Volume 95  ·   Issue 05  ·  2015

Pituitary adenoma is a common benign tumor of the nervous system, accounting for 15% ~20% of intracranial tumors, ranking second, the incidence rate of population is 8.2% ~14.7%, and the discovery rate of autopsy is 20% ~30%^[1,2]。 At present, doctors in more and more hospitals have carried out surgical treatment of pituitary adenoma. However, due to the lack of knowledge of doctors about this disease, the treatment is not standardized and the mastery of surgical indications is deviated; Due to the lack of experience in surgical treatment, the postoperative efficacy varies greatly. In addition, due to China's vast territory and unbalanced economic development, the configuration of examination and surgical equipment in various hospitals is quite different, and even the diagnostic criteria of pituitary adenoma in various hospitals are different. Therefore, standardizing the surgical treatment of pituitary adenoma is an urgent problem to be solved. China Pituitary Adenoma Collaboration Group organized experts from neurosurgery, endocrinology, neuroimaging, nuclear medicine and pathology in many hospitals across the country to write the Expert Consensus on Surgical Treatment of Pituitary Adenoma in China^[3]We hope to improve the understanding of the surgical treatment of pituitary adenoma, standardize the behavior of pituitary surgical treatment, and make contributions to the development of pituitary surgery in China.

The pituitary gland is an important endocrine gland located in the sella turcica and is divided into adenopituitary and neuropituitary. The former regulates the endocrine function of the corresponding target glands by secreting important hormones such as luteinizing hormone, follicle stimulating hormone, growth hormone, prolactin, thyroid stimulating hormone and adrenocorticotropin, and plays an important physiological role in growth and development, energy metabolism, immune function and reproduction. Pituitary adenoma is a benign tumor derived from adenopituitary cells. Because some pituitary adenomas themselves have secretory function, and may damage the function of other adenopituitary-target gland axis, compress and destroy the surrounding important tissue structures, the clinical manifestations are complex and diverse, and the diagnosis and treatment require the cooperation of endocrinology, neurosurgery, radiotherapy, imaging, ophthalmology, obstetrics and gynecology, etc. Standardized diagnosis and treatment can alleviate the related symptoms and signs caused by pituitary adenomas to the maximum extent and maintain normal adenopituitary function. The diagnosis and treatment of pituitary-related diseases in China began in the 1970s. At present, more and more clinicians pay attention to the diagnosis and treatment of pituitary adenoma. However, due to the unbalanced development of medical level in various regions, there are great differences in the diagnosis and treatment concepts and levels of pituitary adenoma among medical institutions at all levels, and the lack of standardized diagnosis and treatment procedures and good follow-up mechanism seriously affects the prognosis and long-term quality of life of patients.

To explore the efficacies of neuronavigation-guided pure endoscopic endonasal transsphenoidal approach for removing pituitary adenomas.

Retrospective analyses were conducted for the clinical data of 139 patients undergoing pure endoscopic endonasal transsphenoidal surgery for pituitary adenomas between July 2011 and July 2014. There were 55 males and 84 females with a mean age of 48.9 (21-73) years. The classifications of Hardy-Wilson were Ⅰ (n=16), Ⅱ (n=39), Ⅲ (n=48) and Ⅳ (n=36). Neuronavigation was used in all patients. And neuro-ophthalmological, neuroimaging and endocrinological follow-ups were conducted postoperatively.

Total (n=95, 68.3%), subtotal (n=33, 23.7%) and partial (n=11, 7.9%) removals were achieved. For Hardy-Wilson Ⅰ, gross total removal was achieved (n=16, 100%); Hardy-Wilson Ⅱ (n=35, 89.7%), Hardy-Wilson Ⅲ (n=34, 70.8%) and Hardy-Wilson Ⅳ(n=10, 27.8%). Postoperative visual acuity improved (92.1%, 70/76) and endocrine remission was observed (59.6%, 53/89). The postoperative complications included cerebrospinal fluid (CSF) leakage (n=8, 5.8%), meningitis (n=3), sellar hematoma (n=5) and delayed carotid artery rupture (n=1). And the patient of hemorrhagic shock underwent emergency interventional procedures and was discharged successfully.

Pure endoscopic endonasal transsphenoidal approach for removing pituitary adenoma is both safe and effective. And its efficacies may further increased through combined neuronavigation.

