Pulsatile gonadotropin-releasing hormone therapy induces spermatogenesis in pituitary stalk interruption syndrome:A case report and review of the literature

BACKGROUND Pituitary stalk interruption syndrome(PSIS)is a rare anatomical defect of the pituitary gland falling under the spectrum of holoprosencephaly phenotypes.It is characterized by a deficiency in anterior pituitary hormones,such as growth hormone,gonadotropins,and thyroid hormones.Due to the syndrome's rarity and nonspecific manifestations,there is a lack of standardized treatment strategies.Consequently,early diagnosis through imaging and on-time intervention are crucial for improving patients’outcomes.CASE SUMMARY A 30-year-old man presented with absent secondary sexual characteristics and azoospermia.Laboratory evaluation revealed a deficiency in gonadotropins,while thyroid function was mostly within normal ranges.Magnetic resonance imaging of the pituitary gland showed pituitary stalk agenesis,hypoplasia of the anterior pituitary,and ectopic posterior pituitary,leading to the diagnosis of PSIS.Initially,the patient underwent 6 mo of gonadotropin therapy without significant changes in hormone levels and secondary sexual characteristics.Pulsatile gonadotropin-releasing hormone therapy was then administered,resulting in the detection of sperm in the semen analysis within 3 mo.After 6 mo,routine semen tests showed normal semen quality.The couple faced challenges in conceiving due to abstinence and underwent three cycles of artificial insemination,which was unsuccessful.They also attempted in vitro fertilization,but unfortunately,the woman experienced a miscarriage 10 wk after the embryo transfer.CONCLUSION Early detection,accurate diagnosis,and timely treatment are crucial in improving the quality of life and fertility of PSIS patients.

Pituitary stalk interruption syndrome complicated with liver cirrhosis:A case report

BACKGROUND Pituitary stalk interruption syndrome(PSIS)is a rare disorder,often characterized by delayed growth and development,short stature,and hypogonadism as the main clinical manifestations.It is not clear whether PSIS can lead to liver cirrhosis.CASE SUMMARY This paper reported a case of liver cirrhosis of unknown origin.The patient was admitted to Beijing Ditan Hospital Affiliated to Capital Medical University in November 2023.The diagnosis of PSIS complicated with liver cirrhosis was established after a series of blood tests and pituitary magnetic resonance imaging examination.CONCLUSION We also reviewed the literature from both domestic and international sources to deepen the clinical understanding of PSIS in conjunction with liver cirrhosis among medical practitioners.

Pituitary stalk interruption syndrome and liver changes:From clinical features to mechanisms

Pituitary stalk interruption syndrome(PSIS)is a rare congenital abnormality characterized by thinning or disappearance of the pituitary stalk,hypoplasia of the anterior pituitary and an ectopic posterior pituitary.Although the etiology of PSIS is still unclear,gene changes and perinatal adverse events such as breech delivery may play important roles in the pathogenesis of PSIS.PSIS can cause multiple hormone deficiencies,such as growth hormone,which then cause a series of changes in the human body.On the one hand,hormone changes affect growth and development,and on the other hand,they could affect human metabolism and subsequently the liver resulting in nonalcoholic fatty liver disease(NAFLD).Under the synergistic effect of multiple mechanisms,the progression of NAFLD caused by PSIS is faster than that due to other causes.Therefore,in addition to early identification of PSIS,timely hormone replacement therapy and monitoring of relevant hormone levels,clinicians should routinely assess the liver function while managing PSIS.

Bisecreting Pituitary Neuroendocrine Tumors: About 9 Cases at the Abass Ndao Hospital Center in Dakar

