OBJECTIVE: To observe the clinical efficacy of auricular electroacupuncture for post-stroke dysphagia in the pharyngeal phase. METHODS: Eighty-two patients with post-stroke dysphagia in the pharyngeal phase were randomized into an auricular electroacupuncture group (41 cases) and a swallowing electrical stimulation group (41 cases, 1 case dropped out). In the auricular electroacupuncture group, electroacupuncture was applied at auricular points, i.e. Xin (CO₁₅) and Yanhou (TG₃), using disperse-dense wave, in frequency of 2 Hz/10 Hz, 30 min a time. In the swallowing electrical stimulation group, swallowing electrical stimulation was delivered for 30 min a time. Both groups were treated once daily for 4 weeks. The functional oral intake scale (FOIS) grade, as well as the hyolaryngeal complex displacement, the pharyngeal constriction rate (PCR) and the pharyngeal delay time (PDT) under video fluoroscopic study of swallowing (VFSS) were observed before and after treatment, and the clinical efficacy was evaluated in the two groups. RESULTS: Compared before treatment, the FOIS grade was improved (P<0.01), the forward and upward displacement amplitude of hyoid bone and thyroid cartilage was increased (P<0.05), and the PCR and PDT were decreased (P<0.05) after treatment in the two groups. After treatment, compared with the swallowing electrical stimulation group, the FOIS grade was superior (P<0.01), the upward displacement amplitude of hyoid bone and thyroid cartilage was larger (P<0.05) and the PCR and PDT were lower (P<0.05) in the auricular electroacupuncture group. The total effective rate was 85.4% (35/41) in the auricular electroacupuncture group, which was higher than 62.5% (25/40) in the swallowing electrical stimulation group (P<0.05). CONCLUSION Auricular electroacupuncture can effectively trigger pharyngeal initiation and improve post-stroke dysphagia in the pharyngeal phase.
Humans ; Electroacupuncture ; Male ; Deglutition Disorders/etiology* ; Female ; Middle Aged ; Aged ; Stroke/physiopathology* ; Pharynx/physiopathology* ; Acupuncture, Ear ; Acupuncture Points ; Deglutition ; Treatment Outcome ; Adult

Objective: To understand and analyze the level and trend of lung function of children and adolescents in Yinchuan, Ningxia from 2010 to 2019, and to explore the influencing factors of vital capacity. Methods: Children and adolescents aged 7-13 years were randomly selected from Xingqing District, Jinfeng District and Xixia District of Yinchuan. Based on the data of vital capacity from three surveys in 2010, 2014 and 2019, the trends of changes across residence, ages and sex in 2010-2019 were analyzed, and the influencing factors were explored. Results: From 2010 to 2019, the vital capacity of children and adolescents aged 7- 13 years in urban and rural Yinchuan showed an upward trend( F=194.48, 382.47, P <0.01), with an increasing amount of 410.89 and 554.46 mL, respectively. In 2014, the vital capacity of urban students was higher than that of rural students, but it was lower than rural students in 2019. After stratified by age and sex, its trend was consistent with that of urban and rural areas, but students in all age groups in urban areas declined in 2014-2019. Height, weight, 50 m running, the phenomenon of "crowding out" or "Not attending" physical education and health class in school, the feeling of taking physical education and health class when exercising, the average time spent on exercises between classes every day, whether using pedometer, wearable equipment or exercise APP, travel time to school every day, the recognition on sports, were associated with vital capacity in children and adolescents ( β=-185.70, -54.94, P <0.05). Conclusion In recent years, the vital capacity of 7-13 year old children and adolescents in Yinchuan has shown an increasing trend. Physical fitness indicators and physical activity are influencing factors of lung capacity in children and adolescents. In the future, health management for students should be strengthened and students awareness of physical exercise should be improved.

