The article made a study on the earliest literature and the initial time of the "Five Orbiculi" theory in TCM. By analyzing the masons for different locations of "Five Orbiculi" recorded in ancient TCM books, the author argued against that the term of "Five Orbiculi" originated from ancient India and the "Five Orbiculi" theory was a product with the combination of traditioinal Chinese and Indian cultures. The author further put forward that the "Five Orbiculi" theory most probably was a Chinese traditional medical innovation under the influence of Internal Classic of Medicine, a great development to the theory recorded in Miraculous Pivot On Serious Confusion.

The author generally analyzed "Eight-Profiles" theory of traditional Chinese medicine before the Qing Dynasty, specifically, elucidated the meaning, theory origin, evolution and controversy of "Eight-Profiles" theory.

With the deepening of modernization of traditional Chinese medicine (TCM), the method of quantification and standardization of TCM (i.e., quantitative characterization of TCM) has been more and more widely accepted by researchers. Chemometrics processes complicated data of TCM through applied mathematics, statistics and com-puter technology. And multivariable study was introduced into the quantitative characterization of TCM with great achievements. This article reviewed existed problems of quantitative characterization in TCM, the principles, char-acteristics, limitations, commonly used statistical methods and application conditions on quantitative characteriza-tion of TCM. With this review, a reference for further study of quantitative characterization of TCM was provided and a further research idea of combination with main methods of chemometrics was given.

OBJECTIVETo investigate the clinical features, surgical transcranial approaches and outcomes of giant pituitary adenomas.

METHODSA series of 112 consecutive cases of giant pituitary adenomas underwent microsurgery through transcranial approaches at People' s Liberation Army General Hospital were retrospectively analyzed. Of the 112 patients, 58 were male and 54 were female, with age ranging from 3 to 72 years(mean age 44. 3 years). There were 91 non-functioning adenomas and 21 hormone-secreting adenomas. The maximum tumor diameter varied from 4. 0 to 7. 2 cm, with mean diameter of 4. 8 cm. Unilateral subfrontal approach was chosen in 16 cases, pterional approach in 41 cases, anterior interhemispheric approach in 34 cases, transcallosal-interforniceal approach in 6 cases, transcortical- transventricular approach in 5 cases, combined approach in 6 cases and other approaches in 4 cases. Postoperative MRI and endocrine function were re-examined routinely to evaluate the therapeutic efficacy. Staged operation through transsphenoidal approach or adjuvant treatments including medical and radiation therapies were administered in patients with hormone-secreting adenomas when hormonal excess persisted after surgery and in patients with non-functioning adenomas who had postoperative MRI evidence of residual tumor.

RESULTSTotal removal of the lesion was achieved in 57 cases (50. 9%) , 26 patients (23. 2%) underwent subtotal resection, and 29 patients (25. 9%) underwent partial removal. Postoperative mortality occurred in 3 patients (2. 7%). Major surgical morbidity occurred in 38 patients (33. 9%). Vision was preserved or improved in 98 patients (87. 5%). The postsurgical follow-up period varied from 3 to 64 months (mean 19. 5 months) . Nineteen of the 21 patients with hormone-secreting adenomas were considered to be in hormonal remission, and 87. 2% of the cases were capable of normal work and life and 8 patients suffered recurrence during the followed-up period.

CONCLUSIONSSelection of appropriate transcranial approaches is the key to successful microsurgery for giant pituitary adenomas according to the morphological characteristics presented in image examinations and clinical symptoms. Staged transsphenoidal operation and/or adjuvant therapies including medical and radiation therapies offer the best chances to control the residual tumors after the maximal surgical removal of giant adenomas through transcranial approaches.

Adenoma ; surgery ; Adolescent ; Adult ; Aged ; Child ; Child, Preschool ; Combined Modality Therapy ; Female ; Humans ; Magnetic Resonance Imaging ; Male ; Microsurgery ; methods ; Middle Aged ; Neurosurgical Procedures ; methods ; Pituitary Neoplasms ; surgery ; Postoperative Period ; Retrospective Studies ; Young Adult

Objective To evaluate the therapeutic effects of Lumber continued drainage of cerebrospinal fluid after Key-hole approach operation and craniotomic hematoma elimination on the prognosis of hypertensive in-tracerebral hemorrhage patients. Methods Lumber continued drainage of cerebrospinal fluid after Key-hole ap-proach operation was conducted on 38 hypertensive intracerebral hemorrhage patients. At the 1st month and 6th month after operation, Glasgow coma scale (GCS), Glasgow outcome scale (GOS), Barthel index, language barrier degree evaluation and sports function barrier degree evaluation were measured. The therapeutic effects were observed and compared with 34 patients who were operated by craniotomic hematoma elimination. Results GCS was 6.8± 2.1,6.6±2.3 before operation and 10.5±2.5,8.7±2.2 one week after operation in experimental group and con-trol group respectively; GOS was 3.4±0.3,2.8±0.2 one month after operation and 4.1±0.6,3.2±0.4 six month after operation in experimental group and control group respectively; Bartherl index, language barrier degree and sports function barrier degree were 63.15±11.64,51.76±12.81 and 1.7±0.3,2.3±0.2,2.0±0.3, and 2.6± 0.4 (P<0.05 or P<0.01). Conclusion Lumber continued drainage of cerebrospinal fluid after Key-hole approach operation offers greater help in improving the patients' quality of existence, by which the neurological function recov-ers faster and the patients recover well.

