目的:了解团体心理治疗对孤独谱系障碍(ASD)患儿照料者的照料压力、抑郁及焦虑情绪的影响,并分析其影响因素.方法:选择2021年6月至2021年12月在浙大附属精神卫生中心儿童心理科进行康复训练的ASD患儿的照料者作为研究对象,并随机分为对照组及研究组;研究组予ASD患儿参加康复训练+照料者参加团体心理治疗;对照组予ASD患儿参加康复训练+针对照料者的科普宣教,采用照料者压力问卷(CGSQ)、抑郁自评量表(SDS)和焦虑自评量表(SAS)评价并比较两组ASD患儿照料者的照料压力、抑郁及焦虑情绪的变化.结果:共收集研究组23例,对照组21例.两组ASD患儿照料者经过治疗后照料压力、抑郁及焦虑水平均下降(P均＜0.05);封闭式团体心理治疗比普通科普宣教更能降低照料者的照料压力、抑郁及焦虑水平(P均＜0.05);其中文化程度高预测更好的团体心理治疗效果(r=-0.422,P=0.045).结论:团体心理治疗可缓解ASD患儿照料者的照料压力、抑郁及焦虑情绪,文化程度高是团体心理治疗效果的积极因素.

目的:探索基于严肃游戏构建的青少年自杀风险机器学习预测模型的性能.方法:从医院和学校共招募1135名9～18岁青少年,医生依据临床症状诊断、既往自杀史等资料,心理老师依据量表、观察、访谈等心理普查资料,将青少年自杀风险程度评估为无风险、低风险、中风险或高风险,通过严肃游戏软件获取其行为反应特征数据,运用机器学习算法建立行为反应特征和自杀风险的模型,并评估模型的预测性能.结果:机器学习模型对高风险的预测准确度最高(AUC=0.92),其次依次是中风险(AUC=0.85),无风险(AUC=0.74),低风险(AUC=0.62).模型在区分自杀风险的4个类别(无风险、低风险、中风险、高风险)上的预测准确率为0.81,召回率为0.69,精确率为0.64,F1值为0.66;在区分有无自杀风险上的预测准确率为0.84,召回率为0.80,精确率为0.66,F1值为0.69.结论:通过严肃游戏软件获取的行为反应特征数据集能够在一定程度上解释和预测青少年的自杀风险.

目的 探讨miR-4763-3p在注意缺陷多动障碍(ADHD)儿童血清中的表达及临床意义.方法 选取2019年6月—2022年6月浙江大学医学院附属精神卫生中心收治的ADHD儿童120例纳入观察组,另选取体检的健康儿童100例纳入对照组.采用Conners父母症状问卷评估患儿的行为症状,采集血清样本,应用RT-qPCR法检测样本中miR-4763-3p的表达水平,并比较两组血清miR-4763-3p水平,分析血清miR-4763-3p与ADHD患儿行为症状的相关性,采用ROC曲线分析miR-4763-3p诊断ADHD的临床价值.结果 ADHD患儿血清中miR-4763-3p的相对表达量为(6.75±0.97),对照组血清中miR-4763-3p的相对表达量为(9.12±1.84),两组比较差异有统计学意义(t=12.222,P＜0.001);ADHD-AI型、ADHD-HI型及ADHD-C 型 ADHD 患儿血清 miR-4763-3p 的相对表达量分别为(6.83±0.94)、(7.02±1.38)及(4.73±0.81),3 组 miR-4763-3p相对表达量比较差异有统计学意义(F=4.057,P＜0.05);ADHD-C混合型ADHD患儿血清miR-4763-3p的相对表达量明显低于 ADHD-AI 型和 ADHD-HI 型(t=11.657、9.168,P＜0.001),但 ADHD-AI 型和 ADHD-HI 多型 ADHD 患儿血清miR-4763-3p的相对表达量比较差异无统计学意义(t=0.595,P＞0.05);ADHD患儿血清miR-4763-3p的表达量与学习问题、品行问题、多动、冲动、焦虑及身心障碍评分呈负相关(P＜0.05);血清miR-4763-3p诊断ADHD的曲线下面积为0.834(95％CI:0.791-0.892,P＜0.001),诊断截断值为7.58,诊断灵敏度和特异度分别为91.03％和83.75％.结论 miR-4763-3p在ADHD患儿血清中呈低表达,且其表达水平与患儿行为症状有关,其可能成为ADHD临床诊断的辅助指标.

