ObjectiveTo present the experience of microsurgery for giant sellar region tumor via supraorbital pterional approach. Methods Eighteen patients with giant sellar region tumor were treated microsurgically ,There were 7 pituitary adenomas, 8 craniopharyngiomas, 1 germinoma, 1 meningioma and 1 teratoma.ResultsTumor was totally removed in 12 cases,subtotally removed in 6. The patients were followed up with a period of 4 to 23 months,good recovery was achieved in 12 cases,moderate in 3,severe deficit in 1,1 patient died 16 days after operation. ConclusionSupraorbital pterional approach offers an excellent expposure to sellar region tumor and its surrounding structures. Microsurgical techniques play a great role in tumor removing and preserving hypothalamic function during operation.

The results of detection of circulating antigen(CAg) in cerebrospinal fluids(CSF) of 231 cerebral cysticercosis patients with McAb(4F8)-based ELISA were reported and compared with the case histories , clinical manifestations and CT scans. No relationship was found between CAg detected in CSF of these cases and history of taeniasis. However, the positive rate of CAg in cerebral cysticercosis patients with subcutaneous nodules was found significantly higher than those in cases with simple cerebral cysticercosis and in cases with subcutaneous nodules disappeared after anti-Cysticercus therapy before CSF collection. The results of CAg detection in CSF were related with the CT findings as well as the stage of the disease. It is thus indicated that MeAb(4F8)-based ELISA might be useful not only for diagnosis of neurocysticercosis, but also for the evaluation of efficacy of anti-Cysticercus therapy.

Objective To explore the microanatomy technique of the endoscopy-assisted extreme lateral supracerebellar infratentorial keyhole approach and clinical significance.Methods The extreme lateral supracerebellar infratentorial keyhole approach was imitated in 10 vascular perfusion adult cadaveric heads fixed in formalin,the dorsolateral mesencephalon region was dissected and observed by microscopy and neuroendoscopy from December 2012 to March 2013.Results The extreme lateral supracerebellar infratentorial keyhole approach could be fully exposed the ambient cisterns,the posteromedial tentorial incisura,the dorsolateral mesencephalon region,the trochlear nerve,the root of the trigeminal nerve,the superior cerebellar artery,the posterior cerebral artery and other important anatomical structures.The temporal lobe and parahippocampal gyrus could be exposed when the tentorial was incised.The application of neuroendoscopy could clearly reveal the trigeminal nerve and surrounding structures.Conclusion The extreme lateral supracerebellar infratentorial keyhole approach is suitable for the surgical resection in dorsolateral mesencephalon region.The application of neuroendoscopy can make up for the lack of the trigeminal nerve observed under microscopy and expand the operative field.

OBJECTIVE To investigate the correlative factors that would affect the prognosis of geriatric lower respiratory infection.METHODS A total of 101 geriatric patients diagnosed as lower respiratory infection were enrolled in emergency ICU.The laboratory tests such as blood chemical tests,C-reactive protein,and troponin T(cTnT)were obtained twice 2 hours and 24 hours after admission,respectively.Other parameters including general condition,clinical outcomes as well as APACHE Ⅱ and SIRS scores within 24 hours were recorded.RESULTS The ages,cTnT and SIRS score were negatively correlated to clinical outcome.CONCLUSIONS The ages,SIRS scores and cTNT levels are independent prognostic factors in geriatric lower respiratory infection.

Objective To evaluate effect of the non-fused recombinant antigen in immuno diagnosis of echinococcosis. Methods The coding sequence of the target gene was cloned into prokaryotic non-fusion expression vector pQE30 ( + ) and expressed in E. coli. The recombinant protein was identified by SDS-PAGE and Western Blot, purified with affinity chromatography and used in ELISA to detect specific antibody in patients' sera. Results SDS-PAGE and Western blot demonstrated that Echinococcus multilocularis immunodominant major surface antigen gene was highly expressed in E. coli. The result of ELISA showed that out of 68 echinococcosis sera, 66 samples (97.1% ) were detected positively by the assay. Only 2 samples (2% ) were positive in 100 sera from cases with other infective diseases including cysticercosis or healthy persons. The sensitivity and specificity of the assay were 97.1% and 98% respectively. Conclusion Echinococcus multilocularis immunodominant major surface antigen gene has been highly expressed in E. coli in non-fusion form. ELISA with the recombinant protein is highly sensitive and genus-specific for echinococcosis diagnosis.

