Objective To discuss the operative techniques of endoscopic endonasal transsphenoidal surgery for the resection of pituitary adenoma in elderly patients.Methods From June 2003 to June 2012,a retrospective analysis of 42 elderly patients with pituitary adenoma was conducted.Computed tomography (CT) scan,magnetic resonance imaging (MRI) scan,and endocrinological examinations were performed in all patients before operation.All patients underwent endoscopic endonasal transsphenoidal surgery for the resection of pituitary adenoma.Results The tumors were totally removed in 25 cases (59.5％),sub-totally removed in 8 cases (19.1％) and partly removed in 9 cases (21.4％).1 patient died after operaion.Patients were followed up for 6-36 months.The visual acuity and visual field were improved.Hormone replacement therapy were needed in 20 patients due to hypopituitarism.Tumor residuals were found in 12 patients,among whom 5 patients were treated by γ-knife radiosurgery.Conclusions The endoscopic endonasal transsphenoidal operation is minimally invasive and safe for the treatment of pituitary adenoma in elderly patients.The strengthening of perioperative management is the key to the successful operation.

Objective To compare the clinical efficacy between single and double volume exchange transfusion for neonatal hyperbilirubinemia,and to verify whether single volume exchange transfusion had advantages in maintaining homeostasis and reducing blood transfusion related complications.Methods Clinical materials of 86 neonates with neonatal hyperbilirubinemia who received blood exchange transfusion,from December 2013 to December 2014,in the diagnosis and treatment center of our hospital were retrospectively analyzed.Cases were divided into the single volume group (35 cases,with a blood volume 80-110 mL/kg) and double volume group (51 cases,with a blood volume 150-180 mL/kg) based on blood volume per kilogram of body weight.Comparisons of the homeostasis changes between pre-transfusion and post-transfusion were performed for each group,and the incidence rate of major adverse events were compared between the two groups.Results (1)In the single volume group and double volume group,the average blood exchange transfusion volumes were (98.16 ± 10.75) mL/kg and (157.78 ± 7.37) mL/kg,the exchange rate of bilirubin were (41.68± 8.52) ％ and (50.22 ± 13.14) ％,and the average time for blood transfusion were (85.60 ±18.66) min and(1 1B.22± 24.81)min respectively,and there were statistically significant differences in the exchange rate of bilirubin and average time for blood transfusion between the two groups (P＜0.05).(2)Compared with pre-transfusion,WBC and platelet (PLT)count,levels of serum total bilirubin (TBIL),albumin,serum potassium,serum sodium,serum chlorine,serum calcium and HCO3-,and pH value were significantly decreased after blood exchange transfusion,while RBC count,PT,APTT and blood glucose were significantly increased in the two groups (P＜0.01).Moreover,the changes of blood glucose,PLT and TBIL in the double volume group were more significantly than those in the single volume group,there were statistically significant differences (P＜0.05).No statistically significant difference was found in the rate of major adverse events between the two groups (P＞0.05).Conclusion Compared with double blood exchange transfusion therapy,single volume exchange transfusion can significantly decrease plasmic bilirubin level with less change of homeostasis,less blood volume for transfusion and less human resources consumption,its value in clinical application is recognized.

OBJECTIVETo study the stability and degradation kinetics of Ketoprofen-Paeonol conjugate (Ket-Pae).

METHODRP-HPLC method was used to determine the solubility and partition coefficient of Ket-Pae. Stability test was carried out to investigate the factors affecting Ket-Pae. The kinetic studies of Ket-Pae degradation were conducted in different pH buffer solutions and 80% rat plasma at 37 degrees C.

RESULTKet-Pae showed significant degradation phenomenon at high temperature. The solubility of Ket-Pae was decreased about 200 to 300 times compared with parent drugs in water while the lnP increased about 4 times. The degradation curve displayed a V-shape, and kept maximum stability at week acidic (pH 5.0, t(1/2) = 11.4 d). Ket-Pae degraded quickly with very short half life of 1.3 min in plasma, therefore easily released ketoprofen and paeonol.

CONCLUSIONThe lipophilicity of Ket-Pae is increased, its stability is affected by temperature and pH value.

