Transsphenoidal microsurgery has become a major approach for removal of pituitary adenomas. Due to the anatomic differences of skull base between Chinese and foreigners and the different experience of surgeons, the pre- and post-operation managements of the operation are different. From 1982 to 2002, a total of 1 047 patients received transsphenoidal removal of pituitary adenomas in our hospital and gained satisfactory outcomes. This article summarizes our experience on 1 047 patients and discusses some relevant problems, including the diagnostic standards of adenoma size, surgery indications, the apoplexy operation, the re-operation for recurrent cases, management of complications, post-operation radiotherapy, and the anatomy of sphenoidal sinus and sellar area, hoping to improve the successful rate of the operation.

AIM:To compare the short-term and long-term curative effect between two implantation methods for treating refractory glaucoma.METHODS:A total of 150 patients with refractory glaucoma (150 eyes) were divided into Group A (treated by implantation with Ex-press glaucoma drainage device) and Group B (treated by implantation with Ahmed glaucoma valve) according to different implantation methods.Changes of intraocular pressure and anti-glaucoma drugs at different time points, the success rate of surgery, improvement of visual acuity and complications were compared between the two groups.RESULTS:The intraocular pressure of two groups at 1d, 1wk, 3, 6 and 12mo after surgery was significantly lower than that before surgery (P<0.05).The intraocular pressure of Group A at 3, 6 and 12mo after surgery was significantly lower than that of Group B, while anti-glaucoma drugs at 6 and 12mo after surgery were significantly fewer than those in Group B at the same time point (P<0.05).There were no significant differences between the two groups in 12-month success rate of operation, improvement rate of visual acuity and incidence of postoperative complications (P>0.05).CONCLUSION:The effects of implantation with Ex-press glaucoma drainage device are similar to those of implantation with Ahmed glaucoma valve in the treatment of refractory glaucoma.However, the intraocular pressure control effect of the former is better than the latter, and used anti-glaucoma drugs are fewer.

BACKGROUNDThe coagulation function in carcinoma patients is abnormal, but in renal cell carcinoma the extent and relationships of coagulation function remain unclear. This study retrospectively investigated the relationships between coagulation function, clinical stage and metastasis in patients with renal cell carcinoma.

METHODSA total of 350 consecutive patients admitted to our Urology Department from 2004 to 2010 were diagnosed with renal cell carcinoma by histopathologic examination and were included in this study. A total of 231 cases of renal benign tumors were considered as the control group. Fibrinogen, prothrombin time, activated partial thromboplastin time and international normalized ratio were evaluated in all subjects. Tumor size, clinical stage, lymph node metastasis, and distant metastasis were evaluated using radiologic imaging, intraoperative findings, and histological studies.

RESULTSThe preoperative plasma fibrinogen levels of patients with renal cell carcinoma ((383.9 ± 146.7) mg/dl) were significantly higher than those of the control group ((316.7 ± 62.0) mg/dl) (P < 0.01). We divided the renal cell carcinoma group into stages Ia, Ib, II, III, and IV. The fibrinogen values were (315.6 ± 64.6) mg/dl, (358.3 ± 91.1) mg/dl, (465.6 ± 164.7) mg/dl, (500.0 ± 202.1) mg/dl, and (585.8 ± 179.7) mg/dl, respectively. There were no significant differences in fibrinogen values between stage Ia and control groups. However, results of other stages showed significant differences when compared to control group values (P < 0.01). Using the cutoff value of 440 mg/dl, which defines hyperfibrinogenemia, plasma fibrinogen levels had a positive predictive value of 39.8% and a negative predictive value of 93.3% for predicting distant metastasis, with a sensitivity of 64.7% and specificity of 83.3%.

CONCLUSIONSPreoperative plasma fibrinogen levels are elevated in patients with renal cell carcinoma with distant metastasis or lymph node metastasis. Potential metastasis is more likely if the tumor size larger than 4 cm. Increased preoperative plasma fibrinogen levels, especially hyperfibrinogenemia, may be an indicator of metastasis.

