Geriatric Endocrinology and Metabolism Branch of Chinese Geriatric Society, Geriatric Endocrinology and Metabolism Branch of Chinese Geriatric Health Care Society, Geriatric Professional Committee of Beijing Medical Award Foundation
… +3 more, Expert Committee on Diabetes Prevention, Treatment and Management of Health China Research Center, National Clinical Medical Research Center for Geriatric Diseases (PLA General Hospital)
Zhonghua Nei Ke Za Zhi
· 2026 Mar · PMID 41834616
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The expansion of the elderly population in China has been accompanied by an increase in the prevalence of diabetes among older adults. According to the National Bureau of Statistics, the total number of individuals aged...The expansion of the elderly population in China has been accompanied by an increase in the prevalence of diabetes among older adults. According to the National Bureau of Statistics, the total number of individuals aged 60 and over in China reached 310 million in 2024. Of these, approximately 78.9 million have been diagnosed with diabetes - with over 95% being classified as type 2 - while approximately 141 million have prediabetes. Approximately 90% of these patients present with multiple concurrent metabolic abnormalities, such as overweight/obesity, hypertension, dyslipidemia, and hyperuricemia, which increase the risk of cardiovascular and cerebrovascular disease and organ damage. Additionally, complications due to poor glycemic control are the main risk factors for healthy longevity. Diabetes prevention and treatment remain a priority within the Healthy China (2016-2030) initiative. In line with the main theme of the "Clinical Guidelines for the Prevention and Treatment of Type 2 Diabetes in the Elderly in China (2022 Edition)", we will continue to promote regular comprehensive patient assessments and the formulation/adjustment of personalized management goals to facilitate early diagnosis and intervention among the older population. These frameworks seek to refine diabetes education and self-management models, ensuring that patients can maintain quality of life, perform self-monitoring, adhere to pharmacological regimens, and seek medical treatment. Furthermore, prevention and treatment strategies advocate for the comprehensive management of comorbid metabolic abnormalities and the active and moderate treatment of complications, focusing on the patient's clinical baseline and balancing therapeutic targets to protect cardiac, cerebral, and renal functions, thereby optimizing outcomes. The updated 2026 Edition of the "Clinical Guidelines for the Prevention and Treatment of Type 2 Diabetes in the Elderly in China" incorporates supplemental guidelines and international and domestic research on geriatric diabetes generated over the past four years. This integration informs adjustments to hypoglycemic drug selection and promotes the implementation of standardized prevention, diagnosis, and clinical decision-making, aiming to continuously improve overall diabetes management in older adults.
Zhou Y, Chai Y, Cao HS
… +7 more, Tang WW, Wu C, Tan ZM, Zhu DM, Xu Y, Song JH, Zhuo H
Zhonghua Nei Ke Za Zhi
· 2026 Feb · PMID 41633647
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To evaluate the clinical value of magnetic navigation ultrasound (MNU) combined with digital subtraction angiography (DSA) for dual-guided portal vein stent placement (PTPS) in the treatment of portal vein tumor thrombus...To evaluate the clinical value of magnetic navigation ultrasound (MNU) combined with digital subtraction angiography (DSA) for dual-guided portal vein stent placement (PTPS) in the treatment of portal vein tumor thrombus. This retrospective study analyzed clinical data from 30 patients with portal vein tumor thrombus who underwent PTPS at the Hepatobiliary Center of the First Affiliated Hospital of Nanjing Medical University (Jiangsu Province Hospital) between December 2019 and December 2022. The observation group (15 patients) received dual-guided puncture using novel MNU combined with DSA, while the control group (15 patients) underwent conventional DSA-guided puncture. Parameters compared included operation time, number of puncture attempts, radiation dose (displayed by DSA), patient tolerance, procedural success rate, and postoperative complications. Statistical analysis was performed using SPSS 26.0. Measurement data were expressed as mean±standard deviation (x¯±s) or median, and intergroup comparisons were conducted using -tests or Mann-Whitney tests. The observation group showed significantly shorter operation time [(22.3±9.7) min vs. (41.6±12.9) min, -4.63, 0.001], fewer puncture attempts [(1.9±0.7) vs. (8.3±4.1), -5.99, 0.001], and lower radiation dose [228 (180, 285) vs. 815 (650, 1 050) mGy, -4.67, 0.001]. Two cases in the control group required procedure termination due to pain or prolonged operation time from multiple punctures, whereas all observation group patients successfully completed the procedure. The success rate was higher in the observation group (15/15) than in the control group (13/15). The incidence of puncture site bleeding (1/15), stent thrombosis (2/15), and postoperative infection (2/15) in the observation group were lower than those in the control group (5/15,4/15,and 3/15, respectively). Preliminary data suggest that dual-guided PTPS with MNU and DSA demonstrates improved puncture safety and success rates, indicating potential clinical value.