Objective To study effect and significance of systemic inflammatory response syndrome(SIRS) score and APACHE Ⅱ score in prognosis in severe patients of emergency department.Methods Data of 114 patients were collected at admission.SIRS score and APACHEⅡ score were calculated in 24 hours.To analyze mortality of patients in different score,to estimate dependability of them.Result With SIRS score increasing,mortality rate increased as well and patients with SIRS score ≥2 or APACHE Ⅱ score ≥25 had significantly higher mortality rate.Conclusions SIRS score is a simple,useful predictor of outcome in patients of emergency department.It can be used in clinical generally.

Objective To detect γ-secretase gene mutations in a large Chinese pedigree with acne inversa (AI).Methods Clinical evaluation was carried out in a large pedigree with AI through field investigation.Peripheral blood samples were obtained from 17 family members (11 affected and 6 unaffected) and 100 unrelated healthy human controls.DNA was extracted from the blood samples,and PCR was performed to amplify all the coding regions of PSEN 1,PSENEN and NCSTN genes followed by DNA sequencing analysis.Results There were 67 members over 5 generations in this family,of whom,25 (13 males and 12 females) were affected by AI.AI was inherited in an autosomal dominant manner in this family.Skin lesions were mainly distributed on the neck,back,chest and buttocks,and occasionally in subaxillary regions.DNA sequencing revealed a novel missense mutation,c.1258C＞ T (p.Q420XP),in the exon 11 of the NCSTN gene in 11 affected family members,which leads to a substitution of glutamine by a premature termination codon at amino acid 420 (p.Q420X).The mutation was undetected in either the unaffected members or the unrelated healthy controls,and had not been registered in the single nucleotide polymorphism (SNP) database in National Center for Biotechnology Information.Conclusions There is a novel heterozygous missense mutation,c.1258C ＞ T in the exon 11 of the NCSTN gene,which may be the molecular basis of pathogenesis of AI in this family.

This article aims to study the factors affecting the flexibility of the tip of an epidural anesthesia catheter. The flexibility of the tip of the epidural anesthesia catheter was tested with a softness tester from four aspects:raw materials, tip structure, tip processing technology, and the outer diameter of the catheter. Highly flexible and malleable polymer material with a smooth tip, the tip softening process and the proper outer diameter can effectively improve the tip flexibility of the epidural anesthesia catheter.
Anesthesia, Epidural ; Catheterization ; Catheters ; Epidural Space

OBJECTIVETo study the prognosis and the factors affecting the prognosis in children with acute respiratory distress syndrome (ARDS).

METHODSSeventy-eight children with ARDS were enrolled. The states of their survival within 30 days were followed-up.

RESULTSOf the 78 children with ARDS, 51 cases demised, 27 cases survived, with a 30-days survival rate of 35%. The average survival time was 14.4 days (median: 8 days). The peak of death appeared within 3 days after ARDS. There were significant differences in aspects of age, primary disease, percentage of neonatal hyaline membrane disease, pediatric critical illness score (PCIS), duration of mechanical ventilation, oxygenation index (PaO(2)/FiO(2)), white blood cell count and number of involved organs between the died and survived children (P<0.05 or 0.01). The Cox multiple factors analysis showed that the age (HR 3.924~3.938), primary disease (HR=1.817) and PCIS (HR=0.469) were the risk factors of death.

CONCLUSIONSThe peak of death usually appears within 3 days after ARDS. Age, primary disease and PCIS are the independent factors of prognosis in children with ARDS.

Adolescent ; Child ; Child, Preschool ; Female ; Humans ; Infant ; Infant, Newborn ; Male ; Multivariate Analysis ; Prognosis ; Respiratory Distress Syndrome, Adult ; mortality ; Survival Rate

LC-MS/MS method was used to simultaneously determine anti-oxidative active catechins EGCG, ECG, EGC and EC in plasma of rats treated with tea polyphenols (TP). The integrated plasma concentration (C') of TP was calculated by means of self-defined weighing coefficient based on percent AUC of individual components, thereby assessing integrated pharmacokinetic (PK) parameters of TP via log C'-T curve. The anti-free radical effects of TP were estimated using inhibitory rate of drug-containing serum collected at different times from rats against in vitro lipid peroxidation of mouse liver homogenate. The obtained E-T curves were used to calculate anti-free radical pharmacodynamic (PD) parameters of TP. E-logC and E-log C' plots and linear regression were carried out in order to obtain the correlation coefficient (R2). The results indicated that the log C'-T curves of TP, which could be best described by three-compartment model, corresponded to elimination rule of iv administration of drugs. The integrated PK parameters showed that TP was distributed in body rapidly and widely, and eliminated from deep compartment slowly. From comparison of R2 values and consistence of C'-T course and E-T course, it was evident that TP integrated PK behaviors correlated much better with its PD behaviors than individual active components, and thus demonstrated that integrated PK parameters could characterize to maximal extent holistic disposition of Chinese herbal drugs and reflect residence properties of holistic effective substances in biological body.