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.

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.

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.

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

ObjectiveTo study the influence of EmbryoGlue on the implantation of embryo and pregnancy outcome in vitro fertilization (IVF)-embryo transfer (ET).Methods From August 2010 to January 2011,243 infertile patients in Reproductive Medical Center of Tianjin Medical University General Hospital who underwent IVF or intracytoplasmic sperm injection (ICSI) were divided into two groups,including 129 cases used EmbryoGlue as the embryo transfer medium in experimental group and 114 cases used G-2 as embryo transfer medium in control group.Pregnancy outcome were compared between two groups.Results (1) The female age,IVF/ICSI constituent ratio,previous failure cycles and infertile factors of patients did not show statistical difference between experimental group and control group (P ＞0.05 ).(2) The implantation rate of women in experimental group increased significantly compared with the control group [ 30.4％ ( 85/280 ) vs.18.8％ ( 48/255 ),P ＜ 0.05 ] ; Clinical pregnancy rate increased significantly compared with the control group [48.8％ (63/129) vs.34.2％ (39/114),P ＜0.05] ; Multiple pregnancy rate increased significantly compared with the control group [ 34.9％ (22/63) vs.20.5％(8/39),P ＜ 0.05 ] ; Ectopic pregnancy rate decreased significantly compared with the control group [ 4.8％(3/63) vs.17.9％ ( 7/39 ),P ＜ 0.05 ].ConclusionEmbryoGlue can facilitate embryo implantation in IVF-ET and reduce the occurrence of ectopic pregnancy.

Objective To probe into the epidemic feature, pa tho genic spectrum and main risk factors of diarrhea during the field training in ar my. Methods Detection of morbidity,investigation of risk factor s and detachment of pathogen were performed. Results The diarrh eal incidence rate of army of field training was 4.36%(106/2 433), which was higher than that of hold garrison(0.98%, 2/204). The incidence rate of officers was lower than that of soldiers. Two incidence peaks concerned with the army motion course were foun d. The detection rate of lapactic bacteria from fecal of patients was 63.1%(65/1 03) and most of them were ETEC, followed by the plesiomonas shigelloides. Se ven ind ividual factors concerned with diarrhea disease were found with logistic analysi s, including dr inking unboiled water, going out to eating and so on. Conclusions Incidence of diarrhea in the army increased obviously during the field training and the chief pathogen are ETEC and plesiomonas shigelloides, at the same time, t he occurrence of diarrhea is related with many individual factors.

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

This article,in view of the research status and development tendency of hospital core competence,introduced the index selection process and constructed the evaluation index system of core competence.This system comprises 3 level-1 indexes (social reputation,hospital health resources and development potential)and 9 level-2 indexes,with recommendations on improvements of the existing system.

In this paper,based on theoretical analysis,the concept of hospital core competence is redefined,combined with the needs of hospital's development in medical service market,the connotation is also clearly definition,and the characteri stics is summarized.Meanwhile,on the basis of all above,this paper has carried on a thorough discussion about the construction of Chinese hospital core competence.