Objective To summarize the experience of pituitary adenoma resection by single-nostril transsphenoidal approach and analyze the indications,intraoperative and postoperative common problems in order to improve the technique and quality of life.Methods Summarize the clinical data of 611 pituitary adenoma resections by single-nostril transsphenoidal approach from January 2005 to June 2010 retrospectively,reanalyze the choice of operative indications,analyze the bleeding during the operation and sums up the relevant pro cessing suggestions,and summarize the reasons and countermeasures of postoperative visual impairment.Results The tumors were totally removed in 538 cases,sub-resections in 59 cases,sub-totally removed in 14 cases,and no deaths.Eleven cases were poor gasification or concha sphenoid sinus in 11 totally removed patients.The bleeding came from diploe,emissarium,mucosa of sphenoid sinus,diploe,epidural space,dura matter of the sella turcica region,intercavernous sinuses,tumor or the tumor bed.The bleeding was controlled effectively with different approaches.There were 3 patients who underwent visual impairment,and the impairment was improved after treatment.Conclusion Following the correct operation principle,we can improve the rate of total resection; the single-nostril transsphenoidal approach is also suitable for the poor gasification; The prognosis can improve after deal with the intraoperative and postoperative common problems.

BACKGROUND:Currently, the treatment of proximal humeral fractures mainly contains joint preservation (conservative treatment, open reduction and internal fixation) and arthroplasty, but how to choose the treatment is stil controversial. OBJECTIVE:To evaluate and compare the clinical outcomes of joint preservation versus arthroplasty in the treatment of displaced 3-or 4-part humeral fractures in randomized control ed trials using meta-analysis. METHODS:Medline (January 1966 to December 2013), PubMed (January 1980 to December 2013), Embase (January 1990 to December 2013), Science (January 1990 to December 2013), Springer (January 1990 to December 2013), China National Knowledge Infrastructure (1994 to 2013), and Wanfang database (1982 to 2013) were searched for randomized control ed trials addressing joint preservation and arthroplasty for 3-or 4-part proximal humeral fractures. Articles meeting the inclusion criteria were included. The related data were extracted and loaded onto Comprehensive Meta-Analysis Software for meta-analysis. RESULTS AND CONCLUSION:Seven articles with 320 patients (165 patients undergoing joint preservation and 155 patients receiving arthroplasty) were accepted in this mete-analysis and al of them were high-quality English researches by modified Jadad Scale. Meta-analysis results displayed that the random-effects mean Constant score across al types was 55.9 (95%CI:50.7-61.1;P<0.001). Constant score was higher in the joint preservation group than in the arthroplasty group (P<0.01). The study displayed significant heterogeneity (I2 0.001). In the meta-analysis, Constant scores were decreased with increasing rate of male to female and rate of tuberosity resorption. These results suggested that 3-or 4-part proximal humeral fractures demonstrate improved Constant scores when treated with joint-preserving options compared with arthroplasty. Moreover, age, fracture pattern, gender ratio and complication rate are significant predictors of the Constant score. Given the observed heterogeneity and variance in treatment techniques in the included studies, more randomized control ed trial studies are needed to definitively recommend joint-preserving techniques versus arthroplasty for treatment of 3-or 4-part proximal humeral fractures.=88%, Q statistic=107.6, Q=13;P<0.001). In the meta-analysis, Constant scores were decreased with increasing rate of male to female and rate of tuberosity resorption. These results suggested that 3-or 4-part proximal humeral fractures demonstrate improved Constant scores when treated with joint-preserving options compared with arthroplasty. Moreover, age, fracture pattern, gender ratio and complication rate are significant predictors of the Constant score. Given the observed heterogeneity and variance in treatment techniques in the included studies, more randomized controlled trial studies are needed to definitively recommend joint-preserving techniques versus arthroplasty for treatment of 3- or 4-part proximal humeral fractures.

BACKGROUND:Col agen suture is made of col agen from animals, and has been widely used because it is absorbable, non-rejection and easy to produce, and convenient in use.
OBJECTIVE:To evaluate the effects of col agen suture and silk suture in wound healing after oral implant surgery.
METHODS:100 patients undergoing oral implantation were randomly assigned into col agen suture group and silk suture group. A 2-0 circular needle with absorbable col agen sutures and a 4-0 circular needle with non-absorbable silk sutures were employed for tension-free suture in the two groups. After 3, 5, 7 days of oral implantation, suture threads and wound healing were observed. The suture was removed at 14 days, and patients were reviewed at 14 days.
RESULTS AND CONCLUSION:The wound healing was better in the col agen suture group than the silk suture group at grade I (P<0.05). At 7 days postoperatively, the suture thread was mostly absorbed in the col agen group but not in the silk suture group. In addition, material alba was invisible in the col agen suture group but clear in the silk suture group. These results indicate that the col agen suture is more proper for tension-free suture than the silk suture, which is better matched to the healing time and keeps a better oral environment.

