中华内科杂志最新文献

{"title":"[Expert consensus on endocrine hypertension screening (2025 version)].","authors":"","doi":"10.3760/cma.j.cn112138-20250103-00007","DOIUrl":"10.3760/cma.j.cn112138-20250103-00007","url":null,"abstract":"<p><p>Endocrine hypertension is a common form of secondary hypertension. Affected patients often present without specific symptoms or signs, making the condition easy to overlook or misdiagnose. Early screening can greatly enhance the level of diagnosis while prompt treatment can improve the prognosis of patients. Based on clinical evidence and practice, the Chinese Endocrinologist Association and the Chinese Endocrine Hypertension Collaboration Group reached this consensus after extensive discussions on target populations, screening methods, interpretation of screening results, and other issues related to endocrine hypertension.</p>","PeriodicalId":68309,"journal":{"name":"中华内科杂志","volume":"64 4","pages":"288-301"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143756182","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Research progress of galectins family in rheumatoid arthritis].","authors":"X Y Ai, J W Guo, Y L Chen, J Y Xie, X P Hong, D Z Liu","doi":"10.3760/cma.j.cn112138-20241118-00762","DOIUrl":"10.3760/cma.j.cn112138-20241118-00762","url":null,"abstract":"","PeriodicalId":68309,"journal":{"name":"中华内科杂志","volume":"64 4","pages":"373-376"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143756194","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Role of cumulative hemoglobin A_1c levels and insulin doses in insulin resistance-related metabolic disorders in patients with type 1 diabetes].","authors":"M Shi, Y Zhang, W Q Fan, Y Chen, Y T Xie, C Deng, X Li","doi":"10.3760/cma.j.cn112138-20241117-00761","DOIUrl":"10.3760/cma.j.cn112138-20241117-00761","url":null,"abstract":"<p><p><b>Objective:</b> To examine the effect of cumulative hemoglobin A_1c (HbA_1c) levels and insulin dosage on insulin resistance (IR)-related metabolic disturbances in newly diagnosed patients with type 1 diabetes (T1D). <b>Methods:</b> This retrospective cohort study included T1D patients admitted to the Second Xiangya Hospital of Central South University from November 2015 to March 2023. Clinical data collected comprised age, sex, disease duration, insulin dosage, body mass index, waist circumference, blood pressure, HbA_1c levels, islet autoantibodies, and fasting blood lipid profiles. IR-related metabolic disturbances assessed were overweight, obesity, central obesity, hypertension, and dyslipidemia. Cox regression and cluster analyses were applied to assess the influence of cumulative HbA_1c and insulin dosage on these metabolic disturbances. <b>Results:</b> A total of 235 patients were included, with 97 males (41.3%) and 138 females (58.7%). The median age was 19.8 (13.3, 31.1) years, and the median follow-up duration was 30.8 (20.8, 45.6) months. During follow-up, 41.6% (72/173) of patients developed IR-related metabolic disturbances. Multivariate Cox regression analysis revealed that a cumulative HbA_1c ≥60 mmol/mol was an independent risk factor for any IR-related metabolic disturbance [<i>HR</i> (95%<i>CI</i>): 1.739 (1.067-2.835) ] and for triglyceride abnormalities [<i>HR</i> (95%<i>CI</i>): 3.277 (1.176-9.127)]. Additionally, a cumulative insulin dosage ≥0.5 U·kg^-1·d^-1 was identified as an independent risk factor for overweight, obesity, or central obesity [<i>HR</i> (95%<i>CI</i>): 2.374 (1.059-5.323)]. Cluster analysis further identified that patients with higher levels of cumulative HbA_1c and insulin dosage, particularly those with adolescent-onset diabetes, had the highest likelihood of developing hypertension (<i>HR</i>=2.460, 95%<i>CI</i> 1.008-6.005), overweight/obesity/central obesity (<i>HR</i>=2.707, 95%<i>CI</i> 1.062-6.900), triglyceride abnormalities (<i>HR</i>=5.495, 95%<i>CI</i> 1.842-16.391), high-density lipoprotein cholesterol abnormalities (<i>HR</i>=11.054, 95%<i>CI</i> 4.107-29.751), and any IR-related metabolic disturbance (<i>HR</i>=5.833, 95%<i>CI</i> 2.602-13.077). <b>Conclusions:</b> Elevated cumulative HbA_1c and insulin dosage levels in T1D patients are associated with an increased risk of developing IR-related metabolic disturbances. These findings underscore the urgent need for novel therapeutic strategies tailored to this population.</p>","PeriodicalId":68309,"journal":{"name":"中华内科杂志","volume":"64 4","pages":"309-317"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143756205","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Screening for Fabry disease in patients with kidney disease].","authors":"C Yu, Z Li, R Wang, Y M Zhou","doi":"10.3760/cma.j.cn112138-20240804-00490","DOIUrl":"10.3760/cma.j.cn112138-20240804-00490","url":null,"abstract":"<p><p>This study aimed to determine the prevalence of Fabry disease in patients with kidney disease and observe its clinical features. A total of 1 693 patients in the Renal Department of Shandong Provincial Hospital Affiliated to Shandong First Medical University with proteinuria or renal insufficiency were included from June 2020 to December 2023. The α-galactosidase A level in males and globotriaosylsphingosine (Lyso-GL-3) level in females were detected, and GLA gene detection was performed in those with abnormalities. The GLA gene mutation rate was 0.297% (3/1 010) in males, 1.025% (7/683) in females, and 0.591% (10/1 693) overall. The prevalence of Fabry disease was 0.297% (3/1 010) in males, 0.293% (2/683) in females, and 0.295% (5/1 693) overall. The clinical manifestations of Fabry patients with kidney disease are complex and varied, with high heterogeneity. The pathogenicity of GLA gene mutations in patients with kidney disease requires further comprehensive analysis. Some GLA gene mutations are non-pathogenic and are mostly found in females. Patients with primary or secondary kidney disease should not be ignored regarding screening for Fabry disease.