Objective To determine the correlation between image characteristics and pathology of pineal region tumors （PRTs）in adolescence.Methods The clinical data of the correlation between imaging findings and pathological types of 35 patients of PRTs in adolescence confirmed by postoperational pathological analysis were analyzed retrospectively.Results 35 patients with surgically and pathologically proved PRTs which comprised germinoma（n=19），pinealoma（n=6），astrocytoma（n=7）and others（n=3）.Germinoma lesions were isointensity or hypointensity on T1WI and slight hyperintensity on T2WI.Following enhanced scans，the tumors were obviously homogeneous enhancement.Additionally，the intratumoral calcification and tumor necrosis were often observed.Pineoblastoma lesions were hypointensity on T1WI and T2WI，obviously enhancement followed by enhanced scans.Tumor necrosis was often observed while intratumoral calcification was rare.Astrocytoma lesions were large in PRT with intratumoral cystic change but without intratumoral calcification and tumor necrosis.The tumors were isointensity on T1WI and T2WI.Following the enhanced scans，tumor cystic region were non-enhancement and tumor solid part were homogeneous enhancement.Conclusion Germinoma，astrocytoma and pineoblastoma were the most common pathological type of PRTs in adolescence.Due to the specific image features of different pathological tumors described above，we could make the preoperative qualitative diagnosis of PRTs accurately by analyzing the preoperational image data and the clinical features.

Objective To investigate quality of life of the patients with non-functional pituitary adenomas who underwent transsphenoidal surgery（TSS）and analysis the risk factors related to the quality of life.Methods The clinical date of 40 cases with non-functioning pituitary adenomas who underwent TSS in our department during 2014.Quality of life was assessed by SF-36 questionnaire before and after surgery.Results After TSS，the quality of life of patients with non-functioning pituitary adenomas decreased significantly（119±10）vs（99±11）.Logistic regression analysis showed tumor size was the the risk factor related to quality of life.There was no significant difference between the tumor invasion and quality of life.But there was a significant difference between the tumor size and the quality of life.Hypopituitarism in ACTH axis and HPG axis was significantly related to quality of life（r=-6.928，P=0.0197<0.05），but not hypopituitarism in TSH axis.Conclusion The size of pituitary adenomas is an independent risk factor to evaluate the postoperative quality of life.And hypopituitarism in ACTH axis and HPG axis has much more effect on the quality of life in patients with non-functioning adenomas after TSS.

Objective To investigate the effective of bladder temperature（BT）and nasopharyngeal temperature（NT）monitoring in craniotomy，and to assess the differences and correlations between the two temperature monitoring methods.Methods Fifty patients（ASA Ⅰ～Ⅱ）with general anesthesia and undergoing craniotomy were selected.BT and NT were monitored during anesthesia，and temperature were recorded at the following time points：10 min（T₀）after anesthesia induction，immediately at the beginning of the operation（T₁），20min（T₂），40min（T₃），60min（T₄），80min（T₅），100min（T₆），120min（T₇），140min（T₈），160min（T₉），180min（T₁₀），200min（T₁₁），220min（T₁₂），240min（T₁₃）after surgical incision and at the end of the surgery（T₁₄），the related complications were recorded simultaneously.Results The overall BT was（0.40±0.21）℃ higher than that of NT，and the difference was statistically significant（P<0.01），but the consistency was better.The incidence of NT below 36℃ was significantly higher than that of BT（P＜0.05）.The temperature of the two different parts was highly correlated，and the correlation coefficient was r=0.93，the linear equation is：Y=0.943X+2.449（Y is bladder temperature and X is nasopharyngeal temperature）.Three patients（about 6%）with NT monitoring developed nasal mucosal hemorrhage after surgery.Conclusion Both BT and NT monitoring can reflect the changes of body temperature during craniotomy，but NT may respond more quickly，and the BT may be closer to the core body temperature and be convenient.

