Responsible Institution:
Ministry of Education People's Republic of China
Sponsored by:
Xian Jiaotong University
Chinese Preventive Medicine Association
Editor-in-Chief:
YANG Yu- feng
ISSN 1008-6579   CN 61-1346/R
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29 April 2022, Volume 30 Issue 5
Professional Forum
Focus on the promotion of physical activity and physical fitness in early childhood
GUAN Hong-yan
2022, 30(5):  465-468.  DOI: 10.11852/zgetbjzz2022-0494
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Physical health of Chinese children is not optimistic. Specifically, physical fitness of children and adolescents has been declining for decades, overweight and obesity are rapidly increasing and at a younger age. The rate of myopia among students in elementary school, middle school and high school remains high. And the poor social adaptability has become increasingly prominent. The government attaches great importance to children and adolescents' physical health and has launched a series of policy guidance documents. Promoting the physical activity and physical fitness in early childhood is an essential basis for establishing a healthy lifestyle throughout the entire life, urgently requiring us to pay attention to and attach importance to professional guidance. Based on recent years' new progress in related fields, this paper introduces the connotation and elements of early childhood physical activity and physical fitness, as well as its comprehensive impact on child development, the existing guidelines for physical activity and its monitoring progress. Besides, this paper proposes the implementation and strategy recommendations for government, medical institutes, childcare facilities and families, with a view to raising the awareness of primary child health care professionals on children's physical activity promotion and fitness health in early childhood, as well as strengthening guidance on it.
Original Articles
Association of obesity classified by body mass index and fat mass percentage with cardiometabolic risk factors among school-age children in 6 provinces, China
LIU Jun-ting, YAO Hong-yan, YU Shi-cheng, LIU Jian-jun, ZHU Guang-jin, HAN Shao-mei, XU Tao
2022, 30(5):  469-474.  DOI: 10.11852/zgetbjzz2021-1752
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Objective To explore the association of obesity classified by body mass index (BMI), body fat mass percentage (FMP) and the cross-grouping of BMI and FMP with cardiometabolic risk factors, so as to provide basis for the prevention and control of childhood obesity and related metabolic abnormalities. Methods Based on the cross-sectional data of the survey in China completed in 6 provinces (Heilongjiang, Inner Mongolia, Ningxia, Sichuan, Yunnan and Hunan), 11 542 school-age children aged 10 to 18 were selected as the research subjects. The obesity status was classified separately or cross-classified by BMI and FMP, and the Logistic regression model was used to analyze and compare the risks of cardiometabolic risk factors. Results Without adjusting for the waist circumference (WC), the group [BMI(-)+FMP(+)] had a lower risk of elevated low high-density lipoprotein cholesterol (HDL-C) and elevated blood glucose, however, the other groups had a higher risk of obesity-related metabolic abnormalities. After adjusting for WC, the [BMI(+)+FMP(+)] group had a higher risk of high triglycerides(TG) [OR(95%CI):2.55 (1.29 - 5.02)], dyslipidemia [OR(95%CI):2.07 (1.19 - 3.61)] and elevatedfasting blood pressure [OR(95%CI):2.20 (1.29 - 3.77)] among boys. Among girls, the [BMI(+)] and [FMP(+)] group had a higher risk of dyslipidemia [OR(95%CI):2.02(1.09 - 3.74)]. Conclusion It is necessary to add FMP when assessing child obesity to screen for the risk of dyslipidemia and elevated blood pressure.
Correlation between anthropometric indexes and nonalcoholic fatty liver disease in obese children
DUAN Xiao-long, WANG Li-ming, KANG Yu-rong, YI Xiao-qing, WANG Si-si, XIAO Yan-feng
2022, 30(5):  475-479.  DOI: 10.11852/zgetbjzz2021-1509
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Objective To study the correlation between new anthropometric indicators and childhood obesity with nonalcoholic fatty liver (NAFL), and to explore the cut-off point value of anthropometric indicators in screening NAFL. Methods A total of 94 obese children were selected from the Pediatric Endocrine Clinic of the Second Affiliated Hospital of Xi'an Jiaotong University from June 2018 to December 2019, and were further divided into obesity with NAFL(n=59) and obesity without NAFL(n=35). Meanwhile, 52 normal children is control group. Both groups were measured height(H), weight (W), waist circumference (WC), hip circumference (HC). serum levels of triglycerides (TG), total cholesterol (TC), high density lipoprotein cholesterol (HDL-C) and low density lipoprotein cholesterol (LDL-C) were tested. And abdominal ultrasound examination was conducted in all participants. Furthermore, the body mass index (BMI), waist-to-hip ratio (WHR), waist-to-height ratio (WHtR), abdominal volume index (AVI), lipid accumulation product (LAP) and visceral adiposity index (VAI) and other indicators were calculated. The tangent point value was determined by drawing the receiver operating characteristic (ROC) curve of the anthropometric index and comparing the area under curve (AUC) of each anthropometric index. Results BMI, WC, WHR, WHtR, AVI, LAP, VAI and TG of the obesity group were significantly higher than those of the control group (t=23.090, 21.068, 12.547, 22.855, 17.578, 8.159, 5.394, 6.183, P<0.001). Children in the obesity with NAFL group has higher BMI, WC, AVI, LAP and VAI than those in obesity without NAFL group (t=2.180, 2.389, 2.362, 3.643, 2.839, P<0.05). Taking obesity with or without NAFL as the dependent variable, ROC curves of BMI, WC, AVI, LAP, and VAI were drawn, respectively. The area under the ROC curve from large to small was as follows:LAP, VAI, WC, AVI and BMI. The areas under the LAP+AVI curve, AVI+VAI curve and BMI+WC curves were 0.706 (95%CI:0.595 - 0.817, P<0.001), 0.685(95%CI:0.570 - 0.800, P<0.01) and 0.652, (95%CI:0.537 - 0.768, P<0.05), respectively. The area under the ROC curve of the combined indicator from large to small was ranked as LAP+AVI, AVI+VAI, BMI+WC. Conclusion LAP combined with AVI can better screen childhood obesity with NAFL.
