Table of Content

20 September 2026, Volume 29 Issue 27

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Guidelines·Consensus·Interpretation

Interpretation of the BMJ Living Clinical Practice Guideline on Pharmacological Management of Type 2 Diabetes Based on Cardiovascular-renal Event Prevention and Weight Management

QU Furong, JIN Jiaqi, XUE Guijun, LYU Qingguo, LI Zhipeng, LI Jing, LI Sheyu

2026, 29(27):  3873-3878.  DOI: 10.12114/j.issn.1007-9572.2026.0097

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In August 2025, the BMJ published the Living Clinical Practice Guideline on the Effects of Pharmacological Agents for Type 2 Diabetes on Cardiorenal Outcomes and Weight Management. Compared with the 2021 version, three changes matter most for general practitioners: the guideline has become living and will be iteratively updated; finerenone and tirzepatide have been added; and risk stratification has been simplified from five to three strata with obesity incorporated into decision making. Importantly, the inclusion of finerenone indicates that treatment decisions in type 2 diabetes should focus on patient-important cardiovascular, kidney, and weight outcomes rather than glucose lowering alone. The accompanying visual evidence summaries and the Multiple and Treatment Comparison Health Intervention Tool (MATCH-IT) can help general practitioners intuitively present the absolute benefits, absolute risks, and treatment burden of different drugs to patients. Focusing on the primary care setting in China, this article interprets the clinical value of the living guideline, the rationale for incorporating finerenone into diabetes management guidelines, and the understanding and application of the new risk stratification in general practice outpatient settings.

Management of Cardiovascular Metabolic Risks in Obese Children and Adolescents in China: Based on the 2024 Italian Society of Pediatric Endocrinology and Diabetes Position Paper on Cardiometabolic Risk in Children and Adolescents with Obesity

ZHANG Ying, TANG Yijun, LIU Lidi, JIANG Lihua, JIA Yu, YANG Rong, YANG Ziyu, LIAO Xiaoyang

2026, 29(27):  3879-3887.  DOI: 10.12114/j.issn.1007-9572.2025.0118

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Childhood and adolescents obesity is a critical global public health challenge, posing immediate health risks and increasing the risk of cardiometabolic diseases in adulthood. In 2024, the Italian Society for Pediatric Endocrinology and Diabetology issued a position paper on Cardiometabolic Risk in Children and Adolescents with Obesity, offering significant guidance for the evaluation and management of cardiometabolic risk in obese children and adolescents based on the latest evidence. This article aims to interpret the core content of this document to provide references and recommendations for cardiometabolic risk management of obesity in Chinese children and adolescents.

Interpretation and Discussion of the Royal Australian College of General Practitioners (RACGP) Guidelines for Preventive Activities in General Practice: the Significance of Atrial Fibrillation Screening and Detection in General Practice

ZHANG Hanyu, CHEN Xiaonan, HUANG Yanyan

2026, 29(27):  3888-3890.  DOI: 10.12114/j.issn.1007-9572.2025.0438

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Atrial fibrillation (AF) is one of the most common clinical arrhythmias and is closely associated with serious complications such as stroke and heart failure, posing a significant burden on public health. This article combining the Australian Guidelines for Preventive Activities in General Practice (Red Book) and the Chinese Atrial Fibrillation Management Guidelines (2025), systematically compared similarities and differences in AF screening strategies, target populations, screening methods, and risk factor management between the two countries. It explored their applicability and implementation pathways within the context of general practice in China, aiming to provide references for building an general-led hierarchical AF screening and prevention system suited to China's national conditions.

General Practice/Community Health Service·Physician Development

Analysis of the Current Status of Professional Competence of Primary Care Doctors in China Based on the Iceberg Model

LI Yahui, XIE Kun, LIAN Lu, ZHANG Huaiping, CHEN Jiaying

2026, 29(27):  3891-3898.  DOI: 10.12114/j.issn.1007-9572.2025.0554

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Background

With the growing public awareness of health, residents' demand for medical and health services has increased dramatically, which in turn raises higher requirements for the service capacity of primary healthcare institutions. Strengthening the deployment of general practice talents in primary health facilities serves as an effective way to meet the basic health needs of residents.

Objective

Based on the iceberg model, this study analyzes the current status and interrelationship between the explicit and implicit competencies of primary care doctors in China, and identifies existing problems.

Methods

In August 2020, a multistage stratified cluster sampling method combined with typical sampling was adopted. First, the country was divided into eastern, central, and western regions according to the gradient distribution of socioeconomic development levels. Sample provinces and prefecture-level cities were selected from each region, and one district and one county (or county-level city) were chosen from each sample city as urban and rural survey sites. An online questionnaire survey was conducted among 8 537 primary care doctors. Differences in explicit and implicit competency levels between urban and rural areas, as well as across the eastern, central, and western regions, were compared. A negative binomial regression model was used to analyze the association between implicit and explicit competency levels.

Results

A total of 8 469 valid questionnaires were collected, yielding an effective response rate of 99.2%. Among the respondents, 2 863 (33.8%) were urban primary care doctors, and 5 606 (66.2%) were rural ones. In terms of regional distribution, 2 953 (34.9%) were from the eastern region, 3 200 (37.8%) from the central region, and 2 316 (27.3%) from the western region. Regarding explicit competencies, five areas with the lowest proficiency levels among primary care doctors include use of simple medical devices (4 589/8 469, 54.2%), medical coordination (4 800/8 469, 56.7%), community rehabilitation guidance (5 166/8 469, 61.0%), traditional Chinese medicine service capacity (5 613/8 469, 66.3%), and diagnosis and treatment of common diseases (6 497/8 469, 76.7%). In terms of implicit competencies, 8 167 out of 8 469 physicians (96.4%) possessed humanistic literacy, and 5 768 (68.1%) possessed learning ability. Rural primary care doctors showed higher proficiency rates in most health service competencies than their urban counterparts (P<0.05). The overall competency level of physicians in the western region was relatively low. Furthermore, implicit competencies (humanistic literacy and learning ability) were significantly and positively associated with the comprehensive level of explicit competencies (P<0.001).

Conclusion

The overall level of health service competencies among primary care doctors in China is not high and exhibits regional disparities. Notable weaknesses exist in medical services and learning capacity. Implicit competency is found to be a potential key factor in enhancing the comprehensive level of explicit competency. Therefore, it is recommended that the government strengthen the construction of the primary care workforce in the western region, promote the sharing and flow of medical resources in rural areas, accumulate practical experience, provide targeted skills training, and simultaneously focus on cultivating the intrinsic qualities of primary care doctors, thus improving the overall service capacity.

