Objective To study the significance of trans-sphenoid approach microsurgery in the management of pituitary adenomas. Methods Clinical data of 22 cases of pituitary adenomas treated by trans-sphenoid approach microsurgery in this hospital from January 1990 to December 2001 were analyzed retrospectively. Results The total resection rate was 68.2% (15/22). Follow- up in 17 cases for 1～13 years showed that different degree of improvement was achieved in the 12 cases of impairment in vision or visual field,but no recovery was obtained in the 5 cases of blindness. Conclusions Trans-sphenoid approach microsurgery is a minimally invasive, safe and effective method for the treatment of pituitary adenomas.

Objective:To describe the clinical characteristics , overall survival as well as to evaluate the prognostic factors in Chinese diffuse large B cell lymphoma ( DLBCL) patients.Methods: DLBCL pa-tients who were initially diagnosed and treated in Peking University Cancer Hospital from January 1995 to December 2008 were identified and analyzed ,retrospectively .The 5-year OS rates were estimated with Ka-plan-Meier.Log-rank test was used to compare the survival curves of the different groups .The multivari-ate analysis of prognostic factors was conducted with Cox regression model , which included all statistically significant prognostic factors in the univariate analyses .Results:A total of 525 DLBCL patients were in-cluded in this retrospective analysis , of whom , 294 were male and 231 female ( male∶female=1 .27∶1 ) . The median age at the initial diagnosis was 55 (range 16-90) years, and 37.0% (n=194) were 60 years and above .Regarding the clinical staging at the initial diagnosis , 54 patients (10.3%) were diag-nosed as Stage Ⅰ of the disease, 152 (28.9%) as Stage Ⅱ, 117 (22.3%) as Stage Ⅲ and 202 (38.5%) as Stage Ⅳ.The ‘B symptoms’ and increased serum LDH were presented in 206 (39.2%) and 192 (36.6%) patients, respectively.A total of 197 (37.5%) patients were treated with rituximab (R).The survival follow-up continued till 31 January 2014 with a median follow-up time of 77.5 ( range:0-205) months.A total of 267 patients (50.9%) died during the follow-up period.The medi-al overall survival ( OS) time was 84 months, and 5-year OS rate was 52.3%.There were six statistically significant prognostic factors that were identified in both univariate and multivariate analyses : gender, Ann Arbor stage, B symptom, serum LDH, age at initial diagnosis and rituximab treatment .The relative risk ( RR) of these prognostic factors in the multivariate analyses were: age >60 years /≤60 years=1.380 (95%CI 1.078 -1.765), male /female =1.315 (95%CI 1.025 -1.687), stage Ⅲ/stageⅠ=3.034(95%CI 1.667-5.522), stage Ⅳ/Ⅰ=3.748(95%CI 2.102 -6.681), with B symp-toms/without B symptoms=1.278(95%CI 0.999-1.636),serum LDH increased/LDH not increased=1.351(95%CI 1.057 -1.726), without R treatment /with R treatment =1.543(95%CI 1.182 -2 .015 ) .Compared with the IPI , age >50 years/≤50 years was a statistically significant factor in both univariate and multivariate analyses RR =1.478 (95%CI 1.148-1.902), P=0.002.Conclusion:Six factors were related to DLBCL survival:gender, Ann Arbor stage, B symptom, serum LDH, age at initial diagnosis and rituximab treatment .Compared with the IPI , several specific factors may predict a poor prognosis in Chinese DLBCL patients:male , age>50 years and the presence of ‘B symptoms ’ .But this result is not conclusive until these factors are further tested .

Objective To screen the peripheral blood circRNA differently expressed in patients with rheumatoid arthritis (RA) and to explore the pathogenetic role of peripheral blood cicRNA in RA by analyzing the data with bioinformatics.Methods The study was performed in 3 RA cases and 3 healthy controls,using circRNA microarrays to screen the circRNA in peripheral blood of patients with RA.The data were normalized and analyzed by R soft package,screening by fold change and P value and searching the differently expressed circRNAs between the two samples by t test.Bioinformatics was performed to analyze the differently expressed circRNAs.Results The results from circRNA microarrays revealed that 36 circRNAs were significantly al-tered in RA patients (P ＜0.05) compared with the control group.Among them,22 were significantly up-regulated,and the other 14 were down-regulated.The GO analysis of the genes involved in the circRNA showed that these genes participated in the progress of biological regulation,cell differentiation,and metabolism.We predicted the target miRNA of all the differently expressed circRNAs,among the results there was a miRNA (hsa-miR-125a-3p) targeted by a circRNA(hsa_circ_0005397) experimentally confirmed by other studies.The relationships among circRNA-miRNA-Gene were predicted by Cytoscape software.Conclusion There are many differently expressed cireRNAs in peripheral blood of patients with RA,and the circRNAs maybe involved in the regulatory mechanisms of Rheumatoid Arthritis.

Objective To examine the impact of person-organization fit ( P-O fit) on turnover intention of medical staff and examine the mediating role of job involvement between P-O fit and turnover intention of medical staff.Methods The basic research hypothesis was obtained by combing the relationship among three variables of P-O fit, job involvement and turnover intention of medical staff. A questionnaire survey was conducted among 408 medical staff at 9 general public hospitals in the Pearl River Delta from July to August 2018. The contents of survey were as follows: the match between such factors as medical staff values, culture, personal ability and hospital, as well as turnover intention and job involvement of medical staff.The structural equation model was constructed by Amos 20.0, and the relationship between variables was analyzed.Results The path coefficients between the three variables were 0.436(P<0.001),-0.281 (P<0.05),-0.544(P<0.001), respectively.The total effect value and intermediate effect value were-0.470,- 0.082, respectively. P-O fit was positively related to job involvement. P-O fit and job involvement were negatively related to turnover intention of medical staff.Job involvement partially mediated the relationship between P-O fit and turnover intention. Conclusions In order to reduce the turnover intention of medical staff, hospitals must pay attention to the match of values, culture and personal ability between medical staff and hospitals, establish a match evaluation mechanism between medical staff and hospitals, create good working conditions and atmosphere for medical staff, and encourage medical staff to work harder.