元界

新英格兰医学杂志，第395卷，第14期，2026年10月8日。

New England Journal of Medicine, Volume 395, Issue 14, October 8, 2026.

新英格兰医学杂志，第395卷第14期，第1409-1425页，2026年10月8日。

New England Journal of Medicine, Volume 395, Issue 14, Page 1409-1425, October 8, 2026.

《新英格兰医学杂志》，第395卷，第14期，第1399-1408页，2026年10月8日。

New England Journal of Medicine, Volume 395, Issue 14, Page 1399-1408, October 8, 2026.

腿部溃疡是镰状细胞病（SCD，包括镰状细胞性贫血和其他镰状细胞病）的一种致残性并发症，且尚无经证实的治疗方法。Voxelotor 治疗镰状细胞病腿部溃疡的消退（RESOLVE）是一项 3 期、随机、双盲、安慰剂对照试验，评估 voxelotor 对年龄≥12 岁、患有 SCD（纯合血红蛋白 S [HbSS]/血红蛋白 S β0-地中海贫血 [HbSβ0]）且至少有 1 处活动性下肢皮肤溃疡的受试者腿部溃疡消退的作用。…

Leg ulcers are a debilitating complication of sickle cell disease (SCD, including sickle cell anaemia and other sickle cell disorders) and have no proven treatments. Resolution of Sickle Cell Leg Ulcers with Voxelotor (RESOLVE) was a Phase 3, randomised, double-blind, placebo-controlled trial evaluating voxelotor for leg ulcer resolution in participants aged ≥12 years with SCD (homozygous haemoglobin S [HbSS]/haemoglobin S β0-thalassaemia [HbSβ0]) and ≥1 active cutaneous lower-extremity ulcer.…

背景：肌肉骨骼（MSK）疾病占英国全科就诊的七分之一。尽管有国家指南，次优护理仍然普遍。数字临床决策支持系统（CDSS）提供了一种有前景的途径来改善护理质量，但尚未在肌肉骨骼初级保健中得到严格评估。目的：本研究旨在评估一种用于英国全科肌肉骨骼就诊的临床决策支持系统（CrossCover）的效力、临床有效性和成本效益、碳减排、安全性及实施情况。…

BACKGROUND: Musculoskeletal (MSK) conditions account for one in seven general practice consultations in the United Kingdom. Despite national guidelines, suboptimal care remains common. Digital clinical decision support systems (CDSSs) offer a promising route to improve care quality but have not been robustly evaluated in MSK primary care. OBJECTIVE: This study aimed to evaluate the efficacy, clinical effectiveness and cost-effectiveness, carbon reduction, safety, and implementation of a CDSS (CrossCover) for MSK consultations in UK general practice.…

目的：系统整合关于男孩附睾囊肿（ECs）的流行病学、临床特征、自然病程以及不同管理方法下所报道结局的现有证据。方法：采用符合PRISMA 2020标准的系统评价方法，检索PubMed、Embase和Scopus数据库，时间从建库至2026年8月31日。纳入包含18岁以下男性附睾囊肿患者并报道临床结局的观察性研究。对关键患病率结局进行单臂比例随机效应荟萃分析。…

PURPOSE: To systematically synthesise current evidence on the epidemiology, clinical characteristics, natural history, and outcomes reported under different management approaches for epididymal cysts (ECs) in boys. METHODS: A PRISMA 2020-compliant systematic review was conducted using PubMed, Embase, and Scopus from inception through 31 August 2026. Observational studies including males younger than 18 years with ECs and reporting clinical outcomes were eligible. Random-effects meta-analyses of single-arm proportions were performed for key prevalence outcomes.…

背景：麻醉技术可能影响术后恢复质量（QoR）。瑞马唑仑可能提供血流动力学稳定性和良好的早期恢复特征，但与丙泊酚相比，其对患者报告的QoR的影响仍不清楚。这在小型骨科手术中尤其重要，因为QoR是主要结局。这项随机对照试验使用QoR-40问卷比较了基于丙泊酚和基于瑞马唑仑的全凭静脉麻醉（TIVA）之间的术后QoR。……

