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RESUMO Objetivo comparar as eficácias da terapia fonológica tradicional e terapia fonológica associada à estratégia de gamificação em sujeitos com Transtorno Fonológico (TF). Método participaram dez sujeitos com TF que apresentavam o processo de substituição de líquidas. Os sujeitos foram randomizados em dois grupos: terapia fonológica tradicional (grupo controle - GC) e terapia fonológica associada a estratégia de gamificação mediada por computador (grupo gamificação - GG). A intervenção fonológica compreendeu, para ambos os grupos, etapas de percepção e produção de fala. As intervenções se diferenciaram na etapa de percepção, na qual o GG foi submetido ao jogo com estratégia de gamificação. Ao final de cada sessão, foram registrados a produção de fala dos sujeitos (% de acerto) para cada etapa terapêutica, a partir de palavras-alvo e palavras-sondagem. Para análise foram considerados: média de acerto dos sujeitos para cada etapa terapêutica; valores de PCC-R (Porcentagem de Consoantes Corretas Revisado) pré e pós terapia; além do número de sessões utilizadas para se atingir 85% de produção correta. Resultados não houve diferença estatisticamente significante entre os tipos de intervenção considerando a média de acertos das produções e o número de sessões. Houve efeito significante para as condições pré e pós terapia na comparação dos valores de PCC-R para ambos os modelos. Os sujeitos do GC tiveram os valores de PCC-R maiores do que as do GG. Conclusão ambos os modelos de intervenção apresentam resultados semelhantes, propiciando melhora no desempenho fonológico do sujeito desde a primeira sessão.
ABSTRACT Purpose to compare the efficacies of traditional phonological therapy and phonology associated with the gamification strategy in children with Phonological Disorder (PD). Methods ten individuals with PD participated who showed the process of replacing liquids. They were randomized into two groups: traditional phonological therapy (control group - CG) and phonological therapy associated with a gamification strategy mediated by computer (gamification group - GG). The phonological intervention comprised, for both groups, stages of speech perception and production. Interventions differed in the perception stage, in which the GG was submitted to the game with gamification strategies. At the end of each session, individuals speech production (% of correct answers) were registered for each therapeutic stage, based on target words and sounding words. For analysis the following were considered: The individuals mean of correct answers for each therapeutic stage; PCC-R value (percentage of correct consonants) pre and post therapy; beyond of the number of sessions used to reach 85% of correct production. Results there was no statistical difference between the types of intervention considering the average of correct answers of the productions and the number of sessions. There was a significant effect for pre- and post-therapy conditions in the comparison PCC-R values for both models. The individuals in the GC had the PCC-R values higher than those of GG. Conclusion both models of intervention present similar results, providing an improvement in the individuals phonological performance from the first session.
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Objective:To compare the clinical effect of miniplates plus reconstruction plate fixation assisted by preoperative digital design and conventional miniplates plus reconstruction plate fixation in the treatment of comminuted posterior acetabular wall fracture.Methods:A retrospective cohort study was used to analyze the clinical data of 35 patients with comminuted posterior acetabular wall fracture admitted to General Hospital of Central Theater Command of PLA from January 2012 to June 2019, including 26 males and 9 females, aged 25-63 years [(45.5±9.8)years]. A total of 16 patients received miniplates plus reconstruction plate fixation assisted by preoperative digital design (digital design group) and 19 patients received conventional miniplates plus reconstruction plate fixation (conventional group). The operation time, intraoperative blood loss, hospitalization time and fracture healing