Objective To study the clinical features and therapeutic effects of pituitary adenomas in elderly patients. Methods The clinical materials including main clinical manifestations, diagnostic methods and outcome of treatments of 49 elderly patients with the pituitary adenomas from 1987 to1998 were analyzed retrospectively. Results It was showed from the data that the average duration of illness was 4 4 years; and 46(93 8%) cases were with visual deterioration, 20 (40 8%) with headache, and 16(32 7%) with endocrine abnormality. The diameter of tumors was more than 3 cm in 25 (51 0%), and the non functioning adenomas were found in 27 (55 1%). Operation was undergone through trans sphenoidal (61 2%), subfrontal (32 7%) and extensive subfrontal extradural approaches(6 1%), respectively. Among the 49 cases, tumor was totally or subtotally removed in 38 cases (77 6%), large partially or partially removed in 11 cases (22 4%). The results of operation through the trans sphenoidal approach were superior to other routes All patients were long term followed up for an average of 50 5 months. Visual disturbances were improved in 27 of 46(58 7%). A total of 43 patients could live by themselves Tumor disappearance was observed in 30 cases and recurrence in five cases. Five cases showed no changes in tumor size. 28 cases underwent radiotherapy after surgery and the occurrence rate of hypopituitarism after radiotherapy turned to be 50%. Total tumor control rate was calculated as 93%. Conclusions Macroadenomas and non functional pituitary adenomas happened most frequently in elderly patients and the main clinical symptoms was visual deterioration. Trans sphenoidal route for microsurgery was believed to be the first choice of operation. Tumor recurrence can be controlled or delayed by postoperative radiotherapy, but severe complication of the visual injury and pituitary dysfunction should be paid much attention.

The investigation of characteristic databases in 22 domestic colleges or universities of traditional Chinese medicine showed that the information resources have not been fully developed and the developed databases of tradi-tional Chinese medicine lacked of deep hierarchies.It was pointed out that updating their contents and deepening their hierarchies are the developing orientation for the characteristic databases of traditional Chinese medicine.

Objective To evaluate the diagnosis and efficiency of nasal endoscopic surgery treatment for rhinogenous optic function damage (ROFD).Methods The clinical data of 36 patients (36eyes) with ROFD were retrospectively reviewed.All patients were operated on nasal sinus probing and open sinus surgery through transnasal endoscopic approach,and 10 patients underwent endoscopic optic nerve decompression.Results Seven patients had bilateral pansinusitis,9 patients had unilateral posterior ethmoidal sinusitis and sphenoiditis,8 patients had isolated sphenoiditis,8 patients had fungal sinusitis occured in the sphenoid sinus and unilateral posterior ethmoid sinus,3 patients had unilateral pyocyst and cyst of the sphenoid and ethmoid sinus,1 patient had frontal and ethmoidal sinusitis.All patients were confiemed by pathology after surgery.The visual acuity preoperative were as follows:3 eyes no light perception,10 eyes hand movement,11 eyes fingers counting less than 20 cm and 12 eyes were vision impaired in different degree.The visual acuity postoperative were as follows:3 eyes failed,13 eyes cured,20eyes improved from hand movement or fingers counting to fingers counting (30-60 cm).The efficiency rate was 91.7％(33/36).The other eye symptom was disappeared.Sinus epithelization was happened after surgery in all patients.Conclusions If the medicine expectant treatment is invalid,nasal sinus probing and open sinus surgery through transnasal endoscopic approach should be performed early in treatment of ROFD.Patients who suffered frnm severe visual damage and either unresponsive or intolerant to medical treatment should be administrated endoscopic sinus surgery including endoscopic optic nerve decompression.

Objective To observe the effect of tyrosine kinase Src on activating Notch-1 protein in pancreatic cancer cell line-BxPC3. Methods Notch-1 expression and c-Src expression were inhibited by siRNA interference, and the activation of Src was inhibited by its inhibitor PP2. The growth rate of BxPC3 cells was measured by MTT. The change of Notch-1 NICD level and Src protein level was measured by Western blot. Results The growth of BxPC3 cells decreased after inhibiting Notch-1 expression, as well as the cells were treated with PP2. The level of Notch-1 NICD decreased both after inhibiting c-Src expression and after Src activation was inhibited by PP2. Conclusion In BxPC3 cells, tyrosine kinase Src promotes the level of Notch-1 NICD, which directly influences the cell growth.

Objective To analyze and consider the design for nursing English course through the investigation of demands for nursing English in 6 domestic high-end medical institutions.Methods Firstly,a face-to-face discussion was held with 10 experts in nursing management from above-mentioned institutions,field notes were made and themes were refined afterwards.Then,111 nurses were investigated in the 6 hospitals using purposive sampling method by filling questionnaire.Results In the teaching content,77 kinds of diseases were involved,including 27 most common ones; on the aspect of teaching methods and skills,90.1％ of the nurses recommended situational dialogue,72.1％ in favor of case teaching,92.8％ believed that nursing English course should cultivate students' communication skills; Its teaching emphasis in turn included vocabulary,communication capability,nursing knowledge (89.2％,88.3％,73.0％).Conclusions The objective of nursing English course should focus on cultivating nurse students' applied capability including listening,reading,speaking and written English.The textbook of nursing English should be written based on the characteristics of common diseases in the hospital stressing on nursing knowledge,vocabulary and communication skills.Teaching method of nursing English should consider the situational teaching model in hospital nursing English.

