Objective To study the effects of ankle-foot retractor on ankle joint motion and equilibrium function of stroke hemiplegic patients.Methods 74 patients were divided into two groups: observation group (n=36) and control group (n=38). The control group was trainedby routine rehabilitation training program and electro-uprise bed, the observation group was trained by ankle-foot retractor based on routinerehabilitation training program. The effect was evaluated after 8 weeks. Results After training, either the observation group or the controlgroup showed significant improvement at motion of ankle joint, activity of daily living (ADL), and equilibrium function, but the observationgroup was better than the control group (P<0.001). Conclusion Ankle-foot retractor plays a positive role on motion of ankle joint, ADL andequilibrium function in stroke patients.

Objective To study the effect of motor imagery on balance rehabilitation in hemiplegics after stroke.Methods 20 hemiplegic patients who were in chronic stage(above 6 months)were randomly divided into two groups.Normal rehabilitation was performed in the whole stage and motor imagery was added in group A in stage Ⅰ and group B in stage Ⅱ.All patients were assessed with Berg Balance Scale(BBS),blance subscale of the Fugl-Meyer Assessment(FM-B),max affected limb-loading per weight and Functional Independence Measure(FIM)at the beginning and the ending of the every stage,respectively.Results The deference scores of BBS and FIM,as well as max affected limb-loading per weight between in the stage with motor imagery was better than those in the stage without motor imagery(P<0.01),as well as that of FM-B score(P<0.05).Conclusion Motor imagery can improve balance rehabilitation and activity of daily living in chronic hemiplegics.

Abstract: Objective To explore the risk factors for macrolide unresponsive mycoplasma pneumoniae pneumonia (MUMPP) in children and to develop a model for predicting the risk of MUMPP. Methods Children with mycoplasma pneumoniae pneumonia admitted to the Pediatric Department of Leshan People's Hospital who met the inclusion criteria from March 1, 2023, to December 1, 2023, were retrospectively selected and divided into the responsive group and unresponsive group according to their reactions to macrolides. General patient data, laboratory tests, and imaging findings were collected and compared. Logistic regression analysis was used to analyze the risk factors of the Macrolide unresponsive mycoplasma pneumoniae pneumonia, and R language (R4.2.3) to establish the nomogram model. The goodness of fit, discriminative ability, calibration, and clinical utility of the model were assessed using the Hosmer-Lemeshow goodness of fit test, receiver operating characteristic (ROC) curve analysis, calibration curve analysis, and decision curve analysis, respectively. Results A total of 224 patients were included in the analysis of children. Among them, 156 (70%) were randomly selected as the training set, and the remaining 68 cases (30%) were used as the validation set. Logistic regression analysis revealed that pleural effusion (OR=6.986, 95%CI 1.362-35.847), highest temperature before admission (OR=3.095, 95%CI 1.487-6.439), neutrophil count (OR=1.294, 95%CI:1.103-1.519), C-reactive protein (OR=1.030, 95%CI 1.002-1.058), and procalcitonin (OR=2.899, 95%CI:1.353-6.214) were independent risk factors for MUMPP in children (all P<0.05). A nomogram was established using R software. The Hosmer-Lemeshow goodness of fit tests for the training set and the validation set were χ2=4.018 and χ2=4.657 (all P>0.05), indicating a good fit of the model. The AUC values for the training set and validation were 0.825 (95%CI: 0.755-0.894) and 0.828 (95%CI 0.729-0.928), respectively, suggesting good discriminative ability of the model. Calibration curve analysis suggested that the model had good predictive performance, while decision curve analysis indicated a high clinical application value of the predictive model. Conclusions Pleural effusion, highest body temperature before admission, neutrophil count, C-reactive protein, and procalcitonin are independent risk factors for MUMPP in children. The prediction model constructed based on the above variables has high predictive efficacy and clinical application value.