time were compared in the two groups. Matta radiological standard score was performed to assess the quality of fracture reduction at postoperative 2 days. Modified Merle d′Aubign-Postel score was used to evaluate hip function at postoperative 3 months, 6 months and final follow-up. Postoperative complications were observed.Results:All patients were followed up for 12-48 months [(30.1±8.9)months]. The operation time and intraoperative blood loss were (114.7±16.1)minutes and (323.4±26.1)ml in digital design group, significantly less than (179.8±67.3)minutes and (392.6±87.8)ml in conventional group (all P<0.01). There were no significant differences in hospitalization time, fracture healing time, excellent and good rate of quality of fracture reduction between the two groups (all P>0.05). The modified Merle d′Aubign-Postel score was higher in digital design group [(14.1±2.3)points, (15.4±2.3)points and (17.1±1.8)points] than those in conventional group [(13.7±2.2)points, (15.0±2.5)points and (16.8±2.1)points] at 3 months, 6 months and last follow-up, but there were no significant differences (all P>0.05). The modified Merle d′Aubign-Postel score showed significant differences within each group at each time point (all P<0.01). In digital design group, one patient was found with heterotopic ossification and one with traumatic arthritis. In conventional group, two patients were found with heterotopic ossification, one with traumatic arthritis and one with avascular necrosis of the femoral head. The rate of postoperative complications was 12.5% (2/16) in digital design group and was 21.1% (4/19) in conventional group ( P>0.05). Neither of the two groups had complications such as penetration of screws into the articular cavity, failure of internal fixation or iatrogenic sciatic nerve injury. Conclusion:Both miniplates plus reconstruction plate fixation assisted by preoperative digital design and conventional miniplates plus reconstruction plate fixation can achieve satisfactory clinical efficacy in the treatment of comminuted posterior acetabular wall fracture, but the former can significantly reduce operation time and intraoperative blood loss.
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Objective:To investigate the clinical efficacy of robotic navigation and percutaneous internal fixation in the treatment of fresh undisplaced scaphoid lumbar fractures.Methods:From November 2019 to October 2020, 8 patients were treated at Department of Hand Surgery, Xuzhou Renci Hospital for fresh undisplaced scaphoid lumbar fractures. There were 7 males and one female with an average age of 27.5 years (from 18 to 42 years), and 5 left and 3 right cases. Navigation by a Tianji orthopedic robot was conducted to decide the positions for implantation of percutaneous Herbert screws to fixate the fractures. The bone healing was followed up by regular X-ray and CT examinations. The functional recovery was evaluated by Mayo wrist score, grip strength, pinch strength and wrist range of motion, and the wrist pain was evaluated by visual analogue scale (VAS).Results:All the 8 patients were followed up for a mean time of 12.8 months (from 6 to 19 months). All the wounds healed by the first intention without any inflammation or infection. CT examination at 3 months postoperation found that all the fracture ends got united. At the final follow-up, the average active motions of the injured wrist were: 67.9° in flexion, 64.1° in extension, 21.2° in radial deviation and 52.2° in unlar deviation, respectively. The average grip strength was recovered to 31.3 kg, reaching up to 85.2% (from 66.7% to 100.0%) of the contralateral wrist; the average pinch force was recovered to 19.5 kg, reaching up to 89.3% (from 77.8% to 100.0%) of the contralateral wrist. At the last follow-up, the Mayo wrist function scores averaged 97.5 (from 95 to 100) and all the 8 cases were excellent. The VAS pain score of the wrist averaged 0.88 (from 0 to 2).Conclusion:In the treatment of fresh undisplaced scaphoid lumbar fractures, navigation with a Tianji orthopedic robot can be used to visualize percutaneous minimally invasive screw fixation so that accurate positioning and precise screw placement are ensured, leading to rapid rehabilitation.
