Volume 106 · Issue 06 · 2026

With the accelerating global aging process, health issues among older adults have become increasingly severe. To address the challenges brought about by the aging population, a shift from a disease-centered to a function-centered healthcare model is urgently needed. The World Health Organization (WHO) introduced the concept of intrinsic capacity and published the Integrated Care for Older People (ICOPE): Guidance for Person-Centred Assessment and Pathways in Primary Care, providing an important framework for assessing and optimizing the functional status in older adults. This article systematically reviews the conceptual background and epidemiological characteristics of intrinsic capacity. It highlights that the WHO ICOPE screening tool has been adapted and validated in China, demonstrating high sensitivity in identifying declines in intrinsic capacity. Intervention studies indicate that multidomain interventions can improve intrinsic capacity, although high-quality evidence from randomized controlled trials is still lacking. Based on the WHO ICOPE guidelines, this article proposes a comprehensive management strategy covering screening, assessment, intervention and follow-up. It also recommends promoting implementation through three key aspects: establishing community-based screening systems for intrinsic capacity, improving multidisciplinary collaboration, and promoting the application of digital technologies. In the future, efforts should focus on accelerating the development of localized assessment tools, strengthening evidence-based research on integrated interventions, and promoting health data integration and intelligent early warning systems. These steps will support China in building a function-centered healthcare system for older adults and advance the achievement of healthy aging.

With the accelerating global trend of aging, the incidence of acute kidney injury (AKI) among elderly patients with comorbidities is increasing steadily. For elderly patients, AKI not only accelerates the progression of comorbidities, thereby increasing the difficulty of clinical diagnosis and treatment, but also significantly reduces patients′ survival rates and quality of life. Therefore, it is of great importance to explore more optimized strategies for AKI management. In recent years, smart healthcare has shown broad application prospects in the management of AKI, covering early risk warning, accurate diagnosis and classification, individualized treatment decision-making, and rehabilitation management. This article systematically sorts out and reviews the application of smart healthcare in AKI management in elderly patients with comorbidities, with a focus on summarizing the advantages and shortcomings of existing technologies, aiming to provide insights into future research and clinical practice in the intelligent management of AKI and promote the transformation of AKI management strategies from disease treatment to proactive health maintenance.

The disease burden caused by pregnant women contracting influenza is an important public health issue, which not only directly threatens the health of pregnant women themselves, but also has adverse effects on the health of fetuses and newborns through mother-to-child transmission and other means. Although pregnant women are the preferred group for influenza vaccination, their willingness to receive the vaccine is generally low due to multiple factors, such as psychological mechanisms, socio-cultural factors, and policy implementation barriers in the actual implementation process, resulting in an extremely low vaccination rate. Therefore, building a comprehensive and multi-level precision strategy system based on the behavior change mechanism in the three dimensions of individual-society-policy is of great significance for enhancing pregnant women′s willingness to receive vaccinations and promoting their conversion of willingness into actual vaccination behavior. In the future, we will evaluate the effectiveness of strategies from a more in-depth, systematic, and comprehensive perspective, explore their synergistic effects in different intervention strategies and their adaptability in diverse target populations, thereby expanding the coverage of public health services and enhancing the accuracy and depth of services, aiming to promote the steady development of public health along the path of precision and efficiency, and provide solid and powerful guarantees for the health of the entire population.

Panvascular disease is a systemic condition characterized by atherosclerotic lesions as its common pathological feature. It may present as coronary artery disease, cerebrovascular disease, peripheral artery disease, or polyvascular disease, which is defined as the involvement of two or more vascular beds. As a leading cause of death in China, panvascular disease imposes a substantial health burden worldwide. Dyslipidemia is a well-established key risk factor for the initiation and progression of atherosclerosis. Current challenges in lipid management among patients with panvascular disease in China include insufficient awareness, suboptimal achievement of treatment targets, and inadequate multidisciplinary coordination. There is a pressing need to develop lipid-lowering strategies tailored to the characteristics of the Chinese population. To address this gap, a panel of experts in cardiology, endocrinology, neurology, and vascular surgery developed the "Chinese Expert Consensus on Lipid Management for Panvascular Disease (2025 edition)". This consensus is based on a comprehensive review of the latest clinical evidence and guidelines from both domestic and international literature. It emphasizes standardized management of dyslipidemia in patients with panvascular disease, offering recommendations on risk stratification assessment, lipid target values, lifestyle modifications, and pharmacologic treatment. The document aims to provide clinicians with practical, evidence-based guidance for individualized lipid management, with the ultimate goal of reducing atherosclerotic cardiovascular events and improving long-term outcomes.

