Objective To observe the therapeutic efficacy of low-frequency electrical stimulation (LFES) plus acupuncture in treating deglutition disorders after cerebral stroke. Method Seventy-six patients were randomized into two groups. The treatment group (38 cases) was intervened by LFES plus acupuncture;the control group (38 cases) was by LFES. Result The water drinking test scores were significantly changed after the treatment in both groups (P<0.05); after the intervention, there were significant differences in comparing the water drinking test score, improvement score, and therapeutic efficacy grading between the two groups (P<0.05). Conclusion LFES and acupuncture are both effective in treating deglutition disorders after cerebral stroke, and the combination of the two methods can enhance the clinical efficacy.

Objective To investigate the association between brain structure abnormalities and neuropsychology impairment in CAD patients.Methods Nineteen patients with CAD and 1 7 healthy adults were examed with MRI,and T1 WI,T2 WI,FLAIR,DWI and DKI image were performed,and then comparing the acquired MRI findings between two groups.Results Significant differences were observed for MK values in splenium and body of the corpus callosum,left cerebellar hemisphere and amygdala cerebelli.MK values of CAD group were lower than those of healthy group in these regions,and differences were statistically significant(P <0.05). There were significant correlation between MK values of the left amygdala cerebelli and MoCA scores in CAD group.Conclusion DKI could detect the changes of brain tissue microstructure in CAD patients early.The correlation between MK and neuropsychologi-cal function provides an important basis for early diagnosis and treatment.

Objective To investigate the morphologic changes and hemodynamic parameters of the common carotid artery in obstructive sleep apnea hypopnea syndrome(OSAHS)in a porcine model using ultrasound and color Doppler.Methods A total of 12 pigs were randomly divided into model group and control group(n=6 for each).All pigs were fed under the same conditions with exception of th ose in the model group which were kept in a hypobaric chamber for experiments.The parameters of systolic velocity(S)and diastolic velocity(D),resistant index(RI)and S/D in Doppler as well as maximum IMT(intima-media thickness)with two-dimensional ultrasound were obtained in the carotid artery of all animals were determined,and the latter was confirmed by animal dissection when the symptoms of OSAHS appeared in the model group.Results The diameter of the lumen of the common carotid artery in model group(3.18?0.17)was smaller than that of control group(3.47?0.15,P

Objective To investigate the operative treatment of displaced intra-articular fractures of the calcaneus using a small lateral incision approach.Methods Thirty-one patients with 32 intra-articular calcaneal fractures,were treated with open reduction and internal fixation through a small lateral incision approach from October 2004 to April 2006.The skin incision was made from the distal tip of the fibula to the base of the fourth metatarsal.According to Sanders classification,there were 21 typeⅡfractures and 11 typeⅢfractures.The first change of dressing was done on the second day after operation.The residual blood clots in the wounds were cleaned as much as possible when the drainage sheet was removed.The operated foot was bandaged with pressure dressing of cotton pad.Results After an average follow-up of 10.5 months(range,3 to 18 months),no soft tissue com- plications were found,and all had acceptable reduction.The preoperative X-ray film showed that B(?)hler angle was 6.84??9.36?,Gissane angle was 106.04??12.03?.The postoperative X-ray film demonstrated that B(?)hler angle was 32.06?+6.87?,Gissane angle was 115.81??9.48?,and the difference was statistically significant(P＜0.01).According to the AOFAS evaluation system for Ankle-Hindfoot,two feet scored 60-70 points,nine feet 70-80 points,16 feet 80-90 points and five feet 90-100 points.Condusion The small lateral incision approach is a good option for management of calcaneus fractures,because it causes minimal soft tissue damage,provides excellent exposure,and leads to convenience for later removal of internal fixators and subtalar arthrodesis.

To change the old stereotype of using literal and data information for storage and ex- change in medico—scientific records and provide a new record version rich in word and picture,a gener- al model of multi—media control system of medical records and an information storage pattern have been developed and the feasibility of development methods explored.

Objective To evaluate the clinical effects of partial fascicle from the ulnar nerve to biceps branch of musculocutaneous nerve to treat brachial plexus injury. Methods Six cases of brachial plexus injury were involved in this group.3 cases were upper trunk injury and 3 cases were accompanied partial lower trunk injury.A partial fascicle of ulnar nerve transfered to repair biceps branch underwent in all cases,phrenic nerve or accessory nerve were transfered to repair suprascapular nerve.The mean time from injury to surgery was 2.8 months.Patients were evaluated with regard to elbow flexion and should abduction ansle,grip strengthen,morbidity of ulnar nerve function lose. Results Five cases out of six got follow up.The mean period of follow-up was 18 months(range from 9-30 months).The average reinnervation time for the biceps muscle was 3.3 months. All the patients' recovery of elbow flexion Was M_3~+-M_5; and the shoulder adduction was 90°-180°;the grip strength was not downgraded. No notable impairment of the donor site nerve function was observed in 4 cases,just 1 case with a little more fascicle been harvested had partial ulnar nerve impairments. Conclusion The use of ulnar nerve partial fascicle to biceps branch combined with phrenic nerve or accessory nerve to suprascapular nerve to reconstruct upper roots avulsion of the brachial plexus is a valid and convenient procedure.It can obtain good functional restoration in elbow flexion and shoulder adduction in a resonable time.The cases with partial lower trunk injury of brachial plexus,the partial fascicle of ulnar nerve can still be used for repair the musculocutaneous nerve.

