Objective To observe clinical effect of treating infantile cerebral palsy with acupuncture and massage. Methods 29 cases with cerebral palsy were randomly recurited into a control group and a treatment group. The treatment group was treated with acupuncture and massage, and the control group was treated with western medicine. The clinical effect of both groups was observed after the treatment. Results The total effective rate of the treatment group and the control group was 85.7% and 66.7% respectively, showing a significant difference (P<0.05) . Conclusion The treatment of infantile cerebral palsy with acupuncture and massage was better than treated with western medicine.

Background Retinal flatmount of oxygen-induced retinopathy (OIR) animal models is a useful tool in the study of ischemic retinopathy.The retinas of OIR of rat or mouse pups were small and thick and difficult in operating of conventional preparation and quantitative analysis of retinal flatmounts.Objective This study was to explore an easy and stable operating method of retinal flatmount combined with immunofluorescence staining in rodent.Methods Forty ＜6-hour-old SD rat pups were randomly assigned to OIR model group and normal control group.The pups were raised with nursing mothers in hyperoxia environment (80％) and normal oxygen environment (21％) alternately at a 24-hour interval for 14 days in the OIR model group,and the pups were raised in the room air for 14 days in the normal control group.The eyeballs of the rats were extracted to isolate the retinas intactly.The retinas were stained with glutamine synthetase (GS)-isolectin B4 firstly and then expanded into flatmounted and cut into 4 petals radially.Adobe Photoshop CS3 imaging analysis system was used to match the pictures into entire retinal vascular images and analyzed under the fluorescence microscope.The pixel values of retinal avascular areas and the entire retina were quantified by this system.The percentage of avascular areas to the entire retina was calculated to analyze the severity of non-perfusion areas.The use and care of the animals complied with the Regulations for the Administration of Affair Concerning Experimental Animals by State Science and Technology Commission.Results An intact and smooth retinal flatmount could be obtained by firstly staining method.Ora serrata structure was seen surrounding the whole retina.Strong green fluorescence was exhibited in retinal vessel net with clearly visible vascular branches;while the background fluorescence was weaker.Fully developed blood vessels were displayed in the retinas of the normal control group.Non-capillary areas around the central optic disk and large peripheral avascular areas could be seen in the retinal flatmounts of OIR models.Conclusions The preparation of retinal flatmount is easy and feasible by first immunofluorescence staining for retinal vessels followed by radially cutting of retina.This method of retinal flatmount can ensure the integrity of retinal vascular system and it is available for the observation and evaluation of retinal vascular structure in OIR models.

Objective To assess therapeutic effects and safety of high intensity focused ultrasound ( HIFU ) and radiotherapy for the treatment of rectal carcinoma. Methods In combination with low dose of radiotherapy, we treated 121 cases of rectal carcinoma with FEP BY01 type HIFU therapy from Jul.1998 to Dec.2000 and 43 cases were followed up for more than one year. ResultsComplete response (CR) was achieved in 27 cases(22%), partial response (PR) in 80 cases (66%),and no change(NC)was found in 14 cases (12%) with a total response rate of 88 4%.There were no complications. One year survival rate was 81%(35/43) and 2 year survival rate was 77%(23/30). ConclusionHIFU in combination with radiotherapy is a new method to treat rectal carcinoma with significant therapeutic effect and high safety.

Objective:To study the a feasibility of modified pharyngoplasty in the treatment of velopharyngeal insufficiency.Methods:30 cases of velopharyngeal insufficiency were treated with a modified pharyngoplasty followed by speech training.The effects of the treatment were evaluated by blowing test (BT),chinese articulation inteligibility test (CIT) and hypernasality observation(HO).Results:Before and after treatment BT was 1～26 and 8～40,CIT(%) 20～60 and 47～82,HO(cases) 30 and 3,respectively.Conclusions:The modified pharyngoplastic surgery is feasible in the treatment of velophayngeal insufficiency.

