Objective To observe the effect of acupuncture plus rehabilitation in treating deglutition disorders due to cerebral stroke and its effect on each link of the neural pathway of deglutition function. Method By adopting the prospective randomized controlled method, ninety-nine patients with deglutition disorders after cerebral stroke were recruited and divided into an acupuncture-rehabilitation group, a pharyngeal acupuncture group, and a control group, respectively 33 cases, 34 cases, and 32 cases in each group. The acupuncture-rehabilitation group was intervened by acupuncture respectively at scalp, pharyngeal, and the root of tongue plus basic treatment, the pharyngeal acupuncture group was by acupuncture at the deglutition point (Extra) plus basic treatment, while the control group was by the basic treatment alone, once a day, 4 weeks in total. The Functional Oral Intake Scale (FOIS) and Clinical Nursing Swallowing Assessment Tool (CNSAT) were evaluated and statistically analyzed before and after intervention. Result The component scores of CNSAT were significantly improved after intervention in the acupuncture-rehabilitation group (P<0.01); the component scores of CNSAT were significantly changed after intervention in the pharyngeal acupuncture group (P<0.05);the CNSAT component scores in the acupuncture-rehabilitation group were significantly different from that in the pharyngeal acupuncture group and control group after intervention (P<0.01); the CNSAT component scores in the pharyngeal acupuncture group were significantly different from that in the control group after intervention (P<0.05). The FOIS scores were enhanced in the three groups after treatment; the FOIS score was significantly changed in the acupuncture-rehabilitation group after intervention (P<0.01);the FOIS score was markedly changed in the pharyngeal acupuncture group after intervention (P<0.05);the FOIS scores in the acupuncture-rehabilitation group and pharyngeal acupuncture group were both significantly higher than that in the control group (P<0.01,P<0.05). Conclusion The scalp-pharyngeal-root of tongue sequential-acupuncture plus rehabilitation can effectively mitigate the deglutition problems after cerebral stroke, improve the food-intake ability of the patients, and reduce the risk of mistake inhalation.

Objective To investigate the correlation of the expressions of P170,topoisomerase Ⅱ(TOPⅡ)and the proliferation in gliomas.Methods Ki-67 was used as the marker of the proliferation in gliomas.The expressions of P170,TOPⅡ and Ki-67 were tested by S-P immunohistochemical technique using monoclonal antibody to their protein in 54 cases of low-grade gliomas(WHO Ⅰ～Ⅱ grade)and 54 cases of high-grade gliomas(WHO Ⅲ～Ⅳ grade),analysis of the clinical and follow-up were performed.Results The expressions of P170,TOPⅡ and Ki-67 had significant differences between low-grade and high-grade gliomas(P<0.01).Correlation analysis showed that the expression of P170 was negatively related with Ki-67(r=-0.276,P=0.019);the expression of TOPⅡ was positively related with Ki-67(r= 0.637,P<0.001);there was no correlation between the expressions of P170 and TOPⅡ.Conclusion The expressions of P170 and TOPⅡ are associated with the malignant prognosis in gliomas.

Objective To compare if the Montreal cognitive assessment (MoCA) performed in the morning or afternoon would affect abnormal rate of cognitive function in the elderly with stroke.Methods A total of 378 senile patients (≥ 65 years) with acute ischemic stroke and low NIHSS score (≤ 3) were enrolled in the prospective study,which was held in the Department of Neurology at Cangzhou Hospital of Integrated Traditional Chinese Medicine.MoCA was assessed after one month of hospitalization.Based on the time of MoCA assessment,all patients were randomly divided into the group A (assessed in the morning,9 am-12 am) and the group B (assessed in the afternoon,12 am to 5 pm).Clinical data were collected,and RANKIN scale (mRS) examination was performed.Moreover,patients were further divided into severe cognitive impairment (SCI) subgroup (score ＜ 20),mild cognitive impairment (MCI) subgroup (score 20-25) and no cognitive impairment (NCI) subgroup (score ＞ 26) according to the MoCA score.Results There were 189 patients in the group A (50％),and 189 cases in the group B (50％).There was no significant difference in age,gender,education level,disability (mRS score ＜ 1),history of hypertension,diabetes,hyperlipidemia,smoking and atrial fibrillation between the two groups.Based on the MoCA score,211 cases had NCI,142 had MCI,and 25 had SCI.Compared with patients in group B,patients in group A was associated with significantly higher positive rate of SCI[12.2％ (23/189)vs.1.1％ (2/189),P=0.000],MCI[40.2％ (76/189)vs.34.9％ (66/189),P=0.013]and slightly higher positive rate of NCI[56.6％ (107/189)vs.55.0％ (104/189),P=0.214].Conclusions The test time of MoCA may have an effect on the cognitive function detection rate in elderly patients with stroke,and the time of MoCA examination should be considered in clinical examination.

