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Objective::To observe the clinical efficacy of modified Buyang Huanwu Tang combined with Sanrentang in treating early diabetic nephropathy(DN)with deficiency of spleen and kidney, damp-heat and blood stasis syndrome and its effect on glucose and lipid metabolism, oxidative stress and inflammatory factors, in order to explore its mechanism. Method::A total of 72 early DN atients were randomly divided into control group and treatment group, with 36 cases in each group. The control group was orally treated with losartan potassium tablets(50 mg every time, once/day), while the treatment group was treated with modified Buyang Huanwu Tang combined with Sanrentang orally in addition to the therapy of the control group(1 dose/day). Both groups were treated for 3 months. The changes in clinical efficacy and safety indicators were observed for both groups. The 24 h urine albumin excretion rate(UAER), serum creatinine(SCr), serum cystatin C(Cys C), urea nitrogen (BUN), fasting blood glucose (FBG), 2 h postprandial blood glucose (2 hPG), glycosylated hemoglobin (HbA1c), total cholesterol (TC), triglyceride(TG), low-density lipoprotein cholesterol(LDL-C), high-density lipoprotein cholesterol(HDL-C), malondialdehyde(MDA), superoxide dismutase(SOD), glutathione Peroxidase(GSH-Px), interleukin-2(IL-2), interleukin-4(IL-4), interleukin-8(IL-8), interleukin-10(IL-10), tumor necrosis factor-α(TNF-α)of patients in two groups were observed before and after treatment. Result::The total clinical effective rate was 88.9%in therapy group, which was higher than 61.1%in control group(P<0.05). After treatment, levels of UAER, SCr, Cys C and BUN were lower in both groups(P<0.05), and the levels in treatment group were all lower than those in control group(P<0.05). Levels of FBG, 2 hPG and HbA1c were lower in both groups(P<0.05). There was no significant difference in FBG, 2 hPG and HbA1c levels between two groups after treatment. The levels of HDL-C were higher in both groups(P<0.05), and the levels in treatment group were higher than that in control group(P<0.05). The levels of TC, TG and LDL-C were lower in both groups(P<0.05), and the levels in treatment group were all lower than those in control group(P<0.05). The level of MDA was lower in both groups(P<0.05), and the level in the treatment group was lower than that in control group(P<0.05). The levels of SOD and GSH-Px were higher in both groups(P<0.05), and the levels in the treatment group were all higher than those in the control group(P<0.05). Serum levels of IL-2, IL-8 and TNF-α were lower in both groups(P<0.05), and the levels in the treatment group were lower than those in control group(P<0.05). Serum levels of IL-4 and IL-10 were higher in both groups(P<0.05), and the levels in the treatment group was higher than those in control group(P<0.05). Conclusion::Modified Buyang Huanwu Tang combined with Sanrentang is effective and safe in the treatment of early DN with spleen and kidney deficiency, damp-heat and blood stasis syndrome. They can further improve renal function and lipid metabolism, inhibit oxidative stress reaction and regulate the secretion balance of inflammatory factors in early DN patients.

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OBJECTIVE: To explore the surgical methods and clinical effect of endoscopic endonasal approaches for the treatment of invasive pituitary adenomas (IPAs). METHODS: A retrospective analysis was made of the clinical data of 74 patients (75 procedures) with IPAs treated by different endoscopic endonasal approaches at the Department of Neurosurgery, The First Affiliated Hospital of Shenzhen University from May 2014 to August 2017. The data include clinical manifestation, imaging features, surgical methods and complications, resection rate, cure rate, prognosis, and complications in different Knosp classifications and Hardy stages. The transcavernous approach was used in 47 patients, the lateral-cavernous approach was used in 14 patients, the tuberculum sella planum approach was used in 8 patients, and the diaphragma sellae open or dorsum sellae cut approach was used in 6 patients. RESULTS: The gross total resection (GTR) rate was 70.7% (53 patients) and tumor residue rate was 29.3% (22 patients). GTR rate for pituitary adenoma according to Knosp classification was 89.3% in grade 3 and 28.6% in grade 4. The biology cure rate was 75.0% and 23.8%, respectively. There was significance between them (P < 0.05). In addition, the GTR rate of Hardy stage was 90.5% in stage C, 90.0% in stage D, 26.1% in stage E, and the biology cure rate was 80.1%, 75.0%, and 13.0%, respectively. There was significance among them (P < 0.05) Postoperative severe complications included 9 patients (12.0%) with cerebrospinal fluid leaks, 26 patients (34.7%)with electrolyte imbalance, 36 patients (48.0%) with transient diabetes insipidus, 22 patients (29.3%) with hypopituitarism, 2 patients (2.7%) with permanent hypopituitarism, and 2 patients (2.7%)with epistaxis. The follow-up lasted 2-41 months (average, 19.3 months). No patient experienced recurrence after GTR, 1 patient undergoing subtotal experienced recurrence and underwent reoperation, 3 patients underwent postoperative Gamma Knife treatment, and 2 patients with refractory IPA were given temozolomide and metformin chemotherapy. CONCLUSIONS: According to the invasiveness of IPA, choosing the appropriate endoscopic surgical approach is helpful in removing tumors and reducing complications.

