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.

Objective To find out the state and characteristics of college students' mental health, and analyse the main factor affecting the mental health of college students. Methods This research investigated 1 350 college students sampled by random with the scale of Symptom Checklist 90(SCL-90), and compared the difference of mental health level between groups with the method of classifying comparison. Results The college students' total mean and factor score of SCL-90 were higher than those of youth norm in China, but 13.6% of college students had psychological problems worse than middle degree. After classifying comparison, the groups with higher score in SCL-90 total mean and factors were as follows: low grade, coming from single-parent family, having low degree of satisfaction with their specialty, feeling heavier stress in study, worse classmate relationship, not asking for help when having mental problem. Conclusion The factors which may affect the mental health level of college students are low grade, coming from single-parent family, having low degree of satisfaction with their specialty, feeling heavier stress in study, bad classmate relationship, and not asking for help when having mental problem.

Objective To set up an antibody-capture ELISA method to detect the Japanese encephalitis virus(JEV)antibody.Methods ELISA plate was coated with the monoclonal antibody which was specific to the envelope protein epitope E39 of JEV,JEV SA14-14-2 strain as the source of antigen was used to absorb the monoclonal antibody,the absorbed virus used to capture the JEV'S antibody.The antibody that captured ELISA was established.The indirect ELISA method using the virus particles from cell culture was compared with coating ELISA plate,105 clinical serum were checked.Results The background in indirect ELISA assay could not be abscised,positive and negative serum diluted in a ratio of 1:10,1:100,1:1000,the relative value of A posative/A negative were 1.02,0.99,1.13,all<2.1.But the antibody-captured ELISA method when the serum dilution was 1:10,1:100,the A posative/A negative were 3.57,2.94,all>2.1;when the dilution was 1:1000,the A posative/A negative was 1.42,<2.1,it meant the method could distinguish the positive and negative serum efficiently when the dilution Was 1:100,the background problem in indirect ELISA assay could be solved.Antibody-capture method was used to check 105 serum samples,the A posative/A negative over a range of 0.257～0.321(0.262±0.050),all<2.1,no positive sample found.Conclusion The antibody-capture ELISA method has been preliminary set up with a high specificity,capable of quickly identifying JEV from other virus.

1 mm); A, the screw tip was adjacent to the aorta (≤1 mm); C, the screw tip was felt to be against the aorta and creating contour deformity. The angle composed of the central line of the screw and the central line of vertebral body on posterior X-ray film was also measured. Results The average correction of the main thoracic curve was 77.7% postoperatively. 155 screws were inserted, of which 134 screws(86.5%) had a bicortical purchase. 123 screws(79.4%) were distant from the aorta. Two screws encroached into the spinal canal. There were no significant difference between the proximal screws, the periapical screws and the distal screws. There were no vascular or neurologic complications or instrumentation failure during operation or follow-up. Conclusion Mini-open anterior correction for type Lenke 1 scoliosis enable a satisfy bicortical screw placement and curve correction. Sequential CT scan before surgery may improve the accuracy of screw placement, thus avoid the aortic or neurologic complication.

[Objective] To evaluate the surgical techniques and its clinical results of CDH Legacy in the treatment of scoliosis.[Method]Nine patients(7 female and 2 male)with scoliosis instrumented with posterior CDH Legacy system were recruited for this retrospective study.The etiological classification of scoliosis were idiopathic for 7,congenital for 1,neurofibromatosis(NFl)for 1.The average age was 13.5 years(ranged 11～18 years).The average preoperative Cobb's angle was 54?(ranged 48?～68?).Seven AIS and one CS patients received one stage posterior CDH Legacy instrumentation;the NFl patients received one stage anterior epiphysiodesis and second stage posterior CDH Legacy instrumentation.[Result]There was no death,no infection and no neurological complication.No intra-operative fracture,no dura matter or pleuml laceration occurred.Superior Mesenteric Artery Syndrome occurred in one patients and recovered with conservative treatment.Posterior Cobb's angle averaged 20? with correction rate of 63%.The duration of follow-up averaged 23 months(ranged 20～30 months).Surgical time averaged 260 min(ranged 210～300 min)and mean EBL was 700 ml(300～1 000 ml).Bony fusions were achieved in all patients and no coronal or sagittal plane decompensation occurred.The loss of correction at last follow-up was 4? with 7.4% loss of correction rate.[Conclusion]The clinical results of CDH Legacy are as good as the other three generation implants,its advantage lies in lower profile,solid inter-locking,versatile implants and handy manipulation.

