Objective To explore the prevalence of anxiety and depression among the medical staff of a children's hospital, and to understand their relationship with age, gender, educational background, family income, family harmony, position, marital status, experience, title, work pressure, weekly working hours, chronic diseases and stressful events.Methods The medical staff of a children's hospital were evaluated using Zung's self-rating anxiety scale (SAS) and self-rating depression scale (SDS).The scores were correlated with age, gender, educational background, family income, family harmony, position, marriage, working years, title, work pressure, weekly working hours, chronic diseases, and stressful events data collected about the same respondents.Results There were 320 respondents suffering from anxiety disorders and 392 experiencing depression among the 677 medical staff surveyed.There were 288 who suffered from anxiety associated with depression.There was a significant difference between the males and the females.Marital status, family harmony, chronic disease and stress events were all significant predictors of anxiety or depression.A univariate analysis showed that neither education nor family income had significant predictive power, but age, professional title,working years, working pressure and working in different departments were all significant predictors.Medical staff with different weekly working hours showed significantly different average levels of anxiety, but position had no such effect.Position was, though, significantly correlated with depression score, while weekly working hours were not.Multivariable logistic regression models showed that educational background, working pressure, family harmony, chronic disease and stressful events were all significant predictors of anxiety.Working pressure, family harmony and chronic disease were related to depression.Conclusion Significant anxiety and depression were observed among the medical staff of this children's hospital.Working pressure, family harmony and chronic disease are strong predictors of anxiety and depression.

Objective To evaluate the effectiveness and safety of hyperbaric oxygen (HBO) therapy as an adjunctive therapy for children with dyskinetic cerebral palsy. Methods Seventy-one children with dyskinetic cerebral palsy aged 6 mouths to 2 years were randomly assigned to a HBO group ( n = 35 ) or a control group ( n = 36).All children were given conventional rehabilitative treatment, but the children in the HBO group in addition received 40 sessions of HBO therapy. HBO was administered for 1 h with 85% ～ 90% oxygen at 1.4 atmospheres absolute pressure. All the treatments in both groups continued for 8 weeks. Gross motor function was evaluated with a gross motor function measure ( GMFM ), global motor performance was assessed with a psychomotor development index (PDI), and intelligence was assessed with a mental development index (MDI). Clinical assessments were done before and after treatment. At the same time, hearing impairment was measured using brainstem auditory evoked potentials (BAEPs) in the HBO group. Results All outcomes in both groups improved significantly over the course of study. The average improvement in GMFM in the control group was significantly greater than in the HBO group but other differences were not statistically significant. Hearing impairment developed in 8 children treated with HBO.Conclusion There was no evidence that HBO therapy improved the condition of children with dyskinetic cerebral palsy, and there is a risk of side effects with HBO therapy.

Objective To explore the clinical features and the gene mutations in MECP 2 duplication syndrome. Methods The clinical data of a child with developmental retardation and hypophrenia accompanied with respiratory tract infection was analyzed retrospectively. Microarray analysis technique was used to detect the genes in the patient and his family. The pertinent literature was reviewed. Results A 1-year and 7-month old boy was found to have hypotonia, developmental delay, and recurrent respiratory tract infections after birth. Microarray analysis showed a duplication of 441.88kb in Xq28 area and diagnosis of MECP2 duplication syndrome was confirmed. His grandmother, mother, and two aunts were found duplication of 441.73-441.88kb in Xq28 area, all of whom were MECP2’s female carrier. Conclusions The improvement of chromosome chip technology inspection is helpful to the early diagnosis of MECP2 duplication syndrome.

Objective To explore the effects of transcranial ultrasound (TU) on the sensory functioning of children with cerebral palsy (CP).Methods Sixty-seven children with CP were randomly divided into a TU group (n =33) and a control group (n =34).All of the children were given conventional rehabilitative treatment, but the children in the TU group also received TU stimulation at 1.2 W/cm2 for 20 min daily, 5 times a week.All the treatments continued for 3 weeks in both groups.Before and after the intervention, the latencies and amplitudes of N20 and P37 were recorded and the escape reflex threshold was measured using the Von-Frey method.Results Before the treatment there were no significant differences between the two groups.After the 3 weeks of treatment, significant differences were observed in the N20 and P37 amplitudes, but not in the latencies in the control group.In TU group, however, the N20 and P37 latencies were significantly shorter and the amplitudes were significantly improved after the treatment.So significant inter-group differences were found in terms of N20 latency and both N20 and P37 amplitude after the treatment.The average escape reflex threshold in the TU group was significantly lower than before treatment, but not significantly different from the control group's average.Conclusions Transcranial ultrasound can effectively shorten the latencies and increase the amplitudes of somatosensory evoked potentials, suggesting that it can improve somatosensory functioning in children with CP.

Objective To observe the therapeutic effect of transcutaneous electric nerve stimulation on children with flaccid cerebral palsy. Methods 40 children with flaccid cerebral palsy were divided into 2 groups: treatment group (n=20) and control group (n=20). 2 groups were given conventional rehabilitation training for 30 d, while the treatment group added transcutaneous electric nerve stimulation on quadriceps femoris for 30 d. Quadriceps femoris was assessed by Modified Lovett classification, gross motor function was assessed by Gross Motor Function Measure (GMFM), and integrated electromyogram (iEMG) and root mean square (RMS) were recorded. Results There was significant improvement in 2 groups in Modified Lovett classification, GMFM, and iEMG and RMS (P<0.05) while the treatment group was better than the control group (P<0.05). Conclusion Transcutaneous electric nerve stimulation can enhance the muscle tone and strength of quadriceps femoris to improve gross motor function for children with flaccid cerebral palsy.

