Objective To reconstruct the soft tissue defect in the back or neck after excision of hypertrophoc scar or giant nevus by using transmidline pre expanding scapula flap vascularied by ipsilateral circumflex scapular artery. Methods The reconstruction can be accomplished in two stage procedures. First, scapular flaps were expanded for 4 6 weeks prior to transfer in 8 patients. Second,the pedicled flaps were designed across the entire back to incorporate both scapular territories but were rotated on a single vascular pedicle. Results All flaps survived. Only two flaps had marginal necrosis, and the wound healed well by dressing. Conclusion Flap expansion produces a delay that augments blood supply and increases the area of skin that survives on a single vascular pedicle. This technique may be useful in selected patients in whom a large and thin fasciocutaneous flap is required and there is sufficient time to allow flap expansion prior to thansfer. It is easy to harvest, and donor site morbidity is negligible. The patients can get better functions and quality of life.

Objective To study the application of 16-slice spiral CT imaging in diagnosis of aortic dissection.Methods Sixty-one patients with aortic dissection were examined through 16-slice spiral CT imaging.Post-processing techniques were MPR,MIP and VR.Results According to AD,type Ⅰ were 10 cases,type Ⅱ 8 cases and type Ⅲ 43 cases.After contrast-enhanced scanning,true and false lumen and intimal flap of aortic dissection could be shown in all of 61 cases.32 patients have re-entrance,in which 1 patients had five re-entrances,2 patients three re-entrances and three patients haven't any re-entrance.61 patients had explicited true and false lumen.16 patients had intimal calcification and 28 patients had mural thrombus.Conclusion Angiography with 16-slice spiral CT in the diagnosis and evaluation of aortic dissection is a more effective non-invasive screening method with some essential value for the clinical therapies.

Objective To determine the characteristics of early cognitive dysfunction and N300 event-related potentials(ERPs)in patients with acute cerebral infarction(ACI).Methods Thirty patients with ACI and thirty normal healthy elderly people were studied.The two groups were examined with a picture recognition test and EEG waveforms were recorded.The ERPs were analysed statistically.The mini-mental state examination(MMSE) was used to evaluate cognitive function,and the results were correlated with the ERPs. Results The average MMSE scores of the ACI and control groups were significantly different.Reaction times(RTs)in the picture recognition test were(798.63±49.32)ms in the ACI group and(765.21±35.67)ms in the control group,a difference significant at the 5% confidence level.The average accuracy rates,(59.75±8.45)%and(65.26±9.28)%,were also significantly different.Average N300 ERPs the in the ACI group were significantly lower than those in the control group,and the average latencies were significantly longer.Both latency and amplitude in the ACI group showed a linear correlation with MMSE scores. Conclusion The ERPs of ACI patients have some clinical significance,and can be used as a scale-based assessment of cognitive function.

BACKGROUND:Biological dressing A (porcine Xenoderm) and Physiotule Ag (Coloplast) show good effects on the absorption of exudates, adhesion and anti-bacteria in treatment of degree Ⅱ facial burns. OBJECTIVE:To observe the effectiveness of biological dressing Aversus Physiotule Ag after early debridement of degree Ⅱ facial burns. METHODS:A total of 15 patients with superficial degree Ⅱ facial burn and 10 patients with deep degree Ⅱ facial burns were included. Symmetric facial area of the same patient with the same depth of burn was divided into two parts of same size for treatments. One side was randomly selected as the experimental side, and treated with biological dressing A. The other was selected as the control side and treated with Physiotule Ag. We compared wound healing time, infection, times of changing dressings, skin after healing, drug change comfort and dressing comfort between the two sides. RESULTS AND CONCLUSION:In patients with superficial grade Ⅱ facial burn, times of changing dressings and drug change comfort were better in the experimental side than in the control side (P < 0.05), but the dressing comfort was better in the control side than the experimental side (P< 0.05). No significant difference in wound healing time, infection and skin after healing was detected between the two sides. In patients with deep degree Ⅱ facial burns, wound healing time, times of changing dressings, skin after healing and drug change comfort were better in the experimental side than in the control side (P < 0.05), but the dressing comfort was better in the control side than the experimental side (P< 0.05). No significant difference in infection was detectable between the two sides. Above findings suggested that the therapeutic effects of biological dressing A and Physiotule Ag were similar in treatment of degree Ⅱ facial burns. Biological dressing A in repair of deep degree Ⅱ facial burns promotes the wound healing andelevates the quality of healing.

