Primary aspergillosis of the sphenoid sinus with pituitary invasion – a rare differential diagnosis of sellar lesions

Summary Aspergillosis belongs to the group of mycotic diseases of paranasal sinuses. The invasive forms, and particularly the fulminant forms, are potentially fatal. Isolated aspergillosis of the sphenoid sinus or the clivus is a difficult diagnosis, since the often misleading clinical manifestations of this rare disease develop late. These patients become apparent by neurological signs such as cavernous sinus syndrome, pseudotumor of the pituitary or the orbit. Diagnosis is often made intra-operatively or on histological examination. We report a case of invasive aspergillosis uniquely involving the sellar area revealed by clinical features suggesting a pseudotumor of the pituitary. Although such lesions are almost always seen in immune suppressed subjects, in our case, the patient was immune competent and had no past history of sinusitis. The question of whether, and when to perform limited or extensive surgery remains an issue for discussion, owing to the rarity of this disease honed by lack of experience. It depends on several factors: the kind of disease, the immunity, the subtype of invasive fungal sinusitis and the degree of tissue invasion.     

颈椎病与中医辨证关系的探讨(附100例分析)

目的:探讨颈椎病与中医分型的辨证关系。方法:对100例该病的影像表现与中医分型进行系统分析。结果:主要临床表现颈部活动受限,颈、肩、背部疼痛,常伴头痛、头晕、视物模糊、耳鸣等症状。风寒型以软组织所致颈曲改变为主。肝肾亏虚型、痰湿交阻型以骨质增生、椎间隙及椎间孔狭窄为主。结论:X线、CT是本病首选检查方法,能与中医辨证有机结合,对中西医治疗有重要意义。     

Design of clinical trials for chronic diseases: implications for periodontal disease

In order to make effective use of the statistical theory of design of clinical trials for chronic diseases such as periodontal disease, certain issues must be considered. Any clinical trial requires that the disease definition be well-specified; that patient eligibility be explicit; that the observation times be explicit; that the duration and endpoint of therapy be specified; that the duration of subsequent followup observation be specified; and that the unit of observation (e.g., tooth, set of teeth, patient) be defined. In a chronic disease, the potential biases that can readily be introduced by self-selection of patients who enter the trial and/or who return for subsequent observation become more important, because subjects are required to remain on treatment and/or observation for prolonged periods. Further, the cyclical nature of some chronic diseases may require special attention to baseline definitions of active disease and disease outcome. These issues are illustrated with examples from clinical trials of hypertension, breast cancer screening, and Polycythemia Vera. Implications for periodontal disease are discussed.     

Performance and comparison of the Cockcroft-Gault and simplified Modification of Diet in Renal Disease formulae in estimating glomerular filtration rate in a Chinese Type 2 diabetic population.

AIMS: Our aim was to assess performances of the Cockcroft-Gault and simplified Modification of Diet in Renal Disease (MDRD) formulae in estimating glomerular filtration rate (GFR) in Chinese diabetic populations and their association with vascular risks. METHODS: A total of 1009 patients with Type 2 diabetes were categorized into low estimated GFR groups (GFR < 60 ml/min/1.73 m(2)) and control groups by the two equations. The performances of these formulae were assessed at different stages of kidney function. Carotid artery intima-media thickness (IMT) and the prevalence of diabetic retinopathy or albuminuria were compared among the groups. The ability of these formulae to identify established vascular risk markers using sensitivity, specificity, positive and negative predictive values were also compared. RESULTS: The prevalence of low estimated GFR was 32.7% with the Cockcroft-Gault formula and 5.2% with the MDRD formula, respectively. In low estimated GFR subjects by the MDRD formula, IMT was significantly thicker than those by the Cockcroft-Gault formula (1.2 mm vs. 1.0 mm; P < 0.05), with a higher prevalence of albuminuria (78.4 vs. 52.8%, P < 0.05) and diabetic retinopathy (46.5 vs. 30.5%; P < 0.05). The Cockcroft-Gault formula gave a specificity of 71.7% and a sensitivity of 37.0%, and the MDRD formula gave a specificity of 96.6% and a sensitivity of 7.9% in estimating low GFR relevant for established vascular risks. CONCLUSIONS: These formulae performed differently in Chinese diabetic populations. The simplified MDRD formula is minimally superior to the Cockcroft-Gault formula for its high specificity and positive predictive values in estimating low GFR relevant for vascular risks.     

Lower limb blocks for children

Femoral and lateral cutaneous nerve of the thigh blocks have been performed in a group of 50 children; the method has not previously been described in paediatric practice. The technique was judged to have been successful in 48 (96%) of the children. There were no early or late complications. It is concluded that these blocks are easy to perform, even in small children and infants, and that they can produce reliable postoperative analgesia for a variety of orthopaedic and plastic procedures.     

曼氏血吸虫与日本血吸虫交叉免疫原性的血清学实验研究

以曼氏血吸虫的虫卵和成虫免疫家兔后所产生的特异性抗体,可用以日本血吸虫虫卵、尾蚴和成虫为抗原分别进行的COP,CHR和ELACIEP测出,表明两种人体血吸虫存有显著的交叉抗原成分。应用此种血清交叉反应性,以检测抗异种人体血吸虫的抗体,似有效而可取的,可用以辅助诊断援外回国人员是否感染国外人体血吸虫病。     

识时度势保持特色力求发展--中西医合校的回顾与思考

新疆医科大学为全国第二家中西医合并院校.在新疆进行中西医合校,实属时势所使,事在必行.强弱相合,处于弱势的中医学院只有坚持相对独立,才能保证于合校后发扬中医药特色、办好中医药教育.中西医合校,给原本弱小的新疆高等中医药教育事业的发展带来了诸多可供凭借和利用的积极因素,同时也存在不少负面影响.新疆医科大学在实践中认清了中西医同校的优势与缺憾,采取扶持和爱护中医的策略,不断尝试规避冲突、化解矛盾、趋利祛弊、务期和谐,终喜事业有成,使高等中医药教育得以在新疆生存,并越过低谷,走上健康发展之路.     

孕足月胎膜早破与头位难产的相关性

目的：探讨足月妊娠胎膜早破与难产的关系。方法：选择262例足月妊娠胎膜早破患者作为观察组,另随机抽取本院同期262例无胎膜早破的健康孕妇作为对照组,比较两组难产率的发生情况。结果：观察组难产率为45.0%,明显高于对照组的22.9%（P〈0.01）。两组的难产因素差异无统计学意义（P〉0.05）。结论：胎膜早破与难产有相关性,应及早处理,防止母儿并发症的发生。