1.Pan-Cancer Analysis of Disulfidptosis-Related Genes Affecting Prognosis and Tumor Microenvironment
Jingyang SUN ; Rongxuan JIANG ; Liren HOU ; Huanhuan DONG ; Yihan LIN ; Niuniu DONG ; Guangjian ZHANG ; Yanpeng ZHANG
Cancer Research on Prevention and Treatment 2025;52(1):52-61
Objective To assess the potential role of disulfidptosis-related genes (DRGs) in pan-cancer on prognosis and immunity on the basis of bioinformatics approaches. Methods Pan-cancer RNA-seq data, mutation profiles, clinical information, TMB, MSI, stemness scores, and tumor and immune microenvironment data contained in TCGA and various open-source online databases, and multi-group R-language algorithms were used for comprehensive analysis. The expression levels of DRGs at the cellular level were experimentally validated using qPCR. Results LRPPRC, NCKAP1, NDUFS1, and NUBPL had a better prognosis in renal clear cell carcinoma (P<0.001), whereas SLC7A11, NCKAP1, and SLC3A2 had a worse prognosis in hepatocellular carcinoma (P<0.001). TME analysis showed that LRPPRC was negatively correlated with immune cells, stromal cells, and estimated scores in all tumor types. TMB analysis revealed the potential research value of DRGs for PD-1/PD-L1 therapy in pan-cancer. Drug sensitivity analysis showed that SLC7A11 (r=0.454), SLC3A2 (r=0.366), and NCKAP1 (r=0.455) were significantly associated with Kahalide F (P<0.01). Experimental validation demonstrated the overall higher expression levels of GYS1 and NCKAP1 than normal cells in lung adenocarcinoma, colon adenocarcinoma, esophageal squamous carcinoma, and hepatocellular carcinoma (P<0.05). Conclusion Pan-cancer analysis of DRGs indicates that DRGs may serve as important biomarkers for the diagnosis and prognosis of renal clear-cell carcinoma, lung adenocarcinoma, and hepatocellular carcinoma.
2.Finite element analysis of optimization of femoral prosthesis implantation position in unicompartmental knee arthroplasty in osteoporotic patients
Mengfei LIU ; Gang CHEN ; Yihan SHI ; Lin ZENG ; Kan JIANG ; Yilihamujiang·Wusiman
Chinese Journal of Tissue Engineering Research 2025;29(3):464-470
BACKGROUND:The reasonable implantation range of femoral prosthesis in unicompartmental knee arthroplasty in patients with osteoporosis has not been investigated,and previous studies have often been based on unicompartmental knee arthroplasty models in normal bone,with fewer mechanical studies in models with non-normal bone.Complications after unicompartmental knee arthroplasty have been shown to be highly associated with osteoporosis. OBJECTIVE:To analyze the biomechanical effects of the coronal inclination of the Sled fixed platform femoral prosthesis on unicompartmental knee arthroplasty in patients with osteoporosis and to find the correlation between osteoporosis and mid-and long-term complications after unicompartmental knee arthroplasty. METHODS:Based on the digital imaging technology to obtain the data of the knee joint and prosthesis,a normal bone knee model is then created by using specialized software such as Mimics and Geomagic studio.Based on a validated normal bone knee model,an osteoporotic knee model was created by changing the material parameters.Totally 14 unicompartmental knee arthroplasty finite element models were created using Sled fixed platform femoral prosthesis:standard position(0°),varus and valgus angles:3°,6°,9° in the normal bone and osteoporosis groups.Stress changes on the surface of polyethylene liner,cancellous bone under tibial prosthesis,and cortical bone were calculated and analyzed in all unicompartmental knee arthroplasty models. RESULTS AND CONCLUSION:(1)In the osteoporotic models,the high stress values of the polyethylene liner surface and the cancellous bone under the tibial prosthesis increased with the increase of the tilt angle of the femoral prosthesis,and the high stress values of the cortical bone surface under the tibial prosthesis increased with the increase of the prosthesis valgus angles and decreased with the increase of the varus angles.(2)For the polyethylene liner surface as well as the subcortical bone surface of the tibial prosthesis,the high stress values of the models for each inclination angle in the osteoporosis group were greater than those of the corresponding models in the normal bone group.For the surface of the cancellous bone under the tibial prosthesis,the high stress values of the tilt angle models of the osteoporosis groups were smaller than those of the normal bone groups.(3)Osteoporosis may cause biomechanical abnormalities in the internal structures of the knee after unicondylar replacement,increasing the potential risk of postoperative aseptic loosening of the prosthesis and periprosthetic fractures.Varus and valgus of the femoral prosthesis in the coronal plane should be avoided as much as possible when performing medial unicompartmental knee arthroplasty with a Sled fixation platform in osteoporotic knees.
