摘要:目的:研究垂体瘤转化基因在非小细胞肺癌组织、肺良性病变组织和正常支气管黏膜上皮组织中的表达, 初步探讨其与非小细胞肺癌发生发展,侵袭转移的关系。方法:(1)用SP免疫组化法检测76例临床石蜡组织标本(44例非小细胞肺癌、20例肺良性病变组织和12例正常支气管黏膜上皮组织)中的PTTG蛋白的表达。(2)用RTPCR法分析PTTG mRNA在不同性质肺组织中的表达情况。〖HTH〗结果〖HTSS〗:(1)PTTG蛋白在不同性质肺组织中的表达差别具有明显差异;在TNM分期、淋巴结转移组间差别有统计学意义。(2)PTTG mRNA在不同性质肺组织中的表达差别具有明显差异(Plt;0.001);在TNM分期、淋巴结转移组间差别有统计学意义。结论：细胞肺癌的发生发展及转移有关。Abstract: Objective: To investigate the association between PTTG expression and biological behaviors of human nonsmall cell lung cancer (NSCLC).Methods:SP immunohistochemistry was used to detect the expression of PTTG in 76 cases of paraffinembedded specimens (including 44 surgical specimens from NSCLC patients, 20 pneumonic benign lesion and 19 normal bronchial epithelium).Realtime RTPCR was performed to detect PTTGm RNA expression in 44 cases of fresh carcinoma and corresponding adjacent normal mucosa specimens.Results: The expression levels of PTTG was significantly different between normal mucosa and adenoma tissues.There were statistical relationships between their expressions and TNM stage, lymphnode metastasis. Conclusion: PTTG may play an important role in carcinogenesis、development and metastasis of human nonsmall cell lung cancer.
【摘要】 目的 分析手术治疗垂体瘤患者长期临床恢复以及生活质量改善情况。 方法 回顾性分析2007年12月-2008年9月手术治疗的103例垂体瘤患者术前以及术后长期随访资料，使用SF-36量表对术前、术后患者生活质量进行评估，分析手术治疗前后患者症状、激素水平恢复情况以及生活质量改善情况，并进一步分析肿瘤大小、侵袭程度对术后生活质量的影响。 结果 术后头痛症状消失52例，视力改善76例，其他症状具有不同程度改善；术后SF-36生活质量评估结果显示，患者除精神健康外的7个维度（生理机能、生理职能、躯体疼痛、一般健康状况、精力、社会功能、情感职能）均有明显改善（P＜0.05），不同肿瘤大小及侵袭程度的患者术后生活质量评分均无统计学意义（P＞0.05），垂体功能完全恢复者生活质量评分高于垂体功能低下者（P＜0.05）。 结论 显微手术治疗垂体瘤患者可明显改善患者的一般症状、提高患者的生活质量，单纯肿瘤的大小和侵袭程度对术后生活质量的影响程度较小，术后垂体功能的恢复程度明显影响患者的生活质量，垂体瘤术后患者的激素长期替代治疗尚需进一步加强。【Abstract】 Objective To analyze the long-term clinical recovery and quality of life (QoL) in patients with pituitary adenoma treated by microneurosurgery. Methods The clinical data of 103 patients undergoing microneurosurgery from December 2007 to September 2008 were retrospectively analyzed, health-related questionnairs (SF-36) were used to assess the QoL. The post-surgery recovery of symptoms, endocrine function, and QoL were compared with those of pre-surgery, then the correlation between tumor size, invasive behavior, and QoL were analyzed. Results Headache disappeared in 52 patients. Visual symptoms improved in 76 patients. Other symptoms were also improved. Seven concepts (physical functioning, role physical, bodily pain, general health, vitality, social functioning, role emotioning) were improved after surgery (Plt;0.05). The eight health concepts of SF-36 showed no significant difference between patients with different tumor size and invasive behavior (Pgt;0.05). Differences were considered statistically significant between normal and abnormal pituitary function groups after surgery(Plt;0.05) in all concepts. Conclusion Microneurosurgical treatment can improve the general symptoms and the QoL. The tumor size and invasion have little influence on the QoL after surgery, but the improvement of hormone deficiency has influence on the QoL significantly. More attention should be given to the long-term hormone replacement therapy after the pituitary adenoma surgery.
