联合包膜内外扁桃体等离子切除术、腭咽弓转粘膜瓣缝合腭咽成型术、腺样体等离子轮廓化切除治疗大儿童鼾症的疗效分析

目的探讨联合包膜内外扁桃体等离子切除术、腭咽弓转粘膜瓣缝合腭咽成型术、腺样体等离子轮廓化切除治疗大儿童鼾症的疗效。方法非随机选取2022年3月—2024年4月茂名市中医院收治的60例大儿童鼾症患儿作为研究对象,按治疗方法不同分为两组,各30例。对照组采用扁桃体包膜外等离子切除术与腺样体等离子消融术进行治疗,观察组采用包膜内外扁桃体等离子切除术、腭咽弓转粘膜瓣缝合腭咽成型术、腺样体等离子轮廓化切除进行联合治疗。对比两组手术指标、通气功能和睡眠质量、临床疗效、并发症发生情况。结果观察组术后疼痛时间、手术时间、住院时间、术中出血量均低于对照组,差异有统计学意义(P均<0.05)。治疗后,观察组睡眠呼吸暂停低通气指数低于对照组,睡眠质量高于对照组,差异有统计学意义(P均<0.05)。观察组疗效为100%(30/30),高于对照组的83.33%(25/30),差异有统计学意义(χ^(2)=5.454,P<0.05)。观察组并发症发生率为3.33%(1/30),低于对照组的20.00%(6/30),差异有统计学意义(χ^(2)=4.043,P<0.05)。结论采用包膜内外扁桃体等离子切除术、腭咽弓转粘膜瓣缝合腭咽成型术、腺样体等离子轮廓化切除联合治疗大儿童鼾症患儿,可改善患儿临床症状及相关手术指标,临床治疗效果较为理想且安全性较高,值得借鉴。

发现大儿童

不是穿件卡通衫就叫大儿童。他们骨子里有儿童的天真，兼具大人的老成。体现在穿着上时，你也能轻易辨识。

Canadian Agility and Movement Skill Assessment(CAMSA):Validity, objectivity, and reliability evidence for children 8–12 years of age

Purpose: The primary aim of this study was to develop an assessment of the fundamental, combined, and complex movement skills required to support childhood physical literacy. The secondary aim was to establish the feasibility, objectivity, and reliability evidence for the assessment.Methods: An expert advisory group recommended a course format for the assessment that would require children to complete a series of dynamic movement skills. Criterion-referenced skill performance and completion time were the recommended forms of evaluation. Children, 8–12 years of age, self-reported their age and gender and then completed the study assessments while attending local schools or day camps. Face validity was previously established through a Delphi expert(n = 19, 21% female) review process. Convergent validity was evaluated by age and gender associations with assessment performance. Inter-and intra-rater(n = 53, 34% female) objectivity and test–retest(n = 60, 47% female) reliability were assessed through repeated test administration.Results: Median total score was 21 of 28 points(range 5–28). Median completion time was 17 s. Total scores were feasible for all 995 children who self-reported age and gender. Total score did not differ between inside and outside environments(95% confidence interval(CI) of difference:-0.7 to 0.6;p = 0.91) or with/without footwear(95%CI of difference:-2.5 to 1.9; p = 0.77). Older age(p < 0.001, η2= 0.15) and male gender(p < 0.001, η2= 0.02)were associated with a higher total score. Inter-rater objectivity evidence was excellent(intraclass correlation coefficient(ICC) = 0.99) for completion time and substantial for skill score(ICC = 0.69) for 104 attempts by 53 children(34% female). Intra-rater objectivity was moderate(ICC = 0.52) for skill score and excellent for completion time(ICC = 0.99). Reliability was excellent for completion time over a short(2–4 days; ICC = 0.84) or long(8–14days; ICC = 0.82) interval. Skill score reliability was moderate(ICC = 0.46) over a short interval, and substantial(ICC = 0.74) over a long interval.Conclusion: The Canadian Agility and Movement Skill Assessment is a feasible measure of selected fundamental, complex and combined movement skills, which are an important building block for childhood physical literacy. Moderate-to-excellent objectivity was demonstrated for children 8–12 years of age. Test–retest reliability has been established over an interval of at least 1 week. The time and skill scores can be accurately estimated by 1 trained examiner.

