热性惊厥影响患儿行为的研究

目的 研究热性惊厥(FS)对患儿行为的影响及其特点.方法 采用Achenbach儿童行为量表对2006年10月至2007年9月在广州市儿童医院就诊的138例FS患儿进行行为评定,与128名正常儿童进行对照研究,并将复杂型热性惊厥(CFS)与单纯型热性惊厥(sFS)进行对照研究.结果 2～3岁、>3～5岁FS患儿行为问题发生率高于对照组(P<0.01,P<0.05);2～3岁、>3～5岁CFS患儿行为问题发生率高于SFS(P<0.01,P<0.05);2～3岁、>3～5岁FS患儿睡眠问题、躯体诉述、攻击等行为因子分数及总分高于对照组,差异有统计学意义(P<0.01,P<0.05);2～3岁、>3～5岁CFS患儿睡眠问题、躯体诉述、攻击等行为因子分数及总分高于SFS(P<0.01,P<0.05);CFS首次发病年龄与行为总分呈负相关,反复发作次数与行为总分呈正相关,惊厥持续时间≥15min者行为问题发生率高于<15min者(P<0.05).结论 FS可影响患儿行为,主要表现在睡眠问题、躯体诉述、攻击行为方面;CFS对患儿行为的影响较SFS严重.     

特发性矮小男童个性及心理行为研究

目的探讨特发性矮小男童的个性特征及心理行为有无异常。方法采用艾森克个性问卷(EPQ)及Achenbach儿童行为量表(CBCL)对学龄期特发性矮小男童32例及32例正常儿童进行测试。结果1.EPQ测试结果:特发性矮小组E分值明显低于对照组(P<0.01),N分值明显高于对照组(P<0.01);2.CBCL测试:特发性矮小男童组活动及社交能力均明显低于对照组(P<0.02,P<0.01),但学习情况无显著差异;行为问题中,除社交退缩、交往不良两组有显著差异外(P<0.01),特发性矮小组无其他行为障碍。结论学龄期特发性矮小男童性格偏内向、情绪较不稳定,存在交往不良、社交退缩现象。     

֧��������������Ϊ����������ĸ��������״��������о�

目的探讨支气管哮喘患儿行为特征及其母亲心理健康状况,为临床治疗及早期干预提供依据。方法以2007年10月至2009年2月长治医学院附属和济医院、附属和平医院确诊的4～12岁支气管哮喘患儿96例为支气管哮喘组,采用Achenbach儿童行为评定量表(CBCL)对支气管哮喘组及96名正常儿童(对照组)进行评估。采用症状自评量表(SCL-90)对所有研究对象的母亲进行评估。结果支气管哮喘组患儿社会能力低于对照组,行为问题总检出率为38.5%,明显高于对照组(15.7%),差异有统计学意义(P<0.005);在躯体主诉、抑郁、焦虑、内向性行为、社交退缩、违纪等方面得分高于对照组,差异均有统计学意义(P<0.05)。支气管哮喘组患儿母亲在焦虑、抑郁、敌对、恐怖、精神病性等方面得分均高于对照组儿童母亲,差异有统计学意义(P<0.05)。结论支气管哮喘患儿较正常儿童表现出更多的行为问题,且支气管哮喘患儿母亲较正常儿童的母亲更易出现一些心理问题,故在对支气管哮喘患儿进行规范的药物治疗基础上,应配合适当的心理行为干预。     

肿瘤

024015血液肿摘患儿及其家长心理特点的对照研究/孟馥…//临床儿科杂志一2002,20(5)一295一297 用艾森克人格问卷、Achonbach儿童行为评定量表对57例年龄在6一11岁血液肿瘤患儿进行心理测试,用90项症状自评量表对57例患儿家长进行调查。结果:患儿E质个性低于对照组〔P<。.05);行为问题发生率为21.1%。男孩多有交往不良、躯体诉述、违纪;女孩表现为抑郁、社会退缩。家长各项因子分均高于对照组.两组比较差异有极显著意义(P<0.01)。患儿的行为问题与家长的心理卫生状况有显著的相关性。表4参12(蔡虹蔚) 02401‘小儿恶性肿瘤住院化疗合并感染…     

