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 study the expression of insulin like growth factor binding proteins 3 (IGFBP-3) during inhi-bition of resveratrol (Res) on cell proliferation. Methods The inhibitory effect of Res on BGC-823 cells was determined by MTT method; Real-time qRT-PCR and western blot were applied to detect the expression of IGFBP-3 in Res-treated BGC-823 cells. In addition, cytometry was used to determine the proliferation and apoptosis of Res-treated BGC-823 after knockdown of IG-FBP-3 by siRNA. Results Upon Res (20,40, 80 and 160 μmol · L-1 ) treatment,the viability of BGC-823 cells was (82. 35±10. 65)% ,(74. 30±12. 36)% ,(62. 80±14. 66)% and (50. 75±11. 14)% , respectively. The mRNA and protein ex-pression of IGFBP-3 elevated as high as 2. 96-fold compared to the control group (P<0. 05). The cell viability of BGC-823 cells with IGFBP-3 knockdown was significantly higher than that of the wild type ( P < 0. 05 ) only at high Res concentration (160 μmol·L-1 ). Meanwhile,IGFBP-3 knockdown led to a significant decrease on cell apoptotic rate by Res (160 μmol·L-1 ) [(20. 13±9. 12)% vs (35. 48±11. 12)% ,P<0. 05)]. Conclusion Res can inhibit BGC-823 cell proliferation and promote cell apoptosis, the underlying mechanism of which may be related to the overexpression of IGFBP-3 in BGC-823 cells.

Objective To investigate the clinical value of uterine artery embolization on the treatment of cesarean scar pregnancy(CSP).Methods Clinical data of 112 cases of CSP patient underwent uterine artery embolization in Ningbo Women and Children's Hospital from January to December 2012 were enrolled for retrospectively analysis.Results All 112 patients underwent transvaginal ultrasound examination before admitted to hospital and among them 101 cases were diagnosed as CSP and 11 cases were suspected of CSP.Ninety-four cases were checked by magnetic resonance imaging (MRI) to measure the muscular thickness of uterine scar and the size of pregnant bursa.All patients received bilateral uterine artery embolization successfully,50-100 mg Methotrexat (MTX) were injected into uterine artery during this procedure.After uterine artery embolization,95 cases received curettage under ultrasound guidance,while 17 cases received curettage under hysteroscopy.All patients recovered as schedule.During the follow-up,no serious complication was found.Conclusion The use of uterine artery embolization in the treatment of CSP is safe and effective,and it can preserve patients' fertile ability.It is worthy recommended in the clinical application.

Objective:To investigate the clinical significance of LncRNA anti-differetiation non-coding RNA (ANCR) expression in tumor tissues of gastric cancer patients and its biological effects on cells.Methods:72 cases of gastric cancer tissues and corresponding adjacent tissues were collected from Sep. 2016 to Jun. 2018 in our Hospital. Gastric cancer cell HGC-27 was cultured, lentiviral transfected ANCR cDNA full-length vector was used as a Test group in HGC-27 cells, and transfected blank vector as a control group. Real-time quantitative PCR (qPCR) was used to detect the expression of ANCR, transcription factor Oct4 and Sox2 mRNA in tissues or cells, Western blot was used to detect the expression levels of Oct4 and Sox2 in cells, CCK-8 assay was employed for detecting cell proliferation in both groups, and Transwell invasion and migration assay was used to detect the transfer ability of cells in the two groups.Results:The expressions of ANCR in gastric cancer and corresponding adjacent tissues were respectively 0.013 (0.006, 0.025) and 0.041 (0.011, 0.136) , and the expression of ANCR in gastric cancer tissues was significantly higher than that in adjacent tissues ( P<0.01) , and patients with high expression of ANCR had higher TNM stage and lower cell differentiation ( χ2=7.414 and 8.236, P<0.05) . The expressions of ANCR mRNA in control group and test group were respectively 1.000±0.064 and 6.250±0.889, Oct4 mRNA were respectively 1.000±0.208 and 2.815±0.349, Sox2 mRNA were respectively 1.000±0.173 and 2.526±0.390, Oct4 protein were respectively 1.000±0.148 and 3.396±0.105, Sox2 protein were respectively 1.000±0.119 and 2.916±0.130, and the expressions of ANCR, Oct4 and Sox2 mRNA in the test group were significantly higher than those in the control group ( P<0.01) ; the expression levels of Oct4 and Sox2 protein in the test group were significantly higher than those in the control group. The proliferation abilities of control group and test group were 7.164±0.426 and 9.627±0.605 in 72h, and 13.750±1.089 and 19.166±1.649 in 96h. The proliferation of cells in the Test group at 72 and 96 hours was significantly higher than that in the control group ( P<0.01) . The average number of invasive cells per visual field in control group and test group were 17.26±5.48 and 39.43±5.21, and number of migration cells were 30.49±7.74 and 62.20±7.51, and the number of migration and invasion cells in the Test group was significantly larger than that in the control group ( P<0.01) . Conclusions:The expression of LncRNA ANCR in tumor tissues of gastric cancer patients is significantly increased, and it is closely related to the progression of the disease of patients and the degree of cell malignancy. It can promote the expression of gastric cancer stem cell markers in vitro and enhance the ability of cell proliferation and metastasis.

