Objective To compare the effect of botulinum toxin A(BTX-A)applied according to experi- ence with its effect when the application is guided by electrical stimulation on spasticity in the ankle plantarflexors of children with cerebral palsy(CP).Methods Forty-five children with CP were randomly assigned into 2 groups to receive injections of BTX-A guided by electrical stimulation,or injections of BTX-A guided by experience.All chil- dren received a local injection in the ankle plantar flexors.Physiotherapy and ankle-foot orthoses were applied by a physical therapist 3 days after the BTX-A injections.After the first 10 days,the therapy was administered by the patient's family.Clinical assessments included the patient's passive range of movement(PROM),scoring on the Ash- worth scale(MAS),the composite spasticity scale(CSS),and the D and E dimensions of the gross motor function measure(GMFM),and walking velocity(WV).Assessments were performed before treatment and at 3 days,2 weeks,1,2,and 3 months following the injection with BTX-A.Results All children showed significant decrease in spasticity(PROM,MAS and CSS)after 3 days.The improvement was maintained at 3 months.When compared with the results before the injection,the improvements in standing and walking(GMFM)and in walking velocity were statistically significant after 2 weeks of treatment for both groups,and were maintained at 3 months.The differences in PROM and CSS scores at 3 days,2 weeks,1,2,and 3 months following the injection were statistically significant between the 2 groups.Significant differences were also found between the 2 groups in MAS scores at 3 days,2 and 3 months after treatment,and in GMFM and WV at 2 and 3 months after treatment.Conclusions A BTX-A injec- tion,whether guided by electrical stimulation or experience,in combination with physiotherapy,can reduce spasticity in the ankle plantarflexors of ambulant children with CP and improve their functional performance.BTX-A injection guided by electrical stimulation was more effective than an injection guided by experience.

0.05).Compared with the CSS,GMFM and WV before treatment,there were statistically difference after 6 and 12 weeks treatment in two groups(Pa

Objective: To observe the therapeutic efficacy of acupoint application at different groups of acupoints in treating bronchial asthma in remission stage. Methods:A total of 120 patients with bronchial asthma in remission stage were recruited and divided by the random number table method into acupoint application group 1, acupoint application group 2 and acupoint application group 3, with 40 cases in each group. In all the three groups, Tiantu (CV 22), Dazhui (GV 14) and Feishu (BL 13) were selected, with Dingchuan (EX-B 1) added in acupoint application group 1, Shenshu (BL 23) added in acupoint application group 2, and Gaohuang (BL 43) added in acupoint application group 3. Before intervention, one month and 3 months after intervention, clinical symptoms, peak expiratory flow (PEF) andforced expiratory volume in 1 second percentage of predicted value (FEV1％) of the three groups were observed, and their clinical efficacies were evaluated. Results: Comparing the therapeutic efficacy regarding traditional Chinese medicine symptoms and signs, after 1-month treatment, the total effective rate was 87.5％ in acupoint application group 1, versus 62.5％ in acupoint application group 2 and 55.0％ in acupoint application group 3, and the between-group differences were statistically significant. After 3-month treatment, the total effective rate was 95.0％ in acupoint application group 1, versus 70.0％ in acupoint application group 2 and 65.0％ in acupoint application group 3, and the between-group differences were statistically significant. After intervention, the three groups all showed significant improvements in pulmonary function with statistical significance; among the three groups, the improvement in acupoint application group 1 was more significant than that in the other two groups. Conclusion: Tiantu (CV 22), Dazhui (GV 14) and Feishu (BL 13) as basic prescription plus Dingchuan (EX-B 1) can improve symptoms of bronchial asthma in remission stage, and it works better in improving pulmonary function than the basic prescription plus Shenshu (BL 23) or Gaohuang (BL 43).

Objective To investigate the effect and mechanism of transplantation of marrow multi- function stem ceils in treating femoral head necrosis.Methods Sixty japanese rabbits were divided into A,B and C groups randomly.After creation of the models of hormone induced necrosis of femoral head;A group was designated as the treatment,B as the control and C as the normal groups.The bone marrow of A group was extracted and isolated and then injected into the left femoral head and the right femoral head was decompressed by drilling only.The rabbits were killed at 8 weeks after the treatment and changes in various parameters were observed,including imaging data of molybdenum target films,CT and MRI;routine pathology with HE staining and ultrastructural alteration by election microscopy.Results Eight weeks after the treatment of transplantation of marrow multifunction stem cells,the X-ray showed only a little change but the typical appearances were revealed by CT and MRI.Pathohistologic manifestation demonstrated decrease of empty bone lacuna,increase of osteoblast and new bone formation.Election microscopy displayed abundant organelles in osteoblasts with few empty bone lacuna,in addition the tansplantation of marrow multifunction stem cells could obtain better reconstraction for the involved femoral head.Conclusions The treatment of transplantation of marrow muhifunction stem cells in femoral head necrosis could accelerate the process of repairing,worthy to be acknowledged as a good and valuable management in rabbits.(J Intervent Radial,2007,16:122-126)

OBJECTIVETo compare the effects of botulinum toxin A (BTX-A) injection guided by electric stimulation combined with physiotherapy, with physiotherapy only on the spasticity of the ankle plantar flexor in children with cerebral palsy (CP).