特发性矮小儿童73例抑郁情绪和个性特征

目的研究特发性矮小儿童(ISS)抑郁情绪和个性特征。方法以73例ISS患儿为试验组,50例健康儿童为健康对照组。采用Zung氏抑郁自评量表(SDS)和艾森克个性问卷(EPQ)分别对二组进行测试,并将测试结果进行统计学分析、比较,并与中国常模比较。结果试验组抑郁症状总发生率为52.05%(38/73例),与健康对照组和中国常模组比较差异有显著性(Pa<0.01)。用EPQ量表测定试验组E分值明显低于对照组(P<0.01),N分值明显高于对照组(P<0.01)。结论ISS患儿抑郁症状存在较普遍;性格偏内向、情绪较不稳定。     

意外伤害儿童心理学特点及干预对策

目的 了解意外伤害儿童心理学特点,为采取心理干预措施提供依据.方法 采用艾森克个性问卷(EPQ)和Achenback儿童行为量表(CBCL,父母用表),对7～11岁住院治疗的意外伤害儿童(伤害组)和正常健康儿童(对照组)各81例进行测试.结果 EPQ的P、E、N分量表得分伤害组高于对照组(P均<0.05),对照组L分量表得分则高于伤害组(P<0.001).伤害组CBCL平均得分(37.62±11.03)高于对照组(17.77±12.12,P<0.001);行为问题检出率(32.09%)亦高于对照组(11.11%,P<0.001),OR值3.78,95%c,为1.66～8.59.行为因子的敏感性(32.1%)较低,特异性(88.9%)和阳性结果价值(74.3%)较高.伤害组男童在多动、攻击性、违纪,女童在多动、攻击性、抑郁、违纪等因子M均高于对照组(P均<0.01).伤害组男童CBCL平均得分(39.81±10.99)高于女童(34.26±10.43,P<0.05).伤害的危险因子男童为攻击、多动、违纪,女童为攻击、违纪、抑郁.结论 意外伤害儿童心理、行为问题较多,应采取心理干预措施,降低儿童意外伤害的发生.     

初诊及长期无病生存白血病儿童情绪、自我意识及个性特征的调查分析

目的了解初诊及长期无病生存5年以上白血病儿童的情绪、自我意识特征及个性特征。方法选用儿童焦虑性情绪障碍筛查表、儿童抑郁障碍自评量表、Piers-Harris儿童自我意识量表和儿童版艾森克个性问卷分别对30例初诊白血病、20例长期无病生存5年以上白血病和50例正常对照儿童进行心理评估。结果三组儿童的焦虑总分以及躯体化/惊恐、广泛性焦虑、社交恐怖分量表评分差异有统计学意义(P均0.05),其中长期无病生存组患儿的焦虑总分以及躯体化/惊恐、广泛性焦虑和社交恐怖分量表评分均显著高于正常对照组(P均0.05);而初诊组患儿的社交恐怖分量表得分显著高于正常对照组(P0.05),学校恐怖分量表得分显著低于正常对照组(P0.05)。在抑郁评分方面,白血病患儿和正常对照组比较以及组间比较均无统计学意义(P均0.05)。三组儿童的自我意识总分以及行为、智力与学校情况和焦虑分量表评分差异有统计学意义,其中长期无病生存组患儿的自我意识总分及各分量表得分与正常对照组比较差异无统计学意义(P均0.05),而初诊组患儿的自我意识总分以及行为、智力与学校情况、焦虑分量表得分均显著低于正常对照组(P均0.05);总体白血病患儿与正常对照组比较,自我意识总分以及行为、焦虑分量表得分显著低于正常对照组(P均0.05)。长期无病生存组与初诊组患儿及正常对照组比较,性格普遍偏于内向(P0.01)。结论白血病儿童较正常儿童有更多的焦虑情绪,其自我意识降低,具有内向性格特征。在治疗儿童躯体疾病的同时,对白血病儿童进行社会心理干预非常必要。     

