Objective To observe the effect of neuromuscular electric stimulation (NMES) on post-stroke dysphagia (PSD). Methods Two hundred patients with swallowing dysfunction after stroke were randomly divided into a control group with 67 cases and a study group with 133 cases. All patients received pharmacotherapy and swal-lowing training. The study group also received NMES. The study group was sub-divided into unilateral and bilateral cortical stroke sub-groups, an ischemic stroke sub-group and a hemorrhagic stroke sub-group. The swallowing levels of the groups were compared after 2 courses of treatment with NMES. Results After an average of 20 days of NMES treatment, the level of dysphagia and its severity improved significantly. The patients with dysphagia due to unilateral stroke improved, on average, more than those with bilateral stroke. Patients with dysphagia due to ischemic stroke improved more than those with hemorrhagic stroke. Conclusions NMES therapy combined with rehabilitation train-ing can significantly improve swallowing in patients with PSD.

Objective] To sum up director doctor He Ruoping’s by stages treatment experience in treating bladder cancer. [Method]By learning from director doctor He Ruoping for many years and combining my own clinical experience, from the etiology and pathogenesis, therapeutic principle of TCM syndrome differentiation treatment characteristics, etc, it sums up the teacher He ’s unique feature of by stages treatment of bladder cancer, and with 1 case for detailed explanation. [Result]Teacher He advocating the combination of traditional Chinese medicine and western medicine, puts forward the principle of by stages treatment to bladder cancer:treatment of postoperative perfusion stage, treatment of following up stage without perfusion and treatment of palliative transfer stage, and makes prescriptions in line with the characteristics of each stage. [Conclusion] Teacher He ’s by stages treatment to bladder cancer obtains the good curative effect, having enlightenment meaning to clinical practice, with promotion value.

OBJECTIVE:To investigate the market demand for residence drug allocation and dispatch in Kunming. METHODS:A questionnaire was carried out about the residence drug allocation and dispatch market in plan.RESULTS & CONCLUSION:The target market of residence drug allocation and dispatch is initially established,and the market holds the promising future in Kunming.

Objective To investigate the clinical characteristics, risk factors and prevention measures of carbapenem-resistant Klebsiella pneumoniae (CRKP) infection. Methods Thirty-nine cases whose CRKP isolation and culture were positive and who were confirmed with nosocomial infection in 2nd affiliated hospital medical school of Zhcjiang University between July 2006 and July 2008 were retrospectively investigated. Results There were 22 (56.4%) sputum specimens among CRKP samples. The average age of the patients was 64.0 years old and the average length of staying in hospital was 80.8 days. There wcre 36 patients who had been in intensive care unit (ICU) within 2 weeks and 26 were conscious disturbance,38 received urethral catheterization, 34 inserted with central venous catheter, 32 received tracheal intubation and 30 assisted with mechanical ventilation. There were 27 (69. 2 % ) patients who were co-infected with other bacteria and 8 were co-infccted with fungi. The mortality was 46. 2% in patients with CRKP infection. Before CRKP-positive culture, 27 (69.2%)experienced ＞4 kinds of antibiotics with the majority of β-lactams/β-lactamase inhibitors and carbapenems.Conclusions CRKP infection frequently occurrs in elder and patients who prolonged stay in hospital,especially patients in ICU. Invasive procedures could increase the infection opportunities.

BACKGROUND:Numerous experimental and clinical observations have shown new attachment formation in the periodontium by guided tissue regeneration. OBJECTIVE:To evaluate the efficacy of guided tissue regeneration combined with bone grafting for the treatment of root furcation defects. METHODS:A computer-based online search combined with manual retrieval was conducted up to 2015 to screen the relevant English and Chinese literatures addressing guided tissue regeneration, bone grafting, and root furcation defects. Vertical and horizontal probing depth and attachment loss were analyzed. Meta-analysis was performed using Stata/SE version 12.0 software by extracting data from the relevant articles. Moreover, the publication bias was tested. RESULTS AND CONCLUSION:The meta-analysis results showed that at 6 months after treatment, the alterations in vertical probing depth and periodontal attachment were significantly increased after guided tissue regeneration compared with open-flap debridement (P<0.000 01);the alterations and increment in the periodontal attachment were significantly increased after combined treatment of guided tissue regeneration and bone grafting compared with open-flap debridement (P<0.000 01);the reduction in the vertical and horizontal probing depth and the increment in periodontal attachment were significantly increased after combined treatment of guided tissue regeneration and bone grafting compared with guided tissue regeneration (P<0.000 01 or P=0.01). At 12 months after treatment, the reduction in vertical probing depth and the increment in attachment loss were significantly increased after combined treatment of guided tissue regeneration and bone grafting compared with guided tissue regeneration (P<0.000 01). These results indicate that the guided tissue regeneration combined with bone grafting in the treatment of root furcation defects is superior to guided tissue regeneration or open-flap debridement. In addition, in the latter two therapies, guided tissue regeneration shows a better therapeutic effect. However, the therapeutic effects of various types of regenerated membranes and bone grafts need further in-depth study to define the optimal treatment strategy.

