Neck dissection(ND)is one of the main treatment methods for oral and maxillofacial malignancies.Although ND type is in con-stant improvement,but intraoperative peal-pull-push injury of the accessory nerve,muscle,muscle membrane,fascia and ligament induced shoulder syndrome(SS)is still a common postoperative complication,combined with the influence of radiochemotherapy,not only can cause pain,stiffness,numbness,limited dysfunction of shoulder neck and arm,but also may have serious impact on patient's life quality and phys-ical and mental health.At present,there is still a lack of a systematic evaluation and rehabilitation management program for postoperative SS of oral and maxillofacial malignant tumors.Based on the previous clinical practice and the current available evidence,refer to the relevant lit-erature at home and abroad,the experts in the field of maxillofacial tumor surgery and rehabilitation were invited to discuss,modify and reach a consenusus on the etiology,assessment diagnosis,differential diagnosis,rehabilitation strategy and prevention of SS,in order to provide clinical reference.

Objective To investigate the feasibility of leucocyte-reduced pooled platelet concentrates from whole blood stored at 4℃,and provide theoretical basis for the components preparation.Methods The collected 400 mL ACD-B antico-agulant whole blood was randomly divided into two groups,stored at 4℃and room temperature.The buffy coat was prepared within 6 hours and store at 22℃until next day to prepare leucocyte-reduced pooled platelet concentrates.Platelet samples on day 1,3,5 and 7 were taken for the blood cell count and related parameter detection.The pH,glucose and lactic acid con-tent were determined to reflect the metabolic status,and the thromboelastography,platelet aggregation rate and PAC-1 and CD62P expression were determined to reflect the function and activation of platelets.The difference in platelets between two groups were analyzed.Results With the extension of storage time,the count of leucocyte-reduced pooled platelet concen-trates decreased gradually,but the platelets distribution width(PDW),mean platelet volume(MPV)and platelet-larger cell ratio(P-LCR)increased gradually in two groups,with no statistical significance(P＞0.05).The pH and glucose con-tents in two groups gradually decreased,but the lactic acid content gradually increased,with no significant difference(P＞0.05).The thrombelastogram showed MA value that reflecting platelet function has no significant change during the storage,and there was no significant difference between the two groups(P＞0.05).The aggregation rates decreased while the expres-sion of PAC-1 and CD62P increased gradually with the prolongation of preservation time,with no significant difference be-tween the two groups(P＞0.05).Conclusion There is no significant difference in platelet count,function and activation between whole blood stored at 4℃and at room temperature within 6 hours.Whole blood stored at 4℃within 6 hours can be considered as the raw material for leucocyte-reduced pooled platelet concentrates.

Objective:To investigate the influence of trimethylamine N-oxide(TMAO)on the development of early neurological deterioration(END)in diabetic patients with acute ischemic stroke.Methods:In this cross-sectional study, 108 type 2 diabetes patients with acute ischemic stroke treated at the Department of Neurology in the Affiliated Wuxi People’s Hospital of Nanjing Medical University between October 2019 and November 2020 were consecutively recruited.END was defined as an increase in the National Institutes of Health Stroke Scale(NIHSS)≥ 2 points and exclusion of intracranial hemorrhage or bleeding transformation in cranial imaging evaluation within 5 days of initial deterioration of neurological dysfunction.The patients were divided into 2 groups, an END(n=36)group and a non-END group(n=72). Fasting plasma TMAO was measured using isotope dilution liquid chromatography coupled to tandem mass spectrometry.Results:Of the 108 patients, 36(33.3%)were diagnosed with END, and their plasma TMAO levels were significantly higher compared with patients without END( Z=-3.500, P<0.001). For prediction of END, the area under the ROC curve for plasma TMAO levels was 0.707(95% CI: 0.603-0.811, P<0.001). The frequencies of END in subjects grouped via tertiles of TMAO were 22.2%, 19.4% and 58.3%, respectively, with significant differences between the 3 groups( χ2=14.979, P=0.001). Univariate analysis showed that elevated TMAO( OR=1.160, 95% CI: 1.050-1.282, P=0.004)was associated with END.A multivariate logistic regression model further confirmed the association between TMAO and END( OR=1.145, 95% CI: 1.033-1.269, P=0.010). Conclusions:Increased plasma TMAO levels are associated with END in diabetic patients with acute ischemic stroke.

