Objective To explore the microsurgical techniques for total removal of the suprasellar cranio pharyngiomas via the pterional approach.Methods The clinical data of 28 patients with suprasellar craniopharyngio mas resected by the microsurgery was analyzed retrospectively.Results The tumors were total removed in 24 cases (86%)and subtotal resected in 4 cases(14%).The frequent postoperative complications are diabetes insipidus,hy perthermy,imbalance of water and electrolyte and lower level of hormone.Conclusion It is the key to get fine operation effect that removal sclerotin of base of skull as far as possible and releasing cerebrospinal fluid sufficiently,paying attention to protect the perforating branch and nourishing artery in each operative spaces.

This paper explored the educational reform of dispensing Chinese drugherbs. The education reform included implementing the project of teaching methods, implementing modern experimental methods, cultivating comprehensive quality of students, training students' creative thinking, and stimulating the initiative of students. All these strategies could improve the quality of teaching and make students' comprehensive abilities meet the demand.

Objective To evaluate the value of calcifications in the diagnosis of benign and malignant breast diseases. Methods In 270 female individuals,calcifications had been found in mammography and confirmed by pathology ,biopsy or followed-up. The characteristics of calcifications in benign and malignant breast diseases were analyzed and compared retrospectively. Results In mammography, significant difference characteristics exists in the characteristics of calcifications between the two kinds of breast diseases( P

Objective To study the application of multi-slice spiral CT(MSCT) portography in diagnonsis of pancreatic portal hypertension. Methods Forty-seven patients with lesion in body or tail of pancrease,47 normal subjects and 126 patients with portal hypertension underwent MSCT portography with LightSpeed 16 CT scanner. The inner diameter of portal system and the main collateral veins were measured in maximun intensity projection (MIP) image. The volume of liver and spleen were also measured in volume rendering (VR) image. The liver parenchyma and main portal vein enhancement in portal vein phase were also taken. The endoscopy examination was made in 57 patiens with portal hypertension. Results In 47 patiens with lesion in body or tail of pancreas , stenosis or occlusion of spleen vein were found in 38 patients(pancreatic portal hypertension in 27 patients, chronic and acute pancreatitis in 11 patients). In 38 patients with pancreatic portal hypertension, esophageal varices was found in 5 patients(13.2%), gastric fundus varix in 25 patients (65.8%), gastric body variees in 22 patients (57.9%), short-gastric vein/post-gastric vein(SGV/PGV) in 26 patients (68.4%), coronal gastric vein in 26 patients (68.4%),dilated gasto-omenta vein in 24 patients(63.2%), mesenterica varicesin 1 patient, splenic vein occlusion in 14 patients (36.8%), splenic vein stenosis in 23 patinets(63.2%). Conclusions The patients with pancreatic portal hypertension were demonstrate characteristic changes in MSCT portography. The MSCT portography is helpful in etiological diagnosis of pancreatic portal hypertension by supplying images in vessel morphology.

Objective To evaluate the effects of intrathecal TRESK gene recombinant adenovirus on inflammatory responses mediated by chemokine in the spinal cord of rats with neuropathic pain ( NP ) . Methods Thirty?six male Sprague?Dawley rats, weighing 200-250 g, were randomly divided into 6 groups (n=6 each) using a random number table: control group (group C); sham operation group (group S);NP group; TRESK?overexpressed adenovirus group ( group TRESK ); negative adenovirus group ( group Virus); normal saline group ( group NS) . Spinal nerve injury was produced by exposing the sciatic nerve and its branches and ligation and transection of tibial nerve and common fibular nerve in anesthetized rats. In TRESK, Virus and NS groups, pAd∕CMV∕V5?DEST?TRESK 25 μl (109IU∕ml), negative adenovirus 25 μl and normal saline 25 μl were intrathecally injected, respectively. At 1 day before operation ( base?line, T0 ) and 1, 3, 7 and 14 days after operation ( T1-4 ) , the mechanical paw withdrawal threshold ( MWT) and thermal paw withdrawal latency were measured. Six rats in each group were sacrificed after measurement of pain threshold at T3 . The L4,5 segments of the spinal cords were removed for determination of monocyte chemotactic protein?1 ( MCP?1) , MIP?2, tumor necrosis factor?alpha ( TNF?α) , interleukin?1 beta ( IL?1β) and IL?6 mRNA expression by real?time PCR. Results There was no significant difference in thermal paw withdrawal latency at each time point between groups. Compared with C and S groups, MWT at T1-4 in NP and TRESK groups and at T1-3 in Virus and NS groups were significantly decreased, and the expression of MCP?1, MIP?2, TNF?α, IL?1βand IL?6 mRNA was up?regulated in NP, TRESK, Virus and NS groups. Compared with group NP, MWT was significantly increased at T1-4, and the expres?sion of MCP?1, MIP?2, TNF?α, IL?1β and IL?6 mRNA was down?regulated in group TRESK. Conclusion The mechanism by which intrathecal TRESK gene recombinant adenovirus reduces NP is re?lated to inhibition of inflammatory responses mediated by chemokine in the spinal cord of rats.