Introduction: Pituitary neuroendocrine tumor (PitNET) may present multisecreting forms. Identifying its forms helps to guide management. This management is a real challenge, given the limited resources in our regions. In view of advances in the management of these multisecreting pituitary neuroendocrine tumors and the lack of published data in Africa, and in Senegal particularly, this survey was carried out with the aim of describing the epidemiological, clinical and therapeutic aspects of multisecreting PitNETs. Patients and Method: It was a multicenter, retrospective, descriptive and analytical study carried out on files collected from 1st January 2008 to 31 December 2022 in the neurosurgery departments of the Fann and Principal hospitals in Dakar and the endocrinology department of the Abass Ndao hospital in Dakar. Results: Of the 242 patients treated for PitNET, 09 presented (the mean age of our patients was 41.7 ± 11 years) with bihormonal PitNET, i.e. a proportion of 3.71%. Two types of association were found: 08 tumors with GH (Growth Hormon) + PRL (prolactin) secretion and 01 PitNET with ACTH (Adreno Corticotropic Homon) + prolactin secretion. Clinically, gonadotropic insufficiency was found in all patients (100%). Dysmorphic syndrome was found in 6 patients (66.7%) and tumor syndrome in 7 patients (77.8%). Ophthalmological evaluation revealed a decrease in visual acuity in 66.6% of patients. All had macroadenomas, with extension noted in 02 patients. All patients underwent transsphenoidal surgery with complications such as transient diabetes insipidus (3 patients, 33.3%), followed by cerebrospinal fluid leaks (1 patient, 11.1%). Remission was noted in all 5 patients tested. A comparison between the different secretory forms did not reveal any significant difference in the frequency of postoperative complications. Conclusion: Despite the lack of immunohistochemistry, two types of association were found: ACTH-PRL and GH-PRL. All were macroadenomas, the majority with an associated tumor syndrome. The latter was significantly less frequent in bisecreting PitNETs compared with monosecreting and non-functional forms. However, there was no significant difference in the occurrence of post-operative complications between the three secretory forms of PitNETs.

Identification of key enzymes in lignocellulose biosynthesis from dynamic observations in maize stalks

Maize stalk lignin and cellulose contents are linked to lodging resistance,disease resistance,feed quality and ethanol conversion efficiency.After the six-leaf stage of maize(V6),these constituents are biosynthesized and accumulated under the control of related enzymes and genes.However,the key enzymes,critical MYB transcription factors,and their dynamic alterations pattern under natural field circumstances are still unknown.Hence,we selected five cultivars with significant differences in lignocellulose content and lodging resistance as testing materials,performed field experiments for two years,and investigated the dynamics of lignin and cellulose content,related enzyme concentrations,and gene expression levels in the 3^(rd) and 5^(th) internodes above the ground after V6.The results showed that lignin and cellulose content increased after V6,stabilizing during the silking stage.This study identified COMT(caffeic acid 3-Omethyltransferase),TAL(tyrosine ammonia-lyase)and PAL(phenylalanine ammonia-lyase)as the key enzymes of lignin biosynthesis,while ZmCOMT,ZmCesA10 and ZmCesA8 were identified as essential genes.ZmMYB8,ZmMYB31 and ZmMYB39 were involved in regulating the expression of genes related to lignin synthesis,with ZmMYB31 potentially acting as a key negative regulator,while ZmMYB39 and ZmMYB8 acting as positive regulators.The study also found that around 14 d after V6 was a critical stage for regulating lignocellulose synthesis in the 3^(rd) to 5^(th) basal internode.This provides a theoretical foundation for developing regulatory techniques and breeding new cultivars to enhance lodging and disease resistance as well as the utility of maize stalks.

Determination of Physical, Mechanical and Fire Retardancy Properties of Innovative Particleboard Made from Corn Stalk (Zea mays L.) Particles

The demand for particleboard is increasing along with economic and population growth.However,two major barriers to the manufacture of particleboard are a shortage of raw materials(woodchips)and the emission of formaldehyde from conventional adhesives.Agricultural by-products such as corn stalks contain an abundance of renewable lignocellulosic fiber.This study evaluates the effect of citric acid as a natural adhesive and fire retardant addition on the physical,mechanical,and fire retardancy properties of particleboards fabricated from corn stalks.A cost-effective and inorganic salt,calcium carbonate,was tested to enhance the fire retardancy.Ammonium dihydrogen phosphate was also considered as a comparative control.Particleboards with the addition of calcium carbonate was pretreated with sodium chloride.The particleboards were pressed for 10 min at 200℃.Japanese Industrial Standard JIS A 5908:2022 was used as the benchmark for the physical and mechanical tests.Fire retardancy was dynamically tested by simulating a Bushfire Attack Level of 19 kW/m^(2).The particleboard with 25 wt%citric acid had superior mechanical properties and complied with the JIS A 5908 standard for Type 13 base particleboard.Particleboard with the addition of calcium carbonate(5%and 10%)showed significantly delayed pyrolysis time.