Nitric oxide is a selective pulmonary vasodilator. In recent years, inhaled nitric oxide (iNO) has garnered significant attention for its application in adult perioperative care. To standardize its application during the adult perioperative period, the Chinese Society of Anesthesiology of Chinese Medical Association, the Critical Care Branch of Beijing Perioperative Medicine Study Society, the Critical Care Medicine Branch of Beijing Medical Association, and National Alliance of Geriatric Anesthesiology have jointly developed the"Expert consensus on the clinical application of inhaled nitric oxide in the perioperative period of adult surgical procedures (2026 edition)"based on Chinese clinical practice and the latest research advances. This consensus document addresses key aspects of iNO use in the adult perioperative setting, including dosing range, clinical benefits, equipment setup, patient assessment, and safety monitoring. The consensus presents 11 recommendations, aiming to standardize and enhance clinical understanding and practical competency regarding iNO therapy among relevant disciplines. This document serves as a guidance reference for the clinical use of iNO in the perioperative management of adult surgical patients.

Immune-mediated inflammatory diseases (IMID) are a group of chronic, systemic inflammatory diseases caused by immune dysregulation. IMID often involve multiple organs or systems, are characterized by complex clinical manifestations and significant overlap across different diseases, and may coexist as multiple comorbidities, significantly increasing the disease burden and complicating diagnosis and management. To promote the standardized management of IMID in China, Specialty Committee on Prevention of Rheumatologic and Immunologic Diseases, Chinese Preventive Medicine Association, Chinese Society of Dermatology, Chinese Medical Association and Inflammatory Bowel Disease Group, Chinese Society of Gastroenterology, Chinese Medical Association organized experts in rheumatology, dermatology, gastroenterology, and pharmacy. Based on domestic and international research advances from the past decade and integrated with clinical practice experience, they developed this consensus document. This consensus systematically summarizes the conceptual origin, disease burden, pathogenesis, diagnostic and treatment models, and therapeutic agents for IMID. It establishes a multi-disciplinary team (MDT) diagnosis and treatment system for IMID and provides systematic management recommendations and medication selection strategies for common IMID and their related comorbidities in the fields of rheumatology, dermatology, and gastroenterology. The purpose of this consensus is to provide a comprehensive, standardized, and operable diagnosis and treatment framework for IMID patients in China, aiming to optimize clinical practice and improve long-term outcomes.

To explore the relationship between childhood trauma and depressive symptoms in adolescents with major depressive episodes (MDE), and the mediating roles of perceived stress and abnormal brain structural development.

Adolescents with MDE treated at the Early Intervention Department of Nanjing Brain Hospital from September 2021 to August 2024 were retrospectively enrolled. Childhood trauma was assessed using the Childhood Trauma Questionnaire (CTQ) and patients were categorized into groups with or without childhood trauma. Depressive symptom severity was evaluated with the Patient Health Questionnaire-9 (PHQ-9), and perceived stress was measured using the Perceived Stress Scale (PSS). Functional MRI scans were performed to acquire neuroimaging data. Individual deviations in cortical thickness, relative to healthy population norms, were compared between the two groups. Multiple linear regression was used to examine associations between different types of childhood trauma and depressive symptoms. Mediation analyses were conducted to explore whether perceived stress or cortical thickness deviations mediated the relationship between childhood trauma and depressive symptoms.

