目的 探讨动态社交行为技巧练习联合生物反馈对学龄注意缺陷多动障碍（ADHD）患儿临床症状和社会功能的影响。方法 回顾性选取我院2021年1月~2024年3月收治的81例学龄ADHD患儿作为研究对象，按照治疗方法不同分为对照组（40例）、观察组（41例），对照组接受生物反馈治疗，观察组接受动态社交行为技巧练习联合生物反馈治疗。比较两组临床疗效、临床症状、社会功能、脑电波频率[β波、θ波、感觉运动节律（SMR）波]。结果 观察组总有效率90.24%较对照组的72.50%高（P＜0.05）；治疗后观察组对抗性行为、多动-冲动、注意力不集中评分均低于对照组（P＜0.05）；治疗后观察组家庭、学习与学校、生活技能、自我管理、社交活动及风险活动评分均低于对照组（P＜0.05）；治疗后观察组β波、SMR波均高于对照组，θ波低于对照组（P＜0.05）。结论 动态社交行为技巧练习联合生物反馈对学龄ADHD患儿临床疗效确切，可进一步改善患儿临床症状、社会功能。

Objective To explore the effect of dynamic social behavior skills training combined with biofeedback on clinical symptoms and social function in school-age children with attention deficit hyperactivity disorder (ADHD). Methods A total of 81 school-age children with ADHD admitted to our hospital from January 2021 to March 2024 were retrospectively selected as the research objects. According to different treatment methods, they were divided into control group (40 cases) and observation group (41 cases). The control group received biofeedback therapy, and the observation group received dynamic social behavior skills training combined with biofeedback therapy. The clinical efficacy, clinical symptoms, social function, brain wave frequency [β wave, θ wave, sensorimotor rhythm ( SMR ) wave] were compared between the two groups. Results The total effective rate of the observation group was 90.24% higher than that of the control group (72.50%) (P<0.05). After treatment, the scores of antagonistic behavior, hyperactivity-impulsion and inattention in the observation group were lower than those in the control group (P<0.05). After treatment, the scores of family, learning and school, life skills, self-management, social activities and risk activities in the observation group were lower than those in the control group (P<0.05). After treatment, the β wave and SMR wave in the observation group were higher than those in the control group, and the θ wave was lower than that in the control group (P<0.05). Conclusion Dynamic social behavior skill training combined with biofeedback has definite clinical efficacy in school-age children with ADHD, which can further improve their clinical symptoms and social functioning.

目的 基于生物—心理—社会模式分析精神专科住院患者负荷现状及其关联因素。 方法 选取某三级精神专科医院住院患者为研究对象，构建涵盖住院天数、费用、护理风险、联合用药、危机干预及出院准备难度的住院负荷综合评分，采用多元线性回归和Logistic回归分析影响因素。 结果 患者住院负荷评分为57.16±15.36分，高负荷患者约占三分之一；生物、心理、社会因素联合模型可解释68.4%的负荷变异；明显睡眠问题、既往住院次数≥3次、治疗依从性差、家庭支持低、社会功能重度受损及缺乏社区衔接资源等为高住院负荷危险因素。 结论 精神专科住院负荷具有复合性和多因素累积特征，应建立多维评估与分层干预机制，以优化资源配置和连续照护。

Objective To analyze the current status of inpatient burden and its associated factors among psychiatric inpatients based on the biopsychosocial model. Methods Inpatients from a tertiary psychiatric hospital were selected as study subjects. A comprehensive inpatient burden score was developed, incorporating length of stay, cost, nursing risk, polypharmacy, crisis intervention, and difficulty in discharge preparation. Multivariate linear regression and logistic regression analyses were used to identify influencing factors. Results The mean inpatient burden score was 57.16 ± 15.36 points, with approximately one-third of patients experiencing high burden. The combined model of biological, psychological, and social factors explained 68.4% of the variance in burden. Significant sleep problems, prior hospitalizations ≥3 times, poor treatment adherence, low family support, severe impairment in social functioning, and lack of community follow-up resources were identified as risk factors for high inpatient burden. Conclusion Psychiatric inpatient burden is complex and characterized by cumulative multifactorial influences; therefore, a multidimensional assessment and tiered intervention system should be established to optimize resource allocation and ensure continuous care.

