Objective To investigate the effect of cognitive intervention on language function and quality of life (QOL) in elderly patients with post-stroke aphasia.Methods Fifty-five elderly patients with post-stroke aphasia were randomly divided into the control group (n =27) and the experimental group (n=28).The control group received comprehensive treatment including speech-language therapy (SLT),while the experimental group was subjected to additional cognitive intervention.All patients were enrolled in an eight-week rehabilitation program.The mini-mental state examination (MMSE) was used to assess cognitive function,a device for diagnosis and treatment of language disorders,ZM 2.1,was used to evaluate language function,and the 36-item short-form health survey (SF-36) (Chinese version) was used to assess quality of life (QOL),before and after treatment.Results After treatment,MMSE scores,language function scores in all categories and QOL scores in all dimensions improved in both groups (P＜0.05 for both).Furthermore,after treatment,there were significant differences between the two groups in MMSE scores of orientation,recall,attention and calculation,and in scores of overall language ability and the individual categories (P＜0.05 for all).Scores of the experimental group vs.the control group for the individual categories of language function were as follows:simple instructions (76.6 ± 14.1 vs.67.4± 19.3),complex instructions (66.1±12.8 vs.58.2±14.9),yes or no (72.5±12.1 vs.63.0±14.1),naming (55.0 19.5 vs.43.3±22.2),simple comprehension (67.5±21.4 vs.55.620.6),complex comprehension (44.8±17.0 vs.35.0±18.9),listening and reading words (65.4±16.7 vs.53.7±19.3),calculation (39.3±25.8 vs.25.9±19.2),memory (36.4±18.7 vs.26.3±17.8),matching (75.9±18.6 vs.65.3±17.1),simple general knowledge (68.3±18.2 vs.58.0±19.5),complex general knowledge (58.7±17.4 vs.50.0±13.3),orientation (70.7±19.6 vs.60.5±17.2) and comparison (59.9± 14.6 vs.50.2±17.5) (P＜0.05 for all).There were significant differences between the two groups in emotional function (66.7±18.2 vs.53.1±21.2),general health (67.2±12.6 vs.60.7±9.8),mental health (71.0±5.6 vs.63.1±4.2),social functioning (64.7±9.0 vs.59.3±10.2) and vitality (55.4±14.8 vs.46.9±15.6) (P＜0.05 for all).Conclusions Cognitive intervention combined with SLT can contribute to the recovery of language function and the improvement of QOL in elderly patients with post-stroke aphasia.

Objective To explore the clinical application and value of endoscopic surgery in the treatment of hypertensive cerebral hemorrhage assisted with neuronavigation,we compared it with traditional craniotomy.Methods We collected hypertensive cerebral hemorrhage patients with the application of neuronavigation assisted endoscopic surgery from January 2012 to November 2015,and randomly selected 30 cases as experimental group;and collected hypertensive cerebral hemorrhage patients with craniotomy and then randomly selected 30 cases as the control group.What did we respectively record about the two groups were postoperative GCS score,skin incision length,operation time,bleeding volume,length of stay,postoperative complications,and KPS score of the postoperative follow-up of sixth months;after that,the dates of the two groups were compared and analyzed.Results Compared the experimental group to the control group,postoperative GCS score did not achieve statistically significant difference (P ＞ 0.05);in the skin incision,there was statistically significant difference between two groups (P ＜ 0.05),the average incision length in the experimental group was (4.25 ±0.44) cm,however it was (13.27 ± 1.01) cm in the control group;as for the operation time,it was averagely (93.93 ±21.04) min for the experimental group,and (176.50 ± 35.65) min for the control group,there was statistical difference between two groups (P ＜0.05);with regard to the amount of intraoperative bleeding,the mean amount in the experimental group was (69.83 ± 23.83) ml,and (196.17 ± 33.83) ml in the control group,the difference was statistically significant (P ＜ 0.05);and the average hospitalization days for the test group was (13.33 ± 1.79) d,(16.20 ± 4.31) d for the control group,it was considered statistically significant (P ＜ 0.05);in complications,the test group incidence was significantly lower than that in the control group,the difference between the two groups has statistical significance (P ＜ 0.05);after postoperative follow-up of 6 months,we found that the prognosis of experimental group is better than that of control group,and statistical significance was described by analyzing the KPS scores of two groups (P ＜ 0.05).Conclusions Neuronavigation assisted endoscopic technique in the treatment of hypertensive cerebral hemorrhage has many advantages,such as accurate localization,direct vision,perfect hemostasis,and less bleeding.It is minimally invasive and can also shorten the operation time as well as lengths of stay.Besides,it can reduce the incidence of complications and bring better postoperative recovery.

