OBJECTIVETo discuss the operative techniques of endoscopic endonasal transsphenoidal surgery and perioperative management for treatment of acute pituitar y apoplexy (PA).METHODS A retrospective analysis was conducted on the clinical data of 51 pathologically diagnosed acute PA after transsphenoidal endoscopic endonasal resection at the TianJin HuanHu hospital between January 2000 and December 2013. There were 28 males and 23 females,with median age of 47 and disease course of 4h-7d.The typical clinical manifestations included headache, visual interference and pituitary dysfunction. CT scan, MRI scan and endocrinological examinations were performed in all cases before operation. Glucocorticoids were used during perioperatve period, The postoperation symptoms and the results follow-up visit after operation were recorded. RESULTS The tumors were totally removed in 42 cases and sub-totally removed in 9 cases without operative death and serious complications. The follow-up period was 1 year to 14 years. Of 47 patients with headaches before the operation, all patients were resolved after the operation; In 38 patients with sight disturbance before the operation,the sight was recovered very well in 34 patients after the operation. The visual field was recovered very well in all patients. Of 28 patients with endocrine disturbance before the operation, 22 were improved in endocrine symptom after the operation. No patient recurred.CONCLUSION The endoscopic endonasal transsphenoidal operation is safe and effective for treatment of acute PA.Appropriate perioperative management is important for the success of operation.

OBJECTIVETo evaluate the therapeutic effects of percutaneous kyphoplasty (PKP) for the treatment of osteoporotic vertebral compression fracture (OVCF) with degenerative scoliosis.

METHODSFrom March 2009 to March 2014,121 patients undergoing PKP for the treatment of osteoporotic vertebral compression fracture (OVCF) with degenerative scoliosis were retrospective analyzed. There were 41 males and 80 females,ranging in age from 56 to 92 years with an average of 73.2 years. Preoperative and postoperative 3 d respectively pain visual analogue scale (visual analogue score, VAS) and Oswestry Disability Index assessed pain and functional recovery of patients and preoperative and postoperative 3 d lumbar lordosis, scoliosis Cobb angle were analyzed.

RESULTSAll the patients were followed up, and the duration ranged from 6 to 24 months, with a mean time of 11 months. All the patients achieved success in operation without serious complications. The operation time ranged from 30 to 65 min with an average of 42.2 min. Local leakage of bone cement was not found in canal. The VAS and Oswestry Disability Index at the 3rd day after operation decreased significantly compared with those of the preoperative (P < 0.05), and the lumbar lordosis and scoliosis Cobb angle also improved significantly compared with those of the preoperative (P < 0.05).

CONCLUSIONPercutaneous kyphoplasty (PKP) for the treatment of thoracolumbar scoliosis osteoporotic fracture can significantly improve patients spinal deformity, pain relief, which is worth of recommending.

Aged ; Aged, 80 and over ; Female ; Fractures, Compression ; surgery ; Humans ; Kyphoplasty ; methods ; Male ; Middle Aged ; Osteoporotic Fractures ; surgery ; Scoliosis ; surgery ; Spinal Fractures ; surgery ; Visual Analog Scale

Objective To discuss the microstructure and properties of vascular puncture with a blunt needle Pix'L filling injection.Methods Scanning electron microscopy (SEM) and photoelectron spectroscopy were employed for the analysis of the different morphology and elements,and a rat model was established to study thrusts of different microcannulas and hypodermic needle when stabing vessels.Ultimately we analyzed the correlation between the morphology and puncture force of different microcannulas.Results The SEM images of microcannulas from different manufacturers were different,and revealed the different technics of different manufacturers.Puncture forces of different microcannulas corresponded to the cross-section and smooth degree of the tips.Conclusions The SEM morphology and puncture force of microcannulas from different manufacturers are different,which indicate the different characters and usability.Plastic surgeons should select to use them more judiciously.

OBJECTIVETo explore the preventive effect of Yougui drink on femoral head necrosis in rats under micro CT.

METHODSTwenty-five SD rats were divided into steroid hormone group (group A, 10 rats ), Yougui drink group (group B,10 rats) and normal group (group C,5 rats)with random number table. Endotoxin were injected into abdominal cavity of rats in group A and B for 2 days, methylprednisolone sodium succinate were injected by gluteus for twice a week continued for 6 weeks; group B were gavaged by Yougui drink (veryday for 8 weeks; group C did not do any processing. All rats were killed on the 10th weeks,m icro CT were used to scan femoral head in vitro and preventive effect of Yougui drink (n femoral head necrosis in rats.

