Objective To explore visual-spatial working memory deficits of patients with basal ganglia damage, based on which tried to provide the new method for detecting the injuries in basal ganglia. Methods Twenty-five patients with lesions in the basal ganglia and twenty-five healthy controls performed visual-spatial working memory tasks, including a face-recognition and a spatial delayed-response. Results For the basal ganglia damage group ,the correct rate of both visual- face ( 54.5 ± 9.6 ) % and visual-spatial ( 80.0 ± 11.7 ) % working memory tasks was significantly lower than that of the control group ( ( 64.3 ± 9.5 ) %, ( 93.6 ± 4.9) %, respectively) ,and the difference was statistically significant ( u= - 147.5,80.5, P＜0. 01 ). For the patients injured in the left basal ganglia, the correct rate of visual- face working memory (48.5 ± 5.4 )% was obviously lower than that of patients injured in the right basal ganglia ( 59.2 ± 9.8 ) %, and the difference was statistically significant ( u =25.5, P＜0. 01 ) ;but the difference of correct rate for the visual-space working memory was not statistically significant( u = 52.5, P＞ 0.05 ). In contrast to the controls, both the visual-face and visual-space working memory of the group with injuries in basal ganglia,had appeared to be disable. Conclusions The results confirmed that patients with lesions in basal ganglia had deficits of visual-spatial working memory,and that injuries either in the left or the right basal ganglia can probably cause the shiftiness of cognitive function. Therefore, the injuries in basal ganglia can be detected by the visual-spatial working memory tests.

Objective To explore the feasibility of low-dose multi-slice computed tomography(MSCT) scan on pulmonary artery three-dimensional angiography, and the relationship between pulmonary VR image quality and the SD value of plain scan. Methods Pulmonary artery CT examination was performed in 87 patients. 63 volunteers were administered with low dose as a low-dose group, and the other 24 were scanned with conventional dose as a routine group. Both plain scans were use conventional dose of pulmonary scan with 150 mAs, and the low-dose pulmonary enhanced scans were used with 60 mAs. The images were post-processed with volume rendering(VR) and classified into three grades A, B and C, and VR image quality levels of both groups compared. The receiver operating characteristic curve( ROC) was used to analyze the relationship between VR image quality level and SD value of plain scan image SD value. Results The VR image level of A-class was 100% in the conventional dose group, and 85. 7% was in the low dose group . According to the correlation analysis between the standard deviation(SD) value of plain scan image and pulmonary artery VR image quality, the area under curve in receiver-operated characteristic analysis was 0. 906. Conclusions The low-dose scan of pulmonary artery three-dimensional angiography is feasible. Using 60 mAs low-dose in pulmonary artery enhanced scan could ensure better image quality. With the SD value of the plain scan decreased, the pulmonary artery VR image quality is improved.

Objective To investigate the differential MSCT diagnostic features and comparative study of subtypes of renal cell carcinoma (RCC). Methods All of the renal cell carcinomas including 14 chromophobe RCCs (ChRCC), 10 papillary RCCs type 1(PRCC Ⅰ), 15 papillary RCCs type 2 (PRCC Ⅱ), 7 mucinous tubular and spindle cell carcinomas (MTSCCs) were investigated except for clear cell RCC. Dynamic contrast-enhanced CT was conducted in each case after intravenous administration of contrast agent, and the data including all the CT manifestations and the enhancement features were analyzed and contrasted together. Results The indexes including enhancement homogeneity, border of the tumor, renal pelvis violation, blood vessel in tumor showed statistically significant difference between the 4 subtypes (P<0.05), but no difference in the calcification of the tumor. Only the enhancement degree of MTSCC was lower than the kidney medulla in all of the three enhancement scanning phases, while the other 3 tumors' enhancement degree was higher than the kidney medulla in the cortical phase. Peak contrast enhancement of ChRCC was located in the cortical phase, however, peak contrast enhancement of the others did in the nephrographic phase. Conclusions Enhancement characteristics combined CT features is of great help in differential diagnosis of 4 subtypes of RCC.