OBJECTIVETo investigate the significance of beta-adrenergic receptor 2 (beta2-AR) and vascular endothelial growth factor-2 (VEGFR-2) in the occurrence and development of infantile hemangioma through detecting the expression of beta2-AR and VEGFR-2 in the different stages of infantile hemangiomas.

METHODSAccording to the Mulliken's classification standard, we classified the specimens as proliferating group (32 cases), involuting group (17 cases) and involuted group (11 cases). Normal skin tissue surrounding the hemangioma from 7 cases were chosen as control group. The expression of beta2-AR and VEGFR-2 was detected by immunohistochemical technique in proliferating hemangioma, involuting hemangioma, involuted hemangioma. The mean optical density was measured by image analysis system (Image Pro Plus 6.0) and SPSS 16.0 software was applied for statistical analysis.

RESULTSThe expression of beta2-AR and VEGFR-2 was strongly positive in proliferating hemangioma, while positive in involuting hemangioma and weakly positive in the involuted stage. The mean optical density of each phase was 0.064 751 2 +/- 0.012 747, 0.031 6017 +/- 0.006 848,0.011 869 8 +/- 0.039 349 for beta2-AR, and 0.068 940 9 +/- 0.029 274, 0.028 445 5 +/- 0.006 396, 0.011 184 1 +/- 0.004 198 for VEGFR-2. The differences between different stages had a statistically significance (P < 0.05). Correlation analysis on the mean optical density between beta2-AR and VEGFR-2 had a statistically significance (P < 0. 05).

CONCLUSIONSBeta2-AR and VEGFR-2 may be involved in the occurrence and development of infantile hemangioma.

Child ; Child, Preschool ; Female ; Hemangioma ; metabolism ; Humans ; Infant ; Male ; Receptors, Adrenergic, beta-2 ; metabolism ; Receptors, Vascular Endothelial Growth Factor ; metabolism

Objective To investigate the effect of transitional care on postpartum negative mood for puerpera. Methods One hundred sixty eligible puerperas were recruited between January 2013 and October 2014. By order of hospitalization, participants were randomly assigned into two groups. The control group (80 cases) received routine care. The study group received transitional care which consisted of predischarge assessment, structured home visits and telephone follow-ups, psychological rehabilitation group activities, phone and internet consulting services within six months after discharge. Screenings of predischarge depression and anxiety symptoms of the study group were done by Hospital Anxiety and Depression Scale (HADS). Evaluations of depression and anxiety symptoms of two groups were done by Edinburgh postnatal depression scale (EPDS) and Self-Rating Anxiety Scale(SAS)on postpartum forty-two days and six months. Results There were no differences in demographics, maternal indicators and completion of follow-up between groups (P > 0.05). On postpartum forty-two days, the study group had significantly better depression and anxiety scores (P < 0.05), the depression and anxiety scores of study group were 7.71 ± 2.61and 44.3 ± 6.1, those of control group were 8.31 ± 2.72 and 47.6 ± 5.4. There were no differences in the incidences of depression and anxiety between the two groups (P>0.05). On postpartum six months, the study group had significantly better depression and anxiety scores, less incidences of depression and anxiety than the control group (P<0.05). The depression and anxiety scores of the study
group were 7.13±2.52 and 42.6±6.0, those of control group were 8.87±2.66 and 48.8±5.9. The incidences of depression and anxiety of study group were 6.4%(5/78)and 7.7%(6/78), those of control group were both 26.0%(20/77). Analysis of multiple linear regression suggested that age, education level and family income would affect transitional care intervention on postpartum depression. Conclusions This study established a nurse-led transitional care model which selected the gynecology and obstetrics professional nurse as advanced practice nurse. Results demonstrated that transitional care was effective on improving maternal postpartum depression and anxiety.

Objective To explore the relationship between perceived social support,pro-social behavior and self-esteem of children affected by AIDS,and provide a theoretical basis for the children affected by AIDS to establish good pro-social behavior.Methods 300 children affected by AIDS were taken from Henan province where seriously affected by HIV.Perceive social support scale,self-esteem scale and pro-social behavior scale were used to test the 300 children affected by AIDS.Multiple linear regression analysis,bootstrap testing and other statistical analysis were used for data correlation analysis.Results (1) Children affected by AIDS perceived social support effects are significantly positively related to their self-esteem(r=0.436,P＜0.01) and pro-social behavior(r=0.457,P＜0.01).Children affected by AIDS self-esteem was significantly positively related to pro-social behavior (r=0.477,P＜0.01).(2)The variance of the interpretation of the mutation rate of perceived social support to the pro-social behavior of children affected by AIDS was 20.8％ (F=67.944,P＜0.01).The variance of the interpretation of the mutation rate of self-esteem to the pro-social behavior of children affected by AIDS was 22.8％ (F=76.146,P＜0.01).(3)Self-esteem as an intermediary variable,perceived social support of children affected by AIDS were significantly for both direct effect and indirect effect.The estimation value of the self-esteem's mediating effect was 0.208(P＜0.01) and the estimation value of direct effect between perceived social support and pro-social behavior was 0.272(P=0.02).Conclusion Perceived social support and self-esteem are the chief influencing factors of pro-social behavior of the children affected by AIDS.Self-esteem is the mediator of perceived social support and pro-social behavior.

