Objective: To clarify the meaning and definition method of low-income group, summarize the current economic risk of disease for rural low-income group and the risk pooling effect of medical insurance system. Methods: Using literature research method to systematically review the relevant studies of economic risk of disease for low-income group in rural areas. Results: The risk pooling effects of various medical insurance systems are different. Conclusion: On the basis of defining low-income group scientifically, it is necessary to promote the economic risk protection effect of medical security schemes for low-income group in rural area.

目的探讨对脑瘫患儿家长进行康复训练指导的重要性和必要性。方法采取以集体授课为主、单个指导为辅的方式对患儿家长进行康复训练指导,并鼓励其阅读有关脑瘫康复的书籍。结果大多数患儿家长掌握了简单的家庭训练方法,如仰卧位抬头、翻身训练、坐位训练、四爬位姿势等。结论让患儿家长了解脑瘫的病因、症状及家庭康复训练的重要性,配合治疗师的治疗,可缩短疗程,提高疗效,并在一定程度上减少治疗费用。

OBJECTIVE:To establish a method for the determination of related substances in Pantoprazole sodium for injec-tions. METHODS:HPLC method was adopted. The determination was performed on Kromasil Hypersil ODS column with mobile phases consisting of 0.01 mol/L potassium dihydrogen phosphate buffer solution(pH adjusted to 7.0)-acetonitrile(gradient elution) at a flow rate of 1.0 mL/min. The detection wavelength was set at 290 nm,and the column temperature was 40 ℃,and injection volume was 20 μL. RESULTS:The linear ranges of impurity A,impurity B,impurity C+E,and impurity D were 0.4168-1.0420μg/mL(r=0.9998),0.1950-0.4875 μg/mL(r=0.9999),0.3890-0.9725 μg/mL(r=0.9998),0.1986-0.4965 μg/mL(r=0.9998), respectively. The limits of quantitation were 0.834,0.780,1.556,0.794 ng/mL;the limits of detection were 0.417,0.390,0.778, 0.397 ng/mL,respectively. RSD of precision test was lower than 1.0%;in repetitive test,RSD for total peak area of impurity was lower than 1.0% ;the recoveries were 98.81% -102.49%(RSD=1.18% ,n=9),95.31% -98.44%(RSD=0.91% ,n=9), 96.88%-98.44%(RSD=0.52%,n=9)and 97.87%-101.28%(RSD=1.05%,n=9). CONCLUSIONS:The method is convenient, accurate and suitable for the determination of related substance in Pantoprazole sodium for injection.

Objective To observe the effects of stationary cycle training on lower limb muscle tension and motor function in children with spastic cerebral palsy.Methods Sixty-seven children with spastic cerebral palsy were divided into a treatment group (n =34) and a control group (n =33).Both were treated with routine rehabilitation therapy,including neurodevelopment treatment,massage and physical agent therapy.The treatment group additionally cycled on a stationary bicycle for 20 min a day,five days a week for 3 months.Muscle tension in the children's adductor,hamstring and gastrocnemius muscles was evaluated using the modified Ashworth scale (MAS),while the adductor angle,popliteal fossa angle and foot dorsiflexion angle were measured using a joint protractor.Moreover,the 88-item version of the Gross Motor Function Measure (GMFM-88) was used to evaluate gross motor function.Results After treatment the average muscle tension of both groups was significantly lower than before treatment.The average muscle tension scores of the adductors,hamstrings and calf muscles of the treatment group [(1.79±0.54),(1.00±0.60),(2.29 ±1.77)] were significantly lower than those of the controls [(1.82 ± 0.53),(1.15 ± 0.44),(2.52 ± 1.89)].The adductor angles,popliteal fossa angles and foot dorsiflexion angles of both groups were significantly larger than before treatment,and the angles in the treatment group [(97.06 ± 19.03) °,(53.38 ± 12.54) ° and (8.38 ± 9.11) ° respectively] were significantly larger on average than those in the control [(98.94 ± 21.42) °,(56.52 ± 12.90) ° and (5.30 ± 14.30) ° respectively].After treatment the total GMFM scores of both groups were better than before treatment,but the treatment group's average score(138.18 ± 54.86) was significantly better than that of the control group(112.21 ± 62.44).Conclusion Three months of stationary cycle training can effectively reduce the muscle tension of children with spastic cerebral palsy and improve their motor function.

