Play is a pleasurable physical or mental activity that enhances the child’s skills involving negotiation abilities,problem-solving,manual dexterity,sharing,decision-making,and working in a group.Play affects all the ...Play is a pleasurable physical or mental activity that enhances the child’s skills involving negotiation abilities,problem-solving,manual dexterity,sharing,decision-making,and working in a group.Play affects all the brain's areas,structures,and functions.Children with autism have adaptive behavior,adaptive response,and social interaction limitations.This review explores the different applications of play therapy in helping children with autism disorder.Play is usually significantly impaired in children with autism.Play therapy is mainly intended to help children to honor their unique mental abilities and developmental levels.The main aim of play therapy is to prevent or solve psychosocial difficulties and achieve optimal child-healthy growth and development.Play therapy helps children with autism to engage in play activities of their interest and choice to express themselves in the most comfortable ways.It changes their way of self-expression from unwanted behaviors to more non-injurious expressive behavior using toys or activities of their choice as their words.Play therapy also helps those children to experience feeling out various interaction styles.Every child with autism is unique and responds differently.Therefore,different types of intervention,like play therapy,could fit the differences in children with autism.Proper evaluation of the child is mandatory to evaluate which type fits the child more than the others.This narrative review revised the different types of play therapy that could fit children with autism in an evidence-based way.Despite weak evidence,play therapy still has potential benefits for patients and their families.展开更多
Objective: To evaluate the therapeutic efficacy of atomoxetine hydrochloride (ATX) combined with psychological-behavioral modification therapy for attention-deficit/hyperactivity disorder (ADHD) in children. Methods: ...Objective: To evaluate the therapeutic efficacy of atomoxetine hydrochloride (ATX) combined with psychological-behavioral modification therapy for attention-deficit/hyperactivity disorder (ADHD) in children. Methods: A total of 60 cases of ADHD children admitted to our hospital between November 2021 and November 2022 were selected and randomly grouped into Group I and Group II. There were 30 cases in Group I who were treated with ATX combined with psychological-behavioral modification therapy. There were 30 cases in Group II who were treated with ATX monotherapy, and the therapeutic effects were compared. Results: Before treatment, there was no difference in the behavioral problem scores and cognitive function indexes of the two groups (P>0.05). After treatment, the behavioral problem scores of Group I were lower than those of Group II, and the cognitive function indicators of Group I were lower than those of Group II (P < 0.05). The adverse reaction rate of Group I was lower than that of Group II, and the total effective rate was higher than that of Group II (P < 0.05). Conclusion: ATX combined with psychological-behavioral modification therapy improved the behavioral problems of ADHD children, enhanced their cognitive function, and reduced the adverse reactions to drug treatment.展开更多
Objective: To investigate the effect of VOJTA therapy on gross motor function in children with cerebral palsy. Methods: The 86 children with cerebral palsy were all from the First People’s Hospital of Jingzhou City f...Objective: To investigate the effect of VOJTA therapy on gross motor function in children with cerebral palsy. Methods: The 86 children with cerebral palsy were all from the First People’s Hospital of Jingzhou City from January 2023-December 2023, and were divided into the control group and the study group with 43 cases according to the principle of voluntariness. Results: In terms of total effective rate of treatment, the gross motor function scale-88 (GMFM-88) was used to evaluate the effective rate before and after treatment, and the effective rate of the study group was higher than that of the control group, and the difference was statistically significant, and the scores of gross motor items of GMFM-88 were better than those of the control group after treatment, and the difference was statistically significant (P 0.05). Conclusion: The application of VOJTA therapy in the treatment of children with cerebral palsy can not only promote the rehabilitation of gross motor function, but also help to improve the treatment effect, and the earlier the treatment, the better.展开更多
BACKGROUND Sensory integration intervention is highly related to the child's effective interaction with the environment and the child's development.Currently,various sensory integration interventions are being...BACKGROUND Sensory integration intervention is highly related to the child's effective interaction with the environment and the child's development.Currently,various sensory integration interventions are being applied,but research methodological problems are arising due to unsystematic protocols.This study aims to present the optimal intervention protocol by presenting scientific standards for sensory integration intervention through meta-analysis.AIM To prove the effectiveness of sensory integration therapy,examine the latest trend of sensory integration studies in Korea,and provide clinical evidence for sensory integration therapies.METHODS The database of Korean search engines,including RISS,KISS,and DBpia,was used to search for related literature published from 2001 to October 2020.The keywords,“Children”,“Sensory integration”,“Integrated sensory”,“Sensorymotor”,and“Sensory stimulation”were used in this search.Then,a meta-analysis was conducted on 24 selected studiesRISS,KISS,and DBpia,was used to search for related literature published from 2001 to October 2020.The keywords,“Children”,“Sensory integration”,“Integrated sensory”,“Sensorymotor”,and“Sensory stimulation”were used in this search.Then,a meta-analysis was conducted on 24 selected studies.RESULTS Sensory integration intervention has been proven effective in children with cerebral palsy,autism spectrum disorder,attention deficit/hyperactivity disorder,developmental disorder,and intellectual disability in relation to the diagnosis of children.Regarding sensory integration therapies,1:1 individual treatment with a therapist or a therapy session lasting for 40 min was most effective.In terms of dependent variables,sensory integration therapy effectively promoted social skills,adaptive behavior,sensory processing,and gross motor and fine motor skills.CONCLUSION The results of this study may be used as therapeutic evidence for sensory integration intervention in the clinical field of occupational therapy for children,and can help to present standards for sensory integration intervention protocols.展开更多
Research motivation:Through the 12 weeks dance therapy intervention for children with autism,the purpose is to explore the intervention model of dance therapy for children with autism and the changes in motor ability,...Research motivation:Through the 12 weeks dance therapy intervention for children with autism,the purpose is to explore the intervention model of dance therapy for children with autism and the changes in motor ability,social ability,and communication ability of children with autism after dance therapy intervention.The results of the research are expected to expand the intervention mode of dance therapy in my country and provide practical reference for rehabilitation intervention of children with autism.Research methods:24 autistic boys aged 6 to 12 with mild to moderate symptoms were recruited and screened through the Internet as the subjects of this study.We randomly divided them into experimental group(N=12)and control group(N=12).All children with autism have an autism diagnosis certificate issued by Children’s Hospital or a tertiary hospital,excluding other mental diseases(such as epilepsy,major physical disability,mental illness,no history of drugs and other interventions,etc.).We used the paired sample t-test to compare the score difference between the dance treatment group and the control group before and after the two groups,and used the observation method to record the basic communication behavior and the number of active communication behaviors in the experimental group during the intervention process.All data analysis is used in SPSS 20.0.Research results:After 12 weeks of dance therapy intervention,there were statistically significant differences in the gross movement,balance,and coordination abilities of the children in the experimental group compared with those before the intervention(p<0.01).There was no significant difference between the children in the control group(p>0.05).After 12 weeks of dance therapy intervention,there were statistically significant differences in the scores of the social response scale for children with autism in the experimental group(p<0.05).There was no significant change in the scores of each item of the SRS scale before and after intervention in the control group and the dance treatment group(p>0.05).展开更多
