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1. Low-Dose Aspirin for PI3K-Altered Localized Colorectal Cancer.
作者: Anna Martling.;Ida Hed Myrberg.;Mef Nilbert.;Henrik Grönberg.;Fredrik Granath.;Martin Eklund.;Tom Öresland.;Lene H Iversen.;Carola Haapamäki.;Martin Janson.;Karin Westberg.;Josefin Segelman.;Urban Ersson.;Mattias Prytz.;Eva Angenete.;Rebecka Bergström.;Markus Mayrhofer.;Bengt Glimelius.;Johan Lindberg.; .
来源: N Engl J Med. 2025年393卷11期1051-1064页
Aspirin reduces the incidence of colorectal adenoma and colorectal cancer among high-risk persons. Observational studies suggest that aspirin may also improve disease-free survival after diagnosis, particularly among patients with tumors harboring somatic PIK3CA mutations. However, data from randomized trials are lacking.
2. Oral Semaglutide at a Dose of 25 mg in Adults with Overweight or Obesity.
作者: Sean Wharton.;Ildiko Lingvay.;Pawel Bogdanski.;Ruben Duque do Vale.;Stephan Jacob.;Tobias Karlsson.;Chaithra Shaji.;Domenica Rubino.;W Timothy Garvey.; .
来源: N Engl J Med. 2025年393卷11期1077-1087页
Oral semaglutide at a dose of 25 mg may provide an alternative treatment option to injectable semaglutide (2.4 mg) and higher-dose oral semaglutide (50 mg) for persons with overweight or obesity.
3. One Dose versus Three Doses of Benzathine Penicillin G in Early Syphilis.
作者: Edward W Hook.;Jodie A Dionne.;Kimberly Workowski.;Candice J McNeil.;Stephanie N Taylor.;Teresa A Batteiger.;Julia C Dombrowski.;Kenneth H Mayer.;Arlene C Seña.;Matthew M Hamill.;Harold C Wiesenfeld.;Chunming Zhu.;Charlotte Perlowski.;Jorge E Mejia-Galvis.;Lori M Newman.
来源: N Engl J Med. 2025年393卷9期869-878页
Controversy persists regarding the appropriate duration of therapy with benzathine penicillin G in persons with early (i.e., primary, secondary, or early latent) syphilis (Treponema pallidum infection).
4. Mavacamten in Symptomatic Nonobstructive Hypertrophic Cardiomyopathy.
作者: Milind Y Desai.;Anjali T Owens.;Theodore Abraham.;Iacopo Olivotto.;Pablo Garcia-Pavia.;Renato D Lopes.;Perry Elliott.;Fabio Fernandes.;Nicolas Verheyen.;Lars Maier.;Benjamin Meder.;Olga Azevedo.;Hiroaki Kitaoka.;Kathy Wolski.;Qiuqing Wang.;Wael Jaber.;Lisa Mitchell.;Jonathan Myers.;Thomas Rano.;Zhiqun Gong.;Yue Zhong.;Suzanne Carter-Bonanza.;Victoria Florea.;Ron Aronson.;Steven E Nissen.; .
来源: N Engl J Med. 2025年393卷10期961-972页
Mavacamten is approved to treat adults with symptomatic obstructive hypertrophic cardiomyopathy (HCM). However, its effects in nonobstructive HCM remain uncertain.
5. Aficamten or Metoprolol Monotherapy for Obstructive Hypertrophic Cardiomyopathy.
作者: Pablo Garcia-Pavia.;Martin S Maron.;Ahmad Masri.;Bela Merkely.;Michael E Nassif.;Maria Luisa Peña-Peña.;Roberto Barriales-Villa.;Ozlem Bilen.;Melissa Burroughs.;Brian Claggett.;Juan Pablo Costabel.;Edileide de Barros Correia.;Anne M Dybro.;Perry Elliott.;Sheila M Hegde.;Neal K Lakdawala.;Gregory D Lewis.;Amy Mann.;Zi Michael Miao.;Ajith Nair.;Steen H Poulsen.;Patricia Reant.;P Christian Schulze.;Scott D Solomon.;Andrew Wang.;Regina Sohn.;Indrias Berhane.;Stephen B Heitner.;Daniel L Jacoby.;Stuart Kupfer.;Fady I Malik.;Amy Wohltman.;Michael A Fifer.; .
