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<p><b>OBJECTIVE</b>To observe the clinical effects of arthroscopy-guided core decompression and bone grafting combined with selective arterial infusion for early stage avascular necrosis of femoral head.</p><p><b>METHODS</b>From January 2010 to December 2014, 76 patients(76 hips) diagnosed as Ficat II stage avascular necrosis of femoral head were randomly divided into experimental group and control group. In the experimental group, there were 27 males and 8 females aged from 24 to 55 years old with an average of (43.96±6.81) years, treated with arthroscopic-guided core decompression and bone grafting combined with selective arterial infusion. Along the direction of the femoral neck, an 8 mm-diameter tunnel to necrotic areas was drilled, then curettage of necrotic bone was performed under arthroscope, and the iliac bone was grafted. In the control group, there were 29 males and 12 females aged from 26 to 56 years old with an average of (44.62±7.33) years, treated with percutaneous core decompression combined with selective arterial infusion. The preoperative and postoperative Harris scores were recorded and the changes of X-rays were analyzed.</p><p><b>RESULTS</b>All the patients were followed up with an average of 30 months. Postoperative follow-up at 12 months showed that there was significant difference in imaging outcome between two groups(<0.05), the experimental group was better than that of control group. According to Harris hip score system, at the final follow-up, Harris score of the experimental group was 86.72±4.37 on average, 6 cases got excellent results, 24 good, 4 fair and 1 poor. Harris score of the control group was 78.62±5.62 on average, 2 cases got excellent results, 20 good, 15 fair and 4 poor. After Ridit analysis, there was significant difference in the effect between the two groups(<0.05). By pairing sampletest, there was significant difference between the preoperative and postoperative Harris score in the both groups(<0.05). Between the two groups, there was no significant difference in preoperative Harris score(>0.05), but there was significant difference in postoperative Harris score(<0.05).</p><p><b>CONCLUSIONS</b>The two surgical procedures for early femoral head necrosis are effective. Using arthroscopic-guided core decompression method, the necrotic bone can be positioned and scraped more accurately, and can obtain better results.</p>
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@#Objective To analyze the cost-effectiveness of hospital rehabilitation and hospital-family rehabilitation in children with cere-bral palsy. Methods From January to December, 2016, 60 cases of children aged one to three years with cerebral palsy were divided into hospital rehabilitation group and hospital-family rehabilitation group, with 30 cases in each group. The hospital rehabilitation group received rehabilitation of traditional Chinese and Western medicine treatment, including exercise therapy, physical therapy and Chinese Medical ther-apy; while the hospital-family rehabilitation group received family rehabilitation. The Gross Motor Function Measure (GMFM) and Pea-body Developmental Motor Scale-fine Motor (PDMS-FM) were used to evaluate the motor function and fine motor function before and af-ter treatment. Results The GMFM score was higher (t=5.333, P<0.001), and the total medical cost was higher (t=23.614, P<0.001) in the hospital rehabilitation group than in the hospital-family rehabilitation group. However, the cost of medical care was significantly lower for every 1-point increase in GMFM and visual-motion integration of PDMS-FM in the hospital rehabilitation group than in the hospital-family rehabilitation group (t>2.065, P<0.05). Conclusion The hospital rehabilitation model may be a more economical and effective treatment for younger age children with cerebral palsy, and the hospital-family rehabilitation model could be used as an effective complementary rehabili-tation model for this age group.
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Objective:To observe the clinical efficacy of needling thirteen ghost acupoints for children with autism spectrum disorder. Methods:A total of 90 cases with autism spectrum disorder (ASD) aged between 2 and 6 years were randomly allocated into 2 groups by random number table. The control group (n=45) received routine rehabilitative training, and the treatment group (n=45) received acupuncture at thirteen ghost acupoints plus routine rehabilitative training. The Beijing Gesell developmental (Gesell) scale and autism behavior checklist (ABC) were used to assess the intellectual, language and behavior development before and 3 months after the treatment. Results:After the treatment, the total effective rate in the treatment group was 82.2%, versus 55.6% in the control group, showing a statistical significance (P<0.05). As for the scores of social, emotional and language in Gesell scale, there were significant intra-group differences in the treatment group (allP<0.05), and all the five subscales in the Gesell scale in the treatment group were significantly better than those in the control group (allP<0.05). As for the scores of ABC, there were significant intra-group differences in the treatment group (P<0.05), and the scores in the treatment group were significantly better than those in the control group (allP<0.05). Conclusion: Rehabilitation training plus acupuncture at thirteen ghost acupoints can significantly improve the intellectual, language and abnormal behavior in autism spectrum disorder children.
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@#Objective To analyze the cost-effectiveness of hospital rehabilitation and hospital-family rehabilitation in children with cere-bral palsy. Methods From January to December, 2016, 60 cases of children aged one to three years with cerebral palsy were divided into hospital rehabilitation group and hospital-family rehabilitation group, with 30 cases in each group. The hospital rehabilitation group received rehabilitation of traditional Chinese and Western medicine treatment, including exercise therapy, physical therapy and Chinese Medical ther-apy; while the hospital-family rehabilitation group received family rehabilitation. The Gross Motor Function Measure (GMFM) and Pea-body Developmental Motor Scale-fine Motor (PDMS-FM) were used to evaluate the motor function and fine motor function before and af-ter treatment. Results The GMFM score was higher (t=5.333, P<0.001), and the total medical cost was higher (t=23.614, P<0.001) in the hospital rehabilitation group than in the hospital-family rehabilitation group. However, the cost of medical care was significantly lower for every 1-point increase in GMFM and visual-motion integration of PDMS-FM in the hospital rehabilitation group than in the hospital-family rehabilitation group (t>2.065, P<0.05). Conclusion The hospital rehabilitation model may be a more economical and effective treatment for younger age children with cerebral palsy, and the hospital-family rehabilitation model could be used as an effective complementary rehabili-tation model for this age group.