Skin fold thickness and body composition of Miao nationality students aged 7~15 in Xiangxi prefecture
ZHOU Xian-wei, ZHANG Tian-cheng, ZHANG Fu-lan, XU Tao
2022, 30(5):  480-484.  DOI: 10.11852/zgetbjzz2021-1263
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Objective To investigate the development characteristics of skinfold thickness and body composition of Miao students aged 7 to 15 in Xiangxi prefecture, so as to provide reference for improving physique of minority students. Methods A total of 1 064 Miao students aged 7 to 15 in Xiangxi prefecture were randomly selected by a stratified cluster method from October to November in 2019. Height, weight and the thickness of triceps skinfold (TS), subscapular skinfold (SS) and abdomen skinfold (AS) of students were measured. Body composition was estimated according to Changling and Brozek formulas. Results With the increase of age, the skinfold of Miao students gradually thickened, and the increase was obvious after 13 years old for boys and 12 years old for girls. TS, SS and AS of girls were thicker than those of boys at 8 years old (t=2.659, 2.392, 2.264, P<0.05), 11 years old (t=3.317, 3.251, 3.179, P<0.05), 13 years old (t=5.196, 3.943, 4.651, P<0.05), 14 years old (t=5.941, 4.630, 3.228, P<0.05) and 15 years old (t=4.822, 4.292, 3.210, P<0.05). The average body fat percentage, fat mass and index of female students were higher than those of male students (P<0.05 or <0.01). The age change curves of lean body mass and its index of male and female students gradually increased and crossed twice. Except for body fat percentage of male students, body composition and skin fold thickness were significantly positively correlated with age (P<0.01). Compared with the eight ethnic groups, the thickness of TS of Miao male (9.22 mm) was closer to that of Inner Mongolian Daur, and the thickness of SS (7.33 mm) was close to that of Nujiang Nu. While the thickness of TS of female (11.98 mm) was closer to that of Inner Mongolian Daur, and the thickness of SS (9.35 mm) was closer to that of Guangdong Yao. Conclusions The development of skin fold thickness and body composition in rural students of Miao nationality in Xiangxi prefecture of Hunan province conform to the general rule of growth and development. The subcutaneous fat content is relatively less, and there are gender and age differences.
Cross-sectional study on health status of preschool children of different ethnic groups in Linxiang district, Yunnan Province
HONG Yang-yang, XU Yi-hua, LUO Kai-min, LU He-yun, WANG Qiong-hua, LIU Ju-ming
2022, 30(5):  485-489.  DOI: 10.11852/zgetbjzz2021-1393
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Objective To understand the health status of preschool children in Linxiang district, Yunnan Province, so as to provide scientific basis for children health promotion in the minority areas. Methods In 2019, 1 018 preschoolers were randomly selected from Linxiang district of Yunnan Province, and participated in a cross-sectional survey on the growth indicators and the influencing factors. Binary Logistic regression model was used to find out the adverse factors affecting the health status of ethnic minority children. Results The prevalence rate of low body weight, developmental delays and dental caries increased with age. For 6- to 7-year-old children, the prevalence rates of low body weight, developmental retardation and dental caries were 9.7%,13.3% and 71.4%, respectively(χ2=11.327, 22.939, 58.067, P≤0.001). Binary Logistic regression showed that the risk of growth retardation in children of Lahu nationality was 4.332(95%CI:2.103 - 8.924) times higher than that of Han nationality after adjusting for age and family income. Conclusions The major problems affecting children's health inlclude low body weight, developmental delays and dental caries in Linxiang district, Yunnan Province, which should be paid more attention to from the government and relevant departments. Moreover, it is suggested to take regular follow-up visits and special case management, carry out disease prevention and treatment from multiple aspects and in many ways to improve children's health continuously.
