Objective To explore the generalization effect of a semantic navigation strategy(SNS)on naming in patients with aphasia.Methods Fourteen patients with aphasia were randomly divided into an SNS group (n =7)and an unrelated semantic(US)group(n =7).One hundred and twenty-two words chosen from Chinese word association norms were used in this study.The presentation sequence of words was generated automatically with network analysis techniques for the SNS group and randomly without network analysis techniques for the US group.After baseline tests using the western aphasia battery(WAB)and the mini-mental status examination(MMSE),all patients received language training once a day for 10 consecutive days.The amount of correct responses was recorded every day in order to draw the learning curve.The generalization effect was evaluated with 46 untrained items before and after training with all patients.Results The average learning curve of the SNS group was steeper than that of the US group.Correct responses on trained items were significantly more frequent in the SNS group than in the US group after the 6th day of training.After 10 days the frequency of correct responses on untrained items in the SNS group was significantly higher than it had been before training,and higher than the frequency after training in the US group.The frequency of no response on untrained items in the SNS group had declined,and it had declined more than in the US group.Conclusion A semantic navigation strategy may promote significant generalization while improving the learning curve in naming among patients with aphasia.

Objective To observe the efficacy of open - door expansion laminoplasty in treatment of 36 cases with cervical stenosis. Methods 36 cases with cervical stenosis were all carried out open - door expansion laminoplasty. Then the efficacy and JOA17 scores were observed. Results 36 patients were followed up, the surgery fine rate was 85% ,JOA17-score of peroperation and postoperation was 5.23 and 10. 25 respectively. Conclusion The open - door expansion laminoplasty was a safe and effective surgery methods in treatment of cervical stenosis

Objective To investigate the effeit of Reconstruction of tantalum metal rod implantation in the treatment of early ischemic necrosis of femoral head( Steinberg Ⅰ～Ⅱ period) ,to explore the early femoral head ischemic necrosis of minimally invasive treatme(n)t. Method 24 patients( Steinberg Ⅰ～Ⅱ period) using C-arm fluoroscopy machine,under the greater trochanter through the neck hole to avascular necrosis zone,the first zone of the medullary sclerosis core decompression, re-implantation of tantalum rod to the subchondral bone is about 0.5 cm, through the Harris score before and after surgery for comparison. Results After follow-up 9(2 ～ 12) months,preoperative pain and function were significantly limited nuitigation. The excellent rate was 83% after opertion. MRI manifestations in patients with stable,non-ischemic necrosis increased performance. Conclusion Core decompression can significantly reduce the pressure on the femoral head hardening region, tantalum rod weight-bearing area of femoral head implant provides a structural support for subchondral bone. This method has the characteristics decompression,structural support,minimally invasive,it is worth for clinical use.

BACKGROUND:Monoaxial pedicle screws are not conducive to the instal ation during percutaneous pedicle screw technique, but it has better mechanical conductivity and stability than polyaxial pedicle screws. How to select and use these two kinds of screws in the clinic to exert their advantages and to further elevate efficacy has become a subject worthy of reflection. OBJECTIVE:To compare the clinical efficacy of percutaneous pedicle screw placement for thoracolumbar fracture using monoaxial and polyaxial pedicle screws at different placement selections. METHODS:A total of 46 cases of thoracolumbar fracture without neurological symptoms underwent minimal y invasive percutaneous pedicle screw fixation. 25 patients (monoaxial screw group) were treated with monoaxial pedicle screws and the other 21 ones (polyaxial screw group) with polyaxial pedicle screws. Kyphotic angle, correction rate, correction loss rate and height of injury vertebrae were compared before and after fixation in both groups. The therapeutic effects of monoaxial and polyaxial percutaneous pedicle screw fixation in the treatment of thoracolumbar fractures were evaluated. RESULTS AND CONCLUSION:(1) Fixation time, blood loss, complication and hospital stay were not significantly different in both groups (P>0.05). (2) Kyphotic angle and height of the fractured vertebra body were significantly different between the two groups (P<0.05). (3) The restoration of anterior height of injured vertebrae, kyphotic angle and correction rate were better in the monoaxial screw group than in the polyaxial screw group after treatment (P<0.05). The correction loss rate was significantly better in the monoaxial screw group than in the polyaxial screw group during last fol ow-up (P<0.05). However, there was no significant difference in the posterior height of injured vertebraeafter fixation (P>0.05). (4) These findings indicate that compared with the polyaxial percutaneous pedicle screw fixation, the monoaxial pedicle screw may be preferable in percutaneous pedicle screw fixation for thoracolumbar fractures, has more satisfactory fracture distraction reduction, and has less postoperative correction loss rate.

Objective To evaluate the clinical results of self-designed double-pivot extracorporeal reduction device in internal fixation with percutaneous pedicle screws for thoracolumbar fractures.Methods From January 2014 to May 2015,a total of 41 patients with thoracolumbar fracture without neurological symptoms underwent minimally invasive fixation with percutaneous pedicle screws.Of them,22 were treated with our self-designed double-pivot extracorporeal reduction device and the other 20 with common single-pivot extracorporeal reduction device.The 2 groups were compared in terms of pre-and postoperative kyphotic angles,correction rates and anterior,middle and posterior heights of injured vertebrae to evaluate the therapeutic effects of the self-designed double-pivot extracorporeal reduction device.Results The patients were followed up for 6 to 18 months (average,12.3 months).No iatrogenic impairment of nerve root,postoperative infection,or implant failure happened.Compared with preoperation,significant improvements were observed in all the patients regarding cobb's angle,anterior,middle and posterior heights of the fractured vertebral body (P ＜ 0.05).Compared with the single-pivot group,the double-pivot group were significantly superior in the kyphotic angle,correction rate,and anterior and middle heights of the injured vertebrae(P ＜ 0.05),but there was no significant difference between the 2 groups in the recovery of posterior height of the fractured vertebral body (P ＞ 0.05).Conclusion Compared with the single-pivot reduction device,the self-designed double-pivot reduction device may be preferable in percutaneous pedicle screw fixation for thoracolumbar fractures.

