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25 February 2026, Volume 21 Issue 01 Previous Issue   

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Twenty years of perseverance and progress, forging ahead to new heights-on the 20th anniversary of Journal of Internal Medicine Concepts & Practice NING Guang, LI Qingyun 2026, 21 (01):  1-2.  Abstract ( 0 )   HTML ( 1 )   PDF (278KB) ( 4 )   References | Related Articles | Metrics

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Research progress on immunological non-response in acquired immunodeficiency syndrome patients QI Qingsong, TIAN Meina, YU Yao 2026, 21 (01):  3-11.  DOI: 10.16138/j.1673-6087.2026.01.01 Abstract ( 0 )   HTML ( 1 )   PDF (517KB) ( 10 )   Although highly active antiretroviral therapy (HAART) can achieve long-term and stable viral suppression, some patients with acquired immunodeficiency syndrome still exhibit poor recovery of CD4+ T cell counts after treatment. This condition is commonly referred to as immune non-response (INR). Currently, there is no unified international definition or diagnostic threshold for INR, and the incidence rates reported in different studies vary significantly. INR is associated with multiple factors, but its key mechanisms remain unclear, and effective clinical treatment strategies are still lacking. This article systematically reviews the definitions, influencing factors, and therapeutic approaches for INR in acquired immunodeficiency syndrome-related research, aiming to provide a reference for subsequent studies and lay a foundation for the development of effective treatment strategies for INR. References | Related Articles | Metrics

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Effects of rapid initiation of antiretroviral therapy on viral suppression and immune recovery in treatment-naïve HIV-1-infected patients in Sichuan province HE Yuanhong, LIU Lin, LIU Huanxia, YANG Tongtong 2026, 21 (01):  12-20.  DOI: 10.16138/j.1673-6087.2026.01.02 Abstract ( 0 )   HTML ( 2 )   PDF (548KB) ( 10 )   Objective To evaluate the effects of rapid initiation of antiretroviral therapy (ART) on virological suppression and immune recovery in treatment-naïve patients infected with human immunodeficiency virus type 1 (HIV-1) in Sichuan province. Methods A prospective study was conducted on treatment-naïve HIV-1-infected patients who were diagnosed and received first-time ART at Department of Infectious Disease, the Public Health Clinical Center of Chengdu, from March 2020 to May 2024. Participants were divided into two groups according to the time from diagnosis to ART initiation: a rapid initiation group (≤7 d after diagnosis) and a control group (8–30 d after diagnosis). The primary outcome measures were virological suppression rate and immune recovery (changes in CD4+ T lymphocyte count). Clinical outcomes were compared between the two groups at week 4, 24 and 48 of treatment. Results A total of 306 patients were enrolled, including 134 in the rapid initiation group and 172 in the control group. In the rapid initiation group, the virological suppression rates at week 4, 24 and 48 were 64.7%, 87.9% and 89.7%, respectively. Compared with the control group, the rapid initiation group demonstrated significantly better virological suppression at all follow-up time points (P<0.001). Regarding immune recovery, CD4+ T lymphocyte counts in the rapid initiation group showed a sustained increase from a baseline of 239.5 cells/μL to 390 cells/μL at week 48, along with a continuous improvement in the CD4/CD8 ratio (P<0.001). No significant differences were observed in biochemical parameters between the two groups, and no serious adverse events occurred. Conclusions Rapid initiation of ART significantly improves virological suppression rates and accelerates early immune recovery in treatment-naïve HIV-1-infected patients in Sichuan province. This strategy provides strong evidence for enhancing treatment outcomes of HIV-1 infection and reducing viral transmission. Figures and Tables | References | Related Articles | Metrics

