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Objective@#To evaluate the therapeutic effect of mouse nerve growth factor (mNGF) combined with conventional rehabilitation training on children with cerebral palsy (CP).@*Methods@#According to the inclusion criteria, 60 children with CP(spastic diplegia) who were treated at the Third Affiliated Hospital of Jiamusi University were selected by double-blind method from June to December in 2016.Sixty children with CP were stratified according to age, gender and Gross Motor Function Classification System (GMFCS) (the subjects were classified into 2 age groups: 0-2 years old and 2-4 years old), and then they were randomly divided by draw method: the control group received routine rehabilitation; the experimental group received mNGF additionally.The children with CP in the experimental group were treated with 18 μg mNGF every day for 10 days and then discontinued for 5 days, with 20 injections per month for 1 course, a total of 3 courses.After 3 courses of treatment, the changes in Gesell Development Diagnosis Schedules (GDDS), Peabody Developmental Motor Scales-Gross Motor (PDMS-GM), Peabody Developmental Motor Scales-Fine Motor (PDMS-FM) and Range of Motion (ROM) of the lower extremity were compared between the 2 groups.@*Results@#After 3 months of treatment, the changes of Gesell(gross motor: 57.40±18.13, 44.87±10.95; fine motor: 64.83±18.04, 62.60±17.34; adaptability: 76.07±14.99, 70.57±11.19; language: 74.20±15.07, 71.23±13.38, personal-social interaction: 67.40±14.10, 61.40±12.96), PDMS-GM(94.33±16.03, 81.13±20.15), PDMS-FM scores(91.53±19.73, 91.10±15.84) and ROM[adductors angle: left (69.67±22.2)°, (49.17±21.82)°; right (69.83±21.63)°, (49.67±21.61)°; popliteal angle: left (160.08±30.02)°, (125.50±25.78)°; right (160.17±22.46)°, (126.00±25.31)°; dorsal flexion angle of foot: left (10.17±6.09)°, (4.33±7.28)°; right (9.83±6.23)°, (4.83±7.48)°] in the experimental group and the control group were all significantly higher than those before treatment, and the differences were statistically significant (all P<0.05). After 3 months of treatment, the Gesell gross motor(57.40±18.13) and PDSM-GM scores(94.33±16.03) in the experimental group were significantly higher than those (44.87±10.95, 81.13±20.15, respectively) in the control group, and the differences were statistically significant (all P<0.05).@*Conclusions@#Conventional rehabilitation therapy combined with mNGF has more significant effect on the development and motor function of children with CP than routine rehabilitation training.
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Objective To explore the effects of hand-arm bimanual intensive training (HABIT) in group on functional independence and quality of life of children with hemiplegic cerebral palsy. Methods From November, 2015 to September, 2016, 20 children with hemiplegic cerebral palsy were randomly divided into control group (n=10) and experimental group (n=10). Both groups received routine occupational therapy, and the experimental group received HABIT in group one hour per day additionally, for eight weeks. They were assessed with the Carroll Upper Extremities Functional Test (UEFT), Functional Independence Measure Children's Edition (WeeFIM) and Chinese Version Pe-diatric Quality of Life Inventory (PedsQLTM) 3.0 Cerebral Palsy Module respectively before and after treatment. Results After treatment, the scores of UEFT, WeeFIM and the PedsQLTM3.0 improved in both groups (t>3.970, P2.306, P<0.05). Conclusion HABIT in group could improve the fine function of upper extremity and hands coordina-tion of children with hemiplegic cerebral palsy, and enhance the functional independence and quality of life.
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Objective To explore the optimal dose and ways of anesthesia for creating a rat model of spastic paralysis with intermittent bilateral common carotid artery ligation. Methods 60 Wistar rats were randomly divided into groups A, B, C, D, E and F. Group A was an-aesthetized with 10%chloral hydrate 5 ml/kg injected subcutaneously, while group B with 4 ml/kg subcutaneously, group C with 4 ml/kg in-traperitoneally, group D with 3 ml/kg subcutaneously, group E with 3 ml/kg intraperitoneally, group F with 2 ml/kg subcutaneously. The on-set and duration of anesthesia, and intraoperative and postoperative mortality were compared. Results All the rats in the group A died during anesthesia, while the group F did not achieve the depth of anesthesia, and abandoned. The onset time was (6.5±0.7) min, maintained (121.4± 3.9) min, mortality was 0 in the group B, and it was (5.5±1.1) min, (122.0±3.6) min, 30%in the group C;(9.6±0.8) min, (106.7±3.7) min, 0 in the group D, (7.4±1.2) min, (105.3±3.5) min, 20%in the group E. The overall mortality rate was 0 in the groups accepted subcutaneous in-jected and 25%of intraperitoneal injection. Conclusion Anesthesia with 10%chloral hydrate 4 ml/kg subcutaneous injection is optimal of lower mortality, faster onset and longer maintaining in rats for spastic paralysis model with intermittent bilateral common carotid artery liga-tion.
