Case report of Ureaplasma urealyticum meningitis in a patient with thymoma and hypogammaglobulinaemia.

BACKGROUND: Ureaplasma urealyticum (UU) is found among the normal vaginal flora in a considerable proportion of asymptomatic women; however, adult central nervous system (CNS) infection of UU is extremely rare. Good's syndrome (GS) is an adult-onset immunodeficiency characterized by thymoma, hypogammaglobulinaemia, low or absent B­cells, and an inverted CD4+/CD8+ T­cell ratio. Patients with GS usually have severe or recurrent infections. CASE PRESENTATION: We describe the case report of a 49-year-old woman who developed UU meningitis. Initial routine anti-viral and anti-bacterial therapy showed no improvement in the patient's condition. Next-generation sequencing (NGS) of cerebrospinal fluid (CSF) identified the UU DNA sequence. Accordingly, a diagnosis of UU meningitis was made, and minocycline therapy was initiated. The patient responded favourably, with no signs of disease at subsequent follow-up. According to the severity and rarity of the case, secondary immunodeficiency was suspected. Flow cytometry found hypogammaglobulinaemia. Combined with the previous history of thymoma, the patient was diagnosed with immune deficiency disease of GS. CONCLUSIONS: This case may be the first adult case report in the literature describing UU meningitis in a patient with GS. The diagnosis of GS should be considered in patients presenting with unexplained antibody deficiency and thymoma.

Association between FCGR2A rs1801274 and MUC5B rs35705950 variations and pneumonia susceptibility.

BACKGROUND: Herein, we collected currently published data to comprehensively evaluate the impact of the FCGR2A (Fc fragment of IgG receptor IIa) rs1801274 and MUC5B (mucin 5B, oligomeric mucus/gel-forming) rs35705950 variations on susceptibility to pneumonia diseases. METHODS: We retrieved case-control studies from three online databases and applied the statistical approach of meta-analysis for a series of pooling analyses. RESULTS: A total of fourteen case-control studies were included for FCGR2A rs1801274; while thirty-one case-control studies were included for MUC5B rs35705950. No significant difference between pneumonia cases and controls for FCGR2A rs1801274 was found. However, MUC5B rs35705950 was significantly associated with pneumonia susceptibility in the whole population under the genetic models of allelic T vs. G [OR (odds ratio) =3.78], carrier T vs. G (OR = 3.31), TT vs. GG (OR = 13.66), GT vs. GG (OR = 4.78), GT + TT vs. GG (OR = 5.05), and TT vs. GG + GT (OR = 6.47) (all P < 0.001, Bonferroni-adjusted P < 0.006; false discovery rate-adjusted P < 0.0010). Furthermore, we observed a similar positive result for subgroup analyses of "Caucasian", "Asian", "population-based control", and "idiopathic pulmonary fibrosis". CONCLUSIONS: MUC5B rs35705950, but not FCGR2A rs1801274, increases susceptibility to clinical pneumonia, especially to idiopathic pulmonary fibrosis, in both the Caucasian and Asian populations.

Analysis of the role of rs2031920 and rs3813867 polymorphisms within the cytochrome P450 2E1 gene in the risk of squamous cell carcinoma.