Objective To observe the effect of Shengmai Chenggu Prescription (SCP) on the damage of endothelial cells (EC) induced by endotoxin. Methods EC obtained from rabbit's aorta were cultured and were treated with endotoxin and serum containing SCP respectively. Histological changes and function of the cultured cells were observed under light microscope and electron microscope and with MTT method . Results Endotoxin could result in the pathologic injury of cultured EC and inhibit the proliferation of the cells. Serum containing SCP could increase the activity of EC and promote its proliferation. Conclusion SCP can protect endothelial cells from damage induced by endotoxin.

Objective To explore the cerebrovascular reactivity of the patients with cerebral infarction by transcranial color Doppler ultrasound (TCCD) and breath holding test.Methods TCCD was used to record the color Doppler imaging and Doppler spectrum and to measure peak velocity,mean velocity of double side middle cerebral artery(MCA) in thirty two normal persons and thirty seven patients with cerebral infarction confirmed by CT or MRI.Breath holding test was performed to record the Doppler spectrum and breath holding time and to calculate breath holding index(BHI).Results ①The peak velocity of MCA of the damaged side was abnormally increased by 35.1% and decreased by 40.5% .②The BHI of the damaged side was significantly lower than that of undamaged side and that of control group (P

BACKGROUND: Total hip arthroplasty is an effective measure to treat hip involvement in ankylosing spondylitis.Ankylosing spondylitis patients have different degrees of anemia after total hip arthroplasty. The hidden blood loss accounts for a large proportion of perioperative blood loss in total hip arthroplasty, and can affect the recovery of joint function.OBJECTIVE: To investigate risk factors of hidden blood loss after total hip arthroplasty in patients with hip involvement in ankylosing spondylitis.METHODS: We studied a consecutive series of 70 hips in 60 patients with ankylosing spondylitis hip involvement who were converted to cementless total hip arthroplasty. The average age of surgery was 35.12 years. The hidden blood loss was calculated according to Cross formula linear equation. The effects of operation time, erythrocyte sedimentation rate,C-reactive protein, body mass index, Bath ankylosing spondylitis radiology index, allogenic blood transfusion, and osteoporosis on hidden blood loss after total hip arthroplasty in patients with ankylosing spondylitis were analyzed. The patients were divided into the high blood loss group (≥ 480 mL) and the low blood loss group (< 480 mL) according to the high blood loss. Risk factors of high hidden blood loss after total hip arthroplasty in patients with ankylosing spondylitis were analyzed by single factor analysis and multivariate Logistic regression analysis (SPSS 17.0).RESULTS AND CONCLUSION: (1) The hidden blood loss after primary total hip arthroplasty in patients with ankylosing spondylitis was (737.76±419.18) mL, and the total blood loss was (1312.83±487.41) mL, and the percentage of hidden blood loss was 51.48%. The high blood loss group included 41 hips, and the low blood loss group included 29 hips; and the ratio was 41:29. (2) Single factor analysis showed that the operation time, Bath ankylosing spondylitis radiology index and osteoporosis, allogenic blood transfusion, decrease of hemoglobin were significantly associated with high hidden blood loss. (3) Multivariate Logistic regression analysis showed that Bath ankylosing spondylitis radiology index,allogeneic blood transfusion, and decrease of hemoglobin were significantly associated with high hidden blood loss. (4)Hidden blood loss is an important portion of total blood loss after primary total hip arthroplasty in patients with ankylosing spondylitis. Bath ankylosing spondylitis radiology index, allogeneic blood transfusion and decrease of hemoglobin are risk factors for high hidden blood loss.

