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N Engl J Med[Jour] AND 393[volume] AND 1[issue] 新英格兰医学杂志 393卷1期 https://www.nejm.org/toc/nejm/medical-journal?query=main_nav_lg PERSPECTIVE（观点） 1 The Corporatization of U.S. Health Care: Defining Health Care “Corporatization” 美国医疗保健的企业化：界定医疗保健“企业化” E.C. Fuse Brown N Engl J Med; July 3, 2025; 393(1)：1-3 2 Self-Neglect in Older People — A Clinical, Social, and Ethical Dilemma 老年人自我忽视——临床、社会和伦理困境 K. Lees Haggerty and D.B. Reuben N Engl J Med; July 3, 2025; 393(1)：4-6 3 Biologic Drugs and Medicare Price Negotiation 生物制剂与医保价格谈判 T.J. Hwang , N.L. Keating , and S.B. Dusetzina N Engl J Med; July 3, 2025; 393(1)：6-9 4 The Autopsy Report 尸检报告 K. Klara N Engl J Med; July 3, 2025; 393(1)：9-11 ORIGINAL ARTICLES（论著） 5 Structured Exercise after Adjuvant Chemotherapy for Colon Cancer 结肠癌辅助化疗后的结构化运动 K.S. Courneya and Others N Engl J Med; July 3, 2025; 393(1)：13-25 6 Tirzepatide as Compared with Semaglutide for the Treatment of Obesity 与司美格鲁肽相比，替西帕肽治疗肥胖症的效果 L.J. Aronne and Others N Engl J Med; July 3, 2025; 393(1)：26-36 7 Neoadjuvant and Adjuvant Pembrolizumab in Locally Advanced Head and Neck Cancer 局部晚期头颈癌的新型辅助和辅助帕博利珠单抗治疗 R. Uppaluri and Others N Engl J Med; July 3, 2025; 393(1)：37-50 8 Safety and Efficacy of Obicetrapib in Patients at High Cardiovascular Risk 奥贝胆酸在心血管高危患者中的安全性和有效性 S.J. Nicholls and Others N Engl J Med; July 3, 2025; 393(1)：51-61 REVIEW ARTICLE（综述） 9 Forensic Pathology 法医病理学 R.D. Folkerth , B.A. Sampson , and J.K. Graham N Engl J Med; July 3, 2025; 393(1)：62-71 IMAGES IN CLINICAL MEDICINE（临床医学影像） 10 Diffuse Alveolar Hemorrhage in ANCA-Associated Vasculitis 抗中性粒细胞胞浆抗体相关性血管炎导致的弥漫性肺泡出血 I.S. Lee N Engl J Med; July 3, 2025; 393(1)：72 11 Frostbite Injury from Inhaled Nitrous Oxide Use 吸入一氧化二氮导致的冻伤损伤 M. Patrizio and M. Hayden N Engl J Med; July 3, 2025; 393(1)：e1 CLINICAL PROBLEM-SOLVING（临床问题解决） 12 Caving In to Pressure 屈服于压力 S.I. Gomez-Villegas and Others N Engl J Med; July 3, 2025; 393(1)：73-79 EDITORIALS（社论） 13 The Corporatization of U.S. Health Care — A New Perspective Series 美国医疗保健的企业化——一个新的观点与视角系列 D. Malina and Others N Engl J Med; July 3, 2025; 393(1)：81-82 14 Extending Cancer Survival with Exercise — Time for Oncology to Act 通过运动延长癌症患者生存期——肿瘤学该行动了 M.L. Irwin N Engl J Med; July 3, 2025; 393(1)：82-84 15 Semaglutide and Tirzepatide to Treat Obesity 司美格鲁肽和替西帕肽治疗肥胖症 F.L. Greenway N Engl J Med; July 3, 2025; 393(1)：84-85 16 Harnessing Immunotherapy in Curative-Intent Treatment of Head and Neck Cancer 在头颈癌根治性治疗中运用免疫疗法 A.J. Rosenberg and E.E. Vokes N Engl J Med; July 3, 2025; 393(1)：85-87 SOUNDING BOARD（议事堂） 17 From the National Academy of Medicine: Climate Change and Human Health — A Research Agenda for Action 来自美国国家医学院的观点：气候变化与人类健康——行动研究议程 V.J. Dzau and Others N Engl J Med; July 3, 2025; 393(1)：88-92 CORRESPONDENCE（读者来信） 18 Lifesaving Diagnosis through Prenatal Genomic Sequencing 通过产前基因组测序作出挽救生命的诊断 N Engl J Med; July 3, 2025; 393(1)：93-95 19 Intensive Blood-Pressure Control in Patients with Type 2 Diabetes 2型糖尿病患者强化血压控制 N Engl J Med; July 3, 2025; 393(1)：95-98 20 Antibiotic Treatment for 7 versus 14 Days in Patients with Bloodstream Infections 血流感染患者抗生素治疗7天与14天的对比 N Engl J Med; July 3, 2025; 393(1)：98-101 21 Dapagliflozin in Patients Undergoing TAVI 接受经导管主动脉瓣植入术患者使用达格列净的情况 N Engl J Med; July 3, 2025; 393(1)：101-103 22 Further Comments on Risdiplam for Prenatal Therapy of Spinal Muscular Atrophy 关于利司扑兰用于脊髓性肌萎缩症产前治疗的进一步评论 N Engl J Med; July 3, 2025; 393(1)：103-104 N Engl J Med[Jour] AND 393[volume] AND 2[issue] 新英格兰医学杂志 393卷2期 https://www.nejm.org/toc/nejm/medical-journal?query=main_nav_lg PERSPECTIVE（观点） 1 Who Will Care for America? Immigration Policy and the Coming Health Workforce Crisis 谁来关照美国？移民政策与即将到来的医疗劳动力危机 P.M.G. Santos , R. Jagsi , and C.I.A. Oronce N Engl J Med; July 10, 2025; 393(2)：105-107 2 Exclusion of Elective Care from Hospital Financial Assistance Policies — Arresting a Troubling Development 医院财务援助政策中排除择期护理——遏制令人不安的发展态势 M.A. Hall and J. Garber N Engl J Med; July 10, 2025; 393(2)：107-110 3 Libraries Burned, a Life Lived 图书馆被焚，人生如旅 T. Vijayan N Engl J Med; July 10, 2025; 393(2)：110-111 ORIGINAL ARTICLES（论著） 4 As-Needed Albuterol–Budesonide in Mild Asthma 按需使用沙丁胺醇-布地奈德治疗轻度哮喘 C. LaForce and Others N Engl J Med; July 10, 2025; 393(2)：113-124 5 Global Effect of Cardiovascular Risk Factors on Lifetime Estimates 心血管危险因素对终生风险的全球影响 The Global Cardiovascular Risk Consortium N Engl J Med; July 10, 2025; 393(2)：125-138 6 Intravenous Tenecteplase before Thrombectomy in Stroke 卒中血栓切除术前静脉注射替奈普酶 Z. Qiu and Others N Engl J Med; July 10, 2025; 393(2)：139-150 7 Overall Survival with Inavolisib in PIK3CA-Mutated Advanced Breast Cancer Inavolisib治疗PIK3CA突变型晚期乳腺癌的总生存期 K.L. Jhaveri and Others N Engl J Med; July 10, 2025; 393(2)：151-161 REVIEW ARTICLE（综述） 8 Juvenile Idiopathic Arthritis 幼年特发性关节炎 C.I. Sandborg , G.S. Schulert , and Y. Kimura N Engl J Med; July 10, 2025; 393(2)：162-174 IMAGES IN CLINICAL MEDICINE（临床医学影像） 9 Whipple’s Disease with Endocarditis 伴有心内膜炎的惠普尔病 P. Ackermann and M.A. Borger N Engl J Med; July 10, 2025; 393(2)：175 10 Incarcerated Femoral Hernia 嵌顿性股疝 P. Rana and H. Jivani N Engl J Med; July 10, 2025; 393(2)：e2 CASE RECORDS OF THE MASSACHUSETTS GENERAL HOSPITAL（马萨诸塞州总医院病例记录） 11 Case 19-2025: A 69-Year-Old Man with Headache and Ataxia 病例19-2025：一名69岁男性，头痛且共济失调 A. Venkatesan and Others N Engl J Med; July 10, 2025; 393(2)：176-184 EDITORIALS（社论） 12 Your Combination Asthma Inhaler — Don’t Leave Home without It! 你的联合哮喘吸入器——出门别忘了带！ J.M. Drazen N Engl J Med; July 10, 2025; 393(2)：186-187 13 Estimates of Cardiovascular Risks and Benefits — When Knowing Is Not Enough 心血管风险和获益的评估——光知晓并不够 G.A. Mensah N Engl J Med; July 10, 2025; 393(2)：187-189 14 Thrombolysis before Thrombectomy in Stroke — A Bridge Not Fallen 卒中血栓切除术前溶栓治疗——一座未坍塌的桥梁 T.W. Leung N Engl J Med; July 10, 2025; 393(2)：189-191 SOUNDING BOARD（议事堂） 15 From the National Academy of Medicine: Transforming Health Care — Shared Commitments for a Learning Health System 来自美国国家医学院的观点：转变医疗保健模式——构建学习型医疗系统的共同承诺 J.L. Madara and Others N Engl J Med; July 10, 2025; 393(2)：192-197 CORRESPONDENCE（通信） 16 Expansion of tetM-Carrying Neisseria gonorrhoeae in the United States, 2018–2024 2018-2024年美国携带tetM的淋病奈瑟菌的扩散情况 N Engl J Med; July 10, 2025; 393(2)：198-200 17 Atrial Appendage Closure after Ablation for Atrial Fibrillation 心房颤动消融术后左心耳封堵 N Engl J Med; July 10, 2025; 393(2)：200-203 18 Tumor-Infiltrating Clonal Hematopoiesis 肿瘤浸润性克隆性造血 N Engl J Med; July 10, 2025; 393(2)：203-205 19 Wealth and Mortality in the United States and Europe 美国和欧洲的财富与死亡率 N Engl J Med; July 10, 2025; 393(2)：205-207 20 Addressing Alcohol Use 应对酒精使用问题 N Engl J Med; July 10, 2025; 393(2)：207-208 N Engl J Med[Jour] AND 393[volume] AND 3[issue] 新英格兰医学杂志 393卷3期 https://www.nejm.org/toc/nejm/medical-journal?query=main_nav_lg PERSPECTIVE（观点） 1 The Role of Public Health Agencies in Creating Vaccine Policy 公共卫生机构在制定疫苗政策中的作用 P. Marks N Engl J Med; July 17, 2025; 393(3):209-211 2 New Mammography Tools — The Need for Clinically Meaningful Assessment Standards 新的乳腺钼靶工具——需要有临床意义的评估标准 B. Hyams , K. Kerlikowske , and R.F. Redberg N Engl J Med; July 17, 2025; 393(3):211-213 3 The Second Life of Jacqui B. Jacqui B.的第二人生。 M. Earnest and P. Khazanie N Engl J Med; July 17, 2025; 393(3):214-215 ORIGINAL ARTICLES（论著） 4 Perioperative Durvalumab in Gastric and Gastroesophageal Junction Cancer 杜伐鲁单抗在胃和胃食管结癌围手术期的应用 Y.Y. Janjigian and Others N Engl J Med; July 17, 2025; 393(3):217-230 5 First-Line Treatment of Pulmonary Sarcoidosis with Prednisone or Methotrexate 强的松或甲氨蝶呤治疗肺结节病的一线治疗 V. Kahlmann and Others N Engl J Med; July 17, 2025; 393(3):231-242 6 Graft-versus-Host Disease Prophylaxis with Cyclophosphamide and Cyclosporin 环磷酰胺和环孢素预防移植物抗宿主病 D.J. Curtis and Others N Engl J Med; July 17, 2025; 393(3):243-254 7 Multidose Ondansetron after Emergency Visits in Children with Gastroenteritis 小儿肠胃炎急诊后多剂量昂丹司琼的疗效 S.B. Freedman and Others N Engl J Med; July 17, 2025; 393(3):255-266 8 Brief Report: Rapid Recovery of Donor Hearts for Transplantation after Circulatory Death 简要报告：供体心脏在循环性死亡后快速恢复 A.M. Williams and Others N Engl J Med; July 17, 2025; 393(3):267-274 9 Brief Report: On-Table Reanimation of a Pediatric Heart from Donation after Circulatory Death 简要报告：一名循环死亡后捐赠的儿童心脏在手术台上复活 J.A. Kucera , D.M. Overbey , and J.W. Turek N Engl J Med; July 17, 2025; 393(3):275-280 REVIEW ARTICLE(综述) 10 The Spectrum of Fragile X Disorders 脆性X染色体紊乱谱系 R.J. Hagerman and P.J. Hagerman N Engl J Med; July 17, 2025; 393(3):281-288 IMAGES IN CLINICAL MEDICINE（临床医学影像学） 11 Acrometastases Acrometastases H. O’Rourke and M. Iddawela N Engl J Med; July 17, 2025; 393(3):289 12 Microcysts in Lithium-Induced Nephropathy 锂诱发肾病中的微囊 C.-H. Liao and K.-L. Liu N Engl J Med; July 17, 2025; 393(3):e3 CASE RECORDS OF THE MASSACHUSETTS GENERAL HOSPITAL（马赛诸塞州总医院病例记录） 13 Case 20-2025: An 86-Year-Old Woman with Neck Swelling and Dysphagia 病例20-2025:86岁女性，颈部肿胀和吞咽困难 M.L. Russell and Others N Engl J Med; July 17, 2025; 393(3):290-300 EDITORIALS（社论） 14 New Perioperative Strategy in Gastric Cancer 胃癌围手术期新策略 K. Shitara N Engl J Med; July 17, 2025; 393(3):302-303 15 Methotrexate as Initial Therapy for Symptomatic Pulmonary Sarcoidosis? 甲氨蝶呤作为症状性肺结节病的初始治疗？ R.P. Baughman and E.E. Lower N Engl J Med; July 17, 2025; 393(3):303-305 CORRESPONDENCE（通信） 16 Monoclonal Anti–Platelet Factor 4 Antibodies in Recurrent Pregnancy Loss 单克隆抗血小板因子4抗体在复发性妊娠丢失中的作用 N Engl J Med; July 17, 2025; 393(3):306-309 17 Apixaban for Cancer-Associated Venous Thromboembolism 阿哌沙班治疗癌症相关静脉血栓栓塞 N Engl J Med; July 17, 2025; 393(3):309-312 N Engl J Med[Jour] AND 393[volume] AND 4[issue] 新英格兰医学杂志 393卷4期 https://www.nejm.org/toc/nejm/medical-journal?query=main_nav_lg PERSPECTIVE(观点) 1 Brain Death in Pregnancy — Abortion, Advance-Directive, or End-of-Life Law? 妊娠期脑死亡——人工流产、预先指示还是临终法律问题？ K. Watson N Engl J Med; July 24, 2025; 393(4):313-315 2 The Faulty Logic behind the Supreme Court’s Failure to Protect Trans Minors 最高法院未能保护跨性别未成年人的逻辑谬误 S. Skinner-Thompson N Engl J Med; July 24, 2025; 393(4):316-318 3 The Promise of Real-World Data for Research — What Are We Missing? 现实世界数据研究的前景——我们错过了什么？ A.B. Abbasi , L.H. Curtis , and R.M. Califf N Engl J Med; July 24, 2025; 393(4):318-321 4 Avocado and Salt 鳄梨和盐 G. Yi N Engl J Med; July 24, 2025; 393(4):321-323 ORIGINAL ARTICLES(论著) 5 Weekly Fixed-Dose Insulin Efsitora in Type 2 Diabetes without Previous Insulin Therapy 未接受胰岛素治疗的2型糖尿病患者的每周固定剂量艾塞那肽胰岛素 J. Rosenstock and Others N Engl J Med; July 24, 2025; 393(4):325-335 6 Trastuzumab Deruxtecan or Ramucirumab plus Paclitaxel in Gastric Cancer 德曲妥珠单抗或雷莫芦单抗联合紫杉醇治疗胃癌 K. Shitara and Others N Engl J Med; July 24, 2025; 393(4):336-348 7 Tarlatamab in Small-Cell Lung Cancer after Platinum-Based Chemotherapy 塔拉他单抗在小细胞肺癌铂基化疗后的疗效 G. Mountzios and Others N Engl J Med; July 24, 2025; 393(4):349-361 8 Ivermectin to Control Malaria — A Cluster-Randomized Trial 伊维菌素控制疟疾-一项集群随机试验 C. Chaccour and Others N Engl J Med; July 24, 2025; 393(4):362-375 REVIEW ARTICLE(综述) 9 Medical Education: Competency-Based Medical Education at the Front Lines of Patient Care 医学教育：位于患者护理第一线的基于能力的医学教育 D. Cooper and E.S. Holmboe N Engl J Med; July 24, 2025; 393(4):376-388 IMAGES IN CLINICAL MEDICINE(临床医学影像) 10 Löfgren’s Syndrome 洛夫格伦综合征 M. Hassan N Engl J Med; July 24, 2025; 393(4):389 11 Hydroxychloroquine Retinal Toxicity 羟氯喹视网膜毒性 A. Donnelly and N. Horgan N Engl J Med; July 24, 2025; 393(4):e4 INTERACTIVE MEDICAL CASE(互动式医疗案例) 12 A Case of Crackles 一例啰音病例 J.I. Hsu and Others N Engl J Med; July 24, 2025; 393(4):e5 CASE RECORDS OF THE MASSACHUSETTS GENERAL HOSPITAL(马赛诸塞州总医院病例记录） 13 Case 21-2025: A 75-Year-Old Man with Cough, Dyspnea, and Hypoxemia 病例21-2025:75岁男性，咳嗽、呼吸困难伴低氧血症 A.M. Anandaiah and Others N Engl J Med; July 24, 2025; 393(4):390-399 EDITORIALS(社论) 14 Weekly Insulins and Therapeutic Burden in Type 2 Diabetes 每周胰岛素与2型糖尿病的治疗负担 J.R. Ingelfinger and C.J. Rosen N Engl J Med; July 24, 2025; 393(4):401-402 15 Ivermectin against Malaria — Good News in Bad Times 伊维菌素抗疟疾——艰难时期的好消息 R.W. Steketee N Engl J Med; July 24, 2025; 393(4):402-404 CLINICAL DECISIONS(临床决策) 16 Statin Therapy for Children 儿童他汀类药物治疗 H.K. Marwah, I.K. Luirink , and M. Mietus-Snyder N Engl J Med; July 24, 2025; 393(4):405-407 CORRESPONDENCE(通信) 17 Efficacy and Safety of Obinutuzumab in Active Lupus Nephritis 奥比妥珠单抗治疗活动性狼疮性肾炎的疗效和安全性 N Engl J Med; July 24, 2025; 393(4):408-410 18 Lepodisiran — A Long-Duration Small Interfering RNA Targeting Lipoprotein(a) Lepodisiran -一种靶向脂蛋白(A)的长效干扰性小RNA N Engl J Med; July 24, 2025; 393(4):411-412 19 BCG Revaccination to Prevent Tuberculosis 卡介苗复种预防结核病 N Engl J Med; July 24, 2025; 393(4):412-413 20 Evolving Epidemiology of Mpox in Africa in 2024 2024年非洲猴痘流行病学演变 N Engl J Med; July 24, 2025; 393(4):414 21 Enteral Nutrition in Hospitalized Adults 住院成人肠内营养 N Engl J Med; July 24, 2025; 393(4):415-416 N Engl J Med[Jour] AND 393[volume] AND 5[issue] 新英格兰医学杂志 393卷5期 https://www.nejm.org/toc/nejm/medical-journal?query=main_nav_lg PERSPECTIVE(观点) 1 Revised Recommendations for Covid-19 Vaccines — U.S. Vaccination Policy under Threat Covid-19疫苗修订建议——美国疫苗接种政策受到威胁 J.L. Schwartz N Engl J Med; July 31, 2025; 393(5):417-419 2 Public Policies, Social Narratives, and Population Health 公共政策、社会叙事与人口健康 A.S. Venkataramani , P.S. Tamber , and A. Iton N Engl J Med; July 31, 2025; 393(5):419-421 3 Into the Valley of the Sick 进入病痛的之谷 S. Wesloh N Engl J Med; July 31, 2025; 393(5):421-423 4 Interactive Perspective: Human Papillomavirus and Cancer 互动视角：人类乳头瘤病毒与癌症 J.R. Barzilay and Others N Engl J Med; July 31, 2025; 393(5):e6 ORIGINAL ARTICLES(论著) 5 Measurable Residual Disease–Guided Therapy in Newly Diagnosed Myeloma 可测量的残留疾病–指导新诊断的骨髓瘤治疗 A. Perrot and Others N Engl J Med; July 31, 2025; 393(5):425-437 6 Mitochondrial Donation and Preimplantation Genetic Testing for mtDNA Disease 线粒体捐献和植入前mtDNA疾病基因检测 L.A. Hyslop and Others N Engl J Med; July 31, 2025; 393(5):438-449 7 A Randomized Trial of Acute Normovolemic Hemodilution in Cardiac Surgery 心脏手术中急性等容血稀释的随机试验 F. Monaco and Others N Engl J Med; July 31, 2025; 393(5):450-460 8 Brief Report: Mitochondrial Donation in a Reproductive Care Pathway for mtDNA Disease 简要报告：线粒体捐赠在mtDNA疾病的生殖保健途径 R. McFarland and Others N Engl J Med; July 31, 2025; 393(5):461-468 9 Brief Report: Resolution of Squamous-Cell Carcinoma by Restoring T-Cell Receptor Signaling 简要报告：通过恢复t细胞受体信号传导来解决鳞状细胞癌 P. Ye and Others N Engl J Med; July 31, 2025; 393(5):469-478 REVIEW ARTICLE(综述文章) 10 Motor Vehicle Crash Prevention 预防机动车辆碰撞 S.G. Klauer and Z.R. Doerzaph N Engl J Med; July 31, 2025; 393(5):479-486 IMAGES IN CLINICAL MEDICINE(临床医学影像) 11 Spontaneous Intracranial Hypotension 自发性颅内低血压 S.B. Owais and Y. Kianirad N Engl J Med; July 31, 2025; 393(5):487 12 Spiderweb-like Vessels in Retinopathy of Prematurity 早产儿视网膜病变中的蜘蛛网状血管 X. Zhao and G. Zhang N Engl J Med; July 31, 2025; 393(5):e7 CASE RECORDS OF THE MASSACHUSETTS GENERAL HOSPITAL(马赛诸塞州总医院病例记录） 13 Case 22-2025: A 19-Year-Old Woman with Seizurelike Activity and Odd Behaviors 案例22-2025：一名19岁女性出现癫痫样活动和怪异行为 J.A. Restrepo and Others N Engl J Med; July 31, 2025; 393(5):488-496 EDITORIALS(社论) 14 Opening the Door to Tailored Treatment in Newly Diagnosed Multiple Myeloma 开启新诊断多发性骨髓瘤个性化治疗的大门 P.G. Richardson , N.C. Munshi , and D.L. Longo N Engl J Med; July 31, 2025; 393(5):498-500 15 Reducing the Risks of Mitochondrial Disease in Children 降低儿童线粒体疾病的风险 R. Lovell-Badge N Engl J Med; July 31, 2025; 393(5):500-503 16 Science behind the Study: Advances in Preventing Transmission of Mitochondrial DNA Diseases 研究背后的科学：预防线粒体DNA疾病传播的进展 J. Steffann N Engl J Med; July 31, 2025; 393(5):503-507 MEDICINE AND SOCIETY(医学与社会) 17 Reform and Remedy for Imprecision and Inequity — Ending the Race-Based Evaluation of Occupational Pulmonary Impairment 改革与修正——终结基于种族的职业性肺功能障碍评估 R. Khazanchi and Others N Engl J Med; July 31, 2025; 393(5):508-514 CORRESPONDENCE(通信) 18 Phase 2a Study of Baxdrostat in Primary Aldosteronism 巴司他治疗原发性醛固酮增多症的2a期研究 N Engl J Med; July 31, 2025; 393(5):515-518 19 Pulsed Field or Cryoballoon Ablation for Paroxysmal Atrial Fibrillation 脉冲场或低温球囊消融治疗阵发性心房颤动 N Engl J Med; July 31, 2025; 393(5):518-520 N Engl J Med[Jour] AND 393[volume] AND 6[issue] 新英格兰医学杂志 393卷6期 https://www.nejm.org/toc/nejm/medical-journal?query=main_nav_lg PERSPECTIVE(观点) 1 The Corporatization of U.S. Health Care: A Gilded Age for Patients? The Broken Promises of Profit-Driven Medicine 美国医疗保健公司化：病人的镀金时代？利润驱动的医药破碎的承诺 N. Tomes N Engl J Med;August 7,2025;393(6):521-524 2 Lead Contamination in Milwaukee Schools — The Latest Episode in an Ongoing Toxic Pandemic 密尔沃基学校的铅污染——正在进行的毒性大流行的最新事件 M.S. Kanarek N Engl J Med;August 7,2025;393(6):524-526 3 Training Health Communicators — The Need for a New Approach 培训健康传播者——需要一种新的方法 K. Panthagani and Others N Engl J Med;August 7,2025;393(6):526-529 4 ER and Me 急诊室和我 E. Rourke N Engl J Med;August 7,2025;393(6):529-531 ORIGINAL ARTICLES(论著) 5 Finerenone with Empagliflozin in Chronic Kidney Disease and Type 2 Diabetes 芬尼酮联合恩格列净治疗慢性肾病和2型糖尿病 R. Agarwal and Others N Engl J Med;August 7,2025;393(6):533-543 6 Ciprofloxacin versus Aminoglycoside–Ciprofloxacin for Bubonic Plague 环丙沙星与氨基糖苷-环丙沙星治疗黑死病 R.V. Randremanana and Others N Engl J Med;August 7,2025;393(6):544-555 7 Vepdegestrant, a PROTAC Estrogen Receptor Degrader, in Advanced Breast Cancer Vepdegestrant：一种用于晚期乳腺癌的PROTAC雌激素受体降解剂 M. Campone and Others N Engl J Med;August 7,2025;393(6):556-568 8 First-Line Camizestrant for Emerging ESR1-Mutated Advanced Breast Cancer 一线用药卡米兹斯特兰治疗新发ESR1突变的晚期乳腺癌 F.-C. Bidard and Others N Engl J Med;August 7,2025;393(6):569-580 REVIEW ARTICLE(综述) 9 Testosterone Treatment in Middle-Aged and Older Men with Hypogonadism 中老年低促性腺激素性腺功能减退症患者的睾酮治疗 S. Bhasin and P.J. Snyder N Engl J Med;August 7,2025;393(6):581-591 IMAGES IN CLINICAL MEDICINE(临床医学影像) 10 E-Cigarette– or Vaping-Associated Lung Injury 电子烟–或吸电子烟–相关肺损伤 M.Z. Roslly and S.A. Syed Rozhan N Engl J Med;August 7,2025;393(6):592 11 Crusted Scabies 陈年的疥疮 Y.-J. Sun and H. Gong N Engl J Med;August 7,2025;393(6):e8 CLINICAL PROBLEM-SOLVING(临床问题解决) 12 Gasping for Strength 喘息求生 D. Zarhin , H. Kolb , and A. Gadoth N Engl J Med;August 7,2025;393(6):593-599 EDITORIALS(社论) 13 Combination Therapy for Chronic Kidney Disease and Type 2 Diabetes — A Promising Prelude 慢性肾病和2型糖尿病的联合治疗——充满希望的前奏 C. Zoccali and F. Mallamaci N Engl J Med;August 7,2025;393(6):601-602 14 Chipping Away at an Old Foe 逐步击破旧敌 P. Mead N Engl J Med;August 7,2025;393(6):603-604 15 Science behind the Study: Degradation of the Estrogen Receptor in Breast Cancer 研究背后的科学：乳腺癌中雌激素受体的降解 D.P. McDonnell N Engl J Med;August 7,2025;393(6):604-608 MEDICINE AND SOCIETY(医学与社会) 16 Restoring the Infant Mortality Rate as a Measure of Societal Health and Well-Being 恢复将婴儿死亡率作为衡量社会健康和福祉的一项指标 E.A. Harrison , U. Ndulue , and B.O. Ojikutu N Engl J Med;August 7,2025;393(6):609-614 CORRESPONDENCE(通信) 17 Xenon — Propelling Climbers to the Summits of the World’s Highest Mountains? 氙气—推动登山者登顶世界最高的山脉？ N Engl J Med;August 7,2025;393(6):615-616 18 Daratumumab for High-Risk Smoldering Multiple Myeloma 达雷妥尤单抗用于高危沉默型多发性骨髓瘤 N Engl J Med;August 7,2025;393(6):616-617 19 A Randomized Trial of Automated Insulin Delivery in Type 2 Diabetes 2型糖尿病患者自动胰岛素输送的随机试验 N Engl J Med;August 7,2025;393(6):617-619 20 Enhanced CAR T-Cell Therapy for Relapsed Lymphoma 增强型CAR T细胞疗法治疗复发性淋巴瘤 N Engl J Med;August 7,2025;393(6):619-620 21 Malaria 疟疾 N Engl J Med;August 7,2025;393(6):620-621 22 Neonatal Fc Receptor — Biology and Therapeutics 新生儿Fc受体——生物学与治疗 N Engl J Med;August 7,2025;393(6):621-623 NEngl J Med[Jour] AND 393[volume] AND 7[issue] 新英格兰医学杂志 393卷7期 https://www.nejm.org/toc/nejm/medical-journal?query=main_nav_lg PERSPECTIVE(观点) 1 Dismantling Public Health Infrastructure, Endangering American Lives 拆除公共卫生基础设施危及美国人的生命 T.R. Frieden N Engl J Med;August 14,2025;393(7):625-627 2 Progress Lost — The Unraveling of Medicaid and the Affordable Care Act 停滞不前——医疗补助和《平价医疗法案》的瓦解 J. Oberlander N Engl J Med;August 14,2025;393(7):628-629 3 The Resurgence of Private Law in American Health Care 美国医疗保健私法的复兴 C. Robertson and W.N. Epstein N Engl J Med;August 14,2025;393(7):630-631 4 The Serendipitous Dance between Life and Death 生与死之间的偶然之舞 A. Zorigtbaatar N Engl J Med;August 14,2025;393(7):632-633 ORIGINAL ARTICLES(论著) 5 Coadministered Cagrilintide and Semaglutide in Adults with Overweight or Obesity Cagrilintide和Semaglutide联合应用于超重或肥胖的成人 W.T. Garvey and Others N Engl J Med;August 14,2025;393(7):635-647 6 Cagrilintide–Semaglutide in Adults with Overweight or Obesity and Type 2 Diabetes Cagrilintide–Semaglutide在超重或肥胖和2型糖尿病成人中的应用 M.J. Davies and Others N Engl J Med;August 14,2025;393(7):648-659 7 A Crossover Trial of Hospital-Wide Lactated Ringer’s Solution versus Normal Saline 医院范围内的乳酸林格氏溶液与生理盐水的交叉试验 L. McIntyre and Others N Engl J Med;August 14,2025;393(7):660-670 8 Risdiplam in Presymptomatic Spinal Muscular Atrophy Risdiplam治疗亚临床脊髓性肌萎缩症 R.S. Finkel and Others N Engl J Med;August 14,2025;393(7):671-682 REVIEW ARTICLE(综述) 9 Metabolic Dysfunction–Associated Steatotic Liver Disease 代谢功能障碍相关脂肪性肝病 G. Targher , L. Valenti , and C.D. Byrne N Engl J Med;August 14,2025;393(7):683-698 IMAGES IN CLINICAL MEDICINE(临床医学影像) 10 Snowman Sign in Pituitary Macroadenoma 垂体巨腺瘤的雪人征 Y. Zhou and W. Weng N Engl J Med;August 14,2025;393(7):699 11 Ocular Gnathostomiasis 眼型囊尾蚴病 S. Karkhur and A. Gupta N Engl J Med;August 14,2025;393(7):e9 CASE RECORDS OF THE MASSACHUSETTS GENERAL HOSPITAL(马萨诸塞州总医院病例记录) 12 Case 23-2025: A 28-Year-Old Woman with Respiratory Failure and Abnormal Chest Imaging 病例23-2025：一例28岁女性，呼吸衰竭伴胸部影像异常 W.J. Janssen and Others N Engl J Med;August 14,2025;393(7):700-710 EDITORIALS(社论) 13 Expanding the Treat-to-Target Toolbox for Obesity and Diabetes Care 扩展肥胖和糖尿病的治疗目标工具箱 C.M. Hales N Engl J Med;August 14,2025;393(7):712-714 14 Science behind the Study: Presymptomatic Treatment of a Genetic Disease with a Small-Molecule Drug 研究背后的科学：小分子药物在遗传性疾病亚临床阶段中的治疗 C.J. Sumner N Engl J Med;August 14,2025;393(7):714-717 15 Reviewers for the Journal, January–June 2025 本杂志2025年1月至6月的审稿人  E.J. Rubin N Engl J Med;August 14,2025;393(7):718 CLINICAL DECISIONS(临床决策) 16 Managing Obesity 肥胖治疗 C.P. Kotanidis , A.M. Lincoff , and S.A. Shikora N Engl J Med;August 14,2025;393(7)::719-721 CORRESPONDENCE(通信) 17 A Naturally Occurring Gain-of-Function Mutation in Factor VIII 因子VIII中自然发生的功能获得突变 N Engl J Med;August 14,2025;393(7):722-724 18 Oral Semaglutide and Cardiovascular Outcomes 口服司美格鲁肽与心血管预后 N Engl J Med;August 14,2025;393(7):724-725 19 Lorundrostat Efficacy and Safety in Uncontrolled Hypertension Lorundrostat在未控制的高血压中的疗效和安全性 N Engl J Med;August 14,2025;393(7):725-727 20 Cancer of Unknown Primary Site 原发部位不明的癌症 N Engl J Med;August 14,2025;393(7):727-728 N Engl J Med[Jour] AND 393[volume] AND 8[issue] 新英格兰医学杂志 393卷 8期 https://www.nejm.org/toc/nejm/medical-journal?query=main_nav_lg PERSPECTIVE（观点） 1 Preventive Care at the Supreme Court 最高法院谈预防性医疗 N. Bagley N Engl J Med; Aug 21/28, 2025; 393(8)：729-731 2 Regulating Private Equity in Health Care — The Massachusetts Model 医疗保健领域私募股权的监管——马萨诸塞模式 T.C. Tsai , G.S. Meyer , and D. Blumenthal N Engl J Med; Aug 21/28, 2025; 393(8)：731-733 3 Reforming the Prescription Drug User Fee Program 改革处方药用户费用计划 T.J. Ziaks and Others N Engl J Med; Aug 21/28, 2025; 393(8)：734-736 4 The Consultant 顾问视角 T. Adzemovic N Engl J Med; Aug 21/28, 2025; 393(8)：736-739 ORIGINAL ARTICLES（论著） 5 Overall Survival with Neoadjuvant Nivolumab plus Chemotherapy in Lung Cancer 纳武利尤单抗联合化疗新辅助治疗肺癌的总生存期 P.M. Forde and Others N Engl J Med; Aug 21/28, 2025; 393(8)：741-752 6 Elinzanetant for Vasomotor Symptoms from Endocrine Therapy for Breast Cancer 艾琳扎奈坦特用于乳腺癌内分泌治疗引起的血管舒缩症状 F. Cardoso and Others N Engl J Med; Aug 21/28, 2025; 393(8)：753-763 7 Phase 3 Trial of Inhaled Molgramostim in Autoimmune Pulmonary Alveolar Proteinosis 吸入莫格拉斯汀治疗自身免疫性肺泡蛋白沉积症的3期试验 B.C. Trapnell and Others N Engl J Med; Aug 21/28, 2025; 393(8)：764-773 8 Adjuvant Cemiplimab or Placebo in High-Risk Cutaneous Squamous-Cell Carcinoma 西米普利单抗辅助治疗对比安慰剂用于高危皮肤鳞状细胞癌 D. Rischin and Others N Engl J Med; Aug 21/28, 2025; 393(8)：774-785 REVIEW ARTICLE（综述） 9 Medical Education: Educational Strategies for Clinical Supervision of Artificial Intelligence Use 医学教育：人工智能应用临床监督的教育策略 R.-E.E. Abdulnour , B. Gin , and C.K. Boscardin N Engl J Med; Aug 21/28, 2025; 393(8)：786-797 IMAGES IN CLINICAL MEDICINE（临床医学影像） 10 Paraganglioma in the Organ of Zuckerkandl 颈动脉体旁器官副神经节瘤 R. Cohen and P. Hammill N Engl J Med; Aug 21/28, 2025; 393(8)：798 11 Abdominojugular Reflux Test 腹颈静脉回流试验 S. Bent and G. Dhaliwal N Engl J Med; Aug 21/28, 2025; 393(8)：e10 CASE RECORDS OF THE MASSACHUSETTS GENERAL HOSPITAL（马萨诸塞州总医院病例记录） 12 Case 24-2025: A 32-Year-Old Woman with Fatigue and Myalgias 2025年第24例病例：一例32岁女性，疲劳伴肌痛 D.G. Kwolek and Others N Engl J Med; Aug 21/28, 2025; 393(8)：799-807 EDITORIALS（社论） 13 Redefining Lung Cancer Therapy — A Long-Awaited Shift in Strategy 重新定义肺癌治疗——期待已久的策略转变 V. Calvo N Engl J Med; Aug 21/28, 2025; 393(8)：809-810 14 Menopausal Symptom Management in Breast Cancer Survivors — A Promising New Option 乳腺癌幸存者的更年期症状管理——一种有前景的新选择 A.H. Partridge N Engl J Med; Aug 21/28, 2025; 393(8)：810-812 15 Science behind the Study: GM-CSF in Autoimmune Pulmonary Alveolar Proteinosis 研究背后的科学：GM-CSF在自身免疫性肺泡蛋白沉积症中的作用 J.F. Seymour N Engl J Med; Aug 21/28, 2025; 393(8)：812-816 SOUNDING BOARD（讨论专区） 16 The Path Forward for Vaccine Policy in the United States 美国疫苗政策的未来之路 H.Y. Chu and Others N Engl J Med; Aug 21/28, 2025; 393(8)：817-822 CORRESPONDENCE（读者来信） 17 Targeted Therapy of CAR+ T-Cell Lymphoma after Anti-BCMA CAR T-Cell Therapy 抗BCMA CAR-T细胞治疗后CAR+ T细胞淋巴瘤的靶向治疗 N Engl J Med; Aug 21/28, 2025; 393(8)：823-825 18 Semaglutide in Metabolic Dysfunction–Associated Steatohepatitis 司美格鲁肽治疗代谢相关脂肪性肝炎 N Engl J Med; Aug 21/28, 2025; 393(8)：826-828 19 Omitting Nodal Irradiation after Nodes Clear 淋巴结清除后省略淋巴结放疗 N Engl J Med; Aug 21/28, 2025; 393(8)：828-829 20 AAV Gene Therapy in Severe Hemophilia B 严重血友病B的腺相关病毒（AAV）基因治疗 N Engl J Med; Aug 21/28, 2025; 393(8)：829-830 21 Screening for Prostate Cancer with a Polygenic Risk Score 基于多基因风险评分的前列腺癌筛查 N Engl J Med; Aug 21/28, 2025; 393(8)：831-832 CORRECTION（更正） 22 Improved Outcomes with Enzalutamide in Biochemically Recurrent Prostate Cancer 恩扎卢胺改善生化复发前列腺癌的预后 N Engl J Med; Aug 21/28, 2025; 393(8)：832 N Engl J Med[Jour] AND 393[volume] AND 9[issue] 新英格兰医学杂志 393卷 9期 https://www.nejm.org/toc/nejm/medical-journal?query=main_nav_lg PERSPECTIVE（观点） 1 The Corporatization of U.S. Health Care: The Corporatization Deal — Health Care, Investors, and the Profit Priority 美国医疗保健的企业化：企业化交易——医疗保健、投资者与利润优先 A. Chandra and M. Shepard N Engl J Med; Sep 4, 2025; 393(9)：833-835 2 Advancing Physician-Scientist Training in China — Challenges, Gaps, and Future Directions 推进中国医师科学家培养——挑战、差距与未来方向 P. Li and Others N Engl J Med; Sep 4, 2025; 393(9)：836-838 3 The Rise of Drug Innovation in China — Implications for Patient Access in the United States and Globally 中国药物创新的崛起——对美国及全球患者药物可及性的影响 K.N. Vokinger , G. Li , and O.J. Wouters N Engl J Med; Sep 4, 2025; 393(9)：839-841 ORIGINAL ARTICLES（论著） 4 Once-Monthly Maridebart Cafraglutide for the Treatment of Obesity — A Phase 2 Trial 每月一次的马里德巴特卡弗拉鲁肽治疗肥胖——一项2期试验 A.M. Jastreboff and Others N Engl J Med; Sep 4, 2025; 393(9)：843-857 5 Stem Cell–Derived, Fully Differentiated Islets for Type 1 Diabetes 干细胞衍生的完全分化胰岛用于治疗1型糖尿病 T.W. Reichman and Others N Engl J Med; Sep 4, 2025; 393(9)：858-868 6 One Dose versus Three Doses of Benzathine Penicillin G in Early Syphilis 早期梅毒治疗中苄星青霉素G单次剂量与三次剂量的对比 E.W. Hook III and Others N Engl J Med; Sep 4, 2025; 393(9)：869-878 7 Monoclonal Antibodies in the Pathogenesis of Heparin-Induced Thrombocytopenia 单克隆抗体在肝素诱导的血小板减少症发病机制中的作用 J. Treverton and Others N Engl J Med; Sep 4, 2025; 393(9)：879-886 8 Brief Report: Survival of Transplanted Allogeneic Beta Cells with No Immunosuppression 简短报告：无需免疫抑制的移植同种异体β细胞存活情况 P.-O. Carlsson and Others N Engl J Med; Sep 4, 2025; 393(9)：887-894 REVIEW ARTICLE（综述） 9 Management of Acute Type B Aortic Dissection 急性B型主动脉夹层的管理 F.F. Mussa and P. Kougias N Engl J Med; Sep 4, 2025; 393(9)：895-905 VIDEOS IN CLINICAL MEDICINE（临床医学视频） 10 Ultrasound-Guided Paracentesis 超声引导下腹腔穿刺术 A. Kumar and Others N Engl J Med; Sep 4, 2025; 393(9)：e11 IMAGES IN CLINICAL MEDICINE（临床医学图像） 11 Popeye Sign in Transthyretin Amyloidosis 转甲状腺素蛋白淀粉样变性中的“大力水手”征 S. Kurisu and H. Fujiwara N Engl J Med; Sep 4, 2025; 393(9)：906 12 Radiation Pneumonitis 放射性肺炎 M. Peters and P. Jeene N Engl J Med; Sep 4, 2025; 393(9)：e12 13 Hutchinson’s Sign in Subungual Melanoma In Situ 甲下原位黑色素瘤的Hutchinson征 M. Pasch and J. Tutein Nolthenius N Engl J Med; Sep 4, 2025; 393(9)：e13 CLINICAL PROBLEM-SOLVING（疑难杂症求解探微） 14 A Fruitful Workup 卓有成效的检查过程 N. Jain and Others N Engl J Med; Sep 4, 2025; 393(9)：907-914 EDITORIALS（社论） 15 A Tale of Two Diseases 两种疾病的故事 M.L. Collazo-Clavell N Engl J Med; Sep 4, 2025; 393(9)：916-917 16 Science behind the Study: Replacement of Beta Cells for Type 1 Diabetes 研究背后的科学：1型糖尿病的β细胞替代 K.C. Herold and J.S. Pober N Engl J Med; Sep 4, 2025; 393(9)：917-921 17 Antiquated Tools to Fight an Ancient Foe 用陈旧工具对抗古老敌人 L.A. Barbee and L.H. Bachmann N Engl J Med; Sep 4, 2025; 393(9)：921-923 CORRESPONDENCE（通信） 18 Fulminant Viral Myocarditis Associated with Thogotovirus 与托高托病毒相关的暴发性病毒性心肌炎 N Engl J Med; Sep 4, 2025; 393(9)：924-926 19 Safety and Efficacy of Obicetrapib in Patients at High Cardiovascular Risk 奥比西特拉匹在高心血管风险患者中的安全性与有效性 N Engl J Med; Sep 4, 2025; 393(9)：926-928 20 Porcine Xenotransplantation in End-Stage Kidney Disease 终末期肾病中的猪异种移植 N Engl J Med; Sep 4, 2025; 393(9)：929-931 21 Malnutrition in Older Adults 老年人营养不良 N Engl J Med; Sep 4, 2025; 393(9)：931-933 22 Generative AI in Medicine 医学中的生成式人工智能 N Engl J Med; Sep 4, 2025; 393(9)：933-935 N Engl J Med[Jour] AND 393[volume] AND 10[issue] 新英格兰医学杂志 393卷10期 https://www.nejm.org/toc/nejm/medical-journal?query=main_nav_lg PERSPECTIVE（观点） 1 Efforts toward Equity: Caring for Patients with Intellectual or Developmental Disabilities —A Curriculum for Residents 迈向公平的努力：照顾有智力或发育障碍的患者——住院医师培训课程 L. Clarke and Others N Engl J Med; Sep 11, 2025; 393(10)：937-939 2 Efforts toward Equity: Diaper Need —An Underrecognized Social Driver of Health 迈向公平的努力：尿布需求——一个未被充分认识的社会健康驱动因素 W. Berry , J. Bonville , and S.D. Blatt N Engl J Med; Sep 11, 2025; 393(10)：939-940 3 Efforts toward Equity: Improving Care Coordination for Indigenous Patients with Cancer 迈向公平的努力：改善对患癌原住民患者的护理协调 A.E. Janitz and Others N Engl J Med; Sep 11, 2025; 393(10)：940-942 4 Health