OBJECTIVE: To explore the strategy of pregnancy-preserving and maternal- fetal management in patients with primary gynecologic neuroendocrine tumors (gNETs) during pregnancy. METHODS: We performed whole genome sequencing (WGS) for analyzing maternal and fetal somatic and germline single nucleotide variations (SNVs) and small insertions and deletions (InDels) for a 29-year-old pregnant woman diagnosed with stage IB2 large cell neuroendocrine carcinoma (LCNEC) and adenocarcinoma in the cervix. A systematic literature review was performed to explore the strategies for treatment of such rare histological type while maintaining pregnancy. RESULTS: Global case analysis of cervical NETs during pregnancy suggested that negative lymph node metastasis and an early FIGO stage were potentially associated with a good prognosis of the patients. In the case presented herein, a pregnancy-preserving strategy was adopted and favorable maternal-fetal outcomes were achieved after neoadjuvant chemotherapy, radical surgery and postoperative systemic chemotherapy. At 35 CONCLUSIONS Although gNETs in pregnancy are rare and highly risky, pregnancy-preserving managements of gNETs can still be considered and favorable maternalfetal outcomes are possible with proper assessment of the clinical indications and implementation of multimodal treatments. Precise treatment and follow-up strategies based on the results of WGS for risk-reducing intervention of cancer recurrence or occurrence can potentially benefit the patient and the neonate.
Adenocarcinoma ; Adult ; Carcinoma, Neuroendocrine/genetics* ; Child ; Female ; Humans ; Infant, Newborn ; Neoplasm Recurrence, Local ; Pregnancy ; Uterine Cervical Neoplasms/genetics*

Objective:To investigate whether the squirrels in Yunnan Province carried Yersinia pestis phages and their epidemiological significance. Methods:From 2015 to 2018, plague host animals were investigated in five of Yunnan plague foci and non-plague foci. The spleen, liver and intestinal specimens of the squirrels captured in the investigation were taken and stored at low temperature for later use. Intestinal specimens with PBS solution, were filtered by 0.22 μm and added to LB liquid medium containing 100 μl suspension of plague vaccine strain (EV76) and then oscillated in a constant temperature gas bath at 28 ℃ and 220 r/min for 18 to 24 h. The double-layer plate method was used to isolate and observe the growth of plaque. The morphology and structure of Yersinia pestis phages were observed under electron microscope. Meanwhile, spleen, liver and intestinal specimens were taken for detection of Yersinia pestis specific marker gene caf1. Results:A total of 10 squirrels were captured (8 Callosciurus erythraeus and 2 Dremomys pernyi), and four Yersinia pestis phages were isolated (2 in Callosciurus erythraeus and 2 in Dremomys pernyi). Two were isolated from non-plague foci (Yongshan County), two from house rats plague foci (Mile County and Xinping County), and none was isolated from wild radents plague foci (Jianchuan County and Eryuan County). By naked eye observation, two bacteriophages from the plague foci produced transparent plaques and grew well, while two bacteriophages from non-plague foci produced translucent plaques and with poor growth. By electron microscopy, these Yersinia pestis phages were of typical Myoviridae family, their head diameter was about 40 nm, muscle tail was about 120 nm, and tail filament cluster was slightly visible at the end of muscle tail. And all the 10 samples of squirrels were negative of plague-specific caf1 gene. Conclusions:The proportion of plague phages carried by Yunnan squirrels is relatively high. Although the detection of caf1 is negative. Squirrels may be a carrier of plague transmission due to the existence of Yersinia pestis phages.