目的 探讨早产儿语言-社会行为情况及其影响因素,研究语言-社会行为发育与智能发育之间的关系,为早产儿保健提供指导。方法 采用自制的一般情况问卷对125例早产儿开展随访、追踪,直至2岁时,采用盖泽尔发展量表（GDS）进行语言-社会行为及智能发育评估。结果 早产儿语言发育正常43例（34.4%）,社会行为发育正常40例（32%）。早产儿语言发育商平均为（67.99±25.75）,社会行为发育商平均为（67.75±23.98）,处于发育低下水平。性别、脑出血病史、定期随访史、康复干预史、家庭干预史在语言、社会行为方面比较差异均无统计学意义（P>0.05）。不同胎儿期安胎史、胎龄、出生体质量在语言、社会行为方面比较差异有统计学意义（P<0.05）;且胎儿期反复安胎,胎龄小,出生体质量低,语言及社会行为发育较差。与出生时无中-重度窒息史的患儿相比,出生时有中-重度窒息的患儿存在更多的语言发育异常,比较差异有统计学意义（P<0.05）;但在社会行为发育方面比较差异无统计学意义（P>0.05）。语言-社交行为发育落后的同时,早产儿的大运动、精细动作、适应性行为也存在落后,五大能区比较差异并均有统计学意义（P<0.05）。结论 多数早产儿存在语言-社会行为发育落后,其同时可能伴有更多的运动和适应行为发育问题;语言-社交行为发育落后的患儿在胎儿期存在反复安胎且胎龄较小、出生体质量更低或有中-重度窒息史。对早产儿的语言-社会行为要及时给予关注,早期发现并早期干预,改善预后。

Objective To explore the language-social behavior of preterm infants and its influencing factors,to study the relationship between language-social behavior development and intellectual development,and to provide guidance for preterm infants' health care．Methods A self-administered general questionnaire was used to follow up 125 preterm infants until the age of 2 years,and Gesell development scale（GDS）was used to assess their language-social behavior and intellectual development．Results Preterm infants had normal language development in 43 cases（34.4%）and normal social behavioral development in 40 cases（32%）．The mean language development quotient of preterm infants was（67.99±25.75）and the mean social behavioral development quotient was（67.75±23.98）,which was at the low developmental level．There were no significant differences in gender,history of cerebral hemorrhage,regular follow-up,rehabilitation intervention,family intervention and language or social behavior（P>0.05）．Infants with different fetal age history,gestational age,and birth weight varied significantly in language and social behavior（P<0.05）;and with repeated miscarriage,small gestational age,low birth weight,showed poor language and social behavior development．Compared the children with and without moderate to severe asphyxia at birth,there was statistically significant differences in language development（P<0.05）,but in social behavior there was no significant difference（P>0.05）．The backward development of language-social behavior was accompanied by backwardness in gross motor,fine motor,and adaptive behavior in preterm infants,and the differences in the five major domains were all present and statistically significant（P<0.05）．Conclusions A major of preterm infants have poor language-social behavior development,which may be accompanied by more motor and adaptive behavior development problems;children with poor language-social behavior development have repeated miscarriage prevention at younger gestational ages,lower birth weights,or a history of moderate-to-severe asphyxia during the fetal period．It is important to give timely attention to language-social behavior in preterm infants for early detection and early intervention to improve prognosis．

