Acupuncture Points ; Adolescent ; Adult ; Electroacupuncture ; Female ; Humans ; Male ; Middle Aged ; Spinal Cord Injuries ; complications ; Urinary Bladder, Neurogenic ; etiology ; physiopathology ; therapy ; Urination ; Young Adult

Stroke rehabilitation research has shifted its focus from empiric evidence to biological targets. This article reviewed the plasticity of the brain, spinal cord and skeletal muscle, and suggested rehabilitation techniques targeting central nervous system and skeletal muscle.

BACKGROUND:Extradural cortical stimulation combines the advantages of repetitive transcranial magnetic stimulation, transcranial direct current stimulation, subdural cortical stimulation and deep brain stimulation, which can significantly improve motor and language function after stroke. OBJECTIVE:To review the theoretical research and clinical application of extradural cortical stimulation for stroke recovery. METHODS:An online retrieval of PubMed database and CNKI database between January 1995 and April 2014 was performed for articles on theoretical research and clinical application of extradural cortical stimulation for stroke recovery, with the key words of“cortical stimulation, extradural motor cortex stimulation, extradural cortical implants, extradural cortical stimulation, stroke, rehabilitation”in English and Chinese. RESULTS AND CONCLUSION:Because of implantable cortical stimulation, the advantage of extradural cortical stimulation is its minimal invasiveness, high accuracy and transdural contact with the brain. For lack of effective treatment for the chronic phase of stroke patients with motor and language dysfunction, extradural cortical stimulation may be a new therapeutic method. Motor and language functional improvement must derive from reactivation of plasticity, local enhancement of perilesional areas, enhancement of network function and inter-hemispheric balance function, and amplification of sensory input.

Objective To evaluate the impact of positive end-expiratory pressure (PEEP) on hemodynamic variables including central venous pressure (CVP),mean arterial pressure (MAP) and heart rate (HR) in patients with central respiratory failure treated by mechanical ventilation.Methods Thirty two neurosurgical patients with central respiratory failure,male 19,female 13,mean age (58.8 ± 13.9)years,GCS ≤ 8 points,were enrolled in this prospective,self-control study between June 1,2009,and May 31,2011.Patients were excluded in cases of severe cardiopulmonary disorders,pericardial diseases,person machine confrontation,administration of vasoactive drugs,and hypervolemia or hypovolemia.On admission to neurosurgical intensive care unit,all patients were mechanically ventilated in the mode of synchronized intermittent mandatory ventilation.Hemodynamic effects of six randomly set levels of end-expiratory pressures (0,3,6,9,12,15 cm H2O,every 10 min,1cm H2O =0.098 kPa) were studied in all patients.CVP,MAP and HR were recorded at each of the six end-expiratory pressure levels.One-way analysis of variance and simple linear regression model were used for data analysis.Results The levels of central venous pressure were elevated with increase in end-expiratory pressures.CVP levels were positively correlated with the levels of PEEP (R =0.468,P =0.000),with a simple linear regression equation expressed as:CVP (cm H2O) =7.870 +0.344 ×PEEP (cm H2O),The levels of MAP showed no statistically significant changes at different PEEP levels (F =1.390,P =0.227).No linear correlation between MAP,HR and PEEP levels was found (R =0.042 and 0.160,P =0.413 and 0.002).Conclusions CVP values would be overestimated during mechanical ventilation at different PEEP levels in mechanically ventilated patients due to central respiratory failure,positive correlation existed between CVP values and PEEP levels,whereas MAP was unaffected by different PEEP levels.This study could probably offer a quantitative reference for correct assessment of such a hemodynamic variable as CVP for mechanically ventilated patients without discontinuance of PEEP.Further studies are needed to determine whether these findings could be confirmed in a prospective manner.