Genome-wide association mapping and genomic prediction of stalk rot in two mid-altitude tropical maize populations

Maize stalk rot reduces grain yield and quality.Information about the genetics of resistance to maize stalk rot could help breeders design effective breeding strategies for the trait.Genomic prediction may be a more effective breeding strategy for stalk-rot resistance than marker-assisted selection.We performed a genome-wide association study(GWAS)and genomic prediction of resistance in testcross hybrids of 677 inbred lines from the Tuxpe?o and non-Tuxpe?o heterotic pools grown in three environments and genotyped with 200,681 single-nucleotide polymorphisms(SNPs).Eighteen SNPs associated with stalk rot shared genomic regions with gene families previously associated with plant biotic and abiotic responses.More favorable SNP haplotypes traced to tropical than to temperate progenitors of the inbred lines.Incorporating genotype-by-environment(G×E)interaction increased genomic prediction accuracy.

Pituitary metastasis from lung adenocarcinoma

Pituitary tumor is a common neuroendocrine tumor,but there are also rare clinical metastases at this site,which are generally transferred from extrabellar tumors.Although the clinical incidence is low,the prognosis is poor.The purpose of this editorial is to discuss further the relevant knowledge of pituitary metas-tases and remind clinicians to prevent missed diagnosis and improve the prog-nosis of these patients.

miR-200b-3p accelerates progression of pituitary adenomas by negatively regulating expression of RECK

MicroRNA(miR)-200b-3p has been associated with many tumors,but its involvement in pituitary adenoma is unclear.This study investigated the molecular mechanism underlying miR-200b-3p regulation in pituitary adenomas to provide a theoretical basis for treatment.Bioinformatics was used to analyze pituitary adenoma-related genes and screen new targets related to RECK and miRNA.As well,the relationship between miR-200b-3p and RECK protein was verified using a double-luciferase reporter gene assay.The expression of miR-200b-3p in clinical samples was analyzed by in situ hybridization.Transfection of the miR-200b-3p inhibitor and small interfering-RECK(si-RECK)was verified by qPCR.GH3 cell viability and proliferation were detected using CCK8 and EdU assays.Apoptosis was detected by flow cytometry and western blotting.Wound healing and Transwell assays were used to detect cell migration and invasion.The effects of miR-200b-3p and RECK on GH3 cells were verified using salvage experiments.miR-200b-3p was highly expressed in pituitary tumor tissue.Inhibitors of miR-200b-3p inhibited cell proliferation promoted cell apoptosis,inhibited invasion and migration,and inhibited the expression of matrix metalloproteinases.Interestingly,miR-200b-3p negatively regulated RECK.The expression of RECK in pituitary adenoma tissues was lower than that in neighboring tissues.Si-RECK rescued the function of miR-200b-3p inhibitors in the above cellular behaviors,and miR-200b-3p accelerated the development of pituitary adenoma by negatively regulating RECK expression.In summary,this study investigated the molecular mechanism by which miR-200b-3p regulates the progression of pituitary adenoma through the negative regulation of RECK.The findings provide a new target for the treatment of pituitary adenoma.

Pituitary metastasis from lung adenocarcinoma:A case report

BACKGROUND Pituitary gland metastasis is an unusual event,and pituitary metastasis from lung adenocarcinoma is extremely rare and associated with poor prognosis.To date,approximately 15 cases have been reported.CASE SUMMARY Here,we present the case of a 64-year-old woman with pituitary metastasis derived from lung adenocarcinoma,which was difficult to distinguish from other sellar tumors.The patient presented to the neurosurgery clinic with blurred vision and intermittent headache.During hospitalization,brain computed tomography(CT)and magnetic resonance imaging revealed a pituitary macroadenoma.Chest CT revealed irregular nodules in the basal segment of the lower lobe of the left lung,which were likely lung cancer.Positron emission tomography-CT revealed a carbohydrate metabolism tumor in the lungs and sellar region,which was considered malignant.Postoperative pathological examination of the sellar tumor revealed lung adenocarcinoma.CONCLUSION Excision of pituitary metastases combined with radiotherapy and chemotherapy should be a priority treatment for patients with pituitary metastasis.

