Objective To explore the medium-and long-term efficacy of modified approach arthroscopy in the treatment of ischial tuberosity cysts in middle-aged and elderly people.Methods Clinical data of 19 cases of ischial tuberosity cyst treated arthroscopically from January 2018 to December 2020 were retrospectively analyzed.The cyst wall was removed by using the central approach of the ischial tuberosity cyst and the 3-5 cm approach of the cyst to the outside of the buttocks.Results The operation time was 30-45 min(mean,36.2±4.8 min).The Visual Analogue Scale(VAS)scores of the pain on the 1st,7th,and 28th d after surgery were 2-6(mean,3.7±1.1),1-4(mean,1.9±0.9),and 0-1(mean,0.5±0.2),respectively.There were 18 cases of incision grade A healing and 1 case of grade B healing.The total hospitalization time was 3-6 d(mean,3.8±1.1 d).There were no complications such as incision infection and subcutaneous hematoma.The 19 cases were followed up for 40-81 months(mean,60.5±10.2 months),and 1 case had cyst recurrence at 3 months after surgery.Conclusion The modified approach arthroscopy is safe and effective in the treatment of ischial tuberosity cysts,having satisfactory medium-and long-term efficacy.

Objective To explore the medium-and long-term efficacy of modified approach arthroscopy in the treatment of ischial tuberosity cysts in middle-aged and elderly people.Methods Clinical data of 19 cases of ischial tuberosity cyst treated arthroscopically from January 2018 to December 2020 were retrospectively analyzed.The cyst wall was removed by using the central approach of the ischial tuberosity cyst and the 3-5 cm approach of the cyst to the outside of the buttocks.Results The operation time was 30-45 min(mean,36.2±4.8 min).The Visual Analogue Scale(VAS)scores of the pain on the 1st,7th,and 28th d after surgery were 2-6(mean,3.7±1.1),1-4(mean,1.9±0.9),and 0-1(mean,0.5±0.2),respectively.There were 18 cases of incision grade A healing and 1 case of grade B healing.The total hospitalization time was 3-6 d(mean,3.8±1.1 d).There were no complications such as incision infection and subcutaneous hematoma.The 19 cases were followed up for 40-81 months(mean,60.5±10.2 months),and 1 case had cyst recurrence at 3 months after surgery.Conclusion The modified approach arthroscopy is safe and effective in the treatment of ischial tuberosity cysts,having satisfactory medium-and long-term efficacy.

Objective:To summarize the clinical and genetic characteristics of children with β-ketothiolase deficiency (BKTD).Methods:The clinical characteristics, biochemical, markers detected by tandem mass spectrometry (MS/MS) and gas chromatography-mass spectrometry (GC/MS), as well as the variants in ACAT1 gene among 5 children with BKTD in Children′s Hospital of Chongqing Medical University between October 2018 and December 2022 were retrospectively analyzed.Results:The onset age of the disease in 5 patients (4 males and 1 female) ranged from 9.7 to 28.0 months. During the acute phase, severe metabolic acidosis was observed with a pH of 6.9-7.1, as well as hypoglycaemia (2.3-3.4 mmol/L) and positive urinary ketone bodies (+-++++). Blood levels of methylcrotonyl carnitine, methylmalonyl carnitine and malonyl carnitine were 0.03-0.42, 0.34-1.43 and 0.83-3.53 μmol/L respectively and were significantly elevated. Urinary 2-methyl-3-hydroxybutyric acid was 22-202 and 3-hydroxybutyric acid was 4-6 066, both were higher than the normal levels. Methylcrotonylglycine was mild elevated (0-29). The metabolites detected by MS/MS and GC/MS were significantly reduced after treatment. Analysis of ACAT1 gene mutation was performed in 5 children. Most variants were missense (8/9). Four previously unreported variants were identified: c.678G>T (p.Trp226Cys), c.302A>G (p.Gln101Arg), c.627_629dupTGA (p.Asn209_Glu210insAsp) and c.316C>T (p.Gln106Ter), the first 2 variants were predicted to be damaging by SIFT, PolyPhen-2 and Mutation Taster software. c.316C>T (p.Gln106Ter) is a nonsense variant.Conclusions:β-ketothiolase deficiency is relatively rare, lacks specific clinical manifestations, however severe metabolic acidosis, hypoglycemia, and ketosis during the acute onset were consistent findings. Missense mutations in the ACAT1 gene are common genetic causes of β-ketothiolase deficiency.

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 The research is about optimization of preparation procedure of self-microemulsifying dropping pills of paclitaxel (PTX-SM-DP) .The drug release in vitro of PTX-SM-DP was investigated .Methods The ratio of SMEDDS and bases ,dropping distance ,temperature and speed of dripping were investigated by using the orthogonal test .The weight differ-ence of dropping pill ,hardness and roundness were evaluated to optimize the preparation conditions of PTX-SM-DP .Dissolu-tion of vitro was determined .Results The optimal preparation conditions were as follows :the ratio of SMEDDS and bases was 1∶3 ,dropping distance was 15 cm ,temperature of dripping preparation was 80 ℃ and dripping speed was 30 drops/min . Conclusion The optimized technical condition is stable and feasible .PTX-SM-DP can improve paclitaxel dissolution .

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.

ObjectiveTo study the effects of individualized scalp acupuncture based on the focus and syndrome differentiation in traditional Chinese medicine on mobility ability of children with spastic cerebral palsy. Methods55 cases were randomly divided into 2 groups: treatment group (n=29) and control group (n=26). Treatment group received individualized acupuncture combined with rehabilitation and the control group received Jin's acupuncture combined with rehabilitation for 3 month. They were assessed with the mobility domains of the Pediatric Evaluation of Disability Inventory (PEDI). ResultsThe improvement of PEDI scores was more in treatment group than in control group （P＜0.01）.ConclusionScalp acupuncture combined with rehabilitation has active effects on mobility abilities of children with spastic cerebral palsy, and the individualized acupuncture do better than the Jin's acupuncture.