ObjectiveTo investigate the pattern of the relationship of craniopharyngiomas with pituitary stalks and hypothalamus. Furthermore, based on different patterns affirmed during the operations, surgical strategies were designed for radical excision. MethodsA series of 66 patients with primary suprasellar craniopharyngiomas were treated with microsurgical techniques and the relationships of the craniopharyngiomas with pituitary stalk and hypothalamus were analyzed prospectively. Appropriate surgical approaches were selected preoperatively according to the lesion's sizes and expanding directions. The relationships of the lesions to the pituitary stalks and hypothalamus were identified in detail and dissected carefully with protection of perforating vessels. ResultsThe patterns that pituitary stalks were involved by craniopharyngiomas were identified in 36 cases and divided into four types: no relation (5 cases), adhesion (10 cases), partial invasion (8 cases) and total invasion (13 cases). The anterior floor of the third ventricle was involved in 42 cases, in which it disappeared totally in 10 cases. Total resection was achieved in 58 case, subtotal resection in 8 cases. Diabetes insipidus (DI) was identified in 44 cases postoperatively. No surgical mortality, no recurrence was found during follow-up of mean 35 months. ConclusionThe appropriate selection of surgical approaches preoperatively, careful identification and according treatment of the relationships of the tumors with pituitary stalks and hypothalamus are the keys to protect the pituitary stalk; hypothalamus in craniopharyngiomas resection in adults.

AIM: To explore the effect and mechanism of preoperative transarterial chemoembolization on nephroblastoma.METHODS: Comparative analysis of clinical and pathological features in 39 children with Wilms’ tumor was conducted. TUNEL assay was used to detect the apoptosis of tumor in two groups with or without preoperative interventional treatment. The expressions of P53, Bcl-2 and Bax proteins were detected by immunochemical methods. The patients were followed-up for more than 2 years.RESULTS: The extent of neoplastic cell necrosis and degeneration, interstital fiber tissue hyperplasia of tumor and the number of infiltrating lymphocytes were observed, which were higher in interventional group than those in simple excision group (P

Altitude ; Altitude Sickness ; prevention & control ; Health Services Administration ; Humans

Objective To compare the results of the three grades pictures affiliated With the Synotophore and to choose the opti- mal pictures for the clinician.Design Retrospective case series.Participants 41 normal persons and 44 cases of intermittent exotropia. Methods All participants were separately examined the three grades function with different kinds and degrees pictures affiliated with the Synotophore.The average radian measured with four sorts of pictures of the first grade function and the average measured with the three sorts of pictures of the second grade function were analysed,the stereoacuity of third grade function was measured with qualitative picture and random dot quantitative picture.Comparison was made between two groups of the people who possessed with stereoacuity. Main Outcome Measures Radians and seconds gained from the pictures affiliated with the Synotophone,Results Synotophore of the superposition of the first grade function:the outcome of using four sorts of pictures to examine the normal persons were 1.47+1.68, 1.21?1.21,1.68?1.60,1.32?1.27,F=0.595,P=0.619;the intermittent exotropias were 8.41?4.30,8.73?4.26,8.45?3.86,8.73?4.28,F= 0.070,P=0.987;the difference was not prominent.The fusion range of the second grade of Synotophore,using three different pictures to examine the normal persons were 26.03?6.17,21.11?6.87,17.21?5.40,F=17.260,P=0.000,the result of the fusion range has direct proportion with the degrees of the pictures,the bigger the picture was,the larger the fusion range,the difference was statistically signif- icant.And there was no significant differences for the intermittent exotropias when examined with the same pictures(21.74?7.43,21.31?7.82,20.32?7.53),F=0.590,P=0.556.The stereoaeuity of the third grade of Synotophore,in the normal person group 85.4% and 100%, X~2=4.877,P=0.027,the results were statistically significant between the qualitative picture and the random dot quantitative picture. About the intermittent exotropia group,no statistically significant differences were detected(72.73% and 59.10%),X~2=1.821,P=0.177. Condusion Choose pictures randomly when examine the first grade function of Synotophore;for the second grade function of Syno- tophore in both groups may choose intergraded degree pictures;the stereoacuity of the third grade of Synotophore,normal group should choose quantitative pictures,while strabismic patients may choose both of them.(Ophthalmol CHN,2008,17:120-122)

Objective To explore a feasible and effective method of purse-string suture and traction in proce- dures for prolapse and hemorrhoids(PPH)with circular stapler.Methods Width of resected mucosal band and ex- tent of residual hemorrhoid mucosal lifting were compared between two groups of patients with hemorrhoids receiv- ing PPH with“two-point retraction”method(group one,110 cases)and other retraction methods(group two,40 cas- es).Results For group one of 110 cases with“two-point retraetion”,resected mucosal band of all cases were intact and and average width ranged from 3.5 to 5cm.There was a completely residual hemorrhoid mucosal lifting(com- plete return of prolapsed hemorrhoid into the anal canal)in 100 cases of group one(91%).But in group two with other retraction methods,average width of resected mucosal bands ranged from 0.2 to 3.5cm and there was an in- complete band in 10 cases(25%).The rate of mucosal lifting in this group was only 62.5%(19/40).Conclusion Two-point retraction is a feasible,effective and simple method in PPH,resulting in an intact resected mucosal band and sufficient hemorrhoid mucosal lifting.So the two-point retraction PPH is worth to be extended for application.

