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Chinese rehabilitation guidelines for cerebral palsy (2022) mainly refers to the international evidence-based medicine and relevant guidelines for rehabilitation of cerebral palsy in recent five years.On the basis of the Chinese rehabilitation guidelines for cerebral palsy (2015), combined with the medical literature and research achievements published at home and abroad before June 2022, the evidence-based practice guidelines are revised by combining the common opinions of pediatric rehabilitation experts in China.The content includes introduction, overview, the assessment and intervention guideline for infants at high risk of cerebral palsy, evaluation of children with cerebral palsy under ICF-CY framework, rehabilitation treatment, Traditional Chinese Medicine rehabilitation therapy, rehabilitation nursing, rehabilitation approaches and management.This article interprets the guide in combination with the hot spots of cerebral palsy prevention and treatment at home and abroad, in order to help pediatric rehabilitation workers deepen their understanding of the guidelines and better guide the clinical rehabilitation practice.
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Objective:To establish Sprague-Dawley (SD) rat models of cognitive impairment through repeated stimulation of lipopolysaccharide (LPS) in the early brain development, and to inquire into the effect of " multi-hits" mediated by inflammatory response on the histology and behavior of SD rat models and related molecular mechanisms.Methods:This study adopted a group design for experiments.The " multi-hits" SD rat models were established by intraperitoneal injection of LPS.According to the random number table method, 24 pregnant rats were randomly divided into 4 groups: control group, LPS1 group, LPS2 group and LPS3 group, 6 rats in each group.In the control group, saline was intraperitoneally injected into rats with gestational age of 18 days and 20-day-old neonatal rats.Rats with gestational age of 18 days were intraperitoneally injected with saline in the LPS1 group, 0.05 mg/kg LPS in the LPS2 group, and 0.1 mg/kg LPS in the LPS3 group.The pups in LPS1-3 groups were all injected intraperitoneally with 1 mg/kg LPS at the postnatal age of 20 days.The motor and cognitive function of the pups were evaluated overall by behavioral experiments such as forelimb suspension tests, grid tests and water maze tests.The relative expression of glial fibrillary acidic protein (GFAP), Notch1 and Jagged1 in brain tissue of pups was mainly detected by Western blot (WB) and histological experiments.One-way ANOVA analysis of variance and independent samples t- test were used to compare data among groups and between groups, respectively. Results:(1) Behavioral experiments: compared with the control group, LPS1-3 groups showed progressive decrease in forelimb suspension time [(34.81±5.66) s, (22.47±4.35) s, and (13.20±4.25) s vs.(43.88 ± 4.85) s], and the number of missteps in the grid experiment increased progressively (16.13±2.90, 20.75±3.10, 25.13±4.45 vs.9.00±2.72). The differences were statistically significant ( F=69.77, 35.59, all P<0.001). Both the escape latency and total distance in Morri′s water maze test increased progressively ( P<0.05). (2) WB experiment: the relative expression levels of GFAP, Notch1 and Jagged1 proteins in LPS1-3 groups were significantly higher than that in the control group ( P<0.05). (3) Hematoxylin-eosin (HE) staining and electron microscope pathology: compared with the control group, LPS1-3 groups had more loosely arranged frontal cortices and more obvious cell pyknosis.Under the electron microscope, the cytoplasm was swelling to varying degrees, mitochondrial cristae were broken, and part of the nuclear membrane was damaged. Conclusions:In the " multi-hits" cognitive impairment model, the damage to the brain tissue structure and behavioral changes of pups may be related to the up-regulation of Notch1/Jagged1 pathway mediated by repeated exposure to LPS.
