不同亚型注意缺陷多动障碍儿童视觉工作记忆研究

目的:探讨视觉图形工作记忆、视觉空间工作记忆在不同亚型注意缺陷多动障碍(ADHD)儿童及对照组儿童的脑反应特征及其差异。方法:采用1∶1病例对照研究,对6~12岁102例ADHD儿童〔注意缺陷型(PI)59例,多动/冲动型(HI)20例,混合型(CT)23例〕和102例正常对照组儿童进行视觉图形工作记忆、视觉空间工作记忆测试。结果:①ADHD儿童视觉图形工作记忆、视觉空间工作记忆各项指标均显著低于对照组儿童(P<0.05、P<0.01)。②PI型、CT型ADHD儿童视觉图形工作记忆、视觉空间工作记忆各项指标均显著低于对照组(P<0.05、P<0.01),且PI型、CT型ADHD儿童在图形记忆正确数、相反顺序点圆数低于HI型ADHD儿童(P<0.05)。结论:不同亚型ADHD儿童存在明显的视觉图形记忆、视觉空间记忆处理能力不足,执行功能损害,而且各亚型之间的损害程度有所不同。     

注意缺陷多动障碍患儿智力结构特征

【目的】探讨注意缺陷多动障碍（attention deficit hyperactivity disorder，ADHD）儿童及其三个亚型与正常儿童智力结构的特征。【方法】采用WISC-CR，对110例三个亚型ADHD儿童和35例正常对照组儿童进行病例对照研究。【结果】ADHD组儿童智商多在正常范围或边缘水平，低于正常对照组（P〈0．05）。ADHD组言语智商与操作智商之间的平衡性差，且注意缺陷为主型（PI组）和混合型（CT组）智力发展不平衡者明显高于多动或冲动为主型（HI组）。ADHD组儿童是随着年龄的增加，HI型比例下降，PI型比例上升，差异有显著性。【结论】ADHD组儿童的智力水平较低．其言语和操作能力发展不平衡。     

不同亚型注意缺陷多动障碍儿童威斯康星卡片分类测验研究

目的探讨威斯康星卡片分类测验（WCST）在不同亚型注意缺陷多动障碍（ADHD）儿童及正常对照组之间的反应特征及其差异,为开展对ADHD儿童的干预工作提供依据。方法采用1∶1病例对照研究,对102例ADHD儿童和102例正常对照组儿童进行WCST测试。研究组中注意缺陷型（PI）59例,多动/冲动型（HI）20例,混合型（CT）23例。结果ADHD儿童WCST测试的错误应答数（Re）、概念化水平（Rfp）、持续性应答数（Rp）、持续性错误数（Rpe）、非持续性错误（nRpe）显著低于正常对照组儿童（P〈0.05或〈0.01）。不同亚型ADHD儿童WCST测试的错误应答数（Re）、概念化水平（Rfp）均显著低于正常对照组;PI型的持续性应答数（Rp）、非持续性错误（nRpe）,HI型的持续性错误数（Rpe）,CT型的持续性错误数（Rpe）、非持续性错误（nRpe）均显著低于正常对照组（P〈0.05或〈0.01）。结论不同亚型ADHD儿童存在明显的执行功能损害,且各亚型之间的损害特征有所不同。     

