多巴胺转运体440bp等位基因与儿童孤独症的关系

目的探讨儿童孤独症(CA)与多巴胺转运体(DAT1)440bp等位基因的关系。 方法陕西省纺织医院等于2004年3~8月，采用PCR技术对来自西安市两所康复中心的汉族CA儿童与DAT1基因多态性进行遗传关联分析。 结果(1)DAT1基因多态性中共观察到5种等位基因(320bp，360bp，440bp，480bp，520bp)，6种基因型(480/480，480/320，520/480，480/360，480/440,440/440)。(2)使用相对危险度RR对CA与DAT1基因多态性的等位基因和基因型进行关联分析，显示480/440基因型和等位基因440与CA呈正关联，相对危险度分别为265和230，480/480基因型和等位基因480与CA呈负关联，相对危险度分别为064和077。但统计结果没有发现具有统计意义的差异。 结论中国汉族CA儿童与DAT1440bp等位基因无遗传关联。也许等位基因440bp与基因型480bp/440bp这两个因素是发病的风险因素,还有待今后的进一步研究。     

46例儿童孤独症综合干预疗效分析

观察46例儿童孤独症的综合干预疗效,为医院开展儿童孤独症的治疗提供依据。方法:46例孤独症儿童在训练前后进行PEP-3及Gesell评估,制定个化训练计划,并实施综合干预措施。结果:90%以上取得显著进步。结论:综合干预治疗儿童孤独症效果明显,与智力水平关系密切。     

3岁前有和无睡眠障碍孤独症儿童临床症状的比较分析

目的比较3岁前有无睡眠障碍孤独症儿童临床症状及发展特点。 方法对1999—2006年在北京星星雨教育研究所接受特殊教育的275例孤独症学生进行儿童期孤独症评定量表(CARS)、克氏行为量表(CABS)测量。 结果总体上3岁前有过睡眠障碍者症状严重于无睡眠障碍者。2~4岁时，有过睡眠障碍者比无睡眠障碍者病情严重，如有过睡眠障碍者情感、感觉、行为、社交问题均比无睡眠障碍者严重；5~8岁时，两者病情严重程度却比较接近，且有过睡眠障碍患儿情感反应优于无睡眠障碍患儿。 结论3岁前有过睡眠障碍者与无睡眠障碍者有着不同的病情发展模式。前者起始症状严重，随后病情进展缓慢；后者起始症状虽然较轻，但病情进展迅速，以至于两类患者在学龄初期时病情严重程度基本相当。     

RELN基因单核苷酸多态性与儿童孤独症的关联分析

目的探讨汉族人群RELN基因单核苷酸多态性与儿童孤独症的关系。方法应用聚合酶链式反应和限制性片段长度多态性方法,测定孤独症患儿及正常儿童各30例的基因型和等位基因频率。结果 (1)两组exon6SNP基因型及等位基因频率差异均有统计学意义(P0.05);(2)两组exon50SNP基因型及等位基因频率差异均无统计学意义(P0.05)。结论 (1)exon6SNP与儿童孤独症相关;(2)exon50SNP与儿童孤独症无关。     

催产素受体基因与儿童孤独症关系的初步研究

目的探讨佳木斯地区人群催产素受体(oxytocin receptor,OXTR)基因多态性与儿童孤独症的关系。方法应用聚合酶链反应与限制性片断长度多态性分析方法,对30例孤独症儿童和30例正常儿童进行OXTR单核苷酸多态性片断rs2254298的等位基因和基因型测定。结果OXTR单核苷酸多态性片断rs2254298的基因型分布频率符合Hardy-Weinberg定律(P0.05),并且孤独症组和正常对照组在上述各位点等位基因频率和基因型分布差异有统计学意义(P0.05)。结论OXTR单核苷酸多态性片断rs2254298与儿童孤独症的发病有关。     