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Analysis on etiological characteristics of 322 patients with human immunodeficiency virus infection / acquired immunodeficiency syndrome complicated with pulmonary infection in Henan province WANG Yanli, HOU Mingjie, YUAN Haizhen, XIN Ningbo, ZHANG Yuwei, HAN Lei, ZHANG Yifan, MA Yuqing, ZHAO Qingxia 2026, 21 (01):  21-27.  DOI: 10.16138/j.1673-6087.2026.01.03 Abstract ( 0 )   HTML ( 2 )   PDF (607KB) ( 7 )   Objective To discuss the etiological characteristics of patients with human immunodeficiency virus (HIV) / acquired immunodeficiency syndrome (AIDS) [collectively referred to as people living with HIV (PLWH)] complicated with pulmonary infection, and to evaluate the diagnostic value of metagenomic next-generation sequencing (mNGS) technology. Methods A retrospective study was conducted on 322 PLWH with pulmonary infection, whose clinical data and bronchoalveolar lavage fluid samples were collected. All samples underwent both conventional etiological tests [smear, culture, polymerase chain reaction (PCR)] and mNGS. The pathogen detection rates, reporting times, and detected etiological characteristics were compared between the two methods. Etiological variations under different CD4+ T lymphocyte levels were also analyzed. Results Among the 322 patients, 80.1% (258/322) were male, with a median age of 35 years. The median CD4+ T lymphocyte count was 61 (22, 205) cells/µL, and the median HIV RNA load was 1 343 (0, 159 423) copies/mL. mNGS was successfully performed on 294 patients, detecting a total of 93 pathogen species across 786 instances. Viruses were the predominant pathogens (34.4%, 32 species), with the most common being cytomegalovirus (CMV, 44.7%), Pneumocystis jirovecii (40.4%), Epstein-Barr virus (14.6%), Mycobacterium tuberculosis complex (11.2%), coronavirus disease 2019(COVID-19)(9.0%), and Aspergillus flavus/A. oryzae(8.7%). The overall sensitivity of conventional methods was 64%, with a statistically significant difference (P<0.001) compared to 91.0% for mNGS. The reporting time of mNGS was significantly shorter than of conventional methods. Patients at the AIDS stage, whose CD4+ T lymphocytes<200 cells/µL, had the highest total number of detected pathogens (648 instances). Conclusions Pulmonary infections in PLWH are primarily caused by CMV, P. jirovecii, M. tuberculosis complex, COVID-19, and Aspergillus species, with the etiological spectrum varying according to immune status. Patients with low CD4 counts are susceptible to opportunistic pathogens such as Pneumocystis jirovecii and CMV. As the CD4 count increases, viruses and fungi remain the predominant types of pathogens, but the proportion of bacterial detection relatively increases. mNGS can significantly improve the pathogen detection rate in PLWH with pulmonary infection. Figures and Tables | References | Related Articles | Metrics

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Effects of exercise combined with nutrition intervention on body composition, physical function and sleep quality in elderly patients with sarcopenia ZHANG Yin, SHEN Honghua, XU Yiming, DU Jingbo, LIU Jie, WU Shunjun, LING Xiaonan, REN Lei 2026, 21 (01):  28-38.  DOI: 10.16138/j.1673-6087.2026.01.04 Abstract ( 0 )   HTML ( 1 )   PDF (599KB) ( 8 )   Objective To investigate the effects of combined aerobic and resistance training along with nutritional supplementation on body composition, physical function, and sleep quality in elderly patients with sarcopenia. Methods A total of 83 elderly outpatients and inpatients with sarcopenia from the Department of Respiratory Rehabilitation at the Fourth Rehabilitation Hospital of Shanghai between January and June 2024 were enrolled, and were randomly assigned to a control group (aerobic training only, n=42) or an intervention group [combined aerobic and resistance training + whey protein supplementation containing vitamin D3 and beta-hydroxy-beta-methylbutyrate (HMB), n=41] for a 12-week intervention. Measurements including skeletal muscle index (SMI), 25-hydroxyvitamin D level, grip strength, 6-meter gait speed, and short physical performance battery (SPPB) score were examined before and after treatment. Sleep quality was assessed using the Pittsburgh sleep quality index (PSQI), insomnia severity index (ISI), and Epworth sleepiness scale (ESS). Results After treatment, the intervention group showed significantly greater improvements than the control group in SMI, 25-hydroxyvitamin D level, 6-meter gait speed, and total SPPB score (all P<0.05). The change in 5-time sit-to-stand performance was also significantly greater in the intervention group (P<0.05). Regarding sleep quality, both groups demonstrated significant post-intervention improvements in subjective sleep quality, sleep efficiency, total PSQI score, and ISI score (all P<0.05). Compared with the control group, the intervention group showed more pronounced improvements in subjective sleep quality, sleep duration, sleep disorders, total PSQI score, ISI score, and ESS score (all P<0.05). Logistic regression analysis indicated that the intervention modality [odds ratio (OR)=2.698, P=0.020] and comorbid osteoporosis (OR=2.362, P=0.043) were both associated with the improvement of sleep quality in patients. Conclusions Compared with aerobic training alone, a combined intervention of aerobic and resistance training with nutritional supplementation is more effective in improving muscle function and sleep quality in elderly patients with sarcopenia. The intervention modality and the presence of comorbid osteoporosis are significant factors influencing the efficacy of sleep quality improvement. Figures and Tables | References | Related Articles | Metrics