目的 探索干预因素对4~12岁孤独症谱系障碍（ASD）患儿社交反应的影响,为开展ASD患儿的早期干预提供参考。方法 选取于2020年1月—2023年3月在清远市妇幼保健院儿童神经与发育中心康复干预的ASD患儿,采用社交反应量表（SRS）对患儿进行社交行为评估,采用自编一般情况问卷对家长进行问卷调查,调查内容包括患儿的基本情况（性别、共患病情况、干预时长、上学情况等）。结果 202例ASD患儿中,男性患儿162例（80.2%）,女性40例（19.8%）,性别对社交反应的影响比较差异无统计学意义（t=2.969,P>0.05）。共患病方面,无共患病的ASD患儿与共患智力发育障碍及注意缺陷多动障碍的患儿相比,其SRS得分差异有统计学意义（F=6.920,P<0.05）。在上学情况方面,普通学校就读的患儿与特殊学校及未上学的患儿相比,其SRS得分差异有统计学意义（F=3.823,P<0.05）,但在特殊学校就读的患儿与未上学的患儿相比,差异无统计学意义（P>0.05）。在干预时长方面,干预≥1年与干预<1年及未干预的患儿比较,其SRS得分更低,差异有统计学意义（F=4.477,P<0.05）,但干预<1年与未干预患儿相比,两者差异无统计学意义（P>0.05）。结论 ASD患儿中,是否患有其他无共患病、上学情况、干预时长会影响其社交反应;存在共患疾病的ASD患儿社交反应表现更差;相较于就读特殊教育机构和未上学的患儿,就读于普通学校的ASD患儿社交障碍程度更轻;干预时间越长,其社交障碍程度也越轻。

Objective To explore the impact of intervention factors on social response in children with autism spectrum disorder（ASD）aged 4—12,and to provide reference for early intervention in children with ASD. Methods Children with ASD who underwent rehabilitation intervention at the Children's Neurology and Development Center of Qingyuan Maternal and Child Health Hospital from January 2020 to March 2023 were selected．The social behavior of the children was evaluated using the Social Response Scale（SRS）,and the parents were surveyed using a self-made general situation questionnaire．The survey content included the basic information of the children（gender,comorbidity,intervention duration,and school attendance,etc．）. Results Among the 202 cases of ASD,162 were male（80.2%）and 40 were female（19.8%）．There was no statistically significant difference in the impact of gender on social response（t=2.969,P>0.05）．In terms of comorbidities,there was a statistically significant difference in SRS scores between ASD children without comorbidities and those with comorbidities such as intellectual development disorder and attention deficit hyperactivity disorder（F=6.920,P<0.05）．In terms of school attendance,there was a statistically significant difference in SRS scores between children enrolled in regular schools and those who attended special schools and those who did not attend school（F=3.823,P<0.05）,but there was no statistically significant difference between children enrolled in special schools and those who did not attend school（P>0.05）．In terms of intervention duration,compared with children with intervention≥1 year and those with intervention<1 year and no intervention,the SRS score was lower and the difference was statistically significant（F=4.477,P<0.05）．However,compared with children with intervention<1 year and those without intervention,the difference was not statistically significant（P>0.05）. Conclusions No comorbidities,attending regular schools,and intervention duration≥1 year are positive factors that affect social response．Children with ASD who have comorbidities have poorer social response performance;compared to children who attend special education institutions and those who do not attend school,children with ASD who attend regular schools have lower levels of social impairment;the longer the intervention time,the lighter the degree of social impairment．

目的 了解广州市属医院儿科医生职业倦怠的现状及其社会支持的相关性,对儿科医生的职业倦怠干预提供参考依据。方法 采用职业倦怠量表和社会支持评定量表对广州市属医院儿科医生进行方便抽样调查,并运用Excel和SPSS 25.0对调查结果进行统计描述、方差分析和相关分析。结果 广州市属医院370名儿科医生中共有272人(73.51%)出现不同程度的职业倦怠,中度倦怠者居多,为117人(31.62%)。职业倦怠三个维度中情感耗竭维度得分最高,为(21.64±7.17)分;社会支持总分为(37.68±8.24)分,客观支持、主观支持、支持利用维度得分分别为(7.71±3.23)、(22.53±5.03)、(7.44±1.92)分。其中社会支持处于水平低者居多,为227人(61.35%)。职业倦怠各维度和社会支持各维度两两之间均呈负相关。结论 广州市属医院儿科医生存在较严重的职业倦怠状况,社会支持状况大多处于低水平,尤其客观支持状况较差。社会支持水平越高,职业倦怠程度越轻,提示在缓解职业倦怠时应当充分考虑社会支持对其职业倦怠的影响作用。