Institutional Incentives, Resource Coordination, and Team Empowerment: a Qualitative Study of the Multidimensional Dilemmas and Strategies for Gold Medal Family Doctor Team Development in Tianjin

FU Jiarui, LI Muhao, DU Yue, SHI Yu

2026, 29(27):  3899-3905.  DOI: 10.12114/j.issn.1007-9572.2025.0527

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Background

Family doctor teams are key gatekeepers of residents' health; however, their development commonly faces bottlenecks such as formalistic contracting and mismatches between capacity and resources. Tianjin has designated the development of "Gold Medal Family Doctor Teams" as a 2025 people-centered initiative, yet gaps remain between policy implementation outcomes and the original design intent, warranting a systematic diagnosis.

Objective

To systematically identify barriers to the development of Gold Medal Family Doctor Teams and propose optimization strategies.

Methods

From May 2025 to October 2025, an interview guide was developed based on relevant literature and the study objectives. Using purposive sampling, data were collected through semi-structured interviews with 20 experts, and problems were identified using the ROCCIPI framework (Rules, Opportunity, Capacity, Communication, Interest, Process, Ideology).

Results

The issues were not isolated; rather, they stemmed from three sets of underlying contradictions. At the institutional level, the decoupling of administrative recommendation from incentives undermined the credibility and value of the "gold medal" designation. At the operational level, a fixed pairing support model and fragmented information systems failed to meet real-world service needs. At the organizational level, limited team autonomy and excessive workload among members hindered substantive service delivery. These intertwined contradictions constrained the intended benchmarking role of Gold Medal teams. Accordingly, four strategies are proposed: (1) establish a developmental incentive mechanism featuring "dynamic accreditation linked to honorary recognition"; (2) build a flexible support system integrating a "specialty resource pool" with an intelligent referral platform; (3) grant teams greater autonomy supplemented with process-oriented management tools; (4) on the basis of policy standardization and public communication, explore pilot programs for paid service packages.

Conclusion

Based on the key informant evidence, this study extracts three sets of transferable contradictory structures: "Selection and Incentive" "Support and Synergy" and "Organization and Empowerment", and then constructs corresponding policy tool combinations, providing operational mechanism explanations and intervention paths for the benchmarking policy of grassroots teams from "plaque" to "quality improvement".

Development of Primary Care Traditional Chinese Medicine Workforce in China: a Policy Analysis Using the Three-dimensional "Theme-instrument-evaluation" Framework

YANG Zhaoheng, DANG Yuan, SHI Muran, LI Wenxin, ZHAO Yimo, WANG Zihan, WU Ning

2026, 29(27):  3906-3914.  DOI: 10.12114/j.issn.1007-9572.2025.0193

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Background

Primary-level traditional Chinese medicine (TCM)personnel serve as the cornerstone of China's TCM development. Strengthening this workforce is crucial for advancing the inheritance and innovation of TCM and safeguarding public health.

Objective

This study analyzes the formulation characteristics and implementation outcomes of China's primary-level TCM talent policies (2012-2024), reveals policy instrument preferences, and assesses workforce development status to optimize TCM service capacity at the grassroots.

Methods

Based on a three-dimensional "theme-instrument-evaluation" framework, we employed LDA topic modeling to analyze 47 policy documents publicly available on Chinese government websites, used NVivo coding to examine policy tool distribution, and evaluated policy implementation effectiveness using data from official sources including the National Administration of Traditional Chinese Medicine.

Results

reveal that policy themes predominantly focus on talent utilization and cultivation (combined >65%). Instrument usage exhibits a capacity-building-dominated structure (47.0%)> regulatory (23.5%)> incentive (20.2%)> informational/persuasive (9.3%), yet demonstrates structural imbalances: economic incentives constitute merely 5%, while information provision and promotion tools each account for <5%. By 2023, China's primary-level TCM workforce reached 277 000 personnel, with rural doctors proficient in TCM or TCM-Western integrated practices surging to 128 000 (significant growth since 2012). Structural challenges persist: TCM practitioners comprise only 22.6% of health personnel in corresponding institutions (below the 25% target), per-capita allocation remains inadequate, and shortages of high-caliber professionals endure despite expanded service coverage.

Conclusion

Thematic analysis confirms policy prioritizes talent utilization and cultivation. Instrument deployment reveals a "capacity-building-led, regulation-supported, incentive-supplemented" framework, with training programs, standard-setting, and non-financial incentives as dominant sub-tools. However, insufficient economic incentives and underutilized informational constrain policy effectiveness. Implementation challenges persist: imbalanced talent distribution, regional disparities, and shortages of high-caliber professionals. While systemic policy architecture exists, optimizing instrument combinations and resource allocation remains crucial to enhance the accessibility and sustainability of grassroots TCM services.

Article

Related Factors and Preventive Measures of Hyperuricemia in Elderly Men

JIANG Huajie, ZHUO Lin, LI Xinyue, JIN Rui, MA Yue, CUI Jingqiu, WANG Xiuying

2026, 29(27):  3915-3923.  DOI: 10.12114/j.issn.1007-9572.2025.0040

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Background

With the development of society, hyperuricemia (HUA) has become the "fourth high" alongside the traditional "three highs": hypertension, hyperglycemia and hyperlipidemia. As a high-risk group, the factors associated with illness in elderly men deserve attention.

Objective

To explore the associated factors and prevention and treatment strategies of hyperuricemia (HUA) in elderly men, and to provide reference for the early intervention and treatment of HUA.

Methods

A total of 7 713 elderly men who underwent physical examinations at the Xuzhou Central Hospital (Xuzhou Clinical College of Xuzhou Medical University) in 2021 were included. Baseline data, physical examination results, and laboratory test results were collected to calculate the estimated glomerular filtration rate (eGFR). Univariate analysis and multivariate Logistic regression analysis were employed to investigate the influencing factors of HUA. The IEU database (https://gwas.mrcieu.ac.uk/) was queried, and GWAS datasets from East Asian populations were utilized to examine the clustering of different serum uric acid (SUA) levels with high systolic blood pressure (SBP), high triglycerides (TG), low eGFR, and low high-density lipoprotein cholesterol (HDL-C). Mediation effect analysis was also conducted.