Gao WX, Zhao HH, Zhao JJ
… +6 more, Liu HH, Zhu WJ, Li YZ, Kong LL, Li ZY, Chen W
Zhonghua Nei Ke Za Zhi
· 2026 Feb · PMID 41633646
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To investigate the prognostic utility of the endothelial activation and stress index (EASIX) combined with the serum albumin concentration in patients with hematologic neoplasms complicated by bloodstream infection (BSI)...To investigate the prognostic utility of the endothelial activation and stress index (EASIX) combined with the serum albumin concentration in patients with hematologic neoplasms complicated by bloodstream infection (BSI). This single-center retrospective cohort study analyzed the clinical data of patients with hematologic neoplasms and comorbid BSI admitted to the Department of Hematology of the Affiliated Hospital of Xuzhou Medical University between January 2020 and June 2023. Patients were categorized into survivor and non-survivor groups based on 30-day mortality post-BSI diagnosis. Univariate analysis was used to compare clinical indicators between groups, while multivariate logistic regression was employed to identify independent prognostic factors. The predictive efficacy of the EASIX and serum albumin was evaluated using receiver operating characteristic (ROC) curve analysis. A total of 221 BSI patients were included [113 males (51.1%), 108 females (48.9%)], with a median age of 54 (40, 64) years. The survivor group comprised 158 patients (71.5%) and the non-survivor group 63 patients (28.5%). Univariate analysis revealed that the non-survivor group had significantly higher EASIX scores [3.92 (2.87, 6.05)] and lactate dehydrogenase levels [341 (222, 918) U/L] than the survivor group [2.37 (1.12, 3.93) and 216 (146, 330) U/L, respectively] (both <0.001). Non-survivors presented with lower hemoglobin levels [63 (57, 72) g/L vs. 70 (58, 96) g/L; <0.05] and significantly lower platelet counts [16 (10, 30)×10/L vs. 27 (12, 75)×10/L] and serum albumin concentrations [30.9 (27.8, 34.2) g/L vs. 36.6 (32.9, 39.9) g/L] (both <0.01). Multivariate logistic regression confirmed that both the EASIX score (=1.401, 95% 1.161 to 1.691, <0.001) and the serum albumin concentration (0.851, 95% 0.782 to 0.926, <0.001) are independent prognostic factors. ROC curve analysis yielded an area under the curve (AUC) of 0.717 (95% 0.642 to 0.792) for the EASIX in predicting mortality, and an AUC of 0.764 (95% 0.701 to 0.827) for serum albumin. Their combined use increased the AUC to 0.803 (95% 0.744 to 0.863), with a sensitivity of 93.4%. Elevated EASIX scores and hypoalbuminemia serve as independent predictors of a poor prognosis in patients with hematologic neoplasms complicated by BSI. The combined detection of both indicators significantly improves predictive efficacy and may facilitate early clinical risk stratification.