Objective To explore the effect of evidence-based nursing in elderly patients undergoing coronary artery bypass grafting. Methods From June 2016 to June 2018, 110 elderly patients aged 65 to 80 who underwent coronary bypass transplantation in cardiac surgery ward were selected by convenience sampling. The subjects were divided into control group (55 cases) and observation group (55 cases). The patients in the control group were given routine nursing method. The patients in the observation group were given evidence-based nursing according to routine nursing methods. The incidence of postoperative complications and the satisfaction of nursing care between the two groups were compared. Results The incidence of arrhythmia, mental disorder, respiratory tract infection, hypoxemia, knife-edge infection and pressure sore during mechanical ventilation were 15.3％(9/55),6.8％(4/55),7.5％(6/55), 12.1％(7/55),5.2％(3/55)in the observation group, 35.7％(21/55),27.1％(15/55),25.5％(25/55),12.7％(12/55),15.3％(9/55) in the control group, and the difference was statistically significant (χ2=2.423-17.476, P<0.05 or 0.01). The satisfaction degree was 96.36％(53/55)in the observation group, 81.82％(45/55) in the control group, and the difference was statistically significant (χ2 =5.9864,P<0.05). Conclusions Evidence-based nursing has a better effect in the nursing of elderly patients undergoing coronary artery bypass grafting, and it is worth popularizing in clinical nursing.

Objective: To investigate whether plague phages were present in the indicator animals of plague foci in Yunnan Province, and to explore their epidemiological significance. Methods: Anus swabs were collected from indicator animals (dogs or cats) of the 41 plague affected villages in 26 towns of 10 cities (counties, districts) of Yunnan plague foci from November of 2015 to March of 2018. The Yersinia pestis phages were isolated by plague vaccine strain EV76. The isolation of plague phages from different plague foci, the isolation of plague phages from different canine species (cats), the polymorphism of plaque and the host spectrum of phages were analyzed. Results: A total of 1 014 indicator animals (1 003 dogs and 11 cats) were studied, and 102 of plague phages were isolated. In the 10 cities (counties, districts), plague phages were only not isolated from Lancang County, and the plague phages were isolated from the other 9 cities (counties, districts). The separation rates from high to low were as follows: Yiliang County (21.00%, 21/100), Menghai County (19.23%, 25/130), Yuanjiang County (11.63%, 10/86), Midu County (11.50%, 13/113), Wenshan County (10.10%, 10/99), Mile Country (7.07%, 7/99), Lianghe County (6.67%, 7/105), Baoshan Longyang District (4.90%, 5/102) and Gengma County (3.81%, 4/105). Of the 102 plague phages, 75 were isolated from the native dogs (Chinese pastoral dogs, 9.32%, 75/805), 20 from the pug dogs (13.70%, 20/146), 5 from the wolf dogs (17.24%, 5/29), 1 from Samoye (1/4) and 1 from Alaska dog (1/2). The plaque of the phage was divided by five appearance of complete lysis (the plate was clear), large (2.5-4.0 mm), big (1.5-< 2.5 mm), middle (0.5-< 1.5 mm) and small (< 0.5 mm). The representative phages were all of the Myoviridae family. Most of the phages could lysis the strains of Yersinia pestis, and some phages could lysis Shigella and type 5 Yersinia pseudotuberculosis (PST5). Conclusion The plague phages are present in the plague foci of Yunnan, and the phages are polymorphic.

Objective To identify the causes of nonspecific bands in the detection of a industry standard caf1 gene by polymerase chain reaction(PCR),and to propose a solution to this problem. Methods A total of 112 strains were selected for the experiment, including 40 strains of Yersinia pestis, 72 strains of non-Yersinia pestis;DNA was extracted,and caf1 gene was amplified by PCR;seven non-specific strips were recovered,purified and TA cloning and sequencing; the primer of the caf1 gene was redesigned and validated using all of the strains. Results Using the industry standard caf1 gene primer,DNAs of 40 Yersinia pestis and 72 non-Yersinia pestis were amplified by PCR, 58 non-Yersinia pestis could be amplified with non-specific bands, they were about 400, 500, 600, 700, 800, 900, 1 000 bp. By TA cloning and sequencing, the non-specific bands in the downstream of the industry standard caf1 primer and its reverse complement were amplified. Using the new designed caf1 primer to amplify, 72 non-Yersinia pestis strains showed no non-specific bands. Conclusion Non-specific bands has been amplified in the screening of Yersinia pestis using the primer of the industry standard caf1, and the new caf1 primer can effectively avoid this problem and improve the accuracy of detection.

