Objective To explore the effect of microsurgery for refractory temporal lobe epilepsy . Methods A retrospective analysis was made in 102 patients with refractory temporal lobe epilepsy from January 2005 to December 2011.The patients received comprehensive preoperative localization , intraoperative frontotemporal pterional incision , and microsurgical resection of epileptogenic focus .The efficacy was evaluated according to the Engel standards .Indications such as self-care ability, learning ability, and working ability were used to evaluate the quality of life , which were recorded and compared before and after operation . Results Follow-up was accomplished in all the 102 cases for a duration of 1 year and 9 months to 7 years.There were no mortality and serious complications .The effects evaluations at 1 year after operation showed complete disappearance of symptoms ( levelⅠ) in 61 cases (59.8%), almost disappearance (level Ⅱ) in 17 cases (16.7%), symptoms improvement more than 75% (level Ⅲ) in 13 cases (12.7%),and ineffective (level Ⅳ) in 11 cases (10.8%), bearing an effective rate of 89.2% (91/102) and a good-and-excellent rate of 76.5%(78/102).At one year and nine months postoperatively , 6 patients could not take care of themselves , 32 patients obtained partial self-care, and 64 patients had complete self-care,as compared with which there were 21 patients, 67 patients, and 14 patients preoperatively, respectively, having significant differences before and after surgery (Z =-7.001, P =0.000). Statistical significances were obtained before and after operation in 67 cases of children and adolescents with learning ability ( Z=-3.747, P =0.000) and in 35 adult cases with working ability ( Z =-2.564, P =0.010). Conclusions Microsurgical treatment is an effective method for refractory temporal lobe epilepsy .Patients ’ quality of life can get significant improvement after surgery.

ObjectiveTo improve the teaching quality of medical humanity education in medical university.MethodsA cluster sampling survey was given to 448 sophomores who studied the outline of medical humanities course in military medical university,and the data were descriptively and statistically analyzed.ResultsThe survey shows that 90％ sophomores satisfy with this course,95％ sophomores understand the importance of medical humanity education,and the students have more requirements on education resources and teaching ways.ConclusionOutline of medical humanities course is important to cultivate the medical humanity spirit of medical students,and the course still needs more improvements.

Objective To evaluate the psychological intervention ettectiveness ot socioenvironmental therapyfor heroin addicts accepting compulsory isolation.Methods Totally 100 male heroin addicts accepting compulsory isolation and Labour Camp Rehabilitation were selected and randomly assigned to socioenvironmental therapeutic group (ST group,50 cases) and control group (CT group,50 cases).A two-month socioenvironmental therapy was selectively proceeding in ST group by a same psychological team,while CT group still received conventional rehabilitation.During the 6-month follow-up,self-rating anxiety scale(SAS),self-rating depression scal (SDS) and self-made questionnaires were used every 3 months,to statistically estimate psychological status of subjects.Results Before treatment,no statistically significant difference between the two groups;after treatment,SDS score of CT group was 56.16 ± 9.12,and was lower than that in ST group(48.28-± 9.55) (P ＜ 0.01) ; SAS score of ST group was 46.28 ± 7.78,and was lower than that in CT group (50.72 ± 8.32) (P ＜ 0.01).In the 3-month follow-up evaluation,depression,anxiety scores in CT and ST group were significantly lower,the difference was statistically significant (P ＜ 0.01) ; 6 months after treatment,depression,anxiety score showed was significant difference between two groups(P＜ 0.01).Conclusion Group psychotherapy especially socioenvironmental therapy is quick and long-acting in improving the psychological status of heroin addicts in aspects of depression and anxiety levels,which is distinctly evidenced by the short-term and long-term curative results.

