Objective To explore the operation points of the steps offront-typehypospadias operation in oral mucosa urethroplasty and scrubbed shaped urethra with meat membrane covering.Methods After correction of chordee of penis of 40 patients with Front -type hypospadias, oral mucosa was transplanted and fixed on albuginea surface at the one-third of ventral penile for all the patients to increase the width of the urethra and form the urethra with the selected appropriate size ureter. The skin of dorsal penile was transferred to ventral penile. After clearing the pedicled skin flap, the subcutaneous layer of meat was kept down, and stamped wholly on forming place of urethral reel (including both sides inferior of cut-off cavernous body of glans penis),forming the glans again.Results There was no ankylo-urethria among the 40 front-type hypospadias operation, ureteroscopy examination after two months of the operation showed that all the transplanted oral mucosa survived, and the stamped subcutaneous layer of meat located at both sides inferior of cut-off cavernous body of glans penis adhered with satisfaction,no glans incision dehiscence,there occurred 2 cases of urinary fistula which had been cured by neoplasty,there was 1 case of transferred flap necrosis which had been cured after dressing change.40 patients were satisfied with penis appearance after operation.Conclusion Following up the operation points of “front-type”hyospadias operation,the success rate of operation can be improverd obviously,the plastic effect is good,and the complications after operation can be reduced.stamped wholly on formed urethra.There is a small probability of incidence of urethral stenosis and urinary fistula after operation.

Objective:To observe any effects of repetitive high-frequency transcranial magnetic stimulation (rTMS) on the upper limb motor function of stroke survivors with right hemiplegia.Methods:Forty stroke survivors with right hemiplegia were divided at random into a high-frequency rTMS group and a sham stimulation group, each of 20. In addition to routine rehabilitation, the high-frequency rTMS group was given daily high-frequency rTMS 5d per week for 2 weeks, while the sham stimulation group was provided with sham rTMS. Before and after the treatment, both groups were evaluated using the Fugl-Meyer Upper Extremity motor function evaluation scale (FMA-UE), surface electromyography (sEMG), and electroencephalographic microstatus testing. Any adverse reactions in the course of the treatment were recorded.Results:After the treatment, the average FMA-UE scores of both groups had improved significantly, with the average of the high-frequency rTMS group significantly higher than the other group′s average. After the treatment the peak-to-peak sEMG value of the radial long extensor carpi radialis longus muscle in the high-frequency rTMS group was significantly higher than before the treatment and significantly higher than that of the other group. The temporal coverage of microstate B, the average duration and temporal coverage of microstate C, and the temporal coverage and frequency of occurrence of microstate D after treatment of both groups were also significantly improved. The mean duration of electroencephalographic (EEG) microstate A was negatively correlated with the FMA-UE scale scores ( r=-0.57) and its temporal coverage was positively correlated with the peak-to-peak sEMG value of the ulnar lateral wrist flexor. The mean duration of EEG microstate B was positively correlated with the peak-to-peak sEMG value of the triceps brachii and deltoid, and the mean duration of EEG microstate C was also positively correlated with the peak-to-peak sEMG value of the deltoid muscle. Conclusions:High-frequency rTMS can effectively improve the upper limb motor functioning of stroke survivors with right hemiparesis. After high-frequency rTMS, the functional network activity related to EEG microstate B increases significantly, while that related to microstates C and D decreases significantly.

ObjectiveTo explore the brain mechanism of repetitive transcranial magnetic stimulation (rTMS) on dysfunction after stroke using functional magnetic resonance imaging (fMRI). MethodsLiteratures about the functional magnetic resonance imaging study about repetitive transcranial magnetic stimulation for dysfunction after stroke were retrieved in PubMed, Web of Science, CNKI and Wanfang data from establishment to June 1st, 2021. The quality of the literature was evaluated with Physiotherapy Evidence Database (PEDro) scale. Literature screening, and data extraction were performed by two researchers. ResultsA total of 14 randomized controlled trials were finally enrolled. They were of high or very high quality. They mainly involved the therapeutic effect and imaging mechanisms of rTMS on dysfunction after stroke. ConclusionrTMS could change the excitability of the cerebral cortex and the effective connections between brain regions after stroke, promote the reorganization of brain function, and achieve the recovery of post-stroke dysfunction.