Objective By understanding the current situation of job burnout of pediatricians in Guangzhou municipal hospitals and the correlation of social support, to provide reference basis for pediatricians to intervene in job burnout. Methods The Burnout Inventory and the Social Support Rating Scale were used for pediatricians in Guangzhou municipal hospitals, and Excel and SPSS 25.0 were used to conduct statistical description, variance analysis and correlation analysis of the survey results. Results There were 272 pediatricians (73.51%) showed different degrees of job burnout of the 370 pediatricians in Guangzhou municipal hospitals, among which 117 pediatricians (31.62%) showed moderate burnout. Among the three dimensions of job burnout, the highest score was emotional exhaustion (21.64±7.17). The total score of social support was (37.68±8.24), and the dimensions of the objective support, the subjective support and the utilization of support were (7.71±3.23), (22.53±5.03), (7.44±1.92), respectively. Among them 227 (61.35%) had low level of social support. Additionally, there was a negative correlation between each dimension of job burnout and each dimension of social support. Conclusion Pediatricians in Guangzhou municipal hospitals have more serious job burnout, and most of them have low level of social support, especially poor objective support. The higher level of social support will have the lower degree of job burnout. It suggests that the impact of social support on job burnout should be fully considered for alleviating job burnout.

目的 探讨胰岛素抵抗对缓解期双相障碍患者转归和社会功能的影响。方法 对双相I型患者90例以及正常对照组30例进行体质量指数、空腹血糖、胰岛素等测定,计算胰岛素抵抗指数;长期治疗应答回顾标准量表评估治疗应答、大体社会功评估量表评估社会功能,分析胰岛素抵抗对双相患者转归和社会功能的影响。结果 患有2型糖尿病或胰岛素抵抗的双相障碍患者治疗应答反应差(2.50和2.93 vs 4.77,F=5.636,P<0.01;OR=6.07和4.78,P<0.01),双相发作次数多(0和0.03 vs 0.33,F=59.475,P<0.01),社会功能更差(GAF:56.90和53.23 vs 73.93,F=6.010,P<0.05;OR=1.59和4.82,P<0.01)。治疗应答、社会功能与胰岛素抵抗指数呈负相关(r=-0.383和-0.307,P<0.01)。社会功能与治疗反应、非典型抗精神病药物和药物副反应相关(r=0.467, -0.314,-0.407,P<0.05或P<0.01)。结论 共病糖尿病或胰岛素抵抗可能是双相障碍治疗抵抗、社会功能损害的一个重要的因素。

Objective To investigate the effect of insulin resistance on outcome and social function in patients with bipolar disorder at remission stage. Methods The body mass index(BMI),the levels of fasting plasma glucose,insulin and glyeosylated hemoglobin were detected in 90 BD patients without diabetes(BD group)and 30 normal controls (NC group). Alda scale was used to assess treatment response, and Global Assessment of Functioning Scale was used to assess social function. The effect of insulin resistance on outcome and social function was analyzed. Results Patients with bipolar disorder with type 2 diabetes or insulin resistance have poor response to treatment(2.50,2.93 vs 4.77,F=5.636,P<0.01;OR=6.07& 4.78,P<0.01), more recurrences (0,0.03 vs 0.33,F=59.475,P<0.01;OR=1.59&4.82,P<0.01), and worse social function (GAF:56.90,53.23 vs 73.93,F=6.010,P<0.05). Treatment response and social function were negatively correlated with insulin resistance index (r=-0.383,-0.307,P<0.01), and social function was associated with treatment response, atypical antipsychotics, and side effects (r=0.467, -0.314,-0.407,P<0.05 or P<0.01). Conclusion Diabetes mellitus or insulin resistance may be important factor in therapeutic resistance and social function to patients with bipolar disorder.