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Objective:To analyze the microdeletion and microduplication characteristics of pathogenic copy number variations (pCNVs) and clinical phenotypes in children with neurodevelopmental disorders, and to clarify the genetic pathogenic cause of children with neurodevelopmental disorders.Methods:Children who were identified as neurodevelopment disorders such as global developmental delay and mental disorder, by next generation sequencing-based whole genomic copy number variation testing from January 2017 to November 2019 at the First Affiliated Hospital of Anhui Medical University were enrolled, and the clinical phenotypes and pCNVs were reviewed analyzed.Results:There were 36 pCNVs in total 31 children, consisting of 24 microdeletion segments (66.67%)and 12 microduplication segments (33.33%), with sizes ranging from 320.00 kb to 93.26 Mb (mean 11.33 Mb). pCNVs frequently occurred in chromosome 15 , chromosome 8 and chromosome X, there were 9 children with 9 pCNVs in chromosome 15(25.00%), 3 children with 5 pCNVs in chromosome 8(13.89%)and 3 children with 4 pCNVs in chromosome X(11.11%) .The mainly clinical manifestations were motor disorder (30 children, 96.77%), mental disorder (22 children, 70.97%), speech development delay(22 children, 70.97% )accompanied by the malformation(11 children, 35.48%), abnormal face(11 children, 35.48%) and epilepsy(8 children, 25.81%), multisystem abnormalities generally exist in one individual.Conclusion:This study demonstrates the clinical utility of whole genome CNVs testing in the genetic diagnosis of children with neurodevelopment disorders.Genetic pathogenesis of children with neurodevelopmental disorders can be revealed by the analysis of pCNVs.
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Interpretation of The International Statistical Classification of Diseases and Related Health Problems-11 published by World Health Organization(WHO) and The Diagnostic and Statistical Manual of Mental Disorders of Fifth published by American Psychological Association(APA), and reference of literature in recent 10 years.In order to be in agreement with international standards which used to classify the diagnosis of neurodevelopmental disorders in children and to provide a reference for clinical diagnosis.
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Objective@#To compare the efficacy of goal-activity-motor environment (GAME) therapy and neurodevelopmental therapy (NDT) in the early intervention of high-risk infants with cerebral palsy (IHRCP), and to provide scientific evidence-based medical basis for early intervention of IHRCP.@*Methods@#A total of 62 cases of IHRCP were enrolled in the Children′s Neurological Rehabilitation Center of the First Affiliated Hospital of Anhui Medi-cal University from June 2017 to December 2018.They were divided into GAME group (32 cases) and NDT group (30 cases) according to the admission order.Gross Motor Function Scale (GMFM), Fine Motor Function Measure (FMFM) and Gesell Development Scale (GDS) were used for detection and comparison.The differences among the gross motor, the fine motor score and the developmental quotient (DQ) between two groups before treatment, 9 months after treatment and 12 months after treatment, and the normalization rate and the incidence of cerebral palsy between the two groups at 12 months of age were compared.@*Results@#(1) Motor function was as follows: at 9 months[GAME: (32.63±15.83) scores, (30.03±15.88) scores], [NDT: (33.37±15.61) scores, (29.67±12.54) scores] and at 12 months[GAME: (40.56±15.79) scores, (36.31±14.98) scores], [NDT: (40.47±15.50) scores, (36.73±14.58) scores] after treatment, and GMFM and FMFM scores in GAME and NDT groups were significantly higher than those before treatment[GAME: (27.56±14.24) scores, (21.75±11.35) scores], [NDT: (26.93±14.96) scores, (21.30±10.67) scores], and the differences were significant (all P<0.01), but there was no significant difference between the 2 groups (all P> 0.05). (2) DQ had no significant difference in DQ between GAME group(63.59±10.83) and NDT group (61.59±7.96) before treatment (P>0.05). The total DQ at 9 months, 12 months, the total DQ of GAME group (73.67±12.00, 81.59±13.03) was significantly higher than that of NDT group (66.05±9.54, 75.17±1.92) (all P<0.05). Among them, the improvement of GAME in speech (79.84±16.56, 83.19±17.05) at 9 months and 12 months, and adaptive ability(78.63±16.37, 85.78±13.60) were significantly higher than that of NDT group(71.63±13.36, 72.53±12.77), (68.20±14.97, 77.43±12.10), and the differences were significant (all P<0.05). (3) Prognosis was as follows: at 12 months after treatment, 25 cases in GAME group and 23 cases in NDT group developed into normal children, there was no significant difference in the normalization rate between the 2 groups (P>0.05); the incidence of cerebral palsy was present in 6 cases in GAME group and 5 cases in NDT group, and there was no significant difference between the 2 groups (P>0.05).@*Conclusions@#GAME therapy and NDT had significant effects on both gross and fine exercise of IHRCP, and the efficacy of the two methods is similar.Both GAME therapy and NDT can equally promote IHRCP development into normal infants and reduce the incidence of cerebral palsy.
