Objective To provide the anatomical data for single-nostril transsphenoidal microsurgery for pituitary adenoma.Methods Microanatomic structures were observed and measured in 20 cadaveric a- dults heads.Results(1)The diaphragmal opering was 5 mm or greater broad in 90%.The mean thick- ness of the diaphragma sellae was (0.18?0.08)mm.(2) A sphenoid sinus with complete pneumatization was named as all-sellae type,its percentage in all specimens was 85%,85% sphenoid sinus had middle sep- tum of which only 18.8% located in the medial sagital section.(3)The meant thickness of the sellar floor was (0.81?0.34) mm,70% of which were not more than 1 mm.Of the sellar floors,that the shape was flatness reach 15%.(4) The relationship between ICA and sphenoid sinus had two aspects,one was to be mutually apart (55%),the other was to communicate (45%),which formers carinae on the lateral wall of the sphe- noid sinus,espeially in the superior surface of posterior part.The relationship between optic nerve and sphe- noid sinus,one was to be mutually apart (27.5%),the other was to communicate (72.5% ),which formers carinae on the lateral wall of the sphenoid sinus,especially in the superior surface of anterior part.(5) Three main types of the intercavernous sinus were the anterior intercavernous sinus,present in 80%,the inferior in- tercavenous sinus (25%),and the posterior intercavenous sinus (15%).Conclusion The knowledge of the anatomy of the sellar region and sphenoid sinus is helpful to safe operation in the single-nostril transsphe- noidal approach for pituitary,adenoma microsurgery.

Objective To discuss some problems about current learning objectives for the speciality of clinical medicine in China,including the concepts,the decision-making systems and value-orientation,and to provide the reference for stipulating the learning objectives in future. Methods The objectives of some Chinese medical universities were collected from their websites.Some medical educators were consulted about their feelings about these learning objectives,and also were asked to identify their own objectives. Results Medical educators failed to distinguish their own objectives,and there were four main problems in current learning objectives: generalization,similarity and lack of individuality,difficulty in guide the curricula and teaching,and setting up too high object. Conclusion The learning objectives in clinical medicine should reflect both specialty characteristic and university individuality,so they should be drawn up by teachers,students and educatirnal administrators,moreover their value orientation should be eligible standard,not excellence.

Considerable knowledge about the biology of forest tree has been gained in the recent years by the application of the new genomic technologies to study tree growth and development as well as the response of trees to biotic and abiotic stresses. Proteomics is becoming an important content in the biology of forest tree. A review is given about the progress in forest tree proteomics research in the areas of population genetics, genetic mapping, stress physiology, organs and tissues, and wood formation, etc. Furthermore, forest tree proteome database is briefly introduced. Finally, the prospect of proteomics is discussed.

Objective To investigate the clinical teaching situation by using developmental inspection of School of Medicine,Shanghai Jiaotong University(SJTU-SM),and to put forward some suggestions. Methods By checking questionnaires and informal discussions,the relevant information was collected and analyzed by using SPSS statistics sofware. Results The clinical teaching quality of SJTU-SM was basically satisfied.The satisfaction from internship of grade 2004 was better than that of grade 2003.However,some problems in clinical teaching must be improved.Conclusion The investigation showed that the clinical teaching quality of SJTU-SM is being improving.However,in order to achieve the international accreditation standards,the quality guarantee system of clinical teaching need to be further perfected.

Animals ; Astragalus Plant ; chemistry ; Coxsackievirus Infections ; physiopathology ; Flavonoids ; pharmacology ; Mice ; Mice, Inbred BALB C ; Myocarditis ; physiopathology ; virology ; Myocytes, Cardiac ; drug effects ; virology

Objective To define the variables associated with preterm infants with patent ductus arteriosus (PDA) and identify the optimal timing for PDA closure clinically.Methods Three hundred and fifty-three premature babies with gestational age ＜ 32 weeks in Ba Yi Children's Hospital,Beijing Military General Hospital,from February 2011 to January 2013 were selected.Among them the PDA patients with degree of cardiovascular dysfunction using a scoring system (CVD) ≥3 scores at 48 hour life by using the cardiovascular dysfunction scoring systerm received primary drug treatment with 1-3 cycles Ibuprofen.If drug treatment failed or contraindicated,underwent surgical closure.Gestational age,body weight,presence of symptomatic hypotension,drug treatment or surgical closure were analyzed to see whether these factors were related to clinical outcomes,including hospital mortality,necrotizing enterocolitis (NEC),intraventricular hemorrhage(IVH),retinopathy(ROP) and bronchopulmonary dysplasia(BPD) at 36 weeks.Data were analyzed with Kruskal-Walls test,Wilcoxon signed rank test,Pearson x2 test,Fisher's exact test,Friedman,Halton,Logistic regression model.Results In the PDA patients with CVD≥3 scores persistently,the effectiveness of Ibuprofen was lower as time went on,PDA and BPD(OR =3.163,P =0.002),ROP(OR =2.557,P =0.007) were related markedly,and surgical treatment was possibly required.When CVD scores ≥ 3 after birth,drug treatment for one cycle was effective in 169 cases(47.8％),52 cases (14.7％) for two cycles,and 44 cases(12.5％) required surgical ligation after drug treatment failed.Such patients had younger gestational age [(29.4 ± 2.4) weeks vs (30.7 ± 1.4) weeks,P ＜ 0.000 1],and lower body weight at birth [(1 450 ± 577) g vs (1 750 ± 508) g,P =0.004).Conclusions The prolonged patency of the ductus arteriosus in preterm infants is related to an increase for IVH,BPD and ROP.Surgical ligation of PDA is a safe and effective treatment and should be done soon after two complete cycles of Ibuprofen,especially in selected patients who CVD ≥3 scores,to reduce the possibility of BPD and ROP occurence.