METHODSAfter signing the informed consent, 43 children with CP, aged 52.4 +/- 13.2 months (35 to 82 months), were randomly assigned into 2 groups, (1) BTX-A group (n = 23) treated with BTX-A injection guided by electric stimulation and (2) physiotherapy alone group (n = 20). Children in BTX-A group received injection of HengLi BTX-A in the ankle plantar flexors. A maximum dose of 12 units of BTX-A per kilogram body weight and maximumly 10 units of BTX-A per site were administered. Localization technique was the use of electrical stimulation guidance. Physiotherapy and ankle-foot orthosis were applied to children at 72 hours after injection in BTX-A group and at the time of being recruited into physiotherapy group. Ten days after entering into the study, the program was applied by the parents. Demographic data, including age, gender, number of the spastic lower limbs, affected side (left or right) were recorded. Clinical assessments included the range of passive movement (PROM) measured by goniometer while children maintained the knee extended, modified Ashworth scale (MAS), composite spasticity scale (CSS), D and E dimensions of the Gross Motor Function Measure (GMFM), and walking velocity (WV) was determined before treatment and at 2 weeks, 1, 2, and 3 months after treatment.

RESULTSNo statistically significant differences were found in age, gender, number of the spastic lower limbs, affected side, as well as clinical assessments (PROM, MAS, CSS, GMFM and WV) before treatment between the 2 groups (P > 0.05). All the children showed a reduction of spasticity (PROM, MAS and CSS) after 2 weeks, 1, 2, and 3 months of treatment (P < 0.05). When compared with the baseline findings, the improvement of standing and walking (GMFM), walking velocity were statistically significant after 2 weeks, 1, 2, and 3 months of treatment (P < 0.05). Furthermore, the differences of PROM, MAS and CSS between the 2 groups at 2 weeks, 1, 2, and 3 months examination were also statistically significant (after 3 months of treatment: t(PROM) = 6.48, t(MAS) = 9.74, t(CSS) = 9.59; P < 0.05). The difference in GMFM between the 2 groups was statistically significant (t(1M) = 2.20, t(2M) = 3.26, t(3M) = 4.13; P < 0.05) at 1, 2, and 3 months after treatment. The difference of WV between the 2 groups was statistically significant (t(2M) = 2.12, t(3M) = 2.57; P < 0.05) at 2 and 3 months after treatment.

CONCLUSIONBTX-A injection guided by electrical stimulation in combination with physiotherapy was more effective than physiotherapy alone in terms of reducing spasticity and improving functional performance in standing, walking, walking pattern and velocity on spasticity in ankle plantar flexors of ambulant children with CP.

Ankle Joint ; physiopathology ; Botulinum Toxins, Type A ; administration & dosage ; therapeutic use ; Cerebral Palsy ; drug therapy ; therapy ; Child ; Child, Preschool ; Electric Stimulation Therapy ; Female ; Gait ; Humans ; Male ; Muscle Spasticity ; drug therapy ; therapy

OBJECTIVETo investigate the effects of transcutaneous electrical nerve stimulation (TENS) on motor function in children with spastic cerebral palsy (CP).

METHODSAfter signing the informed consent, 78 children with CP, aged 45.6 +/- 8.5 months (36 to 58 months), were randomly divided into a TENS group (n = 40) and a control group (n = 38). All the subjects received standardized functional exercise program. In TENS group, 2 TENS devices were used and the surface electrodes were applied on the spastic musculotendinous and antagonist muscles in the affected lower extremity. TENS lasted for 20 min per session, 5 days weekly for 6 weeks. After 6 weeks, the functional exercise program was applied by the caregivers. Demographic data were recorded, including age, gender, number of the hemiplegic and diplegic CP, level of gross motor function classification system (GMFCS). Clinical assessments included the composite spasticity scale (CSS), D and E dimensions of the Gross Motor Function Measure (GMFM), and walking velocity was determined before treatment and at 6, 12 and 24 weeks after treatment.

RESULTSNo statistically significant differences were found in age, gender, number of the hemiplegic and diplegic CP, level of GMFCS, as well as clinical assessments (CSS, GMFM and walking velocity) before treatment between the 2 groups (P > 0.05). All the children showed a reduction of spasticity (CSS) after 6, 12 and 24 weeks of treatment (P < 0.05). When compared with the results obtained before treatment, the improvement of standing and walking (GMFM), walking velocity was statistically significant after 6, 12 and 24 weeks of treatment (P < 0.05). Furthermore, the differences of CSS, GMFM and walking velocity between the two groups at 6, 12 and 24 weeks examination were also statistically significant (after 24 weeks of treatment: t value was 8.96, 3.14 and 2.35, P < 0.05, respectively).