基于丹佛模式下的感觉统合训练对2~5岁孤独症谱系障碍患儿交往能力及父母育儿压力的影响

目的探讨基于丹佛模式下的感觉统合训练对2~5岁孤独症谱系障碍患儿交往能力及父母育儿压力的影响。方法选取2018年7月至2019年7月于我院就诊的2~5岁孤独症谱系障碍患儿120例为研究对象,随机分为对照组和观察组各60例。对照组给予沙盘游戏和维生素D₃等综合治疗,观察组在对照组基础上予以基于丹佛模式下的感觉统合训练。3个月后,采用儿童孤独症行为量表(ABC)、儿童孤独症评定量表(CARS)、孤独症治疗评估量表(ATEC)评价患儿核心症状;采用儿童心理教育评估第3版量表(PEP-3)评价患儿交往能力;采用简式育儿压力问卷(PSI-SF)评价父母育儿压力。结果干预后,观察组患儿ABC、CARS、ATEC评分及PSI-SF各项评分均低于对照组,组间均数比较差异有统计学意义(P<0.05)。干预后,观察组患儿PEP-3评分各项高于对照组,组间均数比较差异有统计学意义(P<0.05)。结论基于丹佛模式下的感觉统合训练应用于2~5岁孤独症谱系障碍患儿中,通过改善患儿核心症状、交往能力,从而有效降低父母育儿压力。     

孤独症谱系障碍儿童营养情况与血清矿物质含量分析

目的 评估孤独症谱系障碍(ASD)儿童营养状态和血清11种矿物质含量.方法 选取2019年1～12月在沈阳市儿童医院诊断ASD患儿126例为ASD组和同期于儿童保健科体检儿童200例为对照组.采用电感耦合等离子体质谱法检测血清钙、铁、锌、硒、镁、铜、锰、锂、钴、镍、汞11种矿物质含量.观察两组儿童异常营养状态情况.结果...     

多元化康复治疗儿童孤独症30例疗效观察

目的观察多元化康复治疗模式对孤独症儿童社会适应行为能力的影响。方法 60例孤独症儿童随机分为对照组和观察组各30例。观察组接受一对一、小组及集体形式的训练,对照组只接受一对一形式的训练,均每日训练3h。两组治疗满3个月后进行儿童适应行为能力（ADQ）评定,并进行疗效判定。结果治疗后观察组ADQ显著高于治疗前（P〈0.05）,治疗后疗效显著高于对照组,差异有统计学意义（P〈0.05）。结论多元化康复治疗模式对孤独症儿童的社会适应行为能力的提高显著好于一对一形式康复治疗模式。     

补充与替代医学干预孤独症谱系障碍的研究进展

孤独症谱系障碍(ASD)是一种神经发育障碍性疾病,以社会互动、交流交往障碍,异常的重复刻板行为、兴趣范围狭窄及日常行为活动能力受限为临床特征。因其发病机制不明,目前尚无有效治疗方法。补充与替代医学(CAM)作为一种非主流干预疗法,目前已成为西方主流医学的重要补充体系,并被广泛运用于ASD治疗。本文通过查阅近年来国内外相关文献,概述了CAM治疗ASD的现状及可行性,以期为ASD儿童的治疗提供新的思路。     

Effectiveness of Early Infant Diagnosis (EID) in Detecting the Serostatus of HIV-Exposed Infants and Children

Background/purpose of the study

Although interventions to prevent mother-to-child transmission of HIV infection are being increasingly implemented as a part of national guideline, the prevalence of pediatric HIV remains high. There is remarkable increase in survival if HIV-infected children have access to early infant diagnosis (EID) and treatment.

Methods

The study was conducted in the Department of Obstetrics and Gynecology Medical College, Kolkata from July 2011 to February 2014 after obtaining approval from the institutional ethics committee. All the infants of HIV-positive mothers who came for EID between 6 weeks to 18 months of age during the study period were included in the study. A total number of 151 infants were included in the study and divided into Group A and B according to the time of first testing. It was a prospective observational longitudinal study. Data were collected from the EID register of PPTCT unit Medical College Kolkata. EID was done as laid out in the pediatric ART (anti-retroviral therapy) guidelines of the National AIDS Control Organization.

Results

Effectiveness of EID is judged by the corroboration of results at 6 week, 6 and 18 months. Comparing the results in group A, we found that 10.26, 8.41, and 7.29 % were positive at 6 weeks, 6 and 18 months, respectively, and with p value of 0.5828 the differences were not statistically significant. In group B, we observed that 47.06 and 45.45 % were positive at 6 and 18 months, respectively. Analysis revealed a p value of 0.9072 indicating no significant statistical difference between the results of testing in different periods. This reflects a good correlation between the 6 weeks, 6 and 18 months value, thus establishing the integrity of the EID.

Conclusion

Ultimate integrity of the PPTCT is judged by testing the child. EID is a novel procedure which aims at earlier diagnosis and initiation of treatment in the children.     

