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 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.

Objective To investigate the clinical outcome of intermittent distracting rod for the correction of juvenile scoliosis, and analyze its complications. Methods Between July 1997 through June 2002, 21 patients with scoliosis underwent posterior growing-rod instrumentation, with their age ranged from 6 to 11 years. Risser sign was 0 in all patients. Average curve magnitude was 78 degrees (62 to 94 degrees) before initial instrumentation. A pair of claw-type hooks were inserted at the upper and lower levels respectively, one rod was attached to the upper hooks and the other to the lower hooks. These two rods were allowed to overlap and were connected with a growth connector. Distraction was achieved by means of lengthening the two rods at the connector site. Repetition of lengthening was indicated by the curve deterioration larger than 15 degrees or the interval of 10 to 12 months after the previous operation. After each operation, a Milwaukee brace was worn for external support. Results The initial intraoperative correction averaged 40 degrees, but this decreased to 23 degrees of correction on average at every subsequent lengthening. The total distraction procedure of 4 times only achieved in 5 patients. The reasons for distraction ceasing were as follows: hook dislodgment in 3 patients, looseness of pedicle screw in 2, looseness of dominos connector in 2, wound infection in 1, spontaneous fusion in 2, and insufficient financial support in 6. Conclusion Curve response to correction tends to decline with consecutive distractions. A high rate of complications has been noted during the distraction procedure. The single distracting rod technique is not suitable for the correction of severe scoliosis in Chinese children.

0.05). Conclusion There exist radiological changes in paravertebral muscles in AIS, which may be secondary to AIS and have potential clinical importance on the evaluation of curve progression.

Objective To detect the neurofibromin expression and observe the biological features of the osteoblasts of patients with type 1 neurofibromatosis and scoliosis. Methods 10 cases of congenital scoliosis and 8 cases of NF1 scoliosis were chosen. The two groups were with the similar age(with the average of 11.7 years and 12.5 years) and Cobb angle(with the average of 85? and 94?). Cancellous bone was harvested from the ilia and the bone explants culture system was used. Proliferation of the osteoblasts, and also the specific differentiation index including alkaline phosphatase, type Ⅰ collagen and osteocalcin was assayed in sewnd generation osteoblasts. Neurofibromin expression in the two kinds of osteoblasts was detected with immunoprecipitation followed by Western blot. Results Compared to the osteoblasts of patients with congenital scoliosis, lower level of neurofibromin was expressed in osteoblasts of patients with NF1 scoliosis, (the OD value was 1.05?0.06 and 2.59?1.40 respectively, P=0.002). The level of alkaline phosphatase, type Ⅰ collagen and osteocalcin were significant lower in osteoblasts of patients with NF1 scoliosis than those of CS patients (44.69 IU/mg vs 51.38 IU/mg, P=0.019; 226.34 ng/mg vs 249.93 ng/mg, P=0.014; 7.41 ng/mg vs 8.87 ng/mg, P=0.049). But the proliferation rate of the NF1 osteoblasts was significant higher than that of the CS osteoblasts (3.34 and 2.70 respectively, P=0.049). Conclusion With the decrease of neurofibromin expression, the NF1 osteoblasts show some defects in their function, these function defects may contribute to varieties of skeletal abnormalities as dystrophic change and decreased bone density.

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.