BACKGROUND: To explore the genetic effect of rs2031920 and rs3813867 polymorphisms within the cytochrome P450 2E1 (CYP2E1) gene on the risk of squamous cell carcinoma (SCC), a meta-analysis was performed. METHODS: The eligible case-control studies were obtained by database searching and screening, and the specific statistical analysis was performed with STATA 12.0 software. RESULTS: After the process of database searching and screening, a total of 32 case-control studies with 7435 cases and 10,466 controls were ultimately included in our meta-analysis. With regard to the rs2031920 C/T polymorphism, in comparison to controls, a reduced risk in cases of esophageal squamous cell carcinoma (ESCC) was detected for the models of allele T vs. allele C [P = 0.025, odds ratio (OR) = 0.67], carrier T vs. carrier C (P = 0.014, OR = 0.70), TT vs. CC (P = 0.029, OR = 0.65), CT vs. CC (P = 0.040, OR = 0.56), CT + TT vs. CC (P = 0.035, OR = 0.58). Similarly, a decreased SCC risk was observed for the rs3813867 G/C polymorphism in the allele, carrier, homozygote, dominant, and recessive models of overall SCC meta-analysis and "ESCC" subgroup analysis (all P < 0.05, OR < 1) and in all genetic models of "Asian" and "population-based control (PB)" subgroup analysis (all P < 0.05, OR < 1). Additionally, for the rs2031920/rs3813867 haplotype, a decreased SCC risk was also detected in the overall SCC meta-analysis under the allele, carrier, homozygote and dominant model (all P < 0.05, OR < 1) and the subgroup analysis of "PB" under the allele, carrier, and dominant models (all P < 0.05, OR < 1). CONCLUSIONS: Our meta-analysis supports the "T" allele carrier of the CYP2E1 rs2031920 C/T polymorphism and "C" allele carrier of the rs3813867 G/C polymorphism as protective factors for ESCC patients, especially in Asian populations.

Influence of MDM2 polymorphisms on squamous cell carcinoma susceptibility: a meta-analysis.

PURPOSE: Controversial associations between single-nucleotide polymorphisms (rs2279744, rs937283, rs3730485) of the MDM2 gene and the etiology of squamous cell carcinomas (SCCs) have been reported. This merits further comprehensive assessment. MATERIALS AND METHODS: We systematically reviewed the available data and conducted an updated meta-analysis to evaluate the genetic effect of MDM2 polymorphisms in SCC susceptibility, using Stata/SE 12.0 software. RESULTS: After screening, 7,987 SCC cases and 12,954 controls from 26 eligible case-control studies were enrolled. Overall, compared with the control group, a significantly increased SCC risk was observed for the MDM2 rs2279744 polymorphism in the Asian population (test of association: odds ratio [OR] 1.12, P=0.027 for G vs T; OR 1.26, P=0.016 for GG vs TT; OR 1.25, P<0.001 for GG vs TT + TG; and OR 1.08, P=0.023 for carrier G vs T). In subgroup analysis by SCC type, a similarly increased esophageal SCC risk was detected (OR 1.19, P<0.001 for G vs T; OR 1.46, P<0.001 for GG vs TT; and OR 1.48, P=0.005 for GG vs TT + TG). Furthermore, MDM2-TP53 double mutation was statistically associated with increased SCC susceptibility overall (OR 1.52, P=0.001), especially in the Asian population (OR 1.49, P=0.022). However, no significant difference between the control and case groups was obtained for MDM2 rs937283 or rs3730485 under any genetic model (all P>0.05). CONCLUSION: Our results highlight a positive association between the GG genotype of MDM2 rs2279744 polymorphism and an increased risk of esophageal SCC in the Asian population, which needs to be clarified by more large-scale studies.

Pepper CabZIP63 acts as a positive regulator during Ralstonia solanacearum or high temperature-high humidity challenge in a positive feedback loop with CaWRKY40.

CaWRKY40 is known to act as a positive regulator in the response of pepper (Capsicum annuum) to Ralstonia solanacearum inoculation (RSI) or high temperature-high humidity (HTHH), but the underlying mechanism remains elusive. Herein, we report that CabZIP63, a pepper bZIP family member, participates in this process by regulating the expression of CaWRKY40. CabZIP63 was found to localize in the nuclei, be up-regulated by RSI or HTHH, bind to promoters of both CabZIP63(pCabZIP63) and CaWRKY40(pCaWRKY40), and activate pCabZIP63- and pCaWRKY40-driven ß-glucuronidase expression in a C- or G-box-dependent manner. Silencing of CabZIP63 by virus-induced gene silencing (VIGS) in pepper plants significantly attenuated their resistance to RSI and tolerance to HTHH, accompanied by down-regulation of immunity- or thermotolerance-associated CaPR1, CaNPR1, CaDEF1, and CaHSP24. Hypersensitive response-mediated cell death and expression of the tested immunity- and thermotolerance-associated marker genes were induced by transient overexpression (TOE) of CabZIP63, but decreased by that of CabZIP63-SRDX. Additionally, binding of CabZIP63 to pCaWRKY40 was up-regulated by RSI or HTHH, and the transcript level of CaWRKY40 and binding of CaWRKY40 to the promoters of CaPR1, CaNPR1, CaDEF1 and CaHSP24 were up-regulated by TOE of CabZIP63. On the other hand, CabZIP63 was also up-regulated transcriptionally by TOE of CaWRKY40. The data suggest collectively that CabZIP63 directly or indirectly regulates the expression of CaWRKY40 at both the transcriptional and post-transcriptional level, forming a positive feedback loop with CaWRKY40 during pepper's response to RSI or HTHH. Altogether, our data will help to elucidate the underlying mechanism of crosstalk between pepper's response to RSI and HTHH.

