AimTo report the results of a series of patients undergoing pure endoscopic endonasal pituitary surgery and to evaluate the efficacy and safety of this procedure.Materials and methodsThe data of 1,166 patients that underwent endoscopic endonasal transsphenoidal adenoma removal between December 2006 and June 2013 were retrospectively reviewed. Pre- and postoperative hormonal status (3 months after surgery) were analyzed and compared with the clinical parameters originally presented by the patients. The incidences of tumor removal, hormonal control, and tumor removal complications were retrospectively analyzed.ResultOut of 577 nonfunctioning adenomas, 180 were growth hormone (GH) secreting, 308 prolactin (PRL) secreting, 26 mixed GH/PRL adenomas, 68 adrenocorticotropin secreting, and 7 thyroid-stimulating hormone-secreting adenomas. The gross total removal of pituitary adenomas was achieved in 98 % of microadenomas, 92 % of macroadenomas, and 76 % of giant adenomas. Hormonal control was achieved in 47 (69 %) cases of ACTH adenomas, 119 (66 %) GH adenomas, 262 (85 %) PRL adenomas, and 6 (86 %) TSH adenomas. Postoperative complications were observed in 168 (14.4 %) patients. The most frequent complications were diabetes insipidus (7 %), epistaxis (1.7 %), hyposmia (1.5 %), anterior lobe insufficiency (1.3 %) ,and CSF leaks (0.6 %).ConclusionThe pure endoscopic approach is a safe, efficacious, and minimally invasive technique for the removal of pituitary adenomas. A higher gross total resection rate is vital for non-functional and functional adenomas. For patients with functional adenomas, while hormonal remission is unlikely to be achieved by surgery, the use of adjuvant therapy is advocated to obtain long-term hormonal control.

Clinical studies indicate that high blood levels of leptin or matrix metalloproteinase-7 (MMP-7; matrilysin) proteins are associated with tumor progression of human colorectal cancer (CRC). Leptin could play an important role in cell migration and invasion of cancer cells. Our previous study indicated that lycopene could inhibit the proliferation of human colon cancer cells in vitro. However, the inhibitory effects of lycopene on the progression of human colon cancer cells have not been demonstrated yet. In this study, we investigated the inhibitory effects of lycopene on tumor progression including cell invasion and MMP-7 expression in leptin-stimulated human colon cancer cells in vitro. Our results demonstrated that lycopene significantly inhibited leptin-mediated cell invasion and MMP-7 expression in human colon cancer HT-29 cells. Lycopene could augment the expression and stability of E-cadherin proteins. Our results showed that MAPK/ERK and PI3K/Akt signaling pathways played important roles in leptin-mediated MMP-7 expression and cell invasion. Lycopene could effectively inhibit the phosphorylation of Akt, glycogen synthase kinase-3β (GSK-3β) and ERK 1/2 proteins. The molecular mechanisms of lycopene were in part through decreases in nuclear levels of AP-1 and β-catenin proteins. These novel findings suggested that lycopene could act as a chemopreventive agent to suppress MMP-7 expression and leptin-mediated cell invasion in human colon cancer HT-29 cells.

No abstract

Background. Repetitive transcranial magnetic stimulation (rTMS) is a promising therapeutic tool for Parkinson’s disease (PD), and many stimulation targets have been implicated. We aim to explore whether low-frequency rTMS over the right dorsolateral prefrontal cortex (DLPFC) improves motor and nonmotor symptoms of individuals with PD. Methods. We conducted a randomized, single-blind, sham-controlled parallel trial to compare the effect of 10 consecutive daily sessions of 1 Hz rTMS over right DLPFC on individuals with idiopathic PD between active and sham rTMS group. Primary outcomes were changes in Unified Parkinson’s Disease Rating Scale (UPDRS) part III and Nonmotor Symptom Questionnaire (NMSQ). Secondary outcomes were changes in UPDRS total score, Hamilton Rating Scale for Depression (HRSD), Pittsburgh Sleep Quality Index (PSQI), and Montreal Cognitive Assessment (MoCA). Assessments were completed at baseline, after treatment, and at 1 month, 3 months, and 6 months after treatment. Results. A total of 33 participants with PD were randomized. All participants completed the study and no severe adverse effect was noticed. Compared to baseline, active rTMS showed significant improvements in UPDRS part III and NMSQ at 1 month. Change of scores on UPDRS part III, HRSD, and PSQI persisted for 3 months after rTMS intervention. The beneficial effect on cognitive performance assessed by MoCA was maintained for at least 6 months in the follow-up. No significant changes were observed in the group with sham rTMS. Conclusions. Low-frequency rTMS of right DLPFC could be a potential selection in managing motor and nonmotor symptoms in PD.

