Adenocarcinoma, Sebaceous ; pathology ; Humans ; Male ; Middle Aged ; Parotid Neoplasms ; pathology

ObjectiveTo explore clinical distribution rule of manifestations in patients with CAS,to provide objective basis of standardization,clinical diagnosis and treatment.MethodsEpidemiological methods were used to investigate on guanan'men hospital patients with CAS.Altogether 298 records of CAS patients were enrolled in this study,the frequency of main syndromes and the distribution characteristics of accompanying symptoms were analyzed.ResultsThe main syndromes of CAS were sputum stasis syndrome,qi stagnation and blood stasis syndrome,and deficiency syndrome of both liver and kidney yin,all together accounted for 39.3％.The major symptoms were vertigo or dizziness (64.1％),chest distress (60.1％),dry mouth (63.8％),amnesia (58.7％),and insomnia (50.0％) separately.ConclusionSputum stasis syndrome,Qi stagnation and blood stasis syndrome and deficiency syndrome of both liver and kidney yin group were as a combine form in patients with CAS,and dizziness or vertigo was its main clinical manifestation.

Objective To evaluate the feasibility and efficacy of treatment of leukoplakia vulvae with high-intensity focused ultrasound. Methods 65 patients with leukoplakia of the vulva were treated with high-intensity focused ultrasound. The patients were followed up after the treatment, and the symptoms including itch of the vulva, color change, the elasticity of the vulva lesions, and release of adhesions were observed and evaluated at the different times after treatment. Result All of the patients experienced relief in different degree (the ratio of effectiveness was 100%). Of them 28 patients were complete cured, 29 were distinctly improved, 8 were improved. In 5 patients there was a recrudescence with mild itch 2-3 months after treatment, but there was still a positive response to the second course of treatment. Conclusions High-intensity focused ultrasound is a highly effective instrument in the treatment of leukoplakia of the vulva. The treatment not only stops itch, but enables the color and elasticity of the vulva to recover as well.

Objective To evaluate the feasibility and advantages of transvaginal hysterectomy (TVH) for enlarged uterus without prolapse. Methods Six hundred and ninety-six patients underwent TVH for gynecological disorders from Sept, 1998 to Dec, 2002. Meanwhile, the method of operation, complications of surgery, operation time, estimated operative blood loss, postoperative recovery and hospital stay days were retrospectively analyzed. Results The operation was successful in 693 out of 696 cases (99.6%). The mean operative time was 49.3 minutes (11-125 minutes). The estimated blood loss was 69.7ml (15-450ml). Operative injuries were found in 3 patients (0.4%). Complications attributable to surgery were found in 6 cases (1%). The mean time of subsidence of fever was 1.2 days (0-5 days) and the time of passing flatus was 22.6 hours (8-32 hours). The average hospital stay was 5.3 days (4-15 days). Conclusion TVH can be performed safely for most of non-prolapsed large uterus. Because it has the advantages of less bleeding, short operating time, rapid recovery and less cost compared to TAH and LAVH, it is our opinion it should be the first option for enlarged uterus.

Objective To evaluate the advantages and feasibility of transvaginal excision of ovarian tumor. Methods A series of 62 patients with ovarian benign tumors had the tumors excised transvaginally from Dec 2001 to Oct 2003. The indications of transvaginal surgery, the method of operation, the complications following the operation, the overall operation time, the estimated blood loss during operation, the postoperative complications, and hospital stay days were analyzed retrospectively. Results Transvaginal ovarian tumor excision was successfully completed with neither the aid of laparoscopy or shift to laparotomy. No intra-abdominal spillage of cystic contents occurred. The mean operation time was 39.4 minutes. The estimated blood loss was 37.5ml. No postoperative complications occurred. The mean length of a low fever was 1.3 days, and the time of recovery of bowel movement was 20.1 hours. The average hospital stay was 4.2 days. Conclusion For free benign ovarian tumors, the transvaginal route should be considered to minimize trauma. There would be no skin incision, and it could be carried out in patients who had relatively large ovarian tumors with no intra-abdominal spillage. There would be less blood loss, shorter operation time, shorter hospital stay and lower cost.

