Objective To observe the effect of traditional Chinese medicine vapor bath combined with function training on children with spastic cerebral palsy(CP).Methods 84 cases with spastic CP were divided into the treatment group(39 cases treated by traditional Chinese medicine vapor bath combined with function training treatment)and control group(43 cases treated with function training treatment mainly).Results The total effect rates were 84.6% in the treatment group and 65.1% in the control group with a significant difference between two groups(P<0.05).The muscle tension of the children in the treatment group was lower than that in the control group(P<0.05).Conclusion The traditional Chinese medicine vapor bath can reduce the muscle tension of children with spastic CP.

OBJECTIVE:To provide reference for suitable selection of antibacterial ophthalmic preparation in the clinic. METHODS:The application of antibacterial ophthalmic preparation in a hospital during Jan. 2013-Dec. 2016 were summarized and analyzed to calculate DDDs. The results of bacterial culture and identification,drug sensitivity test were collected. The correlation of DDDs of antibacterial ophthalmic preparation with resistance rates of bacteria was analyzed by using Pearson test. RESULTS:During 2013-2016,there were 7 categories of antibacterial ophthalmic preparations used in this hospital,involving 10 types. To-tal DDDs showed an upward trend with average annual growth rate of 26.16％. DDDs of Tobramycin (dexamethasone) eye drops were the highest for consecutive 3 years (2013-2015). Gatifloxacin eye drops/eye gel and Ofloxacin eye drops/eye oint-ment ranged 2nd-4th place in the list of DDDs. A total of 26143 ocular specimens were examined,and 21 kinds of bacteria were detected,involving 6221 strains with detection rate of 23.80％. Top 3 bacteria in the list of detection rate were Staphylo-coccus epidermidis (3067 strains),Streptococcus pneumoniae (470 strains) and Staphylococcus aureus (321 strains). Resistance rates of above 3 kinds of bacteria to erythromycin were all higher than 70％,while they were sensitive to rifampicin,chlorampheni-col,gentamicin and levofloxacin,etc. Compared to previous year,the average resistance rates of rifampicin(in 2015),gentamicin (in 2015,2016),tetracycline(in 2015),ofloxacin(in 2014,2015),levofloxacin(in 2016)and gatifloxacin(in 2016)had statisti-cally significant differences(P<0.05). DDDs of tetracycline was positively associated with its average resistance rate(r=1.000,P<0.05),and DDDs of other antibacterials had nothing to do with resistance rate(P>0.05). CONCLUSIONS:The main ocular infec-tions were S. epidermidis,S. pneumoniae and S. aureus. DDDs of tetracycline is certainly associated with resistant rates. Regulating clinical use of antibacterial ophthalmic preparation is important for delaying the development of bacterial resistance.

ObjectiveTo evaluate the effect of electromyography biofeedback on motor function in children with spastic hemiplegia. Methods40 children with spastic hemiplegia were divided into control group (n=20) and treatment group (n=20). Both groups received comprehensive rehabilitation treatment. The treatment group received electromyography biofeedback in addition. They were assessed with Gross Motor Functional Measure (GMFM-88) in D and E items before and after treatment. ResultsThe scores of GMFM-88 in both D and E items were significantly different (P<0.01) before and after treatment in both groups, and significantly different between the treatment group and control group (P<0.05) after treatment. ConclusionElectromyography biofeedback can improve the motor capacity in children with spastic hemiplegia.

