Objective: To explore the relationship between non-dipper pattern of blood pressure circadian rhythm and homocysteine (Hcy), carotid atherosclerosis (CAS) in patients with type 2 diabetes mellitus (T2DM). Methods: A total of 240 T2DM patients including 139 male and 101 female were enrolled. According tonocturnal blood pressure falling rates, the patients were divided into 2 groups: Dipper group,n=80 and Non-dipper group,n=160; based on CAS condition, the patients were divided into another set of 2 groups: CAS group,n=119 and Non-CAS group,n=121. Blood levels of Hcy, carotid intima media thickness (CIMT) and 24hSBP, dSBP, nSBP, 24hDBP, dDBP, nDBP were compared between 2 groups in each set; the risk factors of CAS were analyzed. Results: The following indexes were higher in Non-dipper group than Dipper group: Hcy by μmol/L (16.41.0±8.08 vs 12.55±4.07), CIMT by mm (1.00±0.59 vs 0.80±0.30), 24 hSBP by mmHg (138.7±19.2 vs 127.5±15.6), dSBP (139.4±19.2 vs 132.0±16.2), nSBP (136.4±20.0 vs 113.8±15.0), nDBP (74.0±12.0 vs 64.9±9.8), allP<0.01. Multi linear regression analysis indicated that Hcy (β=0.011,P<0.01), nSBP (β=0.021,P<0.01), nDBP (β=0.018,P<0.01) could affect blood pressure circadian rhythm. The following indexes were higher in CAS group than Non-CAS group: CIMT (1.18±0.65 vs 0.69±0.72), age by years (62.33±12.02 vs 59.17±10.80), 24 hSBP (138.2±18.2 vs 131.9±18.9), dSBP (139.5±18.4 vs 134.4±18.5), nSBP (133.9±20.7 vs 123.9±20.9) nDBP (73.3±12.8 vs 68.6±11.0),P<0.05 orP<0.01; while 2 indicators in CAS group were lower than Non-CAS group: SBPF (4.00±7.89 vs 7.66±7.36), DBPF (5.95±8.44 vs 10.19±8.67),P<0.01. Logistic regression analysis showed that age (OR=2.204,P<0.05), nDBP (OR=2.357,P<0.05), SBPF (OR=2.562,P<0.01) were the risk factors for carotid atherosclerosis. Spearman correlation analysis presented that CIMT was positively related to age (0.195,P<0.05) and negatively related to SBPF (r=-0.191,P<0.01). Conclusion: T2DM patients with non-dipper pattern of blood pressure circadian rhythm were usually combining high blood level of Hcy, non-dipper pattern was the independent risk factor for CAS. Restoring blood pressure circadian rhythm is important to prevent atherosclerosis.

Intracranial seminoma is a rare malignant tumor originating from the germ cells,usually occurring in the pineal gland or pituitary gland.In June 2020,the Department of Endocrinology at the First Affiliated Hospital of Army Military Medical University admitted a 20-year-old male patient with an intracranial germ cell tumor and spinal metastases.The patient presented with headache,dizziness,and visual impairment.Enhanced magnetic resonance imaging(MRI)of the head indicated thickening of the pituitary stalk.After multidisciplinary consultation,the patient underwent endonasal transsphenoidal resection of the tumor,with the pathological diagnosis confirming germ cell tumor.The patient received regular radiotherapy postoperatively.One year later,the tumor recurred and metastasized,leading to a second surgery for tumor resection in the thoracic spinal canal,followed by continued chemotherapy.The patient's clinical symptoms,such as headache and visual disturbances,improved,but he continued to experience panhypopituitarism and required long-term hormone replacement therapy.Early diagnosis of intracranial germ cell tumors is challenging,and they are prone to metastasis and highly sensitive to radiotherapy and chemotherapy.Early diagnosis and multidisciplinary comprehensive treatment can help improve the quality of life and prognosis for patients.