Objective The goal of this study is to compare the prognosis of recombinant tissue plasminogen activator (rt-PA) thrombolysis for middle cerebral artery (MCA) occlusion with patients with good and poor cerebral collateral circulation.Methods This retrospective study included 49 patients diagnosed with acute MCA occlusion and treated with rt-PA in the First Affiliated Hospital of Nanjing Medical University between October 1,2014 and February 1,2016.Patients were divided into good collaterals group (n =31) and poor collaterals group (n =18) according to their distribution of leptomeningeal arteries with CTA.Thirty day mortality rate,the incidence of symptomatic intracranial hemorrhage,24h and 30 day Stroke scores with National Institute of Health Stroke Scale (NIHSS) were compared between the two groups.Corrected chi-squared test,Fisher's exact test,or t test was used to statistical analysis as appropriate.Results The 30 day mortality rate of good collaterals group was significantly lower than that of poor collaterals group (0％ vs.16.7％,P ＜ 0.05).There were no significant differences in the incidence of symptomatic intracranial hemorrhage and 24h NIHSS score between the two groups (P ＞ 0.05),however,30 day NIHSS score of good collaterals group was significantly lower than that of poor collaterals group (7.2 ± 3.1 vs.9.6 ± 2.7,P ＜ O.05).Conclusion For patients with MCA occlusion and receiving intravenous thrombolysis,good cerebral collateral circulation may reduce their mortality and improve their clinical outcome after thrombolysis.However,good cerebral collateral circulation does not reduce the risk of symptomatic intracranial hemorrhage in those patients.

Objective To analyze the pulse-field gel electrophoresis (PFGE) patterns and antibiotic resistance of Salmonella enteritidisstrains isolated in Longyan city in order to provide reference for effective control, clinical diagnosis and treatment of outbreaks of food-borne diseases.Methods Seventy-seven Salmonella enteritidis strains isolated from food poisoning cases, livestock and poultry meat samples collected for food safety risk monitoring and sporadic cases in 2014 and 2016 were analyzed by PFGE.Antibiotic susceptibility testing was carried out to determine the minimum inhibitory concentrations (MIC) of 16 common antibiotics to 57 strains.Results Seventeen PFGE types were identified among the 77 Salmonella strains including three predominant types (P4, P6 and P8) and were grouped into three major pulsotypes (Cluster1-3) at 90% similarity level.The predominant types causing outbreaks of Salmonella enteritidis infection were P8, P6, P4 and P14, which were responsible for five cases of food poisoning.These isolated strains were highly resistant to nalidixic acid (93%), followed by resistance towards ampicillin (74%) and streptomycin (54%).Forty-one strains were resistant to three or more antibiotics (71.93%).Conclusion The PFGE types of Salmonella enteritidis strains isolated in Longyan city exhibit polymorphism and are clustered into three major pulsotypes.PFGE molecular typing can provide early-warning of sporadic outbreaks and help to identify the sources of infections in Salmonella enteritidis-related food poisoning.Attentions should be paid to multidrug resistant Salmonella enteritidis.Surveillance for multidrug resistant strains and usage of antibiotics should be strengthened.

BACKGROUND: Fibular fixation and tantalum rod implantation are two commonly used methods for the treatment of early osteonecrosis of the femoral head (ONFH), both of which can effectively delay or even reverse the progress of ONFH. However, further comparative evaluation on their mechanical properties and therapeutic efficacy is required.OBJECTIVE: To compare the clinical efficacy of fibular fixation and tantalum rod implantation on ONFH at early stage.METHODS: Fifty-eight patients (81 hips) suffered from ONFH with ARCO stage 1 and stage 2, and underwent fibular fixation (30 cases, 41 hips) or tantalum rod implantation (28 cases, 40 hips). Postoperatively, both groups were followed up for over 2 years. The Harris scores of the hip were compared between two groups before and after treatment. With femoral head collapse and the collapse distance > 4 mm as observation points, the survival rate of the femoral head was compared between two groups.RESULTS AND CONCLUSION: The postoperative Harris scores of the two groups were significantly improved than before (P < 0.05). With the appearance of femoral head collapse as the observation point, the Kaplan-Meier survival curve showed that the overall survival rate of the hip was 83% in the fibular fixation group and 65% in the tantalum rod implantation group. After examined by log-rank (Mantel-Cox), there was a significant difference in the survival rate of the hip at Stage IIC between two groups (P=0.0431). With > 4 mm collapse as the observation point, the Kaplan-Meier survival curve showed that overall survival rate of the hip was 95% in the fibular fixation group and 83% in the tantalum rod implantation group. After examined by log-rank (Mantel-Cox), there was a significant difference in the survival rate of the hip at Stage IIC between two groups (P=0.0418). To conclude, both fibular fixation and tantalum rods implantation applied to ONFH at early stage can effectively improve the hip function, and the survival rate of the hip at ARCO Stage IIC is better in patients undergoing fibular fixation than tantalum rod implantation.