2026年 · 第12卷第01期

Diabetes mellitus (DM) is a global health challenge with increasing prevalence rates, particularly in low- and middle-income countries. Anthocyanins (ACs) are potential bioactive compounds found in various fruits and vegetables, attracting the attention of researchers due to their possible role in managing diabetes and its complications. Studies have demonstrated the beneficial effects of ACs on blood sugar levels, insulin sensitivity, and glucose tolerance. These effects may be associated with multiple mechanisms, including increased glucose transporter type 4 (GLUT4) expression, enhanced glucose uptake, AMP-activated protein kinase (AMPK) and protein kinase C (PKC) phosphorylation, improved insulin sensitivity, activation of phosphoinositide 3-kinase/protein kinase B (PI3K/AKT) signaling, increased glutathione (GSH) synthesis, production of short-chain fatty acids (SCFAs), glucagon-like peptide-1 (GLP-1) secretion, induction of antioxidant enzymes, improved beta-cell functioning, and activation of insulin signaling pathways. The activity of enzymes (alpha amylase, glucosidase, and dipeptidyl peptidase-IV [DPP-IV]) and the expression of inflammatory biomarkers (tumor necrosis factor [TNF], IL6, and MCP1) are reduced. These findings suggest the potential of ACs as adjunctive therapies. However, further studies, including well-structured clinical trials, are needed to explore the optimal dosage and long-term efficacy of ACs in diabetes management.

Advances in HIV management have transformed HIV into a chronic condition, resulting in improved prognosis and increased survival among people living with HIV (PLWH). Traditional risk factors for metabolic dysfunction-associated steatotic liver disease (MASLD)—including dyslipidemia—are prevalent in PLWH. This systematic review and meta-analysis aim to synthesize current evidence on lipid profile disturbances as contributors to MASLD in PLWH.

This systematic review and meta-analysis were conducted according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines and registered in PROSPERO with registration number CRD420251054477. We searched seven databases to identify studies reporting the prevalence and characteristics of MASLD in PLWH. Meta-analysis was conducted using Review Manager 5.4.1. Mean differences (MDs) were calculated using a random-effects model. Risk of bias was assessed using the ROBINS-E tool.

A total of 17 studies comprising 3933 HIV-positive participants were included, among whom 1226 (37%) had MASLD. Male sex was significantly associated with MASLD (OR = 1.57; 95% CI: 1.13-2.17; p = 0.007). MASLD was significantly associated with higher body mass index (BMI) (MD = 3.23 kg/m²; p < 0.00001). Lipid profile analysis revealed that MASLD patients had higher total cholesterol (MD = 6.62 mg/dL; p = 0.01), low density lipoprotein (LDL) (MD = 3.83 mg/dL; p = 0.01), triglycerides (MD = 63.02 mg/dL; p < 0.00001), and lower high density lipoprotein (HDL) (MD = -3.73 mg/dL; p < 0.0001).

This study demonstrates a significant difference in lipid profiles (higher total cholesterol, LDL, triglycerides, and lower HDL) among PLWH who develop MASLD, suggesting a potential metabolic signature associated with this comorbidity.

Fluctuating chronic conditions (FCC) in young adults aged 18-30 years, such as type 1 diabetes (T1D), sickle cell disease (SCD), and inflammatory bowel disease (IBD), present unique self-management challenges due to unpredictable symptom patterns that disrupt daily life. Tailored self-management interventions are essential for improving quality of life and health outcomes in this population. This scoping review synthesizes the literature on self-management interventions for young adults with T1D, SCD, and IBD, focusing on key concepts, intervention components, barriers, facilitators, and underlying theoretical frameworks. A systematic search was conducted across seven databases (PubMed, Embase, Cochrane Library, PsycINFO, Medline, CINAHL, and Web of Science) for studies in English published between January 2003 and January 2025. Studies were included if they examined self-management interventions for T1D, SCD, or IBD in young adults aged 18-30 years. Thirty-three studies met the inclusion criteria. Key interventions identified included structured educational programs, digital health tools, and peer support networks. Across different conditions, common themes emerged emphasizing patient education, empowerment, self-regulation, and psychosocial support. Interventions that integrated technology with peer support demonstrated improved engagement and health outcomes. Despite the diversity of approaches, there remains a need for more developmentally appropriate, inclusive interventions that address both condition-specific and shared challenges faced by young adults with FCC. This review highlights gaps in the current evidence base and underscores the importance of personalized, technology-enabled strategies to optimize self-management and health outcomes for this population.

