Objective To discuss the clinical effect and safety of transurethral holmium laser resection of bladder tumors.Methods A total of 20 patients with bladder tumors(stage Ta～T2a)was treated by holmium laser resection transurethrally.There were 17 patients with primary tumor and 3 patients with recurrent tumor.The laser power was set at 15～40 W.Small lesions were vaporized directly,while large ones(more than 1.0 cm in diameter and with broad pedicels)were incised from the pedicel,with neighboring tissues 1～2 cm in extent vaporized and cauterized.Results The tumors were removed on one session in all the 20 patients.The operation time was 10～70 min(mean,30 min).No complications such as obturator nerve reflex,bladder perforation,or overhydration occurred.No blood transfusion was required.The postoperative catheterization time was 1～5 days(mean,3 days).No recurrence was found during follow-up examinations for 3 months in 16 patients and 6 months in 4 patients(mean,3.6 months).Conclusions Transurethral holmium laser resection of bladder tumors is a safe and effective procedure for the treatment of bladder tumors.

Objective To compare the clinical efficacy of two minimal invasive surgeries,transurethral Holmium laser and electric incision,in the treatment of cystitis glandularis(CG).Methods From January 2004 to June 2006,63 cases of CG were confirmed pathologically by using cystoscopy.Among the patients,35 were treated by transurethral Holmium laser and 28 by transurethral electric incision.All the cases received postoperative chemotherapy with mitomycin bladder irrigation and were followed up for 6 to 18 months.The efficacy of the two surgical procedures was evaluated during the follow-up.Results Compared with the electric incision group,the mean operation time and hospital stay was significantly shorter [(15.3?5.1) min vs(20.8?6.3) min,t=-3.831,P=0.000;and(2.4?1.7) d vs(4.0?1.5) d,t=-3.909,P=0.000;respectively],and the rate of complications was significantly lower [0%(0/35) vs 14.3%(4/28),?2=5.339,P=0.021] in the Holmium laser group.Six months after the operation,the cure rate of the Holmium laser group was significantly higher and the recurrence rate was significantly lower than those in the electric incision group [82.9%(29/35) vs 60.7%(17/28),?2=3.871,P=0.049;and 5.7%(2/35) vs 25.0%(7/28),?2=4.725,P=0.030].Conclusions The transurethral Holmium laser is a safe,effective,and convenient method for the treatment of CG.Since the method can not only achieve a high cure rate and low recurrence rate,but also avoid lower urinary obstruction,we recommend it as the first choice for CG.

Objective To explore a new surgical method for hypertensive cerebral hemorrhage and its efficacy.Methods A total of 12 patients with hypertensive cerebral hemorrhage in the fundus node at a super early stage(≤6 h)were enrolled in this study.Microsurgery trough the lateral fissure and insula via pterional keyhole approach was employed to treat the patients.Results All but one of the patients survived after the operation.One patient received a second operation because of hemorrhage for twice,one patient developed intracerebral infection.The survivors were followed up for 3 to 6 months.According to GOS scoring system,7 of them achieved excellent outcomes,3 were good,and 1 was moderate.Conclusion Microsurgery trough the lateral fissure and insula via pterional keyhole approach is effective for hypertensive cerebral hemorrhage.

Objective To investigate antiepileptic drug application and the influential factors in patients after epilepsy surgery.Methods During the period from 2002 through 2005,170 patients with intractable epilepsy who received epilepsy surgery in Xuanwu hospital were studied.They were divided into 3 groups according to the stages of operation.Patients in group A received epilepsy surgery during 2002 to October 2003,those in group B received initial phannacentieal care after epilepsy surgery during November 2003 to October 2004,and those in group C received integrated pharmaceutical care after epilepsy surgery during November 2004 to October 2005.The clinical outcomes,factors affecting antiepileptic drugs,safety and compliance with antiepileptic medication were analyzed.Results Patient's clinical outcomes(group B was 71%and group C was 81%),safety and compliance with antiepileptic medication in group B and group C are better than those in group A(46%)with a significance difference(X2=7.08,15.50,P<0.05).Conclusions The integrated pharmaceutical care rendered from the cooperation of neurosurgeon,neurologist and clinical pharmaceutist is a new and effective management mode for postsurgical epilepsy patients.