Objective To summarize the application experience and value of ultrasound-guided vacuum-assisted breast biopsy with double operation.Methods Review the preoperative general conditions，postoperative pathology and postoperative complications of the patients in 5867 patients，analyze some problem and summary experience when utilize vacuum assisted breast biopsy surgery in practice.Results 5867 patients were included.average age of（35.77±11.08）years，average lump size（1.97±0.89）cm，a total number of lesions were 16 832.Postoperative pathology showed benign tumor in 4893 cases （92.00%），atypical hyperplasia in 264 cases（4.80%），ductal carcinoma in situ in 124 cases（2.12%），invasive breast cancer in 68 cases（1.16%），phyllodes tumour in 4 cases（0.07%），inflammatory lesions in 78 cases（1.42%），simple adenopathy and  duct dilation in  50 patients（0.91%）.The most common postoperative complications were painful hematoma and subcutaneous ecchymosis.There are 1125 cases（20.5%） and 482 cases（8.8%），respectively.Moderately-severe pain in 323 cases（5.90%），delayed wound healing in 5 cases（0.09%），skin damage in 9 cases（0.16%），skin sag in 175 cases（3.20%）.Tumor residual recurrence in 449 cases（8.2%），change to traditional to open surgery midway in 3 cases（0.05%）.No incisions or deep tissue infections were found.Conclusion The mode of twoperson operation ultrasoundguided vacuum assisted breast biopsy is simple and efficient.

Objective To explore the correlation between MRI quantitative enhancement parameters and prognostic factors and molecular typing of breast cancer and its clinical application.Methods This study was a retrospective study.126 patients with breast cancer who were treated in our hospital from August 2016 to August 2017 were selected.According to different imaging methods，the control group（CT examination）and the research group（MRI examination）were 63 cases each.Retrospective analysis of clinical data of two groups.Results The sensitivity and accuracy of the diagnostic method in the study group were significantly higher than those in the control group（P<0.05）.The volume transfer constant and rate constant of patients with positive estrogen receptors were significantly higher than those of negative estrogen receptors（P<0.05）.The volume transfer constants and rate constants of Luminal type A and Luminal type B were significantly smaller than those of HER-2 overexpression type and TNBC type（P<0.05），but the volume ratio of extravascular extracellular space of Luminal type A and Luminal type B was significantly larger than that of TNBC type.（P<0.05），in which Luminal B type had the highest extravascular extracellular space volume ratio，while TNBC type had the highest rate constant.Conclusion Quantitative enhancement parameters of MR imaging have certain implications for the prognosis and molecular typing of breast cancer，and have certain correlation with estrogen receptor，but not with human epidermal growth factor receptor-2，which is worthy of clinical promotion.

Objective To investigate the expression of HMGB1 and RAGE in calcific aortic valve disease（CAVD）and normal valve tissues，and to investigate the correlation between HMGB1 and RAGE in the occurrence and development of CAVD.Methods The expression of HMGB1 and RAGE was detected by immunohistochemical method in CAVD valve tissues and normal valves，and the relationship between the expression level of CAVD and clinical pathological features of CAVD were analyzed.Results The expression of HMGB1 was 62.3% in CAVD and 6.7% in normal valve tissues（P<0.05），and the expression of RAGE in CAVD valves（53.6%）was significantly higher than that in normal valve tissues（31.3%）（P<0.05）.HMGB1 and RAGE expression were correlated with the total cholesterol，triglycerides，ox-LDL and calcific score（P<0.05）.Correlation analysis showed that the expression of RAGE and HMGB1 in CAVD was negatively correlated（r=-0.363，P<0.05）.Conclusion The expression of HMGB1 and RAGE in CAVD valves is higher than normal valves.The expression of RAGE decreases with the increase of HMGB1 expression，suggesting higher stage of calcific score.In CAVD，RAGE and HMGB1 are biochemical indicators that are helpful to judging the degree of calcific valves and guiding the clinical treatment．

