BACKGROUND Duodenal Brunner's gland hyperplasia(BGH)is a therapeutic target when complications such as bleeding or gastrointestinal obstruction occur or when malignancy cannot be ruled out.Herein,we present a case...BACKGROUND Duodenal Brunner's gland hyperplasia(BGH)is a therapeutic target when complications such as bleeding or gastrointestinal obstruction occur or when malignancy cannot be ruled out.Herein,we present a case of large BGH treated with endoscopic mucosal resection(EMR).CASE SUMMARY An 83-year-old woman presented at our hospital with dizziness.Blood tests revealed severe anemia,esophagogastroduodenoscopy showed a 6.5 cm lesion protruding from the anterior wall of the duodenal bulb,and biopsy revealed the presence of glandular epithelium.Endoscopic ultrasonography(EUS)demonstr-ated relatively high echogenicity with a cystic component.The muscularis propria was slightly elevated at the base of the lesion.EMR was performed without complications.The formalin-fixed lesion size was 6 cm×3.5 cm×3 cm,showing nodular proliferation of non-dysplastic Brunner's glands compartmentalized by fibrous septa,confirming the diagnosis of BGH.Reports of EMR or hot snare polypectomy are rare for duodenal BGH>6 cm.In this case,the choice of EMR was made by obtaining information on the base of the lesion as well as on the internal characteristics through EUS.CONCLUSION Large duodenal lesions with good endoscopic maneuverability and no evident muscular layer involvement on EUS may be resectable via EMR.展开更多
A case of pedunculated Brunner＇s gland hamartoma （BGH） of the duodenum causing upper gastrointestinal （GI） hemorrhage is reported. The patient was a 47-year-old man who visited our hospital for further evaluation...A case of pedunculated Brunner＇s gland hamartoma （BGH） of the duodenum causing upper gastrointestinal （GI） hemorrhage is reported. The patient was a 47-year-old man who visited our hospital for further evaluation of tarry stools and shortness of breath. Endoscopic examination of the upper digestive tract revealed a large peduncular polyp with bleeding, about 30 mm in diameter, arising from the wall of the second portion of the duodenum. GI bleeding occurred from the base of the stalk of the polyp. Endoscopic polypectomy was performed. Histological examination of the specimen revealed that the main body of the polyp contained several Iobules of mature Brunner＇s gland with areas of cystic dilatation. The surface epithelium consisted of normal duodenal mucosa with areas of focal ulceration. This polyp was diagnosed as a BGH. The symptom of tarry stools resolved after endoscopic resection. Our case shows that treatment is necessary for duodenal BGH if GI bleeding occurs.展开更多
Background: Benign prostate hyperplasia (BPH) is the most common benign disease of human prostate. Currently BPH is associated with unregulated proliferation of connective tissue and glandular epithelium within the pr...Background: Benign prostate hyperplasia (BPH) is the most common benign disease of human prostate. Currently BPH is associated with unregulated proliferation of connective tissue and glandular epithelium within the prostatic transition zone, and it has been described as relevant characteristic of BPH—the increase of the total number of cells, and not only an increase in cell size. To date, there are few studies on the quantitative morphology of glandular tree of BPH compared with normal prostate. The scarce investigations about this particular suggest that the glandular tree branches and expands as the hyperplastic transformation occurs in the prostate. Methods: To verify if this gland expansion and branching was similar to that occurs in the normal prostate, this study deals with the estimation of several stereological parameters as: labeling index for the proliferating cell nuclear antigen to quantify the rate of proliferation of prostate epithelium, average thickness of glandular epithelium, fraction of the volume occupied by the epithelium relative to the total prostate volume, connectivity density of prostate glands, to quantify the branching of prostate glands, and the average volume and the volume-weighted mean glandular volume of prostate acini to assess the mean size of the prostate acini and its variability. Results: All these estimates have been performed in prostate specific antigen immunostained sections from prostates of young men (controls) and in adenomectomy specimens from the adenofibromiomatous variety of BPH. Conclusion: We conclude that the epithelial proliferation is not the only factor intervening in the development of BPH. In addition, a more prolonged survival of epithelial population, together with some degree of hypertrophy of acini expressed by the increase of volume fraction and thickness of acinar epithelium, is relevant in order to the growth and expansion of the BPH glandular tree that shows more abundant and heterogeneous acinar sprouts than in normal prostate.展开更多