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BACKGROUND: To compare the clinical outcomes and complications of 247 pituitary tumor patients managed by endoscopic and microscopic approaches in our hospital. METHODS: The authors performed a retrospective review of 100 pituitary tumor patients treated by endoscopic endonasal transsphenoidal surgery (ETS) and 147 patients treated by microscopic transsphenoidal surgery (MTS) at our center from January 2007 to July 2014. The tumors were stratified by Knosp classification and modified Hardy classification, and tumor gross total resection (GTR)/remission rate, visual improvement rate, complications, operation time, intraoperative bleeding and length of hospital stay were compared between ETS and MTS. RESULTS: The GTR rate decreased with increasing Knosp grades for both ETS and MTS, with the rates of 93.3%, 87.5%, 71.4%, 58.8% for ETS and 82.8%, 92.0%, 70.7%, 36.0% for MTS in resecting Knosp grades 0, I, II, and III tumors, respectively. The visual improvement rates increased with increasing Hardy grades, which was 66.7% and 45.5% for Hardy grade B lesion, 72.2% and 71.4% for grade C lesion, and 88.9% and 78.9% for grade D lesion treated by ETS and MTS, respectively. No significant differences were observed for GTR rate, visual outcome and complication rate between ETS and MTS, while ETS resulted in more intraoperative blood loss, longer operative time, and shorter hospital stay than MTS. CONCLUSIONS: These data conclude that, compared with MTS, ETS needs longer operation time and results in more intraoperative blood loss, but appears to achieve higher GTR rate for Knosp grade III pituitary tumors.

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Objective To explore the effect of neuroendoscopic techniques on treating cerebrospinal fluid (CSF) leakage.Methods Five patient with CSF leakage,admitted to our hospital from November 2012 to April 2013 and treated with surgery under neuroendoscope,were chosen in our study; their clinical data were retrospectively analyzed; the diagnostic methods,surgical methods and clinical effects were summarized.Results Two had traumatic CSF leakage and 3 had iatrogenic CSF leak.In patients with traumatic CSF leakage,brain MR,thin CT scan,skull base reconstruction and cistermography CT were used to determine the location of ventages,while the ventages in patients with iatrogenic CSF leakage can be determined according to clinical experience; the ventages located in the frontal sinus,the ethmoid sinus,the bottom of the saddle,the recessus sphenoethmoidalis,and the border area of middle skull base and parasellar.Direct observation of the ventages was achieved and repair was finished successfully.Follow up for at least three months showed no recurrence or complications.Conclusions Preoperative localization of the ventage of CSF leakage is every important; combination of brain MR,thin CT scan and skull base reconstruction and cistermography CT can accurately locate the ventage in patients with traumatic CSF leakage; for patients with iatrogenic CSF leakage,location of the ventage can be achieved according to clinical experiences.Neuroendoscopy is minimally invasive and having direct view and high success rate,which can be used as the preferred choice for CSF leakage.

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<p><b>OBJECTIVE</b>To investigate the clinical effect of spanishneedles leaves on middle and severe xerophthalmia of menopausal females.</p><p><b>METHOD</b>This study was a prospective random controlled trial. Ninty-six menopausal females diagnosed with xerophthalmnia (aged from 40 to 50) were randomly divided into in two groups: group A' the spanishneedles leaves group (n=48) and group B' the control group (n=48). Both groups were treated with Forte eye drops. All patients were detected at 3, 7, 28 h before and after treatment to evaluate subjective symptoms, OSDI and four tear film indicators. Variance analysis and differential analysis on sample average or median were made on both groups before and after treatment.</p><p><b>RESULT</b>There were no significant difference in symptom and diction indicators between both groups before treatment. For 28 d after treatment, among middle and severe xerophthalmia samples of the spanishneedles leaves group, the mean differences showed significant improvement compared with that before treatment , OSDI and four tear film indicators also showed improvement to varying degrees. For 28 d after treatment, among middle and severe xerophthalmia samples of the vitamin C group, the mean differences showed no significant improvement compared with that before treatment , OSDI and four tear film indicators also showed no remarkable improvement. There were significant differences in OSDI, BUT, SIT, height of tear meniscus and FL between both groups.</p><p><b>CONCLUSION</b>Spanishneedles leaves can effectively improve symposiums and signs of middle and severe xerophthalmia among menopausal females and thus showing clinical significance to some extent.</p>

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Objective To explore the relevant factors of prognosis of intracranial aneurysms after microsurgical treatment and risk factors of cerebral vasospasm (CVS). Methods Three hundred and twenty-two patients with intracranial aneurysms, admitted to and received surgical treatment in our hospital from June 2006 to May 2009, were chosen in our study; their clinical data were retrospectively analyzed. Logistic regression analysis was employed to analyze the influences of age, gender, blood pressure level, blood sugar level, operation time, Fisher's grade, Hunt Hess grade and infection on the prognosis of patients with intracranial aneurysms and the risk of CVS. Results Multivariate logistic analysis indicated that age, Hunt Hess grade, Fisher's grade, CVS, infection and lumber puncture times were the independent risk factors influencing the prognosis of patients with intracranial aneurysms (P< 0.05). Hunt Hess grade, Fisher's grade, number of aneurysms, endplate colostomy, lumber puncture times and infection were the independent risk factors of CVS (P<0.05). Conclusion Age, Hunt Hess grade, Fisher' s grade, CVS, lumber puncture times and infection are the independent risk factors affecting the prognosis of patients with intracranial aneurysms, among which, CVS is the most important factor. CVS is mainly affected by Hunt Hess grade, Fisher's grade, number of aneurysms, endplate colostomy, lumber puncture times and infection.

