Efficacy of Children Neuropsychological and Behavioral Scale in Screening for Autism Spectrum Disorders through a Combination of Developmental Surveillance

Objective This study aimed to explore the clinical value of Children Neuropsychological and Behavioral Scale-Revision 2016(CNBS-R2016)for Autism Spectrum Disorder(ASD)screening in the presence of developmental surveillance.Methods All participants were evaluated by the CNBS-R2016 and Gesell Developmental Schedules(GDS).Spearman’s correlation coefficients and Kappa values were obtained.Taking GDS as a reference assessment,the performance of the CNBS-R2016 for detecting the developmental delays of children with ASD was analyzed with receiver operating characteristic(ROC)curves.The efficacy of the CNBS-R2016 to screen for ASD was explored by comparing Communication Warning Behavior with Autism Diagnostic Observation Schedule,Second Edition(ADOS-2).Results In total,150 children aged 12–42 months with ASD were enrolled.The developmental quotients of the CNBS-R2016 were correlated with those of the GDS(r=0.62–0.94).The CNBS-R2016 and GDS had good diagnostic agreement for developmental delays(Kappa=0.73–0.89),except for Fine Motor.There was a significant difference between the proportions of Fine Motor,delays detected by the CNBS-R2016 and GDS(86.0%vs.77.3%).With GDS as a standard,the areas under the ROC curves of the CNBS-R2016 were above 0.95 for all the domains except Fine Motor,which was 0.70.In addition,the positive rate of ASD was 100.0%and 93.5%when the cut-off points of 7 and 12 in the Communication Warning Behavior subscale were used,respectively.Conclusion The CNBS-R2016 performed well in developmental assessment and screening for children with ASD,especially by Communication Warning Behaviors subscale.Therefore,the CNBS-R2016 is worthy of clinical application in children with ASD in China.

Development of a frailty scale for elderly people in China

Objective:The aim of this study was to develop a frailty scale for the elderly in China and to examine its reliability and validity.Methods:The method of convenient sampling was used to select 375 elderly individuals in different communities of Tianjin,China.EuroQpl-5D was used to evaluate the criterion validity.Cronbach's αcoefficients,correlation analysis,exploratory factor analysis,criterion-related validity,and internal consistency were used to evaluate the reliability and validity of the scale.To evaluate the test—retest reliability,30 old people were re-evaluated after 2 weeks.Results:The final version of the frailty scale(FI-35) consisted of 35 items.Eleven factors were extracted by a principal factor analysis and varimax rotation,with a cumulative contribution of 86.00%.Eleven dimensions were positively correlated(r = 0.130-0.541,P < 0.01).Cronbach's α coefficient was 0.952,and the alpha coefficients of 11 dimensions ranged from 0.730 to 0.992.The test-retest reliability was0.874 for the total scale.The split-half reliability of the scale was 0.808.Structural equation modeling was used to perform a confirmatory factor analysis,and various parameters were all acceptable.Conclusions:FI-35 met the requirement of scale development and showed good reliability and validity;thus,it can be used as an efficient frailty measurement tool for Chinese elderly.

Development and psychometric evaluation of the Ethical Behavior for Thai Nurses Scale

Background:Ethical problems in the nursing profession are mostly found in the undesirable ethical behavior(EBE)of nurses.If there is no concern about these problems,it may negatively affect the quality of nursing care,patients’safety,and trust in the nursing profession.In assessing nurses’EBE,it is important to develop an instrument that reflects the actual EBE of nurses.Objectives:To develop and evaluate the psychometric properties of the Ethical Behavior for Thai Nurses Scale(EBTNS).Methods:The construct definition,5 sub-constructs,43 items,and the hypothesized model were synthesized and generated from a comprehensive literature review and existing research instruments by using document analysis.The EBTNS was verified for content validity by 4 experts.Of the 43 items,37 items were retained for psychometric testing.The construct validity was tested by using second-order confirmatory factor analysis(CFA).The EBTNS was tested on 1500 professional nurses working at tertiary,secondary,and primary hospitals in 6 regions(the central,northern,northeast,eastern,western,and southern)of Thailand.Proportional quota sampling was applied to recruit participants.Results:The hypothesized model fitted the empirical data.All 37 first-order indicators and 5 second-order sub-constructs showed significantly standardized factor loadings and effect sizes.The standardized factor loadings of 37 first-order indicators ranged from 0.58 to 0.89,and the construct reliabilities were moderate to substantial(R2=0.34-0.79).The 5 second-order sub-constructs displayed the standardized effect sizes,ranging from 0.81 to 0.96,and accounted for 65%-96%of the total explained variance.In addition,the construct validity was supported by convergent validity and discriminant validity.It also satisfied Cronbach’s alpha coefficients of 5 sub-constructs from 0.87 to 0.94,and a full scale was 0.97.Conclusions:The psychometric properties of the EBTNS are acceptable.This instrument has the potential to be used for evaluating and monitoring to prevent ethical problems of Thai nurses.

