Objective This study aimed to establish an anatomic basis for the microscopic surgical anatomy of the cavemous sinus via the extended transsphenoidal approach.Methods Simulated surgery via extended transsphenoidal ap-proach was performed on seven adult cadaver heads with red--colored latex injected arteries.The cavernous segment of the ICA and its branch vessels and its relationship with cranial nerve were exposed and its anatomic parameters were measured under microscope.Results The tuberculum sellae,clivus,sellar base,ICA prominence,and optic nerve prominence are the important bone landmarks to define the surgical area.The average of the extent of bone removal of extended transsphe-noidal approach is 37.6 mm(range:28.7 mm～44.0 mm).Conclusions The bone removal from sellar base to the media edge of the foramen rotundum and over the ICA prominence can effectively expose the entire unilateral cavernous sinus.The microscopic cavernous sinus surgery via the extended transsphenoidal approach is an optimal surgical approach for the le-sions that invade the cavernous sinus from sella.

Adult ; Deglutition ; Humans ; Laryngeal Diseases ; Male ; Pharynx

Polymorphism, Genetic ; Gene Frequency ; China ; Genetics, Population ; Microsatellite Repeats/genetics*

With the aging of population, cerebral small vessel disease has attracted more and more attention. A growing body of literature has confirmed that retinal vascular changes can be used as a potential marker for the prediction of cerebral small vessel disease. The retina is recognized as a window into cerebrovascular and systemic vascular conditions. Combining traditional fundus photograph and fundus fluorescein angiography with optical coherence tomography angiography, the retinal vascular system of patients with cerebral small vessel disease can be comprehensively analyzed. This paper summarizes and analyzes the application of retinal angiography technology in different image types of cerebral small vessel disease and makes a review, in order to provide reference for the early diagnosis and prevention of cerebral small vessel disease.

OBJECTIVETo study the effect of Yiqi Wenyang Huoxue Lishui principle (YWHL, a therapeutic principle with Chinese medicine for reinforcing Qi warming Yang, activating blood circulation and promoting urination) on some neuroendocrine factors in patients with congestive heart failure (CHF).

METHODSForty-nine patients of CHF with heart function of grade III-IV were randomly divided into 2 groups. The 29 cases in the treated group were treated with YWHL and the 20 cases in the control group treated with captopril. Changes of angiotensin II (AT II), atrial natriuretic peptide (ANP), endothelin (ET), nitric oxide (NO) and alpha-granule membrance protein -140 (GMP-140) were observed.

RESULTSAfter treatment, plasma level of AT II, ANP, ET, and NO lowered in both groups with insignificant difference, but the GMP-140 reduced more significantly in the treated group (P < 0.05).

CONCLUSIONYWHL showed a regulatory effect of neuroendicrine system partially similar to that of angiotensin-converting enzyme inhibitor, it possibly can improve the ventricular remodeling and would be beneficial to prevent the thrombus formation and improve heart failure by means of inhibiting platelet activity.

Adult ; Aged ; Angiotensin II ; blood ; Atrial Natriuretic Factor ; blood ; Coronary Disease ; complications ; Drugs, Chinese Herbal ; therapeutic use ; Female ; Heart Failure ; drug therapy ; etiology ; physiopathology ; Humans ; Male ; Middle Aged ; Neurosecretory Systems ; drug effects ; P-Selectin ; blood ; Phytotherapy

Objective To investigate the effects of methylprednisolone on the release of cytokines in patients after successful cardiopulmonary resuscitation(CPR).Method Thirty patients after CPR with restoration of spontaneous circulation(ROSC)were randomly divided into two groups:group A(methylprednisolone group,n=14)and group B(control group,n=16)during the period from May 2005 through May 2007.The patients of group were treated with methylprednisolone 3 mg/kg by intravenously twice a day after ROSC.The levels of serum tumor necrosis factor-α(TNF-α),interleukin-1β(IL-1β),interleukin-6(IL-6),interleukin-8(IL-8),interleukin-10 (IL-10)were measured by enzyme-linked immunosorbent assay(ELISA)before CPR,and 24,48,72 hours and 7 days after ROSC.The data were analyzed studentis t test and chi-gquare test.A P value less than 0.05 indicated significant difference.Results There was on significant difference in the mean time from cardiac arrest to return of spontaneous circulation,and the levels of serum cytokines between the two groups before CPR(P＞0.05).In comparisorl with group B,the levels of serum TNF-α,IL-1β,IL-6,IL-8 decreased markedly at 24 and 48 hour after ROSC in group A(P＜0.05-0.01),and the levels of serum IL-8 decreased markedly at 72 hours after ROSC in groupA(P＜0.05).Thelevels of serum TNF-α,IL-1β,IL-6,IL-8 were not of significant differences between the two groups at 7 hys after ROSC(P＞0.05).There was no significant difference in the levels of serum IL-10between the two groups at different time points after ROSC(P＞0.05).Conclusions Methylprednisolone plays a role of preventive effects on patients with ROSC after PCR through decreasing the levels of serum TNF-α,IL-1β,IL-6,IL-8.

OBJECTIVETo observe the impacts of acupoint catgut embedding therapy and acupuncture-moxibustion therapy on the long-term efficacy and patient's life quality in the treatment of allergic rhinitis.