Management of cholelithiasis in Italian children:A national multicenter study

AIM:To evaluate the management of Italian children with cholelithiasis observed at Pediatric and Surgical Departments linked to Italian Society of Pediatric Gastroenterology Hepatology and Nutrition. METHODS: One-hundred-eighty children (90 males, median age at diagnosis 7.3 years; range, 0-18 years) with echographic evidence of cholelithiasis were enrolled in the study; the data were collected by an anonymous questionnaire sent to participating centers. RESULTS: One hundred seventeen patients were treated with ursodeoxycholic acid; in 8 children dissolution of gallstones was observed, but the cholelithiasis recurred in 3 of them. Sixty-five percent of symptomatic children treated became asymptomatic. Sixty-four patients were treated with cholecystectomy and in only 2 cases a postoperative complication was reported. Thirty- four children received no treatment and were followed with clinical and echographic controls; in no case thedevelopment of complications was reported. CONCLUSION: The therapeutic strategies were extremely heterogeneous. Ursodeoxycholic acid was ineffective in dissolution of gallstones but it had a positive effect on the symptoms. Laparoscopic cholecystectomy was confirmed to be an efficacy and safe treatment for pediatric gallstones.

EFFECT OF ACUPUNCTURE ON CEREBRAL IMAGES IN AUTISM CHILDREN

Objective: To observe the effect of acupuncture on images in autism children. Methods; A total of 27 cases of autism children were subjected into this study. By using a SPECT, the cerebral images were collected before and after acupuncture treatment and analyzed according to the recommended methods in 《Clinical Nuclear Medicine》 for assessing the state of blood flow, radioactivity quantity distribution and radioactivity count in bilateral hemispheres. 'JIN's three-needling' was employed. The acupuncture treatment was given once every other day, with 4 months being a therapeutic course and an interval of one month between two courses. Results: After acupuncture treatment, of the 22 cases, 20 had remarkable improvement and 2 had improvement in cerebral blood flow, with the total effective rate being 90.8%. Before the treatment there were significant differences between the left and right cerebrum (P<0. 001), and between the left and right frontal lobes in radioactive areas (P<0.01); however, after treatment, no differences were found between them (P>0.05). After treatment, the radioactivity count in the whole brain decreased significantly in comparison with that of pretreatment (P<0.01). It indicates the improvement of cerebral blood flow and cellular metabolism after the treatment. Conclusion: Acupuncture can significantly improve cerebral blood flow in autism children.

Effect of oral garlic on arterial oxygen pressure in children with hepatopulmonary syndrome

AIM： To study the effect of oral garlic on arterial oxygen pressure in children with hepatopulmonary syndrome, METHODS： Garlic powder in a capsule form was given to 15 children with hepatopulmonary syndrome （confirmed by contrast echocardiography） at the dosage of 1 g/1.73 m^2 per day. Patients were evaluated clinically and by arterial blood gas every four weeks. RESULTS： The garlic capsule was administered to 15 patients with hepatopulmonary syndrome. There were 10 boys and 5 girls with a mean age of 9.4 ± 3.9 years. The underlying problems were biliary tract atresia （4 patients）, autoimmune hepatitis （4 patients）, cryptogenic cirrhosis （4 patients） and presinusoidal portal hypertension （3 patients）. Eight patients （53.3%） showed an increase of 10 mmHg in their mean arterial oxygen pressure. The baseline PaO2 was 65.6 ± 12.1 mmHg in the responder group and 47.1 ± 11.2 mmHg in nonresponder group. At the end of treatment the mean PaO2 in responders and non-responders was 92.2 ± 7.75 mmHg and 47.5 ± 11.87 mmHg, respectively （P 〈 0.01）. CONCLUSION： Garlic may increase oxygenation and improve dyspnea in children with hepatopulmonary syndrome.