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@#Objective To investigate the DNA methylation of skeletal muscle in spastic paralysis rats and correlation with the muscle fiber configuration. Methods 100 5-day old Wistar rats were randomly divided into model group and control group. The former was established the spastic paralysis modle and reared for 30 days. Then, tissues from the gastrocnemius of all the rats were observed with triplicate DNA methylation, myosin heavy chain-I (MHC-I) mRNA with RT-PCR and transmission electron microscopy. Results The DNA methylation was (4.95±0.83)×10% in the model group, significantly less than (6.59±0.75)×10% in the control group (P<0.001); while the MHC-I mRNA was (1.23±0.31), significantly more than (0.44±0.29) in the control group (P<0.001). The Z-line was disordered, and the mitochondria near the Z-line increased, with edema and partially broken in cristae. The balance between the thick and thin filaments was broken, and myofibrils envelope fused. Conclusion Hypomethylation and hyperexpression of MHC-I mRNA have been found in skeletal muscle of spastic paralysis rats, which may result in type I fibers increase. However, there was no sufficient evidence to support the correlation between the DNA methylation and the secondary pathological changes.
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@#Objective To explore the optimal dose and ways of anesthesia for creating a rat model of spastic paralysis with intermittent bilateral common carotid artery ligation. Methods 60 Wistar rats were randomly divided into groups A, B, C, D, E and F. Group A was anaesthetized with 10% chloral hydrate 5 ml/kg injected subcutaneously, while group B with 4 ml/kg subcutaneously, group C with 4 ml/kg intraperitoneally, group D with 3 ml/kg subcutaneously, group E with 3 ml/kg intraperitoneally, group F with 2 ml/kg subcutaneously. The onset and duration of anesthesia, and intraoperative and postoperative mortality were compared. Results All the rats in the group A died during anesthesia, while the group F did not achieve the depth of anesthesia, and abandoned. The onset time was (6.5±0.7) min, maintained (121.4± 3.9) min, mortality was 0 in the group B, and it was (5.5±1.1) min, (122.0±3.6) min, 30% in the group C; (9.6±0.8) min, (106.7±3.7) min, 0 in the group D, (7.4±1.2) min, (105.3±3.5) min, 20% in the group E. The overall mortality rate was 0 in the groups accepted subcutaneous injected and 25% of intraperitoneal injection. Conclusion Anesthesia with 10% chloral hydrate 4 ml/kg subcutaneous injection is optimal of lower mortality, faster onset and longer maintaining in rats for spastic paralysis model with intermittent bilateral common carotid artery ligation.
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Objective To investigate the DNA methylation of skeletal muscle in spastic paralysis rats and correlation with the muscle fi-ber configuration. Methods 100 5-day old Wistar rats were randomly divided into model group and control group. The former was estab-lished the spastic paralysis modle and reared for 30 days. Then, tissues from the gastrocnemius of all the rats were observed with triplicate DNA methylation, myosin heavy chain-I (MHC-I) mRNA with RT-PCR and transmission electron microscopy. Results The DNA methyla-tion was (4.95 ± 0.83) × 10%in the model group, significantly less than (6.59 ± 0.75) × 10%in the control group (P<0.001);while the MHC-I mRNA was (1.23±0.31), significantly more than (0.44±0.29) in the control group (P<0.001). The Z-line was disordered, and the mitochon-dria near the Z-line increased, with edema and partially broken in cristae. The balance between the thick and thin filaments was broken, and myofibrils envelope fused. Conclusion Hypomethylation and hyperexpression of MHC-I mRNA have been found in skeletal muscle of spas-tic paralysis rats, which may result in type I fibers increase. However, there was no sufficient evidence to support the correlation between the DNA methylation and the secondary pathological changes.
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Objective To implement and evaluate evidence-based guidelines for enteral nutrition support in acute stroke patients with dysphagia.Methods This study is a prospective before and after comparison study.Collected 200 acute stroke patients with dysphagia and divided them into test group (trained medical staffs) and control group(untrained medical staffs) equally according to the time order.Two groups of 100 patients were surveyed using a checklist before and after implementation of 10 guidelines about nutrition support.Before the implementation of guidelines,the staffs were enforced training,and summarized regularly.Compliances with guidelines by doctors and nurses were compared,and outcomes of patients were assessed.Results Compared with the control group,the correct implementation of the project significantly improved in the experimental group on nutritional risk screening (92.0％,64.0％; x2 =22.840),nutritional supplements selection (80.0％,48.0％; x2 =22.220),nutrition infusion methods (90％,18％ ; x2 =1.040) and nutrition infusion adjustment (abdominal distension/adjusted:21/10,6/4;x2 =9.634,constipation/adjusted:41/40,57/53 ; x2 =5.122,all P ＜ 0.05).The mortality rate,poor prognosis and length of stay in department of neurology intensive care unit and in hospital were not significant different between the experimental group and the control group.The incidence of hospital-acquired pneumonia was significantly lower in the experimental group (44.3％) than that in the control group (67.5％,x2 =7.281,P =0.007),but other patient outcomes were unaffected significantly.Conclusion Implementation of evidence-based guidelines for enteral nutrition support in acute stroke patients with dysphagia is associated with improvements in clinical quality and selected patient outcomes.