Association of the single nucleotide polymorphism of NOS3 gene with obesity in children aged 6~13 years
SHANG Li, XU Pei-ru, AIERKEN Aibibai, WANG Yi-lin
2022, 30(5):  490-494.  DOI: 10.11852/zgetbjzz2021-1179
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Objective To analyze the correlation of polymorphisms of NOS3 rs1799983, rs2566508 with obesity in children aged 6 to 13, in order to provide scientific basis for further exploration of obesity occurrence, development, prevention and treatment. Methods A cross-sectional survey was conducted at a primary school in Shawan City, Xinjiang Province in September 2019. According to the inclusion and exclusion criteria, 100 cases were screened with obesity and 100 children were in control group. There were 122 cases of Han nationality and 78 cases of Kazakh. Chip capture sequencing and high-throughput sequencing technology were used to detect NOS3 gene rs1799983, rs2566508 polymorphism. Then their correlations with obesity among Han and Kazakh children were analyzed. Results 1) NOS3 gene rs2566508 polymorphism may be associated with obesity in Han girls aged 6 to 13 years. There were significant differences in the frequencies of T and G alleles distribution between the control group and obesity group (χ2=11.247, P=0.001). The risk of obesity increased significantly in carriers of G allele (OR=3.889, 95%CI:1.707 - 8.860). There were also significant differences in the frequencies of TT, TG and GG genotypes distribution between the two groups (χ2=10.389, P=0.004). However, no association between rs2566508 polymorphism and obesity was found in Han boys as well as Kazakh boys and girls. 2) The allele and genotype distribution frequencies of NOS3 gene rs1799983 were not statistically significant in the group differences between Han and Kazakh children (P>0.05). Conclusion NOS3 gene rs2566508 polymorphism may be associated with obesity in Han girls aged 6 to 13, and the risk of obesity increases significantly in the carriers of G allele.
Effect of anemia and small red blood cells on the physical and neuropsychological development of infants
CHENG Bo-li, SUN Qun-ying, XIAO Meng, LI Xing-hui, ZHANG Hui, YANG Rong
2022, 30(5):  495-499.  DOI: 10.11852/zgetbjzz2021-1250
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Objective To study the effect of anemia and small red blood cells on physical growth and neuropsychological development of infants, so as to provide reference for the management of infants with anemia and small red blood cells. Methods Children aged 6 to 36 months who received routine health examination in Child Health Care Department of Affiliated Hospital of the North Sichuan Medical College from January to June 2021 were included, and were divided into anemia group(n=74), small red blood cell group(n=228) and control group(n=143) according to the results of blood routine examination. The results of anthropometric measures and the revised Children Neuropsychological and Behavior Scale in different groups were analyzed retrospectively. Results A total of 445 infants were included. The Z-score of weight-for-age (ZWA) and Z-score of height-for-age (ZHA) of children aged 6 to 11 months and 12 to 36 months in the anemia group were significantly lower than those in the control group (F=12.618, 3.807, 21.266, 3.668, P<0.05). The ZWA and ZHA of children aged 6 to 11 months in the small red blood cell group were also significantly lower than those in the control group (Bonferroni-t= 2.433,2.823, P<0.05). The results of Children Neuropsychological and Behavior Scale showed that for children aged 6 to 11 months, the development quotients of gross motor, fine motor, adaptability, language and personal-social and total development quotient of anemia group were significantly lower than those of control group (Bonferroni-t=2.851, 5.554, 2.749, 2.681, 4.508, 5.158, P<0.05), and the development quotients of fine motor, language, personal-social and total development quotients of small red blood cell group were also significantly lower than those of control group(Bonferroni-t=4.317, 2.506, 3.598, 3.758, P<0.05). For children aged 12 to 36 months, the development quotients of gross motor, language, personal-social and total development quotient of anemia group were significantly lower than those of control group (Bonferroni-t=2.482, 3.038, 2.861, 2.711, P<0.05), and the language and personal-social development quotient and total development quotient of small red blood cell group were also lower than those of control group (Bonferroni-t=2.715, 2.939, 2.473, P<0.05). Conclusions In addition to anemia,microcytosis also affects the growth and development of infants, and requires attention and exploration of appropriate intervention strategies.
Analysis on nutrition status of infants and young children in poor areas of Anhui Province from 2015 to 2020
FANG Liang, HUANG Yong-ling, JI Guo-ping, WU Shu-dong
2022, 30(5):  500-503.  DOI: 10.11852/zgetbjzz2022-0057
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Objective To identify the dynamic changes in nutritional status of infants and young children's in poor rural areas of Anhui Province, and to provide data support for Children's Nutrition Improvement Program. Methods From 2015 to 2020, infants and young children aged 6 - 23 months and their caregivers were selected from counties with Children's Nutrition Improvement Program in poor areas of Anhui Province, using the combination of PPS sampling and random equidistant sampling. Body length and body weight measurement and hemoglobin test were conducted for all children, and their caregivers were surveyed by questionnaires. Results A total of 12 418 infants aged 6 to 23 months and their caregivers were included between 2015 and 2020. There were significant differences in body length, body weight and hemoglobin values between different years (P<0.05), which increased from 77.83 cm, 10.17 kg and 115.23 g/ L in 2015 to 78.24 cm, 10.26 kg and 118.47 g/L in 2020, with an increase of 0.41 cm, 0.09 kg and 3.24 g/L respectively. The growth of body length and hemoglobin value was statistically significant (P<0.05). From 2015 to 2020, the rates of protein-energy malnutrition, overweight obesity and anemia among infants showed a downward trend (Ptrend< 0.05). Down from 4.36%, 23.53% and 29.81% in 2015 to 3.01%, 21.05% and 17.21% in 2020, with a decrease of 30.96%, 10.54% and 42.27% respectively. The decrease of above nutritional diseases showed significant differences in gender and age. Conclusions The nutritional status of infants and young children in poor areas of Anhui Province has been significantly improved after the implementation of the Children's Nutrition Improvement Program. However, the problem of overweight and obesity should be paid attention to.
