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25 February 2025, Volume 24 Issue 01 Previous Issue    Next Issue

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Editorial

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Current situation and challenges of prevention and control of diabetes in China NING Guang 2025, 24 (01):  1-6.  DOI: 10.16150/j.1671-2870.2025.01.001 Abstract ( 76 )   HTML ( 8 )   PDF (485KB) ( 12 )   Diabetes has become a major global public health issue. As of 2021， China had approximately 141 million diabetic patients， with 2/3 remaining undiagnosed， making China the country with the highest number of diabetes globally. This current status poses severe challenges to the prevention and control of diabetes and its complications. To effectively address these challenges， strategies must be comprehensive and involve multi-sectoral collaboration， including nationwide primary prevention， primary prevention for high-risk groups， and secondary prevention for diabetic patients. For the general population， it is critical to promote healthy lifestyles through health education， policy guidance， and technical resource support. For high-risk groups， emphasis should be placed on the importance of diabetes screening， coupled with combined measures of lifestyle interventions and pharmacological treatments. For diabetic patients， the focus should be on the monitoring and management of pan-risk factors associated with cardiovascular complications. China has introduced a new model for diabetes management—the National Metabolic Management Center （MMC）. By providing structured training and education for physicians within its network， the MMC promotes standardized， one-stop management solutions for diabetes， reducing regional disparities in diabetes management and effectively improving the diagnosis and treatment efficiency of diabetes and its complications. To achieve the goals of the "Healthy China 2030" initiative， concerted efforts from governments， sectors， communities， and individuals are required to raise diabetes awareness， expand standardized management coverage， and improve treatment and control rates， while reducing the incidence of diabetes and its complications. These efforts will lay a solid foundation for improving public health and building a healthy China for all. References | Related Articles | Metrics

Experts forum

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Current applications and prospects of visceral fat in obesity diagnosis and comorbidity prediction ZHANG Yifei, SHI Juan, XU Yuening 2025, 24 (01):  7-13.  DOI: 10.16150/j.1671-2870.2025.01.002 Abstract ( 63 )   HTML ( 15 )   PDF (484KB) ( 9 )   In 2021, 2.11 billion adults aged 25 and older worldwide were overweight or obese, with China having the highest number at 402 million. By 2050, the global population of overweight or obese adults is projected to rise to 3.8 billion, with China expected to account for 627 million of this total. Moreover, obesity is strongly associated with the occurrence and progression of various diseases, including cardiovascular diseases, cancers, and type 2 diabetes. Thus, the diagnosis and management of obesity have become a major global health challenge. However, traditional body mass index (BMI)-based diagnostic systems exhibit limitations in accurately reflecting abnormal fat distribution and metabolic dysfunction. Excessive visceral fat accumulation has been identified as a key factor in obesity-related metabolic disorders. Notably, visceral fat area (VFA), as an objective and quantifiable indicator for obesity assessment, demonstrates significant correlations with obesity and its comorbidities. Recent studies show that VFA outperforms BMI in the diagnosis and prediction of obesity and its associated comorbidities. Furthermore, VFA demonstrates superior value in evaluating the therapeutic efficacy of different interventions for obesity. Experience from China's Metabolic Management Center (MMC) has demonstrated the clinical value of VFA measured by standardized bioelectrical impedance analysis in obesity diagnosis and clinical mana-gement. In the future, the diagnosis and clinical management of obesity and its comorbidities should integrate multiple assessment methods incorporating multidimensional stratification analysis and personalized precision evaluation to further enhance comprehensive clinical management of obesity. References | Related Articles | Metrics

