Volume 106 · Issue 02 · 2026

WHO published the WHO position paper on herpes zoster vaccines-July 2025 (hereinafter referred to as the position paper). This position paper was led by the Strategic Advisory Group of Experts on Immunization (SAGE) of the WHO. In March 2025, SAGE convened a meeting in Geneva, Switzerland. Eleven working groups from different fields of expertise participated in drafting the paper, with core members coming from China, France, Australia and the United States. The position paper recommends for the first time that countries where herpes zoster (HZ) is a significant public health problem incorporate zoster vaccination for older adults into their immunization programs, prioritizing recombinant zoster vaccine (RZV). Compared with the 2014 version, this version of the position paper provides the relevant data of RZV, and puts forward guiding opinions on target populations, immunization schedules, booster vaccinations, combined vaccinations, economic evaluations, HZ monitoring and future research directions. This paper analyzes the position paper′s implications for HZ control and prevention in China: (1) clarifying target populations and vaccination strategies; (2) accelerating the research and development of HZ vaccines along multiple technical routes; (3) optimizing the adult vaccination service system; (4) strengthen HZ monitoring and post-marketing evaluation of vaccines; (5) strengthening the training of professionals and public health education; (6) promoting multi-departmental collaboration and policy support.

Respiratory syncytial virus (RSV) is the most common viral pathogen causing lower respiratory tract infections in humans, posing a hefty disease burden among infants, young children, and the elderly population, and representing a significant global public health concern. There is an urgent need in China to establish an integrated medical-preventive collaborative system for RSV infection control, encompassing"prevention, diagnosis, treatment and management, " to shift the focus from a "treatment-centered" to a "health-centered" strategy. To better guide and standardize RSV prevention and control measures in China, a multidisciplinary group of Chinese experts was formed to develop the " expert consensus on the collaboration of medical and preventive care for the prevention and treatment of respiratory syncytial virus infection". This consensus integrates existing evidence-based medical data and practical experiences from both domestic and international sources. Based on the strategic needs of RSV infection prevention and control in China, this consensus aims to provides innovative medical and preventive collaboration mechanisms and decision-making recommendations for medical institutions at all levels, disease prevention and control institutions, and relevant primary care professionals, with the aim of comprehensively enhancing the prevention and treatment level of RSV infection in China.

Influenza is a common acute respiratory infectious disease in China, characterized by pronounced seasonality, rapid transmission, and a high risk of severe illness among high-risk populations. These features pose a substantial threat to public health. Historically, recommendations for influenza treatment and prophylaxis have largely relied on expert consensus in China, with a lack of systematic, evidence-based guidelines. In recent years, accumulating evidence on traditional antiviral agents such as neuraminidase inhibitors, as well as emerging agents targeting RNA polymerase, has expanded therapeutic options for influenza, underscoring the need to systematically update and refine existing treatment recommendations. Accordingly, a multidisciplinary panel of Chinese experts developed the"Clinical practice guidelines for the treatment and prophylaxis of influenza in China (2025 edition)"following established guideline methodology. This guideline focuses on antiviral therapy, adjunctive treatment, and prophylaxis, systematically summarizing and updating treatment indications, drug selection, dosing regimens, duration, and safety management across different populations. Specific recommendations are provided for key groups such as children and pregnant women. The guideline culminates in a series of evidence-based recommendations, providing structured and actionable guidance for the clinical management and prevention of influenza in China.

To investigate the effect of the time interval between full embryo freezing in the fresh cycle and the first frozen embryo transfer on pregnancy outcomes.

A retrospective cohort study was conducted. Patients who underwent full embryo freezing after assisted reproduction with in vitro fertilization/intracytoplasmic sperm injection using the follicular-phase long-acting protocol in the fresh cycle at the Reproductive Medicine Center of the First Affiliated Hospital of Zhengzhou University from January 2019 to December 2021 were included, with a total of 2 408 cases. Patients were divided into three groups according to the interval between oocyte retrieval and frozen embryo transfer: ≤60 d (n=573), 60-90 d (n=1 303), and>90 d (n=532). Restricted cubic spline modeling and multivariable logistic regression were used to analyze the effects of different oocyte retrieval-to-frozen embryo transfer intervals on pregnancy outcomes.

