Objective To explore the effectiveness and significance of neuronavigation in transsphenoidal approach microneurosurgical treatment of pituitary adenoma.Methods A total of 12 patients with pituitary adenomas underwent transsphenoidal surgery.Before the surgery a continuous CT or MRI scanning was adopted,and then the data were inputted into the neuronavigation system for 3-D reconstruction and registration.During the surgery,real-time positioning of the anatomic midline,the anterior wall of the sphenoidal sinus,and the floor of the sella turcica was employed by using the neuronavigation system,as well as the identification of the cavernous sinus and the internal carotid artery to avoid unexpected injury.The extent of tumor resection was assessed postoperatively.Results The mean fiducial error was 2.13?0.94 mm,and the accuracy of targets was

Objective To observe the clinical effect of manipulation combined with McKenzie technique on discogenic low back pain. Methods 80 patients were randomly divided into control group (n=39, 1 case was lost) and observation group (n=40). The patients in obser-vation group received manipulation and McKenzie technique, while the control group received manipulation only. All the patients were eval-uated with Oswestry Disability Index (ODI), Visual Analogous Scale (VAS) and Self-rating Depression Scale (SDS) before and 3 weeks af-ter treatment. Results The scores of ODI, VAS and SDS decreased after treatment in both groups (P<0.01). The score of ODI and VAS were lower in the observation group than in the control group (P<0.05), while there was no significant difference in the score of SDS between two groups after treatment (P>0.05). Conclusion Manipulation combined with McKenzie technique is more effective on discogenic low back pain.

Objective To investigate the variation of lipid profile in patients with acute myocardial infarction (AMI) of different age groups.Methods Total 1214 patients of AMI were admitted to our hospital from May 2007 to July 2011.The age of patients ranged 40-89 years,and patients were divided into 5 age groups with 10-years step.Differences in lipid levels were observed by using pair-wise comparison among different age groups.Results Pair-wise comparisons among different age groups indicated that TC levels were higher in 40-69 years age groups [(4.71 ± 1.08),(4.80 ± 1.30),(4.69 ± 1.03) mmol/L,respectively] than those in the 70-89 age groups [(4.41 ± 0.96),(4.38 ± 1.03) mmol/L],all P ＜ 0.05(t values were 2.381,2.323,4.382,3.965,3.317,3.096).TG levels among three age groups ＜ 59 years had no significant difference,which were higher than those in groups over 60 years.Among 50-89 years age groups,TG gradually reduced with increase of age.HDL levels were lower in 40-59 years age groups [(1.03 ± 0.23),(1.05 ± 0.26) mmol/L,respectively] than those in 60-89 years age groups [(1.11 ±0.28),(1.11±0.28),(1.16±0.34) mmol/L,respectively],allP＜0.05 (t values were-2.777,-2.789,-3.731,-2.543,-2.566,-3.644).Total cholesterol (TC) (r =-0.123,P ＜0.01),lowdensity lipoprotein cholesterol (LDL) (r =-0.139,P ＜ 0.01) and triglyceride (TG) (r =-0.287,P ＜0.01) were negatively but high-density lipoprotein cholesterol (HDL) (r =0.125,P ＜ 0.01) was positively correlated with age of patients.TC levels in female patients were higher than those in male patients in 50-89 years age groups; LDL levels in female patients were higher than those in male patients in 50-69 years age groups and HDL levels in female patients were higher than those in male patients in 40-79 years age groups (all P ＜ 0.05,t values were-2.878,-3.007,-3.352,-3.333).Conclusions Results show that the non-elderly AMI patients (＜60 years) have higher levels of TC,LDL and TG,and lower level of HDL than the elderly patients; the TC,LDL and HDL levels are higher in female AMI patients than those in male patients at the same age groups.

