Rehabilitation medicine is one of the most important specialties in community health institutions. This article introduces the 12 year′s development of rehabilitation medicine in Fenglin Community Health Service Center, focusing on the talent allocation, service capabilities, resource expansion, basic facilities, personnel recruiting, department operating, service scope, and its achievements and influence, to provide reference for planning and construction of featured specialty in community health service centers.

Objective To observe the effect of speech therapy in group on children with autism spectrum disorders(ASD). Methods From July,2014 to July,2015,60 children with ASD were randomly divided into control group(n=30)and ex-perimental group(n=30).Both groups accepted regular rehabilitation training,while the experimental group ac-cepted speech therapy in group in addition,for six months.They were assessed with Autism Behavior Checklist (ABC)and Autism Treatment Evaluation Checklist(ATEC)before and after training,. Results The scores of ABC in both groups decreased after training(t>3.079,P<0.01),and decreased more in the experi-mental group(t=3.149,P<0.01).The score of Health/Physical/Behavior and total score of ATEC decreased in the control group(t>3.018,P<0.01),while the scores of all the items of ATEC decreased in the experimental group (t>2.498,P<0.05)after treatment.The scores of all the items of ATEC decreased more in the experimental group than in the control group(t>2.027,P<0.05). Conclusion The addition of speech therapy in group can further improve the behavior in children with ASD.

Objective: To investigate the current status of screen time in preschoolers during the outbreak of Corona Virus Disease 2019 (COVID-19), and the influences of parent-child active play and school online education on screen time. Methods: A total of 2 370 preschoolers were chosen through clustering sampling from 7 kindergartens in Wuxi urban areas. Questionnaire survey was administered to parents for child screen time, active play, online education as well as characteristics information. Results: A total of 1 428(60.3%) preschoolers reported more than 1 hour screen time a day, and 1 915(80.8%) preschoolers reported more than 20 minutes consecutive screen time. Compared with the weekend before the COVID-19 outbreak, 1 551(65.4%) preschoolers reported an increase of 10 minutes in screen time perday, and 1 444(60.9%) reported an increase of 5 minutes for one sersion. Logistic regression analysis showed that after controlling for confounding factors, high frequency of parent-child active play, parents’ exercise habits, online education from kindergartens and children’s active participation in the online education were negatively associated with preschoolers’ excessive and increased screen time during this period(OR=0.39-0.79, P<0.05). Conclusion During the COVID-19 outbreak, preschoolers’ media use in Wuxi city is worrisome. Parent-child active play, parents’ exercise and online education from kindergartens may play a positive role in reducing preschoolers’ media use.

Community health institutions have entered a new development stage of featured specialty construction. After 12 years of development, rehabilitation medicine now is the featured specialty of Fenglin Community Health Service Center. This article presents the train of thought and key points of specialty construction in primary care institutions based on the Fenglin′s experience. The positioning of featured specialty should be based on the community. The construction process should include 7 elements, namely, the standard operation procedure(SOP)of service system construction, the detailed publicity and implementation of the collaboration of specialists, prevention and control knowledge promotion for general practitioners, prevention and control knowledge education for community residents, service list, clinical efficacy evaluation, and clinical database. In the later iterations, the head of the department should always focus on the service system construction SOP and clinical database construction, and the rest parts can be assigned to the relevant team members.

Objective:To study disease spectrum and genetic profiles of inborn errors of metabolism (IEM) among newborns in selected areas of Nanning city.Methods:From July 2019 to December 2021, neonates born and received IEM screening in our hospital were prospectively enrolled. Heel blood samples were tested using tandem mass spectrometry as IEM screening. Neonates with positive results were called back for recheck. Whole exome sequencing was used to detect possible pathogenic genes in suspected cases and IEM was diagnosed combining clinical manifestations. Sanger sequencing method was used for the diagnosed neonates and their parents to confirm the diagnoses.Results:A total of 16 207 live-birth neonates were enrolled. For initial IEM screening, 1 423 neonates were positive (8.8%) and 1 311 were called back (92.1%). 15 cases were suspected with IEM and 8 were diagnosed. The overall detection rate was 1∶2 026. Among 8 confirmed cases, 4 cases had amino acid metabolism disorders (2 cases of phenylketonuria, 1 case of Citrin deficiency and 1 case of tyrosinemia), 2 cases had organic acid metabolism disorders (1 case of methylmalonic acidemia and 1 case of glutaric acidemia) and 2 cases had fatty acid oxidation disorders (1 case of carnitine palmitotransferaseⅡdeficiency and 1 case of primary carnitine deficiency). 5 cases had homozygous genetic variants (2 in PAH, and 1 in SLC25A13, SLC22A5 and FAH, respectively) and 3 had heterozygous genetic variants (1 in CPT2, MUT, and GCDH, respectively). During follow-up, all 8 cases had normal growth and developmental outcomes after standardized treatment.Conclusions:The overall detection rate of IEM is high, with varied genetic profiles in selected areas of Nanning. Timely genetic testing may lead to early diagnosis and treatment and improve the quality of life of neonates.

