Objective: This study aimed to investigate the effect of atomoxetine hydrochloride (ATX) on the activation of the prefrontal complex (PFC) in children with ADHD during a working memory task. Methods: We recruited 14 drug-naive children with ADHD. PFC functional blood oxygen was recorded by using fNIRS during the n-back task. Clinical symptoms were assessed by parents using the Swanson, Nolan, and Pelham-IV rating scale and Conners measuring scale (parent symptom questionnaire) at the same time. After 8 weeks of treatment with ATX, these children were re-evaluated by using fNIRS, SNAP-IV, and Conners scales. Statistical methods were used to compare the physiological and psychological test indicators in the pre- and post-ATX conditions. Simultaneously, oxygenated hemoglobin concentration variation and the scores of the two scales were used as indicators for correlation analysis between PFC activation and clinical symptoms. Results: Based on the performance data, children showed higher accuracy and lower omission error during the n-back task after ATX treatment. According to fNIRS data, the hemodynamic changes between pre-ATX and post-ATX conditions suggested that high-level activation in channel 36 was found in children under post-ATX conditions. The associated channels were located in frontopolar PFC, dorsolateral PFC, and orbitofrontal cortex. Enhanced trends were also found in channels 5 and 7. Regarding the rating scale scores, children under post-ATX conditions showed relatively lower inattention scores, hyperactivity scores, oppositional defiant score, and total scores on the SNAP-IV scale. Lower conduct problem score, learning problem score, hyperactivity-impulsivity score, and hyperactivity index of Conners measuring scale were observed in children who received treatment. These values were statistically and significantly different. A significantly negative correlation was observed between oxygenated hemoglobin concentration changes and the total score on the SNAP-IV scale. Conclusions: fNIRS is a helpful tool for identifying the effects of ATX on children with ADHD, and its combination with the SNAP-IV scale can provide an objective physiological index for evaluating the efficacy of ATX．ATX can improve the core symptoms and executive function of children with ADHD.

Abstract Background Anti-N-methyl-D-aspartic receptor encephalitis (Anti-NMDAR encephalitis) is the most prevalent form of autoimmune encephalitis in pediatric patients. Autonomic dysfunction is a frequent symptom of Anti-NMDAR encephalitis, yet it often goes unnoticed by pediatricians. Studies have indicated that pediatric patients with autonomic dysfunction exhibit a poorer prognosis compared to those without. To date, research on autonomic dysfunction in encephalitis has predominantly focused on adults, with no studies conducted on pediatric populations. This analysis examines the clinical features of pediatric patients with Anti-NMDAR encephalitis complicated by autonomic dysfunction. Methods We performed a retrospective analysis of patients diagnosed with Anti-NMDAR encephalitis at the Department of Neurology, Children’s Hospital affiliated to the Capital Institute of Pediatrics, from June 2017 to June 2023. Patients were categorized based on the presence or absence of autonomic dysfunction during their illness. We summarized and compared the clinical features of children with autonomic dysfunction and analyzed the risk factors for its development in pediatric Anti-NMDAR encephalitis patients. Results A total of 56 children were included in this study. Twenty-two (39.3%) exhibited autonomic nervous dysfunction. The most prevalent symptom of autonomic dysfunction was cardiovascular autonomic dysfunction(21/22, 95%),with the specific manifestations being sinus tachycardia (8 cases), ventricular premature beats (2 cases), atrioventricular block (2 cases), atrial premature beats (3 cases), and sinus bradycardia (4 cases),hypertension(1 case) and cardiac arrest(1 case). Other symptoms included gland secretion dysfunction (19/22, 86%),ventilate dysfunction(3/22,14%), thermoregulatory dysfunction (3/22,14%), bladder dysfunction(2/22,9%). Compared to the group without autonomic dysfunction, the group with dysfunction showed significantly higher rates of prodrome infection, tumor complications (all ovarian teratoma), consciousness disturbance, elevated cerebrospinal fluid protein, initiation of second-line and long-term immunotherapy, length of hospital stay, and hospitalization costs (P < 0.05). Conclusion Among pediatric patients with Anti-NMDAR encephalitis, cardiovascular autonomic dysfunction is the most common form of autonomic dysfunction. Those with autonomic dysfunction have a worse prognosis and longer hospital stays. Active initiation of second-line and long-term immunotherapy is recommended.