注意缺陷多动障碍儿童个性特征分析

【目的】了解注意缺陷多动障碍(attention deficit hyperactivity disorder,ADHD)儿童个性特点,以及根据DSM-Ⅳ划分的ADHD各亚型的个性特点。【方法】采用儿童艾森克个性问卷(EPQ)对76名符合DSM-Ⅳ诊断标准的ADHD及其亚型诊断的患儿和76名健康儿童进行测试。【结果】ADHD组在精神质(P)、神经质(N)维度得分明显高于对照组,而在内外向(E)、掩饰性(L)维度得分低于对照组,两组比较差异有高度统计学意义(P0.01)。在个性倾向上,ADHD组的内向/倾向内向、不稳定/倾向不稳定以及精神质/倾向精神质所占比例明显较对照组多(P0.01)。不同亚型ADHD在精神质(P)、内外向(E)、神经质(N)维度得分差异有统计学意义(P0.01,P0.05),在掩饰性(L)维度分各亚型间比较差异无统计学意义。在个性倾向上,PI型不稳定/倾向不稳定,内向/倾向内向所占比例较高(79.3%,51.6%),高于CT型和HI型。CT型患儿精神质型所占比例较PI型及HI型高。【结论】ADHD儿童个性有其独特性,个性倾向内向、情绪不稳定,各亚型个性倾向不同,在对ADHD儿童进行治疗和干预时应注意其个性特点。     

不同亚型注意缺陷多动障碍儿童行为问题的研究

目的:对注意缺陷多动障碍(attentiondeficithyperactivitydisorder,ADHD)儿童及其3个亚型与正常儿童行为问题进行比较。方法:采用Achenbach儿童行为量表(Achenbach'schildbehaviorchecklist,CBCL)(家长用)对110例3个亚型ADHD儿童和35例正常对照组儿童进行病例对照研究。结果:①ADHD组及其各亚型儿童行为问题异常率明显高于正常对照组(P<0.05)。②ADHD组各亚型及对照组儿童行为因子异常情况分布显示HI型儿童行为问题发生率较高,与PI型儿童相比差异有显著性。PI型儿童主要是交往不良,HI型儿童主要是多动、攻击性、违纪。结论:ADHD儿童行为问题异常率高于正常对照组儿童,且以HI型儿童显著。     

新疆维汉注意缺陷多动障碍儿童各亚型分布及Conners父母量表因子分比较

【目的】 比较新疆维汉注意缺陷多动障碍儿童各亚型分布情况及Conners父母量表六个因子得分差别。 【方法】 收集乌鲁木齐市儿童医院2008年9月-2010年确诊的3~17岁ADHD儿童,分析维汉ADHD各亚型分布情况;然后按1/6比例随机抽取符合入组标准的三型ADHD汉族儿童,与维族所有各型ADHD儿童组成ADHD组,选取同期3~17岁非ADHD儿童作为对照组,比较维汉ADHD儿童与对照组Conners父母量表各因子分。 【结果】 1)符合入组标准的ADHD儿童共1 164人,汉族1 114人,维族50人,其中注意缺陷型485人,多动冲动型127人,混合型552人。2)维汉ADHD儿童各亚型分布不同,差异有统计学意义(P<0.05),其中,汉族儿童以注意缺陷和混合型为主,维族儿童以混合型为主;汉、维儿童学龄前均以冲动多动型为主,小学阶段以混合型为主,其次为注意缺陷型;汉族儿童中学阶段以注意缺陷型为主,维族儿童各型未见差别;冲动多动型多以年龄段比较小的小学和学龄前为主。汉族ADHA三个亚型在PSQ品行、学习问题、焦虑、多动指数和冲动-多动因子等5个因子上均高于对照组(P<0.05);维族ADHA三个亚型中仅冲动型和混合型在品行问题、学习问题、冲动-多动及多动指数高于对照(P<0.05),在焦虑和身心障碍因子上无差异(P>0.05)。 【结论】 新疆维汉ADHD儿童亚型分布和相应的行为问题不同,应进一步探讨影响因素以进行有针对性的预防和治疗。     

不同亚型注意缺陷多动障碍患儿脑电活动的特征

[目的]探讨儿童注意缺陷多动障碍（attention deficit hyperactivity disorder,ADHD）三个亚型儿童及正常对照组儿童脑电活动的特征.[方法]将门诊符合DSM-Ⅳ诊断标准的110例ADHD儿童分为注意缺陷为主型（PI）49例,多动或冲动为主型（HI）19例,混合型（CT）42例,对照组儿童35例,对其进行脑电图检查并进行比较.[结果]ADHD组儿童脑电频率明显慢于正常对照组（P＜0.05）.三个亚型ADHD患儿中HI型脑电频率最慢,PI型频率最快,三个亚型间两两比较差异有非常显著性（P＜0.01）.HI型内右前额、右额部及右枕部的脑电频率明显慢于左半球（P＜0.05）.三个亚型在右枕部的脑电频率均慢于左半球.[结论]ADHD存在有一定的神经生理基础,其发病机制可能与大脑发育不成熟有关.     

