ObjectiveTo investigate the relationship of clinical manifestations with prognosis of patients with diffuse axonal injury (DAI) and select the indices that can accurately evaluate the prognosis so as to create a predictive model of outcome of DAI patients.MethodsClinical data of 98 DAI patients were retrospectively analyzed to identify the relationship between the indices and outcomes through Cochran-Mantel-Haenszel x2 test or Student-Newman-Keuls one way variance test via SAS 8.1.Then,the indices was analyzed through multivariant cumulative stepwise way so as to establish the Logistic regression model. Results (1)The indices including Glasgow Coma Score (GCS) on admission,combined with other type of cerebral injuries,unstable vital signs,abnormal pupil size and reactivity,decerebrate rigidity,imaging with characteristic DAI signs,paralysis of the limbs and length of coma were correlated with the outcome,while the indices including gender,age,injury mechanism,pathologic signs and decorticate rigidity were insignificantly associated with the outcome.(2) The logistic regression model showed that GCS on admission,paralysis degree of the limbs,abnormal pupil size and reactivity,and combined with cerebral injuries were the optimum predictors of outcome of the DAI patients.ConclusionsThe logistic regression model in the study is a reliable tool in predicting the prognosis of DAI patients.The patients wit higher GCS on admission may have better outcome.The patients with light degree of paralysis,normal pupil size and reaction,and combined with none cerebral injuries may have sound prognosis.

Objective: To analyze the clinical application of manual therapy (MT) to tumor-related adverse reactions via summarizing the research at home and abroad, in order to provide more theoretical evidence for the clinical promotion of MT. Methods: We searched 7 Chinese and English databases, including China National Knowledge Infrastructure (CNKI), Wanfang Academic Journal Full-text Database (Wanfang), Chongqing VIP Database (CQVIP), PubMed, Excerpta Medica Database (EMBASE), Ovid and EBSCO. The publication date was between the establishment date of the database and December 31, 2020. We screened the literature according to the inclusion and exclusion criteria, and then sorted and analyzed the selected information. Results: A total of 46 papers were analyzed. Most studies focused on the adverse reactions in breast cancer patients. MT interventions demonstrated the best efficacy for fatigue, followed by pain, depression and anxiety. In different MT interventions, Tuina (Chinese therapeutic massage) was mainly adopted for fatigue, pain, anxiety, depression, and limb dysfunctions. Acupoint pressing was mainly adopted for gastrointestinal and psychological problems such as abdominal bloating, insomnia, depression and anxiety. The application of reflexotherapy was similar to that of Tuina. Conclusion: MT can alleviate various adverse reactions by effectively relieving patients' somatic symptoms and improving their psychological states and overall functions. It can be popularized as a significant non-drug therapy. Currently, however, the clinical application of MT is neither extensive nor has sufficient basic research. Consequently, we should attach importance to this application.

Objective To explore the method and effect of thumb and finger reconstruction and repair by emergent primary toes transplantation. Methods Three hundred and fourteen fingers of 282 cases including finger thumb defect and complex injury with hyperthena palm radid soft tissue of forearm were reconstructed and repaired by the second toes, wrap-around flap and the second third toes wrap-around flap combined with distal flap of leg or other complex tissue flap transplantation. Results Three hundred and eight reconstructed fingers survived, the survival rate was 98%. After a follow up to 6 months to 6 years, the reconstructed thumbs and fingers have accepted nip, grasp, opponent function. The result was graded as excellent in 214 fingers, good in 63, fair in 26, poor in 5. The excellent and good rate was 88%according to the upper limb functional evaluation criteria issued by the Hand Surgery Society of the Chinese Medical Association. Conclusion Different type of toes and combined toes transplantation can obtain preferable clinical effect on emergent primary thumb and finger defect.

Objective To investigate the effect of manual therapy based on surface electromyography on knee osteoarthritis(KOA)in the older people. Methods A total of 106 outpatient with unilateral KOA were selected from Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine,from August,2023 to June,2024,and were randomly divided into control group(n=53)and experimental group(n=53).The control group accepted routine manual therapy,and the experimental group accepted manual therapy based on the analysis of average electromyography(AEMG).They were assessed with Western Ontario and McMaster Universities Osteoarthritis Index(WOMAC),Visual An-alogue Scale(VAS)for pain,Tinetti Balance and Gait Score,and 6-minute walk test(6-MWT)distances before and after treatment. Results One case dropped down in each group.Before treatment,AEMG decreased in the rectus femoris,medial femoris and medial head of gastrocnemius on the affected side in the experimental group(|Z|>8.647,P<0.001),and it increased in the lateral femoris,semitendinosus and biceps femoris(|Z|>4.808,P<0.001).The scores of WOMAC,VAS,Tinetti Balance and Gait Score,and distances of 6-MWT improved in both groups after treat-ment(|t|>3.987,P<0.001),and improved more in the experimental group than in the control group,except the VAS score(|t|>2.213,P<0.05). Conclusion Manual therapy focusing on activation of rectus femoris,medial femoris and medial head of gastrocnemius,inhibition of the lateral femoris,semitendinosus and biceps femoris,and releasing the tension of the medial and lateral collateral ligaments,according to the results of surface electromyography,can alleviate the pain of the KOA in the older people and improve the mobility of the knee.