Attention deficit hyperactivity disorder (ADHD) is a common neurodevelopmental disorder often managed with medication. Improving cognitive functions alongside medication treatment is crucial for better outcomes. This study mainly aimed to investigate the therapeutic effects of combining digitally targeted cognitive training with medication compared to medication monotherapy on ADHD core symptoms. We hypothesized that targeted cognitive training could enhance treatment efficacy when combined with medication. This was a randomized parallel-group controlled trial. A total of 124 children with ADHD were randomly allocated to two groups: 64 received medication treatment alone (M), including atomoxetine (ATX) and methylphenidate (MPH); 60 received targeted cognitive training combined with medication (TCT + M), including TCT + ATX and TCT + MPH. Both groups received 8 weeks of treatment. The primary outcome was the changes in ADHD core symptoms measured by the ADHD Rating Scale (ADHD-RS). The secondary outcomes were parent-reported ecological executive functions, social functions, and laboratory cognitive functions. Main results: When compared with M treatment, the TCT + M treatment did not show significant greater improvements in ADHD core symptoms, ecological executive functions, social functions, or laboratory cognitive functions. Post-hoc exploratory analysis results: (1) In patients who received ATX treatment, TCT + ATX led to greater improvement in ADHD-RS total, inattention, and hyperactivity/impulsivity symptoms. Similar between-group differences were observed in ecological executive functions, and the improvements were significantly correlated with changes of ADHD core symptoms. (2) In patients who received MPH treatment, no significant differences in the improvement of primary or secondary outcomes were observed between MPH monotherapy and TCT + MPH groups. These findings demonstrated that, in comparison to medication monotherapy, the TCT + M treatment did not lead to more improvements in the core symptoms of ADHD, nor did it show superiority in other secondary outcomes. Specifically in children treated with atomoxetine, there’s a potential promoting effect of targeted cognitive training on medication treatment in terms of the alleviation of ADHD core symptoms. This study was pre-registered with the Chinese Clinical Trial Registry under the identifier ChiCTR2100043525.

Background:Attention deficit hyperactivity disorder (ADHD) is a neurodevelopmental disorder frequently accompanied by cognitive dysfunction. However, the precise etiology of the cognitive impairment remains unclear. Homocysteine is recognized as a risk factor that contributes to cognitive impairment. Objective:To explore the potential changes in serum homocysteine levels in children with ADHD and to evaluate its relationship with cognitive function. Methods:In this cross-sectional and case-control study, 39 children diagnosed with ADHD were recruited from the outpatient clinic of the Capital Center For Children's Health, Capital Medical University, along with 40 age- and sex-matched healthy children from the Health Care Department. Serum homocysteine levels were measured via the enzyme cycle method. Age and sex were incorporated into stratified analyses. Cognitive function in patients with ADHD was evaluated using the Behavior Rating Inventory of Executive Function (BRIEF). Results:Compared with the healthy individuals, patients with ADHD exhibited significantly higher serum total homocysteine levels (7.20 ± 1.19 μmol/L vs. 6.35 ± 1.11 μmol/L, p = 0.002). This association was prominent in younger patients (7.21 ± 1.39 μmol/L vs. 5.84 ± 0.18 μmol/L, p = 0.001) and male patients (7.21 ± 1.15 μmol/L vs. 6.44 ± 1.18 μmol/L, p = 0.010). No significant correlation was observed between serum total homocysteine levels and BRIEF scores (p > 0.05). Conclusion:The study indicates that compared to healthy individuals, patients with ADHD exhibit relatively high homocysteine levels, especially in younger and male patients. However, this study did not support a significant correlation between homocysteine levels and cognitive function in children with ADHD.