SGT1 is required in PcINF1/SRC2-1 induced pepper defense response by interacting with SRC2-1.

PcINF1 was previously found to induce pepper defense response by interacting with SRC2-1, but the underlying mechanism remains uninvestigated. Herein, we describe the involvement of SGT1 in the PcINF1/SRC2-1-induced immunity. SGT1 was observed to be up-regulated by Phytophthora capsici inoculation and synergistically transient overexpression of PcINF1/SRC2-1 in pepper plants. SGT1-silencing compromised HR cell death, blocked H2O2 accumulation, and downregulated HR-associated and hormones-dependent marker genes' expression triggered by PcINF1/SRC2-1 co-overexpression. The interaction between SRC2-1 and SGT1 was found by the yeast two hybrid system and was further confirmed by bimolecular fluorescence complementation and co-immunoprecipitation analyses. The SGT1/SRC2-1 interaction was enhanced by transient overexpression of PcINF1 and Phytophthora capsici inoculation, and SGT1-silencing attenuated PcINF1/SRC2-1 interaction. Additionally, by modulating subcellular localizations of SRC2-1, SGT1, and the interacting complex of SGT1/SRC2-1, it was revealed that exclusive nuclear targeting of the SGT1/SRC2-1 complex blocks immunity triggered by formation of SGT1/SRC2-1, and a translocation of the SGT1/SRC2-1 complex from the plasma membrane and cytoplasm to the nuclei upon the inoculation of P. capsici. Our data demonstrate that the SGT1/SRC2-1 interaction, and its nucleocytoplasmic partitioning, is involved in pepper's immunity against P. capsici, thus providing a molecular link between Ca(2+) signaling associated SRC2-1 and SGT1-mediated defense signaling.

Clinical analysis of 29 cases of nasal mucosal malignant melanoma.

The present study aimed to investigate the clinical features of nasal mucosa malignant melanoma, including the histopathological features and factors affecting prognosis. A retrospective analysis of the clinical data obtained from the Department of Otolaryngology Head and Neck Surgery, Tianjin Huanhu Hospital (Tianjin, China) between October 1999 and June 2013 was performed using the Kaplan-Meier method. In total, 29 cases of nasal mucosal malignant melanoma were analyzed. The overall 3- and 5-year survival rates were 48.3 and 27.6%, respectively. The study group consisted of 18 males and 11 females, with a median age of 61.5 years. Overall, 19 patients underwent surgery, 28 received radiotherapy and 17 received chemotherapy. The American Joint Committee on Cancer staging system (AJCC) was used to retrospectively stage the tumors. In total, 8 were tumor stage (T)1, 10 were T2, 6 were T3 and 5 were T4. The results revealed that the T stage, surgical treatment, location of the tumor and the presence of black pigmentation affected the 5-year survival rate of the patients. By contrast, radiotherapy and chemotherapy had no effect on the overall survival rate. Overall, endoscopic or endoscopic-assisted surgery were the preferred methods of treatment, and histological features, including the presence of tumor melanin pigmentation, affected the prognosis of the patients. This study indicated that the AJCC staging system is able to effectively predict the prognosis of patients with nasal mucosa malignant melanoma.

