[Interpretation of the international expert recommendations of clinical features to prompt referral for diagnostic assessment of cerebral palsy].

Under the guidance and support of national policies in recent years, the community medical system has been developed rapidly, among which primary child healthcare is carried out routinely in community hospitals, greatly alleviating the pressure of specialized pediatric hospitals and departments of pediatrics in secondary and tertiary general hospitals. However, due to the lack of professional training for primary child healthcare personnel in community medical institutions, early symptoms of children with cerebral palsy cannot be identified and so children with cerebral palsy are often unable to receive early diagnosis and intervention, which may affect their prognosis. An article about international expert consensus and recommendations on early identification and referral of cerebral palsy in community medical institutions was published in Development Medicine and Child Neurology in 2020. It proposed six clinical features that should prompt referral and two warning signs that warrant enhanced monitoring, as well as five recommendations for referral to medical experts and other healthcare professionals for the diagnosis of cerebral palsy. The recommendations may help primary child healthcare personnel in community medical institutions to early identify the children at high risk of cerebral palsy, thus reducing the delay of referral and intervention. This article gives an interpretation of the recommendations based on the actual situation in China, in order to improve the ability of primary child healthcare personnel in community medical institutions to early identify high-risk signals of cerebral palsy and conduct reasonable referral. This will help to achieve the early identification, early diagnosis, and early intervention to improve the prognosis of children with cerebral palsy.

Effect of Gan-Pi regulatory needling in treating chloasma.

OBJECTIVE: To study the effect of Gan-Pi regulatory needling (GPRN) in treating chloasma and its influences on female sex hormones, superoxide dismutase (SOD), lipid peroxide (LPO) and melanocyte-stimulating hormone (MSH). METHODS: Ninety chloasma patients were equally randomized to three groups, the treatment group treated with GPRN, the control group treated with conventional Western medicine and the blank group untreated. Changes in the scores of skin lesion (area and color) and symptom, as well as blood levels of female sex hormones, MSH, SOD and LPO were observed and compared after 3 months of treatment. RESULTS: In the treatment group, the scores of skin lesion area and color were reduced from 2.76 + or - 0.96 and 2.48 + or - 0.78 before treatment to 1.42 + or - 0.42 and 1.03 + or - 0.41 after treatment, respectively, while in the control group they were from 2.78 + or - 1.06 and 2.53 + or - 0.88 to 1.58 + or - 1.23 and 1.28 + or - 0.96, respectively, all showing significant changes (P<0.05); the scores were insignificantly changed in the blank group (P>0.05). At the same time, the score of symptoms in the treatment group significantly improved after treatment (P<0.05), significantly different from that of the other two groups. Comparison of female sex hormones among groups showed no significant differences either before or after treatment. The level of LPO decreased and SOD increased in both the treatment group and the control group significantly (all P<0.05), but significant lowering of MSH was only seen in the treatment group (P<0.05). CONCLUSIONS: GPRN can effectively lessen the size and lighten the color of chloasma, improve the accompanying symptoms in patients and decrease LPO and MSH levels and increase the SOD level, but will not affect the level of the female sex hormones.