Basic Experimental Articles
Effects of exosomes derived from stem cells on the movement of premature rats
WANG Juan, ZONG Lu
2022, 30(5):  504-508.  DOI: 10.11852/zgetbjzz2021-1253
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Objective To discuss the effect of exosomes derived from human umbilical cord blood mesenchymal stem cells (Hu-MSCs) on movement ability of the intrauterine infection offspring rats and its mechanism, so as to provide new ideas for treating intrauterine infection and motor function impariment. Methods Ninety pregnant rats were randomly divided into three groups [the experimental group, the lipopolysaccharide(LPS) group and the control group].On the 15th day of embryo(E15), dams of the experimental group were given 0.5 ml 1×106 ng/μl intraperitoneal injection of exosomes, dams of the LPS group and the control group were given intraperitoneal injection of the same amount of physiological saline solution. On the 17th day of embryo(E17), dams of the experimental group and the LPS group were given intrauterine injection of 100 μl 25 μg/μl lipopolysaccharide (LPS) solution, and dams of the control group were given intrauterine injection of the same amount of normal saline. On the 18th day of embryo(E18), fifteen pregnant rats were randomly selected from the three groups and killed. Then ELISA method was used to check the change in the IL-4, IL-10 and IL-12 of the amniotic fluid of the pregnant rats and serum of the offspring. The remaining 15 pregnant rats in each group gave birth naturally and their pregnancy outcomes were observed. And 10 offspring were selected randomly to evaluate their movement ability by using Suspension Test and Basso-Beatie-Bresnahan Scale (BBB Scale) once 15 days old and once 30 days old. Results 1) The levels of IL-4 and IL-10 in the amniotic fluid of the dams and serum of the offspring in the experimental group were significantly elevated from those in the LPS group (t=8.26, 3.97, 7.66, 4.81, P<0.05). The levels of IL-12 in the amniotic fluid of the dams and serum of the offspring in the experimental group were significantly reduced from those of the LPS group (t=3.14, 6.68, P<0.05). 2) In suspension test, the grasp time of the 15-day-old and 30-day-old offspring in the LPS group was significantly shorter than those of the control group(t=8.166,16.283, P<0.05), which were also significantly shorter than those of the experimental group (t=4.867, 6.994, P<0.05).The BBB score of the 15-day-old and 30-day-old offspring in the LPS group were significantly lower than those of the control group (t=7.394, 16.283, P<0.05),which were also significantly lower than those of the experimental group (t=4.096, 7.004, P<0.05). Conclusion The exosomes derived from human umbilical cord blood mesenchymal stem cells (Hu-MSCs) may improve the impairment of premature offspring pup's motor function by reducing the inflammatory response in pregnant and offspring rats.
Effect of mirtazapine on anxiety depression-like behavior in adolescent mice
FU Jia-lei, LAN Nan, JIA Yi-wei, GOU Wei, CHEN Li, HU Hao, LEI Xiao-mei
2022, 30(5):  509-512.  DOI: 10.11852/zgetbjzz2021-1755
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Objective To investigate the effects of different concentrations of mirtazapine on anxiety and depression like behavior induced by chronic restraint stress in adolescent mice, so as to provide data for the treatment of adolescent emotional disorders. Methods A total of 60 male C57 mice aged 3 - 4 weeks were randomly selected. The model group was under chronic restraint stress (CRS) 4 hours per day for 10 days. The treatment group was injected with low concentration (15 mg/kg) or high concentration (30 mg/kg) mirtazapine for 10 days. Anxiety like behavior was detected by open-field test (OFT), depression like behavior was detected by tail-suspension test (TST) and force swim test (FST), and serum mirtazapine level was detected by enzyme-linked immunosorbent assay. Results In the OFT experiment, the residence time of CRS mice in the central area was lower than that in the control group[(106.1±36.64)s vs. (182.5±38.69)s, P<0.01). After the application of high concentration mirtazapine (30 mg/kg), the time was extended to (186.1±23.43)s, which was close to the normal level. In the TST experiment, the resting time of CRS group was higher than that of control group[(176.2±104.5)s vs. (71.05±36.4)s, P<0.01]. After the application of high concentration mirtazapine (30 mg/kg), the time was shortened to (69.13±31.72)s (P > 0.05). In FST experiment, the floating time of CRS group was higher than that of control group[(304.6±87.96)s vs. (196.2±72.6)s, P<0.01]. After high concentration mirtazapine (30 mg/kg), the floating time was shortened to (188.8±49.05)s (P> 0.05). CRS resulted in that serum NE [(34.52±9.03)pg/ml] and 5-HT [(44.42±16.55)ng/ml] levels of mice in CRS group were lower than those of normal mice (P<0.01). After application of high concentration mirtazapine, it returned to the normal level (NE:(105.93±21.42)pg/mL,5-HT:(133.56±32.31)ng/mL. Conclusions CRS may lead to depression and anxiety like mood disorder in adolescent mice. Systemic chronic application of high concentration mirtazapine can improve the symptoms of anxiety and depression.
