Objective To investigate the effects of early core muscles and manual respiratory function training on stroke patients with dysphagia. Methods From June, 2015 to January, 2016, 60 stroke patients with dysphagia were divided equally into control group and obser-vation group randomly. Both groups accepted routine swallowing function training, electrical stimulation and respiratory function training, while the observation group accepted core muscles training and manual respiratory function training, for four weeks. They were evaluated with Standardized Swallowing Assessment (SSA), forced vital capacity (FVC), maximum ventilatory volume (MVV) and the maximum ex-piratory time before and after treatment. Results All the indices improved in both groups after treatment (P<0.001), and improved more in the observation group than in the control group (P<0.001). Conclusion Core muscles and manual respiratory function training at early stage can obviously improve swallowing and respiratory function of stroke patients with dysphagia.

Objective To analyze the feasibility and practicality of the navigational template for antegrade lag screw fixation of the fractures in the posterior column of acetabulum.Methods Spiral CT scan data of 40 normal adult pelvis was collected.3D CT scans of pelvics were performed.Virtual 3D pelvic models were reconstructed with software Mimics 10.01.Virtual cylindrical implants were placed along the longitudinal axis of the acetabular posterior column via the ischial tuberosity among the ipsilateral hemipelvis and some anatomical parameters were measured.To adjust cylinder position to determine the best projection point,the shortest distance of the point to the linea terminalis and the anterior border of the auricular surface,the angle between the cylindrical and the coronal plane (α),and the angle between the quadrilateral district and iliac fossa plane (β) were measured respectively.The 3D models were imported into software UG 6.0.The models of navigational templates were designed according to the anatomic features of the acetabulums and the measured parameters.16 cases of dry left side of pelvis specimens were collected.Simulate acetabular posterior column screw fixation from different screw holes and verify the accuracy of navigation template assisted in the nail.Results The navigational templates was designed and manufactured successfully which was more consistent with the anatomical features of the quadrilateral plane.Placement of lag screw from the first hole:6.3％ achieved accurate positioning,75％ well positioning,and 18.7％ loose.From the second hole:81.3％ had accurate positioning,18.7％ well positioning.From the third hole:37.5％ had accurate positioning,62.5％ loose.Conclusion The navigational template designed according to the anatomic features of acetabulum and the measured parameters can accurately assist lag screw placement.

Objective:To investigate the value of positron emission tomography/computed tomography (PET/CT) in diagnosis of retroperitoneal lymph node metastasis for early cervical cancer.Methods:Retrospectively analyze the preoperative PET/CT examination results and postoperative pathological results of patients with early cervical cancer who underwent surgical treatment from May 5, 2019 to August 31, 2020, and analyze the clinical characteristics, so as to explore the high risk factors of PET/CT in the diagnosis of retroperitoneal lymph node metastasis.Results:The accuracy, sensitivity, specificity and area under the curve (AUC) of PET/CT in the diagnosis of retroperitoneal lymph node metastasis were 75.2%, 60.0%, 81.3% and 0.707, respectively. Univariate analysis showed that 2009 International Federation of Gynecology and Obstetrics (FIGO) stage, tumor diameter >4 cm, lymphovascular space involvement (LVSI) positive, depth of invasion, high squamous cell carcinoma antigen (SCC-Ag) level and cytological grade were important factors for PET/CT in the diagnosis of retroperitoneal lymph node metastasis ( P<0.05); Multivariate analysis showed that tumor diameter >4 cm was an independent risk factor for PET/CT diagnosis of retroperitoneal lymph node metastasis ( P=0.015). Conclusions:PET/CT has a certain diagnostic value in the evaluation of retroperitoneal lymph node metastasis, but it can not fully reflect the facticity of lymph node metastasis; tumor diameter > 4cm is an independent risk factor for PET/CT in the diagnosis of retroperitoneal lymph node metastasis.

Objective To explore the values of shear wave elastography (SWE) and ultrasonic grading in liver grafts from brain death donor (DBD).Methods Liver grafts of 39 DBD cases were examined preoperatively by ultrasonography (US) and SWE.Blood samples were tested preoperatively.Based upon early allograft function of liver recipients,the donors were classified into early allograft dysfunction (EAD) and early allograft function normal (non-EAD) groups.The SWE/ US grading results of EAD group were compared with those of non-EAD group.Receiver operating curve (ROC) was employed for analyzing the diagnostic accuracy of SWE/US grading in EAD.Results The SWE value of EAD group was significantly higher than that of non-EAD group [(6.65 ± 2.69)vs.(3.50 ± 1.27) kPa,P＜0.05].Ultrasonic grading of EAD group was also significantly higher than that of non-EAD group (P＜0.05).The area under ROC curve (AUROC) of SWE in EAD was 0.939,optimal cut-off value 4.56 kPa,AUROC of ultrasonic grading 0.806 (P =0.003) and optimal cut-off value level 3.5.Conclusions SWE quantifies fibrosis in liver grafts of DBD with a high diagnostic accuracy.There are significant correlations between EAD after liver transplantation and SWE value of liver grafts and ultrasonic grading.SWE and ultrasonic grading may improve the assessments of liver grafts of DBD.