Adult ; Aged ; Blood Coagulation ; physiology ; Carcinoma, Renal Cell ; metabolism ; pathology ; physiopathology ; Female ; Fibrinogen ; metabolism ; Humans ; Kidney Neoplasms ; metabolism ; pathology ; physiopathology ; Lymphatic Metastasis ; physiopathology ; Male ; Middle Aged ; Neoplasm Metastasis ; physiopathology ; Neoplasm Staging ; Retrospective Studies ; Thromboplastin ; metabolism

OBJECTIVETo explore the effect of different culture media on viability and expression of tau protein in organotypic hippocampal slice.

METHODSBrain slices (400 microm) from 1, 2, 4, and 8 week-old Wistar rats were prepared and cultured in minimum essential medium (MEM) or Dulbecco's modified eagle medium: nutrient mixture (DMEM/F12) medium respectively for 21 days. Viability of the slices was measured by lactate dehydrogenase (LDH) assay and expression of tau protein was detected by Western blot.

RESULTSThe viability of the slices was not influenced significantly by the two different culture media, while the expression level of tau protein was significantly higher in DMEM/F12 than in MEM (P < 0.05), especially in the slices from 2 and 4 week-old rats.

CONCLUSIONThe slices from 2 or 4 week-old rat hippocampi and DMEM/F12 medium may be the preferred choice for tau associated researches. An ideal Alzheimer's disease model may be established based on the results of these researches.

Animals ; Culture Media ; Hippocampus ; growth & development ; metabolism ; L-Lactate Dehydrogenase ; biosynthesis ; Organ Culture Techniques ; methods ; Rats ; Rats, Wistar ; tau Proteins ; biosynthesis ; genetics

OBJECTIVETo assess the efficacy and safety of neoadjuvant 3-weekly paclitaxel plus trastuzumab (TH) in Chinese women with Her-2 overexpressing operable breast cancer.

METHODSThis is a single center open-label phase II clinical trial. The included patients underwent 4 cycles of neoadjuvant 3-weekly TH before surgery. The primary endpoint was pathologic complete response rate (pCR rate) and the secondary endpoint was overall response rate (OR rate). Patients were also stratified according to hormone receptor status, and pCR rate and OR rate were compared between subgroups. Adverse events were graded according to CTCAE v3.0.

RESULTSThere were 40 eligible patients entering this study with median age of 49 years. All patients completed 4 cycles of neoadjuvant treatment. pCR rate was 52.5% and OR rate was 87.5%. The differences of pCR and OR rates between subgroups were of no statistical significance. No cardiac toxicity event severer than grade 2 was recorded.

CONCLUSION3-weekly TH regimen has satisfactory pCR rate and OR rate in Chinese patients with Her-2 overexpressing operable breast cancer and reliable safety.

Adult ; Antibodies, Monoclonal ; administration & dosage ; Antibodies, Monoclonal, Humanized ; Antineoplastic Combined Chemotherapy Protocols ; adverse effects ; therapeutic use ; Asian Continental Ancestry Group ; Breast Neoplasms ; drug therapy ; metabolism ; pathology ; Carcinoma, Ductal, Breast ; drug therapy ; metabolism ; pathology ; Female ; Humans ; Lymphatic Metastasis ; Middle Aged ; Neoadjuvant Therapy ; Neutropenia ; chemically induced ; Paclitaxel ; administration & dosage ; Receptor, ErbB-2 ; metabolism ; Remission Induction ; Trastuzumab

Objective To evaluate the feasibility and safety of cap-assisted endoscopic nylon loop ligation (C-ENLL) as a new and simple method on gastric fundus submucosal tumors. Methods 74 cases with small gastric fundus submucosal tumors ≤2.00 cm in diameter were reviewed between January 2015 and June 2016. All cases were treated by C-ENLL. The clinical efficacy was analyzed. Results All the 74 patients underwent endoscopic ultrasonography before operation, 70 cases originated from the muscularis propria, 3 cases originated from the muscularis mucosae, 1 case originated from the submucosa. The average diameter of the lesions ranged 0.50 ～ 1.80 cm. C-ENLL achieved an en bloc resection rate of 100.0％, with a mean total procedure time of 26 min. Two patients developed delayed perforation, were treated with nylon rope and metal clip purse suture wound. All of whom were managed successfully. There was no delayed bleeding after operation. Pathological examination showed that 66.2％ (49/74) of the tumors were gastrointestinal stromal tumors. No tumor recurrence was observed during the follow-up. Conclusion The C-ENLL may be a feasible and safe method for the treatment of small gastric fundus submucosal tumors.