Objective: To explore the clinical features and complications of foreign bodies in the upper gastrointestinal tract in children and to investigate the effectiveness of endoscopic management. Methods: Data of patients with foreign bodies in upper gastrointestinal tract were collected retrospectively at Endoscopy Center, the Children's Hospital, Zhejiang University School of Medicine, from January 2011 to December 2016. Clinical characteristics, the types of foreign bodies, the location and duration of foreign body impaction were summarized. The risk factors of complications and endoscopic removal failure were analyzed by using Logistic regression analysis. Results: A total of 1 334 patients (825 males and 509 females) were enrolled. The median age was 2.5 years, with a range from 0.25 to 15 years and peak age 1-3 years. Twenty patients had esophageal diseases. The most common foreign body ingested was coin (n=964, 72.3%). Foreign bodies were most commonly located in the esophagus (n=1 002, 75.1%), especially in the upper esophagus (n=857, 85.5%). The duration of foreign body impaction ranged from 3 hours to 5 years. Among 1 334 patients, 252 patients (18.9%) developed complications, including ulcers (n=101, 40.0%) and perforations(n=13, 5.2%). The success rate of endoscopic removal was 96.6% (n=1 288). By Logistic regression analysis, sharp foreign body ingestion (OR=6.893, 95%CI: 4.421-10.746) , esophageal impaction (OR=5.253, 95%CI:3.352-8.233) and foreign body impaction longer than 24 hours (OR=4.336, 95%CI:3.091-6.082) were risk factors of complications. Sharp foreign body ingestion was the risk factor of endoscopic failure (OR=5.372, 95%CI:2.773-10.406) . Conclusions Coin is the most common foreign body in upper gastrointestinal tract. Sharp foreign bodies impacted in the esophagus over 24 hours increase the risk of complications. Endoscopic removal of foreign bodies from the upper gastrointestinal tract in children has a high success rate. Sharp foreign body ingestion increases the risk of failure in endoscopic removing.

Objective:To investigate the effects of laparoscopy assisted complete mesocolon resection on the stress response and immune function of patients with colon cancer.Methods:From January 2013 to January 2016,130 patients with colon cancer in our hospital were selected and randomly divided into the observation group and the control group with 65 cases in each group according to the random lottery envelopes.The observation group was treated with laparoscopy assisted complete mesocolon resection,the control group was treated with open operation.The changes of semm IL-6,TNF-α and amours of CD4+ cells,blood loss,bowel function restoration time,hospital stays and complication rate of two groups were compared before and after treatment.Results:Both groups of patients were successfully completed the surgery and there was no serious complications occurred in both groups.The amount of bleeding,postoperative intestinal recovery time and postoperative hospital stay in the observation group were significantly less than those of the control group (P＜0.05).The chylous fistula,wound infection,pulmonary infection and complication rate on the 14th day postoperation in the observation group was 1.5％,which was 12.3％ in the control group and significantly higher than that of the control group (P＜0.05).The contents ofCD4+ cells in the observation group and the control group were 36.34± 7.83％ and 33.66± 9.82％,respectively,which were significantly higher than those before treatment(30.33± 6.49％ and 30.49± 5.33％)(P＜0.05),and the contents of CD4+ cells of observation group was significantly higher than that of the control group after treatment (P＜0.05).The serum levels ofIL-6 and TNF-α in both groups were significantly lower than those before treatment on the 14th day postoperation (P＜0.05),and the serum IL-6 and TNF-α levels of observation group were significantly lower than those in the control group on the 14th day postoperation (P＜0.05).Conclusion:Laparoscopy assisted complete mesocolon resection could promote the immune function and inhibit the stress response,which further promoted the rehabilitation and induced the complications in the treatment of patients with colon cancer.