Objective To explore the technique and clinical efficacy of single-nostril transsphenoidal neuroendoscopic resection of pituitary adenomas. Methods A total of 47 patients with pituitary adenoma, among them 21 were male and 26 female, aged 15-70 years old with a mean of 42.7 years, were treated with neuroendoscopic single-nostril transsphenoidal surgical resection in the Air Force General Hospital of PLA from August 2007 to August 2013. Clinical data were analyzed retrospectively, including the operative results, complications, and follow up results. Results Post-operative MRI revealed that the tumor was totally removed in 38 (80.9%) patients, and subtotally in 9 (19.1%, the tumors were large and had invaded the cavernous sinus). Post-operative improvement of clinical symptoms was achieved in 40 (85.1%) patients, among them, headache disappeared in 35 patients, vision and visual field improved in 30 patients. Among the 47 patients, an increase in prolactin hormone (PRH type) was seen in 29, an increase in growth hormone (GH type) in 6, and non-functioning pituitary carcinoma in 12 patients. In 80% (28/36) of the patients hormone secretion was improved after the operation, including 23 of PRH type and 5 of GH type. Post-operative complications were diabetes insipidus in 10 patients, cerebrospinal fluid leakage in 8 and meningitis in one. All the patients were followed up for 6 months up to 6 years, and no death occurred. Conclusion Single-nostril transsphenoidal endoscopic surgery consists of many advantages, such as minimal trauma, clear visual field, higher total resection rate, and rapid recovery after operation, therefore it is a safe and effective approach for the resection of pituitary adenomas.

Objective To compare the effect of right ventricular outflow tract (RVOT) and right ventricular apex (RVA) pacing on ventricular systolic synchrony using gated blood pool SPECT (GBPS).Methods A total of 50 patients implanted with pacemaker due to high degree or complete atria-ventricular block were enrolled in the study. Twenty-three patients were RVOT paced ( Group A, n = 23) and 27 were RVA paced (Group B, n=27). Twenty-four patients with malignancy, normal echocardiographic findings and no history of cardiac diseases were scheduled for pre-chemotherapy evaluation of cardiac structure and function and were enrolled as control group ( Group C, n = 24). All patients underwent GBPS imaging and the values of phase angle (PS), mean phase of each wall, standard deviation (SD) of mean phase of each wall, lateral-septal motion delay of left ventricle ( LV Sep-Lat Delay), septal-right ventricular (RV) delay of LV ( LV Sep-RV Delay) and LV-RV Delay were acquired. The parameters of ventricular systolic synchrony among the three groups were compared using one-way ANOVA. Results The mean phase of LV lateral wall in Groups A and B were significantly higher than that in Group C: Group A (120.50 ±40.58) ms; Group B (103.23±28.34) ms; Group C (84.63 ±22.38) ms (F=7.72, P ＜0.05). There was no significant difference between Groups A and B ( t = 1.30, P ＞ 0.05 ). The mean phase of RV in Group A was significantly larger than those in Groups B and C: Group A ( 137.05 ± 39.27) ms, Group B ( 100.85 ± 23.79) ms,Group C (59. 13 ±30.52) ms (F=35.55, P＜0.05). PS, SD and LV Sep-Lat Delay in Groups A and B were significantly higher than those in Group C: (85.73 ± 12.00)°vs (89.85 ± 15.61 )°vs (58.95 ±9.87)°, (27.68±10.66) ms vs (26.15 ±13.02) ms vs (15.63 ±8.35) ms, (25.06±34.23) ms vs (2. 62 ± 60. 31 ) ms vs ( - 23.66 ± 31.39) ms, F = 41.54,8.55,6.81, all P ＜ 0.01 ), however, there was no significant difference between Groups A and B ( t = 0. 68, 0.68, 1.30, all P ＞ 0.05 ). LV Sep-RV Delay and LV-RV Delay were significantly different among the three groups ( LV Sep-RV Delay: Group A (57.60 ±56.77) ms, Group B (6.36 ±61.88) ms, Group C ( -41.89 ±35.78) ms; LV-RV Delay:Group A (47.36 ±42.59) ms, Group B ( 3.08 ± 38.81 ) ms Group C ( - 26.50 ± 20.99 ) ms, F = 20. 32,25.38, both P ＜ 0.01 ). Conclusion Both RVA and RVOT pacing increase the segmental phases detected by GBPS, causing inter- and intra- ventricular asynchrony compared with patients without pacemakers.

