Effect of methylphenidate hydrochloride combined with mentalization-based family therapy on clinical efficacy and social function in children with attention deficit hyperactivity disorder / 中华行为医学与脑科学杂志

Objective:To observe the effect of methylphenidate hydrochloride (MPH) combined with mentalization-based family therapy (MBFT) on clinical efficacy and social function in children with attention deficit hyperactivity disorder (ADHD).Methods:Sixty-four children with ADHD diagnosed in Wuxi Children's Hospital and Affiliated Hospital of Jiangnan University from June 2019 to May 2021 were selected and divided into observation group ( n=32) and control group ( n=32) according to the random number table.Children in both groups received methylphenidate hydrochloride extended-release tablets, while those in the observation group were given additional MBFT.The duration of treatment was 12 weeks in both groups.The parent symptom questionnaire (PSQ), swanson nolan and pelham-version Ⅳ (SNAP-Ⅳ) parent Al scale, and Weiss impairment functional scale (WFIRS-P) were used to evaluate the effectiveness of treatment.Statistical analysis was performed by SPSS 25.0 statistical software.In particular, the χ2 test was used for counting data and the paired sample t test was used for comparison of measurement data between the two groups before and after treatment. Results:(1) All the PSQ dimension scores of patients in the observation group and the control group after treatment were significantly lower than those before treatment (all P<0.01). Compared with the control group after treatment, the PSQ dimension scores of personality and behavior problems ((1.25±0.15), (0.94±0.18), t=7.484, P<0.001), learning problems ((1.57±0.16), (1.32±0.20), t=5.522, P<0.001), psychosomatic disorders ((0.56±0.11), (0.44±0.13), t=3.986, P<0.001), impulse hyperactivity ((1.76±0.23), (1.54±0.25), t=3.663, P<0.001), anxiety ((0.94±0.12), (0.76±0.11), t=6.255, P<0.001) and hyperactivity index ((1.74±0.19), (1.51±0.16), t=5.238, P<0.001) decreased significantly in the observation group after treatment.(2) Compared with the pre-treatment period, the SNAP-Ⅳ scale scores of attention deficit, impulsivity-hyperactivity and oppositional defiance were significantly lower in both groups after treatment (all P<0.01); and compared with the control group, the SNAP-Ⅳ scale scores of the above three dimensions were significantly lower in the observation group (all P<0.01). (3) All six dimensions (family, learning and school, life skills, self-management, social activities, and risk-taking activities)of the WFIRS-P scale were significantly lower in the children in the observation group after treatment compared with those before treatment (all P<0.01), and all the six dimensions of the WFIRS-P scale were significantly lower in the observation group compared with those in the control group (all P<0.01). Conclusion:Methylphenidate hydrochloride extended-release tablets combined with MBFT can significantly improve the clinical symptoms and social function of children with ADHD.

Clinical efficacy of atomoxetine combined with cognitive behavior therapy on children with attention deficit hyperactivity disorder / 中华行为医学与脑科学杂志

