Effect of intervention treatment from different stages on prognosis in children with central coordination disturbance

BACKGROUND： Central coordination disturbance is regarded as the early-stage symptom of brain injury-induced cerebral palsy. This disease manifests itself as motor disorder, abnormal attitudinal reflex and muscular tension. Early intervention may improve its prognosis. OBJECTIVE： To observe the effects of intervention treatment from different stages on the prognosis of central coordination disturbance following brain injury in children patients. DESIGN： A contrast observation experiment SETTING： Department of Neurology and Rehabilitation, Urumqi Children＇s Hospital PARTICIPANTS ： Totally 151 children who were diagnosed as central coordination disturbance from January 2002 to December 2003 in the Department of Neurology and Rehabilitation of Urumqi Children＇s Hospital were recruited. All the children patients, including 101 male and 50 female, aged from 3 months to 1 year old, met the diagnosis criteria of central coordination disturbance from Vojta. They were divided into slight, moderate and severe abnormity according to Vojta attitudinal reflex. All 151 patients were divided into 2 groups according to their age at diagnosis： 3-6 months old group （n=74）, 62 severe, 10 moderate and 2 slight; 7-12 months old group （n=77）, 66 severe, 7 moderate and 4 slight. All the relatives of children patients were informed of the experiment. METHODS： ① Both groups received physical training （PT） as the main treatment; Hand training was given if necessary. All of the patients received additional hyperbaric oxygen therapy, bioelectric therapy, scalp acupuncture, drug treatment and family training. The importance of integration of hospital and family based rehabilitation was stressed. Those who did not catch up with the normal development or had abnormal reflexes continued to receive treatment. ② Around the age of 2 years old, all children did a final evaluation using Bayley Scales of Infant Development （BSID）. Mental development index （MDI） and physical development index （PDI） were taken as evaluative criteria. Children with scores 80 and above on MDI and PDI were considered to have normal motor and mental development; 79 and below were considered delayers. The Diagnostic Criteria of Cerebral Palsy and Infantecondary School Social Adaptation Scale were used in the final evaluation[scores ≤5 was extremely severe （extremely severe cerebral palsy）, 6 was severe（severe cerebral palsy）, 7 was moderate（moderate cerebral palsy）, 8 was slight（slight cerebral palsy）, 9 was borderline（slight cerebral palsy）, 10 was normal, 11 was above average, 12 was excellent and ≥13 was extremely excellent]. ③ Final evaluative results of 2 groups were compared. And u test was used for the comparison of Bayley development index and Chi-square test for the comparison of normalization rate. MAIN OUTCOME MEASURES： BSID MDI and PDI as well as the normalization rate of motor function and mental behavior of children patients at 2 years old. RESULTS： Totally 151 children patients entered the stage of result analysis. ①Two groups of children patients were given integrated rehabilitation therapy , and evaluated at 2 years old . The 3-6 months old group had higher MDI and PDI than the 7-12 months old group （91.81＋19.99 vs 71.93＋18.98;91.55＋23.61 vs 68.95＋23.51, u=6.265,5.894,P 〈 0.01 ）.②After being given integrated rehabilitation therapy, children patients of 3-6 months old group had significantly higher normalization rate of motor function and mental behavior than 7-12 months old group （73% ,27%,X2=29.723 9,P 〈 0.01 ）. ③Six slight and 17 moderate central coordination disturbance children of 2 groups all completely recovered; After intervention treatment, among 128 severe central coordination disturbance children, 52 recovered and 76 were still abnormal, in which, 43 slight cerebral palsy, 18 moderate cerebral palsy, 5 severe cerebral palsy and 10 extremely severe cerebral palsy. CONCLUSION： To perform integrated intervention treatment before 6 months old can better improve and promote mental and physical development levels of children patients with central coordination disturbance after brain injury than 6 months later.

The Study on the Clinical Features and Prognosis of Pregnancy-related Breast Cancer

Objective: To explore the clinical features ofpregnancy-related breast cancer and the related factorsaffecting the prognosis. Methods: The research workwas carried out in our hospital from January 2018 toJanuary 2019. In this study, 50 patients were selectedas related breast cancer patients and 50 non-pregnancyrelated breast cancer patients were selected as controlgroup. The clinical characteristics and prognosis ofthe two groups were compared and analyzed. Results:According to the incidence of pregnancy-related breastcancer, the onset of breast cancer is in pregnancy andlactation, with more than half of the total number ofpatients having two or more pregnancies and 74.0%of the patients having breast feeding history. In thetwo groups, most of the patients went to see a doctorbecause of palpable breast masses, and the averagemaximum diameter of tumors in PBC group was (5.13± 3.22)cm, including 5 cases accompanied by dimplesign, 7 cases accompanied by nipple depression, 8cases accompanied by inflammatory changes of skin,3 cases with pathological changes involving wholemilk, and 27 cases (54.00%) with palpable axillaryenlarged lymph nodes on the same side. The averagemaximum value of tumor in Non-PABC group was(3.94 ± 2.11) cm, with 5 cases accompanied by dimplesign, 4 cases accompanied by nipple depression, and 9cases (18.00%) with palpable axillary lymph nodes onthe same side. Conclusion: As far as pregnancy-relatedbreast cancer is concerned, the clinical misdiagnosisrate is relatively high and the prognosis is poor.Prenatal examination and breast-feeding breast cancerexamination are needed to ensure early detection anddiagnosis. This is the key factor to ensure the survivalrate of pregnancy-related breast cancer patients and haspositive significance for clinical development.