Results

Participants were categorized into a normal group (n=6 934) and an abnormal group (n=779) based on HUA status. Statistically significant differences were observed between the two groups regarding age, height, weight, BMI, SBP, blood urea nitrogen (BUN), serum creatinine (Scr), eGFR, total cholesterol (TC), TG, HDL-C, low-density lipoprotein cholesterol (LDL-C), and plasma viscosity (PV) (P<0.05). Multivariate Logistic regression analysis indicated that high SBP, high TG, low eGFR, and low HDL-C were risk factors for HUA (P<0.05). Chain mediation effect analysis revealed that the total effect of TG on SUA metabolism was 13.100, with a direct effect proportion of 94.37%, identifying it as the primary mechanism. Elevated TG positively predicted increased SBP (B=1.286, 95%CI=0.931-1.642) and elevated SUA (B=13.110, 95%CI=11.572-14.627), while negatively predicting renal function (B=-1.961, 95%CI=-3.102--0.820). Elevated blood pressure negatively predicted renal function (B=-0.094, 95%CI=-0.166--0.023) and positively predicted elevated SUA (B=0.240, 95%CI=0.145-0.334). Renal function negatively predicted elevated SUA (B=-0.206, 95%CI=-0.236--0.177).

Conclusion

The prevalence of hyperuricemia in elderly men is high. Blood uric acid is associated with high SBP, high TG, low eGFR and low HDL-C, SBP, TG and HDL-C lead to the increase of SUA through the damage of renal function, and eGFR decline plays a mediating role in it. Early control of hyperlipidemia and hypertension in elderly men can protect renal function. When choosing antihypertensive, lipid-lowering and SUA-lowering drugs, a comprehensive assessment of their synergistic effects on metabolism and related organ functions should be conducted, with particular attention paid to the protection of renal function.

Preliminary Application of the Novel Biomarker TANS01 in Cardiovascular Risk Assessment among Individuals with Phlegm-dampness Constitution

GUO Junchi, ZHANG Mingyan, QIN Guangning, XU Qiang, LU Meijuan

2026, 29(27):  3924-3930.  DOI: 10.12114/j.issn.1007-9572.2025.0449

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Background

Cardiovascular disease (CVD) is one of the leading causes of death worldwide, and its incidence continues to rise with the increasing prevalence of metabolic disorders. The phlegm-dampness constitution is considered a potential risk factor for CVD; however, its association with CVD has not been sufficiently validated in epidemiological studies.

Objective

This study aimed to construct a novel variable, TANS01, to characterize the phlegm-dampness constitution and to investigate its association with the risk of CVD, thereby evaluating the cardiovascular risk among individuals with phlegm-dampness constitution.

Methods

We included 15 279 participants from seven survey cycles (2003-2016) of the National Health and Nutrition Examination Survey (NHANES) database. A binary indicator, TANS01, was constructed to represent the phlegm-dampness constitution. Epidemiological analysis was conducted to investigate the potential relationship between the novel TANS01 indicator and CVD incidence. Univariate and multivariate logistic regression analyses were employed to explore the association between TANS01 and various cardiovascular outcome variables.

Results

Based on the TANS01 classification, participants were divided into a phlegm-dampness constitution group (n=6 437) and a non-phlegm-dampness constitution group (n=8 842). Statistically significant differences (P<0.05) were observed between the two groups regarding age, age groups, sex, smoking, alcohol consumption, hypertension, overweight, dyslipidemia, dietary preferences, lack of exercise, heart failure, BMI, white blood cell count (WBC), red blood cell count (RBC), hemoglobin (Hb), glycated hemoglobin (HbA_1c), fasting plasma glucose (FPG), low-density lipoprotein cholesterol (LDL-C), triglycerides (TG), aspartate aminotransferase (AST), alanine aminotransferase (ALT), uric acid (UA), and creatinine (Cr). Univariate Logistic regression analysis indicated that TANS01 was a risk factor for heart failure (OR=2.67, 95%CI=2.04-3.49, P<0.001), coronary heart disease (OR=2.04, 95%CI=1.66-2.51, P<0.001), and angina pectoris (OR=2.29, 95%CI=1.72-3.03, P<0.001). The association remained robust after adjusting for confounding factors (age, sex, smoking, and alcohol consumption) in the multivariate Logistic regression analysis. Subgroup analysis revealed that TANS01 was a risk factor for heart failure across different subgroups defined by sex, age, smoking, alcohol consumption, diabetes, and hypertension status (P<0.05), with no statistically significant difference in predictive efficacy among subgroups (P_interaction>0.05). Similarly, TANS01 was a risk factor for coronary heart disease and angina pectoris across subgroups of sex, age, smoking, and alcohol consumption (P<0.05); however, the predictive value of TANS01 for coronary heart disease and angina pectoris was not statistically significant in patients with diabetes and hypertension (P>0.05).

Conclusion

The findings of this study demonstrate a significant association between TANS01 and the risk of CVD, including heart failure, coronary heart disease, and angina pectoris. This provides epidemiological evidence supporting the phlegm-dampness constitution as a significant risk factor for CVD. Future research should further explore the underlying mechanisms of the phlegm-dampness constitution in CVD and promote its application in clinical prevention.

Comparative Analysis of Prodromal and Postdromal Symptoms in Patients with Primary Headache

DENG Danni, PU Yunling, ZHENG Yan, MAO Mei, YAO Yuanrong, HONG Feng

2026, 29(27):  3931-3937.  DOI: 10.12114/j.issn.1007-9572.2025.0508

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Background

Prodromal and postdrome symptoms are key phases in the course of primary headache disorders, offering insights into pathophysiological mechanisms and guiding early intervention. Current research has predominantly focused on migraine, while studies on prodromal and postdrome features in tension-type and cluster headaches remain limited. This study provides reference for precise clinical diagnosis and treatment through comparative analysis.

Objective

To analyze differences between prodromal and postdrome symptom profiles among patients with migraine, tension-type headache, and cluster headache.

Methods

A total of 1 202 patients with primary headache were enrolled from the Headache Center of the Department of Neurology, Guizhou Provincial People's Hospital between March 1, 2022, and February 1, 2025. Demographic and clinical data were collected, and structured questionnaires were used to gather information on prodromal and postdrome symptoms. The 1∶2∶2 nearest neighbor propensity score matching (PSM) method was used to balance the baseline differences among patients with migraine, tension type headache, and cluster headache. Chi-square tests were used to compare symptom differences between groups after matching, with Bonferroni correction applied for multiple comparisons.

Results

Among the 1 202 patients, 837 (69.6%) had migraine, 321 (26.7%) had tension-type headache, and 44 (3.7%) had cluster headache. Before matching, significant differences were observed in gender, age, education level, and current occupation across the three groups (P<0.05). After PSM, a balanced sample of 220 patients was obtained (44 with cluster headache, 88 with migraine, and 88 with tension-type headache), with no statistically significant differences in demographic characteristics (P>0.05). The male predominance in cluster headache remained unchanged after matching, and all covariates showed SMD<0.1, indicating successful baseline balancing. Migraine patients reported higher frequencies of fatigue, nausea, and photophobia/phonophobia as prodromal symptoms compared to those with tension-type headache (P<0.017). Cluster headache patients exhibited significantly higher rates of depressive symptoms during the prodrome phase than both migraine and tension-type headache patients (P<0.017). In the postdrome phase, migraine and cluster headache patients experienced higher frequencies of fatigue, difficulty concentrating, and dizziness compared to tension-type headache patients (P<0.017).

