Objective To systematically evaluate the psychometric properties of specific self-reported outcome assessment tools for patients undergoing Endoscopic Transnasal Transsphenoidal Surgery(ETTS),with the aim of pro-viding clinical healthcare professionals with evidence to guide the selection of appropriate assessment tools.Methods A systematic search was performed across multiple databases,including the North American Skull Base Society,PubMed,Embase,CINAHL,Web of Science,Cochrane Library,CNKI,VIP database,Wanfang database,and the China Biomedical Literature Database,for studies published from the inception of each database to January 9,2025,that are related to ETTS-specific symptom assessment tools.Totally 2 independent researchers screened the literature and extracted relevant data.The consensus-based health measurement tool selection bias risk checklist and quality standards were used to evaluate the methodological quality and psychometric properties of the included studies,which helped to form the development of recommendations.Results A total of 11 articles were included,covering 8 specific self-reported outcome assessment tools for patients undergoing endonasal transsphenoidal pituitary tumor resection.Of these,the Pituitary Outcome Score and the Leiden Bother and Needs Questionnaire for patients with pituitary disease 2 tools were rated as Grade A recommendations,and 6 tools were rated as Grade B recommendations.Conclusion POS and LBNQ-Pituitary are recommended due to their relatively strong overall methodological quality and psychometric properties.However,further validation with larger sample sizes is necessary.

Objective To systematically evaluate the psychometric properties of specific self-reported outcome assessment tools for patients undergoing Endoscopic Transnasal Transsphenoidal Surgery(ETTS),with the aim of pro-viding clinical healthcare professionals with evidence to guide the selection of appropriate assessment tools.Methods A systematic search was performed across multiple databases,including the North American Skull Base Society,PubMed,Embase,CINAHL,Web of Science,Cochrane Library,CNKI,VIP database,Wanfang database,and the China Biomedical Literature Database,for studies published from the inception of each database to January 9,2025,that are related to ETTS-specific symptom assessment tools.Totally 2 independent researchers screened the literature and extracted relevant data.The consensus-based health measurement tool selection bias risk checklist and quality standards were used to evaluate the methodological quality and psychometric properties of the included studies,which helped to form the development of recommendations.Results A total of 11 articles were included,covering 8 specific self-reported outcome assessment tools for patients undergoing endonasal transsphenoidal pituitary tumor resection.Of these,the Pituitary Outcome Score and the Leiden Bother and Needs Questionnaire for patients with pituitary disease 2 tools were rated as Grade A recommendations,and 6 tools were rated as Grade B recommendations.Conclusion POS and LBNQ-Pituitary are recommended due to their relatively strong overall methodological quality and psychometric properties.However,further validation with larger sample sizes is necessary.

With the course of Clinical Skill Training as an example, this article integrates hierarchical teaching and peer teaching, adopts the problem-based learning (PBL) teaching model and famous traditional Chinese medicine (TCM) teaching clinics, connects the assessment criteria for standardized residency training, and pays attention to cultivating a reasonable teacher team, so as to improve the overall teaching quality of the course and the enthusiasm for the course among students. The application of the teacher inheritance model combined with case-based learning (CBL) teaching can help medical students to learn and inherit the clinical experience and skills, communication methods, and academic ideas of famous old TCM doctors and inherit and carry forward the essence of TCM culture. At the same time, CBL teaching is adopted to promote the integrated and people-oriented teaching concept of TCM, with medical students as the main body and teachers as the supporting role. The training with this model can effectively improve the clinical skills and development potential of TCM students.

Objective To investigate the guidelines implementation status of preventing gastric aspiration by Neurosurgery Intensive Care Unit (NSICU) nurses, and analyze its effects on gastric aspiration outcomes. Methods Using convenient sampling method, two NSICU of Class Ⅲ hospitals in Beijing from June 2016 to January 2017 were selected to investigate the nursing status of preventing gastric aspiration and analyze its relationship with gastric aspiration outcomes. SPSS 21.0 software was used to analyze the data. Results NSICU nursing routine included assessing the nasal feeding tube position, using the compound chlorhexidine in oral care, and assessing gastric residual volumes (GRVs) per 6 hours. However, only a quarter of bedside elevation angle met the guidelines requirements; 55.9% of the cuff pressure was at a low level. There were statistically significant differences in bedside elevation angle, cuff pressure and enteral nutrition velocity in the comparison of aspiration and non-aspiration patients (χ2=13.848,41.093,33.011;P< 0.001). Conclusions Although guidelines for the prevention of gastric aspiration are being constantly added and updated, a gap between the clinical practice and the guidelines exists. This study suggests that the recommended measures should be more rigorous and detailed in practical clinical work to reduce the incidence of gastric aspiration.

