[Summary] The development of pituitary is a complex process involving the interactions of multiple genes.In recent years,the mutations ofHESX1,LHX3,LHX4,PITX1,PITX2,SOX,PROP1,and PIT1 have been confirmed in congenital pituitary diseases.This review summarizes the advances in the roles of these genes in pituitary development.

The traditional Chinese medicine(TCM)has good results in treating asthma at remission stage,treating childhood bronchial asthma,and daily nursing.The western medicine usually takes the therapeutic methods of inhaling aerosol drugs,using anti-inflammatory drugs and undertaking interventional therapy,which have good results in relieve symptoms rapidly,dealing with emergent and severe onset of bronchial asthma and treating complications.The integration of these two medicines can cooperate with each other and exert good therapeufc effects.

Objective To write the school-based teaching material of pathology,and apply it to the students in higher vocational colleges to evaluate the application effect.Methods Two classes of clinical medical students of Grade 201 1were divided into two groups:the experimental group(Class1,58 students) and the control group(Class2,60 students).Both of the two groups take the integration of theory and practice teaching method.The traditional teaching material was applied in the control group while the school-based teaching materials were adopted in the experimental group.Statistical analysis software SPSS 13.0 and two samples t test were used to compare the preparing effect before the class,case study effect and the final examination of the two groups.After the end of the course,students' teaching satisfaction questionnaire was conducted,and the results of the survey for the rank sum test were analyzed.Results The scores of preparing effect before class were higher in experimental group(84.4 ±6.2) than those in the control group(78.2 ±5.8),t=5.61,P=0.001; the case study effect in experimental group(78.6 ± 6.6) was higher than that of the control group(72.8 ± 5.3),t=5.27,P=0.002; there was no significant differences in the final examination between the two class [experimental group (83.5 ± 6.8),control group (81.6 ± 6.9)],t=1.51,P=0.183.The questionnaire shows,in the aspect of the difficulty of teaching material,the degree of satisfaction in the experimental group(satisfied:28,general:30,unsatisfied:0) was higher than the control group(satisfied:18,general:37,unsatisfied:5),Z=-2.43,P=0.015; in the aspect of reading interest,the degree of satisfaction in the experimental group(satisfied:32,general:25,unsatisfied:1) was higher than the control group(satisfied:22,general:35,unsatisfied:3),Z=-2.09,P=0.036; in the aspect of emphasizing on the key point,the degree of satisfaction in the experimental group(satisfied:20,general:38,unsatisfied:0) was higher than the control group(satisfied:12,general:39,unsatisfied:9),Z=-2.72,P=0.007; in the aspect of self-study effect,the degree of satisfaction in the experimental group(satisfied:20,general:38,unsatisfied:0) was higher than the control group(satisfied:16,general:39,unsatisfied:5),Z=-3.13,P=0.002; but there was no significant differences in classroomlearning effect(experimental group:satisfied,38,general,20,unsatisfied,0; control group:satisfied,36,general,23,unsatisfied,1),Z=-0.68,P=0.497.Conclusions The school-based teaching material can contribute to the students' self-learning,enhancing the students' interest of learning and knowledge-application ability.

Objective To evaluate the clinical effect of integrated traditional Chinese and western medicine in treating chronic obstructive pulmonary disease (COPD). Methods 88 patients with COPD were randomly divided into a treatment group and a control group, with 44 patients in each group. The treatment group was treated with conventional western medical therapy plus traditional Chinese medical therapy, and the control group was treated with conventional western medical therapy exclusively. The clinical therapeutic effects were evaluated after 14 days of therapy. Results Symptoms of cough, phlegm, and asthma were improved in both groups. The total effective rate in the treatment group and the control group was 93.2% and 75.0% respectively. There was remarkable difference between the two groups (P＜0.05). Conclusion It is safe and effective for treating COPD with integrated traditional Chinese and western medicine.