目的 探讨GRIN2A基因和GRIN2B基因单核苷酸多态性与哌甲酯治疗注意缺陷多动障碍(ADHD)疗效的关系.方法 选择2016年2月至2019年2月杭州市第七人民医院儿童心理科门诊及住院的6～15岁ADHD患儿80例,治疗前抽取外周血3 ml,用试剂盒提取DNA后-80℃冷冻备用.其中74例患儿完成8周的哌甲酯治疗随访,并于治疗前及治疗8周后进行SNAP-IV、中国韦氏儿童智力测试(C-WISC)、Conners父母评症状量表(PSQ)、注意力竞量测验(T.O.V.A.)和神经心理测评.以GRIN2A基因rs2229193和GRIN2B基因rs2284411作为候选基因位点,采用PCR扩增并结果判读.结果 GRIN2A基因G/A+A/A基因型患儿的SNAP-IV对立违抗分量表得分、PSQ品行问题项目得分均较G/G基因型高(均P＜0.01).GRIN2B基因T/C+T/T基因型患儿的SNAP-IV注意缺陷分量表得分较C/C基因型更高(P＜0.05).治疗有效和治疗无效患儿间GRIN2A基因G/A+A/A基因型频率与G/G基因型频率、GRIN2B基因T/C+T/T基因型频率与C/C基因型频率比较差异均无统计学意义(均P＞0.05);对立违抗改善与未改善患儿的GRIN2A基因G/A+A/A基因型频率与G/G基因型频率比较差异有统计学意义(P＜0.05),而GRIN2B基因T/C+T/T基因型频率和C/C基因型频率比较差异无统计学意义(P＞0.05).结论 GRIN2A基因中A等位基因携带组在接受哌甲酯治疗后,对立违抗行为显著减少,提示GRIN2A基因多态性可能与哌甲酯改善ADHD患儿对立违抗行为的疗效相关.

目的 分析药物治疗、感觉统合训练和行为治疗对儿童注意缺陷多动障碍的治疗效果.方法 选取杭州市第七人民医院2017年1月-2019年6月儿童心理科门诊收治的72例注意缺陷多动障碍(ADHD)患儿作为研究对象;采用随机数字表法将患儿分为对照组(药物治疗+行为治疗)和观察组(感觉统合训练+行为治疗+药物治疗),每组36例.比较2组患儿干预前后Conners父母问卷、感觉统合能力评分、SNAP-4评分、韦氏儿童智力量表(C-WISC)分值,比较2组患儿家属对干预效果的满意率.结果 干预后2组感觉统合能力各项分值均提高且观察组高于对照组(均P＜0.05).干预后2组Conners父母问卷均降低且观察组[(39.01±0.15)分]低于对照组[(41.65±0.16)分,=72.224,P＜0.001].干预后2组SNAP-4均降低且观察组[(56.21±3.21)分]低于对照组[(62.03±3.09)分,t=7.838,P＜0.001].干预后2组C-WISC各项分值均提高且观察组高于对照组(均P＜0.05).观察组家属满意率(97.22％)高于对照组(77.78％,x2=4.571,P=0.033).结论 在行为治疗、药物治疗基础上给予感觉统合训练能进一步提高患几感觉统合能力,改善其行为,提高智力水平和家属对干预效果的满意度,值得推广.