Objective To explore the value of the laparoscopic ultrasonography (LUS) in laparoscopic common bile duct explora-tion(LCBDE) .Methods 47 cases with cholecystolithiasis combined with bile duct dilatation or abnormal liver function were tested by conventional ultrasound ,magnetic resonance cholangiopancreatgraphy (MRCP) CT and LUS after LCBDE .All results were com-pared with the surgical findings and the intraoperative biliary endoscopy results .Results The diagnosis coincidence rate of conven-tional ultrasonography ,CT ,MRCP and LUS in 47 cases were 85 .1% ,72 .3% ,95 .7% ,100 .0% respectively .6 cases completed the surgery under the guidance of LUS ,1 case was converted to open surgery .Conclusion LUS is an examination method to avoid bile duct injury effectively and reduce postoperative residual stone in LCBDE .

Objective:To evaluate the effects of neoadjuvant chemoradiotherapy on anal function after intersphincteric resection (ISR) with low rectal cancer. Methods:A total of 103 patients were classified into the chemoradiotherapy (CRT) group and control group according to whether they received neoadjuvant chemoradiotherapy. Anal function was assessed using vectorial manometry, Saito function questionnaires, and Wexner incontinence scores. Results:The resting vector volume and squeezing vector volume of the CRT group were significantly lower than those of the control group prior to the operation. Both groups showed decreasing manometric re-sults after ISR. However, all indices of the CRT group were significantly lower than those of the control group (P<0.05). At 6 and 12 months after operation, the Saito questionnaire results reveal poor function for the CRT group compared with the control group, except for dyschesia. After 24 months, the stool frequency, ability to distinguish between feces and flatus, fragmentation, and alimentary re-striction remained poor for the CRT group (P<0.05). Although both groups showed decreasing Wexner scores with time, the score of the CRT group remained significantly higher than that of the control up to 24 months after operation. Conclusion:Neoadjuvant chemo-radiotherapy significantly affects the anal sphincter function for intersphincteric resection with low rectal cancer. This effect continues for at least 2 years after operation.

Objective To compare extravascular lung water index (EVLWI) and oxygenation index (PaO2/FiO2) in estimation of acute lung injury(ALI) .Methods Sixteen patients with post traumatic ALI (within 48 h) of both sexes, aged 18-80 yr, were studied. The patients were mechanically ventilated. Right internal jugular vein and femoral artery were catheterized and connected to PiCCO monitor (IntelliVue MP50, Philips, Netherlands).EVLWI was monitored with the PiCCO system. PaO2 was determined every 24 h. ALI was diagnosed based on the following criteria:(1)PaO2/FiO2≤300 mm Hg; (2)X-ray chest film-patchy shadows in the bilateral lungs and (3) CVP≤12 mm Hg.Lung injury score(LIS) was recorded. The patients were divided into PaO2/FiO2≤ 300 group and ≤200 group and EVLWI ≥ 10 group and ＜ 10 group. Results There was no significant difference in LIS between PaO2/FiO2 ≤300 group and PaO2/FiO2 ≤200 group at 24 and 48 h of PiCCO monitoring. At 72 h of PiCCO monitoring LIS was significantly increased in PaO2/FiO2 ≤200 group as compared with PaO2/FiO2 ≤300 group, LIS was significantly higher in EVLWI≥ 10 group than in EVLWI ＜ 10 group at 24, 48 and 72 h of PiCCO monitoring. Conclusion EVLWI is more accurate than PaO2 /FiO2 in estimation of severity of ALI.

In the present study the nutritional status in 1723 inpatients were evaluated. The over nutrition in male, in the cadre, and in patients with cerebrooardiovascular diseases or with diabetes was significantly higher than that in female, in the staff members, and the patient changing the valve in heart with rheumatism, respectively. The over nutrition in patients with breast and colonrectal cancer was obviously higher than that in stomach carcinoma patients. The sum total of lymphocytes was reduced in middle malnutrition patients. The nutritional status was well compared with the abnormal ratio of hemoglobin and serum protein, and A/G reverse was increased in some middle malnutrition patients. The MAC, MAMC and TSF in all of the malnutrition patients were than that of 80% standarized value, and were all the same in the evaluation of body weight.

Objective To examine the effect of ultrasonic debridement combined with continuous skin stretching to repair refractory infective wound bed.Methods From January 2016 to July 2016,we treated 15 cases of chronic,refractory infective wound beds using ultrasonic debridement combined with skin stretching technique.Results All the 15 (100％) cases were cured without necrosis of the stretched skin edges.Conclusions Ultrasonic debridement combined with continuous skin stretching is an appropriate technique for repairing the refractory wound bed in the patients who are older,in poor general condition,or poor condition of local skin and soft tissue,or have poor postoperative effect,or surgical contraindication or at higher risk of surgery.