Objective To provide the anatomical data for single-nostril transsphenoidal microsurgery for pituitary adenoma.Methods Microanatomic structures were observed and measured in 20 cadaveric a- dults heads.Results(1)The diaphragmal opering was 5 mm or greater broad in 90%.The mean thick- ness of the diaphragma sellae was (0.18?0.08)mm.(2) A sphenoid sinus with complete pneumatization was named as all-sellae type,its percentage in all specimens was 85%,85% sphenoid sinus had middle sep- tum of which only 18.8% located in the medial sagital section.(3)The meant thickness of the sellar floor was (0.81?0.34) mm,70% of which were not more than 1 mm.Of the sellar floors,that the shape was flatness reach 15%.(4) The relationship between ICA and sphenoid sinus had two aspects,one was to be mutually apart (55%),the other was to communicate (45%),which formers carinae on the lateral wall of the sphe- noid sinus,espeially in the superior surface of posterior part.The relationship between optic nerve and sphe- noid sinus,one was to be mutually apart (27.5%),the other was to communicate (72.5% ),which formers carinae on the lateral wall of the sphenoid sinus,especially in the superior surface of anterior part.(5) Three main types of the intercavernous sinus were the anterior intercavernous sinus,present in 80%,the inferior in- tercavenous sinus (25%),and the posterior intercavenous sinus (15%).Conclusion The knowledge of the anatomy of the sellar region and sphenoid sinus is helpful to safe operation in the single-nostril transsphe- noidal approach for pituitary,adenoma microsurgery.

Background Researches have demonstrated that ocular hypertension induces the ischemia-reperfusion of retina and further leads to the degeneration of retinal ganglion cells,but its mechanism is beyond understanding.Objective The present study aims to observe the effects of static pressure on the morphology,proliferation activity and viability of cultured retinal microvascular endothelial cells (RMECs) and evaluate the expression of ET-1 and NO in these cells under variant static pressure.Methods RMECs were isolated from 30 healthy Wistar rats and cultured using explant culture method by Ⅷ factor antibody and PECAM-1 antibody.The static pressure of 1.33kPa,2.67kPa,5.33kPa and 10.67kPa was used in culture bottle respectively.The RMECs without static pressure were used as normal control group.The morphology of RMECs under the different static pressure was observed by inverted phase contrast microscopy,and the number of RMECs was counted using the counting plate.Cellular viability was studied by trypan blue staining.The changes of ET-1 and NO_2~-/NO_3~-,two metabolic products of NO,in the medium were detected by radioimmunoassay and Griess's nitrate reductase method.The expression of ET-1,eNOS and iNOS mRNA in RMECs was analyzed by semi-quantitative RT-PCR 24 hours after treatment of variant static pressure.Results Cultured RMECs sticked well at 24 hours and reached to confluence at 48 hours and showed the red fluorescence for Ⅷ factor antibody and PECAM-1 antibody.Enlargement of nuclei,extenders of cell bodies and suspension of RMECs in medium were observed.The number of RMECs was gradually increased.The cell viability was reduced with the raise of static pressure among these four groups(F=12.205,P＜0.01;F=11.180,P＜0.01).The static pressure increased the content of ET-1 released by RMECs in 2.67kPa,5.33kPa and 10.67kPa of static pressure groups,and concentrations of NO_2~-/NO_3~- in the medium showed a significant increase in 5.33kPa and 10.67kPa of static pressure groups compared with normal and 1.33kPa of static pressure groups(P＜0.01).The expressions of ET-1 mRNA,eNOS mRNA and iNOS mRNA were considerably enhanced in 5.33kPa and 10.67kPa of static pressure groups compared with normal control group(P＜0.01).Conclusion Raised static pressure causes the alteration of RMGCs structure and morphology.Static pressure could upregulate the expressions of ET-1,eNOS and iNOS mRNA in RMECs and increase the release of ET-1 and NO.This pathway might be one of pathologic mechanisms of retinal injury induced by high intraocular pressure.

Objective To explore the microcosmic mechanism of pingyangmycin treating infantile proliferating capillary hemangiomas so as to find the optimal method for hemangiomas′ treatment.Methods Sixty samples of infantile proliferating hemangiomas were divided into control group(30 cases,aged from 2 days to 6 months) and experimental group(30 cases,aged from 2 to 6 months).Pingyangmycin was made into emulsion and smeared on the surfaces of the leision in experimental group with 3 times every day as well as only matrix in control group.The specimens were resected on d7,then made into pathological slices and electron microscope slices in order to observe the cells microcosmic structure changes and ultrastructure changes.Furthermore,the apoptotic indexes of two groups were detected by the molecular biology method(TUNEL test).Results The number of apoptotic cells were lower in control group(apoptotic index 18.87?13.67)but higher apparently in experimental group(apoptotic index 29.52?15.33).The difference between two groups was significant(t=2.842 P