目的 探索利伯曼康复治疗对慢性精神分裂症患者社会功能的影响。方法 选取长期住院的慢性精神分裂症患者130例,随机分为研究组65例和对照组65例,研究组实施利伯曼康复治疗,在康复训练前与训练后的第1、3月末分别采用护士用住院病人观察量表(NOSIE)和住院精神病人康复疗效评定量表(IPROS)对患者进行评价。结果 患者通过利伯曼康复治疗后,NOSIE量表总积极分、社会能力、社会兴趣、个人整洁等得分有明显提高;IPROS量表的工疗情况生活能力社交能力讲究卫生能力都有较明显的提高(T、P<0.01)。结论 利伯曼康复治疗对患者的社会功能的改善有积极的意义。

Objective To explore the impacts of Lieberman rehabilitation technique on chronic schizophrenic patient's quality of life. Methods 130 patients diagnosed with chronic schizophrenia with over 5-year long hospitalization were divided into two groups randomly, with 65 samples at either study group or control group. Team to implement a lieberman rehabilitation. NOSIE and IPROS were used by nurse to assess the performance of all samples in one month after the beginning of the study and three months after the beginning study. Results After intervention, the performance of samples in study group indicated that patients had significantly higher score in NOSIE total score, social ability, social interest, individual tidiness. Patient's total negative points including irritability, mental performance, retardation and depression were decreased. IPROS living ability and social ability has improved significantly(P≤0.01). Conclusion Lieberman rehabilitation technique can improve patients'social function.

       目的   探讨运动干预联合治疗性聆听对孤独症谱系障碍儿童社会交往功能的影响。方法   选取黄河三门峡医院2020年1月—2023年10月收治的100例孤独症患儿，应用随机数字表法分为两组，各50例。对照组患儿实施常规护理，观察组在对照组基础上增加运动干预联合治疗性聆听。分别在干预前及干预6个月后采用孤独症治疗评价量表（ATEC）、儿童感觉统合发展评定量表、格塞尔发育量表（GDS）及中国韦氏儿童智力量表（WISC-R）评价两组患儿社会交往能力、感觉统合发展水平、神经发育水平及智力水平变化。结果   干预后两组患儿的ATEC各部分评分，包括健康/生理/行为、感知/认知能力、社交能力、语言表达/沟通能力及ATEC总分均降低，观察组低于对照组（P＜0.05）；干预后两组患儿学习能力发展、本体感觉、触觉防御、前庭功能及儿童感觉统合发展评定量表总分均升高，观察组高于对照组（P＜0.05）；干预后两组患儿动作能、应物能、言语能、应人能相关神经发育情况评分均升高，观察组高于对照组（P＜0.05）；干预后两组患儿言语智商、操作智商、总智商相关WISC-R评分均升高，观察组高于对照组（P＜0.05）。结论  运动干预联合治疗性聆听对孤独症谱系障碍儿童应用效果显著，可提升其社会交往能力，促进感觉统合发展，进而促进其神经发育及智力水平提升。

       Objective  To  explore the  effect  of  exercise intervention  combined with therapeutic listening  on  social communication function in children with autism spectrum disorder．Methods  A total of 100 autistic children who were admitted to our hospital from January 2020 to October 2023 were selected and divided into two groups by random number table method，with 50 children each．The control group received routine care，while the observation group  received exercise intervention combined with therapeutic listening in addition to routine care．The Autism Treatment Evaluation Scale （ATEC），Children’s Sensory Integration Development Scale，Gesell Development Scale，and Wechsler Intelligence Scale for Children-Revised by China （WISC-R）were used before and 6 months after the intervention to evaluate the social communication ability，sensory integration development level，neural development level，and intellectual level changes of the two groups of children．Results  After intervention，the score of every dimension in ATEC including the health/physiology/behavior，perception/cognitive ability，social ability，language expression/communication ability，and total ATEC score of the two groups of children decreased，and the observation group was lower than the control group （P＜0.05）．After intervention，the total scores of the learning ability development insufficient，proprioceptive dysfunction，excessive tactile defense，vestibular dysfunction，and children’s sensory integration development assessment scale in both groups of children increased，with the observation group being higher than the control group （P＜0.05）．After intervention，the neurological development scores related to motor，adapt，language，and social ability in both groups of children increased，and the observation group was higher than the control group （P＜0.05）．After intervention，the WISC-R scores related to verbal intelligence，operational intelligence，and total intelligence in both groups of children increased，and the observation group was higher than the control group （P＜0.05）．Conclusions  The combination of exercise intervention and therapeutic listening has asignificant effect on children with autism spectrum disorder，which can enhance their social communication ability，promote sensory integration development，and ultimately promote their neural development and intellectual level improvement．