Objective:To study the influence of astragalus injection(黄芪注射液) plus Shenmai injection(参麦注射液) on each stage of hemorrhagic fever with renal syndrome(HFRS).Methods:Thirty-six cases with HFRS were randomly divided into treated group(n=19) which was treated with western medicine and traditional Chinese medicine (astragalus injection and Shenmai injection) and control group (n=17) which was treated with western medicine alone during fever stage.The curative effects were compared.Results:In treated group the rates of over hypotensive shock stage and over oliguria stage were both 94.74％ ,they were significantly heigher than those in control group(both P<0.05).The prolonged times of polyguria,increased blood urea nitrogen(BUN),and proteinuria in treated group were significantly shorter than those in control group (all P<0.01).Conclusions:The astragalus injection and Shenmai injection possess the ability to enhance the antidisease capability in patient with HFRS and are able to shorten the shock stage,to reduce the occurance rate of oliguria,to shorten the duration of each stage,and finally to shorten ill course and promote the patients to recovery as early as possible.

Objective To discuss the application of surface anatomy scanning in the department of cerebral surgery. Methods 24 cases were examined by surface anatomy scanning.These included 5 normal cases,10 gliomas,4 metastasis tumors,3 meningiomas,1 cavernous hemangioma and 1 cerebral infarction.Results 5 normal cases with surface anatomy scanning showed excellent visualization of the sulci and gyri on the surface of the brain.In 19 cases with cortical or subcortical lesions,14 cases showed the relationship between the lesion and the brain surface structures well.5 cases could not displayed because of server edema around the lesion.Conclusion The brain surface anatomy scanning is useful for the localization of cortical and subcortical pathology,for the diagnosis of the disease of sulci and gyri,can partly replace the navigation.

Objective To study imageology anatomy concerned of sellar turica and explore its potential role on growth of pituitary adenomas. Methods According to classification of sinus sphenoidalis,103 normal imageology data of sellar turica region were analyzed, including 83 cases with entire saddle type sinus sphenoidalis and 20 cases anti-saddle type sinus sphenoidalis. Furthermore, the clinical data of 45 cases of pituitary adenomas with extension into sinus sphenoidalis were retrospectively studied. Results The relationship between sellar floor's shapes and sinus sphenoidals'types was that the larger the sinus sphenoidalis was, the deeper the floor was(98.8%). The relationship between sellar floor's shapes and the superior surface of hypophysis was that most of depressed sellar floors were companied with depressed superior surfaces of hypophysises(93.8%). The anteroposterior shapes of sellar turica in midsagittal can be divided into 4 types such as bag-type, kettle-type, tube-type, and sifter-type. 45 patients suffering from pituitary adenoms with extension into sinus sphenoidalis all had entire saddle type sinus sphenoidalis. Conclusions The imageology anatomy concerned of sellar turica could explain the phenomena of pituitary adenomas with extension toward sellar floor and sinus sphenoidalis. Referring to the literatures concerned, it indicated that the imageology anatomy was the key factor of affecting the growth of pituitary adenomas.