RESULTSThere was statistical significance in BMD, BV/TV, Tb.N, Tb, Th, Thb, Sp, BS/TV and DA but no significance in SMI between group A and B. Comparison between A and C, there was significant meaning in BMD, BV/TV, Tb.N, Tb, Th, Tb, Sp, BS/TV, DA and SMI.

CONCLUSIONYougui drink on femoral head necrosis in rats under micro CT has preventive effect from BMD BV/TV, Tb.N, Tb, Th, Tb, Sp, BS/TV and DA.

Animals ; Apoptosis ; Bone Density ; Drugs, Chinese Herbal ; therapeutic use ; Femur Head Necrosis ; diagnostic imaging ; pathology ; prevention & control ; Rats ; Rats, Sprague-Dawley ; X-Ray Microtomography ; methods

OBJECTIVETo analyse retrospectively 3-tunnels core decompression with implantation of bone marrow stromal cells(bMSCs) and decalcified bone matrix (DBM) for treatment of femoral head necrosis in early stages, and to study its therapeutic results and indications.

METHODSAccording to the University of Pennsyvania system of classification and staging,to treat the patients with 3-tunnels core decompression with implantation of bone marrow stromal cells (bMSCs) and decalcified bone matrix (DBM) for treatment of early femoral head necrosis. Among the total 87 patients (103 hips), the male was 71 (86 hips) and the female 16 (17 hips) with the average age of 47 years old. The average course of disease was 1.3 year. The effect was evaluated by the clinical symptoms, the Harris' scores and the manifestations of radiology before and after operation.

RESULTSAll the patients were followed up more than 2 years (average 26 months). The average Harris' scores increased from preoperation 47.3 to postoperation 74.0. The average rate of excellent and good results was 75.7%. The rate of excellent and good was 88% (22/25) in type I, 78.7% (37/47) in type II and 61.3% (19/31) in type III. No severe complications were observed.

CONCLUSIONThree-tunnels core decompression with implantation of bMSCs and DBM not only removal the focus of disease, but also use DBM the induction of bone and autologous hone marrow stem cells to differentiate the functions of the femoral head can be resumed loading structure, eliminate pain,improve joint function. It is an effective method for early femoral head necrosis.

Adult ; Aged ; Bone Marrow Transplantation ; Bone Matrix ; transplantation ; Decompression, Surgical ; Female ; Femur Head Necrosis ; surgery ; Follow-Up Studies ; Humans ; Male ; Mesenchymal Stem Cell Transplantation ; Middle Aged ; Retrospective Studies ; Transplantation, Autologous

Objective To deal with the awareness rate of medical precise health care policy of the medical care workers in poverty-stricken areas and the influencing factors of the awareness rate.Methods The questionnaire was designed based on literature analysis and expert discussion,and field investigation was done.Statistical analysis and logistic regression analysis were performed using SPSS19.0.Results Only 26.0％ of medical workers express that they were aware of current health poverty alleviation and related policies,while nearly 40％ were not satisfied with current precision health and poverty alleviation policy.Logistic regression analysis indicated that three factors on health care personnel had an impact on the level of awareness of precision health and poverty alleviation policies,"whether the hospital has acquired help from a superior hospital","where the hospital gives help to junior hospitals" and "where the hospital has preferential policies tilt for employees serving primarily for a long time'.Conclusion The awareness and satisfaction on precision health poverty alleviation policy of medical staff at the public county-level hospitals remains to be improved.From the hospital point of view,establishing close county-level rural health and poverty alleviation structure from the hospital and supportive policy of leader-member,innovating management mode,as well as providing preferential policies tilt for employees serving primarily for a long time are viable options for targeted and healthy poverty alleviation.

OBJECTIVETo establish a chiro chromatography for studying the stereoselective metabolism of propranolol (PL) in S(9) incubates prepared from transgenic cell lines expressing human cytochrome P450.

METHODSThe concentration of each enantiomer in S(9) incubates was determined through precolumn derivatization with GITC, followed by RP-HPLC assay using S-(+)-propafenone as internal standard.

RESULTSBaseline separations among the diastereomers of S(-)-P, internal standard and R(+)-PL were achieved on Shimpack CLC C(18)ODS column, with UV detection and methanol:water:glacial acetic acid (67/33/0.05,v/v/v) as mobile phase. The assay was simple, accurate, precise and specific. The linear range was from 5 to 500 micromol/L for each enantiomer. The limit of quantitation (LOQ) for the method was 5 micromol/L for the S(-)-and R(+)-PL, respectively (n=5, RSD<10%). The analytical method afforded average recoveries of 98.7 and 98.1% for S(-)- and R(+)-PL, respectively. The reproducibility of the assay was good (RSD<10%). The time-dependent studies showed that PL had the stereoselectivity of S-(-)-isomer in metabolism via CYP2C18 and the stereoselectivity of R-(+)-isomer in metabolism via CYP2C9.

