Objective To evaluate the effect of neuromuscular electrical stimulation (NMES) on swallowing function in brain injury patients with dysphagia.Methods Sixty-four patients with dysphagia were divided into A group (n=21,stimulated with T =700 ms,R =2 s,frequency =0.19 Hz),B group (n =22,T =700 ms,R =1 s,frequency =0.29 Hz),and C group (n =21,T =340 ms,R =400 ms,frequency =0.68 Hz).One pair of electrodes was placed at the midline under the chin over the submental muscle group.The intensity of stimulation ranged from 5 to 11 mA.The treatments were once a day,5 times a week,with 20 times as one course.The results were assessed with Kubota's water swallowing test before and 4 weeks after treatment.Results The water swallowing test scores were significantly reduced after treatment in all 3 groups,with significantly greater reductions in A group compared with B and C group.The effectiveness rate was 81％ in A group,73％ in B group and 67％ in C group,all statistically significant differences.Conclusion NMES can be an effective and safe treatment for dysphagia after brain injury.NMES appears to be most effective with T =700 ms,R =2 s,and a frequency of 0.19 Hz.

Objective To analyze the indication,ways,therapeutic effect,dose prescription and complication of skull base tumor treated by Gamma Knife.Methods Clinical data,including general information,method of treatment and therapeutic effect of 278 benign skull base tumors treated by Gamma Knife were studied retrospectively.Results All patients were followed up for at least 2 years.The clinical conditions improved significantly in 130 patients,remained stable in 125 patients,and worsened in 23 patients.The 5 years progression-free survival rate was 89.5%(249/278)by Kaplan-Meier analysis.The results of Log-rank analysis revealed that better results appeared in patients with smaller tumors.≤3 cm compared with those tumors＞3 am(X2=5.41,P=0.02),and in patients experiencing tumor resection compared with those without history of su~ery respectively(X2=3.96,P=0.047).10 of the 11 cases with tumors＞3 cm who were treated by volume-staged prescription achieved local tumor control.Brain edema occurred in 3 patients,apoplexy of tumor in 1 patient,hydrocephalus in 3 patents,dysfunction of cranial nerves in 12 patients.Conclusion For skull base tumor,Gamma Knife is a major choice,with low risk and maybe an alternative for those small tumors.For those residues after craniotomy,Gamma Knife maybe an auxiliary treatment,and it can be cautiously applied in those with large tumors who cannot tolerate surgery for various reasons.

Objective To measure anatomic data related to the thyroid cartilage and cricoid cartilage and to analyze their implications for anterior spine surgery.Methods From January 2015 to February 2017,Cervical spine CT image data of 309 normal adults (195 males,114 females) in our department were retrospectively analyzed.The transverse diameters of the thyroid cartilage and the cricoid cartilage was measured at three different levels as follows:the superior border of the thyroid cartilage(SBTC),the inferior border of the thyroid cartilage(IBTC),and the inferior border of the cricoid cartilage(IBCC).At those levels,the corresponding level and transverse diameter of the cervical vertebra or intervertebral disc were also determined.Differences of anatomic parameters for each gender and level,and the relationship between the transverse diameter and height and weight were analyzed.Results The transverse diameters of the thyroid cartilage or cricoid cartilage and the corresponding cervical vertebra or intervertebral disc were associated significantly with height and weight.The transverse diameters of the thyroid cartilage or cricoid cartilage gradually decreased from the level of SBTC (44.30±4.97 mm) to the level of IBTC (41.39±4.62 mm),and the latter to the level of IBCC (26.36±3.79 mm),but increased from the level of SBTC (27.47±2.66 mm) to the level of IBTC (29.00±3.15 mm),and the latter to the level of IBCC (31.48±3.49 mm) for the cervical vertebra or intervertebral disc.Differences of the transverse diameters of the thyroid cartilage or cricoid cartilage and the cervical vertebra or intervertebral disc on three levels had statistical significance.The transverse diameters of each level had individual differences,while men were greater than those for women.The thyroid cartilage was routinely located above the C5 (56.9％ for male,86.0％ for female).Differences of the frequency between men and women on three levels had statistical significance.Conclusion The Individual and sex differences in the location of the thyroid cartilage and the size of the thyroid cartilage and the cricoid cartilage provided anatomical basis for predicting the difficulty of intraoperative exposure,incidence of esophageal injuries and early postoperative dysphagia.

It was generally believed that muscular atrophy of paralyzed limbs after stroke was due to disuse. However, recent studies have found that secondary lesions of motor neurons in the contralateral anterior horn of the spinal cord and the decrease of motor units lead to denervation, which plays an essential role in muscular atrophy and muscle fiber type transition. This article reviews the phenomenon and mechanism of muscular atrophy and denervation of paralyzed limbs after stroke, to provide a reference for clinical evaluation and experimental research.