Development and psychometric evaluation of the nurse behavior toward confirmed and suspected HIV/AIDS patients (NB-CSHAP) scale

There is a scarcity of literature discussing nurses’ behaviors toward caring for suspected or confirmed human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome (AIDS) patients. The development of a scale specific to measure nurses’ behaviors will allow health institutions to assess the disposition of their nurses in terms of HIV care. This study aims to present the rigors of developing and validating a reliable instrument to contextualize these nurses’ behaviors. This study utilized a sequential exploratory mixed method design to develop the NB-CSHAP scale. Thematic analysis was done on the qualitative data from the interviews with persons living with HIV/AIDS (PLHA) from which items were selected to be included in the scale. Exploratory factor analysis was utilized to extract the factors and Cronbach’s alpha was used to assess the reliability of the instrument. Four factors were extracted and are categorized as either caring or discriminatory behaviors. These include: (1) service-oriented, (2) openhanded, (3) perceptive, and (4) discriminatory. The scale has an internal consistency of 0.73. The scale shows acceptable psychometric properties, hence can be used to assess the nurses’ behaviors in caring for confirmed or suspected HIV clients. The scale may be used by health institutions to determine the quality of the patient care provided by their nurses to clients with confirmed or suspected HIV .

Development and Initial Validation of the Personal and Social Responsibility Scale in Physical Education Settings

This study aims to develop a valid instrument measuring personal and social responsibility in physical education settings that is suitable for Chinese high school students age 14 and above.This instrument consists of eight aspects,which builds upon the levels of responsibility in Hellison’s(2011)[9]Teaching Personal and Social Responsibility Model(TPSR).The eight aspects in the measurement include goal,responsibility,respecting the rights and feelings of others,participation and effort,self-direction,caring,and value.The validation of the measurement was conducted based on the responses from 1091 high school students in Macao,China.The convergent and discriminant validity tests and a maximum likelihood confirmation factor analysis were performed using AMOS 21.The Bollen-Stine bootstrapping model was applied to adjust nonnormality data.Results supported a good validity and reliability of the items in the instrument.

Hospital-acquired insomnia scale:A validity and reliability study

BACKGROUND Sleep breathing,one of the basic human needs,is a physiological need that affects cardiac functions,body temperature,daily vitality,muscle tone,hormone secretion,blood pressure,and many more.In the international literature,studies reported that patients have had sleep problems in the hospital since the 1990s,but no measurement tool has been developed to determine the causes of hospitalacquired insomnia in individuals.These findings suggest that sleep remains in the background compared to activities such as nutrition and breathing.Although patients generally experience hospital-acquired sleep problems,there is no measurement tool to determine hospital-acquired sleep problems.These features show the originality of the research.AIM To develop a measurement tool to determine the sleep problems experienced by patients in the hospital.METHODS A personal information form,hospital-acquired insomnia scale(HAIS),and insomnia severity index(ISI)were used to collect research data.The study population consisted of patients hospitalized in the internal and surgical clinics of a research hospital in Turkey between December 2021 and March 2022.The sample consisted of 64 patients in the pilot application stage and 223 patients in the main application stage.Exploratory factor analysis and confirmatory factor analysis(CFA)analyses were performed using the SPSS 20 package program and the analysis of moment structure(AMOS)package program.Equivalent forms method used.RESULTS The HAIS consisted of 18 items and 5 subscales.The Cronbach alpha values of the subscales ranged between 0.672 and 0.842 and the Cronbach alpha value of the overall scale was 0.783.The scale explained 58.269%of the total variance.The items that constitute the factors were examined in terms of content integrity and named as physical environmental,psychological,safety,socioeconomic,and nutritional factors.CFA analysis of the 5-factor structure was performed in the AMOS package program.The fit indices of the obtained structure were examined.It was determined that the values obtained from the fit indices were sufficient.A significant correlation was determined between the HAIS and the ISI,which was used for the equivalent form method.CONCLUSION The HAIS is a valid and reliable measurement tool for determining patients’level of hospitalacquired insomnia.It is recommended to use this measurement tool to determine the insomnia problems of patients and to adapt it in other countries.

