In May 2026, Lancet published an online global consensus statement on the unified renaming of polycystic ovary syndrome (PCOS). Developed with participation from 56 international organizations, tens of thousands of patient survey datasets, and multidisciplinary expert deliberations, the consensus officially replaced the nearly 90-year-old term PCOS with polyendocrine metabolic ovarian syndrome (PMOS). This nomenclature revision rectifies misleading terminology and accurately reflects the disease's core nature of concurrent endocrine, metabolic, and ovarian dysfunction. This paper reviews the background, methodological rationale, and core connotations of the global renaming consensus, illustrates the paradigm shifts in disease understanding, standardized screening, stratified therapy, and chronic disease management driven by the name change, and proposes targeted countermeasures and transitional management recommendations for endocrinology and metabolism specialties tailored to clinical practice in China. It aims to deliver actionable practical guidance for frontline clinicians.
Objective: To investigate the clinical efficacy of Bankart repair combined with Remplissage procedure in the treatment of anterior shoulder instability with glenoid bone defect≤20%. Methods: A retrospective analysis was conducted on patients with recurrent anterior shoulder dislocation combined with Hill-Sachs lesions admitted to Huashan Hospital, Fudan University from January 2020 to June 2024. All patients were confirmed with a glenoid bone defect≤20% by three-dimensional computed tomography (CT) reconstruction of the shoulder joint. The Constant-Murley score, American Shoulder and Elbow Surgeons (ASES) score, Rowe score, University of California Los Angeles (UCLA) score, and shoulder range of motion were evaluated before surgery and at the last follow-up. The postoperative function and return to sports were observed between patients with 13.5%≤glenoid bone defect≤20% and those with glenoid bone defect<13.5%. Results: A total of 40 patients were included, with an age of (26±6) years, including 35 males and 5 females. The follow-up time was (25.8±12.4) months. The postoperative UCLA score [(33.4±1.1) vs (22.1±3.4)], ASES score [(93.0±4.8) vs (73.3±9.6)], Constant-Murley score [(93.5±4.9) vs (79.3±7.0)], and Rowe score [(96.0±4.1) vs (39.2±9.4)] were all improved compared with those before surgery (all P<0.001). There were no statistically significant differences in postoperative angles of forward flexion, abduction, external rotation at the side, and the spinous process level of internal rotation at the side compared with those before surgery (all P>0.05). No complications such as infection or joint adhesion occurred in any of the patients postoperatively, and there was no recurrence of dislocation. At the last follow-up, all patients returned to sports, of which 31 cases (31/40, 77.5%) returned to the preoperative sports level. There was no statistically significant difference in postoperative function between patients with 13.5%≤glenoid bone defect≤20.0% and those with glenoid bone defect<13.5%, but the proportion of returning to the preoperative sports level (13/21 vs 18/19) showed a statistically significant difference (P<0.05). Conclusion: Arthroscopic Bankart repair combined with Remplissage procedure for patients with recurrent anterior shoulder dislocation combined with Hill-Sachs lesions and a glenoid bone defect≤20% can restore joint stability, improve shoulder function, and does not affect the joint range of motion.