Objective:To evaluate the recurrence and progression of patients with pT1 high grade urothelial carcinoma of bladder (UCB) and glandular differentiation.Methods:We retrospectively analyzed the clinical and pathological information of 208 patients diagnosed as pT1 high grade urothelial carcinoma in the Fifth Central Hospital of Tianjin from January 2006 to February 2019.Among them, 78 cases were diagnosed as glandular differentiation (UCGD), the other 130 patients without histologic variants were served as control. The UCGD group included 62 male and 16 female, whose median age was 67 years old (range 38-81 years old). The control group contained 105 male and 25 female, whose median age was 66 years old (range 40-82 years old). Kaplan-Meier and Cox proportional hazard regression analyses were used to evaluate the predictors of oncologic outcomes.Results:The disease recurrence rate and progression rate in UCGD group were 65.4% (51/78) and 28.2% (22/78), higher than 38.5%(50/130) and 14.6%(19/130) of control group ( P<0.05). The median recurrence time in UCGD group was 41 months while 55 months in the control group. The median progression time in UCGD group was 39 months while 54 months in the control group. According to the univariate analysis, largest tumor size ( P=0.030), UCGD ( P=0.003) and lymphovascular invasion (LVI) ( P=0.032) were associated with disease recurrence. UCGD ( P=0.036) and LVI ( P=0.011) were associated with progression. Additionally, Cox multivariate analysis revealed that UCGD ( P=0.001), LVI ( P=0.038) were the independent factors of disease recurrence. UCGD ( P=0.007) and LVI ( P=0.037) were also found to be the independent factors of disease progression. Conclusions:Patients with T1 stage UCB and UCGD are at higher risk of disease recurrence and progression. Therefore, these patients should be followed up closely after being diagnosed and undergo individual treatment according to the situation.

Objective:To evaluate the recurrence and progression of patients with pT1 high grade urothelial carcinoma of bladder (UCB) and glandular differentiation.Methods:We retrospectively analyzed the clinical and pathological information of 208 patients diagnosed as pT1 high grade urothelial carcinoma in the Fifth Central Hospital of Tianjin from January 2006 to February 2019.Among them, 78 cases were diagnosed as glandular differentiation (UCGD), the other 130 patients without histologic variants were served as control. The UCGD group included 62 male and 16 female, whose median age was 67 years old (range 38-81 years old). The control group contained 105 male and 25 female, whose median age was 66 years old (range 40-82 years old). Kaplan-Meier and Cox proportional hazard regression analyses were used to evaluate the predictors of oncologic outcomes.Results:The disease recurrence rate and progression rate in UCGD group were 65.4% (51/78) and 28.2% (22/78), higher than 38.5%(50/130) and 14.6%(19/130) of control group ( P<0.05). The median recurrence time in UCGD group was 41 months while 55 months in the control group. The median progression time in UCGD group was 39 months while 54 months in the control group. According to the univariate analysis, largest tumor size ( P=0.030), UCGD ( P=0.003) and lymphovascular invasion (LVI) ( P=0.032) were associated with disease recurrence. UCGD ( P=0.036) and LVI ( P=0.011) were associated with progression. Additionally, Cox multivariate analysis revealed that UCGD ( P=0.001), LVI ( P=0.038) were the independent factors of disease recurrence. UCGD ( P=0.007) and LVI ( P=0.037) were also found to be the independent factors of disease progression. Conclusions:Patients with T1 stage UCB and UCGD are at higher risk of disease recurrence and progression. Therefore, these patients should be followed up closely after being diagnosed and undergo individual treatment according to the situation.