Objective To analyze the efficacy and the safety of ultrasound guided multiple-spot sector stereotaxis in unipolar cooling cycle radiofrequency ablation treatment of adrenal malignant tumors.Methods 36 adrenocortical carcinoma primary or metastatic tumors were treated with ultrasound guided percutaneous radiofrequency ablation by the multiple spot sector stereotaxis in unipolar cooling cycle.All patients were performed contrast enchanced ultrasound (CEUS) 15 minutes after treatment to determine whether the tumors were completely inactivated,if did not completely inactivated based on the imaging,the same therapy can be repeated.To evaluate response,contrast-enhanced CT scans (CECT) or CEUS were obtained 1 month after the procedure,if did not completely inactivated,the same therapy can be repeated.Before and after the procedure,the blood cortisol,adrenocorticotropic hormone (ACTH) and sugar level were detected and compared respectively.Results The efficacy:in the 36 lesions,31 lesions were inactivated and 5 lesions were residual by realtime CEUS.32 lesions were inactivated and 4 lesions were residual by CECT one month after the RFA therapy.There were no significant differences between the two groups(x2 =0.127,P =0.722).The hormone level:the blood cortisol,ACTH and sugar level were recovered normal after the therapy.The complication and adverse reaction:①Pain:all the patients felt slight pain and thermal expasion of the ablation region,among them,19 patients felt obvious pain were relieved after using analgesic.② Fluctuation of heart rate:14 patients' heart rate were slowed down,it was reached to 25-55 beats per minute,0.5mg atropine was given by intravenous injection to make the heart rate return to normal.③ Fluctuation of bloodpressure:9 patients' bloodpressure were elevated in the procedure,systolic pressure was 21-28 kPa,diastolic pressure was 13-19 kPa,5 mg nicardipine was given then relieved.There was no serious complication and dead cases in all the patients.Conclusions RFA is a safe and effective procedure for the treatment of adrenal malignant tumors and has great value in clinic applications.

Objective To investigate the features of gallbladder carcinoma in two-phase spiral CT, and to analysis the values of two-phase spiral CT for the differential diagnosis between gallbladder carcinoma and chronic cholecystitis. Methods The two-phase spiral CT manifestations of 30 cases of gallbladder carcinoma, proved by surgery and pathology, and 30 cases of chronic cholecystitis were analyzed. Results According to the CT findings, the gallbladder carcinoma was categorized into 3 types: intraluminal mass of gallbladder in 6 out of 30 (20.0%), thickening of the gallbladder wall in 11 (33.7%), and mass replacing the normal gallbladder in 13(43.4%). The most common enhancement patterns of the wall in gallbladder carcinoma were hyperattenuation during the arterial phase, while isoattenuation with the adjacent hepatic parenchyma during the venous phase; or hyperattenuation during both phases. The most common enhancement pattern of the wall in chronic cholecystitis was isoattenuation during both phases, with clear hypoattenuation linear shadow in the gallbladder fossa. Other ancillary features of gallbladder carcinomas included: infiltration of the adjacent parenchyma, local lymphadenopathy and intrahepatic metastasis. Conclusion Two-phase spiral CT scan can identify the features of the gallbladder carcinoma and is helpful for the differential diagnosis of these two different disease entities.