BACKGROUND Cognitive-behavioral therapy(CBT)and habit reversal training(HRT)have shown application potential in addressing tic symptoms and comorbid psychiatric conditions.Despite their theoretical potential,empirical...BACKGROUND Cognitive-behavioral therapy(CBT)and habit reversal training(HRT)have shown application potential in addressing tic symptoms and comorbid psychiatric conditions.Despite their theoretical potential,empirical evidence on their combined efficacy remains limited.AIM To evaluate the efficacy of CBT combined with HRT on anxiety disorders in children with Tourette’s syndrome(TS).METHODS Clinical data of children with TS admitted to our hospital from January 2022 to June 2023 were collected,and the patients were grouped into the conventional therapy(control)group and the CBT combined with HRT group.Baseline charac-teristics,anxiety scores,tic severity scores,treatment adherence,and parental satisfaction were assessed.Statistical analysis was performed using t-tests,chi-square tests,and correlation analysis.RESULTS A total of 136 patients,including 65 patients in the control group and 71 patients in the CBT combined with HRT group,were included.The CBT combined with HRT group showed remarkable improvements compared with the control group.Post-intervention assessment revealed a decrease in anxiety scores from 63.52±1.81 to 40.53±1.64(t=2.022,P=0.045),and the Yale Global Tic Severity Scale total score decreased from 22.14±5.67 to 16.28±4.91(t=2.288,P=0.024).Treatment adherence was significantly higher in the CBT combined with HRT group(85.47±7.62%)compared with the control group(82.32±6.54%;t=2.596,P=0.010).Parental satisfaction scores were also higher in the CBT combined with HRT group(8.69±1.77)compared with the control group(7.87±1.92;t=2.592,P=0.011).CONCLUSION This study demonstrates that CBT combined with HRT significantly reduces anxiety symptoms and tic severity in children with TS,with higher treatment adherence and parental satisfaction.These findings support the potential application of this comprehensive therapeutic approach for TS treatment.展开更多
This report presents a case study of sandplay therapy for a 3-year-11-month-old child with post-traumatic stress disorder. The child had experienced a distressing traumatic event and exhibited symptoms of anxiety, fea...This report presents a case study of sandplay therapy for a 3-year-11-month-old child with post-traumatic stress disorder. The child had experienced a distressing traumatic event and exhibited symptoms of anxiety, fear, and traumatic reenactment. Sandplay therapy, as a therapeutic modality, was utilized to provide a safe environment for the child to express and process their inner experiences. The case report provides a detailed account of the child’s presentation, treatment goals, therapeutic strategies, and treatment outcomes. Through sandplay therapy, the child achieved emotional release, resolution of internal conflicts, and a reframing of the traumatic event. Ultimately, a significant reduction in symptoms of post-traumatic stress disorder was observed, along with improved functioning and psychological well-being.展开更多
A healthy psychological state is the premise for children to carry out various activities.Previous surveys have shown that children with special needs are affected by their own obstacles and are more prone to psycholo...A healthy psychological state is the premise for children to carry out various activities.Previous surveys have shown that children with special needs are affected by their own obstacles and are more prone to psychological problems such as sensitivity,low self-esteem,and impulsiveness.Therefore,it is necessary to provide more sys-tematic mental health education support for special children.Mental health education programs are an efficient form of maintaining children’s mental health.However,in thefield of special education,the number of mental health education courses developed according to the physical and mental characteristics and developmental needs of special children is relatively small,and there are many difficulties in the implementation process.Autism dis-order(ASD)is a kind of pervasive developmental dysfunction that is relatively common and representative in clinical practice.In recent years,the number of autistic children has continued to surge,and has gradually expanded from a family problem to a serious social problem.At present,the evaluation of the effect of autism intervention mainly relies on various behavioral scales,which are subjective to a certain extent.At the same time,due to the unclear pathogenesis of autism,the treatment of autism cannot be predicated on the right medicine,and can only be intervened in various ways.The purpose of this paper is to explore the difference between the EEG signals of autistic children and typically developing control(TD)children through the analysis method of EEG signals,and based on the analysis of EEG signals from an objective point of view,to study whether the music therapy method of Chinese Zither playing training can effectively Improving the brain functional status of chil-dren with autism yields positive therapeutic outcomes.The experimental results show that the complexity of brain electrical signals of ASD children is much lower than that of TD children,and there is a significant difference in the brain functional state between the two.The music therapy method based on Chinese zither playing training can improve the brain function of autistic patients,and there is a positive therapeutic effect.And with the exten-sion of the training period,the effect may be more significant.Chinese zither playing training can provide a new direction for the intervention of autism.展开更多
Gastric cancer,a prevalent malignancy worldwide,ranks sixth in terms of frequency and third in fatality,causing over a million new cases and 769000 annual deaths.Predominant in Eastern Europe and Eastern Asia,risk fac...Gastric cancer,a prevalent malignancy worldwide,ranks sixth in terms of frequency and third in fatality,causing over a million new cases and 769000 annual deaths.Predominant in Eastern Europe and Eastern Asia,risk factors include family medical history,dietary habits,tobacco use,Helicobacter pylori,and Epstein-Barr virus infections.Unfortunately,gastric cancer is often diagnosed at an advanced stage,leading to a grim prognosis,with a 5-year overall survival rate below 5%.Surgical intervention,particularly with D2 Lymphadenectomy,is the mainstay for early-stage cases but offers limited success.For advanced cases,the National Comprehensive Cancer Network recommends chemotherapy,radiation,and targeted therapy.Emerging immunotherapy presents promise,especially for unresectable or metastatic cases,with strategies like immune checkpoint inhibitors,tumor vaccines,adoptive immunotherapy,and nonspecific immunomodulators.In this Editorial,with regards to the article“Advances and key focus areas in gastric cancer immunotherapy:A comprehensive scientometric and clinical trial review”,we address the advances in the field of immunotherapy in gastric cancer and its future prospects.展开更多
AIM:To report the myopia-controlling effect of repeated low-level red-light(RLRL)therapy in patients with Stickler syndrome(STL),an inherited collagenic disease typically presenting with early onset myopia.METHODS:Thr...AIM:To report the myopia-controlling effect of repeated low-level red-light(RLRL)therapy in patients with Stickler syndrome(STL),an inherited collagenic disease typically presenting with early onset myopia.METHODS:Three STL children,aged 3,7,and 11y,received RLRL therapy throughout the follow-up period of 17,3,and 6mo,respectively after exclusion of fundus anomalies.Data on best-corrected visual acuity(BCVA),intraocular pressure,cycloplegic subjective refraction,ocular biometrics,scanning laser ophthalmoscope,optical coherence tomography,genetic testing,systemic disease history,and family history were recorded.RESULTS:At the initiation of the RLRL therapy,the spherical equivalent(SE)of 6 eyes from 3 patients ranged from-3.75 to-20.38 D,axial length(AL)were from 23.88 to 30.68 mm,and BCVA were from 0.4 to 1.0(decimal notation).Myopia progression of all six eyes slowed down after RLRL therapy.AL in five out of the six eyes shortened-0.07 to-0.63 mm.No side effects were observed.CONCLUSION:Three cases of STL whose progression of myopic shift and AL elongation are successfully reduced and even reversed after RLRL therapy.展开更多