Objective:To investigate the clinical efficacy of atomoxetine combined with cognitive-behavioral therapy (CBT) on children with attention deficit hyperactivity disorder (ADHD).Methods:Totally 104 children diagnosed with ADHD were randomly divided into atomoxetine group ( n=34), CBT group ( n=35) and atomoxetine combined with CBT group ( n=35). After 12 weeks of treatment, questionnaire-children with difficulties (QCD), Swanson child behavior checklist (SNAP-Ⅳ) and Conners parents rating scales (CPRS) were used to evaluate the efficacy and recorded the adverse reactions during the treatment. SPSS 23.0 software was used for statistical analysis. Paired sample t-test was used to compare the scores of the same group before and after treatment, and one-way ANOVA was used to compare the difference between the three groups after treatment. Results:(1)Compared with baseline, the score of QCD increased(32.96±3.01, 43.00±2.22) ( t=-13.35, P<0.01) , while the attention deficit(15.67±3.46, 6.07±1.73), hyperactivity/impulse(13.59±3.41, 7.30±2.43), opposition disobedience(9.85±3.98, 2.59±2.17) and total score(39.11±6.65, 16.59±3.91) of SNAP-Ⅳ decreased in atomoxetine combined with CBT group after treatment ( t=14.96, 10.87, 11.77, 21.49, all P<0.01). The factor scores of behavior problems(0.81±0.30, 0.70±0.26), learning problems(1.58±0.31, 0.32±0.13), psychosomatic disorders(0.22±0.25, 0.16±0.20), impulse hyperactivity(1.27±0.37, 0.71±0.18), anxiety(0.32±0.26, 0.23±0.17) and hyperactivity index(1.19±0.40, 0.79±0.22) of CPRS also decreased ( t=2.71, 21.23, 2.41, 8.87, 2.96, 6.19, all P<0.05) in atomoxetine combined with CBT group after treatment. (2) After treatment, the changes of QCD scores, attention deficit dimension in SNAP-Ⅳ scale, learning problems and impulse hyperactivity dimension in CPRS scale of the three groups before and after treatment were statistically significant (all P<0.05). (3) Post LSD comparison showed that the change in CBT group was significantly lower than that in atomoxetine group and atomoxetine combined CBT group in QCD score(both P<0.05). In the dimension of attention deficit of SNAP-Ⅳ, the difference in CBT group was significantly lower than that in atomoxetine combined CBT group ( P<0.01). In the learning problems and impulse hyperactivity dimensions of CPRS, the changes of atomoxetine combined with CBT group were significantly higher than those of atomoxetine group and CBT group (all P<0.01). Conclusion:Atomoxetine combined with CBT has better curative effect than atomoxetine or CBT alone in patients with ADHD. It can effectively improve the core symptoms and daily life function of ADHD children, and has high safety.

A single arm clinical study of 86 patients with common type of coronavirus disease 2019 treated by integrated traditional Chinese and Western medicine: multicenter case observation from 7 designated hospitals in Henan Province / 中华危重病急救医学

Objective:To evaluate the clinical effect of integrated traditional Chinese and Western medicine on common type of coronavirus disease 2019 (COVID -19) in Henan Province. Methods:A prospective single arm clinical study was performed. Patients with common type of COVID -19 admitted to seven designated hospitals for COVID -19 in Henan Province from January 25th to February 26th, 2020 were enrolled, and treated with integrated traditional Chinese and Western medicine. The negative transformation of 2019 novel coronavirus (2019 -nCoV) nucleic acid, disease outcome, hospital stay, clinical symptoms and signs scores, and chest imaging performance were observed. Results:Totally 86 cases were included in the analysis, including 48 males (55.8%), aged 43.5 (35.0, 53.3) years old, 24 patients (27.9%) with previous medical history. Fifty-eight patients were primarily diagnosed COVID -19 and 28 patients were transferred. The 2019 -nCoV nucleic acid of 86 cases (100%) turned negative, and the median time of turning negative was 10 (7, 14) days. Eighty-six cases (100%) were discharged from hospital, and none turned into the severe type; the average length of hospital stay was (13.8±5.6) days. The scores of fever, cough, chest tightness, shortness of breath, and fatigue decreased with the treatment time, and the scores of 7 days and 14 days after treatment were significantly lower than those before treatment [fever (points): 0 (0, 0), 0 (0, 0) vs. 1 (0, 1); cough (points): 1 (0, 1), 0 (0, 1) vs. 1 (0, 2); chest tightness (points): 0 (0, 0), 0 (0, 0) vs. 0 (0, 1); shortness of breath (points): 0 (0, 0), 0 (0, 0) vs. 0 (0, 1); fatigue (points): 0 (0, 1), 0 (0, 1) vs. 1 (0, 1); all P < 0.05]. The improvement rate of X ray and CT image was 42.9% (12/28) and 81.0% (64/79), respectively. Conclusions:The treatment with integrated traditional Chinese and Western medicine has good curative effect on common type of COVID -19 in 7 designated hospitals of Henan Province. It can improve the clinical symptoms, promote the absorption of pulmonary inflammation, and to some extent control the progress of disease and shorten the time of turning negative of virus nucleic acid and hospital stay.

