Thyrotropin-secreting adenoma in multiple endocrine neoplasia type 1: one case report and literature review / 中华内分泌代谢杂志

Objective:To improve the understanding of thyrotropin-secreting adenoma in multiple endocrine neoplasia type 1(MEN1) through analyzing the clinical diagnosis and treatment process, as well as outcomes in one case of this disorder.Methods:The clinical manifestations, biochemical and hormone levels, imaging presentations, medical and surgical treatments, and post-operational pathologic findings in the process of diagnosis and treatment of a patient with thyrotropin-secreting adenoma in MEN1 were analyzed. The next generation sequencing followed by Sanger method was used for analyzing MEN1 and related genes. The results were evaluated with online PolyPhen2 and PROVEAN for variation hazard.Results:One 19-year old male patient was diagnosed with hyperthyroidism due to thyrotoxicosis and high level of thyroid hormones(THs) with measurable TSH(2.78 mIU/L) and negative thyrotropin receptor antibody(TRAb). Meanwhile, primary hyperparathyroidism was suggested by hypercalcemia, hypophosphatemia, and elevated intact parathyroid hormone(PTH) level, all the parameters were returned to normal after surgical resection of the mass which was below the left thyroid lobe indicated by ultrasound and 99mTc scan. Thyrotoxicosis remained in spite of one year treatment with antithyroid drug, thyrotropinoma was then suspected, and subsequent MRI scan found a macroadenoma at right pituitary. TSH and THs returned to normal 1 month after transsphenoidal removal of the adenoma. As expected, immunohistochemical staining revealed TSH positive. In addition, a pancreatic mass was found by both CT and MRI scan, which was considered as a silent neuroendocrine tumor. Gene analysis revealed a missense mutation of MEN1 as c. 415C>T and p. His139Tyr(H139Y), which was predicted highly hazard. Only five cases of thyrotropinoma in MEN1 were previously reported. Conclusion:Thyrotropinoma should be cautiously identified from hyperthyroidism to avoid misdiagnosis and mistreatment, and it should keep in mind that thyrotropinoma may be associated with MEN1 though it would be very rare.

Thyrotropin-secreting adenoma in multiple endocrine neoplasia type 1: one case report and literature review / 中华内分泌代谢杂志

Objective@#To improve the understanding of thyrotropin-secreting adenoma in multiple endocrine neoplasia type 1(MEN1) through analyzing the clinical diagnosis and treatment process, as well as outcomes in one case of this disorder.@*Methods@#The clinical manifestations, biochemical and hormone levels, imaging presentations, medical and surgical treatments, and post-operational pathologic findings in the process of diagnosis and treatment of a patient with thyrotropin-secreting adenoma in MEN1 were analyzed. The next generation sequencing followed by Sanger method was used for analyzing MEN1 and related genes. The results were evaluated with online PolyPhen2 and PROVEAN for variation hazard.@*Results@#One 19-year old male patient was diagnosed with hyperthyroidism due to thyrotoxicosis and high level of thyroid hormones(THs) with measurable TSH(2.78 mIU/L) and negative thyrotropin receptor antibody(TRAb). Meanwhile, primary hyperparathyroidism was suggested by hypercalcemia, hypophosphatemia, and elevated intact parathyroid hormone(PTH) level, all the parameters were returned to normal after surgical resection of the mass which was below the left thyroid lobe indicated by ultrasound and 99mTc scan. Thyrotoxicosis remained in spite of one year treatment with antithyroid drug, thyrotropinoma was then suspected, and subsequent MRI scan found a macroadenoma at right pituitary. TSH and THs returned to normal 1 month after transsphenoidal removal of the adenoma. As expected, immunohistochemical staining revealed TSH positive. In addition, a pancreatic mass was found by both CT and MRI scan, which was considered as a silent neuroendocrine tumor. Gene analysis revealed a missense mutation of MEN1 as c. 415C>T and p. His139Tyr(H139Y), which was predicted highly hazard. Only five cases of thyrotropinoma in MEN1 were previously reported.@*Conclusion@#Thyrotropinoma should be cautiously identified from hyperthyroidism to avoid misdiagnosis and mistreatment, and it should keep in mind that thyrotropinoma may be associated with MEN1 though it would be very rare.

