OBJECTIVE To systematically evaluate the efficacy of dydrogesterone combined with estradiol valerate for the prevention of intrauterine adhesion （IUA） and prognosis improvement after induced abortion. METHODS Retrieved from CNKI， Wanfang Data， VIP， CBM， PubMed， Embase and the Cochrane Library， randomized controlled trial （RCT） about conventional treatment combined with dydrogesterone and estradiol valerate （trial group） versus conventional treatment （control group） for the prevention of IUA in patients after induced abortion were collected from the inception to Dec. 2024. After screening the literature， extracting data and evaluating the quality of literature， meta-analysis was performed using RevMan 5.4 software. RESULTS A total of 12 RCTs were included， involving 1 109 patients. Meta-analysis showed that the postoperative incidence of IUA [RR＝0.30， 95%CI （0.22， 0.41）， P＜0.000 01]， postoperative vaginal bleeding time [MD＝－1.69， 95%CI （－2.05， －1.32）， P＜0.000 01]， postoperative vaginal bleeding volume [MD＝－10.78， 95%CI （－12.19， －9.37）， P＜0.000 01]， postoperative menstrual resumption time [MD＝－6.99， 95%CI （－8.27， －5.71）， P＜0.000 01]， and the incidence of postoperative reduced menstrual flow [RR＝0.25， 95%CI （0.12， 0.56）， P＝0.000 7] were significantly lower， less or shorter than control group； postoperative endometrial thickness [MD＝ 1.90， 95%CI （1.68， 2.13）， P＜0.000 01] and the rate of postoperative re-pregnancy [RR＝6.26， 95%CI （1.88， 20.83）， P＝0.003] were significantly higher than control group. CONCLUSIONS Dydrogesterone combined with estradiol valerate may reduce the incidence of IUA after induced abortion patients， decrease postoperative vaginal bleeding volume， shorten postoperative vaginal bleeding time and postoperative menstrual resumption time， and increase postoperative endometrial thickness.

Acromegaly is a rare disease characterized by the overproduction of growth hormone(GH)and insulin-like growth factor-1(IGF-1), which affects multiple organ systems and increases mortality risk.As the population ages, the number of elderly patients with acromegaly is rising annually, leading to more pronounced systemic complications and significantly impacting quality of life(QoL). However, there is limited data in the literature regarding the assessment of acromegaly complications in the elderly.Therefore, to enhance our understanding of acromegaly in this demographic, the present review focuses on the epidemiology, diagnosis, complication assessment, and therapeutic prognosis of acromegaly in elderly patients.

Acromegaly is a rare disease characterized by the overproduction of growth hormone(GH)and insulin-like growth factor-1(IGF-1), which affects multiple organ systems and increases mortality risk.As the population ages, the number of elderly patients with acromegaly is rising annually, leading to more pronounced systemic complications and significantly impacting quality of life(QoL). However, there is limited data in the literature regarding the assessment of acromegaly complications in the elderly.Therefore, to enhance our understanding of acromegaly in this demographic, the present review focuses on the epidemiology, diagnosis, complication assessment, and therapeutic prognosis of acromegaly in elderly patients.

Multiple endocrine neoplasia(MEN) is a rare autosomal dominant genetic disorder characterized by hyperplasia or tumor development in two or more endocrine glands. Currently, MEN is classified into four subtypes: MEN1, MEN2, MEN3, and MEN4. Among these, MEN4 is caused by mutations in the CDKN1B gene and presents clinical manifestations similar to MEN1, though the age of onset and disease progression differ. Due to its rarity, this article reviews the pathogenesis and treatment strategies for MEN4, aiming to provide valuable insights for its diagnosis and management.

Cushing syndrome(CS)is an endocrine-metabolic disorder characterized by hypercortisolism.Elevated cortisol levels can induce a hypercoagulable state,increasing the risk of venous thromboembolism(VTE).Both pituitary-origin Cushing disease(CD)and adrenal-origin non-adrenocorticotropic hormone(ACTH)-dependent CS are primarily treated with surgery.The dual impact of surgery and the underlying disease further elevates the risk of VTE,potentially leading to pulmonary embolism,which poses a severe threat to patient survival.Additionally,CS patients in a hypercoagulable state have a higher incidence of cardiovascular diseases and VTE,and even mortality compared with the general population.Untreated active CS patients have a 17.8-fold increased risk of VTE compared to the general population.In recent years,the relationship between the hypercoagulable state in CS and VTE has garnered increasing attention from clinicians.A better understanding of the clinical epidemiological characteristics,pathophysiological mechanisms,and clinical prevention and treatment of VTE and pulmonary embolism in CS can provide valuable references for the standardized use of prophylactic anticoagulant therapy in CS patients.

