Objective To investigate the choice and efficacy of surgury in treatment of hypertensive intracerebral hemorrhage. Methods The clinical data of 278 cases of hypertensive cerebral hemorrhage were retrospectively analyzed. These cases respectively used CT Stereotactic puncture and drainage, minimally invasive craniotomy and Craniotomy hematoma surgical treatment. According to the GCS cores and hematoma volume,they were divided into 3 groups so as to comparatively analyze the efficacy of different surgical methods. Results Hypertensive cerebral hemorrhage CT stereotactic puncture good prognosis group was 74 cases(59.6% ) ,minimally invasive craniotomy group of good prognosis ,48 cases(56.4% ) ,there was no significant difference between the two groups(P＞ 0.05). Craniotomy mortality is 15 cases (21.7% ). Conclusion Three surgical treatment of hypertensive cerebral hemorrhage had their own characteristics:CT stereotactic puncture and drainage characteristics with less trauma,faster recovery,timely and effectively discharge brain compression. It was a simple and effective treatment for hypertensive intracerebral hemorrhage. In many cases, CT sterotactic puncture and drainage could replace invasive hematoma evacuation.

ObjectiveTo explore the treatment desicions of Contusion and laceration of the brain at temporal lobe and frontal lobe with small hematoma and base pond changes. MethodsAccording to three grades of consciousnee,areas of brain contusion or quantity of hematoma,and changes of base pond,it divided 274 patients into different types,then analyzed treatments and retrospect to them. Results33 cases of Type Ⅰ:33 cases had operated immediatelly and 3 cases had died;44 cases of Type Ⅱ:17 cases had delayed operations and 1 case had died;27 cases without operations.Type Ⅲ: 15 cases without operations. ConclusionThese "three-3" method of grade could be regarded as the quantification index of treatment desicions before deterioration.

Objective To explore the the rapeutic efficacies of different surgical methods for hypertensive intracerebral hemorrhage so as to find out their indications. Methods Admittedin to 218 eases of hypertensive intracerebral hemorrhage since, which treated by tereotaetie aspiration or eraniotomy through small bone window or eraniotomy through bone flap was divided into three subgroups according to GCS scores and hematoma volume indications and trerapeutic outcomes of these three surgical methods were analyzed comparatively. Results Satisfactory prognosis was found in 64(60.4%) patients of brain hematoma puncture drainage. Satisfactory prognosis was found in 35(54.7%) patients of small windowing skull. No significant was occurred between the two groups (P＞0.05). The mortality rate decreased obviously in the bone-flap eraniotomy group with greathematoma volume (29.2%). Conclusions Puncture drainagc has small wound and instauration quickly. And valid for time to relief encephalothlipsis. In most circumstances, puncture drainage can replace the small hole craniotomy. Bone flap craniotomy can lower a great deal of apoplexy death rate.

Objective To discuss the clinical characteristics and treatment of upper cervical spine injuries in the elderly. Methods A retrospective study was done on clinical data of 28 elderly patients ( > 60 years old) with upper cervical spine injuries treated from January 2003 to December 2007. There were 20 males and 8 females, at age range of 60-86 years (mean 68.1 years). Injury causes included slip in 16 patients, traffic injury in eight and fall from height in four. Atlas fractures occurred in five patients and axis ones in 15,of which there were eight patients with odontoid fractures, six with C2 vertebral arch fractures and one with C2 body fractures. Upper cervical spine injury was combined with lower cervical spine injuries in five patients. There were combined atlantoaxial injuries including odontoid fractures combined with lateral atlas fracture in one and edontoid fractures combined with anterior atlas arch fracture in one. Atlantoaxial dislocation occurred in one patient and combined spinal injury in four. Of all, eight patients were treated conservatively, eight with open surgical operation and 12 with minimally invasive surgery. Results The average hospital stay was 16.5 days, with no statistical difference be-tween conservative treatment group and open surgical operation group ( P > 0.05 ). While the average hos-pital stay in minimally invasive surgery group was shorter than that in conservative treatment and open sur-gical operation groups ( P < 0.05 ). Of all, two patients in conservative treatment group and one in open surgical operation group died and the other 25 patients were followed up for average 16.8 months (9-56 months). The satisfaction rate was 50% in conservative treatment group, 72% in open surgical operation group and 75% in minimally invasive surgery group. Complications occurred in four patients in conserva-tive treatment group, three in open surgical operation group and two in minimally invasive surgery group. Conclusions With odontoid fracture the most common injury type, upper cervical spine injuries arema-inly caused by low-energy force and characterized by low mobidity of spinal cord injuries and high possi-bility of missed diagnosis in the elderly patients. The surgical treatment especially minimally invasive surgery can bring good results compared with conservative methods.