Objective:To study the use of three-dimensional computer reconstruction in diagnosis and treatment of hilar cholangiocarcinoma.Methods:A retrospective analysis of clinical data was conducted on patients with hilar cholangiocarcinoma admitted to the Department of General Surgery, the First Affiliated Hospital of the University of Science and Technology of China from January 1, 2017 to July 31, 2019. The classification of hilar cholangiocarcinoma, vascular invasion and surgical resectability were determined by preoperative three-dimensional reconstruction. These data were then compared with the findings obtained during operations, by comparing with the three-dimensional reconstruction technology findings in classification of hilar cholangiocarcinoma, vascular invasion, and hilar extent of biliary and vasculature involvement.Results:Of 65 patients included in this study, there were 35 males and 30 females, with an age of (60.35±10.70) years. After operation, these 65 patients were classified into type I ( n=7), type II ( n=4), type III ( n=14), and type IV ( n=40) using the Bismuth classification. The accuracy rates of preoperative three-dimensional reconstruction for hilar cholangiocarcinoma classification, portal vein invasion, hepatic artery invasion, and diagnosis of hilar cholangiocarcinoma vasculature involvement were 90.7% (59/65), 90.7% (59/65), 86.1% (56/65) and 80.0% (52/65) respectively. Conclusions:The three-dimensional computer reconstruction technology could visually and accurately display the shape and spatial extent of hilar cholangiocarcinoma. It has an important clinical use in accurately diagnosing hilar cholangiocarcinoma preoperatively.

Biomarkers ; analysis ; Biopsy ; Child ; Female ; Fluid Therapy ; Humans ; Kidney Diseases ; etiology ; Rhabdomyolysis ; diagnosis ; etiology ; therapy ; Virus Diseases ; complications

Adult ; Bronchoalveolar Lavage ; methods ; Humans ; Male ; Middle Aged ; Pneumoconiosis ; therapy ; Respiration, Artificial ; methods ; Ventilators, Mechanical

Adult ; Aged ; Anesthesia ; methods ; Bronchoalveolar Lavage ; methods ; Female ; Humans ; Male ; Middle Aged ; Pneumoconiosis ; surgery ; Retrospective Studies

Objective To discuss and to compare the curative effects of interventional embolization with different embolic agents in treating giant hepatic cavernous hemangiomas. Methods From 2008 to 2010, a total of 30 cases with clinically proved hepatic cavernous hemangioma were treated with interventional embolization. According to the embolic agents used , the patients were divided into pingyangmycin-lipiodol emulsion mixed with sodium alginate microspheres group(PLE+KMG, group A, n=15) and pingyangmycin-lipiodol emulsion group (PLE, group B, n=15). CT scanning was performed one, 3, 6, 12 months after the treatment to evaluate the curative effect. Results The technical success rate was 100%in both groups. The mean PLE dose used in group A and B was (10.9 ± 5.2) ml and (11.4 ± 4.9) ml respectively, the difference between the two groups was not significant (P > 0.05). CT reexamination performed one, 3, 6 months after the treatment showed that a reduction in tumor volume over 50%in group A was seen in 9, 11 and 14 cases respectively, while in group B it was 0, 3 and 5 cases respectively (P <0.05). One week after the procedure, the degree of pain in patients of group A was more severe than that in patients of group B, the difference between the two groups was statistically significant (P < 0.05). Slight abnormal hepatic function was seen in some patients of both groups, which presented mainly as an elevation of aminotransferase, which returned to normal after symptomatic medication. Follow-up with questionnaire indicted that patients of group A were more satisfied with the treatment than the patients of group B. Conclusion Transhepatic infusion of pingyangmycin-lipiodol emulsion is a safe and effective treatment for giant cavernous hemangioma of the liver. Combination use of pingyangmycin-lipiodol emulsion and sodium alginate microspheres can obviously reduce the tumor size mainly in the first and the third month after the treatment, besides it produces instant clinical effect although the pain is more severe than in patients treated with pure pingyangmycin-lipiodol emulsion.

