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Attention deficit/hyperactivity disorder (ADHD) is one of the most common neuro developmental disorders in childhood.The main symptoms of ADHD are inattention, hyperactivity, impulsivity, etc.ADHD causes lots of adverse effects on patients, families and the society.Currently, medication is a common treatment for ADHD.However, due to a series of adverse effects caused by drug treatment, and some concomitant problems, the effect of drug treatment alone is not ideal.Therefore, non-drug treatment of ADHD is becoming popular.This study aims to review the common non-drug treatment methods and efficacy of ADHD at home and abroad.
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Developmental coordination disorder (DCD) is a developmental disorder that mainly affects children′s motor coordination.The prevalence of DCD in childhood is very high, and it seriously affects the physical and mental health of school-age children.In China, this disease has not yet been fully recognized and understood.There is a lack of standardized and unified diagnostic criteria, and the standardization of relevant clinical assessment tools and the establishment of normative models are insufficient.In addition, the clinical practice and experience of most health professionals in dealing with DCD appear to be limited.Based on international clinical practice recommendations on the definition, diagnosis, assessment, intervention, and psychosocial aspects of DCD issued by the European Academy of Childhood Disability in 2019, the recommendations related to the diagnosis, evaluation and intervention of DCD in the guidelines were compiled and interpreted in the light of the current clinical practice and research in China.The objective of this study is to bring DCD to the attention of more domestic medical experts through the interpretation of this international guideline and to provide preliminary guidance on the clinical diagnosis, assessment, and intervention of DCD.
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Autism spectrum disorders (ASD) is a neurodevelopmental condition characterized by altered social communication,alongside restricted and stereotyped behaviors and interests,bringing a heavy burden to the family and society.International experts develop the International Classification of Functioning,Disability and Health (ICF) core sets for individuals with ASD.The ICF core sets for ASD will be a tool to describe individual functioning comprehensively.
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Objective To investigate the epidemiological characteristics of cerebral palsy(CP)in children aged 1-6 years in China,including the incidence,prevalence,type of CP,etiology,prevention and rehabilitation status. Methods The survey was carried out by standard questionnaires,multi-center collaboration,stratified-cluster ran-dom sampling method.The surveyed adopted the following principles:streets in the city and villages in the rural areas, and the number of the urban and rural children was the same,and the proportion of children in each age group was balanced.The investigation areas included provinces and autonomous regions,including Heilongjiang,Beijing,Henan, Shandong,Shanxi,Shaanxi,Anhui,Hunan,Guangxi,Guangdong,Chongqing and Qinghai,and 323 858 children were in-vestigated.Results The incidence of CP was 2.48‰(155/62 591 cases),and the prevalence was 2.46‰(797/323 858 cases)(1-6 years old).The prevalence varied in different regions,in which the highest prevalence was 5. 40‰(54/9 998 cases)in Qinghai province,and the lowest prevalence was 1.04‰(47/45 133 cases)in Shandong province.The prevalence of the males(2.64‰,461/174 391 cases)was higher than that of the females(2.25‰, 336/149 467 cases),and the difference was statistically significant(P<0.05).The types of CP were spastic type (58.85%,469/797 cases),mixed type(13.17%,105/797 cases),dyskinetic(9.79%,78/797 cases),hypotonic (8.28%,66/797 cases),ataxia(6.25%,52/797 cases)and rigid(3.39%,27/797 cases)respectively in 797 CP children.The first three risk factors for CP were long -term exposure to harmful physical factors during pregnancy, whether there were birth defects among the three generations of relatives of the children,such as children's peers, parents or grandparents,whether there were birth defects among the children's peers,parents or grandparents,and neonatal jaundice or persistent jaundice.Among 797 CP children,79.67% of the children with CP were timely detected and treated in the local hospitals,while the other 19.93% of them were not timely treated.The places which could give them timely detection and early diagnosis and treatment were general hospitals(42.97%),Maternity and Infant Hospitals (27.03%)and Children's Hospitals(20.31%). The main rehabilitation methods for 797 children with CP were 34.58% in the hospitals or rehabilitation centers,31.61% in the communities(including at home),33.80% mainly in the medical institution,and in the communities they could also receive partially rehabilitation services. Conclusions The prevalence of CP in China is coincident with international levels.The prevalence rate of CP in males is higher than that in females.The types of CP distribution are accorded with international distribution characteristics.There were still some children with CP who could not receive timely detection and treatment.Rehabilitation at the medical institutions is the chief way and proper rehabilitation guidance should be carried out in the communities.
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Objective To explore the mental health and personality traits of the parents of cerebral palsy children. Methods 128 parents of cerebral palsy children and other 128 parents of healthy children were investigated with the Symptom Check List-90 (SCL-90), Eysenck Personality Questionnaire (EPQ). Results The scores of SCL-90 were more in the parents of cerebral palsy children, especially in the factors of somatization, obsession, depression, anxiety, and paranoid (P<0.01). The personality traits characterized as introversion (P<0.05) and neu-roticism (P<0.01). The multiple regression showed that some factors of SCL-90 were related with the personality of neuroticism. Conclu-sion The mental health of the parents of children with cerebral palsy are poor, which may be related with the personality of neuroticism.