Review
Research advances on assessment instruments for physical activity parenting practices
NA Ren, SHANG Lei
2022, 30(5):  513-516.  DOI: 10.11852/zgetbjzz2021-1302
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Inadequate physical activity has become a problematic issue that impacts physical and psychological health of children and adolescents around the world. Parents play an important role in developing a good habit of physical activity of kids. Physical activity parenting practices include the context specific behaviors that parents use to accomplish desired childrearing outcomes namely ensuring their children are physically active. Effective assessment of physical activity parenting practices in early stage takes on special significance for planning and developing parental level interventions in later stage. At present, there are many kinds of relevant assessment instruments abroad while they vary in terms of designing theories, constructs, psychometric assessment and application methods. The research on relevant assessment instruments in China is still in its infancy. This paper summarizes the development as well as the application of domestic and international assessment instruments for physical activity parenting practices, and puts forward some suggestions in this field.
Application of speech-evoked auditory brainstem response in children with communication disorders
ZHU Hui-qin, LIU Pan-ting, HONG Qin
2022, 30(5):  517-520.  DOI: 10.11852/zgetbjzz2021-0632
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Communication disorders are common neurodevelopmental disorders, including language disorders, speech sound disorders, speech fluency disorders and so on. Language impairment is one of the most common clinical manifestations of communication disorders. The occurrence and development of language is complex, in which central auditory development plays an important role. Speech-evoked auditory brainstem response(speech-ABR) is a brainstem biological potential induced by the complex speech sounds, which has been used in the research of central auditory development in recent years. Therefore, this paper summarizes the results of speech-ABR in children with communication disorders and reveals the central auditory development characteristics of these children, so as to provide clues for early identification and intervention of language problems.
Research progress on the effect of stress on adolescent depression
WU Yan-ran, LUO Hong
2022, 30(5):  521-525.  DOI: 10.11852/zgetbjzz2021-0340
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Depression is one of the most extensive forms of mental disorders,especially in adolescents.The etiology of depression is not clear,and it is generally believed that it is caused by the interaction of social,psychological and biological factors.Adolescents are in the critical stage of growth and development and the transition stage of life,and the stress process has a significant impact on their mental health,especially depression.This review mainly discusses symptom characteristics,stress-related factors and assessment methods of depression in adolescents,so as to provide reference for clinical treatment of depression.
Research progress in the concept, epidemiology and health hazards of smart phone addiction on adolescents
ZHENG Xiu-xiu, YAN Feng-wu, ZHOU Yun-yun, MA San-ya
2022, 30(5):  526-530.  DOI: 10.11852/zgetbjzz2020-2215
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The popularity of smart phones has provided many conveniences for the lives of adolescents, but it has also brought great harm.In this article, we review the published study on smart phone addiction among adolescents, analyze the concept of smart phone addiction and summarize the prevalence and hazards among adolescents.
Advance in early intervention for high-risk infants
ZHAO Ming-yue, XIANG Dong-liang, ZHANG Chun-yan, WU-YUN Ta-na, YANG Hai-feng, LI Shuang, WANG Yan, WANG Yan
2022, 30(5):  531-534.  DOI: 10.11852/zgetbjzz2020-1763
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As an early and effective intervention measure for high-risk infants, early intervention can effectively improve the physical development and neurobehavioral development of infants, and can also relieve the uneasiness of parents, which is generally recognized in clinical practice. This paper describes the basic concepts of early intervention, analyzes the limitations of the current research, and puts forward the prospects for the future development.
Research progress on the relationship between family factors and adolescent non-suicidal self-injury
TENG Chao, ZHOU Wen-lin, SONG Hai-dong
2022, 30(5):  535-539.  DOI: 10.11852/zgetbjzz2021-1712
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Non-suicidal self-injury (NSSI) is very common among adolescents all over the world, and the incidence is increasing year by year. It has become one of the major public health problems affecting the physical and mental health of adolescents, and has attracted attention of the majority of experts and scholars at home and abroad. However, the mechanism of NSSI is not clear, the current research is in the preliminary stage, and the understanding of NSSI is not uniform in the world. According to current studies, the risk factors of NSSI mainly include individual factors, environmental factors and neurobiological factors. Family, as the most important external environment during adolescents' growth, plays a vital role in their physical and mental development. A good family environment can prevent NSSI and other risk behaviors of adolescents to some extent, and may become an important approach for early intervention in the future. This paper intends to review the relevant literature at home and abroad in recent years, so as to provide ideas for further research on the influence of family factors on adolescents' NSSI behavior, and to provide reference for clinical intervention and treatment.
Clinical Research
Application of body composition analysis in screening overweight and obesity of school-age children
LI Song-ting, ZHONG Yan
2022, 30(5):  540-543.  DOI: 10.11852/zgetbjzz2021-1392
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Objective To evaluate the consistency between body fat percentage(BFP) and body mass index(BMI) in screening overweight and obesity of school-age children, and to explore the screening efficacy of body composition in screening dyslipidemia and nonalcoholic fatty liver(NAFL) of school-age children. Methods Children aged 7 to 12 years who visited the clinic of Children's Health Center of Hunan Children's Hospital from March to September in 2020 were selected as the study subjects, and the body composition was measured by bioelectrical impedance method. The consistency of BFP and BMI in screening overweight and obesity in children was evaluated. ROC curve was used to analyze the AUC of body composition indexes in screening dyslipidemia and NAFL, then the sensitivity and specificity of each best cutoff value were calculated. Results Totally 20.11% of children judged as normal by BMI were overweight and obese by BFP, and 4.98% of children judged as normal by BFP were overweight and obese by BMI with Kappa value of 0.867. The AUC for body fat mass (BF)screening dyslipidemia was 0.659 (P<0.05), with the sensitivity of 0.767 and specificity of 0.521 at an optimal cut-off value of 9.85 kg. The AUC for visceral fat area (VFA) screening NAFL was 0.851 (P<0.05), with a sensitivity of 0.781 and specificity of 0.778 at an optimal cut-off value of 86.50 cm2. Conclusions BFP and BMI are highly consistent in screening overweight and obesity of school-age children. Body composition has better screening efficacy for NAFL in school-age children, and lower screening efficacy for dyslipidemia.
