Objective To summarize the experience of pituitary adenoma resection by single-nostril transsphenoidal approach and analyze the indications,intraoperative and postoperative common problems in order to improve the technique and quality of life.Methods Summarize the clinical data of 611 pituitary adenoma resections by single-nostril transsphenoidal approach from January 2005 to June 2010 retrospectively,reanalyze the choice of operative indications,analyze the bleeding during the operation and sums up the relevant pro cessing suggestions,and summarize the reasons and countermeasures of postoperative visual impairment.Results The tumors were totally removed in 538 cases,sub-resections in 59 cases,sub-totally removed in 14 cases,and no deaths.Eleven cases were poor gasification or concha sphenoid sinus in 11 totally removed patients.The bleeding came from diploe,emissarium,mucosa of sphenoid sinus,diploe,epidural space,dura matter of the sella turcica region,intercavernous sinuses,tumor or the tumor bed.The bleeding was controlled effectively with different approaches.There were 3 patients who underwent visual impairment,and the impairment was improved after treatment.Conclusion Following the correct operation principle,we can improve the rate of total resection; the single-nostril transsphenoidal approach is also suitable for the poor gasification; The prognosis can improve after deal with the intraoperative and postoperative common problems.

BACKGROUND:Col agen suture is made of col agen from animals, and has been widely used because it is absorbable, non-rejection and easy to produce, and convenient in use.
OBJECTIVE:To evaluate the effects of col agen suture and silk suture in wound healing after oral implant surgery.
METHODS:100 patients undergoing oral implantation were randomly assigned into col agen suture group and silk suture group. A 2-0 circular needle with absorbable col agen sutures and a 4-0 circular needle with non-absorbable silk sutures were employed for tension-free suture in the two groups. After 3, 5, 7 days of oral implantation, suture threads and wound healing were observed. The suture was removed at 14 days, and patients were reviewed at 14 days.
RESULTS AND CONCLUSION:The wound healing was better in the col agen suture group than the silk suture group at grade I (P<0.05). At 7 days postoperatively, the suture thread was mostly absorbed in the col agen group but not in the silk suture group. In addition, material alba was invisible in the col agen suture group but clear in the silk suture group. These results indicate that the col agen suture is more proper for tension-free suture than the silk suture, which is better matched to the healing time and keeps a better oral environment.

Objective To analyze the medium and long-term results of tricuspid valve replacement (TVR)and summarize the operative experience for tricuspid valve disease.Methods Clinical data of 27 patients with severe tricuspid valve disease from September 2005 to May 2010 were retrospectively reviewed.Biological valve prosthesis was replaced in 23 patients,while mechanical valve prosthesis was replaced in 4 patients.Accompanying procedures included mitral valve replacement in 8 cases,mitral valve replacement and aortic valve replacement in 4 cases,and repair of atrial septal defect in 4 cases.Results The operative mortality was 11.1％(3/27),among these patients,2 cases died of serious low cardiac output syndrome,1case died of muhiorgan failure on the 7th day after operation,1 case who underwent reoperation for hemorrhage postoperative was improved after treatment.During follow-up,1 patient died of biological valve prosthesis dysfuncion 3 years after operation,1 patient died of cerebral embolism 19 months after operation.Six cases were in New York Heart Association(NYHA)class Ⅰ,and 14 cases in NYHA class Ⅱ during the period of follow-up.Conclusions Because operative and follow-up mortality is high,TVR is the last selection for the treatment of tricuspid valve disease.Appropriate operative technique and perioperative therapy are the key for clinical success.For those older than 50 years,follow-up inconvenience and reproductive-age female patients,biological valve prosthesis should be recommended as a preferential choice.

Objective:To examine whether the use of moderate hypothermic circulatory arrest in a pig model provides comparable vital organ protection outcomes to the use of deep hypothermic circulatory arrest.Methods:Thirteen pigs were randomly assigned to 30 minutes of hypothermic circulatory arrest without cerebral perfusion at 15℃(n=5), 25℃(n=5) and a control group(n=3). The changes in standard laboratory tests and capacity for protection against apoptosis in different vital organs were monitored with different temperatures of hypothermic circulatory arrest management in pig model to determine which temperature was optimal for hypothermic circulatory arrest.Results:There were no significant differences in the capacity for protection against apoptosis in vital organs between 2 groups( P>0.05, respectively). Compared with the moderate hypothermic circulatory arrest group, the deep hypothermic circulatory arrest group had no significant advantages in terms of the biologic parameters of any other organs( P>0.05). Conclusion:Compared with deep hypothermic circulatory arrest, moderate hypothermic circulatory arrest is a moderate technique that has similar advantages with regard to the levels of biomarkers of injury and capacity for protection against apoptosis in vital organs.

