Objective To investigate the voice emotion perception of bimodal listeners,and to provide refer-ence and suggestions for hearing rehabilitation of cochlear implant(CI)users.Methods A total of 17 Mandarin-speaking postingual deafness bimodal adults as well as 20 normal hearing(NH)adults and 18 adults with unilateral CI participated in the study.All participants received voice emotion recognition test.Results The NH group had significantly higher accuracy scores and shorter reaction times than the bimodal group and the unilateral CI group(P＜0.05).There were no significant differences in accuracy between the bimodal group and the unilateral CI group(P＞0.05).The reaction time was significantly shorter in the bimodal users than in the unilateral CI users(P＜0.05).The bimodal listeners spent less time in female-speaker material than that in male-speaker material(P＜0.05).Neutral emotion had the highest accuracy(96.67％)and scared emotion had the lowest accuracy(41.82％).Conclusion A contralateral hearing aid(HA)improves the ability of voice emotion perception for Mandarin-speak-ing bimodal listeners,even though they continue to experience more challenges than NH peers.HA in the nonim-planted ear plays an important role in Mandarin-speaking bimodal listeners'voice emotion perception.

Objective:To evaluate the application of enhanced recovery after surgery in patients undergoing laparoscopic gastric cancer surgery and its impact on the systemic inflammatory response (SIR).Methods:The clinical data of patients undergoing laparoscopic gastric cancer surgery at the Department of Gastrointestinal Surgery, Zhongnan Hospital, Wuhan University from Mar 2021 to Mar 2023 was retrospectively analyzed.Results:A total of 234 patients with gastric cancer were enrolled (120 cases in ERAS group and 114 cases in routine group). There were no significant differences in preoperative indexes between the two groups (all P>0.05). After laparoscopic surgery, the postoperative ventilation time and hospital stay of patients in ERAS group were significantly shorter than those in the conventional group (all P<0.05). Neutrophil to lymphocyte ratio (NLR) , platelet to lymphocyte ratio (PLR) and systemic immune-inflammatory (SII) index of patients in ERAS group were significantly lower on day 1 and day 3 after surgery than in conventional group (all P<0.05). The ratio of lymphocyte to monocyte (LMR) in ERAS group was significantly higher than that in conventional group on day 1 and day 7 after surgery (all P<0.05). Conclusions:ERAS can improve postoperative SIR indexes in patients undergoing laparoscopic gastric cancer surgery, shorten postoperative recovery time, and enhance the efficacy of laparoscopic gastric cancer surgery by reducing perioperative systemic inflammation.

Objective:To explore the consistency of MRI-based ovarian-adnexal report and data system (O-RADS) score and its diagnostic value for ovarian adnexal masses.Methods:The MRI data of 309 patients with ovarian adnexal masses confirmed by pathology were retrospectively collected from January 2017 to August 2021 in the Second Affiliated Hospital of Soochow University, including 327 lesions consisted of 250 benign lesions, 21 borderline lesions, and 56 malignant lesions confirmed by pathology. Borderline and malignant lesions were classified into the malignant group ( n=77) and benign lesions were classified as benign group ( n=250). Two radiologists scored all lesions according to the MRI-based O-RADS, and scored again after 6 months. The proportion of borderline/malignant lesions in each MRI-based O-RADS score was calculated. The weighted Kappa test was used to assess the intra-reader and inter-reader consistency of the image interpretation results. The receiver operating characteristic (ROC) curve analysis was used to evaluate the diagnostic efficacy of MRI-based O-RADS classification for distinguishing benign and malignant ovarian adnexal masses. Results:The weighted Kappa value of the MRI-based O-RADS score between the two radiologists was 0.810 (95%CI 0.764-0.855), and the weighted Kappa values of the two radiologists′ scores at different times were 0.848 (95%CI 0.806-0.889) and 0.875 (95%CI 0.835-0.914), respectively. The borderline/malignant lesions accounted for 0/16, 0.8% (1/127), 10.1% (10/99), 76.0% (57/75), 9/10 and 0/17, 0 (0/122), 8.0% (8/100), 76.2% (48/63), and 84.0% (21/25) of the lesions in the two radiologists based on the MRI O-RADS score of 1, 2, 3, 4, and 5, respectively. When adopting O-RADS score>3 as a cut-off value, the area under the ROC curve of the two radiologists for distinguishing benign and malignant ovarian adnexal masses was 0.928 (95%CI 0.895-0.954) and 0.942 (95%CI 0.911-0.965), respectively. The sensitivity was 0.857 and 0.896, the specificity was 0.924 and 0.924, and the accuracy was 0.908 and 0.917 respectively.Conclusion:The MRI-based O-RADS yields high diagnostic efficiency in the evaluation of benign and malignant ovarian adnexal masses, and the intra-reader and inter-reader consistency of the image interpretation is strong.

