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Objective: To evaluate the incidence of postoperative hemorrhage in children undergoing adenoidectomy, and to discuss its possible causes., Methods: Included in this study were children who underwent adenoid and/or tonsil surgery at Shenzhen Children's Hospital between January 2004 and November 2009. The change of hemoglobin (Hb) and hematocrit (Hct) were retrospectively analysed. The blood loss was estimated by the change of Hct., Results: There were 2078 cases that accomplished the inclusion criteria in the period of study. Ten children bled 0.5 - 4.0 hours after surgery, without superfluous hemorrhage during the operation and post-tonsillectomy. This represented an incidence of 0.48%of immediate postoperative haemorrhage among the 2078 procedures analyzed. Statistical differences were found between boys (0.21%) and girls (1.10%, χ² = 5.597, P < 0.05). The change of Hb and Hct was positively correlated (r = 0.95, P < 0.01), the blood loss was positively correlated with the bleeding time (r = 0.66, P < 0.05). The causes of postoperative hemorrhage were coagulation system deficits, chronic nasopharyngitis, deficient hemostasis and immoderate ravage. To control the postoperative hemorrhage, 2 postnasal packing under topical anaesthesia and 8 electrocautery under general anaesthesia were applied., Conclusions: Poor operative technique and deficient hemostasis are the major causes of primary hemorrhage. Prompt operation to control the postoperative bleeding should be done 2 hours after bleeding under general anesthesia in order to avoid severe complications.

Aim: To evaluate the availability and our experience of intraoperative image-guidance in endoscopic nasocular operation., Methods: Seven cases of endoscopic nasal surgery with intraoperative image-guidance were retropectively reviewed, including 3 cases of optic nerve injury; 3 cases of foreign object of optic behind the eyeball; 1 case of retrobulbar tumor (angeioma)., Results: The preoperative preparatory time would take 15 minutes, including coordination, head holder localization, conventional instrument registration. In our cases, the localization accuracy between 3-D image landmarks of navigation system and actual anatomical landmarks was less than 1.3mm. The optic nerve and other anatomical points could be orientated accurately in intraoperative procedures. No complication occurred., Conclusion: Nasal endoscope combined with image-guidance systems provides accurate anatomical localization of anterior skull base with enlarged operation field. It is possible for surgeons to observe important anatomical structures during endoscopic surgery. It could increase the effectiveness and decrease surgical complications, especially in complicated cases.

Background & Objective: Recombinant human growth hormone (rhGH) has been proved effective in clinic, such as promoting protein synthesis and decreasing the mortality. But there are still many arguments on whether it can be used in hepatocellular carcinoma (HCC) patients. rhGH cannot work except that it combines to its own receptor growth hormone receptor (GHR). The current study was designed to explore the expression of GHR in HCC tissues and to investigate the viability of rhGH for HCC treatment., Methods: Radioreceptor assays were used to determine growth hormone receptor (GHR) in 40 HCC tissues; 6 normal liver tissues were used as control. Receptor binding capacity(RT) and affinity constant(Kd) of GHR were calculated by Scatchard's method; the relationship between RT of GHR in cancer and clinicopathologic factors were also analyzed., Results: The growth hormone- specific singular binding site, namely GHR, was detected respectively in 35 HCC cases and control tissues. The RT and Kd of GHR were 18.5416+/-4.1686 fmol/mg protein and 0.6319+/-0.1978 nmol/L in tumor tissues, 39.5467+/-3.4770 fmol/mg protein and 0.6167+/-0.1007 nmol/L in control tissues, respectively. Compared with the normal liver tissue, RT of GHR in tumor was lower (P< 0.05) but Kd did not show any difference(P >0.05). The RT of the GHR was negatively relevant to the tumor size and disease stage, but was not associated with differentiation of tumor, ages of the patients or whether the patient suffered from cirrhosis at the same time. GHR was undetectable in 5 cases., Conclusion: This study showed that most of the HCC tissues express low levels of GHR. Before their functions are well understood, rhGH should be very carefully used in HCC patients.