The resection of lateral skull base tumour has always been a crucial and difficult aspect of skull base surgery.Its operation development has experienced several evolutionary phases,including unaided eye-surgery which could result in huge trauma,microsurgery and completely endoscopic surgery.At present,the endoscopic technique known for its panoramic visibility,minimal invasion and extensive scope of operation,has opened up a brand new perspective for the lateral skull base tumour surgery.Currently,the approach of lateral skull base tumour endoscopic surgery can be generalized as endoscopic transmaxillary approach (ETA).And based on different pathways and methods to expose the maxillary sinus,ETAs can be divided into three,endonasal transmaxillary approach(ENTA),endoscopic sublabial transmaxillary approach (ESTA) and combined approach,while ENTA includes ipsilateral endonasal transmaxillary approach (IENTA),prelacrimal recess approach (PRA),contralateral endonasal transseptal approach (CENTA) and transnasal Denker approach.In this paper,on the basis of the summarization of ETAs related historical evolution,anatomical studys and clinical researches,the merit and demerit of all sorts of ETAs are compared and analyzed.We hope this review could act as a reference for selecting the personalized endoscopic surgery approach of lateral skull base tumour.

To investigate the risk factors for the occurrence of intracranial infection (ICI) after endoscopic transnasal resection of a pituitary adenoma and to select the best strategy for reconstructing skull base defects. Method: The clinical data of 162 patients with pituitary adenoma admitted into First Hospital of Shanxi Medical University between December 2016 and December 2019 were analyzed retrospectively. The incidence rate of ICI after surgery was analyzed. According to the occurrence of ICI, patients were stratified into ICI and non-ICI groups. The infected and non-infected groups of clinical data were collected and the independent risk factors for ICI after surgery were analyzed. Result: Among the 162 patients, 11 patients (6.79%) developed ICI, whereas 151 patients (93.21%) did not develop ICI. Body mass index (BMI), intraoperative cerebrospinal fluid leakage, postoperative cerebrospinal fluid leakage, and Kelly grades were significantly higher in the ICI group than in the non-ICI group (P<0.05). Logistic regression analysis showed that BMI, intraoperative cerebrospinal fluid leakage, postoperative cerebrospinal fluid leakage, and Kelly grades were independent risk factors for ICI after surgery (P<0.05). Conclusions: The incidence of ICI after endoscopic endonasal surgery is related to BMI, intraoperative cerebrospinal fluid leakage, postoperative cerebrospinal fluid leakage, and Kelly grades. Furthermore, reasonable strategies for skull-base reconstruction should be developed according to the Kelly grading system.

FDG-PET has played a significant role in the clinical management of lung cancer since it can efficiently visualize the functional metabolic changes of normal and pathological tissues in human body. It has been used more and more widely in many aspects of lung cancer management including diagnosis, staging, target volume delineation for radiotherapy plan, treatment response inspection, and recurrence detection. However, the false positive led by benign and inflammation somehow decreases its diagnostic specificity of lung cancer. The diagnostic methods for lung cancer consist of visual interpretation and semi-quantitative analysis based on static imaging and quantitative analysis based on dynamic imaging. This article briefly reviews the current trends, challenges and foreground of this imaging modality in the field of clinical management of lung cancer.

Objective To investigate the efficacy of sorafenib alone or combination with transarterial chemoembolization(TACE)and percutaneous local cryotherapy(PLCT)for advanced hepatocellular carcinoma patients without operation opportunity. Methods Sixty-four advanced hepatocellular carcinoma patients were selected as our subjects,who were underwent treatment of sorafenib alone or combination with TACE and PLCT. Thirty-two cases with sorafenib therapy were served as sorafenib group and another 32 cases with sorafenib in combination with transarterial chemoembolization and PLCT were served as combination group. All patients were followed up for 6 - 32 months. The treatment efficacy and tumor development were recorded. Results All surgeries of the patients were succeed and no death or serious operation complications occurred. Of 64 patients, 11 were achieved a complete remission( CR),31 cases with partial remission( PR),14 cases with stable development(SD),and 8 cases with progressive disease(PD). In the sorafenib group,3 cases were with CR,11 patients with PR,12 with SD,and 6 patients with PD. In the combination group,8 patients were with CR,20 patients with PR,2 patients with SD and 2 patients with PD,and the difference was significant between the two groups(χ2 = 14. 028,P = 0. 003). The median periods to tumor progression were 20 and 53 weeks in the sorafenib group and the combination group,and the difference was significant( χ2 = 14. 773,P = 0. 000). Conclusion For hepatocellular carcinoma patients without operation opportunity,sorafenib combined with TACE and PLCT can increase the tumor remission rate and prolong the periods to tumor progression in patients with hepatocellular carcinoma.

