Mental Health of Mothers of Children with Juvenile Rheumatoid Arthritis: Appraisal as a Mediator

Examined direct and mediated relations between condition parametersand maternal mental health for 53 mothers of 2- to 11-year-oldchildren with juvenile rheumatoid arthritis (JRA). Multivariateanalyses revealed that when considered simultaneously, indicesof both biological severity and functional severity were associatedsignificantly with maternal mental health. Further, mother'sappraisals of the impact of the child's illness on the familypartially mediated the effects of medication type and child'sfunctional status on mother's mental health. Results providesupport for conceptual models that emphasize the cognitive mechanismsby which condition parameters such as biological and functionalseverity might affect maternal mental health. Explicating theprocesses by which a child's JRA might lead to psychologicaladjustment problems in the parent has implications for developingpreventive and treatment interventions.     

儿宝颗粒对幼龄厌食大鼠模型CCK-8的调节作用

目的研究幼龄厌食大鼠中枢及外周八肽胆囊收缩素(CCK-8)的含量变化以及运脾方药对它们的调节作用.方法模拟小儿厌食症的主要病因制作幼龄厌食大鼠模型,用儿宝颗粒治疗,运用放免检测技术测定动物下丘脑及外周血中CCK-8的含量.结果模型动物下丘脑和血浆CCK-8浓度分别为(122.57±31.79)pmoL/g和(506.88±113.32)pg/mL,显著高于正常组(89.15±17.94)pmoL/g(P＜0.05)和(253.76±65.09)pg/mL(P＜0.05);摄食量明显下降,持续3周以上;大小剂量治疗组摄食量均增加,下丘脑及血浆CCK-8含量恢复正常.结论幼龄厌食大鼠模型中枢和外周CCK-8浓度增高,运脾方药对此有明显的抑制作用.     

小儿咽喉乳头状瘤组织人乳头瘤病毒检测及型别分析

目的：探讨人乳头瘤病毒感染和小儿咽喉乳头状瘤的关系。方法：应用ＰＣＲ和ＰＣＲ产物斑点杂交技术检测３５例小儿咽喉乳头瘤组织和１０例小儿声带小结（对照组）ＨＰＶ６、１１、１６、１８、３３五个型别的ＤＮＡ。结果：乳头瘤组织ＨＰＶ感染率为９１．４％（３２／３５）,其中ＨＰＶ６型检出率为５４．２％（１９／３５）,ＨＰＶ１１型感染率为２５．７％（９．３５）,多重型ＨＰＶ６＋１１感染率为１１．４％（４／３５）;     

Attentional Difficulties in Middle Childhood and Psychosocial Outcomes in Young Adulthood

The associations between (dimensionally scored) measures of attentional difficulties at age 8 and psychosocial outcomes at age 18 were examined in a birth cohort of New Zealand children. Increasing attentional difficulties during middle childhood were associated with increased risks of academic failure or difficulties, juvenile offending, and substance use behaviours in young adulthood. However, those with early attentional difficulties were a high-risk group characterised by social disadvantages, early conduct difficulties, lower 1Q, and related characteristics. Statistical adjustments showed: (a) that attentional difficulties were related to later academic success even when due allowance was made for potentially confounding factors; and (b) early attentional difficulties were unrelated to later juvenile offending or substance use behaviours after adjustment for confounding. In all cases there was evidence of consistent dose/response relationships between the extent of early attentional difficulties and later academic outcomes, suggesting that these associations were not confined to those with extreme symptoms.     

Diffuse fibromatosis on the scalp in infancy: A variant of juvenile hyaline fibromatosis

Various types of fibromatosis have been reported in infancy and early childhood. We describe an infant with diffuse fibromatosis on the scalp. A one year and five months-old girl showed a diffuse and hard mass 3 × 5 cm in diameter and no tenderness on the scalp. Two months later, the size of the mass had increased and several other tumors appeared on the lateral head. The magnetic resonance imaging (MRI) disclosed that a large and diffuse tumor had spread from the frontal to occipital head; a ‘helmet-like’ configuration of the tumor was exhibited on sagittal MR images. The tumor showed high signal intensity on T2-weighted images and was enhanced with Gd-DTPA. Histological examination showed a fibroblastic proliferation with intervening thick collagen bundles. The patient was diagnosed as having diffuse fibromatosis. The tumor at the resection site immediately recurred, whereas the tumor in the frontal head showed marked regression. Three months after the resection, new tumors appeared in the occipital head. The size and number of these tumors have remained unchanged for more than 18 months. The sites and appearance of the tumors were identical to that of juvenile hyaline fibromatosis (JHF) in this patient. However, JHF usually includes fibroblasts associated with large amounts of hyalinized collagen-like material, which were not present in our patient. The different histology of JHF comparing our case and other reported cases may depend on the different phase of the disease progression at resection. Long-term observation is necessary for the appropriate diagnosis and evaluation of prognosis in this patient.     