and Medical Research Funding in a Divided America— How to Increase Support 分裂的美国在卫生与医学研究方面的资金投入——如何增加支持 R.J. Blendon , J.M. Benson , and N.B. Le N Engl J Med; Sep 11, 2025; 393(10)：942-945 5 The End of Days 末日终结 I.Thomas N Engl J Med; Sep 11, 2025; 393(10)：945-947 ORIGINAL ARTICLES（论著） 6 Aficamten or Metoprolol Monotherapy for Obstructive Hypertrophic Cardiomyopathy Aficamten或美托洛尔单药治疗梗阻性肥厚型心肌病 P. Garcia-Pavia and Others N Engl J Med; Sep 11, 2025; 393(10)：949-960 7 Mavacamten in Symptomatic Nonobstructive Hypertrophic Cardiomyopathy Mavacamten治疗有症状的非梗阻性肥厚型心肌病 M.Y. Desai and Others N Engl J Med; Sep 11, 2025; 393(10)：961-972 8 Multidomain Rehabilitation for Older Patients with Myocardial Infarction 针对老年心肌梗死患者的多领域康复治疗 E. Tonet and Others N Engl J Med; Sep 11, 2025; 393(10)：973-982 9 Marburg Virus Disease in Rwanda, 2024 —Public Health and Clinical Responses 2024年卢旺达的马尔堡病毒病——公共卫生与临床应对措施 S. Nsanzimana and Others N Engl J Med; Sep 11, 2025; 393(10)：983-993 SPECIAL ARTICLE（专题论著） 10 Medications for Opioid Use Disorder in County Jails —Outcomes after Release 县监狱中阿片类药物使用障碍的治疗药物——释放后的结果 P.D. Friedmann and Others N Engl J Med; Sep 11, 2025; 393(10)：994-1003 REVIEW ARTICLE（综述） 11 Hypertrophic Cardiomyopathy 肥厚型心肌病 E. Braunwald N Engl J Med; Sep 11, 2025; 393(10)：1004-1015 IMAGES IN CLINICAL MEDICINE（临床医学影像） 12 Pityriasis Rosea 玫瑰糠疹 E.A. Rallis and C. Verros N Engl J Med; Sep 11, 2025; 393(10)：1016 13 Acute Epididymo-orchitis in IgA Vasculitis IgA血管炎伴急性附睾- 睾丸炎 S. Pariha and C. Hanna N Engl J Med; Sep 11, 2025; 393(10)：e14 14 Ruptured Pulmonary Hydatid Cyst 肺包虫囊肿破裂 Y. Aydin and H. Ogul N Engl J Med; Sep 11, 2025; 393(10)：e15 CASE RECORDS OF THE MASSACHUSETTS GENERAL HOSPITAL（马萨诸塞州总医院病例记录） 15 Case 25-2025: A 93-Year-Old Woman with Dyspnea and Fatigue 2025年第25例病例：一例93岁女性，呼吸困难伴疲劳 S.V. Arnold and Others N Engl J Med; Sep 11, 2025; 393(10)：1017-1024 EDITORIAL（社论） 16 Expanding the Role of Myosin Inhibition in Hypertrophic Cardiomyopathy — A Tale of Two Conditions 扩大肌球蛋白抑制在肥厚型心肌病中的作用——两种疾病的故事 A.V. Ambardekar N Engl J Med; Sep 11, 2025; 393(10)：1026-1028 MEDICINE AND SOCIETY（医学与社会） 17 The Race-Correction Debates —Progress, Tensions, and Future Directions 种族校正争议——进展、紧张局势和未来方向 D.A. Vyas , L.G. Eisenstein , and D.S. Jones N Engl J Med; Sep 11, 2025; 393(10)：1029-1036 CORRESPONDENCE（读者来信） 18 Long-Term Outcomes of the DanGer Shock Trial DanGer休克试验的长期结果 N Engl J Med; Sep 11, 2025; 393(10)：1037-1038 19 Efruxifermin in Compensated Liver Cirrhosis Caused by MASH Efruxifermin治疗MASH所致的代偿性肝硬化 N Engl J Med; Sep 11, 2025; 393(10)：1038-1039 20 Once-Weekly Mazdutide in Obesity or Overweight 每周一次Mazdutide治疗肥胖或超重 N Engl J Med; Sep 11, 2025; 393(10)：1040 N Engl J Med[Jour] AND 393[volume] AND 11[issue] 新英格兰医学杂志 393卷11期 https://www.nejm.org/toc/nejm/medical-journal?query=main_nav_lg PERSPECTIVE（观点） 1 Reducing Tobacco Use Worldwide: Integrating Pharmacotherapy into Tobacco Control in Low- and Middle-Income Countries — A Critical Need 全球范围内减少烟草使用：将药物治疗纳入中低收入国家烟草控制——一项迫切需求 N.A. Rigotti , N. Walker , and A.S. Amer Nordin N Engl J Med; Sep 18, 2025; 393(11)：1041-1044 2 Protecting Medicaid Enrollees with Chronic Conditions amid Work Requirements 在工作要求下保护患有慢性病的医疗补助计划（Medicaid）参保人 J.Z. Ayanian N Engl J Med; Sep 18, 2025; 393(11)：1044-1046 3 Ultraprocessed Food on an Ultrafast Track 超加工食品驶入超速发展轨道 D.S. Ludwig N Engl J Med; Sep 18, 2025; 393(11)：1046-1049 4 The Consequences of Silencing the “Voice of CDC” “美国疾控中心之声”被消音的后果 S.A. Rasmussen and Others N Engl J Med; Sep 18, 2025; 393(11)：e16 5 Medicaid on the Chopping Block 医疗补助计划（Medicaid）面临削减 E. Park N Engl J Med; Sep 18, 2025; 393(11)：e17 ORIGINAL ARTICLES（论著） 6 Low-Dose Aspirin for PI3K-Altered Localized Colorectal Cancer 低剂量阿司匹林用于PI3K突变的局限性结直肠癌 A. Martling and Others N Engl J Med; Sep 18, 2025; 393(11)：1051-1064 7 Orforglipron, an Oral Small-Molecule GLP-1 Receptor Agonist, in Early Type 2 Diabetes Orforglipron（一种口服小分子GLP-1受体激动剂）用于早期2型糖尿病 J. Rosenstock and Others N Engl J Med; Sep 18, 2025; 393(11)：1065-1076 8 Oral Semaglutide at a Dose of 25 mg in Adults with Overweight or Obesity 口服司美格鲁肽25 mg用于超重或肥胖成人 S. Wharton and Others N Engl J Med; Sep 18, 2025; 393(11)：1077-1087 9 Proportional-Assist Ventilation for Minimizing the Duration of Mechanical Ventilation 比例辅助通气以缩短机械通气时间 K.J. Bosma and Others N Engl J Med; Sep 18, 2025; 393(11)：1088-1103 REVIEW ARTICLE（综述） 10 Tumor Lysis Syndrome 肿瘤溶解综合征 R.G. Bociek and M. Lunning N Engl J Med; Sep 18, 2025; 393(11)：1104-1116 IMAGES IN CLINICAL MEDICINE（临床医学影像） 11 Subcutaneous Panniculitis-like T-Cell Lymphoma 皮下脂膜炎样T细胞淋巴瘤 S. Okada and M. Nishikubo N Engl J Med; Sep 18, 2025; 393(11)：1117 12 Primary Varicella Infection 原发性水痘感染 O. van Not and D. Rauwerdink N Engl J Med; Sep 18, 2025; 393(11)：e18 CASE RECORDS OF THE MASSACHUSETTS GENERAL HOSPITAL（马萨诸塞州总医院病例记录） 13 Case 26-2025: An 11-Year-Old Girl with Chest Pain and Bone and Liver Lesions 2025年第26例病例：一例11岁女孩，胸痛伴骨和肝脏病变 L.P. Carter and Others N Engl J Med; Sep 18, 2025; 393(11)：1118-1127 EDITORIALS（社论） 14 Reducing Tobacco Use Worldwide — A New Perspective Series 全球减少烟草使用——新观点系列 N.A. Rigotti and Others N Engl J Med; Sep 18, 2025; 393(11)：1129-1130 15 An Aspirin a Day for Improved Colorectal Cancer Outcomes 每日一片阿司匹林以改善结直肠癌预后 R.M. Goldberg and J.A. Meyerhardt N Engl J Med; Sep 18, 2025; 393(11)：1131-1132 16 Mimicking Complex Receptor Actions with Small(ish) Molecules 用小（型）分子模拟复杂受体作用 D.B. Lowe N Engl J Med; Sep 18, 2025; 393(11)：1133-1134 CORRESPONDENCE（通信） 17 Introduction of Mpox Virus Clade Ib into the Republic of the Congo 猴痘病毒Ib分支传入刚果共和国 N Engl J Med; Sep 18, 2025; 393(11)：1135-1137 18 Perioperative Pembrolizumab in Head and Neck Cancer 围手术期帕博利珠单抗用于头颈癌 N Engl J Med; Sep 18, 2025; 393(11)：1138-1139 19 Ondansetron after ED Visits in Children with Gastroenteritis 儿童胃肠炎急诊就诊后使用昂丹司琼 N Engl J Med; Sep 18, 2025; 393(11)：1139-1141 20 Navigating the Discontinuity Crisis in Medical Education 应对医学教育中的断层危机 N Engl J Med; Sep 18, 2025; 393(11)：1141-1143 21 Fetal Hereditary Thrombotic Thrombocytopenic Purpura 胎儿遗传性血栓性血小板减少性紫癜 N Engl J Med; Sep 18, 2025; 393(11)：1143-1144 N Engl J Med[Jour] AND 393[volume] AND 12[issue] 新英格兰医学杂志 393卷12期 https://www.nejm.org/toc/nejm/medical-journal?query=main_nav_lg PERSPECTIVE（观点） 1 Structural and Scientific Racism, Science, and Health — Evidence versus Ideology 结构性与科学层面的种族主义、科学与健康——证据与意识形态之争 N. Krieger and M.T. Bassett N Engl J Med; Sep 25, 2025; 393(12)：1145-1148 2 From Health to Wealth — Reframing Global Aid through the Gates Foundation’s Final Chapter 从健康到财富——通过盖茨基金会的终章重新构建全球援助框架 S. Phillips N Engl J Med; Sep 25, 2025; 393(12)：1148-1151 3 Dr. Kolhouse and the Cowboy 科尔豪斯博士与牛仔 M. Earnest N Engl J Med; Sep 25, 2025; 393(12)：1151-1153 ORIGINAL ARTICLES（论著） 4 Digitoxin in Patients with Heart Failure and Reduced Ejection Fraction 地高辛用于射血分数降低的心力衰竭患者 U. Bavendiek and Others N Engl J Med; Sep 25, 2025; 393(12)：1155-1165 5 Apixaban for Extended Treatment of Provoked Venous Thromboembolism 阿哌沙班用于诱因性静脉血栓栓塞症的延长治疗 G. Piazza and Others N Engl J Med; Sep 25, 2025; 393(12)：1166-1176 6 Measurable Residual Disease–Guided Therapy for Chronic Lymphocytic Leukemia 基于可测量残留病灶指导的慢性淋巴细胞白血病治疗 T. Munir and Others N Engl J Med; Sep 25, 2025; 393(12)：1177-1190 7 Early Tirofiban Infusion after Intravenous Thrombolysis for Stroke 卒中静脉溶栓后早期输注替罗非班 C. Tao and Others N Engl J Med; Sep 25, 2025; 393(12)：1191-1201 REVIEW ARTICLE（综述） 8 Medical Education: Advancing Diagnostic Excellence through Medical Education in Diagnostic Equity 医学教育：通过诊断公平性医学教育推进诊断卓越 D.M. Connor , M.L. Lypson , and C.M. Gonzalez N Engl J Med; Sep 25, 2025; 393(12)：1202-1214 IMAGES IN CLINICAL MEDICINE（临床医学影像） 9 Systemic Mastocytosis 系统性肥大细胞增多症 L. Neves da Silva and A.M. Monteiro N Engl J Med; Sep 25, 2025; 393(12)：1215 10 Doxycycline-Induced Phototoxicity 多西环素诱导的光毒性反应 G. Boyd and C. Cheng N Engl J Med; Sep 25, 2025; 393(12)：e19 INTERACTIVE MEDICAL CASE（互动式医学病例） 11 A Fizzy Fix 气泡疗法 M.A. Crane and Others N Engl J Med; Sep 25, 2025; 393(12)：e20 CASE RECORDS OF THE MASSACHUSETTS GENERAL HOSPITAL（马萨诸塞州总医院病例记录） 12 Case 27-2025: A 53-Year-Old Man with Embolic Stroke and Left Ventricular Apical Aneurysm 2025年第27例病例：一例53岁男性，患有栓塞性卒中及左心室心尖部动脉瘤 G.C. Stewart and Others N Engl J Med; Sep 25, 2025; 393(12)：1216-1225 EDITORIALS（社论） 13 Digitoxin — A Reminder for Digoxin 地高辛——对洋地黄的提醒 M.A. Pfeffer N Engl J Med; Sep 25, 2025; 393(12)：1227-1228 14 Art within Evidence — Balancing Anticoagulant Duration in VTE Care 证据中的艺术——平衡静脉血栓栓塞症护理中的抗凝时长 N.A. Zakai N Engl J Med; Sep 25, 2025; 393(12)：1229-1230 CLINICAL IMPLICATIONS OF BASIC RESEARCH（基础研究的临床意义） 15 Transformative Research in Cystic Fibrosis 囊性纤维化的变革性研究 E.J. Sorscher N Engl J Med; Sep 25, 2025; 393(12)：1231-1234 16 Surprisingly Complex Assemblies from Low-Complexity Domains 来自低复杂度结构域的惊人复杂组装 T. Mittag N Engl J Med; Sep 25, 2025; 393(12)：1235-1238 CORRESPONDENCE（通信） 17 CD19 CAR T-Cell Therapy in Multidrug-Resistant Ulcerative Colitis CD19嵌合抗原受体T细胞疗法治疗多重耐药性溃疡性结肠炎 N Engl J Med; Sep 25, 2025; 393(12)：1239-1241 18 Nonoperative Management of Mismatch Repair–Deficient Tumors 错配修复缺陷肿瘤的非手术治疗 N Engl J Med; Sep 25, 2025; 393(12)：1241-1243 19 Cerebral Embolic Protection during TAVI 经导管主动脉瓣置换术中的脑栓塞保护 N Engl J Med; Sep 25, 2025; 393(12)：1243-1245 20 Global Effect of Cardiovascular Risk Factors on Lifetime Estimates 心血管危险因素对终生估计的全球影响 N Engl J Med; Sep 25, 2025; 393(12)：1245-1248 N Engl J Med[Jour] AND 393[volume] AND 13[issue] 新英格兰医学杂志 393卷13期 https://www.nejm.org/toc/nejm/medical-journal?query=main_nav_lg PERSPECTIVE（观点） 1 The Corporatization of U.S. Health Care: Insight into Corporate Governance — What Motivates Hospitals and Delivery Systems 美国医疗保健的企业化：企业治理洞察——医院和医疗交付系统的动机何在 S. Lipstein N Engl J Med; Oct 2, 2025; 393(13)：1249-1251 2 The Risks of Pharmaceutical Tariffs for Generic Drug Availability 药品关税对仿制药供应的风险 T.J. Hwang , Q.