Malnutrition is a significant risk factor for the progression of chronic kidney disease (CKD), and monitoring the nutritional status of CKD patients is crucial for delaying disease progression and improving patient prognosis. Currently, there is a scarcity of studies on malnutrition in CKD, and a unified standard for nutritional assessment in CKD is still lacking. Clinical evaluation must be conducted according to the condition of patients, combined with multiple indicators. Nutritional screening and assessment scales are the common nutritional assessment methods; however, due to limitations in the applicable populations, the applicability of some scales for the CKD population requires further verification. Additionally, anthropometric indicators, body composition analysis, and clinical laboratory indicators can also reflect human nutritional status, each with its respective advantages and limitations. This review summarizes the research status and clinical application characteristics of various nutritional assessment methods in CKD patients, aiming to provide references for the clinical assessment of malnutrition in CKD.

Cerebral small vessel disease (CSVD) is a group of local brain tissue lesions caused by abnormal small vessels in the brain due to different etiologies. The pathogenesis of CSVD is not yet fully understood, and its diagnosis currently mainly relies on clinical imaging examinations. Endothelial cells (ECs) in cerebral blood vessels can play an important role in maintaining the structure and function of the blood-brain barrier, regulating cerebral blood flow, and mediating neurovascular coupling. In recent years, studies have shown that ECs dysfunction plays an important triggering and mediating role in the pathological changes of CSVD, and may even be a key initiating link in its pathogenesis. Moreover, biomarkers related to ECs dysfunction are associated with the severity of CSVD. The review summarizes the role of ECs dysfunction in the pathogenesis of CSVD, and the research progress of related biomarkers, aiming to provide references for the diagnosis and treatment of CSVD.

Trastuzumab deruxtecan (T-DXd) is a new generation of antibody-drug conjugate targeting human epidermal growth factor receptor 2. It has strong antitumor effects and has been recommended by many authoritative guidelines at home and abroad. Drug-induced interstitial lung disease (DILD) is one of the common adverse reactions and causes of death of T-DXd and is an important factor limiting its clinical application. The pathogenesis of DILD induced by T-DXd is still unclear, and the mainstream view holds that it may be related to the non-target-dependent uptake of the drug. Glucocorticoids are an important treatment method for DILD, and other alternative drugs still lack clinical effectiveness evidence. The research progress on the pathogenesis of T-DXd induced DILD was summarized in this review, aiming to provide new ideas for the prevention and treatment of DILD.

Sepsis-induced coagulopathy (SIC), a critical and potentially lethal condition arising from sepsis, results in endothelial damage and significant coagulation dysregulation, making it a major factor contributing to mortality among sepsis patients. Early diagnosis and treatment of SIC are expected to improve the prognosis of sepsis patients. In 2019, the International Society on Thrombosis and Hemostasis (ISTH) issued the first guidelines for the diagnosis and treatment of SIC, but there are no corresponding protocols in China. Therefore, Chinese Society of Thrombosis, Hemostasis and Critical Care, Chinese Medicine Education Association, and Chinese People's Liberation Army Professional Committee of Critical Care Medicine jointly formulated the "Chinese Expert Consensus on the Diagnosis and Treatment of Sepsis-induced Coagulopathy (2024 edition)." This consensus includes 5 parts: pathogenesis, classification, laboratory approaches, diagnosis and treatment, with a total of 14 evidence-based recommendations to guide clinical practice.

Refractory prolactinoma is the most common pituitary neuroendocrine tumor. Dopamine receptor agonists (DA) are the primary choice for drug treatment. Most patients with prolactinomas respond well to DA. However, a minority of prolactinomas patients still show resistance to DA. Although drug-resistant and refractory prolactinomas are rare in clinical practice, their treatment is extremely challenging. Even a combination of drug therapy, multiple surgeries, and radiotherapy may not yield satisfactory outcomes. Therefore, standardizing the diagnosis and treatment process and pathway for refractory prolactionmas and exploring more effective multidisciplinary collaborative treatment strategies are urgent problems to be solved. In the clinical management of refractory prolactinomas, it is often necessary to consider the patient's condition comprehensively, replace other types of DA, or consider surgery, radiotherapy, and immunotherapy, which requires multidisciplinary diagnosis and treatment. This review synthesizes the latest literature at home and abroad to systematically discuss the latest advances in drug therapy, surgery, and radiotherapy treatments for refractory prolactionmas, aiming to provide new ideas for basic research, clinical diagnosis and treatment.

Cushing's disease is a severe endocrine disorder caused by excess secretion of adrenocorticotropic hormone from pituitary. Due to its subtle early clinical manifestations , the diagnosis of Cushing's disease is often delayed, and differentiating it from ectopic adrenocorticotropic hormone syndrome is a challenge. Combined functional tests can improve the diagnostic accuracy of Cushing's disease. The primary treatment for Cushing's disease is surgical removal of pituitary adenoma. However, about 1/3 of patients do not respond or experience recurrence after surgery, necessitating second-line treatments including medication. The development of novel drugs has enhanced the role of pharmacotherapy in the management of Cushing's disease. The review discusses the classic and emerging diagnostic methods and treatment strategies of Cushing's disease to deepen clinicians' understanding of its current treatment status and prospects.