Background Placement of an orbital implant is a main way to prevent orbital atrophy with aging.But its mechanism is under clear.Researchs showed that bone growth factors play important role during the development and repair of bone,especially transforming growth factor-β1(TGF-β1).Objective Present study was to investigate the expression of TGF-β1 protein in orbital bone after enucleation or enucleation with placement of an orbital implant and its function in the mechanisms of preventing and treating the orbital malformed development after enucleation with placement of an orbital implant.Methods Twenty-one age- and weight-matched New Zealand white young rabbits were randomly divided into the enucleation,implant and control groups,and each group including seven rabbits.Eyeball nucleation surgery was performed in the left eyes of 7 1-month-old rabbits,and a spherical orbital implant was inserted after enucleation of the left in matched rabbits in implant group.The left eye of normal rabbits served as controls.The rabbits were sacrificed in 1 month after surgery.The expression of TGF-β1 protein in the left orbital bone was detected using enzyme immunoassay and FITC labelling immunoassay technique in the sections of zygomatic bones.The content of TGF-β1 protein in the left orbital bone tissue was measured by ELISA method.This use of animals complied with the Regulations for the Administration of Affair Concerning Experimental Animals by State Science and Technology Commission.Results The height and width of orbital in enucleation group were significantly lower than those of implant and normal control groups(height:P=0.00,P=0.00;width:P =0.00,P=0.00).The positive bone cells of both enzyme immunoassay and FITC staining were increased in the implant and control groups in comparison with enucleation group,but the positive response intensity for TGF-β1 was resembled between implant group and control group.ELISA result revealed that the content of TGF-β1 protein in bone tissue was significantly lower in the enucleation group than in implant and control groups(P=0.00,P=0.00).The expression and content of TGF-β1 protein in bone tissue is similar between the implant group and the control group(P=0.41). Conclusion The experiment results indicate that TGF-β1 protein participate in the orbital development.TGF-β1 played important role in the prevention and treatment of enucleation-induced orbital malformation in the eye with placement of an orbital implant.

Objective To observe the treatment effect of endovascular embolization on intracranial aneurysms combined with hemorrhagic moyamoya disease (MMD). Methods The clinical features and outcomes of 8 patients with intracranial aneurysms combined with MMD, performed endovascular embolizafion in our hospital from January 2002 to February 2010, were retrospectively analyzed. The aneurysms in 6 patients with major artery aneurysm were successfully embolized with Guglielmi detachable coil, and the other 2 (the peripheral artery type) with n-butyl cyanoacrylate (NBCA). Results In the 6 patients performed embolization with Guglielmi detachable coil, 3 got complete embolization, 2 vestigital of the aneurysm neck, 1 partial embolization and all the parent arteries were unobstructed. In the 2 patients performed embolization with NBCA, no imaging was noted on the parent arteries and aneurysms, and no cerebral infarction appeared in the distal blood supply region.Conclusion For MMD patients with aneurysms, we can treat the aneurysms with endovascular embolization safely and effectively.

OBJECTIVETo study the chemical constituents of the root of Rhaponticum uniflorum.

METHODSeparation and purification were performed on silica gel and Sephadex LH-20 column chromatography. Their structure were elucidated on the basis of physicochemical and spectral analysis.

RESULTFive triterpenoid compounds were isolated and identified as ursolic acid (1), 3-oxo-19alpha-hydroxyurs-12-en-28-oic acid (2), pomolic acid (3), arjunic acid (4) and tormentic acid (5), respectively.

CONCLUSIONCompounds 1 approximately 5 were isolated from the genus Rhaponticum for the first time.