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Objective To investigate the efficacy of CT scanning for 3D reconstruction and 3D printing in the internal fixation for in situ femoral condyle fractures.Methods A retrospective study was conducted of the 111 patients with in situ femoral condyle fracture who had been treated by internal fixation at Department of Traumatic Orthopaedics,The First People's Hospital of Hefei from June 2013 to January 2018.They were 59 males and 52 females,aged from 20 to 59 years(average,47 years).In 74 of them (observation group),the internal fixation was assisted by 3D printing using 3D images.There were 38 males and 36 females with an age of 44.5 ±4.7 years;there were 20 cases of type C1,40 cases of type C2 and 14 cases of type C3 according to the AO classification.In the other 37 patients (control group),the operation was assisted only by 3 D scanning.There were 21 males and 16 females with an age of 43.1 ±4.6 year;there were 8 cases of type C1,19 cases of type C2 and 10 cases of type C3 according to the AO classification.The 2 groups were compared in terms of operation time,clinical fracture healing time,intraoperative blood loss,hospital stay,number of fluoroscopy,knee joint score of Hospital for Special Surgery (HSS),fixation modes and postoperative complications.Results There were no significant differences in the preoperative general data between the 2 groups,showing comparability (P ＞ 0.05).All the patients were followed up for 8 to 12 months (average,10.6 months).The observation group had significantly shorter operation time (62.3 ± 4.7 minutes),fracture healing time (21.2 ± 3.4 weeks) and hospital stay (14.9 ± 3.3 days) than the control group (89.5 ± 6.0 minutes,25.1 ± 3.5 weeks,23.5 ± 3.5 days) (P ＜ 0.05).In the observation group,the intraoperative blood loss (84.1 ± 11.1 mL),fluoroscopy number (2.1 ±0.3 times) and HSS score (94.1 ± 4.2 points) were significantly less than those in the control group (129.6 ± 14.7 mL,4.7 ± 0.4 times and 86.5 ± 4.6 points) (P ＜ 0.05).There were no significant differences between the 2 groups in the use of L type iliac plate,dynamic iliac screws,retrograde interlocking intramedullary nail or minimally invasive internal fixation system (P ＞ 0.05).There were no significant differences in abnormal healing,joint adhesion,fixation fracture or incision infection between the 2 groups either (P ＞ 0.05).Conclusions CT scanning for 3D reconstruction can be used for multi-angle observation of the bone fragments in patients with femoral condyle fracture and 3D printing based on 3D reconstruction for manufacture of physical model of individualized fracture to assist the internal fixation.Combination of the two can help choose an appropriate fixation mode to facilitate fracture reduction.
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Objective To investigate the efficacy of three-dimensional (3D) printing used to assist the treatment of pilon fracture combined with ipsilateral tibial shaft fracture.Methods From May to July 2016,3 patients with pilon fracture combined with ipsilateral tibial shaft fracture were treated at Department of Traumatic Orthopedics,The Second Affiliated Hospital,University of South China.They were all male,aged from 26 to 47 years.They all had preoperative 3D CT scan.Their CT data were imported to Mimics software for 3D reconstruction.After their fracture 3D models were manufactured by 3D printing,precise patient-specific surgical plans were made to guide their actual operations.Postoperatively,Johner-Wruhs scores were used to evaluate the treatment of tibial shaft fracture,Burwell-Charnley scores to evaluate the treatment of pilon fracture and Tornetta scores to evaluate the therapeutic outcomes.Results All the operations were performed according to the patient-specific surgical plans designed preoperatively.All the fractures achieved bony union without any infection,exposure of bone or internal fixation,osteofascial compartment syndrome or neurovascular injury.The outcomes of tibial shaft fracture were excellent by Johner-Wruhs scoring,anatomic reduction was achieved for pilon fractures by Burwell-Charnley scoring and the therapeutic outcomes were excellent by Tornetta scoring.Conclusion In the treatment of pilon fracture combined with ipsilateral tibial shaft fracture,3D printing can help making of precise and patient-specific surgical plans to promote clinical efficacy.