Peng SL, Wang YH, Cui W
… +10 more, He Q, Hao SF, Wang KJ, Bian J, Hu J, Xia J, Yuan XF, Cai J, Ma WJ, Li QF
Zhonghua Nei Ke Za Zhi
· 2026 Feb · PMID 41633645
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To evaluate the diagnostic utility of confirmatory tests [captopril challenge test (CTT) and seated saline infusion test (SIT)] for primary aldosteronism (PA) using liquid chromatography-tandem mass spectrometry (LC-MS/M...To evaluate the diagnostic utility of confirmatory tests [captopril challenge test (CTT) and seated saline infusion test (SIT)] for primary aldosteronism (PA) using liquid chromatography-tandem mass spectrometry (LC-MS/MS) and establish optimized diagnostic cutoffs. This prospective multicenter diagnostic trial enrolled patients at high risk for PA from seven tertiary clinical centers in China between April 2023 and December 2024. All participants underwent aldosterone-to-renin ratio (ARR) screening, the CCT, and the seated SIT. Plasma aldosterone concentrations (PACs) and plasma renin levels were measured LC-MS/MS and chemiluminescence immunoassay (CLIA). PA diagnosis was defined as a CLIA-based post-SIT PAC ≥8.5 ng/dl (235.8 pmol/L) combined with an upright plasma renin concentration of <15 mU/L. Receiver operating characteristic (ROC) curves based on LC-MS/MS data from the CCT and the SIT were plotted to evaluate diagnostic performance. The DeLong test was employed for area under the ROC curve (AUC) comparisons among subgroups. Optimal diagnostic cutoffs for PA were determined based on sensitivity and specificity. The study included 117 patients diagnosed with PA [age: (48±10) years; 58 (49.57%) males] and 354 patients diagnosed with essential hypertension [age: (45±12) years; 207 (58.47%) males]. Two hours post-CCT using mass spectrometry, the AUCs for the ARR and PAC were 0.858 and 0.837, respectively, both superior to PAC suppression percentage (AUC=0.718, both 0.001). Additionally, the diagnostic efficacy of ARR was significantly better than that of plasma renin activity (PRA; AUC=0.784, <0.001). At a diagnostic cutoff of PAC ≥5.7 ng/dl (158.1 pmol/L) or ARR ≥9.3 (ng/dl)/(ng·ml⁻¹·h⁻¹), sensitivity was 61% and specificity was 85%. For the seated SIT using mass spectrometry, the AUCs for the ARR and PAC were 0.828 and 0.852, respectively, significantly better than PRA (AUC=0.680, both 0.001). At a PAC cutoff of ≥5.0 ng/dl (138.7 pmol/L), sensitivity was 68% and specificity was 85%, while an ARR cutoff of ≥ 19.0 (ng/dl)/(ng·ml⁻¹·h⁻¹) yielded a sensitivity of 64% and a specificity of 85%. Both the CCT and the SIT, based on LC-MS/MS, demonstrated excellent diagnostic performance. The recommended optimal cutoff for the ARR 2 hours post-CCT was 9.3 (ng/dl)/(ng·ml⁻¹·h⁻¹), while that for the PAC was 5.7 ng/dl. For the seated SIT, the optimal ARR cutoff was 19.0 (ng/dl)/(ng·ml⁻¹·h⁻¹) and the optimal PAC cutoff was 5.0 ng/dl.
Chinese Medical Association Rare Disease Branch, Beijing Medical Association Rare Disease Branch
Zhonghua Nei Ke Za Zhi
· 2026 Feb · PMID 41633644
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Becker muscular dystrophy (BMD) is an X-linked recessive myopathy caused by pathogenic variants of the dystrophin-encoding DMD gene. The clinical presentation of BMD encompasses four clinical subtypes: limb-girdle muscle...Becker muscular dystrophy (BMD) is an X-linked recessive myopathy caused by pathogenic variants of the dystrophin-encoding DMD gene. The clinical presentation of BMD encompasses four clinical subtypes: limb-girdle muscle weakness, quadriceps myopathy, isolated cramp-pain syndrome, and asymptomatic hyper-creatine kinase-emia. Patients may also present with cardiopulmonary involvement, neuropsychological issues, joint contractures, and spinal deformities. Diagnosis primarily relies on genetic testing and/or muscle biopsies. The treatment and management of BMD requires comprehensive and multidisciplinary interventions involving specialists in neurology, cardiology, respiratory medicine, rehabilitation medicine, orthopedics, gastroenterology, anesthesiology, clinical nutrition, psychology, and medical genetics. This coordinated approach aims to preserve patients' motor function, bone/joint function, cardiopulmonary function, and digestive function, while maintaining a good nutritional status and psychological well-being. To standardize the diagnosis, treatment, and management of BMD in China, a joint committee comprising multidisciplinary experts from the Chinese Medical Association Rare Disease Branch and the Beijing Medical Association Rare Disease Branch was established. This committee formulated the Chinese expert consensus on the diagnosis and treatment of BMD, with the primary objectives of improving patient quality of life and reducing the disease burden.