Objective To review retrospectively the experience of surgical treatment of Ebstein anomaly in 45 adult patients.Methods Between January 2008 and December 2011,45 adult patients underwent surgery for Ebstein anomaly.There were 14 male and 31 female patients aged 18 to 61 years (mean,39 years).The main symptoms included chest tightness,shortness of breath,palpitation.25 patients had cyanosis,while 6 patients with Wolff-Parkinson-White syndrome.Preoperative echocardiography: The septal downward from 2.5 cm to 7.5 cm,average 4.2 cm; the posterior leaflet downward 3.0 cm to 8.0cm,average 5.1 cm.Tricuspid incompetence was moderate in 6 patients and severe in 29.According to Carpentier classification,5 cases of type A,30 type B,type C in 6 cases.Preoperative New York Heart Association(NYHA) functional class Ⅱin 14 cases,Ⅲ 30 cases,Ⅳ in 1 cases.Surgical procedures included modified Danielson's in 15 patients,modified Carpentier's in 23,and 7 patients underwent tricuspid valve replacement(incloud 4 secondary operations).The ratio of tricuspid valve repair was 84.4％.Autologous pericardium patch was used to reconstruct the septal and posterior leaflets in 5 cases.Intraoperative use of annuloplasty rings in 21 cases.Results There were 2 hospital deaths with a postoperative mortality of 4.4％.The main causes of death were low cardiac output and right heart failure.Operation to discharge time was (8.0 ± 3.8)days.The follow up time was 2 to 46 months.Echocardiography examination: Within the 32 patients of severe tricuspid regurgitation before tricuspid valve plasty,16 patients’ tricuspid regurgitation disappeared,13 patients with mild regurgitation,3 moderate regurgitation.Within 5 patients of moderate tricuspid regurgitation before tricuspid valve plasty,4 cases tricuspid regurgitation disappeared after operation,1 case tricuspid valve mild regurgitation.Tricuspid valve leaflets were at normal levels,the atrialized portion of the ventricular disappeared.The heart function improved to be NYHA class Ⅰ to Ⅱ in 95 ％ of the survived patients.Conclusion Operative method of Ebstein anomaly sould be selected according to the type of pathoanatomies.Tricuspid valve repair should be performed to the best of our ability.

ObjectiveTo observe the effect of bubble bath coordinating with functional training on the children with spastic cerebral palsy.Methods210 children with spastic cerebral palsy were randomly divided into the treatment group (n=118) and control group (n=92). All children were treated with functional training, acupuncture and other physical therapies. Children in the treatment group were added with bubble bath one time every day, twenty days as one course. Muscular tension was evaluated with modified Ashworth Scale and range of motion was measured before and after treatment.ResultsIn the treatment group, 55 cases were significant, 53 cases were effective, 10 cases were invalid, the total effective rate was 91.5%; in the control group, 26 cases were significant, 46 cases were effective, 20 cases were invalid, the total effective was 78.2%. There was a significant difference between the total effective rates of two groups (P<0.05).ConclusionBubble bath can significantly decrease the muscular tension of children with spastic cerebral palsy.

Shwachman-Diamond syndrome is a multisystem autosomal recessive disorder characterized by pancreatic and bone marrow abnormalities with frequent liver involvement.Patients with SDS display aminotransaminase elevation and hepatomegaly in their early childhood. For most of the patients, the syptoms tend to improve as they grow. However, a number of the children with progress into cirrhosis even liver failure, and the prognosis is poor.This paper summarizes advances in the epidemiology, pathogenesis, clinical manifestations, and diagnosis and treatment of hepatopathy in Shwachman-Diamond syndrome.

Objective:To investigate the clinical phenotype and genotype of transient infantile hypertriglyceridemia (HTGTI).Methods:The clinical data of two HTGTI children, diagnosed at Children′s Hospital of Fudan University from July 2019 to January 2020, were collected and analyzed retrospectively. The literature up to 25th January 2020 were searched in PubMed, CNKI and Wanfang databases with the key words of "hypertriglyceridemia" and "glycerol phosphate dehydrogenase-1 (GPD1)".Results:Two children, including a 5-month-old female and a 13-month-old male, who presented with hepatomegaly, hypertriglyceridemia, transaminase elevation and hepatic steatosis, were admitted to the hospital. Gene detection found compound heterozygous variation of GPD1. After a low-fat diet with enriched medium-chain fatty acids, their plasma triglyceride level were significantly decreased, and finally normalized in case 2. Literature review found 17 patients with GPD1 gene variation reported in 5 papers, including 16 HTGTI cases and one case of different phenotype. Most of the cases presented with hepatomegaly, hypertriglyceridemia and transaminase elevation, while some had developmental retardation, splenomegaly, hypoglycemia, obesity and insulin resistance. The c.361-1G>C was the most common variation of GPD1.Conclusions:HTGTI caused by GPD1 deficiency is mainly manifested with hepatomegaly, hypertriglyceridemia, transaminase elevation as well as hepatic steatosis and fibrosis. The most common variation of GPD1 is c.361-1G>C.