Introduction: Glomerular filtration is an important elimination pathway for many types of chemotherapy. Accurate estimation of glomerular filtration is essential in the management of children with cancer. Methodology:...Introduction: Glomerular filtration is an important elimination pathway for many types of chemotherapy. Accurate estimation of glomerular filtration is essential in the management of children with cancer. Methodology: This was a prospective cross-sectional study of the descriptive type extending over a period of 6 months from July 01 to December 31, 2021 on all children with cancer followed in the pediatric hemato-oncology unit of the HND with a renal, blood and urinary assessment associated with the GFR calculated by the SCHWARTZ formula during the study period. Results: During the study period, we registered 41 new cases of cancer in the pediatric oncology unit. The age group of 0 - 5 years was the most represented, i.e. 65.85% and the average age was 5.6 ± 4 years. The most cited clinical signs were fever ie 56.10% followed by abdominal pain 34.15% and anemia 26.83%. The most represented diagnosis was Burkitt’s Lymphoma, i.e. 26.83% followed by Retinoblastoma 24.39%. Mean serum creatinine was 70.65 ± 68.93 μmol/L. In our series, patients whose normal glomerular filtration rate were more represented, i.e. 70.73% and 29.27% had an abnormal GFR with an average of 87.28 ± 70 mL/min/1.73m<sup>2</sup>. Proteinuria and leukocyturia were observed in 31.71% and 19.51% respectively. Glycosuria and hematuria with common frequencies of 2.44% of patients. Conclusion: The prevention of renal toxicity of anticancer drugs always involves the precise evaluation of renal function using the Schwartz formula in children. .展开更多
Human immunodeficiency virus(HIV)is a serious public health concern.Globally,1.7 million(1.3–2.1 million)children aged 0–14 were living with HIV at the end of 2021,90%of whom lived in low-and middle-income countries...Human immunodeficiency virus(HIV)is a serious public health concern.Globally,1.7 million(1.3–2.1 million)children aged 0–14 were living with HIV at the end of 2021,90%of whom lived in low-and middle-income countries.Acquired Immune Deficiency Syndrome(AIDS)remains the leading cause of mortality among children worldwide.展开更多
Mental health conditions in children and adolescents can be improved by slow mindful nature connection known as forest therapyor bathing.Forest therapy has recently received growing attention as an enabler of relaxati...Mental health conditions in children and adolescents can be improved by slow mindful nature connection known as forest therapyor bathing.Forest therapy has recently received growing attention as an enabler of relaxation and preventive health care withdemonstrated clinical efficacy.However,it is not well-known that forest therapy also decreases mental health issues amongindividuals with mental health disorders.This study explored the psychological and physiological health benefits of structuredforest therapy programs for children and adolescents with mental health disorders.A one-group pre-test-posttest design wasemployed for our study participants.Twelve participants(aged 9–14 years)engaged in two one-hour guided standard sequenceforest therapy experiences.A Mindful Attention Awareness Scale(MAAS),Connectedness to Nature Scale(CNS),Profile ofMood States(POMS),place meanings(e.g.,functional,emotional,and cognitive attachment to the forest)questionnaire,andphysiological health assessment were administered to the participants.Our results showed that negative mood states weresignificantly reduced and that a positive mood state was significantly improved after the structured forest therapy programs.Also,mindfulness,nature connection,place meanings,and physiological health were significantly boosted after theinterventions.The results demonstrate substantial psychological and physiological health and well-being outcomes ofstructured forest therapy for similar individuals.展开更多
Pain and hospitalization caused a crisis in the child’s life. At the pre-school children, the stress of the disease makes children become less able to cope with separation. As a result, many children show anxious beh...Pain and hospitalization caused a crisis in the child’s life. At the pre-school children, the stress of the disease makes children become less able to cope with separation. As a result, many children show anxious behavior though more vague than toddler age children. Various ways have been conducted by nurses to treat anxiety in children, but the most effective types of the intervention have not be found. Types of intervention that can be done are art therapy and play therapy. This study aims to compare the effects of art therapy and play therapy in reducing anxiety on children who experience hospitalization. A quasi-experimental research design with pre-post test two group design is used. The sample was 23 children pre-school age for art therapy group and 25 children for play therapy with sampling techniques performed purposive sampling. Intervention of art therapy and play therapy each performed for 3 days with duration about 30 minutes. Anxiety levels before and after the intervention were measured by using the facial affective scale. The results show that there is a difference in anxiety between before and after the action in the art therapy group (p = 0.00) and that there are differences in anxiety before and after the action in the play therapy group (0.00). But statistical tests using Man Whitney U indicate that there is no difference in anxiety levels in pre-school children who do art therapy and play therapy (p = 0.26). So, it is concluded that the art therapy and the play therapy can reduce the level of anxiety on pre-school school children that experience hospitalization. Based on these conclusions, it is recommended that the art therapy and the play therapy can be used by nurses and the choice of the intervention should be submitted to the child.展开更多
BACKGROUND Undifferentiated embryonal sarcoma of the liver(UESL)is a rare and aggressive mesenchymal tumor in children.Herein,we describe our experience in neoadjuvant therapy(NAT)and subsequent surgery for the treatm...BACKGROUND Undifferentiated embryonal sarcoma of the liver(UESL)is a rare and aggressive mesenchymal tumor in children.Herein,we describe our experience in neoadjuvant therapy(NAT)and subsequent surgery for the treatment of UESL in children.AIM To evaluate the efficacy of NAT and explore a new choice for successful operation of UESL in children.METHODS We retrospectively analyzed six patients newly diagnosed with unresectable UESL who received NAT and then surgery at our center between January 2004 and December 2019.The tumor was considered unresectable if it involved a large part of both lobes of the liver or had invaded the main hepatic vessels or inferior vena cava.The NAT included preoperative transcatheter arterial chemoembol ization(TACE)and systemic chemotherapy.The patients were 4 boys and 2 girls with a mean age of 7 years.The longest tumor at presentation ranged from 8.6 to 14.8 cm(mean,12 cm).Extrahepatic metastases were present in 2 cases.Preoperative systemic chemotherapy was administered 3 wk after TACE.Tumor resection was performed 3 wk after one or two cycles of NAT.The patients received systemic chemotherapy after surgery.RESULTS All patients successfully underwent NAT and complete resection.The tumor volumes decreased by 18.2%–68.7%,with a mean decrease of 36%after 1 cycle of NAT(t=3.524,P=0.017).According to the Response Evaluation Criteria In Solid Tumors criteria,4 patients had a partial response and underwent surgery,while 2 had stable disease and received another cycle of NAT before surgery.Massive tumor necrosis was seen on pathological examination of the surgical specimen:>90%necrosis in two,>50%necrosis in three,and 25%necrosis in 1,with an average of 71.8%.Post-NAT complications included fever,nausea and vomiting,and mild bone marrow suppression.Elevated alanine transaminase levels occurred in all patients,which returned to normal within 7–10 d after treatment.No cardiac or renal toxicity,severe hepatic dysfunction,bleeding and nontarget embolization were observed in the patients.The median follow-up period was 8 years with an overall survival of 100%.CONCLUSION NAT effectively reduced tumor volume,cleared the tumor margin,and caused massive tumor necrosis.This may be a promising choice for successful surgery of UESL in children.展开更多