Background Executive dysfunction, particularly impairments in inhibitory control, is a key aspect of attention deficit hyperactivity disorder (ADHD). Methylphenidate (MPH) is the main treatment for ADHD; however, its effects on cortical activation and inhibitory control in children with ADHD have not been comprehensively studied. This study aimed to investigate the differences in functional near-infrared spectroscopy (fNIRS) outcomes related to inhibitory control improvement and cortical activation in children with ADHD. Methods Between May 2023 and December 2023, 14 children diagnosed with ADHD and treated with MPH were recruited, and 17 healthy children matched for age and sex were included. fNIRS was used to monitor brain activation in healthy children and children with ADHD before and after medication during Go/Nogo, Stroop, and flanker tasks. Differences in brain activation between healthy children and children with ADHD were compared before and after treatment. Results Swanson, Nolan, and Pelham IV rating scale revealed statistically significant improvements in inattention and hyperactivity-impulsivity in children with ADHD (P < 0.05). Behavior Rating Inventory of Executive Function Parent Edition revealed statistically significant improvements in working memory and monitoring ability after MPH treatment in children with ADHD (P < 0.05). After MPH treatment, the anterior cingulate cortex of the Stroop task significantly improved in children with ADHD (P < 0.05). The fNIRS activation levels in channels 9, 12, 21, and 42 were higher than those in healthy children during the go/no-go task before ADHD medication (P < 0.05). Before medication administration, no significant difference was observed in fNIRS activation between children with ADHD and healthy children during the Stroop and Flanker tasks (P > 0.05). When performing the Go/No-go task, the activation level of channel 7 fNIRS in children with ADHD was lower after treatment than before (P < 0.05). In the Stroop and flaker tasks, no significant differences were observed in fNIRS activation levels in children with ADHD before and after medication (P > 0.05). Conclusions After 8 weeks of treatment with methylphenidate, the behavioral data of children with ADHD showed improvement in the inhibition control neuropsychological test. The characteristic brain regions improved significantly when performing inhibitory control tasks and developed towards the activation direction of healthy children's brain regions.

BackgroundTo explore the clinical characteristics, etiological factors, and clinical-related genetic variant of children with acute necrotizing encephalopathy (ANE) related to the Omicron BF.7.14 novel coronavirus.MethodsGenomic variations were detected through whole exome sequencing. Additionally, we summarized the clinical data to explore the inheritance patterns associated with novel coronavirus-related ANE.ResultsThis study included four patients (2 males and 2 females) with an average age of 2.78 ± 1.93 years. All the patients had prodromal symptoms of Omicron BF.7.14 virus infection, and exhibited symptoms such as altered consciousness, seizures and cognitive/language disturbances. Cranial MRI scans revealed damage to the thalamus, basal ganglia and brainstem. The cerebrospinal fluid (CSF) cell counts were nearly normal, but protein level in CSF increased significantly. Genetic analysis revealed a novel truncated variant of CRMP2 gene in one patient who suffered more severe coma score and prognosis and dead in the later stages. All children exhibited a decrease in the absolute count of T lymphocytes, helper T cells, suppressor T cells, and NK cells to varying degrees. Furthermore, levels of cytokines, including IL-1 β, IL-5, IL-6 and IL-8 were significantly elevated in the CSF, especially in patient with truncated variant of CRMP2 gene.ConclusionThe Omicron BF.7.14 type novel coronavirus can lead to ANE, characterized by T cell immunosuppression and a significant increase in cytokine levels in the CSF. The truncated variation of CRMP2 gene may affect the prognosis of ANE by affecting the migration of cerebral T cells.