Patients were at a mean age of (29.5±3.9) years, with mean ages of (29.3±3.8), (29.3±3.9), and (30.1±3.9) years in the ≤60 d, 60-90 d, and >90 d groups, respectively. The ≤60 d group had lower clinical pregnancy rates [49.2% (282/573) vs 56.8% (740/1 303) vs 60.9% (324/532)] and live-birth rates [71.6% (202/573) vs 80.8% (598/1 303) vs 79.0% (256/532)] compared with the 60-90 d and >90 d groups (all P<0.05). No significant differences were observed among the groups in terms of obstetric complications, neonatal birth weight, or birth defects (all P>0.05). Oocyte retrieval-frozen embryo transfer interval in<60 d group (aOR=0.59, 95%CI: 0.46-0.75; aOR=0.56, 95%CI: 0.43-0.72), age (aOR=0.98, 95%CI: 0.96-0.99; aOR=0.97, 95%CI: 0.95-0.99), natural-cycle endometrial preparation protocol (aOR=1.41, 95%CI: 1.15-1.74; aOR=1.37, 95%CI: 1.12-1.68), endometrial thickness on the day of transfer (aOR=1.10, 95%CI: 1.00-1.22; aOR=1.11, 95%CI: 1.01-1.22), number of embryos transferred (aOR=2.79, 95%CI: 1.50-5.17; aOR=3.12, 95%CI: 1.63-5.97), and D3 embryo type (aOR=0.42, 95%CI: 0.23-0.78; aOR=0.42, 95%CI: 0.22-0.81) were all factors associated with successful clinical pregnancy or live birth (all P<0.05). None of the variables in the 61-90 and >90 d groups were significantly associated with successful clinical pregnancy or live birth (all P>0.05). A nonlinear association was identified between the oocyte retrieval-to-frozen embryo transfer interval and both clinical pregnancy (P_overall<0.001, P_non-linear<0.001) and live-birth rates (P_overall<0.001, P_non-linear=0.005), characterized by an initial rise followed by a plateau, with thresholds at 65 and 64 days, respectively. Below the thresholds, each additional day of interval increased the clinical pregnancy rate by 6.2% (aOR=1.06, 95%CI: 1.04-1.09) and the live-birth rate by 5.6% (aOR=1.06, 95%CI: 1.03-1.09) (both P<0.05).

The timing of frozen embryo transfer after whole-embryo cryopreservation in fresh cycles influences pregnancy outcomes. Performing frozen embryo transfer approximately two months after oocyte retrieval is associated with improved pregnancy rate.

To investigate the diagnostic value of MRI-measured symptomatic condylar movement angle in assessing limited mouth opening among temporomandibular disorder (TMD) patients.

A retrospective cross-sectional study was conducted. Patients with unilateral TMD who underwent their first temporomandibular joint (TMJ) MRI examination at the TMJ specialty clinic of Beijing Friendship Hospital, Capital Medical University, between July 2017 and June 2024 were enrolled. All patients were categorized based on maximum pain-free opening (MMO) as limited opening (MMO<38 mm) or unrestricted opening (MMO≥38 mm). Age-based groups included adults (≥18 years) and minors (<18 years). The same patient′s TMJ were further classified as symptomatic or asymptomatic sides. Bilateral condylar angles were measured on sagittal MRI images of the condyles in the open-mouth position. The angular difference and mean values were calculated. Diagnostic performance for limited mouth opening was evaluated using area under the receiver operating characteristic (ROC) curve (AUC), sensitivity, and specificity for each condylar angle metric. Differences in cut-off values between adult and minor groups were explored.

