Objective To assess the value of 18 F-FDG PET imaging in the localization of epileptic foci.Methods 18 F-FDG PET were performed in 22 patients with medically intractable epilepsy (15 males,7 females,mean years:19.0 years,mean duration:8.2 years). The open skull operations were undergone in 21 patients according to the results of 18 F-FDG PET, combining with scalp EEG and CT or/and MRI. 1 patient was refered for stereotactic operation. During operation,EcoG was detected for identifying the site of epileptogenic focus and lobectomy was performed . All specimens were examninated with the pathological tests. All patients were followed up for the curative effects. Results PET showed abnormalities in 21 patients(95.5%). Among them,single or multiple focal hypometabolisms were found in 20 patients and focal hypermetabolism in 1 patient. The scalp EEGs showed abnormalities in 17 patients(77.3%),but 8 of them did not showed clear latreralizing manifestations.The abnormalities were found on MR or/and CT in only 5 cases (22.7%).The epileptogenic foci detected by PET were consistent well with EcoG in 18cases(85.7%), consistent approximately in 2 cases and not consistent in 1 cases .Among 19 patients with abnormal PET findings , the pathological abnormalities were found in 18 cases (94.7%).No pathological abnormality was found in the patients with nomal PET imaing. After the open skull operations, 9 patients (42.9%) becomed seizure free . 9 patients (42.9%) had more than 50% seizure reduction and 3 patients (14.3%)showed no improvement. The patient treated with stereotactic operation also showed no significant improvement.Conclusion 18 F-FDG PET imaging is a sensitive and accurate modality to localizate the epileptic foci and has important clinical value in surgical therapy.

Objective To investigate the association between physical activity volume and medical care cost in elderly persons aged 70 years and over in Crane Valley, Sendal, Japan. Methods A total of 494 community-dwelling Japanese elderly persons living in residential area of Sendai City in northern Japan completed a self-administered questionnaire that included questions on physical activity. We ascertained total medical care costs through computerized linkage with claims lodged between November 2002 and December 2004 from the Miyagi National Health Insurance Association.Results After multivariate adjustment for potential confounders, the average monthly medical costs of hospitalization, hospital days, outpatient medical expenses, out-patient numbers and the total medical expenses in grade Ⅰ exercise volume group were (196.7±72.1) U.S. dollars, (0. 7±0.3) d, (308. 7±54.4) U.S. dollars, (6.2±1.1) times and (506. 95±94. 2) U.S. dollars; in grade Ⅱ exercise volume group were (139. 8±72.1) U.S. dollars, (0.5±0. 3) d, (295.3±54.6) U.S.dollars, (6.1±1.1) times and (437.8±94.5) U.S. dollars; in grade Ⅲ exercise volume group were (134.1±72.5) U.S. dollars, (0.4±0.3) d, (278.8±54.9) U.S. dollars, (5.8±1.1) times and (418. 1±95.0) U.S. dollars. With the increase in physical activity, there were significant differences between the medical costs of hospitalization and total medical expenses (F=5.85 and 8.11, both P=0.01). Conclusions This prospective study indicates that a higher volume of physical activity is associated with lower medical care costs among Japanese elderly persons.

OBJECTIVE:To observe the curative effect of tazobactam sodium/piperacillin sodium for injection on the Neonatal infections.METHODS:140neonatal infections cases were randomly divided into treatment group and control group:the treated group were treated with tazobactam sodium/piperacillin sodium for injection100～200mg/(kg?d);while the con?trol group were treated with penicillin-G100000～200000IU/(kg?d).The course of therapy for both groups were5d～10d.RESULTS:The effective rates of the treatment group and the control group were91.43%,52.86%(P

