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Objective: To observe the effect of electromyographic biofeedback therapy combined with Wenyang tongluo acupuncture on cerebral hemodynamics and serum nerve factors in children with spastic cerebral palsy. Methods: 135 children with spastic cerebral palsy admitted to Xi’an TCM Hospital of Encephalopathy from April 2021 to May 2023 were divided into control group and combined group according to the random number table method, 67 cases and 68 cases respectively. Control group received electromyographic biofeedback therapy, and combined group received Wenyang tongluo acupuncture on the basis of control group. The spasm, movement, balance function, lower limb muscle strength, cerebral hemodynamics and serum nerve factors were compared between two groups. Results: The improvement of spasm condition in combined group was better than that in control group 3 months after treatment (P＜0.05). The scores of Gross Motor Function Measure (GMFM) and Berg Balance Scale (BBS) in combined group were higher than those in control group 3 months after treatment (P＜0.05). The abductor strength of hip joint, flexor strength of knee joint and extensor strength of knee joint in combined group were higher than those in control group 3 months after treatment (P＜0.05). The arterial systolic peak flow velocity and mean blood flow velocity in combined group were higher than those in control group, and the vascular pulsatility index and vascular resistance index were lower than those in control group 3 months after treatment (P＜0.05). The nerve growth factor (NGF) and brain-derived neurotrophic factor (BDNF) in combined group were higher than those in control group 3 months after treatment (P＜0.05). Conclusion: The combination of wenyang tongluo acupuncture and electromyographic biofeedback therapy in the treatment of children with spastic cerebral palsy, which can effectively improve the spasm, improve the muscle strength and balance function of lower limbs, and improve the cerebral hemodynamics and serum nerve factor levels of the body. [ABSTRACT FROM AUTHOR]

BACKGROUND: Most scholars now believe that children with cerebral palsy who have severe spinal deformities in early childhood (< 15 years of age) may have a higher risk of progression of spinal deformities, which may result from imbalances in movement due to pelvic tilt, pain, etc. OBJECTIVE: To investigate the relationship between lumbar spine development and hip joint development in children with spastic cerebral palsy. METHODS: A retrospective analysis was performed in 102 children with spastic cerebral palsy admitted at Dongzhimen Hospital Affiliated to Beijing University of Chinese Medicine from January 2014 to December 2021. All admitted children had X-rays of the pelvic position and the lumbar lateral position. Anteroposterior X-ray of the pelvis was performed to measure femoral head migration percentage, central edge angle, neck-shaft angle, and acetabular index. The sagittal Cobb angle, sacral slope, arch-top distance, and lumbar lordosis index were measured by the lateral X-ray of the lumbar spine. Correlation of the two sets of indicators was further analyzed. All children were divided into normal group, risk group, hip subluxation group and total hip dislocation group according to their femoral head migration percentage, and the differences in lumbar spine indexes between groups were evaluated. RESULTS AND CONCLUSION: Pearson correlation analysis showed that the femoral head migration percentage was moderately positively correlated with sagittal Cobb angle and arch-top distance, and weakly positively correlated with lumbar lordosis index; the central edge angle was moderately negatively correlated with the arch-top distance and weakly negatively correlated with the sagittal Cobb angle; the neck-shaft angle was weakly positively correlated or not correlated with the sagittal Cobb angle and lumbar lordosis index; and the acetabular index was weakly positively correlated with the sagittal Cobb angle and arch-top distance. No statistically significant correlation was found between the remaining indicators. According to the femoral head migration percentage, the children were divided into four groups, including 25 cases in the normal group, 41 cases in the risk group, 27 cases in the hip subluxation group, and 9 cases in the total hip dislocation group. The sagittal Cobb angle was significantly increased in the risk group, the hip subluxation group and the total hip dislocation group compared with the normal group, showing an increasing trend group by group, and there were significant differences between groups (P < 0.05). Compared with the normal group, the lumbar lordosis index in the risk group and the hip subluxation group increased significantly, and there were significant differences between groups (P < 0.05). There was an increase trend in the lumbar lordosis index of the total hip dislocation group compared with the normal group. Compared with the normal group, the arch-top distance in the hip subluxation group and the total hip dislocation group increased significantly (P < 0.05), and there was a stepwise increasing trend. There was no significant difference in sacral slope between groups. To conclude, the development of the lumbar spine in children with cerebral palsy is closely related to the development of the pelvic hip joint, and the most obvious relationship is between lumbar lordosis and hip dislocation. [ABSTRACT FROM AUTHOR]

Objective To provide reference for the subsequent clinical application of WBV, based on the impacts of whole body vibration (WBV) with different frequencies on gross motor function and walking function in children with dyskinetic cerebral palsy. Methods 60 children aged 6 - 12 with dyskinetic cerebral palsy, who had been treated at the department of rehabilitation medicine in the Affiliated Southwest Medical University from October 2021 to November 2022, were selected. They were randomly divided into a control group (n = 20), (25 ± 5) Hz group (n = 20), and (35 ± 5) Hz group (n = 20). All the three groups received conventional rehabilitation, while the (25 ± 5) Hz group received additional WBV with (25 ± 5) Hz and the (35 ± 5) Hz group received WBV with (35 ± 5 ) Hz. They were treated for eight weeks. The scores on D and E domains of GMFM-88, TUGT, the score on Berg Balance Scale, and footprint analysis were used for assessment of the efficacy after treatment. Results As compared with the baselines, the scores were improved in the three groups after treatment (P < 0.001). BBS (F = 12.502), TUGT (F = 8.211), scores on D and E domains of GMFM-88 (F = 12.802 and 8.505), stride length (F = 12.279), 1MWT distance (F = 12.619), and step width (F = 13.582) were better in the (35 ± 5) Hz group than in the (25 ± 5) Hz group and the control group (P < 0.05 and P < 0.01) ; and the efficacy was better in the (25 ± 5) Hz group than in the control group, the difference was statistically significant (P < 0.05 and P < 0.01). Conclusion WBV can improve trunk control, lower limb gross motor function, and walking function in children with involuntary motor type cerebral palsy. (35 ± 5) Hz is better than (25 ± 5) Hz for the efficacy of WBV. [ABSTRACT FROM AUTHOR]

