The resection of lateral skull base tumour has always been a crucial and difficult aspect of skull base surgery.Its operation development has experienced several evolutionary phases,including unaided eye-surgery which could result in huge trauma,microsurgery and completely endoscopic surgery.At present,the endoscopic technique known for its panoramic visibility,minimal invasion and extensive scope of operation,has opened up a brand new perspective for the lateral skull base tumour surgery.Currently,the approach of lateral skull base tumour endoscopic surgery can be generalized as endoscopic transmaxillary approach (ETA).And based on different pathways and methods to expose the maxillary sinus,ETAs can be divided into three,endonasal transmaxillary approach(ENTA),endoscopic sublabial transmaxillary approach (ESTA) and combined approach,while ENTA includes ipsilateral endonasal transmaxillary approach (IENTA),prelacrimal recess approach (PRA),contralateral endonasal transseptal approach (CENTA) and transnasal Denker approach.In this paper,on the basis of the summarization of ETAs related historical evolution,anatomical studys and clinical researches,the merit and demerit of all sorts of ETAs are compared and analyzed.We hope this review could act as a reference for selecting the personalized endoscopic surgery approach of lateral skull base tumour.

To investigate the risk factors for the occurrence of intracranial infection (ICI) after endoscopic transnasal resection of a pituitary adenoma and to select the best strategy for reconstructing skull base defects. Method: The clinical data of 162 patients with pituitary adenoma admitted into First Hospital of Shanxi Medical University between December 2016 and December 2019 were analyzed retrospectively. The incidence rate of ICI after surgery was analyzed. According to the occurrence of ICI, patients were stratified into ICI and non-ICI groups. The infected and non-infected groups of clinical data were collected and the independent risk factors for ICI after surgery were analyzed. Result: Among the 162 patients, 11 patients (6.79%) developed ICI, whereas 151 patients (93.21%) did not develop ICI. Body mass index (BMI), intraoperative cerebrospinal fluid leakage, postoperative cerebrospinal fluid leakage, and Kelly grades were significantly higher in the ICI group than in the non-ICI group (P<0.05). Logistic regression analysis showed that BMI, intraoperative cerebrospinal fluid leakage, postoperative cerebrospinal fluid leakage, and Kelly grades were independent risk factors for ICI after surgery (P<0.05). Conclusions: The incidence of ICI after endoscopic endonasal surgery is related to BMI, intraoperative cerebrospinal fluid leakage, postoperative cerebrospinal fluid leakage, and Kelly grades. Furthermore, reasonable strategies for skull-base reconstruction should be developed according to the Kelly grading system.

FDG-PET has played a significant role in the clinical management of lung cancer since it can efficiently visualize the functional metabolic changes of normal and pathological tissues in human body. It has been used more and more widely in many aspects of lung cancer management including diagnosis, staging, target volume delineation for radiotherapy plan, treatment response inspection, and recurrence detection. However, the false positive led by benign and inflammation somehow decreases its diagnostic specificity of lung cancer. The diagnostic methods for lung cancer consist of visual interpretation and semi-quantitative analysis based on static imaging and quantitative analysis based on dynamic imaging. This article briefly reviews the current trends, challenges and foreground of this imaging modality in the field of clinical management of lung cancer.

