丰富环境在孤独症谱系障碍患儿中的作用及应用研究进展

孤独症谱系障碍(ASD)是一类神经发育障碍性疾病,患病率呈逐年上升趋势,且目前尚无治疗ASD核心症状的药物。在内在遗传因素不可调控的情况下,越来越多的研究聚焦于环境参数在神经发育方面发挥的作用。该文对丰富环境在ASD患儿中的作用及应用研究进展作一综述。     

孤独症谱系障碍患者攻击行为发生危险因素、病情评估及治疗方法的应用研究进展

孤独症谱系障碍（ASD）是一种发育行为障碍性疾病,攻击行为是一种常见的ASD行为问题。ASD患者发生攻击行为的危险因素包括共患躯体疾病、缺乏沟通技巧、心理社会压力较重、不良的行为强化模式、伴发情绪精神障碍。Achenbach儿童行为量表、异常行为量表及孤独症诊断访谈问卷修订版是目前临床常用的评估ASD儿童攻击行为的病情严重程度量表。ASD攻击行为的治疗包括非药物治疗和药物治疗,行为疗法是目前最常用的非药物治疗方法,当非药物治疗无效时,利培酮、阿立哌唑及n-乙酰半胱氨酸等药物治疗ASD攻击行为的效果较好。     

孤独症谱系障碍患儿血清S100钙结合蛋白B水平变化及其基因多态性观察

目的 观察孤独症谱系障碍（ASD）患儿血清S100钙结合蛋白B(S100B)水平变化及S100B基因rs1051169位点多态性,探讨S100B基因多态性与ASD易感性的关系。方法 选择78例ASD患儿为ASD组、80例健康体检儿童为对照组,抽取两组外周静脉血,采用ELISA法检测血清S100B,采用聚合酶链反应联合DNA直接测序法检测两组S100B基因rs1051169位点基因型,绘制受试者工作特征曲线（ROC）分析血清S100B水平对ASD的诊断效能。结果 与对照组比较,ASD组患儿血清S100B水平高（P<0.001）。S100B诊断ASD的ROC曲线下面积为0.808(95%CI为0.741～0.875),当S100B为0.351 ng/mL时,诊断ASD的特异度为95%、灵敏度为58%。ASD患儿和健康对照儿童S100B基因rs1051169位点基因型及等位基因分布频率差异无统计学意义（P均>0.05）。结论ASD患儿血清S100B水平升高。血清S100B水平诊断ASD的特异度较高。S100B基因rs1051169位点基因多态性可能与ASD的易感性无关。     

儿童孤独症的临床分析

目的分析孤独症儿童的临床特点。方法将50例患有儿童孤独症的患儿作为研究对象,综合观察其孤独症的临床表现,然后再进行发育商的测定和标准CAKS孤独症量表进行评价。结果研究发现这些孤独症患儿在早期的表现行为与其他的正常儿童有明显的不同之处。50例患儿均完成了测试,智力正常2例,占4%;轻度智力缺陷18例,占36%;中度以上智力缺陷30例,占60%。标准CAKS孤独症量表评定:非孤独症型2例,轻度孤独症型28例,严重孤独症型20例。结论孤独症在儿童中出现的频率较高,是一种比较严重的精神方面疾病。对于这种精神疾病,目前尚无良好的治疗方法,因此就需要采用现有的医学手段来进行及早的发现、及早的诊断和及早的干预,减少这类疾病的发生和向坏的方向发展。     

老年人记忆障碍影响因素及干预研究进展

老年痴呆作为老龄化社会的常见病,已成为备受关注的社会问题,痴呆将对社会经济发展和老年卫生保健带来巨大挑战.如果在痴呆临床前阶段对疾病进程进行干预,将节省大量花费.因此,正常老龄化向痴呆过渡状态的轻度认知障碍(MCI),越来越受到医药学术界的关注.MCI最敏感最常见的指标是记忆障碍.目前我国已经步入老龄化社会,老年人群中发生认知障碍尤其是记忆障碍者十分常见.     

儿童应用阿奇霉素发生不良反应的因素及干预方法

阿奇霉素为新一代大环内酯类抗生素,其临床疗效满意,但不良反应发生率高.2004年1月～2005年5月,我们对983例应用阿奇霉素患儿进行观察和临床干预,统计出影响阿奇霉素不良反应的因素,探讨避免阿奇霉素不良反应的方法.现报告如下.……     

儿童注意缺陷多动障碍的健康教育

儿童注意缺陷多动障碍（ADHD）又称儿童多动症，是临床常见的一种儿童卫生问题，其突出表现为注意力缺陷，以多动为主的行为障碍及冲动性，可伴有诸多心理行为问题，影响孩子的学习、性格发展和社会适应能力。文献报道在中小学生中患病率为5％～10％，跟踪报道25％～50％患儿成人期有人格障碍，易冲动和反社会行为。而许多父母和教师对出现的症状不理解，往往对其进行指责、谩骂等，对孩子的身心健康造成严重的损伤。我们对156例ADHD患儿父母及教师，进行必要的健康教育，效果满意，现总结报告如下。     

