Objective:To discuss the effects of walking function-guided interactive Tuina(Chinese therapeutic massage)on spatiotemporal gait parameters in children with spastic cerebral palsy(CP). Methods:Fifty children with spastic diplegic CP were divided into an observation group and a control group following a paired design and random number principle,with 25 cases in each group.The observation group was treated with the walking function-guided interactive Tuina,and the control group was offered the"six methods of spine and back"Tuina,20 min for each session and 5 sessions weekly for 3 consecutive months.The children's changes were assessed using the percentage of dimension E(walking,running,and jumping)of the gross motor function measure-88(GMFM-88)and three-dimensional gait analysis. Results:After treatment,the percentage of GMFM-88 dimension of dimension E(walking,running,and jumping)changed significantly in both groups(P<0.05),and the between-group difference was also statistically significant(P<0.05).After treatment,the step length,walking speed,and step frequency changed markedly in the observation group(P<0.05)and were significantly different from those in the control group(P<0.05).After the intervention,the stance phase and double support extended,and the swing phase became shorter in the observation group(P<0.05);the between-group differences were statistically significant(P<0.05).The maximal knee flexion angle and maximal posterior pelvic tilt angle decreased After treatment in the observation group,and the maximal anterior pelvic tilt angle increased,all showing statistical significance(P<0.05);the between-group differences were statistically significant(P<0.05). Conclusion:Compared with the passive Tuina manipulations,the"six methods of the spine and back",walking function-guided interactive Tuina has its advantage in improving walking function in children with spastic CP,manifesting as better lower-limb force line and walking efficiency.

Background::With functionally heterogeneous cells, tumors comprise a complex ecosystem to promote tumor adaptability and evolution under strong selective pressure from the given microenvironment. Diversifying tumor cells or intra-tumor heterogeneity is essential for tumor growth, invasion, and immune evasion. However, no reliable method to classify tumor cell subtypes is yet available. In this study, we introduced the single-cell sequencing combined with copy number characteristics to identify the types of tumor cells in microsatellite stable (MSS) colorectal cancer (CRC).Methods::To characterize the somatic copy number alteration (SCNA) of MSS CRC in a single cell profile, we analyzed 26 tissue samples from 19 Korean patients (GSE132465, the Samsung Medical Center [SMC] dataset) and then verified our findings with 15 tissue samples from five Belgian patients (GSE144735, the Katholieke Universiteit Leuven 3 [KUL3] dataset). The Cancer Genome Atlas (TCGA) cohort, GSE39582 cohort, and National Cancer Center (NCC) cohort (24 MSS CRC patients were enrolled in this study between March 2017 and October 2017) were used to validate the clinical features of prognostic signatures.Results::We employed single cell RNA-sequencing data to identify three types of tumor cells in MSS CRC by their SCNA characteristics. Among these three types of tumor cells, C1 and C3 had a higher SCNA burden; C1 had significant chromosome 13 and 20 amplification, whereas C3 was the polar opposite of C1, which exhibited deletion in chromosome 13 and 20. The three types of tumor cells exhibited various functions in the tumor microenvironment and harbored different mutations. C1 and C2 were linked to the immune response and hypoxia, respectively, while C3 was critical for cell adhesion activity and tumor angiogenesis. Additionally, one gene ( OLFM4) was identified as epithelium-specific biomarker of better prognosis of CRC (TCGA cohort: P = 0.0110; GSE39582 cohort: P= 0.0098; NCC cohort: P= 0.0360). Conclusions::On the basis of copy number characteristics, we illustrated tumor heterogeneity in MSS CRC and identified three types of tumor cells with distinct roles in tumor microenvironment. By understanding heterogeneity in the intricate tumor microenvironment, we gained an insight into the mechanisms of tumor evolution, which may support the development of therapeutic strategies.

Objective:To explore the characteristics of intestinal flora in children with asthma from the theory of "lung and large intestine being interior-exterior" , and to provide an experimental basis for the study of "lung and intestine axis" .Methods:Based on 16S rDNA high-throughput sequencing technology, stool samples from children with 30 asthma and 28 healthy children were enrolloed and sequenced. All patients are from january 2018 to April 2018, Shanghai Children's Medical Center affiliated to Shanghai Jiaotong University Medical College and Oriental Hospital Affiliated to Tongji University. Statistical methods such as Principal component analysis (PCA), LEfSe analysis, linear discriminant analysis (LDA), and non-metric multidimensional scale analysis (NMDS) were used to analyze intestinal flora characteristics of asthma children.Results:The number of Intestinal flora operating taxon unit (OTU) in asthmatic group (141.96 ± 27.42 vs. 164.54 ± 50.58, P=0.048), Shannon index (2.49 ± 0.51 vs. 2.80 ± 0.56, P=0.044) were significantly lower than those of healthy children group, and Simpson index (0.18 ± 0.06 vs. 0.13 ± 0.07, P=0.010) was significantly higher than that of healthy children. There was no significant difference in intestinal flora abundance between asthmatic children and healthy children ( P>0.05), but there was a decreasing trend. Further differential intestinal flora analysis showed that there were differences in bacterial abundance between children with asthma and healthy children. Conclusion:Children with asthma showed high related with intestinal flora disorders, referring that asthma maybe treated when intestinal flora is treated, which provides a reference for the study of the relationship between lung and intestine from the perspective of intestinal flora.