Treatment of 140 cerebral palsied children with a combined method based on traditional Chinese medicine(TCM)and western medicine

Objective:To observe and evaluate a method that is effective and practical for treatment of cerebral palsied(CP)children in China.Method:The patient's age and disease type and individual specific conditions were considered in choosingtherapy methods accordingly:Chinese herbs,acupuncture,auricnlar seed pressure,point finger pressing,massage,orthopedichand manipulation,physiotherapy,occupational therapy,language therapy,etc.Meanwhile we created a new CP treatment modelthat combines hospitalized treatment with family therapy.Results:The majority of CP patients improved greatly in motor andsocial adaptation capacities after treatment.Wilcoxon paired rank sum test analysis showed that there were significant differencesbetween the data before and after treatment(P<0.01).Conclusion:This combined therapy method,based on traditional Chinesemedicine and western medicine plus family supplemental therapy,is an effective and practical treatment strategy for CP children inChina.

Dixy： A Connection Between the “Typographic Appearance” and the Brain of Children

This study presents a comparison between three different fonts in order to know the possible influence they may have when used in educational materials for children with readers difficulties resulting from dyslexia. Two of the three selected fonts （Arial and MeMimas） are frequently used in textbooks in Spain. The third type of letter （Dixy） was specially developed for typographic research purposes, following graphic features that according to literature and previous studies on reading patterns favor the dyslexic, and could improve reading skills in these individuals. To examine the quality of reading （speed and accuracy） between fonts, a small--but significant--sample was used. Ten children in Madrid, from eight to 10 years old were examined while reading words and pseudowords with three different fonts （Arial, MeMimas, and Dixy）. The result of the study shows the influence of the shapes of the letters in the legibility of texts with familiar and unfamiliar words （pseudowords） in children with dyslexia. The study showed that using the font Dixy, despite not being known by the children, reading is more accurate than using fonts known to them, such as Arial and MeMimas. As to the reading speed, the results indicate that, although the Dixy is a font never seen before by the children, reading speed is similar to a known font for them, as is the Arial, and greater than a hand writing font such as MeMimas.

Media as an Identity Negotiator Among ＂Swedish＂ Children in Athens and ＂Japanese＂ in London

With its transcultural perspective this paper looks at how families （i.e., parents and children） talk about children＇s identity and the importance of mothers＇ homeland media for the children, who are surrounded by a global popular media culture. Both studies used similar methods： interviews, participant observation, and photo-taking. The analysis shows the complexity of identity formation and the need to apply a contextual and relational perspective when wanting to understand the roles of media in the process of forming identity. The mothers＇ homeland media is an important construction tool in the process and helps the children not only with languages but also catch up with information about peers in mothers＇ homeland.

ROLE OF ACULASER THERAPY IN CEREBRAL PALSY CHILDERN (INITIAL DATA & RESULTS)

A single, open and non-comparative study was conducted at Anwar Shah’s First C.P. & Paralysis Clinic and Research Center to evaluate the effects of Aculaser (acupoint-laser) Therapy for children suffering from cerebral palsy (CP) of various types. These children were further classified according to their major complaints. Analysis of the data indicated that 11 children with severe spasticity and stiffness all showed marked improvement (100% success rate); of the 8 children with epileptic fits, 6 patients had a significant reduction in the intensity, frequency and duration of epileptic fits, while the rest 2 cases showed no any improvement or aggravation (75% success rate); out of 5 children with cortical blindness, 2 cases showed complete recovery of vision and 3 had marked improvement (40% cure rate); out of 4 children with hearing difficulties, 2 showed marked improvement (50% success rate); out of 14 children with aphasis, 8 showed improvement (57% improvement rate). Results of this study show that Aculaser Therapy has a high improvement rate of CP children, not only improving the spasticity and stiffness but also the cortical blindness, epilepsy, deafness and speech.

INFLUENCE OF DIFFERENT NEEDLE-RETAINING DURATION ON CEREBRAL HEMODYNAMICS OF CEREBRAL PARALYSIS CHILDREN

Objective: To investigate the effects of different needle-retaining duration on cerebral hemodynamics in cerebral paralysis (CP) children. Methods: A total of 20 cases of CP children were subjected into this study. Changes of systolic peak value (Vs), blood flow velocity at the end-diastolic phase (Ved), mean velocity (Vm), pulsation index (PI) and resistance index (RI) of the cerebral hemodynamics before and after performing JIN’s Three-Needling Therapy with the needles retained for 30 min (group A) and 5 min (group B) were observed by using transcranial Doppler ultrasonography (TCD). Results: After acupuncture, the blood flow in the middle cerebral artery (MCA), anterior cerebral artery (ACA) and posterior cerebral artery (PCA) was accelerated, and the resistance of blood vessels decreased. The effect of needle-retaining-30 min was better than that of needle-retaining-5 min. Conclusion: In treating cerebral paralysis by using JIN’s Three-Needling Therapy, sufficient stimulation provided by needle remaining is an important factor for achieving satisfactory therapeutic effects.