Objective To evaluate the application of osteoporosis self-assessment tool for Asians (OSTA) in screening of osteoporosis for postmenopausal women in community.Methods Total 793 postmenopausal women were included.OSTA were calculated and bone mineral density (BMD)was measured by dual energy X-ray absorptiometry (DXA).The correlation of OSTA index with DXA results was analyzed.Results The prevalence of osteoporosis and osteopenia was 18.3％ (145/793) and 47.7％(378/793) respectively,the remaining 270 women had normal bone mass (34.0％).According to OSTA index the rate of low-risk,medium-risk,high-risk osteoporosis groups were 61.9％ (491/793),29.5％(234/793) and 8.6％ (68/793),respectively.The BMD measured by DXA was positively correlated with OSTA index(r =0.559,P =0.000).The area under receiver operating characteristic curve (ROC) of OSTA for diagnosing osteoporosis was 0.736.Taking-1 as cut off value,the sensitivity and specificity of OSTA in diagnosis of osteoporosis was 73.1％ (106/145) and 69.8％ (452/648),respectively.Conclusion OSTA can be used as an effective index for screening of osteoporosis in postmenopausal women in community.

Objective In this study,we aimed at investigating the clinical,laboratory and management characteristics of adolescent-onset SLE patients compared with adult-onset SLE patients.Methods 470 fe- male patients with SLE were divided into two subgroups:adolescent-onset SLE patients and adult-onset SLE patients.The analyzed variables included clinical,laboratory parameters,damage index and outcome charac- teristics.Results In 470 female patients with SLE,there were 98(20.85%)adolescent-onset SLE patients. The following manifestations occurred more frequently in adolescent-onset SLE patients:malar rash,cutaneous vasculitis,proteinuria and abnormal liver function.Adolescent-onset SLE patients had more severe disease features and had significantly higher mean value of SLEDAI.Mortality was higher in adolescent-onset SLE pa- tients than aduh-onset SLE patients.Renal and blood system were the organs that most frequently involved. Conclusion Adolescent-onset SLE patients accounts for roughly 20.85% of all SLE cases.It is necessary to pay more attention to adolescent-onset SLE patients because the management for them is usually more difficult and the prognosis is usually poorer than aduh-onset SLE patients.

Objective To investigate the clinical feature of fibercolonscopy in children.Methods Olympus PCF-20 and Olympus(PSD-20) were used for all examinations and treatments after bowel preparation and anesthesia.Pathological change was observed,then took pictures,and biopsy was done.Intestine polyps underwent electrocision.Results Fibercoloscopy was performed on 243 children(male 177,female 66).Age ranged from 1 to 18 years,with an average of 6.74 years.The cecum was reached in 232 of 243 cases.Abnormal findings were seen in 116(47.74%) of the cases.There were large intestine polyps in 87(35.80%) cases.All cases underwent electrocision.One hundred and fifty-seven polyps were removed with satisfactory results.Conclusion Fibercoloscopy is effective and safe in diagnosis and treatment in children with intestine diseases.

Objective To study emptying of gallbladder in children with functional dyspepsia(FD),and to investigate correlation of their helicobacter pylori(Hp) status and gallbladder emptying rate.Methods Sixty children with FD were studied,including 30 Hp-ne-(gative) and 30 Hp-positive children.Thirty Hp-positive children received triple eradication therapy 1 week.After 4 weeks,the Hp tests were taken again,27 children became Hp-negative,and the others were still positive eliminated from the study.The difference between the above groups in gallbladder volumes before breakfast and postprandial gallbladder emptying rate were compared.Results The gallbladder volumes before breakfast were bigger and the emptying rate of postprandial gallbladder of children with FD were lower than those of normal controls(P0.05).Conclusions Delayed emptying of gallbladder may cause FD in children.Hp infection isn′t associated with the gallbladder emptying rate.

Objective To observe changes of serum concentrations of interleukin-18(IL-18) and intercellular adhesion molecule-1(ICAM-1) in neonates with hypoxic-ischemic encephalopathy(HIE) and to explore the correlation of the 2 indices and its effect on patients′condition.Methods Thirty newborn infants met the criteria for HIE.There were 16 cases in mild HIE group,14 cases in moderate and severe HIE group.Twenty normal newborn infants were used as control group.The serum concentrations of IL-18 and ICAM-1 of HIE group and control group were detected using ELISA on the third day and 7th day.Results 1.The IL-18 levels of the mild,moderate and severe HIE and control groups measured within 3 days of life were (120.1?12.7),(175.1?15.4),(100.3?12.5) ng/L,respectively.The concentrations of IL-18 in HIE groups were higher than that of control group(Pa