OBJECTIVETo evaluate the effect of individualized scalp acupuncture base on location of brain function for motor dysfunction in stroke patients.

METHODSA total of 180 patients were randomly assigned into an individualized scalp acupuncture (ISA) group, a conventional scalp acupuncture (CSA) group and a rehabilitation group, 60 cases in each one. In the ISA group, we stimulated Sishencong (EX-HN 1), motor area and balance area, matched with pre-motor area for higher muscle tension, application area and's three-needle for involuntary motion, application area for poor motor coordination, forehead five-needle for cognitive disorder, sensory area for sensory disturbance. In the CSA group, the affected Dingnieqianxiexian (MS 6), Dingniehouxiexian (MS 7) and Zhenxiapangxian (MS 14) were selected. Rehabilitation was used during needle retained in the two groups. Simple rehabilitation was used in the rehabilitation group. All the treatment was given from Monday to Friday for 4 weeks, once a day for 20 times. Eight-week follow-up was applied. The Fugl-Meyer assessment (FMA) for motor function, modified Barthel Index (MBI) were used to evaluate clinical effect.

RESULTSAfter treatment and at follow-up, FMA and MBI scores increased compared with those before treatment in the three groups（all<0.01）, with significant differences among the three groups (all<0.000 1) and better results in the ISA group compared with those in the other two groups (<0.05,<0.01) at the two time points. The FMA and MBI scores in the CSA group were higher than those in the rehabilitation group after treatment and at follow-up (all<0.05).

CONCLUSIONThe individualized scalp acupuncture can improve motor dysfunction and self-care ability of daily life for stroke patients.

Objective To study the effect of scalp acupuncture plus facilitation technique on the temporal and spatial parameters of gait in spastic cerebral palsy. Method Thirty eligible patients with spastic cerebral palsy were randomized into a treatment group and a control group based on the inter-group balance in age, palsy type, and the Gross Motor Function Classification System (GMFCS), 15 cases in each group. The treatment group was intervened by scalp acupuncture, together with the facilitation technique during the retaining of the needles; the control group was also by scalp acupuncture and facilitation techniques but with over 1 h interval between the two methods. The treatment was given once a day, totally for 3 months. The walking, running, and jumping items (E category) of the Gross Motor Function Measure-66 (GMFM-66), temporal and spatial parameters of gait, and vertical ground reaction force during stance were compared before and after the treatment. Result There were no significant inter-group differences in comparing the rates of E category of the GMFM-66 before the treatment (P>0.05), the rates were significantly changed after the treatment in both groups (P<0.05), and there were significant differences in comparing the rates between the two groups after the intervention (P<0.05);after the intervention, the step length, walking speed, and step frequency were increased significantly in both groups (P<0.05), while the double-stance phase was decreased significantly, and swing phase was increased significantly (P<0.05); after the intervention, the step length, walking speed, and step frequency of the treatment group were significantly better than that of the control group (P<0.05). Conclusion Acupuncture plus facilitation technique can mitigate the spasticity in spastic cerebral palsy, improve the gross motor function, especially the function of standing and walking, enhance the activities, and benefit the improvement of the step length, step width, and walk speed.

OBJECTIVETo compare the clinical efficacy on upper limb motor impairment in stroke between the interactive dynamic scalp acupuncture therapy and the traditional scalp acupuncture therapy.

METHODSThe randomized controlled trial and MINIMIZE layering randomization software were adopted. Seventy patients of upper limb with III to V grade in Brunnstrom scale after stroke were randomized into an interactive dynamic scalp acupuncture group and a traditional scalp acupuncture group, 35 cases in each one. In the interactive dynamic scalp acupuncture group, the middle 2/5 of Dingnieqianxiexian (anterior oblique line of vertex-temporal), the middle 2/5 of Dingniehouxiexian (posterior oblique line of vertex-temporal) and Dingpangerxian (lateral line 2 of vertex) on the affected side were selected as the stimulation areas. Additionally, the rehabilitation training was applied during scalp acupuncture treatment. In the traditional scalp acupuncture group, the scalp stimulation areas were same as the interactive dynamic scalp acupuncture group. But the rehabilitation training was applied separately. The rehabilitation training was applied in the morning and the scalp acupuncture was done in the afternoon. The results in Fugl-Meyer for the upper limb motor function (U-FMA), the Wolf motor function measure scale (WM- FT) and the modified Barthel index in the two groups were compared between the two groups before treatment and in 1 and 2 months of treatment, respectively.