Marfan syndrome(MFS)is an autosomal dominant disorder that is prone to fibrodysplasia,lens dislocation and rapid height growth,which needs to be distinguished from gigantism.This article reports a 14-year-old patient with MFS who had a typical binocular lens subluxation in both eyes,with visual impairment and rapid height growth.MRI with contrast to the pituitary suggested a pituitary microadenoma,but growth hor-mone and insulin-like growth factor 1 were in the normal range,thus excluding gigantism or acromegaly.Non-functional pituitary adenoma was considered.MFS patients need long-term follow-up and multidisciplinary col-laboration,and attention should be paid to cardiovascular system monitoring and genetic testing,which can be helpful for the diagnosis and treatment of patients and risk prevention and control.

Multiple endocrine neoplasia(MEN) is a rare autosomal dominant genetic disorder characterized by hyperplasia or tumor development in two or more endocrine glands. Currently, MEN is classified into four subtypes: MEN1, MEN2, MEN3, and MEN4. Among these, MEN4 is caused by mutations in the CDKN1B gene and presents clinical manifestations similar to MEN1, though the age of onset and disease progression differ. Due to its rarity, this article reviews the pathogenesis and treatment strategies for MEN4, aiming to provide valuable insights for its diagnosis and management.

Cholesterol metabolism is vital for the progression of prostate cancer (PCa), especially in the occurrence and development. Statins can affect the progression of PCa by reducing cholesterol. This paper will review how cholesterol metabolism affects the progression of PCa.

Objective:To improve the understanding of chronic lymphoblastic leukemia (CLL) with t(14;18)(q32;q21).Methods:The clinical data of 3 cases diagnosed as CLL with t(14;18)(q32;q21) in the Tianjin KingMed Medical Laboratory from January 2020 to January 2021 were retrospectively analyzed. The clinicopathological data, morphological examination, immunophenotype, cytogenetics and somatic mutation of immunoglobulin heavy chain variable region genes of patients were comprehensively analyzed, and the literature was reviewed.Results:All the 3 patients showed lymphatic proliferative diseases, and their morphological characteristics and immunophenotype were typical characteristics of CLL.Conclusions:The diagnosis of CLL is mainly based on the typical morphology and immunophenotype of tumor cells. The presence of t(14;18) should not be used to exclude the diagnosis of CLL.

Objective:To explore the correlation between thyroid hormone content and treatment outcome in patients with biphasic disorder (BPD) and depressive disorder (DPD) before and after treatment.Methods:From June 2017 to June 2019, 72 patients with BPD(BPD group), 46 patients with DPD(DPD group) who met the diagnostic criteria of International Statistics and Classification of Disease and Health problems-10th Edition (ICD-10) in the Third People′s Hospital of Jiangmen, and 20 normal controls(control group) in our Hospital were enrolled in this study.The serum concentrations of total thyroxine (TT 4), total triiodothyronine (TT 3) and high sensitivity thyrotropin (HS-TSH) were measured at baseline, and the above hormone concentrations were measured in the study group after treatment for 12 weeks.The 17 Hamilton depression scale (HAMD-17) and Hamilton anxiety scale (HAMA), Bech-Rafaesdn Mania Rating Scale(BRMS) were used to evaluate the severity of symptoms at baseline and at the end of treatment.The curative effect was compared between the two groups, and the correlation between the curative effect (score reduction rate) and thyroid hormone level (concentration change) was observed. Results:At baseline, the concentrations of TT 4, TT 3 of patients with depressive phase in BPD group[(54.75±12.26)nmol/L, (86.26±15.29)nmol/L] were lower than those in the control group[(145.64±12.15)nmol/L, (156.78±36.54)nmol/L], and the TSH level in BPD group[(68.97±5.98)mIU/L]was higher than that in the control group[(45.59±9.28)mIU/L]; the levels of TT 4, TT 3 of patients with manic and mixed phase in BPD group[(166.75±12.25)nmol/L, (186.36±35.15)nmol/L] were higher than those in the control group, and the level of TSH in BPD group[(7.87±3.56)mIU/L] was lower than that in the control group; the concentrations of TT 4, TT 3 in DPD group[(65.59±23.11)nmol/L, (92.21±19.36)nmol/L] were lower than those in the control group, and the TSH level in DPD group[(69.38±14.75)mIU/L] was higher than that in the control group, the differences were ststistically significant ( t=5.867, 4.657, 2.369, 2.789, 3.247, 6.356, 4.358, 3.265, 2.365, all P<0.05). After treatment for 12 weeks, there were no statistically significant differences in TT 3, TT 4, HS-TSH concentrations among the three groups (all P>0.05). After treatment for 12 weeks, the scores of HAMa+ d, BRMS in BPD group and DPD group were significantly lower than those at baseline ( t=8.854, 12.321, 6.756, all P<0.05). The score of HAMa+ d was negatively correlated with TT 4, TT 3 concentrations, and positively correlated with HS-TSH concentration.The score of BRMS was positively correlated with TT 4, TT 3 concentrations, and negatively correlated with HS-TSH concentration. Conclusion:The level of thyroid hormone in patients with biphasic disorder and depressive disorder is different from that in normal subjects, and the level of thyroid hormone is closely related to the curative effect.