1.Implementation and clinical application of hypertonia assessment tool
Beibei KANG ; Zhihai LYU ; Lei XU ; Yanping FAN ; Zhimei JIANG
Chinese Journal of Applied Clinical Pediatrics 2015;(14):1117-1118
As the urgent need of both clinic and research,the identification of hypertonia subtypes is becoming more and more important. Hypertonia assessment tool is a standardized discriminative measure with good reliability and validity. Hypertonia assessment tool can identify paediatric hypertonia subtypes. For its easily learning,it can be easily generalized in clinician.
2.Research progress of genes of cerebral palsy
Xinyang ZHANG ; Zhimei JIANG ; Zhihai LYU ; Wei PANG ; Jin GUO
Chinese Journal of Applied Clinical Pediatrics 2015;30(23):1835-1837
Cerebral palsy (CP) is the most common activity limitition of children, their movement and posture impairments persist throughout whole life.In recent years, CP has been significantly increasing with the improved survival rate of newborns.This may lead to a great burden and costs to both the family and the society.A variety of risk factors have been proposed to be associated with CP.However, recent abroad researches indicate that genetic factors may predispose to CP of newborns and initial results of related researches infer that several susceptibility genes may contribute to CP's development, masqueraders have a great impact on CP's clinical symptoms.Now, the recent publications related to virulence genes and masqueraders of CP are reviewed.
3.Current situation on epidemic characteristics, standardization prevention and treatment of children with cerebral palsy in Qinghai province
Zhao LI ; Xuejun WANG ; Fawen YANG ; Zhihai LYU ; Songpo YAO ; Yulan LI ; Xiaojie LI
Chinese Journal of Applied Clinical Pediatrics 2017;32(5):374-376
Objective To study the incidence and prevalence in the children aged 1-2 years and 1-6 years with cerebral palsy(CP) in Qinghai province,and to identify the epidemiological characteristics and control status of the children with CP.Methods A stratified cluster random sampling method was used to conduct epidemiological survey of 10 000 children in Qinghai province.Children diagnosed as CP were asked to fill in the CP questionnaires,including children's development,and the status of prevention and treatment of CP.Compared with the children diagnosed as CP,4 healthy children at the same age were asked to fill in the questionnaires related to children's development.SPSS 15.0 statistical software was used for data analysis.Results Seven children with CP were diagnosed at the aged 1-2 years,and the total incidence rate was 3.3‰(7/2 148 cases).The incidence between the urban (0) and the rural areas (12‰) (7/582 cases) was significantly different(P =0.000 1),while there was no significant difference statistically between boys (5 cases) and girls (2 cases) (P > 0.05).Fifty-four children with CP were diagnosed at the age of 1-6 years,and the total prevalence rate was 5.4‰(54/10 000 cases).The prevalence between the urban (2.3‰,17/7 348 cases) and the rural areas (13.9‰,37/2 652 cases) was statistically different (x2 =49.144,P < 0.01),while there was no significant difference statistically between boys (31 cases) and girls (23 cases) (P > 0.05).The proportions of various types of CP were as follows:29 cases(53.70%) of spastic type,9 cases(16.67%) of hypotonia,7 cases (12.96%) of mixed type,4 cases (7.41%) of ataxia,3 cases (5.56%) of rigidity and2 cases (3.70%) of dyskinetic,respectively.Among the spastic types,there were 16 cases (55.17%)of spastic quadriplegia,6 cases (20.69%) of spastic hemiplegia,4 cases (13.79 %) of spastic diplegia,2 cases (6.89 %) of spastic monoplegia and 1 case (3.45%) of spastic triplegia,respectively.The top three risk factors were premature (13 cases,24.1%),hypoxic-ischemic encephalopathy (9 cases,16.7%) and maternal threatened abortion (8 cases,14.8%).The first three complications were mental retardation,language dysfunction and epilepsy.Conclusions The incidence and prevalence of CP in children in Qinghai province are very high,which is higher in the rural areas than that in the urban areas.The most common CP is spastic type.The main risk factors for CP are preterm labor,hypoxic-ischemic encephalopathy and maternal threatened abortion.Intellectual disability,speech disability and epilepsy are the most common complications of CP.Maternal and perinatal infant health care and early intervention need to be further strengthened.
