Objective To evaluate the clinical effect of ultrasound-guided botulinum toxin A (BTX-A)injection for upper limb spasticity in children with cerebral palsy.Methods Twenty children with upper limb spasticity resulting from cerebral palsy were divided equally into a BTX-A injection group and a control group. Both groups received standard rehabilitation treatment. For the injection group, color ultrasonography was used to guide the accurate injection of BTX-A into the spastic muscles of the arm. They received rehabilitation training the day after the injection. For all patients, muscle spasticity and upper limb movement and function were evaluated before treatment and 1, 2, 4, 8 and 12 weeks later using a modified Ashworth scale and the Fugl-Meyer assessment.Results After two weeks of treatment, muscle spasticity and upper limb movement and function in the injection group were significantly better than before the injection.The improvement in muscle spasticity was greatest two weeks after the injection. The average therapeutic effect in the injection group was significantly better than among the controls.Conclusion BTX-A injection under ultrasound guidance helps relieve upper limb spasticity in cerebral palsy. It has the advantages of accurate localization and safety and gives superior results compared to rehabilitation treatment alone.

Based on the thought of Zhishen (a kind of mind regulation), Professor SHI Xue-min, academician of the China Academy of Engineering, found the Xingnao Kaiqiao (to refresh the mind and to cause resuscitation) acupuncture method, which still plays an important role in the acupuncture treatment of wind stroke nowadays. Meanwhile, great importance is attached to the comprehensive treatment of wind stroke. Danqi Piantan capsule (see text) is developed and "wind stroke unit" is set up. In recent years, Professor SHI shifts the center of research to the treatment of hypertension, the risk factor of wind stroke. Taking Renying (ST 9) as the major acupoint, acupuncture with standard measurement and manipulations is established. And good clinical effect has been obtained as well. Therefore, this article focuses on the introduction of Professor SHI Xue-min's contribution to wind stroke treatment.
Acupuncture ; education ; Acupuncture Points ; Acupuncture Therapy ; China ; Humans ; Stroke ; therapy

OBJECTIVETo study the dynamic changes of capillaries and inflammatory cells in different regions of brain in rat with middle cerebral artery obstruction (MCAO), and the effects of acupuncture in different frequencies on them.

METHODSIn reference to Zea-Longa's method, rat model of MCAO was established by thread-ligation. Shuigou point (DU26), the main acupoint for "awakening brain and opening apertures", was stimulated by high (180 times/s) or low (60 times/s) frequency puncturing 5 s every 12 h for 6 times totally. The amount of capillaries (AC) and inflammatory cells (AIC) in brain cortex (BC), hippocampus (Hp) and corpus striatum (CS) was counted.

RESULTSChanges in AC and AIC of all brain regions (except for CS) in rats immediately after modeling were statistically insignificant (P > 0.05). But 72 h later, AC in CS decreased, AC in Hp, AIC in BC and AIC in Hp increased significantly in the modeled rats, showing significant difference to the normal level, but AIC reduced to approach the normal. As compared with the rats un-intervened, AIC in BC and Hp was decreased in rats intervened with high frequency puncturing, AC and AIC in CS were increased in rats intervened by slow frequency puncturing (both P < 0.05).

CONCLUSIONAmount of capillaries and inflammation cells are changed dynamically in MCAO rats after brain ischemia, showing evident brain regional specificity; the ischemic improving effects of acupuncture in different frequencies are various in their action rings, also showing brain regional specificity.

Acupuncture Therapy ; methods ; Animals ; Brain ; pathology ; physiopathology ; Infarction, Middle Cerebral Artery ; pathology ; physiopathology ; therapy ; Male ; Rats ; Rats, Wistar

Objective To make students at different levels not only learn theoretical knowledge of acupuncture-moxibustion manipulation skills but also achieve full operating training, strengthen the combination of theory and practice and improve the teaching quality of clinical disciplines by applyingmultimedia-subject participationteaching method to acupuncture-moxibustion manipulation techniques in the experimental teaching of acupuncture and moxibustion. Method The students were randomized, according to grade, into experiment (n=114) and control (n=115) groups. The teaching content was the same in the two groups. The experiment group received multimedia-subject participationteaching method. After the multimedia teaching, the students did an independent demonstration and made a self-evaluation, the teachers made a comment and the students did independent practice again in groups. The control group received conventional theory teaching and did practice under demonstration in the experimental lesson. The examination and questionnaire were used as assessment indicators to evaluate the effect ofmultimedia-subject participationteaching method applied to acupuncture-moxibustion technique teaching. Result Statistical analysis was made using the SPSS11.5 statistical software package. The independent samples t-test is used for a between-groups comparison. The statistical result showed that satisfaction was 100%in the experiment group and 75.7%in the control group;there was a statistically significant difference between the two groups (P<0.05). Conclusion Multimedia-subject participationteaching method is an innovation in acupuncture-moxibustion technique teaching and helps the students to better master acupuncture-moxibustion manipulation skills. Mastery of theoretical knowledge before real practice is the key to proficient manipulation. The combination of the two in classroom teaching yields twice the result with half the effort. Carrying out multimedia-subject participation teaching method will help to further deepen the teaching reform and to improve the level and quality of“Acupuncture and Moxibustion”teaching.