To analyze the safety and efficacy of surgical removal of recurrent or regrowing pituitary adenomas by endoscopic endonasal transsphenoidal approach.

The clinical data were retrospectively reviewed for 28 patients undergoing endoscopic endonasal transsphenoidal surgery for recurrent or regrowing pituitary adenomas between April 2010 and December 2013. There were 9 males and 19 females with a mean age of 44.2 (11-73) years. The maximal tumor diameter ranged from 2.1 to 6.9 cm. The Knosp grades were 1-2 (n=11), 3 (n=8) and 4 (n=9). Fifteen tumors were endocrinically functional and the remainder endocrinically nonfunctional. All operations were performed with an assistance of intraoperative neuronavigation. Neuro-ophthalmological, neuroimaging and endocrinological results were followed up postoperatively. And surgical outcomes and risk factors were analyzed for incomplete tumor resection in previous operations.

The mean follow-up period was 19.1 (3-45) months. Gross total resection (n=18, 64.3%), subtotal resection (n=6, 21.4%) and partial resection (n=4, 14.3%) were achieved. Postoperatively, visual acuity improved in 11 patients (73.3%) and 6 patients (40.0%) showed endocrine remission. One patient had short-term postoperative leakage of cerebrospinal fluid (CSF).

Endoscopic endonasal transsphenoidal surgery is both safe and effective for recurrent or regrowing pituitary adenomas.

Visual dysfunction is a sever complication of transsphenoidal surgery of pituitary adenoma. In this study, we explored the mechanisms and strategies of prevention and treatment of early acute visual deterioration after transsphenoidal surgery for removal of pituitary adenoma.

Clinical data of 12 patients with transsphenoidal pituitary adenoma resection of early postoperative acute visual deterioration were analyzed retrospectively. All the cases were come from Peking Union Medical College Hospital during Jan 1991 to May 2014.

Among 12 cases, 8 were with intrasellar haematoma, 2 with suprasellar haematoma, 2 with vascular spasm. After all these treatments, good recovery achieved in 10 cases, not so well in 1 with rupture of intracranial aneurysm, and 1 case death with supra-sellar haematoma and intracranial infection.

Blood circulation variation of the optic nerve and optic chiasma could be caused by long-term compressing with thepituitary adenoma, on this basis, combined with the intrasellar haematoma, direct injury during the operation, and acuteischemia of the optic chiasma andtamping too tight in the sella turcica, etc, resulting in acute visual function disorder after pituitary adenomas transsphenoidal surgery, find the reason and early treatment can be effective to save the patient's visual acuity.

To evaluate the diagnostic value of magnetic resonance enterography (MRE) for small intestinal disease.

From January to July 2013, 53 consecutive patients (male/female=22/31, median age= 61 years) with suspected small intestinal disease were recruited. And the examinations of MRE and capsule endoscopy (CE) examinations were performed.

MRE revealed 31 cases (31/53) and CE 30 cases (30/45) of small intestinal diseases. Receiver operating characteristic (ROC) curve revealed that the area under the curve (AUC) of MRE was 90% in detecting small intestine lesions and AUC of MRE was 72.9% in diagnosing small intestine lesions. There was a remarkable coherence of MRE and CE in detecting small intestine lesions (χ²=28.800, P=0.000).

MRE is ideal for detecting and diagnosing small bowel disease.

To evaluate the clinical diagnosis and treatment of hemorrhage after pancreatoduode-nectomy via digital subtraction angiography (DSA) and transcatheter arterial embolization (TAE).

The clinical and imaging data of 23 patients receiving DSA examination and TAE treatment due to hemorrhage after pancreatoduodenectomy at our interventional center from October 2012 to October 2014 were retrospectively reviewed. And the manifestations of DSA and therapeutic efficacies of TAE were summarized and analyzed.

Among them, 16 patients showed positive signs of extravasation of contrast medium (n=8), pseudoaneu-rysm formation (n=3), ruptured pseudoaneurysm plus extravasation of contrast medium (n=2) and local vascular spasm and non-smooth arterial intima (n=3). And the remainder with negative signs (n=7) underwent surgery. The 16 patients with positive signs underwent TAE with a technical success rate of 16/16. And clinical success was achieved in 12/16 patients. Among 4 rebleeders, two were successfully managed by surgery. And bleeding was caused by stress ulcer in gastrojejunal anastomosis (n=1) and necrosis of pancreatic stump (n=1). Another two on conservative treatment died from multiple organ failure.