Objective To investigate the clinical effect of super selective embolization combined with opera-tion for treatment of meningiomas.Methods 82 cases treated by operation and pathology in return for meningioma were collected in the study,including 44 cases of preoperative superselective embolization for aneurysms as the treat-ment group,and the remaining 38 cases without preoperative embolization of patients as the control group.The opera-tion time,bleeding amount in the operation and the rate of total tumor removal were recorded and compared between the two groups.Results The average amount of bleeding of treatment group was (330.36 ±95.41)mL.The average amount of bleeding of control group was (460.82 ±114.64)mL.The data of the two groups was statistically significant (t =5.624,P <0.01).,The treatment group bleeding amount was less than that of the control group;,the mean oper-ation time of treatment group was (5.36 ±2.62)h,,the average operation time of control group was (6.63 ±2.25)h.The data of the two groups was statistically significant (t =2.355,P =0.021 ),the operation time of the treatment group was less than that of the control group.The total resection rate was 70.4% in treatment group and 36.8% in the control group,there was statistically significant (P <0.05),and the total resection rate in the treatment group was higher than that in the control group.Conclusion Compared with single operation treatment of meningiomas superse-lective embolization combined with operation for treatment of meningiomas can shorten operation time,reduce intraoperative hemorrhage,improve the rate of total tumor removal.It can reduce the operation risk and improve the treatment effect.

Objective To investigate the clinical application of CT perfusion imaging in assessing the hemodynamic changes in patients with small hepatocellular carcinoma (<5 cm) before and after transcatheter arterial chemoembolization (TACE). Methods Twelve patients with small hepatocellular carcinoma were enrolled in this study. CT perfusion imaging of the liver was performed 1 - 2 days before and 3 - 4 weeks after TACE. By using the perfusion parameters the hemodynamics of the preoperative and postoperative tumor tissue, the hemodynamics of the preoperative tumor tissue and the normal tissue, and the hemodynamics of the postoperative active tumor tissue and the normal tissue were determined , and the results were compared between each other. Results Before TACE, the blood flow (BF), hepatic arterial fraction (HAF), hepatic arterial perfusion (HAP) and permeability of surface (PS) in the tumor tissue were significantly higher than those in the normal tissue (P < 0.01), while after TACE all the perfusion parameters except blood volume (BV) were significantly decreased in the tumor tissue (P < 0.01). After TACE, BF, PS, HAF and HAP in the activity tumor tissue were increased more than those in the normal tissue (P < 0.05). Conclusion CT perfusion imaging is of great clinical value in diagnosing < 5 cm hepatocellular carcinoma , in evaluating the hemodynamic changes after TACE and in demonstrating the activity of the residual tumor tissue.

Objective To evaluate the clinical effect of infrapopliteal arterial balloon angioplasty in the treatment of ischaemic diabetic lower limbs.Methods 53 cases of ischaemic diabetic lower limb containing 64 ischeamic limbs were treated with infrapopliteal angioplasty by Amphirion Deep Balloon.Observation of clinical remission including the ulcers was carried out before and after the procedure.Results 119 ateries of the 53 cases were chosen for PTA and 101 PTA in 50 cases were accomplished,with technical success rate of 84.9%.All the 50 patients got clinical remission including the shrinkage of ulcers and none amputation.Conclusin Infrapopliteal arterial angioplasty is effective,minimal invasive and safe for the ischaemic diabetic lower limbs.