Research Progress in the Treatment of Pituitary Tumors

Pituitary tumor is a common intracranial neuroendocrine tumor, generally belonging to benign tumors. It mainly originates from pituitary cells in the sella region. There is no significant difference in the ratio of men to women. The tumor grows to the lower part of the parasellar thalamus, and may even reach the third ventricle to involve the cavernous sinus, extend into the middle cranial fossa, grow into the interpeduncular cistern, and enter the nasopharynx in the sphenoid sinus. A few tumors are rich in blood supply and easy to bleed, leading to pituitary tumor stroke. The incidence of pituitary tumor ranks the third among intracranial tumors. In recent years, with the development of endocrine examination and imaging technology, the detection rate is increasing year by year. The hormone disorder and the pressure on the surrounding important tissues will have a great impact on the quality of life of patients, and have a great impact on the growth and development of patients, labor ability, growth and development and social psychology. In this paper, the research progress of three methods for the treatment of pituitary tumor (surgical therapy, drug therapy, radiation therapy) is reviewed, aiming to provide reference for the clinical treatment of this disease

Surgical Treatment of Hypertensive Cerebral Hemorrhage

Intracerbral hemorrhage (ICH) refers to primary non-traumatic hemorrhage in the parenchyma, also known as spontaneous cerebral hemorrhage, accounting for 20%-30% of acute cerebrovascular diseases. Every year 2 million to 3 million people in the world suffer from intracerebral hemorrhage, accounting for 10%-15% of all new strokes, and the total incidence of intracerebral hemorrhage in the world is 24.6/ (100,000 · year). In China, the incidence of cerebral hemorrhage is 60-80/ (100,000 · year), which is much higher than that of other Asian countries. Primary intracerebral hemorrhage accounts for 80%-85%, and primary hypertensive intracerebral hemorrhage combined with hypertension accounts for 50%-70% [1]. Hypertensive intracerebral hemorrhage accounts for about 50% of the causes of non-traumatic intracerebral hemorrhage, and its mortality rate takes the first place in non-traumatic intracerebral hemorrhage [2]. Hypertensive intracerebral hemorrhage has rapid onset, high mortality rate and slow recovery, and often leaves various degrees of neurological dysfunction. This paper analyzes the pathological features of hypertensive intracerebral hemorrhage, the clinical features of the bleeding site, the indications, timing, surgical methods and the advantages and disadvantages of surgical treatment, hoping to provide reference for the selection of surgery for clinicians

MTR4 drives liver tumorigenesis by promoting cancer metabolic switch through alternative splicing.

The metabolic switch from oxidative phosphorylation to glycolysis is required for tumorigenesis in order to provide cancer cells with energy and substrates of biosynthesis. Therefore, it is important to elucidate mechanisms controlling the cancer metabolic switch. MTR4 is a RNA helicase associated with a nuclear exosome that plays key roles in RNA processing and surveillance. We demonstrate that MTR4 is frequently overexpressed in hepatocellular carcinoma (HCC) and is an independent diagnostic marker predicting the poor prognosis of HCC patients. MTR4 drives cancer metabolism by ensuring correct alternative splicing of pre-mRNAs of critical glycolytic genes such as GLUT1 and PKM2. c-Myc binds to the promoter of the MTR4 gene and is important for MTR4 expression in HCC cells, indicating that MTR4 is a mediator of the functions of c-Myc in cancer metabolism. These findings reveal important roles of MTR4 in the cancer metabolic switch and present MTR4 as a promising therapeutic target for treating HCC

Comparison of pharmacokinetic profiles of seven major bioactive components in normal and non-alcoholic fatty liver disease (NAFLD) rats after oral administration of Ling-Gui-Zhu-Gan decoction by UPLC-MS/MS

