Objective To explore clinical and neuroimagine features, as well as the management of rare ectopic pituitary adenoma in clivus. Methods We reported two cases of ectopic pituitary adenoma verified by histology in the clivus region, reviewed the relevant literature briefly, summarized the clinical and neuroimaging features, along with the management of ectopic pituitary adenoma in clivus. Results Ectopic pituitary adenoma in clivus caused symptoms of endocrinopathy and/or neurological dysfunction. Imaging studies showed an occupying lesion in the clivus. Pituitary adenoma was diagnosed in one patient preoperatively, the other was diagnosed as chordoma. The tumors were microsurgically removed through the trans-sphenoidal route. Tumor was radically removed in one patient, and during one-year follow-up, there was no recurrence. The other was partially resected, and suffered postoperative cerebrospinal fluid rhinorrhea and intracranial infection, follow-up of this patient lost finally. Conclusions The patients with ectopic pituitary adenoma in clivus have endocrinopathy or/and neurological dysfunction, and MRI plays a valuable role in the diagnosis. Although extremly rare, ectopic pituitary tumour needs to be considered in case of an occupying lesion in the clivus. Radical resection of tumor can cure the patient.

ObjectiveTo study the significance of the non-invasive hemodynamic monitor system in the differential diagnosis of severe acute pancreatitis (SAP) combined with pulmonary edema. Methods Twenty-nine cases of SAP during fluid resuscitation treatment combined with pulmonary edema were reviewed and the data of the non-invasive hemodynamic monitor system was analysed and summarized.According to the diagnosis on discharge, 18 patients were enrolled in test group (noncardiogenic pulmonary edema group) and 11 patients were enrolled in control group(cardiogenic pulmonary edema group). The data of two groups were determined and compared. ResultsIn control group, cardiac output[(3.34±1.09) L/min], cardiac index [(2.06 ± 0.46) L/ (min·m2)], stroke volume [(41.89 ± 13.72) ml], stroke index[(25.59 ± 7.32) ml/m2], accelerate cardiac index [(59.24 ± 28.41) L/100 s2], left cardiac work index [(2.09 ± 0.67) (kg·m)/m2], left ventricular ejection time[(254.32 ± 27.34) ms], ejection fraction (0.37 ±0.03) and velocity index [(27.11 ± 11.32) L/100 s] were all significantly lower than those in test group [(4.12 ± 1.06) L/min, (2.64 ± 0.48) L/ (min·m2), (46.21 ± 11.81) ml, (28.87 ± 5.32) ml/m2, (79.43 ±29.01) L/100 s2, (3.21 ± 0.84)(kg·m)/m2, (281.29 ± 29.11) ms,0.54 ±0.04, (39.34 ± 12.11) L/100 s,respectively] (P < 0.01); pre-ejectionphase [(116.54 ± 22.37) ms] and systolic time ratio (0.48 ± 0.04) were significantly higher than those in test group[(95.24 ± 21.41) ms,0.36 ± 0.02,respectively] (P < 0.01 or <0.05). ConclusionNon-invasive hemodynamic monitor system is helpful in the early differential diagnosis of SAP combined with pulmonary edema.

Abnormalities, Multiple ; genetics ; metabolism ; pathology ; surgery ; Actins ; metabolism ; Adolescent ; Chromosome Inversion ; Chromosomes, Human, Y ; Diagnosis, Differential ; Disorders of Sex Development ; genetics ; pathology ; Humans ; Hypospadias ; pathology ; surgery ; Male ; Mullerian Ducts ; abnormalities ; metabolism ; pathology ; surgery ; Neprilysin ; metabolism ; Proto-Oncogene Proteins c-bcl-2 ; metabolism ; Receptors, Estrogen ; metabolism ; Receptors, Progesterone ; metabolism ; Syndrome

Child ; Child, Preschool ; Craniocerebral Trauma ; etiology ; surgery ; Female ; Humans ; Male

Humans ; Rhinitis, Allergic, Perennial ; Rhinitis, Allergic, Seasonal

OBJECTIVETo observe the clinical effect of Sizhi-Xifang in the improvement of postoperative ankle function.

