Executive function is a superordinate cognitive function of the brain. Executive dysfunction post stroke plays a very impor-tant role in recovery of motor function, which is associated with motor learning, postural control, etc. Executive function training may pro-mote the recovery of motor function. The potential neurological mechanism includes the cerebral network involving a variety of areas.

Carcinoma, Squamous Cell ; diagnosis ; virology ; Head and Neck Neoplasms ; diagnosis ; virology ; Humans ; Laryngeal Neoplasms ; diagnosis ; virology ; Papillomaviridae

Objective To investigate prognosis and related factors of infectious pancreatic necrosis(IPN) caused by multidrug-resistant organisms(MDROs).Methods Clinical data of 53 IPN patients admitted to a hospital between October 2010 and March 2016 were analyzed retrospectively,patients were divided into MDRO infection group and common bacterial infection group according to antimicrobial resistance of pathogens isolated from peripancreatic drainge fluid,prognosis and related factors of two groups were compared.Results Among 53 IPN patients with confirmed evidence for pathogenicity,33(62.3％)were in MDRO infection group,and 20(37.7％)were in common bacterial infection group,the most common MDROs isolated from peripancreatic drainage was multidrug-resistant Acinetobacter baumannii (MDRO-AB) (37.5％,18/48).The mortality of IPN patients was 30.2％ (16/53),mortality of MDRO infection group was higher than common bacterial infection group(39.4％ [13/33] vs 15.0％ [3/ 20],P＜0.05);the severity score,length of intensive care unit (ICU) stay,and hospitalization expenses in MDRO infection group were all higher than common bacterial infection group(all P＜0.05).The mortality of IPN patients were closely associated with MDRO infection and severity score of acute pancreatitis (all P ＜ 0.05).Conclusion Prognosis of patients with MDRO infection is poor,treatment is difficult,MDRO infection has become one of the most important challenge to the treatment of severe acute pancreatitis.

OBJECTIVE: To investigate the distribution patterns of microvascular density(MVD) and lymph vessel density (LVD) in nasopharyngeal carcinoma, and to discuss their relationships with tumor recurrence-metastasis and prognosis. METHOD: One hundred and six patients with pathologically proved nasopharyngeal carcinoma were included in this study. Immunostainings for the vascular endothelial marker CD34 and the lymph vessel marker D2-40 were performed. The microvascular and lymph vessels within the tumor and the peritumoral area were respectively quantified with computer assisted morphometric analysis. RESULT: Both microvascular and lymph vessels were positive in the specimen of 106 nasopharyngeal carcinoma patients, with MVD and LVD higher in the peritumoral area than in the tumor. Univariate analysis showed that intra-tumor MVD,intra-tumor and peritumor LVD were correlated with nasopharyngeal carcinoma recurrence-metastasis (P < 0.05), while no significant correlation was found between tumor recurrence-metastasis and age, gender, T stage, lymph node stage, clinical stage and peritumor MVD (P > 0.05). Multivariate analysis demonstrated that intra-tumor MVD and peri-tumor LVD were two independent risk factors of nasopharyngeal carcinoma recurrence-metastasis. Higher intra-tumor MVD was associated with adverse prognosis of nasopharyngeal carcinoma (P < 0.05). CONCLUSION High MVD and LVD may be of significance in predicting poor prognosis in patients with nasopharyngeal carcinoma. Intra-tumor and peri-tumor microvessels may play different roles in the tumor recurrence and metastasis. Intra-tumor MVD and peri-tumor LVD should be the therapeutic targets in the nasopharyngeal carcinoma.
Adolescent ; Adult ; Aged ; Carcinoma, Squamous Cell ; blood supply ; pathology ; Child ; Female ; Humans ; Lymphangiogenesis ; Lymphatic Metastasis ; Lymphatic Vessels ; pathology ; Male ; Microvessels ; pathology ; Middle Aged ; Nasopharyngeal Neoplasms ; blood supply ; pathology ; Neoplasm Staging ; Neovascularization, Pathologic ; Prognosis ; Young Adult

Objective: To investigate the correlation between the expression of programmed death-1(PD-1), PD ligand-1(PD-L1), indoleamine 2, 3-dioxygenase 1(IDO-1) and clinical parameters in sinonasal malignant mucosal melanoma (SNM). Methods: Samples from 86 SNM patients who did not receive immune-targeted therapy and radio-chemotherapy were analyzed for PD-1, PD-L1, and IDO-1 expression by immunohistochemistry. Results: High clinical/pathologic staging, brain metastases and advanced age were independent risk factors of poor prognosis. The overall survival rate of SNM without pigment was lower than that with pigment. PD-1, PD-L1 and IDO-1 expression was not correlated with tumor pigmentation, but correlated with different primary site.PD-1, PD-L1 and IDO-1 were expressed in 47.6% (41/86), 53.5% (46/86) and 58.1% (50/86)of SNM samples respectively. PD-1 was associated with brain metastasis. Negative expression of PD-1(P=0.031) and IDO-1(P=0.017 9) correlated with worse disease-free survival. No significant association was found between PD-L1 and prognosis. For stages Ⅲ, ⅣA and ⅣB patients, PD-1 expression was associated with better outcome (P=0.025), but PD-L1 negative and IDO-1 positive patients hadworse outcome (P>0.05). PD-1 positive and IDO-1 negative stage ⅣC patients had poorer overall survival. Conclusions In SNM patients, clinical/pathologic staging, brain metastases, age and pigmentation were prognostic indicator. IDO-1 and PD-1 can also be used as reference to evaluate prognosis. Anti-IDO-1 targeted therapy may be suitable for middle to late stage patients, while advanced stage patients might benefit from anti-PD-1 targeted therapy. PD-1/PD-L1 and IDO-1 may be considered as joint targeted therapy.The predictive value of PD-L1 requires further study.