[Analysis on the prognosis of malignant transformation of sinonasal inverted papilloma].

OBJECTIVE: To summarize the clinical characteristics and treatments of patients with malignant transformation of sinonasal inverted papilloma (SNIP), and to explore the factors influencing the prognosis of malignant SNIP. METHOD: To retrospectively analyze the clinical data of 35 patients with malignant SNIP. The prognosis affected by age, gender, pathogenetic locations, pathology, clinical stages and treatments were analysed using Kaplan Meier, Log rank and Cox method. RESULT: In our research, 5 years survival rate was 68.6% in malignant SNIP. There were 3 factors effecting the 5 years survival rate of malignant SNIP: clinical staging, histopathological features and treatments while gender, age, disease location, and percentage of the malignant cell in the entire tumor tissue had no effect on overall survival rate. Clinical staging and treatment were the independent factors that influenced the prognosis of malignant SNIP (P value was 0.019 and 0.006). CONCLUSION: Risk factors that independently influence the survival of patients with malignant SNIP were the clinical staging and treatment. The degree of histo pathological features can be the secondary indicator to judge the prognosis of malignant SNIP. Endoscopic surgery or comprehensive therapy performed on patients properly is therapeutically effective.

Genome-wide identification and transcriptional expression analysis of mitogen-activated protein kinase and mitogen-activated protein kinase kinase genes in Capsicum annuum.

The tripartite mitogen-activated protein kinase (MAPK) signaling cascades have been implicated in plant growth, development, and environment adaptation, but a comprehensive understanding of MAPK signaling at genome-wide level is limited in Capsicum annuum. Herein, genome-wide identification and transcriptional expression analysis of MAPK and MAPK kinase (MAPKK) were performed in pepper. A total of 19 pepper MAPK (CaMAPKs) genes and five MAPKK (CaMAPKKs) genes were identified. Phylogenetic analysis indicated that CaMAPKs and CaMAPKKs could be classified into four groups and each group contains similar exon-intron structures. However, significant divergences were also found. Notably, five members of the pepper MAPKK family were much less conserved than those found in Arabidopsis, and 9 Arabidopsis MAPKs did not have orthologs in pepper. Additionally, 7 MAPKs in Arabidopsis had either two or three orthologs in the pepper genome, and six pepper MAPKs and one MAPKK differing in sequence were found in three pepper varieties. Quantitative real-time RT-PCR analysis showed that the majority of MAPK and MAPKK genes were ubiquitously expressed and transcriptionally modified in pepper leaves after treatments with heat, salt, and Ralstonia solanacearum inoculation as well as exogenously applied salicylic acid, methyl jasmonate, ethephon, and abscisic acid. The MAPKK-MAPK interactome was tested by yeast two-hybrid assay, the results showed that one MAPKK might interact with multiple MAPKs, one MAPK might also interact with more than one MAPKKs, constituting MAPK signaling networks which may collaborate in transmitting upstream signals into appropriate downstream cellular responses and processes. These results will facilitate future functional characterization of MAPK cascades in pepper.

[Endoscopic removal of foreign body in nasal apex: a case report].

We present a rare case report of foreign body of the nasal apex in a 22-year man who were hospitalized because of a bit of metal rebounded. There was slight bleeding at wound site with a feeling of pain and swelling. On physical examination, the apex lied in the median position with a bleeding cut about 3 millimeter in length. There was no visible stump on the cut or rupture in the nasal vestibular. Computed tomographic scan showed the abnormal high-density shadow in the nasal apex while the foreign body was located in the subcutaneous tissue of the antero-upper part of septal cartilage. The admitting diagnosis was foreign body in nasal apex. Endoscopic surgery was adopted to remove the foreign body.

[Treatment of cystic lesions in sella through transsphenoidal endoscopic endonasal approach: retrospective analysis of 46 cases].