A total of 300 patients were included. The childhood trauma group included 51 males and 103 females [mean age (15.1±1.4) years], and the non-trauma group included 49 males and 97 females [mean age (15.2±1.4) years], with no significant differences in age, sex, or diagnosis (all P>0.05). The childhood trauma group exhibited significantly higher PHQ-9, PSS, and CTQ scores compared to the non-trauma group (all P<0.05), and showed more pronounced negative deviations in cortical thickness in the left caudal middle frontal region (false discovery rate correction-corrected P=0.027). Across all patients, multiple linear regression analysis indicated that emotional abuse (β=0.672，95%CI：0.447-0.897) and sexual abuse (β=0.637，95%CI：0.201-1.070) were associated with PHQ-9 scores. Mediation analysis revealed that perceived stress mediated the relationships between emotional abuse [β=0.424 (95%CI: 0.310-0.540), effect size=58.89%, P<0.001] and sexual abuse [β=0.489 (95%CI: 0.151-0.864), effect size=45.74%, P=0.007] with PHQ-9 scores, respectively. Additionally, cortical thickness deviation in the left caudal middle frontal region also mediated the association between emotional abuse and PHQ-9 scores [β=0.029 (95%CI: 0.003-0.070), effect size=4.03%, P=0.026].

Specific types of childhood trauma are associated with depressive symptoms in adolescents with MDE, and this association may be partly explained through the mediating roles of perceived stress and abnormal brain structural development.

To evaluate the efficacy and safety of first-line treatment with atezolizumab plus bevacizumab compared to lenvatinib in patients with unresectable hepatocellular carcinoma (HCC) associated with hepatitis B virus (HBV) infection.

This retrospective study included patients with unresectable HBV-related HCC from October 2020 to December 2024 at General Hospital of Tianjin Medical University. Baseline clinical characteristics, treatment response, and adverse events were collected. According to the different first-line treatment, patients were divided into the observation group (receiving atezolizumab combined with bevacizumab) and the control group (receiving oral lenvatinib monotherapy). Kaplan-Meier analysis was used for making survival curve. The overall survival (OS) and progression-free survival (PFS) were compared between two groups. And log-rank test was used to compare the survival differences between the two groups. Tumor response was evaluated per modified response evaluation criteria in solid tumors (mRECIST). The objective response rate (ORR), disease control rate (DCR) and safety were compared between the two groups.

A total of 110 patients were included, of whom 56 were in the observation group, with an age of [M(Q₁, Q₃)] 61 (39, 77) years, and 44 males; 54 were in the control group, with an age of 62 (38, 75) years, and 41 males. Overall, patients were predominantly classified as Child-Pugh class A for liver function, with a median follow-up time of 15.9 months. The median OS was significantly longer in the observation group compared to the control group (20.4 months vs 14.5 months), with 2-year OS rates of 33.7% vs 20.2%, respectively (P=0.018). Median PFS was also longer in the observation group (7.5 months vs 5.6 months) with 1-year PFS rates of 37.2% vs 14.8% (P=0.006). The ORR in the observation group and the control group was 32.1% and 20.4%, respectively, while the DCR was 75.0% and 72.2%, respectively. Grade≥3 treatment-related adverse events occurred in 46.4% (26/56) of patients in the atezolizumab plus bevacizumab group and 38.9% (21/54) in the lenvatinib group, with no statistically significant difference (P=0.424). The most common adverse events differed between groups: in the observation group, fatigue (73.2%, 41/56), gastrointestinal reactions (62.5%, 35/56), hypertension (28.6%, 16/56), proteinuria (21.4%, 12/56) and liver toxicity (17.9%, 10/56) were more frequent; in the control group, fatigue (61.1%, 33/54), hypertension (48.1%, 26/54) and hand-foot skin reaction (24.1%, 13/54) were more common. No severe liver failure or treatment-related deaths were observed.

In patients with unresectable HBV-related HCC, atezolizumab plus bevacizumab demonstrated a longer OS and higher ORR compared to lenvatinib with a manageable safety profile.

To analyze the characteristics of peak expiratory flow (PEF) and the risk factor for its decline in stroke patients.

This was a case-control study. A total of 809 stroke patients hospitalized in the Department of Rehabilitation of the First Affiliated Hospital of Wenzhou Medical University from January 2020 to December 2022 were prospectively enrolled as the stroke group, and 801 age-and sex-matched healthy subjects from the hospital′s Physical Examination Center during the same period served as the control group. The measured PEF was detected using an adult peak flow meter. The predicted PEF and PEF% (measured/predicted PEF×100%) were calculated based on age, sex, and height. The stroke group was further divided into a normal PEF group (PEF%≥80%) and a decreased PEF group (PEF%<80%). PEF metrics were compared within and between the stroke and control groups. A multivariate logistic regression was used to analyze risk factors for PEF decline in the stroke group.