ObjectiveTo study the characteristics of event related potential P300 in preschool children with attention deficit hyperactivity disorder (ADHD) aged 4–6 years (4≤ age <6), and to explore the differences in cognitive function compared with healthy children. To explore a new method for the study of cognitive function in preschool children with ADHD.MethodsA total of 73 preschool children aged 4–6 years were selected from the outpatient clinic of Neurology Department, the ADHD-specialized Clinic and Health Care Department of the Children's Hospital Affiliated to the Capital Institute of Pediatrics from March 2021 to May 2024. They were divided into the ADHD group (45 cases) and healthy children group (28 cases). Event related potential P300 was measured in all children and the amplitude and latency of the wave were compared between the two groups separately.ResultsThe latency of P300 at all the recording electrodes (Fz, Cz, Pz, Oz, C3, C4) in the ADHD group was significantly longer than controls (p < 0.05). The wave amplitudes of children with ADHD were significantly higher than controls at Pz and Oz points.ConclusionThe differences between two groups in P300 test show that preschool children with ADHD present longer latency at central line of the brain and bilateral central lobes compared with healthy children, and higher amplitude at the central parietal lobe and central occipital lobe. It may suggest that attention cognition has already impaired in preschool children with ADHD.

Background Executive dysfunction in children with attention deficit hyperactivity disorder (ADHD) is thought to be closely related to the prefrontal cortex (PFC). However, there is controversy over the activation of the PFC in children with ADHD. Differences could be related to the subtype. Meanwhile, no study to date has used functional near-infrared spectroscopy (fNIRS) to explore the differences between subtypes. Thus, this study aimed to explore the activation of the PFC in children with different subtypes of ADHD during executive function task. Methods Participants in this study include typically developing (TD) children ( n = 28), ADHD-predominantly inattentive (ADHD-PI) ( n = 39) and ADHD-combined (ADHD-C) ( n = 24). To examine the executive function of ADHD, the Go/No-go task is chosen to assess the response inhibition function. The activation of PFC in all participants during the Go/No-go task was recorded by fNIRS. Meanwhile, behavioral data were also recorded. Results Both TD and ADHD children activated the right PFC [middle frontal gyrus (MFG) and inferior frontal gyrus (IFG)] during response inhibition. However, the range and degree of activation differed among these groups. Compared with TD children, those with ADHD-PI had a smaller extent of activation in the right PFC, and those with ADHD-C only had a tendency to enhance activation. In addition, children with ADHD-PI and ADHD-C had impaired activation of the temporal gyrus. Besides, compared with ADHD-C and TD, those with ADHD-PI also had impaired activation of the right precentral gyrus (PG), and the supplementary motor area (SMA). Compared with ADHD-PI, ADHD-C showed decreased activation of the right MFG. The activation of Ch34 (BA44, rPFC) in children with ADHD-PI and ADHD-C was negatively correlated with their clinical symptoms. Conclusion The activation of the PFC in children with different subtypes of ADHD has both commonalities and differences. The degree of activation of the right PFC Ch34 in children with ADHD is negatively correlated with clinical symptoms. fNIRS could be served as a candidate hemodynamic biomarker for the diagnosis of ADHD.

The effect of vitamin D supplementation on individuals with autism spectrum disorder (ASD) is inconclusive. We aimed to conduct a meta-analysis of the available randomized controlled trials (RCTs) to explore whether vitamin D supplementation can improve core symptoms and coexisting conditions in children with ASD. Data were obtained by searching the PubMed, Embase, Web of Science, CINAHL and Cochrane Library databases up to February 2022 following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Using a random-effects model, mean differences with 95% confidence intervals (CIs) were calculated through a meta-analysis. There were eight RCTs with 266 children with ASD in the present review, among which six RCTs were included in the meta-analysis. Children who received vitamin D supplementation showed a significant improvement in stereotypical behavior scores (pooled mean difference (MD): -1.39; 95% CI: -2.7, -0.07; P = 0.04) with low heterogeneity (I2 = 34%), and there was a trend toward decreased total scores on the Social Responsiveness Scale (SRS) and Childhood Autism Rating Scale (CARS, P = 0.05); however, there were no other significant differences in the core symptoms of ASD and coexisting conditions between groups as measured by the Aberrant Behavior Checklist (ABC). Vitamin D supplementation appears to improve stereotypical behaviors but does not improve other core symptoms and coexisting conditions. Further randomized controlled trials with large sample sizes and individualized doses are needed.

