Objective To observe the effect of respiratory training on post-stroke dysphagia.Methods Forty-two stroke survivors with dysphagia were randomly divided into a control group and an observation group,each of 21.Both groups were given routine swallowing training,while the observation group was additionally provided with respiratory training once a day for 4 weeks.Before and after the treatment,the Kubota drinking water test (KDWT) was administered and a videofluoroscopic swallowing study (VFSS) was performed to assess swallowing function.Forced vital capacity (FVC),forced expiratory volume in one second (FEV1) and peak expiratory flow (PEF) were also measured to assess the subjects' pulmonary function.Results After the treatment,the average KDWT and VFSS scores were significantly better in the observation group than in the control group.The effectiveness rate of the observation group (85.71％) was significantly higher than that of the control group (61.90％).After the intervention,the average FVC [(3.57-±0.48)L],FEV1[(2.83±0.49) L/s] and PEF [(5.36±1.04) L/s] of the observation group were significantly better than those before the treatment and those of the control group after the treatment.Conclusion Swallowing training supported by respiratory training is superior to swallowing training alone for improving the swallowing (and pulmonary) function of post-stroke dysphagia patients.Such combined treatment is worthy of application in clinical practice.

Objective: To investigate the different pattern of neck lymph node metastasis, the choice of surgical methods and prognosis in early tongue squamous cell carcinoma. Methods: A total of 157 patients with early oral tongue squamous cell carcinoma were included in this study. Statistical analysis was performed to identify the pattern of lymph node metastasis, to determine the best surgical procedure and to analyze the prognosis. Results: The occurrence of cervical lymph node metastasis rate was 31%(48/157). Neck lymphatic metastasis was significantly related to tumor size (P=0.026) and histology differentiation type (P=0.022). The rate of metastasis was highest in level Ⅱ [33% (16/48)]. In level Ⅳ, the incidence of lymph node metastasis was 5%(7/157), and there was no skip metastases. The possibility of level Ⅳ metastasis was higher, when level Ⅱ (P=0.000) or Ⅲ (P=0.000) involved. The differentiation tumor recurrence, neck lymphatic metastasis and adjuvant radiotherapy were prognostic factors (P<0.05). Multivariate analyses revealed histology differentiation type, neck lymphatic metastases and adjuvant radiotherapy were the independent prognostic factors. Conclusions Neck lymphatic metastasis rate is high in early tongue squamous cell carcinoma, simultaneous glossectomy and neck dissection should be performed. Level Ⅳ metastasis rate is extremely low, so supraomohyoid neck dissection is sufficient for most of the time. The histology differentiation type, neck lymphatic metastasis and adjuvant radiotherapy are independent prognostic factors.

Objective: To observe the changes in cerebral regional oxygen saturation (CrSO₂) during neonatal blood exchange transfusion(BET) and its effect on the level of bilirubin in neonates with severe hyperbilirubinemia. Methods: From January 2017 to March 2018, 52 newborns with severe hyperbilirubinemia were hospitalized in the Department of Neonatology, Children′s Hospital of Fudan University.Every newborn was treated with BET.Near infrared spectroscopy was used to monitor CrSO₂ in the process of BET.The monitoring lasted from 2 hours before the beginning of BET to 2 hours after the completion of BET.The CrSO₂ were recorded every 2 minutes and total surem bilirubin (TSB) and transcutaneous bilirubin(TCB) was measured.During this period, it is accompanied by the monitoring of neonatal body temperature, heart rate, respiration and bolld oxygen saturation(SpO₂). The differences in CrSO₂ changes at different time points during BET were compared.At the same time, the correlations between CrSO₂ and blood oxygen saturation, TSB and TCB levels were analyzed.The results of repeated measurement analysis of variance compared between the two groups were corrected by Bonfferoni. Results: Among the 52 children, there were 33 males (63.46%) and 19 females (36.54%). The gestational age, average birth weight and average head circumference of newborns were (38.6±2.1) weeks, (3 338±444) g and (33.6±3.2) cm, respectively.The Apgar score of newborn was (8.1±1.6) scores at 1 minute after birth.The level of TSB detected for the first time after admission was (457.9±97.8) μmol/L.The CrSO₂ after BET (74.6%-76.0%) was significantly higher than that before BET (69.4%-69.0%), and the difference was statistically significant (P<0.05). Correlation analysis showed that during BET, CrSO₂ showed a gradual upward trend, SpO₂ also showed a synchronous increase, while the level of bilirubin showed a downward trend, and the downward trend of TSB level was more obvious than that of TCB. Conclusions CrSO₂ can reflect the improvement of cerebral oxygenation during neonatal blood exchange transfusion and avoid cerebral hypoxia in the course of treatment.