Exploration and Rethinking： Children-Voice Studies in China

This paper reviews children-voice studies in China's Mainland over the past 10 years in the context of the globalisation era. The traditional grand narrative in the field of contemporary education research in China has been challenged by individual recounts and by concemsregarding the situation in the classroom, which is reflected in the children-voice studies conducted by young researchers. The paper begins with background regarding society, culture, and schooling, continues on to describe related studies in this field, and ends with a rethinking of current research. The conclusion is that the studies were hampered both by an inherited culture of inertia and cynicism towards students＇ voices and by a dysfunction in research methodology.

The Use of Children＇s Literature With University English as a Foreign Language Learners in Taiwan

This paper reports findings from a longitudinal qualitative study that investigated the use of children＇s literature for Taiwan Residents University English as a Foreign Language （EFL） students＇ reading. During the course of their sophomore year, 17 students participated and each student held two to seven individual reading sessions, to which they brought a self-selected children＇s picture storybook or children＇s novel they had finished reading on their own and orally read it to the researcher. Their oral reading and the discussion of each book with the researcher were audio recorded. To gain insight into the reading progress, these oral data were categorized and analyzed in terms of mispronunciation patterns, misunderstanding of vocabulary, misinterpretation of sentence or passage, and researcher＇s guidance. General findings of the 17 participants were presented in three categories： （1） vocabulary acquisition, （2） common comprehension problems, and （3） common pronunciation problems. Further analysis of two motivated students who read five to seven books revealed that （1） these two EFL learners gradually developed conscious awareness of their own pronunciation and comprehension errors and （2） they progressively acquired better competence to apply the pronunciation tips and reading comprehension techniques provided by the researcher during previous sessions. These findings and corresponding implications are discussed and further research suggestions are made.

大小儿童的节日盛宴

儿童节原本只是小孩子的专属节日，可近年来，越来越多的大儿童也想要在这一天尽惜释放自己的童真，让我们一起来看看大小儿童们有趣的过节方式吧!

Review of evolution of clinical, training and educational services and research program for autism spectrum disorders in Hong Kong

The evolution of a local fragmented model of services for children with autism in Hong Kong emerged gradually over the past three decades with lack of government funding or support. This had been due to increasing number of children with autism being detected and referred for earlier assessment. With increasing pressure from parents due to long waiting time for assessment and training services and the increasing polarization by mass media there had been a gradual increasing public awareness over the past five years. Though still highly fragmented in the availability of services, there is a growing "business model" available in the community due to increasing need and lack of public funding for support. There is a lack of strategic planning for medical diagnostic and management issues in Hong Kong. Our University of Hong Kong based Autism Research Program was pioneered in 1985 based on the increasing load of autism cases referred for assessment for other developmental problems and diagnosed as Autism in the Duchess of Kent Children's Hospital. As the first author has been the staff of the University of Hong Kong, this program flourished as a research based program. The benefits of early identification and intervention of autism spectrum disorder(ASD) had been increasingly recognized, and with the increased public awareness and increasing trend of earlier diagnosis, there has been a continuously high demand from parents for earlier assessment and training for children suspected to have ASD. This model had not received extra funding for this integrated program for research, teaching and training in autism. We had to apply for various donations and grants to support the development of this pioneer program. The research output and organization of forums for public education and awareness are reviewed. The latter part of the paper reports the summary of clinical profile of autism cases(N=1441) assessed from 1985 to 2010 June under the University of Hong Kong. As the waiting time for initial developmental assessment for any children in Hong Kong is 12?24 months, we also report our preliminary experience with a newly launched triaging service provision for children suspected to be ASD since 2009, including multi-disciplinary assessment and parallel interim training in our university affiliated child assessment centre in Hong(N=89).