ObjectiveTo assess the psychosomatic health status of patients with facial steroiddependent dermatitis by using Pittsburgh sleep quality index (PSQI),self-rating anxiety scale (SAS) and selfrating depression scale(SDS).MethodsPsychosomatic health status was evaluated by using PSQI,SDS and SAS in 92 patients with facial steroid-dependent dermatitis and 50 healthy controls.ResultsThe scores on depression and anxiety in patients with steroid-dependent dermatitis were higher than those in the controls (63.11 ± 10.29 vs.36.78 ± 2.46,53.24 ± 9.98 vs.31.29 ± 9.45,both P ＜ 0.01).There were significant differences between the two groups in the quality of sleep.The general and mean PSQI global scores on subjective daytime function,sleep disturbances,time needed to fall asleep and sleep duration were significantly higher in the patients than in the controls.ConclusionsPatients with steroid-dependent dermatitis have a poor sleep quality with the presence of anxiety and depresssion.Psychosocial interventions are warranted for the treatment of patients with steroid-dependent dermatitis.

Objective To summarize the clinical features,treatment and prognosis of infantile hepatic hemangioendothelioma(IHHE) combined with congestive heart failure(CHF) in children.Methods A retrospective analysis was made with the clinical data from 4 children with IHHE combined with CHF in Department of Pediatric Cardiology,Affiliated Guangzhou Women and Children's Medical Center of Guangzhou Medical University from May 2013 to December 2015.Results Among 4 infants,there were 3 male and 1 female,mean aged of 109 days (21-219 days),the average weight of 4 350 g (2 750-6 500 g),and 1 case was admitted because of abdominal swelling and respiratory distress,1 case of abdominal swelling,jaundice,shortness of breath admission,1 case of fever and shortness of breath admission,and 1 case of cyanosis and shortness of breath admission.Two patients were associated with hemangioma and Kasabach-Merritt syndrome.Three cases had multiple liver hemangioma scattered in the left lobe and right lobe of the liver,and 1 case had solitary liver hemangioma scattered in the right lobe.Tumor size diameters were ranged from 2-10 mm.Four children had been used Prednisone [1-2 mg/(kg · d)] and Digoxin,Dopamine,Furosemide,Spironolactone.Two cases responsed well to the therapy and were followed up for 2 years or 1 year and 6 months respectively,whose heart size,heart function and pulmonary hypertension became normal.One case with Kasabach-Merritt syndrome responsed poorly to the therapy.Two cases experienced transcatheter hepatic arteriovenous fistula embolization by using coil occlusion of hepatic artery-venous fistula.The postoperative hepatic tumor volume was significantly decreased,and the heart function was improved.One patient was followed up for 1 year and 6 months,and the heart size,pulmonary hypertension and heart function returned to normal.One case was still under follow-up.One case with Kasabach-Merritt syndrome died from heart failure and severe infection before surgery.The mortality rate was 25％ (1/4 cases).Conclusions IHHE is a rare cause of CHF in children.If heart failure is found unexplained in children,abdominal ultrasound or CT examination should be done immediatey in order to confirm the presence or absence of IHHE.The mortality rate in IHHE associated with CHF is very high.Early identification,early intervention,especially Prednisone combined with transcatheter hepatic arteriovenous fistula embolization can significantly improve heart function,reduce the mortality and improve the prognosis of IHHE associated with CHF in children.

Objective To explore the effects of empowerment education on rehabilitation in patients with celebral hemorrhage . Methods Select 200 cases of patients with celebral hemorrhage cured rehabilitation medical center ,the patients were randomly and single-blindly divided into 2 groups (n=100 each) .Both the treatment group and the control group were given rehabilitation guid-ance on the day of discharge and 1st ,2nd ,4th ,7th ,9th ,12th weeks after discharge .Patients in control group were given compliance education philosophy ,and patients in treatment group were given empowerment education philosophy .Patients of both groups were used Barthel index (BI) to assess the activities of daily living (ADL)and motor assessment scale (MAS) to motor function in the day of discharge and 25th weeks after discharge from hospital .Results The BI [(44 .12 ± 8 .56) vs .(62 .16 ± 8 .77)]and MAS [(18 .70 ± 9 .47) vs .(28 .53 ± 8 .75)]of treatment group were apparently higher than those of the control group (P<0 .01) .The to-tal effective rate of the treatment group was higher than that of the control group(70% vs .85% ) Conclusion Empowerment educa-tion can obviously improve the ADL function and promote the recovery of motor function in patients with cerebral hemorrhage and improve the effect of family rehabilitation .

