Objective To explore whether virtual reality(VR)combined with computerized cogni-tive training intervention can improve the cognitive function in elderly stroke patients.Methods A total of 202 stroke patients admitted to our department from January 2022 to January 2024 were recruited and randomly divided into control group(101 cases,traditional cognitive training intervention)and study group(101 cases,VR combined with computerized cognitive training in-tervention).Before and after 3 months of intervention,Montreal Cognitive Assessment Scale(MoCA),Mini-Mental State Examination(MMSE),National Institutes of Health Stroke Scale(NIHSS),Fugl-Meyer Assessment(FMA),Activities of Daily Living Scale(ADL)were applied,serum levels of dopamine,neuropeptide Y(NPY),5-hydroxytryptamine(5-HT)and norepineph-rine(NE)were detected,and P300 wave of event-related potential was measured.The results were compared before and after intervention,and between the two groups.Results After intervention,the scores of MoCA,MMSE and FMA,the levels of NPY,5-HT,NE,dopamine,and the ampli-tude of P300 wave were obviously higher in both groups when compared with those before inter-vention(P＜0.05).The study group obtained notably higher MoCA score(27.64±0.62 vs 26.83±0.65),MMSE score(27.67±0.61 vs 26.83±0.62),NPY,5-HT,NE,dopamine,FMA score and amplitude of P300 wave after intervention than the control group(P＜0.01).The NIHSS score,ADL score and latency in the two groups after intervention were significantly lower than those before intervention(P＜0.05),and the above indicators in the study group were significantly low-er than the control group(P＜0.01).Conclusion VR combined with computerized cognitive training intervention can effectively improve the cognitive function,neurological function,motor function and daily life function,and enhance the neurotransmitter levels in elderly stroke patients.

Objective: To investigate the impact of extracurricular physical activity on heart rate variability (HRV) among primary and secondary school students in Chengdu City, so ao to provide references for scientific exercise prescription. Methods: Using a convenient sampling method, 1 323 primary and secondary students were enrolled from central Chengdu who underwent physical fitness assessments at Sichuan Provincial Institute of Sports Science from September 2020 to January 2022. According to the standards of the National Physical Fitness Monitoring Center, boys and girls were divided into groups with and without extracurricular physical exercise habits. HRV was monitored using the SA-3000P device. Key HRV parameters were evaluated separately by gender, including standard deviation of normal to normal intervals (SDNN), root mean square of successive differences (rMSSD), total power (TP), low frequency power (LF) and high frequency power (HF). Statistical analyses were employed by t-test, Mann-Whitney U-test and Chi square test. Results: lgSDNN, lgrMSSD, TP, LF and HF in the group without extracurricular physical exercise habit [boys:(1.67±0.13)ms, (1.59±0.20)ms, (7.34±0.73)ms 2, (6.11±0.74)ms 2, (6.05±0.87)ms 2; girls:(1.67± 0.13)ms , (1.59±0.19)ms, (7.35±0.60)ms 2, (6.06±0.69)ms 2, (6.12±0.87)ms 2] were lower than those in the group with extracurricular physical exercise habit [boys:(1.75±0.13)ms, (1.72±0.18)ms, (7.69±0.62)ms 2, (6.41±0.76)ms 2, (6.44±0.79)ms 2；girls:(1.73±0.13)ms, (1.68±0.20)ms, (7.60±0.65)ms 2, (6.26±0.86)ms 2, (6.36±0.90)ms 2] ( t =-8.24, -8.75, -6.54, -5.35 , -6.33；-5.10，-4.90，-4.47，-2.71，-2.93, all P ＜0.01). Only the group of boys without extracurricular physical exercise habits showed a decrease in lgLF/HF [0.04(-0.19,0.27)] compared to the group with extracurricular physical exercise habits [ -0.03 (-0.25,0.20)] ( Z=-2.01, P <0.05). When the score classes of autonomic nerve activity, stress index and fatigue index were compared between boys and girls groups without and with extracurricular physical exercise habits, the proportion of boys normal and above scores increased from 79.3%, 84.1%, 71.8% to 91.4%, 95.7%, 87.3%, respectively, and the differences were statistically significant ( χ 2=47.42, 63.66, 38.28); the proportion of girls normal score and above increased from 79.8%, 85.7%, 75.0% to 85.4%, 92.1%, 79.4%, and the differences were statistically significant ( χ 2=48.31, 22.18, 22.22) (all P <0.01). Conclusion The primary and secondary school students who have the habit of extracurricular physical exercise have enhanced compliance in indicators related to HRV, showing more complex heart rate variability.