目的 分析注意缺陷多动障碍(ADHD)患儿血清胶质细胞源性神经营养因子(GDNF)和血管内皮生长因子C(VEGF-C)的表达水平,探讨其诊断价值.方法 选择2017年5月-2019年5月杭州市第七人民医院收治的200例ADHD患儿为观察组,另选择同期体检的200例健康儿童为对照组.采用酶联免疫吸附法(ELISA)检测血清GDNF和VEGF-C水平,采用Pearson法分析ADHD患儿血清GDNF、VEGF-C表达水平与血清铁蛋白、血镁及多动指数的相关性,采用ROC曲线分析血清GDNF、VEGF-C水平对儿童ADHD的诊断价值.结果 观察组血清铁蛋白、血镁水平及多动指数分别为(31.27±9.54)μg/L、(0.54±0.27)mmol/L及(1.87±0.24)分,对照组血清铁蛋白、血镁水平及多动指数分别为(60.62±10.85)μg/L、(0.91±0.36)mmol/L及(1.26±0.17)分,两组比较差异均有统计学意义(t=28.729,11.628,29.332,均P＜0.05).观察组血清GDNF和VEGF-C表达水平分别为(7.27±1.62)pg/ml和(35.62±8.17)ng/ml,对照组血清GDNF和VEGF-C表达水平分别为(9.45±2.15)pg/ml 和(26.27±6.24)ng/ml,两组比较差异均有统计学意义(t=11.452,12.862,P＜0.05).ADHD 患儿血清GDNF水平与血清铁蛋白、血镁水平均呈正相关(r=0.542、0.581,均P＜0.05),与多动指数呈负相关(r=-0.600,P＜0.05);血清VEGF-C水平与血清铁蛋白、血镁水平均呈负相关(r=-0.547、-0.586,均P＜0.05),与多动指数呈正相关(r=0.592,P＜0.05).血清 GDNF 水平诊断 ADHD 的曲线下面积为0.767(95％CI:0.721～0.813,P=0.000),灵敏度为79.0％,特异度为62.5％.血清VEGF-C水平诊断ADHD的曲线下面积为0.824(95％CI:0.783～0.865,P=0.000),灵敏度为72.5％,特异度为80.0％.血清GDNF和VEGF-C水平联合诊断ADHD的曲线下面积为0.833(95％CI:0.792～0.873,P=0.000),灵敏度为72.5％,特异度为85.5％.结论 ADHD患儿血清GDNF表达水平降低,VEGF-C表达水平升高,二者联合检测对儿童ADHD具有较高的诊断价值,临床检测儿童血清GDNF、VEGF-C表达水平对ADHD的早期诊断具有指导意义.

Autism spectrum disorder (ASD) seriously affects children's health, while the gut microbiome has been widely hypothesized to be involved in the regulation of ASD behavior. This study investigated and compared the number, diversity, and population structure of gut microbiota between healthy and ASD children and their susceptibility to zinc oxide nanoparticles (ZnONPs) based on the measurement of live cell number, living/dead bacterial staining test, flow cytometry observation and bacterial community analysis using 16S rRNA gene amplicon sequencing. The result of this present study revealed that ASD children not only significantly reduced the live cell number and the community diversity of gut bacteria, but also changed the gut bacterial community composition compared to the healthy children. In addition, this result revealed that ZnONPs significantly reduced the number of live bacterial cells in the gut of healthy children, but not in that of ASD children. In contrast, ZnONPs generally increased the gut bacterial community diversity in both ASD and healthy children, while a greater increase was found in ASD children than that of healthy children. Furthermore, this study successfully isolated and identified some representative nanoparticle-resistant bacteria based on the color, shape, and edge of colony as well as the 16S rDNA sequence analysis. The community of nanoparticle-resistant bacteria differed in between healthy and ASD children. Indeed, the representative strains 6-1, 6-2, 6-3 and 6-4 from healthy children were identified as Bacillus anthracis, Escherichia coli, Bacillus cereus and Escherichia coli with sequence similarity of 97.86%, 99.86%, 99.03% and 99.65%, respectively, while the representative strains 8-1, 8-2 and 8-3 from ASD children were identified as Bacillus cereus, with sequence similarities of 99.58%, 99.72% and 99.72%, respectively. Overall, this study demonstrated that ZnONPs caused a change in number, diversity, and species composition of gut bacteria, but differed in healthy and ASD children.

