Objective To study the criteria and technique of transsphenoidal microsurgery on pituitary adenoma invaded cavernous sinus Methods 42 patients with pituitary adenoma underwent 45 transsphenoidal operations Sellar base was opened as large as possible under C arm X ray fluoroscopy or neuronavigation monition Dura matter was cut open under microscope Tumors were removed through the direction and tunnel they in invade Bromocriptine was administered to those with little remains Partial remains and those have no response to bromocriptine were given radiotherapy Results No modality 21 tumors were nearly totally removed, 18 tumors were subtotally resected, 3 were partially resected MRI scanned in 2～3 months after the operation showed that 19 tumors disappeared, 20 tumors had little residul, 3 tumors partially remained Conclusion Pituitary adenomas invading the cavernous sinus with enlarged sella turcica and shown soft in MRI can be submitted to transsphenoidal operation Microsurgical technique can ease tumor removal and protection of the sellar and internal carotid artery

Objective To investigate the significance of serum procalcitonin(PCT)levels in children with respiratory syncytial virus(RSV)pneumonia and sepsis.Methods 43 cases of children with RSV pneumonia were divided into two groups,including 28 cases of non -sepsis and 15 cases of sepsis.30 cases of healthy children were choosed as a control group in the same period.The serum PCT levels of three groups were compared.The 29 cases of RSV pneumonia with other organ damage except lung were divided into non -severe group and severe group.The differences of serum PCT levels between the two groups were compared.Results The non -sepsis group and sepsis group serum PCT levels were (0.882 ±0.184)μg/L and (1.001 ±0.268)μg/L respectively,which were higher than the control group[(0.365 ±0.085)μg/L,(t =2.607,2.854,all P <0.05)].The serum PCT levels of the non -sepsis group and septic group were significant different(t =0.372,P >0.05);The serum PCT level of the severe group was (1.181 ±0.281)μg/L,which was higher than the non -severe group[(0.448 ±0.140)μg/L],the differ-ence was statistically significant(t =2.473,P <0.05).Conclusion The serum PCT of RSV pneumonia children was increased,the increased PCT can be an observed indicators of severe infection and multiple organ dysfunction.

Background and purpose: Herpesvirus-associated ubiquitin-specific protease (HAUSP) is a new deubiquitinating enzyme that was recently discovered. It has been demonstrated that HAUSP could deubiquitinate p53 both in vitro and in vivo. These results suggested that HAUSP might act as a tumor suppressor through the stabilization of p53 protein. The aim of this study was to investigate the expression of HAUSP in breast carcinoma, and its association with p53 protein as well as their relationship to prognosis. Methods: The expression of HAUSP mRNA was detected by real-time PCR. HAUSP protein and p53 protein were detected by immunohistochemistry with EnVision system in breast carcinoma tissues and noncancerous tissues. The relationship between their expressions and clinical pathological parameters were analyzed. Results: The expression of HAUSP mRNA was significantly lower in breast cancer tissue than noncancerous tissue (1.85±0.04 vs. 2.74±0.03, P<0.01). The positive rates of HAUSP protein were significantly lower in breast cancer tissue in noncancerous tissue (59.4% vs. 75.0%, P<0.01), and expression of HAUSP protein had no significant correlation with the clinical pathological parameters. There was no significant correlation between HAUSP and p53 protein (P>0.05). The expression of HAUSP mRNA was positively associated with that of HAUSP protein (P<0.01). There was no significant correlation between HAUSP and p53 protein. DFS of patients with both HAUSP positive and p53 negative was significant higher than the controls (P<0.01). Conclusion: Down-regulation of HAUSP protein and HAUSP mRNA in breast carcinoma indicated that HAUSP gene might correlated to tumor carcinogenesis. In addition, the simultaneous evaluation of both HAUSP expression and p53 expression status may be helpful to evaluate the prognosis of breast cancer patients.

