Objective:To explore the differences in balance ability and brain activation level between the cerebral palsy(CP)adolescents and the typically developing(TD)adolescents.Method:Eight adolescents with CP or TD were recruited in this study.The center of pressure(COP)was measured using an AMTI three-dimensional force platform to assess the standing balance under perturbation or non-perturbation condition.Brain activation level was also measured using the fNIRS device to collect the oxy-genated hemoglobin concentrations(ΔHbO2)in the supplementary motor area(SMA),precental gyrus(PreCG),postcentral gyrus(PoCG)and superior parietal lobule(SPL).Result:①Balance ability indicators:During the perturbation condition,DeltaAP,RMS,RMSAP,SPAP in the CP group were significantly greater than those in the control group.In the CP group,DeltaAP,DeltaML,RMS,RMSAP,SPAP during the perturbation condition were significantly greater than those during the non-pertur-bation condition.②Brain activation level indicators:During the perturbation conditions,the ΔHbO2 of SMA in the CP group were significantly greater than those in the control group.In the CP group,the ΔHbO2 of SMA,PreCG,PoCG during the perturbation condition were significantly greater than those during the non-per-turbation condition.Conclusion:Compared to the TD adolescents,the CP adolescents had poorer balance in the anterior-posterior direction and higher level of SMA activation in the external perturbation condition.Under the external perturba-tion condition,the balance ability decreased in the anterior-posterior direction,while the activation level of SMA,PreCG and PoCG increased in the adolescents with CP.

Objective:To investigate the activation characteristics of the cerebral cortex and the coordination characteris-tics of the lower limb joints in adolescents with spastic cerebral palsy during walking,and to provide a theo-retical basis for the rehabilitation training of their gait coordination.Method:A total of eight adolescents aged 12-18 years with spastic cerebral palsy were included as the spas-tic cerebral palsy group and eight normal adolescents aged 12-18 years were included as the control group.Both groups walked on a treadmill at a fixed speed of 0.45 m/s.A Vicon infrared high-speed motion capture system and a functional near-infrared spectroscopy system were applied to collect the kinematic data and hemo-dynamic signals in the sensory-motor cortical region of the two groups while walking on the treadmill.The mean absolute value of the continuous relative phase(MACRP)and the mean of the standard deviation of the relative phase(DP)were calculated to evaluate the coupling coordination characteristics of the lower limb links.The relative concentration change of oxygenated hemoglobin(HbO2)in the cerebral cortex was calculat-ed to evaluate the activation characteristics of the cerebral cortex.Result:①Comparison results of lower limb coordination ability:During walking,the MACRP value of cou-pling coordination of hip-knee joints within the left lower limb of the spastic cerebral palsy group was signifi-cantly smaller than that of the control group(P=0.043,Cohen's d=1.113).The DP value of coupled variability within the limb of the spastic cerebral palsy group was significantly larger than that of the control group for both the hip-knee(P=0.003,Cohen's d=1.755)and knee-ankle(P=0.009,Cohen's d=1.503)joints.②Compari-son results of brain activation levels:Channels 11(P=0.025,Cohen's d=1.258)and 12(P=0.02,Cohen's d=2.310)in the supplementary motor area,channels 6(P=0.043,Cohen's d=1.112),14(P=0.006,Cohen's d=1.633),and 15(P=0.002,Cohen's d=1.886)in the precentral gyrus,channels 6(P=0.043,Cohen's d=1.112),7(P=0.002,Cohen's d=1.837),15(P=0.002,Cohen's d=1.886),and 17(P=0.002,Cohen's d=1.933)in the postcentral gyrus,channels 9(P=0.016,Cohen's d=1.363),10(P=0.045,Cohen's d=1.101)and 18(P=0.001,Cohen's d=2.221)in the superior parietal lobule,the activation levels of the above chan-nels of the spastic cerebral palsy group were significantly greater than those of the control group.Conclusion:During walking,adolescents with spastic cerebral palsy had hyperactivation of the somatosensory-motor cortical area of the brain and an unstable pattern of joint coordination within the lower limbs,with a high degree of variability.