注意缺陷多动障碍(ADHD)是一种儿童期发病的神经发育障碍,遗传因素与环境因素均在发病中起作用.近年来研究表明ADHD患者可伴有维生素D缺乏,补充维生素D可改善患者的部分临床症状.维生素D是一种脂溶性维生素,通过与维生素D受体结合发挥作用,除具有调节钙磷代谢作用外,还具有调节免疫功能的作用.本文主要从维生素D在ADHD中发挥的调节细胞因子、氧化应激、神经营养因子、神经递质、神经元周围基质网络及调节肠道菌群方面作用机制进行综述.

目的 分析5岁及以上细菌性脑膜炎/脑膜脑炎患儿的临床特征.方法 回顾性分析首都儿科研究所附属儿童医院神经内科住院的细菌性脑膜炎/脑膜脑炎患儿的临床资料.结果 共收集到5岁及以上细菌性脑膜炎/脑膜脑炎患儿39例,男28例,女11例,年龄5～15岁.病因包括鼻部感染11例(28.2％)、耳道感染5例(12.8％)、外伤3例(7.7％)、免疫缺陷病3例(7.7％)、面部蜂窝织炎2例(5.1％)、解剖结构异常(皮样囊肿)1例(2.7％)、中枢神经系统肿瘤(淋巴瘤)1例(2.7％)、不明原因13例(33.3％).症状包括发热、头痛、呕吐、意识障碍、惊厥、瘫痪、面瘫、惊厥持续状态等.15例(38.5％)患儿脑脊液中发现病原(包括淋病奈瑟菌、肺炎链球菌、产碱假单胞菌、皮氏罗尔斯顿菌、克氏库克菌、玫瑰单胞菌、金黄色葡萄球菌、中间链球菌、星座链球菌、产单核细胞李斯特菌),其中二代测序发现病原10例、脑脊液培养发现6例.头颅磁共振成像异常17例(43.6％).并发症或后遗症包括硬膜下积液35例(89.7％)、硬膜下积脓6例(15.4％)、脑疝6例(15.4％)、脑积水3例(7.7％)、言语障碍2例(5.1％),死亡1例(2.7％).结论 对于5岁及以上大龄细菌性脑膜炎/脑膜脑炎患儿应积极寻找病因,如颅内皮样囊肿、中枢神经系统原发肿瘤、头面部蜂窝织炎、鼻窦炎、免疫缺陷病和外伤等疾病.

Functional near-infrared spectroscopy (fNIRS) as an emerging optical neuroimaging technique has attracted the interest and attention of many investigators. With the growth of fNIRS data volume, effective data compression methods are urgent. Compressive sensing (CS) has been demonstrated a promising tool to deal with biomedical data. However, whether the compressibility of fNIRS data can discriminate different brain states is unclear. In this study, the fNIRS signals from fifteen attention-deficit/hyperactivity disorder (ADHD) children and fifteen typically developing (TD) children were recorded during an N-back task and a Go/NoGo task respectively. A block sparse Bayesian learning-based CS method was used to reconstruct the compressed fNIRS data. To assess the performance of the CS method, we adopted two metrics, structural similarity index (SSIM) and mean squared error (MSE), both of them effective in evaluating the compressibility of fNIRS data. Then, the two metrics were analyzed to discriminate the brain states of ADHD children and TD children during the two tasks using the multivariate pattern analysis (MVPA) method. As indicated by the results, the CS method could reconstruct the compressed fNIRS data with a high reconstruction quality at different compression ratio ( $\text{SSIM} > \text{0.988}$ and $\text{MSE} < \text{1.2} \times \text{10}^{-4}$ ). Furthermore, the MVPA method could distinguish different brain states with high accuracy, and identify that the prefrontal cortex is a key brain region for distinguishing ADHD vs. TD or N-back vs. Go/NoGo. These findings indicated that CS is very promising for the storage and transmission of massive fNIRS data, and the compressibility of fNIRS data is a potential biomarker for the diagnosis of ADHD.