Objective To study the relationships among postpartum depression,dysfunctional attitudes and automatic thoughts.Methods 274 cases of postpartum women were estimated at fifth or sixth week after delivery by Edinburgh Postnatal Depression Scale (EPDS),Dysfunctional Attitudes Scales (DAS),Automatic Thoughts Questionnaire(ATQ) and some other forms designed by ourselves.Results ①The prevalence of postpartum depression was 18.20％.②The impact of culture degree on postpartum depression was statistically significant(x2 =12.37,P ＜ 0.05).③Compared with normal subjects,the postpartum depression group had significantly higher total score of ATQ (48.98 ± 12.35 vs 79.29 ± 23.90),total scores of DAS (118.92 ± 20.03 vs 148.03 ± 28.47),attraction or repulsion (13.82 ± 4.33 vs 18.01 ± 6.38),perfection (14.53 ± 5.91 vs 19.21 ± 5.23),compulsion(13.09 ± 3.61 vs 19.36 ± 4.98),seeking applause (14.97 ± 4.06 vs 18.78 ± 5.59),dependence (14.30 ±4.12 vs 19.23 ± 5.43),autonomous attitude(16.54 ± 3.67 vs 21.51 ± 4.81),cognition philosophy (12.32 ± 3.79 vs 18.16 ± 3.43),the difference was all statistically significant (P ＜ 0.01).④There was a significant positive correlation in postpartum depression and total scores of ATQ,total scores of DAS,attraction or repulsion,perfection,compulsion,seeking applause,dependence,cognition philosophy (the Pearson correlation was respectively:0.658,0.432,0.187,0.432,0.481,0.304,0.458,0.459,P ＜ 0.01).⑤Through stepwise regression analysis,automatic thoughts,cognition philosophy,compulsion,perfection and dysfunctional attitudes might play considerable role to predict the occurrence of postpartum depression.Conclusion Automatic thoughts,dysfunctional attitudes can predict postpartum depression to some extent.

OBJECTIVEThis study investigated the influence of different designs and porcelain/glaze firing on the marginal and internal fit of three kinds of computer aided design/computer aided manufacturing (CAD/CAM) zirconia ceramic implant-supported crowns.

METHODSThree groups of zirconia ceramic implant-supported crowns with different designs were produced from copings by using a Cercon CAD/CAM system (n = 8). The first two groups comprised double-layer crowns (zirconia coping + veneer) with regular (Group A) and full circumferential zirconia-collar marginal designs (Group B). The third group was composed of anatomic single-layer zirconia crowns without cores (Group C). Initially, the marginal and internal gaps of the copings and crowns were individually replicated by light-body silicon and then measured by micro-computed tomography scanning before and after porcelain/glaze firing. Five measurements were employed: vertical marginal gap (MG); horizontal marginal discrepancy (HMD); chamfer area (CA); axial wall (AW); and axial-occlusal transition area (AOT). Statistical analyses were performed by SPSS 17.0.

RESULTSHMD measurements in Group A were statistically higher than those in Groups B and C (P < 0.05), regardless of whether the values were obtained before or after porcelain/glaze firing. By contrast, the HIMD measurements in Groups B and C showed no significant difference (P > 0.05). Moreover, no differences were noted in MG, CA, AW, and AOT among the three groups (P > 0.05). All the measurements in the three groups showed no significant change after porcelain/glaze firing (P > 0.05), except for MG in Group A, which significantly decreased (P < 0.05).

CONCLUSIONThe marginal fits of the double-layer crowns with full circumferential zirconia-collar and the anatomic single-layer zirconia crowns were superior to that of the double-layer crowns with regular margins. The MG of the crowns with regular margins was obviously influenced by porcelain firing.

Objective To study the impact of personality and coping style on postpartum depression.Methods 273 cases of postpartum women were estimated by Edinburgh Postnatal Depression Scale ( EPDS),NEO Five-Factor Inventory (NEO-FFI) and Trait Coping Style Questionnaire (TCSQ). With the SPSS11.5,t-test,correlation analysis and regression analysis were carried out for the collected data. Results 23. 1% of postpartum women suffered from depression. There were significant differences in personality traits and coping styles between postpartum depression group and normal group(P＜ 0. 01 ). There was a significant correlation in depression of postpartum and neuroticism, extraversion ( r = - 0. 409 ～ 0. 824 ), agreeableness of personality traits, coping styles.The personality traits was related to coping styles ( r = 0.260, - 0.445, - 0. 234,0. 375 , - 0.431 ). The extraversion, agreeableness of personality traits, negative coping style and positive coping style entered the regression equation of depression and can explain the 32.9% percent variance. Conclusion The extraversion, agreeableness of personality traits, negative coping style and positive coping style are important factors for postpartum depression.