Acromegaly is a rare disease characterized by the overproduction of growth hormone(GH)and insulin-like growth factor-1(IGF-1), which affects multiple organ systems and increases mortality risk.As the population ages, the number of elderly patients with acromegaly is rising annually, leading to more pronounced systemic complications and significantly impacting quality of life(QoL). However, there is limited data in the literature regarding the assessment of acromegaly complications in the elderly.Therefore, to enhance our understanding of acromegaly in this demographic, the present review focuses on the epidemiology, diagnosis, complication assessment, and therapeutic prognosis of acromegaly in elderly patients.

Abnormal glucose metabolism is one of the common complications of acromegaly.Patients with acromegaly have a signifi-cantly higher prevalence rate of abnormal glucose metabolism compared with the normal population,and the patients with acromegaly and diabetes mellitus(DM)have significantly higher prevalence rates of tumor and cardiovascular diseases.Growth hormone and insulin-like growth factor-1 have different effects on glucose metabolism in patients with acromegaly,and surgeries or drugs(such as somatostatin receptor ligands)for the treatment of acromegaly may disturb or affect glucose metabolism in the body,which requires fur-ther clarification.This article reviews the research advances in the diagnosis and treatment of abnormal glucose metabolism in patients with acromegaly,in order to identify optimal treatment strategies and achieve better management of acromegaly and related metabolic complications.

Acromegaly is a rare disease characterized by the overproduction of growth hormone(GH)and insulin-like growth factor-1(IGF-1), which affects multiple organ systems and increases mortality risk.As the population ages, the number of elderly patients with acromegaly is rising annually, leading to more pronounced systemic complications and significantly impacting quality of life(QoL). However, there is limited data in the literature regarding the assessment of acromegaly complications in the elderly.Therefore, to enhance our understanding of acromegaly in this demographic, the present review focuses on the epidemiology, diagnosis, complication assessment, and therapeutic prognosis of acromegaly in elderly patients.

Marfan syndrome(MFS)is an autosomal dominant disorder that is prone to fibrodysplasia,lens dislocation and rapid height growth,which needs to be distinguished from gigantism.This article reports a 14-year-old patient with MFS who had a typical binocular lens subluxation in both eyes,with visual impairment and rapid height growth.MRI with contrast to the pituitary suggested a pituitary microadenoma,but growth hor-mone and insulin-like growth factor 1 were in the normal range,thus excluding gigantism or acromegaly.Non-functional pituitary adenoma was considered.MFS patients need long-term follow-up and multidisciplinary col-laboration,and attention should be paid to cardiovascular system monitoring and genetic testing,which can be helpful for the diagnosis and treatment of patients and risk prevention and control.

Objective To observe the effects of Xin-Gui Gel Plaster(Cinnamomi Cortex,Asari Radix et Rhizoma,Euodiae Fructus,Chuanxiong Rhizoma,Borneolum Syntheticum)on peripheral neuropathy in diabetic rats.Methods A single intraperitoneal injection of 1%streptozotonic(STZ,35 mg·kg-1)was used to replicate a type 2 diabetes mellitus(T2DM)rat model followed by the induction of diabetic peripheral neuropathy(DPN)in combination with a long-term(8 consecutive weeks)high-fat and high-sugar diet.SD rats were randomly divided into normal group,model group,Mecobalamin group and Xin-Gui Gel Plaster group,with 6 rats in each group.The rats in the Xin-Gui Gel Plaster group were given Xin-Gui Gel Plaster at acupoints once a day for 8 weeks;the rats in the Mecobalamin group were given Mecobalamin solution by gavage(0.045 mg·kg-1),and the rats in the normal group and the model group were given physiological saline by gavage.Body mass and fasting blood glucose(FBG)were measured at weeks 2,4,6 and 8;the latency of thermal withdrawal latency(TWL)was measured at weeks 4 and 8;nerve conduction velocities,including motor nerve conduction velocity(MNCV)and sensory nerve conduction velocity(SNCV),were measured at week 8;and serum total cholesterol(TC),triglyceride(TG),fasting blood glucose(FBG)were measured using a fully automated biochemical analyzer.Fasting insulin(FINS)levels were detected by ELISA,and the index of insulin resistance(HOMA-IR)was calculated;and pathological changes in the sciatic nerve tissues of rats were observed by HE staining.Results Compared with the normal group,rats in the model group had significantly lower body mass and FINS levels(P＜0.01),significantly higher levels of FBG,TC,TG and HOMA-IR(P＜0.05,P＜0.01);TWL,MNCV and SNCV were significantly decreased(P＜0.01),and sciatic nerve fibres were disorganized and loosely aligned,with demyelination,axon atrophy and vacuole-like phenomenon.Compared with the model group,there was no significant change in body mass and levels of FBG,TC and TG in the Xin-Gui Gel Plaster group(P＞0.05),FINS level was significantly increased(P＜0.05),and HOMA-IR levels was significantly decreased(P＜0.05);TWL,MNCV and SNCV in the Mecobalamin group and Xin-Gui Gel Plaster group were significantly increased(P＜0.05,P＜0.01),sciatic nerve lesions were improved to different degrees,nerve fibre arrangement was more regular,myelin deficiency and axonal atrophy were significantly improved.Conclusion Xin-Gui Gel Plaster can improve insulin resistance,relieve thermal stimulation sensitivity,improve sciatic nerve conduction velocity to a certain extent in DPN rats,and have a protective effect on peripheral nerves in diabetic rats,but the hypoglycemic and hypolipidemic effects are not obvious.