Conclusion

Migraine patients, burdened by more severe symptoms and greater functional impact, have higher healthcare utilization; their prodromal symptom profile is the most extensive, with nausea and sensory sensitivities being characteristic. Cluster headache stands out due to prominent depressive symptoms in the prodrome, and both migraine and cluster headache exhibit significantly heavier postdrome symptom burdens than tension-type headache. By adjusting for baseline confounders, this study provides a more accurate understanding of symptom profiles across different types of primary headache, offering robust evidence for comprehensive symptom management throughout the disease course.

Comparative Study on the Effects of the Computer Assisted Rehabilitation Environment System and Conventional Rehabilitation on Improving Motor Function in Children with Global Developmental Delay

ZHANG Xiaozhen, YANG Chengbo, JIN Qianhui, WANG Shuai, ZHOU Jihe

2026, 29(27):  3938-3946.  DOI: 10.12114/j.issn.1007-9572.2025.0566

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Background

Children with global developmental delay (GDD) often present with motor dysfunction, including impaired walking ability and insufficient balance control. Conventional rehabilitation has limitations in improving walking ability and balance control; therefore, more effective interventions need to be explored.

Objective

To compare the effects of Computer Assisted Rehabilitation Environment (CAREN) intervention and conventional intervention on motor function in children with GDD, and to provide evidence for optimizing rehabilitation programs.

Methods

Thirty children with GDD who received rehabilitation training at the Bayi Rehabilitation Center of Sichuan Province from July to November 2025 were enrolled. They were randomly assigned, using a random number table, to the CAREN group (n=15) and the conventional group (n=15). The conventional group received conventional intervention, including straight-line walking, grid walking and rhythmic walking, standing on a balance pad with weight shifting, obstacle crossing, and functional walking. The CAREN group received CAREN intervention, including Balloon Zoo, 2D Maze, Traffic Command, and Footstep Tracking. Both groups received 60 min of training per session, once daily, 6 days per week, for 12 consecutive weeks. Motor function was evaluated using indicators of walking and balance performance. Walking performance indicators included the Gross Motor Function Measure-88 (GMFM-88) dimensions D and E scores, 6-minute walk distance (6MWD), and spatiotemporal gait parameters. Balance performance indicators included static postural stability (PS) under four postures, namely eyes-open bipedal standing, eyes-closed bipedal standing, eyes-open tandem standing, and eyes-open single-leg standing, and dynamic balance assessed using time to stability (TS) in four directions, namely forward, backward, leftward, and rightward recovery times.

Results

Before intervention, there were no significant differences between the two groups in GMFM-88 dimensions D and E scores, 6MWD, spatiotemporal gait parameters, or balance performance indicators (P>0.05). After intervention, compared with the conventional group, the CAREN group showed higher GMFM-88 dimensions D and E scores, longer 6MWD, greater increases in step length and gait speed, a greater decrease in the percentage of stance phase and a greater increase in the percentage of swing phase, lower PS values under eyes-open bipedal standing, eyes-open tandem standing, and eyes-open single-leg standing, and shorter TS recovery times in all four directions (P<0.05). Significant differences were observed in all indicators before and after intervention in both groups (P<0.05).

Conclusion

Compared with conventional intervention, CAREN intervention may be more effective in improving motor function in children with GDD. This study provides preliminary evidence supporting the application of the CAREN system in the rehabilitation of children with GDD.

Study on the Influencing Factors of Self-management Ability of Atrial Fibrillation Patients in Rural Areas

FU Mengru, XUE Meiqiyang, JIANG Yutong, CHEN Mingsheng, QIAN Dongfu, LI Zhong

2026, 29(27):  3947-3955.  DOI: 10.12114/j.issn.1007-9572.2025.0538

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Background

Rural areas are the weak link in the prevention and treatment of heart and brain vascular diseases such as atrial fibrillation. However, there are relatively few studies on the self-management ability and influencing factors of atrial fibrillation patients in rural areas.

Objective

Based on the health ecology model, this study explores the factors influencing self-management ability and ability of each dimension among patients with atrial fibrillation, aiming to provide a basis for formulating personalized intervention strategies.

Methods

By combining convenience sampling and cluster sampling methods, a questionnaire survey was conducted among patients with atrial fibrillation in Jiangdu District of Yangzhou City and Suining County of Xuzhou City, Jiangsu Province. Based on the health ecology model, independent variables were included for single-factor analysis and multiple linear regression analysis.

Results

Among the 431 respondents, 250 were male (58.0%) and 181 were female (42.0%); the majority were aged between 70 and 79 years old, with 236 individuals (54.8%); 172 had a health score of 71 or above (39.9%); 247 had paroxysmal atrial fibrillation (57.3%); 173 had the disease duration of no more than 5 years (40.1%). The average self-management ability score for atrial fibrillation patients was (3.17±0.56) points. Among the five dimensions, the score for managing bad habits was the highest at 5.00 (1.33); followed by emotional and social management at 3.50 (1.40), medical compliance behavior management at 3.29 (1.00), anticoagulant drug management at 2.33 (2.00), and disease prevention and monitoring management at 2.00 (1.25) points. The results of the multiple linear regression analysis showed that women is a protective factor for the management of bad habits [B (95%CI)=-1.500 (-2.939 to -0.061), P<0.001], and a risk factor for anticoagulant drug management [B (95%CI)=-1.500 (-2.939 to -0.061), P=0.041]; age is a protective factor for the management of bad habits [70-79 years old: B (95%CI)=1.605 (0.670 to 2.540), P<0.001;≥80 years old: B (95%CI)=1.400 (0.339 to 2.460), P=0.010]; health status scores is a protective factor for emotional and social management [60-70 scores: B (95%CI)=1.734 (0.129 to 3.340), P=0.034;≥71 scores: B (95%CI)=3.152 (1.414 to 4.890), P<0.001] and disease prevention and monitoring management [B (95%CI)=1.803 (0.435 to 3.171), P=0.010]; longer disease duration is a protective factor for medical compliance behavior management [B (95%CI)=2.311 (0.871 to 3.751), P=0.002], and a risk factor for bad habit management [B (95%CI)=-0.859 (-1.621 to -0.096), P=0.027); multiple chronic diseases is a protective factor for medical compliance behavior management [1 chronic condition: B (95%CI)=2.349 (0.659 to 4.038), P=0.007; three over chronic conditions: B (95%CI)=2.992 (1.133 to 4.850), P=0.002]; moderate to severe anxiety and depression is a risk factor for emotional and social management [B (95%CI)=-1.504 (-2.849 to -0.159), P=0.029], and a protective factor for disease prevention and monitoring management [B (95%CI)=1.156 (0.092 to 2.221), P=0.033]; not sure if anticoagulant drugs are being used is a risk factor for self-management ability [B (95%CI)=-10.349 (-19.206 to -1.491), P=0.022], while being currently using anticoagulant drugs is a protective factor for medical compliance management [B (95%CI)=2.718 (1.292 to 4.143), P<0.001] and anticoagulant drug management [B (95%CI)=1.571 (0.107 to 3.035), P=0.036]; receiving chronic disease management services through online tools is a protective factor for medical compliance behavior management [B (95%CI)=3.235 (1.803 to 4.667), P<0.001]; a higher level of education is a protective factor for disease prevention and monitoring management [B (95%CI)=2.140 (0.323 to 3.958), P=0.021]; not seeking medical treatment due to economic reasons is a risk factor for self-management ability [B (95%CI)=-5.816 (-11.169 to -0.463), P=0.033]; doctors adjusting health management plans is a protective factor for medical compliance behavior management [B (95%CI)=1.482 (0.110 to 2.853), P=0.034], anticoagulant drug management [B (95%CI)=1.453 (0.034 to 2.872), P=0.045], and disease prevention and monitoring management [B (95%CI)=1.081 (0.103 to 2.059), P=0.030].