Objective To investigate complications associated with Coflex interspinous process device for degenerative lumbar disc diseases and methods to treat.Methods Clinical data of 121 patients with degenerative lumbar disc diseases,who had undergone surgical decompression and additional fixation of Coflex between November 2007 and June 2011,was analyzed retrospectively.There were 76 males and 45 females,aged from 37 to 75 years (average,54.6 years).Surgery-related complications and sequelae were recorded and analyzed.Results Surgery-related complications occurred in 10 patients,and the incidence was 8.3％ (10/121).There were 3 cases of device-related complications,including wing break in 1 case,prosthetic loosening in 1 case and spinal process fracture in 1 case; all 3 cases were treated conservatively and received good results.There were 7 cases of non-device-related complications,including dura mater dilaceration in 2 cases,superficial wound infection in 1 case,insufficient decompression of spinal canal in 2 cases,recurrence of disc herniation in 1 case,and intraspinal hematoma in 1 case; the former 3 patients recovered after corresponding treatment,and the latter 4 patients also recovered after re-operation.Conclusion The incidences of complications and re-operation associated with application of Coflex are low,and the incidence of device-related complications is also low.The precise intraoperative manipulation is the key to reduce incidence of device-related complications.It's absolutely necessary to strictly master surgical indications and perform sufficient decompression in order to receive good surgical results and avoid non-device-related complications.

[ABSTRACT]OBJECTIVETo study of the relationship of age and climate with the nasal mucosa lesions.METHODSAll the patients met with the inclusive criteria were registered and followed-up once a month and their nasal mucosal lesions were observed through nasal speculum and/or nasal endoscope. The recording data was analyzed by SPSS17.0 software.RESULTSA total of 259 patients, 555 person-times and 957 lesion spots were observed. The nasal mucosa was injured by airflow with the highest incidence rate from October to next year April. Patients numbers gradually increased after August, and significantly increased at November, December (P<0.05). Children aged from 2 to 12 years old and the adults aged from 40 to 80 years old were susceptible population (P<0.05), the incidence rate had a negative relation with humidity (P<0.05). The susceptible spots of the lesion were ranked as follows: Little area, inferior turbinate, mucosa of the both side of the deviated nasal septum, inferior meatus, middle meatus, middle turbinate and olfactory area. CONCLUSIONNasal mucosal injury relates to age and seasons. The nasal cavity airflow may be a factor of these lesions.