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Evolution of diagnosis standards for diabetes in China and blood glucose management for special populations ZOU Huimin, WANG Suijun 2025, 24 (01):  14-20.  DOI: 10.16150/j.1671-2870.2025.01.003 Abstract ( 69 )   HTML ( 11 )   PDF (491KB) ( 22 )   The prevalence of diabetes in China has been increasing annually. In 2021, the prevalence rate of diabetes reached 13.79% among individuals aged 20–79, with an undiagnosed rate as high as 56.0%. This indicates that China's diabetes prevention and control faces significant challenges. Diabetes is a chronic metabolic disease. Poor blood glucose control increases the risk of serious complications such as cardiovascular disease, kidney disease, retinopathy, and neuropathy, which impose a heavy burden on both individual health and socioeconomic development. Early detection of diabetes and the implementation of effective interventions are crucial for preventing complications. Currently, China's diabetes diagnosis primarily adopts international standards, using the 75g oral glucose tolerance test (OGTT) and glycated hemoglobin (HbA1c) as the gold standards for diagnosis. However, due to disparities in detection technologies and other factors, these methods still have certain limitations in clinical practice, especially in primary medical institutions where diabetes screening capacity and standardization level require further improvement. In addition, China demonstrates relatively low levels of awareness, treatment, and control rates of diabetes. According to 2021 data, the awareness rate of diabetes in China was 36.5%, the treatment rate was 33.2%, and the control rate was 49.2%. Although China has made some progress in diabetes prevention and treatment in recent years, there is still significant room for improvement. To address the challenges of diabetes prevention and treatment, a series of diabetes guidelines and consensus statements have been released by domestic experts, emphasizing the individualized and stratified management of diabetes patients. Different blood glucose control targets and treatment plans have been formulated for children and adolescents, pregnant women, and elderly patients. Meanwhile, the promotion of glucose monitoring technologies is considered an important approach to improve the rate of achieving blood glucose control targets. However, clinical attention remains inadequate for type 2 diabetes in children and adolescents, gestational diabetes, and elderly diabetes with sarcopenia, lacking standardized treatment strategies and high-quality medical evidence. For the current state of diabetes diagnosis and treatment in China, it remains imperative to further improve the diagnostic testing level, the coverage of examinations, and the ability of stratified management for different population groups. References | Related Articles | Metrics

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Challenges and solutions in diagnosis and treatment of obesity FANG Ping, HAN Junfeng 2025, 24 (01):  21-26.  DOI: 10.16150/j.1671-2870.2025.01.004 Abstract ( 40 )   HTML ( 2 )   PDF (454KB) ( 5 )   According to the World Health Organization (WHO), 2.5 billion adults worldwide were overweight, accounting for 43%, and 890 million were obese, accounting for 16% in 2022. Notably, the onset of obesity has shifted towards younger age groups, with a fourfold increase in adolescent obesity cases worldwide since 1990. China has the highest prevalence and growth rate of overweight/obesity globally. According to the latest Report on Residents' Nutrition and Chronic Diseases (2020), China's rate of overweight and obesity in adults has reached 50.7%, a figure projected to reach 65.3% by 2030. Overweight and obesity can lead to metabolic, functional, and psychological disorders, serving as critical risk factors for mortality and disability. They have emerged as one of the greatest medical challenges facing humanity. Currently, overweight/obesity diagnosis relies primarily on body mass index (BMI), body composition analysis, and imaging techniques. Advances in biomarkers and genomics have facilitated the early identification and diagnosis of obesity. However, conventional anthropometric measurements in clinical practice fail to reflect fat distribution or predict disease prognosis. In recent years, experts both in China and abroad have proposed new advanced frameworks for obesity diagnosis and treatment, emphasizing that comprehensive assessment should integrate anthropometric measurements with clinical evaluation of weight-related complications and their severity. Due to regional and ethnic differences in obesity diagnosis, there is an urgent need to develop obesity diagnosis, staging, and management frameworks aligned with the characteristics of China's population, thereby improving the identification of obesity and its related diseases and standardizing patient management strategies. Pharmacotherapy for obesity is favored by many patients due to its good efficacy, compliance, and non-invasive nature. However, pharmacotherapy faces challenges including adverse effects, muscle loss during weight reduction, and weight rebound after discontinuation. Emerging strategies, such as developing small molecule oral drugs, combination therapies, and peptide-drug conjugates, may offer novel solutions to improve tolerability, optimize weight loss experience, and achieve long-term weight maintenance. References | Related Articles | Metrics