Chinese Sleep Research Society, Chinese Society of Sleep Medicine, China Collaboration Narcolepsy Group
Zhonghua Nei Ke Za Zhi
· 2026 Feb · PMID 41633643
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Wake-promoting agents mainly excite the cerebral cortex and promote wakefulness. They are clinically used to treat excessive daytime sleepiness (EDS) caused by narcolepsy and other diseases, or to maintain alertness duri...Wake-promoting agents mainly excite the cerebral cortex and promote wakefulness. They are clinically used to treat excessive daytime sleepiness (EDS) caused by narcolepsy and other diseases, or to maintain alertness during special tasks. In recent years, a variety of wake-promoting agents have been approved for the treatment of EDS related to narcolepsy, obstructive sleep apnea and other diseases at home and abroad. However, a dedicated expert consensus on the clinical application of wake-promoting agents remains lacking. To facilitate the rational and standardized clinical application of wake-promoting agents in China, the Sleep Disorders Committee of the Chinese Sleep Research Society convened a multidisciplinary panel of domestic experts. This assembly developed this consensus based on the latest clinical evidence sourced from both domestic and international research, as well as relevant guidelines and their collective clinical expertise. The consensus comprehensively reviews the mechanisms of action, approved indications, clinical studies, dosages, and adverse reactions of various wake-promoting agents. It also provides recommendations on drug selection, titration, and the use of wake-promoting agents in special populations for excessive daytime sleepiness caused by various etiologies. It has strong clinical guidance and clinical application value.
Zhang B, Sha JY, Cheng Y
… +4 more, Hu H, Gu WJ, Lyu ZH, Mu YM
Zhonghua Nei Ke Za Zhi
· 2026 Jan · PMID 41506740
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A retrospective analysis was conducted on the clinical data of a patient with adrenal hemangioblastoma (HB), pathologically confirmed at the First Medical Center of Chinese PLA General Hospital. A review of the literatur...A retrospective analysis was conducted on the clinical data of a patient with adrenal hemangioblastoma (HB), pathologically confirmed at the First Medical Center of Chinese PLA General Hospital. A review of the literature relating to adrenal HB was also undertaken. The patient was a 36-year-old male in whom a right adrenal mass was incidentally detected during a physical examination. The mass measured approximately 4.7 cm×4.2 cm and had a CT attenuation value of approximately 55 HU. MRI showed an irregular mass with a slightly long T1, mixed long/short T2 signals, mildly high signal intensity on diffusion weighted imaging, and a slightly low signal on apparent diffusion coefficient. No signal drop was observed on opposed-phase imaging. Dynamic contrast-enhanced scanning revealed progressive, marked enhancement. Ga DOTATATE PET-CT demonstrated a slightly hypodense mass in the right adrenal gland (maximum standardized uptake value 17.3). Functional evaluation showed an elevated chromogranin A (CgA) level of 294.64 pmol/L (normal range: 64-204 pmol/L), with no other abnormalities detected. The preoperative diagnosis was pheochromocytoma, and the patient underwent surgery after adequate preoperative preparation with phenoxybenzamine hydrochloride. Immunohistochemical results-S-100 (focal weak+), melan-A (-), inhibin-α (partial+), FLI-1 (+), CK (-), Syn (partial+), CgA (-), Ki67 (2%+), CD34 (+), CD31 (+), and desmin (-)-confirmed the diagnosis of adrenal HB. Genetic testing detected no VHL gene mutation. No recurrence or metastasis was observed during more than two years of follow-up. A review of the literature revealed that this was the first reported case of adrenal HB in China. Globally, only six cases have been reported to date, four of which were clearly related to von Hippel-Lindau syndrome. Adrenal HB is exceptionally rare and lacks characteristic clinical manifestations. Significant enhancement of the solid component with flow-void vessels on MRI is considered a relatively distinctive imaging feature. Definitive diagnosis relies on pathology and immunohistochemistry. Surgical resection remains the primary treatment, and the prognosis is generally favorable.