BACKGROUND: Anesthetic technique may influence postoperative quality of recovery (QoR). Remimazolam may offer hemodynamic stability and favorable early recovery characteristics, but its effect on patient-reported QoR compared with propofol remains unclear. This is particularly relevant in minor orthopedic surgery, where QoR is a principal outcome. This randomized controlled trial compared postoperative QoR between propofol-based and remimazolam-based total intravenous anesthesia (TIVA) using the QoR-40 questionnaire.…

背景：经前症状可能对女性运动员的心理准备、认知-运动表现和主观疲劳感产生负面影响。红景天（RR）是一种适应原草药，已被研究其对疲劳、应激耐受能力、情绪和运动相关结果的潜在影响。然而，其对女性运动员经前症状和运动表现相关反应的影响仍不明确。……

BACKGROUND: Premenstrual symptoms may negatively influence psychological readiness, cognitive-motor performance, and perceived exertion in female athletes. Rhodiola rosea (RR) is an adaptogenic herb that has been investigated for its potential effects on fatigue, stress tolerance, mood, and exercise-related outcomes. However, its effects on premenstrual symptoms and performance-related responses in female athletes remain unclear.…

引言：屏幕时间与多种不良健康结局相关，包括肥胖。然而，针对儿童和青少年的证据有限且不一致，且潜在的性别特异性差异尚未被阐明。本系统综述旨在综合关于屏幕时间与儿童、青少年及年轻成人肥胖相关结局之间关联的证据，重点关注性别特异性途径及对公共卫生干预的启示。…

INTRODUCTION: Screen time is associated with multiple adverse health outcomes, including obesity. However, evidence for children and adolescents is limited and inconsistent, and potential sex-specific differences have not been characterized. This systematic review aimed to synthesize evidence on the association between screen time and obesity-related outcomes among children, adolescents, and young adults, with a focus on sex-specific pathways and implications for public health interventions.…

背景：在一项试点随机试验中，对于增加外周动脉疾病（PAD）患者的6分钟步行距离（主要结局）和减轻体重（次要结局）而言，面对面或电话动机性访谈（MI）在3个月后比智能手机应用程序更有效。关于与健康社会决定因素（SDOH）相关的干预异质性，目前知之甚少。目的：本研究旨在探讨SDOH是否与MI干预对步行距离和体重减轻的效果相关，并提出干预异质性假设。…

BACKGROUND: In a pilot randomized trial, face-to-face or telephone motivational interviewing (MI) was more efficacious than a smartphone app after 3 months for increasing 6-minute walk distance (primary outcome) and reducing body weight (secondary outcome) in patients with peripheral artery disease (PAD). Little is known about intervention heterogeneity related to social determinants of health (SDOH). OBJECTIVE: This study aimed to explore whether SDOH are associated with the MI intervention effects on walking distance and weight loss and generate intervention heterogeneity hypotheses.…

背景与目的：鉴于长效单克隆抗体（clesrovimab）的出现、完整MELODY试验队列数据的可获得性，以及一项大型随机试验（HARMONIE）的结果，我们更新了此前的网络荟萃分析，以评价单克隆抗体预防婴儿严重呼吸道合胞病毒（RSV）感染的效力和安全性。…

BACKGROUND AND OBJECTIVE: Motivated by the emergence of a long-acting monoclonal antibody (clesrovimab), the availability of data from the complete MELODY trial cohort, and results from a large randomized trial (HARMONIE), we updated our prior network meta-analysis to evaluate the efficacy and safety of monoclonal antibodies for preventing severe respiratory syncytial virus (RSV) infection in infants.…

