Objective To explore the microsurgical treatment for large pituitary adenomas. Methods Surgical approaches were determined according to sites of tumor, texture, hormone level, and T 2 signals of MRI. Transpterional sinus approach was adopted in 82 cases, transinferior frontal approach in 22 ones, transsphenoidal sinus approach in 6 ones and subfrontal transsphenoidal sinus approach in 3 ones. All cases underwent radiotherapy after operation. Results Total resection of tumors was obtained in 102 cases (90 3%), and subtotal resection of tumors in 11 cases (9 7%) under microscope. 2 cases died after operation (1 8%). Postoperative vision and visual field were improved in 98 cases (86 7%) and no change in 15 cases (13 3%). 6 cases relapsed in 5 years postoperatively(6 3%). Conclusions Selecting different surgical approaches based on features of tumor by microsurgery combined with comprehensive therapy are key factors to improve total resection rate and decrease mortality and recurrence rate for large pituitary adenomas.

Objective To investigate the safety of argon plasma coagulation (APC) with submucosal injection for colon polyps.Methods A total of 30 sets of fresh sigmoid colon from healthy pigs were assigned to control group to receive direct APC,and to treatment group to receive APC with submucosal injection,respectively.After same time and energy of APC,each specimen was sampled for pathological evaluation and the damage extent was determined as mucosa,submucosa (superior 1/3,middle1/3,inferior 1/3),and muscularis propria.Ten cases of colon sessile polyps with diameter of about 1-2 cm,elevated within 3mm by endoscopic ultrasonography(EUS).Direct APC or APC with submucosal injection were performed,respectively,and the difference was observed by EUS.Results In 30 cases of control group,the injury depth of 5 cases reached to the muscularis propria and of 25 cases to submucosa layer,among which 4 cases showed damage to superior submucosa 12 middle submucosa and 9 inferior submucosa.In 30 cases of treatment group,there was no damage to muscularis propria.The injury depth of 26 cases reached submucosa layer,among which 22 cases showed damage to superior submucosa,4 middle submucosa.The results showed significant difference between two groups (P ＜0.01).In patients who underwent APC with submucosal injection,EUS showed effective isolation of mucosa and muscularis propria.It confined the injury to the mucosal layer.Without treatment of submucosal injection in advance,it seemed easier to damage the submucosa and muscularis propria.Conclusion Submucosal injection can protect the colon injured by APC,and may reduce the risk of colon perforation by APC for colon polyps.

Objective: To study therapeutic action of Chinese drugs on fibrosis of liver due to chronic hepatitis. Methods: The treatment group (n=40) were treated by Chinese drugs for removing pathogenic heat from the blood and toxic material from the body, and nourishing the kidney and liver, and the control group(n=30) were treated by Aotaile Infusing Powder and Dahuang Zhechong Bolus for 6 months. Changes of indexes of fibrosis of liver were investigated. Results: After treatment, serum hyaluronic acid (HA), laminin(LM), type Ⅳ collagen peptide, and type Ⅲ collagen peptide decreased in the treatment group as compared with those in the control group (P

Objective To explore the relevance between sequence variation of human papillomavirus (HPV)16 subtypes E2 gene or long control region (LCR) and cervical lesions.Methods Fifty specimens from HPV16 infected people in Chengdu were collected,including cervical exfoliated cells from 38 HPV carriers,papilloma tissues from 8 cases of genital warts,2 with cervical intraepithelial neoplasia (CIN) Ⅱ and 2 with CIN Ⅲ in this study.Polymerase chain reaction was used to amplify E2 gene and LCR,then an evolutionary tree was constructed.Results In all the 50 specimens,there were 12 mutation sites in E2 gene,among which,C→A existed in one specimen of genital warts,and ≥2 mutation sites existed in all the other 48 specimens.There were 28 mutation sites of LCR sequence of all the specimens.Ten specimens were chosen to construct evolutionary tree and were sequenced.The data showed that 8 specimens were Asian variants,E2 gene mutation existed in all the specimens while the LCR 7867 G→A only existed in the four CIN.Conclusion LCR 7867G→A is a correlative mutation site of cervical lesions in Chengdu.

The examination is the very important component of course of higher vocational and technical education, which relates to the teaching quality. In order to improve the effect of learning and reinforce the students to master practical skills, according to the problems existing in the examination, combined with the 5 years teaching experiences of our college, this paper gives some advices about the examination in the course of Clinical Occupational Therapy.

According to the current characteristics of higher vocational education, combined with the 5-year teaching experience of our college, this paper had made some explorations on the reforms of teaching contents and methods in the course of Clinical Occupational Therapy.

