Association between serum trace elements and core symptoms in children with autism spectrum disorder: a national multicenter survey / 中国当代儿科杂志

OBJECTIVE@#To study the association of serum levels of trace elements with core symptoms in children with autism spectrum disorder (ASD).@*METHODS@#From September 2018 to September 2019, an investigation was performed for 1 020 children with ASD and 1 038 healthy children matched for age and sex in the outpatient service of grade A tertiary hospitals and special education institutions in 13 cities of China. Autism Behavior Checklist (ABC), Social Responsiveness Scale (SRS), and Childhood Autism Rating Scale (CARS) were used to assess the core symptoms of the children with ASD. The inductively coupled plasma mass spectrometry was used to measure serum levels of trace elements magnesium, iron, copper, and zinc.@*RESULTS@#The children with ASD had significantly lower serum levels of magnesium, copper, and zinc than the healthy children (@*CONCLUSIONS@#The serum levels of magnesium and zinc may be associated with core symptoms in children with ASD, which requires further studies. The nutritional status of trace elements should be monitored for children with ASD in clinical practice.

Association of exposure to polycyclic aromatic hydrocarbons during pregnancy with autism spectrum disorder-related behaviors in toddlers: a birth cohort study / 中国当代儿科杂志

OBJECTIVE@#To study the association of exposure to polycyclic aromatic hydrocarbons (PAH) during pregnancy and autism spectrum disorder (ASD)-related behaviors in toddlers.@*METHODS@#A total of 348 toddlers who had accepted the measurement of PAH-DNA adduct in umbilical cord blood and evaluation of behavior problems at the age of 36 months were enrolled in this birth cohort study. Child Behavior Checklist (CBCL) and Autism Behavior Checklist (ABC) were used to evaluate behavior problems at the age of 36 months. The correlation of the concentration of PAH-DNA adduct in umbilical cord blood with CBCL and ABC scores at the age of 36 months were analyzed.@*RESULTS@#The detection rate of PAH-DNA adduct in umbilical cord blood was 52.3%, and the median concentration was 0.68 ng/mL. The median total scores of CBCL and ABC scales were 23 and 8 respectively. In children aged 36 months, the concentration of PAH-DNA adduct was positively correlated with the score of social withdrawal in the CBCL scale (r=0.205, P<0.05), the total score of the ABC scale (r=0.412, P<0.05), and the self-care score of the ABC scale (r=0.355, P<0.05). The concentration of PAH-DNA adduct was closely associated with the total score of the ABC scale in children aged 36 months (β=0.122, P<0.05).@*CONCLUSIONS@#PAH exposure during pregnancy may be a risk factor for ASD-related behaviors in toddlers. Effective reduction of PAH exposure during pregnancy and detection of PAH-DNA adduct in neonatal umbilical cord blood are of vital importance for early prevention, screening and intervention of ASD.

Effects of hyperbaric oxygen on the level of brain derived neurotrophic factor and parvalbumin in hippocampal CA1 region of valproic acid autism rats / 中华实用儿科临床杂志

Objective To explore the outcome of brain derived neurotrophic factor(BDNF) and parvalbumin (PV) positive neurons after hyperbaric oxygen intervention for the valproic acid(VPA) autism rats in hippocampal CA1 region.Methods The animal model of autism was established by the methods of Schneider and Przewlocki.Animal model groups of autism were obtained in male offspring of the Wistar rats that received intraperitoneal injection of 600 mg/kg VPA on the 12.5 day after pregnancy according to the eye opening time,behavior,weaning weight and the learning and memory abilities which were evaluated by the Y electricity maze test on the 28th day after birth.Forty-eight male VPA autism rats were randomly divided into high-pressure high-oxygen group,high-pressure air group and normal pressure high-oxygen group and normal pressure air group(n =12,each group).Normal control group was obtained in male offspring of Wistar rats that received intraperitoneal injection of equivalent physiological saline in the same period (n =12).Using the immunohistochemistry methods and image analysis to examine the number of BDNF and PV positive neurons in hippocampal CA1 region of different groups.Results The number of BDNF positive neurons in normal pressure air model group was more than that in the normal pressure air control group,with statistical difference between them(5.00 ± 1.60 vs 3.00 ± 1.04,t =3.633,P =0.001).The number of the PV positive neurons in the normal pressure air model group was more than that of the normal pressure air control group,with statistical difference between them (5.33 ± 0.99 vs 2.83 ± 1.29,t =5.369,P =0.000).The number of the PV positive neurons in the high-pressure high-oxygen group was less than that in the normal pressure air model group,with statistical difference between them (3.33 ±0.99 vs 5.33 0.99,t =4.975,P =0.000).The number of the PV positive neurons in the high-pressure highoxygen group was less than that in the high-pressure-air model group (3.33 ± 0.99 vs 4.67 ± 1.92,t =-2.138,P =0.044).Conclusions The pathogenesis of autism may be related to the expression level of BDNF and PV in the hippocampal CA1 region and this may serve as the mechanism of hyperbaric oxygen intervention of autism animal model for effective treatment.