Objective To investigate the influence of somatostatin (SS) and protein tyrosine enzyme 1 B (PTP1B) on the proliferation and the matrix protein secretion and phosphorylation of JAK2/STAT3 of hepatic stellate cells (HSC) induced by leptin. Methods The effect of different concentrations of SS on the proliferation of activatied HSCs induced by leptin was detected with MTT assay. HSCs were divided into control group, leptin group, leptin+10-7 mol/LSS group, leptin+10-6 mol/LSS group, TIMP-1, type I collagen and PTP1B protein and mRNA. Phosphorylation of JAK2/STAT3 were detected by RT-PCR, Western bolt and ELISA assay. Results SS could promote leptin-induced proliferation of HSCs in a dose-adependent manner. SS can improve PTP1B protein and mRNA, and higher does of SS could render more increase compared with the lower does. SS could reduce TIMP-1 mRNA, type I collagen mRNA and protein expression, and make the JAK2/STAT3 dephosphorylated, and the higher SS group reduce these factors more obviously than the lower group. Conclusion SS up-regulates PTP1B expression, inhibits JAK2/STAT3 signal transduction, proliferation, and reduces TIMP-1, I collagen expression in actived HSCs induced by leptin.

Objective To investigate the clinical features and prognosis of the patients with renal cell carcinoma and venous tumor thrombus.Methods Fifty-six patients with renal cell carcinoma and venous tumor thrombus were selected as our subjects,who underwent radical nephrectomy and thrombectomy in the Second Hospital of Tianjin Medical University from June 2002 to May 2014.There were 28 patients with stage Ⅰ tumor thrombus,l5with stage Ⅱtumor thrombus,9 with stage Ⅲ tumor thrombus and 4 with stage Ⅳtumor thrombus.All patients underwent renal tumor resection and embolectomy,and were follow-up.Results Of all the patients,46 were male and 10 were female with a mean age of 61.7(age ranging from 42 to 83).Twenty-four were presented on the left kidney and 32 were right.The clinical features were as follows:The tumor size was 2.5 to 14 cm in diameter(mean:6.2 cm),there were 21 cases with low back pain,18 cases with hematuria,lcases with abdominal.Pathological results showed that 39 with clear cell carcinoma,9 with papillary cell carcinoma,3 with chromophobe cell carcinoma,1 with low-differentiated cell carcinoma and 1 with undifferentiated cell carcinoma,3 with sarcomatoid differentiation.Forty-three patients were followed up,and the median follow up period was 20.4 months (2-90 months).The median survival time for the patients was 47 months and the 5 year overall survival was 45.2％.The survival time of the patients with early tumor thrombus(below hepaticvein) was (55.3 ± 4.9) month,significantly longer than that of the patients with advanced tumor thrombus (above hepaticvein) ((24.8 ± 5.3) months,P =0.047).Conclusion Patients with renal cell carcinoma and venous tumor thrombus are characterized with high malignancy and poor prognosis.Surgical operations are effective therapies for the patients.Long term outcome of the early tumor thrombus patients is significantly better than that of the advanced tumor.

Objective To study the influence of UPPP on resonance characteristics of four resonance cavity in patients with OSAHS .Methods Using multi-channel voice analysis system to test the cavity resonance character-istics and energy distribution of 36 OSAHS patients (including pre - and post -operative) and 36 normal males when they speak /a:/.The frequency spectrum was 4 000Hz(FR1 ,FR2 ,FR3 ,FR4 ) .Results FR2 energy values of the head cavity and mouth cavity of OSAHS patients heighten significantly after UPPP (P<0 .05);FR1 energy val-ues of head ,mouth and thoracic cavity were higher than that of in normal males'after UPPP(P<0 .05) .FR2 ,FR3 , FR4 energy values of head cavity ,FR2 ,FR3 energy values of mouth cavity ,FR2 energy values of thoracic cavity were lower than those of in normal males'after UPPP(P<0 .05) .Conclusion UPPP surgery removes the obstruction of the upper airway of OSAHS patients and changes the morphology of the pharynx ,thas changes the resonance charac-teristics of the head cavity and oral .