Objective: To investigate the efficacy of microwave ablation in the treatment of hepatocellular carcinoma (HCC) within the Milan criteria and to investigate the differences in clinical efficacy of microwave ablation in tumors with different sizes. Methods: A retrospective analysis was performed on the clinical data of the patients with HCC within the Milan criteria who received microwave ablation in our hospital from January 2011 to January 2013. The complete ablation rate, incidence rate of major complications, recurrence rate, and overall survival rate were analyzed and the treatment outcomes were compared between two groups with different tumors sizes. The patients were followed up for 3.4-61.8 months. The Kaplan-Meier method was used to calculate overall survival rate, local recurrence rate, and distant recurrence rate. Comparison of rates between groups was made by the chi-square test and comparison of survival rates between groups was made by the log-rank test. Results: A total of 696 patients with HCC within the Milan criteria involving 801 tumors were included in this study. The complete ablation rate was 93.8% (653/696) and the incidence rate of major complications was 1.7% (12/696). The median survival time was 59.6 months and the 1-, 2-, and 3-year overall survival rates were 94.8%, 82.2%, and 71.7%, respectively. The local recurrence rate was 13.4% (93/696) and the rate of intrahepatic distant metastasis was 40.1% (279/696). The overall intrahepatic recurrence rate was 48.1% (335/696), and the 1-, 2-, and 3-year recurrence rates were 22.9%, 38.4%, and 46.8%, respectively. There were no significant differences in complete ablation rate, incidence rate of major complications, and overall survival rate between the two groups with different tumor sizes (diameters≤3 cm and 3-5 cm) (P = 0.12; P = 0.61; P = 0.61). Conclusion Microwave ablation is a safe and effective treatment modality for HCC within the Milan criteria. And there are no significant differences in safety, effectiveness, and long-term efficacy of microwave ablation between the two groups with different tumor sizes (diameters ≤3 cm and 3-5 cm). However, if the operator’s experience is not rich and cannot accurately use conformal ablation and make an individualized treatment, the tumors with a diameter of 3-5 cm should be carefully treated using microwave ablation to avoid residual tumor after treatment.

Objective To evaluate the curative effect of microwave ablation (MWA) for solitary hepatocellular carcinoma (HCC) sized less than 5 cm,and to discuss the prognosis and its influence factors.Methods The clinical data of 603 HCC patients,who were admitted to authors' hospital during the period from 2011 to 2013 to receive MWA,were retrospectively analyzed.The patients were followed up till March 2016.Results According to the inclusion criteria,a total of 603 patients were enrolled in this study.Complete ablation of HCC lesions was obtained in 5.8％ of patients (35/603).No statistically significant difference in complete ablation rate existed between each other among groups of different tumor diameter (P=0.056).The incidence of severe complications was 1.7％ (10/603).The median survival time was (59.6±1.9)months,while the 1-,2-and 3-year overall survival rates were 94.7％,81.9％ and 71.8％ respectively.In terms of overall survival rate,no statistically significant difference existed between groups of different age as well as between groups of different tumor diameter (P=0.225 and P=0.777 respectively),but statistically significant difference existed between groups of different sex as well as between groups of different recurrence interval (P=0.029 and P＜0.001 respectively).Univariate and multivariate analysis showed that gender,preoperative albumin level and recurrence interval were the factors influencing overall survival rate (P=0.035,P=0.006 and P＜0.001 respectively).Conclusion For the treatment of solitary HCC sized less than 5 cm,MWA has reliable curative effect,it is a safe and minimally-invasive therapy for HCC.The overall survival rate between patients with different age or between patients with different HCC size is not obviously different.The gender,preoperative albumin level and recurrence interval are independent factors that affect the overall survival rate.

Objective:To explore the role of peripheral blood monocyte subsets in the pathogenesis of rheumatoid arthritis (RA),we therefore decided to compare the percentage of monocyte subpopulations in peripheral blood,as well as cytokines secretion function,to that of healthy controls. Methods:22 patients with RA and 22 cases of healthy controls ( HC) were drew 3 ml fresh venous blood into a tube containing heparin. The percentage of monocyte subsets,expression of Toll-like receptor(TLR)2,HLA-DR,triggering receptor expressed on myeloid cells-1(TREM-1) on intermediate monocyte and mean fluorescence intensity(MFI) of intracellular tumor necrosis factor-α ( TNF-α) were evaluated with the methods of flow cytometry ( FCM ) . The correlation between percentage of monocyte subsets and serum cytokines was explored. Statistical significance between parametric data was determined by the students't-test. Results:Compared to HC controls, the percentages of intermediate monocytes were significant higher in RA patients [ ( 11. 7 ± 1. 6)% vs (4. 6±1. 2)%,P<0. 05],as well as the expression(MFI) of TLR2 (750. 2±110. 3 vs 526. 8±98. 6) and TREM-1 (58. 4± 12. 1 vs 40. 3±10. 2) on intermediate monocytes (P<0. 05). The expression of HLA-DR on intermediate monocytes of RA patients had no difference with HC controls (P>0. 05),while MFI of intracellular TNF-αin intermediate monocytes of RA patients were significant higher than that of HC controls (46. 3±6. 4 vs 36. 7±8. 3,P<0. 05). In addition,RA patients showed a positive correlation between the percentage of CD14highCD16+ monocytes and DAS28 scores(r=0. 538,P=0. 009),as well as the serum levels of TNF-α,IL-17 ( r=0. 471,P=0. 027;r=0. 593,P=0. 003). Conclusion:Monocyte subpopulations from RA patients are abnormally skewed toward to in-termediate monocytes which has high expression of TLR2 , TREM-1 and the function of TNF-α secretion. Therefore, intermediate monocytes may play a role in the pathophysiology of RA. By modulating polarization or blocking monocyte cell surface receptors could be a new treatment of RA.