BACKGROUND:Foot position and seat height are important factors affecting "Sit-to-Stand",but most of the current research on "Sit-to-Stand" focuses on healthy people and Parkinson's disease patients. The kinematic and kinetic characteristics of the lower limbs of children with spastic cerebral palsy during the "Sit-to-Stand" task under different foot positions and seat heights are not known.OBJECTIVE:To investigate the effects of different foot positions and different seat height on lower limb kinematic and kinetic parameters during the "Sit-to-Stand" task in children with cerebral palsy. METHODS:Seven children with spastic cerebral palsy were selected as the research subjects. All subjects received the "Sit-to-Stand" test of six tasks,namely three seat heights (high,medium,and low stools) × two foot positions (front and back foot positions). The kinematic and dynamic data of children with cerebral palsy were collected under different foot positions and seat heights.RESULTS AND CONCLUSION:(1) The time characteristics results showed that the total time required for the children with cerebral palsy to perform the sit-to-stand transfer task was significantly smaller in the high stool condition compared to the low stool condition (P=0.046). (2) The kinetic results showed that at the moment of lifting,the knee flexion moment was significantly larger in the bipedal posterior condition than the bipedal anterior condition (P=0.049). The knee flexion moment was significantly smaller in the high stool condition compared to the medium stool condition (P<0.001). (3) It is concluded that raising the seat height and changing the foot position had an effect on the sit-to-stand transfer in children with spastic cerebral palsy. The children were able to perform the sit-to-stand maneuver with less motor compensation in the high-stool bipedal-rear position condition. Meanwhile,the high chair can be used as an aid to enhance the performance of sit-to-stand transfer in children with spastic cerebral palsy. The high stool bipedal hindfoot condition was the most effective in improving the sit-to-stand transfer in children with spastic cerebral palsy.

IgA nephropathy（IgAN）is a common primary glomerular disease in children，characterized by the deposition of IgA or IgA-dominant immune complexes in the glomeruli.The clinical manifestations are highly heterogeneous，with some children progressing to end-stage renal disease.The prognosis of IgAN is influenced by multiple factors，involving clinical，pathological，and laboratory examinations.Among the clinical factors，persistent proteinuria，reduced baseline estimated glomerular filtration rate（eGFR），hypertension during follow-up，and hyperuricemia are risk factors for poor prognosis.The predictive value of hematuria remains controversial.Pathologically，the Oxford classification highlights that segmental sclerosis，tubular atrophy/interstitial fibrosis，and crescents are significantly associated with disease progression，with tubular atrophy/interstitial fibrosis serving as an independent risk factor for poor outcomes.The prognostic significance of mesangial hypercellularity and endocapillary hypercellularity requires further validation.Among the biomarkers，serum galactose-deficient IgA 1 and complement-related markers（such as IgA/C3 ratio）show potential predictive value，but need to be supported by large samples studies.This article reviews the clinical，pathological，and biomarker-related risk factors influencing the prognosis of pediatric IgAN，aiming to provide basis for developing risk prediction models and guiding individualized treatment strategies.

Objective To quantify the lower limb coordination and coordination variability of children with spastic cerebral palsy(CP)during flat ground walking using vector coding technology.Methods From September to December,2023,eight children with spastic CP(patients)from Ji'nan Rehabilitation Hospi-tal and Ji'nan Special Education School,and eight healthy children(controls)from communities walked on a treadmill at a speed of 0.45 m/s.Lower limb kinematic data were collected using Vicon,a three-dimensional mo-tion capture system.Vector coding technology was used to quantify the temporal and spatial parameters of ipsilat-eral lower limb joints to calculate joint coupling angles and coupling angle variability(CAV).Results In the first and second double support phase,the hip-knee coupling angle was significantly larger in the patients than in the controls(|t|>2.317,P<0.05).In the swing phase,the hip-ankle and knee-ankle coupling angles were significantly larger in the patients(|t|>2.346,P<0.05).In the first double support phase and the single support phase,CAV of the hip-knee and hip-ankle were significantly larger in the patients(|t|>2.454,P<0.05),and they were smaller in the swing phase(t>2.560,P<0.05).In the second double support phase and the swing phase,CAV of the knee-ankle was significantly larger in the patients(|t|>2.909,P<0.05).Conclusion Coordination among hip,knee and ankle joints is poor for children with spastic CP during both the stance and swing phases of walking,and variability is more during the stance phase.

