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.

Objective To investigate the different responses of diaphragm and peripheral muscles to cisatracurium in rabbits.Methods 8 male New zealand rabbits were anaesthetized with pentobarbital,and then the diaphragm,tibialis anterior,soleus muscles,phrenic nerves,tibial nerve,and peroneal nerve were gently freeded.The muscles were secured to force displacement transducers,and the nerves were directly stimulated by electrodes with supramaximal square waves.The isometric force of twitch tention of each muscle was recorded.The cumulative dose-response technique was separately used for obtaining the ED50and ED95 values of the cisatracurium in each muscle.Results The muscle-relaxing of cisatracurium on the three muscles in were observed in a dose-dependent manner.The ED50 values and ED95 values were: diaphragm(39.3 ± 2.5)μg/kg and(75.7 ± 4.2)μg/kg,tibialis anterior(80.6 ± 7.5)μg/kg and(123.3 ±9.3)μg/kg,soleus(80.0 ± 7.1)μg/kg and(126.9 ± 9.4)μg/kg,respectively.It had significant difference between diaphragm vs tibialis or soleus,P ＜ 0.05.Conclusions The muscle relaxant effects of cisatracurium on diaphragm and peripheral muscles were different,and diaphragm was more sensitive than peripheral muscles.

Objective: To evaluate the clinical therapeutic efficacy and safety of red-blue light irradiation combined with Xihuang Capsules in the treatment of moderate to severe acne vulgaris.Methods:Eighty patients with moderate to severe acne vulgaris were randomly divided into Xihuang Capsules group (control group)and red-blue light irradiation combined with Xihuang Capsules group (observation group).The patients in observation group were treated with red-blue light irradiation (20 min biw,4 weeks)combined with Xihuang Capsules (1.5 g bid,4 weeks),while the patients in control group took only Xihuang Capsules orally (1.5 g bid,4 weeks),The changes of skin lesions and adverse reactions were observed and the curative efficacies were compared at 2 or 4 weeks after treatment.Results:After 2-week-treatment,the total effective rate in observation group was 67.5% while the total effective rate in control group was 52.5%,there was no statistically significant difference between two groups (P >0.05).The regression number of inflammatory and non-inflammatory skin lesions in observation group was significantly higher than that in control group (P <0.05).After 4-week-treatment,the total effective rate in observation group was significantly higher than that in control group (85.0% vs 65.0% ),and the difference was statistically significant (P < 0.05);the regression number of inflammatory and non-inflammatory skin lesions in observation group was significantly higher than that in control group (P <0.05).During the treatment,there were no severe adverse reactions in two groups.Mild headache and nausea occurred in observation group after red-blue light irradiation,but the above symptoms disappeared after reducing the irradiation dose.Conclusion:Red-blue light irradiation combined with Xihuang Capsules in the treatment of moderate to severe acne is proved to be a significantly effective and safe method,and it is worth to be promoted in clinic.

OBJECTIVE: To explore the influence of obstructive sleep apnea hypopnea syndrome (OSAHS) on physical growth and neuropsychological characteristic of children. METHOD: Eighty-two cases with OSAHS were examined by PSG, and divided to mild, moderate and severe group according to AHI, and 40 healthy children were selected as control group. Physical and mental development were evaluated on the basis of growth and neurodevelopmental assessments, respectively. Psychological behavior were assessed by Wechsler Intelligence Scale for Children Chinese Version and Achenbach Child Behavior checklist. RESULT: (1) The children of mild group were lower than the control group in the height and sitting height. The children of moderate and severe group were significantly lower than the control group in physical growth. (2) The children of mild group showed no difference compared with control group in Wechsler Intelligence Scale test. The moderate group were lower than control group in some test. Mean verbal IQ (VIQ), performance IQ (PIQ) and total scores in cognitive tests for severe groups were within the normal range, but lower than those of controls. (3) Melancholy, disobey, schizophreniform anxiety and offensive behavior were more common in male children with OSAHS than controls. While, offensive behavior, hyperactivity and aggressive behavior were more common in female children with OSAHS than controls. CONCLUSION The physical growth and neuropsychological characteristic can be influenced by obstructive sleep apnea hypopnea syndrome in children, and treatment ought to be done as early in case of the severity of the disease is aggravated.
Case-Control Studies ; Child Behavior ; Child, Preschool ; Female ; Humans ; Intelligence Tests ; Male ; Polysomnography ; Severity of Illness Index ; Sleep Apnea, Obstructive ; physiopathology ; psychology