BACKGROUND:Cdh1 has been shown to express in rat hippocampus and cortex in a large number. Moreover, in vitro test demonstrated that Cdh1 expression was higher in neurons than in neural stem cel s, which possibly associated with the differentiation of neural stem cel s into neurons. However, the effects of anaphase promoting complex Cdh1 on ischemic neuronal damage remain unclear.
OBJECTIVE:To investigate the expression of Cdh1 and its downstream substrate in primary cultured neurons with oxygen-glucose deprivation. METHODS:Primary neurons from cortex of postnatal 24-hour rat pups were cultured in vitro, and identified by immunofluorescence staining. The oxygen-and glucose-deprived models were established by three gas incubator fil ed with nitrogen in sugar-free Earle’s solution. After 1 hour of hypoxia, reoxygenation was conducted. Real-time fluorescent quantitative PCR was used to detect the mRNA expression of Cdh1 and its downstream substrates Skp2, Cyclin B1 before hypoxia, 6 hours, 1, 3, 7 days after oxygen glucose deprivation. RESULTS AND CONCLUSION:After oxygen glucose deprivation, the expression of Cdh1 and Cyclin B1 in primary neurons was increased (P<0.05), while Skp2 expression was decreased (P<0.05). Above data indicated that Cdh1 expression in neurons increased after oxygen-glucose deprivation. It may degrade Skp2 and participate in hypoxic neuronal apoptosis by ubiquitination.

Objective To investigate the gastric contents reflux occurred in the patients in Neurosurgery Intensive Care Unit ( NICU) , and to analyze the risk factors of gastric contents reflux and provide basis for timely and effective nursing intervention measures of clinical practice. Methods A total of 47 patients with mechanical ventilation in NICU of some grade A class three hospitals were collected the data such as age, gender, body posture, state of consciousness, gastric retention, diameter of nasogastric tube, the ballonet pressure of artifical airway and also included samples of throat secretion to test pepsin and pH. Results A total of 235 times watched among 47 patients that the incidence rate of gastric contents reflux was 48. 1%. The single factor analysis showed that there were significant differences of gastric contents reflux between subgroups of different tube diameter, nasal feeding pump rate, gastric retention, Glasgow score and ballonet pressure (χ2 =6. 641, 56. 615, 142. 846, 17. 784, 8. 620;P<0. 05). Further logistic regression analysis indicated that the factors affected gastric contents reflux was nasal feeding pumping rate and gastric retention. Conclusions Gastric contents reflux is a common complication in EN patients in the NICU. According to the Influencing factors, monitoring gastric retention and set proper nasal feeding pump rate is important for continuous nasal feeding patients to reduce gastric contents reflux rate.

OBJECTIVETo investigate the effect of 17-allylamino-demethoxygeldanamycin (17AAG) on the proliferative and invasive ability of gastric cancer cells and associated mechanism.

METHODSThe proliferative ability was tested by MTT method and the cell cycle was detected by flow cytometry(FCM) when 17AAG was used to treat gastric cancer cell SGC7901. Apoptosis was detected by FCM and PI-Annexin V double staining. The invasive ability was tested by transwell method. Expression of HSP90, HSP70, c-met and AKT was detected by Western blot.

RESULTSThe growth of SGC7901 cells was inhibited after the administration of 17AAG, and the inhibitation was dose- and time-dependent. The cell cycle was blocked at the G0/G1 phase. The apoptotic ratio in 17AAG group was much higher than that in blank group and DMSO group (P<0.01). The cellular invasive ability decreased significantly (P<0.01). The expression of HSP70 was elevated by 17AAG, and the expression of c-met and AKT was down-regulated, but no change of HSP90 was observed.

CONCLUSION17AAG can inhibit the proliferative and invasive ability of SGC7901 cells, and induces apoptosis through down-regulating the expression of HSP90 client proteins instead of the target HSP90 itself.

Apoptosis ; Benzoquinones ; pharmacology ; Cell Cycle ; Cell Line, Tumor ; Cell Proliferation ; drug effects ; HSP70 Heat-Shock Proteins ; HSP90 Heat-Shock Proteins ; Humans ; Lactams, Macrocyclic ; pharmacology ; Neoplasm Invasiveness ; Stomach Neoplasms ; pathology