Objective To assess if evaluating with Peabody's fine motor development scale with 4 degree grading is more sensitive than with 3 degree grading, and whether or not it is feasible to evaluate by quantization with monthly averages. Methods A total of 864 normal children aged 1 month to 60 months were evaluated with the Peabody scale using 4 degree grading and 3 degree grading. The development results were averaged by month to express the development. Results Both ways, the monthly averages of children 4-9 months old were higher than the others. The values obtained with 4 degree grading were lower than those with 3 degree grading in each functional area, and the difference was more obvious with increasing age, but the differences were not statistically significant. With 3 degree grading the total score was equal to the actual score after the age of 9 months, but with 4 degree grading this was not true until at least 18 months. Conclusions Evaluating with Peabody's fine motor scale with 4 degree grading and quantization using monthly averages is reliable and more sensitive than 3 degree grading.

Objective To evaluate the precision of BREEZE~(TM) glucose monitor and correlation of glucose measurements between fingertip capillary whole blood glucose(CBG)using BREEZE~(TM) glucose monitor and venous plasma glucose(VPG)using autoanalyzer.Methods All samples of venous plasma and fingertip blood from 188 diabetes or non-diabetes patients were detected for glucose level at fasting,30,60 and 120 min postprandial.BREEZE~(TM) glucose monitor and autoanalyzer measured CBG and VPG respectively.Intra-and inter- coefficients of variations were determined using 10 BREEZE~(TM) glucose monitors with normal,slight high and high glucose levels for the three lots of strips.Results The correlation coefficients between CBG and VPG were all higher than 0.950 at fasting and different postprandial time.98.94% of all measurements were in the A zone when using error-grid analysis.The relevant differences between CBG and VPG were less than 5% at different blood glucose concentrations.The intra-and inter-coefficients of variations of blood glucose values at different blood glucose concentrations using different lots of strips were within 5%.Conclusion BREEZE~(TM) glucose monitor provides high accurate and precise glucose readings on fasting and different postprandial time points over a variety of blood glucose concentrations.

Objective To study the effectiveness of personalized rehabilitation treatments based on threedimensional gait analysis (3DGA) for improving the walking function of children with cerebral palsy (CP).MethodsA total of 21 spastic CP children with diplegia or hemiplegia,IQ scores ＞60,and an average age of 8.5 years received 3DGA.They then received personalized rehabilitation treatment designed according to the 3DGA results.After four weeks of treatment the children accepted 3DGA again.Their gait descriptors before and after treatment were compared. ResultsAfter the personalized rehabilitation the subjects'clinical foot dorsiflexion angle,clinical popliteal fossa angle,walking velocity,stride length,step length,peak ankle dorsiflexion in prime stance,peaking ankle plantar flexion in last stance,peak back ground reaction forces (GRFs) and peak vertical GRF in stance all had improved significantly.The cadence,total support time,swing phase,initial double support time,peak knee extension in stance and the peak forward GRF were not,however,significantly different compared with before the personalized rehabilitation treatment.Conclusion Under the guidance of 3DGA,the walking function of spastic CP children improved significantly after 4 weeks of personalized rehabilitation treatment.3DGA can play an important role in formulating personalized rehabilitation protocols and guiding rehabilitation treatment for CP children.

Objective To explore the effects of group sand play on the behavior of cerebral palsy (CP)children with behavioral problems.Methods Ninety children with CP aged 3-5 with behavioral problems were selected,after those with mental retardation had been excluded through the Peabody picture vocabulary test (PPVT).Their behavioral problems were diagnosed using Achenhach's child behavior check list (CRCL).The children were randomly divided into an experimental group and a control group with 45 cases in each.The experimental group received 10 weeks of sand play treatment in addition to routine rehabilitation.The controls received only routine rehabilitation.Results After treatment,the social withdrawal,depression,aggression and disruptive behavior scores of the 3-year olds in the experimental group were significantly lower than before treatment and significantly lower than those of the controls.For the 4 and 5 year-old boys the results were similar in terms of soclal withdrawal,depression,immaturity,sexual behavior,aggression and delinquent behavior,For the 4 and 5 year-old girls the scores for depression,somatic complaints,social withdrawal,compulsion,aggression,and hyperauctivity showed similar significant improvements.Conclusion Group sand play can improve the behavior and promote the mental health of CP children.