Eating and Drinking Ability Classification System and malnutrition analysis of children with cerebral palsy
CHEN Jing, TONG Guang-lei
2022, 30(5):  544-547.  DOI: 10.11852/zgetbjzz2021-1690
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Objective To analyze the correlation between Eating and Drinking Ability Classification System (EDACS) and Gross Motor Function Classification System (GMFCS) by assessing children with cerebral palsy (CP), and to analyze the influence of different grades of EDACS on the malnutrition status of CP children. Methods A total of 81 children with CP who received treatment in the Department of Pediatric Rehabilitation of Anhui Children's Hospital from January to April 2021 were enrolled in this study, and were assessed with EDACS and GMFCS. World Health Organization Child Growth Standards Z scores were used to assess the malnutrition status for each CP child. Kendall tau_b correlation analysis was used to analyze the correlation between EDACS and GMFCS levels. χ2test was used to analyze the influence of EDACS levels on the detection of malnutrition verified with the Z scores. Results In terms of EDACS, there were 37 cases of grade Ⅰ (45.7%), 26 cases of grade Ⅱ(32.1%), 16 cases of grade Ⅲ (19.8%), 2 cases of grade Ⅳ (2.5%) and 0 case of grade Ⅴ (0.0%) . There were only 72 cases who accepted the GMFCS assessment, and 26 cases of grade Ⅰ (36.1%), 17 cases of grade Ⅱ (23.6%), 11 cases of grade Ⅲ (15.3%), 9 cases of grade Ⅳ (12.5%), 9 cases of grade Ⅴ (12.5%). The Kendall tau-b coefficient between EDACS and GMFCS was 0.345 (P<0.01), showing weak positive correlations. There was significant difference on the detection rate of malnutrition between children with and without eating disorders classified by EDACS(χ2=6.359,P<0.05). Conclusions For CP children, EDACS levels are weakly and positively correlated with GMFCS levels. EDACS level also has influence on malnutrition of CP children. Therefore, EDACS could be considered as a helpful complementary assessment for CP children besides GMFCS, which will be helpful for comprehensive assessment on CP children's growth and nutrition status.
Correlation of serum chemerin, leptin and adiponectin levels with glucose and lipid metabolism preschool simple obese children
CUI Yi-fan, DONG Ming-ming, HU-Dan, MA Xian-zhi, XIAO Xu-wu
2022, 30(5):  548-552.  DOI: 10.11852/zgetbjzz2021-1197
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Objective To study the correlation of serum chemerin, leptin and adiponectin levels with simple obesity and metabolism in preschool children aged 3 to 6 years, so as to provide basis for clinical monitoring and treatment efficacy evaluation of preschool simple obese children. Methods Children aged 3 to 6 years who underwent physical examination in Child Health Clinic of Dalian Maternal and Child Health Hospital from January 2019 to May 2020 were selected as study subjects. Forty one simple obese children were enrolled in the study group, and meanwhile another 43 children with the same age were selected as the control group. Their height and weight were measured, and calculate the height for weight was calculated. Serum levels of chemerin, leptin, adiponectin, fasting plasma glucose (FPG), fasting insulin (FINS), total triglyceride (TG), total cholesterol (TC), high density lipoprotein cholesterol (HDL-c), low density lipoprotein cholesterol (LDL-c) were tested, and insulin resistance index was calculated. Results The levels of FINS, HOMA-IR, LDL-c, serum chemerin and leptin in the simple obesity group were significantly higher than those in the control group (t=3.288, 2.927, 4.939, 3.078, 5.456, P<0.05),while the levels of HDL-c and adiponectin were significantly lower than those in the control group (t=-5.179, -3.145, P<0.05). But there were no significant differences in the levels of FPG, TG and TC between the two groups (t=0.391, 0.768,-0.266, P>0.05). Serum chemerin was positively correlated with height for weight and the levels of FINS, HOMA-IR, TG, LDL-c and leptin (r=0.339, 0.416, 0.227, 0.376, 0.266, P<0.05), and negatively correlated with HDL-c and adiponectin levels (r=-0.410, -0.309, P<0.05). Leptin level was positively related to height for weight, FINS, HOMA-IR, LDL-C and chemokine levels (r=0.492, 0.375, 0.279, 0.269, 0.266, P<0.05), and negatively related to HDL-C and adiponectin (r=-0.467,-0.326,P<0.05). The level of adiponectin was negatively correlated with height for weight, FINS, HOMA-IR, LDL-c, chemerin and leptin (r=-0.296, -0.351, -0.278, -0.229, -0.309, -0.326, P<0.05), and positively correlated with HDL-c level(r=0.234, P=0.032). Conclusions The levels of serum chemerin, leptin and adiponectin are closely related to glucose and lipid metabolism in preschool simple obese children, which are of great significance for the identification, monitoring and intervention of preschool children with simple obesity.