Objective To analyze the results of assessment and authentication of malaria elimination of 7 county?level cities and districts in Changzhou City,Jiangsu Province,and explore the suitable monitoring methods for malaria after the elimination in this region,so as to provide the evidence for formulating and adjusting the malaria elimination strategies and measures. Meth?ods The data from the network reports of malaria epidemic situation,blood examinations of febrile patients,epidemiological questionnaires of malaria cases,investigation of epidemic focuses and disposal tables were collected and analyzed in Changzhou City from 2009 to 2014. The clinicians were assessed with the closed?book written examinations for their ability of the diagnosis and treatment of malaria. The inspection personnel were assessed by the microscopical examinations of Plasmodium. Totally 30 negative blood slides were reviewed. In the natural village where the last local case of malaria was located ,200 blood filter pa?pers were collected for gene detection of Plasmodium. Results From 2009 to 2014,145 malaria cases were reported in Chang?zhou City. Totally 170 638 febrile patients received blood detections for malaria,of which 137 cases were positive and the posi?tive rate was 0.08%. The majority of malaria cases were imported except 8 local malaria infection cases in 2009 and 2 local ma?laria infection cases in 2010. Four of seven county?level cities(districts)gained an average score of 20 points on the microscopi?cal examinations of Plasmodium. Liyang City got a minimum average score of 18.8 points. In capacity assessment of malaria diag?nosis and treatment,Liyang City gained the highest average score of 19.8 points,and Qishuyan District got the lowest average score of 18.0 points. The malaria elimination assessment scores of the 7 county?level cities(districts)were all above 93 points. Four county?level cities(districts)(Xinbei District,Wujin District,Liyang City,and Jintan City)carried out the active case detections. A total of 731 cases were detected and the results were all negative. Liyang City in 2012,Zhonglou District and Jin?tan City in 2013,Tianning District,Qishuyan District,Xinbei District and Wujin District in 2014,passed the malaria elimina?tion assessment at county(district)level,respectively. Conclusions All the 7 county?level cities(districts)of Changzhou City have passed the malaria elimination assessment at a high score. After the malaria elimination ,the monitoring should contin?ue to consolidate the achievements.

Objective To analyze the concentration, distribution and decreasing trend of niclosamide in soil through soil heaping mixed with niclosamide and the effect of Oncomelania control, and to explore the appropriate dosage for the 'heaping' method. Methods The soil samples were collected from six groups in Tezi township, Puge county, Sichuan Province, and the dosages were 16, 8, 4, 2, 1 and 0 g/m~2, respectively. After ultrasonic extraction, centrifugence and concentration, the samples were finally determined by high-performance liquid chromatography (HPLC). The mortality rate of snails was observed after 3 days and 7 days. Results The standard error and range of niclosamide in soil were large. There was no significant difference in concentration of niclosamide between the surface layer and deep layer of soil (P>0.05). After 5 months, niclosamide still could be determined in groups of 4 g/m~2. The mortality rate of snails decreased as the concentration of niclosamide decreased (P<0.05). After 5 months, in the group of 4 g/m~2 dosage, the 3 and 7 days mortality rate of snails were 5.33% and 9.33% in the surface layer, higher than the control group (P<0.05). Conclusions The heaping method is an efficacious measure of controlling snails and its recommended dosage is 4 g/m~2.

Objective To evaluate the effect of comprehensive schistosomiasis control in Changzhou City in recent 10 years, so as to provide the evidences for formulating the future prevention and control strategy. Methods The work reports and the da?ta of the schistosomiasis comprehensive control projects in Changzhou City from 2004 to 2014 were collected,the infection sta?tus of residents and livestock as well the Oncomelania hupensis snail situation were analyzed,and the implementation effect of the comprehensive control projects was evaluated. Results From 2004 to 2014,totally 215 368 person?times were examined, and the positive rate of the blood examinations of the population was 0.24%(478/198 356),and there were no positive cases de?tected out by using the miracidium hatching method. Totally 11 935 domestic animals were detected and no positives were found. From 2004 to 2014,the total area with snails was 92.27 hm2,and marshland,inland and mountain environments accounted for 34.75%,34.82%and 30.43%,respectively. The newly discovered area with snails was 34.40 hm2,and marshland,inland and mountain environments accounted for 2.62%,71.22% and 26.16%,respectively. Totally 8 511 snails were dissected and no schistosome infected snails were found. From 2004 to 2014,a total of 242 600 harmless toilets were built,2 704 700 domestic animals were reared in pens,5.82 km?long rivers were dredged,2 250.11 hm2 of protective forests were constructed,a total area of 625.79 hm2 were controlled with molluscicides,and an area of 149.58 hm2 were environmentally transformed. Totally 5.4 mil?lion people received health education. The awareness rate of knowledge on schistosomiasis control of residents was 96.00% in 2014. Conclusions There exists the risks of snails import and diffusion and schistosomiasis resurrection in Changzhou City, but under the condition of continuous implementation of comprehensive control measures,the endemic situation of schistosomia?sis is stable and the control achievement is consolidated in this city.

Objective To understand the current state of staff for Plasmodium microscopy examinations in Changzhou City in the early stage of eliminating malaria action,so as to provide the evidence for achieving the target of malaria elimination. Methods The staff for Plasmodium microscopy examinations from medical institutions and centers for disease control and prevention at differ-ent levels were investigated by questionnaires and tests of the malaria related theory and microscopic operation. Results Totally 95 people were investigated,and among them,40.0%had college degree and 45.3%were university educated. There were 18.9%of them working on Plasmodium microscopy examinations for less than 1 year,40.0%for 2-5 years,18.9%for 6-10 years and 22.1%for more than 10 years. The numbers of person-time of provincial and municipal level training,district-level training,and unit-level training in the last year were 0.57,0.59,and 0.14,respectively. Totally 18.9%of them had the experience of finding Plasmodium at work,and 97.9% of them considered it was necessary or very necessary to do Plasmodium microscopy examina-tions. However,57.9%and 8.4%of them considered Plasmodium microscopy examinations increased their work load and work dif-ficulty,respectively. The average correct rates of knowledge tests on malaria before and after training were 72.5%and 91.6%re-spectively(P<0.05). The average mark of Plasmodium microscopic tests was 25.3 points(full mark being 50 points),and the passing rate(≥30 points)was 58.9%. Conclusion The working experience of staff for Plasmodium microscopy examinations in Changzhou City is relatively poor,and the related training should be enhanced.