Objective:To investigate the activation characteristics of the cerebral cortex and the coordination characteris-tics of the lower limb joints in adolescents with spastic cerebral palsy during walking,and to provide a theo-retical basis for the rehabilitation training of their gait coordination.Method:A total of eight adolescents aged 12-18 years with spastic cerebral palsy were included as the spas-tic cerebral palsy group and eight normal adolescents aged 12-18 years were included as the control group.Both groups walked on a treadmill at a fixed speed of 0.45 m/s.A Vicon infrared high-speed motion capture system and a functional near-infrared spectroscopy system were applied to collect the kinematic data and hemo-dynamic signals in the sensory-motor cortical region of the two groups while walking on the treadmill.The mean absolute value of the continuous relative phase(MACRP)and the mean of the standard deviation of the relative phase(DP)were calculated to evaluate the coupling coordination characteristics of the lower limb links.The relative concentration change of oxygenated hemoglobin(HbO2)in the cerebral cortex was calculat-ed to evaluate the activation characteristics of the cerebral cortex.Result:①Comparison results of lower limb coordination ability:During walking,the MACRP value of cou-pling coordination of hip-knee joints within the left lower limb of the spastic cerebral palsy group was signifi-cantly smaller than that of the control group(P=0.043,Cohen's d=1.113).The DP value of coupled variability within the limb of the spastic cerebral palsy group was significantly larger than that of the control group for both the hip-knee(P=0.003,Cohen's d=1.755)and knee-ankle(P=0.009,Cohen's d=1.503)joints.②Compari-son results of brain activation levels:Channels 11(P=0.025,Cohen's d=1.258)and 12(P=0.02,Cohen's d=2.310)in the supplementary motor area,channels 6(P=0.043,Cohen's d=1.112),14(P=0.006,Cohen's d=1.633),and 15(P=0.002,Cohen's d=1.886)in the precentral gyrus,channels 6(P=0.043,Cohen's d=1.112),7(P=0.002,Cohen's d=1.837),15(P=0.002,Cohen's d=1.886),and 17(P=0.002,Cohen's d=1.933)in the postcentral gyrus,channels 9(P=0.016,Cohen's d=1.363),10(P=0.045,Cohen's d=1.101)and 18(P=0.001,Cohen's d=2.221)in the superior parietal lobule,the activation levels of the above chan-nels of the spastic cerebral palsy group were significantly greater than those of the control group.Conclusion:During walking,adolescents with spastic cerebral palsy had hyperactivation of the somatosensory-motor cortical area of the brain and an unstable pattern of joint coordination within the lower limbs,with a high degree of variability.

Objective To quantify the lower limb coordination and coordination variability of children with spastic cerebral palsy(CP)during flat ground walking using vector coding technology.Methods From September to December,2023,eight children with spastic CP(patients)from Ji'nan Rehabilitation Hospi-tal and Ji'nan Special Education School,and eight healthy children(controls)from communities walked on a treadmill at a speed of 0.45 m/s.Lower limb kinematic data were collected using Vicon,a three-dimensional mo-tion capture system.Vector coding technology was used to quantify the temporal and spatial parameters of ipsilat-eral lower limb joints to calculate joint coupling angles and coupling angle variability(CAV).Results In the first and second double support phase,the hip-knee coupling angle was significantly larger in the patients than in the controls(|t|>2.317,P<0.05).In the swing phase,the hip-ankle and knee-ankle coupling angles were significantly larger in the patients(|t|>2.346,P<0.05).In the first double support phase and the single support phase,CAV of the hip-knee and hip-ankle were significantly larger in the patients(|t|>2.454,P<0.05),and they were smaller in the swing phase(t>2.560,P<0.05).In the second double support phase and the swing phase,CAV of the knee-ankle was significantly larger in the patients(|t|>2.909,P<0.05).Conclusion Coordination among hip,knee and ankle joints is poor for children with spastic CP during both the stance and swing phases of walking,and variability is more during the stance phase.