Objective:To compare and analyze the differences of exercise cardiopulmonary function and the correlation of different cardiopulmonary function indexes among different aircraft types in pilots.Methods:Retrospective study was used. The exercise cardiopulmonary function of 68 Air Force pilots who were qualified for flight in aeromedical identification were tested with the Italian Cosmed exercise cardiopulmonary function tester at a power increasing rate of 25 W/min. The subjects were divided into fighter group and other aircraft group according to aircraft types. The differences of exercise cardiopulmonary function between 2 groups were compared. The correlation between maximal oxygen uptake and age, body mass index, and the correlation between heart rate recovery and exercise endurance were analyzed.Results:There were significant differences in maximal heart rate, respiratory quotient and heart rate recovery value at 1 min after exercise between fighter group (32 cases) and other aircraft group (36 cases) ( t=2.28, 2.50, 2.37, P=0.026, 0.049, 0.021). There was no significant difference in other indexes. The maximal oxygen uptake was negatively correlated with age and body mass index ( r=-0.329, -0.339, both P<0.001). The values of heart rate recovery at 2 min and 3 min after exercise were positively correlated with maximal oxygen uptake and maximal exercise power ( r=0.284, 0.290, 0.306, 0.268, P=0.001, 0.026, 0.002, 0.002). Conclusions:The indexes of exercise cardiopulmonary function have significant differences among pilots in different aircraft types, and there are significant changes with age and weight gain. The heart rate after exercise can monitor the changes of cardiopulmonary function under different training conditions.

Objective:To compare and analyze the differences of exercise cardiopulmonary function and the correlation of different cardiopulmonary function indexes among different aircraft types in pilots.Methods:Retrospective study was used. The exercise cardiopulmonary function of 68 Air Force pilots who were qualified for flight in aeromedical identification were tested with the Italian Cosmed exercise cardiopulmonary function tester at a power increasing rate of 25 W/min. The subjects were divided into fighter group and other aircraft group according to aircraft types. The differences of exercise cardiopulmonary function between 2 groups were compared. The correlation between maximal oxygen uptake and age, body mass index, and the correlation between heart rate recovery and exercise endurance were analyzed.Results:There were significant differences in maximal heart rate, respiratory quotient and heart rate recovery value at 1 min after exercise between fighter group (32 cases) and other aircraft group (36 cases) ( t=2.28, 2.50, 2.37, P=0.026, 0.049, 0.021). There was no significant difference in other indexes. The maximal oxygen uptake was negatively correlated with age and body mass index ( r=-0.329, -0.339, both P<0.001). The values of heart rate recovery at 2 min and 3 min after exercise were positively correlated with maximal oxygen uptake and maximal exercise power ( r=0.284, 0.290, 0.306, 0.268, P=0.001, 0.026, 0.002, 0.002). Conclusions:The indexes of exercise cardiopulmonary function have significant differences among pilots in different aircraft types, and there are significant changes with age and weight gain. The heart rate after exercise can monitor the changes of cardiopulmonary function under different training conditions.

