The cleft lip and palate (CLP) is one of the most common craniofacial malformations in humans. We collected functional magnetic resonance data of 23 CLP patients before rehabilitation training (Bclp) and 23 CLP patients after rehabilitation training (Aclp), who were performing Chinese character pronunciation tasks, and performed brain activation analysis to explore the changes of brain mechanism in CLP patients after articulation disorder rehabilitation training. The study found that Aclp group had significant activation in the motor cortex, Broca area, Wernicke area and cerebellum. While the Bclp group had weak activation in the motor cortex with a small activation range. By comparing the differences and co-activated brain regions between the two groups, we found that rehabilitation training increased the activity level of negatively activated brain areas (cerebellum, left motor area, Wernicke area, etc.) to a positive level. At the same time, the activity level of weakly activated brain areas (right motor area, Broca area, etc.) was also increased. Rehabilitation training promoted the activity level of articulation-related brain regions. So that the activation intensity of articulation-related brain regions can be used as a quantifiable objective evaluation index to evaluate the effect of rehabilitation training, which is of great significance for the formulation of rehabilitation training programs.
Objective To investigate the influence of airflow limitation upon lung deposition of inhaled corticosteroids in patients with chronic obstructive pulmonary disease ( COPD) . Methods The radionuclide 99mTc was used to lable budesonide which was inhaled through compressor nebulizer. Lung deposition was evaluated by nuclear medicine pulmonary ventilation scintigraphy. Peripheral to central ratio of lung deposition ( P/C% ) was calculated by region of interest ( ROI) metod. Results Forty-threepatients with stable COPD were enrolled in the study, of whom 41 patients completed the trial. The median age was 68 years ( range, 48 to 79 years) and the median FEV1 was 44. 9% predicted. The P/C% was ( 47. 96 ±6. 08) % . The patients with P/C% more than 50% had a higher FEV1% pred and FEV1 /FVC than those with P/C% less than 50% [ FEV1% pred: ( 51. 85 ±18. 20) % vs. ( 40. 52 ±12. 99) % .FEV1 /FVC: ( 59. 95 ±11. 87) % vs. ( 51. 73 ±9. 28) % ] . There was a positive correlation between P/C% and FEV1% pred ( r = 0. 391, P = 0. 024) and FEV1 /FVC ratio ( r = 0. 517, P = 0. 002) . Conclusion Lung peripheral airway deposition of inhaled corticosteroids was limited by airflow obstruction.
Objective To formulate an evidence-based treatment plan for a patient with suspected pyogenic liver abscess. Methods Based on the clinical questions raised by a patient with suspected pyogenic liver abscess, we searched The Cochrane Library (Issue 4, 2007), MEDLINE (1996 to January 2008), ACP Journal Club (1991 to January 2008), and Chinese Journal Full-text Database (1994 to January 2008) for systematic reviews, randomized controlled trials (RCTs) and case-control studies. The quality of the included studies was assessed. Results We did not find any systematic reviews or large-scale RCTs involving a comparison between laparoscopic drainage and surgical drainage in the treatment of pyogenic liver abscess. Four clinical retrospective studies closely related to our questions were found and assessed. These studies concluded that laparoscopic drainage for liver abscesses was a safe alternative for patients requiring surgical drainage. Based on the current evidence, as well as our clinical expertise and the patient’s values, laparoscopic drainage was not used for this patient and surgical drainage was applied. The patient was recovered and discharged. Conclusion Current evidence showed that laparoscopic drainage might be effective and safe for liver abscesses but high-quality large-scale randomized controlled trials are still required.
Objective To explore the safety and feasibility of spontaneous breathing anesthesia combined with tubeless uniportal thoracoscopy in pulmonary bullae surgery. Methods Totally 112 patients with pulmonary bullae in the Affiliated Hospital of Inner Mongolia Medical University from March 2015 to May 2017 were enrolled. According to the random number chosen by computer, the patients were randomly divided into two groups: a tubeless group (spontaneous breathing anesthesia combined with tubeless uniportalthoracoscopy) and a control group (uniportal thoracoscopy by general anesthesia with tracheal intubation) . There were 49 males and 7 females with an average age of 25.5±6.5 years in the tubeless group, and 50 males and 6 females with an average age of 23.5±4.5 years in the control group. The difference of the lowest intraoperative arterial oxygen saturation (SaO2), SaO2 at postoperative one hour, operation time, postoperative awakening time, hospital stay, hospitalization cost and postoperative pain score were analyzed. Results There was no significant difference between the two groups in the operation time, the lowest SaO2, SaO2 at one hour after the operation and the partial pressure of carbon dioxide (PaCO2). The awakening time and duration of postoperative hospital stay in the tubeless group was shorter than those in the control group (P=0.000). The cost of hospitalization in the tubeless group was less than that in the control group (P=0.000). The discomfort caused by urinary tract and visual analogue score (VAS) in the tubeless group were better than those in the control group. Conclusion It is safe and feasible to use spontaneous breathing anesthesia combined with tubeless uniportal thoracoscopy in pulmonary bullae resection.
目的探讨胸腔镜肺癌切除术的临床应用价值。 方法回顾性分析2009年3月至2015年3月内蒙古医科大学附属医院行胸腔镜肺癌肺叶或亚肺叶切除术135例患者的临床资料，其中男86例、女49例，年龄56.3（44～81）岁。完成胸腔镜肺叶切除120例，右肺中下叶切除4例，肺楔形切除6例，肺段切除5例，同时行淋巴结清扫术。 结果围手术期死亡1例，无支气管胸膜瘘及二次手术者。3例患者中转开胸，余均在腔镜下顺利完成手术。 结论胸腔镜肺癌切除术安全有效，合理选择手术适应证可获得良好的治疗效果，值得在基层医院推广应用。