新生儿惊厥对神经精神发育远期影响的相关研究

目的评估新生儿惊厥在神经精神发育方面的预后。方法分别对130例惊厥组和83例对照组进行发育商、气质类型、社会生活能力的测试,并分析新生儿惊厥不同病冈以及惊蹶初次发作时CT、MRI、AEEG的改变与预后的关系。结果惊厥组患儿的发育商、气质类型、社会生活能力均落后于对照组（P〈0．01）,病因为脑器质性病变的预后更差,惊厥初次发作时CT、MRI、AEEG的改变可预测其后神经精神的发育。结论新生儿惊厥对神经精神发育产生不利影响,提示有必要对其进行早期干预,提高其总体健康水平。     

腰椎术后患者疼痛管理智能化方案的制订及应用

目的 制订腰椎术后患者疼痛管理智能化方案并探讨其实施效果。方法 采用非同期对照研究,便利选取郑州市某三级甲等综合医院脊柱病区腰椎术后患者,其中2018年5月—2019年2月115例为试验组,成立多学科协作团队,依托骨科远程辅助诊断智能机器人及自控镇痛电子泵,实施疼痛管理智能化方案;2017年12月—2018年3月120为对照组,实施常规疼痛管理。比较两组疼痛管理及康复的相关指标。 结果 试验组护士疼痛评估时间、患者疼痛控制时间及平均住院日短于对照组,患者术后最严重疼痛程度低于对照组,患者镇痛满意度优于对照组,差异均有统计学意义（均P<0.05）。 结论 腰椎术后患者疼痛管理智能化可提高疼痛管理的效率,改善患者疼痛结局,缩短患者平均住院日。     

影响汉语阅读障碍儿童文章阅读眼动特征的认知因素

目的:了解汉语阅读障碍儿童认知加工特征,探讨与文章阅读时异常眼动模式的关系。方法:采用病例对照研究,以19例汉语阅读障碍(reading disorder,RD)儿童和年龄、性别、年级与之匹配的19例正常儿童为对象,用韦氏智力测验测试两组被试的认知加工特征。以汉字短文为靶标进行眼动研究,采用回归分析探讨被试阅读时的眼动指标与韦氏分测验得分的相关关系。结果:①RD儿童的知识、分类、词汇、编码四项测验得分,言语智商、全智商,言语理解因子、注意/记忆因子得分均明显低于对照组(均P<0.05);②词汇、图形拼凑、数字广度、知识四项与儿童文章阅读时的平均注视时间相关,其中图形拼凑(r=0.32)、数字广度(r=0.27)得分与其呈正相关,词汇(r=-0.32)、知识(r=-0.27)与其呈负相关;木块图、知识两个分测验与阅读时平均眼跳幅度相关,其中木块图与平均眼跳幅度呈负相关(r=-0.31),知识与其呈正相关(r=0.23)。结论:汉语阅读障碍儿童智力结构存在不平衡,其知识、分类、词汇、编码及言语理解因子及注意/记忆方面存在缺陷,知觉组织方面无明显缺陷;文章阅读时的异常眼动,可能与其知识面和语词知识广度窄密切相关。     

Serial changes of prefrontal lobe growth in the patients with benign childhood epilepsy with centrotemporal spikes presenting with cognitive impairments/behavioral problems

Several studies have reported a higher incidence of learning and behavioral difficulties in association with frontal lobe dysfunctions in children with benign childhood epilepsy with centrotemporal spikes (BCECTS). We studied serial changes in frontal and prefrontal lobe volumes using three-dimensional magnetic resonance imaging in BCECTS with or without cognitive impairments and behavioral problems and evaluated correlations between prefrontal lobe growth and active seizure period. Serial changes in regional cerebral volumes were measured in two patients with cognitive impairments and behavioral problems (BCECTS(+)) and five patients without neuropsychiatric deficits (BCECTS(−)). Eleven normal subjects (4-13 years old) served as controls. Volumes of the frontal and prefrontal lobes were determined using a workstation, and the prefrontal-to-frontal lobe volume ratio was calculated. Frontal and prefrontal lobe volumes revealed growth disturbance in BCECTS(+) compared with BCECTS(−) and control subjects. In addition, prefrontal-to-frontal lobe volume ratio increased serially in BCECTS(−) similarly to controls, but was stagnant or decreased in BCECTS(+). Prefrontal growth also revealed more rapid recovery in a BCECTS(+) patient with shorter active seizure period. These findings suggest that longer active seizure period as frequent spike-waves coupled with the occurrence of frequent seizures may be associated with prefrontal lobe growth disturbance, which relates to neuropsychological problems.     

