Objective:To explore the implementation effect of type 2 diabetes mellitus (T2DM) management pathway in a primary hospital, and analyze its influencing factors.Methods:Henan Provincial People's Hospital instructed Zhengzhou Beixia Street Community Health Service Center to implement the conventional T2DM management model from January to December 2019, and to implement the T2DM management pathway from January to December 2020. The implementation effect of the T2DM management pathway was observed. A total of 220 cases of T2DM patients after the implementation were set as the good group and the poor group according to the effect of the pathway management. Logistic regression was used to analyze the influencing factors of the implementation effect of T2DM management pathway.Results:Before the implementation, hospitalization time, hospitalization expenses, incidence of adverse nursing events, patient satisfaction, and good compliance rate of medication, diet, exercise, and blood glucose self-monitoring were (15.39±2.14) d, (4 256.87±536.14) yuan, 12.27% (27/220) , 81.82% (180/220) , 60.45% (133/220) , 69.55% (153/220) , 56.36% (124/220) , 54.55% (120/220) , respectively, and after the implementation were (12.20±2.82) d, (3 158.62±425.16) yuan, 6.36% (14/220) , 91.36% (201/220) , 72.27% (159/220) , 81.82% (180/220) , 73.18% (161 /220) , 78.18% (172/220) , respectively. After the implementation, the hospitalization time of the patients was shorter than that before the implementation, and the hospitalization expenses and the incidence of adverse nursing events were lower than those before the implementation, and the good compliance rate of medication, diet, exercise and blood glucose self-monitoring and patient satisfaction were higher than those before implementation, and the differences were statistical ( P<0.05) . Logistic regression showed that smoking, the course of T2DM, and the irregular pathway management were all factors that affected the implementation effect of the T2DM management pathway ( P<0.05) . Conclusions:The implementation of T2DM pathway management in primary hospitals can achieve obvious effects. Smoking, the course of T2DM, and irregular pathway management are all factors that affect its implementation effect.

Objective To observe the effect of combining virtual reality technology with occupational thera-py in treating children with spastic hemiplegia resulting from cerebral palsy. Methods Thirty-eight spastic and hemiplegic children with cerebral palsy were randomly divided into a treatment group ( n=18) and a control group ( n=20) . Both groups received occupational therapy, while the treatment group was additionally provided with virtual reality-based treatment. The sessions lasted 30 min, 6 times a week for 3 months. Before and after the treatment the upper extremity motor function of both groups was assessed using the fine motor quotients of the Peabody developmen-tal motor scale, the Caroll hand function scale and a activities of daily life scale. Results Before the treatment there was no significant difference between the two groups in terms of any of the measurements. After the 3 months, significant improvement was observed in both groups, but the improvement of the treatment group was significantly greater than that of the control group. Conclusion Virtual reality technology can further improve the motor function of the upper ex-tremities and ability in the activities of daily life beyond that achievable through occupational therapy alone.

Objective To observe the effect of early cognitive and speech intervention on children with developmental delay. Methods 58 inpatient or outpatient children with developmental delay from June, 2014 to June, 2015 were diveded into observation group (n=32) and control group (n=26). The observation group accepted early cognitive and speech therapy and routine rehabilitation training, while the con-trol group accepted the routine rehabilitation only. They were assessed with Gesell Development Schedule before and 3 months after treat-ment. Results The developmental quotient of the gross movement, fine movement, language and peasonal-social improved in both groups af-ter treatment (t>2.90, P<0.001), and improved more in the observation group than in the control group (t>2.84, P<0.05), especially in chil-dren of 1 year old than those of 1-2 or 2-3 years old (F>36.52, P<0.01). Conclusion Early cognitive and speech intervention may improve development of many dimensions in children with developmental delay. The earlier the intervention, the better the outcome.

Objective To explore the characteristics of visual P300 event-related potentials (ERP) in children with mental retardation and evaluate the correlations between visual P300 in event-related potentials and intelligent quotient.Methods Thirty children with mental retardation were selected as the test group who were inpatients or saw a doctor in the Department of Rehabilitation of Hunan Children Hospital.At the same time,thirty normal children were selected as the control group who saw a doctor in the Department of Child Healthcare of Hunan Children Hospital.Two groups had no statistically significant difference in sex and age (P ＞ 0.05) and were comparable.All children were administered with the Wechsler intelligence test in the Department of Child Healthcare and the visual event-related potential test in the Department of Rehabilitation.The results of the visual P300 latency and amplitude were analyzed.Another,the relevance between intelligent quotient (IQ) and P300 latency and amplitude were also compared by statistics.Results Compared to the control group,the visual P300 latency in children with mental retardation (MR) was apparently longer and the amplitude decreased significantly in children with MR,with a statistically significant difference between two groups(P ＜0.05).P300 latency in MR expected negative correlation with intelligent quotient and the amplitude in MR expected no correlation with intelligent quotient.Conclusions P300 latency and amplitude of ERP could objectively reflect cognitive function in children with MR,could be regarded as one of the objective measurement in the evaluation of cognitive function in children with MR.It can be used as an objective electrophysiological index for assisting in the diagnosis of mental retardation of children in clinic.