This paper reviews the clinical researches on acupuncture and moxibustion and Tuina therapy for hemiplegia, due to cerebral apoplexy. It is found that acupuncture and Tuina therapy mainly includes acupuncture, moxibustion, massage, electroacupuncture, as well as the combination of acupuncture and Chinese medicine, acupuncture and massage therapy or the combination of modern rehabilitation technics. The researches showed that all treatments have good clinical effect and few adverse reactions. However, most of the researches focus on self-control, and lacks comparability. There stilllacks strict RCT and unified standard of operation scheme. Besides, the researches on the mechanism should be strengthened.

Objective To explore the difference in efficacy between multiparametric MRI (Mp-MRI) based on prostate imaging reporting and data system version 2 (PI-RADS v2) and abbreviated biparametric MRI (Bp-MRI) in detecting prostate cancer (PCa) and clinically significant prostate cancer (csPCa), and to evaluate the consistency of image interpretation between different readers. Methods The imaging, pathological and clinical data of patients with prostatic Mp-MRI in our hospital from February 2015 to June 2018 were retrospectively analyzed. At the beginning, 250 patients were randomly selected. Two radiologists visually evaluated the images of those patients using two 5-point scoring schemes based on Mp-MRI and Bp-MRI. The remaining cases were independently proceeded by one of the radiologists using two schemes respectively. Weighted Kappa test was used to assess the consistency of the results interpreted by the two radiologists. The receiver operating characteristic (ROC) curve was used to evaluate the efficiency of the two scoring schemes in detecting PCa and csPCa, and with Z test to investigate whether there was any difference in detection efficiency between the two schemes. Results Nine hundred and seventy eight patients were eventually enrolled in the study. The results of the consistency assessment showed that there was good agreement between the two radiologists, whether using Mp-MRI or Bp-MRI, with the weighted Kappa coefficient of 0.800 and 0.812, respectively. The ROC curve analysis showed that the area under the curve (AUC) of PCa detected by Mp-MRI and Bp-MRI was 0.873 and 0.879, respectively, and the AUC of csPCa detected was 0.922 and 0.932, respectively. In addition, there was no statistically significant difference between the AUC of PCa and csPCa detected by the two schemes (P>0.05). Conclusion The Bp-MRI scoring scheme has good stability in the evaluation of benign and malignant prostate, and its detection efficiency of PCa or csPCa is not lower than that of standard Mp-MRI based on PI-RADS v2.

Objective: To investigate an effect on speech recognition after bilateral cochlear implants(CI) simultaneously. Methods: Nine subjects who underwent bilateral CI operation simultaneously in Peking Union Hospital in 2007 were assigned as bilateral group, another 9 subjects with unilateral CI were chosen as unilateral group according to the age, gender, duration of deafness. Hearing threshold, speech recognition of phrases, disyllabic words, single word in quiet and noise environment were calculated, respectively. Three different sound source positions were set up to simulate the three effects of binaural hearing (head shadow, binaural redundancy and binaural squelch) in noise environment. The speech signal intensity was 70 dBSPL, the signal to noise ratio (SNR) was 0 dB, + 4 dB, + 8 dB, and the speech recognition of phrases were examined in bilateral CI group. All the data was analyzed by SPSS 19.0 software. Results: In quiet environment, the average aid-hearing threshold was significantly reduced as (7.2±3.0)dB in bilateral CI group compared to unilateral CI group(P<0.05). However, the speech recognition of phrases, disyllabic words, and single word in quiet and noise environment did not show significant differences between bilateral CI and unilateral CI groups (P>0.05). In the testing under noise environment, the speech recognition of bilateral CI group was significantly higher than that of unilateral CI group (P<0.05). In the estimation of noise environment (SNR=+ 8), the phrase test and speech recognition of head shadow model in bilateral groups were significantly better than that of unilateral group (P<0.01). Further, bilateral CI group showed statistical significances in binaural redundancy and binaural squelch models(P<0.01), there was statistically significant were also found difference between two groups (P<0.01); Bilateral CI group did not reveal significant difference compared with unbilateral CI group in binaural squelch model(P>0.05). Under different signal-to-noise ratio (SNR=+ 8, + 4) noise environment, all the three given models in bilateral CI group show higher signal-to-noise ratio, higher speech recognition rate (Independent-Samples t test, P<0.01). In addition, head shadow model presented negative influences on speech recognition rate compared with binaural redundancy and binaural squelch model by SNR(P<0.05). SNR influences on binaural redundancy and binaural squelch model were almost identical, F=0.371, P=0.549. Conclusion The subjects who underwent simultaneous bilateral cochlear implantation could significantly reduce aid-hearing threshold, and greatly improve the speech recognition of phrases, disyllabic words, and single word under noise environment.