OBJECTIVES:To study the clinical features of children with febrile seizures after Omicron variant infection.METHODS:A retrospective analysis was performed on the clinical data of children with febrile seizures after Omicron variant infection who were admitted to the Department of Neurology, Children's Hospital Affiliated to the Capital Institute of Pediatrics, from December 1 to 31, 2022 (during the epidemic of Omicron variant; Omicron group), and the children with febrile seizures (without Omicron variant infection) who were admitted from December 1 to 31, in 2021 were included as the non-Omicron group. Clinical features were compared between the two groups.RESULTS:There were 381 children in the Omicron group (250 boys and 131 girls), with a mean age of (3.2±2.4) years. There were 112 children in the non-Omicron group (72 boys and 40 girls), with a mean age of (3.5±1.8) years. The number of children in the Omicron group was 3.4 times that in the non-Omicron group. The proportion of children in two age groups, aged 1 to <2 years and 6-10.83 years, in the Omicron group was higher than that in the non-Omicron group, while the proportion of children in two age groups, aged 4 to <5 years and 5 to <6 years, was lower in the Omicron group than that in the non-Omicron group (P<0.05).The Omicron group had a significantly higher proportion of children with cluster seizures and status convulsion than the non-Omicron group (P<0.05). Among the children with recurrence of febrile seizures, the proportion of children aged 6-10.83 years in the Omicron group was higher than that in the non-Omicron group, while the proportion of children aged 3 years, 4 years, and 5 years in the Omicron group was lower than that in the non-Omicron group (P<0.05).CONCLUSIONS:Children with febrile seizures after Omicron variant infection tend to have a wider age range, with an increase in the proportion of children with cluster seizures and status convulsion during the course of fever.

目的 探讨儿童抗髓鞘少突胶质细胞糖蛋白免疫球蛋白G抗体相关疾病(MOGAD)急性期的视觉诱发电位(VEP)特点.方法 回顾性分析2018年5月至2020年2月收治的临床诊断为中枢神经系统特发性炎性脱髓鞘病(CNS-IIDDs)患儿的临床资料,根据血清MOG抗体检测结果以及是否存在视神经炎进行分组,分析不同组间VEP特点.结果 67例CNS-IIDDs患儿中,MOG抗体阳性组29例(43.3％),15例(51.7％)存在视神经炎;MOG抗体阴性组38例(56.7％),19例(50.0％)存在视神经炎.对所有患儿双眼分别进行VEP检测,MOG抗体阳性组含58只眼,MOG抗体阴性组含76只眼,共获得了134只眼的VEP结果.非视神经炎组66只眼中,MOG抗体阳性组的VEP异常率(14/28,50.0％)明显高于MOG抗体阴性组(9/38,23.7％),差异有统计学意义(P<0.05).视神经炎组68只眼中,MOG抗体阳性组的盲及重度视力损害比例高于MOG抗体阴性组,差异有统计学意义(P<0.05).在MOG抗体阳性组58只眼中,不同MOG抗体滴度组之间VEP异常率差异有统计学意义(P<0.05),随着MOG抗体滴度增高,VEP异常率有增高趋势.结论 VEP检查可以较好地发现MOGAD的视神经亚临床病灶.高MOG抗体滴度条件下发生视觉通路损伤的概率可能更高.

目的 初步探索原发性发育迟滞(DD)患儿血清维生素A、25-羟-维生素D3、维生素E含量及其与神经发育的相关性.方法 选取2019年3月至2020年2月首都儿科研究所附属儿童医院(以下简称"我院")神经内科就诊的原发性DD患儿33例为原发性DD组,另选取同期在我院保健科进行健康体检的30名儿童作为健康对照组.采用高效液相色谱串联质谱法测定两组血清维生素A、25-羟-维生素D3、维生素E的含量.采用《0岁-6岁儿童发育行为评估量表》评估原发性DD患儿的神经发育水平,并将各能区评分与维生素含量进行相关性分析.结果 原发性DD组维生素A含量和25-羟-维生素D3含量低于健康对照组(P＜0.05).两组血清维生素E含量比较,差异无统计学意义(P＞0.05).原发性DD组维生素A、25-羟-维生素D3及维生素E不足率高于健康对照组(P＜0.05).25-羟-维生素D3含量与精细运动能区得分呈正相关(r=0.375,P＜0.05).维生素A和25-羟-维生素D3为原发性DD的保护因素(OR＜1,P＜0.05).结论 原发性DD患儿血清维生素A及25-羟-维生素D3含量显著低于同龄健康儿童,血清25-羟-维生素D3缺乏对儿童精细运动的发育存在影响.

