Endonasal transsphenoidal sellar tumor resection in treating non-functioning pituitary adenomas with hyperprolactinemia: An analysis of efficacy / 第二军医大学学报

Objective To explore the therapeutic effect of endonasal transsphenoidal sellar tumor resection surgery for the treatment of non-functioning pituitary adenoma patients with hyperprolactinemia. Methods A total of 80 non-functioning pituitary adenoma patients with serum prolactin level ＞25 ng/mL and ＜200 ng/mL, who underwent endonasal transsphenoidal sellar tumor resection surgery in the Department of Neurosurgery of our hospital from Jan. 1, 2015 to Dec. 31, 2019, were retrospectively included. The clinical characteristics, surgical methods, postoperative complications, and the relief of postoperative hyperprolactinemia and clinical symptoms were analyzed. The predictive factors of postoperative hyperprolactinemia remission were analyzed using logistic regression. Results Out of the 80 patients, 21 were males and 59 were females. The preoperative prolactin level was 51.11 (25.20-136.52) ng/mL, and the tumor volume was 3.99 (0.23-37.11) cm3. Headache was the most common initial symptom (37.5%, 30/80). There was significant difference in the initial symptoms between the male and female patients (P＝0.031), and the female patients were more likely to present with hypogonadotropic hypogonadism compared with the male patients (28.8%［17/59］vs 9.5%［2/21］). The male patients were significantly more likely to have two or more hormonal axis dysfunctions (47.6%［10/21］vs 15.3%［9/59］, P＝0.025). All the 80 patients received the resection surgery and 88.8% (71/80) of them achieved gross or near total resection. Sixty-five (81.2%) patients had remission of hyperprolactinemia within 3 months after surgery, and the prolactin level was 13.44 (1.74-24.19) ng/mL 3 months after surgery; 15 patients had no remission, and the corresponding prolactin level was 32.69 (25.20-115.23) ng/mL. The prolactin levels before and 1 d after surgery were significantly lower in the remission group than those in the non-remission group (preoperative: 45.47 ［25.20-136.52］ng/mL vs 64.82［33.17-130.88］ng/mL, P＝0.003; postoperative day 1: 13.12［0.60-36.35］ng/mL vs 40.06 ［26.25-118.01］ng/mL, P＜0.01). There were no significant differences in gender, age, tumor volume, surgical methods or extent of tumor resection between the two groups (all P＞0.05). Multivariate logistic regression analysis showed that prolactin level ≤25 ng/mL on postoperative day 1 was an independent predictor of remission of hyperprolactinemia (odds ratio 13.500, 95% confidence interval 3.623-50.298, P＜0.01). The visual defect and headache improvement rates were 87.9% (29/33) and 93.9% (31/33), respectively. Among the 17 female patients with menstrual disorders before surgery, 14 (82.4%) returned to normal menstrual cycles. Conclusion Endonasal transsphenoidal sellar tumor resection surgery is a reliable treatment option for non-functioning pituitary adenoma patients with hyperprolactinemia.

Blood pressure lowering efficacy of telmisartan and amlodipine taking on the morning or at bedtime: ABPM results / 中华心血管病杂志

<p><b>OBJECTIVE</b>To observe the blood lowering effect of telmisartan and amlodipine taking on the morning or at bedtime in hypertensive patients.</p><p><b>METHODS</b>A total of 108 individuals with hypertension (grade 2 or above) were randomized to receive telmisartan and amlodipine in one of the following four therapeutic schemes: Group A (26 cases): both medications taken on the morning; Group B (28 cases): both medication taken at bedtime; Group C (27 cases): telmisartan on the morning and amlodipine at bedtime; or Group D (27 cases): amlodipine on the morning and telmisartan at bedtime. ABPM was performed before and after 8 weeks treatment.</p><p><b>RESULTS</b>BP was significantly reduced in 4 groups and the value of 24 hours SBP/DBP decline for each group after treatment was 29.94/16.32, 31.37/18.35, 29.49/17.30 and 25.80/15.51 mm Hg (1 mm Hg = 0.133 kPa) respectively (P < 0.05 vs. baseline). SI (smooth index) of 24 hours SBP/DBP was 1.79/1.34, 2.07/1.54, 1.70/1.43 and 1.55/1.32 respectively (P > 0.05). The night-time BP decline and the distributive difference of dipper, non-dipper, extreme dipper and reverse dipper pattern were similar among groups at both baseline and after various treatment regimens (all P > 0.05) . Morning blood pressure surge (MBPS) after treatment in group B declined more significantly than other groups (P < 0.05).</p><p><b>CONCLUSION</b>Telmisartan/amlodipine administered either on the morning or at bedtime can effectively reduce blood pressure. The efficacy of BP lowering is independent of the drug taking time. There is a trend both in better BP lowering and less BP variability when two medications are administered at bedtime.</p>

Experimental study on therapeutic efficacy of tetrandrine on lung injury induced by acute of paraquat poisoning / 中华劳动卫生职业病杂志