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Status and influencing factors of optimism among reproductive-aged women with HIV CHEN Lijuan, LUO Canwei, LIU Linshan, LI Jiajia, HUANG Shaolan, LI Linghua, LIU Cong 2026, 21 (01):  39-45.  DOI: 10.16138/j.1673-6087.2026.01.05 Abstract ( 0 )   HTML ( 1 )   PDF (534KB) ( 5 )   Objective To investigate the status and influencing factors of optimism among reproductive-aged women with human immunodeficiency virus (HIV), aiming to provide a reference for promoting the comprehensive management of female HIV patients. Methods The convenience sampling method was used to select reproductive-aged women with HIV who attended the infectious disease outpatient clinic of a designated hospital in Guangzhou from December 2023 to June 2024. General information questionnaire, Revised Life Orientation Test (LOT-R), and Medical Coping Modes Questionnaire (MCMQ) were used for the survey. Non-parametric tests and multiple linear regression analysis were conducted using SPSS 26.0 software. Results A total of 185 reproductive-aged women with HIV were included. The total LOT-R score was 22.00（19.00, 25.00） points, with the optimism dimension score being 13.00(11.00, 15.00) points and the pessimism dimension score being 9.00(7.00, 11.00) points. Multiple linear regression analysis results showed that being an only child (β=−0.151) and having changed fertility intentions due to HIV infection (β=−0.141) were negatively correlated with LOT-R scores, while place of residence (β=0.165) and having a history of childbirth (β=0.171) were positively correlated with LOT-R scores. All correlations exhibited statistical significance (P < 0.05). Conclusions The level of optimism among reproductive-aged women with HIV is moderate. Attention should be given to patients who are the only children, reside in rural areas, or have no history of childbirth. It is recommended to use family system intervention as a key entry point to alleviate the role pressure of only daughters; utilize digital tools to expand remote support to narrow the geographical and information gap for rural patients; and provide integrated psychological and medical decision-making counselling for those with fertility-related concerns, thereby comprehensively enhancing the mental health and fertility confidence of this population. Figures and Tables | References | Related Articles | Metrics

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Analysis of the status and influencing factors of patient dignity in the intensive care unit WANG Minhui, KANG Lei 2026, 21 (01):  46-52.  DOI: 10.16138/j.1673-6087.2026.01.06 Abstract ( 0 )   HTML ( 1 )   PDF (535KB) ( 4 )   Objective To explore the current status and influencing factors of dignity among patients in the intensive care unit (ICU). Methods A cross-sectional study was conducted on 240 patients admitted to the ICU of our hospital from April to October 2023. General data were recorded, and the Hospital Anxiety and Depression Scale (HADS), and the Patient Dignity Inventory (PDI) were used for assessment. The current status of dignity among ICU patients and its relationship with clinical characteristics were analyzed. Pearson correlation analysis was used to examine the correlation between ICU patient dignity and anxiety/depression emotions. Multiple linear regression analysis was performed to identify factors influencing ICU patient dignity. Results The total PDI score of the 240 patients was (70.48±10.67) points, with moderate to severe loss of dignity accounting for over 75.58%. Statistically significant differences in PDI scores were observed among patients of different ages, educational levels, family monthly per capita income, living arrangements, primary caregivers, family relationships, and length of ICU stay (P<0.05). Correlation analysis showed that the total PDI score and its dimensions were positively correlated with the total HADS score, anxiety score, and depression score (P<0.05). Multiple linear regression revealed that advanced age, non-family member as the primary caregiver, average family relationships, and longer ICU stay were risk factors for loss of dignity in ICU patients, while high educational level was a protective factor (P<0.05). Conclusions Loss of dignity is common among ICU patients, and its occurrence is closely related to patient age, primary caregiver, family relationships, length of ICU stay, anxiety/depression, and educational level. Close attention should be paid to this issue, and active intervention should be implemented. Figures and Tables | References | Related Articles | Metrics

