2026年 · 第106卷第27期

Just after the first month of the Year of the Horse in 2026, in the morning, I took the team to round the respiratory ward as usual. A female patient was lying in a hospital bed with a cyanotic complexion, wearing a mask to inhale oxygen, and her blood oxygen saturation was only about 85%. I remember the chief resident reported to me that the emergency department had admitted a patient with pulmonary vascular malformation with severe respiratory failure, and asked if he could take the "green channel" to admit it as soon as possible. I was busy at that time, so I casually responded, "Take it, this kind of patient needs surgery as soon as possible!" It should be the patient in front of me. In order to promote the widespread dissemination of the spirit of medical humanities, this journal will open a column of "Medical Humanities" from 2026. The author of this article narrates from the perspective of a doctor, recalls the different moods between being a doctor in his youth and being a senior medical expert now, and details the experience of treating the same patient twice after twelve years. Between the lines, it truly shows the doctor's dedicated attitude of sticking to his original intention and performing his duties, as well as the doctor's benevolence who always cares about patients and gives devotion. At the same time, it vividly reveals the patient's long-term complete trust and gratitude for the medical staff. The emotions of the article are simple and sincere, vividly outlining the sincere emotions of mutual understanding, two-way rush and warmth and mutual dependence between doctors and patients.

The 58-year-old female was admitted to the Department of Cardiology, West China Hospital of Sichuan University on July 22, 2021 due to "dyspnea after activity for 6 months". In the past, he was seen in the department of respiratory medicine, and chest CT showed increased texture in both lungs. The forced expiratory volume decreased by 10% in the first second, and there was no significant improvement after administration of budesonide formoterol inhalation powder spray 1 inhalation/time twice a day; Posterior perfection echocardiography showed a left ventricular ejection fraction of 20%. Laboratory tests after admission showed elevated levels of N-terminal pro-B-type natriuretic peptide (NT-proBNP) to 2 031 ng/L (reference value: 0 to 227 ng/L). The ambulatory electrocardiogram showed a sinus rhythm with a heart rate of 74 beats/min, accompanied by premature atrial beats and multisource premature ventricular beats. Echocardiography showed left ventricular dilatation (left ventricular end-diastolic diameter 63 mm, reference: 37.8-52.2 mm), reduced left ventricular ejection fraction to 25% (reference: 54%-74%), accompanied by "jungle-like" trabeculae, and a ratio of non-densified myocardium to densified myocardium of 5:1 (panels A, B). Cardiovascular MRI revealed enlarged heart and "jungle-like" myocardium (Figures C, D). No typical delayed gadolinium enhancement was found. The patient received drug therapy (torasemide 10 mg/time once daily; tolvaptan 7.5 mg/time once every other day; sacubitril and valsartan sodium tablets 100 mg/time twice daily). As of the last follow-up (10 October 2025), there was no acute heart failure for more than 4 years since the onset of the disease. The left ventricular ejection fraction fluctuated from 23% to 26% at follow-up, and the change range of NT-proBNP was 1,340 to 2,497 ng/L. Whole exon sequencing detectedBAG5A possible pathogenic variation of a gene (stop codon mutation) that is abnormally associated with dilated cardiomyopathy. Combined with the above results, the preliminary diagnosis was dilated cardiomyopathy with excessive trabecularization of the left ventricle, and heart transplantation was recommended. This patient was accompanied byBAG5Cases of "jungle-like" hypertrabecularization in patients with genetically mutated dilated cardiomyopathy, left ventricular remodeling with significant trabecularization contributes to higher stroke volume and limits the increase in wall stress. Nearly half of the ventricular chamber was occupied by abnormally abundant trabeculae, which may contribute to the relative stability of NT-proBNP during its follow-up.

In the article "Expert Consensus on Clinical Application of Intravenous Insulin Infusion (2026 Edition)", Issue 21, 2026, "Secretary: Tang Xiaohan" on page 2103 is changed to "Secretary: Tang Xiaohan", which is hereby corrected.