3.Analysis on Quality of Sojae Semen Praeparatum Based on Traditional Quality Evaluation
Yihan WANG ; Wangmin LIN ; Shuili ZHANG ; Bing YU ; Tiegui NAN ; Liping KANG ; Guofeng LI ; Xiyuan HE ; Zhilai ZHAN ; Luqi HUANG
Chinese Journal of Experimental Traditional Medical Formulae 2024;30(1):31-42
ObjectiveBased on the quality evaluation experience of "it is better to have a fragrant and strong aroma" summarized by materia medica of past dynasties, the chemical components of Sojae Semen Nigrum(SSN) and Sojae Semen Praeparatum(SSP) were systematically compared and analyzed, and the main fermentation products in different fermentation time were quantitatively analyzed, so as to clarify the transformation law of internal components in the processing process and provide scientific basis for the modern quality control of SSP. MethodUltra performance liquid chromatography-quadrupole tandem time-of-flight mass spectrometry(UPLC-Q-TOF-MS) was used for the structural identification of the chemical constituents of SSN and SSP, and with the aid of Progenesis QI v2.3 software, the negative ion mode was employed for principal component analysis(PCA) pattern recognition, and the data were analyzed with the aid of orthogonal partial least squares-discriminant analysis(OPLS-DA) for two-dimensional data to obtain S-plot, and components with |P|>0.1 were selected as the differential constituents. The contents of isoflavonoids in SSP during fermentation was determined by UPLC, and the samples were taken every 8 h in the pre-fermentation period and every 2 d in the post-fermentation period, and the dynamic changes of isoflavonoid contents in different fermentation stages were analyzed. The contents of amino acids and nucleosides in SSP and SSN from different fermentation stages were quantitatively analyzed by phenyl isothiocyanate(PITC) pre-column derivatization and high performance liquid chromatography(HPLC) gradient elution, and the contribution of flavor substances to the "delicious" taste of SSP was discussed by taste intensity value(TAV). ResultA total of 19 kinds of differential components were screened out, mainly soybean saponins and isoflavones, and their contents decreased significantly or even disappeared after fermentation. In the pre-fermentation process of SSP, glycoside bond hydrolysis mainly occurred, and isoflavone glycosides in SSN were degraded and converted into the corresponding aglycones, the content of flavor substances such as amino acids increased gradually. In the post-fermentation process, protein degradation mainly occurred, after 8 d of post-fermentation, the content of isoflavones was basically stable, while the total content of amino acids increased by 8-40 times on average. Different amino acids form the special flavor of SSP, such as the TAV of glutamate is always ahead of other flavor substances, and sweet substances such as alanine and valine have made relatively great contributions to SSP. ConclusionBased on the law of constituent transformation, combined with the traditional evaluation index of "fragrant and strong", it is difficult to control the fermentation degree of SSP by the existing standards in the 2020 edition of Chinese Pharmacopoeia. It is suggested that description of the characteristics of SSP be refined and changed to "fragrant, delicious and slightly sweet", and at the same time, the post-fermentation index compounds such as glutamic acid, alanine and valine should be added as the quality control indicators of SSP, so as to standardize the production process and improve the quality of SSP.
