哌甲酯控释剂对注意缺陷多动障碍患儿生态学执行功能的影响

目的:研究哌甲酯控释剂治疗对注意缺陷多动障碍(attention deficit hyperactivity disorder,ADHD)患者生态学执行功能的影响,探讨执行功能改善和临床症状改善两者之间的关系.方法:对符合美国《精神障碍诊断与统计手册(第4版)》(DSM-Ⅳ)诊断标准的26名8～14岁的ADHD患者使用哌甲酯控释剂(18～54 mg/d)治疗4～6周,以父母填写的简明Conners儿童行为问卷及ADHD-Ⅳ父母问卷为主要疗效评价指标,以家长填写的执行功能行为评定量表(BRIEF)评价患者生态学执行功能的情况.结果:经哌甲酯控释剂治疗后,BRIEF执行总分,元认知指数及其所属的工作记忆和监控因子、抑制因子条目的原始平均分比治疗前显著下降(t＝2.763～3.380,P＜0.05);BRIEF抑制因子减分率与症状最大减分率的相关性差异无统计学意义,BRIEF元认知指数及其所属5个因子的减分率与ADHD-Ⅳ父母问卷中注意缺陷因子的最大减分率呈中度相关(r＝0.415～0.640, P＜0.05).结论:哌甲酯控释剂有望改善ADHD患者的生态学执行功能水平;ADHD患者抑制缺陷的改善与核心症状的改善可能不平行.     

新森林父母培训方案对注意缺陷多动障碍儿童家庭的初步干预研究

目的分析新森林父母培训方案(new forest parenting programme, NFPP)对注意缺陷多动障碍(attention deficit hyperactivity disorder, ADHD)儿童及家庭的干预效能, 探索该方案在中国实施的可行性和有效性。方法纳入2022年1月至2023年5月就诊于暨南大学附属第一医院儿童心理发育行为门诊确诊的22例ADHD儿童及其22例亲密养育人, 根据亲密养育人的个人意愿分为试验组(n=11)和对照组(n=11), 对试验组进行每周1次、为期8周的NFPP干预。采用中文版注意缺陷多动障碍SNAP-Ⅳ评定量表(Chinese version of Swanson Nolan and Pelham, version Ⅳ scale-parent form, SNAP-Ⅳ)、Weiss功能缺陷评定量表父母版(Weiss functional impairment rating scales-parent report, WFIRS-P)评估试验组和对照组在干预前后核心症状及社会功能损害的改善情况。试验组采用中文版父母养育胜任感评定量...     

103例儿童注意缺陷多动障碍综合症(ADHD)的病因调查与分析

目的及时发现与ADHD有关的因素,以便及早进行干预,为降低该病的发病率提供理论依据。方法通过对5所小学2308名6-8岁儿童采用自拟的调查表以及Conners父母症状问卷量表、Conners教师评定量表、Conners儿童活动水平评定量表对儿童进行调查,同时对每名儿童进行血铅的测定。结果有103名儿童初步被诊断为ADHD。结论不正常的家庭状况、不正当的教育方式、儿童体内的含铅量都会导致ADHD的发生。     

前庭康复对注意力缺陷多动障碍儿童的疗效观察

目的 探讨前庭康复(VR)方法治疗注意力缺陷多动障碍(ADHD)患儿的疗效.方法 将2018年2月至2019年8月该院收治的60例ADHD患儿按照随机数表法分为对照组和观察组,各30例.两组均采用认知行为疗法,观察组加用VR方法,每周5次,疗程为2个月.治疗前后采用中文版注意缺陷多动障碍评定量表-父母版(SNAP-Ⅳ)...     

