Objective To observe the effect of rehabilitation training on fine motor in children with Down syndrome. Methods 30 children with Down syndrome accepted rehabilitation training for 3.1~4.6 months. They were assessed with fine motor function in Peabody Developmental Motor Scales (PDMS-FM) before and after treatment. Results The scores of fine motor quotients, grasping and visual-motor integration improved after treatment(P<0.05). Conclusion Rehabilitation can improve the fine motor in children with Down syndrome.

Objective To compare the effect of motor development massage and neural development approach on the children with cerebral palsy. Methods The children with cerebral palsy were selected with layered matching as they accepted motor development massage or neural development approach, and reviewed with their score of Gross Motor Function Measure (GMFM-66). Results There were 24 children in each group. The GMFM-66 score increased after treatment in both groups, but there was no statistical difference between these groups. Conclusion The gross motor function can be improved in the children with cerebral palsy with motor-development massage and neural development approach similarly.

Objective To analyze the activities of daily living (ADL) performance in children with cerebral palsy (CP) with different gross motor function and the correlation between gross motor function and ADL perform-ance. Methods A total of 118 children (81 boys and 37 girls; mean age: 47.7 months, SD: 20.1 months, age range: 18-90 months) with CP were recruited from three different rehabilitation centers in Shanghai. Types of CP included hemiplegia (n = 27), spastic diplegia (n = 53), spastic quadriplegia(n = 29), athetoid (n = 4), dystonic (n = 4), ataxic (n = 1). Gross motor function classification system (GMFCS) and Gross motor function measure (GMFM) were adopted to assess and classify the gross motor function. Pediatric evaluation of disability inventory (PEDI) was adopted to assess ADL performance. Differences of PEDI scores were compared among different levels of GMFCS; and the correlation between GMFCS levels, GMFM scores and PEDI scores were analyzed. Resnlts PEDI scores showed significant differences among CP children with different levels of GMFCS. The PEDI score usually de-creased with the increase of the GMFCS level, and mobility ability was the lowest. Significant correlations were found between PEDI scaled scores and GMFCS (rs = 0.85～0. 50, P < 0.001). Various levels of correlations (r = 0. 85～ 0.54, P<0.001) were found between GMFM scores and PEDI scaled scores. Higher correlations were found between GMFCS levels, GMFM scores and mobility ability. Conclusion ADL performance was significantly different among CP children with different gross motor function. The higher the gross motor function, the better the performance of ADL. Mobility would be improved by promoting gross motor function in CP children. The training of self-care and so-cial communication ability should be emphasized.

Objective To work out the Cerebral Palsy-Gross Motor Function Questionnaire(CP-GMFQ) and evaluate the reliability,validity and responsiveness of CP-GMFQ.Methods 160 children with cerebral palsy(CP)(97 males and 63 females;average age: 47.7±20.1 months,range: 18～90 months) were involved.The first 27 children received second assessment to assess test-retest reliability with a interval of 7 to 18 days.Criterion-related validity was evaluated by comparing CP-GMFQ scores with Gross Motor Function Classification System(GMFCS) levels and scores of Gross Motor Function Measure(GMFM).21 children were randomly selected for responsiveness analysis by effect size.After a interval of 3 to 7 months the re-assessment GMFQ and GMFM were tested.30 children were randomly selected for comparative testing time of GMFQ and GMFM.Results GMFQ had excellent test-retest reliability(ICC=0.9940);criterion-related validity was excellent between GMFQ scores and GMFCS levels and GMFM scores(r=0.77～0.92).Effect size of GMFQ(0.34) between GMFM88 and GMFM66,testing time of GMFQ(average 4.7±1.6 min) were significantly less than testing time of GMFM(average 17.7±4.6 min)(P<0.001).Conclusion The reliability,validity and responsiveness of GMFQ are satisfying.The gross motor functions of children with cerebral palsy could be easy and reasonably measured by GMFQ.

Objective To study the application value of electroencephalogram and CT in children with cerebral palsy.Methods Electroencephalogram and CT examinations were carried out in 224 children with cerebral palsy.Results Abnormal prevalence of electroencephalogram was 47.77%, 58.88% of which were found as epileptic discharge. Abnormal prevalence of CT was 79.46%. The abnormal rate of CT was significantly higher than that of electroencephalogram ( P<0.001). The abnormal rates of electroencephalogram and CT among different types of cerebral palsy were not significantly different ( P>0.05).Conclusion Combination of CT and electroencephalogram will be helpful for the diagnosis and treatment in children with cerebral palsy.