Objective: To investigate the effect of transcranial direct current stimulation (TCDC) combined with rehabilitation training on fine motor function of children with spastic cerebral palsy. Methods: 116 children with spastic cerebral palsy who were admitted to the Children’s Rehabilitation Department of our hospital from July 2020 to June 2022 were selected as the research objects. The children were randomly divided into the observation group and the control group according to the random number table, with 58 cases in each group. The control group was treated with conventional rehabilitation training, and the observation group was treated with t DCS on the basis of the control group. The degree of motion (AROM) of wrist dorsiflexion joint was measured with a goniometer, the fine motor function test scale (FMFM) for children with cerebral palsy was used to assess the fine motor ability of both upper limbs, the Peabody fine motor development scale (PDMS-FM) was used to assess the fine motor function of both hands, and the modified Ashworth muscular tension scale (MAS) was used to assess the muscular tension of the affected side of the elbow joint, The difference of each index between the two groups before and after treatment was compared. Results: After treatment, the AROM score of the two groups was significantly increased compared with that before treatment, and the AROM score of the observation group was significantly higher than that of the control group, with a statistically significant difference (P＜0.05). After treatment, the FMFM scores of the two groups were significantly increased compared with those before treatment, and the FMFM scores of the observation group were significantly higher than those of the control group, with a statistically significant difference (P＜0.05). After treatment, the FMQ scores of the two groups were significantly increased compared with those before treatment, and the FMQ scores of the observation group were significantly higher than those of the control group, with a statistically significant difference (P＜0.05). After treatment, the MAS scores of children in the two groups were significantly lower than those before treatment, and the MAS scores in the observation group were significantly lower than those in the control group, with a statistically significant difference (P＜0.05). Conclusion: Transcranial direct current stimulation intervention combined with rehabilitation training can significantly improve the range of motion of wrist dorsal extension joint, the fine manipulation ability of both upper limbs, the fine motor function of both hands, and the muscle tension of the affected upper limb elbow joint in children with spastic cerebral palsy, and can improve the fine motor function. [ABSTRACT FROM AUTHOR]

Objective: To explore the effect of exercise therapy combined with occupational therapy on the motor function of limbs in children with cerebral palsy. Methods: 80 children with cerebral palsy admitted to the rehabilitation department of our hospital from March 2020 to June 2022 were selected as the research objects. They were randomly divided into two groups with 40 cases each. The matched group received exercise therapy intervention, including Bobath technology and core stability training. The test group received occupational therapy intervention on the basis of the matched group, including hand function, hand eye coordination ability, eating, toilet, dressing and game training. The gross motor function measurement (GMFM), fine motor function assessment (FMFM) and Gesell development scale were used to evaluate the children before and after the intervention, and the clinical effect was evaluated. The patients were assessed using the SF-36 Health Survey Short Form (SF-36). Results: The GMFM score and FMFM score were improved after the intervention, while the test group was higher than the matched group (P<0.05). The DQ scores of the two groups of children after intervention were improved, while the experimental group was higher than the matched group, and the DQ scores of the experimental group increased more than the matched group (P<0.05). The total effective rate (95.0%) of the experimental group was higher than that of the matched group (77.5%) (P<0.05). After the intervention, the SF-36 scores of the two groups were improved, and the test group was higher than the matched group in the dimensions of vitality, social function and mental health (p<0.05). Conclusion: Exercise therapy combined with occupational therapy can effectively improve the motor function of the upper and lower limbs of children with cerebral palsy, improve the rehabilitation effect, and improve the quality of life of children with cerebral palsy. [ABSTRACT FROM AUTHOR]

Objective: To study the predictive value of General movements (GMs) quality assessment and craniocerebral ultrasound (CUS) for exercise development outcome of children at high-risk of brain injury. Methods: 605 premature infants with high-risk factors for brain injury who were admitted to the Neonatal Intensive Care Unit (NICU) of Xuzhou Medical University Affiliated Hospital from October 2019 to June 2021 were selected, and follow-up records were established. CUS examination was performed within24 h, 3 d and 7 d after admission. Abnormal patients were re-examined once a week until discharge, and the most abnormal results were recorded. GMs quality assessment was performed during the writhing movement stage at 36 to 40 weeks of gestational age, and GMs quality assessment during the restless exercise stage at 3 to 6 months of age. exercise development outcome was determined by Gesell Developmental Scale and diagnostic classification criteria for cerebral palsy in children at 12 months of age. The predictive validity of GMs quality assessment and CUS in predicting adverse exercise development outcome and cerebral palsy were analyzed. Results:Complete follow-up data were obtained in 536 high-risk children with brain injury, and the results of exercise development were 424cases of normal exercise development, 105 cases of exercise development retardation, and 7 cases of cerebral palsy at 12 months of age.The sensitivity, specificity of GMs quality assessment of twisting exercise was 56.25%, the specificity was 82.78%. The sensitivity of restless exercise GMs quality assessment was 73.21%, the specificity was 98.82%. CUS had a sensitivity of 54.46%, specificity of94.34% in predicting the outcome of exercise development. The sensitivity of twisting GMs quality assessment combined with CUS was81.25%, the specificity was 81.13%. The sensitivity of restless exercise GMs quality assessment combined with CUS was 84.82%, the specificity was 96.46%. The sensitivity and negative predictive value of GMs quality assessment and CUS for predicting cerebral palsy were both 100.00%. The combination of GMs quality assessment and CUS can significantly improve the sensitivity and positive predictive value of adverse exercise outcome. Conclusion: CUS has good predictive value for adverse exercise development outcome of high-risk infants with brain injury, especially cerebral palsy. GMs quality assessment combined with CUS can significantly improve the early predictive value for adverse exercise development outcome of high risk infants with brain injury. [ABSTRACT FROM AUTHOR]