Objective To explore the influence of dexmedetomidine on blood gas and inflammation cytokines in patients with one-lung ventilation (OLV).Methods Sixty-two patients undergoing radical resection of pulmonary carcinoma were divided into observation group and control group in sequence,31 cases in each group.All patients treated with intravenous sufentanil 0.3-0.5 μg/kg,propofol 1.5-2.5 mg/kg,midazolam 0.5 mg/kg and rocuronium 0.9 mg/kg for induction of anesthesia;intravenous infusion of propofol 6-8 mg·kg-1 ·h-1 and remifentanil 0.1-0.5 μg·kg-1 ·min-1,intermittent intravenous injection of cisatracurium for anesthesia maintenance.The patients in the observation group were given 1μg/kg loading dose dexmedetomidine 10 min before anesthesia induction (infusion in 10 min),maintaining at 0.5 μg·kg-1 ·h-1 until 30 min before the end of surgery.The patients in the control group were given the same amount of saline as a control.The blood gas analysis index,pH,partial oxygen pressure (PaO2),CO2 partial pressure (PaCO2) and such inflammation cytokines as tumor necrosis factor alpha (TNF-α) and interleukin 6 (IL-6) at OLV (T0),after OLVlh (T1),the end of OLV (T2) were respectively tested,the dosage of propofol in the two groups were recorded.Results The dosage of propofol in observation group was significantly lower than that in the control group (P＜0.05);pH declined in the two groups (P＜0.05),but the difference had no statistical significance;PaO2 was rising then declined in the two groups (P＜0.05),but it was significantly higher in the observation group than in the control group(P＜0.05);PaCO2 in the two groups increased gradually(P＜0.05),it was significantly lower in the observation group than in the control group (P＜0.05);The serum TNF-α,IL-6 in the two groups showed a trend of increasing (P＜0.05),it was significantly lower in the observation group than in the control group (P＜0.05).Conclusion Dexmedetomidine can maintain blood gas stability and reduce inflammation caused by single lung ventilation.

Objective:To explore the levels of vitamin A(VA) and vitamin D(VD) in blood of children with tic disorder (Tic disorder, TD) and their associations with tic symptoms severity and clinical types, so as to provide evidence for better prevention and treatment of TD.Methods:A total of 245 children with TD from September 2018 to April 2019 in the department of child Health care, affiliated hospital of qingdao university were enrolled as the case group and 63 healthy children who underwent routine physical examination at the same time as the control group. The levels of VA and VD were measured and their relationship with the severity of tic symptoms and clinical types were analyzed.Results:(1)The VD level of the case group was significantly lower than that of the control group ((23.72±8.87) μg/L , (26.61±7.59) μg/L, t=-2.24, P=0.03), and the proportion of insufficiency or even lack (37.31%, 75/201) was higher than the control group (15.79%, 9/57) (χ 2=9.37, P=0.002). (2)According to the Yale global tic severity scale(YGTSS), the children in the case group were divided into mild TD group, and moderate-to-severe TD group. ①There were significant differences in serum VA and VD levels in mild TD group, moderate-to-severe TD group and the control group ( F=29.79, P<0.01; F=10.90, P<0.01). Among them, the content of VA and VD in moderate-to-severe TD group were lower than those in mild TD group and control group (VA: (0.29±0.06)mg/L, (0.35±0.06)mg/L, (0.34±0.06)mg/L; VD: (21.01±8.30)μg/L, (25.84±8.76)μg/L, (26.61±7.59)μg/L). ②VA and VD levels of children with TD were negatively correlated with the severity of symptoms ( r=-0.325; P<0.01; r=-0.228; P=0.001). (3)According to DSM-V classification criteria, TD children were divided into PTD group, CTD group and TS group. ①There was no significant difference in serum VA level among different clinical types of TD children ( F=0.87, P=0.46). ②The levels of serum VD were different among the four groups ( F=4.13, P=0.007). Among them, the VD level in TS group was the lowest, and its content was significantly lower than that in control group ((21.83±7.60)μg/L, (26.61±7.59)μg/L, P<0.05)). The prevalence of insufficient or even lack of serum VD in children with different subtypes of TD was higher than that in the control group (χ 2=10.88, P=0.01). Conclusion:Vitamin D deficiency exists in children with TD. The level of vitamin A and vitamin D in serum of children with TD is related with the severity of tic symptoms.The VD level is related with clinical type of TD.

Dinitrogen tetroxide is often used as an oxidant in rocket propellant and has strong irritant and corrosive properties. This paper analyzes the clinical data of a patient with dinitrogen tetroxide poisoning admitted in the 63710 Army Hospital of Chinese People's Liberation Army, so as to further explore the poisoning mechanism, clinical characteristics and key points of acute inhaled dinitrogen tetroxide poisoning.

Dinitrogen tetroxide is often used as an oxidant in rocket propellant and has strong irritant and corrosive properties. This paper analyzes the clinical data of a patient with dinitrogen tetroxide poisoning admitted in the 63710 Army Hospital of Chinese People's Liberation Army, so as to further explore the poisoning mechanism, clinical characteristics and key points of acute inhaled dinitrogen tetroxide poisoning.

Objective To investigate the current status and awareness of pharmaceutical services in hospitals in Guizhou province and to provide a reference for exploring and carrying out pharmaceutical service fees.Methods The questionnaire was designed by the"wjx.cn"website.Three kinds of questionnaires were designed for pharmacists,doctors,nurses,and patients as the research objects,with corresponding differences in some questions,and promoted on WeChat,Dingxiangyuan,and other network platforms.Results A total of 655 questionnaires were collected,and 639 valid questionnaires were recovered,with an effective recovery rate of 97.56%.324 pharmacists(50.70%),82 doctors and nurses(12.83%),233 patients(36.46%)were surveyed.The average approval score of these three groups of respondents on pharmaceutical service fees was 4.67,4.23,and 4.22,respectively(full score:5).Conclusions Overall,pharmacists'professional services have received support from medical staff and patients.However,patients'pharmaceutical service projects currently focus on dispensing services.The recognition of pharmacists'work and the public's awareness of pharmaceutical services can be improved by enhancing the professional ability of pharmacists,strengthening publicity and guidance,and exploring"Internet+pharmaceutical services",etc.,to promote the sustainable development of pharmaceutical services.