Objective: To inquire into diagnosis, and treatment of virilizing andfeminizing a-drenal syndrome, differential diagnosis between benign and malignant sex hormoneproducing adrenal neo-plasma and, treatment principles ...Objective: To inquire into diagnosis, and treatment of virilizing andfeminizing a-drenal syndrome, differential diagnosis between benign and malignant sex hormoneproducing adrenal neo-plasma and, treatment principles of congenital adrenal hyperplasia (CAH).Methods: Eight cases of CAH and 5 cases of sex hormone producing adrenal neoplasma were admitted tohospital during 1986-1996. The former included 3 rare cases of 17 a hydroxylase deficiency. Thelatter included 3 cases of feminizing adrenal tumor and 2 cases of virilizing adrenal tumor.Results: Weight, size and CT of the tumor, DHEA, 17 -ks, sex hormone levels, infiltration, andmetastasis were closely related to the degree of differentiation of the tumors. Conclusion:Virilizing and feminizing adrenal neoplasm were removed surgically by different incisions. Modifiedsubcostal incision was recommended as the best choice for huge adrenal mass. Corticoadrenal hormonetreatment fa CAH should be individualized according to the different types of the disease. Sexhormones were not suitable for children suffering from 17 hydroxylase deficiency before puberty.展开更多
BACKGROUND Intercalated duct lesions(IDLs)are considered relatively benign and rare tumors of salivary glands,that were only described recently.Their histopathological appearance may range from ductal hyperplasia to e...BACKGROUND Intercalated duct lesions(IDLs)are considered relatively benign and rare tumors of salivary glands,that were only described recently.Their histopathological appearance may range from ductal hyperplasia to encapsulated adenoma with hybrid patterns of both variants.It is thought that IDLs may be the precursor for malignant proliferations,therefore their correct diagnosis remains crucial for proper lesion management.It is the first reported IDL case arising from the accessory parotid gland(APG),which stands for less frequent but higher malignancy rate tumor developmental area.CASE SUMMARY A 24-years-old male with no accompanying diseases was referred to the hospital with a painless nodule on the right cheek.On physical examination,the stiff,immobile,and painless mass was palpable in the anterior portion of the right parotideomasseteric region,just superior to the parotid duct.Ultrasound examination demonstrated 1.5 cm×1.0 cm hypoechogenic mass on the anterior part of the right parotid gland.Ultrasound-guided fine needle aspiration cytology,followed by liquid-based fine needle aspiration biopsy were performed.However,the results were uninformative.A contrast-enhanced magnetic res-onance imaging(MRI)of the parotid was obtained,demonstrating a 1.5 cm×1.0 cm×0.5 cm tumor with high intensity capsule together with low intensity core in the very anterior part of right superficial lobe,situated in the APG.An MRI features were uncharacteristic to common parotid tumors,therefore surgical resection followed up.After histopathological examination,the final diagnosis of hybrid IDL was confirmed.CONCLUSION Fine needle aspiration biopsy might not always be diagnostic,and given the malignant potential,the surgical resection of such lesion remains the treatment of choice.展开更多
Objective： To explore and analyze the points-selection rules in acupuncture treatment of mammary gland hyperplasia （MGH） by data mining and statistical method. Methods： Clinical literatures about the treatment of ...Objective： To explore and analyze the points-selection rules in acupuncture treatment of mammary gland hyperplasia （MGH） by data mining and statistical method. Methods： Clinical literatures about the treatment of MGH with acupuncture published in the recent 16 years were retrieved from Chinese Journal Full-text Database （CJFD） and established into a database by Excel. The SPSS 20 version software and Clementine 12.0 version software were adopted to analyze the frequency and association rules of points-selection in the treatment of MGH with acupuncture. Results： The top 3 points used most frequently in acupuncture treatment of MGH were Danzhon8 （CV 17）, Taichong （LR 3） and Zusanli （ST 36）; points from the Stomach Meridian of Foot Yangming and Liver Meridian of Foot Jueyin were most commonly used; the commonly selected points were predominantly distributed in thoracic and abdominal regions and lower limbs; emphasis on the combination use of local and distal points; of the specific points, the five Shu-Transmitting points were mostly used; association analysis showed that the associations among Taichong （LR 3）, Danzhong （CV 27） and Zusanli （ST 36） were the most significant. Conclusion： The data mining results substantially accord with the general rules of acupuncture-moxibustion theories in traditional Chinese medicine, able to reflect the points-selection principles and features in acupuncture treatment of MGH and provide evidence for the points selection in the treatment of MGH in acupuncture clinic.展开更多
