Objective To discuss the preoperative diagnosis and the effect of microsurgical transsphenoidal surgery of pituitary Rathke's cleft cysts.Methods Retrospective analysis was performed from January,2011 to May,2015 on 62 cases of Rathke's cleft cyst which confirmed by surgery and pathology at the First Affiliated Hospital of Sun Yat-sen University.Sixty-two cases were performed by the surgery of transsphenoidal approach.Results There were 50 cases with a correct preoperative diagnosis of and consider Rathke's cleft cyst,12 cases of misdiagnosis.Postoperative follow-up was performed within 6-12 months,and the patient's clinical symptons were improved in different degrees,1 case of recurrence,no deaths and serious complications.Conclusion The diagnosis of Rathke's cleft cyst need for comprehensive considerations from many aspects,and the improvement of diagnosis rate base on the clinical features,endocrine examination,and imaging data.The microsurgical transsphenoidal surgery is safe and effective treatment for Rathke's cleft cyst.

Humans ; Head and Neck Neoplasms/therapy*

Objective To review the diagnosis and treatment of adrenal myelolipoma(ML).Methods The medical records of 21 patients with adrenal myelolipoma were reviewed.All patients were examined by B-ultrasound,CT and endocrine tests while some were also examined by MRI and 131I-MIBG.Results All patients had undergone resection of adrenal ML.The mean diameter of tumors was 6.7 cm(4.5 cm～12 cm).Pathological examination of all tumors confirmed the diagnosis of adrenal ML.No recurrence was recorded during the follow-up period(1～15years).Conclusion Adrenal ML is a kind of rare,benign tumor and is often incidentally discovered.Its prognosis is generally good.

Objective To explore the effect of SZ-685C on rat pituitary adenoma GH3 cell line.Methods MTT method evaluated its effect of proliferation and inhibitory concentration 50 (IC5o) on GH3 cells,after treated by 0,2.5,5.0,7.5,10.0,12.5,15.0,17.5,20.0 and 30.0 μmol/L SZ-685C for 48 h,GH3 cells were changed to complete medium for 12 d,crystal violet staining was used to investigate colony formation; microscopy and Hoechst 33342 staining assay observed whether the changes of morphological as the result of apoptosis,then detected cell apoptosis by flow cytometry.Results SZ-685C had a dose-dependent inhibitory effect on GH3 cell proliferation and IC50 was (12.9 ± 0.47) μmol/L,MEF(considered as a control group) had little affect in cell proliferation on the concentration of IC50.Inhibitory effects persisted even on removal of SZ- 685C after 12 d,and SZ-685C blocked colony formation ability of pituitary tumor cells.Apoptotic morphological observation of microscope and Hoechst 33342 staining proved apoptosis during treatment of SZ-685C,flow cytometry detection showed that SZ-685C induces 36.4％ of apoptosis,while only 2.0％ in control group.Conclusion SZ-685C inhibits pituitary tumor cell proliferation and induces apoptosis.SZ-685C can be a new anti-patuitary tumor drug for a further study.

Objective To retrospectively analyze the clinical data of 3 middle-aged and elderly cases with inflammatory myofibroblastic tumor (IMT) of the kidney,in order to improve its diagnosis and treatment.Methods The records of 3 patients who were diagnosed as IMT of the kidney by pathology in our hospital from Jan 2005 to Jun 2014 were reviewed to identify the characteristics including age,gender,clinical manifestation,tumor imaging and pathological features,treatment and prognosis.Results The mean age of the patients was 60 years.One patient underwent partial nephrectorny,1 patient underwent radical nephrectomy,and another patient received nephroureterectomy with bladder cuff excision.Patients were followed up for 8 months to 10 years,and no tumor recurrence was found.Conclusions IMT of the kidney is the tumor of low malignant potential with a good prognosis.Surgery is the first choice for the diagnosis and treatment.

Objective To evaluate the nucleated red blood cell (NRBC)count of Sysmex XN-9000 automatic hematology anal-ysis lines comparing with manual method,and verify the accuracy of the analyzer results.Methods 60 blood samples with more than 1% of NRBCs detected by XN-9000 were counted NRBCs by traditional manual microscopy in blood smears,and verified the analyzer results.Results According to the reliability analysis,the results of total 60 samples were all within the range of the reliability;correlation analysis showed that correlation coefficient (r)of group NRBC (%)1~10 and>10 were 0.972 1 and 0.996 2,respectively.There were no significant differences between them (P>0.05).Conclusion Compared with manual method,the results of NRBC count of XN-9000 were within the range of reliability,and showed good correla-tion.The analyzer test results of NRBC were accurate and reliable and could be applied to the detection of clinical samples.