来源: N Engl J Med. 2025年393卷10期949-960页
Beta-blockers have been the initial treatment for symptomatic obstructive hypertrophic cardiomyopathy (HCM) despite limited evidence of their efficacy. Aficamten is a cardiac myosin inhibitor that reduces left ventricular outflow tract gradients, improves exercise capacity, and decreases HCM symptoms when added to standard medications. Whether aficamten as monotherapy provides greater clinical benefit than beta-blockers as monotherapy remains unknown.
6. Multidomain Rehabilitation for Older Patients with Myocardial Infarction.
作者: Elisabetta Tonet.;Andrea Raisi.;Silvia Zagnoni.;Giorgio Chiaranda.;Giovanni Pasanisi.;Daniela Aschieri.;Paola Emanuela D'Intino.;Rita Pavasini.;Paolo Cimaglia.;Roberta Campana.;Francesco Vitali.;Tommaso Piva.;Gianni Casella.;Serena Caglioni.;Valentina Zerbini.;Giulia Bugani.;Marta Cocco.;Erica Menegatti.;Martina De Raffele.;Simona Mandini.;Donato Martella.;Nicola Pesenti.;Gianni Mazzoni.;Simone Biscaglia.;Stefano Volpato.;Giovanni Grazzi.;Gianluca Campo.; .
来源: N Engl J Med. 2025年393卷10期973-982页
The benefit of rehabilitation interventions in patients who are 65 years of age or older with myocardial infarction and impaired physical performance remains unclear.
7. Phase 3 Trial of Inhaled Molgramostim in Autoimmune Pulmonary Alveolar Proteinosis.
作者: Bruce C Trapnell.;Yoshikazu Inoue.;Francesco Bonella.;Tisha Wang.;Cormac McCarthy.;Toru Arai.;Keiichi Akasaka.;Francesca Mariani.;Nesrin Mogulkoc.;Jin Woo Song.;Tomohisa Baba.;Stephane Jouneau.;Tadahisa Numakura.;Nesrin Öcal.;Florin Mihaltan.;Ali Ataya.;Elisabeth Bendstrup.;Ilaria Campo.;Brenna Carey.;Ross Arena.;Brian Robinson.;Rosanna Fleming.;Yasmine Wasfi.;Raymond Pratt.; .
来源: N Engl J Med. 2025年393卷8期764-773页
Autoimmune pulmonary alveolar proteinosis (aPAP) is a rare disease characterized by progressive surfactant accumulation and hypoxemia caused by autoantibodies against granulocyte-macrophage colony-stimulating factor (GM-CSF), which alveolar macrophages require to clear surfactant. Molgramostim is a formulation of inhaled recombinant human GM-CSF, but its efficacy and safety in patients with aPAP have not been studied sufficiently.
8. Ciprofloxacin versus Aminoglycoside-Ciprofloxacin for Bubonic Plague.
作者: Rindra Vatosoa Randremanana.;Mihaja Raberahona.;Josephine Bourner.;Minoarisoa Rajerison.;Tansy Edwards.;Ravaka Randriamparany.;Tsinjo Fehizoro Razafindratsinana.;Lisy Hanitra Razananaivo.;Gabriella Zadonirina.;Théodora Mayouya-Gamana.;Alex Paddy Abdel Salam.;Reziky Tiandraza Mangahasimbola.;Voahangy Andrianaivoarimanana.;Elise Pesonel.;Rivonirina Andry Rakotoarivelo.;Mamy Jean de Dieu Randria.;Peter Horby.;Piero Olliaro.; .
来源: N Engl J Med. 2025年393卷6期544-555页
Plague is a high-consequence infectious disease with epidemic potential. Current treatment guidelines are based on weak evidence.
