For tic disorders(TD),non -drug therapy including psychotherapy,behavioral intervention,neural regulation have demonstrated efficacy in reducing tic severity,managing co -occurring psychiatric symptoms and impro-ving life quality in addition to pharmacotherapy.Psychotherapy such as supportive psychotherapy,family intervention, school intervention can be major contributors to the development of evidence -based non -drug treatments.Different behavioural therapies that were used included positive reinforcement,extinction,massed negative practice,relaxation therapy,habit reversal training(HRT),exposure with response prevention,self -monitoring,contingency management, cognitive -behavioural therapy,assertiveness training,tension -reduction technique.Overall,HRT is the best -studied and most widely -used technique and there is sufficient experimental evidence to suggest that it is an effective treat-ment.Evidence suggests that exposure with response prevention and self -monitoring are effective,but comprehensive behavioral intervention for tics (CBIT)show more effective and durability of benefit over time.CBIT may promote nor-malization of aberrant cortico -striato -thalamo -cortical associative and motor pathways in individuals with tourette′s syndrome.Based on available evidence,recent published guidelines suggest that CBIT can be considered a first -line treatment for persons with TD.Neural regulation included electroencephalogram biofeedback,deep brain stimulation, transcranial magnetic stimulation are increasingly considered when tics become troublesome or even disabling or self -injurious despite optimal medical therapy.

Objective To explore the pathogenesis of autism by observation of changes of brain-derived neurotrophic factor(BDNF) positive neurons and the morphology of pyramidal cells in hippocampal CA1 region,and provide theoretical evidence for the therapeutic schedule.Methods Animal model of autism was obtained by Schneider method.Using the immunohistochemistry methods and image analysis,the number of BDNF positive neurons was examined in hippocampal CA1 region of the autism model rats and the normal rats,and the changes of pyramidal cell were observed in hippocampal CA1 region after HE staining.Results The numbers of BDNF positive neurons in the hippocampal CA1 region of the autism model rats were more than those of the normal rats (5.00 ±1.60 vs 3.00 ± 1.04,t =3.63,P =0.0015).The morphology of pyramidal cells showed that the pyramidal cells of the autism model rats in hippocampal CA1 region had apoptosis.Conclusion The occurrence of autism may be related to the changes of BDNF and the morphology of pyramidal cells in hippocampal CA1 region.

ObjectiveTo investigate the effect of mescenchymal stem cell (MSC) transplantation on Tourette syndrome(TS)model rats.MethodsStereotypies can be successfully induced in rats by intrastriatal microinfusion of TS sera.MSC suspension was bilaterally injected into the striatum.Survival and differentiation of transplanted MSC were tested through immunohistochemical analyses.ResultsFlow cytometry results demonstrated that the cells strongly expressed CD29(95.2％ ),CD105(97.2％ ),CD44(96.3％ ) and CD106 (94.1％).TS rats with MSC grafts exhibited significantly decreased stereotypic behaviors at 10 and 14 days(95.5 ±6.6,73.1 ± 6.5 vs.114.1 ± 6.0,108.0 ± 6.4).Immunohistochemistry analyses revealed survival of transplanted MSC and differentiation into neurons and astrocytes in the rat brain.ConclusionIntrastriatal transplantation of human MSC can provide therapeutic potential for TS.

Objective:To explore the feature of family environment and rearing styles of parents of children with Tourette syndrome(TS) and obsessive compulsive disorder(OCD).Methods:33 TS+OCD children , 40 pure TS children and 40 normal controls (criteria of DSM-IV) were collected.The instruments included Family Environment Scale-Chinese Version(FES-CV) and the Egna Minnen av Barndoms Uppfostran (EMBU) of Chinese Version. Results:Compared with pure TS group and normal controls group, the scores of cohesion and emotion expression of the TS and OCD group were lower (5.7?1.4/7.1?1.4, 7.6?1.2, P

