简介：生活总是公平无比……还记得上期那颗红色的小M&M豆斯所历的遭遇吗？它差点就被人充作果腹之用了，这次，一颗黄花的M&M豆终于为同胞报了一箭之仇。他变的巨大无比，人类的高楼大厦在他眼里不过是一个个小火柴盒，他跺一跺脚，整座城市都颤抖了。

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简介：AbstractThe contemporary embrace of endoscopic technology in the approach to the anterior skull base has altered the perioperative landscape for patients requiring pituitary surgery. Utility of a multi-disciplinary unit in management decisions facilitates the delivery of optimal care. Evolution of technology and surgical expertise in pituitary surgery mandates ongoing review of all components of the care central to these patients. The many areas of potential variability in the pre, intra and post-operative timeline of pituitary surgery are readily identifiable. Core undertakings and contemporary controversies in the peri-operative management of patients undergoing endoscopic transsphenoidal pituitary surgery are assessed against the available literature with a view to providing guidance for the best evidence-based practice.

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简介：摘要： Cushing综合征 (Cushing's syndrome)，又称皮质醇增多症 (hypercortisolism)，是各种原因所致高皮质醇血症为特征的临床综合征。主要表现为满月脸、多血质外貌、向心性肥胖、紫纹、痤疮、高血压、继发性糖尿病和骨质疏松等。因此 Cushing综合征的护理在临床护理中有重要的意义。

简介：这研究是在RGD-FasL和内在的机制导致的垂体腺瘤房间线GH3/MMQ/AtT20上调查细胞毒素的效果。Fas/DcR3mRNAs被RT-PCR检测，他们的表面表情被流动cytometry测量。RGD-FasL在肿瘤房间上施加的Cytotoxicity与MTT试金被测量，导致的apoptosis被agarose胶化电气泳动决定。房间周期和apoptosis被流动cytometry估计，PI染色。caspase8/9/3，Bcl-2，RANKL和JNK2的表情被西方的弄污检测。约13.7%GH3房间，25.5%MMQ房间，，22.2%AtT20房间表示船边交货23.9%GH3房间，24.1%MMQ房间，4.6%AtT20房间表示DcR3。肿瘤房间上的FasL/RGD-FasL的细胞毒素的效果都以一种剂量依赖者方式被拿。房间线MMQ/AtT20至于FasL显示出一样的敏感到RGD-FasL，当房间线GH3对RGD-FasL不太敏感时。房间周期分析显示RGD-FasL能在G0/G1阶段和G2/M阶段禁止房间。在与RGD-FasL对待的MMQ和AtT20房间，AI不与，在与RGD-FasL对待的GH3房间与FasL对待那显著地不同，AI比与FasL对待的低。当Bcl-2的与RGD-FasL在处理以后被减少时，caspase-8/9/3，RANKL和JNK2的表情被增加，建议RGD-FasL导致通过caspase激活的apoptosis。我们断定RGD-FasL能可能被看作垂体腺瘤的处理的一个新奇therapeutical候选人。

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：

简介：TheundecapeptidesubstanceP(SP)wasshowntobeintimatelyinvolvedinboththestructuralandfunctionalaspectsoftheanteriorpituitary.Yet,inadditiontoitsinfluencesonhormonalsecretion,SPmaywellpossessmoreactionsinthismastergland.ThepresentstudywasfthereforeaimedtoinvestigatetheeffectofSPontheproliferationofratanteriorpituitarycellsinprimaryculture,ItwasfoundthatSPcoulddose-dependentlyincreasetheincorporationoftritiatedthymidine(3H-TdR)intoculturedanteriorpituitarycells.OthermammaliantachykininssuchasneurokininAandneurokininBhadsimilareffectbuttovaryingdegrees.TheequipotentanalogueofSP,Norleucine^11-SP(Nle^11-SP),alsoactedlikewise.withitsactionantagonizablebyspantide,aSPreceptorblocker.TofurthercharacterizethenatureofcellsresponsivetothechallengeofSP,immunocytochemicalstainingagainstS-100proteinandsomeadenohypophysealhormoneswasperformedaloneorplusautoradiography.TheresultsshowedthatthepercentageofS-100proteinimmunorectivecellswasapparentlyelevatedbytheaddtionofNle^11-Spfor48h,whichindicatesapreferentialproliferationoffolliculo-stellatecellsundertheregime.ThiswasconfirmedbyincreasesinimmunocytochemicalorautoradiographicallabellingindicesofanteriorpituitarySubstancePandanteriorpituitarycellproliferation.Cellstreatedsimilarly.Takentogether,TheseresultsrevealthatthetrophicactionofSPobservedpreviouslyinothertissuesisalsopresentatleastinculturedratanteriorpituitarycells.withrespondingcellsbeingpredominantlyfolliculo-stellatecellsastypifiedbyS-100proteinimmunoreactivity.Therefore,anintra-pituitarytrophicactionofSPinvivocouldbeanticipated.