Family-based association study of a variable number of tandem repeat polymorphism of DAT1 gene with Tourette syndrome in a Chinese Han population / 中华医学遗传学杂志

<p><b>OBJECTIVE</b>To assess the association of a 40 bp variable number of tandem repeat (VNTR) polymorphism within 3 untranslated region of dopamine transporter gene (DAT1) with Tourette syndrome (TS) in a Chinese Han population.</p><p><b>METHODS</b>A total of 160 TS patients and their parents were recruited. The VNTR polymorphism was detected with polymerase chain reaction-VNTR analysis, and its association with TS and its subtypes were assessed through a family-based association study comprising transmission disequilibrium test (TDT) and haplotype relative risk (HRR) analysis.</p><p><b>RESULTS</b>The repeat numbers at the DAT1 40 bp locus were 11, 10, 9, 7.5 and 7 among the patients and their parents, with the most common type being a 10-repeat allele. No significant association was detected between the polymorphism and TS (TDT: X ² = 0.472, df = 1, P = 0.583; HRR: X ² = 0.313, P = 0.576, OR = 0.855, 95%CI: 0.493-1.481).</p><p><b>CONCLUSION</b>Our data suggested that the VNTR polymorphism of DAT1 gene is not associated with susceptibility to TS in Chinese Han population. However, our results are to be validated in larger sets of patients collected from other populations.</p>

Subjective quality of life in children with Tourette syndrome / 中国当代儿科杂志

<p><b>OBJECTIVE</b>This study explored the subjective quality of life in children with Tourette syndrome (TS) in order to provide a basis for more effective interference of TS.</p><p><b>METHODS</b>A total of 174 children with TS (≥ 8 years old) and 186 aged-matched healthy children as controls were enrolled. The subjective quality of life was investigated by a case-control study.</p><p><b>RESULTS</b>The total score of subjective quality of life in the TS group (156.6 ± 21.1) was lower than that in the control group (164.2 ± 21.2; P<0.01). The scores of family life, school life, cognitive component, anxiety experience and depression experience (19.1 ± 3.5 vs 20.7 ± 3.0, 24.1 ± 4.4 vs 26.6 ± 3.2, 90.6 ± 13.3 vs 97.9 ± 15.3, 24.0 ± 4.6 vs 25.1 ± 3.1 and 23.8 ± 4.4 vs 24.7 ± 3.5) in the TS group were lower than those in the control group (P<0.05). The correlation analysis showed that the total score of subjective quality of life in children with TS was negatively related to the age, the course of disease, the severity of symptoms, the total score of child behavior problem and family conflict (r=-0.432, -0.213, -0.869, -0.137, -0.257; P<0.01), while it was positively related to family active-cultural orientation (r=0.084, P<0.01). The multiple step regression analysis indicated that the factors influencing the subjective quality of life in children with TS included the severity of symptoms, age, family conflict and family active-cultural orientation (β'=-0.787, -0.171, -0.109, 0.106; P<0.01).</p><p><b>CONCLUSIONS</b>The subjective quality of life is not well in children with TS. It is important to control clinical symptoms and improve family environment for the improvement of the subjective quality of life in children with TS.</p>