Objective:To evaluate the clinical outcomes of patients with borderline developmental dysplasia of the hip (BDDH) and cam-type femoroacetabular impingement syndrome (FAIS) after hip arthroscopy.Methods:Data were retrospectively reviewed for patients with BDDH and cam-type FAIS who underwent hip arthroscopy surgery from June 2017 to December 2019. A total of 32 patients were enrolled, with a mean age of 36.13±8.67 years (range, 20-50 years), including 15 males and 17 females. The preoperative lateral center-edge angle was 22.3°±1.6° (range 20.1°-24.7°), while the preoperative α angle was 64.1°±4.6° (range, 56.0°-69.8°). All patients were treated with arthroscopic limited acetabular plasty, labral repair, femoral osteoplasty, and capsular plication after excluding from external hip diseases by ultrasound-guided hip blocking test. The visual analogue scale (VAS), modified Harris Hip Scores (mHHS) and International Hip Outcome Tool-12 (iHOT-12) scores were used to evaluate the clinical effects.Results:All patients were followed up, and the mean follow-up time was 2.5±0.8 years (range, 2.0-4.7 years). The VAS score decreased from 6.07±1.56 to 1.96±0.92 at 1 year and to 1.86±1.01 at 2 years after operation ( F=112.64, P<0.001); the mHHS score increased from 53.87±13.04 to 86.12±8.64 at 1 year and to 88.71±8.15 at 2 years after operation ( F=101.70, P<0.001); the iHOT-12 score was improved from 40.00±7.33 to 76.27±9.50 at 1 year and to 78.67±10.31 at 2 years after operation ( F=134.91, P<0.001). The α angle improved to 40.27°±4.52° (range, 34.8°-49.7°) with significant difference ( t=9.24, P<0.001). Conclusion:Hip arthroscopy can achieve satisfied short-term outcomes in treating BDDH and cam-type FAIS with few complications and less trauma.

Objective:To compare the efficacy between acupuncture and acupuncture with infrared thermography-guided Chinese massage (Tuina) in treatment of children with Bell′s palsy (BP).Methods:Seventy two children with BP admitted to the Rehabilitation Department of Beijing Children′s Hospital from October 2019 to April 2020 were randomly assigned into two groups: 35 cases were treated with acupuncture alone (acupuncture group) and 37 cases received acupuncture combined with Tuina for treatment (combination group). In combination group, the temperature of forehead, cheek and mandible areas was examined by infrared thermography before each course. Compared healthy side if the temperature on the affected side was lower, higher or the same, rubbing method, tapping method and one-finger meditation push method of Tuina was applied, afterwards the acupuncture treatment was given as in the acupuncture group. Patients in both groups were treated once a day with 5 days for a course and a total of 3 courses. The patients were assessed with House-Brackmann (H-B) facial nerve function evaluation scale and Portmann simple score scale before and after each course of treatment.Results:The H-B classification of the two groups of children at the end of the third course of treatment was significantly better than that before treatment (χ2=31.01, 56.41; P<0.01). There was no significant difference in H-B grading between the two groups before treatment, after the first and second course (χ2=0.58, 8.49, 6.79; P>0.05). After the third course of treatment, the H-B grading assessment of the combination group was significant better than that of the acupuncture group (χ2=10.03, P<0.05). The Portmann scores of the two groups were improved after each course of treatment ( F=9.68, 22.54; P<0.01); however, the facial nerve function of combination group was improved more significantly than that of acupuncture group [(13.97±4.58) vs.(10.97±5.40), t=2.55, P=0.01]. The total effective rate of combination group was higher than that of acupuncture group [51.35% (19/37) vs. 20.00% (7/35), χ2=6.79, P<0.05]. There was a significant difference in the application frequency of three Tuina methods among the forehead, cheek and mandibular areas in the first course and the third course (χ2=21.23, 13.33; P<0.05). In the same area (forehead, cheek and mandible) there was a significant difference in the application frequency of three massage techniques among the three courses of treatment (χ2=31.26, 21.35, P<0.01). Conclusion:With the guidance of infrared thermal imaging, individualized Chinese massage (Tuina) combined with acupuncture treatment is more effective in treatment of children with Bell′s palsy than using acupuncture alone.

OBJECTIVE To identify, synthesize and analyze the structure of unknown impurities unique to bromhexine hydrochloride injection and set the impurities as known impurity to control. METHODS The structure of unknown impurities was derived through two-dimensional liquid chromatography tandem mass spectrometry(2DLC-HRMS/MS), and the source of impurities was derived based on the product's prescription process. The mechanism of impurities generation was analyzed, and impurity monomers were obtained through directional synthesis. The structure of impurities was confirmed using techniques such as 2DLC-HRMS/MS and nuclear magnetic resonance. Finally, HPLC was used to verify the analysis method of impurities. RESULTS It was confirmed that such impurities were produced in a reaction between bromhexine and the excipient glucose. The correction factor of the two impurities were 2.2 and 2.4, the analytical method was specific and reproducible. CONCLUSION Name the two injection specific impurities as impurity 1 and impurity 2 respectively, and use them as known impurities to be included in the standard, calculate the impurity content using the self control and correction factor method. This study is of great significance in guiding the impurity control of bromhexine hydrochloride injection and the screening of excipient glucose.