Objective To investigate the behavioral problems and intelligence in children with attention deficit hyperactivity disorder (ADHD) with different degree of sensory integrative dysfunction (SID).Methods Ninety-eight children with ADHD and fifty typical developing children (TD) whose intelligence were assessed with Chinese revised wechsler intelligence scale for children(C-WISC) in this study.Parental report measures of sensory integrative dysfunction and behavioral problems were administrated using the sensory integrative rating scale of children,conners' parent symptom questionnaire (PSQ) and achenbach children behavior checklist scale (CBCL) respectively.Relationship between behavioral problems,cognitive profiles and SID were examined in in children with ADHD with different degree of SID (33 without SID,33 mild SID and 32 severe SID).Results (1) Behavioral problems:the children with ADHD with severe SID (SS) had higher scores in Conduct problem,Learinng problem,Impulsivity-hyperactivity,Hyperactivity index of the PSQ and Depression,Somatic complaint of the CBCL than the children with ADHD without SID (NS),the children with ADHD with mild SID (MS),and TD.SS group had higher scores in Withdrawn behavior,Hyperactivity index,Aggressive and Delinquent behavior in CBCL than the TD and NS groups(P＜0.05).(2) Intelligence:the SS group(98.53±l0.80) had lower Verbal Intelligence Quotient (VIQ) than the TD group(107.40± 12.03) and lower Performance Intelligence Quotient (PIQ) (94.59± 10.56) than the other groups(TD:108.96± 10.20; NS:101.88±8.15 ; MS:100.73 ± 9.52).Additionally,the SS group had lower full scale intelligence quotient (FIQ) (96.22± 10.12) than the NS(102.70±7.52) and TD group (109.18±9.95)(P＜0.05).(3) The scores of SID were negatively correlated with behavior problems (PSQ and CBCL) and positively correlated with PIQ and FIQ.Conclusion SID have negative impact on behavioral problems and cognitive function in children with ADHD.The relationship between sensory integration and cognitive function may provide a new way for the clinical intervention of children with ADHD.

Objective To investigate the intelligence structure and attention properties,and to explore the relationship between them in children with attention deficit hyperactivity disorder of the predominantly inattention type (ADHD-Ⅰ),predominantly hyperactive-impulsive type (ADHD-HI) and combined type (ADHD-C).Methods Children with ADHD-Ⅰ (n=24),ADHD-HI(n=12) and ADHD-C (n=54) aged between 7-10 years were tested with Chinese Revised Wechsler Intelligence Scale for Children (C-WISC) and integrated visual and auditory continuous performance test (IVA-CPT).Comparisons of cognitive profiles of C-WISC scores between subtypes of ADHD were performed.Additionally,the relationship between attention/response control quotients and cognitive profiles was investigated.Results (1) Intelligence structure:verbal intelligence (VIQ) of ADHD-HI (110.08± 10.64) was higher than that of ADHD-C (101.13± 13.20) and ADHD-Ⅰ (94.71± 11.11).Full scale intelligence quotient (FIQ) of ADHD-HI (104.33±9.63) was higher than that of ADHD-Ⅰ (94.38± 10.48).Factor A of ADHD-HI (45.75±7.14) and ADHD-C (41.41±8.57) were higher than that of ADHD-Ⅰ (36.67±6.72).Factor C of ADHD-HI (33.42±5.42) was higher than that of ADHD-C (29.24±5.26) and ADHD-Ⅰ (29.13±5.39).(2) Attention properties:Full scale attention quotient of ADHD-C (90.26± 11.67) was lower than that of ADHD-Ⅰ (98.17 ± 18.03) and ADHD-HI (99.25± 15.58).Auditory attention quotient of ADHD-C (89.94± 14.16) was lower than that of ADHD-Ⅰ (99.00± 18.66).(3) Relationship between intelligence and attention:the Pearson correlations of the auditory attention quotient and auditory control quotient with the PIQ were 0.24 and 0.29 respectively.The correlations of the visual attention quotient with the PIQ and FIQ were 0.21 and 0.25 respectively.The correlations of the full scale attention quotient with PIQ and FIQ were 0.27 and 0.24 respectively.Each of these correlations reached the level of significance at the 5％ level.Conclusion Cognitive profile and attention properties analysis reveal that children with different subtypes of ADHD have distinct weakness in intelligence structure.The understanding of relationship between intelligence structure and attention properties in children with subtypes of ADHD is useful for ADHD diagnosis and treatment.

Objective To discuss the clinical value of ultrasonic elastography for thyroid nodules,and compared with pathology.Methods 77 patients with 105 thyroid lesions were analyzed.Tissue stiffness on elastography was scored from one(greatest elastics train)to five (no strain).Results On elastography:scores 1 and 2 were found in 75％ benign lesions.Scores 3 to 5 were found in 97.4％ malignant lesions.There were statistically difference in the scores of elastography between the benign and malignant lesions (P ＜0.01).Conclusions The ultrasonic elastography had positive significance in differentiating benign and malignant thyroid nodules.If the score of elastography is more than or equal to 3,the thyroid nodule is highprobablely malignant.