OBJECTIVE: To analyze the clinical and imaging characteristics of patients with cystic lesions in sella region and to describe the experience of endoscopic transsphenoidal surgery. METHODS: Fourty-six cases of cystic lesions in sella region confirmed by surgery and pathology between June 2003 and September 2013 were retrospectively analysed. The clinical features, imaging, surgical technique and postoperative recurrence in 46 cases were presented. RESULTS: All lesions were resected through transsphenoidal endoscopic endonasal approach. Followed up lasted from 6 months to 6 years. Postoperatively, headache was recovered in 26 cases and wasn't recovered in 8 cases, visual was improved in 12 cases and wasn't improved in 2 cases, hypopituitarism was relieved in 18 cases and wasn't relieved in 15 cases, polyuria was disappeared in 8 cases and wasn't disappeared in 4 cases. Seven cases recurred, including 4 cases of craniopharyngioma, 2 cases of pituitary abscess, 1 case of cystic adenoma. There were no death and serious complication. The small age of onset, visual acuity and visual field symptoms, tumor in suprasellar, third ventricle compression was easy to occur in craniopharyngioma; cystic tumor, cavernous sinus invasion, the solid part homogeneous enhancement could be seen in cystic adenoma; Rathke cyst showed simple cystic, lighter clinical symptoms and a short course. Prone to diabetes insipidus, low multiple hormone level and the lesions of annular enhancement was more common in pituitary abscess. CONCLUSIONS: The clinical features and imaging of cystic lesions in sella region feature overlap each other, but there are certain specificity. Transsphenoidal endoscopic endonasal approach for the surgery of cystic lesions in sella is effective and safe.

[Olfactory function in patients with Alzheimer' disease].

OBJECTIVE: To analyze the relationship between olfactory bulb (OB) volume, depth of olfactory sulcus (OS) and olfactory function in patients with Alzheimer' disease (AD). METHOD: Fifty patients with AD patients and 50 healthy subjects were examined by olfactory function T&T testing, OB volume and depth of OS assessed with Magnetic resonance imaging (MRI). RESULT: T&T olfactory testing revealed that AD patients had higher scores than control group (1.50 ± 0.17, 2.80 ± 0.31, P < 0.05). Bilateral and average OB volumes were smaller in AD group [(29.78 ± 5.17) mm3, (30.14 ± 4.87)mm3, (30.05 ± 5.08) mm3] than in control group [(36.65 ± 4.08)mm3, (36.56 ± 4.12)mm3, (36.46 ± 4.11)mm3] (P < 0.01). OS depth study revealed no statistical difference between AD patients and control groups (P > 0.05). Olfactory discriminate threshold was negatively correlated with average olfactory bulb volumes (r = -0. 711, P < 0.05), and was not correlated with depth of OS (r = -0.127, P > 0.05) in AD patients. CONCLUSION: The OB volume were lower in AD patients as compare to controls, the depth of OS has no significant changes in AD patients; The OB volume is correlated with olfactory function, the depth of OS is no correlated with olfactory function. Cognitive impairment degree in AD patients is accordance with the lower degree olfactory function. The olfactory loss may be the earlier period and objective diagnosis indicator for AD patients.

[Related factors analysis of spontaneous cerebrospinal fluid leak recurrence after endoscope operation].

OBJECTIVE: To Summarize and analyze the clinical characteristics and treatment of patients with spontaneous cerebrospinal fluid rhinorrhea, and to explore the related factors of recurrence. METHOD: Retrospective- ly analyze the clinical data of 58 patients of spontaneous cerebrospinal fluid rhinorrhea from July 2002 to July 2012, combined with its clinical characteristics, and statistically analyze the related recurrence factors. RESULT: Fifty-eight cases were accepted the nasal endoscopic repairment of cerebrospinal fluid rhinorrheak, follow-up 3 years, 20 cases (34.5%) recurred, 1 case recurred in half a year after operation. In the first year, there were 10 cases recurred. In the second year there were 9 cases recurred, and 1 case recurred in the third year. Through multiariable analysis it was found that higher BMI, empty sella and skull base bone defect were the independent risk factors influencing the recurrence of spontaneous cerebrospinal fluid rhinorrhea (P < 0.05). CONCLUSION: The recurrence rate of spontaneous cerebrospinal fluid rhinorrhea is high, needing long-term follow-up. Higher BMI, empty sella, skull base bone defect are independent risk factors of recurrence of the disease, and the treatment should be individualized.