Towards a profile-based writing scale for a local post-admission ESL writing assessment

Post-admission language tests tend to have a restricted range of proficiency levels among test-takers due to considerations made during the admission selection process.Although range restriction can present challenges for proficiency-focused assessment,it can also bring opportunities to zoom in on fine-grained performance profiles of test-takers.This study reports on the validation of a profile-based rating scale for an ESL writing placement test in a US university.The profile-based rating scale was created by employing a three-staged,hybrid scale development approach,to provide not only accurate placement decisions but also fine-grained diagnostic information regarding ESL students’writing performance profiles.The scale strikes a balance between argument development and lexico-grammar,to better account for the range of writing performances among test-takers.To gather validity evidence for the profile-based rating scale,this study employs a sequential,mixed-methods approach to examine the quality of test-taker performances across profiles and rater perceptions on the scale.Nine certified raters were recruited to conduct independent evaluations of lexicogrammar and argumentation on a sample of 150 test-taker performances.These evaluations were subjected to many-facet Rasch measurement analysis to examine the differences across writing performance profiles included in the rating scale.Next,semi-structured,follow-up interviews were conducted with the raters,to complement the quantitative findings on the usability and effectiveness of the scale.The findings provide supportive evidence for the validity of the profile-based rating scale.I argue that by focusing on performance profiles,post-admission language tests can strengthen the alignment across curriculum,instruction,and assessment in ESL writing programs.

Towards Lessening Learners’Aversive Emotions and Promoting Their Mental Health:Developing and Validating a Measurement of English Speaking Demotivation in the Chinese EFL Context

While a plethora of studies has been conducted to explore demotivation and its impact on mental health in second language(L2)education,scanty research focuses on demotivation in L2 speaking learning.Particularly,little research explores the measures to quantify L2 speaking demotivation.The present two-phase study attempts to develop and validate an English Speaking Demotivation Scale(ESDS).To this end,an independent sample of 207 Chinese tertiary learners of English as a Foreign Language(EFL)participated in the development phase,and another group of 188 Chinese EFL learners was recruited for the validation of the scale.Exploratory Factor Analysis(EFA)and Confirmatory Factor Analysis(CFA)were employed to determine the factor structure of the scale.The EFA results revealed a six-factor solution with Teacher-related Factors in Learning Spoken English(TFLSE),Interest and Valence in Learning Spoken English(IVLSE),Self-efficacy in Learning Spoken English(SELSE),Negative Peer Influence in Learning Spoken English(NPILSE),Undesirable Environment for Learning Spoken English(UELSE),and Negative Influence of Assessment and Learning Materials in speaking class(NIALM).In the validation phase,Confirmatory Factor Analysis(CFA)was performed to validate the internal structure of the scale.The CFA results showed that the model fits the data well.Overall,the ESDS is a robust and trustworthy psychometric tool that could be utilized to examine L2 speaking demotivation.Implications for diminishing EFL learners’demotivation,lessening their aversive emotions and promoting their mental health are also discussed.

Infanib量表和Gesell发育量表在儿童运动发育评估中的一致性研究

目的探讨infant neurological international battery(Infanib)量表和Gesell发育量表在高危儿运动发育评估中的一致性。方法2022年5月至2023年4月,以在本院就诊的132例高危儿为研究对象,同时使用Infanib量表和Gesell发育量表评估其运动发育,通过计算Kappa值判断评估结果的一致性。结果132例中有111例(84.09%)儿童的Infanib量表和Gesell发育量表评估结果一致,均被评估为正常儿的有90例,而均被评估为境界儿(可疑)或发育迟缓的有21例。Infanib量表和Gesell发育量表在大运动发育商方面的一致性为0.57。在<4月龄、4~8月龄和>8月龄儿童中,二者的评估一致性分别为0.62、0.67和0.41。在足月高危儿中,Infanib量表和Gesell发育量表评估结果的一致性为0.61;在早产高危儿中,二者的评估一致性为0.32。结论Infanib量表和Gesell发育量表的评估一致性整体较好,但在>8月龄儿童和早产高危儿中的一致性偏低。建议根据患儿月龄、出生情况有针对性地选取不同量表进行评估,以准确反映儿童运动发育的真实水平。

