Objective To explore the related high risk factors of hyponatremia after transsphenoidal approach for pituitary adenomectomy and to direct postoperative nursing. Methods The clinical data of seventy-seven patients suffering from pituitary adenomas with the way of treatment by transsphenoidal pituitary adenomectomy from June 2014 to May 2015 were summarized retrospectively. According to the value of postoperative serum natremia, the data were divided into hyponatremia group and non-hyponatremia group. The different data between the 2 groups were compared and the high risk factors related to hyponatremia were analyzed. Results Univariate analysis showed that gender(P=0.254) and high blood pressure(P=0.742) were unrelated to postoperative hyponatremia and there was significant difference between two groups in age (P=0.038), max- diameter of tumors(P=0.004), preoperative pituitary dysfunction (P=0.013), visual deficit (P=0.000), operative procedure duration (P=0.008) and diabetes mellitus rate (P=0.023). While Logistic regression analysis showed that preoperative visual deficit (OR=0.152,P=0.004,95%CI 0.043-0.542) and preoperative pituitary dysfunction (OR=0.069, P=0.046,95%CI 0.005-0.950) were independent factors for postoperative hyponatremia. Conclusions Hyponatremia is a common complication after transsphenoidal pituitary adenomectomy. The optimal treatment can benefit the early recovery and more careful nursing should be focused on these patients who are in high risk of postoperative hyponatremia.

BACKGROUND:The repair effects of bone marrow mesenchymal stem celltransplantation on brain injury were not ideal. Combined therapy with medicine and biological engineering materials is needed. OBJECTIVE:To investigate the effects of bone marrow mesenchymal stem celltransplantation and fingolimod immunosuppressants on memory function recovery in rats with brain injury. METHODS:A total of 60 healthy Sprague-Dawley rats were subjected to hydraulic shock with peak value of 253.312 5-303.975 kPa with a hydraulic head injury instrument so as to induce a model of severe hydraulic head injury. They were randomly divided into brain injury group, bone marrow mesenchymal stem celltransplantation group and fingolimod+bone marrow mesenchymal stem celltransplantation group. The Morris water maze test was tested at 21-28 days after PKH-26-labeled bone marrow mesenchymal stem celltransplantation. The PKH-26 immunofluorescence and hematoxylin-eosin staining were conducted in brain tissues at 4 weeks after brain injury. RESULTS AND CONCLUSION:At 4 weeks after transplantation, the average escape latency was gradual y decreased in each group. The average escape latency was shorter in the fingolimod+bone marrow mesenchymal stem celltransplantation group than in the bone marrow mesenchymal stem celltransplantation group (P<0.05), and significantly shorter than in the brain injury group (P<0.01). The number of times of crossing the platform and the percentage of swimming distance to total distance were higher in the fingolimod+bone marrow mesenchymal stem celltransplantation group than in the brain injury group and bone marrow mesenchymal stem celltransplantation group (P<0.05). The number of PKH-26-positive cells was significantly higher in the fingolimod+bone marrow mesenchymal stem celltransplantation group than in the brain injury group and bone marrow mesenchymal stem celltransplantation group (P<0.05). Results confirmed that bone marrow mesenchymal stem celltransplantation could apparently improve memory function of rats with severe brain injury. The combined application of fingolimod immunosuppressants has synergistic effects.

Extracellular vesicles (EV) miRNAs are a class of small non-coding RNAs that are encapsulated in membrane-containing vesicles from a variety of cells, and which can mediate intercellular communication and transfer of functional molecules. EV miRNAs in circulation can be served as novel molecular markers for cancer diagnosis, monitoring and prognosis, and also the most promising liquid biomarkers for clinical translation and utility currently, while optimal research strategy is crucial for identifying valuable EV miRNAs in clinical study. Moreover, EV miRNAs have recently also been implicated in cancer progression as direct regulators of metabolic reprogramming, mesenchymal-to-epithelial transition, angiogenesis, anti-cancer immune response and drug resistance in the tumor microenvironment. Study on some key EV miRNAs involving in those processes may highlight their potential utility as liquid biopsies in early diagnosis, companion diagnosis, metastasis, therapeutic control, prognosis analysis as their therapeutic potential for patients with cancer.