Objective: To analyze the clinical characteristics of patients with high-frequency sudden sensorineural hearing loss and the factors affecting therapeutic efficacy. Methods: The clinical data of patients with high-frequency sudden sensorineural hearing loss who were treated in the Department of Otology, Chinese PLA General Hospital, from January 2009 to April 2025 were retrospectively reviewed. Demographic characteristics, precipitating factors, accompanying symptoms, comorbidities, and audiological features were collected and analyzed. Multivariate logistic regression analysis was further performed to identify factors affecting treatment efficacy. Results: A total of 90 patients aged (41.1±14.1) years were included, with 57 males and 33 females. Definite precipitating factors were identified in 38.9% (35/90) of patients, and excessive fatigue was the most common factor (14.4%, 13/90). Hypertension was the most frequent comorbidity (20.0%, 18/90). Tinnitus was the most common accompanying symptom (94.4%, 85/90), followed by aural fullness (66.7%, 60/90) and vertigo (20.0%, 18/90). Compared with patients with involvement at 4 and 8 kHz, those with involvement at 2, 4, and 8 kHz were older, had lower phonetically balanced maximum scores, and showed lower otoacoustic emission response rates, with statistically significant differences (all P<0.05). The overall treatment effectiveness rate was only 20.0% (18/90). Multivariate logistic regression analysis demonstrated that delayed presentation after onset (OR=1.07, 95%CI: 1.02-1.12, P=0.005), aural fullness (OR=3.68, 95%CI: 1.05-12.86, P=0.042), and female sex (OR=7.73, 95%CI: 1.70-35.14, P=0.008) were associated with poor prognosis. Conclusions: Patients with high-frequency sudden sensorineural hearing loss frequently present with high-pitched tinnitus and aural fullness. Compared with patients without 2 kHz involvement, those with 2 kHz impairment are older and have poorer speech recognition ability. Overall treatment outcomes are unsatisfactory, and delayed presentation after onset, ear fullness, and female sex are associated with poor prognosis.
Objective: To describe the epidemiological characteristics of functional dependency, cognitive impairment, and depressive symptoms (the "3Ds": Dependency, Dementia, and Depression) among older adults in China, and to evaluate the association of "3Ds" co-occurrence and index with the risk of all-cause mortality. Methods: Based on the 2018 and 2021 waves of the Chinese Longitudinal Healthy Longevity Survey (CLHLS), adults aged≥65 years were included. To characterize prevalence, the baseline sample was classified into five groups: no "3Ds"(intact physical function, cognition, and mental health), dependency only (functional dependency alone), cognitive impairment only, depressive symptoms only, and co-occurrence of all three. To evaluate the association with mortality, participants were grouped by cumulative "3Ds index" score as 0 (no deficit, reference), 1, 2, or 3 (presence of any one, any two, or all three deficits, respectively). Cox proportional hazards models assessed the effects of the "3Ds" and cardiometabolic multimorbidity (CMM) on all-cause mortality; a Random Survival Forest (RSF) model validated variable importance (VIMP); and causal mediation analysis examined the mediating role of self-rated health. Results: Among 13 682 participants at baseline in 2018 [mean age (84.74±11.39) years], the prevalence of functional dependency, cognitive impairment, and depressive symptoms was 22.96% (3 142/13 682), 16.04% (2 194/13 682), and 41.70% (5 705/13 682), respectively, and the co-occurrence rate of all three was 4.03% (552/13 682). In the mortality analysis of 11 909 participants [(median follow-up 28 (1-40) months, 2 872 deaths], multivariable Cox regression showed that, compared with participants scoring 0 on the "3Ds index", the risk of all-cause mortality rose significantly across scores of 1 to 3: HR=1.31 (95%CI: 1.19-1.44) for a score of 1, HR=1.86 (95%CI: 1.66-2.09) for 2, and HR=2.16 (95%CI: 1.83-2.55) for 3, indicating a significant linear dose-response relationship (P for trend<0.001); by contrast, CMM was not significantly associated with all-cause mortality (HR=1.02, 95%CI: 0.91-1.13). The RSF model identified the "3Ds index" as a leading predictor of all-cause mortality (VIMP=0.104), second only to age. Self-rated health significantly and partially mediated the "3Ds"-mortality association, accounting for 9.77%-12.37% of the total effect. Conclusions: Co-occurrence of the "3Ds" is prevalent among Chinese older adults, particularly the oldest-old, and shows significant demographic heterogeneity. The "3Ds index"-reflecting impairment in physical function, cognition, and mental health-shows a significant dose-response association with all-cause mortality that is partially mediated by self-rated health, and may serve as a simple composite indicator for early identification of mortality risk in the oldest-old.