Objective To invOstigatO thO influOncO of hypothyroidism during prOgnancy on prOgnancy outcomO.Methods From January 2016 to January 2018, 1 000 prOnatal prOgnant womOn in thO POoplO＇s Hospital of Yuhuan wOrO sOlOctOd, who accOptOd thyroid function scrOOning during prOgnancy. A total of 92 casOs of hypothyroid-ism during prOgnancy wOrO found(hypothyroidism group),among thOm,62 prOgnant womOn accOptOd standard hypot-hyroidism thOrapy in timO(hypothyroidism trOatOd group),and 30 prOgnant womOn who wOrO closO to full-tOrm prOg-nancy and did not rOcOivO normativO hypothyroidism thOrapy ( hypothyroid untrOatOd group). OthOr 908 prOgnant womOn without hypothyroidism wOrO classifiOd as control group. ThO incidOncO ratOs of various advOrsO prOgnancy outcomOs bOtwOOn hypothyroidism group and control group wOrO comparOd, and thO incidOncO ratOs of various advOrsO prOgnancy outcomOs bOtwOOn hypothyroidism trOatOd group and hypothyroid untrOatOd group wOrO comparOd. Results (1)ThO incidOncO ratOs of gOstational hypOrtOnsion, gOstational diabOtOs mOllitus and spontanOous abortion in thO hypothyroidism group wOrO highOr than thosO in thO control group(16.30% vs. 2.75% , 14.13% vs. 3.08% , 13.04% vs. 2.97% ) (χ2 =39.947, 26.497, 22.602,P=0.000, 0.000, 0.000).(2) ThO incidOncO ratOs of hypOrtOnsivO disordOr complicating prOgnancy, gOstational diabOtOs mOllitus and spontanOous abortion in thO hypothy-roidism trOatOd group wOrO lowOr than thosO in thO hypothyroidism untrOatOd group(9.68% vs. 33.33% , 8.06% vs. 26.67% , 8.06% vs. 23.33% )(χ2 =5.692, 5.766, 4.156,P=0.000, 0.000, 0.000).Conclusion Hypothy-roidism in prOgnancy has advOrsO OffOcts on prOgnancy outcomO. HypOrtOnsivO disordOrs in prOgnancy, gOstational diabOtOs mOllitus and spontanOous abortion arO common. ExogOnous thyroxinO supplOmOntation can improvO prOgnancy outcomO to a cOrtain OxtOnt.

Objective To study the influence of dihydromyricetin on the oxidation and non-enzymatic glycosylation in impaired glucose tolerance rats.Methods Animal model of impaired glucose tolerance rat was built by intragastrical(i.g.) injection of D-galactose generally.After 8 weeks intragastrical(i.g.) injection of dihydromyricetin(experimental group) and metformin (positive control),the levels of fasting blood glucose and tow-hour postprandial blood glucose,the insulin level and its resistance index,the levels of glycosylated hemoglobin (GHb) and advanced glycation end-products(AGEs) were detected,and the activities of superoxide dismutase(SOD) and glutathione peroxidase (GSH-Px),the content of malondiadehyde(MDA) were determined respectively.Results Compared with model group,dihydromyricetin decreased the level of two-hour postprandial blood glucose (P0.05).Conclusion Dihydromyricetin can significantly improve the state of impaired glucose tolerance rats; the mechanism may be related to its effect of improving the antioxidant activity of GSH-Px,inhibiting non-enzymatic glycation,lowering body oxidative stress and insulin resistance and promoting the use of blood glucose in peripheral organizations.