A total of 130 TMD patients aged [M(Q₁, Q₃)] 18.0 (15.0, 31.5) years were included, with 27 males (20.8%) and 103 females (79.2%). There were 59 cases (45.4%) who had limited mouth opening, while 71 cases (54.6%) did not have this symptom; 63 cases (48.5%) were minors, and 67 cases (51.5%) were adults. Among all patients, the AUC for diagnosing limited mouth opening using the symptomatic side condylar angle (0.880, 95%CI: 0.822-0.938) was higher than that using the asymptomatic side condylar angle (0.768, 95%CI: 0.687-0.848) and the bilateral condylar angle difference (0.727, 95%CI: 0.639-0.814) (both P<0.05). The condylar angle on the symptomatic side demonstrated a cut-off value of 89.0° for diagnosing limited mouth opening in the adult group, with a sensitivity of 96.7% and specificity of 83.8%; in the minor group, the cut-off value was 80.5°, with a sensitivity of 75.9% and specificity of 70.6%. The AUC for diagnosing limited mouth opening using the condylar angle on the symptomatic side in the adult group (0.968, 95%CI: 0.933-1.000) was significantly different from that in the minor group (0.779, 95%CI: 0.667-0.892) (P=0.002).

The symptomatic condylar angle demonstrates high diagnostic efficacy for limited mouth opening in TMD patients. The cut-off value of the condylar angle differs between adult and minor patients.

To investigate the associations of body mass index (BMI), waist circumference, and body composition with chronic kidney disease (CKD) among older adults aged≥65 years in longevity regions of China.

This study was based on cross-sectional data from the 2021 wave of the Healthy Ageing and Biomarkers Cohort Study, including 4 781 participants aged≥65 years. Demographic characteristics, lifestyle factors, disease history, as well as BMI, waist circumference, muscle mass, fat mass, body fat percentage, and visceral fat level were collected. Serum creatinine, urinary creatinine, and urinary albumin were measured to calculate estimated glomerular filtration rate (eGFR) and urinary albumin/creatinine ratio (UACR). CKD was defined as eGFR<60 ml·min^-1·(1.73 m²)^-1 or UACR≥30 mg/g. Multivariable logistic regression was used to assess the associations of measurement indicators with CKD prevalence, restricted cubic spline regression was applied to examine dose-response relationship, and multivariable linear regression was conducted to quantify associations of the indices with eGFR. Subgroup analyses were further performed by sex and age.

The mean age of the 4 781 participants was (82.8±10.6) years, with 2 254 males (47.1%), and the prevalence of CKD was 36.5% (1 745 cases). The CKD group had higher age and higher prevalence of hypertension, diabetes, and cognitive impairment compared with the non-CKD group (all P<0.001), while their BMI, waist circumference, muscle mass, and fat mass were significantly lower (all P<0.05). Each 1-standard deviation increase in BMI, waist circumference, and muscle mass was associated with 13.3% (OR=1.133, 95%CI: 1.053-1.219), 12.4% (OR=1.124, 95%CI: 1.019-1.241), and 11.2% (OR=1.112, 95%CI: 1.006-1.228) higher risk of CKD, respectively. Each 1-standard deviation increase in BMI and muscle mass was associated with a decrease of 1.386 ml·min^-1·(1.73 m²)^-1 (β=-1.386, 95%CI:-1.826--0.945) and 1.441 ml·min^-1·(1.73 m²)^-1 (β=-1.441, 95%CI:-2.030--0.853) in eGFR levels, respectively. Restricted cubic spline analyses revealed linear positive associations of BMI and muscle mass with CKD risk (P_{for nonlinearity}=0.19 and 0.18, respectively), and a J-shaped positive association between waist circumference and CKD risk (P_{for nonlinearity}=0.016), with the lowest risk at 79.0 cm cut-off value. Subgroup analyses showed that in men, only BMI (OR=1.218, 95%CI: 1.087-1.365) and waist circumference (OR=1.215, 95%CI: 1.033-1.433) were associated with the risk of CKD, whereas in women, only muscle mass (OR=1.157, 95%CI: 1.035-1.294) was associated with CKD risk. In the age-stratified analysis, only in the younger group (age<80 years) were BMI (OR=1.156, 95%CI: 1.020-1.309) and waist circumference (OR=1.378, 95%CI: 1.140-1.673) associated with CKD risk.

Higher BMI, waist circumference, and muscle mass are associated with increased CKD risk in older adults, and these associations differ by sex and age groups.