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Objective To compare the efficacy of goal_activity_motor environment( xAmE)therapy and neurodevelopmental therapy(NDT)in the early intervention of high_risk infants with cerebral palsy(IHRCP),and to provide scientific evidence_based medical basis for early intervention of IHRCP. Methods A total of 62 cases of IHRCP were enrolled in the Children＇s Neurological Rehabilitation Center of the First Affiliated Hospital of Anhui medi_cal University from June 2017 to December 2018. They were divided into xAmE group(32 cases)and NDT group(30 cases)according to the admission order. xross motor Function Scale(xmFm),Fine motor Function measure(FmFm) and xesell Development Scale(xDS)were used for detection and comparison. The differences among the gross motor, the fine motor score and the developmental quotient( D匝)between two groups before treatment,9 months after treat_ment and 12 months after treatment,and the normalization rate and the incidence of cerebral palsy between the two groups at 12 months of age were compared. Results ( 1 )motor function was as follows:at 9 months[ xAmE:(32. 63 ± 15. 83)scores,(30. 03 ± 15. 88)scores],[NDT:(33. 37 ± 15. 61)scores,(29. 67 ± 12. 54)scores]and at 12 months[xAmE:(40. 56 ± 15. 79)scores,(36. 31 ± 14. 98)scores],[NDT:(40. 47 ± 15. 50)scores,(36. 73 ± 14. 58)scores]after treatment,and xmFm and FmFm scores in xAmE and NDT groups were significantly higher than those before treatment[xAmE:(27. 56 ± 14. 24)scores,(21. 75 ± 11. 35)scores],[ NDT:(26. 93 ± 14. 96)scores, (21. 30 ± 10. 67)scores],and the differences were significant( all P<0. 01),but there was no significant difference between the 2 groups(all P> 0. 05).(2)D匝 had no significant difference in D匝 between xAmE group(63. 59 ± 10. 83)and NDT group(61. 59 ± 7. 96)before treatment(P>0. 05). The total D匝 at 9 months,12 months,the total D匝 of xAmE group(73. 67 ± 12. 00,81. 59 ± 13. 03)was significantly higher than that of NDT group(66. 05 ± 9. 54, 75. 17 ± 1. 92)(all P<0. 05). Among them,the improvement of xAmE in speech(79. 84 ± 16. 56,83. 19 ± 17. 05)at 9 months and 12 months,and adaptive ability(78. 63 ± 16. 37,85. 78 ± 13. 60)were significantly higher than that of NDT group(71. 63 ± 13. 36,72. 53 ± 12. 77),(68. 20 ± 14. 97,77. 43 ± 12. 10),and the differences were significant( all P<0. 05).(3)Prognosis was as follows:at 12 months after treatment,25 cases in xAmE group and 23 cases in NDT group developed into normal children,there was no significant difference in the normalization rate between the 2 groups( P>0. 05);the incidence of cerebral palsy was present in 6 cases in xAmE group and 5 cases in NDT group,and there was no significant difference between the 2 groups(P>0. 05). Conclusions xAmE therapy and NDT had significant effects on both gross and fine exercise of IHRCP,and the efficacy of the two methods is similar. Both xAmE therapy and NDT can equally promote IHRCP development into normal infants and reduce the incidence of cerebral palsy.
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Cerebral palsy or high risk of cerebral palsy can be diagnosed accurately and early using the clinical signs and symptoms of cerebral palsy,involves neuroimaging,standardized neurological and standardized motor assess-ments before 6 months' corrected age. When the clinical diagnosis is suspected but cannot be made with certainty,re-commend using the interim clinical diagnosis of high risk of cerebral palsy until a diagnosis is confirmed,because infant with cerebral palsy require and benefit from different early interventions. Before 5 months' corrected age,the most pre-dictive tools for detecting risk are term - age magnetic resonance imaging(MRI),the Prechtl Qualitative Assessment of General Movements(GMs),and the Hammersmith Infant Neurological Examination(HINE). After 5 months' corrected age,the most predictive tools for detecting risk are MRI,HINE and the Developmental Assessment of Young Children. Early diagnosis and early intervention can optimize infant motor and cognitive plasticity,prevent secondary complica-tions. Cerebral palsy - specific early intervention maximizes neuroplasticity and minimizes deleterious modifications to muscle and bone growth and development. Early interventions included Goals - Activity - Motor Enrichment,neurode-velopmental treatment(Bobath,Vojta),Conductive Education and Environmental enrichment. Infants with of cerebral palsy who receive early CIMT have better hand function,and infants with any type and topography of cerebral palsy who receive GAME have better motor and cognitive skills than those who receive usual care.