Objective To explore the behavior and initial sandtray characters of the children with oppositional defiant disorders (ODD) in order to provide psychological and behavioral intervention as early as possible.Methods The differences of the Conners parent symptom questionnaire (PSQ) and initial sandtrays between 24 children with ODD and 24 normal children were compared.Results PSQ indicated that children with ODD had higher scores of conduct proble((1.31 ± 0.53),(0.36 ± 0.31)),learning problem ((2.01 ± 0.66),(0.57 ±0.5)),hyperactivity-impulsion ((1.60 ± 0.77),(0.35 ± 0.41)),anxiety ((0.60 ± 0.50),(0.27 ± 0.25)) and hyperactivity index((1.12 ± 0.31),(0.78 ± 0.28)) than normal children.On the use of toys,the experimental group was significantly higher in armament and transports and lower in plants and stones(P＜0.05).On the theme of sandtrays,the ODD group was significantly higher in disorder,neglect,injury,threat and lower in integration and energy (P ＜ 0.05).Conclusion The results show that the children with ODD have more anxiety experience than normal children and this may be associated with oppositional conduct.Children with ODD use more aggressive toys and wounded themes,revealing their attack and conflict.Psychological intervention can be provided according to the characters of behavior scale and initial sandtray.

Objective To investigate the effect of neurofeedback training for tics symptoms and electroencephalogram (EEG) spectrum change in children with tic disorder.Methods 19 patients with transient tic disorder (TTD),20 with chronic motor or vocal tic disorder (CTD) and 15 with Tourette' s disorder (TS) received 40 sessions of neurofeedback training.The clinical effect was evaluated with Yale Global Tic Severity Scale,and brain activity improvement with EEG theta/beta,theta / sensorimotor rhythm (SMR) power ratio.Results The patients with three types of tic disorder all showed a reduction of tics symptoms (TTD:10.32 ± 0.82 vs.5.91 ± 5.74;CTD:12.35 ±1.50 vs.4.00 ±2.22; TS:25.33 ±2.80 vs.13.73 ±4.22; P＜0.01).Additionally,the patients showed theta decreasing and SMR enhancing after the sessions.The ratio of theta/beta (TTD:2.52 ±0.38 vs.2.33 ±0.32;CTD:2.43 ±0.39 vs.2.21 ±0.30; TS:2.64 ±0.35 vs.2.39 ±0.26) and theta/SMR was significantly lower than before treatment (P ＜ 0.01).Conclusion Neurofeedback training is an effective and valuable treatment in tic disorder especially in the patients with transient tic disorder and mild chronic motor or vocal tic disorder.

Objective To investigate the cognitive impairment and time-on-task characteristics of combined type(C type) and predominantly inattentive type (Ⅰ type) of children with attention deficit hyperactivity disorder(ADHD).Methods 24 cases with C type ADHD,20 cases with Ⅰ type ADHD and 24 normal children were completed 2 Block period of continuous performance test task,with conducting a comparative analysis of the behavior results of three groups and block1 and block2.Results 1.three groups comparison:hit numbers of C type (64.37 ±5.29) and Ⅰ type (63.55 ±5.28) were lower than that of the normal control group(67.04 ±2.03) ; reaction time of Ⅰ type (540.33 ± 90.33) ms was longer than that of the normal control group (470.56 ± 95.39)ms; intra-individual variability(ⅡⅤ) of C type (174.24 ± 56.3)ms and Ⅰ type (201.12 ± 50.79)ms were higher than that of the normal control group(144.72 ± 37.17) ms.Commission errors of other figures after 1 of C type was higher than that of Ⅰ type; reaction time of commission errors of Ⅰ type[(701.34 ±311.54) ms] was longer than that of C type((512.57 ± 279.22)ms),and all the differences were statistically significant (P ＜ 0.05).2.Timeon-task comparison:hit numbers,omission errors and ⅡⅤ had the significantly main effect of the type of subjects (P ＜ 0.05) ; hit numbers,omission errors,reaction time and ⅡⅤ had the significantly main effect of time-on-task (P＜0.01) ; Block2 the reaction time of C type and Ⅰ type((501.82 ± 112.47)ms,559.33 ± 90.73)ms) were significantly longer than that of Block1 ((473.19 ± 106.43) ms,(523.45 ± 99.86) ms) (P ＜ 0.05),while no significant difference (P＞0.05) in the normal control group.Conclusions C type ADHD has attention deficit and impulsivity and response inhibition defects.Ⅰ type ADHD has attention deficit and information processing capacity backward.Reaction rate of ADHD is more vulnerable to the impact of time-on-task.Two subtypes of ADHD children has different modes of cognitive impairment.