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A survey of knowledge status regarding hyponatremia among general practitioners in a standardized residency training base at a tertiary grade-A hospital in Shanghai and an analysis of related influencing factors ZHANG Xian, HU Yucong, FENG Wenqing, ZHOU Shuying, YAN Hua 2026, 21 (01):  53-58.  DOI: 10.16138/j.1673-6087.2026.01.07 Abstract ( 0 )   HTML ( 1 )   PDF (496KB) ( 6 )   Objective To investigate the current status of knowledge about hyponatremia among general practitioners in a standardized residency training base (hereafter referred to as general practice residents) at a tertiary grade-A hospital in Shanghai, and to analyze potential influencing factors, aiming to provide a reference for further improving the diagnosis and treatment capabilities of general practice residents regarding hyponatremia. Methods A total of 41 general practice residents at Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, were selected as the study subjects from July 2023 to August 2024. A questionnaire was designed based on the Chinese Expert Consensus on Hyponatremia (2023 Edition) (hereafter referred to as the Consensus). The objective survey content included five parts of hyponatremia: classification, etiology, diagnosis and evaluation, treatment, and patient lifestyle interventions. The subjective survey content included whether the general practice residents found it difficult to master the knowledge related to hyponatremia, and whether they considered it necessary to receive related teaching (including lectures and guideline study). Results The average total score of the 41 general practice residents was (73.22 ± 22.63) points, with the lowest score in the treatment of hyponatremia (13.85 ± 5.66) points. Binary Logistic regression analysis showed that the factors influencing the overall test score were whether they had attended lectures on hyponatremia [odds ratio (OR) = 39.127, 95% CI: 2.358~649.180, P = 0.011] and whether they had studied the Consensus (OR=19.189, 95% CI: 1.300~283.287, P = 0.031). Scores across all five sections were significantly higher in the group that had attended the lectures or studied the Consensus compared to those that had not (all P < 0.001). Scores across all five sections were also significantly higher in the group that had participated in the diagnosis and treatment of hyponatremia patients compared to the group that had not (all P < 0.001). Among the 41 residents, 40 (97.56%) considered the knowledge points of hyponatremia difficult to master; 40 (97.56%) believed that related teaching was necessary; 41 (100.00%) considered that lectures on hyponatremia were helpful for clinical work; and 41 (100.00%) believed it necessary to study the related consensus/guidelines. Conclusions Whether having attended lectures on hyponatremia and whether having studied the Consensus are influencing factors for the total assessment score on hyponatremia among general practice residents. The residents perceive the comprehensive management of patients with hyponatremia as somewhat difficult, demonstrating an urgent need to strengthen relevant training and learning. Figures and Tables | References | Related Articles | Metrics

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Olverembatinib combined with inotuzumab ozogamicin in Philadelphia chromosome-positive acute lymphoblastic leukemia with multiple relapses: a case report LIU Heng, XI Rui, PAN Yaozhu, WANG Zonghui, TIAN Hongjuan, MAO Dongfeng, WU Tao 2026, 21 (01):  59-61.  DOI: 10.16138/j.1673-6087.2026.01.08 Abstract ( 0 )   HTML ( 1 )   PDF (446KB) ( 14 )   Relapsed/refractory (R/R) Philadelphia chromosome-positive acute lymphoblastic leukemia (Ph+ ALL) is difficult to treat, facing a poor prognosis and short overall survival. The usage of tyrosine kinase inhibitor (TKI) and immunotherapy has brought new hope for the treatment of R/R Ph+ ALL for patients. This paper retrospectively analyzed a patient with Ph+ ALL experiencing multiple relapses, who was treated with olverembatinib in combination with a reduced dose of inotuzumab ozogamicin. The patient achieved complete response (CR) and minimal residual disease (MRD) negativity upon reexamination two months later, attaining a near-complete molecular response (CMR). A review of relevant literature is included to provide clinical treatment experience. References | Related Articles | Metrics

