With the development of molecular and cell biology,new concept of the etiology of pituitary adenomas was taking shape.The etiology of pituitary adenoma was considered to be related to gene mutation and transforming factors.This paper reviews the roles of gene mutations,transforming factors,expression of receptors on cells and growth factors in the etiology of pituitary adenomas.

Objective By analyzing domestic and foreign papers on plague research with bibliometrics and visualized methods, we explored the current situation research trends and cutting-edge dynamics in order to provide information sup-port for plague research as well as strategies for countering bioterrorism.Methods Based on data sources from SCI and CNKI databases, bibliometrics and visualized methods were adopted,including Pajek,VOSviewer, Bibexcel and Citespace, so as to show the major cutting-edge areas of plague research.Results Comprehensive research analysis showed that the USA is leading in plague research, with some strong related institutions.There is still a gap between China and international community for research.Academy of Military Medical Sciences and other institutions are our main plague research efforts. Conclusion We should strengthen plague research, improve our overall level of plague research to provide the necessary support for effective response to natural epidemics and potential bioterrorism incidents.

NF-?B is one of important transcription factors, which plays an important role in many immune and inflammatory responses. The novel data showed that the NF-?B pathway was also detectable in myocardial cells, vascular endothelial and smooth muscle cells, and involved in the development of many car-diovascular diseases. The present review gives a detail presentation of current advances on relationship betweenNF-?B and cardiovascular diseases.

Objective To evaluate the CT features and pathologic findings of MTC. Methods The CT features of 28 patients with MTC confirmed pathologically were analyzed retrospectively and correlated with pathologic findings. Results The tumor invaded one lobe of the thyroid in 22 cases(78.6%), two lobe in 6 cases(21.4%). 5(17.9%) of them presented with heterogeneous hypodense masses and 23(82.1%) of them presented with homogeneous hypodense solitary masses . 20 patients had metastatic lymph nodes. The thyroid masses were enhanced slightly, while the lymph nodes were enhanced obviously. Correlating with pathologic findings, the heterogeneous lesions composed of cystic areas and/or necrosis, while the homogeneous lesions composed of homogeneously distributed tumor cells with no cystic areas or necrosis. The metastatic lymph nodes were hypervascular. Conclusion The CT features of MTC may be described as homogeneous diffuse hypodense mass, with slight enhancement,and invasion of one thyroid lobe in most cases. The metastatic lymph nodes are characterized with enhancement.

0.05). A Kappa value was 0.435 for overall final assessment. There were moderate agreement in category Ⅰ and Ⅴ (K=0.511 and 0.671), and slight agreement in category Ⅱ (0.373), Ⅲ (0.179), and Ⅳ (0.276). The positive value of different categories assessed by two groups were as follows: category Ⅰ (12.5% vs 22.5%), Ⅱ(3.7% vs 12.5%), Ⅲ(20.83% vs 19.61%), Ⅳ(68.63% vs 60.34%), and Ⅴ(100% vs 89.91%). Twenty three lesions(7.49%)were misdiagnosed by both groups. Conclusion BI-RADS is useful in mammographic diagnoses of breast lesion with symptoms. The misdiagnoses can be reduced combined with the clinical examination and reasonable additional imaging evaluation. For symptomatic breast lesions, the assessing threshold of category Ⅱ or Ⅲ should be improved, and category Ⅳ should be reduced. But BI-RADS has its limitation. We propose that corresponded classification should be drawn according to every application’s condition.

This study is to screen the Chinese herbal compounds which could inhibit the production of Abeta and investigate the underlying mechanism. Ten types of compounds which have potential value in the treatment of AD were selected as initial screening trial. The cell models which used could overexpress Abeta and beta-secretases or Abeta and gamma-secretases. Extracellular Abeta was determined by ELISA after the cell models treated with different concentrations of compounds (0.5-100 micromol x L(-1)), separately. Then the compounds were selected which could inhibit extracellular Abeta and their best concentration ranges were decided, too. Furthermore, the cell viability and apoptosis rate, the level of intracellular Abeta, beta and gamma-secretases were determined after the cell models treated with different concentrations of selected compounds. The results showed that 4 of the 10 compounds could reduce the level of extracellular Abeta; they were cryptotanshinone, astragalosides, gastrodin and paeoniflorin, and their best concentration ranges were 0.5-5.0, 0.5-5.0, 5.0-50, 1.0-25 micromol x L(-1), respectively. Further study indicated that the 4 selected compounds were nontoxic to the cellular models and lowering intracellular Abeta were more effective compared with extracellular; of which astragalosides and gastrodin showed dose-dependent inhibition to the activities of beta and gamma-secretases, with the maximum inhibiting rates of 78.2% and 80.3%, respectively. In conclusion, cryptotanshinone, astragalosides, gastrodin and paeoniflorin could inhibit the expression and secretion of Abeta, and the underlying inhibiting mechanism of astragalosides and gastrodin were related with the reduction of the beta and gamma-secretase activities, respectively.