Immune checkpoint inhibitor therapy has dramatically improved patient prognosis,and thereby transformed the treatment in various cancer types including esophageal squamous cell carcinoma(ESCC)in the past decade.Monocl...Immune checkpoint inhibitor therapy has dramatically improved patient prognosis,and thereby transformed the treatment in various cancer types including esophageal squamous cell carcinoma(ESCC)in the past decade.Monoclonal antibodies that selectively inhibit programmed cell death-1(PD-1)activity has now become standard of care in the treatment of ESCC in metastatic settings,and has a high expectation to provide clinical benefit during perioperative period.Further,anti-cytotoxic T-lymphocyte–associated protein 4(CTLA-4)monoclonal antibody has also been approved in the treatment of recurrent/metastatic ESCC in combination with anti-PD-1 antibody.Well understanding of the existing evidence of immune-based treatments for ESCC,as well as recent clinical trials on various combinations with chemotherapy for different clinical settings including neoadjuvant,adjuvant,and metastatic diseases,may provide future prospects of ESCC treatment for better patient outcomes.展开更多
The aim of the study was to investigate the effect of a hydrotherapy program on FVC, FEV, PEF, RR and SaO<sub>2</sub> on children with Down syndrome over six months and to compare it with a conventional re...The aim of the study was to investigate the effect of a hydrotherapy program on FVC, FEV, PEF, RR and SaO<sub>2</sub> on children with Down syndrome over six months and to compare it with a conventional respiratory physiotherapy program. Eighteen children, with Down Syndrome, aged 6 - 11 years (9.53 ± 0.454), divided into two groups of nine, the intervention group (IG), that participated in the hydrotherapy program and the control group (CG) participated in the classical physiotherapy program. We calculated mean values of FVC, FEV, PEF, RR and SaO2 before and after six months intervention for both groups. There was a statistically significant improvement in all factors for both groups. However, were statistically more significant for the intervention group (IG). Based on a specific protocol of intervention in the water and at the same time with a group of children who participated in a similar program of classical respiratory physiotherapy, it was found to be statistically more important than the second group in improving respiratory function. We recommend the use of hydrotherapy as a complementary therapy that should be part of the weekly program of these children in addition to the existing treatments they attend.展开更多
AIM： To compare the efficacy and safety of five days apostrophe therapy of mebendazole （MBZ） versus quinacrine （QC） on human giardiasis in children.METHODS： A clinical trial was carried out in paediatric patien...AIM： To compare the efficacy and safety of five days apostrophe therapy of mebendazole （MBZ） versus quinacrine （QC） on human giardiasis in children.METHODS： A clinical trial was carried out in paediatric patients （aged 5-15 years） with confirmed symptomatic G. duodenalis mono-infection. Patients were randomly assigned to receive either MBZ [200 mg taken three times per day GRID） （n = 61）] or QC [2 mg/kg bodyweight tid （n = 61）], both for five days. Follow-up faecal samples were obtained at 3, 5 and 7 d after the end of the treatment.RESULTS： Although the frequency of cure was higher for QC （83.6%） than for MBZ （78.7%）, the difference was not statistically significant （P 〉 0.05）. Adverse events were reported more in the QC group （P 〈 0.05）, all of them transient and self-limiting.CONCLUSION： Despite final cure rates ocurring lower than expected, the overall results of this study reconfirmed the efficacy of MBZ in giardiasis and also indicate that, although comparable to QC, at least in this setting the 5 d course of MBZ did not appear to improve the cure rates in this intestinal parasitic infection.展开更多
Objective:In our investigation,we studied the patients with medulloblastoma who received 3-dimensional conformal radiation therapy(3DCRT) and recorded their effects,side effects and failure reasons.Methods:From August...Objective:In our investigation,we studied the patients with medulloblastoma who received 3-dimensional conformal radiation therapy(3DCRT) and recorded their effects,side effects and failure reasons.Methods:From August 2001 to August 2007,34 children with medulloblastoma were treated in our hospital.The age at diagnosis was 3-16 years old,and the mean age at diagnosis was 9.5 years old.Among all the patients,16 cases were included in the high risk group and 18 cases were included in the low risk group.All the patients were performed total resection or subtotal resection and no patients received radiotherapy or chemotherapy before operation.All patients received 3DCRT within 3 weeks after resection.The dose of 30 Gy were given to the whole brain and whole spine,followed by 20-25 Gy boosted to the posterior brain fossa.The median fraction dose was 180 cGy.Every patient received the chemotherapy scheme of the Lomustine,Cisplatinum and Vincristine.Nobody received intrathecal chemotherapy.The tests of the complete blood count,blood biochemistry,hepatic and renal functions were required before every cycle of chemotherapy.Results:5-year overall survival(OS) and 5-year disease free survival(DFS) were 71% and 62% respectively.The median follow-up time was 36.5 months.The 5-year OS of the high risk group was 71% compared to 62% of the low risk group.There were significant difference between the two groups(P = 0.01).There were 13 failure cases in all the patients.Of these 13 patients,10 were dead and the other 3 were alive with tumor.The complete remission(CR) rate was 70.5% and the partial remission(PR) rate was 14%.Among the failure patients,there were 3 patients(8.8%) with the recurrences located in the brain of cribriform region.The 5-year OS of the patients with preoperative metastases was 12.5%(1/8),and which of the patients with residual tumor volume > 1.5 cm3 was 0%(0/5).Through the statistic analysis,it was found that both whether or not the metastases were found before surgery and residual tumor volume have the significant impacts on the prognosis of the children with medulloblastoma(P < 0.05).The major adverse reactions were hematological toxicity(7/34,20.6%) and gastrointestinal reaction(4/34,11.8%).Conclusion:Through the using of 3DCRT for the children with medulloblastoma,the severe side effects rate was not high.The prognosis of the patients in low risk group was satisfied which was opposite to that of the patients in high risk group.And the patients with residual tumor volume > 1.5 cm3 and preoperative metastases also had poor prognosis.It is needed to pay attention to the possible low dose of the brain of cribriform region.展开更多
AIM To evaluate the control, survival, and hepatic function for Child Pugh(CP)-A patients after Stereotactic body radiotherapy(SBRT) in hepatocellular carcinoma(HCC).METHODS From 2009 to 2016, 40 patients with Barcelo...AIM To evaluate the control, survival, and hepatic function for Child Pugh(CP)-A patients after Stereotactic body radiotherapy(SBRT) in hepatocellular carcinoma(HCC).METHODS From 2009 to 2016, 40 patients with Barcelona Liver Clinic(BCLC) stages 0-B HCC and CP-A cirrhosis completed liver SBRT. The mean prescription dose was 45 Gy(40 to 50 Gy in 4-5 fractions). Local relapse, defined as recurrence within the planning target volume was assessed with intravenous multiphase contrast computed tomography or magnetic resonance imaging every 4-6 mo after completion of SBRT. Progression of cirrhosis was evaluated by CP and Model for End Stage Liver Disease scores every 3-4 mo. Toxicities were graded per the Common Terminology Criteria for Adverse Events(v4.03). Median follow-up was 24 mo.RESULTS Forty-nine HCC lesions among 40 patients were analyzed in this IRB approved retrospective study. Median tumor diameter was 3.5 cm(1.5-8.9 cm). Six patients with tumors ≥ 5 cm completed planned selected transarterial chemoembolization(TACE) in combination with SBRT. Eight patients underwent orthotropic live transplant(OLT) with SBRT as a bridging treatment(median time to transplant was 12 mo, range 5 to 23 mo). The Pathologic complete response(PCR) rate in this group was 62.5%. The 2-year in-field local control was 98%(1 failure). Intrahepatic control was 82% and 62% at 1 and 2 years, respectively. Overall survival(OS) was 92% and 60% at 1 and 2 years, with a median survival of 41 mo per Kaplan Meier analysis. At 1 and 2 years, 71% and 61% of patients retained CPA status. Of the patients with intrahepatic failures, 58% developed progressive cirrhosis, compared to 27% with controlled disease(P = 0.06). Survival specific to hepatic failure was 92%, 81%, and 69% at 12, 18, and 24 mo. There was no grade 3 or higher toxicity. On univariate analysis, gross tumor volume(GTV) < 23 cc was associated with freedom from CP progression(P = 0.05), hepatic failure-specific survival(P = 0.02), and trended with OS(P = 0.10).CONCLUSION SBRT is safe and effective in HCC with early cirrhosis and may extend waiting time for transplant in patients who may not otherwise be immediate candidates.展开更多
