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Objective To explore the causes and treatment for cerebrospinal fluid(CSF) leak after microsurgical removal of vestibular schwannomas(VS) with the suboccipital retrosigmoid approach.Methods A retrospective study was accomplished on 258 patients with VS operated through the suboccipital retrosigmoidal approach from Jan 1994 to Aug 2003.After operation,cerebrospinal fluid rhinorrhea occurred in 19 cases and subcutaneous retroauricular CSF leak occurred in 5 cases.Results In 14 cases the CSF leak was stopped after treatment by external lumbar cerebrospinal fluid drainage(CELCFD).Six patients were operated again with sealing the internal acoustic meatus and the mastoid cells with fibrin glue and muscle.The patients were followed up for 14 months to 8 years after treatment,and there was no recurrence of CSF leak or delayed onset meningitis.Conclusion CSF leak was the common complication after vestibular schwannoma removal and the most common reason was the drilled posterior wall of the internal acoustic meatus with opening of the mastoid cells.The closure of petrous air cells was very important to prevent its postoperative CSF leak.Most of the patients were successfully treated by external lumbar cerebrospinal fluid drainage and only a few cases needed revision surgery.

Objective To compare the clinical efficacy and safety of sublingual nifedipine,intravenous urapidil and micropump nitroglycerin in the treatment of APH (acute postoperative hypertension).Methods A retrospective study was conducted to analyze clinical data of 497 patients with AHP undergoing tumor resection from July 2007 through December 2010.Patients received antihypertensive treatment for APH; hypertension occurred within 24 hours after surgery; patients received no long-acting antihypertensive agents within 24 hours.Patients with a previous history of coronary heart disease,arrhythmia,stroke and incomplete clinical data were excluded.All patients were divided into three groups.Nifedipine group,10 mg nifedipine tablet was administered sublingually; urapidil group,12.5 mg of urapidil was diluted in 20 ml normal saline and administered by intravenous injection; nitroglycerin group,25 mg of nitroglycerin was diluted in 40ml normal saline and infused intravenously by a micropump.The x2 test was employed to compare the efficacy and safety among different treatment.Results Treatment with sublingual nifedipine caused a reduction of the systolic blood pressure by 5.8％,and diastolic blood pressure by 4.7％.Treatment with intravenous urapidil caused a reduction of the systolic blood pressure by 11.1％,and diastolic blood pressure by 8.4％.Treatment with micropump nitroglycerin caused a reduction of the systolic blood pressure by 13.1％,and diastolic blood pressure by 10.2％.There is not different between intravenous urapidil and micropump nitroglycerin (63.4％ vs 57.8％,P =0.506).Intravenous urapidil and micropump nitroglycerin were associated with a significantly higher rate of blood pressure control than sublingual nifedipine (63.4％ vs 33.3％,P =0.000; 57.8％ vs 33.3％,P =0.001).The frequency of cardio-cerebrovascular events in intravenous urapidil group was similar to that in sublingual nifedipine group (6.9％ vs 4.7％,P =0.345),but it was significantly higher in micropump nitroglycerin group compared with intravenous urapidil group and sublingual nifedipine group.(24.4％ vs 6.9％,P =0.001 ; 24.4％ vs 4.7％,P =0.000).Conclusions Considering therapeutic effect and safety,we concluded that intravenous administration of urapidil was more suitable for the treatment of APH compared with sublingual nifedipine and micropump nitroglycerin.

Object To provide a basis for the identification of the crude drug of Fructus Schisandrae Sphenantherae Methods Morpholgical characters and microstructural features of the seed surface of Schisandra sphenanthera Rehd. et Wils , S. rubriflora (Franch ) Rehd. et Wils., S. viridis A. C. Smith, and S. henryi Clarke were observed under light microscope and scanning electron microscope. Identification of them was also completed by TLC qualitative analysis for deoxyschisandrin and schisantherin A Results The fruits of S. sphenanthera, S. rubriflora, S. viridis and S. henryi could be classified to three types with the characters of micromorphological features of the seed surface. The results of TLC showed that deoxyschisandrin and schisantherin A were present in the fruits of S. sphenanthera from Pingli, Shaanxi, Luanchuan, Henan, Yangcheng, Shanxi, S. rubriflora and S.viridis, Hengshan Hunan Provinces The fruit of S. henryi contained a little quantity of schisantherin A, but the fruits of S. sphenanthera from Liuba Shaanxi and Xiaolongshan Gansu Provinces did not have deoxyschisandrin and schisantherin A. Conclusion The fruits of S. sphenanthera from different geographical origin, S. rubriflora, S. viridis and S. henryi can be identified by the characters of micromorphological featrues of the seed surface and the TLC qualitative analysis for deoxyschisandrin and schisantherin A