Behavioral problems,self-awareness and family factors in children with simple obese / 中华行为医学与脑科学杂志

Objective To investigate the the association between psychological behavior and self-awareness of obese children and family factors,in order to provide scientific basis for clinical intervention in obese children. Methods Fifty children with obesity ( obesity group) and fifty healthy children ( control group) were included in the study. All children were evaluated with the Achenbach Child Behavior Checklist (CBCL),Piers-Harris Child's self-concept Scale ( PHCSS), Family Environment Scale-Chinese Version ( FES-CV) and Egma Minnen av Bardndosnauppforstran(EMBU). Moreover,correlation analysis was applied in the study to explore family factors affecting behavioral problems and self-awareness of obese children. Re-sults Compared with control group,significant higher ratio of abnormal behaviors was found in children with obesity (P<0. 05). FES-CV showed that the degree of expressiveness((3. 16±1. 93),(4. 65±1. 02)),intel-lectual-cultural orientation((5. 31±1. 28),(6. 10±1. 83)) and active-recreational((2. 78±1. 36),(4. 84± 1. 72)) were lower than control group,and the degree of family conflict((4. 11±1. 45),(3. 32±1. 27)) and control((6. 42±1. 37),(5. 09±1. 65)) were higher in children with obesity (P<0. 05). Moreover,EMBU showed that emotional warmth score was significantly lower in obese group than that in control group (P<0. 01),and the scores of parent's rejection,father's severity,parent's over-interference,and mother's over-protection were significantly higher than the scores in control group(P<0. 05). In obese group,the correlation analyses showed a negative association between social withdrawal in children's behavioral problems and fami-ly expressiveness (r=-0. 62,P<0. 01),and a positive association between aggressivity and family conflict (r=0. 39,P<0. 05). There was a positive correlation between internalizing behavioral problems and mother's over-protection and over-interference(r=0. 60,P<0. 01). Low self-awareness was positive associated with parent's rejection and father's severity(r=0. 46,0. 51,0. 44 respectively,P<0. 05). Conclusion A signifi-cant higher risk of abnormal psychological behaviors and low self-concept can be found in children with obe-sity,which can closely related to family factors.

Genetic polymorphism for 124 Individual Identiifcation SNPs from Chinese Han using Ion PGM? platform / 中国法医学杂志

ObjectiveTo investigate the polymorphisms of 124 individual identiifcation SNPs in Chinese Han using the Ion Personal Genome Machine?(PGMTM).Method Samples from 130 unrelated Chinese Han individuals and two families (8 genealogical individuals) were ampliifed using Ion AmpliseqTM Library kit and sequenced on Ion Torrent PGM? platform.Results 14 148 SNPs were detected.A total of 99.992 9% SNPs were correctly called by the HID SNP Genotyper v4.3 plugin, while 0.007 1% wrongly reported and 62 NN calls needed manual correction. The MP ranged from 0.348 0 (rs2831700) to 0.817 3 (rs740910) with the value of 6.898 4 × 10-34 for CMP. The DP ranged from 0.182 7 (rs740910) to 0.652 0 (rs1355366) with the value of 0.999 999 999 999 999 999 999 999 999 999 999 310 2 for CDP, which was larger than that of 22 STR loci. The PE ranged from 0.007 3 (rs1024116) to 0.278 1 (rs1058083) with the value of 0.999 999 616 7 for CPE, which was smaller than that of 22 STR loci. A total of 8 Y-SNP haplo-types were observed from 72 unrelated male samples. No mutation was observed from pedigrees.Conclusion The 124 IISNPs were high polymorphic in Chinese Han and they were ideal markers for human identiifcation. The PGMTM platform has a potential role in forensic science.

Development of autosomal SNP fluorescent-multiplex by the method of fragment length discrepant allele specific PCR / 中国法医学杂志

Objective To develop autosomal SNP fluorescent-multiplex PCR system,and investigate the allele frequencies of these 13 SNP loci in Southern Liaoning Han population.Methods After selected 13 autosomal SNP loci,SNP fluorescent-multiplex system was developed based on the principle of fragment length discrepant allele specific PCR,and the allele frequencies of these SNP loci in Southern Liaoning Han population were investigated using the established system.Results For the same SNP locus,the homozygote showed a single product peak,and the heterozygote showed two product peaks with different length.For the different SNP loci,the lengths of their PCR products were different.Therefore,we could genotype the 13 SNP loci simultaneously according to the length of products and the amount of product peaks,and the results were in accordance with that of direct sequencing.In the meanwhile,the allelic frequencies of these 13 SNP loci in Southern Liaoning Han population were obtained.Conclusion The SNP fluorescent-multiplex system based on the fragment length discrepant allele specific PCR strategy is simple and economical,and is of a high application value in forensic medicine.