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

Objective:To explore the effect of P-glycoprotein ( P-gp) activity on its mediated imatinib mesylate accumulation and intracellular drug membrane permeability. Methods: 1199G/wt ABCB1 and 1199A/mut recombinant plasmids were transferred into HEK293 cells, respectively, and the expression levels of mRNA in different cell models were investigated by RT-PCR. Cell Counting Kit-8(CCK-8) assay was used to detect the drug toxicity in different cell models, HPLC was applied to determine the drug concentra-tion in different cell models and evaluate the intracellular accumulation, and transmembrane resistance experiment was employed to de-tect the transmembrane permeability and evaluate the effect of P-gp activity on drug transportation. Results: Cytotoxicity test showed that the drug concentration in the transferred cells was lower than that in the control group, which proved that P-gp had the function of mediating drug out of cells. HPLC and transepithelial electrical resistance experiment showed that compared with the wild type of AB-CB1 (1199G) cells, mutation of ABCB1 1199A cells had stronger effect on P-gp mediated mesylate imatinib accumulation and drug membrane permeability. Conclusion:The experiment manifested that ABCB1 (1199G/A) site mutation can change the coding protein P-gp activity and the polymorphisms will lead to the increase of mesylate imatinib clearance rate and the decrease of effective drug con-centration in target cells. Meanwhile, the clarification of ABCB1 genetic types in clinics can guide the individualized medication of imatinib mesylate.

Objective To study the percentages of polymorphonuclear leukocytes (PMN), mononuclear cells (MNC) and fibroblastic cells (FBC) in different post-traumatic intervals after skeletal muscle me-chanical injury in rats. Methods The rat model of skeletal muscle mechanical injury was established. The rats were divided into injured groups (6 h, 12 h, 1 d, 3 d, 7 d, 10 d and 14 d after injury ) and con-trol group. The percentages of PMN, MNC and FBC in different post-traumatic intervals after skeletal muscle mechanical injury were assessed with HE staining and image analysis. Results At post-injury 6-12 h, the percentages of PMN and MNC infiltration appeared in injured sites and that of PMN reached peak. At 1 d, the percentage of MNC infiltration appeared and reached peak, while that of PMN de-creased. At 3-7 d, the percentage of FBC gradually increased, while that of PMN and MNC decreased. At 10-14 d, the percentage of FBC reached peak. Conclusion The percentages of PMN, MNC and FBC in injured zones showed time-dependent changes, which might be used as reference index for determination of age of skeletal muscle injury.

BACKGROUND: Autophagy of osteocytes has been found to be implicated in the pathogenesis of steroid-induced necrosis of the femoral head and closely related to apoptosis.OBJECTIVE: To summarize the research progress of autophagy in the pathogenesis of steroid-induced necrosis of the femoral head by studying the interaction between cell autophagy and cell apoptosis as well as osteocytes.METHODS: A computer-based online retrieval of PubMed, Embase and CNKI databases was performed for relevant literatures published from October 1996 to October 2016 with the keywords of steroid, necrosis of the femoral head, cell apoptosis, cell autophagy, osteocyte in Chinese and English, respectively. The articles concerning steroid-induced necrosis of femoral head and cell autophagy were collected, and the redundant and old researches or Meta analysis were removed.RESULTS AND CONCLUSION: Mammalian target of rapamycin, Beclin-1, microtubule-associated protein 1 light chain 3, bone morphogenetic proteins, fork box protein and transcription gene family and transcription factor 4 are closely related to autophagy. The interaction between autophagy and osteocytes is correlated with steroid dose: the autophagy shows protective factor under the low dose corticosteroids; however, with the increase of the dosage, a large number of apoptotic cells, and the phenomenon of bone loss can been observed. Furthermore, the relationship of cell autophagy with apoptosis and bone mass maintenance is still controversial, which needs to be explored in depth via a series of rational experiments.

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.