Development of a Tool for Assessment of Post-Myocardial Infarction Fatigue

Introduction: After treatment for myocardial infarction (MI) quite a few persons will experience different symptoms, including fatigue, during the recovery phase. The aim of the present study was to construct the multidimensional Post-Myocardial Infarction Fatigue (PMIF) scale, based on empirical data gathered in coronary heart disease contexts. Methods: The construction of the post-MI fatigue scale was conducted in seven steps, ending in a psychometric evaluation of the internal structure of the scale, using confirmatory factor analysis, as well as testing of convergent and discriminant validity, using correlational analysis, in a sample of 141 persons treated for MI. Results: The results showed that the PMIF scale represents three dimensions: physical, cognitive and emotional fatigue. It was also found that the scale is suitable for summing the items to obtain a total score representing a post-MI global fatigue dimension. Conclusion: The PMIF is a brief and easily completed scale for identifying persons experiencing post-MI fatigue. Early identification of fatigue, together with health behavior support, might prevent progression toward a more severe state of fatigue.

磁共振弥散张力成像在早产儿脑白质损伤及神经发育预后评估中的应用

目的探讨磁共振(MRI)弥散张力成像(DTI)在早产儿脑白质损伤(WMI)及神经发育预后评估中的应用价值。方法选择早产儿149例,均行头部MRI+DTI检查,记录感兴趣区(ROI)各向异性分数(FA)、表观弥散系数(ADC)值,根据检查结果将早产儿分为WMI组40例、nWMI组109例,并按检查时纠正胎龄分为33~34周、35~36周、≥37周,比较WMI组与nWMI组各胎龄FA值、ADC值。39例早产儿在纠正月龄约6个月时用格塞尔(Gesell)发育量表评估发育情况,其中适应性行为发育落后18例、个人-社会行为发育落后16例、大运动行为发育落后21例、精细运动行为发育落后25例、语言行为发育落后19例,Spearman相关法分析FA值、ADC值与Gesell发育量表评分的相关性。结果nWMI组不同纠正胎龄阶段各ROI的FA值均高于WMI组(P均<0.05)。纠正胎龄33~34周,WMI组侧室旁白质、胼胝体膝部白质的ADC值高于nWMI组(P均<0.05);纠正胎龄35~36周,WMI组胼胝体膝部、内囊后肢ADC值高于nWMI组(P均<0.05);纠正胎龄≥37周,WMI组半卵圆中心白质、脑室旁白质、胼胝体膝部及内囊后肢白质ADC值高于nWMI组(P均<0.05)。大运动发育落后早产儿脑室旁白质的ADC值与Gesell发育量表评分呈负相关(r=-0.594,P<0.05),认知行为发育落后早产儿内囊前肢的ADC值与Gesell发育量表评分呈负相关(r=-0.524,P<0.05)。结论DTI检查的内囊前肢、后肢及脑室旁白质FA值可反映早产儿WMI情况,脑室旁白质ADC值可反映其大运动发育情况。

Development of a Canadian Adaptation of the Facts on Aging Quiz

Accurate knowledge about older adults is desirable for research into aging populations. The Palmore Facts on Aging Quiz (FAQ) has been one of the most widely used measures of knowledge about aging that has been used in English-speaking countries. The original true-false version has largely been replaced by the current multiple-choice format. Here I present data on a Canadian multiple-choice FAQ from 172 older adult residents in the community with a mean age of 70.3 years old (SD = 8.88). The mean percentage correct on the Canadian FAQ-2C was 54.4%, a proportion higher than the recent Australian data and some older American data on older adults. The Canadian adaptation of the modified Australian multiple-choice version demonstrates the value of the local verification of FAQ items’ scoring key if the knowledge assessed by the FAQ is to be used accurately in a different country or if the local scoring key was developed several years earlier.