[The treatment principles of frontal sinus tract after the frontal approach craniotomy].

OBJECTIVE: To investigate the causes, clinical manifestation and treatment principles of frontal sinus tract after the frontal approach craniotomy. METHOD: The clinic data of 13 patients with frontal skin sinus tract after the frontal approach craniotomy were retrospectively analyzed. All of them were described in the clinical record to have undergone frontal sinus mucosa pushing down or shaving and bone wax filling in the frontal sinus during the surgery, of whom 3 cases had history of frontal abscess incision drainage. All patients were performed endoscopic frontal sinus surgery and forehead skin sinus tract excision and suture. RESULT: All of the patients successfully recovered after one-stage operation, and the frontal skin sinus tract was healed. CONCLUSION: The frontal approach craniotomy with postoperative frontal sinus tract was related with the improper use of bone wax tamponade and sealing of frontal sinus. The treatment principles were to remove bone wax, remove inflammatory granulation tissue around the sinus tract, and to open frontal sinus and promote frontal sinus drainage.

[Clinical analysis of sphenoid sinusitis after transsphenoidal sellar surgery].

OBJECTIVE: To analyze the possible influence factors of sphenoid sinusitis after endoscopic transsphenoidal sellar surgery. METHODS: A retrospective analysis of 177 patients who underwent transsphenoidal sellar surgery, from January 2009 to January 2014 in Tianjin Huanhu Hospital was performed. All patients were followed up with nasal endoscope. The risk factors of sphenoid sinusitis after surgery were analyzed statistically, such as sex, age, categories of disease, surgical produres, tumor size, using artificial or self material repair, with or without EC glue intraoperatively, etc. SPSS 17.0 software was used to analyze the data. RESULTS: After surgery, there were 34 (19.2%) patients developed postoperative sinusitis. EC glue was the sole risk factor for postoperative sinusitis (34.57% vs 6.25%, χ(2)=22.701, P<0.01), but the sex, age, categories of disease, surgical produres, tumor size and patching material had no significant difference (all P>0.05). CONCLUSIONS: In patients with endoscopic transsphenoidal sellar surgery, regular postoperative nasal endoscopic follow-up found that the use of EC glue was the risk factor for the development of postoperative sphenoid sinusitis.

Malignant transformation of sinonasal inverted papilloma: A retrospective analysis of 32 cases.

Sinonasal inverted papillomas (SNIPs) are derived from the benign tumors of the epithelial cells and have the potential to recur and exhibit malignant characteristics. The aim of the present study was to investigate the clinicopathological features and prognosis of patients with malignant transformation of SNIP. A total of 32 consecutive cases, who were patients at the Department of Otorhinolaryngology Head and Neck Surgery, Tianjin Huanhu Hospital from January 1991 to January 2008, were retrospectively reviewed. Survival rates and prognostic factors were calculated using the Kaplan-Meier method and multivariate Cox model survival analysis. The malignancy accounted for 8.99% of all types of SNIP. There were 25 males and seven females, and the median age of onset was 56.5 years. The sites of tumor included 22 in the nasal cavity and ethmoid sinuses, and 10 in the maxillary sinus. The tumors included 21 high-grade tumors, eight intermediate-grade tumors and three low-grade tumors. The number of patients with T1, T2, T3 and T4 stage disease was three, 10, 16 and three, respectively, according to the American Joint Committee on Cancer staging method. Based on the percentage of malignant cells in the entire tumor tissue, five patients had grade I tumors, five had grade II, eight had grade III and14 had grade IV. Among the 32 patients, three cases exhibited distant metastasis, and 19 patients underwent surgery plus postoperative radiotherapy, 10 underwent surgery alone and three underwent radiotherapy alone. The 5-year survival rate was 72.5% and the median overall survival time was 62.2 months. Kaplan-Meier univariate survival analysis indicated that the clinical stage and treatment method were prognostic factors, and multivariate Cox model survival analysis confirmed that the clinical stage and treatment method were independent factors for overall survival (relative risk: 4.211 and 0.312, respectively; P<0.05 for both). T3 and T4 staging and mono-treatment were associated with poor patient survival. Overall, the present study identified that the morbidity of SNIP-associated malignancy was low, the clinicopathological features were not specific, and the prognosis was improved compared with other types of sinonasal squamous cell carcinoma. The clinical stage and treatment method were found to affect the prognosis, and surgery plus postoperative radiotherapy was the predominant form of treatment. The present study may improve the understanding of the prognosis for patients with malignant SNIP in the future.

