Objective To explore the effect of repetitive transcranial magnetic stimulation (rTMS) on intelligence development in children with cerebral palsy with epilepsy. Methods 156 children with cerebral palsy with epilepsy were randomly divided into control group (n=70) and treatment group (n=86). The control group received comprehensive rehabilitation combined with traditional Chinese and western medicine. The treatment group received rTMS in addition. Both groups were evaluated with the development quotient (DQ) of Gesell Development Schedules and Mental Developmental Index (MDI) of Children's Development Center of China (CDCC) intelligence test before, and 2 and 4 months after treatment. Results The DQ and MDI improved more in the treatment group than in the control group (P<0.001). Conclusion rTMS can improve the intelligent development in children with cerebral palsy with epilepsy.

0.05). Conclusion Compound salbutamol sulfate aerosol was able to improve the symptoms of patients with asthma, and the efficacy and safety of this drug are similar to that of Combivent. The results indicated that compound salbutamol sulfate aerosol may be a safe and effective drug in the treatment of asthma.

Spasticity can influence the outcome of the patients with cerebral injury. Most traditional physical therapies often focused on the spastic muscle. The recent development has showed that stimulating the antagonistic muscle can relieve the spasticity, which based on the reciprocal inhibition theory. This paper reviewed these approaches on its theory and application.

Objective To investigate the chemical properties of superficial cardiac neurons. Methods By means of immunohistochemical ABC technique,the study was performed concerning the distribution of calcitonin gene-related peptide(CGRP) and substance P(SP) in the canine main cardiac superficial plexus. Results CGRP-immunoreactive(IR) neurons were found in every plexus,but SP-IR neurons could be observed only in dorsal atria plexus(DAP),inter atria plexus(IAP) and aorta-pulmonary plexus(A-PP).The shape and size of CGRP-IR and SP-IR neurons were similar.The comparative study on atria and ventricles indicated that CGRP-IR and SP-IR neurons in atria were more than those in ventricles.Numerous CGRP-IR,SP-IR nerve fibers could be observed in each fat pats and intermyocardiocytes.These nerve fibers were usually situated near blood vessels,or were attached to vessel wall.Somewhat CGRP-IR and SP-IR nerve fibers were connected with myocardiocytes in some regions.Conclusion The results indicated that actually existed two peptides in canine cardiac superficial plexus.These implied that the regulations of the two kinds of peptidergic neurons to atria and ventricle were different.The two kinds of neurons mentioned above were likely to perform different or similar functions in canine heart.CGRP and SP could possibly modulate the activities of myocardiocytes and vessels of heart directly.

Objective To observe the effects of Salvia injection on the brain pathology,expression of synaptophysin and the synaptic ultrastructure at different time points in neonatal rats after hypoxic-ischemic brain damage (HIBD).Methods One hundred and fifteen healthy newborn SD rats of 7-day-old were randomly divided into normal group,sham group,Salvia high dose group,Salvia low dose group,and the HIBD model group.The HIBD model was prepared by ligation of the left carotid artery combined with hypoxic environment.The rats(in normal group,sham and HIBD model groups) were injected with sterile saline[9.0 mL/(kg · d)],while the rats in high and low dose groups were injected with Salvia injection [9.0 mL/(kg · d) and 4.5 mL/(kg · d) respectively].The intraperitoneal injec tion lasted for 7 and 14 days.The rats' brains were collected at one day,7 days and 14 days after the modeling respec tively.The specimens of brain tissue were observed through hematoxylin-eosin (HE),the expression of synaptophysin (SYP) was determined by using immunohistochemistry method,and the synaptic ultrastructure in the frontal cortex was observed through transmission electron microscope.Results Finally,106 newborn rats were included in statistics analysial.(1)General observation:after HIBD modeling,the neonatal rats were mostly in the left-lateral position,with difficulties in turning over,balance abnormalities,limb shaking and other abnormal behaviors,and the delay of eyes open with the left upper eyelid ptosis.(2) Pathology:the disordered and deep stained nerve cells,the degenerated and necrotic neurons were observed in the brain tissues of the HIBD model group.(3) Expression of synaptophysin:mean density of SYP in the HIBD model group was significantly lower than the normal group on day 1,day 7,and day 14 (P ＜0.05);the SYP expression in the Salvia intervention groups increased compared with the HIBD model group(P ＜ 0.05).(4) Synaptic ultrastructure:the incomplete structure of the frontal cortex neurons,the swelling organelle and the synaptic structure damage were observed in the HIBD rats.Compared with the HIBD model group,the neuronic and synaptic ultrastructure were improved by the intervention treatment of high and low dose Salvia injection.Conclusions The mechanism of Salvia injection in treatment of neonatal rats with HIBD may be associated with the improvement in neuronal ultrastructure and synaptic reorganization.

Base on the definition,classification and diagnostic condition of cerebral palsy published by Pediatrics Neurology Group of Chinese Medical Association in 2005 and Child Rehabilitation Committee of Chinese Rehabilitation Medical Association in 2007.Referencing foreign diagnosis and treatment guidelines for child with cerebral palsy and the current paper report,going through more than once discussion,compiled by Chinese Compiling Committee of Rehabilitation and Treatment Guidelines for Cerebral Palsy so as to guide comprehension of the definition of cerebral palsy,enhance the level of diagnosis and classification of cerebral palsy for clinic doctor and all so acting on international convention.