目的 系统评价经颅磁刺激(TMS)联合康复训练治疗孤独谱系障碍(ASD)的疗效.方法 检索PubMed、Web of Science、Google Scholar、EMBASE、Cochrane Library、知网、维普及万方数据库,检索时间为各数据库建库至2020年12月31日,收集TMS联合康复训练治疗ASD患者的随机对照研究,选取治疗后临床症状的量表评分为疗效指标.由2名研究者独立筛选文献,提取信息,评价纳入文献的方法学质量,进行Meta分析.结果 纳入10篇随机对照研究.TMS联合康复训练治疗ASD患者的临床效果优于单用康复治疗,包括儿童孤独症评定量表评分(OR=-1.06,95％CI:-1.50～-0.61,P＜0.05)、孤独症行为量表评分(OR=-0.95,95％CI:-1.46～-0.43,P＜0.05)、发育商评分(OR=0.74,95％CI:0.49～-0.98,P＜0.05).TMS联合康复治疗ASD患者刺激背外侧前额叶皮层、高频、低频等不同参数的效果均优于单用康复治疗(均P＜0.05).结论 TMS联合康复治疗ASD患者效果优于单用康复治疗.

Background. To date, around 4 per 100,000 adolescents committed suicide within the 29 OECD countries. The suicidal behavior is related to psychological factors, genetics, neurobiology, and other biomarkers. The aim of this study was to examine risk factors for the development of suicidal ideation in adolescent females with depression, focusing on the relationship between different testosterone levels and suicidal ideation, in order to help develop strategies to intervene in suicidal behavior in female adolescents with depression. Method. In this single-center prospective cohort study, we enrolled adolescent females with depression. We collected information on their baseline data, testosterone levels, symptom self-rating scale scores, suicidal ideation, non-suicidal self-injurious (NSSI) behaviours, and suicide attempts. We used multivariate logistic regression to identify risk factors for the development of suicidal ideation in adolescent females with depression. Results. A total of 113 hospitalized adolescent females were enrolled with a mean age of 13.5 (1.20). Among these patients, there were 86 (76.11%) subjects who suffered from suicidal ideation, 59 (52.21%) had NSSI and 23 (20.35%) had suicide attempt behavior. In the final model, higher level of testosterone (p=0.04) and higher age (p=0.02) were associated with the higher odds of having suicidal ideation. Conclusion. In this exploratory cohort study, the emergence of suicidal ideation was common among adolescent females with depression. This study is consistent with the other studies. It shows that the age is a potential predictor for suicidal ideation in hospitalized adolescent females with depression.

Attention-deficit hyperactivity disorder (ADHD) seriously affects children’s health, and the gut microbiome has been widely hypothesized to play a role in the regulation of ADHD behavior. The present study aims to the biosynthesize of zinc oxide nanoparticles (ZnONPs) by using Acinetobacter johnsonii strain RTN1, followed by their characterization through state-of-the-art material characterization techniques, viz., UV–vis spectroscopy, Fourier transform infrared spectroscopy, and transmission and scanning electron microscopic analyses with energy dispersive spectrometry. Moreover, we investigated and compared the population composition of gut microbiota and their susceptibility to biogenic ZnONPs between healthy and ADHD children based on the traditional plate method and 16S rRNA amplicon sequence analysis. The antibacterial effect of ZnONPs against gut bacteria was also determined by measurement of live cell number, living/dead bacterial staining test, and flow cytometry observation. The present study revealed that the number of live gut bacteria in healthy children was more than 10-fold higher than that in ADHD children; however, the community structure of gut bacteria has changed, while greater diversity was found in gut bacteria from ADHD children. In addition, we found that the number of live gut bacteria in healthy and ADHD children was reduced by ZnONPs, which shows an increased and reduced effect in composition of gut bacteria from healthy and ADHD children, respectively. It was also noted that the main mechanism of ZnONPs may be to inhibit the growth of gut bacteria rather than to kill them, while the nanoparticle-resistant strains in healthy children is also different from that in ADHD children. Some representative bacteria, in particular nanoparticle-resistant bacteria, were successfully isolated and identified. Overall, this study revealed the potential correlation of ADHD with gut bacteria and provided a new possibility to prevent ADHD by the combination of nanoparticle and its resistant bacteria.