Objective To detect the expression of extracellular-regulated kinase (ERK) and phosphatedextracellular-regulated kinase (P-ERK) in the hippocampus after pentylenetetrazoloe-induced status epilepsy and the effects of nimodipine on it.Methods Male Sprague-Dawley adult rats (200-250 g) were randomly divided into normal control group(NC,n =35),status epilepsy group (SE,n =40),nimodipine group (NIM,n =40).The rats were injected first with 40 mg/kg pentylenetetrazoloe(PTZ),followed 10 minutes later by 20 mg/kg PTZ,and subsequently,10 mg/kg PTZ ip every 10 minutes until SE occurred,apoint charactered by a loss of postural control and tonic-clonic seizures.Rats in control group received the same number of saline injections.Rats in NIM group were injected NIM(2.5 mg/kg) intraperitoneally 15 min before the injection of PTZ.Rats in every group were killed at 30 minutes,1 hour,3 hours,12 hours,24 horus,72 hours and 7 days after status epilepsy respectively and the hippocampus were dissected.The expression of ERK and P-ERK in the hippocampus were detected by Western blot.Results Nimodipine attenuated the convulsion of PTZ-induced status epilepsy.There was dynamic expression of P-ERK in SE group.In NIM group,the expression of P-ERK was markedly increased than that of SE group at 30 min,1h,3h,12h,24h,72h,and 7d (3.26 ±0.95 vs 2.56 ±0.82 at 30 min,P＜0.05).Conclusion Nimodipine attenuates the convulsion of PTZ-induced status epilepsy with increased expression of phosphated-ERK in the hippocampus of rats.

Objective To describe early clinical experience with the new amplatzer ductal occluder Ⅱ (ADO Ⅱ) for transcatheter patent ductus arteriosus(PDA) in children.Methods Twelve children were diagnosed as PDA from Jan.2013 to Apr.2014 in Guangzhou Children and Women's Hospital.All the children who were treated with the ADO Ⅱ had the indication of a successful interventional therapy successfully.The size of device was chosen according to aortographic and transthoracic echocardiography(TTE) results and pulmonary pressure.The device was delivered in a consequent or reverse way depending on the type of PDA,the minimal diameter of PDA and the size of duct ampulla.The device was delivered in a reverse way in ten patients,and two in a consequent way before detaching the device.Another aortogram was performed in order to check the position and form of the device,the velocities of blood flow in left pulmonary artery and the descending aorta though TTE and whether there was a residual shunt.All patients were examined by TTE in 24 hours after surgery and discharged without any complications 2 days later.The patients were programmed for the cardiologic consult including an TTE and electrocardiogram in 1,3,6 and 12 months after discharge.Results Twelve patients(7 male,5 female) with a median age of(1.59 ± 1.10) years(range 0.53-4.47 years),a median weight of (9.52 ± 3.41) kg(range 5.5-18.3 kg),a median pulmonary blood flow/systemic blood flow (Qp/ Qs) of 1.64 ± 0.45 (range 1.33-2.85),a median pulmonary artery systolic pressure (32.50 ± 10.05) mmHg (range 23-58 mmHg,1 mmHg =0.133 kPa),and the minimum (2.40 ±0.68) mm (1.6-3.8 mm),underwent transcatheter ductal closure with the ADO Ⅱ.Device sizes used were 3 mm ×4 mm(n =7),3 mm ×6 mm(n =3),6 mm ×6 mm (n =2),respectively and delivered with 4 or 5 F delivery catheters.The median fluoroscopy time was (6.39 ± 4.16) min(range 3.2-18.2 min).Complete ductal occlusion was achieved by the end of the procedure in 10 patients.The TTE showed good position of the occlusion and the velocities of blood flow in left pulmonary artery and the descending aorta were in a normal range.There was a trivial residual shunt after the surgery of 2 patients.No residual shunt was found after 24 hours in all 12 patients.In 1 case,the patient had a descending aortic obstruction with pressure gradient of 11 mmHg.Three months after surgery,the pressure descended to 10 mmHg by TTE.Complete ductal occlusion without aortic arch or left pulmonary artery stenosis had been identified in other 11 remaining patients on TTE follow-up of 6 months of 3 patients and 12 months of 6 patients.Conclusions The ADO Ⅱ achieves excellent ductal closure rates through low profile delivery systems in small infants and children with moderate and small PDA or morphologically varied PDAs.It is simple in use with few complications.Occlusion design allows closure with arterial or venous approach and delivery with 4 or 5 F delivery catheters.The children who used arterial approach,transthoracic echocardiography TTE is recommended to replace aortic angiography,so as to avoid puncturing the aorta and reduce vascular injury.