Objective To investigate the contribution of hypoxia-inducible factor inhibitor YC-1 to cisplatin chemo-sensitivity to human ovarian cancer cells A2780s in vitro. Methods Ovarian cancer cells were divided into four groups which were treated with saline, YC-1, cisplatin, and YC-1+cisplatin, separately, mRNA of HIF-1αand VEGF in the A2780s cells were detected by real-time fluorescence quantitative PCR by calculating 2-△△CT;the protein were detected by Western blot, to evaluate the change of hypoxia and angiogenesis capabilities under the ovarian cancer microenvironment. Results Compared with the control group, mRNA and protein of HIF-1αand VEGF expressed less in the group of YC-1, cisplatin and YC-1+cisplatin;while, those in the group of YC-1+cisplatin were lower than the monotherapy (P<0. 05), but no significant difference was detected between the YC-1 and cisplatin groups, and the expression of HIF-1αand VEGF mRNA were positively related(r=0. 830 5)in each group. Conclusion YC-1 exerts the antitumor effect and may contribute to sensitivity to cisplatin in the therapy of ovarian cancer.

Objective To study the asymmetric dimethylarginine(ADMA) concentrations in plasma of acute coronary syndrome (ACS) and its various subgroups ,and analyze the relationship between ADMA and traditional risk factors of ACS .Methods 101 ACS patients were enrolled in the study ,which were divided into several subgroups according to clinical diagnosis ,ECG and coro‐nary angiography .ACS group were divided into unstable angina(UA) group(n=70) and acute myocardial infarction(AMI) group (n=31) ,then AMI group was divided into non‐ST segment elevation myocardial infarction(NSTEMI) group(n=19) and ST seg‐ment elevation myocardial infarction (STEMI) group(n=12) .The control group(n= 40) were recruited in the study during the same period ,who showed normal coronary arteries in coronary angiography .All the patients received coronary attery angiography . The plasma ADMA concentration was measured by using enzyme‐linked immunosorbent assay (ELISA) ,and serum contents of lip‐id(TC ,TG ,HDL‐C ,LDL‐C) ,C‐reactive protein(CRP) ,troponin were detected by automatic biochemic analysis apparatus .Results Compared with the control group ,plasma ADMA concentration of ACS group increased ,the difference was statistically significant (P<0 .05) .The concentrations of ADMA in AMI group and UA group were higher than those in control group ,and the difference was statistically significant(P< 0 .05) .The concentrations of ADMA in AMI group were significantly higher than those in UA group(P<0 .05) .Plasma ADMA negatively correlated with HDL‐C concentrations(r= -0 .222 ,P<0 .05) ,positively correlated with LDL‐C concentration(r=0 .357 ,P<0 .05) ,and positively correlated with CRP(r=0 .619 ,P<0 .05) .Conclusion The occur‐rence of ACS and some of its related risk factors are correlated with plasma ADMA concentration .

Objective To discuss the experience in the diagnosis, treatment, complications and follow up of carotid body tumor. Methods All the 25 cases were diagnosised by DSA and CTA. The tumor was resected under carotid adventitial plane in 18 cases, with external carotid artery resection in 4cases, and in 3 cases, internal carotid artery (ICA) and external carotid artery (ECA) were resected simultaneously in which internal carotid artery was reconstructed in two cases including using self vein bypass in one and anastomosis between ICA and ECA in the other. ICA was ligated in the third case. Results No cases died perioperatively. ALL CBTs were treated successfully. Horner syndrome and trachyphonia were relieved after operation. Postoperative trachyphonia, bucking and lingual paralysis developed in 3 cases, and in one case with vagus resection caused dyspnea tracheotomy was performed. The rate of nerves injuries was 12% but no semiplegia and aphasia occurred. Follow up period was from 4 to 90 months (average 44 ±6 months) for 21 cases. The trachyphonia and bucking were improved during follow up but the lingual paralysis persists, and tumor recurred in two cases with one dying. Conclusions CBT treatment should include active surgery, sufficient preoperative preparation and avoiding the postoperative nervous complications.

Objective To investigate the technical details and therapeutic effect in treating StarIdford B aortic dissection by endovaseular aortic repair(EVAR). Methods We retrospectively review 115 type B aortic dissection cases undergoing the procedure of mini-traumatic EVAR from November 1998 to February 2009.There were 71 male patients and 44 female patients with a mean age of55.7 years and follow up period from 7 to 83 months for 75 cases. Results The procedure Was technically successful in 113 cases and 122 stent grafts were placed with hybrid surgery being carried out in 3 cases of carotid artery bypass.Severe perioperative complications included subclavian steal syndrome in 4 eases,pulmonaryinfections in 3 cases.arterial embolism in 2 cases,acute cerebral infarction in 2 cases,kidney tailure in 2 cases.alimentary tract hemorrhage,graft infection,acute intestinal ischemia and type A dissection occurred in one each case respectively.Five cases died perioperatively.Among the 75 cases that were fouowed up,there were 9 eases with type I endoleak and at last 5 cases redid endovaacular repmr.2 cases with secondary type A dissection accepted graft replacement.There were 6 deaths during the follow-up period,4 dying of acute myocardial infarction(2 cases),cerebral hemorrhage(1 case),type A dlssection (1 case)respectively,the causes of other2 deaths were not confirmed. Conclusion EVAR was effective for Standford B aortic dissection as shown by midterm follow up.