Objective To observe the effect of constraint-induced movement therapy combined with motor imagery on unilateral spatial neglect (USN) in stroke patients. Methods Fifty stroke patients with USN were randomly divided into a treatment group ( n = 27 ) and a control group ( n = 23 ). Both groups received routine physical therapy training, including with the Bobath technique and low frequency electrotherapy, while the treatment group received constraint-induced movement therapy and motor imagery in addition. All the patients were assessed with 4 scales of the regular USN assessment ( cancellation tests, line bisection tests, clock drawing tests,copying drawing tests) and with the Barthel index (BI) before and after 8 weeks of treatment. Results After 8 weeks of treatment, both groups' average USN assessments and Barthel indices improved significantly. Furthermore, both the USN results and the Barthel index scores in the treatment group were, on average, significantly better than those in the control group. Conclusion For USN stroke patients, constraint-induced movement therapy combined with motor imagery improves the symptoms of USN and ADL ability significantly better than routine physical therapy treatment alone.

This paper concluded and analyzed the application of objectivc structured clinical examination (OSCE) in clinical bilingual education.It explored the promotion and inhibition effects of OSCE on bilingual teaching by discussing its implementation process,introduction pattern,advantages,disadvantages and feedback from teachers and students.

Objective To explore the mechanism of blood-stage treatment in patients with psoriasis vulgaris through studying the level change of IFN-?, IL-4, IL-10 and IL-17 in patients with blood-stage treatment during activity and quiescence period separately. Methods 20 patients with psoriasis vulgaris in active stage(blood heat syndrome)and 20 patients with psoriasis vulgaris in resting stage(blood stasis syndrome) were recruitedto observe the treatment effects by the PASI score,and to observe thechange of IFN-?, IL-4, IL-10, IL-17 before and after treatment in the serum by ELISA. Results The PASI scores of two groups were both significantly decreased after treatment (blood heat syndrome group t=6.685, P<0.01;blood stasis syndrome group t=4.959, P<0.01). The levels of cytokines were significantly different between patients in the periods of activity and quiescence. Onvarying degrees, the levels of cytokines of two groups were improved after treatment. The levels of cytokines IFN-?, IL-17 in blood heat group significantly decreased(t=3.024, P<0.01;t=2.543, P<0.05). The levels of cytokines IL-17 drop but the levels of cytokines IL-4 raised in blood stasis group,that were significantly differentwith the levels before treatment(t=2.417, P<0.05; t=2.547, P<0.05). Conclusion The levels of INF-?, IL-4, IL-10 and IL-17 could be effectively modulated with blood-stage treatment in treating psoriasis vulgaris.

Objective To investigate the expression of IgG4 in liver tissues of patients with type Ⅰ autoimmune hepatitis (AIH) and to analyze the clinical manifestation,biochemical indexes,immunological genetic features,pathological characteristics and the effects of immunosuppressive therapy.Methods From March 2012 to July 2013,45 patients diagnosed as type Ⅰ AIH were enrolled.Immunostaining of CD38,IgG and IgG4 in liver tissue slices was performed,inflammation grade G and fibrosis stage S were determined.At the same time,serological indexes (alanine aminotransferase (ALT),aspartate transaminase (AST),alkaline phosphatase (ALP),IgG,antinuclear antibody (ANA) titer,antibodies to asialoglycoprotein receptor (ASGPRAb)) of the patients were collected,serum IgG4 was tested and the response to immunosuppressive therapy was observed.Wilcoxon rank sum test and t test were performed for quantitative data comparison.Spearman correlation coefficient was used for correlation analysis.Results Among 45 patients with type Ⅰ AIH,five patients (11.1％) were IgG4 associated AIH (IgG4-AIH group).There were no significant differences in age,gender,biochemical indexes (serum levels of ALT,AST,ALP),immunity indexes (serum levels of IgG,ANA titer,ASGPRAb) and degree of liver fibrosis between patients with IgG4-associated AIH and classical AIH (40 cases) (all P＞ 0.05).Compared with classical AIH group (18.3(6.7) mg/L).The serum level of IgG4 of IgG4 AIH group was 25.8(9.2) mg/L,which significantly increased (Z=-2.041,P＜0.05).However,there was no significant difference in serum level of IgG4 between the two groups (P＞0.05).There was no correlation between the number of infiltrated IgG4 positive plasma cells and the serum level of IgG4 (r=0.311,P=0.279).The inflammation in the liver tissues of IgG4-AIH group was more significant compared with that of classic AIH group (H=4.120,P＜0.05).The number of CD38' or IgG+ plasma cells was larger compared with that of classical AIH (CD38(39.3(13.5)/high power field (HPF) vs (21.3(8.8))/HPF,IgG(39.3 (14.0))/HPFvs (18.5(8.9))/HPF;Z ＝-3.561 and-3.584,both P＜0.01).The number of IgG4+ plasma cells in liver tissues was positively correlated with the number of CD38+ or IgG+ plasma cells (r=0.884 and 0.791,both P＜0.01).Conclusions Among patients with type Ⅰ AIH,the incidence of IgG4-associated AIH was not high.The serum level of IgG4 did not significantly increase in these patients.However,the histological inflammation activity was significant along with many CD38+ or IgG+ plasma cells infiltration.