Objective: To evaluate the efficacy of acupuncture for the treatment of mammary gland hyperplasia. Methods: Randomized controlled trials before December 2017 in CNKI, China Biology Medicine disc, Chinese sci-tech peri...Objective: To evaluate the efficacy of acupuncture for the treatment of mammary gland hyperplasia. Methods: Randomized controlled trials before December 2017 in CNKI, China Biology Medicine disc, Chinese sci-tech periodical full-text database, Wanfang database, Cochrane Library, Pubmed, Embase and Web of Science were searched. The risks were evaluated by two investigators according to the Cochrane Handbook 5.1.0 criteria. Evaluation GeMTC was used for network-meta analysis. Results: A total of 43 articles were included, involving 5531 patients. Network meta-analysis results showed that there were differences in the comparison before and after treatment: acupuncture + Chinese herbal medicine vs acupuncture, acupuncture + Chinese herbal medicine vs Chinese herbal medicine, acupuncture + Chinese herbal medicine v s acupoint embedding, acupuncture + western medicine vs acupuncture, acupuncture + western medicine vs western medicine, acupuncture + western medicine vs Chinese herbal medicine, fire needle vs acupuncture, fire needle vs Chinese herbal medicine, moxibustion vs acupuncture, moxibustion vs Chinese herbal medicine, acupoint embedding line + Chinese herbal medicine vs Chinese herbal medicine, acupoint embedding line + Chinese herbal medicine vs western medicine, acupoint embedding line + Chinese herbal medicine vs acupuncture, acupoint embedding line + Chinese herbal medicine vs acupuncture + Chinese herbal medicine, acupoint embedding line + Chinese herbal medicine vs acupuncture + western medicine, acupoint embedding line + Chinese herbal medicine vs fire needle, acupoint embedding line + Chinese herbal medicine vs fire needle + Chinese herbal medicine, acupoint embedding line + Chinese herbal medicine vs electroacupuncture, acupoint embedding line + Chinese herbal medicine vs acupoint embedding line, Acupoint embedding line + Chinese herbal medicine vs ear acupuncture, acupoint embedding line + Chinese herbal medicine vs moxibustion, acupoint embedding line + Chinese herbal medicine vs moxibustion + Chines展开更多
文摘BACKGROUND Duodenal Brunner's gland hyperplasia(BGH)is a therapeutic target when complications such as bleeding or gastrointestinal obstruction occur or when malignancy cannot be ruled out.Herein,we present a case of large BGH treated with endoscopic mucosal resection(EMR).CASE SUMMARY An 83-year-old woman presented at our hospital with dizziness.Blood tests revealed severe anemia,esophagogastroduodenoscopy showed a 6.5 cm lesion protruding from the anterior wall of the duodenal bulb,and biopsy revealed the presence of glandular epithelium.Endoscopic ultrasonography(EUS)demonstr-ated relatively high echogenicity with a cystic component.The muscularis propria was slightly elevated at the base of the lesion.EMR was performed without complications.The formalin-fixed lesion size was 6 cm×3.5 cm×3 cm,showing nodular proliferation of non-dysplastic Brunner's glands compartmentalized by fibrous septa,confirming the diagnosis of BGH.Reports of EMR or hot snare polypectomy are rare for duodenal BGH>6 cm.In this case,the choice of EMR was made by obtaining information on the base of the lesion as well as on the internal characteristics through EUS.CONCLUSION Large duodenal lesions with good endoscopic maneuverability and no evident muscular layer involvement on EUS may be resectable via EMR.
文摘A case of pedunculated Brunner＇s gland hamartoma （BGH） of the duodenum causing upper gastrointestinal （GI） hemorrhage is reported. The patient was a 47-year-old man who visited our hospital for further evaluation of tarry stools and shortness of breath. Endoscopic examination of the upper digestive tract revealed a large peduncular polyp with bleeding, about 30 mm in diameter, arising from the wall of the second portion of the duodenum. GI bleeding occurred from the base of the stalk of the polyp. Endoscopic polypectomy was performed. Histological examination of the specimen revealed that the main body of the polyp contained several Iobules of mature Brunner＇s gland with areas of cystic dilatation. The surface epithelium consisted of normal duodenal mucosa with areas of focal ulceration. This polyp was diagnosed as a BGH. The symptom of tarry stools resolved after endoscopic resection. Our case shows that treatment is necessary for duodenal BGH if GI bleeding occurs.