Objective：To compare the epidemiology and clinical characteristics of attention deficit hyperactivity disorder (ADHD) in adolescents (12～16 years) and school-age children (6～11years) to provide reference data for a comprehensive intervention to children ADHD.Methods：A population-based questionnaire study was conducted among subjects aged 6～16 years sampled from schools in Northern Shandong.Totally 4263 children (adolescents 2358,school-age children 1905) were chosen by stratified-clustered-random sampling.The estimation of ADHD was investigated by asking the parents to complete ADHD questionnaires and subjects were followed up.The diagnosis for ADHD was made according to the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV)cliterca,which was divided into three kinds of subtypes in accordance with distribution of symptom dimensions.Results：The total prevalence of ADHD was 6.4% in this sample,which was predominated by the inattentive type (ADHD-I ) (63.7％).The prevalence of ADHD was higher in males than in females (8.9% vs.4.1%,P<0.001),and lower in adolescents than in school-age children (5.3% vs.7.7%,P=0.002).Distribution of subtypes was different in ADHD children of different age.Compared with school-age children group,the hyperactive/impulsive type (ADHD-HI )and combined type (ADHD-C) were lower,and the inattentive type (ADHD-I )was higher in adolescent group (P<0.001).The prevalence of 3 symptomatic factors of inattention and 6 symptomatic factors of hyperactivity/impulsivity in adolescents ADHD was lower than that in school-age children ADHD.Conclusion：Inattention is central symptom for children ADHD.ADHD,symptom of hyperactivity/impulsivity especially in the elder groups have trends of lower prevalence rate.

BACKGROUND: Temperament plays an important role in psychological development of children. Generally speaking, temperament is genetically determined, but it is also influenced by some other factors. The influential factors studies of temperament are important to promote psychological development and reduce behavior problems of children.OBJECTIVE: To explore the correlation between breastfeeding and temperamental characteristics in children aged 4-5 years old.DESIGN: Random cluster sampling.SETTING: Affiliated Hospital of Medical College, Qingdao University, Zibo Central Hospital, and Research Institute of Pediatrics, Medical College of Qingdao University.PARTICIPANTS: 737 children (399 males, 338 females) aged 4-5 years old from 8 kindergartens of 4 districts in Zibo were selected from March to June 2005. All the subjects and their parents were informed about the experimental goal.METHODS: With stratified random cluster sampling, 737 children were investigated by NYLS 3-7 years old children temperament questionnaire and self-made inventory questionnaire. The association of 9 dimensions including adaptability, rhythmicity (regularity), activity level, persistence, quality of mood, approach and withdrawal, intension of reaction, distractibility and threshold of responsiveness with feeding type in the first 4 months after birth and duration of breastfeeding was analyzed; the multiple gradual regressive analysis was carried out with each dimension of temperament as the dependent variable and feeding type in the first 4 months after birth and duration of breastfeeding etc. as the independent variables.MAIN OUTCOME MEASURES: Temperamental dimension, feeding categories in the fist 4 months, and breastfeeding duration.RESULTS: All 737 children were involved in the result analysis. Correlation analysis indicated that temperamental adaptability was positively related with formula milk mainly in the first 4 months after birth (r =0.084, P =0.030);Rhythmicity and distractibility were negatively related with formula milk only (r =-0.087, -0.075, P =0.022, 0.047);Activity level were positively related with breast milk only and negatively with both breast milk and formula milk equally (r =0.084, -0.077, P =0.030, 0.045); Approach and withdrawal was negatively related with breast milk mainly (r =-0.097, P =0.012). Rhythmicity, quality of mood and activity level were negatively related with breastfeeding for 4-6 months (r =-0.082, -0.102, -0.153, P =0.036, 0.009, 0.001); Quality of mood and activity level were positively related with the duration of breastfeeding more than 9 months (r =0.089, 0.088, P =0.024,0.025). After rectifying the family structure, and educational level of parents, the influencing factor of adaptability was formula mainly; intensity of reaction was breastfeeding duration for 4-6 months and breast milk mainly;rhythmicity was breastfeeding duration for 7-9 months and formula only; activity level was both breast milk and formula milk equally and breastfeeding duration for 7-9 months; quality of mood was formula only and duration of breastfeeding for 7-9 months; approach-withdrawal was breast milk mainly and both breast milk and formula milk equally; distractibility was formula milk mainly.CONCLUSION: Temperamental development of children aged 4-5 years old is related to feeding type in the first 4 months after birth and duration of breastfeeding; therefore, it is essential to pay attention to breastfeeding during temperamental cultivation and intervention.