Objective To explore whether virtual reality(VR)combined with computerized cogni-tive training intervention can improve the cognitive function in elderly stroke patients.Methods A total of 202 stroke patients admitted to our department from January 2022 to January 2024 were recruited and randomly divided into control group(101 cases,traditional cognitive training intervention)and study group(101 cases,VR combined with computerized cognitive training in-tervention).Before and after 3 months of intervention,Montreal Cognitive Assessment Scale(MoCA),Mini-Mental State Examination(MMSE),National Institutes of Health Stroke Scale(NIHSS),Fugl-Meyer Assessment(FMA),Activities of Daily Living Scale(ADL)were applied,serum levels of dopamine,neuropeptide Y(NPY),5-hydroxytryptamine(5-HT)and norepineph-rine(NE)were detected,and P300 wave of event-related potential was measured.The results were compared before and after intervention,and between the two groups.Results After intervention,the scores of MoCA,MMSE and FMA,the levels of NPY,5-HT,NE,dopamine,and the ampli-tude of P300 wave were obviously higher in both groups when compared with those before inter-vention(P＜0.05).The study group obtained notably higher MoCA score(27.64±0.62 vs 26.83±0.65),MMSE score(27.67±0.61 vs 26.83±0.62),NPY,5-HT,NE,dopamine,FMA score and amplitude of P300 wave after intervention than the control group(P＜0.01).The NIHSS score,ADL score and latency in the two groups after intervention were significantly lower than those before intervention(P＜0.05),and the above indicators in the study group were significantly low-er than the control group(P＜0.01).Conclusion VR combined with computerized cognitive training intervention can effectively improve the cognitive function,neurological function,motor function and daily life function,and enhance the neurotransmitter levels in elderly stroke patients.

Objective To explore the clinical efficacy of low-frequency pulse therapy combined with ingestion-swallowing training in the treatment of patients with post-stroke dysphagia.Methods A retrospective study was conducted on 122 patients with post-stroke dysphagia admitted in our hospital from January 2022 to January 2024.According to different interventions,they were divid-ed into a control group(ingestion-swallowing training on the basis of conventional treatment,60 cases)and a combined treatment group(low-frequency pulse therapy and the treatments in the control group,62 cases).Before and after treatment,VFSS and standard swallowing assessment(SSA)were performed,hyoid bone movement displacement(hyoid bone forward and upward)and vertebrobasilar artery blood flow indicators[pulsatility index(PI),mean blood flow velocity(Vm),systolic blood flow velocity(Vs)]were observed,and serum levels of nerve growth factor(NGF)and brain-derived neurotrophic factor(BDNF)were detected in all the patients.The chan-ges in quality of life(swallow quality of life questionnaire)and occurrence of complications during treatment were observed in the two groups.Results In both groups after treatment,the VFSS score,quality of life score and swallowing symptom score,hyoid bone forward and upward dis-tances,vertebrobasilar artery Vm and Vs,and serum NGF and BDNF levels were all risen signifi-cantly while the SSA score and vertebrobasilar artery PI were obviously declined when compared with the levels before treatment(P＜0.05).After treatment,the combined treatment group had more remarkably improved VFSS score,quality of life score,swallowing symptom score,hyoid bone forward and upward distances,vertebrobasilar Vm and Vs,and serum NGF and BDNF levels,and more notably declined SSA score and vertebrobasilar PI than the control group(P＜0.05,P＜0.01).No statistical difference was seen in the total incidence of complications between the combined treatment group and control group(4.8％vs 10.0％,P＞0.05).Conclusion Com-bined low-frequency pulse therapy and ingestion-swallowing training can effectively promote the recovery of swallowing function,increase the activity of hyoid bone,promote the vertebrobasilar artery blood flow and neurotrophic conditions,and thus improve the quality of life in patients with post-stroke dysphagia,with less complications.