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RESUMO Objetivo Desenvolver um game sobre saúde e higiene vocal (VoxPedia) e aplicá-lo em adultos, para investigar o conhecimento em cuidados vocais e compreender a autoavaliação vocal dos respondentes. Método Participaram 293 adultos, 204 mulheres e 129 profissionais da voz, convidados através de mídias digitais. Os participantes responderam: 1) Termo de Consentimento Livre e Esclarecido (TCLE); 2) Dados de Identificação; 3) Protocolo do Índice de Desvantagem Vocal (IDV-10); 4) Questionário de Saúde e Higiene Vocal (QSHV); 5) Aplicação do quiz VoxPedia. Resultados O VoxPedia foi desenvolvido com questões simples e com dinâmica que permitiu aos participantes conhecerem seu desempenho em tempo real. Os dados adquiridos através do quiz mostram que os profissionais da voz relataram menos desvantagem vocal e acertaram mais itens no QSHV e questões do VoxPedia. Profissionais da voz ou não, os participantes que erraram a natureza do impacto dos aspectos de saúde no QSHV referiram maior desvantagem vocal no IDV-10. Contudo, apesar da desvantagem autorreferida, a maioria não relata problemas de voz. Em contrapartida, quando o respondente relatou problemas de voz, nem sempre houve desvantagem percebida ou busca por terapia vocal. Conclusão O VoxPedia apresentou alguns conceitos de saúde e higiene vocal aos participantes. Além disso, possibilitou o estudo das relações entre conhecimento em cuidados vocais e autoavaliação vocal. Os dados sugerem que os indivíduos com mais conhecimento em cuidados vocais têm melhor autoavaliação de voz; participantes com pior autoavaliação vocal não percebem problemas de voz; e aqueles que percebem problemas vocais não necessariamente procuram cuidados profissionais.
ABSTRACT Purpose To develop a game on vocal health and hygiene (VoxPedia) and apply it to adults aiming to investigate knowledge about vocal health and the vocal self-assessment in this population. Methods The study sample was composed of 293 adults, of which 204 were women and 129 were voice professionals, invited to participate through digital media. Participants completed to the following forms and instruments: 1) Informed Consent Form (ICF); 2) Identification Data form; 3) Voice Handicap Index: 10 (VHI-10) protocol; 4) Vocal Health and Hygiene Questionnaire (VHHQ); 5) VoxPedia quiz. Results The VoxPedia quiz was developed using simple and dynamic questions that allowed the participants to know their performance in real time. Data collected through this quiz showed that voice professionals reported reduced voice handicap and had higher scores in the VHHQ and VoxPedia. Voice professionals or not, participants who answered wrongly to the nature of impact of health aspects in the VHHQ reported increased voice handicap in the VHI-10; however, despite the self-reported handicap, most of them did not report voice complaints. In contrast, when voice complaints were reported, the participants not always perceived handicap or searched for vocal therapy. Conclusion The VoxPedia quiz presented some concepts on vocal health and hygiene to the participants. In addition, it enabled the study of the relation between knowledge about vocal care and voice self-assessment. The data suggest that individuals with greater knowledge about vocal health and hygiene show better voice self-assessment, those with worse voice self-assessment do not perceive voice problems, and those who perceive voice problems do not necessarily seek professional assistance.
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Humans , Male , Female , Aged , Young Adult , Self-Assessment , Voice/physiology , Health Knowledge, Attitudes, Practice , Health Education/methods , Games, Experimental , Cross-Sectional Studies , Cohort Studies , Middle AgedABSTRACT
Tooth preparation is a basic operation in prosthodontics treatment and the quality of preparation influences the effect of treatment directly. How to achieve a precise and quantitative tooth preparation is always one of the main aims of dental prosthodontics. The known types of tooth preparation guide technique can be divided into visual guidance, passive constraint guidance and active constraint guidance (automated tooth preparation), respectively represented by silicon rubber index, tooth preparation guide plate and computerized numerical control cutting system (CNC cutting system). Studies in advanced manufacturing technologies such as robot systems and numerical control ultra-short pulse laser (USPL) have also been reported recently. This review comprehensively introduced tooth preparation quantitative guide techniques and partially summarized the application effects and limitations to provide reference for relative researches and clinical application.