Conclusion

The self-management ability of rural patients with atrial fibrillation is at a medium to low level. The overall and individual dimensions of their ability are affected by multiple factors such as gender, age, health status score, disease duration, number of chronic diseases, degree of anxiety and depression, whether they use anticoagulant drugs, whether they receive chronic disease management services through online tools, educational level, whether they do not seek medical treatment due to economic reasons, and whether their health management plans are adjusted by doctors. Policy designers and service providers should comprehensively consider multiple intervention targets and construct an integrated intervention strategy in order to enhance the self-management ability and health level of rural patients with atrial fibrillation.

The Prevalence Trend and Association Rules of Chronic Disease Comorbidity among Rural Residents in Ningxia Hui Autonomous Region

ZHANG Fan, CHANG Jianhua, YANG Juan, QIAO Hui, XIE Yongxin

2026, 29(27):  3956-3968.  DOI: 10.12114/j.issn.1007-9572.2025.0185

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Background

In recent years, chronic diseases have posed a serious threat to human health, with the prevalence of chronic disease comorbidity also increasing annually. Understanding the epidemiological trends and predominant types of chronic disease comorbidity among rural residents in Ningxia Hui Autonomous Region facilitates the development of targeted public health policies and promotes the adoption of healthy lifestyles.

Objective

To examine the dynamic epidemiological trends of chronic disease comorbidity among rural residents in Ningxia Hui Autonomous Region over a 10-year period, identify influencing factors and comorbidity patterns, reveal the complex interrelationships of underlying determinants, and provide new insights for formulating chronic disease prevention and control strategies and measures.

Methods

The data for this study were derived from a merged dataset combining the Ningxia Rural Residents Health Follow-up Cohort and the National Natural Science Foundation of China project data. This dataset comprises six waves of panel data spanning 15 years. Using the disease counting method, this study selected four population cohorts from the aforementioned data spanning the 10-year period from 2015 to 2024 (2015, 2019, 2022, and 2024). Ultimately, 70 667 rural residents aged≥18 years with clearly defined key variable information were included as study subjects. Employed χ² tests and trend χ² tests to analyze the prevalence trends of chronic disease comorbidity. Based on 2024 data, utilized the Apriori algorithm to examine patterns of chronic disease comorbidity. Constructed a multifactorial Logistic regression model using variables selected from five spheres—individual traits, behavioral characteristics, interpersonal networks, living and working conditions, and policy environment—grounded in the health ecology model to analyze the determinants of chronic disease comorbidity.

Results

From 2015 to 2024, the prevalence of chronic disease comorbidity among rural residents in Ningxia Hui Autonomous Region showed a year-on-year increasing trend (P<0.05). The prevalence in 2024 [9.97% (1 599/16 045)] increased by 5.27 percentage points compared to 2015 [4.70% (977/20 775)]. Among all subgroups, the prevalence of chronic disease comorbidity showed an annual upward trend in all groups except those aged 18-<45 years and those who self-rated their health as very good (P<0.05). The Apriori algorithm yielded 20 strong association rules, of which 14 were related to hypertension, 10 were associated with cerebrovascular disease, intervertebral disc disease, and rheumatoid arthritis, and 9 were linked to cardiovascular disease. Results from the multivariable Logistic regression model indicate that the risk factors for≥2 chronic diseases and≥3 chronic diseases are largely consistent. Daily exercise duration ≥30 minutes and self-rated health as fair/very good/good serve as protective factors for both comorbidity patterns (P<0.05). Age ≥45 years, BMI ≥28.0 kg/m², and hospitalization within the past year were risk factors for both comorbidity patterns (P<0.05). Additionally, absence of depression was a protective factor for ≥2 chronic disease co-morbidities (P<0.05), while BMI between 24.0-27.9 kg/m² was a risk factor for ≥2 co-morbidities (P<0.05). Average daily sleep duration of 6-8 hours and distance to nearest healthcare facility within 1-5 km were protective factors for≥3 chronic disease co-morbidities (P<0.05).

Conclusion

The prevalence of chronic disease comorbidity among rural residents in Ningxia Hui Autonomous Region shows a marked upward trend, with hypertension being the core disease in chronic disease comorbidity. Resident chronic disease comorbidity is influenced by multiple factors including age, behavioral and lifestyle factors, and healthcare accessibility. It is recommended to focus on key diseases as entry points, strengthen health education for residents, and encourage residents to prioritize healthy behaviors and lifestyles, thereby achieving the prevention and control of chronic disease comorbidity.

Analysis of Prevalence and Influencing Factors of Cardiovascular-kidney-metabolic Syndrome among Adults in Haidian District, Beijing

LIU Zhenyu, WANG Wendong, YAO Qing, WANG Jiangmin, CAO Wendong

2026, 29(27):  3969-3975.  DOI: 10.12114/j.issn.1007-9572.2025.0416

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Background

With the changes in modern lifestyles and the acceleration of population aging, the incidence of obesity, cardiovascular diseases, chronic kidney disease, and metabolic syndrome has increased rapidly. However, research on cardiovascular-kidney-metabolic (CKM) syndrome remains relatively limited. There is an urgent need for regionally representative epidemiological studies to obtain evidence, providing data support and a theoretical basis for formulating strategies and measures for chronic disease prevention and control.