Acetophenones ; chemistry ; Drug Stability ; Drugs, Chinese Herbal ; chemistry ; Hydrogen-Ion Concentration ; Ketoprofen ; chemistry ; Kinetics ; Solubility

To establish the water dynamics model for drying process of Angelicae Sinensis Radix, the Weibull distribution model was applied to study the moisture ratio variation curves, and compared the drying rate and drying activation energy with the drying methods of temperature controllable air drying, infrared drying under different temperatures (50, 60, 70 degrees C). The Weibull distribution model could well describe the drying curves, for the moisture ratio vs. drying time profiled of the model showed high correlation (R2 = 0. 994-0. 999). The result proved that the drying process of Angelicae Sinensis Radix belonged to falling-rate drying period. For the drying process, the scale parameter (a) was related to the drying temperature, and decreased as the temperature increases. The shape parameter (β) for the same drying method, drying temperature had little impact on the shape parameter. The moisture diffusion coefficient increase along with temperature increasing from 0.425 x 10(-9) m2 x s(-1) to 2.260 x 10(-9) m2 x s(-1). The activation energy for moisture diffusion was 68.82, 29.60 kJ x mol(-1) by temperature controllable air drying and infrared drying, respectively. Therefore, the Weibull distribution model can be used to predict the moisture removal of Angelicae Sinensis Radix in the drying process, which is great significance for the drying process of prediction, control and process optimization. The results provide the technical basis for the use of modern drying technology for industrial drying of Angelicae Sinensis Radix.
Angelica sinensis ; chemistry ; Desiccation ; methods ; Models, Theoretical ; Water

To provide a scientific basis for the selection of the appropriate drying method for Mentha Haplocalyx Herba (MHH), determine 2 monoterpenes, 4 phenolic acids and 5 flavonoids in MHH by GC-MS and UPLC-TQ-MS methods, and investigate the effects of the drying methods on the changes in contents of these analytes. The qualities of products obtained with different drying methods were evaluated by the multivariate statistical method of Technique for Order Preference by Similarity to Ideal Solution (TOPSIS). Results showed that the drying methods had the greatest impact on menthol, caffeic acid, and rosemary acid, which were followed by chlorogenic acid and diosmetin-7-O-glucoside. The contents in these analytes processed with hot-air-drying method were higher than those with microwave-drying and infrared-drying methods at the same temperatures. The contents in these analytes processed under low temperature (40-45 °C) were higher than those under higher temperature (60-70 °C). Above all, the contents in phenolic acids processed with microwave fixation (exposed under microwave at 100 °C for several minutes) were obviously higher than those of not being processed, showing an inhibition of some enzymes in samples after fixation. The TOPSIS evaluation showed that the variable temperature drying method of 'Hot-Air 45-60 °C' was the most suitable approach for the primary drying processing of MHH. The results could provide the scientific basis for the selection of appropriate drying method for MHH, and helpful reference for the primary drying proces of herbs containing volatile chemical components.
Desiccation ; methods ; Flavonoids ; analysis ; Hydroxybenzoates ; analysis ; Mentha ; chemistry ; Monoterpenes ; analysis

OBJECTIVETo evaluate the validity of intraoperative magnetic MEP (motor evoked potentials) monitoring in a spinal-cord-menaced surgery.

METHODS32 rabbits were employed in weight-drop spinal cord contusion model. After anesthetized with a combination of Ketamine and Droperidol the spinal cords were surgically exposed with the dura intact, and the contusion injuries were delivered except the rabbits in control group. The MEPs were recorded and the relationship between the variation of the MEPs and the residual locomotor capacity after spinal cord injury was analyzed.

RESULTSThe 6 rabbits in mild-spinal-cord-injury group experienced transient attenuation of their TMS-MEPs, and the locomotor capacity remained intact (scores of 5) in almost all rabbits (5 of 6) when assessed 24 hours later; In the moderate-spinal-cord-injury group the 8 rabbits lost their TMS-MEP immediately after the weight-drop contusion, but they regained them partly in 1 hour one after another and scored 4 or 5 in the assessment of muscle power next day except for one score of 2; 8 rabbits had their spinal cords impaired severely in the contusion procedure and lost their TMS-MEP too but without recovery, their locomotor capacity outcomes were very poor, 5 of them had no response to transcranial magnetic stimulation next day, and in the other 3 rabbits we only found some polyphase waves with variant latency and lower amplitude which did not resemble common compound muscle action potential (CMAPs) evoked by TMS.

CONCLUSIONSMyogenic TMS-MEPs was very sensitive to the spinal cord injury and should be a valid technique for intraoperative monitoring, and a slight change of them, even if a transient lose, should be unnecessarily related to a severe movement disorder. The warning threshold for a given patient should depend on the malady itself.