A sensitive and rapid ultra-performance liquid chromatography–tandem mass spectrometry (UPLC-MS/MS) method was hereby developed for the determination of seven components, namely, glycyrrhizic acid, glycyrrhetinic acid, dehydrotumulosic acid, isoliquiritin, liquiritin, atractylenolide III, and cinnamic acid, in the plasma of rats after the oral administration of Ling-Gui-Zhu-Gan decoction (LGZGD). Besides, this very method was methodologically validated for specificity, linearity, inter-day and intra-day precision, accuracy, matrix effect, extraction recovery, and stability. It was also successfully used for the first time to compare the pharmacokinetic characteristics of the seven components after oral administration of LGZGD to normal rats and non-alcoholic fatty liver disease (NAFLD) rats. The results indicated significant differences between the pharmacokinetic characteristics of normal and NAFLD rats. To further reveal the different pharmacokinetic behaviors, the expressions of enzymes and transporters in the liver of normal and NAFLD rats were detected using UPLC-MS/MS. In the NAFLD rats, UDP-glucuronosyltransferase 1-1 (UGT1A1) and nine transporters were significantly inhibited and a positive correlation was observed between them and the AUC of the major components. The present results indicate that the pharmacokinetic differences between the normal and NAFLD rats might be attributed to the significant lower expression levels of both the metabolic enzyme UGT1A1 and nine transporter proteins in the NAFLD rats than in the normal rats. Meanwhile, UGT1A1 and the nine transporter proteins might be used as potential biomarkers to assess the ameliorative effect of LGZGD on NAFLD, which could provide useful information to guide the clinical application of LGZGD

The Role of Sleep Deprivation in Arrhythmias

Sleep is essential to the normal psychological and physiological activities of the human body. Increasing evidence indicates that sleep deprivation is associated with the occurrence, development, and poor treatment effects of various arrhythmias. Sleep deprivation affects not only the peripheral nervous system but also the central nervous system, which regulates the occurrence of arrhythmias. In addition, sleep deprivation is associated with apoptotic pathways, mitochondrial energy metabolism disorders, and immune system dysfunction. Although studies increasingly suggest that pathological sleep patterns are associated with various atrial and ventricular arrhythmias, further research is needed to identify specific mechanisms and recommend therapeutic interventions. This review summarizes the findings of sleep deprivation in animal experiments and clinical studies, current challenges, and future research directions in the field of arrhythmias

Evidence for lunar tide effects in Earth’s plasmasphere

Tides are universal and affect spatially distributed systems, ranging from planetary to galactic scales. In the Earth–Moon system, effects caused by lunar tides were reported in the Earth’s crust, oceans, neutral gas-dominated atmosphere (including the ionosphere) and near-ground geomagnetic field. However, whether a lunar tide effect exists in the plasma-dominated regions has not been explored yet. Here we show evidence of a lunar tide-induced signal in the plasmasphere, the inner region of the magnetosphere, which is filled with cold plasma. We obtain these results by analysing variations in the plasmasphere’s boundary location over the past four decades from multisatellite observations. The signal possesses distinct diurnal (and monthly) periodicities, which are different from the semidiurnal (and semimonthly) variations dominant in the previously observed lunar tide effects in other regions. These results demonstrate the importance of lunar tidal effects in plasma-dominated regions, influencing understanding of the coupling between the Moon, atmosphere and magnetosphere system through gravity and electromagnetic forces. Furthermore, these findings may have implications for tidal interactions in other two-body celestial systems

Emergency tracheal intubation in 202 patients with COVID-19 in Wuhan, China:lessons learnt and international expert recommendations

Tracheal intubation in coronavirus disease 2019 (COVID-19) patients creates a risk to physiologically compromised patients and to attending healthcare providers. Clinical information on airway management and expert recommendations in these patients are urgently needed. By analysing a two-centre retrospective observational case series from Wuhan, China, a panel of international airway management experts discussed the results and formulated consensus recommendations for the management of tracheal intubation in COVID-19 patients. Of 202 COVID-19 patients undergoing emergency tracheal intubation, most were males (n=136; 67.3%) and aged 65 yr or more (n=128; 63.4%). Most patients (n=152; 75.2%) were hypoxaemic (Sao2 <90%) before intubation. Personal protective equipment was worn by all intubating healthcare workers. Rapid sequence induction (RSI) or modified RSI was used with an intubation success rate of 89.1% on the first attempt and 100% overall. Hypoxaemia (Sao2 <90%) was common during intubation (n=148; 73.3%). Hypotension (arterial pressure <90/60 mm Hg) occurred in 36 (17.8%) patients during and 45 (22.3%) after intubation with cardiac arrest in four (2.0%). Pneumothorax occurred in 12 (5.9%) patients and death within 24 h in 21 (10.4%). Up to 14 days post-procedure, there was no evidence of cross infection in the anaesthesiologists who intubated the COVID-19 patients. Based on clinical information and expert recommendation, we propose detailed planning, strategy, and methods for tracheal intubation in COVID-19 patients