9. Ivermectin to Control Malaria - A Cluster-Randomized Trial.
作者: Carlos Chaccour.;Marta Maia.;Mercy Kariuki.;Paula Ruiz-Castillo.;Caroline Wanjiku.;Lydia Kasiwa.;Aurelia Brazeal.;Aina Casellas.;Mwanajuma Ngama.;Truphena Onyango.;Eldo Elobolobo.;Karisa Kazungu.;Mary Mael.;Winnie Wangari.;Khadija Nuru.;Rachel Otuko.;Almudena Sanz.;Isaac Ringera.;Allan Matano.;Starford Mitora.;Marta Ribes.;Joe Brew.;Nika Gorski.;Patricia Nicolas.;Sara Stanulovic.;Isaiah Omondi.;Joanna Furnival-Adams.;Laura Túnez.;Jamal Mbarak.;Vegovito Vegove.;Esther Yaa.;Shadrack Mramba.;Yegon Kibet.;Naomi Nyambura.;Charles Rotich.;Scholastica Wanjiru.;Musa Vura.;Faith Wanjiku.;Leslie Sam.;Lisa Collins.;Kang Xia.;Felix Hammann.;Francisco Saúte.;Matthew Rudd.;Cassidy Rist.;Caroline Jones.;Joseph Mwangangi.;N Regina Rabinovich.
来源: N Engl J Med. 2025年393卷4期362-375页
Malaria control and elimination is threatened by the spread of insecticide resistance and behavioral adaptation of vectors. Whether mass administration of ivermectin, a broad-spectrum antiparasitic drug that also kills mosquitoes feeding on treated persons, can reduce malaria transmission is unclear.
10. Multidose Ondansetron after Emergency Visits in Children with Gastroenteritis.
作者: Stephen B Freedman.;Sarah Williamson-Urquhart.;Amy C Plint.;Andrew Dixon.;Darcy Beer.;Gary Joubert.;Petros Pechlivanoglou.;Yaron Finkelstein.;Anna Heath.;Jasper Zhongyuan Zhang.;Angela Wallace.;Martin Offringa.;Terry P Klassen.; .
来源: N Engl J Med. 2025年393卷3期255-266页
Ondansetron improves outcomes when administered in emergency departments to children with acute gastroenteritis-associated vomiting. It is commonly prescribed at discharge to reduce symptoms, but evidence to support this practice is limited.
11. Once-Monthly Maridebart Cafraglutide for the Treatment of Obesity - A Phase 2 Trial.
作者: Ania M Jastreboff.;Donna H Ryan.;Harold E Bays.;Peter R Ebeling.;Mia G Mackowski.;Nisha Philipose.;Leorah Ross.;Yimeng Liu.;Cassandra E Burns.;Siddique A Abbasi.;Nicola Pannacciulli.; .
来源: N Engl J Med. 2025年393卷9期843-857页
Maridebart cafraglutide (known as MariTide) is a long-acting peptide-antibody conjugate that combines glucagon-like peptide-1 receptor agonism and glucose-dependent insulinotropic polypeptide receptor antagonism and that is intended for the treatment of obesity.
12. Weekly Fixed-Dose Insulin Efsitora in Type 2 Diabetes without Previous Insulin Therapy.
作者: Julio Rosenstock.;Timothy Bailey.;Lisa Connery.;Eden Miller.;Cyrus Desouza.;Qianqian Wang.;Jennifer Leohr.;Alastair Knights.;Molly C Carr.;Christopher J Child.; .
来源: N Engl J Med. 2025年393卷4期325-335页
In previous treat-to-target trials, adjustments to the dose of basal insulin have been made at least weekly, according to fasting blood glucose levels. A fixed-dose regimen of insulin efsitora alfa (efsitora), a once-weekly basal insulin, may provide a benefit in adults with type 2 diabetes who have not received previous insulin therapy.
13. Orforglipron, an Oral Small-Molecule GLP-1 Receptor Agonist, in Early Type 2 Diabetes.
作者: Julio Rosenstock.;Stanley Hsia.;Luis Nevarez Ruiz.;Sarah Eyde.;David Cox.;Wen-Shuo Wu.;Rong Liu.;Jianghao Li.;Laura Fernández Landó.;Max Denning.;Lisa Ludwig.;Yanyun Chen.; .
来源: N Engl J Med. 2025年393卷11期1065-1076页
Orforglipron is a small-molecule, nonpeptide glucagon-like peptide-1 (GLP-1) receptor agonist in clinical development for type 2 diabetes and weight management. Additional data on the efficacy and safety of orforglipron are needed.
14. Coadministered Cagrilintide and Semaglutide in Adults with Overweight or Obesity.
作者: W Timothy Garvey.;Matthias Blüher.;Cynthia Karenina Osorto Contreras.;Melanie J Davies.;Eva Winning Lehmann.;Kirsi H Pietiläinen.;Domenica Rubino.;Paolo Sbraccia.;Thomas Wadden.;Niels Zeuthen.;John P H Wilding.; .