METHODSFrom Jan. 2006 to Mar. 2008,49 patients were divided randomly into treatment group and control group. The treatment group included 16 males and 8 females with an average age of (41.3 +/- 13.2) years, involving 13 cases of tye A, 9 of type B and 2 of type C based on AO classification. The control group included 15 males and 10 females with an average age of (38.2 +/- 10.9) years, involving 12 cases of type A, 10 of type B, 3 of type C. Minimal invasive percutaneous plate were used in each group. In treatment group 24 cases were treated with Sizhi-Xifang after the incisions were healed.

RESULTSThere were no incision infections, flaps necrosis, bone and plate exposure after treatment in two groups. All patients were followed-up for 4 to 16 months with an average of 8.6 months. According to Johner-Wruhs evaluation standard, there were 7 cases in excellent, 12 good, 5 in fair in treatment group and in control group there were 5 cases in excellent, 7 in good, 10 in fair and 3 in poor. The comparison of effect between two groups had significant difference (P < 0.05).

CONCLUSIONSizhi-Xifang is helpful to improve the ankle postoperative function.

Adolescent ; Adult ; Aged ; Ankle ; physiopathology ; Bone Plates ; Female ; Humans ; Male ; Middle Aged ; Minimally Invasive Surgical Procedures ; methods ; Recovery of Function ; Skin ; Tibial Fractures ; physiopathology ; surgery ; therapy ; Treatment Outcome ; Young Adult

Aim To evaluate the reversal effect of 2-deoxy-D-glucose ( 2-DG ) on multidrug resistance ( MDR) by observing the uptake change of 99m Tc-MIBI in HNE-1/DDP cells, and to explore its mechanism. Methods The uptake of 99m Tc-MIBI in HNE-1/DDP cells under different concentrations of 2-DG was detec-ted by γ-counter, and the clearance rates of 99m Tc-MI-BI in HNE-1 cells and HNE-1/DDP cells after treated with 2-DG (10 mmol·L-1 ) were compared. The con-tent of ATP in HNE-1/DDP cells was detected after treated with 2-DG. P-glycoprotein ( P-gp ) and multi-drug resistance-associated proteins ( MRP ) expression were measured by Western blot. Apoptotic HNE-1/DDP cells treated with DDP alone or combined with 2-DG (10 mmol·L-1 ) were detected by propidium io-dide ( PI ) staining. Results The clearance rate of 99m Tc-MIBI in HNE-1/DDP cells was 54. 8%, which was significantly higher than that ( - 41. 3%) in HNE-1 cells (P<0. 01). The clearance rate of 99mTc-MIBI in HNE-1/DDP cells was -203. 7% after treat-ment with 2-DG ( 10 mmol · L-1 ) , which could be significantly reduced compared with the control group ( P<0. 01 ) . The level of ATP was 55 . 69% compared with the negative control group and the expression of P-gp and MRP protein decreased dramatically in HNE-1/DDP. With the combination of 2-DG and DDP, the ap-optotic rate of HNE-1/DDP cells reached 49 . 4%which was significantly higher than DDP treated group (22. 5%) . Conclusion Multidrug resistance and the reversal effect of 2-DG on multidrug resistance could be evaluated effectively by detecting the uptake change of 99m Tc-MIBI in HNE-1/DDP cells. The mechanism may be related with the inhibition of ATP level and the re-duced expression of P-gp and MRP protein in cancer cells.

