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.

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 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.

Objective To summarize the experience on treatment of esophageal leiomyoma and mesenchymoma with video-assisted thoracoscope under the assistance of a fiber gastroscope.Methods The clinical data of 14 cases of esophageal leiomyoma and 2 cases of esophageal mesenchymoma treated with video-assisted thoracoscope under the assistance of fiber gastroscope from October 2004 to December 2009 was retrospectively analyzed.Selected different surgical path and operation hole position according to the lesion site.Fiber gastroscope was conductive to accurately find lesion positions,and detected esophageal mucosa was breaked or not.Extra-mucosal excision was conducted in 16 cases.Results Ihere was no death and severe complications during perioperative period.Patients were diagnosed by pathological examination.Thirteen cases were followed up for 6-48(18.5 ±9.5)months,all patients ate unobstructed,and without relapse.Conclusion Treatment of esophageal leiomyoma and mesenchymoma with video-assisted thoracoscope under the assistance of fiber gastroscope has the advantages of intraoperative accurate positioning,minimally invasive,thoroughly,fewer complications,and it is the first choice of esophageal benign tumor treatment.

[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.

0.1), the results suggested that the stiffness of resistant torque of ITBW was similar to that of CW. In the bending test, in order to give rise to the fragmental displacement of 2.30? induced by bending load, the bending force of 3.3Nm was needed in ITBW fixation, and was 1.9 Nm greater than CW fixation, so stiffness resistant to bending of ITBW was 2.3 times of that of CW. The patients were followed up from 6 to 78 months, with an average of 38 months. There were no complications of nerve and vessels injury, infection and wire or nails loosening. Varus elbow happened in 2 cases, the mean varus angel was less than 5?. 2 cases and All the cases treated with ITBW healed uneventfully with good functions, there were excellent 32 cases and good 12 cases according to the Flynn evaluation system. Conclusion The fixation effect of ITBW is much better than that of CW. The stability provided by ITBW makes external fixation unnecessary and allows for early mobilization of the elbow. The ITBW technique is in satisfactory agreement with biomechanical principle. It is valuable for widely clinical application.

Objective To analyse the diagnosis and treatment of the single tubular type of diastematomyelia. Methods Clinical scoring and posterior tibial nerve cortical somatosensory evoked potential (PTNCSEP) were performed in 23 cases to define surgical indications and investigate the results of treatment. Results Seven cases without clinical symptoms and 11 cases without progressive neural deficit showed no significant change in terms of clinical scoring and PTNCSEP P40 latent period; while other 5 cases with progressive neural deficit improved after the surgical intervention, and operative findings confirmed that there were fibrous septum or band and other malformations. Conclusion Patients with progressive neural deficit need surgical intervention while those without progressive neural deficit and clinical symptoms only need conservative treatment and routine follow-up.

Objective To evaluate the clinical manifestation and the treatment strategy of the scoliosis associated with Chiari malformation and /or syringomyelia. Methods Fifty-two cases suffered from scoliosis with Chiari malformation and /or syringomyelia were divided into three groups for surgical treatment: 1) Group 1: 18 cases had scoliosis with Chiari Ⅰmalformation and /or syringomyelia without obvious neurologic impairment, their scoliosis was corrected with posterior instrumentation, but their Chiari Ⅰmalformation and syringomyelia were left untreated surgically. 2) Group 2: 12 patients, whose scoliosis was not indicated for surgery but those Chiari malformation associated with syringomyelia, underwent posterior sub-occipital craniectomy to enlarge foramen occipital magnum, C1 posterior arch decompression, duraplasty and syrinx-subarachnoid space shunting no matter whether neurologic deficits were present or not. 3) Group 3: 22 cases in addition of correction of scoliosis, due to neurologic deficits caused by Chiari Ⅰmalformation or syringomyelia, two-stage surgery was indicated: firstly, with posterior suboccipital craniectomy to enlarge foramen occipital magnum, C1 posterior arch decompression, duraplasty and syrinx-subarachnoid space shunting 6 months later, then underwent the scoliosis correction with instrumentation. Results In 34 patients who underwent craniovertebral decompression, only 6 of the 24 cases with preoperatively neurologic deficits achieved mild improvement within 6 months postoperatively. In 40 patients who were treated with posterior correction for scoliosis, the average frontal correction was 63% and the average sagittal correction was 80% for scoliosis less than 90?, the average frontal correction was 49% and the average sagittal correction was 74% for scoliosis more than 90?. At a follow-up of 6 months to 5 years, the average loss of the frontal correction was 6%. Conclusion Scoliosis associated with Chiari malformation and /or syringomyelia can be effectively treated with the similar results, as for adolescent idiopathic scoliosis. The mainstay for diagnosis is MR imaging. Accurate diagnosis and proper treatment for Chiari malformation or syringomyelia before scoliosis surgery will improve the rate of scoliosis correction, decrease the neurological complications.

Objective To evaluate the biomechanical basis and long term clinical outcome of the offset hook-screw combined instrumentation in preventing against correction loss after it is used to treat the unstable thoracolumbar fractures. Methods Of 98 cases treated with the offset hook-screw combined instrumentation from July 1997 to December 2002, 64 with follow-up over two years were reviewed. All 64 cases received operation within average 3.2 days after injury, of which 41 were fixated with CD or CD-Horizon instrumentation and 23 with TSRH instrumentation. The long term clinical outcome evaluation included the maintenance of the vertebral height restoration, the sagittal kyphotic Cobb angle loss and the coronal Cobb angle correction loss. Results No death occurred. But after operation, there was one case with worsened neurological deficits (recovered one week after surgery) and two with deep infection. The average post-operative vertebral height and the coronal Cobb angle were restored by 89.0% and 100.0% respectively and the sagittal kyphotic Cobb angle corrected from preoperative 31?to postoperative -1? . During the follow-up for 24-62 months, no instrumentation breakage occurred. The pseudoarthrosis was affirmed in one case and suspected in two with the vertebral height loss of 8.6% and the kyphotic Cobb angle correction loss of 4?respectively. Conclusions The offset hook-screw combined instrumentation can satisfactorily restore the normal sagittal profile, effectively prevent the fixation loosening or breakage, minimize the mechanical failure of instrumentation, and particularly reduce the loss of long-term correction.