来源: N Engl J Med. 2025年393卷7期635-647页
Semaglutide at a dose of 2.4 mg has established weight-loss and cardiovascular benefits, and cagrilintide at a dose of 2.4 mg has shown promising results in early-phase trials; the efficacy of the combination (known as CagriSema) on weight loss in persons with either overweight and coexisting conditions or obesity is unknown.
15. Cagrilintide-Semaglutide in Adults with Overweight or Obesity and Type 2 Diabetes.
作者: Melanie J Davies.;Harpreet S Bajaj.;Christa Broholm.;Astrid Eliasen.;W Timothy Garvey.;Carel W le Roux.;Ildiko Lingvay.;Christian Bøge Lyndgaard.;Julio Rosenstock.;Sue D Pedersen.; .
来源: N Engl J Med. 2025年393卷7期648-659页
Cagrilintide and semaglutide have each been shown to induce weight loss as monotherapies. Data are needed on the coadministration of cagrilintide and semaglutide (called CagriSema) for weight management in adults with type 2 diabetes, including those in a subgroup who are undergoing continuous glucose monitoring.
16. Neoadjuvant and Adjuvant Pembrolizumab in Locally Advanced Head and Neck Cancer.
作者: Ravindra Uppaluri.;Robert I Haddad.;Yungan Tao.;Christophe Le Tourneau.;Nancy Y Lee.;William Westra.;Rebecca Chernock.;Makoto Tahara.;Kevin J Harrington.;Arkadiy L Klochikhin.;Irene Braña.;Gustavo Vasconcelos Alves.;Brett G M Hughes.;Marc Oliva.;Iane Pinto Figueiredo Lima.;Tsutomu Ueda.;Tomasz Rutkowski.;Ursula Schroeder.;Paul-Stefan Mauz.;Thorsten Fuereder.;Simon Laban.;Nobuhiko Oridate.;Aron Popovtzer.;Nicolas Mach.;Yevhen Korobko.;Diogo Alpuim Costa.;Anupama Hooda-Nehra.;Cristina P Rodriguez.;R Bryan Bell.;Cole Manschot.;Kimberly Benjamin.;Burak Gumuscu.;Douglas Adkins.; .
来源: N Engl J Med. 2025年393卷1期37-50页
The benefit of the addition of perioperative pembrolizumab to standard care with surgery and adjuvant therapy for patients with locally advanced head and neck squamous-cell carcinoma (HNSCC) is unclear.
17. Graft-versus-Host Disease Prophylaxis with Cyclophosphamide and Cyclosporin.
作者: David J Curtis.;Sushrut S Patil.;John Reynolds.;Duncan Purtill.;Clinton Lewis.;David S Ritchie.;David J Gottlieb.;David T Yeung.;Eric Wong.;Siok-Keen Tey.;Travis Perera.;John Moore.;Rachel M Koldej.;Richard De Abreu Lourenco.;John Stubbs.;C Orla Morrissey.;Nadia Munsef.;Andrea Arenas.;Geoffrey R Hill.; .
来源: N Engl J Med. 2025年393卷3期243-254页
Allogeneic peripheral-blood stem-cell transplantation (SCT) from a matched related donor after myeloablative conditioning is the preferred curative treatment for patients with high-risk blood cancers. The combination of a calcineurin inhibitor and an antimetabolite remains standard care for graft-versus-host disease (GVHD) prophylaxis in these patients. Data from two randomized trials have suggested that post-transplantation cyclophosphamide can reduce the risk of GVHD after SCT from a matched donor when it is added to or replaces the antimetabolite. However, the effects of post-transplantation cyclophosphamide specifically after SCT from a matched related donor remain uncertain, and effects in the context of myeloablative conditioning are unclear.