Objective To summarize the treatment experience of refractory systemic juvenile idiopathic arthritis (JIA) by tocilizumab, and to explore the cost-effective treatment. Methods The clinical data of 6 pediatric patients with refractory systemic JIA treated by tocilizumab from 2014 to June 2016 were retrospectively analyzed in the aspects of course and effectiveness of tocilizumab, steroid reduction, adverse reaction, and growth. Results The median age of the six patients (3 males and 3 females) was 6 years, and the course of disease were from 16 to 63 months. All patients were treated by other immunosuppressive agents or biological agents in addition to steroid and traditional anti-rheumatic drug therapy. The courses of tocilizumab treatment were from 7 to 26 months and the median time was 9.5 months. All 6 patients responded to tocilizumab and achieved the clinical remission at different time. After the induced remission, the interval of the treatment intervention was increased from 2 weeks up to 4 weeks in 3 cases, and no disease activity was observed. Except one case, another 5 cases reduced and stopped the use of hormones at 5.8 months after tocilizumab treatment. After hormones was reduced and discontinued, the growth was improved. All 6 patients had no serious adverse reactions. Conclusions Tocilizumab is safe and effective for patients with refractory JIAs. The steroid can be reduced in short time to improve growth. After remission is induced, the interval of the treatment intervention could be prolonged.

BACKGROUNDTo study the effect of DTB against HIV-1, for developing anti-HIV drugs.

METHODSDifferent concentration of DTB was added to cell culture system after viral inoculation, MTT staining method for viable cells (MTT assay) and p24 (ELISA) were used as markers to monitor the viral replication.

RESULTSThe inhibition rates of DTB at concentrations 160, 80, and 40mg/ml were 93.0%, 56.2% and 18.1%, respectively.

CONCLUSIONSDTB could effectively inhibit HIV-1 in vitro.

Anti-HIV Agents ; pharmacology ; Bilirubin ; analogs & derivatives ; pharmacology ; Dose-Response Relationship, Drug ; HIV-1 ; drug effects ; Humans ; In Vitro Techniques

Objective:To gain insight into the constitution of juvenile rheumatic diseases, treatment outcome and trends of rheumatic inpatients in past 12 years, and to improve awareness of juvenile rheumatic diseases.Methods:The clinical data of 5 950 patients in rheumatology department of the affiliated pediatric hospital of Fudan University (from 2005 to 2016) were analyzed retrospectively, and the chi-square test was used to compare and analyze the incidence.Results:Disease changes: ① The top three rheumatic diseases were Kawasaki disease (KD) (44.3%), Henoch-schoniein purpura (HSP) (35.4%), juvenile idiopathic arthritis (JIA)(9.6%). ② The number of all constitution of juvenile rheumatic diseases in hospital increased other than HSP. ③ The rheumatic diseases were increased from 17 to 37 kinds in the past 6 years. ④ The number of systemic lupus erythematosus (SLE) increased year by year (112/2 348 vs 197/3 602, χ2=1.41, P=0.235), as well as the severe SLE (35/112 vs 55/197, χ2=0.38, P=0.536). ⑤ The rate of rheumatic diseases complicated with macrophage activation (MAS) was 7.2‰(43/5 950). 12.9%(26/201) of systemic juvenile idiopathic arthritis(sJIA) were complicated with MAS, which was accounted for 60.5%(26/43) of total number of MAS in rheumatic diseases. In the last 6 years, there was a significant increase in the number of patients with MAS in patients with rheumatic diseases ( χ2=14.1, P<0.01) and sJIA( χ2=11.2, P<0.01). ⑥ 1.1%(64/5 950) of rheumatic diseases patients had lung lesions, juvenile dermatomyositis (JDM) accounted for 24.4%(20/82). In the last 6 years, the number of patients with lung lesions associated with rheumatic diseases increased significantly ( χ2=5.66, P=0.017). ⑦ The mortality rate of juvenile rheumatic diseases was only 3.7‰(22/5 950), and 45.5% occurred in SLE (10/22). The mortality rate of SLE decreased in last 6 years (5/112 vs 5/197, χ2=0.34, P=0.558). Conclusion:The constitution of juvenile rheumatic diseases in our center is decreasing for systemic vasculitis (KD, HSP), JIA, SLE, JDM in last 6 years. The annual total number of patients is relatively stable. But rare, difficult and critically illed cases increase year by year. Although SLE is still the primary cause of death in juvenile rheumatic diseases in recent 6 years, the mortality rate has decreased year by year.