Prospective, naturalistic study of open-label OROS methylphenidate treatment in Chinese school-aged children with attention-deficit/hyperactivity disorder / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Attention deficit hyperactivity disorder (ADHD) is one of the most common mental disorders during childhood, characterized by the core symptoms of hyperactivity, impulsivity and inattention and puts great burden on children themselves, their families and the society. Osmotic release oral system methylphenidate (OROS-MPH) is a once-daily controlled-release formulation developed to overcome some of the limitations associated with immediate-release methylphenidate (IR-MPH). It has been marketed in China since 2005 but still lacks data from large-sample clinical trials on efficacy and safety profiles. The aim of this study was to evaluate the effectiveness and safety of OROS-MPH in children aged 6 to 16 years with ADHD under naturalistic clinical setting.</p><p><b>METHODS</b>This 6-week, multi-center, prospective, open-label study enrolled 1447 ADHD children to once-daily OROS-MPH (18 mg, 36 mg or 54 mg) treatment. The effectiveness measures were parent-rated Inattention and Overactivity With Aggression (IOWA) Conners I/O and O/D subscales, physician-rated CGI-I and parent-rated global efficacy assessment scale. Blood pressure, pulse rate measurement, adverse events (AEs) and concomitant medications and treatment review were conducted by the investigator and were served as safety measures.</p><p><b>RESULTS</b>A total of 1447 children with ADHD (mean age (9.52 ± 2.36) years) were enrolled in this trial. Totally 96.8% children received an OROS-MPH modal dose of 18 mg, 3.1% with 36 mg and 0.1% with 54 mg at the endpoint of study. The parent IOWA Conners I/O score at the end of week 2 showed statistically significant (P < 0.001) improvement with OROS-MPH (mean: 6.95 ± 2.71) versus the score at baseline (10.45 ± 2.72). The change in the parent IOWA Conners O/D subscale, CGI-I and parent-rated global efficacy assessment scale also supported the superior efficacy for OROS-MPH treatment. Fewer than half of 1447 patients (511(35.3%)) reported AEs, and the majority of the events reported were mild (68.2%). No serious adverse events were reported during the study.</p><p><b>CONCLUSION</b>This open-label, naturalistic study provides further evidence of effectiveness and safety of OROS-MPH in school-aged children under routine practice.</p>

Childhood sexual abuses among 1307 adult students and analysis on results of Symptom Checklist-90 test / 中华儿科杂志

<p><b>OBJECTIVE</b>To survey the occurrence of childhood sexual abuses (CSA) among adult students and analyze the correlation between the sexual abuses and the results of Symptom Check-List-90 (SCL-90) test.</p><p><b>METHODS</b>Questionnaire survey of 1307 adult students (701 female students, 606 male students) in a college about their personal experience on childhood sexual abuses. The surveys were conducted anonymously. And SCL-90 test was carried out at the same time.</p><p><b>RESULTS</b>A total of 1307 students were surveyed. 18.67% of them (female students, 155, 22.11%; male students, 89, 14.69%) experienced non-physical contact sexual abuses and/or physical contact sexual abuses before the age of 18 years, among whom 124 students (female students, 81, 11.55%; male students, 44, 7.26%) experienced physical contact sexual abuses, including 35 (26 female; 9 male) who suffered attempted genital or anal sexual intercourse and 11 (8 female and 3 male) were forced for genital or anal sexual intercourse; 13.70% (female 15.66%; male 11.44%) said they experienced sexual abuses before the age of 16 years. Of the boys, experienced sexual abuse 54.7% from age 12 to age 16 years. And among the girls sexual abuses tended to increase with their growth (results of tendency test: chi(2) = 33.5, P < 0.001). The abusers were mostly males; only a small percentage of them used violence; for most female students who experienced non-physical contact sexual abuses, the abusers were strangers (78.7%), while 71.3% of physical contact abuses were from acquaintances, 12.5% of them were teachers, 17.5% were neighbors and 21.3% were relatives. Of the male victims, 89.9% said they knew the abusers before the abuses happened, 14.6% (13 out of 89) of them were teachers, and neighbors constituted another 21.3% (19 out of 89). Students who experienced childhood sexual abuses got higher scores than the students who didn't have such experience in the nine basic symptom factors of SCL-90 and higher than normal model of national young group notably.</p><p><b>CONCLUSION</b>Childhood sexual abuse among students is not rare. The female students' incidence was obviously higher than that among the male students (chi(2) = 11.8, P = 0.001). About half of the abusers were the victims' close relatives, neighbors and teachers who live or study together with them. Personal experience of childhood sexual abuses may be one of the important factors influencing the victims' results of SCL-90 test.</p>

