Background To investigate the feasibility of a novel anterior subtemporal transepidural-anterior transpetrous keyhole approach assisted by neuronavigation in attempt to apply the keyhole conception to imitate a new keyhole approach and to observe microanatomical structures, which can be regard as the base of this approach for clinical use. Methods The new keyhole approach was imitated by using ten adult cadaveric heads fixed in 10% formalin and perfused intracranial vessels with colored silicone. Under operative microscope, the anatomic structures were observed and important structures were measured after the maximal anterior petrous bone removal and the cavernous sinus exposure. Results The approach could provide a full visualization for the lateral structures and the internal contents of the cavernous sinus. The upper and middle clivus, the cerebellopintine angle, basilar artery and anterior inferior cerebellar artery were exposed after the maximal anterior petrous bone removal. Conclusions It is feasible to perform the anterior subtemporal transepidural-anterior transpetrous keyhole approach on operation of lesions involved in the cavernous sinus or/and the upper and middle clival regions.

Objective To establish a model of rat endotoxic pulpitis induced by Lipopolysaccharide (LPS);to study the dynamic expression and location of Oct-4B in rat pulpitis model at different time;To evaluate the role of Oct-4B on pulp injury and reparation in rat endotoxic pulpitis. Method The slides were made and the dynamic expression and location of Oct-4B was examined by immunohistochemistry. Results Oct-4B was moderately positive in the pulp fibroblasts and odontoblasts in 2 weeks. After 2 weeks, it was still positive in odontoblasts and fibroblasts. Up to 3 weeks, it was weakly positive in odontoblasts and fibroblasts. Conclusion Oct-4B is dynamically expressed in the rats with pulpitis, and may play an important role in the incidence,development and recovery of pulpitis.

Arteriosclerosis ; Humans ; Kruppel-Like Transcription Factors

Objective To investigate the effects of all -trans retinoic acid (ATRA),acitretin and tazarotene on apoptosis and active caspase-3 of human melanoma cells A375 and to discuss the relevant significance.Methods The effects of retinoids on apoptosis and active caspase-3 of A375 cells were examined in vitro.Early apoptosis analysis by double staining with annexin V-FITC and PI,and active caspase 3 analysis by the staining of FITC conjugated monoclonal rabbit anti active caspase-3 antibody were measured by flow cytometer.Results ATRA and acitretin induced apoptosis of A375 cells (both P＜0.05),but tazarotene was not effective (P＞0.05).ATRA and acitretin elevated the cell population with detectable active caspase-3 (both P＜0.05),but tazarotene was not effective either (P＞0.05).Acitretin played a most prominent role among the retinoids. Early apoptosis ratio was significantly and positively correlated with active caspase-3 percentage in both ATRA and acitretin (P＜0.05).Conclusions Acitretin and ATRA induce apoptosis of A375 cells in which caspase is critical.Retinoids are prospectively applied as an assisting alternative for treating melanoma.

Objective To explore the value of MRI combined with transvaginal ultrasonography in the diagnosis of cesarean scar pregnancy.Methods Appearances of MRI and transvaginal ultrasonography of cesarean scar pregnancy confirmed by surgery and pa-thology in 30 patients were retrospectively reviewed,and the diagnostic value of MRI and transvaginal ultrasonography in the cesare-an scar pregnancy were compared and analyzed.Results MRI and transvaginal ultrasonography clearly demonstrated the gestational sac at cesarean scar of lower uterine in 30 patients including cystic sacs in 22 and solid ones in 8.Both MRI and transvaginal ultra-sonography showed 5 gestational sacs were located at the myometrium and 1 7 extended to uterine cavity.Intrauterine hemorrhage was detected by MRI in 12 patients and by transvaginal ultrasonography in 8.Transvaginal ultrasonography found 14 yolk sacs and 12 embryonic buds with embryonic heartbeat in 8.However,MRI cannot differentiate yolk sac from embryonic bud,and not judge the embryonic heartbeat.Preoperatively,28 patients were diagnosed as caesarean scar pregnancy and other 2 were as trophoblastic tumor by MRI with an accuracy rate of 93%;meanwhile,27 were diagnosed as caesarean scar pregnancy and other 3 as trophoblastic tumor by transvaginal ultrasonography with an accuracy rate of 90% .There was no statistical difference in diagnostic efficiency be-tween MRI and transvaginal ultrasonography (P >0.05).Conclusion The diagnoses of cesarean scar pregnancy by both MRI and transvaginal ultrasonography is highly consistent with pathological results.The combination of two imaging modalities may maxi-mize their advantages and provide more detailed information for rapid diagnosis of cesarean scar pregnancy.

In this paper, issues of acupuncture using target points and depth of needling were discussed based on the theory of traditional Chinese medicine acupoints and combined with anatomical and neurological research of Western medicine. The theoretical evidence of acupuncture on nerve foramen and ganglion and the reasons for being nonstandard operating on acupoints were analyzed. This study summarized the method of using acupuncture at Xiaguan (ST7), Cuanzhu (BL2), Sibai (ST2) and Jiachengjiang acupoints to align with the spheno-palatine ganglion and additional nerve foramen (supraorbital, infraorbital and mental foramina) to treat primary trigeminal neuralgia. This study adhered to the Standards for Reporting Interventions in Clinical Trials of Acupuncture and helped in development of study standardization for acupuncture processes. The authors hoped that should help in significantly diminishing risk and improving therapeutic efficacy in clinic.