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Mechanisms and research progress of neurological damage caused by HIV and CMV from the perspective of co-infection WANG Yao, WEI Lanlan, CHU Ming, WANG Fuxiang 2026, 21 (01):  62-67.  DOI: 10.16138/j.1673-6087.2026.01.09 Abstract ( 0 )   HTML ( 2 )   PDF (507KB) ( 15 )   With the widespread use of antiretroviral therapy (ART), the lifespan of individuals infected with human immunodeficiency virus (HIV) has been significantly prolonged; however, the prevalence of HIV-associated neurocognitive disorder (HAND) has not decreased correspondingly. Cytomegalovirus (CMV), as a latent opportunistic pathogen, is prevalent among HIV-infected individuals. Co-infection of CMV and HIV may exacerbate neurological damage through synergistic effects and has become a key factor affecting the long-term quality of life and prognosis of patients. This article aims to systematically elucidate the virological and immunological basis, molecular and cellular mechanisms, clinical phenotypes, diagnostic strategies, and therapeutic management of neurological damage caused by HIV and CMV co-infection, and to summarize the latest research progress and future directions, providing an integrated perspective for clinical practice and scientific research. References | Related Articles | Metrics

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Features of multi-organ involvement and management strategies in AIDS-related Kaposi sarcoma ZHANG Yaping, WANG Li, HE Yuanhong, YIN Ke, YANG Tongtong 2026, 21 (01):  68-73.  DOI: 10.16138/j.1673-6087.2026.01.10 Abstract ( 0 )   HTML ( 1 )   PDF (540KB) ( 11 )   Kaposi sarcoma (KS) is a multicentric tumor closely associated with immunosuppression and KS-associated herpesvirus (KSHV) infection. The synergistic interaction between KSHV infection and human immunodeficiency virus (HIV) infection promotes the occurrence and progression of acquired immunodeficiency syndrome (AIDS)-associated KS (AIDS-KS). AIDS-KS is one of the most common malignancies in AIDS patients and thus requires high clinical attention. This article systematically reviews the multicentric pathogenesis of AIDS-KS, the specific clinical manifestations of involvement in different organs and stratified diagnostic and therapeutic strategies, with particular emphasis on the importance of combining antiretroviral therapy (ART) and targeted therapy in disease management. The implementation of individualized and multidisciplinary comprehensive management strategies can better control disease progression and improve patients’ quality of life as well as prognosis. References | Related Articles | Metrics

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Research progress on heterogeneity of aging WANG Tingxu, WANG Xu, ZHOU Lianyao, YIN Shuo, DAI Jingyu, YE Jing 2026, 21 (01):  74-79.  DOI: 10.16138/j.1673-6087.2026.01.11 Abstract ( 0 )   HTML ( 1 )   PDF (599KB) ( 8 )   With the development of Chinese society, the proportion of the population aged 65 and above is increasing, and China is gradually entering an aging society. How to achieve healthy aging and how to delay aging have become important social issues. Due to the heterogeneity of aging, different individuals have different rates of aging. Aging is jointly regulated by internal and external factors. The internal factors include the twelve classic characteristics of aging, and there are multiple aging "clocks" that can indicate the level of cellular senescence. Therefore, the internal factors are clearly studied at present. The external factors include contributing factors and harmful factors. At present, the research on external factors is less and more concentrated in specific risk areas, and the research on the real situation is relatively limited. External factors interact with internal factors to influence aging. The use of multivariate cross analysis calculation to establish a comprehensive model of the interaction between internal and external factors of aging in a universal environment can provide theoretical support and technical means for the prevention and early warning of aging and related diseases. Figures and Tables | References | Related Articles | Metrics

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Advances in the application of 3D printing technology, extended reality, and artificial intelligence in the transcatheter percutaneous intervention for structural heart disease LIAN Chunyan, XUANYUAN Dong, LI Xiaoqun 2026, 21 (01):  80-84.  DOI: 10.16138/j.1673-6087.2026.01.12 Abstract ( 0 )   HTML ( 1 )   PDF (2168KB) ( 9 )   With the advancement of minimally invasive interventional technology, transcatheter intervention for the treatment of structural heart disease (SHD) has developed rapidly. However, due to the complexity of the heart's anatomical structure, the transcatheter intervention treatment for SHD imposes higher demands on preoperative planning, intraoperative navigation, and postoperative assessment. Traditional two-dimensional imaging techniques have limitations when dealing with complex SHD. The application of technologies such as 3D printing, extended reality (XR), and artificial intelligence (AI) provides more accurate technical support for transcatheter interventional treatment of SHD. This article reviews the latest advances in the application progress of these three technologies in SHD transcatheter intervention, including key aspects such as preoperative planning, surgical simulation, intraoperative navigation, and postoperative assessment, with the aim of providing a reference for cardiovascular interventional physicians to optimize diagnosis and treatment strategies for SHD by applying emerging technologies. Figures and Tables | References | Related Articles | Metrics