Original article

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Anoikis-related gene PDK4 and pathogenesis of type 2 diabetes mellitus： A bioinformatics-based study ZHANG Ke, ZHANG Weiyi, SUN Haitian, CAO Mingfeng, ZHANG Xinhuan 2025, 24 (01):  27-34.  DOI: 10.16150/j.1671-2870.2025.01.005 Abstract ( 37 )   HTML ( 3 )   PDF (1790KB) ( 1 )   Objective To identify anoikis-related genes and immune infiltration characteristics in pancreas islet tissues involved in the pathogenesis of type 2 diabetes mellitus (T2DM) using bioinformatic analysis. Methods The dataset GSE76894 was downloaded from the Gene Expression Omnibus (GEO) database as the training set. Diffe-rential gene expression analysis was conducted on T2DM and non-diabetic islet tissues within the training set, and intersected with the anoikis-related gene set to obtain anoikis-related differentially expressed genes (DEGs). Subsequently, key genes were identified using the random forest (RF) and least absolute shrinkage and selection operator (LASSO) algorithms. Receiver operating characteristic (ROC) curves were plotted, and the area under the curve (AUC) was calculated to evaluate the association strength between the expression levels of the identified key genes in pancreas islet tissues and T2DM, followed by validation in the GSE76895 dataset. Protein-protein interaction (PPI) network analysis and gene ontology (GO) enrichment analysis were then performed on the identified key genes. The immune infiltration analysis was conducted using the CIBERSORT algorithm. Results Differential analysis identified 8 anoikis-related DEGs, with 6 upregulated and 2 downregulated genes. Subsequent application of two machine lear-ning algorithms identified 4 key genes: PDK4, BMF, ITGB1, and SNAI2. ROC analysis showed that in the validation set (GSE76895), only PDK4 expression had strong discriminatory power (AUC = 0.721), indicating a significant association with T2DM. Enrichment analysis demonstrated that these key genes were primarily enriched in terms related to integrin-mediated cell adhesion, regulation of lipid biosynthetic processes, integrin complex, and glial cell protrusions. Immune infiltration analysis indicated differential expression of various immune cells in the pancreas islet tissues of T2DM and healthy individuals. Furthermore, PDK4 expression was negatively correlated with that of M0 macrophages. Conclusions PDK4 is downregulated in T2DM islet tissues and negatively correlated with M0 macrophage expression levels, suggesting that the expression of PDK4 is related to the T2DM pathogenesis caused by immune dysregulation to some extent. Figures and Tables | References | Related Articles | Metrics

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Study on exploring Scimp in peripheral blood as a biodiagnostic marker for MAFLD-related cirrhosis based on animal experiments CHEN Hongwei, ZHU Ting, LIU Yan, HOU Yanqiang, FAN Guangjian 2025, 24 (01):  35-42.  DOI: 10.16150/j.1671-2870.2025.01.006 Abstract ( 28 )   HTML ( 1 )   PDF (1239KB) ( 0 )   Objective This study aims to identify biodiagnostic markers for the progression of metabolic-associated fatty liver disease (MAFLD) to cirrhosis, providing evidence for early diagnosis and treatment of cirrhosis. Methods The experiment utilized healthy male Sprague Dawley (SD) rats, which were randomly divided into a normal control (NC) group of 15 rats, a high-fat diet (HFD) group of 15 rats, and a liver fibrosis (LF) group of 15 rats. Rats in the NC group were fed a normal diet, those in the HFD group received continuous high-fat diet to induce fatty liver and mild liver fibrosis, and those in the LF group were fed a high-fat diet and injected with carbon tetrachloride to induce cirrhosis. After 41 weeks of feeding, blood and liver tissues were collected from rats. Liver tissues were stained with hematoxylin and eosin (HE), Oil Red O, and Sirius red to evaluate liver morphology, fat infiltration, and liver fibrosis. Differentially expressed genes in blood samples were screened using mRNA sequencing technology, and the expression of sequencing-screened differentially expressed genes was validated by reverse transcription quantitative real-time polymerase chain reaction (RT-qPCR). Additionally, blood samples from 10 human subjects each in the NC, MAFLD, and cirrhosis groups were collected from January to February 2025 at Songjiang Hospital Affiliated to Shanghai Jiao Tong University School of Medicine to validate the mRNA expression of screened differentially expressed genes. Results The mRNA sequencing of peripheral blood cells in rats identified 17 differentially expressed genes, including Rab3ip, Gprasp2, Emid1, Hbq1b, Scimp,Wipf3, Scrn1, Sez6, Bglap, Bhlhb9, Ranbp10, Ubd, Plekhb1, Nup210l, Gp1bb, Cpne8, and Oscar. The RT-qPCR validation results showed that the mRNA expression levels of the Scimp gene in the NC group, HFD group, and LF group exhibited an increasing trend in sequence, which was consistent with the sequencing results. Pairwise comparisons between groups showed statistically significant differences (P < 0.01). The RT-qPCR validation results of human peripheral blood cells were consistent with the mRNA sequencing and RT-qPCR validation expression trends of the Scimp gene in rat peripheral blood. Scimp showed the same expression differences among NC, MAFLD, and cirrhosis patients (P < 0.05). Conclusions The mRNA expression level of the Scimp gene in peripheral blood cells can serve as a potential non-invasive biodiagnostic marker for early-stage cirrhosis. Figures and Tables | References | Related Articles | Metrics