脑卒中患者情绪障碍的流行状况及心理干预策略的研究进展

<正>脑卒中具有高复发率、高致残率、高病死率的特点,患者易出现躯体功能障碍、语言障碍、认知障碍、情绪障碍等多种功能障碍~([1~3]),其中脑卒中后情绪障碍的发生常影响患者的康复进程、功能结局及生活质量~([4])。对脑卒中患者进行情绪障碍的识别筛查,早期发现和消除负性情绪,及时对其进行有效干预,能减轻脑卒中后情绪障碍对疾病的消极影响,有效改善脑卒中患者的功能结局及生活质量。但目前关于脑卒中后情绪障碍的     

DR患者睡眠障碍非药物干预的研究进展

<正>研究显示,我国糖尿病(DM)慢性并发症的总患病率为73.2%,其中眼病高达36.8%,是致盲的首要原因,给患者家庭和社会造成严重的经济负担^[1]。随着社会的快节奏发展,DM视网膜病变(DR)患者的睡眠问题日益严峻,目前治疗睡眠障碍(SD)主要有药物和非药物干预两种方式,但药物干预副作用大且成瘾性强,而非药物干预方式简单实用,安全有效,能够提高患者的治疗依从性,因此,本文对DR患者SD相关的非药物干预措施进行综述,并分析其安全性和有效性。     

Functional analysis of gut microbiota and immunoinflammation in children with autism spectrum disorders

Background and AimsRecent evidence implicates gut microbiota (GM) and immune alterations in autism spectrum disorders (ASD). We assess GM profile and peripheral levels of immunological, neuronal and bacterial molecules in ASD children and controls. Alarmin HMGB1 was explored as a non-invasive biomarker to monitor gastrointestinal (GI) symptoms.MethodsThirty ASD children and 14 controls entered into the study. GM metagenomic analysis was performed for 16 ASD patients and 7 controls. GM functional profile was assessed by GO term analysis. Blood levels of IL-1β, TNFα, TGFβ, IL-10, INFγ, IL-8, lipopolysaccharide, Neurotensin, Sortilin1 and GSSG/GSH ratio were analyzed in all subjects by ELISA. Fecal HMGB1 was analyzed by Western blot.ResultsWe observed a significant decrease in bacterial diversity. Furthermore, 82 GO terms underrepresented in ASD. Four of them pointed at 3,3 phenylpropionate catabolism and were imputable to Escherichia coli (E. coli) group. Serum levels of TNFα, TGFβ, NT, and SORT-1 increased in ASD patients. Fecal levels of HMGB1 correlated with GI sign severity in ASD children.ConclusionsWe suggest that a decrease of E. coli might affect the propionate catabolism in ASD. We report occurrence of peripheral inflammation in ASD children. We propose fecal HMGB1 as a non-invasive biomarker to detect GI symptoms.     

Traditional Chinese medicine intervention for autism spectrum disorders: A protocol for systematic review and network meta-analysis

Background:Autism spectrum disorder (ASD) is a neurodevelopmental disorder characterized by impairments in social communication, social interaction, and restrictive or repetitive behaviors. Traditional Chinese medicine (TCM) has been used in the clinical management of ASD, especially in mainland China, where studies have shown promising efficacy. However, this remains to be further explored and clarified. Therefore, the purpose of this study was to evaluate the effectiveness and safety of conventional treatment-based TCM interventions for ASD.Method:The study will be conducted from January 2022, and the following electronic databases will be searched: China Biological Medicine Database, Chinese Scientific Journals Database, Wan Fang database, and China National Knowledge Infrastructure, the Cochrane Library, Web of Science, PubMed, and EMBASE Database. Only randomized controlled trials of TCM interventions for ASD will be included. The Autism Diagnostic Observation Scale, Autism Diagnostic Interview-Revised, and Childhood Autism Rating Scale will be the primary outcome indicators. The methodological quality of this Bayesian-based network meta-analysis will be performed using the “Risk of Bias” tool. Stata 14.0 and WinBUGS 1.4.3 will be used to analyze the data. In addition, assessment of heterogeneity, inconsistency, subgroups, sensitivity, and publication bias will be conducted using the Cochrane Collaboration''s tools.Results:The results of this study will be submitted to a peer-reviewed journal for publication.Conclusion:This study will help patients recover better, provide clinical evidence for practitioners, and promote the use of TCM in ASD interventions.     