BACKGROUND: Cerebral palsy is a wide range of nerve injury diseases. Its etiology is still unclear to a great extent, and the molecular indicators used for classification or monitoring of the disease have not been reported. OBJECTIVE: To isolate and culture cerebrospinal fluid derived exosomes from children with cerebral palsy, and analyze the proteomic expression profile characteristics of exosomes by label-free quantitative mass spectrometry proteomics, so as to provide molecular biological basis for typing, diagnosis and prognosis evaluation of children with cerebral palsy. METHODS: Among cerebral palsy patients undergoing selective posterior rhizotomy at Dongzhimen Hospital of Beijing University of Chinese Medicine, there were four patients with spastic cerebral palsy and three patients with mixed cerebral palsy. 3 mL cerebrospinal fluid was extracted from each patient. The exosomes in the cerebrospinal fluid of children with cerebral palsy were separated by ultracentrifugation, and characterized by nanoparticle tracking analysis, transmission electron microscope and protein mass spectrometry. RESULTS AND CONCLUSION: (1) Transmission electron microscopy showed that there were secretory vesicles in cerebrospinal fluid of children with cerebral palsy. Western blot assay detected the expression of secrete marker proteins Syntenin-1 and Flotillin-1. (2) Nanoparticle tracking analysis showed that the size and concentration of vesicles were consistent with the heterogeneity of exosomes. The cerebrospinal fluid exosomes of spastic cerebral palsy and mixed cerebral palsy were analyzed by protein mass spectrometry. A total of 551 proteins were identified. (3) Bioinformatics analysis showed that the identified cerebrospinal fluid exosome proteins were related to the molecular signal mechanism of exosome function and neural development. These proteins were mainly concentrated in brain regions such as frontal cortex and motor cortex, which were closely related to the pathology of cerebral palsy. It is concluded that there are exosomes in cerebrospinal fluid of children with cerebral palsy, and exosome proteins may be related to the molecular pathological mechanism of cerebral palsy. [ABSTRACT FROM AUTHOR]

OBJECTIVE: To probe into the anticoagulant timing of oral anticoagulant rivaroxaban in patients with cerebral infarction complicated with atrial fibrillation and its effects on clinical complex vascular events. METHODS: A total of 153 patients with cerebral infarction complicated with atrial fibrillation admitted into the hospital from Jul. 2019 to Oct. 2020 were extracted to be divided into group A, B and C by simple randomization, with 51 cases in each group. Anticoagulant therapy was started within 3 d after cerebral infarction in group A, from 3 to 14 d after cerebral infarction in group B, and more than 14 d after cerebral infarction in group C. The coagulation function indicators [thrombin time ( TT), activated partial thromboplastin time ( APTT), prothrombin time ( PT ), international normalized ratio (INR)] were compared among three groups before and after treatment. Patients were followed up for 6 months, and the incidence of clinical compound vascular events in three groups was analyzed. RESULTS: After treatment, TT, APTT and PT in group B were longer than those in group A and C, with statistically significant difference (P<0. 05). After 6 months of follow-up, the incidence of clinical compound vascular events in group B (5. 88%, 3 / 51) was lower than that in group A ( 23. 53%, 12 / 51) and group C ( 19. 61%, 10 / 51 ), with statistically significant difference (P<0. 05). CONCLUSIONS: It is the best time for anticoagulant therapy for patients with cerebral infarction complicated with atrial fibrillation from 3 to 14 d after cerebral infarction, which helps to reduce the risk of clinical compound vascular events. [ABSTRACT FROM AUTHOR]

OBJECTIVE: Cerebral palsy seriously affects children's physical and mental health due to its high morbidity and disability rate. Ankle-foot orthoses are an important treatment for this disease. However, it is not very clear about the clinical effect of ankle-foot orthoses on the motor function of children with cerebral palsy. Therefore, this paper systematically assesses the clinical effect of ankle-foot orthoses on the improvement of motor function in children with cerebral palsy. METHODS: Literature retrieval was carried out in the electronic databases of PubMed, EMbase, Web of Science, Cochrane Library, CBM, CNKI, WanFang, and VIP. The time limit for retrieval was from the establishment of these databases to September 9, 2020. According to the inclusion and exclusion criteria, randomized controlled trials of ankle-foot orthoses in the treatment of children with cerebral palsy were included. At least two evaluators extracted the data independently and used Cochrane 5.1.0 bias risk assessment tool to evaluate the quality of included studies. The data were analyzed by Revman 5.3 software. RESULTS: In the end, a total of 12 randomized controlled trials with high quality, involving 480 children with cerebral palsy, were included in this study. Among them, 239 patients in the ankle-foot orthosis group wore ankle-foot orthosis; 241 patients in the control group did not wear ankle-foot orthosis. The treatment course was 0-48 weeks. Meta-analysis results showed that the improvement of Gross Motor Function Measure-88-D/E score (mean difference (MD)=6.26, 95% confidence interval (CI):3.54-8.98, P < 0.000 01), modified Ashworth scale score (MD=-0.60, 95%CI: -0.80 to -0.40, P < 0.000 01), dorsiflexion mean in swing (MD=14.96, 95%CI: 12.03-17.90, P < 0.000 01), effectiveness in improving motor function (MD=2.99, 95%CI: 1.19-7.50, P=0.02), and stride length (MD=0.06, 95%CI: 0.04-0.09, P < 0.000 01) in the ankle-foot orthosis group was better than that in the control group. CONCLUSION: Evidence from these 12 randomized controlled trials indicates that no matter walking with ankle-foot orthosis, or walking without ankle-foot orthosis after wearing for a certain period of time, in the short time, it has remarkable clinical value in improving motor function. However, further studies on the long-term recovery of motor function are required. [ABSTRACT FROM AUTHOR]

