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简介：AbstractAdrenal gland trauma is a rare phenomenon, due to the small size and retroperitoneal location of the organ. The majority of adrenal gland trauma is due to blunt force injury and is only rarely encountered due to the penetrating mechanisms. A 20-year-old male sustained a gunshot wound to the left abdomen. Upon exploration, he was found to have a through and through injury to the left adrenal gland, among other injuries. Injury to the adrenal gland due to penetrating trauma is exceptionally rare. The principles of management are to control bleeding from the gland with debridement and hemostasis rather than attempt to resect the entire organ. The management of a penetrating injury to the adrenal gland is straightforward and should not be a contributor to a patient's morbidity or mortality.

简介：脑出血易并发应激性上消化道出血，一旦发生往往难以控制，病死率较高。在病人并发消化道出血前采取及时有效的防范措施，能大大提高病人生存率。我科采用洛塞克治疗脑出血并Cushing溃疡出血，与西米替丁组对照，疗效显著，现报道如下：

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简介：Splenicmetastasisisgenerallynotacommonclinicalevent.However,metastasistothespleenfromadrenalpheochromocytomaisextremelyrareandhasnotbeenreportedinliterature.Thisreportpresentsacaseofa58year-oldmalepatientwhodevelopedspleen-onlymetastasesinJuly2007.ThepatienthadaprevioushistoryofleftepinephroectomyforadrenalpheochromocytomainJanuary2003.Abdominalcomputedtomographydemonstratedmultipleenhancinglesionssuggestiveofmetastases;thussplenectomywasperformed.Pathologicalexaminationsconfirmedthediagnosisofsplenicmetastasesfrompheochromocytoma.Thepatientwasalivewithoutrecurrence48monthsaftersplenectomy.Thisstudyisthefirstreportonsplenicmetastasisfrompreviousadrenalpheochromocytoma,andlong-termsurvivalwasachievedbysplenectomy.Ahistoryofmalignancyindicatesahighindexofsuspicionforsplenicmetastasis,andlong-termsurvivalcanbeachievedbysplenectomyforspleen-onlymetastasis.

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简介：AbstractBackground:The most common etiologies of Cushing's syndrome (CS) are adrenocorticotropic hormone (ACTH)-producing pituitary adenoma (pitCS) and primary adrenal gland disease (adrCS), both of which burden patients with metabolic disturbance. The aim of this study was to compare the metabolic features of pitCS and adrCS patients.Methods:A retrospective review including 114 patients (64 adrCS and 50 pitCS) diagnosed with CS in 2009-2019 was performed. Metabolic factors were then compared between pitCS and adrCS groups.Results:Regarding sex, females suffered both adrCs (92.2%) and pitCS (88.0%) more frequently than males. Regarding age, patients with pitCS were diagnosed at a younger age (35.40 ± 11.94 vs. 39.65 ± 11.37 years, p = 0.056) than those with adrCS, although the difference was not statistically significant. Moreover, pitCS patients had much higher ACTH levels and more serious occurrences of hypercortisolemia at all time points (8 AM, 4 PM, 12 AM) than that in adrCS patients. Conversely, indexes, including body weight, BMI, blood pressure, serum total cholesterol, low density lipoprotein cholesterol (LDL-C), high density lipoprotein cholesterol (HDL-C), triglycerides, fasting plasma glucose, and uric acid, showed no differences between adrCS and pitCS patients. Furthermore, diabetes prevalence was higher in pitCS patients than in adrCS patients; however, there were no significant differences in hypertension or dyslipidemia prevalence between the two.Conclusions:Although adrCS and pitCS had different pathogenetic mechanisms, different severities of hypercortisolemia, and different diabetes prevalences, both etiologies had similar metabolic characteristics.

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简介：Myeloidsarcoma(MS)isararehematologicalneoplasmthatdevelopseitherdenovoorconcurrentlywithacutemyeloidleukemia(AML).ThisneoplasmcanalsobeaninitialmanifestationofrelapseinapreviouslytreatedAMLthatisinremission.A44-year-oldmalepatientwasdiagnosedwithtestisMSinalocalhospitalinAugust2010.Afteronemonth,bonemarrowbiopsyandaspirationconfirmedthediagnosisofAML.Allogeneicmobilizationperipheralbloodstemcelltransplantationwasperformed,withthesisterofthepatientasdonor,aftercompleteremission(CR)wasachievedbychemotherapy.Fivemonthsaftertreatment,anadrenalmasswasdetectedbypositronemissiontomography-computedtomography(PET-CT).Radiotherapywasperformedforthelocalizedmassafteramultidisciplinaryteam(MDT)discussion.ThepatientisstillaliveasofMay2013,withnoevidenceofrecurrentMSorleukemia.