文摘Play is a pleasurable physical or mental activity that enhances the child’s skills involving negotiation abilities,problem-solving,manual dexterity,sharing,decision-making,and working in a group.Play affects all the brain's areas,structures,and functions.Children with autism have adaptive behavior,adaptive response,and social interaction limitations.This review explores the different applications of play therapy in helping children with autism disorder.Play is usually significantly impaired in children with autism.Play therapy is mainly intended to help children to honor their unique mental abilities and developmental levels.The main aim of play therapy is to prevent or solve psychosocial difficulties and achieve optimal child-healthy growth and development.Play therapy helps children with autism to engage in play activities of their interest and choice to express themselves in the most comfortable ways.It changes their way of self-expression from unwanted behaviors to more non-injurious expressive behavior using toys or activities of their choice as their words.Play therapy also helps those children to experience feeling out various interaction styles.Every child with autism is unique and responds differently.Therefore,different types of intervention,like play therapy,could fit the differences in children with autism.Proper evaluation of the child is mandatory to evaluate which type fits the child more than the others.This narrative review revised the different types of play therapy that could fit children with autism in an evidence-based way.Despite weak evidence,play therapy still has potential benefits for patients and their families.
文摘Objective: To evaluate the therapeutic efficacy of atomoxetine hydrochloride (ATX) combined with psychological-behavioral modification therapy for attention-deficit/hyperactivity disorder (ADHD) in children. Methods: A total of 60 cases of ADHD children admitted to our hospital between November 2021 and November 2022 were selected and randomly grouped into Group I and Group II. There were 30 cases in Group I who were treated with ATX combined with psychological-behavioral modification therapy. There were 30 cases in Group II who were treated with ATX monotherapy, and the therapeutic effects were compared. Results: Before treatment, there was no difference in the behavioral problem scores and cognitive function indexes of the two groups (P>0.05). After treatment, the behavioral problem scores of Group I were lower than those of Group II, and the cognitive function indicators of Group I were lower than those of Group II (P < 0.05). The adverse reaction rate of Group I was lower than that of Group II, and the total effective rate was higher than that of Group II (P < 0.05). Conclusion: ATX combined with psychological-behavioral modification therapy improved the behavioral problems of ADHD children, enhanced their cognitive function, and reduced the adverse reactions to drug treatment.
文摘Objective: To investigate the effect of VOJTA therapy on gross motor function in children with cerebral palsy. Methods: The 86 children with cerebral palsy were all from the First People’s Hospital of Jingzhou City from January 2023-December 2023, and were divided into the control group and the study group with 43 cases according to the principle of voluntariness. Results: In terms of total effective rate of treatment, the gross motor function scale-88 (GMFM-88) was used to evaluate the effective rate before and after treatment, and the effective rate of the study group was higher than that of the control group, and the difference was statistically significant, and the scores of gross motor items of GMFM-88 were better than those of the control group after treatment, and the difference was statistically significant (P 0.05). Conclusion: The application of VOJTA therapy in the treatment of children with cerebral palsy can not only promote the rehabilitation of gross motor function, but also help to improve the treatment effect, and the earlier the treatment, the better.
文摘BACKGROUND Sensory integration intervention is highly related to the child's effective interaction with the environment and the child's development.Currently,various sensory integration interventions are being applied,but research methodological problems are arising due to unsystematic protocols.This study aims to present the optimal intervention protocol by presenting scientific standards for sensory integration intervention through meta-analysis.AIM To prove the effectiveness of sensory integration therapy,examine the latest trend of sensory integration studies in Korea,and provide clinical evidence for sensory integration therapies.METHODS The database of Korean search engines,including RISS,KISS,and DBpia,was used to search for related literature published from 2001 to October 2020.The keywords,“Children”,“Sensory integration”,“Integrated sensory”,“Sensorymotor”,and“Sensory stimulation”were used in this search.Then,a meta-analysis was conducted on 24 selected studiesRISS,KISS,and DBpia,was used to search for related literature published from 2001 to October 2020.The keywords,“Children”,“Sensory integration”,“Integrated sensory”,“Sensorymotor”,and“Sensory stimulation”were used in this search.Then,a meta-analysis was conducted on 24 selected studies.RESULTS Sensory integration intervention has been proven effective in children with cerebral palsy,autism spectrum disorder,attention deficit/hyperactivity disorder,developmental disorder,and intellectual disability in relation to the diagnosis of children.Regarding sensory integration therapies,1:1 individual treatment with a therapist or a therapy session lasting for 40 min was most effective.In terms of dependent variables,sensory integration therapy effectively promoted social skills,adaptive behavior,sensory processing,and gross motor and fine motor skills.CONCLUSION The results of this study may be used as therapeutic evidence for sensory integration intervention in the clinical field of occupational therapy for children,and can help to present standards for sensory integration intervention protocols.
文摘Research motivation:Through the 12 weeks dance therapy intervention for children with autism,the purpose is to explore the intervention model of dance therapy for children with autism and the changes in motor ability,social ability,and communication ability of children with autism after dance therapy intervention.The results of the research are expected to expand the intervention mode of dance therapy in my country and provide practical reference for rehabilitation intervention of children with autism.Research methods:24 autistic boys aged 6 to 12 with mild to moderate symptoms were recruited and screened through the Internet as the subjects of this study.We randomly divided them into experimental group(N=12)and control group(N=12).All children with autism have an autism diagnosis certificate issued by Children’s Hospital or a tertiary hospital,excluding other mental diseases(such as epilepsy,major physical disability,mental illness,no history of drugs and other interventions,etc.).We used the paired sample t-test to compare the score difference between the dance treatment group and the control group before and after the two groups,and used the observation method to record the basic communication behavior and the number of active communication behaviors in the experimental group during the intervention process.All data analysis is used in SPSS 20.0.Research results:After 12 weeks of dance therapy intervention,there were statistically significant differences in the gross movement,balance,and coordination abilities of the children in the experimental group compared with those before the intervention(p<0.01).There was no significant difference between the children in the control group(p>0.05).After 12 weeks of dance therapy intervention,there were statistically significant differences in the scores of the social response scale for children with autism in the experimental group(p<0.05).There was no significant change in the scores of each item of the SRS scale before and after intervention in the control group and the dance treatment group(p>0.05).