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The U. K.' National Institute for Health and Care Excellence (NICE)published the guideline:Cerebral palsy in under 25s:assessment and management in 2017,which emphasizes prenatal and maternity respiratory tract or genito - urinary infection and neonatal sepsis (particularly with a birth weight below 1. 5 kg)are two independent risk factors for cerebral palsy which are worthy of clinical attention. The brain magnetic resonance imaging (MRI)may assess and classify the etiology of cerebral palsy. Of all the children with congenital cerebral palsy,45％are long to cerebral white matter damaged,13％ basal ganglia or deep grey matter damaged,10％ congenital malforma-tion,and 7％ focal infarcts. The early symptoms of cerebral palsy,early identification of dangerous signals are described. The multidisciplinary optimized management is established to deal with difficulties in eating,drinking and swallowing,saliva control,speech,language and communication,pain,discomfort,depression,sleep disturbance,registe-ring and processing sensory information,mental health,nutritional status,comorbidities,medicare and adulthood transi-tion. Its core objective is to improve the social participation and individual function development of children with cere-bral palsy,and to provide information and multidisciplinary support systems for them.
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Objective Through modelling autism spectrum disorder(ASD) in condition of Poly-IC,to analyze the development,nervous pathological changes and behavior of rats in experiments,and to define whether the Sprague-Dawley(SD) rats are suitable for the study of ASD.Methods Ten SD rats were randomly divided in 2 groups with 5 rats in each group.The experimental group rats were injected intraperitoneally with 5 mg/kg Poly-IC at gestational day 12,while the rats in control group were injected intraperitoneally with 9 g/L normal saline at the gestational day 12.The body weight,eye-opening time,swimming performance,and conduct parallel water maze test,social communication ability test of each offspring were recorded,and the developmental state of rats and the existence of autism-like social behavior were evaluated.The alterations in hippocampus morphology of offspring rats were indirectly observed with immunofluorescence double standard dyeing.Results Compared with the control group,the weights of the experimental rats were lighter,opening-eye time was delayed,swimming score was lower,in each measurement point.The differences above all were significant(all P ＜0.05).The near-escape scores of experiment rats in social communication ability test were lower than those of rats in control group.The rats in the experimental group needed more time to get the Morris water maze platform,and the times of rightly run through the Morris water maze decreased significantly,and the differences were significant (all P ＜ 0.05).Pathological results revealed that the mineralocorticoid receptor (MR) average optical density value (0.061 3 ± 0.028 8) and the glucocorticoid receptor (GR) mean optical density value (0.041 9 ± 0.040 3) in hippocampal CA1 area of experiment rats were lower than those of the control group (MR:0.081 3 ±0.053 9;GR:0.061 2 ±0.043 6) (t =10.319,10.241;all P ＜0.05).There was no significant difference between MR/GR ratio(the ratio of MR and GR optical density value in the same vision area) in experimental group and in the control group.Conclusions The Poly-IC during early pregnancy can cause lag behind in motor development,harm the social communication ability,lose memory ability to learn,and develop ASD symptoms of SD rat,and these symptoms may be associated with abnormal expression of MR and GR on the hippo-camp cells surface.AS a consequence,early pregnant SD rats exposed to Poly-IC can be used for the establishment of the model of ASD which can provide a platform for the research of ASD.