文摘Background: Benign prostate hyperplasia (BPH) is the most common benign disease of human prostate. Currently BPH is associated with unregulated proliferation of connective tissue and glandular epithelium within the prostatic transition zone, and it has been described as relevant characteristic of BPH—the increase of the total number of cells, and not only an increase in cell size. To date, there are few studies on the quantitative morphology of glandular tree of BPH compared with normal prostate. The scarce investigations about this particular suggest that the glandular tree branches and expands as the hyperplastic transformation occurs in the prostate. Methods: To verify if this gland expansion and branching was similar to that occurs in the normal prostate, this study deals with the estimation of several stereological parameters as: labeling index for the proliferating cell nuclear antigen to quantify the rate of proliferation of prostate epithelium, average thickness of glandular epithelium, fraction of the volume occupied by the epithelium relative to the total prostate volume, connectivity density of prostate glands, to quantify the branching of prostate glands, and the average volume and the volume-weighted mean glandular volume of prostate acini to assess the mean size of the prostate acini and its variability. Results: All these estimates have been performed in prostate specific antigen immunostained sections from prostates of young men (controls) and in adenomectomy specimens from the adenofibromiomatous variety of BPH. Conclusion: We conclude that the epithelial proliferation is not the only factor intervening in the development of BPH. In addition, a more prolonged survival of epithelial population, together with some degree of hypertrophy of acini expressed by the increase of volume fraction and thickness of acinar epithelium, is relevant in order to the growth and expansion of the BPH glandular tree that shows more abundant and heterogeneous acinar sprouts than in normal prostate.
文摘Objective: To inquire into diagnosis, and treatment of virilizing andfeminizing a-drenal syndrome, differential diagnosis between benign and malignant sex hormoneproducing adrenal neo-plasma and, treatment principles of congenital adrenal hyperplasia (CAH).Methods: Eight cases of CAH and 5 cases of sex hormone producing adrenal neoplasma were admitted tohospital during 1986-1996. The former included 3 rare cases of 17 a hydroxylase deficiency. Thelatter included 3 cases of feminizing adrenal tumor and 2 cases of virilizing adrenal tumor.Results: Weight, size and CT of the tumor, DHEA, 17 -ks, sex hormone levels, infiltration, andmetastasis were closely related to the degree of differentiation of the tumors. Conclusion:Virilizing and feminizing adrenal neoplasm were removed surgically by different incisions. Modifiedsubcostal incision was recommended as the best choice for huge adrenal mass. Corticoadrenal hormonetreatment fa CAH should be individualized according to the different types of the disease. Sexhormones were not suitable for children suffering from 17 hydroxylase deficiency before puberty.
文摘BACKGROUND Intercalated duct lesions(IDLs)are considered relatively benign and rare tumors of salivary glands,that were only described recently.Their histopathological appearance may range from ductal hyperplasia to encapsulated adenoma with hybrid patterns of both variants.It is thought that IDLs may be the precursor for malignant proliferations,therefore their correct diagnosis remains crucial for proper lesion management.It is the first reported IDL case arising from the accessory parotid gland(APG),which stands for less frequent but higher malignancy rate tumor developmental area.CASE SUMMARY A 24-years-old male with no accompanying diseases was referred to the hospital with a painless nodule on the right cheek.On physical examination,the stiff,immobile,and painless mass was palpable in the anterior portion of the right parotideomasseteric region,just superior to the parotid duct.Ultrasound examination demonstrated 1.5 cm×1.0 cm hypoechogenic mass on the anterior part of the right parotid gland.Ultrasound-guided fine needle aspiration cytology,followed by liquid-based fine needle aspiration biopsy were performed.However,the results were uninformative.A contrast-enhanced magnetic res-onance imaging(MRI)of the parotid was obtained,demonstrating a 1.5 cm×1.0 cm×0.5 cm tumor with high intensity capsule together with low intensity core in the very anterior part of right superficial lobe,situated in the APG.An MRI features were uncharacteristic to common parotid tumors,therefore surgical resection followed up.After histopathological examination,the final diagnosis of hybrid IDL was confirmed.CONCLUSION Fine needle aspiration biopsy might not always be diagnostic,and given the malignant potential,the surgical resection of such lesion remains the treatment of choice.