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Myeloid sarcoma: clinical features, bone marrow hematological characteristics, and prognosis of 20 cases LIU Xian, HUANG Lifang, MENG Fankai, MENG Li, WANG Zhiqiong 2025, 24 (01):  43-50.  DOI: 10.16150/j.1671-2870.2025.01.007 Abstract ( 32 )   HTML ( 3 )   PDF (621KB) ( 2 )   Objective To investigate the clinical features and prognosis of myeloid sarcoma (MS). Methods A retrospective analysis was conducted on the clinical data and bone marrow hematological test results of 20 MS patients diagnosed and treated in our department from December 2016 to January 2022. Clinical data were summarized, and the prognosis of three types of MS patients (isolated MS, MS with intramedullary lesions, and secondary MS after AML treatment) was analyzed. Results Among the 20 MS patients, 10 were male and 10 were female. The median age was 37 years (range: 6-62). The most common site of MS was the nasopharynx (25%), followed by the mediastinum (10%), thoracic vertebrae (10%), lymph nodes (10%), breast (10%), cervix (5%), eyes (5%), spleen (5%), testes (5%), abdomen (5%), sacrococcygeal region (5%), and pylorus (5%). There were 10 cases of isolated MS, 6 cases of MS with intramedullary lesions, and 4 cases of secondary MS after AML treatment. Immunohistochemical positive rates, from high to low, were CD99 (100%), CD43 (95%), MPO (95%), BCL-2 (90%), CD68 (75%), CD117 (50%), and CD34 (45%). TdT, CD3, CD20, and PAX-5 were all negative. Fusion gene testing was performed on 17 patients, with 7 positive results (7/17), including 3 cases of AML1-ETO (3/17), 2 cases of CBFβ-MYH11 (2/17), 1 case of MLL-AF10 (1/17), and 1 case of BCR/ABL1 (1/17). Chromosomal karyotype analysis was performed on 17 patients, and 6 showed abnormal karyotypes (6/17). Fluorescence in situ hybridization (FISH) was performed on 4 patients, with 3 positive results (3/4). Genetic mutation testing was conducted on 10 patients, with 9 positive results (9/10). The most frequent mutation was CEBPA (5 cases), followed by NRAS, FLT3, NPM1, and KIT (2 cases each). During the follow-up period of 1-38 months, 7 of the 20 MS patients died, and 13 survived. The cumulative survival rates at 1, 2, and 3 years were 75%, 70%, and 65%, respectively. No statistically significant difference in survival was observed among isolated MS, MS with intramedullary lesions, and secondary MS after AML treatment (P=0.718). Conclusion MS can occur in a wide range of anatomical sites. Pathological immunohistochemical markers, including CD43, CD99, CD68, MPO, CD34, and CD117, are critical for its diagnosis. Bone marrow hematological examination results can provide a basis for targeted therapy. There is no survival difference among the three types of MS patients, and systemic treatment is recommended for all patients. Figures and Tables | References | Related Articles | Metrics

