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 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.

Diabetic nephropathy （DN） is one of the serious and common microvascular complications of diabetes mellitus （DM） and the main cause of end-stage renal disease （ESRD）. Endoplasmic reticulum stress （ERS） is a common stress defense mechanism in eukaryotic cells. In the ERS state， cells activate the unfolded protein response （UPR） to enhance the folding of unfolded proteins and the degradation of misfolded proteins， so as to restore the normal physiological function of the endoplasmic reticulum and avoid cell damage. However， excessive or chronic persistent ERS can induce apoptosis， inflammation， oxidative stress and other pathways to eventually cause cell damage. In recent years， a large number of studies have confirmed that ERS is closely associated with the occurrence and development of DN. In the case of DN， ERS is involved in the damage or protection of podocytes， glomerular mesangial cells， renal tubular epithelial cells， and glomerular endothelial cells. The regulation of ERS has become one of the hotspots in the prevention and treatment of DN and has received extensive attention in the field of traditional Chinese medicine. This paper systematically expounds the role of ERS in the occurrence and development of DN and summarizes the ERS-targeted regulation of DN by traditional Chinese medicine， with a view to providing certain research ideas for the prevention and control of DN with traditional Chinese medicine.

Objective:To evaluate the efficacy and safety of oral anisodine hydrobromide tablets in the treatment of nonarteritic anterior ischemic optic neuropathy (NAION).Methods:A multicenter nonrandomized controlled trial was conducted.A total of 282 acute NAION patients (282 eyes) were recruited from 16 hospitals in China from July 2020 to May 2021.Patients were divided into two groups according to treatment methods, which were control group (124 cases, 124 eyes) receiving regular treatment including citicoline sodium plus Ginkgo biloba leaf liquid extract or Ginkgo biloba leaf extract tablets plus mecobalamin, and experimental group (158 cases, 158 eyes) receiving treatment in control group plus oral anisodine hydrobromide tablets 1 mg, twice daily for 2 to 3 months.Best corrected visual acuity (BCVA), visual field index (VFI), peripapillary retinal nerve fiber layer (pRNFL) and radial peripapillary capillary vessel density (RPC) were assessed at 1, 2, 3, and 6 months after enrollment using the standard decimal visual acuity chart, 750i Humphery visual field analyzer, Cirrus HD-OCT 4000/Cirrus HD-OCT 5000, RTVue-XR optical coherence tomography respectively.The primary outcomes were BCVA and VFI, and the secondary outcomes were pRNFL, RPC, and the side effects during the follow-up.The study adhered to the Declaration of Helsinki.All patients were fully informed about the treatment and purpose of this study and voluntarily signed the informed consent form.The study protocol was approved by Chinese PLA General Hospital (No.S2020-021-01). Results:In all, 242 patients (242 eyes) completed the follow-up of BCVA, and 98 patients (98 eyes) completed the VFI follow-up.In terms of visual function, BCVA and VFI improved significantly over time in the two groups, and BCVA and VFI were better in experimental group than in control group at various follow-up time points (all at P<0.05). In terms of structure, pRNFL gradually decreased in both groups with the extension of treatment, and pRNFL was significanthy thinner in experimental group than in control group at various follow-up time points (all at P<0.05). There was no significant difference in RPC between the two groups at the last follow-up ( P>0.05). There were two cases with side effects and one case was discontinued due to side effects 25 days after enrollment. Conclusions:Oral anisodine hydrobromide can improve visual acuity and visual field in NAION and accelerate the regression of optic disc edema, with good safety.