Objective To evaluate the therapeutic effect of new oral care method for the treatment of swallowing disturbance after cerebral apoplexy. Methods A total of 50 post-apoplexy patients with swallowing disturbance were evenly randomized into treatment group and control group, 25 in each group. Both groups were given routine rehabilitation training for recovering swallowing function, and the rehabilitation training covered fundamental training, swallowing training, and food in-take training. And additionally, the control group was given routine oral care, and the treatment group was given new oral care method which included the stimulation on K point, cold Yin He gargle stimulation and focal application of herbal medicine buccal droplets. Two weeks later, water swallow test results were grading for evaluation of the therapeutic effect of the two groups. Results (1) After treatment for 2 continuous weeks, the water swallow test results were classified into grades 1 and 2 in 23 cases of the treatment group and in 17 of the control group, indicating that the treatment group had better effect on improving swallowing function ( P<0.01). ( 2) The total effective rate was 92.0% in the treatment group, higher than 68.0% in the control group ( P<0.01). Conclusion New oral care method has better effect on relieving swallowing disturbance than routine oral care for the treatment of swallowing disturbance after cerebral apoplexy.

Objective:To study the clinical characteristics of purulent meningitis complicated with hydrocephalus in neonates, and to analyze the risk factors of the disease.Methods:Neonates diagnosed with purulent meningitis complicated with hydrocephalus who hospitalized in the department of neonatology of the Second Affiliated Hospital of Wenzhou Medical University from January 2002 to August 2021 were selected as the case group. Neonates with positive pathogen cultures but no hydrocephalus during the same period were assigned by random number table method as the control group. The ratio of the control group and the case group was 2 ∶1. The clinical data such as bacteria distribution, cranial imaging, therapy and prognosis were compared between the two groups. The risk factors for hydrocephalus were predicted. Statistical analysis was conducted using chi-square test and multiple logistic regression analysis.Results:There were 33 cases in the case group and 66 cases in the control group. A total of 27 cases had confirmed pathogen results, of which 20 cases (74.1%) were Gram-negative bacteria and seven cases (25.9%) were Gram-positive bacteria. The time of diagnosis for hydrocephalus were 13.0(5.5, 28.5) days after the onset. Twenty-six cases received non-surgical treatment, while seven cases received surgery. The cure rate of case group was 42.4%(14/33), which was lower than that of control group (72.7%, 48/66), and the difference was statistically significant ( χ2=8.63, P=0.003). Univariate analysis showed that the incidences of protein>3 g/L in cerebrospinal fluid, glucose<2 mmol/L in cerebrospinal fluid, convulsions, central respiratory failure, intracranial hemorrhage and encephalomalacia in the case group were all higher than those in the control group, with statistical significance ( χ2=19.72, 12.04, 19.04, 5.73, 11.85 and 17.48, respectively, all P<0.050). Multivariate logistic regression analysis showed that convulsions (odds ratio ( OR)=4.476, 95% confidence interval ( CI) 1.091 to 18.363, P=0.037), intracranial hemorrhage ( OR=8.031, 95% CI 1.894 to 34.059, P=0.005) and encephalomalacia ( OR=35.189, 95% CI 2.954 to 419.150, P=0.005) were risk factors for neonatal purulent meningitis complicated with hydrocephalus. Conclusions:Gram-negative bacteria are common pathogen of neonatal purulent meningitis complicated with hydrocephalus. Convulsions, intracranial hemorrhage and encephalomalacia are important predictors for neonatal purulent meningitis complicated with hydrocephalus.

Objective:To observe the effect of a family-centered task-oriented training (TOT) program on the functional independence and life quality of children with spastic cerebral palsy.Methods:A total of 62 children with spastic cerebral palsy were randomly divided into a control group ( n=31) and a TOT group ( n=31). The children in the control group were given family rehabilitation training according to the discharge instruction manual, while the children in the TOT group received family-centered TOT. Both groups trained for 1 hour once a day, 5 days a week for 6 months. The mobility, functional independence and life quality of the two groups were evaluated with the pediatric evaluation of disability inventory (PEDI), functional independence measures for Chinese children (WeeFIM) and a pediatric quality of life inventory (PedsQL) before and after 3 and 6 months of treatment. Results:After 6 months there was significant improvement in the average mobility, WeeFIM and PedsQL scores of both groups. The average mobility, WeeFIM and PedsQL scores of the TOT group were then significantly better than those of the control group.Conclusion:Family-centered TOT training can significantly improve the functional independence and life quality of children with spastic cerebral palsy.

OBJECTIVES: This study examined the associations between adverse childhood experiences (ACEs) and diabetes within a social-ecological framework, incorporating personal and environmental unfavorable conditions during childhood from family, school, and community contexts. METHODS: Data were obtained from the China Health and Retirement Longitudinal Study (2014 life history survey and 2015 survey), including 9,179 participants aged ≥45 years. ACEs were collected through self-report questionnaires, and participants were categorized based on the number of distinct ACEs experienced (0, 1, 2, 3, or ≥4 ACEs). Diabetes was defined by biomarkers, self-reported diagnosis, and treatment status. Logistic regression was conducted to explore the associations between ACEs and diabetes. Subgroup analyses were conducted by gender, age, and obesity status. RESULTS: Compared with participants without ACEs, those exposed to any ACE (odds ratio [OR], 1.19; 95% confidence interval [CI], 1.01 to 1.40), 3 ACEs (OR, 1.32; 95% CI, 1.07 to 1.62) and ≥4 ACEs (OR, 1.29; 95% CI, 1.07 to 1.56) had an increased risk of diabetes. For each additional ACE, the risk of diabetes increased by about 5%. Regarding the source of ACEs, those originating from the family (OR, 1.23; 95% CI, 1.08 to 1.41) were associated with diabetes. In terms of specific ACE types, family members with substance abuse (OR, 1.23; 95% CI, 1.01 to 1.52), emotional abuse (OR, 1.28; 95% CI, 1.12 to 1.46), and poor parental relationship (OR, 1.25; 95% CI, 1.09 to 1.43) were associated with diabetes. CONCLUSIONS ACEs, particularly those originating from the family, were associated with diabetes. Interventions aimed at preventing and mitigating ACEs are essential for the early prevention of diabetes.