METHODSSixty-nine patients were randomized into the combined acupuncture-moxibustion and acupoint catgut embedding therapy group (combined therapy group, 36 cases) and an acupuncture-moxibustion group (33 cases). In the acupuncture-moxibustion group, acupuncture was applied at Yingxiang (LI 20), Shangyingxiang (EX-HN 8), Yintang (GV 29), Shangxing (GV 23), Tongtian (BL 7) and Zusanli (ST 36). Moxibustion was applied at Zusanli (ST 36), Feishu (BL 13), Dazhui (GV 14) and Fengmen (BL 12). In the combined therapy group, on the basis of the treatment as acupuncture-moxibustion group, the catgut embedding therapy was applied at Feishu (BL 13), Fengmen (BL 12), Pishu (BL 20), Shenshu (BL 23), Zhongwan (CV 12) and Qihai (CV 6). The treatment duration was 4 weeks in the two groups. The clinical efficacy of allergic rhinitis and rhinoconjunctivitis quality of life questionnaire (RQLQ) score were observed before and after treatment as well as in the 4-weeks follow-up after the end of treatment respectively.

RESULTSThe markedly effective rate was 72.7% (24/33) in the combined therapy group and 48.4% (15/31) in the acupuncture-moxibustion group after treatment. The efficacy was similar between the two groups (P > 0.05). It was 57.6% (19/33) in the combined therapy group and was 22. 6% (7/31) in the 4-week follow-up after treatment, indicating the long-term efficacy in the combined therapy group was superior to that in the acupuncture-moxibustion group (P<0. 05). Scores of RQLO after treatment and in 4-week follow-up after treatment in both groups were improved as compared with those before treatment (all P < 0.05). In 4-week follow-up, the improvements in sleep and affection in the combined therapy group were superior to the acupuncture-moxibustion group (3.27 +/- 3.23 vs 4.61 +/- 3.56, 3.48 +/- 3.67 vs 5.81 +/- 4.15, both P < 0.05).

CONCLUSIONThe acupoint catgut embedding therapy combined with acupuncture-moxibustion therapy are safe and effective in the treatment of allergic rhinitis and display the more roles in the long-term efficacy.

Acupuncture Points ; Acupuncture Therapy ; instrumentation ; Adolescent ; Adult ; Catgut ; utilization ; Child ; Female ; Humans ; Male ; Middle Aged ; Moxibustion ; Quality of Life ; Rhinitis, Allergic ; Rhinitis, Allergic, Perennial ; therapy ; Treatment Outcome ; Young Adult

Objective To study the NR5A1 gene mutation in patients with idiopathic hypogonadotropic hypogonadism(IHH), and to find the new mutation point.Methods Sixty-one IHH patients and 100 normal control subjects were collected and genomic DNA was extracted from blood samples.These patients were with normal karyotype and no abnormality was discovered in magnetic resonance imaging (MRI) scan of the pituitary.Other endocrine diseases were also excluded.The 2-7 exons and splice-sites of NR5A1 gene were amplified with polymerase chain reaction.DNA of the coding sequence and splice-sites of NR5A 1 were sequenced by double deoxidizing terminal end sequencing method in 61 IHH and 100 normal control subjects.The results of sequencing were compared with their corresponding sequence data.61 IHH kindreds were investigated and the clinical data of these patients were collected.Finally, the phenotype and genotype positive cases were analyzed.Results Six patients carried NR5A1 gene mutational sites in 61 cases of IHH.Analysis of sequencing results from 100 age and ethnicity matched control subjects did not show any of these novel changes.Conclusions One mutation in NR5A1 gene may affect protein structure and function, which should be considered in male IHH patients with normal karyotype and without insufficiency of adrenal function.

Herein we reported a case of follicular lymphoma with 50.26% clonal malignant lymphocytes and 50% tumor cells positive for the immunoglobulin heavy chain gene and B-cell lymphoma 2 gene (IGH-BCL2). To determine whether endothelial cells (ECs) within the tumor share the feature of advanced malignancy, we isolated and purified the ECs from the tumor by using the immunomagnetic beads conjugated with a monoclonal antibody against CD34, a surface marker of ECs. Thereafter, we identified ECs according to their morphology and found that ECs presented consistently flat and elongated appearance with a lot of Weibel-Palade bodies in the cytoplasm. Results of flow cytometry confirmed that ECs isolated from the follicular lymphoma expressed high level of both vWF and CD34 and the purity of the ECs fraction was more than 90%. Additionally, we used FISH to check chromosomal aberration in the purified ECs and found that some of the ECs had only one fusion signal for the green IGH probe and the red BCL2 probe in contrast to typical t(14;18)(q32;q21) translocation with two fusion signals. This phenomenon was also observed in the tumor cells. It might be a different breakpoint of IGH in this case, which induced the loss of the fusion signal, indicating t(14;18)(q32;q21) translocation. The positive cells accounted for 18% of the isolated ECs from the tumor, indicating that a proportion of ECs from follicular lymphoma had the same chromosome aberration as the neoplastic cells.

Aim To study the effect of Baoxinbao film on endothelin(ET) and nitric oxide(NO) secretion in patients with stable angina pectoris(SAP).Methods 76 patients with SAP were randomly divided into two groups, with 40 cases in the baoxinbao group plastered with baoxinbao film and 36 cases in the isosorbide dinitrate group receiving isosorbide dinitrate. The levels of plasma ET and NO before and after treatment were observed. Results The concentrations of plasma ET were increased and plasma NO reduced significantly in the SAP patients respectively, as compared with those in the control group(all P