A retrospective study on the survival rate and risk factors of mortality among 617 inpatients with ischemic stroke / 中华流行病学杂志

<p><b>OBJECTIVE</b>The purpose of this study was to describe survival status and risk factors of mortality on inpatients with ischemic stroke.</p><p><b>METHODS</b>617 patients with continuous ischemic stroke cases were collected from January 2002 to June 2005 retrospectively in the Department of Neurology, Xijing Hospital, Fourth Military Medical University. In order to perceive relevant information on survival and the cause of death. All patients were followed through phone calls or mailing. The follow-up program was completed in January 2006. Kaplan-Meier methods were used for survival description. Monovariant and multivariant Cox's proportional hazard regression model were used to analyze prognostic factors on mortality.</p><p><b>RESULTS</b>The longest time in the follow-up program was 47 months with 59 dropped-out cases, making the dropout rate as 9.5%. Of these patients, 80 cases died during the period of study(60 for ischemic stroke,3 for cerebral hemorrhage, 10 for cardiac disease, 7 for other cause). The median survival time was 42. 16 months. The survival rates of one-year, two-year and three-year period were 91.9%, 89.4% and 85.3%, respectively. Monovariant and multivariant Cox's proportional hazard regression model showed that the risk factors associated with mortality were old age (RR = 1.043, 95% CI: 1.013-1.074), lower Glasgow scores (RR = 0.855, 95% CI: 0.742-0.985) ,poor conscious levels(RR = 4.085, 95% CI: 2.128-7.844) and having complication (RR = 1.765, 95% CI: 1.108-2.812).</p><p><b>CONCLUSION</b>The results of this study suggested that the risk factors were old age, lower Glasgow scores, poor conscious levels and having complication on mortality of ischemic stroke.</p>

Endoscopic endonasal transsphenoidal approach for pituitary adenomas / 中华外科杂志

<p><b>OBJECTIVE</b>To assess the clinical curative effect of the endonasal transsphenoidal approach for removing pituitary adenoma (PA) under neuroendoscope-assisted.</p><p><b>METHODS</b>There were 215 patients who had undergone neuroendoscopic transsphenoidal surgery. Each patient received CT or MRI examination which showed the size and surrounding structural of tumor.</p><p><b>RESULTS</b>Among the 215 patients, 190 cases (88.4%) had total removal, 17 cases (7.9%) achieved subtotal removal and the remaining 8 cases (3.7%) with fibrous tumor was carried out partial removal. Two patients (0.9%) died after operation. Postoperative follow-up period was 1 to 10 months (the average was 3.5 months). In 182 patients, 150 cases (90.9%) got vision recovered rapidly compared with their preoperative symptoms, such as diminished acuities and visual field defects, and 15 cases (9.1%) had gotten improvements to some extend among 165 who diagnosed as pituitary macroadenoma (PMaA); There were 17 patients who diagnosed as microadenoma (PMiA) showed that the pituitary dyshormonism recovered gradually.</p><p><b>CONCLUSIONS</b>The endonasal transsphenoidal surgery under the neuroendoscope-assisted appears to be a safe, effective and micro-invasive method for PA.</p>