The objective of this study is to observe the adult growth hormone level in postoperative pituitary tumor patients of multi-centers, and explore the change of hypophyseal hormones in postoperative pituitary tumor patients. Sixty patients with pituitary tumor admitted during March, 2011–March, 2012 were selected. Postoperative hypophyseal hormone deficiency and the change of preoperative, intraoperative, and postoperative growth hormone levels were recorded. Growth hormone hypofunction was the most common hormonal hypofunction, which took up to 85.0 %. Adrenocortical hormone hypofunction was next to it and accounted for 58.33 %. GH + ACTH + TSH + Gn deficiency was the most common in postoperative hormone deficiency, which took up to 40.00 %, and GH + ACTH + TSH + Gn + AVP and GH deficiencies were next to it and accounted for 23.33 and 16.67 %, respectively. The hormone levels in patients after total pituitary tumor resection were significantly lower than those after partial pituitary tumor resection, and the difference was statistically significant; growth hormone and serum prolactin levels after surgery in two groups were decreased, and the difference was statistically significant. The incidence rate of growth hormone deficiency in postoperative pituitary tumor patients is high, which is usually complicated with deficiency of various hypophyseal hormones. In clinical, we should pay attention to the levels of the hypopnyseal hormones, and take timely measures to avoid postoperative complications.

Using electroencephalography (EEG) for diagnosing subsequent epilepsy in children after febrile seizure (FS) is not common. The present study investigates the relationship between epileptiform discharges and subsequent epilepsy, and looks for the predictive marker for this disorder. A total of 378 children with complex FS and whose EEG showed epileptiform discharges or normal EEG were included. Development of FS was compared between those with epileptiform discharges and those with normal EEG. Risk factors were analyzed using multivariate logistic regression to clarify their effects on subsequent epilepsy. The association between generalized or focal EEG localization, and between frontal epileptiform discharges and subsequent epilepsy, were analyzed. Among 378 patients with complex FS, 51 showed epileptiform discharges. History of epilepsy, frontal seizure, number of FS, and prolonged seizure were the risk factors for epileptiform discharge. Subsequent epilepsy was significantly frequent in patients with more than 2 risk factors (odds ratio [OR] = 17; 95% confidence interval [CI] = 4.1-29.6). Prolonged seizure (OR = 4.98; 95% CI = 1.63-13.29), FS number (OR = 2.96; 95% CI = 1.23-10.51), and family history of epilepsy (OR = 2.67; 95% CI = 1.05-7.63) were significantly correlated with subsequent epilepsy. Of 9 patients with paroxysms in the frontal region, 8 (88.9%) developed epilepsy. There was concordance between frontal epileptiform discharges and subsequent epilepsy (κ = .901). In conclusion, epileptiform discharges are risk factors for subsequent epilepsy. Frontal paroxysmal EEG is a marker for subsequent epilepsy.

<正>妊娠期胆胰疾病多由胆道梗阻引起,及早解除梗阻、通畅引流最为关键[1]。妊娠期胆胰疾病中胆总管结石最常见,经内镜逆行胰胆管造影(endoscopic retrograde cholangiopancreatography,ERCP)是处理胆总管结石的首选方法[2]。常规ERCP需要在X线辅助下完成,尽管大多数专家认为,单次ERCP所需X线照射剂量对孕妇和胎儿的影响不大,但X线照射的安全性

Objective To assess the feasibility and safety of adjustable loop-based purse-string technique in gastrotomy closure of natural orifice translumenal endoscopic surgery (NOTES).Methods Ten healthy female dogs were used in this study.Transgastric NOTES peritoneal exploration was performed in 5 groups (2 dogs in each) via various sites of the stomach ( greater curvature of the antrum; greater and lesser curvature of the body; anterior and posterior wall of the body).The gastric incision was then closed by using loop-based purse-string technique.Healing of the incision and intra-peritoneal infection were checked by endoscopy,necropsy,bacterial culture and histological examination 2 weeks later.Results The performance of NOTES peritoneal exploration and closure with purse-string technique was successful in ten dogs without significant complications.The mean operation time of closure was 7.3 ± 1.8 min.Minor bleeding occurred in 2 dogs (20％) during the incision of greater curvature of the antrum and body,which was controlled by electrocoagulation.Culture of the ascitic fluid and necropsy revealed no sign of abdominal infection or other complications except for adhesion in 1 dog ( 10％ ).The intact incision was confirmed by endoscopic,postmortem and histological examination,which suggested complete healing of the incision.Conclusion It is easy and safe to use loop-based purse-string technique for closure of multi-regional NOTES gastrotomy.This technology may be used for the repair of gastric ulcer perforation theoretically.

Objective To explore the technique and precautions of microsurgical treatment of temporal lobe arachnoid cysts complicated with spilepsy.Methods The clinical data of 32 patients with temporal lobe arachnoid cysts complicated with epilepsy,admitted from Nov.2007 to Apr.2010,were analyzed retrospectively.The diagnosis of temporal lobe arachnoid cysts was confirmed before surgical operation by cranial MRI or CT.Continual video-electroencephalogram monitoring with sphenoidal electrodes were employed in all patients,and spike-wave,polyspike-wave and/or sharp-slow-wave was detected at arachnoid cyst side.Craniotomy was performed under general anesthesia,the temporal lobe arachnoid cysts were treated by microsurgical excision.Besides,partial anterior temporal lobectomy,hippocampectomy,amygdalotomy and bipolar electrogulation on functional cortex were conducted in all cases.Intraoperative electroencephalography(EEG) monitoring was used in all patients.And an one year follow-up after surgery was carried out.Results No postoperative death occurred.Transient aphasia and hemiplegia were found in 14 patients(10 in left and 4 in right) and recovered 7-10 days after treatment.A one-year MRI follow-up showed the temporal lobe arachnoid cysts disappeared in 12 patients(37.5%),shrank in 8(25.0%),and unchanged in 12(37.5%).Epileptic symptom disappeared in 27 cases(84.4%) and temporary symptoms could be observed in 5 cases(15.6%).Continual video-electroencephalogram monitoring with sphenoidal electrodes showed no spike-wave,but sharp wave was detected in 8 cases and sharp-slow wave complexes were detected in 4 cases.Conclusion Microsurgery used in resection of the cysts and epileptic foci may achieve good therapeutic effects for temporal lobe arachnoid cysts complicated with epilepsy.

In the classification and administration of 3 103 patients suffered from earthquake,it is important to undertake the emergency strategy quickly,set up classification organization,identify the staff position and responsibility,choose a reasonable classification site and mark the classification label.Such strategies could adequately utilize human resources and meet different needs of mide or serious patients acquired emergency treatments,and made tasks of emergency and transportation go on well.All patients suffered from earthquake could be classified as three types:patients needing emergency treatments,patients needing delayed treatments and patients who could be expected to be treated.To avoid mass and low efficiency caused by large quantity of patients,three basic patterns were used,such as admitted classification,therapy classification and transport classification.This method of classification and administration is proved to be standard and efficient in emergency treatments for a large number of patients suffered from earthquake.

通过对3 103例地震伤员的现场分类,认为迅速启动应急机制、建立分类组织、明确分类人员职责,选择合理分类场所和佩带分类标志是使大批伤员能得到及时,合理救治的前提.现场将伤员分为3类:一类是紧急救治组,二类是延期治疗组,三类是期待治疗组.采取收容分类、救治分类和后送分类3种基本形式,可避免伤员多所致工作忙乱.救治效率低的问题,为地震灾害中大批伤员分类急救提供一种程序、规范、高效的分类方法.