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Research progress on the regulatory mechanisms of gut and extraintestinal microbiota in gout and uric acid metabolism LIU Zhicheng, CHEN Yinzi, YANG Yifan, XU Jian, LIU Shuang 2026, 21 (01):  85-90.  DOI: 10.16138/j.1673-6087.2026.01.13 Abstract ( 0 )   HTML ( 1 )   PDF (495KB) ( 13 )   Gout is an autoinflammatory metabolic disorder characterized by dysregulation of uric acid metabolism. Recent advances in metagenomics have propelled in-depth research on gout-associated microbiota, with particular attention to the gut, oral, urinary microbiota and their regulatory roles in uric acid metabolism. Dysbiosis of the gout-related gut microbiota is typified by a reduction in probiotics and an increase in opportunistic pathogens, which can regulate uric acid production and excretion by affecting urate-metabolizing enzymes, urate transporters, intestinal barrier function, and inflammatory signaling pathways. Meanwhile, preliminary studies on oral and urinary microbiota suggest that they may not only serve as biomarkers but also participate in the inflammatory response of gout through mechanisms such as “oral-gut translocation” and alterations in urinary microbiota. Microecological interventions—including prebiotics, probiotics, microbiota transplantation, and bioactive compounds derived from traditional Chinese medicine—hold potential clinical translational value in gout management by improving microbial homeostasis, promoting extra-renal urate excretion, and alleviating inflammation. Future research should further elucidate the causal relationship between microbiota and gout, and develop precise microecological intervention strategies to provide theoretical basis and practical guidance for personalized treatment and disease management. References | Related Articles | Metrics

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Nutritional therapy for sarcopenia in rheumatoid arthritis patients YANG Dongming, LI Huilin 2026, 21 (01):  91-97.  DOI: 10.16138/j.1673-6087.2026.01.14 Abstract ( 0 )   HTML ( 1 )   PDF (506KB) ( 7 )   Rheumatoid arthritis complicated with sarcopenia is common in clinical practice, and incidence of sarcopenia is high among patients with rheumatoid arthritis. As rheumatoid arthritis progresses, the development of sarcopenia also accelerates, and the two conditions can influence and exacerbate each other, increasing the risk of dysfunction, disability, falls, frailty, mortality, and severely reducing quality of life in patients. Malnutrition plays a crucial role in the development of sarcopenia. Patients with rheumatoid arthritis often experience varied degrees of malnutrition, anemia, and immune compromise, especially in the elderly. This article reviews the management of rheumatoid arthritis complicated by sarcopenia from the perspective of dietary intervention strategies. The aim is to enhance clinicians' understanding of the diseases and provide a reference for nutritional prevention and treatment. References | Related Articles | Metrics

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Analysis and implications of the standardized nephrology fellowship training model in the United States CHEN Meihan, QIN Ling 2026, 21 (01):  98-102.  DOI: 10.16138/j.1673-6087.2026.01.15 Abstract ( 0 )   HTML ( 2 )   PDF (533KB) ( 6 )   The standardized nephrology fellowship is a crucial phase following standardized residency training. As a tertiary clinical discipline, nephrology encompasses the prevention, diagnosis, and treatment of glomerular and tubular diseases, post-transplant care, hereditary kidney diseases, and acute and chronic renal failure. It is a highly specialized field closely linked with many clinical disciplines and basic medical research. The core objective of the fellowship is to enhance nephrologists’ clinical expertise and academic competence, thereby delivering higher-quality medical services to patients. This article analyzes the training model of nephrology fellowship in the United States and discusses it in the context of the current status and challenges of nephrology fellowships in Shanghai, with an aim to provide references and insights for optimizing the local nephrology fellowship system. Figures and Tables | References | Related Articles | Metrics