Clinical application of reserved gastric tube in neuroendoscopic endonasal surgery for pituitary tumor

BACKGROUND The neuroendoscopic approach has the advantages of a clear operative field,convenient tumor removal,and less damage,and is the development direction of modern neurosurgery.At present,transnasal surgery for sphenoidal pituitary tumor is widely used.But it has been found in clinical practice that some patients with this type of surgery may experience post-operative nausea and vomiting and other discomforts.AIM To explore the effect of reserved gastric tube application in the neuroendoscopic endonasal resection of pituitary tumors.METHODS A total of 60 patients who underwent pituitary adenoma resection via the endoscopic endonasal approach were selected and randomly divided into the experimental and control groups,with 30 in each group.Experimental group:After anesthesia,a gastric tube was placed through the mouth under direct vision using a visual laryngoscope,and the fluid accumulated in the oropharynx was suctioned intermittently with low negative pressure throughout the whole process after nasal disinfection,during the operation,and when the patient recovered from anesthesia.Control group:Given the routine intraoperative care,no gastric tube was left.The number of cases of nausea/vomiting/aspiration within 24 h post-operation was counted and compared between the two groups;the scores of pharyngalgia after waking up,6 h post-operation,and 24 h postoperation.The frequency of postoperative cerebrospinal fluid leakage and intracranial infection were compared.The hospitalization days of the two groups were statistically compared.RESULTS The times of postoperative nausea and vomiting in the experimental group were lower than that in the control group,and the difference in the incidence of nausea was statistically significant(P<0.05).After the patient woke up,the scores of sore throat 6 h after the operation and 24 h after operation were lower than those in the control group,and the difference was statistically significant(P<0.05).The number of cases of postoperative cerebrospinal fluid leakage and intracranial infection was higher than that of the control group,but there was no statistically significant difference from the control group(P>0.05).The hospitalization days of the experimental group was lower than that of the control group,and the difference was statistically significant(P<0.05).CONCLUSION Reserving a gastric tube in the endoscopic endonasal resection of pituitary tumors,combined with intraoperative and postoperative gastrointestinal decompression,can effectively reduce the incidence of nausea,reduce the number of vomiting and aspiration in patients,and reduce the complications of sore throat The incidence rate shortened the hospitalization days of the patients.

The Observation of Pituitary Function in Patients with Acute Pituitary Apoplexy before and after Transsphenoidal Surgery

Objective： To explore the pituitary function of acute pituitary apoplexy and its effect by transsphenoidal surgery. Methods： The clinical data and endocrine hormones level of 25 patients with acute pituitary apoplexy who underwent transsphenoidal surgery from Jan. 2002 to June 2004 were retrospectively analyzed. Results： 13 cases underwent surgery within 3 days after admission and 22 cases within 1 week. Of the 25 cases, 9 patients suffered the impairment of pituitary-thyroidal function, 14 cases of pituitary-adrenal function and 11 cases of pituitary-gonadal function before surgery. After surgery, 5/9, 8/14 and 7/11 were recovered from the corresponding hypopituitarism. Conclusion： Hypopituitarism is a major manifestation of acute pituitary apoplexy. Urgent surgery decompression contributed to the improvement of pituitary function. Patients with hypopituitarism after surgery required the corresponding hormones replacement therapy.

Biomechanical Characteristics of Rape Stalks

[Objective] To study the correlation between the biomechanical properties of rape stalks and rape stem lodging. [Method] Through axial compression tests to the stalks of 4 different rape varieties, the change rules of maximum stem bearing ca- pacity, maximum compressive strength, elastic modulus and moment of inertia along plant height were analyzed, as well as the effect of different varieties and water contents on the biomechanical property indices of rape stalks. [Result] The maximum loads of rape stalks presented liner decrease trend along with the increase of stem height, and all reached the maximums below the height of 50 cm. The maximum stem compressive strength and elastic modulus of the 4 varieties were increased with ascending height, but in a slow rate with small change, thus the modulus of e- lasticity could be considered as unchanged. The maximum bearing capacity, maxi- mum compressive strength and elastic modulus of dry rape stalks were higher than wet stalks, indicating that the water contents of rape stalks had significant effect on their mechanical properties. According to the actual lodging situations in filed, stalks of variety No. 1 owned the worst biomechanical properties and lodging degree, while the biomechanical properties of No. 6 and F5 were better than No. 1 and No. 9, and they also had stronger lodging-resistance. [Conclusion] The study provides parameters and bases for the design of mechanized production and mechanical deep processing of crops, and can better reveal the physical natures of organisms. The methods used in this study can also be used to screen excellent crop stalks.