目的 探究注意缺陷多动障碍(ADHD)合并肥胖患儿发病过程中肠道菌群特点.方法 选取2018年8月-2019年10月期间杭州市第七人民医院接诊的64例ADHD患儿作为本次研究对象,根据体重指数将其分为正常体重ADHD患儿(对照组,32例)和肥胖伴ADHD患儿(观察组,32例),采用宏基因组测序的方法测定粪便菌群,比较2组儿童之间菌群α多样性、物种分类的相对丰度及菌数量的差异.结果 观察组和对照组儿童肠道菌群α多样性差异较小(均P＞0.05).从菌属方面来看,观察组患儿的韦荣球菌属和粪肠杆菌属丰度低于对照组,但气味杆菌属和肠球菌属丰度高于对照组(均P＜0.05).从菌种方面来看,观察组患儿的毛螺科菌、普氏栖粪杆菌、小韦荣球菌以及活泼瘤胃球菌丰度低于对照组,木假单胞菌、粪拟杆菌以及内脏拟杆菌丰度高于对照组(均P ＜0.05).对照组患儿的直肠真杆菌菌数明显高于观察组,多形拟杆菌、双歧杆菌属以及乳酸杆菌菌数明显低于观察组(均P ＜0.05).结论 ADHD合并肥胖患儿肠道菌群发生了改变,或可为ADHD患儿治疗提供参考资料.

目的 探讨儿童青少年抑郁障碍患者合并拒绝上学行为的相关因素.方法 选取2019年3—12月在我院诊断抑郁障碍的儿童青少年患者共84例为研究对象,采用自制的一般情况量表、抑郁自评量表(SDS)、焦虑自评量表(SAS)及家庭亲密度与适应性量表(FACESⅡ)评估患者的人口学特征、临床症状严重程度及家庭功能.单因素及多因素分析儿童青少年抑郁障碍患者合并拒绝上学行为的影响因素.结果 单因素分析显示,女性、同伴关系紧张、父母受教育水平低、非独生子女、抑郁焦虑程度严重的儿童青少年抑郁障碍患者合并拒绝上学行为率更高,差异有统计学意义(P<0.05);多因素分析显示,同伴关系紧张、父亲受教育水平低、非独生子女、抑郁程度高是儿童青少年抑郁障碍患者出现拒绝上学行为的危险因素(P<0.05).结论 儿童青少年抑郁障碍患者合并拒绝上学行为较普遍,而同伴关系紧张、父亲受教育水平低、非独生子女、抑郁程度高是儿童青少年抑郁障碍患者出现拒绝上学行为的危险因素.

目的 探讨N-甲基-D-天冬氨酸受体(NMDAR)亚基NMDA2A基因(GRIN2A)和NMDA2B基因(GRIN2B)单核苷酸多态性与注意缺陷多动障碍(ADHD)的关系.方法 选择2016年2月至2018年4月就诊于浙江大学医学院附属精神卫生中心(杭州市第七人民医院)儿童心理科门诊及住院的ADHD患儿(ADHD组)49例及同时期健康体检儿童(健康对照组)50例,抽取外周血样本,提取DNA,根据dbSNP数据库及既往文献选取GRIN2A的rs2229193和GRIN2B的rs2284411作为候选基因位点,设计引物序列,行PCR扩增及结果判读.比较两组GRIN2A基因型频率G/G和G/A,GRIN2B基因型频率C/C和(T/C+T/T)的分布差异.结合ADHD症状评定量表和神经心理测评[SNAP-Ⅳ儿童注意力量表(包含注意缺陷分量表、多动冲动分量表、对立违抗分量表)、中国韦氏儿童智力量表(C-WISC)、Conners父母评症状量表(PSQ)、注意力竞量测验(T.O.V.A.)]得分,比较GRIN2A、GRIN2B不同基因型ADHD患儿的症状.结果 两组GRIN2A基因型频率、GRIN2B基因型频率分布比较,差异无统计学意义(P>0.05).GRIN2A为G/A+A/A基因型的患儿较G/G基因型的患儿有更高的SNAP-IV对立违抗分量表得分以及更高的PSQ品行问题得分,差异均有统计学意义(均P<0.05).两者SNAP-IV其他分量表得分、C-WISC、PSQ、T.O.V.A.比较,差异均无统计学意义(均P>0.05).GRIN2B为C/C基因型和T/C+T/T基因型的两种患儿SNAP-IV、C-WISC、PSQ、T.O.V.A.比较,差异均无统计学意义(均P>0.05).结论 GRIN2A中A等位基因携带患儿可能有更多的对立违抗行为和品行问题,提示GRIN2A基因多态性可能与ADHD患儿对立违抗障碍及品行障碍相关.

