Objective:To investigate the survival benefit of radiotherapy on the basis of systemic treatment for stage ⅣB esophageal squamous cell carcinoma (ESCC).Methods:Based on inclusion and exclusion criteria, we collected the treatment information of 298 patients with newly diagnosed stage ⅣB ESCC admitted to Affiliated Cancer Hospital of Zhengzhou University from January 2016 to February 2021. All patients were divided into two groups based on treatment: early radiotherapy intervention group (CRT group, n=197) and salvage radiotherapy intervention or no intervention group (CT group, n=101). Propensity score matching (PSM) was used to balance baseline characteristics between two groups. Kaplan-Meier method was used to calculate the survival rate and log-rank was used to test the difference. Cox model was used to analyze the multivariate prognosis. Results:In the CRT and CT groups, the objective response rate (ORR) and disease control rate (DCR) were 52.8% vs. 31.5%( P=0.006) and 98.9% vs. 85.4%( P=0.001) respectively, and the 1-, 2- and 3-year survival rates were 74.2% vs. 52.8%、31.5% vs. 10.1% and 15.7% vs. 2.2%, respectively. Median progression-free survival (PFS) was 8.5 months (95% CI: 6.7-10.3 months) vs. 4.4 months (95% CI: 3.5-5.3 months)( P<0.001). Median overall survival (OS) were 17.1 months (95% CI: 14.9-19.3 months) vs. 12.7 months (95% CI: 8.0-17.4 months)( P<0.001). The difference of adverse reactions was mainly in hematology. Conclusions:For newly diagnosed stage ⅣB patients with ESCC, radiotherapy should be combined with systemic therapy as early as possible. It yields longer PFS and OS, and effectively improves dysphagia. Adverse reactions are tolerated. Further validation is recommended in larger prospective studies.

Objective:To investigate and analyze the somatic symptom disorder, anxiety and depression in patients with myocardial bridge.Methods:A total of 276 patients with myocardial bridge diagnosed by coronary angiography (CAG) were enrolled in the department of cardiology of Renji hospital in Shanghai from June to December in 2016. There were 151 cases of simple myocardial bridge (no coronary stenosis or coronary artery stenosis <30%) and 125 cases of complex myocardial bridge (combined with coronary stenosis >30%). A total of 1067 patients with myocardial bridge without coronary angiography were collected at the same time. Self-rating somatic symptom scale (SSS), generalized anxiety disorder (GAD-7) and patient health questionnaire (PHQ -9) were given to these patients during hospitalization. At the same time, somatic symptoms disorder and anxiety and depression in the myocardial bridge group and non-myocardial bridge group were compared.Results:The prevalence of somatic symptom disorder in patients with myocardial bridge was higher than that in non-myocardial bridge patients (35.86% vs 28.30%, P<0.05). There was significant correlation between somatic symptom disorder and depression and anxiety, with correlation coefficients of 0.629 and 0.565, respectively. The prevalence of depression and anxiety in myocardial bridge patients was higher than that in non-myocardial bridge patients (depression: 23.91% vs 22.11%. P=0.467; anxiety: 17.02% vs 14.15%, P=0.22), but there was no statistical difference. For male patients or female patients, the prevalence of somatic symptom disorder, depression and anxiety in the simple myocardial bridge patients were higher than those in the complex myocardial bridge patients, but there was no statistical difference. The most common non-specific somatic symptoms disorder in patients with myocardial bridge were fatigue (64.5%), followed by sleep disorders (63.8%) and decreased attention (63.0%). Conclusion:The somatic symptom disorder in patients with myocardial bridge is significantly higher than that in non-myocardial bridge group. Especially for patients with myocardial bridge with non-specific somatic symptoms, early identification of somatic symptoms disorder of myocardial bridge patients will be beneficial to proper clinical invitation.

Currently, the value of adjuvant therapy after radical resection of esophageal squamous cell carcinoma remains elusive. Some studies have reported that radiotherapy can improve the locoregional control rate and overall survival of patients. However, the design of radiotherapy target area, intervention time and dose of radiotherapy are controversial. In this article, literature review was conducted and the current status and controversy of adjuvant radiotherapy after radical resection of esophageal squamous cell carcinoma were reviewed.

OBJECTIVETo analyze the effect difference of wave, intensity, time and treatment frequency by orthogonal design so as to explore the optimal parameters of scalp electroacupuncture (EA) for rehabilitation effect on children of cerebral palsy.