103例儿童注意缺陷多动障碍综合症（ADHD）的病因调查与分析

目的及时发现与ADHD有关的因素，以便及早进行干预，为降低该病的发病率提供理论依据。方法通过对5所小学2308名6—8岁儿童采用自拟的调查表以及Conners父母症状问卷量表、Conners教师评定量表、Conners儿童活动水平评定量表对儿童进行调查，同时对每名儿童进行血铅的测定。结果有103名儿童初步被诊断为ADHD。结论不正常的家庭状况、不正当的教育方式、儿童体内的含铅量都会导致ADHD的发生。     

门诊注意缺陷多动障碍儿童家庭环境因素分析

目的 探讨家庭环境因素在儿童注意缺陷多动障碍(ADHD)发病中的作用.方法 采用DSM-Ⅳ标准对门诊因注意力不集中、多动冲动表现或学习成绩下降而就诊的2 296名儿童进行诊断,同时采用自行设计的问卷调查儿童的家庭环境情况,采用单因素分析和非条件多因素Logistic回归分析,研究可能导致ADHD发病的因素.结果 2 296名儿童中,720名诊断为ADHD.ADHD儿童与非ADHD儿童的家庭环境因素比较差异存在统计学意义(P<0.05或P<0.01).可能导致ADHD发病的危险因素包括父母婚姻不融洽、父母有吸烟史以及母亲孕期及产后常有情绪低落现象;儿童年龄大、女性、父亲文化程度高为ADHD发病的保护因素.结论 不良家庭环境对ADHD发病可能产生影响,在对ADHD进行防治时应充分考虑家庭环境因素的作用.     

注意缺陷多动障碍儿童的自我意识及其与家庭环境的关系研究

目的评估注意缺陷多动障碍(ADHD)患儿的自我意识,研究其自我意识与家庭功能的关系。方法采用自制的一般情况调查表、Piers-Harris儿童自我意识量表(CSCS)、家庭功能量表(FAD)对84名7岁～12岁ADHD患儿进行问卷调查。结果①7岁～12岁ADHD患儿自我意识水平偏低、正常、偏高的检出率分别为52.38%、34.52%、13.10%;②CSCS总分:农村患儿低于城市患儿,父母文化程度高的患儿高于父母文化程度低的患儿,母亲职业为干部者高于母亲职业为其他者;③FAD总的功能对自我意识总分、行为、智力与学校情况、焦虑、合群有负向预测作用;沟通对合群有负向预测作用;情感介入对幸福与满足有负向预测作用。结论 ADHD患儿自我意识水平偏低,居住地、父母文化程度和母亲职业对患儿自我意识有不同程度的影响,良好的家庭功能有助于提高ADHD患儿的自我意识水平。     

柳州市6-12岁儿童罹患注意力缺陷-多动障碍的情况调查

目的:调查柳州市儿童注意力缺陷-多动障碍的发病情况。方法:采用SNAP-IV父母等级评定量表对柳州市6所公立小学和1所私立小学共计1021名6-12岁的小学生进行注意力缺陷-多动障碍的筛查,由儿童发育行为专科门诊对初步筛查结果呈阳性的儿童进行随访,按照美国精神病研究协会制定的精神障碍诊断标准以及第4版精神疾病的诊断和统计手册判断这些儿童是否患有注意力缺陷-多动障碍。结果:在本组儿童中,罹患ADHD的儿童占4.31%(44/1021)。男孩患此病的几率为5.63%(29/515),女孩患病的几率为2.96%(15/506),二者相比差异显著(X2=4.401,P=0.036<0.05),有统计学意义。城市儿童与农民工子弟儿童ADHD的患病率相比较差异不显著,无统计学意义(X2=0.007,P=0.931>0.05)。结论:柳州市儿童多动症的患病率与全国水平基本一致;城乡儿童ADHD的患病率相比较无显著差异。将SNAP-IV量表做为儿童ADHD的筛查量表进行ADHD发病率的调查简便易行,此法值得在基层医院推广使用。     

镇江城区小学生注意缺陷多动障碍流行病学调查

目的:了解镇江城区在校小学生注意缺陷多动障碍(ADHD)的患病率以及影响因素.方法:采用随机、分层、整群抽样调查方法,对镇江市3 698名在校儿童的父母进行基本情况问卷调查及DSM-ⅣADHD量表诊断,计算ADHD的患病率,并对影响因素进行χ2检验及多元回归分析.结果:镇江市城区小学生ADHD患病率为6.54%.男生患病率为9.14%,女生患病率为4.01%,两者差别有显著性(χ2=34.933,P＜0.001);4个城区患病率之间差别无显著性;各年级患病率差异无显著性.Logistic回归影响因素分析结果表明:父母关系、父母对子女的教育态度、家庭环境和周围环境、儿童脾气性格及低出生体质量等因素对ADHD患病率有明显影响.结论:镇江市儿童ADHD患病率较高,男生明显高于女生,不存在城区和年级差异,其影响因素是多方面的,其中家庭因素对ADHD的发生有着不可忽视的影响.     

