Objective To study the criteria and technique of transsphenoidal microsurgery on pituitary adenoma invaded cavernous sinus Methods 42 patients with pituitary adenoma underwent 45 transsphenoidal operations Sellar base was opened as large as possible under C arm X ray fluoroscopy or neuronavigation monition Dura matter was cut open under microscope Tumors were removed through the direction and tunnel they in invade Bromocriptine was administered to those with little remains Partial remains and those have no response to bromocriptine were given radiotherapy Results No modality 21 tumors were nearly totally removed, 18 tumors were subtotally resected, 3 were partially resected MRI scanned in 2～3 months after the operation showed that 19 tumors disappeared, 20 tumors had little residul, 3 tumors partially remained Conclusion Pituitary adenomas invading the cavernous sinus with enlarged sella turcica and shown soft in MRI can be submitted to transsphenoidal operation Microsurgical technique can ease tumor removal and protection of the sellar and internal carotid artery

Objective To observe the ingrowth characteristics of the interface between hydroxyapatite coated intervertebral implants and vertebral cortex loaded with physiological compressive stress. Methods Twelve titanium alloy intervertebral implants special for macaque were prepared, 4 of which were coated with corundum (control group) and 8 of which were coated with hydroxyapatite (HA, observed group). One control and two observed implants were randomly inserted into the intervertebral spaces of L2,3, L3,4 and L4,5 in each of 4 healthy homogenous adult macaques (2 males and 2 females). Roentgenology was performed at 3, 6, 12, 24 and 40 weeks postoperatively. Histomorphometry as well as histology were also evaluated at 40 weeks postoperatively. Results All the animals recovered well from the operation. Three days after operation all the animals began to stand and walk with normal gait. Gross anatomy showed excellent healing in the annulus fibrous involved, and no implant loosening or migration was found. On 40 weeks postoperatively, the interface of the observed group were filled with calcified mature bone and partly-mineralized osteoid tissue, the content of calcified bone as well as the amount of osteoblasts and osteocytes were significantly higher in observed group, and the differences were of statistical significance (t=5.001, P=0.000 and t=16.983, P=0.000). A tight connection was observed between the vertebral bones and HA coating. The thickness of coating decreased form 130-150 ?m to 100-130 ?m. And no evident breakage or debris was found on the implant coating. Conclusion HA coating was stable in vivo and had favorable biocompatibility with vertebral bone. It was more effective than corundum coating in inducing intervertebral cortical bone ingrowth under physical compressive loading.

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.

Objective To explore the effects of Medpor in surgical treatment of craniofacial de-pressed deformities. Methods Combining with other surgical methods, 37 patients with craniofacial de-pressed deformities were treated with Medpor. Of them, 29 cases of craniofacial depression and defects subjected to trauma, 6 cases were progressive facial hemiatrophy and 2 case were angle of mandible de-formity. All were followed up from three months to four year. Results Facial configurations and func-tions of all the 37 cases were greatly improved after the treatment, without any complication of infection or rejection;patients were all very satisfactory or relatively satisfied with the results. Conclusion Med-por is an ideal implant material to correct the deformity of earaniofacial, and combining with others methods, the treatment of earaniofacial deformity can obtain good results.

Objective To explore an effective treatment for lactation complications after augmenta-tion mammoplasty with polyacrylamide hydrogel (PAHG). Methods 13 cases with lactation complica-tions after augmentation mammoplasty with polyacrylamide hydrogel (PAHG) were treated with taking out PAHG and the pathological tissue through the periareolar incision, using continual drainage and medi-cation that can choke back hypergalactia. Results All cases were cured and followed up for 3 months to 4 years with satisfactory results. Conclusion This method for the treatment of lactation complications after augmentation mammoplasty with PAHG is effective, safe and simple.

Objective: To investigate the inhibitory effect of Dahuangzhechong pill to platelet activation.Methods: The blood platelet were incubated with the medicated blood plasma with Dahuangzhechong pill,and then activated with ADP and marked with PAC-1 monoclonal antibody.The activation rate of blood platelet was analyzed by flow cytometer.The patients with coronary heart disease or cerebral infarction took Dahuangzhechong pill,after one course of treatment,the patients,blood platelet were separated and then incubated with PAC-1 monoclonal antibody.The activation of blood platelet was detected by ? ow cytometer.Results: Compared with aspirin group(51.7%),the activation rate(20.82%) of blood platelet in Dahuangzhechong pill group decreased(P