4.Selection strategies of hypoglycemic drug for special population with type 2 diabetes mellitus
Jinhua GE ; Na LYU ; Zhihai FENG
China Pharmacy 2022;33(20):2545-2550
The special population with type 2 diabetes mellitus(T2DM)are different from the ordinary T 2DM patients in terms of drug treatment due to age ,gender,physiological and pathological status . Based on the latest evidence of evidence -based medical evidence ,this article systematically reviews the selection strategies of hypoglycemic drug in special population such as T2DM patients with complications , elderly patients , children patients , pregnant/lactating women , etc. To formulate an individualized hypoglycemic treatment plan for T 2DM special population ,it is necessary to reasonably select hypoglycemic drugs according to their different characteristics and the latest evidence -based medical evidence ,so as to precisely reduce blood sugar and prevent and delay the occurrence of diabetic complications . For example ,for T 2DM patients with atherosclerotic cardiovascular disease,heart failure ,kidney disease and liver disease ,sodium glucose co -transporter 2 inhibitors or glucagon-like peptide 1 receptor agonists should be used additionally on the basis of metformin ;for T 2DM patients with gastroparesis ,insulin is recommended ;for T2DM patients with hyperuricemia or gout ,hypoglycemic drugs with uric acid lowering effects should be preferred ,and insulin should be used with caution ;for T 2DM patients with osteoporosis ,hypoglycemic drugs that do not affect bone metabolism or have bone protection effects should be selected ;for the elderly patients with T 2DM,it is recommended to give priority to the drugs with low risk of hypoglycemia alone or in combination .
5.Epidemiological characteristics of cerebral palsy in twelve province in China
Xiaojie LI ; Hongbin QIU ; Zhimei JIANG ; Wei PANG ; Jin GUO ; Liling ZHU ; Zhihai LYU ; Liping WANG ; Qifeng SUN ; Songpo YAO ; Ying SUN ; Lanmin GUO ; Xingzhou LI
Chinese Journal of Applied Clinical Pediatrics 2018;33(5):378-383
Objective To investigate the epidemiological characteristics of cerebral palsy(CP)in children aged 1-6 years in China,including the incidence,prevalence,type of CP,etiology,prevention and rehabilitation status. Methods The survey was carried out by standard questionnaires,multi-center collaboration,stratified-cluster ran-dom sampling method.The surveyed adopted the following principles:streets in the city and villages in the rural areas, and the number of the urban and rural children was the same,and the proportion of children in each age group was balanced.The investigation areas included provinces and autonomous regions,including Heilongjiang,Beijing,Henan, Shandong,Shanxi,Shaanxi,Anhui,Hunan,Guangxi,Guangdong,Chongqing and Qinghai,and 323 858 children were in-vestigated.Results The incidence of CP was 2.48‰(155/62 591 cases),and the prevalence was 2.46‰(797/323 858 cases)(1-6 years old).The prevalence varied in different regions,in which the highest prevalence was 5. 40‰(54/9 998 cases)in Qinghai province,and the lowest prevalence was 1.04‰(47/45 133 cases)in Shandong province.The prevalence of the males(2.64‰,461/174 391 cases)was higher than that of the females(2.25‰, 336/149 467 cases),and the difference was statistically significant(P<0.05).The types of CP were spastic type (58.85%,469/797 cases),mixed type(13.17%,105/797 cases),dyskinetic(9.79%,78/797 cases),hypotonic (8.28%,66/797 cases),ataxia(6.25%,52/797 cases)and rigid(3.39%,27/797 cases)respectively in 797 CP children.The first three risk factors for CP were long -term exposure to harmful physical factors during pregnancy, whether there were birth defects among the three generations of relatives of the children,such as children's peers, parents or grandparents,whether there were birth defects among the children's peers,parents or grandparents,and neonatal jaundice or persistent jaundice.Among 797 CP children,79.67% of the children with CP were timely detected and treated in the local hospitals,while the other 19.93% of them were not timely treated.The places which could give them timely detection and early diagnosis and treatment were general hospitals(42.97%),Maternity and Infant Hospitals (27.03%)and Children's Hospitals(20.31%). The main rehabilitation methods for 797 children with CP were 34.58% in the hospitals or rehabilitation centers,31.61% in the communities(including at home),33.80% mainly in the medical institution,and in the communities they could also receive partially rehabilitation services. Conclusions The prevalence of CP in China is coincident with international levels.The prevalence rate of CP in males is higher than that in females.The types of CP distribution are accorded with international distribution characteristics.There were still some children with CP who could not receive timely detection and treatment.Rehabilitation at the medical institutions is the chief way and proper rehabilitation guidance should be carried out in the communities.