Objective To investigate the relationship between the average amplitude of swallowing-related muscles during pharyngeal swallowing and age and swallow model of healthy adults in different age groups.Methods A total of 200 healthy adults were recruited and divided into 4 age groups:group A (18 ～ 30 years old,n =59),group B (30～50 years old,n=50),group C (50 ～70 years old,n=49) and group D (70 years old,n=40).Surface electromyography was used to acquired the average amplitude of electrical activity of the muscles during three swallow models:resting state,voluntary single swallows of saliva (dry swallowing),voluntary single swallows of 5 ml water at once(wet swallowing)and voluntary single swallows 20 ml water at once.The mean value of the average amplitude of normal adults of different ages were calculated and analyzed.Results ①Intergroup comparison showed no difference in the average amplitude of submental muscles and infrahyoid muscles among the 4 age groups (P ＞ 0.05) in all the three swallowing models ;②Intra-group comparison showed that,there were no statistical differences in the average amplitude of submental muscles among the three swallow models between groups A and B (P ＞ 0.05).In group C,there were no statistical differences between dry swallowing and wet swallowing of 5 ml of water in terms of the average amplitude of submental muscles and infrahyoid muscles during dry swallowing.(P ＞ 0.05),however,but there existed statistical differences in terms of the average amplitude of submental muscles and infrahyoid muscles,when comparing dry swallowing with voluntary single swallowing 20 ml water at once(P ＜ 0.05).The average amplitude of submental muscles and infrahyoid muscles during swallowing of 20 ml water were significantly higher than that during wet swallowing(P ＜0.05).In group D,there was no difference between drying swallow and wet swallowing(P ＞ 0.05)in terms of the mean sEMG amplitude of the muscles,but all lower than swallowing 20 ml of water,with a statistically significant differences(P ＜ 0.05).Conclusions The sEMG amplitude in swallowing-related muscles during pharyngeal swallowing is not related to age,but swallowing models.

[Objective]To investigate the effect of individualized exercises rehabilitation after tibial fracture operation.[Method]A total of 161 cases of tibial plateau fractures from Jan.2003 to Dec.2007 were analyzed retrospectively.In control group,81 patients received traditional rehabilitation.In rehabilitation group,80 patients received individualized rehabilitation exercises guided by Safety Assessment for Orthopaedic Rehabilitation.All cases were followed up and received X-ray exam.HSS (hospital for special surgery knee-rating score) was used to assess the knee function at 3,6,12 months after surgery.[Result]All patients were followed up for 2 years.Internal fixation broken was found in 2 cases in control group,in 3 cases in rehabilitation group.According to HSS scoring system,the good-to-excellent rates of knee joint at 6,12 months postoperatively in rehabilitation group were 77%,87%,significantly higher than 56%,66% in control group (P

BACKGROUND:Compared with bone marrow transplantation, peripheral blood stem cel transplantation has its own advantages, including rich resources of stem cel s from the peripheral blood, convenient and easy col ection, without anesthesia, smal trauma, easily accepted, high safety, and easy to restore the patient’s hematopoietic system.
OBJECTIVE:To observe the function and safety of autologous peripheral blood mononuclear cel s in the treatment of patients with decompensated cirrhosis.
METHODS:Four patients with decompensated liver cirrhosis were selected from November 2010 to July 2011 in the First Affiliated Hospital of Dalian Medical University, aged 31-67 (averagely 44 years). Among them, three cases had hepatitis B, and another one had autoimmune liver disease. Peripheral blood stem cel s were col ected after being mobilized by granulocyte colony stimulating factor. Then, autologous peripheral blood stem cel s were transplanted via a hepatic artery catheter.
RESULTS AND CONCLUSION:There were no adverse reactions such as fever, bleeding and nausea after peripheral blood stem cel col ection and hepatic artery transplantation. Symptoms such as fatigue, poor appetite and abdominal distension gradual y improved at 1, 3 and 6 months after transplantation. Liver function and liver fibrosis indexes were improved to some extent after transplantation.

