OBJECTIVE To study the causes of recurrence and treatment methods in patients with recurrent sinonasal melanoma. METHODS From 1993 to 2003, a retrospective analysis of consecutive 11 cases with recurrent sinonasal melanoma was conducted. RESULTS Four out of the 11 cases with recurrent sinonasal melanoma were caused by misdiagnosis, while the other 7 cases recurred after operation with pathological diagnosis. Among the 7 cases, 5 were found recurrences after operation alone, and the other 2 after the operation and radiation therapy. The recurrence lesions located in nasal and paranasal sinus in 7 cases, in orbit, skull base, soft and hard palate in 1 case, in parotid gland and skin in 1 case. In face, orbit and extended skull base in 1 case. Cervical lymph node recurrence developed in 1 patient. The time of first relapse was 10 months after therapy. The 1-, 2-and 3-year survival rates after reoperation were 72.7 %, 18.2 % and 9.1 % respectively. CONCLUSION The reasonable treatment and decrease the misdignosis are the main measures to improve the cure rate of recurrent sinonasal melanoma.

Objective The aim of the study is to study the effect of manual massage on relapse rate and quality of life of grand mal epilepsy patients.Methods Using prospective research method,clinical data of patients with epileptic seizures and without attack up to 3 years and undergoing withdrawal of drugs for one year were collected.The grand mal epilepsy patients were randomly divided into the experimental group and the control group (76 cases in each group).The experimental group was given manual massage.The control group was not given manual massage.Both groups were given follow-up for 1 year.The relapse rate and quality of life were compared between two groups.Results The relapse rate of the ex perimental group was 17％,and that of the control group was 33％,the difference was significant.The score of life quality in the experimental group was significantly better than that of the control group.Conclusions Manual massage can reduce relapse rate and improve quality of life for patients with epileptic seizures after withdrawal of drugs,which is worthy of wide application.

Good Agricultural Practice for Chinese Crude Drugs is one of the effective measures for protecting and developing resource of Chinese crude drugs..We analyzed the current situation of GAP,discussed its questions and development.

The construction and management working of clinical practice teaching base is an important component of the western medical colleges and universities.The colleges and universities highlights the status of clinical practice teaching base construction,such as improving construction management system of clinical practice teaching base,strengthening the basic teaching facilities construction,the teachers troop construction and the system construction of clinical practice teaching base,strengthening the organization,teaching and funds management of the clinical practice teaching base and improving the quality and level of graduation practice.

Objective To establish nude mouse model with human brain glioma SHG-44 and understand its growing characteristics in vivo.Methods The 4-week-old male mice were randomly divided into high density cell suspension inoculation group(n=10),low density cell suspension group(n=10),the tumor tissue mass vaccination group(n=10)and the blank control group with normal saline injection(n=10).The SHG-44 human brain glioma cell suspension was injected into the subcutaneous of the nude mice' s armpit.The tumor tissue was cut into 1 mm3 after tumor tissue growth and formation,and re-inoculated into the subcutaneous of the new nude mice' s armpits.Apart from daily observation,the long and short diameters of tumor were recorded every 5 days after graft.All the mice were sacrificed at 60 days and the tumor tissues were harvested for pathological examination.Results With a longer incubation period and slower growth rate,the tumor formation rate in high density cell suspension inoculation group and low density cell suspension group was lower compared with that in the tumor tissue mass vaccination group.Around day 20,grafted tumor appeared remarkably big((41.51 ±6.42)mm3) with good morphology.On day 50,the tumor derived from group the tumor tissue mass vaccination group((565.69± 123.36)mm3) showed a bigger size in comparison with that from high density cell suspension inoculation group((203.85±104.63) mm3) and low density cell suspension group ((153.02± 31.76) mm3,all P＜0.05).The tumors in three groups were well defined with a rich vascularity and no apparent invasion was observed.The positive expression of GFAP and S-100 in a large body of tumor cells was observed under optical microscope.Conclusion With a shorter incubation period and faster growth,the mouse tumor models established with tissue pieces from the tumor-bearing mice are much better compared to those with cell suspension.

Objective To summarize the clinical characteristics, diagnosis and surgical management experiences of 51 cases of pulmonary fungal infections. Methods The clinical data of 51pulmonary fungal infection patients hospitalized in department of thoracic surgery of PLA General Hospital from 1981 to 2008 were retrospectively analyzed. Results The recruited cases included three cases of Candida albicans, 22 of Aspergillus, and 26 of Cryptococcus. The clinical symptoms included cough, hemoptysis, fever, chest tightness, chest pain and asthma. Twenty cases were identified through routine healthy examination. Of chest X-ray and computed tomograply scan, 29 cases presented with solid nodules in the lung, some of which had burrs and spikes; 13 presented with pulmonary cavity with even wall thickness and smooth inner wall including 7 with aspergillar glomera.Forty-eight cases underwent standard thoracotomy operations and 3 cases underwent thoracoscope or thoracoscopy-assisted minithoracotomy. Seventeen underwent pulmonary lobectomies, and 34 wedge resections. There was no operative mortality in the 51 patients. All diagnoses were confirmed by postoperative pathology. There was no relapse during 3- 10 years of follow-up. Conclusions Primary pulmonary fungal infections lack characteristic presentations in clinical manifestations and imaging examinations. Pathology is the evidence for definite diagnosis. Surgical intervention is an effective tool for diagnose and treatment of this disease.