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Micronodular thymoma with lymphoid stroma: a clinicopathologic analysis of five cases and literature review CHE Guanhua, ZENG Chang, CHEN Xiaoyan 2025, 24 (01):  51-58.  DOI: 10.16150/j.1671-2870.2025.01.008 Abstract ( 26 )   HTML ( 2 )   PDF (3765KB) ( 1 )   Objective To investigate the clinicopathological characteristics of micronodular thymoma with lymphoid stroma (MNT). Methods A retrospective analysis was conducted on five MNT patients who underwent surgical resection at the Department of Thoracic Surgery, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine between January 2020 and July 2023. Their clinical symptoms, pathological features, immunophenotypes, clinical treatments, and prognosis were evaluated, along with a literature review. Results Among the five MNT patients, three were male and two were female, aged 55 to 68 years. Four cases had tumors located in the anterior mediastinum and one in the superior mediastinum, all incidentally discovered by chest CT. The tumor diameters ranged from 1.3 to 4.5 cm. Three cases had intact capsules with clear boundaries and solid, gray-white, and fine-textured cut surfaces. Two cases exhibited cystic-solid morphology, while two cases showed capsule invasion. Microscopically, all cases demonstrated unique histological features of MNT: tumor primarily consisted of epithelial nodules and lymphocytes. The epithelial cells showed short spindle or oval shapes, with mild atypia, indistinct nucleoli, rare mitotic figures, and no necrosis. Lymphocytes were interspersed between the nodules, accompanied by visible lymphoid follicle formation. Immunohistochemical staining showed that tumor cells in all five cases were positive for AE1/AE3, CK19, P63, and Bcl-2. In one case, epithelial lining cells of the cystic area exhibited EMA expression but were negative for P63 and Bcl-2. Lymphocytes in all five cases showed expression of CD20, CD3, CD5, and TdT (focal +), follicular germinal centers were positive for CD10, and Langerhans cells within the nodules expressed Langerin, S100, and CD1α. EBER in situ hybridization was performed in three cases, all of which were negative for both epithelial and lymphoid cells. During a follow-up period ranging from 7 to 39 months after surgical resection, no recurrence was observed. A literature review of newly reported MNT cases from 2019 to 2023 in PubMed, Medline, China National Know-ledge Infrastructure, and Wanfang databases, along with summarized cases from 1999 to 2018 in the literature was conducted. A total of 206 MNT cases were identified. Among them, 195 were elderly patients (>45 years), 9 were young adults (18-45 years old), and 2 were children (<18 years old). The majority had tumors located in the mediastinum, although some were found in the neck. No significant gender preference was observed. Most cases were incidentally detected during physical examinations. Cystic features were more common on cut surface. Only one case experienced recurrence after surgery. Conclusion MNT is a rare tumor predominantly occurring in the mediastinum of middle-aged and elderly individuals. It demonstrates favorable prognosis after surgical resection. The pathological features of MNT include scattered epithelial nodu-les within a rich lymphoid stroma, with visible lymphoid follicle formation. The nodules contain scattered Langerhans cells and may exhibit cystic changes. A definitive diagnosis can be made based on the tumor’s location, histopathological features, and immunohistochemical markers. However, it still requires differentiation from other lesions. Figures and Tables | References | Related Articles | Metrics

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Cystic neutrophilic granulomatous mastitis: a study on association between dominant bacterial infection and histological characteristics WANG Ziyuan, CHEN Yongqi, FANG Zhen, WU Lili 2025, 24 (01):  59-64.  DOI: 10.16150/j.1671-2870.2025.01.009 Abstract ( 29 )   HTML ( 2 )   PDF (2487KB) ( 2 )   Objective To observe the bacterial types in cystic neutrophilic granulomatous mastitis (CNGM) samples and analyze the association between the dominant bacterial infections and the histological features in CNGM. Methods Using 16S rRNA gene sequencing and bioinformatics technology, bacterial identification and analysis were conducted on 12 CNGM samples (experimental group) and 5 breast fibroadenoma samples (control group). Paraffin sections were prepared from the 17 lesion tissues and stained with hematoxylin and eosin (HE), Gram staining, acid-fast staining, and PAS staining, followed by observation under light microscopy. The association between bacterial types and pathological features was assessed by combining molecular biology techniques with histological observations. Results Linear discriminant analysis effect size revealed significant differences in abundance between the experimental and control groups, with notable species including Corynebacteriales, Corynebacteriaceae, Corynebacterium, Mesorhizobium, uncultured bacterium, Bradyrhizobium, SHA_109, and Nitrobacter. Further analyses revealed that Corynebacterium kroppenstedtii was detected in 9 cases (9/12) of the experimental group, while none of the control group samples (0/5) showed its presence. This difference was statistically significant (P<0.05). Upon examination of histological sections, among 9 CNGM cases positive for Corynebacterium kroppenstedtii, 6 cases (6/9) showed Gram-positive rods within lipid vacuoles at the center of the granulomas. Both acid-fast staining and PAS staining were negative. No Gram-positive bacteria were found in the tissue samples of the control group. Conclusions Corynebacterium kroppenstedtii was detected in 75% of CNGM lesions, and its localization within lipid vacuoles was closely associated with the formation of surrounding pyogenic granulomas. The presence of Gram-positive rods within lipid vacuoles, combined with the typical granulomatous lesions observed in tissue sections, suggests that Corynebacterium kroppenstedtii may play an important role in the occurrence and development of CNGM. Figures and Tables | References | Related Articles | Metrics