Objective To compare the effects of median nerve electrical stimulation on coma patients after traumatic brain injury with different settings. Methods From 2013 to 2015, 161 patients with traumatic brain injury were randomly divided into control group (n=40), experimental group 1 (n=41), experimental group 2 (n=39) and experimental group 3 (n=41). The control group received routine conscious-ness-promoted methods, and the experimental groups received median nerve electrical stimulation with 200μs and 30 Hz, 100 Hz and 50 Hz in sequence, 60 minutes a day for 90 days. They were assessed with Glasgow Coma Scale (GCS) and Coma Recovery Scale-Revised (CRS-R) before, 30 days and 90 days after treatment. Results There was significant difference in the scores of CCS and CRS-R, times of treatment, number of sobered patients and coma time among groups (P<0.01), that the experimental groups were better than the control group (P<0.05), and no significant difference was found between the experimental groups 1 and 2 (P>0.05). The experimental group 3 was better than the experimental groups 1 and 2 (P<0.05). Conclusion Median nerve electrical stimulation with 200μs, 50 Hz could promote co-ma patients to wake up optimally.

Objective:To investigate the characteristics of gonads, the incidence of gonadal tumors and the detection results of SRY gene and Y chromosome microdeletions in 45, X/46, XY chimeras. Methods:The medical records of 45, X/46, XY karyotype or its variant in Jiangxi Children′s Hospital from January 2013 to December 2019 were analyzed retrospectively and analyze the gonadal phenotype and oleculardetection of 45, X/46, YX karyotype.Results:Among the 30 patients with 45, X/46, XY karyotype or its variant, the age of treatment was under 18 years old, with 11 males and 19 females.Fourteen of the patients had undergone prophylactic gonadectomy.Six male cases of unilateral testis and contralateral striated gonads were detected.Pathological section suggested that the gonadal tissue contained testis and ovary in 3 cases, adrenal gland tissue with translocation in 2 cases, and bilateral striated gonad in 8 cases, and both sexes were female.Pathological section indicated that the gonad tissue contained both epididymis and ovary tissue in 1 case, and gonadoblastoma in 1 case.There were 1 case of ovarian dysplasia with granulomatous hyperplasia and 1 case with proliferative nevus cells (mixed nevus). No follicle was found in all patients with B-ultrasound and pathological sections.Among the 11 male children, 5 cases were positive by SRY gene detection.Seven cases by Y chromosome microdeletion detection displayed that 3 cases had partial Y chromosome deletion and 4 cases had no deletion; 10 cases among 19 cases of social gender female patients were detected by SRY gene detection and 9 cases were positive and 1 case was negative; 7 cases were detected by Y chromosome microdeletion and the results are 2 cases with Y chromosome partial deletion, 4 cases with Y chromosome no deletion and 1 case with Y chromosome whole deletion. Conclusions:Most patients with 45, X/46, XY chimera have abnormal gonadal tissue, which has the risk of gonadal tumor, especially among female patients.Most patients had positive SRY gene and had no or partial deletion of Y chromosome.In view of the increased risk of gonadal tumors in these patients, early prophylactic gonadectomy is recommended.

The rotator cuff injury is a kind of chronic tendon disease related to overuse injury. The main clinical manifestations of this disease include shoulder pain and dysfunction，which seriously affects people 's life quality and work capability. Although previous studies have shown that inflammation and de- generation of collagen matrix are closely related to the occurrence and development of this disease，the pathogenesis of the disease is still unclear. In this study，the authors review the pathologic mechanisms of rotator cuff injuries from aspects of oxidative stress，inflammation，macrophage and non-coding RNA so as to provide a reference for subsequent research and treatment.

The spatiotemporal distribution of growth factors in bone tissue-engineered repair and reconstruction is critical. Growth factors can be used in bone tissue engineering through different encapsulation methods. Different encapsulation methods make growth factors have different release kinetics. At present, the common physical entrapment, easily degradable carrier and simple spatial structure usually result in poor sustained release of growth factors by burst release. The optimization of release methods of growth factors enables their release at different times and spaces in a biomimetric manner, which is conducive to improving the effect of tissue repair and avoiding the adverse effects of excessive factors. Starting from the necessity of spatiotemporal sustained release of growth factors, the authors summarize growth factors can attain spatiotemporal sustained release by being directly immobilized on the surface of the carrier, encapsulated in the carrier, encapsulated in the microparticles and encapsulated in the carrier by the microparticles and review the spatiotemporal sustained release of growth factors in different encapsulation methods, so as to provide a reference for optimizing spatiotemporal release of growth factor in bone tissue engineering.