Objective: To explore clinical features of acute myocardial infarction (AMI) caused by left main (LM) coronary artery lesions and to study the effect of percutaneous coronary intervention (PCI) in relevant patients. Methods: A total of 3514 AMI patients received coronary angiography (CAG) in our hospital from 2000-01 to 2015-12 were studied, those including 36 of infarct-related artery (IRA) as LM. There were 28/36 patients received PCI and 8 received CABG. The clinical features and outcomes in 28 LM disease patients were investigated. Results: The patients included 5 female and 23 male at the mean age of (66.5±8.32) years. There were 16 patients with ST-segment elevation myocardial infarction (STEMI) and 12 with NSTEMI; 21 received primary PCI and 7 had elective PCI; there were 16 patients suffered from cardiac shock at admission. The procedural success rate was 82.1% and the in-hospital mortality was 35.7% (10/28). During (66.1±35.2) months follow-up period, 3 patients had re-NSTEMI and 1 of them received PCI again, 3 patients died. No event survival rate was 66.7%. Conclusion: PCI is feasible for treating AMI patients caused by LM lesions, the in-hospital survival rate was 64.3%; while the MACE occurrence rate during long-term follow-up period has been high.

BACKGROUND: The formation of long-term memory includes acquisition, consolidation and reconsolidation. Reconsolidation is very important for the new memory transforming into stable memory. Stress is an important environmental factor in the process of learning and memory. Corticosterone is very important for stress response. At present, research about the impact of corticosterone on reconsolidation of novel object recognition memory is less. Thus, it is very important to test the impact of corticosterone on reconsolidation of novel object recognition memory in rats.
OBJECTIVE: To analyze the effects of corticosterone on the reconsolidation of novel object recognition memory in rats.
METHODS: (1) The rats were intraperitoneal y injected with corticosterone (0.1, 1 and 3 mg/kg) immediately after reactivation. The discrimination index was used to assess memory performance and calculated as the difference in time exploring the novel and familiar objects. (2) The rats were intraperitoneal y injected with corticosterone (3 mg/kg) 6 hours after reactivation. The discrimination index was used to assess memory performance and calculated as the difference in time exploring the novel and familiar objects. (3) The rats were intraperitoneal y injected with corticosterone 3 mg/kg without reactivation. The discrimination index was used to assess memory performance and calculated as the difference in time exploring the novel and familiar objects.
RESULTS AND CONCLUSION: Immediate injection of corticosterone 3 mg/kg after reactivation significantly decreased the discrimination index. At 6 hours after reactivation or without reactivation, corticosterone administration did not impact the discrimination index. These results confirmed that corticosterone administration immediately after reactivation impairs the reconsolidation of novel object recognition memory. The damage effect depends on the reactivation experience and the specific time window after reactivation.

Aim To investigate whether necroptosis mediates chemical hypoxia-induced HT22 mouse hippocampal cell injury and inflammation.Methods HT22 hippocampal cells were exposed to cobalt chloride (CoCl2) to establish a model of the chemical hypoxia-induced injury and inflammation.The expression level of RIP3 (an index of necroptosis) was determined by Western blot.Cell counter kit-8 (CCK-8) assay was used to test the cell viability.Lactate dehydrogenase (LDH) activity in the culture medium was measured with commercial kits.Mitochondrial membrane potential (MMP) was examined by rhodamine123 staining followed by photofluorography.The intracellular level of reactive oxygen species (ROS) was detected by 2', 7'-dichlorfluorescein-diacetate (DCFH-DA) staining followed by photofluorography.The secretion levels of interleukin-1β (IL-1β) and tumor necrosis factor-a (TNF-α) were measured by ELISA.Results Treatment of HT22 hippocampal cells with 600 μmol·L-1 CoCl2 for 36 h markedly induced cytotoxicity, leading to a decrease in cell viability to (52.0±2.65) % , indicating that chemical hypoxia-induced cellular injury model was successfully set up.Besides, CoCl2 induced considerable injuries and inflammation, evidenced by increases in LDH activity, ROS production, MMP loss, as well as the secretion levels of IL-1β and TNF-α.Co-treatment of the cells with 40~100 μmol·L-1 Nec-1 (a specific inhibitor of necroptosis) and CoCl2 markedly attenuated the decrease in viability induced by CoCl2, reaching the best anti-cytotoxicity inhibitory effect at 80 μmol·L-1.Meanwhile, the co-treatment with 80 μmol·L-1 Nec-1 blocked the above injuries and inflammatory response induced by CoCl2.In addition, treatment of HT22 hippocampal cells for 6~48 h up-regulated the expression of RIP3, and Nec-1 alleviated the up-regulation of RIP3 expression level induced by CoCl2.Conclusion Necroptosis mediates chemical hypoxia-induced HT22 hippocampal cell injury and inflammation.