Objective To investigate the expression of chemokine ligand 12/chemokine receptor type 7（CXCL12/CXCR7）in gastric cancer and its correlation with clinicopathological features.Methods In this study，the expressions of CXCL12 and CXCR7 in gastric cancer tissues and adjacent normal tissues of 180 patients undergoing radical gastrectomy in our hospital from December 2016 to December 2017 were determined by immunohistochemical staining.Then the correlation to the clinicopathological features was also analyzed.Results The positive expression rate of CXCL12 in gastric cancer tissues[62.22%（112/180）] was significantly higher than that in adjacent normal tissues[35.56%（64/180）]（P<0.05）.The positive expression rate of CXCR7 in gastric cancer tissues[68.89%（124/180）] was significantly higher than that in adjacent normal tissues[44.44%（80/180）]（P<0.05）.CXCL12 and CXCR7 were positively correlated in gastric cancer tissues（P<0.05）；The expression levels of CXCL12+CXCR7+ among gastric cancer patients with different tumor diameter，degree of invasion，lymph node metastasis and clinical stage showed statistic difference（P<0.05）.The 1-year survival rate of patients with different CXCL12/CXCR7 was significantly different（P<0.05）.The 1-year survival rate of patients with CXCL12+CXCR7+was lower（P<0.05）.Conclusion CXCL12 and CXCR7 are highly expressed in gastric cancer patients，and the biological axis of CXCL12/CXCR7 is significantly correlated with gastric cancer tumor diameter，invasion degree，lymph node metastasis and clinical stage.

Objective To investigate the success rate and safety of endoscopicallyassisted local resection of duodenal tumors，and to provide basic background parameters for clinical studies.Methods Cases of endoscopicallyassisted local resection of duodenal tumors were collected from the hubei cooperation group of endoscopic surgery that could perform routine intraoperative endoscopic examination and treatment for duodenal tumors from January 1，2015 to December 31，2018.Final treatment of planned local excision cases and complications were counted.Results A total of 45 cases，9 cases had been founded the tumor location in the duodenal bulbar，26 cases the tumor location in the descending part of duodenum，4 cases in the horizontal part of duodenum，6 cases in the end of the duodenal or start segment of jejunum.Complete resection of the lesion was completed in all the 45 cases for local resection.17 cases performed by exploratory laparotomy，3 cases performed by robotic assisted the duodenal partial resection，14 cases performed by laparoscopic duodenal partial resection，6 cases performed by complete endoscopic resection and 5 cases performed by endoscopic resection combined withlaparoscopic repaired.2 cases of postoperative complications were all occurred in the descending part of the duodenum.A case tumor of the middle and lower descending duodenum occurred anastomotic leakage，abdominal bleeding and incision infection after surgery.After two operations，he was discharged from hospital.Another case tumor of upper and middle descending duodenum occurred pancreatic wound bleeding，and hemostasis was stopped by suture.Conclusions With the support of endoscopic technology，local resection of duodenal tumors can be performed in a variety of surgical methods，and it is difficult to define the feasibility standard of local resection simply by the size or location of the tumor.

Objective To evaluate the prognostic values of preoperative and postoperative serum inflammation-related indexes，including AGR，CAR and OPNI in patients with resected colorectal cancer.Methods The clinicopathological data，inflammation-related indexes and prognosis of colorectal cancer patients before and 1 month after operation were analyzed.Cox regression was applied to estimate the independentassociation of inflammationrelated indexes with progression-free survival and overall survival.Results A total of 509 colorectal cancer patients were included in this study.166 patients developed cancer progression and 80 died.Multivariate Cox regression showed that preoperative AGR（HR=1.58，95%CI 1.01 to 2.48），CAR（HR=1.72，95%CI 1.08 to 2.74）and OPNI（HR=1.51，95%CI 1.06 to 2.15），and postoperative CAR（HR=1.79，95%CI 1.14 to 2.85）and OPNI（HR=1.64，95%CI 1.04 to 2.60）were independent prognostic factors for PFS.Preoperative AGR（HR=2.58，95%CI 1.49 to 4.47）and OPNI（HR=1.84，95%CI 1.09 to 3.13），and postoperative CAR（HR=3.03，95%CI 1.61 to 5.69）and OPNI（HR=2.31，95%CI 1.30 to 4.13）were independent prognostic factors for OS.Conclusions Inflammation-related indexes before and 1 month after tumor resection can be used as independent prognostic markers of progression-free survival and overall survival in colorectal cancer patients.