The derivatization towards the hydroxyl groups of steroid environmental endocrine disrupting chemicals,such as estrone(E1),17β-estradiol(E2),estriol(E3) and 17α-ethynylestradoil( EE2),with A,O-bis (trimethylsilyl) trifluoroacetamide ( BSTFA ) as derivatization reagent followed by gas chromatography-mass spectrometry(GC-MS) was studied. The effects of the amount of BSTFA,derivatization temperature and time on the derivatization of target compounds,as well as the stability of steroid derivatives,calibration curves,instrumental quantification limits were investigated. The cleavage mechanism of steroid derivatives characteristic fragment ions was also interpreted. The results showed that better derivatization results were obtained when the amount of BSTFA was 25 μL for 100 μL steroids standard mix solution at 0.01 g/L;it is unnecessary to heating in the derivatization,better results were obtained when the steroids were derivatized with BSTFA at room temperature (20℃) for 10 min. The derivatives of target compounds were stable because their relative response factors(RRFs) had no observable change when deposited at -20℃ for 48 h. Under the optimal conditions,good linear correlation was obtained and the instrumental quantification limit was 0. 3μg/L for E1 and E2,while it was 5μg/L for EE2 and E3.

Objective To evaluate the CT and MRI findings and their diagnostic value of central nervous system complications of leukemia (CNSCL). Methods The CT and MRI findings of 18 adult patients with CNSCL proved by clinical features or pathology were retrospectively analyzed. Among 18 cases,7 were acute lymphocytic leukemia, 10 acute non-lymphocytic leukemia and 1 chronic myelomonocytic leukemia. Eleven cases underwent plain CT scan with one of them also receiving contrast-enhanced CT scan enhancement, 16 cases underwent plain MR scan with 11 of them receiving contrast-enhanced MR scan.Results Intracranial lesions in 14 cases: (1)intracranial hemorrhage was found in 7 cases, including intracerebral hematoma in 4 cases, micro-haemorrhage in 2 cases, and intracerebral hematoma accompanying by multiple intracerebral micro-haemorrhage foci in 1 case. All cases with intracerebral hematoma showed multiple lesions, which demonstrated high-density on CT images, and low or mixed signal on T1 WI, high- or intermediate signal with low-signal rim on T2 WI and ring enhancement or no evident enhancement. Microhaemorrhage manifested as multiple mini-mottling and strip hypointense foci on susceptibility weighted imaging, on which the detection rate of micro-haemorrhage foci was much higher than that on CT and other sequences of MRI. Among the 7 cases, one also had cerebral infarction and one subarachnoid hemorrhage.(2) Intracranial mass was found in 5 cases, among which two appeared as masses under or bestride cranium in the left frontal region with hypointensity on T1 WI, mixed signal on T2WI, strong homogeneous enhancement and dural tail sign;one showed a mass in saddle area, with high density on CT, slightly low signal on T1WI, high signal on T2WI and heterogeneous enhancement; one case displayed a mass near lateral ventricle with iso-intensity on T1 WI and T2WI and strong homogeneous enhancement; and one case manifested as cystic mass in the left fronto-apical lobe, with thick wall and ring enhancement (3)Obstructive hydrocephalus was found in 1 case, manifesting dilation of ventricles above the aquaeductus mesencephali. (4) Meningopathy was found in 1 case, manifesting diffuse thickening of meninges with strong homogeneous enhancement on MRI. Pathological changes of spinal canal was found in 4 cases among which two showed para-spinal mass involving vertebral canal and causing bone destruction of adjacent ribs; one case showed fusiform mass posterior to vertebral canal with high and intermediate signal on T1 WI and low and iso-signal on T2WI without enhancement; one showed zonale leison in thoracic cord with high signal on T2WI and fluid attenuated inversion recovery. Conclusion The radiologic manifestations of adult CNSCL are various and the role of CT and MRI for the diagnosis of CNSCL may complement each other. SWI is suggested as routine examination for patients of leukemia, in whom intracerebral lesions were suspected in order to find micro-haemorrhage as early as possible and reduce the risk of intracerebral hematoma occurrence.