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Objective To establish spastic cerebral palsy model of macaque by partial resection of motor cortex and explore its evaluation method.Methods Four individuals of 3-month-old macaques were divided into healthy control group and operation model group according to random number table.Partial resection of the motor cortex was carried out in operation model group,in which precentral gyrus cortex from above the right lateral cerebral fissure to the inter-hemicerebral fissure,together with the posterior-superior frontal gyrus (about 0.3 to 0.5 cm in front of the anterior median sulcus) cortex were removed with the depth of about 0.5 to 0.6 cm.After the operation,the continuous camera shooting was used to record whether left limb motor dysfunction and abnormal posture existed or not.Muscle tension was assessed by manual examination of muscle tone with reference to the modified Ashworth scale.The quantitative indexes of the two groups were detected by using the gross motor and fine motor assessment scale.9.4T magnetic resonance imaging (MRI) was used to detect the brain imaging changes.Results After operation,the macaque in the operation model group immediately showed left hemiparesis,left upper limb abnormal lifting,left lower limb paralysis,left limb claudication,and eating mainly relied on the right side of the body.After 6 weeks of operation,left limb activity of the operation model group was significantly lower than that of the healthy control group,and the gross motor scores and fine motor scores were significantly lower than those of the healthy control group(Friedman test:χ2=33.939,P<0.05;χ2=37.526,P<0.05).The macaque in the operation model group showed some symptoms that abnormal posture mainly tilted to the left for the rest,sitting in a corner of the monkey cage,left arm was put on the cage to maintain postural balance,and movement was left slightly inclined,which had simulated the typical clinical manifestations of human spastic hemiplegic cerebral palsy.Muscle tension was checked by hand,and the left limb paralysis and muscle tension decreased after operation in the model group,and the left muscle tension increased gradually after 5 weeks,and gradually increased to score 4 points and the score remained 3 after 10 weeks.Brain MRI of 3 weeks postoperatively suggested scar tissue formation after right motor cortex resection,which supported the pathological changes of the hemiplegic cerebral palsy models.Conclusions Through the partial resection of the motor cortex,the model of spastic cerebral palsy was established successfully.The results of behavioral evaluation and MRI showed that the model was consis-tent with spastic hemiplegia.
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Objective To discuss the main high-risk factors,clinical features and prognosis of global developmental delay(GDD),so as to provide effective basis for reducing incidence of children with GDD,early diagnosis,early intervention and improving prognosis.Methods One hundred and eighty-five cases of children with GDD,who were first diagnosed and treated in the Pediatric Neurology Rehabilitation Center,the First Affiliated Hospital of Anhui Medical University from October 2011 to September 2013,were included and high-risk factors,clinical features,and prognosis were analyzed.At the same time,the patients were followed up for 2 years and the children with abnormal development received continuous intervention and treatment during the follow-up.x2 test was used to compare high-risk factors and prognosis of different clinical features and Logistic regression models were selected to analyze high-risk factors influencing prognosis.Results In 185 cases with GDD,there were 119 children (64.3％) with motor and language developmental delay,which were the most common features,and followed by types of motor combined cognitive and language developmental delay which make up 30 cases (16.2％) and cognitive merged language developmental delay which make up 22 cases (11.9％) and the rarest type of 14 cases (7.6％) was motor and cognitive developmental delay.The main high-risk factors included neonatal asphyxia,premature birth,pathologic jaundice,intrauterine growth retardation,intrauterine hypoxia,neonatal hypoxic-ischemic encephalopathy (HIE),neonatal infection and pregnancy-induced hypertension syndrome and the differences of various clinical features with premature birth,intrauterine growth retardation,pathologic jaundice were statistically significant.Up to 2 years of follow-up,40 cases (21.6％) turned normal,but 145 children (78.4％) were still abnormal,including 97 children (52.5％) having significantly improved after intervention,30 cases(16.2％)of intellectual developmental disorder and 18 cases (9.7％) of cerebral palsy.The differences in various clinical features showed statistically significance (x2=60.960,P=0.017).The main high-risk factors affecting prognosis were intrauterine growth retardation [β=0.777,odds ratio (OR)=2.174],intrauterine hypoxia (β=0.706,OR=2.026),HIE(β=0.547,OR=1.729) and neonatal asphyxia (β=0.070,OR =1.073).Conclusion Causes of GDD are complex and prognosis is poor and the etiology and prognosis of children with different clinical features are also different.It is important to enhance perinatal care,early diagnosis and intervention for reducing the incidence of GDD and improving prognosis.