Objective: To establish an in vitro fibrotic endometrial organoid model and investigate the early intervention effects of placenta-derived mesenchymal stem cell extracellular vesicles (Pd-MSC-EV) on fibrotic injury in endometrial organoids. Methods: Cell clusters were isolated from the endometrial tissues of healthy female mice and used to establish a three-dimensional endometrial organoid culture system. The structure and cellular composition of the organoids were characterized by histological staining and immunofluorescence staining. To construct an in vitro fibrosis model, the organoids were treated with different concentrations of transforming growth factor-β1 (TGF-β1), and model establishment was evaluated based on organoid morphological changes and the mRNA expression of fibrosis-related genes, including collagen type Ⅰ alpha 1 chain (COL1A1), α-smooth muscle actin (α-SMA), and fibronectin (FN). Pd-MSC-EVs were isolated and characterized by transmission electron microscopy, nanoparticle tracking analysis, and western blotting. The effects of Pd-MSC-EVs on TGF-β1-induced fibrotic changes in endometrial organoids were then assessed by morphological observation, real-time quantitative PCR (RT-qPCR) analysis of COL1A1, α-SMA, and FN mRNA expression, and immunofluorescence detection of COL1A1 and α-SMA protein expression. All experiments were repeated three times. Results: Mouse endometrial organoids with lumen-like structures were successfully established and expressed the epithelial markers E-cadherin and CK8 as well as the stromal marker Vimentin. Compared with the control group, TGF-β1 treatment disrupted organoid architecture and increased the mRNA expression levels of fibrosis-related genes, including COL1A1, α-SMA and FN, in a dose-dependent manner (all P<0.001). The isolated Pd-MSC-EV showed typical cup-shaped or disk-like vesicular morphology, with an average particle size of (163.8±50.0) nm, and expressed the exosomal markers CD63, CD81 and TSG101. Compared with the TGF-β1 group, co-treatment with Pd-MSC-EV alleviated organoid structural damage and reduced the mRNA expression levels of COL1A1, α-SMA and FN (all P<0.001). Immunofluorescence showed that COL1A1 protein expression was lower in the Pd-MSC-EV group than in the TGF-β1 group (P<0.005), while α-SMA protein expression showed a decreasing trend. Conclusion: Pd-MSC-EV attenuate TGF-β1-induced fibrotic changes in endometrial organoids in vitro and reduce organoid structural injury, providing experimental evidence for mechanistic studies and potential intervention strategies for endometrial fibrosis-related diseases such as intrauterine adhesions.
Standardized cancer pain management is an essential component of comprehensive cancer care. Pain is one of the most common and distressing symptoms in palliative care for patients with advanced cancer. Persistent pain severely impairs daily function and quality of life. The implementation of standardized cancer pain management, including standardized assessment, analgesic treatment, adverse effect management, follow-up, and end-of-life care, has significantly improved pain control and quality of life, with the goal of achieving optimal pain relief and preserving dignity throughout the disease course. However, several challenges remain, including inadequate attention, non-standardized assessment, uneven access to analgesics, and limited application of minimally invasive interventions. This review summarizes the current status, role, and key strategies of standardized cancer pain management, aiming to provide evidence for establishing standardized pain management systems and improving comprehensive cancer care.
Cancer pain not only affects the physiological functions of patients with malignancies but also significantly impairs their mental health and quality of life. Single-discipline treatment approaches are often insufficient to address the complex and diverse needs of pain management. The multi-disciplinary team (MDT) model integrates expertise from pain medicine, oncology, psychology, rehabilitation, and other relevant fields to provide comprehensive care through pain assessment, individualized treatment, and continuous follow-up. This review summarizes the current status of MDT-based cancer pain management and focuses on its clinical application and future development.