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Objective To compare the effects and complications between neuroendoscope-assisted and conventional shunt methods in patients with hydrocephalus,Methods The data of 299 patients with hydrocephalus admitted to our hospital from June 2002 and June 2009 were analyzed.Among these patients,98 adopted neuroendscope:78 were performed ventriculoperitoneal shunt(EVPS)combined with endoscopic third ventriculostomy(ETV)and the other 20 with obstructive hydrocephalus were performed ETV only.The other 201 patients adopt conventional operation:VPS was employed in 196 and ventriculoatrial shunt was performed in 5.We compared shunt effectiveness by calculating the pre-and post-operative ventricular indexes,shunt failure rates and complication rates during the follow-up between the 2 groups.Results No difference in etiology of hydrocephalus or clinical characteristics between the 2 groups was found.Compared with the conventional shunt group,neuroendscope-assisted group enjoyed a longer operative time,a higher surgery cost,a lower clogging incidence rote and a higher precision rote of putting the tube(P<0.05).Conclusion Applying of neuroendoscope is a very good option in treating patients with various kinds of hydrocephalus with good long-term follow-up results.

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<p><b>OBJECTIVE</b>To observe the effect of volatile oil of amomum (VOA) on the expressions of mastocarcinoma-related peptide (PS2) and platelet activating factor (PAF) in helicobacter pyloriassociated gastritis (HPG) and to analyze its potential mechanism.</p><p><b>METHODS</b>Eighty patients with HPG were randomly assigned to two groups, 42 patients in the treated group treated with 0.5 mL VOA, thrice per day; and the 38 patients in the control group receiving Western tertiary medicinal treatment. Gastroscopic picture and helicobacter pylori (HP) infection (by quick urease and Warthin-Starry stain) of the gastro-membrane, expressions of PS2 and PAF (by immunohistochemical assay and Western blotting) as well as the contents of aminohexose and phospholipid (by Neuhaus method) in the gastric membrane of all patients were detected before treatment and 4 weeks after treatment. The clinical efficacy in the two groups was compared.</p><p><b>RESULTS</b>The total effective rate in the treated group was 88.1%, which was significantly higher than that in the control group (78.9%, P<0.05). After treatment, in the treated group, gastric membranous contents of aminohexose and phospholipid was increased, expression of PS2 elevated but that of PAF lowered, all showing significant difference as compared with those in the control group (P<0.01). In the control group, the expressions of PS2 and PAF changed insignificantly. The radical eliminating rate of HP in the treated group and the control group was insignificantly different between them (76.1% vs. 65.8%, P>0.05).</p><p><b>CONCLUSION</b>The mechanism of VOA for anti-gastritis might be related with its action in increasing the expression of PS2 and decreasing the expression of PAF, and thus regulating the hydrophobicity of the gastric membrane.</p>

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The aim of this study was to investigate the cryobiological characteristics of placental cord blood (PCB) cryopereserved by using BioArchive auto-preserved liquid nitrogen system (BioArchive system). After Hespan depletion of red blood cells, 5 ml mixture of DMSO and 10% Dextran 40 were added into 20 ml of enriched leukocyte. 53 PCB units were cryopreserved as following protocol: pre-freeze rate 10 degrees C/min, start freeze temperature -3 degrees C, end freeze temperature -10 degrees C to -15 degrees C, post freeze rate 2 degrees C/min, and end temperature -50 degrees C. After rapid thawing at 38 degrees C, the PCB were washed with 5% human serum albumin -10% Dextran 40 and centrifuged at 400 x g, 10 degrees C for 20 minutes. The results showed that the viability of nucleated cells post-thaw was (73.3 +/- 12.5)%, the CD34(+) cell content was (0.3 +/- 0.21)% for pre-freeze PCB and (0.45 +/- 0.36)% for post-t haw PCB. No significant difference for CFU-GM/-G/-GEMM counts was found between pre-freeze and post-thaw PCB. Thawed PCB contained in two compartments (20 ml and 5 ml) of a freezing bag showed similar viability and clonogenic capacity. Differential count of white blood cell was significantly changed. For post-thaw PCB, it was dramatically decreased for the percentage of granulocytes, and highly increased for the percentage of lymphocytes and monocytes. It was concluded that the condition for cryopreservation and thawing of PCB may be harmful to mature cells, and cells with large size, such as granulocyte, but suitable to lymphocyte and monocyte, especially for the cells with small size, such as CD34(+) cells.

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