Adult ; Cerebrospinal Fluid Rhinorrhea ; Female ; Humans ; Sphenoid Sinus ; pathology

Objective To explore the improvement of traditional incision in thoracotomy and the application of subaxillary vertical small incision in lung operations. Methods We carried out a retrospective analysis on documents of 680 cases of subaxillary vertical small incision pneumonectomy conducted in this hospital between December 1996 and June 2003. Results The length of incision was 8~13 cm (mean, 11 2 cm). The time for thoracotomy was 4 5~10 min (mean, 6 min) and the operation time was 50~ 170 min (mean, 135 min). The intraoperative blood loss was 100~1200 ml (mean, 350 ml), the postoperative drainage volume was 120~800 ml (mean, 300 ml), and the perioperative blood transfusion, 0~1400 ml (mean, 300 ml). Postoperative pain classification results revealed that 585 cases of grade 1, 60 cases of grade 2 and 35 cases of grade 3 severity were observed. The postoperative hospital stay was 10~21 days (mean, 14 days). No surgical death occurred. Conclusions Subaxillary vertical small incision can be simply made. It offers minimal invasion, less blood loss, mild postoperative pain, quick recovery and good cosmetic results, being a viable option in most operations of pneumonectomy.

Needling point Xingjian (LR 2 ) through Taichong (LR 3) was used as main therapy to treat 57 headache cases by syndromic differentiation, which was compared with the treatment of another 60 cases with conventional points. The curative rate was 100% and 91.7% separately in one of the two groups. There was a significant difference in curative effect (P ＜0.01 ). The effect of the point-through-point method was superior to that of the conventional point method.

Objective To explore the clinical characteristics of poststroke epilepsy and to discuss the association with the type of stroke,the location of focus.Methods Clinical information of 64 patients with poststroke epilepsy taken from 932 patients with stroke were analyzed retrospectively.Results In the patients with first stroke,the incidence of poststroke epilepsy was 6.9％.Among them,47 cases belong to early seizure (73.4％) and 17 cases belong to late seizure (26.6％).The incidence of poststroke epilepsy was difference between ischemic stroke and hemorrhagic stroke.There were more cases of stroke in cortical focus than subcortial one.Onset seizures type was more cases of partal seizure than generalized tonic-seizure (GTS).The treatment on early seizure could be short-range treatment and the treatment on late seizure should be long-term standardized treatment and regular.Conclusions Occurrence of poststroke epilepsy were involved in the type of stroke,the location of focus (cortex / subcortex).It is helpful for guiding the clinical therapy of patients with stroke and improving the quality of their life to analyse the clinical characteristics of poststroke epilepsy.

Objective To study the effectiveness of postoperative radiotherapy and prognostic factors of soft tissue sarcoma. Methods Sixty-four soft tissue sarcoma patients admitted from June 1987 to May 1997 were treated by complete,partial or extended resection and postoperative external beam radiotherapy. Fourty-eight patients received 1.8～2.0?Gy/fraction,5 f/w, to a dose of 40～72?Gy (median 60?Gy). Sixteen patients received 1.2～1.5?Gy/f, bid, 6 hr interval to a dose of 64.8～85.0?Gy (median 66.5?Gy). The 5-year survival and locoregional control rates were estimated by Kaplan-Meier method. Logrank test and Cox regression were used to study the significance of predictive factors. Results The overall 5-year survival and locoregional control rates were 60.2%, 57.9% respectively. Those of the conventional group and hyperfractionated group were 54.3% and 61.9% vs 64.3% and 42.9% ,respectively. Cox regression analysis showed that histologic grade, size and site of the primary tumor, fractionation of radiotherapy were independent prognostic factors for survival. Conclusions Complete or extended resection followed by radiotherapy are satisfactory for soft tissue sarcoma. Histologic grade , size, site of the primary tumor and method of fractionation were prognostic factors.

Objective To discuss the diagnosis and surgical management of pulmonary sclerosing hemangioma(PSH).Methods Clinical records of 33 cases of PSH(34 lesions) in this hospital from 1987 to 2002 were reviewed.There were 6 male cases and 27 female cases,with a mean age of 41.3 years(range,24~57 years).Twenty-three cases had an initial symptom of bloody sputum,while 10 cases were disclosed by physical examinations.Image findings revealed solitary mass of the lung in all the cases,in 5 of which a "crescent sign" was presented.Results Preoperatively,28 cases were diagnosed as having pulmonary benign tumors(including 5 cases of suspected sclerosing hemangioma),1 case was clarified as having PSH by percutaneous needle aspiration cytology,and 4 cases were misdiagnosed as having lung cancer. All the patients received surgical treatment,including 21 cases of unilateral pulmonary lobectomy,1 case of bilateral lobectomy,5 cases of segmentectomy,4 cases of wedge resection(including 1 case of bilateral thoracoscopic wedge resection),and 2 cases of tumor excision.The operation time was 45~210 min(mean,90 min),and the blood loss was 100~600 ml(mean,230 ml).No peri-operative deaths were encountered.Follow-up surveys in 33 cases for(3~)10 years(mean,5.5 years) found no recurrence.Conclusions In middle-aged women,if the sign of bloody sputum develops,and image findings indicate the solitary mass of the lung,especially with a "crescent sign",a diagnosis of PSH is possible.Percutaneous needle aspiration cytology is helpful to make a confirmative diagnosis in some patients.It is advisable to manage the disease surgically.

?Pterygium is one of the most common ocular surface diseases. Its exact etiology and pathogenesis are not completely understood. At present, it is considered that its occurrence and development is the result of many factors. Current studies have indicated that the occurrence of pterygium is closely related to the environmental factors. Long time exposure to sunlight, dust, pollen and other long - term chronic stimulation are the main incentive factors. Various factors have caused limbal barrier dysfunction, induced the level of a variety of growth factors and inflammatory factors increased, so that the conjunctival tissue degenerate and proliferate to the cornea in the formation of pterygium. In this paper, the research progress of the pathogenesis of pterygium is reviewed.