OBJECTIVE To add to the current bodyof knowledge on isolated sphenoid sinus inflammatorydisease in order to promote early diagnosis and prompttreatment to prevent critical complications. METHODS A retrospective analysis was performed on 23 clinical cases of isolated sphenoid sinus inflammatory disease. The clinical features,radiological features,treatment and follow-up results were reviewed in the light of relevant literature. RESULTS The most common symptoms of the disease were headache and visual disturbance. All patients were treated by endoscopic sinus surgery and followed-up for 6-14 months. No recurrence was observed. CONCLUSION Diagnosis of isolated sphenoid sinus inflammatory disease at its early stages is difficult to ascertain because of the non-specificity of its symptoms. The widespread use of nasal endoscopy and CT examination makes early pre-operative diagnoses possible. Managing sphenoid sinus inflammatory disease with functional endoscopic sinus surgery is the preferred method of treatment.

Objective To explore the surgical treatment of bile duct necrosis.Methods Clinical data of 94 cases of bile duct necrosis treated in this hospital from May1990 to December 2008 were retrospectively analyzed.Results There were no death or severe complications such as biliary fistula and massive hemorrhage in these patients.Conclusion Bile duct necrosis should be treated with a proper surgical approach based on its features.

Objective To study the experience on a variety of hepatectomy by occluding the branches of hepatic artery and portal vein to the liver lobe,segment at hilar H fissure.Methods A total of three hun-dred and ninteen patients accepted hepatectomy in Hunan provincial people's hospital from Decemember 2006 to Decemember 2007 were involved in this study for retrospective analysis.Results There were no perioperative deaths and liver function failure in this series of patients.The average amount of blood loss was 70 15ml,and 302 (95 %)cases did not receive transfusion.Postoperative complications such as liver necro-sis,bile leaking,bleeding were not found.Subphrenic abscesses were found in 3 cases,which were cured conservatively.Conclusion Selective regional occlusion of hepatic blood flow during bepatectomy avoided the risk of ischemia-reflow injury of remnant liver,which is safe and effective to prevent massive bleeding and to reduce the incidence of liver failure.

Objective To study the surgical treatment of pancreatolithiasis.Methods The clinical data of thirty-seven patients with pancreatolithiasis admitted to our hospital from 1994 to 2007 were reviewed.Results According to the results of imaging examination (BUS,CT,ERCP) and finding during surgery, pancreatolithiasis was classified into three types: TypeⅠ,the stones were mainly located in the head of pancreas, and Whipple procedure was the treatment of choice. TypeⅡ, the stones were mainly located in the body and tail of pancreas, and resection of the tail of pancreas alone or combined with splenectomy was the management of choice. TypeⅢ, the stones were diffusely scattered in the main duct from the head to tail of pancreas, and pancreatoduodenectomy,together with pancreatolithotomy and pancreatojejunostomy with wide anastomotic stoma was the choice of management. There was no mortality in this series. Within 2 weeks after treatment, symptoms ameliorated to different degrees in all the patients. Thirty one patients were followed up for 6 to 72 months, the results were satisfactory.Conclusions The individualized strategy, based on the type of stone location, is of great importance in the management of pancreatolithiasis. The key of surgical treatment of pancreatolithiasis is as follows: removal of pancreatoliths, excision of diseased pancreas, and adequate pancreatic drainage.

OBJECTIVE To analyze whether the vidian canal can be served as a landmark to endoscopic nasal skull base surgery and provide clinical reference by imaging and anatomical methods. METHODS Twenty three cadaveric heads were scanned through axial and coronal high resolution CT to observe the vidian canal and its relationship with around structures.Three cadaveric heads, in which arteries were injected with latex,were dissected by endoscopic transnasal or transmaxillary to pterygopalatine fossa and cavernous sinus approaches.RESULTS 1.The course and shape of vidian canal and its relationship with around structures can be clearly detected through high resolution CT.All the vidian canals were on the same level or below the internal carotid canal.2.Anatomic study corresponded to the results of imaging.Vidian content pointed to the anterior genu of internal carotid artery constantly.The vidian canal and foramen rotundum can serve as a surgical corridor.CONCLUSION As the landmark, vidian canal plays an important role in the endoscopic nasal skull base surgery.Being a bony canal,it can be detected through high resolution CT easily and clearly.

