Common Problems and Quality Control in Clinical Rehabilitation Intervention Studies / 中国康复理论与实践

Based on the experience of our team combined with literature analysis, there were some problems in study of clinical intervention, mainly in the aspects of clinical trial registration, construction of intervention programs, recruitment and compliance of research objects, intervention fidelity, selection of outcome indicators and data collection and analysis. It is necessary to understand the importance of clinical trial registration and follow the registration procedure, establish an intervention program based on the theoretical framework, focus on the factors that impede or promote the recruitment of objects to ensure the sample size, formulate strategies to improve the compliance and intervention fidelity of the intervention objects and select the appropriate outcome indicators， apply appropriate data collection and analysis methods based on the content of the study, and thus improve the quality of intervention researches.

Repeat transsphenoidal surgery for pituitary adenoma / 中华神经医学杂志

Objective To explore the strategies of repeat transsphenoidal surgery (TSS) for pituitary adenomas.Methods Surgical techniques and treatment outcomes of 23 patients with pituitary adenomas,performed repeat TSS in our hospital from January 2003 to October 2012,were retrospectively analyzed.Results All repeat TSS were done under a microscope; four patients were performed navigation-guided surgery and one patient used C-arm fluoroscopy.The tumor heights were 15-45 mm,and the tumors were total removed in 12 cases,subtotal resection or most resection in 10 cases and partial removal in 1 case.There were 10 cases of cerebrospinal fluid leakage during operation.Eighteen cases were followed up,with postoperative abducens nerve palsy and long-term diabetes insipidus in one each case,and one case needed the hormone replacement therapy.Conclusion Repeat TSS should correct surgical approach as much as possible and enlarge the tumor' s exposure,and should be alert to the occurrence of cerebrospinal fluid leakage.

Expression of leptin in pituitary adenomas and its clinical significance / 中华神经医学杂志

Objective To detect the expression of leptin in pituitary adenomas and investigate the association of leptin expression with the invasiveness and proliferation of pituitary adenomas. Methods Sixty-one surgical specimens of pituitary adenomas and the clinical data of the cases were obtained from the Department of Nenrosurgery, Changzheng Hospital between February and October in 2007. Immunohistochemical staining was used to detect the expressions of leptin and Ki-67 in the pituitary adenomas to investigate the role of leptin in the occurrence and development of the tumor. Results The overall leptin positivity rate in these pituitary adenomas was 34.4%, significantly lower than that in normal pituitary tissues (P<0.05). The Ki-67 index and diameter of the leptin-positive pituitary adenomas were significantly lower than those of leptin-negative tumors (P<0.05). The leptin expression rate was significantly lower in invasive pituitary adenomas than in non-invasive adenomas (P<0.05). Conlusions Compared with normal pituitary tissues, pituitary adenomas have reduced leptin expression, which is significantly correlated to Ki-67 index, tumor invasiveness and diameter but not to the patients' age or gender.

Effect of platelet-activating factor on cell proliferation & NF-kappaB activation in airway smooth muscle cells in rats.

BACKGROUND & OBJECTIVE: Despite the established pro-inflammatory actions of platelet activating factor (PAF) observed on chronic obstructive pulmonary disease (COPD), its action on airway remodeling has been still unclear. It has been reported that nuclear factor-kappa B (NF-kappaB) activity is necessary for ASMC proliferation. Further, PAF has been identified as the proximal inducer of NF-kappaB. The present study was thus aimed to investigate the effect of PAF on airway smooth muscle cells (ASMC) proliferation and to evaluate the potential role of NF-kappaB in this regulation. METHODS: Healthy male Sprague-Dowley rats of 6-8 wk age were used for obtaining ASMCs. 3-(4,5- dimethylthiazole-2-yl)-2,5-diphenyltetrazolium-bromide (MTT) assay was to investigate the effects of PAF on ASMC proliferation and to confirm its optimum concentration for action. Additionally, cell proliferation was also examined using cell cycle assay by flow cytometry and immunocytochemical staining for proliferating cell nuclear antigen (PCNA). And NF-kappaB DNA-binding activity was assayed by electrophoretic mobility shift assay (EMSA). RESULTS: PAF stimulated ASMC proliferation with its peak at 100 nM. At this optimum concentration, PAF significantly increased the cell proliferation index (PI) and the PCNA-positive rate in the ASMCs, as well as NF-kappaB DNA- binding activity. Whereas, 20 mM N-acetylcysteine (NAC) pre-treatment effectively blocked all of these events. INTERPRETATION & CONCLUSION: The present findings demonstrated that PAF could promote ASMC proliferation, suggesting its potential involvement in airway remodeling. Our study also suggested the promising action of 20 mM NAC on the alleviation of airway remodeling due to direct inhibition of ASMC proliferation. The involved mechanism would be relevant to the change of NF-kappaB activation in ASMCs.