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Application of GYPC gene methylation detection in cervical cancer screening for HR-HPV-positive women LUO Haijun, LIAN Yixiang, WANG Zhigan, JIANG Shali 2025, 24 (01):  65-71.  DOI: 10.16150/j.1671-2870.2025.01.010 Abstract ( 39 )   HTML ( 2 )   PDF (853KB) ( 0 )   Objective To investigate the diagnostic efficacy of GYPC (Glypican) gene methylation (GYPCm) in cervical exfoliated cells for detecting cervical cancer and precancerous lesions among women infected with high-risk human pa-pillomavirus (HR-HPV). Methods This study enrolled a total of 187 HR-HPV-positive women who underwent histopathological examination of colposcopy-guided biopsy at the hospital from October 2022 to July 2023, with a median age of 40.0 years (range: 17-75 years). Cervical exfoliated cells were collected before colposcopy for cytological testing, and the remai-ning specimens were tested for GYPCm status. Using the results of histopathological examination of colposcopy-guided biopsy as the gold standard, this study analyzed the diagnostic efficacy of GYPCm for detecting cervical cancer and precancerous lesions and compared it with cytological test results. Results The ΔCp value of GYPCm decreased significantly with increa-sing severity of cervical lesions. At a cutoff value of 15.975, the areas under the receiver operating characteristic(ROC) curves for detecting cervical intraepithelial neoplasia grade 2 or higher (CIN2+) and grade 3 or higher (CIN3+) were 0.800 (95% CI: 0.733-0.867) and 0.856 (95% CI: 0.784-0.928), respectively. To ensure that the sensitivity of GYPCm detection for CIN3+ was not inferior to cytological testing, the optimal cutoff value was determined to be ΔCp = 15.975. The positive rate of GYPCm detection in patients with cervical squamous cell carcinoma (SCC) was 100%. For CIN3+, the diagnostic sensitivity of GYPCm detection was comparable to that of cytological testing (86.7% vs. 84.4%, P=0.782), with no statistically significant difference. However, GYPCm detection demonstrated significantly higher specificity (65.5% vs. 29.6%, P<0.001) and positive predictive value (44.3% vs. 27.5%, P<0.001) compared with cytological testing. For CIN2+, the specificity and positive predictive value of GYPCm were significantly higher than those of cytological testing (both P<0.001). Conclusions GYPCm detection can serve as an effective triage tool for HR-HPV-positive women in cervical cancer scree-ning, offering better diagnostic efficacy compared with cytological testing. Figures and Tables | References | Related Articles | Metrics

Review

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Advances in research on risk factors and associated diseases of intrapancreatic fat deposition LEICHAO Wenwei, RAO Jialing, ZHOU Mengxue, YANG Hong 2025, 24 (01):  72-79.  DOI: 10.16150/j.1671-2870.2025.01.011 Abstract ( 32 )   HTML ( 2 )   PDF (523KB) ( 1 )   Intrapancreatic fat deposition (IPFD) is defined as the diffuse accumulation of fat within the pancreas. A related term, fatty pancreas (FP), refers to an IPFD fat content of ≥9.5%, which exceeds the normal upper limit. Changes in pancreatic fat content have been shown to affect at least 16% of the global population. Known risk factors for IPFD include demographic characteristics (age, sex, ethnicity), dietary patterns, obesity and metabolic syndrome, non-alcoholic fatty liver disease (NAFLD), metabolic dysfunction-associated steatotic liver disease (MASLD), metabolic dysfunction-associated fatty liver disease (MAFLD), iron overload, genetic disorders, pancreatic duct obstruction, and other potentially related conditions such as bacterial/viral infections, polycystic ovary syndrome, thyroid disorders. Accumulating evidence has established IPFD as a critical risk factor for the pathogenesis and progression of pancreatitis, pancreatic cancer, and diabetes mellitus; additionally, emerging evidence suggests its potential involvement in pancreatic fistula, post-transplant rejection, and atherosclerosis. Currently, the diagnosis of IPFD primarily relies on imaging techniques. With the rapid development of artificial intelligence (AI), AI-assisted imaging is expected to provide more accurate and comprehensive diagnostic tools for IPFD in the near future. Common intervention strategies for IPFD include lifestyle modifications (such as weight loss, dietary optimization, and regular physical activity), pharmacological treatments, and bariatric surgery. Currently, the understanding of IPFD is still unclear, so a review of the risk factors, diagnosis, harms, and intervention measures for IPFD would help improve clinical awareness of IPFD. References | Related Articles | Metrics