电子垃圾拆卸区铅暴露对儿童注意缺陷多动障碍的影响

目的 了解电子垃圾拆卸区铅暴露对儿童注意缺陷多动障碍的影响情况.方法 选择广东贵屿镇172例2～8岁儿童作为研究对象,取其静脉血检测血铅浓度,采用DSM-Ⅳ父母及教师量表对儿童ADHD行为症状进行评分.结果 本组172例2～8岁儿童铅中毒率为29.1％,ADHD流行率根据父母量表为13.4％,教师量表为7.0％.血铅与两量表的ADHD行为症状总评分、各亚型评分均呈正相关性(P均＜0.01).铅中毒组的两量表ADHD行为症状总评分、各亚型评分均高于非铅中毒组,差异有统计学意义(P均＜0.01).男童相对女童在铅中毒情况下更容易表现出ADHD行为症状.结论 电子垃圾拆卸区的铅污染已经对儿童的行为发育造成损害,有必要采取多种手段进行干预,以保护当地儿童的健康成长.     

Value of D-Dimers in patients with acute aortic dissection

Objective: To evaluatel the value of D-dimers in patients with acute aortic dissection (AAD). Methods: This study consisted of 16 patients with AAD and 27 non-AAD patients. Serum D-dimets were measured by Sta-Liatest D-DI immunoturbidimetric assay. Results: D-dimer level was higher (P ＜ 0.001) in patients with AAD(7.91 ± 5.52 μg/ml) than that in non- AAD group(1.57±1.24 μg/ml). D-dimer was positive (＞0.4 μg/ml) in all patients with AAD and in 10 control group patients (37%). Among patients with acute AAD, D-dimers tended to be higher in Stanford A than in Stanford B (8.67 ± 4.31 μg/ml vs. 3.24±1.27 μg/ml, P ＜0.01). D-dimer values tended to be higher in more extended disease(3.84 ± 1.65 μg/ml, 8.57 ± 3.58 μg/ml and 11.87 ± 5.69 μg/ml in thoracic aorta, thoracic and abdominal aorta, thoracic and abdominal aorta and iliacal arteries, respectively, P ＜ 0.05 for both 8.57 ± 3.58 and 11.87 ± 5.69 vs. 3.84 ± 1.65 ). Including the control group into the analysis, we found a sensitivity of 100%, a negative predictive value of 100%, and a specificity of 66% and a positive predictive value of 64% for D-dimer in diagnosis of AAD in our patients with suspected AAD. Conclusion: D-dimer was elevated in patients with AAD. A negative D-dimer test result could be useful in excluding AAD.     

Research of combined liver-kidney transplantation model in rats

Objective： To set up a simple and reliable rat model of combined liver-kidney transplantation. Methods： SD rats served as both donors and recipients. 4℃ sodium lactate Ringer＇s was infused from portal veins to donated livers,and from abdominal aorta to donated kidneys, respectively. Anastomosis of the portal vein and the inferior vena cava （IVC） inferior to the right kidney between the graft and the recipient was performed by a double cuff method, then the superior hepatic vena cava with suture. A patch of donated renal artery was anastomosed to the recipient abdominal aorta. The urethra and bile duct were reconstructed with a simple inside bracket. Results： Among 65 cases of combined liver-kidney transplantation, the success rate in the late 40 cases was 77.5%. The function of the grafted liver and kidney remained normal. Conclusion： This rat model of combined liver-kidney transplantation can be established in common laboratory conditions with high success rate and meet the needs of renal transplantation experiment.     