肾病综合征急性肾炎患儿及家长心理卫生状况初步研究

目的：探讨肾病综合征(NS),急性肾炎(AGN)患儿及家长个性、心理健康状况与疾病的关系,为NS,AGN的心理干预治疗提供理论依据。方法：采用艾森克个性问卷(EPQ)及症状自评量表(SCL-90)对患儿及家长个性心理进行调查。结果：NS患儿P,E量表得分低于正常儿童对照组(P0.05),患儿家长N 和L量表得分高于正常成人对照组(P0.05)。NS患儿SCL-90评定结果,除强迫、精神病性及附加量表外,余如躯体化症状、人际敏感、抑郁、焦虑、敌意、恐惧、偏执得分均明显高于正常儿童对照组(P0.05),而患儿家长SCL-90各项因子得分均高于正常成人对照组(P<0.05)。结论：本研究提示NS患儿具有内向、情绪不稳定的个性倾向,心理上具有明显的焦虑、抑郁、恐惧、躯体化等多方面症状,AGN患儿个性和心理与正常儿童无差异,NS,AGN患儿家长具有内向、神经质个性倾向,心理上亦具有明显的焦虑、抑郁、恐惧、躯体化等症状。     

哮喘儿童及家长心理健康状况调查

目的 了解哮喘儿童及其家长的心理健康状况.方法 采用艾森克人格问卷(儿童)、Rutter's儿童行为量表(父母问卷)对36例6～14岁哮喘儿童进行个性、行为心理测试.采用90项症状自评量表(SCL-90)对其家长进行心理卫生状况调查.结果 哮喘儿童E、N值均高于正常对照组(P<0.05),行为问题发生率为33.3%,哮喘家长SCL-90各项因子分均高于对照组,以抑郁、焦虑、躯体诉述及恐怖因子得分最明显(P<0.05).结论 哮喘儿童及家长的心理问题均较健康对照人群高,应引起高度重视,积极进行心理干预.     

急性白血病患儿血浆基质细胞衍生因子-1及其受体CXCR4表达的临床意义

目的探讨儿童急性白血病(AL)血浆基质细胞衍生因子-1(SDF-1)的水平和骨髓细胞表面CXCR4的表达及其临床意义。方法收集50例AL患儿、20例健康儿童和10例非恶性血液病患儿(对照组)。采用ELISA法分别检测AL患儿初诊时、缓解6个月、复发时和对照组儿童外周血浆SDF-1水平。用流式细胞仪检测50例AL患儿初诊时和10例非恶性血液病患儿骨髓细胞表面CXCR4的表达。结果1.AL初诊组和缓解组血浆SDF-1水平明显高于对照组(Pa<0.01),且初诊组高于缓解组(P<0.01);急性淋巴细胞白血病(ALL)组血浆SDF-1水平高于急性髓细胞白血病(AML)组(P<0.01);SDF-1水平在ALL和AML各亚型之间差异无统计学意义;复发的4例患儿,其血浆SDF-1水平在初诊时和复发时均高于缓解时(Pa<0.05);髓外浸润组SDF-1水平与非髓外浸润组比较差异无统计学意义(P>0.05)。2.AL患儿骨髓细胞表面CXCR4的相对荧光强度明显高于对照组(P<0.01);ALL组高于AML组(P<0.01);CXCR4在ALL的L1组与L2组的表达,无统计学差异,但T-ALL组高于B-ALL组(P<0.05...     

Allergic factors associated with the development of asthma and the influence of cetirizine in a double-blind, randomised, placebo-controlled trial: First results of ETA®

There is a common progression known as the allergic march from atopic dermatitis to allergic asthma. Cetirizine has several antiallergic properties that suggest a potential effect on the development of airway inflammation and asthma in infants with atopic dermatitis. Methods. Over a two year period, 817 infants aged one to two years who suffered from atopic dermatitis and with a history of atopic disease in a parent or sibling were included in the ETAC^® (Early Treatment of the Atopic Child) trial, a multi-country, double-blind, randomised, placebo-controlled trial. The infants were treated for 18 months with either cetirizine (0.25mg/ kg b.i.d.) or placebo. The number of infants who developed asthma was compared between the two groups. Clinical and biological assessments including analysis of total and specific IgE antibodies were performed. Results. In the placebo group, the relative risk (RR) for developing asthma was elevated in patients with a raised level of total IgE (≥ 30 kU/I) or specific IgE (≥ 0.35 kUA/I) for grass pollen, house dust mite or cat dander (RR between 1.4 and 1.7). Compared to placebo, cetirizine significantly reduced the incidence of asthma for patients sensitised to grass pollen (RR = 0.5) or to house dust mite (RR = 0.6). However, in the population that included all infants with normal and elevated total or specific IgE (intention-to-treat - ITT), there was no difference between the numbers of infants developing asthma while receiving cetirizine or placebo. The adverse events profile was similar in the two treatment groups. Discussion. Raised total IgE level and raised specific IgE levels to grass pollen, house dust mite or cat dander were predictive of subsequent asthma. Cetirizine halved the number of patients developing asthma in the subgroups sensitised to grass pollen or house dust mite (i.e. 20% of the study population). In view of the proven safety of the drug, we propose this treatment as a primary pharmacological intervention strategy to prevent the development of asthma in specifically sensitised infants with atopic dermatitis.     