Cost-Benefit Analysis ; Early Detection of Cancer ; Humans ; Mass Screening ; methods ; Neoplasms ; diagnosis ; epidemiology ; therapy ; Program Evaluation

To investigate formation mechanism of secologanic acid sulfonates in sulfur-fumigated buds of Lonicera japonica, secologanic acid was enriched and purified from the sun-dried buds of L. japonica by various column chromatography on macroporus resin HPD-100, silica gel and ODS. The stimulation experiments of sulfur-fumigation process were carried out using secologanic acid reacted with SO2 in the aqueous solution. The reaction mechanism could be involved in the esterification or addition reaction. The present investigation provides substantial evidences for interpreting formation pathway of secologanic acid sulfonates in sulfur-fumigated buds of L. japonica.
Alkanesulfonates ; chemistry ; Carboxylic Acids ; chemistry ; Chromatography, High Pressure Liquid ; Flowers ; chemistry ; drug effects ; Lonicera ; chemistry ; drug effects ; Models, Chemical ; Molecular Structure ; Sulfur ; chemistry ; pharmacology ; Sulfur Dioxide ; chemistry ; Water ; chemistry

The fundamental mechanism of gastrointestinal diseases is the imbalance between the attack factor and the protective factor of stomach mucous membrane. It can not outbreak if the protective factor is stronger than the attack factor; otherwise, it will. Attack and protective function inside the stomach are mediated by various factors. These related factors interaction constitutes a complicated network system. This kind of outbreak theories of imbalance in Western medicine is same as that, "The sense of right saves inside, the evil can't do" and "Evil is competing with right, all diseases occur", in Chinese medicine. So, it is the key which points to futher study the interaction between gastrointestinal attack factors and protective factors by traditional Chinese medicine, thus improving the clinical effect.
Gastrointestinal Diseases ; therapy ; Humans ; Integrative Medicine ; Medicine, Chinese Traditional

Adult ; Bone Screws ; Denture, Partial ; Female ; Humans ; Male ; Middle Aged ; Molar ; diagnostic imaging ; pathology ; Orthodontic Anchorage Procedures ; instrumentation ; methods ; Radiography, Panoramic ; Tooth Movement Techniques ; methods

Objective To compare the efficacy of different target concentrations of sufentanil target-controlled infusion used to supplement topical anesthesia for fiber-optic bronchoscopy (FOB)-assisted awake nasotracheal intubation in patients with obstructive sleep apnea syndrome (OSAS).Methods Forty-five ASA physical status Ⅱ or Ⅲ patients with OSAS,aged 28-60 yr,with body mass index of 30-40 kg/m2,scheduled for elective surgery,were randomly assigned into 3 groups (n =15 each):control group (group C) and sufentanil with the target plasma concentration of 0.4 ng/ml (group S1) and 0.6 ng/ml groups (group S2).Naso-pharyngeal and laryngeal mucous membrane was sprayed with 2％ lidocaine mixed with 1％ ephedrine for topical anesthesia in both groups.In addition 1％ tetracaine 3 ml was injected into trachea through cricothyroid membrane.FOB-assisted awake nasotracheal intubation was performed after the target concentration was achieved.The degree of airway obstruction was scored during intubation.The highest values of MAP and HR,rate-pressure product ＞ 12 000,decreased respiratory rate and hyoxemia were recorded during the period between induction of anesthesia and 3 min after intubation was completed.The changes in MAP and HR as percent of baseline values were calculated.Before topical anesthesia (T0),when target concentrations were reached (T1),and at 1 and 3 min after intubation (T2,3),blood samples were taken to determine the plasma concentrations of epinephrine (E),norepinephrine (NE) and cortisol.Results Compared with group C,the airway obstruction score was significantly decreased in group S1,the incidence of changes in MAP and HR ＞ 30％ of baseline values and rate-pressure product ＞ 12 000 was decreased,the plasma concentrations of E,NE and cortisol were decreased in S1 and S2 groups,and the incidence of the respiratory rate was decreased and hypoxemia was increased in group S2 (P ＜ 0.05).Compared with group S1,the airway obstruction score were significantly decreased,and the incidence of respiratory rate was decreased and hypoxemia was increased in group S2 (P ＜ 0.05).Compared with the baseline value at T0,the plasma concentrations of E,NE and cortisol were significantly increased at T2,3 in group C,while decreased at T1 in S1 and S2 groups (P ＜ 0.05).Conclusion Compared with pure topical anesthesia,sufentanil with the target plasma concentration of 0.4 ng/ml does not induce respiratory depression,maintains hemodynamics stable,attenuates the stress responses and provides better intubation conditions when used to supplement topical anesthesia for FOB-assisted awake nasotracheal intubation in patients with OSAS.