Objective:To observe the effect of repeated, bilateral administration of high-frequency transcranial magnetic stimulation (rTMS) in treating post-stroke dysphagia.Methods:Forty-five persons with post-stroke dysphagia were randomly divided into a bilateral group ( n=14 after one dropout), an affected group ( n=15) and a healthy group ( n=15). All received 30 minutes of conventional swallowing rehabilitation training 5 times a week for 2 weeks from a speech therapist. Those in the affected group also received 5Hz rTMS applied to the motor cortex controlling the suprachyoid muscle group. The bilateral group received the same stimulation bilaterally with the same duration and treatment course. Videofluoroscopy was used to assess their swallowing before and after the 2 weeks of treatment. It was rated using the penetration-aspiration scale (PAS) and the functional swallowing disorder scale (FDS). Surface electromyography was employed to evaluate suprachyoid muscle function. Cortical excitability was assessed by measuring the resting motor threshold (RMT) of the unaffected hemisphere. Results:After the treatment, the average PAS, FDS and muscle function values had improved significantly for all three groups, but significant RMT differences were observed only between the bilateral and the unaffected group. Significant differences in the average FDS and PAS scores were observed after the treatment, as well as significant changes in FDS and muscle function between the affected group and the other two groups. The average FDS scores before and after treatment were significantly different between the unaffected and bilateral group, with the former scoring significantly better than the latter. But no significant differences in the average PAS scores were observed after the treatment.Conclusions:5Hz rTMS of either the unaffected or affected cerebral cortex (or bilateral) can effectively improve the swallowing function of persons with post-stroke dysphagia. Bilateral stimulation has the greatest therapeutic effect, followed by stimulation of the unaffected cerebral cortex.

Objective:To compare the difference and effect of fat grafting assisted by adjustable external volume expansion (EVE) and fat grafting only in female patients who chose autologous fat grafting for breast reconstruction after a breast cancer operation.Methods:A retrospective analysis was carried out in 17 patients in the past four years. The patients in the experimental group wore EVE 10 hours daily for four weeks before surgery, and the negative pressure value was -60 mmHg. From the second week after the operation, they continued to wear EVE 10 hours every day, and the initial negative pressure value was -40 mmHg. After one week, the negative pressure was adjusted to -20 mmHg, and the EVE was worn for four weeks after surgery. Both the experimental group and the control group chose classical Coleman fat for breast reconstruction.Results:The number of operations in the experimental and control groups was 3.0±0.8 and 3.9±1.2, respectively ( t=2.193; P<0.05). The single fat injection volume of the experimental group and the control group was (228.60±15.34) ml and (198.20±12.01) ml, respectively ( t=4.861; P<0.01). The single fat volume preservation rate of the experimental group and the control group was (31.6±5.8)% and (25.8±6.2)%, respectively ( t=2.226; P<0.05). For postoperative complications, there were 3 cases in the experimental group (10 cases in total) and 3 cases in the control group (7 cases in total). Conclusions:For breast cancer patients who choose autologous fat grafting for breast reconstruction, wearing EVE can reduce the number of operations, improve the single fat injection volume and postoperative fat preservation rate, and reduce postoperative complications.

BACKGROUND: Repairing soft tissue defects caused by inflammation, tumors, and trauma remains a major challenge for surgeons. Adipose tissue engineering (ATE) provides a promising way to solve this problem. METHODS: This review summarizes the current ATE strategies for soft tissue reconstruction, and introduces potential construction methods for ATE. RESULTS: Scaffold-based and scaffold-free strategies are the two main approaches in ATE. Although several of these methods have been effective clinically, both scaffold-based and scaffold-free strategies have limitations. The third strategy is a synergistic tissue engineering strategy and combines the advantages of scaffold-based and scaffold-free strategies. CONCLUSION Personalized construction, stable survival of reconstructed tissues and functional recovery of organs are future goals of building tissue-engineered fat for ATE.