Objective To apply sandplay therapy in cerebral palsy children's parents for the psychological problems. Methods 40 parents of cerebral palsy children were randomly divided into experimental group (n=20) and control group (n=20). The experimental group accepted sandplay therapy once a week for 10 weeks, and the control group without any intervention. All the parents were assessed with Symptoms Check-List 90 (SCL-90), Self-Esteem Scale (SES), compliance questionnaire, Quality of Life Questionnaire-Core 30 (QLQ-C30) before and after the experiment. Results The scores of all the factors of SCL-90 were lower in the experimental group than in the control group (P<0.05), with the higher scores of compliance and self-esteem (P<0.05), and the high quality of life in physical function, role in work and social function (P<0.05) in the experimental group. Conclusion Sandplay therapy can be used to solve the psychological problems of cerebral palsy children's parents, and improve their compliance, self-esteem and quality of life.

Objective To assess if evaluating with Peabody's fine motor development scale with 4 degree grading is more sensitive than with 3 degree grading, and whether or not it is feasible to evaluate by quantization with monthly averages. Methods A total of 864 normal children aged 1 month to 60 months were evaluated with the Peabody scale using 4 degree grading and 3 degree grading. The development results were averaged by month to express the development. Results Both ways, the monthly averages of children 4-9 months old were higher than the others. The values obtained with 4 degree grading were lower than those with 3 degree grading in each functional area, and the difference was more obvious with increasing age, but the differences were not statistically significant. With 3 degree grading the total score was equal to the actual score after the age of 9 months, but with 4 degree grading this was not true until at least 18 months. Conclusions Evaluating with Peabody's fine motor scale with 4 degree grading and quantization using monthly averages is reliable and more sensitive than 3 degree grading.

Objective To explore the effects of group sand play on the behavior of cerebral palsy (CP)children with behavioral problems.Methods Ninety children with CP aged 3-5 with behavioral problems were selected,after those with mental retardation had been excluded through the Peabody picture vocabulary test (PPVT).Their behavioral problems were diagnosed using Achenhach's child behavior check list (CRCL).The children were randomly divided into an experimental group and a control group with 45 cases in each.The experimental group received 10 weeks of sand play treatment in addition to routine rehabilitation.The controls received only routine rehabilitation.Results After treatment,the social withdrawal,depression,aggression and disruptive behavior scores of the 3-year olds in the experimental group were significantly lower than before treatment and significantly lower than those of the controls.For the 4 and 5 year-old boys the results were similar in terms of soclal withdrawal,depression,immaturity,sexual behavior,aggression and delinquent behavior,For the 4 and 5 year-old girls the scores for depression,somatic complaints,social withdrawal,compulsion,aggression,and hyperauctivity showed similar significant improvements.Conclusion Group sand play can improve the behavior and promote the mental health of CP children.

Objective To assess the effectiveness and safety of combining methylprednisolone with myco-phenolate mofetil in managing moderate to severe active Graves'ophthalmopathy(GO),and to compare its efficacy against methylprednisolone monotherapy.Methods A retrospective study was conducted to select patients with moderate to severe active GO who received treatment at the Department of Endocrinology and Metabolism,Guizhou Medical University Affiliated Hospital,from January 2019 to January 2024.The patients were divided into two groups:a combination group receiving methylprednisolone combined with mycophenolate mofetil,and a mono-therapy group receiving methylprednisolone alone.The objective was to compare changes in visual score,appearance score,clinical activity score(CAS),eye protrusion,eye fissure width,and eye movement between the two groups of patients while documenting any adverse events.Results A total of 98 patients were enrolled in the study,comprising 32 patients in the combination group and 61 patients in the monotherapy group.Both groups exhibited improvements in quality of life scores,CAS,and degree of protrusion following treatment compared to baseline.However,at the end of the 12-week treatment period,there was no statistically significant difference(P>0.05)observed between the two groups regarding changes in visual scores,appearance scores,CAS,protrusion degree,fissure width,and proportion of reduced eye movement before and after treatment.Notably though,the combined therapy group demon-strated a significantly higher improvement rate for pain relief and reduction of eyelid congestion during eye movement when compared to the monotherapy group(P<0.001).At the endpoint of treatment,there were no statistically significant differences in appearance score,protrusion degree,tear width,and reduction in eye movement between the two groups before and after treatment(P>0.05).The combination group exhibited higher visual scores and greater improvement in CAS compared to the monotherapy group(P<0.05),along with a higher rate of eyelid edema improvement(P<0.05).At 12 weeks,the monotherapy group had an effective rate of 65.0%,while the combination group had an effective rate of 66.7%.By week 24,the combined group achieved an effective rate of 80.0%.The over-all effectiveness at week 12 and treatment endpoints did not show any statistically significant differences between the two groups(P>0.05).No cases of leukopenia or severe infection occurred in the combination group.Conclusions The combination therapy of methylprednisolone and mycophenolate mofetil demonstrates efficacy,tolerability,and safety in the treatment of moderate to severe active GO.While the overall effectiveness of this combination may not surpass that of hormone therapy alone,it exhibits potential superiority in improving visual scores,eyelid congestion,eyelid edema,and eye movement pain when compared to hormone therapy alone.