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.

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.

Vasovagal syncope (VVS) is the most common cause of transient loss of consciousness ( TLOC ),mainly with head-up tilt test (HUTT) for diagnosis and treatment evaluation.Beacause of potential risks in the process of HUTT,it is necessary to explore an early,accurate,safe,effective,inexpensive and convenient means of diagnosis and evaluation for VVS.The means of quantitative history are now in practice of clinical trials.The means commonly used are Calgary Presyncope Form (CPF)and three questionaires about point scores in the Calgary syncope symptom studies.Due to its stable,simple and easy to apply features,CPF has some advantages on assessing the effectiveness of different treatment methods for VVS.The three questionnaires have some application potential in diagnosis for VVS.

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.

Objective To observe the effect of hyperglycemia on intracranial pressure (ICP) and neurological outcome following severe brain injury. Methods A retrospective review was done on 79 cases with severe traumatic brain injury (with no history of diabetes or important extracranial complications) who underwent craniotomy for evacuation of intracranial hematoma and were divided into two groups based on Glasgow outcome scales (GOS) score, ie, favorable group with GOS of 5 or 4 and unfavorable group with GOS less than 3. Statistical analysis of data was accomplished by using SPSS 11.5 software. The outcome was assessed at the 6th month after injury. Results A significant correlation was found between ICP levels and admission or postoperative glucose values. The unfavorable group had significantly higher glucose levels both on admission and after operation compared with the favorable group, with statistical difference (P

Autonomic nervous system(ANS) activity plays an important role in the pathogenesis of cardiovascular disease,including organic cardiovascular disease(such as hypertension,coronary artery disease,etc) and functional cardiovascular disease (such as vasovagal syncope,postural orthostatic tachycardia syndrome,etc).Many methods was used to evaluate ANS function.Heart rate variability is a widely accepted method to assess cardiac autonomic nerve function.Autonomic nervous affected cardiac action potential and let electrocardiogram changes.Through the sympathetic and parasympathetic neurotransmitters which acting on the corresponding receptors.Electrocardiogram changes reflects autonomic nervous function.Present researches suggest that electrocardiogram has an important significance in the evaluation of autonomic nerve function in functional cardiovascular disease.

Biofilms are communities of surface-associated bacteria or fungi embedded in a self-produced extracellular polymeric matrix that are notoriously difficult to be eradicated and are sources of many recalcitrant infections. Treatment for biofilm infection with any individual drug is always less effective, while the combinations of different types of drugs are superior to monotherapy concerning the removing of biofilms. This paper focus on research progress in recent years for synergistic effect of drugs in combination against biofilms formed by Pseudomonas aeruginosa, Staphylococcus aureus, Staphylococcus epidermidis, Escherichia coli and Candida albicans.