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Research progress on mechanisms of glucagon-like peptide-1 receptor agonists in diabetic retinopathy HE Cuihuan, SHI Derong, SUN Dandan, LI Yurui, XIA Guanghao 2025, 24 (01):  80-88.  DOI: 10.16150/j.1671-2870.2025.01.012 Abstract ( 38 )   HTML ( 1 )   PDF (711KB) ( 1 )   The prevalence of diabetes mellitus (DM) and its complication, diabetic retinopathy (DR), continues to rise year by year in China and globally. The global prevalence of DM is approximately 34.6%, with around 30% of patients progressing to DR, which is a major cause of adult blindness. In China, the DR prevalence among DM patients is 16.3%, with no significant urban-rural disparity. Notably, patients with type 1 diabetes mellitus (T1DM) and type 2 diabetes mellitus (T2DM) show substantially higher DR prevalence rates of 40.6% and 37.3%, respectively. The pathogenesis of DR involves complex interplay among multiple mechanisms, including inflammatory responses, microglial activation, oxidative stress, accumulation of advanced glycation end-products (AGEs), vascular endothelial growth factor (VEGF) upregulation, retinal neurodegeneration, and blood-retinal barrier (BRB) disruption. However, the precise mechanisms remain incompletely understood, and current clinical interventions cannot fully halt DR progression or prevent irreversible vision loss. Recent studies on glucagon-like peptide-1 receptor agonists (GLP-1RAs) demonstrate their protective effects against DR through multifaceted molecular mechanisms and cellular pathways. These include suppressing glial cell activation, inhibi-ting the release of inflammatory factors, blocking the nuclear factor κB (NF-κB) signaling pathway, and reducing reactive oxygen species (ROS) generation, along with AGE deposition, mitochondrial protection, vascular endothelial cell protection, neuroprotection, and metabolic regulation. Consequently, GLP-1RAs can mitigate or control the onset and progression of DR. This review summarizes the mechanisms by which GLP-1RAs alleviate or control the onset and progression of DR through anti-inflammatory, antioxidative stress, and anti-angiogenic effects, providing a theoretical reference for future DR treatment strategies. Figures and Tables | References | Related Articles | Metrics

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Clinical research progress on retinal changes in Alzheimer’s disease PENG Hanwei, SHEN Xi 2025, 24 (01):  89-94.  DOI: 10.16150/j.1671-2870.2025.01.013 Abstract ( 27 )   HTML ( 1 )   PDF (497KB) ( 0 )   Neurodegenerative disorders, such as Alzheimer’s disease (AD), often have with subtle early symptoms and lack specific biological markers, leading to a diagnosis typically in the later stages of the disease and missing optimal treatment window. In recent years, advances in embryology and ocular-brain pathology have revealed that the retina, as part of the central nervous system, is found to have a Physiology and anatomical structure highly similar to that of the brain. Research shows that changes in retinal structures, such as the retinal nerve fiber layer (RNFL) and the ganglion cell and inner plexiform layer (GCIPL), are closely associated with the progression of degenerative diseases in central nervous system, and these changes often occur before brain symptoms appear. With the advent of optical coherence tomography (OCT) and optical coherence tomography angiography (OCTA), non-invasive, rapid, and reproducible retinal imaging examinations can now be performed to observe the microvascular networks and microstructures of the retina, enabling the early diagnosis of neurodegenerative diseases. Currently, research on changes of retinal structure and function in AD patients demonstrates that retinal functional indicators, including RNFL thickness, GCIPL, retinal vascular density, and visual function, undergo significant changes in neurodegenerative diseases. These findings offer valuable insights into the retina as a window reflec-ting the progression of neurodegenerative diseases and demonstrate that retinal parameters can serve as a potential biological marker for neurodegenerative diseases. References | Related Articles | Metrics