膝骨关节炎（OA）是OA最常见的形式，也是全球慢性疼痛和残疾的主要原因。其日益增长的负担主要由老龄化和肥胖驱动，与社会重大成本及心血管死亡率增加相关。膝OA现在被认为是一种异质性全关节疾病，涉及生物力学、代谢、炎症、骨软骨和神经血管机制。这种复杂性有助于解释为什么现有镇痛药疗效有限，以及为什么改善病情的OA药物开发一再受挫。……

Knee osteoarthritis (OA) is the most prevalent form of OA and a leading cause of chronic pain and disability worldwide. Its growing burden, driven mainly by ageing and obesity, is associated with major societal costs and increased cardiovascular mortality. Knee OA is now recognized as a heterogeneous whole-joint disease involving biomechanical, metabolic, inflammatory, osteochondral and neurovascular mechanisms. This complexity helps to explain why existing analgesics have modest efficacy and why disease-modifying OA drug development has repeatedly faltered.…

目的：综述lecanemab（一种人源化免疫球蛋白γ1（IgG1）单克隆抗体）用于治疗早期阿尔茨海默病（AD）的药理学、疗效和安全性。数据来源：对Embase、PubMed、International Pharmaceutical Abstracts、Cochrane CENTRAL、Scopus、Web of Science和Google Scholar进行了从建库至2025年12月的全面检索。研究选择与数据提取：纳入评价lecanemab药理学、药代动力学、疗效和安全性的I-III期临床试验、系统评价和荟萃分析。…

OBJECTIVE: Review the pharmacology, efficacy, and safety of lecanemab, a humanized immunoglobulin gamma 1 (IgG1) monoclonal antibody, for the treatment of early Alzheimer's disease (AD). DATA SOURCES: Comprehensive search of Embase, PubMed, International Pharmaceutical Abstracts, Cochrane CENTRAL, Scopus, Web of Science, and Google Scholar were conducted from inception through December 2025. STUDY SELECTION AND DATA EXTRACTION: Phase I-III clinical trials, systematic reviews, and meta-analyses evaluating lecanemab pharmacology, pharmacokinetics, efficacy, and safety were included.…

综合饮食与生活方式指数可捕捉多种健康相关行为的联合效应，与单一暴露因素相比，可能更好地反映真实世界中的癌症风险和生存情况。本伞状综述旨在评估并分级关于综合饮食与生活方式质量指数依从性与子宫内膜癌（EC）结局之间关联的证据强度，这些结局包括风险、EC特异性生存率、总生存率、疾病复发、生活质量以及新发心脏代谢性疾病。…

Composite dietary and lifestyle indices capture the combined effects of multiple health-related behaviours and may better reflect real-world cancer risk and survivorship than single exposures. This umbrella review aimed to evaluate and grade the strength of evidence for associations between adherence to composite dietary and lifestyle quality indices and endometrial cancer (EC) outcomes, including risk, EC-specific survival, overall survival, disease recurrence, quality of life, and new-onset cardiometabolic diseases.…

Veligrotug（veligrotug-vvze；LUMVOA™）是一种由Viridian Therapeutics开发的单克隆抗体胰岛素样生长因子-1受体（IGF-1R）抑制剂，用于治疗甲状腺眼病（也称为格雷夫斯眼病/眼眶病或甲状腺相关性眼病）。2026年6月，基于两项跨国III期临床试验的阳性结果，veligrotug获美国FDA批准用于治疗甲状腺眼病，无论疾病活动性或持续时间如何。

Veligrotug (veligrotug-vvze; LUMVOA™) is a monoclonal antibody insulin-like growth factor-1 receptor (IGF-1R) inhibitor that was developed by Viridian Therapeutics for the treatment of thyroid eye disease (also known as Graves ophthalmopathy/orbitopathy or thyroid-associated ophthalmopathy). In June 2026, veligrotug was approved by the US FDA for the treatment of thyroid eye disease regardless of disease activity or duration, based on positive results from two multinational phase III clinical trials.…