Objective To investigate the expression of DNM T1 and PDCD4 in Tongue Squamous cell carcinoma and their signif‐icance to Clinical .Methods The protein expression of DNM T1 and PDCD4 in 40 cases of TSCC tissues and The adjacent no tumor tissues were measured by Elivision Two Step immunohistochemical method(IHC) ,the relationship between DNM T1 ,PDCD4 and clinicopathological parameters were analyzed .Results There was positively over expression of DNM T1 while the expression of PD‐CD4 was at a low lever or lost in TSCC tissues ,the expression of two genes DNM T1 and PDCD4 in the adjacent no tumor tissues were in contrast ;there was a significant negative correlation between DNM T1 and PDCD4 expression in TSCC(r = - 0 .452 ,P<0 .05) .The expression of DNM T1 protein were associated with histopathological differentiation types ,regional lymph node metasta‐sis and TNM staging(P< 0 .05) ,it had nothing to do with age and gender ;the expression of PDCD4 protein were associated with regional lymph node metastasis and TNM staging(P< 0 .05) ,and it had nothing to do with age ,gender ,histopathological differenti‐ation types .Conclusion Implying the abnormal expression of DNM T1 and PDCD4 protein might be closely related to the develop‐ment and progression of TSCC .DNM T1 may be participates in the inactivation of PDCD4 expression ,and led to the development of the cancer at last .

Objective:To evaluate the effects of neuregulin-1 (NRG-1) pretreatment on diaphragmatic function in septic rats.Methods:Twenty-six clean-grade healthy adult male Sprague-Dawley rats, weighing 220-260 g, were divided into 3 groups using a random number table method: sham operation group (group S, n=6), sepsis group (group Sep, n=10) and NRG-1 group (group N, n=10). Sepsis was induced by cecal ligation and puncture in anesthetized rats.Group S underwent simple laparotomy.At 30 min before operation, recombinant human NRG-1β 10 μg/kg was injected through tail vein in group N, while the equal volume of normal saline was given in S and Sep groups.At 24 h after operation, the survived rats were sacrificed, and the diaphragm was removed for determination of the contractile function and contents of tumor necrosis factor-α (TNF-α) and interleukin-6 (IL-6) (by enzyme-linked immunosorbent assay) and for examination of the pathological changes (by hematoxylin and eosin staining). Results:Compared with group S, the force-frequency curve was shifted downward, and the levels of TNF-α and IL-6 were increased ( P<0.01), inflammatory cell infiltration was observed in Sep and N groups.Compared with group Sep, the force-frequency curve was shifted upward , and the levels of TNF-α and IL-6 were decreased ( P<0.01), inflammatory cell infiltration was alleviated in group N. Conclusion:NRG-1 pretreatment can improve diaphragmatic contractile function in septic rats, and the mechanism is related to reducing diaphragmatic inflammatory responses.

Objective : To evaluate the excess mortality risk related to heat wave in Ningbo, Zhejiang from 2013 to 2018, so as to provide a basis for formulating coping strategies for heat wave. Methods : The data of daily mortality, meteorological and air quality from May to October in Ningbo from 2013 to 2018 were obtained from Ningbo Center for Disease Control and Prevention, Ningbo Meteorological Bureau and Environmental Monitoring Center of Ningbo, respectively. The generalized linear model ( GLM ) and distributed lag non-linear model ( DLNM ) were used to estimate the associations between heat wave and cause-specific mortality. Results : Among 1 104 days of the study period, 18 heat waves occured and lasted for 132 days, accounting for 11.96%. A total of 102 954 deaths were reported in the same period. The risks of mortality in circulatory system diseases ( RR=1.09, 95%CI: 1.03-1.16 ), respiratory system diseases ( RR=1.14, 95%CI: 1.04-1.25 ), digestive system diseases ( RR=1.38, 95%CI: 1.15-1.65 ), nervous system diseases ( RR=1.32, 95%CI: 1.08-1.61 ), mental disorders ( RR=1.51, 95%CI: 1.12-2.03 ) and accidental injury ( RR=1.18, 95%CI: 1.06-1.32 ) and all causes ( RR=1.10, 95%CI: 1.06-1.14 ) increased at lag 0-1 day of heat wave. The total excess death related to heat wave was 1 218 ( 95%CI: 731-1 705 ) . The excess deaths of circulatory system diseases, respiratory system diseases, accidental injury, digestive system diseases, nervous system diseases, mental disorders, urinary system diseases and endocrine system diseases were 313 ( 95%CI: 104-556 ), 206 ( 95%CI: 59-368 ), 164 ( 95%CI: 55-292 ), 122 ( 95%CI: 48-208 ), 69 ( 95%CI: 17-131 ), 56 ( 95%CI: 13-113 ), 18 ( 95%CI: -15-64 ) and 3 ( 95%CI: -51-72 ). The excess deaths of urinary system and endocrine system diseases was not statistically significant ( P>0.05 ). Conclusion Heat wave can increase the mortality risk on the day and after a day in Ningbo from 2013 to 2018. Circulatory system diseases, respiratory system diseases and accidental injury rank top three in excess deaths.