Objective To observe the effect of supplementing constraint-induced movement therapy (CIMT) with virtual reality games in rehabilitating the motor function of hemiplegic children with cerebral palsy (CP).Methods Fifty hemiplegic children with CP were randomly divided into a control group and a treatment group,each of 25.All were given conventional rehabilitation.The children in the control group received CIMT for 4 hours,plus 1 hour of occupational therapy for the more-affected limb supported by therapists and 3 hours of daily training in life activities with their guardians' help.Those in the treatment group received occupational therapy for 1 hour,played virtual reality games for 1 hour and practiced daily life activities for 2 hours per day.All of the treatments were carried out five days a week for 3 weeks.Before and after the intervention the quality of upper extremity skills test (QUEST),the Chinese version of the gross motor function measuring scale (GMFM) and the pediatric evaluation of disability inventory (PEDI) were used to evaluate upper limb function,gross motor function and the social abilities.Results After the treatment,significant improvement was observed in the average QUEST,GMFM and PEDI scores of both groups,but the average scores in the treatment group were significantly higher than among the controls.Conclusions CIMT combined with playing virtual reality games improves the motor function and social abilities of hemiplegic children with CP.

Objective To investigate any protective effect of transplanting EPhrinB2-modified bone marrow mesenchymal stem cells ( BMSCs) with a rat model of cerebral palsy. Methods BMSCs were isolated and cultured, then further modified by lentivirus-mediated transfection of the EPhrinB2 gene. Ninety-six Sprague-Dawley rats were randomly divided into a sham group, a solvent control group ( PBS group) , an empty lentivirus group ( EGFP group) and an EPhrinB2 recombinant lentivirus group ( EPhrinB2 group) , each of 24. A model of cerebral palsy was estab-lished in the rats of the PBS, EGFP and EPhrinB2 groups using hypoxic-ischemic encephalopathy. Seven days after the operation, the lateral ventricles of the PBS, EGFP and EPhrinB2 group mice were injected with phosphate-buff-ered saline solution, BMSCs or EPhrinB2-modified BMSCs respectively. EPhrinB2 protein expression in the hippo-campus was detected using immunohistochemistry 28 days after the operation. The neuron density in the CA1 region of the hippocampus was observed using hematoxylin and eosin staining, and any apoptosis of hippocampal neurons was detected using terminal deoxynucleotidyl transferase dUTP nick end labeling. The expression of nestin and CD31 in the hippocampus was observed using immunofluorescence assays. Morris water maze testing was also conducted to e-valuate changes in learning and memory ability. Results Compared with the other 3 groups, a significant increase in the expression of protein EPhrinB2 was observed in the hippocampuses of the EPhrinB2 group rats. The pathologi-cal changes in the hippocampus among the EPhrinB2 group were significantly less severe than those in the PBS and EGFP groups. The rate of apoptosis in the hippocampuses of the EPhrinB2 group was significantly lower than that of the other groups. Immunofluorescence showed that nestin- and CD31-positive cells were significantly more numerous in the EPhrinB2 group than in the others. In the water maze the average latency of the EPhrinB2 group was signifi-cantly shorter than those of the other groups. Conclusion Lentiviral-mediated EPhrinb2 transfection of BMSCs into the hippocampus can promote EPhrinB2 gene expression, promote angiogenesis and neuron differentiation, inhibit ap-optosis and accelerate the repair of injured nerves.

Objective To observe the effects of Children's Crawling-Promotion-Training-Robot on gross motor function and cognitive function in children with spastic diplegia.Methods From January to December, 2017, 60 children with spastic diplegia were selected and randomly divided into three groups, with 20 cases in each group. All the groups received routine comprehensive rehabilitation therapy. In addition, group I received manual crawling training, group II was treated with crawler-training therapy, and group III was treated with Children's Crawling-Promotion-Training-Robot. They were treated ten minutes every day, five days a week for twelve weeks. Before and after treatment, the gross motor development, the muscle tension and cognitive function were evaluated with Gross Motor Function Measure Scale-88 (GMFM-88), modified Ashworth Scale (MAS) and developmental quotient (DQ) in Gesell Developmental Scale (GDS), respectively.Results After treatment, the overall percentage of GMFM-88 and the score of C dimension which were tightly tied to crawling and kneeling improved in all the groups (t>17.438, P<0.001), and the score was better in groups II and III than in group I (P<0.05), especially in group III (P<0.05); the score of MAS improved in all the groups (t>2.144, P<0.05), and no significant difference was found among them (F=0.199, P>0.05); the score of DQ in GDS improved in groups II and III (t>3.040, P<0.001), and the score was better in groups II and III than in group I (P<0.05), especially in group III (P<0.05).Conclusion Children's Crawling-Promotion-Training-Robot could improve the gross motor and cognitive function of children with spastic diplegia, which is better than manual crawling training and crawler-training.