The auditory nervous system has a rapid development period after birth, if there lack enough sensory(auditory) stimulation during this period, there should be a serious and negative impact on the growth and development of auditory center. In the auditory deprivation persist in the critical period, the auditory and visual cortex should be in cross-model reorganization and reorientation of cortical function. Cochlear implantation, especially intervention in the younger age, could excite the auditory cortex, and continuous stimulation to the cerebral cortex can promote the adaptation and reconstruction of auditory function. Speech and language skills can be developed by the synergistic effect of multiple sensory modalities.

Objective To investigate the value and diagnostic efficiency of the quantitative dynamic contrast enhanced-magnetic resonance imaging (DCE-MRI) and intravoxel incoherent motion (IVIM) parameters using three dimention (3D)-histogram analysis for discriminating the Gleason score (GS) of prostate cancer. Methods A total of 53 patients pathologically confirmed as prostate cancer by systemic prostate biopsy who had routine , DCE and DWI-MRI scans were retrospectively analyzed. There were 15 cases for low-risk and 38 cases for intermediate/high-risk prostate cancer. The 3D ROI of all lesions based on T2WI was achieved by image registration to get the quantitative parameters of DCE-MRI and DWI-IVIM. The parameters of DCE-MRI contains: transfer constant (Ktrans), rate constant (Kep) and extracellular-extravascular volume fraction (Ve).The DWI-IVIM related quantitative parameters were ADC, diffusion coefficient (D), diffusion coefficient related to perfusion (D*) and perfusion fraction (f). Then the histogram analysis of these quantitative parameters was performed to get the mean, median, 25th percentile, 75th percentile, Skewness and Kurtosis. Using the Spearman rank correlation analysis to evaluate the correlation of these parameters and GS of prostate cancer. The diagnostic performance of these quantitative histogram parameters related to the GS in identifying low-risk and intermediate/high-risk of prostate cancer was carried by ROC. Results The Kep and Ktrans (mean, median, 25th, 75th) of DCE-MRI were positively correlated with GS (r value was 0.346 to 0.696, P<0.05). The ADC (mean, median, 25th, 75th), D (mean, median, 25th, 75th, Skewness, Kurtosis) and D*(25th) of DWI-IVIM were correlated with GS (r value was-0.544 to 0.428, P<0.05). The DCE-MRI quantitative parameters Kep (25th) had the highest area under curve (AUC, 0.961); The ADC (median) and D (25th) had higher AUC( 0.832, 0.888) in the quantitative parameters of DWI-IVIM, the difference between Kep(25th) and ADC (median) was statistically significant (Z value was 2.212, P value was 0.027). The difference of AUC between Kep (25th) and D (25th), D (25th) and ADC (median) was not statistically significant (Z values were 1.027 and 1.398, P values were 0.162 and 0.304, respectively).Conclusion DCE and IVIM quantitative parameters (Kep, Ktrans, ADC, D) histogram analysis results are correlated with GS, and can be used for distinguishing low-risk from intermediate/high-risk prostate cancer.