Currently, anesthesia-based sleep therapy is experiencing a role expansion from short-term intervention for perioperative sleep disturbances to long-term treatment of chronic refractory insomnia. Integrating evidence-based data and clinical practice, this article systematically reviews the clinical application of anesthetic agents and techniques in perioperative sleep management and the treatment of chronic refractory insomnia. Rational perioperative use of anesthetic agents such as dexmedetomidine, esketamine, and propofol, together with anesthetic techniques like stellate ganglion block, can ameliorate perioperative sleep disturbances. In the domain of chronic insomnia, anesthesia-induced sleep balance therapy, patient-controlled sleep, and multimodal sleep promotion encompassing innovative anesthesia-based sleep therapy provide novel therapeutic avenues for refractory insomnia. However, current anesthesia-based sleep therapy is confronted with challenges, including low-quality evidence, high dependence on in-hospital medical resources, and underdeveloped professional standards and regulatory frameworks. Future efforts should focus on improving the evidence system, promoting clinical standardization, and advancing systematic framework construction, thereby facilitating the high-quality development of the innovative anesthesia-based sleep therapy within the field of sleep medicine.
Congenital external and middle ear malformations (CEMEMs) represent a key etiology of conductive hearing loss, arising from dysplastic development of the first and second pharyngeal arches during embryogenesis. These malformations may occur in isolation or as a localized manifestation of a syndrome. This review synthesizes recent evidence-based medical findings to elaborate on advances in understanding the pathogenic mechanisms, clinical characteristics, and auditory intervention strategies for CEMEMs, thereby offering a reference framework for clinical diagnosis and management.
Cancer pain is one of the most common symptoms in patients with malignancies and significantly impairs quality of life. Inadequate pain control may reduce treatment adherence and adversely affect overall prognosis. Cancer pain clinics are specialized outpatient services dedicated to standardized assessment, diagnosis, treatment, and longitudinal management of cancer pain. To standardize the establishment and operational management of cancer pain clinics in China, the Chinese Association for the Study of Pain convened experts in relevant fields. Grounded in evidence-based principles and informed by national and international guidelines and policy documents, this consensus was developed using the RAND/UCLA Appropriateness Method and a modified Delphi process to generate recommendations. This consensus provides standardized recommendations on the functional positioning of cancer pain clinics, tiered construction models, personnel qualifications and training, medication and facility requirements, standardized clinical pathways, multidisciplinary collaboration, and quality management. It aims to provide scientific and practical guidance for healthcare institutions to establish standardized cancer pain outpatient clinics, promote the standardization, homogenization, and sustainable development of outpatient cancer pain management.
The data of eight patients with end-stage heart failure who experienced in-hospital sudden cardiac arrest and received cardiopulmonary resuscitation (CPR), followed by extracorporeal membrane oxygenation (ECMO) combined with delayed left ventricular assist device (LVAD) implantation in Fujian Medical University Union Hospital from January 2022 to June 2025 were retrospectively reviewed. Among them, there were seven males and one female, with a median age of 56 (50, 63) years. The etiologies included ischemic cardiomyopathy (five cases), dilated cardiomyopathy (two cases) and low cardiac output syndrome after severe valvular heart disease surgery (one case). All patients were stabilized by ECMO rescue before LVAD implantation, with an ECMO support time of 9.5 (6.5, 12.0) days. All surgeries were performed under general anesthesia with cardiopulmonary bypass. Postoperatively, six cases discharged smoothly, two cases died in hospital, and one case developed cerebral infarction which recovered after interventional thrombectomy. For discharged patients, follow-up was conducted at 1, 3, 6 and 12 months, the mechanical pump functioned normally, and cardiac function was significantly improved. The study suggests that ECMO can stabilize the condition of these high-risk patients, and bridging to LVAD can relieve the pressure on the donor heart and improve prognosis.
Cancer pain in pancreatic ductal adenocarcinoma (PDAC) is characterized by complex mechanisms, severe, and often difficult-to-control. Pain not only represents a major source of suffering for PDAC patients but can also promote tumor progression through intricate neuro-immune crosstalk networks. The traditional three-step analgesic ladder is often insufficient for managing PDAC pain. In recent years, the earlier application of minimally invasive interventional techniques, the adoption of multi-disciplinary team, and the integration of smart healthcare tools are driving PDAC pain management toward more precise approaches. Exploration of the tumor-neuro-immune interaction network offers novel insights for driving personalized analgesia. This article systematically reviews the latest advances in analgesic approaches for PDAC, with an emphasis on optimizing existing therapies, defining the role of minimally invasive interventions, and outlining future research directions for precision analgesia.