Pituitary thyroid-stimulating hormone (TSH) adenomas is a rare pituitary disorder, accounting for less than 2% of pituitary adenomas. The clinical manifestations primarily include mild to moderate symptoms of hyperthyroidism, corresponding symptoms caused by other anterior pituitary hormone secretion disorders, and symptoms resulting from the mass effect of pituitary tumors. Pituitary TSH adenomas need to be differentiated from primary hyperthyroidism (Graves' disease) and resistance to thyroid hormone (RTH), as misdiagnosis can lead to tumor growth and aggravation of the condition. Currently, with the help of sensitive laboratory tests, imaging examinations, and targeted functional tests, pituitary TSH adenomas can be diagnosed relatively accurately. The preferred treatment is surgical resection. In cases where surgery is not feasible or unsuccessful, radiotherapy or medical therapy can be considered. Long-acting somatostatin analogs can effectively reduce tumor volume and decrease TSH secretion, thereby normalizing free 3,5,3',5'-tetraiodothyronine (FT₄) and free 3,5,3'-triiodothyronine (FT₃). Early identification and effective treatment are significant for patients with pituitary TSH adenomas. This review summarizes the epidemiology, pathological characteristics, screening objects, clinical manifestations, auxiliary examinations, diagnosis and treatment, follow-up and evaluation of pituitary TSH adenoma, aiming to provide guidance for the clinical diagnosis and treatment of this condition.

Non-functional pituitary adenomas (NFPAs) are relatively common intracranial sellar tumors. The diagnostic rate of NFPAs has significantly increased in recent years due to the widespread application of computed tomography (CT) and magnetic resonance imaging (MRI) in clinical practice. NFPAs do not exhibit increased biochemical hormone secretion, so they may not present with obvious clinical manifestations. However, as the tumor grows, it can cause mass effect symptoms, such as headache, visual impairment, and related pituitary target gland dysfunction, and even life-threatening pituitary stroke. The evaluation of pituitary function in patients with NFPAs and the selection of treatment plans require close collaboration and scientific management by a multidisciplinary team. The genetic and epigenetic mechanisms underlying the occurrence and development of NFPAs have not yet been fully elucidated. New treatment strategies may be developed through technologies such as whole-genome sequencing combined with chromatin structure analysis. This review systematically summarizes the research progress in epidemiology, histopathology, clinical diagnosis, treatment, and prognosis of NFPAs, aiming to provide reference and guidance for clinical management.

Acromegaly can cause chronic complications in multiple systems such as the cardiovascular, respiratory, digestive, and endocrine systems, increasing the risk of death and significantly shortening the patient's life expectancy. Timely screening and early diagnosis and treatment can significantly improve the prognosis of patients and indirectly reflect the level of diagnosis and treatment of hospitals or teams. Clinical communication and research have revealed that physicians, in the course of clinical practice, are frequently constrained by factors such as time, economic considerations, and patient compliance, which hinder their ability to perform comprehensive screening for acromegaly-related complications. This review draws on expert consensuses and guidelines from both domestic and international sources, integrating them with the specific realities of China, to provide a comprehensive summary of the key aspects of screening and management for acromegaly-related complications. These aspects include the incidence of complications, optimal timing for screening, treatment approaches, long-term monitoring, and strict management protocols. It emphasizes standardization, precision, and personalization in clinical diagnosis and treatment work, aiming to comprehensively improve the diagnosis and treatment level of acromegaly in China, enhance the survival rate of patients, and improve their quality of life.

Objective To explore the influential factors and predictive value of early femoral head collapse progression following allogeneic fibula grafting (AFG) surgery. Methods Clinical and radiological data of 68 patients (75 hips) with osteonecrosis of the femoral head (ONFH) who underwent AFG between January 2008 and December 2022 at the Orthopedics and Traumatology Department, Affiliated Hospital of Nanjing University of Chinese Medicine were retrospectively analyzed. Seventy-five hips were divided into stable (n=40) and progressive (n=35) groups based on the presence or absence of postoperative collapse progression. Age, gender, etiology, location of the lesion, Association Research Circulation Osseous (ARCO) stage, Japanese Committee of Osteonecrosis Investigation (JIC) classification, China-Japan Friendship Hospital (CJFH) classification, and Hounsfield units (HU) value of anterolateral sclerosis rim (ⅠSHU) were collected. Univariate and multivariate logistic regression analyses were used to identify the factors influencing early collapse progression after AFG. Receiver operating characteristic (ROC) curve was used to analyze the predictive value of the identified factors influencing postoperative early collapse progression. Results Of the 75 hips, 35(46.7%) had postoperative collapse progression. Univariate logistic regression analysis showed that age, ARCO stage, JIC classification, and ⅠSHU were in fluencing factors for early femoral head collapse progression after AFG (P<0.05). Multivariate logistic regression analysis showed that ARCO stage ⅢA and JIC classification C2 were independent risk factors for early femoral head collapse progression after AFG, while ⅠSHU was identified as an independent protective factor (P<0.05). The ROC curve analysis showed that the sensitivities of ARCO stage, JIC classification, ⅠSHU, and the combined predictive model were 0.850, 0.725, 0.800, and 0.775, the specificities were 0.486, 0.657, 0.743, and 0.914, and the area under the ROC curve (AUC) were 0.668, 0.725, 0.811, and 0.896, respectively. Conclusions ⅠSHU is associated with early collapse progression after AFG in patients with ONFH. ARCO stage ⅢA, JIC classification C2, and ⅠSHU are independent factors influencing postoperative early collapse progression and have a certain predictive value.