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Objective To report the clinical effects of a 3D-printed metal drilling template used in surgery for complex upper cervical disorders.Methods Between August 2015 and June 2017,5 patients with upper cervical disorder complicated with complex cranial cervical junction deformity underwent instrumentation and fusion.They were 4 males and one female,aged from 3 to 36 years.All the patients underwent thin slice CT scan before operation.The CT image data were imported into a computer workstation for three dimensional reconstruction of individualized models of the upper cervical spine on which individualized drilling templates were designed.Guided by each of the individualized metal drilling templates manufactured by 3D printing,surgery via the posterior approach was performed in 2 cases and surgery via the combined anterior and posterior approach in 3 cases.After surgery,the screw trajectory was evaluated by CT scan.Results Surgery succeeded in all the 5 patients.A total of 5 pedicle screws and 5 laminar screws were drilled.Postoperative CT scan showed accurate placement of all the 10 screws.The patients recovered with no neurovascular complications.Conclusion Since an individualized 3D-printed metal drilling template can improve the accuracy and safety of screw placement,it can reduce surgical risks and enhance surgical success in the surgery for complex upper cervical disorders.
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BACKGROUND:The limitation of the traditional intramedulary nailing relies on the personal experience of the doctor. Moreover, the enlargement of the bone marrow causes the destruction of the biological environment of the marrow cavity and affects the healing of bone. OBJECTIVE:To observe therapeutic effect of digital technology assisted intramedulary nail fixation for femoral shaft fracture. METHODS:A total of 80 patients with femoral shaft fracture, who were treated in the Department of Orthopedics, Affiliated Hospital of Putian University from January 2010 to January 2014, were enroled. Digital technology was used to assist treatment. Three-dimensional digital model of femoral shaft fracture was established before treatment. Virtual reduction was conducted in the three-dimensional digital fractures. The diameter of medulary cavity was measured. Appropriate specification of intramedulary nailing was selected according to the measurement data. Closed reduction and intramedulary nailing were performed according to operation scheme of digital technology. RESULTS AND CONCLUSION:The 80 patients were folowed up for 12 to 24 months. Fractures were completely healed. At 12 months after treatment, they were evaluated by clinical curative effect standard in department of orthopedics. There were excelent in 62 cases, good in 15 cases, and good in 3 cases, with the excelent and good rate of 96%. No complications occurred such as infection, fixator breakage or loosening. These results verify that digital technology assisted intramedulary nail fixation for femoral shaft fracture obtained positive therapeutic effects, could obviously shorten operation time, reduce surgical trauma, and diminish intraoperative X-ray emission to patients and health care workers.
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Objective To discusse the feasibility and application value of the computer-assisted liver cancer ablation planning based on the three dimensional ultrasound.Methods Forty three-dimensional ultrasound images of 39 patients with 40 tumors'maximum diameter between 21 to 70 mm were collected and then acquired image segmentation and visualzation.The computer-assisted liver cancer ablation planning based on three dimensional ultrasound was comparied with the artificial ablation planning based on two dimensional ultrasound to find out the differences in the success rate,damage rate,time-consuming and the number of insertions between these two methods.Results Compared with the artificial ablation planning based on two dimensional ultrasound,the computer-assisted liver cancer ablation planning had a higher success rate(92.31% vs 53.85%,P =0.000),lower damage rate(7.50% vs 25.00%,P =0.034),shorter time-consuming(44.0 s vs 263.0 s,P =0.000)and less insersion times(3 vs 4,P =0.009).Conclusions The computer-assisted liver cancer ablation planning based on three dimensional ultrasound is more efficient and safety than the traditional way.