Objective Discuss medical health integration continuance management mode in the prevention of elderly patients after discharge in bed household application effect of pressure ulcers. Methods To 120 cases of elderly patients in bed in hospital time order is divided into control group and experimental group,by the medical health outreach group respectively in the hospital two days before the assessment of patients and family rehabilitation plan,the control group given conventional discharge and telephone follow-up after discharge,the experimental group according to the medical health integration management mode,made up of medical health outreach team to stay in bed for elderly patients after discharge pressure ulcer risk factors assessment,targeted prevention of pressure sores rehabilitation plan,group management,remote care joint family supervision,timely follow up the capa and the exami-nation of the effect,the pressure ulcer management and quality of life scale to compare two groups of patients at discharge,6 months after hospital discharge,the quality of life of 12 months after discharge and the incidence of pressure ulcers in a year. Results The experimental group was lower than those of control group,the incidence of pressure ulcers was statistically significant difference(P<0.05); 6 months and 12 months after discharge physiological field,psychological field in the quality of life score were higher than control group,the difference was statistically significant(P<0.05); Score compared two groups of environmental and social sciences has no statistical significance (P>0.05). Conclusion Medical health integration continuance management can effectively reduce the incidence of pressure ulcers that occupy the home stay in bed for elderly patients,improve their quality of life.

ObjectiveTo study the effects of group BStreptococcus (GBS) colonization in late pregnancies on neonatal GBS infection.MethodsA total of 17 019 pregnant women who received antenatal care and delivered in Xiamen Maternal and Child Care Hospital from June 1, 2014 to May 31, 2015 were enrolled in this study. Secretions from the lower third of the vagina in the pregnant women at 35-37 weeks of gestation or having premature baby(regardless of gestational age) were obtained to test GBS by standard bacterial culture, and 1 472 cases underwent GBS DNA test by real-time fluorescent quantitative-polymerase chain reaction (PCR) meanwhile. The pregnant women colonized with GBS (GBS culture and/or PCR DNA test positive) were given intrapartum antibiotic prophylaxis (IAP) during parturition or rupture of fetal membranes. Detection rate of the two methods was compared, and the effects of GBS colonization and IAP on neonatal GBS infection were analyzed to identify the risk factors of neonatal early-onset GBS disease (GBS-EOD). Two independent samplest-test,Chi-square test and Logistic regression analysis were used for statistical analysis. ResultsThe detection rate of GBS culture and PCR DNA test was 14.43% (2 456/17 019) and 14.13%(288/1 472), respectively. The total colonization rate was 14.52%(2 472/17 019). Based on the culture results as golden criteria, the sensitivity, specificity, positive predictive value and negative predictive value of PCR assay were 95.05%, 98.74%, 92.31% and 99.21%, respectively. There were 17 332 deliveries from the 17 019 pregnant women, of which 31 cases had GBS-EOD. The incidence of neonatal GBS-EOD in maternal GBS colonization [1.05%(26/2 472)] was 31 times higher than in pregnant women without GBS colonization [0.34‰(5/14 547)]. Among the 31 infants with GBS-EOD, 24 had pneumonia, five had sepsis, and two had meningitis. The case fatality rate was 6.45%(2/31). Logistic regression analysis found that chorioamnionitis was an independent risk factor of neonatal GBS-EOD (OR=40.425, 95%CI: 7.514-379.782,P=0.000). Compared with the non-IAP group,IAP group had a lower incidence of GBS-EOD among the pregnant women colonized with GBS [0.94%(23/2 443) vs 10.34%(3/29),χ2=24.350,P<0.01].ConclusionsGBS colonization in late pregnant women has adverse effects. Therefore, routine maternal rectovaginal culture of GBS may be necessary and IAP should be applied in those with GBS colonization.