Objective To investigate the risk factors leading to complications in patients undergoing laparoscopic cholecystectomy (LC). Methods Clinical data of 11?974 patients undergoing LC from Mar. 1991 to June 2003 were collected and analyzed retrospectively. Fifteen clinical factors were recruited for the study in relation to surgical complications. Data were analyzed by ?2 test and Logistic regression. Results The overall operative complication rate was 1.896%. The procedure was shifted to open surgery in 2.389% of all cases, Logistic regression analysis revealed that Calot triangle adhesion, stage, expertise of the team, gallbladder wall thickness, gallbladder and vicinity adhesion were important risk factors for complications. Conclusion LC complications can be prevented by good training, strictly following protocol, and timely shifting to open surgery.

Objective To explore the development of the anthrax research field in order to provide information and strategies for anti-bioterrorism in China.Methods Pajek, Vosviewer, Bibexcel running on Web of Knowledge platform, and Excel running on CSCD platform were used.Results According to the results of anthrax literature metrology,the USA is by far the leader in research while the Academy of Military Medical Sciences, Chinese Academy of Sciences and other in-stitutions are our main anthrax research institutions in China, but there is a gap between China and international research institutions.Conclusion We should strengthen anthrax research, improve the overall research strength, and provide the necessary protection to respond to potential bioterrorism incidents.

Objective To explore the sedation and analgesia effect of dexmedetomidine (DEX) in patients with multiple trauma during mechanical ventilation.Methods Eighty cases of multiple trauma patients under mechanical ventilation treated from September 2016 to March 2017 were analyzed by retrospective case-control study.There were 58 males and 22 females with an age range of 18-60 years (mean,41.87 years).The injury severity score (ISS) was (18.45 ±4.53)points.The patients were treated with sedation and analgesia,and they were divided into two groups according to the sedative drugs.DEX composite tartaric acid butorphanol were used in 40 patients as DEX group.Midazolam composite tartaric acid butorphanol were used in 40 patients as Midazolam group.The degree of sedation score (Ramsay score) were compared between groups.The time from initial drug use to effective sedation achievement,daily wake-up time,mechanical ventilation duration,emergency intensive care unit (EICU) time,dosage of tartaric acid butorphanol,heart rate,blood pressure changes,and incidence of delirium were compared.Results (1) Two groups could both reach the target of sedation.DEX group had shorter daily wake-up time,shorter mechanical ventilation time and shorter length of EICU stay compared with Midazolam group (P ＜ 0.05).(2) The time to achieve satisfied sedation after initial usage in Midazolam group was shorter than that in DEX group (P ＜ 0.05).(3) DEX group had smaller tartaric dosage of acid butorphanol,and lower incidence of delirium compared those in Midazolam group (P ＜ 0.05).(4) The comparison of systolic blood pressure,diastolic blood pressure,heart rate within either group showed significant difference before and after sedation (P ＜ 0.05),but had no significant difference between two groups (P ＞ 0.05).Conclusions For multiple trauma patients with mechanical ventilation,DEX can attain sedation and analgesia and shorten daily wake-up time,mechanical ventilation time,and length of hospital stay.DEX can reduce the dosage of analgesic (butorphanol) and the incidence of delirium.Blood pressure and heart rate are associated with small variations before and after sedation.

The etiology of hemophagocytic lymphohistiocytosis (HLH) is complicated and difficult to diagnose, unexplained HLH often with hematological malignancies. Invasive biopsy can help to find etiology, the results may be affected by the technique and the location of the puncture site. Multiangle puncture can improve the success rate, but the corresponding risk increases. A patient with HLH was admitted to Affiliated Hospital of Zunyi Medical College. The etiology was unknown. Active symptomatic support treatment was conducted, at the same time, finding the evidence of viral infection, autoimmune disease related detection, blood culture, bone marrow puncture smear and spleen biopsy were performed respectively to find the pathogen basis. Spleen hemorrhage was not being controlled after spleen biopsy in patients, and emergency splenectomy was adopted to stop bleeding for saving lives. Finally, the patients died of low protein, pulmonary edema and respiratory failure. The bone marrow puncture and spleen biopsy failed to provide the basis for tumor invasion, while the spleen pathological slices plus immunohistochemical indicate diffuse large B cell lymphoma (DLBCL) after splenectomy, which was identified as malignant tumor-associated hemophagocytic syndrome. Underscoring the high risk of bleeding after tumor-associated splenomegaly puncture and the importance of having emergency plans. Through analyzing the clinical characteristics, diagnosis and treatment of this patient, we hope to improve the clinicians' understanding of HLH and lymphoma.