Objective To explore the surgical techniques of keyhole approach craniotomy in the treatment of hypertensive intracerebral hemorrhage in old patients. Methods CT-guided keyhole approach craniotomy was performed to treat 50 old patients with hypertensive hematomas from January 2000 to August 2003. Results CT scans within 12 postoperative hours showed over 90% hematomas were removed. The activity of daily living (ADL) classification results 6 months after the surgery were: grade Ⅰin 10 cases (20.0%), grade Ⅱ in 21 cases (42.0%), grade Ⅲ in 9 cases (18%), grade Ⅳ in 3 cases (6.0%), grade Ⅴ in 2 cases (4.0%), and grade Ⅵ in 5 cases (10.0%). Conclusions Senility is by no means a contraindication for surgery in the treatment of hypertensive hematomas and keyhole approach minimally invasive craniotomy can give a satisfactory effect.

0.05), which were both lower than those in the normal control group (P

Objective To explore the cause of the thyroid reoperation ,methods,surgical approach ,and the prevention of complications .Methods 39 cases of thyroid reoperation in patients with clinical data were reviewed and analyzed.Results Thyroid papillary carcinoma in 11 cases,follicular carcinoma in 2 cases,nodular 22 cases of thyroid,thyroid adenoma 1 case,3 cases of primary hyperthyroidism .The incidence of transient hypoparathyroidism ac-counted for 2 cases,temporary laryngeal recurrent nerve injury in 2 cases,chyle leakage in 1 case,in total of 12.8%of postoperative complications .Conclusion Improper operation method choice for the first time and the misdiagnosis was the main cause of reoperation , The reoperation of thyroid is difficult and has more complications .Preoperative evaluation and careful operation can prevent the occurrence of complications .

The aim of laboratory evaluation of basic education is to improve the quality of experimental teaching,which demands thorough reforms of many aspects,including the ranks of teachers,administration,content,methods and instrument of teaching. This article summarizes the experience and achievement of Functional Laboratory Centre,Central South University during under- graduate teaching evaluation by the Ministry of Education in 2006.

Objective:To investigate the relationship between VitD 3 concentration and glucose and insulin levels of OGTT in patients with CKD 3-5 stages.Methods: We included the patients with CKD 3 and 4 and 5 stages who fulfill the including standard.All patients were recorded the concentrations of [1,25 (OH):D3]concentration of glucose and insulin at fasting ,postprandial 1 h,2 h during OGTT and concentration of glycosylated hemoglobin level ,C peptide concentration.We performed the correlation analysis about [1,25 (OH):D3],glucose and insulin.Results: We totally included 91 patients with 3-5 stages CKD into our study.The D3 concentration of stage 3 were 160.9-261.3 mmol/L[(218.38±8.67)mmol/L] of stage 3,75.2-166.3 mmol/L[(117.01±4.72) mmol/L] of stage 4 and 11.8-96.5 mmol/L[(41.91±12.83)mmol/L] of stage 5 (P<0.05).The average concentrations of serum glucose at fasting,1 h after the meal and 2 h after the meal was(4.74±0.21)mmol/L,(8.31±0.43)mmol/L and(7.36±0.32)mmol/L in 3 stage and (4.92±0.25) mmol/L,(9.14±0.15) mmol/L and (9.14±0.39)mmol/L at 4 stage and (4.81±0.13)mmol/L, (10.72±0.41)mmol/L and (10.72±0.49)mmol/L at 5 stage (P<0.05).The average concentrations of insulin during OGTT at fasting,1 h after the meal and 2 h after the meal was (6.58±0.32) μU/L,(57.78±5.63)U/L and (42.77±8.45)U/L in 3 stage (6.03±0.53)U/L,(55.69±7.35)U/L and (62.52±5.39)U/L in 4 stage and (6.12±0.65)U/L,(62.82±9.73)U/L and (77.34± 8.62)U/L in 5 stage (P<0.05).Correlation analysis shows that the concentration of 1,25 (OH):D3 of different stages of patients with CKD and vitamin D 3 concentration and glucose tolerance test was found to be inversely associated with the insulin levels ( P<0.05 ) . Conclusion:There are obvious differences of concentration of vitamin D 3 between patients with 3-5 stages of chronic kidney disease (CKD).There also showed a negative correlation relationships between glucose and insulin levels ,and vitamin D3 concentration and glucose and insulin levels at OGTT of patients with 3-5 stages CKD.

