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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：AbstractIntroduction:Erosive adenomatosis of the nipple is a rare benign lesion involving nipple which can be easily misdiagnosed as more ominous entities such as Pagets disease.Here we reported a case of erosive adenomatosis on the nipple masquerading as paget’s disease.Case presentation:A 21-year-old woman presented with a 6-year history of breast erythema involving her left nipple with tenderness and mild itching. The nipple appeared rough and thickened with areas of erosion and fissuring. Physical examination of other areas of breast as well as imaging studies including ultrasound and mammography showed no abnormalities. The histological examination reveal adiagnosis of erosive adenomatosis of nipple (EAN). The patient was treated by a simple surgical excision without complications and recurrence during 9-month follow-up.Discussion:In the early stage, it can mimic eczema, but in the later stage, more serious diagnosis such as Pagets disease should be differential. It is diagnosed by histopathological examination. Surgical excision is an optimal choice for treament with or without plastic reconstruction.Conclusion:EAN should be considered in the diagnosis of erythema and erosion lesions involving nipple. The gold standard for diagnosis is histopathological examination. A prompt and correct diagnosis of EAN can avoid both unnecessary over treatment and patients emotional stress.

简介：Ampullaryadenomaisacommonindicationforendoscopicpapillectomy.Ampullaryneuroendocrinetumor(NET)isararediseaseforwhichcompletesurgicalresectionisthetreatmentofchoice.However,becauseofthemorbidityandmortalityassociatedwithsurgicalresection,endoscopicpapillectomyisincreasinglyusedinselectedcasesoflowgrade,withnometastasisandnoinvasionofthepancreaticorbileduct.Also,confirmedandcompleteendoscopicresectionofampullaryNETaccompaniedbyadenomahasnotbeenreportedtodate.WereporthereinararecaseofanampullaryNETaccompaniedwithadenoma,whichwassuccessfullyandcompletelyresectedviaendoscopicpapillectomy.Priortopapillectomy,thiscasewasdiagnosedasanampullaryadenoma.

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.

简介：AbstractBackground:Mastectomy techniques have been extended to nipple-sparing mastectomy (NSM). This study aimed to assess the actual application of NSM in China and identify the factors influencing postoperative complications.Methods:The clinical data of 615 patients (641 surgeries) undergoing NSM from January 1st, 2018 to December 31st, 2018 at 28 centers nationwide were retrospectively analyzed to obtain the rate of NSM and investigate factors related to NSM surgery.Results:The proportion of NSM surgery performed in this study was 2.67% (17/641). Malignant breast tumors accounted for the majority of NSM surgery (559/641, 87.2%). A total of 475 (77.3%) patients underwent NSM combined with reconstructive surgery. The rate of reconstruction decreased with age in our study, and implants were the most common option (344/641, 53.7%) in reconstruction. Radial incision was the most selected method regardless of reconstruction. However, for those who underwent reconstruction surgery, 18.4% (85/462) of cases also chose curvilinear incision, while in the simple NSM surgery group, more patients chose circumareolar incision (26/136, 19.1%). The tumor-to-nipple distance (TND) influenced postoperative complications (P = 0.004). There were no relationships between postoperative complications and tumor size, tumor location, histologic grade, molecular subtype, nipple discharge, and axillary lymph nodes.Conclusions:NSM surgery is feasible and only TND influenced postoperative complications of NSM surgery. But the proportion of NSM surgery performed is still low in nationwide centers of China. The selection criteria for appropriate surgical methods are important for NSM in clinical practice. To optimize clinical applications of NSM, further multicenter prospective randomized controlled studies are needed.Trial Registration:ChiCTR.org.cn, ChiCTR1900027423; http://www.chictr.org.cn/showprojen.aspx?proj=38739

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简介：AbstractBackground:Nipple discharge cytology is a simple non-invasive method that may provide valuable information for detecting underlying malignancy. Several studies have investigated the diagnostic value of cytology in breast cancer patients with pathological nipple discharge, but the results have been highly variable. Herein we presented a systematic review and meta-analysis of published studies pertaining to the diagnostic capacity of nipple discharge cytology in patients with breast cancer.Methods:A systematic literature search was performed (Medline/PubMed, Embase, Cochrane Library databases, and Google Scholar) to identify studies that investigated the diagnostic capacity of cytology with regard to breast cancer in patients with pathologic nipple discharge. Two independent researchers identified articles that assessed the sensitivity and specificity of cytological evaluation for breast cancer detection in patients with pathologic nipple discharge published between January 2000 and October 2018. Articles were only included in the meta-analysis if they met predetermined criteria. The characteristics of each study and the data they yielded were summarized. Quality assessment of all articles included was performed using the Methodological Index for Non-randomized Studies Criteria (MINORS) and the Quality Assessment of Diagnostic Accuracy Study 2 (QUADAS-2). Heterogeneity was tested via Cochran Q test and the I2 statistic using Stata 12.0 and Meta-DiSc 1.4 software, and meta-analysis was performed.Results:A total of 286 articles were identified, of which 12 articles including a total of 1476 patients were deemed eligible for inclusion in the meta-analysis. A random-effects model assessing the capacity of nipple discharge cytology to predict breast cancer yielded pooled sensitivity 63% (95% confidence interval [CI]: 53%-72%), specificity 95% (95% CI: 87%-98%), positive likelihood ratio 12.35 (95% CI: 4.87-31.34), and negative likelihood ratio 0.39 (95% CI: 0.30-0.50). The diagnostic odds ratio was 31.88 (95% CI: 11.30-89.98). The area under the summary receiver operating characteristic curve was 0.79 (95% CI: 0.75-0.82). Conclusion: The current meta-analysis suggests that nipple discharge cytology is a useful diagnostic modality for detection of breast cancer in patients with pathological nipple discharge, with moderate sensitivity and high specificity.