Children with Down's syndrome (DS) are at the highest risk for intellectual disability.This article presentes information on the neuropathology attributed to cognition impairment in DS,also presented are the major medical concern and management strategies for an individual with DS from birth to young adulthood.

Child ; Child Development ; China ; Humans ; Pediatrics ; trends

Objective To evaluate the feasibility and clinical application of two stents insertion via single tract for treatment of hepatic hilar cholangiocarcinoma. Methods Eighteen patients with hepatic hilar cholangiocarcinoma who had left and right bile duct obstruction were treated with stents insertion via right bile duct puncturing routeway. These two stents were implanted between right and left bile duct, and between right bile duct and common bile duct. Results Eighteen patients obtained successful two stents placement by right bile duct puncturing tract and succeeded with internal drainage for all bilialy tree jaundice subsided distinctly. Conclusions The technique of two stents insertion via single tract could predigest interventional drainage procedure of high bile duct obstruction ,reduce operation trauma, shorten handling time and possese promising application value.

Objective To explore the characteristics of speech,phone and cognition development of infants and toddlers with mild hearing loss and to study the effect of early intervention.Methods Speech and cognition abilities of 59 children with mild hearing loss,aged 8 months to 2 years and 10 months old were assessed and 34 normal hearing children,aged 8 months to 2 years and 9 months old were compared.Eighteen children with hearing loss were fitted with hearing aids and received speech therapy for 6 months.The participants' speech and cognition development were evaluated with Gesell developmental scale.The phone test was adopted to assess the speech sound development in 59 children with mild hearing loss.Results Of the 59 children with mild hearing loss,37 were judged with normal speech development quotients(DQ),8 with abnormal speech DQ,14 suspect of abnormal speech DQ.The hearing loss in cases with abnormal speech DQ was more serious than that in cases with normal speech DQ(P＜0.05).The speech DQ and personal-social behavior DQ of children with mild hearing loss were significantly lower than normal children(P＜0.01).The speech DQ and personal-social DQ on Gesell developmental scales were significantly higher in 18 children received early intervention,compared with those who did not receive intervention (P＜0.01).Six cases with mild hearing loss demonstrated phone errors,but no abnormal manifestations in tone.After early intervention the phone of those with mild hearing loss improved significantly.No significant difference in gross motor,fine motor and adaptive ability was observed between the children with mild hearing loss and those with normal hearing(P＞0.05).Conclusion The speech ability of children with mild hearing loss is significantly lower than those with normal hearing.Some mild hearing loss children show phone errors.Mild hearing loss affect the adaptation and communication abilities of mild hearing loss children significantly.Early intervention can significantly improve the speech,phone,adaptation and communication abilities of children with mild hearing loss.

Objective To explore the feasibility and validity of Satir model on compulsory drug rehabilitation for female drug users in closed settings. Methods Satir Model-based group psychotherapy was adopted in the treatment on 33 female drug users. Results The findings are that the pre-treatment SCL-90 scores were all higher than norm,indicating very high significant differences(P＜0.01) ; while the post-treatment SCL-90 scores,except the score of somatization, were approximate to norm, showing no statistical differences(P ＞0. 05). Conclusion Satir model played a positive role in the process of female drug users mental health recovery.

Objective To understand the current situation of health education contents as well as the differences in their requirements between clinical medical students and clinicians,and to provide reference for the optimization of health education curricula for medical students.Methods A stratified sampling method was adopted to select 511 medical students (303 females and 208 males) from a medical university,and the survey results of 436 clinicians (144 females and 292 males) were taken as reference.Differences in the degrees of need between clinical medical students and clinicians were compared by chi-square tests.Results There were statistical differences in needs between clinical medical students and clinicians regarding drug compliance,smoking cessation intervention,balanced diet,application of Chinese traditional rehabilitation medicine,mobile health technology education,exercise rehabilitation guidance,and theory of health promotion (P＜0.01).With regard to drug compliance,smoking cessation intervention,and exercise rehabilitation guidance,the proportions of clinical medical students' needs were just 87.1％,82.2％,and 81.2％,respectively,but for clinicians the proportions reached up to 96.3％,93.8％,and 92.8％,respectively.Whereas,there were no statistical differences for mental stress management,chronic infectious disease health education,and acute infectious disease health education (P＞0.05).Conclusion There is still a big gap between medical students and clinical doctors when it comes to the knowledge of chronic disease management and healthy lifestyles;clinical medical students have not yet realized the importance of such knowledge and skills.Therefore,the strengthening of course construction for clinical medical students is suggested.