Acute Disease ; Animals ; Brain ; physiopathology ; Disease Models, Animal ; Evoked Potentials, Motor ; physiology ; Female ; Male ; Monitoring, Physiologic ; Prognosis ; Rabbits ; Spinal Cord Injuries ; physiopathology ; Transcranial Magnetic Stimulation

In this study, the effect of benzo[α]pyrene (BaP) on chaperone-mediated autophagy (CMA) in a simulated hypoxia environment was observed and the relationship to heat shock protein 90 (HSP90) was clarified. With HSP90 inhibitor geldanamycin (GA) and HSP90α silenced, the mRNA and protein expression of hypoxia-inducible factor-1α (HIF-1α), HSP90, heat shock cognate protein 70 (HSC70), and lysosomal associated protein 2A (LAMP-2A) of A549 cells on hypoxic environment by BaP were tested. Alkaline comet experiment, immunofluorescence γ-H2AX focus experiment, quantitative real-time PCR (qPCR), and Western blot analyses were used to clarify the relationship between the DNA damage of different concentrations of BaP in A549 cells and the mRNA and protein expression of CMA-related factors. The results show that hypoxia can promote the expression of mRNA and protein of CMA-related factors in A549 cells. This study found that BaP has an inhibitory effect on CMA under the hypoxic environment. The inhibition or silencing of HSP90 will enhance the inhibitory effect of BaP on CMA. In a normoxic environment, BaP causes DNA damage and promotes CMA.

OBJECTIVES: To investigate the clinical treatment outcomes and the changes of the outcomes over time in extremely preterm twins in Guangdong Province, China. METHODS: A retrospective analysis was performed for 269 pairs of extremely preterm twins with a gestational age of <28 weeks who were admitted to the department of neonatology in 26 grade A tertiary hospitals in Guangdong Province from January 2008 to December 2017. According to the admission time, they were divided into two groups: 2008-2012 and 2013-2017. Besides, each pair of twins was divided into the heavier infant and the lighter infant subgroups according to birth weight. The perinatal data of mothers and hospitalization data of neonates were collected. The survival rate of twins and the incidence rate of complications were compared between the 2008-2012 and 2013-2017 groups. RESULTS: Compared with the 2008-2012 group, the 2013-2017 group (both the heavier infant and lighter infant subgroups) had lower incidence rates of severe asphyxia and smaller head circumference at birth (P<0.05). The mortality rates of both of the twins, the heavier infant of the twins, and the lighter infant of the twins were lower in the 2013-2017 group compared with the 2008-2012 group (P<0.05). Compared with the 2008-2012 group, the 2013-2017 group (both the heavier infant and lighter infant subgroups) had lower incidence rates of pulmonary hemorrhage, patent ductus arteriosus (PDA), periventricular-intraventricular hemorrhage (P-IVH), and neonatal respiratory distress syndrome (NRDS) and a higher incidence rate of bronchopulmonary dysplasia (P<0.05). CONCLUSIONS There is a significant increase in the survival rate over time in extremely preterm twins with a gestational age of <28 weeks in the 26 grade A tertiary hospitals in Guangdong Province. The incidences of severe asphyxia, pulmonary hemorrhage, PDA, P-IVH, and NRDS decrease in both the heavier and lighter infants of the twins, but the incidence of bronchopulmonary dysplasia increases. With the improvement of diagnosis and treatment, the multidisciplinary collaboration between different fields of fetal medicine including prenatal diagnosis, obstetrics, and neonatology is needed in the future to jointly develop management strategies for twin pregnancy.
Bronchopulmonary Dysplasia/epidemiology* ; Female ; Gestational Age ; Humans ; Infant ; Infant, Extremely Premature ; Infant, Newborn ; Pregnancy ; Respiratory Distress Syndrome, Newborn/epidemiology* ; Retrospective Studies ; Treatment Outcome

To provide a scientific basis for the selection and optimization of the modern drying processing method for Angelicae Sinensis Radix (ASR). Three phenolic acids (esters), 6 phthalides were determined by using UPLC-PDA while polysaccharides were determined by UV-Vis spectrophotometry. Then the effects of drying methods on the inner qualities of ASR were evaluated through principle components analysis (PCA) combined with the appearance properties after drying. Results showed that the contents of chlorogenic acid and ferulic acid in samples obtained with controlled temperature and humidity drying (CTHD), medium and shortwave infrared drying (MSID) and microwave vacuum drying (MVD) methods were significantly higher than those with primary drying processing(PDP) method and the fresh samples. Multivariate statistical analysis showed that samples processed with CTHD had more similar general chemical properties with those processed with PDP, suggesting that CTHD was appropriate for the modern primary drying processing of ASR. With samples processed with traditional PDP method as reference, the CTHD method was further optimized in the processing parameters for ASR by orthogonal experiment design. Considering the consumption of drying power and time and other parameters, the modern drying parameters for the primary drying processing of ASR were finally optimized as follows: controlled temperature and humidity drying at 40-45 ℃, relative humidity below 25% and target moisture content about 50% in the first stage of drying process, tempering for 12-24 h, and then drying under the conditions of temperature at 50-60 ℃, relative humidity below 20% and fan frequency at 30-40 Hz in the second stage. The study provided the scientific evidence for the selection of appropriate drying method and suitable parameters for the modern primary drying processing of ASR, as well as the beneficial exploration and practice on the formation of technical standard of primary drying processing for roots and rhizomes types herbal medicines.