<p><b>OBJECTIVE</b>To investigate the antagonistic efficacy of tetrandrine (TET) on lung injury induced by acute paraquat poisoning.</p><p><b>METHODS</b>Male Wistar rats were randomly divided into three groups (control group, non-treatment group and treatment group). The tetrandrine of 30 mg/kg was given by gastric lavage six hours after 32 rats were intraperitoneally injected with paraquat 15 mg/kg (treatment group). Then the same dose of tetrandrine was given once a day. Normal saline of the same volume was given by gastric lavage in another 32 rats intraperitoneally injected with paraquat 15 mg/kg (non-treatment group). Seven rats were intraperitoneally injected by normal saline as the control group. Levels of maleic dialdehyde (MDA), activities of superoxide dismutase (SOD) and glutathione peroxidase (GSH-Px) in plasma and the lung homogenate of three groups were determined at 3 d, 7 d, 14 d and 21 d after exposure to paraquat. Histological changes of the lungs were observed.</p><p><b>RESULTS</b>The levels of MDA at 3 d both in plasma [(3.65 +/- 0.44) nmol/ml] and the lung homogenate [(9.54 +/- 0.92) nmol/mg pro] of the non-treatment group significantly increased compared with the control group (P < 0.01), the activities of GSH-Px and SOD in plasma at 3 d were significantly less than the control group (P < 0.05 or P < 0.01), the activities of GSH-Px (3 d, 7 d) and SOD (7 d, 14 d) in the lung homogenate were significantly less than the control group (P < 0.05). There were no significant difference in the levels of MDA both in plasma and the lung homogenate between the treatment group and the non-treatment group (P > 0.05). The SOD activities of treatment group on the third day was significantly increased compared with the non-treatment group (P < 0.01 or P < 0.05). Although the activities of GSH-Px in plasma and the lung homogenate of the treatment group on the third day were increased, there was no significantly difference compared with the non-treatment group (P > 0.05). The integral score of pulmonary fibrosis in the treatment group were significantly lower than in the non-treatment group (P < 0.01).</p><p><b>CONCLUSION</b>TET has antagonistic effect against acute toxicity of paraquat through significant reduction of pulmonary fibrosis.</p>

Therapeutic efficacy of pralidoxime chloride on acute dichlorvos poisoning / 中华劳动卫生职业病杂志

<p><b>OBJECTIVE</b>To study the therapeutic efficacy and mechanism of oxime drug, pralidoxime chloride (PAM-Cl), on acute dichlorvos (DDV) poisoning.</p><p><b>METHODS</b>The toxic signs and survival rate were recorded and ChE activity in blood was determined in treatment group with PAM-Cl and non-treatment group after DDV was given to rats and mice by gastrogavage; the therapeutic efficacy and reactivation of DDV-inhibited ChE by PAM-Cl were observed on the patients with acute DDV poisoning.</p><p><b>RESULTS</b>(1) The alleviated and delayed toxic signs as well as higher survival rate were found in PAM-Cl treatment group compared with non-treatment group. (2) After the rats were exposed to DDV, the ChE activities of whole blood in different time within 24 h were statistically significantly higher in PAM-Cl treatment group than in non-treatment group (P < 0.05). (3) After PAM-Cl treatment, muscular fasciculation and other nicotinic signs in poisoned patients were disappeared and the inhibited blood ChE activities were gradually reactivated to normal level.</p><p><b>CONCLUSION</b>PAM-Cl has therapeutic efficacy against acute toxicity of DDV through its reactivation of inhibited ChE.</p>

Therapeutic efficacy of N6-cyclopentyladenosine against acute dichlorvos poisoning / 中华劳动卫生职业病杂志

<p><b>OBJECTIVE</b>To study the therapeutic efficacy and mechanism of adenosine receptor agonist N(6)-cyclopentyladenosine (CPA) against acute dichlorvos poisoning.</p><p><b>METHODS</b>Soon after a certain doses of dichlorvos were given to mice and rats by gastrogavage, physiological saline, CPA, atropine or pralidoxime chloride were administered to different groups. Toxic signs and survival rate were recorded and cholinesterase (ChE) activities and acetylcholine (ACh) concentrations in whole blood were determined in treatment group with CPA and non-treatment group after dichlorvos was given to rats by gastrogavage.</p><p><b>RESULTS</b>(1) The alleviated and delayed appearance of toxic signs as well as obvious prolongation of survival time was observed in CPA treatment group compared with non-treatment group. (2) ChE activities in both treatment group with CPA [(0.49 +/- 0.05) U/ml] and non-treatment group [(0.52 +/- 0.04) U/ml] were significantly lower than that [(1.56 +/- 0.15) U/ml] of the control group (P < 0.01), but there was no significant difference between treatment group and non-treatment group (P > 0.05). (3) ACh concentration [(204.24 +/- 20.48) microg/ml] in whole blood of treatment group with CPA was significantly lower than that [(230.91 +/- 25.61) microg/ml] of non-treatment group (P < 0.05).</p><p><b>CONCLUSION</b>CPA has therapeutic efficacy against acute dichlorvos poisoning, which is probably through the decrease in ACh concentration.</p>

Follow-up study on psychic and neuropathic delayed effects of acute organophosphorus pesticides poisoning / 中华劳动卫生职业病杂志

<p><b>OBJECTIVE</b>To study the delayed effect on neuropsychopathy and its related factors after acute organophosphorus pesticides poisoning (AOPP).</p><p><b>METHODS</b>Two hundred and fifty-seven cases of AOPP in the observation period were chosen to follow-up 2 months later from the 4 county hospitals in Shandong Province where the incidence of organophosphorus pesticide poisoning is high.</p><p><b>RESULTS</b>Nine cases of organophosphate induced delayed polyneuropathy (OPIDP) were found and the incidence rate was 3.5%. The occurrence of OPIDP were related to the need for emergent artificial respiration, and the degree of poisoning, and the kinds of organophosphorus pesticides (Ops). The positive rate of symptoms of peripheral nerves, central nerves and psychogeny except auditory and visual hallucination after poisoning was significantly higher than that before (P < 0.05). The patient's situation of health, economy and work became statistically worse (P < 0.05).</p><p><b>CONCLUSION</b>We found some had delayed effects on neuropsychopathy after AOPP which could debase the patient's life quality. The control measure should be administered as early as possible.</p>