This study explored the influence of progesterone (P) levels on the day of ovulation on pregnancy outcomes in patients with normal ovarian response undergoing natural-cycle frozen-thawed embryo transfer. A total of 384 natural-cycle frozen-thawed embryo transfer cycles of patients with normal ovarian response treated at the Reproductive Medicine Center of Beijing Obstetrics and Gynecology Hospital, Capital Medical University, from August 2022 to December 2024 were retrospectively enrolled in the study. Subjects were divided into Group A (P≤1 μg/L), Group B (1 μg/L 3 μg/L) based on serum progesterone concentrations on the ovulation day. Baseline clinical data and pregnancy outcomes were compared across the three groups, and the effects of ovulation-day progesterone levels and other clinical indicators on pregnancy outcomes were statistically analyzed. Group A consisted of 94 patients with a mean age of (31.2±5.4) years; group B included 173 patients with a mean age of (30.4±5.9) years; group C comprised 117 patients with a mean age of (30.8±5.2) years. The results showed that Group B had a clinical pregnancy rate of 55.5%(96/173)and an embryo implantation rate of 46.1%(118/256), which were significantly higher than those of Group A [39.4%(37/94)and 31.5%(45/143)] and Group C [46.2%(54/117)and 37.1%(63/170)], with statistically significant intergroup differences (P<0.05). Multivariate logistic regression after adjustment for confounding variables verified that ovulation-day progesterone level was an independent risk factor for clinical pregnancy (OR=1.27, 95%CI: 1.10-1.45, P=0.001), while BMI acted as a protective factor for clinical pregnancy (OR=0.93, 95%CI: 0.87-1.00, P=0.037). In conclusion, progesterone level on the day of ovulation serves as a crucial indicator affecting clinical pregnancy outcomes of natural-cycle frozen-thawed embryo transfer, and routine monitoring of this parameter in clinical practice is conducive to optimizing transplantation protocols and improving the overall clinical pregnancy rate.
Herpes zoster (HZ) is a skin disease caused by the reactivation of latent varicella-zoster virus (VZV) in the body, clinically characterized by a unilateral vesicular rash distributed along the affected dermatomes. It commonly occurs in older adults and immunocompromised individuals. With the acceleration of global population aging, the incidence of HZ has significantly increased, showing a trend toward younger age groups and a high risk of complications, such as postherpetic neuralgia (PHN), which imposes a heavy health and economic burden on patients and society. In recent years, China has made remarkable progress in the development and application of HZ vaccines, particularly with the approval and use of the recombinant zoster vaccine (RZV) and the zoster vaccine live (ZVL), which are of great significance for the prevention of HZ and its complications. To further standardize HZ vaccination strategies, the Varicella and Herpes Zoster Prevention and Control Branch of the China Association for Vaccines organized national experts in virology, immunology, infectious diseases, geriatrics, and preventive medicine to formulate this consensus based on evidence-based medical evidence and clinical practice experience. This consensus systematically elaborates on the disease burden of HZ, vaccine efficacy and safety, vaccination strategies, recommendations for special populations, and other aspects, aiming to provide scientific and standardized guidance for clinicians and public health workers, and to promote widespread vaccination against HZ in adults and the prevention and control of the disease.
