Background: Neuroendocrine neoplasms are those that develop from a neuroendocrine cell. They most commonly affect the lungs, gastrointestinal tract, and pancreas, being rare conditions in the female genital tract. Whe...Background: Neuroendocrine neoplasms are those that develop from a neuroendocrine cell. They most commonly affect the lungs, gastrointestinal tract, and pancreas, being rare conditions in the female genital tract. When present, these neoplasms often manifest with nonspecific signs and symptoms such as pain, itching, swelling, single-focus lesions, bleeding, and enlargement of inguinal lymph nodes, in addition to the presence of progressively enlarging vulvar nodules. Consequently, the diagnostic investigation involves histopathological examination and confirmation through immunohistochemistry. Objective: To present a comprehensive understanding of this rarely studied pathology. The primary objective is to provide valuable insights that could aid in the future development of universally applicable treatment guidelines. Case Presentation: A 57-year-old female, with no prior comorbidities, menopause at 36, who presented with a left vulvar nodule accompanied by intense pain and swelling, later diagnosed with small cell neuroendocrine carcinoma in the vulva. Conclusion: This case report highlights the importance of enhancing our knowledge regarding small cell neuroendocrine carcinoma in the vulva, given its scarcity in medical literature. The information presented here underscores the need for standardized diagnostic and treatment approaches, paving the way for future consensus on managing this uncommon but challenging neoplasm.展开更多
目的:了解中国女性1990—2019年妇科疾病负担变化趋势及其年龄、时期、队列效应,为妇科疾病的预防和控制策略的制定提供科学依据。方法:利用2019年全球疾病负担研究(Global Burden of Disease Study 2019,GBD 2019)数据,采用Joinpoint...目的:了解中国女性1990—2019年妇科疾病负担变化趋势及其年龄、时期、队列效应,为妇科疾病的预防和控制策略的制定提供科学依据。方法:利用2019年全球疾病负担研究(Global Burden of Disease Study 2019,GBD 2019)数据,采用Joinpoint回归模型分析中国妇科疾病发病率和伤残调整寿命年(disability adjusted life year,DALY)率的变化趋势,基于年龄-时期-队列模型探讨年龄、时期和队列效应对发病率和DALY率的影响,并分析经前期综合征、生殖器脱垂、子宫肌瘤、子宫内膜异位症、多囊卵巢综合征发病率和DALY率的顺位。结果:1990—2019年中国妇科疾病发病率和DALY率均呈下降趋势,平均每年分别下降0.63%(95%CI:-0.73%~-0.54%,P<0.05)和0.34%(95%CI:-0.43%~-0.24%,P<0.05)。年龄-时期-队列模型结果显示,1990—2019年中国妇科疾病发病率和DALY率的纵向年龄曲线均呈先上升后下降的趋势,在30~34岁达高峰。随着时期的推移,妇科疾病的发病风险和DALY风险均呈下降趋势,以2000—2004年为参考时期(RR=1),2015—2019年时期发病风险下降至最低(RR=0.73,95%CI:0.74~0.71)。1905—1909至1985—1989年出生队列的发病风险和DALY风险呈下降趋势,1990—1994至2000—2004年出生队列略呈上升趋势。1990和2019年常见妇科疾病中经前期综合征发病率(7245.53/10万、5695.02/10万)和DALY率(222.21/10万、197.95/10万)居于首位。结论:我国减少妇科疾病负担的工作已取得一定进展,但疾病负担仍然严重,应加强对年轻女性妇科疾病的健康宣传教育,开展有针对性的普查,提高诊断和治疗技术,继续降低我国的妇科疾病负担。展开更多
OBJECTIVE ： The pathogenesis of tardive dyskinesia （TD） is complicated and uncertain, Thus, there is not any effective treatment for it. The psychiatrists pay more and more attention to TD, which lasts for a long t...OBJECTIVE ： The pathogenesis of tardive dyskinesia （TD） is complicated and uncertain, Thus, there is not any effective treatment for it. The psychiatrists pay more and more attention to TD, which lasts for a long time and is difficult to treat. DATA SOURCES： A computer-based online search of Medline database was undertaken to identify articles about the feature of etiology and the progression of treatment for TD published in English by using the keywords of ＂rD, etiology, pathogenesis＂ and ＂TD, therapy, drug treatment＂. Meanwhile, Chinese articles about the feature of etiology and the progression of treatment for TD were searched in Wanfang database and China journal full-text database, and the keywords were ＂TD, etiology, pathogenesis＂ and ＂TD, therapy, drug Treatment＂ in Chinese. STUDY SELECTION： Articles met the following inclusion criteria were selected in this paper. Inclusion criteria： （1） Researches of randomized blind control design, before and after control design and retrospective. （2） Researches of the feature of etiology and the progression of treatment for TD. Exclusion criteria： the repetitive researches and individual reports. DATA EXTRACTION ： Totally 65 articles related the feature of etiology and the progression of treatment for TD of randomized blind control design, before and after control design and retrospective studies were collected, and 53 of them were accorded with the inclusion criteria. Of the 12 excluded ones, 8 were concerning with genetics, 4 were repetitive researches. DATA SYNTHESIS ： The feature