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BACKGROUND:Posterior pedicle screw fixation is an important method to treat various diseases of the spine and to stabilize the spine. Computer navigation system can completely, intuitively and truly reveal the morphology of various tissues and their positions so that the performer can obtain three-dimensional images in time and avoid the risk area of the operation to the utmost, and can directly introduce accurate placement of the screw in the vertebral body. OBJECTIVE:To evaluate the accuracy and safety of computer navigation technique-assisted posterior spinal pedicle screw placement.METHODS:307 patients with spine diseases, who were treated in the First Affiliated Hospital of Guangxi Medical University from July 2008 to January 2014, were enrol ed in this study. They received computer navigation technique-assisted posterior spinal pedicle screw placement and laminectomy for decompression. C-arm fluoroscopy was applied to assess the precision of pedicle screw position during the operation. The mean implantation time per screw and the exposure time to radiation were recorded. 3-day postoperative radiographs and CT examination, which al owed measurements of screw position relative to pedicle position according to Andrew classification, were performed routinely. RESULTS AND CONCLUSION:Of the 1 820 screws inserted by computer-assisted navigation, 1 778 were grade I (accuracy 97.69%). A total of 92 screws were implanted in the cervical vertebrae, including 90 grade-I screws (accuracy 97.82%). 502 screws were implanted in the thoracic vertebrae, including 492 grade-I screws (accuracy 98%). 1 226 screws were implanted in the lumbar vertebrae, including 1 196 grade-I screws (accuracy 97.2%). The mean implantation time per screw was (7.0±1.5) minutes. 215 patients were fol owed up for (12±6) months. No complications such as fixator displacement or breakage or neurovascular injury occurred. Above findings suggested that computer navigation system-assisted spinal pedicle screw implantation provides real-time, multi-perspective, three-dimensional visualization of spinal anatomy, ensures the accuracy and safety of spinal pedicle screw implantation, and apparently reduces exposure time to radiation.
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OBJETIVO: Verificar a aplicabilidade de um software na (re)habilitação de crianças com deficiência auditiva. MÉTODOS: A amostra foi composta por 17 crianças com deficiência auditiva, sendo dez usuárias de Implante Coclear (IC) e sete usuárias de Aparelho de Amplificação Sonora Individual (AASI). Foi utilizado o "Software Auxiliar na Reabilitação de Distúrbios Auditivos (SARDA)". Aplicou-se o protocolo de treinamento durante 30 minutos, duas vezes por semana, pelo tempo necessário para a finalização das estratégias que compõe software. Para mensurar a aplicabilidade do software no treinamento da habilidade de percepção da fala no silêncio e no ruído, foram realizadas avaliações com o Hearing in Noise Test (HINT) pré e pós o treinamento auditivo. Os dados foram analisados estatisticamente. RESULTADOS: O grupo de usuários de IC necessitou em média 12,2 dias para finalizar as estratégias e o grupo de usuários de AASI em média 10,14 dias. Os dois grupos apresentaram diferença entre as avaliações pré e pós no silêncio e no ruído. As crianças mais novas apresentaram maior dificuldade durante a execução das estratégias, porém não houve correlação entre a idade e o desempenho. Não houve influência do tipo do dispositivo eletrônico durante o treinamento. As crianças apresentaram maior dificuldade na estratégia que envolvia estímulos não verbais e na estratégia com estímulos verbais que treina a habilidade de atenção sustentada. A atenção e a motivação da criança durante a estimulação foram fundamentais para o bom rendimento do treinamento auditivo. CONCLUSÃO: O treinamento auditivo com o SARDA foi eficaz, pois propiciou melhora na habilidade de percepção da fala, no silêncio e no ruído, das crianças com deficiência auditiva.
PURPOSE: To verify the applicability of a software in the (re)habilitation of hearing impaired children. METHODS: The sample comprised 17 children with hearing impairment, ten with cochlear implants (CI) and seven with hearing aids (HA). The Software Auxiliar na Reabilitação de Distúrbios Auditivos - SARDA (Auxiliary Software for the Rehabilitation of Hearing Disorders) was used. The training protocol was applied for 30 minutes, twice a week, for the necessary time to complete the strategies proposed in the software. To measure the software's applicability for training the speech perception ability in quiet and in noise, subjects were assessed through the Hearing in Noise Test (HINT), before and after the auditory training. Data were statistically analyzed. RESULTS: The group of CI users needed, in average, 12.2 days to finish the strategies, and the group of HA users, in average 10.14 days. Both groups presented differences between pre and post assessments, both in quiet and in noise. Younger children showed more difficulty executing the strategies, however, there was no correlation between age and performance. The type of electronic device did not influence the training. Children presented greater difficulty in the strategy involving non-verbal stimuli and in the strategy with verbal stimuli that trains the sustained attention ability. Children's attention and motivation during stimulation were fundamental for a successful auditory training. CONCLUSION: The auditory training using the SARDA was effective, providing improvement of the speech perception ability, both in quiet and in noise, for the hearing impaired children.