As first-line options, DSA and TAE are mini-invasive and accurate in the diagnosis and treatment of hemorrhage after pancreatoduodenectomy.

To explore the clinical outcomes of acromioclavicular joint (ACJ) dislocation treated with coracoclavicular ligament (CCL) reconstruction using lateral half of conjoined tendon and tractusiliotibialis with hook plate fixation. Comparative study on their advantages and disadvantages in order to provide the materials for the clinic.

From June 2005 to June 2012, the patients with Rockwood type Ⅲ or severer ACJ dislocation were randomly divided into 2 groups. They underwent CCL reconstruction using lateral half of conjoined tendon (conjoined tendon reconstruction group, n=36) and tractusiliotibialis (tractusiliotibialis reconstruction group, n=38) with subsequent fixation of hook plates. During the follow-up, the AC and CC distances were measured on postoperative plain films after a removal of hook plates. And the outcomes were assessed according to Karlsson criteria and Constant-Murley shoulder score. Ranked data were analyzed with the use of χ ² test and measurement date with two- sample t test.

A total of 74 patients were followed up for an average of 20 (12-24) months. No significant inter-group differences existed in age, gender, injured side or classification. And there was no statistical difference in ACor CC distance between two groups within 6 months (P>0.05) after a removal of hook plates. The AC and CC distances of conjoined tendon reconstruction group were larger than those of tractusiliotibialis reconstruction group (t=2.313, P=0.026; t=2.114, P=0.041) within 12 months. The AC and CC distances of 12 months were both larger than those of 6 months (t=2.631, P=0.017; t=2.297, P=0.032). According to the Constant-Murley shoulder score, conjoined tendon reconstruction group was less than tractusiliotibialis reconstruction group (85.2±10.2 vs 93.1±6.9, t=2.965, P=0.006). According to the Karlsson Criteria, the excellent and good rate of functional recovery was 75.00% in conjoined tendon reconstruction group versus 94.74% in tractusiliotibialis reconstruction group (χ²=8.111, P=0.044).

The efficacy of Rockwood type Ⅲ acromioclavicular joint dislocation for reconstructing coracoclavicular ligament using tractusiliotibialis is better than conjoined tendon. The AC and CC distances increase after a removal of hook plates while it is more obvious for conjoined tendon tractusiliotibialis reconstruction.

To evaluate the value of early diagnosis of myelopathy hand in improving the efficacies of surgical treatment of cervical spondylotic myelopathy.

Analyses were conducted for 118 cases of cervical spondylotic myelopathy at Department of Orthopedics, Changzheng Hospital and Zhabei Campus from January 2009 to November 2012. They were diagnosed with myelopathy hand and classified by finger escape sign, 10-second grip and release test of fist along with electromyography of ill limb to evaluate the movement function of hands . They were divided into early diagnosis group with myelopathy hand (A, n=62) and routine diagnosis group without myelopathy hand (B, n=56). All patients with cervical spondylotic myelopathy underwent anterior corpectomy decompression and fusion. The average follow-up period was up to 4.1 years. Modified Japanese Orthopedic Association (JOA) score was used to evaluate neurological function preoperation and 48 months postoperation respectively. T-test of SPSS statistical software 13.0 was used to analyze the inter-group difference of JOA scores before and after surgery.

There were no inter-group significant differences in age, gender or smoking ratio. The JOA scores of groups A and B were 10.1±2.3, 14.9±2.0; 9.8±3.1, 12.1±2.3 before surgery and 48 months postoperation and the increase of JOA scores were 4.8±0.9, 2.3±0.6. The inter-group differences between JOA scores before and after surgery were statistically significant (P=0.00). And the inter-group differences between the increase of JOA scores at 48 months postoperation were statistically significant (P=0.00).

Neurological function improves more for patients with cervical spondylotic myelopathy diagnosed with myelopathy hand in early stage than those diagnosed conventionally without myelopathy hand. And an early diagnosis of this sign may boost the surgical efficacies for cervical spondylotic myelopathy.

High-volume hemofiltration (HVHF) is an potential therapy for the treatment of sverve sepsis in intensive care unit, but little information is avialible in children. The aim of our study was to evaluate the effects of HVHF compared with standard-volume continuous veno-venous hemofiltration (CVVH) for critically ill children with severe sepsis, and to evaluate the feasibility and tolerance.