Leuzea ; chemistry ; Oleanolic Acid ; analogs & derivatives ; chemistry ; isolation & purification ; Plant Roots ; chemistry ; Plants, Medicinal ; chemistry ; Triterpenes ; chemistry ; isolation & purification

OBJECTIVETo evaluate the efficacy of zoledronic acid combined with local radiotherapy for limited metastatic bone cancer.

METHODSForty-five patients with limited bone metastatic cancers were randomly divided into two groups: 23 in the combination group who received intravenously administration of zoledronic acid and local radiotherapy, the other 22 in the radiotherapy alone group who underwent local radiotherapy only.

RESULTSThe response rate of pain relief was 91.3% in the combination group versus 86.4% in the radiotherapy alone group, without statistically significant difference between two groups (P > 0.05). However, the recalcification rate was significantly higher in the combination therapy group (52.2%) than that in radiotherapy alone group (22.7% P < 0.01), and the proportion of patients with new bone metastasis formation was significantly lower in the combination group (13.0%) than that in the radiotherapy alone group (40.9%, P < 0.05). The common side-effects were transient pyrexia and nausea.

CONCLUSIONZoledronic acid combined with local radiotherapy is effective in relieving pain, improving bone recalcification and reducing the formation of new bone metastasis.

Adult ; Aged ; Bone Density Conservation Agents ; therapeutic use ; Bone Neoplasms ; complications ; drug therapy ; radiotherapy ; secondary ; Bone Regeneration ; drug effects ; Breast Neoplasms ; pathology ; Combined Modality Therapy ; Diphosphonates ; therapeutic use ; Female ; Humans ; Imidazoles ; therapeutic use ; Lung Neoplasms ; pathology ; Male ; Middle Aged ; Nasopharyngeal Neoplasms ; pathology ; Pain ; etiology ; Pain Management ; Radiotherapy

Objective To evaluate the efficacy of a novel hemostatic material AristaTM in the management of active and local bleeding in neurosurgery, and discuss the indications for its application. Methods Forty-eight patients undergoing elective craniotomy in our department between April, 2008 and May, 2009 were randomized into the test group (n=24) and control group (n=24) with intraoperative hemostatic management using AristaTM and gelatin sponge, respectively. The hemostasis time and efficacy of the two materials were compared. Results Hemostasis was effective in all the 48 patients. The mean hemostasis time in the test group and control group was 1.88±0.74 min and 3.38±0.92 min, respectively, showing a significant difference between them (Z=4.711, P=0.001). Conclusion AristaTM allows more efficient management of active and local bleeding than gelatin sponge during neurosurgeries and has great potential for clinical application.

OBJECTIVETo investigate and evaluate different surgical methods applied in living-donor liver transplantation (LDLT).

METHODSFifty patients with end-stage liver disease received LDLT in our department between January 1995 and March 2006. The data were analyzed on a retrospective basis. The choice of different surgical methods, strategies applied to ensure the safety of donors and indications of LDLT in the series were reviewed.

RESULTSAll donors recovered uneventfully. Among the 50 patients, 47 recipients presented with end-stage cirrhosis, 3 patients suffered from malignant tumor. To date, 6 recipients died after LDLT, among them, 3 recipients died of the operation and the other 3 recipients died of long-term complications. Resected donor livers included 9 cases of segments V, VI, VII and VIII (not including the middle hepatic veins) and 1 case of segments V, VI, VII and VIII (including the middle hepatic veins), 36 cases of segments II, III and IV (including the middle hepatic veins) and 4 cases of segments II, III, and part of IV (not including middle hepatic veins).

CONCLUSIONSLDLT helps tackle the problem of donor shortage in the world. The process is complicated, and it is very important to choose appropriate surgical methods for the improvement of surgical achievement and donor safety.

Adolescent ; Adult ; Child ; Child, Preschool ; Female ; Follow-Up Studies ; Humans ; Infant ; Liver Cirrhosis ; surgery ; Liver Neoplasms ; surgery ; Liver Transplantation ; methods ; Living Donors ; Male ; Middle Aged ; Retrospective Studies

OBJECTIVETo assess postoperative effects of microelectrode-guided posteroventral pallidotomy (PVP) for Parkinson's disease.