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Objective To establish the newborn rhesus monkey model of hemolytic hyperbilirnbinemia and provide an experimental basic model for research of hyperbilirubinemia.Methods Sixteen 3-day old newborn rhesus monkeys were divided into experimental group and control group,with 8 newborn rhesus monkeys in each group.Eight newborn rhesus monkeys in experimental group were treated with intravenous injection of l0 g/L phenylhydrazine hydrochloride (50 mg/kg) to establish model of homolytic hyperbilirubinemia.The newborn rhesus monkeys in control group were treated with intravenous injection of 9 g/L saline at the same time.Twenty-four hours and 48 hours after the experimental treatment,the bilirubin in blood was detected to evaluate the models,and the clinical manifestations of newborn rhesus monkeys with hyperbilirubinemia were recorded by using monitoring equipment.The brain slices were made to evaluate the model in 1 dead monkeys of experimental group.Results The newborn rhesus monkey of experimental group showed obvious skin,sclera jaundice and hemoglobinuria.The serum total bilirubin [(252.76 ± 63.42) μmol/L],unconjugated bilirubin[(165.85 ±44.93) pmol/L] and conjugated bilirubin [(87.16 ±21.22) μmol/L] in the experimental group were significantly higher than those [(20.62 ± 5.72) μmol/L,(7.93 ± 2.31) μmol/L,(12.51 ± 3.53) μmol/L] in the control group,and the differences were statistically significant (t =14.581,13.881,14.040,all P ＜ 0.01).The level of hemoglobin [(47.18 ± 10.09) μmol/L] in the experimental group was significantly lower than that of the control group [(136.85 ± 13.48) μmol/L],and the difference was statistically significant (t =-21.308,P ＜ 0.01).The results of pathological showed brain edema,rupture and eosinophilic and bilirubin deposition in the basal nuclei,and necrosis appeared in some severe parts.And there were different degrees of retardation and coordination disorders in the experimental group(s) newborn rhesus monkeys,but gradually returned to normal in 4 months later.Conclusion Intravenous injection of phenylhydrazine hydrochloride can be used to produce newborn rhesus monkey models of hemolytic hyperbilirubinemia.
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Objective To establish the Valproate (VPA) exposure-induced autism spectrum disorder (ASD) model at early pregnancy in rats,and to study the changes of social interaction test and neuroimmune system in autism model rats,and discuss the pathogenic mechanism.Methods Twelve-week-old rats were randomly divided into the non-exposed group (n =10) and the VPA-exposed group (n =10).Their babies were respectively just the normal control group (n =10) and the model group (n =10).The autism-like social behavior was evaluated via the social interaction test.The level of interleukin (IL)-1β,IL-4,IL-6,interferon-gamma (IFN-γ),transforming growth factor-beta (TGF-β) in mothers and offspring were detected by using enzyme-linked immunosorbent assay (ELISA).The histopathological damage in brain was observed with immunohistochemical staining.Results The score of social interaction test in the model group [(-163.16 ± 101.92) scores]was lower than that in the normal control group [(132.73 ± 114.63) scores] (t =-6.100,P ＜ 0.05).The levels of IL-1β,IL-4,IL-6,IFN-γ in VPA-exposed group were higher than those in the non-exposed group (t =5.883,6.394,5.655,5.393,all P ＜ 0.05),while the level of TGF-β was lower than that in the non-exposed group (t =-6.726,P ＜ 0.05).The levels of IL-1β,IL-4,IL-6,IFN-γ in the model group were higher than those in the normal control group(t =3.058,3.048,6.670,5.486,all P ＜ 0.05),while the level of TGF-β was lower than that in the normal control group (t =-6.516,P ＜ 0.05).The change trend of the level of cytokines in the serum of ASD model rats was similar to the change trend of the level of cytokines in the serum of VPA exposed rats.The result of social interaction test the approach-avoidance score was inversely correlated with the levels of IL-1β and IL-4 (r =-0.802,-0.781,all P ＜ 0.05).The result of immunohistochemical staining showed the expressions of glial fibrillary acidic protein (GFAP) and ionized calcium-binding adapter molecule 1 (IBA1) in the model group were higher than those in the normal control group.Conclusions The main neuroimmunological pathogenesis mechanism can be explained as follows:at early pregnancy,the maternal cytokines skewing influenced by VPA exposure can make immune activation,induce immune system dysfunction and affect the brain growth and development,which result in autism-like behavior in offspring.
