Objective To analyse the alterative characteristics of electrophysiology by detecting somatosensory evoked potential(SEP) during cerebral remodeling after transfer of healthy C7 nerve root both in patients and normal individuals. Methods From 2002 to 2003, 12 cases of the left total brachial plexus nerve root avulsion were surgically treated by transferring healthy C7 nerve root to impaired median nerve through bridged ulnar nerve. The waveform of SEP of bilateral cortical expressions were recorded after stimulating median nerve of impaired upper extremity at the wrist and elbow. Meanwhile, latent period and amplitude of wave of SEP, and nerve conduction velocity from the level of wrist to elbow were exhibited and compared. Results There were differences of the latency and amplitude of SEP in normal individuals between two sides of cerebrum to some extent. In the healthy sides (first group), difference of latency of SEP on two sides of cerebral cortex had no statistical significance but in the reverse for the amplitude of SEP. For the diseased sides(second group), difference of amplitude of SEP for both sides of cerebral cortex between the patients and the nonmal individuals were of statistical significance, but on the contrary for the change of latency of SEP. Conclusion Cerebral cortex dominating affected extremity is able to bring up functional remodeling electrophysiologically after nerve transfer of healthy C7 nerve root. Shortened latency and augmented amplitude discrepancy of SEP recorded on both sides of cerebral cortex were preliminary electrophysiological criterions. After contralateral C7 nerve root transfer, the examination of SEP can offer data of corresponding cortex "reinnervation", which provides objective evidence for further treatment to promote functional recovery and cortical plasticity.

Purpose To evaluate the function of swallowing by examining the relative motion of the hyoid bone and larynx(HL)via ultrasonography,and to explore the value of HL motion ratio in the evaluation of stroke with pharyngeal dysphagia.Materials and Methods A total of 43 stroke patients with dysphagia(dysphagia group)and 43 healthy adults(healthy control group)from June 2021 to April 2022 in the Third Affiliated Hospital of Henan University of Traditional Chinese Medicine and the First Affiliated Hospital of Henan University of Traditional Chinese Medicine were enrolled.The displacement and motion time of HL were measured by ultrasonography when the participants swallowed 5 ml water.The median flow tracking algorithm was implemented in Python language to measure the displacement of the hyoid bone,the movement time of the hyoid bone,the displacement of the larynx and the movement time of larynx,and then HL movement ratio was calculated,respectively.The differences in ultrasonography measurements between the two groups were compared,and the influencing factors of stroke with dysphagia were screened out via Logistic regression analysis.Then the receiver operating characteristic curve was drawn,the area under curve and the cut-off value,sensitivity and specificity were calculated subsequently.Results The larynx motion time(static phase),the larynx displacement(elevation phase)and the HL motion ratio were significantly related to swallowing in healthy participants,with significant differences between the two groups(t=4.97,6.38,6.17,P<0.05).The results of Logistic regression analysis showed that the HL motion ratio was the influencing factor of stroke with dysphagia(OR>1,P<0.05).The optimal cut-off value of the HL motion ratio for the diagnosis of dysphagia was 0.58,leading to a sensitivity of 86.0%,a specificity of 93.0%and the area under curve of 0.967,respectively.Conclusion Ultrasonography can quantitatively evaluate the motion of the HL during swallowing,and the HL motion ratio can be considered as a parameter for the evaluation of stroke with dysphagia,providing new insights for clinical diagnosis of dysphagia.

Objective:To investigate the clinical characteristics of patients with keratoconus, and to explore the factors influencing keratoconus severity.Methods:A cross-sectional study was performed.A total of 908 patients (1 476 eyes) with primary keratoconus were enrolled in Henan Eye Hospital from January 2019 to December 2021.The medical history data of patients were collected by face-to-face questionnaire survey.Refractive parameters were measured by subjective optometry.Intraocular pressure (IOP) was measured by a non-contact tonometer, and corrected IOP was calculated by Dresden formula.Corneal topography parameters was obtained using Pentacam HR.The subgroup analysis of clinical characteristics of all patients was performed by age (<21 years, 21~<31 years, ≥31 years) and gender.Disease severity was graded based on steep keratometry (Ks), namely mild (Ks<48 D), moderate (48 D≤Ks<55 D) and severe (Ks≥55 D). The influencing factors of disease severity in keratoconus were analyzed by ordered Logistic regression.This study adhered to the Declaration of Helsinki.The study protocol was approved by the Ethics Committee of Henan Eye Hospital (No.HNEECKY-2019[5]). All subjects or guardians were informed of the purpose and significance of the study and written informed consent was obtained.Results:Of the 908 patients, 622 were with bilateral keratoconus and 286 were with unilateral keratoconus.The median age of onset was 20(17, 26) years, and the median age of diagnosis was 21(18, 27) years.The ratio of males to females was 3.05∶1.There were 9.80%(89/908) of the patients having a history of allergy, 25.55%(232/908) having a history of other systemic diseases, and 1.98%(18/908) having a family history of keratoconus.Of the 1 476 affected eyes, 27.57%(407/1 476) were diagnosed as severe keratoconus, and 61.94%(568/917) had a history of eye rubbing.The medians of sphericity, cylindricity, IOP, corrected IOP, Ks, thinnest corneal thickness (TCT), anterior corneal surface elevation (AE) and posterior corneal surface elevation (PE) were -4.00(-7.00, -1.75)D, -3.50(-6.00, -1.50)D, 12.00(10.30, 13.80)mmHg, 15.40(13.60, 17.00)mmHg, 49.85(46.40, 54.90)D, 460.00(425.00, 490.00)μm, 21.00(13.00, 34.75)μm, 51.00(33.00, 75.00)μm, respectively.The spherical refraction, IOP and corrected IOP were lower and the cylindrical refraction was higher in patients at age <21 years than in patients at age 21~<31 years, and the TCT of patients at age <21 years was higher than that at age ≥31 years, and the differences were statistically significant (all at P<0.05). Compared with female patients, male patients had younger onset age, lower spherical refraction, IOP and corrected IOP, as well as higher cylindrical refraction, AE and PE, showing statistically significant differences (all at P<0.05). The spherical refraction and IOP of male patients were lower than those of female patients at age <21 years, and the cylindrical refraction was higher in males than in females among the patients at age 21~<31 years, and the differences were statistically significant (both at P<0.05). Among the patients with onset age <21 years and diagnosis age <21 years, the ratio of males to females in patients with severe keratoconus was higher than those with mild and moderate disease, and the difference was statistically significant (both at P<0.05). Older age of onset was a protective factor for disease severity in keratoconus (odds ratio=0.981, 95% confidence interval: 0.963~0.999). Conclusions:The younger the onset age of keratoconus patients, the more severe the disease.Among the patients with severe keratoconus, there were more male patients, and males have a younger onset age and severer conditions.It is suggested that early screening of keratoconus in children and adolescents should be strengthened in clinical work, and more active prevention and treatment measures should be taken for younger patients, especially males.