4.Inhibitory effect of Salidroside on the interaction between human platelets and breast cancer MDA-MB-468 cells
Yihan SHAO ; Xiaobao SHAO ; Weina ZHU ; Xin CHEN ; Lin ZHOU ; Peiyuan ZHU
Chinese Journal of Blood Transfusion 2024;37(7):754-760
Objective To study the effect of Salidroside(Sal)on platelet activation and aggregation and the interaction between human platelets and MDA-MB-468 cells of breast cancer.Methods Human platelets were collected,platelet sus-pension was prepared,and platelets were treated with different concentrations of Sal.The effects of Sal on platelet activation and aggregation were detected by thromboelastogram(TEG)and flow cytometry.Breast cancer MDA-MB-468 cells were cul-tured in vitro,and human platelets were treated with different concentrations of Sal,and then activated by thrombin.The effects of Sal on the interaction between platelets and MDA-MB-468 cells were analyzed by adhesion test and scratch test.Re-sults TEG detection:The ADP inhibition rate in the blank control group was(10.97±12.69)%,and the ADP inhibition rate in all Sal intervention groups was higher than that in the blank control group(P<0.05).The AA inhibition rate was(8.11±7.84)%in the control group and(25.96±15.18)%in the 5 μmol/L Sal intervention group,and the difference was statistically significant(P<0.05).Flow cytometry:The expression of CD62P on platelet surface in 40 and 60 μmol/L Sal groups was(56.5±0.17)%and(65.50±0.36)%,respectively,and the difference was statistically significant compared with the positive control group(76.53±0.49)%(P<0.05).The percentages of PAC-1 expression on platelet surface in 40 and 60 μmol/L Sal groups were(62.20±0.10)%and(58.47±0.15)%,and the difference was statistically significant com-pared with the positive control group(72.10±0.20)%(P<0.05).Adhesion experiment:Platelets can have adhesion with MDA-MB-468 cells,and activated platelets have stronger adhesion ability.The adhesion rate in the Sal group was signifi-cantly lower than that in the positive control group,and was negatively correlated with the concentration of Sal.Scratch test:The cell mobility at 24 h in the positive control group was(12.71±0.70)%,and the cell mobility in each Sal treatment group was(4.51±0.44)%,(3.85±0.11)%,(5.37±0.36)%,(4.15±0.13)%and(3.55±0.38)%,respectively,showing significant decrease compared with the positive control group(P<0.05).After 48 h of Sal treatment,the cell mobility of 10,20,40 and 60μmol/L Sal groups decreased,and there was a statistical difference compared with the positive control group(P<0.05).Conclusion Sal can inhibit the adhesion between activated platelets mediated by thrombin and MDA-MB-468 cells and the migration of MDA-MB-468 cells.
5.Analysis of global research trends and hotspots on the correlation between hyperuricemia and cardiovascular disease
Yihan SHI ; Lin ZENG ; SUBATIJIANG-Paerhati ; Lei ZHANG ; Rongxin SUN
China Modern Doctor 2024;62(32):29-33
Objective To analyze the latest research hotspots and development trends of hyperuricemia and cardiovascular diseases in the past 20 years by using CiteSpace software and VOSviewer software.Methods The Web of Science database was searched from January 2005 to July 2024 for the literature on hyperuricemia and cardiovascular diseases,and the keywords,authors,institutions,and countries were analyzed by CiteSpace software and VOSviewer software,and the network cooperation map was constructed.Results A total of 2344 articles written by 5844 authors from 75 countries and 1713 institutions were analyzed.The journal Nutrition Metabolism and Cardiovascular Diseases had published the most papers in this field,with a total of 36 articles.Scholar Johnson has published 19 papers in this field,ranking first.A total of 2678 keywords were included,and the keywords that identified the research frontier and continued through 2024 were"asymptomatic hyperuricemia""xanthine oxidoreductase""adults".Conclusion The literature published in the field of hyperuricemia and cardiovascular disease correlation from 2005 to 2024,are comprehensively summarize,and sort out the development trends and research hotspots in this field in the past 20 years,through bibliometrics and visual analysis,which is expected to provide a reference direction for researchers in this field for subsequent research.
