In recent years,the basal and clinical research in gonadal dysgenesis has achieved great progress.Considerable literatures concerning the diagnosis and therapy of these diseases have been published.In this review,we analyzed and summarized some more instructive literatures for clinical practice,discussed the problems and defects in gonadal dysgenesis research in China,and proposed some suggestions.

From Aug 2014 to July 2015, researches in the field of gonadal diseases have achieved rapid advances with image technology, the technology of biochemistry, and molecular biotechnology progressing. Considerable literatures concerning the pathogenesis, gene and clinical diagnosis, and treatment of gonadal diseases have been published. We reviewed and analyzed some more instructive literatures for clinical practice, proposed some suggestions, and the work plans for the clinicians.

[Summary] Over the past year, researches in the field of gonadal diseases have achieved rapid advances. Considerable literatures concerning the diagnosis and treatment of these diseases have been published. We herely reviewed and analyzed literatures which may be helpful to clinical practice in the future, while the defects and deficiencies in this field in China were also discussed with some suggestions proposed for the future.

Objective To investigate the effects of angiotensin Ⅱ AT1 receptor antagonist-Candesartan on production of leptin, adiponectin and TNF-? in rat. Methods 20 male Wistar Kyoto rats were randomly divided into vehicle and Candesartan treated groups. The dosage of Candesartan was 10mg?kg~ -1 ?d~ -1 . Food intake and bodyweight were recorded each week. Rats were sacrificed by decapitation after 17 weeks. Epididymal and perirenal fat were collected and weighted. Adipocytes were isolated from epididymal adipose tissue with collagenase. Diameter of adipocyte was evaluated. Blood chemistry, insulin, leptin, adiponectin and TNF-? were assayed. mRNA expressions of leptin, adiponectin and TNF-? of epididymal adipose tissue were assayed with RT-PCR. Results In Candesartan treated group, bodyweight and content of adipose tissue were significantly decreased, and adipocytes shrunk. Blood glucose and insulin levels showed no difference between two groups. Plasma leptin level and leptin mRNA expression in adipose tissue were lower, and plasma adiponectin level as well as adiponectin mRNA expression were higher in Candesartan treated group. Plasma TNF-? level was too low to detect with super sensitive kit, and mRNA expression of TNF? was decreased in Candesartan treated group. Conclusions Angiotensin Ⅱ AT1 receptor antagonist decreases the production of leptin and TNF-?, enhances synthesis as well as release of adiponectin in rat adipose tissue.

Objective To analyze the clinical features,auxiliary examination,diagnosis and treatment of pituitary abscess.Methods A retrospective analysis was done in 7 cases of pituitary abscess.All cases’ final diagnose were confirmed by histopathological results.Results 1.Four cases were diagnosed as primary pituitary abscess,the others 3 cases as secondary pituitary abscess which was associated with pituitary adenoma,pituitary cyst,craniopharyngeal duct tumor respectively.2.Clinical features:Of 7 cases,fever was determined in 6 cases,visual disturbance or temporal hemianopia in 5 cases,headache associated with anorexia and nausea and vomitting in 4 cases.High white blood cell counts was present in 3 cases,high PRL levels in 4 cases.Three cases were associated with hypothyroidism,2 cases with hypoadrenocorticism.MR image showed isointense or hypointense signal on T1WI and isointense or hyperintense signal on T2WI in pituitary abscess.Postcontrast T1WI showed a ring-shaped enhancement.Two cases were diagnosed by MR images and clinical features before surgery,the others by surgical histopathology.3.Treatment:All cases were treated with surgery,followed by antibiotics therapy.After operation all symptoms were improved except for optic nerve function.Conclusion It is suggestive of pituitary abscess when any patient present firstly with fever,headache,visual or eyeshot disturbance,partial or whole hypopituitarism associated with saddle area mass.Earlier diagnosis,timely surgery and postoperative proper antibiotics therapy are the keys to the treatment of pituitary abscess.

Objective To study the clinical characteristic of the central hyperthyroidism due to thyrotropin-secreting pituitary adenoma. Methods 5 patients with TSH-secreting pituitary adenoma (4 male and 1 female) among 1500 pituitary adenomas were summarize between 1992 and 2006, and clinical characteristics of the 5 patients were analyzed retrospectively. Results 5 patients represented 0.33% of all pituitary adenoma patients were seen during the same period. The mean age of the patients was 39.8 years old, and mean duration 5.84 years. All patients were presented with thyrotoxicosis. 3 patients were previously considered as suffering from primary hyperthyroidism and were treated with anti-thyroid drug for 6 to 16 years, and one of them subsequently underwent hypothyroid operation twice. None of them had visual field defect. Hyperthyroidism was determined in all patients by means of elevated total or free thyroid hormone levels while serum TSH levels varied between 3.94?54.7mU/L. TRH provoked an increase in serum TSH concentration greater than 30 mU/L from the baseline level in one patient, whereas no response was observed in two patients. MRI showed pituitary macroadenomas in four patients, while microadenomas in remaining patient. Four patients underwent transsphenoidal adenomectomy and followed by radio therapy in three patients. This resulted in normalization of all hormone parameters in all patients 1-2 weeks after operation. Conclusion Central hyperthyroidism due to thyrotropin-secreting pituitary adenoma should be considered in patients with elevated thyroid hormone and non-suppressed serum TSH level. Combined treatment (transsphenoidal adenomectomy and radiotherapy) is the choice for thyrotropin-secreting pituitary adenoma.