Objective To study the operational method and the clinical application of breast reconstruction with the bipedical transverse rectus abdominis. Methods 5 cases of breast reconstruction were performed with bipedical transverse rectus abdominis post mastectomy, and 3 cases of nipple-areola reconstruction. Immediate reconstruction was 3 cases, and delayed reconstruction was 2 cases. Results 4 cases of the breast reconstruction were survival, the morphologies were natural, and touch feeling was normal. Only one case skin flap was partial necrosis, nearly 3cm?2cm. Conclutions The breast reconstruction with bipedical transverse rectus abdominis is a good choice for breast cancer patients with caesarotomy scar.

Objective To explore the clinical efficacy of hepatic segmentectomy under segmental staining and intraoperative chemoembolization for primary liver cancer(PLC).Methods Twenty cases of liver cancer underwent hepatic segmentectomy under segmental staining and intraoperative chemoembolization(observed group),the results were compared with 22 cases of PLC after treated by routine hepatectomy(control group).AFP,CT and MRI were regularly used after hepatectomy to evaluate the outcome.Results In observed group,the operative blood loss was(295?105)mL,blood transfusion was(280?85)mL,liver function levels were in the normal range accounted for 15%(3/20) one week postoperatively,the incidence of postoperative complications was 40%(8/20),the postoperative 3-year survival rate was 60%,and the postoperative local recurrence rate was 35%;while in the control group,these parameters were(490?140)mL,(370?105)mL,40.9%(9/22),45.5%(10/22),40.91% and 68.18% respectively.In observed group,the operative blood loss,blood transfusion,cases with liver function levels in the normal range,the incidence of postoperative complications,postoperative 3-year survival rate,and postoperative local recurrence rate were significantly lower than those in the control group(P0.05).Conclusions The hepatic segmentectomy under segmental staining and intraoperative chemoembolization for PLC may reduce postoperative complications,lower postoperative relapse rate and improve survival rate.

Objective To study the diagnosis,surgical treatment and prognosis of patients with primary duodenal carcinoma.Methods The clinical data of 56 patients with primary duodenal carcinoma treated between 2008 to 2015 were retrospectively analyzed.Results The number of patients with tumors located in the first,second,third and fourth parts of duodenum were 3,44,6,and 3 patients respectively.Tumors which were within the papillary region accounted for 71.4％ (40 patients).Twenty-two patients (22/56,39.3％) had well differentiated adenocarcinoma,16 patients (16/56,28.6％) had moderately differentiated adenocarcinoma and 6 patients (7/56,10.7％) had undifferentiated carcinoma.The clinical manifestations were not specific,which included abdominal pain,abdominal distention,jaundice,bowel obstruction or bleeding.The correct rates of diagnosis made by endoscopy,duodenography,ultrasound and CT were 84.0％,81.3％,30.4％ and 48.2％ respectively.Forty patients underwent pancreaticoduodenectomy,5 segmental duodenectomy,9 bypass operation,and 3 subtotal gastrectomy and duodenal bulb tumor resection.The 1-,3-,and 5-year survival rates of all the patients were 82.6％,56.7％ and 30.1％ respectively.The-1,3-,and 5-year survival rates of the patients who underwent pancreaticoduodenectomy and segmental duodenectomy were 100％,68.8％,42.2％ and 100％,61.8％,0 respectively.All the patients who underwent palliative resection died 6 to 24 months after surgery.Univariate analysis revealed the operation types.,depth of tumor invasion,lymphatic invasion,and tumor differentiation correlated with prognosis.Multivariate analysis showed only the operative types,depth of tumor invasion and lymphatic invasion to be independent prognostic factors.Conclusions Tumors located in the papillary region accounted for the majority of primary malignant tumors of the duodenum and they were mainly adenocarcinomas.Duodenography and endoscopy were the major methods used in the diagnosis of primary duodenal carcinoma.Pancreaticoduodeneetomy was the best therapy for primary duodenal carcinoma.