OBJECTIVETo study the expression and predictive value of MTDH, Bcl-2 and E-cadherin in sinonasal malignant mucosal melanoma (SNM).

METHODSSeventy-four formalin-fixed paraffin-embedded SNM specimens were subjected to immunohistochemical staining of MTDH, Bcl-2 and E-cadherin. Correlation between staining results and disease outcome was analyzed.SPSS 19.0 software was used to analyze the data.

RESULTSPositive staining of MTDH, Bcl-2 and E-cadherin was observed in 56/74 (75.7%), 18/74 (24.3%) and 21/74 (28.4%) cases, respectively. MTDH positive patients had higher metastatic rate than MTDH negative patients (67.9% vs. 33.3%, P=0.009, OR=2.037, 95% CI: 1.034-4.016). Negative Bcl-2 was correlated with worse overall survival time (HR=2.023, P=0.025). Expression of E-cadherin was adversely associated with expression of MTDH (r=-0.315, P=0.006).

CONCLUSIONHigh MTDH expression and low Bcl-2 expression suggest poor prognosis of SNM, while the predictive value of E-cadherin needs further study.

Cadherins ; metabolism ; Cell Adhesion Molecules ; metabolism ; Humans ; Melanoma ; diagnosis ; metabolism ; pathology ; Neoplasm Metastasis ; Nose Neoplasms ; diagnosis ; metabolism ; pathology ; Prognosis ; Proto-Oncogene Proteins c-bcl-2 ; metabolism ; Survival Rate

Objective To explore the effect of hierarchical executive function training on executive dysfunction among stroke survivors.Methods Thirty-six recovering stroke survivors with executive dysfunction were randomly divided into an experimental group (n=18) and a control group (n=18).Both groups received routine rehabilitation training and medication for three weeks,but the experimental group also received working memory training,inhibitory control training,set shifting training,and central executive function training.Before and after the training,everyone's cognitive functioning was screened using the Montreal Cognitive Assessment (MoCA),and executive functioning was evaluated using the digit span test (DST),the color trail test (CTT),the complex fluency test and the simple fluency test.Results Before the training there were no significant differences in clinical indicators between the two groups.After the treatment,the average MoCA,DST,CTT complex fluency test and simple fluency test scores of the experimental group had all improved significantly,but no significant improvement in any of the measurements was observed in the control group except for a significant improvement in their average MoCA score.Conclusion Hierarchical executive function training can improve the sub-components of executive function among recovering stroke survivors,including working memory,set shifting and fluency.

OBJECTIVE: To evaluate the therapeutic effect of malignant tumor of nasal cavity and sinus that based on modern radiotherapy. METHOD: Two hundred cases of malignant tumor of nasal cavity and sinus were retrospectively analyzed from 2004 to 2007. All the cases were location by CT simulator system and were treated with three dimensional conformal radiotherapy. RESULT: Among malignant tumor of nasal cavity and sinus, the incidence for locations was nasal cavity > maxillary sinus > ethmoid sinus > sphenoid sinus; the incidence for the type of pathology was squamous cell carcinoma > adenocarcinoma > olfactory neuroblastoma and olfactory esthesioneuroepithelioma > malignant melanoma > rhabdomyosarcoma; the incidence for general metastasis was rhabdomyosarcoma > malignant melanoma > adenocarcinoma, inverted papilloma and malignant changes > squamous cell carcinoma, olfactory neuroblastoma and olfactory esthesioneuroepithelioma. No severe radiation-related complication were found. CONCLUSION Clinical stage, pathological type were the important factors effecting the prognosis of patients with malignant tumor of nasal cavity and sinus. Three dimensional conformal radiotherapy based on CT simulator system could improve therapeutic effect and protect the normal tissue very well.
Adenocarcinoma ; pathology ; radiotherapy ; Adolescent ; Adult ; Aged ; Carcinoma, Squamous Cell ; pathology ; radiotherapy ; Esthesioneuroblastoma, Olfactory ; pathology ; radiotherapy ; Female ; Humans ; Male ; Middle Aged ; Nasal Cavity ; Nose Neoplasms ; pathology ; radiotherapy ; Paranasal Sinus Neoplasms ; pathology ; radiotherapy ; Prognosis ; Radiotherapy, Conformal ; methods ; Retrospective Studies ; Survival Rate ; Young Adult