The stroke group (539 males, 270 females) aged (63.2±11.9) years and the control group (498 males, 303 females) aged (63.5±12.1) years. The measured PEF in the stroke group was lower than its predicted value [(243.89±139.38) vs (390.45±94.30) L/min, P<0.001], while no significant difference was found between the measured and predicted PEF values in the control group (P>0.05). Compared with the control group, the stroke group had lower measured PEF [(243.89±139.38) vs (371.52±114.78) L/min] and PEF% [(61.80±30.79)% vs (98.14±22.48)%], but higher predicted PEF [(390.45±94.30) vs (379.21±84.78) L/min] and a higher proportion of severe PEF% decline [48.6% (393/809) vs 4.5% (36/801)] (all P<0.05). Within the stroke group, the decreased PEF group had higher proportions of smoking, alcohol drinking, atrial fibrillation, total anterior circulation infarction, higher NIHSS and mRS scores and a higher proportion of dysphagia compared with the normal PEF group (all P<0.05). The decreased PEF group had a lower proportion of partial anterior circulation infarction, Barthel index score, and independent standing (all P<0.05). Multivariate logistic regression identified smoking (OR=1.466, 95%CI: 1.014-2.118), increased NIHSS score (OR=1.072, 95%CI: 1.003-1.145), dysphagia (OR=1.691, 95%CI: 1.161-2.463), and increased mRS score (OR=2.286, 95%CI: 1.263-4.137) as risk factors for PEF decline in stroke patients.

Stroke patients exhibit decreased measured PEF and PEF%, along with higher predicted PEF and a higher proportion of severe PEF% decline. Smoking, neurological dysfunction, impaired mobility, and dysphagia are risk factors for PEF decline in stroke patients.

To investigate the levels of immuno-hematological parameters in patients with Meniere disease (MD) and their associations with clinical features.

The clinical data from MD patients collected at Union Hospital, Tongji Medical College, Huazhong University of Science and Technology between May 2011 and April 2022 were retrospectively analyzed. The parameters were as follows: autoantibodies, humoral immunity markers, lymphocyte subsets, and complete blood counts. Levels of abovementioned parameters were compared between patients with disease duration of≤12 months and>12 months, and among those at audiological stages Ⅰ~Ⅳ.

A total of 113 MD patients aged (52.3±12.8) years were included, with 37 males (32.7%) and 76 females (67.3%). There were 52.2% of patients (59/113) who had a disease duration of>12 months. Audiological staging included 16 stageⅠ, 20 stage Ⅱ, 61 stage Ⅲ, and 16 stage Ⅳ cases. The overall rate of antinuclear antibody (ANA) positivity was 20.5% (23/112), with rates of 25.9% (15/58) and 14.8% (8/54) in patients having a disease duration of>12 months and≤12 months, respectively (χ²=1.835, P=0.176). By stage, ANA positivity was 13.3% (2/15) in stage Ⅰ, 30.0% (6/20) in stage Ⅱ, 19.7% (12/61) in stage Ⅲ, and 18.8% (3/16) in stage Ⅳ(χ²=1.708, P=0.635). Among humoral markers, 5.5% (4/73) of patients had elevated IgG and 30.1% (22/73) had reduced complement C3, with no significant differences by duration or stage (all P>0.05). Abnormal rates for lymphocyte subsets were26.4% (23/87) in total T cells, 33.3% (29/87) in CD4⁺T cells, 29.9% (26/87) in CD8⁺T cells, 21.8% (19/87) in B cells, and 27.6% (24/87) in natural killer (NK) cells, with no significant differences by duration or stage (all P>0.05).

MD patients exhibit certain immuno-hematological abnormalities, which do not directly correlate with disease duration or the degree of hearing impairment.