Development of Adolescent Intuitive Eating Scale and its reliability and validity
WANG Jia, HUANG Jing, LIANG Ya-hong, XI Jing, WANG Yan-yan
2022, 30(5):  553-557.  DOI: 10.11852/zgetbjzz2021-1418
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Objective To develop Adolescent Intuitive Eating Scale, and to test its reliability and validity, so as to provide a reliable tool for the evaluation of adolescent intuitive eating in China. Methods Through literature review, the initial item pool of the scale was established, and the Delphi expert consultation method was used to modify the scale. A survey of 594 adolescents in September 2020 to July 2021 was conducted to evaluate the reliability and validity of the scale. Results 1) The Adolescent Intuitive Eating Scale included 4 dimensions and 19 items. 2) In the decision value analysis, the effective item scores of high score group and low score group were compared, and the differences were statistically significant (P<0.01). Pearson correlation analysis result indicated that the correlation coefficient between the effective item score and the total score of the scale ranged from 0.555 to 0.755 (P<0.05). 3) The value of I-CVI ranged from 0.800 to 1.000, the S-CVI/UA and S-CVI/Ave was 0.842 and 0.968, respectively. Finally 4 common factors were extracted by exploratory factor analysis, and the cumulative contribution rate of variance was 78.555%. Confirmatory factor analysis result showed the load value of each item in the factor to which it belonged ranged from 0.699 to 0.918, and the values of indicators such as(average variance extraction,AVE), CR, RMR and SRMR were all within the reliability limit. In terms of standard correlation validity analysis, the total scores and scores of each dimension of the Adolescent Intuitive Eating Scale was positively correlated with the total score of the adult version of the Intuitive Eating Scale (r=0.272 - 0.803, P<0.01).4) The values of Cronbach's α coefficient, half-fold reliability, and test-retest reliability of the Adolescent Intuitive Eating Scale were 0.923, 0.738 and 0.928, respectively. Conclusions The Adolescent Intuitive Eating Scale has good reliability and validity, and can be used as a tool for evaluating the adolescent intuitive eating situation in China.
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Status quo of child nursing risks among 9 384 infants in Jiaxing city
WANG Xiao, LI Li, ZHANG Ying, DING Jie, SUN Xiao-yan, LIU Hui-juan, LI Jing
2022, 30(5):  558-561.  DOI: 10.11852/zgetbjzz2021-1715
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Objective To know about the status quo of child nursing risks for 0- to 3-year-old children in Jiaxing city, in order to provide appropriate parenting suggestions for the families with children aged 0 to 3 years. Methods A cross-sectional survey was conducted in children aged 0 to 3 years who took physical examination at all child health clinics in Jiaxing city from 1st June to 31st July, 2020. Parents used their mobile phones to fill the Nursing Risk Questionnaire and the social demographic status online. Then family intervention guide was given according to the risk factors. Results A total of 9 384 families with 0- to 3-year-old children were investigated. The detection rate of positive parenting risk was 40.83%(43.11% for boys and 38.32% for girls),49.1% for mothers with middle school education only,40.68% for mothers with high school or college education and 33.51% for those with bachelor degree or above. Those with higher maternal education had a significantly lower positive rate of parenting risk(χ2=124.062,P<0.001). There was no significant difference between urban and rural family, as well as different parity(P>0.05). Boys had more rearing risks than girls and mothers with lower education had more rearing risks than those with higher education(χ2=22.247,124.062, P<0.001). There was no significant difference in rearing risk numbers between urban and rural family, as well as among different parity groups.The top parenting risk factor for infants included rarely having lean meat or eggs everyday(8.95% - 14.90%),no picture books at home(5.27% - 11.88%), nutritional disease(5.77% - 8.02%),not giving the iron-rich food(5.19% - 6.80%), rarely talking or telling story with children(3.60% - 8.02%). Conclusions Currently, infants and young children aged 0 to 3 are generally at risk of poor parenting. Professionals need to strengthen health education and rearing risk screening, especially for boys and families with lower maternal education. Health education of infants' food supplement, early exposure to books and responsive care giving should be stressed to avoid avoidable risks in family parenting, thereby protecting the health of infants and young children physically and mentally.
Application of Alberta Infant Exercise Scale in measuring the influence of early comprehensive intervention on the prognosis of premature infants
LI Xin, WANG Zhan-sheng, CHEN Yan-mei, ZHANG Yin, DU Kun
2022, 30(5):  562-565.  DOI: 10.11852/zgetbjzz2021-1922
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Objective To explore the application value of the Alberta Infant Motor Scale(AIMS) in assessing the effect of early comprehensive intervention on the prognosis of preterm infants, so as to provide evidence for clinical assessment of premature infants. Methods A total of 68 early preterm infants born in the Department of Obstetrics and Gynecology in Shangqiu First People's Hospital from May 2019 to February 2021 were selected into this study, and were divided into observation group (n=34) and control group (n=34). In one week after birth, two rehabilitation therapists used Peabody Developmental Motor Scales-2(PDMS-2) and AIMS to evaluate the motor function of all premature infants, and used video to record the infant's motion status. According to the AIMS or PDMS-2 scoring results, the rehabilitation specialists made early comprehensive intervention plans for premature infants both in the observation group and the control group, and the interventions were implemented by infants' parents. After three months of intervention, the AIMS and PDMS-2 scales were used to assess preterm infants. All AIMS scores were scored a second time by the same two rehabilitation therapists based on the video one month after the score. Results The intra-rater and inter-rater reliability of AIMS was strong, the intra-group and inter-group correlation coefficients were 0.952 (95%CI:0.419 - 0.990) and 0.977 (95%CI:0.947 - 0.990), respectively. The concurrent validity between AIMS and PDMS-2 was 0.948(95%CI:0.907 - 0.971). After three months of intervention, the motor function development score of preterm infants in the observation group was higher than that in the control group, but the difference was not significant(t=0.287,P=0.362). Conclusion AIMS has good reliability and concurrent validity in measuring the effect of early comprehensive intervention on the prognosis of preterm infants, which is an appropriate tool for early assessment of motor function of premature infants.