序贯化发育干预对出生胎龄34周及以前早产儿早期神经运动发育的影响

目的探讨序贯化发育干预计划对出生胎龄≤34周早产儿早期神经运动发育的影响。方法回顾性分析2018年10月至2022年2月在南通大学附属江阴医院新生儿重症监护室(NICU)住院并在该院和江阴市妇幼保健院儿童保健门诊建立健康档案随访至校正6月龄的120例出生胎龄≤34周早产儿的临床资料。根据不同干预方法将其分为观察组(60例)和对照组(60例)。对照组采用常规发育干预:在NICU住院期间采用母乳或早产儿配方奶粉喂养,未进行初乳口腔护理、口腔运动干预、袋鼠护理相关措施,出院后按常规发育规律进行门诊随访指导训练。观察组采用序贯化发育干预:在NICU住院期间采用母乳或早产儿配方奶粉喂养的基础上进行初乳口腔护理、口腔运动干预、袋鼠护理相关措施,出院后复诊时按计划进行全身运动质量评估(GMs)及20项神经运动检查,根据检查结果指导个体化家庭干预。采用0~6岁儿童发育行为评估量表对两组早产儿校正6月龄的发育商结果进行评估。结果两组早产儿出生胎龄、出生体重、出生身长、出生头围,以及性别、宫内发育迟缓、胎膜早破、剖宫产、母亲妊娠期糖尿病、多胎、重度窒息、中重度支气管肺发育不良、颅内出血(Ⅲ~Ⅳ级)、有创机械通气的分布比较差异均无统计学意义(P>0.05)。校正6月龄,观察组早产儿发育商评分明显高于对照组[(79.36±7.12)分vs.(75.96±6.93)分,t=2.647,P<0.05],其中两组的大运动[(86.93±9.06)分vs.(83.67±8.31)分]、精细运动[(80.44±7.46)分vs.(76.63±7.86)分]、适应能力[(76.81±8.39)分vs.(71.95±10.98)分]、社会行为[(76.09±9.01)分vs.(72.68±6.93)分]评分均明显高于对照组(t值分别为2.052、2.725、2.722、2.316,P<0.05),而两组的语言评分比较差异无统计学意义[(77.31±9.50)分vs.(74.84±9.45)分,t=1.423,P>0.05)]。校正6月龄,两组早产儿的体重、身长比较差异均无统计学意义(P>0.05),但观察组头围发育较对照组更好[(42.88±0.74)cm vs.(42.58±0.85)cm,t=2.117,P<0.05]。结论序贯化发育干预有助于促进早产儿早期大运动、精细运动、适应能力及社会行为的发育,对于改善小孕周早产儿神经运动发育预后有重要意义,其在基层医院早产儿儿童保健实施中具有推广意义。

0~1岁婴儿运动发育落后的影响因素分析

目的 探讨0~1岁婴儿运动发育落后的影响因素。方法 选取2022年6月至2023年2月首都医科大学附属北京儿童医院保健中心定期健康体检的足月儿396例,采用Alberta婴儿运动量表(Alberta infant motor scale,AIMS)评分评价婴儿的运动发育情况,根据AIMS得分的百分位将足月儿分为运动发育正常组(AIMS得分百分位>P10)和运动发育落后组(AIMS得分百分位≤P10);采用Gesell发育诊断量表(以下简称Gesell发育量表)评估足月儿的发育商(developmental quotient,DQ),采用多因素logistic回归方程分析足月儿运动发育落后的影响因素。结果 396例足月儿中男221例、女175例,月龄3.0~12.0个月,平均(7.2±2.7)个月;327例(82.6%)足月儿运动发育正常,69例(17.4%)运动发育落后。AIMS与Gesell发育量表评价运动发育落后的Kappa值为0.61(P<0.05)。与运动正常组相比,运动发育落后组Gesell发育量表的适应性、精细动作、语言和个人社交DQ得分较低,差异均有统计学意义(P<0.001)。多因素logistic回归方程结果显示,精细动作DQ>85(OR=0.349,95%CI:0.187~0.653,P=0.001)和语言DQ>85(OR=0.337,95%CI:0.186~0.613,P<0.001)的足月儿发生运动发育落后的风险较低。结论 Gesell发育量表评价0~1岁婴儿大运动与AIMS评价运动发育结果的一致性较好,其中精细动作DQ和语言DQ是0~1岁婴儿运动发育落后的影响因素。应关注0~1岁婴儿精细动作和语言发育,促进早期运动发展。

Spatio-temporal Evolution and Driving Factors of the High-quality Development of Provincial Tourism in China