ObjectiveTo measure the expression of divalent metal transporter 1 (DMT1) in hepatocellular carcinoma (HCC) and to explore its clinical and pathological significance. MethodsFifty-seven liver cancer specimens collected from patients with HCC and preserved in paraffin in Second Affiliated Hospital of Shantou University Medical College from July 1999 to July 2011 were established as HCC tissue group, and 7 specimens of normal liver tissues from autopsy and 8 specimens of liver tissues from patients with intrahepatic bile duct stones and preserved in paraffin were established as normal control group. SP immunohistochemistry was applied to measure the expression of DMT1 in 15 specimens of normal liver tissues and 57 specimens of HCC tissues. One-way analysis of variance was applied to analyze the difference in expression of DMT1 in HCC tissues with varying degrees of differentiation, and χ2 test was applied for the comparison of rates; the correlation between expression of DMT1 and tumor size was analyzed by Pearson correlation analysis. ResultsDMT1 in the liver tissues in normal control group was negative or weakly positive, with a positive rate of 20% (3/5); in HCC tissue group, the positive rate was 789% (45/57), with a strong positive rate of 15.8% (9/57); the two groups showed a significant difference in positive rate (P＜0.05). The expression of DMT1 varied significantly between patients with varying degrees of differentiation in HCC tissues (F=4.011, P＜0.05), while the positive rate of DMT1 showed no significant differences between patients with different clinical stages and with or without blood vessel infiltration (all P＞0.05). Correlation analysis did not find the correlation between expression of DMT1 and tumor size (r=-0.047, P＞005). ConclusionThe positive expression rate of DMT1 increases significantly in HCC tissues and is closely related to the degree of tumor differentiation, which is potentially valuable for clinical and pathological grading of liver cancer.

Objective To explore the clinical value of monitoring intra-abdominal pressure ( IAP) in the monitoring and treatment of patients with severe acute pancreatitis .Methods The changes of IAP in 82 patients with severe acute pancreatitis in the intensive care unit were dynamically monitored , and the effects of the increased IAP on respiratory , hemodynamic , kidney function and so on were analyzed , and the early intervention was carried out .Results No differences were found in the changes of heart rate , blood pressure , peripheral blood oxygen saturation , respiratory before and after the first measurements of IAP in 82 patients(P>0.05).The CVR, HR, oxygenation index, MAP and IAP in 54 patients with increased IAP were respectively (17 ±5) cmH2O, (132 ±18) beats/min, (240 ±60), (45 ±12) mmHg and (22 ±8) mmHg before the intervention, and were (13 ±4) cmH2O, (118 ±12) beats/min, (320 ±80), (65 ±8) mmHg and (12 ± 6) mmHg after the intervention, and the differences were statistically significant ( t =4.59, 5.58, 5.88, 10.19, 7.35, respectively;P<0.01).Conclusions The increased IAP correlates closely with the condition and prognosis of patients with severe acute pancreatitis .The routine IAP monitoring for patients with severe acute pancreatitis is helpful to the evaluation of condition and prognosis , and is also helpful to take timely and effective treatment and nursing , and can prevent the occurrence and development of abdominal compartment syndrome and assist the judgment of operation time for severe acute pancreatitis .

Type D personality plays an important role in the occurrence and development of coronary heart disease. This review interpreted the relationship and mechanism between type D personality and coronary heart disease and confirmed that the type D personality was an important risk factor for coronary heart disease. It benefits to early screening of personality in coronary heart disease patients and provides more specifically clinical treatment and nursing interventions for coronary heart disease patients, thus moves forward the check point of prevention and treatment for coronary heart disease.