Objective To investigate the change of cognitive function and cerebral blood flow in patients with transient ischemic attack(TIA).Methods 35 patients with TIA and 33 normal controls who matched in sex, age, right handed and education were tested by events related potential(ERP), the scale of elderly cognitive function(SECF) and magnetic resonance angiography(MRA).Results The peak latencies of P 3 components of ERP in the patients were significantly delayed as compared with the control group( P

Objective To study the subjective sleep quality in patients with obstructive sleep apnea syndrome(OSAS). Methods Two hundred and seventeen patients with OSAS confirmed by an all-night (7 hrs) polysomnogram(PSG) were evaluated by Pittsburgh Sleep Quality Index (PSQI). Results According to the testing results of PSQI, 88 subjects (40.5%) were identified as "poor sleepers" (4≤PSQI

BACKGROUND: Researches suggest that transient ischemic attack (TIA)can induce cognitive dysfunction, and cerebral blood flow and its distribution are hypothesized to be closely related to cognitive activities.OBJECTIVE: To investigate the alteration of cognitive function and provide insights into its relations with cerebral perfusion in TIA patients.DESIGN: A case-control study.SETTING: Departments of Geriatrics, Electrophysiology and Magnetic Resonance of Urumqi General Hospital of Lanzhou Military Area Command of Chinese PLA.PARTICIPANTS: Totally 35 male right-handed TIA patients aged 45-78 years with an average of (68.1±8.4) years were selected from the inpatients and outpatients in the Department of Geriatrics, Urumqi General Hospital of Lanzhou Command of Chinese PLA between January 2002 and June 2003. Another 33 healthy right handed male subjects aged 45-77 years with an average of (67.8±8.6) years coming for physical examination were recruited to serve as the control group.METHODS: Patients and control subjects were tested with event-related potentials (ERPs) and the scale of elderly cognitive function (SECF) to examine the orientation, learning and memory, span, recall 1 (association),long-term memory, naming of animals, calculation, classification, copying,language and recall 2 (relation). According to the T score transformation table, the original scores were transformed into T scores relative to the age to eliminate the impact of age, and also into T'score to eliminate the interference by the patients'education, so that cognitive function of the patients could be evaluated with T'score, and the lower the score, the poorer the cognitive function. Cases in the two groups were all tested, and TIA patients were also examined with magnetic resonance angiography (MRA).MAIN OUTCOME MEASURES: Results of ERPs, SECF and MRA.RESULTS: Of the 35 TIA patients and 33 control subjects all completed the trial. Examination of ERPs reveled significantly prolonged latency of P300 components of ERP in the TIA group [(336.2±34.2) ms] than that in the control group [(311.3±44.2) ms, P ＜ 0.05]. The scores of span, recall 1,long-term memory, naming of animals, calculation, and recall 2 in SECF in TIA group were all lower than those in control group (39.7±11.9 vs 47.4±12.0; 54.5±14.8 vs 61.8±14.5; 61.1±7.8 vs 64.7±1.7; 59.4±11.0 vs 64.7±8.8; 50.0±14.7 vs 58.1±14.2; 44.6±15.4 vs 53.2±17.8, t=4.151 0-7.292 8, P ＜ 0.05-0.01). MRA identified abnormalities in 33 of the 35 TIA patients (94%), manifested mainly by stenosis and occlusion involving the vertebral artery (54%, 19/35), bilateral anterior, middle and posterior cerebral arteries (40% ,28/70;59% ,41/70;47% ,33/70), basilar artery (5.71%, 2/35) and bilateral internal carotid artery (5.71%, 4/70) respectively.CONCLUSION: TIA patients are characterized by prolonged P300 latency with multiple cognitive impairments especially in memory and cerebral artery stenosis and occlusion as shown by MRA, suggests that TIA patients have persistent low cerebral perfusion and frequently, cognitive dysfunction in the presence of local blood supply disorder in the hemispheres.

Purpose To observe the protective effects of low molecular hirudo peptides on focal cerebral ischemia reperfusion injury in rats and to explore its possible mechanism. Methods Middle cerebral artery occlusion (MCAO) was used to prepare focal cerebral ischemia and the neurological scores and infarction area of brain slices, and water content of brains were assessed. Superoxide dismustase (SOD) activity and malondi-aldehyde ( MDA) content in homogenate of ischemic brain tissue were determined by spectrophotometric assay. Results Hirudo peptides could reduce the percentage of infarction area and the water content in the cerebral hemisphere, increase SOD activity and decrease MDA content in ischemic brain tissue. Conclusion Low molecular hirudo peptides have protective effects on focal cerebral ischemia injury, and its mechanism may be related to the antioxidant action.