Objective To analyze the influence of left atrial dimension (LAD) on the effectiveness of heart valve replacement combined with dipolar radiofrequency ablation in atrial fibrillation (AF). Methods Eighty-one patients with permanent AF and heart valve diseases having undergone surgical treatment were selected. The patients were divided into two groups according to the size of LAD:groupⅠ (45 patients with LAD<60 mm) and group Ⅱ (36 patients with LAD ≥60 mm). All the patients underwent heart valve replacement and douching dipolar radiofrequency ablation, and were given amiodarone therapy after operation. The ultrasonic cardiogram and electrocardiogram after operation were inspected periodically. The changes of cardiac function and electrophysiology activity were observed. The patients were followed up for 12 months. Results The early-stage mortality after operation was 3.7% (3/81), and all of death was caused by postoperative low cardiac output syndrome. Two cases appeared third-degree atrioventricular block after surgery, and they were installed permanent pacemaker. During the follow-up, 1 case died because of sudden cerebrovascular accident. Two cases were loss to follow-up. There was no statistical difference in rate of maintaining sinus rhythm at discharge from hospital between group Ⅰ and group Ⅱ: 75.0% (33/44) vs. 73.5% (25/34), P=0.88. But the rates of maintaining sinus rhythm at 3 and 12 months after operation in groupⅠwere significantly higher than those in groupⅡ:81.4% (35/43) vs. 58.8% (20/34) and 88.1% 37/42) vs. 60.6% (20/33), and there were statistical differences ( P=0.029 and 0.006). Conclusions For the patients in permanent AF and heart valves diseases with LAD <60 mm, the dipolar radiofrequency ablation during heart valve replacement has considerably beneficial effects on rate of maintaining sinus rhythm. But for the patients with LAD≥60 mm, the result is not optimistic and has a lower postoperative sinus rhythm restoration rate.

AIM: To study the absorption performance and purification process of total flavones from Bushen Recipe(Radix polygoni multiflori;Herba epimedii;Rhizoma drynariae;etc) with macroporous resin. METHODS: The contents of total flavones,icariin,tetrahydroxystilbene and naringin were worked as indexes,the adsorptive capacity of D101,DA201 and DM301 resins were investigated,and the static adsorption curve,dynamic leakage curve and elution curve were used for the selection of macroporous resin. RESULTS: The elution parameters of selected DM301 consisted of the 0.25 BV/h feed rate solution ratio of 4 BV water to elute resin and 4 BV 70% alcohol to be collected as elution solvent,and the elution rate of 2.4 BV/h was established. CONCLUSION: Macroporous resin method is a better candidate method for purifying flavones in Bushen Recipe.

0.05),and TRAF2 was related to the tumor grade only(P

Objective To investigate the effect of ketamine on the synaptic long-term potentiation(LTP) in the CA1 area of rat hippocampal slices,and to elucidate the mechanisms underlying the effect of ketamine on memory.Methods Hippocampal slices(400 ?m thick) were obtained from the brains of male Sprague-Dawley rats(2 months old) weighing 200-250 g that were decapitated.The slices were incubated in artificial cerebrospinal fluid(ACSF) at room temperature for at least 120 min before use.Forty-nine slices were randomly divided into 7 groups(n=7):control group,ketamine 1,5,10,30,50 and 100 ?mol?L-1 groups.All the slices in each group were perfused with ACSF,ketamine 1,5,10,30,50 or 100 ?mol?L-1,respectively.The slices in each group were performed to record evoked population spikes(PS) using extracellular microelectrode recording technique.Another forty-nine slices were randomly divided into 7 groups(n=7):LTP group,ketamine-LTP 1,5,10,30,50 and 100 ?mol?L-1 groups.All the slices in each group were perfused with ACSF,ketamine 1,5,10,30,50 or 100 ?mol?L-1,respectively.PSs were recorded for at least 30 min before LTP in each group.For LTP induction,high-frequency stimulation(HFS) conditioning pulses(100 Hz?s-1) were applied to the Schaffer collateral-commissural pathway of hippocampus using a bipolar stimulating electrode.The changes in PS amplitude after HFS were analyzed in each group.Results The PS amplitude of the rat hippocampal slices in ketamine 1,5,and 10 ?mol?L-1 groups had no significant difference compared with control group.The PS amplitude in ketamine 30,50 and 100 ?mol?L-1 groups decreased compared with control group(P