Case report

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Diagnosis and treatment of type B insulin resistance syndrome complicated by mixed connective tissue disease: a case report and literature review HUANG Yu, CUI Yuliang, LIU Jing 2025, 24 (01):  95-99.  DOI: 10.16150/j.1671-2870.2025.01.014 Abstract ( 31 )   HTML ( 1 )   PDF (545KB) ( 3 )   This study reports a case of type B insulin resistance syndrome (TBIRS) complicated by mixed connective tissue disease. The patient, a 54-year-old male diagnosed with mixed connective tissue disease, exhibited symptoms including polyuria, dry mouth, polydipsia, continuous weight loss, hyperglycemia, and acanthosis nigricans. Laboratory tests confirmed insulin resistance and hyperinsulinemia, leading to a final diagnosis of TBIRS. The patient was treated with glucocorticoids, hydroxychloroquine, and insulin sensitizer. After two weeks, the patient showed improvement in polyuria, dry mouth, and polydipsia, with stable blood glucose levels. One month later, the patient's acanthosis nigricans improved, weight stabilized, and blood glucose levels remained stable. TBIRS is an autoimmune disease, more commonly seen in middle-aged females. The majority of cases present with hyperglycemia and hyperinsulinemia, while hypoglycemia is rare. Diagnosis is primarily based on clinical manifestations, and treatment plans should be tailored according to the symptoms and associated autoimmune diseases. TBIRS is often associated with systemic lupus erythematosus. However, this case reported in this study presents a rare instance of TBIRS with mixed connective tissue disease. The prognosis for TBIRS patients is poor, with a high mortality rate. Early diagnosis and treatment can help improve outcomes. In this case, a novel insulin sensitizer chiglitazar sodium was used for blood glucose control for the first time, demonstrating good hypoglycemic efficacy. The combined use of immunosuppressive agents proved effective, providing important guidance for early detection and precise treatment of such diseases in clinical practice. Figures and Tables | References | Related Articles | Metrics

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Clinicopathological analysis of biphenotypic sinonasal sarcoma： a case report GONG Jingqing, CAO Duanrong, ZHUANG Yixin, QIU Li, LI Xiaoming 2025, 24 (01):  100-105.  DOI: 10.16150/j.1671-2870.2025.01.015 Abstract ( 33 )   HTML ( 2 )   PDF (6878KB) ( 2 )   This study reported a rare case of biphenotypic sinonasal sarcoma (BSNS) and analyzed its clinicopathological features. The patient was a 35-year-old male admitted due to "recurrent right-sided nasal discharge mixed with blood for over three months". Endoscopic resection of a mass in the right nasal cavity, paranasal sinuses, and skull base was performed, followed by postoperative pathological biopsy. Under light microscopy, the tumor had an ill-defined boundary, with a surface covered by ciliated columnar epithelium. Focal squamous metaplasia of the ciliated epithelial cells was observed, along with mucosal invagination, dilation, and gland hyperplasia. The tumor was composed of diffusely distributed spindle cells densely arranged in bundles, woven, or herringbone patterns, without obvious cellular atypia. The chromatin was fine, and no obvious mitotic figures or necrosis were observed. In the stroma, thin-walled, dilated, and branched blood vessels resembling antlers were observed, and no definite regions of rhabdomyoblastic differentiation were identified. Immunophenotyping of the tumor tissue showed positive expression of Vimentin, H-Caldesmon, INI-1, Bcl-2, and CD99. Partial positive expression of Calponin, S100, MyoD1, and SMA. The Ki-67 index was approximately 35% in hotspot regions. Myogenin, STAT6, SOX-10, Desmin, β-catenin, CK, CD34, NSE, PR, and EMA were negative. Genetic testing showed PAX3 gene rearrangement, with positive FISH results. No rearrangement of the SYT gene was found, and the FISH result was negative. The clinical features of this case were nonspecific, but histologically, relatively typical features of BSNS were present, including gland-like structures formed by ciliated columnar epithelium invaginating into the spindle cell component with cystic dilation, or proliferative respiratory glands present within the spindle cell component. Differentiation of BSNS from other spindle cell tumors should be based on a comprehensive assessment of the site of origin in the nasal cavity and paranasal sinuses, the composition of relatively bland spindle cells, relatively typical histological features, expression of myogenic and neurogenic immunomarkers, and the characteristic PAX3 gene rearrangement. Figures and Tables | References | Related Articles | Metrics

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Interpretation and enlightenment of European Training Curriculum for radiology ZHONG Jingyu, XING Yue, MIN Qinghua, XIAO Zhengguang, ZHU Caisong, ZHANG Huan, YAO Weiwu 2025, 24 (01):  106-110.  DOI: 10.16150/j.1671-2870.2025.01.016 Abstract ( 38 )   HTML ( 1 )   PDF (865KB) ( 1 )   Figures and Tables | References | Related Articles | Metrics