Liu Y, Xu JB, Chen YM
… +4 more, Wang LL, Xu Y, Chen W, Shen J
Zhonghua Nei Ke Za Zhi
· 2026 Jan · PMID 41506739
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A case of primary biliary cholangitis (PBC) complicated with hypoglycemia admitted to the Department of Endocrinology, the Eighth Medical Center of the Chinese PLA General Hospital in March 2024. The patient was a 76-yea...A case of primary biliary cholangitis (PBC) complicated with hypoglycemia admitted to the Department of Endocrinology, the Eighth Medical Center of the Chinese PLA General Hospital in March 2024. The patient was a 76-year-old man with a history of episodic consciousness disturbance for 8 months. The clinical presentation was characterized by central nervous system suppression consistent with hypoglycemia, with symptoms alleviating after glucose supplementation. At a plasma glucose level of 1.86 mmol/L, the insulin concentration was 79.8 pmol/L, and the C-peptide concentration was 1.49 nmol/L, suggestive of endogenous hyperinsulinemic hypoglycemia. Autoantibody testing showed positivity for anti-mitochondrial antibody M2, anti-centromere B protein antibody, and anti-soluble acidic nuclear protein 100 antibody. The diagnosis of PBC was confirmed by liver histopathology. After comprehensive exclusion of insulinoma, insulin autoimmune syndrome (IAS), and other endocrine and metabolic diseases, the hypoglycemia was attributed to hepatogenic hypoglycemia secondary to PBC. The hypoglycemic symptoms resolved after treatment with ursodeoxycholic acid and dietary modifications. A simultaneous literature review identified three relevant reports describing three cases of PBC-related hypoglycemia. The etiology was IAS in two cases, which resolved with glucocorticoid therapy, and autoimmune hepatitis in one case, which was treated with liver transplantation. While rare, PBC-associated hypoglycemia warrants clinical attention. The possibility of PBC should be considered in the differential diagnosis of unexplained hypoglycemia to improve diagnostic accuracy and treatment outcomes.
Sun B, Li TJ, Chen ZH
… +4 more, Ling L, Cheng HM, Huang XS, Wang HF
Zhonghua Nei Ke Za Zhi
· 2026 Jan · PMID 41506738
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To analyze the clinical and genetic mutation characteristics of Chinese patients with autosomal recessive demyelinating CMT (AR-CMT1/CMT4). A total of 244 patients clinically diagnosed with CMT at the Department of Neur...To analyze the clinical and genetic mutation characteristics of Chinese patients with autosomal recessive demyelinating CMT (AR-CMT1/CMT4). A total of 244 patients clinically diagnosed with CMT at the Department of Neurology, PLA General Hospital between December 2012 and March 2023 were enrolled. Medical history collection, neurological examination, laboratory tests, nerve conduction studies (NCS), high-throughput nucleotide sequencing, and bioinformatics analysis were performed. Among the 244 patients clinically diagnosed with CMT, 11 were found to carry 15 mutations in the FIG4, PRX, GDAP1, SBF1, SBF2, and SH3TC2 genes, including two previously unreported mutations: FIG4 (c.1039+2T>C) and SBF2 (c.1600+3A>G). According to ACMG guidelines, these two novel mutations were classified as pathogenic. AR-CMT1/CMT4 is a rare subtype of CMT. This study identified previously unreported mutations in SBF2 and FIG4 through genetic analysis of clinically diagnosed CMT patients, expanding the genetic spectrum of CMT in the Chinese population.