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.

简介：AbstractBackground:Although the incidence and clinical manifestations of pituitary apoplexy were reported by a few researches, the results are not consistent. This study aimed to explore the risk factors associated with an incidence of apoplexy in pituitary adenomas.Methods:The clinical information of 843 patients with pituitary adenoma from the Department of Neurological Surgery, 1st Affiliated Hospital of Kunming Medical University, was reviewed. The incidence, clinical manifestation, and potential risk factors for pituitary apoplexy were analyzed by a case-control study.Results:In total, 121 patients (14.4%) with macroadenoma were suffered from pituitary apoplexy. Headache, vomiting, and visual impairment are the top 3 symptoms for the pituitary apoplexy. Logistic regression results showed that the hypertension(hypertension vs non-hypertension OR = 2.765, 95%CI: 1.41~5.416), tumor type (negative staining vs. positive staining, OR = 1.501, 95%CI:1.248~5.235), and tumor size (diameter > 2 cm vs. diameter ≤ 2 cm, OR = 3.952, 95%CI:2.211~7.053) are independent factors associated with pituitary apoplexy.Conclusion:Our results indicate that the risk factors for the incidence of pituitary apoplexy depend mainly on properties of the tumor itself (tumor size and pathologic type) and the blood pressure of patients.

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简介：AIM:Toinvestigatetheinfluencingfactorsofvisualfieldimprovementaftertrans-sphenoidalresectionofpituitarymacroadenomas.·METHODS:Thisretrospectivecohortstudyincluded201patients(366eyes)withvisualfielddefectinducedbypituitarymacroadenomas.Allofthemweretreatedwithtrans-sphenoidalsurgery.Ophthalmologicevaluation,best-correctedvisualacuity(BCVA),andvisualfieldexaminationwereperformedbeforeand3moaftersurgery.BCVA,visualfielddefectindexmeandeviation(MD),durationofsymptoms,age,sex,andvolumeoftumorswerecompared.Expressionofvascularendothelialgrowthfactor(VEGF)andKi-67oftumortissueweredetectedbyimmunohistochemicaltechnique.·RESULTS:Themeanageofpatientswas44.23±1.29y.Ninety-threepatientswerefemaleand108weremale.Themeantumorvolumewas14.36±6.23cm~3.Themeandurationofpreoperativesymptomswas11.50±0.88mo.MeanpreoperativeMDwas-17.50±0.82dB.MeanPreoperativevisualacuitywas0.64±0.04.Postoperativevisualfieldimprovedin270(73.77%)eyes,unchangedin96(26.23%)eyes.Multivariatelogisticregressiondisplayedthatthefactorsindependentlyinfluencingvisualfieldimprovementwereyoungage(OR=1.71,95%CI:1.325-2.387,P=0.013),lowpreoperativeMDabsolutevalue(OR=1.277,95%CI:1.205-1.355,P<0.001),smallvolumeoftumor(OR=1.458,95%CI:1.060-4.289,P<0.001),lowexpressionofVEGFintumortissue(OR=1.554,95%CI:1.089-2.457,P=0.022),andlowexpressionofKi-67intumortissue(OR=1.552,95%CI:1.161-2.847,P=0.026).·CONCLUSION:Afterpituitarymacroadenomastranssphenoidalresection,theindependentinfluencingfactorsofthevisualfieldsrecoverywerelowpreoperativeMDabsolutevalue,youngage,smallvolumeoftumor,andexpressionlevelsofVEGF/Ki-67.

