Objective To study the clinical features and therapeutic effects of pituitary adenomas in elderly patients. Methods The clinical materials including main clinical manifestations, diagnostic methods and outcome of treatments of 49 elderly patients with the pituitary adenomas from 1987 to1998 were analyzed retrospectively. Results It was showed from the data that the average duration of illness was 4 4 years; and 46(93 8%) cases were with visual deterioration, 20 (40 8%) with headache, and 16(32 7%) with endocrine abnormality. The diameter of tumors was more than 3 cm in 25 (51 0%), and the non functioning adenomas were found in 27 (55 1%). Operation was undergone through trans sphenoidal (61 2%), subfrontal (32 7%) and extensive subfrontal extradural approaches(6 1%), respectively. Among the 49 cases, tumor was totally or subtotally removed in 38 cases (77 6%), large partially or partially removed in 11 cases (22 4%). The results of operation through the trans sphenoidal approach were superior to other routes All patients were long term followed up for an average of 50 5 months. Visual disturbances were improved in 27 of 46(58 7%). A total of 43 patients could live by themselves Tumor disappearance was observed in 30 cases and recurrence in five cases. Five cases showed no changes in tumor size. 28 cases underwent radiotherapy after surgery and the occurrence rate of hypopituitarism after radiotherapy turned to be 50%. Total tumor control rate was calculated as 93%. Conclusions Macroadenomas and non functional pituitary adenomas happened most frequently in elderly patients and the main clinical symptoms was visual deterioration. Trans sphenoidal route for microsurgery was believed to be the first choice of operation. Tumor recurrence can be controlled or delayed by postoperative radiotherapy, but severe complication of the visual injury and pituitary dysfunction should be paid much attention.

Objective To study curative efficacy of radix notoginseng saponin dispersible tablets combined with rivaroxaban in treatment of tibial fracture after operation and its effects on joint function and the leves of inflammatory factors .Methods 90 patients of tibial fracture who received therapy from March 2014 to March 2016 in our hospital were selected.According to random number table,all elective surgery,those patients were divided into the observation group (n=45) and the control group (n=45),the control group was treated with radix notoginseng saponin dispersible tablets,while the observation group was treated combined with rivaroxaban.After two weeks of treatment, the hemorheology, inflammatory factors, joint function were compared between two groups.Results The patient swelling time and bed time in the observation group were shorter than the control group (P<0.05);after treatment,the levels of red cell volume, whole blood viscosity,fibrinogen in the observation group were lower than the control group (P<0.05);the levels of tumor necrosis factor TNF-α, IL-1,IL-6 in the observation group were lower than the control group (P<0.05);after treatment three months and six months,the Baird-Jackson scores in the observation group were higher than the control group (P <0.05).Conclusion Radix notoginseng saponin dispersible tablets combined with rivaroxaban is well for tibial fracture after operation,which can improve hemorheology,reduce the level of inflammatory factors,promote joint functional recovery.

Objective To analyze the clinical key points of minimally invasive tracheostomy with percutaneous horn expansion applicated in ICU,and to discuss the problems encountered in minimally invasive surgery and the solutions.Methods The clinical data of 25 patients of minimally invasive tracheostomy with percutaneous horn expansion in ICU were analyzed retrospectively.Results Twenty-one patients with minimally invasive tracheostomy with percutaneous horn expansion were successfully performed in 25 patients of ICU (no incision sputum,subcutaneous emphysema,pneumothorax and other complications),2 patients had more postoperative bleeding,2 patients were difficult to imbedding catheter,of which 1 case abandoned the catheter and received conventional tracheotomy.Conclusion Percutaneous horn expansion minimally invasive tracheostomy has the advantages of small incision,less injury,less operative time,less blood loss and low incidence of complications.However,ICU patients are in severe condition and easy to change.Adequate preoperative preparation,controlling the key steps in the operation can find a solution to the problme.

Objective To analyze the clinical and laboratory results and epidemiological characteristics of brucellosis.Methods The clinical and laboratory characteristics brucellosis cases (confirmed by Brucellosis Guidelines 2012) at the Department of Infectious Disease of the First Hospital of Jilin University between 2000 and 2016,were retrospectively evaluated.The patients were divided into two groups according to acute and chronic stages.According to the range of lesions,the lesions were divided into two groups,and comparative analysis of data between groups was done.Results The ages of the 607 patients (489 males,118 females) were ranged from 2 to 80 years.Among the 607 patients,570 (93.9％) were diagnosed with acute brucellosis,37 (6.1％) with chronic brucellosis.Focal involvement was found in 418 (68.9％) patients.Among them,382 patients were in acute stage,and the other in chronic phase (36).Acute patients' alanine aminotransferase (ALT) and aspartate transaminase (AST) were higher than those of chronic brucellosis (U/L:47.2 vs 26.7,44.5 vs 24.0,Z =-3.684,-3.754,all P ＜ 0.05).Although the white blood cell count,platelet values,C-reactive protein,and blood sedimentation were higher in patients with focal involvement (x 103/mm3:7.3 vs 5.4,211 vs 176;mg/L:56.0 vs 30.5;mm/h:37 vs 28,Z =-4.407,-2.709,-2.334,-2.137,all P ＜ 0.05),patients without focal involvement had higher ALT and AST (U/L:33.3 vs 53.9,30.2 vs 48.1,Z =-4.102,-3.730,all P ＜ 0.05).Peripheral arthritis was the most common type of osteoarticular involvement in 317 patients with focal involvement,and peripheral arthritis was found to be the most frequently identified in the knee joint,112 patients (35.3％).Totally 80 patients were followed up,the relapse rate was 20.0％ (16/80),2 patients treatment failure,only 1 patient died after 1 month of treatment who was diagnosed neuropathic brucellosis.Conclusions Focal involvement should be investigated in the presence of leucocytosis,and pain of a certain part.

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Cervical lymph node metastasis in thyroid cancer is closely related to the disease recurrence and prognosis of patients. Accurate judgment of lymph node metastasis is vital for tumor stage and treatment in patients with thyroid cancer, which can effectively improve the prognosis of patients. However, preoperative detection of cervical lymph node metastasis is the key points and difficulties in individualized treatment of thyroid cancer. Currently, fine needle aspiration washout fluid thyroglobulin is often used to assess cervical lymph node metastasis of differentiated thyroid cancer preoperatively, and it has a higher diagnostic efficacy. The continuous exploration and application of tumor markers and emerging biomarkers have provided new perspectives for the preoperative diagnosis of lymph node metastasis in thyroid cancer. As a new non-invasive detection technique, liquid biopsy is convenient to obtain samples and has broad clinical application in early diagnosis of cervical lymph node metastasis of thyroid cancer. In addition, the analysis and application of liquid biopsy biomarkers will help the development of clinical diagnosis and treatment strategies, and provide the possibility of early precision therapy for thyroid cancer patients. This review summarizes current research surrounding the molecular markers related to cervical lymph node metastasis of thyroid cancer.