【Objective】 To investigate the feasibility of differentiation of human AB plasma hematopoietic stem/progenitor cells (HSCs/HPCs) from peripheral blood into mature erythrocytes. 【Methods】 Hematopoietic stem/progenitor cells were induced to be differentiated into mature erythrocytes in the medium supplemented with 5% FBS, 3% FBS + 2% human AB plasma and 8% human AB plasma, respectively, and inoculated in 24-well culture plate at the density of 1×10⁶/mL. Cell proliferation and morphological changes were observed in three different groups. Flow cytometry was used to detect erythroid terminal differentiation markers, i. e. GPA, Band3 and α4(α4-integrin), and late erythroid cell enucleation in different group. The effects of different culture conditions on HSCs/HPCs differentiation into mature erythrocytes were compared. 【Results】 The cell growth and proliferation multiples of the three groups (8% human AB plasma, 5% FBS and 3% FBS+ 2% human AB plasma) were 2 573±116 vs 2 514±246 vs 2 539±119(P>0.05), respectively. The morphological changes of the three groups were similar. With the extension of culture time, the cells differentiated from proerythroblasts to basophils, polychromatic erythroblasts and positive erythroblasts, and almost all of them differentiated into erythrocytes enucleation on day 21. GPA expression and enucleation rate(%) of the three groups were 97.17±1.91 vs 94.95±1.61 vs 96.15±1.38, and 85.1±3.26 vs 86.93±5.96 vs 86.5±3.36(P>0.05), respectively. 【Conclusion】 The differentiation of HSCs/HPCs from peripheral blood plasma into mature erythrocytes from human AB was similar to that of fetal bovine serum.

Objective:To explore the quantitative effect of smoking on pilots′ physical fitness.Methods:According to smoking index, 215 fighter pilots were chosen as subjects and divided into non-smoking group (143 cases), low smoking-index group (23 cases), moderate smoking-index group (20 cases) and high smoking-index group (29 cases). Subjects were asked to rest on the power bicycle for 3 min, then start warm up at a speed of 60 r/min (no-load, low-level exercise at 60 r/min) for 3 min, and then execute continuously exercise at a constant speed with a power increase of 25 W/min. The load exercise was stopped immediately when the maximum exercise level was reached. Age and body mass index (BMI) were recorded, and cardiopulmonary function indexes such as exercise time, exercise power and respiratory exchange rate (RER) were measured.Results:There was no significant difference on age, BMI and RER among the 4 groups ( P>0.05), but there were significant differences in exercise time and exercise power ( F=6.02, 6.25, P=0.001, P<0.001). Under the condition of the same RER, the exercise time and exercise power of the moderate and high smoking-index group (472.1±54.6 s, 456.9±60.4 s and 197.2±23.1 W, 190.2±24.4 W) were significantly less than those of the non-smoking group (506.3±65.5 s and 211.1±26.9 W) ( P<0.05). Conclusions:This study showed that the exercise time and exercise power of moderate and high smoking-index pilots in increasing power bicycles were significantly lower than those of non-smoking pilots. If the pilots were with moderate-high smoking index their cardiopulmonary function would be affected.

Objective:To explore the relationship between neck muscle strength and elastic strain of flying personnel by comparing the changes of neck muscle elastic strain values and neck muscle strength before and after neck muscle training in flying personnel with neck pain.Methods:By using CME-1 neck muscle strength trainer, 56 flying personnel were trained under isometric and changeable velocity and resistant (CVR) training mode for 2 weeks. The neck muscle strength and neck muscle elastic strain values before and after training were compared.Results:The elastic strain values of longus colli, splenius capitis and levator scapula were significantly increased by neck muscle training ( t=4.154, 2.348, 2.745, P<0.001, P=0.040, 0.006). The relative growth rate of the average elastic strain values of longus colli, splenius capitis and levator scapula after training was 13.75%, 4.18% and 2.8%, respectively. After neck muscle training, the average maximum neck muscle strength and average 10 s maximum impulse in the directions of forward flexion, backward extension, left flexion and right flexion were higher than those before training, and the difference was statistically significant ( t=3.364-8.284, all P<0.01); The relative growth rate of the average maximum neck muscle strength in each direction was 39.3%, 34.6%, 35.2% and 28.4%, respectively, and the relative growth rate of the average 10 s maximum impulse was 51.4%, 33.6%, 42.7% and 34.5%, respectively. The elastic strain values of levator scapula and longus colli were negatively correlated with the average maximum muscle strength of anterior flexor ( r=-0.281, -0.387, P=0.036, 0.004). Conclusions:Neck muscle training can effectively improve the strength of neck muscle groups and the elastic strain of some muscle groups. The elastic strain values of levator scapula and longus colli are negatively correlated with the average maximum muscle strength of anterior flexor, those suggesting that neck muscle training has a certain effect on enhancing the activity of anterior flexor muscle groups and maintaining the physiological lordosis of cervical spine.

