2015年 · 第95卷第05期

Pituitary adenoma is a common benign tumor of the nervous system, accounting for 15% ~20% of intracranial tumors, ranking second, the incidence rate of population is 8.2% ~14.7%, and the discovery rate of autopsy is 20% ~30%^[1,2]。 At present, doctors in more and more hospitals have carried out surgical treatment of pituitary adenoma. However, due to the lack of knowledge of doctors about this disease, the treatment is not standardized and the mastery of surgical indications is deviated; Due to the lack of experience in surgical treatment, the postoperative efficacy varies greatly. In addition, due to China's vast territory and unbalanced economic development, the configuration of examination and surgical equipment in various hospitals is quite different, and even the diagnostic criteria of pituitary adenoma in various hospitals are different. Therefore, standardizing the surgical treatment of pituitary adenoma is an urgent problem to be solved. China Pituitary Adenoma Collaboration Group organized experts from neurosurgery, endocrinology, neuroimaging, nuclear medicine and pathology in many hospitals across the country to write the Expert Consensus on Surgical Treatment of Pituitary Adenoma in China^[3]We hope to improve the understanding of the surgical treatment of pituitary adenoma, standardize the behavior of pituitary surgical treatment, and make contributions to the development of pituitary surgery in China.

The pituitary gland is an important endocrine gland located in the sella turcica and is divided into adenopituitary and neuropituitary. The former regulates the endocrine function of the corresponding target glands by secreting important hormones such as luteinizing hormone, follicle stimulating hormone, growth hormone, prolactin, thyroid stimulating hormone and adrenocorticotropin, and plays an important physiological role in growth and development, energy metabolism, immune function and reproduction. Pituitary adenoma is a benign tumor derived from adenopituitary cells. Because some pituitary adenomas themselves have secretory function, and may damage the function of other adenopituitary-target gland axis, compress and destroy the surrounding important tissue structures, the clinical manifestations are complex and diverse, and the diagnosis and treatment require the cooperation of endocrinology, neurosurgery, radiotherapy, imaging, ophthalmology, obstetrics and gynecology, etc. Standardized diagnosis and treatment can alleviate the related symptoms and signs caused by pituitary adenomas to the maximum extent and maintain normal adenopituitary function. The diagnosis and treatment of pituitary-related diseases in China began in the 1970s. At present, more and more clinicians pay attention to the diagnosis and treatment of pituitary adenoma. However, due to the unbalanced development of medical level in various regions, there are great differences in the diagnosis and treatment concepts and levels of pituitary adenoma among medical institutions at all levels, and the lack of standardized diagnosis and treatment procedures and good follow-up mechanism seriously affects the prognosis and long-term quality of life of patients.

All antidepressants, including tricyclic antidepressants (TCAs) and novel antidepressants, have potential epileptogenic risks, and the higher the dose, the greater the risk. Although the mechanism of how high-dose antidepressants produce epileptogenic effects is still unclear, it is an important clinical problem to avoid seizures induced by antidepressants while treating depressive disorders. This article expounds this problem in order to help the clinical practice.

Pituitary adenomas are common intracranial tumors, and the mechanism of their occurrence is unknown. Some pituitary adenomas, especially aggressive and atypical pituitary adenomas, have limited treatment and poor prognosis. MicroRNAs (miRNAs) are a class of non-coding small RNA molecules with post-transcriptional regulatory functions, which have been confirmed to play an important role in the development of a variety of human tumors, including pituitary adenomas. In recent years, more and more studies have confirmed that the abnormal expression of miRNAs in pituitary adenomas may be significantly related to tumor development, clinical characteristics and prognosis. The research progress of miRNAs in pituitary adenoma is reviewed as follows.

SAPHO syndrome (Synovitis-Acne-Pustulosis-Hyperostosis-Osteitis syndrome), or Synovitis-Acne-Pustulosis-Bone Hypertrophy-Osteitis syndrome, is a chronic inflammatory disease mainly involving bones, joints and skin. This disease name was originally written by Chamot et al.^[1]It is proposed that there have been previous names such as sternoclavicular hypertrophic osteitis, chronic recurrent multifocal osteomyelitis, and palmoplantar pustular osteitis. This disease is rare, and the incidence rate may not exceed 1/10 000^[2]It is more common in young and middle-aged people, and the incidence of women is slightly higher than that of men^[3,4,5,6,7]。 Most of the foreign reports of SAPHO syndrome come from European countries such as France and Italy. With the in-depth research and increasing understanding of the disease, the number of domestic reports has gradually increased in recent years, and the clinical characteristics are similar to those of foreign patients. The pathogenesis of SAPHO syndrome is still unknown, but it may be related to many factors such as heredity, infection and immunity.

In recent years, with the improvement of socio-economic level and people's health awareness, the discovery rate of pituitary adenoma is increasing year by year. Because pituitary adenoma not only has various characteristics of tumor, but also can cause abnormalities of endocrine function (including infertility and infertility), which brings great adverse effects to patients, families and society. Pituitary adenoma is a benign tumor, and surgical treatment is the main treatment for patients with many types of pituitary adenoma. If properly treated, most patients can be cured. However, due to China's vast territory, unbalanced economic development and uneven medical level, there are great differences in the understanding and treatment of diseases by medical staff, which seriously affects the prognosis of patients with pituitary adenoma. In order to solve the above problems and improve the level of surgical treatment of pituitary adenoma, China Pituitary Adenoma Collaborative Group organized experts and scholars related to pituitary adenoma to write the Expert Consensus on Surgical Treatment of Pituitary Adenoma in China, hoping that through the consensus, the understanding of surgical treatment of pituitary adenoma can be improved, the behavior of pituitary surgical treatment can be standardized, and the development of pituitary surgery in China can be contributed.