文摘BACKGROUND Cognitive-behavioral therapy(CBT)and habit reversal training(HRT)have shown application potential in addressing tic symptoms and comorbid psychiatric conditions.Despite their theoretical potential,empirical evidence on their combined efficacy remains limited.AIM To evaluate the efficacy of CBT combined with HRT on anxiety disorders in children with Tourette’s syndrome(TS).METHODS Clinical data of children with TS admitted to our hospital from January 2022 to June 2023 were collected,and the patients were grouped into the conventional therapy(control)group and the CBT combined with HRT group.Baseline charac-teristics,anxiety scores,tic severity scores,treatment adherence,and parental satisfaction were assessed.Statistical analysis was performed using t-tests,chi-square tests,and correlation analysis.RESULTS A total of 136 patients,including 65 patients in the control group and 71 patients in the CBT combined with HRT group,were included.The CBT combined with HRT group showed remarkable improvements compared with the control group.Post-intervention assessment revealed a decrease in anxiety scores from 63.52±1.81 to 40.53±1.64(t=2.022,P=0.045),and the Yale Global Tic Severity Scale total score decreased from 22.14±5.67 to 16.28±4.91(t=2.288,P=0.024).Treatment adherence was significantly higher in the CBT combined with HRT group(85.47±7.62%)compared with the control group(82.32±6.54%;t=2.596,P=0.010).Parental satisfaction scores were also higher in the CBT combined with HRT group(8.69±1.77)compared with the control group(7.87±1.92;t=2.592,P=0.011).CONCLUSION This study demonstrates that CBT combined with HRT significantly reduces anxiety symptoms and tic severity in children with TS,with higher treatment adherence and parental satisfaction.These findings support the potential application of this comprehensive therapeutic approach for TS treatment.
文摘This report presents a case study of sandplay therapy for a 3-year-11-month-old child with post-traumatic stress disorder. The child had experienced a distressing traumatic event and exhibited symptoms of anxiety, fear, and traumatic reenactment. Sandplay therapy, as a therapeutic modality, was utilized to provide a safe environment for the child to express and process their inner experiences. The case report provides a detailed account of the child’s presentation, treatment goals, therapeutic strategies, and treatment outcomes. Through sandplay therapy, the child achieved emotional release, resolution of internal conflicts, and a reframing of the traumatic event. Ultimately, a significant reduction in symptoms of post-traumatic stress disorder was observed, along with improved functioning and psychological well-being.
文摘A healthy psychological state is the premise for children to carry out various activities.Previous surveys have shown that children with special needs are affected by their own obstacles and are more prone to psychological problems such as sensitivity,low self-esteem,and impulsiveness.Therefore,it is necessary to provide more sys-tematic mental health education support for special children.Mental health education programs are an efficient form of maintaining children’s mental health.However,in thefield of special education,the number of mental health education courses developed according to the physical and mental characteristics and developmental needs of special children is relatively small,and there are many difficulties in the implementation process.Autism dis-order(ASD)is a kind of pervasive developmental dysfunction that is relatively common and representative in clinical practice.In recent years,the number of autistic children has continued to surge,and has gradually expanded from a family problem to a serious social problem.At present,the evaluation of the effect of autism intervention mainly relies on various behavioral scales,which are subjective to a certain extent.At the same time,due to the unclear pathogenesis of autism,the treatment of autism cannot be predicated on the right medicine,and can only be intervened in various ways.The purpose of this paper is to explore the difference between the EEG signals of autistic children and typically developing control(TD)children through the analysis method of EEG signals,and based on the analysis of EEG signals from an objective point of view,to study whether the music therapy method of Chinese Zither playing training can effectively Improving the brain functional status of chil-dren with autism yields positive therapeutic outcomes.The experimental results show that the complexity of brain electrical signals of ASD children is much lower than that of TD children,and there is a significant difference in the brain functional state between the two.The music therapy method based on Chinese zither playing training can improve the brain function of autistic patients,and there is a positive therapeutic effect.And with the exten-sion of the training period,the effect may be more significant.Chinese zither playing training can provide a new direction for the intervention of autism.
文摘Gastric cancer,a prevalent malignancy worldwide,ranks sixth in terms of frequency and third in fatality,causing over a million new cases and 769000 annual deaths.Predominant in Eastern Europe and Eastern Asia,risk factors include family medical history,dietary habits,tobacco use,Helicobacter pylori,and Epstein-Barr virus infections.Unfortunately,gastric cancer is often diagnosed at an advanced stage,leading to a grim prognosis,with a 5-year overall survival rate below 5%.Surgical intervention,particularly with D2 Lymphadenectomy,is the mainstay for early-stage cases but offers limited success.For advanced cases,the National Comprehensive Cancer Network recommends chemotherapy,radiation,and targeted therapy.Emerging immunotherapy presents promise,especially for unresectable or metastatic cases,with strategies like immune checkpoint inhibitors,tumor vaccines,adoptive immunotherapy,and nonspecific immunomodulators.In this Editorial,with regards to the article“Advances and key focus areas in gastric cancer immunotherapy:A comprehensive scientometric and clinical trial review”,we address the advances in the field of immunotherapy in gastric cancer and its future prospects.
文摘AIM:To report the myopia-controlling effect of repeated low-level red-light(RLRL)therapy in patients with Stickler syndrome(STL),an inherited collagenic disease typically presenting with early onset myopia.METHODS:Three STL children,aged 3,7,and 11y,received RLRL therapy throughout the follow-up period of 17,3,and 6mo,respectively after exclusion of fundus anomalies.Data on best-corrected visual acuity(BCVA),intraocular pressure,cycloplegic subjective refraction,ocular biometrics,scanning laser ophthalmoscope,optical coherence tomography,genetic testing,systemic disease history,and family history were recorded.RESULTS:At the initiation of the RLRL therapy,the spherical equivalent(SE)of 6 eyes from 3 patients ranged from-3.75 to-20.38 D,axial length(AL)were from 23.88 to 30.68 mm,and BCVA were from 0.4 to 1.0(decimal notation).Myopia progression of all six eyes slowed down after RLRL therapy.AL in five out of the six eyes shortened-0.07 to-0.63 mm.No side effects were observed.CONCLUSION:Three cases of STL whose progression of myopic shift and AL elongation are successfully reduced and even reversed after RLRL therapy.