In vitro fertilization children: Early psychosocial development

Following community concerns regarding the status of children conceived by in vitro fertilization (IVF). 33 children who had received pediatric follow-up were seen for a psychosocial evatuation. Parents were interviewed in a semistructured format by a child psychiatrist regarding their child's development, child-centered problems, parental problems, marital issues, parenting experience, and experience of the IVF program. The Bayley Scales of Infant Development were administered to the children by a clinical psychologist. Childrens ages ranged from 12 to 37 months (the majority between 12 and 20 months). There was a high incidence of prematurity and twins in the population seen. Twenty-two children had no current problems and seven presented minor problems. Of the four with significant developmental problems, two had been very low-birth weight infants with significant neurological problems and one had severe congenital heart disease. Overall Bayley Scale scores were within the normal range and parents as a group were seen to function well. Problems presented were in accordance with those expected in a population of this age range. particularly considering the high incidence of prematurity.     

卵母细胞胞质内单精子注射的形态学观察

目的 了解卵母细胞胞质内单精子注射（ｉｎｔｒａｃｙｔｏｐｌａｓｍｉｃ ｓｐｅｍｒｍ ｉｎｊｅｃｔｉｏｎ,ＩＣＳＩ）过程中配子及卵裂球期胚胎各种异常形态与ＩＣＳＩ结果的相关性。方法 对１９９８年１１月至１９９９年８月在我中心接受ＩＣＳＩ治疗的４３个周期进行观察、分析。促性腺激素释放激素激动剂降调节长方案进行超促排卵,ＩＣＳＩ常规操作,比较配子及卵裂球期胚胎正常与各种异常形态同ＩＣＳＩ结果的相关性。结     

Psychological factors and preterm labour

Evidence‐based parenting programmes frequently undergo modifications when delivered in community mental health centres. Adaptations are made to the original curriculum due to clientele demographics, practitioner judgement and resource restrictions. It is thus important to evaluate whether adapted interventions successfully meet their expected goals once they are implemented in the community. The current pilot study examined the effectiveness of an attachment‐focused parent group training programme that was based on an empirically validated parenting course (Right from the Start), but adapted for use in a children’s mental health clinic with a diverse client population. Twenty‐two caregiver–child dyads participated, with children’s ages ranging from 4 to 41 months. As expected, following completion of the intervention, parenting stress had decreased, parenting confidence had improved and caregivers’ cognitive growth fostering skills had increased. However, the programme did not meet its primary goal of improving maternal sensitivity. Implications and directions for future research are discussed.     

20例早发型子宫内膜癌的临床特点分析

目的：探讨40岁以下子宫内膜癌患者的临床及病理特征。方法：对2004年12月—2012年12月收治的子宫内膜癌病例进行回顾性分析,其中≤40岁的患者（早发组）20例（占4%,20/498）,＞40岁的患者（普通组）478例,比较2组患者的多项临床指标,分析患者的临床特征、高危因素、治疗方法、病理类型、组织学分级、肌层浸润深度、淋巴结转移与附件转移的关系。结果：早发组原发不孕发病率为30.0%（6/20）,普通组为4.2%（20/478）,差异有统计学意义（χ2=25.855,P=0.000）。普通组合并高血压率高于早发组（χ2=7.954,P=0.003）。早发组患者病理类型均为子宫内膜样腺癌,普通组子宫内膜样腺癌78.5%（375/478）,2组患者病理类型差异有统计学意义（χ2=5.433,P=0.020）。早发组、普通组患者细胞分化为G1者分别占90%和49.8%。早发组、普通组临床病理Ⅰ期者分别占80%和74.1%,2组患者细胞分化程度及临床病理分期差异有统计学意义（Z分别为－8.259和－9.488,均P=0.000）。2组患者肌层浸润、宫颈累及、淋巴结转移、附件累及和腹水细胞学检查比较差异均无统计学意义（均P＞0.05）。结论：在子宫内膜癌患者中年轻妇女有着一定的比例,不孕不育是40岁以下子宫内膜癌患者的高危因素,年轻子宫内膜癌患者以子宫内膜样腺癌为主,细胞分化级别高,手术病理期别较早,深肌层浸润、淋巴结转移以及附件转移等情况与年长者相似。     