BACKGROUNDAdvances in treatment have greatly reduced the risk of blindness from this disease, but because diabetes is so common, diabetic retinopathy remains an important problem. The purpose of this study is to investigate the risk factors of diabetic retinopathy (DR) in Chinese type 2 diabetic patients.

METHODSTotally 746 type 2 diabetic patients were selected for biochemical and clinical characteristics test and examined by the retina-camera for diabetic retinopathy and the average age was 55.9 years old.

RESULTSA total of 526 patients was classified as non-DR, 159 patients as non-proliferative-DR and 61 patients as proliferative-DR. Duration of diabetes [(66.09 +/- 72.51) months vs (143.71 +/- 93.27) months vs (174.30 +/- 81.91) months, P = 0.00], systolic blood pressure [(131.95 +/- 47.20) mmHg vs (138.71 +/- 21.36) mmHg vs (147.58 +/- 24.10) mmHg, P = 0.01], urine albumin [(32.79 +/- 122.29) mg/L vs (190.96 +/- 455.65) mg/L vs (362.00 +/- 552.51) mg/L, P = 0.00], glycated hemoglobin (HbA1c) [(8.68 +/- 2.26)% vs (9.42 +/- 1.84)% vs (9.42 +/- 1.96)%, P = 0.04], C-reactive protein (CRP) [(3.19 +/- 7.37) mg/L vs (6.36 +/- 23.59) mg/L vs (3.02 +/- 4.34) mg/L, P = 0.03], high-density lipoprotein cholesterol (HDL-C) [(1.23 +/- 0.37) mmol/L vs (1.33 +/- 0.35) mmol/L vs (1.24 +/- 0.33) mmol/L, P = 0.01], uric acid (UA) [(288.51 +/- 90.85) mmol/L vs (300.29 +/- 101.98) mmol/L vs (337.57 +/- 115.09) mmol/L, P = 0.00], creatinine (CREA) [(84.22 +/- 16.31) micromol/L vs (89.35 +/- 27.45) micromol/L vs (103.28 +/- 48.64) micromol/L, P = 0.00], blood urine nitrogen (BUN) [(5.62 +/- 1.62) mmol/L vs (6.55 +/- 2.74) mmol/L vs (8.11 +/- 3.60) mmol/L, P = 0.00] were statistically different among the three groups. Logistic regression analysis showed that diabetic duration and urine albumin were two independent risk factors of DR (the OR values were 1.010 and 1.003 respectively).

CONCLUSIONSDiabetic duration and urine albumin are two independent risk factors of diabetic retinopathy in elderly type 2 diabetic patients.

Adolescent ; Adult ; Aged ; Aged, 80 and over ; Albuminuria ; complications ; Cholesterol, HDL ; blood ; Diabetes Mellitus, Type 2 ; complications ; Diabetic Retinopathy ; etiology ; Female ; Humans ; Logistic Models ; Male ; Middle Aged ; Risk Factors ; Time Factors

Objective To observe toxic effect of deoxynivalenol(DON)on articular cartilage and synovium of New Zealand rabbits's knee ioints.Methods Fifteen male rabbits were divided randomly into 3 groups:control, high-dosage,and low-dosage group.In high-dosage and low-dosage group,saline solution of DON was injected with a dose of 0.10 and 0.05 ms/kg every 48 h into ear vein of rabbits.Specimen of articular cartilage and synovium were through pathologY methods,and IL-1β,TNF-α,NO levels were assayed in joint liquid,after 20 days. Results Morphological changes were observed, such as synovium inflammative infiltration, chondrocytes deformation and necrosis under light microscope.The levels of IL-1β,TNF-α and NO had statistical significance in comDarison between 3 grouPs(F=19.396,18.195,22.136,P＜0.05).The levels of IL-1β,TNF-α and NO were significantly higher(all P＜0.05),high-dosage[(0.451±0.091),(0.575±0.122)μg/L;(70.27±11.53)μmol/L] and low-dosage group[(0.295±0.107),(0.387±0.131)μg/L;(45.32±12.24)μmol/L]compared with control ((0.1 13±0.049),(0.138±0.087)μg/L;(23.56±9.35)μmoL/L],and high-dosage compared with low-dosage group Conclusions DON results in articular and synovial impairment,which has the symptom similar to osteoarthritis. DON probably causes osteoarthritis.