OBJECTIVE: To probe into the effect of pentoxifylline on the improvement of cognition impairment in patients with non-demented vascular cognitive impairment. METHODS: Totally 55 patients with non-demented vascular cognitive impairment admitted into the Eighth People’s Hospital of Hebei Province from Jun. 2019 to Aug. 2020 were selected and divided into control group (27 cases) and observation group (28 cases) via random number table. The control group was given conventional therapy, while the observation group was treated with Pentoxifylline sustained-release tablets based on the control group. The regional cerebral blood flow, neurological function deficit score (NFDS), activity of daily living (ADL) score and cognitive function scores[mini mental status examination (MMSE), Montreal Cognitive Assessment (Mo CA) ]of the two groups were observed, and drug safety evaluation was performed. RESULTS: Compared with the control group, the observation group had significantly higher blood flow in all cerebral regions, significantly lower NFDS score and significantly higher ADL, MMSE and Mo CA scores at 1, 3 and 6 months of treatment, all these differences were statistically significant (P < 0. 05) . The incidences of adverse drug reactions of observation group and control group were respectively 3. 57% (1/28) and 7. 41% (2/27), the difference was not statistically significant (χ2= 0. 001, P = 0. 974) . CONCLUSIONS: Pentoxifylline can effectively improve the clinical symptoms of patients with non-demented vascular cognitive impairment, improve the blood flow volume of cerebral vessel, reduce NFDS scores, promote ADL, MMSE and Mo CA scores, with significant clinical efficacy and high safety. [ABSTRACT FROM AUTHOR]

OBJECTIVE: To probe into the effects of Yinxingye capsules combined with alprostadil injection on cerebral blood flow, serum homocysteine（ Hcy） and fibroblast growth factor 21（ FGF21） in patients with posterior circulation ischemic vertigo（ PCIV）. METHODS: Totally 224 patients with PCIV admitted into People’s Hospital of Xinjiang Uygur Autonomous Region from Jan. 2019 to Oct. 2020 were retrospectively extracted. The control group（ 104 patients） was treated with alprostadil injection, while the observation group（ 120 patients） received Yinxingye capsules combined with alprostadil injection. The course of treatment was 2 weeks. Clinical efficacy, clinical symptom score, blood flow velocity of vertebrobasilar artery and levels of serum Hcy and FGF21 were observed in two groups. RESULTS: After treatment of two weeks, the total effective rate of the observation group was 92. 5%（ 111/120）,significantly higher than that of the control group 83. 7%（ 87/104）,the difference was statistically significant（ P <0. 05）. After treatment, the scores of vertigo degree, vertigo duration, vertigo frequency and accompanying symptoms in patients with PCIV in the observation group were significantly lower than those in the control group, the differences were statistically significant（ P < 0. 05）. After treatment, the blood flow velocity of left vertebral artery, right vertebral artery and basilar artery of the observation group was significantly faster than that of the control group, and the levels of serum Hcy and FGF21 were significantly lower than those of the control group, the differences were statistically significant（ P < 0. 05）. CONCLUSIONS: The efficacy of Yinxingye capsules combined with alprostadil injection in the treatment of patients with PCIV is significant, which can effectively improve the clinical symptoms and cerebral blood flow, reduce the levels of serum Hcy,FGF21. [ABSTRACT FROM AUTHOR]

OBJECTIVE: To systematically evaluate the clinical efficacy and safety of ganglioside combined with edaravone in the treatment of acute cerebral infarction. METHODS: CNKI, WanfangData, VIP database, PubMed and Cochrane Reviews were retrieved to collect the randomized controlled trials of ganglioside combined with edaravone in the treatment of acute cerebral infarction(the study group was given ganglioside combined with edaravone, while the control group received edaravone). The retrieval time was from the establishment of the database to Apr. 2021, the language of the literature was Chinese and English. According to inclusion and exclusion criteria, literature were screened, extracted, scored with newcastle-Ottawa scale, and meta-analysis was performed with RevMan 5. 3 and Stata 15. 0 software. RESULTS: Totally 11 literature were collected, including 1 011 patients(505 patients in the study group and 506 patients in the control group). Adverse drug reactions were mentioned in 7 literature. Meta-analysis results showed that the total effective rate in the study group was significantly higher than that in the control group (OR =3. 53,95%CI = 2. 26-5. 52,Z = 5. 52,P<0. 000 01), and the reduction degree of national institutes of health stroke scale(NHISS) score in the study group was significantly better than that in the control group(MD = -6. 21, 95%CI = - 6. 63-- 5. 80, Z = 29. 25, P < 0. 000 01), the differences were statistically significant. There was no significant difference in the incidence of adverse drug reactions between two groups(OR =1. 04,95%CI =0. 55-1. 94, Z =0. 11,P =0. 91). CONCLUSIONS: Based on existing evidence, ganglioside combined with edaravone is effective in the treatment of acute cerebral infarction. [ABSTRACT FROM AUTHOR]