OBJECTIVE: To study the expression of Survivin in laryngeal squamous cell carcinoma (LSCC) and laryngeal papilloma in adults and its significance in carcinogenesis and development of the LSCC. METHOD: The expressions of Survivin protein were detected by immunohistochemistry technique in 46 cases of LSCC, 24 cases of adjacent nontumorous laryngeal epithelium, 20 cases of laryngeal papilloma and 16 cases of normal laryngeal epithelium. RESULT: The positive rates of Survivin protein expression in laryngeal carcinoma, adjacent nontumorous laryngeal epithelium and laryngeal papilloma were 71.74% (33/46), 33.33% (8/24)and 40.00% (8/20) respectively. There was no expression in normal laryngeal epithelium. The positive rate of Survivin protein expression in laryngeal carcinoma was significantly higher than that in the adjacent nontumorous laryngeal epithelium, laryngeal papilloma and normal laryngeal epithelium. But there was no statistically significant correlations between Survivin protein expression and the clinicopathological characteristics of tumor site, T-stage, pathological grading, UICC-stage and lymph node metastasis (P > 0.05). Expression of Survivin protein in 3 cases in laryngeal papilloma group which turned into laryngeal carcinoma later were all positive. CONCLUSION There was overexpression of Survivin in the laryngeal carcinoma. The expression of Survivin might play an important role in the carcinogenesis of LSCC and might be an early event during laryngeal carcinogenesis. It could be a diagnostic marker for evaluating the malignant potential of laryngeal papilloma in adults.
Adolescent ; Adult ; Aged ; Carcinoma, Squamous Cell ; metabolism ; pathology ; Female ; Humans ; Inhibitor of Apoptosis Proteins ; metabolism ; Laryngeal Neoplasms ; metabolism ; pathology ; Lymphatic Metastasis ; Male ; Middle Aged ; Neoplasm Staging ; Papilloma ; metabolism ; pathology ; Survivin ; Young Adult

Taking the occurrence and development of general consent as the research object, this paper compared the differences between the ethical characteristics of broad consent and informed consent of specific research through the analysis of the content revision process of broad consent in the U.S. Broad Rules, and tried to explore the feasibility of implementing broad consent in Chinese medical institutions.

Objective To investigate the cognition of medical staff on the control and treatment of venous thromboembolism ( VTE) at the municipal general hospitals in Beijing, for due countermeasures. Methods Customized questionnaires were used to survey the medical staff at 7 general hospitals in Beijing. The data so acquired were divided into approval items and disapproval items to calculate the ratio of approval items, while the comparison between those of different specialties and academic titles was subject to logistic regression analysis. Results 2 496 valid questionnaires were recovered, and the results showed that over 95% of them recognized the necessity of the VTE control and treatment work in the hospital, yet they need to improve their professional knowledge in this regard. There were differences in the cognition level among different specialties, and the higher the professional title, the better the recognition. Top three concerns for VTE work were increased workload, increased hospitalization expenses and extended hospital stay in turn. Top three difficulties in the work were patient′s compliance, coordination of auxiliary departments, and doctors′ cognition and involvement. Conclusions Cognition of VTE needs to be enhanced, and it is imperative to improve the VTE control and treatment system, carrying out the work in a scientific, standardized and economic manner.

In the evaluation of medical postgraduate scholarship, objective method is adopted to evaluate subjective indicators. According to the specific practices for experts and the views of students to establish a set of subjective and objective indicators combined with the evaluation index system, objective indicators including research ability, academic achievement, various school activities, subjective indicators such as ethics, communication and coordination ability, innovation ability etc. To evaluate the subjective index according to the analysis, the inherent requirements of subjective index application case scenario simulation and peer evaluation and other objective methods, we aim to eliminate the scholarship evaluation process of subjective indicators "passing" or "useless" phenomenon, more fair and equitable selection of truly outstanding students.

ObjectiveTo investigate the clinical application value of two-step separation approach in laparoscopic left lateral sectionectomy (LLLS).MethodsA total of 156 patients undergoing LLLS with two-step separation approach in Hunan Provincial People's Hospital between January 2009 and September 2014 were included in this prospective study. Among the 156 patients, 76 were males and 80 were females with the age ranging from 18 to 75 years old and the median of 56 years old. The informed consents of all patients were obtained and the local ethical committee approval had been received. The patients were in bladder lithotomy position or straddle position and pneumoperitoneum was established with 4-hole approach and periumbilical puncture. Hepatectomy was performed using two-step separation approach. The liver parenchyma was dissected to the plane of left lateral hepatic pedicle-left hepatic vein using ultrasonic scalpel along the left of falciform ligament. Then, the hepatic pedicle and the left hepatic vein was dissected using Endo-GIA stapler.ResultsAll patients completed the surgery successfully and no case was converted to laparotomy. Eighty-nine patients underwent simple left lateral hepatic artery occlusion and 67 patients did not undergo hepatic inlfow occlusion. The median operation time was 85 (53-150) min and the liver dissection time was 17 (8-35) min. The intraoperative blood loss was 25 (10-100) ml and the postoperative length of stay was 7 (5-10) d. No death case and no serious postoperative complication was observed. Only 7 patients developed mild bile leakage and recovered after effective drainage.ConclusionTwo-step separation approach in LLLS is safe and easy, which can be taken as a standard operation and widely popularized.