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25 September 2005, Volume 20 Issue 09 Previous Issue    Next Issue
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Clinical features of the subtypes of attention deficit hyperactivity disorder in 748 Chinese children. Qian Qiujin,Yang Li,Wang Yufeng. 2005, 20(09): 530-533 .  Abstract ( )   To explore the features of three clinical subtypes of attention deficit hyperactivity disorder (ADHD) in Chinese outpatient children. MethodsUsing DSM-Ⅳ Structured Clinical Diagnostic Interview Scale(CDIS),the 748 ADHD children were clascified into three subtypes,and identified 398 ADHD-I，307 ADHD-C,and 43 ADHD-HI.We compared the comorbidities in CDIS,the behavioral problems in Rutter and Conners Child Behavior Questionnaire completed by the parents among ADHD three subtypes. ResultsFor ADHD-C subtype,the frequencies of comorbidity with disruptive behavior disorder (oppositional defiant disorder and conduct disorder) and bipolar disorder,and the frequency of A-type behavior in Rutter's scale,were higher than those in the ADHD-I and ADHD-HI subtypes (P<0.01).For ADHD-I subtype,the frequencies of comorbidity with learning disability and M-type behavior in Rutter's scale,were significantly higher than those in the ADHD-C and ADHD-HI subtypes (P<0.001).The frequencies of conduct problems,implusive-hyperactive,and hyperactivity index in ADHD-C and ADHD-HI were greater than that in ADHD-I subtype(P≤0.001). ConclusionThere is a higher prevalence of comorbid disruptive behavior disorders in the ADHD-C subtype,but there is a higher prevalence of comorbid learning disability in the ADHD-I subtype.

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Comparison of treatment for young children with sleep-onset associated disorder. Jiang Fan，Jin Xingming,Jiang Yuelian 2005, 20(09): 534-536 .  Abstract ( )   To assess the efficacy of behavioral management,diphenhydramine and phenobarbital for sleep-onset associated disorder in young children and to find out the high risks of sleep-onset associated disorder in young children. MethodsParticipants were 85 children aged 6 to 27 months who were randomly distributed into three treatment groups:behavioral management,diphenhydramine and phenobarbital,and their parents were asked to complete the questionnaire of their children's sleep habit and the children's sleep log during the therapy course. ResultsAll three treatments showed the same effectiveness in the 3 months' follow-up.Of these treatments,behavioral treatment was more likely to be effective in shortening settle time in the longer term,while phenobarbital had more immediate effect on giving up wrong sleep association.The high risk factors related to children's sleep-onset association were instable caregiver,low education of caregiver,high gestation age,C-section,boy and over-crowded house. ConclusionBehavioral treatment with sleep education may be recommended as the first choice for parents of children with sleep-onset associated disorders.

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Expression of neuroglobin in the resected brain tissues of intractable epileptic patients Deng Yaxian,Gao Baoqin,Zhang Jianguo 2005, 20(09): 537-539 .  Abstract ( )   To observe the expression of NGB in the resected brain tissues of intractable epileptic patients. MethodsThe pathological changes were observed by histological method.The expression of NGB in the surgically resected brain tissues(hippocampus and temporal lobe)in 7 cases with medically intractable epilepsy was observed using immunohistochemistry. ResultsThe pathology of all cases presented significant increase of reactive astrocytes,which was the common pathological characteristic of intractable epilepsy.Immunohistochemistry coupled with computer-assisted image analysis showed that the expression level of NGB protein in hippocampus was lower than that in temporal lobe and decreased in both with the increase of course. ConclusionNGB-immunoreactive positive cells are more abundant in temporal lobe than that in hippocampus,which may be related to the excessive increase of oxygen in focus when seizures.