OBJECTIVE: To probe into the effects of high-dose atorvastatin combined with alteplase on serum inflammatory factors and neurological function in patients with acute cerebral infarction. METHODS: Totally 196 patients with acute cerebral infarction admitted into Wuming Hospital of Guangxi Medical University from Mar. 2017 to Mar. 2021 were extracted to be divided into the observation group and the control group via the random number table. Ninety-eight patients in the observation group were treated with high-dose atorvastatin combined with alteplase, and 98 patients in the control group received high-dose atorvastatin combined with urokinase. Clinical efficacy, national institutes of health stroke scale ( NIHSS) score, activity of daily living ( ADL) score, total cholesterol (TC), low density, lipoprotein cholesterol ( LDL-C), triglyceride ( TG) and high-density lipoprotein cholesterol ( HDL-C) levels, serum tumor necrosis factor-a ( TNF -a ), high sensitivity C-reactive protein ( hs-CRP ) and matrix metalloproteinase-9 ( MMP-9) levels before and after treatment in two groups were observed. RESULTS: The total effective rate of the observation group was 95. 92% ( 94/ 98), and the total effective rate of the control group was 91. 84% ( 90/98), with no statistically significant difference between two groups ( P> 0. 05). After 42 d of treatment, the NIHSS scores of two groups were significantly lower than those before treatment, and the observation group was significantly lower; the ADL score was significantly higher than those before treatment, and the observation group was significantly higher, the differences were statistically significant ( P<0. 05). After 42 d of treatment, the levels of TC, TG and LDL-C of two groups were significantly lower than those of the same group before treatment, and the levels of HDL-C were significantly higher than those of the same group before treatment, and the differences were statistically significant ( P 0. 05) . After 42 d of treatment, the levels of TNF-cx, hs-CRP and MMP-9 in two groups were significantly lower than those before treatment, and the reduction in the observation group was significantly greater than that in the control group, the differences were statistically significant ( P < 0. 05). CONCLUSIONS: Compared with high-dose atorvastatin combined with urokinase, high-dose atorvastatin combined with alteplase has advantages in improving neurological damage, restoring the ability of daily life and reducing the inflammation in patients with acute cerebral infarction. [ABSTRACT FROM AUTHOR]

OBJECTIVE: To explore the pathogen distribution and drug sensitivity test results of craniocerebral injury complicated with pulmonary infection, and probe into the therapeutic effect of high pressure oxygen combined with bronchoalveolar lavage in the treatment of craniocerebral injury complicated with pulmonary infection. METHODS: Totally 96 patients with severe craniocerebral injury complicated with pulmonary infection admitted into Pinggu Hospital of Beijing Friendship Hospital Affiliated to Capital Medical University from Jan. 2017 to Jun. 2019 were selected and analyzed in terms of pathogen distribution and drug sensitivity. These patients were divided into research group and control group via random number table, with 48 cases in each group. The control group was given bronchoalveolar lavage for treatment, while the research group was given high pressure oxygen combined with bronchoalveolar lavage for treatment, so that the therapeutic effect was compared between two groups. RESULTS: Totally 215 strains of pathogenic bacteria were isolated, of which 141 strains were gram-negative bacteria ( 65. 58% ), 66 strains were gram-positive bacteria ( 30. 70%), 8 strains were fungus ( 3. 72%) . The drug sensitivity test indicated that the major gram-negative bacteria were relatively more sensitive to cefoxitin/sulbactam and imipenem, while less sensitive to piperacillin, cefoperazone and cefotaxime; the major gram-positive bacteria were relatively more sensitive to compound sulfamethoxazole tablets and vancomycin, while less sensitive to penicillin, azithromycin, ciprofloxacin, clindamycin and cefazolin. The arterial partial pressure of oxygen ( PaO2 ) level and Glasgow coma score ( GCS) of patients in both groups were significantly higher after treatment, and the PaO2 level and GCS score of patients in the research group were significantly higher than those in the control group, with statistically significant differences ( P < 0. 05). The total effective rate of the research group was 95. 83% ( 46/48), which was significantly higher than that of the control group ( 81. 25%, 39/ 48), with statistically significant difference ( P<0. 05). CONCLUSIONS: The main pathogenic bacteria of craniocerebral injury complicated with pulmonary infection are gram-negative bacteria, the drug sensitivity test can guide the rational application of antibiotics; the application of high pressure oxygen combined with bronchoalveolar lavage can effectively improve the therapeutic efficacy in the treatment of patients with craniocerebral injury complicated with pulmonary infection. [ABSTRACT FROM AUTHOR]

