Objective To summarize the clinical features of pituitary carcinoma and discuss the diagnosis,treatment and prognosis.Methods Clinical manifestations,imaging,pathologic features of one case of pituitary carcinoma were analyzed and literatures about diagnosis,treatment and prognosis of pituitary carcinoma were reviewed.Results The patient manifested polyuria onset,headache and anterior pituitary dysfunction and MRI showed pituitary lesions.He had been undergone two transsphenoidal surgery in our hospital,pathologic examinations were respectively non-functioning adenomas and atypical pituitary adenoma and tumor proliferation index (Ki-67) both were more than 30％.He was recommended radiation therapy but refused.Five months later,he was diagnosed as primary pituitary gland cancer due to the tumor widespread intracranial metastasis and no other malignant lesions in body.Conclusions Primary pituitary carcinoma is a very rare tumor,mostly transformed from the invasive pituitary adenoma.It helps predict tumor proliferation and prognosis to test the level of Ki-67 index.Primary pituitary adenocarcinoma needs comprehensive treatment and the prognosis is related to the treatment response.

Objective: To uncover the underlying mechanisms of action of the Yinlai decoction on high-calorie diet-induced pneumonia through proteomics analysis. Methods: Based on the Gene Expression Omnibus (GEO) database, lung tissue samples from normal and high-fat diet (HFD) fed mice in the GSE16377 dataset were selected as test cohorts to identify differentially expressed genes and conduct bioinformatics analyses. In the animal experiments, mice were randomly divided into the control (N), high-calorie diet pneumonia (M), and Yinlai decoction treatment (Y) groups. Mice in the M group received high-calorie feed and a 0.5 mg/mL lipopolysaccharide solution spray for 30 min for 3 d. The mice in the Y group were intragastrically administered 2 mL/10 g Yinlai decoction twice daily for 3 d. Pathological evaluation of the lung tissue was performed. Differentially expressed proteins (DEPs) in the lung tissue were identified using quantitative proteomics and bioinformatics analyses. The drug-target relationships between Yinlai decoction and core DEPs in the lung tissue were verified using AutoDock Vina and Molecular Graphics Laboratory (MGL) Tools. DEPs were verified by western blot. Results: GEO data mining showed that an HFD altered oxidative phosphorylation in mouse lung tissue. The Yinlai decoction alleviated pathological damage to lung tissue and pneumonia in mice that were fed a high-calorie diet. A total of 47 DEPs were identified between the Y and M groups. Enrichment analysis revealed their association with energy metabolism pathways such as the tricarboxylic acid cycle (TCA) and oxidative phosphorylation. The protein-protein interaction network revealed that Atp5a1, Pdha1, and Sdha were the target proteins mediating the therapeutic effects of Yinlai decoction. Molecular docking results suggested that the mechanism of the therapeutic effect of Yinlai decoction involves the binding of brassinolide, praeruptorin B, chrysoeriol, and other components in Yinlai decoction to Atp5a1. Conclusion The Yinlai decoction alleviated lung tissue damage and pneumonia in mice that were fed a high-calorie diet by regulating the TCA and oxidative phosphorylation. Our study highlights the importance of a healthy diet for patients with pneumonia and provides a scientific basis for the prevention and treatment of pneumonia through dietary adjustments.

Pituitary adenoma is one common type of intracranial tumors, accounting for about 10% of intracranial tumors. Although pituitary adenomas are benign tumors, the complete resection and recurrence prevention remain challengeable due to aggressive growth of tumor, limited equipment conditions and surgical techniques of the surgeon. The proportion of recurrent pituitary adenomas is rising year by year and the difficulty of treatment also increases. This article reviews the diagnosis and treatment of recurrent pituitary adenomas based on the summary data of invasive or recurrent pituitary adenomas cases in our center, including indication for the second transsphenoidal surgery, surgical techniques, and prevention and treatment of postoperative complications, to provide reference for clinicians in this field.

Objective:To explore the structural and functional characteristics of microbiota in oropharynx of sub-healthy children with gastrointestinal heat retention syndrome(GHRS)differentiated by traditional Chinese medicine,and screen the biometric operational taxonomic units(OTUs)to assist the clinical diagnosis.Methods:We recruited children according to the"GHRS diagnostic scale",collected their oropharyngeal swabs,and sequenced the 16S rDNA V4 region.We described the bacterial structure with alpha-indexes,beta-distances,and relative abundances;moreover,we screened the differential genera/OTUs with Wilcoxon rank-sum test,MetagenomeSeq analysis,and linear discriminant analysis effect size(LEfSe)analysis,in which biometric OTUs were selected to construct the receiver operating characteristic curve to verify the diagnostic value.The bacterial function was predicted with Kyoto Encyclopedia of Genes and Genomes pathways according to 16S rDNA gene by using Phylogenetic Investigation of Communities by Reconstruction of Unobserved States.Results:The study population was composed of 10 children with GHRS and 10 healthy control children.GHRS children were more likely to overeat(gluttony,P=.033).Alpha-indexes,such as Sobs,abundance-based coverage estimator,Bootstrap,and Qstat,were significantly higher in the GHRS group,while beta-distances did not exhibit any significant intergroup differences.There were 9 differently distributed non-predominant genera between the groups in Wilcoxon rank-sum test,as well as 13 non-predominant genera in MetagenomeSeq analysis and 3 non-predominant OTUs in LEfSe analysis.OTU44 and OTU196 were used to construct the receiver operating characteristic curve,and the area under curve was 0.92.Predicted functions showed that pathways related to oxidative phosphorylation and carbon metabolism were enriched in healthy control samples,while the pathway related to renin secretion was remarkably enriched in GHRS samples.Conclusion:Unique oropharyngeal microbial structure and function were identified in GHRS children.OTU44 and OTU196 were specific OTUs,which could be used as biomarkers of GHRS to assist clinical diagnosis.