Effects of Feeding Corn Stalks on Economic Indicators of Tenebrio molitor

[Objective] The study aimed at reducing the economic cost in feeding Tenebrio molitor and improving the utilization ratio of corn stalks.[Method] The effects of different proportions of corn stalks on the weigh of Tenebrio molitor and the contents of crude protein,crude fat,Ca,P,dry matter and crude ash in the half-dry matter of Tenebrio molitor had been studied in the laboratory.[Result] Compared with the recipes of all wheat bran and pure fine fodder,feeding Tenebrio molitor by applying 30%-60% of corn stalks could significantly improve the content of crude protein in the half-dry materials of Tenebrio molitor,but it was detrimental to the improvement in weight of Tenebrio molitor and the accumulation of crude fat.To be specific,the recipe V（50% of corn stalks ＋ 50% of fine fodder） was beneficial to the accumulation of dry matter and crude ash.The recipe VII（70% of corn stalks ＋ 30% of fine fodder） and the recipe VIII（70% of corn stalks treated with Guangda feed leaven ＋ 30% of fine fodder） were beneficial to the accumulation of crude protein,Ca and P.There were differences among the influences of corn stalks in different treatments on the crude protein and other nutrition indicators of Tenebrio molitor.[Conclusion] Appropriately applying corn stalks can improve the accumulation of the crude protein,crude ash,dry matter,Ca and P of Tenebrio molitor but was detrimental to the growth and development of Tenebrio molitor and the accumulation of crude fat.

Relationship Between Histopathology and Clinical Prognosis of Invasive Pituitary Adenoma

Objective: To study the relationship between histopathology and clinical prognosis of invasive pituitary adenoma subjected to transsphenoidal surgery. Methods: The enrolled were 82 patients with invasive pituitary adenomas undergoing transsphenoidal surgery during Jan. 2000 - May 2003 in our department with full MR imaging findings, pathology data and follow-up information. The follow-up duration was 5-30 months. Results: MR imaging findings of invasive pituitary adenoma included: depression of the sellar floor, involvement of sphenoid sinus and cavernous sinus, breakthrough of diaphragma sellae, encasement of internal carotid artery, etc. Pathological examination revealed that the invasion rate of dura in sella turcica was the highest among the structures around tumor. Pituitary adenoma apoplexy was found in 20 cases (24.4%). The total removal rate for PRL-secreting adenomas was significantly lower than that for non-secreting adenomas (P<0.01), but non-, GH-, ACTH-secreting adenomas had no significant differences. The recurrence rate of PRL-secreting adenomas was higher than that of non- and GH-secreting adenomas (P<0.05). Conclusion: Among invasive pituitary adenomas, the therapeutic effects of non-and GH-secreting pituitary adenomas are better than that of PRL-secreting adenomas. Invasive biological behaviors of invasive pituitary adenomas result in radical operation failure and postoperative recurrence.

Effects of Dilute Acid-intensified Hydrolysis on Fermentative Biohydrogen Production Capacity of Maize Stalk

[Objective] This study was to explore the effects of dilute acid hydrolysis on fermentative biohydrogen production capacity of maize stalk. [Method] Using maize stalks subjected to mechanical disintegration,steam explosion and dilute acid hydrolysis as experimental materials,we measured and analyzed the effects of different treatments and particle size of maize stalk were analyzed. [Result] The optimal fermentative biohydrogen production was found under following parameters：pretreatment of 0.8% dilute H2SO4 following steam explosion,particle size of maize stalk of 0.425-0.850 mm,liquid-solid ratio [0.8% H2SO4 （M）：stalk （W）] of 10：1. [Conclusion] Post steam explosion,dilute 0.8% dilute H2SO4 intensified hydrolysis on maize stalk could produce fermentative biohydrogen production capacity.

Clinical case discussions-Hypopituitarism and pituitary apoplexy caused by pituitary Adenomas

A case of“Hypopituitarism and pituitary apoplex induced by pituitary Adenomas”was collected in the Third Affiliated Hospital of Inner Mongolia medical University Geriatric Department.A rare and atypical disease as it is,delayed diagnosis and treatment is easily seen among those cases.Therefore,the paper aims to investigate the difference of clinical characteristics and treatment outcome of pituitary adenomas in elder patient through the case analysis.Clinically,patients with pituitary dysfunction may have life-threatening crisis so that timely diagnosis and aggressive treatment can be effective in reducing the pituitary crisis and reducing the misdiagnosis rate.

