Objective To appraise the clinical results of uterine bracesuture technique in the postpartum hemorrhage caused by uterine inertia of cesarean section treatment. Methods 21 cases of postpartum hemorrhage of cesarean section treated with uterine bracesuture technique served as the research group, 19 parturient patients treated with traditional technique for postpartum hemorrhage of cesarean section were recruited as control group. Operation time,hemorrhage volume,puerperal morbidity and therapeutic efficacy between the two groups were compared. Results All the cases in the research group were effectively stanched with preservation of uterine and no postoperative complication was found. The differences were statistically significant for operation time,hemorrhage volume,puerperal morbidity and the successful rate between the research group and control group ( P < 0.05). Conclusion Uterine bracesuture technique was particularly useful because its simplicity of application,lifesaving potential,relative safety and capacity for preserving the uterus and subsequent fertility. Uterine bracesuture technique was one of effective treatment for postpartum hemorrhage.

Aim: To develop a new preparation consisting of colon adhesive pellets of sodium 4-amino salicylate for the treatment of ulcerative colitis, and to characterize the adhesive of the prepared pellets. Methods: Centrifu-gation-granulation was used to prepare sodium 4-amino salicylate pellets into which HPMC K4M and Carbomer 934P as matrix were incorporated. The pellets were coated with Surlease~((R)), and filled into enteric-coated cap-sules. The release of sodium 4-amino salicylate from the pellets was evaluated in the pH 7. 4 buffer. The adhesive property of the pellets was characterized by evaluating the transit rate of the pellets in the rat intestine in vivo, and by determing the remaining( %) of the pellets in the isolated rat colonic segment in vitro. The adhesive of the pel-lets in vivo was also verified by X-rays. Results: It was shown that the resultant pellets of round shape, good uni-formity in size, and favorable rigidity possessed the colon-adhesive and sustained-release properties. Conclusion:The simple, economical and practical approach was sucessfully utilized in the preparation of sodium 4-amino sa-licylate pellets with the remarked colonic adhesion and targeting.

Objective To evaluate the fiber altering and clinical relationship in patients with occipital and temporal lobe cerebral infarction with DTI.Methods Fifty patients suffering from cerebral stroke were analyzed with conventional MRI,DWI and DTI. The fibers of visual pathway were depicted ,and their fractional anisotropy (FA),apparent diffusion coefficient (ADC),isotropic im-age (Iso)and T2-weighted trace were measured and analyzed.Results Regions of interest (ROIs)were placed in infarction and nor-mal contralateral tissue for tracking the visual pathways.The different parameters were measured.FA is useful to differentiate hy-per-acute stroke from acute and sub-acute stroke.FA values increased slightly in hyper-acute and decreased in acute,sub-acute and chronic phase.The values of ADC in infarction regions in hyper-acute,acute and sub-acute phases were lower than those of the con-tralateral tissue.Iso and T2-weighted trace increased in acute phase and decreased in chronic phase.DTT was used to show the way and chang of visual pathway.Conclusion DTI could track the fiber of visual pathway,and depict the fiber of infarction zone.DTT could be used in evaluating the prognosis of patients.

Objective:To observe the effect of repeated, bilateral administration of high-frequency transcranial magnetic stimulation (rTMS) in treating post-stroke dysphagia.Methods:Forty-five persons with post-stroke dysphagia were randomly divided into a bilateral group ( n=14 after one dropout), an affected group ( n=15) and a healthy group ( n=15). All received 30 minutes of conventional swallowing rehabilitation training 5 times a week for 2 weeks from a speech therapist. Those in the affected group also received 5Hz rTMS applied to the motor cortex controlling the suprachyoid muscle group. The bilateral group received the same stimulation bilaterally with the same duration and treatment course. Videofluoroscopy was used to assess their swallowing before and after the 2 weeks of treatment. It was rated using the penetration-aspiration scale (PAS) and the functional swallowing disorder scale (FDS). Surface electromyography was employed to evaluate suprachyoid muscle function. Cortical excitability was assessed by measuring the resting motor threshold (RMT) of the unaffected hemisphere. Results:After the treatment, the average PAS, FDS and muscle function values had improved significantly for all three groups, but significant RMT differences were observed only between the bilateral and the unaffected group. Significant differences in the average FDS and PAS scores were observed after the treatment, as well as significant changes in FDS and muscle function between the affected group and the other two groups. The average FDS scores before and after treatment were significantly different between the unaffected and bilateral group, with the former scoring significantly better than the latter. But no significant differences in the average PAS scores were observed after the treatment.Conclusions:5Hz rTMS of either the unaffected or affected cerebral cortex (or bilateral) can effectively improve the swallowing function of persons with post-stroke dysphagia. Bilateral stimulation has the greatest therapeutic effect, followed by stimulation of the unaffected cerebral cortex.

