To investigate feasibility and effect of schizophrenia treatment by stereotactic lesioning, CRW stereotactic apparatus and PICKER spiral CT were used to define nucleus location and RADONICS radiofrequency instruments were used to lesion different subnucleuses of amygdala and the front part of callosal gyrus. All schizophrenic patients were diagnosed by ICD Ⅲ standards, In cases with one year followup ,the effect were analysed with Global Improvement (GI) scoring. In this group , 21 cases were significantly improved , 8 cases improved, 3 cases slightly improved, 1 case unchanged, and 0 case deteriorated. These results suggest selective lesioning subnucleus of amygdala according to different symptoms of schizophrenia could improve the curative effect of surgical treatment for schizophrenia.

Objective To discuss the postoperative complications of hypertensive intracerebral hemorrhage treated with freehand drilling skull minimally invasive puncture drainage therapy .Methods The clinical data of 158 patients with hypertensive intracerebral hemorrhage were retrospectively analyzed .The incidence rate ,causes and preventative measures of the postoperative complications of hypertensive intracerebral hemorrhage treated with free -hand drilling skull minimally invasive puncture drainage therapy were analyzed .Results 10 cases of scalp bleeding , 4 cases of epidural hemorrhage , 9 cases of puncture pathway bleeding , 24 cases of secondary bleeding , 1 case of intracranial infection,3 cases of low intracranial pressure ,5 cases of pneumoencephalos and 2 cases died.Conclusion Freehand drilling skull minimally invasive puncture drainage leads to less complications and so far it is a safe and effective therapy for hypertensive intracerebral hemorrhage .

OBJECTIVE:To investigate the effects of calcitriol on related indicators in patients with chronic renal failure (CRF). METHODS:114 patients with CRF were randomly divided into observation group(57 cases)and control group(57 cas-es). Control group was given high-quality low-protein and low phosphorus diet,if necessary,phosphate binders,Calcium D3 tablet and other conventional treatment;observation group was additionally given 0.25 μg Calcitriol soft capsule,once a day. The treat-ment course for both groups was 8 weeks. Serum levels of inflammatory factors,alkaline phosphatase,hemoglobin,erythrocyte, serum creatinine and urea nitrogen levels and adverse reactions in 2 groups before and after treatment were observed. RESULTS:Before treatment,there were no significant differences in the serum levels of inflammatory factors,alkaline phosphatase,hemoglobin, erythrocyte,senum creatininine and ureanitrogen between 2 groups(P>0.05). After treatment,serum inflammatory factors,alkaline phosphatase,serum creatinine and urea nitrogen levels in 2 groups were significantly shorter than before,and observation group was lower than control group,the differences were statistically significant (P<0.05);there were no significant differences in the hemoglobin and erythrocyte levels before and after treatment between 2 groups(P>0.05). And there was no obvious adverse reac-tions between 2 groups during treatment. CONCLUSIONS:Based on the conventional treatment,calcitriol can reduce the levels of serum inflammatory factors and improve micro-inflammatory state and renal function in patients with CRF.

At present, navigation path deviation caused by brain shift is the main factor that affects the accuracy of neurosurgical navigation. A new method of near infrared spectroscopy (NIRS) based neurosurgical navigation is presented in the paper. The correlation between NIRS optical parameters and medical image is used and the gray information of navigation path is regarded as the priori knowledge, sample-points curvatures are calculated by Hermite interpolation and the Mean Hausdorff distance as measurement criterion is used to match feature segments, then the real-time correction model is established. The algorithm of the given model is simple and can realize the best match within the error, it provides an effective method for real-time navigation path correction.
Algorithms ; Artificial Intelligence ; Calibration ; Humans ; Image Interpretation, Computer-Assisted ; methods ; Neuronavigation ; methods ; Spectroscopy, Near-Infrared ; methods ; Surgery, Computer-Assisted ; methods

