Correlation between the Position of the Pituitary Stalk as Determined by Diffusion Tensor Imaging and Its Location as Determined at the Time of Surgical Resection of Pituitary Adenomas

Objective@#: An important factor during pituitary adenoma surgery is to preserve pituitary stalk (PS) as this plays a role in reduction of the risk of postoperative diabetes insipidus. The hypothalamic-hypophyseal tract (HHT) projects through the PS to the posterior pituitary gland. To reconstruct white matter fiber pathways, methods like diffusion tensor imaging (DTI) tractography have been widely used. In this report we attempted to predict the position of PS using DTI tractography and to assess its intraoperative correlation during surgery of pituitary adenomas. @*Methods@#: DTI tractography was used to tract the HHT in nine patients before craniotomy for pituitary adenomas. The DTI location of the HHT was compared with the PS position identified at the time of surgery. DTI fiber tracking was carried out in nine patients prior to the planned craniotomy for pituitary adenomas. In one patient, the PS could not be identified during the surgery. In the other eight patients, a comparison was made between the location of the HHT identified by DTI and the position of the PS visualized at the time of surgery. @*Results@#: The position of the HHT identified by DTI showed consistency with the intraoperative position of the PS in seven patients (88.9% concordance). @*Conclusion@#: This study shows that DTI can identify the position of the HHT and thus the position of the PS with a high degree of reliability.

Tonic Electromyogram Density in Multiple System Atrophy with Predominant Parkinsonism and Parkinson's Disease / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Both Parkinson's disease (PD) and multiple system atrophy (MSA) have associated sleep disorders related to the underlying neurodegenerative pathology. Clinically, MSA with predominant parkinsonism (MSA-P) resembles PD in the manifestation of prominent parkinsonism. Whether the amount of rapid eye movement (REM) sleep without atonia could be a potential marker for differentiating MSA-P from PD has not been thoroughly investigated. This study aimed to examine whether sleep parameters could provide a method for differentiating MSA-P from PD.</p><p><b>METHODS</b>This study comprised 24 MSA-P patients and 30 PD patients, and they were of similar age, gender, and REM sleep behavior disorder (RBD) prevalence. All patients underwent clinical evaluation and one night of video-polysomnography recording. The tonic and phasic chin electromyogram (EMG) activity was manually quantified during REM sleep of each patient. We divided both groups in terms of whether they had RBD to make subgroup analysis.</p><p><b>RESULTS</b>No significant difference between MSA-P group and PD group had been found in clinical characteristics and sleep architecture. However, MSA-P patients had higher apnea-hypopnea index (AHI; 1.15 [0.00, 8.73]/h vs. 0.00 [0.00, 0.55]/h, P = 0.024) and higher tonic chin EMG density (34.02 [18.48, 57.18]% vs. 8.40 [3.11, 13.06]%, P < 0.001) as compared to PD patients. Subgroup analysis found that tonic EMG density in MSA + RBD subgroup was higher than that in PD + RBD subgroup (55.04 [26.81, 69.62]% vs. 11.40 [8.51, 20.41]%, P < 0.001). Furthermore, no evidence of any difference in tonic EMG density emerged between PD + RBD and MSA - RBD subgroups (P > 0.05). Both disease duration (P = 0.056) and AHI (P = 0.051) showed no significant differences during subgroup analysis although there was a trend toward longer disease duration in PD + RBD subgroup and higher AHI in MSA - RBD subgroup. Stepwise multiple linear regression analysis identified the presence of MSA-P (β = 0.552, P < 0.001) and RBD (β = 0.433, P < 0.001) as predictors of higher tonic EMG density.</p><p><b>CONCLUSION</b>Tonic chin EMG density could be a potential marker for differentiating MSA-P from PD.</p>

Curative effect of Shuxuening injection for patients with acute pancreatitis and which influence on the oxidative stress / 药物评价研究