Objective To understand the quality of blood smears for Plasmodium detection in Changzhou City,so as to pro?vide the technical support for malaria surveillance in the post?elimination period. Methods The blood smears of fever patients from each cities(districts)in Changzhou City in 2014,including more than 3%of the negatives and all the positives,were se?lected. The quality of the blood smear making,dyeing,cleanliness and results were reviewed by the experts from the municipal malaria microscopy station,and the data were analyzed statistically. Results Totally 996 negative blood smears were reviewed in 2014,with a review rate of 4.52%. The qualified rates of blood smear making,dyeing and cleanliness were 92.87%,93.27%and 94.48%,respectively. A total of 34 positive blood smears were reviewed,and there were no false detections and leak detec?tions. The qualified rates of blood smear making and dyeing were more than 90%in all the seven cities(districts). As for quali?fied rate of cleanliness,except the rate in Qishuyan District(81.36%),those in the other six cities(districts)were all above 90%. The qualified rates of blood smear making,dyeing and cleanliness were all more than 90%in first?class,second?class and third?class hospitals. The major quality defects of the blood smears were sediment,abnormal making and thick membrane shed?ding,and the proportions were 25.91%,21.76%and 19.17%,respectively. Conclusions The quality of blood smears for Plas?modium detection in Changzhou City is satisfying. In the future,the training and supervision still should be strengthened to guar?antee the capacity of microscopic examinations for Plasmodium detection in the surveillance of post?elimination period.

Objective To grasp the malaria epidemic situation in Changzhou City from 2010 to 2014,so as to provide the ev?idence for formulating and adjusting malaria control strategies and measures. Methods The epidemiological data of malaria cas?es in the special report system from 2010 to 2014 were collected,and the malaria epidemic situation and the diagnosis and treat?ment of malaria patients were analyzed. Results There were 132 malaria cases reported in Changzhou City from 2010 to 2014, with a decrease of 27.47%compared to 182 cases from 2005 to 2009. Among the 132 cases,2 cases were local infected cases and the remaining 130 cases were imported cases. Four cases were clinically diagnosed and 128 cases were laboratory con?firmed,with 97 cases of malignant malaria,14 cases of vivax malaria,13 cases of ovale malaria,and 4 cases of quartan malar?ia. The 132 cases were distributed in five districts:56 cases in Jintan City,51 cases in Liyang City,19 cases in Tianning Dis?trict,3 cases in Wujin District,and 3 cases in Xinbei District. The median duration between the onset and treatment of the dis?ease was 2 days,and the median duration between the diagnosis and treatment was 1 day. The diagnosing units were concentrat?ed on the county?level disease control agencies,and medical institutions at county and municipal levels,accounting for 92.42%(122/132). From 2011 to 2014,there were no local malaria cases. Conclusions From 2012 to 2014,there have been no local malaria cases in Changzhou City,and the goal of eliminating malaria has been achieved basically. However,there are still many imported malaria cases,and the infected species are diverse. Therefore,imported malaria is still the key of malaria prevention and control.

Objective To analyze the epidemic characteristics of imported malaria in Liyang City,so as to provide the evi?dence for formulating appropriate control strategies and measures. Methods The malaria epidemic situation reports,case epi?demiological investigations and the follow?up materials of counterparts returned together with the cases were collected and ana?lyzed in Liyang City from 2007 to 2014. Results Totally 53 imported malaria cases were reported and they were all laboratory confirmed in Liyang City from 2007 to 2014. Forty ? nine cases(92.5%)were imported from African countries,37 cases (69.8%)were Plasmodium falciparum infection,and 37 cases(69.8%)had overseas incidence history. Forty cases(75.5%) were aged between 30 and 49 years,and 52 cases(98.1%)were male,42 cases(79.2%)were farmers. These cases were dis?tributed in all the 10 towns and there were no obvious seasonal variation for onset time. The median time from onset to seeing a doctor was 3 d,and the median time from seeing a doctor to being diagnosed was 0 d. The first visit health facilities by the pa?tients were various,and the diagnostic health facilities were all the medical institutions at the county level or above,and the standardized treatment rate was 100%. Conclusion During the last 5 consecutive years,there have been no local infected ma?laria cases in Liyang City,and the remarkable results have been achieved in malaria elimination. However,there are still many imported malaria cases,and the infected species are diverse. Therefore,the imported malaria is still the key of malaria preven?tion and control.