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.

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 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.

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 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.

Objective To investigate the pubertal growth patterns and anthropometric characteristics of the patients with adolescent idiopathic scoliosis(AIS) by anthropometry measurements. Methods The anthropometric data of 256 AIS girls were collected. The mean age of diagnosis was 14.1 years old(from 12 to 16 years old). The children with more than 10 degree of the scoliosis angle at coronal level were diagnozed as AIS. The control group consisted of 462 age-matched health girls. Four variables were measured: height, sitting height, arm span and menstrual states. Height and sitting height were adjusted using Bjure formula to make up the height loss from spinal deformity. The above variables were analyzed between AIS group and the controls. Results There were no differences in the composition of age between two groups. There were no significant differences in height,sitting height and arm span between the 256 cases of AIS girls and the 462 controls. However, the corrected height and sitting height were significantly higher in AIS than those of the controls. The menstrual onset time was earlier in AIS than that in controls. There were no statistical differences in corrected height, corrected sitting height and arm span between AIS girls and the controls at the age group of 12 years old. On the contrary, the AIS girls showed shorter uncorrected height than the controls did at this age. However, the scoliotic girls were found in the corrected height, the corrected sitting height and the arm span significantly taller than the controls between ages of 13 and 15 years. There were significant differences in corrected height and corrected sitting height between AIS girls and the controls at the age of 16 years old, while no difference were found in the variables of height, sitting height and arm span. Conclusion There is an abnormal growth pattern in AIS during pubertal growth spurt, which may be related to the pathogenesis of AIS.

[Objective]To investigate the value of intra-operative somatosensory-evoked potential monitoring in surgery for thoracic spinal stenosis.[Method]Twenty-two patients with thoracic spinal stenosis underwent decompressive laminectomy surgery.The preoperative and intraoperative SPEs were recorded.The SEPs were analyzed with three indices:(1)SEPs wave pattern;(2)P40 latency;(3)P40-N50 amplitude.More than 50% decrease in SEPs amplitudes or more than 10% increase in latency was considered to be the warning threshold.[Result]Cases were classified into four groups according to preoperative SPEs wave pattern.Type Ⅰ inclued 2 cases whose SEPs monitoring had least meaning,and the spinal cord function remained unchanged postoperatively.4 cases with Type Ⅱ and the SEPs wave pattern were too unreliable to make analysis.Eleven cases in Type Ⅲ showed significant changes on SEPs,and most patients felt relief of symptom a week later.Type IV with 5 cases showed normal SEPs and all of them got well restored neurological function.[Conclusion]SEPs has good correlation with clinical outcomes.Its sensitivity,instant response and quantitative analysis make SEPs with great effectiveness in intraoperative monitoring on surgery of thoracic spinal stenosis.

[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.