Objective Analysis of the outcome of the electric brain stem auditory response (EABR) before cochlear implantation (CI) and the mapping parameters after CI in 187 cases,to explore the significance of EABR before CI.Methods From February,2008 to December,2014,EABR were performed in 187 patients with normal cochlear structures before CI with Nucleus 24R multi-channel cochlear.Including 105 cases of male,82 cases of female;152 cases of no residual hearing,35 cases of residual hearing.Self-design electrical stimulator and US Bio-logic auditory evoked potential were taken,EABR were performed under general anesthesia before CI,recording EABR waveforms,measuring the latency of Ⅱ,Ⅲ,Ⅳ,Ⅴ wave and the Ⅲ-Ⅴ interval,Ⅴ-wave amplitude,Ⅴ-wave threshold and I/O curve slope.Data were analysis by SPSS19.0.Results EABR waveforms were recorded in all 187 patients.The Ⅱ,Ⅲ,Ⅳ,Ⅴ waves are similar with the acoustic evoked ABR,the waveforms differentiation were different in ages,but no significant difference in gender.At 50 μs pulse electrical stimulation,the average threshold of V-wave was (156.37 ± 21.44) CL,the average dynamic range was (36.33-± 8.63) CL.20 CL above the threshold,average latency of wave Ⅱ,Ⅲ,Ⅴ was (1.54 ± 0.12) ms,(2.06 ± 0.23) ms and (4.14 ± 0.25) ms,the Ⅲ-Ⅴ interval was (2.08 ± 0.24) ms,the average amplitude of Ⅴ-wave was (0.35-0.07) μⅤ.One month later,the 187 patients achieved different degrees of hearing,the average C value of mapping was (163.55 ± 27.43)CL,significantly correlated with EABR threshold(r =0.915,P =0.013).The EABR threshold in 35 cases of no residual hearing value was (163.82 ± 16.21)CL and V-wave I/O curve slope was 0.035 227 ± 0.013 918,and the threshold was (148.41 ± 15.38)CL,the slope was 0.041 364 ±0.013 623 in paired group of 35 residual hearing patients,there was a statistically significant difference between two groups(t =15.838 and 4.328,P ＜ 0.05).Conclusions The EABR detection method is reliable,extraction rate is high.EABR can be used to evaluate the auditory pathway before inserting electrode,which could provide the help for the screening operative indications of CI.

OBJECTIVE: To investigate the intra-operative electrical evoked auditory brain stem response (EABR) characteristics and the hearing and speech rehabilitation effects of cochlear implantation (CI) in patients with internal auditory canal stenosis (IACS). METHOD: A retrospective study was performed on 16 patients with IACS (IACS group) matched with 16 implanted without IACS (control group), who received multi- channel CI because of pre-lingual sensorineural hearing loss. The integrity and functional status of the auditory pathway were assessed by EABR, recording waveforms, thresholds and dynamic ranges intra-operation before CI. Interviewed the implanted parents or teachers, asking them to rate the implanted hearing and speech ability according to Categories of Auditory Performance (CAP) and Speech Intelligibility Rating (SIR). Paired T test was performed to compare scores of CAP and SIR between before and 1 year after CI, while Spearman test was performed to compare correlation between EABR grades and post-operative CAP scores. RESULT: Among the IACS group, 2 cases weren't recorded typical EABR waveforms and without auditory response 1 year after a successful CI. The EABR waveforms in the IACS group were poorer than that in the control group, their EABR thresholds higher than the control group, and their EABR dynamic ranges less than the control group. The hearing and speech rehabilitation after CI showed that the results of CAP and SIR values (3.47 +/- 1.09 and 1.62 +/- 0.50) scored significantly lower than the control group (5.06 +/- 0.79 and 2.59 +/- 0.58) (P < 0.05), but significantly increased compared with pre-operation. Intra-operative EABR grades and post-operative CAP scores showed significant correlation (r = 0.78 , P < 0.05). CONCLUSION Intra-operative EABR can accurately monitor the integrity and functional status of the auditory pathway, be of important clinical value in predicting whether patients can acquire auditory responses with the aid of CI. CI can help patients with IACS to improve the ability of hearing and speech with EABR to screen out compatible implanted.
Adolescent ; Auditory Pathways ; Child ; Child, Preschool ; Cochlear Implantation ; Constriction, Pathologic ; Ear, Inner ; surgery ; Evoked Potentials, Auditory, Brain Stem ; Female ; Humans ; Infant ; Labyrinth Diseases ; physiopathology ; surgery ; Male ; Retrospective Studies ; Treatment Outcome ; Young Adult