BACKGROUND: Vitamin D receptor (VDR) gene shows restriction fragment length polymorphism with incision enzyme Bsm Ⅰ ,Apa Ⅰ ,Taq Ⅰ ,which is related to bone mineral density (BMD).However, it is unclear that the relationship between VDR gene (Bsm Ⅰ ) polymorphisms and BMD,osteoporosis.OBJECTIVE: To analyze the distribution regularity of vitamin D receptor gene polymorphism related to BMD in postmenopausal women of Han,Uygur, Kazak and Mongoloid nationality in China. DESIGN: controlled observation.SETTING: Institute of Gerontology,General Hospital of Chinese PLA.PARTICIPANTS: Totally 179 women of Han,who were taking physical examination in General Hospital of Chinese PLA from January 2002 to December 2003, at the average age of (59±3) years,were selected. A total number of 122 women of Uygur with average age of 56.49 years; 63 women of Kazak with average age of (55±3) years; and 112 women of Mongoloid with average age of (57±3) years,who were all taking physical examination in department of geriatrics, Urumqi General Hospital of Lanzhou Military Area Command of Chinese PLA from January 2001 to December 2003.All of them were informed consent.METHODS: VDR genotypes(Bsm Ⅰ ) were defined with polymerase chain reaction-restriction fragment length polymorphism,so as to analyze distribution of Vitamin-D receptor gene (Bsm Ⅰ )polymorphisms of postmenopausal women in Han,Uygur, Kazak,Mongoloid nationality,and compared with the data of USA,Australia,France,Japan,Korea. Enumeration data were compared with Chi-square test.MAIN OUTCOME MEASURES: VDR (Bsm Ⅰ ) polymorphisms in healthy postmenopausal women from Han, Uygur, Kazak, Mongoloid populations in China, which were compared with the data of USA, Australia,France, Japan, Korea.RESULTS: For women of Han, Uygur, Kazak and Mongoloid nationality,the BB genotypes accounted for 0, 4.1%, 6.35% and 4.46%, the bb genotypes accounted for 90.5%, 69.67%, 38.1% and 50% respectively. There was a significant difference between women of Han, Uygur, Kazak, and Mongoloid nationality(P ＜ 0.01). There was insignificant difference in comparation of distribtuion of VDR genotype between Kazak nationality and the west races, but it was significantly different to that in Japan,Korea races.CONCLUSION:VDR genotype polymorphisms is characterized by obvious racial diversify in postmenopausal women of Han,Uygur, Kazak,Mongoloid populations in China;Distribution of VDR gene frequency of Kazak population is similar with the west race ,but is different to Japanese and Korea's race.

BACKGROUND: It is found reported that polymorphism of Fok 1 restriction endonuclease cut site on exon 2 of 5' end start codon of 5' end start codon (SC), which affected the structure of VDR amino acids,and was relative related to bone mineral density(BMD).OBJECTIVE: To analyze the association between Vitamin D receptor gene (Fok 1) polymorphisms and osteoporosis in the elderly men.DESIGN: case-controlled trialstudy.SETTING: Institute of Gerontology, Chinese PLA General Hospital and Department of Endocrinology,Second Artillery General Hospital of Chinese PLA.PARTICIPANTS: A total of 26 elderly men with osteoporosis at out-patients clinic of Chinese PLA General Hospital and Department of Endocrinology,Second Artillery General Hospital of Chinese PLA from January 2002 to June 2002 were selected involved as osteoporosis case group,with and the average age of was (70±5) years, and BMD in osteoporosis group was 2.0-2.5 SD lower than 2.0-2.5 SD of the peak of BMD. Totally 66 healthy men with average age of (70±5)years were selected as control group during at the same time. All the subjects signed the informed consent,who were Beijing inhabitants of Han nationality, and there was no blood relationship among them.METHODS:VDR-Fok1 genotypes in both groups were detected with by polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP),and distributiondistribution of VDR-Fok 1 genotypes were analyzedanalyzed.MAIN OUTCOME MEASURES: distribution Distribution of VDR-Fok1genotypes in both each groups.RESULTS: Totally 66 healthy elderly men and 26 elderly men with osteoporosis entered analysis of results. The frequencies of FF, Ff and ff genotype were found to be 42%, 42% and 15% in control group, and 15%,50%,35% in osteoporosis group, respectively,and there was significantly different between two groups(x2=12.078,P ＜ 0.01).Frequency of allele were significantly different between control group and osteoporosis group (64%,36% vs 40%,60%, x2=8.232,P ＜ 0.01).CONCLUSION: There is a significant difference in the frequency distrinution of VDR gene start codon polymorphism between healthy elderly men and those with osteoporosis.