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Therearemanywaystoestablishanimalmodelsofneonatalhyperbilirubinemia,suchasintraperitoneal or intravenous injection , genetic defect animal models , the use of chemical drugs , and injection of bilirubin into cerebellomedullary cistern , and so on . In order to study the etiology , pathogenesis , and therapy of neonatal hyperbilirubinemia through animal models , we review the literature on rodent and primate models of neonatal hyperbilirubinemia ,including establishment of models and their applications , in order to provide reference for the research of neonatal hyperbilirubinemia .
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Objective To establish and evaluate a reliable and highly reproducible neonatal rat model of hyper-bilirubinemia and to provide an experimental basis for research of kernicterus and related mechanism of neuroinjury.Meth-ods Sixty 7-day old SD rats (28 male and 32 female) were used in this study.Three doses of phenylhydrazine hydrochlo-ride (25, 50, and 75 mg/kg) were intraperitoneally injected respectively to the neonatal rats to establish models of hyper-bilirubinemia induced by hemolysis.The control group was set up at the same time.48 hours after the experimental treat-ment, the bilirubin in blood and brain tissue, neuron-specific enolase (NSE) of brain tissue, and hemoglobin were detec-ted to evaluate the models.Results Compared with the control group, the bilirubin in the blood and brain tissue and the brain tissue NSE in the three experimental groups were significantly higher than that in the control group (P0.05).Conclusions Intraperitoneal injection of phenylhydrazine hydrochloride can be used to produce neonatal rat mod-els of hyperbilirubinemia, mimicking the clinical features of this disease, and 50 mg/kg of phenylhydrazine hydrochloride is the best concentration.It is an ideal method to establish newborn rat models of hyperbilirubinemia.
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Objective To study the influence of pregnant rats' prenatal chronic stress (PS) on learning and memory of their offspring rats and its possible molecular mechanisms.Methods Pregnant females were individually restrained for 45 min 3 times a day during pregnancy from day 14 to day 21.Control pregnant females were left undisturbed in their home cages.The rat offsprings were randomly assigned to PS group or control group.Males and females were kept for the study separately.The learning and memory of the developing rat offspring in the Morris water maze were examined.The basal levels of corticosterone (COR) and adreno-cortico-tropic-hormone (ACTH) were analyzed by using radioimmunoassay.The Golgi-Cox impregnation technique was used to compare density and morphology of the CA1 hippocampal dendritic spines.Results The escape latency (EL) to find the platform in the control group was significantly less than that in the PS group in female rat offspring (F =4.533,P ＜ 0.05),and the difference was statistically significant on the 5th day (t =2.788,P ＜ 0.01).EL to find the platform in the control group was significantly less than that in the PS group in male rat offspring (F =6.101,P ＜0.05),and the difference was statistically significant on the second day (t =3.051,P ＜ 0.01).In the space exploration experiments of the water maze,the retention time observed for the control group and the PS group in the goal quadrant was similar(P ＞ 0.05).The basal levels of the serum COR in the PS group were higher than those in the control group of female rat offspring(t =3.658,P ＜ 0.01) and the basal levels of the serum ACTH in the PS group were higher than those in the control group of male rat offsprings(t =2.319,P ＜ 0.05).A simplified pattern was observed in the CA1 hippocampal dendritic spines in the PS group,showing a less extent of dendritic arborization and the density was significantly lower than that in the control group(t =-3.072,P ＜ 0.01).Conclusions Altered function of the hypothalamic-pituitary-adrenal axis in the offspring mediates the cognitive alterations observed following prenatal stress should to be associated with the lower density and simplified pattern of CA1 dendritic spines.
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Diffusion tensor imaging(DTI) is a magnetic resonance imaging technique widely used in clinical experiences without invasion.It's the only technique to display the tacts of the white matter in viva,and it can exhibit the relationship between lesion in the brain and white matter.DTI plays a significant role in the research of brain development,maturation and aging,as well as in the diagnosis of various diseases of central nervous system.The application of DTI in the cerebral palsy was reviewed in this article.