简介：目的探讨特勤人员S_ⅠS_ⅡS_Ⅲ综合征特点。方法选取Ⅰ、Ⅱ、Ⅲ标准导联同时存在S波的患者心电图,分析Ⅰ、Ⅱ、Ⅲ、aVR、V1、V5导联R波与S波比值、心电轴及年龄、体型以及病史等相关参数。结果（1）S_ⅠS_ⅡS_Ⅲ综合征发生率低,仅0.9%（51/5639人）;（2）51例S_ⅠS_ⅡS_Ⅲ综合征患者心电轴偏移范围宽,在-110°～＋178°,平均（27.49±79.74）°,其中心电轴正常19例（37.3%）、右偏15例（29.4%）、左偏13例（25.5%）、心电轴不确定4例（7.8%）;（3）S_ⅠS_ⅡS_Ⅲ综合征多见于体质量指数偏低即呈瘦长体型年轻人,体质量指数〈24.0者占58.8%（30/51）;（4）疗养体检无其他异常发现。结论健康特勤人员可出现S_ⅠS_ⅡS_Ⅲ综合征,多见于瘦长体型年轻人,可能系正常心电图变异,但诊断要慎重,须经心脏超声及X射线等检查排除器质性疾病。

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简介：Thequestforneuroprotectivedrugstoslowtheprogressionofneurodegenerativediseases(NDDs),includingAlzheimer'sdisease(AD),Parkinson'sdisease(PD),andHuntington'sdisease(HD),hasbeenlargelyunrewarding.Preclinicalevidencesuggeststhatrepurposingquetiapine,lithium,valproate,fluoxetine,donepezil,andmemantineforearlyandpre-symptomaticdisease-modificationinNDDsmaybepromisingandcanspareregulatorybarriers.Theliteratureofthesepsychotropicsinearlystageandpre-symptomaticAD,PD,andHDisreviewedandpropitiousfindingsfollow.Mildcognitiveimpairment(MCI)phaseofAD:salutaryhumanrandomizedcontrolledtrialfindingsforlow-doselithiumand,inselectedpatients,donepezilawaitreplication.Pre-symptomaticAD:humanepidemiologicaldataindicatethatlithiumreducesADrisk.Animalmodelstudies(AMS)revealencouragingresultsforquetiapine,lithium,donepezil,andmemantine.EarlyPD:valproateAMSfindingsshowpromise.Pre-symptomaticPD:lithiumandvalproateAMSfindingsareencouraging.EarlyHD:uncontrolledclinicaldataindicatenon-progressionwithlithium,fluoxetine,donepezil,andmemantine.Pre-symptomaticHD:lithiumandvalproateareauspiciousinAMS.Manyotherpromisingfindingsawaitingreplication(valproateinMCI;lithium,valproate,fluoxetineinpre-symptomaticAD;lithiuminearlyPD;lithium,valproate,fluoxetineinpre-symptomaticPD;donepezilinearlyHD;lithium,fluoxetine,memantineinpre-symptomaticHD)arereviewed.Dose-andstage-dependenteffectsareconsidered.Suggestionsforsignal-enhancementinhumantrialsareprovidedforeachNDDstage.

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简介：Neurotrophicfactorscompriseessentialsecretedproteinsthathaveseveralfunctionsinneuralandnon-neuraltissues,mediatingthedevelopment,survivalandmaintenanceofperipheralandcentralnervoussystem.Therefore,neurotrophicfactorissuehasbeenextensivelyinvestigatedintothecontextofneurodegenerativediseases.Alzheimer'sdiseaseandParkinson'sdiseaseshowchangesintheregulationofspecificneurotrophicfactorsandtheirreceptors,whichappeartobecriticalforneuronaldegeneration.Indeed,neurotrophicfactorspreventcelldeathindegenerativeprocessesandcanenhancethegrowthandfunctionofaffectedneuronsinthesedisorders.Basedonrecentreports,thisreviewdiscussesthemainfindingsrelatedtotheneurotrophicfactorsupport–mainlybrain-derivedneurotrophicfactorandglialcellline-derivedneurotrophicfactor–inthesurvival,proliferationandmaturationofaffectedneuronsinAlzheimer'sdiseaseandParkinson'sdiseaseaswellastheirputativeapplicationasnewtherapeuticapproachforthesediseasesmanagement.

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简介：Paget'sdiseaseofboneisafocaldisorderofboneremodellingcausedbyabnormallyincreasedosteoclast-mediatedboneresorption.qtleaffectedboneschangeinshaw,sizeanddirection,whiletherestoftheskeletonremainsnormal.TheclinicalconsequencesofthediseasewerefirstdescribedbySirJanlesPagetin1876(Figure1).

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简介：摘要目的了解beagle犬垂体Rathke′s囊肿及甲状旁腺Küerstriner′s囊肿发生率与性别关系，为垂体及甲状旁腺毒性病理诊断提供参考。方法以460只成年beagle犬为研究对象，雌雄各半。以10％中性福尔马林固定垂体及甲状旁腺，石蜡包埋，5μm切片，HE染色，光学显微镜下观察，统计垂体Rathke′s囊肿及甲状旁腺Küerstriner′s囊肿发生率，并比较雌、雄性动物间区别。结果显示雌、雄beagle犬垂体Rathke′s囊肿发生率均为10.87%，而甲状旁腺Küerstriner′s囊肿发生率为8.70%，其雌雄犬Rathke′s囊肿及Küerstriner′s囊肿发生率差异无统计学意义。且无动物同时发生上述两种囊肿。结论成年雌雄beagle犬Rathke′s囊肿发生率均为为10.87%，甲状旁腺Küerstriner′s囊肿发生率为8.70%，且雌雄间无差异，两种囊肿发生无关联性。