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  • Yue-Peng Wang, Bing Li, Zhao-Hui Lyu, Wei-Jun Gu
    Medical Journal of Chinese People’s Liberation Army. 2024, 49(11): 1244-1250. doi:10.11855/j.issn.0577-7402.0236.2024.0924

    Cushing's disease is a severe endocrine disorder caused by excess secretion of adrenocorticotropic hormone from pituitary. Due to its subtle early clinical manifestations , the diagnosis of Cushing's disease is often delayed, and differentiating it from ectopic adrenocorticotropic hormone syndrome is a challenge. Combined functional tests can improve the diagnostic accuracy of Cushing's disease. The primary treatment for Cushing's disease is surgical removal of pituitary adenoma. However, about 1/3 of patients do not respond or experience recurrence after surgery, necessitating second-line treatments including medication. The development of novel drugs has enhanced the role of pharmacotherapy in the management of Cushing's disease. The review discusses the classic and emerging diagnostic methods and treatment strategies of Cushing's disease to deepen clinicians' understanding of its current treatment status and prospects.

  • Jing-Chun Song, Ren-Yu Ding, Ben Lyu, Heng Mei, Gang Wang, Wei Zhang, Jing Zhou, Jun Guo, Chinese Society of Thrombosis, Hemostasis and Critical
    Medical Journal of Chinese People’s Liberation Army. 2024, 49(11): 1221-1236. doi:10.11855/j.issn.0577-7402.1189.2024.0918

    Sepsis-induced coagulopathy (SIC), a critical and potentially lethal condition arising from sepsis, results in endothelial damage and significant coagulation dysregulation, making it a major factor contributing to mortality among sepsis patients. Early diagnosis and treatment of SIC are expected to improve the prognosis of sepsis patients. In 2019, the International Society on Thrombosis and Hemostasis (ISTH) issued the first guidelines for the diagnosis and treatment of SIC, but there are no corresponding protocols in China. Therefore, Chinese Society of Thrombosis, Hemostasis and Critical Care, Chinese Medicine Education Association, and Chinese People's Liberation Army Professional Committee of Critical Care Medicine jointly formulated the "Chinese Expert Consensus on the Diagnosis and Treatment of Sepsis-induced Coagulopathy (2024 edition)." This consensus includes 5 parts: pathogenesis, classification, laboratory approaches, diagnosis and treatment, with a total of 14 evidence-based recommendations to guide clinical practice.

  • Jing-Chun Song, Qing Song, Wei Zhang, Wei-Qin Li, Xi-Jing Zhang, Shu-Yuan Liu, Yan Gao, Hai-Ling Li, Heatstroke Prevention and Treatment Research Center of Chinese PLA, Expert Group of Heatstroke Prevention and Treatment of Chinese PLA, and Chinese PLA Professional Committee of Critical Care Medicine
    Medical Journal of Chinese People’s Liberation Army. 2025, 50(4): 367-386. doi:10.11855/j.issn.0577-7402.0506.2025.0328

    In recent years, the incidence and mortality of heatstroke have been increasing annually alongside global warming, with a marked rise in cases exhibiting atypical symptoms. To address the increasingly complex challenges in heatstroke prevention and treatment, Heatstroke Prevention and Treatment Research Center of Chinese PLA, Expert Group of Heatstroke Prevention and Treatment of Chinese PLA, and Chinese PLA Professional Committee of Critical Care Medicine have jointly developed this guideline (2025 edition). Utilizing the Grading of Recommendations Assessment, Development and Evaluation (GRADE) system, Appraisal of Guidelines for Research and Evaluation (AGREE) criteria, and Reporting Items for Practice Guidelines in Healthcare (RIGHT) standards, and based on the 2015 draft "Expert Consensus on the Standardized Diagnosis and Treatment of Heatstroke" and the 2019 "Chinese Expert Consensus on the Diagnosis and Treatment of Heatstroke", this guideline has been crafted. This guideline provides 25 evidence-based recommendations to guide the prevention, treatment and research of heatstroke, which thoroughly covers 8 critical domains: clinical classification, pathophysiological mechanisms, clinical manifestations, diagnostic criteria, differential diagnosis, treatment protocols, rehabilitation and return to work, and prevention.