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Objective To investigate the influence of primary cultured neonatal rat hippocampal neurons caused by human cytomegalovirus (HCMV AD169) infection on intracellular calcium and its mechanism.Methods Twenty SPF SD rats born within 24 hours(10 cases of male and 10 cases of female) were assigned to establish the primary rat hippocampal neuronal monolayer cells; After cultured 8 days in vitro,the eligible cells were randomly divided into HCMV infection group,HCMV + MK-801 group,MK-801 group and control group,with 10 wells in each group.The fluorescence intensity values of the intracellular free calcium were detected after 24 hours of treatment with Fluo-3AM fluorescence staining.Results Inoculation of HCMV neurons after 24 h turned to round and swollen gradually,and 4days later,most of the cells disappeared; by immunohistochemistry in cultures of hippocampal neurons in HCMV,visible early proteins,brownish yellow granules,hematoxylin were found after being stained with brown pigment.The fluorescence intensity values of neuronal intracellular calcium (215.5 ± 14.9) in HCMV group was higher than that of control group (116.4 ± 5.9) (t =15.2,P ＜ 0.01),whilerise,that in MK-801 group (88.1 ± 4.5) was significantly lower than that of control group,with decreased rate of (24.0 ± 6.7) ％ (t =-9.3,P ＜ 0.01).The fluorescence intensity values of neuronal intracellular calcium in HCMV + MK-801 group (135.5 ± 8.6) was significantly decreased compared with that of HCMV group (215.5 ± 14.9),with decreased rate of (37.0 ± 3.4) ％ (t =11.3,P ＜ 0.01).Conclusions Intracellular calcium overload of cultured rat hippocampal neurons in vitro with HCMV AD16 strains infection can be detected.One of its main mechanisms is the N-methyl-D-aspartic acid receptor channel-mediated calcium influx.
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Base on the definition,classification and diagnostic condition of cerebral palsy published by Pediatrics Neurology Group of Chinese Medical Association in 2005 and Child Rehabilitation Committee of Chinese Rehabilitation Medical Association in 2007.Referencing foreign diagnosis and treatment guidelines for child with cerebral palsy and the current paper report,going through more than once discussion,compiled by Chinese Compiling Committee of Rehabilitation and Treatment Guidelines for Cerebral Palsy so as to guide comprehension of the definition of cerebral palsy,enhance the level of diagnosis and classification of cerebral palsy for clinic doctor and all so acting on international convention.
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ObjectiveTo study the intelligence quotient(IQ) profile of the children with idiopathic generalized tonic-clonic seizure (GTCS) and the factors influencing IQ of them.MethodsAll 28 children with GTCS were selected who were aged 9 ～ 16 years in 20 GTCS families in a mountain area of the south of Anhui Province,all available healthy siblings of the children included in the epilepsy group,did not have epilepsy,and were nearest in age to the children with GTCS ( control group 1 ),and thirty children aged 9 ～ 16 years old who had lived in the same village ( control group 2) entered into our study.The IQ was studied of the three groups of children and the factors influencing IQ of children with GTCS at the same time.The data were input SPSS12.0 and analyzed.ResultsThe IQ of children with GTCS(85.64 ±20.57)was lower than that control group 1( 103.39 ± 11.17)and the control group 2 ( 106.17 ± 11.67).The difference between children with GTCS and the two control groups were significant for almost all the subtest quotients except completion of drawing and picture arrangement.No significant differences were found between the control group 1 and the control group 2 on the IQ and the subtest quotients.IQ scores of children with GTCS showed significant linear correlation with father's education( r=0.453,P＜0.01 ),age at onset of epilepsy( r=0.506,P＜0.01 ),duration of seizure disorder( r=-0.533,P＜0.0l ),status epilepticus( r=-0.732,P＜0.01),total number of seizures( r=-0.761,P＜0.01) and seizure frequency ( r=-0.708,P ＜ 0.01 ).ConclusionThe IQ scores of the children with idiopathic GTCS are lower significantly than general children population.Epilepsy-related variables affecting IQ scores of the children with idiopathic GTCS are duration of seizure disorder,status epilepticus,age at onset of epilepsy,total number of seizures,seizure frequency.