Objective To study the clinical manifestations,etiology,magnetic resonance imaging features,prognosis of patients with bilateral medial medullary infarction.Methods The clinical information of two case reports were summarized with review of the literature.Results The 2 patients with bilateral medial medullary infarction reported here were manifested with progressive quadriplegia,both complicated with respiratory disorders.On etiology,both were due to atherosclerosis,and one was combined with congenital vascular variation.The Y shaped hyperintense signals were seen in diffusion weighted imaging (DWI) cross-section in the medulla oblongata level.And both had poor outcomes that one was dead and the other was discharged with tracheotomy and severe sequela.Conclusions Bilateral medial medullary infarction is presented with complicated symptoms such as quadriplegia,dysarthria,hypoglossoplegia,even respiratory failure,in which quadriplegia is most often seen,and it is associated with a poor clinical prognosis.DWI appears the characteristic Y Shaped sign.

Objective:To investigate the clinical effect of hearing aid combined with cognitive rehabilitation training in the treatment of dementia with hearing loss.Methods:Forty-six cases of dementia patients with hearing loss in Dalian Municipal Central Hospital Affiliated of Dalian Medical University from September 2019 to September 2020 were divided into two groups by random number table method. The treatment group received cognitive rehabilitation training assisted by sound amplifier, while the control group only received cognitive rehabilitation training for 7 weeks. Before and after treatment, questionnaires were used to evaluate the training effect of patients, including MMSE, HAMA, HAMD and ADL, and satisfaction questionnaire was used to evaluate the satisfaction of caregivers.Results:After treatment, the MMSE score of the treatment group was significantly higher than that of the control group: (20.22 ± 3.38) scores vs. (19.89 ± 3.10) scores ( P<0.05), and HAMA and HAMD were significantly lower than those of the control group: (11.43 ± 5.07) scores vs. (11.83 ± 4.79) scores, (8.39±3.37) scores vs. (9.67 ± 5.34) scores ( P<0.05); there was no difference in activities of daily living between the treatment group and the control group ( P>0.05); the caregiver satisfaction of the treatment group was significantly improved, compared with that of the control group ( P<0.05). Conclusions:Hearing assisted cognitive training can improve the cognitive function of patients with hearing-impaired dementia, promote mental and emotional stability, and improve the feelings of caregivers; we emphasize the importance of hearing evaluation for the elderly with dementia, and the importance of cognitive rehabilitation training with hearing assistance.