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Child , Female , Humans , Male , Auditory Perceptual Disorders/rehabilitation , Correction of Hearing Impairment/methods , Therapy, Computer-Assisted/methods , Cochlear Implants , Hearing Aids , Medical Informatics Applications , Speech PerceptionABSTRACT
Objective: To observe the effect of computer-assisted cognitive training on the cognitive function and depression in patients with brain injury. Methods: Forty-six patients with cognitive impairment and depressive symptoms from 18 days to 1 year after brain injury were selected using single-blind method. The patients were divided into a computer-assisted training group (n = 26) and a traditional rehabilitation training group (n = 20). All patients received traditional rehabilitation training such as Bobath and Brunnstrom neurodevelopmental techniques, for 30 to 40 minutes twice a day, and drug therapy. At the same time, the computer-assisted training group received computer-assisted cognitive training for 30 minutes, twice a day. The training period was 5 weeks for both groups. The neurobehavioral cognitive status examination (NCSE) scale, clock drawing test and clinical judgment were used to identify the cognitive function; the Hamilton depression (HAMD, > 8) scale was used to assess the depressive state. Results: Before the training, there were no significant differences in the abilities of orientation, focus, language, memory, calculation, reasoning ability, and structure organizational skill scores of the NCSE scale, clock drawing test scores and HAMD scores between the computer-assisted training group and the traditional rehabilitation training group (P > 0.05). Circled digit oneAfter the training, all the scores of the NCSE scale and the scores of the clock drawing test were higher than those before training in both groups (P < 0.05 or P < 0.01); compared with the traditional rehabilitation training group, apart from the structure organizational skills, all other NCSE scale scores and the clock drawing test scores increased in the computer-assisted training group (P < 0.05 or P < 0.01). Circled digit twoAfter the training, the HAMD score in the computer-assisted training group was significantly lower than that before training (P < 0.01), and there was no significant change in the traditional rehabilitation training group. The HAMD score in the computer-assisted training group was lower than that in the traditional rehabilitation training group (P < 0.05). Conclusion: The computer-assisted cognitive training may improve cognitive impairment and depressive symptoms in patients with brain injury.
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Objective To evaluate the efficacy of servo controlled sevoflurane closed-circuit anesthesia and the feasibility of the predictive and intelligent control.Methods One hundred and forty-three ASA Ⅰ-Ⅲ patients (90 males, 53 females) aged between 3-77 yrs undergoing elective surgery were studied. Anesthesia was induced with intravenous fentanyl 2-3 ?g ?kg-1 , midazolam 0.12 mg?kg-1 and vecuronium 0.1 mg?kg-1 . After tracheal intubation the tracheal tube was connected to the servo-controlled closed-circuit system composed of IBM computer, O2 mass flow controller and electrically controlled sevoflurane injection pump and multifunctional monitor. The fresh gas flow of O2 = [body weight (kg)3/4 ? 10 + 20] ml?min-1 . The end-expired sevoflurane concentration was maintained at 1.3 MAC by predictive and intelligent control.Results The average wash-in time to reach the target concentration was (5.2 ?2.4) min. The O2 flow rate was(0.22?0.04) L?min-1 . The cumulative uptake of sevoflurane was 5.16 ml, 7.74ml, 9.17ml, 11.08ml, 12.57ml, 13.00ml, 14.18ml, 15.60ml, 18.56ml and 24.6 ml at 30, 60, 90, 120, 150, 180, 210, 240, 300 and 420 min respectively. The uptake rate of fluid sevoflurane was equivalent to (0.2673e-0.0598t + 0.2269e-0.0597t + 0.1150e-0.002t) ml?min-1 . Conclusion The servo controlled sevoflurane closed-circuit system can effectively control the pre-set end-tidal sevoflurane concentration in spite of the influence of multiple factors and is safe and effective.