Objective: To explore the effect of neuromuscular joint promotion training on the intelligence and limb function of children with cerebral palsy (CP, cerebral palsy). Methods: From December 2016 to December 2018, 134 children with cerebral palsy who were selected for treatment in the outpatient department of the Pediatric Care Department of our hospital were divided into observation group and control group, with 67 cases in each group. The control group was given regular rehabilitation training, and the observation group was given neuromuscular joint promotion training in the control group. The two groups were observed for 3 months of rehabilitation, and the changes in intelligence and limb function were recorded. Results: The total effective rate of the observation group was 98.5%, which was higher than 83.6% of the control group (P<0.05). The gross motor function measure (GMFM) scores of the two groups after rehabilitation were higher than those before rehabilitation (P<0.05), and the observation group was higher than the control group (P<0.05). The adaptation and language behavior scores of the two groups after rehabilitation were higher than those before rehabilitation (P<0.05), and the observation group was also higher than the control group (P<0.05). The F wave amplitude of the two groups after rehabilitation was higher than before rehabilitation (P<0.05), and the threshold was lower than before rehabilitation (P<0.05). The difference between the observation group and the control group after rehabilitation was also statistically significant (P<0.05). Conclusion: The application of neuromuscular joint promotion training in children with cerebral palsy can promote the improvement of intelligence and limb function, rebuild the children's electromyographic function, and improve the therapeutic effect. [ABSTRACT FROM AUTHOR]

Copyright of Chinese Journal of Contemporary Pediatrics is the property of Xiangya Medical Periodical Press and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Chinese Journal of Contemporary Pediatrics is the property of Xiangya Medical Periodical Press and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objective: To investigate the effects of extubation under deep anesthesia on agitation in children with cerebral palsy after selective posterior rhizotomy. Methods: From August 2017 to February 2019, 89 cases of children with cerebral palsy who were diagnosed and treated in our hospital were selected and were divided into observation group of 49 cases and control group of 40 cases accorded to different anesthesia methods. All children were treated with selective posterior rhizotomy and general anesthesia. The observation group were continuously pumped with propofol intravenously during deep anesthesia during anesthesia maintenance, and the control group were extubated under deep anesthesia with sevoflurane. Results: There were no significant difference in anesthesia time, eye opening time and extubation time compared between the two groups (P>0.05). The incidence of postoperative restlessness in the observation group were 2.0 %, which were significantly lower than 15.0 % in the control group (P<0.05). The postoperative 1 month of adaptation and speech behavior scores in the two groups were significantly higher than in the preoperative 1 d (P<0.05), and the observation group were significantly higher than the control group (P<0.05). The postoperative 1 month of Vs and Vd of the middle cerebral arteries in the two groups were significantly higher in the two groups than preoperative 1 d (P<0.05), and the observation group were significantly higher than the control group (P<0.05). Conclusion: The application of extubation under selective posterior rhizotomy in children with cerebral palsy undergoing selective spinal nerve root resection can reduce the occurrence of postoperative restlessness without affecting the effect of anesthesia, thereby improve the treatment effect and improving cerebral hemodynamics. [ABSTRACT FROM AUTHOR]

Objective To investigate the nutritional status of children with cerebral palsy (CP) and the clinical effectiveness of Subjective Global Nutritional Assessment (SGNA) in nutritional assessment of hospitalized children with CP. Methods A total of 208 children with CP, aged 1-5 years, who were hospitalized from April to October 2019 were enrolled as subjects. SGNA was used to investigate nutritional status, and the Z-score method recommended by the World Health Organization was used as a reference standard to validate the clinical effectiveness of SGNA. Results The detection rate of malnutrition in children with CP was 42.3% by SGNA and 39.4% by the Z-score method (P>0.05). The application of SGNA showed high consistency between different evaluators (κ=0.621, P<0.001). With the Z-score method as the reference standard, SGNA had a sensitivity of 80.5%, a specificity of 82.5%, a positive predictive value of 75.0%, and a negative predictive value of 86.7%, and high consistency was observed between the two evaluation methods (κ=0.622, P<0.001). SGNA was moderately consistent with weight-for-age Z-score and height-for-age Z-score (κ=0.495 and 0.478 respectively, P<0.001) and was poorly consistent with weight-for-height Z-score (κ=0.197, P<0.05). Conclusions There is a relatively high incidence rate of malnutrition in children with CP. SGNA can be used as a tool to assess the nutritional status of children with CP. [ABSTRACT FROM AUTHOR]

BACKGROUND: The foot is an important part of the human motor system. Foot diseases and injuries have become a troubling problem. Orthopedic insoles can effectively treat and prevent foot diseases and injuries and reduce the risk of injuries. It has become the main method of physical correction. OBJECTIVE: To clarify the design principles of orthopedic insoles, to classify orthopedic insoles according to the production methods, to sort out the rehabilitation function of orthopedic insoles to human joint-related diseases, children’s hemiplegia, and sports injuries, to explore the current research status and shortcomings of orthopedic insoles, and to make suggestions for future research and development. METHODS: A search of CNKI, WanFang, Baichain, Baidu Library, and PubMed was performed for relevant literature published from 2005 to 2019. Search terms were “Orthopedic insoles,” “valgus hallux, flat feet, high arch, plantar fasciitis,” “knee varus, knee valgus, knee osteoarthritis,” “scoliosis,” “foot and ankle injury,” “gait,” and “abnormal gaits” in Chinese and “Orthopedic insoles, Corrective effect, Motion pattern characteristics” in English. Included articles were screened, summarized and analyzed. RESULTS AND CONCLUSION: The design principles of the insoles include four aspects: adjusting the force bearing point of the vola and dispersing plantar pressure; supporting the arch of the foot, improving cushioning ability; improving the force line of the lower limb, providing a stable support; improving proprioception and foot comfort. Orthopedic insoles can be divided into three types: prefabricated, semi-customized and customized. Orthopedic insoles can play an effective prevention and rehabilitation function in ankle, knee, spinal deformity, hemiplegia-type cerebral palsy in children, and sports injuries. Orthopedic insoles have certain limitations in clinical application and in therapeutic effects. In the development and evaluation of orthopedic insoles, the changes in foot shape and shoe shape during human movement should be considered to reflect the concept of “foot-shoe integration.” Different shapes, materials, and hardness of orthopedic insoles can be used to conduct more in-depth research on the effects of orthopedic insoles to prevent and treat injuries and improve exercise capacity. [ABSTRACT FROM AUTHOR]