  • Committee for the Prevention and Treatment of Senile Tumors, Chinese Society of Clinical Oncology (CSCO)
    Medical Journal of Chinese People’s Liberation Army. 2023, 48(9): 993-999. doi:10.11855/j.issn.0577-7402.0681.2022.0401

    With the improvement of people's health awareness and the popularization of low-dose spiral CT (LDCT) screening, more and more pulmonary nodules have been found. Pulmonary nodules gradually become a common and frequently occurring disease. The diagnosis and treatment of pulmonary nodules has also become a clinical problem. The rise of transbronchial pulmonary nodule diagnosis and treatment technology guided by various navigation technologies provides possibility for more minimally invasive diagnosis and treatment of pulmonary nodules. Navigation guided bronchoscopy is in a rapid development stage both at home and abroad. In order to standardize and promote the development of navigation bronchoscopy technology in China, Committee for the Prevention and Treatment of Senile Tumors of the CSCO organized domestic experts with rich experience in this field to jointly agree and write the consensus.

  • Expert consensus group on aeromedical identification of vasogenic white matter hyperintensities in Chinese aircrews
    Medical Journal of Chinese People’s Liberation Army. 2025, 50(5): 505-512. doi:10.11855/j.issn.0577-7402.0321.2025.0416

    White matter hyperintensities (WMH) are abnormal high-signal manifestations in white matter areas on magnetic resonance T2-weighted or fluid-attenuated inversion recovery (FLAIR) sequences, with vasogenic WMH being the most common. Its pathological mechanism is related to cerebrovascular lesions and can lead to multi-dimensional brain functional impairments in cognition, movement, and emotions. Due to their unique working conditions, aircrews are more prone to vasogenic WMH than the general population. Moreover, with the widespread use of magnetic resonance imaging in cranial disease screening for aircrews, the detection rate of vasogenic WMH in aircrews has significantly increased. However, to date, no national or academic organization has issued standardized aviation medical assessment criteria for vasogenic WMH in aircrews. Therefore, led by Xijing Hospital of Air Force Medical University and the Chinese PLA General Hospital, a multi-disciplinary expert panel involved in aviation medicine, neurology, radiology, psychology, and related fields was assembled to formulate this consensus. The document integrates evidence from a systematic review of PubMed, CNKI, Wanfang Data, and VIP databases, incorporates existing WMH guidelines, and synthesizes clinical expertise from Chinese specialists. The consensus outlines three key domains: target population, neuroimaging protocols for vasogenic WMH screening, and clinical assessment and aeromedical identification for aircrews with vasogenic WMH. The aim is to provide evidence-based support and expert recommendations for standardizing and improving the accuracy of aviation medical evaluations of vasogenic WMH in aircrews.

  • He Tian, Kang Chen, Ping An
    Medical Journal of Chinese People’s Liberation Army. 2022, 47(7): 647-652. doi:10.11855/j.issn.0577-7402.2022.07.0647

    Surgical injury is a major stressor, because patients with adrenal insufficiency are unable to secrete enough cortisol during perisurgery, such as giving only physiological alternative doses of glucocorticoids can induce adrenal crisis, life-threatening.Based on this, in February 2020, the Association of Anaesthetists, the Royal College of Physicians and the Society for Endocrinology UK published the Guidelines for the management of glucocorticoids during the peri-operative period for patients with adrenal insufficiency.In order to better understand and learn from the guide and promote the standardization of perioperative glucocorticoid replacement therapy in patients with adrenal insufficiency in China, this paper explains the epidemiology of glucocorticoid, adrenal cortex and adrenal crisis and perioperative glucocorticoid supplementation from the main content of the guide.