Objective: To investigate the ameliorative effect of vitamin D on sciatic nerve chronic compression injury(CCI) rats and its regulatory effect on nuclear factor κB(NF-κB)/cystathione-β-synthase(CBS)-hydrogen sulfide(H2S) system. Methods: Fifty rats were randomly divided into five groups: control group,model group,vitamin D group,activator group,and activator + vitamin D group,with 10 rats in each group. Except for the control group,the rats in the other groups underwent sciatic nerve ligation to establish the CCI model. The vitamin D group received intraperitoneal injection of 500 mg/kg vitamin D,the activator group received intraperitoneal injection of10 mg/kg NF-κB activator lipopolysaccharide,and the activator + vitamin D group received intraperitoneal injection of 500 mg/kg vitamin D along with 10 mg/kg lipopolysaccharide. The control and model groups received intraperitoneal injection of an equal volume of saline,once per day for 2 weeks. The following parameters were compared among the groups: paw withdraw thermal latency(PWTL),mechanical withdrawal threshold(MWT),serum 25-hydroxyvitamin D3[25(OH)D3]levels,H2S content,calcitonin gene-related peptide(CGRP),prostaglandin E2(PGE2) levels,and the expression of vitamin D receptor(VDR),NF-κBp65,and CBS proteins in the L4-L6 dorsal root ganglia of rats. Results: Compared with the control group，the model group showed decreased PWTL，MWT，25( OH) D3 levels and VDR protein expression，while H2 S content，CGRP and PGE2 levels，and NF-κBp65 and CBS protein expression significantly increased ( P＜0. 05) ．Compared with the model group，the vi- tamin D group exhibited increased PWTL，MWT，25 ( OH) D3 levels and VDR protein expression ( P ＜0. 05) ， while H2 S content，CGRP and PGE2 levels，and NF-κBp65 and CBS protein expression significantly decreased ( P < 0. 05) ．Compared with the activator group，the activator + Vitamin D group showed increased PWTL，MWT， 25( OH) D3 levels and VDR protein expression，and decreased H2 S content，CGRP and PGE2 levels and decreased NF-κBp65，CBS protein expression ( P＜0. 05) ．Compared with the vitamin D group，the activator + vitamin D group showed decreased PWTL，MWT，25( OH) D3 levels and VDR protein expression，while H2 S content，CGRP and PGE2 levels，and NF-κBp65 and CBS protein expression significantly increased ( P ＜0. 05) ． Conclusion Exogenous supplementation of vitamin D can relieve nerve pain and reduce pain sensitivity in CCI rats，possibly by inhibiting NF-κB / CBS-H2 S signaling pathway．