Objective

To investigate the prevalence and influencing factors of CKM syndrome in Haidian District, Beijing.

Methods

A total of 8 130 respondents from the 2024 Haidian District Adult Chronic Disease and Related Risk Factors Surveillance Program were included. Baseline data, physical examination results, and laboratory indicators were collected. Estimated glomerular filtration rate (eGFR), BMI, and urine albumin-to-creatinine ratio (UACR) were calculated. A multivariate Logistic regression model was constructed to explore the influencing factors of advanced CKM syndrome.

Results

In the overall population, the prevalence of CKM syndrome stages 0, 1, 2, 3, 4, and advanced CKM syndrome were 17.0% (95%CI=15.8%-18.3%), 22.2% (95%CI=20.8%-23.6%), 54.4% (95%CI=52.9%-55.9%), 2.8% (95%CI=2.3%-3.5%), 3.6% (95%CI=3.1%-4.1%), and 6.4% (95%CI=5.7%-7.2%), respectively. Multivariate Logistic regression analysis showed that in the total population, age groups 40-59 years (OR=4.52, 95%CI=2.18-9.38) and 60-79 years (OR=33.92, 95%CI=18.62-61.77), education level of junior high school (OR=2.02, 95%CI=1.20-3.42) and high school (OR=1.75, 95%CI=1.04-2.94), smoking (OR=1.82, 95%CI=1.40-2.37), and sleep duration >9 h (OR=1.36, 95%CI=1.04-1.78) were risk factors for advanced CKM syndrome (P<0.05). Being married (OR=0.59, 95%CI=0.42-0.85) and excessive red meat intake (OR=0.72, 95%CI=0.56-0.92) were protective factors (P<0.05). In the male population, age groups 40-59 years (OR=4.29, 95%CI=2.16-8.50) and 60-79 years (OR=26.75, 95%CI=14.24-50.23), education level of junior high school (OR=1.94, 95%CI=1.06-3.54), smoking (OR=1.81, 95%CI=1.35-2.43), and sleep duration<7 h (OR=1.70, 95%CI=1.08-2.69) were risk factors (P<0.05); excessive red meat intake (OR=0.70, 95%CI=0.54-0.91) was a protective factor (P<0.05). Among females, age group 60-79 years (OR=37.08, 95%CI=11.86-115.93) and sleep duration >9 h (OR=1.73, 95%CI=1.16-2.58) were risk factors (P<0.05); being married (OR=0.41, 95%CI=0.22-0.75) was a protective factor (P<0.05).

Conclusion

The prevalence of CKM syndrome is high among the adult population in Haidian District, Beijing. Future efforts should prioritize monitoring and intervention in high-risk groups, including the elderly, males, smokers, unmarried individuals, those with excessive sleep duration, and those with insufficient red meat intake, by developing and implementing more effective public health policies to reduce the disease burden of CKM syndrome.

Article·Drug Use Guide

Application and Mechanisms of Sodium-glucose Cotransporter 2 Inhibitors in Heart Failure with Different Etiologies: Evidence from Ischemic and Non-ischemic Heart Failure

WANG Wei, YU Fei, YAN Xiaohong

2026, 29(27):  3976-3984.  DOI: 10.12114/j.issn.1007-9572.2026.0047

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Heart failure (HF) can be classified into ischemic and non-ischemic types based on etiology, with differences in their pathological basis and remodeling patterns. Since 2019, sodium-glucose cotransporter 2 inhibitors (SGLT2i) have been shown in numerous randomised controlled trials (RCT) to reduce the risk of HF getting worse and of cardiovascular events, with benefits that are not dependent on a person's diabetic status. This article systematically reviews evidence on the consistency of SGLT2i efficacy in ischemic and non-ischemic HF, potential sources of heterogeneity, and their multi-pathway cardio-renal-metabolic mechanisms. It discusses clinical integration strategies based on research progress in Chinese populations, with a focus on the latest findings and advancements in the field. Existing RCT subgroup analyses and meta-studies collectively indicate that SGLT2i significantly reduces HF hospitalization/worsening risk in both etiological groups, with most interaction tests showing no statistical significance. At the mechanism level, cross-etiological benefits may be achieved through common terminal pathways such as decongestion and glomerular hyperfiltration correction, myocardial energy metabolism improvement, ion homeostasis and inflammatory fibrosis inhibition. In the future, it is necessary to carry out prospective studies stratified by etiology under a unified and operable etiology determination framework, combining imaging and biomarkers to promote precise treatment.

Screening Optimal Traditional Chinese Medicine Compound Formulas for ADHD Treatment: a Study Integrating Network Meta-analysis and Entropy-weighted TOPSIS Method

JIANG Yanlin, WANG Zhe, ZHAI Rui, ZHANG Mengjie, CHEN Xi, WANG Junhong

2026, 29(27):  3985-3994.  DOI: 10.12114/j.issn.1007-9572.2025.0116

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Background

The incidence of attention deficit hyperactivity disorder (ADHD) in Chinese pediatric populations has shown a marked upward trajectory in recent years. While traditional Chinese medicine (TCM) compound formulas have demonstrated distinctive advantages in ADHD treatment and related clinical research continues to expand, there remains a notable gap in comprehensive evaluations integrating multiple parameters. Current studies still fall short in conducting multi-dimensional evaluation and optimal regimen screening of TCM compound formulas by integrating indicators such as treatment duration, therapeutic efficacy, and medication frequency.

Objective

To identify optimal TCM compound formulas for treating ADHD through multicriteria decision making based on network meta-analysis (NMA) and the entropy-weighted technique for order preference by similarity to an ideal solution (TOPSIS) method.

Methods

Comprehensive literature searches were conducted across databases including CNKI, Wanfang Data, VIP, CBM, PubMed, Cochrane Library, Web of Science, and Embase to identify randomized controlled trials (RCTs) investigating TCM compound formulas for ADHD treatment. The search timeframe spanned database inception through December 20, 2024. Two researchers performed study selection and data extraction independently. Assessment of the quality of included studies was performed with the Cochrane risk of bias tool for randomized trials (ROB 2.0), while the certainty of evidence from the NMA was graded using CINeMA. NMA was conducted to derive synthesized surface under the cumulative ranking curve (SUCRA) values for both therapeutic efficacy rates and hyperactivity indices of various TCM compound formulas. Concurrently, weighted averages of intervention duration and administration frequency were calculated using original study sample sizes as weighting coefficients. These parameters were integrated to construct a multicriteria decision matrix. Objective weights for evaluation metrics were determined through entropy weighting, followed by systematic screening of optimal regimens using the TOPSIS method to resolve multi-dimensional trade-offs.

