[Effect of combination of acupuncture and psychological intervention on attention, response inhibition and cerebral blood flow in children with attention deficit hyperactivity disorder].

OBJECTIVE: To observe the clinical curative effect on attention deficit hyperactivity disorder (ADHD) and explore the relevant mechanism of acupuncture in treatment. METHODS: A total of 100 ADHD children were randomized into an observation group (50 cases, 2 cases dropped off) and a control group (50 cases, 1 case dropped off). In the control group, the routine psychological intervention was used. In the observation group, on the base of the treatment as the control group, acupuncture was applied to Taichong (LR 3), Neiguan (PC 6), Shenmen (HT 7), Sanyinjiao (SP 6), Baihui (GV 20), Sishencong (EX-HN 1), etc., once daily, for 3 months. The Cambridge neuropsychological tests automated battery (CANTAB) was adopted to evaluate attention and response inhibition in two groups before and after treatment. Digi-Lite color transcranial Doppler was used to measure cerebral arterial blood velocity. The therapeutic effect was compared between the two groups. RESULTS: Regarding evaluation of attention, the mean delay time in the observation group after treatment was shorter than that before treatment and that in the control group separately (P<0.05), and rapid visual information processing A' statistics (RVP A') value was higher than that before treatment and that in the control group separately (P<0.05). For evaluation of response inhibition, the number of Go signal error, the time of stop signal response and the number of stop Go signal error after treatment were all reduced as compared with those before treatment in the two groups (P<0.05). The number of stop signal error was also reduced after treatment as compared with that before treatment in the observation group (P<0.05). The number of Go signal error and the number of stop signal error in the observation were lower than those in the control group (P<0.05). After treatment, the average flow velocity of bilateral posterior cerebral artery (PCA) was increased than that before treatment in the two groups (P<0.05). The average flow velocity of the left middle cerebral artery (MCA-L) and bilateral anterior cerebral artery (ACA) after treatment was increased than that before treatment in the observation group (P<0.05), and the average flow velocity of left PCA, MCA-L and bilateral ACA in the observation group was faster than that in the control group (P<0.05). The total effective rate was 90.5% (19/21) in the observation group, remarkably higher than 50.0% (11/22) in the control group in children with attention deficit (P<0.05). The total effective rate was 83.3% (40/48) in the observation group, also higher than 63.3% (31/49) in the control group (P<0.05). CONCLUSION: Acupuncture combined with psychological intervention may improve attention and response inhibition in ADHD children, which is possibly related to the regulation of cerebral blood flow.

[Effect of maternal immune level at different pregnancy stages on cow's milk protein allergy in infants].

OBJECTIVE: To study the association between maternal Th1/Th2 immune level at different pregnancy stages and cow's milk protein allergy (CMPA) in infants. METHODS: The healthy women with a singleton pregnancy, as well as their offspring, who attended Yidu Central Hospital of Weifang and Qingzhou Traditional Chinese Medicine Hospital from July 2016 to December 2018 were enrolled. The maternal levels of interleukin-2 (IL-2), interferon gamma (IFN-γ), interleukin-4 (IL-4), and interleukin-10 (IL-10) at the second and third trimesters of pregnancy were measured. A CMPA questionnaire survey was conducted within one year after birth. Food avoidance and cow's milk oral challenge tests were performed in infants suspected of CMPA. The 48 infants who met the diagnostic criteria for CMPA were included in the observation group, and the remaining 977 normal infants were included in the control group. A univariate analysis was performed on the infants with CMPA. A Poisson regression analysis was used to determine the association between maternal Th1/Th2 immune factors at different pregnancy stages and CMPA. RESULTS: The detection rate of CMPA was 4.68%. The clinical manifestations included the symptoms of the digestive system, skin, and respiratory system and other symptoms. The univariate analysis showed that compared with the control group, the observation group had significantly higher incidence rates of maternal food allergy and maternal history of allergic diseases (P<0.05) and a significantly lower breastfeeding rate (P<0.05). The observation group had significantly lower maternal levels of IL-2 (second and third trimesters) and IFN-γ (third trimester) than the control group (P<0.05). Maternal low IFN-γ at the third trimester and maternal low IL-2 at the second and third trimesters were significantly associated with CMPA in infants (P<0.05). After correction of the factors of breastfeeding, maternal food allergy, and maternal history of allergic diseases, it was found that maternal low IL-2 and IFN-γ at the third trimester were still significantly associated with CMPA in infants (P<0.05). CONCLUSIONS: The maternal decrease in Th1 level at the third trimester of pregnancy may lead to the change in fetal immunity and thus increase the risk of CMPA in offspring.

[Change in the expression of the NLRP3 inflammasome signaling pathway in peripheral blood and its significance in children with Mycoplasma pneumoniae pneumonia].

OBJECTIVE: To investigate the expression of the NLRP3 inflammasome signaling pathway in peripheral blood and its significance in children with Mycoplasma pneumoniae pneumonia (MPP). METHODS: According to the severity, 147 children with MPP were divided into mild group with 83 children and severe group with 64 children. According to the stage of disease, the children were divided into acute group with 77 children and recovery stage with 70 children. A total of 50 healthy children were enrolled as the control group. Quantitative real-time PCR was used to measure the mRNA expression of NLRP3, ASC, and caspase-1. ELISA was used to measure the serum levels of interleukin-1ß (IL-1ß) and interleukin-18 (IL-18). RESULTS: Compared with the control group, the children with MMP had significantly higher relative mRNA expression levels of NLRP3, ASC, and caspase-1 in peripheral blood and serum levels of IL-1ß and IL-18 (P<0.05). Compared with the control group, both mild and severe groups had significantly higher relative mRNA expression levels of NLRP3, ASC, and caspase-1 in peripheral blood and serum levels of IL-1ß and IL-18 (P<0.05). The severe group had significantly higher levels of above mentioned parameters than the mild group (P<0.05). Both acute group and recovery group had significantly higher relative mRNA expression levels of NLRP3, ASC, and caspase-1 in peripheral blood and serum levels of IL-1ß and IL-18 than the control group (P<0.05). The acute group had significantly higher levels of above mentioned parameters than the recovery group (P<0.05). The relative expression level of NLRP3 was positively correlated with the relative mRNA expression levels of ASC and caspase-1 and the serum levels of IL-1ß and IL-18 (r=0.701, 0.717, 0.676, and 0.645 respectively; P<0.05). CONCLUSIONS: The NLRP3 inflammasome signaling pathway might be involved in the pathogenesis of MPP in children and is closely associated with the severity and course of the disease.