Objective To optimize the culture medium for scarless wound healing in outbred fetal Kunming (KM) mice,and to locate and preliminarily analyze the region with active cell proliferation.Methods After 6 pregnant mice were sacrificed at the gestational age of 15 days,a total of 180 skin grafts were obtained from the back of 60 fetal mice,and wounds on the skin grafts were made uniformly with minimally invasive sterile device.Then,these skin grafts with wounds were randomly and equally divided into 6 groups to be treated with high-glucose Dulbecco's modified Eagle's medium (DMEM),DMEM + 5％ fetal bovine serum (FBS),DMEM + 10％ FBS,low-glucose Eagle's minimum essential medium (MEM),MEM + 5％ FBS,and MEM + 10％ FBS for 3 days,respectively.Then,these skin grafts were embedded in optimal cutting temperature (OCT) compound,and subjected to hematoxylin and eosin (HE) staining to select the optimal culture condition for wound healing.Under the optimal culture condition,the region with active cell proliferation was located by labeling and tracking cutaneous stem cells with 5-ethynyl-2-deoxyuridine (EdU),and activator protein-1 (AP-1) expression was detected by immunofluorescent staining.Results After 3-day cultivation,wound healing rates significantly differed among the DMEM group,DMEM + 5％ FBS group,DMEM + 10％ FBS group,MEM group,MEM + 5％ FBS group and MEM + 10％ FBS group (0,3.33％,6.67％,3.33％,46.67％ and 26.67％,respectively,x2 =41.39,P ＜ 0.05).Additionally,the MEM + 5％ FBS group showed a significantly higher wound healing rate than the other groups except the MEM + 10％ FBS group (all P ＜ 0.01).Logistic regression analysis showed that the type of basal medium (MEM:OR =11.717,95％ CI:3.274-41.934,P ＜ 0.001) and FBS concentrations (5％ FBS:OR =24.625,95％ CI:3.027-200.299,P =0.003;10％ FBS:OR =13.449,95％ CI:1.618-111.813,P =0.016) were factors influencing fetal wound healing.Under the culture condition of 5％ FBS + MEM,the dermis and epidermis healed well without epidermal thickening.The cutaneous stem cell labeling technique showed that the papillary dermis and basal layer of the epidermis were the two major regions with active cell proliferation in the wound of fetal mouse skin.Moreover,AP-1 was expressed abundantly in these two regions as well.Conclusions The culture condition of 5％ FBS + MEM is considered to be optimal for in vitro wound healing in fetal mice.The papillary dermis and basal layer of the epidermis are two major regions with active cell proliferation during wound healing in fetal mouse skin,and play important roles in wound healing process.

BACKGROUND:As an oral anticoagulant drug, many experiments have proved that rivaroxaban can prevent the deep venous thromboembolism after the hip arthroplasty. The foreign literatures indicate that it can significantly reduce the incidence of deep venous thromboembolism after extending the treatment course to 35 days. But there is no significant conclusion at home, and the safety of drugs after extentding the course has not been confirmed. OBJECTIVE:To analyze the efficacy and safety of rivaroxaban versus low-molecular-weight heparin for the prevention of deep venous thrombosis after the hip arthroplasty. METHODS:106 patients with primary unilateral hip arthroplasty in the Second Clinical Medical College of Shanxi Medical University between March 2011 and September 2012 were selected. The patients were randomly divided into rivaroxaban group and low-molecular-weight heparin group. The patients in two groups were given drugs at 6 hours after replacement, the patients in the rivaroxaban group were given rivaroxaban 10 mg/d with the course of 5 weeks;the patients in the low-molecular-weight heparin group were given low-molecular-weight heparin 4 100 U/d with the course of 2 weeks. RESULTS AND CONCLUSION:The review and fol ow-up results showed there was no deep vein thrombosis or symptoms of deep vein thrombosis in patients of the rivaroxaban group after replacement, while seven cases (13%) of deep vein thrombosis were observed in the low-molecular-weight heparin group, and there was significant difference in the incidence rate of deep vein thrombosis between two groups (P<0.05). There were no significant differences in venous blood hemoglobin level, platelet level and coagulation function before and after replacement, as wel as the drainage volume and subcutaneous ecchymosis area after replacement of the patients received unilateral hip arthroplasty between two groups (P>0.05). The results indicate that ful course of rivaroxaban has clear effect and reliable security in the prevention of deep venous thrombosis after hip arthroplasty.

Objective To compare the clinical outcomes of bone transport technique versus induced membrane technique for treatment of infected bone nonunion.Methods A retrospective study was made on 46 cases of infected bone nonunion admitted from April 2011 to December 2014.They were 33 males and 13 females,aged from 12 to 68 years (mean,45.3 years),involving 40 tibial and 6 femoral fractures.Bone transport technique was used in 37 cases while 9 cases were treated with induced membrane technique.Fracture union and complications were recorded.The function of the affected limb was evaluated at the final follow-up using Johner-Wruhs criteria.Results The 46 cases were followed up for 9 to 18 months (mean,14 months).In the bone transport group,bone union was achieved after a mean duration of 6.5 months (range,from 4 to 11 months) without complications like wound infection or neurovascular lesions.In the induced membrane group,bone union was achieved after a mean duration of 5.8 months (range,from 4 to 11 months) and there was one case of re-infection.According to the Johner-Wruhs score system,34 cases were rated as excellent,9 as good and 3 as fair,with a total excellent and good rate of 93.5％.Bone transport technique led to 28 excellent,4 good and one fair cases in the patients with tibial nonunion,and one excellent,2 good and one fair cases in the patients with femoral nonunion.Induced membrane technique led to 3 excellent,3 good and one fair cases in the patients with tibial nonunion,and 2 excellent cases in the patients with femoral nonunion.Conclusions Both bone transport technique and induced membrane technique are effective for infected bone nonunion.Bone transport technique may be preferred for tibial infected nonunion while induced membrane technique preferred for femoral infected nonunion.