BACKGROUND: Under well-controlled conditions, changes in myoelectric signal activity can largely reflect muscle changes such as muscle function, muscle tension, muscle strength, and multi-muscle coordination, providing objective analysis of the muscle function. OBJECTIVE: To investigate the changes in surface electromyography (SEMG) of the lower limb muscles in cerebral palsy children standing or walking on tiptoes.METHODS: Using TELEMYO 2400R G2 SEMG telemeter produced by NORAXON Company in the United States, surface EMG features of bilateral anterior tibial muscles and medial gastrocnemius muscles were detected in 20 cerebral palsy children standing or walking on unilateral tiptoes. The myoelectric activity of the testicular muscles between the pointed and contralateral side was compared in all the subjects. The study protocol was approved by the Ethics Committee of Shanghai Ruijin Hospital, and all subjects and their guardians signed an informed consent prior to the participation in the study.RESULTS AND CONCLUSION:When the subjects were standing and walking normally, the average SEMG amplitude and average SEMG integral of the medial gastrocnemius at the tiptoe side were significantly lower than those at the contralateral side (P < 0.05); the mean and median frequencies of the anterior tibial muscles and medial gastrocnemius muscles at the tiptoe side were significantly higher than those at the contralateral side (P < 0.05). These findings indicate that there are abnormal SEMG signals in the anterior tibial muscles and medial gastrocnemius muscles at the tiptoe side in children with cerebral palsy, and the muscle activity of the lower limbs in such children is not balanced. Therefore, SEMG is of practical value in evaluating the functional status of the neuromuscular system in children with cerebral palsy. [ABSTRACT FROM AUTHOR]

Objective To study the effect of functional chewing training (FuCT) on masticatory function, the severity of tongue thrust, and the severity and frequency of drooling in children with cerebral palsy. Methods A prospective study was performed for 48 children who were diagnosed with oral motor dysfunction from January 2019 to January 2020, and they were randomly divided into an FuCT group and an oral motor training group, with 24 children in each group. Both groups received FuCT or oral motor training for 12 weeks, and then they were evaluated in terms of the changes in the masticatory function, the severity of tongue thrust, and the severity and frequency of drooling. Results There were no significant differences between the two groups in the masticatory function, the severity of tongue thrust, and the severity and frequency of drooling before treatment (P>0.05). After the 12-week training, the FuCT group showed significant improvements in the masticatory function and the severity of tongue thrust and drooling (P<0.05), but with no improvement in the frequency of drooling (P>0.05), while the oral motor training group had no improvements in the masticatory function, the severity of tongue thrust, and the severity and frequency of drooling (P>0.05). After the 12-week training, the FuCT group had more significantly improvements in the severity of tongue thrust and the severity and frequency of drooling than the oral motor training group (P<0.05). Conclusions FuCT can effectively improve the masticatory function, the severity of tongue thrust, and the severity and frequency of drooling in children with cerebral palsy. [ABSTRACT FROM AUTHOR]

Objective: From the perspective of traditional Chinese medicine, explore the mechanism of the treatment of cerebral palsy in children with "spleen and strong kidney". Methods: A retrospective analysis was conducted to collect relevant articles on the treatment of cerebral palsy in children with Chinese and Western medicine, and to analyze the causes, treatment methods and mechanism of cerebral palsy in children. Results: In the Chinese medicine, cerebral palsy in the brain, spleen, kidney, cerebral palsy children generally have spleen and kidney deficiency, which is characterized by muscle thinness and weak bones, so it belongs to the category of "five late" and "five soft". This is consistent with the dyskinesia and nutrient dysfunction of children with cerebral palsy observed in modern medicine. Therefore, in addition to the application of modern rehabilitation techniques, the disease should also be carried out from the perspective of replenishing spleen and kidney. Children who cannot receive oral medication in the clinic can be treated with pediatric massage, and the treatment effect is remarkable. Conclusion: In the rehabilitation of cerebral palsy, the spleen and strong kidney pediatric massage method can be used to improve the vegetative growth level, shorten the rehabilitation course, improve the rehabilitation effect, and finally achieve the purpose of comprehensively promoting the rehabilitation of children with cerebral palsy. [ABSTRACT FROM AUTHOR]

Objective: To explore the effects of sensory integration training combined with routine rehabilitation training on balance control and motor function in children with spastic cerebral palsy. Methods: 80 cases of children with spastic cerebral palsy who were admitted to the Department of Rehabilitation of Chengdu Women’s and Children’s Central Hospital from January 2016 to December2017 were selected as subjects. 80 children were divided into control group(40 cases) and observation group(40 cases) according to the random number table method. The control group was treated with routine rehabilitation training, while the observation group was treated with sensory integration training combined with routine rehabilitation training. The scores of balance control function, gait, gross motor function test-88(GMFM-88) D area and E area were compared between the two groups. Results: 3 months after treatment, the scores of Rivermead activity index and the Berg balance scale were significantly higher in two groups, and the scores of Rivermead activity index and the Berg balance scale in observation group were higher than those in control group(P<0.05). 3 months after treatment, the walking length, walking speed of the two groups were significantly increased, and walking width of the two groups were significantly decreased(P<0.05). The walking length and walking speed of the observation group were larger than those of the control group, and the walking width was smaller than that of the control group(P<0.05). 3 months after treatment, the scores of GMFM-88 D area and GMFM-88 E area in the two groups were significantly increased(P<0.05). The scores of GMFM-88 D area and GMFM-88 E area in the observation group were higher than those in the control group(P<0.05). Conclusion: Sensory integration training combined with routine rehabilitation training can effectively improve balance control function, gait and gross motor function in children with spastic cerebral palsy. [ABSTRACT FROM AUTHOR]