Objective To compare the event-related potential(ERP) difference waveforms between attention deficit hyperactivity disorder (ADHD) children and normal children in the conflict task,and to investigate the neural mechanism of conflict monitoring of ADHD. Methods ERPs elicited by performing the spatial SimonStroop task were recorded in 32 children with ADHD and 32 normal children. The differences of ERP and behavior dren with ADHD(0.80±0. 11 ,0.87 ±0.08) were less than normal children (0.88 ±0.07,0.93 ±0. 04)in Sireaction time of ADHD group( (773.03 ±99.34)ms) in the Siin were longer than the control group( (737.21 ±81.40)ms) ,the differences had statistic significance (P＜0. 05). 2. ERP results:the amplitude of N2 of the children with ADHD in the four conditions were smaller than the control group, the difference in Siin had statistic sigof prefrontal and anterior cingulate cortex of ADHD were weaker than the control group. Conclusions The results suggest that, due to the inadequate allocation of attention resources of the children with ADHD, they have conflict monitoring function defects compare with normal children. The function defects of conflict information processing related brain areas may be the main neural mechanism. The result of the behavior and ERP can become the reference indicator for the early diagnosis and treatment of ADHD.

The effect of obesity on idiopathic central precocious puberty (ICPP) girls is still under discussion.The relationship between body mass index (BMI) and sexual hormone levels of gonadotropin-releasing hormone (GnRH) stimulation test in ICPP girls is controversial and the underlying mechanism is unclear.This study aims to further explore the independent effect of excess adiposity on peak luteinizing hormone (LH) level of stimulation test in ICPP girls and the role of other related factors.A retrospective cross-sectional study was performed on 618 girls diagnosed as having ICPP,including 355 cases of normal weight,99 cases of overweight and 164 cases of obese.The results showed that obese group had more progressed Tanner stage and no significant difference (P=0.28) in LH peak was found as basal LH value was used as a covariate.The obese group had higher total testosterone (TT),adrenocorticotrophic hormone (ACTH),17-α hydroxyprogesterone (17-αOHP) and androstendione (AN),with significantly increased fasting insulin (FIN) and homeostasis model of assessment for insulin resistance index (HOMA-IR).Stratified analysis showed inconsistency of the relationship between BMI-standard deviation score (BMI-SDS) and LH peak in different Tanner stages (P for interaction=0.017).Further smoothing plot showed linear and non-linear relationship between BMI-SDS and LH peak in three Tanner stages.Then linear regression model was used to analyze the relationship between BMI-SDS and LH peak in different Tanner stages,with and without different confounding factors being adjusted.In B2 stage,BMI-SDS was negatively associated with LH peak.In B3 stage,when BMI-SDS ＜1.5,as BMI-SDS increased,the level of LH peak decreased (model Ⅰ:β=-1.8,95％ CI=-4.7 to 1.1,P=0.214).When BMI-SDS ≥1.5,BMI-SDS was significantly positively associated with LH peak (model Ⅰ:β=4.5,95％ CI=1.7 to 7.4,P=0.002).In B4 stage,when BMI-SDS ＜1.5,BMI-SDS was negatively associated with LH peak (model Ⅰ:β=-11.6,95％ CI=-22.7 to-4.5,P=0.049).When BMI-SDS ≥1.5,BMI-SDS was positively associated with LH peak (model Ⅰ:β=-4.2,95％ CI=-3.3 to 11.7,P=0.28).It is concluded that there is an independent correlation between BMI-SDS and LH peak of stimulation test in ICPP girls,their relationships are different in different Tanner stages,and the effect of BMI-SDS can be affected by adrenal androgens,estradiol and glucose metabolism parameters.

Objective:To investigate the characteristics of event-related potentials(ERPs)P300 in the development of attention cognitive function of school-age children.Methods:A total of 180 school-age children were divided into 3 groups according to their ages (7-8 years old group with 48 cases, 9-10 years old group with 44 cases and 11-12 years old group with 48 cases). All of the participants completed an Oddball task, and their behavioral data, P3a and P3b components of ERPs were analyzed by SPSS 21.0.Results:(1)The differences of hit numbers(49(47.25, 50), 50(49, 50), 50(50, 50) ), correct reaction time((533.37±56.94) ms, (486.91±61.12) ms, (411.55±51.97) ms), and Omission errors (2(1, 4), 2(1, 3), 1(0, 2) ) among the three groups were statistically significant( F/χ 2=20.635, 54.477, 13.169, all P<0.01). (2)There was a main effect of age( F=3.884, P=0.023) and an interaction effect between age and condition( F=3.314, P=0.038) on the amplitude of P3a, while the main effect of condition was not significant( F=0.111, P=0.740). The amplitude of P3a component in 11-12 years old group ((11.02±6.00)μV) was significantly larger than that of 7-8 years old group ((7.36±4.48)μV) and 9-10 years old group ((7.76±5.17)μV, both P<0.05). However, there was no significant interaction effect between age and condition on P3a latency, P3b amplitude and latency ( P>0.05). Conclusion:P3a may be a sensitive indicator of cognitive function in school-age children, and the age of 11-12 years old is a sensitive period for the development of children's attention orientation and selection ability, which may be related to the development of brain network.