OBJECTIVE: To evaluate the applicative value of multimodal navigation combined with intraoperative magnetic resonance imaging system in the treatment of complex lesions of middle skull base. METHOD: Nineteen consecutive patients undergoing complex lesions resection using multimodal microscopic navigation combined with iMRI were included. Preoperative radiological images were imported into navigation planning system, based on which approach and microsurgical window were designed. Transcranial approach and extracranial approach(include trans-oral-nasal-sphenoidal approach and transsphenoidal approach) were performed in our series. After presumptively total resection were finished, intraoperative magnetic resonance (iMRI)were performed, followed by navigation images updating, and continuing resection if necessary. RESULT: iMRI scan were performed from 1 time to 2 times. In 5 cases with residual seen on iMRI scan, continued resection were carried on in 2 of them. There was no iMRI-associated complications. CONCLUSION Microscopic-based neuronavigation, in combination with intraoperative magnetic resonance, could provide objective basis for resection, and improve the safety level of tumor resection.
Adult ; Aged ; Female ; Humans ; Magnetic Resonance Imaging ; Male ; Microsurgery ; methods ; Middle Aged ; Neurosurgical Procedures ; Skull Base ; surgery

Objective To evaluate the reliability and accuracy of three-dimensional digital fusion anatomy in the preoperative evaluation and therapeutic strategy choice of intracranial tumors.Methods MRI scan,including regular MRI,MRA,MRV and DTI,were performed in 87 case.Then tumor themselves as well as tumor-associated structures were reconstructed and fused through iPlan 2.6 software.Based on the reconstructed images,therapeutic strategy were established,preoperative and intraoperative imags were compared.Results The digital reconstruction were successfully finished in all cases.Meanwhile,digital images,originally radiological images and actual images matched well.No approach-associated complication were met in our series.Among tumors in the convexity,the relationship of the reflux veins and the tumors were divided into three types:anterior(12 cases),posterior(19 cases) and overriding(3 cases).All of the relationships were seen in the preoperative fusion image,and the veins were all effectively protected during operation.The tumor-associated arteries could be pushed or wraped by the tumors,and the three-dimensional fusion image could provided their virtually aberrant pathway as well as their relationship with tumor.During microsurgical managment of tumors in the deep brain parenchyma,safe approach were found with the help of comprehensive understanding of the tumors and their adjacent structures.Conclusion Three-dimensional digital fusion anatomy can vividly and accurately display full rang of information about the tumor,and facilitate tumor treatment safely.

Although the diagnosis of glioma is constantly changing with the update of WHO diagnostic guidelines, the current treatment methods are still mainly surgical treatment, supplemented by radiotherapy and chemotherapy. It is a pity that the treatment effect of high-grade glioma is still unsatisfactory. How to improve the prognosis of patients is the key problem in the field of medical exploration of glioma. It is gratifying that many new ideas and methods have emerged in the diagnosis and treatment of glioma, in which some trials represented by tumor treating fields have achieved good results in clinical research, moreover, the fields of immunotherapy and targeted therapy have developed too. This paper aims to share and explore these new methods and summarize the progress of diagnosis and treatment of glioma.

Objective To describe the prevalence and risk factors of insomnia among adults in YiBin City. Meth?ods Using multi-stage stratified cluster sampling, 12000 subjects over 18 years old were identified in YiBin City. The subjects were screened using the insomnia survey self-edited and risk factors of insomnia were identified through logistic analysis. Results A total of 11227 subjects completed the survey in which 1671 people (14.9%, 95%CI:14.2%~15.5%) were diagnosed insomnia using ICD-10. Among them, 9.4% (157 patients) had seeked for professional help. The multi?variate logistic analysis showed that low level of life quality(OR=2.42,P<0.01), jobless(OR=1.87,P<0.01), over 60 years old(OR=1.69,P<0.01), fewer years of education(OR=1.41,P<0.01), female(OR=1.41,P<0.01)and lower annu?al per capita income(OR=1.15,P=0.01)were risk factors in insomnia people. Conclusion The incidence of insomnia is high in YiBin city. Sleep quality in high-risk group needs more attention and corresponding measures should be taken in order to increase the rate of asking for help in insomnia people.

OBJECTIVE: To understand the clinical condition of the positive blood serum HIV antibody cases in otorhinolaryngology patients and explore its clinical characteristic. METHOD: The positive cases in otorhinolaryngology patients were detected by the primary screening test for HIV from 2005 to 2010 , then were confirmed by the confirmation laboratory WB of CDC in Chengdu City. To analyse the results of the positive cases of HIV and collate the clinical manifestation. RESULT: Totally 10 serum samples were positive by the primary screening test for HIV, among them 9 were confirmed by the confirmation laboratory, and the coincidence rate was 90.00%. CONCLUSION The positive cases by the primary screening test for HIV in otorhinolaryngology patients are increasing recently, but there are some false-positive cases. The clinical manifestation of HIV/AIDS patients are multiform because of the different stage of AIDS. To attach importance to diagnoses of HIV/AIDS in otorhinolaryngology is valuable in preventing nosocomial infection and avoiding medical staff infection due to occupational exposure and also reducing the occurrence of medical dispute.
Adult ; China ; epidemiology ; Female ; HIV Antibodies ; blood ; HIV Seropositivity ; diagnosis ; epidemiology ; Humans ; Male ; Middle Aged ; Otolaryngology ; Young Adult