ABSTRACT
Objective To compare the advantages and disadvantages of botulinum toxin A (BTX-A) and phenol block in the treatment of spasticity in children with cerebral palsy. Methods Four hundred and twenty children with spastic cerebral palsy were divided into an experimental group (375 cases) and a control group (45 cases).The children were aged from 1 to 22 years ( average age 6 years).The children in the experimental group were treated with BTX-A block at a dosage of 55 to 350 IU (average 130.5 IU).The children in the control group were treated with a 5％ phenol solution block at a dosage of 0.5 to 4.6 ml ( average 2.2 ml).Children of both groups were given systematic functional rehabilitation training. All the children were evaluated with a physician rating scale (PRS) and the modified Ashworth scale (MAS) before and after the blocking.Effectiveness rates,effectiveness durations and side effects rates were calculated. Results Before treatment there was no significant difference in terms of motor disorder or spasticity between the 2 groups.After treatment,spasticity had been significantly reduced in both groups.The effectiveness rate was 98.4％ in the experimental group and 95.6％ in the control group,a difference which was not significant.The average effectiveness duration was ( 24.9 ± 5.76 ) weeks in the experimental group and ( 69.2 ± 13.76) weeks in the control group,significantly longer.The side effects rate was 5.33 ％ in the experimental group and 15.56％ in the control group,also a significant difference. Conclusion BTX-A could be more widely used because of its safety and credibility.
ABSTRACT
@#Objective To investigate the optimal dose of botulinum toxic A(BTX-A)for releasing spasticity of cerebral palsy(CP)and related factors.Methods 39 children with CP was treated by BTX-A injected in local muscles to release the spasticity.Results After treatment,23 children had good curative effect.In them,15 cases were male,8 cases were female,the mean age was 60.7±26.9 months(range 33 to 145 months).There was no correlation between the optimal unit dose of BTX-A and those including sex,age,body weight,diagnosis type,degree of Gross Motor Function Classification System(GMFCS),etiological factor and the injections.There was a linear positive correlation between the optimal unit dose of BTX-A and the score of Modified Ashworth Scale(MAS).Conclusion BTX-A can release the spasticity of CP children,the injecting dose is correlated with MAS score.
ABSTRACT
@#Objective To determine the coefficient in the formula of the optimal dose of botulinum toxin A(BTX-A) to treat spastic cerebral palsy(CP).Methods58 CP children(male 38,female 20,mean age 59.3±24.6 months,range 27 to 144 months) were divided into A,B,C,D and E five groups according to used coefficient and treated by BTX-A with different doses to release the spasticity.ResultsAccording to the improvement of motor function,the BTX-A dose of the group D was optimal.According to the effective endurance,the BTX-A dose of the group C was optimal.The optimal coefficient was 1.8.ConclusionThe formula of the optimal BTX-A dose injected in triceps surae is dose =(1+1.8×MAS score)×body weight.
ABSTRACT
@#Objective To determine the coefficient in the formula of the optimal dose of botulinum toxin A(BTX-A) to treat spastic cerebral palsy(CP).Methods58 CP children(male 38,female 20,mean age 59.3±24.6 months,range 27 to 144 months) were divided into A,B,C,D and E five groups according to used coefficient and treated by BTX-A with different doses to release the spasticity.ResultsAccording to the improvement of motor function,the BTX-A dose of the group D was optimal.According to the effective endurance,the BTX-A dose of the group C was optimal.The optimal coefficient was 1.8.ConclusionThe formula of the optimal BTX-A dose injected in triceps surae is dose =(1+1.8×MAS score)×body weight.
ABSTRACT
@#Objective To investigate whether the curative effect of Botulinum Toxic A(BTX-A) block increased and prolonged when the dose calculated according to certain formula.Methods 15 children with cerebral palsy(CP) were appointed as the trial group and the dose of BTX-A was calculated according to the designed formula.The other 58 CP children were appointed as the control group and the BTX-A dose was determined by routine method.Results After treatment,the motor function of the children in trial group was superior to that in the control group(P<0.05) and the duration of therapeutic effect of the trial group was significantly longer than the control group(P<0.001).Conclusion BTX-A dose calculated according to the formula can increase effect and prolong the duration.
ABSTRACT
@#ObjectiveTo investigate the correlation between current and therapeutic effect of block myoelectricity fixed Botulinum Toxin A(BTX-A) injection in cerebral palsy.Methods15 children with spastic cerebral palsy were treated with BTX-A block injection under block myoelectricity fixing.The dose of BTX-A was identified with the weight of the child and the Modified Ashworth Scale.The correlation between current and period in effect was analyzed.ResultsThere was negative correlation between current and period in effect(r=-0.769,P=0.01).ConclusionThe BTX-A should be injected where the fixed current is less.