Association of screen exposure, outdoor activities with sleep among toddlers
XIE Liang-liang, YAN Shuang-qin, CAO Hui, GAO Guo-peng, CAI Zhi-ling, WANG Su-mei, YIN Xiao-gang, XIE Fang-fang, ZHU Hai-qin, LI Qing, TAO Fang-biao
2022, 30(5):  566-569.  DOI: 10.11852/zgetbjzz2021-1832
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Objective To examine the association of screen exposure, outdoor activities and sleep among toddlers, so as to provide scientific basis for the prevention and intervention of children's sleep problems. Methods Based on the established maternal and infant health birth cohort in Ma'anshan, single live infants born from June 2015 to June 2016 were followed up to 2 years of age. The information on social demographic, screen exposure, outdoor activities and sleep were collected. A total of 1 575 valid questionnaires were obtained, including 833 boys and 742 girls. χ2 test and Logistic regression were used to analyze data. Results The incidence rate of poor sleep quality among toddlers was 26.16%. The proportion of TV turning on time (not necessarily watching) ≥2 h/d, TV watching time ≥1 h/d and mobile phone playing time ≥30 min/d were 50.73%, 45.21% and 26.03%, respectively. The proportion of outdoor activity time ≥2 h/d was 71.30%. The proportion of went to outdoor places ≥2 times/week and the average time spent in outdoor places ≥2 h/time were 76.31% and 37.71%, respectively. After adjusting for confounding factors such as demographic data, average time on TV (not necessarily watching TV) ≥2 h/d (OR=1.40, 95%CI:1.11 - 1.77), average time spent on watching TV ≥1 h/d (OR=1.39, 95%CI:1.11 - 1.75), and average time spent on using mobile phones ≥30 min/d (OR=1.55, 95%CI:1.21 - 1.99) all increased the risk of poor sleep quality in toddlers(P<0.05), but frequency of outdoor activities ≥2 times per week (OR=0.72, 95%CI:0.55 - 0.93) and average time spent outdoors ≥1 hour per time (OR=0.78, 95%CI:0.62 - 0.99) were associated with reduced risk of poor sleep quality in children(P<0.05). Conclusions There are a certain proportion of toddlers with sleep problems. Screen exposure and outdoor activities are associated with toddler's sleep. It is suggested to reduce screen time and do more outdoor activities to improve toddler's sleep.
Analysis of growth and nutrition status of children aged 0~3 years in four areas of Jiangsu
LI Zhun, WANG Xu-dong, LUO Can, LU Ying, XU Bai-rong, QIN Rui, ZHANG Xin-hua
2022, 30(5):  570-574.  DOI: 10.11852/zgetbjzz2022-0110
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Objective To investigate the current situation of growth and malnutrition across children under the age of 3 years in Jiangsu, and provide reference and evidence of improvement for children's healthcare during first three years in Jiangsu. Methods The research was based on a dynamic cohort of multi-center and large sample. The data was from the National Children Nutrition and Health Monitoring. Four monitored districts/counties in Jiangsu were selected, four communities (towns) from each district/county were chosen. Healthy children of permanent residence in these chosen communities (towns) under the age of 3 undergone the health monitoring from January 2016 to December 2019 were recruited as the research objects. Their monitored anthropometric data were analyzed, and compared with WHO growth standard. Weight and length (height) growth rates were analyzed and evaluated. Z score was employed for the evaluation of children's status of nutrition. Results A total of 43 518 healthy children under the age of 3 were recruited. The mean values of weight and length (height) of children at each age were all significantly higher than 2006 WHO standard (P<0.05). The weight and length (height) of males were all significantly higher than those of females at each age (P<0.05). The growth rates of males' weight before 8 months and length (height) before 6 months were all faster than those of females (P<0.05). The rates of underweight, stunting, emaciation, overweight and obesity of all children were 0.14%, 0.28%, 0.55%, 3.88% and 0.55%, respectively. The rates of underweight, stunting, overweight and obesity of overall males were all significantly higher than those of overall females (χ2=6.612, P=0.01; χ2=13.287,89.339, 18.732, P<0.001). Conclusions The status of growth during first three years are favourable but several types of malnutrition still exist in these 4 areas of Jiangsu. The prevalence of underweight, emaciation and stunting are all in low levels. However, overweight and obesity are still the significant issues in children's healthcare supposed to be paid attention in the future.