Objective:To investigate the role of inspiratory muscle training in improving the respiratory function of pa-tients with subacute complete high cervical spinal cord injury(C2-C5).Method:From January 2020 to June 2021,60 patients with subacute complete cervical spinal cord injury(C2-C5)ASIA level A were randomly divided into experimental group(n=30)and control group(n=30).The patients in control group were conducted with routine rehabilitation training,in experimental group,inspiratory muscle training was added on the basis of routine rehabilitation treatment.Before and after training for a total of 6 weeks,maximum inspiratory pressure(Plmax),vital capacity(VC),forced expiratory vital capacity(FVC),forced expiratory volume in the first second(FEV1),maximal ventilatory volume(MVV),and dia-phragm thickness were measured,the cases of pulmonary infection were counted.Result:After the training,the improvement of PImax,VC,FVC,FEV1,MVV and diaphragm thickness in patients in experimental group were significantly better than that in patients in control group(P＜0.05),and the rate of pulmonary infection was lower(P＜0.05).Conclusion:Inspiratory muscle training added on the basis of routine rehabilitation treatment can significantly improve the respiratory function of patients with subacute complete high cervical spinal cord injury.

Objective:To investigate the role of inspiratory muscle training in improving the respiratory function of pa-tients with subacute complete high cervical spinal cord injury(C2-C5).Method:From January 2020 to June 2021,60 patients with subacute complete cervical spinal cord injury(C2-C5)ASIA level A were randomly divided into experimental group(n=30)and control group(n=30).The patients in control group were conducted with routine rehabilitation training,in experimental group,inspiratory muscle training was added on the basis of routine rehabilitation treatment.Before and after training for a total of 6 weeks,maximum inspiratory pressure(Plmax),vital capacity(VC),forced expiratory vital capacity(FVC),forced expiratory volume in the first second(FEV1),maximal ventilatory volume(MVV),and dia-phragm thickness were measured,the cases of pulmonary infection were counted.Result:After the training,the improvement of PImax,VC,FVC,FEV1,MVV and diaphragm thickness in patients in experimental group were significantly better than that in patients in control group(P＜0.05),and the rate of pulmonary infection was lower(P＜0.05).Conclusion:Inspiratory muscle training added on the basis of routine rehabilitation treatment can significantly improve the respiratory function of patients with subacute complete high cervical spinal cord injury.

Objective:To evaluate the outcomes of posterior-column dominating three-column tibial plateau fractures treated by raft-nailing and cannulated screwing via the posteromedian approach.Methods:From October 2017 to June 2019, 15 patients with posterior-column dominating three-column tibial plateau fracture were surgically treated at Department of Orthopedics, The First Affiliated Hospital to Harbin Medical University. They are 11 males and 4 females, aged from 26 to 65 years (average, 41.2 years). All patients were operated on under general anesthesia or spinal anesthesia. After full exposure via the posteromedian approach using a popliteal S-shaped incision, their fractures were treated with raft-nailing and cannulated screwing. Wound healing and neurovascular injury were observed after operation. X-ray films were taken regularly to monitor fracture union and measure the tibial plateau angle (TPA) and posterior slope angle (PA) of the tibial plateau. The knee function was assessed using The Hospital for Special Surgery (HSS) scoring system at 12 months after operation.Results:Incisions healed by the first intention after surgery in 14 patients but the healing was delayed due to fat liquefaction in one patient. No symptoms of neurovascular injury were observed in the 15 patients who were followed up for 12 to 29 months (average, 16.5 months). All fractures united after 12 to 20 weeks (average, 15.4 weeks). At 3 days and 12 months after operation, respectively, their PA was 9.3°±2.1° and 9.7°±1.6° and their TPA 4.3°±1.2° and 4.1°±1.1°, showing no significant difference ( P>0.05). At 12 months after operation, their HSS scores ranged from 84 to 95 (average, 89.3), their knee flexion from 105° to 138° (average, 126.5°) and their knee extension from 0° to 8° (average, 3.4°). Conclusions:In the treatment of posterior-column dominating three-column tibial plateau fractures, raft-nailing combined with cannulated screwing via the posteromedian approach can achieve not only full exposure by a single incision but also stable plateau fixation, reduce operative invasion, and simplify operative procedures, leading to fine surgical outcomes.

Objective:To observe the clinical efficacy and side effects of injecting different doses of botulinum toxin type A (BTX-A) into children with spastic cerebral palsy (CP) and tiptoe deformity.Methods:A total of 107 children with tiptoe deformity resulting from CP were divided into group A ( n=35), group B ( n=36) and group C ( n=36) using a random number table. Group A received 3u/kg injections of BTX-A, group B received 4u/kg injections and group C received 5u/kg. The injections were guided by color Doppler ultrasound and followed by 4 courses of rehabilitation therapy. Before and 1, 3 and 6 months after the treatment, the modified Tardieu scale (MTS) was used to assess gastrocnemius spasms, while sections D and E of gross motor function scale 88 (GMFM-88) and the pediatric balance scale (PBS) were used to evaluate motor functioning and balance. Any side effects were also observed. Results:After the treatment, improvement was observed in all of the measurements, though there were no significant differences in the degree of improvement nor in the incidence of side effects among the three groups.Conclusions:There is no significant difference in clinical efficacy or side effects involved in using different doses of BTX-A to treat tiptoe deformity in children with spastic cerebral palsy. The recommended dosage is therefore 3u/kg.

Objective:To observe the clinical efficacy and any side effects of using ultrasound-guided injection of botulinum toxin A in treating juvenile sialorrhoea.Methods:Forty children with sialorrhoea were randomly divided into group A and group B, each of 20. Under the guidance of color Doppler ultrasound, botulinum toxin type A (BoNT-A) was injected into the children′s 2 parotid glands and their submandibular glands. Each parotid gland was injected with 20u of BoNT-A, while 10u was injected into the submandibular gland in group A and 20u was injected in group B. Before and 2, 8 and 12 weeks after the injections, the children′s sialorrhoea was evaluated using teacher drooling sizing (TDS), the drooling quotient and the Saxon test (ST). Any side-effects were also observed.Results:There was no significant difference in the average TDS score, drooling quotient or ST score between the two groups before the intervention. After the intervention all of those measurements had decreased significantly, but there were still no significant differences between the two groups in any measurement at any time point.Conclusions:Botulinum toxin type A injection under the guidance of ultrasound is accurate and safe. The injection of 10u is sufficient to relieve children′s sialorrhoea without serious side effects.