注意缺陷多动障碍儿童不同亚型的神经心理特征

[目的]分析注意缺陷多动障碍(ADHD)儿童不同亚型的神经心理特征. [方法]将门诊儿童符合DSM-IV ADHD诊断标准者172例分为注意缺陷为主型(PI)57例,多动/冲动为主型(HI)21例和混合型(CT)94例,对三型儿童进行视觉-运动整合发育测验(VMI)和联合型瑞文测验(CRT),并进行组间比较,将ADHD儿童的VMI测验结果和常模比较. [结果]随着年龄的增长,HI型比例下降,PI型比例上升,差异有显著性;HI型男童的构成比较大,PI型则女童的构成比较大.得到相同的VMI原始分的年龄,ADHD儿童大于常模组儿童;和常模组比较,原始分为9分组差异有非常显著性(P＜0.001),10～12分组差异有显著性(P＜0.05);ADHD三型之间的VMI结果有差别,PI型最差、HI型和PI型之间差异有显著性(P＜0.05).CRT结果PI型较差,但三型之间差异无显著性. [结论]ADHD的分型和年龄、性别有关;ADHD儿童的视觉运动整合能力较正常儿童差,VMI更能反映ADHD亚型中的注意力障碍问题;各亚型之间计划能力、一般智力没有明显的差异.     

注意缺陷多动障碍儿童脑功能特征的病例对照研究

【目的】探讨注意缺陷多动障碍（attention deficit—hyperactivity disorder，ADHD）儿童的脑功能特征．为临床诊断与疗效观察提供依据。【方法】对符合DSM-Ⅳ标准的110例ADHD及35名对照组儿童进行病例对照研究．额部及顶部脑功能测查采用美国产A-620脑电神经生物反馈仪。【结果】ADHD组前额及顶部θ波脑电功率、θ／SMR、θ／β、α／SMR、α／β脑电功率比值明显高于对照组（P〈0．01）；ADHD亚型中多动或冲动为主型（HI）组θ波脑电功率高于混合型（CT）组；ADHD组顶部与额部比较差异无显著性（P〉0．05）。【结论】ADHD儿童前额及顶部θ波段脑电功率占优势；脑电功能检查比单纯的脑电波描记更有临床诊断意义。     

两种亚型注意缺陷多动障碍男童执行功能特征

【目的】 探讨注意缺陷多动障碍(attention deficit hyperactivity disorder,ADHD)混合型(ADHD-CT)及注意缺陷为主型(ADHD-IT)的男童执行功能特征。 【方法】 采用抑制(反应/不反应任务、停止信号任务、Stroop色-字任务)及工作记忆功能任务(顺背数字、倒背数字、Corsi木块回忆、n-Back)对76名ADHD-CT、15名ADHD-IT及15名对照组男童进行测试。 【结果】 1) ADHD组儿童在反应/不反应任务、Stroop色-字任务、倒背数字、Corsi木块回忆任务上的表现明显差于对照组儿童,控制年龄、年级、总智商后比较差异有统计学意义。2) ADHD-CT与ADHD-IT组儿童在各测试任务上的表现差异无统计学意义。 【结论】 ADHD儿童存在执行功能损伤。ADHD-CT与ADHD-IT亚型执行功能损伤模式相同。     

Calcium intake in the elderly: validation of a dietary questionnaire

Epidemiological studies of calcium and osteoporosis have been hampered by the lack of a suitable tool for assessing calcium intake. This report describes a new frequency and amount questionnaire for measuring present and past calcium intake in the elderly. The validity of the questionnaire was tested against two commonly used standards of dietary assessment, five-day duplicate diets and seven-day weighed dietary inventories. The resulting correlation coefficients were, respectively, r = 0.76 and r = 0.69, while that for repeatability was r = 0.84. Furthermore, the questionnaire categorized subjects into thirds of the distribution of intake with almost no gross misclassification. It is suggested that the present findings may be extended to the majority of normal, healthy elderly subjects, implying wide application for the questionnaire in the assessment of calcium intake in the elderly.     