RESULTSAfter treatment, the U-FMA score, WMFT score and the score of the modified Barthel index were all apparently improved as compared with those before treatment (all P < 0.01). The improvement in the U-FMA score after treatment in the interactive dynamic scalp acupuncture group was better than that in the traditional scalp acupuncture group (P < 0.05). For the patients of IV to V grade in Brunnstrom scale, WMFT score in 2 months of treatment and the score of Barthel index after treatment in the interactive dynamic scalp acupuncture group were improved apparently as compared with those in the traditional scalp acupuncture group (P < 0.05, P < 0.01). But, for the patients of III grade in Brunnstrom scale, WMFT score and the score of Barthel index after treatment in the interactive dynamic scalp acupuncture group were not different significantly as compared with those in the traditional scalp acupuncture group (both P > 0.05).

CONCLUSIONFor the patients of IV to V grade in Brunnstrom scale in stroke, the interactive dynamic scalp acupuncture therapy achieves the superior improvements of the upper limb motor function and the activity of daily life as compared with the traditional scalp acupuncture therapy, and the longer the treatment lasts, the more apparent the improvements are. For the patients of III grade in Brunnstrom scale, the interactive dynamic scalp acupuncture therapy achieves the similar improvement in the upper limb motor impairment as compared with the traditional scalp acupuncture therapy.

Activities of Daily Living ; Acupuncture Points ; Acupuncture Therapy ; Adult ; Aged ; Female ; Humans ; Male ; Middle Aged ; Occupational Therapy ; Scalp ; Stroke ; physiopathology ; therapy ; Stroke Rehabilitation ; Treatment Outcome ; Upper Extremity ; physiopathology

Objective To investigate the effect of complementary dynamic scalp acupuncture on motor function in stroke. Methods 36 stroke patients were randomly allocated to control group (n=19) and treatment group (n=17). The control group received traditional scalp acupuncture and rehabilitation training, while the treatment group received scalp acupuncture and rehabilitation training in the same time,for one month. Their motor function and activities of daily living (ADL) were assessed with the Fugl-Meyer Assessment (FMA), Wolf Motor Function Test (WMFT) and modified Barthel Index (MBI) before and after treatment, respectively. Results The scores of FMA, WMFT and MBI increased significantly in both groups after treatment (P<0.01). The difference of scores of FMA of the lower extremities and MBI was statistically significant between the two groups after treatment (P<0.05), while the difference of scores of FMA of the upper extremities and WMFT was not (P>0.05). Conclusion Complementary dynamic scalp acupuncture is more effective on lower limbs motor function and activities of daily living in stroke patients.

Cognitive behavioral therapy (CBT) has been widely used in many clinical fields, especially the mental illness, as well as the somatic diseases, behavior disorders in children, and intervention for the caregivers and family members of patients with various diseases.

Rehabilitation and related professions have grown rapidly in China during this decade. Quality of life becomes a top priority after acute care service has been delivered. Communication is a unique and essential skill of humans and is one of the main factors influencing quality of life. People share their ideas with each other and advocate for their rights by communicating. The purpose of this paper is to introduce the general concepts of Augmentative and Alternative Communication (AAC). The paper includes a brief explanation of AAC, types of AAC, targeted populations benefitted by AAC, principles of a language-based service delivery, and a discussion of interdisciplinary team member roles.>Rehabilitation and related professions have grown rapidly in China during this decade. Quality of life becomes a top priority >after acute care service has been delivered. Communication is a unique and essential skill of humans and is one of the main factors influencing >quality of life. People share their ideas with each other and advocate for their rights by communicating. The purpose of this paper is to introduce>the general concepts of Augmentative and Alternative Communication (AAC). The paper includes a brief explanation of AAC, types>of AAC, targeted populations benefitted by AAC, principles of a language-based service delivery, and a discussion of interdisciplinary team>member roles

Objective To explore whether there is significant difference in the oral-pharyngeal resonance function between children with spastic and athetoid cerebral palsy. Methods The acoustic parameters (F1、F2) of /ɑ/、/i/、/u/ were compared between these two kinds of children. Results The incidence of oral-pharyngeal resonance disorder were 71% and 95% in the children with spastic cerebral palsy and athetoid cerebral palsy respectively. There was no significant difference in F1 and F2 of /ɑ/、/i/、/u/ between these two kinds of children. Conclusion The incidence of oral-pharyngeal resonance disorder is high in both two kinds of children, and there is no significant difference in the oral-pharyngeal resonance function between them.