Objective:To explore the correlation between glycemic control of type 2 diabetes mellitus (T2DM) patients and brachial-ankle pulse velocity (baPWV). Methods:A community-based cross-sec-tional study was conducted in Beijing, China. Every subject underwent physical examinations, glycated hemoglobin ( HbA1 c ) , blood lipid and baPWV measurements and completed a standardized question-naire. T2DM patients were divided into well controlled and poorly controlled groups according to HbA1c levels. The correlation between glycemic control of T2DM patients and baPWV was analyzed. Results:In this study, 1 341 subjects were recruited, including 733 T2DM patients and 608 non-diabetes sub-jects. Compared with non-diabetes subjects, abnormal baPWV ( baPWV≥1 700 cm/s) rate for T2DM patients was higher (40. 8% vs. 26. 8%, P<0. 001). With HbA1c<6. 5% or <7. 0% as the aim of glycemic control in T2DM patients, the abnormal baPWV rates for non-diabetes subjects, well controlled and poorly controlled T2DM patients were significantly different (non-diabetes vs. HbA1c<6. 5% T2DM vs. HbA1c≥6. 5% T2DM: 26. 8% vs. 32. 8% vs. 42. 6%, P <0. 001; non-diabetes vs. HbA1c <7. 0% T2DM vs. HbA1c≥7. 0% T2DM:26. 8% vs. 36. 1% vs. 43. 4%, P<0. 001). After being ad-justed for gender, age, smoking status, diabetes mellitus family history, T2DM duration, cardiovascular diseases ( CVD ) , waist hip ratio ( WHR ) , systolic blood pressure ( SBP ) , diastolic blood pressure ( DBP) , total triglycerides ( TG) , high density lipoprotein cholesterol ( HDL-C) , and low density lipo-protein cholesterol ( LDL-C ) , the Logistic regression models suggested that glycemic control status of T2DM patients was associated with abnormal baPWV. Compared with non-diabetes subjects, the ORs for abnormal baPWV in HbA1 c <6 . 5% T2 DM patients and HbA1 c≥6 . 5% T2 DM patients were 0 . 927 (95%CI 0. 560-1. 537) and 1. 826 (95%CI 1. 287-2. 591). Compared with non-diabetes subjects, the ORs for abnormal baPWV in HbA1c<7. 0% T2DM patients and HbA1c≥7. 0% T2DM patients were 1. 210 (95%CI 0. 808-1. 811) and 1. 898 (95%CI 1. 313-2. 745). Conclusion:The glycemic con-trol status of T2DM patients from communities is significantly associated with baPWV. Poor glycemic con-trol is a risk factor for abnormal baPWV. Keeping HbA1c under control might lower the risk of cardiovas-cular diseases in T2DM patients.

