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.

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.

Objective To investigate the feasibility of VTQ value of spleen in noninvasive assessment of staging of liver fibrosis in patients with hepatitis B.Methods VTQ values of spleen were measured in 56 patients with hepatitis B by using ARFI technique and liver biopsy was performed.The patients were then grouped according to the stages of liver fibrosis stage.The results were analyzed by the intergroup comparison,Pearson Correlation analysis,and receiver operating characteristic curve (ROC curve).Results There was positive association of the VTQ value with the stages of liver fibrosis,whose correlation coefficient was 0.83 (P ＜ 0.05);There was no significant difference between the spleen VTQ value and the liver fibrosis S1 and SO (P ＞ 0.05),whereas there were significant differences among other groups (P ＜ 0.05).The area under the ROC curve was 0.95,the cut-off value was 2.79m/s,and the specificity and sensitivity were 81.8％ and 91.7％ respectively.Conclusions The VTQ value measured by ARFI technique has a better value in noninvasive diagnosis of stages of hepatitis B liver fibrosis.

Objective To explore the mucosal healing quality of hydrotalcite combined with esomeprazole in gastric ulcer.Methods Forty-two patients visiting from June 2014 to December 2015 and diagnosed with gastric ulcer were selected and divided into combination therapy group and single therapy group with 21 patients in each group.The patients of combination therapy group received esomeprazole combined with hydrotalcite,and the patients of single therapy group received esomeprazole alone.The total therapeutic course was eight weeks.At the same period,21 health check-up participants were enrolled as normal control group.The healing of gastric ulcer was observed under white light endoscopy.The morphological changes of gastric pits and microvessel of mucosal at peripheral mucosa around ulcer and normal gastric mucosal were observed under narrow band imaging magnifying endoscopy.The gastric mucosa tissues of the two groups before and after treatment,and normal gastric mucosa of healthy control group were taken.The amount of deposition and composition of collagen fibers,the expression level of factor Ⅷ,the level of transforming growth factor (TGF)-beta1 and the content of hydroxyproline were analyzed by Masson,immunofluorescent and immunohistochemistry staining as well as enzyme linked immunosorbent assay.Chi square test,one-way analysis of variance (ANOVA),least significant difference (LSD) method,Dunnett's T3 and Kruskal-Wallis test and other method were used for comparison.Results After treatment,18 patients of combination therapy group (21 patients) had regular microvessel nets (85.7％),which was significantly more than those of single therapy group (12 cases,57.1％) and healthy control group (10 cases,47.6 ％),and the differences were statistically significant (x2 =4.200,P=0.040).In the comparison of maturity of regenerative mucosa between combination therapy group and single therapy group after treatment,the ration between collagen type Ⅰ and Ⅱ,deposition of collagen fibers,the number of factor Ⅷ positive cells,the level of TGF-beta1 and the content of hydroxyproline were 36.05 and 23.14;269 375.63.± 171 608.63 and 137 693.14±98 330.93;34.91±8.40 and 28.24±6.93;104 498.71±40 487.96 and 70 757.11±19 323.95;(1 897.80±879.35) and (1 230.57±536.05) μg/L,respectively;while in healthy control group,the above parameters were 36.81,245 696.90 ± 224 687.00,23.10 ± 8.40,94 048.04 ±41 306.55 and 1 681.20 ± 423.61 μg/L,and the differences were statitically significant among these three groups (H=7.375,F=3.465,11.680,5.190,5.160;all P＜0.05).Those parameters of combination therapy group were significantly higher than those of single therapy group (H=2.416,LSD method;all P＜0.05).Conclusion Hydrotalcite combined with esomeprazole in the treatment of gastric ulcer could significantly improve microvessel morphology,maturity degree of regenerative mucosal structure and function,and the mucosal healing quality was also superior to single esomeprazole group.

Objective To investigate factors impacting on local recurrence in cases of primary retroperitoneal liposarcoma (RPLS) after complete enbloc resection.Methods The clinical data of 47 cases of primary retroperitoneal liposarcoma were retrospectively analyzed.Results 3-year local recurrence rate was 62％.Single and multiple regression analysis showed preoperative needle biopsy,histological subtype,tumor size and capsular invasion were all risk factors related to postoperative local recurrence in primary retroperitoneal liposarcoma undergoing complete resection (P ＜ 0.05).Conclusion Preoperative aspiration biopsy,tumor poor differentiation,large tumor size tumor extracapsular spread all lead to high local recurrence rate after complete resection of primary retroperitoneal liposarcoma.

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 .