-D. Trinh , and K.N. Vokinger N Engl J Med; Oct 2, 2025; 393(13)：1252-1253 3 Goals for Opioid Use Disorder Medications — Protection, Remission, and Recovery 阿片类药物使用障碍治疗药物的目标——保护、缓解和康复 A.T. McLellan and N.D. Volkow N Engl J Med; Oct 2, 2025; 393(13)：1253-1255 ORIGINAL ARTICLES（论著） 4 Intravenous Rehydration for Severe Acute Malnutrition with Gastroenteritis 伴有胃肠炎的严重急性营养不良的静脉补液治疗 K. Maitland and Others N Engl J Med; Oct 2, 2025; 393(13)：1257-1268 5 Medical Imaging and Pediatric and Adolescent Hematologic Cancer Risk 医学影像与儿童和青少年血液系统癌症风险 R. Smith-Bindman and Others N Engl J Med; Oct 2, 2025; 393(13)：1269-1278 6 Targeting APOC3 with Olezarsen in Moderate Hypertriglyceridemia 使用针对APOC3的奥列扎森治疗中度高甘油三酯血症 B.A. Bergmark and Others N Engl J Med; Oct 2, 2025; 393(13)：1279-1291 7 Clesrovimab for Prevention of RSV Disease in Healthy Infants 克莱斯罗维玛布预防健康婴儿呼吸道合胞病毒疾病 H.J. Zar and Others N Engl J Med; Oct 2, 2025; 393(13)：1292-1303 8 Home-Based Care for Hypertension in Rural South Africa 南非农村地区高血压的家庭护理 M.J. Siedner and Others N Engl J Med; Oct 2, 2025; 393(13)：1304-1314 REVIEW ARTICLE（综述） 9 Monoclonal Gammopathy of Undetermined Significance 意义未定的单克隆丙种球蛋白病 S.V. Rajkumar and S. Kumar N Engl J Med; Oct 2, 2025; 393(13)：1315-1326 IMAGES IN CLINICAL MEDICINE（临床医学图像） 10 Uremic Frost 尿毒症霜 M.A. Wani and Z.H. Shah N Engl J Med; Oct 2, 2025; 393(13)：1327 11 Herpes Simplex Virus Esophagitis 单纯疱疹病毒食管炎 A.Agarwal and A. Agarwal N Engl J Med; Oct 2, 2025; 393(13)：e21 CLINICAL PROBLEM-SOLVING（疑难杂症破解之道） 12 A Shifting Frame 视角转换 A.Terrett and Others N Engl J Med; Oct 2, 2025; 393(13)：1328-1334 EDITORIALS（社论） 13 Data versus Dogma — Safety of Intravenous Rehydration in Severely Malnourished Children 数据与教条之争——严重营养不良儿童静脉补液的安全性 M.J. Peters N Engl J Med; Oct 2, 2025; 393(13)：1336-1337 14 Studying Cancer Risks Associated with Diagnostic Procedures — Interpret Wisely 研究诊断程序相关的癌症风险——明智解读 L.M. Morton N Engl J Med; Oct 2, 2025; 393(13)：1337-1339 CLINICAL DECISIONS（临床决策） 15 Allergy or Assumption of Allergy — When to Test for a Penicillin Allergy 过敏还是假定的过敏——何时进行青霉素过敏测试 H. Marwah , A. Ramsey , and E.M. Macy N Engl J Med; Oct 2, 2025; 393(13)：1340-1342 CORRESPONDENCE（读者来信） 16 Clesrovimab in Infants and Children at Increased Risk for Severe RSV Disease 克莱斯罗维玛布用于有严重呼吸道合胞病毒疾病高风险的婴儿和儿童 N Engl J Med; Oct 2, 2025; 393(13)：1343-1345 17 Nerandomilast in Patients with Pulmonary Fibrosis 奈拉度米拉司特用于肺纤维化患者 N Engl J Med; Oct 2, 2025; 393(13)：1346-1347 18 Trastuzumab Deruxtecan in Gastric Cancer 德曲妥珠单抗用于胃癌 N Engl J Med; Oct 2, 2025; 393(13)：1347-1348 19 Tarlatamab in Small-Cell Lung Cancer 塔拉他玛布用于小细胞肺癌 N Engl J Med; Oct 2, 2025; 393(13)：1348-1349 20 Cyclophosphamide and Cyclosporin for GVHD Prevention 环磷酰胺和环孢素预防移植物抗宿主病 N Engl J Med; Oct 2, 2025; 393(13)：1349-1351 N Engl J Med[Jour] AND 393[volume] AND 14[issue] 新英格兰医学杂志 393卷14期 https://www.nejm.org/toc/nejm/medical-journal?query=main_nav_lg PERSPECTIVE（观点） 1 Occupational Health and Safety on the Chopping Block — What’s at Stake? 职业健康与安全岌岌可危——有何利害关系？ A.T. Gabrielson and C. Corwin N Engl J Med; Oct 9, 2025; 393(14)：1353-1355 2 Emergency Medicaid at Risk — Preserving State Authority and Access to Care 紧急医疗补助岌岌可危——维护州政府权限与医疗保障可及性 J.A. Budhu and Others N Engl J Med; Oct 9, 2025; 393(14)：1356-1358 3 Pharmaceutical Wholesalers — Under-the-Radar Middlemen? 药品批发商——鲜为人知的中间商？ H. Rooke-Ley and R.E. Sachs N Engl J Med; Oct 9, 2025; 393(14)：1358-1360 4 “You Still Going to Be Doing This?” “你还会坚持下去吗？” E.J. Shapiro N Engl J Med; Oct 9, 2025; 393(14)：1360-1361 ORIGINAL ARTICLES（论著） 5 Efficacy and Safety of Baxdrostat in Uncontrolled and Resistant Hypertension 巴克斯德罗沙特（Baxdrostat）治疗未控制及难治性高血压的疗效与安全性 J.M. Flack and Others N Engl J Med; Oct 9, 2025; 393(14)：1363-1374 6 Nexiguran Ziclumeran Gene Editing in Hereditary ATTR with Polyneuropathy 针对伴有多发性神经病的遗传性转甲状腺素蛋白淀粉样变性病的Nexiguran Ziclumeran基因编辑疗法 J.D. Gillmore and Others N Engl J Med; Oct 9, 2025; 393(14)：1375-1386 7 Randomized Trial of Targeted Indoor Spraying to Prevent Aedes-Borne Diseases 靶向室内喷洒预防埃及伊蚊传播疾病的随机试验 N.E. Dean and Others N Engl J Med; Oct 9, 2025; 393(14)：1387-1398 8 Permethrin-Treated Baby Wraps for the Prevention of Malaria 使用氯菊酯处理过的婴儿包裹物预防疟疾 R.M. Boyce and Others N Engl J Med; Oct 9, 2025; 393(14)：1399-1408 REVIEW ARTICLE（综述） 9 Idiopathic Intracranial Hypertension 特发性颅内压增高 J.C. Horton N Engl J Med; Oct 9, 2025; 393(14)：1409-1419 IMAGES IN CLINICAL MEDICINE（临床医学影像） 10 Butterfly Vertebra 蝴蝶椎 S. Ding and X. Pan N Engl J Med; Oct 9, 2025; 393(14)：1420 11 Oral Verruciform Xanthomas 口腔疣状黄瘤 G. Anaya-Saavedra and M. Vázquez-Garduño N Engl J Med; Oct 9, 2025; 393(14)：e22 CASE RECORDS OF THE MASSACHUSETTS GENERAL HOSPITAL（马萨诸塞州总医院病例记录） 12 Case 28-2025: A 36-Year-Old Man with Abdominal Pain, Fever, and Hypoxemia 2025年第28例病例：一例36岁男性，出现腹痛、发热伴低氧血症 G. Dhaliwal and Others N Engl J Med; Oct 9, 2025; 393(14)：1421-1434 EDITORIAL（社论） 13 Aldosterone Synthase Inhibition for Hypertension 醛固酮合成酶抑制剂治疗高血压 T.J. Guzik and M. Tomaszewski N Engl J Med; Oct 9, 2025; 393(14)：1436-1439 CORRESPONDENCE（读者来信） 14 Specificity of CRISPR-Cas9 Editing in Exagamglogene Autotemcel — Update Exagamglogene Autotemcel中CRISPR-Cas9编码的特异性——更新 N Engl J Med; Oct 9, 2025; 393(14)：1440-1442 15 Weekly Fixed-Dose Insulin Efsitora in Type 2 Diabetes 每周固定剂量艾氟司他（Efsitora）胰岛素治疗2型糖尿病 N Engl J Med; Oct 9, 2025; 393(14)：1442-1444 16 Diphtheria Outbreak among Migrants in Europe 欧洲移民群体中的白喉疫情 N Engl J Med; Oct 9, 2025; 393(14)：1444-1445 17 Clearance of Squamous-Cell Carcinoma by Restoring T-Cell Receptor Signaling 通过恢复T细胞受体信号传导清除鳞状细胞癌 N Engl J Med; Oct 9, 2025; 393(14)：1446-1447 18 Case 17-2025: A Man with Respiratory Failure and Shock after Kidney Transplantation 2025年第17例病例：一例肾移植后出现呼吸衰竭和休克的患者 N Engl J Med; Oct 9, 2025; 393(14)：1447-1448 N Engl J Med[Jour] AND 393[volume] AND 15[issue] 新英格兰医学杂志 393卷15期 https://www.nejm.org/toc/nejm/medical-journal?query=main_nav_lg PERSPECTIVE(观点) 1 Reducing Tobacco Use Worldwide: The Contribution of Digital Treatment to Efforts to Reduce Global Tobacco Use 减少全球烟草使用:数字治疗对减少全球烟草使用的贡献 F. Naughton and A. Nadkarni N Engl J Med; October16, 2025; 393(15):1449-1452 2 Advancing Surveillance of Health Care–Associated Infections — Targeting Hospital-Onset Sepsis 推进卫生保健相关感染的监测-针对医院发生的败血症 F. Manzoor , C. Rhee , and M. Klompas N Engl J Med; October16, 2025; 393(15):1452-1454 3 The AI Frontier in Humanitarian Aid — Embracing Possibilities and Addressing Risks 人工智能在人道主义援助中的前沿——拥抱可能性与应对风险 M. Barry , J. Hansen , and G.L. Darmstadt N Engl J Med; October16, 2025; 393(15):1454-1457 4 Proliferation of Prior Authorization in Traditional Medicare — None the WISeR? 传统医疗中预先授权的扩散——更明智了吗？ M. Liu , K.T. Kadakia , and R.K. Wadhera N Engl J Med; October16, 2025; 393(15):1457-1459 5 On Bearing Witness 关于见证 S. Attar N Engl J Med; October16, 2025; 393(15):1459-1461 6 Not Otherwise Specified — Season 3: The Forever Crisis of Primary Care: Alive and Kicking — NOS Episode 3.1 未作特别说明（NOS）——第三季：初级医疗的永恒危机：愈演愈烈 ——NOS第3季第1集 N Engl J Med; October16, 2025; 393(15):e24 ORIGINAL ARTICLES(论著) 7 Sentinel-Lymph-Node Biopsy Alone or with Lymphadenectomy in Cervical Cancer 宫颈癌中仅行前哨淋巴结活检或联合淋巴结清扫术 H. Tu and Others N Engl J Med; October16, 2025; 393(15):1463-1474 8 A Phase 3 Trial of Telitacicept for Systemic Lupus Erythematosus Telitacicept治疗系统性红斑狼疮的3期临床试验 R.F. van Vollenhoven and Others N Engl J Med; October16, 2025; 393(15):1475-1485 9 Long-Term Safety and Efficacy of Gene Therapy for Adenosine Deaminase Deficiency 基因治疗腺苷脱氨酶缺乏症的长期安全性和有效性 C. Booth and Others N Engl J Med; October16, 2025; 393(15):1486-1497 10 Mass Administration of Azithromycin to Infants in Mali to Reduce Mortality 马里婴儿大量使用阿奇霉素以降低死亡率 F.C. Haidara and Others N Engl J Med; October16, 2025; 393(15):1498-1508 CLINICAL PRACTICE(临床实践) 11 Hair Loss in Women 女性脱发 E.A. Olsen N Engl J Med; October16, 2025; 393(15):1509-1520 IMAGES IN CLINICAL MEDICINE(临床医学影像) 12 Pneumococcal Sepsis in a Patient with Asplenia and Hypogammaglobulinemia 脾缺失合并低丙种球蛋白血症患者发生肺炎球菌性败血症 S.J. Starke and I. Miller N Engl J Med; October16, 2025; 393(15):1521 13 Stercoral Colitis 粪石性结肠炎 A. Bajer and E. Levine N Engl J Med; October16, 2025; 393(15): e23 CASE RECORDS OF THE MASSACHUSETTS GENERAL HOSPITAL(马萨诸塞州总医院的病例记录) 14 Case 29-2025: A 43-Year-Old Woman with Depression, Suicidal Ideation, and Fever 病例29-2025：一例43岁女性，抑郁、自杀倾向伴发热 M.S. Abers and Others N Engl J Med; October16, 2025; 393(15):1522-1531 EDITORIALS(社论) 15 Risk and Benefit 风险与收益 E.J. Rubin N Engl J Med; October16, 2025; 393(15):1533-1534 16 Sentinel Lymphadenectomy for Early-Stage Cervical Cancer — the New Standard? 早期宫颈癌的前哨淋巴结切除术——新标准？ K. Bixel N Engl J Med; October16, 2025; 393(15):1534-1536 MEDICINE AND SOCIETY(医学与社会) 17 The Primary Care Puzzle: Is a Long-Simmering Crisis Boiling Over? U.S. Primary Care Today 初级医疗之谜：长期酝酿的危机正在爆发？美国初级医疗现状 L. Rosenbaum N Engl J Med; October16, 2025; 393(15):1537-1541 CORRESPONDENCE(通信) 18 In Vivo CD19 CAR T-Cell Therapy for Refractory Systemic Lupus Erythematosus 体内CD19 CAR T细胞疗法治疗难治性系统性红斑狼疮 N Engl J Med; October16, 2025; 393(15):1542-1544 19 BCMA T-Cell Engager Therapy in Patients with Refractory Autoimmune Disease 顽固性自身免疫性疾病患者的BCMA T细胞接合疗法 N Engl J Med; October16, 2025; 393(15):1544-1547 20 Competency-Based Medical Education at the Front Lines of Patient Care 以能力为本的一线患者护理医学教育 N Engl J Med; October16, 2025; 393(15):1548-1550 21 More about the Phase 2a Study of Baxdrostat in Primary Aldosteronism 更多关于巴司他治疗原发性醛固酮增多症的2a期研究 N Engl J Med; October16, 2025; 393(15):1550-1552 N Engl J Med[Jour] AND 393[volume] AND 16[issue] 新英格兰医学杂志 393卷16期 https://www.nejm.org/toc/nejm/medical-journal?query=main_nav_lg PERSPECTIVE（观点） 1 Involving Palliative Care to Improve Outcomes in Sickle Cell Disease 纳入姑息治疗以改善镰状细胞病预后 E. Nwogu-Onyemkpa and Others N Engl J Med; Oct 23, 2025; 393(16)：1553-1556 2 Thirty Years of Hydroxyurea for Sickle Cell Anemia — Scientific Progress, Global Health Gaps 羟基脲治疗镰状细胞贫血三十年——科学进展与全球健康差距 E. Costa and Others N Engl J Med; Oct 23, 2025; 393(16)：1556-1559 3 Fetal Personhood and Reproductive Criminalization — Implications for Patients, Clinicians, and Public Health 胎儿人格与生殖犯罪化——对患者、临床医生和公共卫生的影响 T. Riley and A. Hassan N Engl J Med; Oct 23, 2025; 393(16)：1559-1561 4 Living in the Present Tense 活在当下 J.A. Feinstein N Engl J Med; Oct 23, 2025; 393(16)：1561-1563 5 Not Otherwise Specified — Season 3: The Forever Crisis of Primary Care: Can AI Solve Primary Care? — NOS Episode 3.2 未作他类说明——第三季：初级保健的永恒危机：人工智能能否解决初级保健问题？