Objective To treat the complex nephrolithiasis with the combination of all-seeing needle percutaneous nephroscopy and flexible ureteroscopy and observe the efficacy.Methods 87 patients with complex nephrolithiasis were selected.All-seeing needle percutaneous nephroscopy combined with flexible ureteroscopy was adopted for patients in the observation group（n=44），while the ordinary percutaneous nephroscopy was adopted for patients in the control group（n=43）.Statistics were conducted for indicators of two groups，including intraoperative blood loss，incidence of operative complications and residual rate of calculi，etc.Results Patients of the observation group had significantly lower intraoperative blood loss（134.4±21.1）ml，incidence of operative complications（2.27%） and higher clearance rate of calculi（95.45%） than those of the control group[（153.6±29.2） ml，13.95% and 79.06%）].Conclusion Having the advantages of less trauma and high stone clearance rate，etc.，all-seeing needle percutaneous nephroscopy combined with flexible ureteroscopy is an effective means to treat complex nephrolithiasis.

Objective To analyze the calculus composition and characteristic for patients from  Shiyan area，so as to provide a basis for the prevention and treatment of urinary  stone.Methods Stone specimens from  999 patients with urinary tract stone were collected in our hospital from Jan.2017 to sep.2018.The stone composition was detected and analyzed by infrared spectrum automatic analysis system，and then the clinical characteristics of them were analyzed.Results The main components of urinary stones were calcium oxalate（89.79%）and carbonate apatite（50.95%），and almost weremixed stone.The overall male/female ratio was 2.41/1，and the overall upper urinary tract stone/lower urinary tract stone ratio was 13.27∶1.The overall high-incidence age of upper urinary tract stone ranged from 40 to 59 years old，however  the overall high-incidence age of lower urinary tract stone was over 59 years old.There  were significant difference beween men and women about calcium oxalate stone，carbonate apatite stone，anhydrous uric acid stone（P<0.05），whereas there were no significant difference between men and women about magnesium ammonium phosphate stone，cystine stone（P>0.05）.Conclusion The main components urinary stones are calcium oxalate stone，carbonate apatite stone in patients from Shiyan area.We analyze the calculus compositions and factors  in order to the prevention and treatment of urinary stones  more effectively.

Objective To investigate the efficacy of the clinical application of silicone rubber negative pressure suction ball used in Type Ⅲ wounds in emergency laparotomy.Methods A total of 106 patients with in the infected laparotomy wounds，were treated with wound suture.The patients were radomly divided into observation group and control group，54 cases in observation group，52 cases in control group .The silicone rubber negative pressure suction balls were used in observation group，while the control group underwent conventional abdomen closure.Postoperative wound infection healing was observed in two groups of patients.Results The observation group had higher primary healing rate than in the control group，There were significant differences between the two groups，in the primary healing rate（90.7%，71.2%），the hospital stays of observation group and control group were（10.49±2.10）d and（16.26±5.48）d，respectively；the time of dressing change（3.62±1.72）and （8.23±4.99），respectively， and the postoperative incision pain（3.79±0.88）and（5.20±1.25），respectively（P＜0.05）.Conclusion The silicone rubber negative pressure suction ball used in the infected  laparotomy wounds can effectivly reduce the incidence of postoperative infection，the effct is significant.