Objective:To investigate the efficacy of Xiaoer Jinqiao granule combined with interferon α-2b on acute herpangina in children and its effect on immune function and myocardial enzyme. Methods:A total of 102 children with acute herpangina who received treatment in Hangzhou Ninth People's Hospital from January 2019 to January 2020 were randomly assigned to receive treatment with either interferon α-2b (control group, n = 51) or Xiaoer Jinqiao granule combined with interferon α-2b (observation group, n = 51) for 5 d. The time to disappearance of main symptoms, changes in humoral immune function, changes in cellular immune function and myocardial enzyme level after treatment relative to before treatment as well as curative effect were compared between the control and observation groups. Results:The time to disappearance of pharyngeal herpes [(3.05 ± 0.74) d], salivation [(2.31 ± 0.68) d], and fever [(1.36 ± 0.39) d] in the observation group were significantly shorter than those in the control group [(4.38 ± 0.98) d, (3.83 ± 1.07) d, (2.54 ± 0.71) d, t = 7.773, 8.562, 10.403, all P < 0.05]. After treatment, serum IgA [(1.49 ± 0.16) g/L], IgG [(10.29 ± 0.89) g/L] and IgM [(1.26 ± 0.14) g/L] levels in the observation group were significantly higher than those in the control group [(1.13 ± 0.12) g/L, (9.35 ± 0.72) g/L and (0.98 ± 0.13) g/L, t = 12.855, 5.864 and 10.466, all P < 0.05]. After treatment, CD 3+ [(74.29 ± 2.15)%], CD 4+ [(40.85 ± 1.65)%] and CD 4+/CD 8+ expression [(1.87 ± 0.23)] in the observation group were significantly higher than those in the control group [(67.96 ± 2.43)%, (38.02 ± 1.20)% and (1.49 ± 0.14), t = 13.933, 9.906 and 10.079, all P < 0.05]. After treatment, serum creatine kinase [(147.86 ± 15.42) U/L] and lactate dehydrogenase [(128.64 ± 14.25) U/L] in the observation group were significantly lower than those in the control group [(176.95 ± 13.15) U/L and (184.32 ± 18.98) U/L, t = 10.251, 16.754, both P < 0.05]. Total effective rate in the observation group was significantly higher than that in the control group [92.16% (47/51) vs. 74.51% (38/51), χ 2 = 5.718, P < 0.05]. Conclusion:Xiaoer Jinqiao granule combined with interferon α-2b has obvious curative effect on acute herpangina in children because it can improve the humoral and cellular immune function and reduce myocardial damage.

Objective To analyse the relationship and mechanism between chronic periodontitis (CP) and IgA nephropathy (IgAN) by establishing animal model of chronic periodontitis and IgA nephropathy in SD rats.Methods Eighty health male SD rats were divided into four groups,control group (A,n=20),IgAN group (B,n=20),CP group (C,n=20),CP accompanied with IgAN group (D,n=20).CP model was established by ligating silk suture and besmeared pathogenic bacterium in rats dental cervix.Experimental IgAN model was established by lavage of bovine serum albumin (BSA) and injection of lipopolysaccharide (LPS) and carbon tetrachloride (CCl4).Ten rats were sacrificed in every group at the end of week 8 and 12.The blood,urine,kidney tissue samples were examined.The observation index included proteinuria,kidney and liver function,renal tissue pathology and periodontal tissue pathology.The data were statistically analysed.Results Animal models were established successfully.The levels of Scr and BUN in group A,B,C were not obvious difference,but that in group D was higher than the other third groups at 8 weeks (P ＜ 0.05).The levels of Scr and BUN in group D and group B were significantly higher than that in group A,meanwhile that in group D was significantly higher than that in group B at 12 weeks(P ＜ 0.05).The levels of 24 h urine protein in B,C,D groups were higher than that in group A at 8 weeks(P ＜ 0.05),but at 12 week,that in group D was higher than that in group B and C (P ＜ 0.05).At 8 weeks,glomeruli had little mesangial broadening and renal interstitium had mild hyperplasia of fibrous tissue in group B and D,and that in the group D significantly was heavier than that in group B.The focal varying degrees were glomerular mesangial proliferation hardening,glomerular mesangial broadening,focal segmental sclerosis,and diffuse or focal inflammatory cell infiltration in D group at the end of week 12.The score of PAS between group A and group C had no statistical significance.The scores of PAS in group B and D were higher than that in group A (P ＜ 0.01),and that in group D was higher than that in group B (P ＜ 0.01).Obvious inflammation of periodontal tissue was observed in group C and D,and modified sulcus bleeding index (MBI) were higher than that in group A and B,and MBI in group D was significantly higher than that in group C (P ＜ 0.01).Conclusions The model can be used to research the change of biochemistry and pathology and observe the relationship between chronic periodontitis and IgAN.This study shows that there is relationship between chronic periodontitis and IgAN.Chronic periodontitis maybe make more serious pathology damage in kidney by inflammation mechanism.