of etiology for TD includes：（1） Hypothesis of dopamine receptor super-sensitivity： The dopamine receptor is persistently blocked, so it will result in functional disorder in CNS, and then TD may take place. （2）） Hypothesis of neuronal degeneration： The concentration of aminosuccinic acid and glutamic acid will increase after the antipsychotic used for a long time and this will result in neuronal degeneration through glutamic acid receptor in the postsynaptic membrane; meanwhile with free radical, the nerve cells of corpus striatum may degenerate and become necrosis. （3） Sex and age： The females and gerontal patients are liability to the TD disease. It is may related to the lower estrogen. （4） Molecule heredity： TD may association with the dopamine and 5-HT receptor gene polymorphism. （5） Other theories： Hypofunction of γ-amino-butyri acid （GABA）, hypothesis of noradrenaline 5-serotonin and nutrition metabolism can cause TD disease. Treatlent for TD： （1） Dopamine receptor agonist： The therapeutic effect is not satisfactory, especially for gerontism females. （2） Oxygen free radical scavenger： As represent of vitamin E, it can clear out free radicals and reduce the potential cytotoxic effect of free radicals. （3） Calcium channel blocker： This maybe related to block calcium ions releasing from muscle cells and inhibit muscle convulsion; therefore, it can be used for symptomatic treatment. （4） GABA receptor agonist： It is more effective for the prominent dysmyotonia than dancing slowly symptom. （5） Antipsychotic： There is some therapeutic effect with ciozapine, but the effect will reduce because of the age growing up and the symptom exacerbating. （6） Other therapies： Valproate sodium, cyproheptadine, melatonin, branched chain amino acid, ahalysantinfarctasum, electric acupuncture and injection ad acumen, traditional Chinese drug have a certain effects on TD. Prevention of TD： The serum creatine phosphokinase （CPK） combined with symptoms should be checked regularly so as to early discovery TD. CONCLUSION ： （1） Etiology of TD： The hypothesis of dopamine receptor super-sensitivity is denyed; the hypothesis of neuronal degeneration is approved in academic circles; the sex and age is a finding of generally received; but the dopamine and 5-HT receptor gene polymorphism, hypofunction of GABA, noradrenaline, 5-serotonin and nutrition metabolism cannot explain the pathogenesis of TD. （2） Treatment for TD： The therapeutic effect of dopamine receptor agonist is not satisfactory; the oxygen free radical scavenger maybe effective; calcium channel blocker maybe used for symptomatic treatment; GABA receptor agonist maybe more effective for the prominent dysmyotonia than dancing slowly symptom; the consequence of antipsychotic is discrepancy; other therapies maybe use to adjunctive therapies. （3） As far as prevention of TD is concerned, and the serum CPK combined with symptoms should be checked regularly so as to early discovery TD.展开更多
文摘Background: Neuroendocrine neoplasms are those that develop from a neuroendocrine cell. They most commonly affect the lungs, gastrointestinal tract, and pancreas, being rare conditions in the female genital tract. When present, these neoplasms often manifest with nonspecific signs and symptoms such as pain, itching, swelling, single-focus lesions, bleeding, and enlargement of inguinal lymph nodes, in addition to the presence of progressively enlarging vulvar nodules. Consequently, the diagnostic investigation involves histopathological examination and confirmation through immunohistochemistry. Objective: To present a comprehensive understanding of this rarely studied pathology. The primary objective is to provide valuable insights that could aid in the future development of universally applicable treatment guidelines. Case Presentation: A 57-year-old female, with no prior comorbidities, menopause at 36, who presented with a left vulvar nodule accompanied by intense pain and swelling, later diagnosed with small cell neuroendocrine carcinoma in the vulva. Conclusion: This case report highlights the importance of enhancing our knowledge regarding small cell neuroendocrine carcinoma in the vulva, given its scarcity in medical literature. The information presented here underscores the need for standardized diagnostic and treatment approaches, paving the way for future consensus on managing this uncommon but challenging neoplasm.