Objective To summarize the prevention and management of common intraoperative complications during thoracoscopic lobectomy. Methods During June 2007 to December 2009, 96 patients received thoracoscopic lobectomy through 3 mini-incisons, including right upper lobectomy in 28 cases, right middle lobectomy in 7, right middle and lower lobectomy in 3, right lower lobectomy in 28, left upper lobectomy in 12, and left lower lobectomy in 27. Results All procedure were carried out safely. No severe complications or perioperative death occurred in all cases. The common intraoperative compliations during the surgery included: the bleeding of wounds and vessels, thoracic cavity extensive adhesion, and air leak of bronchus stumps. There were four patients conversed to open thoracotomy. The mean operation time was ( 180 ±59) minutes (range,90 - 360 minutes), and the mean blood loss was ( 191 ± 92 ) ml ( range,50 - 700 ml ), including 2 cases blood transfusio(n). The chest drainage lasted (4.6 ± 2.4 ) days, the average length of stay after operation was ( 8.0 ± 3.2 ) days. Pathological diagnosis included primary lung cancer in 85 cases, sclerosing hemangioma in 3, bronchiectasis in 3, tuberculoma in 2, pulmonary sequestration in 2, and fungus ball in 1. Conclusion It is helpful to master the prevention and management of common intraoperative complications for thoracoscopic lobectomy.

Objective To investigate the effect of acupunctures variable with stages on lumbar intervertebral dise protrusion (LIDP). Methods 98 LIDP patients in our hospital from October, 2014 to July, 2015 were randomly divided into control group (n=49) and observa-tion group (n=49) according to the sequence of first diagnosis time. The control group received routine acupuncture, and the observation group acupunctured at Ouch point and Huantiao point (GB30) with different acupuncture according to manifestations and courses. Modified Yang acupuncture was adopted in acute phase, triple acupuncture was used in remittent phase, and lateral needling was used in the recovery phase. They were both treated once a day, 7 days as a course for 3 courses with 2 days of interval. Visual Analogue Scale (VAS), Oswestry Disability Index (ODI) and clinical effects were assessed before and 1, 2, 3 courses after treatment. Results Both VAS and ODI scores im-proved after treatment (F>7.12, P<0.05), especially in the observation group (t>4.43, P<0.05). The efficiency was higher in the observation group than in the control group (χ2=5.594, P<0.05). Conclusion Compared with normal acupuncture, the acupunctures variable with stages is more effective on LIDP than routine.

Objective To investigate antibiotic resistance and molecular epidemiology profile of methicillin-resistant Staphylococcus aureus (MRSA) in Shanghai. Methods The antibiograms of 140 MRSA isolates from 5 hospitals for 13 drugs were analyzed by agar dilution and broth dilution. The PVL gene and SCCmec were detected by PCR; The clonal relatedness of 140 isolates were determined by PFGE and 39 strains were chosen to be characterized further by spa typing. Results All 140 MRSA are PVL negative and most of them were identified as SCCmec Ⅲ [45.7% (64/140)], followed by SCCmec Ⅲ a [25.0% (35/140)], SCCmecⅢb [14.3% (20/140)], SCCmecⅡ [10.7% (15/140)] and SCCmecⅣ [4.3% (6/140)]. All isolates were susceptible to vancomycin, teicoplanin and daptomycin. The resistance to gentamicin, sulphamethoxazole and clindamycin was 98. 6% (138/140), 98. 6% (137/140) and 97. 9% (137/140), respectively. Resistance to erythromycin, ciprofloxacin and tetracycline was above 80%, and resistance to rifampicin was 10. 7% (15/140). Sixteen different PFGE patterns(A-P) were found and most of MRSA belonged to group C[30. 7% (43/140)] ,B[13.6% (19/140)]and Ⅰ [10. 7% (15/140)]. Among 39 strains with prevalent PFGE patterns, 4 spa genotypes were identified: t002133. 33% (13/39)] ,t030 [12. 82% (5/39)] ,t037[51.28% (20/39)]and t459[2. 57% (1/39)]. Conclusions Sixteen different PFGE patterns and 4 spa genotypos were found from 5 hospitals in Shanghai. The most popular MRSA clone is PVL negative, SCCmec Ⅲ, with resistant profile of erythromycin, ciprofloxacin,clindamycin,etracycline, gentamicin,and sulphamethoxazole [E-C-L-T-G-M-]. This result suggests that hospital infection control and reasonable antibiotic usage are critical.

Objective To explore the effects of recombinant human hormone(rhGH) on the plasma total protein,plasma albmin,healing of Wound surfaces in patients with the second degree burns wound.Methods 38 pa- tients with the second degree burns wound were divided into treatment group and control group randomly.All the patients were subject general.19 patients in the treatment group were given rhGH in a dose of 0.2U/kg for 14 days beginning from postoperative 5 days.The plasma total protein concentration,plasma albumin concentration,healing rat of wound surface and scar of patients of the two group were compared.Results The plasma total protein concen- tration plasma albumin concentration of the treatment group were significantly in creased,the scar hyperplasia of the treatment group were significantly mitigated and the healing time of wound surfaces of the treatment group were sig- nificantly shortened.Conclusion rhGH is found to promote protein anabotism and shorten the healing time of wound surfaces and mitigate the scar hyperplasia patients with the second degree burns wound.