Objective To study the offactory function test in Parkinson' s disease(PD), in order to promote the diagnosis of the PD. Methods Subjects included 95 middle-aged volunteers and 37 Pdpatients. A subjective olfactometry with T&T olfactometer was performed in all volunteers and patients.Olfactory event related potentials with isoamyl acetate were obtained in all volunteers and patients. Results The T&T olfactometer Results for the 2 sides were 4.6±1.1,4.4±1.2 in PD patients older than 70 years old and 3.9±1.7, 4.0±1.7 in those, respectively; while the data were 0.4±0.9,0.4±0.9 in volunteers older than 70 years, were 0.5±0.8,0.5±0.8 younger than 70 years old. There was a significant differencein T&T olfactometer Results between PD and volunteers (t=15.246,15.378,8.664,8.776, P<0.01). TheP2 latencies were respectively (734.9±143.2), (696.1±165.9) ms for the 2 sides in PD older than 70years, and (730.5±159.4), (719.5±159.2) ms in PD younger than 70 years;while they were (547.9±65.0), (558.5±56.3) ms, and (523.3±61.9), (526.8±62.0) ms in volunteers younger than 70 years.There was a significant difference in P2 latency between PD and volunteers (t = -3.940, -3.750,- 7. 514, - 8.205,P<0.01). Conclusions Olfactory dysfunction is an important index in PD. Olfactory function test is an useful method in the diagnosis of PD.

AIM To analyze the dynamic changes of five constituents in Ligustri lucidi Fructus at five picking time (August,September,October,November,December).METHODS The HPLC analysis of Ligustri lucidi Fructus ethanol extract was performed on a 25 ℃ thermostatic Aglient Zorbax SB-C1s column (4.6 mm ×250 mm,5 μm),with the mobile phase comprising of acetonitrile-0.1％ phosphoric acid flowing at 1 mL/min in a gradient elution manner,and the detection wavelength was set at 224 nm.RESULTS Salidroside,tyrosol,luteolin-7-O-glucoside,ligustroflavone and specnuezhenide showed good linear relationships within their own ranges (r ＞0.999 0),whose average recoveries were 99.56％-100.30％ with the RSDs of 0.89％-1.23％.The contents of various constituents (except for tyrosol) were the highest in samples picked up in September,followed by those picked up in October.CONCLUSION The suitable picking time of Ligustri lucidi Fructus is September and October.

Object To determine the contents of schisantherin A, deoxyschizandrin, schisandrin B and schisandrin C in the stems and fruits of Schisandra rudriflora (Franch ) Rehd. et Wils , which were collected from different areas Methods An HPLC method was set up: Column, Sphereclone, ODS (250 mm?4 6 mm, 5 ?m); mobil phase, A: H 2O, B: MeOH; gradient elution was with 70% B from 0-4 min, 70%-100% B from 4-54 min; the flow rate was 0 4 mL/min; the column temperature was 25 ℃ and the DAD detector was used at 254 nm Results The contents of schisantherin A, deoxyschizandrin, schisandrin B and schisandrin C in S. rubriflora were 0.026%-0.083%, 0.007%-0.945%, 0.002%-0.121%, 0.010%-0.038%, respectively. Deoxyschizandrin exists widely in S. rubriflora and its content is higher in fruits than that in stems Conclusion Deoxyschizandrin is the main active lignan in the fruits of S rubriflora

The case of long-term complicated infectious mass on the inner thigh root after transobturator urethral sling is rare. This paper reported a case, who underwent a surgery of the "trans-obturator mid-urethral slings" for stress urinary incontinence 9 years ago. A mass on the root of the right thigh was found 3 months ago, accompanied with low fever. About 1cm tape was exposed on the front wall of the right side of the vagina. The patient underwent resection of the mass on the root of the right thigh and partial removal of the tape under spinal anesthesia. After one year’ follow-up, there was no significant change in urinary control ability compared with that before the operation.

OBJECTIVETo investigate the efficacy and safety of nebulizing glucocorticoid combined with olfactory training in the treatment of postviral olfactory dysfunction.METHODSPatients with postviral olfactory dysfunction were recruited in this study. All patients underwent T&T olfactory testing, sinonasal computer tomgraphy scanning, as well as magnetic resonance scanning of the olfactory pathway. Nebulizing glucocorticoid (pulmicort repulse) was inhaled once daily at the starting dose of 2 mg tapered to 1 mg after two weeks combined with olfactory training for 4 weeks. T&T olfactory testing were repeated after 4-week treatment.RESULTS Twenty four patients received teatment, with a mean age of 54 years old(range 37 to 81 years old), a mean olfactory dysfunction course of 2.20 months(range, 0.25-9 months). Of whom, 21 were anosmia, 3 were hyposmia. After teatment, complete recovery were achieved in 4 patients(16.7%), obvious improvement in 9 (37.5%), improvement in 5 (20.8%), no improvement in 6 (25.0%). No side effect and untoward effect were found.CONCLUSIONThe primmary outcomes suggest the efficacy and safety of nebulizing glucocorticoid combined with olfactory training in the treatment of postviral olfactory dysfunction.