Objective To investigate the influence of tumor necrosis factor-?(TNF-?) on ATP binding cassette transporter A1(ABCA1)in THP-1 macrophage foam cells, and the intervention effect of nuclear factor-?B(NF-?B) inhibitor TPCK on the TNF-?, so as to determine the role of TNF-?/ NF-?B in cellular cholesterol efflux. Methods Foam cells were transformed from THP1 cells. The correlation of cellular cholesterol efflux from foam cells with different concentrations and time stimulated by TNF-? were estimated. Subsequently foam cells were treated with TNF-? at satulated concentration(10.0 ng/ml ), TPCK(10?mol/L),or TPCK(10?mol/L) pretreated for 60 min before TNF-? stimulation. ABCA1 gene expression was analyzed by RT-PCR. ABCA1 protein level was detected by Western blot. Results TNF-? decreased cellular cholesterol efflux of foam cells in concentration-and time-dependent manner. 10 ng/ml of TNF-? down-regulated the levels of both ABCA1 mRNA and protein expressions in time-dependent manner. TPCK was observed to efficiently block the suppressive effect of TNF-? on ABCA1. Conclusions TNF-? decreases cellular cholesterol efflux mainly through the down-regulation of ABCA1. TPCK, an inhibitor of NF-?B activation, is observed to partly block the suppressive effect of TNF-? on ABCA1, suggesting a mechanism involving NF-?B signal transduction. TNF-?/NF-?B might play a critical role in the progression of atherosclerosis by decreasing cellular cholesterol efflux from foam cells.

Objective To observe the effects of genistein and 17?-estradiol on microstructure of cancellous bone in ovariectomized (OVX) rats.Methods Ninty 7-month-old SD rats were randomly divided into baseline group,ovariectomized (OVX),sham-operated (SHAM),17?-estradiol treated (10?g?kg~(-1).day~(-1),EST) and genistein treated (5 mg?kg~(-1)?day~(-1),GEN) groups,and were killed at the beginning of the experiment,the 3rd and 15th week after operation.MicroCT scanning was performed on the left tibia in vitro.The regions involving 0.5 mm slice thickness and 1.6 mm distal to the tibial growth plate were selected as the regions of interest.Results At the 3rd week after operation,the tissue bone mineral density (tBMD) and trabecular thickness (sTh.Th) in group GEN were significantly higher than those in OVX and EST groups (all P

OBJECTIVETo evaluate the effect of rosuvastatin on the functions of the surviving myocardium and arteriosclerosis plaque in patients with ST-segment elevation after acute myocardial infarction (STEMI) and percutaneous coronary intervention (PCI).

METHODSSixty-five STEMI patients were randomized to receive 40 mg simvastatin (n=32) or 10 mg rosuvastatin (n=33) before sleep in addition to conventional medications. Before PCI and after the 12-month medications, the plasma levels of total cholesterol, low-density lipoprotein cholesterol (LDL-C), C-reactive protein (CRP) and tumor necrosis factor-α (TNF-α) were measured, and echocardiography and (99)Tc(m)-MIBI single-photon emission computed tomography (SPECT) were performed to assess the therapeutic effects.

RESULTSAt the end of 12 months, the patients in simvastatin group showed significantly reduced total cholesterol, LDL-C, CRP, TNF-α, and (99)Tc(m)-MIBI uptake fraction. In rosuvastatin group, these reductions were even more obvious; the intima media thickness (IMT) of the common carotid artery was reduced significantly after a 12-month rosuvastatin therapy, but almost remained unchanged after simvastatin therapy.