BACKGROUND:Foot position and seat height are important factors affecting "Sit-to-Stand",but most of the current research on "Sit-to-Stand" focuses on healthy people and Parkinson's disease patients. The kinematic and kinetic characteristics of the lower limbs of children with spastic cerebral palsy during the "Sit-to-Stand" task under different foot positions and seat heights are not known.OBJECTIVE:To investigate the effects of different foot positions and different seat height on lower limb kinematic and kinetic parameters during the "Sit-to-Stand" task in children with cerebral palsy. METHODS:Seven children with spastic cerebral palsy were selected as the research subjects. All subjects received the "Sit-to-Stand" test of six tasks,namely three seat heights (high,medium,and low stools) × two foot positions (front and back foot positions). The kinematic and dynamic data of children with cerebral palsy were collected under different foot positions and seat heights.RESULTS AND CONCLUSION:(1) The time characteristics results showed that the total time required for the children with cerebral palsy to perform the sit-to-stand transfer task was significantly smaller in the high stool condition compared to the low stool condition (P=0.046). (2) The kinetic results showed that at the moment of lifting,the knee flexion moment was significantly larger in the bipedal posterior condition than the bipedal anterior condition (P=0.049). The knee flexion moment was significantly smaller in the high stool condition compared to the medium stool condition (P<0.001). (3) It is concluded that raising the seat height and changing the foot position had an effect on the sit-to-stand transfer in children with spastic cerebral palsy. The children were able to perform the sit-to-stand maneuver with less motor compensation in the high-stool bipedal-rear position condition. Meanwhile,the high chair can be used as an aid to enhance the performance of sit-to-stand transfer in children with spastic cerebral palsy. The high stool bipedal hindfoot condition was the most effective in improving the sit-to-stand transfer in children with spastic cerebral palsy.

Objective:To explore the differences in balance ability and brain activation level between the cerebral palsy(CP)adolescents and the typically developing(TD)adolescents.Method:Eight adolescents with CP or TD were recruited in this study.The center of pressure(COP)was measured using an AMTI three-dimensional force platform to assess the standing balance under perturbation or non-perturbation condition.Brain activation level was also measured using the fNIRS device to collect the oxy-genated hemoglobin concentrations(ΔHbO2)in the supplementary motor area(SMA),precental gyrus(PreCG),postcentral gyrus(PoCG)and superior parietal lobule(SPL).Result:①Balance ability indicators:During the perturbation condition,DeltaAP,RMS,RMSAP,SPAP in the CP group were significantly greater than those in the control group.In the CP group,DeltaAP,DeltaML,RMS,RMSAP,SPAP during the perturbation condition were significantly greater than those during the non-pertur-bation condition.②Brain activation level indicators:During the perturbation conditions,the ΔHbO2 of SMA in the CP group were significantly greater than those in the control group.In the CP group,the ΔHbO2 of SMA,PreCG,PoCG during the perturbation condition were significantly greater than those during the non-per-turbation condition.Conclusion:Compared to the TD adolescents,the CP adolescents had poorer balance in the anterior-posterior direction and higher level of SMA activation in the external perturbation condition.Under the external perturba-tion condition,the balance ability decreased in the anterior-posterior direction,while the activation level of SMA,PreCG and PoCG increased in the adolescents with CP.

Objective To investigate the frequency of staging behaviors involved in intimate partner homicide cases,as well as their correlation with the nature of death,medico-legal characteristics,and their correspondence with real causes of death.In order to improve the forensic understanding of staging behaviors in intimate partner homicide cases.Methods Using 100 investigated intimate homicides,forensic elements were statistically analyzed.The Chi square test was used to analyze the correlation between staging behavior and intimate partners,cause of death,injury weapons,time of death,degree of injury,resistance injury,postmortem intervals,and other specific elements and the occurrence of staging behavior.The corresponding partner between staging cause of death and real cause of death was clarified.Results Among the 100 intimate partner homicides,22 involved staging behaviors.Out of 10 cases of"staging"suicide,6 cases(60%)were attributed to staged causes of death.Among the 12"accidental"cases,there were 10 cases(83.33%)of staged causes of death.Staging manner of death appeared in 3 cases(30%)of"suicide"cases,and there was only one in"accidental"case(8.3%).The proportion of staged causes of death in strangulation cases was relatively high(35.71%,10/28).In cases with mild damage,the proportion of staging causes of death is higher(15/46).In cases without defense injuries,the proportion of staged causes of death was 23.19%(16/69).Among the true causes of death,strangulation in homicide was most commonly staged.Conclusion Different relationships of intimate partners did not affect the occurrence and distribution of staging behaviors.In cases involving staging behavior,the number of cases with staging as"accidental"nature of death is higher than that of"suicide"cases.The deaths with minor surface injuries such as strangulation and poisoning can be easily staging as suicide or accident.