This retrospective study analyzed three GSDME-related deafness pedigrees diagnosed at the Chinese PLA General Hospital between January 2014 and December 2020. Through whole-exome sequencing and Sanger sequencing validation, all three pedigrees were found to carry splice-site variants causing exon 8 skipping. The patients presented with bilateral, symmetrical, and progressive sensorineural hearing loss, with an age of onset ranging from five to 25 years. The hearing loss initially affected high frequencies and gradually progressed to involve all frequencies. Significant phenotypic heterogeneity was observed, even within the same pedigree, with notable variations in the age of onset and progression rate among individuals carrying the same mutation. A review of the literature indicated that 15 GSDME-caused deafness variants have been reported globally, predominantly clustered around exon 8. This study further confirms that GSDME-related deafness has specific pathogenic mechanisms and significant phenotypic heterogeneity.

This paper reports a case of allergic pneumonia with migratory pulmonary nodular shadows in both lungs. The 49-year-old female was seen in the Ninth Medical Center of the People's Liberation Army General Hospital on May 6, 2025, mainly because of "intermittent cough and lung shadow for more than 2 years". The patient had intermittent cough, mainly dry cough, chest tightness and wheezing after activity. Chest CT showed multiple nodules in both lungs, and dynamic chest CT showed that the pulmonary nodules were migratory. After bronchoscopic alveolar lavage fluid examination, the nucleated cell count was 240×10⁶/L, lymphocyte percentage 41%, neutrophil percentage 3%, angiotensin converting enzyme 57.3 U/L. In order to confirm the diagnosis, one-port thoracoscopic wedge resection of left upper lobe was performed, and the postoperative pathology was consistent with allergic pneumonia. The patient was given prednisone acetate 30 mg once/d, reduced to 25 mg once/d after 1 month, and reduced to 20 mg once/d after 2 months. In July 2025, the patient had no cough, chest tightness and wheezing. Re-examination of chest CT showed that both lung nodules were absorbed and the condition improved.

This paper reports a case of eosinophilic cholangitis (EC) misdiagnosed as cholangiocarcinoma before surgery. A 67-year-old male was admitted to hospital due to "skin and sclera yellowing for more than 1 month". Blood routine showed an increase in eosinophil count and percentage. Abdominal MRI showed dilatation of intrahepatic bile duct and upper common bile duct, stenosis of the lumen of the pancreatic segment of the common bile duct, and enlargement of the pancreatic head, which could not be ruled out as malignant. Laparoscopic exploration, choledochoscopic exploration and biopsy were performed. No tumor cells were found in intraoperative frozen section pathological examination, and the operation was ended. The postoperative pathological results showed chronic bile duct inflammation, submucosal fibrous tissue hyperplasia, with abundant eosinophil infiltration, and the diagnosis was EC. After 3 months of oral treatment with methylprednisolone, the symptoms and signs improved significantly, and the patient's condition was stable after follow-up until September 2025.

Glioblastoma (GBM) is the most common and most malignant primary tumor in the central nervous system, and its occurrence and development are closely related to complex genetic and epigenetic abnormalities. In recent years, RNA methylation modifications represented by N6-methyladenosine (m6A), 5-methylcytosine (m5C), N1-methyladenosine (m1A) and 7-methylguanosine (m7G), as the core mechanism of epitranscriptome regulation, have been confirmed to play a key regulatory role in the malignant progression of GBM, such as proliferation, invasion, metabolic reprogramming, maintenance of stem cell characteristics, therapy resistance and poor prognosis. This paper systematically reviews the latest research progress of the biological functions, molecular mechanisms and regulatory factors (including writers, erasers and readers) of non-classical RNA methylation modifications such as m6A, m5C, m7G, m3C and m1A in the malignant progression of GBM, and emphasizes their specific roles in the maintenance of tumor stem cells, the regulation of immune microenvironment, metabolic adaptation and the formation of drug resistance. At the same time, the potential of RNA methylation regulators as prognostic markers, liquid biopsy-based detection strategies and their application prospects in immunotherapy combinations were discussed, and the current challenges faced by the research and development of small molecule inhibitors targeting RNA methylation (such as blood-brain barrier penetration, substrate selectivity, etc.) were prospected.