The dialysis method was employed to prepare blank and doxorubicin (DOX) loaded micelles formed by temperature- and pH- sensitive polyhistidine-co-polyDL-lactide-co-glycolide-co-polyethyleneglycol-co-polyDL-lactide-co-glycolide-co-polyhistidine (PHis-b-PLGA-b-PEG-b-PLGA-b-PHis). The critical micelle concentrations (CMC) of the copolymers were measured with Pyrene Fluorescent Probe Technique. The temperature- and pH- sensitive properties of the blank micelles solution were investigated by optical transmittance measurement. The morphology and diameter of DOX micelles were characterized by transmission electron microscopy (TEM) and dynamic light scattering (DLS). The entrapment rate and drug-loading rate were determined with dialysis method. The in vitro release study was further performed to examine the temperature- and pH-responsive drug release behavior from DOX-loaded micelles. The results indicated that the CMC, entrapment efficiency and drug-loaded amount of the micelles were 7.5 x 10(-3) g x L(-1), 85.2 +/- 3.1% and 10.4 +/- 4.5%, respectively. The DOX micelle was globular-shaped with a mean diameter of 91.1 +/- 15.8 nm. The transmittance of micelle solution consistently increased with the increasing temperature or decreasing pH. In comparison to the drug release profile at physiological conditions (37 degrees C, pH 7.4), the DOX-loaded micelles showed faster drug release rate at higher temperature (41 degrees C), lower pH (pH 7.0, pH 6.5, pH 5.0) or higher temperature and lower pH (41 degrees C, pH 5.0). This indicated that the micelles showed a temperature and pH-triggered drug release pattern. Base on the above results, it can be concluded that PHis-b-PLGA-b-PEG-b-PLGA-b-PHis block copolymer micelles which respond to temperature and pH stimuli are promising smart carriers for anti-tumor drugs with the advantages of temperature- and pH- triggered drug release.

Objectives To detect ultrasonic knife frequency and correct the result.Methods Oscillography analysis law was adopted to determine the frequency.Results Oscillography analysis law was practical for the determination of ultrasonic knife frequency.Conclusion This paper realizes the quantitative detection of ultrasonic knife frequency without related national standard and industrial standard.

Objective To investigate the distribution of cytotoxin-associated gene A (cagA) of Helicobacter pylori (Hp) and the polymorphism of EPIYA motifs in patients with upper gastrointestinal diseases in Changchun area of China and to evaluate the association between EPYIA motifs patterns and gastrointestinal diseases.Methods Hp strains were isolated from clinical samples.Their cagA gene was analyzed by PCR and sequencing analysis.Nucleotide sequence of cagA gene was translated into amino acid sequence by using DNAMAN software,and then the amino acid sequence was imported into software MEGA6.0 for multiple comparisons and construction of a phylogenetic tree.Results A total of 60 Hp strains were isolated and identified from gastric mucosa specimens collected from 298 patients.Hp infection was not correlated with patient's age or sex (P>0.05).The isolation rate of Hp in peptic ulcer disease (PUD) group was higher than that in non-peptic ulcer dyspepsia (NUD) group (P<0.05).Of the 60 Hp strains,90% (54/60) carried cagA gene.Twenty-three out of 26 successfully sequenced strains (88.4%) were East Asian-type including 22 containing EPIYA-ABD motif and one containing EPIYA-ABBD motif.The other three strains (11.6%) were Western type including two carrying EPIYA-ABC motif and one carrying EPIYA-BC motif.Results of the phylogenetic tree showed that the sequences of cagA gene were clustered into two groups,East Asian-type and Western-type groups.East Asian-type strains caused no disease cluster of statistical significance.All Western-type Hp strains were isolated from patients with peptic ulcer disease (PUD).Four mutant Hp strains were detected in the PUD group and the amino acid mutations preferentially occurred in the EPIYA-B segment.Conclusion The positive rate of Hp cagA gene is 90% in this region.Its distribution is not related to the type of gastrointestinal diseases.EPIYA-ABD (84.6%,22/26) is the predominant EPIYA motif.The amino acid mutation of EPIYA-B segment is closely related to peptic ulcer disease.Neither significant change in the sequence of 3' region of Hp cagA gene nor regional difference is observed in those Hp strains circulating in Changchun area of China.