Objective:To investigate the prevalence of physical violence against children (PVAC)by parents and to explore possible related factors.Methods:In two primary schools in Liaoning Province,1164 parents of pupils in grade 1 to 6 were surveyed by a self-administered questionnaire anonymously to analyze situation about PVAC and related factors.PVAC was defined as having one or more following parent-to-child behaviors in the past three months:push,or shook a child;pinch,screw,or scratch a child;hit child's buttocks with hand;hit child's hand,foot,arm,leg or back with hand;hit child's buttocks with an object;hit child's face or head with hand;hit elsewhere (not buttocks)with an object;kicked a child with a foot or hit with a fist.Results:Of 1164 parents,53.1% reported that they had minor PVAC (51.0%)or/and severe PVAC (19.8%).Multivariate logistic regres-sion analysis indicated that following factors increased the risk of PVAC:child's male gender (OR =1.49),younger age of children (OR =1.38),poor school performance of children (OR =1.85 ),mother (OR =2.09),parents'childhood physical violence victimization experiences (OR =1.53),parents'supportive or tolerant attitudes towards corporal punishment (OR =3.15),parents'lower awareness of the harmfulness of physical violence against children (OR =2.31),and lower social economic status (OR =1.47).Conclusion:The PVAC by their parents may be com-mon in the present study.Parents'supportive or tolerant attitudes toward corporal punishment and low awareness of the harmfulness of physical violence is the main risk factors of PVAC.

Objective: This study was designed to evaluate the impact of a schoolbased child sexual abuse (CSA) prevention education on knowledge and skills of schoolaged children in a rural area of China, and to provide a reference for conducting CSA prevention program in the rural area in the future. Methods: Three hundred and sixtyfive schoolage children, recruited from grade 2-5 in 2 rural schools of northeast China, were assigned to a CSA prevention education group or a control group by class. CSA prevention education was implemented by school teachers. Questionnaire surveys were conducted before and after the intervention. To evaluate intervention impact on students’ knowledge and skills, ttest was used to compare scores increment in knowledge and skills between intervention group and the control group. Results: The findings showed that scores in CSA prevention knowledge and skills among children in both groups was significantly improved after intervention. The increment of knowledge and skill scores in intervention group was 3.49 and 1.99, respectively, significantly higher than that of control group(1.05 and 1.11). Conclusion The present study shows that school CSA prevention education is helpful to improve children’s knowledge and skills of personal safety in the rural area. Schoolbased CSA prevention education methods and evaluation methods needs to be further improved.

Objective To exam the exposure status to tobacco advertisement and promotion programs in Chinese middle school students.Methods Stratified multi-stage cluster sampling was used to select participated grade 7-9 middle school students in 31 provinces (n=155 117).A self-administrated questionnaire was used in which questions related to behavior on tobacco use,exposure to second-hand smoking (SHS),access to tobacco products and prices,tobacco control advocacy,exposure to tobacco advertisement,and promotion as well as attitude and knowledge towards tobacco,etc.Data was weighted and analyzed,using the complex survey module of SAS 9.3 software.Results In the past 30 days,48.5％ of the students had a chance to see advertisement or promotion programs on tobacco.Tobacco advertisement or promotion were most frequently seen on TV (21.3 ％) among students,followed by outdoor billboard (20.1％),at the stands for sale (17.5％),and Internet (15.6％).In addition,4.6％ of the students reported having kept the items related to brand logos of tobacco products; 2.0％ reported having been offered a free tobacco product by tobacco company representatives; 69.7％ reported having seen scenes related to smoking on TV/videos/movie screens.Twenty five point two percent of the student smokers reported buying individual sticks at last purchase.Among those students who had never been exposed to tobacco,the ones who had been exposed to tobacco advertisement and promotion programs reported that they were more likely to feel smoking attractive than those who had not.They also reported that if a cigarette was offered by friends,they might try to smoke within the next 12 months,feeling that smoking would make him/her comfortable,and finally to feel that they might enjoy smoking (P＜0.000 1).Conclusion Adolescents had been heavily exposed to tobacco advertisement and promotion programs in China.Students who had been exposed to tobacco advertisement or promotions were more likely to express positive attitude to tobacco use.It is urgent to make amendments to China's Advertising Law to completely prohibit tobacco advertisement,promotion and sponsorship programs,to keep the young people away from tobacco.