6.Relationship between preoperative SARS-CoV-2 vaccination and postoperative delirium
Haoran ZHANG ; Yihan CHEN ; Xu LIN ; Bin WANG ; Yunchao YANG ; Yanlin BI
Chinese Journal of Anesthesiology 2023;43(5):526-530
Objective:To evaluate the relationship between preoperative SARS-CoV-2 vaccination and postoperative delirium(POD) in the patients.Methods:A total of 938 participants of either sex, aged 50-90 yr, weighing 50-90 kg, of American Society of Anesthesiologists Physical Status classificationⅠorⅡ, with preoperative Mini-Mental State Examination score ≥24, without communication barriers, undergoing elective knee or hip joint replacement under combined spinal-epidural anesthesia from June 2020 to June 2022 in Qingdao Municipal Hospital, were enrolled. The vaccination with SARS-CoV-2 inactivated vaccine within 6 months before operation was recorded. The cerebrospinal fluid 2 ml was extracted after the puncture needle was successfully inserted into the subarachnoid space for determination of the concentrations of Aβ42, total tau protein (t-tau), and phosphorylated tau protein (p-tau) by enzyme-linked immunosorbent assay (by enzyme-linked immunosorbent assay). The Aβ42/t-tau and Aβ42/p-tau ratios were calculated. POD was assessed using the Confusion Assessment Method twice a day within 7 days after surgery or before discharge.The patients were divided into POD group and non-POD group according to whether they developed POD. The risk factors of which P values were less than 0.20 in the univariate logistic regression would enter the multivariate logistic regression analysis to investigate the relationship between SARS-CoV-2 vaccine and level of cerebral spinal fluid (CSF) biomarkers and POD. Results:Eight hundred and seventy-four patients were finally enrolled in the analysis, of which 169 patients developed POD, with an incidence of 19.3%.The results of logistic regression showed that vaccination with SARS-CoV-2 inactivated vaccine within 6 months before operation, preoperative concentrations of Aβ42 in CSF, and increase in Aβ42/t-tau and Aβ42/p-tau ratios were protective factors for POD, and preoperative elevated concentrations of t-tau and p-tau in CSF were risk factors for POD ( P<0.05). After gender, age, preoperative Mini-Mental State Examination score, years of education, history of drinking, hypertension, diabetes mellitus and coronary heart disease were added to eliminate the influence of confounding factors, the results still showed that vaccination with SARS-CoV-2 inactivated vaccine within 6 months before operation was a protective factor for POD. Conclusions:Vaccination with SARS-CoV-2 inactivated vaccine within 6 months before operation is a protective factor for POD in patients.
7.A study on epithelial cell adhesion molecule targeted nucleic acid aptamer drug conjugate in gastric cancer targeted treatment
Tao PAN ; Yihan ZHENG ; Hui CAO ; Lin TU ; Yang SUN
Chinese Journal of Digestive Surgery 2023;22(10):1219-1225
Objective:To investigate the affinity and toxicity of epithelial cell adhesion molecule (EpCAM) targeted nucleic acid aptamer drug conjugate SYL3C-MMAE on human gastric epithelial cells GES-1 (hereinafter referred to as GES-1 cells) and human gastric cancer cells AGS and MKN45 (hereinafter referred to as AGS cells and MKN45 cells).Methods:The experimental study was conducted. The expression level of EpCAM in gastric cancer tissues was detected using immunohistochemistry. The mRNA expression level of EpCAM in gastric cancer tissues was detected using real-time fluorescence quantitative PCR (RT-PCR). The expression level of EpCAM protein in GES-1, AGS and MKN45 cells was detected using Western blot. The affinity of SYL3C on GES-1, AGS and MKN45 cells was detected using flow cytometry. SYL3C-MMAE was synthesized through a thiol-maleimide reaction. The toxicity of drugs on GES-1, AGS and MKN45 cells was detected using CCK-8 assay. The cell cycle condition of GES-1, AGS and MKN45 cells after drug treatment was detected using propidium iodide (PI) staining. Observation indicators: (1) expression of EpCAM in gastric cancer; (2) affinity of antibodies targeting EpCAM and SYL3C on GES-1, AGS and MKN45 cells; (3) situation of drug synthesis; (4) drug toxicity and inhibition of cell cycle. Measurement data with normal distribution were represented as Mean± SD. One-way ANOVA was used for comparison among multiple groups, and pairwise comparison was conducted using the least significant difference test. Comparison of unequal variances was conducted using the Welch' t test. Measurement data with skewed distribution were represented as M(IQR), and comparison between groups was conducted using the paired rank sum test. Count data were described as