——未作他类说明第3.2集 N Engl J Med; Oct 23, 2025; 393(16)：e25 ORIGINAL ARTICLES（论著） 6 Hypertonic Saline or Carbocisteine in Bronchiectasis 高渗盐水或羧甲司坦治疗支气管扩张症 J.M. Bradley and Others N Engl J Med; Oct 23, 2025; 393(16)：1565-1577 7 Aspirin in Patients with Chronic Coronary Syndrome Receiving Oral Anticoagulation 接受口服抗凝治疗的慢性冠状动脉综合征患者使用阿司匹林的情况 G. Lemesle and Others N Engl J Med; Oct 23, 2025; 393(16)：1578-1588 8 Common Diseases in Clinical Cohorts — Not Always What They Seem 临床队列中的常见疾病——并不总是如表面所见 F. Rahimov and Others N Engl J Med; Oct 23, 2025; 393(16)：1589-1598 9 Sotatercept for Pulmonary Arterial Hypertension within the First Year after Diagnosis 诊断后第一年内使用索塔生塞普（Sotatercept）治疗肺动脉高压 V.V. McLaughlin and Others N Engl J Med; Oct 23, 2025; 393(16)：1599-1611 10 Association of 2024–2025 Covid-19 Vaccine with Covid-19 Outcomes in U.S. Veterans 2024-2025年新冠疫苗与美国退伍军人新冠结局的关联 M. Cai , Y. Xie , and Z. Al-Aly N Engl J Med; Oct 23, 2025; 393(16)：1612-1623 REVIEW ARTICLE（综述） 11 Medical Education: Educational Strategies to Prepare Trainees for Clinical Uncertainty 医学教育：为受训者应对临床不确定性做准备的教育策略 J.S. Ilgen and G. Dhaliwal N Engl J Med; Oct 23, 2025; 393(16)：1624-1632 IMAGES IN CLINICAL MEDICINE（临床医学影像） 12 Human East African Trypanosomiasis 人类东非锥虫病 L. Veletzky and S. Winkler N Engl J Med; Oct 23, 2025; 393(16)：1633 13 Thoracic Ectopia Cordis 胸部心脏异位 Z. Duric and H. Gasparovic N Engl J Med; Oct 23, 2025; 393(16)：e26 CASE RECORDS OF THE MASSACHUSETTS GENERAL HOSPITAL（马萨诸塞州总医院病例记录） 14 Case 30-2025: An 82-Year-Old Woman with Abdominal Distention, Edema, and Pleural Effusion 2025年30号病例：一名82岁女性，出现腹部膨隆、水肿和胸腔积液 Z. Kanjee and Others N Engl J Med; Oct 23, 2025; 393(16)：1634-1644 EDITORIALS（社论） 15 Time to Reconsider Mucoactive Agents for Airway Clearance 是时候重新考虑用于气道廓清的黏液活性药物了 J. Hansen-Flaschen and G. Tino N Engl J Med; Oct 23, 2025; 393(16)：1646-1647 16 A Rare-in-Common Paradigm for Precision Genomic Medicine 精准基因组医学中的“罕见共性”范式 P.N. Robinson N Engl J Med; Oct 23, 2025; 393(16)：1648-1649 CORRESPONDENCE（读者来信） 17 Resurgence of Zoonotic Highly Pathogenic Avian Influenza A(H5N1) Virus in Cambodia 柬埔寨人畜共患高致病性禽流感A(H5N1)病毒卷土重来 N Engl J Med; Oct 23, 2025; 393(16)：1650-1652 18 Perioperative Durvalumab in Gastric Cancer 胃癌围手术期使用度伐利尤单抗 N Engl J Med; Oct 23, 2025; 393(16)：1652-1654 19 Tirzepatide vs. Semaglutide for Obesity Treatment 替西帕肽与司美格鲁肽治疗肥胖症的对比 N Engl J Med; Oct 23, 2025; 393(16)：1654-1656 N Engl J Med[Jour] AND 393[volume] AND 17[issue] 新英格兰医学杂志 393卷17期 https://www.nejm.org/toc/nejm/medical-journal?query=main_nav_lg PERSPECTIVE（观点） 1 Efforts toward Equity: Disparities in Kidney Disease and the Race-Neutral eGFR — Research and Action in NYC’s Public Hospital System 努力迈向公平：肾脏疾病中的差异与无种族差异的估算肾小球滤过率（eGFR）——纽约市公立医院系统的研究与行动 A. Bocour and Others N Engl J Med; Oct 30, 2025; 393(17)：1657-1658 2 Efforts toward Equity: Automating WIC Screening and Enrollment in Pediatric Primary Care 努力迈向公平：儿科初级保健中妇女、婴儿和儿童（WIC）筛查与登记的自动化 L. Suarez and Others N Engl J Med; Oct 30, 2025; 393(17)1659-1660 3 Efforts toward Equity: Listening and Responding to Community Voices — The Community Wellness HUB 努力迈向公平：倾听并回应社区声音——社区健康中心 L.S. Jemmott and Others N Engl J Med; Oct 30, 2025; 393(17)：1660-1662 4 Flaws in the FDA’s New Priority Voucher Program 美国食品药品监督管理局（FDA）新优先审评券计划的缺陷 D. Carpenter , T.J. Hwang , and A.S. Kesselheim N Engl J Med; Oct 30, 2025; 393(17)：1662-1664 5 Standing by Our Colleagues in Gaza — A Plea to the U.S. Medical Community 声援我们在加沙的同行——对美国医学界的呼吁 F. Sidhwa and Others N Engl J Med; Oct 30, 2025; 393(17)：1664-1667 6 Not Otherwise Specified — Season 3: The Forever Crisis of Primary Care: Misunderstandings — NOS Episode 3.3 未明确说明——第三季：初级保健的长期危机：误解——未明确说明（NOS）第3.3集 N Engl J Med; Oct 30, 2025; 393(17)：e27 ORIGINAL ARTICLES（论著） 7 European Study of Prostate Cancer Screening — 23-Year Follow-up 欧洲前列腺癌筛查研究——23年随访结果 M.J. Roobol and Others N Engl J Med; Oct 30, 2025; 393(17)：1669-1680 8 Overall Survival with Amivantamab–Lazertinib in EGFR-Mutated Advanced NSCLC 阿米万他单抗联合拉泽替尼治疗EGFR突变型晚期非小细胞肺癌的总生存期 J.C.-H. Yang and Others N Engl J Med; Oct 30, 2025; 393(17)：1681-1693 9 A Randomized Trial of Physical Therapy for Meniscal Tear and Knee Pain 半月板撕裂和膝关节疼痛的物理治疗随机试验 J.N. Katz and Others N Engl J Med; Oct 30, 2025; 393(17)：1694-1703 10 Safety, Efficacy, and Immunogenicity of a Salmonella Paratyphi A Vaccine 甲型副伤寒沙门菌疫苗的安全性、有效性和免疫原性 N. McCann and Others N Engl J Med; Oct 30, 2025; 393(17)：1704-1714 REVIEW ARTICLE（综述） 11 Noninvasive Assessment of Liver Fibrosis 肝脏纤维化的无创评估 L. Castera , M.E. Rinella , and E.A. Tsochatzis N Engl J Med; Oct 30, 2025; 393(17)：1715-1729 IMAGES IN CLINICAL MEDICINE（临床医学影像） 12 Herpes Simplex Virus Blepharitis 单纯疱疹病毒性睑缘炎 P. Ros-Arlanzón and M. Alcaraz-Graña N Engl J Med; Oct 30, 2025; 393(17)：1730 13 Nasal Leech 鼻腔水蛭 W. Wu and J. Tan N Engl J Med; Oct 30, 2025; 393(17)：e28 CASE RECORDS OF THE MASSACHUSETTS GENERAL HOSPITAL（马萨诸塞州总医院病例记录） 14 Case 31-2025: A 56-Year-Old Man with Left Lower Abdominal Pain and Anemia 病例31-2025：一例56岁男性，左侧下腹部疼痛伴贫血 B.E. Sands and Others N Engl J Med; Oct 30, 2025; 393(17)：1731-1740 EDITORIALS（社论） 15 Early Detection of Prostate Cancer — Time to Fish or Cut Bait 前列腺癌的早期检测——是时候行动还是放弃 A. Vickers N Engl J Med; Oct 30, 2025; 393(17)：1742-1743 16 EGFR-Mutated Lung Cancer — Letting the Butterfly Out of the Cocoon EGFR突变型肺癌——破茧成蝶 A. Dimou and A. Mansfield N Engl J Med; Oct 30, 2025; 393(17)：1743-1745 MEDICINE AND SOCIETY（医学与社论） 17 The Primary Care Puzzle: The Concierge Cure? 初级保健难题：私人医生服务是解决之道吗？ L. Rosenbaum N Engl J Med; Oct 30, 2025; 393(17)：1746-1750 CORRESPONDENCE（读者来信） 18 Two-Year Outcomes after Transcatheter Arterialization of the Deep Veins 深静脉经导管动脉化两年后的疗效 N Engl J Med; Oct 30, 2025; 393(17)：1751-1753 19 Finerenone with Empagliflozin in Chronic Kidney Disease and Type 2 Diabetes 非奈利酮联合恩格列净治疗慢性肾脏病和2型糖尿病 N Engl J Med; Oct 30, 2025; 393(17)：1753-1755 20 As-Needed Albuterol–Budesonide in Mild Asthma 按需使用沙丁胺醇-布地奈德治疗轻度哮喘 N Engl J Med; Oct 30, 2025; 393(17)：1755-1756 21 Donor Hearts for Transplantation after Circulatory Death 循环死亡后供体心脏的移植 N Engl J Med; Oct 30, 2025; 393(17)：1756-1760 N Engl J Med[Jour] AND 393[volume] AND 18[issue] 新英格兰医学杂志 393卷18期 https://www.nejm.org/toc/nejm/medical-journal?query=main_nav_lg PERSPECTIVE（观点） 1 The Corporatization of U.S. Health Care: The Antitrust Antidote to Hospital and Nursing Home Corporatization — Promises and Pitfalls 美国医疗保健的企业化：用反垄断法应对医院和养老院企业化——承诺与陷阱 Y. Singh N Engl J Med; Nov 6, 2025; 393(18)：1761-1764 2 Adverse Health Effects of Energy-Related Provisions in the “One Big Beautiful Bill” “宏伟美丽法案”中能源相关条款对健康的不利影响 R.L. Glicksman N Engl J Med; Nov 6, 2025; 393(18)：1764-1766 3 Medicaid Cuts and U.S. Children’s Health — Fixing a Broken System 医疗补助削减与美国儿童健康——修复破碎的体系 E.E. McGinty , A. Bitton , and S.R. Permar N Engl J Med; Nov 6, 2025; 393(18)：1766-1769 4 Not Otherwise Specified — Season 3: The Forever Crisis of Primary Care: If You Break It, 未作其他说明——第三季：初级保健的永恒危机：若你将其破坏 They Won’t Come — NOS Episode 3.4 N Engl J Med; Nov 6, 2025; 393(18)：e29 5 Perspective Roundtable: Pursuing Health Equity in the United States 观点圆桌会议：在美国追求健康公平 C.W. Cené and Others N Engl J Med; Nov 6, 2025; 393(18)：e30 ORIGINAL ARTICLES（论著） 6 Ten-Year Survival after Postmastectomy Chest-Wall Irradiation in Breast Cancer 乳腺癌术后胸壁放疗的十年生存率 I.H. Kunkler and Others N Engl J Med; Nov 6, 2025; 393(18)：1771-1783 7 Oral Icotrokinra for Plaque Psoriasis in Adults and Adolescents 口服伊可曲金拉治疗成人和青少年斑块状银屑病 R. Bissonnette and Others N Engl J Med; Nov 6, 2025; 393(18)：1784-1795 8 Orforglipron, an Oral Small-Molecule GLP-1 Receptor Agonist for Obesity Treatment 奥福格列隆：一种用于肥胖治疗的口服小分子GLP-1受体激动剂 S. Wharton and Others N Engl J Med; Nov 6, 2025; 393(18)：1796-1806 9 Safety and Immunogenicity of an rVSV Lassa Fever Vaccine Candidate 一种rVSV拉沙热候选疫苗的安全性和免疫原性 E. Malkin and Others N Engl J Med; Nov 6, 2025; 393(18)：1807-1818 10 Sevabertinib in Advanced HER2-Mutant Non–Small-Cell Lung Cancer 塞瓦伯替尼治疗晚期HER2突变型非小细胞肺癌 X. Le and Others N Engl J Med; Nov 6, 2025; 393(18)：1819-1832 CLINICAL PRACTICE（临床实践） 11 Opioid Deprescribing in Patients with Noncancer Pain 非癌性疼痛患者的阿片类药物减量 C.-W.C. Lin and A.V. Langford N Engl J Med; Nov 6, 2025; 393(18)：1833-1842 IMAGES IN CLINICAL MEDICINE（临床医学影像） 12 Patent Persistent Omphalomesenteric Duct 持续性脐肠管未闭 P.-L. Verot and P.-Y. Rabattu N Engl J Med; Nov 6, 2025; 393(18)：1843 13 Goiter, Bounding Pulses, and Thyroid Bruit in Thyroid Storm 甲状腺危象中的甲状腺肿、洪脉和甲状腺杂音 T. Yagi and T. Kawasaki N Engl J Med; Nov 6, 2025; 393(18)：e31 CLINICAL PROBLEM-SOLVING（临床问题解决） 14 Spiraling into a Distant Past 陷入遥远的过去 J. Van den Eynde and Others N Engl J Med; Nov 6, 2025; 393(18)：1844-1850 EDITORIALS（社论） 15 Omission of Chest-Wall Irradiation after Mastectomy for Breast Cancer 乳腺癌乳房切除术后省略胸壁放疗 J. de Boniface N Engl J Med; Nov 6, 2025; 393(18)：1852-1853 16 Oral Psoriasis Therapy — For Whom and at What Cost and Risk? 口服银屑病疗法——适用于哪些患者，成本和风险如何？ R.S. Stern N Engl J Med; Nov 6, 2025; 393(18)：1854-1855 CLINICAL DECISIONS（临床决策） 17 Carotid-Artery Stenting or Carotid Endarterectomy for Symptomatic Carotid-Artery Stenosis? 症状性颈动脉狭窄：颈动脉支架置入术还是颈动脉内膜切除术？ S. Gorey , G.J. de Borst , and T.N. Nguyen N Engl J Med; Nov 6, 2025; 393(18)：1856-1858 CORRESPONDENCE（读者来信） 18 Cold Perfusion vs. Static Cold Storage of Deceased-Donor Kidneys — at 10 Years 已故供体肾脏的冷灌注与静态冷保存——10年对比 N Engl J Med; Nov 6, 2025; 393(18)：1859-1861 19 Vepdegestrant in Advanced Breast Cancer 维培吉司他治疗晚期乳腺癌 N Engl J Med; Nov 6, 2025; 393(18)：1861-1862 20 Testosterone for Middle-Aged and Older Men with Hypogonadism 睾酮治疗中老年男性性腺功能减退症 N Engl J Med; Nov 6, 2025; 393(18)：1863-1864 N Engl J Med[Jour] AND 393[volume] AND 19[issue] 新英格兰医学杂志 393卷19期 https://www.nejm.org/toc/nejm/medical-journal?query=main_nav_lg PERSPECTIVE（观点） 1 The Erosion of Harm Reduction 损害减少策略的削弱 J.A. Barocas N Engl J Med; Nov 13, 2025; 393(19)：1865-1867 2 Religious Liberty as a Shield for Public Health — The Case of Overdose-Prevention Centers 宗教自由作为公共卫生的护盾——过量预防中心案例 B.A. Barsky , A. Caplan-Bricker , and C. Robertson N Engl J Med; Nov 13, 2025; 393(19)：1867-1869 3 Truly Prioritizing Child Health — The Missed Opportunities of the MAHA Commission 真正将儿童健康置于首位——MAHA委员会错失的机遇 J.M. Perrin and T.L. Cheng N Engl J Med; Nov 13, 2025; 393(19)：1869-1872 4 What Is Hospice? 什么是临终关怀？ T.D. Brender N Engl J Med; Nov 13, 2025; 393(19)：1872-1873 5 Not Otherwise Specified — Season 3: The Forever Crisis of Primary Care: Undervalued — NOS Episode 3.5 未作特别说明——第三季：初级保健的永恒危机：价值被低估——NOS 第 3.5 集 N Engl J Med; Nov 13, 2025; 393(19)：e32 ORIGINAL ARTICLES（论著） 6 Deferring Arterial Catheterization in Critically Ill Patients with Shock 对休克危重患者推迟动脉导管置入术 G. Muller and Others N Engl J Med; Nov 13, 2025; 393(19)：1875-1888 7 Beta-Blockers after Myocardial Infarction without Reduced Ejection Fraction 无射血分数降低的心肌梗死后使用β受体阻滞剂 B. Ibanez and Others N Engl J Med; Nov 13, 2025; 393(19)：1889-1900 8 Beta-Blockers after Myocardial Infarction in Patients without Heart Failure 无心力衰竭的心肌梗死后患者使用β受体阻滞剂 J. Munkhaugen and Others N Engl J Med; Nov 13, 2025; 393(19)：1901-1911 9 Sacituzumab Govitecan in Untreated, Advanced Triple-Negative Breast Cancer Sacituzumab Govitecan 用于未经治疗的晚期三阴性乳腺癌 J. Cortés and Others N Engl J Med; Nov 13, 2025; 393(19)：1912-1925 REVIEW ARTICLE（综述） 10 Acromegaly 肢端肥大症 A. Giustina and A. Colao N Engl J Med; Nov 13, 2025; 393(19)：1926-1939 IMAGES IN CLINICAL MEDICINE（临床医学影像） 11 Erythema Infectiosum 传染性红斑 J. Martinez-Coronado and R. Salazar N Engl J Med; Nov 13, 2025; 393(19)：1940 12 Forehead Venous Pulsations in Severe Tricuspid Regurgitation 严重三尖瓣反流患者的额部静脉搏动 E.F. Aleong and Y.S. Chatzizisis N Engl J Med; Nov 13, 2025; 393(19)：e33 CASE RECORDS OF THE MASSACHUSETTS GENERAL HOSPITAL（马萨诸塞州总医院病例记录） 13 Case 32-2025: A 79-Year-Old Man with Dyspnea, Edema, and Pacemaker-Lead Displacement 病例 32-2025：一例79 岁男性，出现呼吸困难、水肿和起搏器导线移位 J. Liu and Others N Engl J Med; Nov 13, 2025; 393(19)：1941-1951 EDITORIAL（社论） 14 A Less Invasive Approach to Intensive Care 重症监护的侵入性较小的治疗方法 H.B. Gershengorn N Engl J Med; Nov 13, 2025; 393(19)：1953-1954 MEDICINE AND SOCIETY（医学与社会） 15 The Primary Care Puzzle: PCPs, APPs, and the Everything Bagel Problem — Choosing Not to Choose 初级保健难题：初级保健医生、高级实践护士与“全能包”问题——选择不选择 L. Rosenbaum N Engl J Med; Nov 13, 2025; 393(19)：1955-1959 CORRESPONDENCE（读者来信） 16 A Mammarenavirus Close to Lassa Virus in a Patient with Meningoencephalitis 一名脑膜脑炎患者体内发现与拉沙病毒接近的哺乳动物雷斯顿病毒 N Engl J Med; Nov 13, 2025; 393(19)：1960-1962 17 Acute Normovolemic Hemodilution in Cardiac Surgery 心脏手术中的急性等容性血液稀释 N Engl J Med; Nov 13, 2025; 393(19)：1963-1964 18 Adjuvant Cemiplimab in Cutaneous Squamous-Cell Carcinoma 辅助西米普利单抗治疗皮肤鳞状细胞癌 N Engl J Med; Nov 13, 2025; 393(19)：1964-1965 19 Educational Strategies for Clinical Supervision of Artificial Intelligence Use 人工智能使用临床监督的教育策略 N Engl J Med; Nov 13, 2025; 393(19)：1965-1968 N Engl J Med[Jour] AND 393[volume] AND 20[issue] 新英格兰医学杂志 393卷20期 https://www.nejm.org/toc/nejm/medical-journal?query=main_nav_lg PERSPECTIVE（观点） 1 Tobacco Use Reduction: Integration of Tobacco-Cessation Interventions into Tuberculosis and HIV Care 减少烟草使用：将戒烟干预措施纳入结核病和艾滋病护理 J. Shuter , S. Goel , and S.S. Himelhoch N Engl J Med; Nov 20, 2025; 393(20)：1969-1972 2 Regulating Corporate Control in Health Care — Oregon’s Attempt to Revive the CPOM Doctrine 规范医疗保健中的企业控制——俄勒冈州尝试重振“专业执业组织”原则 J.M. Zhu and H. Rooke-Ley N Engl J Med; Nov 20, 2025; 393(20)：1972-1974 3 Pistachio Ice Cream 开心果冰淇淋 B.B. Kamdar N Engl J Med; Nov 20, 2025; 393(20)：1975-1977 ORIGINAL ARTICLES（论著） 4 Increasing the Potassium Level in Patients at High Risk for Ventricular Arrhythmias 提高高危室性心律失常患者的血钾水平 C. Jøns and Others N Engl J Med; Nov 20, 2025; 393(20)：1979-1989 5 Reduction of Antihypertensive Treatment in Nursing Home Residents 减少养老院居民的抗高血压治疗 A. Benetos and Others N Engl J Med; Nov 20, 2025; 393(20)：1990-2000 6 Efficacy, Immunogenicity, and Safety of Modified mRNA Influenza Vaccine 改良信使核糖核酸（mRNA）流感疫苗的有效性、免疫原性和安全性 D. Fitz-Patrick and Others N Engl J Med; Nov 20, 2025; 393(20)：2001-2011 7 Belzutifan for Advanced Pheochromocytoma or Paraganglioma Belzutifan治疗晚期嗜铬细胞瘤或副神经节瘤 B. Jimenez and Others N Engl J Med; Nov 20, 2025; 393(20)：2012-2022 REVIEW ARTICLE（综述） 8 Long QT Syndrome 长QT综合征 P.J. Schwartz and L. Crotti N Engl J Med; Nov 20, 2025; 393(20)：2023-2034 IMAGES IN CLINICAL MEDICINE（临床医学影像） 9 Cutaneous Metastases from Breast Carcinoma 乳腺癌的皮肤转移 Y.-H. Hsu and H.-J. Wang N Engl J Med; Nov 20, 2025; 393(20)：2035 10 Ortner’s Syndrome in Pulmonary Hypertension 肺动脉高压伴发的奥特纳综合征 R. Plácido and B. Baptista N Engl J Med; Nov 20, 2025; 393(20)：e35 CASE RECORDS OF THE MASSACHUSETTS GENERAL HOSPITAL（马萨诸塞州总医院病例记录） 11 Case 33-2025: A 27-Year-Old Man with Abnormal Behaviors, Confusion, and Seizure 病例33-2025：一例27岁男性，出现行为异常、意识模糊和癫痫发作 N.V. Quijije and Others N Engl J Med; Nov 20, 2025; 393(20)：2036-2045 EDITORIALS（社论） 12 Targeting Potassium for Prevention of Ventricular Arrhythmias 以钾为靶点预防室性心律失常 N.A. Chatterjee N Engl J Med; Nov 20, 2025; 393(20)：2047-2048 13 An Early Look at mRNA Vaccines to Prevent Influenza 预防流感的信使核糖核酸（mRNA）疫苗的早期审视 H.M. El Sahly and R.L. Atmar N Engl J Med; Nov 20, 2025; 393(20)：2048-2050 CLINICAL DECISIONS（临床决策） 14 To Treat or Not to Treat? Watchful Waiting or Oral Antihypertensives for Asymptomatic Inpatient Hypertension 治疗还是不治疗？无症状住院高血压患者的观察等待或口服抗高血压药物选择 S. Gorey , M. Rothberg , and T.I.-H. Chang N Engl J Med; Nov 20, 2025; 393(20)：2051-2053 CLINICAL IMPLICATIONS OF BASIC RESEARCH（基础研究的临床意义） 15 A New Stage for Seasoned Actors — Food Anaphylaxis and the Cysteinyl Leukotrienes 资深“演员”的新舞台——食物过敏性休克与半胱氨酰白三烯 J.A. Boyce N Engl J Med; Nov 20, 2025; 393(20)：2054-2057 MEDICINE AND SOCIETY（医学与社会） 16 The Primary Care Puzzle: Why Have We Chosen Not to Fix Primary Care? The Vicious Cycle of Medical Hierarchy 初级保健难题：我们为何选择不修复初级保健？医疗等级制度的恶性循环 L. Rosenbaum N Engl J Med; Nov 20, 2025; 393(20)：2058-2062 CORRESPONDENCE（读者来信） 17Toward Same-Day Genome Sequencing in the Critical Care Setting 在重症监护环境中实现当日基因组测序 N Engl J Med; Nov 20, 2025; 393(20)：2063-2065 18 Cagrilintide–Semaglutide in Adults with Overweight or Obesity Cagrilintide-Semaglutide治疗超重或肥胖成人 N Engl J Med; Nov 20, 2025; 393(20)：2065-2068 19 Neoadjuvant Nivolumab plus Chemotherapy in Lung Cancer 新辅助纳武利尤单抗联合化疗治疗肺癌 N Engl J Med; Nov 20, 2025; 393(20)：2068-2070 20 Pathogenesis of Heparin-Induced Thrombocytopenia 肝素诱导的血小板减少症的发病机制 N Engl J Med; Nov 20, 2025; 393(20)：2070-2071 N Engl J Med[Jour] AND 393[volume] AND 21[issue] 新英格兰医学杂志 393卷21期 https://www.nejm.org/toc/nejm/medical-journal?query=main_nav_lg PERSPECTIVE（观点） 1 Untangling the Risks of Antidepressants in Pregnancy 理清孕期服用抗抑郁药的风险 K.F. Huybrechts , S. Hernández-Díaz , and B.T. Bateman N Engl J Med; Nov 27, 2025; 393(21)：2073-2075 2 Restoring Confidence in Public Health 重拾对公共卫生的信心 P. Marks N Engl J Med; Nov 27, 2025; 393(21)：2075-2077 3 Venture Capital Investments by U.S. Academic Medical Centers 美国学术医疗中心的风险投资 N. Uppal and Z. Song N Engl J Med; Nov 27, 2025; 393(21)：2077-2080 4 A Wrinkled White Coat 皱巴巴的白大褂 M.A. Pacult N Engl J Med; Nov 27, 2025; 393(21)：2080-2081 5 Not Otherwise Specified — Season 3: The Forever Crisis of Primary Care: Doctor with a Capital D — NOS Episode 3.6 非特别说明——第3季：初级保健的永恒危机：有着大写D的医生——非特别说明第3.6集 N Engl J Med; Nov 27, 2025; 393(21)：e34 ORIGINAL ARTICLES（论著） 6 Early Discontinuation of Aspirin after PCI in Low-Risk Acute Myocardial Infarction 低风险急性心肌梗死患者经皮冠状动脉介入治疗（PCI）后早期停用阿司匹林 G. Tarantini and Others N Engl J Med; Nov 27, 2025; 393(21)：2083-2094 7 Early Withdrawal of Aspirin after PCI in Acute Coronary Syndromes 急性冠状动脉综合征患者经皮冠状动脉介入治疗后早期停用阿司匹林 P.O. Guimarães and Others N Engl J Med; Nov 27, 2025; 393(21)：2095-2106 8 Daily Mosnodenvir as Dengue Prophylaxis in a Controlled Human Infection Model 在可控人体感染模型中，每日服用莫努那韦作为登革热预防措施 A.P. Durbin and Others N Engl J Med; Nov 27, 2025; 393(21)：2107-2118 9 Phase 1 Trial of CRISPR-Cas9 Gene Editing Targeting ANGPTL3 针对ANGPTL3的CRISPR-Cas9基因编辑1期试验 L.J. Laffin and Others N Engl J Med; Nov 27, 2025; 393(21)：2119-2130 10 Engasertib versus Placebo for Bleeding in Hereditary Hemorrhagic Telangiectasia 恩加塞替尼与安慰剂治疗遗传性出血性毛细血管扩张症出血的对比研究 H. Al-Samkari and Others N Engl J Med; Nov 27, 2025; 393(21)：2131-2141 REVIEW ARTICLE（综述） 11 Medical Education: Strategies to Reinvigorate the Bedside Clinical Encounter 医学教育：重振床边临床诊疗的策略 B.T. Garibaldi and S.W. Russell N Engl J Med; Nov 27, 2025; 393(21)：2142-2150 IMAGES IN CLINICAL MEDICINE（临床医学影像） 12 Spironolactone-Induced Gynecomastia 螺内酯引起的男性乳房发育症 A.I. Celik and T. Bezgin N Engl J Med; Nov 27, 2025; 393(21)：2151 13 Subcutaneous Dirofilariasis 皮下丝虫病 R. Moroti Constantinescu and G.A. Dumitru N Engl J Med; Nov 27, 2025; 393(21)：e37 CASE RECORDS OF THE MASSACHUSETTS GENERAL HOSPITAL（马萨诸塞州总医院病例记录） 14 Case 34-2025: A 57-Year-Old Woman with Visual Disturbances and Right-Arm Shaking 2025年第34例病例：一例57岁女性，出现视觉障碍与右臂震颤 N. Wang and Others N Engl J Med; Nov 27, 2025; 393(21)：2152-2162 EDITORIALS（社论） 15 Discontinuation of Aspirin in Acute Coronary Syndromes Treated with Coronary-Artery Stents 冠状动脉支架置入术治疗急性冠状动脉综合征后停用阿司匹林 J.A. Leopold N Engl J Med; Nov 27, 2025; 393(21)：2164-2166 16 Toward a Dengue Pill 迈向登革热药物 X. Xie N Engl J Med; Nov 27, 2025; 393(21)：2166-2167 CORRESPONDENCE（读者来信） 17 Adrenal Aldosterone Synthase Expression Imaging in Primary Aldosteronism 原发性醛固酮增多症肾上腺醛固酮合成酶表达成像 N Engl J Med; Nov 27, 2025; 393(21)：2168-2170 18 Osilodrostat for Bilateral Adrenal Hypercortisolism in Primary Aldosteronism 奥西洛司他治疗原发性醛固酮增多症伴双侧肾上腺皮质醇增多症 N Engl J Med; Nov 27, 2025; 393(21)：2170-2172 19 Low-Dose Aspirin for PI3K-Altered Localized Colorectal Cancer 低剂量阿司匹林治疗PI3K突变的局部结直肠癌 N Engl J Med; Nov 27, 2025; 393(21)：2173 20 Cardiac Rehabilitation for Older Patients 老年患者的心脏康复 N Engl J Med; Nov 27, 2025; 393(21)：2173-2175 21 Medications for Opioid Use Disorder in County Jails — Outcomes after Release 县监狱中阿片类药物使用障碍患者的药物治疗——释放后的结果 N Engl J Med; Nov 27, 2025; 393(21)：2175-2176 N Engl J Med[Jour] AND 393[volume] AND 22[issue] 新英格兰医学杂志 393卷22期 https://www.nejm.org/toc/nejm/medical-journal?query=main_nav_lg PERSPECTIVE（观点） 1 The Corporatization of U.S. Health Care: Has Corporatization Met Its Match? The Challenge of Making Money by Keeping People Healthy 美国医疗保健的企业化：企业化是否遇到了对手？