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Objective To explorer the effectiveness of game-based surface electromyographic biofeedback training (GBsEMGBF) on dysphagic brainstem injury patients.Methods Thirty-six brainstem injury dysphagic patients were randomly and evenly divided into a treatment group and a control group,both of 18,by using a random number table.Both groups were given conventional swallowing rehabilitation including oral sensory and motor training,Mendelsohn swallowing training and balloon dilatation of the cricopharyngeal muscle.The treatment group was additionally provided with GBsEMGBF training.All the treatments were provided 5 times per week for 5 weeks.Both groups were assessed using the functional oral intake scale (FOIS),penetration-aspiration scale (PAS),hyoid anterior movement (HAM),hyoid superior movement (HSM) and upper esophageal sphincter opening (UO) before and after the intervention.Results Before the treatment there were no significant differences between the two groups in all the measurements.After the treatment,there was a significant improvement in the average FOIS,PAS,HAM and HSM scores in both groups,but with significantly greater improvement in the treatment group.Significant improvement was observed in the average UO score after the intervention,but without significant differences between the two groups.Conclusion GBsEMGBF can significantly improve the swallowing function and hyoid motor function in dysphagic patients caused by brainstem injury.
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Objectlve To study the significance of injury and posthumous changes to the axonal in brain stem and provide evidence to the forensic discrimination of brainstem injury. Methods Select the cases that died of the primary brainstem injury or other disease randomly, All cases were divided into control group and experimental group, control group and experimental group that were autopsied at the postmortem interval less than 24h or 48h, or longer than 24h or 48h. The brainstem tissue were cut and stained by silver; Two hundred four samples were observed in microscope and selected 9～10 widest axonal to measure its diameter, then analysis the data. Results There is significant difference in axonal diameter of midbrain and mudella between control group (not including those cases died of cardiovascular diseases) and experiment group (P0.05). Conclusion The axonal swelling of the brainstem is closely related with the traumatic injury, so axonal swelling is a finding useful for identification of traumatic brainstem lesions, but death from cardiovascular diseases should be excluded.
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Objective To study pathological changes of acute brainstem injury and evaluate their significance in forensic postmortem diagnosis of brainstem injury. Method To establish an acute brainstem injury model by using a gravitational force of a free falling weight. 50 rats were divided into two groups, an experimental group (35 rats) and a normal control group (15 rats): Neuron apoptosis and neurofilament (NF) of the brain stem were observed by HE, TUNEL and LSAB methods respectively. Results The brainstem injury model was mimic with that occurred in the forensic pathological practice. HE stain showed congestion, edema, loosening of the blood vascular wall as well as the circle hemorrhage of the brain stem and other part of the brain tissues. TUNEL method showed that the neuron apoptosis increased significantly in the cerebral cortex (P
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To study the significance of the pathological changes of axon and myelin sheath in injured brainstem.The neurofilament and myelin basic protein was demonstrated immunohistochemically,and the pathological changes of axons and myelin sheathes in human brainstem following trauma were observed.In the injured brainstem,irregular swelling and disconnecting axons could be found as early as 0 5h after injury, while pathological changes in myelin sheaths such as tortuous change,partial peeling off from axon and intermittent disappearance could be observed at 19～22h after injury.However,in the normal brainstem,there were no evident changes in axons and myelin sheaths.Pathological changes of axon and myelin sheath in brainstem would occur after trauma,which could be used for postmortem diagnosis of brainstem injury.
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Objective To study GFAP changes of astrocyte and expression of Endothelin-1 in molecular pathology in brainstem injury of human being and explore its forensic medical significance. Method 15 brain specimens of acute brainstem injury and 5 brain specimens of no brainstem injury in different time were selected and their microscopic morphological changes were observed with HE staining, and we study the pathological changes of GFAP of astrocyte and expression of Endothelin-1 in monoclonal antibody im-munohistochemistry SP method. Results The number of GFAP positive cells was increased, the bulk of the cell became bigger and expression of Endothelin-1 could be observed. Conclusion The above pathological changes might be a valuable base used for postmortem diagnosis of acute brainstem injury.