Objective To investigate the clinical, biochemical and genetic features of a Chinese boy with holocarboxylase synthetase deficiency (HCSD). Methods The clinical and genetic data of a rare case of HCSD were retrospectively analyzed. Results After birth, the boy showed development delay. At 3 months old, the boy was started with rehabilitation. Tandem mass spectrum and gas chromatography analysis was carried in the 5th month after birth because of the recurrent upper respiratory tract infection and elevated level of C5-OH in the blood and decreased level of C0,and elevated level of 3-OH-propionic, pyruvic acid, methylcrotonylglycine in the urine were in accordance with the HCSD. Genetic analysis found compound heterozygous mutations of c.1648G>A and c.1544G>A in gene, of which the latter one is novel. After the treatment of biotin (20 mg/d) and L-Carnitine, the condition of this boy was gradually improved. Conclutions HCSD is characterized with slow onset and inconspicuous manifestations. The confirmed diagnosis can be built with MS/MS, GC/MS analysis and gene mutation analysis. The effect of early biotin treatment is satisfactory. In this study,we carried out clinical and genetic diagnosis,which lays a solid foundation for prenatal diagnosis and early treatment.

Chinese rehabilitation guidelines for cerebral palsy (2022) mainly refers to the international evidence-based medicine and relevant guidelines for rehabilitation of cerebral palsy in recent five years.On the basis of the Chinese rehabilitation guidelines for cerebral palsy (2015), combined with the medical literature and research achievements published at home and abroad before June 2022, the evidence-based practice guidelines are revised by combining the common opinions of pediatric rehabilitation experts in China.The content includes introduction, overview, the assessment and intervention guideline for infants at high risk of cerebral palsy, evaluation of children with cerebral palsy under ICF-CY framework, rehabilitation treatment, Traditional Chinese Medicine rehabilitation therapy, rehabilitation nursing, rehabilitation approaches and management.This article interprets the guide in combination with the hot spots of cerebral palsy prevention and treatment at home and abroad, in order to help pediatric rehabilitation workers deepen their understanding of the guidelines and better guide the clinical rehabilitation practice.

Intellectual disability is a common disease in children′s nervous system, which seriously endangers children′s physical and mental health.The etiology of the intellectual disability is complex, and many genetic and environmental factors are involved in the process of it.Inherited metabolic disorders are an important cause of the disease.With the improvement of diagnosis and treatment level, the clinical outcome of children with inherited metabolic disorders can be greatly improved after early diagnosis and treatment.Therefore, it is of great significance for guiding the treatment, prognosis and reproduction of patients to identify the inherited metabolic disorders that lead to intellectual disability in time and as early as possible.Now, the known inherited metabolic disorders that lead to intellectual disability, such as phenylketonuria, mitochondrial disease, urea circulatory disorder, creatine deficiency syndrome, and lysosomal storage syndrome, etc, are summarized, which are helpful to understand its clinical characteristics and improve the clinical recognition.

Objective Mitochondrial DNA depletion syndrome is a rare autosomal recessive disorder characterized by complex genetic and clinical manifestations.This study aimed to investigate the clinical and laboratory features of a boy with mitochondrial encephalomyopathy caused by SUCLG1 mutation.Methods The clinical data and genetic test of a patient with mitochondrial DNA depletion syndrome were retrospectively analyzed.Result The proband presented with limb weakness at the 4th month after birth,and presented dystrophic appearance,muscular hypotonia,psychomotor retardation,failure to thrive,hearing impairment,scoliosis,thoracocyllosis and facial features at 9 months old.Laboratory tests showed blood lactic acid and pymvate increased,liver damage and abnormal myocardial enzymes.Plasma camitine ester profiling showed that amino acids decreased and C4-dicarboxylic-carnitine increased.Urinary organic acid analysis showed increased concentration of methylmalonic acid and its metabolites indicating methyl malonic aciduria.MRI showed bilateral T2 hyperintensities in bilateral caudate nuelei and lenticular and brain atrophy-like changes.Brainstem auditory evoked potential showed severe hearing loss.His development quotient was 35.Genetic sequencing of MUT,,MMAA,MMAB and other classic mitochondrial disease related genes of the proband revealed no mutation.Two heterozygous mutations,c.961C＞G and c.713T＞C,inherited from the phenotype of normal parents were detected in his SUCLG1 gene.The copy number of mitochondrial DNA was 244/cell in peripheral blood leukocytes,equivalent to 68.4％ of that in normal control.Conclusion In this study,an infant with muscular hypotonia,psychomotor retardation,deafness and slightly increased urine methyl malonic acid was diagnosed by genetic test.For patients with unexplained hypotonia,mental retardation,abnormal movements,hearing disorder together with increased blood pyruvic acid and lactic acid,mild methylmalonic acidemia and abnormal acylcarnitine,mitochondrial DNA depletion syndrome should be considered.Gene analysis is important for diagnosis and prenatal diagnosis of the next pregnancy.