The occurrence of antimicrobial substances in toilet,sink and shower drainpipes of clinical units: A neglected source of antibiotic residues

Antibiotics represent one of the most important drug groups used in the management of bacterial infections in humans and animals. Due to the increasing problem of antibiotic resistance, assurance of the antibacterial effectiveness of these substances has moved into the focus of public health. The reduction in antibiotic residues in wastewater and the environment may play a decisive role in the development of increasing rates of antibiotic resistance. The present study examines the wastewater of 31 patient rooms of various German clinics for possible residues of antibiotics, as well as the wastewater of five private households as a reference.To the best of our knowledge, this study shows for the first time that in hospitals with high antibiotic consumption rates, residues of these drugs can be regularly detected in toilets, sink siphons and shower drains at concentrations ranging from 0.02?μg·L^?1 to a maximum of 79?mg·L^?1. After complete flushing of the wastewater siphons, antibiotics are no longer detectable, but after temporal stagnation, the concentration of the active substances in the water phases of respective siphons increases again, suggesting that antibiotics persist through the washing process in biofilms. This study demonstrates that clinical wastewater systems offer further possibilities for the optimization of antibiotic resistance surveillance.     

Self-reported health problems among Swedish miners one year after unemployment

Unemployment is considered to be a public health concern sincedeterioration in the health of the unemployed is often anticipated.However, for some groups, such as miners, unemployment mightimprove health due to a cessation of potentially harmful occupationalexposures. This study evaluates the health of 79 miners in oneSwedish iron-ore mine, and 226 age-matched controls from thegeneral population, during one year after the closure of themine. The participants received a questionnaire regarding medicalhistory and subjective symptoms at the beginning of the studyperiod, and after one year. Statistically significant negativeeffects on self-reported health attributable to unemploymentwere not found, although neuropsychiatric symptoms were morecommon among the unemployed miners. The miners reported a statisticallysignificant improvement in grip force (p=0.031). They had asignificantly higher prevalence of symptoms associated withmining related exposures when compared with the population controls;pain in the upper extremities [relative risk (RR)=2.27, 95%confidence interval (Cl)=1.44–3.59), back pain (RR=1.84;Cl=1.237–2.75), vasospastic disease of the fingers (RR=2.05;Cl=1.18–3.57) and obstructive respiratory symptoms (attacksof dyspnea and wheezing: RR=3.67; Cl=1.167–11.6).     

Excès de cas humains et animaux de tularémie en France au cours de l’hiver 2007–2008 : émergence ou phénomène isolé ?

Context

Tularemia is a zoonosis affecting humans and hares in France. We describe the results of surveillance in both species, in 2007 and 2008.

Methods

Human tularemia cases are mandatorily notifiable in France since 2003. In hares, surveillance relies on volunteer hunter associations in all districts of the country. Data from mandatory reports and volunteer surveillance in 2007/2008 were analyzed and compared with previous results.

Results

In 2007/2008, 144 cases were reported in humans and 117 cases in hares. This was a 100% increase compared to previous years. Human cases differed from those of previous years only by the frequency of contact with breeding animals. Human cases without any documented risk exposure were also more frequent.

Conclusion

An increase of tularemia cases occurred in 2007/2008 in both species. Complementary studies are needed to identify the species reservoir in France to understand the causes of this peak of cases.     