OBJECTIVE: To analyze the clinical characteristics and genetic basis of a child affected with Glass syndrome. METHODS: Clinical manifestations and auxiliary examination results of the child were analyzed. Potential mutation was detected with next generation sequencing and validated by Sanger sequencing. RESULTS: The child has featured growth and mental retardation, delayed speech, cleft palate, crowding of teeth, and downslanting palpebral fissures. DNA sequencing revealed a de novo heterozygous missense mutation c.1166G>A (p.R389H) in exon 8 of the SATB2 gene in the child. CONCLUSION The heterozygous mutation c.1166G>A (p.R389H) of the SATB2 gene probably account for the Glass syndrome in the patient.
Abnormalities, Multiple ; genetics ; Child ; Chromosome Deletion ; Chromosomes, Human, Pair 2 ; Humans ; Intellectual Disability ; genetics ; Matrix Attachment Region Binding Proteins ; genetics ; Mutation ; Transcription Factors ; genetics

Objective: To evaluate the reliability and validity of warning signs checklist developed by the National Health and Family Planning Commission of the People′s Republic of China (NHFPC), so as to determine the screening effectiveness of warning signs on developmental problems of early childhood. Method: Stratified random sampling method was used to assess the reliability and validity of checklist of warning sign and 2 110 children 0 to 6 years of age(1 513 low-risk subjects and 597 high-risk subjects) were recruited from 11 provinces of China. The reliability evaluation for the warning signs included the test-retest reliability and interrater reliability. With the use of Age and Stage Questionnaire (ASQ) and Gesell Development Diagnosis Scale (GESELL) as the criterion scales, criterion validity was assessed by determining the correlation and consistency between the screening results of warning signs and the criterion scales. Result: In terms of the warning signs, the screening positive rates at different ages ranged from 10.8%(21/141) to 26.2%(51/137). The median (interquartile) testing time for each subject was 1(0.6) minute. Both the test-retest reliability and interrater reliability of warning signs reached 0.7 or above, indicating that the stability was good. In terms of validity assessment, there was remarkable consistency between ASQ and warning signs, with the Kappa value of 0.63. With the use of GESELL as criterion, it was determined that the sensitivity of warning signs in children with suspected developmental delay was 82.2%, and the specificity was 77.7%. The overall Youden index was 0.6. Conclusion The reliability and validity of warning signs checklist for screening early childhood developmental problems have met the basic requirements of psychological screening scales, with the characteristics of short testing time and easy operation. Thus, this warning signs checklist can be used for screening psychological and behavioral problems of early childhood, especially in community settings.

Objective: To investigate smoking cessation behaviors and factors influencing it among adult community smokers in Beijing. Methods: This was a cross-sectional epidemiological study. A questionnaire survey was administered among community smokers over 18 years old, in which information on basic demographics, tobacco use, attempts to quit smoking, tobacco-related awareness, and environmental assessment of smoking cessation support were collected. Descriptive analysis was conducted on the basic information, smoking situation, and demand for smoking cessation intervention of the respondents. Two tests were used to examine the quitting attempts of respondents. Tobacco attempts was found to be correlated with socio-demographic indicators, and factors such as tobacco use, awareness of tobacco-related issues, and the smoking cessation support environment. Dual logistic regression was used to further explore the dependence of identified factors and attempted smoking cessation behavior. Results: A total of 449 respondents were enrolled in this study, 410 of them were men (91.3%). Among the respondents, 272 people (60.6%) had tried to quit smoking and 177 people (39.4%) did not try to quit smoking. Monthly income level, tobacco-related awareness, degree of surrounding people supporting smoking cessation, whether medical treatment was sought in the previous year, number of visits, whether to persuade medical staff to quit smoking in the past year, and whether smoking was given up in the past year were the identified factors. These seven factors, such as whether they have been asked about smoking, are the influencing factors in trying to quit smoking（P<0.05）. Under the logistic regression model, monthly income level (OR=1.271, 95%CI:1.081-1.493), the support of people around them to quit smoking (OR=1.251, 95%CI:1.035-1.512), and the suggestion of medical personnel in the past year (OR=2.382, 95%CI: 1.054-5.381) were found to encourage attempts to quit smoking. Conclusion Factors such as health status, environmental support, hazard perception, and economic level influence attempts to quit smoking. Lack of self-determination and other people's influence are the main reasons for failing to quit smoking. Taking community places as the basic unit of intervention combined with professional guidance of smoking cessation clinic doctors and forming an online comprehensive linkage smoking cessation hospital community intervention model is an innovative way to optimize the management of tobacco dependence.