Objective To evaluate the impairment of ulnar nerve and its relationship with sensory symptoms in the ulnar territory in patients with carpal tunnel syndrome (CTS) through electrophysiological approach.Methods We retrospectively reviewed 55 cases with CTS admitted in our hospital from January 2012 to February 2013.Patients with CTS were graded as mild-moderate (35 cases) and severe (20 cases) according to Stevens standard and were divided into symptomatic and non-symptomatic group according to the presence of sensory symptom in little finger region.Twenty healthy volunteers were included as control.Median and ulnar nerves electrophysiological study were performed using the Keypoint.net (Medoc Ltd) electromyogram device.Results Finger 5-wrist sensory conduction velocities (SCVs) of ulnar nerve were reduced ((51.71 ± 2.93) m/s vs (58.62 ± 3.21) m/s,t =8.80,P ＜ 0.01) in CTS group,compared with control group.But the sensory nerve action potential (SNAP) amplitudes had no difference.Pearson correlation analysis showed that finger 5-wrist SCVs and the SNAP amplitudes of ulnar nerve were negatively correlated with the distal motor latency of the median nerve,while positively correlated with the compound muscle action potential amplitudes,finger 1-wrist,finger 3-wrist SCVs and SNAP amplitudes of median nerve,in mild-moderate group,finger 5-wrist SCVs of ulnar nerve were slowed and the SNAP amplitudes were reduced ((51.59 ±2.70) m/s vs (53.72 ±2.58) m/s; (13.51 ± 1.84) μV vs (15.21 ±2.16) μV,t =2.24,2.30,P ＜ 0.05 respectively) in the symptomatic group,compared with the non-symptomatic group.However,in severe group,only 2 cases had sensory symptom in little finger region.Conclusions CTS patients may have impairments due to ulnar nerve entrapments at wrist,which aggravate with disease progression.Sensory symptoms in ulnar territory are more frequent during the mild-moderate stage,and may relate with ulnar nerve involvement.

Objective To observe the clinical efficacy of midazolam intravenous therapy for children with convulsive status epilepticus (CSE).Methods 133 admitted CSE children were randomly divided into treatment group (n =6 8) and control group (n =6 5).Based on symptomatic treatment,the control group was given diazepam plus phenobarbital intravenous injection,the treatment group was given midazolam injection plus intravenous infusion scheme.The clinical efficacy and adverse drug reactions were observed and compared between the two groups.Results After treatment for 3h,the total effective rate of the treatment group was 91.2％,which was significantly higher than 76.9％ of control group(x2 =5.078,P =0.024).Among children with markedly effective and effective effect,the mean onset time (49.3 ± 10.4)min and seizure control time (112.1 + 24.7)min of the treatment group were significantly lower than those of control group (73.8 + 15.4) min,(157.2 ± 38.4) min,the differences were statistically significant(u =9.619,7.191,P =0.000).15 ineffective cases of control group were transferred into midazolam intravenous therapy,the total effective rate after 3h was 73.3％ (11/15).1 case died in both two groups.In control group,the proportion of complications such as muscle tension descending,heart rate and blood pressure variation,respiratory depression,et al.was 49.2％,which was significantly higher than 30.9％ of the treatment group (x2 =4.668,P =0.31).Conclusion Compared with diazepam plus phenobarbital scheme,midazolam intravenous administration in treatment of children with CSE takes effect faster,and with higher safety.With the increasing of midazolam dosage,alert should be taken to drug influence on respiration and heart rate.