Rotator cuff injury often leads to shoulder pain and dysfunction. For the injured rotator cuff tendon without continuous interruption, conservative treatment is often used. However, the shoulder is used frequent in daily life, which makes that the rotator cuff injury generally shows gradual aggravation and eventually progresses to complete tear due to poor blood supply of the rotator cuff tendon tissue and weak repair ability. In order to reverse the pathophysiological changes after rotator cuff injury and promote the repair of injured rotator cuff tendon, a series of conservative treatments for rotator cuff injury have been explored. Extracorporeal shock wave therapy (ESWT) is one of the representative treatments, but its molecular biological mechanism in promoting rotator cuff repair is still unclear. Therefore, the authors review the progress of ESWT for rotator cuff injury from aspects of the molecular biological mechanism and clinical application status, so as to provide a reference for future researches and clinical application of ESWT.

Objective:To explore the effect of standardized patients stimulation combined with microteaching method in clinical teaching practice of students majored in rehabilitation therapy. Methods:From March, 2017 to March, 2018, 47 students majored in rehabilitation therapy in our department were selected with convenience sampling. Then they were randomly divided into control group (n = 23) and experimental group (n = 24). The control group received routine teaching method, while the experimental group received standardized patients stimulation combined with microteaching method. Their theoretical achievement, practical skills achievement and feedback on teaching effect were compared after this course. Results:The theoretical scores and practical skills scores were higher in the experimental group than in the control group (t > 2.366, P < 0.05). Meanwhile, the scores were higher in the experimental group than in the control group in the following aspects: the design capability of rehabilitation treatment program, the capability of selection of rehabilitation assessment tools, the communication and expression ability, learning enthusiasm and initiative, and the ability to relate theory to practice (t > 2.082, P < 0.05). Conclusion:Standardized patients simulation combined with microteaching method could improve the clinical practice effect of students majored in rehabilitation therapy.

【Objective】 To investigate the predictive value of high preoperative neutrophile-lymphocyte ratio (NLR) for the prognosis of nonurothelial carcinoma of the bladder (NUBC) after radical cystectomy (RC). 【Methods】 Clinical and follow-up data of NUBC patients undergoing RC during Jan.2005 and Dec.2020 were collected. The optimal cut-off value of NLR was determined with the receiver operating characteristic (ROC) curve. The survival curve was drawn with Kaplan-Meier method to compare the differences in cancer specific survival (CSS) and overall survival (OS) between the high-NLR and low-NLR groups. The independent risk factors of CSS and OS were screened with Cox proportional hazard regression model. 【Results】 Of the 62 eligible cases,34 (54.8%) were diagnosed with adenocarcinoma,17 (27.4%) with squamous cell carcinoma, 6 (9.7%) with small cell carcinoma and 5 (8.1%) with sarcoma. Kaplan-Meier analysis results showed high NLR was associated with poor CSS (P=0.001) and OS (P<0.001). Cox regression results indicated that high NLR (HR=2.42, 95%CI: 1.12-5.23, P=0.025) and advanced pathologic tumor stage (HR=3.21, 95%CI:1.53-6.74,P=0.002) were independent risk factors of unfavorable CSS. Similarly, high NLR (HR=2.75, 95%CI: 1.35-5.56, P=0.005) and advanced pathologic tumor stage (HR=2.81, 95%CI:1.43-5.57, P=0.003) were independent risk factors of unfavorable OS. 【Conclusion】 As an independent risk factor of unfavorable CSS and OS in NUBC patients undergoing RC, high preoperative NLR is of great value in the prediction of long-term prognosis and may help to optimize individualized treatment.