Objective To treat the patients suffering from intractable epilepsy after brain injury with low-dosage linac accelerator stereotactic radiosurgery through positron emission tomography (PET) localization. Methods PET examination based on 18 F-2-fluorine-2-deglucose (FDG) was carried out in 32 patients in order to localize epileptogenic foci followed by radiosurgery with peripheral radiation dose of 9-13 Gy. The follow-up was conducted over one year. The seizure frequency of epilepsy was recorded to evaluate the therapeutic effect. Results The PET imaging showed that the cortical area around the cerebromalacia caused by primary injury presented low metabolic change. The metabolic changes in different injury areas mainly concentrated in the epileptic foci. In some cases,the low metabolic areas not only was localized at the part of impact lesion but also at the part of contrecoup lesion. The seizure frequency gradually decreased after radiosurgical treatment in most patients,with obvious statistical significance compared with pretreatment. According to Wieser's classification of operative effect,the cases at the grades Ⅰ-Ⅱ accounted for 44% (14/32),grades Ⅲ-Ⅳ for 41% (13/32) and grades Ⅴ-Ⅵ for 16%(5/32). No fresh complications were found in all the cases. Conclusions Low-dosage stereotactic radiosurgery with the PET localization is a safe,effective and minimally invasive surgical approach to intractable posttraumatic epilepsy.

Objective To explore the association between complement C3 and the prevalence of simple fatty liver disease and nonalcoholic steatohepatitis. Methods A total of 2 799 health check-up participants were recruited from Tianjin Medical University General Hospital-Health Management Centre. Serum C3 levels were measured using immunoturbidimetry method and simple fatty liver disease and nonalcoholic steatohepatitis were diagnosed by liver ultrasonography and serum alanine aminotransferase concentration. Multiple logistic regression analysis was used to examine the association between quartiles of serum C3 levels and the prevalence of simple fatty liver disease and nonalcoholic steatohepatitis. Results After adjusting for covariates, the odds ratios (95% confidence interval) of simple fatty liver disease and nonalcoholic steatohepatitis for increasing quartiles of C3 were: 1.00 (reference), 2.15 (1.55, 3.01), 3.28 (2.35, 4.6) and 4.31 (3.11, 6.02); and 1.00 (reference), 4.54 (1.68, 15.91), 7.81 (3.02, 26.67) and 14.91 (5.94, 50.14) (both P for trend<0.000 1), respectively. Conclusions The study found that the elevated C3 levels were significantly associated with the prevalence of simple fatty liver disease and nonalcoholic steatohepatitis. Further study is needed to clarify whether C3 has a predictive value for the occurrence of nonalcoholic fatty liver disease.

Objective To observe the changes and clinical significance of procalcitonin(PCT) level in children with bacterial pneumonia.Methods The levels of PCT,hs-CRP and WBC were detected in 31 pneumonia children pre and post antibiotic treatment,and the changes were observed.Results The PCT levels of the 31 patients were all increased before treatment.After cured,PCT level of 28 cases returned to normal.But in the 28 normal cases,WBC level increased in 10 cases(35.7％),and hs-CRP level elevated in 4 cases(14.3％).In the other 3 cases,the PCT levels decreased from 5.69ng/mL,1.25ng/mL and 0.83ng/mL at admission to 0.51ng/mL,0.55ng/mL and 0.52ng/mL,respectively.And in these 3 cases,there was one case with the levels of WBC and hs-CRP respectively ascended,in which WBC level descended from 13.1 × 109/L to 12.1 × 109/L and hs-CRP level reduced from 20.92mg/L to 7.38mg/L.Conclusion The sensitivity of the index PCT is the highest at the accurate time phase of bacterial pneumonia,which can guide the reasonable use of antibiotics.

Objective To analyze the efficacy of early management of eomplications in patients with multi-ple traumas by applying the damage control theory. Method All total of 116 patients admitted to Wuhan Tongji Hospital between Jan 2006 and Jan 2008 were included in this retrospective study and were classified according to treatment method. Overall, 55 cases underwent damage control operations and 61 cases underwent conventional management. The groups of patients were compared in terms of parameters such as length of operation time, time to resuscitate from shock, lethal triad of death (LTD), complications and treatment outcomes after operation. Results The length of operation time was (67.43±19.52) min, resuscitation time from shock was (6.77±3.16) h and LTD was (11.54±4.10) h in the damage control group, and (163.95±55.41) min, (22.51±11.65) h and (34.55±5.63) h, respectively, in the conventional group, with significant differences between the two groups (P< 0.01). The per capita complication and mortality rates were 227.27 % and 3.64 %, respectively, in the dam-age control group and 363.93 % and 9.84%, respectively, in the conventional group (P <0.05). Couclusions Here, we demonstrated that early management of patients with multiple traumas undergoing operations by apply-ing the damage control theory significantly decreased the operation time, and decreased time to resuscitation from shock and LTD. Furthermore, this approach significantly reduced the incidence of comphcations and the mortality rate of patients with severe multiple traumas.