Objective To understand and master the situation of residents consumption of iodized salt in Chenzhou city of Hunan province,to identify problems and take appropriate interventions to ensure the residents consumption of qualified iodized salt,and to provide a scientific basis for elimination of iodine deficiency disorders (IDD).Methods According to the National Iodized Salt Monitoring Program (Amendment) and the Evaluation Scheme for Elimination of Iodine Deficiency Disorders at the County Level,the monitoring counties,towns and villages were selected in Chenzhou city from 2008 to 2011,the content of iodine in salt was detected using direct titration.The data was analyzed by SPSS 17.0 and Excel 2003.Results A total of 12700 salt samples were tested from 2008 to 2011.The iodized salt coverage rate,the qualified rate of iodized salt,the consumption rate of qualified iodized salt and the rate of non-iodized salt was 99.19％ (12597/12700),96.33％ (12135/12597),95.55％(12135/12700) and 0.81％ (103/12700),respectively.There were significant differences between each year from 2008 to 2011 (x2 =13.99、42.35、48.45、13.99,P all ＜ 0.01).The coefficient of variation was 21.19％.The median and average of iodine content in salt samples was 32.2 mg/kg and 31.9 mg/kg,respectively.Compared with the median and average of iodized salt content,there was no significant difference between each year from 2008 to 2011 (t =2.941,P ＞ 0.05),while there was significant difference among the 11 counties(t =2.983,P ＜ 0.05).Conclusions The goal of eliminating IDD has realized in the city of Chenzhou since 2010.To consolidate the IDD control results,surveillance should be strengthened in future.

Objective To evaluate the effect of intensity-modulated radiation therapy(IMRT) on parotid function in nasopharyngeal carcinoma(NPC). Methods Eighty-three NPC patients received prima-ry IMRT between 2001 and 2003. Xerostomia before radiotherapy, at the end of radiotherapy, at 6-month, 1-,2-,3-,4- and 5-year after radiotherapy were investigated, respectively. The relation between xerostomia and parotid dose distribution was analyzed. Results Of all the patients,4,31,31 and 17 had stage Ⅰ,Ⅱ,Ⅲ and ⅣA disease, respectively. Sixteen patients received chemo-radiotherapy. The median followed-up time was 65 months. The 5-year local control and regional control rate were 96% and 95% ,respectively. The 5-year overall survival rate was 80%. The mild xerostomia rate at the seven time points was 42%, 51%, 71%, 77%, 58%, 38% and 26%. The corresponding moderate xerostomia rate was 52%, 53%, 21%,8%, 3%, 2% and 2%, respectively. No serious xerostomia was observed. The mean dose of the bilateral parotid glands was 34.34 Gy. Xerostomia at 6-month after radiotherapy was positively correlated with the mean dose of the parotid glands, and D50 was the independent factor in predicting the xerostomia. Parotid function was well protected when the mean dose and D50 were no more than 33 Gy and 29 Gy,respectively. Conclusions IMRT can improve the local-regional control of NPC and protect the parotid glands from radiation-induced in-jury.