Objective To investigate the effect of MOTOmed intelligent training system training on balance and lower limb motor function in stroke patients. Methods 120 stroke patients were randomly divided into observation group (n=60) and control group (n=60) according to the random number table. Both groups were treated with routine rehabilitation training, the observation group received MOTOmed intelligent training system in addition. They were evaluated with Fugl-Meyer assessment (FMA), Functional Ambulation Category (FAC), Barthel index (BI), Motricity index (MI-L), modified Ashworth scale (MAS) and Berg balance scale (BBS) before and 4, 8, 12 weeks after treatment. Results There was no difference in the score of FMA, BI, MI-L, BBS, MAS, FAC and the maximum walking speed, stride length and stride frequency between 2 groups before treatment (P>0.05). The scores of FMA, BI, MI-L, BBS, FAC and the maximum walking speed stride length and stride frequency increased in the observation group and there was a uptrend 4 weeks, 8 weeks and 12 weeks after treatment (P<0.05). The score of MAS decreased in the observation group and there was a downtrend after treatment (P<0.05). All the indexes were better in the observation group than in the control group (P<0.05). Conclusion MOTOmed training system combined with routine rehabilitation training can improve the balance and lower limb motor function in stroke patients.

Objective To explore the feasibility and reasonable of low-dose scan on abdominal angiography in 64-slice spiral helical CT. Methods Phantom test: at 120 KV and from 200 mAs to 30 mAs at an interval of 10 mAs in each image acquisition, it was measured standard deviation (SD) of CT number, high contrast resolution and low contrast resolution, and then analyzed the relationship between the three parameters and the mAs values. Three mAs values were chosen to undertake clinical analysis.Clinical analysis: 90 randomly selected objects with abdominal angiography were divided into three groups,scanning with above three mAs values.Measurement of the SD value at the plain scan images was performed and the enhanced low-dose scan images were used post-processing with three-dimensional volume reconstruction (VR). The VR images were classified into three grades (excellent, moderate, bad) with the blind evaluation of three CT radiologists. The quality-correlation analysis was used between the standard deviation (SD) values of plain scan image and abdominal angiography VR image. Results According to the quality-correlation analysis between the standard deviation (SD) value of plain scan image and abdominal angiography VR image, the area under curve in receiver-operated characteristic (ROC) analysis was 0.921, 0.906 and 0.893 in each three group, respectively. Conclusions The low-dose scan of abdominal angiography is feasible. 80mAs can ensure better image quality. The enhanced scan probably can use 60mAs when the SD value is less than 5.78 in the plain scan; but when the SD value of plain scan is greater than 11.8, the enhanced scan is used best 100 mAs or higher.

Objective To detect the differences of grey matter volume between the patients with mental retardation (MR) presented clinically as operation deficit (OD) or as language deficit (LD) and the children with typical normal development using optimal VBM.The developmental connections between brain gray matter and language or operation skills were examined.Methods Magnetic resonance imaging was obtained from 9 children with mental retardation presented as OD predominantly and 11 children with mental retardation presented as LD mainly,as well as the age-matched control group (11 and 14 normal children,respectively) on a 1.5 T scanner.Voxel-based morphometry analysis with an optimization of spatial segmentation and normalization procedures was applied to compare the volume of grey matter between the two groups (OD VS.control; LD VS.control).Statistically,the total and local gray matter volumes were compared between the two groups with t test.Results The total gray matter volume of OD group was [(1.030 ± 0.078) × 106 mm3].Compared to that of controls [(0.984 ± 0.058) × 106 mm3],it was increased significantly (t =-2.6,P ＜ 0.05).And the gray matter volume in the posterior cingulated gyrus,left superior prefrontal gyrus,left cuneus,left middle prefrontal gyrus and the body of left caudate nucleus showed significantly increased.Meanwhile,the total gray matter volume of the MR children presented as LD [(1.002 ± 0.068) × 106 mm3] showed significantly increased(t =-3.0,P ＜ 0.05) compared with that of control group [(0.957 ±0.057) × 106 mm3].The gray matter volume in bilateral thalami,the left inferior temporal gyrus,the left inferior frontal gyrus,and the left cerebellum of the LD group was more than that of normal children.Conclusion As revealed by VBM,there are differences in alterations of gray matter volume between MR children presented with OD and with LD relative to control.