Objective To investigate the correlation between the indicators of common carotid artery mechanical dynamics, a circumferential wal tension (CWT) and a shear stress (SS), and cerebral smal vessel disease (SVD). Methods The neurological outpatients without obvious cardiovascular disease were enrol ed consecutively. The inner diameters of carotid arteries and blood flow velocity of the patients w ere measured by ultrasound examination, and their CWT and SS w ere calculated. Lacunar infarction and/or leukoaraiosis w ere determined according to the findings of MRI. Results A total of 296 patients w ere enrol ed, 163 of them had lacunar infarction and 132 had leukoaraiosis. Univariate analysis show ed that there w ere significant differences in the distributions of age, hypertension, diabetes, systolic blood pressure, diastolic blood pressure, CWT, and SS betw een the lacunar infarction group and the non-lacunar infarction group, as wel as between the leukoaraiosis group and the non-leukoaraiosis group (al P<0.05). After adjusting for relevant risk factors, multivariate logistic regression analysis show ed that the peak systolic CWT (odds ratio [OR] 3.60, 95% confidence interval [CI] 1.48-8.30) and end diastolic CWT (OR 1.22, 95%CI 1.21-1.25) w ere the independent risk factors for lacunar infarction, w hile the peak systolic SS (OR 0.90, 95%CI 0.75-0.95 ) and end diastolic SS ( OR 0.87, 95%CI 0.84-0.98 ) w ere the independent protective factors for lacunar infarction; the peak systolic CWT (OR 4.67, 95%CI 2.05-10.52) and end diastolic CWT (OR 1.25, 95%CI 1.22-1.47) were the independent risk factors for leukoariosis, w hile the peak systolic SS (OR 0.93, 95%CI 0.75-0.94) and end diastolic SS (OR 0.91, 95%CI 0.85-0.98) w ere the independent protective factors for leukoaraiosis. Conclusions The common carotid artery mechanical stress w as associated w ith the occurrence of SVD.

Objective To analyze the impact and quality of life of minimally invasive surgery combined with catheter attract surgery on patients with cerebral hemorrhage.Methods A total of 90 patients with cerebral hemorrhage in our department from February 2013 to De-cember 2014 were randomly divided into invasive group and the control group.Minimally invasive surgery group were given to cerebral hemor-rhage minimally invasive surgery combined with catheter attract surgery,the control group received traditional craniotomy.The postoperative recovery,nerve function scores,quality of life and morbidity between two groups were compared.Results The operation time and edema vol-ume of tissue postoperative 7 days in minimally invasive surgery group was significantly lower than those of the control group.The hematoma clearance rate 1 day after surgery was higher than that of control group,with statistically significant difference(P <0.05).NIHSS scores of two groups were gradually decreased 7 d,15 d,30 d after surgery(P <0.05).NIHSS scores of the minimally invasive surgery group 7 d,15 d, 30 d after surgery were lower than that of control group,with statistically significant difference(P <0.05).The scores of vitality,physiological function,physical function,general health,bodily pain,emotional function,social function,mental health after 6 months of the surgery in the min-imally invasive group was higher than those of control group,with statistically significant difference(P <0.05).The rate of postoperative pulmo-nary infection,electrolyte imbalance,gastrointestinal bleeding in MIS group were lower than those in the control group,with statistically signifi-cant difference(χ2 =5.400 0,4.405 7,4.615 4,P <0.05).Conclusion Minimally invasive surgery combined with catheter attract surgery can improve neurological function and quality of life for patients with intracerebral hemorrhage, and reduce the incidence of complications.

Objective To explore the clinical application of GlideScope video laryngoscope combined with fiberoptic bronchoscope for double-lumen endobronchial tube intubation in patients with difficult glottis exposure.Methods Forty patients undergoing scheduled for thoracic surgery (24 males,1 6 females,aged 24-78 years,falling into ASA Ⅰ or Ⅱ,Mallampati classification Ⅲ or Ⅳ, were randomly divided into two groups (n=20 each):GlideScope video laryngoscope combined with fiberoptic bronchoscope group (group GF)and Macintosh laryngoscope group (group M).In group GF,GlideScope video laryngoscopy combined with fiberoptic bronchoscope was used to guide the double-lumen tube bronchial intubation and then bronchoscope was used to check the placement of the tube.In group M,the double-lumen endobronchial tube was intubated with conventional macintosh laryngoscope,and then the placement of the tube was checked by bronchoscope.The results of the Cormack and Lehane grade measuring the degree of glottic opening during laryngoscopy,the intuba-tion time consumed,one-time intubation success rate,patients manoeuvre needed to aid tracheal intu-bation and endotracheal intubation related complications within 48 hours after operation were recorded and compared between the two groups.Results Compared with group M,the Cormack and Lehane grade was significantly better (P < 0.01 ), intubation time consumed was significantly shorter [(104.3±1 1.1)s vs.(138.6 ± 33.0)s](P < 0.01 ),one-time intubation success rate was higher (90% vs.55%)(P <0.05 ),fewer patients needed manoeuvre to aid tracheal intubation (20% vs. 90%)(P < 0.01 )and postoperative complications of hoarseness and pharyngalgia within 48 hours were significantly fewer (5% vs.35%,25% vs.75%)in group GF(P <0.05 ).Conclusion Com-pared with conventional method, GlideScope video laryngoscope combined with fiberoptic bronchoscope used to guide double-lumen endobronchial tube intubation in patients with difficult glottis exposure may improve the success rate of intubation,reduce the stress response of intubation and postoperative complications of hoarseness and pharyngalgia.

Objective To summarize experience to prevent the main postoperative complications after hypospadias repairs. Method The clinical data of 189 cases of hypospadias repairs was from May 2005 to August 2010,retrospectively analyzed. Results One hundred and seventy-four cases were surgically cured by single-stage operation. All cases had been followed up for 4-36 (18.5 ± 5.5) months, the cases who had become adults were normal penile development and erectile function. Postoperative complications occurred in 15 cases,9 cases of them were urethral fistulas,6 cases were urethral strictures,all were cured or improved after symptomatic treatments. Conclusions Some methods are necessary to raise single-stage urethroplasty success rate and decrease the incidence of fistulas and strictures, such as preoperative antibiotic prophylaxis,appropriate procedure,intraoperative suprapublic urinary diversion,the good blood supply of the flap, modified enswathement, postoperative manage and nursing.