Objective To explore the curative effect of Shuxuening injection for patients with acute pancreatitis and which influence on the oxidative stress.Methods 150 patients with acute pancreatitis were enrolled in our hospital from December 2013 to November 2016,of which patients divided into two groups randomly,control group (n =65) accepted conventional therapy,and study group (n =85) adopted Shuxuening injection based on the treatment of control group.The curative effect of two groups were evaluated,and the factors of inflammatory and oxidative stress response were detected responsibly before and after treatment,the pancreatic injury degree were evaluated via the gauge of APACHE Ⅱ and BISAP.Results The total effective rate of study group for curative effect was higher significantly than those patients in control group (P ＜ 0.05);After treatment,the tumor necrosis factor α (TNF-α),interleukin-6 (IL-6) and malondialdehyde (MDA) of two groups decreased significantly compared with before treatment (P ＜ 0.05),and the level of which factors in study group were lower than those control group,and which difference was significance (P ＜ 0.05),the superoxide dismutase (SOD) of all patients increased significantly compared with before treatment (P ＜ 0.05),and SOD level of patients in study group was higher than those patients in control group (P ＜ 0.05);the APACHE Ⅱ[and BISAP score of all patients went down remarkably compared with before treatment (P ＜ 0.05),and which score of patients in study group was lower than that control group,and which difference was significance (P ＜ 0.05).Conclusions Shuxuening Injection for patients with acute pancreatitis deserved popularization in clinic,which not only decreased the inflammatory and oxidative stress response significantly,but also increased the curative effect remarkably.

Curative effect of Shuxuening injection for patients with acute pancreatitis and which influence on the oxidative stress / 药物评价研究

Objective To explore the curative effect of Shuxuening injection for patients with acute pancreatitis and which influence on the oxidative stress.Methods 150 patients with acute pancreatitis were enrolled in our hospital from December 2013 to November 2016,of which patients divided into two groups randomly,control group (n =65) accepted conventional therapy,and study group (n =85) adopted Shuxuening injection based on the treatment of control group.The curative effect of two groups were evaluated,and the factors of inflammatory and oxidative stress response were detected responsibly before and after treatment,the pancreatic injury degree were evaluated via the gauge of APACHE Ⅱ and BISAP.Results The total effective rate of study group for curative effect was higher significantly than those patients in control group (P ＜ 0.05);After treatment,the tumor necrosis factor α (TNF-α),interleukin-6 (IL-6) and malondialdehyde (MDA) of two groups decreased significantly compared with before treatment (P ＜ 0.05),and the level of which factors in study group were lower than those control group,and which difference was significance (P ＜ 0.05),the superoxide dismutase (SOD) of all patients increased significantly compared with before treatment (P ＜ 0.05),and SOD level of patients in study group was higher than those patients in control group (P ＜ 0.05);the APACHE Ⅱ[and BISAP score of all patients went down remarkably compared with before treatment (P ＜ 0.05),and which score of patients in study group was lower than that control group,and which difference was significance (P ＜ 0.05).Conclusions Shuxuening Injection for patients with acute pancreatitis deserved popularization in clinic,which not only decreased the inflammatory and oxidative stress response significantly,but also increased the curative effect remarkably.