Autism spectrum disorder (ASD) seriously affects children's health. Recently, propionic acid (PA) has been reported to play a significant role in the formation of ASD. In this study, we investigated the community structure of PA-related bacteria in healthy and ASD children by isolation and culture, while a group of representative PA-related bacteria were identified and characterized based on colony morphological observation, physiological and biochemical tests, as well as living/dead cells staining analysis and 16S rRNA gene sequencing. The results showed that the number of PA-related bacteria in healthy children was >100-fold higher than that in ASD children, while compared to healthy children, greater diversity was found in PA-associated bacteria from ASD children. The sensitivity of the representative strains to PA was affected by bacterial species, PA concentration and incubation time. The decrease of pH value was found in PA-resistant Lactobacillus plantarum strain 6-1 but not in PA-sensitive Enterococcus lactis strain 4-1, while biofilm formation of both strains were unaffected by PA. Furthermore, PA inhibited the propagation of the two selected bacteria rather than killed them, while the greater inhibitory effect was observed on strain 4-1. Overall, the result is of great significance for revealing the role of PA-related bacteria in development of ASD.

目的 研究听觉统合训练对孤独症儿童的疗效及起效时间.方法 选取住院孤独症患儿80例,符合ICD-10儿童孤独症的诊断标准,随机分为研究组和对照组,各40例.两组均进行一般康复训练,研究组在康复训练时给予1个疗程的听觉统合训练.分别用孤独症行为检查量表(ABC量表)及儿童孤独症评定量表(CARS量表)在训练前、训练开始1、3及6个月后评估患儿症状.结果 研究组在治疗1、3、6个月后效果均优于对照组(均P＜0.05).结论 听觉统合训练起效较快,且对后续康复训练有一定帮助,值得临床借鉴推广.

Backgrounds: Although increasing evidence suggests a role for the gut microbiota in neurodevelopment, the actual structure and composition of microbiota in children with attention-deficit/hyperactivity disorder (ADHD) remain unclear. Methods: Thus, the present study aimed to define the characteristics of gut microbiota in treatment-naive children with ADHD and to assess their relationship with the severity of ADHD symptoms. High-throughput pyrosequencing was used to investigate the microbiota composition in fecal matter from 51 children with ADHD and 32 healthy controls (HC). Results: An operational taxonomical unit (OTU)-level analysis revealed a significant decrease in the fractional representation of Faecalibacterium in children with ADHD compared to HC. In individuals with ADHD, the abundance of Faecalibacterium was negatively associated with parental reports of ADHD symptoms. However, there was no significant difference in alpha diversity between the ADHD and control groups. Conclusions: This present findings support the involvement of microbiota alteration in psychiatric diseases and Faecalibacterium may represent a potential novel marker of gut microbiota in ADHD. Future studies are needed to validate these findings and to elucidate the temporal and causal relationships between these variables.