Accelerating the promotion of high-quality development of tourism(HQDT) is of great significance to the sustainable development of tourism. This paper defined the concept of HQDT, and then built an evaluation system for HQDT measurement to analyze the spatio-temporal evolution characteristics of China’s HQDT based on provincial panel data from 2010 to 2019, using Geodetector to explore the similarities and differences between driving factors of HQDT and tourism development scale(TDS). The results show that:1) Taking the development concepts of innovation, coordination, green, openness and sharing as the guidance, and considering the organic unity of quantity and quality, the evaluation index system of the HQDT consists of six dimensions of economic stability, innovation driving, coordination and linkage, green and sustainability, openness and cooperation, and sharing and harmony, which respectively represent the basis, momentum, means, orientation, direction and purpose of the HQDT;2) The level of China’s HQDT shows an upward trend, presenting the characteristics of eastern region > central region > western region > northeastern region in 2019. The regional differences in China’s HQDT show a downward trend, and the intra-regional differences have replaced the inter-regional differences as the main source of regional differences;3) China’s HQDT shows the characteristics of higher in the east and lower in the west along the Hu line, while the improvement speed of HQDT shows the characteristics of faster in the west and slower in the east, making the decline of east-west differentiation of China’s HQDT and the movement of the gravity center towards southwest;4) Both HQDT and TDS are obviously driven by tourism capital investment and regional consumption. In terms of differences, the HQDT is more driven by government guidance, innovation driving force, and opening up, while the main driving factors of TDS are more biased toward capital elements and hardware facilities, including informatization, tourism resource, traffic, and eco-environment.

Neurodevelopmental outcome in congenital diaphragmatic hernia: Evaluation, predictors and outcome

To review the reported neurodevelopmental outcome of congenital diaphragmatic hernia(CDH) survivors, identify important predictors of developmental disabilities, and describe the pathophysiological mechanisms contributing to adverse outcome. A Medline search was performed for English-language articles cross-referencing CDH with pertinent search terms. Retrospective, prospective, and longitudinal follow-up studies were examined. The reference lists of identified articles were also searched. Neurodevelopmental dysfunction has been recognized as one of most common and potentially most disabling outcome of CDH. Intelligence appears to be in the low normal to mildly delayed range. Neuromotor dysfunction is common during early childhood. Behavioral problems, hearing impairment, and quality of life related issues are frequently encountered in older children and adolescence. Disease severity correlates with the degree of neurological dysfunction. Neurodevelopmental follow-up in CDH children should become standard of care to identify those who would benefit from early intervention services and improve neurological outcomes.

家庭互动式阅读对1~6岁语言发育迟缓患儿语言康复的作用

目的探究家庭互动式阅读对1~6岁语言发育迟缓(language development delay,LDD)患儿语言康复的作用。方法随机数字表法将本院2020年4月~2021年6月就诊的85例1~6岁LDD患儿分为研究组43例与对照组42例,对照组给予药物干预和康复训练,研究组在对照组基础上加以家庭互动式阅读。干预3个月后评价疗效及家长满意度,干预前后Gesell发育量表(gesell developmental test scales,GDS)调查。结果研究组总有效率83.72%,显著高于对照组61.90%(P<0.05)。干预后两组GDS量表各行为发育商(development quotient,DQ)评分比干预前均显著提升,且研究组显著高于对照组(P<0.05)。干预后研究组患儿家长对康复效果、专业水平、服务态度、人文关怀评分及总分均显著高于对照组(P<0.05)。结论家庭互动式阅读有利于1~6岁LDD患儿语言、运动行为改善,家长满意度高。

血清25(OH)D、叶酸水平在孤独症谱系障碍患儿中的临床意义

目的:了解孤独症谱系障碍(ASD)患儿血清25(OH)D、叶酸水平,分析其与患儿病情及发育情况的关系,以期为ASD患儿提供全新的药物治疗思路。方法:选取安徽省儿童医院2021年6月-2022年6月就诊的114例ASD患儿为ASD组,选取同期在本院体检的100例健康儿童为正常组,比较两组血清25(OH)D、叶酸水平,同时采用儿童孤独症评定量表(CARS)评估ASD患儿病情的严重程度、格里菲斯发育评估量表-中文版(GDS-C)评估ASD患儿的发育水平,并将血清指标与病情严重程度、发育水平进行相关性分析。结果:ASD组血清25(OH)D、叶酸水平分别为(33.28±11.05)、(14.74±4.84)ng/mL,均低于正常组的(44.71±6.32)、(23.17±6.16)ng/mL(P<0.05)。ASD组CARS评分为(33.11±2.01)分,GDS-C评分为(58.49±10.70)分。ASD组的血清25(OH)D、叶酸水平与CARS评分均呈负相关(P<0.05),与GDS-C评分均呈正相关(P<0.05)。结论:ASD患儿血清25(OH)D、叶酸水平较正常儿童降低,且与患儿的病情严重程度及发育水平相关。