Objective To analyze the data of specialist counseling on tuberculosis, investigate the patients' demands,and to provide references for supplementing the content of specialized health education and making personalized health education plans. Methods Data of 2877 original telephone consultations and outpatient consultations were retrospectively collected and analyzed. Results The majority of client population were adults aged from 18 to 60 years old, from other provinces or cities, lowly educated (junior high school),married, newly diagnosed workers infected with pulmonary tuberculosis. 31.62% of the reasons of consultation were concern of the transmission of tuberculosis among patients and their families. Their knowledge about tuberculosis mainly came from the network, accounting for 54.01%. The contents of consultation included types of knowledge, information, service and psychological, with the rates of 67.43%, 13. 1%, 13.45% and 6.01%, respectively. 46.76% of the psychological problems were fears of tuberculosis. 98.75% of patients'problems were resolved in time by counseling. Conclusions Based on the analysis of the data, specialist counseling services should be carried out as it has great significance for improving health education and extensive services of tuberculosis patients.

OBJECTIVETo evaluate the safety and efficacy of sublingual immunotherapy with 'Dermatophagoides Farinae Drops' in D. farinae allergic asthma and/or rhinitis patients.

METHODSA 25-week double-blind, placebo-controlled, multi-centered trail was conducted in 278 children (aged 4 - 18 yr) with mite-induced asthma and/or rhinitis. Patients were randomly assigned to receive sublingual immunotherapy (SLIT) with 'Dermatophagoides Farinae Drops' (n = 139) or placebo (n = 139) for 25 weeks and the dosage and administration strictly followed the manufacturer's instructions. At the beginning of the 2nd, 3rd, 4th, 6th, 10th, 14th, 18th, 22nd week of the treatment, the patients were asked to accept follow-up visit, during the clinical trial all patients and parents were asked to keep a daily record of their asthma symptom scores, rescue medicine use, rhinitis symptom scores, morning and evening peak expiratory flow. Asthma symptom scores, reduction in use of rescue medicine, rhinitis symptom scores, lung function tests, skin sensitivity to mite, mite-specific immunoglobulin (Ig) E and IgG4, and quality of life and adverse effect were assessed during the study.

RESULT(1) Of the 278 children, 27 dropped out before the study completion. (2) After 25 weeks of treatment, the median variability of PEFR was -1.38 for SLIT group and -0.90 for the placebo (P < 0.05). (3) Besides, the mean variability of medicine score of asthma was -0.08 for SLIT group and 0.52 for the plcebo (P < 0.05). (4) The median variability of rhinitis symptom score was -1.96 for SLIT group and -1.03 for the placebo (P < 0.01). (5) The rescue medicine usage of SLIT reduced but did not show significant differences between SLIT and placebo. (6) After 25 weeks treatment, the increase of D. farinae specific IgE antibody of two groups were similar, while specific IgG4 increased significantly in SLIT compared to the patients in control one (P < 0.01); (7) No severe adverse events happened in the trial and the most-likely adverse events were mild asthma and local rash.

CONCLUSIONDermatophagoides Farinae Drops is safe and effective in treating allergic asthma and atopic rhinitis.

Adolescent ; Animals ; Asthma ; therapy ; Child ; Child, Preschool ; Dermatophagoides farinae ; chemistry ; metabolism ; Double-Blind Method ; Female ; Humans ; Infant ; Infant, Newborn ; Male ; Mites ; chemistry ; Rhinitis ; therapy

OBJECTIVETo compare the efficacy differences among acupotomy, electroacupuncture and acupuncture for treatment of simple obesity.