Objective:To investigate the effects of recombinant adenovirus with human vascular endothelial growth factor 165 (Ad-hVEGF 165) and recombinant adenovirus with human tissue inhibitor of metalloproteinase 1 (Ad-hTIMP-1) on rats with myocardial infarction (MI) and its mechanism. Methods:A total of 30 healthy 8-week-old male Wistar rats were randomly divided into 5 groups: sham-operated group (sham), virus control group (Ad-Track), Ad-hVEGF 165 group, Ad-hTIMP-1 group and Ad-hVEGF 165+Ad-hTIMP-1 group (hVEGF 165+hTIMP-1) ( n=6 per group). Except the sham group, all rats were ligated the left anterior descending coronary artery to induce MI model with ST-segment elevation and Q waves or T-wave inversion on electrocardiogram and local myocardial whitening. The corresponding recombinant adenovirus comprising 100 μL (1×10 10 VP/100 μL) combined with NaCl solution was injected into the myocardial infarction area at four points respectively. The sham group received no treatment. After 4 weeks, all rats were sacrificed after echocardiography was completed and heart tissues were collected. The expression of hVEGF 165 and hTIMP-1 were detected by immunohistochemistry. The mRNA expression of apoptosis-related factors were detected by real-time PCR. The protein expression of apoptosis-related factors were detected by immunohistochemistry. Differences between groups were determined by One-way analysis of variance. Multiple comparisons between groups were performed using the least significant difference t-test. Results:(1) Both heart rate (HR) (480.83±24.09) beats/min, left ventricular end-diastolic dimension (LVEDD) (6.88±0.44) mm and left ventricular end-systolic dimension (LVESD) (4.85±0.42) mm were increased in the Ad-Track group than those in the sham group (433.16±17.86) beats/min, (6.20±0.45) mm, (4.06±0.70) mm (all P<0.05), and left ventricular ejection fraction (LVEF) (62.70±3.17) % and left ventricular fractional shortening (LVFS) (29.52±1.88) % were significantly decreased in the Ad-Track group than those in the sham group (72.78±5.44)%, (29.52±1.88) % (both P<0.01). Compared with the Ad-Track group, LVEF (71.50±6.23) % and LVFS (36.17±5.27) % in the hVEGF 165-hTIMP-1 group were significantly increased (both P<0.01), and LVEDD (6.22±0.39) mm and LVESD (4.13±0.23) mm were decreased (both P<0.05). LVEF and LVFS in the hVEGF 165-hTIMP-1 group were increased significantly than those in the Ad-hVEGF 165 group (64.65±4.00) %, (30.95±2.57) % (both P<0.05). The mRNA expression of BCL2-associated X protein (Bax), cysteine aspartate specific proteinase 3 (Caspase-3) and BCL-xL/BCL-2-associated death promoter (Bad) in the hVEGF 165-hTIMP-1 group were decreased than those in the Ad-Track group ( P<0.01 or P<0.05), and B-cell lymphoma/leukemia-2 (Bcl-2) in the hVEGF 165-hTIMP-1 group were increased than those in the Ad-Track group ( P<0.01). The mRNA expression levels of Bax and Caspase-3 in the hVEGF 165-hTIMP-1 group were decreased than those in the Ad-hVEGF 165 group (both P<0.05). There was no statistically difference in the mRNA expression of Bax, Caspase-3, Bad, and Bcl-2 between the hVEGF 165-hTIMP-1 group and the sham group (all P>0.05). The protein expression of Bax and Caspase-3 in the hVEGF 165-hTIMP-1 group were significantly decreased than those in the Ad-hVEGF 165 group, the Ad-hTIMP-1 group and the Ad-Track group (all P<0.01), and the protein expression of Bcl-2 in the hVEGF 165-hTIMP-1 group was increased than those in the Ad-hVEGF 165 group, the Ad-hTIMP-1 group and the Ad-Track group (all P<0.05). There were no statistically differences in the protein expression of Bax, Caspase-3 and Bcl-2 between the hVEGF 165-hTIMP-1 group and the sham group (all P>0.05). Conclusions:Ad-hVEGF 165 and Ad-hTIMP-1 can improve cardiac contractile function of MI rats and the beneficial effects are largely attributable to inhibiting myocyte apoptosis. The combination of hVEGF 165 and hTIMP-1 may have a synergistic effect on MI.

