Objective:To investigate the clinicopathological features of Crooke cell tumor of adrenocorticotropic hormone differentiation specific transcription factor (TPIT, also known as transcription factor 19, TBX19) lineage neuroendocrine tumors.Methods:Six cases of Crooke cell tumor diagnosed at the First Affiliated Hospital of University of Science and Technology of China, Hefei, China from October 2019 to October 2023 were collected. The clinical and pathological features of these cases were analyzed.Results:Among the six cases, one was male and five were female, with ages ranging from 26 to 75 years, and an average age of 44 years. All tumors occurred within the sella turcica. Clinical presentations included visual impairment in two cases, menstrual disorders in one case, Cushing′s syndrome in one case, headache in one case, and one asymptomatic case discovered during a physical examination. Preoperative serum analyses revealed elevated levels of cortisol and adrenocorticotropic hormones in two cases, elevated cortisol in two cases, elevated adrenocorticotropic hormone in one case, and one case with a mild increase in prolactin due to the pituitary stalk effect. Magnetic resonance imaging revealed uneven enhancement of masses with maximum diameters ranging from 1.7 to 3.2 cm, all identified as macroadenomas. Microscopically, tumor cells exhibited irregular polygonal shapes, solid sheets, or pseudo-papillary arrangements around blood vessels. The cell nuclei were eccentric or centrally located, varying in size, with abundant cytoplasm. Some tumor cells showed perinuclear halo. Immunohistochemistry demonstrated diffuse strong positivity for TPIT in five cases, focal weak positivity for TPIT in one case, diffuse strong positivity for adrenocorticotropic hormone in all cases, and faint staining around the nuclei in a few cells. CK8/18 showed a strong positive ring pattern in more than 50% of tumor cells, focal weak positive expression of p53, and the Ki-67 positive index ranged 1%-5%. Periodic acid-Schiff staining revealed positive cytoplasm and negative perinuclear areas.Conclusions:Crooke cell tumor is a rare type of pituitary neuroendocrine tumors. Its pathological characteristics include a distinctive perinuclear clear zone and immunohistochemical markers, such as CK8/18 exhibiting a ring or halo pattern. This entity represents a high-risk subtype among pituitary neuroendocrine tumors, displaying a high risk of invasion and a propensity for recurrence. Accurate diagnosis is crucial for the postoperative follow-up and multimodal treatment planning.

OBJECTIVE: To analyze the clinical characteristics, prognosis and parallel clinical course of ovarian cancer (OC) and dermatomyositis (DM). METHODS: The medical records of 23 consecutive patients who were diagnosed with OC and DM and were treated at Peking Union Medical College Hospital (PUMCH) between 2002 and 2017 were reviewed. Propensity score matching method was used to match control group (OC patients without DM) at a ratio of 1:5. The correlation between OC and DM was measured using the Pearson correlation scatter plot and Pearson's r. Kaplan-Meier survival analysis and Cox proportional hazard regression analysis were performed to evaluate the prognostic factors. RESULTS: After matching, 23 patients who have the concurrence of OC and DM (DM group) and 115 patients diagnosed with OC alone (No DM group) were included. The 5-year overall survival rates (71.6% vs. 51.8%, p=0.020) and 5-year progression-free survival (30.5% vs. 0%, p=0.018) were poorer in DM group. Correlation between serum cancer antigen 125 (CA 125) and creatine kinase (CK) level was observed in 12 patients. The time between OC and DM diagnosis is significant through univariable analysis (p=0.021) but not in multivariable analysis in patients who have the concurrence of OC and DM. CONCLUSION: The concurrence of OC and DM as a paraneoplastic syndrome is rare and has a poor prognosis. The risk for patients diagnosed with DM is highest within 3 years before or after OC diagnosis. A correlation and a parallel clinical course exist between these 2 diseases.
Beijing ; Creatine Kinase ; Dermatomyositis ; Diagnosis ; Disease-Free Survival ; Humans ; Medical Records ; Methods ; Ovarian Neoplasms ; Paraneoplastic Syndromes ; Prognosis ; Propensity Score ; Survival Rate ; Treatment Outcome

Objective To discuss the significance of the diagnosis of hypothyroidism or subclinical hypothyroidism and evaluate the correlation of adverse pregnancy outcomes and the intervention effects of levothyroxine in early pregnancy .Methods 500 pregnant women who from April 2015 to April 2016 came to our hospital obstetrics do prenatal outpatient service were served as the objects in our study, at the same time, all the pregnant women received the five items of thyroid function screening.The statistically analyzed the results and followed up the pregnant women who with hypothyroidism and subclinical hypothyroidism to learn the treatment and adverse pregnancy outcomes, so as to evaluate the correlation and the intervention effects. Results In 500 cases of pregnant women,there were 6 cases of hyperthyroidism (1.2%),55 cases of hypothyroidism or subclinical hypothyroidism (11%),includeing four cases of hypothyroidism and 51 cases of subclinical hypothyroidism.The values of TSH,T3, T4,FT3 and FT4 in the group of hypothyroidism pregnant women were significant different to the normal control group (P<0.05), the values of TSH, T3, T4 and FT4 in the group of subclinical hypothyroidism pregnant women were significant different to the normal control group (P<0.05).Then the 25 cases of pregnant women with hypothyroidism or subclinical hypothyroidism received the treatment with levothyroxine, and the incidence rate of adverse pregnancy outcomes in treatment group was significantly lower than the untreated group ( P<0.05 ) .Conclusion The diagnosis of hypothyroidism or subclinical in early pregnancy and then treated with levothyroxine has important significant in decreasing the adverse pregnancy outcomes .