absolute numbers, comparison between groups was conducted using the paired chi-square test. Results:(1) Expression of EpCAM in gastric cancer. Results of immunohistochemistry on tissue microarrays showed that the positive rate of EpCAM was 82.9%(29/35) and 22.9%(8/35) in the 35 pairs of gastric cancer and its adjacent tissues (normal tissues), respectively, showing a significant difference between them ( P<0.05). Results of RT-PCR showed that the mRNA relative expression levels of EpCAM was 1.23 (4.13) and 4.04 (1.72) in 12 pairs of gastric cancer and its adjacent tissues respectively, showing a significant difference between them ( Z=-2.67, P<0.05). Results of Western blot showed that the relative expression levels of EpCAM protein in GES-1, AGS, and MKN45 was 0, 1.00, and 0.27, respectively, with the expression level of EpCAM protein in AGS cells as the standard. (2) Affinity of antibodies targeting EpCAM and SYL3C on GES-1, AGS and MKN45 cells. Results of flow cytometry showed that antibodies targeting EpCAM and SYL3C had good affinity on AGS and MKN45 cells but no affinity on GES-1 cells. (3) Situation of drug synthesis. Results of mass spectrometry showed that the drug solution of compound formed by connecting SYL3C with monomethylorestatin E (VcMMAE) exhibited a strong peak at the molecular weight position of 16 355, consistent with the expected molecular weight of the SYL3C-MMAE complex, indicating that SYL3C-MMAE was successfully synthesized. (4) Drug toxicity and inhibition of cell cycle. Results of CCK-8 assay showed that the half maximal inhibitory concentration (IC 50) of VcMMAE on GES-1, AGS and MKN45 cells was 123.00, 30.48 and 51.83 nmol/L, respectively. The IC 50 of SYL3C-MMAE on GES-1, AGS and MKN45 cells was 241.80, 20.66 and 27.64 nmol/L, respectively. Results of PI staining and flow cytometry showed that both VcMMAE and SYL3C-MMAE could induce G2/M phase blockage in the cell cycle of GES-1, AGS and MKN45 cells. Conclusion:The SYL3C-MMAE has a good affinity on gastric cancer cells. Compared with VcMMAE, SYL3C-MMAE exhibits efficient inhibition on gastric cancer cells, but less influence on normal cells.
8.Echocardiographic evaluation of the domestic D-Shant device for treatment of patients with chronic heart failure
Yi ZHOU ; He LI ; Yuman LI ; Lingyun FANG ; Jie LIU ; Wenqian WU ; Zhenxing SUN ; Ziming ZHANG ; Lin HE ; Yihan CHEN ; Yuji XIE ; Xiaoke SHANG ; Nianguo DONG ; Mingxing XIE
Chinese Journal of Ultrasonography 2022;31(9):737-745
Objective:To evaluate the efficacy of the domestic D-Shant device for the treatment of patients with chronic heart failure (CHF) using echocardiography.Methods:Twenty-four CHF patients who were treated with domestic D-Shant device in Union Hospital, Tongji Medical College, Huazhong University of Science and Technology from September 2020 to December 2021 were enrolled in the study. Pulmonary capillary wedge pressure (PCWP)/ left atrial pressure (LAP), right atrial pressure (RAP), pulmonary artery pressure, interatrial septal gradient pressure, cardiac index and pulmonary/systemic blood flow ratio (Qp/Qs) were measured before and after implantation using right heart catheterization.Left atrial end-diastolic area index (LAEDAI), left atrial end-diastolic volume index (LAEDVI), left ventricular end-diastolic volume index (LVEDVI), left ventricular end-systolic volume index (LVESVI), left ventricular ejection fraction (LVEF), right atrial end-diastolic diameter, right ventricular end-diastolic diameter, tricuspid annular plane systolic excursion (TAPSE), right ventricular tractional area change (RVFAC), device shunt aperture, velocity and pressure, together with mitral and tricuspid regurgitation severity were measured using echocardiography before, and 1 month as well as 3 months after D-Shant device implantation. Clinical data were collected and analyzed including 6-minute walking test (6MWT), New York Heart Association (NYHA) classification and the Kansas City Cardiomyopathy Questionnaire (KCCQ). Spearman correlation analysis was used to determine the relation between the changes in PCWP/LAP as well as echocardiographic parameters before and 3 months after implantation and NYHA classification. Binary Logistic regression analysis was performed to determine the predictive factors of NYHA classification improvement at 3-month follow-up after D-Shant device implantation.Results:①D-Shant devices were successfully implanted in all patients. ②Compared with preoperative values, invasive PCWP/LAP systolic, diastolic and mean pressures, transatrial septal gradient, and pulmonary systolic, diastolic and mean pressures decreased significantly after implantation(all P<0.001); Qp/Qs increased significantly after