BACKGROUND:Behavioral problems among preschool children affect the quality of life in childhood, and it may predict psychiatric disorders in adulthood.OBJECTIVE:To investigate the correlation of behavioral problem occurrence with gender and breastfeeding in children aged 4-5 years old.DESIGN: A stratified random cluster sampling investigation.SETTING:Department of Child Health Care,Affiliated Hospital of Medical College of Qingdao University,and Department of Preventive Medicine, Medical College of Qingdao University.PARTICIPANTS:Totally 600 children (301 boys and 299 girls) aged4-5 years old from 10 kindergartens in 4 districts in Qingdao city were chosen by stratified random cluster sampling during May in 2004.They. all used to be full-term infants of natural labor.METHODS:Achenbach Child Behavior Checklist (CBCL) for parents and self-made inventory scale influencing children's behavior were adopted. Behavioral problems were dependent variables whereas feeding category and breastfeeding duration were independent variables. The effects of feeding category in the first 4 months of life and breastfeeding duration on children's behavior were examined by single factor and multiple factors logistic regression (backward selection).MAIN OUTCOME MEASURES:Breastfeeding condition, breastfeeding duration and behavioral development.RESULTS:According to intention-processing analysis, 600 children 14.2% (85/600) among the 600 children investigated. It was 17.94%(54/301) in males and 10.4% (31/299) in females,with a significant indicated that boys who had been fed on "more infant formula than problem occurrence (OR=2.72,4.29). Breastfeeding duration ≥9months was a protective factor for males (OR=0.43) Girls who feeding duration ＜ 1 month had a risk of behavioral problem ocfeeding duration were set as independent variables and with or without behavioral problems was set as dependent variable to perform multiand breastfeeding duration ≥ 9 months were the risk factors and protective factors of behavioral problem occurrence for males (OR=3.76,ioral problem occurrence for females (OR=2.55,7.79,7.79), which were tective factors of behavioral problem occurrence for males (OR=3.48,behavioral problem occurrence for females ( OR=2.49,9.81,12.89).CONCLUSION:Male is a risk factor of behavioral problems;less breastfeeding and shorter breastfeeding duration are the risk factors of behavioral problem occurrence in children aged 4 to 5 years.

Objective To explore the association of dietary behavior of children with Tourette syndrome (TS) and tic symptoms.Methods 207 TS children and their 264 corresponding controls,who visited our hospital during the period of November 2008 to October 2010,were investigated with children' s dietary behavior questionnaire,under the guidance of professional staff,and the TS tic symptom severity was also evaluated according to The Yale Global Tic Severity Scale (YGTSS).Kruskal-Wallis H rank-sum test was applied for univariate analysis and multinominal logistic regression for further multivariate analysis,with values of odds ratio (OR) and population attributable risk (PAR) obtained to demonstrate the relation strength between dietary behavior and tic symptom severity.Results Results of univariate analysis showed that western fast meal,barbecues,cream food,cold food,and spicy food were related to TS tic symptom severity (P＜0.05).Results of multivariate analysis demonstrated that western fast meal,fruits and vegetables,cream food and spicy food were risk factors for mild TS compared with control group,with OR and 95％ CI of 3.282 (1.922,5.064),2.239 (1.298,3.861),2.341 (1.355,4.046),2.118 (1.327,3.380) and their corresponding PAR of 0.306,0.464,0.169,0.250 respectively.As to moderate and severe TS,the risk factors included western fast meal,fruits and vegetables,and spicy food,with their respective OR and 95％ CI of 2.581 (1.322,5.038),2.364 (1.166,4.795),1.822 (1.014,2.272) and PAR of 0.234,0.487,0.197.Conclusion Dietary behavior,especially western fast meal,fruits and vegetables,cream food and spicy food,are considered to be associated with TS tic symptom severity.Therefore it' s obligatory to rectify undesirable dietary behaviors for TS children.

