Plurihormonal PIT1-lineage pituitary neuroendocrine tumors: a clinicopathological study / 中华病理学杂志

Objective: To investigate the clinicopathological characteristics of plurihormonal PIT1-lineage pituitary neuroendocrine tumors. Methods: Forty-eight plurihormonal PIT1-lineage tumors were collected between January 2018 and April 2022 from the pathological database of Sanbo Brain Hospital, Capital Medical University. The related clinical and imaging data were retrieved. H&E, immunohistochemical and special stains were performed. Results: Out of the 48 plurihormonal PIT1-lineage tumors included, 13 cases were mature PIT1-lineage tumors and 35 cases were immature PIT1-lineage tumors. There were some obvious clinicopathological differences between the two groups. Clinically, the mature plurihormonal PIT1-lineage tumor mostly had endocrine symptoms due to increased hormone production, while a small number of immature PIT1-lineage tumors had endocrine symptoms accompanied by low-level increased serum pituitary hormone; patients with the immature PIT1-lineage tumors were younger than the mature PIT1-lineage tumors; the immature PIT1-lineage tumors were larger in size and more likely invasive in imaging. Histopathologically, the mature PIT1-lineage tumors were composed of large eosinophilic cells with high proportion of growth hormone expression, while the immature PIT1-lineage tumors consisted of chromophobe cells with a relatively higher expression of prolactin; the mature PIT1-lineage tumors had consistently diffuse cytoplasmic positive staining for keratin, while the immature PIT1-lineage tumors had various expression for keratin; the immature PIT1-lineage tumors showed more mitotic figures and higher Ki-67 proliferation index; in addition, 25.0% (12/48) of PIT1-positive plurihormonal tumors showed abnormal positive staining for gonadotropin hormones. There was no significant difference in the progression-free survival between the two groups (P=0.648) by Kaplan-Meier analysis. Conclusions: Plurihormonal PIT1-lineage tumor belongs to a rare type of PIT1-lineage pituitary neuroendocrine tumors, most of which are of immature lineage. Clinically increased symptoms owing to pituitary hormone secretion, histopathologically increased number of eosinophilic tumor cells with high proportion of growth hormone expression, diffusely cytoplasmic keratin staining and low proliferative activity can help differentiate the mature plurihormonal PIT1-lineage tumors from the immature PIT1-lineage tumors. The immature PIT1-lineage tumors have more complicated clinicopathological characteristics.

One year after the implementation of 2015 Tobacco Control Regulation on persons aged 15 years and over tobacco use in Beijing / 中华流行病学杂志

Objective: To understand the current status of smoking and smoking cessation in persons aged 15 years and over in Beijing and evaluate the effect of 2015 Beijing Tobacco Control Regulation. Methods: In 2014 and 2016, based on the principles and methodology of the Global Adult Tobacco Survey. A total of 50 communities or townships were selected from 324 communities or townships in Beijing through multistage cluster sampling, and 2 community (village) committees from each community or township were selected with the method of probability proportional to size (PPS). A total of 100 surveillance sites were set, and 100 households were selected from each surveillance site by using simple random sampling. Data were collected through face-to-face interview from the eligible family members aged 15 years and over with the assistance of a tablet computer. Statistical analyses were conducted by using complex sampling analyses module of SPSS 20.0, with weights as a combination of sampling weights, non-response weights and post- stratification weights, for the calculation of current smoking prevalence, daily smoking prevalence, smoking cessation rate, etc. Results: A total of 8 484 and 9 372 valid questionnaires were obtained, respectively, in 2014 and 2016, with the response rate of 86.5% and 96.5%. The current smoking prevalence in persons aged 15 years and over was 23.4% in 2014, and 22.3% in 2016. According to the 6(th) national census data, the current smoking population decreased by 199 000 in Beijing. The proportion of daily smokers declined from 20.7% in 2014 to 19.2% in 2016. The daily number of cigarettes consumed by current smokers increased from 14.6 in 2014 to 15.4 in 2016. The smoking cessation rate was 14.9% in 2014 and 16.8% in 2016. The proportion of current smokers who had at least one smoking cessation attempt in the past 12 months increased from 22.3% in 2014 to 23.2% in 2016, and the proportion of current smokers who planned to quit smoking increased from 11.6% to 15.5%. Among the current smokers who had visited doctors in the past 12 months, the proportion of those having smoking cessation advice was 58.9% in 2014 and 59.2% in 2016. In 2016, among the current smokers who had attempted to quit in the past 12 months, 36.8% were aware of the smoking cessation clinics, and 29.5%were aware of the quitline. Among those who were aware, only 7.7% had actually visited the cessation clinics, and 5.5% had used the quitline. Conclusions: After the implementation of 2015 Beijing Tobacco Control Regulation for 1 year, the current smoking prevalence in persons aged 15 years and over showed decreasing. It is necessary to further prompt the expansion of smoking cessation service to cover more current smokers.

First aid protocols for severe pelvic fractures / 中华创伤骨科杂志

Objective To discuss diagnostic classification and emergency treatment protocols for complex pelvic fractures. Methods The first aid management of 23 cases of major pelvic fractures were analyzed retrospectively. Results 22 of the patients survived, but one died of hemorrhagic shock.Conclusions Correct classification of severe pelvic fractures is of guidance value to the first aid management. Cooperation among multiple departments, comprehensive application of various surgical methods, early stabilization of hemodynamics, rapid repair of injured organs, stabilization of pelvic ring with external fixator are effective techniques to enhance the survival rate of patients with severe pelvic fractures.