In order to investigate the effects of thyroid hormone on gonadotropin secretion in rat pituitary cells,the cultured rat pituitary cells were exposed to a series of concentrations of T 3 (0, 0 001, 0 01, 0 1, 1 and 10?g/ml). rLH and rFSH were determined after exposure to of T 3 The secretion ability of pituitary cells of rats with different thyroid function was evaluated in vitro. The results showed that high concentrations of T 3 (1 and 10?g/ml) inhibited the secretion of rLH ( P

Objective To analyse the clinical characteristics of the patients with intracranial germinoma.Methods Medical records of 45 patients with intracranial germinoma between 1993 and 2005 were retrospectively reviewed.Results The study population consisted of 30 males and 15 females,ranging in age from 20 months to 56 years old.Nineteen patients' tumors(42.2%)were in sellar region,13(28.9%)in pine region.Twenty-four patients(53%)had headache,nausea and vomiting.Twenty patients(40%)had blurred vision and visual field damage.Seventeen patients(38%)had diabetes insipidus.Twelve patients(27%)had hypopituitarism.Image study showed lesions were high density in CT and long T1,T2 in MRI.The signal was enhanced equally by contrast medium.?-hCG level of serum and CSF was measured,4 of 6 patients' serum ?-hCG level was elevated.Among those 4,?-hCG level in 2 patients' CSF was increased.Twelve patients were diagnosed pathologically,and 11 patients were diagnosed with experimental radiation.Others were diagnosed by clinical manifestation and image study.Eleven patients accepted operation therapy.Most of patients were treated with radiotherapy and chemotherapy.Symptoms were relieved obviously.Conclusion Intracranial germinoma mainly affects male children and adolescents.Common location of lesions is suprasellar and pine.Main manifestations of intracranial germinoma are headache,nausea,vomiting,blurred vision,visual field damage and diabetes insipidus.Biochemical and image examination have significance to diagnosis.Radiotherapy is a common and effective treatment for intracranial germinoma.

Objective To compare the value of EUS and DSA in the preopreation localization of insulinomas.Methods Twenty-three cases were examined by ultrasonography(US)and spiral computed tomography(CT),of whom 17 cases were examined by endoscopic ultrasonography(EUS),18 cases were examined by digital subtracation angiography(DSA).The preoperative accurate rates of localizing insulinomas were compared among four methods.Results The detective rate of four methods was 13.3% of US,50.0% of CT,73.9% of EUS and 80.0% of DSA.The sensitivity of EUS was significantly higher than US and CT(P

Objective To discuss the diagnostic paradigm of non-Hodgkin lymphoma with bilateral adrenal gland and pituitary involvement.Methods Clinical features of one patient with non-Hodgkin lymphoma with bilateral adrenal gland and pituitary involvement,manifesting fever of undetermined origin and refractory hyponatremia,were analyzed retrospectively.The related literature was reviewed,and experience in diagnosis of non-Hodgkin lymphoma with bilateral adrenal gland and pituitary involvement was summarized.Results Clinical manifestations of the patient was nonspecific,and there was definite evidence to support the diagnosis of infectious and autoimmune diseases.However,the abnormal elevation of serum lactate dehydrogenase(LDH)and ?2 microglobulin,which were suggestive of the diagnosis of lymphoma.The diagnosis of non-Hodgkin lymphoma with bilateral adrenal gland involvement was finally established by adrenal gland biopsy under CT.On the other hand,the endocrine evaluation indicated there was pituitarism even though the lesion was not obvious on the MRI image.However,18F fluorodeoxyglucose-positron emission tomography-computed tomography(18F-FDG PET-CT)clearly showed lesions in pituitary,liver and lymph node of neck.With supplementation of hydrocortisone,sodium the serum level gradually elevated to above the normal range,and the lesions in pituitary and adrenal glands disappeared after three courses of CHOP chemotherapy.The functions of pituitary and adrenal gland recovered 3 months later.Conclusions Non-Hodgkin lymphoma with bilateral adrenal gland and pituitary involvement is a rare disease.Early diagnosis relies on the logical clinical evaluation and 18F-FDG PET-CT image.