Objective To evaluate the category modifications and prognosis of cirrhotic nodules depending on MRI imaging report and data system of LR-2,LR-3 and LR-4.Methods Clinical data of 109 patients(151 lesions)with cirrhosis who underwent two or more MRI examinations in the Third People's Hospital of Nantong City from September 2012 to February 2017 were retrospectively collected. All the patients were diagnosed as LR-2, LR-3 and LR-4 lesions for the first time without biopsy or operation. Among all the lesions, 40 were LR-2,71 were LR-3 and 32 were LR-4.Routine liver MRI scanning,DWI and multiphase dynamic contrast-enhanced MRI were performed on all patients. The follow-up time and category modifications were recorded for each lesion. The single-factor analysis was used to analyze the follow-up time of LR-2, LR-3 and LR-4 lesions. The incidence of up-regulation of LR-2, LR-3 and LR-4 nodules were analyzed by Kaplan-Meier curve. Log-Rank test was used to compare the results. Results The mean follow-up time of LR-2, LR-3 and LR-4 was (17.4 ± 9.2), (16.3 ± 8.5) and (12.4 ± 9.3) months respectively,the difference were statistically significant(F=3.30,P=0.041).Among 48 index LR-2 lesions, 1 upgraded to LR-5 after 52.3 months of follow-up, 4 upgraded to LR-3, 29 remained stable, and 14 decreased to LR-1. Among 71 index LR-3 lesions, 13 upgraded to LR-5, among which 12 demonstrated threshold growth, 9 developed newly enriched pleural signs, 7 showed capsules and 3 demonstrated hypervascular transformation;6 upgraded to LR-4,34 remained stable and 18 decreased to LR-1.Among 32 index LR-4 lesions, 14 upgraded to LR-5, among which 11 demonstrated threshold growth, 1 developed newly enriched pleural signs,6 showed capsules and 1 demonstrated hypervascular transformation;1 leision developed to LR-5V with portal vein thrombosis, 15 remained stable and 2 decreased to LR-1. The cumulative incidence of LR-4 nodules up-regulated to LR-5 was higher than that of LR-2 and LR-3 nodules (all P<0.01). The cumulative incidence of LR-4 nodules at 3, 6, 12 months to LR-5 were 6.3%, 18.8%, 34.4%, and LR-3 nodules were 0, 4.2%, 5.6%. LR-2 nodules are 0. The cumulative incidence of LR-3 nodules classified as LR≥4 was higher than that of LR-2 nodules(P<0.01).Conclusion LR-2,LR-3,and LR-4 nodules have different prognostic outcomes based on the LI-RADS classification criteria for MRI,and the cumulative incidence of LR-4 progression to LR-5 was higher.

Objective: To improve the diagnosis and therapy of childhood pulmonary thromboembolism (PTE) by analyzing the clinical features of this rare condition. Methods: A total of 8 pediatric patients (4 males, 4 females) with PTE diagnosed in the Children′s Hospital of Zhejiang University School of Medicine from March, 2014 to March, 2019 were enrolled. The clinical manifestation, laboratory results, imaging findings, diagnosis and treatment were summarized. Results: Among these 8 cases, aged from 9 hours to 14 years and 10 months. Fever was found in 4 cases, cough aggravation in 4, short of breath in 3, chest pain in 2, abdominal and back pain in one, hemoptysis in 2, cyanosis in 1, and edema of lower extremities in 2. Physical examination found decreased breath sound in 2 cases, phlegm rale in 3, and pleural friction rub in one. Pleural effusion was found in 5 cases by ultrasound. Plasma D-dimer increased in 6 cases (0.66-9.96 mg/L) and hypersensitive C-reactive protein elevated in 5 cases (10.78-78.00 mg/L). Chest enhanced CT showed pulmonary artery or venous filling defects, including pulmonary artery embolism in 7 cases and pulmonary vein embolism in one. The primary disease of these patients included Mycoplasma Pneumoniae pneumonia in 4 cases, nephritis in 2 and postoperative congenital heart disease in 2. Apart from one case who withdrew the treatment and was discharged, the other 7 patients received anticoagulant treatment had good outcome. Conclusions For children with Mycoplasma pneumoniae pneumonia, immune disorders, long-term hormone therapy, cardiovascular invasive operation or other high-risk factors, PTE should be considered when fever, cough aggravation, short of breath, chest and back pain with pleural effusion are present. Chest enhanced CT scan should be performed as soon as possible, and anticoagulation should be started once the diagnosis is confirmed.