To explore the clinical characteristics and long-term prognosis of nervus intermedius sectioning via a retrosigmoid approach for the treatment of nervus intermedius neuralgia (NIN). A total of 10 NIN patients treated at the First Affiliated Hospital of Fujian Medical University between May 2016 and October 2024 were included retrospectively. All patients underwent nervus intermedius sectioning through the retrosigmoid approach, with combined microvascular decompression (MVD) performed for those with concomitant trigeminal neuralgia (TN) or glossopharyngeal neuralgia (GN) based on intraoperative findings. Surgical efficacy was evaluated using the Barrow Neurological Institute (BNI) Pain Intensity Score, with a follow-up period of 14-109 months. Among the 10 patients [3 males, 7 females; mean age: (58.7±11.5) years; median disease duration: 3.0 years], pain was predominantly electric shock-like (6 cases, 60.0%) and stabbing (3 cases, 30.0%). Beyond typical deep ear pain (6 cases, 60.0%), pain also involved the periauricular area (4 cases, 40.0%), cheek (2 cases, 20.0%), root of tongue (1 cases, 10.0%) and 2/3 of the tongue (1 case, 10.0%). Intraoperative exploration identified offending vessels in 7 cases (anterior inferior cerebellar artery in 5 cases and posterior inferior cerebellar artery in 2 cases). The immediate postoperative efficacy rate (BNI Ⅰ-Ⅱ) was 90.0% (9/10). Over a mean follow-up period of (61.5±31.8) months, the long-term efficacy rate at the last follow-up was 70.0% (7/10). Complications included facial paralysis, taste impairment, and wound infection in 1 case each, with no instances of hearing loss or intracranial infection. Nervus intermedius sectioning is an effective treatment for NIN with a high immediate relief rate, although a certain risk of long-term recurrence remains. For patients with concomitant cranial neuralgias, nervus intermedius sectioning combined MVD can enhance overall therapeutic outcomes.
Objective: To explore the clinical efficacy and application value of O-arm navigation-assisted zoning laminectomy in the treatment of severe thoracic ligamentum flavum ossification (TOLF). Methods: A retrospective cohort study was conducted to analyze 83 patients with severe TOLF admitted to Zhengzhou Orthopedic Hospital from May 2019 to August 2023. There were 48 males and 35 females, the age was (50.1±6.0) years. Preoperative three-dimensional reconstruction of the ossified ligamentum flavum in the thoracic spine was performed using Mimics 21.0 software for preoperative planning. According to different treatment methods, patients were divided into the O-arm navigation-assisted zoning laminectomy group (navigation group, n=41) and the simple zoning laminectomy group (control group, n=42). The baseline data, operation time, intraoperative blood loss and total hospital stay of the two groups were compared. The modified Japanese Orthopaedic Association (mJOA) score and improvement rate were used to evaluate the changes in neurological function before the operation, 1 month, 3 months after the operation and at the last follow-up. The occurrence of complications in the patients was recorded. Results: The 83 patients were followed up for (20.3±6.9) months. There was no statistically significant differences in gender, age, lesion involved segments and disease duration between the two groups (all P>0.05). The operation time of the navigation group was significantly shorter than that of the control group [(134.4±29.9) vs (152.9±30.2) min, P=0.006]. There were no statistically significant differences in intraoperative blood loss [(412.2±98.6) vs (433.3±80.1) ml] and total hospital stay [(7.8±1.5) vs (7.8±1.4) d] between the navigation group and the control group (both P>0.05). The mJOA scores of the navigation group at 1 month, 3 months after the operation and the last follow-up were significantly higher than the preoperative mJOA score (all P<0.001). There was no significant difference in mJOA scores between the two groups at each time point (all P>0.05). There was no statistically significant difference in therapeutic effect between the two groups (P=0.616). There was no significant difference in the improvement rate of mJOA between two groups [(67.8%±19.9%) vs (69.8%±19.3%), P=0.760]. There were 7 cases of cerebrospinal fluid leakage after the operation in the navigation group. In the control group, there were 11 cases of cerebrospinal fluid leakage and 1 case of transient neurological dysfunction. The incidence of postoperative complications in the navigation group was lower than that in the control group [(7/41, 17.1%) vs (12/42, 28.6%), P=0.035]. Conclusion: O-arm navigation-assisted technology helps achieve precise decompression during surgery, shortens the operation time and enhance the surgical safety.