利特昔替尼（Litfulo®）是一种Janus激酶（JAK）3与肝细胞癌中表达的酪氨酸激酶（TEC）激酶家族的口服双重抑制剂。已在全球多个国家获批用于治疗成人和12岁及以上青少年的重度斑秃。…

Ritlecitinib (Litfulo®) is an oral dual inhibitor of Janus kinase (JAK) 3 and the tyrosine kinase expressed in hepatocellular carcinoma (TEC) family of kinases. It is approved in several countries worldwide for the treatment of severe alopecia areata in adults and adolescents 12 years of age and older.…

抗菌素耐药性日益严峻的挑战促使开发具有新型作用机制的新抗生素。吉泊达星是一种首创的三氮杂苊烯类抗生素，开发用于治疗女性成人和青少年的非复杂性尿路感染（uUTIs）。它通过作用于DNA旋转酶和拓扑异构酶IV上不同于氟喹诺酮类药物的独特结合位点来抑制细菌DNA复制，因此呈现出一种新型作用机制。

The growing challenge of antimicrobial resistance has necessitated the development of new antibiotics with novel mechanisms of action. Gepotidacin is a first-in-class triazaacenaphthylene antibiotic developed for the treatment of uncomplicated urinary tract infections (uUTIs) in female adults and adolescents. It inhibits bacterial DNA replication by targeting both DNA gyrase and topoisomerase IV at a distinct binding site, differing from fluoroquinolones and therefore presenting a novel mechanism of action.…

过去二十年的研究已将运动从一般性生活方式建议重新定位为一种潜在的抗癌干预措施。对超过140万名参与者的汇总分析将规律体育活动与至少13种肿瘤类型的较低发病率联系起来，前瞻性队列数据报告，在最活跃的乳腺癌、结直肠癌、前列腺癌和肺癌患者中，癌症特异性死亡率降低24%–31%，尽管这些估计值来自使用自我报告活动量的观察性设计。…

Research over the past two decades has repositioned exercise from a general lifestyle recommendation to a potential anticancer intervention. Pooled analyses of more than 1.4 million participants link regular physical activity with lower incidence of at least 13 tumour types, and prospective cohort data report cancer-specific mortality 24-31% lower among the most active patients with breast, colorectal, prostate and lung cancer, although these estimates derive from observational designs using self-reported activity.…

目的：总结成人心脏手术患者使用比伐卢定抗凝对比普通肝素（UFH）在发病率、死亡率和输血需求方面的证据。测量与主要结果：共纳入三项随机对照试验（RCTs）中的407名患者进行汇总分析。主要结局（因出血再次手术探查）在两组间无显著差异（风险比：1.38，95%置信区间：0.42至4.48）。…

OBJECTIVES: To summarize the evidence on the morbidity, mortality, and transfusion requirements of adult patients undergoing cardiac surgery using bivalirudin for anticoagulation compared to unfractionated heparin (UFH). MEASUREMENTS AND MAIN RESULTS: A total of 407 patients in three randomized controlled trial (RCTs) were included for pooled analysis. There was no significant difference in the primary outcome; reexploration for hemorrhage between groups (risk ratio: 1.38, 95% confidence interval: 0.42 to 4.48).…

卵巢癌仍然是最致命的妇科恶性肿瘤，主要由于诊断延迟、快速进展以及对标准化疗的耐药。姜黄素是从姜黄（Curcuma longa）中提取的天然多酚，已因其通过调节多种分子通路而具有潜在抗癌特性而受到研究。本系统综述探讨了姜黄素及其纳米制剂在卵巢癌临床前模型中的机制和治疗作用。…

Ovarian cancer remains the most fatal gynecological malignancy, primarily due to delayed diagnosis, rapid progression, and resistance to standard chemotherapy. Curcumin, a natural polyphenol from Curcuma longa, has been investigated for its potential anticancer properties through the modulation of multiple molecular pathways. This systematic review examines the mechanistic and therapeutic roles of curcumin and its nanoformulations in preclinical models of ovarian cancer.…