�¶�֢��ϵ�ϰ���ע��ȱ�ݶද�ϰ������ڵ�ת��

孤独症谱系障碍(autistic-spectrum disorders,ASDs)近年来患病率逐年攀升至1%左右,其症状往往伴随终生,成为严重威胁儿童健康和发展的神经发育性疾患;注意缺陷多动障碍(attention deficit hyperactivity disorder,ADHD)是儿童期最常见的精神障碍,国内报道患病率为4.13%～5.83%,其症状可延续至青少年期,甚至到成年期[1]。这两类精神障碍在成年期的临床表现、共患病、治疗策略和预后与儿童期有哪些不同呢?本文通过回顾相     

EXCITING NEW TREATMENT APPROACHES FOR PATHYPHYSIOLOGIC MECHANISMS OF SICKLE CELL DISEASE

During the past several decades, our understanding of the complex pathophysiology of vasoocclusion associated with sickle cell disease has improved greatly. Interaction of genes, hemoglobin molecules, red cell membrane and metabolic changes, cell-cell interactions and cell-plasma interactions, red cell adhesion to vascular endothelium, activation of coagulation, and vascular reactivity play a role in vaso occlusion. Penicillin prophylaxis of pneumococcal infections and appropriate use of blood transfusions and other supportive measures improved survival of sickle cell patients. Hydroxyurea made a major impact on sickle cell therapy when it was shown to decrease acute painful episodes, acute chest syndrome, and the need for blood transfusion in adults. Significant experience in the use of hydroxyurea has been accumulated in older children. The benefits and risks of hydroxyurea for younger children and long-term risks in all patients will be evaluated in future investigations. Other promising therapies include butyrate compounds, clotrimazole, magnesium supplementation, poloxamer 188, antiadhesion agents, anticoagulant approaches, and nitric oxide. Hemopoietic transplantation remains the only curative therapy. However, several transgenic mouse models are available for studies of gene therapy or other treatment approaches on biochemical, cellular, and pathologic effects of mutant genes.     

Infiltrations of Epstein-Barr virus-carrying cells in granular lymphocyte-proliferative disorders corresponding to chronic active Epstein-Barr virus infection

A 21-year-old man with granular lymphocyte-proliferative disorders (GLPD) associated with chronic active Epstein-Barr virus (EBV) infection is described. Chromosomal analyses revealed several clonal abnormalities and two of them were mainly repetitious. High copy numbers of monoclonal EBV genome were also detected in the proliferative large granular lymphocytes (LGLs), indicating the monoclonal expansion of EBV-infected LGLs. The patient had an indolent course for several years, and there was no evidence of infiltrations of his bone marrow until the end stage. At autopsy, microscopic studies revealed marked infiltrations of LGL in the liver and spleen, and the infiltrating cells were NK-cell immunophenotype. The infiltrated LGLs showed latency I.     

LUTEINIZING HORMONE RECEPTOR MUTATIONS IN DISORDERS OF SEXUAL DEVELOPMENT AND CANCER

Human male sexual development is regulated by chorionic gonadotropin (CG) and luteinizing hormone (LH). Aberrant sexual development caused by both activating and inactivating mutations of the human luteinizing hormone receptor (LHR) have been described. All known activating mutations of the LHR are missense mutations caused by single base substitution. The most common activating mutation is the replacement of Asp-578 by Gly due to the substitution of A by G at nucleotide position 1733. All activating mutations are present in exon 11 which encodes the transmembrane domain of the receptor. Constitutive activity of the LHR causes LH releasing hormone-independent precocious puberty in boys and the autosomal dominant disorder familial male-limited precocious puberty (FMPP). Both germline and somatic activating mutations of the LHR have been found in patients with testicular tumors. Activating mutations have no effect on females. The molecular genetics of the inactivating mutations of the LHR are more variable and include single base substitution, partial gene deletion, and insertion. These mutations are not localized and are present in both the extracellular and transmembrane domain of the receptor. Inactivation of the LHR gives rise to the autosomal recessive disorder Leydig cell hypoplasia (LCH) and male hypogonadism or male pseudohermaphroditism. Severity of the clinical phenotype in LCH patients correlates with the amount of residual activity of the mutated receptor. Females are less affected by inactivating mutation of the LHR. Symptoms caused by homozygous inactivating mutation of the LHR include polycystic ovaries and primary amenorrhea.     

