Objective To evaluate the diagnostic significance of blood cells and electrolyte in preoperative diagnosis and surgical treatment of Cushing's disease (CD).Methods 116 csses of CD and 21 cases of adrenocortical adenoma (ACA) patients pathologically proven adrenocorticotropic hormone (ACTH) adenoma from Jan.2003 to Dec.2010 were enrolled into the study.They were given transsphenoidal surgery (TSS) and laparoscopic resection of adrenal adenoma (LRAA).Patients were divided into remission group ( group A),non-remission group (group B) and ACA group (group C) according to the remission criteria of CD.The preoperative and postoperative level of blood cells and electrolyte were determined.Results TSS treatment improved the abnormal level of blood cells and electrolyte in patients with CD.Group A had significant change in preoperative and postoperative level of blood cells and electrolyte,while group B and group C didn't.Conclusions Compared with the endocrine examination items which need huge expense and harsh conditions,the change of blood cells and electrolyte level is more superior in assessing diagnostic and cruative effects on CD patients.

One patient confirmed as pituitary carcinoma by histopathology was retrospectively analyzed according to the great changes of tumor invasive growth in imaging examine and clinical characters. Clinically,pituitary carcinoma quickly grows,and the growth character of tumor is helpful in the diagnosis. Moreover,the treatment for pituitary carcinoma is different from pituitary adenoma.The rapid progress of pituitary adenoma indicates the possibility of primary carcinoma.More experience should be accumulated for the diagnosis and treatment of the disease.

Objective To investigate the risk factors for acute ischemic stroke in patients with lower extremity atherosclerosis (LEA).Methods The consecutive patients with acute ischemic stroke admitted to hospital within 7 d after onset were enrolled retrospectively.Color Doppler flow imaging was used to detect LEA.The demographic characteristics,vascular risk factors,and laboratory parameters were identified and analyzed.Results A total of 156 patients with acute ischemic stroke were enrolled,including 138 with LEA.Univariate analysis showed that age (69.5± 11.8 years vs.60.4± 11.5 years;t =3.063,P =0.003) and the proportion of patients with hypertension (81.1％ vs,55.6％;x2 =2.467,P =0.014) in the LEA group were significantly higher than those in the non-LEA group.Multivariate logistic regression analysis showed that after adjustment for confounders such as gender,baseline systolic blood pressure,diabetes mellitus,and ischemic heart disease,age (odds ratio [OR] 1.059,95％ confidence interval [CI] 1.016-1.105;P=0.007),and hypertension (OR 3.128,95％ CI 1.084-9.026,P =0.035) were the independent risk factors for acute ischemic stroke complicated with LEA.Conclusions Age and hypertension are associated with acute ischemic stroke complicated with LEA.

Morita therapy has been bom for more than 100 years.Inpatient Morita therapy is highly oper-able and easy to master.It can improve many refractory neuroses through four-stage treatment.But more neuroses are treated in outpatient clinics,and Morita therapy cannot be used in hospitalized patients.Therefore,the formula-tion of expert opinions on outpatient operations is particularly important.This paper is based on domestic and for-eign references,and after many discussions by domestic Morita therapy experts,and then drew up the first version of the expert opinions on operation of outpatient Morita therapy.Meanwhile the operation rule of Morita therapy in three stages of outpatient treatment was formulated:in the etiological analysis stage,under the theoretical guidance of Morita therapy,analyze the pathogenic factors,to improve treatment compliance and reduce resistance;during the operating stage,guide patients to engage in constructive and meaningful actions,realizing the achievement of letting nature take its course principle;in the cultivating character and enriching life stage,pay attention to positive infor-mation,expanding the scope and content of actions,improving the ability to adapt to complex life,and preventing recurrence caused by insufficient abilities.It will lay a foundation for the promotion of Morita therapy in domestic outpatient clinics,so that more patients with neurosis and other psychological diseases could receive characteristic Morita therapy treatment in outpatient clinics.