BACKGROUND:Artificial femoral head replacement provides a new idea for the repair of unstable intertrochanteric fracture. Artificial prosthesis replacement may affect original femoral biomechanical stability and lead to a variety of adverse consequences. OBJECTIVE:To analyze the stress distribution of femoral head replacement in the treatment of unstable femoral intertrochanteric fractures with three-dimensional finite element analysis. METHODS:One male old volunteer was randomly selected from population who underwent health examination. The left femur was scanned with spiral CT, and the three-dimensional finite element models of the human femur and prosthesis were established. The three-dimensional finite element model was used to simulate the actual working conditions of human climbing stairs, and the stress distribution of the bone channels around the surface of the femur and the prosthesis was analyzed with three-dimensional finite element analysis. RESULTS AND CONCLUSION: Under normal condition, the stress of the human femur was in a consistent state. Stress changed gradualy from the proximal end to the distal end. The stress of the prosthesis was concentrated in the middle section. The prosthesis of inner stress distribution was analyzed to obtain stress distribution of prosthesis and femur cancelous bone interface. The analysis found that stress change trend was consistent. The results suggest that artificial femoral head replacement does not have a significant effect on the overal stress distribution of the human femur, and the overal stress distribution does not change, and the maximum stress region is located in the middle of the whole femur. After the reconstruction, the stress concentration of the femur is not observed.

Objective: To investigate the effect of diabetes on the intensity of sarcoplasmic reticulum Ca2+-ATPase (SERCA2a)-SUMOylation and SERCA2a activity of myocardium in experimental rats.
Methods: The 8 weeks old SD rats were divided into 2 groups, Diabetic group, with diet-induced type 2 diabetic rats and Control group, with normal rats. The systolic and diastolic cardiac functions were evaluated by echocardiography and left ventricular pressure measurement. The intensity of SERCA2a-SUMOylation was examined by co-immunoprecipitation and SUMOylation kit.
Results: Compared with Control group, Diabetic group had decreased systolic and diastolic cardiac functions, especially for diastolic function;decreased SERCA2a protein expression and intensity of SUMOylation;decreased SUMOylation E2 (Ubc9 ) protein expression. The protein levels of SUMO1, SAE1 and SAE2 were similar between 2 groups.
Conclusion: The intensity of SERCA2a-SUMOylation and Ubc9 decreased in diabetic myocardium which implies that SERCA2a-SUMOylation and Ubc9 were closely related to the damage of diabetic myocardium in experimental rats.

Objective To summarize the results of valve re-operative cases after cardiac valve replacement, to find the better re-operative time, and to estimate the re-operative methods and influencing factors of the operation. Methods Thirteen valve re-operative cases after cardiac valve replacement from October 2008 to February 2010 were retrospectively studied. According to NYHA classification, 9 cases belonged to class Ⅳ, and only 4 cases belonged to class Ⅲ preoperatively. Mitral valve replacement (MVR)was performed in 7 cases, aortic valve replacement (AVR) in 3 cases, MVR + AVR in 3 cases. Results The early-stage postoperative mortality was 7.7%( 1/13),and the reason was low cardiac output syndrome. Two cases who underwent re-operation and re-intubation respectively after operation for hemorrhage were improved after treatment. Twelve cases were discharged in 3-6 weeks after heart valve surgery and all were followed up for 6-15 months. The cardiac function of all the discharged patients recovered well and no death occurred during follow-up. Conclusion The key factors to reduce the death of re-operation are improving preoperative heart function,setting up extracorporeal circulation as soon as possible,consummating myocardial preservation,perfecting operating skills,correcting low cardiac output syndrome in time and preventing complications.

ObjectiveTo explore the surgical treatment of congenital heart disease combined with severe pulmonary hypertension.MethodsThirty-two patients of congenital heart disease combined with severe pulmonary hypertension were included in the study.The saturation of arterial oxygen ranged from 0.84 to 0.94 and echocardiography showed left to right slow velocity shunt in 20 eases,double direction shunt in 10 cases and no shunt in 2 cases.The pulmonary arterial pressure was 65-120 (82 ± 14) mm Hg ( 1 mm Hg =0.133 kPa).All patients received surgical repairs under cardiopulmonary bypass and were treated preoperatively with oxygen inhalation therapy,oral intake of beraprost sodium or silaenafil respectively according to the degree of pulmonary hypertension.During cardiopulmonary bypass,pulmonary artery perfusion was performed with protective solution containing ulinastatin for lung protection.Vasoactive drugs were routinely administrated postoperatively.Results Thirty-two cases underwent the surgical treatment successfully with their postoperative pulmonary arterial pressure decreased 20 -40 mm Hg and 2 cases died of severe low cardiac output syndrome and fatal arrhythmia.The mortality was 6.25％(2/32).ConclusionComprehensive perioperative management followed by radical operation can achieve a good clinical result on congenital heart disease combined with pulmonary hypertension.