Macrophage polarization plays a central role in the pathogenesis of diabetic nephropathy. MicroRNA (miRNA) is a non-coding single-stranded RNA that participates in the macrophage polarization process by targeting inflammatory signaling pathways and metabolic reprogramming. This paper reviews the biological characteristics of miRNA and macrophage polarization, and the mechanism and application prospect of miRNA regulating macrophage polarization in diabetic nephropathy.

Pemphigus is a class of autoimmune cutaneous and mucosal vesicular diseases mediated by IgG autoantibodies and mainly targeting desmosome core proteins (Dsg) 1 and 3. Previously, glucocorticoids combined with immunosuppressants are its first-line treatment options. In recent years, with the in-depth understanding of its immune pathogenesis, novel therapeutic strategies around immune targets have gradually developed and entered clinical practice. This article reviews the immunological mechanisms of pemphigus pathogenesis and the research progress of its targeted therapy, systematically expounds the therapeutic strategies and clinical translation status of targeted surface molecules, cytokine regulation and other mechanisms, aiming at providing theoretical support and practical paths for realizing individualized and precise therapy.

Coronary CT flow reserve fraction (CT-FFR) can provide anatomical and physiological information of coronary arteries simultaneously during a single examination, improve the performance of traditional coronary CT angiography (CCTA) in diagnosing lesion-specific ischemia, realize the leap from "anatomy" to "functionality" in coronary heart disease assessment, and is of great value in guiding patient clinical management and evaluating prognosis. CT-FFR can optimize the allocation of medical resources, promote accurate diagnosis and treatment decisions for coronary heart disease (CHD), and provide a basis for personalized diagnosis and treatment of CHD. This paper briefly describes the technical principle and influencing factors of CT-FFR, elaborates its clinical application value (including decision optimization, revascularization guidance and prognosis assessment), and discusses the challenges and future development trends of CT-FFR clinical application and research.

The patient, a 73-year-old male, was admitted to the Department of Thoracic Oncology of Qingdao Municipal Hospital on April 30, 2023 due to "chest pain for 1 month". Admission specialist physical examination left lower lung breathing sound was weakened, both lungs did not hear rales. Negative nucleic acid test for common respiratory pathogens; Lung cancer-related tumor markers: carcinoembryonic antigen (CEA) was 23.52 μ g/L, neuron-specific enolase (NSE) was 23.64 μ g/L, soluble cytokeratin 19 fragment (CYFRA21-1) was 4.62 μ g/L, and squamous cell carcinoma antigen was 1.8 μ g/L. On May 2, 2023, the enhanced CT of the chest showed a massive soft tissue density shadow in the subpleural area of the left lung, with a larger cross section of about 64 mm ×80 mm. After the enhanced scan, it showed uneven enhancement (Figures A and B), and there was no adhesion between the lower edge of the tumor and the chest wall and parietal pleura (Figure C). Four days after admission, CT-guided puncture biopsy was performed to confirm the diagnosis. The pathological results showed that the tumor cells were oval and fusiform, diffusely distributed, and the mitotic images were more common (Figure D, hematoxylin-eosin staining ×100). Immunohistochemical results showed CK (-), Vimentin (+), TTF-1 (-), WT-1 (-), CD34 (-), S100 (-), CD99 (+), BCL2 (weakly positive), EMA (-). The final diagnosis was primary pulmonary synovial sarcoma (PPSS). The patient refused surgery and chemoradiotherapy, oral anlotinib and symptomatic supportive treatment. In December 2023, the patient died of respiratory failure in the end stage of the tumor. PPSS is a rare malignant tumor originating from the internal mesenchymal tissue of the lung, which often appears clinically with chest pain, cough, dyspnea and other symptoms. Chest CT usually shows a large soft tissue mass in the lungs or under the pleura, with significantly uneven enhancement on enhancement scans. The diagnosis of this disease mainly depends on pathology, which is characterized by tumor cells in spindle or epithelial arrangement, and immunohistochemistry shows positive antibodies such as Vimentin and CD99. PPSS are highly aggressive, and early diagnosis and treatment are the key to improve prognosis.