METHODSNinety children of cerebral palsy were assigned into 9 groups by orthogonal design, 10 cases in each one. The acupoints were bilateral excitable area, foot motor sensory area, speech two area, speech three area, balance area, and intelligent nine acupoints, including Shenting (GV 24), Sishencong (EX-HN 1), and bilateral Benshen (GB 13) and Touwei (ST 8). EA was applied at bilateral excitable area and speech three area. We designed an orthogonal experiment with four factors and three levels. We studied wave (sparse wave of 2 Hz, density wave of 100 Hz, sparse and density wave of 2 Hz /100 Hz), intensity (1 mA, 2 mA, intensity based on tolerance), time (10 min, 20 min, 30 min), frequency (once a day, once every other day, twice a week). The Gesell developmental scale was used to evaluate the developmental quotient (DQ); and gross motor function measure (GMFM), motor function before and after treatment.

RESULTSThe optimal parameters for DQ and GMFM were 2 Hz/100 Hz, 20 min, once every other day. .

CONCLUSIONThe optimal parameters for cerebral palsy may be 2 Hz/100 Hz, 20 min, once every other day.

OBJECTIVETo explore the effect of scalp acupuncture for children with cerebral palsy whose video-electroencephalogram(VEEG) showed epileptiform discharges.

METHODSA total of 184 children with cerebral palsy whose VEEG showed epileptiform discharges or those combined with epilepsy were randomly assigned into a combination group (99 cases) and a rehabilitation group (85 cases). All the cases were treated with the original antiepileptic drugs. The conventional physical training and massage were applied in the rehabilitation group for 3 courses with 20 d at the interval, once a day, 5 times a week and 15 times as one course. Based on the treatment as the rehabilitation group, scalp acupuncture was used in the combination group for 3 courses with 15 d at the interval, once the other day and 10 times as one course. Shenting (GV 24), Benshen (GB 13), Sishencong (EX-HN 1) were selected as the main acupoints, combined with motor zone, foot motor-sensory area, balance zone,and temple-three-needle etc. Clinical onset and VEEG results were observed before and after treatment.

RESULTSAfter treatment in the combination group, 27 cases improved; 47 cases had no effect; 25 cases aggravated. While in the rehabilitation group, 11 cases improved; 46 cases had no effect; 28 cases aggravated. There was no statistically significance between the two groups (>0.05). As for the cases with epilepsy onset in the combination group, 8 cases improved; 4 cases had no effect; 4 cases aggravated. In the rehabilitation group, 4 cases had no effect; 7 cases aggravated. The result in the combination group was better than that in the rehabilitation group (<0.05). As for the cases with epileptiform discharges in the combination group, 19 cases improved; 43 cases had no effect; 21 cases aggravated. In the rehabilitation group, 11 cases improved; 42 cases had no effect; 21 cases aggravated. There was no significance between the two groups (>0.05).

CONCLUSIONSScalp acupuncture therapy does not increase the risk of onset or epileptiform discharges in the children with cerebral palsy combined with epilepsy or epileptiform discharges. Scalp acupuncture combined with rehabilitation is better than simple rehabilitation for thosewith cerebral palsy and epilepsy onset.

Objective To apply the Comprehensive Function Assessment for Disabled Children in family care for children with cerebral palsy. Methods From May, 2014 to May, 2015, 120 cerebral palsy children were equally divided into control group and observation group. The control group accepted routine rehabilitation, and the observation group accepted targeted family rehabilitation program based on the evaluation of Comprehensive Function Assessment for Disabled Children. They were assessed with Comprehensive Function Assessment for Disabled Children before and three months after rehabilitation. Results The scores of cognitive function, language function, exercise abil-ity, self-care movement and social adaptation ability improved in both groups after rehabilitation (t>2.498, P<0.05), and improved more in the observation group than in the control group (t>2.062, P<0.05). Conclusion The application of Comprehensive Function Assessment for Disabled Children may help to plan a targeted rehabilitation nursing program for the nurses and the parents, that benefits the rehabilitation for children with cerebral palsy.

