in patients with hypertension and persistent atrial fibrillation (HT-PeAF). Methods: We retrospectively analyzed clinical data from patients with HT-PeAF hospitalized at Chinese People's Liberation Army General Hospital between 2010 and 2019. Predictive variables were selected based on multivariable logistic regression analysis and clinical relevance, which were then incorporated into a clinical nomogram. Model performance was evaluated using the area under the receiver operating characteristic curve (AUC) for discrimination, the Hosmer-Lemeshow test for calibration, and decision curve analysis for clinical utility. Results: Of the 395 enrolled patients, 151 experienced heart failure. Nine predictive variables were identified: prior catheter ablation, low-density lipoprotein cholesterol, hemoglobin, uric acid, creatinine, total bilirubin, fasting blood glucose, red blood cell distribution width, and coronary artery disease. The nomogram demonstrated good discriminative ability (AUC = 0.77, 95% CI : 0.72-0.81), good calibration (P = 0.44), and favorable clinical utility. Conclusion: This accessible tool facilitates individualized risk stratification for heart failure in HT-PeAF patients, though prospective validation in multicenter Asian cohorts is warranted.
Keywords：hypertension;Persistent atrial fibrillation;heart failure;risk factors;nomogram

6

|

1

|

0

<HTML>
<L-PDF>

<Citation> <Bulk Citation> 171246876 false

Updated：
Research Article
Global epidemiological and indirect economic burden of neurological, mental, and substance use disorders: An analysis based on the global burden of disease data

Tao Rong-Shan, Sun Zhi-Hong, Long Rui-Yu

Vol. 41, Issue 2, Pages: 62-71(2026) DOI: 10.1016/j.cmsj.2026.08.002

Abstract：Objective: To evaluate the global disease burden and indirect economic costs of neurological, mental, and substance use disorders (NMSDs) from 1990 to 2023. Methods: This study analyzed data on incidence, prevalence, and disability-adjusted life years (DALYs) for NMSDs using data from the Global Burden of Disease 2023 database. Joinpoint regression analysis was used to calculate average annual percentage change. Spearman correlation was applied to examine the association between age-standardized rates and socio-demographic index (SDI). The indirect economic burden was estimated using the human capital approach, incorporating age-adjusted productivity weights and gross domestic product (GDP) per capita. Results: From 1990 to 2023, the absolute numbers of incident cases, prevalent cases, and DALYs for NMSDs increased substantially, with DALYs for neurological and mental disorders approximately doubling. Age-standardized rates demonstrated divergent trends across disease categories. For mental disorders, the age-standardized incidence, prevalence, and DALY rates increased by 15.00%, 24.00%, and 29.00%, respectively, with the overall burden rising markedly in 2019. In contrast, while the overall burden of substance use disorders declined, a notable exception emerged in high-income North America, where rising rates were observed specifically for opioid and cocaine use disorders. The burden of neurological and mental disorders was higher in females than in males, whereas substance use disorders showed the opposite pattern. The age-standardized DALY rate for motor neuron disease exhibited a significant positive correlation with SDI (ρ_s = 0.82, P ＜ 0.001). The indirect economic burden and its share of GDP increased in most countries, while the share for substance use disorders in China declined by 46.19%. Conclusion: The disease burden and economic costs of NMSDs increased globally from 1990 to 2023, with significant geographic, national, and demographic disparities. These findings highlight an urgent need for targeted resource allocation and integrated interventions.
Keywords：Neurological disorders;Mental disorders;Substance use disorders;Global burden of disease;Indirect economic burden;Disability-adjusted life years

9

|

1

|

0

<HTML>
<L-PDF>

<Citation> <Bulk Citation> 171246904 false

Updated：
Research Article
Continuous wound infiltration with local anesthetics in adult patients undergoing cardiac surgery: A PRISMA-compliant systematic review and meta-analysis

Yao Yun-Tai, More Aditya, Chao Mark, Huang Shuo

Vol. 41, Issue 2, Pages: 88-98(2026) DOI: 10.1016/j.cmsj.2026.07.003

Abstract：Background: Effective postoperative analgesia is critical to recovery after cardiac surgery. Continuous wound infiltration (CWI) with local anesthetics (LAs) has been proposed as an opioid-sparing adjunct, but its efficacy beyond pain control and its safety profile remain incompletely defined. Methods: We conducted a PRISMA-compliant systematic review and meta-analysis of randomized controlled trials (RCTs) comparing CWI with control in adult cardiac surgery. PubMed, Embase, and Cochrane CENTRAL were searched from inception to August 30, 2025, and updated on April 2, 2026. Primary outcomes were postoperative Visual Analogue Scale (VAS) pain scores and cumulative morphine consumption. Secondary outcomes included mechanical ventilation duration, length of stay, mortality, complications, patient satisfaction, and adverse events. Risk of bias was assessed using the Cochrane RoB 2.0 tool, and certainty of evidence was evaluated using Grading of Recommendations Assessment, Development and Evaluation (GRADE). Results: Twelve RCTs involving 2,117 patients were included. CWI significantly reduced VAS during mobilization at 24 h (MD = -0.93, 95% confidence interval [ CI]: -1.53--0.33, P = 0.002) and 48 h (MD = -0.80, 95% CI: -1.17--0.44, P ＜ 0.001), and decreased 48-hour morphine consumption (MD = -8.10 mg, 95% CI: -13.41--2.79, P = 0.003). No significant effects were observed on VAS at rest, mechanical ventilation duration, ICU or hospital length of stay, mortality, or major cardiovascular, pulmonary, renal, gastrointestinal complications, or postoperative infections. Patient satisfaction was higher with CWI. Technical complications were uncommon, and no clinically significant LA toxicity was reported. Conclusions: In adult cardiac surgery, CWI with LAs modestly improves analgesia during mobilization and reduces opioid requirements without clear improvement in major clinical outcomes or length of stay. CWI appears safe and feasible and may serve as an adjunct in multimodal, opioid-sparing analgesia strategies. Further adequately powered trials are warranted to define its comparative effectiveness within contemporary enhanced recovery after surgery pathways.
Keywords：cardiac surgery;Continuous wound infiltration;Local anesthetics;meta-analysis;Opioid-sparing analgesia;postoperative pain

