OBJECTIVE: To investigate the cause, genetics, clinical features, pathological mechanism, diagonosis and treatment of the Giant pleomorphic adenoma of the parotid gland (GPA). METHOD: A case of GPA was reported and relevant literatures were reviewed. RESULT: GPAs were more commonly found in elderly patients, duration of more than 10 years, with a possible malignant degeneration. CT scan shows uneven density, different degrees of enhancement and clear boundary. Pathological examination shows that the composition of tumor tissue are epitheli al cells, myoepithelial cells and mucus. CONCLUSION GPA is an uncommon disease and is associated with human factors. The diagnosis of GPA is oriented by medical history, physical examination and imaging tests. The total resection of the tumor and preservation of the facial nerve is an effective way for the treatment of GPA.
Adenoma, Pleomorphic ; pathology ; Female ; Humans ; Middle Aged ; Parotid Neoplasms ; pathology

Objective To assess the predicting value of homocysteine ( HCY), low density lipoprotein cholesterin (LDL-C) and carotid intima-media thickness (IMT) for women with coronary artery disease (CAD). Methods To choose 115 patients with CAD and 102 patients of non-CAD;Homocysteine, LDL-C and IMT were assayed respectively;comparison and correlation analysis were performed based on genders. Results The rates for hyperhomocysteinemia and High Lipoproteinaemia in female CAD patients are 59. 6% and 75.0%,respectively,while they are 69. 9% and 78.6% for male CAD patients,which are both remarkably higher than 23.0% ,26.7%, 22. 2% and 23.6% in non-CAD patients ( Ps ＜ 0. 05 ). ROC curve shows that the best diagnostic boundary point is 0.953 mm for female IMT and 1. 021 mm for male IMT. At the boundary point,the sensitivity,specificity,positive predictive value and negative predictive value are 83.7% ,91.4% ,95.7% and 63. 8% in female, much higher than 62.9%, 65.3%, 76.2% and 53.3% in male. Conclusion hyperhomocysteinemia, high lipoproteinaemia are the important risk factors for women with coronary artery disease;IMT might be used as the predictor of CAD, which have more advantages for female than for male patients.

Objective To discuss the effect of music therapy on anxiety control of patients with maxillofacial cancer.Methods 140 cases in head and neck surgery department were divided into the test group and the control group with 70 cases in each group from March 2004 to November 2005.The test group received music intervention based on routine nursing.The degree of anxiety was evaluated on the first day of hospitalization(T1),the previous day before the operation(T2),the first day after operation(T3)and the third day after operation after listening to music.The control group only received routine nursing.The condition of anxiety at different time points was evaluated and compared.Results The scores of anxiety(SAS)in the two groups were statistically different(P＜0.05).The intra-group comparison of anxiety degree in the test group(T1-T2,T1-T3,T1-T4)had statistical difference(P＜0.05).The intra-group comparison of anxiety degree in the control group(T1-T2,T1-T3)had no statistical difference(P＞0.05).While evident difference existed in T1-T4 in the control group.P＜0.05.Conclusion Music intervention facilitated the rehabilitation of anxiety condition in cancer patients.

OBJECTIVE:To observe the clinical efficacy and safety of Pudilan xiaoyan oral liquid combined with bronchial dil-atation drugs in the treatment of moderate to severe stable chronic obstructive pulmonary disease(COPD). METHODS:According to admission time,102 patients with stable moderate to severe COPD were randomly divided into treatment group(n=53)and con-trol group(n=49). Control group received Budesonide and formoterol fumarate powder for inhalation and Tiotropium bromide pow-der for inhalation;based on control group,treatment group was additionally treated with Pudilan xiaoyan oral liquid,10 ml/time, 3 times a day, for 12 weeks. The lung function index, number of acute COPD attack, modified medical research council (mMRC),CAT and CCQ were performed and comparison in the two groups. RESULTS:After 12 weeks of treatment,the IC of treatment group was improved significantly,compared to before treatment and control group;there was statistical significance(P<0.05). There was no statistical significance in FEV1 and FEV1/FVC%of treatment group after treatment,compared to before treat-ment and control group(P>0.05);there was no statistical significance in the number of acute COPD attack between 2 groups(P>0.05). mMRC,CAT score and CCQ total score of treatment group were improved significantly,compared to before treatment and control group;there was statistical significance (P<0.05). No obvious ADR was found in 2 groups. CONCLUSIONS:Pudilan xiaoyan oral liquid combined with bronchial dilatation drugs for inhalation is better than powder for inhalation in the treatment of moderate to serve stable COPD,can improve pulmonary function significantly,exercise tolerance and quality of life.

On the basis of the system requirement on medical oxygen supply in modern hospital, from the aspects of rigorous installation, ensuring logical course environment, following related technological standard and enhancing personnel training, the whole quality course management is put up. It is indicate that proper equipment and quality control in evary link are the quarantee of clinical service.