Objective:To observe the clinical efficacy of Governor Vessel-unblocking and brain-refreshing scalp acupuncture for cerebral palsy (CP) complicated with intellectual disabilities. Methods:A total of 300 CP cases aged between 1 and 5 years were randomly allocated into a treatment group (n=150) and a control group (n=150). Patients in the treatment group were treated with Governor Vessel-unblocking and brain- refreshing scalp acupuncture combined with rehabilitation training, whereas patients in the control group received rehabilitation training alone. The Beijing Gesell developmental (Gesell) scale and gross motor function measure (GMFM) scale were used to assess the motor and intellectual development before and 3 months after the treatment. In addition, the head CT/MRI examination was applied to assess the brain nerve repair before and after the treatment. Results:After the treatment, the total effective rate in the treatment group was 78.0%, versus 42.7% in the control group, showing a statistical significance (P<0.05). As for scores of five subscales in the Gesell scale, there were significant intra-group differences in the treatment group (allP<0.05); and the scores in the treatment group were significantly better than those in the control group (allP<0.05). As for scores of five dimensions in GMFM scale, there were significant intra-group differences in the treatment group (allP<0.05); and the scores in the treatment group were significantly better than those in the control group (allP<0.05). According to the head CT/MRI findings, the total effective rate was 73.3% in the treatment group, versus 62.0% in the control group, showing a statistical significance (P<0.05). Conclusion:When used in combination with rehabilitative training, Governor Vessel-unblocking and brain-refreshing scalp acupuncture can significantly improve the clinical efficacy for cerebral palsy complicated with intellectual disabilities. It can also improve the patients' motor function, intelligence and language ability.

Objective:To observe the effect of Governor Vessel-unblocking and mind-refreshing needling technique on diffusion tensor imaging (DTI) in cerebral palsy (CP) children with periventricular leukomalacia (PVL) and investigate the underlying mechanism.
Methods:A total of 18 CP children with PVL received modern rehabilitation training and scalp acupuncture. The before-after study was conducted to compare the fractional anisotropy (FA) of the white matter fiber tracts, gross motor function measure (GMFM) score, Gesell developmental scale and changes in muscle tone.
Results:For the comparison before and after the first course of treatment, there were no statistical differences in DTI findings and FA values (both P>0.05); there were statistical differences in GMFM dimensions A and B (bothP<0.05) and no statistical differences in dimensions C, D and E (allP>0.05); and there were statistical differences in six items of Gesell development test (P<0.01 orP<0.05). For the comparison before and after two courses of treatment, there were statistical differences in DTI findings and FA values in 8 cases between before and after 30 and 60 treatments (bothP<0.05); there were statistical differences in GMFM dimensions A, B and C between before and after 30 and 60 treatments and between 30 and 60 treatments (allP<0.05); there were no statistical differences in GMFM dimensions D and E (allP>0.05); and there were statistical differences in six items of Gesell developmental test between before, after 30 and 60 treatments and between 30 and 60 treatments (P<0.05 or P<0.01).
Conclusion:The Governor Vessel-unblocking and mind-refreshing scalp acupuncture has no significant efficacy on the repair and regeneration of white matter fibers in children with PVL and CP in a short period of time; however, it gradually works along with the prolonged treatment time. In addition, it can improve the motor function and mental development and the efficacy is closely associated with the time of treatment.

Objective: To observe the clinical effect of acupuncture plus occupation therapy for fine motor functions in children with spastic cerebral palsy. Methods:A total of 80 cerebral palsy kids with fine motor dysfunction were allocated into two groups by envelop, 40 cases in each group. Cases in the control group were treated with occupation therapy. Based on the therapy given to the control group, cases in the treatment group were supplemented with acupuncture at the points of the three yang meridians of hand. The treatment was done every other day and 10 times for a course. There was a 15-day interval between two courses, and 3 courses in total. The therapeutic efficacies were evaluated using Peabody developmental motor scale 2 (PDMS-2) and modified Ashworth scale (MAS) before and after treatment. Results:After treatment, the standard score for grasping (Grs), standard score for visual-motor integration (Vis), fine motor quotient (FMQ) and modified Ashworth scale (MAS) were significantly improved in both groups (P<0.05). The improvement in the treatment group was more obvious than that in the control group (P<0.01). Conclusion:Acupuncture plus occupation therapy can achieve better effect than occupation therapy alone in improving fine motor functions of upper limbs in cerebral palsy kids.

Objective To investigate the effect of acupoint application of Fangfeng Baishu San on immunologic function in patients with cerebral palsy. Methods Sixty patients with cerebral palsy were randomly allocated to treatment and control groups, 30 cases each. The control group received routine rehabilitation training and the treatment group, application of Fangfeng Baishu San on bilateral points Zusanli, Pishu and Feishu in addition. Serum IgG, IgM, IgA, C3 and C4 were measured in the two groups of patients before and after treatment. Statistical analysis was made. Results There were statistically significant pre-/post-treatment differences in serum IgG, IgM and IgA in the treatment group (P<0.05). There were statistically significant post-treatment differences in serum IgG, IgM and IgA between the treatment and control groups (P<0.01). There were no statistically significant post-treatment differences in serum IgG, IgM, IgA, C3 and C4 between the patients with different ages, sexes or CP types (P>0.05). Conclusion Acupoint application of Fangfeng Baishu San can improve immunologic function in patients with cerebral palsy.