Objective:To investigate the clinicopathological features, immunophenotype and differential diagnosis of clear cell hidradenoma, and to analyze the origin of clear cell hidradenoma and the underlying mechanism.Methods:The clinical data of 23 cases of clear cell hidradenoma who underwent surgical resection in Suzhou Municipal Hospital between December 2017 and July 2021 were retrospectively analyzed. Clinical manifestation, imaging features, pathological features and prognosis of the 23 cases of clear cell hidradenoma were analyzed. Expression levels of epithelial membrane antigen, cytokeratin 20, cytokeratin 7, cytokeratin 14, carcinoembryonic antigen, and gross cystic disease fluid protein 15 were detected by immunohistochemical staining technique using the EnVision system. Periodic acid-Schiff (PAS) staining was performed to visualize glycogen.Results:Among the 23 cases, 8 were male and 14 were female, aged 14-94 years, with a median age of 55 years. The first symptom of clear cell hidradenoma was epidermal bulgels in 18 cases.Contrast ultrasonography showed a subcutaneous cystic solid echo mass with abundant blood flow in the solid part. The tumor histologically consisted of two types of cells: secretory epithelial cells or glandular epithelial cells and clear cells. Twenty cases had tumors with the features of benign clear cell hidradenoma. Two cases had atypical clear cell hidradenoma with atypia and mitosis. One case had malignant clear cell hidradenoma. Tumor cells were positive for epithelial membrane antigen, cytokeratin 7, cytokeratin 14, carcinoembryonic antigen, and gross cystic disease fluid protein 15 and they were Periodic acid-Schiff-positive. Twenty-three patients were followed up for 2-36 months, of which 4 were lost to follow-up and the rest had no recurrence of clear cell hidradenoma.Conclusion:Clear cell hidradenoma is rare and has a good prognosis. Malignant clear cell hidradenoma is rarer and has a poor prognosis. Diagnosis of clear cell hidradenoma is mainly based on comprehensive analysis of pathological features and immunophenotypes. Clear cell hidradenoma should be differentiated from metastatic clear cell carcinoma, spiral adenoma, cortical adenoma, and malignant melanoma.

Objective To study the estimated value of general pituitary hormone levels and "overall levels of pituitary hormone" in patients with pituitary adenoma.Methods Sixty-six patients presented with non-function pituitary adenomas,admitted to our hospital from January 2009 and April 2013,were chosen in our study.Pre-and post-operative hormonal levels and MR imaging data were collected.Patients were divided into two groups:macroadenoma (1 cm＜diameter＜3 cm) group and huge adenoma (diameter＞3 cm) group,and the patients were divided into subtotal resection group (resection rate＞60％) and partial resection group (resection rate＜60％).Self-made scale of "overall levels of pituitary hormone" was performed to assess the remnant pituitary function.The levels for 6 kinds of pituitary hormones and "overall levels of pituitary hormone" were compared between each two groups.Results (1) The levels of 6 kinds of pituitary hormones between the macroadenoma group (n=38) and huge adenoma group (n=28) showed no significant difference before surgery (P＞0.05);the per-operative "overall levels of pituitary hormone" were statistically different between the macroadenoma group (19.59±2.71) and huge adenoma group (18.07±2.00,P＜0.055);there were 13 patients (34.2％) from macroadenoma group and 17 (60.7％) from huge adenoma group having one or more kinds of pituitary hormones lower than normal levels,with significant difference (P＜0.05).(2) The levels of 6 kinds of pituitary hormones between subtotal resection group (n=57) and partial resection group (n=9) showed no significant difference after surgery (P＞0.05);the post-operative "overall levels of pituitary hormone" in the subtotal resection group were significantly higher than those in the partial resection group (P＜0.05);there were 34 patients (59.6％) from subtotal resection group and 2 (22.2％) from partial resection group having one or more kinds of pituitary hormones lower than normal levels,without significant difference (P＜0.05).Conclusions The "overall levels of pituitary hormone",in which 6 kinds of pituitary hormones are seen as a whole,can assess the remnant pituitary function in pituitary adenoma patients more accurately than evaluation of the 6 kinds of pituitary hormone levels separately.

Objective:To systematically evaluate the efficacy and safety of controlled low central venous pressure (CLCVP) applied in patients undergoing hepatectomy.Methods:PubMed, Web of Science, Cochrane Library, CNKI, Wanfang, and VIP databases were searched from inception to October 1, 2022 for randomized controlled trials (RCTs) involving CLCVP in hepatectomy.All RCTs enrolled included CLCVP group and conventional operation group.The major evaluation indicators were intraoperative blood loss, operation duration and intraoperative blood transfusion.The secondary evaluation indicators were intraoperative monitoring indicators, postoperative liver and renal function, and complications at 1 day after operation.Meta-analysis was performed using the RevMan 5.3 software.Results:A total of 25 RCTs involving 1 816 patients were finally included.Compared with conventional operation group, the intraoperative blood loss was significantly reduced, the operation time was shorten, the rate of intraoperative blood transfusion was decreased, the amount of blood transfused was decreased ( P<0.01), and no significant change was found in intraoperative hemodynamic parameters and parameters of liver and renal function at 1 day after operation, and incidence of gas embolism, pleural effusion and bile leakage in CLCVP group ( P>0.05). Conclusions:CLCVP is safe and effective during hepatectomy.

