Inavolisib

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

前言 近期，欧洲肿瘤内科学会（ESMO）于Annals of Oncology发布了转移性乳腺癌（MBC）生活指南系统治疗更新1，其中对诊断环节的优化尤为关键——明确强调在首次诊断MBC时需强化转移灶活检，核心目的是重新评估肿瘤生物学特征，尤其是人类表皮生长因子受体2（HER2）的表达水平。同时，指南还对生物标志物检测的推荐进行了更新：HER2阴性患者需新增PALB2突变检测，HR阳性/HER2阴性患者需加测AKT1/PTEN突变，且所有检测均结合ESMO分子靶向临床可行性量表（ESCAT）评分，依据最新证据明确临床优先级。此外，指南还特别强调芳香化酶抑制剂（AI）治疗后，通过组织或液体活检检测ESR1突变状态的重要性。这些更新为HR阳性/HER2阴性MBC的精准诊断筑牢基础，并直接关联到后续个体化治疗决策的制定。 固定布局                                                        工具条上设置固定宽高背景可以设置被包含可以完美对齐背景图和文字以及制作自己的模板 ESMO转移性乳腺癌生活指南核心生物标志物检测 指南围绕MBC患者的治疗需求，对生物标志物检测项目、推荐级别、证据等级及临床可行性（ESCAT评分）进行明确界定，具体推荐如下： 图1. MBC患者生物标志物检测路径2 表1. MBC患者生物标志物检测更新建议1-2 注：IHC：免疫组织化学；FISH：荧光原位杂交 分层解析：指导治疗决策的生物标志物 ► HER23,4 在HER2阴性晚期乳腺癌患者中，约45%-55%为HER2低表达人群（IHC 1+或IHC 2+/ISH-），而近年来的研究进一步拓宽了HER2表达的边界，HER2超低表达人群（IHC 0但≤10%浸润癌细胞呈微弱细胞膜染色）也逐渐进入临床视野。 研究显示，HER2低表达在乳腺癌中并非罕见状态，原发肿瘤中HER2低表达率约为34%，转移灶中为37%，且原发肿瘤与匹配远处转移灶间HER2表达状态的不一致率可达40%-50%，这也提示了动态监测HER2表达状态的必要性。因此，精准检测HER2低表达、超低表达状态，成为筛选特定治疗方案获益人群的关键前提。 ► BRCA1/2和PALB23 抑癌基因BRCA1和BRCA2的体细胞（s）突变与种系（g）突变均与同源重组缺陷（HRD）相关，且对癌症遗传具有重要意义。PALB2与BRCA2具有协同作用，是同源重组修复的关键辅助因子。其中，gBRCA1/2基因突变与接受CDK4/6抑制剂治疗患者的不良预后独立相关。对于gBRCA1/2或gPALB2突变患者，当前指南建议可采用PARP抑制剂治疗，因此需检测HRD基因改变以指导治疗决策。 ► PD-L15 PD-1受体属于CD28超家族，当其与配体PD-L1结合时，会抑制T细胞活化及免疫应答，导致肿瘤发生免疫逃逸。目前已有大量临床试验将PD-1/PD-L1作为乳腺癌的治疗靶点展开研究，其中抗PD-1疗法（如帕博利珠单抗）与抗PD-L1疗法（如阿替利珠单抗）均得到了广泛探索，也逐渐获批应用于临床。因此，指南将PD-L1检测列为三阴性乳腺癌推荐检测标志物，为免疫治疗方案选择提供直接依据。 ► PIK3CA3 PIK3CA基因编码PI3K催化亚基，在HR阳性/HER2阴性乳腺癌患者中突变发生率达30%-40%；其突变会导致经典的PI3K/AKT/mTOR（PAM）通路异常激活，进而驱动细胞的代谢与增殖。在转移性管腔型乳腺癌中，PI3K通路的激活与内分泌治疗（ET）耐药相关，这一发现推动了针对PAM通路的抑制剂的研发。III期INAVO120试验证实，在哌柏西利与氟维司群基础上联合伊那利塞，可显著改善PIK3CA突变HR阳性/HER2阴性晚期乳腺癌患者的中位PFS，明确了该突变检测对靶向方案选择的价值。基于临床研究证据，伊那利塞（PI3Kα抑制剂）获批乳腺癌适应证；此外，针对PIK3CA/AKT1/PTEN改变的卡匹色替（AKT抑制剂）也获得批准，为该类乳腺癌患者提供更多治疗选择。 ► AKT1/PTEN3,6 AKT1/PTEN同为PAM通路中的关键分子：AKT1编码AKT激酶，激活后能够磷酸化多种下游靶点，促进细胞增殖和存活；PTEN则通过负向调控PAM通路抑制肿瘤。AKT1/PTEN发生改变时，导致PAM通路过度激活，进而促进肿瘤发生发展。 CAPItello-291研究中，对于PI3K/AKT/PTEN通路存在异常、且既往接受过一线CDK4/6抑制剂治疗的患者，卡匹色替（AKT抑制剂）联合氟维司群治疗相较于安慰剂联合氟维司群，显著延长了患者的mPFS。 ► ESR13 ESR1基因负责编码雌激素受体（ER）α。转移性HR阳性/HER2阴性乳腺癌患者使用芳香化酶抑制剂（AI）治疗后出现耐药情况时，有研究显示高达48%的患者可能检测到ESR1基因突变。此外，一线CDK4/6抑制剂联合AI治疗一年后，ESR1突变率可达50%。 ESR1突变通常导致患者对CDK4/6抑制剂联合AI治疗产生耐药性，但对CDK4/6抑制剂联合氟维司群治疗则无明显影响，提示ESR1突变可作为氟维司群（ER拮抗剂）治疗的潜在生物标志物。即使患者未见影像学进展，一旦检测到ESR1突变，及时从AI转换为氟维司群治疗，也能带来显著的临床获益。EMERALD研究进一步证实了这一点：对于ESR1突变且对CDK4/6抑制剂敏感的患者，采用新型口服选择性雌激素受体降解剂（SERD）elacestrant治疗，中位PFS得到显著改善。这一结果进一步验证了ESR1突变检测在临床实践中的重要价值。 总结 2025年ESMO MBC生活指南对生物标志物检测的更新，为MBC精准诊断与治疗搭建了更清晰的“分子导航”体系。从强化转移灶活检以捕捉肿瘤动态生物学特征，到细分HER2全表达谱、完善PIK3CA/AKT1/PTEN/ESR1等核心标志物检测，每一项调整都紧扣“诊断指导治疗”的核心逻辑，尤其为HR阳性/HER2阴性这一最常见乳腺癌亚型的诊疗提供了精准依据。 未来，随着液新型检测技术的普及，MBC的诊断将更趋动态化、个体化，有望实现“实时监测肿瘤分子变化、及时调整治疗策略”的精准管理目标。临床实践中，唯有严格遵循指南推荐，将生物标志物检测深度融入诊疗流程，才能真正让“精准诊断”成为提升患者生存获益、改善生活质量的坚实基石。 参考资料： [1] Trapani D,et al. Ann Oncol. 2025 Aug 12. DOI:10.1016/j.annonc.2025.07.017 [2] https://www.esmo.org/guidelines/living-guidelines/esmo-living-guideline-metastatic-breast-cancer/hr-positive-her2-negative-metastatic-breast-cancer [3] Cejalvo Andújar JM, et al. Cancer Drug Resist. 2025;8:5. Published 2025 Jan 22. doi:10.20517/cdr.2024.169 [4] Shang J, Liu Y. Transl Breast Cancer Res. 2024;5:29. Published 2024 Oct 21. doi:10.21037/tbcr-24-33 [5] Jin M, et al. Mol Cancer. 2024;23(1):266. Published 2024 Nov 29. doi:10.1186/s12943-024-02176-8 [6] Miricescu D, et al. Int J Mol Sci. 2020;22(1):173. Published 2020 Dec 26. doi:10.3390/ijms22010173 本材料由阿斯利康提供，仅供医疗卫生专业人士参考 审批编号：CN-168735 过期日期：2026-10-14 撰写：KIKI 审校：KIKI 排版：Mythero 执行：Atai 本平台旨在为医疗卫生专业人士传递更多医学信息。本平台发布的内容，不能以任何方式取代专业的医疗指导，也不应被视为诊疗建议。如该等信息被用于了解医学信息以外的目的，本平台不承担相关责任。本平台对发布的内容，并不代表同意其描述和观点。若涉及版权问题，烦请权利人与我们联系，我们将尽快处理。