BLOOD PRESSURE CHANGE WITH AGE IN SALT-SENSITIVE TEENAGERS

Objective To observe blood pressure change with age in salt-sensitive teenagers whose salt sensitivity were determined by repeated testing.Methods Salt sensitivity was determined through intravenous infusion of normal saline combined with volume-depletion by oral diuretic furosemide in 55 teenagers. After five years, salt sensitivity was re-examined and subject blood pressure was followed up. Blood pressure changes in salt-sensitive teenagers were compared to that of non-salt sensitive teenagers over five years.Results After 5 years, the repetition rate of salt sensitivity determined by intravenous saline loading is 92.7%. In teenagers with salt sensitivity on the baseline, both the systolic blood pressure increments and increment rates were much higher than non-salt sensitive teenagers (12.7±12.1 mmHg vs. 2.8±5.2 mmHg, P＜ 0.01; 12.2%± 12.0% vs. 2.5% ±4.4%, P＜ 0.001,respectively). There was a similar trend for diastolic blood pressure (8.4 ± 6.4 mmHg vs. 3.7 ± 6.4 mmHg, P = 0.052; 13.2% ±10.6 % vs. 6.8%± 10.1%, P = 0.053, respectively).Conclusions Salt sensitivity determined by intravenous saline loading showed good reproducibility. Blood pressure increments with age were much higher in salt-sensitive teenagers than non-salt sensitive teenagers, especially in terms of systolic blood pressure.     

安心颗粒对急诊经皮冠状动脉介入术后生活质量影响的研究

目的：评价使用安心颗粒对急诊经皮冠状动脉介入术（PPCI）术后生活质量的影响.方法：将160例接受PPCI的急性ST段抬高型心肌梗死患者随机分为安心颗粒组（术前顿服安心颗粒8.8g,术后安心颗粒4.4 g/次,每日2次）和对照组（仅接受基础药物治疗）.所有患者均服用阿司匹林、氯吡格雷和阿托伐他汀.分别在入院时、出院前1d、出院后180 d时,应用心肌梗死多维度量表（MIDAS）、中文版SF-36评价量表对患者生活质量评分.并观察术后30 d以内的出血并发症、血小板减少症发生情况.结果：入院时和出院前1d,两组患者的心肌梗死MIDAS、SF-36量表评分比较无差异（P＞0.05）;出院后180 d时,与对照组比较,安心颗粒组MIDAS、SF-36评分明显减低（P＜0.05）;组内与入院时比较,两组出院前1d、出院后180 d时,MIDAS、SF-36评分均降低（P＜0.05）.两组患者在随访期间均无大量出血、少量出血、重度和极重度血小板减少症发生,安心颗粒组有4例、对照组有7例发生不明显出血（P＞0.05）.两组发生轻度血小板减少症的患者数比较无差异（P＞0.05）.结论：PPCI使用安心颗粒,能改善急性ST段抬高型心肌梗死患者的生活质量,且不增加出血风险.     

The comparative studies of the influences of Urapidil and Nicardipine on sino-atrial node function, atrio-ventricular node function and hemodynamics

Objective:To investigate the influences of urapidil and nicardipine on rabbit sinus function,atrio-ventricular node function and hemodynamics.Methods:Thirty-two Angora's rabbits were selected and randomly divided into four groups.U1 group:urapidil 0.25 mg/kg;U2 group:urapidil 0.5 mg/kg;N1 group:nicardipine 10 μg/kg;N2 group:nicardipine 20 μg/kg.All these medicine were administrated within 30 seconds.Measurements were taken before and after the administration of urapidil or nicardipine for the following data:mean blood pressure(MAP),heart rate(HR),sino-atrial conduction time(SACT),maximal sinoatrial recovery time(SNRTmax)corrected sinus node recovery time(CSNRT),index of sinus node recovery time(SNRTI),Wenckebach A-V conduction frequency (WB),and P-R interval.Results:Significant MAP and HR changes were identified in all of the four groups before and after administration of both urapidil and nicardipine.No significant changes could be found in the rest of the parameters.Intergroup analysis showed that SACT and CSNRT of N1 and N2 groups were shorter than those of the U2 group(P＜0.01);the MAP decreased(P＜0.01)and the HR increased drastically(P＜0.01).Conclusions:Neither urapidil(0.25 mg/kg,0.5 mg/kg)nor nicardipine(10μg/kg,20μg/kg)has any significant influence on rabbit sinus function or rabbit atrio-ventricular node function.Nicardipine could be a better choice than urapidil for parafunctional sinus node patients.     

