Objective To observe any rehabilitative effects of individualized exercise training in the treatment of rotator cuff injury in elite table tennis players.Methods Forty table tennis players from the Chinese National Team were studied.Twenty (the experimental group) had rotator cuff injuries and 20 without the injury formed the control group.An individualized rehabilitation treatment protocol was prepared for each of the players in the experimental group and implemented twice weekly for a total of 8 weeks.There was no intervention for the control group.Before and after the treatment,both groups were assessed using a questionnaire for disabilities of the arm,shoulder and hand (DASH),a motion assessment,and BIODEX isokinetic muscle testing.Results There were significant differences in average DASH scores between the two groups,with the experimental group scoring higher than the controls both before and after the treatment.Before the treatment,at angular velocities of 60°/s,180°/s and 300°/s the peak moments of the ER (external rotation,ER) and IR (internal rotation,IR) muscles and the ER/IR ratio were all lower in the experimental group than among the controls.However,after the treatment the performance of the experimental group had improved in all three tests.Conclusion The ER/IR ratio of the dominant shoulder of table tennis players with rotator cuff injury is lower than that of the players without the injury,but individualized rehabilitation treatment can effectively increase the ratio and help to improve their shoulder function.

Objective To compare the accuracy of auditory brain stem response (ABR) thresholds to tone burst and tone burst ipsilaterally masked by notched noise in estimating puretone thresholds of adults with normal hearing.To study characteristics of ABRs evoked by tone burst and tone burst in notched noise of two different intensities.These three kinds of ABRs were named as follows:tb-ABR,amtb-ABR and bmtb-ABR.Methods Puretone audiometry,ABRs to tone burst and tone burst ipsilaterally masked by notched noise of different intensities were tested in 20 adults (totally 40 ears) with normal hearing.Results ①Thresholds for tb-ABR,amtb-ABR and broth-ABR of each frequency all approximated each other,and there were no statistically significant differences between them.②The mean differences between puretone thresholds and thresholds for tb-ABR,amtb -ABR and bmtb-ABR of each frequency were all less than 15 dB.Those mean differences of different ABRs of the same frequency were approximate to each other and had no statistically differences.③No matter what kind of ABR was tested,the latencies of wave V shortened with increase of frequency in each ABR at the same intensity.When the intensity and frequency of the tone burst were the same,the latency of wave V of tb-ABR was always statistically shorter than that of amtb-ABR.The latter was also always statistically shorter than that of bmtb-ABR.Conclusion Thresholds for ABRs to tone burst and tone burst ipsilaterally masked by notched noise were useful in predicting puretone thresholds.

Objective To study the characteristic of acoustically short latency negative response (ASNR) in auditory brainstem response (ABR) evoked by tone burst in children with hearing loss. Methods ABRs to click and tone burst were recorded from 0～6 years old children with hearing loss using SmartEP auditory evoked potential system. The threshold and latency was analyzed if ASNR was recorded. Results Among all the 80 ears tested, ASNR were recorded in 7 ears (8.75%) when using click, and in 40 ears (50%) when using tone burst. ASNR was most frequently evoked by 1 kHz tone burst (in 37 ears), and 2 kHz (in 25 ears) was the second. Among the ears with ASNR, the lowest threshold of ABR wave V was 65 dB nHL. The lowest threshold of ASNR was 80dB nHL. The latencies of ASNR for 0.5,1,2 and 4 kHz tone burst was 6～8, 5～7,3～5 and 3～4 ms, respectively. The latency decreased along with the increase of intensity. Conclusion ASNR can be recorded while recording tone-burst ABR, but it has no effect in predicting hearing level using the wave V threshold of tone-burst ABR.

Objective To examine the practical value of early detection of heart-type fatty acid binding protein (H-FABP)for risk stratification and prognosis assessment in cardiac troponin T (cTnT)-negative acute coronary syndrome(ACS)patients.Methods From March 2010 to March 2012,55 patients with chest pain and negative cTnT were selected from 232 ACS patients at the General Hospital of PLA.Expression levels of cTnT and H-FABP were detected within 6 h of the onset of clinical symptoms.H-FABP and cTnT values at 12,24,and 48 h from the onset of clinical symptoms were continuously measured to monitor the dynamic changes.Based on prognosis,patients were divided into two groups,levels of H-FABP were compared,and its predictive value for prognosis was assessed with the ROC curve.Results Within 6 h of the onset of clinical symptoms,cTnT levels in cTnT-negative ACS patients increased gradually as disease progressed and reached the peak value at 12 h before decreasing slowly and arriving at 50％ of the peak value at 48 h.Meanwhile,HFABP levels reached the peak within 6 h,decreased slightly(12.8％) at 12 h,and then decreased rapidly at 48 h (about 79％).Of 55 patients,24 had acute myocardial infarction during hospitalization.The H-FABP level within 6 h was a good predictor for cTnT-negative ACS patients.The area under ROC curve was 0.946 and the cutoff value was 15.47 μg/L.The prediction sensitivity was 87.5 ％,with a specificity of 90.3％.Eleven patients had cardiovascular events after a 12-month follow-up.Levels of H-FABP were different in patients with or without cardiovascular events,[(38.08±8.43) μg/L vs.(18.96 ± 2.85) μg/L (t =2.438,P＜0.05)].ROC curve analysis showed that the area under the curve was 0.772 and the prediction cutoff value was 44.71 μg/L.The rates of cardiovascular events were markedly different between patients with high(≥44.71 μg/L)and those with 1ow(＜44.71 μg/L)H-FABP levels(54.5％ vs.11.4％).Conclusions For ACS patients with negative cTnT,H-FABP is a good index for early risk stratification and prognosis assessment.