Novel ABA-type dumbbell-like water-soluble copolymers [D230(EI) 4 , D400(EI) 4 , and D400(EI) 8 ] were synthesized by introducing ethylenimine (EI) groups into both sides of polyoxypropylenediamines via a simple in situ ethylamination of polyoxypropylenediamine with 2-chloroethylamine hydrochloride. The structures of the resultant polymers were identified by Fourier transform infrared spectroscopy and 1 H NMR. The percentages of primary, secondary, and tertiary amine present were determined by the potentiometric titration method after treatments with the appropriate chemicals of salicylaldehyde and acetic anhydride. The surface tension and solubilizing behavior of pyrene in the presence of these polymers in aqueous medium were also investigated, and the efficiency to reduce the surface tension and solubilizing behavior of pyrene depends on the attachments of EI to polymer backbone. The chelating properties of these polymers were examined quantitatively by ultraviolet-visible (UVvis) spectroscopy in the presence of Cu 2ϩ ions in aqueous solution, and continuous variation analysis revealed that the most stable complex is formed at the normality ratio of [N]/[Cu 2ϩ ] ϭ 3.0. UV-vis spectroscopy and transmission electron microscopy were used to evaluate the dumbbell-like water-soluble copolymer, D400(EI) 8 , as a stabilizer for preparing colloidal noble metal nanoparticles (Au and Pt) in aqueous solution.

To dispose of the large amount of OSA (oil shale ash) and FA (fly ash) in Northeast China, a novel subgrade material obtained by modifying SC (silty clay) with OSA and FA was produced. First, the effect of F-T (freeze-thaw) cycles and stress states on the resilient modulus of unmodified SC and the modified SC were investigated. Second, the damage ratio was introduced to describe the relationship of resilient modulus versus F-T cycles. Third, the effect of F-T cycles on the microstructure of soils was investigated. The results indicate that in addition to stress state, resilient modulus is significantly influenced by F-T cycles. For unmodified SC, the resilient modulus continually decreases with increasing F-T cycles. As for the modified soil, the resilient modulus decreases sharply after the first F-T cycle and then tends to be stable. The damage ratio and its fitting equation are effectively adopted to describe the variation characteristic of the resilient modulus after F-T cycles. As observed from SEM testing, the effect of F-T cycles on soils is to destroy the initial structure and increase the porosity of soils. It could be concluded that the microstructure change during F-T cycles is the main factor that results in the decrease of the resilient modulus.

To evaluate effect of sellar reconstruction during pituitary adenoma resection surgery by the endoscopic endonasal transsphenoidal approach using artificial cerebral dura mater patch.This was a retrospective study of 1281 patients who underwent endoscopic transsphenoidal resection for the treatment of pituitary adenomas between December 2006 and May 2014 at the Neurosurgery Department of the People's Liberation Army General Hospital. The patients were classified into 4 grades according to intraoperative cerebrospinal fluid (CSF) leakage site. All patients were followed up for 3 months by telephone and outpatient visits.One thousand seventy three (83.7%) patients underwent sellar reconstruction using artificial dura matter patched outside the sellar region (method A), 106 (8.3%) using artificial dura matter patched inside the sellar region (method B), and 102 (8.0%) using artificial dura matter and a mucosal flap (method C). Method A was used for grade 0-1 leakage, method B for grade 1 to 2 leakage, and method C for grade 2 to 3 leakage. During the 3-month follow-up, postoperative CSF leakage was observed in 7 patients (0.6%): 2 among patients who underwent method B (1.9%) and 5 among those who underwent method C (4.9%). Meningitis was diagnosed in 13 patients (1.0%): 2 among patients who underwent method A (0.2%), 4 among those who underwent method B (3.8%), and 7 among those who underwent method C (6.7%).Compared with other reconstruction methods, sellar reconstruction surgery that only use artificial dura mater as repair material had a low rate of complications.

Beyond the common difficulties faced in the natural image captioning, medical report generation specifically requires the model to describe a medical image with a fine-grained and semantic-coherence paragraph that should satisfy both medical commonsense and logic. Previous works generally extract the global image features and attempt to generate a paragraph that is similar to referenced reports; however, this approach has two limitations. Firstly, the regions of primary interest to radiologists are usually located in a small area of the global image, meaning that the remainder parts of the image could be considered as irrelevant noise in the training procedure. Secondly, there are many similar sentences used in each medical report to describe the normal regions of the image, which causes serious data bias. This deviation is likely to teach models to generate these inessential sentences on a regular basis. To address these problems, we propose an Auxiliary Signal-Guided Knowledge Encoder-Decoder (ASGK) to mimic radiologists' working patterns. In more detail, ASGK integrates internal visual feature fusion and external medical linguistic information to guide medical knowledge transfer and learning. The core structure of ASGK consists of a medical graph encoder and a natural language decoder, inspired by advanced Generative Pre-Training (GPT). Experiments on the CX-CHR dataset and our COVID-19 CT Report dataset demonstrate that our proposed ASGK is able to generate a robust and accurate report, and moreover outperforms state-of-the-art methods on both medical terminology classification and paragraph generation metrics.