Objective To explore the molecular mechanism of programmed cell death 10(PDCD10)mediating glioma migration.Methods A PDCD10-silenced glioma cell line(U251)was constructed by siRNA,and the cells were treated with Okadaic Acid(OA),a protein phosphatase 2A(PP2A)phosphatase inhibitor,to investigate the effect of down-regulation of PDCD10 on the behavior of U251 cells;Western Blot(WB)was applied to detect the expression of PDCD10,PP2A,PP2Ac-307,p38 and pP38 in the control group and PDCD10 down-regulation group of U251 cells,to study the mechanism of PDCD10 regulation of PP2A/p38 signaling.Results Down-regulation of PDCD10 in U251 cells promoted the cells migration(P＜0.05),which could be inhibited by PP2A phosphatase inhibitor OA(P＜0.01).Further studies showed that down-regulation of PDCD10 promoted glioma cell migration via modulating the phosphorylation of PP2A,which in turn altered the activity of p38(P＜0.01).Conclusion PDCD10 may mediate glioma cell migration by regulating PP2A/p38 signaling.

Objective To investigate the clinical efficacy and postoperative complications of surgical treatment for middle-aged and severe elderly patients with traumatic intracranial hematoma.Methods A retrospective analysis was conducted on the clinical data,efficacy,and postoperative complications of 80 elderly patients with traumatic intracranial hematoma who underwent surgical treatment at the Neurosurgery Department of Jianli People's Hospital from January 2021 to November 2023.The Glasgow Outcome Scale was used to evaluate their clinical prognosis,and they were divided into a good prognosis group and a poor prognosis group based on their scores.Univariate analysis and multivariate logistic regression analysis were used to analyze the influencing factors related to poor prognosis,and compared with the expected prognosis calculated by the International Clinical Trial Study on Brain Injury Prognosis(IMPACT)model to evaluate the therapeutic effect of the surgery.Results Among 80 patients aged 60 and above who underwent surgery for moderate to severe traumatic intracranial hematoma,46(57.5％)had a good prognosis after 6 months of follow-up,34(42.5％)had a poor prognosis,and 13(16.25％)died.The expected poor prognosis rate was calculated to be 63.8％by using the IMPACT experimental core model,and the expected mortality rate was 46.6％.The actual prognosis was better than the expected one.The difference between the actual and expected prognosis and the actual and expected mortality was statistically significant(P＜0.05).Univariate analysis suggests that patient's pupil response,preoperative GCS score,hematoma location,cisternaambiens status,midline displacement,and hematoma size are correlated with patient prognosis.Multivariate analysis suggests that the status of the cisternaambiens is an independent risk factor for poor prognosis in elderly patients with moderate to severe traumatic brain injury.Conclusion Elderly patients with traumatic intracranial hematoma who have surgical indications should be treated with surgery,and the results of aggressive treatment are good.The failure to correct intracranial hypertension in postoperative patients is the main cause of death.

Background::Risk assessment and treatment stratification for three-vessel coronary disease (TVD) remain challenging. This study aimed to investigate the prognostic value of left atrial volume index (LAVI) with the Synergy Between Percutaneous Coronary Intervention with Taxus and Cardiac Surgery (SYNTAX) score II, and its association with the long-term prognosis after three strategies (percutaneous coronary intervention [PCI], coronary artery bypass grafting [CABG], and medical therapy [MT]) in patients with TVD.Methods::This study was a post hoc analysis of a large, prospective cohort of patients with TVD in China, that aimed to determine the long-term outcomes after PCI, CABG, or optimal MT alone. A total of 8943 patients with TVD were consecutively enrolled between 2004 and 2011 at Fuwai Hospital. A total of 7818 patients with available baseline LAVI data were included in the study. Baseline, procedural, and follow-up data were collected. The primary endpoint was major adverse cardiac and cerebrovascular events (MACCE), which was a composite of all-cause death, myocardial infarction (MI), and stroke. Secondary endpoints included all-cause death, cardiac death, MI, revascularization, and stroke. Long-term outcomes were evaluated among LAVI quartile groups. Results::During a median follow-up of 6.6 years, a higher LAVI was strongly associated with increased risk of MACCE (Q3: hazard ratio [HR] 1.20, 95% confidence interval [CI] 1.06-1.37, P = 0.005; Q4: HR 1.85, 95%CI 1.64-2.09, P <0.001), all-cause death (Q3: HR 1.41, 95% CI 1.17-1.69, P <0.001; Q4: HR 2.54, 95%CI 2.16-3.00, P <0.001), and cardiac death (Q3: HR 1.81, 95% CI 1.39-2.37, P <0.001; Q4: HR 3.47, 95%CI 2.71-4.43, P <0.001). Moreover, LAVI significantly improved discrimination and reclassification of the SYNTAX score II. Notably, there was a significant interaction between LAVI quartiles and treatment strategies for MACCE. CABG was associated with lower risk of MACCE than MT alone, regardless of LAVI quartiles. Among patients in the fourth quartile, PCI was associated with significantly increased risk of cardiac death compared with CABG (HR: 5.25, 95% CI: 1.97-14.03, P = 0.001). Conclusions::LAVI is a potential index for risk stratification and therapeutic decision-making in patients with three-vessel coronary disease. CABG is associated with improved long-term outcomes compared with MT alone, regardless of LAVI quartiles. When LAVI is severely elevated, PCI is associated with higher risk of cardiac death than CABG.