Objective To investigate the effect of albumin on expression of NLRP3 inflammasome and its downstream cytokines IL-1β and IL-18 in tubular epithelial cells.Methods Thirty mesangioproliferative glomerulonephritis (MsPGN) patients with different levels of proteinuria were selected, and their renal biopsy samples were stained by PAS and Masson to observe tubular epithelial cells injury and inflammatory cells infiltration.NLRP3, caspase-1, IL-1β and IL-18, as well as different inflammatory cells, were detected by immunohistostaining.In vitro, Western blotting and real-time PCR were employed to detect NLRP3, caspase-1, IL-1β and IL-18 protein and mRNA in HK-2 cells stimulated by bovine serum albumin (BSA) (20 g/L).Results In MsPGN patients with high levels of proteinuria, there were obvious renal tubular epithelial cell injury and inflammatory cells infiltration (all P ＜ 0.05), and the expressions of NLRP3, caspase-1, IL-1β and IL-18 were up-regulated compared to patients with low levels of proteinuria (all P ＜ 0.05).Furthermore, IL-1β and IL-18expressions were positively correlated with the degree of proteinuria (r=0.836, P ＜ 0.05;r=0.901, P ＜0.05).NLRP3, caspase-1, IL-1β and IL-18 protein and mRNA were significantly increased in HK-2cells stimulated by BSA compared to the control group (all P ＜ 0.05).Conclusions Albumin is able to induce NLRP3 inflammasome activation in tubular epithelial cells, which may be the mechanism of tubulointerstitial injury and inflammation caused by proteinuria.

Objective To evaluate the methods and efficacy of microsurgical treatment for the premalignant and malignant lesions of the conjunctiva. Methods Forty-seven patients witn premalignant and malignant lesions of the conjuncitva were managed by microsurgical, these patients include 12 melanoma, 26 squamous cell carcinoma, 6 Bowen’ diseases, 3 primary acquired melanosis. The surgical method differs with limbal tumors, extralimbal tumors, and primary acquired melanosis. Results In all 47 patients, the tumor was completely removed in in one procedure. After follow-up for 4~60 months(mean 17 months), these were no tumor recurrence. Conclusion It is effective methods that premalignant and malignant lesions of the conjunctiva are managed by microsurgical resection, alcohol application, and supplemental cryotherapy. Careful propeirativa clinical evaluation of patient with a conjunctiva neoplasm is important in making the correct diagnosis and planning the surgical approach.

Objective To investigate the effect of different intestinal cleaning methods on bowel preparation for laparoscopic peritoneal vaginoplasty.Methods One hundred patients undergoing laparoscopic peritoneal vaginoplasty were divided into experiment group and control group with 50 cases in each group .For bowel preparation,the experiment group was managed with oral sodium phosphate salt solution of 45 mL and the control group with oral senna leaf of 30 g in boiled water.The two groups were compared in terms of intestinal cleaning degree,adverse reactions and postoperative exhaust time.Results The incidence of adverse reactions in the former group was significantly lower than the control group.Degree of bowel cleaning satisfaction was significantly better than that of the control group and the postoperative exhaust was significantly earlier than that in the control group(P<0.05).Conclusion The method of oral sodium phosphate salt solution for bowel preparation for laparoscopic peritoneal vaginoplasty can improves the intestinal cleanliness,reduce incidence of intestinal adverse reaction and promote postoperative exhaust so that it can improve postoperative intestinal restoration of kinetic energy.

Objective To compare the value of intrarectal filling with water and filling in rubber sheath with water in endoluminal uhrasonography for preoperative staging of rectal tumors. Methods 215 cases of rectal tumors were divided into two groups. 120 cases using the method of filling in rubber sheath with water and 95 cases using intrarectal filling with water were diagnosed with uhrasonography. The results were compared with corresponding pathologic results for the judgment of their accuracy. Results The accuracy for the diagnosis of infiltration depth was 60.0 % in the first group and was 73.7 % in the second. The difference was statistically significant (P <0.05). The accuracy for diagnosis of metastases of perirectal lymph nodes was 82.5 % in the first group and was 80.0 % in the second. The difference has no statistical significance (P >0.50). Conclusion Intrarectai filling with water is better than filling in rubber sheath with water in the diagnosis of infiltration depth of rectal tumors, while there is no difference in the diagnosis of metastasis of perirectal lymph nodes.

With the change of medical model and the transfer of health to communities and rural towns,the expanding enrollment of colleges and universities makes collegiate internship progrms more and more difficult Clinical College of Guilin Medical University explores the new methodology of teaching practice,constructs and practises the new molde of internal madichine teaching,Combines the coummunity internship programs with hospital internship programs.and was improved the quality of practice teaching