Objective To explore the clinical efficacy of low-frequency pulse therapy combined with ingestion-swallowing training in the treatment of patients with post-stroke dysphagia.Methods A retrospective study was conducted on 122 patients with post-stroke dysphagia admitted in our hospital from January 2022 to January 2024.According to different interventions,they were divid-ed into a control group(ingestion-swallowing training on the basis of conventional treatment,60 cases)and a combined treatment group(low-frequency pulse therapy and the treatments in the control group,62 cases).Before and after treatment,VFSS and standard swallowing assessment(SSA)were performed,hyoid bone movement displacement(hyoid bone forward and upward)and vertebrobasilar artery blood flow indicators[pulsatility index(PI),mean blood flow velocity(Vm),systolic blood flow velocity(Vs)]were observed,and serum levels of nerve growth factor(NGF)and brain-derived neurotrophic factor(BDNF)were detected in all the patients.The chan-ges in quality of life(swallow quality of life questionnaire)and occurrence of complications during treatment were observed in the two groups.Results In both groups after treatment,the VFSS score,quality of life score and swallowing symptom score,hyoid bone forward and upward dis-tances,vertebrobasilar artery Vm and Vs,and serum NGF and BDNF levels were all risen signifi-cantly while the SSA score and vertebrobasilar artery PI were obviously declined when compared with the levels before treatment(P＜0.05).After treatment,the combined treatment group had more remarkably improved VFSS score,quality of life score,swallowing symptom score,hyoid bone forward and upward distances,vertebrobasilar Vm and Vs,and serum NGF and BDNF levels,and more notably declined SSA score and vertebrobasilar PI than the control group(P＜0.05,P＜0.01).No statistical difference was seen in the total incidence of complications between the combined treatment group and control group(4.8％vs 10.0％,P＞0.05).Conclusion Com-bined low-frequency pulse therapy and ingestion-swallowing training can effectively promote the recovery of swallowing function,increase the activity of hyoid bone,promote the vertebrobasilar artery blood flow and neurotrophic conditions,and thus improve the quality of life in patients with post-stroke dysphagia,with less complications.

Objective To investigate the training process of clinical practice ability in medical undergraduates in the context of tutorial system,as well as new clinical training models and evaluation methods.Methods A total of 40 medical undergraduates who entered the stage of clinical practice were randomly divided into tutorial group and control group,with 20 undergraduates in each group.A diversified evaluation system was used to perform a comprehensive evaluation of clinical practice ability of medical undergraduates at different stages,with a combination of professional theory examination,Mini-Clinical Evaluation Exercise,Direct Observation of Procedural Skills,and clinical case report.All the data were analyzed by SPSS 23.0,t test was used for statistical analysis.Results Compared with the control group after the internship ended,the tutorial group had significantly higher scores of clinical professional theory (86.24 ± 2.93),clinical practice ability (7.53 ± 0.48),clinical operation skills (4.35 ± 0.47),and clinical thinking ability (6.31 ± 0.52) (all P＜0.05).Conclusion The application of the tutorial training mode during the internship of medical undergraduates can improve their comprehensive qualities such as professional quality,medical theory,and practical skills.The diversified evaluation system can evaluate the teaching effect and reflect the cultivation of comprehensive quality among students.