A single-center prospective trial was performed on the data of critically ill children with sverve sepsis, who were treated with 48hours HVHF (effluent rate 50-70 ml·kg^-1·h^-1) versus more than 48hours CVVH (effluent rate 35 ml·kg^-1·h^-1) from May, 2009 to April, 2014 in Shanghai Children's Hospital, Shanghai Jiao Tong University. Biomarkers and clinical outcomes were compared between the HVHF and standard-volume CVVH groups included 28-day mortality, lengths of PICU stays, vasopressor dose reduction and adverse events.

A total of 72 critically ill patients with severe sepsis comfirmed less than 72 hours were enrolled. male 42 cases (58.3%) and female 30 cases (41.7%), median age was 56 months (range from 3 to 168 months). Patients were randomized to either HVHF (n=34) at 50-70 ml·kg^-1·h^-1 or standard-volume CVVH (n=38). There were no signifcant difference either PRISM Ⅲ score or pediatric critical illness score betwwen HVHF and standard-volume CVVH group (P>0.05). Death occurred in 24 cases, the total mortality was 33.3%. Mortality at 28 days was lower than expected but not statistically significant differences HVHF 29.4% compared with standard-volume CVVH 36.8% (χ²=0.45, P= 0.50). After blood hemofiltration therapy the dosage of heparin in HVHF group are lower than CVVH group (P<0.05). Complications of hypernatremia, alkali imbalance and glucose abnormalities in HVHF group is higher than that of standard-volume CVVH group (P<0.05 orP<0.01).

Compared with standard -volume CVVH, HVHF is safe on severe sepsis in children and is trend to reduce the case fatality rate. But still expect the multi-center and larger sample study for evaluation the 28days mortality in pediatric critically ill with severe sepsis.

To investigate the topological properties of the functional brain network in unilateral sensorineural hearing loss patients.

In this study, we acquired resting-state BOLD-fMRI data from 19 right-sided SNHL patients and 31 healthy controls with normal hearing and constructed their whole brain functional networks. Two-sample two-tailed t-tests were performed to investigate group differences in topological parameters between the USNHL patients and the controls. Partial correlation analysis was conducted to determine the relationships between the network metrics and USNHL-related variables.

Both USNHL patients and controls exhibited small-word architecture in their brain functional networks within the range 0.1-0.2 of sparsity. Compared to the controls, USNHL patients showed significant increase in characteristic path length and normalized characteristic path length, but significant decrease in global efficiency. Clustering coefficient, local efficiency and normalized clustering coefficient demonstrated no significant difference. Furthermore, USNHL patients exhibited no significant association between the altered network metrics and the duration of USNHL or the severity of hearing loss.

Our results indicated the altered topological properties of whole brain functional networks in USNHL patients, which may help us to understand pathophysiologic mechanism of USNHL patients.

To confirm the possible relationships between serum level of uric acid (UA) and benign paroxysmal positional vertigo (BPPV).

A total of 87 patients with BPPV and 36 age- and gender-matched control subjects were recruited from our hospital between July 1, 2013 and July 1, 2014. All patients underwent a complete audio-vestibular test battery, such as Dix-Hallpike maneuver for posterior semicircular canal and supine roll test for horizontal semicircular canal. All risk factors such as the histories of heart and cerebral vascular diseases, and routine hematological and biochemical analyses were analyzed between two groups.

No significant inter-group differences existed in age, gender, histories of hypertension, diabetes mellitus, hyperlipidemia, coronary heart disease, smoking or drinking (P>0.05). No significant differences existed between systolic blood pressure, diastolic blood pressure, ejection fraction, whole blood count, lipid profile, homocysteine, prealbumin and blood urea nitrogen in patients with BPPV compared with controls (P>0.05). However, the values of UA (267±86 vs 325±75) μmol/L, hemoglobin a1c (5.6±1.4 vs 6.5±1.0)%, albumin (36±4 vs 40±4) g/L and creatinine (72±20 vs 81±22) μmol/L were much lower in patients with BPPV versus controls (P<0.05). According to multiple Logistic regression model, the lower levels of hemoglobin a1c and albumin were independently associated with BPPV (P<0.05) with the odds ratio of 1.473 (95%CI 1.066-2.037) and 1.162 (95%CI 1.025-1.318), respectively. However, the level of UA was not independently correlated with the occurrence of BPPV [OR=1.005 (95%CI 1.000-1.011), P=0.063].