Objective To determine the reliability of hand-held electronic dynamometer (HHD) tests for lower limb muscle strength measurement in children with spastic cerebral palsy (CP). Methods Twenty-eight children ( 15 boys and 13 girls; mean age 5 years 8 months) with different types of CP (2 with spastic quadriplegia,8 spastic diplegia, 6 hemiplegia, 1 triplegia and 1 monoplegia) , and at different functional levels ( 19 graded at gross motor function classification system level Ⅰ, 6 level Ⅱ, 2 level Ⅲ and 1 level Ⅳ ) were recruited from the Rehabilitation Center of the Children's Hospital of Fudan University. Standardized HHD protocols were used to measure the strength of their hip, knee and ankle muscles. The HHD test was performed by the same examiner twice with an interval of 10 min in between. The HDD test was also performed with 15 randomly selected CP children by 2 examiners with an interval of 10 min in between. The test-retest and inter-rater reliabilities of the HDD readings were determined by calculating the intra- and inter-class correlation coefficients. Results The HHD measurements showed fine testretest reliability ( ICC = 0.74-0.97 ) and inter-rater reliability ( ICC = 0.63-0.97 ) in measuring lower-limb muscle strength of children with spastic CP, with the highest test-retest reliability for the hip flexion, foot plantar flexion and knee extension muscle groups. The highest inter-rater reliability was achieved with the hip flexion and foot dorsiflexion muscle groups. Conclusions Standardized HHD testing of lower-limb muscle strength in children with spastic CP shows fine test-retest and inter-rater reliability. The HHD can reliably assess the lower-limb muscle strength of children with spastic CP.

OBJECTIVERealizing wireless communication based on handset devices for medical staff; providing an instant messaging method.

METHODSConstructing a set of communication protocols and standards; developing software both on server and client.

RESULTSBuilding an instant messaging system which follows the customized specification; based on Android the client provides functions like address book, message, voice service etc.

CONCLUSIONAs an independent module of the mobile medical terminal, the system can provide convenient communication for medical service with other mobile business.

ObjectiveTo explore the reliability of Modified Ashworth Scales(MAS) measuring muscular tone of lower extremities of children with spastic cerebral palsy(CP).Methods31 children with spastic CP(19 males, 12 females) were included in this study. The mean age for the children was （51.3±26.8） months; 20 diplegia, 7 quadriplegia, 4 hemiplegia. The muscle tone of hip adductor, hamstring, soleus muscles were tested bilaterally with MAS in lower extremity of the children. Two evaluators used the MAS to assesse the muscles tone of children. To compare with the relativity of the results of interrater and intrarater, the reliability was confirmed.ResultsThe reliability of interrater was poor, the total ICC value was 0.68, while better for the reliability of intrarater, the total ICC value was 0.83.ConclusionIt should be cautions in assessment of spasticity of muscles in the lower extremities of children with spastic CP by MAS.

Objective: To explore the sensitivity and specificity of the Chinese version of the volume and viscosity swallowing test with modified safety and effectiveness indicators (VVST-CV) in assessing deglutition disorders. Methods: The solvent, volume, viscosity, and test index of the volume and viscosity swallowing test were modified before it was used to evaluate 89 patients with swallowing disorders. The positive rates of the safety indexes (coughing, voice changes and blood oxygen saturation decline at least 3%) and the efficiency indexes (poor lip closure, oral residue, pharynx residue and swallowing) were recorded and compared and compared with the positive rates of penetration, aspiration and food residue determined by means of according to the videofluoroscopic swallowing study, then the sensitivity, specificity, positive predictive value and negative predictive value of the modified VVST-CV with regard to the safety and efficiency of swallowing were calculated. Results: The VVST-CV′s sensitivity in detecting dysphagia was 0.97. For impaired safety it was 0.85 and for impaired swallowing efficiency it was 0.95. The sensitivity of the coughing index was 0.65, that of sound change was 0.60 and that of oxygen saturation decrease was 0.42. The positive predictive values for coughing, sound change and oxygen saturation decrease were 0.98, 0.94 and 0.94, respectively. Conclusion The VVST-CV is simple, feasible and sensitive. It can be widely useful in the evaluation of dysphagia in clinical practice.

Objective: To construct the Z-score models for normal fetal brain fissures. Methods: Four hundred and eighty-seven pregnant woman who underwent prenatal ultrasonography from January to August 2018 in the Second Xiangya Hospital of Central South University were collected randomly for analysis, and all the fetuses(18-38 weeks) were healthy. The calacarine fissure, pariet-ooccipital fissure, sylvian fissure of the fetuses were measured and they were chosed as the dependent variables, while the independent variable were the gestational age and biparietal diamete, as well as femur length. The regression analyses of the mean(M) and the standard deviation(SD) for each parameter were performed separately. Two observers randomly measured the brain fissures depth two hours apart to evaluate the interobserver repeatability. Results: The brain fissure depth in normal fetuses during geatational age between 18 to 38 weeks can be evaluated by Z-score model.Positive correlations were found between the depth of calacarine fissure, pariet-ooccipital fissure, sylvian fissure and gestational age, biparietal diameter and femur length. Conclusions Z-score can intuitively reflect the development of brain fissure more accurate, and is valuable, and can be used as a powerful supplement to the traditional method.