文摘Introduction: Glomerular filtration is an important elimination pathway for many types of chemotherapy. Accurate estimation of glomerular filtration is essential in the management of children with cancer. Methodology: This was a prospective cross-sectional study of the descriptive type extending over a period of 6 months from July 01 to December 31, 2021 on all children with cancer followed in the pediatric hemato-oncology unit of the HND with a renal, blood and urinary assessment associated with the GFR calculated by the SCHWARTZ formula during the study period. Results: During the study period, we registered 41 new cases of cancer in the pediatric oncology unit. The age group of 0 - 5 years was the most represented, i.e. 65.85% and the average age was 5.6 ± 4 years. The most cited clinical signs were fever ie 56.10% followed by abdominal pain 34.15% and anemia 26.83%. The most represented diagnosis was Burkitt’s Lymphoma, i.e. 26.83% followed by Retinoblastoma 24.39%. Mean serum creatinine was 70.65 ± 68.93 μmol/L. In our series, patients whose normal glomerular filtration rate were more represented, i.e. 70.73% and 29.27% had an abnormal GFR with an average of 87.28 ± 70 mL/min/1.73m<sup>2</sup>. Proteinuria and leukocyturia were observed in 31.71% and 19.51% respectively. Glycosuria and hematuria with common frequencies of 2.44% of patients. Conclusion: The prevention of renal toxicity of anticancer drugs always involves the precise evaluation of renal function using the Schwartz formula in children. .
基金supported by the National Natural Science Foundation of China[NSFC81971934]+2 种基金Guangxi Key Research and Development Program[Guike AB18050022,to HL]National Key R&D Program of China[No.2022YFC2305001]the"13th Five-Year Plan"National Science and Technology Major Project[2018ZX10715-008-002]。
文摘Human immunodeficiency virus(HIV)is a serious public health concern.Globally,1.7 million(1.3–2.1 million)children aged 0–14 were living with HIV at the end of 2021,90%of whom lived in low-and middle-income countries.Acquired Immune Deficiency Syndrome(AIDS)remains the leading cause of mortality among children worldwide.
基金funded by the 2018 Faculty Research Grant and the 2019 College of Science and Health Dean’s Distinguished Fellowship Grant at the University of Wisconsin-La Crosse,La Crosse,WI,USA.
文摘Mental health conditions in children and adolescents can be improved by slow mindful nature connection known as forest therapyor bathing.Forest therapy has recently received growing attention as an enabler of relaxation and preventive health care withdemonstrated clinical efficacy.However,it is not well-known that forest therapy also decreases mental health issues amongindividuals with mental health disorders.This study explored the psychological and physiological health benefits of structuredforest therapy programs for children and adolescents with mental health disorders.A one-group pre-test-posttest design wasemployed for our study participants.Twelve participants(aged 9–14 years)engaged in two one-hour guided standard sequenceforest therapy experiences.A Mindful Attention Awareness Scale(MAAS),Connectedness to Nature Scale(CNS),Profile ofMood States(POMS),place meanings(e.g.,functional,emotional,and cognitive attachment to the forest)questionnaire,andphysiological health assessment were administered to the participants.Our results showed that negative mood states weresignificantly reduced and that a positive mood state was significantly improved after the structured forest therapy programs.Also,mindfulness,nature connection,place meanings,and physiological health were significantly boosted after theinterventions.The results demonstrate substantial psychological and physiological health and well-being outcomes ofstructured forest therapy for similar individuals.
文摘Pain and hospitalization caused a crisis in the child’s life. At the pre-school children, the stress of the disease makes children become less able to cope with separation. As a result, many children show anxious behavior though more vague than toddler age children. Various ways have been conducted by nurses to treat anxiety in children, but the most effective types of the intervention have not be found. Types of intervention that can be done are art therapy and play therapy. This study aims to compare the effects of art therapy and play therapy in reducing anxiety on children who experience hospitalization. A quasi-experimental research design with pre-post test two group design is used. The sample was 23 children pre-school age for art therapy group and 25 children for play therapy with sampling techniques performed purposive sampling. Intervention of art therapy and play therapy each performed for 3 days with duration about 30 minutes. Anxiety levels before and after the intervention were measured by using the facial affective scale. The results show that there is a difference in anxiety between before and after the action in the art therapy group (p = 0.00) and that there are differences in anxiety before and after the action in the play therapy group (0.00). But statistical tests using Man Whitney U indicate that there is no difference in anxiety levels in pre-school children who do art therapy and play therapy (p = 0.26). So, it is concluded that the art therapy and the play therapy can reduce the level of anxiety on pre-school school children that experience hospitalization. Based on these conclusions, it is recommended that the art therapy and the play therapy can be used by nurses and the choice of the intervention should be submitted to the child.
基金Youth Program of Natural Science Foundation of Zhejiang Province,No.LQ20H160027National Natural Science Foundation of China,No.U20A20137。
文摘BACKGROUND Undifferentiated embryonal sarcoma of the liver(UESL)is a rare and aggressive mesenchymal tumor in children.Herein,we describe our experience in neoadjuvant therapy(NAT)and subsequent surgery for the treatment of UESL in children.AIM To evaluate the efficacy of NAT and explore a new choice for successful operation of UESL in children.METHODS We retrospectively analyzed six patients newly diagnosed with unresectable UESL who received NAT and then surgery at our center between January 2004 and December 2019.The tumor was considered unresectable if it involved a large part of both lobes of the liver or had invaded the main hepatic vessels or inferior vena cava.The NAT included preoperative transcatheter arterial chemoembol ization(TACE)and systemic chemotherapy.The patients were 4 boys and 2 girls with a mean age of 7 years.The longest tumor at presentation ranged from 8.6 to 14.8 cm(mean,12 cm).Extrahepatic metastases were present in 2 cases.Preoperative systemic chemotherapy was administered 3 wk after TACE.Tumor resection was performed 3 wk after one or two cycles of NAT.The patients received systemic chemotherapy after surgery.RESULTS All patients successfully underwent NAT and complete resection.The tumor volumes decreased by 18.2%–68.7%,with a mean decrease of 36%after 1 cycle of NAT(t=3.524,P=0.017).According to the Response Evaluation Criteria In Solid Tumors criteria,4 patients had a partial response and underwent surgery,while 2 had stable disease and received another cycle of NAT before surgery.Massive tumor necrosis was seen on pathological examination of the surgical specimen:>90%necrosis in two,>50%necrosis in three,and 25%necrosis in 1,with an average of 71.8%.Post-NAT complications included fever,nausea and vomiting,and mild bone marrow suppression.Elevated alanine transaminase levels occurred in all patients,which returned to normal within 7–10 d after treatment.No cardiac or renal toxicity,severe hepatic dysfunction,bleeding and nontarget embolization were observed in the patients.The median follow-up period was 8 years with an overall survival of 100%.CONCLUSION NAT effectively reduced tumor volume,cleared the tumor margin,and caused massive tumor necrosis.This may be a promising choice for successful surgery of UESL in children.