[Clinical analysis of nasogenic brain abscess].

OBJECTIVE: To investigate the clinical features of nasogenic brain abscess. METHOD: Four patients with nasogenic brain abscess diagnosed in Tianjin huanhu hospital between June 2007 and January 2013 were reported and the relevant literatures reviewed. RESULTS: All four patients were frontal abscess, however, the pathogeny of frontal abscess were different. These four patients were treated by different methods and followed up from 12-28 months, no recurrence was found. All four patients were cured. CONCLUSIONS: The clinical manifestation of nasogenic brain abscess was hiding and was easy to misdiagnosis. Enhanced MRI is the key of the diagnosis. According to the pathogeny of brain abscess, it was important to cure nasogenic brain abscess with different ways.

[Analysis of intracranial infection factors after transnasal endoscopic repair of cerebrospinal fluid rhinorrhea].

OBJECTIVE: To analyze the factors of intracranial infection after transnasal endoscopic repair of cerebrospinal fluid rhinorrhea. METHODS: One hundred and seventy-three patients who accepted transnasal endoscopic repair of cerebrospinal fluid rhinorrhea were retrospectively analyzed. The intracranial infection factors was analyzed by Logistic regression analysis with SPSS 17.0 software. RESULTS: Postoperative infection was found in 17 cases among 173 patients, the infection rate was 9.83%. The unsuccessful transnasal endoscopic repair of cerebrospinal fluid rhinorrhea (χ(2) = 6.89, P = 0.001) , the defective diameter of skull base (χ(2) = 9.98, P = 0.001) and medical history of intracranial infection (χ(2) = 11.08, P = 0.001) were infection factors after transnasal endoscopic repair of cerebrospinal fluid rhinorrhea (all P < 0.05), while sex, age, the site of defection, the aetiological agent, longer application of antibiotics before or after operation and the use of artificial material had no obvious effect (all P > 0.05). CONCLUSION: Intracranial infection after transnasal endoscopic repair of cerebrospinal fluid rhinorrhea is affected by many factors, such as the unsuccessful transnasal endoscopic repair of cerebrospinal fluid rhinorrhea, the defective diameter of skull base and medical history of intracranial infection.

[Transsphenoidal endoscopic endonasal approach for the surgery of pituitary abscess].

OBJECTIVE: To evaluate the effectiveness of transsphenoidal endoscopic endonasal approach for the surgery of pituitary abscess. METHODS: Eighteen pathologically diagnosed pituitary abscess were resected through transsphenoidal endoscopic endonasal approach at Tianjing Huanhu hospital between January 2000 and December 2011.Retrospective analysis was done upon clinical presentations and imaging features. There were 6 males and 12 females. The average age was 48.5 years old and the average disease course was 5.8 years. The typical clinical manifestations included headache (13 cases), pituitary dysfunction (10 cases), Diabetes Insipidus (4 cases) visual interference (8 cases) and fever (4 cases). All cases were resected by transsphenoidal endoscopic endonasal approach with general anesthesia. The postoperative symptoms and follow-up results were recorded. RESULTS: All patients were followed up from 6 months to 6 years. Postoperatively, headache was recovered in 13 cases, visual was improved in 6 cases, hypopituitarism was relieved in 8 cases and polyuria was disappeared in 3 cases. One case was recurrent and cured by transsphenoidal endoscopic endonasal approach. CONCLUSIONS: Transsphenoidal endoscopic endonasal approach for the surgery of pituitary abscess is effective.