Objective:To conduct a systematic evaluation of prognostic factors for retreatment of esophageal cancer patients with locoregional recurrence after radical chemoradiotherapy, and provide a clinical reference for selecting individualized retreatment schemes and improving their survival.Methods:A retrospective analysis was performed on the clinical data of 85 patients with esophageal cancer who experienced locoregional recurrence at least 1 year after radical radiotherapy or chemotherapy at the Department of Radiation Oncology in the Fourth Hospital of Hebei Medical University from January 2008 to December 2017. The effects of different nutritional and immune status and retreatment schemes on survival were compared, and the prognostic factors for retreatment were subjected to comprehensive subgroup analysis.Results:As of December 2021, the follow-up rate for all patients was 93%. The 1-, 2-, 3-, and 5-year overall survival rates of all patients after retreatment were 31.5%, 18.6%, 10.6%, and 6.6%, respectively. For patients who received radiotherapy or chemoradiotherapy, the 1-, 2-, 3-, and 5-year overall survival rates were 36.8%, 22.3%, 13.0% and 9.3%, respectively. Multivariable analysis showed that the time interval between the first treatment and recurrence, the retreatment schemes after recurrence, the level of serum albumin before retreatment, and the prognostic nutritional index before retreatment were independent prognostic factors for survival after retreatment ( P<0.05). Subgroup analysis was performed on the combinations of peripheral blood hemoglobin level, albumin level, and prognostic nutritional index before retreatment, as well as systemic immune inflammation index and short-term curative effect after retreatment. The results showed that the comprehensive analysis of blood routine and serum albumin indicators could accurately predict the survival after retreatment. Conclusions:The nutritional and immune status of patients with locoregional recurrence of esophageal cancer after chemoradiotherapy can be used to predict the prognosis of retreatment. The time interval between the first treatment and recurrence and the retreatment scheme significantly affect the survival after retreatment. The retreatment scheme should be rigorously evaluated and appropriately selected to improve the benefit-risk ratio.

β-elemene has been observed to exert inhibitory effects on a multitude of tumors,primarily through multiple pathways such as the inhibition of cancer cell proliferation and the induction of apoptosis.The present study is designed to elucidate the role and underlying mechanisms of β-elemene in the thera-peutic intervention of non-small cell lung cancer(NSCLC).Both in vitro and in vivo experimental models corroborate the inhibitory potency of β-elemene on NSCLCs.Our findings indicate that β-elemene fa-cilitates the maturation of miR-127-3p by inhibiting CBX8.Functioning as an upstream regulator of MAPK4,miR-127-3p deactivates the Akt/mTOR/p70S6K pathway by targeting MAPK4,thereby inducing autophagy in NSCLCs.Additionally,β-elemene augments the packaging of miR-127-3p into exosomes via SYNCRIP.Exosomal miR-127-3p further stimulates M1 polarization of macrophages by suppressing ZC3H4.Taken together,the detailed understanding of the mechanisms through which β-elemene in-duces autophagy in NSCLCs and facilitates M1 polarization of macrophages provides compelling scientific evidence supporting its potential utility in NSCLC treatment.

Objective:By establishing the reference intervals of free thyroxine (FT 4), thyroid stimulating hormone (TSH) and thyroid peroxidase antibody (TPOAb) of pregnant women in different pregnancy in Yangzhou, and analyzing the dynamic trends of each indicator, so as to provide a basis for timely and accurate diagnosis of thyroid disease during pregnancy, and promote prenatal and postnatal care. Methods:Clinical data of 3 726 healthy early (1 747 cases), middle (1 481 cases), and late (498 cases) pregnant women were collected from the Department of Perinatal and Health Care in Yangzhou Women and Children Hospital, the Affiliated Hospital of Yangzhou University Medical College from October 2017 to October 2018. At the same time, data of 407 non-pregnant women in the same period were collected as normal controls. The levels of serum FT 4, TSH and TPOAb in each stage of pregnancy were detected by Beckman automatic chemiluminescence analyzer. The reference interval was established by using the 95% reference value of the bilateral limit, and the differences of early, middle and late pregnancy were compared. Results:There were significant differences in FT 4 levels between early, middle and late stages of pregnancy ( H = 82.56, P < 0.01), with the early stage higher than the middle stage ( P < 0.01) and the middle stage higher than the late stage( P < 0.01). The difference of TSH levels was statistically significant ( H = 91.27, P < 0.01), in which the early stage was lower than the middle stage ( P < 0.01), and the middle stage was lower than the late stage ( P < 0.01). There was a statistically significant difference in TPOAb levels ( H = 30.36, P < 0.01). There was no significant difference between the early stage and the middle stage ( P > 0.05), and the early and middle stages were higher than the late stage ( P < 0.01). The reference intervals of thyroid function index in different pregnancies were, early pregnancy: FT 4 8.28 - 15.66 pmol/L, TSH 0.11 - 4.23 mU/L, TPOAb 0.10 - 16.46 U/ml; middle pregnancy: FT 4 7.38 - 14.36 pmol/L, TSH 0.13 - 4.67 mU/L, TPOAb 0.10 - 18.97 U/ml; and late pregnancy: FT 4 6.33 - 11.39 pmol/L, TSH 0.40 - 3.96 mU/L, TPOAb 0.10 - 6.17 U/ml. Conclusions:There are significant differences in serum thyroid function indicators in different pregnant women. Establishing reference intervals of thyroid function indicators in different stages of pregnancy have important clinical significance for diagnosis of thyroid disease and eugenics.