Search

Malignant insulinoma is a kind of rare and challenging neuroendocrine tumor. It is often accompanied by distant metastasis, among which liver metastasis is most common, and the prognosis is often non-promising. In this paper, we report a case of multiple liver metastases from malignant insulinoma. The patient, a 70-year-old male, was admitted to the hospital due to "episodic consciousness disorder for more than four months." Blood glucose monitoring revealed recurrent hypoglycemia in the early morning, after meals, and at night. Pancreatic perfusion CT and dynamic enhanced MRI of the liver revealed a mass in the uncinate process of the pancreatic head and multiple liver metastases. Percutaneous liver biopsy confirmed the diagnosis of insulinoma. After multidisciplinary discussions, hepatic artery embolization and radiofrequency ablation were performed in stages, in combination with everolimus treatment. Thereafter, the enhanced CT demonstrated that some liver metastases shrank. The patient had regular meals, and the blood sugar gradually increased and remained normal thereafter. This article discusses this case's clinical characteristics and multidisciplinary collaborative diagnosis and treatment, aiming to provide experience for the comprehensive clinical diagnosis and treatment of malignant insulinoma patients.

A middle-aged man was presented with poor appetite, polyuria, polydrpsia, and headache. A sellar mass was found, along with total pituitary hypofunction and visual field defect. A biopsy of the lesion via the trans-sphenoidal approach showed inflammatory changes and granuloma formation. However, repeated cerebrospinal fluid and pathogenic examination of the pathological tissue showed no positive indications. The initial diagnosis considered autoimmune hypophysitis, and treatment of glucocorticoids combined with immunosuppressants was administered, which led to a temporary shrinkage of the lesion, but it gradually enlarged subsequently. After multidisciplinary discussion, a high possibility of pituitary tuberculosis infection was decided upon. After standardized anti-tuberculosis treatment was initiated, the lesion reduced noticeably and the patient′s condition improved. Pituitary tuberculosis infection is incredibly rare and extremely easy to misdiagnose. This case was diagnosed and treated in a timely and effective manner through a multidisciplinary approach, highlighting the importance of such an approach in dealing with rare diseases.

One year seedlings of Ziziphus jujuba var. spinosa were used as test material, the pot water control method was used, and 4 treatments including 80% (suitable water, CK), 60% (light stress, L), 40% (moderate drought, M), and 20% (severe drought, S) soil moisture content were set up to simulate different levels of drought stress. The relative water content, peroxidation product content, antioxidant enzymes activities and chlorophyll fluorescence parameters and other physiological characteristics of Z. jujuba var. spinosa seedlings under different drought stresses were investigated. The results showed that with the increase of drought stress level, the relative water content of leaves of Z. jujuba var. spinosa seedlings generally showed a decreasing trend; the malondialdehyde (MDA) content of Z. jujuba var. spinosa seedlings showed an increased trend; the free proline (Pro) content increased, as well as the activities of superoxide dismutase (SOD), peroxidase (POD) and catalase (CAT). The photosynthetic fluorescence characteristics of Z. jujuba var. spinosa seedlings were influenced by drought stress significantly. Under the drought stress, the initial fluorescence (Fo) and non-photochemical quenching coefficient (qN) increased significantly, while the maximum fluorescence (Fm), photochemical quenching coefficient (qP), maximum photochemical efficiency PSII (Fv/Fm) and actual photochemical efficiency (ΦPSII) were significantly reduced. Drought stress had significant effects on the physiological indexes of Z. jujuba var. spinosa seedlings. The physiological indexes including activities of antioxidant enzymes and osmotic adjustment substances content of Z. jujuba var. spinosa seedlings were regulated in response to the drought stress. [ABSTRACT FROM AUTHOR]

Objective: To investigate the changes of skeletal muscle mass and strength and the expressions of matrix metalloproteinase-1 (MMP-1), tissue inhibitor of metalloproteinases-1 (TIMP-1) and collagen-1 in the skeletal muscle of aged rats with sarcopenia., Methods: With 11 young (6-month-old) SD rats as control group, 18 aged (25-month-old) SD rats were divided into two groups (n=9) according to the relative lean mass determined dual X-ray absorptiometry (DXA), namely aged control group and aged sarcopenia group (the relative lean mass was 2SD higher in aged control than in aged sarcopenia group. The forelimb grip strength of the rats was measured using an electronic grip strength meter. The extracellular matrix (ECM) of the rat's gastrocnemius was observed with HE staining and sirius Red staining, and the protein expressions of collagen-1, MMP-1, and TIMP-1 in the muscular tissues were detected with Western blotting., Results: Compared with the young rats, the aged control rats had significantly lower relative grip strength ( P < 0.01) and increased expressions of collagen-1 and TIMP-1 ( P < 0.05) and ECM content in the skeletal muscles, but the relative lean mass and MMP-1 protein expression were comparable between the two groups ( P >0.05). Compared with the aged control rats, the aged sarcopenic rats had significantly lowered relative lean mass ( P < 0.01) and MMP-1 expressions of ( P < 0.05) and increased expressions of collagen-1 and TIMP-1 proteins and ECM content in the muscular tissues ( P < 0.05) without significant changes in the relative grip strength ( P >0.05)., Conclusions: MMP-1/TIMP-1 imbalance in the skeletal muscle during aging affects ECM metabolism and leads to increased collagen fibers, which in turn affects the skeletal muscle mass and function and contribute to the onset of sarcopenia.