Objective: The purpose of our study was to investigate the predictive abilities of clinical and computed tomography (CT)features for outcome prediction in patients with coronavirus disease (COVID-19). Materials and Methods: The clinical and CT data of 238 patients with laboratory-confirmed COVID-19 in our two hospitalswere retrospectively analyzed. One hundred sixty-six patients (103 males; age 43.8 ± 12.3 years) were allocated in thetraining cohort and 72 patients (38 males; age 45.1 ± 15.8 years) from another independent hospital were assigned in thevalidation cohort. The primary composite endpoint was admission to an intensive care unit, use of mechanical ventilation, ordeath. Univariate and multivariate Cox proportional hazard analyses were performed to identify independent predictors. Anomogram was constructed based on the combination of clinical and CT features, and its prognostic performance wasexternally tested in the validation group. The predictive value of the combined model was compared with models built on theclinical and radiological attributes alone. Results: Overall, 35 infected patients (21.1%) in the training cohort and 10 patients (13.9%) in the validation cohortexperienced adverse outcomes. Underlying comorbidity (hazard ratio [HR], 3.35; 95% confidence interval [CI], 1.67–6.71;p < 0.001), lymphocyte count (HR, 0.12; 95% CI, 0.04–0.38; p < 0.001) and crazy-paving sign (HR, 2.15; 95% CI, 1.03–4.48;p = 0.042) were the independent factors. The nomogram displayed a concordance index (C-index) of 0.82 (95% CI, 0.76–0.88),and its prognostic value was confirmed in the validation cohort with a C-index of 0.89 (95% CI, 0.82–0.96). The combinedmodel provided the best performance over the clinical or radiological model (p < 0.050). Conclusion Underlying comorbidity, lymphocyte count and crazy-paving sign were independent predictors of adverseoutcomes. The prognostic nomogram based on the combination of clinical and CT features could be a useful tool for predictingadverse outcomes of patients with COVID-19.

Objective:To analyze and summarize the oncological outcomes after laparoscopic radical trachelectomy (LRT) for early stage cervical cancer.Methods:The clinical data and follow-up results of 148 patients with early stage cervical cancer who underwent LRT in Renji Hospital, School of Medicine, Shanghai Jiao Tong University from July 2014 to June 2023 were collected, while tumor outcomes and postoperative pregnancy were analyzed retrospectively.Results:(1) General situation: the median age of 148 patients with LRT was 33 years (range: 19-42 years). Pathological type: 111 cases of squamous cell carcinoma, 36 cases of adenocarcinoma, 1 case of adenosquamous carcinoma. International Federation of Gynecology and Obstetrics (2018) stage: 17 cases of stage Ⅰa1 with lympho-vascular space invasion, 25 cases of stage Ⅰa2, 102 cases of stage Ⅰb1, and 4 cases of stage Ⅰb2. (2) Tumor outcomes: 148 patients were followed up regularly after LRT, and the median follow-up time was 59 months (range: 2-104 months). During the follow-up period, 5 cases of tumor recurred (including 1 death), and the median recurrence time was 10 months (range: 4-33 months). Among them, there were 3 cases of pelvic metastasis, 1 case of distant metastasis, and 1 case of both pelvic and distant metastasis. Both 3-year and 5-year disease-free survival rates of 148 patients were 94.5%, and the 5-year overall survival rate was 98.9%. (3) Postoperative pregnancy: among 148 patients with LRT, 67 patients had pregnancy requirements, followed up for 1 year, and 20 of them were pregnant, with a pregnancy rate of 29.9% (20/67). Among the 20 pregnant patients, 2 cases early abortion, 1 case mid-term abortion, and 17 cases gave birth (including 4 cases of premature birth and 13 cases of full-term birth).Conclusion:Under the condition of strict control of surgical indications, guaranteed surgical scope and tumor-free operation, LRT in patients with early cervical cancer has a good outcome.

"Belt and Road" is an opportunity for the development of traditional Chinese medicine (TCM) education.Based on the analysis of international development of TCM education,this paper focused on how to seize the "Belt and Road" strategic development opportunities to further promote the strategy analysis on international development of TCM education,and put forward specific implementation measures.