Yu, Linyang, Jinqing Feng, Chen Zhou, Xiaohan Zhu, Xiaobin Lou, Jian Yang, Haiying Qi, and Jia Li. Cognitive function mainly shaped by socioeconomic status rather than chronic hypoxia in adolescents at high altitude. High Alt Med Biol. 23:223-231, 2022. Background: The study evaluated cognitive function in relation to the changes in brain tissue oxygenation in three groups of high school students from different socioeconomic regions including Tibetans in Jiuzhi and Lhasa (both at 3,600 m), and Han in Beijing (44 m). Methods: Jiuzhi, Lhasa, and Beijing Group included 21 Tibetans, 24 Tibetans, and 23 Han, respectively. Wechsler Intelligence Scale was used for cognitive evaluation. Functional near infrared spectroscopy was used to measure the changes of oxygenated hemoglobin (oxy-Hb) during the cognitive assessment. Gross domestic product (GDP) was used to indicate the socioeconomic status. Results: All the cognitive scores were significantly lower in the two high altitude groups compared with the Beijing Group (p < 0.001). The scores in Jiuzhi Group were significantly lower compared with the Lhasa Group (p < 0.001). The changes in oxy-Hb in channels 6 and 15 in both high-altitude groups were significantly greater compared with the Beijing Group (p < 0.05), without significant difference between the two high-altitude groups. GDP was significantly correlated with all the scores (p < 0.001), but not altitude. Conclusions: Cognitive impairment occurs in adolescents at high altitude, being severer in Jiuzhi Group compared with the Lhasa Group. The lower performance in both high-altitude groups require greater brain activity over-compensated by cerebral oxygen delivery as indicated by the changes in oxy-Hb. The cognitive scores were significantly correlated with GDP rather than altitude. Cognitive function in adolescents at high altitude is not limited by chronic hypoxia, but mainly shaped by socioeconomic determinants.

目的 了解学龄前正常儿童事件相关电位N400潜伏期、波幅特点和发展规律,为早期发现学龄前儿童语言认知功能障碍提供客观依据.方法 对2015年8月-2020年1月健康体检的220例3～5岁学龄前正常儿童进行事件相关电位检测,采用声影匹配任务刺激,记录头皮电极Fz、Cz和Pz点N400的潜伏期和波幅.其中对127例记录了 F3、F4点N400的潜伏期和波幅.结果 学龄前正常儿童3～5岁组N400的潜伏期随年龄增加有逐渐缩短的趋势,但其差异无统计学意义(P＞0.05);N400的波幅存在随着年龄增长逐渐降低的趋势,在Fz点和Cz点3岁～组和4岁～组[Fz点(-10.95±9.78)vs.(-6.40±6.53)μV,Cz 点(-12.48±9.45)vs.(-7.71±7.80)μV]、3岁～组和5岁～组[Fz 点(-10.95±9.78)vs.(-7.01±7.47)μV,Cz点(-12.48±9.45)vs.(-7.62±7.90)μV]的差异有统计学意义(P＜0.05).性别和左右侧对学龄前儿童N400潜伏期和波幅的影响不显著(P＞0.05).结论 学龄前儿童的N400波形清晰稳定,潜伏期和波幅随着年龄增长而变化.