Objective To investigate the application value of closed single-port thoracoscopic and laparoscopic radical esophagectomy for esophageal cancer.Methods The retrospective and descriptive study was conducted.The clinical data of a 49-year-old male patient with esophageal cancer who was admitted to the Fujian Medical University Union Hospital in November 2018 were collected.The patient underwent closed single-port thoracoscopic and laparoscopic radical esophagectomy and three-field lymph node dissection.In the thoracic part,esophageal separation and thoracic lymph node dissection were performed with closed pneumothorax,semi-lateral position and multi suspension methods.In the abdominal part,gastric separation and lymph node dissection were accomplished with lifting of liver lobe and respective separation of greater curvature and lesser curvature of stomach.The operation time,volume of intraoperative blood loss,time for out-of-bed activities,time of postoperative drainage tube removal,volume of thoracic drainage fluid,postoperative complications,postoperative pathological examination results,time for discharge from hospital and results of follow-up were observed.Follow-up using outpatient examination and telephone interview was performed to detect tumor recurrence and metastasis of patients after operation up to February 2019.Count data were described as absolute number.Results The patient underwent successfully closed single-port thoracoscopic and laparoscopic radical esophagectomy and three-field lymph node dissection.The operation time and volume of intraoperative blood loss was 310 minutes and 120 mL.The patient resumed out-of-bed activities at 2 days after operation.The abdominal drainage tube,thoracic closed drainage tube and right cervical drainage tube were removed at 2 days after operation with fasting,acid suppression,nutritional support.The thoracic Abel drainage tube and the left cervical drainage tube were removed at 5 days after operation.The volume of thoracic drainage fluid was 550 mL.No obvious sign of anastomotic leakage was found on esophageal angiography at 5 days after operation.The patient recovered well after operation without hoarseness,pulmonary infection and chylothorax.The postoperative examination result of the patient showed midthoracic esophageal squamous cell carcinoma (pT3N1M0G3 ⅢB stage).The patient was discharged at 8 days after operation.The patient was followed up for 3 months,and was able to engage in light physical activity.CT reexamination showed no sign of local recurrence or distant metastasis of the tumor.Conclusion Closed singleport thoracoscopic and laparoscopic radical esopahgectomy for esophageal cancer is safe and feasible,with good short-term efficacy.

Purpose To evaluate the differential diagnostic value of conventional ultrasound in the ureteral polyps and ureteral carcinoma via continuous observation.Materials and Methods The conventional ultrasound of patients with ureteral polyps and ureteral carcinoma treated in Shaanxi Provincial People's Hospital were retrospectively analyzed from June 2015 to June 2022.According to the pathological results,all participants were divided into the ureteral polyp group(98 cases)and the ureteral carcinoma group(151 cases).All clinical and ultrasound data were recorded,and the differences of echo,blood flow and peristalsis were compared between the two groups.Results There were significant differences in ureteral peristalsis,color Doppler flow distribution,periureteral tissue thickening,increased echo,and hydronephrosis(χ2=197.50,138.89,26.97,36.13,all P<0.05)between the two groups.Low echo was predominant in both groups[67(68.37)vs.114(75.50)],with no significant difference(χ2=1.52,P>0.05).In the ureteral polyp group,67 cases were found in the upper ureter,89 cases were observed continuously with common peristalsis,and 73 cases with color blood flow were mostly central blood flow,while in the ureteral cancer group,85 cases were found in the middle and lower ureter,148 cases showed almost no peristalsis,and 122 cases with color blood flow were mostly peripheral blood flow.Conclusion There are some differences in clinical features such as the location as well as whether hydronephrosis between ureteral polyps and carcinoma.Peristalsis can provide the differential diagnosis for ureteral polyps and ureteral carcinoma via continuous observation.

Objective:To assess the combination of conventional ultrasound with contrast-enhanced ultrasound(CEUS)in the diagnosis of urothelial carcinoma(UC)of the renal pelvis in elderly patients.Methods:Sixty-seven elderly patients with a histopathologic diagnosis of UC of the renal pelvis and surgically treated at our hospital between April 2015 and March 2023 were retrospectively analyzed.Characteristics of regular preoperative 2D ultrasound, color Doppler flow imaging(CDFI)and CEUS were examined.Results:Of 67 patients, 49(73.13%)were found to have localized lesions in the renal pelvis and renal calyces.Lesions in 53 patients(79.10%)could be clearly identified by conventional ultrasound, with 46(86.79%)being isoechoic or hypoechoic, and 7(13.21%)being hyperechoic.Analysis of tumor blood flow by CDFI found 22 cases(41.51%)with avascular lesions, 21(39.62%)with hypovascular lesions and 10(18.87%)with hypervascular lesions.The average value of the resistance index(RI)was 0.64.Enhancement was seen in 62 lesions(92.54%)by CEUS after injection of SonoVue.Compared with the cortex of the ipsilateral kidney, a slow enhancement pattern was observed in 46(74.19%), 14(22.58%)showed simultaneous enhancement, and 2(3.23%)showed fast enhancement.At peak enhancement, 43 lesions(69.35%)had hypo-enhancement, 10(16.13%)had iso-enhancement, and 9(14.52%)had hyper-enhancement, compared with the cortex.Concerning the homogeneity of enhancement, 16(25.81%)displayed heterogeneous enhancement, with tumor necrosis or hemorrhage, and 46(74.19%)had homogeneous enhancement.When the contrast agent washout rate was assessed, a fast washout pattern was observed in 53(85.48%), synchronous washout in 6(9.68%), and slow washout in 3(4.84%).Conclusions:UC of the renal pelvis mostly shows isoechoic and hypoechoic lesions on conventional ultrasound, avascular or hypo-vascular lesions on CDFI, and slow-in, fast-out and hypo-enhancement on CEUS, compared with the cortex.Conventional ultrasound combined with CEUS can help improve the diagnostic accuracy of UC of the renal pelvis.