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Changes of cerebral blood flow and cerebral oxidative metabolism in asphyxia newborn during brain auditory activation. Lai Hong,Chen Saying,Zhang Lan 2005, 20(09): 540-542 .  Abstract ( )   To study the changes of cerebral oxidative metabolism and cerebral blood flow in newborns of asphyxia during brain auditory activation. Methods34 cases of asphyxiated newborn as asphyxia group:mild asphyxia 18 cases,severe asphyxia 16 cases,compared with 40 cases of health newborn as normal group.Using near-infrared spectroscopy (NIRS) to monitor the concentration changes of \[Hb O2\]、\[Hb H\]、\[Hb tot\] and to idendify the changes of cerebral oxidative metabolism and cerebral blood flow.According to the different changes of \[Hb O2\]、\[Hb H\] and \[Hb tot\] during auditory stimulation,the curves were classified into pattern A( \[Hb O2\]、\[Hb H\] and \[Hb tot\] increase),B( \[Hb O2\]、\[Hb tot\] increase,\[Hb H\] decrease)and C( \[Hb O2\]、\[Hb tot\] decrease,\[Hb H\] increase). ResultsAmong asphyxia group,25 cases(25/34,73.5%) showed pattern C.Among normal group,28 cases(28/40,70%) showed pattern A.Comparing the number of cases of A and C between two groups,differences were significant,P<0.05.Comparing the rang of changes in \[Hb O2\] and \[Hb tot\] between two groups,differences were significant too,P<0.05. ConclusionDuring brain auditory activation in asphyxiated newborns,cerebral oxidative metabolism and cerebral blood flow all decrease,especially in the severe asphyxiated newborns.

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Determination of serum and sputum IL-4,IFN-γ levels in children with mycoplasma pneumoniae pneumonia. Wang Jun,Han Xiaohua,Yang Baisong 2005, 20(09): 543-545 .  Abstract ( )   To study the contribution of IL-4,IFN-γ in serum and in induced sputum in children with MPP. MethodsThe IL-4 and IFN- γ levels were determined in 38 serum and 24 induced sputum using an ELISA kit in the acute episode and remission period in MPP children. ResultsThe IL-4 levels in the serum and induced sputum were significantly higher in the acute episode period in MPP compared with children in remission period and the controls(P<0.01).The IL-4/IFN-γ ratios in the acute episode period were higher than that in remission period and the controls(P<0.05).The IL-4 levels in the serum and induced sputum were significantly higher in severe patients than mild patients with MPP ( P<0.01).The serum and induced sputum IL-4/IFN-γ ratios in severe patients were higher than that of mild patients(P<0.05).The serum was in accordance with sputum in two kinds of specimens examination result.The cytokines density in sputum were higher than that of serum,both positively related. ConclusionThe data of serum and sputum cytokine suggest that the imbalance of TH1/TH2 exists in the MPP children.It seems to represent a predominant TH2-like cytokine response in MPP.The IL-4 and IFN-γ may play a significant role in the immunopathologic responses in MPP.

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Outcome of adrenocorticorticotropia hormone therapy for infantile spasms. Chen Guoli,Zhang Yuehua,Qin Jiong 2005, 20(09): 546-549 .  Abstract ( )   Follow up the IS patients treated with ACTH in order to analyze the long-term outcome and its influenced factors. Methods1.The medical records of 53 patients with IS were analyzed with retrospective studies.2.53 patients with IS,who were treated with ACTH,the dosage ranging from 25IU to 40IU daily for 4 weeks,were analyzed. ResultsFactors influencing seizure outcome were treatment lag and the initial effects of ACTH on seizure.The patients with shorter treatment lag (≤2 months) were better than those with longer treatment lag (>2 months);the patients with the better initial effects of ACTH on seizure were better than those with the worse initial effects of ACTH on seizure.Seizure outcome had not correlates with the age of onset and etiologies.Patients with shorter treatment lag (≤2 months) showed a better mental outcome than those with longer treatment lag (>2 months).Cryptogenic group showed a better mental outcome than symptomatic group.Mental outcome in seizure-free patients were better than that in those having seizures.Mental outcome had not correlated with the age of onset and the initial effects of ACTH on seizures. Conclusion1.The patients with shorter treatment lag and with the better initial effects of ACTH on seizures showed a better seizure outcome.2.Mental outcome correlated with treatment lag,etiology and seizure outcome(patients with shorter treatment lag,cryptogenic and seizure-free showed a better mental outcome).