ObjectiveTo explore the association between paroxetine (Seroxat) and level of blood sugar and endocrine hormones in pre-diabetes patients with anxiety and depression. MethodsFifty-four pre-diabetes patients with anxiety and depression diagnosed from January 2010 to December 2012 were recruited. The self-rating anxiety scale (SAS) and self-rating depression scale (SDS) were used to assess depression and anxiety. All the patients were treated by paroxetine. The glucose tolerance test (OGTT), ACTH and cortisol were tested in patients at baseline and within 24 weeks. ResultsAfter 24 weeks' treatment, the level of anxiety and depression as well as the OGTT 0.5 h (0.5 h PG), OGTT 1 h (1 h PG), OGTT 2 h (2 h PG), glycated hemoglobin (HbA1c), adrenocorticotropic hormone (ACTH) and cortisol were significantly decreased (P<0.05 or P<0.01). The glycated HbA1c had a positive correlation with adrenocorticotropic hormone (ACTH) and cortisol (F). Before and after treatment, the reduced rate of ACTH and reduced rate of cortisol respectively exhibited a positive correlation with the reduced rate of HbA1c, reduced rate of SAS and reduced rate of SDS. ConclusionAnti-anxiety depression treatment can lower blood sugar level in pre-diabetes patients with anxiety and depression significantly, which may be related to the activity of HPA axis.
Objective To analyze the central visual fields and the ocular fundus changes of both eyes of patients with pituitary adenoma.Methods A total of 70 cases of pituitary adenoma received the examination of static central visual fields of all-liminal values by Humphrey instruments 750 cycloscope and the fundus exams by Topcon TRC-50X fundus photography before operations. Results There were 64.3% patients with decreased visual acuities, 80.7% with the defect of visual field, and 46 .4% with fundus changes. The decrease of the visual acuity was the first diagnostic symptom in 45.7% patients, among whom 28.6% were misdiagnosed as ocular diseases.Conclusions The misdiagnosed cause is that the first diagnostic symptom is the decrease of visual acuity without defect of visual field accompanied by ocular diseases. To avoid the misdiagnosis and the omitter of pituitary adenoma, general examination of visual field should be carried out in the patients with decreased visual acuity and optic atrophy with unknown reason in the clinical diagnosis of ophthalmology. (Chin J Ocul Fundus Dis，2003，19：18-19)
摘要:目的:探讨神经内镜经单鼻腔蝶窦入路在切除垂体腺瘤中的临床应用。 方法:对58例垂体腺瘤患者进行手术切除。应用神经内镜直接自单鼻腔进入,暴露双侧蝶窦开口,打开蝶窦前壁进入蝶窦腔切除肿瘤。 结果: 肿瘤全部切除42例,约占 72%;次全切除16例,约占28%,无严重并发症。结论:神经内镜经单鼻腔蝶窦入路切除垂体腺瘤是一种更微创、暴露更好、并发症少的手术方式。Abstract: Objective: To investigate the clinic application of endoscopic end nasal transsphenoidal surgery for pituitary tumors. Methods: 58 patients were treated. A endoscope was used to open the anterior wall of the sphenoid sinus and resected tumors. Results: 42 cases (72%) underwent total resection, 16 cases (28%) underwent subtotal resection. No severe complications was found. Conclusion: Endoscopic end nasal transsphenoidal surgery for pituitary tumors can reduce the tissue trauma, improved visualization, more complete tumor removal, and reduce complications.