METHODSOne hundred and five cases were randomly divided into an acupotomy group, an electroacupuncture group and an acupuncture group, 35 cases in each group, and Zhongwan (CV 12), Tianshu (ST 25), Shangjuxu (ST 37), Sanyinjiao (SP 6), etc, were selected in three groups and also with selection of acupoints according to symptoms. The acupotomy group was treated with acupotomy 40 mm in length and 0.6 mm in diameter, the electroacupuncture group with the Han's LH402A electroacupuncture stimulator and the acupuncture group with simple acupuncture treatment. The clinical therapeutic effects of three groups were compared. The obesity signs such as body weight, body mass index (BMI), obesity degree, etc., and blood lipid and fasting blood sugar (FBS) were observed.

RESULTSThe markedly effective rate of 91.4% (32/35) in the acupotomy group was higher than that of 71.5% (25/35) in the electroacupuncture group and that of 42.9% (15/35) in the hand acupuncture group (both P<0.05). There were significant differences in the obesity signs and blood fat and FBS of the three groups before and after treatment (P<0.05, P<0.01). The differences rates of body weight, BMI, obesity degree, chest circumference, waistline, thighline, waist-hip ratio, total cholesterol before and after treatment in the acupotomy group were all better than those in the electroacupuncture group and in the acupuncture group (all P<0.05), and the differences rates of hipline, FBS in the acupotomy group were better than those in the acupuncture group (both P<0.001).

CONCLUSIONAcupotomy treatment can obviously reduce fat, FBS and blood lipid and has obvious therapeutic effects on simple obesity.

Acupuncture Points ; Acupuncture Therapy ; Adult ; Body Mass Index ; Body Weight ; Electroacupuncture ; Female ; Humans ; Lipids ; blood ; Male ; Middle Aged ; Obesity ; metabolism ; therapy ; Young Adult

Objective To investigate the effects of different dialysates on expression of protein kinase C-? (PKC?) and apoptosis of U937 cell line. Methods Different dialysates were added into culture fluid with U937 cell line at exponential phase of growth, and groups were divided: fluid A+fluid B group (dialysate A+dialysate B), fluid A+fluid B+rottlerin (PKC? specific inhibitor)group, fluid A+powder B group (dialysate A+powder B) and fluid A+powder B + rottlerin group. Besides, blank control group and normal control group were established. Cells were harvested 24 h and 48 h after treatment, morphological changes were observed by Hoechst33258 fluorescence staining, cell apoptosis was measured by Annexin-V-FITC/PI double staining, and expression of PKC? mRNA and protein was detected by RT-PCR and Western blotting, respectively. Results Cell apoptosis significantly increased in fluid A+powder B group, with typical morphology of apoptosis. After treatment for 24 h and 48 h, cell apoptosis rates in fluid A+powder B group were significantly higher than those at corresponding time points in blank control group, normal control group and fluid A+powder B+rottlerin group (P0.05). Conclusion Fluid A+powder B can significantly increase apoptosis of U937 cell line, the mechanism of which may be associated with the up-regulation of expression of PKC?. Compared with fluid A+powder B, fluid A+fluid B is superior in reducing apoptosis of peripheral blood monouclear cells.

Objective To report the surgical nursing strategy of a patient undergoing resection of a rare giant neurofibroma.Methods Through the preoperative comprehensive assessment of patients,multidisciplinary joint consultation and proposed possible surgical risks and countermeasures,specialist to formulate surgical plans,surgical care and nursing key points,difficulties and countermeasures.Results The psychological nursing,detailed and perfect the preoperative preparation work,the personnel allocation was sufficient,the division of labor was clear,the disease changes were actively observed in the operation,the venous pathway was strictly managed,the accurate record,the risk that might occur in the active prevention operation and the treatment plan,the postoperative closely monitors the condition.Good observation and nursing in the operation area to prevent infection.Conclusions In view of difficult and complicated operation,through the comprehensive formulation of surgical nursing measures and strict execution in surgery,it is the guarantee for the smooth completion of the operation,the operation process is smooth,the successful implementation of tumor resection,the effect is satisfactory,the patient is returned to the ward,and there is no special discomfort.