METHODSIntraoperative microelectrode recordings and microstimulation were used to explore the globus pallidus to performance of posteroventral pallidotomy in 48 patients with Parkinson's disease (47 unilateral and 1 bilateral). Assessment was made at baseline preoperatively and at 6 months intervals postoperatively, with unified Parkinson's disease rating scale (UPDRS).

RESULTSAll patients were significantly improved on the limbs contralateral to the lesion side 6 - 34 months after operation (mean 24 months). The improvement was seen in the 'on' or 'off' state: UPDRS scores with patients on levodopa were improved by an average of 28.7%, while off medication scores showed reductions (47.6%) at 24 months. There were no deaths and no visual complications, but there were 4 patients (8.3%) of a delayed contralateral limbs dystonia after pallidotomy.

CONCLUSIONSThe techniques of microelectrode recording and microstimulation indicate the location of the internal capsule and optic tract, which allow easy identification of these structure and facilitate PVP target in conjunction with radiofrequency microelectrode stimulation.

Adult ; Aged ; Catheter Ablation ; methods ; Female ; Follow-Up Studies ; Globus Pallidus ; surgery ; Humans ; Male ; Microelectrodes ; Middle Aged ; Parkinson Disease ; surgery ; Stereotaxic Techniques ; Treatment Outcome

OBJECTIVETo study the mechanism of enhancement of the CTL activity in mice co-expressing of CD80, CD86 and CD137L genes.

METHODSThe mice were randomly divided into five groups, named A, B, C, D and E. The group A and B were control groups (CG). H22-BAL B/c HCC mouse model was established by subcutaneous injection with hepatocellular carcinoma cells of cell line H22-Wt (group A), H22-neo (group B), H22-CD80/CD86(+) (group C), H22-CD137L(+) (group D) and H22-CD80/CD86/CD137L(+) (group E), respectively. On the 14th, 35th, 56th and 84th day after the first inoculation of tumor cells, TUNEL staining and DNA ladder examination were used to detect apoptosis of splenic T lymphocytes in all groups at each post-inoculation time point. Electrophoretic mobility-shift assay (EMSA) method was used to detect the activity of nuclear factor kappaB (NF-kappaB) in splenic T lymphocytes in each group at each time point post-inoculation.

RESULTSApoptosis was found in a great number of T lymphocytes in CG on the 14th day, much more than that in group C and E. The number of apoptotic T cells in group C had a significant difference compared with that in the group E from 14th to 84th day (P = 0.003). DNA ladder analysis showed typical positive results in group C and E. The significant apoptosis fragments were found in group C on 21st, 35th and 84th days. NF-kappaB activity of T cells in groups C and E was remarkably higher than that of groups CG and D, with higher in group D than that of CG (P = 0.002), and with no significant difference between group C and E on 14th day. The activity in group E was stable and remarkably higher than that of group C on 56th and 84th days after the first inoculation.

CONCLUSIONH22-CD80/CD86/CD137L(+) induces higher NF-kappaB activity of the host T cells by synergistic action of CD28 and CD137, which may be one of the mechanisms of enhancement of the host CTL activity induced by co-expression of CD80, CD86 and CD137L genes.

4-1BB Ligand ; metabolism ; Animals ; Apoptosis ; B7-1 Antigen ; metabolism ; B7-2 Antigen ; metabolism ; CD28 Antigens ; Cell Line, Tumor ; Female ; Gene Expression Regulation, Neoplastic ; Liver Neoplasms, Experimental ; immunology ; metabolism ; pathology ; Lymphocyte Activation ; Mice ; Mice, Inbred BALB C ; NF-kappa B ; metabolism ; Random Allocation ; Spleen ; pathology ; T-Lymphocytes ; metabolism ; pathology ; T-Lymphocytes, Cytotoxic ; immunology