围术期小儿焦虑状态行为干预方式的研究进展

许多研究发现小儿在麻醉中遭受了巨大的心理压力,术前、麻醉诱导期及术后复苏小儿遭受着巨大的焦虑和不适。心理行为干预方式可以降低小儿围术期心理焦虑,现对各类行为干预方式研究进展作一综述。     

Yoga complemented cognitive behavioral therapy on job burnout among teachers of children with autism spectrum disorders

Background/objective:Job burnout is a syndrome of reaction to chronic job-related stress which affects overall health, limits occupational efficacy, and personal accomplishments of employees thereby thwarting organizational outcomes. Burnout symptoms are common among teachers of children with autism spectrum disorders (ASD) and affect the academic progress of the children. This study investigated the effectiveness of Yoga-based cognitive behavioral therapy (Y-CBT) in reducing occupational burnout among teachers of children with autism in Lagos States, Nigeria.Methods:A group-randomized control-trial with immediate intervention and waitlist control groups was design was adopted. Participants included 58 teachers of children with autism in public and private special schools in the area. Participants were randomly assigned to Y-CBT (N = 29) and waitlist control (N = 29) groups. The Y-CBT group participated in a 2 hours Y-CBT program weekly for 12 weeks. Three instruments Demographic variable, Single Item Stress Questionnaire (SISQ), and Maslach Burnout Inventory-Educators’ Survey (MBI-ES) were used to collect data. Data were collected at baseline; post-test and follow-up evaluations. Data were analyzed using means, standard deviations, t test statistics, repeated measures analysis of variance, and bar charts.Results:Results revealed that job-burnout reduced significantly at post-test assessment among the Y-CBT group compared to the waitlisted group. The reduction in the participant was sustained across 3months follow-up evaluation.Conclusion:It was concluded that Y-CBT modalities could help to reduce the burnout symptoms among teachers of children with ASD.     

Promoting social behavior with oxytocin in high-functioning autism spectrum disorders

Social adaptation requires specific cognitive and emotional competences. Individuals with high-functioning autism or with Asperger syndrome cannot understand or engage in social situations despite preserved intellectual abilities. Recently, it has been suggested that oxytocin, a hormone known to promote mother-infant bonds, may be implicated in the social deficit of autism. We investigated the behavioral effects of oxytocin in 13 subjects with autism. In a simulated ball game where participants interacted with fictitious partners, we found that after oxytocin inhalation, patients exhibited stronger interactions with the most socially cooperative partner and reported enhanced feelings of trust and preference. Also, during free viewing of pictures of faces, oxytocin selectively increased patients’ gazing time on the socially informative region of the face, namely the eyes. Thus, under oxytocin, patients respond more strongly to others and exhibit more appropriate social behavior and affect, suggesting a therapeutic potential of oxytocin through its action on a core dimension of autism.     

The role of lipid peroxidation in individuals with autism spectrum disorders

Metabolic Brain Disease - The role of malondialdehyde-modified low-density lipoprotein (MDA-LDL), an oxidized LDL, in the pathophysiology of autism spectrum disorder (ASD) is unclear. We studied...     

Aging in autism spectrum disorders: a mini-review

This article addresses an important and barely researched topic: what happens to children with autism spectrum disorders when they grow old. We review the small published literature on aging in autism. We then consider the relevance of research on 'neurotypical' aging in core domains of autistic impairment: social cognition, executive function, cognitive style and memory. Research themes from the study of normal aging, including cognitive reserve, compensation, quality of life, loneliness and physical health are of relevance for future research on autism. Studies of aging in autism will be important not only to plan appropriate services, but also to shed light on the full developmental trajectory of this neurodevelopmental condition, and perhaps provide clues to neuropathology and etiology.     

Brain enlargement is associated with regression in preschool-age boys with autism spectrum disorders

Autism is a heterogeneous disorder with multiple behavioral and biological phenotypes. Accelerated brain growth during early childhood is a well-established biological feature of autism. Onset pattern, i.e., early onset or regressive, is an intensely studied behavioral phenotype of autism. There is currently little known, however, about whether, or how, onset status maps onto the abnormal brain growth. We examined the relationship between total brain volume and onset status in a large sample of 2- to 4-y-old boys and girls with autism spectrum disorder (ASD) [n = 53, no regression (nREG); n = 61, regression (REG)] and a comparison group of age-matched typically developing controls (n = 66). We also examined retrospective head circumference measurements from birth through 18 mo of age. We found that abnormal brain enlargement was most commonly found in boys with regressive autism. Brain size in boys without regression did not differ from controls. Retrospective head circumference measurements indicate that head circumference in boys with regressive autism is normal at birth but diverges from the other groups around 4-6 mo of age. There were no differences in brain size in girls with autism (n = 22, ASD; n = 24, controls). These results suggest that there may be distinct neural phenotypes associated with different onsets of autism. For boys with regressive autism, divergence in brain size occurs well before loss of skills is commonly reported. Thus, rapid head growth may be a risk factor for regressive autism.