ABSTRACT
@#ObjectiveTo investigate the optimal dose of botulinum toxic A (BTX-A) block to relax spasticity in cerebral palsy.Methods61 children (27～144 months old) with spastic cerebral palsy were treated by BTX-A block and divided into A, B, C, D and E groups according to the dose coefficient. The dose of BTX-A block was 30～160 IU (average 69.0±32.4 IU) according to the weight and the score of Modified Ashworth Scale.Results55 BTX-A blocks were successful. The muscles tone turned below and the function were improved. The effective rate was 90.16%. The effective time ranged from 8 weeks to 32 weeks, average 17.56±8.30 weeks. The effective time of the group C (2≤dose-coefficient<3) was the longest in the five groups.ConclusionThe optimal dose of BTX-A block in triceps surae should be counted as follow: dose(IU)=(score of Modified Ashworth Scale+2.5)×weight(kg).
ABSTRACT
@#ObjectiveTo test the reliability of Gross Motor Function Classification System(GMFCS) among different raters.MethodsUsing the Chinese translation vision of the GMFCS,5 doctors(raters) determined the level of each cerebral palsy(CP) child(aged 0～12) independently.After finishing classification of all the 23 CP children's level,the reasons of disparities among raters were discussed and analyzed,and the supplementary classification sentences were formulated.ResultsThere was no statistic significant difference in classifications among 5 raters,the GMFCS levels were correlated well with mobility and self-care domain scores in comprehensive function assessment,and higher degree of agreement could be achieved by referring to the supplementary classification sentences while classifying.ConclusionFor classifying the level of gross motor function of CP children,Chinese translation vision of the GMFCS has high degree of reliability.
ABSTRACT
@#ObjectiveTo improve the assessment of the cerebral palsy (CP) children with mental retarded disability, develop their potentials and prevent further psycho-psychotics disability.Methods220 children with CP were assessed respectively before and after rehabilitation using IQ test, and diagnosed and received rehabilitation for one treating course (3 months).Results164 children had found with mental retarded among 220 cases, made up 74.5% of the total. 90% of the children with serious CP were also with mental retardation. The children had effect after rehabilitation was with a lower rate having mental retardation.ConclusionMany factors can influence the results of the intelligence assessment. Comprehensive judgment and analysis should be made in the intelligence assessment for the children with CP, a better and more reasonable assessment method is expected.
ABSTRACT
@#ObjectiveTo study the effect of SSY-B2 on regeneration of central nervous system of rats with bilateral fornix/fimbria transaction.MethodsMale adult SD rats were divided randomly into 6 groups as sham group,model group, positive control agent piracetam group, SSY-B2 low dosage(1.5g crude drug/kg) group, medium dosage(3g crude drug/kg) group and high dosage(6g crude drug/kg) group.The bilateral fornix/fimbria transection in the rats were carried out. After operation, drugs were fed introgastrically to each group respectively for 6 weeks. The immunoreactive products of growth-associated protein-43(GAP-43 )and chondroitin sulfate proteoglycans(CSPG) in defined areas were measured using immunohistochemical methods. ResultsThere was no difference in number of cells expressing GAP-43 between the model group and sham group (P>0.05),but that in low dosage group increased compared with the model group (P<0.001). The CSPG in parietal lobes after lesion expressed,which was in sham group and model group(sham group and model group respectively, 56.43±59.6,116.36±10.561), and SSY-B2 in low and medium dosage inhibited its expression compared with the model group (P<0.05,P<0.01). Conclusions SSY-B2 can enhance the expression of GAP-43 and inhibit the expression or deposition of CSPG, promote axonal regeneration in the CNS, and thus structural repair and functional restoration in certain degree.
ABSTRACT
Objective To investigate the effect of B TX -A block by insulative needle to release the spasticity in cerebral palsy. MethodsFrom June 2000 to November 2002, 47 children wit h spastic cerebral palsy aged 2 to 15 years old, averaged( 6.32?2.52) years o ld were divided into an experiment group and a control group. The 33 children in the experiment group were blocked with BTX-A by insulative needles. The other 14 children in the control group were blocked with BTX-A by use of the convent ional syringe. ResultsThe spasticity in the experim ent group reduced to a larger extend than that in the control group, and the th erapeutic effect lasted longer in the experiment group. Conclusi onUsing insulative needle can improve the effect of BTX-A block.