Results

A total of 27 articles were included, and 20 TCM compound regimens were identified through NMA and weighted calculations. The top-three regimens identified by entropy-weighted TOPSIS method were Ningdong Granule, Pediatric Huanglong Granule, and Longmu Anshen Granule. These regimens demonstrated superior advantages in higher clinical efficacy rates, significant reductions in hyperactivity indices, and lower dosing frequency.

Conclusion

The identified protocols, including Ningdong Granule and Pediatric Huanglong Granule, were identified as favorable treatment options due to their balanced benefits in both clinical effectiveness and time efficiency. This outcome may inform clinical decision-making in TCM compound formulas and direct future research on new drug development. Furthermore, the integration of NMA and entropy-weighted TOPSIS method introduces an innovative methodology for constructing and selecting optimized herbal interventions for ADHD.

A 10-Year Clinical Review of Raw Pinelliae Rhizoma in Tumor Treatment: Usage Patterns and Safety Evaluation

DU Ruofang, CAO Yang, LIU Dianna, ZHANG Qixin, WANG Xiaofan, SHI Enze, ZHANG Yuxin, LI Quanwang

2026, 29(27):  3995-4003.  DOI: 10.12114/j.issn.1007-9572.2025.0415

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Background

Raw Pinelliae Rhizoma (a toxic TCM decoction piece) has demonstrated confirmed therapeutic efficacy in malignant tumor treatment. However, due to its inherent toxicity characteristics, substantial controversies persist regarding its safe dosage range and standardized administration protocols, posing significant clinical challenges in balancing toxicity and efficacy.

Objective

This study aimed to investigate the clinical medication characteristics and safety of raw Pinelliae Rhizoma in the outpatient service of the Department of Oncology, Dongfang Hospital, Beijing University of Chinese Medicine, from 2012 to 2023, thereby providing evidence-based references for the standardized application of raw Pinelliae Rhizoma in medical institutions.

Methods

A retrospective collection of data from tumor patients who were prescribed formulations containing raw Pinelliae Rhizoma between 2012 and 2023 was conducted. The dataset included demographic characteristics, clinical visit records, prescription details, and liver and kidney function test results. Data integration, statistical analysis, and graphical processing were performed using Microsoft Excel, IBM SPSS Statistics 30.0, R 4.3.2, and Origin Pro 2025b.

Results

A total of 44 066 prescriptions were included, involving 11 971 tumor patients (51.91% male, 48.09% female), predominantly elderly (69.87%, 8 364/11 971). The core syndrome types included Intermingled Phlegm and Blood Stasis Syndrome, Qi-Yin Deficiency Syndrome, and Qi Stagnation-Blood Stasis Syndrome. Out of the prescriptions, 35 349 (80.22%) used a single-dosage range of 10-15 g, exceeding the recommended dosage in the Chinese Pharmacopoeia (3-9 g); meanwhile, 63.10% of patients (7 553 cases) had a treatment course of ≤30 days. The number of prescriptions containing raw Pinelliae Rhizoma showed a decreasing trend over the past decade (r=-0.964, P<0.001). Lung cancer, colorectal cancer, and breast cancer were the primary tumor types for which raw Pinelliae Rhizoma was prescribed. Taking lung cancer as the reference, esophageal cancer, liver cancer, uterine cancer, ovarian cancer, and pancreatic cancer were identified as influencing factors for the dosage of raw Pinelliae Rhizoma (esophageal cancer: B=-145.195, 95%CI=-280.686 to -9.705; liver cancer: B=-253.363, 95%CI=-400.976 to -105.751; uterine cancer: B=-866.593, 95%CI=-1 023.046 to -710.140; ovarian cancer: B=-847.736, 95%CI=-1 008.190 to -687.281; pancreatic cancer: B=-236.043, 95%CI=-423.324 to -48.762, P<0.05). Age and gender were not found to be significant factors affecting the dosage of raw Pinellia (P>0.05). Safety analysis showed that all prescriptions strictly followed the operational standard of 30-minute pre-decoction; 86 prescriptions (0.20%) had incompatibility with Aconitum species, 3 476 prescriptions (7.89%) were combined with ginger-family herbs (fresh ginger/dried ginger) for toxicity reduction, and 15 214 prescriptions (34.53%) were compatible with licorice for detoxification. Statistical analysis of liver and kidney function indicators showed no significant differences before and after treatment in the Chinese medicine monotherapy group (n=71) (P>0.05). In the combined Chinese medicine with chemotherapy/targeted therapy group (n=7), a statistically significant difference was observed in albumin (ALB) (P<0.05). In the Chinese medicine monotherapy group, there was no statistically significant difference between the dose subgroups of ≤9 g (n=21) and 10-15 g (n=48) before and after treatment (P>0.05). After excluding 754 patients who received combined chemotherapy during the treatment period, among 11 217 patients, 289 (2.58%) experienced grade 1 gastrointestinal adverse events. The incidence was 3.22% (60/1 861) in the ≤9 g group and 2.47% (229/9 255) in the 10-15 g group, with no statistically significant difference between the two groups (χ²=3.439, P>0.05). A total of 78 patients (0.70%) reported transient palpitations after medication, with an incidence of 0.75% (14/1 861) in the ≤9 g group and 0.67% (62/9 255) in the 10-15 g group. The difference between the two groups was not statistically significant (χ²=0.155, P>0.05).

Conclusion

In the Department of Oncology of this hospital, raw Pinelliae Rhizoma is commonly used for syndromes complicated by phlegm pathogens, with a typical dosage range of 10-15 g. The administered amount is adjusted based on the severity of phlegm pathogens across different cancer types. Standardized clinical administration, including strict decoction procedures (pre-decocted for 30 minutes) and rational combination with detoxifying agents (such as ginger and licorice), ensures medication safety. In this study, no significant correlation was observed between excessive use of raw Pinelliae Rhizoma or combined medication and definitive organ function impairment.The available data support that, under standardized operations, raw Pinelliae Rhizoma within the dosage range of 10-15 g has reliable safety in tumor patients, providing empirical references for its rational clinical application.