Objective To optimize the matrix formula of propranolol hydrochloride gels. Methods On the basis of single factor experiment, central composite design-response surface method was used to optimize the formula. Addition levels of glycerol (A), PEG-400 (B) and HPMC (C) were evaluated as the independent variables.Eight-hour accumulative penetration amount per unit area measured by HPLC was used as the index. Quadratic polynomial was used to estimate the relationship between the index and the independent variables, and to delineate response surface and overlay contour plots in order to select the optimal formulations.Finally, predicted responses were verified. Results The optimized formula consisted of 18.53% glycerol, 8.54% PEG-400 and 2.35% HPMC.The quadratic polynomial regression model of 8-h accumulative penetration amount per unit area:R1=-7 415. 69+306. 10A+167. 47B+4 820. 59C-8. 26A2-9. 81B2-1 025. 75C2 , and the cumulative transmittance was 49.6%. Conclusion A credible model is established by using central composite design-response surface method and the formula of propranolol hydrochloride gels is optimized and the gel is stable and controllable.

Objective To explore the therapeutic effect and the efficacy of external carotid artery catheterization and drug infusion therapy for severe infant hemangiomas in oral and maxillofacial regions.Methods The clinical and follow-up data of 126 cases with severe infant oral and maxillofacial hemangiomas were retrospectively analyzed in Henan Provincial People's Hospital between June 2004 and December 2009.The patients included 45 male and 81 female cases,and the average visiting age of the patients was 3.9 months (ranged 10 days to 1 year and 4 months).Among 126 patients,24 cases occurred with Kasabach-Merritte syndrome (KMS).The patients were treated with ligation of external carotid artery,insertion of a tube inside the lesion and injection of 400 g/L Carbonyldiamide after operation.Methylprednisolone was added in infusion if the patients were combined with KMS.Results The mean follow-up period was 6.1 years (ranged 4.3 to 10.2 years).All of 126 cases were cured through the management including external carotid artery catheterization and drug infusion therapy in 94 cases,and the combination treatment of the infusion and local Carbonyldiamide injection in 32 cases.The size of hemangiomas gradually shrank and disappeared after the therapy.The hemangiomas in 105 cases disappeared completely in 6-12 months,and 21 cases disappeared in 1-2 years.Twenty-four patients were complicated with KMS.The thrombocyte count and blood coagulation function also returned to normal after the therapy.Among the 24 cases,the thrombocyte count in 13 cases was back to normal within 3-7 days,and 7 cases within 8-14 days.In the remaining 4 cases,it normalized within 15-30 days.The weight,height,immunity of the patients were in keeping with the healthy counterparts after long term follow-up.And no serious adverse effect was observed.Conclusions For severe infant hemangiomas in oral and maxillofacial regions,the external carotid artery catheterization and drug infusion therapy can obviously shorten the treatment time,and reduce the drug side effects.It is a better and more reliable treatment method.

Objective To build a multi-system chain transitional care programme for postpartum pelvic floor training and test its effect.Methods By a prospective randomized controlled trial,the study group (n=60) received a multi-system chain transitional care programme which consisted of ward nurse,home visiting doctor,post-natal care clinic doctor,pelvic floor doctor and pelvic floor nurse.The control group(n=60) received routine care.The pelvic floor muscle strength,sexual function and patient satisfaction of baseline,on the 42th days,3rd months and 6th months were compared between two groups by short-term follow-up.Results There was no difference in baseline consisting of age,gestational weeks,birth weight and so on between groups.Participants in the study group had significantly better improvement and score in pelvic floor muscle strength,sexual thoughts,sexual arousal,sexual psychopathy and problems affecting sexual function.There was no difference in score of sexual pleasure and ejaculation time between two groups.Conclusions This study was an original effort to establish and evaluate a multi-system chain transitional care program for postpartum pelvic floor training.Results demonstrated that this transitional care was effective in improving pelvic floor function.