Tobacco and Alcohol Use as an Explanation for the Association Between Externalizing Behavior and Illicit Drug Use Among Delinquent Adolescents

The prevalence and persistence of adolescent substance use and abuse is a national health issue, and substance use among adolescents is frequently comorbid with other psychiatric disorders. Most studies in this area utilize samples of middle or high school students or from inpatient settings. Less is known about substance use and psychiatric comorbidity among delinquent adolescents. The present study examined data from two cohorts of juvenile offenders collected over a 2-year period (n = 245, n = 299). Participants reported frequency of cigarette, alcohol, marijuana, and other substance use. Participants' parents completed a measure of behavior problems. Path analyses suggested that parental reports of externalizing problems were significantly related to self-reported substance use while parental reports of internalizing problems were not. Results also suggested that smoking and alcohol use act as mediators between externalizing problems and marijuana and other drug use. Although there were some mean differences by gender, the pattern of relationships amongst the variables did not differ by gender. Implications of the findings and future directions are discussed.     

非甾体类消炎药联合甲氨蝶呤治疗全身型幼年特发性关节炎疗效观察

目的探讨非甾体类消炎药(NSAIDs)联合甲氨蝶呤(MTX)治疗全身型幼年特发性关节炎(SO-JIA)的疗效。方法分析比较32例SO-JIA患儿以NSAIDs联合MTX治疗后临床症状的变化,关节炎病情改善评估参照美国风湿病学会推荐的类风湿性关节炎改善标准。结果32例患儿治疗后,体温恢复正常27例,退热有效率为84.4%(27/32例),5例加用糖皮质激素后热退;31例关节炎症状改善,有效率为96.9%(31/32例),1例加用来氟米特后关节炎症状缓解。停药观察3例,复发1例。结论SO-JIA诊断确立后应尽早予NSAIDs联合MTX治疗,NSAIDs能较好地退热及减轻关节症状,MTX可有效持续改善关节炎症。糖皮质激素不作为首选退热用药。     

幼年特发性关节炎患儿外周血Th细胞亚群变化

目的探讨幼年特发性关节炎(JIA)患儿外周血CD4 T淋巴细胞及其亚群CD4 CD45RA 、CD4 CD45RO 的表达及其临床意义。方法采用免疫荧光标记技术和流式细胞仪检测36例JIA患儿外周血CD4 T淋巴细胞及其亚群CD4 CD45RA 、CD4 CD45RO 的表达,同期检测20例年龄、性别无差异的健康儿童为对照。结果JIA患儿外周血CD4 T淋巴细胞明显低于对照组(t=2.099,P<0.05),CD4 CD45RA T淋巴细胞数与对照组比较明显降低(t=3.450,P<0.01),CD4 CD45RO T淋巴细胞数明显升高(t=3.913,P<0.01),CD4 CD45RA T/CD4 CD45RO T比值明显降低(t=4.904,P<0.01);与对照组比较,JIA各亚型(全身型、多关节型、少关节型)的CD4 CD45RO T淋巴细胞数均明显升高,CD4 CD45RA T/CD4 CD45RO T比值明显降低(P<0.01);CD4 CD45RA T淋巴细胞数与正常对照组比较在全身型中显著降低(t=4.192,P<0.01);在多关节型中明显降低(t=2.214,P<0.05);在少关节型中稍有降低,但与对照组比较差异无显著性(t=1.793,P>0.05)。结论JIA患儿的免疫功能紊乱主要表现为CD4 T淋巴细胞及其亚群CD4 CD45RA T/CD4 CD45RO T失衡,这可能在JIA发病机制中起着重要的作用。     

类风湿性关节炎患儿关节滑液和外周血上皮嗜中性粒细胞激活肽水平变化

目的测定类风湿性关节炎(RA)患儿的关节滑液和外周血上皮嗜中性粒细胞激活肽(CXCL-5)水平,探讨其在疾病发生发展过程中作用。方法收集26例RA和16例健康儿童膝关节滑液和外周血清标本,采用双抗体夹心酶联免疫吸附法(ELISA)检测CXCL-5水平。部分RA患儿接受激素等治疗,待临床症状控制后,复查外周血和关节滑液CXCL-5水平,观察CXCL-5与疾病发展的关系。结果RA患儿膝关节滑液CXCL-5水平明显较对照组增高(P<0.001),而外周血CXCL-5水平与对照组无明显差异(P>0.05)。经合理使用激素治疗后,RA患儿关节滑液CXCL-5水平较治疗前明显下降(P<0.001),并接近健康对照者。结论CXCL-5可能直接刺激JA患儿中性粒细胞向关节滑膜内移动,并参与关节滑膜的炎症过程。