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Clinical expression and EEG features of 44 cases of juvenile myoclonic epilepsy. Qiu Pengling,Yao Peili,Sun Daokai. 2005, 20(09): 550-552 .  Abstract ( )   To summarize our experience in the clinical expression and EEG features of patients with juvenile myoclonic epilepsy (JME) in chidren. MethodsForty-four patients had been involved.Clinical data such as seizure type,cause of misdiagnosis,antiepileptic drugs,and EEG and sleep EEG had been analyzed. Results100%of 44 cases showed myoclonic jerks;16 cases(36.4%) also had typical absences;33 cases(75%) also had generalized tonic-clonic seizures;11 cases (25%) had all three seizure types;6 cases (13.6%) only had myoclonic seizures.13 cases had been diagnosed at the first time.31 cases were misdiagnosised.The positive rate for EEG was 50%，and for sleep EEG was 95.5%.39 cases were seizure free.7 cases (15.9%) occurred myoclonic epileptic status. ConclusionJME is a very common form of epilepsy.Physicians should be aware of its characteristics.With the help of sleep EEG，physicians can get correct diagnosis，and choose the reasonable antiepileptic drugs for better control.

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Effects of topamax on certain endocrine-hormones in children with epilepsy. Wang Ruming,Liu Huawei,Wen Zhaochun 2005, 20(09): 553-555 .  Abstract ( )   To study the effects of Topamax on certain endocrine hormones in children with epilepsy. MethodsThe concentrations of certain blood endocrine-hormones were determined and compared in 36 children with epilepsy at the be ginning,the end of the third and the end of the sixth therapeutic month. ResultsTriidiothyronine(T3) levels were significantly higher at the end of the third month than the beginning (P<0.05),but were not increased obviously at the end of the sixth therapeutic month.Insulin(INS),corticol(F),and C-peptide(C-P) concentrations were significantly lower at the end of the third and the end of the sixth therapeutic month than the beginning(P<0.05),whereas they remained unaltered between the end of the third and the end of the sixth therapeutic month.Thyroxine(T4),thyroid stimulating hormone(TSH) and growth hormone(GH) concentrations were not significantly changed during the course of the therapy.Body mass index(BMI) was significantly reduced at the end of the third therapeutic month,while it returned a little at the end of the sixth therapeutic month. ConclusionTopamax has no significant effect on growth hormone,so it doesn't afect children's growth and development.

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Biological characteristics of human airway smooth muscle cells in vitro cultured and passively sensitized. Shao Jie,Wang Yuzhen,Li Yunzhu 2005, 20(09): 556-558 .  Abstract ( )   To explore the biological characteristics of passively sensitized airway smooth muscle(ASM) cells in hyperplasia,protein and DNA synthesis abilities. MethodsASM cells derived from human bronchus were in vitro cultured and passive sensitized with atopic serum,which was collected from asthmatic individuals with serum total IgE>106IU/L,specific IgE≥III.Cell counting by cell growth curve,protein synthesis by Bio-rad DC protein assay and 3 H-TdR incorporation assays were performed. ResultsPassively sensitized with atopic serum,ASM cells were more active in proliferation,protein synthesis and DNA synthesis compared with non-atopic serum sensitized ASM.In details,cellular proliferation was counted after culture of 72h，96h and 120h,which were (5.21±0.87)×104/well，(6.43±0.57)×104/well and (7.25±0.65)×104/well respectively in passively sensitized airway smooth muscle cells and (3.78±0.50)×104/well,(4.80±0.49)×104/well,(5.55±0.77)×104/well in non-passively sensitized airway smooth muscle cells,showing significant difference(P<0.01).Meanwhile,passively sensitized ASM cells synthesis produced more proteins than non-sensitized ASM (3.81±0.52mg/L vs 1.90 ±0.35mg/L,P<0.01),incorporation of 3H-TdR also had significant difference between two groups (196.4±45.2cpm/well vs 127.2±33.3cpm/well,P<0.01). ConclusionAtopic serum has synergetic effects on promoting ASM cells proliferation and protein synthesis.Hyperproliferation of ASM cells increase the ASM mass,which is an important change in later asthma airway remodeling.