Objective To evaluate the feasibility and advantages of the excision of uterine fibroids by vaginal myomectomy. Methods A series of 58 patients with uterine fibroids were managed with myomectomy from May 2001 to Dec 2003. Meanwhile, the indications of vaginal surgery, the methods of operation, the complications of surgery, the overall operating time, the estimated operative blood loss, the postoperative recovery and hospital stay were explored. Results Myomectomy were successfully completed vaginally without shifting laparotomy in 57 patients. The successful rate was 98 3%. The mean operative time was 48 16 minutes. The estimated blood loss was 70 58ml. The postoperative complication was occurred in one patient with uterine infection. The mean length of lower fever was 1 8 days and the bower movement was 1 3 days. The average hospital stay was 4 9 days. Conclusions For uterine fibroids, the vaginal myomectomy is a good choice when the indication of operation are managed properly. It can be used in patients who have numerous, relatively large, and intramural fibroids with micro invasive surgery, little interfering with abdominal organs, less blood loss, less operating time, less cost and less hospital stay in comparison with abdominal myomectomy or laparoscopic myomectomy

Objective To evaluate the value of bispectral index(BIS)monitoring as an indicator for extubation sedation level after children's oper?ation by total intravenous anesthesia. Methods One hundred and eighty children(2?13 years old)were randomly divided into six groups with 30 cases in each. Group A kept BIS 56?60,and Group B 61?65,Group C 66?70,Group D 71?75,Group E 76?80,Group F 81?85 till extubation. All children were given fentanyl,propofol and cisatracurium besilate when induced,and maintained with propofol and remifentanil. All cases kept BIS 40?55 during the operation. Then the changes of electrocardiogram,mean arterial pressure,heart rate,SpO2,postoperative complications and recovery time were observed. Results Groups A and B were extubated at deep anesthesia,cycle stability,but with high incidence of adverse reactions and awaked with a long time. Groups E and F were extubated when awaked,but with greater stimulation and easier agitation. Groups C and D were lighter hemodynamic responses,less respiratory effects and less postoperative complications of anesthesia. Conclusion The BIS level of 66?75 is a good se?dation level for extubation,especially in the level of 71?75.

Objective To summarize surgical strategies and skills against aneurysms of posterior circulation .Methods Twenty-one cases of posterior circulation aneurysms who had undergone microsurgery between March 2008 and March 2013 were analyzed retrospectively .Two of these cases had their basilar artery aneurysms clipped via the pterion approach and five through the subtemporal approach .Five posterior cerebral artery aneurysms were clipped via the subtemporal approach , two anterior inferior cerebellar artery aneurysms were clipped via the retrosigmoid approach , three posterior inferior cerebel-lar artery aneurysms were clipped through the far lateral approach , and two vertebral artery aneurysms were clipped similar-ly approach.Results All the aneurysms were clipped successfully .According to Glasgow Outcome Scale (GOS), the cura-tive effect was poor in 3 cases(GOS 2-3 points), good in 16 cases(GOS 4-5 points) and 2 patients died(GOS 1 point). Conclusion Aneurysms of posterior circulation can be treated through microsurgery .Proper surgical strategies , operative ap-proach and delicate surgical skills are critical to the success of surgeries and curative effects .

Objective To investigate changes of brainstem auditory evoked potential (BAEP)and somatosensory evoked potential (SEP) in patients with acute cerebral infarction,and discuss their relation with prognosis of the patients.Methods The study involved 60 patients with acute cerebral infarction.Changes of BAEP and SEP in each patient were detected and recorded continuously.Prognosis evaluation was performed by using GCS.Another 60 age-matched and gender-matched healthy human beings were enrolled as controls.Results Incubation period of BAEP wave Ⅰ had no significant difference between the cerebral infarction and control groups (P ＞ 0.05).However,interspike intervals of other BAEP waves in cerebral infarction group were different from those in control group (P ＜ 0.05).A series of waves of SEP (P14-N60) were all significantly prolonged in cerebral infarction group (P ＜0.05).Conclusion BAEP and SEP can effectively reflect function of brain stem in patients with acute cerebral infarction and have some values in determining their prognosis.

Objective To explore the X-ray ,CT and MR manifestations of spinal giant cell tumor(GCT) for improving the diag-nosis level of this rare disease .Methods The X-ray ,CT and MR data in 16 cases of spinal GCT were retrospectively analyzed on the location ,size ,morphology ,margin ,CT density/MR signal intensity and enhancement pattern .Results 4 cases located in cervical vertebra ,8 cases in thoracic vertebra and 4 cases in lumbar vertebra ;in which ,6 cases only involved in vertebral body and other 10 cases involved in vertebral body and and appendix .The lesion affected two neighboring vertebrae in 8 cases ,and affected only one vertebra in the remaining 8 cases .16 cases were protruded into the spinal canals and oppressed the spinal cord .The prominent X-ray and CT images showed eccentric growth ,osteolytic and swelling bone destruction .MR showed isointensity or slight hypointensity on T1WI ,and isointensity or slight hyperintensity on T2WI .After intensified scanning ,the solid portion showed marked inhomoge-neous enhancement .Conclusion Spinal GCT has certain imaging characteristics .CT and MR examination could accurately display the extent of lesion and tumor involvement ,which provides more accurate image information for formulating the strategy of clinical therapy .