文摘目的:了解中国女性1990—2019年妇科疾病负担变化趋势及其年龄、时期、队列效应,为妇科疾病的预防和控制策略的制定提供科学依据。方法:利用2019年全球疾病负担研究(Global Burden of Disease Study 2019,GBD 2019)数据,采用Joinpoint回归模型分析中国妇科疾病发病率和伤残调整寿命年(disability adjusted life year,DALY)率的变化趋势,基于年龄-时期-队列模型探讨年龄、时期和队列效应对发病率和DALY率的影响,并分析经前期综合征、生殖器脱垂、子宫肌瘤、子宫内膜异位症、多囊卵巢综合征发病率和DALY率的顺位。结果:1990—2019年中国妇科疾病发病率和DALY率均呈下降趋势,平均每年分别下降0.63%(95%CI:-0.73%~-0.54%,P<0.05)和0.34%(95%CI:-0.43%~-0.24%,P<0.05)。年龄-时期-队列模型结果显示,1990—2019年中国妇科疾病发病率和DALY率的纵向年龄曲线均呈先上升后下降的趋势,在30~34岁达高峰。随着时期的推移,妇科疾病的发病风险和DALY风险均呈下降趋势,以2000—2004年为参考时期(RR=1),2015—2019年时期发病风险下降至最低(RR=0.73,95%CI:0.74~0.71)。1905—1909至1985—1989年出生队列的发病风险和DALY风险呈下降趋势,1990—1994至2000—2004年出生队列略呈上升趋势。1990和2019年常见妇科疾病中经前期综合征发病率(7245.53/10万、5695.02/10万)和DALY率(222.21/10万、197.95/10万)居于首位。结论:我国减少妇科疾病负担的工作已取得一定进展,但疾病负担仍然严重,应加强对年轻女性妇科疾病的健康宣传教育,开展有针对性的普查,提高诊断和治疗技术,继续降低我国的妇科疾病负担。
文摘OBJECTIVE ： The pathogenesis of tardive dyskinesia （TD） is complicated and uncertain, Thus, there is not any effective treatment for it. The psychiatrists pay more and more attention to TD, which lasts for a long time and is difficult to treat. DATA SOURCES： A computer-based online search of Medline database was undertaken to identify articles about the feature of etiology and the progression of treatment for TD published in English by using the keywords of ＂rD, etiology, pathogenesis＂ and ＂TD, therapy, drug treatment＂. Meanwhile, Chinese articles about the feature of etiology and the progression of treatment for TD were searched in Wanfang database and China journal full-text database, and the keywords were ＂TD, etiology, pathogenesis＂ and ＂TD, therapy, drug Treatment＂ in Chinese. STUDY SELECTION： Articles met the following inclusion criteria were selected in this paper. Inclusion criteria： （1） Researches of randomized blind control design, before and after control design and retrospective. （2） Researches of the feature of etiology and the progression of treatment for TD. Exclusion criteria： the repetitive researches and individual reports. DATA EXTRACTION ： Totally 65 articles related the feature of etiology and the progression of treatment for TD of randomized blind control design, before and after control design and retrospective studies were collected, and 53 of them were accorded with the inclusion criteria. Of the 12 excluded ones, 8 were concerning with genetics, 4 were repetitive researches. DATA SYNTHESIS ： The feature of etiology for TD includes：（1） Hypothesis of dopamine receptor super-sensitivity： The dopamine receptor is persistently blocked, so it will result in functional disorder in CNS, and then TD may take place. （2）） Hypothesis of neuronal degeneration： The concentration of aminosuccinic acid and glutamic acid will increase after the antipsychotic used for a long time and this will result in neuronal degeneration through glutamic acid receptor in the postsynaptic membrane; meanwhile with free radical, the nerve cells of corpus striatum may degenerate and become necrosis. （3） Sex and age： The females and gerontal patients are liability to the TD disease. It is may related to the lower estrogen. （4） Molecule heredity： TD may association with the dopamine and 5-HT receptor gene polymorphism. （5） Other theories： Hypofunction of γ-amino-butyri acid （GABA）, hypothesis of noradrenaline 5-serotonin and nutrition metabolism can cause TD disease. Treatlent for TD： （1） Dopamine receptor agonist： The therapeutic effect is not satisfactory, especially for gerontism females. （2） Oxygen free radical scavenger： As represent of vitamin E, it can clear out free radicals and reduce the potential cytotoxic effect of free radicals. （3） Calcium channel blocker： This maybe related to block calcium ions releasing from muscle cells and inhibit muscle convulsion; therefore, it can be used for symptomatic treatment. （4） GABA receptor agonist： It is more effective for the prominent dysmyotonia than dancing slowly symptom. （5） Antipsychotic： There is some therapeutic effect with ciozapine, but the effect will reduce because of the age growing up and the symptom exacerbating. （6） Other therapies： Valproate sodium, cyproheptadine, melatonin, branched chain amino acid, ahalysantinfarctasum, electric acupuncture and injection ad acumen, traditional Chinese drug have a certain effects on TD. Prevention of TD： The serum creatine phosphokinase （CPK） combined with symptoms should be checked regularly so as to early discovery TD. CONCLUSION ： （1） Etiology of TD： The hypothesis of dopamine receptor super-sensitivity is denyed; the hypothesis of neuronal degeneration is approved in academic circles; the sex and age is a finding of generally received; but the dopamine and 5-HT receptor gene polymorphism, hypofunction of GABA, noradrenaline, 5-serotonin and nutrition metabolism cannot explain the pathogenesis of TD. （2） Treatment for TD： The therapeutic effect of dopamine receptor agonist is not satisfactory; the oxygen free radical scavenger maybe effective; calcium channel blocker maybe used for symptomatic treatment; GABA receptor agonist maybe more effective for the prominent dysmyotonia than dancing slowly symptom; the consequence of antipsychotic is discrepancy; other therapies maybe use to adjunctive therapies. （3） As far as prevention of TD is concerned, and the serum CPK combined with symptoms should be checked regularly so as to early discovery TD.