Objective To evaluate feasibility of totally laparoscopic surgical treatment of congenital choledochal cysts(CCC) in adult patients.Methods The clinical data of 36 adult CCC patients were analyzed retrospectively.In this study there were 31 type Ⅰ cases and 5 type Ⅳ cases,divided into laparoscopic operation group (n =18) and open operation group (n =18).Results There were no death cases in perioperative period and all patients were followed up.The total operative time of laparoscopy group compared with open group respectively was (212 ± 43) min and (135 ± 20) min (P ＜ 0.05),the volume of blood loss during operation was (75 ± 20) ml and (150 ± 49) ml,(respectively t =6.875,6.000,P ＜0.05).Postoperative recovery time of intestinal function was (65 ± 15) h vs (94 ± 12) h,celiac drainage tube indwelling time was (72 ± 20) h vs (89 ± 26) h,postoperative hospital stay was (5.8 ± 1.4) d vs (8.9 ± 0.9) d,(respectively t =6.444,2.199,7.908,P ＜ 0.05).One case suffered from reflux cholangitis in the laparoscopic group,1 case of choledochojejunostomy stricture and recurrence of intrahepatic calculi in the open group.Conclusion Laparoscopic cystectomy and cholangiojejunostomy for congenital choledochal cyst in adults is safe and feasible.

Cryoablation therapy with explicit anti-tumor mechanisms and histopathological manifestations has a long history.A large number of clinical practice has shown that cryoablation therapy is safe and effective,making it an ideal tumor treatment method in theory.Previously,its efficacy and clinical application were constrained by the limitations of refrigerants and refrigeration equipment.With the development of the new generation of cryoablation equipment represented by argon helium knives,significant progress has been made in refrigeration efficien-cy,ablation range,and precise temperature measurement,greatly promoting the progression of tumor cryoablation technology.This consensus systematically summarizes the mechanism of cryoablation technology,indications for oral mucosal melanoma(OMM)cryotherapy,clinical treatment process,adverse reactions and management,cryotherapy combination therapy,etc.,aiming to provide reference for carrying out the standardized cryoablation therapy of OMM.

Objective:To analyze the risk factors of bronchopulmonary dysplasia(BPD)in very preterm infants(VPI), and to provide scientific basis for the prevention and treatment of BPD in VPI.Methods:A prospective multicenter study was designed to collect the clinical data of VPI in department of neonatology of 28 hospitals in 7 regions from September 2019 to December 2020.According to the continuous oxygen dependence at 28 days after birth, VPI were divided into non BPD group and BPD group, and the risk factors of BPD in VPI were analyzed.Results:A total of 2 514 cases of VPI including 1 364 cases without BPD and 1 150 cases with BPD were enrolled.The incidence of BPD was 45.7%.The smaller the gestational age and weight, the higher the incidence of BPD( P<0.001). Compared with non BPD group, the average birth age, weight and cesarean section rate in BPD group were lower, and the incidence of male infants, small for gestational age and 5-minute apgar score≤7 were higher( P<0.01). In BPD group, the incidences of neonatal respiratory distress syndrome(NRDS), hemodynamically significant patent ductus arteriosus, retinopathy of prematurity, feeding intolerance, extrauterine growth restriction, grade Ⅲ~Ⅳ intracranial hemorrhage, anemia, early-onset and late-onset sepsis, nosocomial infection, parenteral nutrition-associated cholestasis were higher( P<0.05), the use of pulmonary surfactant(PS), postnatal hormone exposure, anemia and blood transfusion were also higher, and the time of invasive and non-invasive mechanical ventilation, oxygen use and total hospital stay were longer( P<0.001). The time of starting enteral nutrition, cumulative fasting days, days of reaching total enteral nutrition, days of continuous parenteral nutrition, days of reaching 110 kcal/(kg·d) total calorie, days of reaching 110 kcal/(kg·d) oral calorie were longer and the breastfeeding rate was lower in BPD group than those in non BPD group( P<0.001). The cumulative doses of amino acid and fat emulsion during the first week of hospitalization were higher in BPD group( P<0.001). Multivariate Logistic regression analysis showed that NRDS, invasive mechanical ventilation, age of reaching total enteral nutrition, anemia and blood transfusion were the independent risk factors for BPD in VPI, and older gestational age was the protective factor for BPD. Conclusion:Strengthening perinatal management, avoiding premature delivery and severe NRDS, shortening the time of invasive mechanical ventilation, paying attention to enteral nutrition management, reaching whole intestinal feeding as soon as possible, and strictly mastering the indications of blood transfusion are very important to reduce the incidence of BPD in VPI.

Antibodies, Neutralizing/immunology* ; Antibodies, Viral/immunology* ; COVID-19/virology* ; COVID-19 Vaccines/immunology* ; Humans ; SARS-CoV-2/pathogenicity* ; Spike Glycoprotein, Coronavirus/immunology* ; Vaccines, Inactivated/immunology*