Objective To investigate the efficacy of sorafenib alone or combination with transarterial chemoembolization(TACE)and percutaneous local cryotherapy(PLCT)for advanced hepatocellular carcinoma patients without operation opportunity. Methods Sixty-four advanced hepatocellular carcinoma patients were selected as our subjects,who were underwent treatment of sorafenib alone or combination with TACE and PLCT. Thirty-two cases with sorafenib therapy were served as sorafenib group and another 32 cases with sorafenib in combination with transarterial chemoembolization and PLCT were served as combination group. All patients were followed up for 6 - 32 months. The treatment efficacy and tumor development were recorded. Results All surgeries of the patients were succeed and no death or serious operation complications occurred. Of 64 patients, 11 were achieved a complete remission( CR),31 cases with partial remission( PR),14 cases with stable development(SD),and 8 cases with progressive disease(PD). In the sorafenib group,3 cases were with CR,11 patients with PR,12 with SD,and 6 patients with PD. In the combination group,8 patients were with CR,20 patients with PR,2 patients with SD and 2 patients with PD,and the difference was significant between the two groups(χ2 = 14. 028,P = 0. 003). The median periods to tumor progression were 20 and 53 weeks in the sorafenib group and the combination group,and the difference was significant( χ2 = 14. 773,P = 0. 000). Conclusion For hepatocellular carcinoma patients without operation opportunity,sorafenib combined with TACE and PLCT can increase the tumor remission rate and prolong the periods to tumor progression in patients with hepatocellular carcinoma.

Adult ; Aged ; Benzamides ; therapeutic use ; Case-Control Studies ; Female ; Humans ; Imatinib Mesylate ; Immunoglobulins ; metabolism ; Leukemia, Myelogenous, Chronic, BCR-ABL Positive ; drug therapy ; immunology ; Male ; Middle Aged ; Piperazines ; therapeutic use ; Pyrimidines ; therapeutic use ; T-Lymphocyte Subsets

Objective To evaluate the safety and efficacy of radical antithrombotic therapy(aspirin,clopidogrel and tirofiban) in the treatment of senile (≥ 75 years) non-ST-elevation acute coronary syndrome (NSTEACS).Methods A total of 146 senile patients with NSTEACS were divided into observation group (70 cases) and control group(76 cases) by random digits table method.The control group was given aspirin,low molecular weight heparin and clopidogrel,and the observation group was added tirofiban (intravenous loading dosage:0.4 μ g/ (kg· min) for 30 min and then maintaining 0.1 μ g/ (kg· min) for 48-72 h).The occurrence of major adverse cardiovascular events (MACE) within 30 d after treatment,7 d angina pectoris control rate and adverse reactions were observed in two groups.Results The occurrence rate of MACE within 30 d after treatment was 5.7％ (4/70) in observation group,and 14.5％ (11/76) in control group,and there was significant difference (P ＜ 0.05).The 7 d angina pectoris control rate was 92.9％ (65/70) and 76.3 ％ (58/76) in observation group and control group,and there was significant difference (P ＜ 0.05).The incidence of bleeding was 10.0 ％ (7/70) and 7.9 ％ (6/76) in observation group and control group,and there was no significant difference (P ＞ 0.05).There were no major bleeding events in two groups.One case had thrombocytopenia in observation group,but there was no significant difference compared with that in control group(P ＞ 0.05).Conclusion Triofiban on the basis of aspirin and clopidogrel in the treatment of senile NSTEACS is effective and safe.

ObjectiveTo study the influence of EmbryoGlue on the implantation of embryo and pregnancy outcome in vitro fertilization (IVF)-embryo transfer (ET).Methods From August 2010 to January 2011,243 infertile patients in Reproductive Medical Center of Tianjin Medical University General Hospital who underwent IVF or intracytoplasmic sperm injection (ICSI) were divided into two groups,including 129 cases used EmbryoGlue as the embryo transfer medium in experimental group and 114 cases used G-2 as embryo transfer medium in control group.Pregnancy outcome were compared between two groups.Results (1) The female age,IVF/ICSI constituent ratio,previous failure cycles and infertile factors of patients did not show statistical difference between experimental group and control group (P ＞0.05 ).(2) The implantation rate of women in experimental group increased significantly compared with the control group [ 30.4％ ( 85/280 ) vs.18.8％ ( 48/255 ),P ＜ 0.05 ] ; Clinical pregnancy rate increased significantly compared with the control group [48.8％ (63/129) vs.34.2％ (39/114),P ＜0.05] ; Multiple pregnancy rate increased significantly compared with the control group [ 34.9％ (22/63) vs.20.5％(8/39),P ＜ 0.05 ] ; Ectopic pregnancy rate decreased significantly compared with the control group [ 4.8％(3/63) vs.17.9％ ( 7/39 ),P ＜ 0.05 ].ConclusionEmbryoGlue can facilitate embryo implantation in IVF-ET and reduce the occurrence of ectopic pregnancy.