Intrahepatic cholangiocarcinoma (ICC) is a highly malignant liver tumor with strong invasion and poor prognosis. ICC originates from the bile duct and locates in the liver, so it is classified as either primary liver cancer or cholangiocarcinoma, which the classification is indeterminate and the pathological typing is still debatable. The mechanism of ICC induced by many high-risk factors is still unclear. There are no characteristic manifestations in early symptom and no specific tumor markers, and the diagnosis of ICC mainly depends on imaging examination, which enhanced CT and MRI are the most important evaluation method. TNM staging of ICC is of great significance to guide the treatment, nevertheless, the division of T stage updated by AJCC 8th Edition is still controversial. Radical surgery is the only way to cure ICC currently, but there are still many controversies on definition of R0 resection and the scope of lymph node dissection. The application of local therapy and the rapid development of immunity and targeted therapy bring new hope for the transformation therapy of locally advanced patients, however, the efficacy needs to be verified by multi center large sample clinical studies. To grasp the current focus issues in diagnosis and treatment of ICC timely will be an important direction of basic and clinical research of ICC in the future.

Objective To investigate the effect of hypnotherapy on test anxiety in high school students.Methods 21 students with test anxiety were treated with hypnotherapy(6 cases),relaxation therapy(7 cases),or no intervention(8 cases).Results The scores of Test Anxiety Scale(TAS) in subjects accepted hypnotherapy were the lowest among these groups,however,there was no significant difference in test scores.Conclusion Hypnotherapy can alleviate effectively test anxiety in high school students,but it may not work to enhance the test scores.

Accidents, Occupational ; mortality ; Animals ; Cause of Death ; Humans ; Male ; Nitriles ; poisoning ; Rats

The occurrence of nasopharyngeal carcinoma is a multi-gene,multi-step process.Among them,oncogene activation and antioncogene inactivation is the important mechanism.The related oncogenes of nasopharyngeal carcinoma contain Bcl-2,hepatocyte growth factor (HGF),cyclooxygenase-2 (COX-2) and latent membrane protein-1 (LMP-1).The related antioncogenes of nasopharyngeal carcinoma contain p53,p16,Nm23-H1 and PTEN.With the deepening research on genes,studies also find that nasopharyngeal carcinoma is related to PECAM-1,MMP-9 and RECK.These genes play important roles in the occurrence and development of nasopharyngeal carcinoma,which may become new targets for the treatment of nasopharyngeal carcinoma.

Objective To develop a Chinese version questionnaire of psychosocial adaptation for breast cancer patients with good reliability and validity.Methods The preliminary questionnaire was formed by extensive literature review,semi-structured interview for 10 breast cancer patients and consultation for 4 experts.In order to analyze items and test reliability and validity,228 postoperative breast cancer patients were selected.Results Psychosocial adaptation questionnaire included 44 items and 5 dimensions.It had good content validity and construct validity.With the method of principle components analysis,and five factors were extracted,the cumulative contribution rate was 54.578％,loading for most factors was over 0.4.The result indicated that the structure of the questionnaire was similar to the theory construction.The criterion-related validity with self-rating anxiety scale,the general self-efficacy scale,and self-acceptance questionnaire was-0.757、0.505、0.691.Cronbach's α coefficient of the overall questionnaire was 0.945,retest correlation coefficient was 0.961.Conclusions The developed questionnaire showed good reliability and validity.It can objectively and effectively evaluate psychosocial adaptation of breast cancer patients,so it has practicality and popularization value.

Biliary stricture after cholecystectomy poses difficult management problems to surgeons because of high and stable incidence.In contrast to malignant stricture,benign stricture requires durable repair.Repeated operations may not only increase the suffering of the patient,but also reduce the likelihood of a better outcome. A 56-year-old woman with biliary stricture after cholecystectomy who had undergone several operations in other hospitals was admitted to Chinese PLA General Hospital.Computed tomography (CT) scan showed a dilated biliary tree and localized the level of ductal obstruction in the hepatic hilar stricture.In addition,CT identified fluid collections in the left upper quadrant and no artery injury was detected. Ultrasound-guided percutaneous abdominal drainage was performed to control the abdominal infection. Magnetic resonance cholangiopancreatography classified the injury as Bismuth Ⅲ.The patient with bile leakage and severe abdominal infection was treated with antibiotics before the final operation.On June 1,2012,the patient received Roux-en-Y hepaticojejunostomy.After operation,the patient recovered smoothly without severe complications,such as bile leakage,cholangitis and recurrent stricture.Liver function of the patient was back to normal and T tube drainage was pulled out at the end of 3 months of follow up.

The birth rate of very low birth weight(VLBW)is rising year by year,and its survival rate increases with developing of modern methods of neonatal intensive care.The outcomes of VLBW have become a social concern.VLBW have different brain structure compared with term children,mainly in the reduction of brain volume.including the reduction of gray matter volume and white matter vollame.Because of these pathologic changes in brain.some VLBW show severe neurodevelopmental disorders in childhood,including cognitive problems.behavioral and psychological problems,motor clumsiness and so on.