Objective To explore the repair mechanism of olfactory ensheathing cells (OECs)-neurotrophin-3 (NT-3) gene engineering cell on neuron myeline and axon of experimental allergic encephalomyelitis (EAE).Methods OECs-NT-3 gene engineering cell, constructed by ueurotrophin-3 transinfecting OECs inducted by retrovirus, was transplanted into lateral ventricle.The migration and distribution were observed and compared with control group and OECs transplantation group.Then myeline repair and axon regeneration were evaluated in the aspects of function score, morphological structure, SYN grey level Results (1) OECs-NT-3 could survive, diffuse, migrate with axons, spread in the focus diffusely on the 28th day after transplantation.(2) OECs-NT-3 survived and migrated to the transcription level of NT-3 mRNA in transgene group, being (212.3±16.1)×10-2, significantly higher than OECs group ((1.98±0.19)×10-2) and the contrast group ((1.23±0.13)×10-2, t = - 31.161, -31.928, P < 0.01).(3) The myeline of transgene group was kept complete and the number of inflamatory focus was lower than those of other groups (t = 11.388-22.728, P <0.01).(4) The SYN grey level of transgene group was obviously higher (P < 0.01).Conclusion OECs-NT-3 cell expresses NT-3 in EAE stably and effectively, which contributes to the repair of myeline and the regeneration of axon.

Objective Investigate the clinical features,diagnosis and treatment of the scimitar sydrome.Methods A retrospective analysis of clinical data of six children with scimitar syndrome from 2008 to 2014,including clinical symptoms and signs,chest X-ray,echocardiography,chest CT and cardiac catheterization,treatment outcome and follow-up and review of the literature.Results Six patients with scimitar syndrome were diagnosed between 2008 and 2014.There were 3 girls and 3 boys;5 cases ＜ 6 kg in weight.Scimitar syndrome was suspected in 5 cases because of extroversion,and diagnosed by color Doppler echocardiography in all 6 when a scimitar vein was detected entering the inferior vena cava.Computed tomography confirmed the diagnosis in all patients.One patient had horseshoe lung,3 had a unilobar right lung,3 had a hypoplastic right lower lobe.Three patients had severe pulmonary arterial hypertension,1 had moderate to severe pulmonary arterial hypertension,and 2 had moderate pulmonary arterial hypertension.All patients had lower respiratory tract infections,volume loss of the right lung,a normal or hyperinflated left lung,dextroversion of the heart,and scimitar arteries from the descending aorta.4 cases of pulmonary venous drainage correction surgery,3 underwent body-pulmonary embolism,1 case of 9-year-old asymptomatic children without surgery,and 1 patient with heart failure,severe pulmonary hypertension,pulmonary infection,septicemia died before surgery.Conclusion Clinically,found children with heart of dextrocardia position,growth retardation,recurrent lung infections,unexplained right heart failure,pulmonary hypertension,should consider the possibility scimitar syndrome.Early diagnosis and early treatment of pulmonary venous drainage and pulmonary vascular embolization,can significantly improve the clinical symptoms in children and reduce mortality.