The lower levels of hemoglobin a1c and albumin are independently associated with BPPV. Although the value of UA is lower in patients with BPPV versus controls, it is not an independent risk factor for BPPV. Due to limited patient data, further studies are needed to clarify the association in a larger sample size of different ethnic groups or longer follow ups.

To explore the changes over time of cannabinoid receptor 1 (CB1R) in hippocampus of status epilepticus (SE) rats.

A rat model of SE was established by an intraperitoneal injection of kainic acid (KA). The animals were scarified 30 minutes later. And the changes of CB1R were detected by immunohistochemistry and Western blot at 4 hours, 1 day, 1 week, 1 month and 2 months post-SE.

CB1R in CA1 area of hippocampus of SE rats increased gradually at 1 week and then decreased to normal afterward (KA vs NS: 5.5±1.1 vs 1.8±0.2, 6.4±3.7 vs 3.1±0.7, 16.9±10.4 vs 3.7±1.7, 8.8±5.4 vs 6.9±4.0, 3.2±1.0 vs 4.4±1.9). And CB1R in area of CA3, DG had the same trend as CA1. The IA of CB1R significantly increased at 1week (P<0.05) and insignificantly deceased after 1 week (P>0.05).

There is a protective increase of CB1R in hippocampus of SE rats and then it returns to normal. Thus CB1R may be involved in the occurrences and terminations of seizures.

To explore the effect of whole brain irradiation (WBI) on neurogenesis in hippocampus and its relationship with histone acetylation.

A signal dose of 30Gy 4MeV electron beam was offered to male Sprague-Dawley rats (150-200 g). At Days 7 and 30, immunohistochemistry and Western blot were used to analyze the effects of WBI on neurogenesis and the expression of acetyl-H3 and histone deacetylase 1 (HDAC1) in hippocampus. Finally trichostatin A (TSA), a HDAC1 inhibitor, was used to verify whether H3 acetylation was associated with neurogenesis impairment.

Immunofluorescence showed that, at Day 7 post-irradiation, the number of BrdU+ NeuN+ cells reduced by 67% (P<0.01) and it approached zero at Day 30 (P<0.01). Meanwhile, a significant decrease of HDAC1-dependent H3 acetylation was observed. Western blot showed 30% (P<0.05) and 61% (P<0.01) reductions in H3 acetylation at Days 7 and 30 post-irradiation respectively. These results were further confirmed by immunofluorescent staining. Also HDAC1 levels significantly increased in a time-dependent manner at Days 7 and 30 post-irradiation. And TSA rescued neurogenesis impairment after WBI.

Radiation-induced HDAC1-dependent H3 acetylation decline is associated with long-term neurogenesis impairment in dentate gyrus.

To explore the prevalence, diagnosis and treatment of restless leg syndrome (RLS) among military elders.

A cross-sectional study was conducted among retired military elders in Shanxi Province from 2010 to 2011. According to age, they were divided into 4 groups to compare the prevalence of RLS and evaluate the severity of symptoms as "mild, moderate and severe". And the compositions of symptom severity were compared among different age groups. Also the rate of correct diagnosis of RLS was examined. Univariate analyses were conducted with SPSS 13.0.

There were 559 RLS patients in 3 472 elder subjects. The prevalence of RLS was 16.1% and 15.8% in male elders. The prevalence of RLS in male elders increased significantly with advancing age (P<0.05). No significant difference existed in the compositions of symptom severity among different age groups of RLS patients (P>0.05). Only 3.22%RLS patients were previously diagnosed and none received a proper therapy.

The prevalence of RLS among military elders is higher than that of their foreign counterparts. The prevalence of RLS in male elders increases significantly with advancing age. Symptom severity of RLS has no obvious relationship with advancing age. Since the rate of correct diagnosis and therapy is rather low for RLS elders in China, we should pay greater attention to the knowledge of RLS.

All antidepressants, including tricyclic antidepressants (TCAs) and novel antidepressants, have potential epileptogenic risks, and the higher the dose, the greater the risk. Although the mechanism of how high-dose antidepressants produce epileptogenic effects is still unclear, it is an important clinical problem to avoid seizures induced by antidepressants while treating depressive disorders. This article expounds this problem in order to help the clinical practice.

