Congenital generalized lipodystrophic diabetes(CGLD) is a rare form of diabetes caused by the genetic defects affecting insulin action. This article describes two cases of CGLD within a family. The patients, siblings, exhibited systemic fat atrophy, severe hypertriglyceridemia, insulin resistance and hepatomegaly. Genetic analysis revealed a shared homozygous nonsense mutations in the BSCL2 gene c. 757G>T: p.E253*. Case 1(elder brother) presented with more severe hypertriglyceridemia, pronounced microvascular complications of diabetes, and abnormalities in bone metabolism. In contrast, Case 2(younger brother) demonstrated lower body fat content and reduced limb muscle strength. Despite sharing the same pathogenic mutation, the siblings displayed notable differences in clinical presentation, underscoring the phenotypic heterogeneity of CGLD. These findings highlight the importance of recognizing variable clinical manifestations in CGLD. Endocrinologists should consider this heterogeneity to ensure accurate diagnosis and tailored treatment strategies for affected individuals.

Congenital generalized lipodystrophic diabetes(CGLD) is a rare form of diabetes caused by the genetic defects affecting insulin action. This article describes two cases of CGLD within a family. The patients, siblings, exhibited systemic fat atrophy, severe hypertriglyceridemia, insulin resistance and hepatomegaly. Genetic analysis revealed a shared homozygous nonsense mutations in the BSCL2 gene c. 757G>T: p.E253*. Case 1(elder brother) presented with more severe hypertriglyceridemia, pronounced microvascular complications of diabetes, and abnormalities in bone metabolism. In contrast, Case 2(younger brother) demonstrated lower body fat content and reduced limb muscle strength. Despite sharing the same pathogenic mutation, the siblings displayed notable differences in clinical presentation, underscoring the phenotypic heterogeneity of CGLD. These findings highlight the importance of recognizing variable clinical manifestations in CGLD. Endocrinologists should consider this heterogeneity to ensure accurate diagnosis and tailored treatment strategies for affected individuals.

Objective:To investigate the clinical efficacy of ear acupoint pressing beans combined with escitalopram tablets in the treatment of depression.Methods:A total of 100 patients with depression who received treatment in the Department of Psychiatrics, The Third People's Hospital of Yongkang from October 2021 to February 2023 were included in this randomized controlled study. These patients were randomly divided into a control group and an observation group, with 50 patients in each group, using a random number table method. The control group was treated with escitalopram tablets, while the observation group was treated with ear acupoint pressing beans combined with escitalopram tablets. The two groups were treated for 8 weeks. Hamilton Depression Scale (HAMD), traditional Chinese medicine syndrome scores, Pittsburgh Sleep Quality Index (PSQI), serotonin levels, clinical efficacy, and adverse reactions were recorded in each group.Results:After treatment, the HAMD scores in each group were significantly decreased compared with those before treatment (both P < 0.001). After treatment, the HAMD scores in the observation group were significantly lower than those in the control group [(15.89 ± 1.08) points vs. (19.24 ± 1.27) points, t = 14.21, P < 0.001]. After treatment, the traditional Chinese medicine syndrome scores in each group were significantly lower than those before treatment (both P < 0.001). After treatment, the traditional Chinese medicine syndrome scores in the observation group were significantly lower than those in the control group [(6.83 ± 1.24) points vs. (9.78 ± 1.80) points, t = 9.54, P < 0.001]. After treatment, the PSQI scores in each group were significantly decreased compared with those before treatment (both P < 0.001). After treatment, the PSQI scores in the observation group were significantly lower than those in the control group [(7.00 ± 1.34) points vs. (9.48 ± 1.82) points, t = 7.76, P < 0.001]. After treatment, the levels of serotonin in each group were significantly decreased compared with those before treatment (both P < 0.001). The levels of serotonin in the observation group were significantly higher than those in the control group [(40.65 ± 5.37) μg/L vs. (32.52 ± 4.20) μg/L, t = 8.43, P < 0.001]. The total effective rate in the observation group was significantly higher than that in the control group [94% (47/50) vs. 80% (40/50), χ2= 4.33, P = 0.037]. The incidence of adverse reactions in the observation group was significantly lower than that in the control group [8% (4/50) vs. 10% (5/50), χ2= 0.12, P = 0.727]. Conclusion:The combination of ear acupoint pressing beans and escitalopram tablets shows good clinical efficacy in the treatment of depression. This combined therapy can reduce symptoms, improve sleep quality, increase serotonin levels and also has fewer adverse reactions, making it a worthy candidate for clinical promotion.

Objective This study aims to explore the formation of the dilemma of"giving care"for disabled elderly people in nursing homes from the perspective of active health.Methods Purposive sampling was used to select caregivers and disabled elderly people from a nursing home in Chongqing as research subjects from July 2022 to December 2022.One-on-one in-depth interviews were conducted and Colaizzi's 7-step thematic analysis method was employed to collect and analyze the interview data.Results 4 themes were identified:①the dominance of the"giving"care concept,including the cultural thoughts of filial piety,passive acceptance of care characteristics and consumer psychology regarding paid services;②insufficient"participation"care ability,including lack of knowledge regarding active health and a weakening of skills to promote participation;③the hindrance to"transformation"of care models,including objective limitations in terms of human resources and delays in adapting aging environments;and ④the decline in"utilization"of internal abilities,including excessive avoidance of potential risks,a heavy workload of care and poor quality of individual care.Conclusion The formation of the dilemma of"giving care"for disabled elderly people in nursing homes is affected by multiple factors such as social background,service system,supply resources,and management mode.Transforming disabled elderly individuals from a state of"passive giving care"to"active participation in their health"is an important measure to realize the concept of positive aging and healthy aging.

The association of non-HDL-cholesterol and non-HDL-C-to-HDL-cholesterol ratio (non-HDL-C-to-HDL-C ratio) with early diabetic nephropathy in patients with type 2 diabetes mellitus was investigated.Non-HDL-C and non-HDL-C-to-HDL-C ratio were positively related with microalbuminuria (P＜0.05 or P＜0.01).Non-HDL-C-to-HDL-C ratio is an independent risk factor of early diabetic nephropathy in patients with type 2 diabetes mellitus.