Objective To observe the application of the mini-mental status examination (MMSE)cognitive assessment in the patients with brain glioma before and after surgery. Methods Using MMSE,36 pastients with primary brain glioma were subjected to the cognitive assessment before surgery, after surgery,and 3 monthsr after surgery. Results The quantitative cognitive assessments with MMSE before surgery revealed the hidden cognitive dysfunction patients.The quantitative cognitive assessments after surgery showed that surgeons might need to protect the non-function area and to form the idea of cognitive function in patients with glioma.Conclusion MMSE assessment is a simple,understandably,and convenient method having good compliance of patient. It may be effectively used to assess cognitive impairment for patients with glioma and worth being studied continuously and used widely in the clinic practice.

Objective To observe the therapeutic efficacy of different treatment programs on the acute subjective tinnitus . Methods 327 patients with acute subjectivity tinnitus were randomly divide into physical ,medication and comprehensive treatment group .The 97 cases in physical group were treated with hyperbaric oxygen ,acupuncture and sound therapy ;the 103 cases in medica‐tion group were treated with microcirculation and oral steroids ;the 127 cases in comprehensive treatment groups were treated with combination the therapy of above what have mentioned .THI was used to evaluate three groups before the treatment ,two and four weeks after treatment .Results After two week′s treatment ,the efficiency rate for physical group is 60 .82% ,64 .78% in medica‐tion group and 70 .08% in comprehensive group .After four weeks of treatment ,the efficiency rate of each group is 70 .10% , 72 .81% and 80 .31% .At two‐week time point ,there was no significant difference between drug and physics group (P> 0 .05) , there was statistically significant difference between medication group and comprehensive group (P< 0 .05) .At four‐week time point ,the difference of physics group and drug group had no statistically significance compared with the two‐week in each group (P>0 .05) ,but there was a statistically significant difference in comprehensive group (P<0 .05) ,meanwhile ,there was statistically significant differences between comprehensive group and the physical group and drug group (P<0 .05) .Conclusion Physical and medication therapy have quite effects on acute subjective tinnitus ,but the effect was worse than the comprehensive therapy group . After four weeks of treatment ,the efficiency of purely physical and drug therapy have not been significantly improved compared with two weeks time ,but still improved of comprehensive treatment .

Objective To analyze the complications of transvaginal natural orifice transluminal endoscopic surgery( TV-NOTES) nephrectomy, and to explore effective measures to prevent and manage those complication.Methods From May 2010 to January 2015, a total of 178 females who had been married and given birth underwent TV-NOTES nephrectomy in our center.The average age was 47 ( ranging 23 to 71 ) years and the average BMI was 23.6 ( ranging 14.7 to 31.9 ) kg/m2.Pathological diagnosis included 142 cases of non-functional kidneys, 29 cases of renal tumors ( T1 N0-1 M0 25 cases, T2 N0-1 M0 4 cases) , and 7 cases of renal tuberculosis.One hundred and sixty hybrid TV-NOTES nephrectomy procedures (simple in 132, radical in 28) and 18 pure TV-NOTES nephrectomy procedures (simple in 17, radical in 1) were performed.Intraoperative and postoperative complications were graded according to Satava and Clavien-Dindo grade classifications.The major complications and relative treatments were analyzed.Results Among the 178 TV-NOTES nephrectomy procedures, there were 40 ( 22.5%) complications occurred, including 13 (7.3%) major complications, in which there were 11 cases of intraoperative complications (6.2%),2 cases of postoperative complications (1.1%).All the complications were successfully managed using organ repair or resection, embolectomy, hemostasis, and so on.No intraoperative and postoperative deaths occurred.There was no significant difference in major complications between hybrid TV-NOTES and pure TV-NOTES nephrectomy (6.9%vs.11.1%, P=0.620).The intraoperative major complications in the early developmental stage of TV-NOTES nephrectomy were more than that of the late stage (20.0%vs.3.4%, P=0.004).There was no significant difference in postoperative complications between the early and late developmental stage of TV-NOTES nephrectomy (13.3%vs.10.8%, P=0.751).Conclusions TV-NOTES nephrectomy is safe and feasible, but there are some major complications worthy of attention.Personal prevent and treatment strategy should be considered.

OBJECTIVETo evaluate the application of multidisciplinary treatment (MDT) in patients with liver metastasis of colorectal cancer(CLM).

METHODSClinical data of 118 patients with liver metastasis of colorectal cancer, including 32 patients with MDT (MDT group) and 86 patients without MDT (control group), from February 2014 to April 2015 in PLA General Hospital were analyzed retrospectively. Compliance of preoperative examination and adjuvant therapy, and efficacy-associated indexes were compared between the two groups.

RESULTS(1) As compared to control group, statistically significant increase in imaging examination ratio was found in MDT group: chest CT [87.5%(28/32) vs. 40.7%(35/86), P=0.0000], abdominal MRI [84.4%(27/32) vs.61.6%(53/86), P=0.019], pelvic MRI [63.7%(7/11) vs. 24.3%(8/33), P=0.017]. The preoperative assessment of TNM staging was also higher in MDT group [100%(32/32) vs. 20.9%(18/86), P=0.0000], while there was no significant difference in accuracy rate of TNM staging between the two groups [81.3%(26/32) vs. 66.7%(12/18), P=0.2465]. (2) Rates of preoperative chemotherapy and chemotherapy completion were also higher in MDT group than those in control group [90.6%(29/32) vs. 62.8%(54/86), P=0.0033; 82.8% (24/29) vs. 57.4% (31/54), P=0.000], but conversion rate of unresectable CLM showed no significant difference [24.0% (6/25) vs. 14.3% (7/49), P=0.299 ]. (3) Rate of one-stage resection or ablation was higher in MDT group compared to control group [76.9%(10/13) vs. 36.0%(9/25), P=0.038], and resection rate of metastasis nidus was also higher in MDT group [77.0%(20/26) vs. 44.9%(13/29), P=0.015]. No significant differences were observed in rates of R0 resection, positive surgical margin, lymph node clearance, ablation of metastasis nidus, pathological complete response, postoperative chemotherapy or postoperative complications (all P>0.05).

CONCLUSIONMDT has the advantages on standardization of preoperative examination and perioperative chemotherapy, and can improve the rate of one-stage resection or ablation, as well as resection of metastasis nidus.

Aged ; Colorectal Neoplasms ; pathology ; Combined Modality Therapy ; Female ; Hepatectomy ; Humans ; Liver Neoplasms ; secondary ; therapy ; Lymph Nodes ; Male ; Middle Aged ; Neoplasm Staging ; Postoperative Complications ; Retrospective Studies ; Tomography, X-Ray Computed ; Treatment Outcome