Retrospectively, patients who were pathologically diagnosed with early-stage mycosis fungoides (MF) in the Department of Dermatology, Zhongshan Hospital Affiliated to Xiamen University, from October 1, 2023 to April 1, 2024 and had a history of misdiagnosis were enrolled in this study. Their clinical characteristics, dermoscopic manifestations of skin lesions as well as cutaneous histopathological features were analyzed. A total of 10 patients with early-stage MF were included, among whom 8 were males and 2 were females, with a mean age of (30.1±14.3) years. Dermoscopic examination revealed that all patients presented with a dark yellowish-red background accompanied by patchy orange-yellow areas. The main vascular pattern in most cases (9/10) was "spermatozoa-like vessels", and dotted vessels as well as short linear vessels were observed in all 10 cases. Histopathological examination showed vacuolar interface change accompanied by superficial perivascular inflammation pattern in all cases, together with lymphocytic epidermotropism, intraepidermal atypical lymphocytes and Pautrier microabscesses. After standardized treatment, follow-up dermoscopic examinations were performed one year later, and the aforementioned dermoscopic manifestations disappeared in 9 patients. This study suggests that early-stage MF with different clinical phenotypes has relatively consistent dermoscopic and cutaneous histopathological features.

This paper reports the anesthesia management of a patient with hemorrhagic shock and severe hyperkalemia caused by ruptured uterine pregnancy with stump horn who underwent laparoscopic exploration in emergency department. A 26-year-old female underwent an emergency "laparoscopic stump horn hysterectomy with gestation removal" for ectopic pregnancy with hemorrhagic shock. Emergency critical value reported before anesthesia serum potassium (K⁺) 8.25 mmol/L, active K reduction during the perioperative period⁺The patient recovered well after comprehensive treatment; In this context, severe hyperkalemia is extremely rare, and it is necessary to be vigilant and aware to ensure the safety of patients.

Vitiligo is an autoimmune skin disease characterized by skin depigmentation. Its skin lesions tend to occur in exposed parts of the body surface, which easily affects the appearance of patients, and then causes psychological problems such as anxiety. Negative emotions such as anxiety can further aggravate the condition through neuroendocrine and immune regulation, forming a vicious circle of "skin symptoms-psychological stress-immune disorder". Recent studies have shown that neuroimmune regulatory mechanisms play a key role in vitiligo complicated with anxiety. This paper discusses the neuroimmune mechanism of vitiligo complicated with anxiety, and proposes that psychological stress (such as anxiety) can activate the neuroimmune-endocrine network through the "brain-skin axis", including hypothalamus-pituitary-adrenal axis dysregulation, interleukin-17/helper T cell 17 pathway activation (pro-inflammatory microenvironment), abnormal serotonin metabolism, intestinal flora-skin axis disorder and mitochondrial dysfunction, which jointly aggravate melanocyte damage and depigmentation; And explore the combined treatment strategy based on accurate classification, in order to provide new ideas for clinical realization of body and mind simultaneous treatment.

With the acceleration of population aging, senile atopic dermatitis (AD) has attracted more and more attention because of its special pathological mechanism, clinical manifestations and risk of comorbidities. Among them, the incidence of neuropsychiatric disorders (such as anxiety, depression and cognitive impairment) in elderly patients with atopic dermatitis is significantly increased, and the two forms a close bidirectional connection through the inflammation-neuroendocrine axis. Combined with the latest research progress, this paper reviews the correlation between atopic dermatitis in the elderly and comorbid neuropsychiatric disorders, potential comorbid mechanisms and comprehensive treatment strategies, aiming at improving the understanding of atopic dermatitis in the elderly and its comorbid neuropsychiatric disorders, and providing references and suggestions for constructing comprehensive management strategies of inflammatory-neuroendocrine homeostasis.

With the ageing of the global population, the incidence of head and neck squamous cell carcinoma (HNSCC) in the elderly continues to rise, but its diagnosis and treatment are restricted by the lack of evidence-based evidence and strong physiological heterogeneity. This paper expounds the epidemiological characteristics, clinical and biological characteristics, evaluation and treatment status and optimization strategies of elderly HNSCC, emphasizes the core position of comprehensive geriatric assessment (CGA) in multidisciplinary collaboration (MDT), and provides reference for clinical diagnosis and treatment optimization.