Surgical management of intracranial mirror aneurysms / 中华外科杂志

<p><b>OBJECTIVE</b>To study the clinical characteristics and treatment strategies of mirror aneurysms.</p><p><b>METHODS</b>Nineteen patients with 20 pairs of mirror aneurysms from November 2007 to November 2012 were retrospectively analysed. Among the 19 patients, 13 were female and 6 were male, mean age was 56 years (ranged 32-75 years). Distribution of the lesions included 11 bilateral posterior communicating artery aneurysms (one with a pair of anterior choroidal artery aneurysm), 4 bilateral middle cerebral artery aneurysms, 3 bilateral paraclinoidal aneurysms, and 1 bilateral pericallosal-callosomarginal artery aneurysm. Surgical strategies were selected according to location of hemorrhage, Hunt-Hess grade, location and size of aneurysm, etc.</p><p><b>RESULTS</b>Four mirror aneurysms were clipped at one stage, 3 mirror aneurysms were clipped at two stages, 2 were treated with combination of clipping and coiling and remaining 10 were clipped unilaterally. At discharge, 15 out of 19 patients had a Glasgow Outcome Scale score of 5, 4 patients had a score of 4. The mean clinical follow-up was 18.6 months (range 3-50 months). Two patients had oculomotor nerve palsy postoperatively. At 3-month follow-up, 1 improved and 1 unchanged. In 10 patients with unilateral clipping, contralateral aneurysms were unruptured, small ( < 5 mm) and regular. No remnant or recurrence of aneurysm were found in other 9 patients whose bilateral aneurysms had been treated.</p><p><b>CONCLUSIONS</b>The mirror aneurysms are rare kinds of multiple aneurysms. The aneurysm responsible for hemorrhage should be treated with first priority. The contralateral unruptured aneurysm could be observed, clipped or coiled in one stage, or treated in two separate stages.</p>

Different treatment modalities of fusiform basilar trunk aneurysm: study on computational hemodynamics / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Unclippable fusiform basilar trunk aneurysm is a formidable condition for surgical treatment. The aim of this study was to establish a computational model and to investigate the hemodynamic characteristics in a fusiform basilar trunk aneurysm.</p><p><b>METHODS</b>The three-dimensional digital model of a fusiform basilar trunk aneurysm was constructed using MIMICS, ANSYS and CFX software. Different hemodynamic modalities and border conditions were assigned to the model. Thirty points were selected randomly on the wall and within the aneurysm. Wall total pressure (WTP), wall shear stress (WSS), and blood flow velocity of each point were calculated and hemodynamic status was compared between different modalities.</p><p><b>RESULTS</b>The quantitative average values of the 30 points on the wall and within the aneurysm were obtained by computational calculation point by point. The velocity and WSS in modalities A and B were different from those of the remaining 5 modalities; and the WTP in modalities A, E and F were higher than those of the remaining 4 modalities.</p><p><b>CONCLUSIONS</b>The digital model of a fusiform basilar artery aneurysm is feasible and reliable. This model could provide some important information to clinical treatment options.</p>

Surgical treatment of the tumors of posterior part of third ventricle and pineal region / 军事医学科学院院刊

Objective:To summarize the experiences of the surgical treatment of tumors in the posterior part of the third ventricle and pineal region. Methods: Twenty-seven patients with tumors in this region treated microsurgically from 1990 to 2000 were analyzed. The surgical indications, approaches, and operative key points were discussed. The prognostic factors were also analyzed. Results:Tumors were removed totally in 11 patients, removed subtotally in 7 and removed partially in 5. Biopsy and ventriculo-peritoneal shunt was performed in 4 patients. Of 17 patients in follow-up, 13 patients survived longer than 5 years. Conclusions: Most tumors in the posterior part of the third ventricle and pineal region can be surgically removed.Sufficient specimen obtained in the operation can confirm pathologic property of the tumor,guiding next chemotherapy and radiotherapy.

Determination of Environmental Estrogens in Surface Water and Tap Water / 环境与健康杂志

Objective To understand the environmental estrogens contamination of tap water and source water. Methods Environmental estrogens in the water samples were concentrated by macroporous adsorption resin H103. The effect of environmental estrogens in concentrated samples was assessed by the recombinant yeast system. Results The results showed that some source water and tap water really contained environmental estrogens. The activity of environmental estrogens in concentrated samples of some source water increased as the volume of concentrated sample increased. The concentrate of 100 ml water sample could show the estrogenic effect. Conclusion Some source waters and tap waters in China have been contaminated by environmental estrogens. Environmental estrogens in source water can not be removed completely by drinking water treatment system of city.