Objective: To analyze the electrocardiographic (ECG) characteristics for the ifrst diagonal branch of infarction related artery (IRA) in patients with acute ST-segment elevation myocardial infarction (STEMI) in order to ifnd the rule for physician to make quick diagnosis. Methods: A total of 28 STEMI patients with coronary angiography (CAG) confirmed first diagonal branch of IRA were retrospectively analyzed. The patients were treated in our hospital from 2005-01 to 2014-06 and their ECG changes at admission were studied for ST-segment elevation/depression and q wave, Q wave changes during the period of evolution at different leads in all patients. Results: CAG presented that there were 19/28 (67.9%) patients with single vessel disease, 13 (46.4%) with isolated diagonal lesion. From onset of chest pain to AMI graph shown on ECG was about 240 (252 ± 71) min in all patients. All 28 (100%) patients were with ST-segment elevation in lead aVL, 27 (96.4%) in lead I, and 15 (55.6%) patients with ST-segment elevation by (0.5-1.0) mm. The incidence of ST-segment elevation in the chest lead was, in turn as 21 (75.0%) patients in lead V2, 16 (57.1%) in lead V3 and 12 (42.9%) in lead V1respectively; while ST-segment depression was as 28 (100%) patients in lead III, 27 (96.4%) in lead aVF and 22 (78.6%) in lead II respectively. During the period of evolution, the most q wave or Q wave formation were, in turn as 22 (88.0%) patients in lead aVL, 10 (40.0%) in lead V2, 9 (36.0%) in lead V3 and 7 (28.0%) in lead I respectively. Conclusion: The ECG changes in STEMI patients with diagonal branch of IRA have the high prevalence of ST-segment elevation in lead aVL and lead I, while there is an important feature that the ST-segment elevation < 1 mm in about half amount of relevant patients.

Objective To compare epididymis-sparing orchiectomy (group A) with traditional orchiectomy (group B ) in patients with advanced prostate cancer,and to evaluate which procedure is better.Methods A total of 60 cases of advanced prostate cancer patients were enrolled,with 30 cases in group A and 30 cases in group B.They were given oral anti-androgen from 1 day after castration.Serum level of testosterone and prostatic specific antigen (PSA) was detected before castration,and 1 week,1,3,6,9 and 12 months after castration.Patient satisfaction was also evaluated.Results On time point of 12 months after castration,the average level of serum testosterone was 0.2 nmol/L (95 ％ confidence interval,0.1 ～ 0.9 nmol/L) in group A and 0.3 nmol/L (95％ confidence interval,0.2 ～ 0.9 nmol/L) in group B (P ＞0.05 ) ; the average value of PSA was 0.22 ng/ml in group A and 0.27 ng/ml in group B (P ＞0.05 ) ; patient satisfaction rate was 96.7％ (29/30) in group A and 53.3％ (16/30) in group B.Conclusions No significant difference of testosterone level and PSA is found between the 2 groups.However,epididymis-sparing orchiectomy meets the psychological needs better because it helps to maintain the appearance of the scrotum through epididymis preservation and epididymoplasty.