AIM: To evaluate the effects of NS-398, a cyclooxygenase-2(COX-2) inhibitor, on the proliferation and apoptosis in HepG2 cells. METHODS: The effects of NS-398 on the proliferation of HepG2 cells was evaluated by MTT. DNA fragmentation gel analysis was used to analyze the apoptotic cells; DNA ploidy and apoptotic cell percentage were examined by flow cytometry. Furthermore, the expression of COX-2 and Bcl-2 mRNA was identified by competitive RT-PCR. RESULTS: NS-398 inhibited cell proliferation and induced apoptosis in HepG2 in a concentration-dependent manner. DNA ploidy analysis showed that S phase cells were significantly decreased with NS-398 concentration increasing. The quiescent G_0/G_1 phase was accumulated with decreasing of Bcl-2 mRNA. Whereas NS-398 had no effect on the expression of COX-2 mRNA, no correlations were found between COX-2 mRNA and the HepG2 cell proliferation and apoptosis induced by NS-398 (r=0.056 and r=0.119, respectively). CONCLUSION: NS-398 significantly inhibits the proliferation and induces apoptosis in HepG2. Mechanisms may be involved in accumulation of quiescent G_0/G_1 phase and decrease in Bcl-2 mRNA expression, but independent to COX-2 mRNA expression. [

Objective:To study the effect of rotational errors on the positioning accuracy (PA) and to assess whether correcting rotation in patients with head-neck tumors in radiotherapy or not.Methods:The image information of 34 patients with head-neck tumors treated at Zhongnan Hospital of Wuhan University between August 2019 and January 2020 was collected. Mega-voltage computed tomography (MVCT) images of each patient were taken before radiotherapy, and were registered with planned kilo-voltage computed tomography (KVCT) images by two registration methods. All information was divided into control group (translation only) and intervention group (translation and rotation) according to different registration methods, there were 144 fractioned registered images for each group, respectively. The position errors of the two registration methods were recorded and compared. Data were carried out with Wilcoxon signed rank test and Spearman rank correlation.Results:Translational errors of the control group and the intervention group were 0.10 (5.35) mm and 0.00 (5.78) mm in right-left direction, and there was a statistically significant difference ( Z=-2.675, P=0.007); 0.75 (2.78) mm and 0.60 (2.68) mm in superior-inferior direction, and there was a statistically significant difference ( Z=-2.819, P=0.005); 0.10 (0.90) mm and 0.20 (1.28) mm in anterio-posterior direction, and there was a statistically significant difference ( Z=-3.984, P<0.001). Rotational errors of the intervention group were -0.20 (0.60)°, 0.35 (2.00)°, 0.00 (0.98)° in pitch, roll, yaw, respectively. The distribute of 3D vector corrected frequency for two groups was positively skewed. The corrected cumulative frequency (CCF) varied with 3D vector, 3D vector was 8.0 mm, and 19 F and 16 F fractioned treatments of the control group and the intervention group were not corrected, respectively; 3D vector was between 8.0-13.5 mm, the corrected tendency of the intervention group was slower and fractioned treatment was completed later. The analytical results of Spearman rank correlation showed that rotational errors in pitch were negatively correlated with translational errors of the control group in superior-inferior direction ( r=-0.182, P=0.029) and the intervention group in anterio-osterior direction ( r=-0.484, P<0.001); rotational errors in roll were negatively correlated with translational errors of the intervention group in right-left direction ( r=-0.334, P<0.001); rotational errors in yaw which were positively correlated with translational errors of the intervention group in right-left direction ( r=0.370, P<0.001) were negatively correlated with translational errors of the control group in superior-inferior direction ( r=-0.171, P=0.040) and the same was true for the intervention group ( r=-0.203, P=0.015); total angles were positively correlated and negatively correlated with translational errors of the control group in superior-inferior direction ( r=0.246, P=0.003) and anterio-posterior direction ( r=-0.188, P=0.024), and positively correlated with 3D vector of the control group ( r=0.198, P=0.017), total angles were positively correlated with translational errors of the intervention group in superior-inferior direction ( r=0.170, P=0.041) and with 3D vector of the intervention group ( r=0.239, P=0.004); there were no correlations between rotational errors and the other translational errors (all P>0.05). Conclusion:Although the corrected rotation increases translational errors in anterio-posterior direction and 3D vector, it improves PA for head-neck tumors in radiotherapy. When rotational errors are not corrected, rotational offsets are present with corrected translation to decrease its effect on PA.