Objective: To investigate the current application status of detection methods and reagents for islet autoantibodies in domestic medical institutions, and to assess their detection proficiency. Methods: From October 15, 2024 to March 15, 2025, a total of 175 questionnaires were distributed to core network member units of the National Clinical Research Center for Endocrine and Metabolic Diseases, member units of the Chinese Diabetes Society and the Chinese Society of Endocrinology, member units of the China Type 1 Diabetes Alliance, and other relevant institutions. After collection, statistical analysis of detection methods for islet autoantibodies and the proportion of domestic reagents. Ten representative institutions were selected, and each was provided with 150 blinded and coded standardized evaluation samples (including 50 new-onset type 1 diabetes samples and 100 healthy donor samples). After each institution completes testing and submits the results, the national center uniformly analyzes the sensitivity, specificity and accuracy, as well as the consistency between test results from participating laboratories and those of the"gold standard"[radioligand assay (RLA) or electrochemiluminescence (ECL)]. Spearman correlation analysis was adopted to assess the correlation between the test results of participating laboratories and the gold standard measurements. Results: A total of 127 valid questionnaires were collected from all 31 provinces, municipalities, and autonomous regions in China. The proportion of institutions adopting chemiluminescence immunoassay(CLIA) was 76.6%(95/124), and that of domestic reagents used was 91.7%(121/132). Results from 10 institutions showed the following results: the median sensitivity values for glutamic acid decarboxylase autoantibody (GADA), protein tyrosine phosphatase-2 autoantibodies (IA-2A), insulin autoantibody (IAA), zinc transporter 8 autoantibody (ZnT8A) were 76.0%(range:38.0%-90.0%), 36.0%(range:8.0%-66.0%),24.0%(range:2.0%-50.0%), and 46.0%(range:0-54.0%), respectively; the median specificity values were 100.0%(range:98.0%-100.0%),100.0%(range:99.0%-100.0%), 98.0%(range:95.0%-100.0%),99.0%(range:98.0%-100.0%), respectively; the median accuracy values were 92.0%(range:78.0-96.7%), 78.7%(range:69.3-88.7%), 72.7%(range:66.0-83.3%), and 80.7%(range:66.0%-84.7%), respectively. The median concordance rates between test results from institutions and the "gold standard" were 95.7% (range:82.7%-100.0%) for GADA, 88.3% (range:80.7%-96.7%) for IA-2A, 87.3% (range:82.7%-92.0%) for IAA, and 94.4% (range:81.3%-96.0%) for ZnT8A. The median correlation coefficients (ρ) were 0.857 (range:0.780-0.905) for GADA, 0.829 (range:0.507-0.871) for IA-2A, 0.781 (range:0.601-0.811) for IAA, and 0.805 (range:0.448-0.887) for ZnT8A. Conclusions: At the present stage in China, the mainstream detection method for islet autoantibodies is CLIA, and reagents have basically achieved localization. Overall, the detection quality for GADA is relatively satisfactory; however, the detection levels of IA-2A, InT8A, and particularyl IAA, still need further improvement.
To analyze the ultrasonic features of abdominal and retroperitoneal lipoblastoma in children. A retrospective analysis was performed on the ultrasonic images of 6 children with abdominal and retroperitoneal lipoblastoma confirmed by surgical and pathology in Tianjin Children's Hospital from July 2019 to January 2025. There were 1 male and 5 females, with a median age of 5 years (range: 5 months to 6 years). All patients presented with a single lesion, 2 located in the retroperitoneum, 2 in the mesentery, and 2 in the greater omentum. The median maximum diameter was 98.5 mm (range: 43-130 mm), and all masses were larger than 30 mm in maximum diameter. Ultrasound findings: well-defined margins in 6 cases, lobulated morphology was seen in 4 cases. Irregular ring-shaped extensive calcification with posterior acoustic shadow was detected in 1 case, cystic areas within the masses were noted in 2 cases, small vessel penetration in the masses was visualized in 2 cases, blood flow signals within the masses were detectable in 3 cases. All 6 cases showed a predominantly hyperechoic mass with cord-like hyperechoic areas (fat-like echogenicity). Preoperative ultrasound suggested lipoblastoma in 5 cases, and teratoma in 1 case at initial diagnosis. The typical ultrasonic features of abdominal and retroperitoneal blastoma in children are solitary, large, possibly lobulated, and well-defined fat-like echo masses, with certain characteristic ultrasonic manifestations. Combined with clinical characteristics such as age, ultrasound as a safe and non-invasive imaging method, can be used as a routine examination for screening and the main method for long-term follow-up.