</p>","PeriodicalId":68309,"journal":{"name":"中华内科杂志","volume":"64 4","pages":"344-348"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143756208","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[A case report of VEXAS syndrome].","authors":"P Song, Z Yao","doi":"10.3760/cma.j.cn112138-20240520-00326","DOIUrl":"10.3760/cma.j.cn112138-20240520-00326","url":null,"abstract":"","PeriodicalId":68309,"journal":{"name":"中华内科杂志","volume":"64 4","pages":"355-357"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143756129","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[A brief discussion on the standardized management strategy of glucocorticoid withdrawal syndrome].","authors":"P Pang, Z H Lyu","doi":"10.3760/cma.j.cn112138-20250206-00069","DOIUrl":"10.3760/cma.j.cn112138-20250206-00069","url":null,"abstract":"","PeriodicalId":68309,"journal":{"name":"中华内科杂志","volume":"64 4","pages":"277-282"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143756122","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Microwave ablation for primary hyperparathyroidism related to multiple endocrine neoplasia type 1 in 3 cases of a family].","authors":"Q Q Lyu, X Han, Y T Zhao, Y Z Zhang, Z W He, Y Xing, C Liu, S H Xu","doi":"10.3760/cma.j.cn112138-20241104-00728","DOIUrl":"10.3760/cma.j.cn112138-20241104-00728","url":null,"abstract":"","PeriodicalId":68309,"journal":{"name":"中华内科杂志","volume":"64 4","pages":"349-354"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143756192","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Diagnostic evaluation on bilateral adrenal lesions].","authors":"P An, K Chen, Y M Mu","doi":"10.3760/cma.j.cn112138-20241018-00694","DOIUrl":"10.3760/cma.j.cn112138-20241018-00694","url":null,"abstract":"","PeriodicalId":68309,"journal":{"name":"中华内科杂志","volume":"64 4","pages":"362-367"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143756179","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[A rare case of monoclonal gammopathy-associated fibrillary glomerulonephritis].","authors":"S X Ai, Y B Wen, G Chen, X S Zhao, K Zheng, Y Qin, X M Li","doi":"10.3760/cma.j.cn112138-20240724-00469","DOIUrl":"10.3760/cma.j.cn112138-20240724-00469","url":null,"abstract":"","PeriodicalId":68309,"journal":{"name":"中华内科杂志","volume":"64 4","pages":"358-361"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143756135","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Analysis of serum 25-hydroxyvitamin D₃ levels and prognosis in patients with amyotrophic lateral sclerosis].","authors":"H F Wang, H R Wang, Y C Lin, J M Bai, M Li, X S Huang","doi":"10.3760/cma.j.cn112138-20240728-00481","DOIUrl":"10.3760/cma.j.cn112138-20240728-00481","url":null,"abstract":"<p><p><b>Objective:</b> To evaluate serum 25-hydroxyvitamin D₃ [25(OH)D₃] as a potential biomarker for amyotrophic lateral sclerosis (ALS) severity and to identify risk factors influencing ALS prognosis. <b>Methods:</b> This study included 217 ALS patients hospitalized at the Department of Neurology, First Medical Center, Chinese PLA General Hospital, between October 2018 and October 2021, who met the revised El Escorial diagnostic criteria. A cross-sectional analysis assessed differences in clinical indicators-including the ALS Functional Rating Scale-Revised (ALSFRS-R) and forced vital capacity percentage (FVC%)-across different serum 25(OH)D₃ levels. The correlation between 25(OH)D₃ levels and individual ALSFRS-R components was also examined. Conduct a prospective cohort study to identify independent risk factors affecting the survival time of ALS patients. <b>Results:</b> Among three groups categorized by serum 25(OH)D₃ levels, there were significant differences in the proportion of males (<i>χ</i>²=10.51, <i>P</i><0.05). Serum 25(OH)D₃ levels correlated positively with lower limb function scores in the ALSFRS-R (<i>r</i>=0.05, <i>P</i><0.05), but they were not identified as an independent risk factor for survival (<i>HR</i>=0.98, 95%<i>CI</i> 0.93-1.04, <i>P</i>>0.05). In contrast, delayed diagnosis(<i>HR</i>=0.94, 95%<i>CI</i> 0.89-0.99, <i>P</i><0.05) and reduced FVC%(<i>HR</i>=0.94, 95%<i>CI</i> 0.97-0.99, <i>P</i><0.05) were independent predictors of shorter survival. <b>Conclusion:</b> Serum 25(OH)D₃ levels differ by gender distribution and may be linked to better lower limb function in ALS patients. However, their role in prolonging survival remains uncertain.</p>","PeriodicalId":68309,"journal":{"name":"中华内科杂志","volume":"64 4","pages":"325-332"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143756154","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}