Objective:To explore the quantitative effect of smoking on pilots′ physical fitness.Methods:According to smoking index, 215 fighter pilots were chosen as subjects and divided into non-smoking group (143 cases), low smoking-index group (23 cases), moderate smoking-index group (20 cases) and high smoking-index group (29 cases). Subjects were asked to rest on the power bicycle for 3 min, then start warm up at a speed of 60 r/min (no-load, low-level exercise at 60 r/min) for 3 min, and then execute continuously exercise at a constant speed with a power increase of 25 W/min. The load exercise was stopped immediately when the maximum exercise level was reached. Age and body mass index (BMI) were recorded, and cardiopulmonary function indexes such as exercise time, exercise power and respiratory exchange rate (RER) were measured.Results:There was no significant difference on age, BMI and RER among the 4 groups ( P>0.05), but there were significant differences in exercise time and exercise power ( F=6.02, 6.25, P=0.001, P<0.001). Under the condition of the same RER, the exercise time and exercise power of the moderate and high smoking-index group (472.1±54.6 s, 456.9±60.4 s and 197.2±23.1 W, 190.2±24.4 W) were significantly less than those of the non-smoking group (506.3±65.5 s and 211.1±26.9 W) ( P<0.05). Conclusions:This study showed that the exercise time and exercise power of moderate and high smoking-index pilots in increasing power bicycles were significantly lower than those of non-smoking pilots. If the pilots were with moderate-high smoking index their cardiopulmonary function would be affected.

Objective:To explore the relationship between neck muscle strength and elastic strain of flying personnel by comparing the changes of neck muscle elastic strain values and neck muscle strength before and after neck muscle training in flying personnel with neck pain.Methods:By using CME-1 neck muscle strength trainer, 56 flying personnel were trained under isometric and changeable velocity and resistant (CVR) training mode for 2 weeks. The neck muscle strength and neck muscle elastic strain values before and after training were compared.Results:The elastic strain values of longus colli, splenius capitis and levator scapula were significantly increased by neck muscle training ( t=4.154, 2.348, 2.745, P<0.001, P=0.040, 0.006). The relative growth rate of the average elastic strain values of longus colli, splenius capitis and levator scapula after training was 13.75%, 4.18% and 2.8%, respectively. After neck muscle training, the average maximum neck muscle strength and average 10 s maximum impulse in the directions of forward flexion, backward extension, left flexion and right flexion were higher than those before training, and the difference was statistically significant ( t=3.364-8.284, all P<0.01); The relative growth rate of the average maximum neck muscle strength in each direction was 39.3%, 34.6%, 35.2% and 28.4%, respectively, and the relative growth rate of the average 10 s maximum impulse was 51.4%, 33.6%, 42.7% and 34.5%, respectively. The elastic strain values of levator scapula and longus colli were negatively correlated with the average maximum muscle strength of anterior flexor ( r=-0.281, -0.387, P=0.036, 0.004). Conclusions:Neck muscle training can effectively improve the strength of neck muscle groups and the elastic strain of some muscle groups. The elastic strain values of levator scapula and longus colli are negatively correlated with the average maximum muscle strength of anterior flexor, those suggesting that neck muscle training has a certain effect on enhancing the activity of anterior flexor muscle groups and maintaining the physiological lordosis of cervical spine.