Objective To compare the outcomes of surgical treatment of ankle fracture with or without repair of deltoid ligament(DL) rupture.Methods Between March 2009 and December 2015,75 patients were treated surgically at Department of Foot and Ankle Surgery,Honghui Hospital for ankle fracture with DL rupture.Of them,the DL rupture was repaired in 20(repair group) and not in 54(non-repair group).The 2 groups were compared in terms of pre- and post-operative medial clear space(MCS),rate of radiological MCS malreduction(MCS>5mm),rate of surgical failure,the American Orthopaedic Foot and Ankle Society(AOFAS) ankle-hindfoot score and visual analogue scale(VAS).The outcomes of AO/OTA types B and C were also compared between the 2 groups.Results The 2 groups were compatible due to insignificant differences in their preoperative general data and follow-up time(46.9±22.5 months versus 56.3±23.9 months)(P>0.05).The MCSs after operation(3.3±0.3 mm) and at the last follow-up(3.2±0.3mm) in the repair group were significantly shorter than those in the non-repair group(3.8±1.0mm and 3.8±1.2mm)(P<0.05).The rate of radiological MCS malreduction in the repair group(0) was significantly lower than that in the non-repair group(20.4%)(P<0.05).There were no significant differences between the 2 group in rate of surgical failure(0 versus 7.4%),AOFAS ankle-hindfoot score(88.0±5.8 versus 85.9±8.7) or VAS(1.2±0.8 versus 1.6±1.6)(P>0.05).The rate of radiological MCS malreduction for AO/OTA type C ankle fracture in the non-repair group was significantly higher than those for AO/OTA types B and C in the repair group and AO/OTA type B in the non-repair group(P<0.05).Conclusion Surgical repair of the DL rupture may help decrease the rate of postoperative MCS malreduction,especially for AO/OTA type C ankle fractures.

Objective To investigate the prevalence of psychological violence against children by parents and to explore possible influencing factors.Methods In two primary schools from a city,located in the northeast part of China,1 164 parents of the pupils from grade 1 to 6,were anonymously surveyed by a self-administered questionnaire,to analyze the situation of psychological violence and influencing factors.Results Of the 1 164 parents,78.1％ reported that they practised psychological violence towards their children.Compared with girls,boys were more psychologically maltreated by their parents (81.3％ vs.74.7％,P＜0.01).Data from the multivariate logistic regression analysis indicated that following factors increased the risk of psychological violence against children:child being male (OR=1.684);initiated by the mother (OR=1.640),parents experiences of psychologically violent victimization (OR=2.064) during their childhood,supportive or tolerant attitudes towards corporal punishment (OR=2.618) from the parents,low awareness of the harmfulness of psychological violence against children (OR=1.666) of the parents,and lower social economic status (OR=1.745) of the family,etc.Conclusion Psychological violence experienced by the parents appeared very common.Prevention programs on psychological violence should be strengthened to increase the awareness of parents on this serious problem.

Objective:To observe the curative effects of triplane intra-articular osteotomy in the treatment of malunion of calcaneal intra-articular fracture.Methods:The 16 patients were retrospectively analyzed who had been admitted to Foot and Ankle Surgery Department, Honghui Hospital from January 2016 to December 2019 for malunion of calcaneal intra-articular fracture. They were 12 males and 4 females, with an average age of 43.4 years (from 31 to 58 years). The left side was affected in 10 cases and the right side in 6 cases. All malunions were type Yu Ⅱ (compressed bone fragments on the posterior articular surface) and treated with triplane intra-articular osteotomy. The curative effects were assessed by comparing the radiological parameters, American Orthopaedic Foot and Ankle Surgery Society (AOFAS) ankle-hindfoot score, pain visual analog scale (VAS) and psychological and physical scores in Health Survey 12-item Short Form (SF-12) between preoperation and the final follow-up.Results:All the patients were followed up for 20 to 60 months (average, 42.9 months); the bone healing time was 10 to 14 weeks (average, 11.5 weeks). At the final follow-up, their B?hler angle (25.7°±2.3°), Gissane angle (117.1°±5.8°), Meary angle (2.9°±1.3°), talocalcaneal angle (31.3°±3.0°), hindfoot alignment angle (3.9°±1.8°), ankle height [(82.3±2.6) mm], calcaneus height [(56.9±2.4) mm], calcaneus width [(41.4±2.1) mm], AOFAS ankle-hindfoot score [(82.3±7.3) points], median VAS score [3 (2, 3) points], SF-12 psychological score [(46.6±3.6) points], and SF-12 physiological score [(43.6±3.5) points] were significantly improved than the preoperative values [8.4°±2.7°, 137.5°±9.3°, 8.3°±4.3°, 24.6°±3.7°, -4.6°±3.2°, (76.1±3.1) mm, (53.8±3.0) mm, (50.2±2.2) mm, (51.9±7.7) points, 6 (6, 7) points, (37.5±3.8) points, and (31.0±2.6) points] (all P<0.01) Conclusion:In the treatment of type Yu Ⅱ malunion of calcaneal intra-articular fracture, triplane osteotomy can anatomically reduce the bone fragments of collapsed posterior articular surface, reshape the normal anatomy of the calcaneus, and preserve the subtalar joint, leading to positive short- and mid-term follow-up effects.