Objective To observe the therapeutic effect of acupuncture plus blood-letting with three-edged needle for the acute stage of Bell's palsy of wind-heat syndrome in TCM.Methods The 100 patients were randomized into treatment and control groups with 50 in each,and treated with acupuncture plus blood-letting with three-edged needle and only acupuncture respectively.Four courses of treatment were given.The main symptoms,signs and clinical efficacy were observed at 1 week,2 weeks and 1 month after treatment.Results In both groups,the scores of symptoms and signs before and after treatment were remarkably different(P

Objective To examine the effect of metformin on serum thyrotropin (TSH) level in diabetic patients with subclinical hypothyroidism (SCH).Methods The long-term effects of metformin on thyroid axis hormones were assessed in 55 diabetic patients with primary SCH who were untreated with L-T4(study group),as well as in 31 diabetic patients with normal thyroid function (control group).According to using metformin or not,patients of study group were divided into the metformin group (group 1,n =28),and the non-metformin group(group 2,n =27).Serum TSH levels were compared between baseline and follow-up in patients receiving metformin treatment.Results After 30 weeks of metformin administration,a significant TSH decrease(t =2.91,P ＜ 0.05) was observed in group 1 [from(6.98 ± 1.92) to(2.44 ± 0.61) mIU/L].After stopping metformin therapy,the level of TSH at 52 weeks fol low-up was back to the baseline level [(6.99 ± 1.76) mIU/L,P ＞ 0.05].There was no significant difference in TSH level between baseline and after 30 weeks follow-up in group 2[(6.01 ± 1.63) mIU/L vs(6.21 ± 1.71) mIU/L,P ＞0.05].At the end of 30 weeks follow-up,no significant differences were found in body mass index and thyroid func tion in both metformin group and non-metformin group.In control group,metformin administration for 30 weeks had no effect on TSH level(P ＞ 0.05).Conclusion Metformin administration influences TSH without change of FT4 level in type 2 diabetic patients with primary SCH.

OBJECTIVE: To investigate the relative factors of pharyngo cutaneou fistulas after larynx cancer and lower pharynx cancer surgery. METHOD: The clinical datas of 87 larynx cancer patients and lower pharynx cancer patients admitted were retrospectively analyzed. According to the type of postoperative complications all cases could be divided into pharyngo cutaneou fistulas group and no pharyngo cutaneou fistulas group. Thirty-eight kinds of factors,including age, clinical stage, plasma electrolytes level and type of procedure are in the multivariate analysis, and the variability indicators are in binary-regression analysis. RESULT: Eleven patients had pharyngo cutaneou fistulas (12.64%). Univariate analysis indicated that BMI, pre-operative serum potassium, operation time, cervical lymph dissection, post-operative prealbumin, post-operative hemoglobin, infection and delayed union of incision were the risk factors of pharyngo cutaneou fistulas (P < 0.05). Logistic stepwise regression analysis indicated that post-operative prealbumin and operation time were the independent risk factors. CONCLUSION To avoid pharyngo cutaneou fistulam, it is very necessary to correct electrolyte disorder and negative nitrogen balance. To shorten the operation time, to avoid incision infection and delayed union were helpfulness, too.
Cutaneous Fistula ; pathology ; Digestive System Fistula ; pathology ; Humans ; Laryngeal Neoplasms ; surgery ; Laryngectomy ; Multivariate Analysis ; Otorhinolaryngologic Surgical Procedures ; Pharyngeal Neoplasms ; surgery ; Pharynx ; pathology ; surgery ; Postoperative Complications ; Retrospective Studies

OBJECTIVETo verify the effect of electroacupuncture (EA) for female stress urinary incontinence (SU).

METHODSForty-two patients were randomly divided into an observation group(20 cases) and a control group (22 cases). EA at Zhongliao (BL 33) and Huiyang (BL 35) was used in the observation group. Sham acupuncture at non meridian points, one can beside Zhongliao (BL 33) and Huiyang (BL 35), was applied, and placebo EA was adopted in the control group. Treatment with needle retained for 30 min a time was given once every other day and three times a week for continuous six weeks in the two groups. Urinary and reproductive simple score (UDI),visual analogue scale (VAS) and the frequency of nocturnal enuresis were observed before treatment, at the second, forth and sixth week of treatment in the two groups, and the efficacy was compared.

RESULTSThe effective rates of the observation group were 80.0% (16/20), 95.0% (19/20) and 95.0% (19/20), which were better than 40.9% (9/22), 31.8% (7/22) and 27.3% (6/22) of the control group at the second, forth and sixth week of treatment. The differences were statistically significant between the two groups (all P < 0.05). After treatment in the observation group, the results of UDI, VAS and frequency of nocturnal enuresis were improved compared with those before treatment (all P < 0.05). Along with treatment, all indices were gradually improved, and the change at the sixth week was the most obvious in observation group. The results of the observation group were better than those of the control group at all times (all P < 0.05).

CONCLUSIONEA achieves obvious effect for female SUI, and effectively improves the lower urinary trace symptoms, the degree of urinary incontinence and the frequency of nocturnal enuresis. The effect becomes increasingly better along with treatment within six weeks.

Objective To investigate perioperative anxiety and depression of patients undergoing prosthetic augmentation mammoplasty.Methods A total of 123 patients undergoing prosthetic augmentation mammoplasty were involved in the retrospective analysis.Hamilton anxiety scale (14 Edition) and Hamilton depression scale (version 24) were used to evaluate anxiety and depression perspectively before and after surgery.The data were subjected to statistical analysis and correlation factor analysis.Results We found that anxiety scale scores had significant difference before and after surgery (P＜0.05),and ression scale scores had no significant difference (P＞0.05).We also found that the anxiety after surgery were positively correlated with anxiety and depression before surgery (r=0.377,0.313,P=0.001),and the depression after surgery was also positively correlated with anxiety and depression before surgery (r=0.359,0.298,P=0.001).It suggested the patients with symptoms of anxiety and depression before surgery might appear the same symptoms within a week after surgery.Conclusions Anxiety symptoms before surgery in patients with prosthetic augmentation mammoplasty are significantly higher than that after surgery,but the symptoms decrease when finished surgery.The patients with symptoms of anxiety and depression before surgery probably present with symptoms of anxiety and depression in a week after surgery.