Objective To investigate the effect of the endoscopic surveillance system in irrigating fluid absorption and bleeding during transurethral resection of the prostate.Methods In vitro trials,we simulated the fluid absorption and bleeding in the operation by using self-developed endoscopic surveillance system from January 2013 to June 2013.Continuous irrigation of 5 ％ mannitol solution,we extracted 5 times irrigating fluid (each time 100 ml and a total of 500 ml) in the process of irrigation and recorded absorption measurements of every time extraction rinses.At the same time,we dripped human whole blood 5 times(each time 5 ml and a total of 25 ml) in the process of irrigation and recorded the bleeding measurements.The above process was repeated three times to detect the accuracy and consistency of the endoscopic surveillance system.In clinical trials,50 cases of BPH were monitored in surgery and the biochemical index,hemodynamics,irrigating fluid absorption and bleeding were compared from October 2016 to April 2017.The included criteria contained as follow:the age of patients should be more than 50 years.The transabdominal ultrasound showed that the volume of prostate should be more than 60 ml.The maximal uroflowmetry should be less than 15ml/s.The IPSS scores should be more than 8.Based on the operative time,two groups (＜60 min and ≥ 60 min) were classified.Results We developed the endoscopic surveillance system which is original in the world.In vitro trials,the average irrigating fluid were (100.60 ± 2.07) ml,(201.00±3.39) ml,(302.00±4.67) ml,(403.60±4.39) ml and (502.40 ±7.57) ml;and the average bleeding were (5.06 ± 0.11) ml,(10.10 ± 0.16) ml,(15.04 ± 0.15) ml,(20.06 ± 0.11) ml and (25.10 ± 0.16) ml.No significant difference was observed in all groups (P ＞ 0.05).In clinical trials,we compared some preoperative and postoperative indexes.The average blood oxygen saturation were (94.46 ± 2.49) ％ and (92.39 ± 2.77) ％ (P ＜ 0.01),the average Serum sodium ion concentration were (141.05 ± 2.52) mmol/L and (138.06 ± 4.27) mmol/L(P ＜ 0.01),the average HGB were (143.50 ± 13.43) g/L and (137.04 ± 14.25) g/L(P ＜ 0.01).The average HCT were (42.05 ± 4.09) ％ and (137.04 ± 14.25) ％ (P ＜ 0.01).The average HR were (77.9 ± 7.6) beats per minute and (77.93 ± 6.93) beats per minute (P＞0.05).The MAP were (90.32 ± 9.75) mmHg and (91.07±8.96)mmHg(P＞0.05).The average serum potassium ion concentration were (4.13 ± 0.53) mmol/L and (4.09 ± 0.37) mmol/L (P ＞ 0.05).The average irrigating fluid absorption of the group less than 60 minutes and the group equal or more than 60 minutes were (401.83 ± 279.23) ml and (885.25 ± 367.68) ml (P ＜ 0.01).The average blood loss were (64.10 ±47.47) ml and (158.40 ± 65.22) ml(P ＜0.01).The preoperative and postoperative hemodynamic,blood biochemical and hematology showed difference in our trials.Irrigating fluid absorption and blood loss were positively associated with operation time.Conclusions The endoscopic surveillance system was safety and accuracy.It can offer real-time monitoring data and alarm mechanism for the surgeons that possibly improve operation safety.

Based on the particularity of the following medical disciplines, Three orientation is the higher medical personnel training mode which orients in the future development of medical students, and makes scientific allocation and combination to medicine curriculum system , personnel training system , management mode and evaluation system and so on. The clinical practice ability of medical students is the core of the professional quality training in the three orientation. In this article, the ability of professional quality, clinical practice ability and the ability to operate are clinical practice ability training goals and the training methods and evaluation system are divided into 2 stages, the fourth year and the fifth year, as well as three aspects such as professional quality ability training, clinical practice ability training and skills training.

ObjectiveTo investigate the condition of infants with urolithiasis caused by melaminetainted powdered formula at one-year follow-up. Methods Eighty-one young children with melamine-induced urolithiasis were followed up,which included urinalysis,renal-function tests,urinary tests for biochemical markers of renal glomerular and tubular function,and ultrasonography.Eighty-one age-matched healthy infants without exposure to melamine-contaminated formulas were enrolled as controls. Results Fifty-one of the patients were male and 30 female,with a mean age of 26 months (range 13 -48 months).The 81 children were divided into 2 groups according to treatment protocols.Group 1 received conservative treatment ( n =54 ) and Group 2 received surgical treatment ( n =27 ).In Group 1,3 patients (5.6％) had stone-residual:1 girl had calculus of 0.4 cm in diameter in the left kidney and 2 girls had calculus of 0.3 cm in diameter in the right kidney.In Group 2,2 patients (7.4％) had stone-residual,1 boy had crystallization of 0.2 cm in diameter in the right kidney and 1 boy had calculus of 1.5 cm in diameter in the left kidney,positive stone was confirmed by X-ray and accepted percutaneous nephrolithotomy.Urinary microalbumin levels were significantly increased in the children with melamine-induced urolithiasis compared with the control group (P ＜0.01 ).Blood urea nitrogen and serum creatinine were within the normal range with no significant difference between the 2 groups. ConclusionsAt one-year follow-up most of the children exposed to melamine-tainted infant formula in both treatment groups had returned to a healthy state,suggesting a satisfactory outcome for both treatment options.However,surgery is recommended in patients with stoneresidual ＞ 10 mm.