Objective To explore the feasibility of employing a risk category system in evaluating the treatment outcome of locoregionally advanced nasopharyngeal carcinoma (NPC) treated by intensitymodulated radiation therapy (IMRT) alone,and offering evidence for relevant perspective studies.Methods Totally 185 locoregionally advanced NPC patients were divided into high-risk and low-risk groups for evaluation and comparison.The patients who met at least one of the following criteria were defined as high-risk group and others as low-risk group:GTVnx ＞ 30 cm3;Clinical stage T4N2M0;multiple neck node metastases with 1 node size ＞4 cm,and N3 with any T stage.Results With a median follow up of 110.9 months (6.7-152.4 months),the 5-year overall survival,locoregional relapse-free survival,distant metastasis-free survival for the high-risk group vs.the low-risk group were 61.0％ vs.90.5％ (x2 =30.298,P＜0.05),78.3％ vs.91.5％ (x2 =6.352,P＜0.05)and 71.6％ vs.92.0％ (x2 =16.346,P ＜0.05).Conclusions As a simple and practicable method,the risk category system is helpful for discriminating locoregionally advanced nasopharyngeal carcinoma with different risk-group of treatment failure and in further perspective clinical research.

Objective To sum up the experience in the management of acute infrarenal abdominal aorta occlusion. Methods We retrospectively analyzed 34 cases of acute infrarenal abdominal aorta occlusion treated during a period of 18 years. Cell saver was used intraoperatively in five cases.Results Twelve cases died postoperatively in this group (35 3%), with acute post operative renal failure, metabolic acidosis and hyperkalemia being the main causes of death. No acute renal failure and metabolic acidosis occurred in all cases treated by cell saver during operation. Limbs were salvaged in 36 out of 44 extremities of patients surviving the surgical procedure. ConclusionsPrompt diagnosis, proper surgery and correct management of post operative complications are necessary to decrease mortality. Perioperative application of cell saver is recommended to eliminate metabolic wastes from the body.

Objective To report the clinical outcome and prognostic factors for locally recurrent nasopharyngeal carcinoma(NPC)treated with intensity modulated radiotherapy(IMRT).Methods From January 2001 to August 2004,the data of 132 such NPC patients were analyzed retrospectively;104 male and 28 female with a median of 44.5 years(range 21-73 years).Ninety-eight patients(74.2%)were confirmed by biopsy as having NPC:9 with WHO TypeⅡand 89 WHO TypeⅢ.The other 34 patients were only diagnosed by MRI scan because of the extension/invasion was in the base of skull and/or cavernous sinus.Median interval time were 24 months(range 6-184 months).According to the 1992 Chinese Fuzhou Staging System:stageⅠ3.8 %,Ⅱ10.6 %,Ⅲ22.0% andⅣa 63.6%;T1 5.3%,T2 10.6%,T3 22.7% and T4 55.3%.Twenty-two patients had recurrence in the neck lymph nodes.IMRT was given with the sequential tomotherapy system(NOMOS Peacock systems)of 6 MV X-rays.Prescription dose was 60-70 Gy in GTV,with the fractional dose of 1.94-2.8 Gy.Sixty patients were also supplemented with two to six courses of cisplatin-based chemotherapy.Results The median volume of GTV was 39.5 cm~3(range 0.8-158.9 cm~3).The D95,V95,mean dose and fractionation dose of GTV was 66.9 Gy,98.3%,69.8 Gy and 2.32 Gy,respectively.The median follow-up time was 12 months(range,2-47 months).The 1-,2-and 3-year local progression-free rate was 96.4%,88.4% and 85.3%,respectively.The overall 1-,2-and 3-year survival rate was 6.5.9%,49.6% and 41.6%,respectively.Eleven patients developed distant metastases.Forty-seven patients were observed to devdop mucosa necrosis and/or massive hemorrhage in the nasopharynx.On univariate and multivariate analysis,fractional dose and vohane of GTV were significant prognostic factors for overall survival(P=0.016,0.009).Conclusions The local control and survival rate can be improved for patients with locally recurrent nasopharygeal carcinoma after treatment of intensity modulated radiotherapy.The fractional dose and volume of GTV are independent prognostic factors for the overall survival. The main death reasons are mucosa necrosis and/or massive hemorrhage in the nasopharynx.