儿童睡眠姿势与睡眠障碍关系分析

摘要：目的　探讨儿童睡眠姿势与睡眠障碍发生的关系。方法　2006年6月至2007年4月对长沙市5个行政区内2706名3～12岁儿童家长进行《儿童睡眠状况调查问卷》调查。 结果　2706名儿童中睡眠姿势为侧卧位者为50.92%,俯卧位为26.42%,仰卧位为22.65%。平均年龄：侧卧位组（7.83±2.69）岁、俯卧位组（6.35±2.49）岁、仰卧位组（7.79±2.63）岁,3组间年龄差异有统计学意义（P < 0.05）。睡眠障碍发生率：俯卧位组为50.6%,侧卧位组为37.6%,仰卧位组为29.9%,不同睡眠姿势组间的睡眠障碍发生率差异有统计学意义（χ2 = 63.101,P < 0.05）。俯卧位组多汗、磨牙、辗转不安、肢体抽动、觉醒的发生率明显高于仰卧位组（χ2 = 61.828、8.973、8.946、8.614、7.154,均P < 0.0125）;俯卧位组多汗、打鼾、辗转不安、用口呼吸的发生率亦高于侧卧位组（χ2 = 6.553、11.176、9.693、9.552,均P < 0.0125）。结论　睡眠姿势与睡眠障碍有相关性,儿童以采取仰卧位睡眠较好。     

解脲支原体脂质相关膜蛋白与Toll样受体的相关性研究

解脲支原体（UU） 是人泌尿生殖道中最常见的一种共生病原微生物,属于柔膜体纲支原体科,1954年Shperd从非淋菌性尿道炎患者尿道中分离出来,能分解尿素,有其特异的生化结构及功能。多数研究表明,UU浓度大于106拷贝/mL时有单独致病意义,与临床多种疾病发生发展有关。近年又证实,UU与人乳头瘤病毒（HPV）及人类免疫缺陷病毒（HIV）感染有关,且与HIV的传播有一定关系。UU在人群中的致病性一直是研究的重点,但是其发病机制尚未阐明。因此,某些与UU相关的疾病仍缺乏有效的防治。近年来,Toll样受体（TLRs）在启动宿主固有免疫和适应性免疫的作用成为研究热点,尤其是在感染性疾病中,UU及其脂质相关膜蛋白（LAMPs）可通过TLRs激活胞内信号转导通路诱导宿主细胞凋亡,这可能与多种疾病的发生有关。探索这一机制,阐述其发病进程有望为临床相关疾病的诊断和治疗提供新的方法。     

川崎病合并冠状动脉瘤63例临床分析

目的分析川崎病(KD)合并冠状动脉(以下简称冠脉)瘤患儿的临床特点。方法对首都医科大学附属北京儿童医院2000—2007年收治的63例超声心动图诊断为冠脉瘤的KD患儿临床资料、实验室检查、超声及心电图检查结果、治疗情况及随诊资料进行回顾性分析。结果(1)冠脉瘤患儿男性明显多于女性，男∶女为5.3∶1；冠脉巨大瘤男女比例为8.3∶1；<1岁患儿多发，占28.6%。(2)本组患儿中不完全KD、静脉注射丙种球蛋白(IVIG)抵抗以及KD复发的发生率均较高，分别为36.5%、30.2%和7.9%；急性期57例(90.5%)患儿使用IVIG冲击治疗，3例未用，3例使用情况不详；36例(57.1%)患儿发病至丙种球蛋白应用的时间间隔大于10 d。(3)超声检查发现小冠脉瘤患儿7例，中等冠脉瘤19例，巨大瘤37例，左冠脉受累者占76.2%，其中58.3%发生在前降支；右冠脉受累者达87.3%，其中47.3%发生在右冠Ⅱ段；双侧冠脉同时受累者占63.5%。(4)随诊发现71.4%冠脉瘤呈现回缩趋势，45.2%的受累分支冠脉瘤消退，平均消退时间为(2.1±1.5)年。结论对于男性、发病年龄<1岁、不完全KD、发生IVIG抵抗、复发患儿及应用IVIG治疗较晚患儿要警惕冠脉瘤的发生；左冠前降支及右冠脉瘤样病变最多见，多数冠脉瘤在恢复期发生回缩。     

The opinions and practices of providers toward the sexual issues of cervical cancer patients undergoing treatment

Objectives

Cervical cancer and its treatments impair women's sexual function. These complications may or may not be regarded when clinicians develop treatment plans. We aim to investigate the considerations of providers toward the sex life of cervical cancer patients.