Cushing syndrome(CS)is an endocrine-metabolic disorder characterized by hypercortisolism.Elevated cortisol levels can induce a hypercoagulable state,increasing the risk of venous thromboembolism(VTE).Both pituitary-origin Cushing disease(CD)and adrenal-origin non-adrenocorticotropic hormone(ACTH)-dependent CS are primarily treated with surgery.The dual impact of surgery and the underlying disease further elevates the risk of VTE,potentially leading to pulmonary embolism,which poses a severe threat to patient survival.Additionally,CS patients in a hypercoagulable state have a higher incidence of cardiovascular diseases and VTE,and even mortality compared with the general population.Untreated active CS patients have a 17.8-fold increased risk of VTE compared to the general population.In recent years,the relationship between the hypercoagulable state in CS and VTE has garnered increasing attention from clinicians.A better understanding of the clinical epidemiological characteristics,pathophysiological mechanisms,and clinical prevention and treatment of VTE and pulmonary embolism in CS can provide valuable references for the standardized use of prophylactic anticoagulant therapy in CS patients.

Multiple endocrine neoplasia(MEN) is a rare autosomal dominant genetic disorder characterized by hyperplasia or tumor development in two or more endocrine glands. Currently, MEN is classified into four subtypes: MEN1, MEN2, MEN3, and MEN4. Among these, MEN4 is caused by mutations in the CDKN1B gene and presents clinical manifestations similar to MEN1, though the age of onset and disease progression differ. Due to its rarity, this article reviews the pathogenesis and treatment strategies for MEN4, aiming to provide valuable insights for its diagnosis and management.

Objective:To investigate the current status of the nurturing care ability of primary intergenerational caregivers for infants and young children aged 0-3 years old, and explore its influencing factors, providing reference for further constructing strategies to enhance the nurturing care ability of primary intergenerational caregivers.Methods:From November 2022 to February 2023, cluster sampling was used to select 673 primary intergenerational caregivers of infants and young children aged 0-3 from three communities in Zunyi City as participants. The survey was conducted using the General Self-Efficacy Scale and the self-made Primary Intergenerational Caregiver Nurturing Care Ability Questionnaire for 0-3 Year Old Infants and Young Children. The nurturing care ability of primary intergenerational caregivers was evaluated from five dimensions of health care, nutrition care, safety care, responsive care, and early learning opportunities. Single factor analysis and multiple linear regression were used to analyze the factors influencing the nurturing care ability of primary intergenerational caregivers.Results:Among 673 primary intergenerational caregivers, the total score for the nurturing care ability was (88.15±13.19), and the mean of each item was (2.38±0.36). Multiple linear regression analysis showed that marital status, educational level, occupational status, and general self-efficacy were the influencing factors on the nurturing care ability of primary intergenerational caregivers for infants and young children aged 0-3 years old ( P<0.05), which explained 21.4% of the total variation. Conclusions:The nurturing care ability of the primary intergenerational caregivers for infants and young children aged 0-3 in Zunyi City are at upper middle level. Healthcare professionals should attach importance to evaluating the nurturing care ability of primary intergenerational caregivers, and provide targeted and effective interventions and support to improve their nurturing care abilities, comprehensively ensuring the healthy growth of infants and young children aged 0-3.

Objective:To investigate the current status of the nurturing care ability of primary intergenerational caregivers for infants and young children aged 0-3 years old, and explore its influencing factors, providing reference for further constructing strategies to enhance the nurturing care ability of primary intergenerational caregivers.Methods:From November 2022 to February 2023, cluster sampling was used to select 673 primary intergenerational caregivers of infants and young children aged 0-3 from three communities in Zunyi City as participants. The survey was conducted using the General Self-Efficacy Scale and the self-made Primary Intergenerational Caregiver Nurturing Care Ability Questionnaire for 0-3 Year Old Infants and Young Children. The nurturing care ability of primary intergenerational caregivers was evaluated from five dimensions of health care, nutrition care, safety care, responsive care, and early learning opportunities. Single factor analysis and multiple linear regression were used to analyze the factors influencing the nurturing care ability of primary intergenerational caregivers.Results:Among 673 primary intergenerational caregivers, the total score for the nurturing care ability was (88.15±13.19), and the mean of each item was (2.38±0.36). Multiple linear regression analysis showed that marital status, educational level, occupational status, and general self-efficacy were the influencing factors on the nurturing care ability of primary intergenerational caregivers for infants and young children aged 0-3 years old ( P<0.05), which explained 21.4% of the total variation. Conclusions:The nurturing care ability of the primary intergenerational caregivers for infants and young children aged 0-3 in Zunyi City are at upper middle level. Healthcare professionals should attach importance to evaluating the nurturing care ability of primary intergenerational caregivers, and provide targeted and effective interventions and support to improve their nurturing care abilities, comprehensively ensuring the healthy growth of infants and young children aged 0-3.

Multiple endocrine neoplasia(MEN) is a rare autosomal dominant genetic disorder characterized by hyperplasia or tumor development in two or more endocrine glands. Currently, MEN is classified into four subtypes: MEN1, MEN2, MEN3, and MEN4. Among these, MEN4 is caused by mutations in the CDKN1B gene and presents clinical manifestations similar to MEN1, though the age of onset and disease progression differ. Due to its rarity, this article reviews the pathogenesis and treatment strategies for MEN4, aiming to provide valuable insights for its diagnosis and management.