Research upon the Structure and Pyrolysis of Cotton Stalk

[Purpose]To research upon the structure and pyrolysis of cotton stalk.[Method] In this paper thermogravimetric analysis is adopted to study pyrolysis characteristics on the longitudinal direction of cotton stalk（the stick and the root）and on the traverse direction（the cuticle,cortex and medulla）.[Result] Cotton stalk is a material of uneven and irregular texture,and there are great differences in the structure of all these parts on the longitudinal and traverse directions,especially in the contents of different components in each layer.The reaction in the stick and root becomes violent along with the increase in the rising rate of temperature,and carbon yield rate decreases in turn.Besides with the same rising rate of temperature,carbon yield rate of cotton stick is higher than the one of cotton root.Carbon yield rates of cuticle,cortex and medulla decrease in turn while the violence of the reaction in cuticle is less severe than in cortex and medulla.[Conclusion] It has provided theoretical basis for obtaining activated carbon technology of cotton stick.

Heshouwu decoction, a Chinese herb for tonifying kidney, ameliorates hypothalamic-pituitary-testicular axis secretion in aging rats

An increasing amount of evidence demonstrates the anti-aging effect of Heshouwu in pill form. In this study, a subacute aging rat model was established by continuous intraperitoneal injection of D-galactose and treated with Heshouwu decoction （a Chinese herb for tonifying the kidney, comprising Heshouwu pill, Herba Epimedii, Radix Salviae Miltiorrhiae, and Poria）. Heshouwu pill treated rats were the positive control group. Radioimmunoassay, immunohistochemical staining, and western blot assay showed hypothalamic gonadotropin-releasing hormone, hypothalamic substance P, and serum gonadotropin levels to be significantly increased in the model rats; the concentrations of hypothalamic ~3-endorphin, and serum levels of insulin-like growth factor I and testosterone were significantly decreased. 1713- and 3[3-hydroxysteroid dehydrogenase expression in testicular tissue was also decreased. Intragastric administration of Heshouwu decoction at high （9.6 g/mL/100 g）, medium （4.8 g/mL/100 g）, and low （2.4 g/mlJ100 g） doses, Heshouwu decoction pretreatment at a medium dose （4.8 g/mL/100 g）, and Heshouwu pill （2.06 g/mL/100 g） significantly reversed these changes. Heshouwu decoction pretreatment and high-dose Heshouwu decoction had the greatest anti-aging effects. These experimental findings indicate that Heshouwu decoction can improve hypothalamic-pituitary-testicular axis secretion in a subacute aging rat model, and prevent and delay gonadal axis aging, with an effect superior to that of Heshouwu pill.

Clinical features of patients with pituitary stalk thickening: a review of 159 cases from one medical center

Background:Pituitary stalk thickening (PST) used as an imaging diagnosis plays a major role in diagnosis and treatment of the hypothalamus and pituitary disease at an early stage.Up until now,several lines of systematic investigations have been conducted among adolescents,and the results indicated that PST is possibly one of the principal early manifestations of sellar region tumor.To characterize the major clinical features of PST and to identify the most effective treatments we conducted this study.Methods:This was a retrospective review of patients with PST evaluated at Huashan Hospital over an eight-year period between 2007 and 2014.One hundred fifty nine patients who were diagnosed PST were included.The data including demographics,clinical presentations,imaging examinations,laboratory results and surgery were thoroughly reviewed and carefully analyzed.According to their clinical presentations and examinations,relevant treatments were adopted and different prognosis were observed.Results:Of the 159 patients,57 were males and 102 were females (median age was 29 and 43.4％ were under the age of 21 years).And of the patients in the age group between 30 and 35 years,84％ were females.'Polydipsia and polyuria' was the most common clinical manifestation observed in 90 cases (＞50％).49.5％ of the patients were diagnosed to have at least one anterior pituitary dysfunction.The sellar region MRI (SR-MRI) data showed that patients who had different clinical presentations or pituitary function showed different SR-MRI appearance.Over 60％ patients who performed followup MRI showed shrunken PST.Fourteen cases who received radiotherapy appeared to be improved as shown by MRI.Conclusions:PST is most commonly seen in the teenagers and the women of reproductive age.Distinct etiology may be identified based on the clinical manifestations,age and SR-MRI,which would help to make the final decision for treatments.Radiotherapy and immuno-suppressed therapy are effective in alleviating clinical symptoms and shrinking the stalk thickening.