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@#Objective To explore the level of polyunsaturated fatty acids (PUFAs) in blood plasma and its relation with the behavior ofchildren with autism. Methods High performance liquid chromatography was used to measure the level of free PUFAs of blood plasma in30 autistic children and 20 healthy children. Conner's Parent Rating Scale (parents) and the Repetitive Behavior Scale-Revised (RBS-R) RatingScale were used to evaluate the behavior of the children, and the relationship between the PUFAs level and abnormal behavior in the childrenwas also analyzed. Results The level of α-linolenic acid (ALA), docosahexenoic acid (DHA) and total n-3 PUFAs were lower in autisticchildren than in healthy children (P<0.05), especially lower in DHA (P<0.01). There was no significant difference in n-3 PUFAs betweentwo groups (P>0.05); There were negatively correlations between the level of DHA and total n-3 PUFAs in blood plasma and impulsion-hyperactivity,hyperactivity index, learning, anxiety, stereotypic behavior, self-injurious behavior, compulsions, ritualistic behavior and samenessbehavior. Conclusion The level of n-3 PUFAs in blood plasma of autistic children was lower than the healthy children and the level ofPUFAs were correlated with the behavior of autistic children.
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@#Objective To study the effect of brain function biofeedback on children with spastic cerebral palsy following attention deficit disorder. Methods 44 children with spastic cerebral palsy were divided into 2 groups: 23 cases in observation group and 21in control group. The routine rehabilitation including physical therapy, occupational therapy, sensory integration, speech therapy and traditional Chinese medicine were used in two groups, while at the same time EEG biofeedback therapy was used in the observation group 5 times a week for 3 months. Chinese Binet Intelligence Scale (CBIS) and The Test of Variables of Attention (TOVA) were used to assess the effect before and after treatment. Results After the treatment, the intellectual level of the observation group significantly improved (P<0.01), omissions significantly reduced (P<0.01), error number was lower (P<0.05), reaction time was significantly shorter(P<0.01), mutation rate was significantly lower (P<0.01); while the intellectual level of the control group didn't significantly improve (P>0.05), omissions and reaction time significantly reduced (P<0.01), there was not obvious difference in error number and the mutation (P>0.05). Conclusion Brain function biofeedback can effectively improve attention disorder in children with spastic cerebral palsy.
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@#ObjectiveTo observe the effects of Balance Performance Monitor (BPM) on balance capacity of children with spastic cerebral palsy. Methods96 children (2～5 years old) with spastic cerebral palsy were randomly divided into the experimental group and the control group. BPM training combined with Bobath approach was used in the experimental group, and the Bobath approach was used in the control group. They were assessed with the BPM before and 2 months after training. Results2 months after training, the balance capacity in both groups improved than before（P<0.05）. Furthermore, the index of experimental group is better than those of the control group（P<0.05）. ConclusionBPM can improve the effects of Bobath approach on the balance capacity of the children with spastic cerebral palsy.
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@#ObjectiveTo study the optimum method to evaluate the motor function of cerebral palsy neonatal rats caused by intrauterine infection. Methods48 Wistar 17 d pregnant rats were consecutively injected with lipopolysacchide (LPS) (450 μg/kg) for 2 d (LPS group), and other 10 Wistar 17 d pregnant rats (control group) were injected with the same dose of saline. The neonatal rats were selected randomly in control group (A) (n=60) and LPS group (n=120), the latter was divided into intervention group (B1, n=60) and nonintervention group (B2, n=60). The CP rats were identified with neurobehavior detection on the 25th day. Then the CP rats in the B1 group (B1CP) continued their intervention, the CP rats in the B2 group (B2CP) and 10 rats random from group A (A′) were raised routinely. They were assessed with neurobehavior detection and improved BBB assessment on the 25th and 42nd day. ResultsThere were 7 CP rats in B1 group, and 13 in B2 group. There was significant difference in the scores of hanging test, slopes test, open-field experiment, resist captured reaction between the 25th and 42nd day in B1CP group (P<0.01), as well as in improved BBB assessment (P<0.01), but not in neurobehavior detection; while there was not significant difference in B2CP group and in A′ group in all the assessment above. ConclusionNot neurobehavior detection, but hanging test and BBB assessment, can be used to evaluate the motor function of cerebral palsy rats caused by intrauterine infection.
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20?mm?Hg, nonpulmonary hypertension group (control group n=9), with preoperative mean pulmonary artery pressure
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ObjectiveTo determine the role and significance of transesophageal echocardiography (TEE) in the closure of atrial septal defects (ASD) during minimally invasive cardiac surgery. MethodsSeventeen patients with secundum atrial septal defect (ASD) were examined by transthoracic echocardiography (TTE) and TEE. TTE usually allowed selection of cases likely to be suitable for closure in this fashion. TEE provided indispensable informations in the selection of eligible atrial septal defects, evaluates the exact size, location and morphology of the defect. Skin incisions were made on the right anterior chest which were 2.5 ～ 3.5 cm long. A special catheter carrying Amplatzer occluder were inserted into the left atrium via ASD. Under TEE guidance, the device was released and ASD was successfully closed. ResultsThe occluder device was successfully implanted in 15 patients. The size of ASD varied from 11 to 35 mm [mean (23?6) mm] measured by TEE, upper septal rim 4 to 17 mm[mean (10?4) mm], lower septal rim 6 to 22 mm[mean (14?6) mm]. The intracardiac procedure time ranged from 10 to 45 min[(24?13) min]. They were all discharged from the hospital 3 or 4 days after the operation. ConclusionsTEE serves as an important monitoring tool during deployment of the device. It is a necessary adjunct to minimally invasive cardiac surgery. Constant echocardiographic visualisation of the device and its position relative to the atrial septum facilitates proper placement.