Objective Based on the medical records and follow-up records of hospitalized patients who received anti-tuberculosis therapy in the Third People' s Hospital of Zhenjiang in Jiangsu province from 2006 to 2012,we investigated the incidence and outcome of anti-tuberculosis drug induced hepatotoxicity (ATDH) and provided evidence for the prevention of ATDH.Methods According to tuberculosis patients' medical information and liver function test records,ATDH patients were diagnosed according to the criteria of International Consensus Meeting and American Thoracic Society respectively,then the related factors and outcomes were analyzed.Results A total of 1 967 hospitalized tuberculosis patients were reviewed retrospectively,in which 1 403 (71.3％) were men,1 790 (91.0％) were pulmonary tuberculosis patients,1 528 (77.8％) were patients receiving initiative treatment,979 (49.8％) were sputum smear-positive patients,and 1 297 (65.9％) had other complicated diseases.According to the criterion of International Consensus Meeting,the incidence of ATDH was 16.5％,the median time of onset was 25 days.According to the criterion of American Thoracic Society,the incidence of ATDH was 8.3％,the median time of onset was 23 days.The incidence of ATDH was significantly higher in males and HRZE therapy group (P＜0.05).Under the two liver criteria,69.5％ and 70.1％ of the patients changed primary therapy respectively after ATDH occurred.89.8％ and 88.4％ patients' liver function returned to normal range after changing or stopping therapy.Conclusion According to two liver injury criteria,the incidences of ATDH were 16.5％ and 8.3％ in hospitalized tuberculosis patients respectively,and ATDH mainly occurred in the furst month of anti-tuberculosis treatment.The monitoring of liver function should be strengthened in males and HRZE therapy group to reduce the incidence of ATDH.

Objective:To explore the predictive value of serum corrected calcium and intact parathyroid hormone (iPTH) for hypoparathyroidism after total thyroidectomy.Methods:A prospective study was used to select 86 patients with papillary thyroid carcinoma who underwent total thyroidectomy and central lymph node dissection in Chizhou people's Hospital from June 2017 to June 2019 as the observation objects, and the occurrence of postoperative hypoparathyroidism and its risk factors were analyzed. According to the occurrence of postoperative hypoparathyroidism, the patients were divided into hypoparathyroidism group and non-hypoparathyroidism group, the levels of serum corrected calcium and iPTH of patients in two groups were compared before operation, 1, 3 days after operation, and during follow-up (6 months after operation). Receiver operating characteristic (ROC) curve was used to evaluate the predictive value of serum corrected calcium and iPTH levels in patients with hypoparathyroidism after total thyroidectomy on the first day after surgery.Results:Among 86 patients with papillary thyroid carcinoma, 17 were males and 69 were females, aged (46.3±5.6) years old; 42 patients had postoperative hypoparathyroidism (48.84%); among them, 32 cases (37.21%) had hypocalcemia in different degrees, and 2 cases (2.33%) had permanent hypoparathyroidism. Logistic analysis showed that extraglandular invasion [odds ratio ( OR)=19.28, 95% confidence interval ( CI): 2.63-136.81], bilateral central lymph node dissection ( OR=1.84, 96% CI: 1.36-9.13) were risk factors for hypoparathyroidism after total thyroidectomy. There were no significant differences in serum corrected calcium and iPTH levels between hypoparathyroidism group and non-hypoparathyroidism group before and 6 months after operation ( P > 0.05); the serum corrected calcium and iPTH levels in the hypoparathyroidism group were significantly lower than those in non-hypoparathyroidism group 1 and 3 days after operation ( P < 0.01). The ROC curve results showed that the area under the curve (AUC) of serum corrected calcium was 0.724, the sensitivity and specificity were 76.68% and 62.14%, respectively; the AUC of iPTH was 0.947, the sensitivity and specificity were 97.68% and 92.14%, respectively. Conclusion:Extraglandular invasion and bilateral central lymph node dissection are risk factors for hypoparathyroidism after total thyroidectomy, and the iPTH level is a more reliable predictor of hypoparathyroidism.