Objective:To explore the regional brain activities in healthy adolescent subjects after sleep deprivation (SD) using amplitude of low-frequency fluctuation (ALFF) method.Methods:Total of 16 healthy adolescent subjects (8 males,8 females;aged 13-20 years) were recruited in the community and the campus through the internet and posters.Each of the 16 healthy adolescent subject underwent the attention network test and magnetic resonance imaging (MRI) session twice:once was after rested wakefulness (RW condition),and the other was after SD condition.Amplitude of low frequency fluctuation (ALFF) method was used to assess the local brain features.The mean ALFF signal values of the different brain areas were performed to investigate their relationships with the accuracy rate,reaction time and lapse rate in the attention network test,and were analyzed with a receiver operating characteristic (ROC) curve to investigate their sensitivities and specificities to distinguish the SD condition from the RW condition.Results:Subjects showed a lower response accuracy rate [(83 ± 12) ％ vs.(97 ± 4) ％,P ＜ 0.05],a longer response time [(832 ± 134) ms vs.(715 ± 97) ms,P ＜ 0.05] and a higher lapse rate [(15 ± 11)％ vs.(2.4 ±7.3)％,P ＜0.05] under SD condition than under RW condition.They showed higher ALFF area in the right cuneus (BA 17,BA 18),and lower ALFF areas in the right lentiform nucleus,right claustrum,left dorsolateral prefrontal cortex (BA 46) and left inferior parietal cortex (BA 39) under SD condition than under RW condition.Under SD condition,the mean ALFF signal value of the right claustrum showed a significant positive correlation with the accuracy rate (r =0.69,P ＜0.05),and a negative correlation with the lapse rate (r =-0.71,P ＜0.05).The mean ALFF signal value of the dorsolateral prefrontal cortex showed a significant positive correlation with the reaction time (r =0.68,P ＜ 0.05).The values of area under the curve of the right cuneus,right lentiform nucleus,right claustrum,left dorsolateral prefrontal cortex and left inferior parietal cortice were 0.9,0.8,0.9,0.8 and 0.9,respectively.These different ALFF areas also showed high degree of sensitivities and specificities.Conclusion:Sleep deprivation leads to the dysfunction in the default mode network,anticorrelated " task-positive" network,and advanced cognitive function brain areas,and the functional compensation in the visual network.

目的 探讨注意缺陷多动障碍(ADHD)儿童的气质类型,了解与ADHD儿童气质的相关因素.方法 采用中国学龄儿童气质量表(CSTS)测查115例6～12岁ADHD儿童及115例正常对照组,同时采用自制儿童生长发育调查表,内容包括儿童家庭情况、母亲妊娠期和围生期、儿童出生发育的既往史和现病史三大部分,由家长填写,分别对115例ADHD儿童及115例正常儿童进行评定.结果 ADHD儿童气质维度9个因子分中8个高于对照组,在活动水平、坚持度、注意分散度、趋避性比较差异有统计学意义(P＜0.05或P＜0.01);而节律性、适应性、情绪本质、反应强度、反应阈等5个维度差异无统计学意义(P＞0.05).ADHD儿童气质类型以难养型为主,与对照组比较差异有统计学意义(x2=6.9,P＜0.05).单因素spearman相关分析,结果表明父母的职业、学历、父亲吸烟及嗜酒、母亲孕期疾病、精神创伤、看电视时间、家庭结构、居住面积及喂养方式与ADHD儿童的气质相关.结论 ADHD儿童的气质特点,与家庭情况、母孕期及儿童生长发育中的不良因素相关.

注意缺陷多动障碍（attention-deficit+hyperactivi-ty+disorder，ADHD）的主要特征表现是注意力不集中、多动和冲动[1]。《美国精神障碍诊断与统计手册（第4版）》把ADHD分成三种亚型[2]：注意力缺陷、多动/冲动、注意力缺陷合并多动。国内报道在学龄期患病率约为3%～5%[3]。儿童社会期望作为一种人格特征，反映了儿童对社会认可的依赖程度，即儿童对社会认可的需要或对社会不认可的恐惧，是影响个人行为的重要内在动机之一[4]。本次研究从教养方式角度分析影响ADHD儿童社会期望的原因，以期能够提出一些有效建议，进一步促进孩子的身心健康发展。