文摘Immune checkpoint inhibitor therapy has dramatically improved patient prognosis,and thereby transformed the treatment in various cancer types including esophageal squamous cell carcinoma(ESCC)in the past decade.Monoclonal antibodies that selectively inhibit programmed cell death-1(PD-1)activity has now become standard of care in the treatment of ESCC in metastatic settings,and has a high expectation to provide clinical benefit during perioperative period.Further,anti-cytotoxic T-lymphocyte–associated protein 4(CTLA-4)monoclonal antibody has also been approved in the treatment of recurrent/metastatic ESCC in combination with anti-PD-1 antibody.Well understanding of the existing evidence of immune-based treatments for ESCC,as well as recent clinical trials on various combinations with chemotherapy for different clinical settings including neoadjuvant,adjuvant,and metastatic diseases,may provide future prospects of ESCC treatment for better patient outcomes.
文摘The aim of the study was to investigate the effect of a hydrotherapy program on FVC, FEV, PEF, RR and SaO<sub>2</sub> on children with Down syndrome over six months and to compare it with a conventional respiratory physiotherapy program. Eighteen children, with Down Syndrome, aged 6 - 11 years (9.53 ± 0.454), divided into two groups of nine, the intervention group (IG), that participated in the hydrotherapy program and the control group (CG) participated in the classical physiotherapy program. We calculated mean values of FVC, FEV, PEF, RR and SaO2 before and after six months intervention for both groups. There was a statistically significant improvement in all factors for both groups. However, were statistically more significant for the intervention group (IG). Based on a specific protocol of intervention in the water and at the same time with a group of children who participated in a similar program of classical respiratory physiotherapy, it was found to be statistically more important than the second group in improving respiratory function. We recommend the use of hydrotherapy as a complementary therapy that should be part of the weekly program of these children in addition to the existing treatments they attend.
文摘AIM： To compare the efficacy and safety of five days apostrophe therapy of mebendazole （MBZ） versus quinacrine （QC） on human giardiasis in children.METHODS： A clinical trial was carried out in paediatric patients （aged 5-15 years） with confirmed symptomatic G. duodenalis mono-infection. Patients were randomly assigned to receive either MBZ [200 mg taken three times per day GRID） （n = 61）] or QC [2 mg/kg bodyweight tid （n = 61）], both for five days. Follow-up faecal samples were obtained at 3, 5 and 7 d after the end of the treatment.RESULTS： Although the frequency of cure was higher for QC （83.6%） than for MBZ （78.7%）, the difference was not statistically significant （P 〉 0.05）. Adverse events were reported more in the QC group （P 〈 0.05）, all of them transient and self-limiting.CONCLUSION： Despite final cure rates ocurring lower than expected, the overall results of this study reconfirmed the efficacy of MBZ in giardiasis and also indicate that, although comparable to QC, at least in this setting the 5 d course of MBZ did not appear to improve the cure rates in this intestinal parasitic infection.
文摘Objective:In our investigation,we studied the patients with medulloblastoma who received 3-dimensional conformal radiation therapy(3DCRT) and recorded their effects,side effects and failure reasons.Methods:From August 2001 to August 2007,34 children with medulloblastoma were treated in our hospital.The age at diagnosis was 3-16 years old,and the mean age at diagnosis was 9.5 years old.Among all the patients,16 cases were included in the high risk group and 18 cases were included in the low risk group.All the patients were performed total resection or subtotal resection and no patients received radiotherapy or chemotherapy before operation.All patients received 3DCRT within 3 weeks after resection.The dose of 30 Gy were given to the whole brain and whole spine,followed by 20-25 Gy boosted to the posterior brain fossa.The median fraction dose was 180 cGy.Every patient received the chemotherapy scheme of the Lomustine,Cisplatinum and Vincristine.Nobody received intrathecal chemotherapy.The tests of the complete blood count,blood biochemistry,hepatic and renal functions were required before every cycle of chemotherapy.Results:5-year overall survival(OS) and 5-year disease free survival(DFS) were 71% and 62% respectively.The median follow-up time was 36.5 months.The 5-year OS of the high risk group was 71% compared to 62% of the low risk group.There were significant difference between the two groups(P = 0.01).There were 13 failure cases in all the patients.Of these 13 patients,10 were dead and the other 3 were alive with tumor.The complete remission(CR) rate was 70.5% and the partial remission(PR) rate was 14%.Among the failure patients,there were 3 patients(8.8%) with the recurrences located in the brain of cribriform region.The 5-year OS of the patients with preoperative metastases was 12.5%(1/8),and which of the patients with residual tumor volume > 1.5 cm3 was 0%(0/5).Through the statistic analysis,it was found that both whether or not the metastases were found before surgery and residual tumor volume have the significant impacts on the prognosis of the children with medulloblastoma(P < 0.05).The major adverse reactions were hematological toxicity(7/34,20.6%) and gastrointestinal reaction(4/34,11.8%).Conclusion:Through the using of 3DCRT for the children with medulloblastoma,the severe side effects rate was not high.The prognosis of the patients in low risk group was satisfied which was opposite to that of the patients in high risk group.And the patients with residual tumor volume > 1.5 cm3 and preoperative metastases also had poor prognosis.It is needed to pay attention to the possible low dose of the brain of cribriform region.
文摘AIM To evaluate the control, survival, and hepatic function for Child Pugh(CP)-A patients after Stereotactic body radiotherapy(SBRT) in hepatocellular carcinoma(HCC).METHODS From 2009 to 2016, 40 patients with Barcelona Liver Clinic(BCLC) stages 0-B HCC and CP-A cirrhosis completed liver SBRT. The mean prescription dose was 45 Gy(40 to 50 Gy in 4-5 fractions). Local relapse, defined as recurrence within the planning target volume was assessed with intravenous multiphase contrast computed tomography or magnetic resonance imaging every 4-6 mo after completion of SBRT. Progression of cirrhosis was evaluated by CP and Model for End Stage Liver Disease scores every 3-4 mo. Toxicities were graded per the Common Terminology Criteria for Adverse Events(v4.03). Median follow-up was 24 mo.RESULTS Forty-nine HCC lesions among 40 patients were analyzed in this IRB approved retrospective study. Median tumor diameter was 3.5 cm(1.5-8.9 cm). Six patients with tumors ≥ 5 cm completed planned selected transarterial chemoembolization(TACE) in combination with SBRT. Eight patients underwent orthotropic live transplant(OLT) with SBRT as a bridging treatment(median time to transplant was 12 mo, range 5 to 23 mo). The Pathologic complete response(PCR) rate in this group was 62.5%. The 2-year in-field local control was 98%(1 failure). Intrahepatic control was 82% and 62% at 1 and 2 years, respectively. Overall survival(OS) was 92% and 60% at 1 and 2 years, with a median survival of 41 mo per Kaplan Meier analysis. At 1 and 2 years, 71% and 61% of patients retained CPA status. Of the patients with intrahepatic failures, 58% developed progressive cirrhosis, compared to 27% with controlled disease(P = 0.06). Survival specific to hepatic failure was 92%, 81%, and 69% at 12, 18, and 24 mo. There was no grade 3 or higher toxicity. On univariate analysis, gross tumor volume(GTV) < 23 cc was associated with freedom from CP progression(P = 0.05), hepatic failure-specific survival(P = 0.02), and trended with OS(P = 0.10).CONCLUSION SBRT is safe and effective in HCC with early cirrhosis and may extend waiting time for transplant in patients who may not otherwise be immediate candidates.
