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 .

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.

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 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 study the diagnostic value of contrast-enhanced CT scan with split bolus for the ureleropelvic junction obstruction(UPJO) caused by aberrant vessel of kidney.Methods 52 patients with UPJO underwent contrast-enhanced CT scan with split bolus.The aberrant vessels and its origin as well as the relationship between aberrant vessels and UPJO were observed comparatively with the results of surgery.Results In 52 cases,CT showed UPJO caused by aberrant vessl of kidney in 14 cases,including accessory renal arteries in 10,ovarian artery originated from left renal artery in one,right accessory renal artery in one and gonad veins in 2.CT findings were corresponded to operations in all these 14 cases.The sensitivity and specificity of CT in evaluating UPJO were 100% respectively.Conclusion The UPJO caused by aberrant vessel of kidney can be diagnosed accurately by contrast-enhanced CT scan with split bolus,which can be offered for surgical treatment for UPJO.The patient's CT dose can be decreased with split bolus.

Objective To investigate the expression and significance of mRNAand exon mutationof NT5C2 gene in acute lymphoblastic leukemia (ALL) bone marrow.Methods Case control study design was used in this study.Bone marrow samples were collected from ALL patients in Anhui Provincial Cancer Hospital in recent 4 years.The patientswere divided into the initial diagnosis group , the complete remission group and the recurrence group.And they could specifically be divided into 36 patients initially diagnosed, 36 patients who achievedcomplete remission and 16 patients who relapsed with children B -ALL,15 patients initially diagnosed,15 patients who achievedcomplete remission and 9 patients who relapsed with children T -ALL, 18 patients initially diagnosed,18 patients who achievedcomplete remission and 12 patients who relapsed with adult B-ALL, and 11 patients initially diagnosed,11 patients who achievedcomplete remission and 6 patients who relapsed with adult B -ALL.The initial diagnosis,complete remission and recurrence samples were matched.8 children and 8 adults without hematologic malignanciewere used as controls .Real-time PCR was performed to detect the level of NT5C2 mRNAin ALL patients.The exons of NT5C2 gene were cloned and sequenced for the common mutations in all cases .The results of NT5C2 mRNA levels in different groups were performed using non -parametric test by SPSS16.0 analytics software, and then non-parametric test together with correlation analysis was analyzed between NT 5C2 mRNA levels of different initial diagnosis groups and gender, age, leukocyte level and risk classification .Results (1)The expression of NT5C2 mRNA levels of recurrence group were higher than that of initial diagnosis group ,complete remission group and controls in children and adult B -ALL respectively(P <0.01).(2)NT5C2 mRNA expression in children and adult T-ALL showed no difference in initial diagnosis ,complete remission, recurrence group and controls (P >0.05).(3)NT5C2 mRNA expression of initial diagnosis group in children and adult B -ALL and T-ALL was not correlated with risk classification (P >0.05).(4)A newheterozygousmutation p.P414A of NT5C2 was discovered in a recurrencesample.Conclusions (1) High expression ofNT5C2 mRNA is associated with recurrence inchildren and adult B-ALL, and it may be an indicator of monitoring recurrence .(2)The incidence of exons mutation of NT5C2 gene in ALL is low in China.

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.