Objective To investigate the renal pelvic pressure(RPP) during minimally invasivepereutaneous nephrolithotomy(MPCNL),and inspect its influence to postoperative fever. MethodsThe RPP was measured by baroeeptor,and these data about pressure and postoperative fever wereevaluated statistically. Results The mean RPP was 14.72 mm Hg,the mean accumulative time of RPP≥30 mm Hg was 116.06 s. Fifteen cases(18. 75%)had a postoperative fever. Logistical analysissuggested that postoperative fever did not correlate to sex(P=0.195),age(P=0.641),urinary tractinfection (P=0.663),white blood cell≥10 × 109/L in blood routine examination postoperatively (P=0.751),once an occurrence of RPP≥40 mm Hg(P=0.662),while infection calculi (P=0.000),percutaneous tract size(P=0.029),mean RPP(P=0.036) ,mean RPP≥20 mm Hg(P=0.013),accumulative time of RPP≥30 mm Hg(P=0.010) and RPP≥30 mm Hg longer than 50 s(P=0.024)contributed to postoperative fever. Conclusions Renal pelvic pressure generally remains lower than alevel to back flow (30 mm Hg) during MPCNL. A transient renal pelvic pressure≥30 mm Hg don'tcountribute to postoperative fever,while a temporary high pressure status(50 s)would had an accumulated effect which means an enough back flow to bring a fever.

Objective:To predict and analyze the secondary structure and B cell epitopes of Izumo protein.Methods: The secondary structure and flexible regions of Izumo protein were predicted by the methods of Chou-Fasman,Gamier-Robson and Karplus-Schulz.Moreover,hydrophilicity plot,surface probability plot and antigenic index of Izumo protein were predicted by the methods of Kyte-Doolitde,Emini and Jameson-Wolf,respectively.Results: Izumo protein contained moreαhelix regions.There were several centers ofαhelix in the regions of 6-17,30-40,88-99,103-120,153-160,173-188,249-260,283-297,334-338 and 339-346 of Izumo protein,and several centers of βsheet in the regions of 21-25,198-200,245-248 and 320-323.Moreover,many distinct B cell epitopes in Izumo protein possibly localized in the regions of 3642,62-66,94-99,118-122,129-132,151-154,161-164,173-177,205-208,212-216,256-265,271-276,283-288,314-318 and 336-350.Conclusion:These results are helpful for identification of the dominant B cell epitopes and the functional domains of Izumo protein.

Objective To explore the protective ventilation strategies in hyaline membmne disease(HMD) of neonates,in order to decrease the incidence of ventilator-associated lung injury(VAU).Methods 68 newborn infants,diagnosed as of neonatal hyaline membrane disease and needed ventilator support,were recruited from the neonatal intensive care unit from 2003 to 2005.Infant with HMD were divided into the conventional ventilation practice group (the control group) and protective ventilation strategies group (the experimental group).The ventilator settinns,artery blood gas analysis,ventilator-associated lung injury and other clinical data were analyzed and compared.Results The incidence of ventilator-associated lung injury in the experimental group wag significantly lower than that in the cntrol group(2.94% VS 17.6%,P＜0.05).PaCO2 in experimental group was significantly higher than that in control group.The mortality in the experimental group was significantly lower than that in control group.Condusion The protective ventilation strategies can decrease the incidence of ventilator-associated lung injury in neonatal HMD.the protective ventilation strategies can decrease the mortality in neonatal HMD.