Objective To explore the predictive value of soluble growth STimulation expressed gene 2(sST2) on major adverse cardiovascular events(MACE) of acute myocardial infarction (AMI) after percutaneous coronary intervention (PCI).Methods The study included 148 patients with first episode of AMI admitted from January 2015 to May 2016 in the heart center of the First Hospital of Lanzhou University.Serum sST2 level before PCI was tested and all patients were followed up clinically for 6 months after PCI.Results 1.MACEs were found in 23 patients during follow up.The sST2 leveles were significantly higher in patients with MACEs than the non-MACE group [(44.50 ±5.32) ng/ml vs.(23.59±1.15) ng/ml, P=0.001].Pearson correlation analysis showed that serum sST2 were positively correlated with MACE and type Ⅲ procollagen amine terminal peptide (PⅢNP) but was not correlated with NT-proBNP.2.Serum sST2 found to be correlated with the body mass index, blood pressure, triglycerides, aspartate aminotransferase, left ventricular end-systolic volume (LVESV) and left ventricular ejection fraction (LVEF).3.The area under the ROC curve of sST2 to predict the occurrence of MACE after PCI was 0.787 which was higher than that of NT-proBNP.The area under curve of sST2 combined with NT-proBNP was 0.820.4.The survival rate of patients with serum sST2 level ≤29 ng/ml was higher than patients with sST2>29 ng/ml in 6 months after PCI.Conclusions sST2 is affected by a variety of factors.sST2 combined with NT-proBNP can improve the predictive value of MACE after PCI, and higher the level of sST2, higher the mortality rate in 6 months after PCI.

Objective To evaluate the feasibility of application of PBL method on otolaryngology education for medical undergraduates.Methods Totally 61 medical undergraduates of Class 2009 at Peking Union Medical College were enrolled into this study.There are 22 males and 39 females and aged 23-26 years old.They were grouped randomly into two groups: the PBL group (n=29) and the traditional teaching method group (n=32).Questionnaires were collected and statistical analyses were conducted.Results The scores of the evaluations for education of otolaryngology after teaching were much better than those before teaching in the PBL group in most aspects according to the questionnaires (P<0.05).In traditional teaching method group, there are only few aspects` scores much better than those before teaching.Comparing the two teaching methods shows, in most aspects, the scores of PBL group are much higher than those of the traditional teaching method group.ConclusionsCombination of PBL with other teaching method will be an ideal way for medical education in otolaryngology.

Objective To study the different expressions of neurotensin (NT) at gene and protein level in orthotopic model of prostate cancer . Methods The animal models of androgen dependent prostate cancer(ADPC,castrated for 3 days) and androgen independent prostate cancer(AIPC) were established by planting tumor tissue or undergoing surgical castra-tion. Affymetrix microarray technology was carried out to compare the gene expressions of NT. The result was verified by qRT-PCR. HE staining was used to observe the change of pathology. ELSIA and immunohistochemistry technology were fi-nally performed to detect protein expression of prostate-specific antigen(PSA) and NT in three different groups of prostate cancer tumor tissues. Results The expression of NT was 5.10 times higher in AIPC group than that in ADPC group. The ex-pression of NT was 0.33 times lower in castrated 3-day group than that in ADPC group. Results of RT-PCR and qRT-PCR showed that the expression levels of NT gene were 1.41 and 7.27 times respectively higher in AIPC group than that in ADPC group,but the expression levels of NT gene were 0.78 and 0.46 times respectively lower in castrated 3-day group than that in ADPC group (P<0.05). HE results showed that nuclear atypia and tumor structure in three groups. Immunohistochemistry and ELISA results showed that the values of PSA and NT were (0.48±0.03) and (0.031±0.008)μg/L in ADPC group;(0.17± 0.03) and (0.021±0.004)μg/L in castrated 3-day group,and (0.87±0.02) and (0.042±0.010)μg/L in AIPC group. There were significantly lower expressions of NT and PSA in castrated 3-day group that those of ADPC group (P<0.01). Conclusion In the transition from ADPC to AIPC, the over-expression of NT suggested that NT may be associated with prostate cancer progression. NT may be used as a new therapeutic target and specific diagnostic method of AIPC.

Objective To evaluate the effects of phonosurgery combined with voice therapy in patients with vocal polyps accompanied with muscle tension dysphonia (MTD) .Methods The study retrospectively enrolled 117 patients with a diagnosis of vocal polyps accompanied with MTD .All the patients were divided into two groups ac‐cording to the different remedies:the surgery group (n=57) ,and the combination group (n=60) .The Xion acous‐tic analysis was carried out on the two groups before and after therapy .We compared the results in each group ,the results of post-therapy between two groups ,and that of post-therapy with the control group(n=50) .The acous‐tic parameters were jitter percent (jitter) ,shimmer percent (shimmer) ,dysphonia severity index (DSI) .Results The results obtained in the study showed that all the voice analysis parameters were significantly improved after therapy in both the surgery group and combination group(P<0 .05) .Jitter and shimmer in post -therapeutic out‐come of the combination group were lower than those of in surgery group ,and DSI was even higher(P<0 .05) .Jit‐ter and shimmer in post-therapeutic outcome of surgery group were higher than those of in normal group ,and DSI was lower than those of in normal group(P<0 .05) .But there were no clinically significant differences in post -therapeutic outcomes of combination group compared with control group(P>0 .05) .Conclusion As for vocal polyps accompanied with M TD ,successful phonosurgical treatment and voice therapy can improve patients’ voice quality .