This case report presents a child with intermittent exotropia who was treated with tuina. The main clinical manifestation was right eye deviation, which was diagnosed as liver and kidney deficiency and spleen and stomach qi deficiency. The treatment principles focused on harmonizing qi and blood, dispersing wind and unblocking orifices, and tonifying the liver and kidney. Tuina was applied at the head, face, and neck regions, including "opening the heavenly gate", "pushing kan palace", "rubbing the forehead" and point stimulation of Jingming (BL1), Cuanzhu (BL2), Yuyao (EX-HN4), Sizhukong (TE23), Tongziliao (GB1), as well as massaging Taiyang (EX-HN5), Qiuhou (EX-HN7), Quanliao (SI18), Chengqi (ST1), Sibai (ST2), Muchuang (GB16), Chengguang (BL6), Yifeng (TE17), and Yiming (EX-HN14). Tuina was also applied at upper limbs, including massaging Binao (LI14), Quchi (LI11), and the lower limbs, including pressing and plucking along the liver meridian. The treatment was combined with eye exercises with a "" character pattern. The tuina was administered daily during the first week; every other day from the second to fourth weeks; every four days in the second month; and once weekly in the third month. After 3 months of treatment, the patient's eye position returned to normal. A follow-up after 3 months revealed no recurrence.
Child ; Humans ; Acupuncture Points ; Exotropia/drug therapy*

Objective To understand the application value of spacial clusters detection of human schistosomiasis epidemic,based on small scale level in heavy mountainous and hilly endemic areas, Songzi County,Hubei Province,China. Methods Positive results of human serological detection antibody titer equal or above 80,and positive schistosomiasis cases of fecal examination from 2016 to 2018 as research object in Songzi County.The flexible irregular space scan statistics was used to analyse the spatial clustering analysis of human schistosomiasis epidemic in the heavy mountainous and hilly endemic areas, setting parameter K=2 ,K=6 or K=10, respectively,based on small scale of village level in Songzi County. Results There was none positive schistosomiasis cases of fecal examination in Songzi County from 2016 to 2018.The number of human serological detection antibody titer equal or above 80 were  74, 206, 83, from 2016 to 2018，respectively.There was spatial clusters of positive of human serological detection antibody titer equal or above 80 for schistosomiasis cases in the county from 2016-2018. Areas of flexible irregular space scan statistic in cluster detection changing with the change of different K values. Under different parameters of flexible irregular space scan statistic results show that the most likely cluster of 40 endemic villages in three towns,inculding Laocheng town,Chendian town and Wangjiaqiao town were the prominent. Conclusion There are spatial clusters of human schistosomiasis based on small scale of village level by flexible irregular space scan statistic in mountainous and hilly endemic areas, Songzi County,Hubei Province.Therefore,the monitoring and control of schistosomiasis should be consolidated in the future,in order to achieve schistosomiasis elimination in Hubei Province at an early date.

Higher service efficiency and better medical experience are main goals of the healthcare system reform.The article explained the logical framework, main actions, initial results of the " one visit for all" reform, which aims at promoting the efficiency of medical services and management in Hangzhou.Policy suggestions are raised, namely involving more people into the governance mechanism, collaboratively optimizing the working process of medical staff, improving the information security mechanism, and perfecting the effectiveness evaluation system.These measures are designed to accelerate the construction of modern hospital management system, and to build a scientific and orderly hierarchical medical system.

Objective To analyze the effect of long-term anti-viral treatment in children with acquired immune deficiency syndrome (AIDS) and investigate the factors affecting the treatment efficacy and growth and development of the children, so as to provide reference for improving the efficacy of antiviral drugs.Methods Children with AIDS receiving anti-retroviral treatment during 2004 to 2016 were retrospectively enrolled.The height, weight and CD4+ T cell counts were recorded every half year and the measurement of HIV RNA load was recorded on an annual basis.The CD4+ T cell counts and viral inhibition rates for the children who were under the treatment in the first year, 1~<5 years, 5~<10 years, and ≥10 years were compared.And their growth and development were also assessed.Treatment efficacy and growth and development of the children were compared between those who raised by social organization and by family.Children who raised by family were further divided into two groups: high-income and low-income groups.All categorical data were analyzed using chi-square test and those non-normal distribution were compared by rank-sumtest.Results After comparison between the children who have received anti-virus treatment for 1 to 5 years (including 5 year) and those for 5 to 10 year (including 10 years), the baseline CD4+ T cell counts were 436.5(265, 728)cells/μL and 334 (102, 535)cells/μL, respectively with the statistically significant difference (Z=-2.619, P<0.01).The last measured CD4+ T cell counts were 779 (622, 1 024)cells/μL and 720 (640, 977)cells/μL, respectively with no statistical significance (Z=-0.708, P>0.05);and viral inhibition rates were 92.9% and 97.6%, respectively with no statistical significance (χ2=1.071, P>0.05).The viral inhibition rate for the children receiving the treatment for 1 year was 85.7%, while that for whose treatment lasted for more than 10 years was 100.0%.A total of 5 cases developed drug-resistance (2 cases treated for 1 to 5 years and 3 cases for 5 to 10 years), and the virus replication was completely inhibited after switching to Lopinavir/ritonavir (LPV/r).The drug compliance was more than 95.0%.64.8% of children met the standard height, while 68.5% met the standard body mass.The baseline and last measured CD4+ T cell counts showed no significant differences between family-raised and social organization-raised children (Z=-1.159 and -0.523, respectively, both P>0.05).The children from high-income families had no significant differences compared with those from low-income ones in terms of the baseline and last measured CD4+ T cell counts (Z=-0.019 and -0.776, respectively, both P>0.05).Conclusions The long-term anti-retroviral treatment can effectively elevate the CD4+ T cell counts, inhibit viral replication and ensure drug compliance, which may promote the growth and development of children.However, approximately 30% children are still lower than the normal standards in terms of height and body mass.The drug-taking observer plays a central role on treatment effect.Most of the children′s family suffer from poor economic conditions.

Objective To observe the efficacy and safety of high-dose amiodarone administered by continuously intravenous infusion for cardioversion of paroxysmal atrial fibrillation.Methods From 2008 to 2010,109 patients suffered from paroxysmal atrial fibrillation were treated with high-dose arniodarone (125 mg/h) administered by continuously intravenous infusion.Before cardioversion,patients were treated with low molecular weight heparin anticoagulant therapy,Laboratory tests on FT3,FT4,TSH,serum ions,etc,and coloured Doppler ultrasound imaging of heart,and ECG and blood pressure monitoring were carried out.Amiodarone hydrochloride injectio of 150 mg was mixed with sodium chloride 50 mL homogeneously,and then infused continuously by micro-pump in a rate of 41 mL/h until resume of sinus rhythm or infusion was kept up to 24 h.After successful cardioversion,as appropriate,the intravenous amiodarone was maintained in a rate of 0.5-1.0 mg/min for 6-12 h joined with oral amiodarone dosing,and the total dose was limited up to 3000 mg.Results A cohort of 104 (95.4％) patients had the restoration of sinus rhythm after cardioversion.The mean dose of amiodarone for cardioversion was (774.52 t 700.53) mg,and time required for cardioversion was (6.3 ± 5.55) hours.Conclusions The patients with paroxysmal atrial fibrillation are given high-dose amiodarone (125 mg/h) continuously intravenous infusion therapy and have high cardioversion success rate,less complications and side effects,as well as other advantages at the basic hospital.The method above has broad application prospects.