Resurgence of measles in Singapore: profile of hospital cases

OBJECTIVE: To ascertain the profile of cases of measles seen at a general hospital during a recent outbreak that occurred despite a measles vaccination program. METHODOLOGY: A retrospective study from January 1991 to March 1998. All patients with measles (ICD code 055. 9) seen at the emergency unit or as inpatients were included. RESULTS: There were 87 cases identified. The diagnosis was clinical in all and proven serologically in 71%. Eighty-five per cent of the cases occurred between January 1997 and March 1998. There was a bi-modal age distribution with peaks in the very young (相似文献   

Personality profiles and heart rate variability (vagal tone) in children with recurrent abdominal pain

The aim of the study was to explore psychological factors and autonomic activity in children with recurrent abdominal pain and to compare them with those in a control group of healthy children. The Personality Inventory for Children was used for assessment of developmental, emotional and psychosocial factors in 25 children with recurrent abdominal pain (age, 7-15 y). Parasympathetic and sympathetic functions in these children and in 23 healthy control subjects (age, 7-13 y) were also investigated, non-invasively using a computerized polygraph. Vagal tone (parasympathetic function) was indexed by calculation of respiratory sinus arrhythmia in beats/min. Skin conductance (sympathetic function) was recorded by the constant current method. On the Personality Inventory for Children, 16 patients had high scores on somatic concern. Several patients had scores in the clinical range for depression, withdrawal and anxiety, but the mean scores for these personality profile scales were well within the normal range of healthy children. Interestingly, there was a spike on the L (Lie)-scale for most of the patients and 15 patients had scores above or close to the clinical cut-off value. As compared with the scores in healthy children, vagal tone and sympathetic tone were normal. Conclusion: Many children with recurrent abdominal pain have scores in the clinical range for depression, withdrawal, anxiety and L-scale indicating coping problems, denial and a trend towards somatic concern that may contribute to the evolution of abdominal pain. Autonomic nerve activity was not disturbed in these children.     

Overcoming surfactant inhibition with polymers

Inhibition of the function of pulmonary surfactant in the alveolar space is an important element of the pathophysiology of many lung diseases, including meconium aspiration syndrome, pneumonia and acute respiratory distress syndrome. The known mechanisms by which surfactant dysfunction occurs are (a) competitive inhibition of phospholipid entry into the surface monolayer (e.g. by plasma proteins), and (b) infiltration and destabilization of the surface film by extraneous lipids (e.g. meconium-derived free fatty acids). Recent data suggest that addition of non-ionic polymers such as dextran and polyethylene glycol to surfactant mixtures may significantly improve resistance to inhibition. Polymers have been found to neutralize the effects of several different inhibitors, and can produce near-complete restoration of surfactant function. The anti-inhibitory properties of polymers, and their possible role as an adjunct to surfactant therapy, deserve further exploration.     

Understanding infant formula

The World Health organisation recommends breast feeding infants for the first six months of life. When this breast feeding does not occur either through parental choice or medical need, infant formulas will be required. There is a bewildering array of formulas on the UK market for many different requirements. When faced with an unsettled infant many parents (and healthcare professionals) will experiment with the infant formula available and then attend the paediatric clinic looking for help and advice. It is therefore essential that paediatricians understand what milks are available and what the key differences between different products are. This review attempts to provide a simple guide through many of the formulations currently available in the UK; and offers advice for the dietary management of the child with extra calorie requirements, infants with cow's milk protein allergy, gastro oesophageal reflux disease, apparent unresolved hunger and infantile colic. Whatever the underlying condition, there is likely to be an infant formula that is suitable in this generation of ever expanding formulations.