Su ZJ, Zhang YX, Li JL
… +11 more, Li JY, Ma LQ, Zhen QN, He YF, Jing Y, Shen H, Song Y, Hu JB, Yang SM, Li QF, Chongqing Primary Aldosteronism Study (CONPASS) Group
Zhonghua Nei Ke Za Zhi
· 2026 Jan · PMID 41506737
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To investigate the intra-individual variability of the plasma aldosterone concentration (PAC) and the plasma renin concentration (PRC) and explore its impact on screening for primary aldosteronism (PA). This cross-secti...To investigate the intra-individual variability of the plasma aldosterone concentration (PAC) and the plasma renin concentration (PRC) and explore its impact on screening for primary aldosteronism (PA). This cross-sectional study enrolled patients with PA and patients with essential hypertension (EH) who were admitted to the First Affiliated Hospital of Chongqing Medical University from July 2018 to December 2024. Clinical and biochemical data, including PAC and PRC, were collected. The intra-individual coefficient of variation (CV) and percentage difference (PD) were calculated. The rates of PA diagnosis missed were further analyzed. In total, 431 patients with PA [mean age 48.2 years; 192 males (44.5%)] and 495 patients with EH [mean age 49.6 years; 198 males (40.0%)] were included. In the PA group, the intra-individual CVs for PAC, PRC, and the aldosterone-to-renin ratio (ARR) were 21.3%, 36.9%, and 39.5%, respectively, and the corresponding mean PDs were 23.1%, 38.5%, and 43.5%. In the EH group, the intra-individual CVs for PAC, PRC, and ARR were 23.5%, 33.5%, and 32.5%, respectively, and the mean PDs were 25.7%, 36.1%, and 36.3%, respectively. Due to intra-individual variability, 10.2% (44/431) of PA patients may be missed during screening, 70.5% (31/44) of whom exhibit a history of hypokalemia and/or adrenal nodules. Plasma aldosterone and renin levels display considerable intra-individual variability, which may compromise the accuracy of PA screening. Repeat testing is recommended for patients with an initial negative screening result who have a history of hypokalemia and/or adrenal nodules.
Tang R, Zhang Y, Shi M
… +3 more, Ji XL, Fan L, Li X
Zhonghua Nei Ke Za Zhi
· 2026 Jan · PMID 41506736
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To investigate the multidimensional glycemic profiles and their associations with chronic complications in patients with type 1 diabetes (T1D) of over 10 years' duration. This cross-sectional study used data from the pr...To investigate the multidimensional glycemic profiles and their associations with chronic complications in patients with type 1 diabetes (T1D) of over 10 years' duration. This cross-sectional study used data from the prospective Peer Support for Long-standing T1D (PS-LT1D) cohort. T1D patients with a disease duration of 10-30 years were enrolled from the Chinese Type 1 Diabetes Consortium between 2022 and 2024. In addition to hemoglobin A (HbA) and continuous glucose monitoring metrics, advanced glycation end products (AGEs) were non-invasively measured as a surrogate marker for cumulative metabolic memory. Logistic regression analysis was employed to identify potential correlations between multidimensional glycemic indicators and diabetic microvascular/macrovascular complications. K-Means clustering was then applied to explore characteristic differences in complication prevalence across distinct glycemic patterns. A total of 128 patients (median age 31.5 years; 41 men, 87 women) with a median disease duration of 14.3 years were included. Despite a median time-in-range (TIR) of 70.9%, the prevalence of microvascular complications remained high (42.2%, 54/128). Logistic regression analysis revealed that an elevated metabolic memory burden, represented by skin AGEs, was a significant risk factor for both microvascular and macrovascular complications (=1.04, 95% 1.01-1.07, 0.009; 1.06, 95% 1.03-1.10, 0.001, respectively), whereas TIR or HbA were not. Based on the clustering of multidimensional glycemic indicators, patients were categorized into three glycemic control phenotypes. The subgroup characterized by a high metabolic memory burden demonstrated the highest risks of retinopathy and macrovascular complications. A significant "metabolic memory" effect persists in patients with T1D even during the mid-to-long term course of the disease. AGEs are strongly associated with the risk of chronic complications. Complication risks vary markedly across glycemic control patterns. In assessing complication risk among patients with long-duration T1D, AGE accumulation, serving as a cumulative metabolic memory indicator, holds greater predictive value than short-to-medium term glycemic markers such as HbA.