Objective To summarize the effectiveness of skin distractor with K-Wire and nylon cable ties for repairings skin defects.Methods Between december 2016 and february 2018，15 patients used the install of K-Wire and nylon cable ties for repairings skin defects.Among them，5 cases had thigh flap donor wounds，4 cases had chronic nonunion defects of the lower leg，3 cases had defect wounds after the incision of osteofasical compartment syndrome，and 3 cases had defect wounds after the resection of body suface masses.The largest wound measured 8.0cm×15.0cm，the smallest 2.5cm×4.0cm.The wounds defects had enough blood supply，and the patients were tolerable to surgery without diabetes mellitus disease.Results Skin defect wounds closed directly in one stage in 5 cases and device removed after 2 weeks；10 cases were closed after continuously stretching for 15～23 days（mean，18.9 days）；All patients were followed up 8～12 months（mean，10.2 months）.The wound was linear healing with small scar，and no invasive margin，poor blood flow，necrosis，and poor sensory function happened.Conclusion Our device is a reliable and economical treatment with K-Wire and nylon cable ties in repair of skin defects.It is an improvement on the previous skin stretcher，which can significantly reduce the cost of consumables by about 50% and reduce the burden of patients.

Hemifacial spasm is a kind of common cranial nerve disease，characterized by intermittent involuntary convulsions of facial muscles.The effect of drug therapy is limited，microvascular decompression is the only radical treatment.In this paper，the pathogenesis of HFS，the application of preoperative radiological evaluation and intraoperative electrophysiological monitoring are reviewed.

Idiopathic trigeminal neuralgia（ITN）is one of the common clinical diseases.Typical ITN pain is episodic in nature，lasting seconds to minutes；electric or lancinating；and associated with triggers such as touching the face，talking or chewing，wind blowing on the face，or brushing teeth.Long term history of pain seriously affects the living quality.There are many surgical methods for treating trigeminal neuralgia.This article summarizes the minimally invasive surgery for treating idiopathic trigeminal neuralgia in recent years.

The effect of parity on breast cancer risk has been well documented.Pregnancy is associated with a reduction in a women，s lifetime risk of developing breast cancer.It remains controversial whether parity affects breast cancer subtype and survival.Current research shows that fertility not only affects the incidence of breast cancer，but also affects the prognosis of breast cancer.On the basis of studies on pregnancy-associated breast cancer（PABC），foreign scholars have recently proposed the concept of the time since last birth to breast cancer diagnosis（TSBB），which found that breast cancer patients with TSBB < 5 years had poorer survival outcomes.It is suggested to strengthen postoperative adjuvant therapy for these patients.Some studies suggest that this is not an independent predictor of poor prognosis of breast cancer，but is related to the biological characteristics of the tumor itself.The effect of fertility on the prognosis of breast cancer patients is still controversial.

Spinal intramedullary tuberculomas（SIMT）refers to central nervous system tuberculosis that occurs in the spinal cord of tuberculoma.Because the incidence of SIMT is low，clinical cases are rare，clinical symptoms and imaging findings are similar to intramedullary tumor sym-ptoms，so clinical diagnosis and treatment are relatively difficult.At present，domestic and foreign literature reports that SIMT is mostly reported in the form of case.The diagnosis of SIMT is mainly based on imaging and postoperative pathology.The treatment of SIMT mainly inclu-des chemotherapy alone，surgery and chemotherapy.This article summarizes the diagnosis and treatment of SIMT based on the current domestic and foreign literatures.

The complex anatomy of the distal radioulnar joint is the basis for its forearm rotation function and power transmission.It is important to research the anatomical structure and biomechanical mechanism of the distal radioulnar joint to understand the mechanism of the instability of the distal radioulnar joint.The instability of the distal radioulnar joint can be divided into primary instability，post-traumatic or postoperative instability.The combination of medical history，physical examination and imaging findings on the classification of instability of the distal radioulnar joint is helpful for the diagnosis and treatment of the disease.The treatments for the instability of the distal radioulnar joint are conservative treatment and surgical treatment.