Objective To observe the effect of injecting botulinum toxin type A ( BTX-A) into the tibialis anterior muscle on spasm and the walking function of stroke survivors with spastic foot drop and strephenopodia. Methods Fifty-six stroke survivors with spastic foot drop and strephenopodia were randomly divided into a tibialis anterior injection group ( Group TA) and a conventional injection group ( Group CG) , each of 28. Both groups had 50 U of BTX-A injected into the medial-lateral heads of the affected gastrocnemius and soleus muscles, and 35 U in-jected into each of two sites in the tibialis posterior. Group TA was additionally injected with 30 U in the tibialis ante-rior. Before the injection, as well as 2, 4 and 12 weeks afterward, both groups were evaluated using the modified Ashworth scale (MAS) for the plantar flexors and varus muscle groups, a 10-minute walking test (10 m-WT), a simple Fugl-Meyer assessment ( FMA) of the lower limb and a timed up and go test ( TUG) . Results Before the injection, there were no statistically significant differences in the average MAS, 10 m-WT, FMA or TUG results be-tween the two groups. After 2 weeks, however, the average MAS score of both groups had decreased significantly, and that improvement was maintained at 4 and 12 weeks after the injection. Moreover, 2, 4 and 12 weeks after the injec-tion, significant differences in the average MAS score were observed between the two groups. The average 10m-WT re-sults, FMA scores and TUG times of both groups also improved significantly, but there were significant differences between the two groups′10m-WT times and FMA scores after 2 and 4 weeks. Conclusions Injecting a small dose of BTX-A into the tibialis anterior can further relieve spasm in the tibialis anterior muscle and improve the walking a-bility of stroke survivors with spastic foot drop and strephenopodia.

Objective:To explore the effect of high-frequency and low-frequency transcranial magnetic stimulation (rTMS) on the unaffected pharyngeal motor cortex of dysphagic stroke survivors.Methods:Forty-two stroke survivors with dysphagia were enrolled and randomly divided into a high-frequency stimulation group ( n=14), a low-frequency stimulation group ( n=13), and a sham group ( n=15). All received conventional swallowing training. The high- and low-frequency stimulation groups additionally received 250 pulses of 5Hz or 1Hz rTMS over the cortical representation of the mylohyoid muscle on the unaffected side daily for 2 consecutive weeks. In the sham group, sham rTMS was applied with identical protocols. Before and after the intervention, all subjects were subjected to a videofluoroscopic swallowing study and surface electromyography (sEMG). They were also evaluated using the fuctional dysphagia scale (FDS) and the penetration aspiration scale (PAS). Results:After the intervention, a significant improvement was observed in the average PAS, FDS and sEMG results in both rTMS groups compared with the sham control group. The average FDS score of the high-frequency stimulation group had improved significantly more than that of the low-frequency group.Conclusions:rTMS of the contra-lesional cortical representation of the mylohyoid muscle at either 5Hz or 1Hz can effectively improve dysphagia post-stroke. The higher frequency gives superior results.

Purpose: To evaluate the incidence and identify the risk factors for radiotherapy-induced oral mucositis among patients with nasopharyngeal carcinoma. Methods: A meta-analysis was conducted. Eight electronic databases (Medline, Embase, Cochrane Library, CINAHL Plus with Full Text, Web of Science, China National Knowledge Infrastructure, Wanfang Database, and Chinese Scientific Journals Database) were systematically searched from inception to 4 March 2023 for relevant studies. Study selection and data extraction were conducted by two independent authors. The Newcastle‒Ottawa scale was used for quality assessment among the included studies. Data synthesis and analyses were performed in R software package version 4.1.3 and Review Manager Software 5.4. The pooled incidence was calculated using proportions with 95% confidence intervals (CIs), and the risk factors were evaluated using the odds ratio (OR) with 95% CIs. Sensitivity analysis and predesigned subgroup analyses were also conducted. Results: A total of 22 studies published from 2005 to 2023 were included. The results of the meta-analysis showed that the incidence of radiotherapy-induced oral mucositis was 99.0% among nasopharyngeal carcinoma patients, and the incidence of severe radiotherapy-induced oral mucositis was 52.0%. Poor oral hygiene, overweight before radiotherapy, oral pH < 7.0, the use of oral mucosal protective agents, smoking, drinking, combined chemotherapy, and the use of antibiotics at early treatment stage are risk factors for severe radiotherapy-induced oral mucositis. Sensitivity analysis and subgroup analyses also revealed that our results are stable and reliable. Conclusions Almost all patients with nasopharyngeal carcinoma have suffered from radiotherapy-induced oral mucositis, and more than half of patients have experienced severe oral mucositis. Facilitating oral health might be the key focus of reducing the incidence and severity of radiotherapy-induced oral mucositis among nasopharyngeal carcinoma patients.Registration numberCRD42022322035.