Objective To explore the parallel validity of Alberta infant motor scale (AIMS) and Peabody developmental motor scale-2 (PDMS-2) in assessing motor function of high risk infants. Methods 60 high risk infants, aged from 1 month to 9 months, were assessed by both the AIMS and PDMS-2. The total scores of AIMS and the total original scores of PDMS-2 gross motor scale (GMS) were compared by the Spearman's analysis. The AIMS's percentage and PDMS-2 gross motor quotient (GMQ) were compared with qualitative analysis by Kappa value. The examination time of the two scales was also compared. Results The correlation coefficient of the total scores of AIMS and the original scores of GMS was 0.91 (P<0.001). The correlation coefficient of AIMS's percentage and GMQ was 0.6. The mean time of AIMS was (10.47±3.63) min, and that of PDMS-2 was (26.5±7.77) min for examination (t=28.895, P<0.001). Conclusion AIMS and PDMS-2 are in a high level of consistency when assessing the motor function of 1-month-old to 9-month-old high risk infants.

OBJECTIVETo establish a HPLC-DAD model for the simultaneous determination of two selaginellins (selaginellin and selaginellin B) and four biflavones (amentoflavone, sequoiaflavone, hinokiflavone and isocryptomerin) contained in 10 batches of Selaginella tamariscina and 12 batches of S. pulvinata produced in different areas.

METHODThe analysis was performed on a Waters Cosmosil C18 column (4.6 mm x 250 mm, 5 microm) eluted with acetonitril-0.1% formic acid as mobile phase in a linear gradient mode. The detection wavelength was set at 280, 337 nm. The flow rate was kept at 1.0 mL x min(-1), and the column temperature was 30 degrees C.

RESULTThe six active constituents showed significant different in content. Amentoflavone in S. tamariscina contains (5. 628-9. 184 mg x g(-1)) is more than that contained in S. pulvinata (0.823-7.131 mg x g(-1)), while selaginellin in S. pulvinata (0.123-0.593 mg x g(-1)) is more than that contained in S. tamariscina (0.067-0.133 mg x g(-1)). All the calibration curves showed good linear correlation coefficients (r > 0.9997) over the wide test ranges.

CONCLUSIONThe developed HPLC-DAD method is simple, sensitive and accurate and has the good repeatability in separation, which is available for the quality control of S. tamariscina and S. pulvinata.

Biflavonoids ; chemistry ; Biphenyl Compounds ; chemistry ; Chromatography, High Pressure Liquid ; methods ; Cyclohexanones ; chemistry ; Flavones ; chemistry ; Flavonoids ; chemistry ; Selaginellaceae ; chemistry

Objective To discuss the differences of the types of cerebral palsy and the comorbidity between premature and full-term infants. Methods 233 children with cerebral palsy were divided into premature group (n=98) and full-term group (n=125). The types of cerebral palsy and the complications were analyzed. Results The high risk factors were low birth weight, jaundice, asphyxia, intracranial hemorrhage and cord around neck in sequence in the premature group, and were asphyxia, jaundice, fetal distress, intracranial hemorrhage and intrauterine infection in sequence in the full-term group. Besides auditory handicap. The frequency of spastic diplegia was higher in the premature group than in the full-term group (P<0.001), and the incidence of spastic hemiplegia was higher in the full-term group than in the premature group (P<0.01). There was no significant difference in dysgnosia, epilepsy and visual disturbance (P>0.05), but auditory handicap (P<0.05) between 2 groups. Conclusion The main clinical types of premature and full-term children with cerebral palsy were spastic diplegia and spastic hemiplegia respectively. The prevalence of auditory handicap was higher in preterm children

Objective To observe the effect of Botulinum toxin type A (BTX-A) injection combined with rehabilitation functional training on upper extremity motor function in children with spastic hemiplegic cerebral palsy (CP). Methods 60 spastic hemiplegic CP children were treated with constraint-induced movement therapy (CIMT), physical therapy, electromyographic biofeedback stimulation therapy, occupational therapy, family-based training and so on after injected with BTX-A. The muscle tension of the hemiplegic upper extremity accessed by Modified Ashworth Scale (MAS), the wrist angle of active dorsiextention motion by orthrometer, fine movement quotient (FMQ) by Peabody developmental motor scale (PDMS-Ⅱ), and activities of daily living (ADL) were performed to evaluate the effects before and 3 months after treatment. Results These outcomes were improved significantly after treatment (P<0.001). Conclusion BTX-A injection combined with rehabilitation functional training could rapidly reduce spasticity of the upper extremity, increase the range of motion, improve motor function of upper extremity in children with spastic hemiplegic CP.

Objective To investigate the characteristics of motor development in children with mental retardation. Methods Motor development was assessed with the Peabody Developmental Motor Scale 2 (PDMS-2) and mental development with adaptive developmental quotient (ADQ) of Gesell developmental schedules (GDS) in 430 infants (6~36 months old) with mental retardation. Results The gross (GDQ), fine (FDQ) and total motor developmental quotient were poor in all the children, and significantly different among children with slight, mild, and serious retardation (P<0.01). ADQ correlated with each sub-score of PDMS-2 (P<0.01). For PDMS-2, FDQ correlated with sub-scores of gross motor, and GDQ with sub-scores of fine motor (P<0.01) in all the mental retardate children. Conclusion The development of both gross and fine motor is poor in children with mental retardation. Mental development correlate with motor development, and gross with fine motor development.

Objective To evaluate the effect of Botulinum Toxin A (BTX-A) on spastic diplegia by surface electromyography (sEMG). Methods 50 children with cerebral palsy following spastic diplegia were recruited and injected with BTX-A in triceps surae. They were assessed with the clinical test and the sEMG before and after the treatment. Results After the treatment, the integrated electromyography(iEMG) of triceps surae and foot dorsiflexion angle all decreased. Conclusion sEMG is an objective tool to assess the change of spasticity in children with diplegia after BTX-A injection.