Objective To evaluate the bacteriostatic effect of recombinant human lactoferrin(rhLF) on Helicobacter(H .) py‐lori and its influence on CagA ,Ure and gastric mucosal IL‐8 .Methods The minimum inhibitory concentration(MIC)and the influ‐ence of different drug concentrations on the proliferation of H .pylori were detected .The effects of rhLF on the mRNA and protein expressions of CagA and Ure in H .pylori were detected by RT‐PCR and Western blot ,respectively .The animal study :Balb/c mice were adopted and assigned randomly into four groups ,including the standard triple+rhLF(group A) ,rhLF(group B) ,standard tri‐ple(group C) and normal saline(group D) .The histopathological HE staining was used to observe the gastric inflammation and ELISA was used to detect the IL‐8 level of gastric tissue in each group .Results MIC was 0 .5 mg/mL ,moreover rhLF inhibited the bacterial growth and proliferation with a concentration‐dependent manner .rhLF could reduce the expression of H .pylori major viru‐lence factor CagA ,mRNA and protein of Ure .Comparing the group A with the group B ,C and D ,the gastric mucosal inflammation score and the IL‐8 levels of gastric tissue homogenates had statistically significant differences(P<0 .05) .Conclusion rhLF inhibits the growth and proliferation of H .pylori ,moreover inhibit the expression of major virulence factor CagA in H .pylori ,mRNA and protein of Ure in different degrees ,weakens its pathogenicity ,meanwhile reduces the IL‐8 level in mice gastric mucosa ,and allevi‐ates H .pylori related gastric mucosal inflammatory response .

Objective To study the effects of enriched rehabilitative training on the expression of microtu-bule associated protein 2 (MAP-2) and synaptophysin (SYN), and to explore its relationship with brain plasticity. Methods Seventy-seven male Wistar rats weighing 160 to 200 g were randomly divided into an ischemia + enriched rehabilitation group (IE, n=36), an ischemia + standard rehabilitation group(IS, n=8), a sham ischemia + en-riched rehabilitation group (SE, n=21) and a sham ischemia + standard rehabilitation group (SS, n=12). Rats in the ischemia groups had their middle cerebral artery sutured for two hours before reperfusion, while those in the sham groups had a similar operation without occlusion. The enriched groups were given enriched rehabilitative train-ing, while the standard groups were left without any training. Behavioral tests, including the acrobatic performance, were administered once daily 2 days after operation, and SP staining of MAP2 and SYN were used to observe the func-tional recovery and brain plasticity changes among the groups at 1,7, 14, 21 and 28 days after the operations. Re-sults Acrobatic performance times reduced gradually. Bederson scores were significantly better in the IE than in the IS group by the 28th day after the operation). There was no significant difference between IE and IS groups in a foot fault test). The expression of MAP-2 and SYN around the infarct and in the hippocampus decreased significantly at first), then recovered gradually. The expression of MAP-2 and SYN in the IE group was significantly higher than that in the IS group at various time points of observation). Conclusion Enriched rehabilitative training can improve functional recovery and the expression of MAP-2 and SYN after brain ischemia, and the functional enhancement may attribute to the brain plasticity.

ObjectiveTo study the effect of enriched rehabilitative training on the functional recovery and neuronal dentritic growth following cerebral ischemia/reperfusion.Methods32 male Wistar rats,weighting 180～200 g,were randomly divided into a ischemic group(n=16) and a sham-operation group(n=16) after beforehand trainings.Rats were subjected to 2 h of right middle cerebral artery occlusion before reperfusion.After surgery,the ischemic group were randomly divided into a ischemia + enrichment(IE) group and a ischemia + standard housing(IS) group;the sham-operation group were randomly divided into a sham + enrichment(SE) group and a sham + standard housing(SS) group.After 24 h reperfusion,IE and SE groups were housed in enriched cages,and given enriched rehabilitative training according to the scheme.At the same time,IS and SS groups were housed in standard cages without any training.The functions of 4 groups were evaluated at 24 h,1 week,2 weeks,3 weeks and 4 week after operation.Dentritic growth of layer V pyramidal cells of the undamaged forelimb motor cortex was examined using Golgi-Cox procedure.ResultsIE group showed better function than IS group in all behavioral test.There was no significant difference in limb-placement test at 3 weeks(P>0.05) and in footfault test at 4 weeks(P>0.05) after operation between IE and SE group.The mean of basilar dentrite branching points in IE group was significantly greater than that of other groups(P<0.01).ConclusionEnriched rehabilitative training can promote functional recovery and enhance neural plasticity after cerebral ischemia/ reperfusion in rats.