Objective:To analyze the disease spectrum among children who were using hydroxychloroquine (HCQ), and evaluate the drug′s safety and compliance.Methods:From January 2008 to December 2019, children from Children′s Hospital of Fudan University who used HCQ were selected as subjects, the disease spectrum of HCQ was analyzed, and the drug safety and compliance were evaluated for the patients who were followed up for more than 6 months. Demographic information, diagnosis, initial dose, time of continuous use, cumulative dosage and related adverse reactions report, project and the results of eye test were collected.Results:A total of 528 cases used HCQ during the 12 years, with 156 male cases and 372 female cases, and age at initial medication was (10.5±3.2) years. Among them, 514 cases (97.3%) had rheumatic disease, 5 had pulmonary interstitial lesions and 9 had other system diseases. The top three of the rheumatic diseases were systemic lupus erythematosus (SLE) in 316 cases (316/514,61.5%), juvenile idiopathic arthritis in 69 cases (69/514,13.4%), and juvenile dermatomyositis in 56 cases (56/514,10.9%). During the same period, 397 cases were diagnosed with SLE, and the utilization rate was 79.6% (316/397), which was the highest compared with other diseases and increased year by year. Pulmonary interstitial lesions included 4 cases with SFTPC gene defect related interstitial lung disease. Of the 528 ceses who were treated with HCQ, 397 cases were included for evaluating HCQ′s safety and compliance, the initial dose was (4.2±1.0) mg/kg, duration was 29.6 (14.9, 48.8) months, the longest usage time was 127 months, the largest cumulative dosage was 566.8 g. The continuous usage duration ( Z=-3.191, P=0.001) of SLE was significantly higher than those of other diseases, as well as cumulative dosage ( Z=-5.355, P=0.001). All cases received comprehensive eye exams before medication, 354 cases (354/397, 89.2%) were followed up in the ophthalmological department, and 65.5% (232/354) of them could be reviewed regularly at least 1 time per year. One case suffered from severe skin adverse reactions when the drug was used for 32.7 months, and no other serious adverse reactions were reported. HCQ related retinopathy was not seen during the follow-up period. There were 5 cases stopped HCQ on their own. Conclusions:HCQ was widely used in rheumatic disease in children, especially in those with SLE. It was safe for long-time usage in children, and the medication compliance and the ophthalmic follow-up was good.

Hip fractures are among the most common fractures in the elderly, presenting to be a leading cause of disability and mortality. Surgical treatment is currently the main treatment method for hip fractures. The incidence of perioperative malnutrition is increased after hip fractures in the elderly due to the comorbidities, decreased basal metabolic rate, accelerated protein breakdown, weakened anabolism and surgical stress. However, malnutrition not only increases the incidence of postoperative complications, but also leads to increased mortality, indicating an important role of perioperative nursing management of nutrition for the elderly patients with hip fractures. At present, there still lacks scientific guidance and application standards on perioperative nursing management of nutrition for the elderly patients with hip fractures. Therefore, the Orthopedic Nursing Committee of Chinese Nursing Association and the Editorial Board of Chinese Journal of Trauma organized relevant experts to formulate the Expert consensus on perioperative nursing management of nutrition for elderly patients with hip fractures ( version 2023) according to evidence-based medical evidences and their clinical experiences. Fourteen recommendations were made from aspects of nutrition screening, nutrition assessment, nutrition diagnosis, nutrition intervention and nutrition monitoring to provide guidance for perioperative nursing management of nutrition in elderly patients with hip fractures.