7

|

1

|

0

<HTML>
<L-PDF>

<Citation> <Bulk Citation> 171246923 false

Updated：
Review Article
Gu Fangzhou: A monument to polio elimination in China

Huang Fu-Min, Chai Rong, Liu Hai-Sheng, Wang Yun-Feng, Tang Guo-Xing, Liu Jing

Vol. 41, Issue 2, Pages: 72-75(2026) DOI: 10.1016/j.cmsj.2026.07.002

Abstract：Commemorating the centenary of Professor Gu Fangzhou's birth, this memorial article documents his landmark contributions to eliminating poliomyelitis in China. It details his strategic prioritization of the live attenuated oral polio vaccine (OPV) and his team's breakthroughs in overcoming logistical hurdles through the sugar-coated pill formulation and mass immunization campaigns. Furthermore, the review highlights his development of diagnostic reagents and a national surveillance network, which culminated in China's polio-free certification in 2000. Ultimately, the paper honors Professor Gu's legacy as a trailblazing scientist, demonstrating how his low-cost, high-efficiency research model provided a replicable template for global polio eradication and laid the institutional foundation for China's modern public health system.
Keywords：Gu Fangzhou;Poliomyelitis;Polio vaccine;Polio-free certification;Public health

4

|

1

|

0

<HTML>
<L-PDF>

<Citation> <Bulk Citation> 171065274 false

Updated：
Review Article
Post-traumatic dementia: Advances in understanding neurodegenerative mechanisms

He Xiao-Jie, Wang Hui, Zhang Yi

Vol. 41, Issue 2, Pages: 76-83(2026) DOI: 10.1016/j.cmsj.2026.08.001

Abstract：Traumatic brain injury can trigger long-term neurodegenerative diseases beyond its devastating acute effects. This narrative review summarizes current understanding of the neurodegenerative mechanisms underlying posttraumatic dementia. Core mechanisms involve multiple pathophysiological processes: long-term dysfunction of the blood-brain barrier, which impairs the clearance of toxic proteins; diffuse axonal injury, leading topersistent disruption of axonal transport, dysregulation of calcium homeostasis, and Wallerian-like degeneration; and the abnormal deposition of key pathological proteins such as amyloid- β, hyperphosphorylation and propagation of tau protein, and dysfunctional TAR DNA-binding protein-43, all of which disrupt protein homeostasis. In addition, chronic neuroinflammation mediated by microglia and astrocytes acts as a critical link, continuously exacerbating synaptic damage and neurodegeneration through the release of pro-inflammatory factors. Genetic factors, such as the APOE4 allele, can significantly amplify these pathological processes. Collectively, this evidence indicates that traumatic brain injury is not an isolated acute event but rather initiates and accelerates a long-term, multifactorial neurodegenerative cascade, ultimately resulting in cognitive dysfunction. These insights provide important targets for the development of targeted intervention strategies.
Keywords：traumatic brain injury;Dementia;Blood-brain barrier;Axon;neuroinflammation

2

|

1

|

0

<HTML>
<L-PDF>

<Citation> <Bulk Citation> 171065739 false

Updated：
Review Article
Dedication to a lifelong mission: Gu Fangzhou and the Chinese road to polio elimination

Wu Jun, Zhao Yuan, Liu Yi-Fan

Vol. 41, Issue 2, Pages: 84-87(2026) DOI: 10.1016/j.cmsj.2026.08.003

Abstract：This paper reviews Professor Gu Fangzhou's contributions to polio control and elimination in China. Following the 1955 polio outbreak, he advocated for the live oral polio vaccine (OPV) route tailored to national conditions. To validate vaccine safety, he initiated human trials by testing the vaccine on himself and his infant son. He led the construction of the domestic OPV production base and pioneered the sugar-coated pill formulation to overcome cold chain constraints, ultimately facilitating the nationwide elimination of indigenous wild polioviruses by 1994. Furthermore, he established China's OPV production and quality control standards and trained numerous public health professionals.
Keywords：Gu Fangzhou;Polio;Sugar pill vaccine;Live oral polio vaccine;Public health;People's scientist;medical education

4

|

1

|

0

<HTML>
<L-PDF>

<Citation> <Bulk Citation> 171065754 false

Updated：