Objective To investigate the relationship between duration of hypertension and cognitive function in adult hypertension patients.Methods A total of 224 subjects with normal blood pressure were enrolled in group A,and 1 296 patients with poorly controlled hypertension were further divided by the duration of hypertension into group B (≤5 years),group C (6-10 years),group D (11-20years) and group E (＞ 20 years).Face-to-face surveys were conducted in all the subjects by trained physicians using Mini-Mental-State-Examination (MMSE) and Clock-Drawing-Test (CDT).The incidences of cognitive impairment were compared among the five groups and the relationship between duration of hypertension and cognitive function were analyzed by SPSS 18.0 software.Results (1) Compared with the normotensive group,the hypertensive group performed worse in the scores of MMSE,CDTs,the memory type cognitive function and the non-memory type cognitive function (MMSE:Z =-2.585,P =0.010;C DTs:Z =-3.689,P ＜ 0.001 ; memory type cognitive function:Z =-2.718,P =0.007 ; non-memory type cognitive function:Z =-1.994,P =0.046).(2) The incidences of cognitive impairment in the five groups were 3.6％ (8/224),6.6％ (26/393),16.6％ (72/433),19.7％ (55/279) and 33.5％(64/191),respectively.(3) Compared with the group A,the cognitive function was significantly worse in the group E (MMSE:Z =61.314,P ＜ 0.001 ; CDTs:Z =44.642,P ＜ 0.001 ; memory type cognitive function:Z =35.703,P ＜ 0.001 ; non-memory type cognitive function:Z =54.440,P ＜ 0.001).Conclusions Hypertension is a risk factor for the cognitive dysfunction.The incidence of cognitive dysfunction and the severity are positively associated with the duration of hypertension.In those with hypertension over 20 years,the cognitive dysfunction occurs much more obviously.

Objective To evaluate the factors affecting the measurement of lung tumor activity concentration (AC) with FDG-PET. Methods High count Monte-Carlo simulations,based on VIP-Man (marked VHP atlas) added with spherical lung tumors of different diameter and activity,were performed to generate the essentially noiseless projection data for PET. The factors related with the measurement of tumor AC were evaluated. Results Using the maximum value in the tumor region of interest (ROI) generally resulted in the over-estimation of AC,and the degree of over-estimation would also increase as the noise became severer. For the small tumors with low AC,the proper partial volume correction was needed. Drawing ROI after post-reconstruction filtering could improve the reproducibility of AC measurement compared with no filtering first. Conclusion The accuracy and reliability of AC measurement depends strongly on factors including tumor size,post-reconstruction filter,noise level,ROI definition,PVE correction,etc.

Objective To evaluate the clinical effect of splenic internal jugular shunt for Budd Chiari Syndrome (BCS). Methods A retrospective analysis was made on the clinical data of 21 patients of BCS who underwent this operation. Results There was no death in 21 patients receiving this operation, The average post operative reduction of FPP was 0.97Kpa.2 suffered postoperative lung infection . Abdominal incision infection occurred in one patient. Tweenty cases were followed up for one month to forty five months. Lower extremity varicose veins and abdomen wall varicose veins basically disappeared a month postoperatively; ascites vanished completely 3 months postoperatively,and lower limb ulcer healed 6 months postoperatively. Seventeen patients followed by CDFI showed that no thrombus was found in their artificial vessel. Barium meal studies in 12 cases displayed that oesophageal varicose veins had basically disappeared during the follow up period. Conclusions Splenic jugular shunt bridged by artifical vessel is safe,effective and less traumatic for patients with type III and some patients with type II Budd Chiari syndrome. It is currently the best choice for treatment of BCS.