Objective: To investigate the clinical effect of external counterpulsation combined with speech training on children with cerebral palsy and language retardation. Methods: From December 2015 to December 2017, 52 children with cerebral palsy and language retardation were randomly divided into treatment group and control group, with 26 cases in each group. The control group was given only speech training, the treatment group was given external counterpulsation combined with speech training, with a course of 4 weeks, two groups were treated for 3 courses. Before and after treatment, the changes of speech development quotient and cognitive development quotient(CDQ) were assessed and compared by the Chinese version of children’s language development assessment method S-S method and Gesell development score method. Results: After treatment, the speech development quotient and cognitive development quotient of the two groups were significantly higher than those before treatment, and the speech development quotient and cognitive development quotient of the treatment group were significantly higher than those of the control group(P < 0.01). Conclusion: External counterpulsation combined with speech training can improve speech development and cognitive development of children with cerebral palsy and language retardation more effectively than simple speech training. [ABSTRACT FROM AUTHOR]

ABSTRACT Objective: To evaluate and treat high-risk infants with cerebral palsy by using Alberta Infant Motor Scale, and to explore the evaluation method of early motor development of infants. Methods: Twenty-four high-risk children with cerebral palsy were randomly divided into treatment group and control group with 12 cases in each group from December 2017 to December 2018 in the general outpatient department of pediatric care and Rehabilitation Department of The International Peace Maternity & Child health Hospital. The parents in the treatment group were instructed to have family rehabilitation by the scale, while the parents in the control group were only followed up to evaluate the improvement of children's motor development after three months. Result: After three months of treatment, Alberta scale was used to evaluate the two groups of children. The Alberta score of the control group was higher after treatment than before treatment, and that of the treatment group was higher after treatment than before treatment, and that of the treatment group was better than that of the control group. There were significant differences in Alberta scores before and after treatment in each group (all P<0.01), and the treatment group was better than the control group. Conclusion: Using Alberta Infant Motor Scale to guide the evaluation and treatment of high-risk infants with cerebral palsy has a remarkable effect and is worthy of clinical promotion. [ABSTRACT FROM AUTHOR]

Objective: To compare the effect of intranasal dexmedetomidine and chloral hydrate combined with dexmedetomidine on the MRI Examination of children with cerebral palsy. Methods: 160 cases of cerebral palsy were collected in our hospital from January 2015 to July 2016 and divided into the simple group and the complex group according to the number of visits sorted random numbers, 80 cases in each group. The simple group was given Dexmedetomidine 2 g/kg+saline nasal oral (0.1 mL/kg), the compound group was given oral chloral hydrate 50 mg/kg+ dexmedetomidine (2 g/kg) by nasal drip, University of Michigan pediatric sedation score (UMSS) was used to evaluate the effect and success rate of sedation, the heart rate (HR), oxygen saturation (SpO2), respiratory rate (RR) before and after administration, sleep time, recovery time, check time and separation time with parents were compared between the two groups. Results: Before administration, no significant difference was found in the UMSS score between two groups (P>0.05), at 15min and 30 min after administration, the UMSS score of complex group were significantly higher than those of simple group (P<0.05); at 30min after administration, the success rate of sedation in complex group was 98.8%, which was 91.3% in the simple group and obviously lower than that of the complex group (P<0.05); no statistical difference was found in the HR, SpO2, RR before and after administration (P>0.05). The sleep, recovery, examination time and separation time of simple group were longer than those of the complex group(P<0.05). Conclusion: Chloral hydrate combined with dexmedetomidine nasal drops showed better sedative effect on the MRI examination of children with cerebral palsy than simple dexmedetomidine nasal drops. [ABSTRACT FROM AUTHOR]

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Objective: To investigate the effect of aerobic rehabilitation exercise combined with Traditional Chinese Medicine on the serum levels of NSE, EF-1 and 1,25-(OH)2-Vit D3 in cerebral palsy children. Methods: 80 children with cerebral palsy from our hospital were selected and divided into the control group and the experimental group according to different treatment. The patients in control group were treated by routine treatment of internal medicine and rehabilitation exercise and the patients in experiment group were treated by aerobic rehabilitation combined with Traditional Chinese Medicine. The level of NSE, endothelin(EF-1), 1,25-(OH)2-Vit D3,amylase and the situation of appetite, defecation, complexion, physical fitness were compared before and after treatment. Results:Compared with the control group, the level of NSE and EF-1 were lower in experimental group with statistical significance(P<0.05), and the level of 1,25-(OH)2-Vit D3, trace elements, amylase and physical signs were higher in experimental group with statistical difference compared with control group(P<0.05). Conclusions: Aerobic rehabilitation exercise combined with oral decoction can reduce NSE and EF-1, then indirectly promote neurological recovery, and also can accelerate the 1,25-(OH)2-Vit D3 synthesis efficacy and promote nutrient absorption and metabolism, so it is an ideal clinical treatment scheme for the children with cerebral palsy. [ABSTRACT FROM AUTHOR]