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Objective To compare the validity of Montreal cognitive assessment (MoCA) versus mini-mental state examination (MMSE) in screening cognition impairment in elderly patients with cranio-cerebral trauma.Methods Cognitive function in 40 elderly patients with cranio-cerebral trauma and 40 healthy elderly individuals were assessed by MoCA and MMSE.Receiver operating characteristic (ROC) curve analysis were performed to determine the optimal sensitivity and specificity of MoCA and MMSE.Results The total score and all the sub-test scores of MoCA were much lower in cranio-cerebral trauma patients than in the control group (all P＜0.05).The total score and orientation,calculation,recall,language sub scores of MMSE were significantly decreased in the elderly patients with cranio-cerebral trauma as compared with those in the controls (P＜0.05),while there were no significant differences in the immediate memory and language scores between the two groups (both P＞0.05).The area under the receiver operating characteristic curve showed that MoCA (0.92±0.03) ＞ MMSE (0.74±0.06) (Z=2.460,P＜0.01).When screening the cognition impairment in elderly patients with cranio cerebral trauma,the best cut-off scores of MoCA and MMSE were 24.5 and 27.5 respectively.Conclusions Cognition impairment is decreased in elderly patients with cranio cerebral trauma.The MoCA is superior to the MMSE as a screening instrument in detecting cognition impairment in elderly patients with cranio-cerebral trauma.
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Objective To observe the effect of cognitive rehabilitation training based on games on cognition of the traumatic brain injury (TBI) patients.Methods 60 cases of patients according with the inclusion and exclusion criteria were divided into the control group and the training group with 30 cases in each group.The Montreal cognitive assessment (MoCA) test scores of all patients were lower than 26 points.The training group accepted the cognitive rehabilitation training based on games such as exactly the same game,drum game and picture memory game,while the control group did not accept the training.After one month,all patients accepted the MoCA test again.Then we analyzed the differences of the cognition between the two groups.Results After 30 days of training,all items of the cognitive function increased except the sub-item of abstraction.While in the control group,only the scores of attention,delayed recall,orientation and the total score showed alleviation.And all the scores of the training group were higher than those of the control group except the sub-item of abstraction.Conclusions Cognitive rehabilitation training based on games can effectively improve the cognitive function of TBI patients.
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Objective To evaluate the utility of modified Z-stent in treatment for Budd-Chiarisyndrome (BCS). Methods A retrospective study was used in twelve BCS patients treated in twohospitals. The Doppler examination was carried out in all patients preoperatively, so as to confirm thenature of the lesion and chose correct type of endovascular modified Z-stent. Under DSA monitoring formembranotomy and dilation of the inferior vena cava(IVC), after that, insert the marked modified Z-stent to IVC correctly, and put the non-stent part to hepatic vein orifice. The cavography and hepaticvenography should confirm the position of the Z-stent. All of 12 patients with membranous obstructionof the IVC(MOVC) or segmental obstruction of the IVC (SOVC)were underwent modified Z-stentplacement. Results The IVC pressure (IVCP) before smd after membranotomy (dilation) were 27.33± 4.12cmH2O and 18.67 ± 5.07cmH2O (P＜0.01). Comparing with dilation and putting stent group,the IVCP decreased from 18.67 ± 5.07cmH2O to 11.42 ± 2.11 cmH2O ( P ＜ 0.01 ). The modffied Z-stent could avoid hepatic vein orifice getting compression and resist the retraction of IVC throughly infollowing-up period of 2.5 years. Conclusion s The endovascular treatment of BCS with modified Z-stent is more effective and safer to prevent thrombosis. Further study will be required to observe theirlong term effects.
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Objective To evaluate the effect of rediological intervention on thrombotic membranous obstructive Budd-Chiari syndrome(TMOB-CS) .Methods Seventeen cases of TMOB-CS were treated with mutliple stent inplantation to press the thrombus with PTA.Results The inferior vena cave(IVC) pressure declined from(29.4?3.13)cm H 2 O to (3.45?3.20)cm H 2 O after the multiple stent inplantation.There was no severe complication such as pulmonary thrombembolism occurrence in this series.All the patients had been followedup for 3 to 40 months and showed good results.Conclusion Multiple stent inplantation pressing the thrombus with PTA can be used to treat the patients with TMOB-CS.