ABSTRACT
@#ObjectiveTo study the effect of SSY-B2 on improvement of learning/memory function of rats with bilateral fornix/fimbria transection.MethodsMale adult SD rats were divided randomly into 6 groups as sham group,model group,positive control agent piracetam group, SSY-B2 low(1.5g crude drug/kg), medium(3g crude drug/kg)and high dosage (6g crude drug/kg)group. Half to 1 hour before operation, water or drugs were fed introgastrically to each group respectively. From the fourth week, Morris water maze and tunnel water maze tests were used. Escape latency of rats in Morris test, escape latency and errors in tunnel test were recorded.ResultsIn both Morris test and tunnel water maze test, low dosage and medium of SSY-B2 markedly shorten the escape latency or reduced the errors.ConclusionsSSY-B2 can ameliorate spatial learning/memory dysfunction produced by fornix/fimbria transection. Functional compensation in other neural structure other than regeneration of the septohippocampal pathway is considered to be responsible for the effects.
ABSTRACT
@#ObjectiveTo explore the superiority of the screw CT in diagnosing the cerebral palsy complicated with dislocation of hip joint compared with the traditional X-ray.Methods35 patients with cerebral palsy were checked with screw CT and X-ray, and then their Perkin's check, Shenton line and Calve line were individually measured.Results24 cases(68.57%) are half dislocation of hip joint. The abnormalities of Perkin's check, Shenton line and Calve line in hip joint showed in screw CT were respectively compared with X-ray. The statistics shows P<0.05 or <0.01.Conclusions The screw CT is superior to the traditional X-ray in diagnosing the cerebral palsy complicated with dislocation of hip joint and can provide the important anatomy information.
ABSTRACT
@# ObjectiveTo observe the effect of SSY-B2 on microglial cells in rats after bilateral fornix/fimbria transection.MethodsMale adult SD rats were divided randomly into 6 groups as sham group,model group,positive control agent piracetam group, SSY-B2 low(1.5g crude drug/kg), medium(3g crude drug/kg)and high dosage (6g crude drug/kg)groups. Half to 1 hour before operation, water or drugs were fed introgastrically to each group respectively and continued for 6 weeks.The tissues of brain was gained and the immunoreactive products of BS-I B4 (Isolectin B4 from Bandeiraea Simplifolia, a marker for microglia) in the perilesion area was measured using immunohistochemical methods.ResultsThe number of microglia of the sham and model groups was (30.3±21.8) and (114.5±102.3) respectively, P<0.05. That of three different dosage of SSY-B2 groups was(249.7±149.4), (252.0±191.7)and (244.2±154.9), P<0.05 for each group compared with the model group.ConclusionMicroglia number in the perilesion area can be increased by SSY-B2, which may contribute to the nerve repair and functional improvement after injury.
ABSTRACT
@#ObjectiveTo evaluate the possible effect of SSY-B2 on reducing the loss of neurons and enhancing the expression of nerve growth factor(NGF).MethodsMale adult SD rats were divided randomly into 6 groups as sham group,model group,positive control agent piracetam group, SSY-B2 low(1.5g crude drug/kg), medium(3g crude drug/kg)and high dosage (6g crude drug/kg)group.Bilateral fornix/fimbria transection was carried out in the rats' septohippocampal pathway and 6 weeks' drug treatment was administered with different doses of SSY-B2 and positive control agent piracetam. After behavioral tests, the numbers of neurons in medial septum and immunoreactive products of NGF in different areas were measured, using Nissle staining and immunohistochemical methods.ResultsThere was neural loss in medial septum after fornix /fimbria transection, but SSY-B2 at each dosage markedly reduced the loss(59.13±22.02,50.60±23.18,63.93±18.35,the number of neurons for three SSY-B2 dosage groups,P<0.005 for all compared with the model group 20.33±14.01).The number of NGF positive cells decreased in model group, but did not show significant statistic difference compared with the sham group (P>0.05) in the medial septum, polymorph layer of dentate gyrus and entorhinal cortex/Subiculum area. In the medial septum, all three dosage enhanced the expression of NGF positive cells(145.1±57.7,161.3±08.2,200.6±58.2,the number of neurons for three SSY-B2 dosage group,P<0.005 for all compared with the model group 50.2±48.6). SSY-B2 at low and medium dosage group also increased the number in both entorhinal cortex/Subiculum and polymorph layer of dentate gyrus.Conclusions SSY-B2 can reduce the loss of neurons in the medial septum, which may be involve in increasing expression of NGF;NGF expression in dentate gyrus, subiculum of hippocampal formation and entorhinal cortex increased by SSY-B2 may play a role in the compensation of these area for learning/memory.