Objective To investigate the effects of normobaric hyperoxia intervention on learning and memory abilities of valproic acid(VPA) autism model rats and the morphology of pyramidal cells in hippocampus CA1 area.Methods Animal model groups of autism were obtained in male offspring of the Wistar rats that received intraperitoneal injection of 600 mg/kg VPA at 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 at the 28th day after birth,40 male VPA autism model rats were randomly selected 20 only and divided into normobaric hyperoxia model group (group A,n =10),atmospheric air model group (group B,n =10).Normal control groups were obtained in male offspring of Wistar rats that received intraperitoneal injection of equivalent physiological saline at the same period pregnancy.(group C,n =10).Rats in group A were treated with oxygen for 1 h per day and lasted 1 week;group B and C were treated with normal air.The learning and memory abilities of three groups were assessed at the 35th day after birth.The immunohistochemistry methods and image analysis were used to observe the pyramidal cells of autism model rats in hippocampal CA1 region.The effect of normobaric hyperoxia therapy on pyramidal cell of autism model rats in hippocampal CA1 region were evaluated by HE staining technique.Results The trying times of group A after treatment were less than those before treatment (31.15 ± 0.99 vs 31.54 ± 0.97,t =2.739,P =0.018).The memory times were more than those before treatment (3.00± 0.58 vs 2.69 ± 0.48,t =-2.309,P =0.040).The trying times of group A after treatment were less than those in group B after treatment (P =0.016).The memory times of group A were not different from that in group B after treatment(P=0.810).The morphology of pyramidal cells in hippocampal CA1 region showed that the pyramidal cells of the autism model rats had apoptosised.The number of apoptotic cells reduced and the number of normal form cells increased after the normobaric hyperoxia intervention compared with the autism model rats.Conclusion Normobaric hyperoxia intervention can improve the learning and memory abilities of the autism model rats.The apoptosis of the pyramidal neurons in hippocampal CA1 might be reduced after the normobaric hyperoxia intervention.

Objective To investigate the effects of hyperbaric oxygen on learning and memory ability in rats with a model of VPA autism and on the pyramidal cells in the CA1 region of the hippocampus.Methods An animal model of autism was established in the offspring of Wistar rats which had received a single intraperitoneal injection of sodium valproate at the 12.5th day of pregnancy.A total of 48 male VPA autism model rats were randomly divided into the hyperbaric oxygen group,a high pressure air group,a normal pressure high oxygen group and a normal pressure air group (each group with 12 rats).A normal control group was obtained by injecting physiological saline.The autism model rats of the hyperbaric oxygen group were treated with high pressure oxygen in an animal experiment cabin which was cleaned with pure oxygen for 10 min,pressurized for 15 min,held at 2.0 atmospheres absolute (ATA) for 45 min and then had the pressure relieved over 15 min.For the high pressure air group the cabin was pressurized with air for 15 min,held at 2.0 ATA for 45 min and the pressure was relieved over 15 min.For the normal pressure,high oxygen group the cabin was cleaned for 10 min with pure oxygen,then pure oxygen was supplied for 1 hour with the cabin door open.The normal pressure air group rats were placed in the open cabin with no pressure or additional oxygen.The testing lasted 7 days for 1 hour per day.The normal control group rats were placed in ordinary cages.Learning and memory were evaluated using the Y electric maze test before and after the interventions.Any changes in the pyramidal cells in the CA1 region of the hippocampus were observed after hematoxylin and eosin (HE) staining.Results The average number of tries of the hyperbaric oxygen group after treatment was significantly less than before treatment and memory retention times were increased.The number was also less in the normobaric hyperoxia group and memory retention times again improved.The number of apoptotic cells was reduced and the number of normal form cells in the CA1 region increased after the hyperbaric oxygen intervention.Conclusions The learning and memory abilities of the autistic rats improved after the hyperbaric oxygen intervention.Pyramidal cells in the CA1 region proliferated and the number of apoptotic cell decreased.This may be the mechanism by which hyperbaric oxygen intervention treats autism.