Objective To explore the clinical efficacy of locking plate in the treatment of postoperative nonunion of limb long bone fracture.Methods We treated 53 patients whose limb long bone fracture failed to unite after operation with locking plate between April 2011 and November 2014.They were 38 men and 15 women,aged from 20 to 69 (average,39.7).There were 18 humeral fractures,5 radioulnar ones,9 femoral ones,and 21 tibial ones.On average,each patient had undergone 1.2 previous operations (from 1 to 2 times),including plating in 29 cases,intramedullary nailing in 15,and external fixation in 9.In the 15 patients whose intramedullary nails were reserved because of slightly loosening only under axial stress,lateral force and rotation,the nonunion was treated with bone autograft + unicortical or full-thickness locking plate.In the other 38 patients whose original implants were removed,the nonunion was treated by re-reaming of the medullary cavity + bone autograft + locking plate internal fixation.Regular radiological follow-ups were conducted for the patients.The functional recovery of upper limbs was evaluated by the Neer system while that of the lower limbs by the Johner-Wruhs system.Results One patient was lost to the follow-up.The rest 52 were followed up for 4 to 15 months (average,12.7 months).Nonunion was found in 2 patients whose internal fixation was broken and loosened.Bone healing was achieved in 50 cases after 4 to 6 months(average,5 months).Removal of implants was conducted in 36 patients at 12 to 24 months after operation (average,13.3 months).At the final follow-ups,the Neer score of upper limb was excellent in 15 cases,good in 5,fair in one and poor in one,giving an excellent to good rate of 90.9％;the Johner-Wruhs score of lower limb was excellent in 24 cases,good in 3,fair in 2 and poor in one,giving an excellent to good rate of 90.0％.Conclusion Locking plate can have good curative efficacy in the treatment of postoperative nonunion of long bone fracture.

Objective To compare the efficacy between the treatment courses of 4 weeks and 8 weeks of lansoprazole in the treatment of endoscopic mucosal stripping ( ESD ) induced iatrogenic gastric ulcer.Methods 84 gastric adenoma or early gastric cancer patients were randomly divided into two groups after lansoprazole(30 mg/day) treatment for 4 weeks and 8 weeks.After 8 weeks of ESD, the efficacy between two groups were compared.Results 69 patients from the total 84 patients were included into the final analysis, 34 patents in 4 week-treatment group and 35 patients in 8 week-treatment group.There was no significant difference between the two groups of the ulcer stage(68% in the scar stage of 4 week-treatment group and 69% in the scar stage of 8 week-treatment group, P=0.93 ).There was no significant difference between the two groups of ulcer reduction radio (0.0081 ±0.015 in 4 week-treatment group and 0.0037 ±0.008 in 8 week-treatment group, P=0.15) 8 weeks after ESD.There was no difference in scar stage and ulcer reduction radio between 4 week-treatment group and 8 week-treatment group of patients with large ulcers ( >30 mm ) . Conclusion For ESD-induced gastric ulcer, there was no significant difference in efficacy of lansoprazole between 4 week-treatment and 8 week-treatment.It may be sufficient for proton pump inhibitors only 4 weeks’ treatment in ESD-induced gastric ulcers.

Objective To explore the mechanism of β-catenin/Akt signaling pathway in the apoptosis of gastric cancer cells induced by selenite sodium.Methods Gastric cancer cell line SGC-7901 was cultured, and 0 mol/L, 5 mol/L, 10 mol/L and 20 mol/L selenite sodium treated cells; flow cytometry was used to detect the cell apoptosis rate after 24 h;10 mol/L sodium selenite treated cells, flow cytometry was used to detect the cell cycle changes after 24 h;10 mol/L sodium selenite treated cells,protein expression ofβ-catenin,cyclin D1 and protein kinase B ( Akt) activity were detected by Western blot after 0,6,12,24 h.Results Cells apoptosis rate was significantly higher than 0 mol/L after cells was treated by 5 mol/L, 10 mol/L and 20 mol/L sodium selenite, due to cells apoptosis rate was higher by 10 mol/L sodium selenite treated than 5 mol/L and 20 mol/L, 10 mol/L sodium selenite treated cells for follow-up study;gastric cancer cells was treated by 10 mol/L sodium selenite for 24 h, compared with the control group, G0/G1 phase cells decreased, cells in S phase and G2/M phase significantly increased(P<0.05);gastric cancer cells was treated by 10 mol/L sodium selenite for 0 h, 6 h, 12 h and 24 h,protein expression of β-catenin and cyclin D1 and Survivin in 6 h, 12 h and 24 h was significantly lower than that in 0 hour (P<0.01),and with the extension of time, protein expression gradually decreased;gastric cancer cells was treated by 10 mol/L sodium selenite could significantly decrease the phosphorylation of p-Akt in 6,12,24 h, while there was no significant difference of Akt among difference time points( P <0.01).Conclusion Sodium selenite could induce apoptosis of gastric cancer cells, and the cells were arrested in S phase.The mechanism may be associated with beta-catenin/Akt signaling pathway.