[Objective]To evaluate diagnostic and the therapeutic options of osteoid osteoma of the spine associated with scoliosis. [Methods]Nine patients with osteoid osteoma of the spine were treated from 1997 to 2006.All patients presented with spine deformity as their main complaint at the first consultation.The mean age was 15.2 years (range 8-21 years).Two patients had their osteoid osteoma in the thoracic area,2 in the thorcolumbar area ,and 5 in the lumbar area.Three were well controlled after long term administration of nonsteroidal anti-inflammatory drugs,and the other 6 were treated with en bloc excision.[Results]All the 6 patients with en bloc excision of the tumor were pain-free post-operatively.The scoliotic curve disappeared or was less than 15 degrees in 5,but the structural curve persisted in 4.[Conclusion]The spinal osteoid osteoma should be suspected when back pain or painful scoliosis occurs in adolescents.Computed tomography is necessary to evaluate the location and features of the lesion.En bloc excision of the tumor can be suggested if the symptoms are not well relieved with nonsteroidal anti-inflammatory drugs.

35? in 40. Risser sign was 0 in 38,Ⅰin 19,Ⅱin 13, and Ⅲ in 7. The standing AP X-ray films were obtained at intervals of 3 to 6 months. The Cobb's angle, the apical vertebral rotation and the Risser sign were measured at initial brace application and at the latest follow-up. Results With a follow-up of 24 to 60 months (mean, 30 months), 23 patients (29.9%) were judged as curve progression. Patients with double major curve were found to have the lowest percentage of curve progression, but there was no significant difference compared with other patterns of curves. The lower the Risser sign, the higher the initial brace correction rate and the percentage of curve progression. The difference of the initial brace correction rate was significant(P35?(P35?. 21 patients required surgical correction before completing bracing treatment because of curve progression, but in 13 of them, the surgical intervention was postponed about 12-20 months. Conclusion The Risser sign is a good predictor of bracing effect. Patients with double major curve have the lowest rate of treatment failure. The greater the amount of the Cobb's angle, the higher the percentage of curve progression. Bracing should be considered as successful if it can effectively reduce curve progression and postpone surgery.

Objective To compare the clinical outcomes of selective thoracic spinal fusion in adolescent idiopathic scoliosis using either iliac bone or autologous rib combined with allografts. Methods A retrospective study was made in 84 cases of idiopathic thoracic scoliosis, who were operated on with posterior instrumentation of CD, CDH or TSRH from 1999 to 2000. These patients were divided into two groups. In Group A, 34 patients, who were 12 to 20 years with a mean age of 14.5 years with a mean Cobb angle 56?(range, 40? to 82?), received autologous iliac bone grafting, and no thoracoplasty were performed. In group B 50 patients, who were 13 to 19 years with a mean age of 15.4 years with a mean Cobb angle of 54? (range, 38? to 80?), had allograft bone grafting combined with the ribs from thoracoplasty. The patients were followed up for at least 2 years with an average of 3.4 years regarding the clinical and radiographic outcomes. Results For group A, an average of 73.2% correction rate was achieved, and average 10% loss of correction and 3% of pseudoarthrosis was recorded at 2 year follow-up. The incidence of donor site morbidity was 26%, which included deep infection, hematoma, delayed healing of incision and continuous pain. For group B, an average of correction rate was 70.4% with 9% average loss of correction and 2% of pseudoarthrosis at 2 year follow-up. The complications related to thoracoplasty consisted of intraoperative tear of parietal pleural, pneumothorax, effusive pleuritis, and chest pain. Conclusion The clinical outcomes are comparable between the group of iliac bone grafing and the group of rib grafing associated with allografts in terms of fusion rate and loss of correction. If chose appropriately, allografts plus autologous rib harvested from thoracoplasty will be a good alternative to iliac crest regarding its safety, efficacy and reliability.

0.05). Conclusion Thoracoscopic anterior spinal release have comparable clinical results as conventional thoracotomic release for AIS patients.

Objective To determine the effectiveness and clinical result of intraoperative monitoring of compound muscle action potential (CMAP) in avoiding nerve root impingement during lumbar spine intrapedical instrumentation. Methods Twenty-five cases were given intraoperative stimulus-evoked electromyographic monitoring. After anode of stimulating electrode was placed at the Kirschner wire inside the passage of pedicle screws, the integrity of the pedicle cortex was tested by stimulating each screw head and recording compound action potentials of relevant muscles. Results Stimulation at an intensity of 16.2 mA evoked a compound muscle action potential in one case and that at over 35 mA did in four cases. No neurologic deficits were found in any case intraoperatively or postoperatively. Conclusions Stimulating intensity below 10 mA needs rearranging screw site. A stimulation intensity of 10-20 mA indicates X-ray inspection and visual inspection to exclude any pedicle breaches. Stimulation thresholds above 20 mA can be regarded as safe threshold to monitor the nerve root impingement. Intraoperative electromyographic monitoring provides a real-time watch-dog for monitoring spinal nerve root injury during posterior lumbar instrumentation.