Objective To investigate expressions of STAT3 and phosphorylated STAT3(p-STAT3)in cutaneous malignant melanoma(CMM)lesions, and to explore their significance. Methods The expressions of STAT3 and p-STAT3 were detected with an immunohistochemical method using polymer enzyme-labeled secondary antibodies in skin specimens from 22 CMM lesions and 23 pigmented nevus lesions. The effects of STAT3 and p-STAT3 expressions on lymph node metastasis of CMM were evaluated. Results The expression rate of STAT3 was significantly higher in CMM lesions than in pigmented nevus lesions (95.5% vs. 56.5%, χ2 = 9.23, P < 0.05), so was that of p-STAT3 (90.9% vs. 43.5%, χ2 =11.38, P < 0.05). STAT3 expression in CMM lesions had no obvious effects on lymph node metastasis of CMM (P > 0.05), while the elevated expression of p-STAT3 in CMM lesions was a predictive factor for lymph node metastasis in CMM (OR = 1.88, 95% CI: 1.05 - 3.38, P < 0.05). Conclusion Increased expression of STAT3 and p-STAT3 in CMM may play important roles in the pathogenesis of CMM, and elevated p-STAT3 expression may contribute to invasion and metastasis of CMM.

Objective To evaluate the clinical value of carbon nanoparticles suspension in gallbladder carcinoma lymphadenectomy.Methods 21 cases of gallbladder carcinoma who received radical resection from January 2008 to August 2013 were randomly divided into experimental group (11 cases received carbon nanoparticles injection into the subserosa around the tumor before operation) and control group (10 cases did not receive any tracer).The number of dissected lymph nodes,black-stained lymph nodes and positive lymph nodes were analyzed.Results A total of 138 lymph nodes were resected in experiment group,average 12.546±5.047 lymph nodes per patient,which was significantly more than that in control group in which there were overall 87 lymph nodes,average 8.700±2.497 lymph nodes per patient (t =2.176,P =0.042).The blacken rate of lymph nodes in experimental group was 56.522 ％ (78/138).There were 46 metastasis lymph nodes out of 79 blacken lymph nodes,and the positive rate was significantly higher than that of non-blacken lymph nodes [58.228 ％ (46/79) vs 38.983 ％ (23/59),P=0.039].There was no local or systemic adverse reaction occurred in experimental group.Conclusions Carbon nanoparticles suspension maybe helpful for lymphadenectomy during radical gallbladder carcinoma dissection to reduce operating damage and be safe.

Objective To investigate the role of oxidized LDL and coronary endothelial dysfunction in the development and progress of coronary heart disease(CHD).Methods 29 patients with unstable angina(UA),25 patients with stable angina(SA) and 20 patients without coronary heart disease(control) were studied.Oxidized low-density lipoprotein(ox-LDL)、 Nitric oxide(NO),and circulating endothelial cells(CEC) were measured in both coronary sinus and peripheral blood during percutaneous coronary intervention(PCI).Results The level of NO in coronary sinus in patients with CHD was lower,while the level of ox-LDL and CEC was markedly higher than those in the control group.In CHD patients,the level of NO in coronary sinus blood was lower,while the level of ox-LDL and CEC was higher than that in peripheral blood.It was no siginificant difference between coronary sinus and peripheral blood was observed in the control group.Conclusion Oxidized LDL not only plays an important role in coronary endothelial dysfunction,but also contributes to the progress in the cornornary heart disease.It may be one of the pathophysiological basis of acute coronary incidents.

Objective To explorer the clinical therapeutic effects of applying hyperbaric oxygen drenching(HOD) combined with microsurgical technique on peripheral nerve injuries induced in plateau military training.Methods Forty-one hospitalized patients(52 nerves) with peripheral nerve injuries induced in plateau military training from Jan.2000 to Dec.2007 were randomly divided into treatment group(21 patients,27 nerves injured) and control group(20 patients,25 nerves injured).Microsurgery and postoperative HOD treatment were performed to the patients in treatment group,only microsurgery was performed to the patients in the control group.The restorative procedures for injured nerves were adopted with direct end-to-end suture or sural nerve autograft according to the degree of injury.The recovery of nerve function was assessed and compared between the two groups.Results All patients were followed up for a mean period of 18 months(ranged 6-30 months) after operations.The recovery of nerve function was assessed according to the single nerve functional evaluation criteria.In treatment group,the excellent and fine results were obtained in 7 and 16 nerves,the fineness rate was 85.2%;while in control group,the excellent and fine results were obtained in 2 and 11 nerves,the fineness rate was 52.0%,a significant difference existed on the fineness rate between the two groups(?2=6.71,P