CONCLUSIONRosuvastatin therapy in addition to conventional medications can significantly reduce IMT and improve the functions of the surviving myocardium in patients with STEMI after PCI.

Aged ; Angioplasty, Balloon, Coronary ; Coronary Artery Disease ; pathology ; Electrocardiography ; Female ; Fluorobenzenes ; therapeutic use ; Heart ; physiopathology ; Humans ; Hydroxymethylglutaryl-CoA Reductase Inhibitors ; therapeutic use ; Male ; Middle Aged ; Myocardial Infarction ; drug therapy ; physiopathology ; therapy ; Pyrimidines ; therapeutic use ; Rosuvastatin Calcium ; Sulfonamides ; therapeutic use

Objective To systematically evaluate the clinical efficacy of the prescriptions for softening hardness to dissipate mass combined with Levothyroxine Sodium in the treatment of postoperative thyroid cancer,and to provide evidence-based medical proof for clinical treatment of postoperative thyroid cancer.Methods Computer search was performed in the major domestic and oversea databases for the retrieval of clinical randomized controlled trials(RCTs)of prescriptions for softening hardness to dissipate mass combined with Levothyroxine Sodium for the treatment of postoperative thyroid cancer.After screening the literature according to the inclusion and exclusion criteria,the quality of the included literature was evaluated using the tools for analysis of the bias recommended by Cochrane Reviewer's Handbook and the modified JADAD rating scale,and meta-analysis was performed using RevMan 5.4 software.Results A total of 11 RCTs involving 749 patients were eventually included.The results of meta-analysis showed that compared with Levothyroxine Sodium alone,prescriptions for softening hardness to dissipate mass combined with Levothyroxine Sodium significantly enhanced the efficacy of postoperative patients with thyroid cancer(RR=1.30,95%CI[1.21,1.41],Z = 6.81,P＜0.000 01),and improved the thyroid functions parameters of serum thyroid stimulating hormone(TSH)(SMD=-1.75,95%CI[-2.38,-1.13],Z = 5.47,P＜0.000 01),thyroglobulin(TG)(SMD=-1.13,95%CI[-1.71,-0.55],Z = 3.81,P = 0.000 1),free triiodothyronine(FT3)(SMD=3.42,95%CI[0.73,6.10],Z = 2.50,P = 0.01),free thyroxine(FT4)(SMD=1.85,95%CI[0.05,3.66],Z = 2.02,P = 0.04),and thyroglobulin antibody(TgAb)(SMD=-0.63,95%CI[-1.11,-0.15],Z = 2.55,P = 0.01),increased Karnofsky Performance Status(KPS)scores(SMD= 2.19,95%CI[1.30,3.08],Z = 4.81,P＜0.000 01),shortened the time for the relief of clinical symptoms after thyroid cancer surgery(MD=-4.67,95%CI[-5.38,-3.96],Z = 12.87,P＜0.000 01),reduced the diameter of the largest thyroid nodule after thyroid cancer surgery(MD=-2.51,95%CI[-3.13,-1.89],Z = 7.94,P＜0.000 01),regulated the immune function indicators of T lymphocyte population CD3+(MD=8.68,95%CI[4.97,12.39],Z = 4.59,P＜0.000 01)and CD4+(MD=10.77,95%CI[5.46,16.08],Z = 3.97,P＜0.000 1)levels,and reduced the incidence of postoperative complications of thyroid cancer(RR=0.34,95%CI[0.18,0.65],Z = 3.26,P = 0.001).The differences were all statistically significant(P＜0.05).Conclusion prescriptions for softening hardness to dissipate mass combined with Levothyroxine Sodium can enhance the efficacy of postoperative patients with thyroid cancer.The combined therapy is superior to Levothyroxine Sodium alone in improving thyroid function indicators,KPS score,time for the relief of clinical symptoms,diameter of the largest thyroid nodule,immune function indicators,and the incidence of postoperative complications.However,due to the small amount of included trials and the fact that the prescriptions for softening hardness to dissipate mass vary in the composition,the conclusions of the analysis need to be confirmed by more high-quality,multi-center,large-sample clinically randomized controlled trials.