2026年 · 第106卷第27期

The first month of the Year of the Horse in 2026 had just passed, and this morning, as usual, I led my team to make rounds in the respiratory ward. A female patient was lying in a hospital bed with a cyanotic complexion. She was wearing a mask and inhaling oxygen, and her blood oxygen saturation was only about 85%. I remember the chief resident physician reported to me that the emergency department had admitted a patient with a pulmonary vascular malformation with severe respiratory failure, and asked if he could be admitted through the "green channel" as soon as possible. I was busy at the time and casually replied, "Take it, this kind of patient needs surgery as soon as possible!" It must be the patient in front of me. To promote the widespread dissemination of the spirit of medical humanities, this journal will launch the "Medical Humanities" column starting in 2026. The author of this article narrates from the perspective of a doctor, recalling the different state of mind between practicing medicine in his youth and now as a senior medical expert, and recounting in detail his experience of treating the same patient twice, twelve years apart. The words truly demonstrate the doctors' dedication to upholding their original aspirations and fulfilling their duties, as well as their benevolence in always caring for patients and devoting themselves wholeheartedly. At the same time, they vividly reveal the patients' long-standing complete trust and gratitude to the medical staff. The article is simple and sincere in its emotions, vividly outlining the sincere feelings of mutual understanding, mutual support, and warm dependence between doctors and patients.

The patient, a 58-year-old female, was admitted to the Department of Cardiology at West China Hospital of Sichuan University on July 22, 2021, due to "difficulty breathing for 6 months after activity". He had previously visited the respiratory medicine department, and a chest CT scan showed increased texture in both lungs. The forced expiratory volume decreased by 10% in the first second. Budesonide formoterol inhalation powder was given once per inhalation, and there was no significant improvement after twice a day. Post-perfect echocardiography showed a left ventricular ejection fraction of 20%. Post-admission laboratory tests showed an increase in N-terminal pro-B-type natriuretic peptide (NT-proBNP) levels to 2,031 ng/L (reference value: 0 to 227 ng/L). The dynamic electrocardiogram showed a sinus rhythm with a heart rate of 74 beats/min, accompanied by atrial premature beats and multiple ventricular premature beats. Echocardiography showed a dilated left ventricle (63 mm end-diastolic inner diameter of the left ventricle, reference value: 37.8-52.2 mm), a decrease in left ventricular ejection fraction to 25% (reference value: 54%-74%), accompanied by "jungle-like" trabeculae, and a 5:1 ratio of non-densified to densified myocardium (Figures A, B). Cardiovascular MRI suggested an enlarged heart and a "jungle-like" myocardium (Figures C, D). No typical delayed gadolinium enhancement was found. The patient received medication (torasemide 10 mg once daily; tolvaptan 7.5 mg once every other day; sacubitril valsartan sodium tablets 100 mg twice daily). As of the last follow-up visit (October 10, 2025), the patient had not experienced acute heart failure for more than 4 years after spontaneous disease. The left ventricular ejection fraction fluctuated between 23% and 26% at follow-up, and the NT-proBNP ranged from 1,340 to 2,497 ng/L. Whole exon sequencing detectedBAG5A possibly pathogenic variant (stop codon mutation) in a gene that is associated with dilated cardiomyopathy. Based on the above results, the preliminary diagnosis was dilated cardiomyopathy combined with excessive trabeculosis of the left ventricle, and heart transplantation was recommended. This patient was accompanied byBAG5Cases of "jungle-like" excessive trabecularization occur in patients with genetically mutated dilated cardiomyopathy, and left ventricular remodeling with significant trabecularization helps achieve higher stroke output and limits the increase in wall stress. Nearly half of the ventricular cavity is occupied by abnormally abundant trabeculae, which may contribute to the relative stabilization of NT-proBNP during its follow-up.

In the article "Expert Consensus on Clinical Application of Intravenous Insulin Infusion (2026 Edition)" in the 21st issue of this journal in 2026, page 2103, "Secretary: Tang Xiaohan" has been changed to "Secretary: Tang Xiaohan", which is hereby corrected.