基金supported by National Natural Science Foundation of China, No.81673979, No. 81473688, No. 81173265Supporting Program for New Century Excellent Talents in University of China, No.NCET-13-0827+4 种基金Administration of Traditional Chinese Medicine of Guangdong Province,No. 20141070Science and Technology Supporting Program of Guangzhou, No.2014J4100104Science and Technology Planning Project of Guangdong Province, No.2014A020212672Natural Science Foundation of Guangdong Province, No.2016A030313114, No. 2015A030313333Scientific Research and Innovation Fund of Jinan University/Fundamental Research Funds for the Central Universities, No. 21617467, No.21615464, No. 21615412~~
文摘Objective： To explore and analyze the points-selection rules in acupuncture treatment of mammary gland hyperplasia （MGH） by data mining and statistical method. Methods： Clinical literatures about the treatment of MGH with acupuncture published in the recent 16 years were retrieved from Chinese Journal Full-text Database （CJFD） and established into a database by Excel. The SPSS 20 version software and Clementine 12.0 version software were adopted to analyze the frequency and association rules of points-selection in the treatment of MGH with acupuncture. Results： The top 3 points used most frequently in acupuncture treatment of MGH were Danzhon8 （CV 17）, Taichong （LR 3） and Zusanli （ST 36）; points from the Stomach Meridian of Foot Yangming and Liver Meridian of Foot Jueyin were most commonly used; the commonly selected points were predominantly distributed in thoracic and abdominal regions and lower limbs; emphasis on the combination use of local and distal points; of the specific points, the five Shu-Transmitting points were mostly used; association analysis showed that the associations among Taichong （LR 3）, Danzhong （CV 27） and Zusanli （ST 36） were the most significant. Conclusion： The data mining results substantially accord with the general rules of acupuncture-moxibustion theories in traditional Chinese medicine, able to reflect the points-selection principles and features in acupuncture treatment of MGH and provide evidence for the points selection in the treatment of MGH in acupuncture clinic.
文摘Objective: To evaluate the efficacy of acupuncture for the treatment of mammary gland hyperplasia. Methods: Randomized controlled trials before December 2017 in CNKI, China Biology Medicine disc, Chinese sci-tech periodical full-text database, Wanfang database, Cochrane Library, Pubmed, Embase and Web of Science were searched. The risks were evaluated by two investigators according to the Cochrane Handbook 5.1.0 criteria. Evaluation GeMTC was used for network-meta analysis. Results: A total of 43 articles were included, involving 5531 patients. Network meta-analysis results showed that there were differences in the comparison before and after treatment: acupuncture + Chinese herbal medicine vs acupuncture, acupuncture + Chinese herbal medicine vs Chinese herbal medicine, acupuncture + Chinese herbal medicine v s acupoint embedding, acupuncture + western medicine vs acupuncture, acupuncture + western medicine vs western medicine, acupuncture + western medicine vs Chinese herbal medicine, fire needle vs acupuncture, fire needle vs Chinese herbal medicine, moxibustion vs acupuncture, moxibustion vs Chinese herbal medicine, acupoint embedding line + Chinese herbal medicine vs Chinese herbal medicine, acupoint embedding line + Chinese herbal medicine vs western medicine, acupoint embedding line + Chinese herbal medicine vs acupuncture, acupoint embedding line + Chinese herbal medicine vs acupuncture + Chinese herbal medicine, acupoint embedding line + Chinese herbal medicine vs acupuncture + western medicine, acupoint embedding line + Chinese herbal medicine vs fire needle, acupoint embedding line + Chinese herbal medicine vs fire needle + Chinese herbal medicine, acupoint embedding line + Chinese herbal medicine vs electroacupuncture, acupoint embedding line + Chinese herbal medicine vs acupoint embedding line, Acupoint embedding line + Chinese herbal medicine vs ear acupuncture, acupoint embedding line + Chinese herbal medicine vs moxibustion, acupoint embedding line + Chinese herbal medicine vs moxibustion + Chines