CONCLUSIONWhen compared with the control group, 6 weeks of TENS treatment on the affected lower extremity was more effective in terms of reducing spasticity and improving functional performance in standing, walking, and walking velocity in ambulant children with the spastic CP.

Cerebral Palsy ; therapy ; Child ; Electric Stimulation Therapy ; methods ; Female ; Gait Disorders, Neurologic ; therapy ; Hemiplegia ; therapy ; Humans ; Male ; Muscle Spasticity ; therapy ; Transcutaneous Electric Nerve Stimulation ; methods ; Treatment Outcome

Breast cancer has the highest incidence rate among all women's malignant tumors worldwide.Surgery,radiotherapy and chemotherapy are three major treatments,while most patients showed adverse effects or complications during or after the treatment,including lymphedema,gastrointestinal reactions and leukopenia,which cause severe impact on patients' recovery and quality of life.Moxibustion has been used and certified to alleviate adverse effects of surgery or chemoradiotherapy for breast cancer.We have summarized literatures in recent years and suggest more systematic research in the future for the underlying mechanism.

Children with autism spectrum disorder(ASD)may suffer from motor skill dysfunction,and perform as motor delay,coordination disorder,fitness decline,visual-motor integration disorder and so on,which disturb their daily life,school-based activities,and other social activities. Due to the obvious core symptoms of children with ASD,the problem of motor skills may be ignored. Children with ASD should be monitored for the motor development at their early stage and be evaluated with proper assessment tools. Children with ASD should be trained with individualized plan according to their features in order to develop motor skills and improve the core symptoms. As evidence of motor intervention for children with ASD is increasing,we should pay more attention to the motor skill dysfunction problem in children with ASD and make them benefit from the motor intervention and sport program.

OBJECTIVETo verify the clinical efficacy of acupuncture on motor dysfunction in ischemic stroke of subacute stage.

METHODSThe multi-central randomized controlled trial was adopted. One hundred and twenty-six cases of ischemic stroke of subacute stage were randomized into an acupuncture group (61 cases) and a conventional treatment group (65 cases). The basic treatment of western internal medicine and rehabilitation training were applied to the patients of the two groups. In the acupuncture group, acupuncture was supplemented at the body points located on the extensor of the upper limbs and the flexor of the lower limbs. In combination, scalp acupuncture was applied to NS5, MS6 and MS6 on the affected side. The treatment was given 5 times a week and totally 8 weeks were required. The follow-up observation lasted for 3 months. The scores in Fugl-Meyer scale and NIHSS scale and Barthel index were compared between the two groups before treatment, in 4 and 8 weeks of treatment and the 3-month follow-up observation after treatment separately.

RESULTSIn 4 and 8 weeks of treatment and the follow-up observation, Fugl-Meyer scale score was improved obviously in the patients of the two groups (all P<0. 01). In 8 weeks of treatment and the follow-up observation, Fugl-Meyer scale score in the acupuncture groupwas im proved much apparently as compared with that in the conventional treatment group [68. 0 (43. 0,86. 5) vs 52. 5 (30.3, 77.0), 77.0 (49.5, 89.0) vs 63. 0 (33.0, 84.0), both P<0. 05]. Except that NIHSS scale score was not reduced apparently in 4 weeks of treatment in the conventional treatment group (P>0.05), the results of NIHSS scale at the other time points were all decreased obviously as compared with those before treatment in the patients of the two groups (all P<0. 01). In 8 weeks of treatment and the follow-up observation, the results in the acupuncture group were reduced much apparently as compared with those in the conventional treatment group [5. 0 (3.0,8.0) vs 7. 0 (3.0,13.8), 4. 0 (1.5,7.0) vs 6.0 (2.0,11.7) ,both P<0. 05]. In 8 weeks of treatment and the follow-up observation, Barthel index was improved obviously as compared with that before treatment in the patients of the two groups (all P<0. 05). The improvement in the acupuncture group was much more significant as compared with the conventional treatment group [75. 0 (60. 0,87. 5) vs 65. O (36. 3, 87. 5), P<0. 051.

CONCLUSIONBased on the conventional treatment, Acupuncture achieves the satisfactory clinical efficacy on motor dysfunction in ischemic stroke of subacute stage.

Acupuncture Therapy ; Adult ; Aged ; Aged, 80 and over ; Female ; Humans ; Male ; Middle Aged ; Motor Activity ; Stroke ; physiopathology ; therapy ; Treatment Outcome