To evaluate the efficacy of whole brain radiotherapy (WBRT) or/and stereotactic radiotherapy (SRT) concomitant with first-generation epidermal growth factor receptor tyrosine kinase inhibitors (TKI), like erlotinib and gefitinib, in the treatment of brain metastases from non-small cell lung cancer (NSCLC).

Comprehensive searches were performed in different databases, including EMBASE, MEDLINE and Cochrane Library, etc. All randomized controlled trials (RCTs) and non-randomized controlled trials (non-RCTs) comparing radiotherapy (RT) plus TKI with RT alone in the treatment of brain metastases from NSCLC were included for meta-analysis with Cochrane Collaboration's RevMan5.2 software. The primary end-points were objective remission (OR), disease control (DC) and toxicity while the secondary end-point was overall survival (OS).

Three RCTs and one non-randomized controlled trial were selected and included for final analysis. The RT+ TKI group had significant improvements in OR rate (RR=1.80, P<0.01) and DC rate (RR=1.31, P<0.01). Meanwhile, rash (RR=14.36, P=0.003) and diarrhea (RR=3.49, P=0.005) increased in the RT+ TKI group. Yet there was no significant difference in nausea or vomiting (P=0.20).

For NSCLC with brain metastases, RT plus TKI could improve OR, DC and OS, but there was a higher incidence of rash and diarrhea. There fore future high-quality and prospective RCTs are warranted to confirm the clinical efficacy of RT plus TKI in the treatment of NSCLC with brain metastases.

SAPHO syndrome (Synovitis-Acne-Pustulosis-Hyperostosis-Osteitis syndrome), or Synovitis-Acne-Pustulosis-Bone Hypertrophy-Osteitis syndrome, is a chronic inflammatory disease mainly involving bones, joints and skin. This disease name was originally written by Chamot et al.^[1]It is proposed that there have been previous names such as sternoclavicular hypertrophic osteitis, chronic recurrent multifocal osteomyelitis, and palmoplantar pustular osteitis. This disease is rare, and the incidence rate may not exceed 1/10 000^[2]It is more common in young and middle-aged people, and the incidence of women is slightly higher than that of men^[3,4,5,6,7]。 Most of the foreign reports of SAPHO syndrome come from European countries such as France and Italy. With the in-depth research and increasing understanding of the disease, the number of domestic reports has gradually increased in recent years, and the clinical characteristics are similar to those of foreign patients. The pathogenesis of SAPHO syndrome is still unknown, but it may be related to many factors such as heredity, infection and immunity.

Pituitary adenomas are common intracranial tumors, and the mechanism of their occurrence is unknown. Some pituitary adenomas, especially aggressive and atypical pituitary adenomas, have limited treatment and poor prognosis. MicroRNAs (miRNAs) are a class of non-coding small RNA molecules with post-transcriptional regulatory functions, which have been confirmed to play an important role in the development of a variety of human tumors, including pituitary adenomas. In recent years, more and more studies have confirmed that the abnormal expression of miRNAs in pituitary adenomas may be significantly related to tumor development, clinical characteristics and prognosis. The research progress of miRNAs in pituitary adenoma is reviewed as follows.

In recent years, with the improvement of socio-economic level and people's health awareness, the discovery rate of pituitary adenoma is increasing year by year. Because pituitary adenoma not only has various characteristics of tumor, but also can cause abnormalities of endocrine function (including infertility and infertility), which brings great adverse effects to patients, families and society. Pituitary adenoma is a benign tumor, and surgical treatment is the main treatment for patients with many types of pituitary adenoma. If properly treated, most patients can be cured. However, due to China's vast territory, unbalanced economic development and uneven medical level, there are great differences in the understanding and treatment of diseases by medical staff, which seriously affects the prognosis of patients with pituitary adenoma. In order to solve the above problems and improve the level of surgical treatment of pituitary adenoma, China Pituitary Adenoma Collaborative Group organized experts and scholars related to pituitary adenoma to write the Expert Consensus on Surgical Treatment of Pituitary Adenoma in China, hoping that through the consensus, the understanding of surgical treatment of pituitary adenoma can be improved, the behavior of pituitary surgical treatment can be standardized, and the development of pituitary surgery in China can be contributed.