Objective:To explore the characteristics of high-impact health science popularization short videos in public hospitals and the improvement path, and provide reference for improving the level of health science popularization in public hospitals.Methods:Based on the list of " Ranking of China′s Hospitals in the Video Impact Ranking List of Provinces (2022.07)" released by the official account of the " Medical Policy Think Tank", selected the WeChat video channel of the tertiary grade A public hospitals in the east, middle and west regions of China, and then selected the health science popularization short video with the highest number of likes published as of September 22, 2023 from the WeChat video channel of each hospital as the research object. Using the communication index as the result variable and the title length, video duration, expert appearance, net-sense language, content type, and hot topic selection as conditional variables, a fuzzy-set qualitative comparative analysis was applied to explore the relationship between multiple conditional variables and their combinations and high-impact for health science popularization short videos.Results:A total of 90 short health science popularization videos were included, with 30 each from the East, Central, and West regions of China. The consistency of individual condition variables was<0.9, which was not a necessary condition for health science popularization short videos to obtain high-impact. Five configuration paths to increase the impact of health science popularization short videos were summarized, in which Path 1 attracted users through features such as expert appearances, hot topics, short titles, and avoiding the use of net-sense language; Path 2 attracted users by superimposing expert appearances and hot topics, and by adopting compact titles, short duration, and informative content types; Path 3 attracted users through long duration with expert appearances and informative content types, as well as detailed titles; Path 3 attracted users through long duration with expert appearances, informative content types, and detailed titles; Path 4 attracted users with detailed titles, expert appearances, and net-sense language, as well as short durations and exemplary content types; and Path 5 attracted users with long durations, expert appearances, and topical selections, and avoided net-sense language and employed informative content types. The consistency of the solution was 0.875 and the coverage of the solution was 0.555.Conclusions:The impact of health science popularization short videos can be enhanced through different configuration paths. Public hospitals can use this as a reference, fully utilize their own resources, and adopt appropriate paths to produce health science popularization short videos according to different situational requirements, in order to improve the dissemination effect of health science popularization.

Objective:To evaluate the association between the use of emergency medical services (EMS) and the severity of disease among patients admitted to the emergency room, to analyze the characteristics of the patients, and to build prediction model providing evidence-based use of EMS resources.Methods:The data of patients admitted to the Emergency Room of the First Affiliated Hospital of University of Science and Technology of China from January 2020 to July 2021 were extracted from the Chinese Emergency Triage Assessment and Treatment (CETAT) database. Patients were divided into the EMS use group (AB+ group) and self-seeing group (AB-group) according to whether they used EMS. The patients’ general condition, vital signs and laboratory tests results were recorded. The severity of patients’ condition was judged based on whether the patient was admitted to the department of critical medicine, specialized care unit, emergency operation and/or emergency percutaneous intervention. A 9-variable model that did not require laboratory inspection and 22-variable model that required laboratory inspection were established to correct the propensity score to analyze the correlation between the severity of disease and the EMS use. In the subgroup analysis, the correlation between the EMS use and severity of the patients was analyzed according to the reason of the patient’s visit.Results:During the study period, 16 489 patients were admitted to the emergency room, and 6975 patients were finally enrolled in this study. There were 2768 patients (39.7%) in the AB+ group and 4207 patients (60.3%) in the AB-group. In the AB+ group 522 patients (18.9%) were in high risk, and in the AB-group 563 patients (13.4%) were in high risk. Compared with the AB-group, patients in the AB+ group were older and had a higher proportion of coma, a faster autonomic heart rate, and a lower diastolic blood pressure and peripheral oxygen saturation (SpO 2). In the 9-variable model, sex, consciousness, temperature, heart rate and diastolic blood pressure were associated with the EMS use. In the 22-variable model, consciousness, SpO 2, neutrophils, and albumin were the relevant factors for patients using EMS. Before the correction of propensity score, the EMS use was an independent risk factor for critically ill patients ( OR=1.5, 95% CI 1.32-1.72, P<0.001). After adjusted using 9-variable propensity score, the EMS use ratio decreased significantly compared with that without correction ( OR=1.24,95% CI 1.08-1.42, P<0.001). Interestingly, after adjusted with propensity score match with 22-variable model, there was no association between the severity of disease and t the EMS use ( OR=1.10,95% CI 0.95-1.28, P=0.195). In subgroup analysis, patients’ chief complaint of central nervous system, cardiovascular system, and trauma were the top three reasons at admission. Before the propensity score correction, the EMS calling patients with chief complaint of central nervous system, digestive system, and trauma were related to the severity of the patients. After adjusted with 9-variable model the EMS use was associated with the severity of the disease only in trauma patients, and after adjusted with 22-variable model there was no statistical difference considering the severity of the disease in all subgroups. Conclusions:The EMS use is common. However, the association of the EMS use with the severity of disease is decreased with variable models using propensity score. These findings indicate that the EMS use should be based on multivariable models, which may be important in detecting critically ill patients, optimizing the EMS use, and avoiding unnecessary call in the future.