implantation( P<0.001). ③Compared with preoperative values, TAPSE, RVFAC and pulmonary artery flow velocity increased at 1 month after implantation(all P<0.05), whereas a significant reduction in mitral regurgitation grade, and an increase in LVEF and pulmonary artery flow velocity at 3 months after implantation(all P<0.05). Right atrial end-diastolic diameter, right ventricular end-diastolic diameter, LAEDAI, LAEDVI, LVEDVI, LVESVI, ratio of early to late diastolic peak velocities of mitral inflow(E/A), systolic peak velocity of mitral annulus at septal site(S′), ratio of early diastolic peak velocity of mitral inflow to diastolic peak velocity of mitral annulus(E/e′), pulmonary artery diameter, inferior vena cava diameter and degree of tricuspid regurgitation did not change among before, and 1 month as well as 3 months after implantation. There were no significant changes in the device shunt aperture, velocity and pressure between 1 month and 3 months after implantation(all P>0.05). ④The significant improvements in NYHA classification, KCCQ scores and 6MWT were observed at 1 and 3 months after implantation compared with preoperative values (all P<0.01). ⑤NYHA classification at 3 months after implantation was correlated with LVEF pre-post, PCWP/LAP pre-post, TAPSE pre-post and RVFAC pre-post ( rs=0.738, -0.730, 0.738, 0.723; all P<0.001). Logistic regression analysis showed that LVEF pre-post was an independent predictor for NYHA classification improvement at 3 months after implantation ( OR=0.687, 95% CI=0.475-0.992, P=0.045) . Conclusions:Domestic D-Shant device can effectively improve the cardiac function and clinical symptoms in patients with CHF. Echocardiography is a feasible and effective method to evaluate the benefits of domestic D-Shant device for the treatment of CHF.
9.Deep transcranial magnetic stimulation based on H-coil in nervous system diseases
Yihan WANG ; Mengmeng WANG ; Ziyang ZHOU ; Zhi LI ; Yongzhong LIN
Chinese Journal of Neuromedicine 2022;21(1):76-80
Deep transcranial magnetic stimulation (DTMS) is a novel non-invasive neural regulation technology developed on the basis of repetitive transcranial magnetic stimulation; it adopts the Hesed coil (H-coil), which can stimulate wider range of cerebral cortex and deeper brain regions without increasing the stimulation intensity; Currently, it has been applied to the treatment of depression and other mental diseases. In this paper, we review the research status of DTMS in Parkinson's disease, Alzheimer's disease, motor dysfunction after stroke, and aphasia.
10.Analysis of Three-Dimensional Gait Characteristics before and after FSPR Surgery of Patients with Spastic Cerebral Palsy
Jie ZHANG ; Yihan XU ; Siyu LIN ; Caixia LI ; Wen XIA ; Jiejiao ZHENG
Journal of Medical Biomechanics 2021;36(5):E712-E717
Objective To analyze gait characteristics of patients with spastic cerebral palsy (CP) before and after functional selective posterior rhizotomy (FSPR) surgery, so as to evaluate curative effects of the surgery objective ly. MethodsFifteen patients with spastic CP to be treated by FSPR were selected. The VICON three-dimensional (3D) motion analysis system and AMTI 3D force plates were used to collect and analyze the spatiotemporal gait parameters, kinematic and dynamic parameters before and after FSPR surgery. Results After the surgery, the left and right support phases were longer,and the left-side step length was significantly larger. The step height, velocity and the max displacement of center of gravity (COG) in coronal plane were smaller than those before surgery.The sagittal plane angle (flexion and extension angle) of the knee during initial landing was significantly increased, while no significant differences were found in that of the hip and ankle.The range of motion (ROM) of the left/right hip, knee and ankle in sagittal plane was increased to some extent during walking, with statistical differences. The ROM of right ankle in coronal plane was also increased obviously. The minimum flexion angle of the right knee and the maximum plantar flexion angle of the left/right ankle were significantly reduced. The maximum vertical forces of left and right support phases were significantly increased, while no significant differences were found in torque of lower limbs. Conclusions The 3D gait analysis can be used to evaluate the effect of FSPR on patients with spastic CP. The spasticity of patients with spastic CP is relieved after FSPR surgery, and the spatiotemporal gait parameters and kinematics parameters are improved significantly. But the improvement of dynamic parameters was not obvious, and further rehabilitation treatment is needed.

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