18. Proportional-Assist Ventilation for Minimizing the Duration of Mechanical Ventilation.
作者: Karen J Bosma.;Karen E A Burns.;Claudio M Martin.;Yoanna Skrobik.;Jordi Mancebo Cortés.;Sorcha Mulligan.;Myriam Lafreniere-Roula.;Kevin E Thorpe.;Juan Carlos Suárez Montero.;Indalecio Morán Chorro.;Núria Rodríguez-Farré.;Ron Butler.;Tracey Bentall.;Gaëtan Beduneau.;Pauline Enguerrand.;Marlene Santos.;Thomas Piraino.;Savino Spadaro.;Federica Montanaro.;John Basmaji.;Eileen Campbell.;Alain Mercat.;François M Beloncle.;Guillaume Carteaux.;Tommaso Maraffi.;Emmanuel Charbonney.;Marie Lecronier.;Martin Dres.;Yaseen M Arabi.;Andre Carlos Kb Amaral.;Nicole Marinoff.;Neill K J Adhikari.;Anna Geagea.;Phil Shin.;Katerina Vaporidi.;Eumorfia Kondili.;Jason Shahin.;Josie Campisi.;Pablo O Rodriguez.;Mariano Setten.;Ewan C Goligher.;Niall D Ferguson.;Vito Fanelli.;Gabriela Ferreyra.;Francois Lellouche.;Stephanie Sibley.;Laurent Brochard.; .
来源: N Engl J Med. 2025年393卷11期1088-1103页
In critically ill patients, acceleration of liberation from mechanical ventilation is important in order to reduce the risk of complications and to improve long-term outcomes. Whether the use of proportional-assist ventilation with load-adjustable gain factors (PAV+) results in a shorter time to successful liberation from mechanical ventilation than pressure-support ventilation (PSV) is unclear.
19. A Crossover Trial of Hospital-Wide Lactated Ringer's Solution versus Normal Saline.
作者: Lauralyn McIntyre.;Dean Fergusson.;Tracy McArdle.;Shane English.;Deborah J Cook.;Alison E Fox-Robichaud.;Claudio Martin.;John Marshall.;Michael Pugliese.;Kusum Menon.;Kednapa Thavorn.;Ian D Graham.;Steven Hawken.;Akshai Iyengar.;Kwadwo Kyeremanteng.;Raphael Saginur.;Andrew J E Seely.;Ian G Stiell.;Daniel Bainbridge.;Charles Weijer.;Monica Taljaard.; .
来源: N Engl J Med. 2025年393卷7期660-670页
Whether lactated Ringer's solution is clinically superior to normal saline for routine intravenous administration of fluids is uncertain.
20. A Randomized Trial of Acute Normovolemic Hemodilution in Cardiac Surgery.
作者: Fabrizio Monaco.;Chong Lei.;Matteo Aldo Bonizzoni.;Sergey Efremov.;Federica Morselli.;Fabio Guarracino.;Giuseppe Giardina.;Cristina Arangino.;Domenico Pontillo.;Michelangelo Vitiello.;Alessandro Belletti.;Valentina Ajello.;Margherita Licheri.;Caetano Nigro Neto.;Gaia Barucco.;Nazar A Bukamal.;Carolina Faustini.;Lorenzo Filippo Mantovani.;Alessandro Oriani.;Cristina Santonocito.;Marta Mucchetti.;Francesco Federici.;Chiara Gerli.;Sabrina Porta.;Anna Mara Scandroglio.;Hui Zhang.;Marina Pieri.;Roman Osinsky.;Stefano Lazzari.;Elizaveta Leonova.;Maria Grazia Calabrò.;Daniele Amitrano.;Stefano Turi.;Paolo Prati.;Stefano Fresilli.;Filippo D'Amico.;Jacopo D'Andria Ursoleo.;Rosa Labanca.;Marilena Marmiere.;Alessandro Pruna.;Tommaso Scquizzato.;Kaan Kırali.;Giacomo Monti.;Maria José Carvalho Carmona.;Kenichi Tanaka.;Valery Likhvantsev.;Lian Kah Ti.;Tiziana Bove.;Gianluca Paternoster.;Karen Singh.;Mustafa Emre Gürcü.;Vladimir Lomivorotov.;Giovanni Landoni.;Rinaldo Bellomo.;Alberto Zangrillo.; .
来源: N Engl J Med. 2025年393卷5期450-460页
Patients undergoing cardiac surgery often receive red-cell transfusions, along with the associated risks and costs. Early intraoperative normovolemic hemodilution (i.e., acute normovolemic hemodilution [ANH]) is a blood-conservation technique that entails autologous blood collection before initiation of cardiopulmonary bypass and reinfusion of the collected blood after bypass weaning. More data are needed on whether ANH reduces the number of patients receiving allogeneic red-cell transfusion.
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