Obesity in the elderly has become a prominent public health issue. Due to physiological changes and multimorbidity in the elderly population, obesity presents complex clinical manifestations with markedly increased management difficulties. Based on this, National Center for Gerontology, Obesity and Diabetes Group, Chinese Diabetes Society, Chinese Medical Association organized a multidisciplinary panel of experts in obesity and formulated this consensus after multiple rounds of rigorous evaluation and iterative revisions. The consensus emphasizes that the management of geriatric obesity requires a comprehensive assessment tailored to age and overall health status, employing a patient-centered, individualized and stratified management strategy. Following the principle of "safety first, functional improvement, and steady progress", the goal is to reduce visceral fat accumulation, maintain or increase muscle mass, protect bone health, and improve physical function and health status. Special attention should be paid to sarcopenia in the elderly. Adequate intake of high-quality protein foods, combined with a comprehensive resistance exercise program tailored to individual limitations, could effectively improve muscle mass. Furthermore, weight loss medications should be selected based on the evidence of benefit for obesity-related complications or comorbidities, with close monitoring of adverse reactions.
A rare case of composite pheochromocytoma (PCC) with ganglioneuroblastoma (GNB) was reported in this article, and the patient's diagnostic and treatment course-including biochemical evaluation, imaging findings, surgery, pathology, genetic testing, and postoperative follow-up-was retrospectively analyzed. Relevant literature in PubMed, Embase, CNKI, and Wanfang Data from database inception to October 1 2025 was systematically searched to identify comparable adult cases, and their clinicopathological features were summarized. The patient was a 48-year-old man who presented to the Department of Endocrinology, First Medical Center of Chinese PLA General Hospital on March 25, 2025, with hypertension for 3 months and a left adrenal mass detected 12 days earlier. Biochemical testing showed markedly elevated normetanephrine (NMN). MRI and 18F-NOTATATE somatostatin receptor positron emission tomography-computed tomography (18F-NOTATATE-PET-CT) revealed a cystic-solid mass in the left adrenal gland, with increased uptake in the solid component [The maximum standardized uptake value (SUVmax) was 9.4]. Robot-assisted laparoscopic tumor resection was performed on the patient. Composite PCC, consisting of a pheochromocytoma component and a GNB component, was confirmed by postoperative pathology. No clearly pathogenic variants were detected by germline whole-exome sequencing. After surgery, blood pressure was normalized without antihypertensive medication, and no evidence of recurrence or metastasis was observed at the 6-month follow-up. The literature review identified 14 adult cases of PCC with GNB; together with the present case, 15 cases were analyzed. The age [M(Q1, Q3)] was 49 (35, 55) years. Hypertension was documented in 11 patients, elevated catecholamines or their metabolites were observed in most cases, tumors>5 cm in maximum diameter were found in 8 patients, and hereditary syndromes were identified in 3 patients. Composite PCC with GNB in adults is exceedingly rare. Its clinical, biochemical, and imaging manifestations frequently overlap with those of conventional PCC, rendering definitive diagnosis dependent on histopathological examination. Prognosis appears to be correlated with tumor components, size, and genetic syndrome status. Therefore, comprehensive postoperative pathological evaluation, germline genetic testing, and long-term surveillance are strongly recommended.