Association of breastfeeding with behavioral problems and temperament development in children aged 4-5 years / 中国当代儿科杂志

<p><b>OBJECTIVE</b>Childhood behavioral problems can predict future psychiatric disorders. Temperament development is important for a healthy personality in adulthood. This study investigated whether breastfeeding is associated with the occurrence of behavioral problems and the temperament development in preschool children.</p><p><b>METHODS</b>A total of 737 children (399 boys and 338 girls) aged 4-5 years in Zibo City were recruited by stratified random cluster sampling. They were born at term with a birth weight of >/= 2.5 kg. The feeding patterns and the breastfeeding duration in infancy were collected. Behavioral and temperament developments were investigated by the Achenbach Child Behavior Checklist (CBCL), temperament questionnaire for 3-7-year-old children and a self-designed inventory questionnaire. The association of feeding patterns and the breastfeeding duration with behavioral problem occurrence and the temperament development in children were analyzed by a multivariate non-conditional logistic regression analysis and a multivariate stepwise regression analysis.</p><p><b>RESULTS</b>After controlling for confounding variables, such as family income and parental education levels, it was found that a breastfeeding duration of >/= 9 months was a protective factor against behavioral problem occurrence in boys (OR=0.184). In girls, a breastfeeding duration of >/= 9 months was also a protective factor against behavioral problem occurrence (OR=0.165), while a mixed feeding with more breast milk and less formula milk was a risk factor (OR=2.203). The factors influencing temperament development consisted of exclusive formula feeding and the duration of breastfeeding (lasting for 4-6 months or 7-9 months) as well as a mixed feeding (with more formula milk and less breast milk, more breast milk and less formula milk, or equal amount of both).</p><p><b>CONCLUSIONS</b>The fewer amounts and the shorter duration of breastfeeding are risk factors for behavioral problems occurrence in children aged 4-5 years. Children's temperament development is correlated with the feeding patterns and the breastfeeding duration.</p>

Study on the risk factors and characteristics on childhood sexual abuses among female students in a college / 中华流行病学杂志

<p><b>OBJECTIVE</b>To study the risk factors and abusers' characteristics on childhood sexual abuses among female students to provide reference data for preventive measures on child sexual abuse.</p><p><b>METHODS</b>Annonymous questionnaire survey of 701 adult female students in a college about their personal experience on childhood sexual abuses, their home conditions and abusers' characteristics.</p><p><b>RESULTS</b>A total number of 701 female students were surveyed. 115 (22.11%) experienced non-physical contact sexual abuses before the age of 18, including 26 (3.71%) who suffered from attempted and 8 (1.14%) were forced with genital or anal sexual intercourse. 117 (16.69%) said they had suffered from sexual abuse before the age of 16. Most abusers were males (99.4%) and only a small percentage of them (3.2%) used violence. Most non-physical contact sexual abuses were from strangers (78.7%), while 71.3% of physical contact abuses were from acquaintances including 12.5% of them were teachers, 17.5% were neighbors and 21.3% were relatives. The risk factors of child sexual abuses were: frequent use of violence, bad hobbies and poor health conditions of parents, tight family relationships, and living in remarried families. Having well-educated fathers was a preventive factor.</p><p><b>CONCLUSION</b>Studies on childhood sexual abuses among females revealed that the incidents were not rare, and family environment played an important role.</p>

Association between Infant Breastfeeding and Cognition and Behavior Development in School Age Children / 实用儿科临床杂志

Objective To explore the association between infant breastfeeding and cognition and behavior development in school age children.Methods Five hundred and eighty-one children aged 7-11 years old from two schools in Ningyang of Tai′an.Their cognition and beha-vior development during school age were assessed by Ravin's standard progressive matrices and child behavior check list(CBCL).Their feeding conditions during infant period,family environment,education level of parents,et al,were investigated with self-made inventory questionnaire.Association between infant breastfeeding types,duration of breastfeeding and cognition,behavior development were analyzed.Results The single factor analysis showed the scores of perceptual distinction,similarity,and Abstract thought in children who were only breast fed before 4 months were higher than those of controls for male children(Pa