Occupational health hazards in mining: an overview

This review article outlines the physical, chemical, biological, ergonomic and psychosocial occupational health hazards of mining and associated metallurgical processes. Mining remains an important industrial sector in many parts of the world and although substantial progress has been made in the control of occupational health hazards, there remains room for further risk reduction. This applies particularly to traumatic injury hazards, ergonomic hazards and noise. Vigilance is also required to ensure exposures to coal dust and crystalline silica remain effectively controlled.     

Manufacture and use of nanomaterials: current status in the UK and global trends

This paper provides an overview of the production and use of nanomaterials (NMs), particularly in the UK. Currently, relatively few companies in the UK are identifiable as NM manufacturers, the main emphasis being the bulk markets in metals and metal oxides, and some niche markets such as carbon nanotubes and quantum dots. NM manufacturing in the UK does not reflect the global emphasis on fullerenes, nanotubes and fibres. Some assumptions have been made about the types of NM that are likely to be imported into the UK, which currently include fullerenes, modified fullerenes and other carbon-based NMs including nanotubes. Many university departments, spin-offs and private companies have developed processes for the manufacture of NMs but may only be producing small quantities for research and development (R&D) purposes. However, some have the potential to scale up to produce large quantities. The nanotechnology industry in the UK has strong R&D backup from universities and related institutions. This review has covered R&D trends at such institutions, and appropriate information has been added to a searchable database. While several companies are including NMs in their products, only a few (e.g. manufacturers of paints, coatings, cosmetics, catalysts, polymer composites) are using nanoparticles (NPs) in any significant quantities. However, this situation is likely to change rapidly. There is a need to collect more information about exposure to NPs in both manufacturing and user scenarios. As the market grows, and as manufacturers switch from the micro- to the nanoscale, the potential for exposure will increase. More research is required to quantify any risks to workers and consumers.     

深圳公立医院管理体制改革制度设计

深圳公立医院管理体制改革实行政事分开、管办分开,在理事会架构下按法定机构模式组建市医管中心,落实公立医院运营管理自主权.作者从当前公立医院管理体制的弊端入手,介绍了深圳市进行公立医院管理体制改革的基本思路及改革方案设计的主要举措,深入剖析了的改革方案的特点,并对改革效果进行了预测.     

Effects of nitrogen dioxide on red blood cells of rats: Changes in components of red cell membranes during in vivo exposure to NO2

Red cell membranes, prepared from red blood cells of rats exposed to 4, 10, or 20 ppm nitrogen dioxide (NO₂) for 1 to 10 days, were examined for evidence of changes in membrane components. Appreciable changes were not found in contents of phospholipid and cholesterol during exposure to 10 ppm NO₂. By contrast, protein content altered with the time of exposure. Moreover, changes in protein composition were observed by employing sodium dodecyl sulfate — polyacrylamide gel electrophoresis. Twenty-four-hour exposure to NO₂ at the concentration above 10 ppm resulted in a marked increase in the percentage of lysophosphatidylethanolamine (LysoPE) to the total phospholipids. The prolonged exposure to 10 ppm NO₂ gave rise to a further increase in LysoPE, whereas the percentage of phosphatidylethanolamine (PE) showed a gradual decrease. A 1-day exposure to 4.0 ppm NO₂ also caused an increase in sialic acid content and decreases in those of PE and hexose. In addition to contents of these components the percentage of LysoPE increased 5 days after exposure and the elevated values were maintained up to the end of exposure period. These results demonstrate that red blood cells in circulation exhibit different membrane properties in terms of lipid and carbohydrate composition during 10 days of exposure to 4.0 ppm NO₂.     

Investigating clusters in the workplace and beyond

Clusters of disease are common and occur in the workplace and in the general community. They often arouse considerable concern among the population. Investigations have sometimes lead to exciting new knowledge, but in general the investigation of clusters is difficult and often unrewarding, especially for community clusters. In the workplace, investigations are more likely to find associations and even new causes, but still many clusters remain enigmatic. Despite this, there are many reasons for investigating clusters, including allaying community concern and identifying uncontrolled exposures. A structure for investigating clusters in the workplace is suggested.