Several observational studies have reported associations between low levels of fat-soluble vitamins (A, D and E) and the incidence of pneumonia. Whether infection affects or negatively regulates serum vitamin levels remains controversial. Our aims were to develop and validate a simple-pretreatment and fast method to determine the serum levels of selected fat-soluble vitamins, namely vitamin A (retinol), vitamin D (25-OH-D3, 25-OH-D2, and 3-epi-25-OH-D3), and vitamin E (α-tocopherol), in children suffering from pneumonia during the acute phase and after inflammatory marker recovery. The sample preparation procedure involving protein precipitation and filtration was finished in one step, and separation took 8 min per sample. The calibrations were linear, with R2 > 0.99. Both the intra-run (n = 6) and inter-run (n = 3) precision (relative standard deviation, RSD%) values were below 14.61%. The spiked recoveries at 3 concentrations ranged from 80.97 to 111.91%. Accuracies were calibrated using both National Institute of Standards and Technology serum (NIST 968f) and external quality assurance (EQA) samples offered by the National Center of Clinical Laboratories of China, and the relative error (RE%) values ranged from -13.17% to 12.53%. Clinical sample analysis revealed that infection did alter the serum retinol concentration and it did not alter the 25-OH-D and α-tocopherol levels in young children with pneumonia.

Attention-deficit/hyperactivity disorder (ADHD) is one of highly prevalent neurodevelopmental disorders in children. It is of great value to find an objective, simple and non-invasive diagnosis method to compliment current diagnostic criteria. A discriminant correlation analysis (DCA) based multi-view feature fusion method combined with support vector machine (SVM) was proposed to identify ADHD children. The functional near-infrared spectroscopy signals from twenty-five ADHD children and twenty-five typically developing children were recorded during an n-back task. The DCA method was used to find a joint feature by fusing the features extracted in 1-back condition and 0-back condition. Then a SVM model was trained with the joint feature to identify the ADHD children. The results showed that the DCA-SVM method could identify the ADHD children with a classification accuracy of 88.0%. Meanwhile, part of left dorsolateral prefrontal cortex and left medial prefrontal cortex, posterior superior frontal cortex and bilateral temporal cortex were more discriminative in 1-back condition, left dorsolateral prefrontal cortex and part of left medial prefrontal cortex were more discriminative in 0-back condition. Our findings indicated that the DCA-SVM method is promising in clinical diagnosis of ADHD children.

Objective:To summarize the suspected cases of pertussis, to explore the pathogen, and to analyze the clinical features of pertussis.Methods:A retrospective study was conducted to analyze the clinical data of suspected pertussis cases who visited the Department of Infectious Diseases in the Children′s Hospital Affiliated to Capital Institute of Pediatrics from June 2015 to May 2019.Results:(1) The PCR test for respiratory secretions of Bacillus pertussis was completed in 400 cases, with 198 cases positive (49.5%). (2) Among the 198 cases, 158 cases with pertussis were less than 1 year old (79.8%), 113 cases had a clear history of close contact with cough patients (57.1%), and 162 cases were not vaccinated or did not complete full diphtheria and tetanus toxoids and pertussis(DTP) vaccination (81.8%). The incidence of spasmodic cough was 73.7%(146/198 cases); the duration from onset to diagnosis was (17.2±12.3) d; the incidence of cyanosis after cough was 31.3%(62/198 cases), cough with vomiting 17.7% (35/198 cases), inspiratory croup 12.1%(24/198 cases); other concomitant symptoms included wheezing, runny nose, fever, diarrhea, etc.(3) All the patients were divided into the pertussis group (198 cases), other pathogen group (104 cases), and unknown pathogen group (98 cases). Comparison of the clinical symptoms of the three groups showed the highest incidence of cyanosis after cough in pertussis group ( χ2=15.334, P<0.001), and the highest incidence of wheezing, dyspnea, fever, pulmonary rales and stridor in other pathogen group ( χ2=79.208, 38.214, 16.709, 44.794, 42.480, all P<0.001). The percentages of white blood cells, lymphocytes and platelets in the pertussis group were higher than those in the other two groups ( F=15.812, 18.198, 10.819, all P<0.001). Conclusions:Suspected cases of pertussis are infected with various pathogens.Improving the pertussis nucleic acid detection and respiratory virus detection can help to make a clear diagnosis.Pertussis is more common in infants under 1 year of age and in those who have not completed vaccination.The most prominent clinical symptom is spasmodic cough, and the incidence of cyanosis after cough is higher than that of patients infected with other pathogens.