Adult ; Aged ; Benzamides ; therapeutic use ; Case-Control Studies ; Female ; Humans ; Imatinib Mesylate ; Immunoglobulins ; metabolism ; Leukemia, Myelogenous, Chronic, BCR-ABL Positive ; drug therapy ; immunology ; Male ; Middle Aged ; Piperazines ; therapeutic use ; Pyrimidines ; therapeutic use ; T-Lymphocyte Subsets

Objective:Thought reviewing the literature of prescription of treating rheumatoid arthritis(RA)to enrich and improve the theory of treating RA and provide the instruction for the clinical practice of treating RA.Methods:340 Prescriptions of treating RA were collected,these prescriptions were analyze according to the theory of traditional Chinese medicine.Results:Principle of treating RA was strengthening healthy qi to eliminate pathogens.Conclution:The traditional therapeutics of RA was plentiful,and provided theory nucleus and reference for treating RA.

AIM:To compare the mutant prevention concentration(MPC)of linezolid and vancomycin against methicillin resistant staphylococcus aureus(MRSA)and study the correlation between minimal inhibitory concentration(MIC)and MPC.METHODS:MICs and MPCs of two drugs against 35 MRSA clinical stains were determined by agar plates dilution method.The correlations between MIC and MPC were determined by linear regression.The ability to restrict the resistance was evaluated according the pharmacokinetics of two drugs.RESULTS:The MPCs of two drugs against MRSA were 16 and 8 ?g/mL and the MPC/MIC was 8.MPCs and MICs correlated poorly(R2 were 0.32 and 0.008,respectively).According to pharmacokinetics of two drugs,the concentration of linezolid was inside the MSW(mutant selective window)for the entire dosage interval,while the concentration of vancomycin exceeded the MPC for the most dosage interval.CONCLUSION:The capacity of vancomycin for restricting the selection of MRSA resistant mutants is stronger than that of linezolid.There is low correlation between MPC and MIC.

Aluminum Compounds ; toxicity ; Animals ; Animals, Newborn ; Apoptosis ; drug effects ; Cells, Cultured ; Cerebral Cortex ; cytology ; drug effects ; Chlorides ; toxicity ; Dose-Response Relationship, Drug ; Neurons ; cytology ; drug effects ; Rats ; Rats, Wistar

Objective:To explore the differences of CBCT image gray value of commonly used dental materials.Methods:CBCT was used to scan 36 kinds of commonly dental material blocks,the tomographic image gray value was measured by Mimics software.Re-sults:CBCT image gray values of the materials were obtained.There were differences of the gray values of the materials not only among the different types,but also among the different varieties of the same materials.Conclusion:The discipline of CBCT image gray value differences of commonly used dental materials provided an objective basis for the establishment of 3D digital model including dental ma-terials.

Objective To evaluate the safety and efficacy of radical antithrombotic therapy(aspirin,clopidogrel and tirofiban) in the treatment of senile (≥ 75 years) non-ST-elevation acute coronary syndrome (NSTEACS).Methods A total of 146 senile patients with NSTEACS were divided into observation group (70 cases) and control group(76 cases) by random digits table method.The control group was given aspirin,low molecular weight heparin and clopidogrel,and the observation group was added tirofiban (intravenous loading dosage:0.4 μ g/ (kg· min) for 30 min and then maintaining 0.1 μ g/ (kg· min) for 48-72 h).The occurrence of major adverse cardiovascular events (MACE) within 30 d after treatment,7 d angina pectoris control rate and adverse reactions were observed in two groups.Results The occurrence rate of MACE within 30 d after treatment was 5.7％ (4/70) in observation group,and 14.5％ (11/76) in control group,and there was significant difference (P ＜ 0.05).The 7 d angina pectoris control rate was 92.9％ (65/70) and 76.3 ％ (58/76) in observation group and control group,and there was significant difference (P ＜ 0.05).The incidence of bleeding was 10.0 ％ (7/70) and 7.9 ％ (6/76) in observation group and control group,and there was no significant difference (P ＞ 0.05).There were no major bleeding events in two groups.One case had thrombocytopenia in observation group,but there was no significant difference compared with that in control group(P ＞ 0.05).Conclusion Triofiban on the basis of aspirin and clopidogrel in the treatment of senile NSTEACS is effective and safe.