BACKGROUND: Recently emerged immunosuppressive scheme combined with basiliximab following liver transplantation, such as the early steroid withdrawal or half amount of steroid. Many studies demonstrated that it would not increase the rejection rate in reducing the use of steroid. However, there were rare reports addressing whether it was safe and effective to replace the steroid by basiliximab. OBJECTIVE: Through the application of non-steroid and early steroid withdrawal immunosuppressive scheme in patients of hepatocellular carcinoma following liver transplantation, to evaluate the therapeutic effect and safety of two treatments. METHODS: A total of 80 patients of hepatocellular carcinoma receiving liver transplantation were divided into the experimental and control group. In the experimental group, 33 patients were applied with non-steroid treatment (Tacrolimus+mycophenolate mofetil+basiliximab); additionally 47 patients were applied with early steroid withdrawal treatment (Tacrolimus+mycophenolate mofetil+ steroid). Steroid was reduced gradually from the first day after transplantation to discontinuation after 1 month. The rates of rejection, infection, cancer recurrence and 1 -year survival were measured. RESULTS AND CONCLUSION: Compared to the control group, the rates of infection and cancer recurrence were significantly smaller in the experimental group (P < 0.05). However, there was no significantly difference between 2 groups in the rates of rejection and 1 -year survival (P > 0.05). It revealed that the non-steroid treatment can be safely and effectively applied in the patients with hepatocellular carcinoma following liver transplantation. The non-steroid treatment can significantly cut down the infection rate and cancer recurrence rate, which has no effect on the rejection and 1 -year survival rate.

Objective To study the function of Fkbp51 in the heart and liver by analyzing the differential RNA expression profiles in the wild-type mice (WT) and Fkbp51 knockout (KO) mice, and to elucidate the role of Fkbp51 gene in metabolic pathways in the heart and liver.Methods Using the second generation of high-throughput gene sequencing technology, the mRNA expression profiles of heart and liver were sequenced in WT and Fkbp51 KO mice.The data of sequencing of heart tissues were analyzed by DEGseq, and the results of sequencing of liver tissues were analyzed by BRB-Array Tools.The differential genes of the heart and liver in the mice were screened respectively.Gene ontology (GO) analysis and KEGG pathway analysis were performed to analyze the differentially expressed genes using the online tool DAVID.In addition, the differential genes of the two organ tissues were analyzed by Venn diagram.The interaction network of proteins was analyzed using the STRING database.Results (1) The absence of Fkbp51 led to changes in mRNA expressions of heart-related signal pathways such as vascular smooth muscle contraction, chemokine, retinol, and MAPK signaling pathways.(2) The lack of Fkbp51 mostly induced changes in cholesterol synthesis and metabolism, lipid metabolism, redox and other related genes and pathways in the liver.(3) In the heart and liver, Fkbp51 deletionresult ed in four co-differential genes, among them, down-regulation of Rnaset2b, Hmga1 and Fkbp51, while Cyp2b10 was down-regulated in the heart but up-regulated in the liver.All these proteins may interact with HSP90 protein and participat in the metabolism of heart and liver tissues.Conclusions Fkbp51 is involved in different metabolic and gene expression regulation pathways of heart and liver, and the roles are both independent and interrelated.

Objective To study the value of lung window and soft tissue window in measuring colon diseases with experimental CTVC examination.Methods Twenty-four artificial polypoid diseases were placed with glue in a thoroughly cleaned porcine colon(overall length,150 era)that was distented with air and submerged in a water phantom and scanned 10 times on a 64-MSCT(GE Light speed)with identical scanning parameters.The data were reconstructed every 0.625 mm and reviewed using 2D images, navigation,MPR and 3D volume-rendered images on a GE AW 4.2 workstation.The maximum diameters of the artificial polypoids were measured by two radiologists with more than 10 years working experience in lung window(W = 1000,L =-700)and soft tissue window(W =400,L =40),respectively.The average value of maximum diameters of the artificial polypoids were measured for 10 times and were compared with the actual diameter.Results Twenty-four artificial polypoid diseases and their shape,size,loeation and relation of diseases with bowel wall were all showed excellently.The maximum diameter measured was close to the actual diameter.The average value was mostly less than actual diameter and a few of them more than the actual diameter.The maximum diameter measured in lung window was close to the actual diameter,and there was no difference between the two data sets(t =0.431,P =0.669).There was difference between the maximum diameter measured in soft tissue window and the virtual diameter(t = 2.691,P = 0.010). Conclusion In screening the colon diseases,CTVC is a good method of choice with no insult or less insult, and higher repeatability.The lung window should be chosen in measuring colon diseases in CTVC examination.