ABSTRACT
Objective To compare lateral orbital keyhole approach(LOK) with conventional keyhole approach including supraorbital keyhole approach (SOK) and pterional approach(PTK) for exposuring the sellar region and oper-ation ability, to provide theoretical and practical basis for the clinic. Methods From January, 2017 to Feburary, 2018, 15 cadaver head specimens of Chinese (30 sides) fixed by formalin were randomly divided into 3 groups, simu-lating SOK, LOK and PTK, application of frameless neuronavigation system, intersection of the posterior margin of the optic chiasma and the lamina terminalis served as the base point. Six different reference points were selected to radi-ate into the parasellar region of the skull base. The direction of the 2 adjacent reference points were connected to the base point to form a triangle. Six triangles constituted the sellar region to represent the total area. The supratentorial area, ipsilateral area, inferior area and contralateral area were calculated by stacking triangle. The comparison was made between groups. The Salma operation exposure scale was used to simulate the aneurysms of the common parts in the brain and the quantitative scores were performed. Results The total parasellar regions by SOK, LOK and PTK respectively were:(1641.6±295.6)mm2, (1782.3±294.6)mm2 and (1552.5±307.4)mm2. There was no statistical differ-ence(P>0.05); To compare the supratentorial region, SOK and LOK were both bigger than PTK ( P<0.05); To compare the ipsilateral and infratentorial area, LOK and PTK were both bigger than SOK respectively ( P<0.05);To compare the contralateral area, SOK, LOK and PTK were increased in turn (P<0.05). Salma operation exposure scale was used to get the scores:the score of SOK was 29.7 (39.08％), LOK was 37.0 (48.68％), and PTK was 36.1 (47.50％). Conclusion Anatomical analysis displayed that the 3 keyhole approaches showed different exposure of each part the parasellar re-gions, the LOK had a good exposure to the parasellar region and so as the higher maneuverability. But the clinical appli-cation should be comprehensive analysis, pay attention to specific lesions and make an appropriate choice. It has impor-tant clinical significance to improve the prognosis of patients.
ABSTRACT
The author explained in the first place what was meant by the modernization of hospitals. In his view, modernization of a hospital includes modernization of its buildings and modernization of its science and technology. The former refers to the modernization of a hospital's main buildings and supporting facilities and modernization of its environment, the style of which should be in line with the main buildings. These manifest as having functional, ecological, humane, intelligent and artistic features. The latter refers to the degree of bit and modernization seen in the ideas and quality of the managers. Then the author gave an account of how the hospital he works with put the above ideas into practice during the second phase of its construction.
ABSTRACT
Taking the 8-year management practice of Sanjiu Brain Hospital of Guangdong since its founding as a case, the paper gives an account of how the hospital managed to grow by leaps and bounds. The steps taken include: guiding decision-making with innovations in thought and blazing new trails in such aspects as growth strategies, leadership structure, system of operation, quality control, nursing management, service skills, marketing management, hospital culture, and logistics management. The paper argues that innovation is the soul and driving force of hospital management and reform and that daring to and knowing how to make innovations are indispensable to enhancing the core competitiveness of the hospital and promoting its fast and sustainable growth.