  • Xiao-Jun Chen, Yan-Quan Liu, Su-Rong Huang, Li-Wei Zhao, Jian-Zhen Shen
    Medical Journal of Chinese People’s Liberation Army. 2021, 46(10): 1040-1044. doi:10.11855/j.issn.0577-7402.2021.10.14

    Blastic plasmacytoid dendritic cell neoplasm (BPDCN) is a highly malignant hematological tumor derived from plasmacytoid dendritic cells (pDC) precursor cells, which has both lymphoma and leukemia characteristics, and is clinically rare. The disease easily involves the bone marrow, with low long-term survival rate and poor prognosis. Skin lesions can be seen in most BPDCN patients as the fi rst symptom, and their skin manifestations lack speci fi city, so is easy to be misdiagnosed and missed in clinic. High dose induction chemotherapy combined with hematopoietic stem cell transplantation (HSCT) are the main treatment methods for BPDCN,and new targeted therapies and immunotherapeutic drugs have also been put into clinical use. The de fi nition, epidemiology, pathogenesis,diagnosis and differential diagnosis, the latest research progress of treatment and prognosis of BPDCN have been summarized and discussed in present article, aiming to provide new ideas and references for the clinical diagnosis and treatment of BPDCN.

  • Yang Li, Lian-Yang Zhang
    Medical Journal of Chinese People’s Liberation Army. 2022, 47(10): 957-960. doi:10.11855/j.issn.0577-7402.2022.10.0957

    Surgery and resuscitation are the core capabilities of combat casualty care. Early treatment should be carried out within 3 hours, and divided into two phases, emergency treatment and surgical resuscitation, emphasizing the capability building of resuscitation and surgery. This paper interprets the capability requirements of the early casualty care level. According to the domestic and international progress in the care of civilian trauma and combat casualty, the relationship between "surgery" and "resuscitation" in the early treatment level of combat casualty, and the key technological progress are summarized, indicating that only the coordinated development of surgery and resuscitation ability and mutual support can provide safe, standardized and efficient treatment and reduce the death rate of the combat casualties.

  • Jin-Bao Zhao, Qian Wang, Tian-Yu Xin, Han-Ding Mao, Ye Tao, Bo Ning, Zhen-Zhen Qin, Shu-Yuan Liu, Qing Song
    Medical Journal of Chinese People’s Liberation Army. 2025, 50(5): 612-618. doi:10.11855/j.issn.0577-7402.0071.2024.1025

    Heat stroke is a heat-related illness caused by an imbalance between the body's heat production and heat dissipation, which could lead to multiple organ dysfunction syndrome with a high mortality rate. Rapid and effective reduction of core body temperature is key to successful treatment. This article reviews recent progress in the treatment of heat stroke, including new understandings of organ injury mechanisms, the timing, velocity and goals of cooling treatment, evaluation and selection of traditional cooling techniques (such as cold water immersion), and scientific evaluation of new cooling technologies (such as blood purification technology and intravascular heat exchange cooling technology), aiming to promote understanding and treatment of heat stroke.

  • Drug Therapy Committee of Chinese Antiepileptic Association
    Medical Journal of Chinese People’s Liberation Army. 2022, 47(7): 639-646. doi:10.11855/j.issn.0577-7402.2022.07.0639

    Status epilepticus is one of the critical illnesses involving multiple clinical disciplines. Although treatment is comprehensive, rapid termination of status epilepticus episodes is critical. The purpose of this article is to provide an actionable approach to rapidly terminating status epilepticus episodes by organizing multidisciplinary experts to improve patient outcomes.In the consensus, the experts put forward the purpose of the consensus, the scope of adaptation, the method and clinical practice of rapid termination of status epilepticus, and discuss several issues that need to be paid attention to in the treatment of status epilepticus, hoping to provide clinicians with an alternative when faced with status epilepticus.