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简介：""Mensaytheyhatetoshop,""saysZhukin,CityUniversityofNewYorkSociology(社会学)professor.""Yetwhenyouaskthemdeeperquestions,itturnsoutthattheyliketoshop.Mengenerallyliketoshopforbooks,musicandhardware.Butifyouaskthemabouttheshoppingtheydoforbooksormusic,they'llsay,'Well,that'snotshopping.That'sresearch.'""

简介：Romanticismisanimportantstageintheevolutionofman’sself-consciousness.Itshowsnewinterestinandnewconcernwithmanandnature.Wordsworthiswell-knownasanaturepoet.Thethemeofhumanmindandnatureinhispoemshaslongattractedreaders’attention.However,hedoesnotindulgeinnatureitselfbuttakesitasconsolationandinspirationforhumankind.Inordertohighlightthepoet’sconcernwithhumanmind,thepresentpaperchoosestoexploreWordsworth’sconcernwithchildren’smind,basedontheanalysisofWordsworth’sThePreludeandmanyofhispoemsaboutchildren.

简介：BACKGROUND:Ithasbeenreportedthatperoxisomeproliferator-activatedreceptorγ(PPARγ)ishighlyexpressedinlungcancer,coloncancer,andgastriccancer,aswellasothertumors.OBJECTIVE:TostudyexpressionofPPARγinpituitaryadenomasandanalyzetheroleofPPARγinhormonaltypingofpituitaryadenomas.DESIGN,TIMEANDSETTING:Semi-quantitativeimmunohistochemistryofpathologicalspecimens.TheexperimentwasconductedattheDepartmentofNeurosurgery,WuxiSecondHospitalAffiliatedtoNanjingMedicalUniversitybetweenJanuary2002andMay2005.MATERIALS:Surgicalresectionsamplesofpituitaryadenomasfrom38cases(18maleand20female)wereanalyzed.Eightcasesweredeterminedtobeinvasivepituitaryadenomasand30caseswerenon-invasivepituitaryadenomas.Hormonalclassificationofthetypesofpituitaryadenomasrevealedsomatotrophicadenomasinsixcases,corticotrophicadenomainfivecases,prolactinomasin13cases,multi-hormonesecretingadenomasinsixcases,andeightcasesofadenomawithoutalteredendocrinefunction.Fiveautopsyspecimenswerecollectedduringthesameperiodfrompatientsofmatchingagethatdiedfromunrelateddiseasesandwereincludedasnormalanteriorpituitarycontrols.METHODS:Cellcountsforpositiveimmunohistochemicalsignalswererecordedfromhistopathologicalsections.Thepercentageofpositivecellswasreportedasasemi-quantitativeanalysis.MAINOUTCOMEMEASURES:TherateofPPARγpositivecellsindifferenttypesofadenomawasbasedonhormonallevelsandinvasivenessofpituitarytumorcells.RESULTS:AlltumorbiopsiesweredeterminedtoexpressPPARγTherateofPPARγ-positivecellsrangedbetween8%-65%inthepituitaryadenomas.Accordingtohormonaltype,PPARγexpressiondidnotvarybetweenthegroups.Inaddition,therewasnosignificantdifferenceinPPARγexpressionbetweenthenon-invasiveandinvasivepituitaryadenomas.CONCLUSIONS:HumanpituitaryadenomasexpressPPARγ,andthisexpressionisunrelatedto

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简介：Sinceancienttimes,asoneofthesymbolsofuglyanddirty,prostitutesareinvariablylivingintheblackmarginsofsociety.Facingprostitutes’miseries,peoplealwayscannotunderstandtheiremotions,mentalitiesanddesires,ortreatsthemasequals,particularlyaswomen.ProstitutesareaspecialgroupintheoppressedwomeninWesternsocieties.MargaretandNanaaretwotypicalimagesoftheminthehistoryofwesternliterature.Withtearsandlives,theydeducetheirmiserablelifestoriessimilarly.

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