新冠疫情期间滨州市0~3岁婴幼儿发育情况研究

目的探讨新型冠状病毒肺炎(新冠肺炎)疫情居家健康监测期间滨州市0~3岁婴幼儿的发育情况。方法采用横截面研究方法,收集新冠肺炎疫情前(2019年4月1日至5月31日)、疫情后(2020年4月1日至5月31日)各2个月,在滨州医学院附属医院儿保科健康体检的婴幼儿,共计2282人。统计其《0~6岁儿童神经心理发育量表》发育商及各功能区得分。比较全年龄组发育商及各功能区得分;疫情前后分别按月龄不同分成5个小组,分别为0~4月龄组(<5月龄)、5~8月龄组(≥5月龄且<9月龄)、9~12月龄组(≥9月龄且≤12月龄)、1~2岁组(>12月龄且≤24月龄)、2~3岁组(>24月龄且≤36月龄),分别评估不同年龄阶段各功能区的受影响情况。两组比较进行χ^(2)、t检验。结果疫情后,0~3岁全年龄组婴幼儿在发育商、粗大运动、精细运动、适应能力、语言及社交行为方面的得分分别为(96.7±9.1)、(95.5±14.3)、(92.0±12.9)、(94.6±12.8)、(102.5±18.2)、(98.8±16.5)分,均高于疫情前[(93.6±8.7)、(93.7±14.9)、(88.6±13.7)、(91.2±13.1)、(97.6±17.4)、(96.7±14.9)分],两组比较,差异均有统计学意义(均P<0.01)。在不同年龄阶段比较中,有以下方面差异有统计学意义:0~4月龄的发育商、精细运动、语言、社交行为,5~8月龄的发育商、粗大运动、精细运动、适应能力、语言及社交行为,9~12月龄的发育商、粗大运动、适应能力、语言,1~2岁的发育商、精细运动、适应能力;而2~3岁各评分差异均无统计学意义(均P>0.01)。结论居家健康监测期间滨州市0~3岁婴幼儿发育水平有所提高,在2岁前更为明显。

不明原因散发性全面发育迟缓儿童遗传因素预测表的制订及临床应用

目的 通过分析散发性不明原因全面发育迟缓(GDD)患儿的临床特征,制订该类患儿的遗传因素风险预测表,以助于筛选需要进一步进行遗传学检测的患儿,缩短病因学诊断流程。方法 选取2019年6月—2022年6月在赣州市妇幼保健院儿童神经康复科就诊的散发性不明原因GDD患儿396例。依据基因测序结果将检测结果阳性的患儿归为阳性组(130例),检测结果阴性的患儿归为阴性组(266例)。通过回顾性分析25项临床特征的组间差异,制订遗传因素风险预测表,并使用受试者工作特征(ROC)曲线评估该量表预测患儿基因诊断阳性率的效能。结果 阳性组与阴性组患儿父亲高龄生育、MRI提示结构畸形、癫痫、毛发异常、头围异常、颅骨外观异常、皮肤异常、眼外观异常或畸形、鼻梁外观异常或畸形、耳廓畸形或耳位异常、下颌畸形、牙齿异常、出生低张力、非智力因素合并症比较,差异均有统计学意义(P <0.05),依据综合筛选,将19个条目归类至双亲因素、异常面容、器官畸形、非智力因素合并症、异常头颅MRI改变5个项目作为最终量表条目,制订遗传因素风险预测表。ROC曲线结果提示量表曲线下面积为0.707,最佳截断值为3分,敏感性为60.8%(95%CI:0.518,0.691),特异性为75.6%(95%CI:0.699,0.805)。结论 不明原因GDD儿童遗传因素风险预测表可以根据临床特征预测不明原因GDD儿童基因检测结果的阳性概率,加快病因学诊断流程,为后续诊疗决策提供参考,具有临床应用价值。