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Objective:To observe the clinical efficacy of needling thirteen ghost acupoints for children with autism spectrum disorder. Methods:A total of 90 cases with autism spectrum disorder (ASD) aged between 2 and 6 years were randomly allocated into 2 groups by random number table. The control group (n=45) received routine rehabilitative training, and the treatment group (n=45) received acupuncture at thirteen ghost acupoints plus routine rehabilitative training. The Beijing Gesell developmental (Gesell) scale and autism behavior checklist (ABC) were used to assess the intellectual, language and behavior development before and 3 months after the treatment. Results:After the treatment, the total effective rate in the treatment group was 82.2%, versus 55.6% in the control group, showing a statistical significance (P<0.05). As for the scores of social, emotional and language in Gesell scale, there were significant intra-group differences in the treatment group (allP<0.05), and all the five subscales in the Gesell scale in the treatment group were significantly better than those in the control group (allP<0.05). As for the scores of ABC, there were significant intra-group differences in the treatment group (P<0.05), and the scores in the treatment group were significantly better than those in the control group (allP<0.05). Conclusion: Rehabilitation training plus acupuncture at thirteen ghost acupoints can significantly improve the intellectual, language and abnormal behavior in autism spectrum disorder children.
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Objective To explore the effect of Jian Zu San Zhen acupuncture on tip foot in children with spastic cerebral palsy. Methods From January to December, 2016, 120 children with spastic cerebral palsy aged one to six years were randomly divided into control group (n=60) and observation group (n=60). Both groups were treated with conventional rehabilitation, while the observation group added Jian Zu San Zhen acupuncture. They were evaluated with Gross Motor Function Measure (GMFM), foot dorsiflexion angle and surface electromyog-raphy. Results After treatment, the scores of GMFM in B, C, D and E dimensions and the total score significantly increased in the observa-tion group (t>4.325, P<0.001), and were higher than that of the control group (t>2.711, P<0.01);the foot dorsiflexion angle significantly de-creased in the observation group (t=17.627, P<0.001), and was significantly less than that of the control group (t=15.416, P<0.001). The root mean square (RMS) of surface electromyography of gastrocnemius muscle under active plantarflexion and passive dorsiflexion of ankle joint improved after treatment (t≥3.058, P<0.01), and was better in the observation group than in the control group (t=-2.199, P<0.05). Conclusion Jian Zu San Zhen acupuncture can effectively reduce the gastrocnemius muscle tension, and do not reduce the gastrocnemius muscle strength, which could also improve the ability of foot flexion, and facilitate to recover the function of standing and moving.
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Objective To evaluate the clinical curative effect of applying the modified Xiaojing Decoction, an experienced recipe prescribed by Professor LIU Zhen-Huan, for the treatment of attention deficit hyperactivity disorder(ADHD)children with liver-kidney yin deficiency by using the Swanson,Nolan,and Pelham,VersionⅣ(SNAP-Ⅳ) rating scale. Methods By the methods of randomized controlled trial, 60 cases of ADHD children were randomly divided into Chinese medicine group and control group,30 cases in each group. Chinese medicine group was treated with Xiaojing Decoction orally, and the control group was given Methylphenidate Tablets orally. After treatment for 4 weeks, the scores of subscales of SNAP-Ⅳ rating scale and clinical remission rate of the two groups were compared. Results(1)After treatment for 4 weeks,the scores of attention-deficit subscale and hyperactivity-impulsivity subscale of the two groups were much improved (P<0.01 compared with those before treatment),and the improvement in Chinese medicine group was superior to that in the control group(P<0.05).(2)Clinical remission rate of Chinese medicine group arrived to 60.0%,and that of the control group was 33.3%,the difference being significant(P < 0.05). Conclusion The modified Xiaojing Decoction,an experienced recipe prescribed by Professor LIU Zhen-Huan,exerts certain therapeutic effect for the treatment of ADHD children with liver-kidney yin deficiency.
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Objective To explore the effect of Jian Zu San Zhen acupuncture on tip foot in children with spastic cerebral palsy. Methods From January to December, 2016, 120 children with spastic cerebral palsy aged one to six years were randomly divided into control group (n=60) and observation group (n=60). Both groups were treated with conventional rehabilitation, while the observation group added Jian Zu San Zhen acupuncture. They were evaluated with Gross Motor Function Measure (GMFM), foot dorsiflexion angle and surface electromyog-raphy. Results After treatment, the scores of GMFM in B, C, D and E dimensions and the total score significantly increased in the observa-tion group (t>4.325, P<0.001), and were higher than that of the control group (t>2.711, P<0.01);the foot dorsiflexion angle significantly de-creased in the observation group (t=17.627, P<0.001), and was significantly less than that of the control group (t=15.416, P<0.001). The root mean square (RMS) of surface electromyography of gastrocnemius muscle under active plantarflexion and passive dorsiflexion of ankle joint improved after treatment (t≥3.058, P<0.01), and was better in the observation group than in the control group (t=-2.199, P<0.05). Conclusion Jian Zu San Zhen acupuncture can effectively reduce the gastrocnemius muscle tension, and do not reduce the gastrocnemius muscle strength, which could also improve the ability of foot flexion, and facilitate to recover the function of standing and moving.