Objective To observe the results of function MRI and perimetry in patients with visual pathway diseases.Methods Three patients (6 eyes) with pituitary adenoma and craniopharyngioma diagnosed via pathological examination and three healthy volunteers aged from 24 to 30 were collected. The best corrected visual acuity was nonlight perception1.0 in the 6 sick eyes and 1.0 in the healthy eyes; all the involved individuals had no other ocular diseases except myopia and without any contraindications of MRI. Common tests including the best visual acuity, fundus test by direct or indirect ophthalmoscope, center static visual field tested by Octopus 101 perimeter, program 32, tendency oriented perimetry were performed. The visual stimulation subtended a field of view of about 12 degrees，consisted of high contrast and drifting checkerboards. MRI parameters: GE signa VH/i 30T scanner. Functional data: GRE-EPI sequence，20 slices lying perpendicular to the calcarine sulcus. Anatomical data was obtained using 3DSPGR sequence to acquire high resolution. The cortical surface was unfolded and then cut and inflated. Functional data was presented to the inflated surface and subsequently analyzed by AFNI software.Results In six eyes, three had temporal defects, two had upper temporal visual field defects, and the other one did not finish the visual field test. The retinotopic representations of health adults were obtained by using the phaseencoded visual stimulation. The Eccentricity coordinate maps showed that foveal representations lay in the occipital poles and the representations appeared further anterior as eccentricity increased. The polar angle coordinate maps showed that early retinotopically organized areas had a representation of visual field. The visual cortex beneath the calcarine sulcus matched with the upper visual field of the opposite side and which upon the calcarine sulcus matched with the under visual field of the opposite side. Less or no visual cortex response was revealed in the patients′ function MRI or the response in injury side was vanished. The visual cortex response related with the visual field defects could not be induced in function MRI.Conclusion There is a good correlation between function MRI data and the results of perimetric evaluation. The function MRI can show the visual cortex response correlated with the visual field defects of the patients with visual pathway diseases.
ObjectiveTo explore the value of bilateral inferior petrosal sinus sampling (BIPSS) for preoperative diagnosis of adrenocorticotropic hormone (ACTH) microadenomas.MethodsWe retrospectively analyzed the clinical date of patients with ACTH microadenomas, who were experienced BIPSS preoperatively from October 2013 to May 2017. The qualitative and localized diagnostic significance of BIPSS was evaluated based on the criteria of the plasma ACTH concentration ratio of inferior petrosal sinus to ulnar vein (≥2), and the ratio of left to right inferior petrosal sinuses (≥1.4).ResultsFive patients (1 male and 4 females) were involved in the study. The mean age was (49.6±9.2) years, and the mean disease course was (17.2±7.5) months. The plasma ACTH concentration of all the cases ran up to the criterition of the ratio of inferior petrosal sinus to ulnar vein (≥2). Three cases were found that the actual locations of the microadenomas were inconsistent with the indications from the results of BIPSS. After the BIPSS procedure, there was no intracranial infection or death case, except that one patient suffered from ecchymoma and another one suffered from transient nausea.ConclusionBIPSS is valuable for qualitative diagnosis, but not effective for localization diagnosis of the ACTH microadenomas preoperatively.
ObjectiveTo investigate the risk of cardiac valve regurgitation in patients with pituitary prolactinoma treated with bromocriptine for a long time. MethodsBetween January 2012 and February 2013, 26 pituitary prolactinoma patients treated with bromocriptine for at least 6 months were included in the observation group, and 101 healthy people were regarded as the control group. Transthoracic echocardiography were performed on these patients for cardiac regurgitation, and the echocardiographic data were compared between the two groups. ResultsTrace tricuspid regurgitation was presented in 38.46% of patients in the observation group, and 19.80% of the controls (P=0.046). Interventricular septum thickness was (8.62±0.31) mm in patients in the observation group, and it was (8.57±0.12) mm in the controls (P=0.042). ConclusionNo clinical significant cardiac valve regurgitation has been observed in pituitary prolactinoma patients treated by bromocriptin for a long time. Long-term echocardiographic follow-up of these patients is necessary.