Generation and identification of pluripotent stem cells from NOD mouse / 中华内分泌代谢杂志

Three factors ( Oct4,Sox2,and Klf4) were introduced into tail tip-derived fibroblasts of NOD mouse by retrovirus infection.The induced pluripotent stem cells ( iPSCs ) generated from this method were analyzed in several aspects,including surface antigens,gene expression,alkaline phosphatase activity,and teratoma formation assays.The NOD mouse iPSCs generated from this study had ES-like characters,expressed ES-specific surface antigens,and possessed the ability to differentiate into 3-germ layers.Such NOD mouse-iPSCs should be useful in tyre 1 dialectic disease modeling,as well as for cell replacement therapy.

Value of using CT software technic to prevent the postoperative syndrome in functional endoscopic sinus surgery / 中国医师进修杂志

Objective To evaluate the guiding effect of CT software to reduce the postoperative syndrome and surgery risk in patients with sinus disease performed the functional endoscopic sinus surgery (FESS). Methods Fifty patients of accessory sinus disease were scanned by spinal CT, and then three dimensions reconstruction made in workstation. Under center of ethmoid sinus ,the five groups of anatomy data measured were obtained , used to guide surgery and contrasted with result of no used to guide surgery in 68 patients in FESS. The data were performed the statistical management and compared with results of FESS. Results Under guided by five groups of anatomy data measured ,the postoperative syndrome was reduced by 16.0 percent; the curative effect went up by 15.0 percent; the pay for hospital was reduced 31.0 percent and the recurrence rate was reduced 8.6 percent. Conclusion Used the technic in FESS, the surgery risk, the recurrence rate and pay for hospital are reduced, but the curative effect go up. The technic is much adapt to be used in village and towns hospital where there aren′t navigation equipment.

Magnetic resonance diagnosis of chronic pancreatitis / 基础医学与临床

Objective To evaluate the accuracy of MRI diagnosis and the clinical value of multi-MR imaging techniques.Methods Clinical,pathologic and MRI findings were retrospectively reviewed in 25 cases with chronic pancreatitis.The MRI manifestation included pancreatic morphology and volume change,signal feature,dynamic contrast-enhanced MRI and MRCP.The MRI techniques included: both before and after Gd-DTPA enhancement FS FLASH T1WI,FLASH TIWI,HASTE T2WI and MRCP.Results The characteristic signs in diagnosis of chronic pancreatitis were as follows: diffuse enlargement of the body;hypointense on T1WI FS;dynamic contrast-enhanced MRI,lesion and normal area always enhanced at the same time;pancreatic duct dilated like a string of beads which penetrated into the lesion shown by MRCP.Conclusion MRI can detect chronic pancreatitis earlier than CT,and it can display pancreatic duct and pseudo-cysts so is of great value in the diagnoses of chronic pancreatitis.

The Diagnostic Value of Using Three-dimensional Reconstruction and Incising Software in Maxillofacial Fracture / 中国医师杂志

Objective To evaluate the clinical value of using three-dimensional reconstruction and incising software in facial fracture. Methods Twenty-nine patients of facial fracture were examined with spiral CT first and then the images were taken with three-dimensional reconstruction and incising software on work-station. 2D images, 3D images and incising images were evaluated. Results BZ 3D images were superior to 2D images in demonstrating the space relationship of facial fractures, such as the fracture location, range, fragments displacement. However 2D images were better in illustrating deep structure; The 3D images could illustrate deep structure as well as 2D images when combined with incising software. Conclusion 3D images can provide information of space relationship in assessing facial fracture. The range can be extended combining with the incising software, and do better for illustrating deep struction.

ULTRASTRUCTURAL STUDIES ON INITIAL LYMPHATICS OF HUMAN GASTRIC CARCINOMA / 解剖学报

Objective To study the ultrastructural features of initial lymphatics of gastric carcinoma,to discuss the metastasis mechanism of malignant cells by lpmphatics. Methods The postoperative samples of patients with gastric cancer were obtained in center,peripheral and normal region of cancer.Common Resin-embedded specimens were made.Lymphatics were located by hemithin sections under light microscope and observed by ultrathin sections under electron microscope. Results There were no lymphatics in carcinomatous centre region.Compared with normal region,there were more initial lymphatics in peripheral region of gastric carcinoma.The lumina were dilated and irregular and the endothelium were destroyed;The organelle of endothelial cells changed obviously.The distribution and morphology of the lymphatics did not changed evidently in the normal region.Conclusion These results suggest that amount,ultrastructure and morphology of lymphatics changed in peripheral region of carcinoma;Gastric cancer cells may invade lymphatics via destroyed parts of endothelium or interendothelial openings.