The liver is increasingly recognized as a major regulator of systemic cardio-renal-metabolic health. Evidence is mounting that sex-chromosome dosage per se itself, independent of gonadal sex hormones, modulates hepatic physiology and liver disease risk. Turner syndrome (TS; monosomy X) and Klinefelter syndrome (KS; 47, XXY and variants) are the two most common sex-chromosome aneuploidies and carry a clinically relevant, yet often under-appreciated, burden of liver disease. Population studies show that individuals with TS have 2- to sixfold higher odds of raised liver enzymes, steatotic liver disease, advanced fibrosis, and even hepatocellular malignancy compared with to sex- and age-matched controls. In KS, the prevalence of metabolic dysfunction-associated steatotic liver disease (MASLD) reaches approximately 45%, with testosterone deficiency, visceral adiposity, and systemic inflammation acting as key drivers. Pathogenetic mechanisms converge on vascular dysgenesis and estrogen deficiency in TS, and on hypogonadism-related metabolic derangements in KS, together accelerating steatosis, inflammation, and fibrogenesis. This concise review/Comprehensive perspective reviews discusses historical background, epidemiology, hepatic phenotypes, pathophysiology, and current diagnostic and management recommendations. It also highlights critical knowledge gaps, including the need for prospective cohorts, optimized hormone-replacement protocols, and trials of emerging pharmacological approaches anti-MASH agents. Raising awareness among all stakeholders, endocrinologists, hepatologists, and primary-care physicians is essential for early detection, multidisciplinary management, and improved hepatic and extra-hepatic outcomes in these vulnerable patient populations.

Myeloid-derived suppressor cells (MDSCs) are important tumor microenvironment components in small cell lung cancer (SCLC). We successfully identified MDSCs expressing the surface marker CD33 in SCLC; nonetheless, whether CD33⁺MDSCs promote SCLC angiogenesis remains unclear. This study aims to explore the angiogenic effect and clinical significance of CD33⁺MDSCs derived from SCLC.

Nineteen patients diagnosed with extensive-stage SCLC at Jilin Cancer Hospital were selected as the research subjects. CD33⁺MDSCs were isolated from the peripheral blood of patients with SCLC using magnetic bead separation and CD33 expression was detected by flow cytometry. The angiogenic potential of CD33⁺MDSCs derived from the peripheral blood of patients with SCLC and healthy individuals was assessed using human umbilical vein endothelial cell (HUVEC) angiogenesis assays, and the clinical significance of CD33⁺MDSCs in promoting angiogenesis in patients with SCLC was analyzed using clinical data.

Compared to healthy individuals, the CD33⁺MDSCs (CD14⁺CD33⁺) isolated from the peripheral blood of SCLC patients exhibited a greater ability to promote HUVEC tubular growth (average vessel length: 57.60 mm [47.78 mm] vs. 39.07 mm [15.84 mm], p = 0.000; vessel area: 371,890 mm³ [699,927 mm³] vs. 334,652 mm³ [219,520 mm³], p < 0.000; total number of junctions: 141 [301] vs. 120 [94], p < 0.005), and their angiogenic ability was associated with older age, female sex, high performance status scores, no systematic treatment, and treatment unresponsiveness (p < 0.050). Furthermore, the enhanced angiogenic ability of CD33⁺MDSCs may represent a risk factor for treatment unresponsiveness (average vessel length: Odds ratio = 3.904, 95%CI = 1.812-8.409, p = 0.001; vessel area: Odds ratio = 2.501, 95%CI = 1.187-5.267, p = 0.016; total number of junctions: Odds ratio = 3.630, 95%CI = 1.686-7.815, p = 0.001) and is associated with a poor SCLC prognosis (average vessel length: Hazard ratio = 2.210, 95% CI = 1.299-3.758, p = 0.003; vessel area: Hazard ratio = 2.170, 95% CI = 1.274-3.693, p = 0.004; total number of junctions: Hazard ratio = 2.267, 95% CI = 1.333-3.853, p = 0.003).

CD33⁺MDSCs derived from the peripheral blood of patients with SCLC promote angiogenesis, which is a risk factor for treatment unresponsiveness and is associated with poor prognosis.

卡非佐米（CFZ）是一种不可逆蛋白酶体抑制剂，目前被批准用于治疗复发性多发性骨髓瘤（MM）。它被认为是血栓性微血管病（TMA）的原因，大多发生在两个疗程的化疗后。CFZ相关TMA的发生率、危险因素和治疗仍不清楚。这里我们描述两个案例。卡非佐米（CFZ）是一种不可逆蛋白酶体抑制剂，目前被批准用于治疗复发性多发性骨髓瘤（MM）。它被认为是血栓性微血管病（TMA）的一个原因，大多数发生在两个疗程的化疗后。CFZ相关TMA的发生率、危险因素和治疗仍不清楚。这里我们描述两个案例。病例1为70岁女性。她在2010年被诊断为MM，λ轻链伴Durie-Salmon III期，国际分期系统（ISS）-I期。基线时肾功能正常。在以硼替佐米为基础的一线方案（硼替佐米、表柔比星和地塞米松，PAD）和沙利度胺维持治疗后，达到了完全缓解。第一次复发发生在5年后，当时她因乳头状癌接受了甲状腺切除术。随后，她接受了包含硼替佐米、来那度胺和ixazomib的多个疗程的化疗，疾病控制不令人满意。24小时尿λ水平在1000至2500 mg之间波动，血清FLC-λ范围在350至500 mg/L之间。为了改善结局，她在2023年12月70岁时接受了由卡非佐米（第1天和第2天静脉注射30 mg）、泊马度胺（第1-21天口服4 mg）和泼尼松（每周口服40 mg）组成的KPD方案治疗。全血细胞计数（CBC）在正常范围内。