Objective To investigate the clinical features,prognosis and its influencing factors of cerebral venous sinus thrombosis (CVST).Methods The clinical data of 163 patients with CVST were analyzed retrospectively.The outcome was assessed with the modified Rankin Scale (mRS).The influencing factors on prognosis were analyzed by logistic regression model.Results Among the 163 CVST cases,headache was found in 140 cases,motor and (or) sensory deficits in 16 cases,coma in 6 cases,serious intracranial hypertension (＞ 350 mm H2O,1 mm H2O＝0.0098 kPa) in 68 cases,lateral sinus thrombosis in 129 cases,straight sinus thrombosis in 11 cases and intracranial hemorrhage in 21 cases.Follow-up data was obtained by telephone in 150 cases (92％).The mRS scores were 0-1 in 89 cases,2 in 13 cases,3-5 in 44 cases,and 6 in 4 cases respectively.Poor outcome (mRS score ＞ 2) was found in 29.4％(48/163) patients.The total mortality rate was 2.7％ (4/150).Univariate analysis identified factors associated with poor outcome were motor and (or) sensory deficits,straight sinus thrombosis,serious intracranial hypertension (＞ 350 mm H2O) and intracranial hemorrhage.In logistic regression analysis,serious intracranial hypertension(＞ 350 mm H2O; OR =0.169,95％ CI 0.053-0.541,P =0.003) and intracranial hemorrhage (OR =0.075,95％ CI 0.018-0.311,P =0.000) were identified as independent predictors of poor prognosis.Conclusions The clinical manifestations of CVST are complicated and nonspecific.It is still a disease that may lead to death or disability.Serious intracranial hypertension(＞ 350mm H2O) and intracranial hemorrhage were independent predictors of poor prognosis.

Objective To evaluate the effectiveness and side-effects of antithymocyte globulin(ATG) and antilymphocyte globulin(ALG) in nonmyeloablative stem cell on transplantation complication.Methods Fourteen cases of hematologic malignancies and 11 cases of sever aplastic anemia(SAA) were treated with allogenic bone marrow transplantation or cord blood haemopoietic stem cell transplantation based on ATG/ALG.Five patients with malignant hematonosis were received donor lymphocyte infusion(DLI) after transplantation.The protocols for graft-versus-host disease(GVHD) prophylaxis consisted of Cyclosporin A(CSA) and methotrexate(MTX) for malignant hematonosis patients or CSA and methylprednisolone(MP) for patients with SAA.Results Three patients had not evidence of engraftment and died from infection at early stage.Other patients recovered haematopoiesis.The mean time of ANC more than 0.5?10~9/L and Plt more than 20?10~9/L were 12.1(3～29) and 20.1(5～79) days posttransplant respectively.Three patients achieved donor complete chimera(CC).Five malignant patients with transient mixed chimerism(MC) grdually converted into complete chimerism by DLI post transplant.Nineteen patients achieved MC and four of them coverted into donor haematopoietic cell complete chimerism.There was no aGVHD in early stage post transplant.There were 1 patient with Ⅰgrade aGVHD,3 with Ⅱgrade aGVHD,2 with skin local cGVHD and 2 with extensive cGVHD after DLI,respectively.There were 2 patients with bacteria infection complications,4 with virous infection and 5 with fungal infection.All patients complicated with chills and fever in the use of ATG and ALG.Conclusion Treatment with ATG and ALG is safety and tolerant for the patients,and can enhance the engraftment of haemopoietic stem cell and decrease the aGVHD.

Objective To evaluate the effect of extracorporeal membrane oxygenation(ECMO) for critical acute respiratory distress syndrome(ARDS).Methods Twenty-two patients with critical ARDS were treated with ECMO after failure of conventional ventilation therapy.The PaO_2,PaCO_2,DO_2,VO_2 and hemodynamic parameters were retrospectively analysed.Result PaO_2,DO_2,VO_2 was improved significantly after ECMO.Sixteen patients survived.Conclusion Whenever other treatments fail to improve PaO_2 on critical ARDS patients,ECMO should be considered.