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Objective:To investigate the preschool period neurodevelopmental status and analyze the perioperative data which associated with delayed neurodevelopment in patients underwent antergrade cerebral perfusion(ACP).Methods:To access the preschool period neurodevelopmental status in patients underwent ACP using Griffiths mental development scale-Chinese(GDS-C). Patients were classified as normal development group(ND) and low development group(LD) depending on the outcomes of assessment. Perioperative data including age, weight, CPB time, aortic cross-clamp time, mean arterial pressure, ACP time and flow were analyzed retrospectively.Results:62 children who met the inclusion criteria, of which 19 were accessed by GDS-C scale. Fourteen cases were lagged in general quotient(GQ) compared with normal children. The outcomes of assessment in six subscales of GDS-C scale indicated that 13 cases were delayed in language(C) and practical reasoning(F). Eight cases were delayed in locomotor(A) and personal-social(B). Eleven cases were delayed in eye-hand coordination(D). Ten cases were delayed in performance(E). The children in LD group had significant longer CPB time and aortic cross-clamp time than those in ND group. There were no differences between two groups in other perioperative data.Conclusion:The incidence of preschool period neurodevelopmental delay after ACP in infants is relatively high. In detailed analysis, their language and practical reasoning ability are lagged significantly. In addition, the longer time of CPB and aortic cross-clamp are associated with the neurodevelopmental delay.
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Objective:To explore the value of congenital muscular torticollis severity classification scores (CMT-SCSTs) in the diagnosis and prognosis of infants′ congenital muscular torticollis (CMT).Methods:A total of 89 CMT children were examined using ultrasound to determine the size of the affected side and the contralateral sternocleidomastoid mass or the abnormal area of the muscle fringe echo from the head and neck. They were also rated using CMT-SCST scoring. They were then given 15 minutes of massage once a day and 5 minutes postural correction twice a day for 3 to 6 months. They were reviewed using ultrasound and the CMT-SCST 3 and 6 months later.Results:The number of treatments was negatively correlated with the initial CMT-SCST score. For those with a baseline CMT-SCST score ≥7 it was effective after 3 and 6 months. Those with a baseline CMT-SCST score ≥9 were almost cured after 3 and 6 months. Gender, age, signs of hip dysplasia, and comorbid global developmental delay (GDD) were not consistently related to the severity and the outcome of CMT. The CMT-SCST was more sensitive in prognosis than the CMT-SCS published in 2013.Conclusions:CMT-SCST scoring provides a theoretical foundation for the diagnosis and treatment and evaluation of infants with CMT. It deserves wider popularity and application in clinical practice.
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Objective To observe the effect of free muscle localization and ultrasound-guided injection of botulinum toxin type A (BTX-A) combined with rehabilitation training on lower limb spasm of cerebral palsy children.Methods Sixty-one cerebral palsy children with lower limb spasticity were randomly divided into a manual localizing group (31 cases) and an ultrasound-guided group (30 cases).The children of both groups underwent BTX-A injection at adductors,hamstrings and calf triceps.The former group was injected with bare hands,while the latter was injected under the guidance of ultrasound.Both groups were administered with rehabilitation training from the 3rd day onwards after injection.Before and 12 weeks after the injection,the modified Ashworth scale (MAS) and gross motor function scale (GMFM) were used to evaluate the lower limb spasticity and function in 2 groups.Results Before the injection,there was no significant difference between the 2 groups in terms of MAS and GMFM scores (P ＞ 0.05).However,12 weeks after the injection,the average MAS scores of the two groups decreased,and that of the ultrasound-guided injection group (1.43 ±0.50) was significantly lower than that of the manual localizing group (1.77 ± 0.56).After the injection,the average GMFM scores of both groups increased,and that of the ultrasound-guided injection group was significantly higher than the manual localizing group (67.10 ± 11.25).Conclusion Ultrasound-guided injection of BTX-A with intensive rehabilitation training can significantly reduce the lower limb spasticity in children with cerebral palsy,and increase their motion of joint and motor function,and improve their posture and gait.
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Objective To observe the effect of ultrasound-guided injection of botulinum toxin type A (BTX-A) combined with orthosis training for the treatment of lower limb spasticity for children with cerebral palsy.Methods Fifty-four patients with spastic cerebral palsy were randomly divided into an observation group and a control group using a random number table.Patients in the control group were given conventional rehabilitation training,while those in the observation group were additionally given ultrasound-guided BTX-A injection,followed by daily knee-ankle-foot orthosis rehabilitation training 24 h after the injection.Before and 6 weeks after treatment the lower limb function of the 2 groups was evaluated using the modified Ashworth scale (MAS) and the gross motor function measure (GMFM).Adductor angles,popliteal angles and motor ranges of the ankle joint were also measured and compared.Results After 6 weeks the average MAS scores were lower than before treatment in both observation[(1.26±0.63) vs (3.07±0.68)] and control group [(2.56±0.71) vs (2.89±0.64).And in both groups the average GMFM scores,adductor angles and popliteal angles,as well as range of motion of the ankle were all much better than before treatment.The observation group,however,improved significantly more than the control group(P ＜ 0.05).Conclusion Ultrasound-guided injection of BTX-A can effectively alleviate spasticity of lower extremity for children with cerebral palsy with accurate positioning,obvious curative effect and less adverse reactions.Knee-ankle-foot orthosis rehabilitation training after the injection can further alleviate spasticity and improve the motor function of the limbs.
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AIM: Studying the mechanism of protective role of metallothionein (MT) in hypoxic preconditioning(HPC) of cultivated rat cardiomyocytes. METHODS: Using the model of hypoxia/reoxygenation of cultivated rat cardiomyocytes. Determing the contents of MT, malonyldialdehyde (MDA) - metabolism product of lipid peroxidation and the activities of Na+ - K+ ATPase, Ca2+ - Mg2+ ATPase of cardiomyocytes 24 h after HPC, the determining the relevant changes after using MT antibody. RESULTS: After 24 h in HPC, the contents of MT and activities of Na+ - K+ ATPase, Ca2+ - Mg2+ ATPase were obviously higher than those in the control and hypoxia/reoxygenation(P＜ 0. 05 ), and the contents of MDA were decreased remarkedly (P ＜ 0.01 ). Then after using MT antibody, the activities of two enzyme were progressively decreased and the contents of MDA were significanily higher than those in the control and MT antibody - free groups(P ＜ 0.01 ). CONCLUSION: HPC may induce excessive synthesis of MT, and MT can protect myocardial reoxygenation injury by eliminating lipid peroxidation and rising the activities of Na+ - K+ ATPase and Ca2+ - Mg2+ ATPase.