Consulting Room of General Practitioner

The Whole Course Management of Diabetic Foot Based on the Co-care Model of "Specialist-General Practitioner" Family Medicine Team Contractual Services: a Case Report and Literature Review

WANG Shujuan, FENG Xiaokai, LI Na, GAO Juan, ZHAO Jihua, LIU Yujiang

2026, 29(27):  4004-4010.  DOI: 10.12114/j.issn.1007-9572.2024.0435

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Background

As one of the serious chronic complications of diabetes, diabetic foot is characterized by high rate of disability and high burden of diseases. which require multi-disciplinary collaboration and long-term standardized management in the prevention and treatment of diseases. At present, there are many difficulties during the management of diabetic foot in all community-level medical and health care institutions, such as insufficient specialized resources and lack of continuous care.Through the analysis of a successful management path in diagnoses and treatments process of a case of type 2 diabetes patient complicated with diabetic foot, to investigate the feasibility of promoting the co-care management model based on the"Specialist-General Practitioner" family medicine team contractual services in the management of diabetic complications in community health service center.

Methods

Through combing and analyzing the whole treatment and management pathway of a diabetes foot patient under the new model of "Specialist-General Practitioner"family medicine team contractual services. we searched for relevant literature from 2004 to 2024 in the full-text journal of CNKI, Wanfang data, Vip and PubMed with the key words of "Diabetic foot, Community"in Chinese and"Diabetic foot and Management, Diabetic foot and Administration, Community diabetic foot"in English. The results showed that the new model for co-care management in diabetic foot had more obvious advantage and widespread concern than the existing community management models and contents.

Results

Under the new model of "Specialist-General Practitioner"family medicine team contractual services, the patient's gangrenous toes linked to his diabetes were preserved and the foot infection associated with diabetes was cured. Meanwhile, the patient's blood sugar, blood lipids, and blood pressure gradually reached the standard of good control. According to the document retrieval results, it is found that most of the management models for community diabetes foot at home and abroad are still in the primary stage, including community-based management model, hospital-community linkage management model, hospital-community-family management model, Internet plus hospital-community-family intelligent nursing model, self-management model, multidisciplinary teams management, telemedicine model by using computer software, smartphones, apps running on tablets, network camera and other devices, artificial intelligence prediction model for diabetes foot ulcers and multi-disciplinary integration of diabetes foot management team.

Conclusion

The co-care model based on "Specialist-General Practitioner"family medicine team contractual services got remarkable effect on the management of diabetes foot in the community. Compared to the similar models in China and abroad, this model has a simple team structure, clear division of labor among members, emphasis on individualization of services, and work more efficiently, which is worth spreading and applying in the community health service center.

A Case Report and Literature Review of Hepatocyte Nuclear Factor 4α Gene Mutation Leading to Maturity-onset Diabetes of the Young

WU Yuqiong, CHU Xiangling, HUANG Youye, SUN Li, JIANG Tian, ZHANG Qiu, HU Honglin

2026, 29(27):  4011-4015.  DOI: 10.12114/j.issn.1007-9572.2025.0123

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Maturity-onset diabetes of the young (MODY) is a distinct class of diabetes mellitus characterized by a heterogeneous group of monogenic disorders caused by genetic defects primarily affecting insulin secretion, synthesis, or action mechanisms, accounting for 1%-5% of diabetic patients. It is the most common form of monogenic diabetes. This article reports a case of diabetes diagnosed in the Department of Endocrinology and Metabolism Diseases, First Affiliated Hospital of Anhui Medical University. Genetic testing revealed a mutation in the hepatocyte nuclear factor 4α(HNF4A) gene, specifically c.334 (exon4)C>T(p.Arg112Trp), leading to a definitive diagnosis of MODY1. The diagnostic and treatment process of this case is described, along with a review of relevant literature. Given the low prevalence of MODY1, this report of a family case expands the spectrum of known HNF4A gene mutations, which may enhance clinicians' understanding of the disease. This, in turn, can promote precise diagnosis, classification, and treatment of MODY.

Review & Perspectives

Research Progress of Wearable Technology in the Diagnosis and Treatment of Mental Disorders

FENG Yachen, LIU Lewei, XUE Jinyue, SUN Xianlin, LIU Huanzhong

2026, 29(27):  4016-4025.  DOI: 10.12114/j.issn.1007-9572.2025.0239

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Wearable technology is an emerging technology field that combines miniaturized electronic devices with daily wearable items, and through the integration of sensors, microprocessors, and communication modules and other technological means, it can realize the monitoring of human physiological data, information interaction, and environment sensing and other functions. In recent years, with the continuous progress of technology, the application of wearable technology in the field of mental disorders has gradually attracted attention and shown great potential. Unlike previous studies that primarily focused on the application of wearable technology for a single mental disorder or a single function, this paper comprehensively and systematically reviews the use of wearable technology in the diagnosis, symptom assessment, and treatment of mental disorders, while also conducting an in-depth analysis of its potential advantages and challenges. Furthermore, this paper not only covers mainstream applications but also prospectively highlights innovative pathways in continuous monitoring of multidimensional physiological and behavioral indicators, constructing digital phenotypes, and implementing multimodal interventions. It aims to provide new insights for the early identification and precise intervention of mental disorders, offering references and inspiration for clinical practice and future research.

Research Progress on Cell Pyroptosis in Colorectal Cancer Transformation and Disease Development

SHI Zhiyao, GAO Yu, LIU Likun, GUO Zhi, WANG Xixing

2026, 29(27):  4026-4032.  DOI: 10.12114/j.issn.1007-9572.2025.0195

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Colorectal cancer, one of the most prevalent malignancies globally with persistently high incidence and mortality rates, poses a significant threat to human health. However, its early detection rate remains relatively low, with many patients diagnosed at intermediate or advanced stages, resulting in suboptimal treatment outcomes and prognoses. Current research predominantly focuses on surgical interventions, while studies on cellular and molecular mechanisms remain limited. With the deepening research in tumor biology, the close relationship between inflammation and tumors has gradually been revealed. As a novel programmed cell death mechanism, cellular pyroptosis has attracted significant attention in tumor immunity and microenvironment regulation. This study systematically reviews the research progress on inflammatory carcinogenesis and cellular pyroptosis in colorectal cancer, analyzing their interaction mechanisms and the role of cellular pyroptosis in disease progression. The findings indicate that chronic inflammation regulates the transformation of undifferentiated cells into cancer stem cells through cytokines and growth factors, thereby constructing a procarcinogenic microenvironment. Cellular pyroptosis, triggered by inflammatory body activation and mediated by caspase family and gasdermin family proteins, exhibits dual effects: it promotes tumor cell death while influencing the tumor microenvironment through the release of cytokines such as IL-1β and IL-18. Targeting strategies for inflammatory carcinogenesis and cellular pyroptosis demonstrate therapeutic potential. This study provides theoretical foundations at the cellular and molecular levels to understand colorectal cancer pathogenesis, lays the groundwork for developing precision-targeted therapies, and facilitates the transition of colorectal cancer treatment from surgery-focused approaches to multi-mechanism combined interventions, ultimately improving patient prognosis.