The association between sleep spindles and IQ in healthy school-age children

Recent studies have suggested that sleep is associated with IQ measures in children, but the underlying mechanism remains unknown. An association between sleep spindles and IQ has been found in adults, but only two previous studies have explored this topic in children. The goal of this study was to examine whether sleep spindle frequency, amplitude, duration and/or density were associated with performance on the perceptual reasoning, verbal comprehension, working memory, and processing speed subscales of the Wechsler Intelligence Scale for Children-IV (WISC-IV). We recruited 29 typically developing children 7–11 years of age. We used portable polysomnography to document sleep architecture in the natural home environment and evaluated IQ. We found that lower sleep spindle frequency was associated with better performance on the perceptual reasoning and working memory WISC-IV scales, but that sleep spindle amplitude, duration and density were not associated with performance on the IQ test.     

全民食盐加碘对沿海城区儿童智力发育的影响

目的了解沿海地区实施有效全民食盐加碘对补碘后出生的儿童智力发育的影响。方法用联合型瑞文测验测定全民食盐加碘出生的儿童智商(IQ)，同时分析社会-经济-文化因素对智力发育影响。结果沿海地区补碘后出生的儿童智力低下的发生率明显低于补碘前出生的儿童。将社会-经济-文化因素与儿童的智商进行多元逐步回归分析，R^2=0．232，结论全民食盐加碘可有效改善儿童智力发育，后天的环境因素对儿童智力发育的影响是有限的。     

韦氏成人智力量表第四版中文版的信度和结构效度

目的:考察韦氏成人智力量表第四版(WAIS-Ⅳ)中文版的信度和结构效度.方法:以年龄、性别、受教育程度为主要变量按比例分层取样,全国16岁以上人口中的实际有效样本1757人,应用WAIS-Ⅳ中文版对样本进行个体智力测验,其中84名被试间隔22d后接受WAIS-Ⅳ中文版的重测.结果:WAIS-Ⅳ中文版的平均信度系数在分测验、过程分数、合成分数上分别为0.82 ～0.94、0.79 ～ 0.83,0.90 ～0.98.重测信度在分测验上为0.68～0.86,过程分数为0.61 ～0.72,合成分数上是0.78 ～0.91.内部相关性研究在言语理解各分测验间为0.65 ～0.71,知觉推理各分测验为0.49～0.57,工作记忆各分测验为0.61,加工速度各分测验为0.61.4个指数分数与全量表智商分数的相关为0.76～0.88.验证性因素分析表明量表的四因素结构拟合较好(RMSEA=0.05,NFI、NNFI、CFI、IFI、RFI、GFI、AGFI均＞0.90,SRMR=0.024).结论:韦氏成人智力量表第四版中文版具有良好的信度和结构效度.     

Long-Term Outcome of Children with Fetal Alcohol Syndrome: Psychopathology, Behavior, and Intelligence

Within an interdisciplinary research project, the long-term outcome of children with fetal alcohol syndrome was studied. Methods for the assessment of psychopathology, behavior, and intelligence included psychiatric interviews, behavior checklists for parents and teachers, and intelligence tests. The children were assessed during preschool age, early school age (6 to 12 years), and late school age (≥ 13 years). An excess of psychopathology, (including hyperkinetic disorders, emotional disorders, sleep disorders, and abnormal habits and sterotypies) with a strong persistence over time was found. Cognitive functioning was marked by a large proportion of mentally retarded children and also did not change considerably over time. This long-term outcome study reflects the handicapping effects of fetal alcohol syndrome.     

碘缺乏对人群智力影响的研究

对乌鲁木齐地甲病轻、重病区和非病区的8～12岁1664名儿童进行了智力测验,重病区儿童智商为72.84,轻病区为77.97,非病区为88.65。智力落后者重病区占35.95％,轻病区占20.95％,非病区占5.60％。经补碘后重病区儿童智商可提高11.79。用选择反应时试验,重病区错误次数在6次以上者占32.80％、10次以上占36.80％,明显多于非病区儿童。     

乳果糖治疗亚临床肝性脑病的临床研究

目的 前瞻性对比乳果糖长、短程治疗对亚临床肝性脑病(SHE)的效果及其对SHE病程的影响。方法 经智力测验(数字连接试验和数字符号试验之一异常)诊断的SHE 64例随机分入对照组(21例)、短程组(21例)和长程组(22例),后2组分别服乳果糖达8周和24周。治疗前以及治疗后每间隔8周行血氨、智力测验和体感诱发电位(SEP)等检查,共随访24周。结果 每组各有20例完成追踪。与对照组和治疗前相比,长程组血氨和智力测验显著改善(P＜0．05—0．01)且SEP的N50波潜伏期稳定不变,短程组治疗到第8周也有改善(P＜0．05),但停药后又逐渐恶化。对照组的血氨、智力测验和N50波潜伏期逐渐恶化,在16周时后2项与治疗前差异有显著性(P＜0．05—0．01);而长程组血氨持续降低,其肝性脑病(HE)患病率(5％)显著低于短程组(30％)和对照组(40％)(P＜0．05)。结论 乳果糖维持治疗能够降低血氨、改善智力测验结果并可能防止SEP的恶化,最终降低HE的患病率。