Objective To compare the effect and safety of arthroscopic debridement enmbined with intercondylar fossa angioplasty in the elder with knee osteoarthritis.Methods Six-eight elderly with knee osteoarthritis were selected from June 2012 to December 2014 in this hospital and they were averagely and randomly divided into group A and B.Patients in group A were given arthroscopic debridement,while in group B were given and arthroscopic debridement,intercondylar fossa angioplasty.The levels of VAS scores,Lysholm scores,WOMAC scores and joint range of motion were measured and compared between the two groups after 3 months,6 months and 12 months of operation.The adverse events of the two groups were supervised and compared as well.Results All elder in the two groups had apparently decreasing in VAS scores and WOMAC scores (P＜0.05) after operation.Compared with group A,patients in group B had lower levels of VAS scores and WOMAC scores(P＜0.05) at 12 months after operation.The level of Lysholm score was significantly increased in the two groups after treatment(P＜0.05),while group B had a higher level at 12 months after treatment than group A (P＜0.05).The joint range of motion in the two groups were improved after treatment(P＜0.05).The elder patients in group B had better joint range of motion than group A at 6 and 12 months after operation (P＜0.05).Early postoperative swelling in the joints was the adverse event after operation,but there was no statistically difference between two groups.Conclusion The combination of arthroscopic debridement and intercondylar fossa angioplasty is effective to release knee pain,increase the clinical efficacy and improve the knee function.

BACKGROUND: Navigation systems all can improve the accuracy rate in cervical pedicle screw insertion, but cannot achieve desired outcomes because of some shortcomings, such as poor imaging quality, complicated operation, poor real-time performance, and invasive navigation.OBJECTIVE: To study the accuracy of X-ray fluoroscopy and CT three-dimensional image navigation in cervical pedicle screw insertion.METHODS: Totally 90 patients undergoing cervical pedicle screw insertion from the First Affiliated Hospital of Nanyang Medical College were enrolled, and randomly divided into control and experimental groups (n=45 per group). 132 cervical pedicle screws were inserted into the patients in the control group manually under X-ray fluoroscopy, and 128 ones were inserted into the patients in the experimental group assisted with CT three-dimensional image navigation. The operation time and intraoperative blood loss in the two groups were recorded. Postoperative CT three-dimensional reconstruction was performed to compare the placement accuracy between two groups.RESULTS AND CONCLUSION: The excellent and good rate of placement in the experimental group (95.3%) was significantly higher than that in the control group (88.6%, P < 0.05). (2) The operation time and intraoperative blood loss in the experimental group were significantly higher than those in the control group, and the navigation matching time and radiant quantity in the experimental group were significantly less than those in the control group (P < 0.05). (3) The Japanese Orthopedic Association scores showed no significant difference between two groups before surgery (P > 0.05),and were significantly improved in the experimental group compared with the control group at 3 and 6 months postoperatively (P < 0.05). The incidence of complications in the experimental group was significantly lower than that in the control group (7% versus 16%, P < 0.05). (5) These results suggest that compared with X-ray fluoroscopy, CT three-dimensional image navigation can improve the accuracy of cervical pedicle screw insertion, showing higher safety and precision. However, it needs complicated operation skills, and long operation time results in massive intraoperative blood loss; thereafter, choosing which placement method depends on the patient condition.

Objective To explore an ideal surgical method for mid-low face lifting.Methods In this procedure,the first surgical step was subcutaneous undermining that was performed through the incision along temporal hairline,anteriorear,and mastoideae.It extended distally beyond the furthest skin fold and along the mandibular border or the midline of the neck if nacessary.Then three layers suspension were performed,which included three procedures:first,SMAS was purse string sutured in certain direction;secondly,the malar fat pad was suspended to tow directions backward and upward and anchored in the periosteum of zygoma and SMAS too;lastly,through traction suture of reducing tension step-by-step,lots of the tension was relieved from the incision;at the same time,new retaining ligaments between flap and SMAS were reestablished.And redundant skin was removed in incision at the end of the procedure.Results A total of 22 cases received this operation.16 cases were followed up from 3 months to 24 months after operation.The results of operation were divided into three degrees:excellent,acceptable and poor;and those were evaluated by patients themselves.14 cases obtained excellent result (87.5 ％),2 cases regarded that their results were acceptable (12.5 ％).The total satisfactory rate was 100 ％.None serious complication occurred in those eases except some slight complications,such as local edema,skin numbness and small hematoma which relieved in 3 to 6 months after operation.Scar was inconspicuous.Conclusions This technique can correct the posies of lower tow-third face better,especially for mitigating the nasolabial fold and enhancing the elastic of face skin.Simultaneously,it is an effective,safe and simple technique.

Treatment of the iliosacral joint complex injury is a ehallenge for orthopedist due to the unique anatomic structure.Currently,the internal fixation has become the primary treatment method,including ilio-sacral screws,transiliac rods,anterior plates posterior compression plate,and so on.This article reviews the development process of the internal fixation methods in the treatment of the iliosacral joint complex injury.