Expression of OPGmRNA and ODFmRNA in the patients of hip fracture due to osteoporosis

Objective：To investigate the gene expression of osteoprotegerin（OPG） and osteoclast differentiation factor（ODF） in the bone tissue of patients with hip fracture due to osteoporosis. Methods：OPGmRNA and ODFmRNA in the bone tissue in 50 cases of osteoporosis sufferers（over 50 years old） with hip fracture（Observer Group） and 30 cases of hip facture sufferers with no osteoporosis（Control group） were analyzed with the Semi-Quantitative RT-PCR method. Results：The mRNA expressed of ODF, OPG were both high in the patients with hip fracture. In the control group, the expression of OPG mRNA was observed, while the expression of ODF mRNA was very slight. Conclusion：Aged patients contained all signals including OPG, ODF that are essential for inducing osteoclastogenesis and promoting bone resorption.     

Dynamic Changes in Serum Estradiol and Progesterone levels in Patients of Premenstrual Syndrome with Adverse Flow of Liver-qi

Objective:To probe into the influence of changes of ovarian hormones on the pathogenesis of the specific sub-type premenstrual syndrome(PMS)and reveal partial microcosmic mechanisms of adverse flow of liver-qi.Methods:Estradiol(E2)and progesterone(P)levels in serum were determined at different phases of menstrual cycle by radioimmunoassay.Results:In the group of PMS with adverse flow of liver-qi.the secretive peak value Of E2 and P at the follicular phase significantly decreased,and the secretive peak value at the luteal phase did not come into being.Conclusions:Low E2 and P secretive peak at the follicular phase and absence of secretive peak at the luteal phase is one of the microcosmic mechanisms of PMS with adverse flow of liver-qi.One of the pathophysiologic mechanisms of specific sub-type PMS is probably the continuous low level of E2and P.     

Real-time Three-dimensional Echocardiography in Assessment of Left Ventricular and Right Ventricular Volumes

Real-time three-dimensional echocardiography (RT3DE)is a new ultrasound technique that enables dynamic threedimensional visualization and quantification of the heart in real time. Investigation of feasibility and methodology of RT3DE in determining left ventricular (LV) and right ventricular (RV) volumes, RT3DE was performed in 35 normal adults using Philips SONOS 7500 system with a 2-4 MHz matrix array transducer. The 60°×60° "pyramid" volume database was obtained and analyzed on a TomTec echo workstation. Both LV and RV volumes were calculated with four 3DE methods (i.e. apical 2, 4, 8, and 16-plane) through manually tracing ventricular endocardial borders in end diastole and end systole. Stroke volumes were then calculated. LV volume was also measured by 2DE Simpson's rule using GE VIVID 7 ultrasound machine.     

SCREENING FOR A 21-CHROMOSOME ABNORMALITY IN PREIMPLANTED EMBRYOS OF ELDERLY WOMEN

Increasing maternal age is the only etiological factor unequivocally linked to Down's syndrome in humans. The occurrence rate of newborns with Down's syndrome is about 1/220 in women over 35 years old. However, the occurrence rate in embryos fertilized in vitro, of the elder woman is unclear. Using FISH we screened the number of chromosome 21 in preimplanted embryos of 5 elderly women (average age, 38.4 years) to study the feasibility and necessity of screening trisomy 21 in embryos in patients over 35 years old at the in vitro fertilization (IVF) center.     

Scientific principles and rigorous processes should be followed in developing clinical guidelines for therapeutic interventions of integrative medicine

A clinical guideline for the therapeutic interventions of integrative medicine may be defined as a written document which states a series of recommendations on therapeutic interventions of integrative medicine for a special disease or condition. The guideline may provide assistance to medical professionals in making clinical decisions aimed at improving the clinical outcome of patients and reducing the costs of medical care（~＇4~. Recommendations issued by a guideline should be based on the best available evidence in both Western and Chinese medicine. For fulfilling this purpose, the development of clinical guidelines for therapeutic interventions in the field of integrative medicine should follow scientific principles and undergo a rigorous processes.