CONCLUSIONThe method allows to study of stereoselective metabolism of PL in vitro.

Chromatography, High Pressure Liquid ; Cytochrome P-450 Enzyme System ; genetics ; physiology ; Humans ; Propranolol ; analysis ; metabolism ; Reproducibility of Results ; Stereoisomerism ; Transgenes

AIMTo study the mechanism of protective effect of GABA against hypoxic injury in rat hippocampal slices.

METHODSThe hippocampal slices from adult rats and extracellular recording technique were used to observe the effect of GABA on the evoked population spikes in rat hippocampal slices after hypoxia in vitro.

RESULTSGABA can significantly delay the disappearance of PV, but have no effect on PS. When the receptor antagonist of GABA (bicuculline) and the inhibitor of Cl- channel (NPPB) were given, the protect effect could be suppressed.

CONCLUSIONGABA increases hypoxic tolerance of hippocampal slices. The mechanism of the effect of GABA may be involved in the elevation of chloride influx through GABA receptor.

Animals ; Chloride Channels ; physiology ; Evoked Potentials ; Hippocampus ; physiopathology ; Hypoxia ; drug therapy ; physiopathology ; In Vitro Techniques ; Male ; Neuroprotective Agents ; therapeutic use ; Rats ; Rats, Wistar ; gamma-Aminobutyric Acid ; therapeutic use

OBJECTIVETo establish a more stable method to isolate osteocytes in vitro, and then to find the differences with osteoblast biological characteristics.

METHODSOsteocytes and osteoblasts were isolated from the bone tissue of 3-day-old rats using sequential collagenase digestion. The cells were identified through cell morphology after 24 hours later. Alkaline phosphatase (ALP) kit was used to stain the first generation cells by Kaplow-way, the bone gla protein (BGP) of the cells were stained by immunocytochemitry. Measured ALP and computed its activity.

RESULTSOsteocytes and osteoblasts showed obviously differences in cell morphology. Osteocytes were star-shaped or dendrite-shaped within more dendrites, while osteoblasts were spindle-shaped with short dendrites. Osteocytes were negative for ALP, but osteoblasts were positive; Osteocytes were more positive for BGP, and osteoblasts were less positive. The secretion of ALP in osteocytes was lower than that of osteoblasts.

CONCLUSIONOsteocytes can be isolated and cultured in vitro. These characteristics of osteocytes are apparently difference with those of osteoblasts.

Alkaline Phosphatase ; analysis ; Animals ; Cell Separation ; methods ; Osteoblasts ; chemistry ; cytology ; Osteocalcin ; analysis ; Osteocytes ; chemistry ; cytology ; Rats ; Rats, Sprague-Dawley

OBJECTIVE The aim of the study was to characterize the pharmacokinetics (PK) and pharmacodynamics (PD) profile of cisatracurium in 0-2 years and 2-5 years old children patients with cheilopalatognathus, to find if there are some connections between the different muscle relaxation action and different PK procedure . METHODS 14 children patients were divided into two groups, ≤2 years and 2-5 years group, venous samples were taken before injection of a 0.15 mg·kg- 1 dose of cisatracurium and then at 2, 5, 10, 30, 60, 90, and 120 min. Cisatracurium plasma concentrations were determined by ultra- performance liquid chromatography/electrospray ionization/triple quadrupole tandem mass spectrometer system (UPLC/MS/MS). The degree of neuromuscular block was measured by train of four (TOF) testing. An indirect PK-PD link model with a sigmoid Emax model was established using Win Nonlin software. The model were applied to PK and PD data analysis, respectively. RESULTS The TOF monitor parameters showed that cisatracurium works very quickly, the onset time were (2.64± 0.93) min and (2.59 ± 0.90) min for ≤2 years and 2- 5 years group respectively. Young children ≤2 years have longer muscle blocking duration time (62.5 ± 6.01 min vs 53.86 ± 12.18 min) and slower recovery index (32.14±7.10 min and 27.43±10.63 min) than those children in group of 2-5 years. More children ≤2 years have postoperative complication than that in 2-5 children. PK parameters showed that there were no statistical differences in blood concentration and pharmacokinetic parameters. While the concentration of cisatracurium in muscle site calculated by using PK/PD model were higher and longer for ≤2 year children than that of 2-5 year children. This means that cisatracurium could stay at high concentration for a longer time in younger children' muscle tissue. CONCLUSION As a result young children tend to have postoperative complications related to slower muscle recovery action and increased concentration in skeletal muscle. So more careful observation and monitor are needed for younger children, our study could be of use in clinical practice for the administration of cisatracurium to children patients.