Objective To summarize the clinical characteristics, follow-up and prognosis of Kawasaki disease (KD) in infants under 3 months. Method The clinical data of infants under 3 months diagnosed with KD during January 2009 to December 2013 were analyzed retrospectively. Results In a total of 1504 cases diagnosed with KD during during the study period, there were 40 (2.66%) infants under 3 months (30 males and 10 females). Except for fever, the frequencies of the other 5 main clinical manifestations were less than 50%. Laboratory tests suggested inflammatory reactions, thrombocytosis, anemia, and so on. Coronary artery disease was found in 32 cases (80%), including 24 cases of coronary artery dilatation, 8 cases of coronary artery aneurysm and 3 cases of coronary giant aneurysm. By the end of the follow-up period, there were no myocardial ischemia, myocardial infarction and death in all the patients; coronary artery diameter was normal in 37 cases (92.5%); 3 cases of giant coronary artery aneurysm still had coronary artery aneurysm and thrombosis. Conclusion The clinical manifestations of KD in little infants were atypical, the incidence of coronary artery disease is high, and color doppler echocardiography should be performed in time.

Objective To study improvement of neural function by stereotaxic transplantation of adipose-derived stem cells (ADSC) into lateral cerebral ventricle after intracerebral hemorrhage in rats and its mechanism. Methods ADSC were cultured and proliferated in vitro, which had been marked with Brdu for 48 h before transplantation. The rat caudate nucleus hemorrhage (ICH) models were divided into 2 groups. ADSC were stereotaxically transplanted into the right lateral ventricles in ADSC group, and equal volume of saline was transplanted into control group. The score of neurological behavior were evaluated at modeling and 1, 3, 7, 14, 28 days after transplantation respectively.Double-staining immunofluorescence technique was used to detect Brdu-positive cells and the differentiation of neurons and astrocytes. In accordance with the instructions of TUNEL kit, cell apoptosis, and the expression of VEGF and angiogenesis were assayed. Results In vitro ADSC expressed undergo osteogenic and adipogenic differentiation. Compared with the control group, ADSC group had better motor function at 3, 7, and 14 days (P＜0. 05). Double-staining immunofluorescence showed mostly grafted Brdu-reactive ADSC had migrated to the hematoma zone, and some survivedand expressed Neun of Gfap. TUNEL analysis revealed that, 3 days after transplantation, the number of apoptotic cells in ADSC group was significantly less than in the control group (P＜0. 05). Three days after transplantation, VEGF expression levels in ADSC group were significantly higher than in the control group (P＜0. 05). Conclusion ADSC stereotaxially transplanted into the lateral ventricle can survive and differentiate into neuron-like cells. ADSC transplantation may reduce apoptosis and secret VEGF to promote the angiogenesis, and improve neural functional in intracerebral hemorrhage rats.

The curative efficacy of percutaneous transluminal angioplasty and stenting (PTAS) in the treatment of patients with ischemia cerebrovascular disease caused by artery stenosis was explored. The clinical data of 111 patients with ischemia cerebrovascular disease receiving PTAS in Guangdong Province General Hospital from Aug. 2007 to Nov. 2009 were retrospectively analyzed. In total 132 stents were implanted in the 111 patients. The mortality and rate of neural and non-neural complications were assessed perioperatively. Outcomes [including the frequency of transient ischemic attack (TIA), stroke, or death from vascular diseases) were assessed after operation. NIHSS rating was performed in all cases before and at first week, 6th month and 12th month after the operation. The PTAS success rate was 100%. The degree of stenosis was reduced after PTAS. The total complication rate during perioperative period was 15.3% (the rate of neural complications was 3.6%). Sixty-seven patients were followed up. Three patients (4.48%) developed cerebrovascular events within 1 month, containing one case of TIA, one case of ipsilateral mild stroke and one case of contralateral mild stroke. No severe stroke or death was observed. During a follow-up period of 12 months 7 patients had cerebrovascular events (10.44%), including 2 cases of ipsilateral TIA (2.99%), 2 cases of ipsilateral mild stroke and 2 cases of contralateral mild stroke (2.99%), one case of severe stroke (1.49%). In 13 patients receiving DSA re-examination one year after PTAS, 2 patients (15.38%) had in-stent restenosis. NIHSS scores were obviously decreased during a follow-up period as compared with those pre-operation (P<0.05). It was concluded that PTAS could significantly alleviate the neural function deficit of the patients with ischemia cerebrovascular disease. The success rate of PTAS was high, and the rate of complications was lower and the clinical outcomes were satisfactory. PTAS is a safe and effective therapeutic method, though the long-term outcomes need further study.