Objective To investigate the status and associated factors of demand satisfaction (DS) of services for older adults with visual disability (OAVD).Methods Based on the 2nd National Sample Survey on Disability in 2006,a total number of 24 017 OAVD cases were included.Associated relationships among demographic,health-related,social,economic factors and services of DS,including health demand (Type Ⅰ),basic livelihood demand (Type Ⅱ),and environmental support demand (Type Ⅲ) were analyzed.Results The proportions of DS of Type Ⅰ,Ⅱ,Ⅲservices for OAVD were 35.1％,9.3％ and 4.3％ respectively.Eight factors as:having pension insurance (OR =1.64),living in urban areas (OR =1.54),per capita household income at ≥ 5 000 or over Yuan (OR=1.46) were favorable ones on OAVD DS while at age ≥ 80 or above (OR =0.90),being male (OR=0.93) were adverse factors of Type Ⅰ.Four factors as:being male (OR=1.43),living in urban areas (OR=1.15),subjects defined as grade Ⅱ (OR=1.36) and grade Ⅰ (OR=1.70)etc.,were favorable factors on OAVD DS.Five factors as:range of age groups at 15-59(OR=0.57)or at ≥60 (OR=0.45),per capita household income at 1 000-1 999 Yuan(OR=0.77),2 000-4 999 Yuan (OR =0.58) and ≥ 5 000 Yuan (OR =0.39) were adverse factors of Type Ⅱ.Factors as:living in urban areas (OR =1.23),defined as grade Ⅱ (OR =1.38) and grade Ⅰ (OR =1.34),having pension insurance (OR=1.62) and per capita household income at ≥5 000 Yuan (OR=1.42) etc.,were favorable factors of Type Ⅲ.Conclusion The DS degree of older adults with visual disability was generally very low while factors as:per capita household income,situation on social insurance,age,degree of disability,age when disability was identified,areas of residence,gender,grade of disability,marriage status,levels of education etc.,were significantly associated with the service on DS.

Cervical cancer is a common malignant tumor of female reproductive system. The treatment of cervical cancer is based on surgery and radiotherapy (or concurrent chemoradiation). Lower extremity lymphedema (LEL) is a frequent complication after cervical cancer treatment, which significantly affects the quality of life of patients. Both pelvic surgery and radiation for cervical cancer can lead to LEL. The risk factors for LEL are complicated and involving characteristics regarding patient (age, comorbidities, lifestyle, etc.), tumor [International Federation of gynecology and Obstetrics (FIGO) stage, lymph node metastasis, etc.], and treatment (number of resected lymph nodes, removal of circumflex iliac nodes, adjuvant therapy, etc.). Comprehensive measures are proposed to prevent cervical cancer patients from LEL, and further investigations in terms of effectiveness are warranted.

Objective To explore the effect of comprehensive intervention on emotion and coping style in adolescents with internet addiction disorder ( IAD ) .Methods Fifty-nine IAD adolescents received the diverse treatment including the medicine , psychology and nursing for three months .The positive and negative affect scale ( PANAS ) and simple coping style questionnaire ( SCSQ ) were used to assess the emotion and coping style in patients on admission and 3 months after the treatment .Results The score of positive emotion in patients was (37.31 ±4.24) three months after the treatment, and was significantly higher than (27.33 ± 4.09) on admission; the score of negative emotion in patients was (19.10 ±3.96) three months after the treatment, and was significantly lower than (26.08 ±5.39) on admission;and the differences were statistically significant (t=-16.556, 9.899, respectively;P<0.01).The score of positive coping style in patients was (28.02 ±4.50) three months after the treatment, and was significantly higher than (18.86 ±4.06) on admission;the score of negative coping style in patients was (6.79 ±2.46) three months after the treatment , and was significantly lower than (9.79 ±3.42) on admission; and the differences were statistically significant (t=-16.621, 7.609, respectively;P <0.01).Conclusions Comprehensive intervention has a certain intervention effect on the negative emotion and negative coping style in IAD adolescents , and can help patients give up internet addiction and restore social function .

Objective To investigate the effect of standardized extended care on the patients after endoscopic sinus surgery .Methods Eighty cases after endoscopic sinus surgery , from January 2012 to January 2013 , were randomly divided into treatment group and control group , with 40 cases each .The control group was taken the usual care and discharge guidance , and the treatment group was given the standardized extended care . Results The effective rate of the treatment group and the control group were 97.5% and 85.0%.There was significant difference between groups (χ2 =2.23,P <0.05).2 cases in the treatment group occurred nasal adhesions, with a complication rate of 5.0%.In the control group, 6 cases occurred nasal adhesions;1 case occurred maxillary sinus stenosis; 1 case occurred orbital hemorrhage , with a complication rate of 20.0%. There was significant difference between groups (χ2 =3.45,P =0.561).Conclusions The standardized extended care can significantly improve patient treatment efficiency and reduce complications .It is worthy of clinical application .