通过保持人们健康来盈利的挑战 D.M. Cutler and R.S. Huckman N Engl J Med; Dec 4, 2025; 393(22)：2177-2180 2 The New U.S. Global Health Strategy — A Reset of America’s Health Cooperation 美国新的全球卫生战略——美国卫生合作的重置 J. Ratevosian and Others N Engl J Med; Dec 4, 2025; 393(22)：2180-2182 3 From Bandwidth to Bedside — Bringing AI-Enabled Care to Rural America 从带宽到病床边——将人工智能赋能的医疗服务带到美国农村地区 A.E. Volandes , A.D. Davis , and N.E. Goldstein N Engl J Med; Dec 4, 2025; 393(22)：2182-2185 ORIGINAL ARTICLES（论著） 4 A Pragmatic Trial of Glucocorticoids for Community-Acquired Pneumonia 社区获得性肺炎糖皮质激素的实用试验 R.K. Lucinde and Others N Engl J Med; Dec 4, 2025; 393(22)：2187-2197 5 A Randomized Trial of Shunting for Idiopathic Normal-Pressure Hydrocephalus 特发性正常压力脑积水分流术的随机试验 M.G. Luciano and Others N Engl J Med; Dec 4, 2025; 393(22)：2198-2209 6 Trial of Pegcetacoplan in C3 Glomerulopathy and Immune-Complex MPGN Pegcetacoplan治疗C3肾小球病和免疫复合物膜增生性肾小球肾炎的试验 F. Fakhouri and Others N Engl J Med; Dec 4, 2025; 393(22)：2210-2220 SPECIAL ARTICLE（专题） 7 Updated Evidence for Covid-19, RSV, and Influenza Vaccines for 2025–2026 2025 - 2026年新冠肺炎、呼吸道合胞病毒和流感疫苗的最新证据 J. Scott and Others N Engl J Med; Dec 4, 2025; 393(22)：2221-2242 REVIEW ARTICLE（综述） 8 Idiopathic Normal-Pressure Hydrocephalus 特发性正常压力脑积水 M.D. Johnson and M.A. Williams N Engl J Med; Dec 4, 2025; 393(22)：2243-2253 IMAGES IN CLINICAL MEDICINE（临床医学影像） 9 Complete Heart Block Detected by Consumer-Facing Digital Health Technologies 消费级数字健康技术检测到的完全性房室传导阻滞 J.E. Ip N Engl J Med; Dec 4, 2025; 393(22)：2254 10 Empyema Necessitans 脓胸穿孔 A.Ayoola and K. Zejnullahu N Engl J Med; Dec 4, 2025; 393(22)：e38 CLINICAL PROBLEM-SOLVING（临床疑难问答） 11 Clouded by Smoke 烟雾笼罩 D.R. Soled and Others N Engl J Med; Dec 4, 2025; 393(22)：2255-2261 EDITORIALS（社论） 12 Glucocorticoids for Pneumonia in Africa — Old Therapy, New Context 非洲肺炎的糖皮质激素治疗——旧疗法，新背景 A.Kwizera and M.W. Dünser N Engl J Med; Dec 4, 2025; 393(22)：2263-2264 13 Small Steps, Big Ventricles: Idiopathic Normal-Pressure Hydrocephalus 小步伐，大心室：特发性正常压力脑积水 A.H. Ropper N Engl J Med; Dec 4, 2025; 393(22)：2264-2266 14 Pegcetacoplan for Treatment of C3 Glomerulopathy and Immune-Complex MPGN Pegcetacoplan治疗C3肾小球病和免疫复合物膜增生性肾小球肾炎 L. Zand and F.C. Fervenza N Engl J Med; Dec 4, 2025; 393(22)：2266-2267 CLINICAL DECISIONS（临床决策） 15 Simplify or Stratify? The Debate over Medical School Grading Systems 简化还是分层？医学院评分系统的争论 H. Marwah and Others N Engl J Med; Dec 4, 2025; 393(22)：2268-2270 CORRESPONDENCE（读者来信） 16 Stability of Avian Influenza A(H5N1) Virus in Milk from Infected Cows and Virus-Spiked Milk 感染奶牛的牛奶和加标牛奶中禽流感A(H5N1)病毒的稳定性 N Engl J Med; Dec 4, 2025; 393(22)：2271-2273 17 Once-Monthly Maridebart Cafraglutide in Obesity — A Phase 2 Trial 每月一次的Maridebart Cafraglutide治疗肥胖症——一项2期试验 N Engl J Med; Dec 4, 2025; 393(22)：2274-2275 18 Orforglipron, an Oral GLP-1 Receptor Agonist, in Early Type 2 Diabetes Orforglipron（一种口服胰高糖素样肽-1受体激动剂）治疗早期2型糖尿病 N Engl J Med; Dec 4, 2025; 393(22)：2276-2279 19 Measurable Residual Disease–Guided Therapy for Chronic Lymphocytic Leukemia 基于可测量残留病灶指导的慢性淋巴细胞白血病治疗 N Engl J Med; Dec 4, 2025; 393(22)：2279-2280 N Engl J Med[Jour] AND 393[volume] AND 23[issue] 新英格兰医学杂志 393卷23期 https://www.nejm.org/toc/nejm/medical-journal?query=main_nav_lg PERSPECTIVE（观点） 1 History of Medicine: Smallpox at the Siege of Boston, November 1775–March 1776 医学史：1775年11月至1776年3月波士顿围城期间的天花疫情 D.S. Jones , S.H. Podolsky , and J. Barr N Engl J Med; Dec 11, 2025; 393(23)：2281-2284 2 Enhancing FDA Drug-Safety Surveillance — Beyond Releasing Daily Adverse-Event Data 加强美国食品药品监督管理局（FDA）药品安全监测——超越每日发布不良事件数据 J.D. Wallach , J.S. Ross , and R. Ramachandran N Engl J Med; Dec 11, 2025; 393(23)：2284-2286 3 Bedside to Bench — AI and the New Science of Medicine 从床旁到实验台——人工智能与医学新科学 Z. Obermeyer N Engl J Med; Dec 11, 2025; 393(23)：2287-2289 4 Not Otherwise Specified — Season 3: The Forever Crisis of Primary Care: Raising a RUCkus — NOS Episode 3.7 未明确分类——第三季：初级保健的永恒危机：掀起一场RUC风波——未明确分类第3.7集 N Engl J Med; Dec 11, 2025; 393(23)：e36 ORIGINAL ARTICLES（论著） 5 High-Dose Influenza Vaccine Effectiveness against Hospitalization in Older Adults 高剂量流感疫苗对老年人住院的预防效果 N.D. Johansen and Others N Engl J Med; Dec 11, 2025; 393(23)：2291-2302 6 High-Dose Influenza Vaccine to Reduce Hospitalizations 高剂量流感疫苗减少住院情况 J. Pardo-Seco and Others N Engl J Med; Dec 11, 2025; 393(23)：2303-2312 7 Ticagrelor and Aspirin or Aspirin Alone after Coronary Surgery for Acute Coronary Syndrome 急性冠状动脉综合征冠状动脉手术后使用替格瑞洛和阿司匹林或仅用阿司匹林 A.Jeppsson and Others N Engl J Med; Dec 11, 2025; 393(23)：2313-2323 8 Disitamab Vedotin plus Toripalimab in HER2-Expressing Advanced Urothelial Cancer 维迪西妥单抗联合特瑞普利单抗治疗HER2表达阳性晚期尿路上皮癌 X. Sheng and Others N Engl J Med; Dec 11, 2025; 393(23)：2324-2337 CLINICAL PRACTICE（临床实践） 9 Complex Regional Pain Syndrome 复杂性区域疼痛综合征 A.Goebel N Engl J Med; Dec 11, 2025; 393(23)：2338-2348 IMAGES IN CLINICAL MEDICINE（临床医学影像） 10 Aortic Intramural Hematoma 主动脉壁内血肿 S. Bouwmeester and A. Tjon Joek Tjien N Engl J Med; Dec 11, 2025; 393(23)：2349 11 Monteggia Fracture 孟氏骨折 Y.C. Chen and T.-L. Hsu N Engl J Med; Dec 11, 2025; 393(23)：e39 CASE RECORDS OF THE MASSACHUSETTS GENERAL HOSPITAL（马萨诸塞州总医院病例记录） 12 Case 35-2025: A 5-Year-Old Boy with Fever and Rash 2025年第35例病例：一例5岁发热出疹男童 M.J. Feldman and Others N Engl J Med; Dec 11, 2025; 393(23)：2350-2359 EDITORIALS（社论） 13 Current and Emerging Approaches to Evaluating Influenza Vaccine Performance 评估流感疫苗效果的当前及新兴方法 K.M. Neuzil N Engl J Med; Dec 11, 2025; 393(23)：2361-2362 14 Disitamab Vedotin plus Toripalimab — New Players in Urothelial Carcinoma 维迪西妥单抗联合特瑞普利单抗——尿路上皮癌治疗新方案 J. Bedke N Engl J Med; Dec 11, 2025; 393(23)：2363-2364 SOUNDING BOARD（专题讨论） 15 FDA’s New Plausible Mechanism Pathway 美国食品药品监督管理局（FDA）新的合理机制途径 V. Prasad and M.A. Makary N Engl J Med; Dec 11, 2025; 393(23)：2365-2367 CLINICAL IMPLICATIONS OF BASIC RESEARCH（基础研究的临床意义） 16 Understanding How Aspirin Prevents Metastasis 了解阿司匹林如何预防转移 R.E. Langley and J. Burn N Engl J Med; Dec 11, 2025; 393(23)：2368-2371 MEDICINE AND SOCIETY（医学与社会） 17 The Primary Care Puzzle: Immeasurable Excellence — What Happens to Medicine without the “Good Doctor”? 初级保健难题：无法衡量的卓越——没有“好医生”的医学将何去何从？ L. Rosenbaum N Engl J Med; Dec 11, 2025; 393(23)：2372-2376 CORRESPONDENCE（读者来信） 18 Molecular Evidence of Multiorgan Damage in Patients with Immune-Related Adverse Events 免疫相关不良事件患者多器官损伤的分子证据 N Engl J Med; Dec 11, 2025; 393(23)：2377-2379 19 Extended Treatment of Provoked Venous Thromboembolism 诱因性静脉血栓栓塞症的延长治疗 N Engl J Med; Dec 11, 2025; 393(23)：2379-2381 20 Oral Semaglutide in Adults with Overweight or Obesity 口服司美格鲁肽治疗超重或肥胖成人 N Engl J Med; Dec 11, 2025; 393(23)：2381-2383 21 Abdominojugular Reflux Test 腹颈静脉回流试验 N Engl J Med; Dec 11, 2025; 393(23)：2383-2384

这是一种罕见却极具破坏力的常染色体显性遗传病，发病时可累及眼睛、大脑、脊髓、肾上腺、胰腺、肾脏，甚至生殖系统等多个器官，引发良性或恶性肿瘤。由于起病早、症状隐匿，许多患者初次就诊时常被误诊：有人因视力模糊前往眼科，结果查出视网膜血管母细胞瘤；有人因剧烈头痛求助神经外科，才发现脑部肿瘤；还有人因腹部不适走进泌尿科，最终确诊为肾上腺或肾脏病变……若缺乏对疾病整体性的认识，仅采取“头痛医头、脚痛医脚”的碎片化诊疗方式，患者可能错失早期干预的关键窗口，最终陷入反复手术、多器官功能受损，甚至生活质量严重下降的困境。而这一切的根源，是一种名为VHL综合征的罕见遗传病。值得欣慰的是，近年来随着“健康中国”战略的深入推进和国家罕见病诊疗体系的不断完善，VHL综合征正逐渐从医学边缘走入临床关注的中心。在这样的背景下，全国各大媒体走进北京大学第一医院、上海仁济医院、中山大学肿瘤防治中心，与多位VHL领域的顶尖专家，围绕“不止罕见”这一议题，就疾病认知、筛查策略、多学科管理及最新治疗进展等内容展开了深度探讨与交流。缺医少药，VHL综合征诊疗困境待破资料显示，VHL综合征（von Hippel–Lindau综合征，又称希佩尔-林道综合征）是一种罕见的常染色体显性遗传性多器官肿瘤综合征，其名称源自德国眼科医生Eugen von Hippel和瑞典病理学家Arvid Lindau，以纪念两位学者对该病的早期发现与系统描述。从国际文献所披露的数据来看，VHL综合征的发病率并不高，大约在1/36,000至1/91,000这个区间。虽然我国目前尚无官方流行病学数据，但基于庞大的人口基数推算，VHL综合征患者总数并不罕见。2023年9月，综合考虑疾病的罕见性、严重性、可诊可治性及社会关注度等因素，VHL综合征被正式列入我国第二批罕见病目录（国卫医政发〔2023〕26号）。其典型特征为多器官肿瘤发病，可累及中枢神经系统、肾脏、胰腺等重要器官，导致血管母细胞瘤、肾细胞癌等严重病变。更令人揪心的是，该病具有50%的遗传概率——也就是说，每位患者的子女从出生起就有近一半的可能携带致病基因，未来或将走上与父辈相似的疾病之路。这种“代际传递”的阴影，不仅加重了家庭的心理与经济负担，也使得早筛、早诊、规范管理和遗传咨询变得尤为迫切。然而，就是这样一种疾病——在20年前，当发达国家的年轻住院医师已能迅速识别并脱口说出“VHL综合征”时，国内却有超过90%的医务人员对其知之甚少，甚至闻所未闻。这种巨大的认知差距，不仅反映了当时罕见病诊疗意识的薄弱，也埋下了长期误诊、漏诊和治疗延误的隐患。而这一差距背后，折射出的是我国VHL综合征等罕见病患者至今仍在面对多重现实困境。首先，是“缺医”。能够系统识别、诊断并管理VHL的多学科专业团队极为有限，大量基层医生缺乏相关知识，亟需通过持续的科普宣教和专业培训提升整体诊疗能力；其次，是“少药”。由于患者群体小、研发成本高、市场回报低，药企对罕见病药物投入意愿不足，导致针对性治疗选择长期稀缺；再者，由于“经济压力大”，许多VHL患者往往需经历多次手术，若叠加昂贵的靶向药物费用，极易导致家庭因病致贫、因病返贫，迫切需要完善医保覆盖、专项救助及多层次医疗保障制度。从“无人识病”到“有医可寻、有药可用、有保可依”，每一步都关乎一个家庭的命运，也考验着整个社会对罕见病群体的温度与担当。100余位专家深度参与，新版共识即将发布在这样的背景下，推动VHL诊疗走向规范化、体系化，已然成为临床专家们义不容辞的共同使命。值得着重提及的是，2018年，由北京大学第一医院泌尿外科主任医师龚侃教授牵头编写的《中国von Hippel–Lindau病诊治专家共识》应时而生，成功填补了我国在该领域长期缺失统一诊疗标准的空白。北京大学第一医院泌尿外科主任医师龚侃教授这份共识的落地，并非仅仅依靠医学层面的专业判断，无数患者及其家庭的真实经历与坚定信念，同样为其提供了坚实的支撑。在临床诊治的漫漫征途中，龚侃教授就遇到过这样两位令人印象深刻的患者。有一位患者，在怀孕5个月时，因担忧胎儿携带致病基因的风险，再加上家庭突遭变故，陷入无助与迷茫，四处求助。然而当时，国内尚无相关的产前诊断技术。面对这一困境，龚侃教授团队没有退缩，而是联合多领域专家展开攻关。经过不懈努力，成功建立了国内首个VHL综合征产前诊断体系。并且，至今他们仍与北医三院乔杰院士团队紧密合作，积极探索第三代试管等前沿技术，为优生优育提供更多保障。还有一位来自海南的年轻患者，他与网恋女友相知相恋，感情深厚。女友为了陪伴他，毅然放弃外地教师的工作，在他患病期间不离不弃，悉心照料。龚侃教授被他们二人的深情所打动，自费前往三亚担任他们的证婚人，并如实告知了疾病可能存在的风险。即便如此，女方依旧坚定地选择与他相守。后来，患者因肾癌转移不幸去世，但他的妻子始终坚守着当初的承诺。这些故事让医务工作者深切体会到患者的困境与坚守，更成为推动相关诊疗技术研发、持续助力罕见病患者的精神动力。近年来，随着医学科技和诊断技术的飞速发展，国内外在VHL综合征的基础研究、基因检测、靶向治疗等领域取得了显著进展。然而，先进技术要真正惠及患者，关键在于它能否转化为规范、可及的临床实践。遗憾的是，目前这一转化过程仍面临巨大挑战。尤其是在基层，许多医生对VHL认知有限，诊疗行为缺乏统一标准，导致患者常因误诊或漏诊而错失最佳干预时机。正因如此，龚侃教授团队深知，专家共识也需要不断地“与时俱进”——打通从“指南”到“床边”的路径，亟需建立一套标准化、可推广、普适性强的诊疗流程（SOP），并依托多学科协作与高质量临床研究，持续积累高等级循证医学证据，为指南的动态更新与优化提供坚实支撑。基于这一目标，龚侃教授团队于2023–2024年牵头组织全国100余位来自遗传、眼科、神经外科、泌尿外科、内分泌、影像等多个领域的专家，历时半年多反复打磨，完成新版《VHL综合征中国专家共识》的修订工作。目前共识已定稿排版，预计将于2025年12月底在《中华医学杂志》正式发表，为VHL诊疗领域带来新的指引与规范。MDT协作、精准施治...VHL诊疗迈入新阶段北京大学第一医院院内MDT据介绍，得益于七八年间疾病诊疗领域的突飞猛进，新版专家共识相较于2018年版，在多个关键方面取得了令人瞩目的新进展。在诊断环节，引入了二代测序等前沿新技术，实现了无创、快捷且精准的诊断；基因检测方面，不仅能够预测发病风险，还成功建立了AI精准诊疗模型；手术领域，微创射频消融技术得以应用；药物研发更是成果丰硕，如贝组替凡已投入使用，国内外仍有多款以 HIF-2α 等通路为靶点的创新药物处于不同阶段的临床研究，其中龚侃教授团队牵头了其中3种药物的研发工作。这些新进展无疑将为医患双方提供更多切实有效的帮助。北京大学第一医院泌尿外科主治医师周靖程医生该团队另一位成员、北京大学第一医院泌尿外科主治医师周靖程医生北京大学第一医院泌尿外科主治医师周靖程医生也详细介绍道，与旧版相比，本次新版《VHL综合征中国专家共识》实现了两大核心升级。其一，是系统化诊疗理念的全面强化。当前，国内外权威共识，包括美国、丹麦的指南以及即将发布的中国新版共识，都明确且坚定地强调：VHL综合征的管理必须依托多学科协作（MDT），并且要贯穿患者从疾病发现到生命终结的全生命周期。这一转变彻底告别了过去“头痛医头、脚痛医脚”的碎片化模式，转而以整体视角统筹筛查、监测、手术、药物及心理支持，真正实现“早发现、少损伤、保功能、提生活质量”的目标。其二，VHL综合征的治疗手段也迎来了重要突破。随着对VHL - HIF信号通路机制研究的不断深入，靶向HIF - 2α的抑制剂（如贝组替凡）作为首个获批的系统性治疗药物，已经显著改变了疾病的管理格局，这标志着VHL正式迈入了精准治疗时代，患者不再仅仅依赖反复的手术来应对疾病。2024年11月，贝组替凡获批上市，成为全球范围内唯一获批用于VHL综合征的系统性药物。据周医生介绍，该药物在国内获批近一年来，其所在中心作为全国罕见病诊疗协作网的重要牵头医院之一，已为近百例VHL患者提供治疗，处于国内前列、国际前沿。随访数据显示，大多数患者肿瘤生长得到控制，部分病灶明显缩小，对视网膜血管母细胞瘤相关囊性病变和胰腺囊肿等也显示出一定疗效。药物总体安全性良好，副作用可控，患者耐受性较高。值得一提的是，基于国际LITESPARK-004研究和中国主导的LITESPARK-015研究，CSCO指南已将贝组替凡的推荐等级从III级提升至II级。这一升级标志着贝组替凡正从“可尝试用药”迈向接近标准治疗的重要选择。在采访过程中，周靖程医生还分享了一例福建VHL患者家庭的对比故事：父亲因早年缺乏规范诊疗，反复接受开颅、肾部分切除等手术，生活质量严重受损；而其携带相同致病基因的儿子，在规范化管理和新药干预下，肿瘤得到有效控制，顺利结婚就业，成功避免重蹈覆辙。“切断代际绝望、守护家庭希望”，正是现代医学超越疾病本身的价值所在。多位专家指出，VHL诊疗已正在逐步向可长期管理的慢性病状态转变。随着基因检测普及和靶向药物可及，患者不再孤军奋战。坚持科学、规范随访，与医生建立长期信任的伙伴关系，不仅能有效控制病情，更有机会拥抱充实而有希望的人生。返回搜狐，查看更多